Background:Incidence of intracerebral hemorrhage (ICH) is twice as high as in Western countries. Prognostic factors for predicting function outcome and mortality play a major role in determining the treatment outcome.Methods:A prospective study of male and female patients ≥12 years with primary nontraumatic intracranial hemorrhage were included. Hemorrhage caused by trauma, anticoagulant or thrombolytic drugs, brain tumor, saccular arterial aneurysm or vascular malformation were excluded. Functional outcome of patients was determined by modified Rankin's scale. Glasgow Coma Scale (GCS) score and ICH score were calculated for each patient.Results:Hypertension was present in 45 out of 49 patients (92%) with ICH of basal ganglia. Hypertension was significantly associated with worst clinical outcome. Mortality was high if the patient was comatose/stuporous compared to drowsy state (P < 0.0001). Mortality was found to be high when the size exceeded 30 cm3. High ICH score, low GCS score at the time of admission, presence of intraventricular hemorrhage, and midline shift were significantly associated with poor clinical outcome.Conclusions:Intracranial hemorrhage can be deleterious if present with low GCS score, high ICH score, intraventricular extension, and midline shift.
Aims CFS/ME is a complex illness, causing severe incapacitating fatigue, physical and cognitive complaints and is as disabling as many other serious chronic conditions. The prevalence in children is estimated to be 0.2-0.5%. The aim of this study was to take a cohort of children and adolescents with the condition and determine the pattern of co-morbid conditions. Methods Our study took the form of a quantitative and semi-qualitative analysis undertaken as a retrospective case note review of a cohort of 131 patients attending a hospital based, consultant-led specialist CFS/ME clinic. Patients must have been diagnosed with CFS/ME using NICE and RCPCH criteria whilst under the care of a consultant paediatrician to be eligible to be included in the study. Information gathered from their hospital notes included basic demographics, CFS/ME diagnosis information and any co-morbid conditions present. Results 80% of patients were female which was as expected, with CFS/ME acknowledged to be a female dominated disease. The median age at diagnosis of CFS/ME was 14 years, and there were a total of 38 different symptoms recorded at diagnosis. Other than fatigue, the most common symptoms were headaches, abdominal pain, musculoskeletal pain and decreased concentration and short term memory. 56% of the cohort had at least 1 co-morbid condition. There were 51 separate co-morbid conditions, with the most common conditions being psychiatric, gastrointestinal, respiratory and musculoskeletal problems. 30% of the patients had at least 1 co-morbid condition that the RCPCH lists as a differential diagnosis of CFS/ME. Conclusion This is the first study exploring co-morbid conditions in children and adolescents with CFS/ME. More than half of the cohort had at least one co-morbid condition. We wish to highlight to paediatricians that the presence of a co-morbid differential diagnosis does not appear to exclude CFS/ME.
"Nutraceuticals" are the combination of Nutrition and pharmaceutical. The term Nutraceutical was given by Dr. Stephen in 1989. A dietary supplement is a product taken by mouth that contains a dietary ingredient (Vitamins, Minerals, Herbs, Amino acids etc.) Numerous definitions and nomenclature for dietary supplements exist worldwide. In India Food Safety and Standards authority (FSSA), defines Nutraceuticals as "foods for special dietary uses or functional foods or health supplements". In Philippines Nutraceuticals are known as food supplement & dilatory supplement. In Sudan, Nutraceuticals are known as dietary supplement & health product .In Cambodia Nutraceuticals are known as health supplement product. Every country has their own guidelines, regulatory requirements which deal with regulatory registration procedures of Nutraceuticals. In order to enter the Indian Nutraceutical market, some of the very important areas of focus include product evaluation, actual product analysis, procuring licenses and developing India specific health and label claims.
Introduction: Malaria is a vector borne disease highly prevalent in the topical developing countries. Two main species of plasmodium causing majority of diseases manifestations are P. Vivax and P. falciparum. The approach to antimalarial selection is determined based on the location of the patient. For treatment of uncomplicated P. falciparum malaria, according to WHO guidelines first line therapy mainly includes Artemisin Combined Therapy. Concerns about the emergence of resistance to artemisin derivatives have increased recently. The main aim of the present study is to investigate the effect of using a combination of intravenous artesunate along with oral doxycycline, as a novel ACT for Malarial infections-falciparum vs. vivax. Methodology: Prospective observational study was carried out at V S General Hospital in Ahmedabad, Gujarat, India. A full history of current illness was taken followed by examining the serial peripheral smear reports of the patients till the malarial parasites are not seen on two consecutive occasions. Samples were taken at least 6 hours apart by the capillary method and oral temperature was measured every 6 hours. We excluded other associated viral fevers such as dengue, pediatric age group (<12 years) and Co-Morbid illnesses like hepatic or renal dysfunction. Data analysis was done using SPSS software version 20. Results: Student t test showed that PCT was significantly more in falciparum (mean= 74.53 hours) patients as compared to vivax patients (mean= 51.89 hours). (p<0.001). Also duration of stay was significantly more in patients having falciparum (mean =3.63 days) as compared to patients having vivax (mean = 2.32 days) (p<0.001) Multivariate analysis by linear regression showed that species of the parasite was the most significant independent predictor (B=12.552) of the time to parasite clearance and other significant variable was Grade of parasitemia at 0 hour (B= 12.798). We also found that patients with residual parasitemia was 83.78%, 40.54% and 10.81% in vivax group whereas it was 100%, 88.15% and 46.05% in falciparum respectively at 24, 48 and 72 hours. Conclusion: The study shows that PCT and residual parasitemia is very high in falciparum patients as compared to previous reports of different studies and also as compared to vivax group patients. ACT resistance is a grave concern for falciparum and more studies should be done to understand pathophysiology and its prevalence in India. We strongly suggest that a continues monitoring needs to be implemented in health policy to understand the dynamicity of emerging resistance
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