Epidemiology and pathogenesis of stroke in preterm infants: A systematic review

BACKGROUND:

Perinatal stroke is one of the principal causes of cerebral palsy (CP) in preterm infants. Stroke in preterm infants is different from stroke in term infants, given the differences in brain maturation and the mechanisms of injury exclusive to the immature brain. We conducted a systematic review to explore the epidemiology and pathogenesis of periventricular hemorrhagic infarction (PVHI), perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT) in preterm infants.

METHODS:

Studies were identified based on predefined study criteria from MEDLINE, EMBASE, SCOPUS and WEB OF SCIENCE electronic databases from 2000 –2019. Results were combined using descriptive statistics.

RESULTS:

Fourteen studies encompassed 546 stroke cases in preterm infants between 23 –36 weeks gestational ages and birth weights between 450 –3500 grams. Eighty percent (436/546) of the stroke cases were PVHI, 17%(93/546) were PAIS and 3%(17/546) were CSVT. Parietal PVHI was more common than temporal and frontal lobe PVHI. For PAIS, left middle cerebral artery (MCA) was more common than right MCA or cerebellar stroke. For CSVT partial or complete thrombosis in the transverse sinus was universal. All cases included multiple possible risk factors, but the data were discordant precluding aggregation within a meta-analysis.

CONCLUSION:

This systematic review confirms paucity of data regarding the etiology and the precise causal pathway of stroke in preterm infants. Moreover, the preterm infants unlike the term infants do not typically present with seizures. Hence high index of clinical suspicion and routine cUS will assist in the timely diagnosis and understanding of stroke in this population.

Total antioxidant capacity and profiling of polyphenolic compounds in jute leaves by HPLC-DAD

Jute leaves (Corchorus spp.) have been used as a medicinal plant for the treatment of various diseases. The study was investigated on the antioxidant activities and HPLC profiling of polyphenolic compounds in ethanol extract of Corchorus olitorius (C. olitorius) and Corchorus capsularis (C. capsularis) leaves. The total antioxidant capacity was evaluated by phosphomolybdenum method and Identification and quantification of polyphenolic compounds were performed using HPLC-DAD system. The results indicated that eight polyphenolic compounds were found in the C. capsularis leaves but C. olitorius leaves contain six polyphenolic compounds. In fact, major identified polyphenolic compounds of C. capsularis leaves were caffeic acid (CA), 55.93±0.13; trans-ferulic acid (FA), 58.02±0.18; rutin hydrate (RH), 32.16±0.08; ellagic acid (EA), 53.65±0.11 and quercetin hydrate (QU), 46.17±0.09 mg/100 g of dry extract respectively. Whereas in C. olitorius leaves which were rutin hydrate (RH), 152.17±0.51; ellagic acid (EA), 143.27±0.58 and quercetin hydrate (QU), 292.83±0.73 mg/100 g of dry extract respectively. The results showed that C. capsularis leaves contained high level of total antioxidant capacity (214.32±1.95 mg of ascorbic acid/g of dry extract) than that of C. olitorius (165.66±1.30 mg of ascorbic acid/g of dry extract) leaves. The overall data suggested that C. olitorius and C. capsularis leaves contain a significant amount of several polyphenolic compounds that could be used as a natural antioxidant for functional foods.

Clinical characteristics of fibroblast growth factor receptor 3 antibody-related polyneuropathy: a retrospective study

BACKGROUND AND PURPOSE

Autoantibodies are increasingly being used as a diagnostic biomarker of chronic inflammatory neuropathies. However, their role and associated clinical syndrome are not well defined.

METHODS

This retrospective chart review evaluated the clinical presentation, diagnostic workup and therapeutic responses in fibroblast growth factor receptor 3 (FGFR3) antibody-associated neuropathy.

RESULTS

A total of 27 patients [14 men, aged 29-87 (65 ± 14) years] with positive FGFR3 antibody were included. Distal lower-extremity paresthesia (66%), unsteady gait (26%) and foot drop (11%) were common presenting symptoms. Symptom onset was acute in four (15%) cases. Distal lower-extremity weakness (mild in eight and severe in three patients) was the most frequent motor finding. Decreased distal sensation to pinprick (59%) and loss of vibration sensation (37%) were observed. Titer of FGFR3 ranged between 3100 and 30 000 (normal < 3000) with a mean of 10 688 ± 7284. Apart from the occasional association of other neuropathy-related autoantibodies, comprehensive neuropathy workup was otherwise unrevealing. Six patients had other autoimmune disease and seven patients had a history of cancer. Electromyography reflected sensorimotor neuropathy with mixed axonal and demyelinating features in 11 cases. Pure sensory neuropathy was noted in three patients. Demyelination was found in five of six nerve biopsies. Intravenous immunoglobulin response was observed in 8/10 treated patients.

CONCLUSIONS

The FGFR3 antibody appears not to be restricted to sensory neuropathy only. Its role in the pathogenicity of chronic inflammatory neuropathies is not yet well established and, although there may be a role for immunotherapy, larger studies are warranted.

Development of quinolone resistance and prevalence of different virulence genes among Shigella flexneri and Shigella dysenteriae in environmental water samples

The purpose of this study was to find out the mechanism of quinolone resistance in Shigella sp. isolated from environmental water samples from various parts of Kolkata, India. Out of 196 Shigella sp. isolated from 2014 to 2017, we selected 32 Shigella isolates for antimicrobial susceptibility tests. The minimum inhibitory concentrations (MIC) for quinolones ranged from 30 to 50 μg ml^-1 for ofloxacin, 5-20 μg ml^-1 for ciprofloxacin and 20-30 μg ml^-1 for norfloxacin. A few amino acid changes were found in quinolone resistance determining region (QRDR) of gyrA. Mutations in gyrA lead to a higher increment of MIC of quinolones. Among the plasmid-mediated (PMQR) quinolone resistance genes investigated, qnrB and aac(6')-lb-cr genes were found in all isolates. qnrA and qnrS were found in 25% and 62% of the isolates, respectively. ipaH gene was found in all of the isolates followed by the presence of other virulence genes ial, sen and stx1. Almost all the isolates having high MICs showed efflux pump activity in drug accumulation assay. All the mechanisms may or may not be present in a single strain. Several types of efflux pumps, presence of PMQR genes and mutations in drug target site of QRDR region may play the crucial role for resistance in our isolates.

P2257Self-care abilities and depression symptoms linked to brain injury in heart failure

Methods

Two high-resolution T1-weighted data were collected from each 42 HF subjects (age, 55.65±7.61; 30 male; LVEF 27.74±9.40%; NYHA class II/III) using a 3.0-Tesla MRI scanner. Depression, anxiety, sleep quality, daytime sleepiness, cognition, and self-care issues were examined with Beck Depression Inventory (BDI), Beck Anxiety Inventory (BAI), Pittsburgh Sleep Quality Index (PSQI), Epworth Sleepiness Scale (ESS), Montreal Cognitive Assessment (MoCA), and Self-Care of Heart Failure Inventory (SCHFI) respectively. Both T1-weighted scans were realigned, averaged, and segmented into gray matter (GM), white matter, and cerebrospinal fluid tissue type. GM maps were normalized (unmodulated) to a common space and smoothed to obtain GM density maps. The smoothed GM density maps were used to examine the association of brain damage with disease symptoms (SPM 12; partial correlation; covariates, age and gender; p<0.005). Region of interest analyses were performed in prefrontal cortices, insular lobe and hippocampus to evaluate the correlation using partial correlation (SPSS, covariates, age and gender, p<0.05).

Results

The average scores for BAI 9.55±9.90, BDI 8.69±7.05, ESS 7.00±3.72, MoCA 24.64±3.48, PSQI 6.62±3.90, maintenance 73.12±13.78, management 70.28±13.98, and confidence 73.77±15.96 were calculated. Significant negative correlations was observed between GM density values and BAI (prefrontal cortices, r=−0.532, p<0.001), BDI (prefrontal cortices, r=−0.60, p<0.001; insula, r=−0.528, p<0.001, hippocampus, r=−0.432, p<0.005), ESS (prefrontal cortices, r=−0.419, p=0.007; insula, r=−0.443, p=0.004), and PSQI (prefrontal cortices, r=−0.517, p=0.001) scores, and positive correlation between GM density values, MoCA (prefrontal cortices, r=0.462, p=0.003) and SCHFI scores (maintenance: prefrontal cortices, r=0.422, p=0.007; insula, r=0.412, p=0.009, hippocampus, r=0.455, p=0.004; management: prefrontal cortices, r=0.728, p=0.001; insula, r=0.707, p=0.001, hippocampus, r=0.775, p<0.001) (Figure 1).

Figure 1

Conclusions

HF subjects show more wide-spread and significant correlations between regional GM density values and BDI as well as SCHFI management scores compared to the other disease symptom measures. The findings suggest that damage in mood, autonomic, and cognitive functions sites better correlate with BDI and SCHFI over other measures.

Acknowledgement/Funding

NIH/NINR 1R01 NR014669

Comparison of hospitalization rates in schizophrenic patients on first generation versus second generation antipsychotic depots

Introduction

There is limited data on the efficacy rates between first and second generation antipsychotic depots. One good indicator of efficacy is the rates of hospitalization. Some studies have shown that second generation depot antipsychotics significantly reduce hospitalizations rates as compared to conventional depots.

Objectives

Comparison of hospitalization rates for patients with schizophrenia on first and second generation antipsychotic depots.

Methods

A retrospective observational study was done by reviewing the records of an antipsychotic depot clinic in Essex, United Kingdom. A list of 47 patients enrolled and receiving depot antipsychotics was obtained. Their records were studied and hospital admission rates calculated.

Results

Of the 47 patients 11 were excluded as they were on depot antipsychotics for non-schizophrenic diagnoses.

Of the 36 patients with schizophrenia, 12 were on second generation and 24 were on first generation depots.

Amongst the 24 patients on first generation depots, 19 were male, 5 female and mean age was 52 years.

Of the 12 patients on second generation depots, 10 were male and 2 female and mean age was 46 years.

When comparing hospital admission rates between the 2 groups, the following data was noted (Table 1).

Conclusions

There is no difference in hospitalization rates between patients on first generation antipsychotic depots as compared to second generation antipsychotic depots.

Disclosure of interest

The authors have not supplied their declaration of competing interest.

Does arthroscopic subacromial decompression improve quality of life

INTRODUCTION

There has been a significant rise in the volume of subacromial decompression surgery performed in the UK. This study aimed to determine whether arthroscopic subacromial decompression improves health related quality of life in a cost effective manner.

METHODS

Patients undergoing arthroscopic subacromial decompression surgery for impingement were enrolled between 2012 and 2014. The Oxford shoulder score and the EQ-5D™ instruments were completed prior to and following surgery. A cost-utility analysis was performed.

RESULTS

Eighty-three patients were eligible for the study with a mean follow-up duration of 15 months (range: 4-27 months). The mean Oxford shoulder score improved by 13 points (95% confidence interval [CI]: 11-15 points). The mean health utility gain extrapolated from the EQ-5D™ questionnaire improved by 0.23 (95% CI: 0.16-0.30), translating to a minimum cost per QALY of £5,683.

CONCLUSIONS

Subacromial decompression leads to significant improvement in function and quality of life in a cost effective manner. This provides justification for its ongoing practice by appropriately trained shoulder surgeons in correctly selected patients.

Competing Magnetic Fluctuations in Iron Pnictide Superconductors: Role of Ferromagnetic Spin Correlations Revealed by NMR

In the iron pnictide superconductors, theoretical calculations have consistently shown enhancements of the static magnetic susceptibility at both the stripe-type antiferromagnetic and in-plane ferromagnetic (FM) wave vectors. However, the possible existence of FM fluctuations has not yet been examined from a microscopic point of view. Here, using ^{75}As NMR data, we provide clear evidence for the existence of FM spin correlations in both the hole- and electron-doped BaFe_{2}As_{2} families of iron-pnictide superconductors. These FM fluctuations appear to compete with superconductivity and are thus a crucial ingredient to understanding the variability of T_{c} and the shape of the superconducting dome in these and other iron-pnictide families.

Is energy drink safe? A cross sectional study on the effects of energy drink on medical students from a medical school of Nepal

Background: Energy drinks that contain caffeine, taurine, vitamins, herbal supplements, sugar or sweeteners are marketed to improve energy, weight loss, stamina, athletic performance and concentration. Recently some of energy drink has been banned in different countries like Saudi Arabia. In Nepal none of the studies has been done to report the effect of energy drink on health. The main objective of the study was to find out the effect of energy drink on health of medical students. Materials and Methods:  It was a cross sectional questionnaire based study done at Manipal College of Medical Sciences, Pokhara, Nepal on November 2013. Results: Out of 206 students 202 completed the questionnaire completely and their responses were evaluated which gives an overall response rate of 98.05%%. Out of 202 students, 88 (43.56%) students were found consuming energy drinks. The research finding revealed that most of the students who consumed energy drink were male 58%. Most of the students felt energetic after consuming energy drink. The majority of the students were from the second year 79.5%. The majority of the students, 71.6% consumed < 5 cans/week. Among the CNS manifestations students felt energetic, insomnia, euphoria, anxiety, dizziness, hallucination, headache and seizure disorder. Most of the students suffered from palpitation among the CVS manifestations. Other GIT and CVS Manifestations were discomfort, nausea, vomiting, diarrhoea, abdominal pain, constipation, weight loss and chest pain. ANS and miscellaneous manifestations were also seen among the students among which increased stamina , micturation, dry mouth, sweating, burning sensation in the throat, allergic reactions, breathlessness were noted by the students. Headache and insomnia was found more prevalent in males [OR 1.836 95% (CI 0.458, 7.367)] and [OR 1.214, 95 %(CI 0.517, 2.852)], respectively as compared to female students. However, in the case of GIT manifestations viz. abdominal pain and constipation revealed that it was more prevalent among male students [OR 2.292, 95 %(CI( 0.343, 13.638)] and [OR 1.836, 95 %(CI 0.458, 7.367)]. Conclusion:  It is concluded that energy drink gives energy and increases the stamina but it produces neurologic, psychiatric, cardiovascular and gastrointestinal complications on health. Further studies are required on the same field to find out its effect on health in Nepalese population. 

Belonephobia and finger pricking associated pain in hematology laboratory: A cross sectional study among undergraduate medical students in Nepal

BackgroundNeedle phobia, clinically termed as Belonephobia strongly influences psychological behaviors. Physiological responses include palpitations, shortness of breath, nervousness and fainting. In Nepal, first year MBBS students prick their own finger for hematology practical. They use to suffer from Belonephobia and pain due to finger prick. The main objective of this study was to determine influential fear factors and assessment of pain during hematology practical.Material and Methods:One hundred and forty two first year medical students of basic sciences participated in the study. Standard pricking was performed by blood lancet in the middle and side of the middle finger during hematology practical for the assessment of pain in Young Baker scale and visually rating scale. They also responded to a questionnaire on factors associated with fear of needles and lancets, symptoms etc.Results:Out of 142 students, numbers of males were 76 and females were 66. Belonephobia persisted among 65.2% females and 42.1% males, p<0.01. Watching others during lancing or receiving injection was a significant fear factor. Lateral side pricking was preferred by students for less pain. Mild, moderate, “hurts little bit”, “little more”, “even more” were the maximum response for pain sensation.Conclusion:Positive approaches like separation of lancing area, systematic exposure, behavioral therapy, counseling and administration of anti-anxiety drugs for severely needle phobics, can alleviate fear and anxiety. Female students need more assistance. Development of proper strategies and necessary interventions are required, which will facilitate to overcome this phobia.DOI: http://dx.doi.org/10.3126/nje.v4i5.12024 Nepal Journal of Epidemiology 2014; 4(5):433-40

Ethical statement in medical research manuscripts: A Necessary step for quality control

Recently there are several budding medical journals which are coming from developing countries and also there is a large number of publishers. It will foster medical research from these countries. Authors will improve the skill of medical writing because of these journals senior, experienced international/ national editorial and review board. Also this team is responsible for the quality of the journal. Journals primary aim should not be making money and get other benefit to the people who are dealing with it. Journals should produce evidence based new information to the medical science which will benefit to the new generation physicians, scientists and readers.  There is a tremendous increase in the medical research articles in the recent years because most of the institutions, universities and funding agencies consider the publication history of the scientists for their promotion and incentive. It results with good practice and bad practice of research. There are several scientists and teaching faculty members who publish the articles without proper data or they plagiarise other scientist work.  It can be stopped only by the national medical research authorities like Indian Council of Medical Research [India], Nepal Health Research Council [Nepal], etc. for each country level and the Institutional Research and Ethics Committee in  the institutional level. DOI: http://dx.doi.org/10.3126/nje.v4i3.10661Nepal Journal of Epidemiology 2014; 4(3):348-50

Prevalence of Strongyle infections in goat of Maha Koushal region, Madhya Pradesh, India

The coproculture study on Strongyle infection of goats was carried out in small holder farmers kept under semi-intensive management system in Balaghat, Narsinghpur and Chhindwara district, Madhya Pradesh, during the period from July 2011 to February 2012. Copro-culture of the samples positive for Strongyle infection revealed Haemonchus sp., Trichostrongylus sp., Oesophagostomum sp., Strongyloides sp., and Bunostomum sp. in a decreasing order in goats. The larvae of Haemonchus sp. (61.63 %) and Strongyloides sp. (7.50 %) were highest in Balaghat, Trichostrongylus (18.13 %) in Narsinghpur, while Oesophagostomum sp. (10.50 %) and Bunostomum sp. (5.75 %) were in Chhindwara district. The finding of this study indicates that, even though subclinical in nature, Strongyle infection are one of the major problems that could hamper health and productivity and there is need for design a programme to minimize and control Strongyle infection in goats in the study area.

Prevalence of gastro-intestinal parasitic infections in goat of Madhya Pradesh, India

Gastrointestinal (GI) parasitism in animals is one of the major problems in India causing emaciation, anaemia, oedema, weakness, diarrhoea and death. Present study was designed to generate epidemiological data on GI parasitism of goats of Madhya Pradesh, India. During 8 months study period, a total of 960 samples were collected and examined by sedimentation and floatation methods followed by egg per gram out of 960 samples, 907 (94.48 %) were positive for one or more gastrointestinal parasite, wherein coccidia was predominant (82.4 %) followed by strongyles (69.27 %), amphistomes (22.71 %), Strongyloides sp. (9.17 %), Trichuris sp. (3.85 %), Moniezia sp. (3.02 %), Schistosomes sp. (2.29 %) and Fasciola sp. (1.77 %). The seasonal incidence was found highest in monsoon (98.06 %) and lowest in winter (91.67 %). The incidence of gastrointestinal parasitism was found higher in kids (96.25 %) in comparison with adult goats (93.89 %).

Mapping of glycine distributions in gliomas

BACKGROUND AND PURPOSE

Increased glycine concentration in the brain is associated with altered metabolism in cancer and can be detected by using in vivo MR spectroscopy. This has been proposed as a marker for grade IV gliomas; however, little is known about the potential significance and frequency of in vivo glycine observation. The purpose of this study was to examine the rate of occurrence and spatial distribution of glycine observation with respect to other MR imaging parameters.

MATERIALS AND METHODS

Data from volumetric whole-brain MR spectroscopic imaging of 59 subjects with glioma were analyzed with glycine included in the spectral model. The associations of the signal amplitude and spatial distributions of glycine with findings from contrast-enhanced T1, perfusion, and diffusion MR imaging were then examined.

RESULTS

Glycine was detected in 24% of all studies, though with a wide range of signal amplitude and extent of the spatial distributions. While more commonly seen in grade IV tumors (42% of studies), relatively large concentrations were also detected in grade II and III gliomas. Coanalysis with other metabolites indicated a strong association with choline and that glycine was frequently seen to be overlapping with, and adjacent to, areas of high lactate concentration. Increased glycine was always associated with contrast enhancement and areas of increased cerebral blood flow, but without any clear association with other image parameters.

CONCLUSIONS

Detection of increased glycine in gliomas appears to identify a subgroup of tumors and areas of increased proliferation.

Infections in acute leukemia in Indian Children

Aims: In the present study acute leukemic children were studied to determine the incidence and principal site of infection, correlation with absolute neutrophil count, causative organisms and to standardize the initial empirical anti microbial therapy. Materials and methods: A total 40 children in the age group 6 month to 12 year with acute leukemia relapse were included in this study. A total 82 infectious episodes including 61 febrile episodes were investigated for infectious etiology. Results: We found that the frequency of infections increased significantly with the degree of immunocompromisation specially neutropenia (ANC < 500/cmm). The skin and soft tissue was the commonest site of infection (26.83%), followed by respiratory tract (21.95%). Staphylococcus nonhemolytic coagulase-negative (34%), followed by Klebsiella (17%) were the most common organisms isolated from blood. Staphylococcus non-hemolytic coagulase-negative was also the commonest isolate (26%) from other sites of infection. Most strains were sensitive to Cloxacillin, cephalosporin and aminoglycosides. Conclusion: For the treatment of febrile episodes, empirical use of beta-lactamase resistant penicillin e.g. Cloxacillin or cephalosporin combined with an aminoglycosides with a broad spectrum antifungal like fluconazole in selective cases at the first sign of infection is recommended. Journal of College of Medical Sciences-Nepal, 2013, Vol-9, No-1, 40-47 DOI: http://dx.doi.org/10.3126/jcmsn.v9i1.9672

DTI correlates of cognition in conventional MRI of normal-appearing brain in patients with clinical features of subacute combined degeneration and biochemically proven vitamin B(12) deficiency

BACKGROUND AND PURPOSE

Vitamin B12 deficiency may cause neural injury that results in cognitive deficits. The main purpose of our study was to evaluate morphometric and microstructural changes in the brain and relate them to cognition in subacute combined degeneration of the spinal cord and patients with biochemically deficient vitamin B12.

MATERIALS AND METHODS

Fifty-one patients were recruited and underwent nerve-conduction velocity tests and routine hematologic examinations. Serum vitamin B12 and homocystine levels were also measured. All patients and 46 age- and sex-matched controls underwent cervical spine and brain MR imaging along with cognition tests. MR imaging included conventional scans and DTI. Voxel-based morphometry was performed for determining the WM and GM volumes, based on T1-weighted images. DTI measures that included fractional anisotropy, ADC, radial diffusivity, and axial diffusivity were determined by using tract-based statistics.

RESULTS

None of the patients showed any abnormality on conventional MR imaging. No significant changes in GM and WM volumes were observed in patients compared with controls. Significant reductions in the fractional anisotropy and an increase in ADC and radial diffusivity values were observed in multiple brain regions in patients compared with controls. These changes were confirmed on the region-of-interest analysis. Neuropsychological scores were significantly different in patients compared with controls and showed significant correlation with fractional anisotropy and radial diffusivity in a few brain regions.

CONCLUSIONS

Microstructural changes are seen in WM regions on DTI in patients with vitamin B12 deficiency and correlate with cognition scores. DTI can be used for objective assessment of microstructural changes in the brain in vitamin B12 deficiency.

Plagiarism: Who is responsible author or the journal editors?

I am writing in context to an article recently been published in the Journal of Drug Delivery and Therapeutics, Volume 3, Issue 4, July-August 2013 entitled ‘’Medications For Anxiety: A Drug Utilization Study In Psychiatry Outpatients From A Tertiary Care Centre Of Eastern India’4. http://jddtonline.info/index.php/jddt/article/view/574 I was very shocked to see that the above article is plagiarized from one of my paper which is the most  popular article 53475 views till 21st July 2013 in NJE, ‘’Medications for Anxiety: A Drug Utilization Study In Psychiatry Inpatients From A Tertiary Care Centre of Western Nepal’’5 published in Nepal Journal of Epidemiology on September 2011. http://nepjol.info/index.php/NJE/article/view/5753DOI: http://dx.doi.org/10.3126/nje.v3i3.9190 Nepal Journal of Epidemiology 2013;3(3): 277-278

Patient-reported outcome measures: an on-line system empowering patient choice

An innovative web-based system was developed to allow patient-reported outcome measures (PROMs) to be easily administered. Stakeholders guided the design and implementation. The software gives patients access to their current and previous scores. This pilot study focused on patients undergoing arthroscopic subacromial decompression, evaluated using the Oxford shoulder score (OSS). Patients showing good improvement in their OSS were offered the choice to return for routine follow-up clinic appointments, or continue rehabilitation, reassured by their improved score. Thirty-six of 117 patients were eligible. Thirty of these (83%) were opted to avoid further clinics. PROMs 2.0 can be used for any medical intervention with a validated PROM. Evolution and refinement is ongoing. Funding has been granted for 12 primary and secondary healthcare trusts to implement PROMs 2.0. Further work is needed to assess economic impact, patient views and satisfaction with the process.

Analysis of 3 common polymorphisms in the KCNK18 gene in an Australian Migraine case-control cohort

Migraine is a common neurological disorder characterised by temporary disabling attacks of severe head pain and associated disturbances. There is significant evidence to suggest a genetic aetiology to the disease however few causal mutations have been conclusively linked to the migraine subtypes Migraine with (MA) or without Aura (MO). The Potassium Channel, Subfamily K, member 18 (KCNK18) gene, coding the potassium channel TRESK, is the first gene in which a rare mutation resulting in a non-functional truncated protein has been identified and causally linked to MA in a multigenerational family. In this study, three common polymorphisms in the KCNK18 gene were analysed for genetic variation in an Australian case-control migraine population consisting of 340 migraine cases and 345 controls. No association was observed for the polymorphisms examined with the migraine phenotype or with any haplotypes across the gene. Therefore even though the KCNK18 gene is the only gene to be causally linked to MA our studies indicate that common genetic variation in the gene is not a contributor to MA.

Kearns-Sayre Syndrome: A Rare Mitochondrial Deletion Disorder

A 9 yr girl presented with bilateral ptosis and deafness of gradual onset for the last four years. Associated ophthalmoplegia and pigmentary retinopathy, heart block, raised CSF protein and serum lactate was suggestive of the diagnosis of Kearns-Sayre syndrome (KSS), a rare entity in the spectrum of the mitochondrial deletion syndrome. Search for endocrinopathy revealed no abnormality. DOI: http://dx.doi.org/10.3126/jnps.v33i1.6696 J Nepal Paediatr Soc. 2013;33(1):61-62