scholarly journals Neurological presentation of COVID-19: experience from a tertiary care hospital of Bangladesh

2020 ◽  
pp. 33-40
Author(s):  
Md Rashedul Islam ◽  
Tanbin Rahman ◽  
Syed Mohaimeen Ahmed ◽  
Mohammad Sakhawat Hossen Khan ◽  
Md Rihan Azad ◽  
...  
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Mental Status ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Altered Mental Status ◽  
Cerebrovascular Event ◽  
Care Hospital ◽  
Nervous System Disorder ◽  
System Disorder

Background: Neurological manifestations of COVID-19 are being recognized day by day although predominant presentation is of respiratory illness. Understanding of impact of the virus on nervous system is important for selection and evolution of treatment now and in the future. The aim of the study was to describe the manifestations of COVID-19 affecting nervous system in a tertiary care hospital of Bangladesh Methods: This cross-sectional study was carried out in Department of Neurology, Bangladesh Institute of Research and Rehabilitation in Diabetes, Endocrine and Metabolic Disorders (BIRDEM) General Hospital from March, 2020 to October, 2020. Total forty patients who were admitted under neurology department were included in the study. Evidence of SARS-CoV-2 infection was confirmed in all the patients if RT-PCR of respiratory samples (eg, nasal or throat swab) was positive for viral ribonucleic acid (RNA). Clinical syndromes associated with COVID-19 were classified broadly as a cerebrovascular event, altered mental status and peripheral nervous system disorders. Data were collected on the basis of specific clinical case definitions. Results: Median age of the patients was 58.6 years (range 22–73). Among those, 26 (65%) were male and 14 (35%) were female. Twenty two (55%) of 40 patients presented with cerebrovascular event, of whom 15 (68%) had an ischaemic stroke, 5 (23%) an intracerebral haemorrhage. Two (9%) patients were diagnosed as cerebral venous sinus thrombosis on the basis of clinical presentation and magnetic resonance venography (MRV) finding. Apart from cerebrovascular events, 14 (35%) of 40 patients presented with altered mental status, comprising 9 (64%) patients with unspecified encephalopathy and 5 (36%) patients with encephalitis. Four (10%) patients were diagnosed as peripheral nervous system disorder among those 2 (50%) as Guillain-Barré syndrome (GBS) and 2 (50%) as Bell’s palsy. If we analyze the presenting features of the 40 patients, it is found that, 22 (55%) patients presented with headache, 20 (5%) with hemiparesis, 20 (50%) with speech problems, 19 (48%) with altered mental status, 10(25%) with facial asymmetry, 4 (10%) with seizure. Few percentages of patients presented with anosmia (10%), ageusia (5%) and quadriparesis (5%). Conclusion: Neurological involvement in COVID-19 is one of the major focuses of neurologist now a day. We have found cerebrovascular disese, encephalopathy and peripheral nervous system disorder as presentation of COVID-19 in our study. Prompt recognition of cases and early initiation of therapy will hasten better outcome of the patients. Neurological complications can cause permanent disability that will cost large scale health and economic burden. Further nationwide study is needed to quantify the association and disease burden. Birdem Med J 2020; 10, COVID Supplement: 33-40

scholarly journals Altered Mental Status and a Not-So-Benign Rash

2011 ◽  
Vol 2011 ◽  
pp. 1-2
Author(s):  
Aakash N. Bodhit ◽  
Latha Ganti Stead
Keyword(s):  
Emergency Department ◽  
Mental Status ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Peripheral Blood Smear ◽  
Altered Mental Status ◽  
Care Hospital ◽  
Case Presentation ◽  
Presenting Symptoms ◽  
Symptoms And Signs

Introduction. The authors are presenting a case of Thrombotic Thrombocytopenic Purpura (TTP) that presented with complaints of altered mental status and found to have petechiae.Case Presentation. An 81-year-old female patient presented to the Emergency Department (ED) of a tertiary care hospital with chief complains of dizziness, slurred speech, and weakness. She was found to have lower extremity petechiae on physical examination. On blood exam, she had thrombocytopenia, and her peripheral blood smear showed schistocytes. Her renal function was also impaired. The CT scan of head was without any abnormality. She was finally diagnosed as having TTP and transferred to ICU but ultimately passed away.Conclusion. TTP is a rare syndrome with preventable mortality if diagnosed early and managed appropriately with plasmapheresis. The Emergency Department physicians should be aware of the presenting symptoms and signs of TTP.

scholarly journals A STUDY ON ADVERSE DRUG REACTIONS IN PATIENTS ON ANTIRETROVIRAL THERAPY IN A TERTIARY CARE HOSPITAL AT JAIPUR, RAJASTHAN

2021 ◽  
Vol 5 (8) ◽  
Author(s):  
Vishnu Gupta ◽  
Abhishek Agarwal
Keyword(s):  
Nervous System ◽  
Peripheral Nervous System ◽  
Early Recognition ◽  
Tertiary Care ◽  
Hiv Treatment ◽  
Research Review ◽  
Care Hospital ◽  
Medical College ◽  
The Status ◽  
Definition Of

Background: The present study was conducted to know the status of ADRs caused due to the first line ART in the ART center of SMS Hospital Jaipur, Rajasthan. This study would be beneficial to the HIV infected patients, with the ultimate goal of improving the tolerability and effectiveness of HIV treatment by promoting the early recognition of potentially serious adverse effects. Methods: Hospital based Prospective, Observational study conducted after approval by research review board and ethics committee SMS Medical College Jaipur (Rajasthan). WHO definition of ADR was used (any response to a medicine which is noxious and unintended and which occurs at doses normally used in man). The detail of ADRs collected including suspected drug involved, treatment given for ADRs and outcome. Results: Majority of ADRs were related to central and peripheral nervous system related 55 (47%) followed by gastro intestinal 28 (23.9%), dermatological 15 (12.8%), musculoskeletal 9 (7.7%) and metabolic 5 (4.3%). Conclusion: Majority of ADRs were related to central and peripheral nervous system related followed by gastro intestinal. Keywords: ADRs, HIV, WHO.

scholarly journals Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital

2016 ◽  
Vol 7 (01) ◽  
pp. 114-124 ◽  
Author(s):  
Souren Pal ◽  
Kaushik Sen ◽  
Nirendra Mohan Biswas ◽  
Anirban Ghosal ◽  
S. K. Rousan Jaman ◽  
...  
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tertiary Care Hospital ◽  
Dengue Infection ◽  
Tertiary Care ◽  
Case Series ◽  
Neurological Complications ◽  
Care Hospital ◽  
Eastern India ◽  
Cns Involvement

ABSTRACT Background and Objective: Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement. Materials and Methods: All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens. Results: Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement. Conclusion: This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome.

scholarly journals Analysis of histopathological spectrum of intracranial central nervous system tumours in a tertiary care hospital

2021 ◽  
Author(s):  
Nikhil S. Deshpande ◽  
Anil B. Munemane ◽  
Ravindra R. Karle
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Histopathological Diagnosis ◽  
Care Hospital ◽  
Who Grade ◽  
Central Nervous System Tumours ◽  
International Data ◽  
Cns Tumours

<p><strong>Background:</strong> Descriptive epidemiology of intracranial central nervous system (CNS) tumours is a significant part of tumour studies which provides information on magnitude and distribution of the lesions. The objective of this study is to provide an overview of frequency of intracranial CNS tumours with comparison with national and international data.</p><p><strong>Methods: </strong>In this retrospective study 101 intracranial CNS tumours diagnosed over a period of 4 years were included. Histological diagnosis of tumours was confirmed and they were classified according to revised WHO classification of CNS tumours 2016. Frequencies of tumours in accordance to age, gender, location, laterality and grades were evaluated.</p><p><strong>Results: </strong>Total 101 cases including 59 (58.42%) males and 42 (41.58%) females were studied. Paediatric and adult cases accounted for 17 (16.83%) and 84 (83.17%), respectively. Most tumours were noted in the 6th decade. Out of total cases, 91 (90.1%) were primary intracranial CNS tumours and 10 (9.9%) were metastatic tumours. Most common tumours were astrocytoma followed by meningioma. Among children, astrocytoma (41.18%), medulloblastomas (41.18%), ependymomas (11.76%) and meningiomas (5.88%) were the reported lesions. In adults, astrocytoma (39.29%), meningiomas (23.81%), metastatic tumours (11.90%), ependymomas (8.33%), hemangioblastomas (5.95%) and schwannomas (4.76%) were common. Glioblastomas were the commonest astrocytoma. WHO grade I tumours were commonest followed by grade IV.<strong> </strong></p><p><strong>Conclusions:  </strong>The study gives a glimpse of prevalence of intracranial central nervous system tumours forming a baseline profile based primarily on the histopathological diagnosis at rural tertiary care hospital.</p>

scholarly journals HISTOPATHOLOGICAL STUDY OF SPECTRUM OF THE LESIONS OF CENTRAL NERVOUS SYSTEM IN A TERTIARY CARE HOSPITAL

2015 ◽  
Vol 4 (07) ◽  
pp. 1145-1150
Author(s):  
Kasa Lakshmi ◽  
Hemalatha M ◽  
Surya Babu Sunkesula ◽  
Tamil Arasi D S ◽  
Lingeswara Rao B
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Histopathological Study ◽  
Care Hospital

scholarly journals Rationality of Fixed Dose Combinations of Central Nervous System Drugs in a Tertiary Care Hospital

2019 ◽  
Vol 9 (4-A) ◽  
pp. 15-18
Author(s):  
B.P Anilasree ◽  
K.P Anuroopa ◽  
S Arun Jyothi ◽  
T. Basila ◽  
Swathi Saji
Keyword(s):  
Central Nervous System ◽  
Nervous System ◽  
Tertiary Care Hospital ◽  
Tertiary Care ◽  
Essential Medicine ◽  
World Health ◽  
Fixed Dose ◽  
Care Hospital ◽  
Health Organization ◽  
The Individual

Objectives: To analyze the rationality of central nervous system fixed dose combinations used in a tertiary care hospital. Methodology: The study was an hospital based observational study. The data was collected from an annual drug compendium entitled “Hospital Drug List”. Fixed dose combinations (FDCs) enlisted in central nervous system (CNS) sections were selected for the study purpose. The active pharmacological ingredients (APIs) in FDC was checked for approval by Drug Control General of India (DCGI), World Health Organization (WHO) and essential medicine (EML)/national essential medicine list (NEML),both or none and all the ingredients (molecule, excipients) present in the FDC was checked whether banned or under any controversies in India as well as worldwide.  Efficacy and safety of the individual active pharmacological ingredients (APIs) and their combination were searched. Details of each drug were collected [Generic name, Pharmacokinetics, Interaction affected, Pharmacodynamics, and Advantages of FDCs]. The data collected was analyzed by a tool to assess the rationality of fixed dose combinations which is pre-tested and validated by Shah et al., based on WHO guidelines. Result and Discussion: A total of 25 CNS FDCs were taken, on assessment of CNS FDCs 21 (84%) were found to be rational and 4 (16%) were found to be irrational with the mean rationality score of 7.2. By winding up, state of nonbeing, absenteeism of legality and effectiveness of the formulations appeared in to a peculiar combinations and inadequate practice. The approval process of these combinations by various committees should be robust. Keywords:  Rationality; Fixed Dose Combinations; CNS Drugs; Safety and Efficacy.

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