Diabetic neuropathy and zinc therapy.

This was a double blind study conducted on 60 subjects; 20 age and sex matched healthy controls (Group-I), 20 patients of diabetes mellitus with neuropathy who received placebo for 6 weeks (Group-IIA); and 20 patients of diabetes mellitus with neuropathy who were given oral 660 mg zinc sulphate for 6 weeks (Group-IIB). Serum zinc level, fasting blood sugar (FBS), blood sugar 2 hour after breakfast (2HABF) and motor nerve conduction velocity (MNCV) were estimated on day 0 and after 6 weeks in all subjects. Serum zinc levels were significantly low (p<0.001) in group II-A and II-B as compared to healthy controls (group-I) at base line. After 6 weeks the changes in pre and post therapy values of FBS, 2HABF and MNCV (median and common peroneal nerve) were highly significant (p<0.001) for group II-B alone with insignificant change (p>0.05) in group II-A. Therefore, zinc therapy helps in achieving better glycemic control and improvement in peripheral neuropathy as assessed by MNCV.

Depression after stroke-analysis of 297 stroke patients.

Stroke is commonly followed by some form of psychiatric disturbance. Association and severity of depression at the 3rd and 12th months after stroke in patients and controls were compared. Two registers of stroke patients were maintained over 2 years period in two different centers--one in Barisal Town and other in Mitford Hospital, Dhaka. A total of 297 first-ever strokes were registered. These patients were called back at the 3rd and 12th month interview and assessment. Beck's Depression Inventory (BDI), with 10 as the cut off point for depression, was applied to 161 of 212 survivors at the 3rd month and to 156 of 195 survivors at the 12th month. At the 3rd month, 41% of patients and 18% of controls were depressed (P<.001) and the difference was maintained at the 12th month 42% versus 19% (P<.05). Univariate risk factors for depression at the 3rd month were female sex, severe prognostic score at the onset of stroke, age more than 70 years, family history of stroke and living alone after stroke. Depression was common among stroke survivors at the 3rd months and its rate did not decrease at 1 year follow-up. Depression could be decreased if post-stroke rehabilitation services are improved. After the development of depression earlier diagnosis and management help a lot to the patients and care givers.

Study of complications in hypertensive patients having irregular treatment.

One hundred cases of hypertensive complications due to irregular drug-therapy were studied in medicine units of Dhaka Medical College Hospital for the period of one year from February 7, 1989 to February 6, 1990. Among those stroke had headed the list (48%) manifesting in various ways e.g. cerebral haemorrhage with focal neurological signs--hemiplegia, hemiperesis, aphasia etc. Hypertension associated with varying degrees of cardiac ischaemias and heart failure was seen in 14% and 10% cases respectively. Highest incidence of complications was seen in 1-5 years after detection of hypertension with mean age of 55 +/- 18.70 years. Out of 48 cases of strokes, smoker were 41 (75.92%). Regarding reasons of noncompliance of drugs, personal carelessness was the prominent one (47%). Among the risk-factors for atherosclerosis family history tops the list (66%). Diabetes coexists with hypertension in 13% cases. Ocular complications were seen in 06% cases of malignant hypertension with variable retinal changes.