Augmented reality has been increasingly used as a therapeutic tool in psychiatry. In particular, augmented reality exposure therapy (ARET) has been developed from and proposed as an alternative to standard cognitive behavioral therapy (CBT) for the treatment of phobic disorders. Using real-time 3D model and visual displays, the child is immersed in different computer-generated virtual environments designed for different types of phobia. As imaginative or in vivo exposure therapy, ARET consists in a gradual presentation of phobic stimuli. The desensitization through ARET has been found to be efficient in different types of anxiety disorder, and in particular in phobic disorders. The endeavor of this work is to examine researches done in the field of AR applied to children With Disorders. Thus, we will try to verify whether the use of these techniques makes useful or not an intervention in the case of children with disorder. The work presented aims at a reflection on the introduction of the use of AR in the treatment of these children by means of current researches. We will also observe, throughout this work, the involvement of NICTs such as augmented reality in changing the activities made with these tools on the didactic and methodological level.
{"title":"Coronavirus: introduction of the application of augmented reality to help children with disorders to overcome the phobia of contamination facing an indefinite end of the pandemic","authors":"Naila Bali, A. Fridhi, Zied Hassen","doi":"10.37897/rjn.2022.2.13","DOIUrl":"https://doi.org/10.37897/rjn.2022.2.13","url":null,"abstract":"Augmented reality has been increasingly used as a therapeutic tool in psychiatry. In particular, augmented reality exposure therapy (ARET) has been developed from and proposed as an alternative to standard cognitive behavioral therapy (CBT) for the treatment of phobic disorders. Using real-time 3D model and visual displays, the child is immersed in different computer-generated virtual environments designed for different types of phobia. As imaginative or in vivo exposure therapy, ARET consists in a gradual presentation of phobic stimuli. The desensitization through ARET has been found to be efficient in different types of anxiety disorder, and in particular in phobic disorders. The endeavor of this work is to examine researches done in the field of AR applied to children With Disorders. Thus, we will try to verify whether the use of these techniques makes useful or not an intervention in the case of children with disorder. The work presented aims at a reflection on the introduction of the use of AR in the treatment of these children by means of current researches. We will also observe, throughout this work, the involvement of NICTs such as augmented reality in changing the activities made with these tools on the didactic and methodological level.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45312407","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}
T. E. Purwata, Dessy Rachmawati Emril, Y. Yudiyanta, P. Rizaldy, Henny Anggraini Sadeli, S. Suroto, Putu Eka Widyadharma, Susi Aulina, Audry Devisanty Wuysang, I. Suharjanti, S. Kurniawan, Widodo Mardi Santosa, Endang Mutia, B. Sutrisno, Yetty Hambarsari, O. Octaviani, H. Sugiharto, Theresia Runtuwene, Sekplin A. S. Sekeon, Wisnu Nalendratama, Agustian Permadi
Background. Pain is one of the most common health problems often experienced by the elderly. Research on pain and its comorbidities in elderly are crucial, because it relates to disability and impairment in quality of life. Unfortunately research related to pain in the elderly and co morbidities are still limited in Indonesia, better understanding about pain can be a vital consideration of treatment and drug consideration. This study was conducted to provide an overview of pain and its comorbidities in elderly. Materials and methods. This was an observational cross sectional study to 949 subjects. Subjects were recruited from outpatients neurology department in 10 big cities Hospitals in Indonesia. Data obtained from subjects who completed the self-made pain questionnaire and medical records. Subjects were characterized based on type of pain, location of pain, properties of pain, time of exacerbation, and comorbidities. All data were processed descriptively. Results and conclusion. A total of 949 subjects met the inclusion criteria. The subjects consist of 476 (50.16%) female and 473 (49.84%) male, with common age group between 60-74 years (80.08%). The Most common pain characteristic are mild pain intensity (46.79%), mixed type of pain (44.68%), chronic pain (64.59%), multiple site pain location (45.42%) and uncertain time pain exacerbation (37.40%). Six hundred and eighteen (65.12%) subjects have comorbidity and 331 (34.88%) without comorbidity. The most common comorbidity found were hypertension (41.31%) and diabetes (14.23%), with 561 (90.78%) subjects have 1 comorbidity. These study provide the overview of the geriatric problems especially in pain and the comorbidities so that the clinician can provide a comprehensive management of pain problems in geriatric.
{"title":"Characteristics of pain and comorbidities in geriatric subjects in Indonesia: A hospital-based national clinical survey","authors":"T. E. Purwata, Dessy Rachmawati Emril, Y. Yudiyanta, P. Rizaldy, Henny Anggraini Sadeli, S. Suroto, Putu Eka Widyadharma, Susi Aulina, Audry Devisanty Wuysang, I. Suharjanti, S. Kurniawan, Widodo Mardi Santosa, Endang Mutia, B. Sutrisno, Yetty Hambarsari, O. Octaviani, H. Sugiharto, Theresia Runtuwene, Sekplin A. S. Sekeon, Wisnu Nalendratama, Agustian Permadi","doi":"10.37897/rjn.2022.2.11","DOIUrl":"https://doi.org/10.37897/rjn.2022.2.11","url":null,"abstract":"Background. Pain is one of the most common health problems often experienced by the elderly. Research on pain and its comorbidities in elderly are crucial, because it relates to disability and impairment in quality of life. Unfortunately research related to pain in the elderly and co morbidities are still limited in Indonesia, better understanding about pain can be a vital consideration of treatment and drug consideration. This study was conducted to provide an overview of pain and its comorbidities in elderly. Materials and methods. This was an observational cross sectional study to 949 subjects. Subjects were recruited from outpatients neurology department in 10 big cities Hospitals in Indonesia. Data obtained from subjects who completed the self-made pain questionnaire and medical records. Subjects were characterized based on type of pain, location of pain, properties of pain, time of exacerbation, and comorbidities. All data were processed descriptively. Results and conclusion. A total of 949 subjects met the inclusion criteria. The subjects consist of 476 (50.16%) female and 473 (49.84%) male, with common age group between 60-74 years (80.08%). The Most common pain characteristic are mild pain intensity (46.79%), mixed type of pain (44.68%), chronic pain (64.59%), multiple site pain location (45.42%) and uncertain time pain exacerbation (37.40%). Six hundred and eighteen (65.12%) subjects have comorbidity and 331 (34.88%) without comorbidity. The most common comorbidity found were hypertension (41.31%) and diabetes (14.23%), with 561 (90.78%) subjects have 1 comorbidity. These study provide the overview of the geriatric problems especially in pain and the comorbidities so that the clinician can provide a comprehensive management of pain problems in geriatric.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49668929","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}
Chung-Yong Yang, H. Park, Jisu Yang, Young Seo Kim, Li-Qun Zhang
Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy is the most common inherited cerebral microangiopathy. Its clinical features include recurrent central nervous system symptoms—including lacunar stroke, migraine, psychiatric disturbance, acute reversible encephalopathy, and cognitive impairment. We report a case of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in a patient presenting with severe low back pain and a herniated nucleus pulposus. A 45-year-old female patient with a prior history of right-sided sciatic pain, hypoesthesia, and paresthesia in the right S1 sensory dermatome was referred after back surgery because of persistent low back pain and a spastic gait abnormality. Imaging revealed a right protruding disc herniation of L5/S1 with right S1 nerve root compression and right posterior disc bulging at L4/5 with foraminal stenosis and disc degeneration, for which she underwent surgery. After surgery, she experienced mild sciatica, an antalgic limping gait with foot-dragging, and progressive motor weakness. Her family history was significant for a parent and sibling affected by stroke. The diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy was established by polymerase chain reaction sequencing, which showed a mutated exon 11 of NOTCH3 on chromosome 19. Clinicians should assess patients with non-specific extra-central nervous system symptoms or atypical courses for potential underlying diseases.
{"title":"Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy presenting as severe herniated nucleus pulposus: A case report","authors":"Chung-Yong Yang, H. Park, Jisu Yang, Young Seo Kim, Li-Qun Zhang","doi":"10.37897/rjn.2022.1.13","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.13","url":null,"abstract":"Cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy is the most common inherited cerebral microangiopathy. Its clinical features include recurrent central nervous system symptoms—including lacunar stroke, migraine, psychiatric disturbance, acute reversible encephalopathy, and cognitive impairment. We report a case of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy in a patient presenting with severe low back pain and a herniated nucleus pulposus. A 45-year-old female patient with a prior history of right-sided sciatic pain, hypoesthesia, and paresthesia in the right S1 sensory dermatome was referred after back surgery because of persistent low back pain and a spastic gait abnormality. Imaging revealed a right protruding disc herniation of L5/S1 with right S1 nerve root compression and right posterior disc bulging at L4/5 with foraminal stenosis and disc degeneration, for which she underwent surgery. After surgery, she experienced mild sciatica, an antalgic limping gait with foot-dragging, and progressive motor weakness. Her family history was significant for a parent and sibling affected by stroke. The diagnosis of cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy was established by polymerase chain reaction sequencing, which showed a mutated exon 11 of NOTCH3 on chromosome 19. Clinicians should assess patients with non-specific extra-central nervous system symptoms or atypical courses for potential underlying diseases.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49605109","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. Multiple countries affected by the Coronavirus disease 2019 (COVID-19) pandemic have noticed a drop in the number of patients attending the emergency department with acute stroke. This study aimed to assess the numbers of acute stroke admission during the COVID-19 pandemic in a major hospital in Yogyakarta. Methods. This is a retrospective study design of stroke admissions, data on the numbers of hospital admissions and mortality from the same period (March to December) in 2019 and 2020 were collected. The data were analyzed descriptively. Results. We collected data from a total of 1928 patients admitted with acute stroke. From March to December, the mean rate of admission was 114.9 cases per month in 2019 (Pre-COVID era), which dropped to 77.9 cases per month in 2020 (COVID era), with an overall reduction of 32.2%. There was a decrease in the numbers of ischemic (-36%) and hemorrhagic (-18%) stroke admissions during the state of the COVID-19 era compared with 2019. Furthermore, we also observed a reduction in the mortality rate of ischemic (-43%) and hemorrhagic (-1%) stroke patients. Conclusions. The COVID-19 pandemic had an impact on the care for stroke patients, resulting fell in acute stroke admissions and mortality rate.
{"title":"Effect of the COVID-19 pandemic on acute stroke admissions at a Referral Stroke Center in Indonesia: A descriptive study","authors":"R. Pinzon, V. Wijaya","doi":"10.37897/rjn.2022.1.7","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.7","url":null,"abstract":"Background. Multiple countries affected by the Coronavirus disease 2019 (COVID-19) pandemic have noticed a drop in the number of patients attending the emergency department with acute stroke. This study aimed to assess the numbers of acute stroke admission during the COVID-19 pandemic in a major hospital in Yogyakarta. Methods. This is a retrospective study design of stroke admissions, data on the numbers of hospital admissions and mortality from the same period (March to December) in 2019 and 2020 were collected. The data were analyzed descriptively. Results. We collected data from a total of 1928 patients admitted with acute stroke. From March to December, the mean rate of admission was 114.9 cases per month in 2019 (Pre-COVID era), which dropped to 77.9 cases per month in 2020 (COVID era), with an overall reduction of 32.2%. There was a decrease in the numbers of ischemic (-36%) and hemorrhagic (-18%) stroke admissions during the state of the COVID-19 era compared with 2019. Furthermore, we also observed a reduction in the mortality rate of ischemic (-43%) and hemorrhagic (-1%) stroke patients. Conclusions. The COVID-19 pandemic had an impact on the care for stroke patients, resulting fell in acute stroke admissions and mortality rate.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48057396","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. Naghavi, O. Mirmosayyeb, M. Najafi, Hamed Ghoshouni, Iman Adibi, V. Shaygannejad
Coronavirus (COVID-19) is a worldwide epidemic. Although the main target of COVID-19 is the respiratory system, it is known that the virus can cause neurological complications. Previous studies have shown that its neurological manifestations are usually seen in critically ill patients. In this study, we introduced patients who developed COVID-induced encephalitis despite their good general condition and mild symptoms. The only symptoms of encephalitis in these patients were cognitive impairment, that persisted for more than 6 months. This disorder was confirmed by Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) test results in patients. While previous studies have shown that COVID-induced cognitive impairment improves over time. Therefore, it is recommended that the diagnosis and treatment of encephalitis be considered in patients with COVID-19 who have mild cognitive and behavioral symptoms.
{"title":"Persistent cognitive impairment as a rare manifestation of mild COVID-19 infection - A case series","authors":"S. Naghavi, O. Mirmosayyeb, M. Najafi, Hamed Ghoshouni, Iman Adibi, V. Shaygannejad","doi":"10.37897/rjn.2022.1.15","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.15","url":null,"abstract":"Coronavirus (COVID-19) is a worldwide epidemic. Although the main target of COVID-19 is the respiratory system, it is known that the virus can cause neurological complications. Previous studies have shown that its neurological manifestations are usually seen in critically ill patients. In this study, we introduced patients who developed COVID-induced encephalitis despite their good general condition and mild symptoms. The only symptoms of encephalitis in these patients were cognitive impairment, that persisted for more than 6 months. This disorder was confirmed by Neuropsychiatry Unit Cognitive Assessment Tool (NUCOG) test results in patients. While previous studies have shown that COVID-induced cognitive impairment improves over time. Therefore, it is recommended that the diagnosis and treatment of encephalitis be considered in patients with COVID-19 who have mild cognitive and behavioral symptoms.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44184171","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
The common chronic complication from diabetes mellitus (DM) is painful diabetic neuropathy. The available symptomatic treatment with standard therapy is not sufficient for pain reduction. Previous studies showed that vitamin D deficiency was common in type 2 diabetes. Some studies report the benefit of vitamin D supplementation. We report a case of a type 2 diabetic 54-year-old obese female with painful diabetic neuropathy. The combination of lifestyle modifications and 2000 IU vitamin D supplementation improved neuropathy eight weeks of therapy symptoms. The literature search found a valid article that supports the use of combined exercise and vitamin D supplementation. Further research with a larger sample and better design is warranted.
{"title":"Benefits of vitamin D as an additional therapy in painful diabetic neuropathy: Case report and recent literature review","authors":"R. Pinzon, Diana Teresa","doi":"10.37897/rjn.2022.1.12","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.12","url":null,"abstract":"The common chronic complication from diabetes mellitus (DM) is painful diabetic neuropathy. The available symptomatic treatment with standard therapy is not sufficient for pain reduction. Previous studies showed that vitamin D deficiency was common in type 2 diabetes. Some studies report the benefit of vitamin D supplementation. We report a case of a type 2 diabetic 54-year-old obese female with painful diabetic neuropathy. The combination of lifestyle modifications and 2000 IU vitamin D supplementation improved neuropathy eight weeks of therapy symptoms. The literature search found a valid article that supports the use of combined exercise and vitamin D supplementation. Further research with a larger sample and better design is warranted.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46375854","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}
Suneeta Amrat, N. Bullo, Dileep Kumar, Saira Abbas, Aijaz Ali, M. Asghar
Objectives. Neuroleptic malignant syndrome (NMS) is a life-threatening adverse reaction of antipsychotic drugs, especially of dopamine receptor antagonists (DRA’s). Excitation, exuberant behavior, violent behavior and lack of insight predispose the patients to the use of depot preparations and high doses of the antipsychotics. These behaviors also make the patients suffer from dehydration leading to cognitive impairment, confusion and incontinence. In addition to clinical and pharmacological risk factors, legal and ethical risk factors may be contributory towards the incidence, diagnosis and prognosis of NMS in Pakistan. Material and methods. This study was conducted as a descriptive, observational study to determine the frequency of deranged pattern of clinical and laboratory feature patients presenting with Neuroleptic Malignant Syndrome at Department of Neurology, Jinnah Postgraduate Medical Center (JPMC), Karachi. Data was prospectively collected from patients after taking a verbal consent. 55 patients who met the diagnostic criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification chi square test was applied taking p-value of ≤0.05 as significant. Outcomes. A total of 55 patients who met the inclusion and exclusion criteria were included in this study. Mean age, duration of NMS symptoms, length of hospital stay, SBP and DBP in our study was 39.41±12.67 years, 10.56±7.29 hours, 9.74±3.21 days, 135.87±10.97 mmHg and 83.21±6.42 mmHg. 24 (43.6%) and 31 (56.4%) were male and female. Out of 55 patients, 81.8%, 38.2%, 69.1%, 56.4%, 47.3%, 74.5% and 25.5% had fever, autonomic dysfunction, EPS symptoms, altered GCS, elevated CPK, elevated WBC and abnormal LFT. Conclusions. NMS is an important preventable clinical entity. Early diagnosis and judicious use of antipsychotics is warranted to prevent mortality and heightened morbidity.
{"title":"Frequency of pattern of clinical and laboratory features in patients presenting with neuroleptic malignant syndrome at Department of Neurology, Jinnah Postgraduate Medical Center (JPMC), Karachi","authors":"Suneeta Amrat, N. Bullo, Dileep Kumar, Saira Abbas, Aijaz Ali, M. Asghar","doi":"10.37897/rjn.2022.1.8","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.8","url":null,"abstract":"Objectives. Neuroleptic malignant syndrome (NMS) is a life-threatening adverse reaction of antipsychotic drugs, especially of dopamine receptor antagonists (DRA’s). Excitation, exuberant behavior, violent behavior and lack of insight predispose the patients to the use of depot preparations and high doses of the antipsychotics. These behaviors also make the patients suffer from dehydration leading to cognitive impairment, confusion and incontinence. In addition to clinical and pharmacological risk factors, legal and ethical risk factors may be contributory towards the incidence, diagnosis and prognosis of NMS in Pakistan. Material and methods. This study was conducted as a descriptive, observational study to determine the frequency of deranged pattern of clinical and laboratory feature patients presenting with Neuroleptic Malignant Syndrome at Department of Neurology, Jinnah Postgraduate Medical Center (JPMC), Karachi. Data was prospectively collected from patients after taking a verbal consent. 55 patients who met the diagnostic criteria were included. Quantitative data was presented as simple descriptive statistics giving mean and standard deviation and qualitative variables was presented as frequency and percentages. Effect modifiers were controlled through stratification to see the effect of these on the outcome variable. Post stratification chi square test was applied taking p-value of ≤0.05 as significant. Outcomes. A total of 55 patients who met the inclusion and exclusion criteria were included in this study. Mean age, duration of NMS symptoms, length of hospital stay, SBP and DBP in our study was 39.41±12.67 years, 10.56±7.29 hours, 9.74±3.21 days, 135.87±10.97 mmHg and 83.21±6.42 mmHg. 24 (43.6%) and 31 (56.4%) were male and female. Out of 55 patients, 81.8%, 38.2%, 69.1%, 56.4%, 47.3%, 74.5% and 25.5% had fever, autonomic dysfunction, EPS symptoms, altered GCS, elevated CPK, elevated WBC and abnormal LFT. Conclusions. NMS is an important preventable clinical entity. Early diagnosis and judicious use of antipsychotics is warranted to prevent mortality and heightened morbidity.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46068353","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}
Noor Ul Ain Zameer, Sheharyar Zameer, Jahanzeb Liaqat
Background. COVID-19 emerged in Wuhan, China and spread rapidly, becoming a global health pandemic. The condition, apart from its typical respiratory presentation, may also cause neurological complications. Case presentation. A 35-year-old, ex-smoker presented with bilateral lower limb weakness associated with urinary incontinence and constipation following the resolution of a suspected COVID-19 infection. His MRI-Spine showed areas of abnormal densities confirming the diagnosis of transverse myelitis. On the presence of positive SARS-CoV-2 antibodies, COVID-19 was concluded as the pathological trigger for the condition. He was treated using Methylprednisolone and Plasmapheresis with supportive limb physiotherapy which led to a partial recovery of the patient’s disability. Conclusion. This is the first case of TM associated with COVID-19 in Pakistan and considering the current scenario of a global pandemic, COVID-19 needs to be considered as an important differential for not only TM but other neurological manifestations like encephalitis, neuritis etc.
{"title":"A case of transverse myelitis post COVID-19 infection in Pakistan","authors":"Noor Ul Ain Zameer, Sheharyar Zameer, Jahanzeb Liaqat","doi":"10.37897/rjn.2022.1.14","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.14","url":null,"abstract":"Background. COVID-19 emerged in Wuhan, China and spread rapidly, becoming a global health pandemic. The condition, apart from its typical respiratory presentation, may also cause neurological complications. Case presentation. A 35-year-old, ex-smoker presented with bilateral lower limb weakness associated with urinary incontinence and constipation following the resolution of a suspected COVID-19 infection. His MRI-Spine showed areas of abnormal densities confirming the diagnosis of transverse myelitis. On the presence of positive SARS-CoV-2 antibodies, COVID-19 was concluded as the pathological trigger for the condition. He was treated using Methylprednisolone and Plasmapheresis with supportive limb physiotherapy which led to a partial recovery of the patient’s disability. Conclusion. This is the first case of TM associated with COVID-19 in Pakistan and considering the current scenario of a global pandemic, COVID-19 needs to be considered as an important differential for not only TM but other neurological manifestations like encephalitis, neuritis etc.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47491957","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. Saadat, F. B. Sheykhangafshe, B. Eghbali, Seyed Sepehr Khatami, Adele Isanazar
Objectives. Epilepsy is a debilitating disease that can have long-term unpleasant psychological consequences. For this purpose, various psychological interventions have been provided to improve the quality of life of these patients. In this review study, the effectiveness of these interventions has been surveyed. Materials and methods. This study was conducted through a systematic review method from January 2010 to April 2021. Keywords such as quality of life, clinical trials and randomized clinical trials, epilepsy, seizure, psychology, intervention, chronic disease, empowerment, psychotherapy and psychological interventions were searched in PubMed, Scopus, and Google Scholar indexing databases. Out of 1866 articles found, 13 articles were selected for review. Results. The surveys showed that psychological therapies increase the quality of life, social functioning, self-care behaviors, memory, self-esteem, job and social adjustment of many epileptic patients. On the other hand, according to the results, with the improvement of mental health of patients with epilepsy, we saw a reduction in stress, anxiety, depression, pain intensity, seizure, suicidal ideation and social stigma of patients with epilepsy. Conclusion. Various psychological interventions lead to a reduction in psychological problems in patients with epilepsy. It causes patients to be in good mental health, accept their pain and show less recurrence of their disease. For this purpose, it is necessary to pay more attention to the psychological health of patients with epilepsy in medical centers to reduce the incidence of mental disorders and improve the health of epileptic patients.
{"title":"Epilepsy and psychological interventions: A systematic review study","authors":"S. Saadat, F. B. Sheykhangafshe, B. Eghbali, Seyed Sepehr Khatami, Adele Isanazar","doi":"10.37897/rjn.2022.1.3","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.3","url":null,"abstract":"Objectives. Epilepsy is a debilitating disease that can have long-term unpleasant psychological consequences. For this purpose, various psychological interventions have been provided to improve the quality of life of these patients. In this review study, the effectiveness of these interventions has been surveyed. Materials and methods. This study was conducted through a systematic review method from January 2010 to April 2021. Keywords such as quality of life, clinical trials and randomized clinical trials, epilepsy, seizure, psychology, intervention, chronic disease, empowerment, psychotherapy and psychological interventions were searched in PubMed, Scopus, and Google Scholar indexing databases. Out of 1866 articles found, 13 articles were selected for review. Results. The surveys showed that psychological therapies increase the quality of life, social functioning, self-care behaviors, memory, self-esteem, job and social adjustment of many epileptic patients. On the other hand, according to the results, with the improvement of mental health of patients with epilepsy, we saw a reduction in stress, anxiety, depression, pain intensity, seizure, suicidal ideation and social stigma of patients with epilepsy. Conclusion. Various psychological interventions lead to a reduction in psychological problems in patients with epilepsy. It causes patients to be in good mental health, accept their pain and show less recurrence of their disease. For this purpose, it is necessary to pay more attention to the psychological health of patients with epilepsy in medical centers to reduce the incidence of mental disorders and improve the health of epileptic patients.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48574506","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, Mohd Fandi Al Khafiz, Anna Misyail, A. Payus, Y. Yan, A. Khan, Loh Wei Chao, B. Janudin, Maz Anirah, Liyanatul Najwa, W. Aliaa, H. F. Kee, H. Basri
Intravenous (IV) thrombolysis is a safe and effective treatment for acute ischemic stroke. The therapeutic benefit is not extended to more than 4.5 hours in many patients due to the protocol’s time window restriction. Here, we reported two acute stroke cases with a moderate National Institutes of Health Stroke Scale (NIHSS) and onset greater than 4.5 hours that were successfully thrombolysed with intravenous recombinant tissue plasminogen activator (tPA) - low-dose Tenecteplase (TNK). The decision to thrombolysed both patients were based on Magnetic Resonance Imaging (MRI) Diffusion-weighted imaging (DWI)-Fluid Attenuation Inversion Recovery (FLAIR) mismatch – tissue basis rather than a time window, and this resulted in a good neurological recovery with a significant improvement in functional Modified Rankin Score (MRS) to zero at 90 days post stroke regardless of the stroke aetiology. In summary, Intravenous thrombolysis in acute ischemic stroke outside the therapeutic window but with significant penumbra based on MRI DWI-FLAIR tissue mismatch resulted in a remarkable neurological recovery after 90 days.
{"title":"Successful stroke thrombolysis beyond guidelines: A case series","authors":"A. Ibrahim, Mohd Fandi Al Khafiz, Anna Misyail, A. Payus, Y. Yan, A. Khan, Loh Wei Chao, B. Janudin, Maz Anirah, Liyanatul Najwa, W. Aliaa, H. F. Kee, H. Basri","doi":"10.37897/rjn.2022.1.17","DOIUrl":"https://doi.org/10.37897/rjn.2022.1.17","url":null,"abstract":"Intravenous (IV) thrombolysis is a safe and effective treatment for acute ischemic stroke. The therapeutic benefit is not extended to more than 4.5 hours in many patients due to the protocol’s time window restriction. Here, we reported two acute stroke cases with a moderate National Institutes of Health Stroke Scale (NIHSS) and onset greater than 4.5 hours that were successfully thrombolysed with intravenous recombinant tissue plasminogen activator (tPA) - low-dose Tenecteplase (TNK). The decision to thrombolysed both patients were based on Magnetic Resonance Imaging (MRI) Diffusion-weighted imaging (DWI)-Fluid Attenuation Inversion Recovery (FLAIR) mismatch – tissue basis rather than a time window, and this resulted in a good neurological recovery with a significant improvement in functional Modified Rankin Score (MRS) to zero at 90 days post stroke regardless of the stroke aetiology. In summary, Intravenous thrombolysis in acute ischemic stroke outside the therapeutic window but with significant penumbra based on MRI DWI-FLAIR tissue mismatch resulted in a remarkable neurological recovery after 90 days.","PeriodicalId":37662,"journal":{"name":"Romanian Journal of Neurology/ Revista Romana de Neurologie","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2022-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43121817","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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