Brief Answer:
Anticonvulsant and skeletal muscle relaxant

Detailed Answer:
Greetings
Welcome to Health Care Magic

Dear Ms. XXXXXXX

We are really sorry to know about your sister in law's condition. Our prayers and good wishes are with her.

Based on MRI findings, there is diffuse brain cell injury along with sub arachnoid hemorrhage which explains her prolonged coma. Further prognosis is guarded due to prolonged coma like state. All that is currently required is supportive care and maintenance of nutrition and important medications to prevent infection, convulsions etc.. She is currently on this supportive care as per the list of medications you have provided.

Regarding Medicine Epsolin: It is Phenytoin sodium which is an anticonvulsant used to either prevent or as treatment for convulsions. This becomes one of the important supportive care in any patient with head injury to prevent convulsions and thereby reduce further damage to brain.

Regarding Medicine Tolperitas 50: It is Tolperisone which is a skeletal muscle relaxant/ antispastic used to prevent spasm of muscles due to trauma or injury.

Currently, the only option is to manage your sister in law with good supportive and nutrition care. One important advise i would like to give you is to make sure there will be no pressure sores/ bed sores. This is one of the complication seen in bed ridden patients for long time.

Also lots of patience and perseverance would be required for the family members and friends.

I would request you for some additional information
1. Is she breathing spontaneously or on ventilator support
2. Is she on nasogastric tube?
3. Did she have any episodes of convulsions?
4. Does she respond to painful stimuli or any commands?

Do get back to me with the answers so that we can discuss on her prognosis and recovery.

We wish your sister in law good health and speedy recovery.

Take care.

Best regards,
Dr. T. Shobha Deepak
MBBS, MD

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Brief Answer:
Has good prognosis

Detailed Answer:
Hi XXXXXXX

That's really good news that your sister in law is currently breathing on her own and responds to commands. This implies that she is improving as day passes and this is good sign. She definitely has good prognosis and one of the important factor is her age. Since she is still young there is good chances of recovery.

All that is to be done is proper supportive care. Each individual is different and thereby the recovery time and pattern from any kind of stress or disease vary from individual to individual. However, there are few important things to be taken care of to ensure speedy recovery and to reduce mortality and morbidity.
1. Prevention of Infection especially respiratory infection like pneumonia. Currently she is on antibiotics which shall take care of that.
2. Prevention of bed sores on pressure points: by frequent changing of patients position, use of water bed etc..
3. Physiotherapy: to prevent rigidity of joints and muscles
4. Good nutrition
5. Prevention of exposure keratitis: of eyes.
6. I would also advise you to get Ultrasound abdomen and pelvis every month once to look for bladder, kidney and ureter. This is because of high pressure bladder causing back pressure in bed ridden patients.

Rest assured things will improve.

Do get back to me for any additional information. I would advise you to stay in touch with me and update me the progress of your sis in law. I understand this is a paid website but it is always better to keep the progress updated to the doctors.

Take care. Wish good health to all. Make sure you and your family has health insurance which has become very important these days.

Best regards
Dr. T. Shobha Deepak

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Brief Answer:
wish ur sis in la good health and speedy recovery

Detailed Answer:
Hi XXXXXXX

Sure. I would wait for positive news.

Wish your sis in law good health and speedy recovery.

Take care.

Best regards,
Dr. T. Shobha Deepak
MBBS, MD

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