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Biomedical subjects

Fary Khan

Publications and source records attributed to Fary Khan.

4 recordsLinked to original sources

Rehabilitation for postpolio sequelae.

BACKGROUND: Postpolio sequelae (PPS) are new, late manifestations that occur many years after the initial poliomyelitis infection. Recurrence of symptoms and fear of reactivation of the polio virus is particularly distressing to polio survivors. OBJECTIVE: This article outlines the diagnosis, pathophysiology, and management of PPS disabilities using a case vignette. DISCUSSION: Clinical features of PPS include fatigue, joint and muscle pain, new muscular weakness and bulbar symptoms. Diagnosis can be complicated particularly in nonparalytic cases of poliomyelitis. Disabilities in PPS may not be obvious to the observer but significantly affect the quality of life of the PPS patient. Previous rehabilitation intervention focussed on physical effort and determination to overcome disability at all costs. The treatment in PPS is now modified, and aggressive physical measures that may exacerbate muscle weakness are avoided. Most disabilities in PPS can be well managed with rehabilitation interventions that address limitations in patient activities of daily living, mobility and cardiopulmonary fitness.

Aged↗

Poststroke depression.

BACKGROUND: Poststroke depression (PSD) is common and often unrecognised. The diagnosis can be difficult due to deficits of stroke such as impaired self reporting and cognition, poor insight and dysphasia. Untreated PSD can interfere with recovery and adversely affect functional and social outcomes. OBJECTIVE: This article outlines the diagnosis, pathophysiology and treatment for PSD. DISCUSSION: The natural history of PSD suggests that most PSD is not immediate but develops over months with peak prevalence between 6 and 24 months, and in some cases persists up to 3 years following stroke. General practitioners and treating specialists need to actively monitor patients for PSD. While antidepressant medication is the mainstay of treatment for PSD, psychotherapeutic interventions are important. Treatment should include patient and family education, reestablishment of sleep pattern, addressirng functional difficulties, increasing community participation, improving diet and regular exercise.

Antidepressive Agents↗

Rehabilitation in Guillian Barre syndrome.

BACKGROUND: Guillian Barre syndrome (GBS) is the most common form of neuromuscular paralysis. It mostly affects young people and can cause long-term residual disability. OBJECTIVE: This article outlines the rehabilitation treatment for patients recovering from GBS. DISCUSSION: Recovery from GBS can be prolonged. Early rehabilitation intervention ensures medical stability, appropriate treatment and preventive measures to minimise long term complications. Specific problems include deep venous thrombosis prevention, complications of immobility, dysautonomia, de-afferent pain syndromes, muscle pain and fatigue. Longer-term issues include psychosocial adjustment, return to work and driving, and resumption of the role within the family and community. Effective communication between the GP and rehabilitation physicians is imperative for improved functional outcomes and successful social reintegration.

Autonomic Nervous System Diseases↗

4: Rehabilitation after traumatic brain injury.

Traumatic brain injury (TBI) commonly affects younger people and causes life-long impairments in physical, cognitive, behavioural and social function. The cognitive, behavioural and personality deficits are usually more disabling than the residual physical deficits. Recovery from TBI can continue for at least 5 years after injury. Rehabilitation is effective using an interdisciplinary approach, and close liaison with the patient, family and carers. The focus is on issues such as retraining in activities of daily living, pain management, cognitive and behavioural therapies, and pharmacological management. The social burden of TBI is significant, and therefore family education and counselling, and support of patient and carers, is important. General practitioners play an important role in providing ongoing support in the community, monitoring for medical complications, behavioural and personality issues, social reintegration, carer coping skills and return-to-work issues.

Activities of Daily Living↗