International Journal of Neurology and Neurosurgery

 Not Provided.

  Internal jugular venous cannulation is a common procedure performed in the hospitals for monitoring and therapeutic purposes. We report an extremely rare complication of mediastinal haematoma following Internal jugular venous cannulation in a 55 years old female patient with subarachnoid haemorrhage following rupture of right p-com aneurysm. Post procedural chest X ray showed a large mediastinal haematoma occupying the right hemithorax and the patient became symptomatic in the form of development of stridor for which she had to be reintubated. Patient was managed conservatively and subsequent serial chest X- ray showed gradual resolution of the haematoma. The occurrence of mediastinal hematoma resulting from vascular injury in close proximity to the mediastinum is an extremely rare complication. It is documented in the literature in very few case reports [10]. We report this rare case to highlight the importance of supervised catheter insertion, use of ultrasound for insertion , the important role of post procedural chest X ray to detect and for early management of complications. 

Key words: Cannulation; Haematoma; Internal Jugular Vein; Mediastinum; Stridor. 

  In adults and older age group, Low back pain is exceedingly and eminently widespread and frequent and is the most familiar and repeated reason for seeking medical attention. Herniated lumbar disc accounts for majority of cases in them necessitating further refinement in management strategy. However unconstrained and spontaneous disappearance of large herniated lumbar disc has been reported very rarely in the literature till the time being. The authors report a distinctive and particular case of spontaneous regression of a large extruded lumbar disc in a 50 year old male. The patient presented with remarkably large lumbar extruded disc with backache and progressive neurological deficits and counseled for surgical discectomy but patient was lost on follow up. Later on the disc regressed spontaneously with improvement in clinical symptoms & evidenced by MRI scan done after 6 months. This paper has reviewed various literature & also discussed possible mechanism of disc regression with its impact on outcome. 

Keywords: Lumbar Disc Herniation; Spontaneous Regression; MRI, Foraminal Stenosis; Cauda Equina Syndrome.

  Among 34 million people living with HIV, genetic forms of HIV-1 differ significantly around the globe and sub type C infects highest population worldwide. Although disease severity has been reduced by the successful introduction of cART, complete assessment of therapy to CNS is not potentialy unbeaten. In postHAART era, the predominance of HAND depends upon the likely effect of clade diversity. Neurological complication in HIV infection intimately related to virological, cellular and immunological factors which can either be beneficial or detrimental. Many experts report that immune system cells hinder the healing in subtype B which is somehow suppressed or eliminated in clade C. Other scientists claim that viral factors may mediate the stimulation and secretion of anti-inflammatory cytokines and neuroprotective factorswhich consequences less neuropathogenesis in subtype C infections. Hence less neurocognitive impairment in Indian subtype C is a dispute. This article reviews the co-operative action of viral, cellular and immunological factors involved in HIV-1 associated neurological complications in clade C and elucidate our knowledge in comparison to clade B. 

Keywords: HIV-1 Clade C; Neuropathogenesis; Viral Factors; HAND; Cognitive Impairment. 

  Objectives: The objectives of the study were to explore and describe the lived experiences of CVA patients and to find the functional independence in activities of daily living of CVA patients. ethods: Data collection tools include demographic and clinical proforma, Standardized Barthel Index and a semi- structured interview with a lead question, “Could you tell me what happened when you had the stroke?” The ethical principles of informed consent, anonymity and confidentiality, beneficence and justice were acknowledged and addressed in this study. Pilot study was conducted among three patients with CVA attending Nandi’s Rehabilitation Centre, Quilandi, Calicut and the study design was found to be feasible.Main study was conducted among 10 patients attending Malabar Rehabilitation Centre, Nadakkavu, Calicut, Kerala. Purposive sampling technique was used till data was saturated. Average of 45 minutes to one hour were taken to complete each interview. The interviews were audio recorded for analysis.The transcribed data was translated into English; the themes were derived and submitted to three experts for validation. esults: The major themes derived from the study were adaptation to life after stroke, living in a restricted world, dealing with trapped emotions, living with altered perception of self and life as rehabilitation…post stroke stage. Conclusion: Study concluded that CVA patients find different ways to adapt to their life after stroke. Providing them with opportunities to narrate their experiences and feelings to persons outside the home context might be helpful. Implementing measures to improve function and prevent disability will help to improve their well being.

Keywords: Living with CVA; Stroke; Experience; Qualitative Research. 

  Background: Alzheimer Disease (AD) is one of the major threatof ageing. In current time it creates a social stigma among people so for this disease is important for research orientations. Herbal medicine offers several options to modify the progress and symptoms of AD hence new trend in the preparation and marketing of drugs based on medicinal plants, and their scientific and commercial significance appears to be gathering momentum in health-relevant areas. Current insilico study signifies the potentiality of Ginkgolide against Fyn C kinase in case of Alzhemier disease. Material and Methods: In the current study 3D model of Fyn C kinase receptor was predicted by comparative homology modeling program MODELLER. The computed model’s energy was minimized and validated using PROCHECK, ProSa and Errat tool to obtain a stable model structure. Stable model was used for molecular docking against screened phytochemical and available synthetic molecules using AutoDock 4.2, which resulted in energy- ased descriptors such as Binding Energy, Intermol energy, vdW + Hbond + desolv Energy and Electrostatic Energy. Results: These interactions between the active residues may lead to significant conformational change in that particular portion of the protein. This efficacy and suitability of ligand was determined on the basis of binding energy calculations. Ginkgolideshowed minimum binding energy calculations among selected 4 other natural ligands. Conclusion: Such information may open new prospects in the use of natural compounds and their derivatives as a potential drug candidateagainst Fyn C kinase for treatment of Alzheimer Disease (AD). 

Keywords: Molecular Modeling; Alzheimer; Ginkgolide; Molecular Interaction; Binding Energy; Natural Ligands.