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Barrett A.M.,Stroke Rehabilitation Research | Muzaffar T.,Vardhman Mahavir Medical College
Current Opinion in Neurology

Purpose of review Stroke rehabilitation needs to take major steps forward to reduce functional disability for survivors. In this article, we suggest that spatial retraining might greatly increase the efficiency and efficacy of motor rehabilitation, directly addressing the burden and cost of paralysis after stroke. Recent findings Combining motor and cognitive treatment may be practical, as well as addressing the needs after moderate-to-severe stroke. Spatial neglect could suppress motor recovery and reduce motor learning, even when patients receive appropriate rehabilitation to build strength, dexterity, and endurance. Spatial neglect rehabilitation acts to promote motor as well as visual-perceptual recovery. These findings, and the previous underemphasized studies, make a strong case for combining spatial neglect treatment with traditional exercise training. Spatial neglect therapies might also provide motor stimulation if people cannot participate in intensive movement therapies because of limited strength and endurance after stroke. Summary Spatial retraining, currently used selectively after right-brain stroke, may be broadly useful after stroke to promote rapid motor recovery. © 2014 Wolters Kluwer Health | Lippincott Williams & Wilkins. Source

Chugh P.K.,Vardhman Mahavir Medical College

With improvements in survival rates for women with systemic lupus erythematosus (SLE) in the last few decades, the focus has now shifted towards the management of the associated complications. These include cancer, cardiovascular disease, osteoporosis and early menopause. These co-morbidities are believed to be the result of a complex interplay between the inflammatory process and disease treatment, and they complicate the management. A majority of women with SLE suffer considerable morbidity in the prime of their life. A team of multidisciplinary specialists is required to ensure aggressive and comprehensive management of risk factors, treatment of symptoms and prevention of complications to ensure successful outcomes. © 2013 Elsevier Ireland Ltd. Source

Kakkar A.K.,Vardhman Mahavir Medical College | Dahiya N.,Lady Hardinge Medical College
European Journal of Pharmacology

Parkinson's disease (PD) is chronic progressive neurodegenerative disorder characterized by profound loss of dopaminergic neurons in the nigrostriatal pathway. It is recognized by the cardinal clinical features of bradykinesia, rigidity, tremor and postural instability. Current therapeutic options are primarily dopamine replacement strategies that only provide symptomatic improvement without affecting progressive neuronal loss. These treatments often fail to provide sustained clinical benefit and most patients develop motor fluctuations and dyskinesias as the disease progresses. Additionally, non-motor symptoms such as autonomic disturbances, sensory alterations, olfactory dysfunction, mood disorders, sleep disturbances and cognitive impairment cause considerable functional disability in these patients and these features often fail to respond to standard dopaminergic treatments. This mini review outlines the current pharmacotherapeutic options for PD and highlights the emerging experimental therapies in various phases of clinical development. © 2015 Elsevier B.V. All rights reserved. Source

Malhotra N.,University of British Columbia | Upadhyay R.P.,Vardhman Mahavir Medical College
Acta Paediatrica, International Journal of Paediatrics

Aim To examine the barriers and facilitating factors for seeking treatment for childhood diarrhoea and to determine the main causes for delay in seeking treatment. Methods Data from Indian Demographic and Health survey 2005-06 (NFHS-III) were used. Mothers were asked whether their children (<5-years) had suffered from diarrhoea during the 2 weeks preceding the survey. Data were collected on the time of seeking treatment after start of the illness and days waited to seek treatment after the diarrhoea started. Multivariate logistic regression analysis was performed to find the determinants of seeking treatment at the health facility and the factors responsible for the 'delay' in seeking advice/treatment. Results Of a sample of 41 287 children, 3890 (9.4%) reportedly had diarrhoea. Sixty percentage of children with diarrhoea were taken to a health facility. Mother's education till higher secondary and above (OR 1.65; 95% CI, 1.08-2.54), richest (OR 1.76; 95% CI, 1.24-2.48) wealth index, and possession of a health card by the mother (OR 1.35; 95% CI, 1.12-1.62) increased the odds of seeking treatment. There was a strong gender bias; a male child had lower odds of experiencing a 'delay' in seeking treatment, compared with a female child (OR 0.71; 95% CI, 0.55-0.92). Access to a health facility still remains a major issue: treatment seeking was delayed when distance to a health facility was reported as a 'major problem' (OR 1.33; 95% CI, 1.01-1.76). Conclusion(s) Improved care seeking for childhood diarrhoea in India is still constrained by access to a health facility and requires expansion and strengthening of the public health system. The caregivers, especially the mothers need to be educated about the importance of seeking timely treatment and the benefits of oral rehydration solution. © 2013 Foundation Acta Pædiatrica. Published by John Wiley & Sons Ltd. Source

Sharda N.,Vardhman Mahavir Medical College
Cardiology in the Young

Cardiac involvement is a rare initial presentation of systemic lupus erythematosus. An 11-year-old girl was described to have massive haemorrhagic pericardial effusion and cardiac tamponade, which was later diagnosed as systemic lupus erythematosus. Therefore, in children presenting with cardiac tamponade, systemic lupus erythematosus should be considered as one of the differential diagnoses, as morbidity and mortality associated with cardiac tamponade can be dramatically reduced with early diagnosis and use of steroids. © 2013 Cambridge University Press. Source

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