Medicine and Health Sciences Commons^™

Anti-Caspr 2 Antibody Encephalitis: A Case Report, Maryam Khalil, Zaid Waqar, Hira Badar Abbasi, Amina Saddiqa, Bushra Khalid, Soban Khan

Pakistan Journal of Neurological Sciences (PJNS)

Encephalitis is a term denoted to Inflammation in the brain which can be due to infection, autoimmunity, or can be a part of a paraneoplastic phenomenon with malignancy. Anti-CASPR 2 antibody encephalitis is a rare form of encephalitis that can be associated with malignancy, paraneoplastic phenomenon or can be an autoimmune disease. We present a case of a young boy who presented with new onset seizures and altered sensorium and was diagnosed with anti-CASPR 2 antibody encephalitis. Anti-CASPR 2 Antibody Encephalitis is a rare form of encephalitis which due to its great diverse presentation should be kept in the differential …

Primary Angiitis Of The Central Nervous System Presenting As Sudden Vision Loss In A Young Patient, Ayisha Farooq Khan, Lubna Jafri, Saad Shafqat

Pakistan Journal of Neurological Sciences (PJNS)

Primary angiitis of the central nervous system is a rare disorder that primarily affects the cerebral vessels and can prove to be a diagnostic challenge to the clinicians. It can present with a variety of clinical manifestations and lacks the evidence of any systemic disease. Digital subtraction angiography is often necessary to confirm the diagnosis of cerebral vasculitis but in cases where it may fail to do so, brain biopsy is eventually required. Obliviousness to this condition may lead to false management strategies and hence it is imperative to make an accurate diagnosis to facilitate proper treatment that mainly includes …

Ataxic Variant Of Guillain Barre Syndrome: A Case Report, Haris Majid Rajput, Malik Muhammad Adil, Maryam Khalil, Nayab Aslam, Zaid Waqar

Pakistan Journal of Neurological Sciences (PJNS)

A 17-year-old girl was admitted after acute onset of unsteady gait succeeding acute gastroenteritis. Neurological examination reported normal power in all four limbs, impaired finger-nose, heel-shin tests, areflexia and ataxic gait. We eliminated other diseases with cerebellar symptoms; for example, Wernicke encephalopathy, multiple sclerosis, cerebellar vascular disease , encephalitis in the brain stem and cerebellum. Blood serum collected from the patient during the acute phase showed no anti-ganglioside antibodies. As the patient presented with evident cerebellar ataxia without muscle weakness, ophthalmoplegia or proprioceptive sensory disruption a diagnosis of ataxic form of Guillain-Barré syndrome (GBS) after nerve conduction studies. Though ataxic …

Patient-Reported Value Of A Standardized Welcome Letter For Huntington Disease Clinic, Kirthan S. Reddy, Shayan Abdollah Zadegan, Jorge Patino, Frank Ramirez, Amber Mccarthy, Natalia Pessoa Rocha, Erin Furr Stimming

Teaching in Clinics

Communication is an essential component of patient satisfaction, which can be especially challenging in patients with neurobehavioral symptoms. As an effective form of communication, Patient Welcome Letter (PWL) should be designed in a way to cover a wide range of literacy. We designed a PWL for our Huntington Disease (HD) clinic using readability and suitability measures. Of the 80 patients that received the PWL, 47 filled out the survey. A majority of patients (>90%) found the PWL clear, understandable, and well-organized. The PWL was deemed valuable overall by 91.4% of participants.

Pengaruh Durasi Penggunaan Smartphone Di Kalangan Pelajar Terhadap Frekuensi Nyeri Leher, Irawan Wibisono, Didik Purnomo, Suci Amanati

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Neck pain is a musculoskeletal problem that is often encountered in productive age, one of the triggers for neck pain is an unergonomic position for a long time. For example when using a smartphone, the position of the neck will tend towards the front. The use of smartphones in this technological era takes a long time. This is because smartphones have become part of student life. This study aims to determine the effect of the duration of smartphone use on the frequency of neck pain. This research method uses descriptive cross sectional with a total sample of 68 people, while …

Aerobic Exercise Terhadap Peningkatan Endurance Pada Pasien Penyakit Jantung Koroner Dengan Pemeriksaan 6mwt : Studi Kasus, Dela Fariha Fuadi, Andrew Wijaya Saputra, Nabilla Nur Awaliah Dzatikhulwani

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Background: Coronary heart disease (CHD) is a condition in which the heart's blood vessels (coronary arteries) are blocked by fat deposits. Based on data from Riskesdas (2018) it is revealed that cases of heart and blood vessel disease in Indonesia are increasing every year, increasing the mortality rate. This is due to the presence of risk factors that support the emergence of coronary heart disease. Objective: The aim of this paper is to evaluate the evaluation of aerobic exercise to increase endurance in patients with coronary heart disease by examining 6MWT. Method: This research is in the form of a …

Efektivitas Manual Therapy Dan Ultrasound Terhadap Peningkatan Fungsi Gerak Bahu Pada Kasus Nyeri Bahu Et Causa Bursitis Subacromialis Dengan Parameter Spadi Di Rsud Muhammad Natsir, Fadhilah Az-Zahra, Ronal Lufitos, Faizah Abdullah Djawas

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

ABSTRACT: Adhesive Capsulitis is a disorder that occurs in the shoulder area in the form of inflammation of the joint capsule which causes a feeling of stiffness and pain. Glenohumeral joint mobilization with the Maitland mobilization technique is using passive mobilization with physiological oscillatory movements which can produce a stretching effect and release of adhesive on the ligament capsule in the shoulder so that the range of motion of the shoulder joint can be increased. Hold relax is an exercise therapy with the principle of reciprocal inhibition which aims to improve antagonistic pattern relaxation, and mobilization, and to reduce pain. …

Single Leg Depth Jump Kombinasi Core Plank Knee To Elbow Terhadap Power Otot Tungkai Atlet, Maya Triyanita, Siti Sardianti Dwi Tirta

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Power limit training is defined as the movement to get a jump on athletes in doing the maximum jump smash. Badminton requires leg muscle explosive power because it is the muscle's ability to overcome loads and with a high speed of contraction. This study aims to determine the effect of the single leg depth jump exercise, the combination of the knee to elbow core plank, on increasing leg power in badminton athletes.

This study uses an experimental design method. This research was conducted on badminton athletes using a total sampling technique of 13 people, namely the Pliometric Simgle Leg Dept …

Neurodynamic Technique Terhadap Penurunan Nyeri, Peningkatan Grip Strength, Dan Peningkatan Kemampuan Fungsional Pada Carpal Tunnel Syndrome, Safrin Arifin, Fathia Dheanisa

Jurnal Fisioterapi Terapan Indonesia or Indonesian Journal of Applied Physiotherapy

Carpal tunnel syndrome is a syndrome that occurs in 1-4% of the total population worldwide. This condition causes disruption of function and motion in the wrist that spreads to the fingers. Physiotherapy intervention is necessary to reduce the severity of symptoms in patients with CTS. Neurodynamic Techniques are nerve mobilization techniques that aim to restore homeostasis in the nerves so as to reduce pain and improve functional ability. Materials and methods. This research was conducted through searching several databases, found 31 articles which were then filtered and selected as many as 10 articles. However, of the 11 articles, further screening …

A Rare Case Of Combined Immunodeficiency Syndrome With Otomastoiditis, Parotitis & Facial Nerve Palsy, Parth Garg, Amulya T M, Prakash B.G., Sandhya D

Digital Journal of Clinical Medicine

This article presents a case study of a 4-month-old female baby with combined immunodeficiency syndrome complicated by bilateral otomastoiditis, right-sided parotitis, and facial nerve palsy. The patient presented with symptoms of fever, cold, earache, and ear discharge. Clinical examination revealed redness and swelling in the post-auricular region, along with bloody discharge from the right ear. Further investigations, including blood tests, culture sensitivity, ultrasound scans, and imaging studies, confirmed the diagnosis. The patient was treated with appropriate antibiotics, antifungals, and supportive care. The article discusses the challenges in diagnosing and managing primary immunodeficiency diseases (PIDs), emphasising the importance of early recognition …

Eosinophilic Granulomatosis With Polyangiitis (Churg Strauss Syndrome) – A Case Report, Rudrani Mukherjee, Bhanukumar M

Digital Journal of Clinical Medicine

Eosinophilic granulomatosis with polyangiitis (EGPA), previously known as Churg Strauss syndrome, is a rare small vessel vasculitis characterized by asthma, eosinophilia, and systemic involvement. This case report presents a 51-year-old man with a history of asthma, who presented with neurological symptoms including blurring of vision, bilateral ptosis, and altered sensorium. The patient had a previous history of cervical and lumbar spine surgeries for symptoms attributed to spondylosis. Further examination revealed hyperpigmented lesions on the limbs, wasting of small muscles, and foot drop.

Investigations showed eosinophilia and thrombocytosis on blood analysis, with bone marrow aspiration revealing eosinophilic and megakaryocytic hyperplasia. The …

Journal Club: Glymphatic System In Neurodegenerative Diseases, Ronald G. Lott Iii, Xavier Zonna, Samuel Wlasowicz

Advances in Clinical Medical Research and Healthcare Delivery

Neurodegenerative diseases such as Alzheimer's Disease impact a multitude of individuals worldwide. The neural Glymphatic system is a relatively newly discovered cellular transport pathway within the brain that has been implicated in neurodegenerative diseases. This article serves to provide a journal club review of current literature on the Glymphatic system to raise awareness of this system and its potential for future treatment and prevention of neurodegenerative conditions.

Cerebellar Manifestation Secondary To Rectal Neoplasia, Soban Khan, Zaid Waqar, Maryam Khalil, Bushra Khalid, Sajid Ali, Ijaz Ali, Muhammad Tariq, Muhammad Adil

Pakistan Journal of Neurological Sciences (PJNS)

The condition known as paraneoplastic cerebellar degeneration (PCD) is among the most disabling examples of a cancer's remote effects. Serology for paraneoplastic antibodies, clinical suspicion, and a targeted search for malignancy all play a role in the diagnosis. Tests for neuronal autoantibodies aid in diagnosis and point the way for the search for malignancy. Unfortunately, even with an early diagnosis, existing therapeutic approaches only have little success. Here we present the case of a young male who developed cerebellar syndrome secondary to rectal neoplasia.

Intravenous Thrombolytic Therapies In The Management Of Unknown Onset And Wakeup Strokes: A Scoping Review, Saima Nazish

Pakistan Journal of Neurological Sciences (PJNS)

ABSTRACT Background: The efficacy and safety of intravenous recombinant tissue plasminogen activator (IV rt-PA) for the management of unknown time onset stroke (UTOS) and wake-up stroke (WUS) are in a debate. Objective:The objective of this review is to discuss the UTOS and its management with intravenous thrombolytic therapies. Data Sources: Databases searched included PubMed and Cochrane electronic databases and manual search. Study Selection and Data Extraction: 45 articles of potential relevance were selected. Results: 14 relevant papers were included. Most of studies including recent trials using Magnetic resonance imaging diffusion-weighted imaging fluid-attenuated inversion recovery (MRIDWI FLAIR) mismatch or Computed tomography …

Association Of Hyperuricemia With Ischemic Stroke In Adult Population, Ijaz Ali, Zaid Waqar, Bushra Khalid, Maryam Naseem, Soban Khan, Sajid Ali, Muhammad Tariq, Muhammad Adil, Hira Badar Abbasi, Mazhar Badshah

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Stroke is the second most prevalent cause of dementia, the third biggest cause of mortality, and the top cause of disability globally. Hyperuricemia is frequently seen in patients with vascular risk factors. The objective of this study was to determine the association of hyperuricemia with ischemic stroke in adult patients presenting to neurology department of a tertiary care hospital.

Methods:This was a case-control study of 200 patients, 100 patients with stroke and 100 unmatched controls were accessed for vascular risk factors and hyperuricemia. The setting was Pakistan Institute of Medical Sciences, Islamabad and study duration was …

Frequency Of Depression Among Patients With Parkinson Disease, Mohammad Lateef, Wasim Ikram Alvi, Abdul Malik, Neelum Jamal, Muhammad Umair, Muhammad Athar Khan

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Parkinson's disease is a degenerative neurological condition that affects a large number of individuals worldwide. One of the common non-motor symptoms associated with this disease is depression, which can pose challenges for both patients and their caregivers. The main objective of this research was to determine the frequency of depression among patients with Parkinson disease.

Methods:This was a cross-sectional study that was conducted in Karachi, Pakistan, between March 26, 2022, and September 30, 2022. Male and female patients diagnosed with Parkinson's disease according to the UK Parkinson's Disease Society Brain Bank Clinical Diagnostic Criteria, who were …

Clinical Presentation, Evaluation, And Management Of Patients With Myasthenia Gravis At A Tertiary Care Center In Pakistan, Aziz Sonawalla, Shafaq Saleem, Salim Allana, Rabia Qaiser, Rohma Shamsi

Pakistan Journal of Neurological Sciences (PJNS)

Background and objectives:

Little is known about the clinical profile and outcome of myasthenia gravis in Pakistan. The objective of this study is to review the clinical characteristics of patients with myasthenia gravis in Pakistan, and the outcome of investigations and treatment.

Methods: The study comprised a retrospective review of charts of patients diagnosed with myasthenia gravis at Aga Khan University Hospital in Karachi, Pakistan, over a period of 16 years from 1987 to 2003. The following features were reviewed: (i) clinical presentation, (ii) investigations especially nerve conduction studies, acetylcholine receptor antibodies, and imaging studies of the thorax, (iii) treatments …

Neurobehavioral And Biochemical Effects Of Choline Chloride Administration In Rats, Lubna Anis, Irfan Sajid, Shoaib Ahmad, Saida Haider

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objective:

Choline is an essential nutrient related to vitamin B complex activity. It can be received through different food sources. It is an important component of acetylcholine which is involved in different brain functions. The present study is designed to assess the behavioral effects of choline chloride in animal models.

Methods:This case-control study was performed in the Department of Biochemistry, Federal Urdu University, Karachi for eight months from May 2022 to December 2022. Twenty-four adult male albino Wister rats were divided into four groups, one control and three test groups. Choline chloride dissolved in saline was given …

Frequency Of Hyperlipedemia In Patients Coming With Ischemic Stroke In Tertiary Care Hospital Karachi, Bushra Ammad, Abdul Malik, Rabia Sana Muhammad, Maryam Javed, Hina Imtiaz

Pakistan Journal of Neurological Sciences (PJNS)

Background and objective:

Stroke is the second leading cause of death and the third leading cause of disability. This study was designed to determine the frequency of hyperlipidemia in patients with ischemic stroke visiting at a tertiary care hospital in Karachi.

Methods:This was a descriptive cross-sectional study and was done in Department of Medicine, LCMD/ Dar-ul-Sehat Hospital Karachi, Pakistan. A total of 184 patients were studied during the study period of six months and all the consecutive patients were recruited who presented with acute stroke in the department of medicine from the duration April 1st 2022 to September 30th, …

Chronic Hepatitis B, C, And Stroke; Association And Pathophysiology, Hamza Imran, Adnan Yousuf, Mohammad Wasay

Pakistan Journal of Neurological Sciences (PJNS)

Background and Objectives:

Hepatitis infection may raise the incidence of stroke and other cerebrovascular abnormalities, according to several studies. However, its association is controversial. This review looked to compile the most recent research on the relationship between HBV and HCV, atherosclerosis, and stroke.

Methods:This article reviews the literature on the connection between hepatitis B and C viruses with stroke and atherosclerosis. The search included articles from PubMed, PakMediNet, and Google Scholar, as well as a Medline search using specific keywords and MeSH terms. A total of 2655 articles were identified. Out of these 2655 articles we identified 134 articles …

Lack Of Stroke Care Centers In Sindh, Adnan Malik, Rahul Agia

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Fibromyalgia: The Misunderstood Victim, Wajid Jawaid

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Mandatory Child Neurology Training For Adult Neurology Residents In Pakistan, Tipu Sultan

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Terson Syndrome In A Patient With Unrepaired Tetralogy Of Fallot, Amina Saddiqa, Zaid Waqar, Maryam Khalil, Muhammad Anas, Zeeshan Munawar, Ifrah Ayaz, Zakir Jan, Haris Majid

Pakistan Journal of Neurological Sciences (PJNS)

Tetralogy of Fallot is the most commonly seen cyanotic congenital heart disease. It includes four cardinal features: right ventricular outflow tract obstruction, misaligned ventricular septal defect, overriding aorta, and concentric right ventricular hypertrophy. Intracranial pathologies such as brain abscesses, cerebrovascular accidents, and intracranial haemorrhage all have been reported with Tetralogy of Fallot. Here we present a case who had subarachnoid haemorrhage with vitreous haemorrhage in Tetralogy of Fallot.

National Guidelines For The Treatment Of Common Headaches Disorders In Pakistan, Abdul Malik, Sabrina Khan, Mohammad Wasay, Aziz Sonawalla, Samaira Younis, Faisal Mohammad Amin

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Tips And Tricks For Laparoscopic Cholecystectomy In The Patient With Ventriculoperitoneal Shunt; A Case Report, Carmen Popa, Andrei Moisin, Mihai Faur, Mihaela Racheriu, Ramona Coca, Cristian Mihai Branescu, Tiberiu Trotea, Denisa Tănăsescu

Journal of Mind and Medical Sciences

Laparoscopic surgery in patients with ventriculo-peritoneal shunt is challenging in terms of technical approach. The severity of possible complications and the lack of studies on this association increase the surgeon's discomfort with such surgery. The main complications that may occur are increased intracranial pressure, secondary pneumo-peritoneum pneumocephalus, encephalitis and the risk of catheter injury during laparoscopic procedures. We present the case of a 56-year-old patient operated in 2004 for a basilar artery top aneurysm with subarachnoid hemorrhage and secondary hydrocephalus, for which a ventriculo-peritoneal shunt was fitted. This patient presented in our clinic with diffuse abdominal pain, more accentuated in …

World Health Organization Intersectoral Global Action Plan (Who-Igap); Implications And Impact On Neurological Care In Pakistan, Mohammad Wasay Wasay, Safa Younis, Abdul Malik, Akhtar Sherin

Pakistan Journal of Neurological Sciences (PJNS)

No abstract provided.

Application Of Multiphase Ct Angiography In Acute Ischemic Stroke, Salman Mansoor

Pakistan Journal of Neurological Sciences (PJNS)

This article explores the use of multiphase CT angiography (CTA) as a valuable tool in acute stroke management. Unlike traditional imaging methods, multiphase CTA provides a more comprehensive view of the neurovascular system and can detect occlusions and aid in treatment decision-making. Recent studies have shown that multiphase CTA has high accuracy in identifying patients who are suitable for endovascular treatment. Furthermore, it has also been used to visualize intracranial aneurysms and track the development of collateral circulation during and after treatment. Despite concerns regarding radiation exposure and image interpretation, multiphase CTA remains an essential imaging modality in the management …

Myositis As A Complication Of Dengue Viral Infection, Amina Sadiqa, Usama Hayyan, Zaid Waqar, Taha Pasha

Pakistan Journal of Neurological Sciences (PJNS)

Dengue fever is a febrile illness caused by an arbovirus transmitted by the Aedes aegypti mosquito. It occurs as a seasonal epidemic every year in Pakistan. Apart from febrile illness and its associated hemorrhagic complication, dengue fever is associated with multi-system involvement and their respective complications, including myriad neurological complications. In this case report we describe two patients who developed acute viral myositis.

Creutzfeldt-Jakob Disease Experience In Patients Presenting To A Tertiary Care Hospital: A Case Series, Zaid Waqar Waqar, Amina Sadiqa, Soban Khan, Muhammad Annas Farooq Farooq, Zeeshan Munawar, Maryam Khalil, Adil Awan

Pakistan Journal of Neurological Sciences (PJNS)

Creutzfeldt-Jakob disease (CJD) is a rare cause of rapidly progressive dementia, it is a neurodegenerative disorder caused by the misfolding of prion proteins in the brain, and misfolded proteins further propagate by causing misfolding of other proteins. It presents with insidious onset of neurobehavioral symptoms that rapidly develop into cognitive and motor decline and uncontrolled seizures. The diagnosis is established with help of clinical signs and symptoms, and using imaging and lab investigations to rule out other treatable causes. Some imaging findings point to the diagnosis of CJD that will be viewed in the cases below. Diagnosis can be augmented …