Background:Definite etiology of amyotrophic lateral sclerosis (ALS) is still a matter of debate.Aims:The study was designed to evaluate the role of environmental, occupational, and familial risk factors in development of ALS.Materials and Methods:This was a case control study of 110 cases of definite ALS with 240 age and sex matched controls. Investigations were done on the following aspects- family history, occupation, living place, source of drinking water, exposure to industrial, chemical, agricultural toxins and heavy metals, physical and electrical injury, working under magnetic field for more than 10 years in both the groups. Clinical examinations, electrophysiological, and neuroimaging studies were done in every patient. Chi square test, logistic regression analysis, and calculation of odds ratio were used to analyze the data.Results:Rural livings (odds ratio = 1.99), smoking (odds ratio = 1.88), insecticides, and pesticides exposures (odds ratio = 1.61), electrical injury (odds ratio = 6.2) were detected as the associated factors in development amyotrophic lateral sclerosis.Conclusions:The study expressed the need of extensive research globally in molecular and genetic levels to detect the associated factors in etiopathogenesis of ALS for better understanding the etiology and for remedial aspects.

Background:From a single CT scan in primary intracerebral hemorrhage (ICH), clinical outcome can be assessed on admission by using the CT scan parameters.Aims:The study aims to find out how hematoma volume, location of stroke, midline shift, intraventricular extension of bleed and ventricle compression influence the clinical outcome in patients with acute ICH.Materials and Methods:Non-contrast CT scan was done on admission in hospital for every patient with acute hemorrhagic stroke and was analyzed accordingly. Clinical assessments were done in National Institute of Health Stroke Scale (NIHSS). Chi-square test and multiple logistic regression analysis were used for statistical analysis.Results:Mean hematoma volume associated with death before 30 days is 33.16 cm3 (P < 0.0001), with survived after 30 days is 15.45 cm3 (P < 0.0001), with NIHSS score ≥16 is 29.03 cm3 (P < 0.0001) and with NIHSS score <16 is 13.69 cm3 (P < 0.0001). Independent poor prognostic factors were hematoma volume > 30 cm3 (OR = 27.857), brain stem hemorrhage (OR = 6.000), intraventricular extension of bleed from other location (OR = 7.846), presence of ventricular compression alone (OR = 2.700) and in combination with midline shift of ≥ 5 mm (OR = 2.124).Conclusions:From a single CT scan during hospital admission, mortality and morbidity in next 30 days can be predicted. A hematoma volume >30 cm3, brain stem hematoma, intraventricular extension of bleed and ventricular compression along and with midline shift are associated with early mortality in ICH.

Background: Despite intensive research during the past several decades, the cause of Parkinson’s disease remains unknown. Infections, toxins, lifestyle and hereditary factors have all been supposed to play a role in the genesis of Parkinson’s disease. The final mechanisms of neuronal injury and death are probably similar, where both genetic and environmental factors are important, and these two factors interact along the etiopathogenic pathway. Objective: The purpose of the present study is to evaluate the role of familial, environmental and occupational factors in the development of Parkinson’s disease. Methods: We evaluated 345 cases of idiopathic Parkinson’s disease (215 males, 130 females; mean age 62 ± 2 years) and 370 controls (220 males, 150 females; mean age 62 ± 3 years) between January 2003 and January 2008 with regard to the following aspects in detail: place of living, family history of Parkinson’s disease and tremor, source of drinking water, exposure to insecticides, pesticides, herbicides and industrial toxins, acute poisoning, CNS infections and head injury. The duration of exposure to the risk factors and the history of Parkinson’s disease among the cases were investigated after obtaining written informed consent from cases and controls. Results and Conclusions: Family history of Parkinson’s disease and familial tremor (p = 0.035), exposure to insecticides and pesticides (p = 0.049), well water use for drinking purposes (p = 0.03), Japanese B encephalitis (p = 0.04) and acute organophosphate poisoning (p = 0.046) were associated with the development of Parkinson’s disease in this region of India. Further research is needed at the epidemiological, genetic and molecular levels for a better understanding of the etiopathogenesis of Parkinson’s disease as well as remedial aspects.

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Hydatid cysts usually involve the liver; extrahepatic localization is reported in 11% of all cases of abdominal hydatid disease. Cyst at unusual localization includes kidney, heart, spleen, pancreas and brain. Isolated involvement of muscle is also rare in children. Here is a case of hydatid cyst in a female child involving the rectus abdominis muscle, which is a very rare presentation. There were no cysts in any other location. Serological tests were negative for cystic echinococcosis. The patient was operated on and the cyst was completely excised. The pathologic examination confirmed the diagnosis of hydatid cyst.

BACKGROUNDMannitol has been used for several years to reduce cerebral oedema in acute ICH (intracerebral haemorrhage). Study on mannitol with its effect on haematoma volume and clinical outcome is limited.The main aim of this study is to measure haematoma volume before and after mannitol therapy in acute spontaneous ICH.

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