Publications by authors named "Bahadar S Srichawla"

Cerebral autoregulation (CA) is the mechanism that maintains stable cerebral blood flow (CBF) despite fluctuations in systemic blood pressure, crucial for brain homeostasis. Recent evidence highlights distinct regional variations in CA between the anterior (carotid) and posterior (vertebrobasilar) circulations. Non-invasive neuromonitoring techniques, such as transcranial Doppler, transfer function analysis, and near-infrared spectroscopy, facilitate the dynamic assessment of CBF and autoregulation.

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  • Delayed post hypoxic leukoencephalopathy syndrome (DPHLS) is a rare neurological condition that emerges weeks after hypoxia, causing cognitive and neurological deficits that are challenging to diagnose and treat.
  • The study aims to gather and synthesize existing knowledge on DPHLS, focusing on its biological mechanisms, symptoms, diagnostic methods, and management while identifying areas needing more research.
  • A review of 73 cases indicated that hypoxia often results from substance overdoses (like benzodiazepines and opioids), with common symptoms including cognitive decline and abnormal neuroimaging findings showing changes in the brain's white matter.
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  • * A 34-year-old man initially showed no brain abnormalities on scans, but later imaging revealed significant microbleeds specifically in the corpus callosum, pointing to a unique type of brain injury.
  • * The patient received intensive care and targeted temperature management, leading to a positive outcome with significant recovery and no neurological deficits, although the long-term effects of such microbleeds remain unclear.
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  • - Acute cholangitis is a serious bacterial infection of the bile ducts, leading to high mortality rates (up to 15%) despite advancements in treatment options like antibiotics and emergency procedures.
  • - There’s been a rise in cases involving multidrug-resistant bacteria, necessitating updated antibiotic strategies based on the severity of the condition and culture results from bile samples.
  • - This review focuses on the latest information regarding the epidemiology, treatment options, complications, and the importance of guiding antibiotic therapy to combat resistance, presenting a thorough approach to managing acute cholangitis.
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Myeloproliferative neoplasms (MPNs) occur due to the abnormal proliferation of one or more terminal myeloid cell lines in peripheral blood. Subjects suffering from MPNs display a high burden of cardiovascular risk factors, and thrombotic events are often the cause of death in this population of patients. Herein, we provide a brief overview of dyslipidemia and metabolic syndrome and their epidemiology in MPNs and examine the common molecular mechanisms between dyslipidemia, metabolic syndrome, and MPNs, with a special focus on cardiovascular risk, atherosclerosis, and thrombotic events.

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Multimodal monitoring (MMM) in the intensive care unit (ICU) has become increasingly sophisticated with the integration of neurophysical principles. However, the challenge remains to select and interpret the most appropriate combination of neuromonitoring modalities to optimize patient outcomes. This manuscript reviewed current neuromonitoring tools, focusing on intracranial pressure, cerebral electrical activity, metabolism, and invasive and noninvasive autoregulation monitoring.

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  • HPV is a double-stranded DNA virus that often causes asymptomatic infections, with about 90% resolving on their own, but high-risk strains can lead to cancerous lesions in areas like the cervix and anus.
  • The virus is known to contribute to various malignancies, particularly via its beta strains in skin cancers such as cutaneous squamous cell carcinoma, though its exact role in other skin cancers remains unclear.
  • Recent studies suggest that HPV may also play a role in triggering other skin cancers, like basal cell carcinoma and melanoma, prompting a closer examination of its contributions to both benign and malignant skin lesions.
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Background: Arboviruses are RNA viruses and some have the potential to cause neuroinvasive disease and are a growing threat to global health.

Objectives: Our objective is to identify and map all aspects of arbovirus neuroinvasive disease, clarify key concepts, and identify gaps within our knowledge with appropriate future directions related to the improvement of global health.

Methods: : A scoping review of the literature was conducted using PubMed, Scopus, ScienceDirect, and Hinari.

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Objectives: This study aimed to analyze the Vaccine Adverse Event Reporting System (VAERS) database and systematically review the literature to provide a comprehensive analysis of reversible cerebral vasoconstriction syndrome (RCVS) and posterior reversible encephalopathy syndrome (PRES) secondary to vaccination.

Methods: The authors analyzed the VAERS database and conducted a systematic review following PRISMA guidelines. The inclusion criteria for VAERS data were a score of ≥3 on the RCVS score and/or radiographic findings consistent with the diagnosis of RCVS or PRES.

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Rationale: Hodgkin lymphoma, a lymphatic system cancer, is treated by chemotherapy, radiation therapy, and hematopoietic stem cell transplantation. Posterior reversible encephalopathy syndrome (PRES) is a rare neurotoxic effect associated with several drugs and systemic conditions. This case study emphasizes the potential risks of intensive chemotherapy regimens and postulates the impact of the circle of Willis variants on the heterogeneity of hemispheric lesions in PRES.

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Objectives: To analyze the symptoms and severity of coronavirus disease 2019 (COVID-19) in people with multiple sclerosis (pwMS) on disease-modifying therapies using data from the COVID-19 in multiple sclerosis (MS) Global Data Sharing Initiative dataset.

Methods: The open-access COVID-19 in MS Global Data Sharing Initiative dataset was obtained through credentialed access using PhysioNet. The variables analyzed included BMI, symptoms of COVID-19, age, current use of disease-modifying therapy (DMT), efficacy of DMT, comorbidities, hospitalization status, and type of MS.

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Objectives: To examine the associations between catheter ablation treatment (CA) vs. medical management and cognitive impairment among older adults with atrial fibrillation (AF).

Methods: Ambulatory patients who had AF, were ≥65-years-old, and were eligible to receive oral anticoagulation could be enrolled into the SAGE (Systematic Assessment of Geriatric Elements)-AF study from internal medicine and cardiology clinics in Massachusetts and Georgia between 2016 and 2018.

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Neurolymphomatosis occurs due to the infiltration of a nerve by malignant cells. Cranial neurolymphomatosis is a rare disease process associated with non-solid tumors (i.e.

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Background: Coronavirus disease 2019 (COVID-19) can present with significant cardiac dysfunction, including cardiogenic shock. Mechanical circulatory support with an Impella device may be utilized in these patients to support and offload native right ventricle (RV) and left ventricle (LV) functions. This systematic review aims to describe clinical indications, management, laboratory data, and outcomes in patients with severe cardiogenic shock from COVID-19 treated with an Impella device.

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Classical Philadelphia-negative myeloproliferative neoplasms (MPNs), , polycythemia vera, essential thrombocythemia, and primary/secondary myelofibrosis, are clonal disorders of the hematopoietic stem cell in which an uncontrolled proliferation of terminally differentiated myeloid cells occurs. MPNs are characterized by mutations in driver genes, the JAK2V617F point mutation being the most commonly detected genetic alteration in these hematological malignancies. Thus, JAK inhibition has emerged as a potential therapeutic strategy in MPNs, with ruxolitinib being the first JAK inhibitor developed, approved, and prescribed in the management of these blood cancers.

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  • * Individuals with MPNs face an elevated risk for cardiovascular complications, and MI can either present early on or develop as the disease progresses.
  • * The review discusses the understanding of MI in MPNs, including how it occurs, its symptoms, and possible treatment options, as well as the exploration of various biomarkers for better understanding the link between MI and MPNs.
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Objectives: To examine the associations between catheter ablation treatment (CA) versus medical management and cognitive impairment among older adults with atrial fibrillation (AF).

Methods: Ambulatory patients who had AF, were ≥ 65-years-old, and were eligible to receive oral anticoagulation could be enrolled into the SAGE (Systematic Assessment of Geriatric Elements)-AF study from internal medicine and cardiology clinics in Massachusetts and Georgia between 2016 and 2018. Cognitive function was assessed using the Montreal Cognitive Assessment (MoCA) tool at baseline, one-, and two years.

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Rationale: Toxic leukoencephalopathy, a condition resulting from exposure to toxic substances, can lead to malignant catatonia, a severe motor dysfunction with symptoms such as muscle rigidity and high-spiking fever, hypertensive urgency, and tachycardia. This case study investigates the relationship between toxic leukoencephalopathy-induced malignant catatonia and heart rate variability (HRV), a marker of autonomic nervous system function.

Patient Concerns: A 51-year-old male presented to the emergency department with acute onset of progressively worsening mental status.

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The liver has a central role in metabolism, therefore, it is susceptible to harmful effects of ingested medications (drugs, herbs, and nutritional supplements). Drug-induced liver injury (DILI) comprises a range of unexpected reactions that occur after exposure to various classes of medication. Even though most cases consist of mild, temporary elevations in liver enzyme markers, DILI can also manifest as acute liver failure in some patients and can be associated with mortality.

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Optimal anticoagulation management in patients with atrial fibrillation (AF) during acute ischemic stroke is complex and often poses a significant clinical challenge. An 82-year-old man with AF presented with left-sided hemiparesis and hypoesthesia due to occlusion of the right middle cerebral artery (MCA) after discontinuing apixaban for 5 days. Successful mechanical thrombectomy (MT) achieved thrombolysis in cerebral infarction (TICI) score of 2C.

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Background: Diagnosing pancreatic lesions, including chronic pancreatitis, autoimmune pancreatitis, and pancreatic cancer, poses a challenge and, as a result, is time-consuming. To tackle this issue, artificial intelligence (AI) has been increasingly utilized over the years. AI can analyze large data sets with heightened accuracy, reduce interobserver variability, and can standardize the interpretation of radiologic and histopathologic lesions.

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Neuromyelitis optica, an autoimmune inflammatory disorder affecting the central nervous system, can occur in a paraneoplastic context, although rare. We report an intriguing case of a 71-year-old woman with a history of triple-negative infiltrating ductal breast carcinoma, manifesting with paraneoplastic neuromyelitis optica that led to significant respiratory failure and required a cervical laminectomy. The patient presented with pain in the left breast, weakness in the lower extremities, and neck pain.

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Brain calcifications, previously known as Fahr's disease, is a rare neurological disorder marked by various clinical symptoms, including movement disorders, cognitive impairment, and psychiatric disturbances. Despite its clinical importance, its pathophysiology is unclear and there are no specific treatments. We present four cases of brain calcifications from our tertiary care center, with three female patients (75%) and an average age of 63 years.

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