ABSTRACT
Background: The H-reflex derived its name from Hoffman. Hoffmann reflex is an electrically induced reflex analogous to the mechanically induced spinal stretch reflex. This measurement can be used to assess the response of the nervous system to various neurological conditions, musculoskeletal injuries, and application of therapeutic modalities, pain, exercise training, and performance of motor tasks. This simple and reproducible physiological response was studied to evaluate conduction along the course of the whole “final common pathway” from the moto neuron to the terminal axon as well as to gain some information regarding the function of large diameter group la afferent fibers supplying the muscle spindle. Aims and Objectives: The aim of the study was to compare the H-reflex latency between the normal person and in neuropathic patients. The study aimed to see whether there is any difference in H-reflex latency in the right leg of normal person and in neuropathic patients. The study aimed to see whether there is any difference in H-reflex latency in the left leg of normal person and in neuropathic patients. Materials and Methods: The study was conducted among 25 normal subjects and 25 neuropathic patients between 20 and 70 years of age from Nootan Medical College and Research Centre, Visnagar. The normal subjects were evaluated clinically to find their normal condition. The neuropathic patients which are included in study are of diabetic neuropathy, plexopathy, radiculopathy, vitamin deficiency, and Guillain Barre Syndrome. The patients who had bilateral neuropathy were included in the study. The study was conducted using mainly stimulator circuit, stimulating and recording electrodes, preamplifier, and oscilloscope. The software used for this experiment was RMS EMG EPMK II, one of the latest software with facilities for nerve conduction velocity, electromyography, F-wave, and H-reflex recording. Results: Out of the 50 participants, 25 participants who were suffering with any kind of neuropathy evaluated for their H-reflex latency in both leg. Patients with neuropathy showed higher latency in the right leg compared to the 25 participants in the control group in the right leg demonstrated significantly higher latency in the group with neuropathy. The 25 participants who were suffering with any kind of neuropathy evaluated for their H-reflex latency left leg compared to the 25 participants in the control group left leg demonstrated significantly higher latency in the group with neuropathy. Conclusion: The results show that there is an increase in the H-reflex latency in neuropathy patients as compared to normal subjects but it can be not used as a specific test for diagnosis of neuropathies, because the H-reflex latency may also change in normal subjects as the age of the persons is increases or the height of the persons increases but H-reflex latency can be used for the diagnosis of the proximal nerve root injuries as it mainly investigates the proximal nerve reflex arc.
ABSTRACT
Background:Stroke is the second leading cause of death worldwide. In the acute phase, stroke patients are susceptible to complications like chest infections, cardiac dysfunction, and urinary tract infections. Globally, the incidence of pneumonia among stroke patients is e stimated to be around 14%. The A2DS2 score (age, atrial fibrillation [AF], dysphagia, sex, and stroke severity using the National Institutes of Health Stroke Scale[NIHSS] score) is a simple scoring system to find risk of stroke associated pneumonia (SAP). Here our aim is planned to assess the risk of SAP in patients with acute stroke using the A2DS2 score.Material And Methods:This prospective observational study was conducted on patients with Ischemic stroke, time from symptom onset within 7 days and Age > 18 years admitted in tertiary care hospital. NIHSS score and A2DS2 score were calculated on admission. Follow up of all thepatients was done during their hospital stay and those who fulfilled Mann’s diagnostic criteria for pneumonia were diagnosed as SAP. Result:Out of 110 patients (M:60, F:50, Mean age 60.37+7.07), the commonest comorbidity was Hypertension (85, 77.27%) andthe commonest symptom was Facial Asymmetry (73, 66.4%). Among these, 19 (18.8%) patients developed SAP. Patients with SAP had higher mean age, male preponderance, commonest symptom dysphagia, higher NIHSS score and higher A2DS2 score. Patients with acute ischemic stroke who had high A2DS2 scores (5-10) higher risk of developing SAP and worse outcome (P <0.05). Conclusion:In conclusion, patients in the high A2DS2 score group had higher incidence of SAP and non-favourable outcome compared to patients with low A2DS2 scores who had more favourable outcomes
ABSTRACT
Background:The metabolic syndrome is a highly prevalent condition among the patients with detrimental impact on short-term outcome. Early diagnosis, treatment including lifestyle modification and prevention of the metabolic syndrome may reduce the development of cardiovascular diseases like myocardial infarction including its complications. So, in this study we tried to find out prevalence of metabolic syndrome and study clinical profile, analyzebiochemical parameters and study risk factors in patients with metabolic syndrome. Material And Methods:A prospective cross-sectional study was conducted in the department of medicine of tertiary care teaching hospital, Ahmedabad, India. Between August 2017 to August 2019. A total of 280 patients were selected randomly who visited the medical OPD. Diagnosis of Metabolic syndrome is based on: NCEP-ATP III 2001 (National cholesterol Education Program Adult Treatment Panel III). A detailed medical history ofthe patient including symptomatology, details of past illness, occupation, habits (smoking and alcohol) was obtained. A complete physical examination and systemic examination was performed. Results were expressed as mean± SD for continuous data and were compared by chi square test between two groups. Result:Out of the 280 cases, metabolic syndrome was present in 184 cases with incidence of 65.72%. 30% of males and 70% of females had metabolic syndrome. Mean age of metabolic syndrome in was 58 (57.84+11.35) years with age of patients ranged from 20 to 85 years with maximum number of cases were in the 51-60 years age group (33.2%). The most common mode of presentation in metabolic syndrome group was chest pain 45 (24.5%), followed by headache, 41 (22.3%), gabharaman, 29 (15.8%), fatigability, 29 (15.8%), and giddiness, 28 (15.2%).31.5%, 22.3% and 22.8% of metabolic syndrome patients had past history of diabetes mellitus, hypertension and IHD respectively. In patients with metabolic syndrome, mean values of fasting blood glucose, serum triglyceride level, systolic blood pressure were 155.19mg/dl, 179.16mg/dl, 143.43 mm of Hg respectively. In patients with metabolic syndrome mean values of hdl level were 31.29mg/dl and 39.29mg/dl in male and females respectively. The most common biochemical abnormality was found to be increased triglyceride levels followed by increased fasting blood sugar. Conclusion:Early diagnosis, treatment including lifestyle modification and prevention of the metabolic syndrome may reduce the development of cardiovascular diseases like myocardial infarction including its complications. So, cardiovascular disease patients with metabolic syndrome must be identified and managed aggressively to reduce both morbidity and mortality. In this study,metabolic syndrome was more common amongst women who can be particularly attributed to high BMI, low HDL and increased waist circumference.