for Journals by Title or ISSN
for Articles by Keywords
help

Publisher: Medknow Publishers   (Total: 355 journals)

 A  B  C  D  E  F  G  H  I  J  K  L  M  N  O  P  Q  R  S  T  U  V  W  X  Y  Z  

        1 2 | Last   [Sort by number of followers]   [Restore default list]

Showing 1 - 200 of 355 Journals sorted alphabetically
Advanced Arab Academy of Audio-Vestibulogy J.     Open Access  
Advances in Human Biology     Open Access   (Followers: 1)
African J. for Infertility and Assisted Conception     Open Access  
African J. of Business Ethics     Open Access   (Followers: 6)
African J. of Medical and Health Sciences     Open Access   (Followers: 1)
African J. of Paediatric Surgery     Open Access   (Followers: 7, SJR: 0.269, h-index: 10)
African J. of Trauma     Open Access  
Ain-Shams J. of Anaesthesiology     Open Access   (Followers: 3)
Al-Azhar Assiut Medical J.     Open Access  
Al-Basar Intl. J. of Ophthalmology     Open Access   (Followers: 1)
Ancient Science of Life     Open Access   (Followers: 6)
Anesthesia : Essays and Researches     Open Access   (Followers: 7)
Annals of African Medicine     Open Access   (Followers: 1, SJR: 0.331, h-index: 15)
Annals of Bioanthropology     Open Access   (Followers: 3)
Annals of Cardiac Anaesthesia     Open Access   (Followers: 12, SJR: 0.408, h-index: 15)
Annals of Indian Academy of Neurology     Open Access   (Followers: 3, SJR: 0.308, h-index: 14)
Annals of Maxillofacial Surgery     Open Access   (Followers: 6)
Annals of Medical and Health Sciences Research     Open Access   (Followers: 7)
Annals of Nigerian Medicine     Open Access   (Followers: 1)
Annals of Pediatric Cardiology     Open Access   (Followers: 7, SJR: 0.441, h-index: 10)
Annals of Saudi Medicine     Open Access   (SJR: 0.24, h-index: 29)
Annals of Thoracic Medicine     Open Access   (Followers: 4, SJR: 0.388, h-index: 19)
Annals of Tropical Medicine and Public Health     Open Access   (Followers: 15, SJR: 0.148, h-index: 5)
APOS Trends in Orthodontics     Open Access   (Followers: 1)
Arab J. of Interventional Radiology     Open Access  
Archives of Intl. Surgery     Open Access   (Followers: 9)
Archives of Medicine and Health Sciences     Open Access   (Followers: 3)
Archives of Pharmacy Practice     Open Access   (Followers: 5)
Asia Pacific J. of Clinical Trials : Nervous System Diseases     Open Access  
Asia-Pacific J. of Oncology Nursing     Open Access   (Followers: 3)
Asian J. of Andrology     Open Access   (Followers: 1, SJR: 0.879, h-index: 49)
Asian J. of Neurosurgery     Open Access   (Followers: 2)
Asian J. of Oncology     Open Access   (Followers: 1)
Asian J. of Transfusion Science     Open Access   (Followers: 2, SJR: 0.362, h-index: 10)
Astrocyte     Open Access  
Avicenna J. of Medicine     Open Access   (Followers: 1)
AYU : An international quarterly journal of research in Ayurveda     Open Access   (Followers: 6)
Benha Medical J.     Open Access  
BLDE University J. of Health Sciences     Open Access  
Brain Circulation     Open Access  
Bulletin of Faculty of Physical Therapy     Open Access   (Followers: 1)
Cancer Translational Medicine     Open Access   (Followers: 1)
CHRISMED J. of Health and Research     Open Access  
Clinical Dermatology Review     Open Access   (Followers: 1)
Clinical Trials in Degenerative Diseases     Open Access  
Clinical Trials in Orthopedic Disorders     Open Access   (Followers: 1)
Community Acquired Infection     Open Access  
Conservation and Society     Open Access   (Followers: 12, SJR: 0.82, h-index: 12)
Contemporary Clinical Dentistry     Open Access   (Followers: 4)
Current Medical Issues     Open Access   (Followers: 1)
CytoJ.     Open Access   (Followers: 2, SJR: 0.339, h-index: 19)
Delta J. of Ophthalmology     Open Access  
Dental Hypotheses     Open Access   (Followers: 3, SJR: 0.131, h-index: 4)
Dental Research J.     Open Access   (Followers: 9)
Dentistry and Medical Research     Open Access  
Digital Medicine     Open Access  
Drug Development and Therapeutics     Open Access  
Education for Health     Open Access   (Followers: 5, SJR: 0.205, h-index: 22)
Egyptian J. of Bronchology     Open Access  
Egyptian J. of Cardiothoracic Anesthesia     Open Access  
Egyptian J. of Cataract and Refractive Surgery     Open Access   (Followers: 1)
Egyptian J. of Dermatology and Venerology     Open Access   (Followers: 1)
Egyptian J. of Haematology     Open Access  
Egyptian J. of Internal Medicine     Open Access   (Followers: 1)
Egyptian J. of Neurology, Psychiatry and Neurosurgery     Open Access   (Followers: 1, SJR: 0.121, h-index: 3)
Egyptian J. of Obesity, Diabetes and Endocrinology     Open Access  
Egyptian J. of Otolaryngology     Open Access  
Egyptian J. of Psychiatry     Open Access   (Followers: 2)
Egyptian J. of Surgery     Open Access   (Followers: 1)
Egyptian Orthopaedic J.     Open Access  
Egyptian Pharmaceutical J.     Open Access  
Egyptian Retina J.     Open Access  
Egyptian Rheumatology and Rehabilitation     Open Access  
Endodontology     Open Access  
Endoscopic Ultrasound     Open Access   (SJR: 0.473, h-index: 8)
Environmental Disease     Open Access  
European J. of Dentistry     Open Access   (Followers: 2, SJR: 0.496, h-index: 11)
European J. of General Dentistry     Open Access   (Followers: 1)
European J. of Prosthodontics     Open Access   (Followers: 2)
European J. of Psychology and Educational Studies     Open Access   (Followers: 7)
Fertility Science and Research     Open Access  
Formosan J. of Surgery     Open Access   (SJR: 0.107, h-index: 5)
Genome Integrity     Open Access   (Followers: 4, SJR: 1.227, h-index: 12)
Global J. of Transfusion Medicine     Open Access   (Followers: 1)
Heart India     Open Access   (Followers: 1)
Heart Views     Open Access   (Followers: 2)
Hepatitis B Annual     Open Access   (Followers: 3)
IJS Short Reports     Open Access  
Indian Anaesthetists Forum     Open Access  
Indian Dermatology Online J.     Open Access   (Followers: 3)
Indian J. of Allergy, Asthma and Immunology     Open Access   (Followers: 1)
Indian J. of Anaesthesia     Open Access   (Followers: 8, SJR: 0.302, h-index: 13)
Indian J. of Burns     Open Access   (Followers: 1)
Indian J. of Cancer     Open Access   (SJR: 0.318, h-index: 26)
Indian J. of Cerebral Palsy     Open Access   (Followers: 1)
Indian J. of Community Medicine     Open Access   (Followers: 2, SJR: 0.618, h-index: 16)
Indian J. of Critical Care Medicine     Open Access   (Followers: 2, SJR: 0.307, h-index: 16)
Indian J. of Dental Research     Open Access   (Followers: 4, SJR: 0.243, h-index: 24)
Indian J. of Dental Sciences     Open Access  
Indian J. of Dentistry     Open Access   (Followers: 1)
Indian J. of Dermatology     Open Access   (Followers: 2, SJR: 0.448, h-index: 16)
Indian J. of Dermatology, Venereology and Leprology     Open Access   (Followers: 3, SJR: 0.563, h-index: 29)
Indian J. of Dermatopathology and Diagnostic Dermatology     Open Access  
Indian J. of Drugs in Dermatology     Open Access   (Followers: 1)
Indian J. of Endocrinology and Metabolism     Open Access   (Followers: 4)
Indian J. of Health Sciences     Open Access   (Followers: 2)
Indian J. of Medical and Paediatric Oncology     Open Access   (SJR: 0.292, h-index: 9)
Indian J. of Medical Microbiology     Open Access   (Followers: 1, SJR: 0.53, h-index: 34)
Indian J. of Medical Research     Open Access   (Followers: 4, SJR: 0.716, h-index: 60)
Indian J. of Medical Sciences     Open Access   (Followers: 2, SJR: 0.207, h-index: 31)
Indian J. of Multidisciplinary Dentistry     Open Access   (Followers: 1)
Indian J. of Nephrology     Open Access   (Followers: 1, SJR: 0.233, h-index: 12)
Indian J. of Nuclear Medicine     Open Access   (Followers: 2, SJR: 0.213, h-index: 5)
Indian J. of Occupational and Environmental Medicine     Open Access   (Followers: 4, SJR: 0.203, h-index: 13)
Indian J. of Ophthalmology     Open Access   (Followers: 5, SJR: 0.536, h-index: 34)
Indian J. of Oral Health and Research     Open Access  
Indian J. of Oral Sciences     Open Access   (Followers: 1)
Indian J. of Orthopaedics     Open Access   (Followers: 9, SJR: 0.393, h-index: 15)
Indian J. of Otology     Open Access   (Followers: 1, SJR: 0.218, h-index: 5)
Indian J. of Paediatric Dermatology     Open Access   (Followers: 2)
Indian J. of Pain     Open Access   (Followers: 1)
Indian J. of Palliative Care     Open Access   (Followers: 5, SJR: 0.35, h-index: 12)
Indian J. of Pathology and Microbiology     Open Access   (Followers: 1, SJR: 0.285, h-index: 22)
Indian J. of Pharmacology     Open Access   (SJR: 0.347, h-index: 44)
Indian J. of Plastic Surgery     Open Access   (Followers: 12, SJR: 0.303, h-index: 13)
Indian J. of Psychiatry     Open Access   (Followers: 3, SJR: 0.496, h-index: 15)
Indian J. of Psychological Medicine     Open Access   (Followers: 1, SJR: 0.344, h-index: 9)
Indian J. of Public Health     Open Access   (Followers: 1, SJR: 0.444, h-index: 17)
Indian J. of Radiology and Imaging     Open Access   (Followers: 4, SJR: 0.253, h-index: 14)
Indian J. of Research in Homoeopathy     Open Access  
Indian J. of Rheumatology     Open Access   (SJR: 0.169, h-index: 7)
Indian J. of Sexually Transmitted Diseases and AIDS     Open Access   (Followers: 2, SJR: 0.313, h-index: 9)
Indian J. of Social Psychiatry     Open Access   (Followers: 2)
Indian J. of Urology     Open Access   (Followers: 3, SJR: 0.366, h-index: 16)
Indian J. of Vascular and Endovascular Surgery     Open Access   (Followers: 2)
Industrial Psychiatry J.     Open Access   (Followers: 2)
Intl. J. of Academic Medicine     Open Access  
Intl. J. of Advanced Medical and Health Research     Open Access  
Intl. J. of Applied and Basic Medical Research     Open Access  
Intl. J. of Clinical and Experimental Physiology     Open Access   (Followers: 1)
Intl. J. of Critical Illness and Injury Science     Open Access   (Followers: 1)
Intl. J. of Educational and Psychological Researches     Open Access   (Followers: 3)
Intl. J. of Environmental Health Engineering     Open Access   (Followers: 1)
Intl. J. of Forensic Odontology     Open Access   (Followers: 1)
Intl. J. of Green Pharmacy     Open Access   (Followers: 4, SJR: 0.229, h-index: 13)
Intl. J. of Health & Allied Sciences     Open Access   (Followers: 3)
Intl. J. of Health System and Disaster Management     Open Access   (Followers: 2)
Intl. J. of Heart Rhythm     Open Access  
Intl. J. of Medicine and Public Health     Open Access   (Followers: 7)
Intl. J. of Mycobacteriology     Open Access   (SJR: 0.239, h-index: 4)
Intl. J. of Noncommunicable Diseases     Open Access  
Intl. J. of Nutrition, Pharmacology, Neurological Diseases     Open Access   (Followers: 4)
Intl. J. of Oral Health Sciences     Open Access   (Followers: 1)
Intl. J. of Orthodontic Rehabilitation     Open Access  
Intl. J. of Pedodontic Rehabilitation     Open Access  
Intl. J. of Pharmaceutical Investigation     Open Access   (Followers: 1)
Intl. J. of Preventive Medicine     Open Access   (Followers: 1, SJR: 0.523, h-index: 15)
Intl. J. of Shoulder Surgery     Open Access   (Followers: 7, SJR: 0.611, h-index: 9)
Intl. J. of Trichology     Open Access   (SJR: 0.37, h-index: 10)
Intl. J. of Yoga     Open Access   (Followers: 15)
Intl. J. of Yoga : Philosophy, Psychology and Parapsychology     Open Access   (Followers: 6)
Iranian J. of Nursing and Midwifery Research     Open Access   (Followers: 2)
Iraqi J. of Hematology     Open Access  
J. of Academy of Medical Sciences     Open Access  
J. of Advanced Pharmaceutical Technology & Research     Open Access   (Followers: 4, SJR: 0.427, h-index: 15)
J. of Anaesthesiology Clinical Pharmacology     Open Access   (Followers: 8, SJR: 0.416, h-index: 14)
J. of Applied Hematology     Open Access  
J. of Association of Chest Physicians     Open Access   (Followers: 2)
J. of Basic and Clinical Reproductive Sciences     Open Access   (Followers: 1)
J. of Cancer Research and Therapeutics     Open Access   (Followers: 4, SJR: 0.359, h-index: 21)
J. of Carcinogenesis     Open Access   (Followers: 1, SJR: 1.152, h-index: 26)
J. of Cardiothoracic Trauma     Open Access  
J. of Cardiovascular Disease Research     Open Access   (Followers: 3, SJR: 0.351, h-index: 13)
J. of Cardiovascular Echography     Open Access   (SJR: 0.134, h-index: 2)
J. of Cleft Lip Palate and Craniofacial Anomalies     Open Access   (Followers: 2)
J. of Clinical and Preventive Cardiology     Open Access   (Followers: 1)
J. of Clinical Imaging Science     Open Access   (Followers: 1, SJR: 0.277, h-index: 8)
J. of Clinical Neonatology     Open Access   (Followers: 1)
J. of Clinical Ophthalmology and Research     Open Access   (Followers: 2)
J. of Clinical Sciences     Open Access  
J. of Conservative Dentistry     Open Access   (Followers: 4, SJR: 0.532, h-index: 10)
J. of Craniovertebral Junction and Spine     Open Access   (Followers: 4, SJR: 0.199, h-index: 9)
J. of Current Medical Research and Practice     Open Access  
J. of Current Research in Scientific Medicine     Open Access  
J. of Cutaneous and Aesthetic Surgery     Open Access   (Followers: 1)
J. of Cytology     Open Access   (Followers: 1, SJR: 0.274, h-index: 9)
J. of Dental and Allied Sciences     Open Access   (Followers: 1)
J. of Dental Implants     Open Access   (Followers: 7)
J. of Dental Lasers     Open Access   (Followers: 2)
J. of Dental Research and Review     Open Access   (Followers: 1)
J. of Digestive Endoscopy     Open Access   (Followers: 3)
J. of Dr. NTR University of Health Sciences     Open Access  
J. of Earth, Environment and Health Sciences     Open Access   (Followers: 1)
J. of Education and Ethics in Dentistry     Open Access   (Followers: 5)
J. of Education and Health Promotion     Open Access   (Followers: 5)
J. of Emergencies, Trauma and Shock     Open Access   (Followers: 9, SJR: 0.353, h-index: 14)
J. of Engineering and Technology     Open Access   (Followers: 6)
J. of Experimental and Clinical Anatomy     Open Access   (Followers: 2)
J. of Family and Community Medicine     Open Access   (Followers: 2)
J. of Family Medicine and Primary Care     Open Access   (Followers: 9)

        1 2 | Last   [Sort by number of followers]   [Restore default list]

Journal Cover Annals of Indian Academy of Neurology
  [SJR: 0.308]   [H-I: 14]   [3 followers]  Follow
    
  This is an Open Access Journal Open Access journal
   ISSN (Print) 0972-2327
   Published by Medknow Publishers Homepage  [355 journals]
  • Epidemiology of peripheral neuropathy: An Indian perspective

    • Authors: Sweety Trivedi, Alak Pandit, Goutam Ganguly, Shyamal Kumar Das
      Pages: 173 - 184
      Abstract: Sweety Trivedi, Alak Pandit, Goutam Ganguly, Shyamal Kumar Das
      Annals of Indian Academy of Neurology 2017 20(3):173-184
      Peripheral neuropathy (PN) is a common disorder and presents as diagnostic and therapeutic challenge to physicians and neurologists. In epidemiological studies from India from various regions the overall prevalence of PN varied from 5 to 2400 per 10,000 population in various community studies. India is composed of a multiethnic, multicultural population who are exposed to different adverse environmental factors such as arsenic and lead. Use of different chemotherapeutic agents with propensity to affect peripheral nerves, increasing methods of diagnosis of connective tissue disorders and use of immunomodulating drugs, growing aging population is expected to change the spectrum and burden of peripheral neuropathy in the community. The other important aspect of peripheral neuropathies is in terms of the geographical and occupational distribution especially of toxic neuropathies like arsenic which is common in eastern belt; lead, mercury and organo-phosphorous compounds where occupational exposures are major sources. Inflammatory neuropathies either due to vasculitis or G B Syndrome, chronic inflammatory polyradiculopathies are another major group of neuropathies which is increasing due to increase longevity of Indian subjects and immunological impairment, also adds to morbidity of the patients and are potentially treatable. Leprous neuropathy is common in India and although its frequency is significantly decreasing because of national control program yet pure neuritic form still remains a cause of concern and similar is the case with another infective cause like diptheric neurpathy. Thus this article is an attempt to cover major categories and also highlight the areas where further studies are needed.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):173-184
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_470_16
      Issue No: Vol. 20, No. 3 (2017)
       
  • Levodopa: History and therapeutic applications

    • Authors: Sujith Ovallath, Bahiya Sulthana
      Pages: 185 - 189
      Abstract: Sujith Ovallath, Bahiya Sulthana
      Annals of Indian Academy of Neurology 2017 20(3):185-189
      Levodopa – the aromatic amino acid L-3,4–dihydroxy phenylalanine has held the attention of neurologists and pharmacologists alike for more than half a century. Even though extensive research has been done across the globe in treatment of Parkinson's disease, with different molecules, none could replace the gold standard treatment or provide complete relief for the debilitated. Although research brought us better tips and tricks to modulate the dopamine blood levels to balance between the desired and deleterious effects, it could never replace the basic substrate. From simple oral preparation to more advanced treatment like duodenal dopa administration for better efficacy and compliance, L-dopa has sure undergone scrutiny and stayed strong as the fundamental neurotransmitter replacement therapy to pave path for many more new therapeutic strategies. So as a token of gratitude to the revolutionary agent and pioneers behind it, a trip down the memory lane is in order.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):185-189
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_241_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Levodopa-induced dyskinesia: Clinical features, pathophysiology, and
           medical management

    • Authors: Sanjay Pandey, Prachaya Srivanitchapoom
      Pages: 190 - 198
      Abstract: Sanjay Pandey, Prachaya Srivanitchapoom
      Annals of Indian Academy of Neurology 2017 20(3):190-198
      Levodopa-induced dyskinesia (LID) is commonly seen in Parkinson's disease patients treated with levodopa. This side effect is usually encountered after long duration of treatment, but occasionally, this may be seen even after few days or months of treatment. LID is broadly classified as peak-dose dyskinesia, wearing-off or off-period dyskinesia, and diphasic dyskinesia. Pathogenesis of LID is complex, and different neurotransmitters such as dopamine, glutamine, adenosine, and gamma-aminobutyric acid play important role altering the normal physiology of direct and indirect pathway of cortico-basal ganglia-thalamic loop responsible for fine motor control. Treatment of LID requires careful history taking and clinical examination to find the type of dyskinesia as different approach is required for different types. Changes in dopaminergic medication including continuous dopaminergic stimulation are very helpful in the management of peak-dose dyskinesia. Different types of surgical approaches including unilateral pallidotomy and deep brain stimulation have given very good result in patients, who cannot be managed by medications alone. The surgical management of LID is dealt with in detail in another review in this series.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):190-198
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_239_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Surgical treatment of levodopa-induced dyskinesia in
           parkinson's disease

    • Authors: Syam Krishnan, Krishnakumar Kesava Pisharady
      Pages: 199 - 206
      Abstract: Syam Krishnan, Krishnakumar Kesava Pisharady
      Annals of Indian Academy of Neurology 2017 20(3):199-206
      The treatment of motor manifestations of Parkinson's disease (PD) is essentially a trade-off between adequate relief of motor symptoms and prevention and control of motor complications, particularly levodopa-induced dyskinesia (LID). Progression of PD is paralleled by a progressive difficulty in achieving the balance. Functional neurosurgical procedures provide sustained relief of LID in carefully selected patients when further tailoring of medical therapy fails to achieve this goal. Though deep brain stimulation (DBS) has superseded lesioning surgeries, pallidotomy still has a role in those patients in whom DBS is not feasible for financial or other reasons.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):199-206
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_244_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • James wenceslaus papez, his circuit, and emotion

    • Authors: Kalyan B Bhattacharyya
      Pages: 207 - 210
      Abstract: Kalyan B Bhattacharyya
      Annals of Indian Academy of Neurology 2017 20(3):207-210
      James Papez worked on the anatomical substrates of emotion and described a circuit, mainly composed of the hippocampus, thalamus and cingulum, and published his observations in 1937. However, such an idea existed before him, as evidenced by the rudimentary indications from Paul Broca, and Paul MacLean added some other structures like, septum, amygdala, and hypothalamus in its ambit and called it the limbic system. Paul Ivan Yakovlev, proposed a circuit which also referred to orbitofrontal, insular, anterior temporal lobe, and other nuclei of thalamus. Further works hinted at cerebellar projections into this system and the clinical picture of aggression, arousal and positive feeding responses with stimulation of cerebellar nuclei, attests its possible role. Finally, the work of Heinrich Klüver and Paul Bucy of the United States of America on ablating the temporal lobes and amygdala and the resultant behaviour of the animals, almost incontrovertibly adduced evidence for the operation of a neural circuitry in the genesis of emotion. Additionally, Papez circuit may also be concerned with memory and damage to its various components in Parkinson's disease, Alzheimer's disease, Korsakoff's syndrome, semantic dementia, and global amnesia, where cognitive disturbance is almost universal, lends credence to its putative role.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):207-210
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_487_16
      Issue No: Vol. 20, No. 3 (2017)
       
  • Acute ischemic stroke treatment using mechanical thrombectomy: A study of
           137 patients

    • Authors: Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
      Pages: 211 - 216
      Abstract: Rakeshsingh K Singh, Vishal Annaji Chafale, Rakesh Shyam Lalla, Keyurkumar Chandrakantbhai Panchal, Anil Pandurang Karapurkar, Satish Vasant Khadilkar, Pawan K Ojha, Yogesh Godge, Rakesh K Singh, Rajesh Benny
      Annals of Indian Academy of Neurology 2017 20(3):211-216
      Background: Mechanical thrombectomy (MT) is the most effective treatment in large vessel occlusion (LVO). We have analyzed our initial experience of MT of 137 patients in anterior circulation (AC) and posterior circulation (PC) LVO using Solitaire stent retriever device. Methods: Retrospective cohort analysis of 112 AC and 25 PC acute ischemic strokes was done considering various baseline characteristics, risk factors, National Institute of Health Stroke Scale (NIHSS) change, revascularization rate, complications, and functional outcome at 3 months using modified Rankin score. Results: Out of 137 patients, occlusion was found in M1 segment (44.5%), carotid T occlusion (37.2%), and basilar artery (18.2%). Atrial fibrillation was important risk factor for Carotid T occlusion. 50.4% patients received intravenous thrombolysis. Baseline mean NIHSS in AC was 15.5 (±4.32), and PC was 19 (±5.5). Tandem lesions were noted in 14.6%. There was significant difference in mean door-to-needle time for AC and PC (220 ± 80.6 and 326 ± 191.8 min, respectively). Mean time to revascularization for AC (39.5 ± 14.1) and PC (42.2 ± 19.4) was similar. Procedural success (modified thrombolysis in cerebral infarction ≥2b) observed in AC and PC was 92.9% and 84%, respectively (P = 0.154). NIHSS at admission between 5 and 15 and immediate postprocedure NIHSS improvement >4 was associated with significant better clinical outcome at 3 months. Overall complication rate was about 15.3% including symptomatic intracranial hemorrhage in 8.1% and 6.6% deaths. Conclusion: MT is safe treatment and equally effective for both AC and PC LVO. With careful patient selection, clinical outcome in PC was comparable to AC despite delayed presentation and higher baseline NIHSS.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):211-216
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_158_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Short version of the bilingual aphasia test in Malayalam

    • Authors: Gopee Krishnan, Reema Elizabeth Mathew
      Pages: 217 - 219
      Abstract: Gopee Krishnan, Reema Elizabeth Mathew
      Annals of Indian Academy of Neurology 2017 20(3):217-219
      Background: Brain damage can impair the use of all languages in bilingual persons. For effective management of aphasia (i.e., impaired language) in such persons, assessment of all languages is essential. The most widely used test for this purpose – the Bilingual Aphasia Test (BAT) – is cumbersome and requires a considerable amount of time for administration. To overcome this limitation, a short version of the BAT has been recommended. Objective: The objective of this study was to derive a short version of BAT for Malayalam-English bilingual persons with aphasia and to establish the test–retest reliability as well as the content and construct validities of this version. Methods: Following the recommendations of the test developers, we used seven subtests from the draft of an adapted full version of Malayalam BAT. These subtests in Malayalam and their counterparts in English were administered on a group of 22 Malayalam-English bilingual participants with aphasia. The scores obtained from these two languages were used to establish content and construct validities of the short version of the BAT in Malayalam. Further, we readministered the short version of BAT in a group of ten participants with aphasia to examine the test–retest reliability within 14 days from the date of first administration. Results: The short version of BAT in Malayalam revealed high test–retest reliability as well as content and construct validities. The administration time ranged between 30 and 45 min. Conclusions: Thus, the short version of the BAT in Malayalam can be considered a valid and reliable language test that can be quickly administered in Malayalam-English bilingual persons with aphasia.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):217-219
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_10_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Long-term response of cerebrospinal fluid pressure in patients with
           idiopathic intracranial hypertension – A prospective observational
           study

    • Authors: V Abdul Gafoor, B Smita, James Jose
      Pages: 220 - 224
      Abstract: V Abdul Gafoor, B Smita, James Jose
      Annals of Indian Academy of Neurology 2017 20(3):220-224
      Background: Idiopathic intracranial hypertension (IIH) is increased intracranial pressure (ICP) with normal cerebrospinal fluid (CSF) contents, in the absence of an intracranial mass, hydrocephalus, or other identifiable causes. The current knowledge of the treatment outcome of IIH is limited, and the data on the natural history of this entity are scant. Objective: The objective of the study is to study the treatment response of IIH by serially measuring the CSF opening pressure and to delineate the factors influencing the same. Materials and Methods: A prospective observational study in a cohort of fifty patients with IIH in whom CSF opening pressure was serially measured at pre-specified intervals. Results: The mean CSF opening pressure at baseline was 302.4 ± 51.69 mm of H2O (range: 220–410). Even though a higher body mass index (BMI) showed a trend toward a higher CSF opening pressure, the association was not significant (P = 0.168). However, the age of the patient had a significant negative correlation with the CSF pressure (P = 0.006). The maximum reduction in CSF pressure occurred in the first 3 months of treatment, and thereafter it plateaued. Remission was attained in 12 (24%) patients. BMI had the strongest association with remission (P = 0.001). Conclusions: In patients with IIH, treatment response is strongly related to BMI. However, patients with normal BMI are also shown to relapse and hence should have continuous, long-term follow-up. The reduction in CSF pressure attained in the first 3 months could reflect the long-term response to treatment.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):220-224
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_32_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Hospital-based retrospective study of cryptococcal meningitis in a large
           cohort from India

    • Authors: Karkal Ravishankar Naik, Aralikatte Onkarappa Saroja, Darshan Kiran Doshi
      Pages: 225 - 228
      Abstract: Karkal Ravishankar Naik, Aralikatte Onkarappa Saroja, Darshan Kiran Doshi
      Annals of Indian Academy of Neurology 2017 20(3):225-228
      Background: Cryptococcal meningitis is an important and a fatal neuroinfection. Early diagnosis and treatment is of utmost importance in reducing morbidity and mortality. Materials and Methods: Data of patients with laboratory-confirmed cryptococcal meningitis seen in tertiary care hospital were reviewed. Details of demographic profile, clinical data, laboratory parameters, complications, and in-hospital mortality were studied. Results: Among 97 patients with cryptococcal meningitis (79 men, 18 women), 88 were HIV-positive, two were diabetic, and seven were sporadic. Their age ranged from 23 to 67 years (39.16 ± 9.49). Additional pathogens for meningitis were identified in 24 patients. Headache was the most common symptom (91%) followed by fever (66%), vomiting (51%), altered sensorium (31%), and seizures (20%). Neurological deficits included cranial nerve palsies (28), motor deficits (11), sphincter disturbances (5), and sensory involvement in four patients. Complications included renal dysfunction (20%), dyselectrolytemia (20%), seizures (16%), hypersensitivity (7%), and hepatic dysfunction (5%). Favorable outcome was seen in 72 patients, 13 remained unchanged, and 12 died. Rapid clinical progression, low cerebrospinal fluid (CSF) cell count and protein were associated with higher mortality. CSF cell count and protein were lower in patients who had isolated cryptococcal meningitis compared to those with additional pathogen. Mean sugar levels were higher and duration of illness was shorter in HIV-negative individuals. Conclusion: Cryptococcal meningitis is common in patients with AIDS. Effective and early antifungal treatment carries a good prognosis. On rapid evolution of the disease, decreased CSF cell count and protein heralds poor prognosis and warrants initiation of early specific treatment.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):225-228
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_39_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Rituximab in neuromyelitis optica spectrum disorders: Our experience

    • Authors: Jui Dilip Jade, Srishti Bansi, Bhim Singhal
      Pages: 229 - 232
      Abstract: Jui Dilip Jade, Srishti Bansi, Bhim Singhal
      Annals of Indian Academy of Neurology 2017 20(3):229-232
      Background: Neuromyelitis optica (NMO) is an inflammatory demyelinating central nervous system disease, with recurrent attacks of severe bilateral optic neuritis and longitudinally extensive transverse myelitis. Aggressive immunosuppression is essential to prevent clinical relapses and permanent disability. Rituximab, a monoclonal antibody to CD20, has been found effective in several reports and small uncontrolled studies. There is a paucity of data regarding its use in Indian patients. Objectives: The aim of this study was to report the results of rituximab treatment in NMO spectrum disorders (NMOSDs) in the Indian scenario. Methods: This study is a retrospective, observational study including 13 NMOSD patients treated with rituximab. After initial therapy in the acute episode with IV methylprednisolone and if needed plasma exchange, therapy was initiated as a cycle of intravenous rituximab, two doses 2 weeks apart of 1 g each. Subsequent cycles were advised at intervals of every 6 months. The primary outcome measure was annualized relapse rate (ARR), defined as a number of clinical attacks per year. Clinical adverse events were recorded throughout the study. Results: In the study, mean ARR reduced from 2.61 to 0.09 after therapy (P = 0.000685). Of 13 patients, 8 (61.54%) were completely relapse free after starting treatment with rituximab. Treatment was well tolerated and no serious adverse events were noted. Conclusions: The treatment of NMOSDs with rituximab in Indian patients reduces the frequency of relapses and is well tolerated.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):229-232
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_499_16
      Issue No: Vol. 20, No. 3 (2017)
       
  • Stigma and polytherapy: Predictors of quality of life in patients with
           epilepsy from South India

    • Authors: M Nagarathnam, B Vengamma, B Shalini, S AA Latheef
      Pages: 233 - 241
      Abstract: M Nagarathnam, B Vengamma, B Shalini, S AA Latheef
      Annals of Indian Academy of Neurology 2017 20(3):233-241
      Background: Apart from unpredictable seizures and consequent injuries, people with epilepsy (PWE) confront with psychosocial adjustments. Quality of life (QOL) varies with culture and socioeconomic milieu. Identification of predictors for QOL enables comprehensive and effective care. Objective: The objective of this study was to investigate the role of stigma, demographic, socioeconomic, and clinical factors in QOL among PWE. Subjects and Methods: In this prospective observational study, 170 PWE answered QOL in epilepsy-31 (QOLIE-31) and stigma questionnaire. Internal consistency of instruments was evaluated by Cronbach's alpha and reproducibility by intracorrelation coefficient (ICC). Descriptive statistics were calculated, and predictors were identified by regression analysis. Results: Mean age of the PWE was 34.39 ± 11.49. Cronbach's alpha and ICC of the QOLIE-31 were 0.946 and 0.974 and stigma scale was 0.903 and 0.954, respectively. Mean total QOL was 60.29 ± 14.12. Highest and lowest scores of subscales of QOL were observed in medication effects and social functioning. Mean stigma score of PWE was 22.21 ± 14.64. Majority of PWE had mild stigma (75%) followed by moderate (22%) and high stigma (1%). Stigma score correlated with total and subscales of QOL (P < 0.01). Statistically significant decrease in scores of total and subscales of QOL was observed in high and moderate stigma when compared to mild stigma (P < 0.01). Stigma (standardized beta coefficient = −0.652, P< 0.00) and polytherapy (standardized beta coefficient = −0.180, P< 0.02) were found to be the significant predictors of QOL. Significant decrease in total and subscale scores of QOL was observed in PWE under polytherapy when compared to monotherapy and also in seizure frequent against seizure-free PWE (P < 0.01). Conclusions: Besides control of seizures, encouragement of monotherapy and destigmatization campaigns may improve the QOL of PWE.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):233-241
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_36_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Association of serum 25-hydroxyvitamin D in carotid intima-media
           thickness: A study from South India

    • Authors: Jaydip Ray Chauduri, K Rukmini Mridula, Matapathi Umamashesh, Banda Balaraju, V C. S. Srinivasarao Bandaru
      Pages: 242 - 247
      Abstract: Jaydip Ray Chauduri, K Rukmini Mridula, Matapathi Umamashesh, Banda Balaraju, V C. S. Srinivasarao Bandaru
      Annals of Indian Academy of Neurology 2017 20(3):242-247
      Background: Abnormal carotid intima-media thickness (IMT) is a marker of carotid atherosclerosis which is a risk factor for cerebrovascular and cardiovascular diseases. Recent studies have found an association of 25-hydroxyvitamin D deficiency with abnormal carotid IMT. Purpose: The purpose of the study was to investigate the association of serum 25-hydroxyvitamin D levels with carotid IMT in Indian participants. Materials and Methods: We prospectively recruited 300 participants at Yashoda Hospital, Hyderabad, during the study period between January 2012 and December 2014. All participants were assessed for fasting blood sugar, lipid profile, C-reactive protein (CRP), serum alkaline phosphatase, serum calcium, serum phosphorous, serum 25-hydroxyvitamin D levels, and carotid Doppler examination. Results: Among the 300 participants, men were 190 (63.3%) and mean age was 51.9 ± 7.7 years with a range from 35 to 64 years. On risk factors evaluation, 105 (35%) were hypertensive, 79 (26.3%) diabetics, 63 (21%) smokers, and 56 (18.6%) were alcoholics. On evaluation of biochemical parameters, 81 (27%) had dyslipidemia, 120 (40%) had elevated CRP levels, 119 (39.6%) had 25-hydroxyvitamin D deficiency, mean alkaline phosphatase was 93.9 ± 14.9 IU/L, serum calcium (mg/dL) was 9.2 ± 2.3, and serum phosphorous 4.4 ± 1.2 mg/dL. On carotid imaging, 121 (40.3%) had abnormal IMT. After multivariate analysis, 25-hydroxyvitamin D deficiency (odds ratio [OR]: 2.14; 95% confidence interval [CI]: 1.29–3.55), dyslipidemia (OR: 2.53; 95% CI: 1.46–4.40), elevated CRP (OR: 2.27; 95% CI: 1.37–3.76), smoking (OR: 2.09; 95% CI: 1.16–3.77), and diabetes (OR: 1.84; 95% CI: 1.05–3.21) were independently associated with abnormal IMT. Conclusion: In our study, we established 25-hydroxyvitamin D deficiency as an independently associated with abnormal IMT in Indian participants.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):242-247
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_37_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Delayed orthostatic hypotension: A pilot study from India

    • Authors: Arun Grace Roy, Siby Gopinath, Suresh Kumar, Sudheeran Kannoth, Anand Kumar
      Pages: 248 - 251
      Abstract: Arun Grace Roy, Siby Gopinath, Suresh Kumar, Sudheeran Kannoth, Anand Kumar
      Annals of Indian Academy of Neurology 2017 20(3):248-251
      Introduction: Orthostatic hypotension is defined as a sustained decrease in systolic blood pressure of 20 mm Hg or a decrease in diastolic blood pressure of 10 mm Hg within three minutes of standing compared with blood pressure from the sitting or supine position or by head-up tilt-table testing (1). When sustained blood pressure (BP) drop is after three minutes of upright posture it is called delayed orthostatic hypotension (delayed OH) (2). Aim of the Study: To detect the incidence of delayed orthostatic hypotension in patients referred to our autonomic lab. Materials and Method: BP was measured noninvasively at 1-minute intervals with an automated cuff sphygmomanometer over the right brachial artery for 45 minutes. The onset and duration of falls in blood pressure either systolic or diastolic or both were documented, and any associated symptoms were recorded. Only patients with sustained falls in BP were included. Drugs causing OH was stopped 48 hours before testing as per protocol followed in lab. We also looked into other autonomic function test abnormalities in patients with delayed OH. Inclusion criteria: Patients above age of 18 years referred for evaluation of autonomic function tests. Exclusion criteria: Patients with severe cardiac failure and cardiac arrhythmias were excluded and patients with rapid fall in BP and bradycardia (Neurally mediated syncope) were excluded. Results: Total 170 patients underwent tilt table testing. Orthostatic hypotension was seen within 3 minutes in seventy patients, fifty patients had delayed OH (BP fall after 3 minutes). There were twenty seven males and twenty three females in this group. Twenty nine of the 50 patients with delayed orthostatic hypotension, had symptoms during the tilt table procedure. Asymptomatic OH was more common in patients who developed OH after 10 minutes. Conclusion: This is a pilot study, first in India where we looked into the incidence of delayed orthostatic hypotension in patients undergoing tilt table testing in our autonomic lab. We found that fifty patients had delayed orthostatic hypotension which could have been missed on clinical evaluation. High clinical suspicion is needed to detect this disorder and tilt table testing should be done in suspicious cases since orthostatic hypotension is cause of high morbidity.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):248-251
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_498_16
      Issue No: Vol. 20, No. 3 (2017)
       
  • Can transcranial color doppler spectral signatures be a novel biomarker
           for monitoring cerebrovascular autoregulation and intracranial pressure? a
           speculative synthesis

    • Authors: Sandhya Mangalore, Kotresh, Rakshith Srinivasa, Alangar Sathyaranjandas Hegde, Rangashetty Srinivasa
      Pages: 252 - 262
      Abstract: Sandhya Mangalore, Kotresh , Rakshith Srinivasa, Alangar Sathyaranjandas Hegde, Rangashetty Srinivasa
      Annals of Indian Academy of Neurology 2017 20(3):252-262
      Background: Trans Cranial Colour Doppler (TCCD) has been extensively used in various neurological and neurosurgical conditions causing severe raise in the intracranial pressure (ICP). Material and Method: Our study explores the sequential evolution of TCCD flow pattern by correlating with pupillary reactivity, Glasgow coma scale (GCS), and imaging. Our cohort consisted of thirty patients with ten patients in each subgroup admitted to the neuro-Intensive Care Unit (NICU) for various neurological and neurosurgical causes. Middle cerebral artery was insonated through the transtemporal window at the time of admission to NICU. Doppler waveform and parameters such as peak systolic velocity, end-diastolic velocity, systolic by diastolic ratio, pulsatility index, and resistivity index were recorded. The clinical variables for evaluating the degree of raised ICP were the GCS and pupil size. Other systemic parameters such as mean arterial pressure, heart rate, and respiratory rate were also considered and these results were further correlated with TCCD findings. The groups were divided into three groups based on GCS, pupillary reactivity, and imaging. Imaging was done to indicate the etiology for ICP changes and also to look for signs of raised ICP. Results: Ten distinct types of waveform patterns were noted, and these waveforms correlated with various physiological parameters suggestive of raised ICP. Conclusion: The sequential evolution of distinct patterns of Doppler waveform with increasing degree of raise in ICP has been described and can act as a quick screening tool in NICU and helps stratify patients for treatment and prognostication.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):252-262
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_80_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Clinical, biochemical characteristics and hospital outcome of acute
           intermittent porphyria patients: A descriptive study from North India

    • Authors: Susheel Kumar, Ashish Bhalla, Navneet Sharma, Deba Prasad Dhibar, Savita Kumari, Subhash Varma
      Pages: 263 - 269
      Abstract: Susheel Kumar, Ashish Bhalla, Navneet Sharma, Deba Prasad Dhibar, Savita Kumari, Subhash Varma
      Annals of Indian Academy of Neurology 2017 20(3):263-269
      Introduction: Acute intermittent porphyria (AIP) is an inherited metabolic disease characterized by disordered heme biosynthesis. There is no recent study reported from India. Materials and Methods: It was a retrospective, observational study. Clinical records of patients of AIP with acute porphyric attacks admitted from April 2008 to December 2016 were analyzed. Results: Fifteen AIP patients constituted of eight females and seven males were analyzed. Mean age at presentation was 34.33 ± 15.86 years. Thirteen patients (86.67%) had acute flaccid paralysis (AFP). All of them had peripheral neuropathy. These patients concomitantly had abdominal pain, seizure, encephalopathy, autonomic hyperactivity, history of passage of dark urine, and electrolyte abnormality (hyponatremia) in various combinations. Abdominal pain was the presenting symptom in 11 (73.33%) patients. Seven (46.67%) patients had seizure episodes. Five patients (33.33%) had hyponatremia at presentation. Significantly higher percentage of them had seizure at presentation or during hospital stay (P = 0.007). These patients also had evidence of autonomic hyperactivity in the form of higher pulse rate, systolic and diastolic blood pressure at presentation. They had prolonged duration of hospital stay as well (P = 0.016). Eleven patients had partial recovery and rest four patients (26.67%) had in-hospital mortality. Conclusion: Patients had severe neurological involvement manifesting mainly as AFP and seizure episodes. We recommend screening for AIP in patients presenting with features of AFP along with any combination of clinical/laboratory manifestations such as abdominal pain, seizure, encephalopathy, autonomic hyperactivity, passage of dark urine, and hyponatremia. Electrolyte abnormality in the form of hyponatremia was an important severity marker.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):263-269
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_91_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Juvenile myoclonic epilepsy with frontal executive dysfunction is
           associated with reduced gray matter volume by voxel-based morphometry

    • Authors: Sreeja H Pillai, Sheelakumari Raghavan, Mrudula Mathew, Geetha M Gopalan, Chandrasekharan Kesavadas, Sankara Sarma, Sanjeev V Thomas
      Pages: 270 - 273
      Abstract: Sreeja H Pillai, Sheelakumari Raghavan, Mrudula Mathew, Geetha M Gopalan, Chandrasekharan Kesavadas, Sankara Sarma, Sanjeev V Thomas
      Annals of Indian Academy of Neurology 2017 20(3):270-273
      Objective: Frontal executive dysfunction (FED) and abnormalities in volumetric magnetic resonance imaging (MRI) have been described in juvenile myoclonic epilepsy (JME). We aimed to compare JME patients with and without FED by group analysis of voxel-based morphometric (VBM) estimates of brain volume in MRI. Subjects and Methods: We studied frontal executive functions in patients with JME and analyzed the possible association of FED with their demographic, clinical, and electrographic characteristics. We aimed to do group analysis of the VBM MRI brain data to compare the gray matter (GM) volumes of JME patients with and without FED. Results: We recruited 34 patients (20 women) with JME (mean age 23.7 ± 4.58 years) from the epilepsy outpatient services. FED was detected in twenty patients (58.8%). Group analysis of VBM MRI brain showed significant (P < 0.001) reduction in GM volume in dorsolateral prefrontal cortex (left Brodmann area [BA] 10, 46, 9, Z-score 3.36, 2.91, 2.03, respectively, and right BA 10 and BA 45, Z-score 2.98 and 3.36, respectively), left insula (BA 13, Z-score 2.14), temporal lobe (BA 38, Z-score 2.76), in the subgroup of JME with FED. Inference: JME with FED has an anatomical correlate in the form of reduced GM volume in dorsolateral prefrontal cortex.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):270-273
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_44_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • The prevalence and severity of autonomic dysfunction in chronic
           inflammatory demyelinating polyneuropathy

    • Authors: Suresh Babu Pasangulapati, TV Murthy, Ajith Sivadasan, L Rynjah Gideon, AT Prabhakar, Aaron Sanjith, Vivek Mathew, Mathew Alexander
      Pages: 274 - 277
      Abstract: Suresh Babu Pasangulapati, TV Murthy, Ajith Sivadasan, L Rynjah Gideon, AT Prabhakar, Aaron Sanjith, Vivek Mathew, Mathew Alexander
      Annals of Indian Academy of Neurology 2017 20(3):274-277
      Introduction: In chronic inflammatory demyelinating polyneuropathy (CIDP), emphasis has been on motor disabilities, and autonomic dysfunction in these patients has not been addressed systematically. Materials and Methods: Autonomic function was prospectively analyzed in 38 patients with CIDP. Quantitative autonomic function testing was done using Finometer® PRO and severity of adrenergic and cardiovagal dysfunction graded according to composite autonomic severity score and sudomotor dysfunction assessed using sympathetic skin response. Results: Thirty-four (89%) patients had features of autonomic dysfunction. Thirty-three (86%) patients had cardiovagal dysfunction, 21 (55%) had adrenergic dysfunction, and 24 (63%) had sudomotor dysfunction. Autonomic dysfunction was mild to moderate in the majority (86%). Conclusions: Autonomic dysfunction in CIDP is underreported and potentially amenable to therapy. Our cohort had a high proportion of adrenergic dysfunction compared to previous studies.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):274-277
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_102_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Clinical spectrum, therapeutic outcomes, and prognostic predictors in
           sjogren's syndrome-associated neuropathy

    • Authors: Ajith Sivadasan, Karthik Muthusamy, Bimal Patel, Rohit Ninan Benjamin, AT Prabhakar, Vivek Mathew, Sanjith Aaron, Mathew Alexander
      Pages: 278 - 283
      Abstract: Ajith Sivadasan, Karthik Muthusamy, Bimal Patel, Rohit Ninan Benjamin, AT Prabhakar, Vivek Mathew, Sanjith Aaron, Mathew Alexander
      Annals of Indian Academy of Neurology 2017 20(3):278-283
      Objectives: There are limited data regarding long-term follow-up and therapeutic outcomes in Sjogren's syndrome (SS)-associated peripheral neuropathy. In this study, we aim to study the clinical, electrophysiological spectrum and therapeutic responses among the different subtypes of SS-associated neuropathy. The predictors of suboptimal treatment response will be identified. Methods: The study included a retrospective cohort of patients with SS-associated neuropathy between January 2012 and November 2015. Baseline clinical, laboratory, electrophysiological data and details of treatment were noted. Therapeutic outcomes were assessed at follow-up and compared among the different subtypes. Prognostic predictors were determined using logistic regression analysis. Results: Fifty-four patients were included in the study. Sensory ataxic neuropathy (17, including 9 with sensory ganglionopathy) and radiculoneuropathy (11) were the main subtypes. Notable atypical presentations included acute neuropathies, pure motor neuropathies, and hypertrophic neuropathy. Concomitant autoimmune disorders were present in 24 (44.4%) patients. Most presentations were subacute-chronic (51, 94.4%). Minor salivary gland biopsy had a higher yield compared to serological markers (81.5 vs. 44.4%). Sensory ataxic neuropathy was associated with greater severity and autonomic dysfunction. Improvement was noted in 33 (61%) patients. Cranial neuropathy and radiculoneuropathy subtypes were associated with the best treatment responses. Chronicity, orthostatic hypotension, baseline severity, and marked axonopathy (nerve biopsy) were predictive of a suboptimal therapeutic response. Conclusions: The study highlights the heterogeneous spectrum, atypical presentations, and differential therapeutic responses. SS-associated neuropathy remains underdiagnosed. Early diagnosis and prompt initiation of immunotherapy before worsening axonal degeneration is paramount. SS-associated neuropathy need not necessarily be associated with a poor prognosis.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):278-283
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_116_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Relationship between factor V leiden gene variant and risk of ischemic
           stroke: A case–control study

    • Authors: Amit Kumar, Shubham Misra, Ram Sagar, Pradeep Kumar, Arun K Yadav, Pumanshi Talwar, Ritesh Raj, Kameshwar Prasad
      Pages: 284 - 288
      Abstract: Amit Kumar, Shubham Misra, Ram Sagar, Pradeep Kumar, Arun K Yadav, Pumanshi Talwar, Ritesh Raj, Kameshwar Prasad
      Annals of Indian Academy of Neurology 2017 20(3):284-288
      Background: Factor V Leiden is the most common genetic variation among the blood coagulation pathway which leads to prothrombotic state, therefore, is considered an important gene for understating the stroke mechanism. Aim: The aim of the present study is to determine the relationship between single nucleotide polymorphism at G1691A position of Factor V gene and risk of ischemic stroke (IS) in North Indian population. Materials and Methods: In a retrospective case–control study, 250 patients with IS and 250 age- and gender-matched controls were enrolled in the period of October 2012 to September 2014 from in- and out-patient department of Neurology, All India Institute of Medical Sciences, New Delhi, India. Deoxyribonucleic acid for each case and control was isolated from peripheral blood using phenol-chloroform extraction method. Polymerase chain reaction-restriction fragment length polymorphism method was used to determine the polymorphism. Data were analyzed using STATA Software Version 13. Results: The mean age of IS patient was 52.8 ± 12.5 years and in control group was 50.97 ± 12.7 years. Genotypic frequency distributions were in accordance with Hardy–Weinberg equilibrium in both cases and controls. As expected hypertension, diabetes, dyslipidemia, smoking, heavy alcohol intake, family history of stroke, and poor economic status were significantly associated with the risk of IS. Multivariate analysis revealed 5.17 times higher odds for developing the risk of large vessel subtype of IS in patients carrying Factor V Leiden G1691A gene variation as compared to control subjects (OR, 5.17; 95% CI, 1.32–20.3, P= 0.01). Conclusion: The present study suggests that Factor V Leiden G1691A polymorphism may be significantly associated with the risk of large vessel subtype of IS. Large sample size studies using prospective cohort designs are required to corroborate the present findings.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):284-288
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_31_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Clinical features, risk factors, and short-term outcome of ischemic
           stroke, in patients with atrial fibrillation: Data from a population-based
           study

    • Authors: G William Akanksha, Kaur Paramdeep, Singh Gagandeep, Bansal Rajinder, S Paul Birinder, Singla Monika, Singh Shavinder, J Samuel Clarence, J Verma Shweta, Meenakshi Sharma, D Pandian Jeyaraj
      Pages: 289 - 293
      Abstract: G William Akanksha, Kaur Paramdeep, Singh Gagandeep, Bansal Rajinder, S Paul Birinder, Singla Monika, Singh Shavinder, J Samuel Clarence, J Verma Shweta, Meenakshi Sharma, D Pandian Jeyaraj
      Annals of Indian Academy of Neurology 2017 20(3):289-293
      Objectives: Atrial fibrillation (AF) is the most common sustained cardiac rhythm disorder associated with stroke. This study was done to describe risk factors, clinical features, and short-term outcomes of stroke patients with AF. Materials and Methods: This study was a part of the Indian Council of Medical Research funded “Ludhiana urban population based Stroke Registry.” Data were collected using WHO STEPS stroke method. All patients ≥18 years of age, who developed ischemic stroke between March 26, 2011, and March 25, 2013, were included in this study. Data about demographic details, clinical features, and risk factors were collected. The outcome was assessed at 28 days using modified Rankin scale (mRs) (good outcome: mRS ≤2; poor outcome >2). The statistical measures calculated were descriptive statistics, Chi-square test, Fischer's exact test, and independent t-test. Results: Of the total 7199 patients enrolled in the registry, data of 1942 patients who fulfilled inclusion criteria were analyzed, and AF was seen in 203 (10%) patients. AF patients were older (AF 62 ± 14 vs. non-AF 60 ± 15 years, P= 0.01), had more hypertension (AF 176 [87%] vs. non-AF 1396 [80%], P= 0.03), hyperlipidemia (AF 60 [32%] vs. non-AF 345 [21%], P= 0.001), coronary artery disease (AF 60 [30%] vs. non-AF 195 [11%], P< 0.0001), and carotid stenosis (AF 14 [7%] vs. non-AF 57 (3%), P= 0.02). They had worse outcome (mRS >2; AF 90 [50%] vs. non-AF 555 [37%], P= 0.001). Conclusions: Ten percent of stroke patients had AF. They were older, had multiple risk factors and worse outcome. There was no gender difference in this large cohort.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):289-293
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_16_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Spectrum of visual impairment in cerebral venous thrombosis: Importance of
           tailoring therapies based on pathophysiology

    • Authors: Sanjith Aaron, Anupriya Arthur, AT Prabakhar, Pavitra Mannam, NK Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
      Pages: 294 - 301
      Abstract: Sanjith Aaron, Anupriya Arthur, AT Prabakhar, Pavitra Mannam, NK Shyamkumar, Sunithi Mani, Vivek Mathew, Jeyanthi Peter, Ajith Sivadasan, Anika Alexander, M Karthik, Rohith Ninan Benjamin, Mathew Alexander
      Annals of Indian Academy of Neurology 2017 20(3):294-301
      Visual impairment can complicate cerebral venous thrombosis (CVT). Here, we describe the various pathophysiological mechanisms and treatments available. A retrospective chart review of all patients treated for CVT in a large quaternary teaching hospital was done, and cases with visual impairment due to CVT were identified. The various mechanisms causing visual impairment in CVT were (1) raised intracranial pressure (ICP) caused by venous thrombosis without venous infarcts resulting in a benign intracranial hypertension-like presentation of CVT, (2) venous infarcts involving the occipital cortex, (3) raised ICP following the development of a secondary dural arteriovenous (AV) fistula, and (4) arterial occipital infarcts due to posterior cerebral artery compression secondary to herniation in large venous infarcts. Apart from using systemic anticoagulants to attempt recanalization and drugs with carbonic anhydrase inhibitor activity to reduce the ICPs, treatment modalities employed to save vision were (1) recanalization by local thrombolysis, stenting, or mechanical devices; (2) cerebrospinal fluid diversion procedures such as theco-periotoneal shunting; (3) optic nerve sheath fenestration; and (4) specific treatment for conditions such as dural AV fistula occurring as a late complication. CVT can cause visual impairment through different pathophysiological mechanisms. Depending on the mechanism, treatment strategies need to be tailored. Furthermore, very close monitoring is needed both in the acute and in the follow-up period, as new pathophysiological mechanisms can arise, compromising the vision. This may require a different treatment approach. Literature on this aspect of CVT is lacking.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):294-301
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_11_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Detection of dysferlin gene pathogenic variants in the Indian Population
           in patients predicted to have a dysferlinopathy using a blood-based
           monocyte assay and clinical algorithm: A model for accurate and
           cost-effective diagnosis

    • Authors: Rashna Sam Dastur, Pradnya Satish Gaitonde, Munira Kachwala, Babi R.R Nallamilli, Arunkanth Ankala, Satish V Khadilkar, Nalini Atchayaram, N Gayathri, AK Meena, Laura Rufibach, Sarah Shira, Madhuri Hegde
      Pages: 302 - 308
      Abstract: Rashna Sam Dastur, Pradnya Satish Gaitonde, Munira Kachwala, Babi R.R Nallamilli, Arunkanth Ankala, Satish V Khadilkar, Nalini Atchayaram, N Gayathri, AK Meena, Laura Rufibach, Sarah Shira, Madhuri Hegde
      Annals of Indian Academy of Neurology 2017 20(3):302-308
      Background: Limb-girdle muscular dystrophy (LGMD) is the most common adult-onset class of muscular dystrophies in India, but a majority of suspected LGMDs in India remain unclassified to the genetic subtype level. The next-generation sequencing (NGS)-based approaches have allowed molecular characterization and subtype diagnosis in a majority of these patients in India. Materials and Methods: (I) To select probable dysferlinopathy (LGMD2B) cases from other LGMD subtypes using two screening methods (i) to determine the status of dysferlin protein expression in blood (peripheral blood mononuclear cell) by monocyte assay (ii) using a predictive algorithm called automated LGMD diagnostic assistant (ALDA) to obtain possible LGMD subtypes based on clinical symptoms. (II) Identification of gene pathogenic variants by NGS for 34 genes associated with LGMD or LGMD like muscular dystrophies, in cases showing: absence of dysferlin protein by the monocyte assay and/or a typical dysferlinopathy phenotype, with medium to high predictive scores using the ALDA tool. Results: Out of the 125 patients screened by NGS, 96 were confirmed with two dysferlin variants, of which 84 were homozygous. Single dysferlin pathogenic variants were seen in 4 patients, whereas 25 showed no variants in the dysferlin gene. Conclusion: In this study, 98.2% of patients with absence of the dysferlin protein showed one or more variants in the dysferlin gene and hence has a high predictive significance in diagnosing dysferlinopathies. However, collection of blood samples from all over India for protein analysis is expensive. Our analysis shows that the use of the “ALDA tool” could be a cost-effective alternative method. Identification of dysferlin pathogenic variants by NGS is the ultimate method for diagnosing dysferlinopathies though follow-up with the monocyte assay can be useful to understand the phenotype in relation to the dysferlin protein expression and also be a useful biomarker for future clinical trials.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):302-308
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_129_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Post bariatric surgery acute axonal polyneuropathy: Doing your best is not
           always enough

    • Authors: Zakia Mohammad Yasawy, Ali Hassan
      Pages: 309 - 312
      Abstract: Zakia Mohammad Yasawy, Ali Hassan
      Annals of Indian Academy of Neurology 2017 20(3):309-312
      Neurological complications are frequently recognized with weight reduction surgeries for morbid obesity. The spectrum of peripheral neuropathies complicating the weight loss surgery is wide, and among them, the acute axonal peripheral neuropathy resembling Guillain-Barre syndrome is rare and only less than a dozen cases are reported. We present three cases, which after bariatric surgery developed acute polyneuropathy that rapidly progressed over 4 weeks from the onset. All patients responded to aggressive parenteral Vitamin B1 and B12 replacement therapy. These cases highlight the fact that bariatric surgery although is a promising option to treat morbid obesity; it is certainly not devoid of potential neurological complications due to micronutrient deficiencies. Delay in the diagnosis of acute polyneuropathy may worsen its long-term sequelae. A multidisciplinary team management with careful nutritional monitoring at regular interval is crucial in all patients for early recognition and intervention to avoid these complications after bariatric surgery.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):309-312
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_24_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Gyriform infarction in cerebral air embolism: Imaging mimicker of status
           epilepticus

    • Authors: Konark Malhotra, Appaji Rayi
      Pages: 313 - 315
      Abstract: Konark Malhotra, Appaji Rayi
      Annals of Indian Academy of Neurology 2017 20(3):313-315
      Cerebral air embolism (CAE) is a potentially fatal iatrogenic complication related to common procedures including central venous catheter (CVC) removal. We report an interesting case of CAE related to CVC removal that was further complicated with status epilepticus. Neuroimaging of CAE and status epilepticus could pose diagnostic dilemmas and require consideration of wide diagnostic differentials. We discuss the clinical presentation, mechanism, and diagnostic approach, especially neuroimaging to differentiate various etiologies in CAE patients.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):313-315
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_94_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Hyper acute demyelinating encephalomyelitis of childhood: A rare entity

    • Authors: Suman Kushwaha, Ashutosh Gupta, Neha Agarwal, Sujata Chaturvedi, Deepak Jha
      Pages: 316 - 318
      Abstract: Suman Kushwaha, Ashutosh Gupta, Neha Agarwal, Sujata Chaturvedi, Deepak Jha
      Annals of Indian Academy of Neurology 2017 20(3):316-318
      A young child with catastrophic neurological illness diagnosed as a rare variant of acute demyelinating encephalomyelitis (ADEM). She succumbed to her illness despite of aggressive and appropriate management. Malignant demyelinating encephalomyelitis should be considered in children who are refractory to the treatment of ADEM.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):316-318
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_52_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Susceptibility-weighted imaging torch fire sign in a patient with dystonia
           due to hypoxic-ischemic injury

    • Authors: Savith Kumar, Chandrasekharan Kesavadas, Bejoy Thomas
      Pages: 319 - 319
      Abstract: Savith Kumar, Chandrasekharan Kesavadas, Bejoy Thomas
      Annals of Indian Academy of Neurology 2017 20(3):319-319

      Citation: Annals of Indian Academy of Neurology 2017 20(3):319-319
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_59_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Leptomeningeal carcinomatosis presenting as cauda equina syndrome

    • Authors: Bhagyadhan A Patel, Rahul T Chakor, Swaleha Nadaf, Kaumil V Kothari
      Pages: 320 - 321
      Abstract: Bhagyadhan A Patel, Rahul T Chakor, Swaleha Nadaf, Kaumil V Kothari
      Annals of Indian Academy of Neurology 2017 20(3):320-321

      Citation: Annals of Indian Academy of Neurology 2017 20(3):320-321
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_127_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • A rare but treatable cause of paroxysmal nonkinesigenic choreoathetosis

    • Authors: Sahil Mehta, Dheeraj Khurana, Gourav Jain, Vivek Lal
      Pages: 322 - 323
      Abstract: Sahil Mehta, Dheeraj Khurana, Gourav Jain, Vivek Lal
      Annals of Indian Academy of Neurology 2017 20(3):322-323

      Citation: Annals of Indian Academy of Neurology 2017 20(3):322-323
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_23_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Surgical interventions for task-specific dystonia (writer&#39;s
           dystonia)

    • Authors: Paresh K Doshi, Raghvendra Vijay Ramdasi, Bharati Karkera, Dilraj B Kadlas
      Pages: 324 - 327
      Abstract: Paresh K Doshi, Raghvendra Vijay Ramdasi, Bharati Karkera, Dilraj B Kadlas
      Annals of Indian Academy of Neurology 2017 20(3):324-327
      Objectives: Writer's cramp is a focal dystonia producing abnormal postures during selective motor activities. Thalamotomy or globus pallidus internus deep brain stimulation (GPi DBS) has been used as a surgical treatment in patients not responding to medical treatment. Materials and Methods: Eight patients (all men, age 16–47 years) with refractory focal hand dystonia underwent either ventrooralis (Vo) thalamotomy (seven patients) or GPi DBS (one patient) using stereotactic techniques. Preoperative video recordings, Writing movment score for dystonic posture and latency of dystonia (WMS), and symptom severity scores (SSSs) were evaluated at baseline and latest follow-up ranging from 1 to 4 years. Results: All patients had difficulty in performing their most common tasks. The duration of symptoms ranged from 6 months to 12 years. All patients obtained immediate postoperative relief from the dystonic symptoms, and the effect was sustained during the follow-up period. The WMS (range 0–28) improved from a mean of 14.5 before surgery to 2, whereas the SSS (maximum 43 and minimum 10) improved from a mean of 15.3 before surgery to 2 at the last follow-up. There were no surgical complications, morbidity, or mortality. Conclusion: Vo thalamotomy or GPi DBS offers successful symptom relief in patients with task-specific dystonia.
      Citation: Annals of Indian Academy of Neurology 2017 20(3):324-327
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_15_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Mitochondrial neurogastrointestinal encephalomyopathy syndrome with an
           unusual pattern of inheritance

    • Authors: Bhavesh Trikamji, Hadi Mohammadkhanli, Nastaran Rafiei, Shri Mishra
      Pages: 328 - 328
      Abstract: Bhavesh Trikamji, Hadi Mohammadkhanli, Nastaran Rafiei, Shri Mishra
      Annals of Indian Academy of Neurology 2017 20(3):328-328

      Citation: Annals of Indian Academy of Neurology 2017 20(3):328-328
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_117_17
      Issue No: Vol. 20, No. 3 (2017)
       
  • Stroke in a child with dengue encephalopathy

    • Authors: Sangeetha Yoganathan, Sniya Valsa Sudhakar, Leena Priyambada, Maya Thomas
      Pages: 329 - 331
      Abstract: Sangeetha Yoganathan, Sniya Valsa Sudhakar, Leena Priyambada, Maya Thomas
      Annals of Indian Academy of Neurology 2017 20(3):329-331

      Citation: Annals of Indian Academy of Neurology 2017 20(3):329-331
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_504_16
      Issue No: Vol. 20, No. 3 (2017)
       
  • Modern day management of headache questions and answers

    • Authors: Satish V Khadilkar
      Pages: 332 - 332
      Abstract: Satish V Khadilkar
      Annals of Indian Academy of Neurology 2017 20(3):332-332

      Citation: Annals of Indian Academy of Neurology 2017 20(3):332-332
      PubDate: Thu,10 Aug 2017
      DOI: 10.4103/aian.AIAN_286_17
      Issue No: Vol. 20, No. 3 (2017)
       
 
 
JournalTOCs
School of Mathematical and Computer Sciences
Heriot-Watt University
Edinburgh, EH14 4AS, UK
Email: journaltocs@hw.ac.uk
Tel: +00 44 (0)131 4513762
Fax: +00 44 (0)131 4513327
 
Home (Search)
Subjects A-Z
Publishers A-Z
Customise
APIs
Your IP address: 54.81.59.211
 
About JournalTOCs
API
Help
News (blog, publications)
JournalTOCs on Twitter   JournalTOCs on Facebook

JournalTOCs © 2009-2016