A 31-year-old woman presented with a one-week history of headache, generalised lethargy, weakness and poor appetite. Clinical examination showed that her blood pressure was 200/120 mmHg. On an earlier occasion, her blood pressure was found to be normal by a general practitioner whom she last visited three months earlier when she had an upper respiratory tract infection. Investigations showed hypokalaemia, suppressed serum renin and aldosterone. Further history was taken and revealed that she had been craving for guava fruits which she ate with flavoured "asam boi" (containing glycyrrhizic acid) at least three spoonfuls twice a day for the past six weeks. The hypertension and hypokalaemia resolved after two weeks of stopping the "asam boi". Her clinical picture was compatible with exogenously-induced hypermineralocortoidism.
Aiming at the implementation of brain-machine interfaces (BMI) for the aid of disabled people, this paper presents a system design for real-time communication between the BMI and programmable logic controllers (PLCs) to control an electrical actuator that could be used in devices to help the disabled. Motor imaginary signals extracted from the brain’s motor cortex using an electroencephalogram (EEG) were used as a control signal. The EEG signals were pre-processed by means of adaptive recursive band-pass filtrations (ARBF) and classified using simplified fuzzy adaptive resonance theory mapping (ARTMAP) in which the classified signals are then translated into control signals used for machine control via the PLC. A real-time test system was designed using MATLAB for signal processing, KEP-Ware V4 OLE for process control (OPC), a wireless local area network router, an Omron Sysmac CPM1 PLC and a 5 V/0.3A motor. This paper explains the signal processing techniques, the PLC's hardware configuration, OPC configuration and real-time data exchange between MATLAB and PLC using the MATLAB OPC toolbox. The test results indicate that the function of exchanging real-time data can be attained between the BMI and PLC through OPC server and proves that it is an effective and feasible method to be applied to devices such as wheelchairs or electronic equipment.
Central vein stenosis is usually associated with previous cannulation or trauma to the affected vein. This pathology may present as ipsilateral arm swelling in patients in whom a recent arteriovenous fistula has been prepared for chronic hemodialysis. The presence of central vein stenosis without prior trauma or cannulation is not hitherto reported to the best of our knowledge. We herewith report a patient with end-stage renal disease who was initiated on chronic dialysis using an arteriovenous fistula, who was noted to have central vein stenosis. This was despite her never having had any central vein cannulation or previous known trauma. Venogram confirmed the presence of brachiocephalic vein stenosis. The patient underwent venographic stenting of the involved vein with good success.
Systemic Lupus Erythematosus (SLE) is a disease with multiorgan involvement and multiple autoantibody production including antineutrophil cytoplasmic antibodies (ANCA). Despite its reported prevalence in more than one third of SLE patients, the role of ANCA in the pathogenesis or otherwise in SLE remains unresolved. 131 SLE patients had been previously studied for various serologic parameters of disease activity. Their cumulative organ involvement in the course of their disease had also been determined and the Lupus Activity Index (LAI) calculated. Their stored sera were then screened for the presence of ANCA by two methods viz Indirect immunofluorescence (IIF) and also enzyme-linked immunosorbent assay (ELISA). ANCA was present in 24.8% of these SLE patients. The atypical ANCA pattern was predominant and accounted for an overall of 20.6%. Anti-MPO and anti-PR3 were detected in 1.5% of patients respectively. No association was found between ANCA positivity and disease activity. There was also no association of ANCA with specific organ involvement. Despite the high prevalence of ANCA especially the atypical variant in SLE, they probably represent only one of the wide repertoire of autoantibodies found in this disease. Routine testing for ANCA in lupus patients is therefore not recommended.