Patients with grade IV astrocytoma or glioblastoma multiforme (GBM) have a median survival of <12 months, increased to 14.6 months by maximal safe resection with radiation and temozolamide. In the absence of chemotherapy, radiotherapy or chemoradiotherapy, spontaneous regression of GBM or regression while only being on dexamethasone (DEX) and levetiracetam (LEV) have seldom been reported. Here, we present a case of a patient who had significant regression of the GBM with DEX and LEV alone. In this study, we hypothesise a plausible antineoplastic role of DEX and or LEV in GBM and highlight molecular, preclinical and clinical studies supporting this role.

Vancomycin induced thrombocytopenia (VIT) is an uncommon side effect of vancomycin which can manifest from mild petechiae to life-threatening bleed. Decreased renal clearance of vancomycin results in prolonged thrombocytopenia by antibody-mediated platelet destruction in the presence of vancomycin. Improvement in thrombocytopenia is achieved with the elimination of vancomycin. We describe a patient with end stage renal disease who experienced a protracted course of thrombocytopenia from vancomycin. We illustrate the mechanism of thrombocytopenia and the treatment modalities used by us and those described in literature. VIT is an important differential in patients with thrombocytopenia admitted to the hospital.

Background Osteoarthritis is a common arthropathy of the knee. In India, the prevalence of the disease in the adult rural population is estimated to be 5.8%.   Aim To measure the prevalence of knee osteoarthritis among adults in a rural area and to study the risk factors associated with knee osteoarthritis in the study population. To compare the EULAR 2009 criteria with the modified clinical criteria given by American College of Rheumatology (ACR) for the diagnosis of primary osteoarthritis of the knee joint.   Materials and methods A cross-sectional study was conducted across seven villages coming under a sub-center, from December 2011 to January 2012. A total of 342 subjects were selected by stratified random sampling. An interviewer-administered questionnaire was used to estimate the prevalence and associated risk factors of osteoarthritis based on EULAR 2009, modified ACR criteria, anthropometry, and clinical examination of the knees. The data was analyzed using standard statistical software.   Results The mean age of the population was 42.56 ±16.5 years. The corresponding prevalence of osteoarthritis calculated using the ACR and the EULAR 2009 criteria were 17% and 5.6% in the adult population and 54.1% and 16.4% in the elderly. The etiological factors found to be associated with osteoarthritis are age (P <0.0001), poor education (P <0.0001), previous knee injury (P = 0.046), and regular climbing of stairs (P <0.0001).

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