Problemas neurológicos

Background: Depression is a critical public health concern among older Americans. However, little is known about how older adults’ social engagement activities, health protocol maintenance, and social interaction (both physically and virtually) potentially contribute to their feelings of depression.

Methods: Data were collected from the COVID-19 supplement to the National Health and Aging Trend Study (NHATS) and core longitudinal follow-up study. A total of 3,181 Medicare eligible older adults between June and December 2020 were examined how self-reported depression is related to social engagement activities, health protocols, social interaction with friends and family (F and F), and doctors using multiple logistic regressions.

Results: This study reveals that the lack of social engagement activities, such as birthday parties and long-term care visits significantly contributes to older adults’ depression (OR: 1.34, 90% CI: 1.07-1.68, p=0.012, and OR: 1.28, 90% CI: 1.01-1.65, p=0.053 respectively). Subsequently, health protocols compliance with washing hands and wearing masks in public places were more likely 2.36 times and 3.44 times higher symptoms of depression for the older adults than those who were not maintaining those protocols (OR: 2.36, 90% CI: 1.24-4.57, p=0.009, OR: 3.44, 90% CI: 1.97-6.17, p<0.001 respectively). Furthermore, the lack of virtual social interaction via phone and text message with F and F is significantly related to depression whereas email or video call are not significantly related to depression for older adults. During COVID-19 pandemic, in-person visits with doctors significantly reduced patients' depression on the other hand email communication significantly increased. However other virtual interactions with doctors did not significantly associate with patients' depression.

Conclusion: The lack of social engagement, maintaining health protocols, and lacking virtual interactions over the phone significantly increase depression symptoms for older adults during the COVID-19 pandemic. Therefore, it would be beneficial to take initiative to engage older adults in a variety of social activities to make them feel more connected to their community. The older population should be contacted by phone during the COVID-19 pandemic with encouraging messages and informed of the importance of maintaining health protocols.

Background: Globally traumatic brain injuries (TBIs) are the leading cause of death in people under the age of 45. 2020 saw a series of social lockdowns as a response to the COVID-19 pandemic. We aimed to unveil the impact of the different levels of lockdown on TBI incidence at Tshepong Hospital.

Method: A retrospective review of patients with TBIs during the first 30 days of each of the 5 lockdown levels, between 1st of April-20th October 2020 was conducted. Each lockdown level was compared to a control of a similar period in 2019.

Results: Level 5 lockdown resulted in a 66% reduction in total incidence of TBI, with a decrease in the daily incidence median value to 0 when compared to its control group median of 1 (P=0.004). However, Level 3 and 2 resulted in a significant 133% and 200% increase respectively in TBI incidence for similar period the year before.

There was a 0,75% decrease in total trauma during the non-lockdown periods in relation to the lock down periods with a lockdown mean incidence of 53,4 (std Dev. 26.6) and non-lockdown mean of 53 (std Dev 20.8).

Conclusion: The cumulative effect of the lockdowns made miniscule changes in the overall TBI incidence but led to significant variation in TBI incidence in the comparative months. A “rebound trauma” phenomena is observed in transitioning from severe social restrictions to milder ones with unemployment and unbanning of alcohol as possible contributory factors. Further studies are needed to investigate these complex interactions.

The current research aims to investigate psychological factors that impact levels of individual susceptibility levels to online phishing attacks. A critical review of existing literature was conducted focusing on relevant factors that affect the level of online risk, including The Big Five Personality traits and cognitive processes such as heuristic based thinking. Also investigated were the impact of urgency cues, online habits, and the Covid-19 pandemic on susceptibility levels. During this literature review, relationships between these factors that are currently mainly unexplored were also established to address gaps in the existing literature and broaden the scope of understanding surrounding this topic.

A 23 year-old man treated with anti-tubercular therapy to describe a case of a Guillain-Barré syndrome with pulmonary tuberculosis as an inciting agent. Pulmonary tuberculosis causing Guillain-Barré has very few case reported. However it is one of the few causes of a quadriparesis which can show recovery if managed appropriately. He developed no further complications and his condition improved clinically.

Background: The novel coronavirus disease has led individuals in several medical, psychosocial and economic burdens among the majority of the society. This pandemic is a disastrous health crisis and becoming a current public health issue across the world. The widespread of COVID-19 has brought not only the risk of death but also major psychological pressure. It leads to unavoidable psychological distress, anxiety, depression, denial, and fear. It is severely affected the community and influences the day-to-day life of individuals in Ethiopia. This systematic review used to investigate the pooled estimate on the psychological impact of COVID-19 in Ethiopia.

Objective: The main aim of this systematic review and meta-analysis were to provide comprehensive evidence on the psychological impact of COVID-19 in Ethiopia.

Methods: This systematic review and meta-analysis searched through Pub Med, Cochrane Library, Google, Google Scholar, and web of sciences. Data extracted by Microsoft Excel then statistical analyses done using STATA Version 14 software with a random-effects model. The funnel plot checked. The heterogeneity of the studies checked. Subgroup analysis done in relation to the study area and authors’ names.

Results: A total of 10 studies with 4,215 participants were included. The psychological impact of coronavirus disease in Ethiopia was 42.50% (95% CI) (31.18%, 53.81%). In subgroup analysis, the highest the psychological impact was 66.40% and 16.20% in Addis Ababa and Amhara regions respectively.

Conclusion: The psychological impact of coronavirus disease was. Multiple educations and training focusing on the psychological impact should be avail properly for the community in Ethiopia.

Background: Traumatic Brain Injury (TBI) is a leading cause of sudden death and disability amongst young people. About 28% of children managed for TBI in Uganda report some degree of physical disability one year post-injury, but little is known about their psychosocial outcomes. We aimed to elucidate the psychosocial outcomes of children with TBI, and associated factors.

Methods: A cross-sectional study carried out in the Neurosurgical Unit of Mulago National Referral Hospital (MNRH), Uganda. The Pediatric Quality of Life Inventory version 4.0 parent proxy was administered to parents/guardians of children aged 6 to 17 years who were previously managed for TBI in MNRH more than a year post-injury; their medical records were also retrieved. Linear regression was used to determine factors associated with psychosocial outcomes.

Results: A total of 116 children were recruited. The overall mean psychosocial functioning was 82 ± 22.74. Using a standard deviation below the mean score as a cut-off standard, 85.7% of those children had good psychosocial functioning versus 14.3% with poor functioning. A long time of more than 2 years post- TBI (adjusted β=1.36, p=0.012) and absence of associated injuries (adjusted β=0.30, p=0.025) were associated with good psychosocial functioning, while TBI severity was negatively associated with poor psychosocial functioning (adjusted β=-0.36, p=0.041).

Conclusion: Children managed for TBI continue to have psychosocial dysfunctioning after one year following injury, although improving after 2 years. The severity of TBI and the presence of associated injuries are important determinants of the psychosocial quality of life of children. Multi-disciplinary supportive care should be very effective during the first 2 years following the injury to improve the quality of life of children with TBI.

Arnold Chiari, also known as Chiari malformation (CM), is a congenital anomaly of the cranio-vertebral junction and hindbrain and is characterized by varying degrees of displacement of posterior pit structures from the foramen magnum to the spinal canal with or without other associated intracranial or extracranial defects such as hydrocephalus, syrinx or spinal. In this malformation group In this process, neuronal dysfunction is observed in the brainstem, cerebellum, and cranial nerves as a result of changes in the spinocerebellar axis due to pathologies such as inferior displacement of the cerebellar vermis, medullary fold formation in the dorsal midbrain, medullary curling, and tectal beaking. Evoked potentials (EPs) are important for clinico-topographic and neurophysiological/neuropathological evaluation. In this review, we aim to review CM neuro-radiologically at the diagnosis stage and to emphasize the importance of neurophysiological recognition of CM in the early stage, especially in asymptomatic patients.

Background: Ischemic stroke impacts roughly 700,000 patients per year in the United States, yet there are limited options to improve recovery for individuals with a completed stroke and associated neurological deficit. We describe a preliminary clinical trial of a novel non-invasive device that provides peripheral somatosensory stimulation using intermittent jets of air to the affected hand in patients with ischemic stroke.

Methods: The safety and short-term impact of the use of a non-invasive device providing peripheral somatosensory stimulation were investigated in four patients after mild to moderate stroke. Perfusion MR imaging was performed with the device off and then on in each patient. Serial evaluations of the NIH stroke scale score, Glasgow Outcome Score, and Barthel Index were performed in each case.

Results: All patients tolerated treatment with the device. No complications related to the use of the device were encountered. A non-blinded neuroradiologist interpreted the MR imaging as demonstrating improved perfusion in three of four cases. All patients demonstrated neurological improvement over the course of treatment.

Conclusion: It has been suggested that peripheral somatosensory stimulation may improve recovery from stroke. We investigated the use of a novel noninvasive device that delivers intermittent jets of air to the affected forearm and hand. In this small, preliminary series, treatment was well-tolerated in all cases. A larger trial properly empowered to demonstrate clinical benefit may be warranted.

Background: Epilepsy is a common condition worldwide and has been observed to affect quality of life. Epilepsy patients have a lower quality of life than the general population as well as many other chronic disease patients. However, aside from focusing on symptom reduction, no attention is paid to the quality of life of those with epilepsy. This study aims to evaluate quality of life and associated characteristics among epilepsy patients who visited North Shoa zone hospitals in Ethiopia.

Methods: An institution-based cross-sectional study design was conducted from April-May 2021 at North Shoa zone hospitals. A systematic random sampling technique was used to get a total number of 472 samples. Data on quality of life was assessed through interviews using the World Health Organization Quality of Life-Brief (WHOQOL BREF) Version. The collected data were coded, entered into Epi Data 3.1, and analyzed by using SPSS version 25. Simple and multiple linear regression analysis models were fitted and the unstandardized β coefficient at 95% confidence interval was employed. The statistical significance was accepted at p-value<0.05.

Results: From a total of 472 participants the response rate was 98%. The mean score of quality of life was 57.2 ± 12.3. Age (β=5, 95% CI: 2.301, 7.699), marital status (β=-6.914, 95% CI: -8.867, -4.961),seizure frequency (β=-.2.307, 95% CI: -4.795, .020), Anti-epileptic drug non-adherence (β=-.11.016, 95% CI: -13.642, -8.389), anxiety (β-4.062, 95% CI: -6.503, -1.621), poor social support (β=-6.220, 95% CI: -8.422, -4.017) and moderate social support (β=-5.58, 95% CI: -7.792, -3.368) were significantly associated with quality of life.

Conclusion: The mean quality of life of people living with epilepsy in this study was low. Age, marital status, seizure frequency, concomitant anxiety, antiepileptic drug non-adherence, number of anti-epileptic drugs/day, moderate and poor social support were all found to be predictors of quality of life in this study. As a suggestion, the patient treatment plan should include a quality of life assessment that addresses psychosocial concerns; professional counseling on how to cope with psychological, environmental, and social difficulties should be increased.

We investigated the correlation between leukoaraiosis (LA) grades and wrong-way entry on highways, main roads, or narrow roads with one-way using a largescale data of brain healthcare checkups with magnetic resonance imaging (MRI). Multiple and large multiple LA were significantly associated with wrong-way entry and near one on highways, not with wrong-way entry on main and narrow roads. In addition to conventional measures such as legal penalties for drunken driving, lifestyle improvement and medical treatments to suppress LA progress may be useful measures against wrong-way driving on highways.