Use of social media as a tool for antibiotics awareness K Raksha Apollo Medicine 2019 16(3):137-140 Objective: Antimicrobial resistance (AMR) is a global health threat; public perception about AMR is a huge lacuna which many researchers, doctors, and policymakers fail to pay attention to. Infection control is often limited to diagnosis and treatment in hospitals, presentations, and panel discussions. On the other side of the fence, usage of social media to spread information about health care is a common practice among the public today. Twitter is one such online platform.Materials and Methods: This was a cross-sectional tweet-based poll titled “antibiotic awareness survey” for 7 days with five simple yet pertinent questions asked to the participants in the Twitter poll and also to retweet (RT) the questions to their followers. The questions were designed keeping in mind the limitation of tweets on the timeline and the necessity of addressal to the issue among the random group. Results: Seventy-two percent responded saying they procure antibiotics based on doctor's prescription. The most common reason to stop antibiotics for 35% of the participants was symptomatic relief and the perception that it is okay to stop, but 56% said they always complete the course. 52% of the participants said that the treating doctor does not explain to them about the antibiotics while prescribing, but 81% said that the doctor advises them on completing the course. 75% of the participants said that antibiotics are in danger and require regulation, 22% said maybe to an extent. Conclusion: Social media plays a critical role in dissemination of AMR-related information; the unrestricted and unregulated access to knowledge shapes the views and opinions of society. The perception and practices were thus reflected through this weeklong discourse about antibiotics on Twitter, and we doctors of today have a responsible role to play.

The puzzle of spontaneous versus traumatic subarachnoid hemorrhage Ezequiel García-Ballestas, Yeider Durango-Espinosa, Romario Mendoza-Flórez, Luis Rafael Moscote-Salazar, Ravish Keni, Harsh Deora, Amit Agrawal Apollo Medicine 2019 16(3):141-147 Subarachnoid hemorrhage (SAH) is a neurological emergency occurring frequently and has significant morbidity and mortality. Etiological classification divides it into traumatic and nontraumatic or spontaneous. Even though it has been referred that these are almost the same pathology, there is a slight difference between them regarding several aspects, such as epidemiological, pathophysiological, clinical, and diagnostic approach and treatment. These differences deserve detailed understanding to help physicians treat this disease more efficiently. We reviewed all available literature regarding these two types of SAH and tried to elicit differences between them with respect to etiology and treatment. The differences were made keeping in mind the utility of the same to a general physician so that rapid and informed decisions can be made at that level. Pathophysiological differentiation of these two diseases is of paramount importance, and etiological diagnosis determines prognosis. Knowledge of the same is essential and lifesaving.

Neurological uses of cannabis Pushpendra Nath Renjen, Dinesh Mohan Chaudhari, Anjali Mishra, Abhas Kumar Apollo Medicine 2019 16(3):148-151 Cannabis preparations have been used as medications since the 19th century in Europe and much longer as a traditional medicine in other cultures. The American Academy of Neurology recently published a position statement and concluded that medical marijuana is “probably effective” for some symptoms of multiple sclerosis (spasticity, central pain, painful spasms, and urinary dysfunction), “probably ineffective” for levodopa-induced dyskinesias of Parkinson's disease, and of “unknown efficacy” in nonchorea symptoms of Huntington's disease. This article is focused on review of the medicinal use of cannabis in neurological disorders.

Prevent falls in older adults OP Sharma, Raju Vaishya Apollo Medicine 2019 16(3):152-156 Falls are common in the elderly and may lead to serious injuries. Recurrent falls are also frequent and are responsible for significant morbidity and mortality in older adults. The most serious injuries due to these falls are head injury and the fractures. The effect of a fall on an older person can be a devastating event, resulting in chronic pain, loss of independence, and reduced quality of life. Hence, the prevention of fall is better than the treatment of the injuries resulting from it.

Edaravone: A new hope for patients with amyotrophic lateral sclerosis Shivangi Garg, Dinesh Chaudhari, Pushpendra Nath Renjen, Anjali Mishra, Abhas Kumar, Rajendra Pradhan Apollo Medicine 2019 16(3):157-160 Although the exact pathophysiology of amyotrophic lateral sclerosis (ALS) remains unclear, oxidative stress is known to play a pivotal role. There is no cure for ALS, but there are two drugs available to slow the progression of the disease. Till recently, riluzole, a glutamatergic neurotransmission inhibitor, was the only drug approved for ALS. However, in May 2017, edaravone, which is a potent-free radical scavenger, was also approved by the Food and Drug Administration for the treatment of ALS. In this article, the mechanism of action of edaravone and clinical trials establishing its efficacy are reviewed.

Supratentorial ependymoma: A rare presentation in an adolescent Dilip Rajasekharan, Kanjithanda Subbaiah Bopaiah, Aumir Moin, Jayanth Bannur Nagaraja Apollo Medicine 2019 16(3):161-163 Ependymomas are rare primary glial tumors that arise from ependymal cells found in the central nervous system. While usually intracranial, they rarely arise from the supratentorial parenchyma. They have a variable clinical course and are aggressive in nature. Among the important prognostic factors include tumor location, histology, and extent of resection. Total surgical excision is the rule. Diagnosis is confirmed by histopathology. Suspicion of an ependymoma must, however, be borne in mind while dealing with a supratentorial space-occupying lesion.

Gall stone ileus with cholecystoduodenal fistula Elangkumaran Vellode Manoharan, P Kanakarajan, G Ramkumar, E Selvakumar Apollo Medicine 2019 16(3):164-166 Gallstone ileus and cholecystoduodenal fistula are rare and life-threatening conditions which are due to cholelithiasis and recurrent attacks of cholecystitis. It predominantly affects female population. The signs and symptoms are non-specific, sometimes only established during surgery. Prompt surgical management would avoid the complications and reduce the hospital stay.

Pediatric ileocolic intussusception Reddy Ravikanth Apollo Medicine 2019 16(3):167-170 Intussusception occurs when a more proximal portion of the bowel invaginates into more distal bowel. These patients often present with a wide range of nonspecific symptoms, with <1 quarter presenting with the classic triad of vomiting, abdominal pain, and bloody stools. Thus, the diagnosis continues to rely on clinical suspicion. Intussusception is the most common cause of small bowel obstruction in young infants. Therefore, a high index of suspicion and thorough knowledge of this condition is of major importance to be able to diagnose and treat this potentially life-threatening condition. Surgical intervention in intussusception can be prevented by nonoperative reduction, especially if presented early with no signs of peritonitis. Timely nonoperative reduction can prevent surgical intervention and complications. Here, we present a case of an 18-month-old infant who presented with ileocolic intussusception.