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Pathogenesis Primary brain stem injury is the result of the direct effect of the trauma which results in its distortion and displacement. Kalyanaraman and Ramamurthi (1969) reported 42 cases of brain stem injury among 1100 cases of head injury patients admitted to their head injury unit in 18 months.[[1]] As late at 2007, Shukla et al. stated, "Several autopsy studies of head injury are available, but pathology of brain stem and hypothalamus injury are addressed in very few of them. "In many general surgical works today the diagnosis of primary brain stem injury amounts to pronouncement of death sentence" (Kalyanaraman and Ramamurthi 1969) It is interesting that around the same time as the above statement on ominous saying in some centers in Delhi acquired a similar predicament, "Yeh to brain stem ho gaya ab iska kuch nahi ho sakta" (He has become brain stem, now nothing can be done about it). While brain stem hemorrhage is more common in the secondary group of brain stem lesions, these are not uncommon in the primary injury especially in the lateral part of the mid-brain, the superior cerebellar peduncle, and rostral pons. [Extracted from the article]

The article presents summaries of articles on neuroscience, published as of March 2018. Topics include impact of postoperative bracing on pain and quality of life after posterior spinal instrumented fusion (PSIF), implantation of an empty polyetheretherketone cage in anterior cervical discectomy and fusion, and comparison between tubular discectomy and conventional microdiscectomy for the treatment of lumbar disc herniation.

Background: Bibliometric analyses allow detecting citation trends within a field, including assessments of the most cited journals, countries, institutions, topics, types of study, and authors.Objective: The aim of this study was to perform a bibliometric analysis of the 100 most cited papers within infectious meningitis research.Materials and Methods: The 100 most cited publications and their data were retrieved from Scopus and Web of Science during 2019.Results: The New England Journal of Medicine had the greatest number of articles (27) and citations (12,266) in the top 100. Articles were mainly published after the late 1980s. Bacteria were the most discussed agents (72 articles and 26,362 citations), but Cryptococcus sp represented the most-discussed single agent (16 articles and 6,617 citations). Primary research represented 70 articles and 25,754 citations. Among them, the most discussed topic was Clinical Features and Diagnosis/Outcomes (22 articles and 8,325 citations). Among the 27 secondary research articles, the most common type of study was Narrative Review (18 articles and 5,685 citations). The United States was the country with the greatest number of articles (56) and citations (21,388). Centers for Disease Control and Prevention (CDC) and Yale University had the greatest number of articles (six each), being CDC the most cited (3,559).Conclusions: The most cited articles within meningitis research are primary research studies, more frequently published in high IF journals and by North American institutions. Bacterial meningitis comprises the majority of publications. The articles were mainly published after the AIDS pandemic and after the implementation of the main vaccines for meningitis. [ABSTRACT FROM AUTHOR]

Objective: This study analyses the research output in India in neurosciences during the period 1999-2008 and the analyses included research growth, rank, global publications' share, citation impact, share of international collaborative papers and major collaborative partner countries and patterns of research communication in most productive journals. It also analyses the characteristics of most productive institutions, authors and high-cited papers. The publication output and impact of India is also compared with China, Brazil and South Korea. Materials and Methods: Scopus Citation database was used for retrieving the publications' output of India and other countries in neurosciences during 1999-2008. Results: India's global publications' share in neurosciences during the study period was 0.99% (with 4503 papers) and it ranked 21st among the top 26 countries in neurosciences. The average annual publication growth rate was 11.37%, shared 17.34% of international collaborative papers and the average citation per paper was 4.21. India was far behind China, Brazil and South Korea in terms of publication output, citation quality and share of international collaborative papers in neurosciences. Conclusion: India is far behind in terms of publication output, citation quality and share of international collaborative papers in neurosciences when compared to other countries with an emerging economy. There is an urgent need to substantially increase the research activities in the field of neurosciences in India. [ABSTRACT FROM AUTHOR]

This review article highlights the necessity and importance of peer review of articles submitted to journals. Publication in a peer reviewed, good impact indexed journal is an indirect endorsement of the article contents. The editor and the readership depend on the integrity and total involvement of reviewers. What is expected of the reviewer and the authors is discussed. Reviewers need to be sensitive to authors' reactions. Authors should also respond, not react or be hypersensitive. [ABSTRACT FROM AUTHOR]

Background: Traumatic injury to the spine can be a complex diagnostic and therapeutic entity often with devastating consequences. Outside of the isolated vertebral column injury costs; annual costs associated with spinal cord injury (SCI) are estimated to exceed $9.7 billion.Objective: To identify the 100 most-cited articles on spine trauma.Methods: The Thomson Reuters Web of Science citation indexing service was queried. The articles were sorted by times cited in descending order. Two independent reviewers reviewed the article titles and abstracts to identify the top 100 most-cited articles.Results: The top 100 articles were found to be cited between 108 (articles #99-100) and 1595 times (article #1). The most-cited basic science article was cited 340 times (#12 on the top 100 list). The oldest article on the top 100 list was from 1953 and most recent from 2012. The number of patients, when applicable, in a study ranged from 9 (article #34) to 34,069 (article #5). Top 100 articles were published in 41 different journals with a wide range of specialities and fields most commonly multidisciplinary. Basic science research encompassed 34 of the 100 articles on the list.Conclusions: We present the 100 most-cited articles in spinal trauma with emphases on important contributions from both basic science and clinical research across a wide range of authors, specialties, patient populations, and countries. Recognizing some of the most important contributions in the field of spinal trauma may provide insight and guide future work. [ABSTRACT FROM AUTHOR]

A response from the author of the article "Highest cited papers published in Neurology India: An analysis for the years 1993-2014" in the November 2016 issue is presented.

In 1896 Joseph François Felix Babinski described for the first time the phenomenon of the toes; nevertheless in this first paper he simply described extension of all toes with pricking of the sole of the foot. It was not until the second paper of 1898 that he specifically described the extension of the hallux with strong tactile stimulation (stroking) of the lateral border of the sole. Babinski probably discovered his sign by a combination of chance observation and careful re-observation and replication. He also had in mind practical applications of the sign, particularly in the differential diagnosis with hysteria and in medico-legal areas. Several of the observations and physiopathological mechanisms proposed by Babinski are still valid today, e.g, he realized since 1896 that the reflex was part of the flexor reflex synergy and observed that several patients during the first hours of an acute cerebral or spinal insult had absent extensor responses. He also found that most patients with the abnormal reflex had weakness of dorsiflexion of the toes and ankles and observed a lack of correlation between hyperactive myotatic reflexes and the presence of an upgoing hallux. He discovered that not all patients with hemiplegia or paraplegia had the sign but thought erroneously that some normal subjects could have an upgoing toe. Between 1896 and 1903 Babinski continued to think on the sign that bears his name and enrich its semiological and physiopathological value. [ABSTRACT FROM AUTHOR]

The article discusses the summaries of several published seminal papers in neuroscience. Topics mention including the comparison regarding the effectiveness of the revascularization procedure in pediatric and adult patients with moyamoya disease, comparative study between carotid artery stenting and carotid endarterectomy and predictive factors of the postoperative seizures in pediatric patients.

The article discusses the evolution regarding the management of brain stem gliomas (BSG) surgery. Topics mention including recognizing the clinical challenge in resecting the brainstem tumors by Harvey Cushing, identifying the BSG through modern classification and influenced of intraoperative imaging.

The article focuses on the study of neurovascular syndromes. It mentions that pulsatile propulsion of blood through blood vessels help in the circulation and transport of oxygen and nutrients. It mentions that pulsatile impulse by the heart in the cardiac cycle improves the pressure-related events to capillaries.

Objective: Guillain-Barre Syndrome (GBS) is an acute inflammatory polyradiculoneuropathy causing limb weaknesses. The mortality is around 8%, with about 20% of patients remaining disabled. The purpose of this study is to examine the performance of Indian Medical Scientists in the area of GBS over a period of 40 years. India's contribution to GBS has been examined based on the global publication output and share, growth rate, citation impact, publication share in various field, highly cited papers and their impact, most productive authors and their citation impact and collaboration of research on GBS with the international community . Materials and Methods: The data for this study has been taken from Scopus, a multidisciplinary database using keywords GBS and Miller Fisher Syndrome. The contribution of India on GBS has been compared with different countries for its publication and citation count during a period of 40 years (1973-2012). Results: It is found that there were 10,633 publications available from global medical research covering the various aspects of GBS. India's share is 2.92% of global output and holds 10th rank in overall publication output on GBS, whereas United States topped the rank with the highest number of publications. Sanjay Gandhi Post-graduate Institute of Medical Research, Lucknow is the most productive institutions while Tally AB from the National Institute of Mental Health and Neurosciences, Bangalore is the most productive author who has contributed the highest number of papers on GBS. Conclusion: India is far behind in GBS research as compared to other countries like USA, as there might be a low case report of GBS in Indian population. Still the research focusing this disease is quite prominent and needs a careful medical attention through research capacity building in order to look for better treatment of the disease in Indian cases. This study shall be helpful in enhancing the awareness of the GBS by Indian scientists. [ABSTRACT FROM AUTHOR]

The article presents summaries of several neuroscience-related papers published in various journals. One paper in the March 2015 issue of the "Journal of Neurosurgery" describes an augmented reality system developed for image-guided neurosurgery. An editorial in Volume 76 of "Neurosurgery" focuses on the role of early endovascular intervention in acute stroke patients.

The article presents abstracts of seminal papers in neurosciences topics which include effect of radiosurgery versus radiosurgery in a whole brain radiation therapy on cognitive function in patients with brain metastases, predictors of biochemical remission and statin therapy and parkinson disease.

Context: The highest cited papers published in a journal provide a snapshot of the clinical practice and research in that specialty and/or region.Aims: The aim of this study was to determine the highest cited papers published in Neurology India and analyze their attributes.Setting and Design: This study was a citation analysis of all papers published in Neurology India since online archiving commenced in 1993.Methods: All papers published in Neurology India between the years 1993-2014 were listed. The number of times each paper had been cited up till the time of performing this study was determined by performing a Google Scholar search. Published papers were then ranked on the basis of total times cited since publication and the annual citation rate. Statistical Techniques: Simple counts and percentages were used to report most results. The mean citations received by papers in various categories were compared using the Student's t-test or a one-way analysis of variance, as appropriate. All analyses were carried out on SAS University Edition (SAS/STAT®, SAS Institute Inc, NC, USA) and graphs were generated on MS Excel 2016.Results: The top papers on the total citations and annual citation rate rank lists pertained to basic neuroscience research. The highest cited paper overall had received 139 citations. About a quarter of the papers published had never been cited at all. The major themes represented were vascular diseases and infections.Conclusions: The highest cited papers reflect the diseases that are of major concern in India. Certain domains such as trauma, allied neurosciences, and basic neuroscience research were underrepresented. [ABSTRACT FROM AUTHOR]

The article presents abstracts on medical topics including a comparison of transforaminal endoscopic discectomy and microdiscectomy, the effect of lordotic correction on C5 palsy after cervical laminectomy and fusion, and mechanical thrombectomy following intravenous alteplase after stroke.

A response from the author of the article about the cited papers published in Neurology India, in the November 2016 issue is presented.

The article presents several abstracts on neuroscience including the mortality of patients with right hemispheric intracerebral haemorrhage, the efficacy of nonvenous medications for acute convulsive seizures and the role of magnesium sulfate in the treatment of eclampsia.

The global increase in the number of Alzheimer's disease (AD) patients has posed numerous treatment challenges. Six Food and Drug Administration-approved medications (e.g., donepezil and memantine) have demonstrated some efficacy but are primarily used to alleviate symptoms. The etiology of AD is unknown, and the blood-brain barrier restricts drug penetration, which severely restricts the use of various therapeutic agents. With their high targeting, long-lasting effect, and multifunctionality, inorganic nanomaterials provide a novel approach to the treatment of AD. A review of inorganic nanoparticles in the diagnosis and therapy of AD. This paper reviews the research literature on the use of inorganic nanomaterials in the treatment of AD. Gold nanoparticles, superparamagnetic iron oxide nanoparticles, magnetic nanoparticles, carbon nanotubes, and quantum dots are among the inorganic nanomaterials studied. As knowledge of the origins of AD remains limited, the majority of studies on inorganic nanomaterials have primarily focused on interventions on Aβ proteins. Adjusting and enhancing the properties of these inorganic nanomaterials, such as core-shell structure design and surface modification, confer benefits for the treatment of AD. Inorganic nanoparticles have a wide spectrum of therapeutic potential for AD. Despite their potential benefits, however, the safety and translation of inorganic nanomaterials into clinical applications remain formidable obstacles. [ABSTRACT FROM AUTHOR]

I deem it a privilege to have been asked by Prof. P. Sarat Chandra, Editor, to write a Commentary on the paper mentioned above by Prof. Dastur et al., published half a century ago. Neurol India 2018;66:301-3. 3 Dastur DK, Lalitha VS, Udani PM, Parekh U. The brain and meninges in tuberculous meningitis-Gross pathology in 100 cases and pathogenesis. New Delhi: Indian Academy of Medical Sciences; 1973. p. 269-75. 66 Tandon PN, Pande A. (a) Tuberculosis of the central nervous system, (b) Tuberculous meningitis. [Extracted from the article]

Pituitary carcinoma is a rare entity comprising 0.1–0.2% of all pituitary tumors and presents significant diagnostic and therapeutic challenges. Intraspinal drop metastasis in these tumors is even rarer. We report a case of a prolactin secreting pituitary carcinoma with intracranial metastasis and multiple intraspinal drop metastasis. This is the first case where 68Gallium labelled [1,4,7,10 – tetraazacyclododecane – 1,4,7,10 – tetraacetic acid] -1- NaI3 - octreotide (68Ga-DOTANOC) whole-body positron emission tomography–computed tomography (PET-CT) has been used in a case of malignant prolactinoma, in an attempt to ascertain the somatostatin receptor (SSTR) expression on tumor cells. Through this paper, we suggest that SSTR targeted radionuclide therapy could have a potential role in aggressive pituitary tumors and pituitary carcinomas similar to the promising role of lutetium-labelled peptides in inoperable or metastasized gastroentero-pancreatic neuroendocrine tumors (GEP-NETs). [ABSTRACT FROM AUTHOR]

Introduction of international consensus criteria (2015 IPND criteria) for neuromyelitis optica spectrum disorders (NMOSDs) has improved diagnostic accuracy for aquaporin 4 (AQP4)-IgG-associated and seronegative NMOSDs. This study aimed to review relevant publications related to the incidence and prevalence of NMOSDs and provide an updated review of the global epidemiology of NMOSDs in the light of new diagnostic criteria. A comprehensive literature search was performed from January 2015 to June 2021 by using appropriate keywords in PubMed, Scopus, and Web of Science. Relevant papers that fulfilled inclusion criteria were shortlisted and reviewed. Twenty-one papers were selected for this review. Incidence of NMOSDs was 0.04-0.25/100,000 in predominantly white and 0.34-1.31/100,000 in nonwhite populations. Prevalence was 0.70-1.91/100,000 in white and 0.86-4.52/100,000 in nonwhite populations. The 2015 IPND criteria significantly improved the incidence and prevalence rates for NMOSDs when compared to the Wingerchuk 2006 criteria. Incidence of MOG-IgG-associated NMOSDs was 0.12-0.13/100,000, with prevalence in children 0.03-1.4/100,000 and in adults 0.65-2/100,000. In this systematic review, studies that used uniform diagnostic criteria and confirmed cases after testing for AQP4-IgG were included. The prevalence of NMOSDs was estimated to be <5/100,000 globally. A clear bias was seen in favor of nonwhite and indigenous populations. This review highlights the need for prospective population-based epidemiological studies and the importance of surveys in nonwhite populations around the globe. [ABSTRACT FROM AUTHOR]

Background: Medicine has begun adapting to new information-sharing paradigms in the hyper-connected social media era. In this milieu, the role of journal websites in the dissemination of clinical and research information needs to be reevaluated. Objective: We sought to explore whether reader engagement with neurosurgical journal websites, reflected by the number of article views and downloads, correlated with the eventual number of citations received by the articles. Methods: The websites of all Medline indexed neurosurgical journals were screened to identify those that provided information regarding the number of abstract and full text views and downloads. Articles published in these journals between July 2010 and June 2011 were included in this analysis. Various article attributes were identified and the number of citations per article was obtained from Google Scholar. The impact factors of the selected journals for the year 2010 were obtained from the Journal Citation Reports. Results: Twenty-two journals that had published 2527 articles were finally included in this analysis. The number of abstract views, full-text views, and downloads all correlated strongly with the journal impact factors in 2010 as well as the eventual citations per article. The number of article downloads independently predicted the citations per article on multivariate analysis. Neurology India had significantly higher article views and downloads but lower citations per article than the other journals. Conclusions: Readers were found to engage significantly with neurosurgical journal websites and therefore, open access to articles would lead to increased visibility of articles, resulting in higher citation rates. [ABSTRACT FROM AUTHOR]

Background: Incidental diagnosis of saccular aneurysms is more common with the advent of imaging techniques. Because of the severe morbidity and mortality that they can cause, treatment is chased for them, either microsurgical treatment or endovascular, even when they are diagnosed incidentally. Carotid cave aneurysms are rare, and they seem to have a more benign course compared to other intracranial aneurysms, probably related to the physical enveloping effect of the surrounding structures. Yet, their microsurgical treatment is a serious challenge technically for the neurosurgeon, with its severe morbidity and mortality for the patient. Endovascular techniques have their risks, too. Purpose: In this paper, we analyzed and presented our series of incidentally diagnosed carotid cave aneurysms. Materials and Methods: The age, gender of patients, the size, laterality, and MR angiographic follow-up of aneurysms were reported. Their clinical results were noted. Results: Fifty-six patients who had incidentally been diagnosed with 59 carotid cave aneurysms were followed up. No patient was microsurgically treated, but 15 patients had endovascular treatment for 15 aneurysms. The mean size of 15 treated aneurysms was 4.6 ± 2.1 (range = 2-10) mm, and it was 3.0 ± 1.5 (range = 1.7-10) mm for the untreated aneurysms (n = 44). There was no significant difference between the follow-up times of the treated and untreated groups (P = 0.487). The median follow-up of 59 aneurysms in 56 patients was 52 (mean = 49.6 ± 27.9, range = 1-124) months, with a total follow-up of 244 aneurysm years. None of the patients had subarachnoid hemorrhage related to carotid cave aneurysms during follow-up, and none of the aneurysms had shown growth. Two patients who had endovascular treatment had ischemic complications with minor neurologic deficits. Conclusion: Follow-up can be a reasonable option for the incidental aneurysms that are located and confined to the carotid cave. Additionally, TOF might be a reliable method for follow-up imaging of carotid cave aneurysms. [ABSTRACT FROM AUTHOR]

Objective: To identify and characterize the top-cited articles on idiopathic intracranial hypertension.Methods: We used "Web of Science database" to identify the top-cited articles published between the years of 1975-2017. The articles were evaluated using citation count and other factors that have an effect on the citation count.Results: The search yielded a total of 2,141 articles and the most frequently cited articles received between 58-476 citations. Most articles were published between the years 1990-1999. The most popular study design involved natural history studies. USA ranked first in productivity with 72 articles and the leading institution was University of Iowa. The journal "Neurology" published the greatest number of articles. In assessing the specialties, neurology contributed to 32% of top 100 articles. There was no correlation between the citation count and number of references, years since publication, number of authors, authors' H-index, and number of institutions that had collaborated. There were positive correlations between the citation count and journal impact factor, Scimago journal rank and journal source-normalized impact per paper values. While descriptive keywords were more frequent between 1980s and 1990s, keywords describing surgical management options such as "nerve sheath decompression" and "cerebrospinal-fluid diversion" were top-listed keywords after the year 2000.Conclusions: Our study can help researchers identify the most significant and impactful articles on idiopathic intracranial hypertension, as well as to provide insight into the most noteworthy scientific trends and to visualize future research needs of the topic. [ABSTRACT FROM AUTHOR]

There is a plethora of papers on the role of stereotactic radiosurgery (SRS) in various benign and malignant intracranial tumors, and it is possible to overlook the most important and landmark studies. Thus, the necessity of citation analysis arises, which reviews the most cited articles and recognizes the impact made by these articles. Utilizing the 100 most cited articles describing the use of SRS for intracranial and spinal pathologies, this article aims to provide meaningful information regarding the historical trends and recent directions in which this field is headed. We performed a search of the Web of Science database using the keywords “stereotactic radiosurgery,” “gamma knife,” “GKRS,” “gamma knife radiosurgery,” “LINAC,” and “Cyberknife” on May 14, 2022. Our search retrieved a total of 30,652 articles published between the years 1968 and 2017. The top 100 cited articles were arranged in descending order based on citation count (CC) and citation per year (CY). The journal with the largest number of publications as well as citation count was the International Journal of Radiation Oncology Biology Physics (n = 33), followed by Journal of Neurosurgery (n = 25). The most cited article was authored by Andrews, which was published in 2004 in The Lancet (1699 CC, 89.42 CY). Flickinger, with 25 papers and 7635 total citations, was the author with the highest impact. Lunsford, with 25 publications and total citations of 7615, was a close second. The USA was the leading country with the maximum number of total citations (n = 23,054). Ninety‑two articles described the use of SRS for intracranial pathologies (metastases, n = 38; AVM, n = 16; vestibular schwannoma, n = 9; meningioma, n = 8; trigeminal neuralgia, n = 6; sellar lesion, n = 2; glioma, n = 2; functional, n = 1; and procedure related, n = 10). Eight studies describing spinal radiosurgery were included, out of which four were on spinal metastases. Citation analyses of the top 100 articles revealed that the focus of research in the field of SRS started with functional neurosurgery and progressed to benign intracranial tumors and AVMs. More recently, central nervous system (CNS) metastases have received the maximum attention with 38 articles, including 14 randomized controlled trials finding a place in the top 100 cited articles. Presently, the use of SRS is concentrated in developed countries. Efforts need to be made for more widespread use in developing nations to bring the maximum possible benefits of this focused noninvasive treatment to a wider population. [ABSTRACT FROM AUTHOR]

The document is a reply to a letter discussing the correlation between reader engagement and article citations in neurosurgery journals. The authors emphasize the importance of traditional metrics in determining article viewership and citations, noting that social media sharing often redirects to journal websites. They explain their focus on views correlating with citations and exclude open access journals due to limited citation data availability. The authors defend the narrow scope of their analysis and assert the validity of their results. [Extracted from the article]

Objective: The purpose of the study is to conduct the systematic review of literature available on resting-state functional MRI (fMRI) and brachial plexus injury.Methods: We reviewed all the literature that are available on PubMed; keywords used were resting state, brachial plexus injury, and functional imaging. The reference papers listed were also reviewed. The research items were restricted to publications in English. Some papers have also incorporated studies such as task-based fMRI and transcranial magnetic stimulation (TMS), but only resting-state studies were included for this review.Results: A total of 13 papers were identified, and only 10 were reviewed based on the criteria. The reviewed papers were further categorized on the basis of whether or not any surgical intervention was done. Seven papers have surgical management such as contralateral cervical 7 (CC7) neurotisation or intercostal nerve (ICN) musculocutaneous nerve (MCN) neurotisation.Conclusion: There is conclusive evidence showing that there is cortical reorganisation following brachial plexus injury in both birth and traumatic cases. The changes are restricted to some of the resting-state networks only (default mode network, sensorimotor network, in particular). However, no study till date has focused on a far more longitudinal approach at studying these changes. It will be interesting to see the exact time and effect of these changes. [ABSTRACT FROM AUTHOR]

A letter to the editor is presented in response to the article, about the cited papers in Neurology India, in the November 2016 issue.

Background: Disease-modifying agents like Pioglitazone have shown promising effects on neuroinflammation and homeostasis of amyloid plaques, but there is a lack of research papers providing conclusive evidence. Objectives: This study is aimed to determine the safety and efficacy of Pioglitazone in improving cognitive function in patients with mild-moderate Alzheimer's disease (AD). Materials and Methods: Trials published in the last 12 years were identified from PubMed, Scopus, Cochrane Central, and other trial registries. Five hundred twenty-five records were obtained, from which five studies were included for quantitative analysis. Studies comparing Pioglitazone with a suitable placebo or other oral hypoglycemic agent were considered for review. Data was extracted using a pretested form, which was followed by a risk of bias assessment (ROB) with Cochrane's ROB assessment tool. Results: This meta-analysis included studies where Pioglitazone (15–30 mg) was compared to other oral hypoglycemic agents, placebo, or diabetic diet for a minimum duration of 6 months. Pioglitazone did not show a statistically significant improvement in Alzheimer's Disease Assessment Scale-Cognitive Subscale (ADAS-Cog) scores [mean difference (MD): −1.16; 95% confidence interval (CI): −4.14–1.81]. By conducting sensitivity analysis with the removal of one study, significant efficacy was obtained [MD: −2.75; 95% CI: −4.84–−0.66]. The Wechsler Memory Scale-Revised logical memory I (WMS-R) scores had a significant improvement in the Pioglitazone group [MD: 2.02; 95% CI: 0.09–3.95]. Conclusion: Pioglitazone is a safe medication that has a promising effect in slowing the advancement of AD. [ABSTRACT FROM AUTHOR]

Background and Objective: Current recommendations prescribe either nicardipine or labetalol as the first-line treatment for acute hypertension due to ease of use, availability, and low price. However, it is unclear if these drugs have different effectiveness and safety profiles. This systematic review and meta-analysis aimed to compare the efficacy and safety of labetalol and nicardipine in patients with acute stroke. Materials and Methods: MEDLINE via PubMed, Scopus, Embase, and Google Scholar databases were electronically searched for the eligible publications from inception until March 2022. All full-text journal papers in English which compared the efficacy of nicardipine with that of labetalol on lowering blood pressure (BP; or treating hypertension) in all subtypes of acute stroke were included. The Cochrane Collaboration tool was used to assess the risk of bias. Data were analyzed using specific statistical methods. Results: Following the abstract and full-text screening, this meta-analysis included five retrospective cohorts and one prospective pseudorandomized cohort. Nicardipine's effect on time at goal BP was significantly superior to that of labetalol in patients with acute stroke (0.275 standardized mean difference [SMD], 95% confidence interval [CI]: 0.112-0.438, P = 0.001). The incidence of adverse events was significantly higher in the nicardipine group than that in the labetalol group. The pooled odds ratio (OR) was 1.509 (95% CI: 1.077-2.113, I2 = 0.00%, P = 0.757). The quality of included studies was found to be low. Conclusion: More prospective, comparative trials are needed to investigate the efficacy of BP management as well as clinical outcomes in acute stroke patients receiving continuous labetalol and nicardipine infusions. [ABSTRACT FROM AUTHOR]

Carpal tunnel syndrome (CTS) is a disease caused by compression of the median nerve passing through the wrist. Patients suffer from severe pain and paresthesis in the median nerve. Compression of the median nerve occurs, with prolonged working on keyboards (computer or laptop or music players) being one of the reasons along with others such as diabetes or rheumatoid arthritis. CTS research holds great promise for the patients as well as doctors for better medical treatment. The study has been carried out with an objective to analyze research progress based on the literature published on CTS during the last 35 years. The retrospective study has been carried out from the data indexed in SCOPUS multidisciplinary database from 1983 to 2017 (35 years). The study involves analysis of publication trends in terms of total articles, productive countries, institutions, journals, productive authors, most cited articles along with impact in terms of citation and h-Index. The SCOPUS database yielded 13187 articles during the study period. These articles were analyzed further for interpreting results. In the last 35 years, the number of scientific publications on CTS has been increasing with an annual growth rate of 9.86% per year. USA has been the most productive country. Literature pertaining to females is more than clinical studies involving males. [ABSTRACT FROM AUTHOR]

Prof B Ramamurthi was a pioneer of Indian neurosurgery and a major force in the development of Indian neuroscience. Founding the Madras Institute of Neurology and later the A Lakshmipathi Neurosurgical Centre (ALNC), both at Madras (or Chennai as it is now called), he developed centres of excellence in his career that spanned over five decades. During this period of time he made Madras, a destination for neurosurgery and neuroscience. Along with his colleagues a large number of publications were produced which influenced the world. Notable among his contributions were those in Stereotaxy for movement disorders, epilepsy, pain and psychiatric illness. He also had notable contributions in brain tumours especially acoustic neurinomas and pituitary tumours. His papers on the low incidence of aneurysms is still quoted widely. Head injuries formed a major part of the neurosurgical work and major contributions were made in that field too. As a developing country with socio-economic issues, infections of the nervous system were seen commonly. His publications on tuberculomas of the brain are noteworthy. He was intrigued by the neurophysiological basis of consciousness. He writings on the subject reflect his attempt to bring together ancient eastern thoughts and concepts of consciousness and life and western science. In the later part of his career he spoke on ethics in and the changing milieu of neurosurgery. While contributions to spinal surgery were not seen in the first half of his career, he along with his colleagues from ALNC published original articles on spinal surgery especially tumours and OPLL. Prof B Ramamurthi, has not only influenced, taught and mentored, during his lifetime, a great many neuroscientists, but he also continues to do so through his publications which continue to be relevant in todays world. A glimpse into his contributions show us how without the technology of today a lot was achieved - and we need to see that, to inspire us to achieve more and to strive for greater heights. [ABSTRACT FROM AUTHOR]

Background: The literature survey shows improvement in cognitive performance following acute bouts of physical exercise and chronic exercise patterns. However, neurocognitive growth through karate, a moderate intensity physical activity, is very limited. The synchronization of the nervous and endocrine system can be best reflected through this martial art form through neurogenesis and cognitive potentiation. Numerous outstanding reviews have summarized these findings for martial arts like judo and taekwondo. This review tries to orchestrate the efficiency of karate in neurocognition. Objective of the Study: The specific aim of this review paper is to magnify the efficiency of karate training in cognitive functions, through its response to neurochemical transmissions and electrophysiological signaling Materials and Method: Numerous related literature were evaluated, screened, and selected using the Preferred Reporting Items for Systematic reviews and Meta-Analyses eligibility criteria. All appropriate publications that satisfied the primary objective of the study were scientifically and schematically presented in this review paper. Results: The psychophysiological effect of karate training and their relation with brain functions have been elaborated. This review compiles the few studies established on the cognitive benefits of karate through the electrical stimuli and neurochemical release. Conclusion: Karate may be effective in advancement of particular brain functions and neurocognitive actions through a life time. Electrophysiological studies have unraveled improved neural efficiency, stress tolerance, working and muscle memory but need further exploration. Similarly, to better understand the effects of karate on neurochemical secretions, further research involvement is required. [ABSTRACT FROM AUTHOR]

Early detection of brain tumor has an important role in further developing therapeutic outcomes, and hence functioning in endurance tolerance. Physically evaluating the various reversion imaging (magnetic resonance imaging [MRI]) images that are regularly distributed at the center is a problematic cycle. Along these lines, there is a significant need for PC-assisted strategies with improved accuracy for early detection of cancer. PC-backed brain cancer detection from MR images including growth location, division, and order processes. In recent years, many inquiries have turned to zero in traditional or outdated AI procedures for brain development findings. Presently, there has been an interest in using in-depth learning strategies to detect cerebral growths with an excellent accuracy and heart rate. This review presents a far-reaching audit of traditional AI strategies and in-depth study methods for diagnosing brain cancer. This research paper distinguishes three main benefits i.e. exhibition, estimation and measurements of brain tumour detection. [ABSTRACT FROM AUTHOR]

Background: Currently, there is still no clear consensus on bridging thrombolysis (BT) before mechanical thrombectomy (MT). In this study, we aimed to compare clinical and procedural outcomes and complication rates of BT versus direct mechanical thrombectomy (d‑MT) in anterior circulation stroke. Methods: A total of 359 consecutive anterior circulation stroke patients who received d‑MT or BT in our tertiary stroke center between January 2018 and December 2020 were retrospectively analyzed. The patients were divided into two groups as Group d‑MT (n = 210) and Group BT (n = 149). The primary outcome was the impact of BT on clinical and procedural outcomes, whereas the secondary outcome was the safety of BT. Results: The incidence of atrial fibrillation was higher in the d‑MT group (p = 0.010). The median duration of the procedure was significantly higher in Group d‑MT than in Group BT (35 vs 27 min, respectively; P = 0.044). The number of patients achieving good and excellent outcomes was significantly higher in Group BT (p = 0.006 and P = 0.03). The edema/malign infarction rate was higher in the d‑MT group (p = 0.003). Successful reperfusion, first‑pass effects, symptomatic intra‑cranial hemorrhage, and mortality rates were similar between the groups (p > 0.05). Conclusions: In this study, BT seems to yield better clinical and procedural outcomes with lower complication rates than d‑MT. These findings may support the additional value of intravenous alteplase in anterior system strokes. Further large‑scale, prospective, randomized‑controlled studies will clarify the gray lines in this consensus, but this paper is important for reflecting the real‑world data in developing countries. [ABSTRACT FROM AUTHOR]

The book "Write It Up" by Paul J. Silvia is a highly respected resource for researchers and scholars looking to improve their academic writing skills and navigate the complex world of journal publication. Silvia offers valuable recommendations on various challenges, including selecting appropriate journals, crafting different sections of a paper, managing collaborative projects, and submitting and revising manuscripts. The book is part of the American Psychological Association's Series and draws on Silvia's expertise in academic writing and publishing. It covers fundamental elements of effective writing, provides strategies for overcoming obstacles like writer's block, and offers guidance on handling revisions and ethical considerations. The book is accessible and relevant to researchers at all career stages. [Extracted from the article]

Background: The duration of anti-tuberculous therapy in tuberculous meningitis is controversial. There is variation in recommendations by different societies and expert groups on this issue. Objective: To determine the strength of evidence for short-term therapy in tuberculous meningitis through review of literature and critical appraisal. Materials and Methods: Cochrane CENTRAL (Issue 4, 2010), TRIP database, and PubMed (from 1966 to present) were searched for relevant papers with keywords 'meningeal tuberculosis' and tuberculous meningitis' combined with 'chemotherapy'. A critical appraisal of a systematic review was done using standard criteria. Results: A total of 10 relevant papers were identified. All papers were included in a systematic review. The systematic review did not specify study design of studies to be included, had only case series but no randomised controlled trial, and unclear definition of endpoints. Conclusions: The evidence base for short-term therapy for tuberculous meningitis is weak. There is a need to conduct a randomised controlled trial with non-inferiority hypothesis of adequate sample size with well-defined end points and adequate follow-up. This is a challenge as well as opportunity for Indian neurologists. [ABSTRACT FROM AUTHOR]

Background: Disability from migraine has a profound impact on the world's economy. Research has been ongoing to identify biomarkers to aid in diagnosis and treatment.Objective: The aim of this study was to highlight the purported diagnostic and therapeutic migraine biomarkers and their role in precision medicine.Methods: A comprehensive literature search was conducted using PubMed, Google Scholar, and clinicaltrials.gov using keywords: "migraine" OR "headache" combined with "biomarkers" OR "marker." Other keywords included "serum," "cerebral spinal fluid," "inflammatory," and "neuroimaging."Results: After a review of 88 papers, we find the literature supports numerous biomarkers in the diagnosis of migraine. Therapeutic biomarkers, while not as extensively published, highlight calcitonin gene-related peptide (CGRP) and pituitary adenylate cyclase-activating peptide-38 (PACAP-38) as biomarkers with the most substantiated clinical relevance. Genetic markers mainly focusing on gene mutations with resultant biochemical alterations continue to be studied and show promise.Conclusion: Although there are several proposed biomarkers for migraine, continued research is needed to substantiate their role in clinical practice. [ABSTRACT FROM AUTHOR]

A paradigm shift in human evolution, from our predecessors, the 'hunter-gatherers' to the 'era of digital revolution', has made certain human skills more and more machine driven. This digital revolution has made possible a constant connectivity, wearable technologies, customized platforms, enormous data storage and cloud computing at high speeds, smart phones and apps, internet of things, artificial intelligence, telemedicine, etc. These have made real-time monitoring and interventions possible in healthcare. Most advanced countries have made electronic health records (EHR) mandatory. The Government of India has an agenda of Digital India and digital healthcare and might insist on EHRs. EHR is a real-time, patient-centered digital version of a patient's paper record/chart, available instantly and securely to authorized users. EHR contains a patient's medical history, diagnosis, medications, treatment plans, immunization dates, allergies, radiological images, and laboratory results. It can access evidence-based tools that help to make safer decisions about a patient's care with enhanced decision support, clinical alerts, reminders and medical information. The procedure is also more reliable for dispensing medications and introduces the convenience of e-prescriptions. While the advanced technology and digital devices are well received by the healthcare providers, universal acceptance of the EHRs is far from achieving its full potential. The author, in this paper, discusses the current scenario and issues concerned with EHRs in the digital healthcare. [ABSTRACT FROM AUTHOR]

Background: Medial sphenoid wing meningiomas constitute 15%-20% of all intracranial meningiomas. These lesions have a propensity to encase the vessels of the circle of Willis and the surrounding cranial nerves. Thus, radical excision is a difficult proposition.Objectives: In this paper, we analyzed our series of sphenoid wing meningiomas. We describe our surgical strategy, which was based on zone-wise dissection of the tumor. We describe the complications and outcomes of surgery.Materials and Methods: This case series is a retrospective analysis of a single surgeon series of medial sphenoid wing meningiomas operated over a 13-year period. Clinical, radiographic, and outcome variables were studied. The surgical videos were analyzed in detail. The meningioma and its extensions were divided into several zones and a zone-wise strategy for tumor excision was evolved.Results: Twenty-four patients with medial sphenoid wing meningiomas were operated. In 14 patients, Simpson grade 3 excision could be achieved; 5 patients had Simpson grade 4 and 1 patient, grade 5 excision. Four (of 24 patients, 16.7%) had vessel injuries.Conclusions: Medial sphenoid wing meningiomas are difficult lesions to excise radically. Close follow-up of residual lesions (especially if attached to the basal dura) is warranted. Additional modalities of treatment like radiosurgery may be required in case of any progression and for higher-grade lesions. [ABSTRACT FROM AUTHOR]

Background: Measurement of two-point discrimination (2-PD) is used in clinical practice to evaluate the severity of nerve injuries, neuropathy, and recovery of patients following nerve repair. Commercially available 2-PD testing devices are costly and therefore not available everywhere.Methods and Material: We made an economical indigenous 2-PD testing device from off-the-shelf components and tested its efficacy in volunteers.Statistical Analysis: The data were analyzed using Minitab Statistical Software Version 17.0 and Kappa statistics were used in the assessment of agreement between two devices.Results: A total of 30 (23 men, 7 women) subjects were included in the study. There was good agreement between the measurements of static 2-PD with the two different test devices: from fair (Kappa = 0.408, P = 0.018) to strong (Kappa = 0.618-0.795, P = 0.000).Conclusions: This device is simple to make, very economical, and obtains accurate 2-PD measurements. [ABSTRACT FROM AUTHOR]

Background: Endovascular treatment is the preferred treatment for acute ischemic stroke (AIS) due to main artery steno-occlusive disease, but it has temporal and technical limitations. Moreover, there is no established treatment for progressive stroke. Superficial temporal artery (STA)-middle cerebral artery (MCA) bypass is sometimes considered as a treatment option. Objective: The objective of this paper is to review the treatment outcomes of patients with AIS undergoing urgent STA-MCA bypass. Methods and Material: This was a retrospective study including 32 patients diagnosed with AIS treated with urgent STA-MCA bypass at our facility. The patients had small infarct volumes and a large diffusion-perfusion mismatch. Results: New ischemic lesions in postoperative diffusion-weighted images were detected in 15 patients (46.9%), but only four (12.5%) developed paralysis. Hyperperfusion occurred in nine patients (28.1%), and five (15.6%) had bypass occlusion at 1 week. Delayed wound healing were found in four patients (12.5%). Neurological outcome was measured 3 months after onset: Manual Muscle Testing (MMT), 3–5 in 27 patients (84.4%); modified Rankin scale (mRS), 0–2 in 17 patients (53.1%); and 0–3 in 26 patients (81.3%). Prognosis was better in patients who underwent surgery after 24 h of stroke onset (mRS, 0–2 in 56.0% cases and 0–3 in 88.0% at 3 months). Statistical analyses revealed that MMT before surgery had a significant association with favorable outcomes (P = 0.041). Conclusions: Urgent STA-MCA bypass for progressive stroke may result in a good prognosis if the right patients are selected and may play an important role in cases treated 24 h after onset in whom endovascular treatment is ineffective. [ABSTRACT FROM AUTHOR]