Day 1 :
- Keynote Forum
CNS Medical Director in Aventis France
Michel DIB is Neurologist, professor assistant; at the Hospital de la Pitié-Salpêtrière he was also CNS Medical Director in Aventis France.
Received specialist Neurology training at the University of PARIS VI (Pierre et Marie Curie) School of Medicine; Hospital de la Pitie-Salpêtrière, Paris (1990 – 1994).
Master's degree in Human Biology (Pharmacology) from the University of PARIS (1992-1994)
Consultant Neurologist, Department of Neurology, Hospital de la Pitie-Salpetriere, Paris. Between March 95 and 2004,
Patrician Hospitalier, department of Neurology, Hospital de la Pitie-Salpetriere, Paris. Since 2004
Scientific Organizer of the Seminars on Methodology in Neurology in France between1998 and 2014.
Member of the French Society of Neurology
Member of the French Society of Neuro-vascular Medicine
Author of around ninety scientific publications (ALS, dementia, migraine, etc)
Neurodegenerative diseases pose specific challenges for drug development. These diseases typically have a slow and variable clinical course and insidious onset. Symptom expression is only observed when a significant proportion of neurones are already lost. It is important to identify vulnerability factors and other determinants of clinical course in order to be able in the future to select patient populations for clinical trials with a predictable prognosis. The neurodegenerative process itself is not amenable to direct observation and thus cannot be monitored in clinical trials. For this reason, surrogate biomarkers are required to use as outcome parameters. In this respect, magnetic resonance imaging has proved valuable for assessing disease activity and progression in multiple sclerosis. Rating scales are of use as outcome measures, but as these generally measure symptom severity, they are most appropriate for use in assessing symptomatic treatments. Survival has been used with success as an outcome measure in trials in amyotrophic lateral sclerosis, where disease progression is rapid. The optimal outcome measure, the sample size required and the treatment duration need to be chosen in function of the phase of the disease. Potential new treatments can be chosen based upon new knowledge of the genetics and physiopathology of neurodegenerative diseases and, in some cases, screened in transgenic mouse models, although it should be recognised that the validity of these models in terms of treatment response has yet to be established empirically
Experience gained over the last decade allows several lessons to be drawn about how we can anticipate drug development in neurodegenerative disease to evolve over the coming years and several needs to be identified for future research directions.
We need to develop well-validated biological surrogate markers for disease progression in neurodegenerative disease that can be implemented in smaller pilot studies to evaluate experimental treatments. Currently, such proof-of-concept studies are infeasible due to the absence of such markers, necessitating large, long and costly studies for each evaluation. A rapid system of screening promising therapies in pilot studies would speed up the drug development process considerably. Recent advances with MRI in the field of multiple sclerosis suggest that the development of valid surrogate markers can indeed be envisaged.
In conclusion, the lessons of the last decade about clinical drug development in neurodegenerative disease have the potential to shape clinical trials of the future and optimise the chances of identifying therapies that will attenuate progression of these very disabling disorders.
Dr. Jonwals Niramay Ayush Panchkarm Health Institute & Research Pvt. Ltd.India
Dr. Laxman G. Jonwal is chairman for Dr. Jonwals Niramay Ayush Panchkarm Health Institute & Research Pvt. Ltd.India
- Neurodegeneration & Aging Disorders|Case Report|Brain injury|Neurology|Mental disorder |Psychology & Neuroscience
Brian L. Ackerman MD a Harvard Medical School Psychiatrist who is the Director of Meditation and Mindfulness training and Services and the Thrive Behavioral Health Program at the Kent Center in Rhode Island,
Brain model to help us understand how to use the best part of the brains, our neo-cortex and pre-frontal cortex to restrain and understand better what emanates from another part of our brains: the Amygdala and Limbic system. Dr. Ackerman will suggest that because all human beings have an Amygdala and Limbic system, all human beings suffer from limbic dysregulation, and that our so called normal brain is itself disordered.
Dr. Ackerman is having great success with this new treatment modality that seeks to help patients and staff alike become more interested in themselves by learning, in greater detail, how their brain works and the resultant two levels of mind: upper and lower, which leave every human being divided.
Dr. Ackerman posits that the evolution of the brain from mammalian to human changed in such a way as to allow humans to think abstractly. This capacity for abstraction, allows us both to have ideas and then beyond this to ponder further which of these ideas are useful and constructive, and which are not. Dr. Ackerman will go on to propose that because humans are the only species who can be aware of their own thoughts, that this particular facility; not our thinking per se, but our ability to meta-think: think about what we think, puts human beings in the driver’s seat of their own evolution. We have the ability to train ourselves to ‘naturally select’ our best thoughts, feelings, moods, and impulses, and behaviors while learning with mindfulness to develop our capacity to free themselves from all that is counterproductive.
University of Bergen, Norway
Berit Marie Dykesteen Vik has her expertise in exploring the brain’s neural networks during music-production, that is when playing an instrument. Her passion is in how music can change the brain’s function in linking up lost neural connections and thus improve health and wellbeing. She has designed a method for neurologic music therapy after years of experience in research, evaluation, teaching and administration both in hospital and education institutions. She has founded the Institute of Cognitive Rehabilitation after Traumatic Brain Injury, an institute that applies her method in cognitive rehabilitation of brain disorders.
Damage to the orbitofrontal cortex (OFC) often occurs following traumatic brain injury (TBI) and can lead to complex behavioural changes with a negative impact on the individual’s social outcome. To investigate the effects of musical training on patients with behavioural and cognitive deficits following mild to moderate TBI, we performed a structured music-supported intervention of 8 weeks and recruited TBI patients in a chronic phase two years post injury. The intervention consisted of playing piano, two sessions per week, with instructor. Additional playing was required with minimum 15 minutes per day as home-practising. Mean time was 3 hours per week during 8 week. Additional two control groups of healthy participants were included in the study. One group received music intervention whereas the second group were a baseline group without intervention. Participants were assessed with neuropsycholgical tests, fMRI pre-post intervention. The clinical group were presented semi-structured interviews in order to obtain subjective behavioural data. The music groups performed a daily log of practicing time. All TBI patients were on sick leave at the time of intervention. 6 out of 7 patients returned to work post intervention. The results demonstrated significant improvement of neuropsychological tests, functional changes in OFC, and enhancement of social interaction. We propose a causal relationship between musical training and improved social functioning in reference to qualitative assessment, neuro-psycological tests and functional neuroplastic changes in OFC. The novelty of the intervention may have clinical relevance for patients with behavioural problems following traumatic brain injury.
Chettinad Hospital and Research Institute, Chennai
Siddharth Gautam Department of Neurosurgery, Chettinad Hospital and Research Institute, Chennai, India
Inflammatory Pseudotumours(IPT) are mostly benign lesions , mimicking malignant lesions and affecting almost all organ systems and are characterised by fibrotic ground tissue and polyclonal mononuclear infiltrate on histopathology. It is a disease of unknown pathogenesis and the brain is a rare site of occurrence. Here we present one such case we operated recently in our department.
Inflammatory Pseudotumour(IPT) is a rare nonneoplastic condition that usually involves the lung and orbit, but is known to affect almost all the organ systems. The term ´Inflammatory Pseudotumour´ was coined by Umiker and Iverson in 1954, after finding out that the clinical and image findings mimicked that of a malignant lesion. The cause of IPT is unknown. It is characterised histologically by the presence of acute and chronic inflammatory cells with a variable fibrotic response. It is also called spindle cell Pseudotumor, plasma cell granuloma, inflammatory myofibroblastic tumor. The condition is rare in the brain and is usually an intracranial extension of an extracranial tumour arising from the orbit. Rarely , the condition is primarily intracranial or within spinal cord, affecting young men mostly.
Genc Struga, Department of Neuroscience, University Hospital, Mother Teresa, Tirana, Albania
Genc Struga Consultant Neurologist and Stroke with at least 10 years experience in cerebrovascular intensive care and Neurosonography Transcranial vascular and Carotid artery imaging. He complteted his PhD in Neuroscience and finished a postgraduate Diploma in Clinical Neurology at University College London. He enjoy teaching undergraduate and postgraduate students
Albanian language resemble one of the oldest surviving member of the Paleo-Balkan or Illyricum and oldest member of Indo-European family of languages.
Certain characteristics of Albanian language such as Phonosymbolisem , small words and the capability to form compound word or new lexeme , richness in sound (Albanian resembles 36 to 53 letters from the recent to older Alphabets) makes interesting to study of how this languages brain processing is perform.
Special word resembling phonosymbolisem and classified especially old from the most genuine Albanian Geg dialect were defined , these would be compare with similar word in other languages using fMRI.
Cedars-Sinai Medical Center
LUIS ANGEL FRANCISCO SORROZA LOPEZ completed medical school at age 26 at Universidad Regional del Sureste, Medical School, in Oaxaca, Mexico, and master studies in Clinical Pharmacology at La Salle University, Mexico, School of Chemical Science. He received first prize in the category of master level Health Sciences (2015) from this current University, and has been speaker at the 5th International Congress of Dementia and Alzheimer in London (2016), and published the correspondent article
Dementia is growing as a major cause of disability in the world due to neurodegeneration, it is considered a syndrome under which several pathologies are included with the hallmark of cognitive deficits and progressive loss of ability in the performance of regular activities of daily life which eventually jeopardize the self-sufficiency of the person suffering the condition; therefore representing a burden for family carers and health systems all over the world. Aging has been considered the strongest risk factor, but it is not a normal part of it, and the incidence is increasing also in younger population. The accumulation of beta-amyloid, hyperphosphorilation of TAU and oxidative stress have been a hardcore of the neurodegenerative process, and incredible advances have been done in the research of the pathogenesis lately. We have researched the database of PubMed, Cochrane, Medline, Science-direct, and EBSCO, to collect evidence of 325 references on the following subjects: dementia, Alzheimer´s disease, pathophysiology, epidemiology, systematic reviews, diabetes, insuline dysregulation, blood brain barrier, genetics and epigenetics. We have made a review to analyze the different theories focusing in the multifactorial interaction in the pathophysiology of the condition. Nevertheless it is still necessary to pursue further research, which in the near future will offer a more detailed understanding of the process, and probably will reveal specific fields to provide effective treatment, or preventive strategies in very early stages of the disease, probably isolating certain conditions from the common tree of the syndrome, but with better overall results.
National Human Resources Development Network
Shyam Shukla is presently Dean-Industry Institute Interaction and former Director & Principal in-charge of the Central Institute of Business Management Research & Development Nagpur. Dr. Shyam Shukla is also Executive Chairman of International Centre for Spiritualism and Leadership. Dr. Shyam Shukla had been founder member and President of National Human Resources Development Network, Nagpur Chapter. Dr. Shyam Shukla is also a member of Decision Sciences Institute USA.. He is also representing TUA Silicon Valley USA for the expansion and academic development. He is also instrumental in designing new courses for YCMOU Maharashtra. He is also Chairman Nagpur Region for Association of Management of MBA/MMS Institute (AMMI) Pune. Dr. Shyam Shukla is also Co-chairman of International Centre of Research & Development, Nagpur. Dr. Shyam Shukla did his Masters & Ph. D. in Business Administration.
Emotions are the state of feelings which results due to physical and psychological changes that affects one behavior. It is any conscious experience which reflects certain degree of happiness or unhappiness. A human being continuously passing through different kind of emotions consciously or subconsciously. Mental illness can be described as inability to manage the disturbances in thought and behavior pattern. It may lead to depression, dementia, anxiety disorders and many other complex disorders. In modern life style mental illness has become a common feature among the school going children, adults and aged ones. It has become a need of the day how can we help some one having following syndromes of mental illness
Lawson is recently retired as Associate Dean for Health Disparities and professor of psychiatry, at the Dell Medical School, University of Texas, Austin, where he also held appointments in psychology and pharmacy. He was also Professor of psychology at Huston-Tillotson where he was Director of Community Health Programs at the Sandra Joy Anderson Community Health and Wellness Center and also the Director of Health Disparities Policy and Research at Austin Travis County Integral Care. He received a PhD in Psychology from the University of New Hampshire and MD from the Pritzker School of Medicine University of Chicago, did his residency at Stanford University and a fellowship at the National Institute of Mental Health. He has held faculty positions at the University of Illinois, Urbana, University of California, Irvine, Vanderbilt University, University of Arkansas, and Howard University. He has held numerous senior positions and received national recognition including past President of the DC chapter of Mental Health America, Past President of the Washington Psychiatric Society, past Chair of the Section of Psychiatry and Behavioral Sciences of the National Medical Association, and past president of the Black Psychiatrists of America. He received the American Psychiatric Foundation Award for Advancing Minority Mental Health, the Solomon Carter Fuller Award by the American Psychiatric Association, the Sigma XI the scientific honor society and Alpha Omega Alpha, the medical honor society, the National Alliance for the Mentally Ill Exemplary Psychiatrist Award and Outstanding Psychologist Award, the Jeanne Spurlock Award from the American Psychiatric Association, and the E.Y. Williams Clinical Scholar of Distinction Award from the NMA, and the George Winokur Clinical Research Award from the American Academy of Clinical Psychiatrists. He has over 200 publications, and is the editor in chief of the Journal of the National Medical Association. He has continuously received federal, industry, and foundation funding to address mental and substance abuse disparities. He has incorporated to address to use research, education, and clinical care to reduce racial disparities in mental health outcomes.
Advances in the neurosciences have begun to elucidate the neurobiological and pharmacological basis of schizophrenia and related disorders. Abnormalities in functional and structural imaging, pharmacological responsiveness, and identification of some risk genes clearly show a neurobiological etiology. Yet these disorders are treated differently than other chronic neurological disorders. They are much more likely to get arrested, placed in the correctional system. Another consequence is that these individuals receive the less optimistic treatment and are disproportionally assumed to belong to racial and ethnic minorities. One proposal is to relabel these disorders to neurological disorder. The pros and cons and relevance to positive outcomes will be discussed.
DnyÄnamudrÄ Centre For Techno-Creative Education, Nagpur, India
Ramaa Golwalkar is a Communicologist and Indologist pursuing her post-doctoral research from Deccan College Post Graduate and Research Institute Pune on the topic ‘Ritualistic Visual Symbols of Ancient Indian Communication System. She worked as Assistant Professor and trainer for media and communication at Symbiosis International University, Pune and various other prestigious educational institutes for culture and communication. She is a published writer and her books are widely referred by the journalism and mass communication students of Maharashtra State of India. Her weekly column on deciphering ancient Indian Symbols in the daily Tarun Bharat is well-received and appreciated by the common readers and elites
Statement of the Problem: The focus of this paper is to analyse the impact of Upanayan sanskÄr and GÄyatri Mantra (GM) on the brain body and mind with the initial hypothesis that both the ritual and the chant classically condition the brain provides favourable condition to tune the body and mind for better learning.
Indian culture being the oldest living culture in world known for its multi-disciplinary diverse approach towards teaching and learning its ancient education system. There are 16 different rituals prescribed in Vedas (dates back before circa 1900 B.C.E.) to be performed at 16 different stages of human life to make it worth living. These rituals are popularly known as sanskÄr namely process in all the regional languages in India. Upanayan sanskÄr is prescribed to be performed at the age of 8 and the child becomes entitled to chant GÄyatri Mantra (GM) and leaves his parents to stay with his Guru for formal education.
Day 2 :
- Keynote Forum
Ehlers-Danlos is an hereditary disease, multisystemical and frequent of the collagen tissue, which excludes the nervous system. However, a deceitful symptomatology of this disease, poorly known and described will often lead the practitioner toward a neurological or psychiatric pathology with iatrogenic risks.
Our experience is based on a cohort of 5.600 patients, women (80%), men and children with an important alteration of their collagen tissue, including meningeal (with a fragilisation of the brain) and a proprioceptive disorder with hyper sensoriality at the origin of their symptoms. 5 of the 9 following clinical signs allow for a precise diagnosis at 99.6% without reliable genetic testing : rebellious and widespread chronical pain, chronical fatigue, difficult motor control with frequent clumsiness, joint instability, skin fragile and thin, hypermobility joints, ecchymosis, gastroesophageal reflux, hyperacusis. We have spotted erroneous neurological diagnoses with our patients
Institute for Women's Health,UK
Mariya Hristova is Senior Research Associate and leads the Perinatal Brain Repair Group at the Institute for Women’s Health, University College London. She has very strong expertise in neuroimmunology and in the hypoxia-ischaemia model, therapeutic hypothermia and brain analysis investigating the role of post-translational modifications, transcription factors (STAT3), cytokines (TNFa) and pH changes following neonatal hypoxia-ischaemia. She has been an essential part of the team studying the combination of xenon and therapeutic hypothermia, and melatonin and therapeutic hypothermia in a neonatal piglet model of transient birth asphyxia
Neonatal hypoxic-ischaemic encephalopathy (HIE) is a leading cause of neonatal mortality and morbidity, affecting 1-3 per 1000 live-births in developed countries with rates about 5-10 times higher in low-income setting. About 40% of the affected children die in the neonatal period and further 30% develop life-long neurological disabilities. Therapeutic hypothermia is the only clinically approved care for moderate to severe neonatal hypoxic-ischaemic (HI) brain injury, however it reduces death and disability only by 11% with about 40% of the treated infants still developing neurological incapacities. Therefore it is necessary to establish simple, safe and effective supplementary therapies to add to the current therapeutic strategy for HIE.
Signal Transducer and Activator of Transcription 3 (STAT3) is strongly up-regulated by HI in the immature brain. Data obtained in our lab suggests that STAT3 removal in neurons or astrocytes, and, to some extent, systemic STAT3 inhibition reduces inflammation and tissue loss.
Exploring the role of extracellular signal-regulated kinase (ERK) isoforms in neonatal HI at cellular level we observed a cell-specific and time-dependent role of ERK, with a predominant, neurotoxic effect of neuronal ERK2, which was counteracted by neuroprotection by ERK1 and astrocytic ERK2. We observed time- and cell-dependent ERK phosphorylation (pERK), with strongly up-regulated pERK first in periventricular white matter axons, followed by forebrain astrocytes and neurons. Overall, global pharmacological inhibition of pERK is strongly neuroprotective.
Stem cell therapy decreases brain injury either by replacing lost cells, promoting the differentiation of host progenitors, and/or modulating the host immune system. We demonstrated that a single contralateral injection of human amniotic fluid stem cells into the neonatal HI mouse brain decreased the brain lesion, reduced cell death and microglial activation, prevented demyelination and reduced TGFβ1 levels. Thus STAT3 and ERK inhibition, as well as stem cell therapy have potential as supplementary therapies for neonatal HIE.
- Mental disorder | Brain Injury and Rehabilitation | Neurosurgery|Neurology|Addiction
Chettinad Hospital and Research Institute,India
Chronic subdural haematoma (CSDH) is one of the common problems seen in Neurosurgical practice. There are many surgical options available including twist drill drainage, burr hole drainage and craniotomy. Majority of neurosurgeons use burr hole drainage. Even in this, there is a controversy whether to use single or two burr holes, whether to use irrigation or not, whether to use drains or not and the type of drain and so on. Only very few studies using the subgaleal drain for treatment of CSDH are available in the literature.
Thirty two cases of Chronic Subdural Haematoma have been analysed in this prospective observational study over a three year period. The use of Subgaleal drainage system was utilised in all the cases and the various pros and cons of the use the subgaleal drain in the treatment of Chronic Subdural Haematoma were analysed and it was concluded that Subgaleal drainage system should be considered as a safe, simple and effective alternate to Subdural, Subperiosteal Drainage system in the treatment of Chronic Subdural Haematoma.
This is only the third study in available literature for the use of subgaleal closed system drainage for Chronic Subdural Haematoma.
Chronic subdural haematoma (CSDH) is an encapsulated collection of old blood between the dura mater and subarachnoid caused by tear of bridging veins. Repeated bleeding from external membrane capillaries facilitated by fibrin degradation products leads to its expansion7. Chronic subdural haematoma (CSDH) is one of the common problems seen in Neurosurgical practice, especially in the elderly with incidence ranging between 1.73 to 13.18 per 100,000 population. This population is also likely to have other associated co- morbidities that can impact on immediate postoperative outcome and overall survival.
Known risk factors for chronic subdural haematoma include coagulopathy, alcoholism, trauma and low intracranial pressures for example after lumbar drainage or ventricular peritoneal shunt.
Clinical presentation is varied but patient commonly presents with headaches, confusion, drowsiness, vomiting, seizures, ataxia among other presentations and on examination, patient have various neurological deficits including a low Glasgow coma scale, ophthalmoplegia, hemi paresis/hemiplegia among other deficits.
Diagnosis is confirmed by non-contrast CT scan head as study of choice although in some instances MRI may be indicated. The imaging pattern has a direct influence on post-operative outcome especially in terms of recurrence.12
Symtomatic Chronic Subdural haematoma are managed surgically. In surgery the various options available are twist drill drainage, burr hole drainage system and craniotomy. Majority of neurosurgeons use burr hole drainage. Even in this, there is a controversy whether to use single or two burr holes, whether to use irrigation or not, whether to use drains or not and the type of drain (conventional vs tube drain, open vs closed drain) and so on.
Conventional method of drainage is to keep the drain in the subdural space. With a subdural drain, there is always a potential risk of drainage tube coming in contact with the brain causing seizures or haemorrhage due to direct injury and there is increased risk of infection spreading into the intracranial compartment. In subgaleal placement of the drain, with the tip of the drain near the burrhole site subgaleally, the potential complications associated with the placement of subdural drain can be avoided. Only limited experience using the subgaleal drain for treatment of CSDH are available in the literature.
National Institute of Mental Health ,Bangladesh
Md Faruq Alam is Director of National Institute of Mental Health ,Bangladesh
Frequent physical comorbidity among children with neurodevelopmental disorders impairs management process. The study aimed at identifying common physical comorbid disorders associated with neurodevelopmental disorders. Chidren with neurodevelopmental disorders attending Child Guidance Clinic (CGC) of National Institute of Mental Health, Dhaka during the period of September 2017 to April 2018 were assessed. DSM-5 criteria for neurodevelopmental disorders were followed for diagnosis by child psychiatrists working in the institute. Physical comorbidities were diagnosed by history, physical examination, relevant investigations and consultation with the consultants of the respective disciplines. Major physical comobidities found in the study included epilepsy, cerebral palsy, obesity, diabetes mellitus, eneurisis, respiratory tract infection, skin diseases, ear infection and urinary tract infection. Care of the physical disorders needs attention for proper management of these children.
Ladoke Akintola University of Technology Ogbomosho, Nigeria
Eyinade Olusegun Adewale, is a Senior consultant and Associate Professor at Ladoke Akintola University of Technology, Ogbomosho, Oyo State, Nigeria. Have passion in improving health care and wellbeing of the community, he have build model after year of in Research, Evaluation and teaching both in hospital and medical institution
Behavioral addiction refers to several mental health conditions in which a person engage in a particular behavior repeatedly; even if the behavior cause them harm-it may seem as if they simply cannot resist engaging in it. While alcoholism addiction is a serious medical disease with signs and symptoms that vary depending on the amount and frequency of consumption .sign and symptoms of behavioral and alcoholism addiction include :
- Preoccupation with the behavior
- Diminished ability to control behavior
- Building up a tolerance to the behavior so the behavior is needed more often or in grater intensity to get the desire gratification.
- Loss of control over amount consumed once they begin drinking.
- Regular inattention of family and professional obligations.
- Dangerous behaviors that carry risk of legal, financial and health consequences for themselves and others.
- Insomnia, which may be followed by oversleeping.
- Increase in expressions of anger or other emotions especially in inappropriate setting.
Conclusion and Significant: Progressive increase in frequency and quantity of alcohol consumption can begin to produce more serious medical symptoms of alcoholism. A person can reach a level of intoxication that can become a life threatening i.e. Alcohol poisoning which can make the respiratory system become depressed and make one stop Breathing. Alcohol abuse can make drinking a central activity of one’s life, displacing healthy activity and relationship resulting in negative consequences. Ideally ,people suffering from behavioral addiction will receive multiple forms of treatment, for example in inpatient setting ,you will participate in one-on-one therapy session ,groups therapy skill building activities and coping skill development .This diverse therapeutics approach offers the greatest chance of success beating a behavioral addiction
Genc Struga, Department of Neuroscience, University Hospital, Mother Teresa, Tirana, Albania
The Albanian native speaker’s have a better pronunciation or accent of the foreign language they learn and these phenomena are unique in so called Indoeuropean languages group, a family group where Albanian is one of the oldest surviving member.
Albanian language richness in sound is expressed with writing system of different large alphabets up to 53 letters.
Further certain element of ethnography of singing such as iso-polyphony considered by UNESCO as word heritage which has been a form of ancient singing in north as well in the south Albania including Macedonia still vivid in Albania.
Characterized by songs consisting of two solo parts, a melody and a countermelody with a choral drone. The structure of the solo parts varies according to the different ways of performing the drone, which has a great variety of structures, especially in the popular style adopted by all groups performing this music.
There are these language characteristics and ethnography that affects the native neuropasticity abilities in learning another language easier and with better pronunciation or accent .
This process is similar to musician ability of better cognitive abilities for learning and better pronunciation.
This factors is independent of CPH (critical period hypothesis) influencing L2 (second language) acquisition better pronunciation or accent.
Other than influence of CPH on L2 speech pronunciation or foreign accent is the fact whether the L1 is native language and how close is this native language to L2 language etymological formation .
The Albanian abilities seems more prominent in the languages more close to theirs inside the the Indo-european languages
Jos University Teaching Hospital
Godwin Osaigbovo Department of Internal Medicine, Jos University Teaching Hospital, Nigeria
Stroke is the second leading cause of death worldwide. Stroke mortality has been shown to be higher in blacks in multiracial studies; it is also a very important cause of disability with its attendant deterioration in the quality of life in survivors. The profile of stroke in North-central Nigeria has been sparsely described despite the fact that it constitutes about 50 to 60% of neurological admission in this part of the world.
Objectives: To determine the risk factors associated with stroke, assess the case fatality 90 days post stroke, determine the bad prognostic factors of stroke and assess the sensitivity and specificity of clinical sub-typing of stroke using the WHO and Siriraj stroke scoring tools.