Therapeutic Effect of Plasma Exchange in Steroid Refractory Inflammatory Demyelination of Central Nervous System: Outcome from a Tertiary Centre in Malaysia

Nidra is considered as one among the Trayoupasthambha1 which is very essential to lead happy and healthy life. In present era because of stressful lifestyle many people suffering from one or the other psychosomatic illnesses, among that insomnia is the most common health problem which affects the functions of central nervous system and even other systems. Around 9% of general population are suffering from insomnia, around 28% of people suffering from initiation and maintenance of sleep. At present the medical management of insomnia includes different variety of benzodiazepines’ which causes various toxic effect and also drug dependency. For this one can find out the best remedies in Ayurvedic system of medicine, for the treatment of this disease. Saraswatharista2 is one of the best shamana medicine with Bramhi panchanga as main ingredient, having Rasayana effect as well as properties which can cure the diseases like Unmada, Mada, Apasmara as both Shareerika and Manasika vyadhi are inter-related6 . And Jaladhara is very safe, effective, readily available and cost effective without any side effect which mainly having aaswasahara4 and nidrajanana action hence, present clinical trial is planned to compare the therapeutic effect of Saraswatharista and Jaladhara in Nidranasha with special reference to Insomnia is undertaken.

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Acute hyperviscosity: syndromes and management

Blood ◽

10.1182/blood-2018-06-846816 ◽

2018 ◽

Vol 132 (13) ◽

pp. 1379-1385 ◽

Cited By ~ 15

Author(s):

Morie A. Gertz

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Cell Count ◽

Plasma Exchange ◽

Clinical Presentation ◽

Rare Complication ◽

White Cell Count ◽

Red Cell ◽

Asymptomatic Patients ◽

Red Cell Count

Plasma hyperviscosity is a rare complication of both monoclonal and polyclonal disorders associated with elevation of immunoglobulins. Asymptomatic patients with an elevation in the serum viscosity do not require plasma exchange, and the majority will have other indications for therapeutic intervention. For patients with hemorrhagic or central nervous system manifestations, plasma exchange is the therapy of choice and is relatively safe. Viscosity measurements are not required to initiate therapy if the index of suspicion is high and the clinical presentation is typical. However, patients should have a sample sent for confirmation of the diagnosis. Whole-blood hyperviscosity is seen in patients with extreme elevation of the red cell and white cell count. Phlebotomy of patients with primary and secondary elevation of the red cell count is a well-established therapy.

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Beneficial Plasma Exchange Response in Central Nervous System Inflammatory Demyelination

Archives of Neurology ◽

10.1001/archneurol.2011.34 ◽

2011 ◽

Vol 68 (7) ◽

pp. 870 ◽

Cited By ~ 112

Author(s):

Setty M. Magaña

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Plasma Exchange

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Plasma exchange in acute attacks of demyelinating diseases of the central nervous system: clinical outcomes and predictors of response

Neurological Sciences ◽

10.1007/s10072-020-04382-w ◽

2020 ◽

Vol 41 (9) ◽

pp. 2569-2574

Author(s):

Michael A. Palacios-Mendoza ◽

María L. Martínez Ginés ◽

Pedro J. Melgarejo Otálora ◽

Juan P. Cuello ◽

Antonio Sánchez-Soblechero ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Plasma Exchange ◽

Clinical Outcomes ◽

Demyelinating Diseases ◽

Predictors Of Response ◽

The Central Nervous System ◽

Acute Attacks

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Treatment of the bone marrow stromal stem cell supernatant by nasal administration—a new approach to EAE therapy

Stem Cell Research & Therapy ◽

10.1186/s13287-019-1423-6 ◽

2019 ◽

Vol 10 (1) ◽

Cited By ~ 1

Author(s):

Xi Wang ◽

Wantong Zhai ◽

Jiahui Zhu ◽

Wei Zhao ◽

Xiaoyi Zou ◽

...

Keyword(s):

Central Nervous System ◽

Bone Marrow ◽

Nervous System ◽

Therapeutic Effect ◽

Inflammatory Cells ◽

Nasal Administration ◽

Inflammatory Factors ◽

Therapeutic Effects ◽

The Central Nervous System ◽

Functional Features

Abstract Introduction Multiple sclerosis (MS) is one of the most common autoimmune diseases of the central nervous system (CNS). CNS has its own unique structural and functional features, while the lack of precision regulatory element with high specificity as therapeutic targets makes the development of disease treatment in the bottleneck. Recently, the immunomodulation and neuroprotection capabilities of bone marrow stromal stem cells (BMSCs) were shown in experimental autoimmune encephalomyelitis (EAE). However, the administration route and the safety evaluation limit the application of BMSC. In this study, we investigated the therapeutic effect of BMSC supernatant by nasal administration. Methods In the basis of the establishment of the EAE model, the BMSC supernatant were treated by nasal administration. The clinical score and weight were used to determine the therapeutic effect. The demyelination of the spinal cord was detected by LFB staining. ELISA was used to detect the expression of inflammatory factors in serum of peripheral blood. Flow cytometry was performed to detect pro-inflammatory cells in the spleen and draining lymph nodes. Results BMSC supernatant by nasal administration can alleviate B cell-mediated clinical symptoms of EAE, decrease the degree of demyelination, and reduce the inflammatory cells infiltrated into the central nervous system; lessen the antibody titer in peripheral bloods; and significantly lower the expression of inflammatory factors. As a new, non-invasive treatment, there are no differences in the therapeutic effects between BMSC supernatant treated by nasal route and the conventional applications, i.e. intraperitoneal or intravenous injection. Conclusions BMSC supernatant administered via the nasal cavity provide new sights and new ways for the EAE therapy.

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CBS-Induced H2S Generation in Hippocampus Inhibits EA-Induced Analgesia

Evidence-based Complementary and Alternative Medicine ◽

10.1155/2020/5917910 ◽

2020 ◽

Vol 2020 ◽

pp. 1-10

Author(s):

Wen-Jing Ren ◽

Jia Fu ◽

Hai-Yan Yin ◽

Neng-Gui Xu ◽

Chun-Zhi Tang ◽

...

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Hydrogen Sulfide ◽

Therapeutic Effect ◽

Inflammatory Pain ◽

Inflammatory Process ◽

Chronic Inflammatory Pain ◽

Important Mediator ◽

The Central Nervous System ◽

Allosteric Activator

Hydrogen sulfide (H2S) is an important mediator participating in both physiological and pathological systems and related to the inflammatory process. Acupuncture has a therapeutic effect on inflammatory pain. However, whether H2S generated in the central nervous system (CNS) is a mediator of electroacupuncture (EA) treatment for inflammatory pain is unknown. We injected complete Freund’s adjuvant (CFA) to induce inflammatory pain and applied EA treatment as an interventional strategy for pain relief. The results presented here show that S-adenosyl-l-methionine (SAM), an allosteric activator of cystathionine-β-synthetase (CBS), may reverse the therapeutic effect of EA. CBS-induced H2S generation might get involved in the mechanism of EA-induced analgesia in the hippocampus on chronic inflammatory pain.

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Treatment of Pediatric Life Threatening Amitriptilin Intoxication with Plasma Exchange

International Journal of Clinical Case Reports and Reviews ◽

10.31579/2690-4861/143 ◽

2021 ◽

Vol 8 (1) ◽

pp. 01-03

Author(s):

Deniz Karakaya

Keyword(s):

Central Nervous System ◽

Nervous System ◽

Plasma Exchange ◽

Fatal Outcome ◽

Gastric Lavage ◽

Volume Of Distribution ◽

Tricyclic Antidepressant ◽

High Dose ◽

Life Threatening ◽

The Central Nervous System

Tricyclic antidepressant (TCA) overdose is one of the most common causes of serious drug poisoning in children. Amitriptyline is a major TCA drug that is used widely. Tricyclic antidepressant intoxications are very important because of their severe adverse effects and probable fatal outcomes. It may cause cardiovascular, respiratory and neurological side effects. Poisoning results in hypotension, cardiac dysrhythmia, depression of the central nervous system (CNS) and seizures. The most common effects on the central nervous system are agitation, lethargy, seizures, and coma. Cardiovascular toxicities manifest itself especially with electrocardiographic (ECG) abnormalities, arrhythmias, and refractory hypotension and they are the leading cause of fatal outcome. Treatments in TCA overdose are mainly conservative including gastric lavage, activated charcoal and vasopressors for hypotension, sodium bicarbonate for dysrhythmias, and benzodiazepines for seizures. Magnesium sulfate (MgSO4) also has an effective role in the treatment of fatal cardiac arrhythmias occurring in high-dose amitriptyline intoxication. Intravenous lipid emulsions have been increasingly studied as antidotes to reverse acute, life-threatening drug toxicity. Unpredictable and poor results with hemoperfusion (HP) and hemodialysis (HD) should be expected, as the drug binds rapidly to tissues and has a large volume of distribution. But beside it, in the last few years, HP has been successfully used in severe TCA overdose, especially in patients with persistent respiratory, cardiac, and neurologic symptoms. Besides all these, recently, plasma exchange, have been increasingly used. A reduction of plasma levels by 63% after plasmapheresis in TCA poisoning has been reported. Here, we report a successful treatment of plasma exchange 3 year patient with amitriptyline overdose who had arrhythmias and seizures that wasn't respond all to conservative therapies.

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