scholarly journals Clinical Study of Bell's Palsy at Tertiary Care: Our Experience

2019 ◽  
Vol 02 (01) ◽  
pp. 16-20
Author(s):  
M. B. Bharathi ◽  
Thanzeem Unisa ◽  
Swathi Chandresh ◽  
Venkatesh C. R. ◽  
Harsha S.

Abstract Introduction Bell's palsy (BP) is the common cause of facial palsy. This study aims to report and analyze the age, sex distribution, symptomatology, site of lesion, and prognosis in 101 patients with (BP). Materials and Methods This is a cross-sectional study conducted at tertiary referral center, JSS Hospital, Mysuru. All patients consenting to participate in this study, of all ages, of either sex, both outpatients and inpatients with a diagnosis of BP during this study period were included. Results Of the 101 patients analyzed, maximum cases (25.7%) were in third decade of age; 55.4% were males, and both right and left sides of the face were equally involved. Maximum number of patients (50.5%) had a history of postaural pain at presentation Topodiagnostic tests showed majority of BP cases involving geniculate or suprageniculate regions (67.3%) in our study. 20.8% had lesion above the nerve to stapedius, and 11.9% had lesion below the nerve to stapedius. Electrodiagnostic test—electroneuromyography (ENMG)—was abnormal in 57 (67.1%) individuals at day 4. 50.4% of patients had a House-Brackmann (HB) facial nerve grade IV at presentation. 90% of the BP group in our study recovered normal to near-normal facial nerve function by the end of 28 days’ time. Conclusion Each case of BP should be evaluated with thorough clinical examination, topodiagnostic tests, and electrodiagnostic tests. Appropriate management will help in almost full recovery of disease.

2020 ◽  
Vol 24 (2) ◽  
pp. 149-155
Author(s):  
Hamzullah Khan ◽  
Mohammad Zahid Khan ◽  
Mian Mohammad Naveed

Objective: To determine the frequency of COVID-19 and characteristics of patients presenting to the COVID-19 clinic at Qazi Hussain Ahmed Medical Complex (QHAMC) Nowshera. Methodology: This cross-sectional study was conducted from 21st Feb 2019 to April 8, 2020, in QHAMC Nowshera. Relevant information was collected on a pre-designed Performa prepared following the objectives of the study. Results: Out of 220 patients, 165(75%) were males, and 55(25%) females. 96(43.6%) of the patients were in the age range 18-30 years followed by 52(23.6%) in age range 31-45years and 17(7.7%) with age>60 years etc. Out of total the nasopharyngeal swabs of 26(11.6%) strong suspects were sent for PCR testing. 208(94.5%) were sent home while 12(5.5%) were advised quarantine. Forty-seven (21.4%) had a travel history to an epidemic area in the last 14 days. 51(23.2%) had a positive history of contact. Eighty-five (38.6%) had a fever and sore throat followed by 27(12.3%) with (fever & cough), 24(10.9%) with (cough and shortness of breath/dyspnea) and 14(6.4%) with a simple flue, etc. Out of 26 cases, 6(2.7%) were COVID-19 Positive, 12(5.5%) were negative and results of 8(3.6%) were still awaited. The PCR repeated the test for confirmed cases showed;  4(1.8%) negative, one died and one was refractory positive.  A positive correlation (p=0.03, r=0.4) of an increase in age with the severity of the disease/outcome was recorded. Conclusion: The frequency of infectivity with COVID-19 was 2.6%. A higher number of patients with mild symptoms attend the COVID clinic. The rate of infection and mortality was higher in age> 60 years.


2018 ◽  
Vol 12 (1) ◽  
pp. 827-836 ◽  
Author(s):  
Ahmed Hassan Kamil Mustafa ◽  
Ahmed Mohammed Sulaiman

Background: Bell’s palsy is an acute idiopathic facial nerve paralysis of sudden onset. It is the most common cause of lower motor neuron facial nerve paralysis with an annual incidence of 15-30 per 100,000. The objective of this work is to study the prevalence and the management of Bell’s palsy in the Sudan. A descreptive retrospective cross-sectional study was carried at Khartoum Teaching Dental Hospital, Khartoum General Teaching Hospital. In the retrospective, the records and files of 698 patients with Bell’s palsy, were reviewed in relation to age, gender, site, risk factors, season, and type of treatment. In addition, 48 patients with Bell’s palsy were evaluated using the House–Brackman scale in relation to the above-mentioned variables. Therefore, a total number of 746 cases were studied. Fifty five percent of them were females and the remaining 45% were males, around 38% of them were in the age group 21-40 year. Fifty seven percent of the patients were affected on the right side of the face. Winter was the commonest season of onset where 53.5% of the cases occurred. Steroids are the commonly prescribed drugs in majority of the cases, accounting for 47.3%. Study Design: The study is a retrospective cross sectional hospital based study. The study was carried out in Khartoum Teaching Dental Hospital and in the Physiotherapy Department of Khartoum Teaching General hospital. The files and records of the patients with Bell’s palsy in Khartoum Teaching Dental Hospital in the years 1/1/2004 -31/12/2008, and Khartoum Teaching General Hospital (physiotherapy department) in the years 2007- July 2009 (total number 746). Results: A total number of 746 cases were studied . Fifty five percent of them were females and the remaining 45% were male. Around 38% of them were in the group 21-40 year. Fifty seven percent of the patients were affected on the right side of the face. Winter was the commonest season of the onset where 53.5% of the cases occurred. Conclusion: The study showed predominance of females. A peak incidence was seen in the age group 21-40 years. A predilection was found for the right side of face.


2021 ◽  
pp. 46-48
Author(s):  
Muzaffer Rashid Shawl ◽  
Fahad ul Islam Mir ◽  
Saad Abdul Rahman ◽  
Anil C Anand ◽  
Manav Wadhawan ◽  
...  

NAFLD is hepatic pandemic of the twenty rst century, being leading cause of chronic hepatic disease in western world. We did a cross sectional study to nd out prevalence of NAFLD among prospective healthy liver donors at a tertiary care hospital at New Delhi, India over a period from June 2014 to March 2016. 124 apparently healthy prospective liver donors were selected. Exclusion criteria were set to exclude all those who had signicant history of alcohol intake (dened as greater than 30g/day for men and greater than 20g/day for women over last two years), Hepatitis B or C infection, severe surgical weight loss or emaciation, Obstructive Sleep Apnea, Celiac disease, history of drug intake known to cause hepatic steatosis. Out of 124 prospective liver donors included in this study, 29 (23%) donors were found to have fatty liver on USG abdomen; 38 (31%) donors had fatty liver on unenhanced CTof the abdomen (LAI of ≤ 5 HU); 61 (49%) donors had fatty liver on magnetic resonance.


2021 ◽  
Vol 09 (3) ◽  
pp. 650-656
Author(s):  
Ram Lakhan Meena ◽  
Santoshkumar Bhatted ◽  
Nilam Meena

Bell’s palsy, also known as acute idiopathic lower motor neuron facial paralysis, is characterized by sud-den onset paralysis or weakness of the muscles to one side of the face controlled by the facial nerve. In contemporary science, administration of steroids is the treatment of choice for complete facial palsy. Cer-tain Panchakarma procedures and internal Ayurvedic medicines have been proved to be beneficial in the management of Ardita vata. The present report deals with a case of 62-year-old male patient diagnosed as Ardita vata was treated with various Panchakarma procedures like Nasya, Shirobasti, Kukkutanda Swedana, Dashmoola Ksheer Dhoom, Gandoosh and oral Ayurveda medicines. Criteria of assessment was based on the scoring of House-Brackmann Facial Nerve Grading scale. After completion of Ayurveda treatment, the patient Shown almost complete recovery without any adverse effects. This case is an evi-dence to demonstrate the effectiveness of Ayurveda treatment in case of Ardita vata (Bell’s palsy).


Author(s):  
Pooja Gupta ◽  
Mariyam Faruqi ◽  
Subrat Chandra ◽  
Sameer S. Shah ◽  
Rupita Kulshreshtha

Background: The study was undertaken to see the correlation between cervical cytology, histopathology and colposcopy in the diagnosis and management of various cervical lesions.Methods: It is a cross sectional study conducted at a tertiary care hospital in Mumbai, in the department of obstetrics and gynecology from February 2007 to March 2008. A total 55 sexually active women were enrolled for the study who belonged to age group greater than 20 years with history of chronic leucorrhoea or post-coital bleeding/spotting, intermenstrual bleeding/spotting or examination findings of erosion, an unhealthy cervix, a lesion bleeding on touch or an abnormal or suspicious Papanicolaou smear. These women then underwent cytology, colposcopy and cervical biopsy.Results: The accuracy of cytology when compared to colposcopy was 81.82%. The accuracy of colpo-histopathology was 83.6%. The combined accuracy was 76.36%.Conclusions: The simultaneous use of cytological studies and screening colposcopy has been shown to increase the cervical cancer detection. Colposcopy offers an excellent tool in the hands of a gynaecologist to evaluate the uterine cervix and it is not possible to develop this kind of perspective by any other method.


2014 ◽  
Vol 2 (2) ◽  
pp. 64-67 ◽  
Author(s):  
Tanzima Begum ◽  
Md Ismail Khan ◽  
Shamima Kawser ◽  
Md Ehsanul Huq ◽  
Nadira Majid ◽  
...  

Background: Drug can cure ailment when used rationally on the other hand they may become harmful or even may threaten a life when used irrationally. Absence of guidelines for antibiotic use, protocols for rational therapeutics and infection control committees, have led to overuse and misuse of antimicrobials even in different specialized units in hospitals. Objective: The study has been designed to get a picture of use of antibiotics in a tertiary care hospital of Bangladesh. Materials and method: Cross sectional study was conducted in the department of Medicine of Sir Salimullah Medical College and Mitford Hospital, Dhaka, Bangladesh, for 3 months from 1st January 2009 to 31st March 2009. Admitted patients of Medicine unit-1 who got antibiotics were included in the study. Total number of patients was 1563. Results: Five hundred out of 1563 patients were prescribed antibiotics (38%). Out of 500 prescriptions, 68(14%) prescriptions were found irrational. Conclusion: Continuous surveillance should be carried out to reduce the irrational use of antibiotics. DOI: http://dx.doi.org/10.3329/dmcj.v2i2.20526 Delta Med Col J. Jul 2014; 2(2): 64-67


2017 ◽  
Vol 156 (5) ◽  
pp. 828-833
Author(s):  
Carlos Andrés Cárdenas Palacio ◽  
Francisco Alejandro Múnera Galarza

Objective Bell’s palsy is a cranial nerve VII dysfunction that renders the patient unable to control facial muscles from the affected side. Nevertheless, some patients have reported cutaneous changes in the paretic area. Therefore, cutaneous sensibility changes might be possible additional symptoms within the clinical presentation of this disorder. Accordingly, the aim of this research was to investigate the relationship between cutaneous sensibility and facial paralysis severity in these patients. Study Design Prospective longitudinal cohort study. Settings Tertiary care medical center. Subjects and Methods Twelve acute-onset Bell’s palsy patients were enrolled from March to September 2009. In addition, 12 sex- and age-matched healthy volunteers were tested. Cutaneous sensibility was evaluated with pressure threshold and 2-point discrimination at 6 areas of the face. Facial paralysis severity was evaluated with the House-Brackmann scale. Results Statistically significant correlations based on the Spearman’s test were found between facial paralysis severity and cutaneous sensitivity on forehead, eyelid, cheek, nose, and lip ( P < .05). Additionally, significant differences based on the Student’s t test were observed between both sides of the face in 2-point discrimination on eyelid, cheek, and lip ( P < .05) in Bell’s palsy patients but not in healthy subjects. Conclusion Such results suggest a possible relationship between the loss of motor control of the face and changes in facial sensory information processing. Such findings are worth further research about the neurophysiologic changes associated with the cutaneous sensibility disturbances of these patients.


2021 ◽  
Vol 7 (6) ◽  
pp. e639
Author(s):  
Chul-Hoo Kang ◽  
Young Mee Kim ◽  
Yang-Ji Kim ◽  
Su-Jeong Hong ◽  
Do Yoon Kim ◽  
...  

ObjectiveThis study aimed to determine the frequency of pathogenic NOTCH3 variants among Koreans.MethodsIn this cross-sectional study, we queried for pathogenic NOTCH3 variants in 2 Korean public genome databases: the Korean Reference Genome Database (KRGDB) and the Korean Genome Project (Korea1K). In addition, we screened the 3 most common pathogenic NOTCH3 variants (p.Arg75Pro, p.Arg544Cys, and p.Arg578Cys) for 1,000 individuals on Jeju Island, where the largest number of patients with cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL) have been reported in Korea.ResultsThe pathogenic NOTCH3 variant (p.Arg544Cys) was found in 0.12% of sequences in the KRGDB, and 3 pathogenic variants (p.Arg75Pro, p.Arg182Cys, and p.Arg544Cys) were present in 0.44% of the Korea1K database. Of the 1,000 individuals on Jeju Island, we found 2 cysteine-altering NOTCH3 variants (p.Arg544Cys variant in 9 and p.Arg578Cys in 1 individual) in 1.00% of the participants (95% confidence interval: 0.48%–1.83%). The presence of cysteine-altering NOTCH3 variants was significantly associated with a history of stroke (p < 0.001).DiscussionPathogenic NOTCH3 variants are frequently found in the general Korean population. Such a high prevalence of pathogenic variants could threaten the brain health of tens of thousands to hundreds of thousands of older adults in Korea.


2012 ◽  
Vol 30 (2) ◽  
pp. 78-84
Author(s):  
L Khondker ◽  
AM Choudhury ◽  
MOR Shah ◽  
M Shahidullah ◽  
MSI Khan ◽  
...  

A cross sectional study, conducted in the department of  Dermatology and Venereology, Bangabandhu Sheikh Mujib  Medical University (BSMMU) for duration of January 2009  to December 2010. Hundred twenty patients with  onychomycosis were selected by purposive type of nonprobability  sampling technique. Majority of the patients  61(150.8%) were in the age group of 21-30 years old. Mean  age of the patients were 32.8±14 years and most of the  patients were house wives 36(30.0%). Disfigurement  117(97.5%) and discomfort 89(74.2%) were more common  chief complaints of the patients. The mean duration of  disease was 20.4±15.4 months and nail fold changes were  associated with 37(30.8%) patients and more than a half  63(52.5%) of the patients had history of wet works.  Regarding the history of past illness, it was observed that  previous onychmycosis found 26(21.7%), nail trauma  26(21.7%) and immune suppression 6(5.0%). In  endocrinopathies, hypothyroidism was observed in 1(0.8%),  Diabetes Mellitus 6(5.0%) etc. Regarding the pattern of nail  changes, thickening of nail plate 88(73.3%), onycholysis  67(55.8%), subungunal hyperkeratosis 61(50.8%) were  more common changes. Paronychia was observed in 34  (28.3%) cases. In concomitant fungal infection, it was  observed that T. manuum in 6(5.0%), T. pedis 3(2.5%),  Interdigital intertrigo 2(1.7%) and T. cruris 1(0.8%). This  was a study on a limited number of cases. Future studies  must include economical support, then large sample size  could be ensured and study finding would be more reliable.  There is a great need of epidemiological studies also, with  sufficient follow-up, systematic reviews and meta-analyses  on this issue.   DOI: http://dx.doi.org/10.3329/jbcps.v30i2.11408   J Bangladesh Coll Phys Surg 2012; 30: 78-84    


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