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Acta Scientific Neurology

Journal Papers (52) Details Call for Paper Manuscript submission Publication Ethics Contact Authors' Guide Line
1 Effect of Renal Complications on Brain - An Overview , Shalini K Mehta and Sivakumar JT Gowder
The association between chronic kidney disease (CKD) and cardiovascular disease has been extensively studied but, at the same time, little information has been available on the relationship between kidney and brain. In this manuscript, we have evaluated the recent updates on the relation between CKD and neurological disorders based on literature review and survey. A wide spectrum of neurological disturbances and behavioral changes such as fatigue, head ache, sensory clouding, vision impairment, seizures, delirium and coma can be observed in patients with renal complications [1-4]
2 Optic Neuritis and Hypophysitis: Partial Remission after Pulse Therapy , Isabela Morales Cozeto, Lívia Norcia Zenerato, Letícia Alarcão Max-ta, Ricardo Baer Filho, Érico Paulo Heilbrun, Márcio Luis Duarte and Lucas Ribeiro dos Santos
Lymphocytic or autoimmune hypophysitis (AH) is a rare disorder characterized by inflammation of the pituitary gland. There is no consensus on treatment, but may include corticosteroid therapy and decompression surgery. Optic neuritis (ON) is an inflammati-on of the optic nerve, both of unknown etiology and autoimmune hypothesis. The association of pathologies is rare, with few reports in the literature. The diagnosis of ON is clinical and treatment with high dose corticosteroids. A case initially diagnosed as ON with pituitary macroadenoma is described: 55-year-old woman with sudden bilateral visual loss associated with nausea, vomiting, diarr-hea and hypotension, MRI with pituitary expansive lesion with optic chiasm compression and laboratory tests showing thyrotrophic, corticotrophic and gonadotropic axes deficiencies, associated with mild hyperprolactinemia. Methylprednisolone pulse therapy was performed for ON treatment. Patient presented improvement of visual acuity, decreased pituitary volume and recovery of cortico-trophic axis, raising the hypothesis of AH. The case demonstrates the importance of careful neuro-ophthalmologic and radiographic evaluation of patients with pituitary adenoma and visual loss. NO and AH should be considered in the differential diagnosis as this may prevent unnecessary invasive procedures.
3 Impact of Psycho-Social Intervention in Patient with GBS in Neurological Rehabilitation Set Up: A Case Report , Arun M and BP Nirmala
The current case report describes the psycho-social assessment carried out with a person diagnosed with Guillain-Barre syndro-me. Psycho-social assessment sheet which is developed for assessing psycho-social factors of patients with neurological disorder and hospital anxiety and depression scale has been used in the case report. This report also focuses on the caregiver’s issues and the associated interventions. The common psycho-social intervention which was used in this case has alleviated patient’s emotional distress and helped her go through rehabilitation process effectively. Findings of this case study support the fact that medical mana-gement complimented with psychosocial intervention could help the patient and family members deal with social and psychological dysfunctions effectively.
4 The Psychology of Patients Infected with COVID 19 in Tunisia during the Treatment Period , Kahna Mohamed, Cherni Bochra and Baaouni Zaineb
The COVID-19 still causes anxiety and apprehension among many patients today, which can lead to a refusal of care or difficult working conditions. It, therefore, appears prerequisite to set up conditioning and relaxation methods for patients and caregivers to optimize care and working conditions. In this regard, we assess the psychological levels of patients in their forties to detect the fac-tors in order to facilitate the treatment.
5 Coronavirus - The New Generation Influenza Psychiovirus , Vahram R Sargsyan
The paper presents a new scientific approach for interpreting the mechanisms of functioning of the influenza virus in nature. New biological theories are discussed - viral theories, on the basis of which the coronavirus known to everyone since 2019 is considered as a psycho-influenza virus. More details are given - the viral theory of biocommunication and the viral theory of signal transduction. In conclusion, modern scientific methods of protection against infectious diseases are proposed.
6 Enhancement of Function of the Prefrontal Cortex to Improve Symptoms of Schizophrenia , Prajjita Sarma Bardoloi
Schizophrenia is a chronic psychotic illness with multifactorial etiology that manifests with a constellation of positive, negative, affective and cognitive symptoms [1]. As we are learning more about the neurobiology of schizophrenia, the role of the prefrontal cortex (PFC) in schizophrenia has become more evident. While various medications are available to treat psychotic symptoms in schizophrenia, treatment of cognitive functions, residual symptoms and comorbid disorders is still a substantial challenge. Here we present a case of a young male who suffers from schizophrenia, with a previous diagnosis of ADHD and substance abuse, who showed remarkable improvement following treatment with the alpha-2A adrenergic agonist guanfacine, likely related to enhanced PFC function
7 Mental Health of Healthcare Personnel during Quarantine for Infectious Epidemic--Real-time Data , Uriel Halbreich and Fanqiang Meng
Background: The 2020 Coronavirus (COVID-19) pandemic has been causing significant fear and anxiety among the general public and demonstrate insufficient preparedness of Healthcare systems. It shed light on front-line Healthcare-personnel who should func-tion and treat others while they share the same stressful situations.Objective: To provide actual real-time data on mood and mental symptoms of Healthcare personnel in quarantined wards during the Chinese-SARS epidemic, in order to support procedures for functioning of personnel during current and future epidemics.Setting, Participants and Measurements: Cross-sectional Study was conducted during the acute exacerbation of the SARS epide-mic at quarantined wards by nurses who were embedded and quarantined with the patients. Mood and perceptions of Healthca-re-personnel infected (n = 55) and not infected (n = 149) with SARS, as well as those during quarantine “rehabilitation” (n = 62) were compared to SARS patients (n = 96), healthy quarantined students (n = 55) and healthy non-quarantined controls (n = 52).Structured interviews were conducted with the Beck Depression Inventory (BDI), Spielberger’s State-Trait inventory, symptoms Checklist-90 (SCL-90) and a situation-specific questionnaire.Results: Healthcare-personnel -- infected and not-infected, suffered as much mood, anxiety and other stress-induced symptoms as their SARS patients. Strictly enforced quarantine amplified personnel’s frustration, mental symptoms and mistrust in authorities.Limitations: Data was collected when many patients were assisted by respirators, some could not be included.Conclusion: During acute epidemics front-line Healthcare-Personnel are exposed to same and even more extreme situations as their patients. Their emotional state under tumultuous situations should be of concern.Implications: Mental well-being procedures and enhancement of Mental resilience of Healthcare teams should be an integral com-ponent of their preparedness for future disasters
8 Takotsubo Cardiomyopathy Resulting from Transient Global Amnesia Following a Sexual Encounter , Kamalpreet Dhaliwal, Sonia Randhawa, Nabihah Kabir, Yadwinder Sidhu, Harsimran Singh, Shawn Banash, Muhammed Janjua and Vib-hav Bansal
Background: Transient global amnesia (TGA) is a neurological condition described as acute onset anterograde amnesia that resolves within 24 hours. TGA is often associated with migraine history, psycho-physical stress, and cardiovascular risk factors. Takotsubo Cardiomyopathy (TTC), also known as Broken Heart Syndrome, is a reversible, stress-induced weakening of the left ventricle (LV) resulting in cardiomyopathy. Concurrent occurrence of the two syndromes have rarely been reported. To date, there have been 10 documented concurrent TGA and TTC cases, all unrelated to sexual triggers. Here we report the first patient with simultaneous TGA and TTC following a sexual encounter.Insights and Aim: Summarize a case and its associated factors to establish awareness of a possible causal relationship between TGA and TTC following a sexual encounter as a precipitating factor. Case Report: A 66 year-old woman presented to the emergency department with sudden onset confusion and forgetfulness wit-nessed by the patient’s husband immediately after sexual intercourse.Neurologic exam on admission revealed short-term memory deficits, resulting in repeated questions of similar nature regarding the peri-ictal period. Lab results revealed an elevated High Sensitivity Troponin-T of 51 ng/L (normal, < 14 ng/L); all other pertinent labs were within normal limits. The patient’s neurological manifestations of amnesia resolved 14 hours after the time of presentation. Conclusion: Although TGA is considered a primary neurologic disorder, it is important to recognize a possible relationship between TGA and TTC in order to manage the cardiac complications that may arise from TTC
9 The Transcranial Direct Current Stimulation (tDCS) and Biofeedback (BFB) as a Mixed Methods in Reducing Symptoms of Migraine , Mohammadjavad Hoseinpourfard and Masoumeh Shajarian.
Migraines may be induced by triggers such as fatigue, certain foods, weather, and so on. Of-course some patients with migraine report other experiencing triggers include dietary and sleep disor-ders. Many of symptoms pertaining to the migraine may start, up to 24 hours after a trigger and continue for 72 hours. In addition, the psycho-physiological aspects could consider as other important triggers.
10 Class-I MHC-Restricted T-Cell Associated Molecule (CRTAM) Expression in Cerebellum. , Esther López-Bayghen, Karla Pérez-Toledo, Leticia Ramírez- Martínez, Jacqueline Robledo,Vianney Ortiz and Arturo Ortega.
The class-I MHC-restricted T-cell associated molecule (CRTAM), an activation molecule expressed in activated Natural Killer cells (NKT) and CD8+ T cells, is highly expressed in the cerebellar cortex, both in neurons and glial cells. During cerebellar development, granule cell migration over Bergmann glia cells depends on neuronal/glia glutamatergic signaling, suggesting a regulated cell-cell in-teraction process, opening the possibility of CTRAM and Nectin-like 2 involvement. Through the use of the well-established model of chicken cerebellar Bergmann glial cells and a wound/healing assay, we describe herein that glutamate represses CRTAM expression, enhancing migration. These results reveal an unexpected function of CTRAM in the cerebellum.
11 Corona Virus (COVID-19): A Brief Status in India about its Transmission and Precaution. , Abhishek Jha, Deepak kumar Mishra, Deepika Sharma  and Suvercha Arya.
Coronaviruses were first discovered in the 1930s when an acute respiratory infection of domesticated chickens was shown to be caused by infectious bronchitis virus (IBV). Coronavirus disease 2019 (COVID-19), caused by severe acute respiratory syndrome coronavirus 2 (SARS-CO-V-2), was first reported in Wuhan, Hubei province, China has now rapidly spread over 200 countries. Rapid worldwide spread of Coronavirus Disease 2019 (COVID-19) has resulted in a global pandemic. Current Scenario of India is also not however very good and facing a high risk despite a continuous lockdown from 22nd March - 17th May 2020. However, the lockdown is again increased from 18th May - 31st May 2020.
12 External Ventricular Drains: An Overview of Indications, Technique, and Complications. , Anudeep Yekula,  Aditya Mittal, Varun Sagi  and Mihir Gupta.
External ventricular drains (EVDs or ventriculostomies) are frequently required for acute management of intracranial hyper-tension and monitoring intracranial pressure. Patients with ventriculostomies are frequently co-managed by multiple specialists including neurologists, neuro-intensivists, trauma specialists, emergency department physicians and neurosurgeons. We provide background on the indications, placement technique, troubleshooting and complications related to this procedure. We also discuss emerging best practices for preventing complications such as ventriculostomy-related infection. We conclude with considerations regarding ventriculostomy removal and areas of ongoing study. This review serves as a primer that may facilitate collaborative care between diverse allied providers.
13 Need for Antimicrobial Agents in Daily Applications in Hygiene and Disinfection: An Opinion. , Shimon Shatzmiller.
The hygienic situation in hospitals and other health facilities have become a source of sickness that is killing thousands all over the place, and in Israel as well. A similar situation is in agricultural land. Since the ban on the use of methyl-bromide for soil disinfec-tion, agricultural products can be infected with species of dead causing microbes, germs, and viruses. Imitation of natural materials isolated from amphibians and reptiles (crocodiles) can bring relief. These natural substances act on the bacteria in a way that does not cause the resistance of the microbes. Natural like synthetic imitators can be used, which can be produced in large quantities and low economic requirements and eradicate the pathogens in the soil and hospitals.  
14 Simple Strategies for Brain Health. , Seyedeh Nasim Habibzadeh.
The brain is a major organ in human body that is made up of a large nervous system of nerve tissues which process the sensory information and controls the thoughts, memory and speech. The brain also governs the movement of the limbs and the function of many other organs within the body. The brain is very highly sensitive organ which can harm easily. Any bad news, unexpected shocks and daily pressures can affect the brain functions. However, the servers kind of negative aforementioned stresses can cause the brain waves or vibrations and even any low level of stresses can induce the brain unwanted waves afterwards. In this regards, stress management would account for a good strategy to improve the brain health. Avoiding of being in stressful environments and performing some gentle exercise like walking and listening to the music can be very beneficial approaches to protect the brain and its functionality in time.
15 Love, Bonding Phenomenon, and the Healthy Narcissism. , Ronnie Solan  and Anat Ben-Artsy.
It is common psychoanalytic knowledge that the influence deriving from childhood experiences carries well on into adulthood. This article’s main objective is to disclose the survival motive behind the influence of childhood experiences throughout life. The survival motive seems to relate to the Healthy Narcissism Processing [1-3], a process metaphorically scrutinized to an Emotional immune system. Memory traces of childhood experiences, such as intimacy with the object or Separation Anxiety, etc., reverberate all along life through the processing of Healthy Narcissism. Accordingly, the sense of the Familiar Self may be preserved, immunized and assisted. Likewise, the “Me” and its belongings (like its objects and love relations) are recognized as familiar, stimulated to be restored, revived and recharged in present experiences according to past involvements. Re-finding the familiar senses in present events, according to the models of past experiences, facilitates adaptation to daily relationships and to almost familiar occurrences.
16 Critical Evaluation of Physical Exercise on Brain Structure and Function. , Mahsa R M Mansouri and Sivakumar J T Gowder.
Physical activity or physical exercise act against the sedentary lifestyle-induced health matters such as cognitive decline or neu-rodegenerative diseases. Physical exercise and physical activity is important for people of all age groups that not only could enhance mental capacity and social interactions development of pre-school aged children, but also could maintain and ameliorate muscle strengthening and health condition such as high blood pressure of old adults. Physical exercise also, acts as gene modulator which develops brain function due to structural and functional changes such as neurogenesis, glycogenesis, brain volumes, white matter integrity, neurotrophies levels and or cognitive performance.
17 Physical Therapy in Mental Health? , Stavros Stathopoulos
The core of physical therapy in mental health is to optimize wellbeing and empowering the individual by promoting functional movement, movement awareness and physical activity, exercise, bringing together physical and mental aspects. Physical therapists in mental health play a key part in the inte-grated multidisciplinary team/interprofessional care.
18 A Neuroscientific Study of the Brain Stimulator and Simulation Model to Predict Breakfast PPG Using GH-Method: Math-Physical Medicine , Gerald C Hsu
The author interprets the brain stimulator and its associated simulation model of predicted breakfast postprandial plasma glu-cose via a food or meal segmentation analysis and Sensor PPG waveform characteristics study. He has been using a continuous glucose monitoring device applied to his left upper arm and has collected 74 glucose data each day since 5/5/2018. However, by the mid-2019, he noticed that many of his post-breakfast glucose values escalated approximately one hour after the first bite of his breakfast, even when eating pure protein such as eggs without any carbs/sugar content. Therefore, during October of 2019, he modi-fied his computer software to sort out different food contents and processed their associated PPG waveforms. By using a pure protein egg breakfast case study, this research paper offers some explanations to his speculation and hypothesis on how when eating food, this would prompt the brain to send an order to the liver to start the glucose production. This paper further links the functions of our brain, liver, and pancreas working together.
19 Centralized Pain: Status Review and Medical Management , Ihsan F Shanti, Bilal F Shanti, Ali Otom,  Ali Al Rjoub  and Khalil Al-Abbadi
Centralized pain is non-fatal disorder linked to permanent changes and chaotic imprinting of pain inputs within the central ner-vous system. This occurs without obvious logical reasons that we know of. This persistent heightened alert of the nervous system is very exhausting to the patients and their families. The magnitude of other symptom comorbidities makes this pain entity even more challenging to diagnose and treat. Fortunately, recent research discoveries have introduced a few theories such the concept of glial activation and neuroinflammation as having some plausible role in this complex syndrome. This review manuscript will seek to explain and simplify some of the non-procedural clinical medical management options available to date, as tools for us, clinicians, to fight this painful entity
20 Thermotherapy and Vibroacoustic Therapy in Preventing and Possibly Reversing Dementia and Alzheimer’s , George Grant and Jay P Vanden Heuvel
The Objective of this Literature Review is to find any published scientific evidence to correlate the use of both Thermotherapy [Hyperthermia][Heat Therapy] and Vibroacoustic therapy [Vibration + Sound] to prevent and possibly reverse chronic neurological conditions like Dementia and Alzheimer’s Disease.
21 Defeating the Devil in the Waste: Remediation of Infectious Covid-19 Waste. , Sachin Kumar and Pinky Kain
The Covid-19 infectious-biomedical waste generated from the health care and research activities are posing a huge invisible threat. The waste containing many deadly microorganisms, their toxins and particularly Corona Virus are posing a risk of infection relapse and occurrence of future infection waves. Workers who are involved in taking care of this waste are at risk of getting exposed to Covid-19 and other dangerous biological agents by punctures/cuts (contaminated sharps), skin-mucous contact/projection of blood or biological fluids, ingestion or inhalation of contaminated particles.
22 COVID 19 Pandemic Anxiety and its Management , Suprakash Chaudhury, Pooja V, Mahesh Thakur and Daniel Saldanha
The COVID-19 Pandemic is likely to evoke questions within the minds of a vast number of individuals across the globe due to its high degree of communicability and an apparently greater fatality rate compared to many other flu-causing viruses. No specific medi-cations against COVID 19 are available presently. A vaccine against it has also not been developed thus far. The only known methods to prevent the disease are non-pharmacological measures like avoiding contact with infected person, social distancing, use of face masks, through hand-washing with soap and water or alcohol based sanitizers, etc.
23 Brain Imaging and Aging , Shimon Shatzmiller, Galina M Zats and Inbal Lapidot
Brain imaging is one of the main obstacles of modern disease diagnostics since it has to allow accurate and quantitative mea-surements on a living organ that is placed in adults (in neonatal humans skull penetration is somewhat easier) inside a bone cage. Inside is the brain, the main function controller of our body that has to be done in a non-invasive way on the living operation brain. Many spectroscopic methods are trying to overcome the difficult access to the brain: Photoacoustic microscopy, Confocal microsco-py, Two-photon microscopy, Optical coherence tomography, Scan-ning Laser Acoustic Microscopy, Acoustic microscopy, Ultrasonog-raphy, positron tomography, fluorescence methods, photo caustic microscopy and multy (two) photon imaging spectroscopy.
24 Distal Catheter Migration to Mediastina in Ventricular-peritoneal Shunt, a Case Report , Amir Kamalifar, Samar Kamalifar , Amir Rezakhah  and Firooz Salehpoor
Ventricular-peritoneal shunting (VPS) is common neurosurgical procedure in childhood and have many complication like mal-function infection and malposition, we present a case with a positioning of distal catheter in thoracic region.
25 Schizo-obsessive Disorder - Diagnostic and Therapeutic Difficulties - Case Report , Anna Urbańska, Aneta Perzyńska-Starkiewicz, Łukasz Proć, Agnieszka Lis, Aleksandra Kordyga-Proć and Marcin Olajossy
A case of patient with schizo-obsessive disorder is presented. Schizo-obsessive disorder causes many diagnostic difficulties. The patients may not respond to the basic treatment regimens for schizophrenia or schizo-affective disorder and they may need poly-pharmacotherapy more often than usual.
26 Concussion in Older Population , Oyeneyin Babatunde David, Opeyemi Oluwasanmi Adeloye  and Oyeneyin Oluwatosin
Concussion present with many symptoms but the most common is headache. Other symptoms include dizziness, nausea, imbalance or vertigo, fatigue or drowsiness, sensitivity to light and noise, amnesia (which is a typical feature), abnormal behavior and seizure. At old age, the human skull has an increased space as the brain begin to shrink just like the other body tissues which experience the same physical changes due to ageing. Subdural hematoma, easily occur in the aged brain vessels following an accident and could be worsened when patient is on anti-inflammatory drugs. In this study, we critically review the current knowledge of concussion in the older populations.
27 “Haquapathy” - The Most Natural Holistic Approach to Weight Loss , Faris Al Hajri
Haquapathy is one of the basic methods of revitalization in the system of natural medicine, which we also coined it as Haqua Re-vitalize® Therapy (HART), otherwise known as; Hot Aqua Therapy (HAT), Hot Water Therapy (HOWT), Hydrothermal Therapy (HTT), Aqua Calidum Therapy (ACT), Maysakhin Therapy (MST), and Majimoto Therapy (MMT), that we instigated, being the origina-tor and founder of this therapy since we discovered its significant health benefits to the human body in August 2007, until the pres-ent moment.
28 The Brain and Consciousness , Mette Mouritsen
A “knee experience” is a complicated process that requires coordination of the skin cell’s recording of touches and the mus-cle-tendon’s registration of position and more in order to bring a mental image to the brain. The brain cannot by itself generate the experience "knee," it requires a lived experience of the knee at the cellular level, which in all provides an awareness and remem-brance of “knee.” The experience of knee thus requires informa-tion from several different cells and direct contact. There must be something or someone that relate to the knee by touching it, before the knee can be experienced to its full, otherwise it will just be a mental image, which also is an experience of “knee,” however it is entirely a mental image.
29 Death and Consciousness , Mette Mouritsen
When observing a dead body, it is obvious that something is missing. The glow, warmth and movement that characterizes a liv-ing human being are obviously lacking. “The thing”, which is lack-ing is the formless energy that makes a person alive. The entire physical body including the brain and the heart and the genes are left back, they are no longer self-propelled as they seemed to be when the body was fully alive. In a metaphor the notes and the instruments that contributed to the orchestra of the body are still there, but the conductor and the sound has left the orchestra. It all happens in a breath, one moment alive the next moment dead.
30 “KD Ear Blow Sign” in Rabies , Vinod Kumar Tewari, Abhishek Gupta, Devesh Johari and Lori Tewari
In rabies patient on blowing on any ear, the respiratory muscle spasms is increased. This “KD EAR BLOW SIGN IN RABIES” is due to increase in humidity (examiners moist air blow) in the auditory canal which in turn sends impulses via those auditory nerves to temporal lobe thus stimulating reflex.
31 COVID-19 and Nervous Relation , Vijay Kumar
The COVID-19 predominantly affects the respiratory system, causes alveolar damage, edema, and inflammation [1]. However, many experimental studies and case reports on coronaviruses (CoVs) highlighted their potential neurotropism. The neuro-inva-sive propensity has been illustrated as a common feature of CoVs. The SARS-CoV and SARS-CoV-2 showed the greater similarity, it is quite possible that they also possess similar potential. The neuro-trophic viruses may enter the brain by direct infection injury, hy-poxic injury, blood circulation pathway, immune-mediated injury, neuronal pathway, and include other mechanisms [2]. After the invasion, the impact of SARS-CoV-2 on neurological manifestation and complications can be seen in central and peripheral nervous system.
32 Preterm Births and Cognitive Development , Frolli A, Ricci MC, Valenzano L, Cavallaro A, Pastorino GMG and Operto FF.
The birth of a premature baby is a decisive factor in determining long-term consequences on cognitive development. Considering the Wechsler Intelligence Scale for Children (WISC) as a reference, there are several evidences resulting from numerous studies that show a variation in the cognitive profile: preterm-born children have been shown to have an increased risk of cognitive impairment and have consistently shown lower results than control groups on standardized tests of general intellectual functioning. In our study we expand the sample age and evaluate the cognitive profile of adolescents and understand if cognitive abilities had specific effects, comparing a group of adolescents born preterm (group 1) with a group of adolescents born on term (group 2). Broadening the study population age, we may conclude that the impairment of WM’s abilities persists during the course of development, and therefore subjects with a preterm birth history continue to present difficulties in global cognitive functioning, also impacting lifestyle.
33 Rare Case of Inflammatory Pseudotumour of Central Nervous System - A Case Report , Siddharth Gautam
Inflammatory Pseudotumours (IPT) are mostly benign lesions, mimicking malignant lesions and affecting almost all organ systems and are characterised by fibrotic ground tissue and polyclonal mononuclear infiltrate on histopathology. It is a disease of unknown pathogenesis and the brain is a rare site of occurrence. Here we present one such case we operated recently in our department.
34 Epilepsy and its Management in Unani Medicine , Azma Waseem, Anwar Jamal, Usama Akram and M Fazil.
Epilepsy is one of the oldest ailments that have been affecting the human beings. As per World Health Organization (WHO), epi-lepsy is a chronic non communicable brain disease that may affects people of all ages. It is characterized by two or more provoked seizures, which are brief episodes of involuntary movement that may involve the whole body or a part of the body. Near about 50 mil-lion people is suffering from epilepsy worldwide, and approximately 5 million people are diagnosed with epilepsy each year making it the most common neurological disease globally. Discrimination and social stigma is still associated with epilepsy in the world and it impact on the patient’s quality of life and their families as well. Most of epilepsy patients live in developing countries and unable to get the proper treatment for the disease. In Unani system of medicine, epilepsy is described as Sar‘. Classification of epilepsy in this ancient system of medicine has been done on the basis of temperament, predominance of humor involved, internal and external factors etc. In this paper an attempt has been made to explore the concept of epilepsy in Unani medicine, its type, etiology and management through various modes of Unani treatment. This article will help in reducing the burden of this common neurological problem and development of new intervention for the disease
35 Complications of the Anterior Cervical Discectomy and Fusion , Muthana Ibrahim Jameel, Liwa Abdullah Ali, Ihssan S Nema and Zahraa F Al-Sharshahi
Background: Anterior cervical discectomy and fusion (ACDF) means removing the symptomatic disc by an anterior approach with placement of a bone graft or a synthetic cage. Many studies have shown the procedure to be effective, but associated with complica-tions.Objective: To document and record the type and incidence of complications associated with ACDF, and to find any predisposing fac-tors or associated medical illnesses and other demographic factors or conditions that increase the complications.Patients and Methods: A prospective review of 48 patients who underwent an anterior cervical discectomy and fusion between (May\2012 - July\2014) in two hospitals with an average 6 months follow up.Results: The sample of patients was classified according to age, gender, diagnosis, complications, associated medical illnesses, level of the operation. Then the complications were analyzed according to these parameters trying to find any predisposing factors or as-sociations. Hoarseness of voice was 79%, Dysphagia 54%, Neurapraxia 14.6%, Other medical illnesses 12%, Infection 4%, Reopening 4%, wrong diagnosis 4%, worsening 4% and Death 2%.Conclusion: The complication rate for ACDF is low in experienced hands. Hoarseness is the most common reported complication. Dysphasia, laryngeal edema or a sensation of a lump in the throat are also reported. Associated medical illnesses especially asth-matics and smokers and any patient with chronic cough or respiratory problems are the major cause of complication. Also there is marked association of complications in patients with multisystemic chronic diseases.
36 Use of Dopamine Agonist in Tetanus Spasms - A Novel Approach to Revert the Respiratory Spasm - The Cause of Mortality , Vinod Kumar Tewari, Abhishek Gupta, Devesh Johari and Lori Tewari.
In tetanus patients Levodopa and Carbidopa combination (which is usually used to relieve the signs of extrapyramidal) causes respiratory muscles spasm relief thereby the need for sedatives is decreased and patient saved later on via central nervous system mechanism, by providing the inhibitory neurotransmitters at Anterior Horn cells.
37 Post-intensive Care Syndrome in COVID 19: Monitoring from the Physical Medicine and Rehabilitation and Clinical Psychology , Espinosa-Gil Rosa María and Monteagudo-Santamaría María
The Covid-19 has been a great challenge. At this time, it is interesting to approach patients with severe COVID who have required prolonged admission to the Critical Care Unit (ICU), intubation with connections to mechanical respiration, even connection to the extracorporeal oxygenation membrane (ECMO), because our hospital (Virgen de la Arrixaca, University Hospital, in Murcia), is reference for connection to ECMO.We have elaborated a process/protocol for offering physical and psychological care (assessment, diagnosis and treatment) from the hospital environment and specifically from Rehabilitation Service. This constitutes a challenge and we consider that it will have a significant improvement in both physical and psychological symptoms. We are working in the context to Post ICU Syndrome.The sample is reduced by the severity of the patients.We cannot offer results due to the recent pandemic and because in our region it occurred one month later than in the rest of the most affected regions in Spain (Madrid, Barcelona, Bilbao). We are in the first medical and psychological evaluations and treatment in the actuality.
38 The Bitter Truth: Lessons from Pandemic Covid-19 , Pinky Kain
The pandemic is treating everybody equal. Current rise in Co-vid-19 cases in USA has taught that no country is a super power or leading now. Nobody is as educated as we think. We all are proving failures. Even the wealthiest are hiding and isolating. Riches having less immunity is a weaker and most vulnerable class. Lack of tis-sues rolls, grocery, medical supply, health insurance and food has driven the upper class crazy. The poor class is actually more on the safer side where having no money is a blessing in disguise. Their strong will powers and immunity is shielding them.
39 COVID-19 and the Brain , Maria Elena López and Sofia Isea
During the present pandemic of COVID-19 disease, interest has shifted from the respiratory system affectation to involvement of other organs and systems. Recently pre-eminence of neurological symptoms and signs has emerged. We have done a comprehen-sive review of the literature published as open access in various databases with the purpose of increasing our understanding of the disease and aid in the identification of patients with these neurological conditions. We have reviewed articles reporting neurologic manifestations in young individuals and children. Although there is nor enough data to establish prevalence of the conditions affect-ing pediatric population, as the number of worldwide cases increases we expect to find an increase in these reports. it is considered of utmost importance to urge clinicians to document symptoms and neurological signs in the context of the disease in order to contribute to a better understanding of Neurocovid and to generate a body of knowledge that influences the optimization of the diagnosis and approach of this entity, taking as a premise that the early installation of individualized and reasoned treatments will translate in a better survival rate of those affected and lower the occurrence of eventual ongoing deficits.
40 Coronation's Disturbing Effect: Even After they Recuperate - The Sense of taste and Smell did not Return to Some of the Adhesives , Shimon Shatzmiller
A Wall Street Journal study claims that a high percentage of re-covering Corona researchers already claimed that the loss of taste and smell is one of the symptoms of those infected with the virus. Some patients experience this sensory loss along with other symp-toms, such as high fever, cough, or shortness of breath. According to a study published in the Wall Street Journal, some patients have recovered from Coronavirus SARS-COV-2 and most of its many effects on the human body. But have reported that their sense of taste and smell has not returned to this day.
41 Impact of the COVID 19: Losses and Mourning , Eva María Esparza Meza
At birth we humans are in a situation of absolute deviation, to survive we depend on the physical and psychic care that is provid-ed to us. The state of helplessness resulting from the immaturity with which we are born, is compensated by the devoted care of the mother, who, with the support of her partner, family and society in general, lends the baby a kind of external nesting that subjudges this first catastrophe called birth
42 Mental Health through Unani Medicine , Usama Akram, Neelam Quddusi, Azma Kausar, Mohammed Fazil and A A Khan.
Mental health is defined as a state of well-being in which every individual realizes his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community. In 2017, there were an estimated 46.6 million adults aged 18 or older in the United States with mental disorder. Young adults aged 18-25 years had the highest prevalence of mental disorder (25.8%) compared to adults aged 26-49 years (22.2%) and aged 50 and older (13.8%). In low and middle-income countries, between 76% and 85% of people with mental disorders receive no treatment for their disorder.Unani system of medicine is the only system which intervenes with six essential factors (Asbab-e-Sitta Zarooriya) especially by Bodily AND Psychic movement (Harkat wa Sukoon Nafsani) and sleep AND wakefulness (Naum wa yaqza). In this regard, Tadeel-e-Ruh is the basic concept to keep away mental disorders. Equilibrium between these two causes of health (Asbab-e-Sehat) is enough to keep away mental problems. In spite of that there are a number of Unani single (Mufradat) and compound (Murakkabat) drugs for examples Sedative (Musakkinat), exhilarants (Mufarrihat), Mubrridat (cold inducers) and brain strengthener (Muqwaiy-e-Demagh) keep away mental disorder such as Dementia, Insomnia, Headache, Depression and other mental disorders.
43 Proper Names and Repression. A Freudian Finding , Araceli Colín
I intend to locate Freud's contributions in relation to personal names and repression. His most spreaded idea of the unconscious is a consequence of repression. Repression operates in three stages described in his metapsychology. In order to articulate his findings, it is necessary to highlight the way in which the personal name is tied to a lack. Without lack the reality-test could not be installed and the separation between conscious and unconscious could not be established. For Freud, the core of the unconscious is made up of agents of the representation (Vorstellungrepräsentanz). They are of the order of nonsense. In my opinion those representatives are letters. Letters of personal names are one of the first fixation materials (Fixierung). Fixation constitutes the first time of repres-sion: It is a necessary but not sufficient condition for the psychic apparatus to be founded. I also analyze another Freudian idea of the unconscious: the inherited unconscious. Freud deployed this idea in his last work.
44 Evidence of a Neuroprotective Function for Niclosamide in Human SH-SY5Y Neuroblastoma and Rat PC12 Neural Cells , Kevin C Bermea, Edgar A Casillas, Liza D Morales, Laura L Valdez, Brenda Bin Su, Andrew Tsin and Benxu Cheng
Neurodegenerative disease is a debilitating and incurable condition that affects millions. It results in the loss of function and eventual death of neural cells. It has been established that exposure of model neuronal-derived cell lines to the proteasome inhibitor MG132 emulates in vitro neurodegeneration as evidenced by a marked decrease in protein degradation concomitant with an increase in aggregate intracellular ubiquitinated proteins and endoplasmic reticulum (ER) stress (via upregulation of CHOP/GADD153). Consequently, apoptosis ensues corresponding to the upregulation of p53, activation of caspase-3, cleavage of poly (ADP-ribose) polymerase (PARP), and DNA condensation/fragmentation. In this study, we investigated the potential neuroprotective function of niclosamide and its associated signaling mechanisms in SH-SY5Y and PC12 neural cells exposed to MG132. All markers of MG132-induced neurodegeneration, including the accumulation of ubiquitinated proteins, were prevented by exposure to niclosamide. In addition, niclosamide was shown to induce autophagy independently and to enhance autophagy induced by MG132. These results show that niclosamide may serve as a potential neuroprotective agent through its ability to inhibit proteasome dysfunction-induced protein ubiquitination.
45 10,000-fold Effect by a Nitric Oxide Donor (Sodium Nitroprusside) in Duchenne Muscular Dystrophy (DMD) Via Intrathecal Superfusion and Oral Tadalafil - A Case Report , Vinod Kumar Tewari, Neeraj, Devesh Johari and Lori Tewari
Duchenne Muscular Dystrophy (DMD) is a slow, progressive and fatal X-linked neuromuscular disorder due to loss of dystrophin that links the contractile apparatus to the sarcolemma via the dystrophin-associated protein complex (DPC). The NOD (Nitric Oxide Donor) causes release of Nitric Oxide (NO) by nitric oxide synthase (NOS) and then via 10,000-fold effect NOR (Nitric Oxide Receptor) it acts to release cGMP thus modulates DPC and improves the skeleton muscle functionality. We have used intrathecal sodium nitroprusside to activate the 10000-fold effect to modulate the retrograde neuroregulation in DMD (diagnosed by muscle biopsy) and oral Tadalafil as NODs and well checked by AL-TENS (acupuncture like transepidermal neu-ral stimulation) in pre ITSNP and post ITSNP phase
46 Peduncular Hallucination Status Secondary to Thalamic Stroke: Brief Case Report and Review of the Literature , Carmen Maura Carrillo de Albornoz Calahorro, Margarita Guerrero-Jiménez and Luis Gutiérrez-Rojas.
Background: The role of thalamus in the pathogenesis of visual and auditory hallucinations has been described as “Peduncular Hal-lucinosis”. This kind of hallucinations has been reported to be associated with thalamic injury joined to midbrain structures damage. Hallucinations are filled with vivid images of animals and colorful characters in motion and in many cases are associated with sleep disorders. Despite these characteristics, patients generally distinguish them as not real. Case Report: The present case has the distinction of having characteristics somewhat different from those described in published cases. In the first place, it is the case of the longest duration published up to date, 5 years, secondly, contrary to what usually happens, the patient does not criticize the objects and understands them as realConclusions: We present an updated review about literature published and redefinition of the concept the particular characteristics of this rare syndrome. When facing hallucinatory cases of an organic type, especially in patients with cardiovascular risk factors, it is important to rule out rare syndromes such as Charles Bonnet or hallucinations of thalamic origin.
47 Estrogen Detoxification and Neuroendocrinological Activation and Balancing Via Hormonal Yoga , Vidhu Gill, Kritanjali Singh and Ashok Kumar.
Estrogen is the major sex hormone formed in both males and females and is responsible for development of reproductive organs as well as secondary sexual characters. In females, its major function is to maturation and regulation of ovaries and uterus. Its major forms are Estrone (E1), Estradiol (E2), and Estriol (E3), but E2 is the most effective form of estrogen and is formed from cholesterol (steroid) ring. Most of the estrogen formed along with other hormones like progesterone is utilized in maintenance of menstrual cycle, uterine health and pregnancy by number of feedback mechanisms. Major detoxification of this chemical messenger occurs in liver by two phase mechanism: hydroxylation and methylation and usually take 2-OH pathway of detoxification which is the safest and the most efficient at molecular levels. This pathway also reduces the chances of formation of estrogen adducts which leads to abrupt DNA processing, mutation, and base exclusion. 4-OH and 16-OH pathways of detoxification is usually neglected but if there is disturbances in feedback mechanisms and estrogen load increases it might leads to blockage of energy channels by overlapping them with steroid hormone. These blocked energy channels can be healed and reopened by yoga and naturopathic interventions along with dietary and lifestyle modifications. Yoga kriyas, asanas, bandhas, mudras and relaxation reactivates and balances hormones by suppressing over-processing or rejuvenating endocrine glands to form more of these chemical messengers, without any synthetic chemicals or invasive interventions
48 Sacral Nerve Stimulation for Neurogenic Bladder: Our Experience , R Ramnarayan and H Krishna Moorthy.
Introduction: Neurogenic bladder is a condition causing significant effect on the quality of life of the patient. Sacral nerve stimula-tion (SNM) has a good role in these patients. We report our experience with sacral neuromodulation. Methods: 15 patients with refractory urinary bladder were included in this study. The aetiology of the neurogenic bladder included 7 spinal cord injury, 3 meningomyelocele, 2 failed back surgery syndromes, two multiple sclerosis and one mixed bowel/bladder (aetiology unknown). All 15 underwent test stimulation.Results: Only 10 out the 15 had a positive trial and proceeded to the next stage of implantation. The 3 patients with failed trial were all patients with complete cord injury or injuries below T12 (vertebral level) and more than 8 years duration. Of the other two one was a meningomyelocele and other was a case of advanced multiple sclerosis. Follow up period was upto four years; all 10 patients doing well. One of early cases had lead migration and had to be repositioned. One patient used to develop shock like sensation in perineum; the stimulation was stopped for six weeks and restarted at lower frequency. Conclusion: SNM is a very effective therapy for neurologic bladder in selected patients. Detailed preoperative assessments and trial are very important in this selection.
49 Concomitant Chronic Inflammatory Demyelinating Polyradiculoneuropathy and Myasthenia Gravis-A Two-Case Report , Nan Jiang and Mohamed Kazamel
Few cases of co-existing chronic inflammatory demyelinating polyradiculoneuropathy (CIDP) and seropositive myasthenia gravis (MG) were reported. However, there is no reports on co-existence of CIDP with seronegative MG or on the responses to treatment of both diseases. We report two cases with diagnosis of CIDP and MG. The first case is 38-year-old African American female with initial diagnosis of CIDP and later onset bulbar symptoms. She was diagnosed with seronegative MG by clinical suspicion and single fiber electromyography (SFEMG). The other case is a 65-year-old British male who initially diagnosed as seropositive MG then he devel-oped paresthesia and difficult walking a few months later. CIDP was confirmed by electrodiagnostic study and albuminocytologic dissociation in cerebrospinal fluid analysis. The first case underscores the importance of performing SFEMG on cranial muscles in cases of CIDP with cranial nerve involvement even if serological testing for MG is negative. In both cases, bulbar symptoms were more responsive to immunomodulatory treatment than limb symptoms.
50 Unusual Occurrence of Spinal Chondromyxoid Fibroma of the C2 Odontoid: A Case Report of a Rare Tumor at an Extremely Uncommon Site , Jean Marie Vianney Hope, Jean Paul Bitega, Edmond Mukimbili, Francis Mugabo and Albert Ndata.
Chondromyxoid fibroma is a rare benign cartilaginous bone tumor that is uncommonly found in the spine. To date, among 13 cas-es reported in the cervical spine, only two cases involve the C2 vertebra and all arise from the body. We report the first case occurring in the odontoid process of a 26-year-old woman. Firstly, because of the craniocervical instability, fusion from the occipital condyles to the posterior elements of C1 through C3 was performed. Secondarily, an expansile tumor of the C2 odontoid process was resected along with phenolization and synthetic processed bone grafting via a transoral approach. The postoperative course was uneventful without recurrence at 3-year-follow up. Then, she has returned to full-time employment
51 Typical and Atypical NMOSD - Its Implications , Venkata Krishna Chaitanya Koduri, Venkata Sundarachary Nagarjunakonda, Veeramma Uppala and Ramakrishna Gajula.
Background:Neuromyelitis optica (NMO) has evolved from Devic’s classical description to a broader disease spectrum of NMO Spectrum Disorder (NMOSD), from monophasic illness to a polyphasic illness with multiple recurrences, disease confined to optic nerve and spinal cord to now brain stem, cerebrum and even with endocrinopathy due to hypothalamic involvement [1], coexisting infections [2] and a variety of autoimmune diseases, including non-organ specific autoimmune diseases and co-existent autoanti-bodies without diseases [3].Objectives:To report, the epidemiological characteristics, clinical presentations, recurrence rate, treatment and response to therapy in 23 patients with NMO spectrum disorder among the Indian population.Materials and Methods:An observational, retrospective analysis of our prospectively maintained data base of patients during the period of May 2018 - June 2018 who satisfied International Panel for NMO Diagnosis (IPND) revised criteria [4] of NMOSD was done.Results:1. 23 case records of NMOSD were retrieved. 14 cases were aquaporin4 positive and 9 were aquaporin4 negative.2. Mean age is 39.6 years. Median age is 42 years (Range 17 - 64). Female to male ratio is 1:2.8.3. Clinical presentations included longitudinally extensive transverse myelitis being the most common followed by optic neuri-tis, area postrema syndrome, seizures and brainstem encephalitis.4. Two had associated herpes simples virus encephalitis, one CSF VDRL positivity. Two had associated retro viral disease. 5. Two had ANA, Anti ds DNA antibody positive vasculitis.6. One had CSF oligoclonal bands in CSF and an open ring enhancement on MRI suggestive of tumefactive demyelination.Discussion and Conclusion:• Contrary to current literature an unusual there is male preponderance in our study population [1,5,6].• Atypical lesions or course(Red flags)should suggest additional work up for associated diseases and prompt treatment of which can lead to significant recovery.• Aquaporin 4 antibody positivity, severity at presentation, associated diseases and relapse rate determine the prognosis.
52 PLEDs and NCSE: To Split or Lump them Together? , Keni Ravish Rajiv, Deepak Menon and Ashalatha Radhakrishnan.
Periodic lateralised epileptiform discharges are electrophysiological biomarkers of acute and sometimes chronic brain injury. A major controversy through the years has been whether PLEDs are truly ictal or just interictal or post-ictal epiphenomenon, and whether these discharges warrant any treatment. In this review, we aimed to critically analyze this issue of whether to actively treat or wait and watch PLEDs in various situations. We conclude that the etiology of PLEDs, depth of encephalopathy and presence of clinical seizures is associated with poor outcome rather than presence of PLEDs per se. Continuous EEG monitoring is warranted to recognise ictal or high risk interictal EEG patterns akin to NCSE before treating aggressively with antiepileptic drugs.