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Posterior reversible encephalopathy syndrome in immunocompromised children - A single-center study from South India. 免疫力低下儿童的后可逆性脑病综合征--来自南印度的一项单中心研究。
IF 1.4 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-13 DOI: 10.25259/JNRP_390_2023
Sudeep Gaddam, Rajesh Kodandapani, Nikhita Mani, Dhaarani Jayaraman, B Nikitha Abirami

This study describes the profile of children diagnosed with posterior reversible encephalopathy syndrome (PRES) in the pediatric hematology oncology unit and highlights the clinical features of PRES in immunosuppressed children. This retrospective study included 10 children diagnosed with PRES with a mean age of 6.8 years. Acute lymphoblastic leukemia was the most common primary diagnosis followed by post-hematopoietic stem cell transplant patients. Most cases of PRES occurred within one month of treatment initiation. Hypertension was noted in all at the time of diagnosis. Neuroimaging revealed bilateral lesions with parietal and occipital lobe involvement being the most common. All patients received corticosteroids as part of treatment for primary diagnosis. Controlling blood pressure was critical in managing PRES. Consideration of PRES as a clinical possibility in pediatric hematology oncology unit in children presenting with symptoms such as headache, seizures, and visual disturbances will aid in early diagnosis after ruling out other causes of these symptoms.

本研究描述了在儿科血液肿瘤科确诊的后可逆性脑病综合征(PRES)患儿的概况,并强调了免疫抑制儿童 PRES 的临床特征。这项回顾性研究纳入了10名被诊断患有PRES的儿童,他们的平均年龄为6.8岁。急性淋巴细胞白血病是最常见的主要诊断,其次是造血干细胞移植后患者。大多数PRES病例发生在开始治疗的一个月内。所有患者在确诊时都患有高血压。神经影像学检查发现双侧病变,顶叶和枕叶受累最为常见。所有患者在初诊时都接受了皮质类固醇治疗。控制血压是治疗 PRES 的关键。在儿科血液肿瘤科,如果儿童出现头痛、癫痫发作和视力障碍等症状,考虑到PRES的临床可能性,将有助于在排除引起这些症状的其他原因后进行早期诊断。
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引用次数: 0
Reversible dementia in a case of functional gonadotropin-secreting pituitary adenoma: Different shades of gray 功能性促性腺激素分泌型垂体腺瘤病例中的可逆性痴呆:灰色的不同色调
IF 1.4 Q3 Medicine Pub Date : 2024-04-01 DOI: 10.25259/jnrp_66_2024
Souvik Singha, P. S. Mathuranath, Dhaval P. Shukla, A. Uppar, Shilpa Rao
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引用次数: 0
Erratum: A case of anterior cerebral artery A1 segment hypoplasia syndrome presenting with right lower limb monoplegia, abulia, and urinary incontinence. 更正:一例大脑前动脉 A1 节段发育不全综合征,表现为右下肢单瘫、失语和尿失禁。
IF 1.4 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-05-07 DOI: 10.25259/JNRP_157_2024

[This corrects the article DOI: 10.4103/0976-3147.168438.].

[此处更正了文章 DOI:10.4103/0976-3147.168438]。
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引用次数: 0
Transcranial direct current stimulation-efficacy in mild cognitive impairment: A meta-analysis. 经颅直流电刺激对轻度认知障碍的疗效:荟萃分析
IF 1.4 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-04-16 DOI: 10.25259/JNRP_629_2023
G Sandhya, Palash Kumar Malo, Thomas Gregor Issac

Objectives: Mild cognitive impairment (MCI) is a transition state in which individuals have cognitive abilities that are in between those of normal aging and dementia. Although not everyone with MCI develops dementia, the risk of progression to dementia is higher in people with MCI. Interventions at this stage can prevent or delay the onset of dementia. In recent years, studies on non-invasive brain stimulation techniques, namely transcranial direct current stimulation (tDCS), have gained momentum for cognitive enhancement in MCI. Since there are very few studies that also report varied results, it becomes important to analyze the effect of tDCS in MCI. The aim of this study was to systematically review the available evidence about using tDCS for MCI and to assess its efficacy using meta-analysis.

Materials and methods: Eight single- or double-blinded randomized controlled trials were included in the study. Montreal cognitive assessment (MoCA) and mini-mental state examination (MMSE) for global cognition; and digit span test forward and backward, trail-making test (TMT) A and B; and logical memory test (LMT) assessing specific cognitive domains were considered. A random-effects model was used wherein the standardized mean difference (SMD) and its 95% confidence intervals were reported.

Results: The effect of the active tDCS (MoCA [SMD 0.37, 95% CI -0.22-0.95], MMSE [SMD 0.26, 95% CI 0.25-0.77], TMT-A [SMD -0.01, 95% CI -0.42-0.40], and LMT [SMD 0.80, 95% CI -0.24-1.83]) when compared with the sham tDCS was statistically insignificant.

Conclusion: The current meta-analysis identified insignificant improvement in cognitive performance with active tDCS treatment as compared to sham tDCS among people with MCI.

目的:轻度认知障碍(MCI)是一种过渡状态,患者的认知能力介于正常衰老和痴呆之间。虽然并非所有 MCI 患者都会发展成痴呆症,但 MCI 患者发展成痴呆症的风险较高。在这一阶段进行干预可以预防或延缓痴呆症的发生。近年来,有关非侵入性脑刺激技术(即经颅直流电刺激(tDCS))的研究在增强 MCI 患者认知能力方面取得了进展。由于报告结果各异的研究很少,因此分析经颅直流电刺激在 MCI 中的效果变得非常重要。本研究的目的是系统回顾有关使用 tDCS 治疗 MCI 的现有证据,并使用荟萃分析法评估其疗效:研究纳入了八项单盲或双盲随机对照试验。研究考虑了蒙特利尔认知评估(MoCA)和迷你精神状态检查(MMSE)对整体认知的影响,以及数字跨度测试(前向和后向)、线索制作测试(TMT)A 和 B,以及逻辑记忆测试(LMT)对特定认知领域的影响。研究采用随机效应模型,报告了标准化平均差(SMD)及其 95% 置信区间:结果:与假性 tDCS 相比,活性 tDCS(MoCA [SMD 0.37, 95% CI -0.22-0.95]、MMSE [SMD 0.26, 95% CI 0.25-0.77]、TMT-A [SMD -0.01, 95% CI -0.42-0.40]和 LMT [SMD 0.80, 95% CI -0.24-1.83])的效果在统计学上并不显著:目前的荟萃分析发现,与假tDCS相比,主动tDCS治疗对MCI患者认知能力的改善并不显著。
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引用次数: 0
Cerebral microbleeds: Causes, clinical relevance, and imaging approach - A narrative review. 脑微出血:原因、临床相关性和成像方法 - 综述。
IF 1.4 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-03-08 DOI: 10.25259/JNRP_351_2023
Amit Agarwal, Pranav Ajmera, Preetika Sharma, Sangam Kanekar

With advances in magnetic resonance imaging (MRI) sequences, there has been increased identification of microbleed/microhemorrhage across different population ages, but more commonly in the older age group. These are defined as focal areas of signal loss on gradient echo MRI sequences (T2* and susceptibility-weighted images), which are usually <5 mm in size representing hemosiderin deposition with wide ranges of etiologies. Susceptibility-weighted imaging (SWI) has become a routine MRI sequence for practices across the globe resulting in better identification of these entities. Over the past decade, there has been a better understanding of the clinical significance of microbleeds including their prognostic value in ischemic and hemorrhagic stroke. Cerebral amyloid angiopathy and hypertension are the two most common causes of microbleeds following peripheral and central pattern, respectively. In the younger age group, microbleeds are more common due to familial conditions or a wide range of hypercoagulable states. This review outlines the pathophysiology, prevalence, and clinical implications of cerebral microhemorrhage along with a brief discussion about the technical considerations of SWI.

随着磁共振成像(MRI)序列的发展,微出血/微出血的识别率在不同年龄段的人群中都有所提高,但在老年群体中更为常见。微出血是指在梯度回波磁共振成像序列(T2*和感度加权图像)上出现的信号缺失灶,通常表现为以下特征
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引用次数: 0
Progressive multifocal leukoencephalopathy associated with rituximab treatment. 与利妥昔单抗治疗相关的进行性多灶性白质脑病。
IF 1.4 Q3 Medicine Pub Date : 2024-04-01 Epub Date: 2024-02-07 DOI: 10.25259/JNRP_434_2023
Hiroshi Yokota, Yoshihiko Hoshida, Kotaro Watanabe, Tomonori Yamada
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引用次数: 0
Use of cannabidiol in the treatment of drug-refractory epilepsy in children and young adults: A systematic review 使用大麻二酚治疗儿童和青少年药物难治性癫痫:系统回顾
IF 1.4 Q3 Medicine Pub Date : 2024-03-21 DOI: 10.25259/jnrp_618_2023
Samuel Fernando Vargas Chico, Daniel Alejandro Melendez Diaz, Neyder Contreras-Puentes
Epilepsy poses a significant challenge in pediatric and adolescent populations, impacting not only seizures but also psychological and cognitive comorbidities, leading to higher mortality rates than the general population. Drug-refractory epilepsy, resistant to conventional treatments, affects a range of 7–20% of pediatric patients. The search for alternative therapies has led to exploring the therapeutic potential of Cannabis sativa L. compounds, particularly cannabidiol (CBD). Examine the use of CBD for treating drug-refractory epilepsy in children and young adults, summarizing existing evidence on its efficacy.A systematic review, following Preferred Reporting Items for Systematic Reviews and Meta-analyses guidelines, assessed studies from 2018 to 2023, focusing on CBD’s efficacy and safety for treatment-resistant epilepsy in pediatric and juvenile populations. The search spanned seven databases, and the studies underwent rigorous screening and data extraction.Out of 6351 identified articles, eight were selected for review. The included studies reported positive outcomes, with CBD leading to a reduction in seizure frequency ranging from 50% to complete seizure freedom. Adverse effects were mostly mild and reversible, including drowsiness, diarrhea, and loss of appetite.The CBD emerges as a promising tool for refractory epilepsy in pediatric patients, showing efficacy in reducing seizure frequency and improving overall quality of life. Despite mild and reversible adverse effects, CBD’s benefits outweigh the risks. However, more research on long-term effects is needed to fully understand its implications.
癫痫是儿科和青少年群体面临的一项重大挑战,它不仅影响癫痫发作,还影响心理和认知并发症,导致死亡率高于普通人群。对常规治疗产生抗药性的难治性癫痫影响着 7-20% 的儿科患者。为了寻找替代疗法,人们开始探索大麻化合物的治疗潜力,特别是大麻二酚(CBD)。一项系统性综述遵循《系统性综述和荟萃分析首选报告项目》指南,评估了2018年至2023年的研究,重点关注CBD对儿童和青少年人群中难治性癫痫的疗效和安全性。此次检索跨越了七个数据库,研究经过了严格的筛选和数据提取。在6351篇鉴定文章中,有8篇被选中进行综述。纳入的研究报告了积极的结果,CBD 导致癫痫发作频率降低了 50%,甚至完全摆脱了癫痫发作。CBD是治疗儿科难治性癫痫的一种很有前景的工具,在减少癫痫发作频率和改善整体生活质量方面显示出疗效。尽管CBD的不良反应轻微且可逆,但其益处大于风险。不过,要充分了解其影响,还需要对长期效果进行更多研究。
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引用次数: 0
Sphenopalatine ganglion block for the treatment of spontaneous intracranial hypotension without demonstrable cerebrospinal fluid leak: A report of two cases 治疗无明显脑脊液漏的自发性颅内低血压的脊髓神经节阻滞术:两个病例的报告
IF 1.4 Q3 Medicine Pub Date : 2024-03-21 DOI: 10.25259/jnrp_30_2024
Ankur Khandelwal, Sanghamitra Sarma, Masaraf Hussain
Spontaneous intracranial hypotension (SIH) is a condition characterized by orthostatic headache associated with nausea, vomiting, tinnitus, vertigo, hypoacusis, neck pain/stiffness, and photophobia. Usual treatment includes bed rest, hydration, caffeine, analgesics, epidural blood patch, steroids, fibrin glue (N-butyl-cyanoacrylate), and surgical repair. In this series, we report two cases, who presented to us with features of SIH and were managed successfully with sphenopalatine ganglion block. This is a novel modality of management of SIH and has not been reported before.
自发性颅内压过低(SIH)是一种以正压性头痛为特征的疾病,伴有恶心、呕吐、耳鸣、眩晕、听觉减退、颈部疼痛/僵硬和畏光。通常的治疗方法包括卧床休息、补充水分、咖啡因、止痛药、硬膜外血贴、类固醇、纤维蛋白胶(N-丁基氰基丙烯酸酯)和手术修复。在本系列报道中,我们报告了两例具有 SIH 特征的病例,他们成功地接受了脊髓神经节阻滞治疗。这是一种治疗 SIH 的新方法,以前从未报道过。
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引用次数: 0
Clinical and radiological spectrum of acquired inflammatory demyelinating diseases of the central nervous system in a tertiary care center 一家三级医疗中心获得性中枢神经系统炎症性脱髓鞘疾病的临床和放射学谱系
IF 1.4 Q3 Medicine Pub Date : 2024-03-21 DOI: 10.25259/jnrp_603_2023
Yellaturi Sivaroja, P. R. Sowmini, K. Muralidharan, P. G. P. K. Reddy, K. Mugundhan
Demyelinating diseases of central nervous system (CNS) are a broad spectrum of conditions with autoimmune process against myelin. In a resource limited country like India, it is imperative to perform proper clinical evaluation, neuroimaging to differentiate among various categories of CNS demyelinating diseases to decide regarding further workup and treatment. The objective of our study was to determine clinical presentation, imaging findings, serology results, diagnosis, and treatment outcome of primary demyelinating disorders of CNS.In this prospective study, a total of 44 patients were enrolled over a period of 1 year. After proper evaluation, patients were categorized into different groups applying newer diagnostic criteria. Patients were treated with steroids, appropriate immunomodulatory therapy, and outcomes were analyzed.The majority of cases were of neuromyelitis optica spectrum disorder (NMOSD) (45.5%) with an overall female-to-male ratio of 3.4:1 and mean age of presentation was 30.5 ± 11.15. Myelitis (52.3%) followed by optic neuritis (45.5%) was the most common initial presentation. The most common site of involvement on magnetic resonance imaging was the spinal cord (particularly the cervicodorsal cord). The majority showed good response to therapy (77.27%) and two patients did not survive.Higher disability observed among seropositive NMOSD patients warrants aggressive treatment during the first attack itself. It is important to suspect myelin oligodendrocyte glycoprotein antibody disease in patients with preceding viral infection. A good outcome in the majority is likely due to the availability of serological assays and aggressive immunomodulatory therapy.
中枢神经系统(CNS)脱髓鞘疾病是一种针对髓鞘的自身免疫过程的广泛疾病。在印度这样一个资源有限的国家,必须进行适当的临床评估和神经影像学检查,以区分各类中枢神经系统脱髓鞘疾病,从而决定进一步的检查和治疗。我们的研究旨在确定中枢神经系统原发性脱髓鞘疾病的临床表现、影像学结果、血清学结果、诊断和治疗效果。经过适当评估后,根据新的诊断标准将患者分为不同的组别。大多数病例为神经脊髓炎视网膜频谱障碍(NMOSD)(45.5%),男女比例为 3.4:1,平均发病年龄为(30.5 ± 11.15)岁。最常见的首发症状是脊髓炎(52.3%),其次是视神经炎(45.5%)。磁共振成像最常见的受累部位是脊髓(尤其是颈背侧脊髓)。大多数患者对治疗反应良好(77.27%),有两名患者未能存活。在血清反应阳性的 NMOSD 患者中观察到较高的致残率,因此需要在首次发病时进行积极治疗。在血清反应阳性的髓鞘少突胶质细胞糖蛋白抗体阳性患者中,有较高的致残率,因此应在首次发病时积极治疗。由于血清学检测方法的出现和积极的免疫调节治疗,大多数患者的预后良好。
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引用次数: 0
Farmer’s mental health and well-being: Qualitative findings on protective factors 农民的心理健康和幸福:关于保护性因素的定性研究结果
IF 1.4 Q3 Medicine Pub Date : 2024-03-21 DOI: 10.25259/jnrp_403_2023
Sayujya Saju, Shanivaram K. Reddy, Somashekhar Bijjal, Sadananda Reddy Annapally
Agriculture is associated with various physical and mental health risks. There has been growing concern about the psychological hazards associated with farming including high stress levels, depression, anxiety, and increasing rates of suicide. To bolster resilience and overall survival within the farmers, it is imperative to gain a comprehensive understanding of the protective factors that contribute to mental and psychological well-being.The study followed an explorative research design and used purposive sampling to select samples from Chikkaballapur District in Karnataka. Nine farmers were interviewed based on inclusion and exclusion criteria. The interview schedule was prepared based on the literature review. Experts in the field did content and face validation. The transcribed data were coded using the free version of QDA Miner. The thematic analysis approach was used for data analysis,Three broader themes and 15 sub-themes emerged: (1) Personal protective factors: feeling of autonomy, purpose in life, passion for work, problem-solving skills, positive mindset and building resilience, learning new skills, and spiritual and religious beliefs; (2) social protective factors: friends and peer group, belongingness, family, and social engagements; and (3) environmental protective factors: lifestyle and being physically active, rural environment, government/institutional support, and recognition in the society.The study successfully emerged three overarching protective factors that farmers perceived as significant for their mental health and well-being, entitled personal, social, and environmental. The study findings provide valuable insights for social work practitioners, guiding them in developing interventions and strategies to support the mental health and well-being of the farming population.
农业与各种生理和心理健康风险有关。人们越来越关注与农业相关的心理危害,包括高压力水平、抑郁、焦虑和不断上升的自杀率。为了提高农民的抗压能力和整体生存能力,必须全面了解有助于精神和心理健康的保护性因素。这项研究采用探索性研究设计,并使用目的性抽样从卡纳塔克邦奇卡巴拉普尔地区选取样本。根据纳入和排除标准,对九位农民进行了访谈。访谈表是根据文献综述编制的。该领域的专家对访谈内容和访谈对象进行了验证。使用免费版 QDA Miner 对转录数据进行编码。数据分析采用了主题分析法,得出了三个大主题和 15 个子主题:(1) 个人保护因素:自主感、生活目标、工作热情、解决问题的技能、积极心态和建立复原力、学习新技能以及精神和宗教信仰;(2) 社会保护因素:朋友和同伴群体、归属感、家庭和社会参与;以及 (3) 环境保护因素:生活方式和积极锻炼身体、农村环境、政府/机构支持以及社会认可。这项研究成功地提出了农民认为对其心理健康和幸福具有重要意义的三大保护因素,即个人、社会和环境因素。研究结果为社会工作从业者提供了宝贵的见解,指导他们制定干预措施和策略,以支持农民的心理健康和幸福。
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引用次数: 0
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Journal of Neurosciences in Rural Practice
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