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Biomedical subjects

A J Akhtar

Publications and source records attributed to A J Akhtar.

29 records · Page 2Linked to original sources

Neurological disorders in the elderly at home.

Eight hundred and eight subjects participated in three surveys of random samples of people aged 65 years or more living in their own homes. Neurological history and examination showed the prevalence of completed stroke to be 73 per 1000. Eighty-seven subjects per 1000 gave a history of transient cerebral ischaemic attacks. These prevalence rates were unaffected by age or sex. Senile dementia was diagnosed in 24 subjects per 1000 under 75 years and 109 per 1000 over that age. The prevalence of dementia of all types was 43 per 1000 under, and 140 per 1000, over 75 years of age. Parkinsonism was diagnosed in 16 subjects per 1000, and essential tremor in 17 per 1000. The prevalence of epilepsy was four subject per 1000. Other neurological disorders were diagnosed in 36 subjects, and a similar number had neurological abnormalities to which a definite diagnosis could not be given.

Age Factors↗

Pilot study of factors associated with exacerbations in chronic bronchitis.

The factors associated with exacerbations of chronic bronchitis were investigated in a pilot study of 23 male patients over a period of 29 months. There were 63 exacerbations-56 were fully investigated and in seven only serological studies were possible. Evidence of the presence of an infective agent was sought in the early stages of the exacerbations and during relative quiescence. Significantly more potential pathogens, both bacterial (pneumococci and Haemophilus influenzae) and viral and mycoplasmal, were found during exacerbations than in quiescent periods. It was not possible to demonstrate that atmospheric pollution or low temperature influenced exacerbations, but the data are insufficient to exclude a small effect.It is emphasized that the value of future work on these lines would be increased if agreement could be reached on the definition of an exacerbation.

Adult↗

Miliary tuberculosis in adults.

Of 40 adults with miliary tuberculosis 24 had "overt" disease; in them miliary mottling was usually present on the chest radiograph, and tubercle bacilli were readily isolated from sputum, urine, or cerebrospinal fluid. In the remaining 16 patients the disease was termed "cryptic" because its usual clinical and radiographic features were absent. This cryptic type is as common as the overt type in patients over 60 years. In this series the peak age incidence was in the eighth decade, and possibly this increase in the incidence age is due to the breakdown of old tuberculous foci in patients with diminished immunological mechanisms.Cryptic miliary tuberculosis is a difficult diagnostic problem and should be suspected in any elderly patient, particularly a woman, who has an unexplained pyrexia, pancytopenia, or leukaemoid reaction. In 10 cases it was diagnosed by a therapeutic trial with para-aminosalicylic acid and isoniazid, a fall of temperature to normal (usually within a week), weight gain, a rise in haemoglobin, and increased well-being being the criteria of improvement The use of such a trial is strongly advocated as a specific method of diagnosing cryptic miliary tuberculosis.

Adult↗

Predicting functional outcome following acute stroke using a standard clinical examination.

In a series of 149 patients admitted to a stroke unit, the outcome of the acute phase of stroke rehabilitation, assessed by the patients' return to independence, was found to be related to the results of standardized weekly clinical examinations of mental, motor, sensory and communication function. The prediction of subsequent independence was estimated just as accurately using the results from three of these tests (upper limb motor function, postural function and proprioception) as when using the entire set of tests. A group of patients with little chance of responding to rehabilitation was identified.

Acute Disease↗