ABSTRACT
Sydenham's chorea is an uncommon neurological manifestation of rheumatic fever and has many and varied differential diagnosis. It may mimic encephalitis when presents as an isolated feature even when silent cardiac lesions are present. Early diagnosis, treatment and penicillin prophylaxis prevents recurrence and progression of cardiac lesions. Prompt symptomatic relief and alleviation of distress is obtained with therapeutic intervention. A case of rheumatic chorea with silent cardiac valve lesions which mimicked herpes simplex encephalitis with choreoathetosis, in a 13 year old girl is presented along with review of literature.
Subject(s)
Chorea , Rheumatic Fever , Adolescent , Chorea/diagnosis , Chorea/etiology , Early Diagnosis , Female , Humans , Rheumatic Fever/complications , Rheumatic Fever/diagnosisSubject(s)
Cockayne Syndrome/genetics , DNA Repair Enzymes/genetics , Mutation , Transcription Factors/genetics , Adolescent , Asian People , Child , Female , Humans , MaleABSTRACT
BACKGROUND: Prostate Specific Antigen (PSA) has been widely used in the diagnosis and management of patients with prostate cancer. It may be elevated in other prostatic diseases and surgical procedures. PSA exists in two forms, a major bound form (cPSA) and a free form (fPSA). OBJECTIVES: The objective of the study was to determine the relationship between serum fPSA levels and histologic findings in biopsy specimens of men with prostatic disease. MATERIAL AND METHODS: This study includes 91 patients planned for transurethral resection of prostate (TURP). Blood samples were collected before TURP and tested for fPSA. Histology of the tissue samples collected after TURP were studied and the relationship with fPSA analysed using SPSS 11.5. RESULTS: The median values for benign, premalignant and malignant lesions were 1.8 ng/ml, 4.5 ng/ml and 13.20 ng/ml respectively (p<0.001). Most cases of benign prostatic hyperplasia(BPH) without inflammation had fPSA levels <2 ng/ ml, while most with active inflammation had levels >5 ng/ml. Low grade prostatic intraepithelial neoplasia (LGPIN) saw levels <5 ng/ml while high grade intraepithelial neoplasia (HGPIN) and prostate cancer (PCa) had levels > 5 ng/mL (p<0.05). For detection of high grade lesions (HGPIN and PCa), the sensitivity and specificity of fPSA level > 5 ng/ml was found to be 88.8% and 90.2% respectively. CONCLUSIONS: Serum fPSA is elevated marginally in patients with BPH without inflammation. Active inflammation and high grade lesions are associated with fPSA level more than 5 ng/ml.
Subject(s)
Prostate-Specific Antigen/blood , Prostatic Hyperplasia/blood , Prostatic Intraepithelial Neoplasia/blood , Prostatic Neoplasms/blood , Adenocarcinoma/blood , Adenocarcinoma/pathology , Aged , Aged, 80 and over , Biomarkers, Tumor/blood , Biopsy , Enzyme-Linked Immunosorbent Assay , Humans , Male , Middle Aged , Prostatic Hyperplasia/pathology , Prostatic Intraepithelial Neoplasia/pathology , Prostatic Neoplasms/pathology , ROC Curve , Sensitivity and Specificity , Transurethral Resection of ProstateABSTRACT
This paper presents findings based on a five-year, noncomparative study of Norplant contraceptive subdermal implants in Nepal. The study was designed to evaluate the contraceptive safety, efficacy, and overall acceptability of Norplant. Four hundred and seven women enrolled in the clinical trial, which began in 1985, at two study sites, located in Patan and Kathmandu. Follow-up visits were scheduled at 1, 3 and 6 months after Norplant insertion and every six months thereafter until removal or at the end of five years. Although five pregnancies were reported during the study, only two women (one from each center) were diagnosed as becoming pregnant while using Norplant. The pooled gross cumulative life-table pregnancy rate was 0.6 per 100 women at the end of five years. The pooled cumulative continuation rate was 62 per 100 women at the end of five years. The three most frequently reported reasons for discontinuation were menstrual problems, personal reasons, and medical reasons. Of the 125 women who completed a five-year user satisfaction questionnaire, the majority of the women (86%) planned to continue using contraception after study completion. Of these women, almost one half said they planned to use a second Norplant set. The findings suggest that the Norplant system is a safe, effective, and acceptable method of contraception among Nepalese women.
Subject(s)
Contraceptive Agents, Female , Drug Implants , Levonorgestrel , Adolescent , Adult , Consumer Behavior , Contraceptive Agents, Female/administration & dosage , Contraceptive Agents, Female/adverse effects , Evaluation Studies as Topic , Female , Humans , Levonorgestrel/administration & dosage , Levonorgestrel/adverse effects , Menstruation Disturbances/chemically induced , Nepal , Pregnancy , Surveys and QuestionnairesABSTRACT
PIP: This study analyzes the records of clients who underwent voluntary surgical contraception (VSC) at the Central Clinic of the Family Planning Association of Nepal in order to evaluate the demographic impact of sterilization. Sterilization is the most popular method of contraception (80%) in Nepal. Thus, this study, along with a partner study of male participation in family planning, will contribute to the planning of service delivery and information dissemination education and communication activities of their family planning program. In 1987, 1643 clients underwent VSC at the abovementioned clinic; of this, 1243 (75.65%) were males and 400 (24.35%) were females. 955 of the men (76.83%) had wives who were age 29 younger. Conversely, female sterilization in this age group was only 67%. Of vasectomized males, 872 (70.15%) had 3 or fewer children whereas only 61.25% of sterilized females had this number of children. The data shown a much higher male participation for VSC in achieving the small size family norm. Vasectomy therefore has greater demographic impact than female sterilization. However, initial findings need further comparative study in the hilly areas and the Terai district of Nepal.^ieng