Biomedical subjects
Publications and source records attributed to V P Dhopesh.
The survey on our unit revealed that 80% of injection drug users (IDUs) had hepatitis B core antibody (HBcAB), and 90% had hepatitis C virus antibody (HCVAB). Less than half of each group did not know or were unsure of the mode of transmission and spread of HCV. These findings emphasize the need to focus on education, especially about transmission of hepatitis B and C infection in drug addicts, particularly IDUs.
Dopamine deficiency is found in both chronic cocaine abusers and Parkinson's disease. The authors sought to determine whether parkinsonian signs occur in chronic cocaine abusers. Fifty male patients with a history of chronic heavy cocaine abuse were examined on the Unified Parkinson Disease Scale (UPDS) and compared with 20 non-cocaine-abusing, age- and sex-matched control subjects. UPDS scores of cocaine abusers ranged from 0 to 1 (mean: 0.08 +/- 0.28) and, in control subjects, from 0 to 3 (mean: 0.15 +/- 0.49; P = 0.5; NS). This study suggests that chronic heavy cocaine abuse does not cause parkinsonism.
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Results of routine thyroid function tests in heavy cocaine abusers at the time of treatment admission were not statistically different from normal values for our laboratory or from a similar group of other substance abuse patients in treatment. This suggests that heavy cocaine use per se does not affect thyroid function. Therefore, if the thyroid function tests are abnormal in a cocaine abuser, then a true thyroid dysfunction should be considered and completely evaluated. In addition, nonspecific alterations in thyroid function tests in nonthyroidal illnesses should be kept in mind.
A case is reported illustrating two points: 1. haemorrhage can occur in cerebral infarct even without the use of anticoagulants; 2. this haemorrhage can extend into the subarachnoid space, causing chemical meningitis, and may produce moderately severe low CSF sugar. The importance of this point is emphasised when faced with a stroke patient who develops fever.
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Our retrospective review of the charts of patients receiving radiation therapy for brain metastasis revealed that one third presented neurologic symptoms without prior diagnosis of cancer. Lung cancer was detected in two thirds of this group, and in one third, the primary site remained unknown. There was good clinical and CT correlation.
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Seven of eight patients had a clinical diagnosis other than brainstem hemorrhage before computed tomography (CT). Four were diagnosed as infarction, one as intracerebral hemmorrhage, one as hypertensive encephalopathy, and one as subdural hematoma. All survived except one, who died of pulmonary embolus. Although the yeild of posterior fossa lesions on CT is thought to be small, our experience indicates that CT is exceedingly valuable in demonstrating and localizing brainstem hemorrhage. The prognosis of brainstem hemorrhage appears to be better than reported in the literature.
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Two cases of spinal arteriovenous malformation (AVM) in young patients are presented. Symptoms were compatible with the spinal form of multiple sclerosis in both cases. The lesions were not diagnosed on initial evaluation. Subsequently they were found by myelography and arteriography, the one eight months and the other nine years after the first symptoms. The contrasting clinical courses of the two patients suggest that: (a) the diagnosis of multiple sclerosis where symptoms and signs are restricted to the spinal cord should be made only after a thorough investigation which includes myelography, to rule out the presence of a surgically correctible lesion such as an AVM; (b) myelography should be carried out in both the supine and prone positions as an AVM may be completely missed by routine prone myelography views; (c) early surgery of the resectable AVM may prevent a progressive deterioration of neurological function, making early diagnosis particularly important.
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