@article{Manorenj_2025h,

title = {Anticoagulant initiation after cardioembolic stroke: practical timing and options},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/14185/8653},

doi = {10.18203/2394-6040.ijcmph20252872},

issn = {2394-6032},

year  = {2025},

date = {2025-08-30},

urldate = {2025-08-30},

journal = {International Journal of Community Medicine and Public Health},

volume = {12},

issue = {9},

pages = {4186-4195},

abstract = {Cardioembolic Stroke (CES) is a leading cause of Acute Ischemic Stroke (AIS) and is linked to worse outcomes. There is a notably increased risk of “hemorrhagic transformation” (HT) in CES cases, where anticoagulant therapy is essential for patients with atrial fibrillation (AF) to prevent future strokes. Additionally, larger infarcts are associated with a higher risk of HT, effectively doubling the mortality risk. Currently, there are no clear guidelines connecting infarct size to “anticoagulation” decisions or management of HT cases. This review specifically focuses on the timing of “anticoagulation” initiation in patients with AF. Out of 380 articles evaluated, 50 relevant studies were included in this review. Generally, existing guidelines recommend starting “anticoagulation” between 4 to 14 days after anAIS. The review seeks to summarize current research on early versus late “anticoagulation” initiation in AF patients who experience AIS, providing clinicians with practical insights on optimal timing and the selection of effective and safe anticoagulants.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025g,

title = {Hot water epilepsy: a case report with EEG findings and clinical insights},

author = {Sandhya Manorenj and Eluka Mounika Reddy},

url = {https://sciencevolks.com/neurology/pdf/SVOA-NE-06-017.pdf},

doi = {10.58624/SVOANE.2025.06.017},

issn = {2753-9180},

year  = {2025},

date = {2025-06-25},

urldate = {2025-06-25},

journal = {SVOA Neurology},

volume = {6},

issue = {3},

pages = {86-90},

abstract = {Hot water epilepsy (HWE) is a rare form of reflex epilepsy triggered by exposure to hot water, typically during baths, and can be difficult to diagnose due to normal electroencephalogram (EEG) results. This case outlines a 30-year-old woman who experienced recurrent seizures over five years while bathing in hot water. Despite her history of generalized epilepsy, her initial EEG and MRI results were unremarkable. A subsequent sleep-deprived video EEG detected ictal discharges originating from the frontal lobes, confirming epilepsy. The patient was advised to continue her anti-seizure medication and to avoid hot baths. The discussion emphasizes the challenges in identifying the anatomical substrate of HWE, as most cases typically involve the temporal or parietal regions. This case contributes to a deeper understanding of HWE by identifying frontal lobe discharges as a potential correlate and highlights the vital role of EEG in guiding treatment adjustments.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kumar_2025b,

title = {A case of bilateral spiller syndrome},

author = {S. Sravan Kumar and Sandhya Manorenj and Chillapuram Shashanka},

url = {https://journals.lww.com/neur/fulltext/9900/a_case_of_bilateral_spiller_syndrome.108.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-24-00780},

issn = {0028-3886},

year  = {2025},

date = {2025-06-18},

urldate = {2025-06-18},

journal = {Neurology India},

abstract = {No abstract available},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Zoheb_2025,

title = {Dynamin-related protein 1 expression as a non-invasive biomarker for mitochondrial dysfunction in Parkinson’s disease},

author = {Mohammed Zoheb and Tahmeen Jameel and Shaik Iqbal Ahmed and Safia Begum and Bushra and Aleem Ahmed Khan},

url = {https://rjn.com.ro/articles/2025.2/RJN_2025_2_Art-14.pdf},

doi = {10.37897/RJN.2025.2.14},

issn = {1843-8148},

year  = {2025},

date = {2025-06-16},

urldate = {2025-06-16},

journal = {Romanian Journal of Neurology},

volume = {24},

issue = {2},

pages = {134-143},

abstract = {Background. Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by dopaminergic neuron loss. Mitochondria-mediated mechanisms – including excessive fission, impaired fusion, defective mitophagy, and oxidative stress – contribute to its pathogenesis. However, the relationship between mitochondrial dynamics and PD progression remains poorly defined. Dynamin-related protein 1 (Drp1), a master regulator of mitochondrial fission, is implicated in neurodegeneration. This study assessed whether peripheral blood Drp1 gene expression reflects mitochondrial dysfunction in PD and may serve as a non-invasive biomarker. Materials and methods. Drp1 gene expression was analyzed by RT-qPCR in peripheral blood samples from 25 PD patients and 25 age- and sex-matched healthy controls. Results. Drp1 expression was significantly upregulated in PD patients, suggesting heightened mitochondrial fission. ROC curve analysis revealed an area under the curve (AUC) of 0.94, indicating strong diagnostic potential. Stratified analysis showed that patients aged ≥60 years had significantly higher Drp1 levels than younger patients, with a stratified AUC of 0.89. No significant sex-based differences were observed. Conclusion. These findings support the role of altered mitochondrial dynamics in PD and suggest that peripheral Drp1 expression may offer diagnostic value, particularly when stratified by age. Targeting mitochondrial dynamics may enable precision therapies to mitigate neurodegeneration. By identifying a potential non-invasive biomarker, this study contributes to understanding the molecular mechanisms of PD and informs future therapeutic development.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Kumar_2025,

title = {A deadly duo: viper bite-induced coagulation disorder and multiple territory ischemic stroke},

author = {S. Sravan Kumar and Sandhya Manorenj},

url = {https://journals.lww.com/annalsofian/citation/9900/a_deadly_duo__viper_bite_induced_coagulation.436.aspx},

doi = {10.4103/aian.aian_1015_24},

issn = {0972-2327},

year  = {2025},

date = {2025-06-11},

urldate = {2025-06-11},

journal = {Annals of Indian Academy of Neurology},

abstract = {No abstract available},

note = {Online ahead of print},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025f,

title = {Isolated starfield pattern and the type 1 cerebral fat microembolism: a radiological perspective},

author = {Sandhya Manorenj and S. Sravan Kumar and Sravan Kumar Marupaka and Farah Naaz},

url = {https://journals.lww.com/annalsofian/fulltext/2025/05000/isolated_starfield_pattern_and_the_type_1_cerebral.19.aspx},

doi = {10.4103/aian.aian_1042_24},

issn = {0972-2327},

year  = {2025},

date = {2025-06-09},

urldate = {2025-06-09},

journal = {Annals of Indian Academy of Neurology},

volume = {28},

number = {40485206},

issue = {3},

pages = {435-436},

abstract = {No abstract available},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025e,

title = {Teaching video neuroImage: palmo-facial reflex a variant of the palmomental reflex},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka and Eluka Mounika Reddy},

url = {https://www.neurology.org/doi/full/10.1212/WNL.0000000000213731},

doi = {10.1212/WNL.0000000000213731},

issn = {0028-3878},

year  = {2025},

date = {2025-05-22},

urldate = {2025-05-22},

journal = {Neurology},

volume = {104},

issue = {12},

pages = {e213731},

abstract = {No abstract available},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025c,

title = {Cytotoxic edema of bilateral semicentrum ovale in uremic encephalopathy: a rare radiological entity},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka},

url = {https://sciencevolks.com/neurology/pdf/SVOA-NE-06-009.pdf},

doi = {10.58624/SVOANE.2025.06.009},

issn = {2753-9180},

year  = {2025},

date = {2025-03-21},

urldate = {2025-03-21},

journal = {SVOA Neurology},

volume = {6},

issue = {2},

pages = {47-49},

abstract = {Uremic encephalopathy can mimic clinically and radiologically like a stroke. The presence of cytotoxic edema in bilateral semicentrum ovale without involvement of basal ganglion is uncommon in uremic encephalopathy in a diabetic patient. Here we demonstrate the rare white matter radiological subtype of uremic encephalopathy in a 48-year-old woman with chronic kidney disease.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025d,

title = {Acute migraine: an overview},

author = {Sandhya Manorenj},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/13681/8304},

doi = {10.18203/2394-6040.ijcmph20250952},

issn = {2394-6032},

year  = {2025},

date = {2025-03-19},

urldate = {2025-03-19},

journal = {International Journal of Community Medicine and Public Health},

volume = {12},

issue = {4},

pages = {1952-1964},

abstract = {Migraine is a primary headache disorder that affects people of all ages. It is the second most common type of headache disorder after tension headache. Migraine headache usually begins in adolescence, peak in the third decade of life, and becomes less frequent and less severe in later decades. Migraine affects women three times more often than men. Migraine can be very debilitating and can significantly impair an individual's ability to perform daily activities. Creating a clinical review on acute migraine and its management, using a pragmatic approach based on recent advances. The author reviewed the available literature on migraine and identified relevant articles through a literature search in the PubMed database to create this review. Migraine diagnosis is based on clinical examination and medical history, and imaging is usually not required. There are two main types of pharmacological treatment for migraine: abortive treatment to stop acute attacks and prophylactic treatment or preventive medication to reduce the frequency and severity of attacks. The treatment of migraine is constantly improving with new target-specific treatments, neuromodulation devices, and non-oral formulations of established medicines. This comprehensive review focuses on recent guidelines, newer approved drugs, and emerging therapies for managing acute migraine. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025i,

title = {I-Beam sign in progressive supranuclear palsy},

author = {Sandhya Manorenj and Chillapuram Shashanka},

url = {https://journals.lww.com/neur/fulltext/2025/03000/i_beam_sign_in_progressive_supranuclear_palsy.20.aspx},

doi = {10.4103/neurol-india.neurol-india-d-24-00101},

issn = {0028-3886},

year  = {2025},

date = {2025-03-01},

urldate = {2025-03-01},

journal = {Neurology India},

volume = {73},

number = {pmid40176225},

issue = {2},

pages = {330-331},

abstract = {Background: Postural instability occurs in both progressive supranuclear palsy (PSP) and idiopathic Parkinson’s disease (IPD). Objective: Testing for postural instability using a pull test helps to differentiate IPD from PSP based on the presence of an I-beam sign in the latter. Methods and Materials: Here, we demonstrate the I-beam sign in a 65-year-old lady who presented with initial marked postural instability. Results: In PSP, postural instability occurs early. Here, we found that in patients with PSP on the backward pull test, they fall without taking a single step, like a building falls without an I-beam. This sign is called I-beam sign. In patients with IPD, this sign is absent as they take one or a few steps before falling. Clinical examination showed mild restriction of upward gaze, and there was radiological evidence of midbrain atrophy. The present case was diagnosed as PSP with a postural instability variant. Conclusion: The presence of the I-beam sign in patients with Parkinsonism suggests PSP.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025,

title = {Diaphragmatic myoclonus effectively treated with lacosamide: a very rare phenomenon of belly dancer syndrome},

author = {Sandhya Manorenj and Bushra Naaz and Manju Madhavan},

url = {https://journals.lww.com/neur/fulltext/2025/01000/diaphragmatic_myoclonus_effectively_treated_with.26.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-23-00458},

issn = {0028-3886},

year  = {2025},

date = {2025-02-07},

urldate = {2025-02-07},

journal = {Neurology India},

volume = {73},

issue = {1},

pages = {149-151},

abstract = {Diaphragmatic myoclonus, also called diaphragmatic flutter, has characteristic abdominal movements resembling those of a belly dancer; hence, it is also called belly dancer syndrome (BDS). BDS is characterized by high-frequency involuntary diaphragmatic contractions. BDS can occur due to a lesion anywhere in the pathway for diaphragmatic control, from the motor cortex to the neural supply to the diaphragm. Here we report a 21-year-old girl who presented with acute-onset abdominal movements of 5 days duration. Clinical examination showed abdominal jerky movements with preserved awareness. Electroencephalograms (EEG) showed polyspike wave discharges consistent with cortical myoclonus. These abdominal myoclonic jerks disappeared dramatically on treatment with lacosamide, a third-generation antiepileptic drug. There are few case reports of BDS in the literature with a cortical myoclonus origin instead of the widely described segmental myoclonus form. The case also highlights the efficacy of lacosamide in treating diaphragmatic myoclonus jerk in young adults.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2025b,

title = {Acquired hepatocerebral degeneration and accumulation of manganese},

author = {Sandhya Manorenj and Sravan Kumar Marupaka},

url = {https://journals.lww.com/annalsofian/fulltext/2025/01000/acquired_hepatocerebral_degeneration_and.17.aspx},

doi = {10.4103/aian.aian_633_24},

issn = {0972-2327},

year  = {2025},

date = {2025-01-02},

urldate = {2025-01-02},

journal = {Annals of Indian Academy of Neurology},

volume = {28},

issue = {1},

pages = {107-109},

abstract = {A 43-year-old man with chronic liver disease (CLD) due to alcoholism and hepatitis B virus (HBV) infection presented at the emergency department after experiencing a generalized tonic–clonic seizure and altered consciousness. He had been diagnosed with adult-onset epilepsy 3 years ago and was taking medication for seizure, which he had missed 2 days before. In addition, he was being treated with entecavir for the HBV infection.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024g,

title = {Efficacy and safety of tenecteplase versus alteplase in acute ischemic stroke: evidence from a South Indian cohort},

author = {Sandhya Manorenj and Maryam and Iqra Jahan and Syeda Noor Fatima and Yumna Fatima and Mir Wajahath Ali},

url = {https://rjn.com.ro/articles/2024.4/RJN_2024_4_Art-13.pdf},

doi = {10.37897/RJN.2024.4.13},

issn = {1843-8148},

year  = {2024},

date = {2024-12-26},

urldate = {2024-12-26},

journal = {Romanian Journal of Neurology},

volume = {23},

issue = {4},

pages = {403-409},

abstract = {Background. Acute ischemic stroke (AIS) requires efficient thrombolytic therapy to re-establish vascular permeability and mitigate tissue damage. Alteplase and tenecteplase are prominent tissue plasminogen activators (tPAs) employed in this clinical scenario. This study compares these two agents, focusing on their efficacy, safety profiles, time parameters, and rates of re-hospitalization.

Objectives. To compare the efficacy and safety of tenecteplase versus alteplase for treating acute ischemic stroke in South Indian patients: a prospective study.

Methods. At a single center, we conducted a prospective, observational, non-interventional study of patients receiving thrombolytics alteplase or tenecteplase from November 2023 to July 2024, which included patients within a 4.5-hour window of symptom onset. The principal outcome of this study is to evaluate early neurological improvement using the clinical assessment scales – the National Institutes of Health Stroke Scale (NIHSS) at baseline and 24 hours, and the Modified Rankin Scale (mRS) at admission and 3 months. The secondary outcomes include the door-to-needle time (DTN) and assessing the need for re-hospitalization. Data was scrutinized using a t-test and median interquartile range (IQR).

Results. The study enrolled 64 patients, 32 treated with alteplase and 32 with tenecteplase. Statistical significance was found for the efficacy of the drugs (NIHSS post-treatment p = 0.01 and mRS p = 0.002). The DTN and re-hospitalization were found to be non-significant.

Conclusion. Both alteplase and tenecteplase efficiently manage AIS, with tenecteplase demonstrating advantages in early neurological improvement, ease of administration, and cost-effectiveness.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2024d,

title = {A pseudo guillain barre syndrome (GBS) presentation of sjogren’s syndrome},

author = {Reshma Sultana Shaik and Sandhya Manorenj},

url = {https://journals.lww.com/neur/fulltext/2024/11000/a_pseudo_guillain_barre_syndrome__gbs_.29.aspx},

doi = {10.4103/ni.ni_4_23},

issn = {0028-3886},

year  = {2024},

date = {2024-12-17},

urldate = {2024-12-17},

journal = {Neurology India},

volume = {72},

issue = {6},

pages = {1283-1284},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Mohiuddin_2024,

title = {Vasculopathy and posterior circulation stroke after measles in two children},

author = {Mohammed Fahad Mohiuddin and Sandhya Manorenj and Shalini Akunuri and Ahlaam Arif},

url = {https://journals.lww.com/neur/fulltext/9900/vasculopathy_and_posterior_circulation_stroke.5.aspx},

doi = {10.4103/neurol-india.neurol-india-d-24-00502},

issn = {1998-4022},

year  = {2024},

date = {2024-11-29},

urldate = {2024-11-01},

journal = {Neurology India},

publisher = {Medknow},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024e,

title = {Awake bruxism in a patient with advanced alzheimer’s disease: an epiphenomenon of anxiety or marker of advanced disease},

author = {Sandhya Manorenj},

url = {https://journals.lww.com/neur/fulltext/2024/09000/awake_bruxism_in_a_patient_with_advanced.35.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-23-00401},

issn = {0028-3886},

year  = {2024},

date = {2024-10-31},

urldate = {2024-10-31},

journal = {Neurology India},

volume = {72},

number = {pmid39428794},

issue = {5},

pages = {1103-1104},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024f,

title = {Unilateral asymptomatic multiple cerebral microbleeds: a very rare radiological entity},

author = {Sandhya Manorenj and S. Sravan Kumar and Chillapuram Shashanka and Sravan Kumar Marupaka},

url = {https://journals.lww.com/annalsofian/fulltext/2024/27050/unilateral_asymptomatic_multiple_cerebral.18.aspx},

doi = {10.4103/aian.aian_383_24},

issn = {0972-2327},

year  = {2024},

date = {2024-09-06},

urldate = {2024-09-06},

journal = {Annals of Indian Academy of Neurology},

volume = {27},

number = {pmid39240195},

issue = {5},

pages = {573-575},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024d,

title = {Basal cistern sparing pattern of subarachnoid hemorrhage: an imaging clue for SAH beyond aneurysm},

author = {Sandhya Manorenj},

url = {https://journals.lww.com/neur/fulltext/2024/07000/basal_cistern_sparing_pattern_of_subarachnoid.40.aspx},

doi = {10.4103/neurol-india.Neurol-India-D-23-00705},

issn = {0028-3886},

year  = {2024},

date = {2024-08-31},

urldate = {2024-08-31},

journal = {Neurology India},

volume = {72},

number = {pmid39216057},

issue = {4},

pages = {892-893},

abstract = {NA},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2024b,

title = {Acute necrotizing encephalopathy of childhood (ANEC) in a patient with dengue and leptospirosis},

author = {Reshma Sultana Shaik and Sandhya Manorenj and Sravan Kumar Marupaka},

url = {https://journals.lww.com/neur/fulltext/2024/03000/acute_necrotizing_encephalopathy_of_childhood.43.aspx},

doi = {10.4103/ni.ni_984_21},

issn = {0028-3886},

year  = {2024},

date = {2024-04-30},

urldate = {2024-04-30},

journal = {Neurology India},

volume = {72},

number = {pmid38691496},

issue = {2},

pages = {433-434},

abstract = {None},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2024c,

title = {Cervicomedullary compression in achondroplasia: a feared complication and an unforeseen risk factor of posterior circulation stroke},

author = {Reshma Sultana Shaik and Sandhya Manorenj and Sravan Kumar Marupaka},

url = {https://journals.lww.com/neur/fulltext/2024/03000/cervicomedullary_compression_in_achondroplasia__a.31.aspx},

doi = {10.4103/ni.ni_537_21},

issn = {0028-3886},

year  = {2024},

date = {2024-04-30},

urldate = {2024-04-30},

journal = {Neurology India},

volume = {72},

number = {pmid38691484},

issue = {2},

pages = {399-402},

abstract = {Achondroplasia is an autosomal dominant disorder with defect in the ossification of the cartilage of long bones. Many bony abnormalities constitute its clinical features, with craniovertebral junction (CVJ) anomalies being one of most common issues which need to be addressed at the earliest. CVJ anomalies in individuals may cause neurovascular compression, which may warrant an early surgery to prevent catastrophic complications. Posterior circulation strokes secondary to CVJ anomalies are well known. We hereby present an unusual case of posterior circulation stroke in an achondroplastic dwarf who presented to our tertiary care centre. Prospective case study. The present case adds to the existing literature about one of the preventable causes of fatal posterior circulation strokes in the young. A high index of suspicion for neurovascular compression at the foramen magnum and early initiation of treatment in achondroplastic young individuals may have gratifying results.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024c,

title = {A neurologist’s perspective of approach to falls in the elderly},

author = {Sandhya Manorenj and Reshma Sultana Shaik},

url = {https://journals.lww.com/aomd/fulltext/2024/07010/a_neurologist_s_perspective_of_approach_to_falls.2.aspx},

doi = {10.4103/aomd.aomd_56_22},

issn = {2590-3446},

year  = {2024},

date = {2024-04-29},

urldate = {2024-04-29},

journal = {Annals of Movement Disorders},

volume = {7},

issue = {1},

pages = {3-12},

abstract = {Falls constitute an important public health problem that impact the quality of life of an individual. Falls contribute to disability, especially among older adults and elderly individuals. Recurrent fallers are those who fall one or more times per year. The purpose of this article is to provide a detailed systemic qualitative review of the recent definition of falls, their mechanism, risk factors, classification; falls in neurodegenerative disorders; and their approach and management. Sources of literature were drawn from peer-reviewed original and systematic review articles published until January 2024 in the PubMed database using the following key words: falls, elderly, definition, management, etiology, neurodegenerative diseases, epilepsy and fall, dementia and fall, and prevention and diagnostic tests for postural instability and falls. This review summarizes the current understanding of falls and provides a pragmatic and clinically focused approach to their management. Falls are usually multifactorial. Neurodegenerative disorders such as cognitive decline and parkinsonism lead to increased risk of falling. There are several tools to assess the risk of early falls. A multidisciplinary approach is needed in the management of falls. The main goal is encouraging physical activity, home hazard modification, management of postural hypotension, and underlying neurodegenerative diseases.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Zoheb_2024,

title = {High blood pressure, hyperlipidemia, type 2 diabetes with prior history of atrial fibrilation caused stroke},

author = {Mohammed Zoheb and Deeba Rana and Shaikh Mahmood},

url = {https://www.worldwidejournals.com/international-journal-of-scientific-research-(IJSR)/article/high-blood-pressure-hyperlipidemia-type2-diabetes-with-prior-history-of-arterial-fibrilation-caused-stroke/NTUzMDY=/?is=1&b1=&k=},

issn = {2277-8179},

year  = {2024},

date = {2024-04-01},

journal = {International Journal of Scientific Research},

volume = {13},

issue = {4},

pages = {1-2},

abstract = {The stroke cases are on rise, to know its causes, symptoms & treatment patients have to be studied in detail and get the appropriate result. Stroke is a serious medical condition that can sometimes be deadly. Stroke cases are emerging at a startling rate at the moment. People with specific medical problems are more susceptible to stroke, even though it may affect anybody. A stroke or brain stroke can be fatal and result from inadequate blood supply to a portion of the brain, according to the Cleveland Clinic. The most common causes of this are cerebral hemorrhage or arterial obstruction. If insufficient blood flow occurs, oxygen-starved brain cells begin to die. A stroke may happen to anybody, at any age, although certain people are more susceptible than others. Furthermore, beyond the age of 65, the danger rises. Strokes occur commonly in either sex. Strokes are the second largest cause of mortality worldwide. Not only that, but stroke is a leading global cause of disability. The following are a few examples of stroke symptoms paralysis on one sides peaking difficulties or loss of speech distorted or double vision (diplopia) inability to coordinate light headedness

and vomiting stiff neck personality shift agitation or confusion seizure loss of memory headache loss of consciousness the blood clotting disorder atherosclerosis Heart abnormality (ventricular or atrial septal defect) microvascular ischemia elevated blood pressure tumors of the brain (including cancer)Heart abnormality (ventricular or atrial septal defect) microvascular ischemia elevated blood pressure tumors of the brain (including cancer) etc.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024b,

title = {Ictal nystagmus in a patient with nonketotic hyperglycemia: a rare clinical phenomenon of occipital epilepsy},

author = {Sandhya Manorenj and Deepika Venniveli and Mounika E. Reddy and Srujana Billa},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10941902/pdf/AIAN-27-77.pdf},

doi = {10.4103/aian.aian_800_23},

issn = {0972-2327},

year  = {2024},

date = {2024-02-06},

urldate = {2024-02-06},

journal = {Annals of Indian Academy of Neurology},

volume = {27},

number = {pmid38495234},

issue = {1},

pages = {77-79},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Ali_2024,

title = {Knowledge of stroke and the window period for thrombolytic therapy in ischemic stroke among South Indians: a hospital-based survey with educational intervention},

author = {Reem Jaffer Ali and Sandhya Manorenj and Ruqya Zafar},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10927053/?report=printable},

doi = {10.25259/JNRP_312_2023},

issn = {0976-3147},

year  = {2024},

date = {2024-02-05},

urldate = {2024-02-05},

journal = {Journal of Neurosciences in Rural Practice},

volume = {15},

number = {pmid38476435},

issue = {1},

pages = {111-116},

abstract = {Objectives: The objective of this study was to determine the awareness of stroke in regards to the risk factors, warning symptoms, and knowledge of the therapeutic window period among varied strata of non-medical people attending a tertiary care center.

Materials and Methods: The interventional study involved the collection of data regarding awareness of stroke using a structured questionnaire with a total score of 16. Pre-intervention assessment was followed by intervention in the form of education regarding awareness of stroke administered one-on-one for personalized and effective comprehension by subjects. Then, subjects were asked to recall the information that was delivered to them and were scored accordingly.

Results: Among the 500 subjects included, 51% were female. About 76.8% of participants were young (age <50 years), and 83.4% were literate. Only 25.4% of participants were aware of the brain as the site of stroke. About 32.2% of candidates were aware of a few risk factors for stroke. Among them, the majority of participants were aware of hypertension (24%) as a risk factor. The most known warning symptom was “Numbness” or weakness of arm. The majority of the subjects (97.8%) were unaware of a therapeutic window period for stroke being 4.5 h or below. The mean pre-intervention score was 2.52 ± 1.65 while the mean post-intervention score was 15.10 ± 1.79 (P < 0.0001).

Conclusion: The study showed that even among literate participants, only a meager number of subjects were aware of the golden window period of intravenous thrombolysis. Educational intervention by means of an in-person and one-on-one explanation achieved significant levels of understanding of stroke. The study could be used to formulate large-scale educational programs that focus on spreading awareness of symptoms and risk factors while also instilling the importance of timely medical intervention for efficient thrombolytic therapy.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2024,

title = {An interesting case of chronic isolated apathetic syndrome},

author = {Sandhya Manorenj and Rindha V. Rao and Reshma Sultana Shaik},

url = {https://sciencevolks.com/neurology/pdf/SVOA-NE-05-0124.pdf},

doi = {10.58624/SVOANE.2024.05.0124},

issn = {2753-9180},

year  = {2024},

date = {2024-01-10},

urldate = {2024-01-10},

journal = {SVOA Neurology},

volume = {5},

issue = {1},

pages = {37-40},

abstract = {An apathy syndrome is defined as a syndrome of primary motivational loss, that is, loss of motivation not attributable to emotional distress, intellectual impairment, or a diminished level of consciousness. The main anatomical correlate of apathy is the medial frontal lobe. Here we report a case of a 49-year-old male who presented with a history of lack of interest for the past 10 months without any other neurological symptoms. He was diagnosed with depression and was receiving treatment from multiple psychiatrists. In view of his persistent symptoms, he approached us and was evaluated. Examination showed anosmia with apathy that paved the way to the orbitofrontal location of the lesion. Psychiatric symptoms may be an unusual presentation of a space-occupying lesion of brain. Strong suspicion and imaging the brain is indicated in all cases to prevent the unnecessary use of psychiatric medicines and their complications. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2023b,

title = {Diffusion restriction in bilateral thalami: beyond artery of percheron infarct},

author = {Sandhya Manorenj and Reshma Sultana Shaik and Sravan Kumar Marupaka and Tasneem Ara},

url = {https://journals.lww.com/neur/fulltext/2023/71040/diffusion_restriction_in_bilateral_thalami__beyond.22.aspx},

doi = {10.4103/0028-3886.383876},

issn = {0028-3886},

year  = {2023},

date = {2023-08-18},

urldate = {2023-08-18},

journal = {Neurology India},

volume = {71},

issue = {4},

pages = {754-759},

publisher = {Medknow},

abstract = {Background: Bilateral thalamic infarction, especially the medial thalamus, has been characteristically described in the artery of Percheron (AOP) affection. However, bilateral thalamic restriction has been described in many entities beyond the AOP infarction. Objective: Here we describe a case series (three cases) with infection as an etiology for bilateral thalamic lesions in the topographic distribution of the AOP from a tertiary care center in tropical India. Materials and Methods: Case series during a 1-year period collecting cases with bilateral thalamic diffusion restriction on MRI who did not have thalamic infarcts and their outcomes. Results: Bilateral thalamic lesion can occur in both bacterial and viral infections such as tuberculosis, dengue, and SARS-COV-2. Thus, we intend to add infections as one of the etiologies in the ever-expanding list of conditions that produce bilateral thalamic restriction. Conclusions: All the acute symmetric thalamic lesions are not always secondary to vascular insult. Accurate assessment and prompt diagnosis can prevent unnecessary delays in treatment. To our knowledge, this is the first case series in the literature that throws light on the bilateral thalamic lesions in the topographic distribution of the AOP secondary to infections in a tropical country like India.},

key = {pmid37635510},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2023,

title = {Grace face sign in generalized myasthenia gravis (MG)},

author = {Reshma Sultana Shaik and Sandhya Manorenj},

url = {https://www.neurologyindia.com/temp/ni713606-2077886_054618.pdf},

doi = {10.4103/0028-3886.378674},

issn = {0028-3886},

year  = {2023},

date = {2023-06-15},

urldate = {2023-06-15},

journal = {Neurology India},

volume = {71},

issue = {3},

pages = {606},

publisher = {Medknow},

key = {pmid37322783},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2023b,

title = {A peccant tale of an innocent investigation- unmasking of asymptomatic idiopathic intracranial hypertension (IIH)},

author = {Reshma Sultana Shaik and Sandhya Manorenj and Sravan Kumar Marupaka and S. Chandra Reddy},

url = {https://www.neurologyindia.com/temp/ni712338-1753714_045217.pdf},

doi = {10.4103/0028-3886.375426},

issn = {0028-3886},

year  = {2023},

date = {2023-04-29},

urldate = {2023-04-29},

journal = {Neurology India},

volume = {71},

issue = {2},

pages = {338-339},

publisher = {Medknow},

key = {pmid37148067},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2023,

title = {Coexistence of congenital myasthenic syndrome and schizophrenia: could there be a genetic link?},

author = {Sandhya Manorenj and Reshma Sultana Shaik},

url = {https://www.neurologyindia.com/temp/ni711180-2164337_060043.pdf},

doi = {10.4103/0028-3886.370441},

issn = {0028-3886},

year  = {2023},

date = {2023-02-24},

urldate = {2023-02-24},

journal = {Neurology India},

volume = {71},

issue = {1},

pages = {180-181},

publisher = {Medknow},

key = {pmid36861611},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2023,

title = {Aetiopathogenesis of ischemic stroke in rheumatoid arthritis: a case series study from tertiary care centre of South India},

author = {Sandhya Manorenj and Reshma Sultana Shaik and Sravan Kumar Marupaka },

url = {https://www.msjonline.org/index.php/ijrms/article/view/11415/7500},

doi = {10.18203/2320-6012.ijrms20223655},

issn = {2320-6012},

year  = {2023},

date = {2023-01-01},

urldate = {2023-01-01},

journal = {International Journal of Research in Medical Sciences},

volume = {11},

issue = {1},

pages = {323-327},

publisher = {Medip Academy},

abstract = {Stroke is a major health concern worldwide. Published meta-analyses showed significant higher risk of ischemic and hemorrhagic stroke in patients with rheumatoid arthritis (RA) compared to the general population. Major etiopathogenesis of ischemic stroke in RA is non-atherosclerotic vasculopathy. Here the authors described varied aetiopathogensis of ischemic stroke in patients with RA which had been seldom reported in the literature. It was one of the first case series which threw light in this genre. Observational, prospective case series study was conducted over a period of one year. Amongst four cases presenting as an ischemic stroke with co-existing RA; each patient had a medium or small vessel vasculopathy, which had never been described earlier. Case 1 had cardio embolic source plus large vessel vasculopathy, case 2 had intracranial non-atherosclerosis vasculopathy; case 3 had secondary Moya-Moya disease; case 4 had both intracranial and extra cranial vasculopathy. Underlying aetiopathogensis of stroke in patients with RA can be attributed to insufficient cardiovascular treatment (well described in the literature) and vasculopathy of extracranial and intracranial vessels and secondary Moyamoya disease due to RA. Thorough evaluation is needed to prevent recurrence of stroke. The treatment strategy in these patients are immunotherapy apart from the conventional therapy with antiplatelet and statins.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2022c,

title = {Hyperammonemia presenting as opsoclonus–myoclonus–ataxia–tremor syndrome: a case report},

author = {Sandhya Manorenj and Govind Verma},

url = {https://journals.lww.com/aomd/fulltext/2022/05030/hyperammonemia_presenting_as.9.aspx},

doi = {10.4103/aomd.aomd_6_22},

issn = {2590-3446},

year  = {2022},

date = {2022-12-30},

urldate = {2022-12-30},

journal = {Annals of Movement Disorders},

volume = {5},

issue = {3},

pages = {198-201},

abstract = {Opsoclonus myoclonus syndrome (OMS) is a rare autoimmune condition occurring due to Purkinje cell degeneration due to remote aetiology. Most often it occurs as a paraneoplastic syndrome. Here we report a case of opsoclonus-myoclonus–ataxia tremor syndrome in a 60-year-old woman that occurred due to hyperammonemia and she recovered completely with immunotherapy and correction of hyperammonemia. OMS is the first in literature associated with hyperammonemia.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Zaffer_2022,

title = {Efficacy of gabapentin vs oxcarbazepine in terms of pain, sleep and quality of life in patients with diabetic peripheral neuropathy},

author = {Wadha Nawal Zaffer and Faiz Unnisa and Farath Unnisa and Ayesha Tahoora Fatima and Azmath Unnisa Begum and Mohammed Zoheb},

url = {https://rjn.com.ro/articles/2022.3/RJN_2022_3_Art-08.pdf},

doi = {10.37897/rjn.2022.3.8},

issn = {1843-8148},

year  = {2022},

date = {2022-09-01},

urldate = {2022-09-01},

journal = {Romanian Journal of Neurology},

volume = {21},

issue = {3},

pages = {242-247},

publisher = {AMALTEA Medical Publishing House},

abstract = {Background. The treatment of peripheral diabetic neuropathy is difficult to treat considering the pain is severe, long-lasting and does not respond to analgesics. Gabapentin has been recommended as the first line treatment for DPN but owing to cognitive dysfunction and other side effects the drug is discontinued. Recent studies suggest that oxcarbazepine; an antiepileptic drug has good-efficacy in management of DPN. This prospective, observational and comparative study was done to compare gabapentin and oxcarbazepine monotherapy in patient of DPN. Objectives. We assessed the efficacy of Oxcarbazepine monotherapy in terms of pain score, sleep score and quality of life and compared with gabapentin monotherapy. Methods. 100 patients with DPN or examinations suggesting DPN were divided into 2 groups to receive gabapentin 300-1200 mg/day or Oxcarbazepine 300-600mg/day. Assessment of pain scores, sleep score and quality of life were done at different duration during the course of therapy. Results. Out of total subject selected, the maximum (46%) subjects were between age group 60-90 years and the least effected were (24%) between age group 50-59 years. Male were more prevalent with 57% when compared to females with 43%. Improvement in Sleep was seen on using Group II with p value (0.0005). However, the correlation of Pain and Quality of life with the treatment shows p –value 0.24, 0.31 and 0.27 respectively showing non-significance. Conclusion. The sleep improved statistically correlated in patients with DPN, but not with quality of life and pain as the calculated p value was (p= 0.24, 0.31 and 0.27) respectively. Findings of this study suggest that oxcarbazepine can be used as an alternative treatment owing to its similar analgesic efficacy and improvement in sleep.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fathima_2022c,

title = {Role of cell-free DNA for predicting incidence and outcome of patients with ischemic stroke},

author = {Nusrath Fathima and Sandhya Manorenj and Sandeep Kumar Vishwakarma and Aleem Ahmed Khan},

url = {https://f6publishing.blob.core.windows.net/0bb64623-48a1-4d1c-9e53-15650da40f4a/WJN-8-1.pdf},

doi = {10.5316/wjn.v8.i1.1},

issn = {2218-6212},

year  = {2022},

date = {2022-08-30},

urldate = {2022-08-01},

journal = {World Journal of Neurology},

volume = {8},

issue = {1},

pages = {1-9},

publisher = {Baishideng Publishing Group Inc.},

abstract = {Early diagnosis and prognosis of ischemic stroke remains a critical challenge in clinical settings. A blood biomarker can be a promising quantitative tool to represent the clinical manifestations in ischemic stroke. Cell-free DNA (cfDNA) has recently turned out to be a popular circulating biomarker due to its potential relevance for diagnostic applications in a variety of disorders. Despite bright outlook of cfDNA in clinical applications, very less is known about its origin, composition, or function. Several recent studies have identified cell-derived mitochondrial components including mitochondrial DNA (mtDNA) in the extracellular spaces including blood and cerebrospinal fluid. However, the time course of alterations in plasma mtDNA concentrations in patients after an ischemic stroke is poorly understood. DNA is thought to be freed into the plasma shortly after the commencement of an ischemic stroke and then gradually decreased. However, the importance of cell-free mtDNA (cf-mtDNA) in ischemic stroke is still unknown. This review summarizes about the utility of biomarkers which has been standardized in clinical settings and role of cfDNA including cf-mtDNA as a non-invasive potential biomarker of ischemic stroke.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Fathima_2022b,

title = {Cell-free mitochondrial DNA quantification in ischemic stroke patients for non-invasive and real-time monitoring of disease status},

author = {Nusrath Fathima and Sandhya Manorenj and Sandeep Kumar Vishwakarma and Aleem Ahmed Khan},

url = {https://f6publishing.blob.core.windows.net/7f307e4a-b015-447a-a322-f1d12b1e8878/WJTM-10-14.pdf},

doi = {10.5528/wjtm.v10.i2.14},

issn = {2220-6132},

year  = {2022},

date = {2022-08-06},

urldate = {2022-08-06},

journal = {World Journal of Translational Medicine},

volume = {10},

issue = {2},

pages = {14-28},

publisher = {Baishideng Publishing Group Inc.},

abstract = {BACKGROUND: Acute ischemic stroke (AIS) is one of the major causes of the continuous increasing rate of global mortality due to the lack of timely diagnosis, prognosis, and management. This study provides a primitive platform for non-invasive and cost-effective diagnosis and prognosis of patients with AIS using circulating cell-free mitochondrial DNA (cf-mtDNA) quantification and validation. AIM: To evaluate the role of cf-mtDNA as s non-invasive, and affordable tool for real-time monitoring and prognosticating AIS patients at disease onset and during treatment. METHODS: This study enrolled 88 participants including 44 patients with AIS and 44 healthy controls with almost similar mean age group at stroke onset, and at 24 h and 72 h of treatment. Peripheral blood samples were collected from each study participant and plasma was separated using centrifugation. The cf-mtDNA concentration was quantified using nanodrop reading and validated through real-time quantitative polymerase chain reaction (RT-qPCR) of NADH-ubiquinone oxidoreductase chain 1 (ND1) relative transcript expression levels. RESULTS: Comparative analysis of cf-mtDNA concentration in patients at disease onset showed significantly increased levels compared to control individuals for both nanodrop reading, as well as ND1 relative expression levels (P < 0.0001). Intergroup analysis of cf-mtDNA concentration using nanodrop showed significantly reduced levels in patients at 72 h of treatment compared to onset (P < 0.01). However, RT-qPCR analysis showed a significant reduction at 24 h and 72 h of treatment compared to the disease onset (P < 0.001). The sensitivity and specificity were relatively higher for RT-qPCR than nanodrop-based cf-mtDNA quantification. Correlation analysis of both cf-mtDNA concentration as well as ND1 relative expression with National Institute of Health Stroke Scale score at baseline showed a positive trend. CONCLUSION: In summary, quantitative estimation of highly pure cf-mtDNA provides a simple, highly sensitive and specific, non-invasive, and affordable approach for real-time monitoring and prognosticating AIS patients at onset and during treatment.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2022,

title = {Diet a modifiable risk factor for stroke: linking diet and stroke; an Indian perspective},

author = {Sandhya Manorenj and Reshma Sultana Shaik},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/9907/6077},

doi = {10.18203/2394-6040.ijcmph20221779},

issn = {2394-6032},

year  = {2022},

date = {2022-07-31},

urldate = {2022-07-31},

journal = {International Journal of Community Medicine and Public Health},

volume = {9},

issue = {7},

pages = {3040-3045},

abstract = {Stroke is the second leading cause of death and disability worldwide. The incidence of stroke in India has increased to hundred  percent  in past  few  decades.  It  was  the  Framingham  heart  study  trial  in  2001  which  has  first  identified  the role  of  dietary  habits  for  prevention  of  atherosclerotic  cardiovascular  disease.  Majority  of  secondary  prevention strategies  for  Ischemic  stroke  are  directed  towards  pharmacotherapy  with  antiplatelet  and  statins,  while  dietary modifications  are  not  projected.  However  dietary  and  lifestyle  modification  can  reduce  stroke  risk  by  60%.  Hence Diet  and  nutrition  play  an  active  role  in  prevention  of  stroke.  This  reviewsummarizes  the  dietary  intake,  dietary patterns and risk of stroke among Indians and provides clinicians with pragmatic guidance to their management. We searched  Pub  Med,  MEDLINE,  for  articles  about  diet  and  stroke  in  India  published  in  English  till  May  2021.  Diet plays  a  major  role  in  pathophysiology  of  stroke.  Modification  of  dietary  pattern  is  the  major  non  pharmacological treatment for the primary and secondary prevention of stroke. Indian traditional diet should be modified according to dietary  pattern  followed  in  each  region.  As  a  whole  reduction  of  rice  consumption,  higher  protein  consumption  and lower fat  consumption  should be  encouraged at  macronutrient level,  while higher intake  of fruits and vegetables are advised  at  micronutrient  level.  Dietary guidelines  should  be  customized  and  tailor  made  based  on  the  regional customs and annual income in various subsections of the society.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Shaik_2022b,

title = {"Neuroleptic malignant syndrome (NMS) sans rigidity" .....Does it exist??},

author = {Reshma Sultana Shaik and Sandhya Manorenj and Rindha V. Rao},

url = {https://journals.lww.com/annalsofian/fulltext/2022/2506/_neuroleptic_malignant_syndrome__nms__sans.62.aspx},

doi = {10.4103/aian.aian_593_22},

issn = {0972-2327},

year  = {2022},

date = {2022-01-01},

urldate = {2022-01-01},

journal = {Annals of Indian Academy of Neurology},

volume = {25},

issue = {6},

pages = {1235-1236},

publisher = {Medknow},

key = {pmid36911465},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2022d,

title = {Diagnostic performances of susceptibility weighted imaging brain for the detection of cerebral venous thrombosis in patients presenting with headache},

author = {Sandhya Manorenj and Sravan Kumar Marupaka and Kiran Kumar Ramineni},

url = {https://www.ijcmsr.com/uploads/1/0/2/7/102704056/ijcmsr_585_v1.pdf},

issn = {2565-4802},

year  = {2022},

date = {2022-01-01},

journal = {International Journal of Contemporary Medicine Surgery and Radiology},

volume = {7},

issue = {1},

pages = {A29-A33},

abstract = {Introduction: Magnetic resonance venography (MRV) brain is the gold standard for diagnosing cerebral venous thrombosis (CVT). Susceptibility-weighted imaging (SWI) is a high-spatial resolution, (MR) technique that is exquisitely sensitive to venous blood, hemorrhage and iron storage. Study aimed to know the diagnostic performance of SWI in detecting CVT compared to MRV and to facilitate early diagnosis of CVT where MRV not feasible.

Material and Methods: A prospectively study, included patients presenting with clinical symptoms of CVT who underwent MRI (1.5T) brain with MRV. We determined the sensitivity, specificity, predictive value, accuracy, degree of agreement between SWI and MRV in detecting CVT.

Results: Out of 100 cases, 64 were females. Majority of patients presented with headache (100%) and CVT was diagnosed in 55 cases. Majority of patient had transverse sinus (TS) thrombosis (54%). The overall diagnostic accuracy of SWI sequence was 76.31% and that of MRV was 95.18%. Sensitivity of SWI versus MRV was 63.22% Vs 91.23%; Specificity 92.31% Vs 100%; Positive predictive value 90.95% vs 100%; Negative predictive value 67.25% vs 90.32% respectively. 95% confidence interval was observed for the specificity and positive predictive value of the SWI test. There exists good degree of agreement between both imaging modalities with 98% accuracy to detect cortical vein thrombosis by SWI.

Conclusion: SWI sequence added on the conventional MRI can be used as the first line imaging modality for evaluation of patient with CVT where MRV brain is not feasible. SWI has higher diagnostic performance in detecting isolated cortical vein thrombosis.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2021b,

title = {Chronic psychiatric illness masquerading as bipolar disorder in a family secondary to familial systemic lupus erythematosus with limbic encephalitis},

author = {Sandhya Manorenj and Reshma Sultana Shaik},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8522607/?report=reader#__ffn_sectitle},

doi = {10.4103/indianjpsychiatry.indianjpsychiatry_178_21},

issn = {0019-5545},

year  = {2021},

date = {2021-10-12},

urldate = {2021-10-12},

journal = {Indian Journal of Psychiatry},

volume = {63},

issue = {5},

pages = {517-519},

abstract = {NA},

key = {pmid34789947},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Khatoon_2021,

title = {Serum calcitonin gene related peptide (CGRP) levels in migraine: a study on its clinical correlation and diagnostic efficacy},

author = {Sofia Khatoon and Noorunissa Begum and Hafeeza Sultana and Maryam Rashed and Mohammed Zoheb and Aleem Ahmed Khan and Sara Shreen and Syed Iqbal Ahmed},

url = {https://rjn.com.ro/articles/2021.3/RJN_2021_3_Art-13.pdf},

doi = {10.37897/RJN.2021.3.13},

issn = {1843-8148},

year  = {2021},

date = {2021-08-10},

urldate = {2021-08-10},

journal = {Romanian Journal of Neurology},

volume = {20},

issue = {3},

pages = {342-348},

abstract = {Migraine is a primary headache disorder marked by recurrent unilateral headache episodes. Calcitonin gene related peptide (CGRP) plays major role in migraine pathophysiology. CGRP is multifunctional, and its vasodilating activity within the central and peripheral blood vessels is one in all its primary functions.The intention is to prove serum calcitonin gene related peptide (CGRP) as an early diagnostic tool for migraine and the novelty is to correlate it with characteristics of migraine so that it helps in early initiation of treatment.

Methods. 100 subjects including 90 patients with migraine and 10 with non-headache (NH) age-matched controls were prospectively recruited in our current study. The subjects were aged from 15- 50 years. The clinical assessment was made every month for the three months after the start of therapy. The subjects were compared based on the serum CGRP values. Serum CGRP concentrations were measured by using CGRP ELISA kit. Results. Out of total subjects selected, the maximum (23.3%) subjects were between age 26 and 30 years and least effected age group was 46-50 years (4.44%). Females’ predominance with 82% than males with 18%.Stress was major trigger occurring in 57% of cases. Throbbing pain with elevated CGRP levels 130.44±114.22 and p value (p = 0.01). The average CGRP levels was higher in test group 149.00±93.86 compared to control 61.30±24.37 with p value (p = 0.02). Conclusions. The serum CGRP levels were statistically more in migraine patients correlated with characteristics like throbbing type of pain, stress and inadequate sleep. Hence, the serum CGRP levels estimation can be considered as a diagnostic tool for migraine when the clinical character’s over lap or early in the course of migraine when all criteria for diagnosis are not yet fulfilled.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2021c,

title = {Validation of the new international league against epilepsy 2017 classification for determining seizure type in Indian patients},

author = {Sandhya Manorenj and Navya Sagari},

url = {https://www.thieme-connect.com/products/ejournals/pdf/10.1055/s-0041-1731934.pdf},

doi = {10.1055/s-0041-1731934},

issn = {2213-6320},

year  = {2021},

date = {2021-07-20},

urldate = {2020-07-20},

journal = {International Journal of Epilepsy},

volume = {7},

pages = {29-35},

abstract = {Introduction Epilepsy is a common condition in neurology comprising several electroclinical syndromes and seizure disorders of varying known and unknown etiologies that require variable diagnostic workup, treatment, and have obviously different prognoses. Therefore, for appropriate patient management, the best possible classification system for epilepsy is required. The International League Against Epilepsy (ILAE) is continuously working on this with the latest classification provided in 2017. There is little knowledge about seizure type based on newer classification systems in Indian patients. Aims and Objective To test the applicability of the newer ILAE 2017 classification of epilepsy in determining seizure type in Indian patients, with respect to right patient management, the best classification system for epilepsy is necessary. Materials and Methods: Prospective data of 310 consecutive patients with seizures presenting in neurology department was collected from December 2017 to June 2018 and analyzed according to the newer systems of classification of seizures proposed by ILAE in 2017. Results All 310 patients in age ranging from one year to 72 years with seizures could

be classified according to the ILAE 2017 classification system. Focal onset seizure was noted in 66 patients (21.3%), while 244 patients (78.7%) had generalized onset based on clinical onset of seizure. Awareness was impaired in 262 (84.5%) patients. Motor onset seizure was observed in 278 patients (89.6%), while nonmotor seizure included absence, sensory, cognitive, and autonomic seizures. Conclusion The present study showed that all patients could be classified using ILAE 2017 classification system. Majority of seizure were generalized onset, predominantly motor type of seizure with impaired awareness using clinical description of classifying

seizure, while focal onset seizure was the majority type of seizure when ancillary information was considered.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2021,

title = {Clinical efficacy, safety, and tolerability of dual versus single antiplatelet therapy in acute ischemic cerebrovascular disease with lacunar stroke in Indian patients. One year prospective study with outcome assessed at 90 days },

author = {Sandhya Manorenj and Srikant Jawalkar},

url = {https://bcn.iums.ac.ir/article-1-1972-en.html},

doi = {10.32598/bcn.12.4.2973.1 },

issn = {2008-126X},

year  = {2021},

date = {2021-07-19},

urldate = {2021-07-19},

journal = {Basic and Clinical Neuroscience},

volume = {0},

issue = {0},

abstract = {Introduction & Background: Lacunar stroke, comprising 18% of Ischemic stroke, is the second most common subtype of stroke in India. Available data on the effect of dual antiplatelets treatment with aspirin plus clopidogrel vs single antiplatelet therapy with aspirin alone and their doses in Lacunar stroke happens to be very limited. Aim: The aim of our study was to decipher the efficacy, safety & tolerability of dual versus single antiplatelet therapy in the treatment of patients with recent occurrence of lacunar stroke. Materials & Methods: It was a prospective, single centre study conducted at the Department of Neurology. Patients with recent occurrence of Lacunar stroke were randomly divided into 4 groups to receive Aspirin 150 mg (Group1), Aspirin 150 mg plus clopidogrel 75 mg (Group 2), aspirin 75mg plus clopidogrel 75 mg (Group 3), and aspirin 75 mg (Group 4) once daily and were closely monitored for 90 days. Results: 360 patients were recruited and followed for 90 days. Mean age of the patients was 57.8 ±14.1 years. 188 patients (52.2%) were males. Recurrence of Ischemic stroke occurred highest in group 4 (22%) with no recurrence in group 2 .Comparisons of recurrence of Ischemic stroke between group 1 and group 4 (95% CI: 2.6829% to 31.73551%) and between group 3 and group 4 (95% CI: 3.9439% to 32.1542%) showed a statistically significant value <0.05. Haemorrhagic events occurred among recipients on dual antiplatelets therapy. Conclusions: Efficacy wise, Group 2 with 150 mg aspirin plus 75 mg clopidogrel, was found superior to other groups in the prevention of Lacunar stroke. Groups with dual antiplatelet therapy manifested a worrisome thread of bleeding events. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Farooqui_2020,

title = {A comparative evaluation of antiplatelet regimens for prevention of recurrence in patients with ischemic stroke: a pilot study},

author = {Sadia Farooqui and S. Arfaa and S. Nousheen and S. Fatima and Mohammed Zoheb},

url = {https://ijpsr.com/bft-article/a-comparative-evaluation-of-antiplatelet-regimens-for-prevention-of-recurrence-in-patients-with-ischemic-stroke-a-pilot-study/},

doi = {10.13040/IJPSR.0975-8232.11(10).5071-75 },

issn = {0975-8232},

year  = {2020},

date = {2020-10-01},

urldate = {2020-10-01},

journal = {International Journal of Pharmaceutical Sciences and Research},

volume = {11},

issue = {10},

pages = {5071-5075},

abstract = {Background: Prevention of recurrence is important for patients with ischemic stroke. The purpose of the study was to compare the effectiveness of two antiplatelet regimens-aspirin plus clopidogrel versus aspirin plus cilostazol in early secondary stroke prevention using National Institutes of Health Stroke Scale (NIHSS) Scores. Methods: In this study, we randomly assigned 30 patients to receive aspirin plus clopidogrel once daily or to receive aspirin once daily plus cilostazol twice daily. The patients were followed up for a period of three months, and the NIHSS scores were taken on admission, and every month thereafter. After completion of the study duration, the scores of both the groups were compared, and results were interpreted. Results and Discussion: More number of patients were found to be in the age group of 60- 70 years with a mean age of 63 years. In both the groups, the percentage of females was higher than that of males. Hypertension (80%) and diabetes mellitus (56.6%) appeared to be the major risk factors. The percentage of death rate in the aspirin/clopidogrel group (20.25%) was higher than that of the aspirin/cilostazol group (6.75%). Recurrent stroke and vascular events did not occur in any group. Conclusion: Aspirin/cilostazol significantly reduced the risk of early stroke recurrence based on NIHSS scores. Hence, it can be considered as a supplement to aspirin or an alternative to clopidogrel in dual therapy for secondary prevention of ischemic stroke. There is no evidence that either of the two antiplatelet regimens was superior to the other in the prevention of recurrent stroke.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2020,

title = {Prevalence, risk factors and clinical profile of patients with cardioembolic stroke in South India: a five-year prospective study},

author = {Sandhya Manorenj and Sudhakar Barla and Srikant Jawalkar},

url = {https://www.ijcmph.com/index.php/ijcmph/article/view/6337/4100},

doi = {10.18203/2394-6040.ijcmph20203002},

issn = {2394-6032},

year  = {2020},

date = {2020-07-26},

urldate = {2020-07-26},

journal = {International Journal of Community Medicine and Public Health},

volume = {7},

issue = {7},

pages = {2708-2714},

abstract = {Background:Stroke  is  the  second  leading  cause  of mortality  and  morbidity  worldwide.  Cardioembolic  stroke accounts  for  15-30%  of  Ischemic  stroke.  There  have  been  very  few  clinical  studies  on  cardioembolic  stroke, especially  from  India.  Our  aim  was  to  provide  a  demographic,  risk  factor  and  clinical  profileof  patients  with cardioembolic stroke in South India.Methods:A  prospective  study was conducted at  the  Neurology Inpatient Department over a  period of 5 years from January  2013  to  January 2018  collecting  necessary  information  and  data  from  all  cases  diagnosed  as  cardioembolic stroke.Results:651  patients  were  diagnosed  to  have  acute  Ischemic  stroke.  Of  the  76  patients  (11.6%)  diagnosed  with cardioembolic  stroke,  35  (46%)  were  females.  Mean  age  was  53.5±12.2  years.  Occurrence  of  cardioembolic  stroke wasseen  to  be  higher  (71%  vs  28.9%,  pvalue<0.0001)  in  patients  of  older  age  group  (46  years  or  more).  A significant  proportion  of  patients  of  the  older  age  group  (37%)  had  hypertension  (pvalue=0.0048).  Coronary  artery disease (CAD) was the most prevalent cardiac disorder, observed in 42 patients (55.2%),valvular heart disease in 22 patients  (28.9%)  and  atrial  fibrillation  in  14  patients  (18.4%).  Limb  weakness  (84.2%)  and  Middle  Cerebral Artery (MCA) territory (73.6%) infarct were observed in majority of the patients.Conclusions:Prevalence  of  cardioembolic  stroke  in  this  region  is  lower  than  reported  worldwide.  While  male predominance  of  cardioembolic  stroke  was  noted,  old  age  and  hypertension  were  the  major  vascular  risk  factors identified. CAD was the major source of cardioembolism.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Yusra_2020,

title = {A study of serum high sensitive c-reactive protein and serum homocysteine levels in young adults with acute ischemic stroke},

author = {Fatima Yusra and Shafiqur Rehman Mohammed and Mohammed Zoheb},

url = {https://njmr.in/index.php/file/article/view/61/56},

issn = {2277-8810},

year  = {2020},

date = {2020-06-30},

urldate = {2020-06-30},

journal = {National Journal of Medical Research},

volume = {10},

issue = {2},

pages = {80-84},

abstract = {Background: High sensitivity C-reactive protein (hsCRP) and homocysteine are considered important markers for cardiovascular and cerebrovascular diseases. Many studies have shown that high hsCRP and homocysteine levels are risk factors for ischemic stroke. Objective: Our objective is to investigate hsCRP and homocysteine levels in blood in young (49 years or below) and older (over 49 years) adults with ischemic stroke in a tertiary care hospital. Material and Methods: We retrospectively studied forty acute ischemic stroke patients admitted at Owaisi Hospital and Research Centre, Hyderabad, for six months (June 2019 to December 2019). Patients were divided into younger and older adults and all underwent tests as per standard protocol for stroke. Results: HsCRP level was elevated in 20 of 24 older stroke patients and in all young stroke patients (p<0.05). The mean hsCRP was significantly high in stroke patients overall (11.7mg/L).Fasting serum homocysteine level was elevated in 12 patients, mean value in them being 31.54 mg/dl and the difference was insignificant between younger and older patients. Conclusions: Elevated hsCRP, fasting homocysteine levels are strongly associated with acute ischemic stroke. A higher proportion of young stroke patients are found to have elevated hsCRP levels compared to older adults, while there is no significant difference in fasting homocysteine levels between the same.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Nunavath_2019,

title = {Hypocalcemic recurrent generalized seizures with bilateral basal ganglia and frontal calcification as the initial manifestation of Albright’s hereditary osteodystrophy in a child: a pictorial and video-graphic representations},

author = {Akhilesh Kumar Nunavath and Sandhya Manorenj and Srikant Jawalkar and Bushra Naaz},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6935980/},

doi = {10.4103/jpn.JPN_86_19},

issn = {1817-1745},

year  = {2019},

date = {2019-12-31},

urldate = {2019-12-31},

journal = {Journal of Pediatric Neurosciences},

volume = {14},

issue = {4},

pages = {232-235},

abstract = {Albright hereditary osteodystrophy (AHO) is a hereditary metabolic disorder that presents with seizure secondary to hypocalcaemia. A careful phenotypic assessment of patients presenting with seizure clues to the diagnosis of AHO. The characteristic features are short stature,obesity and brachydactyly. Pseudohypoparathyroidism (PHP) is observed in patients with AHO and is characterized by inability of the body to respond appropriately to parathormone, mainly characterized by hypocalcaemia, increased serum parathormone concentration, insensitivity to the biological activity of parathormone, and hyperphosphatemia. In this study, we report a 14-year-old boy with distinctive phenotype of AHO, oral manifestations, and signs of tetany with PHP presenting as recurrent generalized seizure.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2019,

title = {Clinical profile of patients with Parkinsons disease in Hyderabad region},

author = {Sandhya Manorenj},

url = {https://www.worldwidejournals.com/international-journal-of-scientific-research-(IJSR)/fileview.php?val=July_2019_1561808429_4306180.pdf},

issn = {2277-8179},

year  = {2019},

date = {2019-07-31},

urldate = {2019-07-31},

journal = {International Journal of Scientific Research},

volume = {8},

issue = {7},

pages = {12-14},

abstract = {INTRODUCTION: Parkinson disease (PD) is the second most common neurodegenerative disorder that causes progressive motor and non-motor disability. This condition is diagnosed clinically and is characterized by the presence of bradykinesia, accompanied either by rest tremor or rigidity. The present study aimed to provide the demographic and clinical profile of PD in patients from Hyderabad and also to create a database on PD in this region. METHODS: A prospective cross-sectional hospital based study was conducted over a period of 3 years commencing in December 2014. The study included cases of PD diagnosed in accordance with the United Kingdom PD Society Brain Bank criteria and analyzed its demographic and clinical features. RESULTS: 40 patients (26 males, 14 females) were found to have features compatible with PD. The average age at onset was 51.55± 10.18 years. Majority of patients had onset of PD at an older age (≥50 years; 24 patients, 60%) when compared to the rest who were younger (age<50 years, 16 patients, 40%).The most common initial symptom was tremor (36 patients, 90 %). Postural instability was observed in 22% patients. The average progression from mild to moderate/severe PD (stage3) was seen to be 3.8±5 years among the young and 3.7±3.2 years among the older patients. Non motor feature of PD was observed in 25% patients and the most common non motor feature was found to be disturbance in sleep (15%). CONCLUSION: Unilateral limb tremor was seen to be the most common initial symptom and disturbance in sleep was the most common non motor symptom. Male predominance and older onset of PD was observed in this region. },

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Durga_2019,

title = {Dietary pattern in adult patients with acute stroke in South India: a case-control study from a tertiary care center in Hyderabad},

author = {Adabala Vijaya Durga and Sandhya Manorenj},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454960/?report=reader},

doi = {10.4103/jnrp.jnrp_237_18},

issn = {0976-3147},

year  = {2019},

date = {2019-06-30},

urldate = {2019-06-30},

journal = {Journal of Neurosciences in Rural Practice},

volume = {10},

issue = {2},

pages = {283-293},

abstract = {Background and Objective: Diet plays a crucial role in the occurrence of stroke. But very few studies have so far been conducted with focus on this aspect of acute stroke in India. The objective of the study was to identify the dietary pattern in patients with acute stroke in South India. Materials and Methods: Patients with first-ever acute stroke (ischemic and hemorrhagic) admitted between June 2017 and November 2017 were enrolled and compared with age- and sex-matched controls. Information was collected using a pro forma. Results: Out of 293 acute stroke patients, 150 were enrolled and compared with 150 controls. The mean age was 52.3 ± 12.6; years 112 (74.6%) patients were male. The majority of them were on traditional diet that included a daily intake of rice (98.6%) and pulses (40.6%). Hypertension (73.3%) was the major vascular risk factor for stroke (P < 0.0001). Significant differences were observed in risk factors such as diabetes (P < 0.0001), smoking (P = 0.0001), alcohol use (P = 0.0017), and heart disease (P = 0.0002), when stroke patients were compared with controls. Stroke patients reported a lower intake of green leafy vegetables (P = 0.0001; odds ratio [OR] 0.17), roots and tubers (P = 0.0016; OR 0.21), and fruits (P = 0.0022; OR 0.29). There was at the same time a higher intake of red meat products (P = 0.04; OR 2.41), organ meats (P = 0.0093; OR 4.35), fried snacks (P = 0.0038; OR 2.01), and pickles (P = 0.04; OR 1.81) although the data suggested lesser consumption of prawn and crab (P = 0.04; OR 0.55) and water (P = 0.0001 OR 4.59) among stroke patients. Higher consumption of fruit juices (P = 0.0008) and junk foods (P = 0.03) was observed in young stroke patients (age ≤45 years) whereas the intake of chicken (P = 0.03) and alcohol (P = 0.0001) was observed to be more among men than among women.

Conclusion: Majority of stroke-afflicted patients in South India consume white rice and dal. There is lower intake of water, green leafy vegetables, and fruits and higher consumption of red meat, organ meat, and pickles among stroke patients.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}

@article{Manorenj_2019b,

title = {Clinical characteristics of essential tremor in South India: a hospital-based cohort study},

author = {Sandhya Manorenj and Chintha Shravani and Srikant Jawalkar},

url = {https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6454942/?report=reader},

doi = {10.4103/jnrp.jnrp_348_18},

issn = {0976-3147},

year  = {2019},

date = {2019-06-30},

urldate = {2019-06-30},

journal = {Journal of Neurosciences in Rural Practice},

volume = {10},

issue = {2},

pages = {245-249},

abstract = {Introduction: Essential tremor (ET) is the most common adult movement disorder. Classic ET is characterized by action tremor of hands (95% cases), and tremor involving other regions is less common. Recent studies have revealed a few patients exhibiting nontremor features that include cognitive disorders, tandem gait abnormality, mood fluctuations, olfactory abnormality, hearing impairment, and sleep disorders. Very few studies on ET have so far been conducted in India, and the present study is a pioneering attempt to evaluate the clinical characteristics of patients diagnosed with ET. Materials and Methods: A standardized assessment protocol was used to collect data. Diagnosis of ET was established using consensus criteria established by the Movement Disorder Society. Tremor Research Group Essential Tremor Rating Assessment Scale was used to evaluate tremor impact. The severity of hand tremor was assessed by Glass Scale, and cognitive function was assessed by Mini–Mental Status Examination. Results: Out of the 45 patients enrolled, 73.3% were male and 26.6% were female, with a mean age of 44 ± 15 years. Postural tremor was observed in all, followed by intention tremor in 9 and rest tremor in 6 patients. Tremor of the hand was identified to be most predominant (100%). Voice tremor was observed in 15 (33.3%) patients and head tremor in 12 patients (26.6%) who were all females. Leg tremor was observed in 12 patients (26.6% of patients) and tongue tremor in 6 (13%) patients. Baseline asymmetry of tremor was observed in 60% of patients and positive family history in 35% of patients. The most common nontremor feature was tandem gait abnormality (40%). Moreover, most of the patients had Glass Scale II. Conclusion: Baseline asymmetry of tremor and male predominance were observed in the study. While hand tremor was the most common form of tremor, tandem gait abnormality was the most common nontremor feature as observed in patients with ET.},

keywords = {},

pubstate = {published},

tppubtype = {article}

}