1.Oral ribofl avin versus oral propranolol in migraine prophylaxis: An open label randomized controlled trial
Natasha J Nambiar ; Cuckoo Aiyappa ; R Srinivasa
Neurology Asia 2011;16(3):223-229
Background: Migraine is a chronic, often debilitating disease. The treatment of migraine with
propranolol (80-240 mg/day) is limited by side effects and lack of tolerability. Ribofl avin (vitamin
B2) is the precursor of fl avin mononucleotide and fl avin adenine dinucleotide which are involved in
mitochondrial transport chain. The use of ribofl avin in migraine prophylaxis is based on the hypothesis
of a defi cient mitochondrial energy reserve as a causal factor in migraine pathogenesis, and on the
fi ndings of its safety and effectiveness at high doses (400 mg/day) in the treatment of migraine like
headaches in classic mitochondriopathies. Objectives: To compare the effi cacy of lower dose oral
ribofl avin at 100 mg/day with oral propranolol 80 mg/day in the reduction of migraine frequency and
severity. Methods: One hundred patients diagnosed with migraine were randomized to receive either
oral ribofl avin 100 mg/day or propranolol 80 mg/day for a period of 3 months. Patients were issued
a migraine diary and explained how to record the frequency of migraine attacks, headache intensity,
duration and to report any side effects. Follow-up was at the end of 3 and 6 months. Results: Both
study groups showed a reduction of migraine frequency, duration and severity of headache by visual
analogue scale (VAS), and disability by migraine disability questionnaire (MIDAS) score at 3 months.
No signifi cant difference was seen between the two study groups in most of the measures. Side effects
were signifi cantly less in the ribofl avin group (P=0.035).
Conclusion: Oral ribofl avin 100mg/day is a safe, equally effective and well tolerated alternative in
migraine prophylaxis.
2.A Rare Unilateral Variation in the Course of External and Internal Carotid Arteries
Satheesha BN, Srinivasa RS, Swamy RS ; Deepthinath R ; Sudarshan S ; Naveen K
Journal of Surgical Academia 2014;4(2):35-37
Vascular variations in the neck region are not uncommon. Knowledge of incidence of morphological variations in
the course and branching of the carotid arteries is important for radiological interpretation and surgical correction
when they are symptomatic. Internal carotid artery (ICA) is known to show elongation in its extra cranial course.
Previous studies have demonstrated the incidence and clinical symptoms of this morphological entity. However, the
occurrence of elongation and looping of the external carotid artery (ECA) is seldom reported in the literature. During
regular dissections, we came across a rare case of unilateral morphological variation of both ECA and ICA, in a male
cadaver aged about 55 years. ICA presented a curved course with convexity directed posteriorly, at the level of the
C2-C3 vertebrae. ECA presented a pronounced kinking or coiling, one inch below the level of the angle of the
mandible. In addition, a linguo-facial trunk arising from the ECA also presented a pronounced kinking throughout its
entire length.
3.Unusual Path of Branches of Ilioinguinal Nerve: A Clinically Important Anatomic Variant
Satheesha BN ; Srinivasa RS ; Prakashchandra S ; Surekha DS ; Deepthinath R ; Raghu J ; Abhinitha P ; Jyothsna P
Journal of Surgical Academia 2014;4(2):59-61
Ilioinguinal nerve is a collateral branch of lumbar plexus. Its anatomical variations in relation to adjacent
musculoaponeurotic structures play a crucial role in the development of neuropathies associated with lower
abdominal surgeries. In this report, we present a rare case of unusual course and branches of the ilioinguinal nerve, in
a 55-year-old male cadaver. In the lateral part of inguinal canal ilioinguinal nerve gave three branches. Two of its
branches pierced the external oblique aponeurosis, about 6 cm above the pubic symphysis, to supply the skin of the
lower part of the anterior abdominal wall. Another branch pierced the conjoint tendon, in the medial part of the
inguinal canal about 2 cm above the superficial inguinal ring. Knowledge of unusual path of these branches may be
important to avoid injuries during the surgical repair of groin hernias. Further care should be taken while dealing
with the conjoint tendon in the Bassini procedure.
4.A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite.
Rohan MAHALE ; Anish MEHTA ; Mahendra JAVALI ; R SRINIVASA
Journal of Stroke 2014;16(3):205-207
No abstract available.
Occipital Lobe*
5.A Case of Bilateral Occipital Lobe Infarcts Following Indian Tree Viper Bite.
Rohan MAHALE ; Anish MEHTA ; Mahendra JAVALI ; R SRINIVASA
Journal of Stroke 2014;16(3):205-207
No abstract available.
Occipital Lobe*
6.Extraparenchymal (Racemose) Neurocysticercosis and Its Multitude Manifestations: A Comprehensive Review.
Rohan R MAHALE ; Anish MEHTA ; Srinivasa RANGASETTY
Journal of Clinical Neurology 2015;11(3):203-211
Neurocysticercosis is an infection of the central nervous system caused by the larval form of the pork tapeworm Taenia solium. In the brain it occurs in two forms: parenchymal and extraparenchymal or racemose cysts. The clinical presentation of racemose cysts is pleomorphic, and is quite different from parenchymal cysticercosis. The clinical diagnosis of racemose cysts is quite challenging, with neuroimaging being the mainstay. However, the advent of newer brain imaging modalities has made a more accurate diagnosis possible. The primary focus of this article is racemose neurocysticercosis and its multitude manifestations, and includes a discussion of the newer diagnostic modalities and treatment options.
Brain
;
Central Nervous System
;
Cysticercosis
;
Diagnosis
;
Neurocysticercosis*
;
Neuroimaging
;
Taenia solium
7.Keyhole craniectomy in the surgical management of spontaneous intracerebral hematoma.
S. Balaji Pai ; R.G. Varma ; J.K.B.C. Parthiban ; K.N. Krishna ; R.M. Varma ; R. Srinivasa * ; P.T. Acharya * ; B.P. Mruthyunjayana * ; M. Eesha *
Neurology Asia 2007;12(1):21-27
Although the surgical management of spontaneous intracerebral hematoma (SICH) is a controversial issue, it can be life saving in a deteriorating patient. Surgical techniques have varied from the open large craniotomy, burr hole and aspiration to the minimally invasive techniques like stereotactic aspiration of the SICH, endoscopic evacuation and stereotactic catheter drainage. The authors report their experience with a keyhole craniectomy for the surgical evacuation of SICH. Ninety-six cases of SICH were treated using the keyhole craniectomy technique. A small craniectomy of 2-2.5 cm diameter was made using a vertical incision over a relatively ‘silent area’ of the cortex closest to the clot. Using a small cortical incision the hematoma was evacuated and decompression was achieved. Hemostasis was achieved using standard microneurosurgical techniques. Good to excellent outcome was achieved in 55 cases. Mortality was noted in 23 patients. Blood loss was minimal during the procedure. Good evacuation of the clot was seen in all but 5 cases as judged by the postoperative CT scan. The keyhole craniectomy technique is minimally invasive, safe and can achieve good clot evacuation with excellent hemostasis. It can be combined with microscopic or endoscopic assistance to achieve the desired result.
Hematoma
;
Methodology
;
Good
;
desires <1>
;
Hemostasis procedure
8.Short Axillary Vein and an Axillary Venous Ladder Formed by Basilic and Brachial Veins – An Anatomical and Clinical Perspective
Satheesha Nayak B ; Srinivasa RS ; Ashwini AP ; Naveen K ; Swamy RS ; Deepthinath R ; Surekha DS ; Prakashchandra S
Journal of Surgical Academia 2015;5(2):29-32
Knowledge of anatomic variants of veins in the arm and axilla play a key role in planning of successful venous
access. Possible anatomic variants of axillary vein, brachial vein and basilic vein and their clinical implications have
been well described in the literature. We report a rare case of formation of a short axillary vein associated with
complex venous communications between the basilic and brachial veins forming a venous ladder in the axilla, in
formalin embalmed male cadaver. Axillary vein was formed in the upper part of the axilla by the fusion of basilic
vein and unpaired brachial vein, and it was about 3cm in length. The higher-up confluence of basilic and brachial
veins was also associated with presence of three communicating veins between the basilic and brachial veins in the
axilla. Knowledge of reported venous variations is very useful during preoperative venous mapping and also for
planning and execution of various surgical invasive procedures involving these veins.
Axillary Vein
9.Unilateral duplication of vas deferens: a cadaveric case report.
Srinivasa Rao SIRASANAGANDLA ; Satheesha B NAYAK ; Raghu JETTI ; Kumar M R BHAT
Anatomy & Cell Biology 2013;46(1):79-81
Duplication of vas deferens is a rare congenital anomaly. All previously reported cases of this rare anomaly were identified during procedures such as orchiepexy, inguinal hernia repair, vasectomy, varicocoelectomy, and radical prostatectomy. Here, we report a case of unilateral duplicated vas deferens noted in an adult cadaver during regular dissection for medical students. The right spermatic cord contained 2 separate and completely developed cord-like structures. Both cords communicated separately with the tail of the epididymis. When traced cranially, both traversed the inguinal canal as content of the spermatic cord and finally fused at the level of the deep inguinal ring. No other variations were found in the testis or epididymis, and no variations were seen in the left spermatic cord. In addition, no associated renal abnormalities were noted.
Adult
;
Cadaver
;
Epididymis
;
Hernia, Inguinal
;
Humans
;
Inguinal Canal
;
Male
;
Prostatectomy
;
Spermatic Cord
;
Students, Medical
;
Testis
;
Vas Deferens
;
Vasectomy
10.The role of percutaneous neurolysis in lumbar disc herniation: systematic review and meta-analysis
Laxmaiah MANCHIKANTI ; Emilija KNEZEVIC ; Nebojsa Nick KNEZEVIC ; Mahendra R. SANAPATI ; Alan D. KAYE ; Srinivasa THOTA ; Joshua A. HIRSCH
The Korean Journal of Pain 2021;34(3):346-368
Background:
Recalcitrant disc herniation may result in chronic lumbar radiculopathy or sciatica. Fluoroscopically directed epidural injections and other conservative modalities may provide inadequate improvement in some patients. In these cases, percutaneous neurolysis with targeted delivery of medications is often the next step in pain management.
Methods:
An evidence-based system of methodologic assessment, namely, the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) was used. Multiple databases were searched from 1966 to January 2021. Principles of the best evidence synthesis were incorporated into qualitative evidence synthesis.The primary outcome measure was the proportion of patients with significant painrelief and functional improvement (≥ 50%). Duration of relief was categorized as short-term (< 6 months) and long-term (≥ 6 months).
Results:
This assessment identified one high-quality randomized controlled trial (RCT) and 5 moderate-quality non-randomized studies with an application of percutaneous neurolysis in disc herniation. Overall, the results were positive, with level II evidence.
Conclusions
Based on the present systematic review, with one RCT and 5 nonrandomized studies, the evidence level is II for percutaneous neurolysis in managing lumbar disc herniation.