About some reflexes with plantar flexion of the fingers

While studying cases of organic lesions of the central nervous system, we noticed a great inequality of the reflexogenic wontons of the dorsum of the foot in relation to reflexes of the toe-plantar flexion type, which forced us to study this issue in more detail.

COTARD SYNDROME IN A MIDDLE AGED MAN WITHOUT ORGANICITY

Cotard's syndrome is a rare neuropsychiatric condition characterized by delusions of nihilism / non-existence concerning one's own body first described in 1880. Most commonly seen in severe depression, psychoses mostly associated with organic lesions of the nondominant temporoparietal regions of brain. Till now E.C.T remains the treatment of choice.Presented case report is of middle aged man with cotard syndrome with duration of untreated illness of few months and without any organic cause.

Incidence of depressive and anxiety disorders in COVID-19 patients

The aim of this study is to analyze the occurrence of depressive and anxiety disorders in patients with COVID-19 and to study the relationship of these disorders with organic damage to the central nervous system. Material and methods. An analysis of occurrence of depressive and anxiety disorders in patients with COVID-19 was carried out at the infectious hospital of the KBGMU for the period June-August 2020. Depression and anxiety were identified using the Hospital Anxiety and Depression Scale (HADS) and compared with the MRI data of the brain. Statistical data processing was carried out using Microsoft Excel 7.0. Results. According to the analysis, out of 76 patients with COVID-19, depressive disorders were observed in 36 (46.3%) patients, anxiety disorders subclinical anxiety in 16 (21.05%), clinical anxiety in 19 (25%). The absence of depressive disorders was observed in 40 (52.63%), the absence of anxiety in 41 (53.94%). By gender differentiation of patients, depressive disorders in men 20 (46.5%), women 16 (48.48%). Anxiety disorders: subclinical anxiety in men 11 (25.5%), women 5 (15.15 %), clinical anxiety in men 7 (16.2%), women 12 (36.36%). The average age of patients at the time of the study was 45.7 years. When conducting MRI of brain, organic lesions were detected in 12 (16%) people, in 64 (84%) at the time of the study, organic lesions were not detected. When collecting a follow-up in 31 patients, depressive disorders were noted in 8 (25.8%), subclinical anxiety 2 (6.45%), clinical anxiety 2 (6.45%), no anxiety 27 (87.09%), no depression 23 (74.19%). No organic lesions were found at the time of MRI of brain. Conclusion. When studying the occurrence of depressive and anxious states and their organic substrates, we found that there is no clear relationship between them and rather have a functional character.

For casuistic cases of pronounced Cheyne - Stokes respiration in case of diffuse organic lesions of the brain

We had to observe a case of a very pronounced and prolonged Cheyne-Stokes breathing in a patient, representing the manifestation of diffuse organic lesion of the brain with simultaneous organic suffering of the heart and lungs. Since this case, in our opinion, is rare, then we allow ourselves to give a description of it here.

Risk factors for the formation of gastroenterological pathology after infectious hemocolitis in children

The aim of the study was to determine the risk factors for the formation of gastroenterological pathology in convalescents of infectious hemocolites. In the Department of intestinal infections, 120 children aged over 1 month who had intestinal infections with hemocolitis syndrome were observed. The etiology of the disease was verified, clinical and laboratory signs of intoxication, dehydration, local and systemic inflammatory response were detected. Non-specific complications (respiratory diseases, urinary tract infection) were diagnosed. In the acute period of the disease, the composition of the intestinal microbiota was evaluated by PCR-RT. During 6 months, 65 convalescents were observed in the catamnesis. If there were complaints from the gastrointestinal tract, functional gastrointestinal disorders (FGID) were diagnosed. When «symptoms of anxiety» appeared, organic intestinal lesions were detected. When «symptoms of anxiety» appeared, organic intestinal lesions were detected. The results were evaluated using the student's test, the Mann-Whitney U-test, the Kruskal-Wallis test, the Pearson correlation method, and discriminant analysis. Studies have shown that there were 43 children with a favorable outcome (66.2%), 17 children with FGID (26.1%), and 5 children with organic intestinal lesions (7.7%). In patients who formed organic lesions, the bacterial etiology of hemocolitis was more often noted. Gastroenterocolitis was more often diagnosed in patients with a favorable outcome (41.9%; p > 0,05). Non-specific complications were more often observed in patients who formed FGID and organic lesions. The frequency of FGID decreased with age and was higher in girls (58.8%) than in boys (41.2%) (p > 0,05). Organic intestinal lesions were observed only in girls. In convalescents with FGID, more often (83.3%) than in convalescents with a favorable outcome (64.3%), signs of anaerobic intestinal imbalance were detected. A complex of clinical and laboratory signs of an acute period of infectious hemocolites that determine the risk of FGID formation has been established. It was shown that the risk of developing FGID is higher in young convalescents, and the risk of forming organic intestinal lesions is higher in girls of preschool and school age. Patients who showed more pronounced systemic inflammatory responses in the acute period of the disease were more likely to have a favorable outcome.

Prolonged contracture of the chewing muscles

Among the numerous symptoms, which are expressed by the functional and organic lesions of the nervous system, contracture of the masticatory muscles, trismus, occupies far from the last place, arising under the influence of very different conditions. Most often, it develops on the basis of general neuroses and in such a case it differs for the most part in a transient character. Quite often, we can also observe the reflex origin of this contracture, especially with irritation of the sensitive nerves of the trigeminal nerve; known ex. cases when a minor dental operation in nervous subjects had as its result the reduction of the jaws, which lasted up to three months (observation of Travers'a).

Main directions and types of medical rehabilitation

Medical rehabilitation refers to the process of systematic and continuous restoration of a patient’s physical and mental health and ability to work, basis for the development of which is physical or mental injuries, occupational diseases, or severe organic lesions of organs and systems. The purpose of medical rehabilitation is to organize quick and effective return of the patients to society to fulfill work skills and domestic functions which they lost. The main objective of medical rehabilitation is prevention of disability, recovery and extension of active life, social integration and ensuring the proper level of quality of life. The “maximum” program during medical rehabilitation consists in achieving the full social and everyday level that existed before the disease or injury; the “minimum” program is to ensure the patient’s ability to elementary self-care.

**C225** Chap. 8.

Barker explains that the Medical Museum (Philadelphia) and the Medical Repository (New York City) were rare books in Maine that could not conveniently be purchased by young physicians. Because he was known to have an unusually good personal library, Barker was asked to excerpt some of the most extraordinary cases of consumption from those journals. For example, a twenty-year-old West Indian seaman died at New York Hospital with a diagnosis of phthisis pulmonalis manifested by extreme emaciation, cough, catarrh, and fever. On dissection the lungs showed no adhesions, no traces of organic lesions, and no inflammation. The physician was of the opinion that phthisis pulmonalis was “not always attended with tubercles and ulcers,” and that death was due to another cause. He suggested that in some cases the disease yielded to calomel, symptoms disappeared, but the patient still died.

Organic Lesions in the Brain MRI of Children with Febrile Seizure

Objective: Seizure is the most common neurological disorders in children, where, 4-10% cases experience at least one seizure before the age of 16. The most frequent causes of seizures in children are fever, epilepsy, infection and brain damage. The aim of this study was to investigate the frequency of organic lesions in MRI of children with seizure unrelated to fever. Materials and Methods: This cross-sectional study included children presented with fever-unrelated seizures. The MRI was examined by a radiologist to identify abnormal findings in each patient. A researcher-made questionnaire including general information, history of head trauma, obstructed labor and the history of seizure were completed for the patients. Results: Of 287 children with fever-related seizure, 127 (45.7%) were male and 151 (54.3%) were female. History of seizure, history of obstructed labor, abnormal MRI, complete delay, use of antiepileptic drug and history of trauma were 22(9.9%), 1 (0.4%), 11(4%), 5(1.8%), 259(93.2%) and 12 (4.3%) respectively. Of 11 patients with abnormal MRI, 4 had MTS lesions, 2 had tumor lesions, 2 had scarring trauma, 1 had epidural abscess and 1 had meningitis. Frequency of organic lesions had no significant differences based on gender, use of anti-epileptic drug and traumatic history, but it had a significant relation with obstructed labor and the history of seizure. Conclusion: The results showed that organic brain lesions in children with fever-unrelated seizure, which had a significant relation with the history of seizure and obstructed maternal labor.

Adult intussusception secondary to diverticular disease

Intussusception is the invagination of a proximal segment of bowel into the lumen of an adjacent distal segment. It is a common condition in the paediatric age group although it rarely occurs in adults. Organic lesions in the bowel wall are the primary cause of adult intussusceptions with malignant neoplasms being the most common. However, we present a rare case of a 92-year-old man diagnosed with an intussusception of the sigmoid-rectal colon secondary to a diverticular stricture.