Browsing by Author "T.T. Favas"

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Neuro-Leptospirosis: Experience from a tertiary center of North India
(Elsevier Masson s.r.l., 2023) K. Bismaya; P. Dev; T.T. Favas; A. Pathak
Leptospirosis is a common zoonotic disease, especially in agricultural countries. Neurological manifestations of leptospirosis (neuroleptospirosis) have been reported in a study with a small number of patients. Here we report seven consecutive patients with neuroleptospirosis admitted to a neurology ward. All seven patients had a meningoencephalitis-like presentation. Leptospirosis was confirmed by polymerase chain reaction. None of the patients had systemic involvement. All patients responded significantly to intravenous ceftriaxone and oral doxycycline, recovering completely. Diagnosis of neuroleptospirosis should always be considered in patients with acute meningoencephalitis along with bacterial and viral encephalitis. Prognosis is good with early diagnosis and appropriate treatment. © 2022 Elsevier Masson SAS
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.
Novel therapeutics for diverse neurodegenerative disorders
(Elsevier, 2024) Rameshwar Nath Chaurasia; T.T. Favas
Neurodegenerative diseases are a diverse category of illnesses that are characterized by the progressive degradation of the central nervous system and peripheral nervous system. Examples of novel therapeutics in NDDs include gene therapy, immunomodulation, liposomal-based therapy, neuromodulation, targeting protein aggregation and misfolding, using autophagy, using neurotrophic factors, and stem cell therapy. Gene therapy includes vector-based gene therapies and RNA-based gene therapies. Immuno-modulation strategies include therapeutics targeting inflammatory markers and passive or active immunization. Drug delivery by liposomal carriers can avoid obstacles in reaching the target in brain parenchyma like the blood-brain barrier. NDDs, essential tremors, epilepsy, dystonia, headaches, obsessive-compulsive disorder, and pain can all be treated with neuromodulation techniques. For many NDDs, preventing protein aggregation and misfolding is a potential therapeutic target. Inducing autophagy can be used in NDDs since it is a key intracellular mechanism for clearing aggregated proteins and damaged organelles. Neurotrophic factors like GDNF, brain-derived neurotrophic factor, and NGF can influence the growth, differentiation, and functioning of neurons. Stem cell therapy can replace degenerated neurons, control inflammation, decrease apoptosis, and stimulate the release of growth factors and neurotrophic factors. Therapeutic efforts should incorporate a variety of different techniques for effective therapy together with next-generation delivery devices. © 2024 Elsevier Inc. All rights reserved.
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.