Tacrolimus induced reversible encephalopathy

Tacrolimus is a novel immunosuppressant used to prevent graft rejection after allogenic organ transplantation. Serious neurological complications of tacrolimus are rare. We present a lady who developed confusion, paresthesiae and visual hallucinations while on tacrolimus following a renal transplant.Her tacrolimus level was high and she improved on stopping the drug. This case highlights the reversible encephalopathy induced by tacrolimus

Trigeminal neuralgia in an elderly male patient with serologically proven myasthenia gravis: Co-occurrence or causation?

Trigeminal neuralgia and myasthenia gravis, both are debilitating neurological pathologies causing a significant negative impact on a person's quality of life by virtue of symptoms like unrelenting excruciating pain and muscle weakness respectively. The case was distinct as the elderly male presented with two variable presentations of distinct neurological diseases over a short period. He presented to us with sudden onset ptosis and monocular diplopia followed by sharp stabbing lancinating hemifacial pain around the V1-V2 region two months later. Hereby, trigeminal neuralgia was diagnosed in a case of seropositive ocular myasthenia gravis. Timely and appropriate diagnoses were made with the support of pertinent investigation and imaging and a relevant treatment plan was commenced

FPGA based Security Login System using GSM with OTP Generation

Security of system is major concern in this age of high-tech infrastructure. In today\u27s materialistic world, security holds an in dispensable place. Security in every aspect is highly desirable may be at home or at office etc. as thefts and robberies are increasing day by day. To overcome this security threat, a security system has been proposed using GSM technology, by generating One Time Password and implementing in FPGA. As FPGAs offer all of the features needed to implement most complex designs. This security system activates, authenticates and validates the user and then unlocks the system. This project attempts to create security login systemwhere the user is granted access if he enters the correct predefined password and is denied access if he enter the wrong password. When password is entered GSM gets activated and send SMS to user\u27s mobile phone, after authentication random OTP is generated and should be verified such that the system gets accessed. In every 3 minutes this OTP verification code will change and is valid for 3 minutes. The outcome of each and all would be available in the LCD of the Spartan 3E board. VHDL codes are used to design this system using Xilinx ISE 9.2i

Rethinking headache as a global public health case model for reaching the SDG 3 HEALTH by 2030

The 2030 Agenda for Sustainable Development sets out, through 17 Sustainable Development Goals (SDGs), a path for the prosperity of people and the planet. SDG 3 in particular aims to ensure healthy lives and promote well-being for all at all ages and includes several targets to enhance health. This review presents a “headache-tailored” perspective on how to achieve SDG 3 by focusing on six specific actions: targeting chronic headaches; reducing the overuse of acute pain-relieving medications; promoting the education of healthcare professionals; granting access to medication in low- and middle-income countries (LMIC); implementing training and educational opportunities for healthcare professionals in low and middle income countries; building a global alliance against headache disorders. Addressing the burden of headache disorders directly impacts on populations’ health, as well as on the possibility to improve the productivity of people aged below 50, women in particular. Our analysis pointed out several elements, and included: moving forward from frequency-based parameters to define headache severity; recognizing and managing comorbid diseases and risk factors; implementing a disease management multi-modal management model that incorporates pharmacological and non-pharmacological treatments; early recognizing and managing the overuse of acute pain-relieving medications; promoting undergraduate, postgraduate, and continuing medical education of healthcare professionals with specific training on headache; and promoting a culture that favors the recognition of headaches as diseases with a neurobiological basis, where this is not yet recognized. Making headache care more sustainable is an achievable objective, which will require multi-stakeholder collaborations across all sectors of society, both health-related and not health-related. Robust investments will be needed; however, considering the high prevalence of headache disorders and the associated disability, these investments will surely improve multiple health outcomes and lift development and well-being globally.info:eu-repo/semantics/publishedVersio

Tele-Neurorehabilitation During the COVID-19 Pandemic: Implications for Practice in Low- and Middle-Income Countries

The importance of neurorehabilitation services for people with disabilities is getting well-recognized in low- and middle-income countries (LMICs) recently. However, accessibility to the same has remained the most significant challenge, in these contexts. This is especially because of the non-availability of trained specialists and the availability of neurorehabilitation centers only in urban cities owned predominantly by private healthcare organizations. In the current COVID-19 pandemic, the members of the Task Force for research at the Indian Federation of Neurorehabilitation (IFNR) reviewed the context for tele-neurorehabilitation (TNR) and have provided the contemporary implications for practicing TNR during COVID-19 for people with neurological disabilities (PWNDs) in LMICs. Neurorehabilitation is a science that is driven by rigorous research-based evidence. The current pandemic implies the need for systematically developed TNR interventions that is evaluated for its feasibility and acceptability and that is informed by available evidence from LMICs. Given the lack of organized systems in place for the provision of neurorehabilitation services in general, there needs to be sufficient budgetary allocations and a sector-wide approach to developing policies and systems for the provision of TNR services for PWNDs. The pandemic situation provides an opportunity to optimize the technological innovations in health and scale up these innovations to meet the growing burden of neurological disability in LMICs. Thus, this immense opportunity must be tapped to build capacity for safe and effective TNR services provision for PWNDs in these settings

Rehabilitation of multiple sclerosis patients in India

Multiple sclerosis (MS) is a chronic progressive disease which is one of the leading causes of handicap in young subjects. The large range of symptoms associated with MS lead to continuing decline in neurologic status and quality of life. The coexistence of physical and cognitive impairments, together with the imprevisible evolution of the disease makes MS rehabilitation very challenging. The main objective of rehabilitation is, therefore, to ease the burden of symptoms by improving self-performance and independence. Inpatient, outpatient and Home rehabilitation with multidisciplinary team has been shown to be beneficial in improving disability. Individualized programs elaborated by a multidisciplinary team of experts are the key to success of rehabilitation. Family plays a big role and Family Based Rehabilitation will be important in long term rehab program in MS

Isolated palatal weakness without optic neuritis as the presenting manifestation of multiple sclerosis and its diagnostic dilemma with acute disseminated encephalomyelitis in a young boy

We present a case of a young boy who at initial presentation was diagnosed as acute disseminated encephalomyelitis (ADEM) but subsequently on follow-up was diagnosed as multiple sclerosis (MS). Differentiating ADEM from MS in their first presentation can be tricky as the features may not be typical of anyone. The importance lies in the close follow-up of these patients

Real world experience with an indigenously manufactured stent Cobal C – A retrospective study

Background: Second generation bare metal stents made of cobalt chromium alloy are superior to first generation stain less steel stents. The thin struts are shown to reduce clinical and angiographic adverse outcomes. Objective: To study the long term clinical and angiographic outcomes in patients who underwent coronary angioplasty with an indigenously made cobalt chromium bare metal stents with thin strut Cobal+C™ (Relisys). Methods: A total of 268 consecutive patients who underwent coronary angioplasty with Cobal+C stents were studied retrospectively. Clinical follow up was done after a minimum period of nine months through telephonic interview and angiographic follow up was done in 80 patients chosen randomly. The end points analyzed included major adverse cardiac events (MACE) at nine months and the rate of binary restenosis at follow up angiogram done between 9 and 15 months post angioplasty. Results: Thirty four percent were diabetic and 33% had acute myocardial infarction. Females constituted 17%. Mean stent diameter was 2.88 ± 0.28 and mean stent length 18.8 ± 4.2. MACE at nine months was 4.5% with TLR 0.3%. The rate of binary restenosis was 21%. Patients with longer stent lengths and non-compliance with medications had significantly higher rates of binary restenosis. Conclusions: The use of Relisys Cobal+C stents was associated with good long term clinical and angiographic outcomes as evidenced by low incidence of MACE and binary restenosis rates for a bare metal stent