Publications by authors named "Ojha Rajeev"

Article Synopsis
  • Knowledge of the genetic factors contributing to Parkinson's disease has significantly expanded, starting from the identification of the first mutation in α-synuclein to discovering various other related genes.
  • Genetic research helps understand the diverse symptoms of Parkinson's disease and promotes the search for new biomarkers and treatment options, with several clinical trials in progress.
  • Efforts to include previously under-represented populations in genetic studies are fostering collaboration and promising new insights, although challenges persist, offering opportunities for a more comprehensive understanding of the disease worldwide.
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Background: The Levodopa Equivalent Daily Dosage (LEDD) calculation algorithms help in capturing and harmonization of Parkinson's Disease (PD) therapies. Analyzing these updates is essential for validating their effectiveness.

Objective: To assess updated LEDD conversion factors in capturing the newer therapies in PD and therapy modules in different geographical cohorts.

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Background And Aims: Neurodegenerative disorders (NDDs) are a growing global health concern with a rise in prevalence with the aging population, leading to increased healthcare utilization and costs. Understanding its prevalence is crucial for effective diagnostics and resource allocation, especially in developing nations with limited resources. This study aims to explore the frequency and types of NDDs, while also collecting demographic, clinical, and neuro-radiological data from patients with NDDs attending a tertiary care hospital in Nepal.

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Background: The field of neurology encompasses the study and treatment of disorders that affect the nervous system, and patients with neurological conditions often require specialized care, particularly in the ICU. Predictive scoring systems are measures of disease severity used to predict patient outcomes. The aim of this study was to compare the discriminative power of commonly used scoring systems, namely the sequential organ failure assessment (SOFA) and acute physiology and chronic health evaluation II (APACHE II) in the ICU of a tertiary care hospital.

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Background Dyslipidemia and obesity are both important risk factors for the first and recurrent ischemic strokes. Dyslipidemia is highly prevalent among Asian populations, and the prevalence of obesity is also noted to be progressively increasing in this population. This study was carried out to determine the prevalence of dyslipidemia and central obesity and their association with each other and various cardiovascular risk factors among patients who presented with an acute ischemic stroke to a tertiary care university hospital in Nepal.

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Objective: To describe the state of literature regarding prevalence, clinical types of tremor in Multiple Sclerosis and associated disability.

Background: Tremor has long been recognized as an important symptom of multiple sclerosis. This can be intention and postural tremor that affects the upper limbs.

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Unlabelled: Augmented reality (AR) technology is being used recently in healthcare, especially for rehabilitation purposes, owing to its ability for repetition, rapid feedback, and motivation for patients. This systematic review and meta-analysis aims to compare the efficacy of AR-based interventions to conventional physical interventions in improving balance, mobility, and fall risk.

Material And Methods: PubMed, Google Scholar, Scopus, and the Cochrane Central Register of Controlled Trials were systematically searched from inception to January 2023.

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Background: The human immunodeficiency virus (HIV) causes movement disorders in persons living with HIV (PLH).

Objectives And Methods: We conducted a systematic review on the spectrum of movement disorders in PLH using standard terms for each of the phenomenologies and HIV.

Results: Movement disorders in PLH were commonly attributed to opportunistic infections (OI), dopamine receptor blockade reactions, HIV-associated dementia (HAD), presented during seroconversion, developed due to drug reactions or antiretroviral therapy (ART) itself and lastly, movement disorders occurred as a consequence of the HIV-virus.

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Unlabelled: The coronavirus disease 2019 (COVID-19) pandemic has affected the number of stroke activations, admission of patients with various types of strokes, the rate and timely administration of reperfusion therapy, and all types of time-based stroke-related quality assessment metrics. In this study, we describe the different types of strokes, different delays in seeking and completing treatment occurring during the second wave of the COVID-19 pandemic, and predictors of outcome at 3 months follow-up.

Materials And Methods: This is a single-centered prospective cross-sectional study carried out from May 2021 to November 2021, enrolling patients with stroke.

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Painful tonic spasms initially described in association with multiple sclerosis are actually more common in patients with neuromyelitis optica spectrum disorder. Characterized by fierce pain and tonic posture of limbs, painful tonic spasms are common in patients during the recovery phase after the first episode of myelitis. A 68-year-old man presented with painful tonic spasm after 2 months of diagnosis of neuromyelitis optica spectrum disorder.

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Unlabelled: The type, quantity, and potency of the organophosphorus compound (OPC) taken determine the symptoms of OPC poisoning as well as their severity. The exact etiology for organophosphorus (OP) poisoning delay neuropathy regulating Wallerian degeneration is still unknown.

Case Presentation: We report here a rare case of a 25-year-old lady with Wallerian degeneration in the brain found in an MRI in a patient after OPC ingestion.

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Unlabelled: Neurologic manifestations in primary Sjögren syndrome (SS) range in prevalence from 8 to 49%, and most of the studies suggest a prevalence of 20%. The incidence of SS patients developing movement disorders is about 2%.

Case Presentation: The authors herein report a case of a 40-year-old lady with MRI of the brain mimicking autoimmune encephalitis in SS who presented with chorea.

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Unlabelled: Osmotic demyelination syndrome (ODS) as a result of the hyperosmolar hyperglycemic state is rare and can present with variable neurological manifestation due to lysis of myelin sheath.

Case Presentation: A 44-year diabetic male presented with complaints of sudden onset, progressive bilateral weakness in lower limbs, and slurring of speech for the past 1.5 months.

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Unlabelled: Guillain-Barré syndrome (GBS) is an immunological demyelinating disorder characterized by progressive, ascending flaccid weakness, usually resulting after infection or some immune stimulation. Its occurrence during pregnancy is rare and due to attribution of its symptoms to pregnancy, diagnosis might be delayed.

Case Presentation: A 39-year-old G4P3L2A0 woman at 13 weeks 6 days period of gestation presented with acute, symmetrical, ascending type of flaccid quadriparesis leading to slurring of speech, swallowing difficulty, and eventually respiratory failure.

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Stiff Person Syndrome (SPS), a progressive Central Nervous System disorder is accompanied by progressive muscle rigidity, hyperreflexia, and spasms mainly in truncal and proximal leg muscles mainly associated with autoimmune disorders. Here, we report a rare case of SPS in a middle-aged Nepalese man with uncontrolled diabetes mellitus and ketonuria.

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Background And Aims: Central nervous system (CNS) infection is one of the most common causes of morbidity, mortality, and hospital admission worldwide. The natural history of CNS infection is quite fatal. Early diagnosis and treatment have been proven to have a crucial role in patients' survival.

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A rare case of chorea hyperglycemic basal ganglia syndrome in a 56-year-old woman who presented with left-sided hemichorea in the setting of uncontrolled, non-ketotic, type II diabetes mellitus is reported. Early blood glucose control could lead to complete resolution of symptoms. Despite an excellent prognosis, delayed recognition and management can lead to prolong disability due to movement disorder.

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Introduction: Wake-up stroke (WUS) is a type of acute ischaemic stroke (AIS) that occurs during sleep with unknown time of symptom onset. The best treatment is usually not suitable for WUS, as thrombolysis is usually provided to patients who had a symptomatic AIS within a definite 4.5 hours, and WUS remains a therapeutic quandary.

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Article Synopsis
  • A reported case involved a patient with diabetes who presented with seizures and altered awareness, initially thought to be due to high blood sugar, but scans showed brain damage typical of central pontine myelinolysis.
  • Research revealed that this syndrome can also be triggered by other factors, including autoimmune liver disease, Sjogren's syndrome, and non-Hodgkin's lymphoma, besides diabetes.
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Symptoms of Guillain-Barre Syndrome (GBS) may be mistaken for typical puerperal changes, delaying diagnosis. Surgery and anesthesia may be triggers for GBS with an overall increase in pro-inflammatory cytokines in the postpartum period. We report a unique case of GBS in the postpartum period who made a good recovery with supportive measures.

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Background: Cerebral venous thrombosis (CVT) is a rare thrombotic condition which is traditionally treated with anti-coagulation therapy. Subsets of patients with severe CVT have been treated with endovascular thrombectomy (EVT). Despite the high estimated mortality associated with severe CVT, there has been only one randomized control trial done regarding safety and efficacy of EVT in severe CVT compared to standard medical management.

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Objective: To compare the efficacy and safety of Levetiracetam (LEV) and Oxcarbazepine (OXC) as monotherapy for the treatment of newly diagnosed focal epilepsy.

Methods: We searched PubMed, Cochrane Library, EMBASE, and Google Scholar from January 1, 2000 to May 11, 2022, with no language restrictions along with The ClinicalTrials.gov website and the WHO International Controlled Trials Registry platforms.

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Article Synopsis
  • Thyrotoxic periodic paralysis (TPP) is a rare condition characterized by recurring muscle weakness due to low potassium levels, often linked to thyrotoxicosis, particularly from Graves' disease, and can lead to effective treatment if recognized early.
  • A case involving a 25-year-old male experiencing recurrent limb weakness was diagnosed with thyrotoxicosis after treatment with potassium and imaging studies, highlighting the condition's potential misdiagnosis.
  • Effective management involves treating the underlying thyroid disorder and administering potassium during attacks, but caution is needed to avoid complications like hyperkalemia.
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Introduction: Increasing evidence suggests Amyotrophic Lateral Sclerosis (ALS) as a widespread pathological process comprising nonmotor features like fatigue, mild sensory symptoms, cognitive decline, and visual impairment. Measurements of retinal nerve fiber layer (RNFL) thickness using Optical Coherence Tomography (OCT) may correlate with the neurodegeneration associated with ALS. In addition to RNFL thickness, other OCT parameters have been explored in the context of diagnosing ALS and predicting disease severity.

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