Homoeopathy in the Treatment of Post-Stroke Complications: A Case Report

2021 ◽  
Vol 34 (04) ◽  
pp. 311-316
Author(s):  
Abhijit Dutta
Keyword(s):  
Muscle Power ◽  
Causal Attribution ◽  
Single Case ◽  
Clinical Approach ◽  
Limb Weakness ◽  
Subsequent Increase ◽  
Gradual Improvement ◽  
Therapeutic Modalities ◽  
Neuropsychiatric Complications ◽  
Long Run

Abstract Background Long-term muscular and neuropsychiatric complications are common in stroke survivors. The main aim of therapeutic modalities for such cases is to limit the extent of disabilities and subsequent increase in the activity of daily living. Every case is different in pathology and manifestation, so requires an individualistic approach. Case A 63-year-old man presented with right upper limb weakness, dysarthria and memory weakness after stroke. He had been undergoing conventional physical rehabilitation therapy but due to feasibility issues, he could not continue and opted for homoeopathic treatment. Following a thorough clinical and psychological evaluation, he was treated with homoeopathic medicines tailored to his specific needs. The Medical Research Council scale for muscle power, the Modified Ashworth Scale for muscle spasticity and the Stroke Impact Scale for quality of life after stroke were used to assess outcomes at various time points. Different physical and cognitive domains showed gradual improvement. Conclusion This case demonstrates the complexities of clinical outcomes following a stroke and how those can be improved through the individualistic approach of homoeopathy. Nevertheless, a firm conclusion regarding causal attribution cannot be drawn from a single case, but a detailed clinical approach may be followed. Large-sample randomised controlled trials are impractical for the individualised approach of therapy or complex clinical conditions; thus, the ‘n-of-1’ trial may be adopted in the long run.

EFFICACY OF SHASTIKA SHALI PINDA SWEDA IN MUSCULAR DYSTROPHY: A CASE STUDY

2021 ◽  
Vol 12 (4) ◽  
pp. 12-14
Author(s):  
Pratima Yadav ◽  
Ajay Kumar
Keyword(s):  
Muscular Dystrophy ◽  
Muscle Power ◽  
Muscle Tone ◽  
Single Case ◽  
Lower Limbs ◽  
Single Case Study ◽  
Limb Weakness ◽  
Loss Of Appetite

Muscular dystrophy is a group of diseases that make muscles weaker and less flexible over time. This disease comes under Beeja dosha and Mamsavaha Srotodushti which leads to Mamsavaha Kshaya and impairment of Mamsagni and can be treated as Mamsagat vata which is explained in Ayurvedic text. This is a single case study was conducted to evaluate the efficacy of Shastika Shali Pinda Sweda in muscular dystrophy. The case report is A female patient aged 14 years was admitted in IPD of Kayachikitsa and Panchakarma with complains of both lower limb weakness, loss of muscle strength. It was a diagnosed case of muscular dystrophy. The patient was unable to walk, sit and stand properly due to the weakness in lower limbs and other associated symptoms loss of appetite, weakness. Diagnosis done by the examination of muscle power and tone. During the examination, Muscle tone and power diminished in the lower limbs of the patient. Materials and methods are Shastika Shali, Bala mool (decoction), Milk, Ksheer bala tail (for Abhyanga). Triphala churna 1 gram at bedtime and Shunthi churna 0.5 gram two times before meal given to enhancing the appetite. Shastika Shali Pinda Sweda was done for 14 days regularly and then follow-up after 1 month. The patient showed significant improvement in muscle weakness, and she can be able to do her work without any support. This single case study shows the efficacy of Panchakarma procedure and minimize the severity of disease and improving quality of life of patients.

scholarly journals The heart of myofibrillary myopathy

2021 ◽  
Author(s):  
Natália Merten Athayde ◽  
Alzira Alves de Siqueira Carvalho
Keyword(s):  
Protein A ◽  
Cardiac Pacemaker ◽  
Fatty Degeneration ◽  
Lower Limbs ◽  
Clinical Approach ◽  
Limb Weakness ◽  
Muscle Mri ◽  
Morphological Findings ◽  
Neurological Exam ◽  
Determining Factor

Context: Myofibrillar myopathies (MFM) represent a heterogeneous group of disorders of skeletal and cardiac muscle caused by mutations in genes that encode proteins of sarcomere. Diagnosis is a challenge due to clinical and genetic variability. Case report: Woman, 36 years old, presenting stumbles and falls for 3 years evolving with proximal limb weakness. At age 30, she fainted and a cardiac pacemaker was implanted. Non-consanguineous parents. Neurological exam: proximal and distal weakness in lower limbs and distal atrophy; osteotendinous reflexes normal. Bilateral scapula alata. Exams: CPK = 457 U / l; EMG: myopathic pattern. Muscle MRI: diffuse and heterogeneous fatty degeneration, marked in sartorius, gracilis and semitedinous. Panel NGS myopathies: pathogenic variant, c.1175T> C, missense in heterozygosis in desmin gene. CONCLUSION: The diagnosis of MFM is based on the morphological findings of muscle biopsy with the presence of protein aggregates as a determining factor. Currently, genetic testing by NGS has facilitated early diagnosis allowing for a more appropriate clinical approach. The desmin gene was the first one described to be associated with this group of myopathies. It encodes the desmin protein, a member of the intermediate filament family present in cardiac and skeletal muscle. Several phenotypes are related to desmin gene: isolated dilated cardiomyopathy; scapuloperoneal weakness and distoproximal weakness with cardiac alterations. Desminopathy is a rare cause of cardiomyopathy and / or myopathy. The diagnosis should be thought in patient with muscle weakness and cardiac changes.

Nutritional neuropathy postoesophagogastrectomy

2021 ◽  
Vol 14 (5) ◽  
pp. e242716
Author(s):  
Paul Ryan ◽  
Peter Kinirons
Keyword(s):  
Lower Limb ◽  
Proximal Gastrectomy ◽  
Immunoglobulin Therapy ◽  
Blood Levels ◽  
Limb Weakness ◽  
Intravenous Immunoglobulin Therapy ◽  
Gradual Improvement ◽  
Csf Analysis ◽  
Spinal Imaging ◽  
Guillain Barré

We report a case of a patient who presented complaining of a 1-week history of progressive lower limb weakness and decreased sensation bilaterally suggestive of a peripheral neuropathy, with vague associated symptoms of fluctuating concentration. Clinically, we suspected a Guillain-Barré variant. However, her functioning continued to decline despite intravenous immunoglobulin therapy, and she had normal spinal imaging studies and CSF analysis. Of note, she had a subtotal oesophagectomy and proximal gastrectomy 20 months previously for oesophageal cancer. We found her to be deficient in vitamin D, vitamin E and copper. She was treated with nutritional supplementation of these vitamins and infusion of trace elements, resulting in a gradual improvement in lower limb power, sensation and coordination, as well as improved cognition and mentation. Monthly outpatient neurology follow-up shows continued improvement in symptoms and return towards baseline functioning with regular infusions of nutritional elements and monitoring of blood levels.

Level and Trend of Writing Sequences: A Review and Meta-Analysis of Writing Interventions for Students With Disabilities

2019 ◽  
Vol 86 (2) ◽  
pp. 174-192
Author(s):  
Shawn M. Datchuk ◽  
Kyle Wagner ◽  
Bridget O. Hier
Keyword(s):  
Students With Disabilities ◽  
Single Case ◽  
Meta Analysis ◽  
Strategy Development ◽  
Writing Difficulties ◽  
Gradual Improvement ◽  
Information Theoretic ◽  
Writing Interventions ◽  
Disability Status ◽  
Competing Models

We examined effects of intervention on the level and trend of text-writing sequences of students with disabilities and writing difficulties, in addition to potential moderating effects related to student demographics (i.e., disability status, age, gender, and race) and writing task (i.e., sentence, essay, and narrative). We reviewed 18 single-case experimental design studies with a total of 96 students and subsequently meta-analyzed 15 of these studies with a total of 79 students using mixed-effects linear regression and an information-theoretic ranking of competing models. Results indicate that writing interventions, including direct instruction and self-regulated strategy development, produced gradual improvement in the trend of correct writing sequences per minute. Older students produced higher levels of writing sequences, but younger students showed steeper trends during intervention. Furthermore, students had higher levels of writing fluency on sentence-writing tasks than on discourse-writing tasks (narratives and essays).

Respiratory Failure and Hypoxemia (DRAFT)

2018 ◽  
Author(s):  
Jeffrey K. Javed ◽  
Jason E. Moore
Keyword(s):  
Respiratory Failure ◽  
Work Of Breathing ◽  
Rapid Response Team ◽  
Clinical Approach ◽  
Airway Patency ◽  
Therapeutic Modalities ◽  
Patient Deterioration ◽  
Effective Care ◽  
Response Team ◽  
Treatment Priorities

Respiratory failure and hypoxemia are among the most common problems encountered by the rapid response team (RRT) and can lead to rapid patient deterioration and arrest. A brief, systematic approach focusing on treatment priorities such as airway patency, correcting hypoxemia, and supporting work of breathing, allows RRT responders to quickly provide the appropriate level of supportive care and narrow the complex differential diagnosis of acute respiratory failure. This chapter reviews a logical and efficient clinical diagnostic evaluation, therapeutic modalities including rescue treatments and mechanical ventilation, and transport considerations for this patient group. The pragmatic, problem-based clinical approach discussed in this chapter will help RRTs provide effective care for this group of patients.

BSC and long-term deployment: an actors' perspective

2020 ◽  
Vol 21 (3) ◽  
pp. 383-396
Author(s):  
Pierre-Laurent Bescos ◽  
Aude Deville ◽  
Philippe Foulquier
Keyword(s):  
Balanced Scorecard ◽  
Single Case ◽  
Actor Network Theory ◽  
Insurance Company ◽  
Cross Sectional ◽  
Content Type ◽  
The Balanced Scorecard ◽  
Long Run ◽  
Human Actors

PurposeThis paper examines the roles of the balanced scorecard (BSC) in a long-term perspective and with a large deployment along numerous hierarchical levels. For this purpose, we use a longitudinal analysis of an implementation in a mutual insurance company.Design/methodology/approachWe combine actor–network theory (ANT) with interventionist research (IVR) to analyze the interrelation between human and non-human actors. Our study is based on various materials like interviews, meeting reports, graphs and so on.FindingsThe BSC is considered as a non-human actor which influences the human actors and provides specific benefits from a long-term use, due to various roles played by this tool (a mediator role, completed by a role of translator and revealer).Research limitations/implicationsResearch based on larger cross-sectional studies are necessary to more deeply validate our results based on a single case study.Practical implicationsThis paper gives some insights on processes and on actors an organization can mobilize to maintain the benefits provided by a large BSC use in the long run.Originality/valueIn line with the ANT concepts, our main contribution is to explain the outcomes of an innovation in management accounting by the consequences of adaptation mechanisms grounded on actors, translations, alliances and trials of strength.

scholarly journals MACROSCOPIC OBSERVABLES AND THE BORN RULE, I: LONG RUN FREQUENCIES

2008 ◽  
Vol 20 (10) ◽  
pp. 1173-1190 ◽  
Author(s):  
N. P. LANDSMAN
Keyword(s):  
Quantum Mechanics ◽  
Quantum System ◽  
Single Case ◽  
Born Rule ◽  
C Algebra ◽  
C Algebras ◽  
Long Run ◽  
Frequency Interpretation ◽  
Continuous Fields ◽  
The One

We clarify the role of the Born rule in the Copenhagen Interpretation of quantum mechanics by deriving it from Bohr's doctrine of classical concepts, translated into the following mathematical statement: a quantum system described by a noncommutative C*-algebra of observables is empirically accessible only through associated commutative C*-algebras. The Born probabilities emerge as the relative frequencies of outcomes in long runs of measurements on a quantum system; it is not necessary to adopt the frequency interpretation of single-case probabilities (which will be the subject of a sequel paper). Our derivation of the Born rule uses ideas from a program begun by Finkelstein [17] and Hartle [21], intending to remove the Born rule as a separate postulate of quantum mechanics. Mathematically speaking, our approach refines previous elaborations of this program — notably the one due to Farhi, Goldstone, and Gutmann [15] as completed by Van Wesep [50] — in replacing infinite tensor products of Hilbert spaces by continuous fields of C*-algebras. Furthermore, instead of relying on the controversial eigenstate-eigenvalue link in quantum theory, our derivation just assumes that pure states in classical physics have the usual interpretation as truthmakers that assign sharp values to observables.

scholarly journals Successful treatment of granuloma faciale

2020 ◽  
Vol 7 (1) ◽  
pp. 129
Author(s):  
Sahar H. Alsharif ◽  
Reda H. Saifaldeen ◽  
Logain G. Alghanemi
Keyword(s):  
Successful Treatment ◽  
Topical Steroids ◽  
Erythematous Plaque ◽  
Gradual Improvement ◽  
Topical Tacrolimus ◽  
Therapeutic Modalities ◽  
Granuloma Faciale ◽  
The Face ◽  
History Of

<p class="abstract">Granuloma faciale (GF) is a chronic condition characterized by asymptomatic erythematous plaque with prominent telangiectasia presenting usually over the face. Although the condition is benign, its treatment is often unsatisfactory. Therapeutic modalities that have been tried include topical steroids and topical tacrolimus sometimes enhanced with topical dapsone. Others include intralesional corticosteroids, antimalarials, isoniazid and pulsed-dye laser. We report a case of a 58 years old female with a 1 year history of a solitary slowly progressive plaque over the nose. Diagnosis of GF was made based on the histopathological findings. The patient was started on the combination of topical tacrolimus, intralesional corticosteroids injection and oral doxycycline for 3 months. The patient showed gradual improvement in 3 months without any side effects. This case supports previous papers of successful treatment of GF with topical tacrolimus. There was no recurrence at follow-up 18 months later. It also supports the use of combination therapy especially in resistant cases.</p>

scholarly journals Hypokalaemic paralysis and metabolic alkalosis in a patient with Sjögren syndrome: a case report and literature review

2021 ◽  
Vol 22 (1) ◽  
Author(s):  
Rasika Ranaweerage ◽  
Shehan Perera ◽  
Aruna Gunapala
Keyword(s):  
Lower Limb ◽  
Metabolic Alkalosis ◽  
Muscle Power ◽  
Autoimmune Disorders ◽  
Sjögren Syndrome ◽  
Gitelman Syndrome ◽  
Sjogren Syndrome ◽  
Limb Weakness ◽  
Primary Sjögren Syndrome ◽  
History Of

Abstract Background Acquired Gitelman syndrome is a very rare disorder reported in association with autoimmune disorders, mostly Sjögren syndrome. It is characterized by the presence of hypokalaemic metabolic alkalosis, hypocalciuria, hypomagnesaemia and hyper-reninaemia, in the absence of typical genetic mutations associated with inherited Gitelman syndrome. Case presentation A 20 year old woman who was previously diagnosed with primary Sjögren syndrome and autoimmune thyroiditis presented with two week history of lower limb weakness and salt craving. Examination revealed upper limb and lower limb muscle weakness with muscle power of 3/5 on MRC scale and diminished deep tendon reflexes. On evaluation, she had hypokalaemia with high trans-tubular potassium gradient, metabolic alkalosis and hypocalciuria, features suggestive of Gitelman syndrome. New onset hypokalaemic alkalosis in a previously normokalaemic patient with Sjögren syndrome strongly favored a diagnosis of acquired Gitelman syndrome. Daily potassium supplementation and spironolactone resulted in complete clinical recovery. Conclusions Acquired Gitelman syndrome associated with Sjögren syndrome is rare. It should be considered as a differential diagnosis during evaluation of acute paralysis and hypokalaemic metabolic alkalosis in patients with autoimmune disorders, especially Sjögren syndrome.

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