Browsing by Author "Shahnawaz Ahmad"

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Efficacy and Safety of Early Neuromuscular Electrical Stimulation on Shoulder and Arm Paresis in Patients of Acute Ischaemic Stroke—A Quasi-experimental Study
(SAGE Publications Inc., 2025) Shahnawaz Ahmad; Varun Kumar Singh; Rameshwar Nath Chaurasia; Vijay Nath Mishra; Abhishek Pathak; Anand Kumar; Deepika Srivastava Joshi; Girish Singh
Background: Shoulder subluxation and shoulder pain are frequent after a stroke. Neuromuscular electrical stimulation (NMES) has been used widely in the sub-acute and chronic stages, but its use in the early stage is infrequent. Aims and Objectives: The study’s objective is to see the effect of early neuromuscular electrical stimulation on hand function, shoulder subluxation, and shoulder pain after three months of stroke. Methods: This study included 60 acute ischaemic stroke survivors. The intervention group received early NMES with standard rehabilitation, whereas the control group only received standard rehabilitation. The assessment was done at baseline and three months follow-up. The outcome measures were the presence of a sulcus sign, the Numerical Rating Scale (NRS), the Fugl-Meyer Assessment-Upper Extremity (FMA-UE, sub-scale A and A-D) and the Motor Activity Log (MAL) (sub-scale HOW WELL and AMOUNT). Result: The intervention group had eight patients and the control group had nine patients with shoulder subluxation at follow-up. Hand functional outcomes were significantly better in the intervention group compared to the control group, with the FMA-UE-A scores of 27 (19–36) versus 18.5 (4.7–24.75), p = .007 and FMA-UE-A-D scores of 28.5 (4–48.25) versus 7.5 (4–23.75), p = .011. The HOW WELL and AMOUNT scores also showed significant differences, with 90 (30–150) versus 30 (0–90), p = .027. The intervention group did not experience any adverse events related to NMES. Conclusion: The application of early NMES prevents shoulder subluxation and improves hand function. Randomised control trials with larger sample sizes and additional treatment sessions are needed to generalise the results. © 2025 Indian Academy of Neurosciences (IAN). This article is distributed under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (https://creativecommons.org/licenses/by-nc/4.0/) which permits non-commercial use, reproduction and distribution of the work without further permission provided the original work is attributed as specified on the SAGE and Open Access page (https://us.sagepub.com/en-us/nam/open-access-at-sage).
NMR based Serum metabolomics revealed metabolic signatures associated with oxidative stress and mitochondrial damage in brain stroke
(Springer, 2024) Sachin Yadav; Abhai Kumar; Smita Singh; Shahnawaz Ahmad; Gurvinder Singh; Abdul Rahman Khan; Rameshwar Nath Chaurasia; Dinesh Kumar
Brain stroke (BS, also known as a cerebrovascular accident), represents a serious global health crisis. It has been a leading cause of permanent disability and unfortunately, frequent fatalities due to lack of timely medical intervention. While progress has been made in prevention and management, the complexities and consequences of stroke continue to pose significant challenges, especially, its impact on patient’s quality of life and independence. During stroke, there is a substantial decrease in oxygen supply to the brain leading to alteration of cellular metabolic pathways, including those involved in mitochondrial-damage, leading to mitochondrial-dysfunction. The present proof-of-the-concept metabolomics study has been performed to gain insights into the metabolic pathways altered following a brain stroke and discover new potential targets for timely interventions to mitigate the effects of cellular and mitochondrial damage in BS. The serum metabolic profiles of 108 BS-patients were measured using 800 MHz NMR spectroscopy and compared with 60 age and sex matched normal control (NC) subjects. Compared to NC, the serum levels of glutamate, TCA-cycle intermediates (such as citrate, succinate, etc.), and membrane metabolites (betaine, choline, etc.) were found to be decreased BS patients, whereas those of methionine, mannose, mannitol, phenylalanine, urea, creatine and organic acids (such as 3-hydroxybutyrate and acetone) were found to be elevated in BS patients. These metabolic changes hinted towards hypoxia mediated mitochondrial dysfunction in BS-patients. Further, the area under receiver operating characteristic curve (ROC) values for five metabolic features (methionine, mannitol, phenylalanine, mannose and urea) found to be more than 0.9 suggesting their high sensitivity and specificity for differentiating BS from NC subjects. Graphical abstract: [Figure not available: see fulltext.] © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.