Phytosterols are effective in lowering low-density lipoprotein-cholesterol levels, and do not appear to increase atherosclerotic risk, but additional research on this topic is necessary.

Background-Hypercholesterolemia (HC) induced endothelial cell dysfunction and decreased endothelial nitric oxide formation result in impaired angiogenesis & subsequent cardiovascular disorders. Therapeutic angiogenesis is known to be a novel strategy for treatment of those patients with ischemic heart disease. We have shown that secoisolariciresinol diglucoside (SDG) is angiogenic & cardioprotective against myocardial ischemia. In the present study we examined the efficacy of SDG in a hypercholesterolemic myocardial infarction (MI) model.

Background: COVID-19 related strokes (CORS) are increasingly being diagnosed across the world. The knowledge about the clinical profile, imaging findings and outcomes are still evolving. Here we describe the characteristics of a cohort of 62 CORS patients from 13 hospitals, from Bangalore city, south India. Objective: To describe the clinical profile, neuroimaging findings, interventions and outcomes in CORS patients Methods: Multicenter retrospective study of all CORS patients from 13 hospitals from south India from 1st June 2020 to 31st August 2020.Demographic, clinical, laboratory and neuroimaging data were collected along with treatment administered and outcomes. SARS-CoV-2 infection was confirmed in all cases by RT- PCR testing. The data obtained from the case records were entered in SPSS 25 for statistical analysis. Results: During the 3-month period we had 62 CORS patients, across 13 centers. 60 (97%) had ischemic strokes while 2 (3%) had hemorrhagic strokes. The mean age of patients was 55.66 ±13.20 years, with 34 (77.4%) males. 26 % (16/62) of patients did not have any conventional risk factors for stroke. Diabetes Mellitus was seen in 54.8%, hypertension was present in 61.3%, coronary artery disease in 8% and atrial fibrillation in 4.8%. Base line NIHSS score was 12.7 ±6.44. Stroke severity was moderate (NIHSS 5-15) in 27 (61.3%) patients, moderate to severe (NIHSS 16-20) in 13 (20.9%) patients and severe (NIHSS 21-42) in 11(17.7%) patients. According to TOAST classification for ischemic strokes, 48.3% was stroke of undetermined etiology, 36.6% had large artery atherosclerosis, 10% had small vessel occlusion and 5% had cardioembolic strokes. 3 (5%) received intravenous thrombolysis with tenecteplase 0.2 mg/Kg and 3 (5%) underwent mechanical thrombectomy two endovascular and one surgical. Duration of hospital stay was 16.16± 6.39 days. 16% (13/62) died in hospital, while 37 (59.7%) had a mRS of 3-5 at discharge. Hypertension, atrial fibrillation and higher baseline NIHSS scores were associated with increased mortality. A comparison to 111 historical controls during the non COVID period showed a higher proportion of strokes of undetermined etiology, higher mortality and higher morbidity in CORS patients. Conclusion:CORS are increasing being recognized in developing countries like India. Stroke of undetermined etiology appears to be the most common TOAST subtype of CORS. CORS were more severe in nature and resulted in higher mortality and morbidity. Hypertension, atrial fibrillation and higher baseline NIHSS scores were associated with increased mortality.

No abstract

Objectives: The prevalence and characteristics of COVID-19-related headaches are not known in Indian patients. We aim to determine the prevalence and characteristics of headache in COVID-19-infected individuals and make a comparison with those without headaches. Methods: This prospective cross-sectional observational study was conducted from 1 October to 31 October 2020. Data were collected using a detailed questionnaire. We compared the data of those with and without headaches to identify the differences between the groups. Results: During the study period of 1 month, among 225 COVID-19-infected patients, 33.8% patients had headaches. The mean age of patients with headache was 48.89 ± 15.19 years. In all, 53.9% were females. In 65.8%, headache occurred at the onset of viral illness; 44.7% described the headache as dull aching; 39.5% had bifrontal headache; and 32.9% had holocranial headache. In total, 78.9% had complete resolution of headache within 5 days. A comparison between those with and without headaches showed that those with headaches were more younger (48.89 ± 15.19 vs 54.61 ± 14.57 years, p = 0.007) and of female gender (41/76(53.9%) vs 41/149 (27.5%), p = 0.001). Primary headache disorders were more common in the headache group. Levels of inflammatory markers such as leukocyte count (7234.17 ± 3054.96 vs 8773.35 ± 5103.65, p = 0.017), erythrocyte sedimentation rate (39.28 ± 23.29 vs 50.41 ± 27.61, p = 0.02) and ferritin (381.06 ± 485.2 vs 657.10 ± 863.80, p = 0.014) were lower in those with headaches. Conclusions: Headaches are a common and early symptom of acute SARS-CoV-2 infection more frequently seen in young females and in those with a history of primary headache disorders. The lower level of inflammatory markers in those with headaches suggests that these headaches are probably due to the local spread of virus through the trigeminal nerve endings, resulting in activation of the trigeminovascular system.

Objective Essential oils are plant‐derived oils and are widely used as an over‐the‐counter remedy for common ailments. Many essential oils are found to have proconvulsant effects. Here we report a small case series of 3 adults with eseential oil‐related status epilepticus. Methods This was an observational study conducted in a tertiary care hospital in south India from January 2018 to December 2019. We collected the demographic, clinical, and imaging features of all cases of status epilepticus resulting from exposure to essential oils. Cases of status epilepticus secondary to all other causes were excluded. Results There were 3 young adults with essential oil‐related status epilepticus. Two had de novo generalized tonic–clonic status epilepticus, and 1 with posttraumatic occipital lobe epilepsy had focal‐impaired awareness status epilepticus. The first 2 cases presented with histories of ingestion of eucalyptus oil. The third case had focal‐impaired awareness status epilepticus after topical application of various balms containing eucalyptus and camphor. Conclusions Proconvulsant essential oils of eucalyptus and camphor can cause both generalized and focal status epilepticus. Physicians dealing with patients of status epilepticus should enquire about the exposure to proconvulsant essential oils.

No abstract

Essential oils with proconvulsive properties are known to cause seizures and may worsen migraine. Here, we report two cases of cluster headache temporally related to the use of toothpastes containing essential oils of camphor and eucalyptus.