Orbital Complications After Cochlear Implant Surgery in a Patient With Silent Sinus Syndrome.

Cochlear implantation is an effective procedure for treating patients with severe to profound sensorineural hearing loss. Silent sinus syndrome (SSS) is an uncommon disease that affects the maxillary sinus. It is diagnosed clinically and confirmed radiologically. This study describes the case of a four-year-old child who presented with bilateral profound congenital hearing loss with a family history of congenital hearing loss. The patient had no significant complaints regarding the paranasal sinuses or orbits. Radiological evaluation, including temporal bone computed tomography (CT) and magnetic resonance imaging (MRI) of the ear and internal auditory meatus, showed normal anatomy of the inner ear and petrous bone bilaterally. However, findings of SSS were incidentally detected in the left maxillary sinus. The patient underwent bilateral simultaneous cochlear implantation. On the second postoperative day, he developed left-sided ophthalmoplegia, pain on eye movement, mild proptosis, and upper and lower eyelid swelling with erythema and tenderness. The patient improved rapidly following antibiotic treatment and was almost normal by the fifth postoperative day with no notable findings; hence, he was discharged. Surgeons should carefully evaluate preoperative radiological images of the paranasal sinuses for any malformation or pathology, so that appropriate medical or surgical treatment can be given.

The effect of educational animation compared to leaflets on patients' knowledge regarding root canal treatment: a randomized controlled trial.

BACKGROUND: Incorporating video as a tool for education offers a multitude of advantages. However, it is unknown what is the best educational tool to use for increasing public awareness, consequently reducing fear about root canal treatment. For this reason, this study aimed to compare the effectiveness of educational animation and leaflets as delivery methods for providing information on root canal treatment to patients and to assess their ability to retain the information. METHODS: One hundred fifty adult volunteers were recruited via social media and Umm Al-Qura University Dental Hospital to participate in this randomized control trial study. The volunteers were divided into the study group (SG) and the control group (CG). The SG was provided with information through animations created by the research team, while the CG received the same information through a leaflet. Pre-intervention (T1), immediate post-intervention (T2), and one-month post-intervention (T3) validated questionnaires were completed by the participants to assess the changes in their knowledge. To evaluate the impact of the information delivery method, the knowledge scores of T2 and T3 were compared to T1 within each group using Paired T-tests. Additionally, the study compared the knowledge scores of the two groups using unpaired T-tests. The significance level was set at a P-value of less than 0.05. RESULTS: A significant improvement in endodontic therapy knowledge among the participants in both groups (T1 compared to T2 in the same group) was noted (P < 0.050). However, when comparing T2 between groups, no significant difference was found in delivering the information and improving the knowledge (P = 0.080). Still, the mean differences between T1 and T2, as well as T1 and T3, were greater (P < 0.050) in the SG than in the CG. Furthermore, the total knowledge score in the SG at T3 was significantly higher than the CG. CONCLUSION: Both educational animation and leaflets are practical tools to increase patients' awareness about root canal treatment. However, educational videos are more effective than leaflets in delivering and retaining information about root canal treatment. TRIAL REGISTRATION: This study was retrospectively registered as a randomized control trial at the ISRCTN registry with the document number ISRCTN18413241, 15/05/2023.

Desmoplastic Small Round Cell Tumor Presenting as an Intra/Extracranial Mass.

Desmoplastic small round cell tumors (DSRCTs) are highly malignant tumors, with distinct reciprocal chromosome translocation (11;22)(p13;q12). Intracranial metastasis is a very rare complication of this tumor, with only a few cases reported in the literature. To our knowledge, this is the only case presenting an extracranial extension of intracranial metastasis of DSRCT. A 33-year-old man was diagnosed with DSRCT in the pelvic cavity. He presented with a scalp lump and right-sided weakness. A biopsy showed metastasis from DSRCT. Metastatic DSRCT to the brain is extremely rare. Surgical resection followed by adjuvant treatment, including chemotherapy and radiation, is indicated as it has a poor prognosis. Moreover, aggressive treatment is warranted to prevent progression and relapse.

Novel partially cross-linked nanoparticles graft co-polymer as pore former for polyethersulfone membranes for dyes removal.

A newly developed water-soluble polymeric nano-additive termed "partially cross-linked nanoparticles graft copolymer (PCLNPG)" has been successfully synthesized and harnessed as a pore former for modifying a polyethersulfone ultrafiltration membrane for dyes removal. The PCLNPG content was varied in the PES polymeric matrix aiming to scrutinize its impact on membrane surface characteristics, morphological structure, and overall performance. Proposed interaction mechanism between methylene blue (MB), methyle orange (MO), and malachite green (MG) dyes with PES membrane was presented as well. Hydrophilicity and porosity of the novel membrane increased by 18 and 17 %, respectively, when manufactured with a 3 Wt. % PCLNPG, according to the findings. Besides this, the disclosed increased porosity, rather than the hydrophilic properties of the water-soluble PCLNPG, was the principal cause of the diminished contact angle. Meanwhile, raising the PCLNPG content in the prepared membrane made worthy shifts in its structure. A sponge-like region was materialized near the bottom surface as well. The membrane's pure water flux (PWF) synthesized with 3 Wt.% PCLNPG recorded 628 LMH, which is estimated 3.95 fold the pristine membrane. MG, MB, and MO dyes were rejected by 90.6, 96.3, and 97.87 %, respectively. These findings showed that the performance characteristics of the PES/PCLNPG membrane make it a potentially advantageous option to treat the textile wastewater.

Risk factors for recurrence of chronic rhinosinusitis with nasal polyps after endoscopic sinus surgery: A retrospective study.

OBJECTIVES: To assess the pathophysiological factors leading to chronic rhinosinusitis (CRS) recurrence with nasal polyps (CRSwNP) after endoscopic sinus surgery (ESS) and compare the clinical and imaging findings between both groups. METHODS: A retrospective study was carried out at a tertiary hospital. Patients with recurrent nasal polyps were compared to those with no recurrence by demographics, risk factors, anatomical abnormalities, clinical features, and Lund-Mackey (LM) scores. Both groups were followed up for 24 months after the primary surgery to detect recurrence. RESULTS: Among the 134 patients who underwent ESS for CRSwNP, 69 patients were in the recurrence group and 65 in the non-recurrence group. No significant difference was found in demographics, comorbidities, and anatomical abnormalities between both groups. However, asthma was more prevalent in the recurrence group (73.9% vs. 29.2%; p<0.01). All clinical features were similar between both groups. However, the recurrence group had more patients with bilateral polyps than non-recurrence (95.7% vs. 80%; p<0.01). We found that 26.1% (n=18) of the 69 patients with recurrence needed revision surgery. Smoking rates were significantly different between reoperated vs. non-reoperated patients (16.7% (3/18) vs. 2% (1/51); p=0.02), and the extent of primary ESS was different between them. CONCLUSION: Asthma is a significant risk factor for CRS recurrence. Furthermore, smoking and inadequate primary surgery increase the chance of revision surgery in case of recurrence.

Quality of Life Among Adults With Hearing Loss Who Were Prescribed Hearing Aids in Aseer Province, Saudi Arabia: A Cross-Sectional Tertiary Center-Based Study.

Introduction Hearing loss affects people of all ages, and it may become a burden for patients as well as for those around them. It leads to social isolation and impacts the quality of life (QOL). Many studies aim to investigate the outcome of hearing aids as an intervention to treat hearing loss. Our study's objective is to assess the QOL in participants and investigate the possible factors that have an impact on the outcomes of hearing aid use. Methods The study adopted a cross-sectional design and was carried out in the Armed Forces Hospital South Region, a tertiary care center in Aseer Province, Saudi Arabia. Participants were patients who presented to the ENT clinic with a complaint of hearing loss from 2017 to 2019 and who were prescribed hearing aids as their treatment. The study uses the World Health Organization Quality of Life BREF (WHOQOL-BREF) questionnaire and the International Outcome Inventory for Hearing Aids (IOI-HA) to measure the QOL and its determinants in patients using hearing aids. Results A total of 210 patients were included in the study. Sensorineural hearing loss (SNHL) was found in 72.2%, and 20% of patients were found to have bilateral hearing loss. Moderate or severe hearing loss was found in 80% of the patients in the worst hearing ear. The overall QOL among the participants was satisfactory, with the highest domain score being the social relationship domain (85.9%). The QOL was significantly higher in participants who were in an intimate relationship (P = 0.02). A positive correlation was found between the IOI-HA scores and the WHOQOL-BREF scores in general health (R = 0.14, P = 0.034), psychological health (R = 0.16, P = 0.018), and the overall QOL score (R = 0.15, P = 0.035). Conclusion Hearing aids are a cost-effective intervention that improves QOL and prevents associated comorbidities. Compliance and adherence to hearing aids improve the QOL for patients, as well as for their spouses. Patients suffering from hearing loss while also in an intimate relationship had better QOL scores. A correlation was found in outcomes between the IOI-HA scores and the WHOQOL-BREF scores in general health, psychological health, and overall health.

The Effects of Social Media Addiction, Psychological Distress, and Loneliness on Suicide Ideations and Attempts Among Healthcare Professionals in Saudi Arabia.

INTRODUCTION: Recently, there has been an alarming increase in psychological distress in many populations. One of the reasons can be attributed to the rapid development of technology and social media, which could adversely affect the mental health of individuals, including those working in healthcare. This study aimed to assess the influence of social media addiction, psychological distress, and loneliness on suicidal ideations and suicide attempts among healthcare students and professionals in Saudi Arabia. MATERIALS AND METHODS: This cross-sectional study collected data from healthcare students and professionals using a five-part questionnaire: (i) demographics, (ii) the Bergen Social Media Addiction Scale (BSMAS), (iii) the Kessler Psychological Distress Scale (K10), (iv) the De Jong Gierveld Loneliness Scale (DGLS), and (v) suicide ideation and attempts scale. RESULTS: There were 800 participants from 33 cities who completed the questionnaire. A total of 31.37% reported lifelong thoughts of suicide, regardless of whether they would actually go through with it (S1), 18.38% had suicidal thoughts within the last 12 months (S2), and 11% had attempted suicide (S3). Of those who attempted suicide, 79 (89.77%) reported seeking help. Multiple logistic regression showed that lifetime suicidal thoughts were predicted by psychological distress, emotional loneliness (EL), social loneliness (SL), and age. Having had suicidal thoughts within the prior 12 months was predicted by psychological distress, SL, and age. Suicidal attempts were predicted by psychological distress, EL, age, and social media addiction. CONCLUSIONS: Our findings demonstrated that psychological distress and loneliness are strongly associated with suicidal ideas and suicide attempts. Such results could serve as a warning call that assists healthcare professionals and mental health teams in arranging and planning effective interventions and actions to raise awareness, as well as reduce the levels of psychological distress and loneliness that could lead to grave consequences.

Gliosarcoma Invading the Temporal Bone, Temporalis Muscle, and Skull Base.

Gliosarcoma (GS) is a primary central nervous system tumor. It is an unusual type of glioblastoma multiforme (GBM) and rarely invades the skull base. It has a biomorphic tissue pattern with rapid alternation zones of glial and mesenchymal differentiation. We report the case of a 62-year-old male who presented with a one-month history of unsteady gait associated with dizziness. Brain MRI showed a right temporal mass that invaded the skull base with perilesional edema and a significant mass effect on the right lateral ventricle. The patient underwent a right-sided frontotemporal craniotomy with gross total resection. The pathology confirmed the diagnosis of GS. Postoperatively, the patient had an uneventful recovery with no complications and was discharged two days post-surgery.

Comparative assessment of attitudes among medical and dental professionals in Saudi Arabia toward e-professionalism using the SMEPROF-S scale.

Background: Social media (SM) usage is on the rise among health professionals at all levels to align with the emerging digital and SM era. e-Professionalism is described as attitudes and actions that resemble traditional professionalism paradigms but are expressed through digital media. Although there are a number of studies conducted in the past several years measuring e-professionalism of medical and dental professionals, there is no validated scale to assess the level of e-professionalism among medical and dental professionals in Saudi Arabia. Therefore, this study aimed to assess attitudes toward e-professionalism among medical and dental professionals in Saudi Arabia using the SMePROF-S scale. Methods: This cross-sectional study recruited 338 medical and dental students and practitioners from 20 cities in Saudi Arabia to complete an online SMePROF-S self-reported questionnaire measuring attitudes about e-professionalism. Results: Among participants, 31.66% believed that it is acceptable to communicate with patients through SM, but only 16.86% agreed with communicating via personal SM account messaging. Many participants (35.80%-50%) fear that SM use can cause problems with getting hired, people making inaccurate assumptions and perceptions, and job losses. There were 31.36% who believed that sharing patient information without consent is acceptable. The majority (63.02%-63.31%) do not believe that medical/dental professionals should be barred from using SM, and 40.53% believe that schools/organizations have no right to interfere with their online activities. Only 22.19% believed that SM use removed professional protections from the public. A few statements were statistically different by specialty and gender. Conclusion: There is a variability of attitudes about e-professionalism among medical and dental professionals in Saudi Arabia, with some alarming issues requiring national guidelines to ensure patient rights, privacy, and confidentiality.

A Comparison of Symptom Improvement and Outcomes After Septoplasty Alone Versus Septoplasty With Turbinoplasty.

Background Various causes can lead to nasal obstruction, with the most frequent anatomical cause being deviated nasal septum. It seriously affects patients' quality of life. As a result, septoplasty is performed to enhance the nasal airways. This study aimed to compare the improvement of nasal symptoms following septoplasty with or without turbinoplasty and evaluate the surgical outcomes in both different groups. Methodology A retrospective study was conducted at a tertiary hospital among patients who had undergone septoplasty with or without turbinoplasty between 2020 and 2022. Data regarding demographics, clinical features, surgical data, and complications were collected from patient files. The Nasal Obstruction Symptom Evaluation (NOSE) scale score was assessed through structured interviews. Results In our analysis of 209 patients who underwent surgery for deviated nasal septum, septoplasty was done in 110 (52.6%) patients, whereas the remaining 99 (47.4%) underwent septoplasty with turbinoplasty. The mean NOSE score was found to be 32.94 ± 35.67%. Patients who underwent septoplasty alone significantly showed higher mean scores (56.36 ± 34.62%) compared to those who underwent septoplasty with turbinoplasty (11.14 ± 18.93%) (p < 0.001). The long-term complications showed revision surgery was done in 13 patients, which was comparatively more often done in patients who underwent a septoplasty. Other long-term complications were found to be significantly higher in patients who underwent septoplasty (76.9%) compared to those who underwent septoplasty with turbinoplasty (23.1%). Conclusions Patients who underwent additional turbinoplasty experienced an improvement in nasal symptoms than those who underwent septoplasty alone. In addition, more long-term complications were noted in patients who underwent septoplasty alone.

Novel MXene-Modified Polyphenyl Sulfone Membranes for Functional Nanofiltration of Heavy Metals-Containing Wastewater.

In this work, MXene as a hydrophilic 2D nanosheet has been suggested to tailor the polyphenylsulfone (PPSU) flat sheet membrane characteristics via bulk modification. The amount of MXene varied in the PPSU casting solution from 0-1.5 wt.%, while a series of characterization tools have been employed to detect the surface characteristics changes. This included atomic force microscopy (AFM), scanning electron microscopy (SEM), contact angle, pore size and porosity, and Fourier-transform infrared spectroscopy (FTIR). Results disclosed that the MXene content could significantly influence some of the membranes' surface characteristics while no effect was seen on others. The optimal MXene content was found to be 0.6 wt.%, as revealed by the experimental work. The roughness parameters of the 0.6 wt.% nanocomposite membrane were notably enhanced, while greater hydrophilicity has been imparted compared to the nascent PPSU membrane. This witnessed enhancement in the surface characteristics of the nanocomposite was indeed reflected in their performance. A triple enhancement in the pure water flux was witnessed without compromising the retention of the membranes against the Cu2+, Cd2+ and Pd2+ feed. In parallel, high, and comparable separation rates (>92%) were achieved by all membranes regardless of the MXene content. In addition, promising antifouling features were observed with the nanocomposite membranes, disclosing that these nanocomposite membranes could offer a promising potential to treat heavy metals-containing wastewater for various applications.

Recent progress and future directions of membranes green polymers for oily wastewater treatment.

The preparation, modification and application of green polymers such as poly-lactic acid (PLA), chitosan (CS), and cellulose acetate (CA) for oily wastewater treatment is summed up in this review. Due to the low environmental pollution, good chemical resistivity, high hydrophobicity, and good capacity for water-oil emulsion separation of the presented polymers, it then highlights the various membrane production methods and their role in producing effective membranes, with a focus on recent advances in improving membrane properties through the addition of various Nano materials. As a result, the hydrophilic/hydrophobic properties that are critical in the oil separation mechanism are highlighted. Finally, it looks at the predictions and challenges in oil/water separation and recovery. These ideas are discussed with a focus on modern production methods and oil separation proficiency.

Incidental and Clinical Significance of Slit Ventricles in Fixed Pressure Valves.

INTRODUCTION: Slit ventricle syndrome (SVS) is a recognized delayed complication of cerebrospinal fluid (CSF) shunting in children. It had been linked to the use of low-pressure shunts and considered an argument for the use of programmable valves. In this study, we aim to assess the rate of SVS in children that were shunted using fixed-pressure valves. METHODOLOGY: This study is a retrospective cohort study that occurred in King Abdulaziz Medical City, Jeddah, which reviews 100 patients with a median age of 15.5 months that were shunted by using fixed pressure valves during the period from 2010 to 2018. Fixed low-pressure valves were used in 69% of patients, while fixed medium-pressure valves were used in 31% of patients. SVS was defined by the presence of slit-like ventricles (fronto-occipital [F-O] horns ratio was ≤ 0.2 on any post-shunt CT scan) and the occurrence of slit-like ventricle-related symptoms (chronic headache, nausea, vomiting, and altered conscious level_ in the absence of other causes of shunt malfunction. RESULTS: The overall SVS rate in the cohort was 6%. Nine children had slit-like ventricles, but only six of them were symptomatic. Relatively higher SVS rates were observed in younger male children, obstructive hydrocephalus, and medium-pressure valves. Slit-like ventricle-related symptoms in the absence of a slit-like ventricle were reported in 24 out of 91 (26%) patients. A total of 42 patients underwent shunt revisions for other complications. All SVS patients were treated conservatively. There was a temporal fluctuation in the F-O horns ratio and in some patients with SVS their F-O horns ratio returned to normal at further follow-up without intervention. CONCLUSIONS: The overall SVS rate following the use of fixed-pressure CSF valves in children is low and managed conservatively. Not all patients with slit-like ventricles are symptomatic and the radiological appearance of SVS may improve on further follow-up without intervention. Fixed pressure valves remain an acceptable device in the treatment of hydrocephalus in children.

Cervical Spinal Cord Ischemic Reperfusion Injury: A Comprehensive Narrative Review of the Literature and Case Presentation.

Cervical spinal ischemic reperfusion injury (CSIRI) refers to a state of sudden neurological deterioration after surgical spinal decompression. The CSCIRI refers to a state of sudden neurological deterioration after surgical spinal decompression. The pathophysiology is hypothesized to be due to instant relief of a chronically compressed spinal cord, leading to an inflammatory cascade named ischemic reperfusion injury. Deterioration of neurological function after cervical spine decompression surgery often occurs secondary to direct cord injury, compressing hematoma, or hardware failure. Complete loss of neurological function with no organic explanation is an extremely rare complication, with only a few cases reported in the literature. We are reporting a 67-year-old male patient diagnosed with severe cervical spinal canal stenosis at level C5/6 who underwent anterior cervical discectomy and fusion (ACDF). The patient developed complete transient loss of neurological functions after the surgery and was labeled as a case of CSCIRI after excluding compressing pathology. A literature review of the CSCIRI was carried out, and ten articles were included. Due to the rarity of these cases, there is no class 1 or 2 evidence to establish management protocol nor identifiable risk factors to predict their occurrence. However, we recommend using an intra-operative neurophysiology monitor in cases with long-standing severe cervical canal stenosis with myelomalacia and managing these cases according to the acute spinal cord injury management protocol after excluding compressing pathologies.

Pneumothorax/pneumomediastinum as a complication of foreign body inhalation in 3 pediatric patients: A case series.

INTRODUCTION: Foreign body inhalation (FBI) is a serious and common emergency in children. Such children present in the emergency room (ER) with cough, shortness of breath, choking, or wheezing but rarely present with pneumomediastinum. PATIENT CONCERNS: Three children aged 2 to 5 years (2 girls and 1 boy) were seen in our ER complaining of FBI. Emergency bronchoscopy removal of the inhaled foreign body was performed; however, all 3 patients developed pneumomediastinum. DIAGNOSIS: A foreign body inhalation complicated by Pneumomediastinum/pneumothorax. INTERVENTION AND OUTCOMES: All the patients underwent emergency bronchoscopy and foreign body removal. After the ER intervention, 2 children were placed in the pediatric intensive care unit, and the pneumomediastinum resolved without intervention. The third patient required an operation for chest tube placement, which was then observed in the pediatric intensive care unit, and had several chest radiography follow-ups. After 5 days, the patient exhibited clinical improvement, and the chest tube was removed. CONCLUSION: In this case series, we present 3 cases of children aged 2 to 5 years seen in our ER with a history of different types of organic FBI complicated by pneumomediastinum/pneumothorax. Pneumomediastinum/pneumothorax is a rare complication of FBI in pediatric patients. However, such complications require multidisciplinary collaboration for early diagnosis and intervention.

Radiation metrics for vascular and interventional radiology procedures in a tertiary care institution: A retrospective cohort study over 5-years.

OBJECTIVES: To evaluate the radiation metrics from frequently carried out vascular and interventional radiology (VIR) procedures at a tertiary care institution and compare them to international diagnostic reference levels (DRLs). METHODS: A retrospective study of the radiation metrics of VIR-procedures carried out from January 2015 to December 2019. The collected data included age, gender, height and weight, reference point air kerma (mGy), dose area product (DAP; Gy.cm2), and fluoroscopy time (min.) The body mass index (BMI) and peak skin dose were calculated. The study cohort included 8942 adult patients (54.4% male, 45.6% female) with a mean age of 56.96 years and mean BMI of 26.86. RESULTS: Transjugular intrahepatic portosystemic shunt (TIPS) creation recorded the highest mean fluoroscopy time of 69.41 min., followed by central venous recanalization 39.67min. TIPS creation had the highest mean DAP (1161.16 Gy.cm2), followed by trans arterial chemoembolisation (TACE) (500.63Gy.cm2). TIPS creation was associated with the highest peak skin dose (2766.81mGy), followed by TACE (1588.29mGy). Compared to other studies, TIPS creation and TACE are associated with significantly higher DAP. CONCLUSION: Majority of VIR-procedures demonstrate no significant institutional variations in dosimetry compared to other studies. Using these studied values as reference levels may help identifying procedures that need quality control to minimize unnecessary exposures.

Preparation of zinc oxide nanoparticles using laser-ablation technique: Retinal epithelial cell (ARPE-19) biocompatibility and antimicrobial activity when activated with femtosecond laser.

The unusual physical, chemical, and biological features of nanoparticles have sparked considerable attention in the ophthalmological applications. This study reports the synthesis and characterization of zinc oxide nanoparticles (ZnONPs) using laser-ablation at 100 mJ with different ablation times. The synthesized ZnONPs were spherical with an average size of 10.2 nm or 9.8 nm for laser ablation times of 20 and 30 min, respectively. The ZnONPs were screened for their antimicrobial activity against ophthalmological bacteria, methicillin-resistant S. aureus (MRSA) and Pseudomonas aeruginosa. The significant decrease in bacterial growth was observed after treatment with ZnONPs in combination with 400 nm femtosecond laser irradiation. ZnONPs were investigated for their antioxidant activity and biocompatibility towards retinal epithelial cells (ARPE-19). ZnONPs showed moderate antioxidant and free radical scavenging activity. ZnONPs prepared with an ablation time of 20 min were safer and more biocompatible than those prepared with an ablation time of 30 min, which were toxic to ARPE-19 cells with LC50 (11.3 µg/mL) and LC90 (18.3 µg/mL). In this study, laser ablation technique was used to create ZnONPs, and it was proposed that ZnONPs could have laser-activated antimicrobial activity for ophthalmological applications.

Effect of daflon-500®, a flavonoid compound on chlorpyriphos-induced oxidative changes in the hypophysis and testes in adult male rats.

Alteration of redox status is one of the molecular pathways commonly associated with pesticide toxicity. Antioxidants, including those obtained from plant phenolics, have been shown to mitigate pesticide-induced cellular injury. The present study was aimed at evaluating the effect of daflon-500 ® , a flavonoid compound on sub-chronic chlorpyriphos-evoked changes in antioxidant and biochemical parameters in the hypophysis and testes of adult male rats. Twenty-five male albino rats were randomly divided into 5 groups of 5 animals each. Group I (DW) received distilled water (2 ml/kg); group II (SO) was dosed with soya oil (2 ml/kg); Group III (DAF) received daflon-500 ® at 1000 mg/kg ~ 1/5th of LD50 (≥ 5000 mg/kg); group IV (CP) was administered chlorpyriphos at 7.74 mg/kg ~ 1/10th of LD50 (77.4 mg/kg) while group V (DAF + CP) was previously treated with daflon-500 ® (1000 mg/kg) and then exposed to CP (7.74 mg/kg), 30 min later. Daily oral regimen administration was done for 60 days after which the animals were sacrificed by cervical venesection after light chloroform anesthesia. The hypophysis and testicular tissues were harvested, and their homogenates were analyzed for malondialdehyde, catalase and superoxide dismutase, and acetylcholinesterase levels. A significant increase in the hypophysis and testicular MDA concentrations, coupled with a decrease in the SOD, CAT, and AChE activities were observed in the CP group. The levels of these oxidative and biochemical parameters were alleviated in the group pretreated with Daflon-500 ® . Results of this study demonstrated that pre-treatment with Daflon-500 ® mitigated CP-induced alterations in oxidative and biochemical parameters apparently due to the antioxidant effect of the flavonoid compound.

Choroid Plexus Papilloma of the Fourth Ventricle in a Pediatric Patient: A Case Report.

Choroid plexus papilloma (CPP) is a rare intraventricular tumor. The common locations of the tumor vary based on the age of the patient. It usually occurs in the supratentorial region in children, however in adult patients, these tumors commonly present in the infratentorial region. We are presenting a rare case of a pediatric patient with a two month history of decreased activity and loss of interest in his surroundings and gait imbalance. He underwent a suboccipital craniotomy and excision of a CPP in the fourth ventricle. In conclusion, CCP should be considered as part of the differential diagnosis of intracranial tumors when the clinical presentation and investigations are suggestive regardless of the location to avoid misdiagnosing it when it occurs in an uncommon location.

An Acute Subdural Hemorrhage Due to a Left Supraclinoid Internal Carotid Artery Aneurysm Rupture Without a Subarachnoid Hemorrhage.

Acute subdural hemorrhage (SDH) is a rare complication that can occur after a spontaneous intracranial aneurysmal rupture. It is commonly associated with a subarachnoid and/or an intracerebral hemorrhage but rarely occurs as an SDH alone. A 52-year-old female presented to our institution with a severe headache and third cranial nerve palsy. A computed tomography (CT) scan revealed acute left SDH, without a subarachnoid hemorrhage (SAH), and a computed tomography angiogram (CTA) and cerebral angiography demonstrated the presence of a left supraclinoid aneurysm pointing towards the cavernous sinus. Endovascular occlusion of the aneurysm was performed using a flow diverter. A follow-up CT scan revealed a resolved SDH. In similar situations, vascular imaging, such as CTA and cerebral angiography, is required to assess the cerebral vasculature. This case report describes a patient presenting with the sudden onset of a severe headache associated with a cranial nerve palsy and a brain CT scan showing an acute SDH in the absence of trauma or an anticoagulation history. The treating physician should be highly vigilant of the possibility of a ruptured intracranial aneurysm as the underlying SDH etiology.