Objective: To determine the prevalence of asymptomatic bacteriuria in pregnant women and antimicrobial susceptibility pattern of pathogens isolated and also to determine the relationship between asymptomatic bacteriuria and pyuria. Methods: A total of 392 urine specimens were collected from 392 pregnant women with asymptomatic bacteriuria attending different antenatal care clinics for regular perinatal care between April, 2007 and July, 2008. All specimens were processed using standard microbiological procedures. All the subjects were evaluated for bacteriuria. Results: The prevalence of asymptomatic bacteriuria was 6.1% among the pregnant women in Srinagar. From 92 (23.5%) patients who had ≥5 pus cells per high power field, only 15 (16.3%) had positive urine culture. E.coli (~71%) was the commonest causative agent of asymptomatic bacteriuria followed by Klebsiella pneumoniae (~17%), group B Beta haemolytic Streptococcus (8.3%) and Proteus mirabilis (4.2%). Ciprofloxacin was found to be highly sensitive against all isolates. Conclusion: Screening of bacteriuria in pregnancy and proper treatment must be considered as an essential part of antenatal care in this community. To prevent asymptomatic bacteriuria complications, all pregnant women should be screened at the first antenatal visit. A negative test for pyuria is not a reliable

Introduction:The diagnosis and management of narcolepsy in the Indian context needs to be revisited especially in the wake of concerns raised by sleep medicine experts that the entity could be formidably underdiagnosed, as well as undertreated in our setting.Materials and Methods:The history, clinical records, polysomnographic/multiple sleep latency test data, and treatment records of five hundred consecutive patients attending a dedicated sleep clinic between the years 2013 and 2016 were retrospectively analyzed. The response to treatment measures and improvement in daytime functioning were periodically assessed by personal/telephonic interview and E-mail communication.Results:Thirteen patients were diagnosed with narcolepsy based on the standard criteria of which three had cataplexy. The mean age of presentation was 23.23 years and the male:female ratio was 2.25:1. The mean duration from the onset of symptoms to diagnosis was 4.2 years. Two patients responded to nonpharmacological interventions alone, and six to modafinil, while two patients remained symptomatic and required treatment with methylphenidate. One patient was lost to follow-up, while two others are due for their first follow-up.Conclusion:A refurbished outlook of the diagnostic methodology and treatment paths tailored to our clinical scenario can potentially impact the future of narcolepsy management and research in our country.

Transient ischemic attack (TIA) is defined as a temporary focal neurological deficit of presumed vascular origin, lasting for less than 1 h, with no evidence of infarct on neuroimaging. If a patient is suffering from multiple cardiovascular risk factors and presents with transient and recurrent focal neurological deficits, the most likely diagnosis considered is TIA. As the possibility of stroke within first 24 h is high, such patients need aggressive investigation and management, and ideally should be hospitalized. TIA usually occurs due to major intracranial or extra cranial artery stenosis. However, if vascular imaging and cardiac workup is normal, possibility of small vessel disease is considered. Space occupying lesions usually presents with seizure, symptoms of raised intracranial pressure or progressive neurological deficits rather than TIA. There are a few case reports where meningioma presented as TIA, due to vascular compromise by encasing internal carotid artery. 1,2 transient focal neurological deficits can have other differentials like post ictal palsy and negative motor seizures. In a given patient with space occupying lesion like meningioma presenting with recurrent transient focal neurological deficits we need to consider all these differentials. We are hereby reporting a case of convexity meningioma, which presented as recurrent focal neurological deficit due to negative motor seizures, mimicking transient ischemic attack.