RESUMO
Introduction and importance: Tolosa-Hunt syndrome is a rare condition with unknown aetiology that manifests clinically as unilateral orbital pain and ophthalmoplegia. It is a diagnosis of exclusion that resolves spontaneously but can recur and respond dramatically to systemic steroids. Case presentation: The authors herein report a case of a 38-year-old male who presented with horizontal diplopia, limited outward movement of the right eye, and blurry vision for two days which was managed with oral Prednisolone. The patient visited 3 months later with progressive ptosis and vertical diplopia with periorbital pain over the right eye. It was eventually diagnosed via magnetic imaging resonance studies and successfully treated for Tolosa-Hunt syndrome with IV methylprednisolone followed by oral prednisolone. Clinical discussion: Hence, the typical clinical presentation of the case with significant response to steroids, exclusion of other conditions from investigation and imaging, and subsequent recurrence of similar symptoms were crucial for making the diagnosis of Tolosa-Hunt syndrome. Conclusion: Tolosa-Hunt syndrome is a syndrome of painful ophthalmoplegia which responds well to steroid therapy but has a tendency to recur. Hence, patients must be adequately informed about the reoccurrence and kept under follow-up.
RESUMO
BACKGROUND: Diabetes complication poses a new challenge in Nepal as the disease is becoming endemic. Identifying risk factor for diabetes can be an essential step in preventing complication related to diabetes. Abnormal Uric acid and lipid profile are the important risk indicators of diabetes mellitus complications, so the study was done to know the association between uric acid and lipid profile in type 2 diabetes. METHODS: A cross-sectional study was done from 118 patients with type 2 diabetes mellitus visiting Nepal Medical College and Teaching Hospital. Three ml of venous blood was analyzed for fasting blood glucose, uric acid, and lipid profile. Correlational analysis was done between fasting blood glucose with triglycerides, high density lipoproteins and uric acid. RESULTS: A significant positive correlation between fasting blood glucose and triglyceride (r =.211, p = .022) was found in diabetic. There was significant negative correlation of fasting blood glucose with uric acid (r = -.196, p =.034) and high-density lipoprotein cholesterol (r = -.181, p = .049). Uric acid was also found to have significant positive correlation with triglyceride (r = .235, p = .010) and negative correlation with high density lipoprotein cholesterol (r = -.420, p = .000). CONCLUSIONS: Negative correlation of serum uric acid with fasting blood glucose and high-density lipoprotein and positive correlation with triglycerides suggests a possible connection of uric acid as a risk factor for diabetes.