Chronic pain is a multifaceted condition affecting not only the individuals, but the whole society as well [1]. It has been estimated that 20% of surveyed Europeans suffer from moderate to severe chronic pain which in turn impairs functioning, work and quality of life. Interestingly, direct and indirect health costs for chronic pain exceed those estimated for diabetes, heart disease and cancer.

Coronavirus SARS-CoV-2 emerged in a wet market in Wuhan, China, and within a few weeks the morbidity and mortality exhibited by it led to the declaration by WHO of a worldwide pandemic of COVID-19 on the 11th of March, 2020 [1]. Plans to halt the pandemic were devised - based on the proportion of the population at risk that needed to be protected in order for transmission to end significantly and quickly enough. The strategies revolved around the Basic Reproductive Number, R0 being reduced to less than 1. At this value the spread of infection shrinks and gradually shrivels up [2]. The R0 for India was calculated to be 1.2561 [3]. The highest R0for any country was that of the Syrian Arab Republic at 2.7936 and the lowest was for Nigeria at 1.0011. The mean R0 was estimated to be 2.2

A 56 year old male patient presented with slowness of activities, gait disturbance and altered behaviour for four weeks. Patient had been diagnosed as a case of alcoholic liver disease for two years. Neurologically, he had rigidity, severe bradykinesia with short stepping gait while walking. Following investigations, patient was diagnosed as a case of alcoholic liver disease with hepatic encephalopathy. He was treated with appropriate diet, laxatives and low dose levodopa therapy. He improved over the next few days as his blood ammonia levels also fell. Parkinsonism is a rare presentation of liver cirrhosis with hepatic encephalopathy.

Background: Diabetic neuropathy (DN) is the most common complication of diabetes mellitus resulting in a decrease in quality of life. The association between lipid profiles and the presence of DN is controversial. We investigated the association of total choles-terol, triglycerides levels, and the presence of diabetic neuropathy. Methodology: A cross-sectional study among seventy diabetic types 2 patients with (n = 35) and without diabetic neuropathy (n = 35). The presence of diabetic neuropathy was evaluated using the Michigan Neuropathy Screening Instrument (MNSI) and asked for fasting venous blood collection for the examination of total cholesterol using the CHOD-PAP method and triglycerides using GPO-PAP method. The association of serum total cholesterol and triglyceride level and the presence of DN were obtained from Chi-square test analysis.

After initiation of experimental model of demyelination and remyelination, was investigate morphological changers of neurons and myelinated nerve fibers in organs of central nervous system (CNS) and organ of immune system - thymus.In its experimental work was use model of demyelination - EAE (experimental allergic encephalomyelitis) in rats, and was study changers of neurons in cortex of cerebrum, cerebellum and spinal cord on 21 days and 39 days after initiation EAE. Histological sections of the brain and spinal cord was stain by toluidine blue and cresyl violet, we observed the percentage of neurons with unmodi-fied, moderate and severe structural changes. In organs of CNS we studied of demyelination process in nervous fibers. In investiga-tions of nervous fibers was use methods of electron microscopy and morphometry. On early period EAE we observed demyelination process of nervous fibers, after influence of Rebif®(interferon beta-1a) by 2 weeks, we observed of remyelination.

Objective: Simulation offers an important avenue for surgical and anesthesia training. This is especially important for crisis management scenarios where individuals need to act quickly and efficiently for optimal patient care. Practice based performance can be measured and real time feedback provided during debriefing scenarios. Methods: In this paper, we highlight a dual anesthesia and otolaryngology cavernous carotid injury scenario. The trials were run three different times with inter-trial debriefing.

Moyamoya disease is a chronic progressive arteriopathy involving the cerebral vessels and is one of the rare causes of young stroke. Etiology can be idiopathic as well secondary to some other primary disease. It does affect the members of the same family but the definite pattern of inheritance has not been found out yet. There are few studies in the literature about the familial presentation of idiopathic Moyamoya disease, most of them from East Asian countries, which is why there are no common opinions and guidelines regarding the follow up and management of asymptomatic family members of such patients. We present and discuss the case reports of two family members with Moyamoya disease from India to further emphasise upon the need of research and long term follow up studies.

We report a case of a 22 year old female patient who presented with altered behaviour in the form of anxiety, irritability and agitation for two days. Patient was a diagnosed case of juvenile myoclonic epilepsy for past 10 years on valproate therapy. Patient had been switched to Levetiracetam (1500 mg daily) two weeks back in view of valproate induced side effects. Formal psychiatric evaluation suggested acute psychosis possibly Levetiracetam induced. Levetiracetam was stopped and replaced with lamotrigine. Patient dramatically improved over next two days and became asymptomatic.

A very rare neurological complication of SARS-CoV-2 infection includes transverse myelitis. I assume a post-infectious etiology in terms of secondary immunogenic overreaction. Iontophoresis is the process of the permeation of ionic (charged) drugs into the body under the influence of electrical current. Besides increasing therapeutic efficiency by, by passing first pass metabolism there are less risks of systemic absorption and undesirable side effects. The study was conducted in a SARS-CoV-2 patient with transverse myelitis, by transdermal application of dexamethasone sodium phosphate, cyclophosphamide and miconazole by iontophoresis at corresponding vertebral levels to look for the neurological outcome who had been unresponsive to intravenous methylprednisolone. With Dexamethasone sodium phosphate and cyclophosphamide iontophoresis there was modulation of the activity of posterior grey column, fasiculus gracilis and corticospinal tracts, and with miconazole iontophoresis I was able to ameliorate the dyesthesias, fasiculations and muscle atrophy probably due to neuromodulation at substantia gelatinosa and lamina IX and remyelination effect. There were no systemic or localized side effects and no adverse effects occurred during the treatment period.

Low blood pressure occurs when blood pressure is much lower than normal. This means the heart, brain, and other parts of the body do not get enough blood. Normal blood pressure is mostly between 90/60 mmHg and 120/80 mmHg.Certain medicines and substances can lead to low blood pres-sure, including: alcohol, anti-anxiety, medicines, certain antidepressants, diuretics, heart medicines, including those used to treat high blood pressure and coronary heart disease, medicines used for surgery, painkillers. Other causes of low blood pressure include: nerve damage from diabetes, changes in heart rhythm (arrhythmias), not drinking enough fluids (dehydration), and heart failure

There are approximately 13 million people suffering from Epilepsy in India and the treatment gap is 50 - 75% largely due to myths and taboo associated with Epilepsy [1]. About 70% patients are treatable with single medicine if the treatment is started in time. Epilepsy Foundation India, established in the year 2009, is a ‘Non Profit’ organization and registered under sections 12A and 80G of the Income Tax Act, 1961. It is dedicated to ‘Cure and Rehabilitation of Patients suffering from Epilepsy’, spreading awareness and educating the people about Epilepsy

Introduction:Head injury is the leading cause of death and disability among young adults. It constitutes close to 50% of all injuries. Data have shown that a significant proportion of the world’s population, over 57 million are living with neurological sequalae of head injury. The study aimed to describe the epidemiology of head injury in a center with no previous neurosurgical services in North Eastern Nigeria.Materials and Methodology:Aprospective study that involved all patients managed with head injury between September 2018 and August 2019. Demographic, clinical radiological details obtained and patients categorization made using Glasgow coma scale (GCS) and the treatment offered based it. The outcome was measured with Extended Glasgow Outcome Score (GOSE). Descriptive statistics were obtained Mean Standard deviation SD, Frequencies, Percentages.

Background: Excessive drooling is common and problematic issue faced by Parkinson’s disease (PD) patients and their caregivers. Drooling can cause both physical and psychosocial disability. Recent studies of Botulinum toxin type-A (BoNT-A) in PD-related drooling have shown favorable results with minimal side effects. Aim: To evaluate the safety and efficacy of botulinum toxin injections into salivary glands in decreasing PD-related drooling.

Background: Covid-19 emerged as a global pandemic and its catastrophic effects have been felt throughout the world. The pandemic has caused a serious impact on mental health and loneliness of the people. The aim of the present research was to analyze the impact of the Covid-19 on the psychological health of residents of Karachi during the second lockdown. Method: It was a cross-sectional study conducted during the second wave of corona virus via an online survey, in which 380 persons participated. The survey consists of questions for the assessment of symptoms of depression, anxiety, stress by using DAAS-21 scale and for the questions related to loneliness, the UCLA-3 Item Loneliness Scale was used. Participants were selected by convenient and snow ball sampling method.

Air pollution is a dangerous condition to health that adversely affects human societies especially in industrialized countries [1]. However, there are some conditions that air pollution has an addictive effect on the preexisting condition. Nowadays the COVID-19 pandemic has compressed human societies, it is necessary to minimize the addictive factors such as air pollution to decrease the risk of transmission, replication, and may be mutation since air pollution is stressful to living creatures.

Cluster headache is a trigeminalautonomic headache that predominantly affects young men. In its pathophysiology, it is believed that there is involvement of the ipsilateral trigeminal nociceptive pathways and activation of the cranial parasympathetic system. We report a case of a 23-year-old man presenting the chronic form of cluster headache from the beginning, according to ICHD-3 criteria. After effective prophylactic treatment, he evolved into an episodic form. To our knowledge, chronic form of cluster headache is uncommon and when it is successfully treated it evolves into the episodic form.