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Sami mohamad nassar-Stroke-(Lebanon)-Posted on Jan.05,2015

Views Posted at 2015/01/05

Name: Sami mohamad nassar                  
Sex: Male
Country: Lebanon
Age: 48 years
Diagnosis: Sequelae of stroke, hypertension type 3, Diabetes type 2 , hyperlipidemia, hyperuricemia, hypokalemia.
Date: Dec. 12, 2014
Days Admitted to Hospital: 20days

Before treatment:
      The patient is male, 48 years old. He was presented with weak physical movement of the right side of his body for more than 6 years. He was diagnosed with sequelae of stroke. He had hypertension for 6 years, highest Bp: 200/110mmHg. He regularly takes Atenolol, Moxonidine and Diovan to control his hypertension. Systolic pressure was 150-170mmHg, diastolic pressure was 80-90 mmHg. He had diabetes for more than 12 years. He regularly takes Glimepiride, Acarbose and Dimethylbiguanide to control his diabetes, BFS: 7-9mmol/L, 2 hours postprandial blood sugan>11.1 mmol/L. He had a laser surgery 3 years ago to treat fundus hemorrhage for both eyes, and he also had surgery of the right eye to reduced pressure of aqueous humor.

Admission PE:
      Bp: 135/82mmHg; Hr: 66/min. RP:18/min, BT: 36.2 degrees, his growth and nutrition were both normal. The skin with no yellow stains or bleeding spots, there was no edema of both lower limbs. The thorax was symmetrical. The respiratory sounds in both lungs were clear, with no dry or moist rales. The heart sound was strong. The cardiac rhythm was regular, with no obvious murmur in the valves. The abdomen was swollen and soft, with no masses, The liver and spleen were normal, blood sugar:8-15mmol/L, blood uric acid and blood fat were significantly increased, potassium:3.2mmol/L.

 
Nervous System Examination:
      Sami mohamad nassar was alert and spoke slowly. His calculation, memory, orientation, understanding and judgment abilities were normal. Both pupils were equal in size and round, the diameter was 3.0mms, both eyeballs reacted normally to light stimulus and could move freely. No nystagmus. The forehead wrinkle pattern was symmetrical. He had strength to close his eyes, both nasolabials were equal in depth, his tongue was centered in the oral cavity, both sides soft palates could be lifted, pharyngeal reflex was normal. The muscle strength of right upper limb was at level 3, grip at level 2+. The carpal joint of right limb was hard to bend and extend, his right forearm couldn’t pronator or supinate. The muscle strength of right lower limb was at level 4. His right foot couldn’t do dorsiflexion or bend downward. The muscular tension of his right upper limb was a little higher. Tendon reflex of right limb was a little active. Pathological sign was negative. The deep and shallow sensation was normal. The heel-knee-tibia test of right side was doing slowly. He couldn’t finish the diadochokinesia test, finger-nose test at right side. Meningeal irritation signs were all negative.

Treatment:
      Sami mohamad nassar received consummate examination and he was diagnosed as Sequelae of stroke, hypertension type 3, Diabetes type 2, hyperlipidemia, hyperuricemia, hypokalemia. He received treatment for repairing and regenerating nerves, activating his stem cells, regulating blood pressure, Blood sugar, blood lipids, uric acid and electrolytes, at the same time improved his circulation and nerve nutrition. We also gave him daily physical rehabilitation.

Post-treatment:
      After the treatment, the muscle strength of his right upper limb and gripping are at level 4+. Muscular tension of right hand is lower, his fingers can half extend. The muscle strength of right lower limb is at level 4+. The movement endurance is stronger.  His blood pressure and blood sugar are more stable than before. Both uric acid, blood lipids and potassium have improved. His condition is better and the treatment has been completed. He can now be discharged.
 

 


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