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Year : 1962  |  Volume : 28  |  Issue : 2  |  Page : 70--79

Follow up of Treatment of Neurosyphilis


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Correspondence Address:
N A Subramanyam


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Observation during the period of surveillance of the effects of penicillin and bismuth therapy in late syphilis with neuroaxis involvement and critical study and analysis of two groups of cases of neuro-axis involvement have been presented. Interpretation of progress in treatment and therapeutic efficacy have been made by (a) clinical analysis in the pre and post treatment phase in the first group of 51 cases and by (b) a CSF syndrome study in 250 cases of neuro-axis involvement by a serial examination of the CSF from the pretreatment period to and during the post treatment phase of varying periods of 'Zone Level days, up to 900 days in many cases. The limitations in judging the therapeutic efficacy and progress in treatment solely by clinical evaluation in neuro-syphilis and the importance of CSF serial study forming the most substantive basis as a precise and definite indicator to estimate and determine the progress of treatment and capable of accurate interpretation to evaluate up to the extreme degree has been brought out. Treatment schedule was 9.6 MU of penicillin and 3 courses of bismuth of 10 injection of 0.2 Grams each. Total of 6 Grams and the findings represent the results achieved from a combined therapy schedule. Treatment results in terms of improvement in clinical manifestations and of achievement of CSF normality have been indicated as diagramatic and graphic representations. In the CSF findings 83.5 % became normal by the third zone going up to 93.6 % by the 9th zone of Observation period. The importance of bismuth in combination with penicillin in treatment of late syphilis has been brought out although no comparative control study without has been carried out. Results achieved from a combined therapy schedule appear to be highly satisfactory.






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