This mini-review explores the potential of using ChatGPT, an artificial intelligence language model, to build personalized rehabilitation plans for elderly patients. Creating such plans improve the function of morbid and frail elderly, and can be time-consuming, requiring a multidisciplinary team of health-care professionals. ChatGPT can generate human-like responses to text inputs, making it a valuable tool for health-care professionals in creating personalized rehabilitation plans. The review outlines a case study in which trial and error questioning was done to develop a set of optimal parameters that can be input into ChatGPT to develop personalized rehabilitation plans for patients. Six case scenarios involving different organ systems were assessed by expert geriatricians for quality of advice. ChatGPT use offered several benefits for developing personalized plans, such as its easy and free accessibility, personalized chatbot, ability to integrate complex multiple morbidities, and reduced need for extra personnel. However, its limitations include limited accuracy, no reference of information, bioethical considerations, lack of information storing capabilities, and patient mistrust in machine learning software. Overall, our review suggests that ChatGPT has the potential to be an excellent tool for developing personalized rehabilitation plans for elderly patients. However, it is important to consider the limitations and ensure that health-care professionals review and approve any plans generated by ChatGPT before implementing them. It is crucial to note that ChatGPT should be used to support clinical decision-making rather than replace health-care professionals' expertise and knowledge.
{"title":"Use of ChatGPT by physicians to build rehabilitation plans for the elderly: A mini-review of case studies","authors":"Kartik Mittal, Minakshi Dhar","doi":"10.4103/jiag.jiag_27_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_27_23","url":null,"abstract":"This mini-review explores the potential of using ChatGPT, an artificial intelligence language model, to build personalized rehabilitation plans for elderly patients. Creating such plans improve the function of morbid and frail elderly, and can be time-consuming, requiring a multidisciplinary team of health-care professionals. ChatGPT can generate human-like responses to text inputs, making it a valuable tool for health-care professionals in creating personalized rehabilitation plans. The review outlines a case study in which trial and error questioning was done to develop a set of optimal parameters that can be input into ChatGPT to develop personalized rehabilitation plans for patients. Six case scenarios involving different organ systems were assessed by expert geriatricians for quality of advice. ChatGPT use offered several benefits for developing personalized plans, such as its easy and free accessibility, personalized chatbot, ability to integrate complex multiple morbidities, and reduced need for extra personnel. However, its limitations include limited accuracy, no reference of information, bioethical considerations, lack of information storing capabilities, and patient mistrust in machine learning software. Overall, our review suggests that ChatGPT has the potential to be an excellent tool for developing personalized rehabilitation plans for elderly patients. However, it is important to consider the limitations and ensure that health-care professionals review and approve any plans generated by ChatGPT before implementing them. It is crucial to note that ChatGPT should be used to support clinical decision-making rather than replace health-care professionals' expertise and knowledge.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"22 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134067243","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Frailty syndrome is a transitional state in a dynamic process, dependent on various physical, psychological, and social factors, which interact and disturb the physiological balance. Tilburg Frailty Indicator (TFI) is a valid multidimensional assessment tool of frailty. Most developed countries recognize frailty as a syndrome. In India, the number of elderly population is increasing, with few studies on frailty. Purpose: Hence, this study aimed to find the prevalence of frailty among the elderly population of Ahmedabad, Gujarat. Methods: An observational study of 200 geriatric people aged more than 60 years was conducted in the community using convenience sampling. They were asked to fill out the TFI along with demographic data. Results: Among 200 geriatric people screened, 26.5% (36.7% of women and 18.6% of men) were found to be frail, mean score of TFI = 3.3 ± 2.15. Association of frailty scores was tested with gender using Chi-square test, χ2 (1) = 0.80 (P < 0.05) was found. Conclusion: The prevalence of frailty was 26.5% among the elderly population of Ahmedabad, Gujarat, India.
{"title":"Prevalence of frailty in geriatric population of Ahmedabad, Gujarat: A cross-sectional study","authors":"Shivani Sheth, Megha Sheth","doi":"10.4103/jiag.jiag_18_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_18_23","url":null,"abstract":"Background: Frailty syndrome is a transitional state in a dynamic process, dependent on various physical, psychological, and social factors, which interact and disturb the physiological balance. Tilburg Frailty Indicator (TFI) is a valid multidimensional assessment tool of frailty. Most developed countries recognize frailty as a syndrome. In India, the number of elderly population is increasing, with few studies on frailty. Purpose: Hence, this study aimed to find the prevalence of frailty among the elderly population of Ahmedabad, Gujarat. Methods: An observational study of 200 geriatric people aged more than 60 years was conducted in the community using convenience sampling. They were asked to fill out the TFI along with demographic data. Results: Among 200 geriatric people screened, 26.5% (36.7% of women and 18.6% of men) were found to be frail, mean score of TFI = 3.3 ± 2.15. Association of frailty scores was tested with gender using Chi-square test, χ2 (1) = 0.80 (P < 0.05) was found. Conclusion: The prevalence of frailty was 26.5% among the elderly population of Ahmedabad, Gujarat, India.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"25 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124070433","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
S. Samuel, S. Viggeswarpu, B. Chacko, A. Belavendra
Background: Although there is increasing interest in exploring outcomes and predictors of outcomes of older adults who present with sepsis in developing countries, there is limited information from the low- and middle-income countries. Objective: This study was done to determine inhospital mortality and ascertain the factors predicting mortality among older inpatients with sepsis. Materials and Methods: This was a prospective observational study, from March 2018 to September 2019 in a tertiary care center in India. Baseline clinical, demographic, laboratory parameters and mortality were recorded from patients above the age of 60 years with a diagnosis of sepsis who were admitted to either the ward or intensive care unit (ICU). Logistic regression analysis was performed to determine predictors of inhospital mortality. Results: We found that 201 patients, predominantly male (64.6%) with a mean (standard deviation) age of 70.3 (7.8) years and a median (interquartile range) admission Sequential Organ Failure Assessment score of 5 (3–7), were admitted with sepsis. Lung infection was the most common source of sepsis (47.2%). Seventy-three patients (36.3%) required ICU admission, and inhospital mortality was 40.2%. Predictors of mortality included high Charlson Comorbidity Index (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1–1.6, P = 0.08), serum albumin (OR: 0.41, 95% CI: 0.20–0.80, P = 0.009), invasive mechanical ventilation (OR: 3.24, 95% CI: 1.2–8.9, P = 0.022), and the use of vasoactive agents (OR: 7.44, 95% CI: 2.8–19.9, P < 0.001). Blood culture positivity was found to have a survival benefit on Kaplan–Meier estimates. Conclusion: The mortality rate in older inpatients with sepsis was 40.2%. A high comorbidity burden, low serum albumin, and the need for invasive mechanical ventilation and vasoactive agents were independent predictors of mortality.
背景:尽管人们对探索发展中国家出现败血症的老年人的结局和结局预测因素越来越感兴趣，但来自低收入和中等收入国家的信息有限。目的:探讨老年脓毒症住院患者的住院死亡率及预测死亡率的因素。材料和方法:这是一项前瞻性观察研究，于2018年3月至2019年9月在印度的一家三级医疗中心进行。基线临床、人口学、实验室参数和死亡率记录来自60岁以上诊断为败血症的患者，这些患者住在病房或重症监护病房(ICU)。采用Logistic回归分析确定住院死亡率的预测因素。结果:我们发现201例患者因脓毒症入院，主要为男性(64.6%)，平均(标准差)年龄为70.3(7.8)岁，入院顺序器官衰竭评估评分中位数(四分位数范围)为5(3-7)。肺部感染是最常见的脓毒症来源(47.2%)。73例(36.3%)患者需要进入ICU，住院死亡率为40.2%。死亡率的预测因素包括高Charlson合病指数(比值比[OR]: 1.3, 95%可信区间[CI]: 1.1-1.6, P = 0.08)、血清白蛋白(OR: 0.41, 95% CI: 0.20-0.80, P = 0.009)、有创机械通气(OR: 3.24, 95% CI: 1.2-8.9, P = 0.022)和血管活性药物的使用(OR: 7.44, 95% CI: 2.8-19.9, P < 0.001)。根据Kaplan-Meier估计，血培养阳性对生存有好处。结论:老年住院败血症患者病死率为40.2%。高合并症负担、低血清白蛋白、需要有创机械通气和血管活性药物是死亡率的独立预测因素。
{"title":"Predictors of outcome in older adults admitted with sepsis in a tertiary care center","authors":"S. Samuel, S. Viggeswarpu, B. Chacko, A. Belavendra","doi":"10.4103/jiag.jiag_20_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_20_23","url":null,"abstract":"Background: Although there is increasing interest in exploring outcomes and predictors of outcomes of older adults who present with sepsis in developing countries, there is limited information from the low- and middle-income countries. Objective: This study was done to determine inhospital mortality and ascertain the factors predicting mortality among older inpatients with sepsis. Materials and Methods: This was a prospective observational study, from March 2018 to September 2019 in a tertiary care center in India. Baseline clinical, demographic, laboratory parameters and mortality were recorded from patients above the age of 60 years with a diagnosis of sepsis who were admitted to either the ward or intensive care unit (ICU). Logistic regression analysis was performed to determine predictors of inhospital mortality. Results: We found that 201 patients, predominantly male (64.6%) with a mean (standard deviation) age of 70.3 (7.8) years and a median (interquartile range) admission Sequential Organ Failure Assessment score of 5 (3–7), were admitted with sepsis. Lung infection was the most common source of sepsis (47.2%). Seventy-three patients (36.3%) required ICU admission, and inhospital mortality was 40.2%. Predictors of mortality included high Charlson Comorbidity Index (odds ratio [OR]: 1.3, 95% confidence interval [CI]: 1.1–1.6, P = 0.08), serum albumin (OR: 0.41, 95% CI: 0.20–0.80, P = 0.009), invasive mechanical ventilation (OR: 3.24, 95% CI: 1.2–8.9, P = 0.022), and the use of vasoactive agents (OR: 7.44, 95% CI: 2.8–19.9, P < 0.001). Blood culture positivity was found to have a survival benefit on Kaplan–Meier estimates. Conclusion: The mortality rate in older inpatients with sepsis was 40.2%. A high comorbidity burden, low serum albumin, and the need for invasive mechanical ventilation and vasoactive agents were independent predictors of mortality.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"33 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"128190172","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Incidence of cardiac conduction disorders are escalating in the current era especially due to enhanced life expectancy in the geriatric population and better standards of medical care and coronary revascularization. Aims and Objectives: This study aimed to analyse the demographical aspect and temporal trends of permanent pacemaker (PPM) therapy in patients aged above 60 years of age from an observational 2-year retrospective data from a single-center tertiary care academic hospital. Results: Males consisted of more than two-third of the patients and complete atrioventricular block was the most common conduction pathology. Fascicular and Bundle branch blocks appeared to have a male preponderance, whereas sinus node dysfunction was found to have statistically significant association with the female cohort. Most of the patients were implanted out of admission from cardiac emergency and single chamber ventricle paced and sensed, inhibition response with rate adaptation (VVIR) mode was the predominant modality of pacing management, not found to be influenced by the age or sex of the patients. However, there was a statistical correlation noted of utilization of dual chamber Dual paced and sensed, dual inhibition with rate adaptation (DDDR) mode in patients with sick sinus pathology. Conclusion: Implantation of PPM is on the rise as a modality of bradyarrhythmia treatment in the increasing proportion of geriatric population with advanced life expectancy.
{"title":"An observational study of pattern of bradyarrhythmia and pacing management modality in geriatric population: A single-center 2-year analysis data","authors":"Soumik Ghosh, Tusharkanti Patra, Salini Mukhopadhyay","doi":"10.4103/jiag.jiag_14_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_14_23","url":null,"abstract":"Background: Incidence of cardiac conduction disorders are escalating in the current era especially due to enhanced life expectancy in the geriatric population and better standards of medical care and coronary revascularization. Aims and Objectives: This study aimed to analyse the demographical aspect and temporal trends of permanent pacemaker (PPM) therapy in patients aged above 60 years of age from an observational 2-year retrospective data from a single-center tertiary care academic hospital. Results: Males consisted of more than two-third of the patients and complete atrioventricular block was the most common conduction pathology. Fascicular and Bundle branch blocks appeared to have a male preponderance, whereas sinus node dysfunction was found to have statistically significant association with the female cohort. Most of the patients were implanted out of admission from cardiac emergency and single chamber ventricle paced and sensed, inhibition response with rate adaptation (VVIR) mode was the predominant modality of pacing management, not found to be influenced by the age or sex of the patients. However, there was a statistical correlation noted of utilization of dual chamber Dual paced and sensed, dual inhibition with rate adaptation (DDDR) mode in patients with sick sinus pathology. Conclusion: Implantation of PPM is on the rise as a modality of bradyarrhythmia treatment in the increasing proportion of geriatric population with advanced life expectancy.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"18 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123356827","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2023-04-01DOI: 10.4103/0974-3405.307225
Sharon Joseph, M. Fernandes, Jacintha Martis, R. Bhat, Sukumar Dandekeri, R. Monteiro, J. Jayaraman, M. D'souza
Objective: The objective of the study was to evaluate the spectrum of skin diseases among older patients in a coastal city of Southern India and its association with systemic illness. Materials and Methods: In this retrospective, cross-sectional study, medical records from the dermatology outpatient clinics were assessed. Patients over 60 years old and attending the dermatology outpatient clinic between November 2021 and June 2022 were included in the study. Results: Of 1182 records, 663 were male (56%) and 519 were female (43.9%). Most of the patients were in the age group between 60 and 70 years (71.7%). Overall, the most frequent dermatologic diseases in this cohort of patients were infections (41.37%), eczematous dermatitis (30.02%), and papulosquamous disorders (9.39%). Among the physiological changes of aging skin, xerosis was the most common manifestation observed in 66 (5.5%) cases, followed by seborrheic keratosis in 24 (2%) cases. Twelve (1.01%) individuals had premalignant and malignant lesions identified. Bowen's disease (n = 5, 0.4%), basal cell carcinoma (n = 6, 0.5%), and leukoplakia (n = 1) were the most prevalent. Conclusion: Dermatoses in the older population are among the most common causes of daily consultations. In our study, infectious causes of dermatoses are more common than eczematous diseases. We discovered a higher prevalence of premalignant diseases like Bowen's disease, emphasizing the need for screening in people of skin color.
{"title":"Analysis of dermatoses in the older adults","authors":"Sharon Joseph, M. Fernandes, Jacintha Martis, R. Bhat, Sukumar Dandekeri, R. Monteiro, J. Jayaraman, M. D'souza","doi":"10.4103/0974-3405.307225","DOIUrl":"https://doi.org/10.4103/0974-3405.307225","url":null,"abstract":"Objective: The objective of the study was to evaluate the spectrum of skin diseases among older patients in a coastal city of Southern India and its association with systemic illness. Materials and Methods: In this retrospective, cross-sectional study, medical records from the dermatology outpatient clinics were assessed. Patients over 60 years old and attending the dermatology outpatient clinic between November 2021 and June 2022 were included in the study. Results: Of 1182 records, 663 were male (56%) and 519 were female (43.9%). Most of the patients were in the age group between 60 and 70 years (71.7%). Overall, the most frequent dermatologic diseases in this cohort of patients were infections (41.37%), eczematous dermatitis (30.02%), and papulosquamous disorders (9.39%). Among the physiological changes of aging skin, xerosis was the most common manifestation observed in 66 (5.5%) cases, followed by seborrheic keratosis in 24 (2%) cases. Twelve (1.01%) individuals had premalignant and malignant lesions identified. Bowen's disease (n = 5, 0.4%), basal cell carcinoma (n = 6, 0.5%), and leukoplakia (n = 1) were the most prevalent. Conclusion: Dermatoses in the older population are among the most common causes of daily consultations. In our study, infectious causes of dermatoses are more common than eczematous diseases. We discovered a higher prevalence of premalignant diseases like Bowen's disease, emphasizing the need for screening in people of skin color.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"449 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"134237356","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
{"title":"A case of anatomic cohabitation of psoriasis and vitiligo in an elderly female","authors":"Sharang Gupta, A. Bhagya, D. Chopra","doi":"10.4103/jiag.jiag_22_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_22_23","url":null,"abstract":"","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"125536062","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Subhasish Kumar, S. Majumdar, Mahul Mukherjee, Avijit Paul
Introduction: Aging is associated with gradual accumulation of a wide variety of molecular and cellular damage resulting in different types of morbidities in geriatric population, especially in rural areas in India where health infrastructure is insufficient. Aims: The aim of the study was to assess sociodemographic profile and quality of life (QOL) of geriatric population in Memari-I block of East Burdwan district, West Bengal. Materials and Methods: A cross-sectional observational study was done among 436 rural geriatric population from October to December 2020 at Memari-I block in West Bengal, and multistage proportionate population sampling was done. Data were collected through house-to-house survey by pretested, predesigned, structured schedule and data analyzed with the help of IBM SPSS v16. Results: Among the study population, 263 (60.3%) were male and 272 (62.4%) were in the age group of 60–69. Nearly one-third of the population (37.8%) was underweight and half of them belonged to lower socioeconomic group (51.6%). Their QOL was significantly influenced by age, caste, family type, addiction, body mass index (BMI), dependency on others, socioeconomic status, and the presence of hypertension or diabetes. Conclusion: From the present study, it can be concluded that geriatric population from the Memari block was underweight and belonged to lower socioeconomic group. Significant association of QOL was found with age, caste, family type, addiction, BMI, dependency on others, socioeconomic status, and the presence of hypertension or diabetes.
{"title":"Quality of life among geriatric population in a rural area of West Bengal: A cross-sectional study","authors":"Subhasish Kumar, S. Majumdar, Mahul Mukherjee, Avijit Paul","doi":"10.4103/jiag.jiag_11_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_11_23","url":null,"abstract":"Introduction: Aging is associated with gradual accumulation of a wide variety of molecular and cellular damage resulting in different types of morbidities in geriatric population, especially in rural areas in India where health infrastructure is insufficient. Aims: The aim of the study was to assess sociodemographic profile and quality of life (QOL) of geriatric population in Memari-I block of East Burdwan district, West Bengal. Materials and Methods: A cross-sectional observational study was done among 436 rural geriatric population from October to December 2020 at Memari-I block in West Bengal, and multistage proportionate population sampling was done. Data were collected through house-to-house survey by pretested, predesigned, structured schedule and data analyzed with the help of IBM SPSS v16. Results: Among the study population, 263 (60.3%) were male and 272 (62.4%) were in the age group of 60–69. Nearly one-third of the population (37.8%) was underweight and half of them belonged to lower socioeconomic group (51.6%). Their QOL was significantly influenced by age, caste, family type, addiction, body mass index (BMI), dependency on others, socioeconomic status, and the presence of hypertension or diabetes. Conclusion: From the present study, it can be concluded that geriatric population from the Memari block was underweight and belonged to lower socioeconomic group. Significant association of QOL was found with age, caste, family type, addiction, BMI, dependency on others, socioeconomic status, and the presence of hypertension or diabetes.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"124222821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: The challenge for neuroscience in patients with stroke is to provide an accurate prediction of functional impairment poststroke, to aid therapy and help early recovery. The sensitivity of diffusion tensor imaging (DTI) metrics to predict the clinical outcome using the modified Rankin Scale and Barthel score in early stroke was the objective of the study. Materials and Methods: A prospective observational study was conducted between October 2019 and October 2021 involving 86 patients with stroke. DTI sequences were taken on day 2–day 10 after the stroke. The National Institutes of Health Stroke Scale (NIHSS) was obtained at the time of the scan. The modified Rankin Score (MRS) and Barthel index scoring were used to do the clinical assessment and were done on day 7, day 30, and day 90. Results: There was a weak positive correlation between the NIHSS and Fractional Anisotropy (FA) and the NIHSS and axial diffusivity curve. There was a strong positive correlation between the NIHSS and voxels (infarct), and this correlation was statistically significant (rho = 0.75 and P ≤ 0.001. There was a weak positive correlation between the relative Average Diffusion Coefficient (rADC) and MRS of day 7, day 30, and day 90. There was a strong positive correlation between the voxels and NIHSS, and this correlation was statistically significant (rho = 0.75 and P ≤ 0.001). Conclusions: The NIHSS is a well-known clinical indicator to classify the severity of stroke. DTI metrics – FA and relative Fractional Anisotropy (rFA) are surrogate markers to predict the long-term motor outcome in stroke patients.
{"title":"Diffusion tensor imaging – Magnetic resonance tractography in stroke patients to predict clinical outcome","authors":"P. Hemachandra, K. Ravi, M. Srinivas","doi":"10.4103/jiag.jiag_7_23","DOIUrl":"https://doi.org/10.4103/jiag.jiag_7_23","url":null,"abstract":"Background: The challenge for neuroscience in patients with stroke is to provide an accurate prediction of functional impairment poststroke, to aid therapy and help early recovery. The sensitivity of diffusion tensor imaging (DTI) metrics to predict the clinical outcome using the modified Rankin Scale and Barthel score in early stroke was the objective of the study. Materials and Methods: A prospective observational study was conducted between October 2019 and October 2021 involving 86 patients with stroke. DTI sequences were taken on day 2–day 10 after the stroke. The National Institutes of Health Stroke Scale (NIHSS) was obtained at the time of the scan. The modified Rankin Score (MRS) and Barthel index scoring were used to do the clinical assessment and were done on day 7, day 30, and day 90. Results: There was a weak positive correlation between the NIHSS and Fractional Anisotropy (FA) and the NIHSS and axial diffusivity curve. There was a strong positive correlation between the NIHSS and voxels (infarct), and this correlation was statistically significant (rho = 0.75 and P ≤ 0.001. There was a weak positive correlation between the relative Average Diffusion Coefficient (rADC) and MRS of day 7, day 30, and day 90. There was a strong positive correlation between the voxels and NIHSS, and this correlation was statistically significant (rho = 0.75 and P ≤ 0.001). Conclusions: The NIHSS is a well-known clinical indicator to classify the severity of stroke. DTI metrics – FA and relative Fractional Anisotropy (rFA) are surrogate markers to predict the long-term motor outcome in stroke patients.","PeriodicalId":350641,"journal":{"name":"Journal of the Indian Academy of Geriatrics","volume":"49 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-04-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129787218","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. Mittal, Kritartha Kashyap, Anupam Kumar, Minakshi Dhar
Sjögren's syndrome (SS) is a chronic autoimmune disorder characterized by lymphocytic infiltration of exocrine glands, leading to dryness of the mouth and eyes. Although it can affect all age groups, it is relatively less common in older adults. Renal involvement is a rare, and as initial presentation even rarer reported, a serious complication of SS, which can have a significant impact on patients' quality of life, functional and physical status, and their overall survival. This is a case report of an elderly male patient who presented to us with rapidly progressive renal dysfunction and uremic symptoms, who was diagnosed as a case of SS with a high possibility of renal involvement. However, the patient succumbed to sepsis before the initiation of disease-modifying therapy. This case report emphasizes an extensive workup of unexplained renal dysfunction, even in geriatric patients, so that potentially manageable conditions like SS can be caught early, and allow early initiation of disease-modifying therapies that can slow down progression, and prevent life-threatening exacerbations of such diseases, which overall will reduce morbidity burden and improve quality of life of elderly patients.
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Pub Date : 2023-04-01DOI: 10.4103/0974-3405.380506
G. Venugopalan
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