1.Polysomnographic Evaluation of Sleep Disorders in Essential Tremor and Essential Tremor Plus: A Comparison With Healthy Controls
Ravi Prakash SINGH ; Mythirayee S ; Doniparthi Venkata SESHAGIRI ; Gulshan KUMAR ; Rohan MOHALE ; Pramod Kumar PAL ; Bindu M KUTTY ; Jitender SAINI ; Nitish L KAMBLE ; Vikram HOLLA ; Ravi YADAV
Journal of Movement Disorders 2025;18(1):45-54
Objective:
To explore sleep patterns in individuals with essential tremor (ET) and essential tremor plus (ET-Plus) compared with healthy controls and assess differences between ET and ET-Plus, given the lack of established polysomnography (PSG) data on these groups and the potential for sleep disturbances to serve as clinical markers.
Methods:
We conducted a prospective cross-sectional study at National Institute of Mental Health and Neurosciences, Bengaluru, from November 2021 to August 2023 on 45 patients (26 ET, 19 ET-Plus) and 45 controls. Tremor severity was assessed using The Essential Tremor Rating Assessment Scale (TETRAS) and Fahn‐Tolosa‐Marin Clinical Rating Scale (FTMRS). Sleep symptoms were assessed via the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Mayo Sleep Questionnaire, restless legs syndrome questionnaire, Berlin questionnaire, Generalized Anxiety Disorder Scale 7, and Patient Health Questionnaire-9. All patients and controls underwent overnight video PSG. Sleep scoring was manually performed by a trained sleep research technician and the first author following the American Academy of Sleep Medicine (2017) guidelines, with data analyzed using R studio.
Results:
Compared with ET-Plus patients, ET patients had a younger onset age (46.8±11.1 years versus 30.8±16.7 years, respectively). Compared with ET patients, ET-Plus patients had higher TETRAS and FTMRS scores (p<0.005). Compared with controls, both ET patients and ET-Plus patients presented poorer sleep quality, excessive daytime sleepiness, rapid eye movement (REM) sleep behavior disorder, and restless legs syndrome symptoms. PSG findings supported these clinical observations, showing an elevated apnea‒hypopnea index, reduced total sleep time, prolonged REM latency, decreased sleep efficiency, increased N1 stage duration, and reduced N2/N3 durations and percentages in patients versus controls.
Conclusion
The study highlights significant sleep architecture abnormalities in both ET and ET-Plus patients compared with healthy controls, with no differences between the ET groups.
2.Polysomnographic Evaluation of Sleep Disorders in Essential Tremor and Essential Tremor Plus: A Comparison With Healthy Controls
Ravi Prakash SINGH ; Mythirayee S ; Doniparthi Venkata SESHAGIRI ; Gulshan KUMAR ; Rohan MOHALE ; Pramod Kumar PAL ; Bindu M KUTTY ; Jitender SAINI ; Nitish L KAMBLE ; Vikram HOLLA ; Ravi YADAV
Journal of Movement Disorders 2025;18(1):45-54
Objective:
To explore sleep patterns in individuals with essential tremor (ET) and essential tremor plus (ET-Plus) compared with healthy controls and assess differences between ET and ET-Plus, given the lack of established polysomnography (PSG) data on these groups and the potential for sleep disturbances to serve as clinical markers.
Methods:
We conducted a prospective cross-sectional study at National Institute of Mental Health and Neurosciences, Bengaluru, from November 2021 to August 2023 on 45 patients (26 ET, 19 ET-Plus) and 45 controls. Tremor severity was assessed using The Essential Tremor Rating Assessment Scale (TETRAS) and Fahn‐Tolosa‐Marin Clinical Rating Scale (FTMRS). Sleep symptoms were assessed via the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Mayo Sleep Questionnaire, restless legs syndrome questionnaire, Berlin questionnaire, Generalized Anxiety Disorder Scale 7, and Patient Health Questionnaire-9. All patients and controls underwent overnight video PSG. Sleep scoring was manually performed by a trained sleep research technician and the first author following the American Academy of Sleep Medicine (2017) guidelines, with data analyzed using R studio.
Results:
Compared with ET-Plus patients, ET patients had a younger onset age (46.8±11.1 years versus 30.8±16.7 years, respectively). Compared with ET patients, ET-Plus patients had higher TETRAS and FTMRS scores (p<0.005). Compared with controls, both ET patients and ET-Plus patients presented poorer sleep quality, excessive daytime sleepiness, rapid eye movement (REM) sleep behavior disorder, and restless legs syndrome symptoms. PSG findings supported these clinical observations, showing an elevated apnea‒hypopnea index, reduced total sleep time, prolonged REM latency, decreased sleep efficiency, increased N1 stage duration, and reduced N2/N3 durations and percentages in patients versus controls.
Conclusion
The study highlights significant sleep architecture abnormalities in both ET and ET-Plus patients compared with healthy controls, with no differences between the ET groups.
3.Letter to Editor: Effect of furosemide on prevertebral soft tissue swelling after anterior cervical fusion: a comparative study with dexamethasone
Sneha SHARMA ; Sanjay Singh RAWAT ; Udit Kumar JAYANT ; Ravikiran VANAPALLI ; Venkatesh KUMAR S. ; Sujit Kumar SINGH
Asian Spine Journal 2025;19(2):330-331
4.Polysomnographic Evaluation of Sleep Disorders in Essential Tremor and Essential Tremor Plus: A Comparison With Healthy Controls
Ravi Prakash SINGH ; Mythirayee S ; Doniparthi Venkata SESHAGIRI ; Gulshan KUMAR ; Rohan MOHALE ; Pramod Kumar PAL ; Bindu M KUTTY ; Jitender SAINI ; Nitish L KAMBLE ; Vikram HOLLA ; Ravi YADAV
Journal of Movement Disorders 2025;18(1):45-54
Objective:
To explore sleep patterns in individuals with essential tremor (ET) and essential tremor plus (ET-Plus) compared with healthy controls and assess differences between ET and ET-Plus, given the lack of established polysomnography (PSG) data on these groups and the potential for sleep disturbances to serve as clinical markers.
Methods:
We conducted a prospective cross-sectional study at National Institute of Mental Health and Neurosciences, Bengaluru, from November 2021 to August 2023 on 45 patients (26 ET, 19 ET-Plus) and 45 controls. Tremor severity was assessed using The Essential Tremor Rating Assessment Scale (TETRAS) and Fahn‐Tolosa‐Marin Clinical Rating Scale (FTMRS). Sleep symptoms were assessed via the Epworth Sleepiness Scale, Pittsburgh Sleep Quality Index, Mayo Sleep Questionnaire, restless legs syndrome questionnaire, Berlin questionnaire, Generalized Anxiety Disorder Scale 7, and Patient Health Questionnaire-9. All patients and controls underwent overnight video PSG. Sleep scoring was manually performed by a trained sleep research technician and the first author following the American Academy of Sleep Medicine (2017) guidelines, with data analyzed using R studio.
Results:
Compared with ET-Plus patients, ET patients had a younger onset age (46.8±11.1 years versus 30.8±16.7 years, respectively). Compared with ET patients, ET-Plus patients had higher TETRAS and FTMRS scores (p<0.005). Compared with controls, both ET patients and ET-Plus patients presented poorer sleep quality, excessive daytime sleepiness, rapid eye movement (REM) sleep behavior disorder, and restless legs syndrome symptoms. PSG findings supported these clinical observations, showing an elevated apnea‒hypopnea index, reduced total sleep time, prolonged REM latency, decreased sleep efficiency, increased N1 stage duration, and reduced N2/N3 durations and percentages in patients versus controls.
Conclusion
The study highlights significant sleep architecture abnormalities in both ET and ET-Plus patients compared with healthy controls, with no differences between the ET groups.
5.Letter to Editor: Effect of furosemide on prevertebral soft tissue swelling after anterior cervical fusion: a comparative study with dexamethasone
Sneha SHARMA ; Sanjay Singh RAWAT ; Udit Kumar JAYANT ; Ravikiran VANAPALLI ; Venkatesh KUMAR S. ; Sujit Kumar SINGH
Asian Spine Journal 2025;19(2):330-331
6.Letter to Editor: Effect of furosemide on prevertebral soft tissue swelling after anterior cervical fusion: a comparative study with dexamethasone
Sneha SHARMA ; Sanjay Singh RAWAT ; Udit Kumar JAYANT ; Ravikiran VANAPALLI ; Venkatesh KUMAR S. ; Sujit Kumar SINGH
Asian Spine Journal 2025;19(2):330-331
7.Unlocking therapeutic potential: Exploring nuclear receptors in brain cancer treatment.
Sujitha JAYAPRAKASH ; Hiu Yan LAM ; Ravichandran VISHWA ; Bandari BHARATHWAJCHETTY ; Kenneth C-H YAP ; Mohammed S ALQAHTANI ; Mohamed ABBAS ; Gautam SETHI ; Alan Prem KUMAR ; Ajaikumar B KUNNUMAKKARA
Chinese Medical Journal 2025;138(21):2722-2752
Brain cancer remains among the most lethal malignancies worldwide, with approximately 321,476 new cases and 248,305 deaths reported globally in 2022. The treatment of malignant brain tumors presents substantial clinical challenges, primarily due to their resistance to standard therapeutic approaches. Despite decades of intensive research, effective treatment strategies for brain cancer are still lacking. Nuclear receptors (NRs), a superfamily of ligand-activated transcription factors, regulate a broad range of physiological processes including metabolism, immunity, stress response, reproduction, and cellular differentiation. Increasing evidence highlights the involvement of NRs in oncogenesis, with several members demonstrating altered expression and function in brain tumors. Aberrations in NR signaling, encompassing receptors such as androgen receptors, estrogen receptors, estrogen-related receptors, glucocorticoid receptors, NR subfamily 4 group A, NR subfamily 1 group D member 2, NR subfamily 5 group A member 2, NR subfamily 2 group C member 2, liver X receptors, peroxisome-proliferator activated receptors, progesterone receptors, retinoic acid receptors, NR subfamily 2 group E member 1, thyroid hormone receptors, vitamin D receptors, and retinoid X receptors, have been implicated in promoting hallmark malignant phenotypes, including enhanced survival, proliferation, invasion, migration, metastasis, and resistance to therapy. This review aims to explore the roles of key NRs in brain cancer, with an emphasis on their prognostic significance, and to evaluate the therapeutic potential of targeting these receptors using selective agonists or antagonists.
Humans
;
Brain Neoplasms/drug therapy*
;
Receptors, Cytoplasmic and Nuclear/metabolism*
;
Animals
;
Signal Transduction/physiology*
8.Lysine-specific demethylase 1 controls key OSCC preneoplasia inducer STAT3 through CDK7 phosphorylation during oncogenic progression and immunosuppression.
Amit Kumar CHAKRABORTY ; Rajnikant Dilip RAUT ; Kisa IQBAL ; Chumki CHOUDHURY ; Thabet ALHOUSAMI ; Sami CHOGLE ; Alexa S ACOSTA ; Lana FAGMAN ; Kelly DEABOLD ; Marilia TAKADA ; Bikash SAHAY ; Vikas KUMAR ; Manish V BAIS
International Journal of Oral Science 2025;17(1):31-31
Oral squamous cell carcinoma (OSCC) progresses from preneoplastic precursors via genetic and epigenetic alterations. Previous studies have focused on the treatment of terminally developed OSCC. However, the role of epigenetic regulators as therapeutic targets during the transition from preneoplastic precursors to OSCC has not been well studied. Our study identified lysine-specific demethylase 1 (LSD1) as a crucial promoter of OSCC, demonstrating that its knockout or pharmacological inhibition in mice reversed OSCC preneoplasia. LSD1 inhibition by SP2509 disrupted cell cycle, reduced immunosuppression, and enhanced CD4+ and CD8+ T-cell infiltration. In a feline model of spontaneous OSCC, a clinical LSD1 inhibitor (Seclidemstat or SP2577) was found to be safe and effectively inhibit the STAT3 network. Mechanistic studies revealed that LSD1 drives OSCC progression through STAT3 signaling, which is regulated by phosphorylation of the cell cycle mediator CDK7 and immunosuppressive CTLA4. Notably, LSD1 inhibition reduced the phosphorylation of CDK7 at Tyr170 and eIF4B at Ser422, offering insights into a novel mechanism by which LSD1 regulates the preneoplastic-to-OSCC transition. This study provides a deeper understanding of OSCC progression and highlights LSD1 as a potential therapeutic target for controlling OSCC progression from preneoplastic lesions.
STAT3 Transcription Factor/metabolism*
;
Animals
;
Histone Demethylases/genetics*
;
Phosphorylation
;
Mouth Neoplasms/immunology*
;
Mice
;
Carcinoma, Squamous Cell/immunology*
;
Disease Progression
;
Cyclin-Dependent Kinase-Activating Kinase
;
Precancerous Conditions/metabolism*
;
Humans
;
Cyclin-Dependent Kinases/metabolism*
;
Disease Models, Animal
9.Community dynamics during de novo colonization of the nascent peri-implant sulcus.
Tamires Pereira DUTRA ; Nicolas ROBITAILLE ; Khaled ALTABTBAEI ; Shareef M DABDOUB ; Purnima S KUMAR
International Journal of Oral Science 2025;17(1):37-37
Dental implants have restored masticatory function to over 100 000 000 individuals, yet almost 1 000 000 implants fail each year due to peri-implantitis, a disease triggered by peri-implant microbial dysbiosis. Our ability to prevent and treat peri-implantitis is hampered by a paucity of knowledge of how these biomes are acquired and the factors that engender normobiosis. Therefore, we combined a 3-month interventional study of 15 systemically and periodontally healthy adults with whole genome sequencing, fine-scale enumeration and graph theoretics to interrogate colonization dynamics in the pristine peri-implant sulcus. We discovered that colonization trajectories of implants differ substantially from adjoining teeth in acquisition of new members and development of functional synergies. Source-tracking algorithms revealed that this niche is initially seeded by bacteria trapped within the coverscrew chamber during implant placement. These pioneer species stably colonize the microbiome and exert a sustained influence on the ecosystem by serving as anchors of influential hubs and by providing functions that enable cell replication and biofilm maturation. Unlike the periodontal microbiome, recruitment of new members to the peri-implant community occurs on nepotistic principles. Maturation is accompanied by a progressive increase in anaerobiosis, however, the predominant functionalities are oxygen-dependent over the 12-weeks. The peri-implant community is easily perturbed following crown placement, but demonstrates remarkable resilience; returning to pre-perturbation states within three weeks. This study highlights important differences in the development of the periodontal and peri-implant ecosystems, and signposts the importance of placing implants in periodontally healthy individuals or following the successful resolution of periodontal disease.
Humans
;
Dental Implants/microbiology*
;
Microbiota
;
Male
;
Adult
;
Female
;
Biofilms
;
Middle Aged
;
Peri-Implantitis/microbiology*
10.Is Quadriceps-Strengthening Exercises (QSE) in MedialCompartment Knee Osteoarthritis with Neutral and Varus Malalignment a Paradox? – A Risk-Appraisal of StrengthTraining on Disease Progression
Garg R ; Krishna A ; Daga R ; Arora S ; Puri S ; Kumar M
Malaysian Orthopaedic Journal 2024;18(No.1):73-83
Introduction: The present inquiry seeks to investigate
whether the current regimens of QSEs (QuadricepsStrengthening Exercises) aggravate the disease while
mitigating symptoms.
Materials and methods: A comparative study was
conducted on 32 patients with medial compartment
osteoarthritis of knees. While the neutral group of 16 patients
was constituted of those with an anatomical-lateral-femorotibial-angle (aFTA) 176-180º, varus group comprised an
equal number of patients with an aFTA >180º. A home-based
12-week strength-training program involving weekly visits
to hospital for supervised sessions was administered. The
outcome measures were visual-analog-scale (VAS), medial
patello-femoral joint tenderness (MPFJT), time-up-and-gotest (TUGT), stair-climb test, step test, WOMAC, IKDC
scores, aFTA, hip-knee-ankle (HKA) angle, lateral-tibiofemoral-joint-separation (LTFJS), and horizontal-distancefrom-centre-of-knee-to-Mikulicz-line.
Results: There was a significant increase in quadriceps
strength (p<0.01) in both groups. Values for neutral group
with VAS score (p=0.01), MPFJT (p=0.01), TUGT (p=0.01),
timing of the stair climb test (p=0.01), WOMAC (p<0.01),
and IKDC (p=0.03) were better compared to varus group
with VAS score (p=0.13), MPFJT (p=0.03), TUGT (p=0.90),
timing of stair climb test (p=0.68), WOMAC (p<0.02), and
IKDC (p=0.05). Varus group also showed an increase in
aFTA and LTFJS in 12 patients, increase in HKA in 11, and
increase in horizontal distance from the centre of knee to the
Mikulicz line in 7 patients.
Conclusion: The present study brings to the fore the
paradoxical role played by QSEs in management of medial
knee OA. While there is a radiological progression of the
disease in both neutral and varus mal-aligned knees more so
in the latter than the former.


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