Publications by authors named "Mvp Srivastava"

Background And Objectives: Tau PET is being increasingly appraised as a novel diagnostic modality for dementia work up. Given limited data among South Asians, we assessed the frequency, patterns, phenotypic associations and incremental value of positive Tau PET scans in clinically diagnosed neurodegenerative dementia.

Methods: This cross-sectional study recruited consecutive patients of Alzheimer's disease (AD) and non-AD syndromes (September 2021 to October 2022, India).

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Background And Objectives: Rising hypertension from inadequate detection, noncompliance with treatment, and poor control presents a major public health challenge. Previously, adopting the strategy of self-monitoring of blood pressure (SMBP) showed better hypertension detection, control, and medication adherence. However, evidence from India is scarce.

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Stroke is a leading cause of morbidity and mortality in humans. Most strokes are ischemic in nature and early recanalization of occluded vessels determines good outcomes. Recanalization of occluded vessels depends on many angiographic and demographic features.

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Article Synopsis
  • The EAST-AIS trial aims to assess the effectiveness of tenecteplase for treating acute ischemic stroke in patients treated 4.5-24 hours after symptoms start, rather than the standard 4.5 hours.
  • The study involves 100 participants, with half receiving tenecteplase and the other half a placebo, focusing on patients with specific eligibility criteria such as age and stroke severity.
  • The main goal is to evaluate the safety and efficacy of tenecteplase, measured by the modified Ranking Scale (mRS) score 90 days after the stroke.
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Background: Mechanical thrombectomy has been established as a safe, standard and effective treatment option for occlusions of the proximal segment of the middle cerebral artery (MCA), as demonstrated in numerous studies. However, performing thrombectomy in the M2 divisions of MCA presents inherent challenges. In this institutional experience, we aim to delineate the recanalisation rates achieved through mechanical thrombectomy in cases involving the M2 segment of the MCA.

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Background And Purpose: Mechanical thrombectomy is the standard treatment modality for flow restoration in acute ischemic stroke. In cases of persistent occlusion, the optimal number of retrieval attempts before considering procedure termination is currently undetermined and is a topic for research. Therefore in this study, we studied the impact of the number of stent retrieval maneuvers on the recanalization of vessels.

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Facioscapulohumeral muscular dystrophy (FSHD) is the third most common form of hereditary myopathy. Sixty per cent of the world's population lives in Asia, so a significant percentage of the world's FSHD participants is expected to live there. To date, most FSHD studies have involved individuals of European descent, yet small-scale studies of East-Asian populations suggest that the likelihood of developing FSHD may vary.

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Introduction: Guidelines recommend screening older people (> 60-65 years) with type 2 diabetes (T2D) for cognitive impairment, as it has implications in the management of diabetes. The Montreal Cognitive Assessment (MoCA) is a sensitive test for the detection of mild cognitive impairment (MCI) in the general population, but its validity in T2D has not been established.

Methods: We administered MoCA to patients with T2D (age ≥ 60 years) and controls (no T2D), along with a culturally validated neuropsychological battery and functional activity questionnaire.

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Stroke is the second leading cause of death and a major cause of disability worldwide. Stroke severity scales serve as reliable means to track a patient's neurological deficit, predict outcome, and guide treatment decisions in clinical practice. The National Institute of Health Stroke Scale (NIHSS) was introduced over 30 years ago, marking a significant milestone in the field of stroke.

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Article Synopsis
  • The study focuses on Minimum Clinically Important Difference (MCID), which is the smallest change in a measure that has real clinical significance, helping with treatment assessment and outcome measure development.
  • The systematic review analyzed 2763 reports, ultimately including 32 studies, with most being of good quality, and highlighted the Unified Parkinson's Disease Rating Scale (UPDRS) as the most frequently evaluated.
  • The review provides a comprehensive list of MCID thresholds for various scales used in movement disorders, emphasizing the importance of standardized MCID measures for future research.
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  • Primary CNS Vasculitis (PCNSV) is a rare inflammatory condition affecting blood vessels in the central nervous system, making diagnosis complex due to its variability and lack of clear laboratory markers.
  • A study analyzed 56 patients with confirmed PCNSV, finding that most exhibited symptoms in the cerebral hemisphere or brainstem, with common MRI findings being bilateral white matter lesions, predominantly in the frontal lobe.
  • Key imaging features included a high prevalence of susceptibility-weighted imaging (SWI) hemorrhages and a distinct dot-linear enhancement pattern on T1-weighted images, suggesting that these imaging characteristics should be considered for improved diagnostic criteria for PCNSV.
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Background: Coronavirus disease of 2019 (COVID-19) pandemic has posed challenges for clinicians with respect to questions regarding vulnerability of patients with chronic autoimmune diseases like Multiple Sclerosis (MS) and other demyelinating central nervous system (CNS) disorders.

Objectives: We assessed outcomes of COVID-19 disease among patients with CNS demyelinating disorders and its effect on neurological disability.

Methods: This was an electronic survey in which a structured questionnaire was distributed to patients registered with neuroimmunology and MS clinics at All India Institute of Medical Sciences, New Delhi, India.

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  • The study investigates the use of corticosteroids in treating tuberculous meningitis (TBM) through two methods: overlap oral dexamethasone (OOD) and direct oral dexamethasone (DOD), administered for a total of 8 weeks.! -
  • Results showed similar rates of symptomatic resolution one month post-treatment and comparable morbidity and mortality at 3 and 6 months between both methods, with no significant differences in outcomes.! -
  • The study suggests that injectable steroids may be used for the first week for TBM patients in earlier stages, but this protocol is not applicable for patients with severe stage IV TBM or specific complications.
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  • There is increasing recognition of minimum clinically important differences (MCIDs) in stroke research, representing meaningful changes in patient outcomes.
  • This review offers a detailed overview of various scales and patient-reported outcome measures (PROMs) used in stroke studies, along with their MCID values and methodologies for determining them.
  • Despite some challenges in estimating MCIDs, using both anchor-based and distribution-based methods, along with patient self-evaluation, is essential for accurately assessing treatment effects and improving stroke care.
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There is a pressing clinical need for thrombolytic agents that can effectively disaggregate arterial thrombi in acute ischemic stroke without significantly increasing the risk of bleeding. This pilot study aimed to investigate the safety and efficacy of N-acetylcysteine (NAC) as an adjunctive therapy to intravenous recombinant tissue plasminogen activator (rtPA or alteplase). A randomized, open-label, blinded assessor pilot study was conducted.

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The concept of the minimal clinically important difference (MCID) emerged from the recognition that statistical significance alone is not enough to determine the clinical relevance of treatment effects in clinical research. In many cases, statistically significant changes in outcomes may not be meaningful to patients or may not result in any tangible improvements in their health. This has led to a growing emphasis on the importance of measuring patient-reported outcome measures (PROMs) in clinical trials and other research studies, in order to capture the patient perspective on treatment effectiveness.

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Objective: To determine the feasibility, reliability, and acceptability of video teleconference (VTC)-based neuropsychological assessment using Addenbrooke's cognitive examination-III (ACE-III).

Methods: This study was performed from January 2022 to April 2022, during the third wave of the COVID-19 pandemic in India. We administered ACE-III using video-teleconferencing and compared the scores to face-to-face (FTF) testing for the eligible participants.

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  • Neuropathic Tremor (NT) can occur in patients recovering from Guillain-Barré Syndrome (GBS), characterized by a postural/kinetic tremor of the upper extremities.
  • NT in this context features a fine, fast, slightly jerky tremor with frequencies between 8 to 10 Hz, often accompanied by dystonic posturing and overflow movements.
  • Electrophysiological evaluations suggest that NT involves a central oscillator mechanism, potentially linked to cerebellar dysfunction due to impaired sensorimotor feedback during recovery from GBS.
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Azathioprine (AZA) has demonstrated efficacy in multiple randomized control trials (RCTs) for Relapsing-Remitting Multiple Sclerosis (RRMS). However, we still need comparative real-world data with other first-line disease-modifying therapies (DMTs). We aimed to assess AZA's effectiveness regarding relapses, disability progression, time to the first relapse, magnetic resonance imaging (MRI) activity, and safety compared with other approved first-line DMTs in an Indian population in a real-world setting.

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Background And Purpose: Although rare, neurological adverse events have been reported post-COVID-19 vaccination. This study reports 16 patients diagnosed with CNS inflammatory demyelinating diseases (CNS-IDD) within 6 weeks of COVID-19 vaccine administration.

Methodology: A prospective observational study was conducted from June 2021 to May 2022.

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Introduction: The benefit of endovascular treatment in large anterior circulation ischaemic strokes with low ASPECTS score (<6) is uncertain. Recent randomised studies have demonstrated the benefit of endovascular treatment (EVT) in large ischaemic strokes. The present meta-analysis aims to assess the combined effect of these studies on efficacy and safety of endovascular treatment in this group of patients.

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