Annals of Indian Academy of Neurology最新文献

{"title":"Determinants of Caregiver Burden in Stroke Survivors who Underwent Decompressive Craniectomy.","authors":"Karnam Anand, Sai Sirisha, Sanjana Putta, Sudhindra Vooturi, Manas Panigrahi, Sita Jayalakshmi, Subhash Kaul","doi":"10.4103/aian.aian_448_24","DOIUrl":"10.4103/aian.aian_448_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>For stroke survivors (SS) who undergo decompressive craniectomy (DC), quality of life is intertwined with the care they receive. Burden on caregiver becomes an important determinant of recovery of SS. In this study, we aimed to analyze the determinants of burden on caregivers of SS who undergo DC.</p><p><strong>Methods: </strong>Caregivers of 198 SS who underwent DC formed the study population of this prospective observational study. The study was conducted in a tertiary referral unit between September 2019 and March 2021. Caregiver burden was quantified using Zarit Burden Interview. Analysis for association between the reported burden and modified Rankin Scale (mRS) score was done.</p><p><strong>Results: </strong>Mean age of the participants was 47.00 ± 11.2 years. The mRS outcome was poor in SS aged >60 years, Glasgow coma scale (GCS) score at presentation of <8, and in SS with bilateral/dominant hemisphere involvement. Outcome was better when DC was done ≤48 h (74.2% vs. 47.2%, P < 0.001) and if SS were shifted to a rehabilitation unit. Among caregivers, 58% and 16% reported to be always and frequently burdened, respectively; 33.3% of caregivers considered a retrospective review of consent for DC. A higher mRS score was associated with more burden.</p><p><strong>Conclusion: </strong>Early DC and care at rehabilitation unit were associated with better functional outcomes in SS. Nearly 75% of caregivers of patients post-DC reported high burden of providing care to SS, and the burden increased linearly with mRS score.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"647-650"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142852134","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}

{"title":"Levetiracetam-Induced Parkinsonism: A Short Case Series.","authors":"Thomas Mathew, Amitoj S Chadha, Sita Jayalakshmi, Surabhi Garg, Aditya H Ravindranath, Uday Murgod, Shagun Bhardwaj, Pranjali Ektare, Saji K John, Raghunandan Nadig, Gosala Rk Sarma","doi":"10.4103/aian.aian_430_24","DOIUrl":"10.4103/aian.aian_430_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"742-744"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142339790","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}

{"title":"Vision Loss, Deafness, and Ataxia Complicating Bacterial Meningitis: A Rare Pathogen.","authors":"Jomal Mathew, Chris M Antony, V K Smitha","doi":"10.4103/aian.aian_478_24","DOIUrl":"10.4103/aian.aian_478_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"748-750"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142370819","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}

{"title":"Assessing the Impact of TLR4 rs4986790 Polymorphism on Bacterial Meningitis Risk: A Systematic Review and Meta-Analysis.","authors":"Praveen Kumar Chandra Sekar, Ramakrishnan Veerabathiran","doi":"10.4103/aian.aian_443_24","DOIUrl":"10.4103/aian.aian_443_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Toll-like receptor ( TLR2 ) gene plays an important role in the pathogenesis of bacterial meningitis (such as meningococcal meningitis and pneumococcal meningitis). The association between TLR4 rs4986790 polymorphism and the susceptibility to bacterial meningitis has been extensively studied. However, the results of these studies remain inconsistent. Therefore, we performed a meta-analysis to evaluate the association between TLR4 rs4986790 polymorphism and the susceptibility to meningococcal meningitis and pneumococcal meningitis.</p><p><strong>Methods: </strong>Google Scholar, Embase, and PubMed databases were searched for case-control studies on TLR4 polymorphisms and the risks of meningococcal meningitis and pneumococcal meningitis, published up to May 31, 2024. To assess the strength of the association between TLR4 polymorphism and meningococcal meningitis and pneumococcal meningitis, the odds ratios (ORs) with 95% confidence intervals (CIs) were used. The meta-analysis of the associations between the TLR4 rs4986790 polymorphism and meningococcal meningitis and pneumococcal meningitis was carried out under different genetic models. Meta-analyses were conducted using Cochrane RoB 2 tool and Metagenyo to calculate the ORs and 95% CIs. Fourteen published studies with 3599 cases and 7438 controls were included.</p><p><strong>Results: </strong>Overall, there was a strong correlation between TLR4 polymorphisms and meningococcal meningitis observed across three genetic models using a random-effects model: GG + GA vs. AA (OR: 0.34, 95% CI: 0.14-0.79, P = 0.01, I ² = 60%); GA vs. AA (OR: 0.34, 95% CI: 0.13-0.91, P = 0.03, I ² = 65%); and GG vs. AA (OR: 0.34, 95% CI: 0.14-0.78, P = 0.01, I ² = 59%). Conversely, a fixed-effects model also revealed a significant association in the G vs. A model (OR: 0.84, 95% CI: 0.73-0.96, P = 0.01, I ² = 38%). In pneumococcal meningitis, a fixed-effects model analysis demonstrated a significant association in the GG vs. AA model (OR: 0.35, 95% CI: 0.14-0.87, P = 0.02, I ² = 48%) respectively.</p><p><strong>Conclusion: </strong>This meta-analysis showed a strong correlation between TLR4 rs4986790 polymorphism and susceptibility to meningococcal meningitis and pneumococcal meningitis. Further studies with diverse populations are needed to validate and strengthen these findings.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"629-637"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142685864","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}

{"title":"Rituximab in Refractory Myasthenia Gravis - Challenges and Lessons Learnt.","authors":"Karthika A Valaparambil, Soumya Sundaram, Sruthi S Nair","doi":"10.4103/aian.aian_579_24","DOIUrl":"10.4103/aian.aian_579_24","url":null,"abstract":"<p><p>Nearly 10%-15% patients with generalized myasthenia gravis (MG) have refractory disease and are candidates for newer nonconventional immunotherapies. Rituximab has emerged as an attractive option in them. We describe the efficacy and safety of rituximab in 12 patients with refractory MG treated over a period of 4 years in a tertiary care center. We had a female-predominant cohort (10 females) in the age range 10-67 years. There were eight seropositive patients (acetylcholine receptor, muscle-specific kinase, or both antibodies) and eight had undergone thymectomy. Median number of crises was 2 before treatment with rituximab. Sustained improvement at 12 months was seen in seven patients and steroid dose could be reduced in them. Four worsened on therapy (including one death following prolonged ventilation and septicemia). One patient who had no response to therapy was re-evaluated and diagnosed with congenital myasthenic syndrome related to biallelic CHRNE mutation. In summary, nearly two-thirds (7/11, 63.6%) of autoimmune refractory MG in this cohort showed a good response to rituximab.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"706-709"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765754","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}

{"title":"Evolution of Sleep Apnea and Arousals in Patients with Ischemic Stroke: A Longitudinal Follow-Up Study.","authors":"P R Srijithesh, Sivasubramanian Mythirayee, Doniparthi Venkata Seshagiri, Nitish L Kamble, Sanjib Sinha, Ravi Yadav","doi":"10.4103/aian.aian_439_24","DOIUrl":"10.4103/aian.aian_439_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Sleep-disordered breathing (SDB) is characterized by pauses or shallow breathing during sleep. It is linked to poorer outcomes and increased stroke recurrence in stroke patients. We aimed to evaluate the proportion, severity, type, and evolution of SDB and arousals in ischemic stroke patients.</p><p><strong>Methods: </strong>Ischemic stroke patients were recruited to evaluate SDB. Patients underwent overnight polysomnography (PSG) twice - within 1 month of stroke onset and again after 3 months. Clinical outcomes were evaluated at 6, 18, and 24 months.</p><p><strong>Results: </strong>Of 141 acute ischemic stroke patients screened, 111 patients recruited in the study and 105 patients had technically adequate polysomnography. The mean age of patients was 50.5 years (standard deviation [SD]: 12.30), 78.4% of the patients were males, and the mean body mass index was 26 (SD: 5.4). Results showed that 81.9% had an apnea-hypopnea index (AHI) ≥5, with 12.5% having an AHI >30. The median arousal index (ArI) was 15.4 (interquartile range [IQR]: 0.5-50.5), which increased as the apnea increased. During follow-up, 56.8% patients had an AHI ≥5, with 12.5% having severe apnea. The median ArI decreased from 15.4 (IQR: 0.5-50.5) initially to 11.54 (IQR: 0.5-21.1) at follow-up. Numerical change in AHI severity categories were noted during the follow-up (mild: 8 vs 15; moderate: 17 vs 11; severe 19vs 7). For AHI >30, ArI decreased from 24.63 (IQR: 0.7-50.05) to 10.54 (IQR: 7.1-15.07) at follow-up. Sleep efficiency and rapid eye movement (REM) sleep duration increased on follow-up.</p><p><strong>Conclusions: </strong>The study showed a high proportion of SDB in acute ischemic stroke patients. In the follow-up, SDB improved, as reflected in AHI and ArI changes.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"651-656"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142783614","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}

{"title":"Broad Autism Phenotype Questionnaire - Translation and Validation in a South Indian Language.","authors":"Betsy Baby, Sandhya Pushpagiri, P Ravi Prasad Varma, L S Saritha, S J Dhiya, Shoba S Meera, M Rekha, Manju Mohan, Soumya Sundaram","doi":"10.4103/aian.aian_147_24","DOIUrl":"10.4103/aian.aian_147_24","url":null,"abstract":"<p><strong>Background and objectives: </strong>Broad Autism Phenotype (BAP) refers to specific behaviors or minor deficits in social/communication skills not meeting the diagnostic criteria for autism spectrum disorders (ASDs). The BAP Questionnaire (BAPQ) measures aloof personality (AP), rigid personality (RP), and pragmatic language (PL) deficits of BAP. The study objective is to translate and validate BAPQ into Malayalam, a South Indian language, and to establish new cut-off scores for detecting BAP in the Indian population.</p><p><strong>Methods: </strong>BAPQ was translated into Malayalam (BAPQ-M), following which it was tested for reliability and internal consistency and factor analysis was conducted in 40 parents of ASD and neurotypical children. The receiver operating characteristic curve analysis generated new cut-off scores.</p><p><strong>Results: </strong>The content validity index was ≥ 0.8 for each item. For the self and informant versions, Cronbach's α was 0.753 and 0.807, respectively, while Spearman's correlation coefficient was 0.953 ( P < 0.001) and 0.918 ( P < 0.001). The items demonstrated good communality (0.532-0.870), and on factor rotation, 12 components had eigenvalues > 1, which explained 72.3% of the total variance. The new cut-off scores for total estimate, AP, RP, and PL subscales were 2.60 (sensitivity 0.825; specificity 0.575; odds ratio [OR] 6.38, 95% confidence interval [CI] 2.28-17.84; P < 0.001), 2.60 (sensitivity 0.60; specificity 0.75; OR 4.50, 95% CI 1.73-11.70; P 0.002), 2.90 (sensitivity 0.8; specificity 0.475; OR 3.62, 95% CI 1.342-9.77; P 0.011), and 2.70 (sensitivity 0.5; specificity 0.825; OR 4.71, 95% CI 1.69-13.13; P 0.003), respectively.</p><p><strong>Conclusions: </strong>BAPQ-M has good psychometric properties for determining the presence of BAP among the people of Kerala, a South Indian state.</p>","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"668-676"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142794330","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}

{"title":"The Learning Curve - A Neurosurgeon's Memoir.","authors":"Venkataraman Sundaram","doi":"10.4103/aian.aian_882_24","DOIUrl":"10.4103/aian.aian_882_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"758"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142845661","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}

{"title":"Piriformis Syndrome as a Cause of Non-discogenic Sciatic Pain in a Young Bharatanatyam Dancer.","authors":"Thomas Mathew, Akshata Huddar, Shagun Bhardwaj, Sharath Kumar Goddu Govindappa","doi":"10.4103/aian.aian_401_24","DOIUrl":"10.4103/aian.aian_401_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"737-738"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142153018","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}

{"title":"Posterior Circulation Stroke Due to Arterial Thoracic Outlet Syndrome: A Case Report and Literature Review.","authors":"Raiz Iqbal, V Sriramakrishnan, S Saravanan, K Rajesh, F Jason Ambrose, R Nandini","doi":"10.4103/aian.aian_442_24","DOIUrl":"10.4103/aian.aian_442_24","url":null,"abstract":"","PeriodicalId":8036,"journal":{"name":"Annals of Indian Academy of Neurology","volume":" ","pages":"744-745"},"PeriodicalIF":1.9,"publicationDate":"2024-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"142765730","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}