Browsing by Author "Shivani Rath"

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Co-existent Trigeminal Neuralgia and SUNCT: A Clinician's Dilemma
(Wolters Kluwer Medknow Publications, 2022) Anand Kumar; Shivani Rath; Ram Bhupal Reddy; Deepika Joshi
[No abstract available]
Oxidative stress and aging
(Elsevier, 2025) Vineeta Singh; Anamika; Nidhi Chandra; Vartika Gupta; Priyanka Gautam; Shivani Rath; Arshdeep Kaur Sethi; Rameshwar Nath Chaurasi; Vijay Nath Mishra
Oxidative stress results from an imbalance between reactive oxygen species and reactive nitrogen species production and the body’s antioxidant defense mechanisms. Excessive accumulation of these reactive molecules damages lipids, proteins, and DNA, contributing to cellular dysfunction and aging. The Free Radical Theory of Aging, proposed by Denham Harman, suggests that oxidative stress accelerates molecular deterioration, leading to age-related functional decline. However, modern research highlights a nuanced perspective where oxidative stress plays both detrimental and adaptive roles, influencing cellular signaling and stress responses. Emerging evidence underscores the interplay of genetic and environmental factors in oxidative homeostasis, offering insights into potential therapeutic interventions for aging-related disorders. Understanding oxidative stress as a dynamic and regulated process rather than a purely degenerative force opens avenues for targeted strategies to modulate aging and extend healthspan. © 2026 Elsevier Inc. All rights reserved..
Protein misfolding and aggregation and its role in dementia with Lewy bodies
(Elsevier, 2025) Vineeta Singh; Anamika; Nidhi Chandra; Vartika Gupta; Priyanka Gautam; Bhargawi Mishra; Arshdeep Kaur Sethi; Shivani Rath; Vijay Nath Mishra
Dementia with Lewy bodies (DLB) is a progressive neurodegenerative disorder characterized by the accumulation of misfolded α-synuclein within Lewy bodies, leading to widespread neuronal dysfunction. Protein misfolding and aggregation serve as key pathological mechanisms, influenced by genetic mutations, as well as environmental triggers like toxins and infections. The interplay between α-synuclein and other neurodegenerative pathways, particularly tau and amyloid-β, exacerbates disease progression. Advances in biomarker research, including neuroimaging and fluid-based assays, are enhancing early detection, while emerging therapeutic strategies focus on molecular chaperones, autophagy enhancement, and gene-editing approaches. Understanding the mechanisms of protein misfolding in DLB not only improves diagnostic accuracy but also provides potential avenues for disease-modifying therapies. Ongoing research offers promising prospects for targeted interventions, bridging the gap between pathophysiological insights and clinical applications in neurodegenerative disorders. © 2026 Elsevier Inc. All rights reserved..
Reversible drug-induced progressive supranuclear palsy-like presentation: A report of three cases
(Wolters Kluwer Medknow Publications, 2019) Shivani Rath; Deepika Joshi
Drugs, such as dopamine receptor blockers or dopamine depleters, produce a functional dopamine-deficient state mimicking parkinsonism, but presentation with a progressive supranuclear palsy (PSP) is a rare manifestation. We report three patients with a PSP-like presentation, with symmetrical parkinsonism, postural instability, and gaze palsy due to drugs, such as metoclopramide, risperidone, and olanzapine, which reversed after drug withdrawal. © 2019 Annals of Movement Disorders.
Study of Knowledge, Attitude, and Practice among Epilepsy Patients in North India
(Georg Thieme Verlag, 2020) Arshdeep Kaur Sethi; Vineeta Singh; Rameshwar Nath Chaurasia; Deepika Joshi; Abhishek Pathak; Shivani Rath; Ashutosh Mishra; Vijay Nath Mishra
Background ?Religious and sociocultural beliefs influence the nature of treatment and care received by people with epilepsy. Objective ?This study aimed to study knowledge, attitude, and practice (KAP) among epilepsy patients in north India. Materials and Methods ?In this study, 201 patients attending the outpatient and inpatient services of the neurology department of Sir Sunderlal Hospital, Banaras Hindu University, were asked to fill a questionnaire comprising 25 questions assessing the KAPs in English or Hindi, whichever the patient was proficient with. The same questionnaire was also given to 200 patients without epilepsy for the control group. Responses were recorded as yes/no/do not know. Results ?Approximately, 67% of the patients consisted of a young population, of which 64.7% were males and 35.3% were females. Around 25.9% of patients had studied up to 10th class, 96.5% of patients had heard of epilepsy, and 89.05% thought it was treatable by modern drugs. Out of all patients, 80.1% of patients believed that epilepsy was not contagious, 87.6% believed that they can work, 93.5% believed that they can marry, 66.5% did not feel discriminated by batchmates, and 78.5% did not feel discriminated by teachers. Of all patients, 41.8% said that they would disclose the epileptic condition of their daughters before marriage and 96.01% knew epilepsy patients should be taken to hospital. Conclusion ?Poor knowledge, negative attitude, and malpractices regarding epilepsy are still prevalent in North India. Epilepsy patients have better knowledge than normal people about this disease. There is still a need to educate people about epilepsy. ©2020 Association for Helping Neurosurgical Sick People.
Successfully treated hepatitis b positive refractory myasthenic crisis with Rituximab
(Jaypee Brothers Medical Publishers (P) Ltd, 2020) R. Kumar Singh; Deepika Joshi; Shivani Rath
Myasthenia gravis (MG) is an autoimmune disorder of neuromuscular transmission, which presents with fluctuating and variable weakness in ocular, bulbar, limb, and respiratory muscles resulting from an antibody-mediated, T-cell-dependent immunologic attack on the postsynaptic membrane of the neuromuscular junction. Although treatment of MG and myasthenic crisis is based on few specific principles, it is highly individualized. We report a successfully treated case of refractory myasthenic crisis who was on a ventilator for 7 months (210 days), perhaps the longest from India, and required multiple cycles of plasma exchange, intravenous immunoglobulin infusion, and one cycle of rituximab. It exemplifies the role of highly individualized therapy and interdisciplinary cooperation in management of refractory myasthenic crisis. © TheAuthor(s). 2020.
Synaptic Plasticity and Neuroinflammation: A Therapeutic Approach to Neurological Illnesses
(CRC Press, 2024) Vineeta Singh; Arshdeep Kaur Sethi; Shivani Rath; Vijaya Nath Mishra
The central nervous system (CNS) has historically been viewed as an immune-privileged site, shielded from conventional immune responses. However, recent discoveries have challenged this notion, revealing intricate bidirectional communication between the nervous and immune systems. Evidence indicates that the CNS actively participates in immune surveillance, and immune mediators profoundly influence synaptic remodeling and plasticity -processes crucial for learning, memory, and cognition. This chapter explores the emerging role of glial cells as active participants in CNS immune responses and synaptic modulation, rather than mere support cells. It highlights the significant impact of immunological factors like cytokines and major histocompatibility complex molecules on synaptic memory processes-an influence long underestimated. Furthermore, the chapter examines the potential implications of this neuroimmune crosstalk in the pathophysiology of neuroinflammatory disorders associated with cognitive decline, such as Parkinson’s disease and Alzheimer’s disease. The interplay between abnormal inflammatory substance expression during CNS inflammation and disease-specific defects may disrupt synaptic adaptation and remodeling, destabilizing neuronal networks and contributing to cognitive impairment. Challenging the traditional immune-privileged view of the CNS, this chapter provides insights into the complex mechanisms underlying neurological disorders and fosters a deeper understanding of nervous-immune system communication. Ultimately, this emerging knowledge holds promise for developing novel therapeutic strategies targeting the neuroimmune interface to treat cognitive and neurodegenerative diseases. © 2025 selection and editorial matter, Sangeeta Singh, Sachchida Nand Rai, and Santosh Kumar Singh.
Toxin-induced animal models in Parkinson's disease: Recent updates
(Elsevier, 2025) Vineeta Singh; Arshdeep Kaur Sethi; Shivani Rath; Nidhi Kumari; Damini Shukla; Vijay Nath Mishra
Parkinson's disease (PD) is a prevalent neurodegenerative disorder primarily affecting older adults. It is characterized by motor symptoms such as tremor, rigidity, and bradykinesia, resulting from the degeneration of dopaminergic neurons in the substantia nigra pars compacta. While PD's etiology is multifaceted, toxin-induced models have significantly advanced our understanding of its pathogenesis and potential treatments. Key environmental neurotoxins used in PD research include 1-methyl-4-phenyl-1,2,3,6-tetrahydropyridine, 6-hydroxydopamine, paraquat, and rotenone. These compounds can cross the blood-brain barrier and selectively damage dopamine neurons, mimicking PD pathology through mechanisms involving mitochondrial dysfunction, oxidative stress, and neuroinflammation. Researchers use various model systems to study toxin-induced PD, including rodents, primates, zebrafish, and invertebrates. The effectiveness of these models depends on the route of administration and concentration of neurotoxins. Understanding these parameters is crucial for accurately reproducing Parkinsonian features in research settings and developing novel therapeutic strategies. © 2026 Elsevier Inc. All rights reserved.
Vascular Parkinsonism and Parkinson's disease: A prospective, clinico-radiological comparative study
(Wolters Kluwer Medknow Publications, 2021) Shivani Rath; Anand Kumar; Abhishek Pathak; Ashish Verma; Varun K. Singh; Rameshwar N. Chaurasia; Vijay N. Mishra; Deepika Joshi
Background: Vascular parkinsonism (VP) is an atypical Parkinsonian syndrome that is believed to have a temporal association with cerebrovascular disease. However, now it is evolving as a heterogeneous entity with no clear consensus on the definition and diagnostic criteria. Aim and Objectives: This study aimed at evaluating the clinico-radiological profile of patients with VP and Parkinson's disease (PD). Materials and Methods: The present study was conducted at a tertiary care university hospital. A total of 80 patients, with a diagnosis of probable VP (40) and PD (40), were evaluated and compared with Unified Parkinson's Disease Rating Scale (UPDRS) part III, gait scale, Mini-Mental State Examination (MMSE), Frontal Assessment Battery (FAB), and MRI brain. Results: Significantly older age of onset (P = 0.005), higher vascular risk factors (P < 0.001), and motor scores in UPDRS part III (P < 0.001), gait scale (P < 0.001), and modified Hoehn and Yahr (P < 0.001) were seen in the VP as compared with the PD. On the cognitive scales, patients with VP scored significantly lower in MMSE (19.92 ± 6.0 vs. 24.90 ± 3.34; P < 0.001) and FAB (7.75 ± 4.27 vs. 11.22 ± 2.75; P < 0.001); on the modified Hachinski scale (7.77 ± 3.19 vs. 3.30 ± 1.97; P < 0.001), they scored higher compared with patients with PD. Periventricular ischemic changes, generalized brain atrophy, and multiple lacunar infarcts were the most common radiological abnormality found significantly more in patients with VP. Conclusion: An older age, worse cognitive scores and motor scores, and more profound periventricular and subcortical lesions on MRI favored VP. © 2021 Annals of Movement Disorders.