Sodium and potassium excretion in normotensive and hypertensive population in Kashmir

One hundred thirty five hypertensive patients and equal number of age and sex matched healthy controls were taken up for studying the relationship of 24 hour urinary sodium and potassium excretion, sodium-potassium molar ratio and body mass index (BMI) with blood pressure in normotensive and hypertensive population in Kashmir. There was statistically significant elevated 24 hour urinary sodium excretion (p < .001), increased Na+-K+ molar ratio, significantly higher BMI in hypertensive population as compared to controls whereas there was a lower 24 hour urinary excretion of potassium (p > .20) in patients with hypertension. Thus sodium and potassium excretion, Na+-K+ molar ratio and body mass index has direct bearing in perpetuation or causation of hypertension in Kashmir which may be related to intake of salt tea.

Alkaline phosphatase in pleural effusions

BACKGROUND

Pleural effusion (PF) is a common clinical presentation in several diseases. Various parameters from pleural fluid have been studied to identify the cause. The diagnostic value of these parameters varies. The present study was carried out to evaluate the value of alkaline phosphatase concentration in the pleural effusions as a diagnostic tool.

METHODS

One hundred and one patients with pleural effusion admitted over a period of two years were studied. The diagnosis was confirmed by pleural biopsy and cytology for malignant cells.

RESULTS

Pleural fluid alkaline phosphatase levels of more than 75 mg/dl was found in exudative effusions and less than 75 mg/dl in transudative ones. But it did not differentiate tubercular pleural effusions from other exudative ones.

CONCLUSION

Pleural fluid alkaline phosphatase of >75 mg/dl is a useful biochemical marker to suggest exudative effusions.

Hypocomplementemic urticarial vasculitis and lower cranial nerve palsies

A 55 years post menopausal lady presented with puffiness of face, and a pruritic urticarial rash over face and upper trunk of one week duration with accompanying dysphagia. Clinical examination revealed an urticarial rash over face and upper trunk, two small ulcers over floor of mouth and evidence of bilateral VIII, IX and Xth cranial nerve palsies. Hypocomplementemia, negative immune profile and evidence of vasculitis on skin biopsy suggested a diagnosis of hypocomplementemic urticarial vasculitis. The patient responded to a course of steroids.

Prognostic value of facial nerve latency and blink reflex in Bell's palsy

Twenty six patients of Bell's palsy, 16 men and 10 women, with the mean age of 27?0.2 years were enrolled for the study. An equal number of age and sex matched normal healthy individuals formed the control group. Clinical assessment and electrophysiological tests like facial nerve latency (FNL), blink reflex (BR), and peripheral nerve conduction studies were done to assess the prognostic value of these electrophysiological tests early in the disease. Clinical severity of weakness in the first week correlated positively with the outcome at 8 weeks. The mean FNL did not bear prognostic relation to the outcome, it being significantly prolonged in both partial and full recovery groups. BR proved to be of prognostic value. Though the amplitudes of various components of BR were low in all patients, significant prolongation of latencies was seen only among those with partial recovery. Nerve conduction studies of peripheral nerves were normal in all the patients. Clinical examination and early blink reflex abnormalities are of prognostic value in Bell's palsy patients.

Incidence of photosensitive epilepsy in unselected Indian epileptic population

The recognition of photosensitivity depends upon the finding of an abnormal EEG response to intermittent photic stimulation (IPS). Photosensitive epilepsy being the most common form of reflex epilepsy, has been studied most extensively and is reported to account for 5-10% of the epileptic population in general. One thousand unselected epileptics hailing from different parts of Northern India were screened for photosensitivity, both clinically and on a standard protocol of IPS-provoked EEG recordings. Six patients (mean age 14.5 +/- 3.56 yr) were found to be photosensitive: 4 had generalized, 1 had complex partial and 1 mixed seizures; 3 had history of seizures provoked by visual stimuli. The baseline EEG in 4 patients showed generalized and 2 partial, with secondary generalized, epileptiform discharges. On IPS, similar EEG findings were obtained with a wide range of stimulus frequency (6-60 cycles/s). There is a low incidence of photosensitivity in our epileptic population, for which we believe, genetic factors are responsible.

Sporadic distal renal tubular acidosis and periodic hypokalaemic paralysis in Kashmir

Twenty-one cases of renal tubular acidosis presenting with periodic hypokalaemic muscular weakness, that were seen over an 8-year period, are presented. The biochemical features suggested a diagnosis of distal renal tubular acidosis and absence of family history with negative screening of eighteen families pointed towards the primary sporadic nature of the disorder in nineteen of the cases. Alkali and replacement potassium therapy resulted in immediate and sustained clinical recovery in all the cases.