Monday, December 31, 2018

Guillain Barre Syndrome (GBS) - Presentation and Diagnosis

What is GBS?

GBS is a post infective demyelinating neuropathy of unknown cause. it usually occurs one to three weeks after an episode of respiratory tract infection, diarrhoea, surgery or vaccination.GBS is a immunologically mediated disease.In most of the cases GBS follow an infection with CMV (Cytomegalovirus), mycoplasma or campylobacter jejuni. 


A patient of GBS usually presents with the complaints of weakness of Lower limbs for few days and difficulty in walking for same duration.Flaccid type of paraplegia is seen in a patient of GBS. 
Important clinical examination findings in GBS
The higher cerebral function of patient of GBS is usually normal. All the cranial nerves are intact. The muscle tone of the Lower limbs of the patient is diminished but the muscle bulk of the patient is normal. The sensory function of the nerves are usually intact.The striking abnormality is seen in a GBS patient when the jerks of the patient are tested. The knee and the ankle jerks are often seen absent but the biceps and triceps jerks are normal.The jerks in the upper limbs may be absent in a patient of GBS in very advanced stage.

Investigations to diagnose GBS

A CSF study may be sufficient to declare GBS. Albuminocytological dissociation is found in the CSF of a GBS patient.(Albumin maybe found very high in the CSF of a GBS patient) But if the lymphocytes count is more than 50/cmm then GBS is unlikely.
Investigations to identify CMV, mycoplasma and campylobacter jejuni can be done.
Nerve condition study can be done and may show slow condition, condition block or demyelinating neuropathy.

Friday, September 7, 2018

Low birth weight and its causes

Low Birth Weight: Babies with birth weight of less than 2500grams irrespective of gestational age may be called as low birth weight.
There are a wide range of causes of low birth weight. Some of them are mentioned below.

Placental Causes:
a.      Fetal distress
b.     Multiple gestation
c.      Erythroblastosis fetalis
Uterine Causes:
a.      Bicornuate uterus
b.     Incompetent Cervix
Maternal Causes:
a.      Teenage mother
b.     Pre eclampsia
c.      Chronic medical illness
d.     Infections
Other Causes:
a.      Pre mature rupture of membrane (PROM)
b.     Polyhydramnios
c.      Diabetes
d.     Rh incompatibility
More over any factor that causes Intra uterine growth retardation can lead to a low birth weight.

Thursday, August 9, 2018

Complication of Small Incision Cataract Surgery (SICS)

Though SICS is a popular and cheap method of cataract extraction and posterior chamber intra ocular lens implantation in the developing and under developed countries, it’s not free of complication. Actually, no surgical procedure  is free of complications.
The possible complications of SICS are as below:
Per operative complications of SICS:
a)     Endothelial injury
b)    Injury to iris and iris prolapse
c)     Hyphaema
d)    Posterior capsular tear

SICS Complication

Post operative complications of SICS:
a)     Raised IOP (Intra Ocular Pressure)
b)    Iris prolapse
c)     Wound leak
d)    Acute bacterial endopthalmitis