Review article: DOES INTRA-ARTERIAL HEPARIN FLUSHING (IAHF) CAN ACTUALLY INCREASE MANUAL MUSCLE TEST (MMT) SCORE IN CHRONIC ISCHEMIC STROKE PATIENTS?

Stroke is still a major health problem in the world. Ischemic stroke accounts for 87% of all acute stroke occurrences. In 2013, the American Heart Association (AHA)/American Stroke Association (ASA), published a Guideline for the Early Management of Patients with Acute Ischemic Stroke. The managements consist of the use of recombinant tissue plasminogen activator (rtPA), endovascular treatment, etc. Unlike acute ischemic stroke, until now, no guidelines have been provided about the management of chronic ischemic stroke that approved universally. The result of the study with the title of “Intra Arterial Heparin Flushing Increases Manual Muscle Test – Medical Research Councils (MMT-MRC) Score in Chronic Ischemic Stroke Patient” is very interesting, because it is a new attempt to treat patients with chronic ischemic stroke. The purpose of this article is to review the study mentioned above, in accordance with the applied scientific principles and is based on the standard literatures and guidelines. Our review is limited only to the discussion of the study results. From this discussion can be proved the existing references that support and/or refuse the study results. Based on the discussions and conclusions of this study, there were no references to support that IAHF can improve motor functions (muscles) in patients with chronic ischemic stroke

Neuroprotective Effect Of Citicholine In Mercury Intoxication

Objective: Mercury induces cell death in various cell lines by apoptosis or necrosis. It is associated with alteration of some apoptosis regulators such as p53 and caspase-3. Citicholin has been widely used as neuroprotectant in cerebrovascular disease and other neurologic disorder. Previous studies have shown beneficial effect of citicholin in reducing inflammation and apoptosis in patient with stroke and pain, but none of those have used mercury intoxicated rat animal model. We try to investigate the neuroprotective effect of citicholin mercury intoxication. Methods : We conducted an controlled study using male rats (Rattus Novergicus) as animal model and devided the subjects into 5 groups (P0,P1,P2,P3,P4) and 0.4 mg/kg BW of MeHgCl3 is administered for 21 days to all groups. Citicholin (0,5,10,20 and 40 mg/kgBW/day was added during the exposure. Protein p53 and Caspase-3 expression on neurons were counted. Result : The mean scores±SD of p53 in group P0;P1;P2;P3;P4 were 8,406±0,70; 6,828±1,40; 4,680±1,2; 1,752±0,4; 0,807±0,1 respectively and for Caspase 3 were 8,854±1,91; 6.670±0,61; 4,21±1,02; 2,632±1,00; 0,818± 0,22 respectively. Conclusion : citicoline treatment exerts neuroprotective effect against neuronal apoptotic changes by reducing the expression of p53 and caspase-3 in dose dependent manner on mercury intoxicated rat

The Effect of Ginkgo Biloba (Egb) Extracts on the Expression of Hsp 90, Vegf and Bdnf in the Rattus Novergicus with Lead (Pb) Exposure

The rapid industrial growth did regrettably create new problems, especially in a heavy amount of lead (Pb) waste. This may cause intoxication, that give rise to health problems specifically in the nervous system. EGb is believed to have neuroprotective effects. Despite lots of studies, the mechanism of action of EGb on repairing brain cell damage due to exposure to Pb remains unclear. The effect of EGb on neuron proteins related to apoptosis and neuronal cell death due to Pb intoxication remains unknown. To determine the effect of Ginkgo biloba extract on the expression of HSP 90, VEGF and BDNF on Rattus novergicus exposed to Pb. This study was experimental by means of randomized experimental post study design. The study population used was male rats, aged 4-5 months, weighing 140-150 grams. The sample of this study was healthy male rats fulfilling the inclusion criteria and exclusion criteria, that was divided into 4 groups. The variables in this study were independent variables, dependent variables, and controlled variables. After the data were obtained and analyzed, a statistical analysis was performed. Based on the acquired data, the HSP 90 levels among groups differed significantly (p=.004), so did the VEGF (p=.030). Likewise, a significant difference among treatment groups was also recorded on the expression of BDNF (p=.004). EGb can reduce HSP 90 expression in rats exposed to lead. EGb can increase VEGF expression in rats exposed to lead. EGb can increase BDNF expression in rats exposed to lead

Ekspresi Kaspase 8 dan Perubahan Jumlah Sel Neuroglia pada Regulasi Mekanisme Apoposis Sel Otak Akibat Keracunan Merkuri

Introduction : Mercury is a potent neurotoxin since it induces apoptosis and inflammatory respond in brain. Caspases e.g. caspase 8is one of central effectors of apoptosis and serve as signaling mediators that orchestrate apoptotic execution pathways by cleaving a subset of cellular proteins. Whereas brain inflammatory response is triggered by the activation of neuroglial e.g. microglial cells and astrocytes and this glial reactivity has been used as an early marker of neurotoxicity.To study the effects of neurotoxicity mercury we use caspase 8 and microglial as a parameter of methyl mercury neurotoxicity. Aims : To observe the process of apoptosis and inflammatory processes in the brain caused by methylmercury poisoning rats Rattus novergicus. Methods : Rattus novergicus aged 4 months was used as experiental model and devided into 3 group of treatment with orally administered: aquabidest; methylmercury 0,2 mg and 0,4 mg/BW/day. Brains of the mice were removed after 30 days of exposure and tissue samples were obtained for examination. Caspase8 was identified by imunohystochemistry staining using Avidin-biotin complex method. Microglial cell was counted from hystophatology examination of the HE stained brain tissue. Results : Mean of caspase 8 in group of aquabidest; methylmercury 0.2 and 0.4 mg/BW/day were 68?8.95;197.3?36.83;275.6?34.19 respectively whereas mean of microglial cell count:65.6?19.61;137.1?15.32;167.9?12.8 respectively. Conclusions : Mercury exposure increases both of caspase 8 expression and neuroglia cell count in Rattus novergicus brain tissue. The result suggests that methylmercury induces apoptosis and inflammatory respond in brain

Pengukuran Tingkah Laku Pada Model Nyeri Neuropatik Perifer: Tikus dengan CCI (Chronic Constriction Injury)

Neuropathic pain occurs in 20% of patients with chronic pain. This mainly due to the lack of effective treatment and the presence of drug’s side effects. Animal models have been broadly utilized in validating the therapeutic target and the development of analgesic drugs. Chronic constriction injury (CCI) is a model of peripheral neuropathic pain characterized by allodynia and hyperalgesia. Chronic constriction injury model is produced by loose ligation of the sciatic nerve resulting in nerve damage, thus sensitizes and lowers pain threshold. The pain threshold test is performed by providing a pressure and thermal sensory stimulus that results in observable withdrawal behavior. This article discusses several methods in assessing pain-related behavior on the CCI neuropathic pain model

Bekam Sebagai Terapi Alternatif Untuk Nyeri

Pain is still a world’s problem. Current pain treatment is still unsatisfactory due to its chronicity and existing drugs’ side effects. Due to dissatisfaction with the existing treatment, many patients are choosing a traditional therapy for their pain treatment. Cupping therapy is one of the traditional therapies that is widely used to relieve pain. Cupping therapy has been used in many countries in the world. Some of these countries have used cupping therapy as a pain treatment in hospitals. Neurologists are handling pain cases in their daily practice. Nearly 80% of patients come to the doctor with one of their complaint related to pain directly. The knowledge of cupping therapy for pain is important for the development of new therapies in order to solve the pain problems that so far have not reached a satisfactory level

The Association of Lipoprotein-a Levels, Neutrophil Lymphocyte Ratio and Hypertension with the Clinical Severity Scale Measured by NIHSS Scale in Patients with Acute Thrombotic Stroke

Background: The correlation between levels of Lipoprotein-a, Neutrophil Lymphocyte Ratio and hypertension with clinical severity scale remains a controversial issue. Objective: To determine the correlation of levels of Lipoprotein-a, Neutrophil Lymphocyte Ratio and hypertension with the severity scale measured by NIHSS scale in patients with acute thrombotic stroke. Method: Lipoprotein-a levels, Neutrophil Lymphocyte ratio, blood pressure in patients with acute thrombotic stroke were measured and clinical severity scale was assessed by NIHSS scale. The levels of lipoprotein-a were grouped into normal and high levels of lipoprotein-a, Lymphocyte Neutrophil Ratios were grouped into low and high and hypertension were grouped into stage 1 and 2. The data was analyzed using logistic regression. Results: There were 40 patients consisting of 29 (72.50%) male patients and 11 (27.50%) female patients. The demographic data included gender, age, LDL level, random blood sugar level, diabetes mellitus status and smoking status which were all homogeneous in both groups of lipoprotein-a, Neutrophil Lymphocyte ratio and hypertension stage. In the logistic regression analysis, the lipoprotein-a and neutrophil lymphocyte ratio were correlated with clinical severity scale (p = 0.018, RO 0.122 (CI 95% 0.022-0.696) vs p = 0.041, RO 0.068 (95% CI 0.005-0.895) while hypertension stage was not correlated with clinical severity scale (p = 0.97, RO 1.02 (95% CI 0.28-3.80). Conclusion: The levels of lipoprotein-a and lymphocyte neutrophil ratio were related to the clinical severity measured by NIHSS scale but not with hypertension

Pengukuran Tingkah Laku pada Model Nyeri Neuropatik Perifer: Tikus dengan CCI (Chronic Constriction Injury)

Neuropathic pain occurs in 20% of patients with chronic pain. This mainly due to the lack of effective treatment and the presence of drug’s side effects. Animal models have been broadly utilized in validating the therapeutic target and the development of analgesic drugs. Chronic constriction injury (CCI) is a model of peripheral neuropathic pain characterized by allodynia and hyperalgesia. Chronic constriction injury model is produced by loose ligation of the sciatic nerve resulting in nerve damage, thus sensitizes and lowers pain threshold. The pain threshold test is performed by providing a pressure and thermal sensory stimulus that results in observable withdrawal behavior. This article discusses several methods in assessing pain-related behavior on the CCI neuropathic pain model

Thymoquinone Modulates Local MMP-9, IL-10, and IgG in Sciatic Nerve Crush Injury Animal Model

BACKGROUND: Interleukin (IL)-10 is involved in Wallerian degeneration after peripheral nerve crush injury. Oral thymoquinone was previously observed to decrease local immunoglobulin-G (IgG) in a crush- injured rat model. No study has evaluated the pathway of various thymoquinone dosages on local IgG and IL-10 in this injury. METHODS: This experimental study used 126 Rattus norvegicus Wistar rats that were divided into 18 groups: six groups received a placebo, the other six groups received thymoquinone at 100 mg/kg/day and the last six groups received thymoquinone at 250 mg/kg/day, respectively. Rats were sacrificed at 12, 18, 24, 5x24, 6x24, and 7x24 hours. Matrix metalloproteinase-9 (MMP-9), IL-10, and local IgG levels were assessed by Enzyme-Linked Immunosorbent Assay (ELISA). The nuclear factor KappaB (NF-κB) expressions on Schwann cells were examined by flow cytometry. Path analysis was performed using SmartPLS. RESULTS: The path analysis showed that 100mg/kg/day of thymoquinone significantly decreased NF-κB expression. However, NF-κB did not affect local MMP-9, and MMP- 9 had no significant relationship with local IL-10 and IgG. Thymoquinone 250 mg/kg/day also significantly inhibited NF-kB expression, decreased local MMP-9, and, in turn, decreased local IL-10 and IgG. CONCLUSION: Administration of oral thymoquinone 250 mg/kg/day decreases local IgG and IL-10 levels via suppressing NF-κB expression and MMP-9 level

Vim line technique thalamotomy for Parkinson tremor: Case series

Introduction The ventral intermediate (Vim) nucleus of the thalamus is difficult to identify even with 3 T magnetic resonance imaging. Stereotactic Vim thalamotomy is a usual procedure to control Parkinson tremor. Successful relieving of the tremor depends on the accuracy of defining the Vim location. Presentation of cases Three patients with Parkinson tremor were subjected to stereotactic thalamotomy using the Vim line technique (VLT) so as to precisely determine the Vim location. All patients showed good results, with improved tremors, as indicated by the UPDRS score, without any complications. Discussion The precise targeting of the Vim nucleus is crucial importance for the successful Vim thalamotomy. Various method has been developed to determine Vim location. Atlas based and Guiot’s technique routinely used by neurosurgeon. VLT is a new technique that has been developed to determine the Vim location on MRI. Conclusion VLT is useful for the determination of the Vim location. However, further research is warranted to prove its effectiveness