Neurological Disorders

ISSN: 2329-6895

Open Access

Current Issue

Volume 9, Issue 9 (2021)

    Editorial Note Pages: 1 - 1

    Editorial on Neurological Disorders-September

    Shanmugam Rajendran

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    Commentary Pages: 1 - 1

    HPTLC and GC-MS Analyses of Biologically Active Extracts and Fractions from Premna Latifolia Roxb Leaves

    Rajesh Kumar, Brijesh Kumar*, Ashutosh Kumar, Ajay Kumar, Manish Singh

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    Editorial Note Pages: 1 - 1

    Fragile X Syndrome Protective for Subsequent Cancers

    Maryam Sotoudeh Anvari

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    Review Pages: 1 - 4

    The Differences of Optical Coherence Tomography (Oct) and Pattern Electroretinogram (P-ERG) in Adult Patients with Anisometropic and Strabismic Amblyopia Might shows a Difference Injure in Visual Pass-Way

    Shuai Liu

    Objective: To investigate the changes of retinal thickness and P-ERG signals in adult patients with anisometropic and strabismic amblyopia. Methods: Sixty patients with monocular adult amblyopia, including 30 Anisotropic Amblyopes (AA group) and 30 Strabismic Amblyopes (SA group), were enrolled in our study at the outpatient clinic of The Hefei First Peoples Hospital of Anhui medical University from June 2019 to November 2020. Retinal Nerve Fiber Layer (RNFL) thickness was measured within 3.4 mm diameter range surrounding the optic nerve, and Ganglion Cell Complex (GCC) layer thickness within 6 mm diameter range surrounding the fovea by an Optovue RTVue Optical Coherence Tomography (OCT) in both amblyopic and fellow eyes. The amplitude and latency of P50 and N95 in Pattern-Electroretinogram (P-ERG) were recorded by a Roland electrophysiology instrument under two stimulation conditions with different temporal and spatial frequencies that were designed to bias the parvocellular and magnocellular pathways respectively. Data between amblyopic and fellow eyes was statistically analyzed by paired t test. The correlation between axial length and parameters of OCT and P-ERG was examined by Pearson correlation test. Results: Changes in RNFL thickness: In the AA group, RNFL thickness in temporal sector was significantly thinner (p=0.033), while that in the nasal, superior and inferior sectors increased (p<0.05) compared with fellow eyes. In SA group, no significant difference (each sector p>0.05) was found between amblyopic eyes and fellow eyes. Changes in GCC thickness compared with fellow eyes, in the AA group, GCC layer thickness of amblyopic eyes was significantly increased (p=0.039), whereas in the SA group, we did not find a significant difference between amblyopic eyes and fellow eyes (p>0.05). P-ERG stimulated mode biased the parvocellular pathway when compared with fellow eyes (n=15), in the AA group, the amplitudes of P50 (p=0.004) and N95 (p=0.038) were significantly decreased in amblyopic eyes, but no significant latent time difference (p>0.05) was found. In the same stimulus pattern, no statistically significant difference (n=15, p>0.05) between amblyopic eyes and fellow eyes was found in the amplitude and latency of P50 and N95 in the SA group. P-ERG stimulated mode biased the magnocellular pathway the amplitude and latency of P50 and N95 showed no statistically significant difference (p>0.05) in either the AA group or the SA group. We found no significant correlation between axial length and OCT, P-ERG parameters (p>0.05) in either group. Conclusion: Our results showed that the alterations in structure and function of retina that could be seen in adult anisometropic amblyopia were not found in adult strabismic amblyopia group. We thought the functional loss in anisometropic amblyopia was more bias to the parvocellular pathway. These findings indicated that the pathological mechanisms were different between anisometropic and strabismic amblyopia.

    Case Report Pages: 1 - 3

    Bilateral Cerebellar Ataxia with no Apparent Cerebellar Lesions: A Case of Wernekink's Commissure Syndrome

    Moussavou Cedrick

    Wernekink commissure syndrome was first described in 1941 by Lhermitte, but it wasn't until 1958 that it made its first appearance in a publication at the 22nd International Neurological Meeting. This syndrome takes its name from the first illustrations made in 1840 by Franz Joseph Julius Wilbrand, the successor of Friedrich Christian Wernekink (1798-1835). Wernekink's commissure syndrome is characterized by the combination of bilateral cerebellar ataxia with dysarthria or anarthria, associated with occasional internuclear ophthalmoplegia and delayed-onset palatal myoclonus (Holmes tremor), secondary to caudal paramedian midbrain infarction.

    Volume 9, Issue 8 (2021)

      Mini Review Pages: 1 - 8

      V.R.Sanal Kumar*, Rajaghatta Sundararam Bharath, Charlie Oommen, Nichith Chandrasekaran, Vigneshwaran Sankar, Ajith Sukumaran, Shiv Kumar Choudhary and Pradeep Kumar Radhakrishnan

      Evidences are escalating on the diverse neurological disorders associated with COVID-19 pandemic. The theoretical discovery of Sanal flow choking is a paradigm shift in the
      diagnostic science of asymptomatic stroke causing neurological disorders in earth and at the microgravity condition (human spaceflight). A critical review has been carried out herein for correlating the phenomenon of Sanal flow choking (PMCID: PMC7267099) and hemorrhagic stroke. Herein, we show that when systolic to diastolic blood pressure ratio (BPR) reaches the lower critical hemorrhage index (LCHI) the internal flow choking and shock wave generation occurs in the downstream region of the vessels, with sudden expansion, divergence, bifurcation, stenosis and/or occlusion, leading to pressure overshoot causing brain hemorrhage and/or neurological disorders. The critical BPR for internal flow choking is uniquely regulating by the biofluid/blood heat capacity ratio (BHCR). The BHCR is well correlated with BPR and blood viscosity. The closed form analytical model reveals that the relatively high and the low blood viscosity are risk factors of internal flow choking causing aneurysm and hemorrhagic stroke. In vitro data shows that fresh blood samples of healthy subjects evaporate at a temperature range of 37°C-40°C (98.6°F-104°F) and generate carbon dioxide, nitrogen, and oxygen gases in the vessel. The single phase in silico results demonstrated the occurrence of Sanal flow choking and pressure overshoot causing memory effect (stroke history) leading to progressive neurological disorders. We concluded that disproportionate blood thinning medication increases the risk of flow choking causing hemorrhagic stroke. The risk of brain hemorrhage and various types of neurological disorders in COVID-19 patients and others in earth and microgravity environment could be diminished by concurrently lessening the viscosity of biofluid/blood and flow turbulence by increasing the thermal tolerance level in terms of BHCR and/or by decreasing the BPR. The effect of Sanal flow choking is more severe in blood vessels with divergent/bifurcation regions because it leads to the shock wave generation and the transient pressure overshoot causing irreversible neuronal damage forming the core of infarction. We concluded that, for a healthy life all subjects with high BPR inevitably has high BHCR for reducing the risk of the internal flow choking (biofluid/Sanal flow choking) triggering neurological disorders as results of infraction.

      Case Report Pages: 1 - 5

      Orestes Lopez Piloto*, Tania Margarita Cruz Hernandez, Lismary Martinez Valdes, Emmanuel Batista Geraldino, Orestes Lopez Ayala, Luis Torres Alvarez and Claudia Diaz Villalvilla

      Introduction: The complexity of the pathology treated by this route, frequently of tumor origin, lies in the close anatomical relationship that they have with
      important neurovascular structures which, most of the time, are deformed, displaced or completely engulfed in them.
      Methods: A retrospective, descriptive, cross-sectional study was carried out. The universe of study was made up of all the patients operated by an endoscopic
      endonasal approach at the Institute of Neurology and Neurosurgery, in the period from May 2017 to April 2021.
      Results: A sample of 65 patients was identified. The average age was 52 years. Among the treated lesions, patients with pituitary macroadenomas (52.3%),
      followed by craniopharyngioma (20%) predominated. The postoperative complications that were recorded in our series were postoperative CSF fistula, epistaxis
      and vascular lesion (frontopolar artery) with a total of 3 cases (4.6%) and two deaths (2.9%) The degree of tumor resection in our series was total in 64.7% of the
      cases operated on by both the standard endoscopic endonasal approach (21.5%) and the extended approach for 43.2%.
      Conclusion: The endoscopic endonasal approach is a fundamental tool for the management of most lesions of the anterior cranial base and the sellar / parasellar
      region because it allows for extensive resections with a relatively low number of complications.

      Mini Review Pages: 1 - 3

      Rita K. Garnto*

      It is well known by the medical community that stress overload negatively impacts the health and well-being of individuals on psychological, emotional, spiritual, and
      physical levels. The results from multiple studies and research show that regular self-care does, in fact, help combat the negative effects of stress overload. However, the
      year 2020 has created such an elevated level of chronic stress that traditional self-care may no longer be enough to combat these negative effects effectively. By adding a
      new kind of self-care, called simple self-care to our busy daily schedules when done on a regular basis, has been proven to further reduce the negative effects of stress on
      a more immediate level. This paper examines the definition and concepts of simple self-care which has been federally copyrighted as a concept and theory of application,
      along with the benefits it has on creating a healthier lifestyle of stressing less and living happier. These results are supported by an accumulation of multiple studies and
      research which has been documented in reports and books pertaining to negative effects of chronic stress, human anatomy and physiology, and the benefits of self-care.
      The data suggests that by adding short intervals of simple self-care into our daily schedules regularly, we can start negating the harmful effects of stress overload and begin
      building up our stress resistance to better deal with chronic stress leading to a healthier and happier future.

      Review Pages: 1 - 5

      Santosh Nagare*

      As we know that pain is the most common reason for which a patient takes medicine. Pain is not a single entity but may be classified as nociceptive pain, inflammatory
      pain, and neuropathic pain. In this review we have exclusively Neuropathic pain is caused by the direct lesion on the neuron or damage or dysfunction of peripheral
      or central neurons. Although the neuropathic pain is single entity theoretically but it involve broad arena of receptor and mediators like melanocortin and its receptor
      (Type4), TLR7, TLR8, Sphingosine-1 phosphate receptor, CCL2, P2X4, and PARP-1 regulated expression of inflammatory mediator. Because of such dynamic interplay
      amongst the mediators and its corresponding receptor in addition to the inflammatory ligand and its receptor even the smallest stimulation results in spontaneous intense
      pain after that it gets transformed into chronic pain syndrome which is difficult to treat. In chronic pain syndrome, plastic changes occur in nociceptive neurons which
      can’t be reversed by pharmacological treatment. In this review, we have discussed the core pathophysiology of neuropathic pain and advances in mediator and receptor
      accompanied their consequences or interaction to sustain the neuropathic pain.

      Editorial Pages: 1 - 1

      Shanmugam Rajendran*

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      Volume 9, Issue 10 (2021)

        Case Report Pages: 1 - 3

        Lateral Medullary Infarction after Administration of mRNA COVID-19 Vaccine

        Priyankan Sharan

        As the COVID-19 Vaccination program is rampantly and progressively rolling out, increase in the number of adverse events become alarming and many rare complications have been notified. During the current period of COVID-19 vaccination, a high index of suspicion is required to identify thrombotic episodes following vaccination. However, it is important to remember that these side effects are rare and much less common than both cerebral venous thrombosis and ischemic stroke associated with COVID-19 infection itself. Neurological complications are potentially disabling AEFI (adverse event following immunization) that may range from facial palsy to stroke. The authors report the first case of lateral medullary infarct after administration of Moderna mRNA vaccine in Singapore.

        Review Pages: 1 - 6

        Non-Medical Hurdles for the Development of Causal Treatments in Neurodegenerative Diseases?

        Frank P. Maier-Rigaud

        Neurodegenerative Diseases (NDDs) occur when nerve cells in the brain or peripheral nervous system lose function over time and ultimately die. The risk of being affected by a neurodegenerative disease increases drastically with age. With increasing life expectancy neurodegenerative diseases have been on the rise. The absence of a cure for NDD implies a high burden to the individual patient but also a tremendous cost to society. This article advances some possible economic explanations for the absence of disease-modifying treatments for NDDs by exploring relevant non-medical hurdles in research and development. While the development of disease-modifying treatments for NDDs may present intrinsic hurdles existing economic research provides arguments why other explanations for the absence of causal therapies may play a role. Notably economic science can shed light on the incentives for developing causal treatments. In this article we analyse the innovation inhibiting effect of an already existing drug portfolio. Moreover we demonstrate that different regulatory mechanisms in essence price controls and health insurance as well as patent protection might distort companies’ incentives to innovate. This may tilt incentives towards research geared to smaller and lower incremental value innovations which could be an explanation for the lack of causal therapies in NDDs

        Commentary Pages: 1 - 2

        Brief Note on Mental Disorders and Psychological Wellness

        Vahid Eidkhani

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        Editorial Pages: 1 - 1

        Editorial on Neurological Disorders

        Shanmugam Rajendran

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        Volume 11, Issue 6 (2023)

          Research Article Pages: 1 - 5

          Zebrafish Whole Mount Staining Using Luxol Fast Blue Stain

          Waseem Hasan, Mazen Shafea, Doua Abdulrahman and Sahar Daas*

          DOI: 10.4172/2329-6895.11.6.570

          Background: Neurological disorders prevalence burdens the healthcare system. These neurological disorders are defined as functional impairments that affect the nervous system; the clinical neuropathological manifestations can present structural, biochemical, or electrical abnormalities.

          Zebrafish disease models have been used extensively to study human neuropathological and behavioral disorders due to the unique in vivo live real-time visualization of the developing nervous system within the transparent model.

          Myelin is a lipoprotein of a fatty multilayered membrane that surrounds the axons of the nerve cells. The myelination of the axons increases the electrical impulse speed rate through the nervous system and indicates the proper function of the nervous system.

          In zebrafish model, histological procedures are employed to study the nervous system. However, the proper orientation and serial sections should be obtained the neuroanatomy of the brain at the cellular level. Consequently, it is challenging to examine the structural alterations in real dimensional developing brain.
          Luxol fast blue is used to stain myelin sheath which is rich in phospholipids. This stain is used to differentiate white matter (rich in myelin) from the grey matter in brain tissue sections.

          Results: Here, we developed a new method of whole-mount staining that optimize the penetration of staining regents of luxol fast blue into the white and gray matter of zebrafish larvae developing brain with decrease non-specific binding and background. Our result showed the clear anatomical structures of the central nervous system as a utility for experimental neuropathology in zebrafish model.

          Conclusion: Our developed method provides three-dimensional visualization of the developing central nervous system of zebrafish; this is useful to characterize neuron demyelination in corresponding disease model.

          Research Article Pages: 1 - 6

          Neural Correlation of Relation Information-evidence from ERP

          Xiaofei Jia* and Changle Zhou

          DOI: 10.4172/2329-6895.11.6.571

          Central-parietal N200 is an ERP component that associates with orthographic processing in Chinese word recognition. Studies have shown that it may be related to the early processing of morpheme structures. Compound words can be regarded as the smallest unit of morpheme combination, the recognition process can be analogous to the comprehension of the sentence, including combining constituent morphemes. This process includes grammatical combinations and semantic combinations. Studies have found that the semantic combination takes place during the N400 time-window. Generally speaking, the grammatical combination should occur before the semantic combination, so does the structure priming that occurred during the N200 time-window represent grammatical combination? We explored this issue by using Chinese coordinative compounds and ERP technology. We found that there is a significant grammatical structure priming effect in the processing of Chinese compound words. This effect occurs in the early stage of word processing, that is, the N200 period. Combined with the previous research, the semantic relation priming occurred in the N400 window, indicating that the grammatical combination did appear before the semantic combination, and outlined the time course of the effect of relation information.

          Case Report Pages: 1 - 3

          Spinal abscess mimicking acute stroke

          Priyankan Sharan* and Puneet Seth

          DOI: 10.4172/2329-6895.11.6.572

          With the emerging as well evolving revascularization therapy of central nervous system there is always an urgency to diagnose stroke at earliest presentation. In intent to avoid treatment within window period we are on the benefit of doubt, thus stroke mimic baffles clinician especially emergency physician. Here, we report a 46 years old male presenting with unilateral neurological deficit secondary to cervical spinal abscess provisionally diagnosed as stroke.

          Volume 11, Issue 3 (2023)

            Research Article Pages: 1 - 6

            Associated Risk of Anxiety among CAD Patients in PSCC in Qassim, Saudi Arabia

            Mansour M. Alharbi*

            DOI: 10.4172/2329-6895.11.3.551

            Context: The presence of anxiety in individuals with Coronary Heart Disease (CHD) is widespread, and it is related to a higher risk of negative outcomes. There has been a dearth of research on the management of anxiety in people with coronary artery disease.

            Aims: The present study aimed to determine the associated risk of anxiety among Coronary Artery Disease (CAD).

            Settings and design: This was a cross-sectional study conducted on a group of patients with IHD between the ages of 20 and 60 years.

            Methods and material: A total of 200 individuals participated. Medical records were one of the data sources. The data of patients who meet the selection criteria gathered from the cardiology departments of the PSCC in KFSH.

            Statistical analysis used: Statistical package for Social Science (SPSS) version 23 was used for statistical analysis.

            Results: This research comprised 200 patients, the majority of whom were male (81%) and female (19%). According to the findings, 70% of people had minimal depression, 13.5% had mild depression, 8.5% had moderate depression, 4.5% had severe depression, and 3.5% had moderately severe depression. Medications were utilized in the majority of cases (98%).

            Conclusion: Anxiety disorders that manifest themselves in the setting of heart disease must be recognized and treated with caution in the early stages of the disease. When giving medical therapy, it is important to examine the effects of the drugs on the heart, as well as the possibility of drug-drug interactions.

            Research Pages: 1 - 12

            Dysregulation of Insulin Signaling in Human AD Brain and Alleviation of A?-Induced Insulin Resistance by Amyloid-? Binding Peptide (ABP) in Neural Cells

            Yuka Sai, Balu Chakravarthy, Debbie Callaghan, Qiao Li and Wandong Zhang*

            DOI: 10.4172/2329-6895.11.3.552

            Alzheimer’s disease (AD) is a progressive neurodegenerative disorder characterized by the accumulation of extracellular amyloid-β peptides (Aβ) and intraneuronal neuro-fibribillary tangles in the brain. Increasing evidence builds a strong case for the role of soluble Aβ oligomers (AβOs) in the impairment of insulin signaling in AD. Insulin signaling pathway begins upstream at the insulin receptor by phosphorylating IRS1 and propagating the signal downstream to the PI3K/ Akt which down-regulates GSK3β activity for tau phosphorylation and activates mTORC1 that mediates a wide range of cellular functions. Our study found that human AD brains had high levels of Aβ peptides with cerebral amyloid angiopathy (AD/CAA) and showed low activities of insulin signaling-responsive transcription factors as compared to age-matched non-demented controls (ND). Our further studies with neuroblastoma 2a (N2a) cells stably transfected with a human AβPP695 gene (N2a-AβPP), which secrete excessive Aβ, show that the basal levels of the expression and phosphorylation of several but not all critical signaling proteins along insulin signaling pathway are dysregulated as compared to the parental N2a cells. N2a-AβPP cells were phenotypically insulin resistant in response to insulin stimulation. Pre-treatment of N2a-AβPP cells with the Aβ-binding peptide (ABP), which binds and removes Aβ oligomers, significantly enhanced insulin signaling response in cells compared to controls. Taken together, our data suggest that human AD/CAA brains had dysregulation of insulin signaling and that Aβ oligomers may be responsible for inducing the insulin-resistant phenotype in N2a-AβPP cells and the removal of Aβ oligomers by ABP improved insulin signaling and relieved insulin resistant phenotype.

            Case Report Pages: 1 - 3

            Bluetooth Hyperosmia: Chemosensory Variant of Delusional Somatic Symptom Disorder: A Case Report

            Shweta Kalita, Nikita Mehdiratta* and Alan R. Hirsch

            DOI: 10.4172/2329-6895.11.3.554

            Objective: Correlation of Bluetooth transmission with subjective hyperosmia.
            Background: Subjective hyperosmia, as a manifestation of belief of exposure to Bluetooth transmission, with testing demonstrating the absence of true hyperosmia, has not heretofore been described.
            Case presentation: This 53-year-old right-handed single woman presented with a 10-year history of increased sensitivity to the aroma and enhanced perception of smells upon exposure to Wi-Fi electromagnetic radiation. She noted an intensity-duration effect: With higher intensity and duration of Wi-Fi exposure, her sense of smell would escalate and persist: After a few hours of exposure, her smell would jump to 190% of normal and last for two weeks.
            Result: Abnormalities in the neurological examination: Reflexes: 0 in both lower extremities. Chemosensory Testing: Alcohol Sniff Test: 8 (hyposmia). Gustation: Waterless Empirical Taste Test: Brothy: 4/8 (hypogeusia).
            Discussion: Nidus for such hyperosmic delusions may be a primary olfactory system disorder, with induction of ephaptic transmissions, causing intermittent phantosmia or otherwise misperceived odor, misattributed to the ambient environment. The assignment of the source of the hyperosmia to Bluetooth is consistent with the zeitgeist of mistrust and paranoia of higher technology. This may be a form of expectation effect due to visual evidence (high tower wires); suggestion combined with subcultural group dynamics with belief in harm of such electromagnetic/Bluetooth waves, with distorted information recall and misattribution. Suchgroup dynamics and shared misperceptions may fuel a delusion, as in the Mandela effect. Perchance, this case represents not having delusional hyperosmia due to a functional psychiatric disorder but instead having a neuroanatomic basis. Those with subjective hyperosmia and hypersensitivity to aromas have demonstrated hypertrophied gray matter volume in the posterior sub-region of the right hippocampus, left precuneus, left superior frontal gyrus, and right hypothalamus. In those with subjective hyperosmia, a neurological investigation is warranted.

            Case Report Pages: 1 - 4

            The Case of Acute Necrotizing Encephalopathy in an Adolescent with COVID-19

            Ling Liu, Rong Ou, ZongWen Chen, Wen Zhong and Hongxia Chen*

            DOI: 10.4172/2329-6895.11.3.553

            Introduction: Acute Necrotizing Encephalopathy (ANE) is a rare severe disease with high mortality or severe neurological sequelae characterized by rapid onset of consciousness disturbance and symmetric bilateral thalamic necrosis shown on imaging. To date, there have been limited investigations on SARS-CoV-2-related ANE, mainly in the form of case reports.
            Case presentation: A previously healthy 13-year-old girl presented with rapid deterioration of consciousness, status epilepticus, elevated aminotransferase, and symmetrical multi-focal brain lesions on MRI images during the Omicron pandemic. She accepted mechanical ventilation and had a good response to plasma exchange and continuous blood purification, intravenous immunoglobulin and high-dose methylprednisolone.
            Conclusion: ANE is a rapidly progressing disease that necessitates prompt detection through a combination of clinical presentation and imaging modalities. It is of paramount importance to enhance the awareness and knowledge of pediatricians regarding SARS-CoV-2-related encephalopathy. Upon diagnosis, treatment with high-dose intravenous methylprednisolone and IVIG should be contemplated. Additionally, plasma exchange and continuous blood purification could help alleviate liver damage in patients with ANE.

            Case Report Pages: 1 - 2

            Restlessness in Opioid Withdrawal: A Unique Presentation of Whole-Body Involvement

            Nikita Mehdiratta*, Shweta Kalita, Drushti Birwatkar and Alan R. Hirsch

            DOI: 10.4172/2329-6895.11.3.555

            Introduction: Restless Leg Syndrome (RLS) is a known phenomenon observed in individuals experiencing opioid withdrawal, which can worsen heroin dependence. Typically,RLS affects only the legs, but this case report presents a unique instance of generalized Restless Body Syndrome (RBS) induced by opioid withdrawal.
            Case presentation: The report describes a 67-year-old male undergoing opioid detoxification who experienced restlessness throughout his body, resembling RLS sensations.The restlessness affected various areas, including the thorax, abdomen, back of legs, lower back, arms, and legs, excluding the face. The sensations were described as periodic electric waves that intensified at night or during periods of inactivity and improved with physical activity, mainly walking. Similar sensations were also noted during withdrawal from opioids or buprenorphine/naloxone, significantly when the dose was reduced to 1mg/day, and they resolved upon reintroduction of buprenorphine/naloxone.
            Results: Neurological examination revealed specific abnormalities, such as recent impaired recall, facial akinesia, decreased blink frequency, cog wheeling in upper extremities,a stooped, shuffling gait, and resting tremor in both upper extremities. Neuropsychiatric tests showed abnormal results in the Go-No-Go Test (4/6) and a minimal level of depression according to the Beck Depression Inventory Type-II (score: 9). The patient also scored as a problem drinker on the Michigan Alcohol Screening Test (score: 35).
            Discussion: Exploration of the similarities between RBS and RLS, highlighting that RBS affects additional areas of the body, including the upper extremities, thorax, and back. While RBS may represent a variant of RLS, it could also be a different condition. Another potential explanation is that it may be a form of serotonin syndrome induced by opioid use, including fentanyl, which can lead to generalized myoclonus. Although RLS associated with opioid withdrawal is well-documented, the underlying mechanisms responsible for its manifestation throughout the body, including the neck, remain unclear. One hypothesis suggests a generalized polyneuropathy affecting the upper limbs and lower extremities, particularly in cases of iron deficiency. The report suggests that variants of RBS may occur in individuals undergoing opioid withdrawal, potentially requiring low-dose opioids for treatment. Consequently, evaluating RBS as part of the assessment for opioid withdrawal is necessary.

            Volume 11, Issue 4 (2023)

              Research Article Pages: 1 - 5

              The Long-Term Incidence of Recurrent Stroke and Risk Factors Associated with Transient Ischemic Attack Patients

              Hongmei Ding, Bilal Muhammad, Xiaolong Wang, Shu Kan, Weiwei Chen, Yingfeng Mou, Ruiguo Dong and Deqin Geng*

              DOI: 10.4172/2329-6895.11.4.562

              Background: The incidence of recurrent stroke and mortality ratio of patients with a transient ischemic attack (TIA) and minor ischemic stroke (MIS) is a challenging issue, especially the long-term recurrence ratio.
              Aims: This study aimed to estimate the long-term incidence of ischemic stroke recurrence and identify the risk factors associated with recurrent stroke in the Xuzhou region of China.
              Settings and design: This was a cross-sectional study conducted on a group of patients with TIA or MIS between the ages of 20 and 80 years.
              Methods and material: A total of 297 individuals participated. Medical records were one of the data sources. The data of patients who meet the selection criteria gathered from the Neurology department, affiliated hospital of Xuzhou medical university Statistical analysis used: Statistical package for Social Science (SPSS) version 23 was used for statistical analysis.
              Results: In this study, 297 patients were included for analysis; 30 (9.17%) patients were lost to follow-up at 5 years. Post onset of the TIA and MIS analysis reveals that the cumulative incidences of recurrent stroke at 3,6,12, 36, and 60 months were 6.73% (20/297), 10.77% (32/297), 18.86% (56/297), 25.25% (75/297), and 33.33% (99/297), respectively. Multivariate regression analysis demonstrated that age, current smoking, poorly controlled hypertension, diabetes, vascular stenosis, and plaque vulnerability as independent risk factors for ischemic stroke recurrence. Further analysis based on different vascular stratification of carotid atherosclerosis showed that 5-year cumulative survival was 10% lower in patients with severe stenosis than in patients with plaque vulnerability.
              Conclusion: This study aimed to estimate the long-term incidence of ischemic stroke recurrence and identify the risk factors associated with recurrent stroke in the Xuzhou region of China.

              Case Report Pages: 1 - 4

              Examining the Enantiopathic Effect of Covid-19 on Olfactory Sensitivity: A Case Report

              Shweta Kalita, Chiraag Ashokkumar* and Alan R. Hirsch

              DOI: 10.4172/2329-6895.11.4.563

              Objective: Pathophysiology behind reduced olfactory ability in hyperosmic individuals.
              Background: Covid-19 infection as an enantiopathy to hyperosmia has not been described.
              Design/Methods: A 63 year-right-handed male presented with hyperosmia of 150% of normal whereby aromas appeared distorted and disgusting. Shortly, he tested positive for Covid-19 which led to a resolution of his hyperosmia. Alcohol Sniff Test scores fluctuated between zero and three (anosmia). Gradually, his smell improved from 80% and 100% of normal. However, post Covid-19 infection, it returned to 130% of normal.
              Results: Neurological abnormalities, Olfatory testing, Odor discrimination memory test, Total 7/12 (hyposmia). Bilateral olfactory threshold testing to phenylethyl alcohol 3 (hyposmia). Taste Threshold and Suprathreshold Testing: Mild hypogeusia to Sucrose. Ageusia to Hydrochloric acid, urea and propothiocarbamide. Olfactometer Identification Testing: Left nostril: 10 (anosmia), Right nostril: 8 (anosmia).
              Conclusion: The mechanism whereby Covid-19 acts to reduce olfactory ability in normosmic individuals has been postulated as viral involvement of olfactory nerve at olfactory bulb, pathology of sustentacular cells, olfactory receptor site destruction vasculopathy/arteriopathy of cranial nerve or central connections of olfactory nerve or inflammatory response induced destruction of lamina propria and olfactory nerve apoptosis. The same may have incited a reduced olfaction in hyperosmic individuals-such may be under grouped as understanding the pathophysiology of this subject’s hyperosmia. Perceived hyperosmia is often objectively hyposmic pathology of inhibiting the inhibitory olfactory discharges that result in enhancement of perceived odor. Elimination of hyperosmia reduces functionality of remaining normosmic neurons which then became relatively hyposmic, but were perceived as normal due to lack of the inhibitory factors. Recovery of hyperosmia upon recovery of olfactory function from Covid-19 would be consistent with such a postulation. Of those with preexisting chemosensory dysfunction, query as to impact of Covid-19 on remaining sensory function is warranted.

              Research Article Pages: 1 - 6

              Postural Balance Control and its Relation to Daily Living Skills in Patients with Autism Spectrum Disorder: A Systematic Review

              Brito Mayara Pacífico and Boffino Catarina Costa*

              DOI: 10.4172/2329-6895.11.4.561

              Introduction: Autism Spectrum Disorder (ASD) is a condition that involves a spectrum of manifestations, including alterations in restricted and repetitive sensory motor behavior and social communication deficits that expresses in activities of daily living. The functionality of posture and balance is investigated by observing aspects related to physical measures and clinical characteristics of the center of pressure sway and daily living skills (DLS) in individuals with ASD.
              Objective: To characterize the functionality of postural control in patients diagnosed with ASD and to observe correlations between changes in postural control in clinical features and DLS.
              Methodology: This study conducted a bibliographical survey in the PubMed, SciElo, PEDro, and Bireme databases. The inclusion criteria included studies from 2011 to 2021, free texts in Portuguese and English, and articles of evaluations in children up to the age of adults (44 years) that were within the study objective. Articles excluded described coordination and balance disorders other than ASD, studies proposing treatment protocols, and evaluations of adults older than 45.
              Results: Five pieces compose this review in which the characteristics observed show postural balance changes. There is a difference in the performance of individuals with ASD and typical development (TD), showing a longer time for postural development and difficulties in DLS.
              Conclusion: Although the studies present different ways of evaluating postural and balance development, balance disorders are evident, considering a correlation between DLS and IQ.

              Review Pages: 1 - 5

              Sensing Sounds on the Skin: A Review of Auditory-Tactile Synesthesia and Its Implications for Perception and Attention

              Syed Adnan Ali*, Syed Noor Ali and Rehan Khan

              DOI: 10.4172/2329-6895.651.4.565

              This review paper explores auditory tactile (AT) synesthesia, a rare neurological condition where sounds evoke tactile sensations. The paper provides a historical overview of the condition and discusses its epidemiology, with a prevalence of less than 1% of the general population. The neurological basis of AT synesthesia is explored, including the role of cross-modal processing and hyper connectivity within the brain. The paper also describes the phenomenology of the condition, including the range of tactile sensations that can be experienced in response to different sounds. The occurrence of AT synesthesia in the present-day world is discussed, including its relationship to music and art. Various hypotheses surrounding the development and maintenance of AT synesthesia are reviewed, focusing on genetic and environmental factors. The implications for clinical practice are explored, including potential benefits for individuals with sensory processing disorders. Finally, the paper concludes with a discussion of future directions for research in this field, including the need to explore further the underlying neural mechanisms of AT synesthesia and potential therapeutic interventions.

              Research Article Pages: 1 - 5

              Concentration Dependency of Characteristic Times in the Reactions between Protein and Antibody-functionalized Magnetic Nanoparticles via Immunomagnetic Reduction

              Huei-Chun Liu, Hsin-Hsien Chen, Ming-Hung Hsu, Kun-Hung Lee and Shieh-Yueh Yang*

              DOI: 10.4172/2329-6895.11.4.564

              Immunomagnetic Reduction (IMR) is an ultrasensitive assay for low-concentrated circulating proteins associated with diseases, such as cancers, inflammation, preterm birth, and neurodegenerative diseases. In addition to exploring clinical utilities, investigations of the chemical kinetics of the associations between biomarker molecules and nanoparticles in IMR have attracted much interest. To this end, the real-time alternating current (AC) magnetic signal, χ ac, of the reagent after being mixed with a sample was recorded, i.e., χac -t curve. Total tau protein (T-Tau), which is associated with neurodegenerative diseases, was used as a representative biomarker. Detailed characterizations, such as characteristic times in the χac -t curve, instant reaction rates, and orders of reactions, were investigated in this work. In particular, the effect of the concentration of the biomarker (T-Tau) on these parameters was explored. The results show that the nanoparticle-biomolecule association consists of two steps: Diffusion and binding. The time to initiate the binding step decreases as the T-Tau concentration increases, but the time to finish the association increases. During the binding step, the instant reaction rate reaches a maximum before the first half of the binding step is completed. The period of the second half is longer than the first half by 65% to 112%. Furthermore, the nanoparticle-biomolecule association is found to be a first-order reaction. The contributions of various factors, such as the collision frequency, surface energy barrier, substrate mobility, numbers of nanoparticles/molecules, etc., are discussed to clarify the chemical kinetics of the reactions in the IMR assay.

              Volume 12, Issue 1 (2024)

                Volume 11, Issue 5 (2023)

                  Case Report Pages: 1 - 3

                  Arteriovenous Fistula Leading into Early-Onset Cerebral Venous Thrombosis

                  Man Bahadur Paudyal*, Neha Mehta, Niraj Gautam, Bijay Sharma, Bikas Baral and Kusha Kc

                  DOI: 10.4172/2329-6895.11.5.548

                  Prothrombotic conditions generally ranging from acquired to genetic, oral contraceptives, malignancy, puerperium, infection, head injury are the common risk factors for cerebral venous thrombosis. Here, we present a case of 18 years males who developed recurrent cerebral thrombosis on the background of the presence of Arteriovenous Fistula

                  Research Article Pages: 1 - 16

                  Links between Serotonin Levels and Stress: Cortisol, Candida a./Mycetes, Omega 3/6 ratio and Dysbiosis (Skatole/Indoxyl Sulfate) Role in Chronic Fatigue Syndrome (CFS) and Depression

                  Daniele Orlandoni*, Giuseppe Di Fede, Mauro Mantovani, Nava Consuelo, Marco Tomasi and Paola Fusi

                  DOI: 10.4172/2329-6895.11.5.568

                  Thanks to the large amount of evidence, a broader and more multidisciplinary vision of the intestine has emerged refers to the role that this anatomical structure plays in human body. A new sophisticated conception has arisen which has imposed a different approach in terms of investigating bowel importance and the repercussions that its functional deficit has towards other systems directly or indirectly related to it. It is, in fact, a complex structure interconnected with other systems (nervous, endocrine and immune) whose efficiency is strongly influenced by a condition of dysbiosis.

                  Intestinal microbiota attracts daily attention of a growing number of researchers and the data accumulated today allow us to highlight how dysbiosis plays a very important role in Irritable Bowel Syndrome (IBS), Inflamed Bowel Syndrome (IBD), Crohn's disease (CD) and even in Leaky Gut Syndrome (LGS) rather than Polycystic Ovary Syndrome (PCOS), food intolerance, diabetes, metabolic syndrome and fibromyalgia, cancer, etc.. However the composition of the microbiota is influenced diet, use/abuse of drugs, lifestyle and especially from stress and its reverberation on the Autonomous Nervous System (ANS), etc.

                  In our study we wanted to analyze how a condition of intestinal dysbiosis may be related to chronic fatigue syndrome (CFS) and depression through the exchange of information through the intestinal-brain axis (GBA).

                  We studied 33 subjects, 13 males and 20 females, who reported chronic fatigue syndrome or/and depression: We investigated their salivary cortisol levels, blood serotonin (5-hydroxytryptamine, 5-HT), omega 3/6 ratio, intestinal dysbiosis (calculated on the levels of urinary metabolites of tryptophan-TRP-: Indoxyl sulfate and skatole), and we looked for the presence of Candida a. or mycetes in the stool.

                  The data accumulated with this research show a correlation between the presence of Candida a./miceti, indoxyl sulfate urine values ??beyond the physiological (characteristic of dysbiosis) and low 5-HT levels. In addition, data analysis showed that the EPA/DHA values ??also show pro-inflammatory levels in case of dysbiosis and low 5-HT levels.

                  The relationship, however, with cortisol levels requires further research although this study showed a statistically significant positive correlation between these values, measured at specific times, and 5-HT levels.

                  With this research we wanted to try to highlight the existing contact points, in some cases not so obvious, among these topics, contact points that, although they give us interesting indications, show the need to be further deepened by analyzing a larger amount of data.

                  Aim: We investigated the relationship between stress (evaluated through the measurement of salivary cortisol levels) and gastrointestinal efficiency measured as a function of intestinal fermentative and putrefactive dysbiosis, evaluating the levels of urinary indoxyl sulfate in the first case (a possible correlation with the presence of Candida a. or mycetes in the subjects feces was investigated), urinary skatole levels in the second one, in patients with chronic fatigue syndrome (SFC) and depression. In these patients we also have studied omega 3/6 ratio. Finally we have analyzed the impact that the alteration of all these parameters can have on the 5-HT levels.

                  This research attemps to highlight the contact points, in some cases not so obvious, among these topics, contact points that, although they give us interesting indications, show the need to be further deepened by analyzing a larger amount of data.

                  Research Article Pages: 1 - 6

                  Peripheral Somatosensory Stimulation in the Treatment of Post-Traumatic Stress Disorder. A Clinical Trial

                  TM Janjua, JM Pederson and Eric S. Nussbaum*

                  DOI: 10.4172/2329-6895.11.5.569

                  Objective: Posttraumatic Stress Disorder (PTSD) is a complex condition that represents a significant burden in terms of individual disability and societal costs. Despite decades of research investigating treatment options, PTSD remains a major cause of quality-of-life impairment. We hypothesized that patients with PTSD might benefit from peripheral somatosensory stimulation (PSS) therapy.
                  Methods: 6 adult patients with clinically diagnosed PTSD were enrolled to undergo daily PSS therapy over a 4-week period. Patients completed two surveys evaluating satisfaction with treatment and overall well-being (Survey 1) and severity of PTSD symptoms (Survey 2). Survey 1 was completed weekly during the course of the study. Survey 2 was based on the 9-question National Stressful Events Survey PTSD Short Scale (NSESSS) and was completed as a baseline prior to initiation of therapy and then at the conclusion of the trial. All data were analyzed by an independent statistician.
                  Results: 6 male patients were enrolled in the study; all completed the trial. All patients demonstrated a decrease in symptoms within one week of initiation of therapy. This benefit was sustained and appeared to further improve over the course of the trial. For Survey 1, the overall median scores demonstrated a significant time-dependent improvement across measurement times (p<0.001). For Survey 2, patients had statistically significant improvements from baseline regarding feelings of being emotionally upset and being overly alert. Results from a cumulative link mixed model demonstrated that treatment yielded a 38.2-fold higher likelihood of transitioning from a higher PTSD score at baseline to a lower (improved) score at week 4. No adverse events were described by the patients.
                  Conclusion: PSS stimulation appeared to improve symptoms in all six patients with PTSD symptoms in this trial. Patients had unanimous and clinically meaningful improvement in overall PTSD symptoms with treatment. By week 4, all patients responded that they enjoyed the treatment and would like to keep their device. We suggest that further investigation into the potential usefulness of PSS therapy in patients with PTSD is warranted.

                  Research Article Pages: 1 - 3

                  Prognostic Aspect of Cerebellar Hematomas in Tropical Environments: Study of 33 Cases at Conakry University Hospital

                  Konate Ibrahima Sory*, Camara Mamady, Camara Mohamed Salifou, Diallo Souleymane Mbara, Dore Male, Conde Mohamed Lamine, Toure L, Mohamed Lamine Toure, Cisse Fode Abass and Cisse Amara

                  DOI: 10.4172/2329-6895.11.5.566

                  Background: Cerebellar hematoma is thought to result from a collection of blood in the cerebellar parenchyma. It is a rare topographical form, accounting for 5%-10% of hemorrhagic strokes, with an unpredictable and often dreadful prognosis. The aim of our study is to determine the prognostic factors of cerebellar hematomas in the Neurology Department of the CHU Ignace Deen in Conakry.
                  Methodology: We conducted a retrospective descriptive study lasting four (4) years, from June 1, 2017 to May 31, 2021, in the neurology department of the CHU de Conakry, focusing on patients hospitalized with a cerebellar hematoma confirmed by cerebral CT scan. The variables were epidemiological, clinical, therapeutic and prognostic. Any p-value <0.05 was considered statistically significant.
                  Results: A total of 33 patients, representing 9.7% of cerebellar hematomas, with a mean age of 60 ± 12.50 years, ranging from 33 to 82 years, and a male predominance of 69.7% (sex ratio 2.3). Hypertension was the main risk factor in 87.9% of cases. The main symptoms were headache in 90.9% of cases, dizziness in 81.8% and vomiting in 60.6%. The factor associated with a favorable outcome was an ICH score ≤ 2 (p-value=0.004)). The mortality rate was 27.3%. A favorable outcome without sequelae was observed in 18.2% of cases, versus 54.6% in cases with neurological sequelae.
                  Conclusion: At the end of this study, we concluded that cerebellar hematoma constitutes a diagnostic and therapeutic emergency. High ICH and modified Rankin
                  at re-entry were poor prognostic factors associated with functional sequelae and a high mortality rate.

                  Research Pages: 1 - 3

                  Ultrasound 2d Fetal Developing Brain Image Classification and Disease Prediction

                  Sridharan K, Gokul N*, Giridharan L and Akashdeep V

                  DOI: 10.4172/2329-6895.11.5.547

                  Ultrasound imaging processing technology has been employed for more than 50 years. Although it has developed quickly, it has some advantages and particular challenges. It is crucial to establish the fetal survival rate, gestational age, and other factors early on, from the standpoint of ultrasound picture analysis. In a bid to better understand the fetus's continuing growth, fetal anatomy ultrasound image analysis techniques have recently been studied and have emerged as an essential tool for prenatal anomaly diagnosis. The moment has come to thoroughly analyse prior efforts in this area and forecast future directions. Thus, this article discusses cutting edge methods along with fundamental concepts, theories, and advantages and disadvantages of ultrasound picture technology for the entire fetal along with different anatomies. It begins by summarizing the ongoing issues and introducing the widely used image processing techniques, such as classification, segmentation, etc.

                  Drugs for Stroke (2023)

                    Volume 11, Issue 2 (2023)

                      Research Article Pages: 1 - 6

                      Early-Onset Anterior Endplate Fractures of Adjacent Vertebras in Balloon Kyphoplasty and SpineJack

                      Kuan-Nien Chou, Ming-Hsuan Chung, Peng-Wei Wang and Da-Tong Ju*

                      DOI: 10.4172/2329-6895.11.2.542

                      Background: Vertebral compression fractures (VCFs) occur most commonly on the thoracolumbar junction, which are the most vulnerable biomechanical
                      regiments at the thoracolumbar junction between the thoracic kyphosis and lumbar lordosis. Percutaneous vertebroplasty and kyphoplasty are currently
                      the primary minimally invasive surgical treatments for thoracolumbar VCFs. The principal aim of this study is to compare the clinical efficacies of percutaneous
                      balloon kyphoplasty (BKP) and SpineJack® (SJ) techniques in the treatment of thoracolumbar VCFs by evaluating the risk factors for early-onset adjacent level
                      fractures (ALFs) over a 6 month follow-up.
                      Methods: A total of 106 patients with thoracolumbar (T11-L2) VCFs, treated with kyphoplasty techniques (64 with BKP and 42 with SJ), were enrolled in
                      this retrospective study. Patterns of preoperative, postoperative day 1, and postoperative 6 month thoracolumbar spine images and discrepancies of
                      long-term kyphosis correction functions were compared using two different kyphoplasty procedures.
                      Results: A total of 19 new early-onset ALFs were found within one month postoperatively (9 in BKP and 10 in SJ groups), and all presented as anterior
                      vertebral endplate fractures. The early-onset ALFs in the BKP group were anterior inferior endplate fractures at the superior vertebral levels mainly. The
                      preoperative anterior-type and severe VCFs were the statistically significant risk factors for early-onset ALFs. The timing of kyphoplasty intervention for
                      acute VCFs within 1 month and patients with advance age were also presented risk factors to developed early-onset ALFs in our study (p=0.018; p<0.001).
                      Conclusion: There was no superiority in the occurrence rate of early-onset ALFs and kyphosis correction effects of BKP or SJ techniques in the treatment of
                      thoracolumbar VCFs. The factors, including pre-OP anterior-type and severe VCFs, patients with advance ages, and kyphoplasty timing within one month
                      since the appearance of symptoms, are the primary risk factors for subsequent early-onset ALFs after kyphoplasty to thoracolumbar VCFs.

                      Case Study Pages: 1 - 5

                      Depression Contributes to the Global Warming

                      Aladdin Mardanov*

                      DOI: 10.4172/2329-6895.11.2.543

                      The globe faces a serious threat coming from the increase in greenhouse gases (GHG) and the damage caused by it. As emissions depend on the performance and efficiency of manufacturing companies as well as on individual lifestyles, the performance of each individual should be taken into consideration. Herein, the susceptibility to the global emission rate can be linked to a mental state of the population. Therefore, an increasing trend in depressive disorders among individuals was shown. It was described the mental state of individuals can affect their decision-making and performance in resource management, including material handling, inventory control, finance, and losses in time and energy. Secondly, major industrial accidents caused by human error, fatigue, and losses of concentration coming from the mental state were shown. Additionally, the way depression affects individuals in terms of consumption of certain products, indifference to an economy of utilities, and how it might lead to compulsive buying was also described. The results of this study can help to highlight growing problem worldwide, so that better studies supported by private sector as well as a government could be done. Consequently, the risk of unanticipated growth in emissions and environmental damage can be prevented.

                      Research Article Pages: 1 - 5

                      Features of the Course and Therapy of Viral Infection Covid-19 in a Repurposed Infectious Diseases Hospital for Patients Aged 90 Years and Older

                      Evsikov Evgeny Mikhailovich, Teplova Natalya Vadimovna, Vechorko Valery Ivanovich, Bairova Kermen Ivanovna* and Dzheksembekov Aldar

                      DOI: 10.4172/2329-6895.11.2.546

                      Background: According to WHO statistics for 2020, the risk of acute infection, which can lead to death, increases with age. The median age of patients with COVID-19 is 61 years. Mortality-after 80 years of life is 15%. The literature discusses the difficulties of timely diagnosis of Covid-19 in the elderly, which in most of them are associated with asymptomatic disease and its atypical course.

                      Goal and tasks: To assess the symptoms, the nature of the course of the pathology and clinical diagnostic data and mortality rates in people aged 90 years and older hospitalized with a diagnosis of COVID-19 in a repurposed emergency hospital in the city of Sochi. Moscow from April 12 to August 3, 2020 Material and methods: We retrospectively analyzed the clinical diagnostic data of 108 patients, including 23 men and 85 women aged 90-98 years,

                      Material and methods: We retrospectively analyzed the clinical diagnostic data of 108 patients, including 23 men and 85 women aged 90-98 years, on average 92.2 ± 1.7, admitted to the hospital for diagnosis and treatment in the period from 04/12/2020 to 12.04.2020. Until 08/03/2020 with diagnoses according to ICD-10: U07.1 U07.1 Coronavirus infection caused by the COVID-19 virus, virus identified (confirmed by laboratory testing regardless of the severity of clinical signs or symptoms); J12.9 J12.9 Community acquired pneumonia. Patients' data were archived in the city computer system DZM KIS EMIAS of the Department of Health of the city of Moscow.

                      Results: Pneumonia, which complicated the course of Covid-19 in patients aged 90 years and older, was characterized by a bilateral process-in 85% of them, involving 75-80% of the lung parenchyma-in 19.7% of cases, with the development of hydrothorax-in 53%, with a pathological decrease in oxygen saturation-in 67% of patients. In the treatment and prevention of cardiovascular complications in such patients, heparin therapy (in 70.4%), treatment with beta-blockers (in 41.7%), ACE inhibitors and blockers occupied a large place angiotensin receptors (in 31.5%), diuretics (in 27.8%). The use of antimalarial drugs (in 15.7%) and antiviral agents (in 9.3%) was limited due to the blurring of clinical symptoms, possible cardiotoxicity, and insufficiently substantiated drug efficacy. Lethality in patients with Covid-19 complicated by pneumonia, exceeded in patients aged 90 years and older-55%, which was closely associated with adverse cardiovascular premorbid background in 85.5% of them and required the initiation of inpatient diagnostics and therapy as soon as possible.

                      Conclusion: Covid-19 complicated by pneumonia in a group of people aged 90 years and older, proceeds with blurred clinical symptoms, with neurological manifestations in 20% and intestinal dysfunction in 6% of patients. High mortality rates at the same time require urgent diagnostic and therapeutic measures in stationary conditions.

                      Research Pages: 1 - 5

                      Application of CURB-65 for Determining the Prognosis of Hospitalized Covid-19 Patients with Neurological Symptoms

                      Fahimeh Vahabizad, Zahra Ebadi, Mansoureh Togha*, Mohammad Reza Fattahi, Sima Naeini, Maryam Karaminia and Seyedeh Melika Hashemi

                      DOI: 10.4172/2329-6895.11.2.545

                      Objective: Covid-19 patients can show various neurological symptoms. We aimed to assess the disease severity and prognosis in Covid-19 patients who experienced neurological symptoms.

                      Methods: In this retrospective, cross-sectional study, we evaluated 225 hospitalized Covid-19 patients with neurological symptoms. Their CURB-65 scores were measured to determine their pneumonia severity in relation to their neurological symptoms.

                      Results: The patients had different types of neurological symptoms, among which an altered level of consciousness was the most common (62.1%), followed by headache (50.7%). Patients with headaches had ultimately an 80% lower mortality rate (p ≤ 0.001). Patients who were conscious at the time of admission were 62% less likely to die (p=0.019). Based on the CURB-65 severity score, most patients (40.4%) were in the mild group, 33.8% were in the moderate group and 25.8% in the severe group. The presence of headache at admission was inversely related to the CURB-65 score, meaning that a patient with early-onset headache recorded a lower CURB-65 score (p ≤ 0.001; r=-0.389).

                      Conclusion: Neurological symptoms are a common part of the Covid-19 clinical spectrum. The severity of Covid-19 varied in patients exhibiting different neurological symptoms. A more severe disease course was observed with altered mental status and a milder course with headache at admission.

                      Case Report Pages: 1 - 3

                      Acute Recurrent Clinico-radiological Manifestations of the CNS in a Patient with Primary Sjogren's Syndrome: A Case Report

                      Orellana Lucas* and Serena Cottet María Daniela

                      DOI: 10.4172/2329-6895.11.2.544

                      Introduction: Primary Sjogren's syndrome (pSS) is an autoimmune inflammatory disease characterized by mononuclear lymphocytic infiltration of exocrine glands (especially salivary and lacrimal) in the setting of antinuclear antibodies. These patients can also develop extraglandular manifestations within which the neurological features are frequent, especially at the peripheral level but also, less frequently, at the central nervous system (CNS).

                      Case presentation: We describe the case of a female patient with pSS who presented with two recurrent acute neurological events associated with CNS impairment along with radiological inflammatory lesions on MRI scans, requiring hospitalization both in 2019 and 2022.

                      Discussion: CNS involvement in patients with pSS shows considerable clinical variability and imposes many difficulties in its differentiation from other diseases with a similar clinical course. Knowing this entity is a crucial aspect of a correct diagnosis in order to achieve adequate treatment and reduce the risk of long-term complications and sequelae.

                      Case Report Pages: 1 - 3

                      A Patient with Extensive Meningeal Calcification due to Pseudohypoparathyroidism: A Case Report

                      Mahmoud Hussien Salih Daoud, Abubakr Elmotesim Abdulla Elamin and Ahmed Fathelrahman Rizgalla Mohammed*

                      DOI: 10.4172/2329-6895.23.11.541

                      Background: This case emphasizes the adulthood onset of PHP with the association of new pattern of brain calcification which is exclusively falx cerebri and supratentorial.

                      Case presentation: A 35 year old man with 17 year history of epilepsy on Carbamazepine, referred from neurosurgical department where was diagnosed with hydrocephalus complicated by secondary severe optic atrophy and underwent Ventriculo-Peritoneal shunt. Imaging revealed Falx Cerebri, Supratentorial calcification, biochemical tests showed hypocalcemia, hypophosphatemia and elevated parathyroid hormone. Patient was given Vitamin D and Calcium in order to improve the outcome.

                      Conclusion: Although PHP being a rare possibility especially in adult, it has to be considered in incidental meningeal calcification and to be picked up early before complications.

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