Several clinical characteristics differentiate VA of epileptic and migrainous origin - if presenting in classical manner. Additional EEG evaluations should be performed in patients with VA of unclear etiology and epileptic VA features added to current classifications to increase their discriminatory power.

The present study was undertaken to create awareness among the general population about the relation between random blood glucose levels and alcoholism.The present study has been performed at Little Flower Medical Research Centre, Angamaly, and Kerala, India. Two hundred and twenty males and females of Kerala with mean age 41 +/- 21 were enrolled. Alcoholics are included in the present study and their blood glucose levels are compared with the people who never use alcohol. Random blood glucose levels are estimated by using one touch glucometer.Mean random-blood glucose values in Non-alcoholics are higher (102 +/- 33 mg/dl) than in alcoholics is (99 ± 29mg/dl), however it is not statistically significant (p value 0.615).In the present study we have observed slightly higher random blood glucose levels in non-alcoholic males than alcoholic males. However this difference is not statistically significant. We suggest to continue the study with higher sample size to confirm the results and to identify the cause for this difference.

Background Contemporary management of patients with synchronous colorectal cancer and liver metastases is complex. The aim of this project was to provide a practical framework for care of patients with synchronous colorectal cancer and liver metastases, with a focus on terminology, diagnosis, and management. Methods This project was a multiorganizational, multidisciplinary consensus. The consensus group produced statements which focused on terminology, diagnosis, and management. Statements were refined during an online Delphi process, and those with 70 per cent agreement or above were reviewed at a final meeting. Iterations of the report were shared by electronic mail to arrive at a final agreed document comprising 12 key statements. Results Synchronous liver metastases are those detected at the time of presentation of the primary tumour. The term ‘early metachronous metastases' applies to those absent at presentation but detected within 12 months of diagnosis of the primary tumour, the term ‘late metachronous metastases’ applies to those detected after 12 months. ‘Disappearing metastases’ applies to lesions that are no longer detectable on MRI after systemic chemotherapy. Guidance was provided on the recommended composition of tumour boards, and clinical assessment in emergency and elective settings. The consensus focused on treatment pathways, including systemic chemotherapy, synchronous surgery, and the staged approach with either colorectal or liver-directed surgery as first step. Management of pulmonary metastases and the role of minimally invasive surgery was discussed. Conclusion The recommendations of this contemporary consensus provide information of practical value to clinicians managing patients with synchronous colorectal cancer and liver metastases.

Results of a survey on peri-operative nutritional support in pancreatic and biliary surgery in Spain Resultados de una encuesta sobre el soporte nutricional perioperatorio en la cirugía pancreática y biliar en España

En este trabajo, se propone un análisis histórico de algunos de los elementos que conforman la industria del videojuego. La guía del análisis son los contenidos y los elementos tecnológicos presentes en las consolas de videojuegos, desde finales de la década de los setenta y hasta la actualidad. En este periodo, diferentes empresas, con diversas estrategias, han participado en configurar el panorama del videojuego. Sin embargo, no olvidamos que el gran factor decisivo para el éxito, es el impacto que ha tenido cada innovación en el gusto de los usuarios y la manera inteligente de saberla posicionar.