Panel II: The pros and cons of early mobilization and of the convalescent phase in rehabilitation. Discussion.
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The assessment of hepatic function by some clinicobiochemical parameters and kinetics of rose-bengal-I-131 in 70 reconvalescents after hemorrhagic fever with renal syndrome indicated impairment of hepatic function, especially in those who had preexisting hepatobiliary disease.
We studied the CT and MR images of a patient with Japanese encephalitis. The first symptom was general malaise with high fever. The diagnosis of meningoencephalitis was made by spinal tap and clinical presentation. CT on the third day of illness showed no significant findings. MRI on the fifth day of illness demonstrated that the left thalamus and bilateral putamen were hyperintense on T2-weighted images. On CT one month later, the density in the thalamus and bilateral putamen was normal. MRI two month later showed high signal intensity only in the left thalamus. The patient recovered, but was judged to have dementia according to the simple dementia scale of Hasegawa. Flaccid paralysis was observed during the acute period.
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80 patients with a primary myocardial infarction (32 anterior and 48 posterior) underwent cardiac catheterisation and angiography (coronary arteriography and selective left ventricular cineangiography) within 12 months of infarction. Analysis of the results of catheterisation and angiography showed: -- Diffuse coronary artery narrowing to be more frequent in patients with posterior infarction. Significant stenosis of the left anterior descending artery was observed in half these cases; -- No correlation between the results of cardiac catheterisation and the distribution of the coronary artery lesions. Changes of ventricular contraction are essentially related to the infarct size and much less to the quality of the healthy myocardium as far as can be appreciated by the usual haemodynamic methods in both anterior and posterior myocardial infarction.
A total of 722 patients recruited from various clinics across Western India, particularly in Western Maharashtra and South Gujarat, recovering from a variety of clinical conditions such as infections of the respiratory tract, malaria, enteric fever, jaundice, surgical procedures and so on were administered a micronutrient appetite normaliser formulation (neogadine) for periods up to 30 days. There was a significant and steady increase in the scores of appetite and well-being during the study period. Very good to good response were reported in 83% of patients. Neogadine was well tolerated with no significant adverse effects on any patients. Based on past experience with this micronutrient formulation as well as the findings of the present study, it is reasonable to conclude that neogadine plays a useful supportive role in the restoration of appetite and well-being in conditions that apply to private practice situations in India.
A 14-year-old girl was diagnosed as having herpes simplex encephalitis by a polymerase chain reaction examination of the cerebrospinal fluid. MRI showed diffuse high signal areas at the bilateral temporal lobes and right frontal lobe. She was treated with a total of 350 mg/kg of acyclovir for 23 days, and discharged without abnormal neurological findings. On the 90th day after the onset, however, she became excitable and aggressive to her family. She excessively seeked relations with several boy friends. MRI revealed dilation of the bilateral ventricles and atrophy of the temporal lobes. These pathologic changes including the atrophy of hippocampus may be responsible for the character changes in this case.
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