19 research outputs found
sj-pdf-1-eso-10.1177_23969873211060819 – Supplemental Material for Micro-embolic signal monitoring in stroke subtypes: A systematic review and meta-analysis of 58 studies
No full textSupplemental Material, sj-pdf-1-eso-10.1177_23969873211060819 for Micro-embolic signal monitoring in stroke subtypes: A systematic review and meta-analysis of 58 studies by Pachipala Sudheer, Shubham Misra, Manabesh Nath, Pradeep Kumar, Deepti Vibha, M.V.Padma Srivatsava, Manjari Tripathia, Rohit Bhatia, Awadh Kishor Pandit and Rajesh K Singh in European Stroke Journal</p
Autologous hematopoietic stem cell transplantation in progressive severe multiple sclerosis
No full textMultiple sclerosis (MS) is a chronic inflammatory disease of central nervous system (CNS), which is disabling and majorly involves younger population. Various available treatments in forms of immunomodulation are not very effective; however, stem cell transplantation seems to be promising in recent literature. The current case report is a novel evidence for autologous hematopoietic stem cell transplantation (HSCT) in progressive MS. Case Summary: A 33 year old male with secondary progressive MS (SPMS), after being failed and/or intolerance to standard approved interferon (IFN) and mitoxantrone therapy, autologous HSCT was administered. At 2years of post-stem cell transplantation follow-up, he has remained stable with some improvement in functional status (Expanded Disability Status Scale (EDSS) reduced by 1.5), with no relapse, no treatment related complications, and no fresh magnetic resonance imaging (MRI) lesions. Conclusion: Autologous stem cell transplantation may be beneficial in progressive forms of MS, but needs to be tested in well-designed randomized trial
Autoimmune encephalitis: A potentially reversible cause of status epilepticus, epilepsy, and cognitive decline
No full textObjectives: To review clinical characteristics and response to immunomodulation therapy in autoimmune encephalitis presenting with status epilepticus (SE), epilepsy, and cognitive decline. Design: Observational, prospective case series. Setting: All India Institute of Medical Sciences, New Delhi, India. Materials and Methods: Prospective analysis of 15 patients, who presented with SE, epilepsy, cognitive decline, and other neurological symptoms with positive autoantibodies. Demographic and clinical characteristics were recorded. Brain magnetic resonance imaging (MRI), cerebrospinal-fluid analysis (CSF), and tumor screening were done periodically. Treatment received and responses (categorized as per patients and treating doctor′s information) were noted. Results: There were 15 (males = 10) patients of autoimmune encephalitis. The mean age of presentation was 24 years (range: 2-64 years). The most common onset was subacute (64%) and four (29%) patients presented as SE. Predominant clinical presentations were seizures (100%) almost of every semiology. CSF was done in 10 patients; it was normal in 60%. Brain MRI was done in all patients, in six (40%) it was normal, six (40%) showed T2W and FLAIR hyperintensities in bilateral limbic areas. Antibodies found were the N-methyl-D-aspartate receptor antibody in seven (50%), voltage-gated potassium channel antibody in five (36%), two of antiglutamic acid decarboxylase, and one patient with double stranded DNA (dsDNA) antibodies. None showed evidence of malignancy. Patients received immunotherapy, either steroids, intravenous immunoglobulin, or both. Follow-up showed significant improvement in majority of cases, neither further seizures nor relapse in nine (67%) cases. One death occurred, due to delayed presentation. Conclusions: Uncommon but potentially reversible causes of SE, epilepsy, and cognitive decline may be immune-related and high index of suspicion will prevent missing the diagnosis
Complementary and alternative medicine in Indian Parkinson's disease patients
No full textAbstractUse of complementary and alternative medicine (CAM; 補充與替代醫學 bǔ chōng yǔ tì dài yī xué) in Parkinson disease (PD) ranged 40–70%. The objective of this study was to determine the frequency, types and factors associated with the use of CAM in Indian PD patients. PD patients, fulfilling UKPD-Society brain-bank diagnostic-criteria, attending Movement-disorders clinic of a tertiary-care teaching hospital in India from 1st May to 15th December 2012 were enrolled. Information on socio-demographic, clinical data and treatment along with factors (source of information, benefits, harms, reason for use and cost) associated with CAM use were recorded. Out of 233 consecutive PD patients, 106 (46%) used CAM. Mean ± SD age of CAM users was 56 ± 11.2 years. Among CAM users, 72% were males, with mean age-onset 49 ± 11.16 years (P = 0.042) and 73% receiving levodopa therapy (p = 0.006). Longer duration PD, higher education (graduates and above), urban residence, and fairly good perceived health were other factors seen among CAM users. Reasons for using CAM were ‘feel good factor’ (73%), 9% took CAM due to side effects from allopathic-medicines. Commonly used CAM were Ayurvedic, homeopathic medicines, and acupuncture (針灸 zhēn jiǔ) [74/106 (70%)]. Median CAM cost in Indian Rupees (INR) was 1000/month (USD16, range: 0-400USD/month in year 2012). Almost half of PD patients use CAM. Three-quarters of Indian CAM using PD patients believe that CAM is harmless, using it at a substantial cost. CAM-users are educated, young, urban dwellers, longer duration PD and receiving levodopa. Commonly used CAM was Ayurvedic, Homeopathic medicines and acupuncture
Review Paper: Association of Transforming Growth Factor Beta-1 -509C/T Gene Polymorphism with Ischemic Stroke: A Meta Analysis
No full textIntroduction: Transforming Growth Factor-Beta 1 (TGF-β1) is a pleiotropic cytokine with
potent anti-inflammatory property, which has been considered as an essential risk factor in the
inflammatory process of Ischemic Stroke (IS), by involving in the pathophysiological progression
of hypertension, atherosclerosis, and lipid metabolisms. -509C/T TGF-β1 gene polymorphism
has been found to be associated with the risk of IS. The aim of this meta-analysis was to provide
a relatively comprehensive account of the relation between -509C/T gene polymorphisms of
TGF-β1 and susceptibility to IS.
Methods: A review of literature for eligible genetic association Studies published before October
20, 2014 was conducted in the PubMed, EMBASE, Google Scholar and Trip database. The
strength of association was calculated by pooled odds ratios (ORs) with 95% confidence intervals
using RevMan 5.3 software. Heterogeneity was examined using Higgins I-squared, Tau-squared,
and Chi-squared tests.
Results: A total of 2 studies involving 614 cases and 617 controls were found. The overall
estimates did not show any significant relation between TGF-β1-509C/T polymorphism and risk
of IS under dominant (CC+CT vs. TT: OR=1.01, 95%CI=0.31 to 3.26; P=0.99), recessive (CC
vs. CT+TT: OR=0.94, 95%CI=0.47 to 1.90; P=0.87), and allelic models (T vs. C: OR=1.06,
95%CI=0.55 to 2.04; P=0.86).
Conclusion: This meta-analysis showed that TGF-β1-509C/T gene polymorphism has no
significant association with the susceptibility of IS. Further well-designed prospective studies
with larger sample size are needed to confirm these findings
Pramipexole-induced syndrome of inappropriate antidiuretic hormone secretion in a patient with young-onset Parkinson’s disease
No full textPramipexole, a dopaminergic agonist, has rarely been implicated as a cause of hyponatremia in patients with Parkinson’s disease (PD). Pramipexole-induced stimulation of anti-diuretic hormone results in euvolemic hyponatremia. This is often neglected, and hyponatremia may lead to worsening of the motor symptoms with PD and an unnecessary increase in dopaminergic medications, causing disabling dyskinesias. This case report describes a patient with young-onset PD who developed newonset hyponatremia due to pramipexole-induced syndrome of inappropriate anti-diuretic hormone within 3 months of starting the drug
Palatal Tremor, Periocular and Perioral Myokymia, and Pseudoathetosis in a Patient with Whipple’s Disease
No full textLoss of Ambulation Due to Calcific Myonecrosis: A Rare but Reversible Complication of Wilson’s Disease
No full textWe report two cases of established Wilson’s disease (WD) presenting with calcific myonecrosis of the pelvic girdle in association with pelvic fractures. Despite initial improvement with chelation, subacute worsening of ambulation in both led to a consideration of neurologic deterioration on chelation therapy. However, evaluation revealed calcific myonecrosis of the hip joint and adjacent muscles as the cause. Both patients improved with intensive rehabilitation. A review of literature indicates that although osseomuscular complications are reported in WD, calcific myonecrosis is a hitherto unknown entity which, if recognized early, may be reversed, preventing disability and unnecessary change in chelation regimens
Atypical Parkinsonism with Positive Anti-amphiphysin Antibodies: Expanding the Phenotypic Spectrum
No full textIs There a Difference in Autonomic Dysfunction Between Multiple System Atrophy Subtypes?
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