Posterior fossa tuberculosis: Unusual presentations of a common disease and literature review.

The burden of tuberculosis is very high in our country and though the number of deaths due to tuberculosis has drastically reduced, still the associated morbidities caused by the disease can be very debilitating.1 Central nervous system tuberculosis is a rare and serious presentation of tuberculosis, the general presentation being hydrocephalus, meningitis, and disseminated miliary lesions.2 More often than not tuberculosis is associated with immunocompromised status and central nervous system tuberculosis in immunocompetent young individuals with no evidence of systemic tuberculosis is very rare.3Association of tuberculosis with ocular manifestations and even blindness is not uncommon, the causes of blindness being causes like uveitis, retinitis, interstitial keratitis, ophthalmitis, and even orbital tuberculosis.4 Classical teaching in neurosurgery is that a posterior fossa lesion unless proven otherwise is a metastasis. Therefore, here we are discussing three cases of central nervous system tuberculosis in isolation, without any systemic involvement in immunocompetent adults in the posterior fossa region as well as a literature review of cases from across the globe of posterior fossa tuberculosis in immunocompetent adults. The first case is regarding a treatable cause like tuberculoma in an immunocompetent young adult causing blindness which is rare as well as unfortunate. The other two cases highlight the need to keep tuberculosis as a differential even when the clinical features, radiological features, and blood and other investigations are not suggestive.

The successful surgical management of a rare case of infratentorial tubercular abscess in an immunocompetent pediatric patient.

Tuberculosis (TB) is a chronic infectious disease commonly diagnosed in developing countries. Even though it is a disease primarily affecting the lungs, it can occur in most of the organs of the body. When it affects the central nervous system (CNS), it can result in various neurological sequelae and even death due to increased intracranial pressure. While supratentorial tubercular lesions are relatively common, the disease affecting the infratentorial compartment is very rare, that too in an immunocompetent pediatric patient. Here we report the case of a 5-year-old boy who presented with features of raised intracranial pressure and was diagnosed to have a cerebellar lesion causing hydrocephalus. An emergency surgical decompression was performed and the histopathological examination revealed that the lesion was suggestive of tubercular abscess. The postoperative scan revealed adequate decompression of the lesion with no adverse events and resolution of hydrocephalus. The child recovered without any neurological deficits and anti-tuberculous treatment was continued for one year, but was subsequently lost to follow-up. The successful surgical treatment of a tubercular abscess at a rare location is described.

Psychosis in a Patient with Davidoff-Dyke-Masson Syndrome.

OBJECTIVES: To report the finding of psychosis in a patient with Davidoff-Dyke-Masson Syndrome. METHOD: Case report. CONCLUSIONS: Right-sided hemiatrophy may be an addition to the list of neuro-developmental and structural cerebral anomalies associated with psychotic disorders including schizophrenia.

The effect of perceived stress and family functioning on people with type 2 diabetes mellitus.

BACKGROUND: Various studies have suggested that support from a patient's family can facilitate his/her recovery from a physical illness and improve the ability of the patient to deal with consequences of Type 2 Diabetes. Stress is considered to play a major role in influencing Type 2 Diabetes Mellitus. AIM: To determine the roles of Perceived Stress and Family functioning on behaviours of individuals with Type 2 Diabetes Mellitus. MATERIAL AND METHODS: The present study included 250 Diabetics as per the WHO criteria and 250 Non-Diabetics. Questionnaires were given to them to obtain data. RESULTS: Stress was found to be high among Diabetics (22.17%) as compared to that in non-Diabetics (16.92%). Family assessment showed a significant difference among its subscales when it was compared between Diabetics and Non-Diabetics. CONCLUSION: Perceived stress influences Type 2 Diabetes Mellitus. Role played by the Family is significant in managing Diabetes.

A comparative study of sexual dysfunction involving risperidone, quetiapine, and olanzapine.

BACKGROUND: With the advent of newer antipsychotic drugs, side effects such as sexual dysfunction have been a major contributor toward treatment compliance. There are only a few studies that have compared different atypical antipsychotic agents regarding sexual dysfunction. We have not come across any data in this area on Indian population. AIMS: To determine and compare the frequency of sexual dysfunction associated with risperidone, olanzapine, and quetiapine, among patients with clinically stable schizophrenia. SETTINGS AND DESIGN: It is a cross-sectional hospital-based study. The subjects were recruited for the study by the purposive sampling technique. MATERIALS AND METHODS: The total sample size was 102, consisting of 25 each in the quetiapine and risperidone groups, 22 in the olanzapine group, and 30 healthy volunteers. A Brief Psychiatric Rating Scale and Sexual Functioning Questionnaire (SFQ) were administered. The Kruskal Wallis test was used to compare the variables in the demographic data and the mean chlorpromazine equivalent doses of the study groups. To analyze the sexual dysfunction, the mean scores on all the domains of sexual functioning in SFQ were compared across the study groups using the Chi square test, for proportions. RESULTS AND CONCLUSION: Twenty-three percent of the healthy volunteers had some impairment in one or more domains of sexual functioning. For the medication groups this was 96, 88, and 90%, respectively for risperidone, quetiapine, and olanzapine. However, there was statistically no significant difference across the study groups although it was relatively less with quetiapine.