Prachi Sharma, Sharath Krishnaswami, Keyur Shah, Rohini M. Surve
Lesions at the cerebellopontine angle (CP angle) are associated with various brain-heart interactions, which can include those from stimulation of the fifth cranial nerve along the scalp incision in a retrosigmoid suboccipital surgical approach. A 27-year-old male patient with recently diagnosed hypertension (on calcium channel blocker) underwent left CP angle lesion decompression. Transient episodes of bradycardia, hypotension, and bradypnea were observed from the skin incision onward, exacerbated during tumor manipulation. Most episodes subsided with cessation of the surgical stimulus while some required intervention. Postoperatively, blood pressure decreased below the pre-operative levels. Thus, trigeminocardiac reflex can occur as early as the skin incision even in a retrosigmoid approach due to stimulation of the mandibular division, when specific risk factors exist. Such episodes may serve as early warning signs for subsequent intraoperative occurrences. Brainstem compression can be a possible etiology of hypertension in young patients. It underscores the importance of considering brain-heart interactions in surgical interventions involving the CP angle.
{"title":"Expanding the spectrum on brain-heart interactions in cerebellopontine angle surgeries","authors":"Prachi Sharma, Sharath Krishnaswami, Keyur Shah, Rohini M. Surve","doi":"10.25259/jnrp_21_2024","DOIUrl":"https://doi.org/10.25259/jnrp_21_2024","url":null,"abstract":"Lesions at the cerebellopontine angle (CP angle) are associated with various brain-heart interactions, which can include those from stimulation of the fifth cranial nerve along the scalp incision in a retrosigmoid suboccipital surgical approach. A 27-year-old male patient with recently diagnosed hypertension (on calcium channel blocker) underwent left CP angle lesion decompression. Transient episodes of bradycardia, hypotension, and bradypnea were observed from the skin incision onward, exacerbated during tumor manipulation. Most episodes subsided with cessation of the surgical stimulus while some required intervention. Postoperatively, blood pressure decreased below the pre-operative levels. Thus, trigeminocardiac reflex can occur as early as the skin incision even in a retrosigmoid approach due to stimulation of the mandibular division, when specific risk factors exist. Such episodes may serve as early warning signs for subsequent intraoperative occurrences. Brainstem compression can be a possible etiology of hypertension in young patients. It underscores the importance of considering brain-heart interactions in surgical interventions involving the CP angle.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140222604","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}
Jayaram Bharath, M. Amuthabharathi, K. Sivasubramaniyan, Subathra Adithan, Sunil K. Narayan, V. C. Sunitha, K. Nagarajan
Cerebral microbleeds (MBs) are recently described entity on magnetic resonance (MR) neuroimaging and are considered one of the markers of small vessel disease. We aimed to study the clinicoradiological features of cerebral MBs that were diagnosed in MR neuroimaging. We studied 109 South Indian patients, who presented to a tertiary care institution for MR neuroimaging with cerebral MBs as diagnosed on MR neuroimaging based on either the gradient T2* imaging or susceptibility-weighted imaging. The clinical details and coexisting MR features of infarcts, macrohemorrhages, lacunar infarcts, and white matter leukoaraiosis were evaluated and analyzed. Of 109 patients, 79 were males and 30 were females. Associated clinical comorbidities noted include hypertension (62.39%), diabetes (23.85%), and alcoholism (31.19%) apart from the history of anti-platelet/anti-coagulant usage (15.5%), previous cardiac disease (12.84%), and previous stroke/transient ischemic attacks (9.17%). Other co-existing neuroimaging abnormalities noted include cortical infarcts (27.52%), old hemorrhages (29.36%), lacunar infarcts (56.88%), and white matter leukaraiosis (67.89%). The clinicoradiological features of cerebral MBs in South Indian patients are similar to other Asian and Western studies with significant coexistence of clinical comorbidities and imaging features of small vessel changes. Further studies with a larger sample are needed to correlate the grade of MBs to the individual risk of these clinicoradiological characteristics.
{"title":"Clinicoradiological features of cerebral microbleeds diagnosed on magnetic resonance neuroimaging","authors":"Jayaram Bharath, M. Amuthabharathi, K. Sivasubramaniyan, Subathra Adithan, Sunil K. Narayan, V. C. Sunitha, K. Nagarajan","doi":"10.25259/jnrp_331_2023","DOIUrl":"https://doi.org/10.25259/jnrp_331_2023","url":null,"abstract":"\u0000\u0000Cerebral microbleeds (MBs) are recently described entity on magnetic resonance (MR) neuroimaging and are considered one of the markers of small vessel disease. We aimed to study the clinicoradiological features of cerebral MBs that were diagnosed in MR neuroimaging.\u0000\u0000\u0000\u0000We studied 109 South Indian patients, who presented to a tertiary care institution for MR neuroimaging with cerebral MBs as diagnosed on MR neuroimaging based on either the gradient T2* imaging or susceptibility-weighted imaging. The clinical details and coexisting MR features of infarcts, macrohemorrhages, lacunar infarcts, and white matter leukoaraiosis were evaluated and analyzed.\u0000\u0000\u0000\u0000Of 109 patients, 79 were males and 30 were females. Associated clinical comorbidities noted include hypertension (62.39%), diabetes (23.85%), and alcoholism (31.19%) apart from the history of anti-platelet/anti-coagulant usage (15.5%), previous cardiac disease (12.84%), and previous stroke/transient ischemic attacks (9.17%). Other co-existing neuroimaging abnormalities noted include cortical infarcts (27.52%), old hemorrhages (29.36%), lacunar infarcts (56.88%), and white matter leukaraiosis (67.89%).\u0000\u0000\u0000\u0000The clinicoradiological features of cerebral MBs in South Indian patients are similar to other Asian and Western studies with significant coexistence of clinical comorbidities and imaging features of small vessel changes. Further studies with a larger sample are needed to correlate the grade of MBs to the individual risk of these clinicoradiological characteristics.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-20","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140227809","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}
S. Phuyal, Baburam Pokhrel, R. Lamsal, B. Mishra, M. Nayak
Simultaneous occlusion of both middle cerebral arteries (MCAs) is very rare and usually devastating. Few case reports are available in the literature where bilateral thrombectomy was done simultaneously to remove the clot. High NIH stroke scale with a low level of consciousness can be a clue for the diagnosis. Timely intervention is necessary to decrease morbidity and mortality in these patients. We also reviewed the existing literature where mechanical thrombectomies were done for bilateral MCA stroke in PubMed, Google Scholar, Cochrane, and Embase. Herein, we report a case of 47-year-old female having rheumatic heart disease presented with simultaneous bilateral MCAs occlusion, treated with mechanical thrombectomies successfully.
{"title":"Sequential mechanical thrombectomies in acute bilateral middle cerebral artery strokes: A case report and review of literature","authors":"S. Phuyal, Baburam Pokhrel, R. Lamsal, B. Mishra, M. Nayak","doi":"10.25259/jnrp_26_2024","DOIUrl":"https://doi.org/10.25259/jnrp_26_2024","url":null,"abstract":"Simultaneous occlusion of both middle cerebral arteries (MCAs) is very rare and usually devastating. Few case reports are available in the literature where bilateral thrombectomy was done simultaneously to remove the clot. High NIH stroke scale with a low level of consciousness can be a clue for the diagnosis. Timely intervention is necessary to decrease morbidity and mortality in these patients. We also reviewed the existing literature where mechanical thrombectomies were done for bilateral MCA stroke in PubMed, Google Scholar, Cochrane, and Embase. Herein, we report a case of 47-year-old female having rheumatic heart disease presented with simultaneous bilateral MCAs occlusion, treated with mechanical thrombectomies successfully.","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-03-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140249171","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}
Deepak Agrawal, Sharwari Joshi, Vaibhav Bahel, Latha Poonamallee, Amit Agrawal
Midline shift (MLS) is a critical indicator of the severity of brain trauma and is even suggestive of changes in intracranial pressure. At present, radiologists have to manually measure the MLS using laborious techniques. Automatic detection of MLS using artificial intelligence can be a cutting-edge solution for emergency health-care personnel to help in prompt diagnosis and treatment. In this study, we sought to determine the accuracy and the prognostic value of our screening tool that automatically detects MLS on computed tomography (CT) images in patients with traumatic brain injuries (TBIs). The study enrolled TBI cases, who presented at the Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi. Institutional ethics committee permission was taken before starting the study. The data collection was carried out for over nine months, i.e., from January 2020 to September 2020. The data collection included head CT scans, patient demographics, clinical details as well as radiologist’s reports. The radiologist’s reports were considered the “gold standard” for evaluating the MLS. A deep learning-based three dimensional (3D) convolutional neural network (CNN) model was developed using 176 head CT scans. The developed 3D CNN model was trained using 156 scans and was tested on 20 head CTs to determine the accuracy and sensitivity of the model. The screening tool was correctly able to detect 7/10 MLS cases and 4/10 non-MLS cases. The model showed an accuracy of 55% with high specificity (70%) and moderate sensitivity of 40%. An automated solution for screening the MLS can prove useful for neurosurgeons. The results are strong evidence that 3D CNN can assist clinicians in screening MLS cases in an emergency setting.
{"title":"Three dimensional convolutional neural network-based automated detection of midline shift in traumatic brain injury cases from head computed tomography scans","authors":"Deepak Agrawal, Sharwari Joshi, Vaibhav Bahel, Latha Poonamallee, Amit Agrawal","doi":"10.25259/jnrp_490_2023","DOIUrl":"https://doi.org/10.25259/jnrp_490_2023","url":null,"abstract":"\u0000\u0000Midline shift (MLS) is a critical indicator of the severity of brain trauma and is even suggestive of changes in intracranial pressure. At present, radiologists have to manually measure the MLS using laborious techniques. Automatic detection of MLS using artificial intelligence can be a cutting-edge solution for emergency health-care personnel to help in prompt diagnosis and treatment. In this study, we sought to determine the accuracy and the prognostic value of our screening tool that automatically detects MLS on computed tomography (CT) images in patients with traumatic brain injuries (TBIs).\u0000\u0000\u0000\u0000The study enrolled TBI cases, who presented at the Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi. Institutional ethics committee permission was taken before starting the study. The data collection was carried out for over nine months, i.e., from January 2020 to September 2020. The data collection included head CT scans, patient demographics, clinical details as well as radiologist’s reports. The radiologist’s reports were considered the “gold standard” for evaluating the MLS. A deep learning-based three dimensional (3D) convolutional neural network (CNN) model was developed using 176 head CT scans.\u0000\u0000\u0000\u0000The developed 3D CNN model was trained using 156 scans and was tested on 20 head CTs to determine the accuracy and sensitivity of the model. The screening tool was correctly able to detect 7/10 MLS cases and 4/10 non-MLS cases. The model showed an accuracy of 55% with high specificity (70%) and moderate sensitivity of 40%.\u0000\u0000\u0000\u0000An automated solution for screening the MLS can prove useful for neurosurgeons. The results are strong evidence that 3D CNN can assist clinicians in screening MLS cases in an emergency setting.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-29","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140415072","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}
Kaiorisa N. Doctor, Shreekanth D Karnad, Shyam Krishnan, A. Narayan, Akshatha Nayak
A group of neuromuscular system anomalies associated with non-progressive issues in the developing fetal or newborn brain are known as cerebral palsy (CP). These abnormalities are typified by poor posture and motor development, which limits the execution of functional activities. Consequently, to achieve the same goals as peers who are typically developing, children with CP employ a variety of compensatory postures and techniques. Given that both sitting and mobility are essential for functioning, assessing each skill alone and in relation to the other is necessary. This study aims to determine if a child’s functional mobility affects their sitting ability. Twenty CP (Gross Motor Function Classification System [GMFCS] levels I and II) children, aged 6–12, were enrolled in the research. The level of sitting scale (LSS) and the modified timed up and go (mTUG) test were utilized to evaluate sitting and functional mobility, respectively. The quality of sitting was shown to have a substantial effect on functional mobility, as a significant difference in mTUG durations was established between LSS levels (P < 0.001) and persisted when analyzed within the same GMFCS level (P = 0.007). The importance of trunk control in functional mobility can be inferred from the link between sitting quality and mobility. To improve children with CP’s functional mobility, this evidence may be utilized to design a well-informed and specific intervention program incorporating trunk control.
一组与胎儿或新生儿大脑发育过程中的非进行性问题有关的神经肌肉系统异常被称为脑瘫（CP）。这些异常的典型表现是姿势和运动发育不良，从而限制了功能活动的执行。因此，为了达到与发育正常的同龄人相同的目标，CP 患儿会采用各种补偿姿势和技巧。鉴于坐姿和活动能力对功能的发挥至关重要，因此有必要单独评估这两项技能以及它们之间的关系。本研究旨在确定儿童的功能性活动能力是否会影响他们的坐姿能力。20 名 6-12 岁的 CP（粗大运动功能分类系统 [GMFCS] I 级和 II 级）儿童参与了研究。研究表明，坐姿的质量对功能活动能力有很大影响，因为坐姿量表（LSS）水平之间的mTUG持续时间存在显著差异（P < 0.001），而且在同一GMFCS水平内进行分析时，这种差异依然存在（P = 0.007）。为了改善CP儿童的功能活动能力，我们可以利用这些证据来设计一个包含躯干控制的、有充分依据的特定干预计划。
{"title":"Is functional mobility associated with quality of sitting in cerebral palsy? A cross-sectional study","authors":"Kaiorisa N. Doctor, Shreekanth D Karnad, Shyam Krishnan, A. Narayan, Akshatha Nayak","doi":"10.25259/jnrp_516_2023","DOIUrl":"https://doi.org/10.25259/jnrp_516_2023","url":null,"abstract":"\u0000\u0000A group of neuromuscular system anomalies associated with non-progressive issues in the developing fetal or newborn brain are known as cerebral palsy (CP). These abnormalities are typified by poor posture and motor development, which limits the execution of functional activities. Consequently, to achieve the same goals as peers who are typically developing, children with CP employ a variety of compensatory postures and techniques. Given that both sitting and mobility are essential for functioning, assessing each skill alone and in relation to the other is necessary. This study aims to determine if a child’s functional mobility affects their sitting ability.\u0000\u0000\u0000\u0000Twenty CP (Gross Motor Function Classification System [GMFCS] levels I and II) children, aged 6–12, were enrolled in the research. The level of sitting scale (LSS) and the modified timed up and go (mTUG) test were utilized to evaluate sitting and functional mobility, respectively.\u0000\u0000\u0000\u0000The quality of sitting was shown to have a substantial effect on functional mobility, as a significant difference in mTUG durations was established between LSS levels (P < 0.001) and persisted when analyzed within the same GMFCS level (P = 0.007).\u0000\u0000\u0000\u0000The importance of trunk control in functional mobility can be inferred from the link between sitting quality and mobility. To improve children with CP’s functional mobility, this evidence may be utilized to design a well-informed and specific intervention program incorporating trunk control.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-28","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140423169","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}
{"title":"Spontaneous rupture of arachnoid cyst","authors":"H. K. Mamik, Mahesh Kuldeep, V. D. Sinha","doi":"10.25259/jnrp_554_2023","DOIUrl":"https://doi.org/10.25259/jnrp_554_2023","url":null,"abstract":"","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140435125","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}
Naima Faez, Fouzia Hmami, Saïd Boujraf, W. Kojmane, Samir Atmani
Premature newborns are exposed to a great deal of over-stimulation, which can affect their cerebral development. For better sleep, certain practices should be recommended. The aim of this study was to evaluate the effect of a professional training program on the improvement of practices promoting respect for the newborn’s sleep-wake cycle. This was an interventional study with a longitudinal, single-group, and before-and-after design. The experimental design followed a three-stage time series: Eight months before, three months after, then eight months after intervention. It targeted a comprehensive sample of 66 professionals. It took place between October 2020 and March 2022 at the Neonatal Intensive Care Unit of the Hassan II University Hospital in Fez, Morocco. It was based on an observation grid and a self-administered questionnaire, validated and tested with a Cronbach’s alpha reliability of 0.91. The light environment showed significant differences between the 1st and 3rd step (3.3% vs. 45.0%; P = 0.02; confidence interval [CI] = 13.644–10.456) for knowledge and (13.3% vs. 78.3%; P = 0.01; CI = 14.412–10.888) for practices; the noise environment showed a positive improvement between the 2nd and 3rd intervention (31.7% vs. 41.7%; P < 0.001; CI = 5.954–2.913) for knowledge and (65.0% vs. 73.3%; P < 0.001; CI = 3.597–1.236) for practices, with an average of (8.98 ± 0.30–28.15 ± 0.48; CI = 3.806–1.094) between the 1st and 3rd step. Practices surrounding sleep and wakefulness reported significant improvement between the three periods (14.35 ± 0.22 vs. 18.10 ± 0.35 vs. 19.90 ± 0.35; P P < 0.001; CI = 4.647–2.853) for sleep and (13.25 ± 0.48 vs. 22.27 ± 0.59; P < 0.001; CI = 10.563–7.471) for wakefulness with statistically significant correlations between knowledge and practices (0.426**) for sleep and (0.606**) for wakefulness. The study demonstrated the positive impact of this sleep management and assessment program on the development of professional skills. Its implementation requires rigorous application of developmental support strategies for individualized care in neonatology.
早产新生儿会受到大量的过度刺激，这可能会影响他们的大脑发育。为了让新生儿睡得更好，我们建议采取一些措施。本研究的目的是评估专业培训计划对改善尊重新生儿睡眠-觉醒周期的做法的影响。这是一项采用纵向、单组、前后对比设计的干预性研究。实验设计遵循三个阶段的时间序列：干预前八个月、干预后三个月、干预后八个月。实验对象为 66 名专业人员的综合样本。实验于 2020 年 10 月至 2022 年 3 月在摩洛哥非斯哈桑二世大学医院新生儿重症监护室进行。光环境显示，第 1 步和第 3 步之间在知识方面存在显著差异（3.3% vs. 45.0%；P = 0.02；置信区间 [CI] = 13.644-10.456），在认知方面存在显著差异（13.3% vs. 78.3%；P = 0.01；CI = 14.412-10.888）。噪音环境在第 2 次和第 3 次干预之间显示出积极的改善（31.7% vs. 41.7%；P < 0.001；CI = 5.954-2.913），而在第 1 次和第 3 次干预之间，在知识方面（65.0% vs. 73.3%；P < 0.001；CI = 3.597-1.236）和在实践方面（65.0% vs. 73.3%；P < 0.001；CI = 3.597-1.236）的平均值为（8.98 ± 0.30-28.15 ± 0.48；CI = 3.806-1.094）。与睡眠和觉醒有关的实践表明，在三个阶段之间，睡眠有了显著改善（14.35 ± 0.22 vs. 18.10 ± 0.35 vs. 19.90 ± 0.35；P P < 0.001；CI = 4.647-2.853），觉醒有了显著改善（13.25 ± 0.48 vs. 22.27 ± 0.59；P < 0.001；CI = 10.563-7.471）。研究表明，该睡眠管理和评估计划对专业技能的发展具有积极影响。该计划的实施需要在新生儿科的个性化护理中严格应用发展支持策略。
{"title":"Practices for respecting the newborn’s sleep-wake cycle: Interventional study in the neonatal intensive care unit","authors":"Naima Faez, Fouzia Hmami, Saïd Boujraf, W. Kojmane, Samir Atmani","doi":"10.25259/jnrp_579_2023","DOIUrl":"https://doi.org/10.25259/jnrp_579_2023","url":null,"abstract":"\u0000\u0000Premature newborns are exposed to a great deal of over-stimulation, which can affect their cerebral development. For better sleep, certain practices should be recommended. The aim of this study was to evaluate the effect of a professional training program on the improvement of practices promoting respect for the newborn’s sleep-wake cycle.\u0000\u0000\u0000\u0000This was an interventional study with a longitudinal, single-group, and before-and-after design. The experimental design followed a three-stage time series: Eight months before, three months after, then eight months after intervention. It targeted a comprehensive sample of 66 professionals. It took place between October 2020 and March 2022 at the Neonatal Intensive Care Unit of the Hassan II University Hospital in Fez, Morocco. It was based on an observation grid and a self-administered questionnaire, validated and tested with a Cronbach’s alpha reliability of 0.91.\u0000\u0000\u0000\u0000The light environment showed significant differences between the 1st and 3rd step (3.3% vs. 45.0%; P = 0.02; confidence interval [CI] = 13.644–10.456) for knowledge and (13.3% vs. 78.3%; P = 0.01; CI = 14.412–10.888) for practices; the noise environment showed a positive improvement between the 2nd and 3rd intervention (31.7% vs. 41.7%; P < 0.001; CI = 5.954–2.913) for knowledge and (65.0% vs. 73.3%; P < 0.001; CI = 3.597–1.236) for practices, with an average of (8.98 ± 0.30–28.15 ± 0.48; CI = 3.806–1.094) between the 1st and 3rd step. Practices surrounding sleep and wakefulness reported significant improvement between the three periods (14.35 ± 0.22 vs. 18.10 ± 0.35 vs. 19.90 ± 0.35; P P < 0.001; CI = 4.647–2.853) for sleep and (13.25 ± 0.48 vs. 22.27 ± 0.59; P < 0.001; CI = 10.563–7.471) for wakefulness with statistically significant correlations between knowledge and practices (0.426**) for sleep and (0.606**) for wakefulness.\u0000\u0000\u0000\u0000The study demonstrated the positive impact of this sleep management and assessment program on the development of professional skills. Its implementation requires rigorous application of developmental support strategies for individualized care in neonatology.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140452174","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}
Rana Pratap Singh, Soumen Kanjilal, A. Mehrotra, Shagun Misra, Pooja Tataskar, Devanshu Mishra, P. Verma, K. Das, A. Jaiswal, Raj Kumar
The determinants of progression-free survival (PFS) and overall survival (OS) for higher-grade meningiomas have not been clearly established and to summarize the long-term clinical outcome for patients with grade 2 or 3 meningioma and assess the PFS and OS factors. The study included all individuals, who had undergone surgical removal of cerebral meningiomas between 2005 and 2020 and whose histological results suggested a World Health Organization (WHO) grade 2 or grade 3 diseases. Kaplan–Meier curves are plotted to examine tumor control and OS after the follow-up. The reverse Wald logistic regression and Mantel-Cox test were used in multivariate analysis for tumor recurrence and mortality. There were 94 individuals enrolled with 82 having WHO grade 2 tumors and 12 having WHO grade 3 lesions. Gross total resection of the tumor was present in 73 patients (78%), and adjuvant radiotherapy (RT) was administered to 43 (45.7%) individuals. During the course of the study, 17 patients died. The WHO grade of the tumor, the extent of resection, and the absence of bone involvement were all independent predictors of better survival in a multivariate analysis. Furthermore, whereas adjuvant RT after surgery enhanced survival, it was not statistically significant (hazard ratios [95% confidence interval CI] = 1.91 [0.15–23.52] [P = 0.61]). The degree of tumor excision is the strongest predictor of PFS and OS. In the event of a recurrence, rather than opting for upfront radiation, a second surgery with the goal of maximum safe resection should be performed.
{"title":"Long-term follow-up in high-grade meningioma and outcome analysis","authors":"Rana Pratap Singh, Soumen Kanjilal, A. Mehrotra, Shagun Misra, Pooja Tataskar, Devanshu Mishra, P. Verma, K. Das, A. Jaiswal, Raj Kumar","doi":"10.25259/jnrp_573_2023","DOIUrl":"https://doi.org/10.25259/jnrp_573_2023","url":null,"abstract":"\u0000\u0000The determinants of progression-free survival (PFS) and overall survival (OS) for higher-grade meningiomas have not been clearly established and to summarize the long-term clinical outcome for patients with grade 2 or 3 meningioma and assess the PFS and OS factors.\u0000\u0000\u0000\u0000The study included all individuals, who had undergone surgical removal of cerebral meningiomas between 2005 and 2020 and whose histological results suggested a World Health Organization (WHO) grade 2 or grade 3 diseases. Kaplan–Meier curves are plotted to examine tumor control and OS after the follow-up. The reverse Wald logistic regression and Mantel-Cox test were used in multivariate analysis for tumor recurrence and mortality.\u0000\u0000\u0000\u0000There were 94 individuals enrolled with 82 having WHO grade 2 tumors and 12 having WHO grade 3 lesions. Gross total resection of the tumor was present in 73 patients (78%), and adjuvant radiotherapy (RT) was administered to 43 (45.7%) individuals. During the course of the study, 17 patients died. The WHO grade of the tumor, the extent of resection, and the absence of bone involvement were all independent predictors of better survival in a multivariate analysis. Furthermore, whereas adjuvant RT after surgery enhanced survival, it was not statistically significant (hazard ratios [95% confidence interval CI] = 1.91 [0.15–23.52] [P = 0.61]).\u0000\u0000\u0000\u0000The degree of tumor excision is the strongest predictor of PFS and OS. In the event of a recurrence, rather than opting for upfront radiation, a second surgery with the goal of maximum safe resection should be performed.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139839530","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}
Rana Pratap Singh, Soumen Kanjilal, A. Mehrotra, Shagun Misra, Pooja Tataskar, Devanshu Mishra, P. Verma, K. Das, A. Jaiswal, Raj Kumar
The determinants of progression-free survival (PFS) and overall survival (OS) for higher-grade meningiomas have not been clearly established and to summarize the long-term clinical outcome for patients with grade 2 or 3 meningioma and assess the PFS and OS factors. The study included all individuals, who had undergone surgical removal of cerebral meningiomas between 2005 and 2020 and whose histological results suggested a World Health Organization (WHO) grade 2 or grade 3 diseases. Kaplan–Meier curves are plotted to examine tumor control and OS after the follow-up. The reverse Wald logistic regression and Mantel-Cox test were used in multivariate analysis for tumor recurrence and mortality. There were 94 individuals enrolled with 82 having WHO grade 2 tumors and 12 having WHO grade 3 lesions. Gross total resection of the tumor was present in 73 patients (78%), and adjuvant radiotherapy (RT) was administered to 43 (45.7%) individuals. During the course of the study, 17 patients died. The WHO grade of the tumor, the extent of resection, and the absence of bone involvement were all independent predictors of better survival in a multivariate analysis. Furthermore, whereas adjuvant RT after surgery enhanced survival, it was not statistically significant (hazard ratios [95% confidence interval CI] = 1.91 [0.15–23.52] [P = 0.61]). The degree of tumor excision is the strongest predictor of PFS and OS. In the event of a recurrence, rather than opting for upfront radiation, a second surgery with the goal of maximum safe resection should be performed.
{"title":"Long-term follow-up in high-grade meningioma and outcome analysis","authors":"Rana Pratap Singh, Soumen Kanjilal, A. Mehrotra, Shagun Misra, Pooja Tataskar, Devanshu Mishra, P. Verma, K. Das, A. Jaiswal, Raj Kumar","doi":"10.25259/jnrp_573_2023","DOIUrl":"https://doi.org/10.25259/jnrp_573_2023","url":null,"abstract":"\u0000\u0000The determinants of progression-free survival (PFS) and overall survival (OS) for higher-grade meningiomas have not been clearly established and to summarize the long-term clinical outcome for patients with grade 2 or 3 meningioma and assess the PFS and OS factors.\u0000\u0000\u0000\u0000The study included all individuals, who had undergone surgical removal of cerebral meningiomas between 2005 and 2020 and whose histological results suggested a World Health Organization (WHO) grade 2 or grade 3 diseases. Kaplan–Meier curves are plotted to examine tumor control and OS after the follow-up. The reverse Wald logistic regression and Mantel-Cox test were used in multivariate analysis for tumor recurrence and mortality.\u0000\u0000\u0000\u0000There were 94 individuals enrolled with 82 having WHO grade 2 tumors and 12 having WHO grade 3 lesions. Gross total resection of the tumor was present in 73 patients (78%), and adjuvant radiotherapy (RT) was administered to 43 (45.7%) individuals. During the course of the study, 17 patients died. The WHO grade of the tumor, the extent of resection, and the absence of bone involvement were all independent predictors of better survival in a multivariate analysis. Furthermore, whereas adjuvant RT after surgery enhanced survival, it was not statistically significant (hazard ratios [95% confidence interval CI] = 1.91 [0.15–23.52] [P = 0.61]).\u0000\u0000\u0000\u0000The degree of tumor excision is the strongest predictor of PFS and OS. In the event of a recurrence, rather than opting for upfront radiation, a second surgery with the goal of maximum safe resection should be performed.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-14","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139779512","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}
P. Panda, Aman Elwadhi, Diksha Gupta, Achanya Palayullakandi, A. Tomar, Mayank Singh, Antara Vyas, Deepak Kumar, I. Sharawat
IMPUTE Inc., a software firm dedicated to healthcare technology, has developed a mobile medical application known as IMPUTE ADT-1 for children with autism spectrum disorder (ASD) based on the principle of applied behavior analysis. The primary objective of this trial was to compare the efficacy of add-on treatment with IMPUTE ADT-1 in children with ASD aged two to six years as compared to standard care alone for 12 weeks (in terms of change in Autism Diagnostic Observation Schedule [ADOS-2] scores). The secondary objective of the study was to assess the compliance with IMPUTE ADT-1 among participants and also to evaluate the feedback of parents regarding IMPUTE ADT-1 at the end of 12 weeks. The application provides personalized programs tailored to each user’s needs, and the program evolves based on the user’s progress. It also utilizes face tracking, eye tracking, and body tracking to gather behavior-related information for each child and apply it in reinforcement learning employing artificial intelligence-based algorithms. Till the time of interim analysis, 37 and 33 children had completed 12-week follow-up in IMPUTE ADT-1 and control arm. At 12 weeks, as compared to baseline, change in social affect domain, repetitive ritualistic behavior domain, total ADOS-2 score, and ADOS-2 comparison score was better in the intervention group as compared to the control group (P < 0.001 for all). A total of 30 (81%), 28 (75%), and 29 (78%) caregivers in the IMPUTE ADT-1 group believed that the ADT-1 app improved their child’s verbal skills, social skills, and reduced repetitive behavior, respectively. IMPUTE ADT-1 mobile application has the efficacy to improve the severity of autism symptoms in children. Parents of these children also feel that the application is beneficial for improving the socialization and verbal communication of their children.
{"title":"Effectiveness of IMPUTE ADT-1 mobile application in children with autism spectrum disorder: An interim analysis of an ongoing randomized controlled trial","authors":"P. Panda, Aman Elwadhi, Diksha Gupta, Achanya Palayullakandi, A. Tomar, Mayank Singh, Antara Vyas, Deepak Kumar, I. Sharawat","doi":"10.25259/jnrp_599_2023","DOIUrl":"https://doi.org/10.25259/jnrp_599_2023","url":null,"abstract":"\u0000\u0000IMPUTE Inc., a software firm dedicated to healthcare technology, has developed a mobile medical application known as IMPUTE ADT-1 for children with autism spectrum disorder (ASD) based on the principle of applied behavior analysis.\u0000\u0000\u0000\u0000The primary objective of this trial was to compare the efficacy of add-on treatment with IMPUTE ADT-1 in children with ASD aged two to six years as compared to standard care alone for 12 weeks (in terms of change in Autism Diagnostic Observation Schedule [ADOS-2] scores). The secondary objective of the study was to assess the compliance with IMPUTE ADT-1 among participants and also to evaluate the feedback of parents regarding IMPUTE ADT-1 at the end of 12 weeks. The application provides personalized programs tailored to each user’s needs, and the program evolves based on the user’s progress. It also utilizes face tracking, eye tracking, and body tracking to gather behavior-related information for each child and apply it in reinforcement learning employing artificial intelligence-based algorithms.\u0000\u0000\u0000\u0000Till the time of interim analysis, 37 and 33 children had completed 12-week follow-up in IMPUTE ADT-1 and control arm. At 12 weeks, as compared to baseline, change in social affect domain, repetitive ritualistic behavior domain, total ADOS-2 score, and ADOS-2 comparison score was better in the intervention group as compared to the control group (P < 0.001 for all). A total of 30 (81%), 28 (75%), and 29 (78%) caregivers in the IMPUTE ADT-1 group believed that the ADT-1 app improved their child’s verbal skills, social skills, and reduced repetitive behavior, respectively.\u0000\u0000\u0000\u0000IMPUTE ADT-1 mobile application has the efficacy to improve the severity of autism symptoms in children. Parents of these children also feel that the application is beneficial for improving the socialization and verbal communication of their children.\u0000","PeriodicalId":16443,"journal":{"name":"Journal of Neurosciences in Rural Practice","volume":null,"pages":null},"PeriodicalIF":1.4,"publicationDate":"2024-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139839974","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}
京公网安备 11010802042870号
京ICP备2023020795号-1
扫码关注我们
求助内容：
应助结果提醒方式：