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Adopting a Local Protocol in the Management of Neuroleptic Malignant Syndrome in the University of Port Harcourt Teaching Hospital (UPTH)
Stanley Catherine Nonyelum,
Stanley Princewill Chuwuemeka,
Nkporbu Aborlo Kennedy,
Osemwegie Nosakhare,
Ugbomah Lucy Obiebi
Issue:
Volume 1, Issue 3, August 2017
Pages:
52-55
Received:
6 March 2017
Accepted:
28 March 2017
Published:
20 May 2017
DOI:
10.11648/j.cnn.20170103.11
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Abstract: Neuroleptic Malignant Syndrome (NMS) is a life-threatening neurologic emergency associated commonly with the use of neuroleptic agents. In view of the high rate of fatality associated with it, urgent careful and adequate management is often required. To highlight the UPTH adopted protocol for the management of Neuroleptic Malignant Syndrome. All the cases of Neuroleptic Malignant Syndrome managed between Jan, 2008–Dec, 2014 in the unit were retrieved and our adopted management protocol critically reviewed. The outcome of our locally adopted management approach of NMS has been largely successful with 100% success rate in all 7 cases managed in the last three (3) years. All our patients recovered without any neurologic sequelae and were scheduled for adequate follow – up after discharge.
Abstract: Neuroleptic Malignant Syndrome (NMS) is a life-threatening neurologic emergency associated commonly with the use of neuroleptic agents. In view of the high rate of fatality associated with it, urgent careful and adequate management is often required. To highlight the UPTH adopted protocol for the management of Neuroleptic Malignant Syndrome. All th...
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Intracerebral Hemorrhage with Severe Ventricular Involvement --External Ventricle Drainage for Acute Obstructive Hydrocephalus
Xuejian Wang,
Yang Chen,
Zhifeng Wang,
Ming Qian
Issue:
Volume 1, Issue 3, August 2017
Pages:
56-59
Received:
20 March 2017
Accepted:
12 April 2017
Published:
24 May 2017
DOI:
10.11648/j.cnn.20170103.12
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Abstract: Background and Purpose: The objective was to analyze the feasibility of an External Ventricle Drainage (EVD) for an obstructive hydrocephalus in patients with severe ventricular hemorrhage. Methods: In this retrospective study, from October 2012 to January 2014 in our department, 23 patients received an EVD for obstructive hydrocephalus. The duration of required EVD, risk factors, and therapeutic effect were analyzed. Results: Twenty three patients were enrolled; Hypertensive cerebral hemorrhage broken into ventricles and caused hydrocephalus in 19 cases, of which 14 cases led an EVD in single lateral ventricle forehead (five cases in left; nine in right side), 5 cases bilateral lateral ventricle forehead drainage; survival for 18 cases, but one case died of pulmonary infection; 4 cases need a further ventriculo-peritoneal shunt. Vascular malformations hemorrhage patients underwent single lateral EVD, bilateral drainage in one case; survived for three cases, one case died due to organ failure after infection; one case needs a further ventriculo-peritoneal shunt. Conclusion: Our data suggest that EVD is a safe and feasible way for treatment of acute obstructive hydrocephalus after intraventricular hemorrhage. After treatment by using an EVD for acute obstructive hydrocephalus, it can relieve patient’s condition and gain time to further save lives.
Abstract: Background and Purpose: The objective was to analyze the feasibility of an External Ventricle Drainage (EVD) for an obstructive hydrocephalus in patients with severe ventricular hemorrhage. Methods: In this retrospective study, from October 2012 to January 2014 in our department, 23 patients received an EVD for obstructive hydrocephalus. The durati...
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Analgesic and Anti-inflammatory Effects of Tanacetum balsamita Essential Oil and One of Its Major Constituents (Quercetin) in Male Rats
Mohammad Kazemzadeh,
Parichehr Yaghmaei,
Saeed Mohammadi
Issue:
Volume 1, Issue 3, August 2017
Pages:
60-66
Received:
29 March 2017
Accepted:
13 April 2017
Published:
26 May 2017
DOI:
10.11648/j.cnn.20170103.13
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Abstract: Tanacetum balsamita is one of the important medicinal plants that is used by iranianan folk medicines. This study aimed to assess the phytochemical Screening, analgesic and anti-inflammatory effects of Tanacetum balsamita essential oil in rats. The essential oil of Tanacetum balsamita (EOTB) was treatment in doses of 10, 50, and 100 mg/kg. In addition, anti-nociceptive activity of EOTB was evaluated by formalin, writhing, and tail-flick tests. The EOTB was also combined with 2 mg/kg naloxone to determine the involvement of opioid mechanism. Anti-inflammatory reaction was evaluated via xylene-induced ear edema. In addition, the EOTB origin has been analyzed by a combination of GC and GC/MS. The EOTB at doses of 10-100 mg/kg have been shown significant analgesic effects (P<0.05). In compare of standard opioid agonist drug (morphine) and non-steroidal anti-inflammatory drug (indomethacine), Use of naloxone plus EOTB has been inhibited pain in all three models. The present results have been shown significant (P<0.05) anti-inflammatory effect of EOTB in the xylene-induced ear edema test in compare to dexamethasone. The major components in the tested oils were mainly contained quercetin, Isoquercitrin and luteolin. In conclusion, findings propose that EOTB probably have analgesic and anti-inflammatory effects. Existent of quercetin may be an important reason for mentioned effects.
Abstract: Tanacetum balsamita is one of the important medicinal plants that is used by iranianan folk medicines. This study aimed to assess the phytochemical Screening, analgesic and anti-inflammatory effects of Tanacetum balsamita essential oil in rats. The essential oil of Tanacetum balsamita (EOTB) was treatment in doses of 10, 50, and 100 mg/kg. In addit...
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Insidence of Martin-Gruber Anastomosis in Turkey: A Cross-Sectional Study
Issue:
Volume 1, Issue 3, August 2017
Pages:
67-69
Received:
27 February 2017
Accepted:
19 April 2017
Published:
15 June 2017
DOI:
10.11648/j.cnn.20170103.14
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Abstract: Martin-Gruber anastomosis (MGA) is a well described anostomosis between the median and ulnar nerves in various levels. MGA involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve and it’s insidence was reported as %10-40. The incidence of this anastomosis is important so that it can cause confusion in the assesment of nerve injuries, compressive neuropathies and it can show different persentages between different population groups. Our objective is to find out an idea about the incidence of MGA in Turkish population. 100 healthy volunteers were inclueded to our study between an age of 17–73 years. Compound muscle action potentials (CMAPs) and motor conduction velocities of median and ulnar nerves were recorded. MGA was made by following criteria: amplitude of CMAP increased after median nerve stimulation at ante-cubital fossa as compared to stimulation at wrist. The corresponding decrease in CMAP amplitude was found after below elbow stimulation as compared with the wrist stimulation in ulnar nerve conduction studies. Martin-Gruber anastomosis was encountered in 29(6 male, 23 female) patients with a persentage of 29% in our present study. The insidence of MGA in Turkish population is high. Understanding the existence of this anatomic variation, its location and its possible presentation is important for the patient’s quality of life. More studies with increased study groups are needed to make us better understand this condition and its insidence in our population.
Abstract: Martin-Gruber anastomosis (MGA) is a well described anostomosis between the median and ulnar nerves in various levels. MGA involves axons leaving either the main trunk of median nerve or the anterior interosseous nerve, crossing through the forearm to join the ulnar nerve and it’s insidence was reported as %10-40. The incidence of this anastomosis ...
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Sporadic Cases of Meningococcal Meningitis Serogroup W-135 — Ethiopia, 2013
Gemechu Defi,
John Fogarty
Issue:
Volume 1, Issue 3, August 2017
Pages:
70-75
Received:
10 April 2017
Accepted:
25 April 2017
Published:
20 June 2017
DOI:
10.11648/j.cnn.20170103.15
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Abstract: Meningococcal meningitis is a serious bacterial infection of the meninges often caused by N. meningitides. Epidemics occur in 8-12 year cycles, usually in the dry season, across the African meningitis belt. In February 2013, West Arsi zone reported a suspected meningitis outbreak to Regional Public Health Emergency Center. Investigation was done to confirm the etiology, identify risk factors, and establish control measures. A suspected case was defined as any person with sudden onset of fever (>38.5°C rectal or 38.0°C axillary) and one of the following signs: neck stiffness, flaccid neck, bulging fontanel, convulsion or other meningeal sign and confirmed case as identified N. meningitidis from the CSF of a suspected case by culture, PCR or agglutination test. From January 23, 2013 up to April 17, 2013, a case investigation was conducted to identify suspected patients and confirmed meningitis for patients cerebrospinal fluid collected. We also conducted case-control study. Descriptive statistics and odds ratios with 95% confidence intervals were calculated to compare risk factors among cases and controls. A total of 99 cases and 3 deaths were occurred from January 23- April 27, 2013. The median age was 12 years with a range from 3 months to 68 years. Majority (89.9%) of the cases were below 30 years of age and children under five years of age were the most affected (28%) and Attack Rate (AR=4.2/100000). Ten (59%) patients with N. meningitidis were confirmed as serotype “A”, 6 (35.3%) patients were confirmed by latex agglutination test and PCR as serotype W135 and 1 (5.9%) patient was confirmed as mixed serotype. 24 confirmed and suspected Meningococcal meningitis patient cases and 96 community matched by sex, age and place of residence controls were included in the case control study. Recent travel to an area where patients with meningitis were reported (Odds Ratio (OR): 10.0, 95% Confidence Interval (CI): 3.7-27.3), attending in the occasion of gathering of population (OR: 7.7, 95% CI: 2.9-20.6) and a history of upper respiratory tract infection (OR: 7.2, 95% CI: 2.6-19.9) were risk factors. We verified sporadic cases of meningococcal meningitis in the areas. Incidence of disease was highest in children under five years of age. This was the first season that W135 was identified in Ethiopia. Further surveillance for W135 should be conducted in Ethiopia to guide vaccination policy.
Abstract: Meningococcal meningitis is a serious bacterial infection of the meninges often caused by N. meningitides. Epidemics occur in 8-12 year cycles, usually in the dry season, across the African meningitis belt. In February 2013, West Arsi zone reported a suspected meningitis outbreak to Regional Public Health Emergency Center. Investigation was done to...
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