A randomised trial to assess the efficacy of add on therapy with aspirin or clopidogrel to the standard medical therapy alone in patients with tubercular meningitis: ACT TBM.

Background: Benefit of antiplatelet therapy for stroke prevention or treatment among patients of Tubercular meningitis (TBM) is uncertain. We hypothesised that add-on therapy with aspirin or clopidogrel to standard treatment will be safe and effective in reducing clinical stroke and/or cerebral infarction in patients with TBM.

Methods: This was a randomised, open-label, superiority trial with blinded outcome assessment.

Defining drug resistance beyond rifampicin: use of Xpert® MTB/XDR assay in tuberculous meningitis.

Purpose: - The emerging drug resistance in Tuberculous meningitis (TBM) worsens the prognosis and hamper elimination efforts. The need of the hour is a relatively simple, rapid, near point-of-care test that could allow universal drug susceptibility testing, beyond rifampicin (RIF). The current study evaluated performance of Xpert MTB/XDR in defining drug resistant TBM.

Dentate calcifications with palatal tremor and facial myorhythmia in adult-onset Cerebral X-linked Adrenoleukodystrophy.

Adrenoleukodystrophy is the most common peroxisomal disorder of beta oxidation with highly complex clinical presentation across different ages of life challenging the diagnostic skills of neurologists. We report a 35-year-male with orbitofrontal lobar dysfunction, spastic paraparesis, cerebellar ataxia and characteristic perioral and palatal tremor with dentate nuclei calcification in imaging.

Dentate calcifications with palatal tremor and facial myorhythmia in adult-onset cerebral X-linked adrenoleukodystrophy.

Adrenoleukodystrophy is the most common peroxisomal disorder of beta oxidation with highly complex clinical presentation across different ages of life challenging the diagnostic skills of neurologists. We report a 35-year-male with orbitofrontal lobar dysfunction, spastic paraparesis, cerebellar ataxia and characteristic perioral and palatal tremor with dentate nuclei calcification in imaging.

Prevalence of Seizures in Patients With Tuberculous Meningitis (TBM) and Their Clinical Outcomes.

Background The diagnosis of tuberculous meningitis (TBM) is challenging, as it requires a high level of clinical suspicion and robust efforts to manage complications. Aim The study focussed on the early detection of seizures and their functional and final outcome with etiological workup radiologically and on lab investigations. Design and methods This was a prospective observational study, in which 100 suspected TBM patients were enrolled based on Lancet consensus criteria at the Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, from August 2022 to December 2023.

Synthetic MRI derived relaxometry parameters: a new insight into characterization of ring enhancing lesions of brain.

Background And Purpose: Synthetic MRI utilizes the quantitative relaxometry parameters to generate multiple contrast images through a single acquisition. We tried to explore the utility of synthetic MRI derived relaxometry parameters in evaluation of ring enhancing lesions of brain.

Materials And Methods: This was a prospective study.

Socioeconomic Risk Factors in Neurocysticercosis.

NCC is responsible for around 30% of active epilepsy in endemic countries such as India. Knowing socioeconomic factors associated with NCC can help in decreasing the incidence of this disease. We intend to study socioeconomic risk factors in NCC patients and how these factors are different from patients without NCC.

ISCCM Position Statement on the Approach to and Management of Critically Ill Patients with Tuberculosis.

Unlabelled: Tuberculosis (TB) is an important cause of morbidity and mortality globally. About 3-4% of hospitalized TB patients require admission to the intensive care unit (ICU); the mortality in these patients is around 50-60%. There is limited literature on the evaluation and management of patients with TB who required ICU admission.

A mobile application-based post-stroke care strategy for survivors and their caregivers for prevention and management of post-stroke complications - "Stroke Home Care:" Development and feasibility.

Objectives: In developing nations such as India, a disparity exists between the available resources for stroke rehabilitation and the substantial burden of stroke cases. Consequently, the provision of cost-effective and multidisciplinary post-stroke rehabilitation care to stroke survivors becomes of paramount importance. The utilization of mobile applications (apps) for stroke care has been on the rise, offering a personalized and pragmatic solution with the potential for wider reach in settings constrained by limited resources.

A case series of post-infectious chikungunya myeloradiculoneuropathy.

Chikungunya fever is an arboviral illness caused by chikungunya virus (CHIKV) and transmitted by the bite of Aedes aegypti and Aedes albopictus. It is an RNA virus belonging to the genus Alphavirus and family Togaviridae. We present a case series of three patients with chikungunya illness developing para/post-infectious myeloradiculoneuropathy.

Role of MicroRNAs as post transcription regulators of matrix metalloproteinases and their association in tuberculous meningitis.

Matrix metalloproteinases (MMPs) have a role in driving neuroinflammation in infectious as well as non-infectious diseases; however, recent reports have potentiated the role of microRNAs in regulating MMPs at post-transcriptional levels, leading to dysregulation of crucial MMP functions like tissue remodelling, blood brain barrier integrity, etc. In present study, microRNAs regulating MMPs (MMP2 and MMP3) were selected from database search followed by literature support. Expression of these microRNAs i.

The Neuro-Ophthalmology of Tuberculosis.

Tuberculosis (TB) is a global health concern and central nervous system (CNS) TB leads to high mortality and morbidity. CNS TB can manifest as tubercular meningitis, tuberculoma, myelitis, and arachnoiditis. Neuro-ophthalmological involvement by TB can lead to permanent blindness, ocular nerve palsies and gaze restriction.

Neurocognitive Functions After 6-Month Buprenorphine (Naloxone)-Based Opioid Agonist Maintenance Treatment: A Controlled Prospective Study.

Background: Medications for opioid use disorder (OUD) may influence neurocognitive functions. Inadequate power, confounders, and practice effects limit the validity of the existing research. We examined the change in cognitive functions in patients with OUD at 6-month buprenorphine (naloxone) posttreatment and compared the cognitive performance of the buprenorphine-treated group with control subjects.

Neurocognitive Dysfunctions in People with Concurrent Cannabis Use and Opioid Dependence: A Cross-Sectional, Controlled Study.

Cannabis and opioid co-dependence is independently associated with cognitive impairments. We examined neurocognitive dysfunctions in people with concurrent opioid dependence with cannabis dependence (OD+CD) or cannabis use (OD+CU) compared to those with only opioid dependence (OD) and healthy controls (HC). We selected adult participants, any sex, who met the diagnosis of OD ( = 268), OD+CU ( = 58), and OD + CD ( = 115).

Complex-Associated Chronic Meningitis: Time to Think Beyond Tuberculosis.

Background: Mycobacterium abscessus complex (MabC) has emerged as an important cause of human infections, including meningitis. In the absence of correct microbiological identification, cases of MabC meningitis are treated with conventional anti-tubercular therapy, thereby worsening the outcome.

Objective: The current study was conducted to determine the clinical features, antimicrobial susceptibility, and outcome of patients with MabC meningitis.