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Università degli Studi di Milano - State University of Milan (Italy)
Università degli Studi di Milano - State University of Milan (Italy)
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Papers by ANAND DIWAN
Journal of Stroke and Cerebrovascular Diseases, 2022
Many countries have seen an unprecedented rise of cases of coronavirus disease 2019 (COVID-19) as... more Many countries have seen an unprecedented rise of cases of coronavirus disease 2019 (COVID-19) associated mucormycosis (CAM). Cerebrovascular involvement in CAM has not been studied so far. We describe clinico-radiological manifestations of cerebrovascular complications observed in CAM. In this multicentric retrospective observational study from India, patients with CAM who developed cerebrovascular involvement were studied. Their demographics, risk factors, clinical manifestations, imaging, laboratory profile and outcomes were noted. Out of 49 subjects with cerebrovascular involvement, 71.4% were males while average age was 52.9 years. Ischemic stroke was commonest (91.8%) followed by intracranial haemorrhage (6.1%) and subarachnoid haemorrhage (2%). The incidence of cerebrovascular complications in CAM was found to be 11.8% in one center. Cerebrovascular symptoms appeared a median of 8.3 days from the onset of mucormycosis. Commonest presentation of mucormycosis was rhino-orbito-cerebral syndrome in 98%. Diabetes mellitus was present in 81.7%. Forty percent developed stroke despite being on antiplatelet agent and/or heparin. Amongst subjects with ischemic strokes, location of stroke was unilateral anterior circulation (62.2%); bilateral anterior circulation (17.8%); posterior circulation (11.1%) and combined anterior and posterior circulation (8.9%). Vascular imaging revealed intracranial occlusion in 62.1%; extracranial occlusion in 3.4% and normal vessels in 34.5%. Mortality was 51% during hospital stay. Cerebrovascular involvement was seen in 11.8% patients of CAM. Angio-invasive nature of the fungus, prothrombotic state created by COVID-19, and diabetes were important causative factors. Subjects with CAM should be screened for involvement of the brain as well as its vessel. Antiplatelet agents/heparin did not seem to provide complete protection from this type of stroke.
Introduction: The central role in the diagnosis of the epilepsy is played by electroencephalogram... more Introduction: The central role in the diagnosis of the epilepsy is played by electroencephalogram (EEG). Also, in India, there exists a large treatment gap as appropriate treatment for the condition is not received by the patients suffering from active epilepsy. The main reasons responsible for this includes poverty, lack of knowledge, social stigma and poor health infrastructure. In developing countries an enormous gap between the number of patients who could be benefited from epilepsy surgery and those who actually receive this treatment has been created by the lack of availability and affordability, which can only be minimized by developing more centres in the country, where epilepsy surgery can be undertaken. Hence; we undertook the present study to create a model for Epilepsy surgery programmse in small cities/ district places accessible to majority of medically refractory patients. Material and methods: The present study was carried out in the epilepsy centre. For predicting m...
MVP Journal of Medical Sciences
International Journal of Epilepsy, 2016
MVP Journal of Medical Sciences
Journal of Stroke and Cerebrovascular Diseases, 2022
Many countries have seen an unprecedented rise of cases of coronavirus disease 2019 (COVID-19) as... more Many countries have seen an unprecedented rise of cases of coronavirus disease 2019 (COVID-19) associated mucormycosis (CAM). Cerebrovascular involvement in CAM has not been studied so far. We describe clinico-radiological manifestations of cerebrovascular complications observed in CAM. In this multicentric retrospective observational study from India, patients with CAM who developed cerebrovascular involvement were studied. Their demographics, risk factors, clinical manifestations, imaging, laboratory profile and outcomes were noted. Out of 49 subjects with cerebrovascular involvement, 71.4% were males while average age was 52.9 years. Ischemic stroke was commonest (91.8%) followed by intracranial haemorrhage (6.1%) and subarachnoid haemorrhage (2%). The incidence of cerebrovascular complications in CAM was found to be 11.8% in one center. Cerebrovascular symptoms appeared a median of 8.3 days from the onset of mucormycosis. Commonest presentation of mucormycosis was rhino-orbito-cerebral syndrome in 98%. Diabetes mellitus was present in 81.7%. Forty percent developed stroke despite being on antiplatelet agent and/or heparin. Amongst subjects with ischemic strokes, location of stroke was unilateral anterior circulation (62.2%); bilateral anterior circulation (17.8%); posterior circulation (11.1%) and combined anterior and posterior circulation (8.9%). Vascular imaging revealed intracranial occlusion in 62.1%; extracranial occlusion in 3.4% and normal vessels in 34.5%. Mortality was 51% during hospital stay. Cerebrovascular involvement was seen in 11.8% patients of CAM. Angio-invasive nature of the fungus, prothrombotic state created by COVID-19, and diabetes were important causative factors. Subjects with CAM should be screened for involvement of the brain as well as its vessel. Antiplatelet agents/heparin did not seem to provide complete protection from this type of stroke.
Introduction: The central role in the diagnosis of the epilepsy is played by electroencephalogram... more Introduction: The central role in the diagnosis of the epilepsy is played by electroencephalogram (EEG). Also, in India, there exists a large treatment gap as appropriate treatment for the condition is not received by the patients suffering from active epilepsy. The main reasons responsible for this includes poverty, lack of knowledge, social stigma and poor health infrastructure. In developing countries an enormous gap between the number of patients who could be benefited from epilepsy surgery and those who actually receive this treatment has been created by the lack of availability and affordability, which can only be minimized by developing more centres in the country, where epilepsy surgery can be undertaken. Hence; we undertook the present study to create a model for Epilepsy surgery programmse in small cities/ district places accessible to majority of medically refractory patients. Material and methods: The present study was carried out in the epilepsy centre. For predicting m...
MVP Journal of Medical Sciences
International Journal of Epilepsy, 2016
MVP Journal of Medical Sciences