7^th Global Neurologists Annual Meeting on Neurology and Neuro Surgery August 22-24, 2016 Vienna, Austria

Gajender Singh Ranga , currently working as Director Professor in a tertiary care hospital and medical college in Delhi. I am keenly involved in research in addition to teaching undergraduates and post graduates in Medicine for last 23 years. I passed my MD examination from our country’s apex institute ( All India Institue of Medical Sciences, Delhi) in 1993 . after that I worked as senior resident there only . I joined as Asstt. Professor in my current medical college and hospital, where I have been working for more than last 20 years. Main research work is on novel biomarkers for diagnosis of atherosclerotic diseases including CAD and stroke.I also have work on role of aspirin for treatment of high levels of Lipoprotenin(a). I have written chapters in cardiology book also. I have about 40 published papers to my credit.

Human Carcinoembryonic antigen (CEA) is used as tumour marker worldwide. Striking similarities have been reported between process of tumourigenesis and atherosclerotic diseases. CEA has been reported as a useful biomarker for diagnosis of acute coronary syndrome whose main pathogenesis mechanism is rupture of atherosclerotic plaque. Although, same pathogenic mechanism leads to ischemic stroke but the role of CEA in this condition has not been studied so far. Hence , this study was aimed at evaluating role of CEA as diagnostic marker for atherothrombotic ischemic stroke. The present study included two groups of male subjects - Group A (ischemic stroke) and Group B ( age and sex matched healthy controls). Two ml venous blood sample was withdrawn as early as possible from each individual immediately after presentation to hospital. Serum samples were stored in deep freezer at -80°C for further processing. Quantitave estimation of CEA conc. was done aftervadjustment of confounding factor. The data was subjected to appropriate statistical analysis. CEA conc. were found significantly higher in patients with ischemic stroke (p<0.001). we can conclude that CEA is promising novel biomarker for diagnosis of acute ischemic stroke. It may have special value when CT scan results are falsely negative or where facilities for imaging modalities are not available

Faleha Zafar graduated from King Edward Medical University, Lahore, Pakistan in 2011, did one year house-job in Pakistan Institute of Medical Sciences, Islamabad. After clearing speciality entrance exam , did 2 year residency in Medicine in Federal Government Services Hospital, Islamabad. Currently working as a post graduate resident in neurology/acute stroke care in Shifa International Hospital, Islamabad.

Background and Purpose: The purpose of this study was to determine the frequency of ischemic stroke subtypes based on TOAST classification in a tertiary care center in Islamabad and quantify them according to age, Gender and risk factors. Methods: A cross sectional study was conducted in Stroke unit of Shifa international hospital, Islamabad. We included 145 patients who presented to us from Nov 2015 to Feb 2016 with neurological deficits consistent with ischemic stroke and were confirmed radiologically. The cause of ischemic stroke was classified according to TOAST criteria. Results: Among the 145 patients diagnosed with Ischemic stroke, mean age was 65+- 14 years. Majority were males (54.1%). Hypertension (62.3%) was the most common risk factor followed by dyslipidemia (44.6%), Diabetes (32.2%), smoking (16.8%) and atrial fibrillation (10.4%). Cardio-embolic (40%) was the most common subtype followed by undetermined etiology (26.89%), small vessel disease (17.24%), large vessel in (13.79 %)and stroke of other etiology ( 2.06%.) Among Cardio-embolic stroke, atrial fibrillation was found in 41 %,left atrial turbulence in 27%,and rest of the cardio-embolic causes accounted for 32 % Conclusion: Our study concludes that cardio-embolic stroke is the most common cause of acute ischemic strokes in our stroke unit, our results are different from other studies found in literature, where small-vessel disease with lacunar infarcts were found to be most common causes of ischemic stroke in Asian population including Pakistan. Atrial fibrillation is found to be the most common cause of Cardioembolic stroke

C Wenger received her degrees, Dr.sci. and M.Sc., from the Faculty of Mathematics of the Technical Univeristy of Vienna in 2012 and 2008 respectively. She is currently working as a postdoctoral researcher at the Institute of Biophysics and Biomedical Engineering at the University of Lisbon. With her reserach group, she publishes pioneering computational studies on the modeling of TTFields. Realistic human head models are used to study treatment efficacy in patients and single cell models are employed to examine mechanisms of action of TTFields. She is a full member of the Society for Neurooncology

Tumor Treating Fields (TTFields) are a physical modality for treating solid tumors. TTFields are approved for the treatment of glioblastoma multiforme (GBM), the most common and agressive brain tumor in humans. TTFields are alternating electric fields in the intermediate frequency range (100-300 kHz) with low intensities (1-3 V/cm), that are applied non-invasively via capacitively coupled transducers placed directly on the skin close to the tumor. TTFields exert an anti-mitotic effect on cells. This effect is frequency-dependent with the maximal effect achieved at different frequencies for different cell lines. Arrest of proliferation also increases with increasing field intensity leading to complete arrest for glioma cells at 2.25 V/cm. TTFields exert their antimitotic effect by disrupting the formation of the mitotic spindle. Preclinical studies show that treatment efficacy is related to the field intensity and field direction, which are not easily measured in patients. Therefore computational models are a valuable tool for understanding how TTFields distribute within the body. These computational models are based on physical phantoms derived from MRI data that are segmented into heterogenous tissue types with distinctive dielectric properties which influence the electric field distribution. Also anisotropy in the tissues can be accounted for by processing a Diffusion Tensor Imaging dataset. These models can be used to perform retrospective analysis of reported treatment outcomes, but also prospectively for personalized treatment planing and investigating alternative transducer array placements.

Shokouhi has completed her PhD at the age of 32 years from Stony Brook University and postdoctoral studies from Vanderbilt University Medical Center. She is an Assistant Professor of Radiology and Radiological Sciences at Vanderbilt University Institute of Imaging Science. She has published more than 19 papers in Nuclear Medicine (PET/ SPECT) instrumentation, data acquisition and image reconstruction and analysis. Her recent research has been focused on PET imaging methods for applications in Alzheimer’s disease

T2-weighted magnetic resonance images (MRI) can display cerebral white matter intensity changes, which are common in elderly subjects and linked to vascular diseases. Few studies have investigated the spatial and temporal associations between the white matter intensity distribution and the retention of amyloid-PET radiotracers Florbetapir and PiB. In this study, we explore these correlations using data from Alzheimer’s disease neuroimaging initiative (ADNI). One of the main objectives is to determine whether the selection of the radiotracer can alter these associations. Methods: For both PET data, we used images with minimum amount of smoothing in order to preserve spatial clusters in images and to determine whether white matter T2 voxel intensity values in the vicinity of high activity clusters in amyloid PET images are different than other areas. These localized spatial correlations were explored by utilizing a new image analysis approach that is based on a randomized sampling of voxel pairs between the two modalities. Results: While in several subjects we observed a slight T2 increase in areas close to the high activity PET clusters, there were some regional and inter-subject variabilities, which could be due to regional differences in amyloid clearance mechanism or the presence of cerebral amyloid angiopathy. However, further studies are required to verify these hypotheses. Conclusion: This study provides new imaging-based methodologies to investigate the presence of subtle within-subject spatial associations between amyloid PET radiotracer retention and its surrounding white matter in Alzheimer’s disease.

Background and Purpose: The purpose of this study was to determine the frequency of ischemic stroke subtypes based on TOAST classification in a tertiary care center in Islamabad and quantify them according to age, Gender and risk factors. Methods: We identified 145 patients who presented to Shifa international Hospital, Islamabad from Nov 2015 to Feb 2016 with neurological deficits consistent with ischemic stroke and were confirmed by CT and MRI. The cause of ischemic stroke was classified according to TOAST criteria. Results: A cross sectional study was conducted in Stroke unit of SIH. 145 patients diagnosed with Ischemic stroke were included. Mean age was 65+- 14 years. Majority were males (54.1%).Hypertension (62.3%) was the most common risk factor followed by dyslipidemia (44.6%), Diabetes (32.2%), smoking (16.8%) and atrial fibrillation (10.4%). Cardio-embolic (40%) was the most common subtype followed by stroke of undetermined etiology (26.89%),small vessel disease( 17.24% ), large vessel disease ( 13.79% ) and stroke of other etiology was found in 2.06%. In Cardioembolic stroke, atrial fibrillation was found in 41 %,left atrial turbulence in 27%,hypokinetic left ventricular segment in 20 %,chronic heart failure in 18.6 %,left atrial thrombus 6.9%, mitral stenosis plus atrial fibrillation 4.6%, rheumatic heart disease 4.6 %, DCMP, infective endocarditis, mitral stenosis without atrial fibrillation, mitral annular calcification, recent MI each accounted for 2.3 % Conclusion: Our study concludes that cardio-embolic stroke is the most common cause of acute ischemic strokes in our stroke unit, and our results are also supported by Western literature. Hypertension Diabetes Mellitus and dyslipidemia were the most common risk factors. Atrial fibrillation is the most common cause of Cardioembolic stroke.

Maryam Noroozian is currently a Professor of Neurology at Tehran University of Medical Sciences (TUMS). She completed her degree as a neurologist at TUMS and sabbatical at New York University (Aging and Dementia Research Center). She is the founder and director of the first Memory and Behavioral Neurology Division in Iran and the chief of the first geriatric medicine department in Iran. She has published more than 61 papers in reputed journals. Moreover she has been candidate for the WHO Prize for Research in Health Promotion from Iran in 2015 because of her endovours and persistance in development and advocacy for eldelry population mental health and dementia.

For nearly one decade there has been an unchallenged dogma about the potential of change in the brain. It was believed that brain has a fixed structure and function because of no neuronal appearance after the birth. Moreover early on it was assumed that animals had different brain maps due to genetic background without any role for lifetime experience. Even though the brain had been previously proved to be an inflexible and unchangeable organism, further studies showed evidences against this point of view. Hence there are many studies which have shown that the brain can rewire itself. Neuroplasticity refers to a broad entity for any adaptive changes in structure or function of the nervous system during development, recovery from injury, and aging. The term gained prominence in the latter half of the 20th century when researchers showed many aspects of the brain remain changeable or plastic even into adulthood. This notion contrasts with the previous scientific consensus that the brain develops during a critical period in early childhood then remains relatively unchangeable or static afterward. The first evidence was down by Kass and Merzenikh who showed that if one finger of owl monkey was denervated, the related of the cortex would be remapped by the other fingers. In addition, the earliest evidence about the appearance of new neurons in the hippocampus was found in 1962. Eventually several crucial studies showed neurogenesis in the song areas of bird brains, neurogenesis in the brain of rats and primates hippocampus, discovery of stem cells that could go on to become new. The important finding that new neurons could incorporate themselves into the functional architecture of the brain proved the concept of Neuroplasticity and Neurogenesis. At first it was assumed that neuroplasticity can occur just in the young brain because of remarkable potential of kids’ brain to tolerate the burden of CNS lesions. Cross Model Neuroplasticity Cross Model Neuroplasticity is integration of the functions of two or more sensory systems in the brain due to the adaptive reorganization of neurons. This type of reorganization of the neural network occurs, following the damage of the brain at an early age, or long term sensory deprivation. Neville study on deaf people showed that they had better peripheral vision than normal subjects, larger area of visual cortex associated with motion and more activity in the areas associated with different sensory inputs indicating the first proof of brain change in the patients with deafness because of showing the potential of to be changed over to doing peripheral vision and motion. She found similar results in a study on blind people which showed better hearing function in the peripheral “sounds” that could stimulate “visual cortex”. Using brain PET Scan Sadato showed that visual cortex is activated when a blind person is activated during reading Braille and this phenomenon happens just when a person loses the sight early on. It is also shown that blind people have improved recall of words just when the visual cortex is activated. Moreover it has been shown that visual cortex in the blind people is able to be active in a language task such as making a verb after listening to a noun while this does not happen in a sighted person. Determining the neuronal mechanisms behind this type of cross-modal plasticity is an important basis for understanding brain development and the impact on recovery from brain damage. One possibility, called the reorganization hypothesis, is that the reorganization of the deprived brain leads to the establishment of new mediating pathways. The second possibility, the unmasking hypothesis, is that damage induces unmasking and strengthening of existing neuronal connections. It should be emphasized that the key part of neuroplasticity is attention. It requires enough mental effort and practice. So more effort is needed when an adult decides to learn a new skill compared to a younger person. Conclusion: it seems brain specialization is not a just a function of anatomy or dictated be genes. It is a result of experience and re-experience. It should be emphasized on the role of motivation, attention and practice and also enjoy. Neuroplasticity is a reality. The brain can change itself. Although our capacity for changing the brain is limited by aging it is not lost. Genetic control is not tight as some has assumed. The impact of neuroplasticity phenomenon can modify the current concept of rehabilitation programs not only in the patients with traumatic brain injuries in neurosurgery but can alter the disappointing horizon of therapeutic approach in the degenerative neurological disorders which seem to be frustrating.

Deepinder has completed her MD from Punjab University. She is the head of department of Microbiology at Dayanand Medical College and Hospital and has published more than 80 papers in reputed journals. She has been the editor of the Journal of gastrointestinal infections (India) from 2011-2014 and is the General secretary of “Gastrointestinal infection society of India” from year 2015.

Cryptococcal meningitis is an opportunistic infection usually seen in immuno-compromised patients, but is also known to affect apparently healthy individuals.Cryptococcal meningitis is a disease with significant morbidity and mortality. Worldwide, approximately 1 million new cases of cryptococcal meningitis occur each year, resulting in 625,000 deaths. This study was undertaken to assess the profile of patients with cryptococcal meningitis in a tertiary care center of north India. Cerebrospinal fluid (CSF) samples from 5716 meningitis patients (from Jan 2007 - Dec 2015) were tested by India ink preparation / antigen detection by latex agglutination test (LAT) / culture. A total of 127(2.2%) patients were positive by one or more tests for Cryptococcus neoformans. Comorbidities associated with the disease were - HIV, diabetes mellitus, renal transplantation, etc. Fever and headache were the most common clinical features. Comparison of Cryptococcal antigen and india ink was done with culture for a period of 6 months and 55.6% of the samples positive by LAT showed growth of Cryptococcus on culture. Diagnostic methods such as culture and India ink are specific but less sensitive. Antigen detection by latex agglutination proved to be both sensitive and specific method for the diagnosis of cryptococcal meningitis. Early diagnosis of infection by detection of cryptococcal antigen by latex agglutination may alter the prognosis of these patients.

Background: Needle electromyography (EMG) examination is not crucial in establishing a diagnosis of carpal tunnel syndrome(CTS). However, the presence of axonal loss in needle EMG helps clinicians determine a treatment strategy such as surgery. Aim of the work: Is to investigate if needle EMG in CTS patients is essentially needed or could be predicted by other nerve conductionstudy (NCS) parameters. Methods and Material: This study included 100 patients with clinical and NCS proven CTS, as well as 50, age and sex matched,control subjects. All subjects were evaluated using electrodiagnostic techniques, including median distal latency (DL), compoundmuscle action potential (CMAP), forearm motor nerve conduction velocity (FMCV), median peak latency (PL), sensory nerve action potentials (SNAP), and sensory nerve conduction velocity (SNCV). All CTS patients underwent EMG examination of the abductor pollicis brevis (APB) muscle, and the presence or absence of spontaneous EMG activity was recorded. Results: Comparison of the NCS parameters between CTS patients with and without spontaneous EMG activity revealed that the main determinant parameters for spontaneous activity were CMAPs, SNAPs and FMCVs. However, logistic regression analysis showed that CMAP was the most powerful predictor of the presence of spontaneous activity (p=0.000, Odds ratio=12.154). Conclusions: It can be concluded that median nerve CMAP amplitudes are the most powerful predictor of the occurrence of spontaneous EMG activity. However EMG examination is still valuable in some CTS patients and NCS cannot completely replace needle EMG examination in these patients. Key-words: Carpal tunnel syndrome, needle electromyography, spontaneous activity. Key Messages: Despite that CMAP amplitudes are the most powerful predictor of the presence of spontaneous EMG activity in CTS patients, EMG examination is still needed in some CTS patients and NCS cannot completely replace EMG examination in these patients.

Sue Xue Ming, MD, PhD, is a pediatric neurologist and pharmacologist. She has been working with children with autism spectrum disorders for more than 18 years at New Jersey Medical School, Newark, NJ, where she is currently Professor of Neurosciences and Neurology. She received a medical degree from Fudan Medical University, and a PhD in pharmacology at New Jersey Medical School. She completed pediatric training at SUNY-Health Science Center, Syracuse, NY and pediatric neurology fellowship at Johns Hopkins School of Medicine

Autism is a neurodevelopmental disorder characterized by social impairment, language delay, repetitive behaviors and restricted interests. Some children with autism spectrum disorder (ASD) fail to gain language or social skills (non-regressive) while other children develop normally and then lose skills (regressive). Our study differentiated risk factors and comorbidities associated with regressive and non-regressive children with ASD. We determined whether children with regressive ASD were more likely to experience social or language regression or a combination of skills. From 1044 self/parental report surveys, we gathered information regarding prenatal and perinatal conditions, family and developmental history including information on regression, medical disorders, current developmental skills and treatment history. Subjects were categorized as follows: no skill regression, 1-2 skills lost, 3-5 skills lost. Chisquare analysis was performed on risk factors/comorbidities in relation to both forms of ASD. Our cohort reported a 22% regression rate. Subjects who regressed in 1-2 areas were more likely to lose social (vs language) skills than those who regressed in many (3-5) areas. Epilepsy was the only factor associated with regressive ASD. No factors were associated with non-regressive ASD. Studies have attempted to characterize ASD, but are often limited by sample size or design (self-report vs clinical verification). Though we utilized a self-report survey, limitations may have been mitigated by the large sample size. In our cohort, regression of social skills was more prevalent in children with less severe regression while loss of language was reported in children with more pervasive regression, epilepsy predisposed regression.

T-F Li has completed his PhD at the age of 29 years from Zheng zhou University. He is an expert in interventional neuradiology. He has published more than 10 papersin reputed journals.

Treatment of symptomatic basilar artery stenosis with ballon expandable Apollo stent: Purpose To observe the safety and effectiveness of ballon expandable Apollo stent for the treatmen of symptomatic basilar artery stenosis of symptomatic basilar artery stenosis. Materials and Methods 52 patients with symptomatic basilar artery stenosis(all>70%) were treated with Applo stent. The mean time of clinical follow-up was 19 months.Clinical evaluation was performed based on the modified Rankin Scale(mRS). Results The stent placement was technically successful in all 52 patients.Clinical symptoms were improved in 42 patients after stenting were ≤2,while of 10 patients were>2. Conclusion Balloon expandable Apollo stent placement is a safe and efficacious alternative for the treatment of symptomatic basilar stenosis.

Takayuki Matsuo, M.D.,Ph.D. Department of Neurosurgery, Nagasaki University School of Medicine . Japan

The transphenoidal approach has been utilized in intrasellar craniopharyngioma surgeries. However, the advent of endoscopic extended transsphenoidal approach (EETSA) has expanded its indication to suprasellar craniopharyngiomas. We compared the indication and limitations of EETSA to those of unilateral basal interhemispheric approach (UBIHA), which presents similar indications for surgery. We analyzed 30 patients with tumors located below the foramen of Monro and the lateral boundary extending slightly beyond the internal carotid artery (UBIHA: N = 18; EETSA: N = 12). Postoperative MRI revealed gross total resection in 10 patients in the EETSA group (83.3%) and 12 in the UBIHA group (66.7%). Postoperative MRI in the EETSA group revealed residual tumor at the cavernous sinus in one patient ,at the prepontine in one; in the UBIHA group, residual tumors were located in the retrochiasmatic area in two patients, infundibulum-hypothalamus in one, on the stalk in one, and in the intrasellar region in two. No intergroup differences were observed in the preservation of pituitary function and postoperative improvement of visual function. The extent of resection was better with EETSA than with UBIHA. EETSA is considered the first-line therapy because the distance between the optic chiasm and the superior border of the pituitary is large; the lateral extension does not go beyond the internal carotid artery; and the tumor does not extend inferiorly beyond the posterior clinoid process. However, in patients showing poorly developed sphenoid sinuses or pituitary stalks anterior to the tumor, surgery is difficult regardless of the selection criteria.

Over preliminary avocation to (virtual) experimentation upon the feasibility of regional or overall transmission of Human Brain’s Electromagnetic waves – as an EEG Signal configuration – to another Person’s Cerebral cortex, But: REMOTELY – like a modulated Signal of compatible Frequency Magnitude, without implement mediation e.g. microchip, cerebral implants or skull electrodes – IN OPEN AIR and ON ANY GPS PARAMETER. Meaning Emission Interaction from Brain to Brain (B-B Interface) means Radio Antennas sensors and Satellite mediated procedures. Primary schedule runs as: EEGgraphic waves properly detected, through specific sensitive appliances are gathered to be Transmitted TO OTHER Participant’s Brain. It follows a with detectable Phase Difference Elaboration of those EEGgraphic Signals because these are compatible with Human Brain’s Electrophysiology. Here Not a PC but Cortex is the Decoding matter. Effects are impressive and constitute COGNITIVE COMMUNICATION of other’s Cerebral functions Thoughts included resulting in Comprehension of them as a copied Speech Analogon–Parallele, coinciding technically to the long spoken concept of Telepathy. That goes back even to the very early origination of Mental Constructions’ that is to Thought and Intangible (sensed) Images΄ making of. Furthermore this Brain to Brain Transmittal comprises not only cognitive but also Sensory interpretations. The quality of Perception and Interaction from person to person coincides with Reality in some fields while simultaneously and at any moment Intangible sensory and cognitive Images – Noetic forms Gestalt - are realized bilaterally: Psychesthetism**Essence in perception and comprehension At all time Speech interaction simulates open space conversation

Ji Ma has completed his PhD at the age of 31 years from Zhengzhou University. He is the director of XXXX, a premier Bio-Soft service organization. He has published more than 20 papers in reputed journals and has been serving as an editorial board member of repute.

Purpose: To present the clinical outcomes of National Institutes of Health Stroke Scale (NIHSS) and visual analog scale (VAS) response after patients treated for cerebral venous sinus thrombosis with endovascular mechanical thrombectomy compared to patients treated with anticoagulation (control). Materials: 42 patients were diagnosed as cerebral venous sinus thrombosis by clinical MRI, and MRV examination. They were divided into anticoagulation therapy group (group A, n=22) and mechanical thrombectomy group (group B, n=20). Heparin 100 mg/24h was infused intravenously during the first 3 days, and after that warfarin was administered orally for half a year in patients of group A; Mechanical thrombectomy with stents were performed and anticoagulant therapy was continued for 6 months in patients of group B. The present symptom (headache) of the patients was scored by VAS at the different time points before and 3 days, 3, 6 and 12 months after the treatment. The neurological function of the patients at the different time points before and after the treatment were evaluated by NIHSS. Results: The VAS scores was 6.4±1.7 three days after the treatment in group A, and it was 3.2±1.2 in group B; the VAS score was 4.2±1.1 three months after the treatment in group A, and it was 2.0±1.3 in group B. There were significant differences between the two groups (P<0.05).②The NIHSS scores were 14.8±2.1, 10.2±1.3, 9.7±1.8, and 7.1±1.2 respectively at3 day, 3, 6, and 12 months after the treatment in group A, and they were 9.0±0.6, 7.1±1.4, 5.9±2.1, and 5.3±2.2 in group B. There were significant differences between the two groups at the same time point (P<0.05). Conclusions: There was a significantly better improving and neurological function in patients treat with endovascular mechanical thrombectomy compared to controls.

Background: Increased plasma D-dimer levels have been correlated with adverse outcomes in various clinical conditions. The prognostic value of D-dimer in acute ischemic stroke is limited and remains controversial. The objective of the study was to evaluate the predictive value of plasma D-dimer at admission on short-term functional outcome after acute ischemic stroke. Methods: We measured fasting plasma D-dimer in consecutive 290 patients (61.7% men, mean age 67.0±12.3 years) within 3 days after the onset of acute ischemic stroke. Plasma D-dimer levels were detected within 24 hours of admission. Outcomes were measured by the modified Rankin Scale (mRS) at 3-months after stroke onset. A good functional outcome was defined as a mRS of 0-2 points, whereas a poor outcome was defined as a mRS of >2 points. Results: The frequency of woman, atrial fibrillation, hypertension, diabetes and involvement of insular cortex, age, and the level of plasma high sensitive C-reactive protein (hs-CRP) and D-dimer were each significantly higher in the poor outcome group (p<0.05). The level of albumin, heart rate and the estimated glomerular filtration rate in the poor outcome group were significantly lower than that in the good outcome group (p<0.05). In age- and plasma creatinine-adjusted analysis, plasma D-dimer levels were positively correlated with NIHSS scores (partial r=0.181, p<0.01) and mRS (partial r=0.257, p<0.001). The cut-off value of D-dimer level for prediction of the poor outcome was 0.35 μg/ml (sensitivity 0.70, specificity 0.63, AUC 0.71). Multivariate logistic regression analysis demonstrated that age (OR, 1.11 for every 1 year; 95% CI, 1.05- 1.16, p<0.001), the presence of DM (OR, 2.51; 95% CI, 1.11-5.66, p<0.05), hs-CRP (OR, 1.16 for every 1.0 mg/dl; 95% CI, 1.01- 1.34,p<0.05), D-dimer (OR, 1.24 for every 1.0 μg/ml; 95% CI, 1.04-1.49, p<0.05), and the involvement of the insular cortex (OR, 3.16; 95% CI, 1.22-8.16, p<0.05) were independently associated with poor functional outcome. Conclusions: Plasma D-dimer is a useful marker for short-term outcome in acute ischemic stroke. D-dimer may have a role in risk stratification for predicting poor outcome.

Anthony Juliano is currently in his predoctoral internship in Clinical Neuropsychology through Chestnut Hill College Internship Consortium in Pennsylvania. He has worked as an affiliate researcher for three years at the University of Illinois: Chicago’s Medical School, Department of Psychiatry. There, he has worked on several structural, functional, and neurochemical imaging studies under the direction of his research mentors.

Pediatric Bipolar Disorder (PBD) is a debilitating psychiatric disorder which has been found to have neurofunctional activation differences with regard to emotional memory compared to healthy controls (HC). To date, there appears to be no research on paired associate memory that involves negative affective stimuli (with in scanner encoding and retrieval phases) to evaluate the activation variability in PBD patients with regard to emotional memory. This study used a novel paired associate learning fMRI task to assess emotional memory in 10 PBD patients in order to compare their performance to 10 HCs that were matched on several demographic and clinical variables. Compared to HCs, participants with PBD showed decreased activation in the left parahippocampus, right supramarginal gyrus, and the left vermis of the cerebellum during the encoding phase (p < 0.005). Further compared to the HC group, the PBD group showed decreased activation in the right SMG and left MFG in angry vs. neutral conditions (p < 0.01). In the recall phase, PBD participants showed increased activation in the left hippocampus, right DLPFC, and right VMPFC (p < 0.005). The emotional processing contrast of the recall phase showed decreased bilateral insula and right VMPFC activation (p < 0.01). The results from the current study suggest that individuals with PBD, compared to HCs, have demonstrative neurofunctional abnormalities during both the encoding and retrieval phases of the emotional memory task. Specifically, the patients with PBD showed functional impairment when encoding or retrieving associative memory of angry faces paired with neutral objects.

Aim: Recognition of Cardiovascular diseases (CVD) risk factors is an important first step in preventing heart attack and stroke. We aimed to elucidate the level of knowledge about CVD risk factors among the population of United Arab Emirates. Methods: Cross sectional questionnaire based survey which included: 1.Questions on knowledge of CHD & stroke (to be answered by ticking – I knew this/ I didn’t know this). 2.Factors that increase risk of CVD (identifying from a list). Results: Total of 1367 Arab and expatriate population of UAE participated. 35% and 45% knew the definition of CHD and stroke respectively. While majority (84%) identified tobacco smoking as risk, but only half knew the risk of regular exposure to second hand smoke. They identified high blood cholesterol and blood pressure (81%), obesity/overweight (78.7%), stress (73%), unhealthy diet (72.5%), physical inactivity (67%), family history (64.5%), increasing age (47.6%) and being male (26.8%) as factors that increase the risk for CVD. Less knew about high risk in female smokers using oral contraceptives (34.4%) and post-menopausal women (22.6%). Knowledge about Transient Ischemic Attack (TIA) and that “people who had TIA have a high risk of stroke” was less (21.6%). Only 36.8% knew that clot dissolving medicines given within 3-4 hours can significantly reduce the effects of stroke and permanent disability. Conclusion: Knowledge regarding some of the risk factors is high, many areas still need improvement. This information can help in development of programs devoted to public health education.