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1%), elimination (86.1%), fingers (76.2%), and arms (73.5%). The BCS scores compared with the sides of lesion, gender differences, and duration of stroke showed no significant differences in the mean (p>0.05). Conclusions Stroke survivors are found to experience disturbances in body image. Low energy level, poor functioning of upper extremities, and disturbed elimination patterns add primarily to body image disturbances. Body cathexis does not differ with side of lesion, gender differences, and duration of stroke.Objectives The aim of the study is to determine the magnitude of repercussions of coronavirus disease 2019 (COVID-19) pandemic on neurosurgical specialty and formulate a management approach. Materials and Methods This combined retrospective and prospective study was done in neurosurgical specialty of IMS-BHU, Varanasi, India, a tertiary care center, between January 1, 2020 and May 31, 2020. Analysis of impact on neurosurgical emergency and electives was done over before pandemic, during lockdown 1 and 2 and during lockdown 3 and 4 timelines. Effects of COVID-19 pandemic on psychology of neurosurgical team (50 members) and on patient party (88) were also evaluated. Virtual learning and webinars as a substitute to residential neurosurgical training were analyzed by a questionnaire given to 13 neurosurgeons of our department. Statistical Analysis Ordinary one-way ANOVA (analysis of variance) and unpaired t -test were used according to data analyzed. p less then 0.05 was considered statistically significant.al teaching and webinars and only two of them (15.4%) accepted improvement of skills based on virtual learning. Conclusion The COVID-19 pandemic is causing a significant impact on health care systems worldwide. For conserving resources elective surgical procedures should be limited. This pandemic has a negative impact on neurosurgical resident training program and psychology of both neurosurgical unit and patients.Objective The aim of the study is to visually rate major forms of dementia using global cortical atrophy (GCA), medial temporal lobe atrophy (MTA), and Fazeka's scales and Koedam's score using magnetic resonance imaging (MRI). The purpose is to correlate the visual rating scales (VRS) with severity of dementia. Materials and Methods Thirty patients fulfilling DSM 5 (Diagnostic and Statistical Manual of Mental Disorders) criteria for Alzheimer's dementia (AD), vascular dementia (VaD), and frontotemporal dementia (FTD) underwent MRI brain. Cortical atrophy, medial temporal, and parietal lobe atrophy were assessed using GCA and MTA scales and Koedam's score, respectively. White matter hyperintensities were assessed using Fazeka's scale. Correlation between VRS and mini-mental state exam (MMSE) scores was done using Pearson correlation coefficient. Results 70% of patients had Grade 2 GCA. More patients with AD had higher MTA scores as compared with others with 57% of AD patients showing abnormal for age MTA scores. Fazeka's scale was abnormal for age in 58.33% of VaD and 57% AD patients. Majority (75%) showing severe parietal atrophy (Grade 3 Koedam's score) were AD patients. Disproportionate frontal lobe atrophy was seen in all four (100%) FTD patients. Significant negative correlation was seen between MMSE and GCA scores of all patients ( p -value = 0.003) as well as between MTA and MMSE scores in AD patients ( p -value = 0.00095). Conclusion Visual rating of MTA is a reliable method for detecting AD and correlates strongly with memory scores. Atrophy of specific regions is seen more commonly in some conditions, for instance, where MTA and parietal atrophy are specific for AD while asymmetric frontal lobe and temporal pole atrophy favor FTD.Background Habituation deficit is considered as a neurophysiological abnormality among migraineurs in the interictal period. For clear comprehension and clarity about the mechanism underlying habituation in migraine, a sophisticated method, i.e., high frequency oscillations (HFOs) evoked potentials, have been utilized. However, studies pertaining to this in the Indian context are rare. Objective The aim of the study is to determine the utility of HFO of somatosensory evoked potential (SSEP) in deciphering the pathophysiology of migraine. Materials and Methods Sixty subjects including 30 migraineurs in the interictal period and 30 healthy controls were considered for the study. Median nerve SSEP was recorded in patients and controls by standard protocols. HFO was extracted offline using the Digital zero-phase shift band-pass filtering at 450 and 750 Hz. The early and late HFOs were determined with respect to the N20 peak and were compared between the groups. Results Of total 30 migraineurs, 18 had hemicranial headache and 12 had holocranial headache. N20 latency, P25 latency, N20 onset to peak amplitude, and N20 onset to P25 amplitude were comparable in migraineurs and controls. The intraburst frequency of early HFOs in migraineurs was significantly higher ( p = 0.04), whereas the peak-to-peak amplitude was significantly lower ( p = 0.001). Conclusion Early HFOs on SSEP represent the thalamocortical excitatory drive in migraineurs. Overall, the study reports that reduced amplitude of early HFOs in the interictal period suggest reduced thalamocortical drive in migraineurs.
Search algorithms used to identify patients with alopecia areata (AA) need to be validated prior to use in large databases.
The aim of the study is to assess whether patients with an International Statistical Classification of Diseases and Related Health Problems (ICD) 9 or 10 code for AA have a true diagnosis of AA.
A multicenter retrospective review was performed at Columbia University Irving Medical Center, Brigham and Women's Hospital, and Massachusetts General Hospital to determine whether patients with an ICD 9 codes (704.01 - AA) or ICD 10 codes (L63.0 -Alopecia Totalis, L63.1 - Alopecia Universalis, L63.2 - Ophiasis, L63.8 - other AA, and L63.9 - AA, unspecified) for AA met diagnostic criteria for the disease.
Of 880 charts, 97.5% had physical examination findings consistent with AA, and 90% had an unequivocal diagnosis. AA was diagnosed by a dermatologist in 87% of the charts. The positive predictive value (PPV) of the ICD 9 code 704.01 was 97% (248/255). The PPV for the ICD 10 codes were 64% (75/118) for L63.0, 86% (130/151) for L63.1, 50% (1/2) for L63.2, 91% (81/89) for L63.8, and 93% (247/265) for L63.9. Overall, 89% (782/880) of patients with an ICD code for AA were deemed to have a true diagnosis of AA.
Patients whose medical records contain an AA-associated ICD code have a high probability of having the condition.
Patients whose medical records contain an AA-associated ICD code have a high probability of having the condition.
Alopecia areata (AA) is an autoimmune disease with an incidence of 2% globally and plays a key role in the quality of life (QOL) of patients with AA. It has been recently shown that there are no sufficient disease-specific questionnaires to assess the QOL in patients with AA.
This study tried to evaluate the validity and reliability of the Persian version of AA-Quality of Life Index (AA-QLI) and compare it with the Dermatology Life Quality Index (DLQI) questionnaire.
During 1 year, 100 individuals were enrolled in this study and asked to complete the DLQI questionnaire and AA-QLI questionnaire. First of all, we enrolled 25 individuals for evaluating the validity of the Persian version of the questionnaire, and after achieving the proper validity, 75 additional patients were enrolled in this project.
The results showed that the test had an appropriate validity (
< 0.001, R = 0.76), reliability (
< 0.001 , internal stability R = 0.89), and (α = 0.91). In this study, we observed that the scores of both questionnaires are quite close. In this regard, in both questionnaires, females had higher scores in comparison to males (
= 0.03), and also both of them correlated with age, age of onset of disease, and skin involvement percentage.
The Persian version of the AA-QLI questionnaire is valid and reliable. The QOL of AA patients needs to be considered more seriously. Psychological evaluation of patients is one of the important suggestions in this study.
The Persian version of the AA-QLI questionnaire is valid and reliable. The QOL of AA patients needs to be considered more seriously. https://www.selleckchem.com/products/Nafamostat-mesylate.html Psychological evaluation of patients is one of the important suggestions in this study.
Lichen Planopilaris (LPP) is a lymphocyte-mediated scarring alopecia that frequently is treatment resistance to both topical and systemic therapies.
The object of this pilot study was to assess the effectiveness of topical mechlorethamine 0.016% gel (Valchlor®) in decreasing disease activity in LPP and the related clinical variant frontal fibrosing alopecia (FAA).
Twelve patients with biopsy-proven LPP/FAA who failed prior topical or systemic therapy with active disease were included. Participants applied mechlorethamine 0.016% gel to involved areas daily for 24 weeks. Outcome measures included LPP Activity Index (LPPAI) score, Physician Global Assessment (PGA) score, Dermatology Quality of Life Index (DQLI) score, and phototrichograms assessing follicular counts before and after six months of therapy.
LPP Activity Index (LPPAI) before and after treatment was significantly different (5.0 before treatment, 2.0 after treatment; p value=0.006). Mean follicular density and follicular units were unchanged during the treatment period.
Treatment with mechlorethamine 0.016% gel for 24 weeks resulted in statistically significant improvement of LLP/FFA with no change in phototrichogram parameters. Treatment duration was limited by high rate of contact dermatitis. Further investigation to optimize dosing frequency and to assess the role of combination topical therapy is needed.
Treatment with mechlorethamine 0.016% gel for 24 weeks resulted in statistically significant improvement of LLP/FFA with no change in phototrichogram parameters. Treatment duration was limited by high rate of contact dermatitis. Further investigation to optimize dosing frequency and to assess the role of combination topical therapy is needed.
The superficial fungal infection of the scalp caused by dermatophytes is called tinea capitis. It has a predilection for the pediatric age group. In developing countries like India factors such as overcrowding, inadequate hygiene, and low literacy rate contribute to its high incidence.
This study aimed at identifying and grading the psychosocial impact of tinea capitis in children and correlating it with disease duration and socioeconomic status of patient's family.
This was a cross-sectional study conducted in our skin outpatient department involving children aged 6-16 years with clinical diagnosis of tinea capitis. We used the children's dermatology life quality index (CDLQI) instrument to observe the psychological implications in these children.
The study included 134 patients, with a mean CDLQI score of 6.01 ± 4.17. There was a male preponderance in our study with 112 (68.3%) male patients and 52 (31.7%) female patients. The age group affected most commonly was 6-8 years (37.8%). The domains affected most severely were symptoms and feelings (Q1 and Q2) followed by sleep (Q 9).
