Tuberculous meningitis (TBM) is a sub acute or chronic inflammation of the cerebral meninges caused by tubercule bacilli, the diagnosis for which is still very intricate. To establish a rapid diagnosis, we used Sodium dodecyl suplhate polyacrylamide gel electrophoresis (SDS-PAGE) for the detection of marker protein in CSF specific to TBM patients. CSF was collected by standard lumbar puncture technique. Polyclonal antibody was raised against sonicated M.tuberculosis of H37RV in rabbit. 145 CSF samples were collected for this study over a period of two and half years which included 44 suspected and one proven case of TBM. In this communication we have investigated for a possible presence of a marker protein(s) in cerebrospinal fluid (CSF) of TBM patients. Two bands, a 30kd and a 14kd were detected. The 30kd band was observed in 92% cases of TBM patients. The 14kd band was not much of diagnostic importance since it was found in only about 45%. None of the control group patients had these protein bands. The 30 kd protein band either disappeared or became faint on anti-TB medication. To evaluate whether the eluted 30 kd protein was a mycobacterium tuberculosis product, gel retardation assay was also performed. The 30kd protein did not react with the polyclonal antisera. The CSF biochemical picture correlated well with the presence of this protein band. This study suggests that 30kd protein band observed in CSF is not a Mycobacterium product and is not only an important diagnostic marker for early diagnosis of TBM but may also be useful for monitoring the post treatment phase.

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Some times, the clinician / researcher may be looking for time or interval before the next event occurs, as in the case of an epileptic fit. The statistical method used for such analysis is life table analysis or survival analysis. This method allows the researcher to use data from patients who drop out/die during the follow up period as well as those who may not experience the event at the end of the study. Thus it is possible to compute the amount of risk of occurrence at a particular time point. In this review an attempt is made to introduce the topic popularly known as survival analysis along with two illustrations.

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We report an unusual hypersensitivity reaction to carbamazephine. A seven year old girl with seizure disorder presented with lymphadenopathy while on carbamazepine. Fine needle aspiration and cytology of lymph nodes revealed features of reactive amenities. Spontaneous resolution of lymphadenopathy was notices after carbamazepine was discontinued. A diagnosis of drug-induced lymphadenopathy was considered.

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The clinical profile of 38 cases of episodic and 6 cases of chronic cluster headache patients seen over a period of 15 years is presented. Cluster headache appears to be an uncommon condition in India though the overall clinical pattern seems to be much the same as described from the west. Missed diagnosis is common and the need for accurate elicitation of history in making a correct diagnosis has been stressed.

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The Present article summarises the changing concepts about hysteria from Egyptian papyrus to early 20th century. The contributions of early physicians including Charcot and his pupils in developing bedside clinical methods to differentiate organic disease from hysterical conversion have been highlighted. Various forms of therapy used over several centuries for this fascinating disorder is also discussed.

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Brain abscess is an extremely rare presenting manifestation of pulmonary arteriovenous malformation. A thirty-year-old lady presented with a right fronto-parietal brain abscess. Clinical examination revealed a continuous murmur in the right mammary and axillary regions. X-Ray chest PA view showed characterstic bag of worm appearance in the mid zone of right lung. The brain abscess was drained and the patient made good clinical recovery after four weeks of chemotherapy. This case report highlights the importance of diligent clinical examination and radiological investigations in identifying the source of brain abscess in a seemingly cryptogenic case.

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Knowledge and attitude regarding epilepsy are major factors influencing outcome of treatment and quality of life in the management of epilepsy. Group session is one of the methods available to achieve these goals. It has the advantage of communication to a large number of patients within a short time. We undertook this study to ascertain the efficacy of this technique to impart knowledge and positive attitude towards epilepsy. A structured questionnaire was self administered to 60 patients before and after the meeting and the responses were scored on a scale of 0 to 100. The mean score improved from the baseline value of 73 + 17 to 83 + 13 after the group sessions, which was statistically significant (P<0.01). The change noticed was uniformly significant for all the aspects covered in the questionnaire viz. treatment, education, employment, emotional aspects, family and social aspects. This study has shown that group sessions are effective means to impart knowledge and positive attitude towards epilepsy.

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