Publications by authors named "Ramesh Rajan"

Processing speech amongst noise requires sensory and cognitive abilities that are often affected by Huntington's Disease. However, their impact on daily communication remains unclear. We examined the effects of Huntington's Disease on speech-in-noise processing using everyday sentences and words in noise contexts and conditions that mimic different daily life scenarios.

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Objectives: Metabolic sequelae of pancreatic resections, especially hepatic steatosis, has seldom been studied in detail. This study aims to examine the change in liver fat content following pancreatic resections, specifically pancreaticoduodenectomy, distal pancreatectomy and to identify potential predictors of post-pancreatectomy hepatic steatosis.

Methods: This prospective observational study was conducted from December 2022 to July 2024 and included patients who underwent pancreatic resections at a single tertiary care centre in southern India.

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A central topic in neuroscience is the neural coding problem which aims to decipher how the brain signals sensory information through neural activity. Despite significant advancements in this area, the characterisation of information encoding through the precise timing of spikes in the somatosensory cortex is limited. Here, we utilised a comprehensive dataset from previous studies to identify and characterise temporal response patterns of Layer 4 neurons of the rat barrel cortex to five distinct stimuli with varying complexities: Basic, Contact, Whisking, Rough, and Smooth.

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 High fat content of pancreas can contribute to its soft texture, which is a strong predictor for postoperative pancreatic fistula (POPF). We propose to assess the relationship of pancreatic computed tomography (CT) attenuation index (PAI) with histopathological fat content of pancreas and postpancreatectomy outcomes.  Data was collected prospectively from patients who underwent pancreatic resections from February 2021 to January 2023.

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Background: The Controlled Oral Word Association Test (COWAT) is a commonly used measure of verbal fluency. While a normal decline in verbal fluency occurs in late adulthood, significant impairments may indicate brain injury or diseases such as Alzheimer's disease. Normative data is essential to identify when test performance falls below expected levels based on age, gender, and education level.

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People with multiple sclerosis (pwMS) frequently present with deficits in binaural processing used for sound localization. This study examined spatial release from speech-on-speech masking in pwMS, which involves binaural processing and additional higher level mechanisms underlying streaming, such as spatial attention. 26 pwMS with mild severity (Expanded Disability Status Scale score <3) and 20 age-matched controls listened via headphones to pre-recorded sentences from a standard list presented simultaneously with eight-talker babble.

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Fibrovascular polyps are rare benign epithelial neoplasia of the cervical esophagus. Usually they are large and frequently require a thoracotomy/thoracoscopy. This is a case report of an elderly lady with a large Fibrovascular polyp who had anemia and weight loss due to dysphagia, managed by rendezvous technique.

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 Postpancreatectomy hemorrhage (PPH) and Hemosuccus Pancreaticus (HP) may present with slow but significant intraluminal bleed which may not be evident on imaging. We evaluated the efficacy of empirical segmental-angioembolization of splenic artery in intraluminal PPH and HP.  This is a cross-sectional study done by analyzing all consecutive patients with PPH and HP who underwent empirical coil embolization of splenic artery.

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Neurons are known to encode information not just by how frequently they fire, but also at what times they fire. However, characterizations of temporal encoding in sensory cortices under conditions of health and injury are limited. Here we characterized and compared the stimulus-evoked activity of 1210 online-sorted units in layers II and IV of rat barrel cortex under healthy and diffuse traumatic brain injury (TBI) (caused by a weight-drop model) conditions across three timepoints post-injury: four days, two weeks, and eight weeks.

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The classical view of sensory information mainly flowing into barrel cortex at layer IV, moving up for complex feature processing and lateral interactions in layers II and III, then down to layers V and VI for output and corticothalamic feedback is becoming increasingly undermined by new evidence. We review the neurophysiology of sensing and processing whisker deflections, emphasizing the general processing and organisational principles present along the entire sensory pathway-from the site of physical deflection at the whiskers to the encoding of deflections in the barrel cortex. Many of these principles support the classical view.

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There is a need for reliable and objective measures of early and mild symptomology in multiple sclerosis (MS), as deficits can be subtle and difficult to quantify objectively in patients without overt physical deficits. We hypothesized that a speech-in-noise (SiN) task would be sensitive to demyelinating effects on precise neural timing and diffuse higher-level networks required for speech intelligibility, and therefore be a useful tool for monitoring sensory and cognitive changes in early MS. The objective of this study was to develop a SiN task for clinical use that sensitively monitors disease activity in early (<5 years) and late (>10 years) stages of MS subjects with mild severity [Expanded Disability Status Scale (EDSS) score < 3].

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The most complex interactions between human beings occur through speech, and often in the presence of background noise. Understanding speech in noisy environments requires the integrity of highly integrated and widespread auditory networks likely to be impacted by multiple sclerosis (MS) related neurogenic injury. Despite the impact auditory communication has on a person's ability to navigate the world, build relationships, and maintain employability; studies of speech-in-noise (SiN) perception in people with MS (pwMS) have been minimal to date.

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Background: Multiple Sclerosis (MS) pathology is likely to disrupt central auditory pathways, thereby affecting an individual's ability to discriminate speech from noise. Despite the importance of speech discrimination in daily communication, it's characterization in the context of MS remains limited. This cross-sectional study evaluated speech discrimination in MS under "real world" conditions where sentences were presented in ecologically valid multi-talker speech or broadband noise at several signal-to-noise ratios (SNRs).

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Background: Laparoscopic Cholecystectomy one of the commonest procedures performed worldwide isn't spared from the risks of disastrous iatrogenic complications. In patients with obscured anatomy, the idea of performing a safe total cholecystectomy can be hindered with a high risk of biliovascular injuries. In such a situation STC (subtotal cholecystectomy) comes to the rescue, where the diseased organ can be tackled fairly, without any further damage.

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Background: Although colorectal cancer (CRC) may not be uncommon in India, accurate data regarding its demographics and surgical outcomes is sparse.

Methods: With an aim to assess demographics and perioperative outcomes of CRC in Kerala, all members of Association of Surgical Gastroenterologists of Kerala (ASGK) were invited to participate in a registry. Data of operated cases of CRC were entered on a web-based questionnaire by participating members from January 2016.

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The effect of halogen substitution in fluorescent BODIPY species was evaluated in the context of staining lipids in situ within brain tissue sections. Herein we demonstrate that the halogenated species maintain their known in vitro affinity when applied to detect lipids in situ in brain tissue sections. Interestingly, the chlorine substituted compound revealed the highest specificify for white matter lipids.

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Diffusible ions (Na, K, Mg, Ca, Cl) are vital for healthy function of all cells, especially brain cells. Unfortunately, the diffusible nature of these ions renders them difficult to study with traditional microscopy within brain tissue sections. This mini-review examines the recent progress in the field, using direct elemental mapping techniques to study ion homeostasis during normal brain physiology and pathophysiology, through measurement of ion distribution and concentration in brain tissue sections.

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There is increased recognition of the effects of diffuse traumatic brain injury (dTBI), which can initiate yet unknown biochemical cascades, resulting in delayed secondary brain degeneration and long-term neurological sequela. There is limited availability of therapies that minimize the effect of secondary brain damage on the quality of life of people who have suffered TBI, many of which were otherwise healthy adults. Understanding the cascade of biochemical events initiated in specific brain regions in the acute phase of dTBI and how this spreads into adjacent brain structures may provide the necessary insight into drive development of improved therapies.

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Non-linguistic sounds (NLSs) are a core feature of our everyday life and many evoke powerful cognitive and emotional outcomes. The subjective perception of NLSs by humans has occasionally been defined for single percepts, e.g.

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Article Synopsis
  • Traumatic brain injury (TBI) disrupts the balance of excitation and inhibition in the brain, leading to neurological deficits, but the specific effects on interneurons and their relationship to behavioral issues are not well understood.
  • This study focused on the lateral fluid percussion injury (LFPI) model in rats, revealing a significant reduction in certain types of inhibitory interneurons in the somatosensory cortex, while other brain areas like the motor cortex showed no loss of these neurons.
  • Behavioral tests indicated that rats with LFPI had impairments in motor tasks and learning challenges, alongside evidence of ongoing neurodegeneration in the cortex and hippocampus, highlighting the need to develop targeted treatments based on the response of specific neuron types after TBI
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Based on anatomical connectivity and basic response characteristics, primate auditory cortex is divided into a central core surrounded by belt and parabelt regions. The encoding of pitch, a prototypical element of sound identity, has been studied in primary auditory cortex (A1) but little is known about how it is encoded and represented beyond A1. The caudal auditory belt and parabelt cortical fields process spatial information but also contain information on non-spatial aspects of sounds.

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The pitch of vocalizations is a key communication feature aiding recognition of individuals and separating sound sources in complex acoustic environments. The neural representation of the pitch of periodic sounds is well defined. However, many natural sounds, like complex vocalizations, contain rich, aperiodic or not strictly periodic frequency content and/or include high-frequency components, but still evoke a strong sense of pitch.

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Article Synopsis
  • Research until the late 20th century suggested sensory modalities in primates were independently processed, with cross-modal integration being limited to specialized areas.
  • Findings in macaques showed that the primary visual cortex (V1) has direct connections from auditory cortex, challenging this model.
  • In a study with marmosets, researchers confirmed similar direct projections from auditory areas to V1, highlighting early-stage audiovisual integration as a common trait in primate sensory processing.
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Changes in inhibition following traumatic brain injury (TBI) appear to be one of the major factors that contribute to excitation:inhibition imbalance. Neuron pathology, interneurons in particular evolves from minutes to weeks post injury and follows a complex time course. Previously, we showed that in the long-term in diffuse TBI (dTBI), there was select reduction of specific dendrite-targeting neurons in sensory cortex and hippocampus while in motor cortex there was up-regulation of specific dendrite-targeting neurons.

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