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Abstract: Carotid artery stenosis (CAS) is a significant cause of stroke, with common risk factors including advanced age, diabetes, coronary artery disease, smoking, and a history of stroke or transient ischemic attack (TIA). An often underrecognized cause is radiation-induced CAS, which can lead to serious complications. While radiotherapy plays a vital role in managing head and neck cancers, it may also damage blood vessels, leading to vascular disease.We report the case of a 71-year-old male with bilateral carotid stenosis secondary to prior radiotherapy, who presented with an acute left cortical infarct. Case Details: The patient arrived with sudden onset of left facial deviation and right-sided weakness, scoring an NIHSS of 8. He had a medical history of hypertension and tongue cancer, treated with chemotherapy and radiotherapy in 2019. MRI revealed an acute infarct in the left cerebral cortex. Cerebral digital subtraction angiography (DSA) showed 70% stenosis of the right internal carotid artery (ICA) and 90% stenosis of the left ICA. As he was outside the window for thrombolysis, conservative management was initiated, followed by left ICA stenting. Post-procedure, he showed good recovery and was discharged on dual antiplatelet therapy and statins. Discussion: Radiation-induced CAS occurs in approximately 25% of patients, with a cumulative 10-year risk exceeding 25%. The incidence varies depending on cancer type, and data specific to tongue carcinoma is limited. A study by Seto K et al., reported only a 4% incidence in tongue cancer patients, underscoring the need for more research. The scarcity of data hampers early diagnosis and preventive care for radiation-associated CAS. Conclusion: Managing radiation-induced CAS is complex due to fibrosis and scarring in the neck region. This case highlights the importance of routine follow-up in patients with a history of head and neck radiotherapy. Carotid Doppler ultrasound may serve as an effective screening tool for early detection.

Mental health defined as the state of emotional, cognitive, psychological, social, and spiritual well-being of individuals. In this sense, older adults, as time goes by, experience situations related to disconnection, abandonment, loss, and, consequently, the disintegration of their social core. Therefore, the objective of this article is to define the importance of mental health in this age group, describing intervention guidelines from a Psychogerontological perspective, with the goal of promoting healthier environments. Finally, the article reflects on the importance of integrating personnel trained in mental health to address the needs of older adults and their families, and to develop strategies for prevention, promotion, and education related to mental health in old age.

Post-Stroke Incomplete Evacuation of Urinary Bladder: Are we Missing Something?

To psychologists, inspiration is a very strong and rapid surge of creativity which pushes a person into original ideas or insights. The study reported in this article was undertaken by Patanjali Yoga Research Centre, Kozhikode, Kerala State, India among a randomly selected sample of 100 yoga practitioners from Kerala State using a questionnaire containing the measure of feeling of inspiration in life, how far yoga practice has contributed to feeling inspired in life, and the characteristics of the yoga practitioners, namely, sex, age, marital status, period of yoga practice (in months), and the effects obtained through yoga practice. Equal interval Likert scale scoring was adopted for the responses to feeling irritated and all the characteristics of the respondents except age, for which the numerical value of the age was considered for analysis. The total inspiration score and the total score for contribution of yoga practice to feeling inspired in life were worked out as the sum of the item scores. The data was analysed as proportion reporting, as scores and through statistical tests. The results show that 60 % of the respondents have total inspiration score in the range of 71.4 to 100 % of the maximum possible score. This is supported by the responses of the yoga practitioners on the level and frequency of experience of various items related to inspiration considered in the study. Statistical significance exists in the difference in total inspiration score based on period of yoga practice. The lowest score is obtained by people who have done yoga for a period of up to 1 year, followed by a comparatively higher score in the case of people having 3 to 4 months of yoga practice and the highest score for those who have practiced yoga for more than 12 months. Statistical significance is observed in the difference in total inspiration score based on the age of the yoga practitioners. Comparatively younger respondents get a higher score than those in the higher age groups. Statistical significance of the difference in total inspiration score of the respondents based on marital status of the yoga practitioners is also evident. Unmarried respondents get a comparatively higher score than those who are married. The results of regression analysis of the characteristics of the respondents on total inspiration score shows that marital status, period of yoga practice, sex, and the effects obtained through yoga practice by the respondents contribute to 62 % of the variation observed in their total inspiration score. Among them, the regression coefficient is significant in the case of the characteristic, namely, the effects obtained through yoga practice. 85 % of the yoga practitioners report 62.5 to 100 % contribution of yoga practice to feeling inspired in life. Feeling inspired in life would help to boost motivation, promote positive coping strategies and foster a sense of purpose, thus improving the psychological wellbeing of the yoga practitioners This could prove useful in reducing their psychological and psychiatric problems also.

Background: Syringomyelia (Syr) is a rare, progressive neurological disorder characterized by the formation of a fluid-filled cavity (syrinx) within the spinal cord, leading to sensory and motor dysfunction. It is challenging to cure, and available treatments often have limited effectiveness. Recurrence is commonly observed after treatment. Objective: This study explores the role of Guan Yin Citta Dharma Door in managing Syr, presenting 2 cases in which Dharma practice led to significant symptom relief. Methods: This study examines two cases of patients diagnosed with Syr who adopted Buddhist practices based on the teachings of Dharma Master Jun Hong Lu. The first patient practiced making vows, reciting Buddhist scriptures, and liberating lives, with progress assessed through symptom relief and overall well-being. In the second case, the patient incorporated Dharma practices to aid recovery following surgery. Results: Through dedicated Dharma practice, the patient in Case 1 experienced significant symptom improvement, reduced pain, and survival beyond the medically expected prognosis. Similarly, in Case 2, Buddhist practices not only supported post-surgical recovery but also alleviated persistent pain and emotional suffering, leading to a profound transformation. These cases underscore the potential benefits of spiritual healing in managing Syr. Conclusion: This study suggests that Guan Yin Citta Dharma Door may provide an alternative approach to improving the quality of life in patients with Syr. While further research is needed, the integration of Dharma practices with conventional treatments may offer a more holistic strategy for managing neurological diseases.

Infectious mononucleosis (IM) or Mononucleosis syndrome is caused by an acute infection of Epstein-Barr virus (EBV). This study was aimed at determining the levels of haemoglobin, total white blood cell (TWBC) count, neutrophils, lymphocytes, monocytes and eosinophils in patients infected with infectious mononucleosis at Federal Teaching Hospital, Owerri. A total of sixty subjects (30 patients and 30 controls) were enrolled in the study after giving their informed consent and completing questionnaires. The procedure was carried out at Federal Teaching Hospital, Owerri. Five millilitres of venous blood sample was collected at the ante-cubital vein aseptically and was dispensed into ethylenediaminetetraacetic acid (EDTA) containers. The EDTA containers were properly labeled with the subject’s name, sample number and date of collection. Haemoglobin was determined using the cyanmethaemoglobin method, TWBC was determined using the improved Neubauer counting chamber, while the differential count was determined using Romanowsky staining method. Data generated were analyzed using SPSS version 27, and mean, standard deviation, t-test, correlation and p-value were determined. The mean values of haemoglobin (8.9±1.44)g/dl and neutrophils (28.53±12.77)%, were significantly reduced in patients with infectious mononucleosis when compared to the controls (12.83±1.34)g/dl and (54.27±10.20 ((p=0.000 and p=0.001)) The mean values of TWBC (17.66±8.54)%, lymphocytes (59.87±13.14)% and monocytes (10.30±6.68)%)% were significantly increased in patients with infectious mononucleosis when compared to the controls (6.17±2.53)%, (49.23±13.57)% and (5.93±2.91)% ) respectively (p=0.000, p=0.003 and p=0.002). There was no significant difference in the mean value of eosinophil count in infectious mononucleosis (1.30±1.56)% (p=0.784) when compared to the controls (1.20±1.24)%. There were no significant differences in the mean values of haemoglobin, TWBC, neutrophil, lymphocyte, monocyte and eosinophil counts in male patients with infectious mononucleosis (9.14±1.52)g/dl, (19.16±9.36)x109/L, (27.69±11.18)%, (59.44±11.17), (10.13±6.12)% and (1.44±1.89)% when compared to the female patients (8.82±1.38)g/dl, (15.94±7.46)x109/L, (29.50±14.38)%, (60.36±15.51)%, (10.50±7.50)% and (1.14±1.09)% (p=0.568, p=0.311, p=0.705, p=0.852, p=0.881 and p=0.614). There was a non-significant positive correlation of haemoglobin with TWBC, neutrophils, lymphocytes, monocytes and eosinophils in infectious mononucleosis patients (r=0.17, p=0.357; r=0.15, p=0.421, r=0.07, p=0.730, r=0.11, p=0.563 and r=0.06, p=0.751). In conclusion, the data in the present study showed that infectious mononucleosis is characterized by increase in lymphocytes and monocytes with decreased levels of haemoglobin and neutrophils. Haemoglobin concentration does not have any relationship with white blood cells in patients with infectious mononucleosis. In the management and treatment of patients with infectious mononucleosis, complete blood count should be incorporated as a routine test, so as to aid in the diagnosis.