Low back pain during pregnancy due to weight gain, biomechanical changes, increase level of relaxin hormone produced by the corpus luteum during pregnancy, are the probable etiologies. Lumbar disc herniation causing radicular pain during pregnancy is a rare clinical entity. Surgical management during pregnancy poses high risk to the developing fetus and the mother. Key issues to be considered are the diagnostic tests, Indications for surgery, timing of surgery in respect of gestation, anesthesia and drugs, operative positioning, and continuation of pregnancy after surgery.Herein, author present three cases of lumbar disc prolapse causing low back pain with radiculopathy in pregnancy.
{"title":"Surgery for Lumbar disc prolapse in pregnancy: Case series","authors":"R. Bharti","doi":"10.18231/j.ijn.2022.044","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.044","url":null,"abstract":"Low back pain during pregnancy due to weight gain, biomechanical changes, increase level of relaxin hormone produced by the corpus luteum during pregnancy, are the probable etiologies. Lumbar disc herniation causing radicular pain during pregnancy is a rare clinical entity. Surgical management during pregnancy poses high risk to the developing fetus and the mother. Key issues to be considered are the diagnostic tests, Indications for surgery, timing of surgery in respect of gestation, anesthesia and drugs, operative positioning, and continuation of pregnancy after surgery.Herein, author present three cases of lumbar disc prolapse causing low back pain with radiculopathy in pregnancy.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"127676811","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. Dahiya, Nadeem Motlekar, Mrinalini Singh, Jerestyn Khapoliwala
: To evaluate effectiveness and safety of intravenous alteplase (tPA) for the treatment of acute ischemic stroke. In this prospective observational study, adult patients with ischemic stroke were treated with intravenous alteplase. We recorded baseline demographics and NIHS score was calculated at baseline, 2 hours, 24 hours and 7 days. Improvement was assessed by evaluating total NIH stroke score at different time points. Based on the neurological assessment, patients were categorised into three categories: unchanged (U), improving (I) and deteriorating (D). Blood pressure was closely monitored until 24 hours after infusion of alteplase. Both neurological assessment and blood pressure was monitored every 15 minutes for the first 2 hours after start of infusion, then every 30 minutes for next 6 hours, and hourly from the post infusion hour until 24 hours after infusion. Twenty-six patients [male 16 (61.50%); female 10 (38.50%)] between 34 to 86 years of age were enrolled in this study. Total NIHS score reduced from 10.77 (+5.01) at pre-treatment to 4.04 (+4.00) at 7 days. The improvement in NIHS score at two hours versus pre-treatment (p<0.001), at 24 hours versus 2 hours (p=0.002) and 7 days versus 24 hours (p<0.001) was statistically significant. Clinically no significant change was observed in the blood pressure of the patients till 24 hours after thrombolysis. At the end of 24 hours, 40% patients showed improved status and in 60% patients, status was unchanged. Intravenous alteplase is effective and safe treatment approach for treatment of acute ischemic stroke. No major complications were observed in this study.
{"title":"Effectiveness and safety of intravenous alteplase in patients with acute ischemic stroke: Results of a single centre study","authors":"A. Dahiya, Nadeem Motlekar, Mrinalini Singh, Jerestyn Khapoliwala","doi":"10.18231/j.ijn.2022.033","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.033","url":null,"abstract":": To evaluate effectiveness and safety of intravenous alteplase (tPA) for the treatment of acute ischemic stroke. In this prospective observational study, adult patients with ischemic stroke were treated with intravenous alteplase. We recorded baseline demographics and NIHS score was calculated at baseline, 2 hours, 24 hours and 7 days. Improvement was assessed by evaluating total NIH stroke score at different time points. Based on the neurological assessment, patients were categorised into three categories: unchanged (U), improving (I) and deteriorating (D). Blood pressure was closely monitored until 24 hours after infusion of alteplase. Both neurological assessment and blood pressure was monitored every 15 minutes for the first 2 hours after start of infusion, then every 30 minutes for next 6 hours, and hourly from the post infusion hour until 24 hours after infusion. Twenty-six patients [male 16 (61.50%); female 10 (38.50%)] between 34 to 86 years of age were enrolled in this study. Total NIHS score reduced from 10.77 (+5.01) at pre-treatment to 4.04 (+4.00) at 7 days. The improvement in NIHS score at two hours versus pre-treatment (p<0.001), at 24 hours versus 2 hours (p=0.002) and 7 days versus 24 hours (p<0.001) was statistically significant. Clinically no significant change was observed in the blood pressure of the patients till 24 hours after thrombolysis. At the end of 24 hours, 40% patients showed improved status and in 60% patients, status was unchanged. Intravenous alteplase is effective and safe treatment approach for treatment of acute ischemic stroke. No major complications were observed in this study.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-09-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"129059637","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}
Idiopathic intracranial hypertension (IIH) is a disorder that leads to isolated raised intracranial pressure characterized by classical symptoms and signs such as headache, papilledema, sixth nerve palsy causing diplopia and pulsatile tinnitus.In our case report, we present a 20-year-old primigravida suffering from IIH presenting with unusual clinically elicited signs, including bilateral proptosis, unilateral ophthalmoplegia, and unilateral facial nerve palsy. Fundoscopy revealed bilateral papilledema and visual field examination showed enlarged blind spots in both eyes. Lumbar puncture was done to detect the opening pressure of cerebrospinal fluid which was measured to be 57cm of water. MRI brain + venogram was suggestive of vertical kinking of right optic nerve and tortuosity of bilateral optic nerves along with stenosis in bilateral transverse sinuses. In previous literature, there are only two reported cases of IIH that were associated with proptosis, both presenting unilaterally, and one reported case of IIH presenting with complete unilateral facial palsy. When a patient presents with these unorthodox signs, the diagnosis of IIH cannot be excluded.
{"title":"Analysis and comparison of synovitis in rheumatoid arthritis and osteoarthritis patients","authors":"U. Kalluri, S. Babu, Roshan Ajoy Kadavan","doi":"10.18231/j.ijn.2022.029","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.029","url":null,"abstract":"Idiopathic intracranial hypertension (IIH) is a disorder that leads to isolated raised intracranial pressure characterized by classical symptoms and signs such as headache, papilledema, sixth nerve palsy causing diplopia and pulsatile tinnitus.In our case report, we present a 20-year-old primigravida suffering from IIH presenting with unusual clinically elicited signs, including bilateral proptosis, unilateral ophthalmoplegia, and unilateral facial nerve palsy. Fundoscopy revealed bilateral papilledema and visual field examination showed enlarged blind spots in both eyes. Lumbar puncture was done to detect the opening pressure of cerebrospinal fluid which was measured to be 57cm of water. MRI brain + venogram was suggestive of vertical kinking of right optic nerve and tortuosity of bilateral optic nerves along with stenosis in bilateral transverse sinuses. In previous literature, there are only two reported cases of IIH that were associated with proptosis, both presenting unilaterally, and one reported case of IIH presenting with complete unilateral facial palsy. When a patient presents with these unorthodox signs, the diagnosis of IIH cannot be excluded.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"3 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"126400820","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. S. Nair, L. Ponnuchamy, Raghavendra Kukehalli, R. Kumar K., Harish Kumar DP
Neurosurgical conditions have been increasingly causing huge burden and associated disability to the person, their families, and the larger society. Casualty- emergency setting bring a huge amount of distress and confusion and in them unknown patients cause increased difficulty for the healthcare professionals in terms of tracing the family and making informed decision keeping in mind their welfare. Two case studies have been presented here speaking about the difficulties, method of social analysis and plan of intervention for them making it important to have a multidisciplinary system of care.
{"title":"Amending the unknown to known: Case series from the emergency psychiatric social work perspective in neurosurgery before and after COVID-19 pandemic","authors":"V. S. Nair, L. Ponnuchamy, Raghavendra Kukehalli, R. Kumar K., Harish Kumar DP","doi":"10.18231/j.ijn.2022.030","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.030","url":null,"abstract":"Neurosurgical conditions have been increasingly causing huge burden and associated disability to the person, their families, and the larger society. Casualty- emergency setting bring a huge amount of distress and confusion and in them unknown patients cause increased difficulty for the healthcare professionals in terms of tracing the family and making informed decision keeping in mind their welfare. Two case studies have been presented here speaking about the difficulties, method of social analysis and plan of intervention for them making it important to have a multidisciplinary system of care.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"339 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"123184014","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}
Migraine is a frequently occurring multifactorial neurovascular disorder affecting over a billion people globally. Migraine load is distinctive concerning gender, i.e. it is more severe in women and has a prolonged healing period. People with migraine have a primary headache disorder, a public health concern in low and middle-income countries. Studies have shown that brainstem regions and the trigeminovascular pathway are linked to the migraine attack's symptomatology. The episode is mediated by the release of Calcitonin Gene-Related Peptide (CGRP). It is a widely expressed neuropeptide with a sole role in sensory neurotransmission. Treatment of migraine remains underdiagnosed; its frequency and intensity are poorly understood. Although patients consume the antagonists of CGRP, migraine still prevails heavily in women. Dietary factors are often considered migraine triggers. One such dietary factor is Zinc deficiency. Zinc deficiency is mainly observed in women with poor dietary intake in rural and sub-rural areas of India. Recently Zinc has been shown to play a role in migraine disorders. This review briefly summarizes how supplementary Zinc may be a potential therapeutic strategy to overcome migraine pain.
{"title":"Migraine and zinc deficiency in women - A mini review","authors":"Pinky Sultana","doi":"10.18231/j.ijn.2022.020","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.020","url":null,"abstract":"Migraine is a frequently occurring multifactorial neurovascular disorder affecting over a billion people globally. Migraine load is distinctive concerning gender, i.e. it is more severe in women and has a prolonged healing period. People with migraine have a primary headache disorder, a public health concern in low and middle-income countries. Studies have shown that brainstem regions and the trigeminovascular pathway are linked to the migraine attack's symptomatology. The episode is mediated by the release of Calcitonin Gene-Related Peptide (CGRP). It is a widely expressed neuropeptide with a sole role in sensory neurotransmission. Treatment of migraine remains underdiagnosed; its frequency and intensity are poorly understood. Although patients consume the antagonists of CGRP, migraine still prevails heavily in women. Dietary factors are often considered migraine triggers. One such dietary factor is Zinc deficiency. Zinc deficiency is mainly observed in women with poor dietary intake in rural and sub-rural areas of India. Recently Zinc has been shown to play a role in migraine disorders. This review briefly summarizes how supplementary Zinc may be a potential therapeutic strategy to overcome migraine pain.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"47 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"133608546","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}
This study presents a noise-removal technique for the microelectrode signals of subthalamic-nuclei (STN) neurons acquired by MER machine through electrical stimulations with subthalamic-nuclei deep brain stimulation/or stimulator (STN-DBS) in local field potentials (LFPs). We proposed a novel method for the removal of induced stimuli-artifacts triggered by pulse-generators differed in typical LFPs (low-frequency potentials) signals. The method is processed and tested for accuracy and computed for execution in vitro-states. Results indicated that the stimulus-artifacts are well suppressed by this method. And also it is tested in vivo-states of Parkinson’s disease (PD) subjects (patients). It is applied to process signals of LFPs gathered intra operatively from PDs to preliminarily explore quantitative dependencies-of beta-band synchronous variations within STN, DBS parameters (stimulus-intensity, stimulus-voltage, frequency, and amplitude pulse-width). Findings showed that the DBS process can overcome excessive beta-frequency (30Hz) activity plus that the degree of reduction rises with increasing DBS current in the range-of 1-3Volts then boosting stimulus-frequency within a range of 60-120Hz. The method offers scientific-research and technical support for exploring the instant effect by induced electrical stimulations in the Parkinson brain activities and it can be utilized as a research tool in the future technologies.
{"title":"Noise removal of deep brain stimulation artifacts in subthalamic nucleus neurons local field induced electrical potentials","authors":"V. R. Raju","doi":"10.18231/j.ijn.2022.027","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.027","url":null,"abstract":"This study presents a noise-removal technique for the microelectrode signals of subthalamic-nuclei (STN) neurons acquired by MER machine through electrical stimulations with subthalamic-nuclei deep brain stimulation/or stimulator (STN-DBS) in local field potentials (LFPs). We proposed a novel method for the removal of induced stimuli-artifacts triggered by pulse-generators differed in typical LFPs (low-frequency potentials) signals. The method is processed and tested for accuracy and computed for execution in vitro-states. Results indicated that the stimulus-artifacts are well suppressed by this method. And also it is tested in vivo-states of Parkinson’s disease (PD) subjects (patients). It is applied to process signals of LFPs gathered intra operatively from PDs to preliminarily explore quantitative dependencies-of beta-band synchronous variations within STN, DBS parameters (stimulus-intensity, stimulus-voltage, frequency, and amplitude pulse-width). Findings showed that the DBS process can overcome excessive beta-frequency (30Hz) activity plus that the degree of reduction rises with increasing DBS current in the range-of 1-3Volts then boosting stimulus-frequency within a range of 60-120Hz. The method offers scientific-research and technical support for exploring the instant effect by induced electrical stimulations in the Parkinson brain activities and it can be utilized as a research tool in the future technologies.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"1 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122780963","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}
Bhabani Sankar Samantaray, Subhransu Jena, Anup K Budhia, S. K. Tripathy
: Posterior circulation strokes account for approximately 15% of all strokes with diverse clinical presentation. They are different from anterior circulation strokes, with reference to risk factors, clinical features, management stratergy and prognosis. We conducted a study in a tertiary care teaching hospital in Eastern India to understand the clinical profile of patients with posterior circulation ischemic stroke. : The study was conducted at Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, with a total of 282 patients during the period from January 2020 to June 2021 (Eighteen months). A detailed medical history and clinical examination aided with neuro-imaging was done in all patients. : Incidence of posterior circulation ischemic stroke was 16.2%. The male to female ratio being 2.27:1, the mean age at presentation was 54.4 (± 13.6) years. Diabetes, hypertension, dyslipidemia and tobacco use were identified as the major risk factors. The common clinical manifestations were motor disturbances, vertigo, gait ataxia, cranial nerve deficits, altered sensorium and visual disturbances. Infratentorial infarcts were seen more frequently and most common anatomical site of involvement was cerebellum (30.5%). Large artery diseases (58.8%) were the most common aetiological causes and 15.6% had cardioembolic source according to TOAST Criteria. Posterior cerebral artery involvement was the most common (43.6%) finding and the incidence of mortality was 6.3% noted in our series.
{"title":"An observational cross-sectional study of clinical profile of posterior circulation ischemic stroke in a tertiary care teaching hospital in Eastern India","authors":"Bhabani Sankar Samantaray, Subhransu Jena, Anup K Budhia, S. K. Tripathy","doi":"10.18231/j.ijn.2022.025","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.025","url":null,"abstract":": Posterior circulation strokes account for approximately 15% of all strokes with diverse clinical presentation. They are different from anterior circulation strokes, with reference to risk factors, clinical features, management stratergy and prognosis. We conducted a study in a tertiary care teaching hospital in Eastern India to understand the clinical profile of patients with posterior circulation ischemic stroke. : The study was conducted at Hi-Tech Medical College and Hospital, Bhubaneswar, Odisha, with a total of 282 patients during the period from January 2020 to June 2021 (Eighteen months). A detailed medical history and clinical examination aided with neuro-imaging was done in all patients. : Incidence of posterior circulation ischemic stroke was 16.2%. The male to female ratio being 2.27:1, the mean age at presentation was 54.4 (± 13.6) years. Diabetes, hypertension, dyslipidemia and tobacco use were identified as the major risk factors. The common clinical manifestations were motor disturbances, vertigo, gait ataxia, cranial nerve deficits, altered sensorium and visual disturbances. Infratentorial infarcts were seen more frequently and most common anatomical site of involvement was cerebellum (30.5%). Large artery diseases (58.8%) were the most common aetiological causes and 15.6% had cardioembolic source according to TOAST Criteria. Posterior cerebral artery involvement was the most common (43.6%) finding and the incidence of mortality was 6.3% noted in our series.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"27 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"122175982","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}
This study discuss the analysis of a real-time multi channel microelectrode recordings of rats with computational simulation and mathematical statistical modeling’s. If the impedance-of every site of neuro-sensor, i.e., electrode is fairly at a low level as well as the gap between sensor-sites is applicably very very minute, a spike-generated and also computed by a neuron is asynchronously/concurrently gathered at multi neuro-sensor/electrode locations in conjunction with distinct stimulus-intensities, i.e., amplitudes (stremgth of the signals).
{"title":"Analysis of real-time multi channel microelectrode recordings of rats: A study with computational simulation","authors":"V. R. Raju","doi":"10.18231/j.ijn.2022.026","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.026","url":null,"abstract":"This study discuss the analysis of a real-time multi channel microelectrode recordings of rats with computational simulation and mathematical statistical modeling’s. If the impedance-of every site of neuro-sensor, i.e., electrode is fairly at a low level as well as the gap between sensor-sites is applicably very very minute, a spike-generated and also computed by a neuron is asynchronously/concurrently gathered at multi neuro-sensor/electrode locations in conjunction with distinct stimulus-intensities, i.e., amplitudes (stremgth of the signals).","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"37 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"117241725","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. Mittal, Akriti Sharma, Gauri Mittal, Ashwini A Mahadule, Monica Pathania
Alzheimer’s disease (AD) consists of 60-80% of all dementia cases, thus is recognized as the commonest form of dementia. The current challenge to clinicians and researchers in the field of AD is development of treatment plans that can target the progression of pathology at molecular level as well newer diagnostic techniques for early detection and prevention of AD. This could be achieved by enhancing our understanding of the underlying pathophysiology of AD. This is systematic and concise review of various pathophysiological mechanisms contributing to AD. Legitimate indexing portals and search websites were used to carry out the literature search for this article. A combination of MeSH terms and Boolean operators were used. Obtained research articles were carefully assessed first by reading title and abstract and finally by reading the whole text. A set of inclusion and exclusion criteria were used to select the reference articles.: In our literature search 75 articles were obtained from PubMed, Google scholar and Cochrane Library after removing duplicate records. These were screened using titles and abstract. 23 articles were excluded from the study as per the exclusion criteria. Full text of 52 articles were read. 7 articles were excluded, 45 were studied thoughrouly and 30 were referenced during the writing of this review.Various risk factors – old age, diabetes, smoking, mutation etc contribute to Aβ plaque accumulation due to cleavage of APP protein by α and ϒ secretase. Aβ plaque further contributes to accumulation of neurofibrillary tangles, neuroinflammation and oxidative stress. This together with disturbance in Calcium homeostasis and excitotoxicity at glutamate receptors contribute to neurodegeneration and synaptic toxicity.
{"title":"Systematic assessment of pathophysiological mechanisms and their interrelation in progression of Alzheimer’s disease","authors":"S. Mittal, Akriti Sharma, Gauri Mittal, Ashwini A Mahadule, Monica Pathania","doi":"10.18231/j.ijn.2022.023","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.023","url":null,"abstract":"Alzheimer’s disease (AD) consists of 60-80% of all dementia cases, thus is recognized as the commonest form of dementia. The current challenge to clinicians and researchers in the field of AD is development of treatment plans that can target the progression of pathology at molecular level as well newer diagnostic techniques for early detection and prevention of AD. This could be achieved by enhancing our understanding of the underlying pathophysiology of AD. This is systematic and concise review of various pathophysiological mechanisms contributing to AD. Legitimate indexing portals and search websites were used to carry out the literature search for this article. A combination of MeSH terms and Boolean operators were used. Obtained research articles were carefully assessed first by reading title and abstract and finally by reading the whole text. A set of inclusion and exclusion criteria were used to select the reference articles.: In our literature search 75 articles were obtained from PubMed, Google scholar and Cochrane Library after removing duplicate records. These were screened using titles and abstract. 23 articles were excluded from the study as per the exclusion criteria. Full text of 52 articles were read. 7 articles were excluded, 45 were studied thoughrouly and 30 were referenced during the writing of this review.Various risk factors – old age, diabetes, smoking, mutation etc contribute to Aβ plaque accumulation due to cleavage of APP protein by α and ϒ secretase. Aβ plaque further contributes to accumulation of neurofibrillary tangles, neuroinflammation and oxidative stress. This together with disturbance in Calcium homeostasis and excitotoxicity at glutamate receptors contribute to neurodegeneration and synaptic toxicity.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"8 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"114957958","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}
To report the clinical features, radiological features and outcomes of patients with diffuse axonal injury in a tertiary care centre. Fifty five patients with history of trauma with low GCS and radiological evidence of DAI were studied from August 2016 to December 2018. It consisted 46 (84%) males and 9 (16%) females. Majority of the patients were in age group of 16-25. Most common modality of injury was RTA. Seven (12.7%) patients had grade 1 DAI, 36 (65.5%) patients had grade 2 DAI and 12 (21.8%) patients had grade 3 DAI. Follow up was done after 3 months of injury. Patients outcome was analysed using the Glasgow Outcome Scale. Patients with GCS 3-8 had GOS 1-3. Patients with GCS of 9-12 had GOS of 3-4 and Patients with GCS of 13-15 had GOS of 4-5. Most patients in our study had grade 2 DAI and GOS 4. Diffuse axonal injury is devastating types of traumatic brain injury. The acceleration-deceleration mechanism is responsible for DAI. It is most commonly analyzed based on the outcomes of GOS Scale. Most of the patients in this study had grade 2 DAI. Good recovery was seen in grade 1 and 2 DAI and high mortality in grade 3 DAI.
{"title":"Analysis and outcomes of diffuse axonal injury in tertiary care centre","authors":"S. Uppal, Visvanathan K","doi":"10.18231/j.ijn.2022.028","DOIUrl":"https://doi.org/10.18231/j.ijn.2022.028","url":null,"abstract":"To report the clinical features, radiological features and outcomes of patients with diffuse axonal injury in a tertiary care centre. Fifty five patients with history of trauma with low GCS and radiological evidence of DAI were studied from August 2016 to December 2018. It consisted 46 (84%) males and 9 (16%) females. Majority of the patients were in age group of 16-25. Most common modality of injury was RTA. Seven (12.7%) patients had grade 1 DAI, 36 (65.5%) patients had grade 2 DAI and 12 (21.8%) patients had grade 3 DAI. Follow up was done after 3 months of injury. Patients outcome was analysed using the Glasgow Outcome Scale. Patients with GCS 3-8 had GOS 1-3. Patients with GCS of 9-12 had GOS of 3-4 and Patients with GCS of 13-15 had GOS of 4-5. Most patients in our study had grade 2 DAI and GOS 4. Diffuse axonal injury is devastating types of traumatic brain injury. The acceleration-deceleration mechanism is responsible for DAI. It is most commonly analyzed based on the outcomes of GOS Scale. Most of the patients in this study had grade 2 DAI. Good recovery was seen in grade 1 and 2 DAI and high mortality in grade 3 DAI.","PeriodicalId":415114,"journal":{"name":"IP Indian Journal of Neurosciences","volume":"13 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2022-06-15","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"131145201","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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