The coronavirus pandemic has caused unprecedented changes in human life all over the world. As is the case with any unknown or unseen natural calamity, this pandemic has also given rise to a lot of myths and rumors. This article is an attempt to document some of those folklores for posterity.
Anup K Bhattacharya
Introduction: Poststroke epilepsy (PSE) is a very important complication after cerebrovascular accident (CVA). Stroke is responsible for 10% of all seizures and about 55% of newly diagnosed epilepsy in elderly population. It may lead to longer hospitalization, worse immediate functional outcome, and high mortality. Aims and objectives: We have studied 369 CVA patients from July 2017 to June 2019 to study the prevalence of epilepsy in stroke survivors, risk factors, and clinical manifestation of PSE. Materials and methods: For this purpose, detailed clinical examination, CT scan brain, MRI brain, blood glucose estimation, serum lipid profile, and EEG were carried out. Observation: Among 369 CVA patients, 34 presented with seizure: 22 patients with early seizure (within 2 weeks) and 12 with late seizure (after 2 weeks). Most of the patients were greater than 60 years of age (27 patients). The male:female ratio was 22:12. Among 34 patients, 26 patients were of cerebral hemorrhage and 8 patients were of cerebral infarct. History of hypertension was present in 29 patients. Majority of PSE patients were diabetic (24 out of total 34). Cortical involvement was present in 29 patients, and in 5 patients there was subcortical involvement. Among 34 patients, 26 experienced focal onset seizure; 5 patients had generalized seizure; and 3 experienced status epilepticus. Conclusion: Physician should always treat stroke survivors with the risk of PSE in mind. While considerable difficulties exist in designing and conducting clinical studies of PSE, such as high heterogeneity of stroke survivors, further studies are necessary to explore primary and secondary prevention of PSE.
Amit K Ghosh,
Introduction: Deep brain stimulation of the subthalamic nucleus (STN) is an effective therapy for medically refractory Parkinson's disease leading to significant improvement of Parkinsonian symptoms through functional inhibition of the STN. Aim of this study: To analyze the outcome of bilateral subthalamic nucleus, deep brain stimulation in advanced Parkinson's disease patients. This is a clinical observational study. Material and methods: This is the result of bilateral subthalamic nucleus-deep brain stimulation (STN-DBS) done in 30 patients for advanced Parkinson's disease in the Institute of Neurosciences, Kolkata, during the past 7 years (2013 to 2019, August) by the authors team. Outcome had been analyzed. Results: Excellent outcome was found after the required programming. Ninety percent patients have shown excellent result. The dosage of antiparkinsonian medications was significantly reduced, with a consequent reduction of dyskinesias. Conclusion: The effect of the STN-DBS on the motor fluctuations and on the levodopa-induced dyskinesias led to a significant improvement of motor part of Unified Parkinson Disease Rating Scale (UPDRS [III]) rating.
With the introduction of competency-based medical education for undergraduate medical education by the Medical Council of India in our country, the need for reorientation of medical education as per societal needs requires a strengthening link with new reforms in the educational system of which integrated teaching–learning methods are of paramount importance. There is a shift from traditional didactic lectures to interactive discussions, group discussions, and integrated learning sessions. With shedding of too much of information overload from basic science subjects, proposals and efforts are there to incorporate basic science in the context of clinical orientation and teach them in system-wise fashion not in discipline-wise way as in the traditional teaching system it was followed. Hence, the new teaching system where teaching will be system-wise and for one system basic science teaching will be followed by clinical teaching along with clinical exposure at wards is the basic essence of integrated learning. The literature says teaching in this way helps students to understand, retain, and build concepts more effectively than the traditional system. Problem-based learning that enhances integrated learning methods provides relevance to the subjects studied. The need of the hour is a socially accountable medical education in India in alignment with global needs also. So, changes are inevitable. Faculty reorientation as per needs of new education system forms the backbone for successful launching of the program country-wise along with gaining of student's trust. Implementation of the integrated teaching–learning concept is a challenge as it needs extreme cooperation from college administration, medical education unit, college routine committee, individual departments, and individual teachers. There are different models of integrated teaching methods and each one of them is unique. To implement them, there are multiple strategies and for success of running the process smoothly the college administration needs to create environments. Assessment of students too needs certain modifications as the aim of the assessment needs to get aligned with launching goals. The aim of such effort is to create an Indian medical graduate competent in possessing requisite knowledge, exercising requisite skills, having values and attitudes as desired, and act with responsiveness and accountability. They will act with confidence in discharging their duties as the physician of first contact of the community and simultaneously will be globally relevant.
Food adulteration causes a lot of adverse health effects. The author here describes an acute public health emergency caused by adulteration of edible oil in the 1980s. The victims suffered from permanent disability.
A patient presenting with movement disorder is a cumbersome situation for the treating physicians. Here is a case of nonketotic hyperglycemia, overt hypothyroidism presenting with a sudden onset of hemiballismus with no organic lesion in the brain. Hemiballismus is a type of hyperkinetic movement disorder.