scholarly journals Outcome of Patients with Gullain Barre syndrome at Tertiary Care Hospital in Eastern Nepal

2018 ◽  
Vol 6 (2) ◽  
pp. 20-24
Author(s):  
Dilli Ram Kafle ◽  
Surendra Shah
Keyword(s):  
Early Diagnosis ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Acute Flaccid Paralysis ◽  
Flaccid Paralysis ◽  
Care Hospital ◽  
Limb Weakness ◽  
Medical College ◽  
History Of ◽  
Tract Infections

Background: Gullain Barre syndrome is the most common cause of acute flaccid paralysis. Early diagnosis and treatment improves survival in patients with Gullain Barre Syndrome.Material and Methods: The purpose of the study was to note the common clinical features and identify predictors of outcome in Patients with Gullain Barre Syndrome. It is a prospective study which was conducted at Nobel Medical College Teaching Hospital from April 2015 to March 2016.Results: Time between onset of symptoms, presentation to hospital and admission was 5 ± 4 days. Four Patients (20%) gave history of upper respiratory tract infections and 12 (60%) had diarrhoea. Limb weakness was the most common symptom, which was documented in 20 (100%) patients. Other common symptoms were limb paresthesia, limb pain, and bladder dysfunction. Cerebrospinal Fluid protein was raised in 16(80%) patients to more than 45 mg/dl. All of our patients had CSF cell count less than 10. One (5%) patient had normal nerve conduction study initially. Eight (40%) patients had axonal (AMAN) variant of GBS, 3(15%) had AMSAN variant of GBS, while 8(40%) had demyelinating neuropathy (AIDP). The mean duration of hospital stay was7.4 ±2.7 days. Three months after hospital discharge 12(60%) patients achieved complete recovery. Eight (40%) patients still needed some support with ambulation. Predictors of worse outcome were old age, rapid progression of disease and AMSAN variant of GBS.Conclusion: Gullain Barre syndrome is an important cause of acute flaccid paralysis in children and adults. Early diagnosis is based on history of symmetrical limb weakness, CSF Findings and nerve conduction study. Majority of patients improve with supportive care while some develop respiratory failure and needs mechanical intubation. Journal of Nobel Medical College Volume 6, Number 2, Issue 11 (July-December, 2017) Page:20-24

Role of Nerve Conduction Study in Polyneuropathy

2019 ◽  
Vol 31 (1) ◽  
pp. 3-8
Author(s):  
Abdullah Al Hasan ◽  
Mohshina Abedin ◽  
Md Robed Amin ◽  
Shah Habibur Rahman ◽  
Salina Daisy ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factor ◽  
Clinical Examination ◽  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Critical Role ◽  
Medical College ◽  
History Of ◽  
Antecedent Infection

Background: Polyneuropathy has many different causes. It is often very difficult to find out the cause. Nerve conduction study (NCS) can classify neuropathy as axonal and demyelinatig variety and direct the search for cause. Methodology: Purposively selected 80 patients from the department of Neurology Dhaka Medical College during the period of January 2009 to June 2010 were taken for NCS whose were compatible with polyneuropathy by history and clinical examination. Clinical, electrophysiological feature and pattern of polyneuropathy were analyzed. Results: Mean age of the patients was 34.5 ±6.8 and M: F was 1.8:1. Students, laborer and cultivators were the most affected people. 55% patients were acute cases and 35% patients were chronic Cases. 30% patient had no known risk factor for neuropathy 25% patient had antecedent infection, 15% had diabetes mellitus, 7.5% were exposed to drugs/toxins or solvents and 5% had family history of neuropathy. In clinical examination 37.5% patients were in motor type, 10% pure sensory type and 52.5% mixed sensorimotor type. In NCS47.5% were motor, 7.5% pure sensory 45% mixed sensorimotor type. Axonal were 47.5%, demyelinating 27.5% and 25% as mixed axonal and demyelinating type. Conclusion: NCS in polyneuropathy play critical role by classifying it as axonal or demyelinating and shorten the cause. Bangladesh J Medicine Jan 2020; 31(1) : 3-8

scholarly journals An audit of patients referred for nerve conduction study in a tertiary care hospital in Bangladesh

2015 ◽  
Vol 23 (1) ◽  
pp. 102-108
Author(s):  
Rajib Nayan Chowdhury ◽  
Md Enayet Hussain ◽  
Md Nahidul Islam ◽  
Mostafa Hosen ◽  
AFM Al Masum Khan ◽  
...  
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Chronic Inflammatory Demyelinating Polyneuropathy ◽  
Tertiary Care ◽  
Retrospective Chart Review ◽  
Demyelinating Polyneuropathy ◽  
Care Hospital ◽  
Tertiary Care Centre ◽  
Medical College ◽  
Inflammatory Demyelinating Polyneuropathy

Background: To examine the pattern and burden of neurologic disorders at electrophysiology lab of a tertiary care centre. Methodology: This retrospective chart review was carried out from the records and notes of electrophysiology lab in National Institute of Neurosciences and Hospital (NINS) from January to December 2013. A total of 1372 patients were evaluated with nerve conduction study (NCS) and electromyography (EMG) during this period. Result: Majority of the patients (67.6%) presented after forty with a mean age at presentation of 48.11±17.3 years. The male patients (55.2%) predominated. Carpal tunnel syndrome (CTS) was the most common condition (19.2%) observed, followed by different form of polyneuropathy namely Guillain Barre Syndrome (GBS) (6.04% with 50% being Acute inflammatory demyelinating polyneuropathy (AIDP), chronic inflammatory demyelinating polyneuropathy (CIDP) (3.27%), sensory motor polyneuropathy 3.13% and multifocal acquired motor axonopathy (MAMA) 2.55%. Though plexopathy and radiculopathy were rare (1.09 and 0.94% respectively), anterior horn cell disease was not that uncommon (8.73%). Disorders of muscle and neuromuscular junction (myasthenia gravis) were seen in 5.1% and 1.89% patient. Other various conditions (e.g. stroke, cerebral palsy, myelopathy) were observed in 10.05%. NCS and EMG were found to be normal in 270 patients (19.6%). Conclusion: Wide ranges of neurological problems are often referred to electrophysiology lab. Where ever the facilities and expert hands are available, these tests can help in diagnosing and classifying these cases. DOI: http://dx.doi.org/10.3329/jdmc.v23i1.22703 J Dhaka Medical College, Vol. 23, No.1, April, 2014, Page 102-108

scholarly journals VAGINAL DISCHARGE

2011 ◽  
Vol 18 (04) ◽  
pp. 598-603
Author(s):  
SHAHIDA SHAIKH ◽  
SALEEM AKHTER SHAIKH ◽  
INAYAT MAGSI
Keyword(s):  
Vaginal Discharge ◽  
Tertiary Care ◽  
Care Hospital ◽  
College Hospital ◽  
Internally Displaced ◽  
Syndromic Management ◽  
Sexually Transmitted ◽  
Medical College ◽  
Abnormal Growth ◽  
History Of

Objective: To observe the results of syndromic management in women living in IDPs camps complaining of chronic vaginal discharge. Design: Descriptive study. Setting: Medical Camps at Larkana set by Chandka Medical College Hospital for Internally Displaced Persons (IDPs) due to floods. Period: 1st September 2010 to 31st December 2010. Material and Methods: Total 200 symptomatic patients aged from 20 to 50 years suffering from chronic vaginal discharge having history of more than 6 months duration were included in the study. Asymptomatic as well as pregnant women and patients with abnormal cervix and having abnormal growth on cervix were excluded from the study. A detailed history and examination (including speculum and vaginal) was done and a proforma was filled. All these patients were given empirical treatment recommended by WHO as syndromic management consisting of stat doses of antifungal along with antibiotics, where no laboratory tests are required before treatment. Results: Next to vaginal discharge which was main symptom in all patients, the other symptoms like dusparunia, dysuria, itching ,lower abdomen pain and low backache was reported 9%, 16%, 20%, 24% and 31% respectively. Also 8% patients reported post coital bleeding. All patients were married and the mean age of the patients was 28+0.2 years and 15% of them were over 40 years. Mean parity was 4±1.Vaginal infection improved in 65% of the patients excellently with a first line single course of antibiotic and percentage raised up to 88% with second course. 19(9.5%) patients couldn’t be followed as they left that camp and 5(2.5%) patients who did not improve with two courses of antibiotics had big cervical erosions, referred to nearby tertiary care hospital for further management. Conclusions: IDPs live in poor conditions in camps without basic facilities and where it is difficult to perform bedside tests like microscopy, Potassium Hydroxide, wet mount films and tests for Sexually transmitted diseases like Chlamydia and gonorrhea are not available, syndromic management there is a rational way of treating cases of chronic vaginal discharge to get quicker response in such desperate women. 

scholarly journals A Clinico-epidemiological Study of Malaria Patients Admitted in A Tertiary Care Hospital of Bangladesh

2020 ◽  
Vol 4 (2) ◽  
Keyword(s):  
Diagnostic Test ◽  
Tertiary Care ◽  
Medical College Hospital ◽  
Clinical Aspects ◽  
Case Report Form ◽  
Care Hospital ◽  
Mosquito Net ◽  
College Hospital ◽  
Medical College ◽  
History Of

Malaria is a public health problem in 90 countries around the world affecting 300 million people and responsible for about 1 million deaths annually. Bangladesh is considered as one of the malaria endemic countries in Asia. Every year large number of people suffered for malaria. But there is little studies about clinico-epidemiology of malaria. Aim: To study the epidemiological and clinical aspects of malaria. Methods: This is a Prospective observational study that was conducted in all medicine unit of Chittagong Medical College Hospital, Chittagong, Bangladesh during August 2017 to June 2018. Total 55 patients were included in the study having malaria diagnosed by blood slide examination or rapid diagnostic test. Patients were enrolled in this study after getting written informed consent from the patient or attendant. Detail demographic and clinical data were recorded in structured case report form. Patients were regularly followed up and outcome recorded. Results: Results showed males (65.5%) of 25±15.109 years of age were the main sufferer. Majority (45%) came from low socio-economic condition (<5000 taka/month). 65.5% patients denied any history of recent travel to malarias’ area. 69.1% cases give history of using mosquito net, but only 25.5% have insecticide treated mosquito net. Majority (89.1%) were diagnosed as severe malaria and only few (10.9%) as uncomplicated malaria. Most of the diagnosis done at Chittagong Medical College Hospital, mainly presenting with coma or altered consciousness and convulsion. At field level diagnostic test done in 67.27% cases, of which RDT in 14.5%, BSE in 45.5% and both in 7.3% cases. 78.2% cases outcome were good with improvement and death occurred in 21.8% cases, mainly due to acute renal failure. Conclusion: Though we are making significant effort to control malaria, still we have to improve in controlling malaria based on both preventing the infection and on prompt effective treatment of the infection and illness when it does occur.

scholarly journals Prevalence and Causes of Infertility in Overweight and Obese Women in a Tertiary Care Hospital Setup in Mangalore - A Retrospective Secondary Data Analysis

2021 ◽  
Vol 8 (29) ◽  
pp. 2656-2660
Author(s):  
Keerthana Dhandapani ◽  
Bhagyalakshmi Kodavanji ◽  
Vinodini N.A ◽  
Priyadarisini N.J ◽  
Shripad B. Deshpande
Keyword(s):  
Healthy Lifestyle ◽  
Tertiary Care ◽  
Secondary Data ◽  
Care Hospital ◽  
Obese Women ◽  
Secondary Infertility ◽  
Infertile Women ◽  
Medical College ◽  
Ovulatory Dysfunction ◽  
History Of

BACKGROUND Obesity has become an epidemic worldwide. Several mechanisms are involved in the relationship of fertility and obesity, including metabolic and reproductive functions. In light of the fact that most of the causes of infertility are treatable, there is a need to document the diagnostic findings in overweight and obese infertile women. The causes of infertility prevalent in a particular region can be provided by hospital-based studies. So, the present study is designed to find out the common causes of infertility in overweight & obese women and to gain knowledge regarding the prevalence of primary and secondary infertility among these infertile women. METHODS The data of 115 infertile women (18 to 45 years) were collected from hospitals under Kasturba Medical College (KMC), Mangalore retrospectively. Data of history of previous conception, body mass index (BMI), type of infertility, duration of infertility, age and the causes of infertility were collected. The prevalence of each cause was evaluated. RESULTS Among 115 infertile women, 92 (80 %) were pre–obese and 23 (20 %) were obese (P - .001). Primary infertility was most common in pre obese women and secondary infertility in obese women which was statistically significant (P < .05). Ovulatory dysfunction was the most common cause in obese infertile women (P - .004), whereas in pre obese women, it was uterine and adnexal causes. CONCLUSIONS Comparatively, maintaining a healthy lifestyle can avoid fertility problems in pre obese women, because the effect of BMI on hypothalamic–pituitary-gonadal (HPG) axis is higher in obese women in whom ovulatory disorders were the leading cause. The significance of weight reduction before pregnancy should be informed to overweight and obese patients and should be aided to lose weight. Treatment of anaemia itself may resolve the infertility issues and should be taken as a first line treatment in all cases. KEYWORDS Female Infertility, Adipose Tissue, Obesity, Infertility Causes, Ovulatory Dysfunction

scholarly journals Parésia Hipocaliemica em Adolescente: Um Caso Clínico

2019 ◽  
Vol 32 (5) ◽  
pp. 400
Author(s):  
Ana Catarina Carvalho ◽  
Joana Matos ◽  
Susana Lira ◽  
Ana Reis
Keyword(s):  
Autosomal Dominant ◽  
Acute Flaccid Paralysis ◽  
Pediatric Emergency ◽  
Sudden Onset ◽  
Periodic Paralysis ◽  
Flaccid Paralysis ◽  
Rare Form ◽  
Fourth Decade ◽  
History Of ◽  
Hypokalaemic Periodic Paralysis

Familial hypokalaemic periodic paralysis is a rare autosomal dominant neuromuscular disease characterized by episodic attacks of flaccid paralysis with concomitant hypokalaemia. We present a case of a 15-year-old male adolescent observed in the pediatric emergency department by flaccid paresis of the 4 limbs of sudden onset and progressive worsening. In the anamnesis, corticosteroid and antihistamine intake were observed on the previous day for urticaria and family history of transient episodes of flaccid paralysis in adolescence, asymptomatic after the fourth decade of life, without an established diagnosis. Diagnostic tests revealed hypokalaemia (K + < 2.4 mEq/L), without hypokaluria and without other changes. Symptomatology resolution after supplementation with potassium was verified until normalization of kaliemia. Flaccid paralysis is a rare form of presentation of hypokalaemia. Several etiologies may be involved in the child or adolescent presenting with acute flaccid paralysis. The description of this case draws attention to the importance of the knowledge of this entity, because if recognized and treated properly, patients usually recover without sequelae.

Relationship between Blood Pressure and Nutrition in Adolescents

2018 ◽  
Vol 3 (02) ◽  
Author(s):  
Dr. Haresh D. Godia ◽  
Dr. Lalit H Nikam
Keyword(s):  
Blood Pressure ◽  
Diastolic Blood Pressure ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Female Students ◽  
Male Students ◽  
Care Hospital ◽  
Medical College ◽  
History Of ◽  
Males And Females

Aims and Objectives of study: This study was confined to healthy groups. Care was taken to exclude persons suffering from obvious disease and/ or recent history of illness Aims and Objective of present study are:- To find out BMI males and females To find out systolic and diastolic blood pressure in males and females. The various parameters which are studies are as follows:- Standing height in cms Weight in kgs. Resting pulse rate Resting systolic blood pressure in mm of Hg. Resting diastolic blood pressure in mm of Hg. Body Mass Index. Background - The study was conducted in GSMC medical college and Tertiary care Hospital. Total 100students were selected for study, out of 50 were male students and 50 were female students.

scholarly journals EARLY DIAGNOSIS IN BELL??S PALSY. A NERVE CONDUCTION STUDY

1980 ◽  
Vol 90 (10) ◽  
pp. 1705???1708 ◽  
Author(s):  
H. Z. Joachims ◽  
V. Bialik ◽  
I. Eliachar
Keyword(s):  
Early Diagnosis ◽  
Nerve Conduction Study ◽  
Nerve Conduction

scholarly journals A Case of Nivolumab-Induced Severe Mononeuropathy Multiplex and Rhabdomyolysis

2017 ◽  
Vol 2017 ◽  
pp. 1-4 ◽  
Author(s):  
Katsuya Sakai ◽  
Hitoshi Mochizuki ◽  
Kosuke Mochida ◽  
Kazutaka Shiomi ◽  
Masahiro Amano ◽  
...  
Keyword(s):  
Nerve Conduction Study ◽  
Nerve Conduction ◽  
Immune Checkpoint Inhibitor ◽  
Checkpoint Inhibitor ◽  
Oral Prednisolone ◽  
Resonance Imaging ◽  
Intravenous Methylprednisolone ◽  
Limb Weakness ◽  
Muscle Impairment ◽  
Multiple Liver Metastases

We report an 81-year-old man with multiple liver metastases after tumorectomy for primary mediastinal malignant melanoma, who experienced limb weakness and sensory disturbance after nivolumab monotherapy. He was diagnosed with nivolumab-induced mononeuropathy multiplex and rhabdomyolysis based on serologic examination, muscle biopsy, magnetic resonance imaging of the limbs, and a nerve conduction study. A course of intravenous methylprednisolone (mPSL) was initiated at 1 g/day for 3 days. After that, oral prednisolone (PSL) was started at 1 mg/kg/day and gradually tapered. Limb muscle strength improved, but when PSL was reduced to 0.3 mg/kg/day, the weakness recurred, and a nerve conduction study showed exacerbation of mononeuropathy multiplex. The patient was again administered intravenous mPSL (0.5 g/day for 3 days) followed by oral PSL at 0.5 mg/kg/day, and his neurological symptoms improved. Nivolumab, an immune checkpoint inhibitor, is used for the treatment of advanced melanoma and other cancers and causes various immune-related adverse events (irAEs). However, neurological irAEs related to nivolumab are rare. Furthermore, there are no reports of simultaneous nerve and muscle impairment. Unexpected irAEs affecting various organs should be recognized and treated appropriately.

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