Objective:Headache is not an uncommon complication of spinal anesthesia. The efficacy of intravenous (IV) hydrocortisone in treating the patients with postdural puncture headache was observed in this study.Materials and Methods:Sixty patients with headache following spinal anesthesia were randomly allocated into two groups. Thirty patients received only conventional therapy (recumbent positioning, IV or oral hydration, analgesics with caffeine, stool softeners, and soft diet) plus 2 ml of normal saline IV (placebo) 8 hourly for 48 h. Thirty other patients received conventional therapy plus hydrocortisone IV (100 mg in 2 ml 8 hourly for 48 h). Headache intensity was measured using visual analogue scale.Results:No significant difference was observed in baseline headache intensity between the two groups (P = 0.6642) before beginning of treatment. After 6 h, the mean headache intensity in patients treated conventionally was 6.02 ± 2.46, while it was 2.06 ± 1.98 in other patients who received additional hydrocortisone IV (P < 0.0001). After 24 h, headache intensity was 3.77 ± 1.85 in conventionally treated group versus 0.94 ± 2.67 in hydrocortisone group (P < 0.0001), while it was 1.95 ± 1.12 in conventionally treated group versus 0.69 ± 1.64 in hydrocortisone group (P = 0.001) after 48 h.Conclusions:Very short-term use of IV hydrocortisone was found effective in reducing headache following spinal anesthesia. However, its clear mechanism of action is yet to be determined. Large-scale studies are recommended to consider the steroid therapy as a standard treatment for postdural puncture headache.
The incidence of leprosy reaction seemed to be more than three times common in borderline tuberculoid (52.33%) group than in lepromatous leprosy (14%) group. Reactions with NFI and disability still occur among multibacillary patients during and after MDT. Early detection and management of leprosy reaction are very important in preventing disability and deformity, and patients should be educated to undergo regular follow-up examinations. Developing reinforced new therapies to curb leprosy reactions is crucial for improving leprosy healthcare services.
Key words: endoscopic third ventriculostomy; obstructive hydrocephalusdoi: 10.3329/jcmcta.v19i2.3867Journal of Chittagong Medical College Teachers' Association 2008: 19(2):27-32
Tuberous sclerosis is a disorder affecting multiple organs leading to morbidity and mortality. It is important to make an early diagnosis of tuberous sclerosis so that lifelong monitoring, early recognition of complications and proactive treatment can lower the morbidity and mortality rates. Here we report a case of a 50-year-old male who presented with seizure. This case report emphasizes the importance of complete evaluation of a case presenting with seizures. Tuberous sclerosis must be included in the differentials if patient presents with seizures, skin manifestations and mental retardation.Birdem Med J 2016; 6(2): 127-129
Cauda equina compression following vertebral compression fractures or vertebral plasmacytomas is relatively uncommon presentation of multiple myeloma. Here we describe a case of cauda equina syndrome due to multiple myeloma in an elderly Bangladeshi male who presented with difficulty in walking, urinary complaints & unexplained weight loss. CT guided FNAC from lesion of spine, bone marrow study, skeletal survey, MRI of spine & immune electrophoresis confirmed the diagnosis of multiple myeloma. We treated the patient with radiotherapy, dexamethasone, antimyeloma therapy, physiotherapy & bisphosphonates in collaboration with hematologists & neurosurgeons. He showed significant improvement both clinically & biochemically in the follow up.
Bangladesh Journal of Neuroscience 2014; Vol. 30 (1): 57-61
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