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Background Haemophilia is characterized by a partial or complete deficiency of clotting factor VIII or IX. The repeated bleeding episodes into the joints contributes to subsequent chronic arthropathy which debilitates the patient and affects the quality of life. There are lot of hurdles in successful management of such patients. We present our experience in dealing such patients. Materials and Methods 24 patients (27 knees) with haemophilic knee arthropathy were included. The preoperative VAS (Visual Analogue Scale) and KSS (Knee Society Score) were assessed. All underwent total knee arthroplasty with stemmed constrained prosthesis. Postoperatively VAS and KSS were analysed at the end of 12 months. Results The mean preoperative VAS was 8.2 (Range 7-10), mean KSS clinical score was 39.9 (Range 12-61) and mean KSS functional score was 51.4(Range 20-70). The mean postoperative VAS was 2.7(Range 2-4), mean KSS clinical score was 70.5 (Range 61-80) and mean KSS functional score was 74.2(Range 60-80). There was statistical significant difference between preoperative and post-operative scores. At the end of 12 months, 17 patients (63%) had good outcome, seven patients (26%) had fair and three patients (11%) had excellent outcome as per the KSS scores. Conclusions Total knee arthroplasty has good outcome with respect to clinical as well as functional outcome in haemophilic arthropathy. Although the results and outcome of total knee arthroplasty in haemophilic knee arthropathy may still be inferior to the results seen in a normal individual, a multidisciplinary approach yields a better functional and quality of living in such haemophilic patients. © 2019 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.The aim of study is to examine the frequency of reoperation and difference in failures for short cephalomedullary nail (SN) and long cephalomedullary nail (LN).We included patients with an intertrochanteric fracture treated with Gamma nail (Stryker®). All radiographs were reviewed, TAD and diastasis were measured, and type of failure registered.216 patients were included, 95 short nails and 121 long nails. We found 12 reoperations, 5 in the SN group and 7 in the LN group. Most common failure was cut out. Our study showed no difference in frequency of reoperations or type of failures. © 2019 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Femoroacetabular Impingement is an established cause of labral tears and chondral delamination. The aim was to test the validity of direct magnetic resonance arthrogram [dMRA] in the diagnosis of the same. We also looked at the short term functional outcome in these patients post hip arthroscopy. The dMRA is valuable in diagnosing labral tears nevertheless poor in detecting cartilage delamination. Hip arthroscopic intervention provided a good short-term functional outcome; however, should be offered with caution in patients over 40 years. To our knowledge, this is the single largest series published with similar methodology. © 2019 Professor P K Surendran Memorial Education Foundation. Published by Elsevier B.V. All rights reserved.Succinic semialdehyde dehydrogenase (SSADH) deficiency is an autosomal recessive disorder of gamma-aminobutyric acid metabolism. Children with SSADH deficiency usually manifest with developmental delay, behavioral symptoms, language dysfunction, seizures, hypotonia, extrapyramidal symptoms, and ataxia. Diagnosis of SSADH deficiency is established by an abnormal urine organic acid pattern, including increased excretion of 4-hydroxybutyric acid and the identification of biallelic pathogenic variants in aldehyde dehydrogenase 5 family, member A 1 (ALDH5A1) gene. Here, we describe a 15-month-old girl with SSADH deficiency presenting with developmental delay, language deficits, and acute-onset right hemiparesis, following recovery from a diarrheal illness. Brain magnetic resonance imaging revealed hyperintense signal changes involving the left globus pallidus in T2-weighted images with restriction of diffusion in the diffusion-weighted images. Increased excretion of 4-hydroxybutyric acid, threo-4,5-dihydroxyhexanoic acid lactone and erythro-4,5-dihydroxyhexanoic acid lactone was detected by urine organic acid analysis and a diagnosis of SSADH deficiency was confirmed by the identification of homozygous pathogenic variant in ALDH5A1. Stroke mimic is a novel presentation in our patient with SSADH deficiency. She was initiated on treatment with vigabatrin and has shown developmental gains with the recovery of right hemiparesis. Trichostatin A molecular weight Follow-up neuroimaging shows near complete resolution of signal changes in the left globus pallidus, while there was subtle hyperintensity in the right globus pallidus. The phenotypic spectrum of SSADH deficiency is widely expanding, and this disorder should be considered in the differential diagnosis of children with metabolic stroke. Copyright © 2006-2020 Annals of Indian Academy of Neurology.Cerebral venous sinus thrombosis (CVST) is a cerebrovascular disease that is caused by a number of factors, including hypercoagulability and vessel wall damage. Sjögren’s syndrome (SS) is a chronic inflammatory autoimmune disease characterized by lymphocyte infiltration of the exocrine glands. CVST could be caused by autoimmune diseases. According to previous reports, the most frequently reported autoimmune diseases which could cause CVST are systemic lupus erythematosus and antiphospholipid syndrome. Reports of SS leading to CVST are scarce. Here, we present a case of a 51-year-old woman who was diagnosed with SS-induced CVST. We tease out knowledge about the pathogenesis, feature of clinic symptom, treatment, and prognosis of SS-associated CVST, and illustrates how a detailed patient history can contribute to an accurate diagnosis. Copyright © 2006-2020 Annals of Indian Academy of Neurology.Meningitis and meningoencephalitis account for the majority of central nervous system infections by Listeria monocytogenes (Lm). Macroscopic listerial brain abscess is a rare infection. Early recognition of Listeria brain abscesses represents a major diagnostic challenge. Mortality from Listeria brain abscesses is high but can be reduced when appropriate treatment is timely started. Immunosuppressed patients are more often affected, and a high suspicion is needed for prompt identification. Treatment should be individualized taking into account the comorbidities, lesion size and location, bacterial resistance, and clinical and radiological response. We present a case of a supratentorial Lm brain abscess in a patient with liver cirrhosis whose family denied surgical management, and despite the large size, clinical and radiological success was achieved with 4 weeks of ampicillin. Copyright © 2006-2020 Annals of Indian Academy of Neurology.