Browsing by Author "Das, A"

Now showing 1 - 12 of 12
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    A case of amyloid myopathy masquerading as inflammatory myopathy
    (NEUROLOGY INDIA, 2010) Das, A; Mahadevan, A; Kishore, A; Shankar, SK
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    Alpha coma evolving into spindle coma in a case of acute fulminant hepatic failure: What does it signify?
    (ANNALS OF INDIAN ACADEMY OF NEUROLOGY, 2010) Das, A; Cherian, A; Dash, GK; Radhakrishnan, A
    A 44-year-old male developed acute fulminant hepatic failure of unknown etiology and expired within four days. His serial electroencephalograms (EEGs) showed diffuse background slowing on day one, which evolved into "alpha coma" and later into "spindle coma" over the ensuing two days. Such EEG transition is hitherto undescribed in patients with hepatic encephalopathy and gives fresh insight into the etiopathogenesis of specific EEG patterns in diffuse encephalopathy.
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    Brain Tumor Segmentation by Integrating Symmetric Property with Region Growing Approach
    (2015 ANNUAL IEEE INDIA CONFERENCE (INDICON), 2015) Gupta, M; Gayatri, KS; Harika, K; Rao, BVVSNP; Rajagopalan, V; Das, A; Kesavadas, C
    Brain tumor segmentation is an important procedure for early diagnosis of brain tumor and planning of its treatment. However it is still a difficult task due to variations in size, shape and location of tumor. In this paper, we propose a novel brain tumor segmentation method using T2-weighted brain MR images by integrating symmetry property of brain with region growing approach. Bilateral symmetry property of brain is used in our method to identify various regions having probability of presence of the tumor. Identification of exact tumor location and its segmentation is then performed by using region growing technique. Qualitative and quantitative evaluation of proposed approach was performed and promising results have been demonstrated when compared with ground truth and other state of art method. The segmented tumor region obtained in our work can assist the doctors and radiologist in the diagnosis of brain tumor and treatment planning.
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    Factors affecting treatment-seeking for febrile illness in a malaria endemic block in Boudh district, Orissa, India: policy implications for malaria control
    (MALARIA JOURNAL, 2010) Das, A; Ravindran, TKS
    Background: Orissa state in eastern India accounts for the highest malaria burden to the nation. However, evidences are limited on its treatment-seeking behaviour in the state. We assessed the treatment-seeking behaviour towards febrile illness in a malaria endemic district in Orissa. Methods: A cross-sectional community-based survey was carried out during the high malaria transmission season of 2006 in Boudh district. Respondents (n = 300) who had fever with chills within two weeks prior to the day of data collection were selected through a multi-stage sampling and interviewed with a pre-tested and structured interview schedule. Malaria treatment providers (n = 23) were interviewed in the district to gather their insights on factors associated with prompt and effective treatment through a semi-structured and open-ended interview guideline. Results: Majority of respondents (n = 281) sought some sort of treatment e. g. government health facility (35.7%), less qualified providers (31.3%), and community level health workers and volunteers (24.3%). The single most common reason (66.9%) for choosing a provider was proximity. Over a half (55.7%) sought treatment from appropriate providers within 48 hours of onset of symptoms. Respondents under five years (OR 2.00, 95% CI 0.84-4.80, P = 0.012), belonging to scheduled tribe community (OR 2.13, 95% CI 1.11-4.07, P = 0.022) and visiting a provider more than five kilometers (OR 2.04, 95% CI 1.09-3.83, P = 0.026) were more likely to have delayed or inappropriate treatment. Interviews with the providers indicated that patients' lack of trust in community volunteers providing treatment led to inappropriate treatment-seeking from the less qualified providers. The reasons for the lack of trust included drug side effects, suspicions about drug quality, stock-outs of drugs and inappropriate attitude of the provider. Conclusion: Large-scale involvement of less qualified providers is suggested in the malaria control programme as volunteers after appropriate capacity development since the community has more trust in them. This should be supported by uninterrupted supply of drugs to the community volunteers, and involvement of the community-based organizations and volunteers in the planning, implementation, and monitoring of malaria control services. There is also a need for continuous and rigorous impact evaluations of the program to make necessary modifications, scale up and to prevent drug resistance.
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    Neurologic disability: A hidden epidemic for India. (Global Perspectives)
    (Neurology, 2012-11) Das, A; Botticello, AL; Wylie, GR; Radhakrishnan, K
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    NEUROLOGIC DISABILITY: A HIDDEN EPIDEMIC FOR INDIA
    (NEUROLOGY, 2012) Das, A; Botticello, AL; Wylie, GR; Radhakrishnan, K
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    Perilesional brain oedema and seizure activity: cause or effect?
    (LANCET NEUROLOGY, 2009) Das, A; Kesavadas, C
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    Post-stroke Fatigue is an Independent Predictor of Post-stroke Disability and Burden of Care: A Path analysis Study
    (TOPICS IN STROKE REHABILITATION, 2016) Mandliya, A; Das, A; Unnikrishnan, JP; Amal, MG; Sarma, PS; Sylaja, PN
    Post-stroke fatigue (PSF) is a common and one of the most distressing symptoms in stroke survivors. However, little is known about the relationship between severity of fatigue and the overall impact it has on post-stroke disability and burden of care. We aimed to examine the role of PSF in post-stroke disability and burden of care among stroke survivors after their first-ever stroke. Methods: We prospectively recruited 163 subjects (35 females) from patients examined consecutively in a tertiary stroke care center in India, after their first-ever ischemic or hemorrhagic stroke (>3 months after event). In addition to demographic and clinical characteristics, the following assessments were done - SF-36 vitality domain (fatigue), Modified Rankin Scale (functional recovery), Hospital anxiety and depression scale (depression), Functional independence measure (disability and burden of care). We used path analysis to identify a model that will capture the interactions of fatigue, depression, and degree of functional recovery in stroke survivors. Results: The severity of PSF positively correlated with the severity of disability and PSF had significant contribution to disability over and above functional recovery and depression, with all three factors accounting for 43% of the variance. Among the four models that were proposed to explore these relationships, the best fitting model showed that the effect of PSF is mediated through both the direct effect of fatigue on disability and through its interaction with depression, which remained a separate contributor to post-stroke disability and burden of care. Conclusions: PSF, therefore, is an important determinant of post-stroke disability and should be evaluated for successful post-stroke rehabilitation.
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    Reduced plastic brain responses to repetitive transcranial magnetic stimulation in severe obstructive sleep apnea syndrome
    (SLEEP MEDICINE, 2013) Das, A; Anupa, AV; Radhakrishnan, A
    Objectives: Abnormalities in cortical excitability have been proposed to underlie the pathophysiology of various neurocognitive manifestations of obstructive sleep apnea syndrome (OSAS). Transcranial magnetic stimulation (TMS) provides a noninvasive method for study and modulation of cortical excitability in the human brain, and repetitive TMS (rTMS) has been proven useful for neurophysiologic investigation in various neurologic conditions. We aimed to investigate cortical excitability in patients with OSAS during wakefulness and to determine if rTMS would change the abnormal excitability patterns. Methods: Measures of motor cortical and corticospinal excitability (resting motor threshold [RMT], motor-evoked potential [MEP] amplitude, and cortical silent period [CSP]) were taken before and after a session of 10-Hz rTMS applied to the motor cortex in 13 individuals with untreated severe OSAS (apnea-hypopnea index [AHI] > 30) and 12 age- and sex-matched healthy controls (HC). Results: OSAS subjects had a significantly higher RMT (P < .003) and a longer CSP duration (P < .002) compared to HC. No difference was observed between MEP values of OSAS subjects and HC (P > .05). In response to rTMS, the HC group had a significant increase in CSP and MEP values from baseline, which were absent in OSAS subjects. Conclusions: Individuals with OSAS demonstrated increased motor cortex inhibition, which did not respond to 10-Hz rTMS. As rTMS-induced changes in MEP and CSP involve a separate neurotransmitter system (N-methyl-D-aspartate [NMDA] and gamma-aminobutyric acid [GABA], respectively), these findings suggest a widespread alteration in cortical neurophysiology in severe OSAS subjects that requires clarification with further exploration. (c) 2013 Elsevier B.V. All rights reserved.
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    Teaching NeuroImages: Floppy eyelids in obstructive sleep apnea syndrome
    (NEUROLOGY, 2011) Das, A; Radhakrishnan, A
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    Volumetric Segmentation of Brain Tumor Based on Intensity Features of Multimodality Magnetic Resonance Imaging
    (2015 INTERNATIONAL CONFERENCE ON COMPUTER, COMMUNICATION AND CONTROL (IC4), 2015) Gupta, M; Rao, BVVSNP; Rajagopalan, V; Das, A; Kesavadas, C
    Brain tumor segmentation is a very difficult task due to vast diversity in appearance of tumor tissues among different patients and huge variations in their size and shape. In this paper, we proposed an approach which focuses on volumetric segmentation of brain tumor in three dimensions using multiple modalities of MRI brain volume including T1-weighted, T2-weighted and T1-contrast enhanced data set. Since these modalities have different contrasts for same tissue type we combined them to develop a robust segmentation approach. Qualitative and quantitative assessment of our segmentation algorithm was performed which demonstrates that proposed algorithm performs well in comparison with ground truth and other state of art methods. Proposed work provides 3D visualization of segmented tumor volume which can assist the doctors and radiologist in the diagnosis of brain tumor, as it gives information about tumor location and its features.