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Biomedical subjects

B T Desai

Publications and source records attributed to B T Desai.

13 recordsLinked to original sources
PubMed1984

Comparative head trauma experiences in two socioeconomically different Chicago-area communities: a population study.

Although a few epidemiologic studies of head injuries have appeared recently, none have examined the incidence, causes and risk factors for an inner city environment. To overcome this deficiency, the authors visited 35 hospitals and the Office of the Medical Examiner and abstracted data from every chart that described a head injury that had been sustained during a 12-month interval by residents of either of two Chicago-area communities: one located in the inner city, comprised almost entirely of blacks; the other the city of Evanston, a Chicago suburb, about 21% black and 75% white. Denominators came from the 1980 Census. Age-adjusted incidence rates, per 100,000 population, were 403 for the inner city community, 394 for Evanston blacks and 196 for Evanston whites. In each race-community category, males were about 2.5 times more likely than females to sustain a head injury. Mortality rates from head trauma were 32 for the inner city community, 19 for Evanston blacks and 11 for Evanston whites. The leading cause of head trauma and death from head trauma was interpersonal attacks for the inner city residents and vehicle accidents for Evanston residents. Community differences, revealed in this study, and in a comparison of this study with previous reports, are discussed. Finally, methodological differences among these studies are examined in an effort to determine which differences in results reflect actual differences in head trauma experience.

Accidents, Traffic↗
PubMed1984

Epilepsy in prison: elevated prevalence and no relationship to violence.

The epidemiologic, clinical, and social characteristics of epilepsy were investigated in men entering the Illinois prison system and compared with a matched control group of prisoners without epilepsy. The prevalence of epilepsy was 2.4%, four times higher than the prevalence among men aged 20 to 39 in Rochester, MN. Head trauma was the probable cause of epilepsy among 45% of the prisoners with epilepsy, a much higher percentage than that reported in studies of other populations. In comparison with an age- and race-matched group of prisoners without epilepsy, the epilepsy group was not convicted of more serious or more violent crimes.

Adolescent↗
PubMed1984

Disposition of mephenytoin and its metabolite, nirvanol, in epileptic patients.

We investigated the conversion of mephenytoin to nirvanol in five patients with uncontrolled complex partial seizures. After a 50-mg single oral dose, mean peak mephenytoin level was 0.48 microgram/ml and nirvanol 0.37 microgram/ml. After 400 mg, peak mephenytoin level was 3.9 micrograms/ml and nirvanol 2.5 micrograms/ml. On 400 mg daily, mephenytoin reached a mean steady-state level of 1.5 micrograms/ml. Nirvanol mean steady-state level was 18 micrograms/ml. Mean plasma half-life was 17 hours for mephenytoin and 114 hours for nirvanol. Two patients had reduced seizures during mephenytoin therapy and one a transient increase during drug withdrawal. No toxicity was seen, but mephenytoin was not more effective than phenytoin.

Adolescent↗
PubMed1984

Sequelae associated with head injuries in patients who were not hospitalized: a follow-up survey.

Data about sequelae associated with head injuries in patients presenting at a suburban hospital but not hospitalized were collected from emergency department medical records and two follow-up telephone interviews. During the study period 669 patients with head injuries were discharged from the emergency department. Of these, 288 were asked to participate in the study, 275 (95%) agreed, and 262 (91%) were eventually contacted. Participants and nonparticipants were compared on six variables and differed significantly only on age--younger patients were more likely to be included. Forty-eight hours after trauma, 52% of the respondents suffered headaches, 14% complained of dizziness, and 13% complained of drowsiness. One week after trauma, the complaints were headaches in 27%, dizziness in 11%, and drowsiness in 9%. Twenty-seven per cent had not resumed normal activity at 48 hours after trauma, and 13% had not at 1 week. Sixty-six per cent of the patients followed the patient instructions regarding head injuries.

Adolescent↗
PubMed1984

Complex partial seizures.

Complex partial seizures, the most common of the adult seizure types, originate in the temporal lobe or limbic system. They include spells with emotional content, cognitive defects, hallucinations and automatisms. Video recordings, EEG telemetry and positron emission tomography have provided a better understanding of the electrophysiology of these seizures. Computed tomography reveals lesions in 50 to 70 percent of the patients. Seizures that are intractable to medical therapy can be treated by temporal lobe resection, with benefits in at least 70 percent of patients.

Anticonvulsants↗
PubMed1983

Seizures in relation to head injury.

Seizures have a two-fold relationship with head injury: they can cause a head injury, or they can be the result of a head injury. We compare these two groups in terms of cause, severity, likelihood of sequelae, outcome, radiological investigation, and surgical intervention. Of 702 patients admitted with a head injury to Cook County Hospital (CCH), 25 patients (3.6%) had seizures causing a head injury (Group 1). Another 29 patients (4.1%) experienced a head injury which caused a seizure (Group 2). The remaining 648 patients (Group 3) had no seizure involvement in relation to their injury. Group 1 and Group 3 were similar in terms of severity and sequelae. Group 2, in which a statistically significant increase in both was noted, was dramatically different. It thus appears that seizures indicate increased severity and sequelae in a head injury only when they result from that injury, and not when they cause it. The emergency physician must thus be prepared to distinguish these two situations, for patients in Group 2 have an increased need for neuroradiologic procedures and neurosurgical intervention.

Craniocerebral Trauma↗
PubMed1983

Seizures and civilian head injuries.

Although several studies have reported on the risk of "early seizures" (seizures occurring within 7 days following a head injury), the reported proportions of patients experiencing these seizures vary from 1.4 to 15%. This wide divergence may be due to problems with methodology such as case selection and definitions of head injury and early seizures. In a series of 702 patients admitted with a head injury to Cook County Hospital (CCH), Chicago, Illinois, 29 (4.1%) had early seizures. This proportion is twice as high as one previously reported in a comparable series. This may reflect an actual difference between the two series or a case selection bias serving to elevate the proportion of patients with early seizures at CCH.

Adolescent↗
PubMed1983

Urban head injury: a clinical series.

Consecutive head-injured patients admitted to Cook County Hospital in Chicago, Illinois, over a 12-month period were examined upon admission and discharge. Information was collected about the nature of the injury, symptoms, signs, and sequelae for 702 patients. Detailed descriptions of the causes of these injuries, and their correlates, were also obtained.Approximately 80 percent of the patients had localized pain, loss of consciousness and/or posttraumatic amnesia, and associated injuries; 16 percent had a skull fracture, 7.0 percent had an intracranial hematoma, 4.1 percent had early seizures, and 2.4 percent died.Skull x-ray examinations were performed on 93.4 percent of the patients (16.9 percent were positive) and radiographic examination of the cervical spine was performed on 67.2 percent (1.7 percent were positive). Utilization of EEGs, computerized tomography scans, and arteriograms was also assessed.Falls were the leading cause of injury (45.8 percent) for patients under 16 years of age and interpersonal injuries accounted for the majority (55.7 percent) of the injuries to adults. About 15 percent of the adults sustained severe or fatal injuries, compared with only 7 percent of the children.It is concluded that although this set of data suggests new considerations for the prevention of head injuries, the lack of comparative data about the medical correlates of these injuries inhibits similar observations about medical care.

Adolescent↗
PubMed1982

Psychogenic seizures. A study of 42 attacks in six patients, with intensive monitoring.

Intractable complex partial seizures and seizures of unknown type were studied in 78 patients, six of whom were found to have psychogenic seizures. Evaluation by intensive monitoring included simultaneous six-hour telemetered EEG and videotape recordings and daily determination of plasma antiepileptic drug levels. Diagnosis was determined by assessment of four major criteria: deviation of seizures from characteristics of known seizure types, absence of epileptiform activity in the ictal EEG, absence of slowing in the postictal EEG, and relation of seizure frequency to decreasing plasma concentrations of antiepileptic drugs. No single criterion is sufficient for an unequivocal diagnosis of psychogenic seizures.

Adult↗
PubMed1978

Active noncompliance as a cause of uncontrolled seizures.

A 26-year-old woman with intractable seizures and fluctuating plasma phenytoin concentrations is described. Noncompliance with prescribed drug regimens was suspected. Phenytoin was first given as a capsule and then as an elixir. Ingestion of the capsule was monitored, and active non-compliance was proved and admitted by the patient. The causes of inadequate plasma phenytoin concentrations are few and can be determined either by specific laboratory methods or by changing the form of the drug.

Adult↗
PubMed1975

Raeder's syndrome.

Raeder's paratrigeminal syndrome is a disorder manifested by unilateral ptosis, miosis, intact facial sweating, and severe pain in the distribution of the ophthalmic division of the fifth nerve. It is a clinical pattern where, usually, a middle-aged male gets a severe throbbing supraorbital headache accompanied by ptosis and miosis. The headache is intermittently present for several weeks or months. Facial sweating may or may not be affected. This report describes a female with Raeder's syndrome who had unilateral facial anhibrosis.

Face↗