Ayurvedic Treatment in the Rehabilitation of Ischemic Stroke Patients in India: A Randomized Controlled Trial (RESTORE) - Findings from the Process Evaluation.

Introduction: The RESTORE trial was the first randomized controlled trial comparing two systems of medicine in stroke. The trial studied about the safety and efficacy of ayurvedic rehabilitative treatment in comparison with conventional physiotherapy in stroke rehabilitation across North and South India. The results showed that ayurvedic rehabilitative treatment was not superior to conventional physiotherapy for improving sensorimotor recovery in ischemic stroke patients, but it was safe to use.

Ayurvedic treatment in the rehabilitation of ischemic stroke patients in India: A randomized controlled trial (RESTORE).

Background: The effect of Ayurvedic Rehabilitation therapy (ART) in improving the sensorimotor recovery of patients with ischemic stroke is unclear irrespective of the fact that ayurveda is a commonly practiced alternate system of medicine in India and south Asia. The trial hypothesized that ayurvedic treatment is superior to physiotherapy (PT) in recovery of ischemic stroke patients.

Methods: We performed investigator-initiated, multi-center prospective, parallel arm randomized controlled trial (RCT) with blinded outcome assessment across four comprehensive stroke centers in India.

Educational and Socioeconomic Correlates of Stroke Risk Behaviors: Findings from the SPRINT INDIA Trial.

Background And Objectives: Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial was a randomized control trial that enrolled 4298 stroke patients and administered educational interventions at 31 centers across India, with the aim to reduce recurrent stroke through increased stroke knowledge. This SPRINT INDIA trial post hoc study aims to investigate the incidence of recurrent stroke, high-risk transient ischemic attack (TIA), acute coronary syndrome (ACS), death, and lifestyle behavioral factors at 1 year. In addition, it examines the relationship between patients' baseline characteristics and education levels, risk factors, and outcomes and performs subgroup analysis within the intervention and control groups.

SPRINT INDIA: Regional Variations in Primary and Secondary Stroke Outcomes Based on Baseline Characteristics in North and South Indian Sites.

Background And Objectives: Regional differences in stroke prevalence and outcomes in India, driven by demographic and risk factors, are crucial for guiding effective prevention and management strategies. This subanalysis of Secondary prevention with a structured semi-interactive stroke prevention package in INDIA (SPRINT INDIA) randomized controlled trial compared the demographics, risk factors, and clinical outcomes of stroke patients from North and South India to identify regional differences and inform targeted interventions for stroke prevention.

Methods: The study analyzed data of 4298 participants from 31 stroke centers across India, focusing on demographics, stroke types, and risk factors.

MOG positive primary autoimmune meningitis mimicking tuberculous meningitis: a case series.

Objectives: Primary autoimmune meningitis presentation of myelin oligodendrocyte glycoprotein (MOG) IgG antibody positivity is infrequently reported. We aim to identify the patients with MOG IgG antibody positivity who were initially misdiagnosed and treated as tuberculous meningitis (TBM).

Methods: A retrospective cross-sectional study conducted in the Neuroimmunology Laboratory and Department of Neurology of Amrita Institute of Medical Sciences, Kochi, Kerala, India between June 2018 and December 2023.

Comparing Stroke Profiles and Outcomes between Urban and Rural India: A Secondary Analysis of the SPRINT INDIA Trial.

Introduction: Stroke causes significant death and disability, with urban-rural disparities in healthcare and limited studies in India, despite its rural majority of 70%. The post hoc study aimed to explore differences in stroke profiles, risk factors, and outcomes between urban and rural participants using data from the Secondary Prevention by Structured Semi-Interactive Stroke Prevention Package in India (SPRINT INDIA) trial.

Methods: The SPRINT INDIA trial was a multi-center randomized clinical trial across 31 Indian sites.

Autoimmune encephalitis with autoimmune myocarditis.

Autoimmune encephalitis can be associated with other autoimmune disorders, but the concurrent presence of autoimmune encephalitis and autoimmune myocarditis is uncommon. A man in his 80s with type 2 diabetes mellitus, hypertension and hypothyroidism presented with altered mental status for 8 months. He was previously diagnosed with myasthenia gravis, but therapy was discontinued due to infection.

Autoimmune Atypical Parkinsonism: A 10 year follow up of the original cohort.

Background: In this research, we extend our initial study in 2016 of a distinct cohort diagnosed with autoimmune atypical parkinsonism, assessing the long-term effects of immunotherapy over a decade.

Objective: To study the long-term effects of immunotherapy in patients with autoimmune atypical parkinsonism over 10 years.

Design: Retrospective Observational Study Design STUDY SETTING: The study was carried out at the Department of Neurology at Amrita Institute of Medical Sciences, Kochi, Kerala.

MOG IgG antibody positivity from laboratory to clinical practice: A real world experience.

Background And Objectives: Myelin oligodendrocyte glycoprotein (MOG) associated disease (MOGAD) is an antibody-mediated inflammatory demyelinating disorder of the CNS with varied presentations like optic neuritis (ON), transverse myelitis, and cortical encephalitis. This study aims to highlight the significance of low MOG IgG antibody positivity and its diagnostic implications in a real-world cohort.

Methods: In this retrospective observational study, serum and CSF from suspected MOGAD cases were tested at a tertiary healthcare centre's Neuroimmunology Laboratory.

Clinical Manifestations of Anti-GABA-B Receptor Encephalitis: A Case Series.

Anti γ aminobutyric acid B(GABA B) receptor encephalitis is a rare form of autoimmune encephalitis. Our aim is to study the clinical characteristics and treatment outcomes of anti GABA B receptor encephalitis. This is a retrospective case series from the Neuroimmunology laboratory of Amrita Institute of Medical Sciences, Kochi, Kerala, India from 2016 to 2021.

Indian Trial of Tranexamic acid in Spontaneous Intracerebral Hemorrhage study protocol.

Rationale: Early mortality in intracerebral hemorrhage (ICH) is due to hematoma volume (HV) expansion, and there are no effective treatments available other than reduction in blood pressure. Tranexamic acid (TXA) a hemostatic drug that is widely available and safe can be a cost-effective treatment for ICH, if proven efficacious.

Hypothesis: Administration of TXA in ICH patients when given within 4.

RE-OPEN: Randomised trial of biosimilar TNK versus TPA during endovascular therapy for acute ischaemic stroke due to large vessel occlusions.

Rationale: Rapid and timely treatment with intravenous thrombolysis and endovascular treatment (EVT) in patients with acute ischaemic stroke (AIS) and large vessel occlusion (LVO) significantly improves patient outcomes. Bridging therapy is the current standard of care in these patients. However, an incompletely answered question is whether one thrombolytic agent is better than another during bridging therapy.

Neurological Manifestations of Glutamic Acid Decarboxylase Autoimmunity in Indian Patients.

Objective: To study the neurological manifestations of glutamic acid decarboxylase (GAD 65) autoimmunity in Indian patients.

Methods: Retrospective study conducted in a tertiary care referral hospital in South India. Patients who tested positive for GAD 65 antibodies from February 2013 to July 2019 were included.

Cerebrospinal fluid indices as predictors of treatment response in autoimmune encephalitis.

Background: Cerebrospinal fluid (CSF) indices reflecting intrathecal antibody production and blood-brain barrier impairment are not routinely assessed in patients with autoimmune encephalitis (AE). We aimed to study CSF indices and their association with the prognosis of AE.

Methods: This retrospective cohort study conducted at Amrita Institute of Medical Sciences (AIMS), Kochi, India, included 60 patients aged more than 18 years with definite/probable/possible AE admitted to the Department of Neurology from August 2016 to November 2021.

The prevalence and clinical phenotype of dual seropositive neuromyelitis optica spectrum disorders at a national reference center in South Asia.

Background: Neuromyelitis Optica Spectrum Disorders (NMOSD) is an autoimmune syndrome that is frequently positive for Aquaporin 4 (AQP4) IgG or Myelin Oligodendrocyte Glycoproteins (MOG) IgG. However, dual positivity to both is rare.

Objective: To assess the prevalence of dual-positive NMOSD and outline its clinical phenotype.

Ayurvedic Treatment in the Rehabilitation of Ischemic Stroke Patients in India: A Randomized Controlled Trial Study Protocol.

In patients with ischemic stroke, motor and sensory impairments are common and are associated with functional disability. Conventional physiotherapy (CP) is the primary modality of rehabilitation for post-stroke sensorimotor dysfunction. Ayurveda is a commonly practiced alternative system of medicine that offers unique rehabilitative measures for post-stroke recovery.

Fluoxetine or Venlafaxine for Early Post Stroke Depression.

Context: Post stroke depression (PSD) is an under diagnosed morbidity of stroke and can negatively affect the prognosis of the patient.

Aims: We intended to study the prevalence of PSD and the commonly used anti-depressants and their outcome in patients with PSD.

Settings And Design: A prospective observational study was conducted in the patients admitted to the stroke unit of a tertiary care centre.

One-year mortality after acute stroke: a prospective cohort study from a comprehensive stroke care centre, Kerala, India.

Objectives: The primary objective was to report the 1-year all-cause mortality among patients with stroke. The secondary objectives were (1) to report the mortality stratified by type of stroke and sex and (2) to report predictors of 1-year mortality among patients with stroke.

Design: A prospective cohort study.

Autoimmune parkinsonism with faciobrachiocrural dystonic seizures: a new phenotype of leucine-rich glioma-inactivated 1 (LGI1) autoimmunity.

Extrapyramidal symptoms are seen in patients with leucine-rich glioma-inactivated 1 (LGI1) antibody-positive patients infrequently and this can be successfully treated with immunotherapy. This is a retrospective hospital-based study from 2013 to 2021 at a tertiary care referral hospital in South India. LGI1 antibody-positive cases with Faciobrachio-crural dystonic seizures [FBCDS] were identified by reviewing electronic medical records and Neuroimmunology laboratory register.

Acute Ischemic Stroke in Children - Should We Thrombolyze?

Ischemic stroke is a major cause of acute neurological symptoms in children with significant long-term neurological sequelae. Unlike in the adult population, the clinical presentation of strokes in children may not be stereotyped. Hence, many other differential diagnostic possibilities might have to be considered in the emergency setting.

High Prevalence of Plasminogen Activator Inhibitor-1 4G/5G Polymorphism among Patients with Venous Thromboembolism in Kerala, India.

Venous thromboembolism (VTE) is a multifactorial clotting disorder in which inherited and environmental factors synergistically contribute to its pathogenesis. The aim of this case-control study was to analyze the prevalence of hereditary thrombophilic risk factors, provoking and non-provoking environmental risk factors in patients with VTE from Kerala, India. We have observed a low prevalence of factor V Leiden (7%), prothrombin G20210A (2%), and prothrombin G20030A (2%) mutations and a high prevalence of plasminogen activator inhibitor-1 () 4G/5G (52%), 4G/4G (24%) genotypes in the VTE patients ( = 147).

Clinical Features and Outcome of Stroke with COVID-19. COVID-19 Stroke Study Group (CSSG), India.

Background And Purpose: Occurrence of stroke has been reported among patients with COVID-19. The present study compares clinical features and outcomes of stroke patients with and without COVID-19.

Methods: The COVID-19 Stroke Study Group (CSSG) is a multicentric study in 18 sites across India to observe and compare the clinical characteristics of patients with stroke admitted during the current pandemic period and a similar epoch in 2019.