Bangladesh Journal of Neuroscience最新文献

{"title":"Digital Subtraction Angiographic Pattern of Extracranial and Intracranial Atherosclerotic Arterial Stenosis among Ischemic Stroke Patients","authors":"Md. Alamgir Hossain, H. Z. Rahman, -. Md Shahidullah, Md. Rafiqul Islam, M. Hannan, A. N. Rizvi, A. K. Sheikh, Suvash Kanti Dey, M. Habib, A. Ahmed, -. Md Rakanuzzaman, Dewan Mushfiqur Rahman, Md Saifullah Ahtesam, Md. Monirul Islam","doi":"10.3329/bjn.v33i2.57523","DOIUrl":"https://doi.org/10.3329/bjn.v33i2.57523","url":null,"abstract":"Background: Stroke is the second leading cause of death in adult population throughout the world and is the most common cause of severe adult physical disability. Atherosclerotic stenosis is one of the predominant cause of ischemic stroke. The aim of this study was to evaluate the type, number and severity of intracranial and extracranial atherosclerotic stenosis and its association with different risk factors. \u0000Methods: This prospective observational study was conducted in the Department of Neurology, BSMMU, Dhaka, from July 2017 to August 2018. Only patients having significant (≥50%) symptomatic stenosis were included in this study. \u0000Results: In total 42 cases, 25 patients had extracranial stenosis, 13 patients had intracranial stenosis and 4 patients had both intracranial and extracranial stenosis. Overall 17 (40.47%) patients have intracranial involvement and 29 (69.04%) patients had extracranial involvement. The most commonly involved intracranial stenotic segment was MCA, present in 8 (32%) out of 25 intracranial segments followed by ICA 7 (28%) and intracranial vertebral artery 4(16%). Most commonly involved extracranial stenotic segment was ICA, present in 37 (77.08%) out of 48 extracranial segments. Diabetes was found to be the most common risk factor of intracranial stenosis (p value 0.022) while hypercholesterolemia was the major risk factor for severe (≥70%) stenosis. \u0000Conclusion: Extracranial arterial stenosis is more common than intracranial arterial stenosis. Anterior circulation stenosis is more common than posterior circulation stenosis. Intracranial stenosis is more prevalent in diabetic patients. Hypercholesterolemiaismore commonly seen in severe (e”70%) stenosis. \u0000Bangladesh Journal of Neuroscience 2017; Vol. 33 (2): 89-95","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"20 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81704768","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Guillain Barré Syndrome after Thrombolysis With Streptokinase for Acute Myocardial Infarction: A Case Report","authors":"M. Uddin, -. Md Shahidullah, S. Dey, R. K. Khan, Md. Rafiqul Islam, H. Z. Rahman, A. N. Rizvi, -. Md Raknuzzaman, M. Bhuiyan, M. Hannan","doi":"10.3329/bjn.v33i2.57525","DOIUrl":"https://doi.org/10.3329/bjn.v33i2.57525","url":null,"abstract":"We would like to report on a patient, a 52-year-old man with acute neurologic disorder, Guillain Barré Syndrome. He was successfully treated by intravenous immunoglobulin. The patient suffered from acute extensive anterior MI. 2 weeks after thrombolytic therapy with streptokinase, he developed GBS. \u0000Bangladesh Journal of Neuroscience 2017; Vol. 33 (2): 103-104","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"4 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"86737016","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association of Serum Uric Acid level in Patients with Alzheimer’s Disease","authors":"Mohammad Saifullah Ahtesam, M. Habib, Md. Rafiqul Islam, M. R. K. Khan, H. Z. Rahman, A. N. Rizvi, M. Bhuiyan, K. K. Barman, Syeeda Showkat, Md. Monirul Islam, -. Md Raknuzzaman, Md. Fakrul Islam, Imran Sarker, M. Hannan","doi":"10.3329/bjn.v33i2.57522","DOIUrl":"https://doi.org/10.3329/bjn.v33i2.57522","url":null,"abstract":"Background: Alzheimer’s disease is the most common cause of dementia. Uric acid is the end product of purine metabolism in humans and acts as a natural antioxidant, accounting up to 60% of the free radical scavenging activity in human blood to prevent free radicals induced oxidative cell injury. This study aimed to explore the association between serum uric acid level and cognitive impairment of Alzheimer’s disease patients compared to those of the non-demented age and sex matched controls. \u0000Methods: This case control study was carried out in the department of neurology, BSMMU, Dhaka. Total 116 patients were enrolled as study population after satisfying inclusion and exclusion criteria. Among them, 58 were grouped as case and rest 58 were control. All blood samples for serum uric acid were measured in the Biochemistry lab, Department of Biochemistry, BSMMU, Dhaka. \u0000Results: A signiûcant reduction of serum uric acid levels in the AD group was found compared to those of the control group (4.35±1.59 Vs 6.89±1.68) which was statistically significant (p<0.001). We also found a positive correlation between serum uric acid levels with severity of Alzheimer’s disease (rp = 0.633, P<0.001). Among demographic variables educational qualification was statistically significant (p=0.006) in AD patients. \u0000Conclusion: This study showed that oxidative injuries have an important role in the pathogenesis of AD. Higher levels of uric acid are associated with a decreased risk of dementia and better cognitive function later in life. \u0000Bangladesh Journal of Neuroscience 2017; Vol. 33 (2): 83-88","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"162 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-07-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"81730926","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Pattern of Presentation of Moyamoya Disease (MMD) Patients in Bangladesh: Experience from Tertiary Care Hospitals","authors":"Sharif Uddin Khan, K. Rahman, A. Hasan, S. Islam, R. Chowdhury, Md Khairul Kabir Patwary, Dewan Mohammad Elyas, A. M. Khan, Md. Amir Hossain, Md Bokhtiar Azam, Md Amirul Hasanat","doi":"10.3329/bjn.v33i1.57465","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57465","url":null,"abstract":"Background: Moyamoya disease is rare but not uncommon throughout the world. Clinical profile of childhood moyamoya (MMD) disease is not well delineated in Bangladesh.\u0000Methods: We conducted this cross sectional study in pediatrics and neurology department of Dhaka Medical College Hospital that involved 20 patients of MMD over a period of one year.\u0000Result: Among the cases about 2/3rd(65%) of the patients were within 8 years age at onset with mean age of the patients being 7.24(±3.34) years at onset with a male: female ratio of 1.2:1. Almost half of the patients had past history of intermittent episodes TIA which precipitated by hyperventilation and crying (p <0.05). Important history related to prothombotic conditions (Family History of stroke, MI, Hyperlipidemia, Obesity, Coagulation disorders) were also statistically significant (p<0.05). Sixteen patients in our series exhibited hemiparesis and out of them 4(25%) were alternating (p<0.05), followed by dysarthria at onest 13(65%). Convulsions and visual impairment were seen in 5 (25%) different patients, 3(15%) different patients had altered consciousness, involuntary movements, ataxia, headache and cognitive impairment at onset. We observed intellectual impairment in and psycho–motor retardation in two different patients. MRA abnormalities were found in 19 cases out of 20. Among 19 cases bilateral ICA stenosis with collaterals seen in 18 cases (90%), MCA stenosis along with bilateral ICA stenosis were seen in 16(80%) cases, ACA stenosis along with bilateral ICA stenosis were seen in 07(35%) cases, PCA stenosis along with bilateral ICA stenosis were observed in 05(25%) cases. No collaterals and without typical “puff of smoke” appearance was seen in 01(5%) and unilateral ICA stenosis with collaterals was seen in 01(5%) cases (probable MMD). Diagnostic Cerebral DSA was done in 07 (35%) patients and typical angiographic findings of Moyamoya disease were present in all of them.\u0000Conclusion: C-MMD may have various presentations. Stroke and TIA are most common presentation. MRA may well delineate the characteristics angrographic abnormality.\u0000Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 24-29","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"7 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"90774737","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of Calcitonin Gene Related Peptide (CGRP) in Migraine","authors":"Md. Ashraf Ali, H. Rahaman","doi":"10.3329/bjn.v33i1.57468","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57468","url":null,"abstract":"Migraine is the second most primary headache. The prevalence of Migraine is 12% in the general population, including 18% in women and 6% in men. Migraine can start in childhood and adolescence and continue throughout lifespan. It is most prevalent among people in their 30s and 40s. Migraine is a debilitating hemicranial headache that is pulsating, aggravated by movement, nausea, vomiting and having sensitivity to light and sound, with or without aura. It can affect all aspects of life as work and school, parenting and family relationships and personal and leisure time. There are some theory regarding pathogenesis of migraine which includes cortical spreading depression, cortical spreading oligemia, activation of trigeminocervical complex leading to neuroinflammation & release of vasodialating neuropeptides which include calcitonin gene related peptide (CGRP), substance P, vasoactive intestinal polypeptide (VIP), nitric oxide (NO), and pituitary adenylate cyclase activating peptide (PACAP) & genetic factor. CGRP is a potent vasodilator and causes perivascular plasma protein extravasation and nociceptive pain. Newer medications target CGRP both for acute and preventive treatment of migraine. \u0000Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 39-43","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"29 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"89155313","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"A Case of Paroxysmal Kinesigenic Dystonia : Epilepsy Mimic","authors":"M. N. Uddin, H. Rahaman, A. Habib, A. N. Rizvi, M. Bhuiyan, Md. Rafiqul Islam","doi":"10.3329/bjn.v33i1.57469","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57469","url":null,"abstract":"Background: We report a rare case of movement disorder Paroxysmal kinesigenic dystonia who was misdiagnosed as Epilepsy and Conversion disorder. \u0000Case report: A 35 -year female presented with episodic painful twisting of her Right hand and arm only when she is awake. These events were triggered by sudden movements and would last several seconds to minutes. Her symptoms were unilateral and her physical and neurological examinations were normal. Treatment with anticonvulsants Oxcarbazepine improved her symptoms. \u0000Conclusion: Although an uncommon movement disorder, it is important to recognize the clinical presentation of Paroxysmal kinesigenic dystonia as most patients respond very well to medical treatment. \u0000Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 44-46","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"2 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"83588153","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Cerebral Venous Sinus Thrombosis- A Study of 4 Cases","authors":"A. K. Sheikh, R. Biswas, A. Roy, S. Tuqan, Mallika Sarker, M. Bhuiyan","doi":"10.3329/bjn.v33i1.57466","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57466","url":null,"abstract":"Cerebral venous sinus thrombosis is an uncommon but important cause of stroke, especially in young-aged woman. Clinical presentation is variable, usually in the form of focal neurological deficit, seizure, headache and other features of raised intracranial pressure, leading to misdiagnosis or delay in treatment. Here we report 4 cases of venous sinus thrombosis with variable presentation. Diagnosis is confirmed by neuroimaging including magnetic resonance imaging with magnetic resonance venography of brain. Treatment consists of anticoagulation along with supportive management. \u0000Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 30-33","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"262 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"74520687","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Comparison of Carbamazipine and Amitryptyline for the Reduction of Diabetic Neuropathic Pain: A Randomized Clinical Trial","authors":"Mm Rahman, R. Khan, N. Rizvi, Md Arifuzzaman M, A. Sharif, S. Khanam","doi":"10.3329/bjn.v33i1.57462","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57462","url":null,"abstract":"Background: Diabetic neuropathy is very difficult to treat.\u0000Objective: The purpose of the present study was to compare the efficacy and safety of carbamazepine and amitryptyline for reduction of diabetic neuropathic pain.\u0000Methodology: This was a randomized controlled trial conducted in the department of Neurology including Neuropathy Clinic of BSMMU and in collaboration with department of Endocrinology, BSMMU, Dhaka from January 2012 to December 2013 for a period of two (2) years. Adult diabetic patients presented with neuropathic pain with symmetrical involvement of distal limbs from indoor and outpatient department of Neurology including Neuropathy clinic as well as indoor and outpatient department of Endocrinology, BSMMU were enrolled in the study population. The study population was divided into two groups named as group A and group B. The group A was experimental group. In this group, patients were treated with oral carbamazepine 400mg/day in two divided doses for initial 2 weeks, then 600mg/ day in three divided doses for further 4 weeks. The group B was control group. In this group, patients were treated with oral amitriptyline 25mg/ day at night for initial 2 weeks, then 50mg/day taking at night for further 4 weeks. During trial, three follow ups were taken at 2 weeks interval and encountered the clinical response by pain score (VAS) and the side effects. The first follow up after 2 weeks of treatment; the second follow up was after 4 weeks of treatment and the third follow up was after 6 weeks of treatment.\u0000Result: A total number of 110 cases clinically diagnosed as painful diabetic polyneuropathy, then 56 cases randomly selected for Group A and 54 cases randomly selected for Group B. During follow up of 6 weeks, 2 case of Group A developed skin rash for which they discontinued drug. From rest of cases, 2 from Group A and 4 from Group B were dropped out. Because they did not come for follow up. So finally 52 cases for Group A group and 50 cases for Group B group were studied. A total of 102 patients were included in the study. They were divided into four Groups according to their age. The mean age was found 52.17(±10.02) years in Group A and 53.41(±8.82) years in Group B. The mean (±SD) of percent improvement in Group A and Group B were 41.11(±11.29) vs. 31.76(±19.14) (P<0.05). Dizziness and Drowsiness were found in Group A as 33.3% and 37.0%. But in Group B dryness of mouth and constipation were found as 46.3% and 7.4%.\u0000Conclusion: In conclusion carbamazepine produced greater improvements than amitriptyline in relieving pain and paresthesia associated with diabetic neuropathy.\u0000Bangladesh Journal of Neuroscience 2017; Vol. 33 (1): 6-12","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"36 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"76346647","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Role of occupational therapy in improving quality of life of physically challenged persons","authors":"M. Rahman","doi":"10.3329/bjn.v33i1.57467","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57467","url":null,"abstract":"Occupational therapy is a branch of medicine which uses different methods to help physically and mentally ill people to develop, maintain, and recover skills needed to function in day to day life, as well as in workplace environments. Thus lives of millions of disabled all over the world are enhanced to a meaningful quality of life. Occupational therapists also focus much of their work on identifying and eliminating environmental barriers to independence and participation in daily activities. This is a client-centered practice that places emphasis on the progress towards the client’s goals. The interventions are made on adapting the environment, modifying the task, teaching the skill, and educating the client/family in order to increase participation in and performance of daily activities, particularly those that are meaningful to the client. They often find it challenging to implement client-centered and occupation-based assessment tools into practice. This part of rehabilitation medicine is neglected in our country. More work is needed to understand how best practices can be incorporated into a changing occupational therapy daily practice. The aim of this review article is to highlight the importance of occupational therapy and its application in improving the quality of life and quality adjusted life years in physically challenged persons. \u0000Bangladesh Journal of Neuroscience 2017; Vol.  33 (1): 34-38","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"8 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"82520786","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Association between Age and New Onset Ischemic Stroke in Diabetic Patients","authors":"H. Sina, Md. Rafiqul Islam, M. Habib, S. K. Ghose, Kazi Gias Uddin Ahmed, A. Chowdhury, K. Saha, Mohammad Arifuzzaman, Iftikher Alam, Tamanna Mustary, S. A. Dhali","doi":"10.3329/bjn.v33i1.57461","DOIUrl":"https://doi.org/10.3329/bjn.v33i1.57461","url":null,"abstract":"Background: Ischemic stroke is the end result of occlusion of a blood vessel supplying the brain by a thrombus originating somewhere outside the brain or as a result of a thrombotic stenosis of a cerebral blood vessel itself. Older people have higher prevalence of ischemic stroke.\u0000Objective: To evaluate the association between higher age and new onset ischemic stroke in patient with diabetes mellitus.\u0000Method: This cross sectional study was conducted in the Department of Neurology, BSMMU, Dhaka from February 2013 to September 2014 on 50 DM patients with first attack of ischemic stroke. mRS was measured on 14th day of the stroke.\u0000Result: Majority of the patients (40.0%) were in age group 51-60 years. The mean age was 58.9 ± 9.6 years with a range from 30 to 75 years. Males were 52.0% and females were 48.0%. Male to female ratio was 1.08:1. It was observed that more than one third (36.0%) patients were current smoker, 9(18.0%) were ex-smoker and 23(46.0%) were non smoker. Majority of the patients, 29(58.0%), had hypertension. Mean systolic BP was found 129 ±16 mmHg with a range from 90 to 160 mmHg. The mean diastolic BP was found 81±11 mmHg with a range from 60 to 100 mmHg. Age has significant positive correlation with modified ranking scale on 14th day of stroke [r= 0.322 (p=0.023)].\u0000Conclusion: As per study result, it can be concluded that increasing age is associated with higher level of mRS.\u0000Bangladesh Journal of Neuroscience 2017; Vol. 33 (1): 1-5","PeriodicalId":8727,"journal":{"name":"Bangladesh Journal of Neuroscience","volume":"3 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2017-01-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"80832551","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}