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This study focuses on the safety part of the passing manoeuvre. Passing is considered as one of the most complex, unavoidable and challenging manoeuvres on two lane roads. A binary logistic regression model was developed to determine the probability of passing or aborting based on field data. The result shows that the probability of passing is affected by the factors such as speed of passing vehicle, speed of overtaken vehicle, speed of opposing vehicle, clearance time, and the total passing time. Risk assessment is an important aspect which should be addressed while assessing the passing operations. In the present study, a risk chart was developed based on clearance time and vehicle interaction. An overall risk table was developed for all possible combinations of risk. The study revealed that the selected road stretch along NH-66 in Kerala, India is more susceptible to passing crashes due to insufficient clearance time. This paper brings out a rational methodology for calculating a safety measure in terms of risk index factor which could be used in simulation softwares for adequate passing sight distance operational analysis. [ABSTRACT FROM AUTHOR]

Objective: No guideline currently exists to choose the clinically equivalent dose of divalproex extended release (ER) formulation while switching over from valproate chrono formulation. To address this issue, we evaluated the serum valproate concentration following switch over from valproate chrono to divalproex ER in persons with epilepsy. Materials and Methods: An open label study was conducted in two parts, each for a period of two months. During Part I, patients on regular twice-daily dose of valproate chrono were switched over to once daily divalproex ER (DESVAL ER ® ) based on the dose escalation recommended when switching over from divalproex DR to ER formulation as the guideline. During Part II, we switched from valproate chrono to divalproex ER with same dosage. Serum valproate concentration, seizure frequency and side effects were assessed serially for two months after changeover and compared with the preswitch data. Results: During Part I, compared to the baseline level, there was a significant increase in mean serum valproate level at two months (67.0 ± 28.4 mg/ml versus 91.9 ± 3.5 mg/ml, P 0.004). With the same dose conversion during Part II, the mean valproate level did not significantly differ before and after the switch (81.5 mg/dl versus 85.7 mg/dl, P 0.08). The mean monthly seizure frequencies and serum ammonia levels did not change during either part. No significant adverse effects occurred. Conclusion: The results of this open label study with small number of patients need to be replicated among larger patient sample through a randomized control design before recommending same dose conversion from valproate chrono to divalproex ER without change in efficacy and tolerability,

Byline: R. Ashalatha, A. Moosa, A. Gupta, S. Krishna Manohar, S. Sandhyamani Atrial myxomas are the most common primary tumors of the heart. Neurologic involvement usually occurs as a stroke [...]

Byline: Firosh. Khan, R. Ashalatha A 65-year-old man presented with progressive symmetric, akinetic rigid syndrome with postural tremors and postural instability of one-year duration. He also had marked apathy and [...]

Byline: R. Ashalatha, A. Kishore, C. Sarada, M. Nair Satoyoshi syndrome (Komuragaeri disease) is a rare disorder of presumed autoimmune etiology, characterized by painful muscle spasms, alopecia, diarrhea, endocrinopathy with [...]

Sir, I read with interest a case report of Satoyoshi syndrome by Ashalatha et al. (1) The similarity with a 'jerking stiff-man syndrome'--a variant of stiff-man syndrome (SMS) is striking. [...]

Presents a letter to the editor commenting on an article published in the periodical "Neurology India," concerning Satoyoshi syndrome.

Purpose: The success of epilepsy surgery lies in identifying the ictal onset zone accurately. The significance of auras has little been explored on surgical outcome in drug-resistant epilepsy. This study focuses on the clinicopathological correlation of aura(s) and its role in predicting surgical outcome in drug-resistant temporal lobe epilepsy (TLE). We compared surgical outcome in TLE between patients with and without aura and identified the clinico-pathological, radiological and surgical differences between the two groups., Methods: Consecutive patients who underwent presurgical evaluation from January 2009 to December 2014 for drug-resistant TLE who underwent anterior temporal lobectomy (ATL) were included. Patients were followed up at 3months, 12 months and then annually., Results: Among 456 patients, 344(75%) had aura. Multivariate logistic regression showed that prototype EEG pattern at ictal onset (OR 2.12, 95% CI 1.18-3.06, p = 0.012) and right sided epileptogenic zone (OR 1.82 95% CI 1.18-3.78, p = 0.007) were significantly associated with presence of aura. There was no difference in surgical outcome between those with and without aura. But patients with auditory aura (OR 7.28, CI 2.80-18.95, p = 0.0002) and vertiginous aura (OR 3.01, CI 1.55-7.85, p = 0.028) had a poor surgical outcome. Bivariate analysis showed that normal MRI (p = 0.028) and normal/indeterminate pathology (p = 0.001) were significantly more common with auditory/vertiginous auras., Conclusions: Mere presence of aura does not affect outcome after TLE surgery. However, auditory and vertiginous auras are predictors of poor surgical outcome. These patients require more extensive screening for an ictal onset zone beyond standard limits of ATL before surgery., (Copyright © 2018 Elsevier B.V. All rights reserved.)