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Background: Diffusion Weighted Images (DWI) is conventionally used to identify acute ischemic lesions. It has now become a routine technique in the magnetic resonance protocols for the evaluation of stroke patients. The objective of the present study was to find the distribution of different cerebral lesions showing restriction on DWI and influence of ADC on them.Methods: This was single blinded prospective study. Evaluating the magnetic resonance imaging was blinded for the clinical data of the patient. This study was done at M.R.I. unit of Department of Radio Diagnosis, C.S.M. Medical University, Lucknow, during a period of one year from August 2008 to July 2009.Total 93 subjects with restricted diffusion with age range of (6 to 95 years) were found. Data were analyzed using statistical software package, STATA 9.2 and the difference was considered to be significant if ‘p’ value was found to be <0.05.Results: Ninety-three cases of diffusion restriction were seen of which 55 of infarcts (37 male and 18 female) with age range of 6 to 95 years. 10 cystic lesions which were showing restriction on DWI with low ADC value were found. Total 12 cases of encephalitis were found showing restriction on DWI. Most of the cases of encephalitis were found to have ADC value between 400 to 800 x 10-6 mm2/s that 75% of total encephalitis cases. Fluid-attenuated inversion recovery was superior to T2 sequencing in showing cortical lesions.Conclusions: MRI with DWI and ADC values are helpful in the earlier diagnosis of the encephalitis, infarcts and helpful in better differentiation of infarcts, abscesses and encephalitis in comparison to MRI without DWI and ADC value.
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Background and Objectives: The well being of oneself, happiness with one’s situation in life and ability to perform and control the different situation of life is HRQoL. Reminiscence therapy is a way for residents of assistant living facilities to become better acquainted with one another and strengthen the personal value and self esteem. The objective of this study was to assess the HRQoL while application of Reminiscence Therapy among the old age people who are residing at a selected old age home in Bengaluru, India. Materials and Methods: For this study quasi experimental research design was selected and convenient sampling technique was used to collect data from 60 samples staying at old age home by using the SF-36 scale. The samples in experimental group receive 10 sessions of reminiscence therapy each session last for 45 minutes to 1 hour. The experimental group was divided into 6 groups each group having five members for group discussion related to the topics like childhood memories, education pattern, first job and first salary, marriage, first child etc. Post test data was collected after a week of implementation of Reminiscence Therapy. Then the data was analyzed and interpreted. Results: The findings of the study with regard to pretest HRQoL reveals that 86.7% has poor HRQoL, 13.3 % moderate HRQoL and no one was having good HRQoL in experimental group. In control group 56.7% has poor HRQoL, 43.3% moderate HRQoL and no one was having good HRQoL. But in posttest, only in experimental group there was significant improvement in HRQoL as 83.3% has good HRQoL, 13.3% moderate HRQoL and 3% poor HRQoL. Conclusion: This study concluded that with significant improvement in the SF-36 Scale score after administration of the reminiscence therapy and seen improvement in HRQoL.
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Background: Children with congenital heart diseases (CHD) are considered to be at high-risk for neurodevelopmental delay, but scant Indian data are available. Objective: To evaluate the neurodevelopmental status of children with CHD. Methods: We enrolled consecutive children aged 6-30 months with echocardiographically-confirmed CHD between June 2013 and January 2014. Children with clinically recognizable genetic syndromes or disorders; visual and/or hearing deficits, and microcephaly; and post-cardiac surgery children were excluded. Development was assessed by Developmental Assessment Scale for Indian Infants (DASII) and Developmental delay defined as Development Quotient (DQ) <70 in either the mental or motor scale. Results: 75 children (53 males) with CHD were enrolled. Acyanotic CHD was seen in 51 children (VSD in 47%), and Tetralogy of Fallot was the commonest cyanotic CHD (25%). Developmental delay was seen in 25% of these children, more in the motor domain (48%) than in mental (12%). Mean motor and mental DQ in acyanotic CHD was 77 and 84, respectively; and 65 and 85, respectively in cyanotic CHD. Mean motor DQ was significantly less than mental DQ in both acyanotic and cyanotic CHD children (P=0.048). Conclusion: Children with CHD are at an increased risk for developmental delay. Periodic surveillance, screening and evaluation should be instituted in them for early identification and appropriate interventions to enhance later academic, behavioral, psycho-social and adaptive function.
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FUNDAMENTO: O bloqueio completo do ramo esquerdo esforço-induzido (BCRE E-I) é um achado infrequente ao teste de exercício e sua prevalência e significado prognóstico não são claros. OBJETIVO: Avaliar de forma longitudinal a prevalência e o significado prognóstico do BCRE E-I em homens americanos veteranos de guerra. MÉTODOS: Avaliamos 9.623 pacientes que realizaram ergometria em esteira (TE) entre 1987 e 2007. Os desfechos foram comparados entre aqueles com TE NL, os com BCRE E-I e os que apresentaram Dep ST anormal. A mortalidade e a causa das mortes foram identificadas de forma cega para os resultados do TE. RESULTADOS: Nesta coorte prospectiva, 6922 indivíduos apresentaram TE NL (57,2 ± 11,4 anos), 1.739 apresentaram Dep ST anormal (62,7 ± 9,8 anos) e 38 casos de BCRE E-I foram identificados (65,2 ± 11,9 anos). A prevalência do BCRE E-I foi 0,38 por cento. Após 8,8 anos, ocorreram 1.699 mortes por todas as causas e 610 mortes cardiovasculares (CV). Doença arterial coronária e insuficiência cardíaca foram mais prevalentes nos pacientes com BCRE E-I. Pacientes com BCRE E-I tiveram razão de azar de 2,37 (p = 0,002) para mortalidade por todas as causas, mas a mesma não foi significativa quando ajustada para idade ou quando a mortalidade cardiovascular foi o desfecho avaliado. CONCLUSÃO: BCRE E-I é um achado raro. Indivíduos com BCRE E-I apresentam maior mortalidade por todas as causas quando comparados aqueles com TE NL. No entanto, tal fato é explicado por esses pacientes serem significativamente mais velhos e por apresentarem mais enfermidades cardiovasculares associadas.
BACKGROUND: Exercise-induced left bundle branch block (EI-LBBB) is an infrequent finding. Its prevalence and prognostic significance are not clear. OBJECTIVE: To evaluate, in a longitudinal study, the prevalence and prognostic significance of EI-LBBB in American war veterans. METHODS: We evaluated 9,623 patients submitted to an exercise test (ET) in treadmill between 1987 and 2007. The outcomes were compared between those with normal TE, the ones with EI-LBBB and the ones with down-sloping ST-segment. Mortality and causes of death were identified while blinded to the ET results. RESULTS: In this prospective cohort, 6,922 individuals had normal ET results (57.2 ± 11.4 years), 1,739 had abnormal ST-segment depression (62.7 ± 9.8 years), and 38 had EI-LBBB (65.2 ± 11.9 years). The prevalence of EI-LBBB was 0.38 percent. After 8.8 years, there were 1,699 deaths due to all-cause mortality and 610 cardiovascular (CV) deaths; coronary artery disease and heart failure were more prevalent in patients with EI-LBBB. Patients with EI-BCRE had a hazard ratio of 2.37 (p = 0.002) for all-cause mortality, but it was not significant when adjusted for age or when the CV death was the assessed outcome. CONCLUSION: EI-LBBB is a rare clinical finding. Individuals with BCRE-EI have higher all-cause mortality when compared to those with normal ET results. However, this fact is explained by the fact that these patients are significantly older and have more associated cardiovascular diseases.
FUNDAMENTO: El bloqueo completo de rama izquierda esfuerzo-inducido (BCRI E-I) es un hallazgo infrecuente en el test de ejercicio y su prevalencia y significado pronóstico no son claros. OBJETIVO: Evaluar de forma longitudinal la prevalencia y el significado pronóstico del BCRI E-I en los hombres norteamericanos veteranos de guerra. MÉTODOS: Evaluamos 9.623 pacientes que realizaron ergometría en cinta (TE) entre 1987 y 2007. Los resultados fueron comparados entre aquellos con TE normal (TE NL), los con BCRI E-I y los que presentaron infradesnivel del segmento ST (Dep ST) anormal. La mortalidad y la causa de las muertes fueron identificadas de forma ciega para los resultados del TE. RESULTADOS: En esta cohorte prospectiva y después de las exclusiones, 6.922 individuos presentaron EC NL (57,2 ± 11,4 años), 1739 tuvieron Dep ST anormal (62,7 ± 9,8 años), y 32 casos de BCRI E-I fueron identificados (65,2 ± 11,9 años). La prevalencia del BCRI E-I fue del 0,38 por ciento. Después de 8,8 años, ocurrieron 1699 muertes por todas las causas y 610 muertes cardiovasculares (CV). La enfermedad arterial coronaria y la insuficiencia cardíaca fueron las más prevalentes en los pacientes con BCRI E-I. Los pacientes con BCRI E-I presentaron azar de 2,37 (p = 0,002) para la mortalidad por todas las causas, pero ella no fue significativa cuando se ajustó para la edad o cuando la mortalidad cardiovascular fue el desenlace evaluado. CONCLUSIÓN: BCRI E-I es un hallazgo raro. Los individuos con BCRI E-I presentan una mayor mortalidad por todas las causas cuando se les compara con los de EC NL. Sin embargo, ese hecho se explica porque esos pacientes son significativamente más viejos y por presentar más enfermedades cardiovasculares asociadas.