Although many approaches have been tried in the attempt to reduce the devastating impact of stroke, tissue plasminogen activator for thromboembolic stroke is the only proved, effective acute stroke treatment to date. Vasopressin, an acute-phase reactant, is released after brain injury and is partially responsible for the subsequent inflammatory response via activation of divergent pathways. Recently there has been increasing interest in vasopressin because it is implicated in inflammation, cerebral edema, increased intracerebral pressure, and cerebral ion and neurotransmitter dysfunctions after cerebral ischemia. Additionally, copeptin, a byproduct of vasopressin production, may serve as a promising independent marker of tissue damage and prognosis after stroke, thereby corroborating the role of vasopressin in acute brain injury. Thus, vasopressin antagonists have a potential role in early stroke intervention, an effect thought to be mediated via interactions with aquaporin receptors, specifically aquaporin-4. Despite some ambiguity, vasopressin V1a receptor antagonism has been consistently associated with attenuated secondary brain injury and edema in experimental stroke models. The role of the vasopressin V2 receptor remains unclear, but perhaps it is involved in a positive feedback loop for vasopressin expression. Despite the encouraging initial findings we report here, future research is required to characterize further the utility of vasopressin antagonists in treatment of stroke.

Objectives: To estimate the prevalence and seasonal distribution of Rotavirus diarrhea in hospitalized children less than 5 years in South Rajasthan. Design: Cross-sectional study. Setting: Bal-Chikitsalaya, RNT Medical College, Udaipur, Rajasthan. Methods: Hospitalized children less than 5 years admitted for acute diarrhea were examined and standardized proforma was used to collect the demographic and clinical profile of the children. Severity of the illness was classified as per Vesikari scoring system and the dehydration was treated as per WHO protocol. Stool samples were collected and tested for gross appearance, routine microscopy, pH, reducing sugar and Rotaviral antigen by a commercial enzyme Immunoassay kit (SD BIOLINE KIT). Results: Out of 300 children, 94(31.33%) were positive for Rotavirus. The prevalence of Rotaviral diarrhea in children was as follows: <6 months-14.8%, 6-12 months-45.7%, 12-24 months-38.3% and >24 months-0.01%. Rotaviral diarrhea was more common during Winter and Spring months (September to April) 91.4%, with highest prevalence in the months of November (52%), December (68%) and January (56%). Rotavirus negative diarrhea had high prevalence (62.6%) during summer and monsoon months (March-August). Out of 94 rotavirus positive children, 6 cases (6.38%) had no dehydration, 55(58.51%) had some dehydration and 33 (35.10%) had severe dehydration. Among the Rotavirus positive children, vomiting was present in 70 (74.46%) children and fever in 52 (55.31%) children. Conclusions: The prevalence of Rotaviral diarrhea in children less than 5 years in southern Rajasthan is high and it is more common during Winter and Spring seasons of the year.

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The hyper-immunoglobulin E syndrome (HIES) is a rare primary immunodeficiency disorder characterized by high serum levels of immunoglobulin E (IgE), recurrent cutaneous and pulmonary infections, chronic dermatitis and a variety of connective tissue and skeletal abnormalities. These patients share characteristic facial appearance and many oral manifestations. We report a case of hyper IgE syndrome (HIES) also known as “Job syndrome“.