Rapidly progressing glomerulonephritis like microscopic polyangiitis and allergic granulomatous angiitis are among the common presentations of perinuclear antineutrophilic cytoplasmic antibody (p-ANCA) vasculitis. Involvement of central nervous system is rare in contrast to mononeuritis multiplex, which is a well-known neurological manifestation of this condition. We report a case presented with uraemic encephalopathy and posterior reversible encephalopathy syndrome (PRES)-related symptoms, which showed recovery after haemodialysis although PRES with seizures recurred later. As uraemic encephalopathy appears to be the underlying aetiology as per the temporal correlation of correction of uraemia and resolution of the symptoms of PRES, it becomes a rare case of uraemia-induced PRES as a presenting manifestation of p-ANCA-associated vasculitis along with necrotising crescentic glomerulonephritis.

Background: Patient safety culture is an essential part of quality health care delivery and is now a major global concern. Patient safety culture is defined as the attitudes, values, beliefs and perspective staff share within the organization. Therefore, present study aimed to evaluate patient safety culture and associated causes among the health care workers. Methods: A cross sectional study was carried out using a predesigned questioner hospital survey on patient safety culture (HSOPSC) from June to July, 2021. A total 1590 employees submitted the questioner form. Results: The overall positive patient safety culture was 77.52 percent. Ninety-six percent of staff agreed about staff help each other during busy timings. On logistic regression analysis, regularly work review (β=0.14,95%, P=0.000), patient safety culture affects when work place is rushed (β= 0.32,95%, P=0.000), staff feel like their mistakes are held against them (β= 0. 14, P=0.000), HOD takes action to address patient safety concerns that are brought in attention (β=0.15, P=0.000), staff speak up when they see something that negatively affects (β=0.08, P=0.04), good corporation and coordination with hospital’s other department (β=0.11, P=0.02), during the shift changes important information is left out (β= 0.14, P=0.000) and fall preventive measures are taken while transferring patients (β=0.08,P=0.01) were significantly associated with the level of patient safety culture. Conclusion: Patient safety culture assessments, helps the healthcare organizations to become aware of present status of the organization in regards to areas which needed to urgent attention, weaknesses, existing present safety problems, the gap which creates the patient safety issues and helps the organization to improve their errors.

Background: Axonal loss is thought to occur early in the course multiple sclerosis (MS) and is supposed to be associated with, and predictive of, neurologic deficits progressing to permanent disability. Axonal loss in the retinal nerve fiber layer (RNFL) is measured by optical coherence tomography (OCT). Material and Methods: A longitudinal observational study, conducted on 30 MS patients. All subjects underwent neurological examination, including expanded disability status scale (EDSS) scoring and OCT on two visits, minimum 2 months apart. Results: Total of 60 eyes of 30 patients were subdivided into 21 eyes having optic neuritis (ON) ['MS-ON'] and 39 eyes without ON. The RNFL thickness (RNFL t) was found to be significantly reduced in all parameters except in temporal quadrant, as the duration of disease increases. Average RNFLt were found to have negative correlation (r =-0.450) with disease duration. Negative correlation (r=-0.657) was also found between EDSS score change and average RNFLt change. The eyes having ON showed statistically significant RNFL thinning as compared to the non-ON fellow eyes. The baseline EDSS score was found to be negatively correlated (moderate degree, r =-0.348) with baseline average RNFL thickness, with p-value of 0.006. Conclusions: The RNFLt is not only significantly thinner in those with history of ON, but it is also affected remarkably even in absence of prior ON, suggesting subclinical ongoing axonal loss in patients with MS. The EDSS score is inversely correlated with RNFL thickness.