COVID-19, neurovascular thrombotic problem and short summary on blood coagulation disorder: a brief review

COVID-19 is the present global public health problem. This respiratory viral infection can manifest atypical presentation including neurological presentations. An important neurological problem in COVID-19 is neurovascular thrombosis. The basic pathogenesis of thrombosis in neurological system is explainable by the basic principle of thrombohemostasis. A hypercoagulability is a possible problem seen in some COVID-19 cases. In this brief review, the authors summarize venous and arterial thrombosis of neurovascular system as a complication of COVID-19. The updated pathophysiology of COVID-associated blood coagulation disorder is discussed. In addition, consideration regarding new COVID-19 vaccine related thrombotic adverse event is also raised.

An Instrumented Assessment of Cerebral Palsy: A Systematic Review

Cerebral palsy is a neurological problem which mainly affects the children and is a frequent reason of physical inability. It affects both motor as well as sensory system. Due to physical disability quality treatment is required for CP children. For an effective treatment proper assessment and selection of correct assessment tool is necessary. This review was aimed to recognize the various assessment scales which are available to assess different domains in person of cerebral palsy patient along with their psychometric properties. We had done a review of literature through Cochrane library, Ovid MEDLINE and GOOGLE SCHOLAR, CINAHL till March 2020. The studies in English‐language related to the assessment scales for the cerebral palsy were reviewed. Many scales were evaluated for different symptoms and good psychometric properties in CP child. We reviewed many research and review article related to assessment for CP. Various titles, abstracts, and references were checked for the relevancy.eview was done for the assessment of alteration in muscle tone, impaired voluntary movement, pain, gross motor function, balance, cognition and gait. Cerebral palsy was the primary goal of findings in 198 studies. Out of these, 58 studies were not proved the definition of cerebral palsy. 96 studies reported assessment of cerebral palsy for different domain, 25 studies used etiology and incidence and 19 studies for other domain which are related to CP. Many cerebral palsy scales are available, but only a very small number of scales were thoroughly validated for use in clinical practice in India. This review will help therapist in selection of appropriate tool and study of various symptoms in CP child before starting the treatment.

A study of clinical, etiological and neurodevelopmental profile of epilepsy in children aged 0-5 years

Background: Seizures constitute the most common neurological problem in children. Appropriate diagnosis and management of childhood epilepsy is essential to improve quality of life in them. Objectives of the study were to study the clinical and etiological profile of early childhood epilepsy and its effect on neurodevelopment.Methods: This was a time bound study; duration being one year from September, 2018 to September 2019. All new patients with acute seizures or status epilepticus admitted in paediatric emergency ward were evaluated and those meeting inclusion criteria were enrolled. On the basis of history, neurological and systemic examination and available investigations primary diagnosis of epilepsy was reached. Neurodevelopmental parameters like vision, hearing, and DQ were assessed. EEG was done in all patients. Other relevant investigations like neuroimaging were carried out when indicated. Collected data was analysed in form of frequency and percentage.Results: A total of 52 patients were enrolled. 60% patients were younger than 2 years. Maximum patients had generalised convulsions; generalised tonic-clonic being the most prevalent. 38% patients had significant perinatal complications like perinatal asphyxia, pyogenic meningitis and kernicterus. Fifty per cent patients had delayed milestones and half of those had severe delay. 67% had abnormal EEG and 20 patients had abnormal neuro-imaging findings. The most common etiologies for epilepsy were hypoxic ischaemic encephalopathy, idiopathic, epilepsy syndromes, metabolic disorders and CNS infections.Conclusions: Majority of early childhood epilepsy is a result of either genetic conditions or perinatal events. They have neurodevelopmental and behavioural associations. While treating epilepsy all these factors should be considered in order to ensure a near-normal life for these patients.

Cognitive Deficiencies pathophysiology are mainly an unknown area. Curing the neurological conditions could be an objective for gene therapy

Currently, it appears that the pathophysiology of Cognitive Deficiency (CD) is mostly uncharted territory. In this study, we used both clinical research and mouse models to identify the reported Systemic lupus erythematosus (SLE) symptoms and to explain how tissue damage occurs in SLE, which helps us develop optimal therapies for CD. The primary goal of treatment is to cure the neurological problem, rather than repair the immunological issues. It should be noted that CD develops even in the absence of flares, indicating that treating it would need much more intensive immunosuppression with more damage. For further study on CD, it will be necessary to collaborate amongst neurologists, rheumatologists, and immunologists. This work would succeed by advancing the ability to unveil or hide the fundamental mechanism of CD.

Neuroprotective Potentials of Natural Vitamin E for Cerebral Small Vessel Disease

Cerebral small vessel disease (CSVD) refers to a spectrum of clinical and neuroimaging findings resulting from pathological processes of various etiologies affecting cerebral arterioles, perforating arteries, capillaries, and venules. It is the commonest neurological problem that results in significant disability, but awareness of it remains poor. It affects over half of people over 65 years old and inflicts up to third of acute strokes, over 40% of dementia, and a significant decline in physical ability in otherwise asymptomatic, aging individuals. Moreover, the unifying theory for the pathomechanism of the disease remains elusive and hence the apparent ineffective therapeutic approaches. Given the growing literature for natural vitamin E (tocopherols and tocotrienols) as a potent antioxidant, this chapter attempts to consolidate the contemporary evidence to shed plausible insights on the neuroprotective potentials of natural vitamin E in addressing the heterogenous CSVD spectrum, in health and in disease.

TINJAUAN PENGGUNAAN DAN POTENSI INTERAKSI OBAT ANTIKEJANG DENGAN OBAT LAIN PADA PASIEN STROKE PERDARAHAN RAWAT INAP RSUP PROF. DR. R. D. KANDOU MANADO

ABSTRACK Hemorrhagic stroke is a stroke caused by intra-cerebral hemorrhage or subarachniod hemorrhage due to rupture of cerebral blood vessels in certain areas so that blood fills the brain tissue. Seizures are the most common neurological problem in stroke patients. The occurrence of seizures due to stroke is believed to be the presence of lesions in the brain during a stroke and the formation of scar tissue. This study discusses the use of anti-seizures and the potential of anti-seizure interactions of hemorrhagic stroke patients in inpatient at RSUP Prof. Dr. R. D. Kandou Manado. This study is involved retrospective data on 30 medical records of stroke patients with Hemorrhage in inpatients that met the inclusion criteria. Phenytoin as many as 23 (76,67%), phenytoin combined with Diazepam can occur as many as 4 (13,33%) and Diazepam by 3 (10%). Drug interactions, phenytoin combined with nicardipine which occurs as many as 2 (40%) interactions occur, phenytoin combined with Diazepam can occur as many as 3 (60%) interactions occur. Based on interactions, pharmacokinetic interactions were 5 (100%) occurrences. Keywords: Hemorrhagic Stroke, anti-seizures, drug interactions ABSTRAK Stroke hemoragik adalah stroke yang disebabkan oleh perdarahan intraserebral atau perdarahan subaraknoid akibat pecahnya pembuluh darah otak di daerah tertentu sehingga darah mengisi jaringan otak. Kejang adalah masalah neurologis yang paling umum pada pasien stroke. Terjadinya kejang akibat stroke dipercayai adanya lesi di otak selama stroke dan pembentukan jaringan parut. Penelitian ini membahas penggunaan anti-kejang dan potensi interaksi anti-kejang pasien stroke hemoragik di rawat inap di RSUP Prof. Dr. R. D. Kandou Manado. Penelitian ini melibatkan data retrospektif pada 30 catatan medis pasien stroke dengan Perdarahan pada pasien rawat inap yang memenuhi kriteria inklusi. Fenitoin sebesar 23 (76,67%), Fenitoin dikombinasikan dengan Diazepam sebesar 4 (13,33%)., dan Diazepam sebesar 3 (10%). Interaksi obat, fenitoin yang dikombinasikan dengan nicardipine yang terjadi sebanyak 2 (40%) interaksi terjadi, fenitoin yang dikombinasikan dengan Diazepam dapat terjadi sebanyak 3 (60%) interaksi terjadi. Berdasarkan interaksi, interaksi farmakokinetik adalah 5 (100%) kejadian. Kata kunci: Stroke Hemoragik, anti-kejang, interaksi obat

Neuropsychologist, Psychologist, 3 years’ experience, USA

This chapter examines how, when treating individuals with Psychogenic Non-Epileptic Events (PNEE), a neuropsychologist operates from a viewpoint of PNEE as a “psycho-neurological” problem. The distinction between a “neurological” and “psychological” origin has important implications for the training necessary to perform the services offered by each specialist, but both specialties actually refer to the same origin of the PNEE. In both cases PNEE clearly arise from the brain. The neuropsychologist views these spheres not as separate and distinct, but rather as being on a continuous spectrum, with the major difference being the scale and scope at which the brain is considered. Neurological problems are typically viewed as large scale, concretely identifiable, and dealing with fundamental functioning and structural integrity. Psychological problems are viewed as small-scale neurological connection problems, too granular for the primary attention of neurologists. This is the clinical domain of psychiatrists, psychologists, and neuropsychologists. PNEE clearly have their origins in the brain, falling within the sphere of small-scale connection problems of brain functioning. Finally this chapter considers the lack of a clear explanation for why and how PNEE manifest in the brain because their true origin remains elusive.

Aging and Health: A New Relationship

Old age is not of itself a pure neurological ‘problem’, pathology or statement of need. ‘Older people’ or an ‘aging population’ are not a homogeneous group and categorisation as a distinct service user group is, arguably, contentious. Furthermore, since the advent of personalisation in the UK for, conceptualizing support by user groups is considered by many as obsolete. People do not receive health services by virtue of being ‘older’. Rather they are in need of a service - for example, because of ill health, physical impairment, mental health difficulties, addiction or offending. This article will enable us to consider the implications of the re-figuring of the relationship between the state, older people and health professions and social work. This constructs an ambiguous place for older people: they feature either as a resource - captured in the idea of the ‘active citizen’, as affluent consumers, volunteers or providers of childcare- or as a problem in the context of poverty, vulnerability and risk.