Day 1 :
Keynote Forum
AV Srinivasan
The Tamil Nadu Dr. M.G.R. Medical University, India
Keynote: Cerebello cognitive and affective syndrome-recent perspectives
Time : 09:30-10:00
Biography:
Avathvadi Venkatesan Srinivasan, driven by his quest for excellence joined Madras Medical College (MMC) and received MD (General Medicine) in 1978. Later he pursued and received DM in Neurology from his alma mater. His thirst for research, skills and the latest development in Neurology made him find his way to the National Institute of Neurology and Neurosurgery, his pioneering research work on Neuroleptic Malignant Syndrome got him bestowed with the PhD degree in 2002. It made him the first ever recipient in Neurology from the Tamil Nadu Dr. M.G.R. Medical University, since its inception in 1988. His path breaking research (6 papers) in Phantom limbs, Stroke etc., with Padma Bhusan Dr. V S Ramachandran, Director, Center of Brain and Cognition, University of San Diego remain acclamatory to his undisputed authority in Behavioral Neurology and Movement disorders. He authored more than 100 scientific papers; dozens of his other work have found places in reputed medical journals and has published 12 chapters. His research papers presented, won acclaims in 60 National conferences and in 25 International conferences held in UK, USA, Japan, Australia, China, Europe and other countries. He is the only one from India to collaborate with Dr V S Ramachandran, who is the first recipient of Padma Bhusan for his contribution to Neurosciences.
Abstract:
Cerebello cognitive affective syndrome (CCAS; Schmahmann’s syndrome) is characterized by deficits in executive function, linguistic processing, spatial cognition and affect regulation. The causes of CCAS include cerebellar agenisis, dysplasia and hypoplasia, cerebellar stroke, tumour, cerebellitis, trauma, PSP, Multiple System Atrophy. This is also seen in children with prenatal early postnatal or developmental diseases. Clinical Impairment is seen in planning, set shifting, abstract reasoning, verbal fluency and working memory with distractibility and inattention.
CCAS challenges the traditional view of cerebellum being predominantly motor functions and focusses on the non-motor function also. This is because of its connection to cerebral cortex and limbic system. One case of CCAS is discussed with video segments.
Case 1: An engineering graduate student met with an accident and was unconscious for hours. He had loss of spatial cognition with perseveration, distractibity and inattention. He had spatial disorganization with visio-spatial memory affected. He had blunting of affect and inappropriate behaviour. He slowly recovered and still has cognitive dysfunction and cerebellar science. He developed depression and needed psychiatric help.
In conclusion, a unified paradigm for cognitive science with simplified neurodynamics and different levels of modelling or important. Recurrent neural network, reservoir computing psychological spaces. The open questions includes in this are:
1.High dimensional P-spaces with finsler geometry needed for visualization of the mind events. At the end of the road, the physics – like theory of events in mental spaces, mind as the shadow of neurodynamics can give us an absolute scientific space for this newer syndrome in neurological literature.
Keynote Forum
J P N Mishra
National Institute of Pharmaceutical Education and Research, India
Keynote: Autonomic nervous system and psychosocial health issues
Time : 10:00-10:30
Biography:
J P N Mishra has completed his Ph.D. in the discipline of Life Sciences (Human Physiology) from Banaras Hindu University, Varanasi, India in 1982. He has worked as Professor and Dean, School of Life Sciences, Central University of Gujarat, India. He has 109 research papers in reputed journals, 10 books and more than 100 popular health articles to his credit. The area of his research is Human physiology, Sleep science and Yoga therapy. He has travelled across the globe to deliver lectures on sleep science and yoga therapy. Currently, he is serving as Registrar at NIPER, Hyderabad, India.
Abstract:
Autonomic Nervous System (ANS) is a component of human body’s one of the control systems, namely ‘Nervous System’ which controls both mechanical and biochemical activities being undertaken by the body. All such activities are classified in two categories: I) Voluntary II) Involuntary. Involuntary activities in the human body are going on independently with the help of inbuilt mechanism within custodian organ(s) with stipulated pace and quantity required for our healthy survival. However, in certain unexpected circumstances caused on the pretext of varying range of stimuli the control system i.e. Central Nervous System, particularly brain, initiates hyperactivity of different involuntary organs, through ‘Sympathetic’ component of ANS. Such hyperactivities result in the state of stress and finally lead to irreparable damage to various organs, associated with significant negative change in the psychological state and behaviour of the individual. Omnipresence of various stimulatory circumstances causes deterioration in behaviour pattern of the majority of population resulting in psychological evils and breakdown in social health state of the community.
To address this problem related to humanity at large, we need to have a viable and cost effective mechanism of action. Taken from the treasure of Indian culture, Yoga, specifically meditation has proved to be one and only such effective mechanism. Pathway of mechanism of the efficacy of meditation on psychosocial health needs to be elaborated.
Keynote Forum
Angela Gnanadurai
Jubilee Mission College of Nursing, India
Keynote: A study to describe the one year outcome on return to work status after stroke
Time : 10:30-11:00
Biography:
Angela Gnanadurai has Completed BSc (N), MSc (N), PhD (N) in 1986, 1991, 2007 respectively from Christian Medical College Vellore. Is fortunate to function with dual responsibility during her services in College of Nursing, Christian Medical College Vellore from Nov 1985 to 4th May 2007. She has done post diploma courses in psychological counseling from behaviour science Center, Chithoor under open University Delhi , certificate course in palliative care from Indian Association of Palliative care (IAPC), Stroke care from American Association of Neuroscience Nurses (AANN), Law on Hospital Administration from CMAI, New Delhi, Certificate in Principles of Bio Ethics and Human Rights from UNESCO, Haifa, United Nation., Diploma in research to publication by BMJ, UK and currently (upgrading) undergoing Post Diploma in Bio Ethics and Human Rights from UNESCO, Haifa, United Nation from June 2021 to June 2022. Awarded fellowship by UICC in cancer prevention from National University Hospital Singapore, Awarded Senior Training Fellowship, through CMC Vellore by Friends of Vellore Association, USA in Neuro critical care from Columbia Presbyterian university hospital, New York; North Western University Hospital, Chicago; Ben Taub Hospital, Huston, Texas, USA. Had an opportunity to visit and collaborate with Christ Church University, Canterbury, Kent, UK as part of faculty exchange programme. She is a Member of more than 10 national and international professional organizations. She is holding NABH Assessor certificate since 2006. Em-paneled external assessor under National Quality Assurance Standards (NQAS) from Feb 2020.
Abstract:
Introduction: Stroke is the greatest cause of disability in adults. 25% of strokes affect people of working age, yet under 50% return to work after stroke. There has been not many studies in India and only very little investigation into what constitutes” return to work” following stroke. The aim of this study is to describe the work metric of stroke survivors.
Methods: Prospective analysis of data collected from patients who were diagnosed to have stroke for 12 months. The matric on work status, working hours, work place, accommodations and costs were gathered through telephonic questionnaires at 3 months, 6 months and 12 months post stroke period for 50 stroke patients. Patients were randomized to receive vocational rehabilitation (intervention or usual care (control).
Result: Two thirds (34 (68%) of participants return to work at some point in the 12 months following stroke. Participants took a mean of 100 days to return to work. Most return to work. Most returned to same role with an existing employer. Only one third (17(33%) of the participants who were employed full time at stroke onset were working full time at 12 months post stroke. More participants experienced a reduction in pre stroke earnings. Work place accommodations were more common among interventional group participants. More participants from interventional group than control group reported satisfaction with work at 6 and 12 months post stroke.
Conclusion: This study illustrates that there are two patterns in nature of return to work among patients with stroke and a very severe impact of stroke on work status, working hours and income. More longitudinal researches are needed to explore the socioeconomic legacy of stroke and include clear definitions of work and accurate measures of working hours and income from all sources.
Key words: Stroke, Rehabilitation, Return to work.
- Neurology | Clinical Neurophysiology | Central Nervous System | Neurosurgery ICU | Neuroscience | Neurogenetic and Neurometabolic Disorders | Neuro Cardiology & Strokes | Neuropharmacology | Neurosurgeon | Neuro Physiotherapy | Neuromuscular Disorders | Clinical Trails & Case Reports
Location: Webinar
Session Introduction
Anna Cornelia Beyer
University of Hull, United Kingdom
Title: Schizophrenia explained by a schizophrenic scientist
Biography:
Anna Cornelia Beyer is a former child-refugee from Eastern Berlin. She holds a PhD in Politics and is a member of Mensa and Intel. She worked for 12 years at the University of Hull, UK.
Abstract:
I am a scientist with the diagnosis of schizophrenia since 2002, and a PhD since 2010. Due to my illness, I have researched schizophrenia for more than a decade and investigated it with testing the results against myself. I have come to a number of accepted, and a number of radically new conclusions:
My understanding of why psychoses happen:
ALL my psychotic breaks happened when political crisis hit, including unemployment and social breakups and deaths (trauma). And then spirit interfered (my voices) to help or harm me, depending on if I had managed well and been right, or wrong and been mean.
Pre-illness:
Born six weeks early, probably due to self-starvation of my mother (I guess, the way I know her), child refugee at 12, afterwards dysfunctional family, became a delinquent, bulimic youth, but recovered. Good at school and highly intelligent.
First Episode: 2002, after 9/11, caused by 9/11 trauma, unemployment, social isolation, harsh financial problems, and deaths around me (spiritual channeling experience, I did nothing wrong)
Second Episode: 2008, caused by a relationship breakup and migration to the UK and the experience of massive sexual violence (angry spirit voices. I had argued far too aggressively with my partner, I guess.)
Worst Episode: since around 2018, caused by Brexit, political chaos, jobloss, loss of friends (mixed symptoms, I got into a massive argument with my mother about forced pregnancy, even if I am already sterilsed. But I also became a better – more spiritual - person otherwise. This resulted in mixed symptoms, angry and nice voices).
What I think helps:
- Medications help reducing the worst symptoms, but don’t take them away completely. They should not be used as the only treatment option. For me personally, I even hear voices (the most common symptom of schizophrenia) on a very high level of two mainstream medications. In addition, these medications have resulted in massive weight gain and physical lethargy, which both are health risks in it-self.
- Vitamins (orthomolecular medicine according to Abram Hoffer) have some benefits that should be respected: vitamin C protects somewhat against cancer, and I am personal proof that vitamin therapy can be useful, because I managed to become the only living scientist with a PhD and with 6 serious books on world politics published and more than 12 years successful work experience at a British University on a regime of nearly only orthomolecular medicine, combined with 2mg Risperidone (which is below the normal treatment amount of this mainstream medicine).
- A healthy lifestyle is key to improve longevity. Patients with schizophrenia have a 10 to 20 years reduced life expectancy. A healthy vegetarian or even vegan diet plus avoidance of drugs and alcohol and avoidance of tobacco (nicotine replacement therapy is the best option if this cannot be achieved) and of course avoidance of drugs can increase the lifespan for about 10 years and hence undo the loss in life expectancy.
- Avoidance of Isolation. Isolation is a key factor for suicide. People with schizophrenia are 10 times more likely to die from suicide than healthy people. According to Emile Durkheim and my own experience, suicide happens especially in complete isolation. Partnered, married, or well included people have a far better protection against suicide. I can testify to this from my own experience with 2 suicide attempts, which happened both in isolation and single life. Isolation can be countered with fighting the stigma of schizophrenia. This can be done by the patients themselves, with learning to become more loving people. It can also be done by the media and other organizations with anti-stigma campaigns.
- Avoidance of harsh poverty. Poverty contributes massively to the development of schizophrenia (I know of no case in my relations that were wealthy and became schizophrenic! Most schizophrenics are financially in dire straits) and contributes to the much lower life expectancy, I guess. Most schizophrenics live on benefits and are unemployed, this is extremely common. Some even say most homeless people are schizophrenic. This is a predictor for drug abuse and an unhealthy lifestyle. One simply does not manage to live very healthy when there is no money to afford a gym or nice healthy food. Desperate poverty might also contribute to suicide attempts. This is a very important, completely ignored, point in the literature about schizophrenia. The social economics of schizophrenia mean that patients will die earlier because they are pushed into the isolated, impoverished margins of society. That poverty contributes to earlier death generally is known. If this ever could be countered, we would probably see a massive improvement of our treatment outcomes. At the brief times when I was happily employed and economically lucky, I rarely needed to see a psychiatrist, was able to manage on a very low level of medication, had no suicide attempts, did not smoke nor abuse alcohol, and had a very healthy lifestyle and a very healthy body. My first episode, and my worst (most recent) episode, happened in times of economic and political crisis, and jobloss and social breakup of relationships (9/11 and Brexit, both accompanied by unemployment, and with loss of relationships, 9/11 accompanied with deaths in my close relationships). The common poverty of people with schizophrenia could be countered by special employment support campaigns. This has been achieved for people with autism. People with autism are especially sought for certain jobs and get special treatment. Something similar should be developed for people with schizophrenia.
- Spirituality/ Love helps becoming a better person and (not allowed in academic talk?) be allowed to ask for God’s help and protection. I believe it does work, if you are meaning it seriously. I became an ever more spiritual person over the years, and I would say it served me well: I found an amazing truly loving partner who can and does support me and have achieved recognition in academic circles, especially as a unique case of schizophrenic success, and I managed to write some really deep books about world peace and have made quite a large amount of friends.
- Music is an incredibly simple, cheap and easily and widely affordable tool to counter the symptoms of schizophrenia. Music can drown out the symptoms (voices that only the patient hears) and can improve mood and concentration.
Biography:
Birendra Kumar Pankaj MD (General Medicine), DM (Neurology), CAC Neurology (Queens Square, London) is a Senior Consultant Neurophysian and Director of JMD BRAIN AND NERVE CLINIC, Jharkhand, India for last 21 years. He has organized many neurological conferences .He has attended more than 100 national and international neurological conferences as delegate, chairperson and speaker. He is currently vice president of Jharkhand state IMA. He is life member of many national and international neurological associations and societies. He was organizing secretary of ANEIMIDCON 2012 and many national conferences. He has few publications also. He has organized more than 100 neurological free checkup and free drug distribution in rural and underprivileged population. He has conducted many webinars and awareness programmers for benefit of society. His key interests are Headache, Epilepsy, Electrophysiology, Vertigo and Stroke.
Abstract:
Vertigo is a relevant clinical symptom and patients with vertigo have more distress and disability. Vertigo has been classified as peripheral and central according to site of lesion and also depending on the duration. There are many clinical examination and tests to differentiate central and peripheral vertigo.
Cardiovascular examination, head, neck and ear examination and bedside examination of the vestibular and ocular motor systems are essential for diagnosis of vertigo and their management. Head impulse test, Rhombergs test, Dix hall pipe maneuver, Head tilt test, Supine roll test, Hearing test and ocular tilt reaction are some of important bed side tests. Eng and Vng are some important laboratory tests.
Vestibular paroxysmia, benign postural vertigo, perilymph tic fistula and phobic postural vertigo are some important short duration differentials. Mennier's disease, Vestibular migraine, Tia and episodic ataxia type 2 are some of long duration differentials.
Vertbrobasilar stroke, vestibular neuritis, bilateral vestibulopathy, degenerative disease (cerebellar ataxia), multifactorial vertigo in the elderly, somatoform/ phobic vertigo are some more prolonged duration differentials. Treatment of vertigo varies according to the cause and vestibular rehabilitation is one of the important aspects of management along with ant vertigo drugs. Dose and duration of anti-vertigo medication varies according to cause of vertigo. Surgery is also required in few diseases causing vertigo when conservative therapy fails.
Sandeep
Jawaharlal Nehru University, India
Title: Apocynin administration ameliorates motor deficits in Paraquat-induced Parkinsonism
Biography:
Myself Sandeep, pursuing my Ph.D. in neurobiology at Jawaharlal Nehru University. I am having passion for research in neurodegenerative disease. Currently I am working on Parkinson’s disease. The in-vivo model that I am working is paraquat-induced Parkinsonism. Parkinson’s disease is a progressive neurological disorder affecting more than 1% of population over age of 60 years. It has motor as well as non-motor symptoms. Aggregation of α- synuclein in the form of Lewy body and loss of dopaminergic neurons in the striatum and substantia nigra region of the brain is pathological hallmark of the disease. Current treatment strategies available are use of L-DOPA or its agonist. But long-term treatment with these results in the bradykinesia, motor fluctuations. So presently no complete cure is available against the disease. I am targeting the molecular pathway involved in the onset and progression of the disease that may open.
Abstract:
Background: Parkinson's disease (PD) is the second most common progressive neurological disorder after alzheimer’s, characterized by presence of intra- cytoplasmic inclusion bodies known as lewy body containing α- synuclein aggregate and the loss of dopaminergic neurons in the substantia nigra regions of the brain. The exact cause of dopaminergic neuronal loss in PD remains unknown for a long time, however, recent studies report that oxidative stress plays a key role in the pathogenesis of PD. Paraquat (PQ), a widely used herbicide is an oxidative stress inducer that has been implicated as a potential risk factor for the development of PD. Pharmacological approaches targeting antioxidant machinery may have therapeutic value against PD. Flavonoids are naturally occurring polyphenolic compounds that display a variety of therapeutic properties against oxidative stress. Apocynin (4-hydroxy-3- methoxyacetophenone) is a natural flavonoid obtained from medicinal plant Picrorhiza kurroa that exhibits neuroprotection against PD-related pathology. However, studies on its neuroprotective role and the underlying mechanisms are scarce.
Aim: The proposed study will explore the potential beneficial effect of Apocynin on PQ-induced motor deficits in rat model of Parkinsonism.
Methods: As a part of preliminary study, we have developed PQ-induced Parkinsonism model in adult Wistar rats. We performed motor coordination related behavioral experiments and histopathological studies in order to validate the establishment of PQ-induced Parkinsonism. Then we determined the effect of apocynin on PQ-induced motor deficits in rat model of Parkinsonism.
Results: PQ-induced nigro-striatal dopaminergic neurodegenerations in the rat model of Parkinsonism. Apocynin improved motor deficits in PQ-induced rat model of Parkinsonism.
Conclusion: Apocynin treatment ameliorates PQ-induced motor deficits in the rat model of Parkinsonism. In future, we will be assessing the neuroprotective effect of Apocynin in the developed model of Parkinsonism.
Keywords: Parkinson’s disease, Paraquat, Neuroprotection, Apocynin, Neurodegeneration.
Biography:
Jeeva Sebastian working in College of Nursing, Christian Medical College, Vellore as Associate Professor. Working as Nurse Manager in the Department of Psychiatry, Department Quality Manager in the department of psychiatry, Qualifications: MSc in Psychology, MSc in Psychiatric Nursing, Post Diploma in Guidance and Counseling and PG Diploma in Bioethics.
Abstract:
Background: Schizophrenia is a severe mental disorder affecting more than 21 million people worldwide. It is associated with considerable disability and may affect educational and occupational performance. Pharmacological and non-pharmacological measures are being used to treat the mental illness. Caregivers who are the primary interface with the health care system often receive inadequate support from health professionals and frequently feel abandoned and unrecognized by the health care system.
Aims: To identify factors associated with relapse in patients with schizophrenia and their care givers.
Method: Cross sectional design was used to recruit 100 consecutive patients with schizophrenia who were currently suffering with relapse along with their care givers who had consented, based on inclusion criteria. Drug Attitude Inventory (DAI-10), Knowledge about Schizophrenia Interview (KASI) and Short Explanatory Model Interview (SEMI) scales were used to assess the factors associated with relapse. Data was analyzed using SPSS for Windows 21. Frequencies, percentages and descriptive statistics were used for the variable description, Chi square test used for finding the association between the variables of interest.
Results: Care givers knowledge: Most of the care givers ( 49%) reported that the patients’ diagnosis was ‘some mental illness’, 44% of them were not aware of the signs and symptoms , 45% of them believed that the illness was due to non-medical causes ( black magic, loss of loved ones, adjustment problem, financial problem, stress, love failure, failure in examination ,marriage related problems and ancestral spirit), 42 % of them were not aware of the medicines taken by their relative(s) (name, frequency, dosage etc.,), 47 % of them were not aware of recurrence, prognosis and many of them were over protective and 14% of them had an idea about supportive therapy. In this study caregivers’ education is significantly associated with awareness of diagnosis (p value <0.001), signs and symptoms (p value=0.001), and etiology of illness (p value=0.004). Occupations of caregivers are significantly associated with awareness of diagnosis (p value =0.019) , etiology of illness ( p value = 0.011). Caregivers’ knowledge about etiology is associated with recovery of the patient from the past episode (p value = 0.004) and knowledge about medication is significantly associated with recovery in the past episode (p value =0.010).
Illness Model: Majority of the Patients believed that the cause of illness was evil spirits (25 %), followed by black magic (15 %), punishment from God (12 %) and karma (11 %). 37 % of them believed that the illness is due to biochemical causes (brain problem, chemical changes in the brain) or genetics .This shows that majority of the subjects (63 %) held non-medical model.
Patients attitude towards antipsychotic drugs: Majority (62%) of the patients had a negative attitude, 21% of them had positive attitude, while 17% of them had a neutral attitude towards the consumption of antipsychotic drugs. In this study, the attitude of patients towards antipsychotic was not significantly associated with any of their socio demographic variables.
Conclusions: This study highlighted the perceptions about schizophrenia, attitude towards anti psychotics and their care givers knowledge about schizophrenia. It shows that there is a significant relationship between relapse with illness model, attitude towards drug and care givers knowledge about schizophrenia. Management of patients with schizophrenia can be improved by addressing the factors influencing relapse as highlighted in this study.