ABSTRACT
Background: Following stroke static as well as dynamic components of postural control were affected. Ability to maintain postural alignment is also a vital component of the postural control system. Pelvic asymmetry is commonly observed in stroke subjects which can influence trunk control. However, there is a paucity of literature that determines the relationship between pelvic alignment and trunk control in subjects with stroke. Aim: To analyze the relationship between pelvic alignments using PALM and trunk control as measured by the Trunk Impairment Scale (TIS). Setting: Inpatient rehabilitation unit, Tertiary Care Hospitals, Mangalore. Design: A cross-sectional study. Subjects: 38 supra-tentorial stroke subjects with more than 3 weeks duration and who can be able to sit independently were recruited. Methods: The medio-lateral pelvic alignment of the stroke subjects was measured in sitting using the PALM™. The deviation in the pelvic tilt on the paretic side in comparison to the non-paretic side was measured in degrees. Following which the trunk control was evaluated using the Trunk Impairment Scale. Results: The correlation between the pelvic tilt and the trunk control in the stroke subjects showed a negative correlation which indicates that a change in the pelvic alignment which affects the trunk control. Pelvic tilt values negatively correlated with all the sub-items of trunk impairment scores (p < 0.00). The pelvic tilt and the items of TIS scores. Brunnstrom’s stage of lower extremity Motor Recovery demonstrated a significant association (p < 0.05), except for the coordination sub score of the TIS. Conclusion: Pelvic alignment influences the trunk control and is also available to be associated significantly with the acute phase of stroke (3 weeks to 3 months). Brunnstrom’s Stage of lower extremity motor recovery is also associated significantly with the static and dynamic sub scores of the TIS, hence trunk control may influence extremity motor recovery.
ABSTRACT
Introduction: The Revised National Tuberculosis Control Programme (RNTCP), the State-run Tuberculosis Control Initiative of the Government of India, recommends intermittent thrice a week Directly Observed Treatment Short course (DOTS) both during intensive phase and continuation phase for a total of nine months for tubercular meningitis. However, most recent guidelines recommend daily regimen. Objective: Assessment of the in-hospital mortality in patients with meningeal tuberculosis. Material and Methods: We retrospectively analyzed the data of patients (n-98) admitted with a diagnosis of meningeal tuberculosis from January Ist 2006 to December 3lst 2009 in a tertiary care centre in South India. Thwaites index score of four or less was used for diagnosis of meningeal tuberculosis which is a weighted diagnostic index score for dichotomised clinical variables including age, blood white cell count, duration of illness, CSF total white cell count, and CSF neutrophil percentage. We compared in-hospital treatment outcome of patients on thrice weekly intermittent DOTS regimen with daily regimen patients. Results: The inhospital mortality was same (27%) in the two treatment regimens (p 0.944). However, there was less incidence of hepatic dysfunction in the intermittent DOTS regimen, even though it was not statistically significant (p 0.148). Conclusions: In the short term, both regimens have similar mortality outcomes and no statistically significant difference in hepatic dysfunction during the hospital stay.