Background: Eclampsia is frequently associated with unexplained coma and takes prolong time in clinical recovery. Neuroimaging of head may be helpful to detect abnormal neurological findings and proper care in Eclampsia. Objective: The objective of the study was to investigate cerebral complications of Eclampsia. For this we corelate neuroimaging study in a series of eclampsia population presented with neurological symptoms. Methods: This one year prospective observational study of Eclampsia was conducted in the Obs and Gyne department of Khulna medical college hospital . Available clinical data were extracted from obstetric records. Computed Tomography (CT) findings of head were studied with respect to neurological signs and symptoms. Results: A total of 92 women with Eclampsia, age group between 16-37 years were studied. 48 (52.7%) of mothers had severe hypertension and proteinuria in 67 (72%) cases. CT scan were abnormal in 21 (70%) cases. Hypertensive encephalopathy were mostly associated with PRES (posterior reversible encephalopathy syndrome) in CT among 20 (66.66%) patients. Prolonged coma, HDU care were more in those with positive CT scan, but not statistically significant. Pearson coefficient was significant in correlation of Intrauterine foetal death and maternal severe hypertension. Conclusion: Cerebral odema and PRES are frequent neuroimaging pathology with Eclampsia,but proper detection is a challenge in resource poor settings. Altered level of consciousness should be a warning for possible brain lesions. Early CT scan of Brain can provide useful information and prompt supportive care preventing death from brain damage. Bang Med J Khulna 2023; 56: 03-07
Background: Radiotherapy of head and neck region generally includes irradiation of the salivary glands. That results in glandular dysfunction which leads to xerostomia. Xerostomia, the subjective sensation of dry mouth which significantly deteriorates the quality of life. Aim and objective: To compare the effects of pilocarpine HCL with basic oral care vs only basic oral care for controlling xerostomia in patients with locally advanced Head and neck squamous Cell Carcinoma patients having definitive concurrent chemoradiotherapy. Material and Method: A prospective observational hospital based study was carried out in the Department of Oncology, Khwaja Yunus Ali Medical College & Hospital from July 2017 to June 2018 on sixty patients of locally advanced HNSCC. All the patients received 66 Gy/33 Fraction/6.5 wks with concurrent weekly cisplatin (40mg/m²). The study group received concomitant Pilocarpine HCL 5 mg three times a day, starting three days prior to start of radiotherapy, continued for 3 months. Patients were evaluated before start of treatment, weekly during radiotherapy and after completion of radiotherapy two weekly over telephone upto 3 months and finally at 6 months using Zimmermen Xerostomia Questionnaire with Visual Analogue Scale and Xerostomia Grading Scale. Result: Overall incidence of xerostomia was significantly lower in pilocarpine group (p<0.05). The average Zimmerman Xerostomia scores of the pilocarpine group as compared to the control group: Dryness of mouth were significantly lower (p<0.05) in each of the assessment after the start of radiotherapy. Significant p value is also found in measurement of comfort status of mouth, sleep impairment, speech impairment and difficulty in eating. Conclusion: Pilocarpine given concomitantly and after radiotherapy has shown to reduce symptoms of xerostomia and lower the degree of post radiation salivary dysfunction than that occurring in the patients who had not received pilocarpine. Bang Med J Khulna 2022; 55; 13-18
