Integrative Approach to COVID-19: An Indian Facebook Recipe for Mental Health

The COVID-19 pandemic has given the world a big blow and has forced the entire world to develop a new thought process. To cope with the stress of lockdown, it was important for people to indulge in educational and health activities to save them from the threats being caused by the news and social media. A Facebook page named Yoga scholars Post Graduate Institute of Medical Education and Research (PGIMER) was created where three sessions were held per day for 225 days regularly. This activity resulted in people adopting an integrative approach towards alternative medicine. This also made possible a trial of Ashwagandha for COVID-19 treatment by the Ayurveda, Yoga, Naturopathy, Unani, Siddha and Homeopathy (AYUSH) ministry.

Predictive Value of Combination of D-dimer and Fibrinogen in Diagnosing Acute CVST

Background: Cerebral venous sinus thrombosis (CVST) is an uncommon subtype of stroke, and the role of D-dimer and fibrinogen in early diagnosis of CVST has been studied with varying results. The present study aims to study the role of the combination of D-dimer and fibrinogen in early diagnosis of acute CVST. Methods: Forty consecutive confirmed acute CVST cases admitted at a tertiary care center were recruited for the study. D-dimer and fibrinogen were assessed by a rapid semiquantitative latex agglutination assay. Results: Out of the 40 CVST patients, 21 (52.50%) were females. The mean age of the patients was 37.58 years ± 19.17 years. Common clinical features were headache ( N = 38 [95%]), papilloedema ( N = 15 [37.5%]), and seizures ( N = 12 [30%]). Although the sensitivity (75%) of the combination of D-dimer and fibrinogen assay was lower than that of D-dimer or fibrinogen alone, the specificity and positive predictive value (75% each) was higher. Conclusions: The combination of D-dimer and fibrinogen testing may aid in an early diagnosis of acute CVST and in better management.

Brain Awareness Week 2021 at Ibn Sina Academy (India): A Report

Brain- and neuroscience-related diseases and research are an important aspect to be discussed and explored at public interest. International Brain Research Organization (IBRO) is an international organization that is involved in spearheading both these activities. Brain Awareness Week (BAW) was never organized in a city which gave rise to the foundation of “Indian Academy of Neurosciences (IAN).” Stalwarts like Professor P. N. Saxena, Professor Om Chandra, Professor Mahdi Hasan, Professor K. C. Singhal, etc. did some significant efforts to promote neuroscience and brain research in Aligarh. They also established “Interdisciplinary Brain Research Centre” at Aligarh Muslim University and organized many scientific events including the Fifth Annual Conference of the IAN from December 7 to December 9, 1986. They also established “Interdisciplinary Brain Research Centre” at Aligarh Muslim University. Likewise, Ibn Sina Academy of Medieval Medicine and Sciences is another institution where a large number of publications on neuroscience exist. With this background, BAW with a theme, “Neuroscience through the ages to modern times” was organized by the courtesy of IBRO-APRC Brain Awareness Week Grant. The exhibition of publications extant at Ibn Sina Academy (depicting history of neuroscience since medieval era specially the works of medieval Arabs who played a significant role in the growth of neurosurgery) and public awareness lectures on importance of neuroscience research helped in some extent to increase public awareness, foster public enthusiasm and interest in the younger generation. Students of all science disciplines including Unani medicine were invited to participate at various events such as presentation of postal stamps on neuroscience, paintings, essay writing competition, and poetry on brain and neuroscience.

Morphometry of Corpus Callosum in South Indian Population

Background: The corpus callosum (CC) is a connecting bridge between two cerebral hemispheres and helps in interhemispheric integration of information. Purpose: The primary objective of the study is to explain the topographical position of CC in relation to the brain in the South Indian population, contributing to the reference values of measurements of CC, which helps in planning surgical interventions. Also, the reference values help in cross-referencing with other populations and ethnic group. Methods and Material: In the study, 40 formalin fixed, full brain specimens were cut in midsagittal plane and CC was measured along with its relation to the brain. The major diameters considered were longitudinal dimension of corpus callosum (LC), distance of CC from frontal pole to genu (AS), distance of CC occipital pole to splenium (PS), and longitudinal dimension of brain (LB) from frontal pole to occipital pole. Statistical Analysis Used: The statistical analysis was carried with the mean, standard deviation, 95% CI, and the range measured for each measurement. The Pearson coefficient was evaluated between dimensions of brain and CC. Multivariate linear regression analysis was done to correlate between LB as a dependent variable, and LC, vertical dimension of brain (CD), and PS as independent variables. Results: Pearson’s ratio showed a positive correlation between LB and PS (0.61), and also between LB and LC (0.59). The ratio of LC/LB was 0.45 and LC/CD was 0.69, which are stable in all brains studied. Conclusions: The study concludes that CC maintains a stable proportion with its parts (genu, rostrum, body, and splenium) and with the horizontal dimension of the brain. Further, measured values help in cross-referencing with other population.

Respiratory Muscle Weakness in Thyrotoxic Periodic Palsy: A Lesson to Remember

Thyrotoxic periodic palsy (TPP) is a sporadic form of hypokalemic periodic palsy that may occur in association with hyperthyroidism mostly with Graves’ disease. Acute thyrotoxic periodic palsy is a disorder most commonly seen in Asian men and characterized by abrupt onset of hypokalemia and paralysis. The disorder primarily affects the lower extremities and can involve all four limbs and presents as acute flaccid paralysis. The diagnosis of thyrotoxic periodic palsy is not difficult, but the disease's low incidence and many differentials for acute flaccid paralysis delay and complicate the diagnosis. TPP is not related to the etiology, severity, and duration of thyrotoxicosis. The treatment is similar to hypokalemic periodic palsy with potassium supplementation and initiation of antithyroid drugs and beta-blocker therapy. Here a similar case of quadriparesis is reported, which got precipitated after abrupt cessation of carbimazole in a young male. This initially was thought to be a case of hypokalemic periodic palsy and was later diagnosed to be TPP and recovered after initiating antithyroid drugs and potassium supplementation.

Neural Correlates of Hiccups in Patients with Lateral Medullary Infarction

Background Hiccups is a known presentation of lateral medullary infarction. However, the region in the medulla associated with this finding is not clearly known. In this study, we aimed to study the neural correlates of hiccups in patients with lateral medullary infarction (LMI). Materials and Methods This retrospective study included all patients who presented with lateral medullary infarction between January 2008 and May 2018. Patients with hiccups following LMI were identified as cases and those with no hiccups but who had LMI were taken as controls. The magnetic resonance imaging of the brain was done viewed and individual lesions were mapped manually to the template brain. Voxel-based lesion-symptom mapping employing nonparametric permutation testing was performed using MRIcron. Results There were a total of 31 patients with LMI who presented to the hospital during the study period. There were 11 (35.5%) patients with hiccups. Using the voxel-based lesion-symptom mapping analysis, the dorso-lateral region of the middle medulla showed significant association with hiccups. Conclusion In patients with LMI, we postulate that damage to the dorsolateral aspect on the middle medulla could result in hiccups.

Role of Microglia and Astrocytes in Spinal Cord Injury Induced Neuropathic Pain

Spinal cord injuries incite varying degrees of symptoms in patients, ranging from weakness and incoordination to paralysis. Common amongst spinal cord injury (SCI) patients, neuropathic pain (NP) is a debilitating medical condition. Unfortunately, there remain many clinical impediments in treating NP because there is a lack of understanding regarding the mechanisms behind SCI-induced NP (SCINP). Given that more than 450,000 people in the United States alone suffer from SCI, it is unsatisfactory that current treatments yield poor results in alleviating and treating NP. In this review, we briefly discussed the models of SCINP along with the mechanisms of NP progression. Further, current treatment modalities are herein explored for SCINP involving pharmacological interventions targeting glia cells and astrocytes. The studies presented in this review provide insight for new directions regarding SCINP alleviation. Given the severity and incapacitating effects of SCINP, it is imperative to study the pathways involved and find new therapeutic targets in coordination with stem cell research, and to develop a new gold-standard in SCINP treatment.

Spike Glycoprotein Is Central to Coronavirus Pathogenesis-Parallel Between m-CoV and SARS-CoV-2

Coronaviruses (CoVs) are single-stranded, polyadenylated, enveloped RNA of positive polarity with a unique potential to alter host tropism. This has been exceptionally demonstrated by the emergence of deadly virus outbreaks of the past: Severe Acute Respiratory Syndrome (SARS-CoV) in 2003 and Middle East Respiratory Syndrome (MERS-CoV) in 2012. The 2019 outbreak by the new cross-species transmission of SARS-CoV-2 has put the world on alert. CoV infection is triggered by receptor recognition, membrane fusion, and successive viral entry mediated by the surface Spike (S) glycoprotein. S protein is one of the major antigenic determinants and the target for neutralizing antibodies. It is a valuable target in antiviral therapies because of its central role in cell-cell fusion, viral antigen spread, and host immune responses leading to immunopathogenesis. The receptor-binding domain of S protein has received greater attention as it initiates host attachment and contains major antigenic determinants. However, investigating the therapeutic potential of fusion peptide as a part of the fusion core complex assembled by the heptad repeats 1 and 2 (HR1 and HR2) is also warranted. Along with receptor attachment and entry, fusion mechanisms should also be explored for designing inhibitors as a therapeutic intervention. In this article, we review the S protein function and its role in mediating membrane fusion, spread, tropism, and its associated pathogenesis with notable therapeutic strategies focusing on results obtained from studies on a murine β-Coronavirus (m-CoV) and its associated disease process.

Syringomyelia Managed with Classical Homeopathy, A Case Report

Background: Syringomyelia (SM) with Chiari malformation is a rare disease with an unpredictable course. Surgery and other interventions help reduce the severity of symptoms, but over 50% patients require re-operation. Auto-resolution is rare in this type of SM, and most cases progress to complications, which may amount to a great burden. Case presentation: We present a case of SM with Arnold-Chiari malformation type 1 in a 54-year-old Russian woman who was treated with individualized classical homeopathy for over eight years with remarkable improvement in the clinical signs and symptoms of the condition and comorbidities. On MRI, the syrinx completely resolved, which further confirmed the benefit of this therapy. Conclusion: This case of SM with Arnold-Chiari malformation type 1 seemed to benefit from individualized classical homeopathy. Scientific investigation into an individualized classical homeopathic approach towards SM is necessary to establish its relevance in this condition.

Potential Role of Yoga in the Management of Ankylosing Spondylitis: A Retrospective Study

Background: Ankylosing spondylitis (AS) is a chronic autoimmune inflammatory spondyloarthropathy with unclear pathogenesis. The inflammatory pain in AS leads to restricted spinal mobility and significant disability. Yoga is a nonpharmacological intervention that has positive effects on various musculoskeletal-related problems. However, its role in AS is unknown. Objective: The present retrospective study assessed the efficacy of a two-week residential yoga intervention on spinal flexibility among AS patients. Methods: The records for 24 male AS patients within the age range 30 to 50 years (average age 38.3 ± 10.5 years) who underwent a two-week residential yoga retreat between 2015 and 2020 were obtained from a yoga center located in South India. Yoga intervention consisted of yoga postures, breathing practices, meditation, a healthy diet, and devotional sessions. Pre and Post data of the sit-and-reach test, blood pressure, heart rate, and symptom score were analyzed using Statistical Package for Social Sciences (SPSS). Results: Compared to the baseline, the post scores of the sit-and-reach test, systolic blood pressure and heart rate were found to be significantly ( P < .05) lower. The symptom score and analgesic medication score also showed significant improvement after two-weeks compared to the baseline. Conclusion: This retrospective study indicates the positive impact of on and analgesic use among AS patients. However, additional studies using robust research designs are warranted.