Siddharth Kharkar

Wockhardt Hospitals · Neurology

Introduction: Deep brain stimulation (DBS) markedly improves motor function in advanced Parkinson's disease (PD), but its effect on sleep is less clear. Patients and methods: Forty PD patients who had subthalamic DBS (STN-DBS) were identified from an on-going non-motor naturalistic longitudinal study (NILS). All patients were followed up for at...

Magnetoencephalography (MEG) is an important tool in the presurgical evaluation of patients with medically refractory epilepsy. The appropriate utilization and interpretation of MEG studies can increase the proportion of patients who may be able to further pursue surgical evaluation, refine surgical planning, and potentially increase the probabilit...

Purpose Previous studies show anti-epileptic drug compliance and seizure control in people with epilepsy (PWE) to be lower among low-income groups and African-Americans. We examined how socio-demographic factors influence seizure control in an inner-city population. Methods The clinic records of 193 PWE were analyzed. Good seizure control was defi...

Accumulating experimental and clinical evidence supports the hypothesis that complex regional pain syndrome type I (CRPS-I) may be a small fiber neuropathy. To evaluate the use of commercially available standard biopsy methods to detect intradermal axon pathology in CRPS-I, and to ascertain if these structural changes can explain quantitative senso...

To provide the long-term outcomes of patients treated with fractionated conformal radiotherapy (FCRT) for presumed optic nerve sheath meningiomas (ONSMs). Between 1995 and 2002, 9 patients with a presumed ONSM were treated with FCRT at our institution. The indications for FCRT were significant visual dysfunction at presentation, progression of visu...

Pain associated with complex regional pain syndrome (CRPS) is frequently excruciating and intractable. The use of botulinum toxin for relief of CRPS-associated pain has not been well described. To assess whether intramuscular botulinum toxin injections cause relief of pain caused by CRPS, and to assess the risks of this treatment. Retrospective cha...

Introduction: Patients with Pseudotumor Cerebri Syndrome (PTCS) may complain of difficulty in thinking or concentrating; however there has been little formal cognitive evaluation in this population. Objective: To evaluate the characteristics and nature of cognitive impairment in patients with PTCS. Methods: We retrospectively reviewed records of 10...

Patients with Pseudotumor Cerebri Syndrome (PTCS) may complain of difficulty in thinking or concentrating; however there has been little formal cognitive evaluation in this population. To evaluate the characteristics and nature of cognitive impairment in patients with PTCS. We retrospectively reviewed records of 10 patients diagnosed with PTCS who...

Pain associated with Complex Regional Pain Syndrome (CRPS) is frequently excruciating and intractable. The use of botulinum toxin for relief of CRPS-associated pain has not been well described. To assess whether intramuscular botulinum toxin injections cause relief of pain caused by CRPS, and to assess the risks of this treatment. Retrospective cha...

We assessed clinical outcome and long-term tumor control after fractionated stereotactic radiotherapy (FSRT) for unilateral schwannoma. Between 1995 and 2007, 496 patients were treated with fractionated stereotactic radiotherapy at Johns Hopkins Hospital (Baltimore, MD); 385 patients had radiologic follow-up that met the inclusion criteria. The pri...

Shunt patency studies are performed to determine whether shunt revision surgery is needed in malfunctioned ventriculoperitoneal shunt. The aim of our study was to develop a simple diagnostic algorithm in the diagnostic workup and identify factors associated with improvement after revision surgery. A retrospective review of patients with confirmed s...

The authors report their experience using preoperative chest radiography and intraoperative ultrasonography for percutaneous positioning of the distal end of the catheter when placing ventriculoatrial (VA) shunts in patients with hydrocephalus. The distal portion of VA shunt catheters were percutaneously placed into the internal jugular vein with t...

Intracranial cavernous malformations are vascular anomalies consisting of endothelium-lined caverns filled with blood at various stages of thrombosis and organization and separated by a collagenous stroma devoid of mature vessel wall elements. They occur in an estimated 0.4% to 0.5% of the population, with male and female patients equally affected...

Little is known about the long-term clinical course and management of patients with normal pressure hydrocephalus (NPH) treated by cerebrospinal fluid (CSF) shunting. We retrospectively reviewed records of 55 patients diagnosed with idiopathic NPH (INPH) and treated with CSF shunts, all of whom were followed for more than 3 years after the original...

Gait abnormalities are an early clinical symptom in normal pressure hydrocephalus (NPH), and subjective improvement in gait after temporary removal of CSF is often used to decide to perform shunt surgery. We investigated objective measures to compare gait before and after CSF drainage and shunt surgery. Twenty patients and nine controls were studie...

Cavernous malformations (CMs) are angiographically occult vascular malformation considered as congenital anomalies of the brain. The first comprehensive review by Voigt and Yasargil (1976) provided a good overview of the knowledge of CMs in the 1970s with special references to epidemiology, diagnosis, and clinical findings. Over the past two decade...

Although microsurgical gross total removal remains the treatment of choice in intracranial meningiomas, numerous reports have shown that total resection of cavernous sinus (CS) meningiomas is not always feasible and whenever possible is associated with high morbidity and mortality rate. In other respects, even in series with high rate of gross tota...

The presentation and natural history of untreated, symptomatic intramedullary spinal cavernomas at our institution were analyzed. The objective is to provide additional information regarding the natural history of conservatively managed, symptomatic, intramedullary spinal cord cavernous malformations. The medical records of patients treated in our...

Long-term anticoagulation is often considered a contraindication to shunt surgery for elderly patients with normal pressure hydrocephalus (NPH). However, no studies have investigated this question. We evaluated 25 patients who were taking warfarin for NPH between 2001 and 2004 with a protocol of cerebrospinal fluid (CSF) pressure monitoring and con...

Studies of the cognitive outcome after shunt insertion for treatment of Normal Pressure Hydrocephalus have reported widely mixed results. We prospectively studied performance of 60 patients with Normal Pressure Hydrocephalus on a comprehensive battery of neuropsychological tests before and after shunt surgery to determine which cognitive functions...

Systems I and II have been operated since the last quarterly report for an additional period of 91 days (day 175-266). They received identical feed substrates of diluted wastewater and phosphates. The concentration of the wastewater was approx. 10% (1000 ppM TOC) for a period of 20 days (day 175-195). On day 196 of operation the concentration of ra...

An anaerobic reactor system consisting of two columns in series, containing Raschig rings and granular activated carbon, respectively, has been acclimated to operate on dilute coal gasification wastewater. The system has been successfully operated at loadings of 2.5 kg chemical oxygen demand (COD)/m/sup 3/d resulting in removals as high as 92% COD,...