ABSTRACT
Tremors are a common movement disorder that affects a person's life adversely. With various drawbacks of current treatment methods, there is a need for a mechanical solution. The authors present a soft orthosis based on layer jamming for the suppression of hand tremors. A vacuum supplied to the layer jamming elements which contain a stack of layers attached to the glove leads to increased stiffness in the glove, suppressing the tremor. The behavior of the tremor in a cohort of patients in Sri Lanka was studied and showed that the tremor's mean frequency was 5.05 ± 2.03 Hz. An existing analytical model was modified and verified experimentally to select the layer jamming element. An element with sandpaper (320 grade) and tracing paper was chosen based on the high stiffness provided at a lower weight (total weight of the glove = 30g). Experimental results show minimal variation in stiffness for vacuum pressures between 10-50 kPa (abs.). The performance evaluation on a test rig was used to verify the efficacy of the glove and showed optimal placement on the palmar side with a mean tremor amplitude reduction of 78.32%. Clinical trials conducted on 11 recruited tremor patients showed a mean frequency power reduction of 41.74 ± 12.11%, 41.99 ± 14.82%, and 24.71 ± 12.18% in the index and middle fingers and in grasping, respectively with a maximum power reduction of 59.15%. The soft, low weight orthosis shows a high tremor suppression in both the test rig and clinical experiments.
Subject(s)
Fingers , Tremor , Hand , Hand Strength , Humans , Orthotic DevicesABSTRACT
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.
Subject(s)
Medical Audit , Stroke/therapy , Humans , Retrospective Studies , Sri LankaSubject(s)
Cluster Headache/diagnosis , Cluster Headache/etiology , Headache Disorders/diagnosis , Headache Disorders/etiology , Anti-Inflammatory Agents, Non-Steroidal/therapeutic use , Cluster Headache/drug therapy , Diagnosis, Differential , Headache Disorders/drug therapy , Humans , Indomethacin/therapeutic use , Male , Middle Aged , Time FactorsABSTRACT
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.
Subject(s)
Foot Ulcer/etiology , Hereditary Sensory and Autonomic Neuropathies/diagnosis , Neurons, Afferent/pathology , Action Potentials , Child , Diagnosis, Differential , Hereditary Sensory and Autonomic Neuropathies/complications , Hereditary Sensory and Autonomic Neuropathies/pathology , Hereditary Sensory and Autonomic Neuropathies/physiopathology , Humans , Hypohidrosis/etiology , Male , Nerve Fibers, Myelinated/pathology , Sural Nerve/physiopathology , Ulnar Nerve/physiopathologySubject(s)
Guillain-Barre Syndrome/diagnosis , Sural Nerve/pathology , Acute Disease , Aged , Axons/pathology , Biopsy , Diagnosis, Differential , Fatal Outcome , Guillain-Barre Syndrome/complications , Guillain-Barre Syndrome/pathology , Guillain-Barre Syndrome/physiopathology , Humans , Inappropriate ADH Syndrome/etiology , Male , Middle Aged , Paralysis/etiologyABSTRACT
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.
Subject(s)
Angiostrongylus cantonensis , Central Nervous System Helminthiasis/diagnosis , Central Nervous System Helminthiasis/parasitology , Eosinophilia , Meningitis/diagnosis , Meningitis/parasitology , Adult , Animals , Central Nervous System Helminthiasis/cerebrospinal fluid , Diagnosis, Differential , Eosinophilia/blood , Eosinophilia/cerebrospinal fluid , Humans , Male , Meningitis/cerebrospinal fluid , Spinal PunctureABSTRACT
We describe a case of essential thrombocythemia (ET), presenting as digital gangrene. ET is a rare myeloproliferative disorder characterised by a persistently elevated platelet count which commonly presents with haemorrhagic manifestations. Thrombosis occurs less frequently and digital gangrene is an uncommon presentation.
