ABSTRACT
Tuberculous involvement of central nervous system is one of the important health issues causing high mortality and morbidity. Uncertainty and doubt dominate all aspects of CNS tuberculosis. Diagnosis is mainly based on clinical features, cerebrospinal fluid changes, and imaging characteristics. Few studies have shown that corticosteroids improve the clinical outcome, although the precise mechanism of action remains tentative. All the cases were selected on strong clinical suspicion of CNS tuberculosis. They were graded according to tuberculous meningitis (TM) severity grades. In this connection, we studied 13 patients in one medicine unit over 12 month's period to see the effect of corticosteroid as part of the outcome. Nine patients (69.23%) were in grade II, three (23.08%) patients were in grade III, and one (7.69%) was in grade I. Seven patients (53.85%) had tuberculous meningitis and six (46.15%) had tuberculoma (CT or MRI). Out of 13 cases 3 patients (23%) died in the hospital and 10 patients (77%) improved, of whom 2 patients (20%) recovered completely and 8 patients (80%) had residual neurological deficit. Our study suggests that the early detection of CNS tuberculosis is the most important prognostic factor. Timely started anti-Koch's treatment with adjuvant corticosteroid therapy has a direct bearing on patient outcome.
ABSTRACT
One hundred consecutive hypertensive patients with stroke admitted to the medicine units of Dhaka Medical College Hospital were studied. The main objective was to study the extent of drug compliance and control of blood pressure in hypertensive patients who had suffered a stroke. Detailed history and clinical examinations were performed in all patients and outcome was recorded. Of the 100 patients studied there were 73(73%) males, 27 (27%) patients had no formal schooling and 53 (53%) had some education. 48 (48%) patients were from middle class and 36 (36%) were poor, 66 (66%) patients were aware that they were hypertensive though only 8 (12.9%) were taking anti-hypertensive drugs regularly. 62% of the patients had suffered from stroke within 5 years of detection of hypertension, and 15 (15%) patients died in the hospital.