Pub Date : 2024-01-01Epub Date: 2023-10-24DOI: 10.25259/JNRP_319_2023
Roshan Koul
{"title":"Hypsarrhythmia and triphasic waves seem to be akin(similar) age-dependent responses of the brain to different insults.","authors":"Roshan Koul","doi":"10.25259/JNRP_319_2023","DOIUrl":"10.25259/JNRP_319_2023","url":null,"abstract":"","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"15 1","pages":"156-158"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927049/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110478","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-01-05DOI: 10.25259/JNRP_584_2023
Sajna Panolan, Benson Thomas M
Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords "postpartum depression," or "postnatal depression," and "prevalence," and "causes," and "risk factors," or "predisposing factors," or "predictive factors" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities.
{"title":"Prevalence and associated risk factors of postpartum depression in India: A comprehensive review.","authors":"Sajna Panolan, Benson Thomas M","doi":"10.25259/JNRP_584_2023","DOIUrl":"10.25259/JNRP_584_2023","url":null,"abstract":"<p><p>Postpartum depression (PPD) is a psychological illness that affects women following delivery. According to the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR), PPD is a serious form of depression that begins four weeks following birth and continues for one year. Pregnancy and the period after delivery can be hazardous for women. Mothers undergo significant biological, emotional, financial, and societal changes during this time. Some women are predisposed to mental health disorders such as melancholy and worry. Many postpartum women do not acknowledge the seriousness of their condition, and many depressed mothers go untreated. Untreated PPD is harmful to both the mother and the newborn. The exact cause of PPD is unclear; however, hormonal fluctuations during pregnancy and childbirth, genetic susceptibility, birth trauma as well as psychosocial and demographic factors may serve as potential risk factors. The objective of this study is to determine the prevalence and risk factors of PPD in India. The review evaluates English language literature on PPD using Scopus, PubMed, and Google Scholar databases searched electronically between 2000 and 2022. The keywords \"postpartum depression,\" or \"postnatal depression,\" and \"prevalence,\" and \"causes,\" and \"risk factors,\" or \"predisposing factors,\" or \"predictive factors\" were used to search the database. The prevalence of PPD varies in different geographical regions and study settings. In India, the overall prevalence of PPD is 22%. However, the greatest prevalence was in the southern regions (26%; 95% confidence interval [CI]: 19-32) and the lowest in the northern regions (15%; 95% CI: 10-21). This study outlines the burden of PPD in India. Comprehensive intervention programs should be implemented to address the disease at a national level. The national authorities should incorporate PPD screening in the National Mental Health Program and emphasize health promotion activities.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"15 1","pages":"1-7"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927066/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110480","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Pub Date : 2024-01-01Epub Date: 2024-01-12DOI: 10.25259/JNRP_312_2023
Reem Jaffar Ali, Sandhya Manorenj, Ruqya Zafar
Objectives: The objective of this study was to determine the awareness of stroke in regards to the risk factors, warning symptoms, and knowledge of the therapeutic window period among varied strata of non-medical people attending a tertiary care center.
Materials and methods: The interventional study involved the collection of data regarding awareness of stroke using a structured questionnaire with a total score of 16. Pre-intervention assessment was followed by intervention in the form of education regarding awareness of stroke administered one-on-one for personalized and effective comprehension by subjects. Then, subjects were asked to recall the information that was delivered to them and were scored accordingly.
Results: Among the 500 subjects included, 51% were female. About 76.8% of participants were young (age <50 years), and 83.4% were literate. Only 25.4% of participants were aware of the brain as the site of stroke. About 32.2% of candidates were aware of a few risk factors for stroke. Among them, the majority of participants were aware of hypertension (24%) as a risk factor. The most known warning symptom was "Numbness" or weakness of arm. The majority of the subjects (97.8%) were unaware of a therapeutic window period for stroke being 4.5 h or below. The mean pre-intervention score was 2.52 ± 1.65 while the mean post-intervention score was 15.10 ± 1.79 (P < 0.0001).
Conclusion: The study showed that even among literate participants, only a meager number of subjects were aware of the golden window period of intravenous thrombolysis. Educational intervention by means of an in-person and one-on-one explanation achieved significant levels of understanding of stroke. The study could be used to formulate large-scale educational programs that focus on spreading awareness of symptoms and risk factors while also instilling the importance of timely medical intervention for efficient thrombolytic therapy.
研究目的本研究旨在确定在一家三级医疗中心就诊的各阶层非医务人员对中风的认识，包括风险因素、预警症状以及对治疗窗口期的了解：这项干预性研究使用结构化问卷收集有关中风认知的数据，问卷总分为 16 分。在进行干预前评估后，以一对一教育的形式对受试者进行有关中风认知的干预，以便受试者个性化地有效理解。然后，要求受试者回忆所获得的信息并进行相应评分：在 500 名受试者中，51% 为女性。约 76.8%的参与者为年轻人（年龄 P < 0.0001）：研究表明，即使在识字的参与者中，也只有极少数人知道静脉溶栓的黄金窗口期。通过面对面和一对一的讲解进行教育干预，可显著提高受试者对中风的认识水平。这项研究可用于制定大规模的教育计划，重点是普及症状和危险因素的意识，同时灌输及时医疗干预对有效溶栓治疗的重要性。
{"title":"Knowledge of stroke and the window period for thrombolytic therapy in ischemic stroke among South Indians: A hospital-based survey with educational intervention.","authors":"Reem Jaffar Ali, Sandhya Manorenj, Ruqya Zafar","doi":"10.25259/JNRP_312_2023","DOIUrl":"10.25259/JNRP_312_2023","url":null,"abstract":"<p><strong>Objectives: </strong>The objective of this study was to determine the awareness of stroke in regards to the risk factors, warning symptoms, and knowledge of the therapeutic window period among varied strata of non-medical people attending a tertiary care center.</p><p><strong>Materials and methods: </strong>The interventional study involved the collection of data regarding awareness of stroke using a structured questionnaire with a total score of 16. Pre-intervention assessment was followed by intervention in the form of education regarding awareness of stroke administered one-on-one for personalized and effective comprehension by subjects. Then, subjects were asked to recall the information that was delivered to them and were scored accordingly.</p><p><strong>Results: </strong>Among the 500 subjects included, 51% were female. About 76.8% of participants were young (age <50 years), and 83.4% were literate. Only 25.4% of participants were aware of the brain as the site of stroke. About 32.2% of candidates were aware of a few risk factors for stroke. Among them, the majority of participants were aware of hypertension (24%) as a risk factor. The most known warning symptom was \"Numbness\" or weakness of arm. The majority of the subjects (97.8%) were unaware of a therapeutic window period for stroke being 4.5 h or below. The mean pre-intervention score was 2.52 ± 1.65 while the mean post-intervention score was 15.10 ± 1.79 (<i>P</i> < 0.0001).</p><p><strong>Conclusion: </strong>The study showed that even among literate participants, only a meager number of subjects were aware of the golden window period of intravenous thrombolysis. Educational intervention by means of an in-person and one-on-one explanation achieved significant levels of understanding of stroke. The study could be used to formulate large-scale educational programs that focus on spreading awareness of symptoms and risk factors while also instilling the importance of timely medical intervention for efficient thrombolytic therapy.</p>","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"15 1","pages":"111-116"},"PeriodicalIF":1.4,"publicationDate":"2024-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927053/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140110479","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Lesion localization has been an important aspect of neurosurgery and has advanced significantly with technological evolution. The journey started from the localization of lesion based on clinical findings to the current era where neuronavigation and virtual reality are being used for the purpose. However, the financial implications of these advanced equipments have made them inaccessible for patients in the majority of low- and middle-income countries. The authors describe techniques to use software, which are cost effective and can be used effectively for the localization of a lesion of the brain.
{"title":"Use of cost-effective software for lesion localization in brain surgery: Technical note","authors":"Kshitij Jha, Mrinal Harsh, Mohit Agrawal, Lokesh Saini, Sarbesh Tiwari, Deepak Kumar Jha","doi":"10.25259/jnrp_546_2023","DOIUrl":"https://doi.org/10.25259/jnrp_546_2023","url":null,"abstract":"Lesion localization has been an important aspect of neurosurgery and has advanced significantly with technological evolution. The journey started from the localization of lesion based on clinical findings to the current era where neuronavigation and virtual reality are being used for the purpose. However, the financial implications of these advanced equipments have made them inaccessible for patients in the majority of low- and middle-income countries. The authors describe techniques to use software, which are cost effective and can be used effectively for the localization of a lesion of the brain.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"11 22","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-26","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139156707","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}
E. El Refaee, Taher M. Ali, A. Al Menabbawy, Mahmoud Elfiky, A. El Fiki, Shady Mashhour, Ahmed Harouni
Traumatic intracranial hematomas represent a critical clinical situation where early detection and management are of utmost importance. Machine learning has been recently used in the detection of neuroradiological findings. Hence, it can be used in the detection of intracranial hematomas and furtherly initiate a management cascade of patient transfer, diagnostics, admission, and emergency intervention. We aim, here, to develop a diagnostic tool based on artificial intelligence to detect hematomas instantaneously, and automatically start a cascade of actions that support the management protocol depending on the early diagnosis. A plot was designed as a staged model: The first stage of initiating and training the machine with the provisional evaluation of its accuracy and the second stage of supervised use in a tertiary care hospital and a third stage of its generalization in primary and secondary care hospitals. Two datasets were used: CQ500, a public dataset, and our dataset collected retrospectively from our tertiary hospital. A mean dice score of 0.83 was achieved on the validation set of CQ500. Moreover, the detection of intracranial hemorrhage was successful in 94% of cases for the CQ500 test set and 93% for our local institute cases. Poor detection was present in only 6–7% of the total test set. Moderate false-positive results were encountered in 18% and major false positives reached 5% for the total test set. The proposed approach for the early detection of acute intracranial hematomas provides a reliable outset for generating an automatically initiated management cascade in high-flow hospitals.
{"title":"Machine learning in action: Revolutionizing intracranial hematoma detection and patient transport decision-making","authors":"E. El Refaee, Taher M. Ali, A. Al Menabbawy, Mahmoud Elfiky, A. El Fiki, Shady Mashhour, Ahmed Harouni","doi":"10.25259/jnrp_93_2023","DOIUrl":"https://doi.org/10.25259/jnrp_93_2023","url":null,"abstract":"\u0000\u0000Traumatic intracranial hematomas represent a critical clinical situation where early detection and management are of utmost importance. Machine learning has been recently used in the detection of neuroradiological findings. Hence, it can be used in the detection of intracranial hematomas and furtherly initiate a management cascade of patient transfer, diagnostics, admission, and emergency intervention. We aim, here, to develop a diagnostic tool based on artificial intelligence to detect hematomas instantaneously, and automatically start a cascade of actions that support the management protocol depending on the early diagnosis.\u0000\u0000\u0000\u0000A plot was designed as a staged model: The first stage of initiating and training the machine with the provisional evaluation of its accuracy and the second stage of supervised use in a tertiary care hospital and a third stage of its generalization in primary and secondary care hospitals. Two datasets were used: CQ500, a public dataset, and our dataset collected retrospectively from our tertiary hospital.\u0000\u0000\u0000\u0000A mean dice score of 0.83 was achieved on the validation set of CQ500. Moreover, the detection of intracranial hemorrhage was successful in 94% of cases for the CQ500 test set and 93% for our local institute cases. Poor detection was present in only 6–7% of the total test set. Moderate false-positive results were encountered in 18% and major false positives reached 5% for the total test set.\u0000\u0000\u0000\u0000The proposed approach for the early detection of acute intracranial hematomas provides a reliable outset for generating an automatically initiated management cascade in high-flow hospitals.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"6 12","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138968045","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}
For this observational study, we evaluated the clinical profile of Parkinsonian features in multiple system atrophy (MSA), as there is no clarity about the specifics of these features in this disease compared to progressive supranuclear palsy (PSP) and Parkinson’s disease (PD). Here, we selected 57 patients with MSA based on standard criteria and grouped them into two categories – Parkinsonian variant of MSA (MSA-P) and cerebellar variant of MSA (MSA-C). However, researchers did not distinguish among patients based on the nature of extrapyramidal syndrome or levodopa responsiveness. Then, we examined the patients at the time of their first visit to outpatient clinics or indoor wards and recorded and analyzed the specific extrapyramidal features or their variations. The extrapyramidal features including levodopa responsiveness were highly variable among MSA-C as well as MSA-P patients. A subset of patients presented with features resembling PSP (symmetry [56.1%], axial rigidity [52.6%], backward falls [28.1%], and down-gaze restriction [17.5%]), while others presented with features resembling PD (asymmetry [43.9%], tremors [71.9%], and peripheral rigidity [40.4%]). After grouping patients based on predominant extrapyramidal features, 36.8% of patients had PD-like, 19.3% had PSP-like, and 43.9 % had mixed presentation. Moreover, 86% of patients had a perceptible levodopa response, including a sustained response for more than six months in 64% of patients. Extrapyramidal features in MSA patients may be PD-like, PSP-like, or mixed. Moreover, an initial presentation resembling PSP or PD may be deceptive and one must follow it up for MSA.
{"title":"Nature of Parkinsonian features in multiple system atrophy","authors":"Sunil Pradhan, R. Tandon","doi":"10.25259/jnrp_445_2023","DOIUrl":"https://doi.org/10.25259/jnrp_445_2023","url":null,"abstract":"\u0000\u0000For this observational study, we evaluated the clinical profile of Parkinsonian features in multiple system atrophy (MSA), as there is no clarity about the specifics of these features in this disease compared to progressive supranuclear palsy (PSP) and Parkinson’s disease (PD).\u0000\u0000\u0000\u0000Here, we selected 57 patients with MSA based on standard criteria and grouped them into two categories – Parkinsonian variant of MSA (MSA-P) and cerebellar variant of MSA (MSA-C). However, researchers did not distinguish among patients based on the nature of extrapyramidal syndrome or levodopa responsiveness. Then, we examined the patients at the time of their first visit to outpatient clinics or indoor wards and recorded and analyzed the specific extrapyramidal features or their variations.\u0000\u0000\u0000\u0000The extrapyramidal features including levodopa responsiveness were highly variable among MSA-C as well as MSA-P patients. A subset of patients presented with features resembling PSP (symmetry [56.1%], axial rigidity [52.6%], backward falls [28.1%], and down-gaze restriction [17.5%]), while others presented with features resembling PD (asymmetry [43.9%], tremors [71.9%], and peripheral rigidity [40.4%]). After grouping patients based on predominant extrapyramidal features, 36.8% of patients had PD-like, 19.3% had PSP-like, and 43.9 % had mixed presentation. Moreover, 86% of patients had a perceptible levodopa response, including a sustained response for more than six months in 64% of patients.\u0000\u0000\u0000\u0000Extrapyramidal features in MSA patients may be PD-like, PSP-like, or mixed. Moreover, an initial presentation resembling PSP or PD may be deceptive and one must follow it up for MSA.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"47 5","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138967705","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}
Madhurika Kate, K. V. Kumar, Akshatha Nayak, Arun Shirali
Globally, stroke is known to be one of the major health problems, resulting in disability among an aging population. Rehabilitation is a process of re-learning of skills, lost due to brain injury. Many factors influence motor learning post neurological insult and practice is one of the key factors which influence relearning or reacquisition of lost motor skills. Practice can be varied concerning order (blocked or random), scheduling (massed or distributed), or whole and part practice. The study observed the effect of variations in practice schedules on motor and functional recovery. Thirty-two acute stroke subjects were recruited and equally divided into two groups (16 in massed and 16 in distributed). Both groups received an accelerated skill acquisition program (ASAP) for six sessions a week for 2 weeks. Pre- and post-outcome measures included stroke rehabilitation assessment of movement (STREAM) for motor recovery, modified Barthel index (MBI) for functional recovery, and brain-derived neurotrophic factor (BDNF) for neuroplasticity. The median scores of participants in the massed practice group before the intervention, of STREAM total, MBI, and BDNF were 23.5, 19, and 0.65, respectively, whereas post values of STREAM total, MBI, and BDNF were 40.5, 60.5, and 0.75, respectively. The median scores of the distributed practice group of the pre-STREAM total, MBI, and BDNF were 23.5, 6.5, and 0.70, respectively, whereas the post-STREAM total, MBI, and BDNF were 41, 45.5, and 0.80, respectively. P-value was reported to be <0.05 while comparing pre- and post-values of STREAM, MBI, and BDNF within both intervention groups. The median change scores of STREAM, MBI, and BDNF reported P ≥ 0.05 when compared between the groups. Both the groups had significant recovery post-intervention designed based on ASAP, about impairment mitigation, pursuing skilled movement leading to significant functional gains. Appropriate timing along with optimal dosage became an active ingredient in functional recovery in acute stroke subjects. The distributed practice might have added effect of spacing, resulting in easier learning and accuracy of skills. The study reveals that distributed practice can be part of regular clinical practice to enhance functional recovery in acute stroke rehabilitation.
{"title":"Comparing distributed versus massed practice on functional recovery and Brain-Derived Neurotrophic Factor (BDNF) in acute stroke subjects","authors":"Madhurika Kate, K. V. Kumar, Akshatha Nayak, Arun Shirali","doi":"10.25259/jnrp_416_2023","DOIUrl":"https://doi.org/10.25259/jnrp_416_2023","url":null,"abstract":"\u0000\u0000Globally, stroke is known to be one of the major health problems, resulting in disability among an aging population. Rehabilitation is a process of re-learning of skills, lost due to brain injury. Many factors influence motor learning post neurological insult and practice is one of the key factors which influence relearning or reacquisition of lost motor skills. Practice can be varied concerning order (blocked or random), scheduling (massed or distributed), or whole and part practice. The study observed the effect of variations in practice schedules on motor and functional recovery.\u0000\u0000\u0000\u0000Thirty-two acute stroke subjects were recruited and equally divided into two groups (16 in massed and 16 in distributed). Both groups received an accelerated skill acquisition program (ASAP) for six sessions a week for 2 weeks. Pre- and post-outcome measures included stroke rehabilitation assessment of movement (STREAM) for motor recovery, modified Barthel index (MBI) for functional recovery, and brain-derived neurotrophic factor (BDNF) for neuroplasticity.\u0000\u0000\u0000\u0000The median scores of participants in the massed practice group before the intervention, of STREAM total, MBI, and BDNF were 23.5, 19, and 0.65, respectively, whereas post values of STREAM total, MBI, and BDNF were 40.5, 60.5, and 0.75, respectively. The median scores of the distributed practice group of the pre-STREAM total, MBI, and BDNF were 23.5, 6.5, and 0.70, respectively, whereas the post-STREAM total, MBI, and BDNF were 41, 45.5, and 0.80, respectively. P-value was reported to be <0.05 while comparing pre- and post-values of STREAM, MBI, and BDNF within both intervention groups. The median change scores of STREAM, MBI, and BDNF reported P ≥ 0.05 when compared between the groups.\u0000\u0000\u0000\u0000Both the groups had significant recovery post-intervention designed based on ASAP, about impairment mitigation, pursuing skilled movement leading to significant functional gains. Appropriate timing along with optimal dosage became an active ingredient in functional recovery in acute stroke subjects. The distributed practice might have added effect of spacing, resulting in easier learning and accuracy of skills. The study reveals that distributed practice can be part of regular clinical practice to enhance functional recovery in acute stroke rehabilitation.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"85 4","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"138622082","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}
The knowledge of the location of the infraorbital foramen (IOF) is crucial in the management of maxillofacial surgeries. The morphology of this foramen is variable in different populations. The purpose of this study is to locate the IOF and to determine the frequency and location of accessory IOF (AIOF) in the Indian population. The study was conducted after getting ethical approval from the institutional review board. It was done on the 60 hemi faces of formalin embalmed heads of 30 cadavers. A modified Weber–Fergusson’s incision was made to expose the anterior surface of the maxilla and the distance of IOF from the root of PM2 teeth and the infraorbital rim (IOR) was measured. The occurrence of AIOF was noted and the neurovascular structures passing through were traced. The distance of the AIOF from the IOF was measured and the statistical analysis was done. The mean distance of the IOF to the IOR on the right side was 6.96 ± 1.79 mm and on the left side was 7.24 ± 1.84 mm. The mean distance of the IOF from the upper PM2 on the right side was 27.11 ± 5.16 mm and on the left side was 26.71 ± 5 mm. The AIOF was present in 10 % of the cadavers dissected and supero-medial in position. It may be single or double, transmitting blood vessels and nerves. The mean distance between the IOF to the AIOF was 9.92 mm on the right and 5.87 mm on the left. Until now, no studies have been conducted on human cadavers to determine if any neurovascular structures pass through AIOF in Indian populations. This human cadaveric study will give additional information to the clinicians that a considerable number of patients may have AIOF and they may transmit neurovascular structures, the knowledge of this is needed to avoid unexpected complications during surgical procedures and nerve block.
{"title":"A cadaveric observation of infraorbital and accessory infraorbital foramen in the Indian population","authors":"Sipra Rout, J. P. F. Sam, Mythraeyee Prasad","doi":"10.25259/jnrp_316_2023","DOIUrl":"https://doi.org/10.25259/jnrp_316_2023","url":null,"abstract":"The knowledge of the location of the infraorbital foramen (IOF) is crucial in the management of maxillofacial surgeries. The morphology of this foramen is variable in different populations. The purpose of this study is to locate the IOF and to determine the frequency and location of accessory IOF (AIOF) in the Indian population. The study was conducted after getting ethical approval from the institutional review board. It was done on the 60 hemi faces of formalin embalmed heads of 30 cadavers. A modified Weber–Fergusson’s incision was made to expose the anterior surface of the maxilla and the distance of IOF from the root of PM2 teeth and the infraorbital rim (IOR) was measured. The occurrence of AIOF was noted and the neurovascular structures passing through were traced. The distance of the AIOF from the IOF was measured and the statistical analysis was done. The mean distance of the IOF to the IOR on the right side was 6.96 ± 1.79 mm and on the left side was 7.24 ± 1.84 mm. The mean distance of the IOF from the upper PM2 on the right side was 27.11 ± 5.16 mm and on the left side was 26.71 ± 5 mm. The AIOF was present in 10 % of the cadavers dissected and supero-medial in position. It may be single or double, transmitting blood vessels and nerves. The mean distance between the IOF to the AIOF was 9.92 mm on the right and 5.87 mm on the left. Until now, no studies have been conducted on human cadavers to determine if any neurovascular structures pass through AIOF in Indian populations. This human cadaveric study will give additional information to the clinicians that a considerable number of patients may have AIOF and they may transmit neurovascular structures, the knowledge of this is needed to avoid unexpected complications during surgical procedures and nerve block.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"38 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236408","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}
Ajay Krishan Adusumilli, G. Sukumar, Gunjan Pandey, Dhaval Shukla
The objectives of the study are to develop a criterion to objectively assess the preparedness of hospitals to manage traumatic brain injuries (TBIs) and to assess and classify the preparedness of secondary and tertiary care hospitals to manage TBIs in an Indian district. This ethically approved hospital-based cross-sectional study was conducted between June 2022 and February 2023 in all eligible secondary and tertiary hospitals in Kolar, Karnataka, India. A study instrument (Form 1, 2, and 3) and the criterion (level-numeric scoring system) to objectively measure the preparedness of hospitals to manage TBIs were developed based on the Neurotrauma Society of India guidelines. This was used to collect data on facilities, manpower, intensive care unit care, drugs, and equipment available for managing TBI in hospitals, by a combination of observation, interview, and verification of records. Based on the assessment, the preparedness of each hospital was categorized into different levels and scores. We assessed all 11 eligible hospitals in the district of which 81% are categorized as having Level 4 preparedness to manage TBIs (corresponds to the management of mild head injury cases). One hospital each had Level 2 and Level 3 preparedness to manage TBIs (moderate and severe). There was no Level 1 preparedness in hospital in the district. Most hospitals were identified to have Level 4 preparedness, indicating a need for comprehensive strengthening of secondary and tertiary hospitals to manage TBI cases in the district.
{"title":"Measuring preparedness of hospitals to manage traumatic brain injuries: Criterion development and assessment in an Indian district","authors":"Ajay Krishan Adusumilli, G. Sukumar, Gunjan Pandey, Dhaval Shukla","doi":"10.25259/jnrp_461_2023","DOIUrl":"https://doi.org/10.25259/jnrp_461_2023","url":null,"abstract":"The objectives of the study are to develop a criterion to objectively assess the preparedness of hospitals to manage traumatic brain injuries (TBIs) and to assess and classify the preparedness of secondary and tertiary care hospitals to manage TBIs in an Indian district. This ethically approved hospital-based cross-sectional study was conducted between June 2022 and February 2023 in all eligible secondary and tertiary hospitals in Kolar, Karnataka, India. A study instrument (Form 1, 2, and 3) and the criterion (level-numeric scoring system) to objectively measure the preparedness of hospitals to manage TBIs were developed based on the Neurotrauma Society of India guidelines. This was used to collect data on facilities, manpower, intensive care unit care, drugs, and equipment available for managing TBI in hospitals, by a combination of observation, interview, and verification of records. Based on the assessment, the preparedness of each hospital was categorized into different levels and scores. We assessed all 11 eligible hospitals in the district of which 81% are categorized as having Level 4 preparedness to manage TBIs (corresponds to the management of mild head injury cases). One hospital each had Level 2 and Level 3 preparedness to manage TBIs (moderate and severe). There was no Level 1 preparedness in hospital in the district. Most hospitals were identified to have Level 4 preparedness, indicating a need for comprehensive strengthening of secondary and tertiary hospitals to manage TBI cases in the district.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":"101 1","pages":""},"PeriodicalIF":1.4,"publicationDate":"2023-11-25","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139236664","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}
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