Context:Cerebral palsy (CP) is a heterogeneous group of permanent, non-progressive motor disorders of movement and posture caused by chronic brain injuries. It is the most common cause of physical disability in childhood; spastic cerebral palsy being the most prevalent of its various forms. There is scanty information about the neurophysiologic investigations in children diagnosed as having spastic CP.Aims:The aim of the study was to investigate the relationship between abnormal VEP and BAEP findings with different clinical parameters in children with spastic cerebral palsy.Materials and Methods:Fifteen children with spastic CP in the age range 4 months to 10 years participated in this study. Evaluation of VEPs, brainstem evoked potentials (BAEPs) were performed in all study patients as well as 35 healthy children as controls. The study was conducted after obtaining ethics committee approval and informed consent of parents.Statistical Analysis Used:Significance of difference in the mean values of different parameters in different groups was assessed by Student’s “t” test and the P value <0.05 was considered to be significant. All the values were expressed as mean ± 1 Std. Deviation.Results:A significant difference was found in the VEP latencies and amplitude between the subjects with CP and controls. Striking BAEP abnormalities in CP patients include prolongation of absolute latency of wave V, interpeak latencies of III-V and lowered I-V ratio. Abnormal VEPs and BAEPs in children with bilateral spastic cerebral palsy demonstrated a correlation with the presence of moderate to severe developmental delay.Conclusions:The differences in VEPs and BAEPs were determined between CP children and healthy children. The abnormalities found are probably linked to the neurological deficits present in cases of cerebral palsy.
Age is one of the important factors in the clinical interpretation of Brainstem auditory evoked potential waveform components and it can change the value of peak latencies and interpeak latencies among different age groups. Initial auditory responses in neonates appear in the 26 th and 27 th weeks of pregnancy. Progressively over time, these follow a "maturation pattern" in which interwave intervals and latencies decrease and the amplitudes of the BAEPs increase. So the following study was performed to show the effect of maturation on BAEP wave latencies and amplitude from infants to children (1 month to 5 years) & adult (18-25 years). We recorded BAEP from sixty subjects; from them 40 were infants & children and 20 were adults. The recording was done using RMS EMG EP MARK II machine manufactured by RMS recorders and medicare system, Chandigarh. The absolute latencies and interpeak latencies for most waves reached to adult equivalence between 9 months to 3 years. The amplitudes of all BAEP waves increased with age, the greatest changes occurring during early infancy. It is clear that there is a distinct maturation pattern for the Brainstem auditory evoked potential.
Brainstem auditory evoked potential is a physiological technique for evaluation of auditory pathway. A number of electrical potentials can be recorded from the human scalp following acoustic stimulation. The potentials which occur within 10 msec of the stimulus onset termed the brain stem auditory evoked potentials (BAEPs). Latency appears to be the most stable measure and in consequence knowledge of the exact limits of normal latency of each wave is important. Since age effects on central conduction time in the acoustic pathway are still debated, the following study was conducted to investigate possible age differences in BAEP component latencies in different age groups. BAEP were elicited from seventy five normoacoustic male subjects aged from 11-60 years. The recorded results are grouped according to patients age ranges of 11-20 (15), 21-30 (15), 31-40 (15), 41-50 (15) and 51-60 (15) years. The absolute peak latency of waves I, III & V and interpeak latency of wave's I-III, III-V & I-V in various age groups are analyzed. The data collected from both ears showed that increase in age will cause an increase in peak latency and interpeak latency values of all waves. Significant changes in the BAEPs in our study support the possible role of age as contributory factors for normal variations.
BACKGROUND:Extended spectrum beta lactamases continue to be major problem in clinical setups world over, conferring resistance to extended spectrum cephalosporins and are associated with significant morbidity and mortality. Urinary tract infections (UTIs) are one of the most common infectious diseases encountered in the clinical practice. Extended spectrum beta lactamases (ESBLs) production in gram negative bacteria, have emerged as a major problem in hospitalized as well as community based patients. ESBLs producing bacteria may not be detected by routine disc diffusion susceptibility test, leading to inappropriate use of antibiotics and treatment failure. The objective of this study was to determine the resistance patterns of the micro-organisms isolated from cases of UTI and to detect ESBLs production in gram negative bacteria. METHODS: Urinary isolates from symptomatic UTI cases (both in patients and out patients) attending the, Kesarsal Medical College and Hospital Ahmadabad were identified by conventional methods. Antimicrobial susceptibility testing was performed by Kirby Bauer's disc diffusion method gram negative isolates resistant to third generation cephalosporins were tested for ESBL production by two methods. RESULTS: Number of urinary isolates from patients with symptomatic UTI was 350 over a study period of one year. E.coli was the predominant isolate (57.7%) both in IPD and OPD patients. A total of 171 gram negative isolates resistant to third generation cephalosporins were tested for ESBL production by two methods-Modified Double Disc Synergy Test (CLSI) Phenotypic Confirmatory Test (PCT). ESBL production was seen in 36 (21.05%) isolates. Maximum ESBL production was seen in K. pneumoniae (22.41%) isolates followed by E.coli (13.26%). CONCLUSION: This study showed E.coli to be the predominant urinary pathogen isolated from UTI cases. Overall incidence of ESBL producing microorganisms was 21.05%.
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