Neurological manifestations of dengue fever are seen in around 0.5-6% patients. Post dengue Gullain Barre Syndrome (GBS) is uncommon and only few cases of GBS have been causally linked to serologically confirmed dengue illness. We report a case of 51-year-old male with acute onset flaccid paralysis of all 4 limbs within 1 week of dengue fever, which worsened rapidly despite early initiation of IVIG. Patient became quadriplegic with bilateral LMN facial paralysis, needing intubation and ventilation. When patient did not improve even after 3 weeks of IVIG therapy, plasmapheresis was started and 5 exchanges were given over 10 days following which patient showed significant recovery and became ambulatory and independent at 6 months. In our case 2 dose of IVIG was not considered as his serum IgG levels were raised.Role of plasmapheresis in patients of GBS, responding poorly to IVIG needs further evaluation.GBS is an uncommon neurological manifestation of dengue fever. Role of plasmapheresis in patients who respond poorly to IVIG needs to be considered.
{"title":"An interesting case of post dengue Guillain Barre syndrome","authors":"Vivek Kumar, Naresh Dang, Preeti Lodhi","doi":"10.18231/j.ijn.2023.046","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.046","url":null,"abstract":"Neurological manifestations of dengue fever are seen in around 0.5-6% patients. Post dengue Gullain Barre Syndrome (GBS) is uncommon and only few cases of GBS have been causally linked to serologically confirmed dengue illness. We report a case of 51-year-old male with acute onset flaccid paralysis of all 4 limbs within 1 week of dengue fever, which worsened rapidly despite early initiation of IVIG. Patient became quadriplegic with bilateral LMN facial paralysis, needing intubation and ventilation. When patient did not improve even after 3 weeks of IVIG therapy, plasmapheresis was started and 5 exchanges were given over 10 days following which patient showed significant recovery and became ambulatory and independent at 6 months. In our case 2 dose of IVIG was not considered as his serum IgG levels were raised.Role of plasmapheresis in patients of GBS, responding poorly to IVIG needs further evaluation.GBS is an uncommon neurological manifestation of dengue fever. Role of plasmapheresis in patients who respond poorly to IVIG needs to be considered.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"24 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139177739","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}
D. Singh, Vineet Kumar Mishra, V. Chand, Neha Singh, Amit Gupta
Surgical management of olfactory groove meningiomas poses significant challenges. Common microsurgical approaches often result in delayed exposure of neurovascular structures. In contrast, the pterional approach offers the advantage of early dissection of the posterior neurovascular complex. Olfactory groove meningiomas constitute 4 to 13% of all meningiomas. Surgery is the primary treatment, but the recommended extent and types of approaches vary. We conducted a retrospective review of our olfactory groove meningioma series treated with microsurgery via standard unilateral or bilateral approaches. Patient records from our department (RMLIMS, LUCKNOW) were reviewed, encompassing cases treated with unilateral or bilateral approaches. Thirty patients who underwent olfactory groove meningioma removal were included, and clinical data, radiological findings, surgical treatment, and clinical outcomes were retrospectively analyzed. A total of 30 craniotomies were performed, with 16 employing unilateral pterional approaches and 14 using bilateral transbasal approaches. Overall, gross total tumor resection was achieved in 27 cases. Postoperative complications included edema (in three patients) and hematoma (in three patients). The unilateral (pterional) approach emerges as an excellent solution for olfactory groove meningioma treatment, offering early visualization of the posterior neurovascular complex. Additionally, it enables frontal sinus preservation and minimizes excessive brain retraction.
{"title":"A comparative evaluation of microsurgical excision of olfactory groove meningioma through unilateral (pterional) vs Bilateral (Bifrontal-transbasal) approach","authors":"D. Singh, Vineet Kumar Mishra, V. Chand, Neha Singh, Amit Gupta","doi":"10.18231/j.ijn.2023.040","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.040","url":null,"abstract":"Surgical management of olfactory groove meningiomas poses significant challenges. Common microsurgical approaches often result in delayed exposure of neurovascular structures. In contrast, the pterional approach offers the advantage of early dissection of the posterior neurovascular complex. Olfactory groove meningiomas constitute 4 to 13% of all meningiomas. Surgery is the primary treatment, but the recommended extent and types of approaches vary. We conducted a retrospective review of our olfactory groove meningioma series treated with microsurgery via standard unilateral or bilateral approaches. Patient records from our department (RMLIMS, LUCKNOW) were reviewed, encompassing cases treated with unilateral or bilateral approaches. Thirty patients who underwent olfactory groove meningioma removal were included, and clinical data, radiological findings, surgical treatment, and clinical outcomes were retrospectively analyzed. A total of 30 craniotomies were performed, with 16 employing unilateral pterional approaches and 14 using bilateral transbasal approaches. Overall, gross total tumor resection was achieved in 27 cases. Postoperative complications included edema (in three patients) and hematoma (in three patients). The unilateral (pterional) approach emerges as an excellent solution for olfactory groove meningioma treatment, offering early visualization of the posterior neurovascular complex. Additionally, it enables frontal sinus preservation and minimizes excessive brain retraction.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"9 12","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178739","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}
Parkinson's disease (PD) is a neurodegenerative disorder characterised by the degeneration of dopaminergic nigrostriatal pathway. Its incidence ranges from 1 to 2 per 1000 in general population. Its a complex disorder characterised by motor and non-motor symptoms that can impair the quality of life (QoL). In the presence of effective symptomatic therapies for the motor symptoms of Parkinson's disease, the non-motor symptoms have become the major prognostic factors determining the overall disease burden and everyday function in Parkinson’s disease patients. Our study aimed at assessing the frequency and proportion of non-motor symptoms in PD patients and to assess their impact on QoL. A total of 88 PD patients visiting the outpatient department of Neurology at Goa Medical College were assessed for various non-motor symptoms using a semi – structured questionnaire and appropriate scales. Quality of life was assessed using PDQ-39 questionnaire. Patients satisfying the United Kingdom Parkinson’s Disease brain bank criteria for idiopathic Parkinson’s diseases were included in the study Single centre, Cross-sectional study. Mean age of study population was 68 years and mean duration of the disease was 5yrs. Attention and memory were the most frequently reported domain in the study population (52 patients, 59.75 percent) followed by mood and cognition (46 patients, 52.74 percent). The least reported symptom was perceptual problems including delusions and hallucinations (11.74%) and miscellaneous domain (10.93 percent) which included pain, olfactory dysfunction, increased perspiration and weight fluctuations. The mean UPDRS (part 3) score was found to be 33.24± 17.37 with values ranging from 3.57 (mild motor impairment) to 44.64 (severe motor impairment).The QoL assessment showed that impairment of Mobility had a major impact on QoL followed by activities of daily living and emotional well-being. Correlation between Non-motor symptoms and PDQ-39 revealed that mood, cognition and perceptual problems had an adverse outcome on their emotional well-being and deficit in attention and memory had significant outcomes on communication. This study highlights the fact that non-motor symptoms in PD significantly impair quality of life and we should incorporate screening tools to evaluate patients with autonomic, sensory or mood disturbances so that they are detected at the earliest as most of them precede motor symptoms by decades.
{"title":"Study of non-motor Symptoms in Parkinsons disease and its impact on their quality of life","authors":"Harshal Mamlekar, Edwin Gomes, Teresa Ferreira","doi":"10.18231/j.ijn.2023.039","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.039","url":null,"abstract":"Parkinson's disease (PD) is a neurodegenerative disorder characterised by the degeneration of dopaminergic nigrostriatal pathway. Its incidence ranges from 1 to 2 per 1000 in general population. Its a complex disorder characterised by motor and non-motor symptoms that can impair the quality of life (QoL). In the presence of effective symptomatic therapies for the motor symptoms of Parkinson's disease, the non-motor symptoms have become the major prognostic factors determining the overall disease burden and everyday function in Parkinson’s disease patients. Our study aimed at assessing the frequency and proportion of non-motor symptoms in PD patients and to assess their impact on QoL. A total of 88 PD patients visiting the outpatient department of Neurology at Goa Medical College were assessed for various non-motor symptoms using a semi – structured questionnaire and appropriate scales. Quality of life was assessed using PDQ-39 questionnaire. Patients satisfying the United Kingdom Parkinson’s Disease brain bank criteria for idiopathic Parkinson’s diseases were included in the study Single centre, Cross-sectional study. Mean age of study population was 68 years and mean duration of the disease was 5yrs. Attention and memory were the most frequently reported domain in the study population (52 patients, 59.75 percent) followed by mood and cognition (46 patients, 52.74 percent). The least reported symptom was perceptual problems including delusions and hallucinations (11.74%) and miscellaneous domain (10.93 percent) which included pain, olfactory dysfunction, increased perspiration and weight fluctuations. The mean UPDRS (part 3) score was found to be 33.24± 17.37 with values ranging from 3.57 (mild motor impairment) to 44.64 (severe motor impairment).The QoL assessment showed that impairment of Mobility had a major impact on QoL followed by activities of daily living and emotional well-being. Correlation between Non-motor symptoms and PDQ-39 revealed that mood, cognition and perceptual problems had an adverse outcome on their emotional well-being and deficit in attention and memory had significant outcomes on communication. This study highlights the fact that non-motor symptoms in PD significantly impair quality of life and we should incorporate screening tools to evaluate patients with autonomic, sensory or mood disturbances so that they are detected at the earliest as most of them precede motor symptoms by decades.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"60 21","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178549","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 72-year-old White male complained of memory loss, trouble recalling names and events, and a regular-duty deterioration. Hypertension, type 2 diabetes, and hyperlipidemia characterized the patient’s history. He never drank alcohol or used illicit drugs. His mother had Alzheimer’s, and his father had a stroke. The patient’s physical examination was unremarkable except for a 20- out-of-30 Mini-Mental State Examination (MMSE) score, suggesting mild cognitive impairment. Rivastigmine 1.5 mg twice a day was started, with an eight-week escalation to 6 mg twice daily. He was given rivastigmine and memantine to slow cognitive impairment. Treatment efficacy and side effects were extensively examined. This report highlights the therapeutic efficacy of rivastigmine in improving cognitive function in patients with Alzheimer’s disease. The improvement in cognitive function and absence of significant adverse effects suggest that the treatment approach was effective in managing the patient's Alzheimer's disease.
{"title":"Therapeutic efficacy of rivastigmine in Alzheimer’s disease","authors":"Durga Prasad S, Tirath Patel","doi":"10.18231/j.ijn.2023.047","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.047","url":null,"abstract":"A 72-year-old White male complained of memory loss, trouble recalling names and events, and a regular-duty deterioration. Hypertension, type 2 diabetes, and hyperlipidemia characterized the patient’s history. He never drank alcohol or used illicit drugs. His mother had Alzheimer’s, and his father had a stroke. The patient’s physical examination was unremarkable except for a 20- out-of-30 Mini-Mental State Examination (MMSE) score, suggesting mild cognitive impairment. Rivastigmine 1.5 mg twice a day was started, with an eight-week escalation to 6 mg twice daily. He was given rivastigmine and memantine to slow cognitive impairment. Treatment efficacy and side effects were extensively examined. This report highlights the therapeutic efficacy of rivastigmine in improving cognitive function in patients with Alzheimer’s disease. The improvement in cognitive function and absence of significant adverse effects suggest that the treatment approach was effective in managing the patient's Alzheimer's disease.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"65 4","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178570","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}
: Embedding carnal (somatic or physical) restraints over the artificial intelligent system (i.e., artificially-intelligent system) in ample the similar way that the ‘human-brain’ must grow, progress plus function in the physically real, tangible and biological constrictions that lets system to advance feature-manifestations of the brains of multifaceted organs and organisms so as to solve brain issues. : Placing carnal restraints on AI-based model-system, i.e., artificially intelligent system. : spatially embedded recurrent neural nets (RNNs), 3D Euclidean space, where message of fundamental neural-cells are hampered by ‘sparse-connectome’ recurrent-neural-nets (RNN). : RNNs converge over anatomical, structural functional features universally originate within primates (cardinal, mandrill), and macaques’ cerebral/rational, brainy-cortices. Explicitly, they congregate/ (converge) over resolving implications via segmental (modular) tiny-world nets, in which functionally analogous-units spatially configure/construct themselves to use the dynamically effective varied-discerning code. Since features occur in union RNNs show how many mutual anatomical, functional-brain patterns (motifs) are deeply linked, can be ascribed to basic biologic optimization-processes. : RNNs merge biophysical limits in AI system plus aid as a bridge amid anatomical functional researchers to move ability neuroscience on.
{"title":"A study of brains complex organs-organisms with artificial intelligence system to evolve cardinal feature-manifestations of brain`s (self-organizing)","authors":"V. R. Raju","doi":"10.18231/j.ijn.2023.043","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.043","url":null,"abstract":": Embedding carnal (somatic or physical) restraints over the artificial intelligent system (i.e., artificially-intelligent system) in ample the similar way that the ‘human-brain’ must grow, progress plus function in the physically real, tangible and biological constrictions that lets system to advance feature-manifestations of the brains of multifaceted organs and organisms so as to solve brain issues. : Placing carnal restraints on AI-based model-system, i.e., artificially intelligent system. : spatially embedded recurrent neural nets (RNNs), 3D Euclidean space, where message of fundamental neural-cells are hampered by ‘sparse-connectome’ recurrent-neural-nets (RNN). : RNNs converge over anatomical, structural functional features universally originate within primates (cardinal, mandrill), and macaques’ cerebral/rational, brainy-cortices. Explicitly, they congregate/ (converge) over resolving implications via segmental (modular) tiny-world nets, in which functionally analogous-units spatially configure/construct themselves to use the dynamically effective varied-discerning code. Since features occur in union RNNs show how many mutual anatomical, functional-brain patterns (motifs) are deeply linked, can be ascribed to basic biologic optimization-processes. : RNNs merge biophysical limits in AI system plus aid as a bridge amid anatomical functional researchers to move ability neuroscience on.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"435 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139177281","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":"Culture-bound syndrome in ICD-11 and DSM 5","authors":"Anand Lingeswaran","doi":"10.18231/j.ijn.2023.048","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.048","url":null,"abstract":"","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"14 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178931","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}
V. Bhandari, Saloni Singhal, Ashar Lodi, Amresh Kumar
Central Nervous Tumors constitute 3% of cancer cases worldwide. The incidence of CNS tumors in India ranges from 5-10 per 100,000 population, ranking 14 among all other tumors and accounting for 2% of all malignancies. The five most frequent tumors are astrocytoma (47.3%), Medulloblastoma (11.4%), craniopharyngioma (9.7%), ependymal tumors (4.8%), and nerve sheath tumors (4.1%). The tumor spectrum varies among different ages and sexes. The medical records of 238 patients were evaluated, out of which only 102 were fit for the study as per the inclusion and exclusion criteria. The 3-year median overall survival (OS) of 8 years and Progression Free Survival (PFS) of 7 years, while the 5-year median OS of 9 years and PFS of 7 years is recorded. Glioblastoma (GBM) is the most aggressive out of all histologies, with a 2-year survival of 31% and a median OS of 8 months, as per our study. We got some good results with brainstem glioma as well, with a 2-year survival of 40% and a median OS of 18 months. The survival in CNS tumours has improved widely with adjuvant concurrent chemotherapy with temozolamide along with radiation postoperatively and then adjuvant for 6months to 1 year and it was also seen that more complete the tumour resection done, the better was the survival seen.
{"title":"Survival and analysis of patients with various central nervous tumors who received post-operative radiation therapy: A retrospective study","authors":"V. Bhandari, Saloni Singhal, Ashar Lodi, Amresh Kumar","doi":"10.18231/j.ijn.2023.041","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.041","url":null,"abstract":"Central Nervous Tumors constitute 3% of cancer cases worldwide. The incidence of CNS tumors in India ranges from 5-10 per 100,000 population, ranking 14 among all other tumors and accounting for 2% of all malignancies. The five most frequent tumors are astrocytoma (47.3%), Medulloblastoma (11.4%), craniopharyngioma (9.7%), ependymal tumors (4.8%), and nerve sheath tumors (4.1%). The tumor spectrum varies among different ages and sexes. The medical records of 238 patients were evaluated, out of which only 102 were fit for the study as per the inclusion and exclusion criteria. The 3-year median overall survival (OS) of 8 years and Progression Free Survival (PFS) of 7 years, while the 5-year median OS of 9 years and PFS of 7 years is recorded. Glioblastoma (GBM) is the most aggressive out of all histologies, with a 2-year survival of 31% and a median OS of 8 months, as per our study. We got some good results with brainstem glioma as well, with a 2-year survival of 40% and a median OS of 18 months. The survival in CNS tumours has improved widely with adjuvant concurrent chemotherapy with temozolamide along with radiation postoperatively and then adjuvant for 6months to 1 year and it was also seen that more complete the tumour resection done, the better was the survival seen.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"128 7","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139177503","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}
Therissa Benerji, Sarath Bodepudi, Gayathri Devi Cherukuri, M. Kodali, K. Parvathaneni
Psychiatric co-morbidity in patients with physical illness is known to influence the course and outcome of both conditions. Consultation liaison psychiatry [CLP] can be regarded as an essential service between psychiatry and other medical specialties. Efficient communication between different levels of care is known to have an impact on the quality of health care. To study the patterns of referrals to the department of psychiatry and diagnostic concordance between referring physicians to CL-Psychiatrist.The present study was a cross-sectional study conducted in the Department of Psychiatry of a tertiary care hospital. All the patients referred to the Psychiatry department for 4 months were taken after excluding referrals sent for disability assessment. Socio-demographic details, source of referral, reason for referral, and the psychiatric diagnosis by both the referring doctor and CL-psychiatrist were recorded. Statistical analysis was done using SPSS 25.0 software and kappa value was used to estimate the diagnostic concordance.In the sample of 100 referrals studied, the mean age of the sample was 40.96±13.42 years. The majority of the cases referred were inpatients (61%), from the department of general medicine and allied branches (85%), (General medicine -55, Neurology- 21). The most common diagnosis was alcohol dependence syndrome 24 (24%), followed by depression (18%) and phobic anxiety (18%).The concordance of the diagnosis between the referral and the psychiatry team was in perfect agreement (κ=0.81- 1.00) for paranoid schizophrenia, bipolar affective disorder, delirium, dissociative disorder, delusional disorder, and alcohol dependence syndrome. Very low concordance was observed in diagnosing obsessive-compulsive disorder (k=0) and adjustment disorder (k=0).The overall diagnostic concordance was poor for adjustment disorder, OCD, and vascular dementia, and good for paranoid schizophrenia, delirium, dissociative disorder, delusional disorder, and BPAD.
{"title":"Diagnostic concordance in consultation liaison psychiatry – Referring physicians to psychiatrists","authors":"Therissa Benerji, Sarath Bodepudi, Gayathri Devi Cherukuri, M. Kodali, K. Parvathaneni","doi":"10.18231/j.ijn.2023.042","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.042","url":null,"abstract":"Psychiatric co-morbidity in patients with physical illness is known to influence the course and outcome of both conditions. Consultation liaison psychiatry [CLP] can be regarded as an essential service between psychiatry and other medical specialties. Efficient communication between different levels of care is known to have an impact on the quality of health care. To study the patterns of referrals to the department of psychiatry and diagnostic concordance between referring physicians to CL-Psychiatrist.The present study was a cross-sectional study conducted in the Department of Psychiatry of a tertiary care hospital. All the patients referred to the Psychiatry department for 4 months were taken after excluding referrals sent for disability assessment. Socio-demographic details, source of referral, reason for referral, and the psychiatric diagnosis by both the referring doctor and CL-psychiatrist were recorded. Statistical analysis was done using SPSS 25.0 software and kappa value was used to estimate the diagnostic concordance.In the sample of 100 referrals studied, the mean age of the sample was 40.96±13.42 years. The majority of the cases referred were inpatients (61%), from the department of general medicine and allied branches (85%), (General medicine -55, Neurology- 21). The most common diagnosis was alcohol dependence syndrome 24 (24%), followed by depression (18%) and phobic anxiety (18%).The concordance of the diagnosis between the referral and the psychiatry team was in perfect agreement (κ=0.81- 1.00) for paranoid schizophrenia, bipolar affective disorder, delirium, dissociative disorder, delusional disorder, and alcohol dependence syndrome. Very low concordance was observed in diagnosing obsessive-compulsive disorder (k=0) and adjustment disorder (k=0).The overall diagnostic concordance was poor for adjustment disorder, OCD, and vascular dementia, and good for paranoid schizophrenia, delirium, dissociative disorder, delusional disorder, and BPAD.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"335 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139177654","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}
Ankan Paul, Utkarsh K Tripathi, Simranjit Kaur, Abhishek Chakladar, Alexander M. Alphonse
“Silent Cerebral Hemorrhage” in a young alcohol-dependent individual can pose a significant challenge to the treating physician. The neuroimaging and clinical presentation maybe dichotomous to a critical extent.Our aim was to explore the scientific understanding of “Silent Cerebral Hemorrhage” and share the wisdom gathered about the diagnosis and management of this rare entity. A 32-year-old male presented with fever and episodes of vomiting alongwith urinary incontinence, in the backdrop of heavy alcohol abuse. Detailed neurological assessment revealed no abnormal findings. MMSE indicated towards no significant cognitive deficits. On MRI, an extensive intracerebral hemorrhage was observed.The I.C.H. score was 2/6 and the FUNC score was 8/11; which was in stark contrast to NIH Stroke Scale score of 0/42.Blood-panel showed deranged liver enzymes. Patient was managed conservatively. Irritability was controlled using Haloperidol. Prophylactic antiepileptics were also started.Upon follow-up, patient showed drastic improvement. Patient was started on Acamprosate for maintenance of abstinence.Through this case report we have tried to highlight that “Silent Cerebral Hemorrhage” can present as a curve-ball for clinicians and psychiatrists. The dichotomy in interpretation of stroke-related scales may cause a dilemma about the course of management.“In this case, the absence of neurological deficits was indeed a stroke of luck for the patient.”: “Silent Cerebral Hemorrhage” can present as a curve-ball for clinicians and psychiatrists. Hence, we should be vigilant about it in our clinical practice. The dichotomy in interpretation of stroke-related scales may cause a dilemma about the course of management.
{"title":"Dichotomous interpretations and a stroke of luck: A case of silent cerebral hemorrhage","authors":"Ankan Paul, Utkarsh K Tripathi, Simranjit Kaur, Abhishek Chakladar, Alexander M. Alphonse","doi":"10.18231/j.ijn.2023.045","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.045","url":null,"abstract":"“Silent Cerebral Hemorrhage” in a young alcohol-dependent individual can pose a significant challenge to the treating physician. The neuroimaging and clinical presentation maybe dichotomous to a critical extent.Our aim was to explore the scientific understanding of “Silent Cerebral Hemorrhage” and share the wisdom gathered about the diagnosis and management of this rare entity. A 32-year-old male presented with fever and episodes of vomiting alongwith urinary incontinence, in the backdrop of heavy alcohol abuse. Detailed neurological assessment revealed no abnormal findings. MMSE indicated towards no significant cognitive deficits. On MRI, an extensive intracerebral hemorrhage was observed.The I.C.H. score was 2/6 and the FUNC score was 8/11; which was in stark contrast to NIH Stroke Scale score of 0/42.Blood-panel showed deranged liver enzymes. Patient was managed conservatively. Irritability was controlled using Haloperidol. Prophylactic antiepileptics were also started.Upon follow-up, patient showed drastic improvement. Patient was started on Acamprosate for maintenance of abstinence.Through this case report we have tried to highlight that “Silent Cerebral Hemorrhage” can present as a curve-ball for clinicians and psychiatrists. The dichotomy in interpretation of stroke-related scales may cause a dilemma about the course of management.“In this case, the absence of neurological deficits was indeed a stroke of luck for the patient.”: “Silent Cerebral Hemorrhage” can present as a curve-ball for clinicians and psychiatrists. Hence, we should be vigilant about it in our clinical practice. The dichotomy in interpretation of stroke-related scales may cause a dilemma about the course of management.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"336 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178032","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}
: Indorsing (endorsing or encouraging) participation plus autonomy (PA) within the people has been tinted or emphasized as an definitive goal-of-rehabilitation for subjects with constant disorders and/or diseases by the World Health Organization (WHO), yet there are insufficient studies concentrating over the “PA” within the subjects through the Parkinson disease (PD). Thus, we present this study objectives to clarify/explain (explicate) the degree of “PA “within the Palasioses’ve the psychosomatic also developmental(behavioral) causes linked through it. : Subjects were inducted as of the neurology of a tertiary care hospital and city neuro research center by applying ease sampling for this type of research study design. A survey casing or layering the societal-demographic, illness-linked typical, Bharat version of impact over the involvement and participation autonomy (“IPA”) survey, and other rating scales including H and Y staging system plus all time UPDRS considering the UK brain bank criteria were employed. A statistical multi latent-variate stepwise linear regression analysis-technique was applied to decide the features/ (factors) which influences IPA. : Regression showed UPDRS-stage III, β=0.34, p<0.001, chi-square, with 2 degree of freedom, highly significant had very good correlation by IPA, followed by drive (i.e., tenacity) as the second robust feature β=-0.24, p< 0.001. Also, H and Y score β=0.18, p< 0.001, plus accessibility-of- community sustain β=-0.11, p =0.001 were great factors. : Standard echelon of PA amid Parkinson`s was middle (worse). Their bodily function, `psychological-resilience` plus `social-support` were the best factors coupled through PA amongst Parkinson`s. Thus the results yield significant insights in to Parkinson`s `PA` which aid clinicians for determining/predicting early-risks of limited PA amid Parkinson`s, executing involvement to endorse, to advance-PA and lastly to complete the decisive therapeutic-treatment.
{"title":"A study of stages and supplementary issues of Parkinson's in Parkinson disease and movement disorders","authors":"V. R. Raju, N. Lavanya, P. Premchand","doi":"10.18231/j.ijn.2023.038","DOIUrl":"https://doi.org/10.18231/j.ijn.2023.038","url":null,"abstract":": Indorsing (endorsing or encouraging) participation plus autonomy (PA) within the people has been tinted or emphasized as an definitive goal-of-rehabilitation for subjects with constant disorders and/or diseases by the World Health Organization (WHO), yet there are insufficient studies concentrating over the “PA” within the subjects through the Parkinson disease (PD). Thus, we present this study objectives to clarify/explain (explicate) the degree of “PA “within the Palasioses’ve the psychosomatic also developmental(behavioral) causes linked through it. : Subjects were inducted as of the neurology of a tertiary care hospital and city neuro research center by applying ease sampling for this type of research study design. A survey casing or layering the societal-demographic, illness-linked typical, Bharat version of impact over the involvement and participation autonomy (“IPA”) survey, and other rating scales including H and Y staging system plus all time UPDRS considering the UK brain bank criteria were employed. A statistical multi latent-variate stepwise linear regression analysis-technique was applied to decide the features/ (factors) which influences IPA. : Regression showed UPDRS-stage III, β=0.34, p<0.001, chi-square, with 2 degree of freedom, highly significant had very good correlation by IPA, followed by drive (i.e., tenacity) as the second robust feature β=-0.24, p< 0.001. Also, H and Y score β=0.18, p< 0.001, plus accessibility-of- community sustain β=-0.11, p =0.001 were great factors. : Standard echelon of PA amid Parkinson`s was middle (worse). Their bodily function, `psychological-resilience` plus `social-support` were the best factors coupled through PA amongst Parkinson`s. Thus the results yield significant insights in to Parkinson`s `PA` which aid clinicians for determining/predicting early-risks of limited PA amid Parkinson`s, executing involvement to endorse, to advance-PA and lastly to complete the decisive therapeutic-treatment.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"97 ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2023-12-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"139178470","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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