cEEG monitoring provides independent prognostic information in patients with altered sensorium and suspected seizures. Unfavorable findings include nonconvulsive seizures, periodic epileptiform discharges and abnormal background. Short term EEG is ineffective in detecting seizures on EEG in patients with altered sensorium and should not be used as substitute for Long term EEG.
In conventional exhaust processes for applying reactive dyes, the alkali accelerates dye hydrolysis, restricting subsequent reuse. Step-up and chemical build-up can complicate accurate color duplication with reused dyes as well. A two-bath method of first applying the dye from a salt and dye bath followed by treatment in a separate alkali bath eliminates the possibility of alkali-induced hydrolysis, step-up, and chemical build-up effects. In this study, four reactive dyes differing in reactive group and dyeing temperatures are applied to cotton poplin fabric from original and reused dyebaths by one- and two-bath application methods, and the percent fixation of adsorbed dyes and the K/S values are determined. Dye hydrolysis and step-up and wash-off effects that occur in the one-bath method interfere with reuse. These complications are eliminated when the reactive dyes are reused by the two-bath method.
We report a rare case of neurodegeneration with brain iron accumulation (NBIA) presented with episodic inspiratory stridor. A 10-year-old boy presented with 3-year history of gradually progressive spastic gait and generalized dystonia (involving all four limbs, neck, jaw, and speech). MRI brain showed “Eye of Tiger” sign. He recently developed severe inspiratory stridor associated with almost gasping respiration. Direct video laryngoscopy showed paradoxical vocal cord closure during inspiration. He was treated with EMG-guided botulinum toxin-A injection given into bilateral thyroarytenoid muscles, resulting in dramatic response with complete disappearance of the stridor within a week. The effect lasted 18 months.
Objective: Decompressive hemicraniectomy (DC) has been shown to reduce mortality among patients with malignant middle cerebral artery ( MCA) infarction in short term. The present study aimed at studying the long term functional outcome of patients undergoing DC for malignant MCA infarctions. Methods: All patients malignant MCA infarction requiring DC were prospectively enrolled. Patients meeting the inclusion criteria but not undergoing surgery due to any reason were taken as controls. Aphasia testing using was done using Western Aphasia Battery. Modified Rankin Scale (mRS) was done at 3, 6 and12 months to grade functional outcome. mRS ≤ 3 was defined as a good outcome. Results: 60 patients were enrolled during the study period. Mean age was 49.6 years with 72% males. 36 patients (60%) underwent decompressive hemicraniectomy (surgery group) and 24 (40%) received best medical management only (medical group). Mean delay to surgery from time of onset of symptoms was 56 hours (9-148). One year follow up completed for 57 patients and 35 patients (61.4%) died over a period of 1year. Significantly high mortality was noted in the control group at discharge, 3, 6 & 12 months. Cumulative risk of death was 83% in controls compared to 38% in surgical group at 1 year. 2.78% (1/36),16.67% (6/36) and 20% (7/35) patients achieving good outcome at 3, 6 and 12 months in the surgery group and none in controls. Repeated ANOVA showed progressive improvement over time from 3 to 6 months (p< 0.01), 3 months to 1year (p< 0.001), and 6 months to 1 year (p<0.019). Mean aphasia quotient improved progressively over time. Conclusions: Decompressive hemicraniectomy leads to a increased and functionally better survival compared to medical management alone. The outcome assessment at 3 months underrepresants the benefits in trials. For life threatening strokes it is prudent to make assessment at longer intervals. There is progressive improvement in aphasia over time in the surgically survived group
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