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Your search keyword '"Nath, Manabesh"' showing total 4 results
Start Over Author "Nath, Manabesh" Publisher sage publications
4 results on '"Nath, Manabesh"'

2. Blood biomarkers for the diagnosis and differentiation of stroke: A systematic review and meta-analysis

Author

Misra, Shubham, Montaner, Joan, Ramiro, Laura, Arora, Rohan, Talwar, Pumanshi, Nath, Manabesh, Kumar, Amit, Kumar, Pradeep, Pandit, Awadh K., Mohania, Dheeraj, Prasad, Kameshwar, and Vibha, Deepti

Subjects
Stroke, Ischemic stroke, Neurology, Acute, Intracerebral hemorrhage, Stroke subtypes
Abstract

Background: Correct diagnosis of stroke and its subtypes is pivotal in early stages for optimum treatment. Aims: The aim of this systematic review and meta-analysis is to summarize the published evidence on the potential of blood biomarkers in the diagnosis and differentiation of stroke subtypes. Methods: A literature search was conducted for papers published until 20 April 2020 in PubMed, EMBASE, Cochrane Library, TRIP, and Google Scholar databases to search for eligible studies investigating the role of blood biomarkers in diagnosing stroke. Quality assessment was done using modified Quality Assessment of Diagnostic Accuracy Studies questionnaire. Pooled standardized mean difference and 95% confidence intervals were calculated. Presence of heterogeneity among the included studies was investigated using the Cochran's Q statistic and I metric tests. If I was ' 50% then a fixed-effect model was applied else a random-effect model was applied. Risk of bias was assessed using funnel plots and between-study heterogeneity was assessed using meta-regression and sensitivity analyses. Entire statistical analysis was conducted in STATA version 13.0. Results: A total of 40 studies including patients with 5001 ischemic strokes, 756 intracerebral hemorrhage, 554 stroke mimics, and 1774 healthy control subjects analyzing 25 biomarkers (within 24 h after symptoms onset/after the event) were included in our meta-analysis; 67.5% of studies had moderate evidence of quality. Brain natriuretic peptide, matrix metalloproteinase-9, and D-dimer significantly differentiated ischemic stroke from intracerebral hemorrhage, stroke mimics, and health control subjects (p ' 0.05). Glial fibrillary acidic protein successfully differentiated ischemic stroke from intracerebral hemorrhage (standardized mean difference −1.04; 95% confidence interval −1.46 to −0.63) within 6 h. No studies were found to conduct a meta-analysis of blood biomarkers differentiating transient ischemic attack from healthy controls and stroke mimics. Conclusion: This meta-analysis highlights the potential of brain natriuretic peptide, matrix metalloproteinase-9, D-dimer, and glial fibrillary acidic protein as diagnostic biomarkers for stroke within 24 h. Results of our meta-analysis might serve as a platform for conducting further targeted proteomics studies and phase-III clinical trials. PROSPERO Registration ID: CRD42019139659.

Published
2020

4. Safety and efficacy of fluoxetine in post-stroke anxiety-A pilot prospective randomized open blinded endpoint (PROBE) study.

Author

Barki S, Vibha D, Pachipala S, Tayade K, Misra S, Nath M, Singh RK, and Kumar N

Abstract

Objective: The prevalence of post-stroke anxiety (PSA) is reported to be 20%-25%. There is insufficient evidence on the efficacy of antidepressants for treating anxiety in such patients. This Prospective Randomized Open Blinded Endpoint (PROBE) study was designed to assess the safety and efficacy of fluoxetine in PSA., Methods: In this single-center pilot study conducted in India, post-stroke patients (between 1 to 6 months) were randomized to fluoxetine (intervention group: 20 mg/day for 12 weeks) or standard medical care (control group). The primary outcome was improvement in the Hamilton Anxiety Rating Scale (HAM-A) at 12 weeks. The secondary outcomes were anxiety remission (>50% improvement in HAM-A), modified Rankin Scale (mRS), Barthel Index (BI), quality of life (SF-36), and Hamilton Depression Rating Scale (HAM-D). A linear regression analysis was done for determinants of HAM-A to account for baseline differences in the intervention and control groups., Results: A total of 60 patients were randomized: (30: intervention, 30: control). The overall prevalence of post-stroke anxiety among participants in the study was 50.8%, and 31.5% experienced both anxiety and depression. The average HAM-A score at baseline was 11, and average follow-up score at study conclusion was 4. There was similar improvement in the HAM-A score at 12 weeks post-randomization in the intervention and control groups [fluoxetine: -8.0 (95% CI = -11.0 to -4.0); control: -7.0 (95% CI = -9.5 to -4.0); P = 0.91]. Likewise, there was no significant difference between intervention and control groups at 12 weeks post-randomization on the mRS, BI, SF-36, or HAM-D. There were no serious adverse events in either group during the study., Conclusion: Fluoxetine and standard medical care had comparable improvement in HAM-A in post-stroke patients with mild anxiety at 12 weeks. Further study of the pharmacological treatment of post-stroke patients with more severe anxiety is needed., Clinical Trial Registration: CTRI/2018/12/016568., Competing Interests: Declaration of conflicting interestsThe author(s) declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

Published
2024
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