Journal of Neurosciences in Rural Practice Vols. 1 to 12; 2010 to 2021

DOI: 10.1055/s-011-52215
  • Agrawal D. Pen Is Mightier than the Sword: Columbia Shows the Way in Formulating Neurotrauma Guidelines. Journal of Neurosciences in Rural Practice 2020; 11: (1) 1'
    Abstract
    None.


  • Osvath P. Psychiatry in 21(st) century: The long and hard road ahead. Journal of Neurosciences in Rural Practice 2015; 6: (1) 1'
    Abstract
    None.


  • Koshy J, Pandian JD. Dengue infection: An emerging cause of neuromuscular weakness. Journal of Neurosciences in Rural Practice 2012; 3: (1) 1'
    Abstract
    None.


  • Agrawal A. The concept of neurosciences in rural practice. Journal of Neurosciences in Rural Practice 2010; 1: (1) 1'
    Abstract
    None.


  • Kavoor AR, Mitra S. Managing Attention Deficit Hyperactivity Disorder during COVID-19 Pandemic. Journal of Neurosciences in Rural Practice 2021; 12: (1) 1-2'
    Abstract
    None.


  • Jayalakshmi S, Vooturi S. Migraine and Mood Disorders: Prevalence, Clinical Correlations, and Disability. Journal of Neurosciences in Rural Practice 2019; 10: (1) 1-2'
    Abstract
    None.


  • Lakhan R, Ekundayo OT, Sharma M. Epilepsy, Behavioral Problems, and Intellectual Disability among Children in India: Conundrums and Challenges. Journal of Neurosciences in Rural Practice 2018; 9: (1) 1-2'
    Abstract
    None.


  • De Sousa A. Coercion and admission in psychiatric facilities. Journal of Neurosciences in Rural Practice 2017; 8: (1) 1-2'
    Abstract
    None.


  • Saarinen JT. Intravenous thrombolysis: Still an important tool in the management of severe ischemic stroke patients. Journal of Neurosciences in Rural Practice 2016; 7: (1) 1-2'
    Abstract
    None.


  • Anderson C. Perihematomal edema as predictor of outcome. Journal of Neurosciences in Rural Practice 2014; 5: (1) 1-2'
    Abstract
    None.


  • Pereira JC. Are symptoms of restless legs syndrome generated in the periphery of the nervous system or are they born centrally?. Journal of Neurosciences in Rural Practice 2013; 4: (1) 1-2'
    Abstract
    None.


  • Agrawal A. Comment on “Systematic Review and Meta-analysis of Efficacy and Safety of Melatonin and Triclofos for Inducing Adequate Sedation for sleep EEG in Children”. Journal of Neurosciences in Rural Practice 2022; 13: (1) 1-2'
    Abstract
    None.


  • Yeolekar M. Changing scenario of neuropractice. Journal of Neurosciences in Rural Practice 2011; 2: (1) 1-3'
    Abstract
    None.


  • Brown JB, Kheng M, Carney NA, Rubiano AM, Puyana JC. Geographical Disparity and Traumatic Brain Injury in America: Rural Areas Suffer Poorer Outcomes. Journal of Neurosciences in Rural Practice 2019; 10: (1) 10-5'
    Abstract
    Introduction: Significant heterogeneity exists in traumatic brain injury (TBI) outcomes. In the United States, TBI remains a primary driver of injury-related mortality and morbidity. Prior work has suggested that disparity exists in rural areas; our objective was to evaluate potential differences in TBI mortality across urban and rural areas on a national scale. Methods: Age-adjusted TBI fatality rates were obtained at the county level across the U.S. from 2008 to 2014. To evaluate geography, urban influence codes (UIC) were also obtained at the county level. UIC codes range from 1 (most urban) to 12 (most rural). Metropolitan counties are defined as those with an UIC </=2, while nonmetropolitan counties are defined as an UIC >/=3. County-level fatality rates and UIC classification were geospatially mapped. Linear regression was used to evaluate the change in TBI fatality rate at each category of UIC. The median TBI fatality rate was also compared between metropolitan and nonmetropolitan counties. Results: Geospatial analysis demonstrated higher fatality rates distributed among nonmetropolitan counties across the United States. The TBI fatality rate was 13.00 deaths per 100,000 persons higher in the most rural UIC category compared to the most urban UIC category (95% confidence interval 12.15, 13.86; P < 0.001). The median TBI rate for nonmetropolitan counties was significantly higher than metropolitan counties (22.32 vs. 18.22 deaths per 100,000 persons, P < 0.001). Conclusions: TBI fatality rates are higher in rural areas of the United States. Additional studies to evaluate the mechanisms and solutions to this disparity are warranted and may have implications for lower-and middle-income countries..


  • Paydas S. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (1) 100'
    Abstract
    None.


  • Shetty SR, Anusha R, Thomas PS, Babu SG. Wallenberg's syndrome. Journal of Neurosciences in Rural Practice 2012; 3: (1) 100-2'
    Abstract
    None.


  • Thomas KA, Sedney C, Gross R. Support for a Three-Item Questionnaire Prior to Spinal Surgery: A Health-Related Quality of Life Outcome Study. Journal of Neurosciences in Rural Practice 2020; 11: (1) 100-5'
    Abstract
    Objective Elective lumbar and cervical operations are becoming more common in the United States. Additionally, there is a movement in the literature and clinical practice to discover short versions of longer measures as a way to anticipate an outcome. This study aims to provide neurosurgeons in practice with a three-item questionnaire that can guide referrals to psychological services presurgery. Ultimately, results could lead to an improvement in health-related quality of life (HRQoL) postspinal surgery. Methods This quantitative-descriptive, survey-based design with a retrospective chart review component followed 47 patients at baseline ( N = 47), 3 months ( N = 20), 6 months ( N = 31), and 1 year ( N = 19). A single item from the Coping Strategies Questionnaire, the Survey of Pain Attitudes, and the Tampa Scale of Kinesiophobia were utilized in the three-item questionnaire as a baseline measure. Patient-Reported Outcomes Measurement Information System Global Health measured HRQoL outcome at all time points. A linear regression model was conducted to predict mental health QoL postspinal surgery. Results This measure can predict mental health QoL outcomes up to 3-month postsurgery. Six-month and 1-year follow-ups are statistically inconclusive. Conclusion Individuals who are undergoing spinal surgery show lower mental health QoL outcome at baseline and 3-month postsurgery when responses on a three-item questionnaire are elevated. Limitations and future directions are discussed..


  • Caldera MC, Senanayake SJ, Perera SP, Perera NN, Gamage R, Gooneratne IK. Efficacy of Botulinum Toxin Type A in Trigeminal Neuralgia in a South Asian Cohort. Journal of Neurosciences in Rural Practice 2018; 9: (1) 100-5'
    Abstract
    Introduction: The antinociceptive effect of botulinum toxin-A (BTX-A) in trigeminal neuralgia (TN) has been described. We evaluated effects of BTX-A in relieving pain in patients with refractory TN at National Hospital of Sri Lanka. Materials and Methods: Pain in patients with TN was assessed using a visual analog from 0 to 10. Three months after commencement of drug therapy with >/=2 drugs including one first-line drug (carbamazepine/oxcarbazepine), pain scores were re-assessed. Twenty-two patients who did not report improvement of >/=50% at 90 days' posttreatment were recruited. They were given adjunct BTX-A directly to the trigger point (if identified) or intradermal. Pain scores were assessed at 10, 20, 30, 60, and 90 days' posttreatment. Results: There was a statistically significant improvement in mean pain scores at 10, 20, 30, 60, and 90 days' posttreatment (5.59 [standard deviation (SD) = 2.7], 5.68 [SD = 2.6], 5.27 [SD = 3.2], 4.77 [SD = 3.7], and 5.32 [SD = 4.0]) compared to pre-BTX-A treatment (7.14, SD = 2.2). Percentage reduction in mean pain score ranged from 20.4% to 33.1%. Maximum response was at day 60 post-BTX-A (50% had >/=50% reduction in pain). No significant difference was found in response with higher doses and injection strategy. Conclusion: Consistent statistically significant reductions in pain scores at the aforesaid intervals compared to pretreatment means that there is a place for BTX in refractory TN..


  • Srivastava VK, Agrawal S, Samal MP, Sharma S. Anesthetic management of spinal decompression in double vessel coronary artery disease. Journal of Neurosciences in Rural Practice 2013; 4: (1) 101-2'
    Abstract
    None.


  • Baldia M, Premlal K, Menon B, Samson SK. Marcus Gunn phenomenon with abducens palsy: As pseudo-false localizing signs. Journal of Neurosciences in Rural Practice 2011; 2: (1) 101-2'
    Abstract
    None.


  • Aladdin Y, Shirah B. Hashimoto's Encephalopathy Masquerading as Rapidly Progressive Dementia and Extrapyramidal Failure. Journal of Neurosciences in Rural Practice 2022; 13: (1) 101-4'
    Abstract
    Hashimoto's encephalopathy is a rare immune-mediated disorder characterized by subacute encephalopathy with elevated thyroid antibodies. Hashimoto's encephalopathy is also known as steroid-responsive encephalopathy associated with autoimmune thyroiditis. We report a rare presentation of Hashimoto's encephalopathy presenting with acute neuropsychiatric disturbances, rapidly progressive dementia, seizures, and extrapyramidal failure. Neuroimaging revealed multifocal vasculitides of major cerebral vessels that support the autoimmune vasculitic theory as the underlying pathogenesis for Hashimoto's encephalopathy. Unfortunately, permanent irreversible cerebral damage has already ensued before her presentation to our center, which rendered steroid therapy ineffective. Serological testing for Hashimoto's thyroiditis must be in the investigation of all rapidly progressive dementias as early diagnosis and timely management of autoimmune thyroiditis may salvage sizable and eloquent cerebral tissues. The rarity of the condition should not preclude the investigation of Hashimoto's disease even in the presence of normal levels of thyroid hormones. Delayed diagnosis may result in irreversibly catastrophic encephalopathy in patients who once presented with potentially curable dementia..


  • Agarwal PP, Manjunatha N, Gowda GS, Kumar MNG, Shanthaveeranna N, Kumar CN, et al.. Collaborative Tele-Neuropsychiatry Consultation Services for Patients in Central Prisons. Journal of Neurosciences in Rural Practice 2019; 10: (1) 101-5'
    Abstract
    Background: Tele-medicine helps to provide clinical care comparable to in-person treatment in various clinical settings. It is a novel system of healthcare delivery in both low-resource settings and sites where adequate medical care continues to pose greatest challenge like in prison's in India and worldwide. Aim: To study the sociodemographic and clinical profile of patients from Central Prisons, having received collaborative Tele-Neuropsychiatric Care. Methodology: Psychiatry, neurology, and neurosurgery specialists provided tele-neuropsychiatry consultation through Specialist-Doctor-Patient model as part of the state-run program for the two central prisons from July 1, 2014, to June 30, 2016. A retrospective file review was done of the tele-neuropsychiatry case records at Tele-Medicine Centre, Located at Tertiary Neuro Psychiatric centre of South India. Results: A total of 53 patients were provided tele-neuropsychiatric consultation over 2-year period. Of these, 48 (90.6%) were male and 34 (64.1%) were aged more than 30 years. In total, 20.7% of them had severe mental illness, i.e., schizophrenia and mood disorders, 20.7% with substance use disorder (alcohol and cannabis), 17% had anxiety disorders while 17% with seizure disorder. Nearly 81.1% of patients (inmates) were advised pharmacotherapy while 18.9% were suggested further evaluation of illness and inpatient care at the higher center. Conclusion: The collaborative care was successful in delivering psychiatry, neurology, and neurosurgery consultation with a Specialist-Doctor-Patient model to prison inmates..


  • Gomes D, Fonseca M, Garrotes M, Lima MR, Mendonca M, Pereira M, et al.. Corpus Callosum and Neglect Syndrome: Clinical Findings After Meningioma Removal and Anatomical Review. Journal of Neurosciences in Rural Practice 2017; 8: (1) 101-6'
    Abstract
    Two types of neglect are described: hemispatial and motivational neglect syndromes. Neglect syndrome is a neurophysiologic condition characterized by a malfunction in one hemisphere of the brain, resulting in contralateral hemispatial neglect in the absence of sensory loss and the right parietal lobe lesion being the most common anatomical site leading to it. In motivational neglect, the less emotional input is considered from the neglected side where anterior cingulate cortex harbors the most frequent lesions. Nevertheless, there are reports of injuries in the corpus callosum (CC) causing hemispatial neglect syndrome, particularly located in the splenium. It is essential for a neurosurgeon to recognize this clinical syndrome as it can be either a primary manifestation of neurosurgical pathology (tumor, vascular lesion) or as a postoperative iatrogenic clinical finding. The authors report a postoperative hemispatial neglect syndrome after a falcotentorial meningioma removal that recovered 10 months after surgery and performs a clinical, anatomical, and histological review centered in CC as key agent in neglect syndrome..


  • Dias E, Dias M. Recurrent meningitis in a child with intranasal encephalocele. Journal of Neurosciences in Rural Practice 2012; 3: (1) 102-3'
    Abstract
    None.


  • Ghosh S, Das D, Varshney R, Nandy S. Orbital extension of trigeminal schwannoma. Journal of Neurosciences in Rural Practice 2015; 6: (1) 102-4'
    Abstract
    Schwannomas, also known as neurilemmomas, are benign peripheral nerve sheath tumors. Trigeminal schwannomas are rare intracranial tumors. Here, we report a 35-year-old female presenting with an axial proptosis of right eyeball with right-sided III, IV and VI cranial nerve palsy. Her best corrected visual acuity in the right eye was perception of light absent and in the left eye was 20/20. MRI scan revealed a large right-sided heterogeneous, extra-axial middle cranial fossa mass that extended to the intraconal space of right orbit. A diagnosis of intracranial trigeminal nerve schwannoma with right orbital extension was made. Successful surgical excision of the mass with preservation of the surrounding tissues and orbital exenteration was done. Post-operative period was uneventful..


  • Pandey S, Batla A. Opalski's syndrome: A rare variant of lateral medullary syndrome. Journal of Neurosciences in Rural Practice 2013; 4: (1) 102-4'
    Abstract
    None.


  • Kucukyuruk B, Biceroglu H, Abuzayed B, Ulu MO, Kafadar AM. Paraspinal gossybipoma: A case report and review of the literature. Journal of Neurosciences in Rural Practice 2010; 1: (2) 102-4'
    Abstract
    Spinal or paraspinal retained surgical sponges (gossybipoma or textiloma) are rare incidents and mostly asymptomatic in chronic cases, but can be confused with other masses such as a hematoma, an abscess or a tumor. In chronic cases, the presentation can be as late as decades after the initial surgery; however, some gossybipomas cause infection or abscess formation in the early stages. The authors report a 40-year-old woman with a history of operation for lumbar disk herniation before 8 months, and got admitted with a complaint of serous fluid leakage from the operation wound. In this report, the authors discuss the clinical presentation, the radiologic findings and the differential diagnosis of gossybipoma..


  • Kapoor N, Sharma R, Iser C, Chaudhari K, Nalleballe K, Brown A, et al.. Cost-Effectiveness of Emergent MRI during Stroke Alert to Diagnose Stroke Mimics: Single-Center Experience. Journal of Neurosciences in Rural Practice 2021; 12: (1) 102-5'
    Abstract
    Objective The aim of this article was to assess the role of emergent magnetic resonance imaging (MRI) for stroke mimics during a stoke alert (within 45 minutes) in reducing direct cost of management and duration of inpatient stay. Methods We did a retrospective chart review of all the patients who received emergent MRI brain during a stroke alert to help make decision about intravenous tissue-type plasminogen activator (IV tPA) administration from January 2013 to December 2015. Using the patient financial resource data and with the help of billing department, we calculated the approximate money saved in taking care of the patients who may have received IV tPA if emergent MRI brain was not available to diagnose stroke mimics as they presented with acute neurologic deficit within IV tPA time window. Results Ninety seven out of 1,104 stroke alert patients received emergent MRI. Of these only 17 (17.5%) were diagnosed with acute ischemic stroke (AIS), and 80 (82.5%) as stroke mimics. By doing emergent MRI for suspected stroke mimics, our study showed an approximate total saving of $1,005,720 to $1,384,560, that is, $12,571 to $17,307 per patient in medical expenditure. Discussion We suggest modification of stroke pathway from current algorithm "CT+CTA>/=IV-tPA/neurointervention>/=MRI" to "MRI+MRA>/=IV-tPA/neurointervention" for possible stroke mimics, which can reduce the cost, radiation exposure, and duration of hospital stay for stroke mimics. Conclusion Emergent MRI is a cost-effective tool to evaluate IV-tPA eligibility for suspected stroke mimics during a stroke alert..


  • Vora M, Kumar S, Sharma S, Sharma S, Makhaik S, Sood RG. Advanced magnetic resonance neuroimaging in bulbar and limb onset early amyotrophic lateral sclerosis. Journal of Neurosciences in Rural Practice 2016; 7: (1) 102-8'
    Abstract
    INTRODUCTION: Amyotrophic lateral sclerosis (ALS) is a fatal and most common motor neuron disease, caused by progressive loss of motor neurons. Diffusion tensor imaging (DTI) and magnetic resonance spectroscopic (MRS) studies detect pathological changes in neuronal fibers in vivo. We evaluated the role of DTI and MRS in early course of the disease, which may prove beneficial in the early diagnosis and better management. MATERIALS AND METHODS: Twenty-one patients with ALS and 13 age-matched controls received 1.5T DTI and three-dimensional multi-voxel MRS. Fractional anisotropy (FA), apparent diffusion coefficient, N-acetyl aspartate (NAA)/Creatine (Cr), and NAA/Choline (Ch) ratios were analyzed in various regions of the brain and compared with healthy controls. ALS patients were classified as definite, possible, and probable category, and patients were also studied in limb versus bulbar onset. RESULTS: Decreased FA and increase mean diffusivity values in regions of corticospinal tract (CST) and corpus callosum (CC) was consistent finding in definite and probable disease category (P < 0.05). In possible disease, CC involvement was not significant. NAA/Cr and NAA/Ch ratios were lower in CC and regions of CST. However, in possible disease, CC involvement was not significant, while regions of CST were showing significant reduction in NAA/Cr and NAA/Ch ratios (P < 0.05). CONCLUSION: DTI and MRS detect changes associated with ALS even in the early phase of the disease. Bulbar onset and limb onset ALS patients show different pattern of involvement. Extramotor involvement suggested by CC involvement is a feature seen in bulbar onset patient and can suggest poor outcome in such patients. The present findings may be helpful for designing further studies in the direction of more early diagnosis of disease and its management..


  • Jellinger KA. Single photon emission tomography as a predictor of outcome in vegetative state of head injury. Journal of Neurosciences in Rural Practice 2012; 3: (1) 103-4'
    Abstract
    None.


  • Garg LN, Agrawal A, Goyal R, Trehan SS, Mittal A, Dureja N. Cloud-like pattern of mineralization in skull base osteosarcoma. Journal of Neurosciences in Rural Practice 2011; 2: (1) 103-4'
    Abstract
    None.


  • Joob B, Wiwanitkit V. Molecular mimicry and cross immunoreactivity in the pathogenesis of Guillain-Barre syndrome. Journal of Neurosciences in Rural Practice 2012; 3: (1) 104'
    Abstract
    None.


  • Brezovska K, Panovska AP, Grozdanova A, Suturkova L, Basta I, Apostolski S. Authors' reply. Journal of Neurosciences in Rural Practice 2012; 3: (1) 104-5'
    Abstract
    None.


  • Gude D. Curcumin in neurology. Journal of Neurosciences in Rural Practice 2012; 3: (1) 105-6'
    Abstract
    None.


  • Zanzmera P, Patel T, Shah V. Diagnostic dilemma: Sturge-Weber syndrome, without facial nevus. Journal of Neurosciences in Rural Practice 2015; 6: (1) 105-7'
    Abstract
    Sturge-Weber syndrome (SWS), a rare sporadic neurocutaneous disease, is characterized by a congenital unilateral port-wine nevus affecting the area innervated by V1, ipsilateral leptomeningeal angiomatosis, and calcification in the occipital or frontoparietal region and glaucoma/vascular eye abnormality. Three types of SWS have been described in literature: Type I (classic) demonstrates facial and leptomeningeal angioma, often with glaucoma; type II has facial angioma and glaucoma, with no evidence of intracranial lesions; and type III (rarest) presents with only leptomeningeal angioma. Only a few cases of type III SWS have been reported. Here, we report a case of a seven-year-old boy with focal complex partial seizure, who was diagnosed with SWS without facial nevus. Recognition of this type of SWS is important, as our patient had been misdiagnosed and received inappropriate antiepileptic drugs for six years. We suggest that in the appropriate clinical scenario, the diagnosis of SWS without facial nevus should be considered before labelling idiopathic or cryptogenic localization-related epilepsy, and gadolinium-enhanced magnetic resonance imaging (MRI) should be done in clinically suspicious cases of SWS, without facial nevus..


  • Dadlani R, Ghosal N, Hegde AS. Bregmatic dermoid cyst in a patent anterior fontanelle. Journal of Neurosciences in Rural Practice 2013; 4: (1) 105-7'
    Abstract
    None.


  • Zhang HL. Placebo - More hatred than love. Journal of Neurosciences in Rural Practice 2011; 2: (1) 105-7'
    Abstract
    A placebo is a sham medical intervention that can produce a placebo effect. Laboratory evidence supports the existence of several mechanisms of placebo effects in both healthy population and patients with a variety of medical conditions. The ethics of placebos have long been debated. However, accumulating ethical concern has arisen from the worldwide use of placebo in randomized control trials (RCTs), which may render their participants without early and optimal treatment. Although the pilgrimage of placebo is still on the way, refinement of controls in RCTs is worth paying new attention to..


  • Singla N, Latawa A. Paradoxical Brain Herniation after Cranioplasty: Secondary Sunken Flap Syndrome. Journal of Neurosciences in Rural Practice 2022; 13: (1) 105-7'
    Abstract
    Decompressive craniectomy is a life-saving procedure done for innumerable etiologies. Though, not a technically demanding procedure, it has its own complications. Among many, sinking flap syndrome or syndrome of the trephined or paradoxical herniation of brain is frequently underestimated. It results from the pressure difference between the atmospheric pressure and the intracranial pressure causing the brain to shift inward at the craniectomy site. This can present with either nonspecific symptoms leading to delay in diagnosis or acute neurological deterioration, memory disturbances, weakness, confusion, lethargy, and sometimes death if not treated. Cranioplasty is a time validated procedure used to treat paradoxical brain herniation with good and early neurological recovery. We, here in, are going to describe a case report in which the paradoxical herniation occurred after cranioplasty which has not been described in literature..


  • Khan FY, Kamal H, Musa R, Hayati A. Moyamoya syndrome in a known case of pulmonary tuberculosis. Journal of Neurosciences in Rural Practice 2010; 1: (2) 105-8'
    Abstract
    We report an unusual association of pulmonary tuberculosis with moyamoya syndrome in a 30-year-old Filipino female who was admitted to our hospital with a 1-week history of fever and cough. Chest X-ray showed widespread bilateral consolidation with cavity, whereas sputum was positive for acid fast bacilli (AFB). Two weeks after starting antituberculous treatment, the patient developed two episodes of loss of consciousness, which were unwitnessed. Urgent brain computed tomography (CT) showed multiple infarctions, suggesting vasculitis. The electroencephalogram showed epileptic discharges. Magnetic resonance angiography showed a picture consistent with moyamoya disease. Brain CT angiography was performed and it showed the same pictures. The patient was diagnosed with pulmonary tuberculosis-associated moyamoya syndrome. On the following days, she was discharged on antituberculous medications, antiepileptic and oral hypoglycemic treatment. After 1 year, the patient was seen in the clinic, she was well and seizure-free..


  • Radhakrishnan S, Moorthy S, Gadde S, Madhavan K. Role of Cardiac Biomarkers in the Assessment of Acute Cerebrovascular Accident. Journal of Neurosciences in Rural Practice 2021; 12: (1) 106-11'
    Abstract
    Background Stroke (cerebrovascular accident) has for long been a global burden in terms of its morbidity and mortality. Serum levels of cardiac enzymes such as creatine kinase-MB (CK-MB) component, troponin T, and brain natriuretic peptide have been found to be elevated among the patients with stroke and also serve to prognosticate these patients. The serum levels of these enzymes correlate directly to the severity of stroke in these patients. Objective Elevated cardiac enzymes among patients with acute cerebrovascular accidents are not uncommon despite the patients not having any cardiac problems. We aimed to identify the occurrence of elevated cardiac enzymes among patients with acute stroke and their correlation with the severity of stroke. Materials and Methods Our study included 100 patients of acute stroke with no previous history of cardiac ailments. Serum levels of troponin I and CK-MB were analyzed among these patients using enzyme-linked immunosorbent assay method within the first 2 hours of admission. Patients outcome during the hospital stay were analyzed. Stroke severity was assessed using the National Institute of Health Stroke score (NIHS score) and the modified Rankin Score (mRS). The cardiac enzyme levels were correlated with these scores. Results Twenty-eight percent of patients had elevated troponin I, while 72% patients had normal levels with the mean values of 10.36 to 106.54 ng/mL and 0.00 to 0.02 ng/mL, respectively. CK-MB levels were found elevated among 14% patients and normal among 86% patients with mean values of 5.8 to 124.36 and 0.0 to 4.3 ng/mL, respectively. Among the six patients who succumbed to death, three patients had increased troponin I and four had elevated CK-MB. NIHS scores of 21.0357+/-6.79 and 105.277+/-5.564 were seen in patients with elevated and normal troponin I, whereas NIHS scores of 20.4285+/-8.658 and 11.8721+/-9.273 were seen among patients with increased and normal CK-MB, respectively. The mRS scores were 4.3214+/-0.367, 2.4305+/-1.374, 4.2143+/-1.412, and 2.756+/-1.749 ng/mL among the patients with elevated and normal troponin I and CK-MB, respectively. Conclusion The mean values of cardiac enzymes troponin I and CK-MB were higher among patients with higher scores of NIHS and mRS. Among them, troponin I was very significant and it may serve as an early biomarker for the severity of stroke and hint on early cardiac evaluation among these patients..


  • Selek A, Cetinarslan B, Canturk Z, Tarkun I, Akyay OZ, Cabuk B, et al.. The Utility of Preoperative ACTH/Cortisol Ratio for the Diagnosis and Prognosis of Cushing's Disease. Journal of Neurosciences in Rural Practice 2018; 9: (1) 106-11'
    Abstract
    Purpose: Cushing's syndrome (CS) is a rare disease having diagnostic difficulties. Many diagnostic tests have been defined but none of these are diagnostic alone. Determination of the cause is another problem which sometimes requires more sophisticated and invasive procedures. Therefore, we aimed to evaluate the utility of pretreatment plasma adrenocorticotropic hormone (ACTH)/cortisol ratios in patients with confirmed endogenous CS for the diagnosis and differential diagnosis of CS. Materials and Methods: This retrospective evaluation included 145 patients with the diagnosis of CS, 119 patients with Cushing's disease (CD), and 26 patients with ACTH-independent CS (AICS), in a university hospital. Furthermore, 114 individuals in whom CS diagnosis was excluded with at least one negative screening test were enrolled to the study as control group. The clinical, laboratory, imaging, postsurgical pathologic records and also clinical follow-up data of all patients were evaluated. Results: The median basal ACTH/cortisol ratio of the patients with CD was significantly higher than AICS and controls. A cutoff ACTH/cortisol ratio >2.5 was found to be diagnostic for CD with 82% specificity and 63% sensitivity. Among CD group, patients with recurrent disease had higher preoperative ACTH levels and ACTH/cortisol ratio than patients with sustained remission. Furthermore, these patients had more invasive, atypical, and larger tumors. Conclusion: An ACTH/cortisol ratio >2.5 would be beneficial to diagnose CD together with other diagnostic tests. It is a simple test with no additional cost. Higher ratios might be related with larger, invasive, and atypical adenoma and also might be helpful to predict recurrence..


  • D'Souza P, Hanson KA, Pillutla P, Presto P, Nagy L. Child Abuse and Deformational Plagiocephaly in a West Texas Hospital System. Journal of Neurosciences in Rural Practice 2020; 11: (1) 106-12'
    Abstract
    Background The aim of this study was to assess deformational plagiocephaly's (DP) predictive value in neglect and physical abuse (nonaccidental trauma [NAT]) within the pediatric population. In addition, we sought to characterize the prevalence of DP and NAT for our hospital's mostly rural catchment area. Methods Data on hospitalized patients diagnosed with NAT and/or neglect between 2012 and 2018 were collected via retrospective chart review. All enrolled children were younger than the age of 4 years at the time of diagnosis, and those without legible head computed tomographies or magnetic resonance images during their initial hospitalization were excluded. Utilizing neuroimaging, we calculated the cranial vault asymmetry index (CVAI) and cranial index for each patient to assess for DP. Differences between the two groups were assessed using Wilcoxon's rank-sum test for continuous variables and Fisher's exact test for categorical variables. A p -value of 0.05 or less was considered statistically significant. All analyses were conducted using SAS 9.4 (Cary, North Carolina, United States). Results The prevalence of DP within the combined cohort of NAT and neglect patients is 21%, similar to that reported in the literature for the general population (20-50%). There was no significance between the prevalence of DP and a history of NAT ( p > 0.1) or neglect ( p > 0.1). Furthermore, there was no correlation between CVAI and characteristics of initial presentation or history of trauma for either NAT ( p -values: 0.359 and 0.250, respectively) or neglect groups ( p -values: 0.116 and 0.770, respectively). Conclusion While there are many limitations to this study, our results suggest that abused children are no more likely to have history of DP than the general population, and the degree of DP is not associated with severity of trauma history or initial presentation. We hope the results of this study promote future investigations for unique and subtle predictive factors of child abuse/neglect..


  • Zafar A, Shahid R, Nazish S, Aljaafari D, Alkhamis FA, Alsalman S, et al.. Nonadherence to Antiepileptic Medications: Still a Major Issue to be Addressed in the Management of Epilepsy. Journal of Neurosciences in Rural Practice 2019; 10: (1) 106-12'
    Abstract
    Context: Medication nonadherence is a significant barrier in achieving seizure freedom in patients with epilepsy. There is a deficiency of data about the reasons for nonadherence in Saudi population. Aims: The aim of this study is to prove the existence of nonadherence to antiepileptic drugs (AEDs) in patients with epilepsy and identify the responsible factors. Setting and Design: This is a prospective, cross-sectional study carried in the Department of Neurology at King Fahd Hospital of the University affiliated with Imam Abdulrahman Bin Faisal University. Subjects and Methods: Patients of all ages diagnosed to have epilepsy as mentioned in their medical record and taking antiepileptic medications were interviewed using a questionnaire. Statistical Analysis Used: Statistical analysis was performed using IBM Statistical Package for the Social Sciences version 21 (IBM Corp., Armonk, NY, USA). Statistical significance was defined as two-tailed with a P </= 0.05. Results: Among 152 participants, 52.6% were male and 47.4% were female. Mean age of the patients was 28 +/- 14.3 (mean +/- standard deviation) years. Of 152 patients, 48.7% were found to be nonadherent to their AED therapy. The most commonly identified factor was forgetfulness. Nonadherence was significantly associated with poor seizure control (P = 0.002). Conclusion: Nonadherence to the AED is common among patients with epilepsy and affects seizure control adversely..


  • Wiwanitkit S, Wiwanitkit V. Neuron-specific enolase and blood sugar level in ischemic stroke patients. Journal of Neurosciences in Rural Practice 2012; 3: (1) 106-7'
    Abstract
    None.


  • Sadashiva N, Nandeesh BN, Shukla D, Bhat D, Somanna S, Devi BI. Isolated Sphenoid Sinus Lesions: Experience with a Few Rare Pathologies. Journal of Neurosciences in Rural Practice 2017; 8: (1) 107-13'
    Abstract
    INTRODUCTION: The sphenoid sinus is often neglected because of its difficult access. The deep position of the sphenoid sinus hinders early diagnosis of pathologies in that location. Delayed diagnosis can cause serious complications due to proximity to many important structures. OBJECTIVES: The aim of this study is to demonstrate different pathologies which can affect the sphenoid sinus and elucidate the findings. METHODS: Cases of isolated sphenoid sinus lesions encountered in the neurosurgical setting which had rare pathologies are discussed. Pathologies such as Langerhans cell histiocytosis, solitary plasmacytoma, chordoma, pituitary adenoma, leiomyosarcoma, fungal infection, and mucocele which appeared primarily in sphenoid sinus are discussed along with their imaging features and pathological findings. CONCLUSION: Multitude of different pathologies can occur in sphenoid sinus. Detailed preoperative imaging is very helpful, but transnasal biopsy and histological study are required often for definitive diagnosis. The possible advantages of early diagnosis before spread of pathology for prognosis cannot be overemphasized..


  • Rocchietti March M. Type 1 neurofibromatosis and pheochromocytoma: Focus on hypertension. Journal of Neurosciences in Rural Practice 2012; 3: (1) 107-8'
    Abstract
    None.


  • Diwan S. Commentary. Journal of Neurosciences in Rural Practice 2011; 2: (1) 107-8'
    Abstract
    None.


  • Salunke P, Sodhi HB, Aggarwal A, Ahuja CK. Delayed cerebral vasospasm following surgery for craniopharyngioma. Journal of Neurosciences in Rural Practice 2013; 4: (1) 107-9'
    Abstract
    None.


  • McClelland S, 3rd, Kim SS. Successful operative management of an upper lumbar spinal canal stenosis resulting in multilevel lower nerve root radiculopathy. Journal of Neurosciences in Rural Practice 2015; 6: (1) 108-11'
    Abstract
    Lumbar stenosis is a common disorder, usually characterized clinically by neurogenic claudication with or without lumbar/sacral radiculopathy corresponding to the level of stenosis. We present a case of lumbar stenosis manifesting as a multilevel radiculopathy inferior to the nerve roots at the level of the stenosis. A 55-year-old gentleman presented with bilateral lower extremity pain with neurogenic claudication in an L5/S1 distribution (posterior thigh, calf, into the foot) concomitant with dorsiflexion and plantarflexion weakness. Imaging revealed grade I spondylolisthesis of L3 on L4 with severe spinal canal stenosis at L3-L4, mild left L4-L5 disc herniation, no stenosis at L5-S1, and no instability. EMG revealed active and chronic L5 and S1 radiculopathy. The patient underwent bilateral L3-L4 hemilaminotomy with left L4-L5 microdiscectomy for treatment of his L3-L4 stenosis. Postoperatively, he exhibited significant improvement in dorsiflexion and plantarflexion. The L5-S1 level was not involved in the operative decompression. Patients with radiculopathy and normal imaging at the level corresponding to the radiculopathy should not be ruled out for operative intervention should they have imaging evidence of lumbar stenosis superior to the expected affected level..


  • Abraham AA, T.M A, P RJ, Vasudevan A, Kumar BS. Clinical Outcome of Neoplastic Meningitis Associated with Breast Cancer. Journal of Neurosciences in Rural Practice 2022; 13: (1) 108-13'
    Abstract
    Background ?Neoplastic meningitis (NM) is considered as a terminal event with poor prognosis. Its impact in clinical oncology is growing. Objective ?To analyze the clinical outcome of patients with carcinoma breast diagnosed with NM. Materials and Methods ?This study was an observational study in breast cancer patients diagnosed with NM. Patients with typical clinical symptoms and signs with either presence of cerebrospinal fluid (CSF) cytology positive for neoplastic cells or typical radiological features of leptomeningeal involvement in the presence of neurological symptoms or signs were taken as leptomeningeal metastasis (LM) or NM. The estimation of survival was done by Kaplan–Meier method. Results ?Out of 1,200 patients diagnosed with carcinoma breast during the study period, 15 developed NM. The median age of study population was 51 (range: 44–55) years. Most common presentations were headache (47%), vomiting (47%), diplopia (20%), seizure (20%), and cerebellar signs (7%). Seven (46%) patients were hormone receptor positive, four (30%) were HER2 (Human epidermal growth factor receptor 2) positive and seven (46%) were triple-negative breast cancer. Median time to develop LM from the time of diagnosis of breast cancer was 6 (range: 3–8) months. Nine patients (90%) had features of NM in CSF cytology. Thirteen patients received palliative whole brain radiotherapy (20 Gy in five fractions). Nine out of 12 patients received single-agent Capecitabine as first-line chemotherapy after palliative radiation therapy (RT). Intrathecal methotrexate was given for seven patients. The median overall survival was 3 (range: 0.5–4) months. Conclusion ?LM is a very aggressive metastatic disease with poor outcome. There is an unmet need for proper guidelines and an overwhelming necessity for a better focus on research for new modalities of disease in this scenario..


  • Buell TJ, Ding D. Optimizing the management of aneurysmal subarachnoid hemorrhage: Lessons learned and future directions. Journal of Neurosciences in Rural Practice 2014; 5: (2) 109-10'
    Abstract
    None.


  • Doukas A. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (1) 109-10'
    Abstract
    None.


  • Xiang-Dong G. Benign paroxysmal positional vertigo. Journal of Neurosciences in Rural Practice 2011; 2: (1) 109-10'
    Abstract
    Benign paroxysmal positional vertigo (BPPV) is a common clinical disorder characterized by brief recurrent spells of vertigo often brought about by certain head position changes as may occur with looking up, turning over in bed, or straightening up after bending over. It is important to understand BPPV not only because it may avert expensive and often unnecessary testing, but also because treatment is rapid, easy, and effective in >90% of cases. The diagnosis of BPPV can be made based on the history and examination. Patients usually report episodes of spinning evoked by certain movements, such as lying back or getting out of bed, turning in bed, looking up, or straightening after bending over. At present, the generally accepted recurrence rate of BPPV after successful treatment is 40%-50% at 5 years of average follow-up. There does appear to be a subset of individuals prone to multiple recurrences..


  • Shukla SK, Sharma V, Singh K, Trivedi A. Primary lumbosacral intradural hydatid cyst in a child. Journal of Neurosciences in Rural Practice 2010; 1: (2) 109-11'
    Abstract
    Primary spinal hydatid cyst is very rare lesion affecting less than 1% of the total cases of the hydatid disease. In this study, we report a case of spinal hydatid in a 5-year old boy presented with a history of backache, leg pain, difficulty in walking, and bowel and bladder incontinence for 4 months. An intradural nonenhancing cystic lesion was detected using magnetic resonance imaging from L4 to sacral region, and histopathological findings were suggestive of hydatid cyst..


  • Sujan MU, Rao MR, Kisan R, Abhishekh HA, Nalini A, Raju TR, et al.. Influence of hydrotherapy on clinical and cardiac autonomic function in migraine patients. Journal of Neurosciences in Rural Practice 2016; 7: (1) 109-13'
    Abstract
    BACKGROUND: Migraine is associated with autonomic symptoms. The growing body of literature suggests that the dysfunctional autonomic nervous system might play a pivotal role in the pathogenesis of migraine. Thermal therapies have been hypothesized to modulate these changes and alleviate pain. However, data regarding the efficacy of hydrotherapy in migraine remain scant. We evaluated the effect of add on hydrotherapy procedure (a hot arm and foot bath with ice massage to head) in migraine patients. METHODS: Forty chronic migraine patients fulfilling the International Classification of Headache Disorders II criteria were recruited from the neurology outpatient clinic. Patients were randomized to receive either hydrotherapy plus conventional pharmacological care (n = 20) or conventional medication only (n = 20). Hydrotherapy group received treatment with hot arm and foot bath (103 degrees F to 110 degrees F) and ice massage to head daily for 20 min for 45 days. Patients were assessed using headache impact test (HIT), visual analog scale for pain and cardiac autonomic function by heart rate variability (HRV) before and after intervention period. RESULTS: There was a significant decrease in HIT score, frequency, and intensity of headaches following treatment in both the groups. However, it was more evident in add on hydrotherapy group compared to pharmacological treatment alone group. There was also significant improvement in the HRV parameters. In particular, there was a significant decrease in heart rate (P = 0.017), increase in high frequency (HF) (P = 0.014) and decrease in low frequency/HF ratio (P = 0.004) in add on hydrotherapy group. CONCLUSION: Our study shows that add on hydrotherapy enhanced the vagal tone in addition to reducing the frequency and intensity of headaches in migraine patients..


  • Chaurasia RN, Pathak A, Singh S, Joshi D, Mishra VN. Study of Knowledge, Attitude, and Practice in Participants with Regular Intake of Lathyrus, But No Spastic Paraparesis. Journal of Neurosciences in Rural Practice 2018; 9: (1) 11-3'
    Abstract
    Background and Purpose: Neurolathyrism is now a disease of the past and also the causative agent, Lathyrus sativus (Khesari Pulse or keerai in Local Hindi and Bhojpuri language) has now been proven to be harmless and has become part of the usual diet. Materials and Methods: The population at risk was screened and studied for demography, economic status, knowledge about Khesari pulse, awareness about so-called harmful effects of Khesari pulse intake in humans, and the effects of ban of Khesari pulse on the population which is using Lathyrus (Khesari) as a major source of pulse since the past 4 years through a questionnaire of three pages. Results: Nearly 97% of total screened population totally fed on Khesari pulse as their major source of food and we did not found a single case of primary walking difficulty. We did find three cases of poststroke paralysis, a case of post-GBS lower limb weakness, and a case of recurrent myelitis as a part of questionnaire-based study and then followed by personally examining the patients to confirm the diagnosis. Conclusion: Khesari pulse if consumed in smaller quantities as a part of a normal mixed diet, its nutritional values can be optimally utilized..


  • Kumar S. Endovascular neurointervention success and complication rates in the first year of independent practice in a suburban hospital setup. Journal of Neurosciences in Rural Practice 2014; 5: (1) 11-7'
    Abstract
    CONTEXT: Endovascular neurointervention (interventional neuroradiology) is a highly demanding science requiring deep understanding of disease, anatomy, clinical skills and manual dexterity, consequently with a long learning curve and thus posing significant challenges to a physician entering new into the competitive arena. AIM: To evaluate the procedural success, complications and outcome in the first year of independent endovascular neurointervention practice in a suburban hospital. MATERIALS AND METHODS: Retrospective analysis of prospectively maintained data of all diagnostic and therapeutic neurointerventional cases performed by the author between the period of January 02, 2012 and December 31, 2012. RESULTS: A total of 61 procedures were performed. The performance success rate of the diagnostic procedures was 100% (38/38) and that of therapeutic procedures was 82.6% (19/23). The periprocedural complication rates were nil and 13%, respectively, for diagnostic and therapeutic procedures. The 3-month patient outcome for therapeutic procedures was good outcome (Modified Rankin Scale <2) in 87% cases (20/23), and poor outcome in 13% (2 dead and 1 debilitated with Modified Rankin Scale of 3). CONCLUSION: For a well-trained endovascular neurointerventionalist, the first year of practice had high procedural success rate and acceptable complication with patient outcome rates comparable to the existing literature..


  • Raina SK. A comment on effect of fluoride exposure on the intelligence of school children in Madhya Pradesh, India. Journal of Neurosciences in Rural Practice 2013; 4: (1) 110-1'
    Abstract
    None.


  • Saxena S, Sahay A, Goel P. Authors' reply. Journal of Neurosciences in Rural Practice 2013; 4: (1) 111'
    Abstract
    None.


  • McMurtray A, Saito E. Does primary headache type influence secondary headache symptoms?. Journal of Neurosciences in Rural Practice 2014; 5: (2) 111-2'
    Abstract
    None.


  • Gautam G, Hashmi M, Pandey A. Neuroacanthocytosis: A rare movement disorder with magnetic resonance imaging. Journal of Neurosciences in Rural Practice 2011; 2: (1) 111-2'
    Abstract
    None.


  • Thomas D. A structured approach to brain injury rehabilitation. Journal of Neurosciences in Rural Practice 2011; 2: (1) 112-4'
    Abstract
    None.


  • Wani NA, Kosar TL, Khan AQ, Ahmad SS. Multidetector-row computed tomography in cerebral hydatid cyst. Journal of Neurosciences in Rural Practice 2010; 1: (2) 112-4'
    Abstract
    Intracranial localization is a rare manifestation of hydatid cyst disease (Echinococcosis). It comprises only 2% of cases of Echinococcosis infection even in endemic areas and is predominantly seen in children. Clinical manifestations resulting from raised intracranial tension are nonspecific. Imaging with computed tomography (CT) may suggest the diagnosis preoperatively with reasonable accuracy. Multidetector-row CT (MDCT) with its high resolution multiplanar reformations can demonstrate the relationship of the cyst with adjacent brain structures and thus help in planning surgery. This has a practical utility in places where magnetic resonance imaging is not available. We describe a case of cerebral hydatid cyst in a 13-year-old boy who was diagnosed with MDCT, which helped in planning its surgical removal..


  • Dudipala SC, Mandapuram P, Ch LK. Eucalyptus Oil-Induced Seizures in Children: Case Reports and Review of the Literature. Journal of Neurosciences in Rural Practice 2021; 12: (1) 112-5'
    Abstract
    Objective Eucalyptus oil (EO)-induced seizures (EOIS) in children is a less recognized entity and a rare cause of acute symptomatic seizures. The purpose of this review outlines the clinical features and outcomes of EOIS with observed cases. Patients and Methods We identified three pediatric patients with EOIS who were treated at Prathima Institute of Medical Sciences, Karim Nagar, India. Results Seizures were developed in three children within 15 to 25 minutes after the ingestion of EO. All the children have taken EO first time and all have the first episode of seizures. One child had status epilepticus. Neuroimaging and electroencephalogram were normal. Two children were treated with antiepileptic drugs for 2 weeks. All the children were recovered within 2 days and none of them had a recurrence of seizures. Conclusion EOIS is an underrecognized and rare entity. The knowledge or awareness of EOIS among health care professionals can prevent unnecessary investigations and long-term antiepileptic drug therapy..


  • Krishnan SS, Bojja S, Vasudevan MC. Spinal accessory nerve schwannomas masquerading as a fourth ventricular lesion. Journal of Neurosciences in Rural Practice 2015; 6: (1) 112-5'
    Abstract
    Schwannomas are benign lesions that arise from the nerve sheath of cranial nerves. The most common schwannomas arise from the 8(th) cranial nerve (the vestibulo-cochlear nerve) followed by trigeminal and facial nerves and then from glossopharyngeal, vagus, and spinal accessory nerves. Schwannomas involving the oculomotor, trochlear, abducens and hypoglossal nerves are very rare. We report a very unusual spinal accessory nerve schwannoma which occupied the fourth ventricle and extended inferiorly to the upper cervical canal. The radiological features have been detailed. The diagnostic dilemma was due to its midline posterior location mimicking a fourth ventricular lesion like medulloblastoma and ependymoma. Total excision is the ideal treatment for these tumors. A brief review of literature with tabulations of the variants has been listed..


  • Palve SS, Palve SB. Impact of Aging on Nerve Conduction Velocities and Late Responses in Healthy Individuals. Journal of Neurosciences in Rural Practice 2018; 9: (1) 112-6'
    Abstract
    Background: Nerve conduction studies are performed to diagnose the disorders of the peripheral nervous system. The reference values for nerve conduction velocity (NCV) and late responses for different nerves considerably vary in different group and type of population. Physiological factors such as age, temperature, height, and gender affect the NCV. However, there are very few studies which show the age group at which these changes become significant. Aim and Objectives: The aim of the study was to establish the electrophysiological data of the specific age group at which changes in NCV as well as late responses of median common peroneal nerve and also see the late response in the form of F-waves and H-reflex. Methodology: Study groups were divided into three categories based on the age: Group I (18-30 years) (n = 80), Group II (31-45 years) (n = 43), and Group III (46-60 years) (n = 27). Out of which, 93 patients were male and 57 were female. The NCVs were determined for median, common peroneal nerve (motor component and sensory component) along with late responses in the form of H-reflex and F-waves. Results: The mean and standard deviation of median, ulnar, peroneal, and tibial nerve was studied for latencies, amplitude, and velocities for both sensory and motor components. Patients with older age had longer latencies, smaller amplitudes, and slower conduction velocities compared with the younger age group. The change with age was greater in sensory nerve conduction and late responses in all the peripheral nerves. Conclusions: Aging has a definite correlation with the NCV and late responses of different peripheral nerves. There is a need to have reference values with relation to age..


  • Guth J. The clinical profile, management, and overall outcome of aneurysmal subarachnoid hemorrhage at the neurosurgical unit of a tertiary care center in India. Journal of Neurosciences in Rural Practice 2014; 5: (2) 113-4'
    Abstract
    None.


  • Scott JG, Lavey RS. What to do when there is no standard of care: A brief review of treatment options for glioblastoma in children. Journal of Neurosciences in Rural Practice 2012; 3: (2) 113-4'
    Abstract
    None.


  • Yee SV, Ghani AR, Raffiq A. Review of CHESS Score in SAH Patients in Local Malaysian Population. Journal of Neurosciences in Rural Practice 2020; 11: (1) 113-8'
    Abstract
    Background Chronic hydrocephalus caused by subarachnoid hemorrhage is a reversible and treatable condition. To date, existing clinical scores for predicting the development of posthemorrhagic hydrocephalus are few and difficult to apply in the clinical settings. Chronic hydrocephalus ensuing subarachnoid hemorrhage score (CHESS) was first published in 2016. Although it showed promising results, no external validation has been done outside Europe. We designed this study to validate the accuracy and reliability of CHESS score and to also look for other factors that may cause posthemorrhagic shunt dependent hydrocephalus. Objectives This study is to determine the reliability of CHESS score and to look for other parameters with predictive value in patients with shunt-dependent posthemorrhagic hydrocephalus. Results Thirty-one percent of the studied population developed shunt-dependent hydrocephalus ( n = 41). CHESS score showed an odds ratio (OR) of 2.184 with p -value < 0.001 and two other risk factors were found to be strongly related to develop shunt-dependent hydrocephalus, that is, early infarct in computed tomography (CT) brain (OR = 0.182; p -value = 0.004) and Fisher's grade > 3 (OR = 1.986; p -value = 0.047). The sensitivity and specificity for CHESS score in this cohort population showed a sensitivity of 73.2% and specificity of 93.3%. The area under the curve for CHESS score in our cohort is 0.922. Conclusion CHESS score is a reliable tool in early prediction of shunt-dependent hydrocephalus post subarachnoid hemorrhage..


  • Majovsky M, Netuka D, Benes V, Kucera P. Burr-Hole Evacuation of Chronic Subdural Hematoma: Biophysically and Evidence-Based Technique Improvement. Journal of Neurosciences in Rural Practice 2019; 10: (1) 113-8'
    Abstract
    Chronic subdural hematoma (CSDH) is one of the most common neurosurgical conditions. Despite ongoing efforts, recurrence and reoperation rates after surgical treatment remain high. We synthesize scientific evidence on the treatment of CSDH with biophysical principles and then propose a simple and effective surgical technique aiming to reduce the recurrence rate. Under local anesthesia, one burr hole is placed in the area above the maximum hematoma thickness. One drain is inserted into the dorsal direction to the deepest point of the hematoma cavity, and a second drain is inserted frontally into the highest point. Next, saline is gently instilled to the dorsal drain to eliminate air from the hematoma cavity through the frontal drain. Once saline has filled the frontal drain, the frontal drain is removed. The dorsal drain is left in situ for 48 h, and the pressure within the cavity may be adapted hydrostatically. We implemented evidence-based conclusions of previous studies and modified the classical burr-hole technique to reduce the recurrence rate. As a result, we developed a straightforward surgical procedure that is possible to perform under local anesthesia, suitable for everyday practice in rural and remote areas while working with limited resources. The novelty of this technique is in the purposeful reduction of postoperative pneumocephalus, a known independent factor of recurrence. Subdural air is eliminated during surgery using a two-drain system. Safety and efficacy of the technique need to be evaluated in future clinical trials..


  • Pal S, Sen K, Biswas NM, Ghosal A, Rousan Jaman SK, Yashavantha Kumar KY. Clinico-radiological profile and outcome of dengue patients with central nervous system manifestations: A case series in an Eastern India tertiary care hospital. Journal of Neurosciences in Rural Practice 2016; 7: (1) 114-24'
    Abstract
    BACKGROUND AND OBJECTIVE: Dengue, an acute viral disease, transmitted by Aedes mosquitoes, has a variable clinical spectrum ranging from asymptomatic infection to life-threatening dengue hemorrhagic fever and dengue shock syndrome. However, neurological complications, in general, are unusual but have been observed more frequently in the recent past, and some studies highlighted varied neurological complications during the course of illness. Although dengue is classically considered a nonneurotropic virus, there is increasing evidence for dengue viral neurotropism. In this study, we have evaluated clinico-radiological profile and outcome of nine serologically confirmed dengue patients having varied manifestations of central nervous system (CNS) involvement. MATERIALS AND METHODS: All the consecutive patients presented with neurological complications with positive serology for dengue infection (IgM positivity) in Department of Medicine, in a tertiary care hospital in Eastern India from August 2013 to October 2014 were included in the study. These patients were subjected to a detailed clinical evaluation, laboratory assessment including complete hemogram, coagulation profile, liver function test, serum electrolytes, and routine CSF (Cerebrospinal Fluid) study with the exclusion of other common neuroinvasive pathogens. RESULTS: Out of 9 patients with neurological complications associated with confirmed dengue infection, 2 (22%) patients had dengue encephalopathy, 5 (56%) patients have dengue encephalitis, 1 (11%) patient had dengue meningitis, and 1 (11%) patient had postdengue immune-mediated CNS involvement. CONCLUSION: This case series reaffirms the occurrence of varied CNS manifestations in dengue virus infection and underlines the importance of inclusion of dengue in the differential diagnosis of acute encephalitis syndrome..


  • Gupta B, Agrawal P, D'Souza N, Soni KD, Kumar A. Delayed presentation of spinal cord trauma. Journal of Neurosciences in Rural Practice 2011; 2: (1) 114-6'
    Abstract
    None.


  • Raju B, Reddy K. Are Counseling Services Necessary for the Surgical Patients and their Family Members during Hospitalization?. Journal of Neurosciences in Rural Practice 2017; 8: (1) 114-7'
    Abstract
    None.


  • Lodha D, Subramaniam JR. High Fructose Negatively Impacts Proliferation of NSC-34 Motor Neuron Cell Line. Journal of Neurosciences in Rural Practice 2022; 13: (1) 114-8'
    Abstract
    Objectives ?The main aim of this study is to identify the deleterious effects of indiscriminately consumed high fructose on motor neurons that are critically affected in many neurological conditions causing movement disorders including paralysis. Materials and Methods ?Neuroblastoma x mouse spinal cord motor neuron cell line (NSC-34) motor neuron cell lines were treated with high fructose and oxygen supplementation (18.8%) and assayed for cell proliferation/death, reactive oxygen species (ROS) generation, and oxidative stress response induction Statistical Analysis ?Mean and standard deviation, significance with and without high fructose (F)-5%, were estimated by t -tests using GraphPad Prism ver. 8.2.1 Results ?F-5% along with O 2 (18.8%) annihilates the cells (?85%) by day10 and inhibits cell division as observed by the presence of multinucleated cells. Unexpectedly, 1 to 2% of cells that survived, differentiated and displayed progressive neurite extension. Though not healthy, they were viable up to 80 days. F-5% increased ROS levels (?34%) not accompanied by concomitant enhanced expression of oxidative stress response regulator, the transcription factor, nrf-2 , or downstream effector, sod-1.Conclusion ?High fructose is extremely harmful to NSC-34 motor neuron cell line..


  • Stieglitz LH. One of nature's basic rules: The simpler the better-why this is also valid for neuronavigation. Journal of Neurosciences in Rural Practice 2014; 5: (2) 115'
    Abstract
    None.


  • Tshikwela ML, Longo-Mbenza B. Spontaneous intracerebral hemorrhage: Clinical and computed tomography findings in predicting in-hospital mortality in Central Africans. Journal of Neurosciences in Rural Practice 2012; 3: (2) 115-20'
    Abstract
    BACKGROUND AND PURPOSE: Intracerebral hemorrhage (ICH) constitutes now 52% of all strokes. Despite of its deadly pattern, locally there is no clinical grading scale for ICH-related mortality prediction. The first objective of this study was to develop a risk stratification scale (Kinshasa ICH score) by assessing the strength of independent predictors and their association with in-hospital 30-day mortality. The second objective of the study was to create a specific local and African model for ICH prognosis. MATERIALS AND METHODS: Age, sex, hypertension, type 2 diabetes mellitus (T2DM), smoking, alcohol intake, and neuroimaging data from CT scan (ICH volume, Midline shift) of patients admitted with primary ICH and follow-upped in 33 hospitals of Kinshasa, DR Congo, from 2005 to 2008, were analyzed using logistic regression models. RESULTS: A total of 185 adults and known hypertensive patients (140 men and 45 women) were examined. 30-day mortality rate was 35% (n=65). ICH volume>25 mL (OR=8 95% CI: 3.1-20.2; P<0.0001), presence of coma (OR=6.8 95% CI 2.6-17.4; P<0.0001) and left hemispheric site of ICH (OR 2.6 95% CI: 1.1-6; P=0.027) were identified as significant and independent predictors of 30-day mortality. Midline shift > 7 mm, a consequence of ICH volume, was also a significant predictor of mortality. The Kinshasa ICH score was the sum of individual points assigned as follows: Presence of coma coded 2 (2 x 2 = 4), absence of coma coded 1 (1 x 2 = 2), ICH volume>25 mL coded 2 (2 x 2=4), ICH volume of </=25 mL coded 1(1 x 2=2), left hemispheric site of ICH coded 2 (2 x 1=2), and right hemispheric site of hemorrhage coded 1(1 x 1 = 1). All patients with Kinshasa ICH score </=7 survived and the patients with a score >7 died. In considering sex influence (Model 3), points were allowed as follows: Presence of coma (2 x 3 = 6), absence of coma (1 x 3 = 3), men (2 x 2 = 4), women (1 x 2 = 2), midline shift </=7 mm (1 x 3 = 3), and midline shift >7 mm (2 x 3 = 6). Patients who died had the Kinshasa ICH score >/=16. CONCLUSION: In this study, the Kinshasa ICH score seems to be an accurate method for distinguishing those ICH patients who need continuous and special management. It needs to be validated among large African hypertensive populations with a high rate of 30-day in-hospital mortality..


  • Zakham F, El Mzibri M. Novel magnetic resonance imaging scoring system for diagnosis of spinal tuberculosis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 115-6'
    Abstract
    None.


  • Tyagi DK, Balasubramaniam S, Sawant HV. Primary calcified hydatid cyst of the brain. Journal of Neurosciences in Rural Practice 2010; 1: (2) 115-7'
    Abstract
    Cerebral hydatid disease is very rare, and in non-endemic areas like India, the occurrence is as low as 0.2% of all intracranial space occupying lesions. Calcification of the cyst wall indicates an even rarer subvariety, i.e., alveolar echinococcosis (AE). AE has hitherto been unreported in the Indian subcontinent. We report such a case in a 25-year-old male, a shepherd by occupation, who presented to us with intractable seizures and headache. He had no gross lesion in the liver. Craniotomy with total excision of the lesion was performed, followed by antiparasitic treatment. The radiological presentation, differential diagnosis and treatment modalities are discussed in relation to our case..


  • Bhuskute G, Manogaran RS, Keshri A, Mehrotra A, Singh N, Mathialagan A. Surgical Candidacy in Skull Base Paragangliomas: An Institutional Experience. Journal of Neurosciences in Rural Practice 2021; 12: (1) 116-21'
    Abstract
    Objective The aim of the study is to determine the surgical candidacy and nuances of skull base paraganglioma surgery in the era of radiotherapy. Materials and Methods This was a retrospective observational study conducted in patients who presented with skull base paragangliomas between January 2017 and December 2019. Primary data, including indication for surgery, the approach used, the extent of resection, complications, and postoperative lower cranial nerve status were studied. Results A total of 21 cases of skull base paragangliomas were analyzed, including seven cases of tympanic paraganglioma, 10 cases of jugular foramen paraganglioma, three cases of multiple paragangliomas, and one case of vagal paraganglioma. Indications for surgery were young age, bleeding from ear, neck mass with upper aerodigestive pressure symptoms, lower cranial nerve paralysis, and patients with intracranial pressure symptoms. Total excision was done in 11 patients, near-total excision in five patients, subtotal in three patients, and surgery was not done in two patients. Facial nerve paralysis was the most common complication observed, followed by bleeding and flap necrosis. Radiotherapy was considered as adjuvant treatment wherever indicated. Conclusion A thorough knowledge and understanding of the pathophysiology of the skull base paragangliomas and its management strategies can help to achieve excellent results in terms of tumor clearance and reduction in complications. A multidisciplinary team approach and meticulous skull base surgical techniques have a significant role to play in the management of paragangliomas, especially in developing countries where availability of radiosurgery is still a challenge..


  • Mohanty A. Biopsy of brain stem gliomas: Changing trends?. Journal of Neurosciences in Rural Practice 2014; 5: (2) 116-7'
    Abstract
    None.


  • Shrivastava SR, Shrivastava PS, Ramasamy J. Antenatal and postnatal depression: A public health perspective. Journal of Neurosciences in Rural Practice 2015; 6: (1) 116-9'
    Abstract
    Depression is widely prevalent among women in the child-bearing age, especially during the antenatal and postnatal period. Globally, post-partum depression has been reported in almost 10% to 20% of mothers, and it can start from the moment of birth, or may result from depression evolving continuously since pregnancy. The presence of depression among women has gained a lot of attention not only because of the rising incidence or worldwide distribution, but also because of the serious negative impact on personal, family and child developmental outcomes. Realizing the importance of maternal depression on different aspects-personal, child, and familial life, there is a crucial need to design a comprehensive public health policy (including a mental health strategy), to ensure that universal psychosocial assessment in perinatal women is undertaken within the primary health care system. To conclude, depression during pregnancy and in the postnatal period is a serious public health issue, which essentially requires continuous health sector support to eventually benefit not only the woman, but also the family, the community, and health care professionals..


  • Kuppili PP, Parmar A, Gupta A, Balhara YPS. Role of Yoga in Management of Substance-use Disorders: A Narrative Review. Journal of Neurosciences in Rural Practice 2018; 9: (1) 117-22'
    Abstract
    Substance use disorders are comparable to chronic medical illnesses and have a chronic relapsing course. Despite being significant contributors to morbidity and mortality, limited treatment options exist. The current narrative review was aimed at providing an overview of yoga therapy in substance-use disorders and discuss the relevant methodological issues. Articles published in English language till May 2017 indexed with PubMed, PubMed central, and Google Scholar were searched using search terms "Yoga," "Substance use," "Drug dependence," "Nicotine," "Tobacco," "Alcohol," "Opioids," "Cannabis," "Cocaine," "Stimulants," "Sedative hypnotics," "Inhalants," and "Hallucinogens" for inclusion in the review. A total of 314 studies were found fulfilling the stated criteria. Out of which, 16 studies were found to fulfill the inclusion and exclusion criteria and 12 were randomized control trials. The majority of studies were available on the role of yoga in management of nicotine dependence. Sample size of these studies ranged from 18 to 624. The majority of studies suggested the role of yoga in reducing substance use as well as substance-related craving (especially in nicotine-use disorders) in short term. However, more studies are required for demonstrating the long-term effects of yoga therapy in substance-use disorder..


  • Molyneux E. Where there is no laboratory, a urine patch test helps diagnose meningitis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 117-8'
    Abstract
    None.


  • Rao GS, Kamath S. Of water bags and wind pipes: The travails of securing airway in occipital encephalocoele. Journal of Neurosciences in Rural Practice 2011; 2: (2) 117-8'
    Abstract
    None.


  • Sodhi HB, Savardekar AR, Mohindra S, Chhabra R, Gupta V, Gupta SK. The clinical profile, management, and overall outcome of aneurysmal subarachnoid hemorrhage at the neurosurgical unit of a tertiary care center in India. Journal of Neurosciences in Rural Practice 2014; 5: (2) 118-26'
    Abstract
    BACKGROUND AND PURPOSE: Several studies report good outcomes in selected patients of aneurysmal subarachnoid hemorrhage (aSAH). The purpose of our study is to project the clinical characteristics, management, and overall outcome of patients with aSAH presenting to a tertiary care center in India. MATERIALS AND METHODS: A prospective study was conducted over a period of 10 months and all patients presenting with aSAH were studied. Patients presenting in all grades and managed with any type of intervention or managed conservatively were included to characterize their clinical and radiological profile at admission, during management, and at discharge. Outcome was assessed with the Glasgow Outcome Score (GOS) at 3 months follow-up. RESULTS: Out of the 482 patients [mean age: 51.3 (+/-13.5); M: F = 1:1], 330 patients were fit to be taken up for intervention of the ruptured aneurysm, while 152 patients were unfit for any intervention. At 3 months follow-up, good outcome (GOS 4 and 5) was observed in 159 (33%), poor outcome (GOS 2 and 3) in 53 (11%), and death in 219 (45.4%) patients, while 51 patients (10.6%) were lost to follow-up. Most (95%) of the patients in the non-intervention group expired, and hence the high mortality rate, as we have analyzed the results of all patients of all grades, regardless of the treatment given. The predictors of poor outcome (GOS 1, 2, and 3) at 3 months follow-up, using multinomial regression model, were: World Federation of Neurological Surgeons (WFNS) grade IV and V (at admission and after adequate resuscitation) [odds ratio (OR): 35.1, 95% confidence interval (CI): 10.8-114.7] and presence of hypertension as a co-morbid illness [OR: 2.7, 95% CI: 1.6-5.6]. All patients showing acute infarction on computed tomography scan at presentation had a poor outcome. CONCLUSIONS: Despite recent advances in the treatment of patients with aSAH, the morbidity and mortality rates have failed to improve significantly in unselected patients and natural cohorts. This may be attributed to the natural history of aSAH, and calls for new strategies to diagnose and treat such patients before the catastrophe strikes..


  • Zoli M, Serracchioli A, Mazzatenta D. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 118-9'
    Abstract
    None.


  • Krishnan P, Das S, Bhattacharyya C. Epidural pneumorrhachis consequent to Hamman syndrome. Journal of Neurosciences in Rural Practice 2017; 8: (1) 118-9'
    Abstract
    None.


  • Cincu R, Rodriguez R, Perez A, Blanco T, Arrotegui I, Barcia C. Solitary fibrous tumor of the thoracic spine. Journal of Neurosciences in Rural Practice 2010; 1: (2) 118-9'
    Abstract
    None.


  • Rigotti S, Zorzi C. The importance of early diagnosis with magnetic resonance imaging in spinal tuberculosis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 119'
    Abstract
    None.


  • Nebhinani N, Mattoo SK, Wanchu A. Quality of Life, Social Support, Coping Strategies, and Psychiatric Morbidity in Patients with Rheumatoid Arthritis. Journal of Neurosciences in Rural Practice 2022; 13: (1) 119-22'
    Abstract
    Background and Objectives ?Patients with rheumatoid arthritis (RA) have greater psychological morbidity, despite that research in this area is scarce from developing countries. This study was aimed to assess the association of quality of life, social support, coping strategies, and psychological morbidity in patients with RA. Materials and Methods ?In this cross-sectional study, 40 patients with RA, who were not receiving steroids or disease modifying antirheumatic drugs, were recruited through purposive sampling. Social support questionnaire, coping strategy check list, and World Health Organization quality of life-BREF (WHOQOL-BREF) were administered to assess social support, coping, and quality of life, respectively. Results ?More than half of the patients had psychiatric disorders (60%), with depression being the commonest disorder (52.5%). Internalization coping and disease severity indicators like tender joints counts, swollen joints counts, pain, and disease activity were found as significant predictors for psychiatric disorders, while externalization coping, quality of life (all domains), and physical functions were found to protect against psychiatric morbidity. Conclusions ?Coping, quality of life, disease severity, and physical functions predicted the psychiatric disorders in RA. Multipronged interventions to enhance quality of life with promoting adaptive coping and timely treatment may further improve their mental health and overall disease course..


  • John LJ, Devi P, John J, Arifulla M, Guido S. Utilization patterns of central nervous system drugs: A cross-sectional study among the critically ill patients. Journal of Neurosciences in Rural Practice 2011; 2: (2) 119-23'
    Abstract
    INTRODUCTION: Critically ill patients often receive central nervous system drugs due to primary disorder or complications secondary to multiorgan failure. The aim of the study was to evaluate the current utilization pattern of central nervous system drugs among patients in the medical intensive care unit. MATERIALS AND METHODS: A prospective observational study carried out over a period of 1 year. The relevant data on drug prescription of each patient was collected from the inpatient case record. Drugs were classified into different groups based on WHO-ATC classification. The demographic data, clinical data, and utilization of different classes of drugs as well as individual drugs were analyzed. RESULTS: A total of 325 consecutive patients were included for the analysis; 211 (65%) patients were males; 146 patients (45%) were above 55 years of age. Encephalopathy [63(19.38%)] and stroke [62(19%)] were the common central nervous system diagnoses. In a total of 1237 drugs, 68% of the drugs were prescribed by trade name. Midazolam (N05CD08) 142 (43.69%), morphine (N02AA01) 201 (61.84%), and atracurium (M03AC04) 82 (25.23%) were the most commonly used sedative, analgesic, and neuromuscular blocker, respectively. Phenytoin (N03AB02) 151 (46.46%) had maximum representation among antiepileptic agents. CONCLUSIONS: Utilization of drugs from multiple central nervous system drug classes was noticed. Rational use of drugs can be encouraged by prescription by brand name..


  • Murthy MKS, Rajaram P, Mudiyanuru KS, Palaniappan M, Govindappa L, Dasgupta M. Potential for Increased Epilepsy Awareness: Impact of Health Education Program in Schools for Teachers and Children. Journal of Neurosciences in Rural Practice 2020; 11: (1) 119-24'
    Abstract
    Background Epilepsy, although a common disorder, yet is highly stigmatized. Under this condition, children with epilepsy are more vulnerable to stigmatization, social isolation, lack of support, and psychological and emotional problems. Thus, there is an immediate need of literature focusing on intervention studies to change the attitudes of school teachers and children. Methods The study was conducted with the objectives to evaluate knowledge, attitude, and practices (KAP) about epilepsy among school teachers and children; provide educational training program to teachers; and check the efficacy of training program imparted by teacher and trainer. Results Repeated measure of analysis of variance shows that knowledge ( F = 1,134.875, p < 0.001), attitude ( F = 2,429.909, p < 0.001), and practice ( F = 2,205.122, p < 0.001) are significantly different between pre- and posttests indicated by Pillai's trace test. Similarly, from the Pillai's test, knowledge ( F = 49.317, p < 0.001), attitude ( F = 125.304, p < 0.001), and practice ( F = 178.697, p < 0.001) are significantly different among teachers, trainer imparting training to children, and teachers imparting training to children. It is seen that KAP scores significantly differ between two time points and across the three groups. Among all the groups, teachers imparting training to children had high level of practice. Conclusion Inclusion of health education programs in the textbooks and health education schemes for teachers and school children are crucial ways to bring a change in their attitude, behavior, and practices toward epilepsy..


  • Chauhan N, Chakrabarti S, Grover S. Identifying Poor Adherence in Outpatients with Bipolar Disorder: A Comparison of Different Measures. Journal of Neurosciences in Rural Practice 2022; 13: (1) 12-22'
    Abstract
    Objective ?Unlike schizophrenia, comparisons of different methods of estimating inadequate adherence in bipolar disorder (BD) are scarce. This study compared four methods of identifying inadequate adherence among outpatients with BD. Materials and Methods ?Two self-reports, the Morisky Medication Adherence Questionnaire (MAQ) and the Drug Attitude Inventory (DAI-10), clinician ratings employing the Compliance Rating Scale (CRS), mood-stabilizer levels, and clinic-based pill counts were compared at intake in 106 outpatients with BD and after 6 months of follow-up ( n ?=?75). Statistical Analysis ?Rates of nonadherence were determined for each method. The ability to detect inadequate adherence was based on sensitivity, specificity, positive and negative predictive values (PPV and NPV), and positive and negative likelihood ratios (LR positive and LR negative). Correlation coefficients and Cohen's kappa values were used to determine the agreement between measures. Correlation coefficients were also used to evaluate the determinants of inadequate adherence Results ?The MAQ and the DAI-10 (cut-off score of two) yielded higher rates of nonadherence (35–47%) than the other methods. They were better at detecting adherence (specificity, 34–42%; PPV, 40–44%; and LR negative, 0.70–0.96) than other measures and had moderate ability to identify nonadherence compared with them (sensitivity, 63–73%; NPV, 54–70%; and LR positive, 1.02–1.16). They were associated with several established predictors of nonadherence. The MAQ and DAI-10 scores and the MAQ and CRS scores were modestly correlated. Multivariate analysis showed that 20% of the variance in the DAI-10 scores was explained by the MAQ scores. Despite their low yield, serum levels had a high sensitivity (88%) and higher accuracy (55%) in identifying inadequate adherence. CRS ratings and pill counts had high sensitivity but low specificity to detect inadequate adherence. Conclusion ?Self-reports appeared to be the most efficient method of ascertaining inadequate adherence among outpatients with BD. However, since none of the measures were adequate by themselves, a combination of different measures is more likely to maximize the chances of identifying inadequate adherence among these patients..


  • Shankar AK, Javali M, Mehta A, Pradeep R, Mahale R, Acharya P, et al.. Role of High Frequency Oscillations of Somatosensory Evoked Potentials in Deciphering Pathophysiology of Migraine. Journal of Neurosciences in Rural Practice 2021; 12: (1) 12-5'
    Abstract
    Background Habituation deficit is considered as a neurophysiological abnormality among migraineurs in the interictal period. For clear comprehension and clarity about the mechanism underlying habituation in migraine, a sophisticated method, i.e., high frequency oscillations (HFOs) evoked potentials, have been utilized. However, studies pertaining to this in the Indian context are rare. Objective The aim of the study is to determine the utility of HFO of somatosensory evoked potential (SSEP) in deciphering the pathophysiology of migraine. Materials and Methods Sixty subjects including 30 migraineurs in the interictal period and 30 healthy controls were considered for the study. Median nerve SSEP was recorded in patients and controls by standard protocols. HFO was extracted offline using the Digital zero-phase shift band-pass filtering at 450 and 750 Hz. The early and late HFOs were determined with respect to the N20 peak and were compared between the groups. Results Of total 30 migraineurs, 18 had hemicranial headache and 12 had holocranial headache. N20 latency, P25 latency, N20 onset to peak amplitude, and N20 onset to P25 amplitude were comparable in migraineurs and controls. The intraburst frequency of early HFOs in migraineurs was significantly higher ( p = 0.04), whereas the peak-to-peak amplitude was significantly lower ( p = 0.001). Conclusion Early HFOs on SSEP represent the thalamocortical excitatory drive in migraineurs. Overall, the study reports that reduced amplitude of early HFOs in the interictal period suggest reduced thalamocortical drive in migraineurs..


  • Kumar H, Gupta N. Neurological disorders and barriers for neurological rehabilitation in rural areas in Uttar Pradesh: A cross-sectional study. Journal of Neurosciences in Rural Practice 2012; 3: (1) 12-6'
    Abstract
    BACKGROUND: In India, the majority of individuals with neurological disorders are rural based and cannot even afford the cost of rehabilitation. At the same time, we do not have barrier free environment in India. AIM: This study attempts to find out the neurological disorders and barriers for neurological rehabilitation in rural areas in Uttar Pradesh, India. SETTING: Rural areas in Uttar Pradesh, India. DESIGN: It is a cross-sectional study. MATERIALS AND METHODS: The study was done by means of an interview method using a questionnaire. The rural areas in Uttar Pradesh were visited personally and a data from 201 individuals was collected. STATISTICAL ANALYSIS USED: Data analysis was done by using descriptive statistics. RESULTS: Out of 201 individuals, 76.6% (n=154) individuals were with polio, 12.9% (n=26) were with cerebral palsy, 7.9% (n=16) were with stroke and 2.4% (n=5) were with spinal cord injury. Reasons for not taking the treatment/discontinuation of treatment were financial problem (44%), lack of awareness (43%), family negligence (6%), transportation problem (3.5%) and other environmental barriers (1%). CONCLUSION: In our study, we found polio to be the most prevalent disorder followed by Cerebral Palsy, Stroke and Spinal Cord Injury. Financial problem was the major barrier for neurological rehabilitation followed by lack of awareness, family negligence and transportation problem..


  • Nayak P, Mahapatra AK. Single photon emission computed tomography scanning: A predictor of outcome in vegetative state of head injury. Journal of Neurosciences in Rural Practice 2011; 2: (1) 12-6'
    Abstract
    BACKGROUND: Neurotrauma is one of the most important causes of death and disability. Some of the severely head injured patients, failed to show significant improvement despite aggressive neurosurgical management and ended up in a vegetative state. AIMS: To assess the outcome at six months and one year using Glasgow outcome scale (GOS), in this prospective study on patients with severe head injury, who remained vegetative at one month. MATERIALS AND METHODS: This prospective study was carried out in the department of Neurosurgery, All India Institute of Medical Sciences (AIIMS), New Delhi, over a period of a year and a half (March 2002 through July 2003). MATERIALS AND METHODS: In patients with severe head injury (GCS < 8), post resuscitation, neurological assessment was done with Glasgow coma scale (GCS), pupillary light reflex, doll's eye movement and cold caloric test in all cases. Fifty patients, who remained vegetative post injury according to the criteria of Jennett and Plum, at one month, were considered for the study. Brain SPECT (Single Photon Emission Computed T omography) Scanning was carried out in selected cases. STATISTICAL ANALYSIS: Data analysis was done by Pearson's chi-square test on computer software SPSS, Version 10 (California, USA). RESULTS: Patients with preserved brainstem reflex and with no perfusion defect on SPECT scan had statistically significant favorable outcome. More than 40% of vegetative patients regained consciousness by the end of one year, of whom 24% had favorable outcome in the form of moderate disability and good recovery. CONCLUSION: SPECT is better than computed tomography/magnetic resonance imaging (CT/MRI) as it assesses the cerebral perfusion and functional injury rather than detecting the lesions only. Further study with a control group is necessary to establish the role of SPECT in head injury..


  • Meybodi KT. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 120'
    Abstract
    None.


  • Mashiko R. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 120-1'
    Abstract
    None.


  • James J, Jose J. Cockayne syndrome with intracranial calcification, hypomyelination, and cerebral atrophy. Journal of Neurosciences in Rural Practice 2017; 8: (1) 120-1'
    Abstract
    None.


  • Aiyappan SK, Ranga U, Veeraiyan S. Neurofibromatosis type 2: Intracranial calcifications as a clue to diagnosis. Journal of Neurosciences in Rural Practice 2015; 6: (1) 120-1'
    Abstract
    None.


  • Walker R. Assessing the quality of evidence for verbal autopsy diagnosis of stroke in Vietnam. Journal of Neurosciences in Rural Practice 2013; 4: (2) 120-1'
    Abstract
    None.


  • Agarwal A, Kakani A. Shunt malfunction due to proximal migration and subcutaneous coiling of a peritoneal catheter. Journal of Neurosciences in Rural Practice 2010; 1: (2) 120-1'
    Abstract
    None.


  • Eksi MS. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 121-2'
    Abstract
    None.


  • Senthilkumaran S, Balamurgan N, Suresh P, Thirumalaikolundusubramanian P. Purple glove syndrome: A looming threat. Journal of Neurosciences in Rural Practice 2010; 1: (2) 121-2'
    Abstract
    None.


  • Kawu AA. Epidural steroid injection in patients with lumbosacral radiculopathy in Abuja, Nigeria. Journal of Neurosciences in Rural Practice 2012; 3: (2) 121-5'
    Abstract
    OBJECTIVE: This prospective-controlled observational study looked at well-matched patients with spinal pain and radicular symptoms, caused by lumbar intervertebral disc herniation to compare the short-term clinical outcome of transforaminal and interlaminar epidural steroid injection (ESI) in a resource challenged tertiary institution in Nigeria. MATERIALS AND METHODS: 49 patients with radicular symptoms who were matched for age, symptom duration, magnetic resonance imaging findings, and pre-injection revised Oswentry Disability Index (ODI) score and Visual Analogue Scale (VAS) were assigned into ESI technique. The ODI and VAS score were analyzed immediately after an injection and upon follow-up (average 178.5 days), also with the need for repeated injections and surgical interventions over a 1-year follow-up interval. RESULT: In the transforaminal group (25 patients), there was a statistically significant improvement in the ODI scores from before the injection (ODI mean 62.4) to immediately after the injection (ODI mean 24.4, P < 0.01), and upon follow-up (ODI mean 20.8, P < 0.01). 9 patients (18.4%) required 1 or 2 repeated injections, 3 (6.1%) patients underwent surgery and 2 (4%) patients lost to follow-up. In the interlaminar group (24 patients), there was a statistically significant improvement in the ODI scores from before the injection (ODI mean 60.7) to immediately after the injection (ODI mean 30.1, P < 0.01), but not upon follow-up (ODI mean 43.2, P = 0.09). 11 (22.4%) patients required 1 or 2 repeated injection, 4 (8%) patients underwent surgery and 3 (6.1%) patients were lost to follow-up. There is an average of 2 fold improvement of transforaminal ESI over interlaminar ESI in a 40 point scale of ODI score on follow-up, which was statistically significant (P < 0.01). The VAS showed similar pattern with the ODI scores in the study. CONCLUSION: Transforaminal ESI to treat symptomatic lumbar disc herniation resulted in better short-term pain improvement and fewer long-term surgical interventions compared to interlaminar ESI..


  • Milanlioglu A, Ozdemir PG, Cilingir V, Ozdemir O. Catatonic depression as the presenting manifestation of creutzfeldt-Jakob disease. Journal of Neurosciences in Rural Practice 2015; 6: (1) 122'
    Abstract
    None.


  • Dikshit R, Karia S, De Sousa A. Risperidone-induced Enuresis in a 12-year-old Child. Journal of Neurosciences in Rural Practice 2017; 8: (1) 122-3'
    Abstract
    Risperidone has been documented to be effective in the management of behavior problems, aggression, and conduct disorder in children. While metabolic side effects like weight gain and obesity have been attributed to Risperidone use in children, side effects of the drug related to the urinary bladder are rare. We present a case of Risperidone-induced enuresis in a 12-year-old boy with conduct disorder that resolved completely after stopping the medication..


  • Agrawal A. Acute inter-hemispheric subdural hematoma in a Kabaddi player. Journal of Neurosciences in Rural Practice 2010; 1: (2) 122-3'
    Abstract
    None.


  • Lalthankimi R, Nagarajan P, Menon V, Olickal JJ. Predictors of Suicidal Ideation and Attempt among Patients with Major Depressive Disorder at a Tertiary Care Hospital, Puducherry. Journal of Neurosciences in Rural Practice 2021; 12: (1) 122-8'
    Abstract
    Objectives Mental disorders have a large impact on death by suicide. Hence, this study aims to determine the prevalence of suicidal behaviors among major depressive disorder (MDD) patients and the associated factors. Materials and Methods This cross-sectional analytical study was conducted among individuals aged 18 to 65 years, diagnosed with MDD in the Psychiatry Outpatient Department of a Tertiary Care Center, Puducherry during March to October 2019. Severity of depression was assessed using Hamilton Depression Rating Scale and Columbia-Suicide Severity Rating Scale was used to find the suicidal behaviors. Results For 166 participants in the study, mean (standard deviation) age was 40 (11) years and majority were females (76%). More than one-third (37%) had severe or very severe depression, and the prevalence of suicidal ideation, plan, and attempts were 83, 24, and 35%, respectively. After adjusting the covariates, the severity of depression and unemployment were significantly associated with suicidal attempts (adjusted prevalence ratios [aPR] = 11.4 and 1.9), and very severe depression was associated with suicidal ideation (aPR = 1.6). Among 140 individuals with suicidal ideation, 45 (32%) had an ideation frequency of 2 to 3 times/week, 69 (50%) had ideation for 1 hour, 36 (26%) could control ideation with little difficulty, and 12% had suicidal ideation mostly to end or stop their pain. Conclusion Suicidal ideation and attempts were significantly high in MDD patients, and the severity of depression was significantly associated with it. Early identification of high-risk suicidal behavior and implementation of effective preventive interventions are necessary to reduce death by suicide in these groups..


  • Chandrasekhar YB, Rajesh A, Purohit AK, Rani YJ. Novel magnetic resonance imaging scoring system for diagnosis of spinal tuberculosis: A preliminary report. Journal of Neurosciences in Rural Practice 2013; 4: (2) 122-8'
    Abstract
    BACKGROUND: There exists a lot of ambiguity in the preoperative diagnosis of the various vertebral lesions. Mostly in these patients tuberculosis of spine (TB) is suspected due to endemicity of the disease in the Indian subcontinent. However, no definite guidelines are available to diagnose tuberculous (TB) vertebral lesions in the current literature. STUDY DESIGN: This prospective study was conducted in the Department of Neurosurgery, Nizam's Institute of Medical Sciences, from August 2009 to March 2012. AIM OF THE STUDY: To formulate non invasive methods to diagnose tuberculous vertebral lesions confidently so that the dependency on histopathologic diagnosis can be reduced. MATERIAL AND METHODS: Spinal MRI images of 45 patients suspected of having tuberculosis aetiology were included in the study prospectively. RESULTS: A total of 64 patients were analysed and 19 patients were excluded due to lack of regular follow up or histological proof. The patients were divided into two groups; those with TB of the spine and those with some other condition affecting the spine (non TB spine) based on the final diagnosis. Of the 45 patients males were 30 (66.6%) and females were 15 (33.3%). There was no significant difference in the mean age of presentation. For TB patients this was 41 +/- 15.56 years and in Non TB was 43 +/- 18.27 years. All patients presented with backache in either group. There was epiphyseal involvement (100%), disc height reduction (71.42%) and pedicle destruction (42.82%) in plain X-rays in the TB group. Lumbar spine was the most common affected region in our study (26.31% in non TB and 34.6% in TB group of patients). Significant P value and the Odds Ratio was found for T1 hypo intensity, T2 hyper intensity, epiphyseal involvement, disc involvement, pedicle involvement, anterior subligamentous extension, paraspinal extension and no spinous process involvement (eight parameters). The eight parameters were tested among both the groups and it was noted that scores >/= 6 favored a tuberculous pathology whereas </=4 were suggestive of non tuberculous etiology. CONCLUSIONS: The eight point MRI criteria of the vertebral lesions are likely to enhance the diagnostic ability of tuberculous and non tuberculous pathologies thereby reducing the dependency on histopathologic diagnosis or invasive method for early initiation of therapy..


  • Banerjee J, Dey PK, Singhamahapatra A, Pradhan S. Assessment of neuropathy by electrophysiology of visual pathway in welding workers. Journal of Neurosciences in Rural Practice 2015; 6: (1) 123'
    Abstract
    None.


  • Upadhyayula PS, Yue JK, Yang J, Birk HS, Ciacci JD. The Current State of Rural Neurosurgical Practice: An International Perspective. Journal of Neurosciences in Rural Practice 2018; 9: (1) 123-31'
    Abstract
    Introduction: Rural and low-resource areas have diminished capacity to care for neurosurgical patients due to lack of infrastructure, healthcare investment, and training programs. This review summarizes the range of rural neurosurgical procedures, novel mechanisms for delivering care, rapid training programs, and outcome differences across international rural neurosurgical practice. Methods: A comprehensive literature search was performed for English language manuscripts with keywords "rural" and "neurosurgery" using the National Library of Medicine PubMed database (01/1971-06/2017). Twenty-four articles focusing on rural non-neurosurgical practice were included. Results: Time to care and/or surgery and shortage of trained personnel remain the strongest risk factors for mortality and poor outcome. Telemedicine consults to regional centers with neurosurgery housestaff have potential for increased timeliness of diagnosis/triage, improved time to surgery, and reductions in unnecessary transfers in remote areas. Mobile neurosurgery teams have been deployed with success in nations with large transport distances precluding initial transfers. Common neurosurgical procedures involve trauma mechanisms; accordingly, training programs for nonneurosurgery medical personnel on basic assessment and operative techniques have been successful in resource-deficient settings where neurosurgeons are unavailable. Conclusions: Protracted transport times, lack of resources/training, and difficulty retaining specialists are barriers to successful outcomes. Advances in telemedicine, mobile neurosurgery, and training programs for urgent operative techniques have been implemented efficaciously. Development of guidelines for paired partnerships between rural centers and academic hospitals, supplying surplus technology to rural areas, and rapid training of qualified local surgical personnel can create sustainable feed-forward programs for trainees and infrastructural solutions to address challenges in rural neurosurgery..


  • Kumar N, Kumar D. Thalamic Hamartoma Presenting with Tremor. Journal of Neurosciences in Rural Practice 2019; 10: (1) 123-4'
    Abstract
    None.


  • Natsis K, Piagkou M. The anatomical variability of the emissary condylar veins, its identification and clinical significance. Journal of Neurosciences in Rural Practice 2015; 6: (1) 123-4'
    Abstract
    None.


  • Pal R. Commentary. Journal of Neurosciences in Rural Practice 2011; 2: (2) 123-4'
    Abstract
    None.


  • Ramanathan SR, Ahluwalia T. Rare complication: Acute syringomyelia due to tuberculoma and tubercular meningitis. Journal of Neurosciences in Rural Practice 2010; 1: (2) 123-5'
    Abstract
    None.


  • Saal-Zapata G, Rodríguez-Varela R. Initial Experience Using the Transradial Approach for Endovascular Treatment of Vascular Pathologies: Safety and Feasibility. Journal of Neurosciences in Rural Practice 2022; 13: (1) 123-8'
    Abstract
    Background ?Endovascular treatment of vascular pathologies through the transradial approach has been increasingly used and has demonstrated a low rate of complications. Objective ?To report our initial experience in the endovascular treatment of cerebrovascular diseases with the transradial approach and to determine its safety and feasibility. Methods ?Consecutive patients who underwent the transradial approach for endovascular treatment of aneurysms and vascular malformations were reviewed at a single institution. Technical success, fluoroscopy time, and access-related complications were analyzed. Results ?Eight patients underwent endovascular treatment with the transradial approach. One arteriovenous fistula, one superficial temporal artery aneurysm, three arteriovenous malformations, and four aneurysms were treated successfully. The radial artery was successfully approached and a 6-F sheath was used in all the cases. Navigation of guiding catheters (5 and 6?F) was done without complications. The most commonly approached artery was the right internal carotid artery, followed by the right vertebral artery. Postoperative vasospasm was identified in three patients. Mean fluoroscopy time was 34.7?minutes. Conversion to transfemoral approach was not required. No postoperative complications were reported. Conclusions ?In our initial experience, the transradial approach is a safe and feasible alternative for the endovascular treatment of cerebrovascular pathologies..


  • Arishima H, Kikuta KI. Magnetic resonance imaging findings of isolated abducent nerve palsy induced by vascular compression of vertebrobasilar dolichoectasia. Journal of Neurosciences in Rural Practice 2017; 8: (1) 124-7'
    Abstract
    If the origin of isolated abducent nerve palsy cannot be found on neuroradiological examinations, diabetes mellitus is known as a probable cause; however, some cases show no potential causes of isolated abducent nerve palsy. Here, we report a 74-year-old male who suffered from diplopia due to isolated left abducent nerve palsy. Magnetic resonance angiography and fast imaging employing steady-state acquisition imaging clearly showed a dolichoectasic vertebrobasilar artery compressing the left abducent nerve upward and outward. There were no abnormal lesions in the brain stem, cavernous sinus, or orbital cavity. Laboratory data showed no abnormal findings. We concluded that neurovascular compression of the left abducent nerve might cause isolated left abducent nerve palsy. We observed him without surgical treatment considering his general condition with angina pectoris and old age. His symptom due to the left abducent nerve palsy persisted. From previous reports, conservative treatment could not improve abducent nerve palsy. Microvascular decompression should be considered for abducent nerve palsy due to vascular compression if patients are young, and their general condition is good. We also discuss interesting characteristics with a review of the literature..


  • Kurzbuch AR, Fournier JY. Os Odontoideum. Journal of Neurosciences in Rural Practice 2019; 10: (1) 125'
    Abstract
    None.


  • Pekcevik Y. Reply to comment on "Prevalence of clinically important posterior fossa emissary veins on CT angiography". Journal of Neurosciences in Rural Practice 2015; 6: (1) 125'
    Abstract
    None.


  • Walsh K. Neurology education: The role of assessment. Journal of Neurosciences in Rural Practice 2015; 6: (1) 125-6'
    Abstract
    None.


  • Pandey S, Singh K, Sharma V, Ghosh A, Suman S. Dorsal spinal epidural psammomatous meningioma in an adult male. Journal of Neurosciences in Rural Practice 2016; 7: (1) 125-7'
    Abstract
    Meningiomas are benign in nature and arise from the arachnoid cells. They are mostly situated in the intracranial compartment, whereas spinal meningiomas are rare. Approximately, in 10% of cases, an extradural component is seen but an exclusively extradural meningioma is quite uncommon. However, WHO Grade II (atypical) and Grade III (anaplastic) tumors can behave aggressively. We reported a case of purely extradural psammomatous meningioma in an adult male affecting the dorsal spine although uncommon meningiomas should be included in the differential diagnosis of extradural intraspinal masses..


  • Diyora B, Nayak N, Kale D, Kamble H, Sharma A. Frontal intraparenchymal "White epidermoid cyst": A rare occurrence. Journal of Neurosciences in Rural Practice 2010; 1: (2) 125-7'
    Abstract
    None.


  • Prabha L, Ganjekar S, Gupta V, Desai G, Chaturvedi SK. A Comparative Study of Health Anxiety in Neurology and Psychiatry Settings. Journal of Neurosciences in Rural Practice 2020; 11: (1) 125-9'
    Abstract
    Objectives Prevalence of health anxiety is highly varied based on different settings and samples studied. This study aimed to assess the prevalence of health anxiety among outpatients attending neurology and psychiatry outpatient setting in tertiary care hospital and understand the clinical correlates. Participants and Methods This was a cross-sectional study conducted in the outpatient settings including participants fulfilling study criteria. The assessments included semi-structured proforma for demographic and clinical details, general hypochondriasis subscale of Illness Behavior Questionnaire, and Short Health Anxiety Inventory. Data were collected in Epi-info and data analysis was done using STATA12. Results The health anxiety was reported to be 25% and 19% among psychiatry and neurology outpatients, respectively. Higher education level positively correlated with health anxiety. Skilled workers tend to have higher health anxiety than semiskilled workers. Patients with diagnosis of somatoform disorder and multiple diagnosis scored higher on health anxiety in both the settings. Conclusion Health anxiety appears to be common in psychiatry and neurology settings and needs further evaluation to understand its impact on consultation and health resource usages..


  • Brezovska K, Panovska AP, Grozdanova A, Suturkova L, Basta I, Apostolski S. Immunoreactivity of glycoproteins isolated from human peripheral nerve and Campylobacter jejuni (O:19). Journal of Neurosciences in Rural Practice 2011; 2: (2) 125-9'
    Abstract
    OBJECTIVE: Antibodies to ganglioside GM1 are associated with Guillain-Barre Syndrome (GBS) in patients with serologic evidence of a preceding infection with Campylobacter jejuni. Molecular mimicry between C. jejuni Lipopolysaccharide (LPS) and ganglioside GM1 has been proven to be the immunopathogenic mechanism of the disease in the axonal variant of GBS. GM1-positive sera cross-react with several Gal-GalNAc-bearing glycoproteins from the human peripheral nerve and C. jejuni (O:19). This study aimed to examine the immunoreactivity of the digested cross-reactive glycoproteins isolated from the human peripheral nerve and C. jejuni (O:19) with Peanut Agglutinin (PNA) as a marker for the Gal-GalNAc determinant, and with sera from patients with GBS. MATERIALS AND METHODS: For this purpose, the cross-reactive glycoproteins from peripheral nerve and C. jejuni (O:19) were enzymatically digested with trypsin and the obtained peptides were incubated with PNA and GBS sera. RESULTS: Western blot analysis of the separated peptides revealed several bands showing positive reactivity to PNA and to sera from patients with GBS, present in both digests from peripheral nerve and C. jejuni (O:19). CONCLUSIONS: These data indicate the possible molecular mimicry between the cross-reactive glycoproteins present in C. jejuni and human peripheral nerve and its potential role in the development of GBS following infection with C. jejuni (O:19)..


  • Lemon TI. Focus on teaching, not assessing, the surgeons and physicians of tomorrow. Journal of Neurosciences in Rural Practice 2015; 6: (1) 126'
    Abstract
    None.


  • Celikyurt IK, Ulak G, Mutlu O, Akar FY, Erden F, Komsuoglu SS. Lamotrigine effects sensorimotor gating in WAG/Rij rats. Journal of Neurosciences in Rural Practice 2012; 3: (2) 126-30'
    Abstract
    INTRODUCTION: Prepulse inhibition (PPI) is a measurable form of sensorimotor gating. Disruption of PPI reflects the impairment in the neural filtering process of mental functions that are related to the transformation of an external stimuli to a response. Impairment of PPI is reported in neuropsychiatric illnesses such as schizophrenia, Huntington's disease, Parkinson's diseases, Tourette syndrome, obsessive compulsive disorder, and temporal lobe epilepsy with psychosis. Absence epilepsy is the most common type of primary generalized epilepsy. Lamotrigine is an antiepileptic drug that is preferred in absence epilepsy and acts by stabilizing the voltage-gated sodium channels. AIM: In this study, we have compared WAG-Rij rats (genetically absence epileptic rats) with Wistar rats, in order to clarify if there is a deficient sensorimotor gating in absence epilepsy, and have examined the effects of lamotrigine (15, 30 mg/kg, i.p.) on this phenomenon. MATERIALS AND METHODS: Depletion in PPI percent value is accepted as a disruption in sensory-motor filtration function. The difference between the Wistar and WAG/Rij rats has been evaluated with the student t test and the effects of lamotrigine on the PPI percent have been evaluated by the analysis of variance (ANOVA) post-hoc Dunnett's test. RESULTS: The PPI percent was low in the WAG/Rij rats compared to the controls (P<0.0001, t:9,612). Although the PPI percent value of the control rats was not influenced by lamotrigine, the PPI percent value of the WAG/Rij rats was raised by lamotrigine treatment (P<0.0001, F:861,24). CONCLUSIONS: As a result of our study, PPI was disrupted in the WAG/Rij rats and this disruption could be reversed by an antiepileptic lamotrigine..


  • Garg P, Aggarwal A, Malhotra R, Dhall S. Osmotic Demyelination Syndrome - Evolution of Extrapontine Before Pontine Myelinolysis on Magnetic Resonance Imaging. Journal of Neurosciences in Rural Practice 2019; 10: (1) 126-35'
    Abstract
    Osmotic demyelination syndrome is a rare entity characterized by noninflammatory demyelination afflicting the central pons, basal ganglia, thalami, peripheral cortex, and hippocampi. Histopathologically, there is a destruction of myelin sheaths sparing the underlying neuronal axons due to the susceptibility of oligodendrocytes to rapid osmotic shifts often encountered in chronically debilitated patients. We present the temporal progression of signal abnormalities on sequential magnetic resonance imaging (MRI) scans in a middle-aged male initially presenting with altered mental status due to severe hyponatremia and subsequently developing rigidity, diagnosed as osmotic demyelination syndrome based on typical imaging findings and supportive laboratory parameters. This case demonstrates the importance of diffusion signal abnormalities as the first indicator of osmotic demyelination, evolution of extrapontine before pontine signal changes and the relative lack of correlation between patient's clinical profile and the extent of MRI signal abnormalities..


  • Marafioti V, Pasqualin A. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 126-7'
    Abstract
    None.


  • Kumar SP. A rare initial neurological presentation of Sjogren's syndrome. Journal of Neurosciences in Rural Practice 2015; 6: (1) 127'
    Abstract
    None.


  • Felicio AC. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 127-8'
    Abstract
    None.


  • Upadhyay P, Tiwary G. Real-time intraoperative ultrasonography in the surgical resection of brain lesions: A cheap, effective, and quick alternative. Journal of Neurosciences in Rural Practice 2010; 1: (2) 127-8'
    Abstract
    None.


  • Wiwanitkit V. Surgical trauma and associated head injuries: A comment. Journal of Neurosciences in Rural Practice 2010; 1: (2) 128'
    Abstract
    None.


  • Shukla D. Neuroendoscopic treatment of idiopathic occlusion of unilateral foramen of Monro presenting as chronic headache. Journal of Neurosciences in Rural Practice 2016; 7: (1) 128-30'
    Abstract
    Asymmetric ventriculomegly due to idiopathic occlusion of the foramen of Monro is rare. Such patients present with clinical features of raised intracranial pressure (ICP). Presentation as chronic headache has not been previously described. In the absence of raised ICP, pursuing surgical treatment raises a clinical dilemma as the headache may be a primary headache with no improvement after surgery. A 21-year-old woman presented with chronic headache. She was found to have asymmetric ventriculomegaly due to the occlusion of the foramen of Monro. She underwent endoscopic septostomy and widening of the foramen of Monro. Her headache subsided after surgery. At 15 months of follow-up, she was free from headache without medications. Unilateral occlusion of the foramen of Monro can present with asymmetric ventriculomegaly resulting in chronic headache. Though the symptoms of raised ICP may not be present, still endoscopic relief of ventriculomegaly leads to cure of headache..


  • Borgohain B. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 128-31'
    Abstract
    None.


  • Zlotnik Y, Plakht Y, Aven A, Engel Y, Am NB, Ifergane G. Alcohol consumption and hangover patterns among migraine sufferers. Journal of Neurosciences in Rural Practice 2014; 5: (2) 128-34'
    Abstract
    AIMS: Alcohol hangover is a poorly understood cluster of symptoms occurring following a heavy consumption of alcohol. The term "delayed alcohol-induced headache" is often used synonymously. Our objective was to compare alcohol hangover symptoms in migraine sufferers and nonsufferers. MATERIALS AND METHODS: In this cross-sectional study, university students were asked to fill structured questionnaires assessing headache history, alcoholic consumption, and hangover symptoms (using the Hangover Symptom Scale (HSS)). Subjects were classified as suffering from migraine with or without aura and nonsufferers according the International Classification of Headache Disorders 2(nd) Edition (ICHD-II). The 13 hangover symptoms were divided by the researches into migraine-like and other nonmigraine-like symptoms. RESULTS: Hangover symptoms among 95 migraine sufferers and 597 nonsufferers were compared. Migraine sufferers consumed less alcohol compared with the nonsufferers (mean drinks/week 2.34 +/- 4.11 vs. 2.92 +/- 3.58, P = 0.038) and suffered from higher tendency to migraine-like symptoms after drinking (mean 2.91 +/- 3.43 vs. 1.85 +/- 2.35, P = 0.002) but not to other hangover symptoms (mean 5.39 +/- 6.31 vs. 4.34 +/- 4.56, P = 0.1). CONCLUSIONS: Migraine sufferers consume less alcohol, especially beer and liquors, and are more vulnerable to migraine-like hangover symptoms than nonsufferers. The finding that the tendency to develop migraine attacks affects the hangover symptomatology may suggest a similarity in pathophysiology, and possibly in treatment options..


  • Bajracharya A, Agrawal A, Roka YB, Agrawal C, Lewis O. Authors' reply. Journal of Neurosciences in Rural Practice 2010; 1: (2) 128-9'
    Abstract
    None.


  • Menon B, Sujit Kumar GS. Giant plexiform neurofibroma presenting with craniovertebral junction instability. Journal of Neurosciences in Rural Practice 2010; 1: (2) 129-30'
    Abstract
    None.


  • Menon B, Remadevi N. Migraine in Nursing Students-A Study from a Tertiary Care Center in South India. Journal of Neurosciences in Rural Practice 2021; 12: (1) 129-32'
    Abstract
    Objective Nursing profession is subject to occupational stress, which can be a trigger for headaches. Our study aimed to study the prevalence of migraine, its characteristics, triggers, and relieving factors among nursing students in a tertiary care center. Materials and Methods This study was performed in a super-specialty hospital in South India. A structured questionnaire captured data on the occurrence of headache, demographics, aura, triggering factors, relieving factors, and lifestyle habits. Results are presented in numbers and percentage. Results A total of 20% of nursing students in the study had headache of which 85% had migraine. Weekly and daily attacks were reported in 12 and 4% students, respectively. Twenty-two percent had headache severity of more than 5 visual analogue scale. Most common accompanying symptoms were photophobia (80%), phonophobia (70%), nausea (75%), vomiting (71%), neck pain (25%), and vertigo (20%). Thirty-nine percent had auras. Ninety-five percent reported triggers with 70% students having more than one trigger. Sleep was the relieving factor in 69%, head massage in 50%, and relaxing from work in 48%. Conclusion The most common type of primary headache in nurses in our study was migraine. More than three-fourths nurses reported triggers and relieving factors. Addressing these factors could help in managing migraines and help in improving the quality of life and increased work productivity of nurses..


  • Sarkar S, Patra C, Dasgupta MK. Bilateral ptosis without upward gaze palsy: Unusual presentation of midbrain tuberculoma. Journal of Neurosciences in Rural Practice 2017; 8: (1) 129-32'
    Abstract
    Central nervous system tuberculoma can have variable presentations depending on the site and number of tuberculomas. We are reporting a rare case of an 11-year-old male child presenting with ptosis and ataxia. Clinical examination revealed bilateral partial 3(rd) cranial nerve palsy (ptosis without any upward gaze palsy) associated with dysdiadochokinesia and ataxia on the right side. Magnetic resonance imaging of the brain revealed a single ring-enhancing lesion in the dorsal midbrain with perifocal edema. Magnetic resonance spectroscopy provided the etiological information as tuberculoma..


  • Venkatakrishnan S, Khanna M, Gupta A. Transcranial Color Coded Duplex Sonography Findings in Stroke Patients Undergoing Rehabilitation: An Observational Study. Journal of Neurosciences in Rural Practice 2022; 13: (1) 129-33'
    Abstract
    Background ?Transcranial color-coded duplex sonography (TCCD) provides information on intracranial blood flow status in stroke patients and can predict rehabilitation outcomes. Objective ?This study aimed to assess middle cerebral artery (MCA) parameters using TCCD in MCA territory stroke patients admitted for rehabilitation and correlate with clinical outcome measures. Materials and Methods ?Patients aged 18 to 65 years with a first MCA territory stroke, within 6 months of onset were recruited. The clinical outcome scales and TCCD parameters were assessed at both admission and discharge. The scales used were the Scandinavian stroke scale (SSS), Barthel Index (BI), modified Rankin Scale (mRS), Fugl–Meyer upper extremity scale (FMA-UE), modified motor assessment scale (mMAS) scores. TCCD parameters measured were MCA peak systolic, end diastolic, mean flow velocities (MFV), and index of symmetry (SI) and were correlated with clinical scores. Results ?Fourteen patients were recruited with median age of 56.5 years, median duration of stroke was 42.5 days. Mean flow velocities of affected and unaffected MCA were 46.2 and 50.7?cm/s, respectively. Flow velocities and SI did not change between the two assessments. There was significant improvement in clinical outcome scores at discharge. Significant correlation was observed for patient group with SI?>?0.9 at admission with FMA-UE, SSS, and BI scores at discharge ( p ?<?0.05). Conclusion ?Flow velocity parameters did not change during in-patient rehabilitation. Patients with symmetric flow at admission had improved clinical outcomes measure scores at discharge. Thus SI can predict rehabilitation outcomes in stroke survivors..


  • Soni S, Walia S, Noohu MM. Hindi translation and evaluation of psychometric properties of Craig Hospital Inventory of Environmental Factors instrument in spinal cord injury subjects. Journal of Neurosciences in Rural Practice 2016; 7: (1) 13-22'
    Abstract
    INTRODUCTION: The Craig Hospital Inventory of Environmental Factors instrument (CHIEF) is one of the few tools to assess the environmental barriers. The purpose of this study was to translate long and short CHIEF into Hindi language, and to determine its validity and reliability. DESIGN AND SETTING: The study design was observational case series with repeated measures. It was carried out at Indian Spinal Injuries Centre New Delhi, a specialized center for rehabilitation for spinal cord injury. METHODS: The CHIEF instrument was translated from English to Hindi based on the Beaton guidelines for the cross-cultural adaptation of health status measures. The Hindi version of the CHIEF instrument was then administered on a convenience sample of 30 spinal cord injured subjects. Its content validity, internal consistency, test-rest reliability (intraclass correlation coefficient [ICC] 2,1), standard error of measurement (SEM), and minimum detectable change (MDC) were determined for both the longer and shorter version. RESULTS: The mean +/- SD of total of Hindi-CHIEF instrument, longer version was 1.44 +/- 0.82 and total score of the shorter version was 1.07 +/- 0.66. The content validity determined by the content validity ratio was found to be 1 for all the items except item number 5, 11, and 12. The content validity index was 0.97 for the longer version and for the shorter version it was 0.98. Internal consistency, Cronbach's alpha value was found to be 0.92 and test-retest value (ICC 2,1) was 0.80 (P < 0.001). The MDC was found to be 0.99 and SEM was 0.36 for the longer version. The Cronbach's alpha was 0.731, ICC 2,1 was 0.63 (P < 0.001), SEM was 0.24, and MDC was 0.66 for the shorter version. CONCLUSION: The Hindi translated version of the CHIEF scale has acceptable content validity and reliability. It can be used to assess environmental barriers perceived by spinal cord injury patients..


  • Kakati A, Bhat D, Devi BI, Shukla D. Injection nerve palsy. Journal of Neurosciences in Rural Practice 2013; 4: (1) 13-8'
    Abstract
    OBJECTIVE: To study the clinical profile and outcome of surgery for injection nerve palsies. MATERIALS AND METHODS: This is a retrospective study of patients with INP who were treated at our institute during May 2000 to May 2009. Clinical, electroneuromyography (ENMG), and operative findings were noted. Intraoperative nerve action potential monitoring was not used in any case. Outcome of patients who were followed was reviewed. RESULTS: INP comprised 92 (11%) of 837 nerve injury patients. Seventy one patients were children less than 16 years. The nerves involved were sciatic in 80 patients, radial in 8, and others in four. Fifty seven patients had power, grade 0/5. ENMG studies revealed absent compound muscle action potential in 64 and absent sensory nerve action potential in 67 patients. Thirty nine (42.3%) of 92 patients underwent surgery. The mean duration since injury in these patients was 5.2 months (3 months to 11 months). All underwent neurolysis. Only 18 patients who underwent surgery had a follow up of more than 3 months. Ten (55.5%) patients had good or fair outcome after surgery. Except for grade of motor deficit prior to surgery, none of the variables were found to significantly affect the outcome. CONCLUSION: The outcome of INP is generally good and many patients recover spontaneously. The outcome of surgery is dependent on preoperative motor power..


  • Muraleedharan A, Ragavan S, Devi R. Are Footedness and Lateral Postures Better Predictors of Hemispheric Dominance Than Handedness: A Cross-sectional Questionnaire-Based Clinical and Pedigree Study. Journal of Neurosciences in Rural Practice 2020; 11: (1) 130-4'
    Abstract
    Objective Approximately 9 out of 10 individuals show right-hand dominance. The remaining 10% include left-hand dominant and mixed handed/ambidextrous individuals. Laterality, lateral postures or lateral preference is defined by various authors as the most comfortable posture that an individual prefers to assume. The current study aims at finding the distribution of these lateral postures and their correlation with handedness/dominant side. Materials and Methods The study was done in medical and nursing students in the age group 18 to 22 years. The patients were asked to fill a self-assessment questionnaire to determine handedness and footedness. The laterality traits were observed by asking the patients to do by themselves after an untailored demonstration. Statistical Analysis The relationship between study parameters was assessed using Chi-square test. Pearson's correlation test was done to assess the strength of association between comfort ratings of the various laterality postures. Results In our study, 96.5% were right handed and 79.9% of patients were right footed. Also, 50.8% preferred right-hand clasping, 53.9% preferred left-arm folding, and 60.6% preferred right-leg folding. A statistically significant correlation was seen between foot preference and lateral postures and arm folding and hand clasping (p < 0.05). A significant association was also found between handedness and positive history of retraining. Sidedness did not follow any Mendelian pattern of inheritance. Conclusions Handedness is affected by genetic and environmental factors. Since cultural and traditional practices can affect the lateral postures and handedness, it is important to know the relationship between laterality postures and sidedness and the impact of retraining on them. These postures are measures of cerebral dominance and are clinically important..


  • Paudel KR, Bhattacharya S, Rauniar G, Das B. Comparison of antinociceptive effect of the antiepileptic drug gabapentin to that of various dosage combinations of gabapentin with lamotrigine and topiramate in mice and rats. Journal of Neurosciences in Rural Practice 2011; 2: (2) 130-6'
    Abstract
    INTRODUCTION: Newer anticonvulsants have a neuromodulatory effect on pain perception mechanisms in a hyperexcitable and damaged nervous system. AIM: This study was designed to study the analgesic effects of gabapentin alone and in combination with lamotrigine and topiramate in experimental pain models. MATERIALS AND METHODS: Adult albino mice (n=490) weighing 20-30 g and rats (n=130) weighing 100-200 g were injected intraperitoneally with gabapentin, lamotrigine, and topiramate alone and in different dose combinations. The hot-plate method, tail-flick method, capsaicin-induced mechanical hyperalgesia, and formalin assay were used to assess the antinociceptive effects. RESULTS: Of the three antiepileptic drugs, when given separately, gabapentin was more efficacious than either topiramate or lamotrigine in all the pain models. Combination of 25 mg/kg gabapentin with 25 mg/kg topiramate was more efficacious (P<.05) than 50 mg/kg gabapentin alone in the capsaicin-induced mechanical hyperalgesia test. Similarly, 50 mg/kg gabapentin with 50 mg/kg topiramate or 5 mg/kg lamotrigine was more efficacious (P<.05) than 50 or 100 mg/kg gabapentin alone in late-phase formalin-induced behaviors. CONCLUSIONS: Combination of gabapentin with either lamotrigine or topiramate produced better results than gabapentin alone in capsaicin-induced mechanical hyperalgesia test and in late-phase formalin-induced behaviors..


  • Tripathy SR. Commentary. Journal of Neurosciences in Rural Practice 2016; 7: (1) 131-2'
    Abstract
    None.


  • Sahin S. Can physicians prevent post-lumbar puncture headache or intracranial hypotension?. Journal of Neurosciences in Rural Practice 2015; 6: (2) 131-2'
    Abstract
    None.


  • Dhandapani S, Manju D, Sharma B, Mahapatra A. Prognostic significance of age in traumatic brain injury. Journal of Neurosciences in Rural Practice 2012; 3: (2) 131-5'
    Abstract
    BACKGROUND: Age is a strong prognostic factor following traumatic brain injury (TBI), with discrepancies defining the critical prognostic age threshold. This study was undertaken to determine the impact of various age thresholds on outcome after TBI. MATERIALS AND METHODS: The ages of patients admitted with TBI were prospectively studied in relation to mode of injury, Glasgow coma score (GCS), CT category and surgical intervention. Mortality was assessed at 1 month, and neurological outcome was assessed at 6 months. Appropriate statistical analyzes (details in article) were performed. RESULTS: Of the total 244 patients enrolled, 144 patients had severe, 38 patients had moderate and 62 patients had mild TBI, respectively. Age had significant association with grade of injury, CT category and surgical intervention (P < 0.01). Mortality at 1 month was significantly associated with increasing age with patients dead at 1 month being 15% for age < 18, 44% for age between 18 and 59 years, and 52% in the age group > 59 years respectively (P < 0.001). Unfavorable outcome showed significant association with an increase in age, every decade (P < 0.001). In multivariate analysis, there was stepwise increase in the odds of unfavorable outcome across age groups centered on 40 years, independent of confounding factors. The adjusted odds ratios for unfavorable outcome with regard to age thresholds 30, 40 and 50 years were 11.3, 53.3 and 1171, respectively (P < 0.005). Moreover, there was significant association of unfavorable outcome with age > 40 years in all subgroups, based on GCS and surgical intervention (P < 0.05). CONCLUSIONS: In patients with TBI, age demonstrates independent association with unfavorable outcome at 6 months, in stepwise manner centered on a threshold of 40 years..


  • Bunevicius A. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 132-3'
    Abstract
    None.


  • Manohar H, Pravallika M, Kandasamy P, Chandrasekaran V, Rajkumar RP. Role of Exclusive Breastfeeding in Conferring Protection in Children At-Risk for Autism Spectrum Disorder: Results from a Sibling Case-control Study. Journal of Neurosciences in Rural Practice 2018; 9: (1) 132-6'
    Abstract
    Background: Gut microflora influences neural development through complex mechanisms. Feeding practices, especially breastfeeding influence gut microbiome and thereby play a pivotal role in immune and neural development. Current understandings of the role of healthy distal gut microflora in the development of immune and neural systems provide insights into immunological mechanisms as one of the possible etiologies in autism spectrum disorder (ASD). Studies have shown that optimal breastfeeding is associated with lower odds of being at-risk for ASD and children with ASD are suboptimally breastfed. Methods: The feeding practices of children with ASD (n = 30) was compared to their typically developing siblings as matched controls (n = 30). Information regarding feeding practices was collected from mothers through a semi-structured questionnaire. Results: About 43.3% of children with ASD received exclusive breastfeeding, whereas 76.7% of their typically developing siblings were exclusively breastfed. Exclusive breastfeeding was associated with lower odds for ASD (odds ratio [OR] = 0.166; 95% confidence interval [CI] = 0.025-0.65), while early introduction of top feeds was associated with higher odds (OR = 6; 95% CI = 1.33-55.19). Difficulties in breastfeeding were attributed to child-related factors in 13.2% of the children. Conclusion: Children with ASD are suboptimally breastfed compared to their typically developing siblings. Exclusive breastfeeding may confer protection in vulnerable children. Further studies on larger prospective sample are required to establish the association..


  • Singh AK, Shukla R, Trivedi JK, Singh D. Association of psychiatric co-morbidity and efficacy of treatment in chronic daily headache in Indian population. Journal of Neurosciences in Rural Practice 2013; 4: (2) 132-9'
    Abstract
    OBJECTIVE: To study the prevalence of psychiatric co-morbidity in patients of chronic daily headache (CDH) and compare the efficacy of treatment between various type of headache associated with psychiatric co-morbidity. MATERIALS AND METHODS: Prospective case control cohort study, 92 consecutive patients of CDH meeting eligibility criteria. The diagnosis of various subtypes of CDH was made according to the IHS criteria. Age, sex, educational, marital and socioeconomic status, matched controls were also selected. Patients were evaluated with the Mini International Neuropsychiatric Interview (MINI) scale at the time of enrolment and at 3 months. RESULTS: CDH accounted for 28% of all headache patients. The mean age of presentation was 30.2 +/- 10.3 years, male: Female ratio of 28:64 and mean duration of 4.56 +/- 0.56 years. Chronic migraine (CM) accounted for 59 patients, chronic tension type headache (CTTH) 22 patients, new daily persistent headache (NDPH) 3 patients and miscellaneous 8 patients. Psychiatric co-morbidity was present in 53.3% patients with CDH, and was more common in CM (62.7%) as compared to CTTH (36.4%). Single psychiatric co-morbidity was seen in 26 patients, while 23 patients had multiple co-morbidity. Major depressive episode, anxiety disorder, agoraphobia and dysthymia were significant psychiatric co-morbidities. Patients with CM were treated with topiramate or divalproex sodium ER and CTTH were treated with amitriptyline. 55 patients came for follow up at 3 months, improvement in headache was seen in 29 patients. CONCLUSION: Psychiatric co-morbidity was present in more than 50% patients with CDH and its presence along with a duration of >/=2 years was associated with a poor response to treatment..


  • Arboix A, Sanchez MJ. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 133-4'
    Abstract
    None.


  • von Brevern M. Acute dizziness and vertigo: The bedside testing is essential. Journal of Neurosciences in Rural Practice 2015; 6: (2) 133-4'
    Abstract
    None.


  • Gowda VK, Kulhalli P, Vamyanmane DK. Neurological Manifestations of Congenital Cytomegalovirus Infection at a Tertiary Care Centre from Southern India. Journal of Neurosciences in Rural Practice 2021; 12: (1) 133-6'
    Abstract
    Background Cytomegalovirus (CMV) is a ubiquitous herpes virus. It is the most common congenital viral infection. Data on congenital CMV in India are lacking and hence the present study was undertaken. Objectives The aim of the study is to evaluate the clinical and radiological profile of neurological manifestations of congenital CMV infections in tertiary care hospital. Methods This is a retrospective chart review of the clinical and laboratory profile of congenital CMV infections presenting from January 2018 to February 2020 to a tertiary care hospital in Southern India. Details of clinical profile, serological and neuroimaging data were obtained and analyzed. Results A total of 42 cases with female preponderance (57%) were reported during the study period. The mean age of presentation was 2.9 years. Clinical features were developmental delay (81%), microcephaly (93%), seizures (33%), intrauterine growth restriction (19%), neonatal encephalopathy (10%), anemia (9%), jaundice (10%), hepato-splenomegaly (7%), and eye abnormalities (14%). Antenatal maternal fever was reported by 12%. Sensorineural hearing loss was present in 57%. Neuroimaging showed periventricular calcification (79%), cerebral atrophy (69%), ventricular dilatation (55%), malformations (26%), dysmyelination (12%), and temporal lobe cysts (5%). CMV-immunoglobulin-M positivity was seen in 14 cases (33%), urinary polymerase chain reaction for CMV was positive in 21 cases (50%), and clinical diagnosis was done in seven cases (16%). Conclusion Common findings in congenital CMV are microcephaly, developmental delay, seizures, anemia, and sensorineural hearing loss. Common neuroimaging findings are periventricular calcification, cerebral atrophy, malformation, white matter signal changes, and cysts. CMV can mimic like cerebral palsy, malformations of the brain, demyelinating disorders, and calcified leukoencephalopathies like Aicardi-Goutieres syndrome..


  • Yokoyama K, Kawanishi M, Yamada M, Tanaka H, Ito Y, Kuroiwa T. Cervical facet dislocation adjacent to the fused motion segment. Journal of Neurosciences in Rural Practice 2016; 7: (1) 133-6'
    Abstract
    This study reports on a case that forces re-examination of merits and demerits of anterior cervical fusion. A 79-year-old male was brought to the emergency room (ER) of our hospital after he fell and struck the occipital region of his head following excessive alcohol consumption. Four years prior, he had undergone anterior cervical discectomy and fusion of C5/6 and a magnetic resonance imaging (MRI) performed 3 years after this surgery indicated that he was suffering from degeneration of C6/7 intervertebral discs. After arriving at the ER, he presented motor impairment at level C7 and lower of manual muscle testing grade 1 as well as moderate loss of physical sensation from the trunk and peripheries of both upper limbs to the peripheries of both lower limbs (Frankel B). Cervical computed tomography (CT) indicated anterior dislocation of C6/7, and MRI indicated severe spinal cord edema. We performed manipulative reduction of C6/7 with the patient under general anesthesia. Next, we performed laminectomy on C5-T1 and posterior fusion on C6/7. Postoperative CT indicated that cervical alignment had improved, and MRI indicated that the spinal cord edema observed prior to surgery had been mitigated. Three months after surgery, motor function and sensory impairment of the lower limbs had improved, and the patient was ambulatory upon discharge from the hospital (Frankel D). In the present case, although C5 and 6 were rigidly fused, degeneration of the C6/7 intervertebral disc occurred and stability was compromised. As a result, even slight trauma placed a severe dynamic burden on the facet joint of C6/7, which led to dislocation..


  • Penner F, Zeppa P, Cofano F, Bianconi A, Ajello M, Zenga F. Cervical Spine Inhomogeneously Enhancing Lesion: Avoiding Confirmation Bias. Journal of Neurosciences in Rural Practice 2022; 13: (1) 134-6'
    Abstract
    Confirmation bias is the tendency to seek information and evidence in order to confirm a preexisting hypothesis while giving less importance and overlook an alternative solution. This report describes the case of a 52-year-old man with a long history of neck pain and bilateral upper limbs paresthesias with a cervical intracanal inhomogeneously enhancing lesion. Despite all the preoperative radiological findings, a spinal meningioma an anterior approach was performed. The mass ended up being a large migrated hernia with the involvement of two levels. Before suggesting treatment, especially surgery, physicians and practitioners need to evaluate all of the possible alternatives in order to optimize patient outcome..


  • Tunthanathip T, Ratanalert S, Sae-Heng S, Oearsakul T, Sakaruncchai I, Kaewborisutsakul A, et al.. Prognostic Factors and Nomogram Predicting Survival in Diffuse Astrocytoma. Journal of Neurosciences in Rural Practice 2020; 11: (1) 135-43'
    Abstract
    Background Prognosis of low-grade glioma are currently determined by genetic markers that are limited in some countries. This study aimed to use clinical parameters to develop a nomogram to predict survival of patients with diffuse astrocytoma (DA) which is the most common type of low-grade glioma. Materials and Methods Retrospective data of adult patients with DA from three university hospitals in Thailand were analyzed. Collected data included clinical characteristics, neuroimaging findings, treatment, and outcomes. Cox's regression analyses were performed to determine associated factors. Significant associated factors from the Cox regression model were subsequently used to develop a nomogram for survival prediction. Performance of the nomogram was then tested for its accuracy. Results There were 64 patients with DA with a median age of 39.5 (interquartile range [IQR] = 20.2) years. Mean follow-up time of patients was 42 months (standard deviation [SD] = 34.3). After adjusted for three significant factors associated with survival were age >/=60 years (hazard ratio [HR] = 5.8; 95% confidence interval [CI]: 2.09-15.91), motor response score of Glasgow coma scale < 6 (HR = 75.5; 95% CI: 4.15-1,369.4), and biopsy (HR = 0.45; 95% CI: 0.21-0.92). To predict 1-year mortality, sensitivity, specificity, positive predictive value, negative predictive value, accuracy, and area under the curve our nomogram was 1.0, 0.50, 0.45, 1.0, 0.64, and 0.75, respectively. Conclusions This study provided a nomogram predicting prognosis of DA. The nomogram showed an acceptable performance for predicting 1-year mortality..


  • Ukwaja KN. Interactions between leprosy and human immunodeficiency virus: More questions than answers. Journal of Neurosciences in Rural Practice 2015; 6: (2) 135-6'
    Abstract
    None.


  • Majdan M. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 135-6'
    Abstract
    None.


  • Garg P, Rajasekaran M, Pandey S, Gurusamy G, Balalakshmoji D, Rathinasamy R. Magnetic resonance imaging brain findings in a case of aquaporin-4 antibody-positive neuromyelitis optica spectrum disorder, presenting with intractable vomiting and hiccups. Journal of Neurosciences in Rural Practice 2017; 8: (1) 135-8'
    Abstract
    Neuromyelitisoptica (NMO) and multiple sclerosis (MS) were once considered to be differing manifestation of same auto immune disease, NMO predominantly involving the optic nerve and cord. Now with discovery of NMO antibody the concept has changed and a spectrum of disorders with lesions in brain has been identified. Occasionally, brain may be the first or the only site of involvement in these disorders hence it is essential to be aware of this spectrum. The brain lesions in NMO/NMOSD may be located in characteristic regions and present with symptoms mimicking non neurological disease. We herein present a case of an adult female who was admitted with intractable vomiting and hiccups; subsequently on MRI brain found to have very tiny demyelinating foci in Area Postrema..


  • Pekcevik Y, Sahin H, Pekcevik R. Prevalence of clinically important posterior fossa emissary veins on CT angiography. Journal of Neurosciences in Rural Practice 2014; 5: (2) 135-8'
    Abstract
    PURPOSE: We assessed the prevalence of the clinically important posterior fossa emissary veins detected on computed tomography (CT) angiography. MATERIALS AND METHODS: A total of 182 consecutive patients who underwent 64-slice CT angiography were retrospectively reviewed to determine the clinically important posterior fossa emissary veins. RESULTS: Of 166 patients, the mastoid emissary vein (MEV) was not identified in 37 (22.3%) patients. It was found bilaterally in 82 (49.4%) and unilaterally in 47 (28.3%) patients. Only six patients had more than one MEV that were very small (<2 mm), and only five patients had very large (>5 mm) veins. The posterior condylar vein (PCV) was not identified in 39 (23.5%) patients. It was found bilaterally in 97 (58.4%) and unilaterally in 30 (18.1%) patients. Only 15 patients had a very large (>5 mm) PCV. The petrosquamosal sinus (PSS) was identified only in one patient (0.6%) on the left side. The occipital sinus was found in two patients (1.2%). CONCLUSIONS: The presence of the clinically important posterior fossa emissary veins is not rare. Posterior fossa emissary veins should be identified and systematically reported, especially prior to surgeries involving the posterior fossa and mastoid region..


  • He QY. Commentary. Journal of Neurosciences in Rural Practice 2016; 7: (1) 136-7'
    Abstract
    None.


  • Mallikarjuna SK, Velayutham SS, Sowmini PR, Jeyaraj MK, Arunan S. See-Saw Relationship and its Reversal after Immunotherapy in a Case of Graves' Disease with Coexisting Myasthenia Gravis. Journal of Neurosciences in Rural Practice 2019; 10: (1) 136-8'
    Abstract
    The unique association of myasthenia gravis (MG) with Graves' disease in clinical practice emphasizes that one autoimmune disease can coexist with another or many. The relationship between these two entities has remained controversial till date. Some authors have reported a see-saw relationship between these two entities, MG waning with hyperthyroidism and waxing with treatment of hyperthyroidism. Treatment of both these disorders concurrently may be challenging at times as treatment for one entity may worsen the other. The use of beta-blockers and steroids for Graves' disease may worsen myasthenic weakness. Antithyroid drugs can worsen myasthenia probably by immunomodulatory effects. We report a case of Graves' disease coexisting with MG in a reciprocal relationship which was subsequently reversed after immunotherapy..


  • Adigun T, Adeolu A, Adeleye A, Shokunbi M, Malomo A, Boadu SA. Anesthetic and surgical predictors of treatment outcome in re-do craniotomy. Journal of Neurosciences in Rural Practice 2011; 2: (2) 137-40'
    Abstract
    INTRODUCTION: Craniotomy is a neurosurgical operation done to remove brain tumor, repair vascular lesion, and relieve intracranial pressure. Complications can arise which may necessitate re-do craniotomy. The study is planned to find out the relationship between variables such as age, American Society of Anaesthesiologist (ASA), Glasgow coma score (GCS), frequency of re-do craniotomy, and surgical outcome of re-do craniotomy. MATERIALS AND METHODS: This is a retrospective study of all the patients who had re-do craniotomy over a 4-year period. The data that were collected included age, sex, ASA classification, indication for re-do craniotomy, GCS, frequency of re-do craniotomy, postoperative complications, and outcome. RESULTS: Twenty-five patients had indication for re-do craniotomy within the study period. Forty percent were male and 60% were female, and their mean age was 38.56 +/- 17.38 years. The indications for re-do craniotomy were removal of residual tumor, evacuation of clot, and cerebrospinal fluid leakage. Seventy-six percent had good outcome, while 24% had poor outcome. Outcome was good for patients who had re-do craniotomy done once, while poor outcome was for patients with second and third craniotomies. Ninety percent of patients with ASA (2) had good outcome, while 9.1% had poor outcome; but 64.3% had good outcome with ASA (3), while 37.7% had poor outcome with a P-value of 0.18. Seventy-five percent had poor outcome in patients with GCS of less than 9, while 25% had good outcome; but 14.3% had poor outcome in patients with GCS above 9, while 85.7% had good outcome with a P-value of 0.031. CONCLUSIONS: Increasing frequency of re-do craniotomy and lower GCS were major factors affecting outcome in re-do craniotomy in our center. The outcome of these patients is valuable in the management of other patients with re-do craniotomy in future..


  • Yadav N, Hedaoo K, Kumar A. Spinal Epidural Lipomatosis Associated with Intrathecal Flow Voids: Demonstration of Engorged Veins Using Flat Panel Catheter Angiotomography. Journal of Neurosciences in Rural Practice 2022; 13: (1) 137-40'
    Abstract
    We present a case of a 54-year-old male with spinal epidural lipomatosis who had associated flow voids on magnetic resonance imaging with dilated intrathecal vessels. During spinal angiogram, 20s DynaCT (flat panel catheter angiotomography) was utilized to demonstrate the intrathecal engorged veins. Venous engorgement of epidural venous plexus has been previously described in epidural lipomatosis; however, dilated intrathecal perimedullary veins have not been demonstrated by imaging. We have described the utility of flat panel catheter angiotomography in understanding venous disorders in such patients..


  • Ogbole G, Adeleye A, Adeyinka A, Ogunseyinde O. Magnetic resonance imaging: Clinical experience with an open low-field-strength scanner in a resource challenged African state. Journal of Neurosciences in Rural Practice 2012; 3: (2) 137-43'
    Abstract
    INTRODUCTION: Despite the fact that an magnetic resonance imaging (MRI) has been in clinical use for over 20 years, its use and availability in Nigeria, a West African state, is still extremely low. Hence, only few publications are available on the clinical experience with MRI from Nigeria. We set out to evaluate our initial clinical experience with a low-field-strength MRI in a Nigeria's foremost university hospital. MATERIALS AND METHODS: A retrospective review of all studies, performed with an open 0.2 Tesla MAGNETOM Concerto (Siemens Medical) MRI scanner over a 5-year period (2006 - 2010) was conducted. All patients with complete records were evaluated for their clinical and demographic characteristics. RESULTS: The records of 799 MRI studies were available. Patients' ages ranged from 1 day to 90 years, with a mean of 40.1 years (+/- 20.7 SD). There were 463 (57.9%) males and 336 (42.1%) females. Over 90% of the studies were requested to evaluate brain or spine lesions. Low back pain represented the commonest (161/799, 20.7%) clinical indication for MRI. The largest number of patients was referred by physicians from surgical specialties (65.6%). CONCLUSION: The awareness and competence for proper use of MRI in Nigeria appears high. Low back pain is the commonest indication for MRI in our institution, and surgeons make a greater use of the facility. The provision of high-signal strength MRI may be beneficial in making a wider range of applications available to clinicians..


  • Joy JL, Ramachandran M, George S. Learned Helplessness, Psychological Wellbeing, and Proenvironment Care Behavior among Victims of Frequent Floods in Kerala. Journal of Neurosciences in Rural Practice 2021; 12: (1) 137-44'
    Abstract
    Background In 2018 and 2019, there were floods in the coastal regions of Kerala. Many individuals and families were victims on both these occasions; these floods had devastating impact on individual psychological wellbeing, their financial stability, and on overall family wellbeing. Furthermore, many people in vulnerable geographical areas still live in uncertainty and fear. In this context, our study examined whether continuous victimization of natural calamities, like floods in Kerala, leads to the development of learned helplessness and decreased psychological wellbeing among those affected. We also studied whether proenvironment care behavior increased among flood-affected individuals. Materials and Methods We studied 374 heads of families in Kerala, selected through the Quota sampling method. They belonged to the following three groups: (1) flood-affected only once (OFA, n = 124), (2) flood-affected twice (TFA, n = 124), and (3) never flood-affected (NFA, n = 124) households. The key variables of learned helplessness, psychological wellbeing, and proenvironment care behavior were measured using learned helplessness scale, psychological wellbeing scale, and the environmental behavior scale, respectively. Statistical Analysis The Kruskal-Wallis test was used to analyze the data for independent groups. Results Learned helplessness was found to be high among the TFA group. Psychological wellbeing and proenvironment care behavior were high among the OFA group as compared with the TFA group. The NFA group had higher learned helplessness in comparison to the OFA group, and psychological wellbeing and proenvironment care behavior were low when compared with the TFA group. Conclusion We conclude that surviving a moderate amount of risk is perhaps necessary for better psychological wellbeing and that too many or too few risks in life are detrimental to good psychological health. Immediate psychological support among victims of natural calamities and periodic examination of well-being and psychological interventions among people who are vulnerable for frequent victimization of natural calamities have to part of disaster management related to natural calamities..


  • Sardesai VR. Leprosy elimination: A myth or reality. Journal of Neurosciences in Rural Practice 2015; 6: (2) 137-8'
    Abstract
    None.


  • Chikani MC, Okwunodulu O, Mesi M, Mezue WC, Ohaegbulam SC, Ndubuisi CC. Surgically Treated Primary Spinal Cord Neoplasms in Southeastern Nigeria. Journal of Neurosciences in Rural Practice 2018; 9: (1) 137-9'
    Abstract
    Background: Primary spinal cord tumors are not as frequently encountered as their cranial counterparts. They could present in such an indolent manner that requires a reasonable index of suspicion for their diagnosis to be considered. Objective: The objective of this study is to analyze the incidence and pattern of primary spinal cord and appendage neoplasms in patients surgically treated in our institution over a decade of practice. Materials and Methods: A retrospective review of clinical, radiological, and histopathology profiles of patients surgically treated for primary spinal cord tumor from 2006 to 2016 was carried out. Retrieved data were analyzed using SPSS version 21. Results: Out of 472 spine procedures were performed within the study period 17 (3.6%) cases of histologically proven primary spinal cord tumors were identified. The age of patients ranged between 17 and 77 years with a mean age was 45 years. The male: female ratio was 1:1.1. Motor deficit and pain were the most common presenting symptoms seen in 35.3% and 29.4% of patients, respectively. Meningiomas are the most common histological diagnosis (70.6%), distantly followed by Schwannoma (17.6%). The most common location of the tumors was intradural extramedullary (70.6%). All patients had gross total resection of tumor with no perioperative mortality. Conclusion: Meningioma is the most common surgically treated primary spinal cord tumor in our setting. Surgery is associated with good outcome..


  • Goomany A, Timothy J, Robson C, Rao A. En bloc resection of a thoracic chordoma is possible using minimally invasive anterior access: An 8-year follow-up. Journal of Neurosciences in Rural Practice 2016; 7: (1) 138-40'
    Abstract
    Thoracic spine chordomas are a rare clinical entity and present several diagnostic and management challenges. Posterior debulking techniques are the traditional approach for the resection of thoracic tumors involving the vertebral body. Anterior approaches to the thoracic spine enable complete tumor resection and interbody fusion. However, this approach has previously required a thoracotomy incision, which is associated with significant perioperative morbidity, pain, and the potential for compromised ventilation and subsequent respiratory sequelae. The extreme lateral approach to the anterior spine has been used to treat degenerative disorders of the lower thoracic and lumbar spine, and reduces the potential complications compared with the anterior transperitoneal/transpleural approach. However, such an approach has not been utilized in the treatment of thoracic chordomas. We describe the first case of an en bloc resection of a thoracic chordoma via a minimally invasive eXtreme lateral interbody fusion approach..


  • Awada AA. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 138-9'
    Abstract
    None.


  • Pillutla P, Nix E, Elberson BW, Nagy L. Complete Femoral Nerve Transection with Sural Nerve Cable Graft in a 21-Month-Old Child. Journal of Neurosciences in Rural Practice 2019; 10: (1) 139-41'
    Abstract
    Severe peripheral nerve injury occasionally requires urgent nerve grafting especially with significant separation of the proximal and distal ends of the injured nerve. Proper reinnervation to provide continued sensory and motor function is essential especially in the pediatric population. These patients would suffer lifelong disability without correction, yet have significantly improved regenerative capacity with prompt and effective management, making nerve grafts an ideal choice for complete nerve transection. This case report describes the successful sural nerve cable graft reinnervation of a transected femoral nerve in a 21-month-old male. This procedure was made difficult by severe trauma to the surrounding area with laceration of the femoral artery, significant separation of the femoral nerve ends, and the compact anatomy of such a young patient..


  • Musa MA, Zagga AD, Danfulani M, Tadros AA, Ahmed H. Cranial index of children with normal and abnormal brain development in Sokoto, Nigeria: A comparative study. Journal of Neurosciences in Rural Practice 2014; 5: (2) 139-43'
    Abstract
    BACKGROUND: Abnormal brain development due to neurodevelopmental disorders in children has always been an important concern, but yet has to be considered as a significant public health problem, especially in the low- and middle-income countries including Nigeria. AIMS: The aim of this study is to determine whether abnormal brain development in the form of neurodevelopmental disorders causes any deviation in the cranial index of affected children. MATERIALS AND METHODS: This is a comparative study on the head length, head width, and cranial index of 112 children (72 males and 40 females) diagnosed with at least one abnormal problem in brain development, in the form of a neurodevelopmental disorder (NDD), in comparison with that of 218 normal growing children without any form of NDD (121 males and 97 females), aged 0-18 years old seen at the Usmanu Danfodiyo University Teaching Hospital, Sokoto, over a period of six months, June to December, 2012. The head length and head width of the children was measured using standard anatomical landmarks and cranial index calculated. The data obtained was entered into the Microsoft excel worksheet and analyzed using SPSS version 17. RESULTS: The mean Cephalic Index for normal growing children with normal brain development was 79.82 +/- 3.35 and that of the children with abnormal brain development was 77.78 +/- 2.95 and the difference between the two groups was not statistically significant (P > 0.05). CONCLUSION: It can be deduced from this present study that the cranial index does not change in children with neurodevelopmental disorders..


  • Olabinri EO, Ogbole GI, Adeleye AO, Dairo DM, Malomo AO, Ogunseyinde AO. Comparative analysis of clinical and computed tomography features of basal skull fractures in head injury in southwestern Nigeria. Journal of Neurosciences in Rural Practice 2015; 6: (2) 139-44'
    Abstract
    BACKGROUND: Basal skull fractures (BSF) in head injury may be missed clinically. Early detection ensures prompt treatment and prevention of complications We compared the clinical and Computed Tomography (CT) features of basal skull fractures in head injured patients in a southwestern Nigerian hospital. MATERIALS AND METHODS: Head injury patients who had cranial CT at a Southwestern Nigerian hospital were selected. CT images were acquired with a 64-slice Toshiba Aquillion CT scanner using a standard head protocol. The images were evaluated for evidence of skull fractures, and associated complications. The clinical data and CT findings were analyzed. RESULTS: One hundred and thirty patients were evaluated, including 103 (79.2%) males. Their ages ranged between 7 months and 81 years, mean 35 years (SD, 20.3). In 59 patients (45.4%, 59/130) BSF was detected on CT, while 71 (54.6%) had no evidence BSF. Forty-two (71.2%) of the 59 patients detected on CT had clinical suspicion of BSF (P < 0.001) while the remaining 17 (28.8%) were not clinically diagnosed. This equaled a sensitivity of 71.2% and, specificity of 90.1% for clinical determination of BSF in this study. There was no statistically significant difference between clinical and CT diagnosis (P > 0.05). The commonest observed clinical feature in patients with confirmed BSF was otorrhagia (45.8%) and the petrous temporal bone (45.8%) was the most commonly fractured bone. The BSF was caused most commonly by motor bike accidents in 53 (40.8%). The most common associated intracranial injuries were intracerebral haemorrhage (34.6%) and subdural (17.3%). CONCLUSION: It appears that neurosurgical evaluation is comparatively reliable in evaluating basal skull fractures in this study area even as they are consistently demonstrated by high resolution CT scanners. A clinical suspicion of BSF should warrant a closer detailed CT evaluation and reporting by radiologists..


  • Marathe R, Yogesh A, Pandit S, Joshi M, Trivedi G. Inca - interparietal bones in neurocranium of human skulls in central India. Journal of Neurosciences in Rural Practice 2010; 1: (1) 14-6'
    Abstract
    UNLABELLED: Inca bones are accessory bones found in neurocranium of human skulls. Occurrence of Inca bones is rare as compared to other inter sutural bones such as wormian bones. These Inca ossicles are regarded as variants of the normal. The reporting of such occurrences is inadequate from Central India. OBJECTIVES: To find the incidence of Inca variants in Central India. MATERIALS AND METHODS: In the present study, 380 dried adult human skulls were examined. All specimen samples were procured from various Medical colleges of Central India. They were analyzed for gross incidence, sexual dimorphism and number of fragments of Inca bones. RESULTS: Gross incidence of Inca bones was found to be 1.315 %. Incidence rate was higher in male skulls than female skulls (male: 1.428%; female: 1.176%). The Inca bones frequently occurred signally. Out of the five observed Inca ossicles, two were fragmented. CONCLUSIONS: This data gives idea regarding gross incidence, sexual dimorphism and number of fragments of Inca bones in neurocranium of human skulls from Central India. The knowledge of this variable is useful for neurosurgeons, anthropologists and radiologists..


  • Sharma V, Singh SK. Retrospective Analysis of Arthrodesis from Various Options after Anterior Cervical Discectomy. Journal of Neurosciences in Rural Practice 2018; 9: (1) 14-8'
    Abstract
    Introduction: Anterior cervical discectomy is a surgical procedure performed to treat a herniated/degenerated disc in the cervical region. There have been various studies comparing arthrodesis rates among various procedures. Our patients belonged to varied socioeconomic background and underwent anterior cervical microdiscectomy without/with instrumentation. Aim: The present study was performed to study and compare the arthrodesis rates in the patients operated for anterior cervical microdiscectomy with and without fusion/instrumentation procedures at our institution. Materials and Methods: This is a retrospective study performed at Vydehi Institute of Medical Sciences and Research Centre, Bengaluru. Pre- and post-operative X-rays were assessed in 96 patients who had undergone anterior cervical discectomy with/without fusion from June 2012 to June 2015. Radiographic arthrodesis was assessed in all patients. An arbitrary grading was designed by us and categorized into Grade I to IV. The criteria considered for adequate arthrodesis in this study were: (a) <2 degrees movement on dynamic X-rays, (b) restored disc space height (+/-2 mm accepted), and (c) evidence of solid bone mass around disc space. Arthrodesis was categorized as Grade I if all the above 3 criteria on X-rays was fulfilled, Grade II if any 2 of the criteria was fulfilled, Grade III if any 1 of the criteria was fulfilled, and Grade IV when pseudoarthrosis/none of the criteria was fulfilled. Grade I arthrodesis was noted in about 79 patients (82.2%), Grade II in 14 patients, and only 3 patients had Grade III arthrodesis. There were no patients with absent arthrodesis/pseudoarthrosis. Results: Satisfactory arthrodesis was noted in 82% of the total patients, with patients undergoing fusion +/- instrumentation procedure having better results. Conclusions: Arthrodesis by an interbody graft/implant with/without plating increases chances of success as compared to anterior cervical discectomy alone. Patients should be motivated for any of the available options for fusion/instrumentation..


  • Srivastava A, Sardhara J, Behari S, Pavaman S, Joseph J, Das K, et al.. Knock and Drill Technique: A Simple Tips for the Instrumentation in Complex Craniovertebral Junction Anomalies without using Fluoroscopy. Journal of Neurosciences in Rural Practice 2017; 8: (1) 14-9'
    Abstract
    CONTEXT: Existence of complex variable bony and vertebral artery (VA) anomalies at craniovertebral junction (CVJ) in subset of complex CVJ anomalies demands individualized instrumentation policy and placing screws in each bone requires strategic preoperative planning and intraoperative skills. AIM: To evaluate the clinical accuracy of knock and drill (K and D) technique for the screw placement in complex CVJ anomalies. SETTINGS AND DESIGN: Prospective study and operative technical note. MATERIALS AND METHODS: Totally 36 consecutive patients (16 - pediatrics, 20 - adult patients) of complex CVJ: Complete/partial occipitalized C1 vertebra; at least one hypoplastic (C1/C2) articular mass, rotational component, and variations in the third part of VA were included in this study. Preoperative detail computed tomography (CT) CT CVJ with three-dimensional reconstruction was done for the assessment of CVJ anatomy and facet joint orientation. The accuracy of novel technique was assessed with postoperative CT to evaluate cortical breach in between 5(th) and 7(th) postoperative day in all the patients. All patients were underwent clinico-radiological evaluation at 6-month follow-up. RESULTS: Totally 144 screws were placed using K and D technique (pediatric group - 64 screws, adult patients - 80 screws). Total of 12 screws were placed in C1 lateral mass in both age group without any bony cortical breach and complication. Sixteen C2 pedicle screws and 12 C2 pars screw in pediatrics and 18 C2 pedicle screws in adult patients were placed without any bony breach or VA injury. Out of thirty subaxial lateral mass screws in pediatric group, the bony breach was encountered with one screw (3.3%). Total of 38 C2 pars screws was placed in adult group in which bony breach along with VA injury was encounter with 1screw (2.6%). CONCLUSION: A simple technique of K and D for placing a screw increases the accuracy and spectrum of bony purchase and has the potential to reduce the complication in patients with complex CVJ anomalies..


  • Dharmasaroja PA, Ratanakorn D, Nidhinandana S, Charernboon T. Comparison of Computerized and Standard Cognitive Test in Thai Memory Clinic. Journal of Neurosciences in Rural Practice 2018; 9: (1) 140-2'
    Abstract
    Background: Computer-based Thai Cognitive Test or Computer-based Thai Mental State Examination (cTMSE) was developed aiming to help doctors to easily get the accurate results of TMSE in a routine, busy outpatient clinics. The purpose of this study was to compare the evaluation process in terms of feasibility, duration of the test, participants/administrator preference, and the results of cognitive test between cTMSE and the standard Thai Mental State Examination (sTMSE). Methods: Twenty-two elderly participants (>60 years old) who were not demented and 22 patients with mild-to-moderate dementia were included in the study. All participants would be asked to have TMSE by standard method (sTMSE) and computer-based method (cTMSE), at least 2 weeks and up to 2 months apart. Scores and duration of the test were compared using dependent paired t-test. Agreement of the tests between two methods and Kappa statistics were analyzed. Results: Paired t-test showed no significant difference in scores between the two methods (mean sTMSE vs. cTMSE: 22.84 vs. 22.62, 95% confidence interval [CI]: [-0.465] to 0.987, P = 0.524). Percent of agreement between the two methods was 92.5%, with the Kappa of 0.85 (P < 0.001). Duration of the test by sTMSE was slightly shorter than the cTMSE (7.31 min vs. 7.97 min, 95% CI: [-1.159] to [-0.175], P = 0.09). Overall, participants liked being tested by cTMSE more than sTMSE. Conclusion: Computer-based TMSE was feasible to use and accurate for screening in aging adults and for cognitive evaluation in patients with mild-to-moderate dementia..


  • Yuksel MO, Gurbuz MS, Tanriverdi O, Ozmen SA. Lipomatous meningioma: A rare subtype of benign metaplastic meningiomas. Journal of Neurosciences in Rural Practice 2017; 8: (1) 140-2'
    Abstract
    Lipomatous meningiomas are extremely rare subtypes of benign meningiomas and are classified as metaplastic meningioma in the World Health Organization classification. We present a 77-year-old man presented with the history of a gradually intensifying headache for the last 3 months. A right frontoparietal mass was detected on his cranial magnetic resonance imaging. The patient was operated on via a right frontoparietal craniotomy, and histopathological diagnosis was lipomatous meningioma. Distinctive characteristics of lipomatous meningiomas were discussed with special emphasis to importance of immunohistochemical examinations, particularly for its differentiation from the tumors showing similar histology though having more aggressive character..


  • Joshi D, Kundana K, Puranik A, Joshi R. Diagnostic accuracy of urinary reagent strip to determine cerebrospinal fluid chemistry and cellularity. Journal of Neurosciences in Rural Practice 2013; 4: (2) 140-5'
    Abstract
    BACKGROUND: The gold standard for diagnosis of meningitis depends on cerebrospinal fluid (CSF) examination by microscopy, biochemistry, and culture, which require an experienced microscopist and laboratory support. We conducted this study to determine if urinary reagent strip is useful to make a semi-quantitative assessment of protein, glucose, and presence of leukocyte esterase in CSF. MATERIALS AND METHODS: All consecutive CSF samples were evaluated in a blinded fashion. CSF was tested using Combur-10 urinary reagent strip as an index test, and CSF microscopy and biochemistry as reference standards. Combur-10 (Boehringer Mannheim) is a urinary reagent strip used to estimate ten parameters including protein, glucose, and leukocytes. We estimated diagnostic accuracy of each index test using corresponding cut-off levels (glucose 1 + vs. CSF glucose >50 mg/dL; protein 1 + and 2 + vs. CSF protein >30 mg/dL and >100 mg/dL; leukocyte esterase positivity vs. >10 granulocytes in CSF sample). We constructed receiver operating curves (ROC) to evaluate overall performance of index tests and estimated area under the curve (AUC). RESULTS: CSF samples of 75 patients were included in the study. All the three indicator tests (CSF cells, protein, and glucose) were normal in 17 (22.6%) samples. Of the three tests, diagnostic accuracy of protein estimation (1 + or more on reagent strip) was best for detection of CSF proteins greater than 30 mg/dL [sensitivity 98.1% (95% CI 90.1-100%); specificity 57.1% (95% CI 34-78.2%)], with AUC of 0.97. Sensitivity and specificity for 2 + on reagent strip and CSF protein > 100 mg/dL were 92.6% (95% CI 75.1-99.1) and 87.5% (95% CI 74.8-95.3), respectively, with AUC of 0.96 (95% CI 0.92-1.01). Leukocyte esterase positivity by test strip had a sensitivity of 85.2 (95% CI 66.3-95.8%) and specificity of 89.6 (95% CI 77.3-96.5%) for detection of CSF granulocytes of more than 10/mm(3). CONCLUSION: Existing urinary reagent strips can be used to diagnose meningitis in low-resource settings..


  • Mohapatra S. Extrapyramidal side-effects of low-dose aripiprazole in an 11-year-old child. Journal of Neurosciences in Rural Practice 2016; 7: (1) 141-2'
    Abstract
    Partial agonism of D2 and 5-HT1A receptors accounts for the low incidence of extrapyramidal side-effects of aripiprazole. Extrapyramidal symptoms (EPS) during treatment with therapeutical doses of aripiprazole have been reported in adults and children. To the best of our knowledge, no cases of EPS with low doses (5 mg) have been reported until now. In this article, we present an 11-year-old child who developed EPS on low doses (5 mg) aripiprazole. This case emphasizes the need for careful surveillance for the development of EPS in patients treated even with low doses of aripiprazole..


  • Abdulla E, Das K, Ravindra J, Shah T, George S. Intractable Trigeminal Neuralgia Secondary to Osteoma of the Clivus: A Case Report and Literature Review. Journal of Neurosciences in Rural Practice 2022; 13: (1) 141-5'
    Abstract
    Skull base osteomas (SBOs) are benign tumors that are frequently detected on radiographic images by coincidence. They are known for being slow-growing tumors and rarely symptomatic. The therapeutic approach for SBOs can differ substantially. Depending on the symptoms, size, and location of the tumor, this can range from serial observation to vigorous surgical extirpation. Clival osteoma is extremely rare. We report a case of clival osteoma, causing intractable trigeminal neuralgia due to the pressure effect on the trigeminal nerve at Meckel's cave. We also provide a review of pertinent literature. A 37-year-old woman presented with intractable trigeminal neuralgia. Cranial magnetic resonance imaging (MRI) demonstrated a large, lobulated, extra-axial lesion involving the right cerebellopontine angle and epicentering the clivus. Pathologically, the specimen was proven to be osteoma. The patient reported complete symptom resolution over a 4-year follow-up period. To the best of the authors' knowledge, this is the first clinical case of intractable trigeminal neuralgia due to clival osteoma..


  • Adrienne C, Manigandan C. Inpatient occupational therapists hand-splinting practice for clients with stroke: A cross-sectional survey from Ireland. Journal of Neurosciences in Rural Practice 2011; 2: (2) 141-9'
    Abstract
    INTRODUCTION: Hand splinting after stroke is a common practice despite inadequate evidence. This warrants a better understanding of the therapists' splinting practice, to develop clinically meaningful treatment options. AIMS: The study examined the nature and prevalence of the factors associated with therapists' hand splinting practice and their perceived splinting efficacy. SETTINGS AND DESIGN: A cross-sectional national survey of hand-splinting practice among inpatient occupational therapists (OTs) in Ireland. MATERIALS AND METHODS: Sixty-two therapists participated in this national survey. STATISTICAL ANALYSIS USED: A number of factors were analyzed to explore their relationship with therapists' perception of splint efficacy using Spearman's rank order correlation. RESULTS: 53(85.5%) out of 62 survey respondents prescribed splints to their clients at the time of taking the survey. To reduce spasticity, to correct contractures and thus increase range of motion (ROM) were the commonly used splinting goals. These were the goals that were significantly associated with the therapists' splinting efficacy too. CONCLUSIONS: Hand-splint prescription following stroke was found to be a common practice among OTs who perceive splints to be quite effective. A custom-made, volar forearm-based wrist-hand splint is the preferred splint among therapists to achieve a number of clinical aims such as improving ROM, stretching soft tissue contractures and reducing spasticity in the upper extremity. A wide variety of splinting regimens is currently practiced, reflecting the lack of a universally accepted and comprehensive practice guideline to regulate therapy. Methodologically valid clinical trials evaluating the efficacy of therapist-preferred splints in achieving their favored outcomes are needed. Development of common, universally accepted therapeutic guidelines based on comprehensive scientific review of such studies is thus needed..


  • Chen CJ, Patibandla MR, Park MS, Kalani MY. Regrowth of a Large Intracranial Aneurysm after On-Label Use of the Pipeline Embolization Device. Journal of Neurosciences in Rural Practice 2019; 10: (1) 142-4'
    Abstract
    Despite the widespread use of the pipeline embolization device (PED), no complete aneurysm regrowth after its placement has been reported in the literature. We report the first case of aneurysm regrowth after the initial follow-up angiography demonstrating near-complete occlusion of the aneurysm and remodeling of the vessel with on-label PED use for a large 20 mm x 24 mm x 22 mm (width x depth x height) cavernous segment internal carotid artery (ICA) aneurysm. The patient was treated with two overlapping PED (4.5 mm x 20 mm and 5 mm x 20 mm). Follow-up angiogram at 4 months after treatment demonstrated remodeling of the ICA with a small residual component measuring approximately 7 mm x 8 mm x 7 mm. However, at 10 months after treatment, there was a complete regrowth of the aneurysm with interval growth, now measuring 25 mm x 28 mm x 18 mm. Despite the high aneurysm occlusion rates reported with the PED, persistent aneurysm filling and aneurysm regrowth, although rare, should not be overlooked..


  • Das DK. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 143-4'
    Abstract
    None.


  • Sahlu A, Mesfin B, Tirsit A, Wester K. Spinal cord compression secondary to vertebral echinococcosis. Journal of Neurosciences in Rural Practice 2016; 7: (1) 143-6'
    Abstract
    We describe a patient with progressive lower limb weakness and paresthesia 3 days after falling from a considerable height. Magnetic resonance imaging and computed tomography revealed collapsed Th2 and Th3 vertebrae. A tuberculous (TB) spondylitis was suspected, and anti-TB medication was started however with no clinical improvement. She was referred to our center and operated. A 3 level discectomy and 2 level corpectomy were performed with iliac bone grafting and anterior plating via an anterior cervical approach. The patient developed an esophagocutaneous fistula that was repaired and cured. The biopsy specimen showed a hydatid cyst of the vertebra as the cause of the lesion. After the result, she was started on oral albendazole. At follow-up nearly 4 months after surgery, the patient had regained significant power in her lower limbs with a muscular strength of 5/5 in both legs, thus making it possible to walk without support..


  • Rammohan K, Shyma MM, Das S, Shaji CV. Clinical Features and Psychiatric Comorbidity of Epicrania Fugax. Journal of Neurosciences in Rural Practice 2018; 9: (1) 143-8'
    Abstract
    Background: Epicrania fugax (EF) is a rare newly described primary headache characterized by paroxysms of unilateral pain radiating across one hemicranium. Aim: We aimed to describe 10 new cases of EF and assess the psychiatric comorbidity. Materials and Methods: Cases of EF were identified from patients attending the neurology outpatient department of a tertiary level referral and teaching hospital by the first author during a period extending from January 1, 2015 to April 31, 2017. Case ascertainment was done as per ICHD 3 beta criteria from among patients presenting with complaints of headache after detailed history and clinical examination. Clinical and demographic features were noted and patients were subjected to Mini Neuropsychiatric Interview to screen for psychiatric comorbidity followed by Becks Anxiety/Depression Inventory. Results: A total of 10 subjects were obtained during the study period, 4 males, and 6 females. Mean age of subjects was 45.3 years (standard deviation-10). Seventy percent had anteroposterior, and 30% had posteroanterior radiation of pain. The most common character of pain was stabbing (50%) followed by electrical (40%) and pressing (10%). None of the subjects had autonomic symptoms or focal symptoms in the scalp while 30% subjects had hyperesthesia in the affected area of the scalp. Six subjects (60%) patients had episodic course while 40% had chronic course. Sixty percent had comorbid anxiety while one (10%) had comorbid depression. A significant relation was obtained between duration of disease and occurrence of anxiety as well as Becks Anxiety Inventory scores while there was no correlation with attack duration. There was also a nonsignificant correlation between visual analog score and occurrence of anxiety symptoms. Conclusions: Our study conclusively proves the existence of EF as a rare, distinct primary headache syndrome in our study population. It has a significant psychiatric comorbidity consisting of 60% of generalized anxiety disorder, 10% of panic attacks, and 10% of depression..


  • Kaloria N, Panda NB, Bhagat H, Kaloria N, Soni SL, Chauhan R, et al.. Pulsatility Index Reflects Intracranial Pressure Better than Resistive Index in Patients with Clinical Features of Intracranial Hypertension. Journal of Neurosciences in Rural Practice 2020; 11: (1) 144-50'
    Abstract
    Background The intracranial pressure (ICP) is measured through various noninvasive methods to overcome complications of invasive ICP monitoring. In this study, transcranial Doppler was used to measure pulsatility index (PI) and resistive index (RI) that were correlated with opening intraventricular ICP. The opening intraventricular ICP was measured with the placement of intraventricular catheter in lateral ventricle without loss of cerebrospinal fluid. Methods The prospective, observational study was conducted on 40 patients with clinical and radiological features of raised ICP who underwent either endoscopic third ventriculostomy or ventriculoperitoneal shunt surgery. The PI and RI were measured simultaneously with opening ICP measurements under general anesthesia. Both PI and RI were correlated with ICP by using Pearson correlation coefficient. The receiver operating characteristic (ROC) curve was used to get the optimal values of PI ad RI for corresponding ICP values. Results The mean PI was 1.01 +/- 0.41 and mean RI was 0.59 +/- 0.32. The mean opening ICP value was 21.81 +/- 8.68 mm Hg. The correlation between PI and RI with ICP was a statistically significant with correlation coefficient of 0.697 and 0.503, respectively. The ROC curve shown statistically significant association between PI and ICP from 15 to 40 mm Hg, whereas the association between RI and ICP was from 15 to 25 mm Hg, with various sensitivity and specificity. Conclusion The opening intraventricular ICP correlated better with PI than RI in patients with features of raised ICP..


  • Gupta PP, Thacker AK, Haider J, Dhawan S, Pandey N, Pandey AK. Assessment of topiramate's efficacy and safety in epilepsy. Journal of Neurosciences in Rural Practice 2014; 5: (2) 144-8'
    Abstract
    OBJECTIVE: To study the significance of topiramate (TPM) addition on seizure control in treatment of epilepsy. DESIGN: A prospective open label add-on trial of TPM addition in patients with epilepsy was done. The events of baseline phase of 12 weeks followed by titration and maintenance phases were recorded. Assessment of the number of seizure and emergent adverse effects was done by a monthly visit for each case. MAIN OUTCOME MEASURES: Reduction of more than 50% mean seizure frequency or response ratio of 0.33 was taken as the criteria for responders. STATISTICAL ANALYSIS: Normal Z-test for significance of differences between two proportions and Chi-square test for presence of association was applied and mean age, median duration, sex ratio, percentage prevalence were depicted. RESULTS: Significant responses to TPM in both partial as well as generalized seizures were observed (Z = 6.66, P < 0.001 and Z = 4.185, P < 0.01). The effect was more pronounced in patients with partial seizures. However, the overall response was highly significant (Z = 7.839, P < 0.001). The best response was noted at the dose of 200-300 mg/day (Z = 6.708, P < 0.001). More than 35% cases of partial and generalized seizures reported more than 75% reduction levels. The drug was well tolerated in more than 65% cases for side effects on psychosis, giddiness, and anorexia. Mild side effects were seen only in about less than 35% cases. CONCLUSIONS: TPM was found as a significantly effective add-on anticonvulsant with some limitation or mild side effects..


  • Saxena S, Sahay A, Goel P. Effect of fluoride exposure on the intelligence of school children in Madhya Pradesh, India. Journal of Neurosciences in Rural Practice 2012; 3: (2) 144-9'
    Abstract
    OBJECTIVE: To assess the relationship between exposure to different drinking water fluoride levels and children's intelligence in Madhya Pradesh state, India. MATERIALS AND METHODS: This cross-sectional study was conducted among 12-year-old school children of Madhya Pradesh state, India. The children were selected from low (< 1.5 parts per million) and high (>/=1.5 parts per million) fluoride areas. A questionnaire was used to collect information on the children's personal characteristics, residential history, medical history, educational level of the head of the family, and socioeconomic status of the family. Levels of lead, arsenic, and iodine in the urine and the levels of fluoride in the water and urine were analyzed. The children's intelligence was measured using Raven's Standard Progressive Matrices. Data analysis was done using the chi-square, one way analysis of variance, simple linear regression, and multiple linear regression tests. P value <0.05 was considered statistically significant. RESULTS: Differences in participant's sociodemographic characteristics, urinary iodine, urinary lead, and urinary arsenic levels were statistically not significant (P>0.05). However, a statistically significant difference was observed in the urinary fluoride levels (P 0.000). Reduction in intelligence was observed with an increased water fluoride level (P 0.000). The urinary fluoride level was a significant predictor for intelligence (P 0.000). CONCLUSION: Children in endemic areas of fluorosis are at risk for impaired development of intelligence..


  • Akil E, Tamam Y, Akil MA, Kaplan I, Bilik MZ, Acar A, et al.. Identifying autonomic nervous system dysfunction in acute cerebrovascular attack by assessments of heart rate variability and catecholamine levels. Journal of Neurosciences in Rural Practice 2015; 6: (2) 145-50'
    Abstract
    OBJECTIVE: This study aimed to evaluate changes in the autonomic nervous system caused by cerebral lesions due to acute stroke. We assessed heart rate variability and catecholamine levels in lieu of stroke lesion localization. MATERIALS AND METHODS: A total of 60 stroke patients and 31 healthy controls were enrolled in the study. Plasma epinephrine and norepinephrine levels were measured on the first, third, and seventh days following the stroke event. Heart rate variability was evaluated with time-domain and frequency-domain analyses via 24-hour Holter monitor recordings. RESULTS: On the first and third day following the stroke, norepinephrine levels were significantly higher in all patient groups as compared to controls. Epinephrine levels on the first, third and seventh days after the stroke were significantly higher in patients with lesions in the right middle cerebral artery territory than controls. In frequency-domain analysis, patients with right middle cerebral artery territory lesions had greater low frequency and low frequency to high frequency ratio values than controls. Time-domain analysis revealed significant decreases in the standard deviation from the mean for 5-minute 288 R-R intervals in patients with lesions in the right middle cerebral artery and posterior cerebral artery territory when contrasted with controls. Patients with lesions in the right middle cerebral artery territory demonstrated the highest increase in the percentage of consecutive R-R intervals differing by more than 50 ms (pNN50) as compared to the control group. CONCLUSION: These findings indicate that autonomic dysfunction favoring an increase in sympathetic activity occurs in acute stroke patients..


  • Meel M, Choudhary N, Kumar M, Mathur K. Epidemiological Profiling and Trends of Primary Intracranial Tumors: A Hospital-Based Brain Tumor Registry from a Tertiary Care Center. Journal of Neurosciences in Rural Practice 2021; 12: (1) 145-52'
    Abstract
    Background and Objectives Hospital-based cancer registry is an essential tool for augmentation of the standard of care, administration motive, and resource for population-based cancer registries. Here, we presented hospital-based brain tumor registry (HBBTR) to outline a comprehensive epidemiological data, both clinical and histopathological, as well as trends of central nervous system tumors. In addition, we compare this data with national brain tumor data as well as an international brain tumor registry. Materials and Methods For the generation of this 7-year HBBTR data of all primary intracranial tumors operated, diagnosed, and registered at the Department of Pathology, Sawai ManSingh, between January 1, 2013 and December 31, 2019, was collected, analyzed, and compared with Tata Memorial Hospital, National Institute of Mental Health and Neurosciences, and Central Brain Tumor Registry of the United States. Results A total of 3,526 patients were of primary intracranial tumors. Out of which, male patients were 1,982 (56.2%), while 1,544 (43.8%) were female patients. Maximum proportion of tumors was in fifth decade. Overall, pediatric and adult patients constituted of 15.5 and 84.5% of the cases, respectively. Among all primary intracranial tumors, meningiomas (20%) were most common followed by glioblastoma multiformat (18%) and least common were germ cell tumors (0.1%) followed by pineal tumors (0.3%). In pediatric cohort astrocytic tumors (30.1%) are most common followed by embryonal tumors (20.8%), while in adults meningiomas (23.1%) were most common followed by glioblastomas (20.3%). Our registry showed similar trends of tumors with national data as compared with international data in median age of presentation. Conclusion This HBBTRs provide prevalence of primary intracranial tumors at a tertiary care center and could be a part of population-based registry..


  • Ding D, Furneaux CE. Combined transchoroidal and subchoroidal approach for resection of a large hemorrhagic epithelial cyst: Expanding the operative corridor to the third ventricle. Journal of Neurosciences in Rural Practice 2017; 8: (1) 145-6'
    Abstract
    None.


  • Kumar S. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 145-6'
    Abstract
    None.


  • Pradeep R, Gupta D, Mehta A, Srinivasa R, Javali M, Acharya PT. Wake-Up Sleepyhead: Unilateral Diencephalic Stroke Presenting with Excessive Sleepiness. Journal of Neurosciences in Rural Practice 2019; 10: (1) 145-7'
    Abstract
    Altered sleep architecture and stroke share a reciprocal relationship. More than half of the stroke patients display sleep abnormalities including hypersomnia, insomnia, parasomnia, periodic limb movements, or sleep-disordered breathing. Conversely, one of the major causes of severe organic hypersomnia is acute brainstem strokes, involving thalamic infarctions, which may be reversible over 6-12 months. Here, we report a patient with increased lethargy and drowsiness who was diagnosed to have a right thalamic and hypothalamic ischemic stroke..


  • M.K UC, S.V NP, Gudla S, Bhuma V. Imaging of Dentate Nucleus Pathologies: A Case Series. Journal of Neurosciences in Rural Practice 2022; 13: (1) 146-50'
    Abstract
    The dentate nucleus is the largest cerebellar nucleus, and it controls cognition and voluntary movement. It is found in each cerebellar hemisphere medially and posterolateral to the lateral ventricle. Pathologies of the dentate nucleus can be detected using computed tomography and magnetic resonance imaging of the brain. Here, we present a case series of seven different dentate nucleus diseases and their neuroimaging findings recovered from archives of our institution..


  • Petridis AK. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 147'
    Abstract
    None.


  • Raina SK, Raina S, Chander V, Grover A, Singh S, Bhardwaj A. Development of a cognitive screening instrument for tribal elderly population of Himalayan region in northern India. Journal of Neurosciences in Rural Practice 2013; 4: (2) 147-53'
    Abstract
    INTRODUCTION: Cognitive impairment, characteristic of dementia, is measured objectively by standard neuropsychological (cognitive) tests. Given the diversity of culture and language in India, it is difficult to use a single modified version of MMSE uniformly to Indian population. In this article, we report methods on the development of a cognitive screening instrument suitable for the tribal (Bharmour) elderly (60 years and above) population of Himachal Pradesh, India. MATERIALS AND METHODS: We used a systematic, item-by-item, process for development of a modified version of MMSE suitable for elderly tribal population. RESULTS: The modifications made in the English version of MMSE and the pretesting and pilot testing thereof resulted in the development of Bharmouri version of cognitive scale. DISCUSSION: The study shows that effective modifications can be made to existing tests that require reading and writing; and that culturally sensitive modifications can be made to render the test meaningful and relevant, while still tapping the appropriate cognitive domains..


  • Al-Mendalawi MD. A single center study of epidemiology of neural tube defects. Journal of Neurosciences in Rural Practice 2017; 8: (1) 147-8'
    Abstract
    None.


  • Kumar MV, Savida P. Pediatric stiff-person syndrome with renal failure. Journal of Neurosciences in Rural Practice 2016; 7: (1) 147-9'
    Abstract
    Stiff-person syndrome (SPS) is an autoimmune neuronitis with progressive myoclonus and stiffness. It is a rare but treatable disorder with few case reports in children. SPS is due to autoantibodies against the enzyme glutamic acid decarboxylase which is present in neuronal and nonneuronal tissues. This is the case report of an 8-year-old boy with clinical and investigational features suggestive of SPS with associated myoglobin-induced renal failure, who completely recovered with treatment..


  • Menendez RH, Erice SG, Vazquez EA, Breitburd K. Infratentorial Epidural Abscess Secondary to Furunculosis: Case Report and a Review of the Literature. Journal of Neurosciences in Rural Practice 2019; 10: (1) 148-50'
    Abstract
    The authors describe a case of infratentorial epidural abscess caused by community-associated methicillin-resistant Staphylococcus aureus (CA-MRSA) in a patient with a recent history of cutaneous furunculosis. This 29-year-old male presented with an occipital headache associated with fever, vomiting, and neck stiffness. Admission magnetic resonance imaging showed a retrocerebellar epidural abscess. Antimicrobial therapy was started, and the patient underwent craniectomy for evacuation of the abscess. Cultures of the surgical specimen were consistent with CA-MRSA. Postoperatively, the patient's condition improved with the resolution of symptoms, and he was discharged home with indication of 6 weeks of antibiotic therapy. Furunculosis is a very rare cause of intracranial epidural abscess but should be considered as a source of infection in an immunocompetent patient..


  • Sawarkar D, Satyarthee GD, Singh P, Gurjar H, Singh MM, Sharma BS. Developing Cerebral Venous infarct presenting with seizure occurring after lumbar drain placement following Trans-sphenoidal Surgery of Cushing's disease: Review of literature. Journal of Neurosciences in Rural Practice 2017; 8: (1) 148-50'
    Abstract
    None.


  • Greenfield LJ. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 149-50'
    Abstract
    None.


  • Sun D. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 149-50'
    Abstract
    None.


  • Jha RK, Mohanty CB, Deopujari CE, Shaikh ST. Upper Cervical Bronchogenic Cyst: A Rare Condition at a Rare Location. Journal of Neurosciences in Rural Practice 2018; 9: (1) 149-51'
    Abstract
    Intraspinal bronchogenic cyst (SBC) is a rare but important cause of spinal cord compression, commonly seen in the cervicothoracic spine. We report a case of a 43-year-old male, presenting with complaints of neck pain, radiating to right shoulder, with numbness of right hand and fingers. Magnetic resonance imaging of the cervical spine revealed an intradural extramedullary, ventral cystic lesion extending from C2 to C4 vertebral levels. Complete surgical excision was performed, and the patient had a complete relief of symptoms postoperatively. Only 11 cases of SBCs have been reported in literature. We discuss the peculiar location of this lesion, possible embryological reasons and the overall surgical outcome of SBC..


  • Ambroise MM. Commentary. Journal of Neurosciences in Rural Practice 2015; 6: (1) 15-6'
    Abstract
    None.


  • Deepika A. Commentary. Journal of Neurosciences in Rural Practice 2015; 6: (2) 150-1'
    Abstract
    None.


  • Chatterjee K, Ghosh A, Sengupta RS. A toe that pointed the wrong way: An unusual presentation of tetanus. Journal of Neurosciences in Rural Practice 2016; 7: (1) 150-2'
    Abstract
    We report the case of a 15-year-old girl who was initially diagnosed to have a striatal toe. Her condition progressed and she later developed clinical features consistent with tetanus. History of blunt trauma to nose was elicited retrospectively. Antimicrobial therapy with metronidazole and both active and passive immunization was started immediately. The patient went on to make a complete recovery..


  • Singla S, Prabhakar V, Singla RK. Role of transcutaneous electric nerve stimulation in the management of trigeminal neuralgia. Journal of Neurosciences in Rural Practice 2011; 2: (2) 150-2'
    Abstract
    BACKGROUND: Trigeminal neuralgia typically involves nerves supplying teeth, jaws and face of older females. Though the etiology is usually obscure, different treatment modalities have been tried for it viz. medicinal treatment, injection alcohol, peripheral neurectomy, rhizotomy, and microvascular decompression etc. Transcutaneous electric nerve stimulation (TENS) is an emerging and promising option for management of such patients. AIMS AND DESIGN: The present study was designed with an aim to study the efficacy of TENS in management of trigeminal neuralgia. MATERIALS AND METHODS: The study was conducted on 30 patients of trigeminal neuralgia confirmed by diagnostic nerve block. They were given bursts of TENS for 20-40 days over the path of the affected nerve and subsequently evaluated at 1 month and 3 month intervals by visual analogue scale (VAS), verbal pain scale (VPS), a functional outcome scales for main daily activities like sleep, chewing, talking, or washing face. RESULTS: The results showed that, on VAS, the score decreased from 8.9 (Pre TENS) to 3.1 at 1 month and 1.3 at 3 months, and on VPS, the score decreased from 3.5 (Pre TENS) to 1.2 at 1 month and 0.3 at 3 months. Similarly, a considerable decrease in scores was seen on functional outcome scale for different activities. No side effects like irritation or redness of skin were seen in any of the patients. CONCLUSIONS: Thus, TENS was found to be a safe, easily acceptable, and non-invasive outdoor patient department procedure for management of trigeminal neuralgia..


  • Luis H. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 151'
    Abstract
    None.


  • Kuriakose CK, Mishra AK, Vanjare HA, Raju A, Abraham OC. Visual Disturbance in Patients with Cryptococcal Meningitis: The Road Ahead. Journal of Neurosciences in Rural Practice 2017; 8: (1) 151-2'
    Abstract
    None.


  • Okunlola AI, Adeolu AA. Chance Fracture in an Unbelted Rear Seat Passenger. Journal of Neurosciences in Rural Practice 2019; 10: (1) 151-3'
    Abstract
    Chance fracture occurs from flexion-distraction injury in motor vehicle road crash usually when the patient is on a seat belt. It is often associated with intra-abdominal injuries. We managed a 22-year old female unbelted rear seat passenger of a bus which was involved in a lone accident. We highlighted the possible mechanism of chance fracture in an unbelted passenger and satisfactory spinal stability on conservative care with neither internal nor external fixation..


  • Altunrende ME, Hamamcioglu MK, Hicdonmez T, Akcakaya MO, Birgili B, Cobanoglu S. Microsurgical training model for residents to approach to the orbit and the optic nerve in fresh cadaveric sheep cranium. Journal of Neurosciences in Rural Practice 2014; 5: (2) 151-4'
    Abstract
    BACKGROUND: Neurosurgery and ophthalmology residents need many years to improve microsurgical skills. Laboratory training models are very important for developing surgical skills before clinical application of microsurgery. A simple simulation model is needed for residents to learn how to handle microsurgical instruments and to perform safe dissection of intracranial or intraorbital nerves, vessels, and other structures. MATERIALS AND METHODS: The simulation material consists of a one-year-old fresh cadaveric sheep cranium. Two parts (Part 1 and Part 2) were designed to approach structures of the orbit. Part 1 consisted of a 2-step approach to dissect intraorbital structures, and Part 2 consisted of a 3-step approach to dissect the optic nerve intracranially. RESULTS: The model simulates standard microsurgical techniques using a variety of approaches to structures in and around the orbit and the optic nerve. CONCLUSIONS: This laboratory training model enables trainees to gain experience with an operating microscope, microsurgical instruments and orbital structures..


  • Macedo M, Reis D, Cerullo G, Florêncio A, Frias C, Aleluia L, et al.. Stroke due to Percheron Artery Occlusion: Description of a Consecutive Case Series from Southern Portugal. Journal of Neurosciences in Rural Practice 2022; 13: (1) 151-4'
    Abstract
    The artery of Percheron (AOP) is an abnormal variant of the arterial supply of the thalamus. Stroke caused by AOP occlusion is seldom reported. AOP leads to bilateral thalamic and rostral midbrain infarct presenting with unspecific manifestations. There are few descriptions of case series of stroke caused by AOP. We sought to review the clinicoradiological characteristics of AOP infarction from Algarve, Southern Portugal. Eight consecutive cases were retrospectively identified by searching the electronic clinical charts, as well as the stroke Unit database (2015–2020). Sociodemographic (age and gender) and clinicoradiological characteristics (etiological classification, admission severity, manifestations, and short- and long-term prognoses) were retrieved. The corresponding frequency of AOP infarction was 0.17% (95% confidence interval: 0.05–0.28). The mean age was 67.1 (range: 60–80) years. The range of stroke severity evaluated assessed by the National Institute of Health Stroke Scale ranged from 5 to 23 (median?=?7.5). None of the patients receive acute ischemic stroke reperfusion treatment. AOP patterns were isolated bilateral paramedian thalamic ( n ?=?2), bilateral paramedian and anterior thalamic ( n ?=?2), and bilateral paramedian thalamic with rostral midbrain ( n ?=?4). Two patients (20%) died on the short term (30 days). At hospital discharge, six patients had functional disability of ?2 on the modified Rankin scale. In the follow-up at 6 months, half ( n ?=?3) of the survivors had persistent hypersomnia and two had vascular dementia. Stroke from AOP presents with variable clinical and radiological presentations and patients do not receive alteplase. The short-term survivor and the long-term functional independency can be compromised after AOS infarct..


  • Onder H, Guncu O, Hasgul B, Dayangac I, Gungorer B. The Reliability of the Evaluation of Diffusion-Weighted Imaging in Suspected Stroke by Emergency Physicians. Journal of Neurosciences in Rural Practice 2020; 11: (1) 151-5'
    Abstract
    Background Stroke is a leading cause of serious disability and death and its accurate and timely diagnosis is critical for better stroke outcomes. However, recent studies indicate that stroke is among the most common dangerous missed diagnoses. Diffusion-weighted imaging (DWI), which was first introduced in the early 1990s among clinical concerns, has become an invaluable tool in the evaluation processes of patients with suspected ischemic stroke. Objective Herein, it is aimed to investigate the reliability of the interpretation of DWI in the diagnosis of stroke by emergency physicians. Methods DWIs of the patients, evaluated in the Emergency Service of Yozgat City Hospital from April 1, 2017 to September 1, 2017, were retrospectively evaluated by four emergency physicians (specialists) separately in a blind and random fashion. The reliability of the evaluations was calculated using Kappa analyses on SPSS Statistics 20. Results DWI of 154 patients was enrolled in this study. Kappa values were determined to be as 0.911 (almost perfect), 0.909 (almost perfect), 0.897 (almost perfect), 0.779 (substantial), respectively. Discussion The results of this study may suggest that the reliability of DWI interpretation by emergency physicians was pretty high, even it can still be improved. Combining the literature data remarking a substantial number of misdiagnosed stroke patients in the emergency department (ED) and study results, it can be hypothesized that the major problem may be related with rather clinical evaluation processes as well as insufficient neurology consultation. Future reports are warranted to understand the basic problems of stroke evaluation processes in the ED. The results of these studies may aid to develop better solutions while constituting effective stroke programs and initiatives..


  • Bhardwaj P, Sharma M, Ahluwalia K. Joubert Syndrome with Orofacial Digital Features. Journal of Neurosciences in Rural Practice 2018; 9: (1) 152-4'
    Abstract
    Joubert syndrome (JS) is an autosomal recessive inherited disorder characterized by hypotonia, cerebellar vermis hypoplasia, ocular abnormalities (e.g., pigmentary retinopathy, oculomotor apraxia, and nystagmus), renal cysts, and hepatic fibrosis. Respiratory abnormalities, as apnea and hyperpnea, may be present, as well as mental retardation. Since the clinical findings of JS are quite heterogeneous, determination of radiological findings is essential..


  • Ding D, Bok AP. Acute subdural hematoma from a ruptured aneurysm of the distal middle cerebral artery. Journal of Neurosciences in Rural Practice 2017; 8: (1) 152-4'
    Abstract
    None.


  • Ali FM, Prasant M, Pai D, Aher VA, Kar S, Safiya T. Peripheral neurectomies: A treatment option for trigeminal neuralgia in rural practice. Journal of Neurosciences in Rural Practice 2012; 3: (2) 152-7'
    Abstract
    BACKGROUND: Trigeminal neuralgia is a commonly diagnosed neurosensory disease of head, neck and face region, involving 5(th) cranial nerve. Carbamazepine is the first line drug if there is decrease in efficacy or tolerability of medication, surgery needs to be considered. Factors such as pain relief, recurrence rates, morbidity and mortality rates should be taken in to account while considering which technique to use. Peripheral neurectomy is a safe and effective procedure for elderly patients and in rural and remote centers where neurosurgical facilities are not available. It is also effective in those patients who are reluctant for major neurosurgical procedures. Although loss of sensation along the branches of trigeminal nerve and recurrence rate are associated with peripheral neurectomy, we consider it as the safe and effective procedure in rural practice, which can be done under local anesthesia. AIMS: The aim of this prospective study is to evaluate the long term efficacy of peripheral neurectomy with and without the placement of stainless steel screws in the foramina and to calculate the mean remission period after peripheral neurectomies for different branches of trigeminal nerve. SETTING AND DESIGN: The sample was divided into 2 groups by selecting randomly the patients, satisfying inclusion criteria. Both groups were operated under local anesthesia by regional nerve blocks. In one group of patients after peripheral neurectomy, the proximal nerve stump was left alone in the foramina, and in another group of patients, obturation of foramina was done with stainless steel screws after peripheral neurectomy. MATERIALS AND METHODS: Peripheral neurectomy was done on the terminal branches of trigeminal nerve in 14 patients. We selected only those cases that were experiencing pain after Carbamazepine therapy, all our patients were from rural and remote areas where facilities to neurosurgical centers are limited. Elderly patients who were unfit for surgical procedures and those patients who were reluctant for major neurosurgical treatments were considered for the study. RESULTS: Post-surgical pain relief varied from 15 months to 24 months in cases where neurectomy was done without placing stainless steel screws in the foramina. Those cases where peripheral neurectomy was done along with the placement of stainless steel screws in the foramina, none of the patient had painful symptoms even after minimum 2 years of follow-up. Student's `t`-test of 2 groups showed the remission period to be statistically highly significant in patients with stainless steel screw obturation, having P-value <0.0005.Obturating the foramen with stainless steel screws can prevent nerve regeneration. Thus, remission of pain can be prolonged. CONCLUSION: Peripheral neurectomy is thus a safe and effective procedure for elderly patients, for those patients living in remote and rural places that cannot avail major neurosurgical facilities, and for those patients who are reluctant for major neurosurgical procedures..


  • Kurwale NS, Suri V, Srivastava A, Suri A, Mohanti S, Yadav P, et al.. Role of bone marrow derived pluripotent stem cells in peripheral nerve repair in adult rats: A morphometric evaluation. Journal of Neurosciences in Rural Practice 2015; 6: (2) 152-9'
    Abstract
    OBJECTIVES: Semi-quantitative and quantitative assessment of the effect of bone marrow-derived mononuclear cells (BM-MNC) on early and late phase of nerve regeneration in rat sciatic nerve model. MATERIALS AND METHODS: Sciatic nerve transection and repair was performed in 50 inbred female Wistar albino rats divided equally in two groups. In the test group the gap was filled with BM-MNCs obtained from the two male rats and fibrin sealant, while in the control group only fibrin sealant was used. Sciatic nerve was harvested at 15 days and at 60 days interval. Parameters of regeneration were assessed at anastomosis (G), intermediate distal (C), and distal site (A). Semi-quantitative (histopathological) and quantitative (morphometric) parameters were analyzed. RESULTS: At 15 days there was a statistically significant difference found in mean axon diameter, mean nerve thickness and myelin thickness at the repair site (P < 0.05). However, in the distal areas, the axons were sparse and myelin rings were very thin in both the groups. At 60 days, the difference in above-mentioned parameters was statistically significant at the distal most sites. FISH assay confirmed the presence of Y chromosome, confirming the presence of BM-MNCs from the male rats. CONCLUSIONS: Transplanting BM-MNCS at the site of peripheral nerve injury leads to significantly better recovery. These differences were evident at the repair site and at the intermediate distal site at 15 days and at the distal most sites at 60 days. With practically no ethical issue regarding their isolation and application, they can be easily used for clinical trials..


  • Gambini O. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 153-4'
    Abstract
    None.


  • Mangaraj S, Choudhury AK, Mohanty BK, Baliarsinha AK. Neurological manifestations of Graves' disease: A case report and review of the literature. Journal of Neurosciences in Rural Practice 2016; 7: (1) 153-6'
    Abstract
    Graves' disease (GD) is characterized by a hyperfunctioning thyroid gland due to stimulation of the thyroid-stimulating hormone receptor by autoantibodies directed against it. Apart from thyrotoxicosis, other clinical manifestations include ophthalmopathy, dermopathy, and rarely acropachy. GD is an organ-specific autoimmune disorder, and hence is associated with various other autoimmune disorders. Myasthenia gravis (MG) is one such disease, which is seen with patients of GD and vice versa. Though the association of GD and myasthenia is known, subtle manifestations of latter can be frequently missed in routine clinical practice. The coexistence of GD and ocular MG poses a significant diagnostic dilemma to treating physicians. The ocular manifestations of myasthenia can be easily missed in case of GD and falsely attributed to thyroid associated ophthalmopathy due to closely mimicking presentations of both. Hence, a high degree of the clinical vigil is necessary in such cases to appreciate their presence. We present a similar case which exemplifies the above said that the clinical challenge in diagnosing coexistent GD and ocular myasthenia..


  • Menon S, Bharadwaj R, Chowdhary A, Kaundinya D, Palande D. Tuberculous brain abscesses: Case series and review of literature. Journal of Neurosciences in Rural Practice 2011; 2: (2) 153-7'
    Abstract
    INTRODUCTION: Tuberculous brain abscess (TBA) is a rare but serious condition. It resembles a pyogenic brain abscess clinically and radiologically and poses a problem in diagnosis and treatment. A final diagnosis is established by smear or culture demonstration of acid fast bacilli (AFB) within the abscess. Here, we report four such cases in our five-year study on brain abscesses, along with the different diagnostic modalities used. MATERIALS AND METHODS: A total of 75 brain abscess pus specimens were collected during neurosurgery, either by burr hole or by craniotomy. These specimens were further subjected to Gram stain, Ziehl-Neelsen (ZN) stain, and conventional microbiological culture. Only those cases which showed presence of AFB on ZN stain along with the growth of Mycobacterium tuberculosis were considered as TBAs. Such TBA cases were further presented along with their In vitro Proton Magnetic Resonance (MR) Spectroscopic findings. RESULTS: Of these four patients, three were males. Though this condition is more commonly seen in immunocompromised patients, three of the patients in this study were immunocompetent. All the four pus specimens showed presence of AFB in the ZN stain. Three of them grew M. tuberculosis as sole isolate. The fourth case was of concomitant tuberculous and pyogenic brain abscess. In vitro Proton MR spectroscopy of the pus specimens showed absence of multiple amino acids at 0.9 ppm, which was found to be hallmark of TBA. One patient died of four. CONCLUSIONS: TBA always poses a diagnostic dilemma. ZN stain and conventional microbiological culture for Mycobacteria always help to solve this dilemma. In vitro Proton MR Spectroscopy also seems to have the diagnostic utility..


  • Rehman T, Singh T, Sharma S, Kumar J, Govindan D, Singh SM. Prevalence of Depression and Anxiety during the COVID-19 Pandemic among the Residents of an Urban Slum in North India. Journal of Neurosciences in Rural Practice 2021; 12: (1) 153-8'
    Abstract
    Objectives This study aimed to estimate the prevalence of depression and anxiety, and assess the knowledge, practice, and concerns regarding coronavirus disease 2019 (COVID-19) among the residents of an urban slum in Chandigarh, India. Materials and Methods Participants were screened using Patient Health Questionnaire-9 and Generalized Anxiety Disorder-7 scales. Results The mean (standard deviation) age of 200 enrolled participants was 33 (13) years with 83% ( n = 166) being females. The prevalence of depression and anxiety was 3.5% (95% confidence interval [CI]: 0.95-6.05) and 2.5% (95% CI: 0.34-4.66), respectively. Of total, 46% ( n = 92) knew that COVID-19 can transmit through droplets and 30.5% ( n = 61) were concerned that they might get infected with disease. Half of the participants ( n = 100) believed that there was unnecessary worry regarding COVID-19 and 78% ( n = 156) covered mouth while coughing or sneezing. Conclusion To cope with this critical situation, it is necessary to strengthen the awareness programs targeting the mental health issues of the people..


  • Nebhinani N. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 154-5'
    Abstract
    None.


  • Umashankar MS, Kumar AB. Clinical Case Presentation on Absence Seizures Diagnosis and Treatment Care Services and Outcomes in an Adult Patient. Journal of Neurosciences in Rural Practice 2019; 10: (1) 154-7'
    Abstract
    Absence seizures are often associated with impaired or loss of consciousness clinically proved to have an impact on motor and cognitive abnormalities of the nerve cells of the brain. Seizure admits several etiopathophysiological events leading to several neurofunctional changes in the reticulothalamocortical circuitry zones of the central nervous system. This paves the episodes of absence seizure events. A clinical case report of absence seizure in a 25 years age adult patient came to the hospital with impaired consciousness. The brain magnetic resonance imaging scanning of the patient detected a small focal flair hypertensive area in the right parasellar region close to cavernous sinus with mild flair hypersensitivity in the left cavernous sinuses, right maxillary, and ethmoid sinusitis. The electroencephalogram of the brain showed normal waves with electrode artifacts was observed. The patient was confirmed with absence seizures, and he was treated with oxcarbazepine 150 mg twice daily. The patient was recovered from seizure and discharged with medications. He was called for follow-up examination once in 3-month period..


  • Savardekar AR, Shukla D. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 155-6'
    Abstract
    None.


  • Katyal N, Korzep A, Newey C. Inadvertent Central Arterial Catheterization: An Unusual Cause of Ischemic Stroke. Journal of Neurosciences in Rural Practice 2018; 9: (1) 155-8'
    Abstract
    Central venous catheter (CVC) insertion is extensively utilized in Intensive Care Units for evaluation of hemodynamic status, administration of intravenous drugs, and for providing nutritional support in critically ill patients. Unfortunately, CVC use is associated with complications including lung injury, bleeding, infection, and thrombosis. We present a patient with an acute ischemic stroke from an inadvertently placed CVC into the right common carotid artery. A 57-year-old male presented to our institution for left hemiplegia and seizures 2 days after a CVC was placed. He was found to have a right frontal ischemic stroke on computed tomography (CT). CT angiography noted that the catheter was arterial and had a thrombosis around it. He was started on a low-dose heparin infusion. A combination of cardiothoracic surgery and interventional cardiology was required to safely remove the catheter. Central arterial catheterization is an unusual cause for acute ischemic stroke and presents management challenges..


  • Das SK, Sekar A, Jaidev S, Patnaik A, Sahu RN. Contiguous-Level Unilateral Cervical Spine Facet Dislocation—A Report of a Less Discussed Subtype. Journal of Neurosciences in Rural Practice 2022; 13: (1) 155-8'
    Abstract
    Unilateral facet dislocation of subaxial cervical spine trauma is characterized by dislocation of inferior facet of superior vertebra over the superior facet of inferior vertebra. The injury is due to high-velocity trauma and associated with instability of spinal column. Such unilateral facet dislocations occurring at multiple adjacent levels for some reason are not reported or studied frequently. We have reported two cases of multiple-level dislocation of unilateral facets managed in our hospital with a review of available literature. The injury occurs as one side of the motion segment translates and rotates around an intact facet on the contralateral side. The major mechanism of injury is distractive flexion injury with axial rotation component. The injury is associated with instability secondary to loss of the discoligamentous complex. In cases with multiple-level dislocations of unilateral cervical facets, there are multiple mechanisms associated with significant neurological injury and most of them succumb at the site of injury. Only three other cases are available in English language literature. The neurological outcome is invariably poor. Multiple-level facet dislocations of subaxial cervical spine are reported sparsely in literature. We suspect that due to high-velocity nature of these injuries, most of them succumb soon after injury and not often reported. This article reports two cases of contiguous-level unilateral facet dislocation of subaxial cervical spine with associated injuries and the outcomes with review of literature..


  • Khan MN, Sharfuzzaman A, Mostafa MG. Spinal cord compression as initial presentation of metastatic occult follicular thyroid carcinoma. Journal of Neurosciences in Rural Practice 2014; 5: (2) 155-9'
    Abstract
    Metastatic tumors are the most common tumors of the spine, accounting for 98% of all spine lesions. But spinal cord compression as the initial presentation of metastatic occult follicular carcinoma without any thyroid enlargement is unusual and relatively rare. This report describes a 35-years-old female patient presenting with paraplegia and urinary incontinence for the last two months. She had no thyroid enlargement; no thyroid related symptoms and her biochemical thyroid profile was normal. Magnetic resonance imaging (MRI) of spine shows a huge mass compressing the spinal cord at D11-D12 involving both the spinal and paraspinal areas. The patient was treated by surgery and radioiodine ablation as the histopathology showed metastatic follicular thyroid carcinoma. This case was reported because of the rarity of the disease. Early diagnosis and initiation of the treatment should promise a good prognosis for a patient with metastatic spinal cord compression..


  • Goel A. Subdural hematoma and mycotic aneurysm bleed. Journal of Neurosciences in Rural Practice 2017; 8: (1) 156'
    Abstract
    None.


  • Menon G. Commentary. Journal of Neurosciences in Rural Practice 2017; 8: (1) 156-7'
    Abstract
    None.


  • Adeolu AA, Azeez AL. Evaluation of spinous process wiring techniques for accidental canal penetration. Journal of Neurosciences in Rural Practice 2013; 4: (2) 156-8'
    Abstract
    BACKGROUND AND OBJECTIVE: Accidental canal penetration with attendant complications constitutes one of the reasons for abandoning the use of wires for posterior spinal fusion techniques. However, there is dearth of information on this risk when the wire is introduced through the base of spinous process as against sublaminar passage. This study was designed to evaluate hardware-related postoperative complications, especially canal penetration, in our patients who had spinal process wiring in two types of posterior wiring techniques. MATERIALS AND METHODS: Patients who had either of two spinous process wiring techniques formed the population for the study. The clinical records were reviewed and the following data were extracted: Age, sex, diagnosis, operation (fusion type), preoperative neurological status, postoperative neurologic deterioration, other postoperative complication and radiologic evidence of canal encroachment. RESULTS: One hundred and seventy four spinous processes were instrumented in 42 patients. The age of the patients ranged from 11 to 78 years while male to female ratio was 2.5:1. Majority of the spinal wiring were for trauma (29 patients; 69.0) while the remaining were tumor (6; 14.3%), degenerative diseases (4; 9.5%) and infections (3; 7.1%). The Rogers technique was performed in 16 (38.1%) patients while 26 (61.9%) underwent Adeolu et al. technique. One patient (2.3%) had neurologic deterioration while 5 patients (11.1%) had varying type of complications from wound infection to fracture of spinous processes. There was no patient with radiological or clinical evidence of canal compromise. CONCLUSION: Spinous process wiring techniques for posterior spinal stabilization appears to be safe as demonstrated in this study..


  • Menon B, Ramalingam K, Kumar R. Evaluating the Role of Oxidative Stress in Acute Ischemic Stroke. Journal of Neurosciences in Rural Practice 2020; 11: (1) 156-9'
    Abstract
    Background The role of oxidative stress in neuronal injury due to ischemic stroke has been an interesting topic in stroke research. Malondialdehyde (MDA) has emerged as a sensitive oxidative stress biomarker owing to its ability to react with the lipid membranes. Total antioxidant power (TAP) is another biomarker to estimate the total oxidative stress in stroke patients. We aimed to determine the oxidative stress in acute stroke patients by measuring MDA and TAP. Materials and Methods MDA and TAP were determined in 100 patients with ischemic stroke and compared with that in 100 age- and sex-matched healthy adults. Demographic data, stroke severity measured by the National Institutes of Health Stroke Scale (NIHSS), and disability measured by the Barthel index (BI) were recorded. The association of MDA and TAP with other variables was analyzed by paired t -test. Results Of the whole sample, 74% represented males. The mean NIHSS score was 13.11 and BI was 38.87. MDA was significantly higher in stroke patients (7.11 +/- 1.67) than in controls (1.64 +/- 0.82; p = 0.00). TAP was significantly lower in stroke patients (5.72 +/- 1.41) than in controls (8.53 +/- 2.4; p = 0.00). The lipid profile and blood sugar levels were also significantly higher in stroke patients. There was no association of MDA and TAP with other variables. Conclusion We found that oxidative stress was associated with acute ischemic stroke. However, we could not establish an association between oxidative stress and the severity of acute stroke..


  • Jasti DB, Naveen Prasad SV, Naveen T, Vengamma B. Kikuchi-Fujimoto disease presenting as brainstem encephalitis with secondary blepharospasm. Journal of Neurosciences in Rural Practice 2016; 7: (1) 157-60'
    Abstract
    Central nervous system involvement in Kikuchi-Fujimoto disease is a very rare clinical manifestation. We report a 15-year-old girl who presented to us with fever, drowsiness, neck swellings, and involuntary closure of both eyelids of 2 days duration. Magnetic resonance imaging brain showed T2-weighted and fluid-attenuated inversion recovery hyperintensities in dorsal midbrain and pons. Cervical lymph node fine-needle aspiration cytology was suggestive of Kikuchi-Fujimoto disease. Blepharospasm secondary to infectious etiology is rare. Positron emission computed tomography brain showed increased focal uptake in anterior cingulate gyrus which can be the site of origin of blepharospasm. The patient was managed with steroids and trihexyphenidyl with significant recovery. Kikuchi-Fujimoto disease is a rare disease which has to be considered as one of the differential diagnosis in a case of acute encephalopathy with cervical lymphadenopathy..


  • Shukla D. Commentary. Journal of Neurosciences in Rural Practice 2011; 2: (2) 157-8'
    Abstract
    None.


  • Ngeow WC. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 158'
    Abstract
    None.


  • Gupta V, Aggarwal K, Nishant P, Arora RK. Rare Case of Sellar and Suprasellar Metastasis from Ewing's Sarcoma of Tibia. Journal of Neurosciences in Rural Practice 2019; 10: (1) 158-61'
    Abstract
    We hereby report a case of metastatic Ewing's sarcoma presenting with rapid-onset total ophthalmoplegia, optic atrophy, and right temporal hemianopia. Comprehensive ophthalmic and neurological evaluation with targeted radioimaging revealed a tumor mass centered over the sella, compressing optic chiasma, extending to involve the left cavernous sinus and the left orbital apex. Whole-body imaging revealed the evidence of multifocal lung and mediastinal metastasis with focal lytic defect in the left femoral head. Histopathological evaluation of transnasal punch biopsy from the nasopharyngeal extension of the tumor revealed small round-cell tumor with strong CD99 positivity, supporting the diagnosis of Ewing's sarcoma. Rapid, aggressive extensions of the metastatic tumor into vital structures despite the initiation of chemoradiation of the extensive intracranial tumor led to unexpected demise of the patient. Our case is an unusual case of Ewing's sarcoma metastasis manifesting as a sellar mass and mimicking a pituitary adenoma radiologically, with a rapid progression within 2 weeks to cause massive extension of tumor into suprasellar, infrasellar, and left parasellar area, indicative of highly malignant nature of the tumor..


  • Phadke RV, Agarwal V, Naik S. Multicystic encephalomalacia secondary to head trauma. Journal of Neurosciences in Rural Practice 2017; 8: (1) 158-9'
    Abstract
    None.


  • Mishra AK, Vanjare HA, Raj PM. Cryptococcal meningitis presenting as acute onset bilateral cerebellar infarct. Journal of Neurosciences in Rural Practice 2017; 8: (1) 159-60'
    Abstract
    None.


  • Sandu N, Schaller B. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 159-60'
    Abstract
    None.


  • Krishnan P, Aditya G. Allergic Contact Dermatitis Due to Cervical Collar. Journal of Neurosciences in Rural Practice 2022; 13: (1) 159-60'
    Abstract
    Cervical collars are routinely applied in neurosurgical units following trauma or cervical spine operations. We describe a case of florid allergic contact dermatitis that developed as a complication following collar application in a postoperative patient..


  • Yiotaldiotariotam ZB, Avci E, Torun F, Cengiz M, Cigdem A, Karabag H, et al.. Airway management for occipital encephalocele in neonatal patients: A review of 17 cases. Journal of Neurosciences in Rural Practice 2011; 2: (2) 159-61'
    Abstract
    INTRODUCTION: Encephalocele, midline defect of cranial bone fusion, occurs most frequently in the occipital region. Airway management in pediatric patients with craniofacial disorders poses many challenges to the anesthesiologist. The purpose of this study is to describe the airway problems encountered for such cases, and describe how these problems were managed. MATERIALS AND METHODS: We reviewed the charts of occipital encephalocele newborn that were treated by surgical correction in Harran University Hospital during 2006-2008. The collected data were categorized into preoperative, intraoperative, and postoperative data. RESULTS: The mean age of the patients was 5.17 days. Of these 17 patients, eight patients (47.1%) had hydrocephaly, one patient (5.8%) with Dandy Walker syndrome. Micrognathia, macroglossia, restriction in neck movements were recorded as the reasons in six cases each. No major anesthetic complication was found. CONCLUSIONS: We reported perioperative management in 17 occipital encephalocele infant. Comprehensive care during peroperative period is essential for successful outcome..


  • Munjal S, Srivastava A, Jain S, Mehta VS. Radiologically Indistinguishable Contiguous Meningioma and Schwannoma in the Same Cerebellopontine Angle in a Patient with NF2: Case Report and Literature Review. Journal of Neurosciences in Rural Practice 2018; 9: (1) 159-62'
    Abstract
    None.


  • Rizzo-Sierra CV, Leon SM, Leon-Sarmiento FE. Higher sensory processing sensitivity, introversion and ectomorphism: New biomarkers for human creativity in developing rural areas. Journal of Neurosciences in Rural Practice 2012; 3: (2) 159-62'
    Abstract
    The highly sensitive trait present in animals, has also been proposed as a human neurobiological trait. People having such trait can process larger amounts of sensory information than usual, making it an excellent attribute that allows to pick up subtle environmental details and cues. Furthermore, this trait correlates to some sort of giftedness such as higher perception, inventiveness, imagination and creativity. We present evidences that support the existance of key neural connectivity between the mentioned trait, higher sensory processing sensitivity, introversion, ectomorphism and creativity. The neurobiological and behavioral implications that these biomarkers have in people living in developing rural areas are discussed as well..


  • Olawale OA, Deih AN, Yaadar RK. Psychological impact of cerebral palsy on families: The African perspective. Journal of Neurosciences in Rural Practice 2013; 4: (2) 159-63'
    Abstract
    BACKGROUND: Psychological stress associated with cerebral palsy (CP) is known to be one of the most depressing conditions of families. In the traditional African society, some peculiar factors may contribute to the stress. AIMS: The aims of this study were to identify and describe, from the African perspective, the psychological impact of CP on families and determine the strategies adopted by families in coping with it. SETTINGS AND DESIGN: The study was a cross-sectional descriptive survey conducted in the Physiotherapy Department of a tertiary hospital. MATERIALS AND METHODS: Participants were 52 parents of children with CP. They completed a questionnaire designed to determine the degree of psychological stress on the families and strategies adopted to cope with the stress. STATISTICAL ANALYSIS: Descriptive statistics were used to show responses in graphical formats. RESULTS: Respondents agreed that having adequate knowledge of CP would help them cope well with the demands of taking care of children with CP. 38.5% of respondents said that people in the society accused them of some wrongdoing that has made their children to have CP. Personal problems experienced include loss of job, lack of concentration at work, loss of family joy, and derangement of financial affairs of the family. 26 (50%) of them resort to religious/spiritual intervention as an alternative or complementary mode of treatment for their children while 28% resort to dependence on the extended family system for support. CONCLUSION: Families caring for children with CP generally have a positive attitude towards their children. However, there is need to educate the public on the causes of CP and treatment options available to families..


  • Gopal VV. Degenerative Lumbar Disc Disease: A Questionnaire Survey of Management Practice in India and Review of Literature. Journal of Neurosciences in Rural Practice 2021; 12: (1) 159-64'
    Abstract
    Objective To identify the current management modalities practiced by neurosurgeons in India for degenerative lumbar disc disease. Materials and Methods Survey questionnaires were prepared in Google forms. It covered the following aspects of managing the lumbar disc pathology: (1) Demographic, institutional details, experience of surgeons, (2)choice of surgical procedures, (3) use of endoscopy and minimally invasive techniques, and (4) pre- and postoperative care. Responses obtained were entered in SPSS datasheet and analyzed. Results Of the 300 surveys sent, 80 were returned and response rate was 26.6%. But four surveys were highly incomplete and were discarded from the analysis. So, the study content is from the analysis of practices of 76 spinal surgeons working in different parts of the country. Majority of the spine surgeons ( n = 70) were neurosurgeons, while 6 were orthopaedic surgeons. Fifty-four were from urban area, 12 from semiurban area, and 10 from rural area. Forty-seven spine surgeons practiced in a teaching hospital. Total 73.6% of spine surgeons opted initial medical management. Sixty-three percent preferred microlumbar discectomy (MLD) and only eight neurosurgeons preferred minimally invasive techniques. None of the respondents used in situ fusion. Fifty-three percent of spine surgeons preferred early mobilization (first postoperative day). Fifty-nine percent preferred to follow-up patients clinically and opted for magnetic resonance imaging only when recurrence or infection was suspected. The institutional nature (government teaching, government nonteaching, private teaching, and private nonteaching) and location of the hospital (urban/semiurban/rural) were found to be influencing the preferred surgical technique, trial of medical management, or postoperative care and complications. Considerable practice variations exist for medical and perioperative management. Conclusion The preferred treatment of choice of majority was MLD, although laminectomy and discectomy were still used by many. Consensus lacks in the operative, perioperative, and postoperative management of degenerative disc disease. Present survey points toward the importance of making management guidelines for this common spinal surgical entity..


  • Thomas R. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (1) 16'
    Abstract
    None.


  • Chauhan N, Padhy SK, Shah R, Malhotra S. Vitamin D Deficiency in Children with Psychiatric Illness in a Tertiary Care Hospital in North India. Journal of Neurosciences in Rural Practice 2019; 10: (1) 16-20'
    Abstract
    Background: Vitamin D is increasingly recognized as important for brain health, apart from its role in endocrine and bone health. There is a growing recognition of worldwide "epidemic" of Vitamin D deficiency, and growing data from adult population illustrate the association between Vitamin D deficiency and psychiatric disorders. In children, its role is implicated in brain development, function, and psychiatric disorders. Aim: The aim of this study was to study the extent of Vitamin D deficiency in children and adolescents with psychiatric disorders. Methodology: Retrospective chart review of participants, who had attended the psychiatry outpatient department, was conducted to ascertain the extent of blood Vitamin D level requisition and its level. Results: Out of 836, 60 participants had received the requisition for blood Vitamin D level, and results were documented for 40 participants (males - 28; females - 12). No specific reason was cited for getting Vitamin D level done. The mean Vitamin D level was in the deficient range, i.e. 13.34 ng/ml with 80% of the sample having Vitamin D deficiency and 13% having insufficient Vitamin D level. More males had Vitamin D deficiency, however, the small number of females in the study limits the generalizability of the results. Among the diagnostic categories, neurodevelopmental disorders had lower mean Vitamin D level, with lowest Vitamin D for autism, i.e., 10.9 ng/ml. Conclusion: The cause-effect relationship between Vitamin D deficiency and childhood psychiatric disorders could not be derived from the study. However, it provides important initial data for the relationship between Vitamin D deficiency and childhood psychiatric disorders from India..


  • Kaushik S, Vani K, Chumber S, Anand KS, Dhamija RK. Evaluation of MR Visual Rating Scales in Major Forms of Dementia. Journal of Neurosciences in Rural Practice 2021; 12: (1) 16-23'
    Abstract
    Objective The aim of the study is to visually rate major forms of dementia using global cortical atrophy (GCA), medial temporal lobe atrophy (MTA), and Fazeka's scales and Koedam's score using magnetic resonance imaging (MRI). The purpose is to correlate the visual rating scales (VRS) with severity of dementia. Materials and Methods Thirty patients fulfilling DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for Alzheimer's dementia (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) underwent MRI brain. Cortical atrophy, medial temporal, and parietal lobe atrophy were assessed using GCA and MTA scales and Koedam's score, respectively. White matter hyperintensities were assessed using Fazeka's scale. Correlation between VRS and mini-mental state exam (MMSE) scores was done using Pearson correlation coefficient. Results 70% of patients had Grade 2 GCA. More patients with AD had higher MTA scores as compared with others with 57% of AD patients showing abnormal for age MTA scores. Fazeka's scale was abnormal for age in 58.33% of VaD and 57% AD patients. Majority (75%) showing severe parietal atrophy (Grade 3 Koedam's score) were AD patients. Disproportionate frontal lobe atrophy was seen in all four (100%) FTD patients. Significant negative correlation was seen between MMSE and GCA scores of all patients ( p -value = 0.003) as well as between MTA and MMSE scores in AD patients ( p -value = 0.00095). Conclusion Visual rating of MTA is a reliable method for detecting AD and correlates strongly with memory scores. Atrophy of specific regions is seen more commonly in some conditions, for instance, where MTA and parietal atrophy are specific for AD while asymmetric frontal lobe and temporal pole atrophy favor FTD..


  • Eyenga VC, Esene IN, Bikono EA, Eloundou NJ. Treatment of Cervical Spine Fractures and Subluxations without the Use of Intraoperative Fluoroscopy in Resource-Limited Settings. Journal of Neurosciences in Rural Practice 2020; 11: (1) 160-3'
    Abstract
    Background Surgical management of subaxial cervical spine injuries remains challenging. Although intraoperative fluoroscopy is usually used for intraoperative spinal level localization (SLL), it is unavailable in most developing countries. The surgeon therefore has to rely on anatomic landmarks. In our setting, in the absence of intraoperative fluoroscopy, we used the carotid tubercle for SLL. Herein we evaluate the accuracy and reliability of the carotid tubercle as a landmark during surgery for traumatic cervical spine injury. Methods This was a retrospective cohort study on 34 patients undergoing anterior cervical surgery for subaxial cervical spine fractures and/or subluxation between January 2005 and February 2011. From their medical records, the patients' sociodemographic, clinical, radiological, and operative data were retrieved and analyzed. Results Thirty-four patients were included in the study. The mean age was 36.2 years. Thirty patients were males. The mean duration between the trauma and surgical intervention was 9.6 days. Six patients were completely tetraplegic. Fourteen patients had fractures and 20 patients had subluxation. The carotid tubercle was palpable in all the 34 cases. Twenty-two (68.8%) patients had partial or complete neurologic recovery. Complete anatomic reduction was achieved in 30 cases. One case of slight malalignment of the plate was observed. No case of significant deviation nor penetration of the screw into the vertebral canal was found. One patient died. Conclusions Carotid tubercle, a palpable intrinsic marker, is an attractive anatomic landmark for SLL during surgeries for traumatic spine injuries in resource-limited settings..


  • Chatterjee SS, Mitra S, Guha P, Chakraborty K. Prevalence of restless legs syndrome in somatoform pain disorder and its effect on quality of life. Journal of Neurosciences in Rural Practice 2015; 6: (2) 160-4'
    Abstract
    BACKGROUND: Persistent somatoform pain disorder (SPD) is a condition in which the patient suffers from persistent, severe and distressing pain; and from associated physical and psychological distress. While presence of restless leg syndrome (RLS) in SPD is understudied, their association might have an impact on general well-being and quality of life (QoL) in SPD. AIMS AND OBJECTIVES: Present study aimed at evaluating the prevalence of RLS in SPD patients attending outpatient department services at a tertiary care institute in eastern India. MATERIALS AND METHODS: Two hundred and forty consecutive patients with SPD were screened initially and after applying appropriate inclusion and exclusion criteria, 192 subjects (male = 85, female = 107) were included in the study. Severity of RLS was assessed using a questionnaire of the International Restless Legs Syndrome Study Group and QoL was measured on QoL Enjoyment and Satisfaction Questionnaire-Short Form (Q-LES-Q-SF). RESULTS: Revealed a 28% prevalence of RLS is in patients with SPD, which is much higher than its estimated population prevalence. A larger proportion of those with RLS had continuous course of SPD, longer duration of SPD, and higher daytime sleepiness. They also had poorer scores on Q-LES-Q-SF, indicating a poorer QoL overall. DISCUSSION AND CONCLUSION: This is the first report, to the best of our knowledge, on this aspect from India. While this association between RLS and SPD may have biological explanation based on abnormal monoaminergic neurotransmission system, the findings call for more vigilant approach to SPD patients in order to improve their QoL and add to their well-being..


  • Parthasarathy R, Derksen C, Saqqur M, Khan K. Isolated intermittent vertigo: A presenting feature of persistent trigeminal artery. Journal of Neurosciences in Rural Practice 2016; 7: (1) 161-3'
    Abstract
    Embryonic carotid - basilar anastomosis when persistent in adult life can present with a variety of neurological symptoms. We present a patient with isolated intermittent vertigo attributable to the embryonic anastomosis and describe the different types of persistent trigeminal artery. A 76-year-old Caucasian man presented with isolated intermittent vertigo and symptoms suggestive of anterior and posterior circulation strokes. Impaired vasomotor reactivity was demonstrated on insonation of the anterior and posterior cerebral arteries in this patient with a persistent left trigeminal artery and 75% stenosis of the left internal carotid artery (ICA). The symptom of intermittent vertigo resolved with carotid endarterectomy. Decreased flow across the stenotic segment of the ICA which subserved the posterior circulation resulted in basilar insufficiency. Hypoperfusion to the flocculonodular lobe supplied by the anterior inferior cerebellar artery is a likely cause for the intermittent vertigo..


  • Rao JV, Vengamma B, Naveen T, Naveen V. Lead encephalopathy in adults. Journal of Neurosciences in Rural Practice 2014; 5: (2) 161-3'
    Abstract
    Lead poisoning is a common occupational health hazard in developing countries. We report the varied clinical presentation, diagnostic and management issues in two adult patients with lead encephalopathy. Both patients worked in a battery manufacturing unit. Both patients presented with seizures and one patient also complained of abdominal colic and vomiting. Both were anemic and a lead line was present. Blood lead level in both the patients was greater than 25 microg/dl. Magnetic resonance imaging of brain revealed bilateral symmetric involvement of the thalamus, lentiform nucleus in both patients and also the external capsules, sub-cortical white matter in one patient. All these changes, seen as hyperintensities in T2-weighted images suggested demyelination. They were advised avoidance of further exposure to lead and were treated with anti-epileptics; one patient also received D-penicillamine. They improved well on follow-up. Lead encephalopathy is an uncommon but important manifestation of lead toxicity in adults..


  • Krishnan P, Ray A. Flecked Calcifications in Scalp Tumors: Two Cases of Giant Ulcerated Trichilemmal Cysts. Journal of Neurosciences in Rural Practice 2022; 13: (1) 161-3'
    Abstract
    In the article, the classical radiological findings in trichilemmal cysts of the scalp are described..


  • Santoro JD, Santoro TN. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 162-3'
    Abstract
    None.


  • Onder H. Dyspraxic Gait due to Right Posterior Cerebral Artery Stroke. Journal of Neurosciences in Rural Practice 2018; 9: (1) 162-4'
    Abstract
    None.


  • Aydin S, Kucukyuruk B, Abuzayed B, Aydin S, Sanus GZ. Cranioplasty: Review of materials and techniques. Journal of Neurosciences in Rural Practice 2011; 2: (2) 162-7'
    Abstract
    Cranioplasty is the surgical intervention to repair cranial defects. The aim of cranioplasty is not only a cosmetic issue; also, the repair of cranial defects gives relief to psychological drawbacks and increases the social performances. Many different types of materials were used throughout the history of cranioplasty. With the evolving biomedical technology, new materials are available to be used by the surgeons. Although many different materials and techniques had been described, there is still no consensus about the best material, and ongoing researches on both biologic and nonbiologic substitutions continue aiming to develop the ideal reconstruction materials. In this article, the principle materials and techniques of cranioplasty are reviewed..


  • Ramanathan RS. Cerebral Microbleeds: Treatment Conundrum in Acute Ischemic Stroke. Journal of Neurosciences in Rural Practice 2017; 8: (2) 163'
    Abstract
    None.


  • Yadav YR, Parihar V, Pande S, Namdev H, Agarwal M. Endoscopic third ventriculostomy. Journal of Neurosciences in Rural Practice 2012; 3: (2) 163-73'
    Abstract
    Endoscopic third ventriculostomy (ETV) is considered as a treatment of choice for obstructive hydrocephalus. It is indicated in hydrocephalus secondary to congenital aqueductal stenosis, posterior third ventricle tumor, cerebellar infarct, Dandy-Walker malformation, vein of Galen aneurism, syringomyelia with or without Chiari malformation type I, intraventricular hematoma, post infective, normal pressure hydrocephalus, myelomeningocele, multiloculated hydrocephalus, encephalocele, posterior fossa tumor and craniosynostosis. It is also indicated in block shunt or slit ventricle syndrome. Proper Pre-operative imaging for detailed assessment of the posterior communicating arteries distance from mid line, presence or absence of Liliequist membrane or other membranes, located in the prepontine cistern is useful. Measurement of lumbar elastance and resistance can predict patency of cranial subarachnoid space and complex hydrocephalus, which decides an ultimate outcome. Water jet dissection is an effective technique of ETV in thick floor. Ultrasonic contact probe can be useful in selected patients. Intra-operative ventriculo-stomography could help in confirming the adequacy of endoscopic procedure, thereby facilitating the need for shunt. Intraoperative observations of the patent aqueduct and prepontine cistern scarring are predictors of the risk of ETV failure. Such patients may be considered for shunt surgery. Magnetic resonance ventriculography and cine phase contrast magnetic resonance imaging are effective in assessing subarachnoid space and stoma patency after ETV. Proper case selection, post-operative care including monitoring of ICP and need for external ventricular drain, repeated lumbar puncture and CSF drainage, Ommaya reservoir in selected patients could help to increase success rate and reduce complications. Most of the complications develop in an early post-operative, but fatal complications can develop late which indicate an importance of long term follow up..


  • Bhad R. Red Blood Cell and Platelet Indices: A Potential Biomarker for Panic Disorder. Journal of Neurosciences in Rural Practice 2017; 8: (2) 164'
    Abstract
    None.


  • Diyora B, Bhende B, Dhall G, Kamble H, Nayak N. Subcutaneous Cerebrospinal Fluid Pseudocyst: An Unusual Complication of Ventriculoperitoneal Shunt. Journal of Neurosciences in Rural Practice 2019; 10: (1) 164-5'
    Abstract
    None.


  • Aarab C, Aalouane R, Boujraf S, Rammouz I. Delicate Situation of Bipolar Disorder and Interferon Therapy. Journal of Neurosciences in Rural Practice 2018; 9: (1) 164-6'
    Abstract
    None.


  • Ng CF, Tan HJ. Parietal Hand Weakness in a Patient with Astrocytoma. Journal of Neurosciences in Rural Practice 2022; 13: (1) 164-6'
    Abstract
    None.


  • Gupta K, Sood S, Modi J, Gupta R. Imaging in Hirayama disease. Journal of Neurosciences in Rural Practice 2016; 7: (1) 164-7'
    Abstract
    Hirayama disease, also known as Sobue disease is a rare nonprogressive spinal muscular atrophy. Here, we report a case series of three young males presenting with atrophy of distal upper limb and Hirayama disease as their clinico-radiological diagnosis. Magnetic resonance imaging (MRI) revealed loss of cervical lordosis with focal areas of lower cervical cord atrophy in a neutral position. MRI in flexion position revealed, anterior displacement of the detached posterior dura from the underlying lamina compressing the thecal sac and widened posterior epidural space with flow voids seen better on 3D-CISS images. All the three patients were managed conservatively..


  • Mojumder DK, Toledo JD. Hyperdense large artery sign in meningitis: A marker of ominous thrombogenic potential of pneumococcus?. Journal of Neurosciences in Rural Practice 2014; 5: (2) 164-7'
    Abstract
    Hyperdensity in the middle cerebral artery (MCA) or posterior cerebral artery (PCA) on non-contrast head CT, suggests the presence of a thrombus inside these vessels, often referred to as the "MCA sign" or "PCA sign" respectively. These two signs are classically associated with strokes secondary to cardiovascular etiologies and are only infrequently reported with other types of stroke. Whereas stroke is a recognized complication of pneumococcal meningitis hyperdense large vessel sign (in this case a combination of MCA and PCA) has not been previously reported. We report a case of rapidly progressive pneumococcal meningitis that presented as acute stroke involving large vessels in the vicinity of the circle of Willis in a patient with a history of non-Hodgkin lymphoma (NHL) in remission for 6 years. This patient had received a week of high dose steroids before admission. Head CT scan on admission showed the presence of hyperdense MCA and PCA signs. The patient rapidly deteriorated and a follow-up head CT revealed diffuse brain edema and increased density in the basal cisterns without evidence of sub arachnoid hemorrhage. Tc99m exametazime brain flow scan showed no intracerebral blood flow both supra and infratentorially. Steptococcus pneumoniae, NHL cells and high-dose steroid use can upregulate tissue factor synthesis and may have led to a hypercoagulable state via activation of the extrinsic pathway in the large intracerbral arteries..


  • Zamani M, Hassanshahi J, Soleimani M, Zamani F. Neuroprotective effect of olive oil in the hippocampus CA1 neurons following ischemia: Reperfusion in mice. Journal of Neurosciences in Rural Practice 2013; 4: (2) 164-70'
    Abstract
    INTRODUCTION: Transient global ischemia induces selective, delayed neuronal death of pyramidal neurons in the hippocampal CA1. Oxidative Stress is considered to be involved in a number of human diseases including ischemia. Preliminary studies confirmed reduction of cell death in brain following treatment with antioxidants. AIM: According to this finding, we study the relationship between consumption of olive oil on cell death and memory disorder in brain ischemia. We studied the protective effect of olive oil against ischemia-reperfusion. MATERIAL AND METHODS: EXPERIMENTAL DESIGN INCLUDES THREE GROUPS: Intact (n = 8), ischemic control (n = 8) and treatment groups with olive oil (n = 8). The mice treated with olive oil as pre-treatment for a week. Then, ischemia induced by common carotid artery ligation and following the reduction of inflammation [a week after ischemia], the mice post-treated with olive oil. Nissl staining applied for counting necrotic cells in hippocampus CA1. Tunnel kit was used to quantify apoptotic cell death while to short term memory scale, we apply y-maze and shuttle box tests and for detection the rate of apoptotic and treated cell, we used western blotting test for bax and bcl2 proteins. RESULTS: High rate of apoptosis was seen in ischemic group that significantly associated with short-term memory loss. Cell death was significantly lower when mice treated with olive oil. The memory test results were adjusted with cell death results and bax and bcl2 expression in all groups' comparison. Ischemia for 15 min induced cell death in hippocampus with more potent effect on CA1. CONCLUSION: Olive oil intake significantly reduced cell death and decreased memory loss..


  • Patra S, Patro BK, Padhy SK. Symptom Recognition to Diagnosis: Pathway to Care for Autism in a Tertiary Care Medical Centre. Journal of Neurosciences in Rural Practice 2020; 11: (1) 164-9'
    Abstract
    Objective There is no systematic report on pathway to care in autism from tertiary care medical centers of India. The present study was aimed to evaluate the pathways to care among parents of children with autism-seeking treatment at a tertiary care medical center. Methods Cross-sectional, observational study involving parents of 38 children with autism spectrum disorder diagnosed with INCLEN diagnostic tool. Pathway to care was assessed using World Health Organization Encounter Form. Statistical Analysis IBM Statistical Package for Social Sciences (SPSS) 20.0 was used for analysis; categorical variables were assessed using Chi-square test keeping statistical significance at 0.05%. Results A total of 74% parents reported going to a general practitioner and 13% reported going to a child psychiatrist as point of first contact. Among them, 71% parents reported seeking care with a child psychiatrist in a tertiary medical center at the fourth point of contact. Also, 84% parents believed in biomedical explanation of autism. Majority of parents sought for speech therapy and medicines for their child with autism which is in tune with their biomedical explanation. Parents were the first to identify developmental concerns, average age of symptom recognition being 2.2 years. Average age of intervention initiation was 40 months, 8 months prior to diagnosis of autism. Conclusions Early symptom recognition and initiation of interventions is encouraging. Despite having a biomedical explanation of autism and ability to recognize developmental concerns, there is a lag of 4 years in diagnosis and reaching a specialized child psychiatry setup. This lag is a cause of concern owing to the impact on access to evidence-based interventions..


  • Philip M, Ramu R, Prasannan RV, Thomas M, James N, V KB. Mothers' Knowledge of Childhood Neurodevelopmental Disorders: Indian Perspective. Journal of Neurosciences in Rural Practice 2021; 12: (1) 165-70'
    Abstract
    Objectives This study aims to assess the knowledge of childhood neurodevelopmental disorders (CNDDs) among mothers of children younger than 5 years and to promote awareness through health education to promote early identification. Methods Quantitative approach, a descriptive survey in nature research design, was used. A total of 173 mothers who contented the inclusion conditions were chosen as sample on the basis of purposive sampling. The research study was done at the selected Primary Health Centre, Bengaluru, Karnataka. The tabulations were measured and construed based on the objectives of the study by using descriptive and inferential statistics. Results The findings showed that most of the mothers have insufficient knowledge (mean and standard deviation: 3.02 +/- 2.75) and there is no substantial relationship found between mothers' knowledge on CNDD and their demographic variables except their occupation and majority of the mothers communicated that they needed further facts toward CNDD. Conclusion The government and nongovernmental organizations can take initiations to conduct health education programs toward childhood developmental delays and disorders for the general public including mothers and community health workers..


  • Gupta R, Ali R, Verma S, Joshi K, Dhyani M, Bhasin K, et al.. Study of Sleep Disorders among Young Children Using Hindi Translated and Validated Version of Pediatric Sleep Questionnaire. Journal of Neurosciences in Rural Practice 2017; 8: (2) 165-9'
    Abstract
    OBJECTIVE: The objective of this study is to assess the prevalence of sleep disorders among children aging between 4 and 9 years using Hindi version of Pediatric Sleep Questionnaire (PSQ). METHODS: This study had two parts first, translation and validation of PSQ into Hindi language, and second, assessment of the prevalence of sleep disorders using PSQ Hindi version. Hindi PSQ was distributed in randomly chosen primary schools in a semi-urban area. The children were requested to get them filled by their parents. When the questionnaires were returned, responses were analyzed. RESULTS: Most of the items of the Hindi version had perfect agreement with original questionnaire in a bilingual population (kappa =1). Totally, 435 children were included in the field study having average age of 6.3 years. Obstructive sleep apnea was reported in 7.5% children; symptoms suggestive of restless legs syndrome were reported by 2%-3%; teeth grinding by 13.9% and sleep talking by 22.6% children. CONCLUSION: PSQ Hindi version is a validated tool to screen for sleep disorders among children. Sleep disorders are fairly prevalent among young children in India..


  • Sharma S, Raina SK, Bhardwaj AK, Chaudhary S, Kashyap V, Chander V. Socio demography of mental retardation: A community-based study from a goitre zone in rural sub-Himalayan India. Journal of Neurosciences in Rural Practice 2015; 6: (2) 165-9'
    Abstract
    INTRODUCTION: Mental retardation is one of the most common disabilities of childhood which can be prevented by timely identification of the causative agent and an adequate management accordingly. District Kangra lies in the sub-Himalayan belt and forms a part of the 2400 km long goitre belt along the southern slopes of the Himalayas. OBJECTIVE: To study the prevalence of mental retardation among children (1-10) years of age. MATERIALS AND METHODS: A two-phase cross-sectional study was conducted in the rural area of district Kangra. A 30-cluster sampling technique was used to screen a population of children 1-10 years of age from five randomly selected panchayats (village government units) of district Kangra. The screening was based on a modified version of the ten questions screen, adapted to the local population. In the first phase a door to door survey was done to identify suspects of mental retardation. In the second phase, the children found positive in the first phase were called for examination by the pediatrician to confirm mental retardation. RESULTS: A total of 2420 children were screened in the first phase of which 95 tested positive. About 52 of these children were found to be mentally retarded in the second phase giving a prevalence of 2.15%. The 69% of these children belonged to the lower middle class and 28.3% belonged to middle class families using the Uday Parekh scale for assessment of the socio-economic status. CONCLUSION: Prevalence of mental retardation is high in district Kangra of Himachal Pradesh in comparison to other states of India. This could be attributed to the good primary health care in Himachal Pradesh where institutional deliveries are about 70%. This may have led to better survival of children with congenital disorders and those that suffer perinatal trauma..


  • Satyarthee GD. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 166-7'
    Abstract
    None.


  • Onder H. Serial Diffusion-Weighted Imaging in Transient Global Amnesia?. Journal of Neurosciences in Rural Practice 2018; 9: (1) 166-7'
    Abstract
    None.


  • Mohammed W. Commentary. Journal of Neurosciences in Rural Practice 2019; 10: (1) 167'
    Abstract
    None.


  • Mogildea M, Varela M, Martins C, Joaquim N, Soleiro J, Nzwalo H. Irreversible Hypersomnolence after Bilateral Thalamic Infarction. Journal of Neurosciences in Rural Practice 2018; 9: (1) 167-8'
    Abstract
    None.


  • Raina SK, Chander V. To evaluate the utility of 10 warning signs questionnaire in assessment of cognitive function among elderly people. Journal of Neurosciences in Rural Practice 2016; 7: (1) 168-70'
    Abstract
    INTRODUCTION: Routine screening of high-risk elderly people for early cognitive impairment using mini-mental state examination (MMSE) and its modifications may be constrained by demographic and other variables. Warning signs (as reported by family/caregivers) may be a useful alternative. The present data analysis was carried out with the aim to identify the role of 10 warning signs screen as an alternative tool for screening for cognitive impairment among elderly. MATERIALS AND METHODS: For the purpose of this analysis (correlation), data available with us from a study conducted on the elderly population (60 years and above) from selected geographical areas (Migrant, Urban, Rural, and Tribal) of Himachal Pradesh was used. RESULTS: A high statistically significant was found between scores on 10 warning signs screen and Hindi mental state examination/Bharmouri mental state examination (modifications of MMSE). CONCLUSIONS: Ten warning signs screen can be an important screening total for assessment of cognitive impairment in the elderly Indians..


  • Yildirim AE, Divanlioglu D, Cetinalp NE, Belen AD. Endoscopic endonasal repair of spontaneous sphenoid sinus lateral wall meningocele presenting with cerebrospinal fluid leak. Journal of Neurosciences in Rural Practice 2014; 5: (2) 168-70'
    Abstract
    Spontaneous sphenoid sinus lateral wall meningoceles are rare lesions with an unknown etiology. Endoscopic endonasal technique is a considerable route in the treatment of this condition. The aim of this paper is to report the etiology, surgical technique, and outcome in a patient repaired via endoscopic endonasal approach. A 51-year-old male patient applied with rhinorrhea started three months ago after an upper respiratory infection. There were no history of trauma or sinus operation. Biochemical analysis of the fluid was positive for beta-2-transferrin. This asypthomatic patient had undergone for repairment of lateral sphenoid sinus meningocele with endoscopic endonasal transsphenoidal approach. After endoscopic endonasal meningocele closure procedure no complications occured and a quick recovery was observed. Endoscopic endonasal approach is an effective and safe treatment modality of spontaneous lateral sphenoid sinus meningoceles and efficient in anterior skull base reconstruction..


  • Thivakaran T, Gamage R, Gooneratne IK. Treatment-related fluctuation in Guillain-Barre syndrome. Journal of Neurosciences in Rural Practice 2011; 2: (2) 168-70'
    Abstract
    Guillain-Barre syndrome (GBS) is usually a monophasic illness but relapses occur. A 55-year-old female with hypertension and vitiligo presented with acute inflammatory demyelinating polyradiculoneuropathy. She improved with immunoglobulin treatment started on day 6 of illness, but relapsed on day 14 warranting repeat immunoglobulin therapy. Thereafter recovery was complete. Her relapse was due to treatment-related fluctuation (TRF). TRF is improvement in the GBS disability scale of at least one grade after completion of immunotherapy followed by worsening of the disability scale of at least one grade within the first 2 months after disease onset. Recurrent GBS and chronic inflammatory demyelinating polyradiculoneuropathy were excluded. During the peak of the illness ANA titres were transiently high. The presence of other medical conditions, predominant proximal weakness and the absence of preceding diarrhea are predictors for TRF seen in this patient. Early treatment and evidence of ongoing immune activation have contributed toward TRF..


  • Rovlias A. Infected Internal Pulse Generator of a Spinal Cord Stimulator Device Treated Successfully without Removal: A Case Report. Journal of Neurosciences in Rural Practice 2019; 10: (1) 168-9'
    Abstract
    None.


  • Dhikav V, Anand KS. Commentary. Journal of Neurosciences in Rural Practice 2018; 9: (1) 169-70'
    Abstract
    None.


  • Onyeama GM. Commentary. Journal of Neurosciences in Rural Practice 2015; 6: (2) 169-70'
    Abstract
    None.


  • Yasar K, Pehlivanoglu F, Cicek G, Sengoz G. The evaluation of the clinical, laboratory and the radiological findings of the fifty-five cases diagnosed with tuberculous, Brucellar and pyogenic spondylodiscitis. Journal of Neurosciences in Rural Practice 2012; 3: (1) 17-20'
    Abstract
    OBJECTIVE: In this study, the evaluation of the clinical, laboratory and radiological findings belonging to 55 cases that were hospitalized in our clinic to be followed-up and were diagnosed with tuberculous, brucellar and pyogenic spondylodiscitis (SD) was aimed. MATERIALS AND METHODS: The cases with SD were evaluated retrospectively. Hematological, serological, biochemical laboratory tests and imaging technics were used for diagnosis. RESULTS: Of 55 cases aged ranging between 25 to 79, 33 (59%) were female. The cases with tuberculous SD (TBSD), brucellar SD (BSD) and pyogenic SD (PSD) were found in 24 (43%), 12 (21%) and in 19 (34%) patients. Erytrocyte sedimentation rate, increased C-reactive protein, and leucocytosis were present in 51 (91%), 22 (39%) and 8 (14%) cases. The number of the cases with history of previous surgery or trauma was 14 (25%). Diagnosis of TBSD was established by acid fast bacilli positiveness and Lowenstein Jensen culture positiveness, in two and seven patients, respectively. While all 12 cases with BSD had positive standard tube aglutination test, only 3 (25%) had hemoculture positivity. In PSDs, diagnosis was confirmed with culture positivity in 9 of 19 cases.Of the cases in our study, 89% responded to medical treatment while three required surgery and three died (5.5% and 5.5%, respectively). CONCLUSION: SD may develop secondary to infections or following spinal surgical procedures and traumas. Also, the importance of endemicity should be kept in mind, beside the helpful diagnostic findings while treatment regulation..


  • Wani RA, Dar MA, Margoob MA, Rather YH, Haq I, Shah MS. Diabetes mellitus and impaired glucose tolerance in patients with schizophrenia, before and after antipsychotic treatment. Journal of Neurosciences in Rural Practice 2015; 6: (1) 17-22'
    Abstract
    BACKGROUND: Treatment with antipsychotics increases the risk of developing diabetes in patients of schizophrenia but this diabetogenic potential of different antipsychotics seems to be different. Moreover, there may be an independent link between schizophrenia and diabetes. So we plan to study the prevalence of glucose dysregulation in patients of schizophrenia before and after treatment with various antipsychotics. MATERIALS AND METHODS: Fifty patients (32 males and 18 females) diagnosed with schizophrenia were evaluated for glucose dysregulation using oral glucose tolerance test, initially (drug naive) and after antipsychotic treatment. Age- and sex-matched healthy volunteer group of 50 subjects (35 males and 15 females) was taken for comparison. Results were interpreted using American Diabetic Association criteria. RESULTS: Though the glycemic status of the patient group was comparable with healthy controls initially but antipsychotic treatment was associated with glucose dysregulation. For first 6 weeks the antipsychotic (olanzapine, risperidone, haloperidol and aripiprazole)-induced glucose dysregulation was comparable, which was seen to be maximum with the olanzapine-treated group at the end of this study, 14 weeks. CONCLUSION: We conclude that antipsychotic treatment of nondiabetic drug naive schizophrenia patients was associated with adverse effects on glucose regulation. For initial 6 weeks the antipsychotic-induced glucose dysregulation was comparable, which was seen to be maximum with olanzapine at the end of study, i.e. 14 weeks. Keeping this at the back of mind we can stabilize a patient initially with a more effective drug, olanzapine, and later on shift to one with less metabolic side effects..


  • Aly TA. Spinal shortening and monosegmental posterior spondylodesis in the management of dorsal and lumbar unstable injuries. Journal of Neurosciences in Rural Practice 2011; 2: (1) 17-22'
    Abstract
    INTRODUCTION: Patients with spinal injuries have been treated in the past by laminectomy in an attempt to decompress the spinal cord. The results have shown insignificant improvement or even a worsening of neurologic function and decreased stability without effectively removing the anterior bone and disc fragments compressing the spinal cord. The primary indication for anterior decompression and grafting is narrowing of the spinal canal with neurologic deficits that cannot be resolved by any other approach. One must think of subsequent surgical intervention for increased stability and compressive posterior fusion with short-armed internal fixators. AIM: To analyze the results and efficacy of spinal shortening combined with interbody fusion technique for the management of dorsal and lumbar unstable injuries. MATERIALS AND METHODS: Twenty-three patients with traumatic fractures and or fracture-dislocation of dorsolumbar spine with neurologic deficit are presented. All had radiologic evidence of spinal cord or cauda equina compression, with either paraplegia or paraparesis. Patients underwent recapping laminoplasty in the thoracic or lumbar spine for decompression of spinal cord. The T-saw was used for division of the posterior elements. After decompression of the cord and removal of the extruded bone fragments and disc material, the excised laminae were replaced exactly in situ to their original anatomic position. Then application of a compression force via monosegmental transpedicular fixation was done, allowing vertebral end-plate compression and interbody fusion. RESULTS: Lateral Cobb angle (T(10)-L(2)) was reduced from 26 to 4 degrees after surgery. The shortened vertebral body united and no or minimal loss of correction was seen. The preoperative vertebral kyphosis averaged +17 degrees and was corrected to +7 degrees at follow-up with the sagittal index improving from 0.59 to 0.86. The segmental local kyphosis was reduced from +15 degrees to -3 degrees. Radiography demonstrated anatomically correct reconstruction in all patients, as well as solid fusion. CONCLUSION: This technique permits circumferential decompression of the spinal cord through a posterior approach and posterior interbody fusion..


  • Jain D, Aggarwal G, Lubana P, Moses S. Penetrating craniofacial arrow injury. Journal of Neurosciences in Rural Practice 2010; 1: (1) 17-9'
    Abstract
    Arrow injuries are an extinct form of injury in most parts of the developed world, but are still seen, albeit infrequently in developing countries. Reports of penetrating injuries of the craniofacial region secondary to projectiles are few and far between. The morbidity-free outcome of surgical removal, in case of penetrating arrow injuries, despite the delay in presentation and, moreover, in the emergency surgical practice, are the salient points to be remembered whilst managing such cases, for 'what the mind knows is what the eyes see and what the eyes see is what can be practiced'. We report the case of a patient who was attacked by a projectile fired from a crossbow. Immediate surgery under general anesthesia was required to remove the arrow, with utmost care to avoid any neurovascular compromise to the facial nerve, as well as minimize postoperative complications such as otitis media and subsequent meningitis..


  • Chauhan R, Luthra A, Mahajan S. Takayasu Arteritis with Cerebral Hypoperfusion: An Unusual Case. Journal of Neurosciences in Rural Practice 2019; 10: (1) 170-1'
    Abstract
    None.


  • Moscote-Salazar LR, Satyarthee GD, Calderon-Miranda WG, Matus JA, Pacheco-Hernandez A, Puac-Polanco PC, et al.. Prolactin Secreting Pituitary Carcinoma with Extracranial Spread Presenting with Pathological Fracture of Femur. Journal of Neurosciences in Rural Practice 2018; 9: (1) 170-3'
    Abstract
    None.


  • Bajaj J, Yadav YR, Pateriya A, Parihar V, Ratre S, Dubey A. Indigenous Inexpensive Practice Models for Skill Development in Neuroendoscopy. Journal of Neurosciences in Rural Practice 2017; 8: (2) 170-3'
    Abstract
    INTRODUCTION: Neurosurgery is a branch having a tough learning curve. Residents generally get very less hands-on exposure for advanced procedures like neuroendoscopy. With the limited number of cadavers available and ethical issues associated with animal models, practice models, and simulators are becoming the able alternative. Most of these simulators are very costly. We tried to build indigenous inexpensive practice models that can help in developing most of the skills of neuroendoscopy. MATERIALS AND METHODS: Models were built for learning hand-eye coordination, dexterity, instrument manipulation, cutting, fine dissection, keyhole concept, drilling, and simulation of laminectomy and ligamentum flavum resection. These were shown in the neuroendoscopic fellowship program conducted in authors' institute, and trainees' responses were recorded. RESULTS: Both novice and experienced neuroendoscopic surgeons validated the models. There was no significant difference between their responses (P = 0.791). CONCLUSION: Indigenous innovative models can be used to learn and teach neuroendoscopic skills. The presented models were reliable, valid, eco-friendly, highly cost-effective, portable, easily made and can be kept in one's chamber for practicing..


  • Nagarajan E, Digala LP, Sivaraman M, Bollu PC. Is Magnetic Resonance Imaging Diffusion Restriction of the Optic Disc Head a New Marker for Idiopathic Intracranial Hypertension?. Journal of Neurosciences in Rural Practice 2020; 11: (1) 170-4'
    Abstract
    Background Idiopathic intracranial hypertension (IIH) is a headache syndrome due to raised intracranial pressure of unknown etiology. Before making the diagnosis of IIH, secondary causes of raised intracranial pressure must be ruled out. The radiological features associated with this condition have variable sensitivity and specificity. In this case series, we aim to describe a potential new radiological marker of IIH, that is, diffusion restriction, in the optic disc head and propose that this can be a specific finding in the appropriate clinical picture. Importance IIH causes vision loss and disabling daily headaches. The diagnosis of this condition is based on history and physical examination findings. Magnetic resonance imaging (MRI) is used to exclude other causes, but specific radiological markers for the diagnosis of IIH are lacking. Observations Five patients presented with the main complaint of headache, which was associated with blurry vision. All of our patients had a formal neuro-ophthalmological evaluation that confirmed the presence of optic disc edema in both eyes. They also underwent an MRI of the brain that showed diffusion restriction in the optic nerve head in either eye or both eyes. Patients underwent lumbar puncture in the lateral decubitus position, which revealed cerebrospinal fluid opening pressures > 25 cm H 2 O. They all responded well to standard treatments, with the resolution of symptoms in their follow-up appointments. Conclusion and Relevance The MRI diffusion restriction in the optic nerve head may be a reliable noninvasive marker for the diagnosis of IIH in the appropriate clinical picture..


  • Jha S, Ansari M, Sonkar K, Paliwal V. Unusual features in chronic inflammatory demyelinating polyneuropathy: Good outcome after prolonged ventilatory support. Journal of Neurosciences in Rural Practice 2011; 2: (2) 171-3'
    Abstract
    Severe respiratory muscle paralysis and ventilatory failure is rare in chronic inflammatory demyelinating polyneuropathy (CIDP). We report a 14 year child who presented with respiratory failure, bulbar and multiple cranial nerves involvement along with bilateral phrenic nerve paralysis. He was diagnosed with CIDP after electrophysiological evaluation. He required AMBU ventilation for about 4 months (including domiciliary use), after which he recovered significantly. Along with several unusual features of CIDP, this report highlights good example of steady basic intensive care to save lives and rewarding outcome of prolonged respiratory support, provided by AMBU ventilation which is a rather primitive, but inexpensive device..


  • Sankararaman S, Riel-Romero RM, Jeroudi M, Gonzalez-Toledo E. Epstein-Barr virus induced hemophagocytic lymphohistiocytosis in X-linked lymphoproliferative disease. Journal of Neurosciences in Rural Practice 2014; 5: (2) 171-4'
    Abstract
    X-linked lymphoproliferative disease (XLP) is a rare, often fatal genetic disorder characterized by extreme vulnerability to Epstein-Barr virus (EBV). EBV-induced hemophagocytic lymphohistiocytosis (HLH) is a known presentation in XLP. In EBV-induced HLH in XLP, the brain imaging findings in the acute phase include a non specific pattern. In this report, we highlight the magnetic resonance imaging and magnetic resonance spectroscopy findings in a child with EBV induced HLH in XLP..


  • Menon V, Sarkar S, Thomas S. Establishing a psychosomatic clinic in a low resource setting: Process, challenges, and opportunities. Journal of Neurosciences in Rural Practice 2016; 7: (1) 171-5'
    Abstract
    BACKGROUND: Specialty psychosomatic clinics are a felt need in low- and middle-income countries, but its benefits and challenges have not been reported so far. AIMS: To describe the process, challenges, and opportunities that we encountered in setting up a specialty psychosomatic clinic at a government medical college in South India. METHODS: The biweekly psychosomatic clinic was located in the Department of Psychiatry and manned by a multimodal team. Structured questionnaires were used to evaluate all patients. All psychiatric diagnoses were made as per International Classification of Diseases-10, clinical descriptions and diagnostic guidelines. Management comprised both pharmacotherapy and psychotherapeutic interventions. RESULTS: A total of 72 patients registered for services in the 1(st) year of the clinic. The mean age of the sample was 36.6 years (range 14-60 years). A median of 2 years and 19 visits to various care providers had elapsed before their visit to the clinic. The index contact was a general practitioner in the majority of cases though an overwhelming majority (95.6%) had also sought specialist care. The most common diagnostic cluster was the somatoform group of disorders (50.0%). Antidepressants were the most commonly prescribed medications (70.6%). CONCLUSION: The specialty psychosomatic clinic provided better opportunities for a more comprehensive evaluation of people with medically unexplained symptoms and better resident training and focused inter-disciplinary research. It describes a scalable model that can be replicated in similar resource constrained settings..


  • Joshua SP, Mahapatra AK. Epilepsy in tropics: Indian perspective. Journal of Neurosciences in Rural Practice 2013; 4: (2) 171-5'
    Abstract
    Epilepsy is a common neurological disorder affecting 0.5-1% of the population in India. The causes and treatment protocols vary widely. A proper understanding of the causes and treatment strategies is essential for managing this patient group. This article analyzes the common causes of epilepsy in India and provides a brief summary on the available treatment strategies..


  • Adeleye AO, Oyemolade TA, Malomo TA, Okere OE. Mannitol Dosing Error during Pre-neurosurgical Care of Head Injury: A Neurosurgical In-Hospital Survey from Ibadan, Nigeria. Journal of Neurosciences in Rural Practice 2021; 12: (1) 171-6'
    Abstract
    Objectives Inappropriate use of mannitol is a medical error seen frequently in pre-neurosurgical head injury (HI) care that may result in serious adverse effects. This study explored this medical error amongst HI patients in a Nigerian neurosurgery unit. Methods We performed a cross-sectional analysis of a prospective cohort of HI patients who were administered mannitol by their initial non-neurosurgical health care givers before referral to our center over a 22-month period. Statistical Analysis A statistical software was used for the analysis with which an alpha value of <0.05 was deemed clinically significant. Results Seventy-one patients were recruited: 17 (23.9%) from private hospitals, 13 (18.3%) from primary health facilities (PHFs), 20 (28.2%) from secondary health facilities (SHFs), and 21 (29.6%) from tertiary health facilities (THFs). Thirteen patients (18.3%) had mild HI; 29 (40.8%) each had moderate and severe HI, respectively. Pupillary abnormalities were documented in five patients (7.04%) with severe HI and neurological deterioration in two with mild HI. Mannitol administration was deemed appropriate in only 43.7% (31/71). Data on mannitol dosing in 60.6% (43/71) of the patients showed 8/43 (18.6%) receiving continuous 10% mannitol infusion. The remaining 35/43 received mannitol as a 20% solution but also showing dosing error in 62.9% (22/35): overdosing in 7/35 (20%), and nonbolus administration in 15/35 (42.9%). The distribution of the dosing error among the referring health facilities (all the 13 [100%] patients from private hospitals, 66.7% from PHF, 60% from SHF, and 45.5% from THF) showed a trend of better performance ( p = 0.002) by the THFs. Conclusion Mannitol use is apparently fraught with an understudied medical error in the pre-neurosurgical care of the head injured..


  • Kattimani S, Sarkar S, Rajkumar RP, Menon V. Stressful life events, hopelessness, and coping strategies among impulsive suicide attempters. Journal of Neurosciences in Rural Practice 2015; 6: (2) 171-6'
    Abstract
    BACKGROUND: Suicides are among the most important causes of death in the economically productive population. Characteristics of impulsive and nonimpulsive suicide attempters may differ which would have a bearing on planning preventive measures. AIMS: This study aimed to characterize the clinical and psychological profile of impulsive and nonimpulsive suicide attempters. SETTINGS AND DESIGN: This retrospective comprehensive chart-based study was conducted at a tertiary care hospital in South India. METHODS: The study utilized records of patients over a period of 3 years. An attempt was considered impulsive if the time between suicidal idea and the attempt was <30 min. Stressful life events were assessed using presumptive stressful life events scale; hopelessness was evaluated using Beck Hopelessness Scale (BHS) and coping was measured using Coping Strategies Inventory Short Form. STATISTICAL ANALYSIS USED: Impulsive and nonimpulsive suicide attempters were compared using appropriate inferential statistical tests. RESULTS: Of 316 patients, 151 were classified as having an impulsive suicidal attempt (47.8% of the sample). The impulsive and nonimpulsive suicide attempters did not differ on demographic characteristics. Use of natural plant products was more common in impulsive attempters (27.2% vs. 12.7%), while physical methods like hanging was less common (0.7% vs. 7.3%). Those with an impulsive attempt were more likely to have a recent contact with a health professional (24.5% vs. 4.5%). Impulsive suicide attempters had higher scores on BHS (Mann-Whitney U = 7680.5, P < 0.001), and had recollected greater number of stressors. CONCLUSION: Impulsive suicide attempters differ from nonimpulsive suicide attempters in clinical features like methods of attempt, presence of hopelessness, and stressors..


  • James J. Diet in Stroke: Beyond Antiplatelets and Statins. Journal of Neurosciences in Rural Practice 2019; 10: (2) 173-4'
    Abstract
    None.


  • Agarwal DK, Thamatapu E, Sanyal S, Krishnan P. Rarely Encountered, Seldom Considered: Posterior Tibial Nerve Schwannoma Mimicking Lumbar Radiculopathy. Journal of Neurosciences in Rural Practice 2018; 9: (1) 173-4'
    Abstract
    None.


  • Mahuad C. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 174-5'
    Abstract
    None.


  • Cugati G, Jain PK, Pande A, Symss NP, Chakravarthy V, Ramamurthi R. Pediatric multifocal glioblastoma multiforme with fulminant course. Journal of Neurosciences in Rural Practice 2012; 3: (2) 174-7'
    Abstract
    Glioblastoma multiforme (GBM) is the most common primary malignant brain tumor. GBM in children is less common than in adults and has a better prognosis. Pediatric GBM is a rare entity, and a multifocal development in a pediatric GBM is much rarer. We report to you one such rare case of pediatric multifocal GBM in a 5-year-old child who developed rapidly increasing multiple lesions after radiotherapy. More studies are required to study the genetic analysis, tumor behavior, management and outcome of these rare tumors..


  • Tyagi DK, Balasubramaniam S, Sawant HV. Giant primary ossified cavernous hemangioma of the skull in an adult: A rare calvarial tumor. Journal of Neurosciences in Rural Practice 2011; 2: (2) 174-7'
    Abstract
    Primary intraosseous cavernous hemangiomas (PICHs) of the cranium are rare benign vascular tumors that account for about 0.2 % of all bone tumors and 10 % of benign skull tumors. They generally present as osteolytic lesions with honeycomb pattern of calcification. Completely ossified cavernous hemangioma of the calvarium in an adult has not been reported previously. A 28-year-old female presented to us with a large right parietal skull mass that had been present since the last 15 years. Total resection of the lesion was performed. Pathological examination was suggestive of cavernous hemangioma of the skull bone. Cavernous hemangioma should be considered as one of the differential diagnosis in any case of bony swelling of the calvarium so that adequate preoperative planning can be made to minimize blood loss and subsequent morbidity..


  • Ransing RS, Patil B, Grigo O. Mean Platelet Volume and Platelet Distribution Width Level in Patients with Panic Disorder. Journal of Neurosciences in Rural Practice 2017; 8: (2) 174-8'
    Abstract
    BACKGROUND: Changes in platelet indices have been reported in patients with panic disorder (PD). However, previous study findings are contradictory and inconclusive. The aim of this study was to evaluate and compare the platelet indices in patients with PD. MATERIALS AND METHODS: Patients with PD (n = 123) and healthy controls (n = 133) were enrolled in this case control study. The platelet indices (mean platelet volume [MPV] and platelet distribution width [PDW]) along with red blood cell (RBC) indices (RBC count and red cell distribution width [RDW]) were compared between the two groups using the unpaired t-test. RESULTS: Patients with PD had lower MPV (7.53 +/- 0.93 fL vs. 8.91 +/- 1.24 fL, P < 0.0001), higher PDW (16.96 +/- 0.85 fL vs. 14.71 +/- 2.07 fL, P < 0.0001), and higher platelet count (274.2 +/- 80.66 x 10(9) L(-1) vs. 243.1 +/- 93.89 x 10(9) L(-1), P < 0.005) than the healthy controls. Furthermore, there were significant differences between patients with PD and healthy controls in terms of their RBC count (4.32 +/- 0.56 x 10(12) L(-1) vs. 4.08 +/- 0.80 x 10(12) L(-1), P = 0.007) and RDW (16.48 +/- 2.26 fL vs. 15.01 +/- 2.25 fL, P < 0.0001). CONCLUSION: Patients with PD have increased PDW and RDW. The platelet and RBC indices may prove to be useful etiological and prognostic markers in patients with PD..


  • Garg K. Depression, Suicidal Ideation, and Resilience among Rural Farmers. Journal of Neurosciences in Rural Practice 2019; 10: (2) 175'
    Abstract
    None.


  • Alemdar M. Expert Commentary on Rare (Nonvestibular, Nontrigenimal) Cranial Nerve Schwannomas. Journal of Neurosciences in Rural Practice 2018; 9: (2) 175-6'
    Abstract
    None.


  • Alsulaiman A. Idiopathic Hypertrophic Spinal Pachymeningitis: A Diagnostic Challenge: A Case Report and Review of the Literature. Journal of Neurosciences in Rural Practice 2020; 11: (1) 175-7'
    Abstract
    Idiopathic hypertrophic pachymeningitis (IHP) can resemble other disorders associated with spinal compression. It is a rare inflammatory fibrosing disease of the dura of unidentified etiology and is considered a diagnosis of exclusion. We present a case of idiopathic hypertrophic spinal pachymeningitis occupying a long segment of cervical dura. This is a case of 38-year-old female patient, who suffered progressive neck pain for 2-year duration. Examination revealed spasticity in all four limbs, plus three symmetric reflexes all over, and the sensory level at T4. Magnetic resonance imaging showed spinal cord compression by a thickened anterior and posterior dura adjacent to the cord from C2 to C7. The diagnosis of spinal IHP was confirmed through biopsy. The patient improved after treatment with corticosteroids. Early surgical intervention with postoperative corticosteroid therapy is a known treatment for this disease, as a way to prevent irreversible neurological damage..


  • Shukla D. Mercedes Benz craniosynostosis. Journal of Neurosciences in Rural Practice 2016; 7: (1) 176'
    Abstract
    None.


  • Menon V. Depression, Suicidal Ideation, and Resilience among Rural Drought-Affected Farmers: Methodological Issues. Journal of Neurosciences in Rural Practice 2019; 10: (2) 176-7'
    Abstract
    None.


  • Abuzayed B, Khreisat W, Maaiah W, Agailat S. Supratentorial primitive neuroectodermal tumor presenting with intracranial hemorrhage in adult. Journal of Neurosciences in Rural Practice 2014; 5: (2) 176-9'
    Abstract
    A 24-year-old female patient presented with complaints of nausea, vomiting and of loss of consciousness lasted for 15 minutes with left sided weakness. Neuroradiological evaluation revealed a hemorrhagic mass lesion in the right frontal lobe. The patient was operated and intraoperative findings showed a cortical-subcortical hematoma including hemorrhagic and disrupted tissue with a pathologic purple tissue on the periphery of the hematoma. Postoperative course was uneventful and postoperative histopathological examination revealed primitive neuroectodermal tumor. The patient was then referred to medical and radiation oncology clinics for further evaluation and treatment..


  • Vachalova I, Kyavar L, Heckmann JG. Pitfalls associated with the diagnosis of herpes simplex encephalitis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 176-9'
    Abstract
    Herpes simplex encephalitis (HSE) still remains a serious illness with high morbidity and mortality. The characteristic presentation of HSE usually consists of fever, headache, and altered mental function. We present three patients with atypical features of HSE. First, a 48-year-old man with symptomatic posttraumatic epilepsy, who developed a gastrointestinal infection, seizures, and fever. After significant clinical improvement, the patient had fever again and developed a status epilepticus, which led to the diagnosis of HSE. Second, an 84-year-old woman with hyperactive delirium after levofloxacin intake. Cranial computed tomography (CCT) revealed hypodense temporal changes, prompting lumbar puncture and diagnosis of HSE. Third, a 51-year-old diabetic woman presented with fever and acute confusion. As CCT and cell count of cerebrospinal fluid (CSF) were normal, infection and hyperglycemia as initial diagnoses were postulated. Due to aphasic symptoms, the differential diagnosis of a stroke was taken into account. Thus a second lumbar puncture led to the correct diagnosis of HSE. These atypical presentations need a high grade of suspicion and a high willingness to reconsider the initial working diagnosis, in order to prevent a diagnostic delay..


  • Chauhan R, Aggarwal A, Jangra K, Bhagat H, Grover VK. Cerebral aneurysm with valvular heart disease: Anaesthetic management and challenges. Journal of Neurosciences in Rural Practice 2016; 7: (1) 177-8'
    Abstract
    None.


  • Chaurasiya A, Ranjan JK, Pandey N, Asthana HS. Clinical and Affective Correlates of Cognitive Functioning in Complicated Mild and Moderate Traumatic Brain Injury Patients Belonging to Rural Areas. Journal of Neurosciences in Rural Practice 2021; 12: (1) 177-81'
    Abstract
    Background/Objective Mild and moderate traumatic brain injury (TBI) is a neglected field especially with reference to its association with cognitive, behavioral, and emotional sequelae. The present study aimed to investigate the association of affective symptoms and clinical factors with neurocognitive functioning in complicated mild and moderate TBI patients. Materials and Methods The sample comprised 39 complicated mild and moderate TBI patients with age range of 18 to 59 years. The study was conducted in the Department of Neurosurgery, Banaras Hindu University, Varanasi. The patients were assessed with the neurocognitive tests, Rivermead Post Concussion Symptom Questionnaire, and Hospital Anxiety and Depression Scale. Statistical Analysis Partial correlations and zero order correlations were used to test the relationships between variables. Results The injury-related factors, namely level of consciousness and Glasgow Coma Scale were found to be associated with divided attention and memory dysfunction ( p < 0.05), respectively. Anxiety was found to be associated with impairment on all domains of neurocognitive function ( p < 0.05) except divided attention. Depressive symptoms were found to be correlated with all the neurocognitive functions ( p < 0.05) except focused and divided attention, whereas head injury symptoms correlated with impairment on focused and divided attention ( p < 0.05). Conclusion Present study highlights the need to acknowledge affective symptoms along with clinical factors in the planning of the rehabilitation programs for such patients in rural scenario..


  • Srinivasan S, Jaleel Q. Norms for a neuropsychological test battery to diagnose dementia in the elderly: A study from Sri Lanka. Journal of Neurosciences in Rural Practice 2015; 6: (2) 177-81'
    Abstract
    AIMS: To pilot a neuropsychological battery for diagnosing dementia and provide normative scores in an elderly Sri Lankan sample. MATERIALS AND METHODS: Consecutive subjects over the age of 60 yrs were administered tests assessing the individual domains of language, verbal episodic memory, visual perceptuospatial skills and executive functions in the Sinhala language. RESULTS: There were a total of 230 subjects in the final sample. The mean age of the entire sample was 69 years, mean education level was 12 years and the sample comprised 53% female. One-month test-retest reliability ranged from 0.71 to 0.85 for the various tests. Most tests were significantly influenced by age and education level but not gender. The exceptions to this were some language subtests (repetition, grammar comprehension and word picture matching) and two tests of executive functioning (maze completion and alternate target cancellation), which were uninfluenced by age. The subtests where ceiling performance was attained by almost all subjects were repetition, grammar comprehension and word picture matching from the language domain, dot position discrimination from the visuospatial domain and maze completion test from the executive function domain. Scores for various tests after stratifying subjects by age and educational level are given. CONCLUSIONS: The tests were well received and could provide a basis for cognitive profiling in similar settings elsewhere..


  • Satyarthee GD. Postdecompressive Craniectomy Surgery, Ventriculomegaly, or Hydrocephalus Development: Imaging, Prevention, and Management. Journal of Neurosciences in Rural Practice 2018; 9: (2) 177-9'
    Abstract
    None.


  • Arslan M, Eseoglu M, Gudu BO, Demir I. Transorbital orbitocranial penetrating injury caused by a metal bar. Journal of Neurosciences in Rural Practice 2012; 3: (2) 178-81'
    Abstract
    Transorbital intracranial injury is uncommon, representing 0.04% of penetrating head trauma with a high mortality rate. Orbital penetrating injuries may cause severe brain injury if the cranium is entered, typically via the orbital roof, the superior orbital fissure, or the optic canal. A 13-year-old male sustained a severe brain injury due to penetration of the right orbit with an iron bar. The bar entered the inferiomedial aspect of the orbit and emerged from the left occipital bone. Neurological examination revealed deep coma (GCS: E1M2V1) with fixed, dilated, and non-reactive pupils. The bar followed an intracranial trajectory, through the third ventricle and suprasellar cistern. The patient underwent an immediate exploration with removal of the bar. Unfortunately, he died 10 days postoperatively due to severe diencephalic injury with brainstem herniation. In this case report, we discuss the radiologic diagnosis and surgical management of transorbital orbitocranial injury by foreign body penetration..


  • Ramineni KK, Jakkani RK, Swamy BVG, M SK. Pulmonary Tuberculosis with Longitudinally Extensive Transverse Myelitis. Journal of Neurosciences in Rural Practice 2020; 11: (1) 178-82'
    Abstract
    Longitudinally extensive transverse myelitis (LETM) is described in neuromyelitis optica spectrum disorders. Simultaneous active pulmonary tuberculosis in these disorders is a relatively rare phenomenon. We report a 16 year-old boy diagnosed as LETM with clinicoradiological correlation. Further evaluation revealed active pulmonary tuberculosis. He had good recovery following the combination of antituberculosis regimen with corticosteroids..


  • Shivji Z, Jabeen A, Awan S, Khan S. Developing Normative Reference Values for Nerve Conduction Studies of Commonly Tested Nerves among a Sample Pakistani Population. Journal of Neurosciences in Rural Practice 2019; 10: (2) 178-84'
    Abstract
    Introduction: Most neurophysiology departments around the world establish their own normative data. However, ethnic differences are not taken into account. Our aim was to establish normal nerve conduction studies (NCS) data for routinely tested nerves in individuals of Pakistani (South Asian) origin and to compare with Western published data. Materials and Methods: One hundred healthy adults' nerves were assessed, using standardized techniques. Individuals were grouped into age groups. Gender differences were assessed. Results: Of the 100 volunteers, 49 were female and 51 were male. Their mean age was 39.8 years. Findings showed statistically significant prolongation of median distal motor latency (DML) and F-wave latency with age and reduction of median, ulnar, and sural sensory amplitudes as age increased. Gender differences showed consistent difference in the normal values for median, ulnar, and peroneal DMLs and respective F-wave latencies, which were significantly shorter in females. Sensory amplitudes of tested upper extremity nerves were significantly lower in males. Comparing with available data, our findings are similar to the Saudi population but significantly different from the American and multiethnic Malaysian populations. Pakistani individuals generally have significantly higher amplitudes and faster conduction velocities with similarities to South Asian studies. Conclusions: We recommend normative NCS parameters for commonly tested nerves for the Pakistani population, using standardized techniques to ensure highest quality testing and outcomes..


  • Kumar S, Sharma R, Goyal S, Husain S. Occipital artery occlusion to facilitate transmastoid posterior fossa tumor embolization. Journal of Neurosciences in Rural Practice 2011; 2: (2) 178-9'
    Abstract
    The transmastoid branch of the occipital artery is an important supply to posterior fossa vascular malformations and tumors and is often difficult to catheterize due to tortuosity and a transforaminal course. In very difficult situations, we can try to induce spasm of the occipital artery just beyond the origin of the mastoid branch by repeated passages of the microcatheter/wire. This induces a temporary 'ligation' like effect so that the microcatheter can then be manipulated into the mastoid branch via the mastoid foramen. Rarely, the occipital artery has to be sacrificed if spasm cannot be induced or is short living, following which particles can be injected from a distance without entering the mastoid foramen. Occluding the occipital artery proximally has no effect on distal perfusion, as collaterals and anastomoses from superficial temporal artery, posterior auricular artery, and opposite occipital artery take over the supply..


  • Sellner J. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 179-80'
    Abstract
    None.


  • Marsala SZ, Pistacchi M, Gioulis M. Subdural hematoma presenting as trigeminal neuralgia: A case report. Journal of Neurosciences in Rural Practice 2016; 7: (1) 179-81'
    Abstract
    None.


  • Dharmadhikari AS, Sinha VK. Psychiatric Comorbidity in Children with Epilepsy: A Cross-sectional 5 Years Rural Prevalence Study. Journal of Neurosciences in Rural Practice 2017; 8: (2) 179-84'
    Abstract
    BACKGROUND: Epilepsy is one of the most common chronic neurological disorders. In children, it has long debilitating course and is associated with comorbidities including psychiatric comorbidity. To tackle this burden of comorbidities, we must know the extent of problem. Hence, there is a need for estimation of prevalence of psychiatry disorder in children with epilepsy. AIM: The present study was aimed at measuring the prevalence of various psychiatry disorders among children suffering from epilepsy. SETTINGS AND DESIGN: Cross-sectional chart review. METHODOLOGY: We reviewed case record files of all patients with a diagnosis of epilepsy in the age group of 9-17 years. Chart review was done for 5 years, May 1, 2007, to April 30, 2012. A total of 718 patients record were included in the study after satisfying inclusion criteria and excluding nonepilepsy diagnosis. STATISTICAL ANALYSIS: Statistics was done using Statistical Package for Social Sciences (SPSS 18.0). Descriptive statistics were used to calculate the result, Chi-square and Mann-Whitney U-test used wherever applicable. RESULTS: The prevalence of childhood psychiatric disorder among children with epilepsy found to be 31.2%. We also found that having a partial component (73.21%, n = 164) in seizure has more chances of psychopathology in comparison to generalized seizure (8.1%, n = 18). Among them, those having a partial component with generalization (66.96%, n = 150) had a greater prevalence of psychopathology. Mental retardation was most common psychiatric disorder among psychopathology followed by manic/depressive illness (unipolar) followed by unspecified nonorganic psychosis. CONCLUSION: From our study, we demonstrate the significant mental health needs of children with epilepsy. The evident high prevalence of psychiatry disorder emphasizes the need for psychopathology assessment and treatment as a part of any comprehensive epilepsy clinic..


  • Chawla H, Walia S, Behari M, Noohu MM. Effect of type of secondary task on cued gait on people with idiopathic Parkinson's disease. Journal of Neurosciences in Rural Practice 2014; 5: (1) 18-23'
    Abstract
    INTRODUCTION: The purpose of this study was to find out the effect of the secondary cognitive and motor task on cued gait in people with Idiopathic Parkinson's disease (PD). DESIGN AND SETTING: A repeated measure same subject design carried out at All India Institute of Medical Sciences, Neurology Department, New Delhi. MATERIALS AND METHODS: THE SUBJECTS WERE MADE TO WALK IN RANDOM ORDER ON A PAPER WALKWAY UNDER THREE CONDITIONS: Free walking with cues at preferred walking speed, coin transference while walking with cues at preferred walking speed and digit subtraction while walking with cues at preferred walking speed. OUTCOME: The stride length, cadence, walking speed and stops were recorded. RESULTS: There was a significant reduction in their walking speed and stride length, but increase in the cadence and the number of stops was seen, when they had to perform dual tasks along with the cued gait, but the changes were more pronounced when secondary cognitive task was added to the cued gait in people with idiopathic PD. CONCLUSION: The results of this study demonstrated that there is a significant difference in the effect of secondary motor task when compared with secondary cognitive task on cued gait parameters in people with Idiopathic PD..


  • Stahl JP. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 180-1'
    Abstract
    None.


  • Chaker N, Bouladi M, Chebil A, Jemmeli M, Mghaieth F, El Matri L. Herpes zoster ophthalmicus associated with abducens palsy. Journal of Neurosciences in Rural Practice 2014; 5: (2) 180-2'
    Abstract
    The extraocular muscle palsies associated with herpes zoster ophthalmicus (HZO) are transient, self-limiting conditions, usually seen in elderly patients. There are different treatment recommendations for paralytic complications, but prognosis has generally reported to be favorable. A 75-year-old male patient presented with diplopia. Clinical history revealed left facial vesicular eruptions and pain treated by oral aciclovir 1 week following symptom onset. On examination, we observed cicatricial lesions with crusts involving left hemiface, a limitation in abduction of the left eye, and a superficial punctuate keratitis (SPK) with decreased visual acuity (4/10). Examination of the right eye was unremarkable. Hess screen test confirmed left six nerve palsy..


  • Cyriac JT, Cherian T, Hadi WA, Jose J. Optic neuropathy due to allergic fungal rhinosinusitis. Journal of Neurosciences in Rural Practice 2011; 2: (2) 180-2'
    Abstract
    An uncommon case of allergic fungal rhinosinusitis presented to the ophthalmology outpatient department of our hospital with complaints of blurred vision in the right eye of a few days duration and vague complaints of pain around the eyes. The visual acuity on examination was grossly reduced in the right eye and normal in the left eye. Color vision was normal. Anterior segment examination including pupils was normal. Dilated fundus examination was normal except for temporal pallor in the right optic disc. Automated perimetry and magnetic resonance imaging (MRI) scan of brain and orbit were done. The imaging report showed a bilateral pansinusitis with pressure on the right optic nerve. Perimetry showed a superior field defect on the right side. ENT consultation and computed tomography (CT) with contrast helped to diagnose this as a case of allergic fungal rhinosinusitis. The patient was started on systemic steroids under the care of the ENT surgeon. After a few days, pre-operative assessment showed a gross improvement of visual acuity. Endoscopic sinus surgery was done to remove the polyps and thick mucus material. Histopathologic examination confirmed allergic fungal mucin. Days after surgery, the visual acuity improved further and repeat perimetry showed gross improvement in the visual field. Good history taking and a detailed ophthalmic examination, keeping in mind the probable causes of loss of vision of few days duration with no findings other than a decreased visual acuity and a suspicious disc, were key to the early diagnosis and investigation in this case. This helped in early referral and management of the case before permanent damage and irreversible visual loss occurred. The optic nerve is a cranial nerve which, once damaged permanently, will not regenerate. The amount of sinus involvement was extensive on both sides and invariably the left optic nerve would have been involved in a few days, if intervention was delayed..


  • Walke SC, Chandrasekaran V, Mayya SS. Caregiver Burden among Caregivers of Mentally Ill Individuals and Their Coping Mechanisms. Journal of Neurosciences in Rural Practice 2018; 9: (2) 180-5'
    Abstract
    Background: During a given year, almost 30% of the people around the world are affected by mentally ill health. In India, it accounts for about 20%. Caregivers face a lot of strain, ill health, and disrupted family life, with literature suggesting an increasing concern about their ability to cope up. The needs of caregivers of the mentally ill are given low priority in the current health-care setting in India. Aim: The aim of the study was to assess the burden of caregivers of mentally ill individuals and their coping mechanisms. Methods: A cross-sectional study was employed with a quantitative approach. A convenient sample of 320 caregivers was taken from two private tertiary care centers and one public secondary care center in Udupi taluk. This study was conducted using the Burden Assessment Schedule (BAS) and Brief Cope Scale (BCS). Statistical analysis was done on categorical variables, and they were expressed as frequencies and percentages. Continuous variables were measured using mean and standard deviation. Univariate and multivariate analysis using binomial logistic regression was done. SPSS version 15 was used to analyze the data. Results: According to BAS, severe burden accounted for 40.9% and moderate for 59.1%. The highest amount of burden was seen in the areas of physical and mental health, spouse related, and in areas of external support. The BCS showed that the most frequently used coping styles were practicing religion, active coping, and planning. Conclusion: This study concluded that caregivers of the mentally ill individuals do undergo a lot of burden. Hence, there is a need to develop strategies that can help them such as providing them with a support structure as well as counseling services..


  • Yilmaz B, Eksi MS, Akakin A, Kilic T. A burning candle in the dark night-incidental intradiploic epidermoid cyst of occipital bone. Journal of Neurosciences in Rural Practice 2016; 7: (1) 181-2'
    Abstract
    None.


  • Perez Bovet J. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 182'
    Abstract
    None.


  • McDonald EM, Patel DV. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 182-3'
    Abstract
    None.


  • Yokoyama K, Kawanishi M, Yamada M, Kuroiwa T. Cervical disc herniation manifesting as a Brown-Sequard syndrome. Journal of Neurosciences in Rural Practice 2012; 3: (2) 182-3'
    Abstract
    Brown-Sequard syndrome is commonly seen in the setting of spinal trauma or an extramedullary spinal neoplasm. The clinical picture reflects hemisection of the spinal cord. We report a rare case of Brown-Sequard syndrome caused by a large cervical herniated disc. A 63-year-old man presented with progressive right hemiparesis and disruption of pain and temperature sensation on the left side of the body. Magnetic resonance imaging showed large C3-C4 disc herniation compressing the spinal cord at that level, with severe canal stenosis from C4 through C7. Decompressive cervical laminoplasty was performed. After surgery, complete sensory function was restored and a marked improvement in motor power was obtained..


  • Tripathi M, Batish A, Mohindra S. Gamma Knife Radiosurgery for Berry Aneurysms: Quo Vadis. Journal of Neurosciences in Rural Practice 2021; 12: (1) 182-4'
    Abstract
    Background Intracranial aneurysms are vascular malformations with significant mortality and morbidity profile. Various treatment modalities have been developed to positively impact the outcome profile with gradual shift to the minimally invasive treatment modalities. Gamma knife radiosurgery (GKRS) is an established primary treatment modality for various intracranial arteriovenous malformations (AVMs); however, its efficacy for berry aneurysmal obliteration has been historically dismal. Objective The aim of this study is to evaluate the factors responsible for poor radio surgical outcome for intracranial aneurysms. Methods The literature is reviewed for the differential efficacy of GKRS for aneurysm and AVM. Results Though both are vascular malformations, aneurysm and AVM have inherent differences in angioarchitecture, intracranial location, surrounding neighborhood, radio-sensitivity, and latency for obliteration. The major difference arises because of surrounding neighborhood of connective tissue stroma which stabilizes the irradiated pathology. Conclusion Though considered radioresistant, aneurysms show promising results with animal models of radiosurgery. The future lies in two hypothetical improvements: with a supporting neighborhood or sensitization of the vessel wall that may change the natural history of an aneurysm, especially an unruptured one..


  • McClelland S, 3rd, Ukwuoma OI, Lunos S, Okuyemi KS. Mortality of Dandy-Walker syndrome in the United States: Analysis by race, gender, and insurance status. Journal of Neurosciences in Rural Practice 2015; 6: (2) 182-5'
    Abstract
    BACKGROUND: Dandy-Walker syndrome (DWS) is a congenital disorder often diagnosed in early childhood. Typically manifesting with signs/symptoms of increased intracranial pressure, DWS is catastrophic unless timely neurosurgical care can be administered via cerebrospinal fluid (CSF) drainage. The rates of mortality, adverse discharge disposition (ADD), and CSF drainage in DWS may not be uniform regardless of race, gender or insurance status; such differences could reflect disparities in access to neurosurgical care. This study examines these issues on a nationwide level. MATERIALS AND METHODS: The Kids' Inpatient Database spanning 1997-2003 was used for analysis. Only patients admitted for DWS (ICD-9-CM = 742.3) were included. Multivariate analysis was adjusted for several variables, including patient age, race, sex, admission type, primary payer, income, and hospital volume. RESULTS: More than 14,000 DWS patients were included. Increasing age predicted reduced mortality (OR = 0.87; P < 0.05), ADD (OR = 0.96; P < 0.05), and decreased likelihood of receiving CSF drainage (OR = 0.86; P < 0.0001). Elective admission type predicted reduced mortality (OR = 0.29; P = 0.0008), ADD (OR = 0.68; P < 0.05), and increased CSF drainage (OR = 2.02; P < 0.0001). African-American race (OR = 1.20; P < 0.05) and private insurance (OR = 1.18; P < 0.05) each predicted increased likelihood of receiving CSF drainage, but were not predictors of mortality or ADD. Gender, income, and hospital volume were not significant predictors of DWS outcome. CONCLUSION: Increasing age and elective admissions each decrease mortality and ADD associated with DWS. African-American race and private insurance status increase access to CSF drainage. These findings contradict previous literature citing African-American race as a risk factor for mortality in DWS, and emphasize the role of private insurance in obtaining access to potentially lifesaving operative care..


  • Sharma D, Singh D, Ganjoo P, Tandon M. Bladder distension: An unusual cause of reflux of blood and hemodynamic changes (autonomic dysreflexia) during endovascular coiling. Journal of Neurosciences in Rural Practice 2011; 2: (2) 183-5'
    Abstract
    Autonomic dysreflexia due to distended bladder is well known. Reflux of blood during endovascular procedure is also a common observation. It happens due to difference in pressure gradient between arterial pressure and that of infusing solution. Generally it happens when the infusion bottle is empty or the pressure in infusion bottles fall. We present an uncommon situation where distended bladder mechanically resulted in reflux of blood into endovascular catheters as well as alteration in hemodynamic parameters. Both settled once the bladder was empty..


  • Khoo CS, Marzukie MM, Yap SS, Wan Yahya WNN, Tan HJ. Cerebral Lupus and Cryptococcal Meningitis in a Pregnant Woman. Journal of Neurosciences in Rural Practice 2020; 11: (1) 183-6'
    Abstract
    Systemic lupus erythematosus (SLE) is a chronic autoimmune and multisystem disorder, which frequently affects young women. During pregnancy, SLE flares could occur up to 65%, with renal and hematological manifestations being the most common. However, reports on neuropsychiatric lupus in pregnant women are scarce. We herein report a 26-year-old lupus pregnant woman, who had cerebral lupus with concurrent cryptococcal meningitis. This case highlights the complexity in diagnosing and managing our patient to achieve the best outcome for both the mother and infant..


  • Aggarwal A, Vaiphei K, Savardekar AR, Salunke P, Mathuriya SN. Stroke in three patients due to spontaneous intra tumoral hemorrhage in meningiomas: Lessons learnt. Journal of Neurosciences in Rural Practice 2016; 7: (1) 183-6'
    Abstract
    None.


  • Alugolu R, Chandrasekhar YB, Shukla D, Sahu BP, Srinivas BH. Xanthogranulomatous colloid cyst of the third ventricle. Journal of Neurosciences in Rural Practice 2013; 4: (2) 183-6'
    Abstract
    Colloid cyst in the third ventricle is a common entity, whereas a variant of it, namely xanthogranulomatous, is quite rare. The closest imaging differential diagnosis is a purely third ventricular craniopharyngioma. We herein describe a case of xanthogranulomatous colloid cyst presenting with hydrocephalus..


  • Urrutia J. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 184'
    Abstract
    None.


  • Panda AK, Gopinath G, Singh S. Parry-Romberg syndrome with hemimasticatory spasm in pregnancy; A dystonia mimic. Journal of Neurosciences in Rural Practice 2014; 5: (2) 184-6'
    Abstract
    Parry-Romberg syndrome (PRS) with hemimasticatory spasm (HMS) is quite an uncommon overlapping phenomenon which very often mimics jaw closing dystonia. A previously healthy 35-year-old female, during her 5(th) month of pregnancy started developing intermittent unilateral painful spasms of jaw while conversation, clinching of teeth, or eating, which led to frequent tongue bites. The spasms were worsened during pregnancy. She used to do certain manoeuvre like sensory tricks in form of touching involved side of the face to relieve the symptoms. Apart from this, she developed progressive hemifacial and hemitongue atrophy. Other medical and neurological examinations were normal. Laboratory investigations as well as neuroimaging were noncontributory. The spasm responded to carbamazepine but hemifacial atrophy persists. To our best knowledge, onset and worsening of this syndrome in pregnancy has not been described earlier which might be correlated either with some hormonal imbalance or some unknown mechanisms..


  • Dadlani R, Ghosal N, Hegde AS. Solitary cerebellous metastasis after prolonged remission in a case of uterine cervical adenocarcinoma. Journal of Neurosciences in Rural Practice 2012; 3: (2) 185-7'
    Abstract
    Intracranial metastasis of a uterine cervical carcinoma is a very rare occurrence. These metastases are characteristically multiple, supra-tentorial, associated with multiple systemic dissemination, usually occur relatively late in the course of the disease, and are most often seen in squamous carcinomas. We present an unusual case which defied these characteristics. This patient was in long-term remission (11 years), presented with a solitary cerebellous metastases, had no evidence of other systemic spread, and the pathology was an adenocarcinoma. We present this rare case with interesting clinical ramifications. This is probably the longest duration of remission prior to the metastasis in the published literature..


  • Mangalore S, Mukku SSR, Vankayalapati S, Sivakumar PT, Varghese M. Shape Profile of Corpus Callosum As a Signature to Phenotype Different Dementia. Journal of Neurosciences in Rural Practice 2021; 12: (1) 185-92'
    Abstract
    Background Phenotyping dementia is always a complex task for a clinician. There is a need for more practical biomarkers to aid clinicians. Objective The aim of the study is to investigate the shape profile of corpus callosum (CC) in different phenotypes of dementia. Materials and Methods Our study included patients who underwent neuroimaging in our facility as a part of clinical evaluation for dementia referred from Geriatric Clinic (2017-2018). We have analyzed the shape of CC and interpreted the finding using a seven-segment division. Results The sample included MPRAGE images of Alzheimer' dementia (AD) ( n = 24), posterior cortical atrophy- Alzheimer' dementia (PCA-AD) ( n = 7), behavioral variant of frontotemporal dementia (Bv-FTD) ( n = 17), semantic variant frontotemporal dementia (Sv-FTD) ( n = 11), progressive nonfluent aphasia (PNFA) ( n = 4), Parkinson's disease dementia (PDD) ( n = 5), diffuse Lewy body dementia ( n = 7), progressive supranuclear palsy (PSP) ( n = 3), and corticobasal degeneration (CBD) ( n = 3). We found in posterior dementias such as AD and PCA-AD that there was predominant atrophy of splenium of CC. In Bv-FTD, the genu and anterior half of the body of CC was atrophied, whereas in PNFA, PSP, PDD, and CBD there was atrophy of the body of CC giving a dumbbell like profile. Conclusion Our study findings were in agreement with the anatomical cortical regions involved in different phenotypes of dementia. Our preliminary study highlighted potential usefulness of CC in the clinical setting for phenotyping dementia in addition to clinical history and robust biomarkers..


  • Krishnan SS, Muthiah S, Rao S, Salem SS, Madabhushi VC, Mahadevan A. Mindbomb Homolog-1 Index in the Prognosis of High-Grade Glioma and Its Clinicopathological Correlation. Journal of Neurosciences in Rural Practice 2019; 10: (2) 185-93'
    Abstract
    Introduction: Gliomas are the most common brain tumors in adults originating from the glial cells. Glioblastoma multiforme is the most malignant and frequent among all gliomas. In recent years, the antibody Mindbomb Homolog-1 (MIB-1) has evolved as a measure of the proliferative nature of the glial tumors. This study aims to investigate the MIB-1 index value as an independent prognostic factor in high-grade gliomas and its correlation with outcome and survival. Materials and Methods: Mean MIB-1 index was determined in 51 high-grade glioma tissue samples in formalin. Its correlation with outcome by assessing the clinicoradiological parameters and median survival of patients in months were assessed. Survival analysis was studied by using the Kaplan-Meier bivariate analysis and Cox proportional ratio. Results: Preoperative Karnofsky Performance Score, WHO-PS, Neurological Performance Scale, and Mini-Mental Status Examination (MMSE) were statistically significant with respect to outcome and survival, whereas tumor factors such as size and perilesional edema were not. In particular, midline-crossing tumors and deep-seated tumors were significantly associated with high MIB-1 index and by correlation with outcome. There were significantly higher number (P < 0.0001) of patients with Grade IV tumors, with an MIB-1 index value above an arbitrary cutoff of 10% compared to Grade III tumors. In addition, median survival period of patients with low MIB-1 index was longer irrespective of tumor grade. Conclusion: Significant correlation between high-grade glioma and MIB-1 index suggests MIB-1 index to be a good prognostic tool, with MIB-1 index and midline-crossing variables being independent prognostic parameters..


  • Gupta PK, Awasthi R, Singh S, Behari S, Maria Das KJ, Gupta RK, et al.. Value of Minimum Apparent Diffusion Coefficient on Magnetic Resonance Imaging as a Biomarker for Predicting Progression of Disease Following Surgery and Radiotherapy in Glial Tumors from a Tertiary Care Center in Northern India. Journal of Neurosciences in Rural Practice 2017; 8: (2) 185-93'
    Abstract
    PURPOSE: Studies have shown that cellularity of glial tumors are inversely correlated to minimum apparent diffusion coefficient (ADC) values derived on diffusion-weighted imaging (DWI). The purpose of this prospective exploratory study was to evaluate whether temporal change in "minimum ADC" values during follow-up predict progressive disease in glial tumors post radiotherapy and surgery. MATERIALS AND METHODS: Adult patients of glial tumors, subjected to surgery followed by Radiotherapy (RT), were included in the study. Serial conventional magnetic resonance imaging with DWI at the following time points - presurgery, pre-RT, post-RT imaging at 3, 7, and 15 months were done. For "minimum ADC" values, multiple regions of interest (ROI) were identified on ADC maps derived from DWI. A mean of 5 minimum ADC values was chosen as "minimum ADC" value. The correlation was drawn between histology and minimum ADC values and time trends were studied. RESULTS: Fourteen patients were included in this study. Histologies were low-grade glioma (LGG) - 5, anaplastic oligodendroglioma (ODG) -5, and glioblastoma multiforme (GBM) - 4. Minimum ADC values were significantly higher in LGG and GBM than ODG. Presurgery, the values were 0.812, 0.633, and 0.787 x 10(-3) mm(2)/s for LGG, ODG, and GBM, respectively. DWI done at the time of RT planning showed values of 0.786, 0.636, 0.869 x 10(-3) mm(2)/s, respectively. During follow-up, the increasing trend of minimum ADC was observed in LGG (P = 0.02). All these patients were clinically and radiologically stable. Anaplastic ODGs, however, showed an initial increase followed by the fall of minimum ADC in all the 5 cases (P = 0.00). Four of the five cases developed progressive disease subsequently. In all the 4 GBM cases, a consistent fall of minimum ADC values was observed (P = 0.00), and they all progressed in spite of RT. CONCLUSIONS: The DWI-derived minimum ADC values are an important yet simple quantitative tool to assess the treatment response and disease progression before they are evident on conventional imaging during the follow-up of glial tumors..


  • Tripathi M, Bhat DI, Shukla DP. Photo atlas of inner skull base using digital single lens reflex camera. Journal of Neurosciences in Rural Practice 2016; 7: (1) 186-7'
    Abstract
    None.


  • Schirmer CM. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 186-7'
    Abstract
    None.


  • Basmaci M, Hasturk AE, Pak I. Cystic mature teratoma of the thoracic region in a child: An unusual case. Journal of Neurosciences in Rural Practice 2011; 2: (2) 186-9'
    Abstract
    Cystic mature teratomas of the spinal cord are rare lesions. Teratomas account for up to 0.1% of all spinal cord tumors. Teratomas include tissues that originate from the three germ layers. Several congenital disorders may accompany the teratoma. Teratomas are classified as mature, immature or malignant type according to their histological characteristics. Thoracic spinal teratomas are uncommon in the pediatric age group. More than half of the patients are adults. We present herein a five-year-old male patient who was referred to our clinic with cystic mature teratoma at the T12 level..


  • Mekaj AY, Morina AA, Mekaj YH, Manxhuka-Kerliu S, Miftari EI, Duci SB, et al.. Surgical treatment of 137 cases with chronic subdural hematoma at the university clinical center of Kosovo during the period 2008-2012. Journal of Neurosciences in Rural Practice 2015; 6: (2) 186-90'
    Abstract
    BACKGROUND: Chronic subdural hematoma (CSDH) is frequent pathology in neurosurgical practice. The aim of this study is to present the first series of patients with CSDH, who got surgically treated in Clinic of Neurosurgery, University Clinical Center of Kosovo. MATERIALS AND METHODS: This is a retrospective study that included 137 patients with CSDH who had been treated during the period 2008-2012. The data were collected and analyzed from the archives and protocols of the University Clinical Center of Kosovo. Patients were analyzed in many aspects such as age, gender, etiological factors, clinical features, localization, diagnoses, methods of surgical interventions, recurrences and mortality of patients. RESULTS: From 137 patients with CSDH, 106 (77.3%) were males and 31 (22.7%) females. Average age of patients was 62.85 years. Analyzed according to the decades, the highest number of causes with CSDH was between 70 and 79 years (46%). The head trauma has been responsible for CSDH in 88 patients (64.3%), while the main symptom was headache (92 patients or 67.1%). One burr-hole trepanation with closed drainage system has been used in majority of cases (in 101 patients or 73.7%). The recurrence of CSDH was 6.5%, whereas mortality 2.9%. CONCLUSION: CSDH is more common in elderly patients. The male-female ratio is 3.4:1. Like other authors we also think that treatment with one burr-hole and drainage is a method of choice, because of its simplicity and safety..


  • Kumar S, Dubey AK, Kalita J, Misra UK. The Role of Clinical Variables and VKORC1 Polymorphism in Efficacy and Stability of Acenocoumarol in Neurological Patients. Journal of Neurosciences in Rural Practice 2018; 9: (2) 186-92'
    Abstract
    Objective: To analyze the clinical importance of VKORC1 polymorphism and its correlation with stability of oral anticoagulation. Patients and Methods: In a hospital-based study, the patients on oral anticoagulant (OAC) were included during 2013-2016. The patients received OAC for cardioembolic stroke, cerebral venous sinus thrombosis (CVST), and prevention of deep vein thrombosis (DVT). Demographic, clinical, and neurological findings were recorded. Stability of anticoagulation was determined by percentage of time international normalized ratio (INR) values were in therapeutic range. Time in therapeutic range (TTR) >65% was defined as stable and <65% was defined unstable. VKORC 1 polymorphism was studied by polymerase chain reaction and correlated with daily dose of OAC and stability of INR. Results: A total of 157 patients with a median age of 40 years were included in the study. Ninety-two patients received OAC for secondary stroke prevention, 62 for CVST, and 3 for DVT. Out of 2976 INR reports, 1458 (49%) were in the therapeutic range, 997 (33.1%) were below the therapeutic range, and 521 (17.5%) were above the therapeutic level. Stable INR was obtained in 75 (47.77%) patients which was improved by drug modification in 3 and dietary adjustment in 12 patients. VKORC1 polymorphism revealed GG genotype in 127 (80.9%), GA genotype in 22 (14%), and AA genotype in 8 (5.1%) patients. Therapeutic range of INR was seen in 49%, below therapeutic range was seen in 31.5%, and above in 17.5%. Conclusion: VKORC1 polymorphism was related to mean daily dose of OAC but not to the stability of INR..


  • Gowda VK, Srinivas S. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 187-8'
    Abstract
    None.


  • Ponnala S. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 187-8'
    Abstract
    None.


  • Bajaj J, Agrawal M, Sinha VD. Blunt orbital injury causing traumatic intracranial aneurysm in a child. Journal of Neurosciences in Rural Practice 2016; 7: (1) 187-9'
    Abstract
    None.


  • Rajan VTT, Dharini GK, 3rd, Anand VSS, Nandish HS. When Mount Fuji Can Erupt after Seven Days: A Case Report of Delayed Posttraumatic Tension Pneumocephalus with Literature Review. Journal of Neurosciences in Rural Practice 2020; 11: (1) 187-90'
    Abstract
    Tension pneumocephalus (TPC) is a neurosurgical emergency that occurs when there is an expansion of trapped intracranial gas causing raised intracranial pressure. Rarely, posttraumatic TPC can occur even after 72 hours although the initial scans are normal. There are less than 20 cases of delayed TPC in the reported literature. Here, we report a case of delayed TPC that occurred 7 days after the initial injury and presented as sudden neurological deterioration. It was promptly diagnosed with a computed tomography brain and appropriate surgical intervention was performed and the outcome was good. We also did a literature review of reported cases of delayed TPC and looked out for factors that may predict its occurrence. The occurrence of an episode of cerebrospinal fluid rhinorrhea, followed by worsening of headache and sensorium in a patient with anterior cranial fossa fracture should alert a neurosurgeon to the possibility of delayed TPC..


  • Chakrabarti I, Ghosh N, Giri A. Cytologic diagnosis of undifferentiated high grade pleomorphic sarcoma of breast presenting with brain metastasis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 188-90'
    Abstract
    Primary sarcoma of breast are rare. Diagnosis by aspiration cytology is difficult due to nonspecific cytomorphologic features. An initial presentation with neurological symptoms due to metastasis of breast sarcoma to the brain has not been previously reported. Here, we describe a case of a 60-year-old female who presented with headache, dizziness and convulsion and was subsequently diagnosed with undifferentiated high grade pleomorphic sarcoma of breast with cerebellar metastasis..


  • Chandra SR, Issac TG. Battered woman syndrome: An unusual presentation of pseudodystonia. Journal of Neurosciences in Rural Practice 2014; 5: (2) 189-90'
    Abstract
    Pseudodystonia is the term used to define abnormal postures, which are not due to the disorders of the basal ganglia and is encountered very rarely in clinical practice and often difficult to distinguish from true dystonia syndromes. We report a rare case of a battered woman who was managed as restricted resistant dystonia with pharmacotherapy and intrathecal baclofen and referred for considering deep brain stimulation (DBS). The patient turned out to be a case of pseudodystonia due to bilateral hip dislocation. This was due to assault by a close relative and the history was masked by the patient for more than one and a half years. In a patient with late onset dystonia, who is resistant to the recommended treatment for dystonia along with atypical clinical features and electrophysiological parameters, pseudodystonia should always be considered as a possible diagnosis and evaluated for causes of the same..


  • Lakhotia M, Pahadiya HR, Prajapati GR, Choudhary A, Gandhi R, Jangid H. A case of anterior cerebral artery A1 segment hypoplasia syndrome presenting with right lower limb monoplegia, abulia, and urinary incontinence. Journal of Neurosciences in Rural Practice 2016; 7: (1) 189-91'
    Abstract
    None.


  • Suchanda B, Alugolu R, Purohit A, Lakshmi V, Sundaram C. A rare concomitant tubercular and Fonsecaea pedrosoi fungal infection of the skull base. Journal of Neurosciences in Rural Practice 2012; 3: (2) 189-91'
    Abstract
    Tuberculosis of the skull base and middle ear cavity is very rare. Infection with neurotropic fungi Fonsecaea pedrosoi is rare, which usually presents as brain abscess. We herein present an unusual case of concomitant tuberculosis and fungal (Fonsecaea pedrosoi) infections involving the middle ear cleft extending and destroying the craniovertebral junction..


  • Munivenkatappa A, Shukla DP, Devi BI, Kumarsamy AD, Bhat DI, Somanna S. Domestic animal-related neuro-trauma: An account, from a tertiary institute. Journal of Neurosciences in Rural Practice 2013; 4: (1) 19-23'
    Abstract
    CONTEXT: Experience of animal-related neurotrauma at an apex institute, National Institute of Mental Health and Neurosciences, Bangalore, India. AIMS: The aim of this study is to review epidemiology, clinical findings, and outcome of animal-related traumatic brain injury (TBI) evaluated and treated at our institute. SETTINGS AND DESIGN: A retrospective study consisting of demographic data, clinical findings, radiological details, and outcomes. MATERIALS AND METHODS: The clinical and imaging records of 30 patients treated for animal-related TBI at the emergency services, from January to July 2010. Outcome was assessed by Glasgow outcome scale (GOS). STATISTICAL ANALYSIS USED: SPSS 15.0 version, descriptive statistics. RESULTS: A total of 6190 neurotrauma cases were evaluated and treated during the study period. Among them, 30 (0.48%) were animal-inflicted injuries. Of these cases, animal-vehicle collision and directly animal-inflicted injuries were 15 (50%) each. The mean age of patients were 39.46 (6-71 years). Twenty-nine (96.66%) cases were from rural areas. Twenty-three (76.6%) had mild, 6 (20%) had moderate, and 1 (3.3%) had severe head injury (Glasgow coma scale). Four (13.3%) patients had abnormal pupillary reaction. Associated injuries were found in 25 (83.3%) patients. CT scan was abnormal in 50% (15/30), common finding was contusion in 8 (26.6%) patients, followed by edema in 6 (20%). There were 3 (10%) spine injuries, 1 (3.3%) internal carotid artery (ICA) dissection, and 2 (6.6%) brachial plexuses injuries. Three (10%) required surgery, and 1 (3.3%) patient expired. As per the GOS, good recovery was seen in 8 (80%) patients, moderate disability in 1 (10%), and vegetative state in 1 (10%) patient..


  • Gupta K, Purani CS, Mandal A, Singh A. Acute Febrile Encephalopathy in Children: A Prospective Study of Clinical Features, Etiology, Mortality, and Risk Factors from Western India. Journal of Neurosciences in Rural Practice 2018; 9: (1) 19-25'
    Abstract
    Introduction: Acute febrile encephalopathy (AFE) in children is a medical emergency and could be a manifestation of many systemic and central nervous system pathologies. The clinical features of AFE are nonspecific and etiological spectrum variable depending on the studied population. Materials and Methods: A prospective, observational study was carried out including children aged between 1 month and 12 years with AFE admitted to the Pediatric Intensive Care Unit of a tertiary care hospital in Western India. The primary objective was to assess the clinical presentation and etiology of AFE while the secondary objectives were to correlate the clinical and etiological findings and to determine the risk factors associated with mortality. Results: Out of the ninety children with AFE included in this study, male:female ratio was 1.2:1; most of them were aged between 1 and 5 years and came with a history of < 7 days (82.2%). All of them had altered sensorium, about 2/3(rd) had seizures and 47.8% having a Glasgow Coma Score (GCS) <8. Etiology remained elusive in about 40% of the cases, and viral infections were the most common among the ones with an identifiable cause. A variety of morbidity (shock, disseminated intravascular coagulopathy, respiratory failure, etc.) and high mortality (40%) was observed with risk factors associated with mortality being GCS < 8, the presence of raised intracranial pressure, shock, and respiratory failure. Conclusion: AFE, though a rare diagnosis in children, is associated with significant morbidity and high mortality in a developing country like India..


  • Hartel PH. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 190-1'
    Abstract
    None.


  • Nayak RB, Bhogale GS, Patil NM, Pandurangi AA. Mania associated with complicated hereditary spastic paraparesis. Journal of Neurosciences in Rural Practice 2011; 2: (2) 190-2'
    Abstract
    Hereditary spastic paraparesis (HSP) is an inherited group of neurological disorders with progressive lower limb spasticity. HSP can be clinically grouped into pure and complicated forms. Pure HSP is one without any associated neurological/psychiatric comorbidity. Depression is the most common psychiatric comorbidity. Presence of mania or bipolar affective illness with HSP is a rare phenomenon. We report a case of a 17-year-old boy who presented with classical features of HSP with complaints of excessive happiness, irritability, increased self-esteem and decreased sleep since 1 month. The patient also had complex partial seizure ever since he had features of HSP. The patient's father and younger sister suffer from pure HSP. The patient was diagnosed to have first episode mania with complicated HSP. The details of treatment and possible neurobiology are discussed in this case report..


  • Sharma P. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 191-2'
    Abstract
    None.


  • Sinha V. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 191-2'
    Abstract
    None.


  • Lapadula G, Caporlingua F, Paolini S, Missori P, Domenicucci M. Epidural hematoma with detachment of the dural sinuses. Journal of Neurosciences in Rural Practice 2014; 5: (2) 191-4'
    Abstract
    Epidural hematoma (EH) is a neurosurgical emergency that requires early surgical treatment. It is rarely extended bilaterally causing a detachment of the dural sinus or sinuses. The authors present two rare cases of EH with dural sinus detachment and describe how they suspend them. In these cases it is crucial to firmly suspend the dura mater and the dural sinus to the inner skull surface to prevent postoperative rebleeding..


  • Tsarouchas A, Mouselimis D, Bakogiannis C, Gkasdaris G, Dimitriadis G, Zioutas D, et al.. Spontaneous Epidural Hematoma of the Cervical Spine Following Thrombolysis in a Patient with STEMI-Two Medical Specialties Facing a Rare Dilemma. Journal of Neurosciences in Rural Practice 2020; 11: (1) 191-5'
    Abstract
    Spontaneous spinal epidural hematoma (SSEH) is a rare, albeit well-documented complication following thrombolysis treatment in ST elevation myocardial infarction (STEMI). A SSEH usually manifests with cervical pain and neurologic deficits and may require surgical intervention. In this case report, we present the first reported SSEH to occur following thrombolysis with reteplase. In this case, the SSEH manifested with cervical pain shortly after the patient emerged from his rescue percutaneous coronary intervention (PCI). Although magnetic resonance imaging reported spinal cord compression, the lack of neurologic symptoms prompted the treating clinicians to delay surgery. A dangerous dilemma emerged, as the usual antithrombotic regimen that was necessary to avoid stent thrombosis post-PCI, was also likely to exacerbate the bleeding. As a compromise, the patient only received aspirin as a single antiplatelet therapy. Ultimately, the patient responded well to conservative treatment, with the hematoma stabilizing a week later, without residual neurologic deficits. In conclusion, the conservative treatment of SSEH appears to be an acceptable option for carefully selected patients, but the risks of permanent neurologic deficits and stent thrombosis have to be weighted for each patient..


  • Pant I, Chaturvedi S, Jha DK, Kumari R, Parteki S. Central nervous system tumors: Radiologic pathologic correlation and diagnostic approach. Journal of Neurosciences in Rural Practice 2015; 6: (2) 191-7'
    Abstract
    OBJECTIVE: This study was conducted to formulate location-wise radiologic diagnostic algorithms and assess their concordance with the final histopathological diagnosis so as to evaluate their utility in a rural setting where only basic facilities are available. MATERIALS AND METHODS: A retrospective analysis to assess the concordance of radiology (primarily MRI) with final histopathology report was done. Based on the most common incidence of tumor location and basic radiology findings, diagnostic algorithms were prepared. RESULTS: For supratentorial intraaxial parenchymal location concordance was seen in all high-grade astrocytomas, low- and high-grade oligodendrogliomas, metastatic tumors, primitive neuroectodermal tumors, high-grade ependymomas, neuronal and mixed neuro-glial tumors and tumors of hematopoietic system. Lowest concordance was seen in low-grade astrocytomas. In the supratentorial intraaxial ventricular location, agreement was observed in choroid plexus tumors, ependymomas, low-grade astrocytomas and meningiomas; in the supratentorial extraaxial location, except for the lack of concordance in the only case of metastatic tumor, concordance was observed in meningeal tumors, tumors of the sellar region, tumors of cranial and paraspinal nerves; the infratentorial intraaxial parenchymal location showed agreement in low- as well as high-grade astrocytomas, metastatic tumors, high-grade ependymoma, embryonal tumors and hematopoietic tumors; in the infratentorial intraaxial ventricular location, except for the lack of concordance in one case of low-grade astrocytoma and two cases of medulloblastomas, agreement was observed in low- and high-grade ependymoma; infratentorial extraaxial tumors showed complete agreement in all tumors of cranial and paraspinal nerves, meningiomas, and hematopoietic tumors. CONCLUSION: A location-based approach to central nervous system (CNS) tumors is helpful in establishing an appropriate differential diagnosis..


  • Lee CC, Lin CF, Shih YH. Parkisonism followed by burr hole drainage for chronic subdural hemorrhage. Journal of Neurosciences in Rural Practice 2011; 2: (2) 193-4'
    Abstract
    There have been few reports on secondary parkisonism caused by chronic subdual hemorrhage (CSDH). In most reports, rigidity-bradykinesia syndrome resolved gradually after decompressive operation for CSDH. We report a 74-year-old male patient who suffered from CSDH status post burr hole drainage twice, and followed secondary parkinsonism thereafter. Decompression by burr hole drainage was successful. However, the conscious level was still altered and the patient began to present with rigidity and bradykinesia. Fortunately, the symptoms dramatically improved after taking L-dopa. CSDH-related parkinsonism may have pre-operative nigrostriatal dysfunction, which can not compensate further insults to the basal ganglia. Prescription of L-dopa may be helpful in these patients..


  • Keshavaraj A, Gamage R, Jayaweera G, Gooneratne IK. Idiopathic hypertrophic pachymeningitis presenting with a superficial soft tissue mass. Journal of Neurosciences in Rural Practice 2012; 3: (2) 193-5'
    Abstract
    Idiopathic hypertrophic pachymeningitis (IHP) is a chronic progressive diffuse inflammatory fibrosis of the dura-mater, leading to its diffuse enlargement. The following describes a case of IHP presenting with a superficial soft tissue mass. A 40-year-old female came to hospital with a subcutaneous lump over the left face and frontal headache for 6 months. An excision biopsy revealed chronic inflammation. Magnetic resonance imaging (MRI) of the brain showed left mastoiditis and early dural inflammation of the left temporal region. A few months later, she developed diplopia, complex partial seizures, and retrobulbar neuritis of the left optic nerve. Repeat MRI brain demonstrated meningeal thickening on both sides of the tentorium cerebelli extending to the left tempero-parietal meninges. The meningeal biopsy revealed markedly thickened fibro-connective dural tissue with infiltration of chronic inflammatory cells. There was no evidence of bacterial, fungal, tuberculous or neoplastic infiltration. IHP was diagnosed and steroid therapy initiated. Within weeks, she showed marked clinical improvement. IHP is a diagnosis of exclusion. The absence of underlying infective, neoplastic, or systemic autoimmune disease favors IHP. The above patient had headache, neuro-ophthalmic signs, seizures, which are features of IHP. However, superficial soft tissue involvement is rare..


  • Mehrotra A, Singh S, Kanjilal S, Attri G, Rangari K, Paliwal VK, et al.. Resistant Temporal Lobe Epilepsy: Initial Steps into a Bigger Epilepsy Surgery Program. Journal of Neurosciences in Rural Practice 2021; 12: (1) 193-6'
    Abstract
    Background Among the patients of drug-resistant epilepsy, a subset which has focal impaired seizures localizes to the temporal lobe region (TLE). A majority of these cases are surgically amenable with anterior-medial temporal lobe resection or "lesionectomy." Objective In India, there is scarcity of "specialized centers" providing "comprehensive epilepsy care" and this dearth is further worse in populous states. In this article, we share our single center, observational, and retrospective experience of TLE in background of limited resources and utmost requirement. Methodology Our study is a retrospective analysis medically refractory epilepsy patients (2016-2019). Patients with medically refractory epilepsy were selected based upon our noninvasive protocol (clinical semiology, interictal scalp electroencephalography (EEG), long-term video EEG monitoring data, and magnetic resonance injury [MRI]). The follow-up was noted from the last out-patient visit record or through telephonic conversation (International League Against Epilepsy score). Results Of 23 cases of TLE ( n = 7, mesial temporal sclerosis; n = 16 temporal lobe like cavernomas, tumors, or arterio-venous malformations). Single photon emission computed tomography/positron emission tomography (SPECT/PET) was performed in five cases (three cases of ictal/interictal SPECT and two cases of PET scan) where there was discordance between EEG/clinical and MRI. The median follow-up was of 19 months with 18 cases being seizure free. Five cases were fully off the antiepileptic drug (AEDs) while in 15 cases, the AEDs dosages or the number were reduced. Average number of AEDs reduced from 2.9 in preoperative period to 1.2 postoperatively. Two cases had quadrantanopia and one case of cerebrospinal fluid leak. Conclusion A multidisciplinary and holistic approach is required for best patient care. The results of our initial surgical experience are encouraging..


  • Akbar S, Tiwari SC, Tripathi RK, Pandey NM, Kumar A. Prevalence of Psychiatric Illness among Residents of Old Age Homes in Northern India. Journal of Neurosciences in Rural Practice 2018; 9: (2) 193-6'
    Abstract
    Context: There are many factors which compelled older adults to live in old age homes (OAHs) and vulnerable to psychological problems. Studies reported high prevalence of mental health problems (20%-60%) among elderlies of OAHs. Therefore, the study was conducted to explore prevalence of psychiatric illness (PI) among residents of OAHs of Northern India. Settings and Design: The present study was conducted in OAHs of Districts Bareilly, Lucknow, Varanasi, Dehradun, and Haridwar, using cross-sectional descriptive study method. Sample Size were 306 (male - 98 [32.5%] and female n = 208 [68%]) residing in OAHs selected by means of purposive sampling. Subjects and Methods: Inclusion criteria: (a) older adults aged 60 years and above residing in OAHs and able to communicate. (b) Staying in OAHs for 6 months or more. (c) Able to understand comprehends and reply to questions and (d) Giving written informed consent. Exclusion criteria: (a) Residents who declined/not interested to participate in the study. (b) Residents having any sensory impairment/physical health problem which can impede the interview. Research tools were (i) a semi-structured pro forma, (ii) Hindi Mental Status Examination, (iii) Survey psychiatric assessment schedule, and (iv) Schedules for clinical assessment in neuropsychiatry-based clinical interview for diagnosis of PIs according to International Classification of Disease 10. Statistical Analysis Used: The quantitative data obtained was analyzed by means of frequency tables. Results: The results show overall prevalence of PI is 43% among residents of OAHs. The prevalence of PI was found to be higher among females compared to males. Depression was the most common among the residents of OAHs. Conclusions: There is an urgent need of trained professionals to provide professional help for highly prevalent psychiatric disorders among residents of OAHs..


  • Hassan KM, Kumar D. Reversible diencephalic dysfunction as presentation of deep cerebral venous thrombosis due to hyperhomocysteinemia and protein S deficiency: Documentation of a case. Journal of Neurosciences in Rural Practice 2013; 4: (2) 193-6'
    Abstract
    A 45-year-old man presented with global headache, vomiting and abnormal behavior after cross-country run at high altitude. There was no seizure, loss of consciousness, fever or head injury. He was conscious, abulic and uncooperative with normal vitals. There was no focal neurological deficit. Non contrast computed tomography scan of head was normal. Magnetic resonance imaging of brain showed venous infarct in bilateral thalami, left basal ganglia and periventricular white matter. Magnetic resonance venography revealed thrombosis involving internal cerebral veins, septal veins, thalamostriate veins, vein of Galen and proximal portion of straight sinus. His condition steadily improved on low molecular weight heparin bridged with oral anticoagulation for one year. At two months, serum homocysteine was 31.51 mumol/l (5.46-16.2 mumol/l) and protein S was 49.00% (77-143.00%). He received methylcobalamin, pyridoxine and folic acid. After 16 months, he was asymptomatic with partially recanalized deep cerebral veins and serum homocysteine falling to 16.50 mumol/l (5.46-16.2 mumol/l)..


  • Menon G, Menon S, Hegde A. Does Universal Bypass before Carotid Artery Occlusion Obviate the Need for Balloon Test Occlusion: Personal Experience with Extracranial-Intracranial Bypass in 23 Patients. Journal of Neurosciences in Rural Practice 2019; 10: (2) 194-200'
    Abstract
    Aim: Carotid artery ligation carries a potential risk of ischemic complications even in patients with good collaterals and adequate cross-circulation. Preoperative assessment through balloon test occlusion (BTO) is technically challenging and not feasible in all patients. We analyze our experience with universal bypass without performing detailed cerebrovascular reserve (CVR) studies in 23 patients before carotid artery ligation. Patients and Methods: This was a retrospective analysis of the case records of 23 patients who underwent cervical carotid artery ligation for various indications since January 2009. Results: The study included 21 patients with cavernous carotid aneurysms, one patient with a large fusiform petrous carotid aneurysm, and one patient with recurrent glomus jugulare encasing the cervical internal carotid artery. The initial 12 patients underwent preoperative BTO with hypotensive challenge. All patients underwent a bypass procedure followed by carotid artery ligation irrespective of the BTO findings. Patients who successfully completed a BTO underwent a low-flow superficial temporal artery to middle cerebral artery bypass. A high-flow extracranial-intracranial bypass using a saphenous vein graft from external carotid artery to middle cerebral artery was done in all patients who either failed the BTO or did not undergo BTO. We had two operative mortalities and one poor outcome. All the other patients had a good recovery with a Glasgow outcome score of 5 at the last follow-up. Graft patency rates were 81.1% in both the low-flow and high-flow groups. Conclusion: Universal high-flow bypass is safe, effective, and should be preferred in all patients before carotid artery ligation. It obviates the need for detailed CVR assessment, especially in centers with limited resources..


  • McClelland S, 3rd, Goldstein JA. Minimally Invasive versus Open Spine Surgery: What Does the Best Evidence Tell Us?. Journal of Neurosciences in Rural Practice 2017; 8: (2) 194-8'
    Abstract
    BACKGROUND: Spine surgery has been transformed significantly by the growth of minimally invasive surgery (MIS) procedures. Easily marketable to patients as less invasive with smaller incisions, MIS is often perceived as superior to traditional open spine surgery. The highest quality evidence comparing MIS with open spine surgery was examined. METHODS: A systematic review of randomized controlled trials (RCTs) involving MIS versus open spine surgery was performed using the Entrez gateway of the PubMed database for articles published in English up to December 28, 2015. RCTs and systematic reviews of RCTs of MIS versus open spine surgery were evaluated for three particular entities: Cervical disc herniation, lumbar disc herniation, and posterior lumbar fusion. RESULTS: A total of 17 RCTs were identified, along with six systematic reviews. For cervical disc herniation, MIS provided no difference in overall function, arm pain relief, or long-term neck pain. In lumbar disc herniation, MIS was inferior in providing leg/low back pain relief, rehospitalization rates, quality of life improvement, and exposed the surgeon to >10 times more radiation in return for shorter hospital stay and less surgical site infection. In posterior lumbar fusion, MIS transforaminal lumbar interbody fusion (TLIF) had significantly reduced 2-year societal cost, fewer medical complications, reduced time to return to work, and improved short-term Oswestry Disability Index scores at the cost of higher revision rates, higher readmission rates, and more than twice the amount of intraoperative fluoroscopy. CONCLUSION: The highest levels of evidence do not support MIS over open surgery for cervical or lumbar disc herniation. However, MIS TLIF demonstrates advantages along with higher revision/readmission rates. Regardless of patient indication, MIS exposes the surgeon to significantly more radiation; it is unclear how this impacts patients. These results should optimize informed decision-making regarding MIS versus open spine surgery, particularly in the current advertising climate greatly favoring MIS..


  • Mohanty A. Cerebrospinal fluid rhinorrhea. Journal of Neurosciences in Rural Practice 2016; 7: (2) 195-6'
    Abstract
    None.


  • Anoop TM, John J, Nair SG, Mathew BS. Intracranial Rosai Dorfman disease. Journal of Neurosciences in Rural Practice 2014; 5: (2) 195-6'
    Abstract
    None.


  • Lowden MR. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 195-6'
    Abstract
    None.


  • Saifudheen K, Jose J, Gafoor VA. Holocord syringomyelia presenting as rapidly progressive foot drop. Journal of Neurosciences in Rural Practice 2011; 2: (2) 195-6'
    Abstract
    None.


  • Deora H, Singh S, Sardhara J, Behari S. A 360-Degree Surgical Approach for Correction of Cervical Kyphosis and Atlantoaxial Dislocation in the Case of Larsen Syndrome. Journal of Neurosciences in Rural Practice 2020; 11: (1) 196-201'
    Abstract
    Larsen syndrome is chronic debilitating disease that presents with multiple joint dislocations and severely affects the cervical spine in the form of cervical kyphosis and atlantoaxial dislocation. Children usually present in early with a myriad of deficits, compressive myelopathy being the most common. In addition to a bony compression, there is sometimes a soft tissue component, which is seldom addressed. We present here a case of atlantoaxial dislocation with cervical kyphosis due to Larsen syndrome, and along with our previous experience on syndromic atlantoaxial dislocations, we try to define an algorithm for the treatment approach of these onerous challenges. The importance of early intervention is also emphasized with a literature review of similar cases. In addition to the obvious physical damage, early intervention can also avoid the more sinister socioeconomic face of this debilitating disease..


  • Joubert C. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 196-7'
    Abstract
    None.


  • McMillan HJ, Ventureyra EC. Commentary. Journal of Neurosciences in Rural Practice 2011; 2: (2) 196-7'
    Abstract
    None.


  • Rahmayani F, Paryono, Setyopranoto I. The Role of Ejection Fraction to Clinical Outcome of Acute Ischemic Stroke Patients. Journal of Neurosciences in Rural Practice 2018; 9: (2) 197-202'
    Abstract
    Aims: The aim of the study was to determine the effect of left ventricular ejection fraction on clinical outcomes of acute ischemic stroke patients. Study Design: This study design was a prospective cohort observational study. Place and Duration of Study: This study was conducted at Stroke Unit, Neurology Ward, and Cardiology Ward at the Dr. Sardjito Hospital, Yogyakarta, Indonesia, between July and December 2016. Materials and Methods: Hospitalized acute ischemic stroke patients were recruited, with sample was taken by consecutive sampling until reaching amount fulfilling inclusion criterion was 62 persons. In this study, clinical outcomes were measured by National Institutes of Health Stroke Scale (NIHSS) scores as well as dependent variables and left ventricular ejection fraction as independent variables. Logistic regression analyses were performed to discover any potential independent variable that can influence the left ventricular ejection fraction role at the clinical outcomes with NIHSS scores. Results: Multivariate analyses revealed that several variables were significantly interacted with the influence of left ventricular ejection fraction at the clinical outcomes with NIHSS scores. These variables were the left ventricular ejection fraction <48% (95% confidence interval [CI]: 0.691-0.925; P = 0.001), left ventricular ejection fraction + low high-density lipoprotein (HDL) (95% CI: 0.73-0.949; P = 0,001), left ventricular ejection fraction + diabetes mellitus (DM) (95% CI: 0.799-0.962; P = 0,001), and left ventricular ejection fraction + low HDL + DM (95% CI: 0.841-0.98; P = 0,001). Conclusion: The influence of the lower left ventricular ejection fraction to clinical outcome of ischemic stroke patients has a worsening of neurological deficit outcome by considering the combination of several independent variables including the DM and low HDL..


  • Linsler S. Giant cavernous malformations. Journal of Neurosciences in Rural Practice 2016; 7: (2) 197-8'
    Abstract
    None.


  • Chaudhuri A. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 197-8'
    Abstract
    None.


  • Aditya G, Raju D, Shukla J, Ghosh N, Krishnan P. Coronavirus Disease 2019: A Wake-Up Call for Neurosurgeons to Learn Percutaneous Tracheostomy. Journal of Neurosciences in Rural Practice 2021; 12: (1) 197-9'
    Abstract
    Tracheostomy is a commonly performed operation in neurosurgical patients. It is an aerosol generating procedure and is considered a high-risk operation in times of the coronavirus disease 2019 pandemic. Though percutaneous tracheostomy has been around for some time, many neurosurgeons still perform open surgical tracheostomy as they have been trained in doing so and are well versed with the procedure. However, this pandemic is a wake-up call for them to learn a new skill that is simple, quick, and has several advantages over the traditional method..


  • Hakan T. Lumbar disk herniation presented with cauda equina syndrome in a pregnant woman. Journal of Neurosciences in Rural Practice 2012; 3: (2) 197-9'
    Abstract
    Despite low back pain being common in pregnancy, cauda equina syndrome is rare. Misdiagnosis and delay in treatment may cause neurological sequelae including urinary and fecal incontinence, sexual dysfunction in patients. A case of cauda equina syndrome in a pregnant woman at 25-week gestation is presented here. The patient underwent an emergency, standard lumbar microdiscectomy under general anesthesia on prone position. Neither the patient nor the baby had any complication related to surgery..


  • Ganz JC. Head injury management guidelines for general practitioners. Journal of Neurosciences in Rural Practice 2011; 2: (2) 198-200'
    Abstract
    A complete examination of a head injured patient in the hospital requires a number of instruments. These include a stethoscope, sphygmomanometer, ophthalmoscope, otoscope, cotton wool, safety pin, tuning fork, reflex hammer and a small key to test the plantar response. Few of these are required at the accident scene. This is because, in the hospital, the aim is optimal definitive treatment. At the accident scene, the aim is prevention of secondary injury, rapid recording of the most important findings and safe efficient transport to the hospital. This short paper reviews how the local doctor should undertake a neurosurgical assessment of traumatic brain injury patients. Moreover, the primary management at accident scenes is described and the rationale behind the approach is outlined..


  • Ozdemir HH, Demir CF, Varol S, Arslan D, Yildiz M, Akil E. The effects of needle deformation during lumbar puncture. Journal of Neurosciences in Rural Practice 2015; 6: (2) 198-201'
    Abstract
    OBJECTIVE: The aim of this study is to assess deformation of the tip and deflection from the axis of 22-gauge Quincke needles when they are used for diagnostic lumbar puncture (LP). Thus, it can be determined whether constructional alterations of needles are important for predicting clinical problems after diagnostic LP. MATERIALS AND METHODS: The 22-gauge Quincke needles used for diagnostic LP were evaluated. A specially designed protractor was used for measurement and evaluation. Waist circumference was measured in each patient. Patients were questioned about headaches occurring after LP. RESULTS: A total of 115 Quincke-type spinal needles used in 113 patients were evaluated. No deflection was detected in 38 (33.1%) of the needles. Deflection between 0.1 degrees and 5 degrees occurred in 43 (37.3%) of the needles and deflection >/= 5.1 degrees occurred in 34 patients (29.6%). Forty-seven (41.5%) patients experienced post lumbar puncture headache (PLPH) and 13 (11.5%) patients experienced intracranial hypotension (IH). No statistically significant correlation between the degree of deflection and headache was found (P > 0.05). Epidural blood patch was performed for three patients. Deformity in the form of bending like a hook occurred in seven needles and IH occurred in six patients using these needles. Two of the needles used in three patients requiring blood patch were found to be bent. CONCLUSION: Deformation of needles may increase complications after LP. Needle deformation may lead to IH. In case of deterioration in the structure of the needle, termination of the puncture procedure and the use of a new needle could reduce undesirable clinical consequences, especially IH..


  • Zenteno M, Lee A, Alvis-Miranda HR, Moscote-Salazar LR. Cerebral aneurysm in a patient with Loeys-Dietz syndrome. Journal of Neurosciences in Rural Practice 2014; 5: (2) 198-9'
    Abstract
    None.


  • Arvin B. Surgical resection of spinal teratomas, when the enemy of good surgical outcome can be trying for better?. Journal of Neurosciences in Rural Practice 2016; 7: (2) 199'
    Abstract
    None.


  • Vupputuri R, Rajesh A. Unusual supratentorial complication following posterior fossa surgery. Journal of Neurosciences in Rural Practice 2014; 5: (2) 199-201'
    Abstract
    None.


  • Dutta SE, Gupta S, Raju M, Kumar A, Pawar A. Platelet Serotonin Level and Impulsivity in Human Self-destructive Behavior: A Biological and Psychological Study. Journal of Neurosciences in Rural Practice 2017; 8: (2) 199-203'
    Abstract
    CONTEXT: Suicide is a disease and a global public health problem. Suicidology has come to become a topic of study for intervention and research. The serotonin (5-hydroxytryptamine [5HT]) system has remained a prime area of investigation. The neurons and platelets display structural and functional similarities. Ninety-nine percent of 5HT is contained in platelets, which shares similar 5HT uptake and release mechanisms with 5HT neurons. AIMS: This study aims to study human self-destructive behavior (HSDB). OBJECTIVES: Exploring the biological (serotonin levels in platelets) and psychological aspects (impulsivity) of attempted suicide or HSDB. SETTINGS AND DESIGN: Thirty-one patients, above the age of 18 years, with a recent history of HSDB, were studied and given an International Classification of Diseases-10 diagnosis, after a detailed interview. SUBJECTS AND METHODS: For the platelet 5HT estimation, blood samples were collected, and enzyme immunometric assay carried out. Detailed assessment of the impulsivity was done by the 25-item structured diagnostic interview for borderlines by Zanarini et al. STATISTICAL ANALYSIS USED: We obtained both categorical and continuous data. Chi-square test, Fisher's test, Student's t-test, and Pearson's product moment correlation were used. RESULTS: Female subjects outnumbered males by 2:1. Major depression, adjustment disorder, personality disorder were predominant diagnoses. The mean platelet serotonin concentration for males = 57.3 ng/ml, that of females = 56.05 ng/ml (P > 0.05). Platelet 5HT levels were found to be negatively correlated with impulsivity scores (P < 0.05). CONCLUSIONS: Platelet serotonin levels in our study sample were quite low when compared with those reported in published literature. Low serotonin levels were inversely related to impulsivity, but only in males..


  • Aalouane R, Rammouz I, Hafidi H, Boujraf S. Genital self-mutilation in an attempt of suicide by a patient with a borderline personality. Journal of Neurosciences in Rural Practice 2013; 4: (2) 199-203'
    Abstract
    Self-mutilation acts are known to characterize the borderline personality disorders. However, voluntary cutting of the male genital organ remains extremely rare. The present paper reports a case of a 25-years-old young male with a borderline personality. The patient committed a genital self-mutilation (GSM) targeting suicide during incarceration stage in jail. In addition, a discussion of the epidemiological and psychopathological aspects of the self-mutilation of borderline patients was been conducted. A particular interest is attributed to the genital self-mutilation and a review of the literature is presented..


  • Shukla D. Customizing Guidelines for Management of Traumatic Brain Injury. Journal of Neurosciences in Rural Practice 2020; 11: (1) 2'
    Abstract
    None.


  • Gloghini A, Carbone A. Primary central nervous system lymphoma. Journal of Neurosciences in Rural Practice 2015; 6: (1) 2-3'
    Abstract
    None.


  • Chitambira B. Importance of preliminary epidemiology studies in rural areas of developing countries. Journal of Neurosciences in Rural Practice 2012; 3: (1) 2-3'
    Abstract
    None.


  • Bajracharya A, Agrawal A, Yam B, Agrawal C, Lewis O. Spectrum of surgical trauma and associated head injuries at a university hospital in eastern Nepal. Journal of Neurosciences in Rural Practice 2010; 1: (1) 2-8'
    Abstract
    BACKGROUND: Trauma is one of the common surgical emergencies presenting at B. P. Koirala Institute of Health Sciences (BPKIHS), Nepal, a tertiary referral center catering to the needs of the population of Eastern Nepal and nearby districts of India. OBJECTIVE: The objective of this study is to analyze the magnitude, epidemiological, clinical profile and outcome of trauma at B P Koirala Institute of Health Sciences. MATERIALS AND METHODS: This descriptive case series study includes all patients with history of trauma coming to BPKIHS emergency and referred to the surgery department. We noted the detailed clinical history and examination, demographics, mechanism of injury, nature of injury, time of reporting in emergency, treatment offered (operative or non operative management) and analyzed details of operative procedure (i.e. laparotomy, thoracotomy, craniotomy etc.), average length of hospital stay, morbidity and outcome (according to Glasgow outcome scale). Collected data were analyzed using EpiInfo 2000 statistical software. RESULTS: There were 1848 patients eligible to be included in the study. The mean age of the patients was 28.9 +/- 19.3 years. Majority of the patients (38%) belonged to the age group of 21 - 40 years and the male to female ratio was 2.7:1. Most of the trauma victims were students (30%) followed by laborers (27%) and farmers (22%) respectively. The commonest causes of injury were fall from height (39%), road traffic accident (38%) and physical assault (18%); 78% of the patients were managed conservatively and 22% underwent operative management. Postoperative complications were seen in 18%. Wound infection 7.5%, neurological deficit including cerebrospinal fluid (CSF) otrorrhea was seen in 2.2% patients. Good recovery was seen in 84%, moderate disability in 5.2% patients and severe disability in 1.4% patients. The mortally was 6.3% and most of the deaths were related to traumatic brain injuries. CONCLUSIONS: In Nepal, trauma-related injury contributes significantly to morbidity and mortality and is the third leading cause of death. There are very few studies on trauma from this country and hence this study will help in understanding the etiology and outcome particularly in the Eastern region of Nepal..


  • Agrawal A, Kakani A, Vagh SJ, Hiwale KM, Kolte G. Cystic hemangioblastoma of the brainstem. Journal of Neurosciences in Rural Practice 2010; 1: (1) 20-2'
    Abstract
    Hemangioblastomas are very highly vascular neoplasm with benign characteristics and; in comparison to cerebellar hemangioblastoma; cases of cystic hemangioblastoma of the brain stem are rare with only a few case reports available in the literature. We report the case of a 43-year-old-female with cystic hemagioblastoma of the brainstem managed successfully and review the relevant literature..


  • Majdan M, Brazinova A, Rusnak M, Leitgeb J. Outcome Prediction after Traumatic Brain Injury: Comparison of the Performance of Routinely Used Severity Scores and Multivariable Prognostic Models. Journal of Neurosciences in Rural Practice 2017; 8: (1) 20-9'
    Abstract
    OBJECTIVES: Prognosis of outcome after traumatic brain injury (TBI) is important in the assessment of quality of care and can help improve treatment and outcome. The aim of this study was to compare the prognostic value of relatively simple injury severity scores between each other and against a gold standard model - the IMPACT-extended (IMP-E) multivariable prognostic model. MATERIALS AND METHODS: For this study, 866 patients with moderate/severe TBI from Austria were analyzed. The prognostic performances of the Glasgow coma scale (GCS), GCS motor (GCSM) score, abbreviated injury scale for the head region, Marshall computed tomographic (CT) classification, and Rotterdam CT score were compared side-by-side and against the IMP-E score. The area under the receiver operating characteristics curve (AUC) and Nagelkerke's R(2) were used to assess the prognostic performance. Outcomes at the Intensive Care Unit, at hospital discharge, and at 6 months (mortality and unfavorable outcome) were used as end-points. RESULTS: Comparing AUCs and R(2)s of the same model across four outcomes, only little variation was apparent. A similar pattern is observed when comparing the models between each other: Variation of AUCs <+/-0.09 and R(2)s by up to +/-0.17 points suggest that all scores perform similarly in predicting outcomes at various points (AUCs: 0.65-0.77; R(2)s: 0.09-0.27). All scores performed significantly worse than the IMP-E model (with AUC > 0.83 and R(2) > 0.42 for all outcomes): AUCs were worse by 0.10-0.22 (P < 0.05) and R(2)s were worse by 0.22-0.39 points. CONCLUSIONS: All tested simple scores can provide reasonably valid prognosis. However, it is confirmed that well-developed multivariable prognostic models outperform these scores significantly and should be used for prognosis in patients after TBI wherever possible..


  • Joseph J, Hooda K, Chauhan I, Dhull K. The Caregiver Reported Autistic Symptoms in Preschool Children: Findings of Chandigarh Autism Screening Instrument (CASI) Linked Screening from North India. Journal of Neurosciences in Rural Practice 2021; 12: (1) 200-3'
    Abstract
    Background Autism is a neurodevelopmental disorder and can be early detected with the aid of screening tools. Chandigarh autism screening instrument (CASI) is a newly developed tool to screen autistic symptoms among children aged between 1.5 to 10 years in the north Indian Hindi speaking population. Objective In this study, we evaluated the caregiver report of autistic symptoms in preschool children (3-6 years) attending selected schools of Rohtak. Materials and Methods The index study was conducted among 225 caregivers of school-going children aged between 3 to 6 years. Social and communication disorders checklist (SCDC-Hindi) and CASI was used to measure autistic symptoms. The modified Kuppuswamy scale was used for assessing the socioeconomic status of the caregivers. Results The autistic symptoms varied from 2.2 to 18.7%, depending upon the CASI (cutoff score of 10) and SCDC (cutoff score of 9) measurements. The items in the shorter four-item version (CASI Bref) of CASI were found to be the predictors of autistic symptoms in this population. Children's gender, age, and socioeconomic status were not found to have any association with autistic symptoms in this setting. Conclusion The study provides preliminary evidence in relation to the CASI-linked screening for autistic symptoms among preschool children. The shorter version of CASI (CASI Bref) can be an efficient quick screener for autistic traits, but the full version of CASI needs to be validated as per age-appropriate autism screening tools..


  • Salunke P, Sharma M, Gupta K, Kovai P, Aggarwal A. Cerebellopontine angle ependymoma in a 2-year- old child. Journal of Neurosciences in Rural Practice 2012; 3: (2) 200-3'
    Abstract
    The management of cerebellopontine angle (CPA) ependymoma in children below 3 years of age is challenging. In addition to the rare occurrence of disease, the difficulty also lies in achieving gross total resection and providing radiotherapy in this subset of patients. We describe a case of CPA ependymoma in a 2-year-old child. Gross total excision was achieved followed by administration of radiotherapy. In this article, a review of literature for this rare entity and the difficulties faced in the surgery and adjuvant treatment has been discussed..


  • Hagos EG, Asfeha GG, Berihu BA. Prevalence of substance abuse among regular degree health science students in Sheba University College in Mekelle Town, Tigray - Ethiopia. Journal of Neurosciences in Rural Practice 2016; 7: (2) 200-5'
    Abstract
    BACKGROUND: Substance abuse (SA) refers to the harmful or hazardous use of psychoactive substances, including alcohol and illicit drugs. The most common substances which are usually abused are alcohol and tobacco. Herein, we assessed the prevalence of SA among regular degree health science students of the Sheba University College (SUC). MATERIALS AND METHODS: A cross-sectional survey was carried out among 1076 SUC students using self-administered structured questionnaire. The simple sampling technique was used to select students. Descriptive statistics, bivariate, and multivariate analysis were done. RESULTS: The overall prevalence of "ever used substance" for at least one was 45.5%. The most commonly used drugs in descending order were alcohol (25.1%), cigarette (11.4%), and khat (9.2%). Male participants, urban setting, peer pressure, personal pleasure, and academic dissatisfaction and pocket money were highly associated with SA. CONCLUSION: This study showed a lower magnitude (45.6% ever use and 21% still using) of SA among students' compared to other studies. Even if a considerable decrease in SA among study subjects, the creation of awareness and health education should be continued to fully combat the problem of abuse..


  • Antic B. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 201-2'
    Abstract
    None.


  • Ajayi E, Obimakinde O. Cephalic tetanus following tooth extraction in a Nigerian woman. Journal of Neurosciences in Rural Practice 2011; 2: (2) 201-2'
    Abstract
    None.


  • Arora PC, Ragi KGS, Arora A, Gupta A. Oral Health Behavior and Treatment Needs among Drug Addicts and Controls in Amritsar District: A Case-controlled Study. Journal of Neurosciences in Rural Practice 2019; 10: (2) 201-6'
    Abstract
    Background: Substance and drug abuse is associated with severe psychosocial problems, violence and health complications. Aims: The aim of the study was to evaluate and compare the oral hygiene status and sugar eating patterns among drug addicts with their age, gender and socio-economic status matched controls. Settings and Design: The present study comprised of two groups-Group A comprised of 100 drug addicts and Group B included 100 controls. The study sample were interviewed and subjected to a comprehensive intra-oral examination. Methods and Material: Standardized methods of evaluation were performed using mouth mirror, dental probe, explorer and WHO probe. Statistical Analysis: The data was subjected to statistical analysis using Chi Square test and student t-test. Results and Conclusions: CPITN index revealed bleeding in 56% addicts and calculus in 20% addicts. The mean DMFT of group A was 5.71 as compared to 2.45 in group B. The frequency of sugar consumption was found to be high in addicts as compared to the controls. Significant P values (< 0.001) of DMFT index, periodontal status and frequency of sugar consumption were obtained on statistical analysis. The caries status was found to be poor in addicts, but the periodontal treatment needs were similar for both group A and B. Oral health promotion should be undertaken in drug rehabilitation centers for overall success of withdrawl treatment..


  • Nayak PK, Dutta J. Craniomapper for accurate localization of lesion during craniotomy: How much benefit does it have over anatomical marking? Report of two cases. Journal of Neurosciences in Rural Practice 2014; 5: (2) 202-3'
    Abstract
    None.


  • Samson SK, Poonoose SI, Rajshekhar V. Intracranial tuberculoma associated with subdural hematoma. Journal of Neurosciences in Rural Practice 2011; 2: (2) 202-3'
    Abstract
    None.


  • Panda S, Verma D. Intractable Hiccups due to Isolated Parainfectious Myelitis. Journal of Neurosciences in Rural Practice 2020; 11: (1) 202-4'
    Abstract
    Demyelinating disorders of the central nervous system are diseases that affect the optic nerves, brain, and spinal cord, leading to visual loss, brainstem dysfunction, and locomotor dysfunction. Intractable vomiting is a rare phenomenon seen due to the involvement of the medulla oblongata in neuromyelitis optica, a rare autoimmune demyelinating disorder. We present our experience with a 33-year-old male who presented to our facility with complaints of intractable hiccups. After extensive evaluation, he was found to have parainfectious myelitis. His symptoms completely resolved following institution of appropriate therapy. Through this report, we hope to bring attention to an unusual cause of intractable hiccups that may often go undiagnosed in general practice..


  • Saxena A, Suman A. Magnitude and determinants of depression in acute stroke patients admitted in a rural tertiary care hospital. Journal of Neurosciences in Rural Practice 2015; 6: (2) 202-7'
    Abstract
    BACKGROUND: Depression is one of the most frequent neuropsychiatric disturbances after a cerebrovascular stroke. The frequency of depression in stroke patients has varied widely in different populations. Post stroke depression is an important factor limiting recovery and rehabilitation in acute stroke patients. SETTINGS AND DESIGN: A cross-sectional hospital-based study was performed in acute stroke patients admitted in the department of Medicine of a rural teaching tertiary care hospital in central India. MATERIALS AND METHODS: In all consecutive acute stroke inpatients, the intensity of depression was assessed by a trained person through a questionnaire, Montgomery-Asberg Depression Rating Scale (MADRS), who is blind of the diagnosis and investigations of the patient. Another study person collected the data including demographics, co-morbid diseases or risk factors. Radiological imaging data was noted from the CT/MRI head reports of stroke patients. RESULTS: Of the total 107 stroke patients, 60 (56%) were males and 47 (44%) were females. Sixty-one (57%) of the 107 stroke patients had depression. Of the 107 stroke patients, 35 (33%) had mild depression, 22 (20%) had moderate depression and 4 (4%) had severe depression. The age, gender, education status and co-morbidities of the stroke patient were not associated with depression. The association of socio-economic status and left-sided lesions with depression was found to be statistically significant (P < 0.05). Type and location of the lesion were not associated with depression. CONCLUSION: Post-stroke depression was present in more than half of the stroke patients and was related to socio-economic status and left-sided hemisphere lesions..


  • Munivenkatappa A, Shukla DP. Atypical meningioma and acute subdural hemorrhage. Journal of Neurosciences in Rural Practice 2014; 5: (2) 203-4'
    Abstract
    None.


  • Menon B. Serpentine calcification: A radiological stigma. Journal of Neurosciences in Rural Practice 2011; 2: (2) 203-4'
    Abstract
    None.


  • Mado S, Aliyu I, Murtala R. Changing Pattern of Childhood Epidemic Cerebrospinal Meningitis in North-Western Nigeria. Journal of Neurosciences in Rural Practice 2018; 9: (2) 203-7'
    Abstract
    Introduction: Nigeria lies within the meningitis belt which extends from the Gambia, Senegal through Nigeria to Eritrea; however, outbreaks have been shown to extend further south involving countries such as Angola and Namibia. Epidemic outbreaks are often recorded every 8-12 years averaging in a 10 yearly circle however endemic cases still occurs. Materials and Methods: The study was retrospective; all results of cerebrospinal fluid (CSF) samples of children with cases of meningitis from January 2010 to December 2010 were collected from the register of the microbiology laboratory of General Hospital Gusau. Relevant information such as their age, sex, CSF macroscopy/microscopy reports, latex particle agglutination test report, and CSF culture report were retrieved and entered into a pro forma. Results: There were 89 (73%) males and 33 (27%) females with male to female ratio of 2.7:1. The age ranged from 2 months to 14 years; the mean was 6.27 +/- 4.00 years. Meningitis was mostly recorded from January to April. W135 was the most common serotype identified. Majority of the samples (54) which were nonreactive for any of the tested antigens had clear CSF (36), while among those that reacted; the W135 group had a high proportion of cases that had turbid CSF (44); (Fisher's exact test = 30.650, P = 0.000). Majority of the samples (99) had no cell count; although those of the W135 group had higher cell counts followed by those in the nonreactive group (Fisher's exact test = 11.226, P = 0.181). Conclusion: Meningitis was highest between January and April, and W135 was the most common serotype..


  • Menon D, Jagtap SA, Nair MD. Guillain-Barre syndrome following acute viral hepatitis A. Journal of Neurosciences in Rural Practice 2014; 5: (2) 204-5'
    Abstract
    None.


  • Hashmi M. Acute inter-hemispheric subdural hematoma in a kabaddi player: A comment. Journal of Neurosciences in Rural Practice 2011; 2: (2) 204-5'
    Abstract
    None.


  • Eseigbe EE, Taju NF, Lateef ST. Challenges in care of the child with special health care needs in a resource limited environment. Journal of Neurosciences in Rural Practice 2013; 4: (2) 204-6'
    Abstract
    To identify challenges encountered in the care of children with special health care needs in a resource limited environment a 10 year-old child with a diagnosis of Tuberous Sclerosis was studied. Challenges identified were in: making a definitive diagnosis, provision of adequate care, cost of care, meeting parental expectations and accessing community support for the child and family. Available specialist health care and related services, including community rehabilitation, were provided for the child and family. The study highlights the need for improved community awareness, development in the provision of specialist health care services and institution of governmental policies that identify, support and protect children with special health care needs..


  • Kumar AP, Babu E, Subrahmanyam D. Cerebrogenic tachyarrhythmia in acute stroke. Journal of Neurosciences in Rural Practice 2012; 3: (2) 204-6'
    Abstract
    The electrocardiac abnormalities following acute stroke are frequent and seen in both ischemic and hemorrhagic stroke. The changes seen in electrocardiogram (ECG) consist of repolarization abnormalities such as ST elevation, ST depression, negative T waves, and QT prolongation. Among tachyarrhythmias, atrial fibrillation is the most common and occurrence of focal atrial tachycardia is very rare though any cardiac arrhythmias can follow acute stroke. We report a case of focal atrial tachycardia following acute ischemic stroke in 50-year-old female without structural heart disease, and their mechanisms and clinical implications..


  • Banakar BF, Hiregoudar V. Clinical Profile, Outcome, and Prognostic Factors of Cortical Venous Thrombosis in a Tertiary Care Hospital, India. Journal of Neurosciences in Rural Practice 2017; 8: (2) 204-8'
    Abstract
    BACKGROUND: Cortical venous thrombosis (CVT) is a rare condition, compared to arterial stroke and often occurs in young individuals presenting with varying clinical features. AIM: The aim is to study clinical profile and assess the outcome and prognostic factors of CVT patients. METHODOLOGY: A case series study was done for 2 years. CVT cases confirmed by magnetic resonance imaging were included in this study. Clinical presentation and risk factors were noted then patients were assessed at the time of discharge for their physical and mental status. Modified Rankin scale was used to group patients, accordingly scores 0-2 were considered as good and 3-6 as poor outcome, respectively. Data were analyzed using Chi-square test to know the association between prognostic factors and outcome. RESULTS: Out of 81 patients, more than half of the patients were in the age group of <35 years (55.6%), and majority of patients were females (79%). Most common symptom was headache (82.7%) and least was fever (14.8%). Superior sagittal sinus was most commonly involved (74.1%). Nearly half of the patients were in puerperal period (44.1%). Patients aged more than 35 years (odds ratio [OR]: 9.1, confidence interval [CI]: 4.463-19.750) presenting with symptoms such as fever (OR: 3.442, CI: 1.088-12.140), impaired consciousness (OR: 5.467, CI: 2.064-15.330) and having clinical signs such as coma (OR: 23.99, CI, 3.844-544.1), papilledema (OR: 25.15, CI: 7.565-101.5), and with focal neurological deficit (OR: 9.366, CI: 2.693-3.41) had statistically significant poor outcome. CONCLUSION: Females formed a major bulk of patients. Higher number patients showed poor outcome. Study showed association between age, headache, impaired consciousness, coma, papilledema, and neurological deficit to poor outcome..


  • Setyopranoto I, Susetyowati, Lestari LA, Probosuseno, Wijayanti PM, Rochmah MA. The Effects of Local Food-Based Enteral Nutrition to Improve Nutritional Status of Post-Stroke Patients. Journal of Neurosciences in Rural Practice 2021; 12: (1) 204-9'
    Abstract
    Objective We used local-based enteral formula for post-stroke patients to see its effects on the nutritional status. Materials and Methods This is an experimental research with a pre- and post-test study design in post-stroke patients. Participants underwent clinical and laboratory examinations to assess their nutritional status before and after the enteral nutrition supplementation. The enteral formula preparation, containing arrowroot powder, cork fish, tempeh (fermented soybeans), nondairy creamer, and pumpkin, was performed in a nationally standardized Food Processing Technology Laboratory in Yogyakarta, Indonesia. The enteral formula was given twice a day for 3 consecutive weeks in addition to the patients' daily meal. Statistical Analysis Nutritional indices before and after enteral nutrition supplementation were analyzed using t-test . All statistical analyses were at 5% significance level. Results Of the 22 post-stroke patients, we used the cutoff point of National Institutes of Health Stroke Scale >/=3 and Barthel Index <90 to represent dependency. Our findings showed significantly reduced mid-upper arm circumference and increased body mass index in independent post-stroke patients after the enteral nutrition supplementation. The tendency of increasing total cholesterol level should be carefully watched in dependent post-stroke patients. Conclusion Local food-based enteral nutrition supplementation for 3 consecutive weeks in post-stroke patients may improve their nutritional status..


  • James J, Jose J, Gafoor VA, Smita B, Balaram N, Ramachandran A. Clinical Course, Imaging Characteristics, and Therapeutic Response in Myelin Oligodendrocyte Glycoprotein Antibody Disease: A Case Series. Journal of Neurosciences in Rural Practice 2020; 11: (1) 205-10'
    Abstract
    Myelin oligodendrocyte glycoprotein (MOG) antibody disease is a novel central nervous system autoimmune disorder which forms part of aquaporin 4 (AQP-4) negative, neuromyelitis optica (NMO) spectrum disorder. It has a distinct clinical profile, neuroimaging features and courses from AQP-4 positive NMO and multiple sclerosis. This article is a case series of six patients with MOG antibody disease with longitudinal follow-up for up to 8 months..


  • Agrawal A. Author's reply. Journal of Neurosciences in Rural Practice 2011; 2: (2) 205-6'
    Abstract
    None.


  • Chroni E. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (2) 206'
    Abstract
    None.


  • Wiwanitkit V. Zidovudine-induced myopathy. Journal of Neurosciences in Rural Practice 2011; 2: (2) 206'
    Abstract
    None.


  • Rozatkar AR. Stigma of suicide. Journal of Neurosciences in Rural Practice 2014; 5: (2) 206-7'
    Abstract
    None.


  • Sagar A, Mohanty AP, Bahal A. Author's reply. Journal of Neurosciences in Rural Practice 2011; 2: (2) 206-7'
    Abstract
    None.


  • Velivela K, Rajesh A. Paradoxical response in spinal tuberculosis: Lessons learnt. Journal of Neurosciences in Rural Practice 2016; 7: (2) 206-9'
    Abstract
    BACKGROUND: Patients with spinal tuberculosis started on antituberculous treatment (ATT) empirically and showing increasing size of the lesion on follow-up are a treatment challenge. We describe our experience in managing such cases. MATERIALS AND METHODS: We treated 80 patients with spinal tuberculosis at our institute from January 2012 to June 2014. Of these, 50 were managed by surgical intervention and the rest 30 were managed conservatively only on anti-tubercular drugs. Six patients out of these 30 patients, showed a paradoxical increase in the size of lesion without any neurological deficits after 3 months of starting ATT. Surgical intervention was done in three cases, whereas other three were managed by ultrasound-guided tapping of the lesion with continuation of ATT. RESULTS: There was an improvement in the symptoms with weight gain and normalcy of appetite. However, all these patients had lymphopenia on differential leukocyte counts at the outset which normalized at 3 months. CONCLUSION: The mainstay of management of paradoxical response in spinal tuberculosis should be conservative with drainage or aspiration of abscesses along with the continuation of ATT. Surgical decompression and stabilization may be necessary in few cases who develop new neurological deficits or deformity or instability..


  • Patel RK, Choubey AK, Soni BK, Sivasankar R, Chauhan V. Pattern of Emergent Head Computed Tomography Findings in a Tertiary Care Hospital during off Working Hours: Retrospective Analysis. Journal of Neurosciences in Rural Practice 2019; 10: (2) 207-11'
    Abstract
    Introduction: Emergency head computed tomography (CT) is rising exponentially during off working hours due to evidence-based medicine, patient's expectation and desires, easy availability and apprehension of medico-legal cases, thereby raising health-care cost. There is huge gap in demand and supply of radiologist, especially during off working hours. There is need to know the pattern of emergency head findings. Materials and Methods: A retrospective analysis of all emergent noncontrast CT head during off working hours in the Department of Radiodiagnosis of a Tertiary Care Hospital, Mumbai, India, which were performed from June 2017 to May 2018. CT findings of 308 patients were analyzed. Results: About 63.6% of total head CT showed no significant abnormality. The most common abnormality was intracranial hemorrhage which was just 9.1% followed by acute infarct which was 6.2%. Extradural hemorrhage, subdural hemorrhage, and subarachnoid hemorrhage was only 1% each of total head CT findings. No significant abnormality was detected in 74.65%, 70.21%, 89.13%, 31.37%, 100%, and 69.09% in cases of head injury, seizure, giddiness/dizziness/syncope, cerebrovascular accident, transient ischemic attack, and altered sensorium, respectively. Conclusion: Pattern analysis of emergent head CT reveals that most of the emergent CT head shows no significant abnormality. There is a need for stringent guidelines for emergent head CT, training of emergency physician as well as CT technician for common findings to bridge the radiologist demand-supply gap for providing effective health care in peripheral hospitals..


  • Mamta, Nebhinani N, Tamphasana L, Gaikwad AD. Nursing students' attitude toward suicide attempters. Journal of Neurosciences in Rural Practice 2014; 5: (2) 207-8'
    Abstract
    None.


  • Shukla D, Rao VS, Rajesh A, Uppin MS, Purohit AK. Lumbar extradural dumbbell cavernous hemangioma: A rare lesion. Journal of Neurosciences in Rural Practice 2013; 4: (2) 207-9'
    Abstract
    A 52-year-old female presented with slowly progressive left lower limb polyradiculopathy. MRI of the lumbar region revealed an extradural dumbbell mass at L3 vertebral level, isointense on T1W and hyperintense on T2W images with homogenous contrast enhancement and extending into paraspinal region through left L3/4 foramen. L2 to L 4 left hemilaminectomy and excision of intraspinal part of tumor was performed. Histopathological examination revealed presence of cavernous hemangioma. This case is reported because of its rarity, unusual dumbbell shape of lesion and difficulty in making a preoperative diagnosis without a coexisting bone lesion..


  • Jadav R, Sinha S, Nagarathna S, Bindu P, Mahadevan A, Bharath R, et al.. Carcinomatous meningitis: Yet another cause for rapidly progressive dementia and triphasic waves in electroencephalograph!. Journal of Neurosciences in Rural Practice 2012; 3: (2) 207-9'
    Abstract
    We report a 65-year-old woman who manifested with progressive cognitive impairment, abnormal behavior, slurred speech, inability to carry out activities with right upper limb, gait disturbances, emotional liability, and double incontinence that evolved progressively over the last 8 months. A clinical syndrome of "rapidly progressive dementia" was considered. The MRI of brain was unremarkable except for small para third ventricular enhancing lesion was detected in the left thalamic region. There was bi/tri-phasic sharp waves in the routine scalp EEG occurring at periodically 1.5-2.0 Hz, mimicking Creutzfeldt-Jakob disease (CJD). She was later diagnosed to have carcinomatous meningitis based on cerebrospinal fluid (CSF) cytology. This case is being discussed for rarity and interesting EEG observations in patients with carcinomatous meningitis and to highlight the importance of CSF cytology in an appropriate clinical setting. One needs to be careful in concluding CJD as possible diagnosis in such scenario..


  • Gupta N, Raja K. Rehabilitation robotics in India. Journal of Neurosciences in Rural Practice 2011; 2: (2) 207-9'
    Abstract
    None.


  • Kalita J, Sonkar KK, Misra UK, Bhoi SK. Does Metabolic Syndrome Determine Severity and Disability of Chronic Low Backache?. Journal of Neurosciences in Rural Practice 2018; 9: (2) 208-13'
    Abstract
    Introduction: Obesity may be associated with more severe and disabling low backache (LBA) due to alteration in biomechanics, but there are no such studies from developing countries. Aims: We report the frequency of metabolic syndrome (MS) in chronic LBA (CLBA) and its association with severity and disability of CLBA. Subjects and Methods: Consecutive patients with CLBA attending to the neurology service from October 2015 to February 2016 were included in the study. Clinical and demographic parameters were recorded. Routine biochemical test was done. The severity of pain was assessed by a 0-10 Numeric Rating Scale (NRS) and disability by Oswestry Disability Index (ODI) version 2. Comparison of variables was done by Chi-square or independent t-test and correlation by Karl Pearson or Spearman's rank correlation test. Results: Seventy-none (39.3%) patients had MS as per the International Diabetic Federation (IDF) criteria and 68 (33.8%) as per the National Cholesterol Education Program Adult Treatment Panel III criteria. Abdominal obesity was the most common (171 [85.1%]) feature of MS. The patients with MS had longer duration of sitting work and did less frequently exercise. The NRS score (6.95 +/- 1.06 vs. 6.65 +/- 0.95; P = 0.04) and ODI score (54.91 +/- 8.42 vs. 51.89 +/- 8.54; P = 0.01) were higher in CLBA patients with MS compared to those without MS. Conclusion: About 40% patients with CLBA have metabolic syndrome, and they have more severe pain and disability..


  • Mojumder DK, Patel S, Nugent K, Detoledo J, Kim J, Dar N, et al.. Pupil to limbus ratio: Introducing a simple objective measure using two-box method for measuring early anisocoria and progress of pupillary change in the ICU. Journal of Neurosciences in Rural Practice 2015; 6: (2) 208-15'
    Abstract
    INTRODUCTION: Measurement of static pupillary size in the ICU is of importance in cases of acutely expanding intracranial mass lesions. The inaccuracies with subjective assessment of pupillary size by medical personnel preclude its use in emergent neurological situations. OBJECTIVE: To determine if the ratio of pupil to limbus diameter (PLD ratio) measured by a two-box method is a reliable measure of pupil size for detecting early anisocoria and measuring pupillary changes. MATERIALS AND METHODS: The PLD ratio was defined as the ratio of the pupillary diameter measured at a para-horizontal axial plane with the limbus diameter measured at the same or parallel axial plane. A two-box method was used to estimate the diameters of imaged pupils. Eyes were imaged using an iPhone 4S cellphone camera. Background illumination was measured and kept constant. The pupils of a 78-year-old woman, who presented with a large intra-axial parenchymal hemorrhage, were imaged. The patient had left pupillary miosis in dark but not in bright light. After presenting this case along with the images of the pupillary examination, a group of 21 medical staff were asked several questions on the pupillary examination. Reliability of PLD ratio were assessed via standard error of mean (S.E.M) of PLD ratios for 3 different subjects each imaged under constant illumination and fixation but from different angles to the optical axis. RESULTS: Analysis of questionnaire data together with PLD ratios revealed that ~ 14% and 10% of participants could estimate the pupillary size in darkness and bright light respectively but none were simultaneously accurate indicating that subjective assessment of pupillary size was unreliable. The approach towards a systematic pupillary examination was inconsistent among the participants. The PLD ratio was found to be a reliable measure of pupillary size with standard error of mean below 0.1 mm for the three subjects tested. CONCLUSION: Static pupillary sizes can be objectively and consistently evaluated using PLD ratios using a two-box method. PLD ratios are resistant, within limits, to changes in imaging angle or choice of para-horizontal axes for measurement..


  • Herreros IC, Campero A. Staging in giant vestibular Schwannoma surgery. Journal of Neurosciences in Rural Practice 2014; 5: (3) 209'
    Abstract
    None.


  • Jepsen JR. Work-related upper limb disorders: Can prevention and management be improved?. Journal of Neurosciences in Rural Practice 2011; 2: (2) 209-10'
    Abstract
    None.


  • Sinha AG, Sharma R. Factors Influencing Utilization of Physiotherapy Service among Children with Cerebral Palsy in Jalandhar District of Punjab. Journal of Neurosciences in Rural Practice 2017; 8: (2) 209-15'
    Abstract
    BACKGROUND: Physiotherapy plays a central role in the management of children with cerebral palsy (CP); however, literature describing the use of physiotherapy service and the factors affecting utilization of physiotherapy service for this group of children in the Indian context remain unexplored. AIMS AND OBJECTIVES: To describe the utilization of physiotherapy services and explore the factors affecting utilization of physiotherapy services among children with CP of Jalandhar district of Punjab. METHODOLOGY: During June 2009 to March 2012 interview of family members of 248 children with CP (male = 159; female = 89) was conducted using a schedule focusing on demography, constraints of resources, expectations, beliefs, awareness, and service utilization. Cross tabulation with Chi-square, univariate, and multivariate logistic regression analysis were the tools of statistical analysis. RESULTS: 44.4% children had not received any physiotherapy in their life time. In univariate analysis exposure to physiotherapy was found significantly associated with age of diagnosis (odds ratio [OR] = 2.47), finance constraint (OR = 2.27), personal constraint (OR = 2.54), transportation constraint (OR = 3.01), lack of advice for rehabilitation (OR = 2.36), ignorance about condition (OR = 11.94), and rehabilitation services (OR = 2.88). Multivariate model (chi(2) = 57.16, df = 15, P < 0.001, pseudo R(2) Cox and Snell = 0.22, Nagelkerke = 0.27) identified two main predictor variables of nonexposure to physiotherapy-ignorance about condition (OR = 7.3) and expectation of normalcy (OR = 0.43). CONCLUSION: The main drivers for the use of physiotherapy among children with CP in Jalandhar district of Punjab were awareness about the condition of CP and expectation of normalcy which demonstrated a complex relationship with sociodemographic factors..


  • Malagi S, Konar S, Shukla DP, Bhat DI, Sadashiva N, Devi BII. Role of Decompressive Laminectomy without Instrumentation in the Management of Nurick Grade 4 and 5 Cervical Compressive Myelopathy. Journal of Neurosciences in Rural Practice 2019; 10: (1) 21-7'
    Abstract
    Introduction: Cervical laminectomy is a very well-known posterior decompressive procedure for cervical compressive myelopathy (CCM). Our objective is to evaluate the functional effect of posterior decompressive laminectomy for poor grade CCM. Methods: This study was an observational retrospective study carried out on patients with poor-grade CCM who underwent decompressive laminectomy from January 2010 to December 2015. Patients with Nurick Grades 4 and 5 (walking with support or bedbound) were included in the study. Clinical data and radiological information were collected from medical records, and objective scales were applied to compare the surgical outcome between preoperative score and postoperative score. Results: A total of 69 patients who underwent decompressive laminectomy for poor grade CCM were included. The mean age was 54.9 years, and the male-to-female ratio was 5.3:1. Ossified posterior longitudinal ligament comprised 52.6% cases. The follow-up data of at least 6 months' duration after surgery was available for 57 (82.6%) cases. On comparing with preoperative Nurick grade at follow-up, 40 of the 57 patients (70.2%) were found to have improvement following surgery by at least one grade. The remaining 17 (29.8%) had either remained the same or had deteriorated further. The mean preoperative modified Japanese Orthopedic Association score was 8.4 +/- 2.8, and the mean follow-up score was 11.8+/-0.3 (P = 0.0001). On multivariate analysis, the number of levels of laminectomy, postoperative deterioration, and anesthesia grade were predictors of outcome. Conclusion: Decompressive laminectomy for poor grade myelopathy is effective in improving functional outcome..


  • Jain J, Lathia T, Gupta OP, Jain V. Carotid intima-media thickness and apolipoproteins in patients of ischemic stroke in a rural hospital setting in central India: A cross-sectional study. Journal of Neurosciences in Rural Practice 2012; 3: (1) 21-7'
    Abstract
    CONTEXT: Carotid intima-media thickness (CIMT) and apolipoproteins have been found as a risk factor for ischemic stroke OBJECTIVE: The objective was to study the carotid intima-media thickness, apolipoproteins, and their relation in patients of ischemic stroke in central rural India. SETTINGS AND DESIGN: A cross-sectional study was performed in a rural hospital in central India. MATERIALS AND METHODS: In all patients of ischemic stroke proven by computerized tomography (CT), CIMT, apolipoprotein A-I (ApoA-I), and apolipoprotein B(ApoB) were measured. STATISTICAL ANALYSIS USED: We used Student's t-test to compare means, a chi-square test to compare proportions, and a Mann-Whitney test to compare medians. A P value <0.05 was considered significant. RESULTS: The mean age of our study population (N=106) was 61 years. The mean CIMT was 0.83 mm ranging from a minimum of 0.45 mm to a maximum of 1.096 mm. Mean CIMT was significantly higher than expected 0.67 values, which was calculated according to the age of the study population. The association of decreased ApoA-I < 100 mg/dl and increased ApoB > 90 mg/dl with CIMT > 0.7 mm was statistically significant with P<0.001. CONCLUSIONS: The CIMT in computerized tomography-proven ischemic stroke was significantly higher than expected for the age of the study population. The relation of decreased ApoA-I and increased ApoB with CIMT > 0.7 mm was also statistically significant..


  • Mucke T. Microsurgical training model for residents to approach the orbit and the optic nerve in fresh cadaveric sheep cranium. Journal of Neurosciences in Rural Practice 2014; 5: (3) 210-1'
    Abstract
    None.


  • Gdovinova Z. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 210-1'
    Abstract
    None.


  • Senthilkumaran S, Balamurugan N, Suresh P, Thirumalaikolundusubramanian P. Transient anisocoria: A pesky palpitation. Journal of Neurosciences in Rural Practice 2011; 2: (2) 210-1'
    Abstract
    None.


  • Radhakrishnan DM, Shree R, Madhaw G, Manchanda R, Mahadevan A, Kumar N. Spinal Muscular Atrophy and Progressive Myoclonic Epilepsy: A Rare Association. Journal of Neurosciences in Rural Practice 2021; 12: (1) 210-2'
    Abstract
    The association of spinal muscular atrophy (SMA) with progressive myoclonic epilepsy, also known as "SMA plus," is a unique syndrome linked to non-survival motor neuron (non-SMN) genes. The disease starts in childhood with progressive weakness and atrophy of muscles; myoclonic epilepsy develops during later childhood, after the onset of motor symptoms. In this report, we describe a case of SMN gene unrelated SMA and myoclonic epilepsy, supported by electrophysiological and neuropathological evidences..


  • Ghanta RK, Tangella P, Koti K, Dandamudi S. A rare case of an extra-axial cavernous angioma in the cerebellopontine angle. Journal of Neurosciences in Rural Practice 2013; 4: (2) 210-2'
    Abstract
    Intracranial extra-axial cavernous angiomas are rare lesions. We report a rare case of extra-axial cavernous angioma in the cerebellopontine angle (CPA) in a 50-year-old male, who presented with lower cranial nerve palsy and gait ataxia. Computed tomography (CT) scan of the brain showed a hyperdense lesion in the left cerebellopontine angle. The lesion was totally excised by the retrosigmoid approach and a pathological examination confirmed the lesion to be a cavernous angioma. Following surgery, the lower cranial nerve palsy recovered significantly..


  • Panday DR, Rauniar GP. Effect of root-extracts of Ficus benghalensis (Banyan) in pain in animal models. Journal of Neurosciences in Rural Practice 2016; 7: (2) 210-5'
    Abstract
    INTRODUCTION: According to the WHO, 70-80% population in developing countries still relies on nonconventional medicine mainly of herbal origin. Even in developed countries, use of herbal medicine is growing each year. Pain is an unpleasant feeling often caused by intense or damaging stimuli. Traditionally, different plant parts of Ficus benghalensis are claimed to have several analgesic properties. Few scientific evidences support these uses. Interestingly, still others contradict these uses. It was shocking to find very scarce scientific studies trying to solve the mystery. MATERIALS AND METHODS: It was a quantitative experimental study in Swiss albino mice of either sex. Sample size was calculated using free sample size calculating software G*Power version 3.1.9.2. Hot-plate test and tail-flick test were central antinociceptive paradigms. Writhing test was peripheral model for pain. Test drugs were aqueous root extracts of F. benghalensis at 100 mg/kg and 200 mg/kg mouse weight prepared by Soxhlet method. Suitable negative and positive controls were used. The experimental results were represented as mean +/- standard deviation statistical level of significance was set at P < 0.05. For calculation, parametric test - one-way analysis of variance (ANOVA) or nonparametric test - Mann-Whitney U-test was appropriately used. RESULTS: Hot-plate reaction time at 100 mg/kg (13.64 +/- 1.30 s) and 200 mg/kg (10.32 +/- 2.23 s) were nonsignificant (P = 0.425 and P = 0.498, respectively) compared to negative control (11.87 +/- 1.92 s). One-way ANOVA revealed nonsignificant (P = 0.178) between-group comparison in mean tail-flick reaction time. Test drug at 200 mg/kg produced statistically significant more writhing (36.00 +/- 14.85 in 10 min) than negative control, normal saline (11.83 +/- 12.43 in 10 min) or the positive control, Indomethacin (3.50 +/- 5.21 in 10 min), P value being 0.031 and 0.003, respectively. CONCLUSION: Aqueous root extracts of F. benghalensis at 200 mg/kg produces statistically significant writhing..


  • Kurzbuch AR, Fournier JY. Tuberous Sclerosis Complex with Lung Involvement. Journal of Neurosciences in Rural Practice 2020; 11: (1) 211'
    Abstract
    None.


  • Matis GK, de ASDO, Chrysou OI, Birbilis TA. The Google+ Project and neurosciences: Will it be as supercalifragilistic-expialidocious as expected?. Journal of Neurosciences in Rural Practice 2011; 2: (2) 211-2'
    Abstract
    None.


  • Kumar N, Prakash V. Lip Tremor in Hypocalcemia. Journal of Neurosciences in Rural Practice 2020; 11: (1) 212-3'
    Abstract
    None.


  • Kandasamy A, Srinath D. Levofloxacin-induced acute anxiety and insomnia. Journal of Neurosciences in Rural Practice 2012; 3: (2) 212-4'
    Abstract
    Fluoroquinolones can cause adverse neuropsychiatric side effects, which are more common in older age. We present three cases of levofloxacin-induced acute anxiety and insomnia in young adults. In all the cases, discontinuation of levofloxacin immediately lead to remission..


  • Rehman L, Afzal A, Aziz HF, Akbar S, Abbas A, Rizvi R. Radiological Parameters to Predict Hemorrhagic Progression of Traumatic Contusional Brain Injury. Journal of Neurosciences in Rural Practice 2019; 10: (2) 212-7'
    Abstract
    Introduction: Traumatic intracerebral contusion is a frequent factor culminating in death and disability, and its progression relates to unfavorable outcome. We evaluated the radiological factors associated with hemorrhagic progression of contusions (HPC). Materials and Methods: Two hundred and forty-six patients were enrolled in this prospective cohort over a period of 1 year. Contusion volume was quantified using the "ABC/2" technique, whereas progression was considered as >30% increase in the initial volume. Univariate and multivariate statistics were used to examine the correlation between the risk factors of interest and HPC. Results: HPC was seen in 110 (44.7%) patients. Binary logistic regression showed in the final adjusted model that multiplicity (relative risk [RR]: 2.24, 95% confidence limit [CL]: 1.00-5.48), bilateral lesions (RR: 2.99, 95% CL: 1.08-8.25), initial volume of contusion (RR: 4.96, 95% CL: 1.87-13.13), frontal location (RR: 1.42, 95% CL: 1.08-3.56), and presence of concomitant intracranial hematoma (extradural-RR: 3.90, 95% CL: 1.51-10.01, subdural-RR: 2.91, 95% CL: 1.26-6.69, and subarachnoid-RR: 2.27, 95% CL: 1.01-5.80) were significantly associated with HPC. The overall mortality was 18.7% and was almost equal among patients with and without HPC. Mortality was significantly associated with Glasgow Coma Scale on admission (adjusted RR: 12.386, 95% CL: 4.789-32.035) and presence of comorbid conditions (adjusted RR: 0.313, 95% CL: 0.114-0.860). Conclusion: Initial computed tomography scan is a good predictor of high-risk group for HPC..


  • Sedney CL, Julien T, Manon J, Wilson A. The effect of craniectomy size on mortality, outcome, and complications after decompressive craniectomy at a rural trauma center. Journal of Neurosciences in Rural Practice 2014; 5: (3) 212-7'
    Abstract
    INTRODUCTION: Decompressive craniectomy (DC) has increasing support with current studies suggesting an improvement in both survival rates and outcomes with this intervention. However, questions surround this procedure; specifically, no evidence has indicated the optimal craniectomy size. Larger craniectomy is thought to better decrease intracranial pressure, but with a possible increase in complication rates. Our hypothesis is that a larger craniectomy may improve mortality and outcome, but may increase complication rates. MATERIALS AND METHODS: A retrospective observational therapeutic study was undertaken to determine if craniectomy size is related to complication rates, mortality, or outcome. Our institution's Trauma Registry was searched for patients undergoing DC. Craniectomy size was measured by antero-posterior (AP) diameter. Mortality, outcome (through admission and discharge Glasgow Coma Score and Glasgow Outcome Scale), and complications (such as re-bleeding, re-operation, hygroma, hydrocephalus, infection, and syndrome of the trephined) were noted. Complications, mortality, and outcome were then compared to craniectomy size, to determine if any relation existed to support our hypothesis. RESULTS: 20 patients met criteria for inclusion in this study. Craniectomy size as measured by AP diameter was correlated with a statistically significant improvement in mortality within the group. All patients with a craniectomy size less than 10 cm died. However, outcome was not significantly related to craniectomy size in the group. Similarly, complication rates did not differ significantly compared to craniectomy size. DISCUSSION: This study provides Level 3 evidence that craniectomy size may be significantly related to improved mortality within our group, supporting our initial hypothesis; however, no significant improvement in outcome was seen. Similarly, in contrast to our hypothesis, complication rates did not significantly correlate with craniectomy size..


  • Gupta A, Karanth SS, Raja A. Infratentorial subdural empyemas mimicking pyogenic meningitis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 213-5'
    Abstract
    Infratentorial subdural empyema is an extremely rare condition which unfortunately mimics pyogenic meningitis in 75% of cases. While an ill-planned lumbar puncture in these cases may be fatal, an inadvertent delay in treatment may be detrimental to the outcome for the patient. We present a case of a young boy with long standing history of chronic suppurative otitis media (CSOM) presenting with an infratentorial empyema with features suggestive of pyogenic meningitis. We also review the available literature to further define the condition in terms of clinical features, treatment options, and outcome. A misdiagnosis of this condition with failure to institute appropriate surgical intervention and antibiotic therapy is potentially life threatening. We highlight this rare condition which requires a high degree of suspicion especially in the presence of associated risk factors..


  • Mariappan R, Gandham EJ, Stephenson SJ, Cherian NE, Lionel KR. Lumbar Erector Spinae Plane Block for Posterior-Superior Iliac Spine Bone Graft Site Pain in Patients Undergoing Occipitocervical and C1-C2 Fusion for Atlantoaxial Dislocation/Odontoid Fracture-A Case Series. Journal of Neurosciences in Rural Practice 2021; 12: (1) 213-6'
    Abstract
    Pain at the autologous bone graft site from the posterior-superior iliac spine (PSIS) is severe enough to affect the postoperative ambulation. It adds to the morbidity of the surgical procedure. Inadequate pain management at the graft site not only affects the postoperative recovery but also can lead to chronic pain. We report the use of ultrasound (US)-guided lumbar erector spinae plane block (ESPB), to deliver effective analgesia for this pain. Patients who underwent occipitocervical fusion (OCF) and C1-C2 fusion using PSIS for atlantoaxial dislocation (AAD)/odontoid fracture from January to March 2020 and who received US-guided lumbar ESPB were retrospectively studied. All the necessary data were collected from the inpatient hospital, anesthesia, and the acute pain service records. A total of six patients received lumbar ESPB, of which one received a single shot injection, and the rest five had a catheter placement for postoperative analgesia. The average volume of intraoperative and postoperative bolus was 27(range: 15-30) and 21 (range: 15-30) mL of 0.2% ropivacaine, respectively. All patients achieved a unilateral sensory blockade ranging from L1 to L3 dermatomes. None of our patients had a numerical rating scale of > 4 on movement at any time point during the first 48 hours except in one, in whom only a single shot bolus was given. No complications related to ESPB were noted. All were ambulated on the second postoperative day except one. The average length of hospital stay was 6 (range: 4-10) days. US-guided lumbar ESPB provides excellent analgesia for PSIS bone graft site pain and promotes early ambulation..


  • Turner AL, D'Souza P, Belirgen M, Al-Rahawan MM. Atypical Presentation of Multinodular and Vacuolating Neuronal Tumor of the Cerebrum in a Boy. Journal of Neurosciences in Rural Practice 2020; 11: (1) 214-5'
    Abstract
    None.


  • Winter Y, Epifanova-Bertschi N, Korchounov A. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 214-5'
    Abstract
    None.


  • Assadeck H, Daouda MT, Djibo FH, Maiga DD, Omar EA. Clinical Profile of Parkinson's Disease: Experience of Niger. Journal of Neurosciences in Rural Practice 2018; 9: (2) 214-8'
    Abstract
    Background: Parkinson's disease (PD) is a chronic neurodegenerative pathology with unknown etiology. It is characterized clinically by the classic triad that associated tremors, bradykinesia, and rigidity. In Niger, there are no data on PD. Aims: We aimed to provide the demographic and clinical profile of PD in patients from Niger to create a database on PD in Niger. Patients and Methods: We conducted a retrospective study at the Neurology Outpatient Clinic of the Hopital National de Niamey (HNN, Niger) over a period of 4.42 years from February 2009 to July 2013 collecting all cases of PD. The demographic and clinical features of all patients were collected and analyzed. Results: During the period of the study, 1695 patients consulted at the Neurology Outpatient Clinic of the HNN, among which 76 patients (4.48%) had secondary parkinsonism and 25 patients (1.47%) had features compatible with PD. Only patients with PD were included in this study. The mean age at onset of symptoms was 58 years (range: 42-74 years). The male sex was predominant (60%) with a sex ratio of 1.5. The mean time interval from the onset of symptoms to diagnosis of PD was 1.8 years (range: 1-5 years). The tremor was the most common symptom (84%). Bradykinesia represented 64% of the symptoms and rigidity 20%. At the time of the diagnosis of PD, 8 patients (32%) were in Stage I of the classification of Hoehn and Yahr, 16 patients (64%) in Stage II, and 1 patient (4%) in Stage III. The levodopa/carbidopa combination was the most used antiparkinsonian drug in our patients (88%). The mean time of follow-up of the patients was 2.5 years (range: 1-4.42 years). During the course of the disease, 9 patients (36%) were in Stage II of the classification of Hoehn and Yahr, 13 patients (52%) in Stage III, and 3 patients (12%) in Stage IV. Conclusion: Our study provides demographic and clinical data of PD in patients from Niger and shows that the hospital frequency of this disease is low (1.47%). The demographic and clinical features of our patients are similar to those of the patients of the prior studies reported in sub-Saharan Africa..


  • Wiwanitkit V. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 215-6'
    Abstract
    None.


  • Potigumjon A, Watcharakorn A, Dharmasaroja PA. Prevalence of Cerebral Microbleeds in Thai Patients with Ischemic Stroke. Journal of Neurosciences in Rural Practice 2017; 8: (2) 216-20'
    Abstract
    BACKGROUND: With the widespread use of magnetic resonance imaging (MRI), cerebral microbleeds (CMBs) are commonly detected. Ethnicity seems to play a role in the prevalence of CMB, with higher prevalence in participants from Asian origin. The purpose of the study is to look for the prevalence of CMBs and associated factors in Thai patients with ischemic stroke. METHODS: Patients with acute ischemic stroke who had MRI and magnetic resonance angiography during January-August 2014 were included in the study. T2*-weighted gradient-recalled echo was used to define CMBs. Baseline characteristics, stroke subtypes, and severity of white matter lesions were compared between patients with and without CMBs. RESULTS: Two hundred patients were included in the study. Mean age of the patients was 61-year-old. Mean National Institutes of Health Stroke Scale was 8. The prevalence of CMBs was 20% (39/200 patients). Hypertension (odds ratio [OR] 3.05, 95% confidence interval [CI] 1.07-8.68, P = 0.037), and moderate-to-severe white matter lesions (Fazekas 2-3, OR 7.61, 95% CI 3.06-18.95, P < 0.001) were related to the presence of CMBs. CONCLUSIONS: CMBs were found in 20% of patients with ischemic stroke, which was lower than those reported from Japanese studies but comparable to a Chinese study. CMBs were associated with hypertension and severity of the white matter lesions..


  • Adeolu AA, Rabiu TB, Orhorhoro OI, Malomo AO, Shokunbi MT. Relationship between injury severity, random blood glucose and management outcome in a cohort of Nigerian patients with head injury. Journal of Neurosciences in Rural Practice 2015; 6: (2) 216-20'
    Abstract
    OBJECTIVE: This study was designed to evaluate the relationship between injury severity, admission Random Blood Glucose [RBG] and management outcome in a cohort of Nigerian patients with Head Injury [HI]. MATERIALS AND METHODS: RBG was determined at admission, twenty four hours as well as seventy two hours after admission in patients with head injury. Severity of injury was graded using Glasgow Coma Scale (GCS). Outcome of management was determined by Glasgow Outcome Score at discharge. Serum glucose level of >/= 11.1 mmol/l was taken as hyperglycaemia. Analyses of variance [ANOVA] was used to determine level of significance and a P value of < 0.05 was considered significant. RESULTS: There were 146 male and 30 female patients (range: 2 years to 78 years; mean; 34.4 years, SD: 16.4 years). Most (36.4%) of the patients had severe HI. Only 2.5% of the patients had hyperglycaemia at admission. Death occurred in 25% of the patients, moderate disability occurred in 30.1% and good outcome occurred in 35.8%. Hyperglycaemia occurred in one patient each in mild and severe head injuries and in two patients with moderate head injury. All the patients with hyperglycaemia had favourable outcome. CONCLUSION: Random blood glucose of >/= 11.1 mmol/l was not common at admission in head injured patients in this cohort of patients and the value was not associated with severe injury or poor outcome..


  • Afe TO, Bello-Mojeed M, Ogunsemi O. Perception of service satisfaction and quality of life of patients living with schizophrenia in Lagos, Nigeria. Journal of Neurosciences in Rural Practice 2016; 7: (2) 216-22'
    Abstract
    OBJECTIVE: To assess service-satisfaction and quality of life among patients with schizophrenia in a tertiary psychiatric healthcare facility in Lagos, Nigeria. METHODS: Cross-sectional survey of 101 (out of 120) patients diagnosed with schizophrenia attending the outpatient clinic of the Federal Neuro-Psychiatric Hospital Yaba, Lagos, Nigeria. The Structured Clinical Interview for DSM-IV diagnosis (SCID), Charleston Psychiatric Out-patient Scale (CPOSS), and the World-Health Organisation Quality of Life -Bref scale (WHOQOL-BREF) was used in assessing diagnosis, patient satisfaction and subjective quality of life respectively. RESULTS: The ages of the patient ranged from 19-81. Males (49.5%) and females (50.5%) had almost equal distribution. Mean duration of attendance was 8.7years +/- 8.50. Service satisfaction ranged between 25-60 on the CPOSS. Areas that had higher mean scores on CPOSS were with items (1) Helpfulness of the records clerk (3.70+/-1.1), (7) Helpfulness of services received (3.69+/-1.0). Subjective quality of life was high (3.65+/-1.8), satisfaction with health was also high (3.40+/-1.1). Service satisfaction correlated with Quality of life at P < 0.00..


  • Ekici B. Combination of Steroid and Flavonoid for the Treatment of Regressive Autism. Journal of Neurosciences in Rural Practice 2020; 11: (1) 216-8'
    Abstract
    None.


  • Ramnarayan R, Anilkumar T, Nayar R. An unusual extra-axial hypodense lesion mimicking a chronic subdural haematoma. Journal of Neurosciences in Rural Practice 2013; 4: (2) 216-9'
    Abstract
    A 59-year-old man was found on the road with multiple injuries. CT scan showed a hypodense extra axial lesion in the left fronto-temporal region suggestive of chronic subdural haematoma. He was treated conservatively but did not improve. He underwent craniectomy after lesion was shown to be increasing in size, only solid tissue was seen which was not biopsied. Patient made good recovery after steroids were put on. He deteriorated again 6 weeks later and radiology showed the frontal lesion without involvement of the brain and with minimal enhancement and mass effect. He underwent biopsy decompression of the lesion with steroids, post-operatively he improved well, but deteriorated when the steroids were tapered. Histopathology report was Non-Hodgkin's lymphoma. No primary was found and the patient died during oncology treatment. This illustrates manifestation of primary dural lymphoma radiologically mimicking chronic subdural haematoma, another common disorder..


  • Dutta P, Nagpal V, Anand K, Mishra M. Bilateral Oculomotor Palsy in Tuberculous Rhomboencephalitis-A Rare Presentation. Journal of Neurosciences in Rural Practice 2021; 12: (1) 217-8'
    Abstract
    None.


  • Gupta V, Kundra S, Chaudhary A, Kaushal R. Cervical epidural hematoma in a child. Journal of Neurosciences in Rural Practice 2012; 3: (2) 217-8'
    Abstract
    Pediatric cervical epidural hematoma is an uncommon diagnosis and very few cases have been reported so far. The condition is difficult to diagnose and requires immediate surgical intervention to obtain the best possible neurological outcome. Most of the cases are of a spontaneous origin. We report a case of traumatic cervical epidural hematoma, which was managed surgically, resulting in complete neurological recovery..


  • Mehra A, Grover S, Agarwal A, Bashar M, Avasthi A. Prevalence of Elder Abuse and its Association with Psychiatric Morbidity in a Rural Setting. Journal of Neurosciences in Rural Practice 2019; 10: (2) 218-24'
    Abstract
    Aim: The aim of this study was to evaluate the prevalence of elder abuse in a rural setting. In addition, the study aimed to evaluate the association of elder abuse with psychiatric morbidity and demographic factors. Methodology: A total of 125 elderly (age >/=55 years) were evaluated for psychiatric diagnosis as per the International Classification of Diseases, 10(th) revision (ICD-10) criteria by the qualified psychiatrist and were evaluated on Vulnerability to Abuse Screening Scale for elder abuse. Results: More than half (58.4%) of the participants had one psychiatric disorder, with depression being the most common. Elder abuse was seen in more than one-third (41.6%) of the study participants. Those with psychiatric morbidity had significantly higher prevalence of abuse. None of the demographic factors was associated with abuse. Conclusion: Elder abuse is highly prevalent in rural setting, especially among those with psychiatric morbidity. Implications: Considering the high prevalence of elder abuse, there is an urgent need to address the problem. Public awareness, education, and sensitization of people toward the abuse are need of the day..


  • Patil VC, Choraria K, Desai N, Agrawal S. Clinical profile and outcome of cerebral venous sinus thrombosis at tertiary care center. Journal of Neurosciences in Rural Practice 2014; 5: (3) 218-24'
    Abstract
    BACKGROUND: Thrombosis of the cerebral venous sinuses (CVST) is an uncommon form of stroke, usually affecting young individuals. Clinical features of CVST are diverse, and for this reason, high degree of clinical suspect is mandatory to diagnose the conditions. MATERIALS AND METHODS: This study was conducted over a period of 1 year (Jan 2011 to Dec 2011). This was a retrospective, observational, and noninterventional study. This study was conducted in the Department of Medicine at a tertiary care teaching center. Total 50 patients where diagnosis of CVST was confirmed by computed tomography/magnetic resonance imaging brain venogram were included in this study. All patients with diagnosis of CVST were treated according to the standard protocol and guidelines. STATISTICAL ANALYSIS: The mean and standard deviation were obtained. The Chi-square test was used to analyze the data and P < 0.05 was considered as statistically significant. RESULTS: Of total 50 patients with diagnosis of CVST, 21 (42%) were males and 29 (58%) were females with 39 +/- 10 years and 29 +/- 7 years, respectively. Total 45 (90%) patients presented with symptoms of headache and vomiting, 13 (26%) had seizures, 12 (24%) had hemiplegia, and 19 (38%) had fever. A total of 13 (26%) patients had papilledema on fundoscopy. Total 9 (31%) out of 29 patients had diagnosis of CVST during peripartum period. Total 12 (24%) patients had hyperhomocysteinemia. Total 23 (46%) patients had sagittal sinus thrombosis, 10 (20%) had multiple sinus thrombosis, 16 (32%) had sigmoid/transverse sinus thrombosis. There was 1 (2%) patient who had bilateral cavernous sinus thrombosis, who presented with bilateral proptosis, conjunctival congestion, and external ophthalmoplegia with a history of acute or chronic maxillary and sphenoid sinusitis. Total 38 patients had evidence of infection in the form of fever, paranasal sinus (PNS) infections, Chronic suppurative otitis media (CSOM). Total 19 (38%) patients had a history and evidence of dehydration. Total 8 (16%) patients died during the course of treatment and 42 (84%) were discharged with partial and/or total recovery. Three (6%) patients required neurosurgical intervention in the form of decompressive craniotomy. Eight (16%) patients died with cerebral edema with transtentorial herniation. The mean age of death in male was significantly greater than in female patients with P < 0.02. Majority of patients succumbed had sigmoid, transverse, and/or multiple sinus involvement. Patients with multiple sinus thrombosis had greater case fatality rate. CONCLUSIONS: The current study highlights the burden of CVST in the study population with headache and vomiting, which was the most common presenting complaint. The superior sagittal sinus thrombosis was the most common and bilateral cavernous sinus thrombosis was the uncommon affection in CVST. One third of female population was affected in peripartum period. The infection and/or dehydration was the most commonly associated precipitating event for development of CVST and more than one fifth of the population had evidence of hyperhomocysteinemia. Mortality was more in patients with affection of sigmoid, transverse, and/or multiple sinus involvement in male patients and superior sagittal sinus thrombosis in female patients. The treatment of CVST has to be aggressive as morbidity and mortality is relatively minimal compared with the arterial stroke..


  • Finsterer J. Consider Stroke-Like Episodes as a Differential of Migrainous Stroke. Journal of Neurosciences in Rural Practice 2020; 11: (2) 219-20'
    Abstract
    None.


  • Adeolu AA, Akinbo OC. Gun shot injury as a cause of elevated skull fracture. Journal of Neurosciences in Rural Practice 2012; 3: (2) 219-20'
    Abstract
    None.


  • Finsterer J, Stollberger C. Endometriosis as Initial Manifestation of Myotonic Dystrophy Type-2. Journal of Neurosciences in Rural Practice 2021; 12: (1) 219-21'
    Abstract
    None.


  • Opakunle T, Aloba O, Akinsulore A, Opakunle O, Fatoye F. Obsessive-Compulsive Inventory-Revised: Factor Structure, Reliability, Validity, and Suicide Risk Screening Characteristics among Nigerian Patients with Schizophrenia. Journal of Neurosciences in Rural Practice 2018; 9: (2) 219-25'
    Abstract
    Objective: This study attempted to explore the feasibility of use of the 18-item Obsessive-Compulsive Inventory-Revised (OCI-R) as a subjective suicide risk assessment tool in a cross-sectional sample of Nigerian patients with schizophrenia. Materials and Methods: Two hundred and thirty-two outpatients with schizophrenia were recruited from the mental health clinic of a university teaching hospital in Southwestern Nigeria. They completed the OCI-R in addition to the Social and Occupational Functioning Assessment Scale, the Positive and Negative Syndrome Scale, and a sociodemographic and illness-related questionnaire. The patients were objectively interviewed with the Mini-International Neuropsychiatric Interview suicidality module items to assess their suicide risk. Results: The 18-item OCI-R demonstrated satisfactory sensitivity (0.900) and specificity (0.662) at a total cutoff score of 10 in relation to the identification of Nigerian patients with schizophrenia with significant suicide risk. At this cutoff score, the area under the receiver operating characteristic curve was 0.817 (95% confidence interval: 0.735-0.898), and positive predictive value (0.726) and negative predictive value (0.869) were also satisfactory. The OCI-R also demonstrated satisfactory internal consistency and construct validity. Conclusion: The OCI-R has demonstrated to be useful as a subjective suicide risk assessment tool among Nigerian schizophrenia patients..


  • Ramakrishnan S, Narayanaswamy VR. Unilateral asterixis, thalamic astasia and vertical one and half syndrome in a unilateral posterior thalamo-subthalamic paramedian infarct: An interesting case report. Journal of Neurosciences in Rural Practice 2013; 4: (2) 220-3'
    Abstract
    A 42-year-old young lady presented with acute onset of dizziness, drooping of left eye with binocular diplopia and inability to walk unassisted. She had past history of uncontrolled diabetes mellitus and hypertension. On examination, she had left fascicular type of third nerve palsy, vertical one and half syndrome (VOHS), left internuclear ophthalmoplegia and skew deviation with ipsilesional hypertropia. She also had thalamic astasia and right unilateral asterixis. Her MRI revealed T2 and Flair hyper intense signal changes with restricted diffusion in the left thalamus, subthalamus and left midbrain. MR Angiography was normal. Thalamic-subthalamic paramedian territory infarct is relatively uncommon. It can present with oculomotor abnormalities including vertical one and half syndrome, skew deviation, thalamic astasia and asterixis. This case is reported for the rarity of the presenting clinical findings in unilateral thalamo-mesencephalic infarcts..


  • Sutar R. Gambling Problems in Patients with Psychotic Disorders in Rural Greece. Journal of Neurosciences in Rural Practice 2020; 11: (2) 221'
    Abstract
    None.


  • Joshi TN. Candida albicans spondylodiscitis in an immunocompetent patient. Journal of Neurosciences in Rural Practice 2012; 3: (2) 221-2'
    Abstract
    None.


  • Jindal A, Diwan H, Kaur K, Sinha VD. Intraoperative Squash Smear in Central Nervous System Tumors and Its Correlation with Histopathology: 1 Year Study at a Tertiary Care Centre. Journal of Neurosciences in Rural Practice 2017; 8: (2) 221-4'
    Abstract
    BACKGROUND: Intraoperative squash smear cytology is a simple and reliable technique for rapid intraoperative diagnosis of neurosurgical specimens. The study was designed to assess the accuracy of intraoperative squash smear in the diagnosis of central nervous system (CNS) space-occupying lesions. MATERIALS AND METHODS: One hundred and fifty cases of CNS space-occupying lesion were studied in a period of 15 months. Smears were prepared from the biopsy sample obtained at the time of operation and were stained with rapid hematoxylin and eosin method. RESULTS: One hundred and forty-one cases showed complete correlation with histopathology, two cases showed partial correlation, and seven cases were discrepant. The overall diagnostic accuracy was found to be 94%. CONCLUSION: Intraoperative squash smear thus provides diagnosis with fair accuracy in brain tumors and is of great value in intraoperative consultation..


  • Assogba K, Belo M, Wateba MI, Gnonlonfoun DD, Ossou-Nguiet PM, Tsanga BB, et al.. Neuromeningeal cryptococcosis in sub-Saharan Africa: Killer disease with sparse data. Journal of Neurosciences in Rural Practice 2015; 6: (2) 221-4'
    Abstract
    INTRODUCTION: The extent of neuromeningeal cryptococcosis (NMC) has increased since the advent of HIV/AIDS. It has non-specific clinical signs but marked by high mortality. OBJECTIVE: To analyze the characteristics of the NMC in sub-Saharan Africa. MATERIALS AND METHODS: We have conducted a literature reviewed on the NMC in sub-Saharan Africa from the publications available on the basis of national and international data with keywords such as "Cryptococcus, Epidemiology, Symptoms, Outcomes and Mortality" and their equivalent in French in July 2011. All publications from 1990 to 2010 with 202 references were analyzed. The following results are the means of different studied variables. RESULTS: We selected in final 43 publications dealing with the NMC which 24 involved 17 countries in Africa. The average age was 36 years old. The average prevalence was 3.41% and the average incidence was 10.48% (range 6.90% to 12%). The most common signs were fever (75%), headaches (62.50%) and impaired consciousness. Meningeal signs were present in 49% of cases. The mean CD4 count was 44.8cells/mm(3). The India ink and latex agglutination tests were the most sensitive. The average time before the consultation and the hospital stay was almost identical to 27.71 days. The average death rate was 45.90%. Fluconazole has been the most commonly used molecule. CONCLUSION: The epidemiological indicators of NMC varied more depending on the region of sub-Saharan Africa. Early and effective taking care of patients to reduce diagnostic delay and heavy mortality remains the challenges..


  • Philip S. Commentary on Impact of COVID-19 and Lockdown on Children with ADHD and Their Families-An Online Survey and a Continuity Care Model. Journal of Neurosciences in Rural Practice 2021; 12: (1) 222'
    Abstract
    None.


  • Raina S, Mahesh D, Rajendra G, Chauhan NS. Reversible posterior leukoencephalopathy syndrome. Journal of Neurosciences in Rural Practice 2012; 3: (2) 222-4'
    Abstract
    None.


  • Quinones-Ossa GA, Durango-Espinosa YA, Padilla-Zambrano H, Ruiz J, Moscote-Salazar LR, Galwankar S, et al.. Current Status of Indications, Timing, Management, Complications, and Outcomes of Tracheostomy in Traumatic Brain Injury Patients. Journal of Neurosciences in Rural Practice 2020; 11: (2) 222-9'
    Abstract
    Tracheostomy is the commonest bedside surgical procedure performed on patients needing mechanical ventilation with traumatic brain injury (TBI). The researchers made an effort to organize a narrative review of the indications, timing, management, complications, and outcomes of tracheostomy in relation to neuronal and brain-injured patients following TBI. The study observations were collated from the published literature, namely original articles, book chapters, case series, randomized studies, systematic reviews, and review articles. Information sorting was restricted to tracheostomy and its association with TBI. Care was taken to review the correlation of tracheostomy with clinical correlates including indications, scheduling, interventions, prognosis, and complications of the patients suffering from mild, moderate and severe TBIs using Glasgow Coma Scale, Glasgow Outcome Scale, intraclass correlation coefficient, and other internationally acclaimed outcome scales. Tracheostomy is needed to overcome airway obstruction, prolonged respiratory failure and as indispensable component of mechanical ventilation due to diverse reasons in intensive care unit. Researchers are divided over early tracheostomy or late tracheostomy from days to weeks. The conventional classic surgical technique of tracheostomy has been superseded by percutaneous techniques by being less invasive with lesser complications, classified into early and late complications that may be life threatening. Additional studies have to be conducted to validate and streamline varied observations to frame evidence-based practice for successful weaning and decannulation. Tracheostomy is a safer option in critically ill TBI patients for which a universally accepted protocol for tracheostomy is needed that can help to optimize indications and outcomes..


  • Lakhan R, Sharma M. Depression in Women Migrants Living in Slums in North India. Journal of Neurosciences in Rural Practice 2021; 12: (2) 223'
    Abstract
    None.


  • Surender S, Gowda VK, Sanjay KS, Basavaraja GV, Benakappa N, Benakappa A. Caregiver-reported health-related quality of life of children with cerebral palsy and their families and its association with gross motor function: A South Indian study. Journal of Neurosciences in Rural Practice 2016; 7: (2) 223-7'
    Abstract
    INTRODUCTION: In children, health-related quality of life (HRQOL) includes parental impact and family functioning along with concepts of illness, functional status, mental health, and comfort. We are focusing on the impact of cerebral palsy (CP) on children's HRQOL and their families, and its relationship with gross motor dysfunction. SUBJECTS AND METHODS: CP children aged 3-10 years under regular neurology follow-up were enrolled. The HRQOL and motor severity were prospectively assessed using lifestyle assessment questionnaire-CP and gross motor function classification systems, respectively. RESULTS: One hundred children participated in this study. Thirty-three percent of children had good, 22% had mildly affected, whereas 45% had moderately to severely affected HRQOL. A significant association is present between gross motor function classification system and HRQOL. CONCLUSION: HRQOL in CP and their caregivers is highly impaired. The degree of impairment is associated with physical independence, mobility, clinical burden, and social integration dimensions. Therapies targeting these dimensions and associated comorbidities will improve the HRQOL. Gross motor function classification system is a good indicator of HRQOL..


  • Rao GU. Intraoperative Rupture of Aneurysm: Does It Add Insult to the Injury?. Journal of Neurosciences in Rural Practice 2021; 12: (2) 224-5'
    Abstract
    None.


  • Kulkarni GB, Ravi Y, Nagaraja D, Veerendrakumar M. Lower motor neuron facial palsy in cerebral venous sinus thrombosis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 224-6'
    Abstract
    With advances in the neuro-imaging modalities, diverse manifestations of the cerebral venous sinus thrombosis (CVT) are being recognized. There are very few reports of isolated cranial nerve palsies in CVT. In this case report, we describe a patient of lower motor neuron facial palsy with CVT who was successfully treated with anticoagulation, highlighting the atypical manifestation of the disease..


  • Basumatary LJ, Das S, Das M, Goswami M, Kayal AK. Leptospirosis presenting as neuroretinitis. Journal of Neurosciences in Rural Practice 2012; 3: (2) 224-6'
    Abstract
    None.


  • Bandlish D, Biswas N, Deb S. Staging in giant vestibular schwannoma surgery: A two consecutive day technique for complete resection in basic neurosurgical setups. Journal of Neurosciences in Rural Practice 2014; 5: (3) 225-30'
    Abstract
    INTRODUCTION: Vestibular schwannomas constitute 8% of all intracranial tumors. A majority of vestibular schwannomas are sporadic and unilateral. Giant vestibular schwannomas are seen in our country due to the late diagnosis and long duration of symptoms before diagnosis. These giant schwannomas are challenging to manage as most of the patients are having brainstem compression. MATERIALS AND METHODS: Twelve cases of a giant vestibular schwannoma were operated in our department between May 2011 and December 2012. Vestibular schwannomas with a maximal diameter of more than 4 cm were defined as a giant vestibular schwannoma. All the patients had a unilateral vestibular schwannoma. Performance status of all the patients were graded as per the Karnofsky performance score. Pre-operative assessment of 5(th), 7(th), 8(th) and lower cranial nerve status was done in all cases. Ventriculoperitoneal shunting was done pre-operatively in all cases. All patients were operated through retromastoid suboccipital craniectomy and retrosigmoid approach. These patients were operated in two stages in two consecutive days with overnight elective ventilation in ICU. Ultrasonic aspirator and nerve monitoring techniques were not used. RESULTS: Giant acoustic schwannomas can be safely resected completely by a staged resection on two consecutive days without any increased morbidity or mortality. This technique may be employed to achieve complete resection of such lesions without deterioration of facial nerve function in institutions which do not have advanced facilities like nerve monitoring or ultrasonic aspirator..


  • Jain M, Sahu RN, Behera S, Rana R, Tripathy SK, Pattnaik A. Standalone Instrumented Posterior Approach Used as Universal Approach for Tuberculosis Spondylodiscitis. Journal of Neurosciences in Rural Practice 2019; 10: (2) 225-33'
    Abstract
    Background: Surgical management of spinal tuberculosis (TB) has been classically the anterior, then combined, and of late increasingly by the posterior approach. The posterior approach has been successful in early disease. There has been a paradigm shift and inquisitive to explore this approach in the more advanced and even long-segment disease. Our study is a retrospective analysis by authors in variable disease pattern of TB Spine operated at an institute using a single posterior approach. Settings and Design: A retrospective case study series in a tertiary level hospital. Aims: The aim of this study is to evaluate the functional and radiological results of an all posterior instrumented approach used as a "universal approach" in tubercular spondylodiscitis of variable presentation. Materials and Methods: The study is from January 2015 to May 2018. Twenty-four of 38 patients met the inclusion criterion with a male: female = 8:16, and mean age 44.26 years. The initial diagnosis of TB was based on clinic-radiologic basis. Their level of affection, number of vertebrae affected, and vertebral body collapse, the kyphosis (preoperative, predicted, postoperative, and final residual) and bony fusion were measured in the preoperative, postoperative, and final X rays. Functional scoring regarding visual analog scale and Frankel neurology grading was done at presentation and follow-up of patients. Histopathological data of all patients were collected and anti-tubercular therapy completed for a period of 1 year with 4 drugs (HRZE) for 2 months and 2 drugs (HR) for rest of period. Statistical Analysis Used: The descriptive data were analyzed by descriptive statistics, and other parameters were calculated using the appropriate statistical tests such as the Student paired t-test for erythrocyte sedimentation rate, visual analog scale score, and kyphosis. Results: The mean number of vertebrae involved was 3.29 +/- 0.86 (2-6) with mean vertebral body destruction was 0.616. Preoperatively, the mean kyphosis angle was 22.42 degrees +/- 12.56 degrees and was corrected postoperatively to 13.08 degrees +/- 11.34 degrees with an average correction of 9.34 degrees (41.66%). At the latest follow-up, there was mean loss of correction of 0.80 degrees resulting in 13.88 degrees of final correction. Bony fusion was achieved in 20 patients (83.33%) cases. Neurological recovery occurred in all patients (100%), and 92% could be ambulatory at 1 year follow-up. There was improvement of visual analog scale from 6.33 +/- 1.05 preoperatively to 1.042 +/- 0.75 at 3 months of postoperative period. Two patients had bed sore, two had urinary infection, and one had neurological worsening requiring re exploration and cage removal eventually recovering to Frankel E. Two patients died due to unrelated cause. Conclusions: The procedure in safe and has satisfactory results in variable group affection of Pott's spine including early and late disease, multisegment involvement using pedicle screw fixation with/without cage support..


  • Rathaur BP, Garg RK, Malhotra HS, Kumar N, Sharma PK, Verma R, et al.. Lennox-Gastaut Syndrome: A Prospective Follow-up Study. Journal of Neurosciences in Rural Practice 2017; 8: (2) 225-7'
    Abstract
    OBJECTIVES: Lennox-Gastaut syndrome is a catastrophic epileptic encephalopathy. In Lennox-Gastaut syndrome, seizures are resistant to pharmacological treatment. In this prospective study, we evaluated the clinical features, neuroimaging, and response to treatment. MATERIALS AND METHODS: Forty-three consecutive newly diagnosed patients of Lennox-Gastaut syndrome were enrolled in the study. Baseline clinical assessment included seizure semiology, seizure frequency, electroencephalography, and neuroimaging. Patients were treated with combinations of preferred antiepileptic drugs (sodium valproate [VPA], clobazam [CLB], levetiracetam [LVT], lamotrigine [LMT], and topiramate [TPM]). Patients were followed for 6 months. The outcome was assessed using modified Barthel index. RESULTS: Tonic and generalized tonic-clonic forms were the most common seizures types. Features suggestive of hypoxic-ischemic encephalopathy (37.2%) were most frequent neuroimaging abnormality. Neuroimaging was normal in 32.6% of patients. With a combination valproic acid (VPA), CLB, and LVT, in 81.4% of patients, we were able to achieve >50% reduction in seizure frequency. Eleven (25.58%) patients showed an improvement in the baseline disability status. CONCLUSIONS: A combination of VPA, CLB, and LVT is an appropriate treatment regimen for patients with Lennox-Gastaut syndrome..


  • Krishnan P, Chowdhury SR. Posture-dependent aphasia: Focal cortical dysfunction in the sinking scalp flap syndrome. Journal of Neurosciences in Rural Practice 2015; 6: (2) 225-7'
    Abstract
    Decompressive craniotomies are being increasingly used in the treatment of raised intracranial pressure due to a variety of reasons like large infarcts, hypertensive hemorrhages and contusions. Though effective in decreasing raised intracranial pressure, they have certain complications like the sinking scalp flap syndrome that is caused by cortical dysfunction of the area below the craniotomy which is exposed to the effects of atmospheric pressure. We describe a 60-year-old patient who underwent decompressive craniotomy for acute subdural hematoma and after an initial uneventful postoperative period developed incontinence, irrelevant verbalization and ataxia. He was found to have hydrocephalus and underwent a ventriculo-peritoneal shunt with resolution of his symptoms. Three weeks later his flap had sunk in deeply and the skin was non-pinchable and he was noted to have headaches, vomiting and retching when he sat up. In addition he became aphasic when seated and the symptoms subsided on lying down. A diagnosis of focal cortical dysfunction due to sinking scalp flap syndrome was made. We highlight the incidence and pathophysiology of this unusual complication of decompressive craniotomy and stress the need to be aware of this entity particularly in patients who do not show an initial improvement after decompressive craniotomy as the cause of their poor neurological status may not be explained by any other mechanism..


  • Dara PK, Parakh M, Choudhary S, Jangid H, Kumari P, Khichar S. Clinico-radiologic Profile of Pediatric Traumatic Brain Injury in Western Rajasthan. Journal of Neurosciences in Rural Practice 2018; 9: (2) 226-31'
    Abstract
    Objective: The aim of this study was to evaluate clinico-radiological profile and outcome of pediatric traumatic brain injury (TBI). Design: Prospective observational study. Setting: Intensive Care Unit, ward and OPD of Pediatrics, Dr. S. N. Medical College, Jodhpur (tertiary care hospital). Participants: A total of 188 children (1 month-18 years) were enrolled and 108 admitted. Intervention: TBI classified as mild, moderate, or severe TBI. Neuroimaging was done and managed as per protocol. Demographic profile, mode of transport, and injury were recorded. Outcome: Measured as hospital stay duration, focal deficits, mortality, and effect of early physiotherapy. Results: Males slightly outnumbered females mean age was 5.41 +/- 4.20 years. Fall from height was the main cause of TBI (61.11%) followed by road traffic accident (RTA) (27.78%). Majority (56.56%) reached hospital within 6 h of injury, out of which 27% of patients were unconscious. Mild, moderate, and severe grade of TBI was seen in 50%, 27.78%, and 22.22% of cases, respectively. About 12.96% of cases required ventilator support. The average duration of hospital stay was 11.81 +/- 12.9 days and was lesser when physiotherapy and rehabilitation were started early. In all children with temporal bone fracture, magnetic resonance imaging (MRI) brain revealed a temporal lobe hematoma and contusion in spite of initial computed tomography (CT) head normal. Children who have cerebrospinal fluid (CSF) rhinorrhea/otorrhea had a high chance of fracture of base of skull and contusion of the basal part of the brain. Conclusion: In India, fall from height is common setting for pediatric TBI besides RTA. Early initiation of physiotherapy results in good outcome. MRI detects basal brain contusions in children presenting with CSF rhinorrhea/otorrhea even if initial CT brain is normal..


  • Lindley RI. Providing Stroke Expertise across India. Journal of Neurosciences in Rural Practice 2021; 12: (2) 226-7'
    Abstract
    None.


  • Zunaina E. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (2) 226-7'
    Abstract
    None.


  • Senthilkumaran S, Balamurugan N, Suresh P, Thirumalaikolundusubramanian P. Cerebral fat embolism in a non-head-injured trauma victim: A diagnostic dilemma. Journal of Neurosciences in Rural Practice 2012; 3: (2) 227-8'
    Abstract
    None.


  • Basumatary LJ, Das M, Goswami M, Kayal AK. Deletion pattern in the dystrophin gene in Duchenne muscular dystrophy patients in northeast India. Journal of Neurosciences in Rural Practice 2013; 4: (2) 227-9'
    Abstract
    Duchenne muscular dystrophy (DMD) is an X-linked recessive disorder that affects 1 in 3,500 males and is caused by mutations in the dystrophin gene. In this paper, we have reported DNA analysis of DMD patients by multiplex polymerase chain reaction (PCR) from various states of northeast India. Of the 69 clinically suspected patients of DMD, deletion was detected by multiplex PCR in 49 (71%) patients. Majority of the deletions (42/49, 85.7%) were located at distal hot spot region that encompasses exons 44-55 and 14.3% of the deletions were located at the proximal hot spot region (exons 2-19). In this study population, the deletion rate was 71% and was more frequent in the distal end exon..


  • Yadav N, Kar S, Madke B, Gangane N. Hansen's disease and HIV coinfection with facial nerve palsy. Journal of Neurosciences in Rural Practice 2015; 6: (2) 228-30'
    Abstract
    There are very few published reports of HIV leprosy co infection in India in spite of having a large burden of both leprosy and HIV. Herein we are reporting a case of co-infection of Hansen's disease and HIV with facial nerve palsy..


  • Mehta A, Mahale R, John AA, Abbas MM, Javali M, Acharya P, et al.. Odorless inhalant toxic encephalopathy in developing countries household: Gas geyser syndrome. Journal of Neurosciences in Rural Practice 2016; 7: (2) 228-31'
    Abstract
    BACKGROUND: Liquefied petroleum gas geysers are used very frequently for heating water in developing countries such as India. However, these gas geysers emit various toxic gases; one among them is colorless, odorless carbon monoxide (CO). In the past few years, there were reports of unexplained loss of consciousness in the bathroom. However, the exact cause for these episodes has been recognized as toxic encephalopathy due to toxic gases inhalation mainly CO. OBJECTIVE: To analyze the clinical profile and outcome of patients brought with loss of consciousness in the bathroom while bathing using gas geyser. MATERIALS AND METHODS: Case records of patients with the diagnosis of gas geyser syndrome from 2013 to 2015 were retrieved and analyzed. Twenty-four cases were identified and included in the study. This was a retrospective, descriptive study. RESULTS: Twenty-four patients were brought to our Emergency Department with loss of consciousness in the bathroom while bathing. Twenty-one cases had loss of consciousness during bathing and recovered spontaneously. Two cases were found dead in the bathroom and were brought to the Department of Forensic Medicine for postmortem. One case was brought in deep altered state of consciousness and succumbed to illness within 1 week. CONCLUSION: Awareness regarding CO intoxication due to usage of ill-fitted, ill-ventilated gas geyser is necessary as they are entirely preventable conditions..


  • Unni C, Pettakkandy V, P AJ, Soren SK, K VK. Atlantoaxial Stabilization by Posterior C1 and C2 Screw-Rod Fixation for Various Pathologies: Case Series and Comprehensive Review of Literature. Journal of Neurosciences in Rural Practice 2021; 12: (2) 228-35'
    Abstract
    We retrospectively analyzed atlantoaxial dislocation (AAD) of various pathologies, namely, rheumatoid arthritis (RA), os odontoideum, and trauma. Various techniques were discussed in relation to C1-C2 stabilization. The study aims to share our clinical experience in a series of six cases of C1-C2 instability that underwent posterior C1-C2 fusion, with free hand technique and limited fluoroscopy. The clinicoradiological presentation for each patient is described. We reviewed different literatures related to our case vividly and focused on the basic neuroanatomy involved in the atlantoaxial joint. All patients of AAD had evidence of severe canal compromise and chronic compressive spinal cord changes. In our study, the patients age ranged from 28 to 52 years. The study included four males and two females. Out of six patients of AAD, three had history of trauma, two had os odontoideum, and one had chronic inflammatory condition (RA). From our case series, we concluded that the Goel-Harms technique is the most versatile and surgeon friendly technique for C1-C2 fixation. Early recognition and surgical intervention of atlantoaxial joint instability is essential to prevent catastrophic neurological complications..


  • Solanki C, Sadana D, Arimappamagan A, Rao K, Rajeswaran J, Subbakrishna DK, et al.. Impairments in Quality of Life and Cognitive Functions in Long-term Survivors of Glioblastoma. Journal of Neurosciences in Rural Practice 2017; 8: (2) 228-35'
    Abstract
    BACKGROUND: The incidence of long-term survival in glioblastoma (GBM), i.e., >3 years, ranges from 3% to 5%. Although extensive research is performed in novel therapies for prolonging survival, there is a scarcity of research focusing on the impact of tumor and treatment on cognitive, psychological, and social status of survivors. This study is an attempt to look into this poorly addressed important issue. MATERIALS AND METHODS: Nine patients (six adults and three children) with GBM who had survived >3 years were included in the study. The quality of life (QOL) functions were assessed with the World Health Organization QOL Questionnaire BREF questionnaire. The neuropsychological assessment was done using the National Institute of Mental Health and Neurosciences neuropsychology battery for adults and children. The scores were compared with normative data. RESULTS: The physical and psychological health-related QOL of long-term GBM survivors were affected considerably due to fatigue, poor quality of sleep, inability to concentrate, presence of depression, financial burden with impaired personal and social relationships (P < 0.05). Different domains of cognitions such as motor speed (P = 0.0173), mental speed (P = 0.0022), sustained attention (P = 0.0001), long-term memory (P = 0.0431), mental flexibility (P < 0.05), and planning and executive functions (P < 0.05) were significantly impaired affecting personal, social, and professional lives. CONCLUSION: The health-related QOL and cognition are significantly impaired in GBM long-term survivors. As the incidence of long-term survival is very less, there is a need for larger multicenter studies to come up with definitive results, which in turn can help in formatting the rehabilitative and support programs for these patients..


  • Arora SK, Aggarwal A, Mittal H. Dengue encephalitis in children. Journal of Neurosciences in Rural Practice 2012; 3: (2) 228-9'
    Abstract
    None.


  • Agarwal A, Gupta R, Jain H. The effect of right or left handedness on caries experience and oral hygiene. Journal of Neurosciences in Rural Practice 2012; 3: (2) 229-30'
    Abstract
    None.


  • Pattankar S, Sankhe M, Chavda K. Efficacy of Gamma Knife Radiosurgery in Refractory Obsessive-Compulsive Disorder: An Indian Experience. Journal of Neurosciences in Rural Practice 2022; 13: (1) 23-31'
    Abstract
    Background ?Obsessive-compulsive disorder (OCD) is a chronic debilitating psychiatric condition with adverse impact on patient's sociooccupational health. Refractoriness to pharmacotherapy and psychotherapy is not uncommon. Gamma Knife radiosurgery (GKRS) is the comprehensively used and reviewed treatment modality in refractory OCD worldwide. In India, the past two decades of increasing GKRS availability has failed to create the necessary local awareness of its usefulness in refractory OCD. Limited native literature deepens the problem. Objective ?To analyze our experience with GKRS in refractory OCD, and report the safety and efficacy/long-term outcome in patients using the Yale–Brown Obsessive-Compulsive Scale (Y-BOCS). Materials and Methods ?A retrospective review of patients receiving GKRS for refractory OCD between 2000 and 2020 was carried out. Case files of the eligible ( n ?=?9) patients were reviewed for clinical, radiotherapeutic, and outcome data. Additionally, patients were contacted via telephone to enquire about their experiences, and to obtain retroactive consent for GKRS in June 2021. Information obtained was collated, computed, and analyzed. Results ?Male-to-female sex ratio was 8:1. Mean age at the time of GKRS and mean duration of OCD prior to GKRS was 30.1?±?9.4 and 10.2?±?5.8 years, respectively. Mean baseline Y-BOCS score was 29.6?±?4.7. Our first patient received cingulotomy, while the rest underwent anterior capsulotomy. Median margin dose (50% isodose) was 70 Gy. Also, 23.8?±?7.7 was the mean Y-BOCS score at the last follow-up (median?=?30 months). Overall, 44.4% patients showed full/partial response (?25% reduction in Y-BOCS score) at the last follow-up. In anterior capsulotomy (eight patients), patients with moderate/severe OCD showed better response (4/5 responders) than those with extreme OCD (0/3 responders). Single case of cingulotomy resulted in no response (<25% reduction in Y-BOCS score). No adverse radiation effects were noted. Also, 55.6% patients gave retroactive consent telephonically. Conclusion ?GKRS is a safe and effective noninvasive treatment modality for refractory OCD. Ventral anterior capsule is the preferred target. Maximum radiation doses of 120 to 160 Gy are well tolerated. Extremely severe OCD cases fared poorer. Proper awareness about the availability and efficacy of GKRS in refractory OCD is required in India..


  • Yue JK, Upadhyayula PS, Avalos LN, Phelps RRL, Suen CG, Cage TA. Concussion and Mild-Traumatic Brain Injury in Rural Settings: Epidemiology and Specific Health Care Considerations. Journal of Neurosciences in Rural Practice 2020; 11: (1) 23-33'
    Abstract
    Background Mild-traumatic brain injury (mTBI) and concussions cause significant morbidity. To date, synthesis of specific health care disparities and gaps in care for rural mTBI/concussion patients remains needed. Methods A comprehensive literature search was performed using PubMed database for English articles with keywords "rural" and ("concussion" or "mild traumatic brain injury") from 1991 to 2019. Eighteen articles focusing on rural epidemiology ( n = 5), management/cost ( n = 5), military ( n = 2), and concussion prevention/return to play ( n = 6) were included. Results mTBI/concussion incidence was higher in rural compared with urban areas. Compared with urban patients, rural patients were at increased risk for vehicular injuries, lifetime number of concussions, admissions for observation without neuroimaging, and injury-related costs. Rural patients were less likely to utilize ambulatory and mental health services following mTBI/concussion. Rural secondary schools had decreased access to certified personnel for concussion evaluation, and decreased use of standardized assessment instruments/neurocognitive testing. While school coaches were aware of return-to-play laws, mTBI/concussion education rates for athletes and parents were suboptimal in both settings. Rural veterans were at increased risk for postconcussive symptoms and posttraumatic stress. Telemedicine in rural/low-resource areas is an emerging tool for rapid evaluation, triage, and follow-up. Conclusions Rural patients are at unique risk for mTBI/concussions and health care costs. Barriers to care include lower socioeconomic status, longer distances to regional medical center, and decreased availability of neuroimaging and consultants. Due to socioeconomic and distance barriers, rural schools are less able to recruit personnel certified for concussion evaluation. Telemedicine is an emerging tool for remote triage and evaluation..


  • Garcia-Rodriguez B. Commentary. Journal of Neurosciences in Rural Practice 2014; 5: (1) 23-4'
    Abstract
    None.


  • Sharma S, Sharma N, Yeolekar ME. Acute subarachnoid hemorrhage as initial presentation of dural sinus thrombosis. Journal of Neurosciences in Rural Practice 2010; 1: (1) 23-5'
    Abstract
    Subarachnoid hemorrhage (SAH) in the older is most often due to aneurismal rupture. Other vascular lesions are known to rarely cause SAH. Cerebral venous thrombosis (CVT) can be difficult to diagnose because of its wide spectrum of clinical manifestations. Its diagnosis can be further complicated when patients initially present with acute SAH. We report a case of dural venous sinus thrombosis with SAH, most probably, due to raised venous pressure draining venous tributaries. A 59-year-old man presented with severe headache. Computerized tomography (CT) scan head was normal. Magnetic resonance imaging (MRI) suggested right parasagittal fronto-parietal hemorrhage. No aneurysm was detected on magnetic resonance angiography (MRA) or digital subtraction angiography (DSA). MRV revealed superior sagittal sinus (SSS) and lateral sinus thrombosis. DSA showed occlusion of intracranial SSS and lateral venous sinus. The patient improved with anticoagulant therapy. This case highlights the fact that SAH may reveal a CVT, and emphasizes on the inclusion of MRV in the diagnostic workup of SAH, particularly in cases in which aneurysm is not detected..


  • McClelland S, 3rd, Ukwuoma OI, Lunos S, Okuyemi KS. The natural history of Dandy-Walker syndrome in the United States: A population-based analysis. Journal of Neurosciences in Rural Practice 2015; 6: (1) 23-6'
    Abstract
    BACKGROUND: Dandy-Walker syndrome (DWS) is a congenital disorder typically manifesting with hydrocephalus. The classic anatomic hallmarks of DWS are hypoplasia of the cerebellar vermis, anterior-posterior enlargement of the posterior fossa, upward displacement of the torcula and transverse sinuses, and cystic dilatation of the fourth ventricle. AIMS: Although optimal treatment of DWS typically requires neurosurgical intervention to prevent intracranial pressure increases incompatible with life, the natural history of this disorder has yet to be evaluated on a nationwide level. SETTINGS AND DESIGN/MATERIALS AND METHODS: The Kids' Inpatient Database covering 1997-2003 was used for analysis. Children younger than age 18 admitted for DWS (ICD-9-CM = 742.3) were analyzed with a matched control group. The primary procedure codes for operative CSF drainage were coded into the analysis. The incidence of DWS was 0.136%; 14,599 DWS patients were included. STATISTICAL ANALYSIS USED: Multiple logistic regression models were used. Odds ratios (OR) were reported with 95% confidence intervals. RESULTS AND CONCLUSIONS: Mortality (OR = 10.02; P < 0.0001) and adverse discharge disposition (OR = 4.59; P < 0.0001) were significantly greater in DWS patients compared with controls. 20.4% of DWS patients received operative cerebrospinal fluid (CSF) drainage, 81-times more than controls (P < 0.0001). CSF drainage reduced mortality by 44% among DWS patients (P < 0.0001). Although DWS is associated with a 10-fold increase in mortality, operative CSF drainage nearly halves the mortality rate. Based on these findings (Class IIB evidence), it is likely that the increased mortality associated with DWS is directly attributable to the nearly 80% of DWS patients who did not receive operative CSF drainage for hydrocephalus. Consequently, increased access to neurosurgical intervention could reduce the mortality rate of DWS towards that of the general population..


  • Nayak P, Kumar R. Retromastoid-sub occipital: A novel approach to cerebello pontine angle in acoustic neuroma surgery-our experience in 21 cases. Journal of Neurosciences in Rural Practice 2011; 2: (1) 23-6'
    Abstract
    BACKGROUND: Acoustic neuroma surgery poses significant challenges regarding definite management and preservation of hearing and the facial nerve are of great concern. AIM: To analyze the efficacy of the retromastoid approach in acoustic neuroma surgery. MATERIALS AND METHODS: Tumors operated between January 2002 and December 2008, by the authors, using the retromastoid approach, were analyzed. Twenty-one patients who presented with acoustic tumor were considered for this study. DISCUSSION: Precise knowledge of the neuroanatomy in the cerebellopontine angle is the key to success and microsurgical technique is the sole factor for good outcome. CONCLUSION: Retromastoid, in fact is the approach to the skull base with minimal or no damage to neurovascular structures, in contrast to the translabyrinthine or presigmoid approach..


  • Goyal N, Agrawal D, Singla R, Kale SS, Singh M, Sharma BS. Stereotactic radiosurgery in hemangioblastoma: Experience over 14 years. Journal of Neurosciences in Rural Practice 2016; 7: (1) 23-7'
    Abstract
    BACKGROUND: Although gamma knife has been advocated for hemangioblastomas, it is not used widely by neurosurgeons. OBJECTIVE: We review our experience over 14 years in an attempt to define the role of stereotactic radiosurgery (SRS) in the management of hemangioblastomas. PATIENTS AND METHODS: A retrospective study was conducted on all patients of hemangioblastoma who underwent SRS at our institute over a period of 14 years (1998-2011). Gamma knife plans, clinical history, and radiology were reviewed for all patients. RESULTS: A total of 2767 patients underwent gamma knife during the study period. Of these, 10 (0.36%) patients were treated for 24 hemangioblastomas. Eight patients (80%) had von Hippel-Lindau disease while two had sporadic hemangioblastomas. The median peripheral dose (50% isodose) delivered to the tumors was 29.9 Gy. Clinical and radiological follow-up data were available for eight patients. Of these, two were re-operated for persisting cerebellar symptoms. The remaining six patients were recurrence-free at a mean follow-up of 48 months (range 19-108 months). One patient had an increase in cyst volume along with a decrease in the size of the mural nodule. CONCLUSIONS: SRS should be the first option for asymptomatic hemangioblastomas. Despite the obvious advantages, gamma knife is not widely used as an option for hemangioblastomas..


  • Jagtap SA, Kamble HJ, Patil AS, Nair M. Ossified Ligamentum flavum causing myelopathy in ankylosing spondylitis. Journal of Neurosciences in Rural Practice 2013; 4: (2) 230-1'
    Abstract
    None.


  • Salunke P, Chandra BR, Sura S, Aggarwal A, Garg R. Aneurysmal bone cyst of the cranio-vertebral junction: Benign or malignant?. Journal of Neurosciences in Rural Practice 2012; 3: (2) 230-2'
    Abstract
    None.


  • Gupta S, Venugopal N. Risk Factors of Asymptomatic Neurocognitive Impairment in People Living with HIV in an Indian Cohort. Journal of Neurosciences in Rural Practice 2020; 11: (2) 230-6'
    Abstract
    Background Asymptomatic neurocognitive impairment (ANI) in people living with HIV (PLWH) can lower quality of life, reduce drug compliance, increase unemployment, and reduce life expectancy. Objective This study was aimed to identify risk factors of ANI in PLWH in an Indian cohort and explore the usefulness of Mini Mental State Examination (MMSE) and Montreal Cognitive Assessment Score (MoCA) as screening tools. Methods PLWH under follow-up at an antiretroviral treatment center who were 18 to 60 years were included in this study. Patients were excluded if they had any cognitive symptoms, previous history of any central nervous system (CNS) pathology, or any systemic illness. Included patients were subjected to domain wise standardized neuropsychological battery. Six domains were screened including language, attention, speed, memory, sensory motor skills, and executive. Abnormal dysfunctional scores in at least two domains were taken as suggestive of ANI. The two groups thus created, ANI and normal cognition, were evaluated for differences. Variables evaluated as risk factors included age, sex, handedness, education, presence of at least one vascular risk factor, duration of disease, biochemical profile, cluster of differentiation 4 (CD4) count (both current and nadir) HIV viral load, and use of antiretroviral therapy (ART) and its CNS penetration effectiveness (CPE). MMSE and MoCA were also done in all patients. Statistical Analysis Regression analysis was used to find out significant variables. MMSE and MoCA scores were correlated using Spearman's correlation coefficient. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were also determined Results Three hundred and eighty-four patients were included out of which 185 (48%) had ANI. In the multivariate regression analysis, female sex with odds Ratio (OR) of 1.89 (95% confidence interval [CI]: 1.21-2.79, p < 0.01), education below 10 years with OR = 2.43 (95% CI: 1.56-3.80, p < 0.01) and presence of at least one vascular risk factor with OR = 2.52 (95% CI: 1.67-3.80, p < 0.01) were found to be significant. Both MMSE and MoCA had a high PPV (0.99 and 0.97, respectively) but poor NPV (0.64 and 0.75) below a score of 25 with MoCA scoring slightly better. Both, MMSE and MoCA correlated well with each other. Conclusion Nearly half of our patients had ANI, despite being on ART. Majority of patients were on ART with CPE > 7 and had relatively preserved immune status. Female HIV patients with at least one vascular risk factor and less than 10 years of formal education were found to be at risk for ANI. MMSE and MoCA are not good screening tools to identify this condition..


  • Akgul O, Ozgocmen S. Commentary. Journal of Neurosciences in Rural Practice 2013; 4: (2) 231-2'
    Abstract
    None.


  • Tewari VK, Dubey RS, Dubey GC. Trans-orbital orbitocranial penetrating injury by pointed iron rod. Journal of Neurosciences in Rural Practice 2015; 6: (2) 231-3'
    Abstract
    Trans-orbital orbitocranial penetrating injury (TOPI) by a foreign body is an extremely rare compound head injury having a potential to cause major morbidity and mortality. Preoperative radiological imaging by CT scan is very important for operative guidance, but in remote area where CT scan is not available, the patient is generally referred to tertiary level. Here we present a case which was dealt successfully without CT scan, only on the basis of stable clinical status and X-rays. We present a case of a 35-year-old man who had an accidental injury (fall from height) by rod. Immediate X-ray (anteroposterior and lateral views) revealed that the pointed end of the foreign body (rod) was inside the ipsilateral anterior fossa via basifrontal bone up to frontal vertex, not crossing the midline. CT scan was not available and his vitals with GCS were normal (15/15). He was operated with the help of an ophthalmic surgeon by right frontotemporal craniotomy. The patient was discharged on 10(th) day without any neurological deficit except restricted right eyeball movement to superolateral and ptosis. The restricted eyeball movements recovered after third month of follow up with remnant ptosis for 2 years. This case highlights an unusual case, direct visualization and repair of brain structures with higher antibiotics can save the life even in remote areas where CT scan is still not available only on the basis of stable GCS and X-rays..


  • Chowdhury FH, Haque MR, Kawsar KA, Sarker MH, Hasan M, Goel AH. Intracranial nonvestibular neurinomas: Young neurosurgeons' experience. Journal of Neurosciences in Rural Practice 2014; 5: (3) 231-43'
    Abstract
    BACKGROUND AND OBJECTIVES: Neurinoma arising from other than nonvestibular cranial nerves is less prevalent. Here we present our experiences regarding the clinical profile, investigations, microneurosurgical management, and the outcome of nonvestibular cranial nerve neurinomas. MATERIALS AND METHODS: From January 2005 to December 2011, the recorded documents of operated nonvestibular intracranial neurinomas were retrospectively studied for clinical profile, investigations, microneurosurgical management, complications, follow-up, and outcomes. RESULTS: The average follow-up was 24.5 months. Total number of cases was 30, with age ranging from 9 to 60 years. Sixteen cases were males and 14 were females. Nonvestibular cranial nerve schwannomas most commonly originated from trigeminal nerve followed by glossopharyngeal+/vagus nerve. There were three abducent nerve schwannomas that are very rare. There was no trochlear nerve schwannoma. Two glossopharyngeal+/vagus nerve schwannomas extended into the neck through jugular foramen and one extended into the upper cervical spinal canal. Involved nerve dysfunction was a common clinical feature except in trigeminal neurinomas where facial pain was a common feature. Aiming for no new neurodeficit, total resection of the tumor was done in 24 cases, and near-total resection or gross total resection or subtotal resection was done in 6 cases. Preoperative symptoms improved or disappeared in 25 cases. New persistent deficit occurred in 3 cases. Two patients died postoperatively. There was no recurrence of tumor till the last follow-up. CONCLUSION: Nonvestibular schwannomas are far less common, but curable benign lesions. Surgical approach to the skull base and craniovertebral junction is a often complex and lengthy procedure associated with chances of significant morbidity. But early diagnosis, proper investigations, and evaluation, along with appropriate decision making and surgical planning with microsurgical techniques are the essential factors that can result in optimum outcome..


  • Rana AQ, Saleh M. Relationship between resting and action tremors in Parkinson's disease. Journal of Neurosciences in Rural Practice 2016; 7: (2) 232-7'
    Abstract
    OBJECTIVE: To determine the relationship between resting tremor (RT) and action tremor (AT) in Parkinson's disease (PD) patients. METHODS: A retrospective study of RT and AT severity was conducted in 100 PD patients. The severity rating for each type of tremor in the upper extremities was assessed. The disparity in tremor severity between extremities for each tremor type was compared to that of the other two to identify commonalities in the laterality of the tremor manifestation. RESULTS: Overall, RT is predictive of AT on the same side, but not the opposing side of the body. Patients with less intense resting right upper limb (RRU) tremor and moderately intense RRU tremor were significantly more likely to have an action right upper limb (ARU) tremor (-1.53, P = 0.020; -1.88, P = 0.005, respectively). Similarly, patients with less intense resting left upper limb (RLU) tremor and moderately intense RLU tremors were significantly more likely to have an action left upper limb (ALU) tremor (-3.49, P = 0.000; -1.86, P = 0.017, respectively). In addition, RRU and ALU tremors were associated with an increase in RLU and ARU tremors, respectively. CONCLUSION: Tremors are common findings in PD patients, and often impair quality of life. By identifying and classifying the relationship between resting and ATs in PD patients, our study sheds light onto the importance of better understanding and future management of this debilitating symptomology..


  • Kutty RK, Sreemathyamma SB, Sivanandapanicker J, Asher P, Prabhakar RB, Peethambaran A, et al.. The Conundrum of Ventricular Dilatations Following Decompressive Craniectomy: Is Ventriculoperitoneal Shunt, The Only Panacea?. Journal of Neurosciences in Rural Practice 2018; 9: (2) 232-9'
    Abstract
    Introduction: Ventriculomegaly and hydrocephalus (HCP) are sometimes a bewildering sequela of decompressive craniectomy (DC). The distinguishing criteria between both are less well defined. Majority of the studies quoted in the literature have defined HCP radiologically, rather than considering the clinical status of the patient. Accordingly, these patients have been treated with permanent cerebrospinal fluid (CSF) diversion procedures. We hypothesize that asymptomatic ventriculomegaly following DC should undergo aspiration with cranioplasty and be followed up regularly. Materials and Methods: All patients with post-DC who were scheduled for cranioplasty and satisfied the radiological criteria for HCP were included. These patients were categorized into two groups. Group 1 included ventriculomegaly with clinical signs attributable to HCP and Group 2 constituted ventriculomegaly but no clinical signs attributable to HCP. All patients in Group 1 underwent ventriculoperitoneal shunt followed by cranioplasty, whereas all patients in Group 2 underwent cranioplasty along with simultaneous ventriculostomy and temporary aspiration of the lateral ventricle. All patients were regularly followed as the outpatient basis. Results: There were 21 patients who developed ventriculomegaly following DC. There were 10 patients in Group 1 and 11 patients in Group 2. The average duration of follow-up was from 6 months to 2 years. Two patients in the shunt group - (group 1) had over drainage and required revision. One patient in aspiration group - (group 2) required permanent CSF diversion. Conclusions: Cranioplasty with aspiration is a viable option in selected group of patients in whom there is ventriculomegaly but no signs or symptoms attributable to HCP..


  • Dadlani R, Ghosal N, Hegde AS. An unusual metastasis from a breast carcinoma to a psammomatous tuberculum sella meningioma. Journal of Neurosciences in Rural Practice 2013; 4: (2) 233-4'
    Abstract
    None.


  • Akinyemi RO. Epidemiology of Parkinsonism and Parkinson's disease in Sub-Saharan Africa: Nigerian profile. Journal of Neurosciences in Rural Practice 2012; 3: (3) 233-4'
    Abstract
    None.


  • Krishna K, Sada E, Vikram A, Gupta A. Multiple brain abscesses - diagnostic dilemma and therapeutic nightmare!. Journal of Neurosciences in Rural Practice 2013; 4: (2) 234-6'
    Abstract
    None.


  • Matta GS, Peddisetty RP. Impact of Etiology on Efficacy of Oral Triclofos in Recording Pediatric Electroencephalography: A Tertiary Care Center Study. Journal of Neurosciences in Rural Practice 2019; 10: (2) 234-7'
    Abstract
    Background and Objectives: Oral triclofos is a frequently used sedative in pediatric age to record sleep Electroencephalography (EEG). This study is aimed to assess efficacy, safety profile, need for second dose, and rescheduling of oral triclofos in relation to etiology. Materials and Methods: This is a retrospective study done enrolling all children aged 6 months to 5 years referred for EEG over 1 year. After a trial for natural sleep, the first dose of oral triclofos was given. If a child does not sleep after an hour, the second dose was given and rescheduled if does not sleep even with the second dose. Age, sex, diagnosis, sleep latency, sleep duration, adverse effects, EEG findings, patients needing second dose, and rescheduling were noted. Descriptive statistics and Chi-square test were used to analyze data. Results: A total of 384 children required oral triclofos. The common etiologies for sleep study were atypical febrile seizures, hypoxic-ischemic encephalopathy (HIE) sequelae, and behavioral disorders such as autism and attention-deficit hyperactive disorder (ADHD). Including the second dose, we were able to successfully record sleep EEG in 372 (96.8%) patients. Rescheduling was required in 3.2% of patients. Mean sleep-onset latency was 36 min and mean sleep duration was 84 min. Single dose was sufficient in 329 (85.6%) and the second dose in 55 (14.4%). Thirty (38.5%) children of HIE sequelae (P < 0.001) required the second dose followed by behavioral disorders (29.1%, P = 0.03). Irritability, vomiting, and dizziness were common side effects which resolved spontaneously. Conclusions: Oral triclofos was effective as sedative for recording EEG. Children with HIE sequelae and behavioral disorders such as autism/ADHD more commonly required second dosing and rescheduling..


  • Gupta P, Agrawal M, Sinha VD, Gupta A. Intraventricular racemose type neurocysticercosis with anterior interhemispheric fissure cyst: A rare case report. Journal of Neurosciences in Rural Practice 2015; 6: (2) 234-7'
    Abstract
    Racemose type of neurocysticercosis (NCC) is a rare form of parasitic infestation of central nervous system. Most commonly it is found in fourth ventricle and cisterns. On reviewing the PubMed and Google databases, we found that this would be the first reported case of racemose type NCC in occipital horn of lateral ventricle with obstructive hydrocephalus, along with an incidental interhemispheric fissure arachnoid cyst..


  • Jimenez-Caballero PE. Crossed cerebellar atrophy: Update. Journal of Neurosciences in Rural Practice 2012; 3: (3) 235-6'
    Abstract
    None.


  • Bhardwaj A, Sharma G, Raina SK, Sharma A, Angra M. Advanced Age and Higher National Institutes of Health Stroke Scale Score as Predictors of Poor Outcome in Ischemic Stroke Patients Treated with Alteplase: A Study from a Tertiary Care Centre in Rural North-west India. Journal of Neurosciences in Rural Practice 2017; 8: (2) 236-40'
    Abstract
    INTRODUCTION: Thrombolytic therapy in acute ischemic stroke has been approved for treatment of acute stroke for past two decades. However, identification of predictors of poor outcome after the intravenous (IV) alteplase therapy in acute stroke patients is a matter of research. The present study was conducted with the aim of identifying poor prognostic factors in patients of acute ischemic stroke patients. METHODS: The data of 31 acute stroke patients treated with alteplase were gathered to identify the factors that were independent predictors of the poor outcome. Outcome was dichotomized using modified Rankin scale (mRS) score and National Institutes of Health Stroke Scale (NIHSS) score at 3 months after treatment into good outcome mRS - 0-2 and poor outcome mRS - 3-6. Predictors of poor outcome were analyzed. RESULTS: Good outcome (mRS - score 0-2) was seen in 15 (48.4%) patients with median age of (60) and poor outcome (mRS - score 3-6) was seen in 16 (51.6%) patients median age of 75 years, which was statistically significant with the P = 0.002. The presence of risk factors such as hypertension, diabetes, dyslipidemia, smoking, alcohol intake, history of stroke, coronary artery disease, and rheumatic heart disease among the two groups did not seem influence outcome. The severity of stroke as assessed by NIHSS score at the time of presentation was significantly higher among the patients with poor outcome, with P = 0.01. CONCLUSION: Advance age and higher NIHSS score at the time of onset of stroke and are the independent predictors of the poor outcome after thrombolysis with IV alteplase treatment in acute ischemic stroke patients..


  • Grover S, Kathiravan S, Dua D. Delirium Research in India: A Systematic Review. Journal of Neurosciences in Rural Practice 2021; 12: (2) 236-66'
    Abstract
    Delirium is the most common psychiatric diagnoses encountered in patients with various medical-surgical illnesses, in all the treatment set-ups, with relatively higher incidence and prevalence in the intensive care units. As delirium is encountered in multiple specialties, it is important to understand the research on this diagnosis. This study aims to assess the research output involving patients of delirium from India. A comprehensive search was undertaken using Medline (PubMed) and other databases. Search words included were "delirium," "delirious," "delirium tremens" AND "India." No filters were used. Internet and hand searches yielded 305 articles. Out of these articles, 151 had the terms "delirium," "delirious," "delirium tremens" in the title and these were included for the review. Additionally, 14 articles were included for the review, although these did not have these terms in the title, but delirium was one of the major outcome parameters in these studies. Majority of the papers were original articles ( n = 81), and these were followed by, case reports ( n = 58), review articles ( n = 10), letter to the editor (not as case reports but as a communication; n = 13), editorials ( n = 2) and one clinical practice guideline. Most of the original papers have either focused on epidemiology (incidence, prevalence, outcome, etc.), symptom profile, with occasional studies focusing on effectiveness of various pharmacological interventions. There is a dearth of research in the field of delirium from India. There is a lack of studies on biomarkers, evaluation of nonpharmacological interventions, and evaluation of prevention strategies. It is the need of the hour to carry out more studies to further our understanding of delirium in the Indian context..


  • Bhandari PR. A comment on effect of plant extracts on Alzheimer's disease: An insight into therapeutic avenues. Journal of Neurosciences in Rural Practice 2013; 4: (2) 236-7'
    Abstract
    None.


  • Femi OL, Ibrahim A, Aliyu S. Clinical profile of parkinsonian disorders in the tropics: Experience at Kano, northwestern Nigeria. Journal of Neurosciences in Rural Practice 2012; 3: (3) 237-41'
    Abstract
    BACKGROUND: No data exists on Parkinson's disease (PD) and secondary Parkinsonism in Northwestern Nigeria. This study was designed to create a database, document the clinical profile of PD in Kano, northwestern Nigerian, and compare this to prior observations within and outside Nigeria. MATERIALS AND METHODS: A database was documented on prospective patients presenting consecutively to the Neurology out-patients clinic of the two tertiary health facilities in Kano northwestern Nigeria over a period of 4 years. Demographic and clinical data at presentation were documented for all patients. Cases were classified as PD or secondary Parkinsonism. The severity at presentation and at last visit was classified using the H and Y scale. RESULTS: Over a period of 4 years, out 1153 a total of 96 patients comprising 74 males and 22 females were enrolled. Eighty (83.3%) of them had clinically diagnosed PD while 16 (16.7%) had clinical features compatible with secondary Parkinsonism. The mean age at onset of symptoms in the PD patients (mean 58.2 +/- 6.72 yrs ) was more than in secondary Parkinsonism (mean 51.4 +/- 10.04 and P = 0.001). There was male preponderance in both idiopathic Parkinsonism (PD) (m:f = 3.2:1) and secondary Parkinsonism (m:f = 4.3:1). Out of the patients with secondary Parkinsonism, 10 (62.5%) and 5 (31.3%) had vascular Parkinsonism and drug-induced Parkinsonism, respectively. Duration of symptoms prior to presentation ranged between 3 months and 16 years. The mean (SD) time interval from the onset of motor symptoms to diagnosis of PD was 3.6 +/- 3.4 yrs and time interval for men and women (male 3.8 +/- 3.7; female 2.8 +/- 2.1; P = 0.249). CONCLUSIONS: Clinical profile of patients with PD and secondary Parkinsonism in Kano is similar to that from other populations within Nigeria and other developing countries. However, delayed presentation, less frequent family history, lower frequency of Young-onset PD as well as treatment challenges occasioned by poverty, inadequacy of expert, and lack of newer drugs and treatment options contrasts the situation in western populations..


  • Grover S, Sharma N, Mehra A. Stigma for Mental Disorders among Nursing Staff in a Tertiary Care Hospital. Journal of Neurosciences in Rural Practice 2020; 11: (2) 237-44'
    Abstract
    Objective This study aimed to evaluate the prevalence of stigma for mental disorders among nursing staff in a tertiary care hospital, and the secondary objective of the study was to assess the correlation of stigma with the socio-demographic profile and previous experience with mentally ill patients. Methods This cross-sectional study was performed among the 210 nurses working in a tertiary care multispecialty teaching public sector hospital in north India. They were evaluated on community attitudes toward the mentally ill (CAMI) scale. Results About two-thirds of the participants (67.1%) were females and had done graduation (64.2%) in nursing. Nearly 50% of the study participants had an experience of working with mentally ill patients. Female had a more significant positive attitude on the domain of social restrictiveness. Authoritarianism had a significant positive correlation with benevolence and social restrictiveness domains. The benevolence domain had a significant correlation with all other domains. Social restrictiveness domain also had a significant correlation with other domains. Conclusion Nurses have a positive attitude toward mentally ill patients..


  • Kumar A, Sahu BP. Ghost vertebra: Do we need to reconsider treatment strategy for sub-axial cervical spine tuberculosis?. Journal of Neurosciences in Rural Practice 2013; 4: (2) 237-9'
    Abstract
    None.


  • Chafale VA, Lahoti SA, Pandit A, Gangopadhyay G, Biswas A. Retrobulbar optic neuropathy secondary to isolated sphenoid sinus disease. Journal of Neurosciences in Rural Practice 2015; 6: (2) 238-40'
    Abstract
    Paranasal sinus disease can cause a condition that mimics optic neuritis. Simultaneous appearance of both diseases would create etiological dilemma. We report two cases of retrobulbar optic neuropathy secondary to isolated sphenoid sinus disease. In the case of a 65-year-old female who had presented with acute loss of vision in the left eye associated with left-sided frontal headache which subsequently turned out to be caused by optic nerve compression at the orbital apex due to collection in abnormally pneumatized left lesser wing of the sphenoid. In another case, a 65-year-old lady had presented with symptoms of bilateral retrobulbar optic neuropathy which was found to be due to direct compression of optic nerves at the orbital apex secondary to metastases from breast carcinoma..


  • Ranjan R, Mehta M, Sagar R, Sarkar S. Relationship of cognitive function and adjustment difficulties among children and adolescents with dissociative disorder. Journal of Neurosciences in Rural Practice 2016; 7: (2) 238-43'
    Abstract
    BACKGROUND AND AIMS: Although it has been suggested that children and adolescents with dissociative disorder have some cognitive deficits, the association of these cognitive impairments with adjustment difficulties has not been evaluated. The present study aimed to assess the relationship between cognitive functioning and adjustment difficulties in children and adolescents with dissociative disorder. METHODS: This cross-sectional, descriptive assessment was carried out in the outpatient setting of child and adolescent psychiatric service in a tertiary care hospital. Fifty newly diagnosed children and adolescents with dissociative disorder were included. The cognitive functions were assessed by varied neuropsychological tests, and Bell's adjustment inventory was used for assessing various domains of adjustment. RESULTS: The mean age of the sample which comprised 40% males was 13.0 (+/-2.4) years. The mean intelligence quotient (IQ) of the sample was 90.6. Impairment in cognitive test was maximum for verbal working memory followed by sustained attention, visual learning and memory, and verbal retention and recall. Adjustment difficulties were greatest in the domains of self, followed by domains of health, school, and family. Significant association was found between the IQ and adjustment in school; visual learning and memory and adjustments in school and overall adjustment; and sustained attention and adjustment of health. CONCLUSIONS: Dissociative children have poor cognitive ability which may be related to poor adjustment scores..


  • Viswanathan DJ, Veerakumar AM, Kumarasamy H. Depression, Suicidal Ideation, and Resilience among Rural Farmers in a Drought-Affected Area of Trichy District, Tamil Nadu. Journal of Neurosciences in Rural Practice 2019; 10: (2) 238-44'
    Abstract
    Background: Changes in climatic conditions and other factors including trade and commerce have influenced agriculture worldwide. These factors have created a crisis among farmers. Objectives: The objective of this study was to find out the prevalence of depression and suicidal ideation, to measure the resilience, and to find out the factors that influence depression and resilience among farmers. Materials and Methods: A community-based cross-sectional analytical study was performed among farmers residing in a drought-affected area of Tiruchirappalli district of Tamil Nadu. The sample size was 191 and cluster sampling was used to select the participants. Structured, pretested questionnaires were used to find the prevalence of depression, suicidal ideation, and resilience among farmers. Pearson Correlation, Student's t-test, analysis of variance, and Pearson Chi-square test were used to identify the factors influencing depression and resilience. Results: A total of 194 farmers participated in the study. The mean age of the farmers was 46.68 +/- 12.6 years, majority 64% were males and 89% were literates. Among the participants, 97.4% had some form of depression, and 67% had severe depression. About 60% of the farmers had suicidal ideation. Male farmers, farmers with few years of farming experience, and severe reduction in yield had a higher level of depression. Suicidal ideation was influenced by gender, small-scale farming, fewer years of experience in farming, and the impact of drought on yield. The mean resilience score was 49.4 +/- 10. Gender and years of experience in farming had a significant association with resilience. Conclusion: High prevalence of depression and suicidal ideation and low level of resilience has been observed among the farmers. Interventions need to be provided for marginal and small-scale farmers, male farmers in the affected area to reduce the impact of drought in these farmers..


  • Mondal R, Roy A, Mukherjee G, Mandal AK. Acute inhalational tobacco poisoning in children. Journal of Neurosciences in Rural Practice 2013; 4: (2) 239-40'
    Abstract
    None.


  • Singh R, Sahu A, Singh K, Prasad RS, Pandey N, Singh RC. Impact of COVID-19 Pandemic on Neurosurgical Practice in a Tertiary Care Center in India. Journal of Neurosciences in Rural Practice 2021; 12: (1) 24-32'
    Abstract
    Objectives The aim of the study is to determine the magnitude of repercussions of coronavirus disease 2019 (COVID-19) pandemic on neurosurgical specialty and formulate a management approach. Materials and Methods This combined retrospective and prospective study was done in neurosurgical specialty of IMS-BHU, Varanasi, India, a tertiary care center, between January 1, 2020 and May 31, 2020. Analysis of impact on neurosurgical emergency and electives was done over before pandemic, during lockdown 1 and 2 and during lockdown 3 and 4 timelines. Effects of COVID-19 pandemic on psychology of neurosurgical team (50 members) and on patient party (88) were also evaluated. Virtual learning and webinars as a substitute to residential neurosurgical training were analyzed by a questionnaire given to 13 neurosurgeons of our department. Statistical Analysis Ordinary one-way ANOVA (analysis of variance) and unpaired t -test were used according to data analyzed. p < 0.05 was considered statistically significant. GraphPad Prism software was used for this analysis. Results On an average 8.22 admissions per day were done in neurosurgical emergency before pandemic. After lockdown these figures reduced to 3.2 admissions per day during lockdown 1 and 2 and to 5.36 admissions per day during lockdown 3 and 4. There was significant reduction in neurotrauma admission rate during lockdown ( p < 0.0001) at our center. There was 76% reduction in emergency neurosurgical operated cases during pandemic. There was significant reduction in outpatient department (OPD) attendance per day, OPD admissions per day ( p < 0.0001), and total elective surgeries ( p < 0.0001) during lockdown. Of 50 neurosurgical team members (neurosurgeons, nursing, and ground staff) interviewed, 90% of them had the fear of contacting the COVID-19 disease, fear of well-being of family and children, and difficulty in transport. Three out of 13 neurosurgeons (23.1%) agreed on change in practice based on what they learned from virtual teaching and webinars and only two of them (15.4%) accepted improvement of skills based on virtual learning. Conclusion The COVID-19 pandemic is causing a significant impact on health care systems worldwide. For conserving resources elective surgical procedures should be limited. This pandemic has a negative impact on neurosurgical resident training program and psychology of both neurosurgical unit and patients..


  • Saramma P, Menon RG, Srivastava A, Sarma PS. Hyponatremia after aneurysmal subarachnoid hemorrhage: Implications and outcomes. Journal of Neurosciences in Rural Practice 2013; 4: (1) 24-8'
    Abstract
    BACKGROUND: Hyponatremia is the most common electrolyte abnormality seen in patients with aneurysmal SAH. Clinically significant hyponatremia (Serum Sodium <131 mEq/L) which needs treatment, has been redefined recently and there is a paucity of outcome studies based on this. This study aims to identify the mean Serum Sodium (S.Na+) level and its duration among inpatients with SAH and to identify the relationship between hyponatremia and the outcome status of patients undergoing surgery for SAH. MATERIALS AND METHODS: This outcome study is undertaken in the department of neurosurgery, The Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala. Medical records of all patients with SAH from 1(st) January to 31(st) July 2010 were reviewed. Preoperative status was assessed using World Federation of Neurosurgical Societies (WFNS) grading system. Discharge status was calculated using the Glasgow outcome score scale. RESULTS: Fifty nine patients were included in the study and 53 (89.8%) of them have undergone surgical treatment. Hyponatremia was observed in 22 of 59 patients (37%). The mean Sodium level of hyponatremic patients was 126.97 mEq/L for a median duration of two days. Glasgow outcome score was good in 89.8% of patients. We lost two patients, one of whom had hyponatremia and vasospasm. CONCLUSION: Hyponatremia is significantly associated with poor outcome in patients with SAH. Anticipate hyponatremia in patients with aneurysmal subarachnoid hemorrhage, timely detect and appropriately treat it to improve outcome. It is more common in patients who are more than 50 years old and whose aneurysm is in the anterior communicating artery. Our comprehensive monitoring ensured early detection and efficient surgical and nursing management reduced morbidity and mortality..


  • Panigrahi S, Mishra SS, Das S, Patra SK. Large subgaleal hematoma as a presentation of parahemophilia. Journal of Neurosciences in Rural Practice 2013; 4: (2) 240-2'
    Abstract
    None.


  • Imbarrato G, Bentley J, Gordhan A. Clinical Outcomes of Endovascular Thrombectomy in Tissue Plasminogen Activator versus Non-Tissue Plasminogen Activator Patients at Primary Stroke Care Centers. Journal of Neurosciences in Rural Practice 2018; 9: (2) 240-4'
    Abstract
    Background: The effect of intravenous tissue plasminogen activator (IV tPA) administration before endovascular intervention as compared to without at thrombectomy-capable low-volume centers on procedural aspects and patient outcomes has not been investigated. Methods: Retrospective chart review was performed in all consecutive large vessel cerebrovascular accident patients treated with endovascular therapy at two select rural primary stroke centers between 2011 and 2015. Patients' data regarding age, sex, and medical history, as well as thrombus location by catheter-based cerebral angiography, postprocedural reperfusion status, and clinical outcomes were reviewed. The primary outcome measure of the study was a comparison of modified Rankin scale (MRS) at 90 days in patients' postendovascular thrombectomy with prior IV tPA administration versus those who underwent thrombectomy and did not qualify for preprocedural IV tPA. Results: After application of the set inclusion and exclusion criteria, data of 46 out of 65 patients were analyzed. Twenty-three patients (50%) received IV tPA before thrombectomy and 23 patients did not qualify for IV tPA (50%). Successful recanalization (thrombolysis in cerebral infarction 2b/3) was achieved in 86% (20/23 patients) of thrombectomy patients without preprocedural IV tPA and 82% (19/23) of patients who received it (odds ratio [OR]: 0.03, confidence interval [CI]: 95% 0.062-0.16, P < 0.0001). MRS of 2 or less at 90 days was 43.4% (10/23) in patients with no preprocedural IV tPA and 39.1% (9/23) in the combined therapy group (OR: 0.84, CI: 0.26-2.70, P = 0.8). Conclusion: Patients undergoing endovascular thrombectomy for large vessel occlusion at select low-volume rural centers showed benefit from this treatment regardless of IV tPA administration. Clinical outcomes and complications at select low-volume thrombectomy-proficient centers are comparable to large volume comprehensive stroke centers as well as the landmark studies proving the efficacy of endovascular treatment..


  • Muangpaisan W. Commentary. Journal of Neurosciences in Rural Practice 2012; 3: (3) 241-3'
    Abstract
    None.


  • Pulivarthi S, Haglind E, McGary CT, Gurram MK. Glioblastoma multiforme and papillary thyroid carcinoma - A rare combination of multiple primary malignancies. Journal of Neurosciences in Rural Practice 2015; 6: (2) 241-4'
    Abstract
    We are describing a 19-year-old white woman who presented with two synchronous primary cancers, namely glioblastoma multiforme and papillary thyroid cancer. The patient was admitted with dizziness, headache, and vomiting. CT head revealed acute intraparenchymal hematoma in the right cingulate gyrus and the splenium of the corpus callosum. Carotid and cerebral angiogram were unremarkable. MRI of the brain demonstrated a non-enhancing and non-hemorrhagic component of the lesion along the lateral margin of the hemorrhage just medial to the atrium of the right lateral ventricle that was suspicious for a tumor or metastasis. Brain biopsy confirmed it as glioblastoma mutiforme. CT chest was done to rule out primary cancer that revealed a 11 mm hypodense lesion in the left lobe of the thyroid and ultrasound-guided fine-needle aspiration biopsy confirmed it as papillary thyroid carcinoma. We should evaluate for multiple primary malignancies in young patients who are found to have primary index cancer..


  • Chandra SR, Advani S, Kumar R, Prasad C, Pai AR. Factors Determining the Clinical Spectrum, Course and Response to Treatment, and Complications in Seronegative Patients with Central Nervous System Tuberculosis. Journal of Neurosciences in Rural Practice 2017; 8: (2) 241-8'
    Abstract
    INTRODUCTION: Tuberculous meningitis remains a major health issue in the community affecting young adults of both genders predominantly from rural background. In India, the disease continues to kill 2 people every 3 min or nearly 1000 daily, according to the Tuberculosis Control Society India. Tuberculosis (TB) of central nervous system (CNS) is the most devastating form of TB. As this disease is associated with very high prevalence in young adults and will ultimately contribute to great workforce loss, we decided to assess the factors deciding the disease and its course in our patients. PATIENTS AND METHODS: Seronegative patients with probable CNS TB and attending our outpatient department were included and followed up for 2 years. RESULTS: Low body mass index, low proteins, albumin, and low CD3 and CD4, pulmonary TB appears to be a common denominator in a vast majority of these patients. Delay in diagnosis and hyponatremia contributes to morbidity. The location of exudates causes morbidity when they are seen in optochiasmal region. Bacille Calmette-Guerin (BCG) vaccination status in the community appears to be very small. CONCLUSION: CNS TB causes considerable morbidity and mortality in rural young adults resulting in severe manpower loss. Awareness into the possible role of BCG in reducing the complications of TB, role of nutrition and immunity even in seronegative patients and high-degree suspicion in medical professionals can bring down the burden of this deadly disease in the society..


  • Mukherjee SK, Hossain M. Traumatic brain injury management can improve in primary care centre in remote area with minimum health assistance by proper training. Journal of Neurosciences in Rural Practice 2013; 4: (2) 242-4'
    Abstract
    None.


  • Salih MR, Bahari MB, Hassali MA, Shafie AA, Al-Lela OQ, Abd AY, et al.. Characteristics of seizure frequency among Malaysian children diagnosed with structural-metabolic epilepsy. Journal of Neurosciences in Rural Practice 2012; 3: (3) 244-50'
    Abstract
    INTRODUCTION: Seizure-free patients or substantial reduction in seizure frequency are the most important outcome measures in the management of epilepsy. The study aimed to evaluate the patterns of seizure frequency and its relationship with demographics, clinical characteristics, and outcomes. MATERIALS AND METHODS: A retrospective cohort study was conducted at the Pediatric Neurology Clinic, Hospital Pulau Pinang. Over a period of 6 months, the required data were extracted from the medical records using a pre-designed data collection form. RESULTS: Seizure frequency showed no significant association with patient's demographics and clinical characteristic. However, significant reduction in seizure frequency from the baseline to the last follow-up visit was only seen in certain subgroups of patients including Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability, and patients with focal seizure. There was no significant association between seizure frequency and rate of adverse events. Polytherapy visits were associated with higher seizure frequency than monotherapy visits (27.97 +/- 56.66, 10.94 +/- 30.96 attack per month, respectively) (P < 0.001). There was a clear tendency to get antiepileptic drugs used at doses above the recommended range in polytherapy (8.4%) rather than in monotherapy (1.4%) visits (P < 0.001). A significant correlation was found between seizure frequency and number of visits per patient per year (r = 0.450, P < 0.001). CONCLUSION: Among children with structural-metabolic epilepsy, Malays, females, patients <4 years of age, patients with global developmental delay/intellectual disability and patients manifested with focal seizure are more responsive antiepileptic drug therapy than the other subgroups of patients..


  • Gupta R, Ali R, Dhyani M, Das S, Pundir A. Hindi translation of Berlin questionnaire and its validation as a screening instrument for obstructive sleep apnea. Journal of Neurosciences in Rural Practice 2016; 7: (2) 244-9'
    Abstract
    BACKGROUND: Obstructive sleep apnea (OSA) is a fairly common problem with adverse health consequences. However, any screening questionnaire is not available in Hindi to screen sleep apnea. MATERIALS AND METHODS: Subjects undergoing video-synchronized in laboratory attended polysomnography were requested to participate in this study. They were screened with the help of Hindi version of Berlin questionnaire (BQ). Outcome of the BQ was tested against the gold standard polysomnography. Descriptive statistics, sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of Hindi version were calculated. RESULTS: 38 patients with polysomnography diagnosed OSA and 12 controls were included in this study. Average body mass index (BMI) in the OSA group was 33.12 + 6.66 kg/m(2) whereas in the control group BMI was 25.01 + 4.20 kg/m(2). Average age in the OSA group was 48.9 + 10.2 years whereas the control group was older (56.9 + 12.1 years). Hindi version had sensitivity of 89% and specificity of 58%. PPV of the instrument was 0.87 whereas NPV was 0.63. CONCLUSION: Hindi version of BQ is a valid tool for screening the OSA irrespective of the literacy status of the subjects..


  • Bhat AR, Wani MA, Kirmani AR, Ramzan AU. Histological-subtypes and anatomical location correlated in meningeal brain tumors (meningiomas). Journal of Neurosciences in Rural Practice 2014; 5: (3) 244-9'
    Abstract
    CONTEXT: Not enough literature is available to suggest a link between the histological subtypes of intracranial meningeal brain tumors, called 'meningiomas' and their location of origin. AIM: The evidence of correlation between the anatomical location of the intracranial meningiomas and the histopathological grades will facilitate specific diagnosis and accurate treatment. MATERIALS AND METHODS: The retrospective study was conducted in a single high-patient-inflow Neurosurgical Center, under a standard and uniform medical protocol, over a period of 30 years from December 1982 to December 2012. The records of all the operated 729 meningiomas were analyzed from the patient files in the Medical Records Department. The biodata, x-rays, angiography, computed tomography (CT) scans, imaging, histopathological reports, and mortality were evaluated and results drawn. RESULTS: The uncommon histopathological types of meningiomas (16.88%) had common locations of origin in the sphenoid ridge, posterior parafalcine, jugular foramen, peritorcular and intraventricular regions, cerebellopontine angle, and tentorial and petroclival areas. The histopathological World Health Organization (WHO) Grade I (Benign Type) meningiomas were noted in 89.30%, WHO Grade II (Atypical Type) in 5.90%, and WHO Grade III (Malignant Type) in 4.80% of all meningiomas. Meningiomas of 64.60% were found in females, 47.32% were in the age group of 41-50 years, and 3.43% meningiomas were found in children. An overall mortality of 6.04% was noted. WHO Grade III (malignant meningiomas) carried a high mortality (25.71%) and the most common sites of meningiomas with high mortality were: The cerebellopontine angles, intraventricular region, sphenoid ridge, tuberculum sellae, and the posterior parafalcine areas. CONCLUSION: The correlation between the histological subtypes and the anatomical location of intracranial meningeal brain tumors, called meningiomas, is evident, but further research is required to establish the link..


  • Finsterer J, Zarrouk-Mahjoub S. Involvement of the Spinal Cord in Mitochondrial Disorders. Journal of Neurosciences in Rural Practice 2018; 9: (2) 245-51'
    Abstract
    This review aims at summarising and discussing the current status concerning the clinical presentation, pathogenesis, diagnosis, and treatment of spinal cord affection in mitochondrial disorders (MIDs). A literature search using the database Pubmed was carried out by application of appropriate search terms and their combinations. Involvement of the spinal cord in MIDs is more frequent than anticipated. It occurs in specific and non-specific MIDs. Among the specific MIDs it has been most frequently described in LBSL, LS, MERRF, KSS, IOSCA, MIRAS, and PCH and only rarely in MELAS, CPEO, and LHON. Clinically, spinal cord involvement manifests as monoparesis, paraparesis, quadruparesis, sensory disturbances, hypotonia, spasticity, urinary or defecation dysfunction, spinal column deformities, or as transverse syndrome. Diagnosing spinal cord involvement in MIDs requires a thoroughly taken history, clinical exam, and imaging studies. Additionally, transcranial magnetic stimulation, somato-sensory-evoked potentials, and cerebro-spinal fluid can be supportive. Treatment is generally not at variance compared to the underlying MID but occasionally surgical stabilisation of the spinal column may be necessary. It is concluded that spinal cord involvement in MIDs is more frequent than anticipated but may be missed if cerebral manifestations prevail. Spinal cord involvement in MIDs may strongly determine the mobility of these patients..


  • Matis GK, Chrysou OI, Birbilis TA. The "Young men may die, but old men must die" concept reappraised: The case of subdural hematomas. Journal of Neurosciences in Rural Practice 2013; 4: (3) 245-6'
    Abstract
    None.


  • Kumar VR, Madhugiri VS, Sasidharan GM, Gundamaneni SK, Yadav AK, Verma SK. Totally thrombosed giant anterior communicating artery aneurysm. Journal of Neurosciences in Rural Practice 2015; 6: (2) 245-7'
    Abstract
    Giant anterior communicating artery aneurysms are rare. Apatient presented with visual dysfunction, gait ataxia and urinary incontinence. MRI showed a giant suprasellar mass. At surgery, the lesion was identified as being an aneurysm arising from the anterior communicating artery. The difficulty in preoperative diagnosis and relevant literature are reviewed..


  • Gupta A, Sivaram A, Krishnan R, Khanna M. Urinary Symptoms and Bladder Dysfunction in Patients with Neuromyelitis Optica Spectrum Disorders: Evaluation with Urodynamics and Management. Journal of Neurosciences in Rural Practice 2020; 11: (2) 245-9'
    Abstract
    Objective To assess lower urinary tract symptoms (LUTSs) in patients with neuromyelitis optica spectrum disorders (NMOSDs) and bladder dysfunction through urodynamics (filling and voiding phase of cystometrography) and management based on findings. Patients and Methods The study included 42 (34 females) patients admitted to the rehabilitation department. Neurologic evaluation was performed and severity of myelitis was assessed using the American Spinal Injury Association Impairment Scale. All patients underwent urodynamics, and management was based on the findings. Results Mean age was 34.5 years (range: 11-64 years; standard deviation: 13.1). Twenty-three (54.8%) patients had a first episode of myelitis, whereas 19 patients had relapses (number of episodes varying from 2 to 7). Eleven (26%) patients had increased frequency, 16 (37%) had urgency, 12 (28%) had urge incontinence, 8 (18.6%) had stress incontinence, 22 (52.4%) had nocturia, 31 (72%) had retention of urine, 22 (52.4%) had incomplete evacuation, and 14 (33.3%) patients had mixed urinary complaints. The common urodynamic findings were neurogenic detrusor overactivity (NDO) with detrusor-sphincter dyssynergia (DSD) in 14 (33.3%) patients, NDO without DSD in 8 (19%), and acontractile detrusor in 20 (47.6%). Pharmacotherapy was advised to 22 (52.4%) patients, whereas clean intermittent catheterization (CIC)/self-catheterization was advised to 39 (92.9%) patients. Conclusions Urinary retention was observed to be the most common urinary complaint in patients with NMOSD followed by NDO with or without sphincter dyssynergia. Urodynamics should be performed in all patients with LUTSs for best management. CIC remains the gold standard for the management of neurogenic bladder dysfunction..


  • Manorenj S, Shravani C, Jawalker S. Clinical Characteristics of Essential Tremor in South India: A Hospital-Based Cohort Study. Journal of Neurosciences in Rural Practice 2019; 10: (2) 245-9'
    Abstract
    Introduction: Essential tremor (ET) is the most common adult movement disorder. Classic ET is characterized by action tremor of hands (95% cases), and tremor involving other regions is less common. Recent studies have revealed a few patients exhibiting nontremor features that include cognitive disorders, tandem gait abnormality, mood fluctuations, olfactory abnormality, hearing impairment, and sleep disorders. Very few studies on ET have so far been conducted in India, and the present study is a pioneering attempt to evaluate the clinical characteristics of patients diagnosed with ET. Materials and Methods: A standardized assessment protocol was used to collect data. Diagnosis of ET was established using consensus criteria established by the Movement Disorder Society. Tremor Research Group Essential Tremor Rating Assessment Scale was used to evaluate tremor impact. The severity of hand tremor was assessed by Glass Scale, and cognitive function was assessed by Mini-Mental Status Examination. Results: Out of the 45 patients enrolled, 73.3% were male and 26.6% were female, with a mean age of 44 +/- 15 years. Postural tremor was observed in all, followed by intention tremor in 9 and rest tremor in 6 patients. Tremor of the hand was identified to be most predominant (100%). Voice tremor was observed in 15 (33.3%) patients and head tremor in 12 patients (26.6%) who were all females. Leg tremor was observed in 12 patients (26.6% of patients) and tongue tremor in 6 (13%) patients. Baseline asymmetry of tremor was observed in 60% of patients and positive family history in 35% of patients. The most common nontremor feature was tandem gait abnormality (40%). Moreover, most of the patients had Glass Scale II. Conclusion: Baseline asymmetry of tremor and male predominance were observed in the study. While hand tremor was the most common form of tremor, tandem gait abnormality was the most common nontremor feature as observed in patients with ET..


  • Maas A. The 'skull flap' for decompressive craniectomy: A gap between concept and practice?. Journal of Neurosciences in Rural Practice 2013; 4: (3) 247'
    Abstract
    None.


  • Das S, Gupta R, Dhyani M, Goel D. Headache secondary to sleep-related bruxism: A case with polysomnographic findings. Journal of Neurosciences in Rural Practice 2015; 6: (2) 248-51'
    Abstract
    Sleep-related bruxism may present with headache. However, in clinical practice it may be difficult to differentiate from other causes of headache, especially in subjects with substance abuse. We are presenting a case of sleep-related bruxism that presented with headache and sleep-related symptoms in the presence of substance abuse. Polysomnography was used to ascertain cause of headache. How the other possible causes of headache ruled out is also discussed in report. In short, Sleep-related bruxism can cause headache that is worse in the morning. It is associated with poor quality sleep..


  • Schepers P. Cycling safety as part of a successful road safety strategy in India. Journal of Neurosciences in Rural Practice 2013; 4: (3) 248-9'
    Abstract
    None.


  • Yusuf AS, Omokanye HK, Adeleke NA, Akanbi RO, Ajiboye SO, Ibrahim HG. Management and Outcome of Infantile Hydrocephalus in a Tertiary Health Institution in Nigeria. Journal of Neurosciences in Rural Practice 2017; 8: (2) 249-53'
    Abstract
    BACKGROUND: Hydrocephalus is a leading cause of disability among children worldwide. The outcome depends on morphology and whether insult is pre- or post-natal. There has been improvement in morbidity in developed countries due to improved surgical care. A paucity of trained personnel impacts negatively on care and outcome of infants with hydrocephalus in many low-income countries resulting poorer outcome. We conducted an audit of patients with hydrocephalus managed in our institution to determine common etiology and outcome. OBJECT: The objective of this retrospective review was to conduct an audit of hydrocephalus care in our institution. MATERIALS AND METHODS: Information was retrieved from case notes, ward records, imaging results, operation notes, and follow-up clinic charts. Type of hydrocephalus, onset, treatment offered, outcome, complications, and follow-up duration were documented. RESULTS: Management of 58 infants with complete data was analyzed. Most hydrocephalus 40 (69%) were congenital with 14 (35%) occurring in association with myelomeningocele and 8 patients confirmed with aqueductal stenosis. Ventriculoperitoneal shunts insertion 53 (91%) was the most common treatment modality. CONCLUSIONS: There is need to improve surgical intervention in the form of endoscopic third ventriculostomy in suitable patients. Subsiding cost of care may be considered for indigent patients..


  • Huded V, De Souza R, Nagarajaiah RK, Zafer SM, Nair R, Acharya H. Thrombolysis in acute ischemic stroke: Experience from a tertiary care centre in India. Journal of Neurosciences in Rural Practice 2014; 5: (1) 25-30'
    Abstract
    UNLABELLED: The management of acute ischemic stroke has undergone a sea of change with the introduction of intravenous thrombolysis (IVT). Current guidelines state that the window period for IVT using rTPA is 4.5 hours. The MERCI, Multi Merci, and Penumbra trials in which patients with acute ischemic stroke were treated using endovascular treatment demonstrated better recanalisation in patients having a large vessel occlusion. However, recently published data from the three large trials IMS 3, Synthesis Expansion, and MR rescue, which compared endovascular treatment with intravenous therapy, failed to demonstrate superiority of endovascular treatment over IVT. In these trials, stent retrievers were used in very few patients. We present our results from a tertiary care center in India where patients are treated using intravenous as well as endovascular modalities. Among the 53 patients with acute ischemic stroke treated between 2010 and 2012, 23 were treated with IVT and 30 with endovascular methods. Stent retriever was used in majority of the endovascular cases. AIMS: To compare the outcomes of acute ischemic stroke patients treated with IVT versus those who were managed using endovascular therapy. To evaluate outcomes of patients with acute ischemic stroke with a large vessel occlusion in whom endovascular modalities were used and to compare them with those of patients who were treated with IVT in presence of a large vessel occlusion. SETTINGS AND DESIGN: Data of patients who underwent thrombolysis at our centre was collected over a 3-year period, that is, from 2010 to 2012. Endovascular treatment was done by an interventional neurologist. MATERIALS AND METHODS: Data of patients with acute ischemic stroke who underwent IVT or endovascular treatment at our centre between 2010 and 2012 was analyzed. Parameters included age, National Institutes of Health Stroke Scale (NIHSS) on admission, door to needle time, stroke subtype, modality of treatment, outcome based on modified Rankin Scale (mRS) Score at 90 days follow up and mortality rates at 90 days. STATISTICAL ANALYSIS: Tabulated results were analysed using INSTAT Graphpad analyser. Data were analysed using paired and unpaired t-test, Chi-square test, and Fishers test as applicable. P value was considered significant when it was <0.05. RESULTS: Upon comparison of the outcomes of patients with acute ischemic stroke and large vessel disease treated with endovascular therapy with those treated with IVT, it was found that the former group had better outcomes. We also found that in spite of there being a significant difference in the NIHSS on admission and a significant difference in the door to needle time, the outcomes of patients treated using intravenous or endovascular therapy were similar. There was no statistically significant difference in mortality rates between intravenous and endovascular groups. CONCLUSIONS: IVT is currently the standard of care in the management of acute ischemic stroke. Endovascular treatment during the window period is reserved for those patients with contraindication to IVT. In this study, we found that patients with documented large vessel disease with no evidence of cross flow through Willisian collaterals benefit from endovascular treatment. We recommend that all patients of acute ischemic stroke, be subjected to a baseline angiogram either computed tomography (CT) or magnetic resonance imaging (MRI) to document vessel status. This will help in identifying patients who may benefit from early endovascular treatment, if they fail to improve with IVT. Further, large trials using stent retrievers are needed, to prove that endovascular treatment is superior to IVT, in presence of documented large vessel disease..


  • Bensbaa S, Agerd L, Boujraf S, Araab C, Aalouane R, Rammouz I, et al.. Clinical assessment of depression and type 2 diabetes in Morocco: Economical and social components. Journal of Neurosciences in Rural Practice 2014; 5: (3) 250-3'
    Abstract
    BACKGROUND: The global prevalence of diabetes is increasing worldwide. In Morocco, diabetes and depression are major public health problems, requiring improvement in their care. Diabetes and depression are associated with morbidity and early mortality. This association contributes to raising the risk of the complications that occur, while causing higher suffering to patients, as also an increased cost toward healthcare. AIM: This study aims to assess the prevalence of depression in patients with type 2 diabetes (T2D), and identify the main risk factors for depression in this category of diabetic patients. PATIENTS AND METHODS: Type 2 diabetic patients and older than 18 years of age were recruited. The exclusion criteria included being type 1 diabetic, pregnant woman, hospitalized patients, a history of neurological disorders, such as, stroke, infectious episidodes, and history of psychiatric disorders. The individual patient data was collected through individual and confidential interviews lasting 30 minutes, at the end of the diabetology consultation, by the same diabetologist, trained to use the psychometric scales that were needed. The Moroccan-Arabic version of the Beck diagnostic scale of depression was used. Patients assessed with depressive disorders were reviewed in a specialized psychiatric consultation. The statistical analysis was achieved by using SPSS package (version 17). We retained a threshold P value of 0.05. SETTINGS AND DESIGN: A cross-sectional study was conducted that included adults with type 2 diabetes. The depression diagnosis was performed using the Arabic version of the Beck Depression scale. STATISTICAL ANALYSIS: We included 142 patients with type 2 diabetes, with an average age of 56.26 years. The prevalence of depression was 33.1%. The risk factors recognized for depression were, lack of social security, hypertension, and a history of type 2 diabetes of more than five years. RESULTS AND CONCLUSIONS: In this study, we have focused on the frequent association of 'Type 2 diabetes and depression' and the risk of mutual aggravation of both pathologies that might require multidisciplinary healthcare, as well as, improvement in the risk factors of depression through improved access to healthcare, with the extension of social security. The stability of the healthcare personnel involved in the treatment of both chronic diseases, including diabetes and hypertension screening, should also be considered for better management of psychiatric complications..


  • Murthy VS, Shukla VS. A Study of Executive Function in Patients with Chronic Kidney Disease before and after a Single Session of Hemodialysis. Journal of Neurosciences in Rural Practice 2020; 11: (2) 250-5'
    Abstract
    Background Executive functions (EFs) are critical to daily life and sensitive to our physiological functioning and emotional states. The number of people living with chronic kidney disease (CKD) on hemodialysis (HD) globally is increasing steadily. We aimed to determine the impact of a single session of HD on EFs in patients with CKD receiving maintenance HD (MHD). Methods This was a quasi-experimental study conducted at the department of psychiatry and dialysis unit of a tertiary hospital. Patients undergoing MHD underwent screening to rule out delirium, using the Confusion Assessment Method prior to EF testing. The tests of EF used were the Trail-Making Test-Part B (TMT-B) and Frontal Assessment Battery (FAB), both of which were administered before and after a session of HD. Statistical tests used were Wilcoxon matched pairs signed ranks test, paired t -test, single sample t -test, and correlation analyses. Results The mean time taken on TMT-B before HD was 195.36 seconds and after HD, 171.1 seconds; difference is significant ( p = 0.0001). The mean FAB score was 13.19 before HD and 14.83 after HD; the difference is significant ( p < 0.0001). Significant differences were observed on similarities (p = 0.003), lexical fluency (p = 0.02), and go-no go ( p = 0.003) subtests of FAB. Mean TMT-B scores before and after HD differed significantly from that of a reference study (reference TMT-B 150.69 seconds), p = 0.0002 and 0.04, respectively. Conclusion We conclude that patients with CKD on MHD, in general, have worse executive cognitive functioning compared with healthy populations. A session of HD results in significant improvement in these functions..


  • Dharmadhikari AS, Jaiswal SV, Tandle AL, Sinha D, Jog N. Study of Frontal Alpha Asymmetry in Mild Depression: A Potential Biomarker or Not?. Journal of Neurosciences in Rural Practice 2019; 10: (2) 250-5'
    Abstract
    Background: Depression, despite being the most common of mental illness lacks any quantifiable and absolute biomarker. Frontal alpha asymmetry (FAA) is proposed as biomarker of depression both in resting and activated state. Yet, the location of extraction of alpha, clinical utility as well as validity of FAA is uncertain. With aim of obtaining clarity on this confusion we conducted this study. Methodology: Electroencephalographic frontal alpha power was calculated in patients of depression (n = 24) and compared with healthy controls (n = 17) for the assessment of FAA. Both groups were studied for resting phase and activation phase changes in FAA. For activation phase, auditory stimuli in the form of Indian classical music were used. Results: Frontal alpha power was measured across FP1, FP2, F3, F4, F7, and F8. Mean powers were compared in resting (before), activated (during) and postactivated resting stage (after). FAA was statistically significant in F7-F8 pair of electrodes and on F7 electrode when compared between cases and controls. Conclusion: Quest for biomarker for depression churned out FAA as frontrunner. Despite of vast amount of research on it, practical utility eludes us. We need to revisit our approach from conventional search of the diagnostic biomarker; as FAA might reflect component of depression but not totally disorder. In our opinion, we are not yet ready for it and have a road ahead to travel..


  • Renjith V, Pai MS, Castelino F, Pai A, George A. Clinical profile and functional disability of patients with migraine. Journal of Neurosciences in Rural Practice 2016; 7: (2) 250-6'
    Abstract
    BACKGROUND: Migraine is a common disabling primary headache disorder. Globally, migraine was ranked as the seventh highest cause of disability. AIM: The aim of the study was to explore the clinical profile and functional disability of patients with migraine. SETTINGS AND DESIGN: A cross-sectional survey was conducted at the neurology outpatient department of a tertiary care hospital in Karnataka. MATERIALS AND METHODS: Using a consecutive sampling technique, 60 patients were recruited for the study. Descriptive and inferential statistics were used to analyze the data. RESULTS: Majority of the participants were in the age group of 18-40 years with a mean age 35.22 years. There was a female preponderance with 70% of study participants being females. The various symptoms experienced by patients include throbbing pain (90%), photophobia (93.3%), phonophobia (85%), nausea (76.7%), and vomiting (41.7%). Most of the subjects (73.3%) under the study belonged to moderate to severe levels of functional disability. About 53.3% of patients were in the category of episodic migraine and 46.7% were in the category of chronic migraine. CONCLUSION: Migraine is associated with moderate to severe functional disability. Frequency of migraine has a positive correlation with the levels of disability/migraine disability assessment scores of migraineurs..


  • Mulligan P, Raore B, Liu S, Olson JJ. Neurological and functional outcomes of subdural hematoma evacuation in patients over 70 years of age. Journal of Neurosciences in Rural Practice 2013; 4: (3) 250-6'
    Abstract
    BACKGROUND: Subdural hematoma (SDH) is a common disease entity treated by neurosurgical intervention. Although the incidence increases in the elderly population, there is a paucity of studies examining their surgical outcomes. OBJECTIVES: To determine the neurological and functional outcomes of patients over 70 years of age undergoing surgical decompression for subdural hematoma. MATERIALS AND METHODS: We retrospectively reviewed data on 45 patients above 70 years who underwent craniotomy or burr holes for acute, chronic or mixed subdural hematomas. We analyzed both neurological and functional status before and after surgery. RESULTS: Forty-five patients 70 years of age or older were treated in our department during the study period. There was a significant improvement in the neurological status of patients from admission to follow up as assessed using the Markwalder grading scale (1.98 vs. 1.39; P =0.005), yet no improvement in functional outcome was observed as assessed by Glasgow Outcome Score. Forty-one patients were admitted from home, however only 20 patients (44%) were discharged home, 16 (36%) discharged to nursing home or rehab, 6 (13%) to hospice and 3 (7%) died in the postoperative period. Neurological function improved in patients who were older, had a worse pre-operative neurological status, were on anticoagulation and had chronic or mixed acute and chronic hematoma. However, no improvement in functional status was observed. CONCLUSION: Surgical management of SDH in patients over 70 years of age provides significant improvement in neurological status, but does not change functional status..


  • Tuzgen S, Kucukyuruk B, Aydin S, Ozlen F, Kizilkilic O, Abuzayed B. Decompressive craniectomy in pat