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Patel ST, Contractor QQ, Nayak CS, Rathi PM. Synchronous pancreatic and scrotal tuberculosis: Double jeopardy. J Postgrad Med 2023; 69:231-233. [PMID: 36751759 PMCID: PMC10846806 DOI: 10.4103/jpgm.jpgm_558_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2022] [Revised: 09/19/2022] [Accepted: 10/03/2022] [Indexed: 01/27/2023] Open
Abstract
We describe a patient who presented with scrotal swelling followed by non-healing and discharging scrotal sinuses, following local trauma and was initially suspected to have an infected scrotal hematoma. An evaluation revealed it to be scrotal tuberculosis. He also complained of upper abdominal pain and on transabdominal ultrasonography was detected to have a mass in the head of the pancreas. Evaluation of the pancreatic mass revealed it to be pancreatic tuberculosis. Both lesions responded well to anti-tubercular therapy. This is an unusual case of two rare sites of extrapulmonary tuberculosis presenting simultaneously in the same individual. Care needs to be exercised while evaluating any non-healing ulcers or sinuses and mass lesions in countries endemic for tuberculosis as this disease can be a great masquerader.
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Affiliation(s)
- ST Patel
- Department of Gastroenterology, Mumbai, Maharashtra, India
| | - QQ Contractor
- Department of Gastroenterology, Mumbai, Maharashtra, India
| | - CS Nayak
- Department of Dermatology, Topiwala National Medical College and BYL Nair Ch Hospital, Mumbai, Maharashtra, India
| | - PM Rathi
- Department of Gastroenterology, Mumbai, Maharashtra, India
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Nayak CS, Kafashan MM, Nascimento FA, Farber NB, Palanca BJA, Hogan RE. Movements and central positive complexes during an ECT-induced seizure: A video-EEG case. Epileptic Disord 2023; 25:795-796. [PMID: 37584591 DOI: 10.1002/epd2.20144] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Revised: 07/15/2023] [Accepted: 08/03/2023] [Indexed: 08/17/2023]
Abstract
Content available: Video.
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Affiliation(s)
- Chetan Sateesh Nayak
- Department of Neurology, Washington University in St. Louis School of Medicine, Ringgold Standard Institution, St. Louis, Missouri, USA
| | - Mohammad Mehdi Kafashan
- Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Ringgold Standard Institution, Saint Louis, Missouri, USA
| | - Fábio A Nascimento
- Department of Neurology, Washington University in St. Louis School of Medicine, Ringgold Standard Institution, St. Louis, Missouri, USA
| | - Nuri B Farber
- Department of Psychiatry, Washington University in Saint Louis School of Medicine, Ringgold Standard Institution, Saint Louis, Missouri, USA
| | - Ben Julian A Palanca
- Department of Anesthesiology, Washington University in Saint Louis School of Medicine, Ringgold Standard Institution, Saint Louis, Missouri, USA
| | - R Edward Hogan
- Department of Neurology, Washington University in St. Louis School of Medicine, Ringgold Standard Institution, St. Louis, Missouri, USA
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Nayak CS, Kiguradze T, Nascimento FA, Hogan RE. Epilepsy with eyelid myoclonia. Epileptic Disord 2023; 25:437-440. [PMID: 37032539 DOI: 10.1002/epd2.20059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 03/14/2023] [Accepted: 03/29/2023] [Indexed: 04/11/2023]
Abstract
Content available: Video
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Affiliation(s)
- Chetan Sateesh Nayak
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Tina Kiguradze
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Fábio A Nascimento
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
| | - Robert E Hogan
- Department of Neurology, Washington University in St. Louis School of Medicine, St. Louis, Missouri, USA
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Krishnan B, Tousseyn S, Nayak CS, Aung T, Kheder A, Wang ZI, Wu G, Gonzalez-Martinez J, Nair D, Burgess R, Iasemidis L, Najm I, Bulacio J, Alexopoulos AV. Neurovascular networks in epilepsy: Correlating ictal blood perfusion with intracranial electrophysiology. Neuroimage 2021; 231:117838. [PMID: 33577938 DOI: 10.1016/j.neuroimage.2021.117838] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2020] [Revised: 12/21/2020] [Accepted: 02/01/2021] [Indexed: 11/25/2022] Open
Abstract
Perfusion patterns observed in Subtraction Ictal SPECT Co-registered to MRI (SISCOM) assist in focus localization and surgical planning for patients with medically intractable focal epilepsy. While the localizing value of SISCOM has been widely investigated, its relationship to the underlying electrophysiology has not been extensively studied and is therefore not well understood. In the present study, we set to investigate this relationship in a cohort of 70 consecutive patients who underwent ictal and interictal SPECT studies and subsequent stereo-electroencephalography (SEEG) monitoring for localization of the epileptogenic focus and surgical intervention. Seizures recorded during SEEG evaluation (SEEG seizures) were matched to semiologically-similar seizures during the preoperative ictal SPECT evaluation (SPECT seizures) by comparing the semiological changes in the course of each seizure. The spectral changes of the ictal SEEG with respect to interictal ones over 7 traditional frequency bands (0.1 to 150Hz) were analyzed at each SEEG site. Neurovascular (SEEG/SPECT) relations were assessed by comparing the estimated spectral power density changes of the SEEG at each site with the perfusion changes (SISCOM z-scores) estimated from the acquired SISCOM map at that site. Across patients, a significant correlation (p<0.05) was observed between spectral changes during the SEEG seizure and SISCOM perfusion z-scores. Brain sites with high perfusion z-score exhibited higher increased SEEG power in theta to ripple frequency bands with concurrent suppression in delta and theta frequency bands compared to regions with lower perfusion z-score. The dynamics of the correlation of SISCOM perfusion and SEEG spectral power from ictal onset to seizure end and immediate postictal period were also derived. Forty-six (46) of the 70 patients underwent resective epilepsy surgery. SISCOM z-score and power increase in beta to ripple frequency bands were significantly higher in resected than non-resected sites in the patients who were seizure-free following surgery. This study provides for the first time concrete evidence that both hyper-perfusion and hypo-perfusion patterns observed in SISCOM maps have strong electrophysiological underpinnings, and that integration of the information from SISCOM and SEEG can shed light on the location and dynamics of the underlying epileptic brain networks, and thus advance our anatomo-electro-clinical understanding and approaches to targeted diagnostic and therapeutic interventions.
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Affiliation(s)
- Balu Krishnan
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA.
| | - Simon Tousseyn
- Academic Center for Epileptology, Kempenhaeghe and Maastricht UMC+, Heeze, The Netherlands
| | - Chetan Sateesh Nayak
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Thandar Aung
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Ammar Kheder
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Z Irene Wang
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Guiyun Wu
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Jorge Gonzalez-Martinez
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Dileep Nair
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Richard Burgess
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Leonidas Iasemidis
- Center for Biomedical Engineering and Rehabilitation Science, Louisiana Tech University, Ruston, LA, USA
| | - Imad Najm
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Juan Bulacio
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
| | - Andreas V Alexopoulos
- Neurological Institute, Cleveland Clinic Foundation, 9500 Euclid Ave, S51, Cleveland, OH 44195, USA
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Abstract
A 15-year-old boy from a child center presented with a three-month history of a growth in the perianal region. There was a history of repeated peno-anal sexual exposures. On examination there was a fleshy, hyperpigmented, verrucous plaque around the anal verge. The Venereal Disease Research Laboratory Test was reactive in a titer of 1 : 64. Lesional biopsy showed marked epidermal hyperplasia without koilocytes, with a dermal infiltrate composed of lymphocytes, plasma cells and histiocytes. Patient was treated with parenteral penicillin with complete healing of the plaque. This is a rare presentation of secondary syphilis showing condyloma lata resembling condyloma acuminata.
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Affiliation(s)
- D J Deshpande
- Department of Dermatology, T.N. Medical College and B.Y.L. Nair Ch. Hospital, Mumbai Central, Mumbai, India
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Abstract
A three month-old boy was brought by his mother with complaints of multiple reddish lesions on his trunk and face since birth. The patient had erythematous annular plaques with scaling on his extremities, palms and soles with periorbital erythema and edema giving the characteristic "eye mask" or "owl's eye" appearance. His mother did not have history of any illness. Hemogram, liver and renal function tests were within normal limits. A skin biopsy was suggestive of subacute cutaneous lupus erythematosus. Immunological work-up was positive for antinuclear antibodies (ANA) (1:40) with anti-Ro titers of 3.4 and 3.47 (>1.1 = clinically significant titre) in the mother and child respectively, although negative for anti-La antibodies. The child's electrocardiogram and 2D echocardiography were normal. We are presenting a case of anti-Ro-positive cutaneous lupus erythematosus with an uncommon skin manifestation.
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Affiliation(s)
- Shankar Sawant
- Department of Dermatology, T. N. Medical College and BYL Nair Charitable Hospital, Mumbai, India.
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Baccush MM, Nayak CS, Gibreel AO. Prevalence of schistosomiasis mansoni in Tauorga town, north-west Libya. J Egypt Soc Parasitol 1993; 23:527-33. [PMID: 8376870] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
Abstract
Study was conducted in 9 localities of Tauorga town, which is situated North-West of Libya, with the objective of finding out the present trend of Schistosomiasis mansoni in general population and to plan suitable strategies for its prevention. 1544 people were selected by two stage cluster random sampling and the data was gathered by direct interview from the family members during home visit. Stool samples were collected and examined for Schistosoma mansoni eggs. The study revealed that the overall prevalence of schistosomiasis mansoni was 20.85%, which was varied between 1.78% and 55.58% in different localities. Significantly higher prevalence was observed in school age group (28.61%), in males (25.28%) and in localities situated within the area of 2 Km from the spring (55.58%).
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Affiliation(s)
- M M Baccush
- Faculty of Medicine, El-Fateh University, Tripoli, Libya
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