Optic nerve sheath diameter measurements using ultrasonography to diagnose raised intracranial pressure in preeclampsia: an observational study

Objective: To estimate the incidence of raised intracranial pressure (ICP) as evident by enlarged optic nerve sheath diameter (ONSD) by ocular ultrasound among patients with preeclampsia and its relationship to severity of disease. Material and Methods: Sixty pregnant mothers with preeclampsia were compared to 30 normotensive, uncomplicated pregnant controls. For ONSD measurement, a 7-MHZ linear probe was used and three values from each optic nerve were taken and the mean of six values of both eyes was recorded. All study subjects were followed until seven days after delivery. Results: Two cut off values (5.8 mm and 4.6 mm) were used to compare ONSD in severe and non-severe preeclampsia with that of healthy pregnant individuals. The incidence of raised ICP among severe preeclampsia above 5.8 mm and 4.6 mm cut-off were 43.3% and 90%, respectively, before delivery. ONSD was significantly elevated among preeclampsia subjects at both cut-off values at pre-delivery (p=0.004 for ONSD >5.8 mm and p<0.001 for ONSD >4.6 mm) compared to controls. There a significant association between presence of neurological manifestations and enlarged ONSD (p<0.001 for ONSD >5.8 mm and p=0.04 for ONSD >4.6 mm) before delivery. Conclusion: Severe preeclampsia with neurological features was associated with increased ONSD, reflecting raised ICP. Further studies are needed to compare ONSD values with invasive ICP monitoring for better understanding of this relationship.

Unusual double pituitary adenoma: a case report.

We report the case of a 60-year-old woman with Cushing disease. Magnetic resonance imaging (MRI) revealed a large sellar and suprasellar mass involving the right cavernous sinus, consistent with pituitary macroadenoma. It was resected by transsphenoidal surgery. Light microscopy revealed two separate pituitary adenomas with different histologic and immunohistochemical features. One was amphophilic and strongly Periodic Acid-Schiff (PAS) positive, the other chromophobic and PAS negative. The former tumor was immunopositive for adrenocorticotropic hormone (ACTH); approximately 30% tumor cells were immunopositive for MGMT (O6-Methylguanine-DNA Methyl-Transferase). The second tumor was a PAS negative, luteinizing hormone (LH) and alpha subunit immunopositive gonadotroph adenoma. In this tumor, about 90% of the cells were immunopositive for MGMT. The Ki-67 nuclear indices of the two tumors were 6% and 2%. Our case represents a rare combination of two morphologically different pituitary adenomas, one producing ACTH and the other LH and alpha subunit. The two tumors differed not only in Ki-67 labeling indices but in MGMT immunoexpression as well.

Localized thermal spike driven morphology and electronic structure transformation in swift heavy ion irradiated TiO2 nanorods.

Irradiation of materials by high energy (∼MeV) ions causes intense electronic excitations through inelastic transfer of energy that significantly modifies physicochemical properties. We report the effect of 100 MeV Ag ion irradiation and resultant localized (∼few nm) thermal spike on vertically oriented TiO2 nanorods (∼100 nm width) towards tailoring their structural and electronic properties. Rapid quenching of the thermal spike induced molten state within ∼0.5 picosecond results in a distortion in the crystalline structure that increases with increasing fluences (ions per cm2). Microstructural investigations reveal ion track formation along with a corrugated surface of the nanorods. The thermal spike simulation validates the experimental observation of the ion track dimension (∼10 nm diameter) and melting of the nanorods. The optical absorption study shows direct bandgap values of 3.11 eV (pristine) and 3.23 eV (5 × 1012 ions per cm2) and an indirect bandgap value of 3.10 eV for the highest fluence (5 × 1013 ions per cm2). First principles electronic structure calculations corroborate the direct-to-indirect transition that is attributed to the structural distortion at the highest fluence. This work presents a unique technique to selectively tune the properties of nanorods for versatile applications.

Rosai-Dorfman disease involving the neurohypophysis.

Rosai-Dorfman disease is a rare, histiocytic proliferative disorder of unknown etiology commonly affecting lymph nodes. Extranodal lesions with or without nodal involvement also occur. We report the case of a 63 year-old woman with disseminated Rosai-Dorfman disease involving the neurohypophysis and associated with adenohypophysial PRL cell hyperplasia.

Risk factors for the development of gestational diabetes mellitus.

A descriptive type of cross sectional study was carried out from July 2003 to June 2004 in Mymensingh Medical College & Hospital. This study was designed to find out the risk factors for the development of Gestational Diabetes Mellitus (GDM). Forty cases of GDM (primigravida and multigravida) with single pregnancy, means exclusion of twin pregnancy were selected as experimental group, while forty other cases of pregnant women without GDM constituted the control group. Questionnaire and observational charts were the research instruments. Statistical analysis was done manually. The results of this study show that, women with GDM tends to be older, associated with bad obstetric history and strong history of diabetes in the first degree relatives. The finding of this study will provide a guideline for preventive programs aimed at improving the quality of gestational mother.