Biomedical subjects

K M Prakash

Publications and source records attributed to K M Prakash.

11 recordsLinked to original sources

PubMed2006

Exploring the relationship between caffeine intake and essential tremor.

BACKGROUND: It has been suggested that environmental factors may be associated with essential tremor (ET). This study was carried out to evaluate the association of caffeine intake with ET. METHOD: In a case control study, patients diagnosed with ET and healthy controls underwent a standardized questionnaire interview to evaluate the exposure to coffee and tea intake. A multivariate logistic regression analysis was carried out to evaluate the association of caffeine intake and other environmental factors with risk of ET. RESULTS: 179 subjects including 79 ET patients and 100 controls matched for age, gender and ethnicity were included in the analysis. Univariate analysis revealed that caffeine consumption in ET patients was higher than control group (median and 90th percentile range: 2300 (0, 9000) mg-years versus 1500 (0, 6090) mg-years, p=0.01). However, the multivariate logistic regression analysis demonstrated that caffeine was no longer a significant factor associated with ET (p=0.119). There was no significant correlation between amount of caffeine intake and disease duration (Spearman's r=0.194; p=0.202) or total tremor score (Spearman's r=0.045; p=0.771) in ET patients. CONCLUSION: Caffeine consumption was not associated with risk of ET in our study population. Further studies are needed to investigate the significance of gene-environmental interaction in ET.

Adult↗

PubMed2006

Mycophenolate mofetil - as an adjunctive immunosuppressive therapy in refractory myasthenia gravis: The Singapore experience.

We report our experience, using mycophenolate mofetil (MyM) as an adjunctive immunosuppressive therapy in patients with severe, refractory and high dose steroid-dependent myasthenia gravis (MG). Five patients were commenced on MyM in addition to other immunosuppressive therapies. All had significant clinical improvement and no subsequent myasthenic crisis requiring intensive care unit admission. MyM was well tolerated and no serious adverse effects were observed. MyM is an effective adjunctive therapy for the treatment of severe, refractory and steroid-dependent MG in our experience.

Adult↗

PubMed2006

Clinical features of childhood onset essential tremor.

Childhood onset essential tremor (ET) is uncommon. It is not clear as to whether ethnicity-specific differences may influence the phenotypic features. To determine the frequency and clinical characteristics of childhood ET in a tertiary referral center. In a prospective evaluation of 120 consecutive ET patients in a movement disorders clinic, we found a 15.5% (19) frequency of childhood onset ET patients. The mean age of onset and mean age was 10.8 +/- 4.1 (6-16) years and 25.7 +/- 15.0 (16-73) years consisting of 73.6% (14/19) men and 26.4% (5/19) women. A positive family history of ET was present in 11 of 19 (52.6%). Presence of a head tremor was observed in 2/19 (10.5%). We highlighted a relatively high frequency (15,5%) of childhood ET in our Asian cohort. In addition, we drew attention to the male preponderance and the low frequency of head tremor in childhood ET corroborating study findings in white ET patients. These observations appear to transcend ethnic and cultural differences and lend further support that gender difference may play a role in the pathogenesis and expression of ET.

Adolescent↗

PubMed2006

Knowledge about the genetics of essential tremor in patients and their relatives.

In a face-to-face questionnaire-based survey involving a total of 111 essential tremor (ET) patients and their relatives, we demonstrated a general lack of genetic insight amongst our study subjects. There was no significant correlation between genetic knowledge of ET and age, level of education, disease duration or severity. A proactive effort is needed to encourage physicians managing ET patients to incorporate genetic information and education into their practice.

Adult↗

PubMed2005

Non-motor manifestations in essential tremor: use of a validated instrument to evaluate a wide spectrum of symptoms.

INTRODUCTION: Recent studies suggest an association between non-motor symptoms and essential tremor (ET). Few studies have assessed psychological symptoms in ET. These studies were limited to western white populations and utilized scales that were specific to only one or two psychiatric domains. By contrast, the Symptom Checklist-90R (SCL-90R) is a validated clinical scale to screen for symptoms related to a spectrum of nine different psychological domains. OBJECTIVE: To determine whether a wide spectrum of non-motor manifestations is associated with ET in patients in an Asian cohort. METHODS: Consecutive ET patients and a group of control subjects were evaluated using the SCL-90R, which is comprised of items in nine major symptom dimensions and three global indices, including the positive symptom distress index. RESULTS: ET patients (N = 84) and controls (N = 78) were similar in age (50.0+/-18.0 vs 46.0+/-14.4 years), gender and other demographic variables. ET patients had higher scores in three of nine major symptom dimensions: anxiety, phobic anxiety (p < 0.0005) and psychoticism (p = 0.005). In multivariate analysis, the anxiety (p < 0.0005) and the positive symptom distress index scores (p < 0.0005) were greater in ET patients compared to controls after adjusting for sex, age, marital status and educational level. The severity, but not duration of ET was correlated with the severity of anxiety symptoms. CONCLUSIONS: Utilizing the SCL-90R, we highlighted that ET patients reported more non-motor symptoms than healthy controls. The more frequent occurrence of anxiety symptoms in our Asian cohort extends the observation that such non-motor manifestations should be considered in the clinical management of ET.

Adult↗

PubMed2005

The role of clinical neurophysiology in bioterrorism.

Chemical and biological agents have been used as weapons of mass destruction for a long time and presents as a serious threat to mankind. They have been used in many great wars and terrorist attacks with devastating results. The knowledge about these weapons of mass destruction is crucial to health care providers. Early recognition of the clinical characteristics of poisoning as a result of these chemical and biological agents is important to initiate appropriate therapy and minimizing casualties. Neurophysiological investigations when integrated with clinical features are helpful in early identification of some of these agents, especially when serological confirmation is not rapidly available. In this review, we have focused on chemical and biological weapons, which affect the nervous system and the role of clinical neurophysiology in such conditions.

Bioterrorism↗

PubMed2004

Posterior antebrachial cutaneous nerve conduction study in radial neuropathy.

Radial neuropathy most commonly occurs as a result of external compression at the spiral groove region. The posterior antebrachial cutaneous nerve (PACN) conduction study was performed in 15 consecutive patients with radial palsy. Unilateral PACN abnormalities were present in 11 patients. A normal PACN study was correlated with clinical improvement at 3 months. Conversely, PACN abnormality was correlated with radial motor axon loss and a poorer prognosis. The PACN study is a simple adjunct which provides additional information relating to the diagnosis and prognosis of radial lesions.

Adolescent↗

PubMed2004

Posterior antebrachial cutaneous nerve conduction studies in normal subjects.

OBJECTIVE: The posterior antebrachial cutaneous (PABC) nerve is a sensory nerve that branches out from the radial nerve at the level of the spiral groove. Thus it can be affected in a radial nerve lesion at or proximal to its origin in the spiral groove. However, there has been limited knowledge about the normal values of PABC nerve conduction studies. This study was done to determine these normal values. METHODS: Sixty-three healthy adults (23 males) with a mean age of 41.5+/-10.6 (range, 20-90) years were recruited with informed consent. A total of 126 nerves were studied. The nerve conduction studies were performed using a Dantec Counterpoint EMG machine (Dantec, Skovlunde, Denmark). RESULTS: The mean+/-standard deviation values for the onset as well as peak latency, conduction velocity, amplitude and side-to-side amplitude ratio were 2.07+/-0.16 (range, 1.80-2.60) ms, 2.35+/-0.15 (range, 2.05-2.90) ms, 58.21+/-4.29 (range, 46.15-66.67) m/s, 6.10+/-2.11 (range, 2.90-13.00) microV and 0.83+/-0.12 (range, 0.60-0.99), respectively. There was a significant correlation between the subject age and the PABC onset and peak latencies as well as the amplitudes. CONCLUSIONS: The PABC nerve is assessable for nerve conduction studies and these normal values may be useful in evaluation of patients with suspected radial nerve lesions.

Adult↗

PubMed2004

SUNCT syndrome in association with persistent Horner syndrome in a Chinese patient.

This is the first case report of a chinese patient with SUNCT (shortlasting, unilateral, neuralgiform headache attacks with conjunctival injection and tearing) presenting with persistent Horner's syndrome. She had episodic, brief, right periorbital pain in association with ipsilateral eye injection, lacrimation and rhinorrhea as well as persistent ipsilateral miosis and ptosis. She had partial response to a combination of indomethacin and carbamazepine therapy.

China↗

PubMed2003

The use of nerve conduction studies in determining the short-term outcome of Bell's palsy.

Bell's palsy is a common neurological problem causing considerable loss of self-esteem among patients. A prospective observational study was conducted to determine the short-term outcome of Bell's palsy at 1 month and 2 months after the onset and the relationship between these outcomes with facial nerve degeneration. We also determined if gender, age, diabetes, systolic and diastolic blood pressure influence the severity of facial nerve degeneration and the clinical outcome at 2 months after the onset. After clinically grading the newly diagnosed unilateral Bell's palsy patients using the House-Brackmann facial nerve grading system, nerve conduction studies of the facial nerve were done to determine the severity of facial nerve degeneration. The recovery of the facial paralysis was clinically graded again at the end of 1 month and 2 months from the onset. A total of 37 patients were recruited. There was a strong positive correlation between facial nerve degeneration and the clinical outcome of Bell's palsy at 1 month (r = 0.794; p < 0.0005) and 2 months (r = 0.732; p < 0.0005) after the onset. There was no significant correlation between either the facial nerve degeneration or the clinical outcome at 2 months with the patients' age (p = 0.288 and p = 0.799 respectively), systolic blood pressure (p = 0.425 and p = 0.933 respectively) or diastolic blood pressure (p = 0.243 and p = 0.579 respectively). Neither the severity of facial nerve degeneration nor the clinical outcome at 2 months were significantly different between male and female patients (p = 0.460 and p = 0.725 respectively) or diabetic and non-diabetic patients (p = 0.655 and p = 0.655 respectively).

Adolescent↗

PubMed1977

Clinical and immunological studies on persons exposed to Parthenium hysterophorus L.

Studies on 300 persons subjected by occupational hazard to the allergenic weed, Parthenium hysterophorus L. for periods ranging from 3 to 12 months revealed that 4% of them developed contact dermatitis of the exposed parts of the body, while 56% of them got sensitized to the weed without apparently exhibiting any dermatitis. None of them suffered from allergic manifestations like rhinitis or bronchial asthma during the period of study which extended for 2 years.

Allergens↗