Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Anwer bhai keep us updated on Jawad's progress. You and your family are in our prayers inshalah.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Just see him.
He is now a totally wise and conscious person.
Best position in last seven years. Looks like just a step away from a new start.
Please continue praying for him.
It is like a world cup.
Not only for us but for Pakistan and whole the humanity.
http://sphotos.ak.fbcdn.net/hphotos-ak-snc6/hs259.snc6/180765_498881389359_608214359_5752494_4046546_n.jpg
الله سب کو خوش رکھے اور صحت دے
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
May Allah heal him. Our prayers are with him, he's a strong human being. I will pray for him.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
There is a link,
Brain Imaging Provides Window Into Consciousness
Latest studies are just close to my experience and finally there is still no scan to measure the consciousness of a human being.
Now I have some thing different. I have to share with you an unusual thing about Jawad Pasha.
We are watching it for lost more than one month.
His grand mother(Nani) is living with us now days. When she comes close to him he reacts immediately , His both hands go up and his mouth opens full like he is shouting.
He always smile and laughs but this all in very serious mood. Look like “Aasaib or Jinnati ammal”.
Our relations and relation between both always happy and normal.
Very surprising.
Otherwise he is going well . He is using his power but perhaps failed to command about directions. He often tries to speak with breath but no voice. Voice comes out while laughing or emotionally or some time using “Balgham” in his mouth. How that can be improved. Loss of motor function is still the basic problem.
I have reported it to to Dr Nitin Sethi, MD who is very kind to discuss me about Jawad but this time his reply is late.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Dr Sethi is asking that if this is a result of any pain. It is not the pain. We now exactly about pain or any other problem. If there is some pain it results of stiffing the body and his smile drops down and if the problem is great it results to Fits/Seizures. It is some thing else.
The world is changing about these patients.
It was me who after informed by some one in Australia told others about scanning the brain to know about conscious.
Persistent Vegetative State,Minimally Conscious State and Lo
Now there are new things happening.
Pioneering Brain Research Launched for Coma Patients
Patients with Locked-In Syndrome Generally Satisfied with Life
And a story.
Beating Locked in Syndrome - A True Story.
Jawad is going on his slow way of recovery.
**
And some good news about Muhammad Hussain.
He is now more talking and moving.
His family is trying for his walking on his own legs.
**
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
My struggle is there
but lost two brothers in last thee months.
Remain alone.Father,mother,brothers,sister all went away at a better place,Today my brother Major Pasha too.
Please prey for us.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
inna lilahe wa inna ilahe rajaoon
may ALLAH SWT grant jannah to your love ones which are gone and patience to your family. Ameen
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
24th May . This is 29th birthday of Jawad Pasha.
http://platform.ak.fbcdn.net/www/app_full_proxy.php?app=124824184241447&v=1&size=p&cksum=4edfbb718654542b7631300807c2e0bc&src=http%3A%2F%2Fimages.freeapphosting.com%2Foa%2Fhappybirthda_joywoa%2Fimages%2Fappdata%2Foa%2Fhappybirthda_joywoa%2Fgifts%2F113_large.gif%3Ft%3D1295335368****
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Happy Birthday Jawad
May you have many many more…and may allah bless **u with health
**
**Ameen Sum Ameen
**
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
There is some change in the medical term.
New Coma Scale Detects More Wakefulness in Some Patients
The task force proposes substituting the common term “minimally conscious state” with “minimally responsive state (MRS),” a term that discerns 2 different **…
Can you believe that my poor English played a big role.
**
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
can you post the article here and give credit? I cannot read without registering and I don't want to register there......
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
They never credit me but I was alone there on many sites for saying that.
New Coma Scale Detects More Wakefulness in Some Patients
May 31, 2011 (Lisbon, Portugal) — A new scale used in the assessment of coma allows the detection of more consciousness in patients with severe brain damage, which may lead to more appropriate resuscitative care in these patients.
Prof. Steven Laureys, MD, PhD, head of the Coma Science Group in the Neurology Department at the University Hospital of Liège in Belgium, presented the report at the 21st Meeting of the European Neurological Society (ENS).
Prof. Steven Laureys “Worldwide, physicians measure consciousness in severely brain damaged patients using a coma scale: the Glasgow Coma Scale (GCS), used since the 70s,” Dr. Laureys told Medscape Medical News. “In our study, we used another more recent scale called the Full Outline of UnResponsiveness (FOUR) scale and showed it to be superior to find subtle signs of consciousness.”
He added that the new scale offers the advantage of being able to be performed in intubated patients who are on a respirator, which currently includes most coma patients, and to identify nonverbal signs of consciousness by assessing visual pursuit (ie, eye tracking); hence, minimal signs of consciousness (about 10% in his study) are measured that are not assessed by the classic coma scales.
Also released here is proposed new terminology with respect to coma, developed by the European Task Force on Disorders of Consciousness, which it is hoped will infer less of a dismal prognosis and therefore may lead to less cessation of treatment in select patients.
**New Terminology **
Patients in a comatose state who are described as being in a “persistent vegetative state” often have a poor prognosis attributed to them, and this “has led to cessation of rehabilitation, neglect, and sometimes the ethically even more problematic decision to deny further feeding or other life-sustaining measures,” Prof. Gustave Moonen, with the Department of Neurology at the University of Liege, stated in a statement from the ENS.
“We find it high time to propose a new, more neutral and descriptive term. By calling it ‘unresponsive wakefulness syndrome’ we describe what we clinically see but do not judge whether there is consciousness or not,” said Dr. Moonen, a member of the European Task Force on Disorders of Consciousness.
New proposed terms for consciousness disorders include the following:
- “Unresponsive wakeful” to replace “vegetative state” to indicate patients who have a functioning wake-sleep rhythm but show no response to commands and all their movements are reflexive.
- The task force proposes substituting the common term “minimally conscious state” with “minimally responsive state (MRS),” a term that discerns 2 different stages. In “MRS-minus,” patients show low-level behavioral responses, such as reacting to pain or following with the eyes. In “MRS-plus” they are additionally able to follow commands, to verbalize intelligibly, and/or to communicate nonfunctionally.
- The term **“functional locked-in syndrome” **has been coined for patients showing no behavioral response but near-normal brain activity measurable by such technologies as functional magnetic resonance imaging, positron emission tomography, electroencephalography, or evoked potentials. These patients clearly seem to be conscious but not able to use their bodies to communicate.
“Overall, we hope that this new wording will help to herald a change in the ethical approach towards patients who need more, not less, attention by their environment, since they are not able to claim on their own their right to human contact,” Dr. Laureys said.
FOUR Score
To assess the new scale, Dr. Laureys and colleagues compared the FOUR, GCS, and Glasgow Liege Scale (GLS) in 176 intensive care unit comatose patients who had had acute brain injury within the past month. Outcomes were evaluated 3 months after injury in 136 patients.
Although the FOUR, GCS, and GLS showed good reliability, 71 patients were considered in a vegetative/unresponsive state based on the GCS; however, the FOUR scale identified 8 of these 71 patients as being minimally conscious based on patients’ visual pursuit.
According to the researchers, the FOUR score is a “valid tool with good interrater reliability that is comparable to the GCS and GLS in predicting outcome” and has the added advantage of including nonverbal signs of consciousness, such as visual pursuit.
“Recent studies have shown that patients with severe brain damage who show little outward signs of perception or understanding may have a certain degree of pain experience and awareness,” Dr. Laureys said. “New methods of measuring awareness, such as this simple scale, could help doctors better treat these patients and give families an indication on whether their loved one is aware of their presence.”
“I fully agree with the intention of Laurey’s group to develop this scale,” noted independent commentator Erich Schmutzhard, MD, professor of neurology and critical care medicine at the Department of Neurology, NICU Medical University Innsbruck, Austria. “Hopefully, with the new scale, the number of misdiagnoses will diminish,” he told Medscape Medical News.
“At our institution, we use a very similar approach in our daily routine to assess the natural course of initially comatose patients developing into unresponsive wakefulness syndrome and then into a minimally conscious state or, better, a minimally responsive state.” He added that clinically they treat patients, even those who are clearly profoundly comatose, “as though they can understand us.”
This means that we’re actually tracing down the elusive phenomenon called consciousness to very specific physiological parameters.
The FOUR score was also recently assessed in a report by Eelco F.M. Wijdicks, MD, from the Mayo Clinic in Rochester, Minnesota, and colleagues, published online May 11 in Neurology. In a pooled analysis of previous studies, they examined the specificity and sensitivity of the FOUR score vs the GCS in predicting outcome among 381 patients with neurologic injury.
Both scales performed equally well, but very low sum scores on the FOUR score provided good prediction of in-hospital and 3-month mortality. “A patient with a FOUR score of 1 or less has an 84% chance of mortality, while the mortality was only 44% in a FOUR score of 2 or greater,” they write. The differences probably reflect a loss of brainstem reflexes, a prominent component of the FOUR score scale, they note.
“The robust predictive value of the FOUR score and low sum scores provides us with the opportunity to investigate this in a prospective manner in patients with a catastrophic neurologic injury who are deteriorating,” Dr. Wijdicks and colleagues conclude. “It also provides the opportunity to better assess comatose patients in clinical trials.”
Clues From Sleep and Connectivity
**More than 250 sensors measure the electrical response of the brain to auditory stimuli in coma patients and allow physicians to detect signs of consciousness. Copyright: comascience.org ** Finally, several other interesting observations by the group from University Hospital of Liège, Belgium, in collaboration with researchers from Italy and the United States were also presented here:
- Using high-density EEG, the researchers examined brain activity during sleep among those in a minimally conscious and vegetative (now wakeful unresponsive by the new terminology) states. They found behavioral but no electrophysiologic sleep-wake patterns among patients in a wakeful unresponsive state but “near to normal” patterns in patients in a minimally conscious state. “We suggest that the study of sleep and homeostatic regulation of SWA [slow wave activity] may provide a complementary tool for the assessment of brain integrity,” in these patients, the researchers, with lead author M. A. Bruno, conclude.
- The same group also used a combination of EEG and transcranial magnetic stimulation to assess cortical effective connectivity in vegetative (wakeful unresponsive) or minimally conscious states, as well as 2 patients with locked-in syndrome after brain injury. A key requirement for consciousness is connectivity, that is, that multiple specialized cortical areas can interact rapidly and effectively, the study authors note.
“Using high-density EEG measurements we discovered that in a wakeful unresponsive state, only bottom-up connectivity but never top-down feedback could be recorded, indicating a breakdown of effective connectivity,” Dr. Laureys said in a statement from ENS. "On the other hand, patients in a minimal conscious state or recovering from wakeful unresponsiveness to MCS or higher states of consciousness showed near-normal cortico-cortical feedback loops. This means that we’re actually tracing down the elusive phenomenon called consciousness to very specific physiological parameters.
“Just as the second half of the 20th century is rightfully called the era of uncovering the genetic code, the first half of the 21st century might one day be called the age of cracking the code of consciousness,” Dr. Laureys concluded. “Being able to correlate consciousness to specific brain activities, we may expect essential insights into the criteria for being an individual human being, as well as into the border areas between life and death.”
21st Meeting of the European Neurological Society (ENS): Oral abstracts 238, 242, and 267. Presented May 30, 2011.
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Authors and Disclosures
Journalist
Emma Hitt, PhD
Emma Hitt is a freelance editor and writer for Medscape.
Disclosure: Emma Hitt, PhD, has disclosed no relevant financial relationships.
Dr. Hitt does not intend to discuss off-label uses of drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.
Dr. Hitt does not intend to discuss investigational drugs, mechanical devices, biologics, or diagnostics not approved by the FDA for use in the United States.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
It is wonderful to share,
Last week his brother brought him to Muree . Some one came and asked the attendant that is he Jawad Pasha,Attendant replied in yes and asked how do you know him. The man said that I have read about him at Paklink.
I am really thankful to all here for making my life little better. I feel my self at home here. My energies are little restored and struggling in a more better way
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Thanks God
After almost seven year I saw him changing side in bed
Karwat say khud seedha ho gia
He moves often but could not complete.
Little more better than before,
Have a link on the issue.
Cracks start to show in ‘vegetative state’ diagnosis
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
^ WOW mashallah. god bless him with more and more health.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
A link giving some hopes,
Rediscovering consciousness in PVS Patients
A picture showing
Harry Potter and the Deathly Hallows
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Thanks God he is visibly improving.
I can not define in words but felling him much better.
Thanks for your prayers. Please Remember us in your prayers.
Just see him . It is seventh year almost complete.
Write Something…
From the album: 3RD DAY OF eid
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
Mashallah…
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
iA he will make a full recovery soon our prayers are with him.
Re: Pakistan a brain injury Persistent vegetative state patients Jawad Pasha
People of northern areas of Pakistan use a traditional method for brain injury.
When a head injury happens to any of them and they realize that it is a brain injury they gets very hot sand in a cloth and try to fix that at the place of the head which is known to them as effected. Their experience of the centuries tells them that it is useful.
You can refer this for further study.