Open Access Case Report

Aseptic Necrosis of the Femoral and Humeral Heads in a Patient who has Received a Course of Cell Therapy

T. Muratova Oleinik, S. Oleinik, D. Khramtsov, Yu. Vorokhta

Asian Journal of Research and Reports in Neurology, Page 1-5

Aims: The article is devoted to the problem of complications of pulse therapy and long-term use of corticosteroids in patients with multiple sclerosis.

Presentation of Case: There was described a case of aseptic necrosis of the femoral and humeral heads in a patient suffering from multiple sclerosis after a course of cell therapy.

Discussion & Conclusion: This case is interesting not only because the patient got aseptic necrosis of the femoral as well as humeral heads but also due to possible role of stem cell therapy applied after intensive course of corticosteroids.

Open Access Short Communication

The Bender Gestalt II- An Underutilized Tool in Brief Neurological Screening

Michael F. Shaughnessy

Asian Journal of Research and Reports in Neurology, Page 1-5

Although the Bender Gestalt has a long history of use in psychological and neurological assessment, evaluation and screening, it’s recent revision has received less attention. This paper provides a cursory overview of the revised Bender Gestalt, discusses the revisions, and proves some information as to its current use and discusses the need for more empirical research with different populations. It is hoped that this paper will sensitize readers to the use of this revised instrument.

Open Access Original Research Article

Stroke Severity Variations in a 12 Month Prospective Study Involving Sub-acute Ischemic Stroke Survivors With and Without Cognitive Impairment in Nnewi, Nigeria

U. P. Okonkwo, S. C. Ibeneme, C. Ihegihu, I. C. Ezema, E. C. Okoye, V. A. Egwuonwu, E. N. Ekechukwu, O. Azubike

Asian Journal of Research and Reports in Neurology, Page 1-12

Background: Stroke severity may intensify with cognitive impairments (CI), and impede functional recovery. Therefore proprioceptive neuromuscular facilitation (PNF) and task specific balance training (TSBT) was an exercise intervention package for stroke survivors with and without cognitive impairment (CI).

Objective: To determine stroke severity variations in sub-acute ischemic stroke survivors with CI and without CI after 12 months prospective study

Methods: One hundred of 143 available sub-acute first-ever ischemic stroke survivors recruited using convenience sampling technique in a non-randomized controlled clinical trial. They were later conveniently allocated to a cognitive impaired group (CIG) and non-cognitive impaired group (NCIG). Proprioceptive neuromuscular facilitation (PNF) and task-specific neuromuscular facilitation (TSBT) interventions applied 3 times a week, 60 mins per session, for 12 months to the two groups. Data analysis was by independent t-test, and repeated measure ANOVA. The outcome measure was National Institute of Stroke Scale (NIHSS). The significance level was at p<0.05.

Results: There was statistical significant (p<0.05) improvement across time points in the stroke severity of CIG and NCIG with a large effect size of .773 and 0.641 after 12 months of PNF and TSBT. There was statistical significant difference between the two groups

Conclusions: Within the groups, a 12-month PNF and TSBT intervention improved stroke severity recovery in the two groups. However, there was significant variation in improvement between the two groups at 4 months of treatment and other time points probably because of effect of cognitive impairment, age differences and the significant difference between NIHSS scores at baseline.

Open Access Original Research Article

The Importance of Increased Serum Ornithine Levels in the Pathogenesıs of Alzheımer and Parkınson’s Dıseases

V. Kenan Çelik, Burhanettin Çiğdem, Serkan Kapancik, Hasan Kiliçgün, Ertuğrul Bolayir

Asian Journal of Research and Reports in Neurology, Page 1-8

Background: The aim of this study was to investigate the levels of enzymes and ornithine involved in the synthesis of polyamines in patients with Alzheimer's and Parkinson's disease and to see their positive or negative effects on the modulation of the immune system.

Methods: Thirty-five healthy subjects as a control group and 35 patients with Alzheimer's and Parkinson's disease were included in this study. Determination of Ornithine decarboxylase, Arginine Decarboxylase and Agmatinase levels were evaluated by using Enzyme-Linked Immunosorbent Assay (Elisa kit). Ornithine levels were measured spectrophotometrically.

Results: When ornithine levels of Alzheimer and Parkinson patients were compared to the control group, differences were found as significant (p<0.05). On the other hand, when Ornithine decarboxylase, Arginine Decarboxylase, Agmatinase levels of Alzheimer and Parkinson patients were compared to the control group, the differences were found as insignificant (p>0.05).

Conclusion: Although the enzyme levels in the pathway of polyamine synthesis in Alzheimer's and Parkinson's diseases do not change, the increase in ornithine level will not contribute to the fight

mode of the immune system. On the contrary, it may change plasticity by increasing osmolality.

Open Access Original Research Article

Bobath versus Proprioceptive Neuromuscular Facilitation in Retraining of Balance and Functional Independence in Activities of Daily Living

Charles Ikechuwku Ezema, Martins Chidi Nweke, Samuel Uchenna Uroko, Ekezie Mmanwanne Uduonu, Chigozie Uchenna Uchenwoke

Asian Journal of Research and Reports in Neurology, Page 1-15

Aim: To ascertain the comparative efficacy of Bobath and Proprioceptive Neuromuscular Facilitation in retraining of balance and functional independence in the activities of daily living.

Study Design: Pre-post experimental design.

Place and Duration: The study took place at the University of Nigeria Teaching Hospital, Enugu between May and August 2013.

Methodology: In this study, a total of 50 (29 men and 21 women) stroke survivors with a modal age of 60-65 years  were purposively recruited, examined, treated and re-evaluated four-weekly. This study lasted for 12 weeks. Functional independence in activities of daily living (ADL) and balance were assessed using the Barthel Index (BI) and the Berg Balance Scale respectively. The gain in function was calculated as the differences between baseline and post-treatment scores. Data were analysed using SPSS version 23, with α set at 0.01.

Results: Comparing gain in functional independence in ADL between Bobath and PNF, the result showed significantly consistent higher gain with the use of Bobath (p < 0.001, 0.02 and 0.04). No statistically significant difference was found in the balance between Bobath and PNF in any of the months (p= 0.16, 0.25 and 0.08). However, going by the clinical important difference of 3 on the Berg balance scale, Bobath was found to be more efficacious than PNF after three months.

Conclusion: Bobath appears superior to PNF in the retraining of balance and functional independence in ADL.

Open Access Original Research Article

Lead II Acetate Induced Physio-Morphological Changes in Prefrontal Cortex of Ocimum gratissimum Fed Wistar Rats

O. A. Udi, P. S. Igbigbi, L. E. Chris-Ozoko, A. A. Oyeleke

Asian Journal of Research and Reports in Neurology, Page 1-10

Indiscriminate consumption of herbs or medicinal plants is said to be harmful without caution. Overtime, the effects of consumption of many of these plants on the brain have remained mysterious. Ocimumgratissimum (scent leaf) is one of such numerous herbs commonly used in Nigeria. This study was undertaken to determine the activity of Ocimum gratissimum leaf extract on the prefrontal cortical area of lead II acetate exposed wistar rats. Twenty five (25) Wistar rats of five (5) rats each were divided into five (5) groups. With Group one (1) being control group (fed with standard rat diet and water only), Groups 2, 3, 4 and 5 formed the experimental group and respectively received 252.98 mg/kg of body weight (bwt)/day of aqueous Ocimum Gratissimum leaves extract for 35 days, 180 mg/kg of lead II acetate for 21 days, 180 mg/kg of lead II acetate for 21 days with continued treatment of 126.49 mg/kg bwt of Ocimum Gratissimumleaves extract for 35 days, and 180 mg/kg of lead II acetate for 21 days with continued treatment of 252.98 mg/kg bwt of Ocimum Gratissimum leaves extract for 35 days. Following treatment period, rats were euthanized and blood samples assayed for biochemical changes. Histological and stereological examinations were also conducted for harvested brain tissue; the prefrontal cortex. Upon comparison with control (group I), a significant decrease was seen in prefrontal cortical Malonaldehyde, Superoxide Dismutase, Glutathione and Catalase levels, suggestive of a relatively fair regeneration of damaged glia cells (Gliosis) across groups. Again, histological section revealed the presence of pyramidal neurons with polygonal cell bodies of prominent dispersed nucleoli, containing chromatin granules with glial cells; Indicative of a potential possibility for gliosis. Similar studies on other areas of the brain are highly recommended.

Open Access Original Research Article

Psychological Adjustment Strategies among Persons with Spinal Cord Injury at the Tamale Metropolis, Ghana

Abdul-Ganiyu Fuseini, Yakubu H. Yakubu, Lawali Yakubu

Asian Journal of Research and Reports in Neurology, Page 1-11

Introduction: Spinal cord injury (SCI) is a devastating condition that creates unique challenges to affected persons and family because of its inherent physical and psychosocial consequences. In spite of these consequences, little efforts have been made by African researchers to explore the psychological adjustment strategies of persons with SCI in Africa, and the majority of studies in this regard were carried out in developed countries such as the United States of America and the United Kingdom. The purpose of this study was to determine the psychological adjustment strategies of persons with SCI in the Tamale Metropolis, Ghana.

Methods: The study employed a descriptive phenomenological design. Purposive sampling technique was used to recruit thirteen participants through the Neurosurgical Unit of the Tamale Teaching Hospital. Data was gathered through semi-structured interviews, and analysed using content analysis. 

Results: The four main psychological adjustment strategies that were identified from our data were ‘Religious Beliefs’, ‘Hope’, ‘Information Seeking’ and ‘Acceptance’.

Conclusion: Although persons with SCI employ a myriad of psychological adjustment strategies such as religious beliefs, hope, information seeking and acceptance, the most important psychological adjustment strategy, according to the findings of the present study is religious beliefs, as it plays a pivotal role in assisting persons with SCI to adjust to the ramifications of the injury.

Open Access Original Research Article

The Challenges and Clinical Outcomes of Intravenous Recombinant Tissue Plasminogen Activator(R-TPA) Administration in a Third World Tertiary Government Hospital in the Philippines

Christian Oliver C. Co, Karisse S. J. Abril, Maria Victoria G. Manuel

Asian Journal of Research and Reports in Neurology, Page 1-9

Background: Stroke is the second most common cause of mortality worldwide and in the Philippines. Intravenous Recombinant Tissue Plasminogen activator(R-TPA), which is provided for free in selected government hospitals, lyses cerebral arterial and venous thrombosis. It is given within a window period of 3 to 4.5 hours from stroke onset. A descriptive, retrospective and prospective analysis is needed to identify the challenges and outcomes in our institution.

Objectives: To determine the clinical profile, treatment outcomes and door-to-needle time of acute ischemic stroke patients given intravenous RTPA in our institution from August 2016 to March 2017.

Materials and Methods: From a total of 547 ischemic stroke patients admitted from August 2016 to March 2017, there were 7 patients who underwent Intravenous RTPA. Clinical data was collected through the hospital database. Outpatient follow up was done to assess long term outcome.

Results: Patients’ mean age was 58 years, most were males. Hypertension, smoking and alcohol use were present in all patients. Average NIHSS score upon admission was 7. The average time from stroke onset to admission was 137 minutes, door-to-imaging time and ictus-to-needle time was 17 and85 minutes, respectively. Length of stay at the emergency room varied. Most patients had improved NIHSS scores and 1 had hemorrhagic conversion. Improved Modified Rankin Scale (MRS) 1 month post-RTPA was also seen, albeit not statistically significant.  

Conclusion: Most patients who underwent thrombolysis had improved outcome. However, there was note of delay in drug administration due to laboratory factors and lack of monitored beds.