Objectives: This aim of the study was to evaluate the efficacy of NS1 antigen assay for early diagnosis of dengue virus infection in a tertiary care hospital. Methods: This cross sectional study was carried out in medicine unit of Square hospital from May to August 2013. Total 100 patients with dengue fever were included. Complete blood count, alanine aminotransferase (ALT), aspartate aminotransferase (AST), Dengue NS1 antigen and IgM and IgG antibodies of dengue virus were done in all cases. Results: Of the 100 sera tested, 75% were positive for dengue virus infection based on dengue NS1 antigen, IgM antibody and IgG antibody. Dengue NS1 antigen and IgM, IgG antibody were able to detect dengue virus infection between day 1 to day 8 in 92% of samples, 86.7% of samples and 82.6% of samples respectively. Sixty nine percent (69%) were found positive for dengue NS1 antigen, 65% were IgM positive and 62% were IgG positive. Based on the dengue NS1 antigen and IgM antibody combination, 74% were positive for dengue virus infections. Sensitivity of Dengue NS1 antigen was 92.3% and specificity of 74.28% in comparison to IgM antibody. Based on the antigen and IgG antibody combination, detection rate increased to 75%. Sensitivity of dengue NS1 antigen was 90.3% and specificity of 65.8% in comparison to IgG antibody. Conclusion: Dengue NS1 antigen is a useful, sensitive and specific test for early diagnosis of dengue virus infection and it improves diagnostic efficiency in combination with antibody test.DOI: http://dx.doi.org/10.3329/jom.v15i1.19856 J Medicine 2014; 15: 28-30

Abstract:Guillain Barre Syndrome (GBS) is an immune mediated polyradiculoneuropathy classically characterized by acute ascending type of motor weakness of limbs with areflexia but in AMAN variant of GBS preserved or exaggerated reflex sometimes can occur. We report a 45 year old female patient who presented with acute flaccid quadriplegia, bilateral facial lower motor type nerve palsy and bulbar involvement, initial hyperreflexia of all four limbs and bilateral plantar extensor response 7 days following an attack of diarrhoea. Sensory and bowel bladder function was intact. She was treated with IV immunoglobulin and IV methylprednisolone. Nerve Conduction study (NCS) revealed AMAN variant of GBS. All reflexes disappeared on the 2 nd day onward but returned on 21 st day of illness when muscle power also improved. Follow up NCS confirmed regeneration of nerves of all four limbs. So in any patient presenting with acute quadriparesis GBS should be in the differential diagnosis even if there is preserved or exaggerated deep tendon reflexes.

Abstract:Background

Guillain- Barrè Syndrome is characterized by acute progressive symmetric limb weakness and areflexia. A 32 year old female presented with progressive ascending areflexic muscular weakness and bilateral lower motor neuron type of facial palsy. She had anorexia, nausea and upper abdominal pain for 2 weeks. The findings of motor nerve conduction study are consistent with acute inflammatory demyelinating polyradiculoneuropathy. She had elevated liver enzyme and positive immunoglobulin M antibody against hepatitis E in blood. Based on clinical features, laboratory findings and electrophysiological study, she was diagnosed as Guillain- Barrè Syndrome following hepatitis E. She was treated with intravenous immunoglobulin and recovered fully. DOI: http://dx.doi.org/10.3329/bccj.v2i1.19973 Bangladesh Crit Care J March 2014; 2 (1): 48-49

Neurological features of severe hypoglycemia range from reversible focal deficits to irreversible coma or death. Diffusion weighted MRI of brain image is a useful tool in evaluating profound hypoglycemic brain injuries. We report a case of 27 year old male who died from brain injuries following an episode of prolonged hypoglycemia. We here discuss the neuropathological and diffusion-MRI changes of hypoglycemic brain injuries and its prognostic importance. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 60-63