Osmotic demyelination syndrome is a condition seen due to the loss of normal myelin in the central nervous system. Multiple etiologies have been identified as causing this condition, however, the most reported cause is the rapid correction of hyponatremia. Different levels of the central nervous system are involved in the condition. Despite variable etiologies and clinical outcomes of the disease, the Magnetic Resonance Imaging (MRI) findings are well-established and characteristic. Hereby, two cases (45 years and 25 years old males) of Osmotic demyelination syndrome are described, to demonstrate the characteristic magnetic resonance imaging findings of the brain. Both cases were chronic alcoholics with a history of few episodes of vomiting, who later developed neurological symptoms. Their biochemical investigations showed severe hyponatremia. The hyponatremia was corrected rapidly, following which they developed neurological symptoms. Non-contrast MRI brain was done for both patients, which showed abnormal hyperintense T2/Fluid-attenuated Inversion Recovery (FLAIR) signals in central Pons. Both cases showed variable, however characteristics findings of osmotic demyelination syndrome on MRI. Despite, multiple causative factors and clinical outcomes of Osmotic demyelination syndrome, MRI with its characteristic findings plays a key role in diagnosis.
Background: Rapid assessment of avoidable blindness gives an estimate of burden of blindness and causes thereof. Aim of the study was to estimate prevalence of blindness and trends and outcome of cataract surgery in rural India using cluster sample survey.Methods: 30 clusters of 100 people aged above 50 years were selected by stratified cluster sampling. Participants were evaluated for history, vision and dilated fundus examination as per pre designed proforma.Results: Of the 3000 people listed severe visual impairment (visual acuity <3/60) was noted in 134 (4.5%) individuals (361 (6.02%) eyes). Blindness was noted in 107 (3.5%) individuals (483 (8.05%) eyes). Cataract was the most common cause of visual impairement in 18.57% eyes. Pseudophakia was present in 551 (9.2%) eyes and 179 (3.0%) eyes had aphakia. Grade III and Grade IV PCO was noted in 52 (9.4%) and 14 (2.5%) eyes respectively.Conclusions: Untreated cataract continues to be the leading cause of avoidable blindness. Startegies are required to manage blindness following cataract while we plan to combat cataract related blindness.
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