Background:Vascular cognitive impairment, being the only treatable cause of dementia in the early stages, and having a diverse etiology, requires sensitive criteria for definition.Aim:This study aimed to study cognitive functions at 3 months post-stroke, utilising the Mini mental scale examination (MMSE) and the Frontal assessment battery (FAB), and to correlate the same with subgroups of ischemic stroke.Results:164 patients were studied, 108 of these having multiple infarcts. Pure cortical infarcts were seen in 41 patients. At 3 months, 112/164 patients had MMSE more than 24, with no frontal executive dysfunction. MMSE score less than 24 was seen in 24 patients, all of them having FAB score below 10. Normal MMSE with impaired FAB was seen in 28 patients.Conclusions:Impairment on either the MMSE or the FAB was thus seen in 31.7% patients (52/164), at 3 months after stroke. FAB impairment alone, with MMSE in normal range, was seen in 28/52 (53.8%) patients. Memory was significantly more commonly affected in muti-infarct strokes as compared to single infarcts. Frontal executive dysfunction was not significantly different when single and multiple infarcts, or cortical and subcortical infarcts, were compared.

Report of a case of young immunocompetent male adult with autopsy proven acanthamoeba meningoencephalitis. The patient presented with a protracted febrile illness of 3 months duration with features of meningoencephalitis, this was followed by rapid deterioration while on anti tuberculous therapy and steroids and ended fatally. His magnetic resonance imaging showed features of hemorrhagic meningoencephalitis and magnetic resonance spectroscopy showed choline peak. Autopsy revealed necrotizing meningoencephalitis and intraocular colonization due to acanthamoeba.

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Sovateltide (Tycamzzi™), a selective endothelin-B receptor agonist, has antiapoptotic activity, protects neural mitochondria, and produces neurogenesis. It showed significant safety and efficacy in preclinical and clinical phase I and II studies. A prospective, multicentric, randomized phase III study was conducted in acute cerebral ischemic stroke (ACIS) patients aged 18 through 78 years. Patients with radiologic confirmation of ischemic stroke could be enrolled if presenting up to 24 hours with NIHSS score of greater than 5. Patients with intracranial hemorrhage and those receiving endovascular therapy were excluded. Sovateltide was administered in three doses, each dose of 0.3 μg/kg, as an intravenous bolus at an interval of 3 hours ± 1 hour on day 1, day 3, and day 6 (total dose/day: 0.9 μg/kg). The primary objectives were to determine the neurological outcome based on the mRS score, NIHSS score, and BI scale score from day 1 through day 90. A total of 158 patients with ACIS were enrolled, of which 137 completed a 90-day follow-up. Patients received saline (n=70, 62% male) or sovateltide (n=67, 66% male) at 16.85 ± 0.74 and 17.40 ± 0.67 hours (mean ± SEM) of stroke onset, respectively. The baseline characteristics and SOC in both cohorts were similar. ASPECTS mean value was similar in the control (7.44) and sovateltide (7.61) groups. A significantly greater number of patients in the sovateltide group had an improvement of mRS of ≥2 points (p=0.004) and NIHSS of ≥6 points (p=0.033) vs. baseline at 90 days of treatment. However, an improvement in BI (change of ≥40 points vs. baseline) missed significance (p=0.063). At 90 days, mRS (p=0.007) and NIHSS (p=0.003) were significantly lower, while BI (p=0.011) and EuroQol-EQ-5D (p=0.0055) were significantly higher in the sovateltide compared to the control group. Sovateltide is safe, well-tolerated, and significantly improved neurological outcomes in ACIS patients and may prove to be a novel, effective agent for its treatment.