T. Alloush, E. Fayez, I. A. Al-azab, M. Bouls, M. Hamdy
Study Objectives: Stroke is a major neurological disease significantly threatening the human health and life with a high morbidity, disability, and mortality. Post-stroke depression (PSD) is one of the common complications of stroke. PSD has been a major factor hindering the recovery of neurological functions and daily activities in stroke patients and is closely related to the social avoidance and increased mortality of stroke patients. Although antidepressant drug treatment has improved during the last decades, symptoms in about 20% of the patients are not in remission two years after initiation of pharmacological intervention. Nowadays, non-invasive brain stimulation; techniques; transcranial direct current stimulation (tCDS) has gained an important interest in the treatment of many neuropsychiatric disorders which might be of some help in treatment of PSD. The goal of the current study is to evaluate the beneficial short term role of tDCS on post-stroke depression. Study Design: This was a randomized double blind placebo-controlled clinical trial included forty hemiparetic patients with post-stroke depression from outpatient clinic of Faculty of Physical Therapy, Cairo University, in the period between June 2018 to June 2019. All patients diagnosed as having a PSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Depression was evaluated by Hamilton Depression Rating Scale (HAM-D) pre and post treatment and quality of life was evaluated by the Stroke Specific Quality Of Life scale (SS-QOL). Patients were assigned randomly into two groups: the study group A and the control group B. Both groups received antidepressant medication in addition to physical therapy program. Group A received tCDS for 30 minutes, three times per week for one month, while the group B received sham transcranial direct current stimulation. Results: Active tDCS was significantly superior to sham with significant improvement in depression and Stroke Specific Quality Of Life in treated group in comparison to group B, p = 0.000. Conclusion: tDCS was effective for post- stroke depression and might be a favorable option for treating post-stroke patients.
{"title":"Role of Transcranial Direct Current Stimulation in the Management of Post-Stroke Depression","authors":"T. Alloush, E. Fayez, I. A. Al-azab, M. Bouls, M. Hamdy","doi":"10.4236/nm.2020.111001","DOIUrl":"https://doi.org/10.4236/nm.2020.111001","url":null,"abstract":"Study Objectives: Stroke is a major neurological disease significantly threatening the human health and life with a high morbidity, disability, and mortality. Post-stroke depression (PSD) is one of the common complications of stroke. PSD has been a major factor hindering the recovery of neurological functions and daily activities in stroke patients and is closely related to the social avoidance and increased mortality of stroke patients. Although antidepressant drug treatment has improved during the last decades, symptoms in about 20% of the patients are not in remission two years after initiation of pharmacological intervention. Nowadays, non-invasive brain stimulation; techniques; transcranial direct current stimulation (tCDS) has gained an important interest in the treatment of many neuropsychiatric disorders which might be of some help in treatment of PSD. The goal of the current study is to evaluate the beneficial short term role of tDCS on post-stroke depression. Study Design: This was a randomized double blind placebo-controlled clinical trial included forty hemiparetic patients with post-stroke depression from outpatient clinic of Faculty of Physical Therapy, Cairo University, in the period between June 2018 to June 2019. All patients diagnosed as having a PSD according to the Diagnostic and Statistical Manual of Mental Disorders (DSM-5). Depression was evaluated by Hamilton Depression Rating Scale (HAM-D) pre and post treatment and quality of life was evaluated by the Stroke Specific Quality Of Life scale (SS-QOL). Patients were assigned randomly into two groups: the study group A and the control group B. Both groups received antidepressant medication in addition to physical therapy program. Group A received tCDS for 30 minutes, three times per week for one month, while the group B received sham transcranial direct current stimulation. Results: Active tDCS was significantly superior to sham with significant improvement in depression and Stroke Specific Quality Of Life in treated group in comparison to group B, p = 0.000. Conclusion: tDCS was effective for post- stroke depression and might be a favorable option for treating post-stroke patients.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"23 1","pages":"1-11"},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"79637616","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. E. S. Bandzouzi, Hugues Brieux Ekouele Mbaki, Dina Happhia Motoula Latou, G. Mpandzou, J. Diatewa, Aimé Kaoudi, N. M. Diouf, Frida Ninelle Awam Amioth, Vital Ebelebe, G. Koubemba, Paul Macaire Osou-Nguiet
We describe the case of a spontaneous multifocal intracerebral hemorrhage in a Congolese subject presenting no risk factor. He is a 32-year-old subject with no particular history admitted for seizures in which the cerebral scanner has revealed spontaneous multifocal intracerebral hemorrhages. He only received medical treatment. It remains a very rare entity. The location of the hematoma is variable and is usually located in the basal ganglia due to chronic hypertension.
{"title":"Multifocal Spontaneous Intracerebral Hemorrhage about a Case and Review of the Literature","authors":"P. E. S. Bandzouzi, Hugues Brieux Ekouele Mbaki, Dina Happhia Motoula Latou, G. Mpandzou, J. Diatewa, Aimé Kaoudi, N. M. Diouf, Frida Ninelle Awam Amioth, Vital Ebelebe, G. Koubemba, Paul Macaire Osou-Nguiet","doi":"10.4236/nm.2020.111002","DOIUrl":"https://doi.org/10.4236/nm.2020.111002","url":null,"abstract":"We describe the case of a spontaneous multifocal intracerebral hemorrhage in a Congolese subject presenting no risk factor. He is a 32-year-old subject with no particular history admitted for seizures in which the cerebral scanner has revealed spontaneous multifocal intracerebral hemorrhages. He only received medical treatment. It remains a very rare entity. The location of the hematoma is variable and is usually located in the basal ganglia due to chronic hypertension.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"38 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"73907396","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}
Background: Since there has been training, there has been discussion about the effect of training. But training evaluation is not systematic until Kirkpatrick came up with the training evaluation model in 1959. At present, the prevailing model in the systematic summary of training evaluation is still The Kirkpatrick’s model. This model was further improved in 1994, more responsive to contemporary needs, and thus widely used all over the world. At the beginning, it was widely used in human resource management of enterprises. In recent years, this model has been gradually used in the medical field to evaluate the effect of medical training. The Kirkpatrick’s model has a systematic, integrated and persuasive evaluation system for trainees. It has good effects in the pre-service nurse training, the professional image and code of conduct nurses training, and the geriatric nurse training. At present, there are few studies on the chemotherapeutic drug training of neurologist nurses in China. In clinical work, nurses’ cognitive and practical behaviors of chemotherapeutic drug protection and drug extravasation prevention and treatment are insufficient. It directly harms the health of nursing staff and increases the complications of chemotherapy, increases pain of tumor patients, delays or interrupts chemotherapy, and aggravates the economic burden of patients. Especially, Chemotherapeutic drugs for neuro-oncology have particularity and necessity of urgent training. Objective: To investigate the effect of chemotherapeutic drug training through mobile terminal for neuro-oncology nurses based on the Kirkpatrick’s model. Methods: The training content and evaluation questionnaire for chemotherapeutic drugs were designed by nursing management personnel and senior nurses in our department according to the guidelines and common diseases requiring chemotherapy in the department. The content includes the basic knowledge of neuro-oncology chemotherapy, pharmacological knowledge, toxic and side effect of chemotherapy, etc., which are regularly pushed through the mobile terminal-WeChat. Forty nurses participated in the training and the effect is evaluated by Kirkpatrick’s model. Result: After the training, 100% of nurses were satisfied with the training content and 97.5% with the training form. The scores of nurses in learning level such as basic pharmacological knowledge, drug configuration and exposure, drug treatment and infusion, observation of toxic and side effects, and treatment of drug extravasation were significantly higher than those before the training (P
{"title":"Evaluation of the Effect of Chemotherapeutic Drug Training on Mobile Terminal for Neuro-Oncology Nurses Based on Kirkpatrick’s Model","authors":"Lan Bai, Qinqin Zhao, Zhihuan Zhou","doi":"10.4236/nm.2020.113010","DOIUrl":"https://doi.org/10.4236/nm.2020.113010","url":null,"abstract":"Background: Since there has been training, there has been discussion about the effect of training. But training evaluation is not systematic until Kirkpatrick came up with the training evaluation model in 1959. At present, the prevailing model in the systematic summary of training evaluation is still The Kirkpatrick’s model. This model was further improved in 1994, more responsive to contemporary needs, and thus widely used all over the world. At the beginning, it was widely used in human resource management of enterprises. In recent years, this model has been gradually used in the medical field to evaluate the effect of medical training. The Kirkpatrick’s model has a systematic, integrated and persuasive evaluation system for trainees. It has good effects in the pre-service nurse training, the professional image and code of conduct nurses training, and the geriatric nurse training. At present, there are few studies on the chemotherapeutic drug training of neurologist nurses in China. In clinical work, nurses’ cognitive and practical behaviors of chemotherapeutic drug protection and drug extravasation prevention and treatment are insufficient. It directly harms the health of nursing staff and increases the complications of chemotherapy, increases pain of tumor patients, delays or interrupts chemotherapy, and aggravates the economic burden of patients. Especially, Chemotherapeutic drugs for neuro-oncology have particularity and necessity of urgent training. Objective: To investigate the effect of chemotherapeutic drug training through mobile terminal for neuro-oncology nurses based on the Kirkpatrick’s model. Methods: The training content and evaluation questionnaire for chemotherapeutic drugs were designed by nursing management personnel and senior nurses in our department according to the guidelines and common diseases requiring chemotherapy in the department. The content includes the basic knowledge of neuro-oncology chemotherapy, pharmacological knowledge, toxic and side effect of chemotherapy, etc., which are regularly pushed through the mobile terminal-WeChat. Forty nurses participated in the training and the effect is evaluated by Kirkpatrick’s model. Result: After the training, 100% of nurses were satisfied with the training content and 97.5% with the training form. The scores of nurses in learning level such as basic pharmacological knowledge, drug configuration and exposure, drug treatment and infusion, observation of toxic and side effects, and treatment of drug extravasation were significantly higher than those before the training (P","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"71 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74954596","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}
R. Alloush, M. Haroun, A. Shalash, H. El-Fawal, M. Hamdy
Study Objectives: Migraine is a complex neurovascular disease and is believed to be due to a mixture of genetic and environmental factors. Study design: This was a cross-sectional observational prospective hospital based study conducted on 100 participants. They were divided into two groups; Group A: 50 migrainous patients according to the criteria of the International Classification of Headache Disorders and Group B: 50 healthy subjects both groups were age and sex matched. All subjects underwent a full neurological and psychiatric examination. Full headache evaluation sheet used in headache outpatient clinic in Ain Shams University Hospitals and HIT-6? Headache Impact Test was used. Assay of serum level of N-acetyl-aspartate (NAA) as mitochondrial function marker was done. Results: There was no significant difference between both groups regarding gender, age or age group, marital state, education, residence and special habits. However, there was a statistical significant difference as regards family history of migraine more in patient group. In this study, serum NAA levels in migraine patients were significantly lower than in healthy controls. Decreased NAA level is generally believed to be a sign of reduced neuronal and glial mitochondrial function. Also, migraine with aura patients showed lower NAA levels when compared to migraine without aura subtypes. However, there was no significant correlation was found between NAA serum levels, and gender, age at onset, age group, type of aura, duration of the illness, type of onset of pain, frequent site of pain, time to max severity, severity of attack, and daily functions (social life, work, psychological wellbeing, sleep and cognition). Conclusions: Findings of this study indicate that NAA in serum may be a marker for neuronal dysfunction predisposing to migraine, probably related to the reduced mitochondria function.
{"title":"Mitochondrial Dysfunctions in Patients with Migraine","authors":"R. Alloush, M. Haroun, A. Shalash, H. El-Fawal, M. Hamdy","doi":"10.4236/nm.2019.104025","DOIUrl":"https://doi.org/10.4236/nm.2019.104025","url":null,"abstract":"Study Objectives: Migraine is a complex neurovascular disease and is believed to be due to a mixture of genetic and environmental factors. Study design: This was a cross-sectional observational prospective hospital based study conducted on 100 participants. They were divided into two groups; Group A: 50 migrainous patients according to the criteria of the International Classification of Headache Disorders and Group B: 50 healthy subjects both groups were age and sex matched. All subjects underwent a full neurological and psychiatric examination. Full headache evaluation sheet used in headache outpatient clinic in Ain Shams University Hospitals and HIT-6? Headache Impact Test was used. Assay of serum level of N-acetyl-aspartate (NAA) as mitochondrial function marker was done. Results: There was no significant difference between both groups regarding gender, age or age group, marital state, education, residence and special habits. However, there was a statistical significant difference as regards family history of migraine more in patient group. In this study, serum NAA levels in migraine patients were significantly lower than in healthy controls. Decreased NAA level is generally believed to be a sign of reduced neuronal and glial mitochondrial function. Also, migraine with aura patients showed lower NAA levels when compared to migraine without aura subtypes. However, there was no significant correlation was found between NAA serum levels, and gender, age at onset, age group, type of aura, duration of the illness, type of onset of pain, frequent site of pain, time to max severity, severity of attack, and daily functions (social life, work, psychological wellbeing, sleep and cognition). Conclusions: Findings of this study indicate that NAA in serum may be a marker for neuronal dysfunction predisposing to migraine, probably related to the reduced mitochondria function.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"127 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"77640731","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}
Background: Musculoskeletal problems, deteriorating posture and pain are common complaints/comorbidities in Parkinson’s disease (PD). The aim of this study was to investigate the frequency of comorbid musculoskeletal problems in PD, and their relationship with disease stage and severity. Methods: The study was approved by the local ethical committee of Duzce University numbered with 2018/52 on date 26.03.2018. Patients with PD (pwPD) underwent a detailed examination to investigate the possible comorbidity of musculoskeletal findings in the orthopedics and traumatology clinic. Socio-demographic features, disease characteristics, motor and non-motor scores were recorded. Results: Thirty-seven pwPD were enrolled in the study. Mean age was 68.75 ± 10.75 years. Comorbid musculoskeletal problems were rotator cuff syndrome (27%), knee osteoarthritis (24.3%), meniscus (13.5%), lumber disc herniation (10.8%), kyphosis (8.1%), myotendinous diseases (16.3%). Rotator-cuff disease and knee osteoarthritis were most common comorbidities, especially in the “mild” and “moderate” stages of pwPD. Conclusion: Since most of the pwPD, especially the ones that have musculoskeletal complaints prior to the diagnosis of PD, present to the orthopedics and traumatology clinics or physiotherapists, it is mandatory to enhance the awareness of the orthopedic surgeons, and physiotherapy specialist in order to keep PD in mind.
{"title":"Frequency of Comorbid Musculoskeletal Problems in Patients with Parkinson’s Disease: What and When?","authors":"E. Değirmenci, Y. Değirmenci","doi":"10.4236/nm.2019.104024","DOIUrl":"https://doi.org/10.4236/nm.2019.104024","url":null,"abstract":"Background: Musculoskeletal problems, deteriorating posture and pain are common complaints/comorbidities in Parkinson’s disease (PD). The aim of this study was to investigate the frequency of comorbid musculoskeletal problems in PD, and their relationship with disease stage and severity. Methods: The study was approved by the local ethical committee of Duzce University numbered with 2018/52 on date 26.03.2018. Patients with PD (pwPD) underwent a detailed examination to investigate the possible comorbidity of musculoskeletal findings in the orthopedics and traumatology clinic. Socio-demographic features, disease characteristics, motor and non-motor scores were recorded. Results: Thirty-seven pwPD were enrolled in the study. Mean age was 68.75 ± 10.75 years. Comorbid musculoskeletal problems were rotator cuff syndrome (27%), knee osteoarthritis (24.3%), meniscus (13.5%), lumber disc herniation (10.8%), kyphosis (8.1%), myotendinous diseases (16.3%). Rotator-cuff disease and knee osteoarthritis were most common comorbidities, especially in the “mild” and “moderate” stages of pwPD. Conclusion: Since most of the pwPD, especially the ones that have musculoskeletal complaints prior to the diagnosis of PD, present to the orthopedics and traumatology clinics or physiotherapists, it is mandatory to enhance the awareness of the orthopedic surgeons, and physiotherapy specialist in order to keep PD in mind.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"72 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90426814","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}
J. Kasolo, A. Namaganda, G. Bbosa, H. Muwonge, R. Lukande, Joshua Nfambi, I. Kimuli, I. Okullo
Background: M. oleifera is a highly valued medicinal plant used widely from time immemorial to treat various ailments. However, with continued un-standardized use of the plant leaves, studies have reported organ toxicity to the liver, kidney and the heart. As communities continue to use M. oleifera leaves for its medicinal and nutritional values, there is need to find an antidote for its hepatotoxicity. Aim: The study established the reversal effect of N-Acetyl Cysteine (NAC) on M. oleifera aqueous leaf extract-induced hepatotoxicity in Wistar albino rats. Methods: Twenty-four (24) rats received a toxic dose (8.05 g/kg bwt) of M. oleifera leaf extract for 28 days to cause sub-acute hepatotoxicity. They were divided into 4 groups of 6 rats each. Group I received 1 ml normal (control group), Group II received 1000 ng/kg NAC, Group III received 1200 mg/kg NAC and Group IV received 1500 mg/kg NAC. Another group of 6 rats (Group V) received 0.75 mg/kg Paracetamol to cause hepatotoxicity. Group V (a positive control) received the prescribed clinical dose of 1200 mg/kg NAC which reverses the hepatotoxicity. All the NAC doses were given once a day intragastric for 7 days. On days: 1, 3 and 7 of receiving NAC, liver serum enzymes and bilirubin were measured. On day 7 the animals were sacrificed and liver tissue harvested for histopathology analysis. Results: A dose of 8.05 g/kg of M. oleifera leaf extract and 0.75 mg/kg Paracetamol were able to induce hepatotoxicity in Wister albino rats in 28 days. The M. oleifera extract induced hepatotoxic rats treated with NAC at doses of 1000 mg/kg, 1200 mg/kg and 1500 mg/kg, had a reduction in mean serum liver enzymes, plus reduced mean serum bilirubin levels. The liver histopathological analysis showed reduced inflammation after treatment with NAC for 3 and 7 days in the M. oleifera and paracetamol induced hepatotoxic rats. Conclusion: NAC can reverse M. oleifera leaf aqueous extract-induced sub-acute hepatotoxicity in Wistar Albino rats.
{"title":"Reversal Effects of N-Acetyl Cysteine on Moringa oleifera Leaves-Induced Sub-Acute Hepatotoxicity in Wistar Albino Rats","authors":"J. Kasolo, A. Namaganda, G. Bbosa, H. Muwonge, R. Lukande, Joshua Nfambi, I. Kimuli, I. Okullo","doi":"10.4236/nm.2019.104028","DOIUrl":"https://doi.org/10.4236/nm.2019.104028","url":null,"abstract":"Background: M. oleifera is a highly valued medicinal plant used widely from time immemorial to treat various ailments. However, with continued un-standardized use of the plant leaves, studies have reported organ toxicity to the liver, kidney and the heart. As communities continue to use M. oleifera leaves for its medicinal and nutritional values, there is need to find an antidote for its hepatotoxicity. Aim: The study established the reversal effect of N-Acetyl Cysteine (NAC) on M. oleifera aqueous leaf extract-induced hepatotoxicity in Wistar albino rats. Methods: Twenty-four (24) rats received a toxic dose (8.05 g/kg bwt) of M. oleifera leaf extract for 28 days to cause sub-acute hepatotoxicity. They were divided into 4 groups of 6 rats each. Group I received 1 ml normal (control group), Group II received 1000 ng/kg NAC, Group III received 1200 mg/kg NAC and Group IV received 1500 mg/kg NAC. Another group of 6 rats (Group V) received 0.75 mg/kg Paracetamol to cause hepatotoxicity. Group V (a positive control) received the prescribed clinical dose of 1200 mg/kg NAC which reverses the hepatotoxicity. All the NAC doses were given once a day intragastric for 7 days. On days: 1, 3 and 7 of receiving NAC, liver serum enzymes and bilirubin were measured. On day 7 the animals were sacrificed and liver tissue harvested for histopathology analysis. Results: A dose of 8.05 g/kg of M. oleifera leaf extract and 0.75 mg/kg Paracetamol were able to induce hepatotoxicity in Wister albino rats in 28 days. The M. oleifera extract induced hepatotoxic rats treated with NAC at doses of 1000 mg/kg, 1200 mg/kg and 1500 mg/kg, had a reduction in mean serum liver enzymes, plus reduced mean serum bilirubin levels. The liver histopathological analysis showed reduced inflammation after treatment with NAC for 3 and 7 days in the M. oleifera and paracetamol induced hepatotoxic rats. Conclusion: NAC can reverse M. oleifera leaf aqueous extract-induced sub-acute hepatotoxicity in Wistar Albino rats.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"43 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"85285130","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}
Mohanad Abdulhadi Saleh Lawgali, Faiaz Ragab Salem Halies, Amina M. Beayou
Background: Neonatal seizures are the most prominent feature of neurological dysfunction during neonatal period, which are abnormal electrical discharges in the central nervous system of neonates, usually manifest as stereotyped muscular activity or autonomic changes, occurring in approximately 1.8 - 3.5/1000 live birth. Objective: The aims of study are to determine prevalence rate, natural history, time of onset, etiological factors, clinical types and the short term outcome of neonatal convulsion. Settings: This study conducted in Neonatal Department at Benghazi Children Hospital—Libya. Patients and Methods: Descriptive cross sectional study, included all neonates who developing clinically identifiable seizures, admitted from 1st of March 2013 to 1st of March 2014. The data collected by using a designed perform including; gender, nationality, residence, place of transfer, gestational age, time of onset, mode of delivery, and history of maternal diseases, family history of neonatal seizures in previous siblings or death, jaundice and exchange transfusion were taken. Details examination include dysmorphic features, weight, head circumference were recorded. Types of seizures were diagnosed by clinical observations, and the etiology of neonatal seizures had been identified from imaging study and from initial relevant investigations which include blood glucose levels, arterial blood gases, serum calcium, electrolytes, phosphate and cerebrospinal fluid examination for evidence of infection. In addition to treatments received, as well as causes of deaths. Results: A total of 2842 neonates were admitted to NNW, out of which 150 had seizures. 86 (57%) were male with M:F ratio of 1.3:1. (97%) were Libyan and (76%) from Benghazi, (42%) admitted directly from home. 131 (87%) were term and 15 (10%) preterm. Most of neonatal seizures (76%) were seen in the 1st week of life, and during initial 72 hours of life (63%), with 24% presented in 1st 24 hours of life. Vaginal delivery conducted in 101 (67%), C/S 49 (33%). Among babies with birth asphyxia, 76% delivered vaginally. 43/150 mothers presented with different medical problems, 32% of them had preeclampsia followed by diabetes in 28%. 127 (85%) babies had normal birth weight and 128 (86%) lie within normal range of head circumference. The most common type of seizure was subtle (48%) followed by clonic (36%). Cranial ultrasound performed to 110 (73%), among them, 16 babies MRI or CT scan were done. The most common cause of seizure was birth asphyxia (30%) followed by infection (16%), hypocalcemia (14%). Phenobarbitone was the most common drug used in treatment (60%), followed by phenytoin (40%) and resistant cases for treatment received pyridoxine (2%). 77 (52%) improved and discharged home without treatment. Mortality rate was 15%; among them 44% from IEM, followed by birth asphyxia 22%. There is strong association between main causes and the outcome with p = 0.005. Conclusion: The majority of neonates in ou
{"title":"Etiology and Short Term Outcome of Neonatal Convulsion in NICU at Benghazi Children Hospital","authors":"Mohanad Abdulhadi Saleh Lawgali, Faiaz Ragab Salem Halies, Amina M. Beayou","doi":"10.4236/nm.2019.104027","DOIUrl":"https://doi.org/10.4236/nm.2019.104027","url":null,"abstract":"Background: Neonatal seizures are the most prominent feature of neurological dysfunction during neonatal period, which are abnormal electrical discharges in the central nervous system of neonates, usually manifest as stereotyped muscular activity or autonomic changes, occurring in approximately 1.8 - 3.5/1000 live birth. Objective: The aims of study are to determine prevalence rate, natural history, time of onset, etiological factors, clinical types and the short term outcome of neonatal convulsion. Settings: This study conducted in Neonatal Department at Benghazi Children Hospital—Libya. Patients and Methods: Descriptive cross sectional study, included all neonates who developing clinically identifiable seizures, admitted from 1st of March 2013 to 1st of March 2014. The data collected by using a designed perform including; gender, nationality, residence, place of transfer, gestational age, time of onset, mode of delivery, and history of maternal diseases, family history of neonatal seizures in previous siblings or death, jaundice and exchange transfusion were taken. Details examination include dysmorphic features, weight, head circumference were recorded. Types of seizures were diagnosed by clinical observations, and the etiology of neonatal seizures had been identified from imaging study and from initial relevant investigations which include blood glucose levels, arterial blood gases, serum calcium, electrolytes, phosphate and cerebrospinal fluid examination for evidence of infection. In addition to treatments received, as well as causes of deaths. Results: A total of 2842 neonates were admitted to NNW, out of which 150 had seizures. 86 (57%) were male with M:F ratio of 1.3:1. (97%) were Libyan and (76%) from Benghazi, (42%) admitted directly from home. 131 (87%) were term and 15 (10%) preterm. Most of neonatal seizures (76%) were seen in the 1st week of life, and during initial 72 hours of life (63%), with 24% presented in 1st 24 hours of life. Vaginal delivery conducted in 101 (67%), C/S 49 (33%). Among babies with birth asphyxia, 76% delivered vaginally. 43/150 mothers presented with different medical problems, 32% of them had preeclampsia followed by diabetes in 28%. 127 (85%) babies had normal birth weight and 128 (86%) lie within normal range of head circumference. The most common type of seizure was subtle (48%) followed by clonic (36%). Cranial ultrasound performed to 110 (73%), among them, 16 babies MRI or CT scan were done. The most common cause of seizure was birth asphyxia (30%) followed by infection (16%), hypocalcemia (14%). Phenobarbitone was the most common drug used in treatment (60%), followed by phenytoin (40%) and resistant cases for treatment received pyridoxine (2%). 77 (52%) improved and discharged home without treatment. Mortality rate was 15%; among them 44% from IEM, followed by birth asphyxia 22%. There is strong association between main causes and the outcome with p = 0.005. Conclusion: The majority of neonates in ou","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"21 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"84588567","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}
Stella Fotiadou, I. Kouroumichakis, Thomas Besios, N. Papanas, E. Giannakou, V. Gourgoulis, N. Aggeloussis
We describe the effects of an exercise programme based on the American Heart Association and American Stroke Association guidelines for stroke patients on gait mechanics in a patient with severe gait disorder due to chronic ischaemic stroke. A 74-year-old female patient, with right hemiparesis as a result of a stroke attack before 18 months followed an 8-week exercise programme, consisting of three hourly sessions per week. Patient’s gait mechanics were evaluated before and after the intervention using a three-dimensional gait analysis system, with six infrared cameras, two force plates, and an electronic timing system. Exercise led to increase of spatial and decrease of temporal gait parameters, increase of joint range of motion and lower limb muscle powers during the entire gait cycle and increase of the moments in the support phase. In conclusion, exercise had a positive effect on this patient’s gait pattern and improved her functionality.
{"title":"Effect of Exercise on Gait Mechanics in a Patient with Severe Gait Disorder Due to Chronic Ischaemic Stroke: A Case Study","authors":"Stella Fotiadou, I. Kouroumichakis, Thomas Besios, N. Papanas, E. Giannakou, V. Gourgoulis, N. Aggeloussis","doi":"10.4236/nm.2019.104023","DOIUrl":"https://doi.org/10.4236/nm.2019.104023","url":null,"abstract":"We describe the effects of an exercise programme based on the American Heart Association and American Stroke Association guidelines for stroke patients on gait mechanics in a patient with severe gait disorder due to chronic ischaemic stroke. A 74-year-old female patient, with right hemiparesis as a result of a stroke attack before 18 months followed an 8-week exercise programme, consisting of three hourly sessions per week. Patient’s gait mechanics were evaluated before and after the intervention using a three-dimensional gait analysis system, with six infrared cameras, two force plates, and an electronic timing system. Exercise led to increase of spatial and decrease of temporal gait parameters, increase of joint range of motion and lower limb muscle powers during the entire gait cycle and increase of the moments in the support phase. In conclusion, exercise had a positive effect on this patient’s gait pattern and improved her functionality.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"63 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"91352045","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}
A. Ibrahim, T. Alloush, Yousry Abo Elnaga, M. Hamdy, M. Fouad
Background: Antioxidants such as vitamin C can eliminate free radicles responsible for oxidative stress. Objective: To assess the serum level of vitamin C in a sample of multiple sclerosis (MS) patients to investigate a possible role of vitamin C in the pathogenesis of MS. Subjects and Methods: Forty patients with MS and twenty healthy controls were included in this study. Vitamin C level was estimated for each participant. Results: Serum vitamin C levels were significantly lower among the patients (ranging from 0.28 mg/dL to 0.75 mg/dL with mean 0.47 ± 0.14 mg/dL and median of 0.46 mg/dL) compared to controls (ranging from 0.60 mg/dL to 2.90 mg/dL with mean 1.87 ± 0.61 mg/dL and median of 1.90 mg/dL) (P < 0.001). A positive correlation was detected between age and serum vitamin C (r = 0.312, P = 0.049). Patients with infratentorial lesions had significantly lower levels of serum vitamin C compared to those who did not have infratentorial lesions (P = 0.017). Conclusion: Patients with MS tended to have low serum vitamin C levels, and younger patients had lower serum levels.
{"title":"Serum Level of Vitamin C in a Sample of Egyptian Patients with Multiple Sclerosis","authors":"A. Ibrahim, T. Alloush, Yousry Abo Elnaga, M. Hamdy, M. Fouad","doi":"10.4236/nm.2019.104029","DOIUrl":"https://doi.org/10.4236/nm.2019.104029","url":null,"abstract":"Background: Antioxidants such as vitamin C can eliminate free radicles responsible for oxidative stress. Objective: To assess the serum level of vitamin C in a sample of multiple sclerosis (MS) patients to investigate a possible role of vitamin C in the pathogenesis of MS. Subjects and Methods: Forty patients with MS and twenty healthy controls were included in this study. Vitamin C level was estimated for each participant. Results: Serum vitamin C levels were significantly lower among the patients (ranging from 0.28 mg/dL to 0.75 mg/dL with mean 0.47 ± 0.14 mg/dL and median of 0.46 mg/dL) compared to controls (ranging from 0.60 mg/dL to 2.90 mg/dL with mean 1.87 ± 0.61 mg/dL and median of 1.90 mg/dL) (P < 0.001). A positive correlation was detected between age and serum vitamin C (r = 0.312, P = 0.049). Patients with infratentorial lesions had significantly lower levels of serum vitamin C compared to those who did not have infratentorial lesions (P = 0.017). Conclusion: Patients with MS tended to have low serum vitamin C levels, and younger patients had lower serum levels.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"166 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"87946330","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}
Vertigo is a common symptom with impact on daily life. Vertigoheel® (VH-04) has demonstrated to be effective for Vertigo in former studies. This paper aims to investigate the mode of action of the medicinal product VH-04 in the rat brain. In an in vitro study neurophysiological recording from hippocampal slices from adult male Sprague Dawley® rats was performed in order to substantiate a possible direct effect on the brain of VH-04 in different concentrations. In an in vivo cross-over study with 11 Fischer 344® rats, a neurophysiological method was applied to systemically analyse VH-04’s activity in the rat brain. This method combines quantitative assessments of telemetrically transmitted field potentials after drug treatment with subsequent discriminant analysis to classify the compound. The database used for the analysis of classification contained numerous chemicals and medicinal products of different dosages, all tested in the same paradigm, which is continuous wireless monitoring of the EEG of freely moving rats before and after drug intake. Following single stimuli on the Schaffer collaterals in the presence of VH-04 in different concentrations, in vitro responses of pyramidal cells increased depending on the VH-04 concentration (0.25 - 4 ml/L). Results were statistically significant for concentrations above 2.5 ml/L. Long-term potentiation was only marginally affected. Out of several specific glutamate receptor antagonists the effect of VH-04 was only antagonized by AMPA and kainic acid receptor-mediated signalling. Their enhancement indicates better information processing in the hippocampus, a brain structure primarily involved in memory processes. The in vivo characterisation of VH-04-induced changes in EEG-signatures of four brain areas (the frontal cortex (FC), the hippocampus (HC), the striatum (ST) and the reticular formation (RF)) revealed a dose-dependent attenuation of delta, theta, alpha 2 and beta 1 waves. The subsequent discriminant function analysis classified the VH-04 EEG-signature into a subset of cognition-enhancing medicinal products.
{"title":"In Vitro Hippocampal Electrophysiology and in Vivo Quantitative EEG Revealed Robust Neurophysiological Effects of the Antivertigo-Agent Vertigoheel® in a Rat Study","authors":"W. Dimpfel, B. Seilheimer, L. Schombert","doi":"10.4236/nm.2019.104030","DOIUrl":"https://doi.org/10.4236/nm.2019.104030","url":null,"abstract":"Vertigo is a common symptom with impact on daily life. Vertigoheel® (VH-04) has demonstrated to be effective for Vertigo in former studies. This paper aims to investigate the mode of action of the medicinal product VH-04 in the rat brain. In an in vitro study neurophysiological recording from hippocampal slices from adult male Sprague Dawley® rats was performed in order to substantiate a possible direct effect on the brain of VH-04 in different concentrations. In an in vivo cross-over study with 11 Fischer 344® rats, a neurophysiological method was applied to systemically analyse VH-04’s activity in the rat brain. This method combines quantitative assessments of telemetrically transmitted field potentials after drug treatment with subsequent discriminant analysis to classify the compound. The database used for the analysis of classification contained numerous chemicals and medicinal products of different dosages, all tested in the same paradigm, which is continuous wireless monitoring of the EEG of freely moving rats before and after drug intake. Following single stimuli on the Schaffer collaterals in the presence of VH-04 in different concentrations, in vitro responses of pyramidal cells increased depending on the VH-04 concentration (0.25 - 4 ml/L). Results were statistically significant for concentrations above 2.5 ml/L. Long-term potentiation was only marginally affected. Out of several specific glutamate receptor antagonists the effect of VH-04 was only antagonized by AMPA and kainic acid receptor-mediated signalling. Their enhancement indicates better information processing in the hippocampus, a brain structure primarily involved in memory processes. The in vivo characterisation of VH-04-induced changes in EEG-signatures of four brain areas (the frontal cortex (FC), the hippocampus (HC), the striatum (ST) and the reticular formation (RF)) revealed a dose-dependent attenuation of delta, theta, alpha 2 and beta 1 waves. The subsequent discriminant function analysis classified the VH-04 EEG-signature into a subset of cognition-enhancing medicinal products.","PeriodicalId":19381,"journal":{"name":"Neuroscience and Medicine","volume":"5 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-10-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89915016","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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