Neurology India最新文献

{"title":"Sleep in Myasthenia Gravis: A Questionnaire-Based Study.","authors":"Rakesh Kumar, Chetan Nayak, Madhu Nagappa, Shivaji Rao, Sanjib Sinha, Arun B Taly","doi":"10.4103/neurol-india.NI_562_17","DOIUrl":"https://doi.org/10.4103/neurol-india.NI_562_17","url":null,"abstract":"<p><strong>Background: </strong>Disturbed sleep and its impact on quality of life (QoL) are underrecognized in myasthenia gravis (MG).</p><p><strong>Aims: </strong>To evaluate the quality of sleep in MG using standard sleep questionnaires and assess factors that determine sleep.</p><p><strong>Settings and design: </strong>Prospective, cross-sectional, hospital-based study.</p><p><strong>Patients and methods: </strong>Fifty patients on stable drug therapy for at least 1 month and age- and gender-matched controls were assessed using standard sleep questionnaires [Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), and NIMHANS Comprehensive Sleep Disorders Questionnaire (NCSDQ)].</p><p><strong>Results: </strong>Myasthenia Gravis Foundation of America (MGFA) grade was I, IIA, IIB, IIIA, IIIB, and IVA in 11, 19, 3, 10, 6, and 1 respectively. The mean PSQI and ESS scores were similar in patients and controls. Patients with abnormal ESS (>10) were older and had greater neck circumference (P = 0.018 and <0.001). Body mass index was greater in patients with PSQI > 5 (P < 0.05). Age, gender, and clinical severity did not affect PSQI. Compared with ESS and PSQI, NCSDQ showed higher frequency of disturbed sleep, snoring, early morning headache, difficulty in initiation, and maintenance of sleep in MG, although the differences between patients and controls were not significant. No correlation was found between QoL and ESS or PSQI.</p><p><strong>Conclusion: </strong>Patients of MG with stable clinical course with adequate treatment have sleep quality comparable with healthy controls. Longitudinal assessment of sleep quality at multiple time points throughout the disease course and correlating with cross-sectional disease severity may further delineate the impact of disease on sleep and QoL.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110104","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":"Surgery for Intra-Dural Extra-Medullary (IDEM) Tumors.","authors":"Sanjeev Kumar","doi":"10.4103/neurol-india.neurol-india_86_24","DOIUrl":"https://doi.org/10.4103/neurol-india.neurol-india_86_24","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110107","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":"A Pan-Cancer Analysis of the Oncogenic Role of Methyltransferase-Like 1 in Human Tumors.","authors":"Ping Zheng, Shunmin Yang, Dabin Ren, Xiaoxue Zhang, Qingke Bai","doi":"10.4103/neurol-india.ni_1354_21","DOIUrl":"10.4103/neurol-india.ni_1354_21","url":null,"abstract":"<p><strong>Background and object: </strong>Although emerging cell- or animal-based evidence supports the relationship between methyltransferase-like 1 (METTL1) and cancers, no pan-cancer analysis is available.</p><p><strong>Methods: </strong>We thus first explored the potential oncogenic roles of METTL1 across 33 tumors based on the datasets of The Cancer Genome Atlas and Gene Expression Omnibus.</p><p><strong>Results: </strong>METTL1 is highly expressed in most cancers, and distinct associations exist between METTL1 expression and prognosis of tumor patients. METTL1 level is related with the dendritic and B-cell infiltration levels in most tumors. Moreover, RNA processing- and RNA metabolism-associated functions were involved in the functional mechanisms of METTL1.</p><p><strong>Conclusion: </strong>Our pan-cancer study offers a relatively comprehensive understanding of the oncogenic roles of METTL1 across different tumors.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110046","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":"Surgery for Head Injury in Elderly: Lengthening Life or Dawdling Death?","authors":"Adnan Hussain Shahid, Manju Dhandapani, Sivashanmugam Dhandapani","doi":"10.4103/neurol-india.NI_243_21","DOIUrl":"10.4103/neurol-india.NI_243_21","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110106","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":"When Lines Tell You the Diagnosis - Incontinentia Pigmenti: What Else to Look For.","authors":"Sayani Mahal, Sarbesh Tiwari, Daisy Khera, Taruna Yadav","doi":"10.4103/neurol-india.Neurol-India-D-24-00323","DOIUrl":"10.4103/neurol-india.Neurol-India-D-24-00323","url":null,"abstract":"","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":0.9,"publicationDate":"2024-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142110112","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":"Thoracic Epidural Chronic Inflammatory Lesion: A Case Report and Review of Literature","authors":"Abhijit G Warade, Karishma Kini, Ramesh B Deshpande, Basant K Misra","doi":"10.4103/ni.ni_1052_21","DOIUrl":"https://doi.org/10.4103/ni.ni_1052_21","url":null,"abstract":"<p>Chronic inflammatory lesions (CIL) in the body are rare and inflammatory pseudotumor (IPT) is a subtype of CIL. Spine is an uncommon location of CIL, with most cases reported in the thoracic spine. Our objective was to review the current literature on IPT. To the best of our knowledge only about 13 cases are reported till date. A retrospective review of 13 existing cases was done. The etiopathogenesis of CIL is uncertain and total surgical excision remains the mainstay. It’s a diagnosis of exclusion after ruling out commonly found lesions, both clinically and radiologically. Only histopathology can confirm the diagnosis. Total surgical resection remains the mainstay of treatment with adjuvant treatment only if there is a residue or a recurrence. CILs are rare lesions in the body with IPT being the commonest. Surgical excision remains the mainstay of treatment and a long-term follow up is warranted.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549931","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":"Anterior Communicating Artery Aneurysms: Surgical Strategy and Outcome based on Proposed Newer Classification","authors":"Suyash Singh, Kamlesh Singh Bhaisora, Rushabh Mulchand Chheda, Priyadarshi Dixit, Arun Kumar Srivastav, Kuntal Kanti Das, Anant Mehrotra, Ashutosh Kumar, Ved Prakash Maurya, Pawan Kumar Verma, Awadesh Jaiswal, Rajkumar, Sanjay Behari","doi":"10.4103/neurol-india.neurol-india-d-23-00100","DOIUrl":"https://doi.org/10.4103/neurol-india.neurol-india-d-23-00100","url":null,"abstract":"<h3>Background: </h3>\u0000<p>The ruptured anterior communicating artery aneurysm is the most frequent intra-cranial aneurysm treated at any neurosurgical department. These aneurysms arise from either the A1-A2-Acom artery junction or Acom artery. The surgical outcome depends on the age of the patient, time duration between ictus and surgery, and Hunt and Hess grade at admission. In this article, we intend to analyze the surgical outcome based on our proposed classification with our overall experience of Acom aneurysm.</p>\u0000<h3>Methods: </h3>\u0000<p>A retrospective review of our surgical database with 250 patients of ruptured Acom was done, and the location, morphology, and direction of aneurysm, along with other clinical parameters including the demographic profile, radiological findings, and intra-operative details, were studied. We classified the Acom based on both site of origin and morphology (Type I, junctional on the dominant side; Type II, fusiform with an ill-defined neck and branching pattern; Type III, saccular true Acom A) and secondarily as described in the literature on the basis of the direction of fundus (Type A–E). The clinical parameters were compared among the above groups using Fischer-exact and one-way analysis of variance test.</p>\u0000<h3>Results: </h3>\u0000<p>A total of 250 patients (M: F =113:137) were included (mean age 52.1 ± 11.5 standard deviation years). 55.2% patients had left A1 dominance. Type I Acom A was commonly found on the left dominant circulation (P = 0.00). The difference in aspect ratio of Type I (2.0 ± 0.8) and Type II (1.8 ± 0.52) aneurysms was insignificant (P = 0.28). However, a significant difference in post-operative vasospasm among different types of aneurysms was found (P &lt; 0.05). The Type I Acom A were anteriorly directed, while Type II and III were posteriorly directed (P = 0.001). The mean follow-up of the study was 44.4 ± 25.7 months, with age (P = 0.007) and Hunt and Hess grade (P = 0.001) at admission correlating with surgical outcome.</p>\u0000<h3>Conclusion: </h3>\u0000<p>Classifying the Acom A pre-operatively based on site and morphology, location, and direction of fundus helps in surgical planning and prognosis. The junctional ‘Type IA aneurysms’ are most common and possess a high intra-operative rupture rate. The anteriorly directed aneurysms have a better prognosis, and visual complaints are usually associated with anterior-inferiorly directed aneurysms.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141552796","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":"The Spectrum of Neurological Manifestations in Scrub Typhus","authors":"Varun Rehani, Amit Sreen, RK Anadure, Salil Gupta","doi":"10.4103/neuroindia.ni_470_20","DOIUrl":"https://doi.org/10.4103/neuroindia.ni_470_20","url":null,"abstract":"<h3>Background: </h3>\u0000<p>Scrub typhus is a mite-borne zoonotic disease caused by Orientia tsutsugamushi and commonly presents with fever, rash, and eschar. Systemic complications develop later in the illness including, meningoencephalitis, pericardial effusion, myocarditis, and pneumonitis. In this article, we will be presenting different neurological manifestations of scrub typhus along with functional outcomes studied at a tertiary care center in New Delhi.</p>\u0000<h3>Methods: </h3>\u0000<p>This ambispective observational study was conducted at Army Hospital Research and Referral, New Delhi, during January 2018- January 2020. Febrile illness, serologically confirmed as scrub typhus and developing neurological complications were included. A predesigned clinical proforma was recorded for demographics, clinical features, neurological examination, supported with laboratory and/or radiology evaluation, and functional outcomes using the modified Rankin Scale (mRS).</p>\u0000<h3>Results: </h3>\u0000<p>In our cohort of 7 patients’ majority were male (71%) with mean age at presentation being 42.5 years. Eschar was present in only 2 cases (28%) and a syndromic clinical diagnosis of meningoencephalitis was made in 3 (43%), acute flaccid quadriparesis in 2 (28%); and symptomatic seizure and parkinsonism in 1 patient each (14%). CSF showed lymphocytic pleocytosis with protein elevation in 57% cases. Systemic dysfunction was noted in the form of thrombocytopenia (57%), hyponatremia (42%), elevated transaminases (57%). Symptoms resolved with Doxycycline ± Rifampicin therapy in all cases, with good functional outcomes in majority of (89%) cases.</p>\u0000<h3>Conclusion: </h3>\u0000<p>Neurological complications in scrub typhus have a wide spectrum involving meninges, encephalon, basal ganglia, cranial, and peripheral nerves. High index of suspicion with early serological testing (ELISA) is a must in undifferentiated fevers. Timely initiation of appropriate therapy leads to good clinical outcomes, in majority of cases with neurological involvement.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549930","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":"Design and Development of a Cost-Effective Transnasal Skull Base Bone Wax Applicator: A Technical Note","authors":"Ramesh Teegala","doi":"10.4103/neuroindia.ni_564_20","DOIUrl":"https://doi.org/10.4103/neuroindia.ni_564_20","url":null,"abstract":"<p>Bone wax is an important hemostatic agent used in neurosurgical practice from more than a century. It acts by mechanical tamponade effect to stop the oozing from cancellous bone. Bone wax application over the skull surface over the vertex is easy and can be applied with fingers. In deeper areas, one uses dissector to apply the bone wax; however, it becomes difficult at times to apply in transnasal surgery using the same dissectors. Author designed a cost-effective 20-cm-long different angled bone wax applicator for skull base transnasal surgery. This applicator is cost-effective and not described previously in English literature.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549928","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":"“Now What Do I Do?” - Practical Challenges Faced By Young Neurosurgeons in their Career Management","authors":"Nishant Yagnick, Harsh Deora, Manjul Tripathi, Atul Goel, Sandeep Mohindra","doi":"10.4103/neuroindia.ni_72_20","DOIUrl":"https://doi.org/10.4103/neuroindia.ni_72_20","url":null,"abstract":"<p>Neurosurgical residency is tough. Grueling hours and tough decisions require a mental makeup unlike many other specialties. But the real examination begins after the residency is over. Many young neurosurgeons are faced with a daunting task of deciding their future as soon as they step out of the medical school. Sometimes, such decisions can shape the entire career of the neurosurgeon. However, over the many years of academic teaching and learning what we are not taught is how to “Manage.” Management of careers, decision making, and understanding the business end of our profession is lacking. Here, we review the career and decisions needed to be taken by a young neurosurgeon through the glass of a business management mindset. We try to define the opportunities and decisions and how they may reflect on the general population and patients as a whole.</p>","PeriodicalId":19429,"journal":{"name":"Neurology India","volume":null,"pages":null},"PeriodicalIF":2.7,"publicationDate":"2024-06-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141549932","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}