Spongiform leukoencephalopathy unveiled in an autopsy of a drug abuser.

Toxic leukoencephalopathy (TLE) is a rare neurological debilitating and fatal condition. It has been previously associated with exposure to leukotoxic offenders such as chemotherapy, cranial radiation, certain drugs, and environmental factors. Currently, it is a commoner white matter syndrome resulting from increased substance abuse, classically by inhaled heroin and other opioids. Herein, we report a case of fatal TLE unveiled in an autopsy of a drug abuser. A 24-year-old male was found dead on the roadside. A day before, he was located in a state of delirium. In this case, the autopsy findings and histopathology characteristics of cerebral cortex involvement particularly directed to speculate the heroine as the principal offender.

Outcome prediction using sequential organ failure assessment (SOFA) score and serum lactate levels in organophosphate poisoning.

Background: Organophosphorus compounds are widely used as pesticides in agriculture practicing countries like India. Since it is readily available and accessible, it is one of the most commonly used agents for suicidal poisoning. The current study was undertaken to evaluate the performance of the SOFA score (scoring system) and the serum lactate level (laboratory parameter) as a mortality predictor in organophosphorus poisoning. Material and Methods: This prospective observational study was conducted at AIIMS, Bhubaneswar, for 17 months. The study population included all patients with an alleged history of ingestion of organophosphorus (OP) compounds reporting to the casualty. The receiver operating characteristic (ROC) curve and the logistic regression analysis were used for the analysis. Results: In our study, 75 patients with OP poisoning were studied after satisfying the inclusion criteria. OP poisoning was commonly seen in married males aged 21-40 years. Twelve (16%) patients died during the process of treatment. There was a statistically significant difference in the mean SOFA score, serum lactate level, pH value, and mean duration of hospital stay between the discharged and the deceased patients. In the current study, the ROC curve analysis used to assess the predictor of the outcome of OP poisoning showed that the area under the curve for SOFA score and serum lactate level were 0.794 (95% CI 0.641-0.948) and 0.659 (95% CI 0.472-0.847), respectively. Conclusion: Sequential Organ Failure Assessment (SOFA) score is significantly associated with the outcome of organophosphate poisoning and can be utilized to predict mortality.

The Perspectives of Educators and Learners on E-Learning: A Cross-Sectional Descriptive Study in a Medical School.

PURPOSE: To determine the challenges, effectiveness, level of reception and acceptance of E-learning by students (learners) and faculty (educators) in a medical college during the lockdown period of the COVID-19 pandemic. METHODS: An online questionnaire-based cross-sectional study was conducted among learners and educators at AIIMS, Bhubaneswar, Odisha, India, in the month of August 2020. A total of 203 learners and 24 educators participated in the study. The link of the Google form containing the questionnaire was sent to the students and teachers, and the responses obtained were analyzed with SPSS software (version 20). RESULTS: Two hundred three MBBS students and twenty-four faculty members participated in the study. In our study, 34.5% (n=70) learners and 62.5% (n=15) educators preferred supplementation of E-learning with conventional mode of pedagogy in the future. There was a significant correlation between the convenience and the effectiveness of E-learning. Both learners and educators considered E-learning to be moderately effective. The major problems faced by the educators while conducting online sessions were network issues, difficulty in conducting practicals, lack of controlled environment, and lack of attentiveness by the learners. More than half of the students were satisfied with the E-learning provided by the institute. Educators found E-learning to be moderately convenient, whereas they felt conventional classroom teaching is highly convenient. CONCLUSION: Educators and learners were quick to adapt to the online mode of learning but the shift was mired with initial challenges. There is a requirement of capacity building in terms of skill development and digital infrastructure building to ensure seamless and effective E-learning.

Spongiform leukoencephalopathy unveiled in an autopsy of a drug abuser

ABSTRACT Toxic leukoencephalopathy (TLE) is a rare neurological debilitating and fatal condition. It has been previously associated with exposure to leukotoxic offenders such as chemotherapy, cranial radiation, certain drugs, and environmental factors. Currently, it is a commoner white matter syndrome resulting from increased substance abuse, classically by inhaled heroin and other opioids. Herein, we report a case of fatal TLE unveiled in an autopsy of a drug abuser. A 24-year-old male was found dead on the roadside. A day before, he was located in a state of delirium. In this case, the autopsy findings and histopathology characteristics of cerebral cortex involvement particularly directed to speculate the heroine as the principal offender.