Optic nerve demyelination is one of the clinical features of combined central and peripheral demyelination (CCPD), an entity with heterogenous immunopathogenesis and clinical characteristics, overlapping between multiple sclerosis (MS) and chronic inflammatory demyelinating polyneuropathy (CIDP). Of interest, earlier studies among patients with CIDP prior to discovery of antibodies against paranodal protein neurofascin 155 (anti-NF 155) also reported optic nerve dysfunction. We aimed to evaluate optic nerve demyelination among anti-NF 155 CIDP patients. We studied 2 patients with anti-NF 155 CIDP using visual-evoked potentials (VEP) and optical coherence tomography (OCT). Both patients had distal acquired demyelinating symmetric (DADS) subtype CIDP. Other common features were prominent sensory ataxia, hand tremors, significantly elevated cerebral spinal fluid protein, high titre anti-NF 155 antibodies and poor response to corticosteroid and intravenous immunoglobulin (IVIg). No central nervous system neuroradiological abnormality detected. Both had normal visual acuity and colour vision, but one had subclinical right relative afferent pupillary defect (RAPD). VEP of both showed bilateral prolonged P100 latencies. OCT for patient with RAPD demonstrated moderate to severe retinal nerve fibre layer (RNFL) thinning. Identification of optic nerve demyelination among subclinical CIDP with anti-NF 155 antibodies expanded the spectrum of demyelination within the subset of CCPD.
Cryptococcosis is an opportunistic fungal infection commonly seen in HIV cases. We present a case of disseminated cryptococcosis with multiple non-continuous infective foci in a non-HIV, non-transplant case.
Neurosyphilis is a broad term used to describe an infection caused by Treponema pallidum in the central nervous system. While this was a common cause of stroke in the 19th century, it saw a decline after the introduction of penicillin. However, in the recent past, there has been an increase in the incidence of syphilis, especially with HIV coinfection. Neurosyphilis results from an untreated primary syphilis. Neuropsychiatric disorder appears to be the commonest manifestation followed cerebrovascular accident, myelopathy, ocular disease and seizure. Known as the 'great imitator', this entity, however, may be easily missed if not for a high index of suspicion. This is especially so because of its similar presentation to other more common clinical conditions. We describe the case of a 39-year-old man displaying acute global aphasia and right-sided facial weakness in keeping with a left middle cerebral artery infarct. This was confirmed with computed tomography of the brain, and subsequently, further investigations revealed a diagnosis of neurosyphilis. The patient was treated with intravenous benzylpenicillin and recovered well with treatment.
Mung bean (Vigna radiata L.) sprout is a popular fresh vegetable, tasty and high in antioxidants. To increase yield and quality after the occurrence of both abiotic and biotic stresses, the application of seaweed extracts is of great importance. Hence, this study was conducted to determine the effect of Ascophyllum nodosum extract (ANE) in the presence of salt on the antioxidant potential of V. radiata sprouts. Different concentrations of ANE viz. 0.00, 0.01, 0.05, 0.10, and 0.50% and NaCl 0, 25, 50, 75, and 100 mM alone and in combinations were tested for researching the antioxidant potential of V. radiata sprouts at 0, 24, and 36 h of sprouting. The DPPH free-radical-scavenging activity of sprouts of V. radiata was found to increase with time and peaked at 24 h of treatment. The A. nodosum extract (0.01%) could reverse the ill effect of the low level of salinity posed by up to 25 mM NaCl. The increasing salinity deteriorated the antioxidant activity using ABTS method of sprouts down to 20.45% of the control at 100 mM NaCl. The total phenolic content (TPC), total flavonoid content (TFC), and reducing power of V. radiata sprouts was found to increase till 36 h of sprouting. A slight increase in TPC, TFC and reducing power was observed when seeds were treated with low concentrations of ANE. The elevation in TPC, TFC and reducing power upon treatment with low concentrations of ANE was also noticed in sprouts in saline combinations. Alpha amylase inhibition activity was found to reach a (67.16% ± 0.9) maximum at 24 h of sprouting at a 0.01% concentration of ANE. Tyrosinase inhibition and alpha glucosidase inhibition was 88.0% ± 2.11 and 84.92% ± 1.2 at 36 h of sprouting, respectively, at 0.01% concentration of ANE. A. nodosum extract is natural, environmentally friendly, and safe, and could be used as one of the strategies to decline stress at a low level and enhance the antioxidant activities in V. radiata sprouts, thus increasing its potential to be developed as an antioxidant-based functional food.
BACKGROUND: Spinal AVF (SAVF), a potentially treatable cause of myelopathy, remains a challenging diagnosis. Its rarity and non-specific imaging findings often result in misdiagnosis despite a high index of clinical suspicion. The classically described high T2 signal in the spinal cord or prominent vascular flow voids in the intradural space were not infrequently missed on initial imaging, only to be picked up at follow-up imaging after progression of symptoms. Additionally, small sized fistulas(
An early detection of Mycobacterium tuberculosis is very important to reduce the number of fatal cases and allow for fast recovery. However, the interpretation of the result from smear microscopy requires skilled personnel due to the propensity of the method to produce false-negative results. In this work, a portable, rapid, and simple sandwich-type immunosensor reader has been developed that is able to detect the presence of M. tuberculosis in sputum samples. By using sandwich-type immunosensor, an anti-CFP10-ESAT6 antibody was immobilized onto the graphene/polyaniline (GP/PANI)-modified gold screen-printed electrode. After incubation with the target CFP10-ESAT6 antigen, the iron/gold magnetic nanoparticles (Fe3O4/Au MNPs) conjugated with anti-CFP10-ESAT6 antibody were used to complete the sandwich format. Differential pulse voltammetry (DPV) technique was used to detect the CFP10-ESAT6 antigen at the potential range of 0.0-1.0 V. The detection time is less than 2 h. Under optimal condition, CFP10-ESAT6 antigen was detected in a linear range from 10 to 500 ng mL-1 with a limit of detection at 1.5 ng mL-1. The method developed from this process was then integrated into a portable reader. The performance of the sensor was investigated and compared with the standard methods (culture and smear microscopy). It provides a good correlation (100% sensitivity and 91.7% specificity) with both methods of detection for M. tuberculosis in sputum samples henceforth, demonstrating the potential of the device as a more practical screening tool.Graphical abstract.