A Retrospective Study about Autonomy of the Patients with Neurological Disorders: A Record base Analysis
Abstract—In the case of neurological disorders, patient autonomy is a fundamental principle which must be taken into consideration. In the case of this pathology, fluctuating mental deterioration is encountered most frequently in the case of mild forms of dementia. In the case of severe forms of dementia, the patient loses any autonomy and requires permanent medical care, as well as a permanent legal representative.
Aim of this study was to know autonomy of the patients with certain neurological disorders about ability of making decisions for their medical care.
Material and method: It is a quantitative retrospective observational study and data for which is gathered from the observation charts of 323 patients attended in either emergency or outpatient, between April to December 2006, in “Prof. Dr. Nicolae Oblu” Clinical Hospital of Emergency, Iasi, Romania. Study subjects were split into 2 groups: Group 1 (with a number of 215 cases) – a group of patients with the diagnostics of acute cerebrovascular accident, aphasia and dementia. Group 2 (with a number of 108 cases) – patients known or recently diagnosed with amyotrophic lateral sclerosis, multiple sclerosis and myasthenia gravis. Consent informed given by patient in the observation charts of above two groups was observed and number of patients who has given consent was compared in both the groups.
Results: On the cases under study, only for 13.6% of the patients of the first group there is consent informed in the observation chart, while for the patients in the second group this percentage was slightly smaller (9.3%).
Conclusions: As very few patients have given written informed consent and more sever the neurological disorder less the chances to have written informed consent by patients. So it can be concluded that medical performance brings indisputable benefits, however it should be done by a careful selection of the subjects and by following ethical principles.
Keywords: Autonomy, Neurological Disorders, Competency
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Mycosis Fungoides presented with De Novo Ulceration: A Case Report
Abstract—Mycosis fungoides is the commonest cutaneous T cell lymphoma. It may be difficult to distinguish it from other dermatoses. Non responsive ulcerated plaques may be a presenting feature of mycosis fungoides. A definitive diagnosis can be made only on careful correlation of the clinical with the histopathological, immunophenotypical and molecular features. A case of mycosis fungoides who presented with de novo ulceration in plaque stage of mycosis fungoides was observed and presented which is a rare presentation.
Key words: Mycosis Fungoides, Ulceration, Plaque
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A Descriptive Study of Differentially Placed Hydatid cysts
Abstract—In Italy the hydatid disease is more prevalent and new cases are highlighted more frequently in Sicily, Sardinia, (Italy). Aim of this study is to put the indication in search of iaditea nature in both spleen swelling and muscle tendon.
Material and Method Patients observed during the period 2007-2009 at the Surgical Clinic III and Digestive Surgery, Policlinico G Rodolico were explored for Hydatid cyste at various sites. Diagnosis of cysts ecchinococcus occurred primarily for various four reasons either for compression of bodies involved or for eosinophilia or for instrumental investigation or for anaphylactic reaction to rupture of cysts. Biological diagnosis is based on serology rather than isolation of the parasite (indirect diagnosis);
Results Patients attended during the period 2007-2009 Hydatid cyst was found in 0.5% of all cases in liver along with 4 in the lung, 3 in splenic, 2 in the mammary and 2 in the chest wall No 2. The Surgical treatment with the complete removal of the cyst with a satisfactory postoperative course in the absence of cases of relapse of the disease and by following the therapeutic act, the assumption of mebendazole 50mg / kg / day for 3 weeks at a dose of 400mg for 4 months
Conclusions There is a need to define diagnostic methods with high specificity and sensitivity, which can provide a valid diagnostic aid for the cases clinically difficult to diagnose. And the final diagnosis must then also be based on the development of immunological methods that allow the determination of specific antibodies in the serum and their titration and / or the circulating antigen determination.
Key words: Cyst Excision Monoclonal Antibodies
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Unusual Presentation of Bacille Calmette-Guérin (BCG) Osteomyelitis in Immunocompetent Saudi Child: A Case Report
Abstract—Osteomyelitis is a rare complication of Bacillus Calmette-Guerin (BCG) vaccine particularly in Immunocompetent children. Recognition and Management of BCG osteomyelitis is challenging. Herein a 7-months-old Saudi girl admitted with right foot swelling, clinical diagnosis of cold abscess was made. MRI imaging revealed osteomyelitis of 1st right tarsal bone, open biopsy tissue culture and PCR were positive for mycobacterium bovis. BCG osteomyelitis is devastating complication of BCG vaccination that should be considered in the appropriate clinical setting.
Keywords– BCG vaccine, Osteomyelitis, Immunocompetent
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Assessment of Daily Parenting Stress and Depressive Symptoms among Parents of Children with Intellectual Disability
Abstract—There is a scarcity of available studies in India on parental stress and depression among parents of children with intellectual disability. Present hospital based cross sectional analytical type of observational study was carried with the specific aims to assess and compare daily parenting stress and depressive symptoms among parents of children with various degree of intellectual disability. Total 90 randomly selected subjects ({both parents of mentally retarded (MR) children and normal children} were evaluated separately for daily parenting stress and depressive symptoms using the Family Interview for Stress and Coping and Hamilton Depression Rating Scale. According to Intelligence Quotient (IQ) of children, three groups were created: Group ‘A’ (30 parents of moderate to profound MR children), group ‘B’ (30 parents of mild to borderline MR children) and group ‘C’ (30 parents of children normal intelligence).IQ of the children was assessed by trained clinical psychologist and diagnosis was made as per ICD-10 criteria. Controls were taken from healthy volunteer and screened by two psychiatrists. A self designed, pre-tested & semi-structured detailed Performa was used for socio-demographical and clinical profile. The data were analyzed using SPSS trial version. Parents in group ‘A’ had significantly higher level of daily parenting stress and depressive symptoms than groups ‘B’ and ‘C’, group ‘B’ parents had higher level of daily parenting stress and depressive symptoms than group ‘C’. Mothers experienced greater depressive symptoms and daily parenting stress compared to fathers. A positive correlation was found between daily parenting stress and depressive symptoms and negative correlation was found between IQ of the children and the daily parenting stress and depressive symptoms.
Key words: Mental retardation, depressive symptoms, daily parenting stress