Background Coronaviruses mainly affect the respiratory system; however, there are reports of SARS-CoV and MERS-CoV causing neurological manifestations. We aimed at discussing the various neurological manifestations of SARS-CoV-2 infection and to estimate the prevalence of each of them. Methods We searched the following electronic databases; PubMed, MEDLINE, Scopus, EMBASE, Google Scholar, EBSCO, Web of Science, Cochrane Library, WHO database, and ClinicalTrials.gov . Relevant MeSH terms for COVID-19 and neurological manifestations were used. Randomized controlled trials, non-randomized controlled trials, case-control studies, cohort studies, cross-sectional studies, case series, and case reports were included in the study. To estimate the overall proportion of each neurological manifestations, the study employed meta-analysis of proportions using a random-effects model. Results Pooled prevalence of each neurological manifestations are, smell disturbances (35.8%; 95% CI 21.4–50.2), taste disturbances (38.5%; 95%CI 24.0–53.0), myalgia (19.3%; 95% CI 15.1–23.6), headache (14.7%; 95% CI 10.4–18.9), dizziness (6.1%; 95% CI 3.1–9.2), and syncope (1.8%; 95% CI 0.9–4.6). Pooled prevalence of acute cerebrovascular disease was (2.3%; 95%CI 1.0–3.6), of which majority were ischaemic stroke (2.1%; 95% CI 0.9–3.3), followed by haemorrhagic stroke (0.4%; 95% CI 0.2–0.6), and cerebral venous thrombosis (0.3%; 95% CI 0.1–0.6). Conclusions Neurological symptoms are common in SARS-CoV-2 infection, and from the large number of cases reported from all over the world daily, the prevalence of neurological features might increase again. Identifying some neurological manifestations like smell and taste disturbances can be used to screen patients with COVID-19 so that early identification and isolation is possible.
Neurogenesis, a process of generation of new neurons, occurs throughout the life in the hippocampus and sub-ventricular zone (SVZ). Bisphenol-A (BPA), an endocrine disrupter used as surface coating for packaged food cans, injures the developing and adult brain. However, the effects of BPA on neurogenesis and underlying cellular and molecular mechanism(s) are still unknown. Herein, we studied the effect(s) of prenatal and early postnatal exposure of low dose BPA on Wnt/β-catenin signaling pathway that controls different steps of neurogenesis such as neural stem cell (NSC) proliferation and neuronal differentiation. Pregnant rats were treated with 4, 40, and 400 μg BPA/kg body weight orally daily from gestational day 6 to postnatal day 21. Both in vivo and in vitro studies showed that BPA alters NSC proliferation and differentiation. BPA impaired NSC proliferation (5'-bromo-2'-deoxyuridine (BrdU(+)) and nestin(+) cells) and neuronal differentiation (BrdU/doublecortin(+) and BrdU/neuronal nuclei (NeuN(+)) cells) in the hippocampus and SVZ as compared to control. It significantly altered expression/protein levels of neurogenic genes and the Wnt pathway genes in the hippocampus. BPA reduced cellular β-catenin and p-GSK-3β levels and decreased β-catenin nuclear translocation, and cyclin-D1 and TCF/LEF promoter luciferase activity. Specific activation and blockage of the Wnt pathway suggested involvement of this pathway in BPA-mediated inhibition of neurogenesis. Further, blockage of GSK-3β activity by SB415286 and GSK-3β small interfering RNA (siRNA) attenuated BPA-induced downregulation of neurogenesis. Overall, these results suggest significant inhibitory effects of BPA on NSC proliferation and differentiation in the rat via the Wnt/β-catenin signaling pathway.
Background: Hirayama disease (HD) is a segmental nonprogressive spinal muscular atrophy found in male patients.Objective: To report the results of a comprehensive evaluation of clinical, magnetic resonance imaging (MRI), electromyography (EMG), and survival motor neuron (SMN) gene analysis of HD.
Myelin is the functional implication of oligodendrocytes (OLs), which is involved in insulation of axons and promoting rapid propagation of action potential in the brain. OLs are derived from oligodendrocyte progenitor cells (OPCs), which proliferate, differentiate, and migrate throughout the central nervous system. Defects in myelination process lead to the onset of several neurological and neurodegenerative disorders. Exposure to synthetic xenoestrogen bisphenol-A (BPA) causes cognitive dysfunction, impairs hippocampal neurogenesis, and causes onset of neurodevelopmental disorders. However, the effects of BPA on OPC proliferation, differentiation and myelination, and associated cellular and molecular mechanism(s) in the hippocampus of the rat brain are still largely unknown. We found that BPA significantly decreased bromodeoxyuridine (BrdU)-positive cell proliferation and number and size of oligospheres. We observed reduced co-localization of BrdU with myelination markers CNPase and platelet-derived growth factor receptor-α (PDGFR-α), suggesting impaired proliferation and differentiation of OPCs by BPA in culture. We studied the effects of BPA exposure during prenatal and postnatal periods on cellular and molecular alteration(s) in the myelination process in the hippocampus region of the rat brain at postnatal day 21 and 90. BPA exposure both in vitro and in vivo altered proliferation and differentiation potential of OPCs and decreased the expression of genes and levels of proteins that are involved in myelination. Ultrastructural electron microscopy analysis revealed that BPA exposure caused decompaction of myelinated axons and altered g-ratio at both the developmental periods as compared to control. These results suggest that BPA exposure both during prenatal and postnatal periods alters myelination in the hippocampus of the rat brain leading to cognitive deficits.
Background and aims Communication plays an important role in advancing public health goals as well as in greater appreciation of underlying science and public policies. It is critical at all times, be it promoting health benefits of immunisation, importance of hand hygiene or taking personal measures for prevention of non-communicable diseases. Communication assumes even greater importance in the time of emergencies like the ongoing Covid-19 pandemic. A primary vehicle for health communication is mass media like television channels, newspapers and radio channels. Methods An analysis of current trends shows that the messages emerging from mass media are getting further amplified and dispersed through digital outlets and social media platforms which have become immensely popular. This has also given rise to a new phenomenon called infodemic or over-abundance of information – both genuine and fake. Results The article examines role of mass media in health communication in times of pandemic and the context of infodemic. Conclusions The analysis points to the need for improvement in health journalism to improve its quality, credibility as well as relevance in a country like India where mass media consumption is high and health literacy is low.
We evaluated the clinical and imaging features of cranial toxoplasmosis in patients without HIV infection. Between 1995 and 2005, 15 patients with serologically proven cranial toxoplasmosis were selected for clinical and imaging study from 233 patients with chronic meningitis and 364 patients with seizures/psychosis. All patients had poor immune status due to nutritional and metabolic causes. Neurological presentations included focal encephalitis, multifocal encephalitis and diffuse meningoencephalitis. The three groups had distinct symptoms and imaging features, with some overlap. Magnetic resonance imaging showed single or multiple nodular or ring-enhancing lesions often at the grey-white junction with subcortical white matter perifocal oedema. Within the large diffuse lesions there were discrete small haemorrhagic lesions and contrast medium administration showed fine-beaded parallel lines or small discrete nodules traversing the white matter suggesting perivenous spread. Complete clinical recovery was noted in 12 patients after several 6-week courses of pyrimethamine and sulfonamide/clindamycin. Five patients required two such courses, three patients required three courses, three patients required five courses and two patients required six courses for the final radiological healing, which was complete in nine patients. One patient was lost to follow-up and one patient died of cardiomyopathy. Knowledge of these three distinct initial presentations may help in the early diagnosis of cranial toxoplasmosis in HIV-seronegative patients. Prognosis in early cases is generally good but complete recovery may need several courses of treatment.
Objectives Poststroke cognitive decline (PSCD) is a serious disabling consequence of stroke. The purpose of this study is to find the prevalence of PSCD and sociodemographic and clinical determinants of risk factors of PSCD. Materials and Methods This study was a prospective, hospital-based study conducted on 200 stroke patients from stroke registry during October 2015 to April 2017. Detailed clinical evaluation was done. Mini-Mental State Examination (MMSE) and Montreal Cognitive Assessment (MoCA) scores were used to determine PSCD after 3 and 6 months as per the Diagnostic and Statistical Manual of Mental Disorders V. Chi-squared test was used to find the association between two variables. The Wilcoxon signed-rank test was used to compare the difference in cognitive impairment between two follow-ups at 3 and 6 months, respectively. A p-value < 0.05 was considered statistically significant. Results The prevalence of PSCD measured by MoCA scale at 3 and 6 months was 67 and 31.6%, respectively. By MMSE scale, cognitive decline prevalence at 3 months was found to be 87 (46.3%), which reduced to 22 (17.1%) at 6 months. The association between MMSE scale and type of stroke was significant at 3 months. Conclusion One-third of the stroke patients developed PSCD within 3 months of onset of stroke, with different levels of severity. The major predictors of new-onset poststroke cognitive impairment were diabetes and hypertension. The prevalence of PSCD reduced significantly at 6 months of stroke on follow-up.
Background Religious and sociocultural beliefs influence the nature of treatment and care received by people with epilepsy. Objective This study aimed to study knowledge, attitude, and practice (KAP) among epilepsy patients in north India. Materials and Methods In this study, 201 patients attending the outpatient and inpatient services of the neurology department of Sir Sunderlal Hospital, Banaras Hindu University, were asked to fill a questionnaire comprising 25 questions assessing the KAPs in English or Hindi, whichever the patient was proficient with. The same questionnaire was also given to 200 patients without epilepsy for the control group. Responses were recorded as yes/no/do not know. Results Approximately, 67% of the patients consisted of a young population, of which 64.7% were males and 35.3% were females. Around 25.9% of patients had studied up to 10th class, 96.5% of patients had heard of epilepsy, and 89.05% thought it was treatable by modern drugs. Out of all patients, 80.1% of patients believed that epilepsy was not contagious, 87.6% believed that they can work, 93.5% believed that they can marry, 66.5% did not feel discriminated by batchmates, and 78.5% did not feel discriminated by teachers. Of all patients, 41.8% said that they would disclose the epileptic condition of their daughters before marriage and 96.01% knew epilepsy patients should be taken to hospital. Conclusion Poor knowledge, negative attitude, and malpractices regarding epilepsy are still prevalent in North India. Epilepsy patients have better knowledge than normal people about this disease. There is still a need to educate people about epilepsy.
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