Neurology India最新文献

{"title":"Assessment of the Economic Burden of Specific Learning Disability by Estimating the Direct, Indirect, and Intangible Costs: A Low- and Middle-Income Country Perspective.","authors":"Prateek K Panda, Aparna Ramachandran, Ajeet S Bhadoria, Indar K Sharawat","doi":"10.4103/ni.ni_805_22","DOIUrl":"10.4103/ni.ni_805_22","url":null,"abstract":"<p><strong>Introduction: </strong>The economic burden of specific learning disability (SLD) in the Indian setting is high, but a few studies have been done in this regard.</p><p><strong>Methods: </strong>This cross-sectional questionnaire-based descriptive cost of illness study was conducted in the pediatric neurocognitive clinic at a premier teaching hospital in North India between January and December 2021 to determine the economic burden of SLD by estimating the direct, indirect, and intangible costs related to this illness from the perspectives of afflicted families, health care providers, and society and to assess the impact of demographic and clinical variables on the economic burden. A \"person-based\" \"bottom-up\" approach for estimating costs from the perspective of the \"afflicted families\" was followed. A pre-designed structured questionnaire, while interviewing the parent/guardian of SLD patients, to collect data related to cost of treatment for SLD in their child under three types of expenses was used. The contingent valuation technique was used to document the willingness-to-pay value for estimating intangible cost data.</p><p><strong>Results: </strong>A total of 162 SLD patients (64% boys, 107 newly diagnosed, and 55 diagnosed in previous years and under regular follow-up) were enrolled. From the perspectives of afflicted families, the direct, indirect, total, and intangible costs were estimated to be INR 2,618,030, 14,525,180, 17,143,210, and 30,658,470, respectively (median 16,878, 89,771, 104,689, and 200,000). The \"average annual total costs of SLD\" were estimated to be INR 11,213,710 (the average annual cost per student was INR 69,220). Expenditure availed on special educators and tuition teachers constituted 64.5% and 54.3% of the direct and indirect costs, respectively. Both socio-economic status (P = 0.001, 0.002, 0.006) and duration of poor scholastic performance (P = 0.01, 0.02, and 0.04) were significant predictors of \"direct costs\", \"indirect costs\", and \"total costs\" for SLD. But only socio-economic status was a significant predictor of \"intangible costs\" (P = 0.009) and co-morbid psychiatric illness was a significant predictor only for \"direct costs\" (P = 0.03).</p><p><strong>Conclusion: </strong>The economic burden of SLD is huge, and most cases are diagnosed/referred late. There is an urgent need for Government-initiated SLD-specific programs to avail affordable remedial education for SLD-afflicted children in schools and create more skilled personnel in schools and hospitals, who can screen these children early and counsel parents to avoid wasteful expenditure.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"298-305"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772912","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Anaesthetic Management of a Patient with Heterotaxy Syndrome for Emergency Mechanical Thrombectomy.","authors":"Soumya Madhusudhan, Manikandan Sethuraman, Smita Vimala","doi":"10.4103/neurol-india.Neurol-India-D-24-00401","DOIUrl":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00401","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"358-360"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772902","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diagnostic Crossroads: Coexistence of Myotonic Dystrophy Type 1 and Hirayama Disease in a Case Report.","authors":"Ashutosh V Dudhatra, Ronak K Arora, Fali F Poncha","doi":"10.4103/neurol-india.Neurol-India-D-24-00566","DOIUrl":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00566","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"368-370"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772753","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Novel Compound Heterozygous Mutation on MYORG Gene in a Chinese Patient with Primary Familial Brain Calcification.","authors":"Jixiang Lin, Yanfei Wang, Xiang Gao, Xiaomin Liu","doi":"10.4103/neurol-india.Neurol-India-D-24-00551","DOIUrl":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00551","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"365-367"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772829","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Giant Extra-Axial Cerebellopontine Angle Ependymoma with Sub-Axial Cervical Extension: A Unique Subtype of Infratentorial Ependymoma.","authors":"Jigish Ruparelia, Jaskaran Singh Gosal, Mayank Garg, Suryanarayanan Bhaskar, Deepak Kumar Jha, Poonam Elhence","doi":"10.4103/neuroindia.NI_53_20","DOIUrl":"https://doi.org/10.4103/neuroindia.NI_53_20","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"389-392"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772821","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Are We Enough Cautious Regarding Blood Pressure Management in Older Adults as a Stroke Preventive Measure?","authors":"Debabrata Chakraborty","doi":"10.4103/neurol-india.Neurol-India-D-24-00568","DOIUrl":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00568","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"356-357"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772910","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"VPS51-Related Disorder in a Toddler: A Novel Golgipathy.","authors":"Singanamalla Bhanudeep, Bramhini Bhargavi Koneti","doi":"10.4103/neurol-india.Neurol-India-D-24-00743","DOIUrl":"https://doi.org/10.4103/neurol-india.Neurol-India-D-24-00743","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"402-403"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772957","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Unique Challenge of Saving Two Lives in Pregnancy with Severe Traumatic Brain Injury: A Narrative Review.","authors":"Archana Kamble, Ninad Sawant, Anjali Chandra, Pooja Sharma Dimri, Kokkula Praneeth, Shivanand Gamanagatti, Shashank Kale, Deepak Gupta","doi":"10.4103/neurol-india.Neurol-India-D-23-00467","DOIUrl":"10.4103/neurol-india.Neurol-India-D-23-00467","url":null,"abstract":"<p><p>A pregnant patient is a body with two lives. Saving the mother and baby after severe head injuries during pregnancy requires intensive monitoring and multidisciplinary team based management. There are many neurosurgical challenges in cases of pregnancy with severe traumatic brain injury (TBI) during pregnancy and the postpartum period due to changes in physiological and anatomical changes due to pregnancy. The strategy to treat post traumatic hydrocephalus using a ventriculoperitoneal shunt is also risky as it tends to malfunction due to a gravid uterus. The challenges and issues faced by the multidisciplinary team of the level I apex trauma center while managing pregnancy complicated by severe TBI and its consequences, like a threat to continue of pregnancy, post traumatic hydrocephalus, anesthesia management if there is requirement of surgery, and perioperative management, are discussed in this review based on available literature. A \"one size fits all\" approach is slowly being replaced by individualized approaches in children and pregnant women. This is affected by novel diagnostics, advanced monitoring, and multispeciality teams in dedicated trauma centers.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"215-221"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772952","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"(Un)Common Carotid Trifurcation.","authors":"Mukesh Kumar, Amith Kumar, Chirag Kamal Ahuja, Dheeraj Khurana","doi":"10.4103/neuroindia.NI_370_19","DOIUrl":"10.4103/neuroindia.NI_370_19","url":null,"abstract":"<p><p>Variations in the position of the bifurcation of the common carotid artery (CCA) and the origin or branching pattern of the external carotid artery are uncommon. Variations in transformation of the embryonic aortic arch system are the genesis of these variations. A 70-year-old female presented with history of sudden onset dizziness followed by right hemiparesis showed a trifurcation of CCA on carotid duplex ultrasound (CDU) scan. Computed tomography angiography (CTA) of the extracranial neck vessels confirmed our sonological findings and it was determined that the third vessel originating from the CCA was an aberrant superior thyroid artery (STA). Knowledge of variant terminations of the CCA is important to prevent inadvertent vascular injury during radical neck dissection, cervical discectomy, and carotid artery catheterization and a CDU is a prudent screening tool for the same.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"349-351"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772794","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Effect of Dexmedetomidine on Dynamic Cerebral Autoregulation in Patients Undergoing Supratentorial Tumor Surgery.","authors":"Ritesh Lamsal, Girija P Rath, Surya K Dube, Hirok Roy, Shashwat Mishra","doi":"10.4103/neurol-india.Neurol-India-D-24-00131","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00131","url":null,"abstract":"<p><strong>Background: </strong>Dexmedetomidine is gaining popularity in neuroanesthesia, but its effect on cerebral autoregulation (CA) is unclear. It is important to maintain CA in patients undergoing surgery for intracranial lesions. Previous studies have not examined the effect of dexmedetomidine on CA in anesthetized patients who have pre-existing intracranial pathology.</p><p><strong>Objective: </strong>The study was done to assess the effect of dexmedetomidine on dynamic CA (dCA) in patients with supratentorial tumors under sevoflurane anesthesia.</p><p><strong>Methods and material: </strong>Forty American Society of Anesthesiologists physical status 1 and 2 patients with supratentorial tumors were randomized to receive either a bolus of dexmedetomidine (1 µg/kg over 10 min) or a matching placebo. The middle cerebral artery (MCA) was insonated using a handheld transcranial Doppler probe and used to calculate the transient hyperemic response ratio, which is the surrogate measure of dCA. This test was repeated before and after administration of the test drug. Variables that can influence dCA like end-tidal carbon dioxide, blood pressure, and depth of anesthesia were tightly controlled throughout the conduct of Doppler studies.</p><p><strong>Results and conclusion: </strong>The MCA flow velocity was comparable in both groups after administration of the test drug (58.05 ± 7.41 cm/s vs 59.95 ± 8.99 cm/s, P = 0.47). The transient hyperemic response ratio was also similar (1.30 ± 0.11 vs. 1.26 ± 0.07, P = 0.22). In anesthetized patients with supratentorial tumors, a bolus dose of dexmedetomidine does not affect dCA.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":"73 2","pages":"280-285"},"PeriodicalIF":0.9,"publicationDate":"2025-03-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143772813","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}