Abstract Non invasive ventilation (NIV) has become the standard practice for patients with neuromuscular respiratory failure. As mechanical ventilator can increase the risk of developing pneumonia or may cause lung injury, non invasive ventilation may be a good alternative for the same in certain neurological disorders. There are two main modalities of NIV: continuous positive airway pressure (CPAP) and Bi-level Positive Airway Pressure (BiPAP). Long-term non-invasive ventilation was introduced in the 1980s, initially for patients with poliomyelitis, muscular dystrophy or chest wall deformities like scoliosis. Bit in the last decade, sleep related disorders like the obesityhypoventilation syndrome and sleep related disordered breathing of which sleep apneas has become one of the commonest reason for referral to most centres providing home based NIV especially.

COVID-19 is a contagious disease caused by the Severe Acute Respiratory Syndrome Corona Virus-2, a single-stranded RNA genome. After its initial occurrence in, in November, 2019, in Wuhan, China, it has resulted in a worldwide pandemic. In India since early 2020 over 1,05,42,000 have been infected and over 1,52,000 have succumbed to it. A year after the first recorded case in India, the immunization exercise against the disease kicked off on 16th January, 2021, with two vaccines: Covishield and Covaxin. Serum Institute of India in Covidhield has grafted the COVID-19 antigen onto an adenovirus.

Neurological symptoms may be vague especially in the elderly with multiple comorbidities and in children. These include altered mental status, headache, anosmia, cerebellar ataxia, seizures, hemiparesis, and syncope. Encephalitis or a Guillain-Barré syndrome like presentation may occur.

Abstract Introduction:Dilated lumbar epidural veins are vascular abnormalities causing compression, ischemic injury and excessive pressure on spinal nerve roots, theca sac or dorsal ganglia, giving rise to symptoms of lumbar radiculopathy of the involved neural structures. Degenerative changes of the spine might also be observed. Importance:The importance of mentioned pathology is in the complexity of its diagnosis - missed diagnosis, relatively small number of observations, classification types, publications and estimates of the long-term outcomes of surgical treatment of this pathology on follow-ups. Misdiagnosis is often encountered due to low awareness even on MRI.Objectives: The aim of this study was to increase the awareness and lay emphasis on the importance of diagnosis, classification, pat-tern of occurrence, and surgical treatment of lumbar epidural varices.

Abstract Background: Multiple sclerosis (MS) is a chronic disease of the central nervous system that causes neuronal damage resulting in a variety of symptoms that include pain, fatigue, muscle weakness, impaired balance, and vision loss. In addition to these neurological symptoms patients also experience a decreased quality of life. Methods: In this study, a cross-sectional analysis was performed to compare the quality of life of MS patients on various treatments including ß-interferon injections, fingolimod oral capsules, and natalizumab intravenous infusion. Quality of life was assessed using the patient-reported EQ-5D-5L assessment. A semi structured question guide was also used to include different research groups from various geographical areas to identify literature study about quality of life and reasons behind their preferences with regard to their treatment and care which was analyzed using content analysis and constructivist approach. Mobility, self-care, participation in usual activities, pain, discomfort, anxiety, and depression were evaluated as predictors of quality of life.

We report a rare case of biopsy proven, thoracic intramedullary neurosarcoidosis in a 52- year-old male, who was thought to have progressive paraparesis as a result of degenerative spondylosis of the thoracic spine. Despite decompressive surgery, he would, over the course of 21 months, become irreversibly paraplegic and unresponsive to steroid treatment. To our knowledge, this is the only reported case of thoracic intramedullary neurosarcoidosis masked by severe thoracic stenosis and spondylotic changes.

Background and Aim:Mood swings such as sadness and depression are very common among the disabled elderly living in nursing homes. A systematic diagnosis of depression is very rare, and treatment is not always based on the best evidence. Distinguishing be-tween grief and non-pathological depression can be challenging, and we have little information about the elderly. The purpose of this qualitative study is to explain the causes of grief and grief from the respective of the elderly living in the nursing home.

Neurocysticercosis (NCC) is the most common parasitic infection of nervous system. We report a case of 42 year old female patient with headache, multiple episodes of seizures and altered sensorium. Magnetic Resonance Imaging (MRI) of brain showed multiple cysticerci in different stages of development compatible with the diagnosis of Neurocysticercosis. Despite administration of multiple antiepileptic drugs and intravenous anaesthetic agent, patient continued to seize and later succumbed to super refractory status epilepticus. Super refractory status epilepticus (SRSE) is characterized by continuous or recurrent seizures without regaining consciousness, lasting for more than 24 hours despite administration of an intravenous (IV) anaesthetic.

Introduction: Bourneville disease or tuberous sclerosis complex (TSC) is an autosomal dominant disease with variable penetrance. It is classically described in the literature as a triad of seizures, intellectual disability and adenoma sebaceum. Rare disease, it concerns 1/10000 live births. Retinal phages are present in almost 50% of patients. These are glial hamartomas characteristic of the affection.Case Report: We report the case of a 9 years-old boy referred to the Ophthalmology Department This patient was followed in Rheu-mato-Dermatology clinic for tuberous sclerosis for about 4 years and there was an evolving of his cutaneous lesions. Dermatologists wanted to find out whether there was ocular manifestations.

Introduction:The temporomandibular disorders are very frequent; few studies exist that reflect the effectiveness of the ozone application intraarticular in the temporomandibular joint.Purpose: To evaluate the remission time of pain in the studied patients after the ozone therapy application. Material and Methods: An intervention study was realized in patients of the International Centre of Investigations of Ozone in La Havana, Cuba. Ozone (O3) was applied with the OZOMED Plus equipment. Ozone was applied intraarticular for ten sections 3 mg/L for a volume of 3 ml equivalent 0.03 mg in one bilateral section. Also combined with a rectal application at a dose of 30 to 40 mg / L for a volume of 200 ml per 20 continuous sections (daily).

The COVID-19 epidemic also affects families in terms of material, work and relationships, and daily habits. The past 9 months are a lot of time during the extraordinary and stressful period, and its effects will be felt in the long run. Increased anxiety (e.g., double incidence in Canada, [15]) may change basic habits and long-term effects cannot be predicted. Presumably, individual- and family-level adaptation patterns, flexibility, or rigidity determine long-term changes. The study addresses the effects on family balance during COVID 19, such as perceived stress, health anxiety, and addresses psychological factors that support flexible adaptation during a pandemic period. For example, in the first wave, activity and movement showed a positive association with resilience [1,30] as an option for self-efficient behavior. Analysis of the first and second samples of our longitudinal study shows similar results where self-efficacy is a protective factor against the stress that occurs in a pandemic.

Aim:To study the usefulness of clinical symptoms and signs in predicting ventriculoperitoneal shunt malfunction in children. Materials and Methods:The study was a cross sectional study of all patients with suspected ventriculoperitoneal shunt dysfunction who presented to the ER. The study was done in a single centre metropolitan tertiary care paediatric hospital over a period of one year. Data from 38 patients were obtained and was analysed using SPSS 14 and Microsoft Excel software. Results: VP shunt block occur more commonly in males and more frequently between the ages of 1-5years. Congenital aqueduc-tal stenosis was the most common aetiology amongst those undergoing shunt revision. Most shunt revisions occurred within 3-12months of the previous shunt surgery. Vomiting, altered sensorium and seizures were the most common presenting symptoms. Bulging AF, CSF leak from operated site and the sunset sign were definitive signs of shunt dysfunction. 74% of cases had an identifi-able ventricular catheter displacement on CT scan. The most common cause was tube block by ependyma and infection as a cause for block was rare.