Background: The burden of stroke is high worldwide, especially in low-middle income countries. We aim to explore the temporal trends of the incidence rate (IR) of stroke over 14 years in Iran’s central areas. Methods: Stroke registry as part of cardiovascular disease (CVD) registry in Isfahan that focused on hospitalized patients (≥15 years) with first or recurrent stroke from 2001 to 2015. Factors included date of symptoms, demographics, management, survival at 28 days, date of admission, history of stroke, and other CVD and clinical diagnosis according to Computer Tomography Scan. We calculated age-, sex, and place-of-residence-adjusted IR based on multiple reference populations. Data were analyzed by bootstrap robust zero-truncated negative binomial regression models using R Statistical Software. Results: From 19,174 registered patients with stroke assessed by ICD-10; 18,010 (93.93%) cases were identified based on WHO-MONICA. Approximately 51% of hospitalized stroke patients were women. The average annual increase in stroke incidence based on ICD-10 ranged from 1.56% (95% CI, 0.14, 2.97) to 2.67% (95% CI, 1.25, 4.09) for different reference populations. In addition, a similar trend was also observed for stroke IR based on WHO-MONICA during the study period for the whole reference population, with an average annual change of 2.5% (95% CI, 1.28, 3.72) to 3.64 % (95% CI, 2.47, 4.82). Conclusion: Given that temporal trends of stroke have increased in both sexes, especially in Iran’s urban areas, prevention programs are needed for public awareness and physician motivation in order to identify risk factors as well as primary and secondary prevention.
{"title":"Temporal trends of stroke incidence over 14 years in Iran: Findings of a large-scale multi-centric hospital-based registry","authors":"Masoumeh Sadeghi, Marjan Jamalian, Fatemeh Nouri, Hamidreza Roohafza, Shahram Oveisegaran, None Marzieh Taheri, Nizal Sarrafzadegan, Habib Rahban","doi":"10.54029/2023ujj","DOIUrl":"https://doi.org/10.54029/2023ujj","url":null,"abstract":"Background: The burden of stroke is high worldwide, especially in low-middle income countries. We aim to explore the temporal trends of the incidence rate (IR) of stroke over 14 years in Iran’s central areas. Methods: Stroke registry as part of cardiovascular disease (CVD) registry in Isfahan that focused on hospitalized patients (≥15 years) with first or recurrent stroke from 2001 to 2015. Factors included date of symptoms, demographics, management, survival at 28 days, date of admission, history of stroke, and other CVD and clinical diagnosis according to Computer Tomography Scan. We calculated age-, sex, and place-of-residence-adjusted IR based on multiple reference populations. Data were analyzed by bootstrap robust zero-truncated negative binomial regression models using R Statistical Software. Results: From 19,174 registered patients with stroke assessed by ICD-10; 18,010 (93.93%) cases were identified based on WHO-MONICA. Approximately 51% of hospitalized stroke patients were women. The average annual increase in stroke incidence based on ICD-10 ranged from 1.56% (95% CI, 0.14, 2.97) to 2.67% (95% CI, 1.25, 4.09) for different reference populations. In addition, a similar trend was also observed for stroke IR based on WHO-MONICA during the study period for the whole reference population, with an average annual change of 2.5% (95% CI, 1.28, 3.72) to 3.64 % (95% CI, 2.47, 4.82). Conclusion: Given that temporal trends of stroke have increased in both sexes, especially in Iran’s urban areas, prevention programs are needed for public awareness and physician motivation in order to identify risk factors as well as primary and secondary prevention.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"6 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637562","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
BETUL TAS, Vasfiye Kabeloglu, Ugur Kacmaz, Ilknur Kivanc Altunay
Background: Psoriasis (PS) has many comorbidities including metabolic-syndrome (MetS) sleep and eating disorders and psychopathologies. Objectives: Investigating the relationship between the presence of MetS and sleep, eating and psychological pathologies in PS-patients through psoriasis quality of life (PSQoL). Methods: In this cross-sectional and descriptive correlation study, besides demographics, MetS-parameters and comorbidities, PS-severity, PS related quality of life (PSQoL), sleep-quality (SQ), depression, anxiety, body image-related QoL (BIQoL), perceived stress, flourishing, social appearance anxiety and eating attitudes of subjects were examined with related scales. Data analyzed using SPSS software, according to two PS groups with and without MetS. Results: Of 107 PS-patients, 68 were diagnosed with MetS. Mean-age and PS-duration were significantly higher in MetS (+) group. PS- severity was correlated with poor PSQoL, anxiety, depression, impairing flourishing, poor overall SQ and impairing in two sleep-subcomponents in MetS (+) group, whereas it was correlated with only poor PSQoL and poor overal SQ in MetS (-) group. Poor PSQoL was correlated with anxiety, depression, poor BIQoL, poor overal SQ and impairing in three sleep-subcomponents in MetS (+) group, whereas no correlation was found between these parameters and PSQoL in MetS(-) group. Conclusions: MetS is seen at high-rate in patients with long-term PS. PS-severity is especially correlated with anxiety, impaired-flourishing, and impaired-SQ in PS-patients with Mets (+). PSQoL appear to be correlated with depression, anxiety, distorted-BI and impaired SQ in these patients. It should be kept in mind that neuropsychological factors may facilitate the development of dysmetabolic events in PS-patients, by impairing PSQoL.
{"title":"Sleep, eating and psychopathologies: Which one(s) may be associated with the development of metabolic syndrome in psoriasis patients through psoriasis quality of life?","authors":"BETUL TAS, Vasfiye Kabeloglu, Ugur Kacmaz, Ilknur Kivanc Altunay","doi":"10.54029/2023taf","DOIUrl":"https://doi.org/10.54029/2023taf","url":null,"abstract":"Background: Psoriasis (PS) has many comorbidities including metabolic-syndrome (MetS) sleep and eating disorders and psychopathologies. Objectives: Investigating the relationship between the presence of MetS and sleep, eating and psychological pathologies in PS-patients through psoriasis quality of life (PSQoL). Methods: In this cross-sectional and descriptive correlation study, besides demographics, MetS-parameters and comorbidities, PS-severity, PS related quality of life (PSQoL), sleep-quality (SQ), depression, anxiety, body image-related QoL (BIQoL), perceived stress, flourishing, social appearance anxiety and eating attitudes of subjects were examined with related scales. Data analyzed using SPSS software, according to two PS groups with and without MetS. Results: Of 107 PS-patients, 68 were diagnosed with MetS. Mean-age and PS-duration were significantly higher in MetS (+) group. PS- severity was correlated with poor PSQoL, anxiety, depression, impairing flourishing, poor overall SQ and impairing in two sleep-subcomponents in MetS (+) group, whereas it was correlated with only poor PSQoL and poor overal SQ in MetS (-) group. Poor PSQoL was correlated with anxiety, depression, poor BIQoL, poor overal SQ and impairing in three sleep-subcomponents in MetS (+) group, whereas no correlation was found between these parameters and PSQoL in MetS(-) group. Conclusions: MetS is seen at high-rate in patients with long-term PS. PS-severity is especially correlated with anxiety, impaired-flourishing, and impaired-SQ in PS-patients with Mets (+). PSQoL appear to be correlated with depression, anxiety, distorted-BI and impaired SQ in these patients. It should be kept in mind that neuropsychological factors may facilitate the development of dysmetabolic events in PS-patients, by impairing PSQoL.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"64 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637779","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
RATHIKA RAJAH, None SHAHRUL AZMIN, None MOHD RIZAL ABDUL MANAF, None Wan Nur Nafisah Wan Yahya
Background & Objectives: Post-stroke pain (PSP) is a common complication that is often overlooked. It leads to depression, impaired quality of life (QoL) and increased economic burden. In this study, we aimed to determine the prevalence and risk factors of PSP in a Malaysian stroke centre. Methods: This is a single-centered, cross-sectional study of 175 post-stroke patients attending the neurology clinic. Their demographic data and clinical variables were collected. They were interviewed using the Brief Pain Inventory (BPI), Geriatric Depression Scale (GDS), Barthel Score (BI) and EuroQol-5D (EQ-5D) questionnaires. Results: The prevalence of PSP was 26.3%, with most of them aged 51-70 years (52.2%). The types of pain included headache (30.4%), pain secondary to spasticity (32.6%), central post-stroke pain (26.1%) and shoulder joint pain (19.6%), in which they first experienced the pain between a week to three months post-index stroke. Our study showed that a high NIHSS, prolonged hospital stay for index stroke, poor modified Rankin Scale (mRS) and no post-discharge rehabilitation increased the probability of developing PSP. This resulted in depression, regression of functional status and poor QoL. There was no correlation between older age, gender, ethnicity, and pre-existing medical conditions with the development of PSP. Conclusion: PSP should be diligently screened and treated in every stroke survivor to improve quality of life.
{"title":"Prevalence and risk factors of post-stroke pain in a Malaysian stroke centre: A cross sectional study","authors":"RATHIKA RAJAH, None SHAHRUL AZMIN, None MOHD RIZAL ABDUL MANAF, None Wan Nur Nafisah Wan Yahya","doi":"10.54029/2023nmp","DOIUrl":"https://doi.org/10.54029/2023nmp","url":null,"abstract":"Background & Objectives: Post-stroke pain (PSP) is a common complication that is often overlooked. It leads to depression, impaired quality of life (QoL) and increased economic burden. In this study, we aimed to determine the prevalence and risk factors of PSP in a Malaysian stroke centre. Methods: This is a single-centered, cross-sectional study of 175 post-stroke patients attending the neurology clinic. Their demographic data and clinical variables were collected. They were interviewed using the Brief Pain Inventory (BPI), Geriatric Depression Scale (GDS), Barthel Score (BI) and EuroQol-5D (EQ-5D) questionnaires. Results: The prevalence of PSP was 26.3%, with most of them aged 51-70 years (52.2%). The types of pain included headache (30.4%), pain secondary to spasticity (32.6%), central post-stroke pain (26.1%) and shoulder joint pain (19.6%), in which they first experienced the pain between a week to three months post-index stroke. Our study showed that a high NIHSS, prolonged hospital stay for index stroke, poor modified Rankin Scale (mRS) and no post-discharge rehabilitation increased the probability of developing PSP. This resulted in depression, regression of functional status and poor QoL. There was no correlation between older age, gender, ethnicity, and pre-existing medical conditions with the development of PSP. Conclusion: PSP should be diligently screened and treated in every stroke survivor to improve quality of life.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"12 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637962","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Health literacy is an important pathway that provides insights into appraise of health information, the ability to search health information, knowledge of caring for the disease and successful practices in health conditions, and also opportunities for effective change in individual health. Health-related quality of life refers to the physical and mental health of an individual or group over time. Both heath literacy and health related quality of life are the priorities of WHO. This study aimed to determine the relationship between health literacy and health-related quality of life among multiple sclerosis (MS) patients, refered to Fars MS society, Shiraz-Iran, a developing country. This is a descriptive- correlational study. Three hundred and nine persons with MS completed two forms: the Multiple Sclerosis and Related Disorders and Multiple Sclerosis Impact Scale validated questionnaires. Health literacy was significantly related to health quality of life in MS patients. The dimensions of health literacy had a significant relationship with health quality of life, and the physical dimension was significantly correlated with health literacy. Among the demographic variables, “source of health information” was most related to heath literacy, and “age” was most related to health quality of life. Thus, holding training classes, communicating with other patients, effective communication with medical staff, using disease-related web facilities, finding correct information in the web environment, and using the facilities of hospital libraries can ensure quality of life of MS patients.
{"title":"What happens to the health-related quality of life of multiple sclerosis patients if they benefit from health literacy related to multiple sclerosis? A cross-sectional study in a developing country","authors":"None Zahra Zeraatkar, None Maryam Kazerani, None Maryam Shekofteh, None Mohammad Reza Bardideh","doi":"10.54029/2023rki","DOIUrl":"https://doi.org/10.54029/2023rki","url":null,"abstract":"Health literacy is an important pathway that provides insights into appraise of health information, the ability to search health information, knowledge of caring for the disease and successful practices in health conditions, and also opportunities for effective change in individual health. Health-related quality of life refers to the physical and mental health of an individual or group over time. Both heath literacy and health related quality of life are the priorities of WHO. This study aimed to determine the relationship between health literacy and health-related quality of life among multiple sclerosis (MS) patients, refered to Fars MS society, Shiraz-Iran, a developing country. This is a descriptive- correlational study. Three hundred and nine persons with MS completed two forms: the Multiple Sclerosis and Related Disorders and Multiple Sclerosis Impact Scale validated questionnaires. Health literacy was significantly related to health quality of life in MS patients. The dimensions of health literacy had a significant relationship with health quality of life, and the physical dimension was significantly correlated with health literacy. Among the demographic variables, “source of health information” was most related to heath literacy, and “age” was most related to health quality of life. Thus, holding training classes, communicating with other patients, effective communication with medical staff, using disease-related web facilities, finding correct information in the web environment, and using the facilities of hospital libraries can ensure quality of life of MS patients.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"744 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637566","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Somdattaa Ray, Vikram V Kamath, Arjun Raju, Tulasi Nayak, Aditya Moorthy, Preeti G Kale, Rohith Gaikwad, Deepak Haldipur, Vishwas Vijaydev, Prithvi S Bachalli, Madhusudan H V, Praveen K S, Arun M A, Prahlad S T, Dhanraj Gangolli
Background: This study aims to describe the clinical and imaging spectrum of neurological involvement in rhino-orbital cerebral mucormycosis (ROCM) following COVID. In this observational study, all patients with confirmed COVID associated mucormycosis were recruited. Consecutive patients with neurological signs and symptoms or patients with evidence of neurological involvement based on imaging were evaluated. MRI of brain and paranasal sinuses were done in 3T MRI scanner and evaluated by a radiologist. Results: A total of 182 patients were recruited into the study out of which 72 (39.56%) patients had neurological involvement. The mean age of the patients was 50.31±11.06 (Range: 33-83) years. A male preponderance was noted with 56 (74.67%) patients being male. The commonest symptom reported was unilateral vision impairment and periorbital swelling. Patients were noted to have both fulminant and indolent course of illness. Clinical evidence of neurological and orbital involvement was observed in 33 and 55 patients, respectively. Meningeal involvement (50%) was the commonest imaging finding noted in our study. Other common findings noted were skull- based osteomyelitis (44.44%), cavernous sinus thrombosis (29.17%), intracranial abscess (27.78%), cerebritis (22.22%), infarcts (33.33%), neuritis and intracranial haemorrhage (2.78%). Conclusion: This study reports one of the largest single centre cohorts with neurological findings in COVID associated mucormycosis. COVID associated mucormycosis can present with plethora of neurological manifestations in imaging, such as infarct, intracranial and extracranial abscess, neuritis and nerve abscess, sinus thrombosis that may or may not be accompanied by focal neurological deficit corresponding to the anatomical involvement.
{"title":"Spectrum of neurological involvement in mucormycosis following COVID 19: A single tertiary centre study","authors":"Somdattaa Ray, Vikram V Kamath, Arjun Raju, Tulasi Nayak, Aditya Moorthy, Preeti G Kale, Rohith Gaikwad, Deepak Haldipur, Vishwas Vijaydev, Prithvi S Bachalli, Madhusudan H V, Praveen K S, Arun M A, Prahlad S T, Dhanraj Gangolli","doi":"10.54029/2023kfj","DOIUrl":"https://doi.org/10.54029/2023kfj","url":null,"abstract":"Background: This study aims to describe the clinical and imaging spectrum of neurological involvement in rhino-orbital cerebral mucormycosis (ROCM) following COVID. In this observational study, all patients with confirmed COVID associated mucormycosis were recruited. Consecutive patients with neurological signs and symptoms or patients with evidence of neurological involvement based on imaging were evaluated. MRI of brain and paranasal sinuses were done in 3T MRI scanner and evaluated by a radiologist. Results: A total of 182 patients were recruited into the study out of which 72 (39.56%) patients had neurological involvement. The mean age of the patients was 50.31±11.06 (Range: 33-83) years. A male preponderance was noted with 56 (74.67%) patients being male. The commonest symptom reported was unilateral vision impairment and periorbital swelling. Patients were noted to have both fulminant and indolent course of illness. Clinical evidence of neurological and orbital involvement was observed in 33 and 55 patients, respectively. Meningeal involvement (50%) was the commonest imaging finding noted in our study. Other common findings noted were skull- based osteomyelitis (44.44%), cavernous sinus thrombosis (29.17%), intracranial abscess (27.78%), cerebritis (22.22%), infarcts (33.33%), neuritis and intracranial haemorrhage (2.78%). Conclusion: This study reports one of the largest single centre cohorts with neurological findings in COVID associated mucormycosis. COVID associated mucormycosis can present with plethora of neurological manifestations in imaging, such as infarct, intracranial and extracranial abscess, neuritis and nerve abscess, sinus thrombosis that may or may not be accompanied by focal neurological deficit corresponding to the anatomical involvement.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"59 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637777","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Methanol intoxication is rare in developed countries. Early identification and elimination of the methanol metabolites are vital to an optimal prognosis. A characteristic brain imaging finding is bilateral basal ganglia necrosis and subcortical white matter changes. Here, we report a rare neuroradiological feature called the lentiform fork sign in a patient with methanol intoxication who survived the acute poisoning stage. We report a 31-year-old woman who presented to the emergency department with acute-onset incoherent speech, consciousness disturbance, and a high-anion-gap metabolic acidosis caused by methanol intoxication. She was treated with antidote administration of fomepizole and enhanced methanol elimination through hemodialysis. Neurological sequelae of cognitive decline and parkinsonism developed, with preserved vision. Brain MRI showed bilateral putaminal necrosis and subcortical white matter changes. The apparent diffusion coefficient map showed low signal intensities in the putamen and globus pallidus bilaterally, with brightly hyperintense rims surrounding both putamina that resembled a fork, indicating a lentiform fork sign. She then had sequelae of cognitive decline and delayed parkinsonism feature, which are compatible with the brain lesions on neuroimage studies. Methanol poisoning is an uncommon life-threatening event, and neurological sequelae result from the accumulation of formic acid, a methanol metabolite that inhibits cytochrome c oxidase in mitochondria, leading to neuronal injury. Methanol intoxication should be considered in patients with imaging findings of bilateral basal ganglia necrosis with lentiform fork sign and a metabolic acidosis of unknown origin.
{"title":"A rare lentiform fork sign in a patient with methanol intoxication with neurological sequelae of parkinsonism and cognitive dysfunction: A case report and literature review","authors":"Bo-Xuan Huang, Chin-Hsien Lin","doi":"10.54029/2023uua","DOIUrl":"https://doi.org/10.54029/2023uua","url":null,"abstract":"Methanol intoxication is rare in developed countries. Early identification and elimination of the methanol metabolites are vital to an optimal prognosis. A characteristic brain imaging finding is bilateral basal ganglia necrosis and subcortical white matter changes. Here, we report a rare neuroradiological feature called the lentiform fork sign in a patient with methanol intoxication who survived the acute poisoning stage. We report a 31-year-old woman who presented to the emergency department with acute-onset incoherent speech, consciousness disturbance, and a high-anion-gap metabolic acidosis caused by methanol intoxication. She was treated with antidote administration of fomepizole and enhanced methanol elimination through hemodialysis. Neurological sequelae of cognitive decline and parkinsonism developed, with preserved vision. Brain MRI showed bilateral putaminal necrosis and subcortical white matter changes. The apparent diffusion coefficient map showed low signal intensities in the putamen and globus pallidus bilaterally, with brightly hyperintense rims surrounding both putamina that resembled a fork, indicating a lentiform fork sign. She then had sequelae of cognitive decline and delayed parkinsonism feature, which are compatible with the brain lesions on neuroimage studies. Methanol poisoning is an uncommon life-threatening event, and neurological sequelae result from the accumulation of formic acid, a methanol metabolite that inhibits cytochrome c oxidase in mitochondria, leading to neuronal injury. Methanol intoxication should be considered in patients with imaging findings of bilateral basal ganglia necrosis with lentiform fork sign and a metabolic acidosis of unknown origin.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"65 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637949","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
MARK ERVING H RAMOS, Steven G Villaraza, Criscely L Go, Romulo Urgel Esagunde, Jose C Navarro
Background: Decompressive hemicraniectomy (DHC) is a surgical procedure in which a substantial piece of the cranium is removed to reduce intracranial pressure. DHC improves mortality. Although the surgical procedure may be lifesaving, many survivors suffer from a severe neurological impairment, which the patients and primary caregivers have to deal with afterward. This study’s purpose is to understand better the primary caregiver’s perception regarding the burden of the outcome of DHC. Methods: This was a descriptive, prospective study that included all primary caregivers of patients who had previously undergone DHC between the years 2019 to 2022 at Jose R. Reyes Memorial Medical Center. A total of 48 primary caregivers were included in the study. Results: Most primary caregivers have adequate knowledge of the pros and cons of the surgery, but few individuals demonstrated insufficient knowledge. Moreover, the primary caregivers also acknowledged the reality of the patient’s surgery, including the demand for the caregiver’s time and other negative effects. Conclusion: There is still a need to comprehensively orient the patient’s primary caregivers on the benefits and risks of DHC to ensure they know what to expect prior to the surgery. Also, fear of the negative outcomes of the surgery, family concerns, and finances were the main hindrances why other primary caregivers may opt out of the surgery.
背景:减压半颅切除术(DHC)是一种外科手术，切除颅骨的大部分以降低颅内压。DHC可提高死亡率。尽管手术可能会挽救生命，但许多幸存者会遭受严重的神经损伤，这是患者和主要护理人员事后必须处理的问题。本研究的目的是更好地了解主要照顾者对DHC结果负担的看法。方法:这是一项描述性前瞻性研究，纳入了2019年至2022年期间在Jose R. Reyes Memorial Medical Center接受过DHC的患者的所有主要护理人员。共有48名主要照顾者被纳入研究。结果:大多数初级护理人员对手术的利弊有足够的了解，但很少有人表现出知识不足。此外，主要护理人员也承认患者手术的现实，包括对护理人员时间的需求和其他负面影响。结论:仍有必要全面指导患者的主要护理人员DHC的益处和风险，以确保他们在手术前了解预期的情况。此外，对手术负面结果的恐惧、家庭担忧和经济状况是其他主要护理人员可能选择退出手术的主要障碍。
{"title":"Knowledge, and attitudes of patient’s primary caregiver towards decompressive hemicraniectomy","authors":"MARK ERVING H RAMOS, Steven G Villaraza, Criscely L Go, Romulo Urgel Esagunde, Jose C Navarro","doi":"10.54029/2023mii","DOIUrl":"https://doi.org/10.54029/2023mii","url":null,"abstract":"Background: Decompressive hemicraniectomy (DHC) is a surgical procedure in which a substantial piece of the cranium is removed to reduce intracranial pressure. DHC improves mortality. Although the surgical procedure may be lifesaving, many survivors suffer from a severe neurological impairment, which the patients and primary caregivers have to deal with afterward. This study’s purpose is to understand better the primary caregiver’s perception regarding the burden of the outcome of DHC. Methods: This was a descriptive, prospective study that included all primary caregivers of patients who had previously undergone DHC between the years 2019 to 2022 at Jose R. Reyes Memorial Medical Center. A total of 48 primary caregivers were included in the study. Results: Most primary caregivers have adequate knowledge of the pros and cons of the surgery, but few individuals demonstrated insufficient knowledge. Moreover, the primary caregivers also acknowledged the reality of the patient’s surgery, including the demand for the caregiver’s time and other negative effects. Conclusion: There is still a need to comprehensively orient the patient’s primary caregivers on the benefits and risks of DHC to ensure they know what to expect prior to the surgery. Also, fear of the negative outcomes of the surgery, family concerns, and finances were the main hindrances why other primary caregivers may opt out of the surgery.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"31 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637954","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background: Endothelin-1 (ET-1) is a potent vasoconstrictor substance mainly secreted by endothelial cells. Increased ET-1 levels in plasma or cerebrospinal fluid (CSF) have been identified in multiple sclerosis (MS). We aimed to analyze tear ET-1 levels; visual evoked potential (VEP) and disability scores in patients with MS and in healthy controls. Methods: Adult patients (18-65 year-old) diagnosed with MS according to the McDonald criteria, and healthy controls were recruited for the study. Demographic features, VEP, and tear ET-1 levels were evaluated. Disability in the MS group was assessed and grouped by EDSS score (<3 vs. ≥3). The EDSS score in healthy controls was zero. Results: Both in the total number of patients overall and in the patients with EDSS score <3, tear ET-1 levels were higher in the MS group than that in the controls (p<0.001). In the MS group, the ET-1 level was higher in the patients with EDSS score ≥3 than in those with EDSS score <3 (p<0.001). The tear ET-1 level was positively correlated with age and EDSS score in the MS group (p<0.001). Conclusion: To the best of our knowledge, there is no study in the literature that measures tear ET-1 levels in MS and examines their relationship with EDSS score and VEP. Higher tear ET-1 levels seem to be associated with disability and abnormal VEP in MS. Tear ET-1 measurement may be a simple new noninvasive marker indicating the disability in the patients with MS in the future.
{"title":"Could tear endothelin-1 levels be associated with disability in multiple sclerosis?","authors":"None Mustafa çam, Hilal Sehitoglu","doi":"10.54029/2023itk","DOIUrl":"https://doi.org/10.54029/2023itk","url":null,"abstract":"Background: Endothelin-1 (ET-1) is a potent vasoconstrictor substance mainly secreted by endothelial cells. Increased ET-1 levels in plasma or cerebrospinal fluid (CSF) have been identified in multiple sclerosis (MS). We aimed to analyze tear ET-1 levels; visual evoked potential (VEP) and disability scores in patients with MS and in healthy controls. Methods: Adult patients (18-65 year-old) diagnosed with MS according to the McDonald criteria, and healthy controls were recruited for the study. Demographic features, VEP, and tear ET-1 levels were evaluated. Disability in the MS group was assessed and grouped by EDSS score (<3 vs. ≥3). The EDSS score in healthy controls was zero. Results: Both in the total number of patients overall and in the patients with EDSS score <3, tear ET-1 levels were higher in the MS group than that in the controls (p<0.001). In the MS group, the ET-1 level was higher in the patients with EDSS score ≥3 than in those with EDSS score <3 (p<0.001). The tear ET-1 level was positively correlated with age and EDSS score in the MS group (p<0.001). Conclusion: To the best of our knowledge, there is no study in the literature that measures tear ET-1 levels in MS and examines their relationship with EDSS score and VEP. Higher tear ET-1 levels seem to be associated with disability and abnormal VEP in MS. Tear ET-1 measurement may be a simple new noninvasive marker indicating the disability in the patients with MS in the future.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"127 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135638081","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Athena Sharifi-Razavi, Amir Moghadam Ahmadi, Nasim Tabrizi, Razieh Daz
Background & Objectives: The risk of recurrence after a transient ischemic attack (TIA) or minor stroke is high especially within three months after first event. The aim of study is assessing the efficacy of ticagrelor plus aspirin in reduction of mild non-cardioembolic ischemic stroke or high risk TIA recurrence during first 3 months. Methods: This is a randomized, controlled, active comparator arm, outcome assessor blind, parallel group, feasibility study design on 90 patients with diagnosis of non-cardioembolic minor ischemic stroke or high risk TIA admitted in Bou-Ali Sina Hospital, Sari, Iran. After meeting all inclusion and exclusion criteria, patients will be randomized to ticagrelor 90 mg BID plus aspirin (ASA) 80 mg daily or clopidogrel 75 mg daily plus ASA 80 mg daily (1:1 ratio) until 21 days and then ASA 80 mg daily. Participants will be visited at month one and three. Any adverse events, serious side effects and outcome events will be recorded. The primary outcome is defined as ischemic stroke recurrence. Conclusion: Ticagrelor plus ASA is expected to be effective for prevention of recurrence in mild non-cardioembolic stroke and high risk TIA. Trial Registration: ClinicalTrials.gov: NCT04738097
{"title":"Ticagrelor plus aspirin vs clopidogrel plus aspirin in mild non-cardioembolic ischemic stroke: A protocol of a randomized, controlled, active comparator arm, outcome assessor blind, feasibility study","authors":"Athena Sharifi-Razavi, Amir Moghadam Ahmadi, Nasim Tabrizi, Razieh Daz","doi":"10.54029/2023tkz","DOIUrl":"https://doi.org/10.54029/2023tkz","url":null,"abstract":"Background & Objectives: The risk of recurrence after a transient ischemic attack (TIA) or minor stroke is high especially within three months after first event. The aim of study is assessing the efficacy of ticagrelor plus aspirin in reduction of mild non-cardioembolic ischemic stroke or high risk TIA recurrence during first 3 months. Methods: This is a randomized, controlled, active comparator arm, outcome assessor blind, parallel group, feasibility study design on 90 patients with diagnosis of non-cardioembolic minor ischemic stroke or high risk TIA admitted in Bou-Ali Sina Hospital, Sari, Iran. After meeting all inclusion and exclusion criteria, patients will be randomized to ticagrelor 90 mg BID plus aspirin (ASA) 80 mg daily or clopidogrel 75 mg daily plus ASA 80 mg daily (1:1 ratio) until 21 days and then ASA 80 mg daily. Participants will be visited at month one and three. Any adverse events, serious side effects and outcome events will be recorded. The primary outcome is defined as ischemic stroke recurrence. Conclusion: Ticagrelor plus ASA is expected to be effective for prevention of recurrence in mild non-cardioembolic stroke and high risk TIA. Trial Registration: ClinicalTrials.gov: NCT04738097","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"44 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637770","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Objective: This study aims to evaluate the effects of C-reactive protein (CRP), albümin, mean platelet volume (MPV) values and neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLO), MPV/PLT ratio, CRP / Albumin ratios on seizure type and seizure control in epilepsy patients who are refractory or non-refractory to treatments. Methods: The study comprised 43 refractory epilepsy, 64 well-controlled epilepsy patients and control group including 68 healthy individuals. Mean platelet volume (MPV), platelet, CRP, and albumin values of the patients were studied. CRP / albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLO), and the MPV/ PLT ratio were determined. Results: The mean serum CRP and CAO were found to be significantly higher in refractory epilepsy patients compared to well-controlled epilepsy patients and healthy control groups, while MPV and albumin levels were found to be significantly lower. Conclusions: Serum CRP and CAO were found to be significantly higher in refractory epilepsy patients compared to well-controlled epilepsy patients and healthy control groups, while MPV and albumin levels were found to be significantly lower. In addition, this inflammatory activity increases as the frequency of seizures increases and the duration of the disease increases. These findings suggest that increased inflammatory response may affect the patient’s prognosis. In light of these findings, we think new treatment strategies that control the inflammatory response are necessary for patients with refractory epilepsy.
{"title":"The evaluation of the inflammatory parameters in the patients with controlled epilepsy versus the patients with resistant epilepsy","authors":"Tülin Gesoglu Demir, Ozlem Ethemoglu, Dilek Agırcan","doi":"10.54029/2023aej","DOIUrl":"https://doi.org/10.54029/2023aej","url":null,"abstract":"Objective: This study aims to evaluate the effects of C-reactive protein (CRP), albümin, mean platelet volume (MPV) values and neutrophil-lymphocyte ratio (NLR), platelet-lymphocyte ratio (PLO), MPV/PLT ratio, CRP / Albumin ratios on seizure type and seizure control in epilepsy patients who are refractory or non-refractory to treatments. Methods: The study comprised 43 refractory epilepsy, 64 well-controlled epilepsy patients and control group including 68 healthy individuals. Mean platelet volume (MPV), platelet, CRP, and albumin values of the patients were studied. CRP / albumin ratio (CAR), neutrophil to lymphocyte ratio (NLR), platelet to lymphocyte ratio (PLO), and the MPV/ PLT ratio were determined. Results: The mean serum CRP and CAO were found to be significantly higher in refractory epilepsy patients compared to well-controlled epilepsy patients and healthy control groups, while MPV and albumin levels were found to be significantly lower. Conclusions: Serum CRP and CAO were found to be significantly higher in refractory epilepsy patients compared to well-controlled epilepsy patients and healthy control groups, while MPV and albumin levels were found to be significantly lower. In addition, this inflammatory activity increases as the frequency of seizures increases and the duration of the disease increases. These findings suggest that increased inflammatory response may affect the patient’s prognosis. In light of these findings, we think new treatment strategies that control the inflammatory response are necessary for patients with refractory epilepsy.","PeriodicalId":49757,"journal":{"name":"Neurology Asia","volume":"45 1","pages":"0"},"PeriodicalIF":0.0,"publicationDate":"2023-09-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"135637776","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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