Objective: To determine the frequency and type of adverse effects associated with plasmapheresis among the patients with neurological disorders at a tertiary care hospital in Pakistan. Study Design: Prospective longitudinal study. Place and Duration of Study: Pak Emirates Military Hospital, Rawalpindi Pakistan, from Jan to Jun 2019. Methodology: The sample population comprised 150 patients with various neurological disorders requiring plasmapheresis at a tertiary care hospital in Rawalpindi, Pakistan. The consultant neuro physician diagnosed the underlying disorder, and a management plan of plasmapheresis was given after the departmental meeting. The presence of adverse effects was observed during the session of plasmapheresis till 48 hours after the session. Results: Out of 150 patients with neurological illness undergoing plasmapheresis at our department, 18 (12%) developed one or more adverse effects due to the procedure, while 132 (88%) did not experience any adverse effects. The mean age of the patients was 30.2 ± 2.698 years. GB syndrome 61 (40.6%) was the commonest disease for which plasmapheresis was done. Allergic reaction 4 (2.6%) was the commonest side effect among the patients undergoing plasmapheresis, followed by abdominal pain 3 (2%). 146 (97.4%) patients were shifted toward, and 4 (2.6%) required intensive care unit admission after the procedure due to complications. Mortality due to this procedure was nil in the given period. Conclusion: Plasmapheresis is a relatively safe procedure for neurological illnesses with an immunological basis. Patients should be told about the common adverse effects they could face during the procedure especially allergic reactions and...
Objective: To look for the role of intravenous magnesium sulphate in acute status migranous among the patients reporting at neurological emergency. Study Design: Prospective longitudinal study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan to Jun 2019. Methodology: A total of 51 patients were enrolled in the study presenting with acute headache in the neurological emergency and diagnosed as suffering from acute status migranous by the consultant neurologist. Pain was measured by using the visual analogue scale (VAS 10) at the time of arrival and other symptoms were also noted. 1gm Intravenous Magnesium sulphate was administered over 15 minutes and pain and other symptoms were noted again after half an hour of administration of magnesium sulphate. Results: 20 (39.2%) patients were males and 31 (60.8%) were females. Mean age of the patients was 34.2 ± thirty minutes after the infusion of magnesium sulphate was 2.31 ± 1.113. There was a statistically significant difference in the visual analogue scale score before and after the administration of intravenous magnesium sulphate. Conclusion: Magnesium sulphate emerged as an effective tool when administered intravenously with a dose of 1gm for relieving the symptoms of acute status migranous. It not only worked for headache but also proved to be effective for the associated symptoms.
Objective: To assess the frequency of patients positive for the presence of anti-ganglioside antibodies and factors related to it among the patients diagnosed with Guillian Barre Syndrome (GBS) at our hospital. Study Design: Prospective longitudinal study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan to Jun 2019. Methodology: Patients were included in the study once detailed assessment and investigations have been carried out by the consultant neurologist and he has declared the patient suffering from Guillian Barre Syndrome. Anti-ganglioside antibodies were performed on all the patients diagnosed with Guillian Barre Syndrome from the immunology department of the laboratory of our hospital. Factors like age, gender, preceding gastrointestinal infection; sensory involvement and need for mechanical ventilation were related with the presence of Guillian Barre Syndrome in our target population. Results: A total of 30 patients were enrolled in the study. Out of these 22 (73.3%) were positive for the presence of antiganglioside antibodies while 08 (26.4%) did not show the presence of detectable levels of these antibodies in their serum. On fisher exact test preexisting gastrointestinal infection and sensory involvement were statistically significantly related to the presence of anti-ganglioside antibodies among the patients suffering from Guillian Barre Syndrome. Conclusion: Relationship of presence of anti-ganglioside antibodies was strong with the Guillian Barre Syndrome among the patients enrolled in our study. It was even stronger in among the patients who presented with the sensory involvement or those who had a gastrointestinal infection prior to the onset of symptoms of...........
Objective: To determine the frequency of poor sleep quality among the patients of Parkinson’s disease (PD) and analyze its relationship with the socio-demographic factors.Study Design: Correlational study. Place and Duration of Study: Pak Emirates Military Hospital Rawalpindi, from Jan 2019 to Jun 2019. Methodology: One hundred and fifty patients of Parkinson’s disease were approached to participate in this study. Pittsburgh sleep quality index (PSQI) was the psychometric tool used to assess the study parameter for the patients. Age, gender, duration of illness, poly pharmacy and tobacco smoking were corelated with presence of poor quality of sleep among the patients of Parkinson’s disease. Results: Out of 150 patients of Parkinson’s disease screened through Pittsburgh sleep quality index, 85 (56.7%)showed the presence of poor sleep quality while 65 (43.3%) had good sleep quality. Mean age of the patients was 66.2 ± 4.648 years. After applying the logistic regression, we found that increasing age and longer duration of illness had significant association with the presence of poor sleep quality among the patients of Parkinson disease. Conclusion: Previously considered a pure motor disorder, Parkinsonism has a lot of other neuro-psychiatricmanifestations as well. Poor sleep quality turned out to be one of these non-motor problems associated with this chronic debilitating illness. Increasing age and longer duration of illness among these patients emerged asindependent risk factors for poor sleep quality in Parkinsonism.
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