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Item Risk factors, etiology, and predictors of outcome in young patients with ischemic stroke(SCTIMST, 2022) Gaddam Balaswamy ReddyItem Item A study on predictors of outcome and recurrence risk in embolic stroke of undetermined source(SCTIMST, 2022) Jithin GeorgeItem Neuropsychological and imaging predictors of longitudinal cognitive trends in Mild Cognitive Impairment (MCI)(SCTIMST, 2021) Prashanth PouloseItem Correlation between pulsatility index in transcranial doppler and post stroke outcomes in patients with acute lacunar strokes(SCTIMST, 2021) Naveen Kumar, PItem Juvenile myoclonic epilepsy: long term outcome and its predictors- a hospital based cohort study(SCTIMST, 2021) Harini PavuluriItem Electro-clinical and radiological predictors of outcome in super refractory status epilepticus(SCTIMST, 2021) Jithu JoseItem A comparative study on clinical and radiological profile of nmo spectrum disorders and mog antibody associated demyelination(SCTIMST, 2021) Lotlikar Radhika SanjayItem Predictors of leptomeningeal collaterals and correlation with outcome in acute ischemic stroke(SCTIMST, 2021) Sharath Chandra ShettyItem A retrospective study on pregnancy in myasthenia gravis(SCTIMST, 2020-12-31) Harikrishnan R.Item Comparitive study of motor unit number estimation in amyotrophic lateral sclerosis and post polio paralysis(SCTIMST, 2020-12-31) Jaffar Vali SayyedItem Locus of control in patients with chronic epilepsy(SCTIMST, 2020-12-31) Vijay Kumar B.Item High resolution mr vessel wall imaging in the diagnosis of intracranial vasculopathy due to middle cerebral artery disease(SCTIMST, 2020-12-31) Vaibhav TandonItem Item Accelerated long-term forgetting and autobiographical amnesia in temporal lobe epilepsy.(SCTIMST, 2020-12-31) Pavan Kumar RudrabhatlaItem Prognostic indicators in guillain barre syndrome with special reference to serum albumin(SCTIMST, 2019-12) Poornima Narayanan NambiarGuillain Barre syndrome (GBS) is a common cause of neuromuscular paralysis, the annual incidence of which is reported to be 0.81–1.89 per 100,000 person–years.1 It is characterised by the combination of rapidly progressive symmetrical weakness in the limbs with or without sensory disturbances, hypoflexia or areflexia, with or without involvement of respiratory muscles or cranial nerve-innervated muscles, with or without autonomic dysfunction, in the absence of a CSF cellular reaction. 2 According to the clinical criteria, maximum weakness is reached within 4 weeks, but most patients usually reach their maximum weakness within 2 weeks.34 Patients then have a plateau phase of varying duration, ranging from 2 days to 6 months (median duration 7 days), followed by a usually much slower recovery phase. 4,5. In patients with GBS who have inability to walk (severely affected patients), about 25% eventually need artificial ventilation because of weakness of the respiratory muscles. Despite treatment with IVIg or Plasma exchange, about 20% of severely affected patients remain unable to walk after 6 months. 6 Hence, the prognosis of GBS is tough to predict because of the considerable variation in outcome. In the past few decades, the GBS Disability Scale by Hughes et al has been used as an outcome scale in the majority of clinical trials in GBS. 7 Nevertheless, it is essential to foresee the outcome of GBS, as those likely to have a severe disease may require more aggressive therapy. Certain indicators postulated to be of prognostic significance are - higher age (>40 or >50 years), preceding diarrhoea, severe weakness with consequent low MRC score on admission and high early GBS disability grade. Electrophysiologically, the most consistently described finding predictive of poor outcome has been low mean or summated CMAPs. 7,8 The Erasmus GBS outcome score has been used to predict inability to walk independently after 6 months, and consists of—the GBS disability score at 2 weeks after admission, age and presence of preceding diarrhea. 9 Hence, the current prognostic models are based predominantly on clinical features, but there is a lack of a serologic biomarker to enhance these models. At present no biomarkers are available to assess the extent of peripheral nerve damage or to predict outcomes in immune-mediated neuropathies. Serum albumin has already been established as a prognostic marker in various pathological conditions like amyotrophic lateral sclerosis, cancer,in geriatric long-term care facility residents,individuals undergoing surgical interventions,patients with kidney disorders, and predicts failure of IVIG therapy in Kawasaki disease. It is unclear whether in these conditions albumin levels are a marker of patients’ nutritional status or chronic inflammatory state, which decreases the hepatic synthesis of albumin through the production of proinflammatory cytokines 10 . In this study, we aim to ascertain if serum albumin levels can serve as a prognostic biomarker in patients with GBS. This would help in anticipating treatment outcomes, and in deciding which patients need early and more aggressive therapy in clinical practiceItem A clinical study on the utility of muscle biopsy in patients with suspected myopathy(SCTIMST, 2019-12) Sudhakar KMyopathy is one of the common disorders in patients attending neuromuscular clinic. Systematic approach comprising a comprehensive clinical history, thorough neurological and systemic examination, nerve conduction studies, EMG and relevant biochemical tests should be undertaken in all cases. Muscle biopsy is one of the most frequently used diagnostic procedures in the evaluation of inherited and acquired myopathies. The yield of muscle biopsy result is dependent on number of factors, including appropriate selection of patients for biopsy, expertise of the laboratory, and techniques used in the analysis. The history of muscle biopsy dates back to 1860 when Duchenne first performed a biopsy on a patient with symptoms of myopathy. Introduction of enzyme histochemical methods by Victor Dubowitz in 1970 revolutionised the role of muscle biopsy in the diagnosis of various primary and secondary muscle diseases(7). Diagnosis of various subtypes of dystrophies was further made easy with beginning of immunohistochemical methods in 1980s However, there are few modern reports documenting the diagnostic yield and clinical utility of open muscle biopsy.(1-5) Clinicians usually rely on personal experience to develop their own criteria for performing muscle biopsy. This may explain the variable diagnostic outcome of muscle biopsy found in previous cohorts which ranged from 13.2% to 59.9%.(8,9). In most of the proximal myopathies and generalised/systemic diseases; vastus lateralis is the standard muscle biopsied by international consensus. (6) The other muscles that are good choices for biopsy are biceps and gastrocnemius. However, many forms of hereditary muscle disorders can now be diagnosed with molecular genetic testing, thereby eliminating the need for performing a muscle biopsy in every patient. In this study, we evaluate the clinical utility of muscle biopsy in patients with suspected myopathy. The primary objective is to determine the diagnostic value of muscle biopsy, as measured by the probability of specific myopathy and depending on the available pre procedure clinical and laboratory dataItem Correlation between pulsatility index (pi) in transcranial doppler (tcd) and cognitive profile of patients with alzheimer’s dementia and vascular dementia(SCTIMST, 2019-12) Saraf Udit UmeshThe World Health Organization (WHO) predicts that by 2025, about 3/4th of the estimated 1.2 billion people aged >60 years will reside in developing countries1 . 4.6 million new cases of dementia are added every year, and the highest rate of growth is expected in South Asian countries including India. Education attainment is known to protect against dementia. Diet and lifestyle can also influence risk of dementia, and studies suggest that disorders affecting the vascular system, such as hypertension, diabetes mellitus and obesity, increase the risk for dementia, including Alzheimer's disease (AD). There is increasing evidence linking cerebral hypoperfusion and neurodegeneration, specifically in Alzheimer’s disease (AD) and vascular dementia (VaD)2 . In the Rotterdam study3 , cerebral hypoperfusion was demonstrated to be a risk or an aggravating factor in dementia. Hypoperfusion because of microangiopathy, macroangiopathy or cardiac dysfunction can promote or accelerate neurodegeneration, blood-brain barrier disruption and neuroinflammation.4 Diagnostic tools that can provide real-time functional assessment of the cerebrovascular tree can have a significant impact on our understanding of the vascular contribution to neurodegeneration at different stages of cognitive decline. Ultrasound can evaluate the cerebrovascular tree for pathological structure and functional changes contributing to cerebral hypoperfusion. Studies have shown an association between leukoaraiosis and transcranial doppler (TCD) pulsatility index (PI) in several kinds of patients.5 Despite increasing evidence supporting the utility of these methods in detection of microvascular pathology, cerebral hypoperfusion, neurovascular unit dysfunction and disease progression, non-availability for routine use and incomplete standardisation limit their use in daily routine. Studies have evaluated the utility of Middle cerebral artery-Pulsatility index (MCA PI) to differentiate between AD and VaD and have found conflicting results.6 PI has been correlated with severity of cognitive decline in few studies. Studies have also evaluated correlation of PI with decline in cognition. However, correlation of PI with detailed cognitive profile has not been evaluated. In this background, we planned our study to assess whether MCA PI can be used to differentiate between patients with AD and VaD. Also, we propose that increase in PI correlates with severity of cognitive deficit in patients with dementia.