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Ravi Shankar S.,NIMHANS
European Journal of Neurology | Year: 2010

Background: The diagnosis of cerebral venous sinus thrombosis (CVST) requires a high index of suspicion owing to the wide spectrum of clinical manifestations. Amongst the different presentations, radiological evidence of subarachnoid haemorrhage (SAH) often leads to diagnostic errors. Methods: Between March 2005 and December 2007, 233 patients with CVST were reviewed at our centre, and this report summarizes 10 cases that presented with SAH. The early clinico-radiological pointers towards a diagnosis of CVST are highlighted and previously published reports are reviewed. Results: The mean age at presentation was 33 years (range 25-50), and the median duration from onset of symptoms to admission was 5 days (range 2-15). In all cases, there was radiological evidence of SAH with or without associated parenchymal bleeding or other signs of CVST. SAH was usually localized, involving the sulci of the cerebral convexity and sparing the basal cisterns. Aetiologically, there were two cases with both hyperhomocysteinaemia and polycythaemia and one case each of antiphospholipid antibody (APLA) syndrome, post-partum state, oral contraceptive use and dehydration because of diarrhoea. Eight patients improved with anticoagulant therapy despite the presence of SAH. Conclusions: Localized SAH (whether focal, unilateral or bilateral), especially when confined to the parasagittal or dorsolateral convexity of the brain and without involvement of the basal cisterns, may provide an early pointer towards an underlying CVST. The presence of predisposing factors for CVST accords a further diagnostic hint. © 2010 EFNS.

Sunagar R.,Gulbarga University | Patil S.A.,NIMHANS | Chandrakanth R.K.,Gulbarga University
Research in Microbiology | Year: 2010

The protective effect of bacteriophage was assessed against experimental Staphylococcus aureus lethal bacteremia in streptozotocin (STZ) induced-diabetic and non-diabetic mice. Intraperitoneal administrations of S. aureus (RCS21) of 2 × 108 CFU caused lethal bacteremia in both diabetic and non-diabetic mice. A single administration of a newly isolated lytic phage strain (GRCS) significantly protected diabetic and non-diabetic mice from lethal bacteremia (survival rate 90% and 100% for diabetic and non-diabetic bacteremic groups versus 0% for saline-treated groups). Comparison of phage therapy to oxacillin treatment showed a significant decrease in RCS21 of 5 and 3 log units in diabetic and non-diabetic bacteremic mice, respectively. The same protection efficiency of phage GRCS was attained even when the treatment was delayed up to 4 h in both diabetic and non-diabetic bacteremic mice. Inoculation of mice with a high dose (1010 PFU) of phage GRCS alone produced no adverse effects attributable to the phage per se. These results suggest that phages could constitute valuable prophylaxis against S. aureus infections, especially in immunocompromised patients. © 2010 Institut Pasteur.

Finsterer J.,Krankenanstalt Rudolfstiftung | Kothari S.,NIMHANS
International Journal of Cardiology | Year: 2014

Objectives One of the most frequently affected organs in mitochondrial disorders (MIDs), defined as hereditary diseases due to affection of the mitochondrial energy metabolism, is the heart. Cardiac involvement (CI) in MIDs has therapeutic and prognostic implications. This review aims at summarizing and discussing the various cardiac manifestations in MIDs.Methods Data for this review were identified by searches of MEDLINE, Current Contents, and PubMed using appropriate search terms.Results CI in MIDs may be classified according to various different criteria. In the present review cardiac abnormalities in MIDs are discussed according to their frequency with which they occur. CI in MIDs includes cardiomyopathy, arrhythmias, heart failure, pulmonary hypertension, dilation of the aortic root, pericardial effusion, coronary heart disease, autonomous nervous system dysfunction, congenital heart defects, or sudden cardiac death. The most frequent among the cardiomyopathies is hypertrophic cardiomyopathy, followed by dilated cardiomyopathy, and noncompaction.Conclusions CI in MID is more variable and prevalent than previously thought. All tissues of the heart may be variably affected. The most frequently affected tissue is the myocardium. MIDs should be included in the differential diagnoses of cardiac disease. © 2014 Elsevier Ireland Ltd. All rights reserved.

Patel M.,NIMHANS | Satishchandra P.,NIMHANS | Saini J.,NIIR | Bharath R.D.,NIIR | Sinha S.,NIMHANS
Epilepsy Research | Year: 2013

Background: Eating epilepsy is one of the rare forms of reflex epilepsy precipitated by eating. Previous studies have demonstrated lesions due to variable aetiology involving the temporolimbic and suprasylvian regions. Objective: To study anatomical correlates of reflex eating epilepsy using multimodality investigations (MR imaging, video-EEG and SPECT). Methodology: Six patients (M:F=3:3; mean age: 20.7. ±. 4.9 years) with eating epilepsy were subjected to MRI of brain, video-EEG studies and SPECT scan. These were correlated with phenotypic presentations. Results: Among the five patients with ictal recording of eating epilepsy during video-EEG, semiology was characterized by behavioural arrest followed by either flexion or extension of trunk and neck and two patients had speech arrest and four had salivation from angle of mouth. Another patient had EEG changes during "thought about eating". Four patients had perisylvian frontal lobe lesions and one had high frontal lesion on MRI. Ictal EEG (n= 6) showed ictal rhythmic slowing/fast activity in parieto-temporal (n= 2) or fronto-temporal (n= 4) regions with subsequent secondary generalization in three. Ictal and interictal SPECT imaging showed changes in frontal lobe (n= 1), anterior temporal lobe (n= 1), and parieto-insular region (n= 1) suggesting it to be seizure onset zone. Three of four patients with structural lesions in MRI had concordant ictal EEG and ictal SPECT changes. Conclusion: Lesions near the perisylvian region might play a major role in eating epilepsy. © 2013 Elsevier B.V.

Venkataramana N.K.,BGS Global Hospital | Mukundan C.R.,NIMHANS
Journal of Pediatric Neurosciences | Year: 2011

Aim: The long term outcomes of congenital hydrocephalus are still not clearly known despite it being a common clinical condition. Several clinical, radiological factors were correlated to predict the functional outcomes. This study aimed to correlate the clinical, radiological parameters with the regional functional outcomes of the brain. Materials and Methods: Children with congenital hydrocephalus were divided into Group A with hydrocephalus alone and Group B hydrocephalus with spina bifida. Ventriculoperitoneal shunt surgery was performed by the same surgeon. CT scans and neuropsychological assessments were performed before and serially after the shunt. The clinical and the radiological findings were correlated with the developmental levels during the follow-up. Results: There were 25 children in Group A and 15 children in Group B; 72% in Group A and 93% in Group B were less than 6 months of age at the time of treatment. Forty percent in Group A and 92% in Group B had the signs of hydrocephalus at admission. Cerebrospinal fluid (CSF) diversion results in the reduction in ventricular dilatation and corresponding increase in the cortical mantle thickness. The ventricular size and the cortical mantle thickness were measured serially and correlated with the development in the neuropsychological function. In this study, 80% in Group B reached near normal development in comparison to 33% in Group A. We have noticed a significant correlation in the increase in the regional cortical mantle thickness with corresponding improvement in the functional development. This clearly ratifies the improvement in the frontal and parietal areas having their distinctive effect on the functional development of the child. Conclusion: Early CSF diversion and timely intervention seems to benefit functional recovery. It is interesting to note that reconstitution of cortical mantle in different areas of the brain showing corresponding improvement in their respective areas. Large ventricles (head circumference more than 50 cm) recurrent subdural collections and repeated shunt obstructions have a bad influence on the long-term outcome. Unlike the previous belief the children with myelomeningocele can have equal benefit in terms of neuropsychological development after the shunt surgery.

Satishchandra P.,NIMHANS | Sinha S.,NIMHANS
Neuroimaging Clinics of North America | Year: 2011

The development in neuroimaging techniques has revolutionized the way neurology is practiced, including neurologic disorders in tropics. Some diseases occur exclusively, whereas some are more common in tropical regions. However, some are becoming increasingly prevalent in the developed world too, as a result of patterns of human migration and globalization. It is imperative to learn about the role of imaging in tropical neurology, which might assist early diagnosis and treatment and also add to the existing knowledge. Infections are more common in the tropics and require special attention in view of their potential treatability. © 2011 Elsevier Inc.

British Journal of Neurosurgery | Year: 2010

Introduction. Aquaporins and astrocytes are important in maintaining water hemostasis in brain. Upregulation of AQP-4 has been described in conditions associated with brain edema. Aims: To study the expression of aquaporin-4 in brain tumors and its correlation with contrast enhancement and perilesional edema. Material and methods.30 cases of brain tumors, both benign and malignant were included in the study to look for expression of AQP-4. Results. AQP-4 expression was increased in brain tumors compared to normal brain but distribution and intensity of expression depend upon the type of tumor. A trend toward increased AQP-4 expression in enhancing lesions with perilesional edema was noticed. Conclusion. AQP-4 expression was seen in tumor tissue and perilesional reactive astrocytes in primary brain tumors, however only perilesional astrocytes showed positivity in secondary brain tumors. AQP-4 could be playing a role in alteration of bloodbrain barrier leading to contrast enhancement and perilesional edema. Increased knowledge of Aquaporins may open new targeted therapy for brain edema. © 2010 The Neurosurgical Foundation.

Annals of Indian Academy of Neurology | Year: 2013

Objective: To observe the urodynamic profile of the patients following non-traumatic myelopathies (NTMs) with neurogenic bladder. Setting: Neurological rehabilitation department of university tertiary research hospital. Materials and Methods: Seventy-nine patients (44 men) with monophasic NTM, with the age range 8-65 years (31.0 ± 16.0 years), were admitted for inpatients' rehabilitation. Length of stay in rehabilitation ranged from 6 to 120 days (32.0 ± 24.8 days). Fifty-six patients (70.9%) had spinal lesion above D10, 17 had lesion between D10 and L2 (21.5%), and 6 (7.6%) had cauda equina syndrome. All patients had neurogenic bladder with urinary complaints. Urodynamic study (UDS) was performed in all patients. Results: UDS showed 71.4% patients (40/56) had neurogenic detrusor overactivity (NDO) with or without sphincter dyssynergy (DSD) with lesion above D10; only 52.9% patients (9/17) had NDO with or without DSD detrusor with lesion between D10 and L2; and majority (5/6 patients) had underactive detrusor in the cauda equina group. Bladder management was based on the UDS findings. No significant correlation was found (P > 0.05) between detrusor behavior and the level, severity (ASIA Impairment Scale) of spinal injury, or gender using chi-square test. Conclusions: Neurogenic bladder following NTM was observed in all patients. UDS suggested predominantly NDO in lesions above D10 and mixed pattern in between D10 and L2 lesions. No significant correlation was found between detrusor behavior and the level or severity of NTM in the study. © 2013 Annals of Indian Academy of Neurology.

Sukhwal M.,NIMHANS | Suman L.N.,NIMHANS
Asian Journal of Psychiatry | Year: 2013

The aim of the present study was to examine spirituality, religiosity, and alcohol-related beliefs among college students. The sample consisted of 236 college students - 120 girls and 116 boys. The age range of the sample was between 18 and 21 years. The tools used in the study were Personal Information Data Sheet, Scale for Assessment of Attitudes toward Drinking and Alcoholism (SAADA), Alcohol Expectancy Questionnaire - Adult Form (AEQ), Beliefs and Values Scale (BVS), and The Religious Background and Behavior Questionnaire (RBBQ). The data were analyzed using t-test and Pearson's product moment correlation. Higher spirituality, religiosity, and both the components of religiosity - God Consciousness and Formal Practices, were all associated with less acceptance of drinking and alcoholism. Positive affect and higher spirituality were both associated with religiosity as well as its components. A positive correlation was found among religiosity and both its components. The results revealed gender differences in that the God Consciousness component of religiosity was found to be higher in girls, but not boys, who did not have exposure to alcohol through prior use or alcohol use in family. The implications for primary prevention for college students are discussed. © 2012 Elsevier B.V.

Sathish Kumar S.V.,NIMHANS
Indian Journal of Public Health Research and Development | Year: 2016

Since the initiation of deinstitutionalization of patients suffering from mental illness, provision of easy access to health care facilities, community participation and rehabilitation of such patients has become practical challenge. Still now patients suffering from long term psychiatric illness lacks adequate care and opportunities which preventing them to become the part of mainstream of the society. Either they spend their life in long term psychiatric hospitals, rehabilitation centres or their life expectancy become shorter due to various adversities which they encounter. It is the high time to address difficulties in rehabilitation of long stay patients at various closed wards of psychiatry hospitals. © 2016, Indian Journal of Public Health Research and Development. All rights reserved.

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