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Introduction. Mannose-binding lectin (MBL) activates complement system and has been suggested to play a role in vascular complications in diabetics. Carotid intima-media thickness (cIMT) detects subclinical atherosclerosis. We evaluated the association of MBL and IMT in type 2 diabetic (T2DM) patients.Methods. Serum MBL levels and cIMT were measured in a total of 103 diabetics and in 98 age-matched healthy controls.Results. There was no significant difference in MBL level in T2DM versus controls. As expected, IMT was significantly higher in T2DM patients than in controls (P=0.001). In T2DM, the lowest cIMT was seen in patients with normal MBL level (500–1000) while cIMT continuously increased with both high MBL and absolute MBL deficiency states. This was especially significant in high MBL versus normal MBL T2DM patients (P=0.002). According to multiple regression analysis the main predictors of IMT in T2DM are age (P<0.003), ApoA level (P=0.023), and the MBL (P=0.036).Conclusions. Our results suggest a dual role of MBL as a risk factor for cIMT in T2DM. MBL may also be used as a marker of macrovascular disease, as both low and high levels indicate the susceptibility for atherosclerosis in T2DM.

Propofol, an intravenous anesthetic agent induces priapism in humans. We hypothesize the probable central nervous system and local mechanisms through which a similar molecule can be used as a therapy in erectile dysfunction. Previous literatures published over a period of 35years (1976–2010) were searched using the key words, mechanisms were identified and discussed. In the central nervous system, propofol has an inhibitory effect on serotonin receptors and on gamma-aminobutyric acid A (GABA-A) receptors as well as a facilitatory action on N -methyl-d-aspartate (NMDA) mediated calcium response and agonistic action on dopaminergic D2 receptors, which might contribute towards maintaining erections. While in the penile tissue, propofol's action may be due to increased synthesis of nitric oxide (NO), the principal mediator of penile erection. In addition, it may also have inhibitory effect on thromboxane A2, a potent vasoconstrictor and stimulatory action on penile adenosine triphosphate (ATP) dependent potassium (K-ATP) channels, a potent vasodilator. In view of the above mechanisms, use of propofol or similar molecule in erectile dysfunction needs to be ascertained and evaluated.

Tension Pneumocephalus (PC) was described 50 years ago. A case of pneumocephalus (PC) following cervical epidural injection in a 50-year-old male worsened by air travel and manifested as tension pneumocephalus, confirmed by advanced neuroimaging, is reported for the first time along with literature review. The patient underwent emergent frontal burr hole evacuation and air gushed under pressure. The patient recovered well and is stable during a follow-up of 12 months. Presenting features and clinical course along with Mount Fuji sign, Peaking sign, and air bubble sign observed in this case are described. Also, the importance of considering neurosurgical and spinal procedures leading to PC have to be considered by practitioners before issuing fitness certificate before air travel, as PC is likely to get transformed to tension PC and can cause an in-flight emergency.

Yawning is phylogenetically ancient and associated with a stereotyped behavioral pattern.To describe the pattern of associated movements observed in hemiplegic limbs during yawning and its relationship to gender, laterality of hemiplegia and muscle tone.An observational study was designed for 75 patients with newly detected anterior circulatory stroke due to ischemia or hemorrhage in the internal capsule region. The subjects were free from any arthropathy, autoimmune disease, muscular disorders and injury/deformity.There were 48 males and 27 females, whose median ages were 48 and 47 years, respectively. The median yawning onset times after stroke in males and females were 36 and 38 h, respectively. Associated movements in hemiplegic limbs during yawning were minimal and observed in 59 hemiplegics (78.6%); significantly more were seen in males (83%) vs. females (70%), left-sided (94%) vs. right-sided hemiplegics (64%), those with hypotonia (87%) vs. hypertonia (61%), and in the upper limbs (91%) vs. lower limbs (83%)and proximal (72%) vs. distal joints (29%), irrespective of limb.The appearance of associated movements in hemiplegic limbs indicates the return of ancestral function observed in quadrupeds. However, further studies are needed to ascertain the reasons for such variations and determine how to utilize these movements in rehabilitation programs.