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Biomedical subjects

M Behari

Publications and source records attributed to M Behari.

At least 55 records · Page 3Linked to original sources
PubMed1994

Randomized controlled trial of dexamethasone in tuberculous meningitis.

SETTING: The patients admitted to the Neurology ward of the All India Institute of Medical Sciences Hospital. OBJECTIVE: To assess the role of dexamethasone as an adjunct to antimicrobial therapy in the treatment of tuberculous meningitis. DESIGN: A randomised controlled trial of 47 patients was conducted over a 13-month period. 41 patients completed the trial. Patients were stratified into mild, moderate and severe groups and randomly allocated to steroid and non-steroid groups. All patients received a standardized antituberculosis drug regime. The end point was 3 months, or death if earlier. The evaluation at the end point included survival, resolution of symptoms, sequelae and activities of daily living. Results were analysed using the Wilcoxon rank sum test. RESULTS: The patients in the dexamethasone group fared better. 75% of this group had mild sequelae as opposed to 62% of the control group. Amongst the survivors, those who received dexamethasone sensorium improved earlier, and there was greater improvement in mental function and daily activities. The difference, however, did not reach statistical significance. CONCLUSIONS: Dexamethasone appears useful as an adjunct in the treatment of tuberculous meningitis especially in patients who have severe disease. The results need confirmation by a larger trial.

Adolescent↗
PubMed1994

Diagnostic criteria for tuberculous meningitis and their validation.

SETTING: Tuberculous meningitis (TBM) has high morbidity and mortality. Demonstration of tubercle bacilli in cerebrospinal fluid (CSF), the only reliable method of diagnosis, is time consuming and has a low yield. Early diagnosis and treatment are of utmost importance for favourable outcome. OBJECTIVE: The study was conceived to define easy to use criteria. METHODS: A set of criteria using clinical features, CSF examination and computed tomography (CT) findings were defined. 76 patients suspected of having TBM were divided into definite, highly probable, probable and possible TBM based on the criteria. The validity of criteria was tested using information from bacterial isolation, polymerase chain reaction (PCR) test for tuberculosis, response to treatment and autopsy. RESULTS: PCR was positive in over 75% of patients in the highly probable and probable groups. 91% of patients with highly probable and 66% with probable TBM improved on antituberculosis therapy. CONCLUSION: The criteria are reliable in making early diagnosis of TBM.

Adult↗
PubMed1994

Albendazole in single CT ring lesions in epilepsy.

Single, small, enhancing lesions that often resolve spontaneously are frequent findings on CTs of Indian patients with seizures. Based on ELISA and biopsy data, the majority of these lesions are probably cysticercosis. To determine if these patients should be treated with albendazole, we performed a double-blind, randomized, placebo-controlled study involving 75 patients with seizures and the appropriate CT abnormality without neurologic abnormality on examination. Patients were randomized to albendazole (15 mg/kg/d) and placebo for 1 week, and we obtained serial CTs at the end of 1 week, 1 month, and 3 months. All patients completed a 3-month follow-up and none had systemic evidence of tuberculosis or cysticercosis. The lesions varied in size from 3 mm to 2.1 cm, with an average size of 1.18 cm. Serum ELISA for cysticercosis was positive in 30 and CSF ELISA was positive in 20 of 45 patients. Forty patients received albendazole and 35 received placebo. At the end of 3 months, a total of 68 patients showed resolution. Thirty-five of 40 patients who received albendazole showed resolution, as opposed to 33 of 35 patients on placebo. We conclude that albendazole therapy was not beneficial.

Adolescent↗
PubMed1994

Botulinum toxin A in blepharospasm and hemifacial spasm.

We report the first Indian experience of botulinum toxin A in the treatment of blepharospasm and hemifacial spasm. Sixteen patients, 7 with essential blepharospasm, 5 with Meige syndrome and 4 with hemifacial spasm received botulinum toxin A injection. One patient received 3 courses of injections, 2 received 2 courses and the rest received only one course. The effect was observed after a latent period of less than 48 hours in all patients and lasted for a mean of 16.65 weeks. More than 70% improvement occurred after 17/20 injections (85%). Poor response was more often seen when blepharospasm was associated with oromandibular dystonia (2/5 injections). Though the duration of response and subjective score of improvement was best in patients with hemifacial spasm, the numbers were very small for any statistical evaluation. The side effects were local, transient, mild and well tolerated. The commonest side effect was blepharoptosis.

Adult↗
PubMed1993

Assessing tremor severity.

A clinical rating scale which measured the severity of tremor in 20 patients (12 with essential tremor and 8 with "dystonic" tremor) was assessed at specific anatomical sites for both inter and intra-rater reliability using four raters. The scores obtained with the scale were compared with the results of upper limb accelerometry, an activity of daily living self-questionnaire and estimates of the tremor induced impairment in writing and drawing specimens. The results show that, for the purposes of routine assessment and therapeutic trials, a clinical rating scale can produce reliable results which are a more valid index of tremor induced disability than standard postural accelerometry.

Activities of Daily Living↗
PubMed1993

Ocular myasthenia--factors predictive for generalisation.

A retrospective analysis was done from case records of 186 patients with myasthenia. Ninety patients had purely ocular symptoms at the onset. Thirty six of these patients continued to have ocular myasthenia while 54 patients developed features of generalised disease. There were no significant difference between the two groups as regards age at onset, sex distribution, response to repetitive stimulation, radiologic evidence of thymic enlargementor associated thyroid disease. The median time for generalisation was 3 months. A later age of onset seemed to prognosticate for early generalisation.

Adult↗
PubMed1992

Haemorheological factors in the pathophysiology of acute stroke.

Blood viscosity studies were carried out in fourteen patients with acute stroke, eight with cerebral infarction, six with cerebral haemorrhage and in thirteen controls. We observed a statistically significant higher values of plasma, red cell and whole viscosity in patients with acute stroke than in normal controls. Plasma fibrinogen levels were statistically higher (p less than 0.01) in patients than in normal controls. The platelet aggregation was increased in two young adults with acute stroke. The results suggest that the haemorheological factors play an important role in the pathophysiology of stroke patients.

Acute Disease↗
PubMed1992

Attenuated late positivity in the visual evoked potential in aphasia induced by lesions in anterior speech area.

Seven anterior aphasics, 7 nonbrain-damaged subjects and 7 normal controls were tested for their visual evoked potentials. Aphasics showed an attenuation of the long latency positivity related to interest in the stimulus. The attenuation may indicate the subject's failure to signal communicative intention. Thus the attenuated positivity may be a physiological correlate of a behavioral state (aphasia) induced by brain lesions.

Adult↗
PubMed1992

Combination therapy of parkinsonism with deprenyl.

In view of the encouraging results in various trials with deprenyl as an added drug therapy for Parkinson's disease, a pilot study to study deprenyl's efficacy in the Indian population was undertaken. Eleven patients were recruited in this open trial and were objectively assessed by Unified Rating Scale for Parkinsonism of Columbia University, Modified Hoehn and Yahr Staging and Schwab and England activities of daily living. Side effects, mood changes, changes in dyskinesia percentage, early morning dystonia and off period percentage were also noted. This study suggests improvement in the above parameters with minimal side effects.

Adult↗
PubMed1991

Rapid diagnosis of tuberculous meningitis by polymerase chain reaction.

The polymerase chain reaction (PCR) in cerebrospinal fluid was compared with conventional bacteriology and an enzyme-linked immunosorbent assay (ELISA) for cerebrospinal fluid antibodies in the diagnosis of tuberculous meningitis (TBM). PCR was the most sensitive technique; it detected 15 (75%) of 20 cases of highly probable TBM (based on clinical features), 4 (57%) of 7 probable cases, and 3 (43%) of 7 possible cases. ELISA detected 11 (55%) of the highly probable cases and 2 each of the probable and possible cases. Culture was positive in only 4 of the highly probable cases. Among the controls (14 pyogenic meningitis, 3 aseptic meningitis, 34 other neurological disorders), 6 subjects tested early in the study (2 pyogenic meningitis, 4 other disorders) were PCR positive. Second DNA preparations from their stored cerebrospinal fluid samples were all PCR negative, suggesting that the false-positive results were due to cross-contamination. 18 PCR-positive TBM samples retested were all still PCR positive. The antibody ELISA was positive in 3 controls despite the use of a high cutoff value.

Bacteriological Techniques↗
PubMed1991

Flunarizine in migraine prophylaxis: an Indian trial.

Flunarizine, a calcium channel blocker is considered useful in migraine prophylaxis. We report the first Indian trial with this drug. Fifteen patients with migraine were studied in a 6 months double-blind, placebo-controlled crossover trial. Flunarizine was superior to placebo in reducing the severity and duration of the individual attacks though there was no statistically significant effect on frequency of migraine attacks. The side effects most frequently caused by flunarizine were weight gain and daytime sleepiness.

Adult↗