Study on Electrophysiological Findings of Guillain Barre Syndrome Patients Attending the Department of Neurology in BSMMU.

Incidence and predominant subtype of Guillain Barre Syndrome (GBS) differ geographically. Electrophysiology has an important role in the early diagnosis and prediction of the prognosis. This study conducted to determine the predominant subtype of Guillain Barre Syndrome in Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh and to compare the nerve conduction study finding between the axonal and demyelinating form of GBS. To analyze the nerve conduction study findings of Guillain Barre Syndrome patients attending the department of Neurology in BSMMU. This observational, descriptive and cross sectional study was carried out in the department of Neurology, BSMMU, Dhaka from July 2014 to June 2016. Considering the inclusion and exclusion criteria, 50 patients recruited as the study population. Then after performing the nerve conduction study, patients classified into three groups: acute inflammatory demyelinating polyneuropathy (AIDP), acute motor axonal neuropathy (AMAN), acute motor and sensory axonal neuropathy (AMSAN). Among the 50 patients that are finally included in the study; about 50%, 42%, 8% had the AIDP, AMAN and AMSAN variety of GBS respectively. Out of all patients, 64% were male and 34% were female. GBS was seen in a wide range of age (18-75 years). In AIDP, maximum clustering of the cases was seen in the elderly population and in the AMAN it was seen in the younger age group. Cerebrospinal fluid (CSF) analysis did not show any significant difference between the AIDP and AMAN variant of GBS. Distal latency prolonged in at least one nerve in all patients with AIDP. In axonal form of GBS (AMAN and AMSAN), the compound muscle action potential (CMAP) amplitude was 80% of the lower limit of the normal in at least two motor nerves. Prolonged F wave latency by >80% of the upper limit of the normal was seen in 40% of the AIDP patients. According to the nerve conduction study, finding- acute inflammatory demyelinating polyneuropathy (AIDP) is the predominant subtype. Although the electrophysiology and the CSF analysis are the important tools for the diagnosis of GBS, classification should not be making based on a distinct finding alone. If all the NCS parameters in multiple nerves tested after one week and within four weeks of onset of symptoms, definite diagnosis is possible in almost all the patients of Guillain Barre Syndrome.

Impact of terminal polar substitution on elastic, electro-optic and dielectric properties of four-ring bent-core nematic liquid crystals.

Here we report the influence of terminal -F, -Cl and -NO2 substitution on the elastic, dielectric and polar switching behavior of four-ring bent-core liquid crystals (LCs). Elastic constants of nematic liquid crystals are the key parameters in determining the threshold voltage and sensitivity to electro-optical response in a device. The elastic properties of bent-core liquid crystal systems show atypical temperature dependence and there is no hard-core theory to explain the behavior. However based on molecular simulation and atomistic calculations it is found in earlier studies that the bend angle dominates the behavior of elastic constants and the terminal or lateral substitutions have very little effect. Here we have studied three bent-core compounds which are differentiated only by their terminal polar substitution. The bend angle is identical (∼146°) for all the three compounds yet they show dramatically different elastic properties. In the fluoro-substituted compound K 11 > K 33, while for the other two compounds K 33 > K 11. Thus it is evident that the terminal polar substitution plays vital role in determining the elastic properties of bent-core systems. Correlating the mesophase ranges with the respective dipole moments of the samples it is observed that the fluoro-substituted compound (11-2M-F) with lowest dipole moment favours only nematic phase with smallest mesophase range (46.1 °C), compound 11-2M-Cl with moderate dipole moment favours short range nematic, broad range smectic with moderate mesophase range (53.1 °C), whereas the compound 11-2M-NO2 possesses the widest mesophase range (99.8 °C) with a very narrow nematic and a broad smectic phase amongst the three studied compounds.

Prediction of local and metastatic recurrence in solitary fibrous tumor: construction of a risk calculator in a multicenter cohort from the French Sarcoma Group (FSG) database.

BACKGROUND: Solitary fibrous tumors (SFT) are rare unusual ubiquitous soft tissue tumors that are presumed to be of fibroblastic differentiation. At present, the challenge is to establish accurate prognostic factors. PATIENTS AND METHODS: A total of 214 consecutive patients with SFT diagnosed in 24 participating cancer centers were entered into the European database (www.conticabase.org) to perform univariate and multivariate analysis for overall survival (OS), local recurrence incidence (LRI) and metastatic recurrence incidence (MRI) by taking competing risks into account. A prognostic model was constructed for LRI and MRI. Internal and external validations of the prognostic models were carried out. An individual risk calculator was carried out to quantify the risk of both local and metastatic recurrence. RESULTS: We restricted our analysis to 162 patients with local disease. Twenty patients (12.3%) were deceased at the time of analysis and the median OS was not reached. The LRI rates at 10 and 20 years were 19.2% and 38.6%, respectively. The MRI rates at 10 and 20 years were 31.4% and 49.8%, respectively. Multivariate analysis retained age and mitotic count tended to significance for predicting OS. The factors influencing LRI were viscera localization, radiotherapy and age. Mitotic count, tumor localization other than limb and age had independent values for MRI. Three prognostic groups for OS were defined based on the number of unfavorable prognostic factors and calculations were carried out to predict the risk of local and metastatic recurrence for individual patients. CONCLUSION: LRI and MRI rates increased between 10 and 20 years so relapses were delayed, suggesting that long-term monitoring is useful. This study also shows that different prognostic SFT sub-groups could benefit from different therapeutic strategies and that use of a survival calculator could become standard practice in SFTs to individualize treatment based on the clinical situation.

Etiological pattern of demented patients attending in a tertiary hospital.

This is a cross sectional study where 125 demented patients were enrolled who attended in neurology department of Bangabandhu Sheikh Mujib Medical University (BSMMU) Hospital. The purpose of the study was to find out the etiology of dementia. Dementia was diagnosed by the criteria indicated by Diagnostic and Statistical Manual of Mental Disorders (DSM)-IV and confirmed by Mini Mental State Examination (MMSE) score. Diagnosis of specific type of dementia was made on the basis of established criteria. The most common etiological factor was post stroke dementia (PSDE) (36%) followed by Alzheimer's disease (AD) (14.4%), multi infarct dementia (MID) (8%), Mixed AD and PSDE (6.4%), vitamin B12 deficiency (4.8%) etc. Vascular dementia is the most common etiological factor. Next to this is the Alzheimer disease. This study will provide baseline information regarding the types of dementia occurring in Bangladeshi population and will be the basis of planning health program and data for future research.

Association of serum uric acid with ischemic stroke.

The present study has examined the association between ischemic stroke and hyperuricemia in Bangladeshi population. This age and sex matched case control study was carried out in the Department of Neurology, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh during the period of January 2007 to December 2008. A total of 120 subjects were included in this study, among them 60 were cases and another 60 were controls. Data were collected purposively. Multiple logistic regressions were done to identify the risk factors for ischemic stroke. In this study 68.3% were male and 31.7% were female in both the groups. Male and female ratio of stroke patients was 2.16:1. Mean±SD of serum uric acid level of case and control group was 4.94±1.76 and 3.72±1.09 respectively. Among the case group 76.7% had normal and 23.3% had abnormal serum uric acid level. On the other hand, 93.3% respondents of control group had normal and 6.7% had abnormal serum uric acid (SUA) level. Significant differences was found between case and control group in term of SUA level (p<0.05). Since SUA level is a quantitative numerical variable, an increase in 1mg/dl has a 47.0% (95% CI 1.0% to 2.16%) increase in odds ratio (OR) of having ischemic stroke. This 47.0% is obtained by taking OR for uric acid-1. Elevated serum uric acid level is not significant for ischemic stroke among the Bangladeshi population.

Loss of vision: a manifestation of TURP syndrome. A case report.

We report a case of transient blindness, part of a TURP syndrome, in a 65 year old man undergoing TUR of the prostate under centro-neuron block. Irrigating fluid consisted of 1.5% glycine. As a result, serum levels of glycine increased to 12,470 mols.l-1 (N176-332 mumols.l-1). We attribute this loss of vision to glycine toxicity.

Intracranial aneurysm surgery in Bangladesh.

In this study of 1000 cerebrovascular disease patients, the commonest age are 50 to 70 years with male predominance. The urban patients are large in number and the risk factors are sedentary life, stress and strain, smoking, and hypertension. The patients are more chronic than acute and transport facilities are poor. Fifteen percent are hemorrhagic stroke, some of them may be due to intracranial aneurysm. In the absence of proper diagnostic facilities and adequate neurosurgeons, infrequent surgical treatment, and lack of statistics of intracranial aneurysm, this study may be a basis for further study of aneurysmal surgery in Bangladesh.