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Dr. D.S. Merchant's Articles in Adult




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  • Guillain Barre Syndrome
    Me score on the Glasgow Outcome Scale at eight weeks (a score of 5, indicating a favorable outcome, vs. a score of 1 to 4, indicating an unfavorable outcome).
    • The mortality rate among adults with acute bacterial meningitis and the frequency of neurologic sequelae among those who survive are high, especially among patients with pneumococcal meningitis.
  • Hyponatremia by eHealthGuide.info
    Hyponatremia:
    Plasma Na < 135meq /L
    • Almost always due to •ADH Secretion
    • Appropriate
    • Inappropriat
    • One Exception: Primary Polydipsia • supression of ADH Secretion BUT still overwhelms kidney’s diluting ability • Free water retention & Hyponatremia

    Epidemiology of Hyponatremia:
    Hyponatremia is among the most common electrolyte disorders encountered in clinical medicine, with an incidence of 0.97% and a prevalence of 2.48% in hospitalized adult patients when plasma [Na+ ] concentration below 130 mEq/L is the diagnostic criterion.

    Clinical Manifestations:
    • < 125 mEq/l •
    • Malaise - Muscle cramps
    • Nausea, Vomiting, Headache
    • Hypotension – Tachycardia

    • < 110 mEq/L •
    • Confusion, convulsions, coma
  • Dexamethasone in Adults with Bacterial Meningitis
    Methods:
    • a prospective, randomized, double-blind, multicenter trial of adjuvant treatment with dexamethasone, as compared with placebo, in adults with acute bacterial meningitis.
    • Dexamethasone (10 mg) or placebo was administered 15 to 20 minutes before or with the first dose of antibiotic and was given every 6 hours for four days.
    • The primary outcome measure was the score on the Glasgow Outcome Scale at eight weeks (a score of 5, indicating a favorable outcome, vs. a score of 1 to 4, indicating an unfavorable outcome).
    • The mortality rate among adults with acute bacterial meningitis and the frequency of neurologic sequelae among those who survive are high, especially among patients with pneumococcal meningitis.
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