Shifted phase of EEG cross-frequency coupling in individuals with Phelan-McDermid syndrome

Background Phelan-McDermid Syndrome (PMS) is a rare condition caused by deletion or mutation of the SHANK3 gene. Individuals with PMS frequently present with intellectual disability, autism spectrum disorder, and other neurodevelopmental challenges. Electroencephalography (EEG) can provide a window into network-level function in PMS. Methods Here, we analyze EEG data collected across multiple sites in individuals with PMS (n = 26) and typically developing individuals (n = 15). We quantify oscillatory power, alpha-gamma phase-amplitude coupling strength, and phase bias, a measure of the phase of cross frequency coupling thought to reflect the balance of feedforward (bottom-up) and feedback (top-down) activity. Results We find individuals with PMS display increased alpha-gamma phase bias (U = 3.841, p < 0.0005), predominantly over posterior electrodes. Most individuals with PMS demonstrate positive overall phase bias while most typically developing individuals demonstrate negative overall phase bias. Among individuals with PMS, strength of alpha-gamma phase-amplitude coupling was associated with Sameness, Ritualistic, and Compulsive behaviors as measured by the Repetitive Behavior Scales-Revised (Beta = 0.545, p = 0.011). Conclusions Increased phase bias suggests potential circuit-level mechanisms underlying phenotype in PMS, offering opportunities for back-translation of findings into animal models and targeting in clinical trials

Sociodemographic, epidemiological, clinical, and treatment profile of snakebite cases presented to a tertiary care hospital in Davangere, Karnataka, India

Background and Objectives: Snakebite is a common medical emergency requiring immediate medical attention. This study was conducted to understand snakebite cases, with particular attention given to where the lacunae lie in current management so that remedial steps may be undertaken. Materials and Methods: This was a cross-sectional, descriptive study and was carried out in Davangere, Karnataka, India. Snakebite cases (729) were included in the study and all the victims were interviewed using a prestructured questionnaire. Victims were evaluated for the nature of bites, first aid measures, treatment modalities, and treatment outcome. Results: The majority of the snakebite victims were from villages, were farmers, and belonged to the 20-40 years age group. Viper bites were the most frequently reported, and an overwhelming number of victims resorted to first aid measures with tourniquet application at the site. Most victims reached a peripheral health institution (PHI) first following the bite, and a small fraction received only one vial of anti-snake venom (ASV). The longest referral pathway to a tertiary hospital was as follows: Bite-traditional healer- primary health center (PHC)-tertiary hospital; fatality was 2%. Most victims had signs of envenomation and received ASV, of whom 32% administered with ASV had developed hypersensitivity reaction. Conclusion: This study showed that PHCs were inadequate in terms of providing optimal treatment and that measures are needed to upgrade these facilities

Correlation of Clinicohaematological Parameters in Paediatric Dengue: A Retrospective Study

Dengue is one of the arthropod-borne (arbo) viral diseases transmitted by female mosquito Aedes aegypti. Dengue fever has a wide spectrum of clinical presentation ranging from flu-like illness to severe complicated stage of dengue hemorrhagic fever leading to mortality. This was a retrospective study conducted in a tertiary care hospital in Coastal Karnataka, South India, to know the correlation between the clinical presentation and haematological parameters in the paediatric cases presented with dengue symptoms. A total of 163 paediatric cases who presented fever and dengue-like illness were included in the study. Of which, 69 were confirmed dengue patients. Critical analysis showed that there was a significant difference in the haematological parameters like total leucocyte count, percent differential leucocyte count, and platelets count, in the erythrocyte sedimentation rate (P<0.05 to 0.0001). Additionally, when compared to nondengue patients, even the liver function and renal function parameters were significantly deranged (P<0.05 to 0.0001). Stratification based on NS1, IgG, and IgM showed significant alterations in the haematological, hepatic, and renal parameters. With respect to the treatment a small percentage of patients, that is, 8% (4 patients), required platelet transfusion as their counts went below 20,000/μL. Two patients succumbed to their illness while three required ICU stay