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Vishnu V, Krishnendu PR, Zachariah SM, S K K. Novel 1-H Phenyl Benzimidazole Derivatives for IBD Therapy - An in-vitro and in-silico Approach to Evaluate its Effects on the IL-23 Mediated Inflammatory Pathway. Curr Comput Aided Drug Des 2024; 20:60-71. [PMID: 37073665 DOI: 10.2174/1573409919666230417103413] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2022] [Revised: 02/02/2023] [Accepted: 02/20/2023] [Indexed: 04/20/2023]
Abstract
OBJECTIVE IBD is a chronic idiopathic gut condition characterised by recurring and remitting inflammation of the colonic mucosal epithelium. Benzimidazole is a prominent and attractive heterocyclic compound with diverse actions. Although seven locations in the benzimidazole nucleus can be changed with a number of chemical entities for biological activity, benzimidazole fused with a phenyl ring has caught our interest. METHODS To find and optimize novel 1-H phenyl benzimidazole compounds with favorable physicochemical features and drug-like characteristics for the treatment of IBD, in-silico studies and in-vitro approach were being used to identify and optimize these derivatives as potent inhibitors of IL-23 mediated inflammatory signaling pathway. RESULTS All six compounds exhibit favorable drug-like properties with good intestinal absorption properties. Its high affinity for the target JAK and TYK, which is thought to be a key immunological signaling cascade in the pathophysiology of IBD, is revealed by docking studies. CONCLUSION Because of their effects on decreasing iNOS-derived NO release and IL-23-mediated immune signaling by decreasing COX-2 and LOX activity, it's conceivable that the compounds CS3 and CS6 are better options for the treatment of IBD based on in-vitro cell line investigations.
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Affiliation(s)
- V Vishnu
- Department of Pharmaceutical Chemistry, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, 682041, Kerala, India
| | - P R Krishnendu
- Department of Pharmaceutical Chemistry, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, 682041, Kerala, India
| | - Subin Mary Zachariah
- Department of Pharmaceutical Chemistry, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, 682041, Kerala, India
| | - Kanthlal S K
- Department of Pharmacology, Amrita School of Pharmacy, Amrita Vishwa Vidyapeetham, AIMS Health Sciences Campus, Kochi, 682041, Kerala, India
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Sahib A, Bhatia R, Srivastava MVP, Singh MB, Komakula S, Vishnu VY, Rajan R, Gupta A, Srivastava AK, Wig N, Vikram NK, Biswas A. Escalate: Linezolid as an add on treatment in the intensive phase of tubercular meningitis. A randomized controlled pilot trial. Tuberculosis (Edinb) 2023; 142:102351. [PMID: 37394301 DOI: 10.1016/j.tube.2023.102351] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Revised: 05/03/2023] [Accepted: 05/21/2023] [Indexed: 07/04/2023]
Abstract
Most drugs used in the treatment of Tuberculous Meningitis have limited CNS penetration thereby limiting efficacy. CSF penetration of linezolid is 80-100%.The study was a prospective, randomized, open label with blinded outcome assessment pilot trial carried out in patients with TBM. Patients were randomized in a 1:1 ratio into two treatment groups either to receive standard ATT alone or add on oral 600 mg BD Linezolid for 4 weeks along with standard four drug ATT [HRZE/S]. Primary outcome was safety and mortality at the end of one and three months measured by intention to treat analysis. 29 patients were recruited and 27 completed three months of follow up. There was no significant difference in terms of mortality with Odds ratio (95% CI) of 2 (0.161-24.87; p = 1) at one month and 0.385 (0.058-2.538; p = 0.39) at three months. There was a significant improvement in GCS in Linezolid group at one month and mRS within the Linezolid group at one and three months. No major safety concerns were observed. The sample size is underpowered to draw any definitive conclusions but improvement in mRS and GCS as well as mortality change make a case for a large sample size trial.
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Affiliation(s)
- Akhil Sahib
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India.
| | - M V Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Snigdha Komakula
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Naveet Wig
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Naval K Vikram
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Ashutosh Biswas
- Department of Medicine, All India Institute of Medical Sciences, New Delhi, India
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Gupta A, Rajan R, Joy S, Yadav CS, Tripathi M, Gaikwad SB, Vishnu VY, Singh MB, Bhatia R, Mahadevan A, Srivastava MVP. Neuronal Antibody-Associated Corticobasal Syndrome. Ann Indian Acad Neurol 2023; 26:787-789. [PMID: 38022470 PMCID: PMC10666851 DOI: 10.4103/aian.aian_560_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2023] [Revised: 08/15/2023] [Accepted: 08/16/2023] [Indexed: 12/01/2023] Open
Affiliation(s)
- Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Shiny Joy
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Madhavi Tripathi
- Department of Nuclear Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Shailesh B. Gaikwad
- Department of Neuroimaging and Interventional Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
| | - VY Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta B. Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Anita Mahadevan
- Department of Neuropathology, National Institute of Mental Health and Neurosciences, Bangalore, Karnataka, India
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Vishnu V, Harikrishnan MP, Warrier AS, Mahanti NK, Basil M, Venkatesh T, Pandiselvam R, Kothakota A. Design consideration and optimization of process parameters in fiber extraction unit via modelling studies. J FOOD PROCESS ENG 2023. [DOI: 10.1111/jfpe.14298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/25/2023]
Affiliation(s)
- V. Vishnu
- Agro‐Processing & Technology Division CSIR‐National Institute for Interdisciplinary Science and Technology (NIIST) Trivandrum Kerala India
| | - M. P. Harikrishnan
- Agro‐Processing & Technology Division CSIR‐National Institute for Interdisciplinary Science and Technology (NIIST) Trivandrum Kerala India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India
| | - Aswin S. Warrier
- Agro‐Processing & Technology Division CSIR‐National Institute for Interdisciplinary Science and Technology (NIIST) Trivandrum Kerala India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India
| | - Naveen Kumar Mahanti
- Post Harvest Technology Research Station Dr. Y.S.R Horticultural University West Godavari Andhra Pradesh India
| | - M. Basil
- Agro‐Processing & Technology Division CSIR‐National Institute for Interdisciplinary Science and Technology (NIIST) Trivandrum Kerala India
| | - T. Venkatesh
- Agro‐Processing & Technology Division CSIR‐National Institute for Interdisciplinary Science and Technology (NIIST) Trivandrum Kerala India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India
| | - R. Pandiselvam
- Physiology, Biochemistry and Post‐Harvest Technology Division ICAR–Central Plantation Crops Research Institute Kasaragod Kerala India
| | - Anjineyulu Kothakota
- Agro‐Processing & Technology Division CSIR‐National Institute for Interdisciplinary Science and Technology (NIIST) Trivandrum Kerala India
- Academy of Scientific and Innovative Research (AcSIR) Ghaziabad India
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Mohan A, Komakula S, Murali S, Anand P, Shah D, Vishnu VY, Pandit AK, Agarwal A, Vibha D, Singh MB, Padma Srivastava MV, Bhatia R. Biosimilar Tenecteplase Versus Alteplase in Acute Ischemic Stroke: A Real World Study. Ann Indian Acad Neurol 2023; 26:54-58. [PMID: 37034051 PMCID: PMC10081554 DOI: 10.4103/aian.aian_754_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2022] [Revised: 11/15/2022] [Accepted: 11/17/2022] [Indexed: 01/06/2023] Open
Abstract
Background and Purpose There is an unmet need for a more effective thrombolytic agent in acute ischemic stroke (AIS) management. Various studies and meta-analysis suggest tenecteplase (TNK) as non-inferior over alteplase (rTPA). The present single-center study compares biosimilar TNK and rTPA in a tertiary care setting. Methods Data of patients who presented with AIS and underwent intravenous thrombolysis (IVT) were recruited retrospectively from January 2018 to July 2021. Primary efficacy outcome was a modified Rankin score (mRS) at 90 days dichotomized at < = 2. Qualitative and quantitative variables were assessed using Chi-square test and Student's t-test, respectively. Results A total of 160 patients, 103 in the rTPA and 57 in TNK group, were analyzed. The baseline characteristics were well matched apart from hypertension. Large artery atherosclerosis was the most frequent subtype of stroke among the two groups. Good functional outcome was seen in 47.92% of patients TNK and 64.77% of patients in rTPA group (p = 0.069). No difference was seen in the rates of any ICH (p = 0.29) and mortality at 3 months (p = 0.32) among the two groups. Conclusion This present study observed no difference in the efficacy and safety between biosimilar TNK and rTPA. Our findings are in concordance with published trials showing equivalence between the two molecules.
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Affiliation(s)
- Ayush Mohan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Snigdha Komakula
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Suhas Murali
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Pooja Anand
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Dyuti Shah
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - VY Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ayush Agarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Deepti Vibha
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - MV Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Pillai KS, Bhat P, Srivastava AK, Rajan R, Radhakrishnan DM, Elavarasi A, Srivastava MP, Singh MB, Vishnu VY, Prasad K, Pandit AK, Goyal V. Zonisamide add-on in tremor-dominant Parkinson's disease- A randomized controlled clinical trial. Parkinsonism Relat Disord 2022; 105:1-6. [PMID: 36323130 DOI: 10.1016/j.parkreldis.2022.10.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2022] [Revised: 10/13/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022]
Abstract
INTRODUCTION and objective: Tremor is a disabling symptom of PD that usually responds poorly to available standard pharmacological agents. This study aimed to assess the effect of Zonisamide 25 mg on tremor in tremor-dominant PD patients as compared to placebo. METHODS This was a randomized, placebo-controlled, double-blind study. Parkinson's disease patients were allocated either to the intervention group (standard treatment along with Zonisamide 25 mg add-on) or the placebo group (standard treatment along with placebo). Baseline Unified Parkinson's Disease Rating Scale (UPDRS) and Tremor Research Group Essential Tremor Rating Scale (TETRAS) scores, as well as accelerometric tremor analysis were done and follow-up assessments of the same were done after 12 weeks of intervention. Percentage change from baseline in the UPDRS tremor score was the primary outcome whereas percentage change from baseline of total UPDRS score, UPDRS rigidity and bradykinesia scores, TETRAS score, and accelerometric tremor analysis values were the secondary outcomes. RESULTS There was no significant difference in the percentage change from baseline UPDRS tremor scores between the two groups (placebo: 8.33 [-19.89-23.86] vs drug: 26.14 [-35.58 to -16.07], p-value: 0.164, CI: 0.157-0.171). Best-case analysis for missing values showed a significant improvement in the drug group, compared to the placebo group (p-value: < 0.001, CI: <0.001 - <0.001). CONCLUSION Zonisamide at a dose of 25 mg per day did not improve tremor in tremor-dominant PD patients, however, a positive trend was seen as compared to Placebo in the UPDRS tremor score. Larger studies are required to confirm this finding.
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Affiliation(s)
| | - Priyanka Bhat
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | | | - Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | | | | | - Mv Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | - Kameshwar Prasad
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | - Awadh Kishor Pandit
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India
| | - Vinay Goyal
- Department of Neurology, All India Institute of Medical Sciences, Delhi, India; Institute of Neurosciences, Medanta the Medicity, Gurugram, Haryana, India.
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Goyal V, Elavarasi A, Kumar A, Samal P, Garg A, Shukla G, Vishnu VY, Singh MB, Srivastava MVP. Cyclophosphamide therapy as an adjunct in refractory post-tubercular arachnoiditis. Indian J Tuberc 2022; 69:325-333. [PMID: 35760482 DOI: 10.1016/j.ijtb.2021.05.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Accepted: 05/22/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION There is no satisfactory treatment for post tubercular arachnoiditis (TB arachnoiditis). We did this study to investigate the efficacy and safety of cyclophosphamide as adjuvant therapy for post TB arachnoiditis refractory to corticosteroids and anti-tubercular therapy (ATT). METHODS This was a retrospective case series of patients of refractory post TB arachnoiditis leading to paraparesis and vision loss who received cyclophosphamide as an adjuvant therapy along with standard ATT and corticosteroids. These patients were treated with intravenous cyclophosphamide (dose 500 mg/m2) once a month for 4 consecutive months after informed written consent and were assessed clinically and radiologically before and after cyclophosphamide therapy. RESULTS We had 4 patients with refractory post TB arachnoiditis of whom three became independently ambulatory. There was significant clinical as well as radiological improvement in all the patients. CONCLUSIONS Cyclophosphamide therapy could be an effective therapy for patients with refractory post TB arachnoiditis. Well-designed randomized controlled studies are essential to study the safety and efficacy of cyclophosphamide in this condition.
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Affiliation(s)
| | | | - Anand Kumar
- Department of Neurology, Banaras Hindu University, Banaras, India
| | - Priyanka Samal
- Department of Neurology, Kalinga Hospitals, Bhubaneswar, India
| | - Ajay Garg
- Department of Neuro-radiology, All India Institute of Medical Sciences, New Delhi, India
| | - Garima Shukla
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - M V Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Mishra NK, Engel J, Liebeskind DS, Sharma VK, Hirsch LJ, Kasner SE, French JA, Devinsky O, Friedman A, Dawson J, Quinn TJ, Selim M, de Havenon A, Yasuda CL, Cendes F, Benninger F, Zaveri HP, Burneo JG, Srivastava P, Bhushan Singh M, Bhatia R, Vishnu VY, Bentes C, Ferro J, Weiss S, Sivaraju A, Kim JA, Galovic M, Gilmore EJ, Pitkänen A, Davis K, Sansing LH, Sheth KN, Paz JT, Singh A, Sheth S, Worrall BB, Grotta JC, Casillas-Espinos PM, Chen Z, Nicolo JP, Yan B, Kwan P. International Post Stroke Epilepsy Research Consortium (IPSERC): A consortium to accelerate discoveries in preventing epileptogenesis after stroke. Epilepsy Behav 2022; 127:108502. [PMID: 34968775 DOI: 10.1016/j.yebeh.2021.108502] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 12/07/2021] [Indexed: 12/18/2022]
Affiliation(s)
| | - Jerome Engel
- Department of Neurology, University of California Los Angeles, Los Angeles, USA
| | - David S Liebeskind
- Department of Neurology, University of California Los Angeles, Los Angeles, USA
| | - Vijay K Sharma
- YLL School of Medicine, National University of Singapore and Division of Neurology, National University Health System, Singapore
| | | | - Scott E Kasner
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | - Jacqueline A French
- Department of Neurology, NYU Grossman School of Medicine, New York City, USA
| | - Orrin Devinsky
- Department of Neurology, NYU Grossman School of Medicine, New York City, USA
| | - Alon Friedman
- Department of Brain and Cognitive Sciences, Ben-Gurion University of the Negev, Beer-Sheva, Israel; Department of Medical Neuroscience, Dalhousie University, Halifax, Canada
| | - Jesse Dawson
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Terence J Quinn
- Institute of Cardiovascular and Medical Sciences, University of Glasgow, Scotland, UK
| | - Magdy Selim
- Department of Neurology, Beth Israel Deaconess Medical Center, Harvard Medical School, Boston, USA
| | | | - Clarissa L Yasuda
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Sao Paulo, Brazil
| | - Fernando Cendes
- Department of Neurology, School of Medical Sciences, University of Campinas - UNICAMP, Sao Paulo, Brazil
| | - Felix Benninger
- Department of Neurology, Rabin Medical Center, Tel Aviv, Israel
| | | | - Jorge G Burneo
- Epilepsy Program, Department of Clinical Neurological Sciences, and Neuroepidemiology Unit, Western University, London, Ontario, Canada
| | - Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Carla Bentes
- Department of Neurology, University of Lisboa, Lisbon, Portugal
| | - Jose Ferro
- Department of Neurology, University of Lisboa, Lisbon, Portugal
| | - Shennan Weiss
- Department of Neurology, State University of New York (SUNY) Downstate, NY, USA
| | | | - Jennifer A Kim
- Department of Neurology, Yale University, New Haven, USA
| | - Marian Galovic
- Department of Neurology, University of Zurich, Zurich, Switzerland
| | | | - Asla Pitkänen
- A.I. Virtanen Institute for Molecular Sciences, University of Eastern Finland, Kuopio, Finland
| | - Kathryn Davis
- Department of Neurology, University of Pennsylvania, Philadelphia, USA
| | | | - Kevin N Sheth
- Department of Neurology, Yale University, New Haven, USA
| | - Jeanne T Paz
- Gladstone Institute of Neurological Disease, Gladstone Institutes, San Francisco, USA; Department of Neurology, University of California San Francisco, San Francisco, USA
| | - Anuradha Singh
- Department of Neurology, Icahn School of Medicine at Mt. Sinai, NY, USA
| | - Sunil Sheth
- Department of Neurology, University of Texas Health Sciences Center, Houston, USA
| | - Bradford B Worrall
- Departments of Neurology and Public Health Sciences, University of Virginia, Charlottesville, USA
| | - James C Grotta
- Department of Neurology, Memorial-Hermann Texas Medical Center, Houston, USA
| | - Pablo M Casillas-Espinos
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Zhibin Chen
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - John-Paul Nicolo
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Bernard Yan
- Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia
| | - Patrick Kwan
- Department of Neuroscience, Monash University, Alfred Hospital, Melbourne, Australia; Departments of Neurology and Medicine, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Australia.
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Bhatia R, Haldar P, Puri I, Padma Srivastava MV, Bhoi S, Jha M, Dey A, Naik S, Guru S, Singh M, Vishnu VY, Rajan R, Gupta A, Vibha D, Pandit A, Agarwal A, Salunkhe M, Singh G, Prasad D, Panda S, Anand S, Rohila A, Khera P, Tiwari S, Bhaskar S, Garg M, Kumar N, Dhar M, Tiwari A, Agrawal N, Raju G, Garg J, Ray B, Bhardwaj A, Verma A, Dongre N, Chhina G, Sibia R, Kaur R, Zanzmera P, Gamit A, Iype T, Garg R, Singh S, Kumar A, Ranjan A, Sardana V, Soni D, Bhushan B, Dhamija R, Saluja A, Bala K, Dabla S, Goswami D, Agarwal A, Shah S, Shah S, Patel M, Joshi P, Awasthi S, Nath S, Chandan S, Malik R, Chowdhury N. Study protocol: IMPETUS: Implementing a uniform stroke care pathway in medical colleges of India: IMPETUS Stroke. Ann Indian Acad Neurol 2022; 25:640-646. [PMID: 36211192 PMCID: PMC9540919 DOI: 10.4103/aian.aian_1033_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction: In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India. Methods and Analysis: This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases. Discussion: Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.
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Agrawal A, Prajapati C, Vishnu VY, Padma Srivastava MV, Goyal V, Singh MB, Garg A, Singh M. Cerebral venous sinus thrombosis presenting with features of raised intracranial tension and en plaque meningeal thickening; A case report. Ann Indian Acad Neurol 2022; 25:135-137. [PMID: 35342264 PMCID: PMC8954330 DOI: 10.4103/aian.aian_633_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 08/13/2020] [Accepted: 10/14/2020] [Indexed: 11/04/2022] Open
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Mishra B, Pandit AK, Miyachi S, Ohshima T, Kawaguchi R, Vishnu VY, Misra S, Srivastava MVP, Srivastava AK, Kale SS, Phalak M. Clinical Utility of Intravascular Ultrasound (IVUS) in Carotid Artery Interventions: A Systematic Review and Meta-analysis. J Endovasc Ther 2021; 29:678-691. [PMID: 34955053 DOI: 10.1177/15266028211064824] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Carotid plaque morphology plays an important role in determining outcome of carotid artery stenting (CAS). Intravascular ultrasound (IVUS) and its extension VH (Virtual Histology)-IVUS evaluate plaque characteristics in real time and guide decision making during stenting. To date, there is no consensus about indications of IVUS and its validated methods. This systematic review and meta-analysis aims to evaluate the clinical utility of IVUS in carotid artery interventions (CAS) and develop a future consensus for research and practice parameters. METHODS A systematic review and meta-analysis was performed of the English literature articles published till February 2021. Studies reporting on IVUS parameters and findings and also its performance compared with other imaging modalities were included in review. Pooled prevalence with 95% confidence intervals (CI) was calculated. The statistical analysis was conducted in R version 3.6.2. RESULTS A total of 2015 patients from 29 studies were included. Proportional meta-analysis was performed on 1566 patients from 11 studies. In 9 studies, stroke/transient ischemic attack (TIA) had a pooled prevalence of 4% (95% CI 3%-5%) while asymptomatic stroke had a pooled prevalence of 46% (95% CI 31%-62%) in 4 studies following IVUS. Two studies reported that IVUS detected more plaque protrusion compared with angiography (n=33/396 vs 11/396). IVUS led to stent type or size change in 8 of 48 cases which were missed on angiography in 3 other studies. Concordance between VH-IVUS and true histology was good at 80% to 85% reported in 2 studies. CONCLUSIONS This systematic review and meta-analysis showed, though IVUS fared better to computed tomography (CT)/magnetic resonance (MR) angiography for better stent selection during CAS, with low to moderate risk of bias in the studies included. However, large scale, preferably randomized controlled studies are needed to predict its role in determining clinical outcome.
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Affiliation(s)
- B Mishra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - A K Pandit
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - S Miyachi
- Department of Neurological Surgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - T Ohshima
- Department of Neurological Surgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - R Kawaguchi
- Department of Neurological Surgery, Neuroendovascular Therapy Center, Aichi Medical University, Nagakute, Japan
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - S Misra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - M V P Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - A K Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - S S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - M Phalak
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Vinny PW, Vishnu VY, Padma Srivastava MV. Artificial Intelligence shaping the future of neurology practice. Med J Armed Forces India 2021; 77:276-282. [PMID: 34305279 DOI: 10.1016/j.mjafi.2021.06.003] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/01/2021] [Accepted: 06/03/2021] [Indexed: 11/17/2022] Open
Abstract
Neurology practice has faced many challenges since Jean-Martin Charcot established its sacred tenets. Artificial Intelligence (AI) promises to revolutionize the time-tested neurology practice in unimaginable ways. AI can now diagnose stroke from CT/MRI scans, detect papilledema and diabetic retinopathy from retinal scans, interpret electroencephalogram (EEG) to prognosticate coma, detect seizure well before ictus, predict conversion of mild cognitive impairment to Alzheimer's dementia, classify neurodegenerative diseases based on gait and handwriting. Clinical practice would likely change in near future to accommodate AI as a complementary tool. The clinician should be prepared to change the perception of AI from nemesis to opportunity.
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Affiliation(s)
- P W Vinny
- Associate Professor, Department of Internal Medicine, Armed Forces Medical College, Pune, India
| | - V Y Vishnu
- Assistant Professor (Neurology), All India Institute of Medical Sciences, New Delhi, India
| | - M V Padma Srivastava
- Professor & Head (Neurology), All India Institute of Medical Sciences, New Delhi, India
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Rajan R, Garg K, Saini A, Kumar M, Binukumar BK, Scaria V, Aggarwal R, Gupta A, Vishnu VY, Garg A, Singh MB, Bhatia R, Srivastava AK, Padma Srivastava M, Singh M. Pallidal Deep Brain Stimulation for KMT2B Related Dystonia in An Indian Patient. Ann Indian Acad Neurol 2021; 24:586-588. [PMID: 34728955 PMCID: PMC8513985 DOI: 10.4103/aian.aian_1316_20] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2020] [Revised: 01/11/2021] [Accepted: 01/27/2021] [Indexed: 12/01/2022] Open
Abstract
Outcomes of pallidal stimulation in KMT2B dystonia have been infrequently reported prospectively. We report the six-month outcomes of bilateral GPi DBS in an Asian Indian patient with early-onset generalized dystonia associated with a novel heterozygous variant in the KMT2B gene.
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Affiliation(s)
- Roopa Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Arti Saini
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Mukesh Kumar
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - BK Binukumar
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Vinod Scaria
- CSIR-Institute of Genomics and Integrative Biology, New Delhi, India
| | - Rajeev Aggarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Anu Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - VY Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Ajay Garg
- Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
| | - Mamta Bhushan Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Rohit Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Achal K. Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Manmohan Singh
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Bhatia R, Gupta P, Misra B, Sudheer P, Singh M, P. Srivastava MV, Tripathi M, Srivastava A, Prasad K, Vibha D, Vishnu VY, Rajan R, Pandit A, Singh R, Gupta A, Elavarasi A, Das A, Divya MR, Ramanujam B, Agarwal A. Patients with neurological illnesses and their experience during the lockdown: A teleinterview-based study. Ann Indian Acad Neurol 2021; 25:76-81. [PMID: 35342269 PMCID: PMC8954335 DOI: 10.4103/aian.aian_468_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/26/2021] [Revised: 07/18/2021] [Accepted: 07/19/2021] [Indexed: 11/04/2022] Open
Abstract
Background: Materials and Methods: Results: Conclusion:
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Kumar A, Singh MB, Garg A, Vishnu VY. Systemic lupus erythematosus presenting with holocord myelitis. J Postgrad Med 2021; 67:33-35. [PMID: 33380595 PMCID: PMC8098870 DOI: 10.4103/jpgm.jpgm_716_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/07/2020] [Revised: 07/28/2020] [Accepted: 09/05/2020] [Indexed: 11/09/2022] Open
Abstract
This is a report of a case of a 25-year-old woman, who presented with a rapidly progressive sensory-motor flaccid quadriparesis which had developed over a few days along with bladder and bowel involvement. She had a past history of photosensitive rash and joint pains along with mild-to-moderate grade fever; for which she had never been evaluated. Serological markers for systemic lupus erythematosus (SLE) were strongly positive and helped in establishing the diagnosis of SLE-related holocord myelitis. High-dose intravenous glucocorticoid followed by intravenous pulse cyclophosphamide was used to treat her and there was a significant improvement. In this case report, the diagnosis of SLE was made for the first time in a patient presenting with holocord myelitis.
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Affiliation(s)
- A Kumar
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - MB Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - A Garg
- Department of Neuro-radiology, All India Institute of Medical Sciences, New Delhi, India
| | - VY Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Agarwal A, Yadav D, Gupta A, Vishnu VY, Rajan R, Singh MB, Bhatia R, Srivastava Mv P. Delayed bilateral internal carotid artery dissection following motor vehicle accident: time to make its screening a part of trauma protocol? QJM 2020; 113:672-673. [PMID: 32096863 DOI: 10.1093/qjmed/hcaa037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Indexed: 11/12/2022] Open
Affiliation(s)
- A Agarwal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - D Yadav
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - A Gupta
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - R Rajan
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - M B Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - R Bhatia
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
| | - P Srivastava Mv
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
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Reddy SPK, Vishnu VY, Goyal V, Singh MB, Arora S, Garg A, Srivastava MVP. CADASIL syndrome and stroke in young people. QJM 2020; 113:118-119. [PMID: 31584664 DOI: 10.1093/qjmed/hcz243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2019] [Revised: 09/14/2019] [Indexed: 11/14/2022] Open
Affiliation(s)
- S P K Reddy
- From the Department of Neurology, New Delhi 110029, India
| | - V Y Vishnu
- From the Department of Neurology, New Delhi 110029, India
| | - V Goyal
- From the Department of Neurology, New Delhi 110029, India
| | - M B Singh
- From the Department of Neurology, New Delhi 110029, India
| | - S Arora
- From the Department of Neurology, New Delhi 110029, India
| | - A Garg
- Department of Neuroradiology, All India Institute of Medical Sciences, 118/11 Sudharshan Cinema Road, Gautham Nagar, South Delhi, New Delhi 110029, India
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Arora S, Srivastava MVP, Singh MB, Goyal V, Häberle J, Gupta N, Prabhakar A, Aggarwal B, Agarwal A, Vishnu VY. Adult onset type II citrullinemia--a great masquerader. QJM 2020; 113:49-51. [PMID: 31532496 DOI: 10.1093/qjmed/hcz238] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/03/2019] [Indexed: 12/30/2022] Open
Affiliation(s)
- S Arora
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - M V Padma Srivastava
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - M B Singh
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - V Goyal
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - J Häberle
- Head Metabolic Laboratory, Division of Metabolism, University Children's Hospital Zurich, Eleonore Foundation, Steinwiesstrasse 75, CH-8032 Zürich, Switzerland
| | - N Gupta
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - A Prabhakar
- Department of Neuroradiology, All India Institute of Medical Sciences, New Delhi, India
| | - B Aggarwal
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - A Agarwal
- Department of Paediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
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Vishnu V, Vinny P, Rajan R, Goyal V, Srivastava P, Lal V, Sylaja P, Narasimhan L, Dwivedi S, Nair P, Ramachandran D, Gupta A. Neurology residents versus a mobile medical application in deducing differential diagnoses in movement disorders: A multi-center, cross-sectional, observational study. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.385] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Sharma J, Srivastava P, Bhatia R, Rajan R, Singh R, Goyal V, Singh M, Garg A, Vishnu V. ‘Prehospital’ delay in acute stroke reperfusion therapy in Delhi: Time for introspection. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.687] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Vinny PW, Gupta A, Modi M, Srivastava MVP, Lal V, Sylaja PN, Narasimhan L, Dwivedi SN, Nair PP, Iype T, Vishnu VY. Head to head comparison between neurology residents and a mobile medical application for diagnostic accuracy in cognitive neurology. QJM 2019; 112:591-598. [PMID: 31086976 DOI: 10.1093/qjmed/hcz106] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 04/16/2019] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND A novel Mobile Medical Application (App) App was created on iOS platform (Neurology Dx®) to deduce Differential Diagnoses (DDx) from a set of user selected Symptoms, Signs, Imaging data and Lab findings. The DDx generated by the App was compared for diagnostic accuracy with differentials reasoned by participating neurology residents when presented with same clinical vignettes. METHODS Hundred neurology residents in seven leading Neurology centers across India participated in this study. A panel of experts created 60 clinical vignettes of varying levels of difficulty related to Cognitive neurology. Each neurology resident was instructed to formulate DDx from a set of 15 cognitive neurology vignettes. Experts in Cognitive Neurology made the gold standard DDx answers to all 60 clinical vignettes. The differentials generated by the App and neurology residents were then compared with the Gold standard. RESULTS Sixty clinical vignettes were tested on 100 neurology residents (15 vignettes each) and also on the App (60 vignettes). The frequency of gold standard high likely answers accurately documented by the residents was 25% compared with 65% by the App (95% CI 33.1-46.3), P < 0.0001. Residents correctly identified the first high likely gold standard answer as their first high likely answer in 35% (95% CI 30.7-36.6) compared with 62% (95% CI 14.1-38.5), P < 0.0001. CONCLUSION An App with adequate knowledge-base and appropriate algorithm can augment and complement human diagnostic reasoning in drawing a comprehensive list of DDx in the field of Cognitive Neurology (CTRI/2017/06/008838).
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Affiliation(s)
| | | | - M Modi
- PGIMER, Chandigarh, India
| | | | - V Lal
- PGIMER, Chandigarh, India
| | | | | | | | | | - T Iype
- Government Medical College, Trivandrum, Kerala, India
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Goyal V, Garg D, Vishnu VY, Singh MB, Padma Srivastava MV. Steroid responsive acute isolated ophthalmoplegia: A rare presentation of anti-Gq1b antibodies syndrome. Ann Indian Acad Neurol 2019; 23:739-740. [PMID: 33623295 PMCID: PMC7887498 DOI: 10.4103/aian.aian_287_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2019] [Accepted: 06/10/2019] [Indexed: 11/20/2022] Open
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Srivastava MVP, Vishnu VY. The infamous story of incident stroke and inflamed gall bladder! Neurol India 2019; 67:389-390. [DOI: 10.4103/0028-3886.258025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Affiliation(s)
- A Krishnamurthy
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - A Hamide
- Department of General Medicine, Jawaharlal Institute of Post Graduate Medical Education and Research, Puducherry, India
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Singh M, Kumar S, Vasantha P, Goyal V, Vishnu V, Garima S, Vishnubhatla S. Classification of epilepsy into focal and generalized: How necessary are investigations? A cross-sectional study. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.1937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Vishnu V, Vinny P, Balaini N, Modi M, Radotra B, Lal V. Computer algorithm as a supporting tool for clinical decision making on a mobile platform. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Vishnu VY, Modi M, Garg VK, Mohanty M, Goyal MK, Lal V, Mittal BR, Prabhakar S. Role of inflammatory and hemostatic biomarkers in Alzheimer's and vascular dementia - A pilot study from a tertiary center in Northern India. Asian J Psychiatr 2017; 29:59-62. [PMID: 29061429 DOI: 10.1016/j.ajp.2017.04.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2016] [Revised: 03/13/2017] [Accepted: 04/18/2017] [Indexed: 10/19/2022]
Abstract
INTRODUCTION A reliable plasma biomarker in differentiating between Alzheimer's disease (AD) and Vascular dementia (VaD) is the need of the hour, in most memory clinics. Even though there is no disease modifying treatment, it is important to know the type of dementia for both symptomatic treatment and prognostication. METHODS Neuropsychological assessment, MRI brain, FDG-PET brain and CSF biomarkers of AD (Aβ42 and total tau) were used for establishing the diagnosis of Mild Cognitive Impairment (MCI), AD or VaD. RESULTS 68 diagnosed patients of AD/MCI/VaD were included. FDG PET brain, plasma fibrinogen, d dimer, IL6 and CRP were done in all 68 patients while 48 patients underwent CSF biomarker analysis. Sixteen patients had MCI, of which 11 were MCI-AD and 5 were MCI-VaSC. There were 41 patients with AD (Mild AD-9, Mod AD-23, Severe AD-9) and 11 patients with VaD. Alzheimer group (MCI-AD and AD) and Vascular group (MCI VaSC & VaD) consisted of 52 and 16 patients respectively. Alzheimer and Vascular groups did not exhibit significant difference in IL6 and CRP levels. Plasma fibrinogen levels were significantly higher in VaD and vascular group as compared to Alzheimer group. But MCI-VaSC was not significantly different from MCI-AD. Plasma d dimer levels were significantly higher in all vascular subgroups compared to Alzheimer subgroups except between MCI-VaSC and MCI-AD. CONCLUSION Hemostatic biomarkers were higher in Vascular group compared to Alzheimer group whereas there was no difference in inflammatory biomarkers. But the sensitivity and specificity of fibrinogen and d-dimer were not high enough for routine clinical use. Further studies in a larger sample are required to confirm these results.
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Affiliation(s)
- V Y Vishnu
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - M Modi
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - V K Garg
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - M Mohanty
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - M K Goyal
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - V Lal
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - B R Mittal
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Affiliation(s)
| | - V Y Vishnu
- Department of Neurology, All India Institute of Medical Sciences, New Delhi 110029, India
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Gupta A, Kumar N, Saharan R, Rastogi P, Vishnu VY, Lal V. Teaching Video NeuroImages: Vertical supranuclear ophthalmoparesis: A diagnostic pearl for Niemann-Pick C. Neurology 2016; 86:e108. [PMID: 26952305 DOI: 10.1212/wnl.0000000000002442] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Affiliation(s)
- Anu Gupta
- From the Departments of Neurology (A.G., R.S., V.Y.V., V.L.) and Hematology (N.K., P.R.), PGIMER, Chandigarh, India
| | - Narender Kumar
- From the Departments of Neurology (A.G., R.S., V.Y.V., V.L.) and Hematology (N.K., P.R.), PGIMER, Chandigarh, India
| | - Rajveer Saharan
- From the Departments of Neurology (A.G., R.S., V.Y.V., V.L.) and Hematology (N.K., P.R.), PGIMER, Chandigarh, India
| | - Pulkit Rastogi
- From the Departments of Neurology (A.G., R.S., V.Y.V., V.L.) and Hematology (N.K., P.R.), PGIMER, Chandigarh, India
| | - V Y Vishnu
- From the Departments of Neurology (A.G., R.S., V.Y.V., V.L.) and Hematology (N.K., P.R.), PGIMER, Chandigarh, India
| | - Vivek Lal
- From the Departments of Neurology (A.G., R.S., V.Y.V., V.L.) and Hematology (N.K., P.R.), PGIMER, Chandigarh, India.
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Vishnu VY, Kesav P, Prabhakar S. Disseminated cysticercosis. QJM 2013; 106:1141-2. [PMID: 23097392 DOI: 10.1093/qjmed/hcs200] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Affiliation(s)
- Praveen Kesav
- Department of Neurology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Affiliation(s)
- Praveen Kesav
- Department of Neurology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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