Browsing by Author "Priya Dev"

Now showing 1 - 18 of 18

Advanced glycation end product molecules as major culprits behind amyloidogenic protein aggregation
(Elsevier, 2025) Priya Dev; Abhishek Pathak; Rameshwar Nath Chaurasia
Advanced glycation end products (AGEs) are lipids or proteins that are glycated after exposure to sugars. They are commonly seen in the vasculature of diabetics and are thought to have a role in the development of atherosclerosis. AGEs impact diseases like diabetes and neurodegenerative disorders because they are essential in the misfolding and aggregation of proteins. AGE molecules have a significant role in the aggregation of amyloidogenic proteins, which in turn facilitates the production of amyloid formations linked to diseases, including Parkinson's and Alzheimer's. Amyloidogenic proteins and AGEs interact to speed up protein aggregation, which aids in the etiology of neurodegenerative illnesses. Glycation, metal binding, and oxidative stress are some elements that affect the complex interactions that result in the creation of stable fibrillary structures and AGEs, which cause protein aggregation. The impact of AGE-induced protein aggregation on diabetes and neurodegenerative diseases is profound, with AGEs playing a significant role in disease progression. Antioxidants, cross-link breakers, RAGE antagonists, and inhibitors target AGEs and provide ways to reduce the consequences of disease and prevent AGE-induced protein aggregation. In this chapter, we will look at all the statements mentioned above and learn about amyloidogenic protein aggregation and its consequences for disease pathophysiology. © 2026 Elsevier Inc. All rights reserved..
Analysis of Wide Modified Rankin Score Dataset using Markov Chain Monte Carlo Simulation
(Lifescience Global, 2024) Pranjal Kumar Pandey; Priya Dev; Akanksha Gupta; Abhishek Pathak; V.K. Shukla; S.K. Upadhyay
Brain hemorrhage and strokes are serious medical conditions that can have devastating effects on a person’s overall well-being and are influenced by several factors. We often encounter such scenarios specially in medical field where a single variable is associated with several other features. Visualizing such datasets with a higher number of features poses a challenge due to their complexity. Additionally, the presence of a strong correlation structure among the features makes it hard to determine the impactful variables with the usual statistical procedure. The present paper deals with analysing real life wide Modified Rankin Score dataset within a Bayesian framework using a logistic regression model by employing Markov chain Monte Carlo simulation. Latterly, multiple covariates in the model are subject to testing against zero in order to simplify the model by utilizing a model comparison tool based on Bayes Information Criterion. © 2024 Pandey et al.; Licensee Lifescience Global.
Antiseizure Medications in Poststroke Seizures: A Systematic Review and Network Meta-Analysis
(Lippincott Williams and Wilkins, 2025) Shubham Misra; Selena Wang; Terry J. Quinn; Jesse Dawson; Johan Zelano; Tomotaka Tanaka; James Charles Grotta; Erum I. Khan; Nitya Beriwal; Melissa C. Funaro; Sravan Kumar Perla; Priya Dev; David Larsson; Taimoor Hussain; David S. Liebeskind; Clarissa Lin Yasuda; Hamada Hamid Altalib; Hitten P. Zaveri; Amr Elshahat; Gazala Hitawala; Ethan Y. Wang; Rachel Kitagawa; Abhishek Pathak; Fabien Scalzo; Masafumi Ihara; Katharina S. Sunnerhagen; Matthew R. Walters; Yize Zhao; Nathalie J. Jetté; Scott E. Kasner; Patrick Kwok Leung Kwan; Nishant K. Mishra
Background and ObjectivesThe most effective antiseizure medications (ASMs) for poststroke seizures (PSSs) remain unclear. We aimed to determine outcomes associated with ASMs in people with PSS.MethodsWe systematically searched electronic databases for studies on patients with PSS on ASMs. Our outcomes were seizure recurrence, adverse events, drug discontinuation rate, and mortality. We assessed the risk of bias using Cochrane Risk of Bias tool for randomized controlled trials and Risk Of Bias In Non-randomized Studies of Interventions tools. Using levetiracetam as the reference treatment, we conducted a frequentist network meta-analysis and determined the certainty of evidence using the Grading of Recommendations Assessment, Development, and Evaluation methodology.ResultsOur search yielded 15 studies (3 randomized, 12 nonrandomized, N = 18,676 patients (121 early and 18,547 late seizures), 60% male, mean age 69 years) comparing 13 ASMs. Three studies had moderate and 12 had high risk of bias. Seizure recurrence was 24.8%. Compared with levetiracetam, very low-certainty evidence suggested that phenytoin was associated with higher seizure recurrences (odds ratio [OR] 7.3, 95% CI 3.7-14.5) and more adverse events (OR 5.2, 95% CI 1.2-22.9). Low-certainty evidence suggested that carbamazepine (OR 1.8, 95% CI 1.5-2.2) and phenytoin (OR 1.9, 95% CI 1.4-2.8) were associated with high drug discontinuation rates. Moderate to high-certainty evidence suggested that valproic acid (OR 4.7, 95% CI 3.6-6.3) and phenytoin (OR 8.3, 95% CI 5.7-11.9) were associated with higher mortality rates. Considering all treatments and using the GRADE approach for treatment ranking, very low-certainty evidence suggested that eslicarbazepine, lacosamide, and levetiracetam had the fewest seizure recurrences. Low to very low-certainty evidence suggested that lamotrigine had the fewest adverse events and drug discontinuations, whereas lamotrigine and levetiracetam exhibited low mortality rates with moderate-certainty evidence.DiscussionWe found that levetiracetam and lamotrigine may be safe and tolerable ASMs for PSS. Despite ASM use, the seizure recurrence rate remains high in the PSS population. Owing to bias and confounding risks, these findings should be interpreted cautiously.Trial Registration InformationPROSPERO: CRD42022363844. © 2025 American Academy of Neurology. Unauthorized reproduction of this article is prohibited.
Blood and CSF biomarkers for post-stroke epilepsy: a systematic review
(BioMed Central Ltd, 2022) Priya Dev; Mareena Cyriac; Kamalesh Chakravarty; Abhishek Pathak
Post-stroke epilepsy is a common complication of ischemic stroke which adversely affects the prognosis of patients. Clinical and radiological parameters cannot adequately predict the risk. Therefore, the discovery of biomarkers is imperatively needed for predicting post-stroke epilepsy. We conducted a systematic review of diagnostic and prognostic biomarkers for post-stroke epilepsy through a comprehensive literature search in different databases. All articles that met our inclusion criteria were assessed for quality using the modified Quality Assessment of Diagnostic Accuracy Studies questionnaire. Eight eligible studies were included in this systematic review. Out of 22 assessed biomarkers, nine biomarkers showed significant association with post-stroke epilepsy. The T allele of CD40 (cluster of differentiation 40) −1C/T polymorphism, the CC genotype of TRPM6 (transient receptor potential cation channel subfamily M member 6) rs2274924, the allele polymorphism of MAD2 (mitochondrial aldehyde dehydrogenase 2), the mRNA level of interleukin-6 (IL-6), the plasma level of endostatin, and the mRNA expression of IL-1β show a positive correlation with post-stroke epilepsy; while S100 calcium-binding protein B, heat shock 70 kDa protein-8 and neuropeptide Y are inversely associated with post-stroke epilepsy. As a small number of patients were recruited, further studies are needed to confirm their potential use for predicting post-stroke epilepsy. © 2022, The Author(s).
Blood biomarkers for the differentiation of cardiac ischemic stroke subtypes: A systematic review
(Bentham Science Publishers, 2019) Abhishek Pathak; Surya P. Pandey; Prasoon Madhukar; Priya Dev; Deepika Joshi; Vijay N. Mishra; Rameshwar N. Chaurasia
Background: Blood biomarkers are a cost-effective and valid method to diagnose ischemic stroke and differentiate its subtypes in countries with poor resources. Objective: To perform a systematic review of published literature evaluating the diagnostic utility of blood-based biomarkers to diagnose and differentiate the etiology of ischemic stroke. Methods: A comprehensive literature search was carried out till December 2017 in major scientific and medical databases including PubMed, Cochrane, OVID and Google Scholar. Modified Quality Assessment of Diagnostic Accuracy Studies questionnaire was used to assess the methodological quality of each study. Results: Twenty-six studies were identified relevant to our systematic review. Various biomarkers have been studied, though only a few biomarkers such as a B-type natriuretic peptide (BNP) and Ddimer have proved their clinical utility. None of the other tested biomarkers appeared to have consistent results to diagnose ischemic stroke subtypes. Most of the studies had limitations in the classification of ischemic stroke, sample size, sample collection time, methods, biomarker selection and data analysis. Conclusion: Our systematic review does not recommend the use of any blood biomarker for clinical purposes based on the studies conducted to date. BNP and D-dimer may present optimal biomarker for diagnosis and differentiation of ischemic stroke. However, large well-designed clinical studies are required to validate utility of these biomarkers to differentiate subtypes of ischemic stroke. © 2019 Bentham Science Publishers.
Effect of persistent organic pollutants in patients with ischemic stroke and all stroke: A systematic review and meta-analysis
(Elsevier Ireland Ltd, 2023) Priya Dev; Kamalesh Chakravarty; Manoj Pandey; Rakesh Ranjan; Mareena Cyriac; Vijaya Nath Mishra; Abhishek Pathak
The role of environmental contaminants and their association with stroke is still being determined. Association has been shown with air pollution, noise, and water pollution; however, the results are inconsistent across studies. A systematic review and meta-analysis of the effect of persistent organic pollutants (POP) in ischemic stroke patients were conducted; a comprehensive literature search was carried out until 30th June 2021 from different databases. The quality of all the articles which met our inclusion criteria was assessed using Newcastle-Ottawa scaling; five eligible studies were included in our systematic review. The most studied POP in ischemic stroke was polychlorinated biphenyls (PCBs), and they have shown a trend for association with ischemic stroke. The study also revealed that living near a source of POPs contamination constitutes a risk of exposure and an increased risk of ischemic stroke. Although our study provides a strong positive association of POPs with ischemic stroke, more extensive studies must be conducted to prove the association. © 2023
Impact of COVID-19 on Guillain-Barre Syndrome in India: A Multicenter Ambispective Cohort Study
(Wolters Kluwer Medknow Publications, 2022) Yareeda Sireesha; Ritu Shree; Madhu Nagappa; Anuja Patil; Monika Singla; M.V. Padma Srivastava; R.K. Dhamija; Neetha Balaram; Abhishek Pathak; Dileep Ramachandran; Sujit Kumar; Inder Puri; Sudhir Sharma; Samhita Panda; Soaham Desai; Priyanka Samal; Aditya Choudhary; Pamidimukkala Vijaya; Teresa Ferreira; S.S. Nair; H.P. Sinha; S.K. Bhoi; Joseph Sebastian; Sanjay Sharma; Aneesh Basheer; Manish Bhartiya; N.L. Mathukumalli; Shaikh Afshan Jabeen; Vivek Lal; Manish Modi; Praveen Sharma P; Subash Kaul; Gagandeep Singh; Ayush Agarwal; Divyani Garg; James Jose; Priya Dev; Thomas Iype; Maya Gopalakrishnan; Ashish Upadhyay; Rohit Bhatia; Awadh K. Pandit; Rajesh K. Singh; Manish Salunkhe; P.M. Yogeesh; Alisha Reyaz; Nishant Nadda; Menkha Jha; Bismay Kumar; P.K. Kushwaha; Harshadkumar Chovatiya; Bhavani Madduluri; P. Ramesh; Abeer Goel; Rahul Yadav; Venugopalan Y. Vishnu
Introduction/Aims: Studies conducted during the coronavirus disease 2019 (COVID-19) pandemic have reported varied data regarding the incidence of Guillain-Barre syndrome (GBS). The present study investigated demographic and clinical features, management, and outcomes of patients with GBS during a specified period of the COVID-19 pandemic, and compared these features to those of GBS in the previous year. Methods: A multicenter, ambispective cohort study including 26 centers across India was conducted. Data from a pre-COVID-19 period (March 1 to August 31, 2019) were collected retrospectively and collected ambispectively for a specified COVID-19 period (March 1 to August 31, 2020). The study was registered with the Clinical Trial Registry India (CTRI/2020/11/029143). Results: Data from 555 patients were included for analysis: pre-COVID-19 (n = 334) and COVID-19 (n = 221). Males were more commonly affected during both periods (male:female, 2:1). Gastroenteritis was the most frequent antecedent event in 2019 (17.4%), whereas fever was the most common event in 2020 (10.7%). Paraparesis (21.3% versus [vs.] 9.3%, P = 0.001) and sensory involvement (51.1% vs. 41.3%; P = 0.023) were more common during COVID-19 in 2020, whereas back pain (26.3% vs. 18.4%; P = 0.032) and bowel symptoms (20.7% vs. 13.7%; P = 0.024) were more frequent in the pre-COVID period. There was no difference in clinical outcomes between the two groups in terms of GBS disability score at discharge and 3 months after discharge. Independent predictors of disability in the pre-COVID period included areflexia/hyporeflexia, the requirementfor intubation, and time to bulbar weakness; in the COVID-19 period, independent predictors included time from onset to admission, intubation, and intubation requirement. The mortality rate was 2.3% during the entire study period (13/555 cases). Discussion: Results of this study revealed an overall reduction in the frequency of GBS during the pandemic. The lockdown likely reduced the risk for antecedent infections due to social distancing and improved hygiene, which may have resulted in the reduction of the frequency of GBS. © 2022 Annals of Indian Academy of Neurology.
Neurological manifestations of COVID-19: a systematic review and meta-analysis of proportions
(Springer-Verlag Italia s.r.l., 2020) T.T. Favas; Priya Dev; Rameshwar Nath Chaurasia; Kamlesh Chakravarty; Rahul Mishra; Deepika Joshi; Vijay Nath Mishra; Anand Kumar; Varun Kumar Singh; Manoj Pandey; Abhishek Pathak
Background: Coronaviruses mainly affect the respiratory system; however, there are reports of SARS-CoV and MERS-CoV causing neurological manifestations. We aimed at discussing the various neurological manifestations of SARS-CoV-2 infection and to estimate the prevalence of each of them. Methods: We searched the following electronic databases; PubMed, MEDLINE, Scopus, EMBASE, Google Scholar, EBSCO, Web of Science, Cochrane Library, WHO database, and ClinicalTrials.gov. Relevant MeSH terms for COVID-19 and neurological manifestations were used. Randomized controlled trials, non-randomized controlled trials, case-control studies, cohort studies, cross-sectional studies, case series, and case reports were included in the study. To estimate the overall proportion of each neurological manifestations, the study employed meta-analysis of proportions using a random-effects model. Results: Pooled prevalence of each neurological manifestations are, smell disturbances (35.8%; 95% CI 21.4–50.2), taste disturbances (38.5%; 95%CI 24.0–53.0), myalgia (19.3%; 95% CI 15.1–23.6), headache (14.7%; 95% CI 10.4–18.9), dizziness (6.1%; 95% CI 3.1–9.2), and syncope (1.8%; 95% CI 0.9–4.6). Pooled prevalence of acute cerebrovascular disease was (2.3%; 95%CI 1.0–3.6), of which majority were ischaemic stroke (2.1%; 95% CI 0.9–3.3), followed by haemorrhagic stroke (0.4%; 95% CI 0.2–0.6), and cerebral venous thrombosis (0.3%; 95% CI 0.1–0.6). Conclusions: Neurological symptoms are common in SARS-CoV-2 infection, and from the large number of cases reported from all over the world daily, the prevalence of neurological features might increase again. Identifying some neurological manifestations like smell and taste disturbances can be used to screen patients with COVID-19 so that early identification and isolation is possible. © 2020, Fondazione Società Italiana di Neurologia.
Neuroprotective activities of medicinal plants and natural bioactive compounds
(Nova Science Publishers, Inc., 2021) Priya Dev; Abhishek Pathak
Neuroprotection is the maintenance of the neuronal building and its utility from affronts that arise against cellular injuries which are induced by a various causes or neurodegenerative disorders. Most of the neuropsychiatric and neurodegenerative diseases, like Parkinson's disease, cerebrovascular injury, seizures, anxiety, depression, Alzheimer's disease, etc. emerge overwhelmingly in the present day because of the stressed routine. Management of these diseases with extended administration of synthetic drugs can cause severe side-effects to patients; also the economic impact of the treatment is high. One strategy for this is the use of therapeutic plants due to the presence of many bioactive compounds and phytochemicals in them which have neuroprotective ability. Therefore, currently, scientists have engrossed their research attention more towards phytochemicals to treat neurological diseases. The nootropic herb denotes to the therapeutic role of numerous plants for their neuroprotective properties by the active phytocompounds which include flavonoids, alkaloids, phenolics, saponins, terpenoids, steroids, etc. Such phytochemicals of different herbal florae show a noteworthy function in preserving the chemical balance of the brain by acting on the receptors for the major inhibitory neurotransmitters. This chapter will emphasize on the significance of phytocompounds on neuroprotective function and other related disorders, notably their action mechanism and healing prospective. © 2021 Nova Science Publishers, Inc..
Periphery biomarkers to assess the vulnerability of type 2 diabetic patients to Alzheimer's disease
(Elsevier, 2025) Priya Dev; Rameshwar Nath Chaurasia; Pranjali Batra
Adult-onset diabetes, which is also known as type 2 diabetes (T2D), is a chronic metabolic disorder associated with increased vulnerability to Alzheimer’s disease (AD), a progressive neuronal degenerative condition. This chapter explores the utility of peripheral biomarkers in assessing the risk of AD in T2D patients. The shared pathophysiological mechanisms between T2D and AD, including insulin resistance, chronic inflammation, oxidative stress, and vascular dysfunction, underline the need for early diagnostic tools. Peripheral biomarkers such as metabolic markers (HbA1c, AGEs), inflammatory markers (CRP, cytokines), neurodegenerative markers (plasma amyloid-β, NfL), and vascular markers (homocysteine, lipid profiles) hold promise for determining risk factors and monitoring the progression of disease. Advances in proteomics, metabolomics, genomics, and epigenetics are expanding the repertoire of potential biomarkers, offering minimally invasive and cost-effective approaches for early detection. Integration of these biomarkers with clinical strategies can enable personalized therapeutic interventions and improve patient outcomes. However, challenges such as biomarker validation, multiomics integration, and translation into clinical practice need to be integrated to facilitate their potential. This chapter emphasizes the significance of peripheral biomarkers in bridging the gap between T2D and AD, paving the way for enhanced prevention and management strategies. © 2026 Elsevier Inc. All rights reserved..
Persistent facial pain in post-stroke patients, a hospital-based cohort study; experience from North India
(Elsevier Ltd, 2024) Priya Dev; Akhilesh Kumar Singh; Devesh Kumar; Mareena Cyriac; Varun Kumar Singh; Anand Kumar; Rameshwar Nath Chaurasia; Vijaya Nath Mishra; Deepika Joshi; Abhishek Pathak
Background: Post-stroke pain is common after a stroke and might be underreported. We describe Persistent Facial Pain (PFP) developed in post-stroke patients. Method: ology: This was a prospective hospital-based cohort study of stroke patients, and patients were followed up. Out of 415 stroke patients, 26 developed PFP. Result: Out of all PFP patients, six patients had an ischemic stroke, and 20 had a hemorrhagic stroke. 57.7% of patients had hypertension, while 34.6 patients had diabetes. The stroke location was left-sided in 12 patients and right-sided in 14 patients. 46.15% of patients responded to venlafaxine, 30.77% responded to amitriptyline, and 23.08% responded to pregabalin. Conclusion: Persistent facial pain is a pain syndrome that might be missed in patients post-stroke. It might be more common in hemorrhagic stroke patients than in ischemic stroke patients. It responds adequately to antidepressants. A high index of suspicion is required to diagnose and appropriately manage these patients. © 2024
Platelet function suggests cardioembolic aetiology in cryptogenic stroke
(Nature Research, 2023) Priya Dev; Mohammad Ekhlak; Debabrata Dash; Abhishek Pathak
Platelet-monocyte (PMA) and platelet-neutrophil aggregations (PNA) play critical roles in the evolution of acute ischemic stroke (AIS). The present study investigates the mechanistic basis of platelet responsiveness in cryptogenic stroke compared with cardioembolic stroke. Platelet from 16 subjects, each from cryptogenic and cardioembolic stroke groups and 18 age-matched healthy controls were subjected to different investigations. Compared to healthy controls, platelet-monocyte and platelet-neutrophil interactions were significantly elevated in cryptogenic (2.7 and 2.1 times) and cardioembolic stroke (3.9 and 2.4 times). P-selectin expression on platelet surface was 1.89 and 2.59 times higher in cryptogenic and cardioembolic strokes, respectively, compared to healthy control. Cell population with [Ca2+i] in either stroke group was significantly outnumbered (by 83% and 72%, respectively, in cryptogenic and cardioembolic stroke) in comparison to healthy controls. Noteworthy, TEG experiment revealed that the cryptogenic stroke exhibited significant decline in Reaction Time (R) and amplitude of 20 mm (K) (by 32% and 33%, respectively) while thrombin burst (α-angle) was augmented by 12%, which reflected substantial boost in thrombus formation in cryptogenic stroke. Although TEG analysis reveals a state of hypercoagulability in patients with cryptogenic stroke. However, platelets from both stroke subtypes switch to a ‘hyperactive’ phenotype. © 2023, The Author(s).
Platelet Hyperactivity in Patients of Vascular Dementia
(Springer Nature, 2025) Priya Dev; Mohammad Ekhlak; Ashish Kumar Yadav; Debabrata Dash; Abhishek Pathak
Platelet-monocyte (PMA) and platelet-neutrophil aggregations (PNA) are critical in causing acute inflammatory reactions favoring vascular dysfunction. However, the precise pathophysiological link between platelet-leukocyte aggregates and vascular dementia (VaD) remains undetermined. Our study aimed to investigate platelet hyperresponsiveness in patients of VaD. Vascular dementia was diagnosed based on the National Institute of Neurological Disorders and Stroke-Association Internationale pour la recherche et l’Enseignement en Neurosciences (NINDS AIREN) Criteria. All the patients were screened based on our pre-defined inclusion and exclusion criteria, and were enrolled in our study. Platelet from 19 VaD patients and 18 age-matched healthy controls were subjected to different investigations. PMA, PNA, P-selectin externalization, and intracellular free Ca+2 ([Ca+2i]) flux were evaluated either in whole blood or in platelet-rich plasma. The result revealed that PMA, PNA, P-selectin, and [Ca+2]i were found to be significantly outnumbered in the VaD group (4.1, 2.8, 2.7, and 2.5 times higher) compared to the control group with p-value < 0.001, < 0.001, < 0.001, and 0.001 at 95% CI = 31.164 to 54.855, 8.653 to 22.793, 35.064 to 94.369, and 8747.015 to 28,829.618, respectively. Patients with vascular dementia have increased platelet leucocyte interaction, and PMA has the most significant prediction of vascular dementia than in subjects of healthy control. Thus, platelets in VaD patients switch to a “hyperactive” phenotype. © The Author(s), under exclusive licence to Springer Nature Switzerland AG 2025.
Raised Blood Urea Nitrogen-Creatinine Ratio as a Predictor of Mortality at 30 Days in Spontaneous Intracerebral Hemorrhage: An Experience from a Tertiary Care Center
(NLM (Medline), 2022) Priya Dev; Varun Kumar Singh; Amit Kumar; Rameshwar Nath Chaurasia; Anand Kumar; Vijaya Nath Mishra; Deepika Joshi; Abhishek Pathak
Background: Spontaneous intracerebral hemorrhage (SICH) accounts for 7.5%-30% of all strokes and carries higher morbidity and mortality. Raised blood urea nitrogen and creatinine ratio (BUNR) is a marker of dehydration and related to poor outcome in stroke patients. However, the ratio varies between 15 and 80 in different studies. The aim of the present study was to assess BUNR as an independent predictor of mortality and its sensitivity and specificity in predicting outcome in the SICH population. Materials and Methods: Patients above the age of 18 years with SICH who were admitted in the Department of Neurology at Sir Sunderlal Hospital, Banaras Hindu University between January 2018 and July 2020 were enrolled in the study and prospectively followed up. Demographic, clinical, radiological, and outcome parameters were recorded. Results: A total of 217 patients were included. Of these, 137 (63%) were males. Seventy-one patients died during the initial 30 days. Number of patients with intraventricular hemorrhage (IVH; P = 0.003), higher mean intracerebral hemorrhage (ICH) volume (P < 0.001) and midline shift (P = 0.021), and poor Glasgow Coma Scale (GCS) score (<9) (P = 0.040) was more in the group which did not survive. Mean level of urea was significantly lower among survivors than in those who died (P = 0.001). BUNR was also significantly higher in those who died than in those who survived (P = 0.001). BUNR with a cutoff value of 39.17 was significantly associated with mortality at 30 days with a sensitivity and specificity of 61.97% and 62.33%, respectively. On performing two different multivariable logistic studies, it was found that model B with BUNR ratio as a predictor of mortality out performed model A (without BUNR). Conclusions: The study showed that SICH was associated with significant mortality. Independent predictors of death at 30 days were lower GCS on admission, larger hematoma volume, and BUNR of more than 39.17.
Soluble form of receptor for advanced glycation end product receptors as novel therapeutic intervention to arrest amyloid-associated pathogenesis
(Elsevier, 2025) Priya Dev; Rameshwar Nath Chaurasia; Abhishek Pathak
Amyloid-beta (Aβ) peptides and other amyloidogenic and inflammatory receptor for advanced glycation end product (RAGE) ligands are neutralized by soluble RAGE (sRAGE), which functions as a decoy receptor and offers a potential therapeutic intervention in neurological conditions such as Alzheimer's disease (AD). The main job of sRAGE, produced by alternative splicing or proteolytic cleavage of the full-length RAGE, is to sequester toxic ligands and stop them from interacting with cell-bound RAGE. In AD, this contact usually sets off proinflammatory and oxidative stress pathways that lead to the development of amyloid plaques, damage to neurons, and cognitive loss. By blocking these ligands, sRAGE provides neuroprotection by minimizing amyloid deposits, reducing neuroinflammation, and decreasing oxidative stress. Preclinical research has demonstrated that in animal models of AD, sRAGE dramatically lowers the amount of amyloid plaque, enhances cognitive function, and decreases inflammation. Clinical trials have shown that sRAGE can reduce patients' amyloid burden and cognitive impairment; nevertheless, there are still issues to be addressed, including patient response variability and the complex nature of neurodegeneration. Beyond AD, sRAGE has potential use in treating disorders including diabetes, atherosclerosis, and cardiovascular diseases by slowing the course of these diseases and inflammatory indicators. Even with these positive results, further study must be done to thoroughly investigate the therapeutic potential of sRAGE in various pathogenic situations, optimize dosage techniques, and customize treatment regimens. To sum up, we’ll look into this chapter on how sRAGE is a useful therapeutic tool and biomarker for treating amyloid-driven neurodegeneration and other inflammation-related disorders because it binds to amyloidogenic ligands and blocks abnormal RAGE signaling. © 2026 Elsevier Inc. All rights reserved..
Systematic Review and Meta‑analysis of Environmental Toxic Metal Contaminants and the Risk of Ischemic Stroke
(Wolters Kluwer Medknow Publications, 2022) Priya Dev; Priya Gupta; Archisman Mahapatra; Mareena Cyriac; Amit Kumar; Varun Kumar Singh; Vijaya Nath Mishra; Abhishek Pathak
Background: Stroke is the second largest cause of mortality (WHO 2014) and long‑lasting disability worldwide. Many risk factors are associated with stroke, such as age, gender, chronic illnesses, cardiovascular disease, lifestyle, and smoking. With global industrialization, the roles of environmental contaminants and their association with stroke are still unclear and have attracted much more attention. Materials and Methods: We conducted a systematic review on the environmental toxic metal contaminants and the risk of ischemic stroke. A comprehensive literature search was carried out till June 30, 2021 from databases such as PubMed, Science Direct, Embase, and Scopus. The quality of all the articles which met our inclusion criteria was assessed using Newcastle–Ottawa scaling, and four eligible studies were included for our systematic review. Results: The serum and urine cadmium concentrations were positively associated with the risk of ischemic stroke. There was an inverse association of serum and urine concentrations of mercury (Hg), serum concentration of gold and cerium with ischemic stroke, and the serum and urine concentrations of lead (Pb) had no association with ischemic stroke risk. Conclusion: The study showed strong associations between heavy metals and ischemic stroke, but more studies are required to prove the associations. © 2022 Annals of Indian Academy of Neurology.
The effect of low dose thyroid replacement therapy in patients with episodic migraine and subclinical hypothyroidism: A randomised placebo-controlled trial
(SAGE Publications Ltd, 2023) Priya Dev; T.T. Favas; Rishab Jaiswal; Mareena Cyriac; Vijaya Nath Mishra; Abhishek Pathak
Introduction: Migraine is a common headache syndrome associated with various other comorbidities. Thyroid replacement in migraine patients with hypothyroidism improves headaches; however, thyroid hormone replacement in subclinical hypothyroidism is debatable, and its efficacy is not known. Objective and methodology: This prospective, single-centre, quasi-randomised interventional study was conducted on patients visiting the General Medicine and Neurology outpatient department at a tertiary centre to look at the efficacy of thyroxine in subclinical hypothyroidism. Results: We assessed 87 patients for analysis; no patients were lost to follow-up. There was a decrease in all parameters evaluated (headache frequency, severity, duration, MIDAS score, MIDAS grade) at three months of follow-up in the treatment group compared to placebo group. There was a significant decrease in headache frequency and severity in the levothyroxine group compared to the placebo group at three months of follow-up. Also, the follow-up MIDAS score (mean ± SD: 6.30 ± 2.455 scores vs. 8.45 ± 5.757 scores) was significantly decreased by treatment at three months follow-up. Conclusion: Treatment of subclinical hypothyroidism effectively reduces migraine headaches, and it is logical to check thyroid function status in patients presenting with migraine headaches. However, a larger randomised controlled trial is required to prove the efficacy of levothyroxine in migraine with subclinical hypothyroidism. © International Headache Society 2023.
Use of Ceftriaxone as a Predictor of Good Outcome in Stroke Patients: A Retrospective Chart Review
(SAGE Publications Inc., 2022) Priya Dev; Varun Kumar Singh; Anand Kumar; Rameshwar Nath Chaurasia; Neelima Alka Singh; Priyanka Gautam; Neetu Rani Dhimani; Vijaya Nath Mishra; Deepika Joshi; Abhishek Pathak
Background: Whether ceftriaxone (CEFT) has any added advantage other than its antibiotics effect in stroke as a neuroprotective agent is not known, and this forms the base of this study. Purpose: We tried to assess the predictive role of the use of CEFT with respect to outcome in stroke patients. Methods: A retrospective chart review was conducted from a stroke registry over consecutive stroke patients admitted at a tertiary teaching institute from January 2017 to December 2018. Patients were categorized into three groups on the basis of antibiotics they received; patients without antibiotic treatment (NAB), piperacillin plus tazobactam treatment, and the CEFT treatment group. The outcome was assessed by the modified Rankin Scale at three months in good (0–3) and poor outcomes (4–6). Results: A total of 390 stroke patients were analyzed with ages ranging between 20 and 95 years and 151 of them were females. It was found that the severity at three months was significantly lower in those patients who were given CEFT antibiotic (P = 0.04; OR = 0.626; 95% CI [0.396, 0.990]). Conclusion: Stroke patients in CEFT-treated group have a better outcome compared to piperacillin–tazobactam therapy or without antibiotics use at three months. This study indicates the possibility of an additional neuroprotective effect of CEFT apart from its antibacterial property. © 2022 Indian Academy of Neurosciences (IAN).