Sunday, June 21, 2020
Scientists have found out a promising diet which is helpful in effectively preventing Alzheimer’s disease by 50 percentage. This diet is called as Mind diet which was developed by RUSH university scientists. Free radicals are generated normally as the brain function. These are harmful substances to the brain. Mind diet reduces the amount of free radicals and thus prevents brain from the damaging chemical products.
This diet consists of 10 food items which are to be included regularly in the diet plan.
· green leafy vegetables
· other vegetables
· whole grains
· olive oil
· butter and Margarine
· red meat
· sugar and pastries
· fast food
Fruits and Vegetables - what they do?
Green leafy vegetables help in maintaining a healthy mind. Lutein, Vitamin k, folate those are all nutrients shown important to the brain. Berries especially blue berries reduce the number of dying neurons. and protect brain plenty of anti oxidants. Whole grains are very good source of vitamin E, folate and fibre. Those nutrients are found to protect the brain.
Red wine is found to be effective in reducing the speed of ageing of brain. Studies have shown that people who consumes wine in a moderate amount has shown a slower pace of cognitive decline as compared to those who do not consume at all. The recommended amount of intake is 1 glass/day for women and 2 glass per day for men. Obviously the excess intake is not good for the brain as well as other organs in the body.
Red meat is the primary sources of saturated fat where as poultry is low in that. No more than 3 servings per week. Low in unsaturated fat. Too much of red meat causes instability to the blood brain barrier and allows dangerous chemicals to enter the brain and prevent good things to enter the brain.
Cheese is to be limited in the diet as it consists of plenty of saturated fat. Don't worry. Researches have advised that low fat varieties of cheese can be taken instead.
People who stick to it even moderately has shown significantly low risk of alzheimer's disease. So try to follow this for a helathy brain.
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Have you ever wondered what must be the weight of human brain?Is it true that if the persons weight of brain is more then the IQ is also high?
Well let’s find out.
An adult human brain contains 16 billion neurons and each neuron has interconnections with around 12,000 neurons. An average adult human brain weighs around 1400 to 1500 grams which is about 2% of the total body weight. But it consumes about 25 percent of whole oxygen requirement.
A newborn's brain is about 300-400 grams.
Adult brain is about 15 cm long.
Who is having the world record for the heaviest brain?
Ivan Turgenev a russian novelist has the world record for the heaviest brain and it was found that it was about 2012 grams. But this is not an official record. We must assume that since he had the heaviest rain he should have the highest IQ the world ever has seen. But the fact is not the same. There is no correlation between the weight of the brain and the person's IQ.
For example Anatole France who was a famous French novelist had a brain which weighed only about 1150 g. But still he won the Nobel prize for literature in 1924.
Albert Einstein who is one of the most intelligent man the world ever has seen didn’t have the heaviest brain in the world.
In Britain in 1890s there was a guy with a brain weighing 1830 g but he spent most of his life in a psychiatric hospital.
So it is clear that there is no relationship between the weight of the brain and the intelligence quotient.
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Sunday, June 7, 2020
The corona virus pandemic which has hit the world in the start of 2020 has become one of the great disasters mankind has ever seen. There’s are a number off questions arises regarding the neurological aspect in the event of Covid 19 pandemic.
Does corona virus causes increases risk of stroke, seizure, brain swelling or confusions state?Most of the corona positive patients does not show any signs other than respiratory system dysfunction. But there are some reports off late that a very small subset of patients exhibit symptoms related to neurological complications more commonly as a confused state. Till now there are no reliable reports saying that Covid 19 virus infection increases the chance of stroke.
The confusions state can occur in the event of hypoxia where brain tissues undergoes ischemic changes and ultimately they die. Another explanation is the possibility of acute necrotising encephalopathy which occur in some severe case of influenza infections. Encephalitis can cause the acute deterioration in the consciousness, seizures etc. We are yet to know more details regarding the Covid 19 virus behaviour in the central nervous system.
The good news is that majority of the Covid 19 patients are normal neurologically. They remain on normal consciousness till their last breath. Even if there is a significant relationship between the virus behaviour and the concurrent CNS damages it should be very less.
There is no simple way solution to prevent your brain from degenerating. It is obvious that the brain will go for atrophic changes as you age. But there are some dietary changes which you can include in your life style to enhance the brain power. We have already discussed about best fruits which can help in brain health.In general brain likes unsaturated fatty acids, antioxidants, plant proteins, omega3 fatty acids etc. These chemicals are not only good for brain but for your heart and blood vessels too. Here we discuss about 5 best foods which can improve your memory and cognitive power.
1. Green Leafy Vegetables
2. Fatty fish
Best fish species with rich omega 3 content
3. Coffee and Green teastudy from Serbia concluded that regular intake of caffeine helps in improving the thinking ability and attention span of human brain.
Green tea is another drink for those who do not like coffee. It contains plenty of flavonoids which are plant pigments. It contains caffeine which increase your alertness as well as L-theanine which is an amino acid which relax you without causing tiredness.
Turmeric is an essential spice in many cuisines. Curcumin which is an ingredient in turmeric crosses blood brain barrier and it has plenty of antioxidant and anti-inflammatory actions. Curcumin also has anticancer activities which protects your whole body from the deadly disease. Researches are ongoing to find out the use of turmeric’s this action into anticancer treatment. As far as brain is concerned curcumin improves mood and growth of brain cells by controlling the neuro transmitter release.
5. Dark chocolate
It is a happy news for chocolate lovers that plenty of chocolate intake can speed up your brain. Chocolate contains plenty of flavonoids, caffeine and other antioxidant compounds which have neuroprotective functions as we discussed already. Many studies have been done on chocolate’s potential to elevate the mood which may be partly by the mental satisfaction the flavour gives. But it has a definite brain boosting property.
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Carpal tunnel syndrome surgery is the most common peripheral nerve surgery done in the United states. Annually about 3,50,000 carpal tunnel release performed here. Females are slightly more affected than the males and people more than 55-60 years are the most common group.
What is Carpal tunnel syndrome?
As the name suggest there is a small tunnel under the carpal ligament in our wrist joint. About 10 structures pass through this small canal including eight tendons, one muscle and one nerve that is median nerve. Whenever the size of this Cana gets compromised either with ligamental hypertrophy, tumour, bone growth etc. the median nerve gets compressed and patient develops pain. This is the mechanism how CTS develops in simple words.
Let us check out the symptoms of carpal tunnel syndrome
The most common symptoms are pain and numbness in the hand. Pain is more in the thumb index and middle finger. This is due to the typical distribution of median nerve supplying the lateral three and a half fingers and thenar aspect of the hand. Carpal tunnel patients have typical increase in pain during night. This increase in pain is due to the venous stasis which happens during the sleep. When you get up a night with severe pain some sort of a relaxing exercise can be done like repeated slow flexion- extension movements of wrist and fingers. This activity increases blood flow and helps in soothing the pain.
In severe carpal tunnel syndrome patients also can have weakness of the hand muscles which is not evident in mild cases. As you develop motor weakness of the hand it is the time to undergo surgical intervention. How to find out whether you have developed motor weakness due to CTS? You will have difficulty in flexing the proximal interphalangeal joint of the index and middle finger. Also you have abduction difficulty of the thumb.
How to diagnose carpal tunnel syndrome by yourself?
There are few tests which can be done at home to get an idea whether you having CTS or not.
You just stop at the centre of the wrist joint at the lower end of the palm multiple times and see whether you are getting a shop like sensation spreading through the palm to the thumb, index and middle finger.
2.Durkan compression test
In this test you just press the same region for about 30 seconds and see whether you are experiencing the similar symptoms or any worsening of the pain. In such case it is high you might be having CTS.
3. Phalen’s test
This is the third test to diagnose CTS. This test you have to flex your wrist as much as possible for about 60 seconds and see for any symptoms.
Medical investigations to diagnose carpal tunnel syndrome
The first test your physician would be doing is a nerve conduction study. In the early stages it will show a delay in the sensory conduction. In severe cases motor conduction will also be affected.
Ultrasound imaging is done to find out any nerve thickening or inflammation. It will be useful in cases where nerve conduction study result is inconclusive.
In conditions where any abnormal bone growth is noted and x-ray or a CT scan may be needed. In case of any nerve tumours or other joint pathologies MRI scan also might be considered.
What are the treatment options for carpal tunnel syndrome
In early cases non-surgical treatment options can be tried. these include
1. Wrist splints
2. Ultrasound therapy
3. Steroid injections
5. Lifestyle modifications
Wrist splints are effective particularly in early stages of CTS. Many people asks the duration of wearing wrist splints. Studies have shown that when it is worn full time it is the best. But people notice it uncomfortable during routine jobs. In such cases brace can be worn during sleep. These splints help in keeping the wrist in neutral position and this will avoid any compressive stress to the nerve.
Locally injected steroids produces significant pain relief but it is often temporary. So in severe cases steroid injection followed by wrist splints can be an option. NSAIDs are anti-inflammatory medications which reduces the pain temporarily.
Ultrasound and laser therapy shows variable results. But there is no harm in trying as there are almost no side effects.
Exercise doesn't have much effect in reducing the symptoms of CTS
Surgery is considered in the following conditions
- failed conservative treatment
- Progressive disease
- Muscle weakness
- Intolerable pain and patient not willing for conservative treatment
There are two types of surgeries.
1. Open Surgey
2. Endoscopic Surgery
Both open and endoscopic surgery have equal efficacy in alleviating the symptoms of carpal tunnel syndrome. It is the surgeon’s familiarity and patient’s choice that decides the best approach in each patient.
Saturday, June 6, 2020
What is post concussion syndrome?As the name implies it happens after traumatic brain injury which is not visible in a CT or MRI brain imaging. Post concussion syndromes occurs due to the physiological and psychological changes that occurs during and after a head injury.
Post head injury many of the patients with concussion injury of the brain may not exhibit any symptoms. After going home may be a few days or weeks later patients will start experiencing the symptoms of post concussion syndrome.
Common symptoms of post concussion syndrome are
· Fatigue and occasional Irritability
· Memory and attention problems
· Sleep problems
How to diagnose post concussion syndrome?
When you have three of the following eight symptoms that develops within 4 weeks after the head injury, it is likely to have post concussion syndrome. They are
· Sleep disturbances
· Problems with memory
· Problems with concentration
· Reduced ability to tolerate stress, emotion
How long the symptoms of post concussion syndrome can last?
The symptoms of post concussion syndromes starts usually within 4 weeks after the head injury. It may last for few weeks to months and in some patients for years. Very few patients have described the symptoms lasting for the rest of their life, but fortunately it is very rare.
What is the treatment of post concussion syndrome?
There is no specific treatment for the post concussion syndrome. Adequate rest after the head injury may be a better way to avoid the occurrence. Also symptomatic medications for headache and other symptoms like lack of sleep etc. is advised usually. As the days progress patients feel better and they learn to manage the symptoms.
Recreational activities and fun therapy reduces to alleviate many symptoms and helps in recovery. Psychological analysis on a regular basis can be done to assess the recovery. Education about the disease, psychosocial support and reassurance are essential in the recovery phase.
Second impact syndrome
Second impact syndrome happens when another head injury happens when the patient is already in the recovery phase of a pervious head injury. This happens more commonly to sport players playing football, boxing etc. and also in the elderly patients with repeated falls.
The exact mechanisms are not known. But the brain which is in a recovery phase after the first head injury starts swelling after the second blow and it can cause sudden neurological deterioration. Minor repeated injuries can cause chronic traumatic encephalopathy syndrome or dementia pugilistica (punch drunk syndrome) in which patients develops dementia and cognitive decline with diffuse cerebral atrophy on MRI.
Friday, June 5, 2020
Concussion of the brain is the most common type of traumatic brain injury and it is the least dangerous type of traumatic brain injury. Around 90 percent of the concussion injury goes unnoticed. Concussion of the brain is defined as a transient loss of consciousness which lasts for seconds or minutes which starts immediately after a head injury associated with anterograde or retrograde amnesia and no visible injuries on CT or MRI scan. In retrograde amnesia person will have a period of memory loss for the events happened immediately before the injury.
How does concussion happen?
Normally our brain is well protected in the skull in a fluid filled cavity. In a head injury the brain is subjected to a sudden thrust. This force causes alterations in the normal physiological functions of the neurons. As the injury is at the neuronal level it is not seen in routine CT or MRI brain scans.
What are the symptoms of concussion?
The common symptoms of concussion are the following
· Transient loss of consciousness
· Nausea and vomiting
· Anterograde or retrograde amnesia
· Concentration difficulties
What are the types of concussion injury?
Concussion of the brain is graded by American Academy of Neurology into three categories depending upon the severity.
Grade 1- mild concussion – confusion, symptoms lasts for less than 15 minutes with no loss of consciousness.
Grade 2- moderate concussion – symptoms lasts for more than 15 minutes with no loss of consciousness.
Grade 3- severe concussion – loss of consciousness present
What is treatment for concussion?
Treatment for concussion injury is to take plenty of rest with symptomatic medications for headache, vomiting etc. Usually the symptoms subside on its own. Some patients will develop Post Concussion Syndrome also.
Whether children can get concussion injury?
Definitely Yes, Young children have comparatively bigger head to body ratio and hence fall injuries can cause concussion in children.
What to do to rule out Concussion after a head injury?
Seek medical attention as early as possible. They will evaluate for traumatic brain injury and if necessary imaging of the brain.
How to prevent concussion injury?
By wearing helmet and other face and head protective equipment while driving and engaging in adventurous sports we can avoid traumatic brain injuries to an extent. Helmet protects from the transmission of high power external forces directly into the skull.
Thursday, June 4, 2020
An auditory brainstem implant is a device which helps people suffering from congenital hearing loss to start hearing sounds. It has been in use for more than 20 years, but still unknown for many people. This device functions like an artificial ear and hence is useful for kids with no ear development at birth.
There are 3 varieties of auditory devices for the deaf children. They are
1. Hearing Aid
2. Cochlear Implant
3. Auditory Brainstem Implant (ABI)
In simple words hearing Aid is prescribed for patients suffering from external ear problems. It makes somebody to hear better by simply amplifying the sound impulses the device receives. Otherwise the hearing pathway works fine.
Cochlear implant is for someone who doesn’t have cochlea or the inner ear. Cochlea is a complex structure which converts the sound impulses into electric signals and it is carried from cochlea to the brain via the 8th cranial nerve. Cochlear implant is placed in the inner ear by an open surgical procedure.
Auditory Brainstem Implant or ABI is the most advanced brain implant which helps the person to hear even if he doesn’t have an Ear including the inner ear and auditory nerve.
WHAT?? Can you hear Without an Ear??
YES, Surgeon’s can make you hear even if you do not have an ear or hearing nerve in the brain.
How do they do that?
The electrode of the implant is inserted into the floor of the brainstem through a complex neurosurgical procedure. This electrode channel bypasses the auditory pathway till the brainstem nuclei.
This device has to components.
1. External receiver and processing unit
2. Internal Electrode unit
External receiving unit has a sound receiving unit which looks like something like a hearing aid. The sound signals received by this go to the processing unit where it is converted as electric signals and it is transmitted into the internal unit. The internal electrode array consists of 12 electrodes arranged in 3 rows . These signals are carried over till the cochlear nuclei in the brainstem. From there the natural hearing pathway works as in normal persons.
|12 Electrodes arranged in 3 horizontal rows|
Who can undergo ABI surgery?
ABI was first developed for patients with neurofibromatosis type 2 which is a genetic disorder. In this patients develop non cancerous tumours in both the auditory nerve which is the 8th cranial nerve. As a result patients will develop hearing loss on both sides and will ultimately become completely deaf.
Is Your child a candidate for ABI?
Recently the indications for ABI has been expanded. This is a good news for many parents having children with congenital hearing loss.
The recent indications are
When to undergo the ABI surgery?
The recent guidelines gives an option of auditory implant placement even in very young children. Surgeon’s advice ABI in children more than 12 months of age. The recent reports says that the outcome is better when they are operated at a very young age, may be with in 12-24 months. Although it is a complex surgical procedure, it is comparatively safe for even young children. The only problem in these children are they may have other congenital defects like septal defects in the heart, tetralogy of Fallot etc. In such cases proper precautions has to be taken at the time of surgery.
Auditory Brainstem Implant surgery Outcome in Children?
The outcome analysis shows that children who are operated early in life shows better hearing results. Also an insufficient hearing function as in auditory nerve hypoplasia has a better outcome than in absent nerve. This could be due to a better development of the auditory pathway in the first group. ABI placement helps in improving the quality of life and better cognitive status. Many children are able to start their mainstream education years after the surgery.
Is surgery the end of treatment?
No, Long term rehabilitation is needed following the surgery. This may be a prolonged therapy in patients who don’t have previous hearing experience as in congenital hearing loss. Their brain has to be trained with the new set of auditory signals which are unknown to the brain till then. Brain has a special feature called “neuroplasticity”, where functions are taken over by a new set of neurons. This is better in young children and hence the outcome is also better in them.
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Wednesday, June 3, 2020
We have heard this question many times.
Normally humans need only 10 percentage of our brain’s potential? The rest of our cognitive potential goes untouched? There is a myth that this non-usage of 90 percentage of the brain is because it consist of glial cells which are the supportive cells of the neurons. But scientists have ruled out this myth. It is possible that humans can access hundred percentage capacity of their brain but it doesn’t happen all the time. Brain is a very powerful organ which consumes about 25 percentage of the total oxygen human body use. It is very important to preserve the efficiency without the brain cells getting exhausted. In order to prevent the wastage of resources, brain tends to localise certain functions in certain areas of the brain. It also makes new neural connections and pathways for routine activities and other learned activities. So routine things we do everyday do not require the whole brain to function. Only certain areas or certain pathways are stimulated which were already created in the neural network system.
Researchers have shown that about 65 percentage of the school teachers in USA believe that they use only 10 percentage of brain potential. In Europe about 50 percentage of similar cohort believe the same. But unfortunately this belief seems to be unreal. We cannot become super heroes by using hundred percentage of our brains Power.
So it is a myth that we are not using the full potential of our brain. The recent imaging techniques like functional MRI shows that there is activity in all areas in the brain at one point or another. All the areas doesn’t function at the same time and that is not required also. Because humans do not work in that way and that is not needed too. The brain learns each activity and it doesn’t need the full system for performing a particular task.
There are of course silent areas in the brain which carry out minor functions like for example – enjoying music, Which may not be useful or evident If you’re not a music lover. If it is only 10 percentage of the brain which functions then definitely the undamaged areas in the brain can take over the functions after a traumatic brain injury. Even though neuro plasticity occurs it doesn’t make the patient fully normal after a severe brain injury.
There are certain chemicals and foods which increase our concentration and memory. For example ‘caffeine’ in the coffee improves the alertness and concentration. There is a particular diet called “MIND DIET” which has shown to be effective in preventing Alzheimer’s disease. But this food habits alone can’t help the brain to function beyond the required threshold.
What is the best thing to improve the brain function?
The best thing is READING. Reading gives the brain new knowledge and makes him think and this gives boost to the brain. Brain will develop new connection and reorganize the neural networks when you learn new stuff. What about doing arithmetic problems? yes it can prevent the cognitive decline which happens as you age.
SO KEEP LEARING
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