Sujets)
Adolescent , Cartographie cérébrale , Électroencéphalographie , Femelle , Études de suivi , Humains , Tests neuropsychologiques , Polyneuropathies/complications , Maladies rares , Appréciation des risques , Indice de gravité de la maladie , Paraplégie spasmodique héréditaire/complications , Sri LankaRésumé
OBJECTIVE: To audit the process of stroke care. DESIGN: Retrospective case record evaluation using an audit package designed by the Royal College of Physicians of London. SETTING: Institute of Neurology, National Hospital of Sri Lanka, Colombo. PATIENTS: 263 patients with stroke admitted over a period of 3 years. MEASUREMENTS: Documentation of 60 audit items related to 13 aspects of stroke care. RESULTS: The process of care was considered 'very good' for only 11 (18.3%), and 'good' for only 9 (15%) of the audit items. Care was 'average' for 5 (8.3%), 'poor' for 9 (15%) and 'very poor' for 26 (43.3%) of the items. CONCLUSIONS: Stroke care was suboptimal in many aspects. Care related to rehabilitation oriented neurological assessments, initiation of secondary preventive measures, rehabilitation planning and discharge planning were especially deficient. Competing interests: none declared. Some of the data reported in this paper have been presented at the Annual Scientific Sessions of the Sri Lanka Medical Association, 1998.
Sujets)
Humains , Audit médical , Études rétrospectives , Sri Lanka , Accident vasculaire cérébral/thérapieSujets)
Adulte , Facteurs âges , Causalité , Infarctus cérébral/diagnostic , Échocardiographie , Hémianopsie/diagnostic , Hémoglobinurie paroxystique/complications , Humains , Hyperhomocystéinémie/complications , Mâle , Parésie/diagnostic , Déficit en protéine C/complications , Accident vasculaire cérébral/diagnostic , TomodensitométrieRésumé
We describe a case of hereditary sensory and autonomic neuropathy (HSAN) type II in a child with a penetrating foot ulcer, acral sensory impairment, and anhidrosis. This is the first documentation of HSAN in Sri Lanka.
Sujets)
Potentiels d'action , Enfant , Diagnostic différentiel , Ulcère du pied/étiologie , Neuropathies héréditaires sensitives et autonomes/complications , Humains , Hypohidrose/étiologie , Mâle , Neurofibres myélinisées/anatomopathologie , Neurones afférents/anatomopathologie , Nerf sural/physiopathologie , Nerf ulnaire/physiopathologieRésumé
A case of eosinophilic meningitis is reported, a condition not previously reported from Sri Lanka. We propose Angiostrongylus cantonesis to be the most likely causative agent in this patient.
Sujets)
Adulte , Angiostrongylus cantonensis , Animaux , Diagnostic différentiel , Éosinophilie/sang , Humains , Mâle , Ponction lombaireRésumé
INTRODUCTION: Neuropathy is considered to be a longterm complication of diabetes. AIMS: To determine the prevalence of peripheral neuropathy in 112 Sri Lankan patients with recently diagnosed non-insulin-dependent diabetes and a control population of 100 people. METHODS: A diagnosis of peripheral neuropathy was made using a clinical symptom score, clinical examination, quantitative sensory testing and electrophysiological studies. RESULTS: 9.8% of diabetic patients at diagnosis had peripheral neuropathy, 2.6% had foot ulcers, 7.1% had signs of neuropathy, abnormal vibration perception threshold and nerve conduction abnormalities and 15.1% had abnormal nerve conduction velocity without signs or symptoms of neuropathy. The peroneal nerve conduction velocity was higher in diabetic patients when compared to controls. There was an inverse correlation between nerve conduction velocity and fasting blood glucose in diabetic patients (p < 0/05). This association was stronger for peroneal nerve conduction velocity (r = -0.73) than for median nerve motor conduction velocity (r = -0.42). CONCLUSIONS: Symptomatic peripheral neuropathy is common among Sri Lankans with newly diagnosed non-insulin-dependent diabetes. This may be due to a later presentation of diabetes or a genetic predisposition.