No abstract

Neurologic involvement of brucellosis is common but exact prevalence of it is unknown due to difficulty in diagnosis and inadequate reporting all over the world. Neurologic involvement may manifest as chronic meningitis, lymphocytic meningoencephalitis, a variety of cranial nerve deficits, or ruptured mycotic aneurysms. We report a case of young male who had history of fever and headache on and off for 2 years and later developed signs of meningitis, lateral rectus palsy, altered sensorium and bilateral papilledema. He did not respond to anti-tubercular therapy and antibiotics. CT scan and MRI brain were normal. He had hepato-splenomegaly with small hypoechoic lesions in the spleen. CSF culture grew gram negative bacilli. Brucella IgG antibodies in serum by EIA 7, IgM negative, Brucella antigen titer was positive, 1:160. Patient received inj. streptomycin 0.75 g for 21 days and doxycycline 100 mg twice daily doxycycline for 6 weeks. The complete improvement in patient's condition after a long lasting illness motivated authors to report this case. Delay or failure in diagnosis of this treatable disease may lead to significant morbidity and mortality so high index of suspicion should be kept in such cases.

To evaluate the outcome of manual small incision cataract surgery (MSICS) under topical anesthesia alone in patients at risk for local invasive anesthesia due to cardiac disease. MATERIALS AND METHODS: A retrospective analysis of all patients with underlying cardiac disease and operated for cataract under topical proparacaine, was done. Data was analyzed for demographic variants, operative experience, intra-and postoperative complications, need of conversion to peribulbar block, visual outcome and effect of surgery on cardiac disease. RESULTS: A total of 78 eyes of 60 patients with existing cardiac disease underwent manual small incision cataract surgery under topical anesthesia were analyzed. All patients underwent surgery without any major surgery related complications. No patient had complications related to IHD both intra-and early postoperative period. CONCLUSION: MSICS under topical anesthesia with proparacaine is safe and effective for high risk patients with coexisting cardiac disease without any compromise in visual outcome.