scholarly journals Addition of the combination of sims technique and semi-fowler positioning to cardiorespiratory exercises in patients with myasthenia gravis: case report

2021 ◽  
Vol 9 (8) ◽  
pp. 2459
Author(s):  
Putu Ayu Meka Raini ◽  
Luh Putu Ratna Sundari ◽  
Ni Kadek Yuni Fridayani
Keyword(s):  
Myasthenia Gravis ◽  
Respiratory Muscle ◽  
Autoimmune Disorder ◽  
Active Range Of Motion ◽  
Postural Drainage ◽  
History Of ◽  
Hospital Acquired Pneumonia ◽  
Respiratory Training ◽  
Hospital Acquired ◽  
Increased Activity

Myasthenia gravis (MG) is an autoimmune disorder characterized by fluctuating muscle fatigue, worsening with increased activity, and improving at rest. Physiotherapy plays a role in reducing symptoms such as shortness of breath, respiratory muscle weakness, and airway obstruction due to decrease the sputum in the lung lobes and prevent of the exacerbation. Respiratory training and postural drainage techniques are part of intervention that given by physiotherapy for patients diagnosed with MG and had symptoms hospital acquired pneumonia (HAP). A male, 28 years old patient diagnosed with HAP and had history of MG hospitalized a month with dyspnoea and disable to do activity daily living. Physiotherapy treatment that given to the patient from 18th July 2018 till 28th July 2018 are respiratory training included breathing exercise, cough exercise, shoulder expansion, Active Range of motion (ROM) exercise, stretching of respiratory muscle and home program exercise that helped by nurse and caregiver. Patient had medical treatment from all medical team by pulmonologist, neurologist and nurse too. Combined this new technique postural drainage and all physiotherapy programs showed significant in patient such as dyspnoea decreased. 

scholarly journals Seeking spark- ocular myasthenia gravis in a juvenile – an Indian case report

2020 ◽  
Vol 5 (7) ◽  
pp. 190-193
Author(s):  
Dr. Usha BR. ◽  
◽  
Dr. Nandhini K ◽  
Dr. Chaitra MC ◽  
◽  
...  
Keyword(s):  
Case Report ◽  
Neuromuscular Junction ◽  
Myasthenia Gravis ◽  
Autoimmune Disorder ◽  
Bilateral Ptosis ◽  
Ocular Myasthenia ◽  
Ocular Myasthenia Gravis ◽  
History Of ◽  
High Index Of Suspicion

Myasthenia gravis (MG) is a rare autoimmune disorder affecting neuromuscular junction by muscleweakness. Myasthenia gravis can be generalized or localized as ocular myasthenia gravis. Casepresentation: We report an 8-year-old boy who presented with 10 days history of drooping of botheyelids and 8 days history of diplopia. Examination revealed bilateral ptosis. A diagnosis of JuvenileOcular Myasthenia gravis was made when symptoms improved with intramuscular Edrophoniumadministration. He was commenced on oral Neostigmine at a dose of 2mg/Kg/ day,4 hourly individed doses and is on regular follow up and had a good response. Conclusion: Ocular Myastheniagravis (OMG) is a rare disease in itself. A high index of suspicion is required in a juvenile as it iseven rarer.

scholarly journals An Unusual Presentation of Lyme Neuroborreliosis

2015 ◽  
Vol 14 (1) ◽  
pp. 32-35
Author(s):  
Laura Kitto ◽  
◽  
Chris McKenna ◽  
Keyword(s):  
Back Pain ◽  
Incidental Finding ◽  
Lyme Neuroborreliosis ◽  
Common Symptom ◽  
Functional Diagnosis ◽  
Acute Medical Unit ◽  
History Of ◽  
Severe Back Pain ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Back pain is a common symptom among patients presenting to the acute medical unit. We describe the case of a 55-year-old man with a brief history of fatigue and severe back pain, unresponsive to escalating doses of opiate analgesia. Blood tests and imaging studies were unremarkable and a functional diagnosis was considered. Several weeks into his admission he developed a lower motor neurone facial nerve palsy. He was treated with antibiotics for an incidental finding of a hospital-acquired pneumonia on imaging, which remarkably led to the resolution of his facial palsy and allowed a dramatic reduction in analgesia. This triggered further investigations; identifying Lyme neuroborreliosis as the cause of his symptoms.

scholarly journals Juvenile Myasthenia Gravis: A Case Report and Review of Literatures

2013 ◽  
Vol 29 (1) ◽  
pp. 64-69
Author(s):  
Narayan Chandra Kundu ◽  
Moushumi Sen ◽  
KM Nazmul Islam Joy ◽  
Feroj Ahmed Quraish
Keyword(s):  
Myasthenia Gravis ◽  
Antibody Test ◽  
Autoimmune Disorder ◽  
Repetitive Nerve Stimulation ◽  
History Of ◽  
Congenital Myasthenia ◽  
Pediatric Presentation ◽  
Juvenile Myasthenia Gravis ◽  
Ice Pack ◽  
Anti Acetylcholine

Juvenile myasthenia gravis (JMG) is a rare autoimmune disorder of childhood. Pediatric presentation of MG is more common in Oriental than in Caucasian populations. JMG need to be differentiated from congenital myasthenia gravis which do not have haan autoimmune basis. An 11 years old girl presented with drooping of eye lids which was more marked at the later part of day and was gradually progressive . She had complained of double vision. She had no family history of myasthenia gravis. Ice pack test, repetitive nerve stimulation test, and anti acetylcholine receptor antibody test support the diagnosis. She was treated with pyridostigmine and was started as 30mg four times daily and increased to 60 mg/qds. Subsequently her symptoms improved gradually and she became stable. Bangladesh Journal of Neuroscience 2013; Vol. 29 (1) : 64-69

scholarly journals Adrenal Incidentaloma In Patient with Bilateral Nephrolithiasis and Infectef Right Kidney Cyst

2020 ◽  
Vol 1 (2) ◽  
pp. 31
Author(s):  
Kholidatul Husna ◽  
Hermina Novida
Keyword(s):  
Left Kidney ◽  
Malignant Lesion ◽  
Adrenal Incidentaloma ◽  
Signs And Symptoms ◽  
Kidney Cyst ◽  
Abdominal Ct Scan ◽  
Suprarenal Mass ◽  
History Of ◽  
Hospital Acquired Pneumonia ◽  
Hospital Acquired

Adrenal incidentaloma (AI) is a rare case, with a prevalence of 3-7% in the general population. We report a case of a 66 year old female, presented with the history of bilateral flank pain. The patient was performed urologic evaluation due to suspicion of right perirenal abscess and left kidney tumor, and from abdominal CT scan it was found suprarenal mass. There were no signs and symptoms of hormonal hyperfunction. Radiological evaluation in the patient showed the present of malignant lesion. Therefore, adrenalectomy was planned. Before undergoing adrenalectomy, the patient had passed away 6 days after first surgery (right pyelolitotomy and unroofing cyst), with septic shock suspected as cause of death due to hospital-acquired pneumonia.

Hospital Acquired Pneumonia

2016 ◽  
Author(s):  
Joshua Lupton
Keyword(s):  
The Elderly ◽  
Chronic Obstructive ◽  
Microbial Infection ◽  
Term Care ◽  
Obstructive Pulmonary Disease ◽  
Increased Risk ◽  
History Of ◽  
Hospital Acquired Pneumonia ◽  
Pulmonary Parenchyma ◽  
Hospital Acquired

Pneumonia consists of inflammation of the pulmonary parenchyma, typically resulting from a microbial infection. Hospital-acquired pneumonia (HAP) occurs in (typically elderly) patients in long-term care facilities, with regular IV therapy, with immunosuppression, or with a history of recent treatment at a hospital. It is associated with high mortality. The majority HAP patients present with some constellation of cough, fever, sputum production, and pleuritic chest pain. Patients with chronic obstructive pulmonary disease (COPD) and cystic fibrosis are at increased risk for pneumonia. The Infectious Disease Society of America requires infiltrates on chest x-ray or other imaging for the diagnosis of pneumonia. For hospitalized patients, empiric antimicrobial therapy for HAP should be given as soon as pneumonia is highly suspected. There is currently a vaccine available against Streptococcus pneumonia that all patients should be offered before discharge from the hospital. The elderly are already more susceptible to HAP due to decreased mobility and increased comorbidities.

scholarly journals Liver Cirrhosis and Diabetes Mellitus Are Risk Factors forStaphylococcus aureusInfection in Patients with Healthcare-Associated or Hospital-Acquired Pneumonia

2016 ◽  
Vol 2016 ◽  
pp. 1-6 ◽  
Author(s):  
Huang-Pin Wu ◽  
Chien-Ming Chu ◽  
Chun-Yao Lin ◽  
Chung-Chieh Yu ◽  
Chung-Ching Hua ◽  
...  
Keyword(s):  
Diabetes Mellitus ◽  
Risk Factors ◽  
Liver Cirrhosis ◽  
Empiric Antibiotic Therapy ◽  
Chronic Obstructive ◽  
Obstructive Pulmonary Disease ◽  
History Of ◽  
Hospital Acquired Pneumonia ◽  
Healthcare Associated ◽  
Hospital Acquired

Background.The risk factors forStaphylococcus aureus(S. aureus) pneumonia are not fully identified. The aim of this work was to find out the clinical characteristics associated withS. aureusinfection in patients with healthcare-associated pneumonia (HCAP) and hospital-acquired pneumonia (HAP), which may be applicable for more appropriate selection of empiric antibiotic therapy.Methods.From July 2007 to June 2010, patients who were admitted to the intensive care unit with severe HCAP/HAP and severe sepsis were enrolled in this study. Lower respiratory tract sample was semiquantitatively cultured. Initial broad-spectrum antibiotics were chosen by Taiwan or American guidelines for pneumonia management. Standard bundle therapies were provided to all patients according to the guidelines of the Surviving Sepsis Campaign.Results.The most frequently isolated pathogens werePseudomonas aeruginosa,S. aureus,Acinetobacter baumannii,Klebsiella pneumoniae, andEscherichia coli. Patients with positive isolation ofS. aureusin culture had significantly higher history of liver cirrhosis and diabetes mellitus, with odds ratios of 3.098 and 1.899, respectively. TheS. aureuspneumonia was not correlated with history of chronic obstructive pulmonary disease, hypertension, and hemodialysis.Conclusion.Liver cirrhosis and diabetes mellitus may be risk factors forS. aureusinfection in patients with severe HCAP or HAP.

Rhabdomyolysis in DOMS

1999 ◽  
Vol 38 (05) ◽  
pp. 164-168 ◽  
Author(s):  
Gloria Ruiz Hernandez ◽  
C. Sanchez Marchori ◽  
J. Munoz Moliner ◽  
C. Martinez Carsi
Keyword(s):  
Bone Scintigraphy ◽  
Previous History ◽  
Biochemical Studies ◽  
History Of ◽  
Increased Activity

SummaryA 26-year-old man with a previous history of external twin bursitis was remitted to our Department for a bone scintigraphy. Before the study, the patient performed an elevated number of intense sprints. Bone scintigraphy showed a bilaterally increased activity in both anterior rectum muscles suggesting rhabdomyolysis. Biochemical studies and MRT confirmed the diagnosis.

scholarly journals Safety and effectiveness of eculizumab in Japanese patients with generalized myasthenia gravis: interim analysis of post-marketing surveillance

2021 ◽  
Vol 14 ◽  
pp. 175628642110019
Author(s):  
Hiroyuki Murai ◽  
Shigeaki Suzuki ◽  
Miki Hasebe ◽  
Yuji Fukamizu ◽  
Ema Rodrigues ◽  
...  
Keyword(s):  
Myasthenia Gravis ◽  
Interim Analysis ◽  
Japanese Patients ◽  
Phase Iii ◽  
High Dose ◽  
Complement Protein ◽  
Double Blind ◽  
Post Marketing Surveillance ◽  
Post Marketing ◽  
History Of

Background: Eculizumab, a humanized monoclonal antibody targeted to terminal complement protein C5, is approved in Japan for treatment of patients with anti-acetylcholine receptor antibody-positive (AChR+) generalized myasthenia gravis (gMG) whose symptoms are difficult to control with high-dose intravenous immunoglobulin (IVIg) therapy or plasmapheresis. Methods: This interim analysis of mandatory post-marketing surveillance in Japan assessed the safety and effectiveness of eculizumab at 26 weeks after treatment initiation in patients with AChR+ gMG. Results: Data were available for 40 adult patients in Japan [62.5% (25/40) female; mean age at eculizumab initiation, 51.0 years]. Fifteen patients had a history of thymoma. Six patients were excluded from the effectiveness analysis set due to participation in the open-label extension part of the phase III, randomized, double-blind, placebo-controlled REGAIN study [ClinicalTrials.gov identifier: NCT02301624]. After 26 weeks’ follow up, 32 patients (80%) were continuing eculizumab treatment. Adverse drug reactions were reported by seven patients [most frequently headache ( n = 3)]. One death was reported during eculizumab treatment (relationship unclear as determined by the treating physician) and there was one death 45 days after the last dose (considered unrelated). No meningococcal infections were reported. Mean (standard deviation) changes from baseline in Myasthenia Gravis-Activities of Daily Living (MG-ADL) and Quantitative Myasthenia Gravis (QMG) scores were −3.7 (2.61) ( n = 27) and −5.6 (3.50) ( n = 26), respectively, at 12 weeks, and −4.3 (2.72) ( n = 26) and −5.6 (4.02) ( n = 24), respectively, at 26 weeks. Improvements in MG-ADL and QMG scores were generally similar in patients with/without a history of thymoma. Frequency of IVIg use decreased following eculizumab initiation. Conclusion: In a real-world setting, eculizumab was effective and well tolerated for the treatment of AChR+ gMG in adult Japanese patients whose disease was refractory to IVIg or plasmapheresis. These findings are consistent with the efficacy and safety results from the global phase III REGAIN study of eculizumab.

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