BACKGROUND:Arterial blood gas (ABG) analysis is routinely performed for sick patients but is fraught with complications, is painful, and is technically demanding.OBJECTIVE:To ascertain agreement between the arterial and peripheral venous measurement of pH, pCO2, pO2, and bicarbonate levels in sick patients with cardiopulmonary disorders in the valley of Kashmir in the Indian subcontinent, so as to use venous gas analysis instead of arterial for assessment of patients.SETTING:Sher-i-Kashmir Institute of Medical Sciences, Srinagar, Kashmir, a 650-bedded tertiary care hospital in North India located at an altitude of 1584 m.METHODS:One hundred patients who required ABG analysis were admitted. Peripheral venous blood was drawn within 5 min of an ABG measurement, and the samples analyzed immediately on a point of care automated ABG analyzer. Finger pulse oximetry was used to obtain oxygen (SpO2) saturation. Data were analyzed using Pearson correlation and bias (Bland Altman) methods.RESULTS:The venous measurements of pH, pCO2, pO2 and bicarbonate, and the digital oxygen saturation were highly correlated with their corresponding arterial measurements. Bland Altman plots demonstrated a high degree of agreement between the two corresponding sets of measurements with clinically acceptable differences. The difference in pO2 measurements was, however, higher (−22.34 ± 15.23) although the arterial saturation and finger oximetry revealed a good degree of agreement with clinically acceptable bias.CONCLUSION:Peripheral venous blood gas assessment in conjunction with finger pulse oximetry can obviate the routine use of arterial puncture in patients requiring ABG analysis.
Idiopathic hypertrophic pachymeningitis (IHP) is a rare, chronic nonspecific and granulomatous inflammatory disorder of the dura with unknown etiology. The diagnosis can be established by an open biopsy and exclusion of all other specific granulomatous and infectious diseases. We report a case of Idiopathic hypertrophic pachymeningitis who manifested primarily by headache and visual loss with optic atrophy. The patient was thoroughly investigated and showed no evidence of underlying cause. The diagnosis was established by an open biopsy. JMS 2011;14(1):25-27
Acute post infectious cerebellitis, also known as acute cerebellar ataxia, is a rare inflammatory syndrome often characterized by cerebellar dysfunction of rapid onset. Although usually benign and self-limiting, acute cerebellitis may manifest a fulminant course. We describe a patient referred to our center with acute cerebellitis, complicated by hydrocephalus. An 32-year-old female presented with headache, nausea, vomiting, and gait and limbs ataxia 2 weeks after following a respiratory tract infection. CT showed obstructive hydrocephalus. MRI showed bilateral cerebellar swelling with hyperintense signals on T2-weighted imaging. The diagnosis was acute post infectious cerebellitis. Following treatment with corticosteroids, the clinical signs resolved. The patient made an uneventful recovery, with elimination of neurologic deficit.(JMS 2010;13(2):67-69)
Background: Seizures and epilepsy are common neurological disorders which significantly affect the quality of life. About 10 % of the population experiences a seizure in their lifetime, and are a common source of referrals for neurological consultation. Seizures can vary from the briefest lapses of attention or muscle jerks to severe and prolonged convulsions and vary in frequency, from less than 1 per year to several per day. Owing to scanty information on epidemiology and etiology on seizures in Kashmir, the present study was undertaken to provide update, identify gaps in our present knowledge. Methodology: This was a prospective and observational study undertaken in two phases. In the first phase households in Hazratbal Community Block Srinagar were surveyed for seizure disorder using cluster sampling. Individuals with seizures were clinically evaluated with detailed history and thorough clinical examination as per protocol in the second phase. All patients were subjected to haematological, biochemical and radiological examination. Special investigations like EEG, and CSF analysis were done wherever it was required for patient. Results: The total number of cases included in this study was 47 with male to female ratio of 1:0.88. Majority of the cases were in the age group of 20-39 years followed by 40-59 years. Neuroinfection was the predominant cause of seizures with encephalitis accounting for 12.63%. Other causes included cerebrovascular accidents (25.53%), metabolic (17.02%), miscellaneous (8.51%) and idiopathic (12.76 %).Higher incidence of seizures was observed in the age group of 20-29, followed by 40-49 and 30-39 age groups. Neuroinfection was observed as the leading cause of seizures in the age group of 20-29 years, followed by age group of 40-49 and 30-39 years. In the age group of 50-59 years metabolic was the common cause of seizures followed by CVA and neuroinfection. Cerebrovascular accidents were found important cause for seizures in all age groups with higher incidence in 40-49 age groups. Conclusion: Prevalence is a measure of the disease burden in the community which has to be considered when planning the health needs. Seizure being a medical emergency, determination of its epidemiology and etiology is a necessary step in its prevention and management. In a sample of 15748 taken randomly out of a population of 150,000, 47 cases of seizure were found. Majority of seizures occurred in the age groups of 20-49 years. Etiological spectrum of seizures was varied and included cerebrovascular accidents, neuroinfection, metabolic, tumour, idiopathic. Neuroinfection and CVA account for significant number of seizures in all age groups.
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