Daily feeding of drinking water containing lead acetate (160 mg/l) or 10% alcohol by volume or a combination of both to rats for a month produced certain deleterious effects through oxidative stress. Both heavy metal lead and alcohol are capable of doing such damages. The deleterious alterations observed were in the parameters of blood, serum and tissues, viz; Hb, Pb, proteins, lipids, lipid per oxidation, Vitamins C and E levels and enzyme activities of AST, ALT, and catalase. Simultaneous feeding of either of the two antioxidants garlic oil (GO) and vitamin E at equal doses of 100 mg/kg/day, to the rats counteracted the deleterious effects of the above two chemicals significantly. The maximum damage was brought about by feeding of drinking water containing both lead acetate and alcohol. The protective effects of GO and Vitamin E were not significantly different. The mechanism of actions of the Vitamin E and GO is probably due to their efficiency as detoxifying agents and antioxidants, to scavenging free radicals as well as an independent action of GO on the removal of lead salt as lead sulfide.
Diabetic striatopathy is an uncommon neurological manifestation of hyperosmolar hyperglycemic syndrome. A case of a 74-year-old woman is presented here. She presented with abnormal movements of left upper and lower limbs and was found to have high index blood sugar. Non contrast CT brain showed hyperdense area in right striatal region. Based on clinical presentation, high blood sugar and radiological finding, she was diagnosed with diabetic striatopathy. The radiological abnormality and the symptoms improved rapidly and remarkably with strict glycaemic control.
Marchiafava-Bignami disease (MBD) is a rare neuro degenerative disease characterized by demyelination of corpus callosum. Clinical diagnosis of MBD is challenging due to its nonspecific neurological manifestations. It's promptly diagnosed by brain Magnetic Resonance Imaging (MRI). Prompt treatment with high dose thiamine could be lifesaving. Here we report a 68 year old male with chronic alcoholism who was diagnosed to have MBD and successfully treated with high doses of intravenous thiamine administration.
Stroke is one of the leading causes of chronic disability and death worldwide1. However, over the last two decades, this trend has been changed by twin advancement in management of acute ischeamic stroke (AIS); especially in thrombolytic therapy and multidisciplinary dedicated stroke unit2. AIS is distinguished by the sudden loss of neurological functions due to acute interruption of blood circulation to an area of the brain. It is commonly caused by thrombotic or embolic occlusion and less often by rupture of a cerebral artery. Stroke is the fourth commonest killer and major cause of disability among adults in Sri Lanka3. Annual expenditure on the management of acute stroke and neuro rehabilitation has been mounting due to increasing cardiovascular risk factors such as hypertension, smoking, diabetes mellitus, dyslipidemia, excessive alcohol intake and sedentary lifestyle concomitantly with ageing population3. There has been an increasing trend of all the above-mentioned non communicable diseases in recent past in North, mainly because of sudden lifestyle transformation by adopting habits introduced by visiting diaspora. Thrombolytic management at dedicated stroke unit plays a crucial part in minimizing its serious outcomes. This paper primarily reviews the indications and contraindications in choosing patients for the administration of intravenous Recombinant tissue plasminogen activator (rtPA), facilities currently available but underutilized, and the challenges faced in AIS management in Northern part of Sri Lanka.
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