The coexistence of anterior communicating artery aneurysm and meningioma: A literature review and illustrative case.

Background: Anterior communicating artery (Acom) aneurysm has an association with many types of intracranial lesions. However, its association with meningioma can be challenging, which is not well addressed in the literature. Herein, we described a literature review focused on the association between Acom aneurysm and meningioma, explicitly highlighting the spatial presence between these two pathologies. We analyzed the literature according to that association with particular emphasis on location-based challenges. Furthermore, we present an illustrative case of surgically treating both lesions in one surgery utilizing the same approach. Methods: A Medline database search was conducted by the following combined formula: (Meningioma [Title/ Abstract]) AND (Aneurysm [Title/Abstract]) AND (((Anterior communicating artery [Title/Abstract]) OR (Acom [Title/Abstract])) OR Acomm [Title/Abstract]))). Additional resources were added after screening the references of the included papers. Results: Nine patients with coexistence of Acom aneurysm and meningioma were found in the literature. The coexistence of both pathologies was found in seven females and two males. The presence of an aneurysm was found to be solitary in 66.67% (n = 6/9). Furthermore, meningioma was found to be an isolated lesion in all included cases, and in 22.2% (n = 2/9), they were located ipsilaterally. The location of the meningioma to the aneurysm seems to be in proximity. Conclusion: Acom aneurysm can coexist with intracranial meningioma; this association can be spatially related intracranially. Such coexistence entails a variety of nuances and challenges that neurosurgeons encounter during the management of these complex lesions.

Dietary effect of probiotics and prebiotics on broiler performance, carcass, and immunity.

This experiment was carried out to evaluate the effects of dietary addition of probiotics (Protexin) and prebiotics (active MOS, mannan oligosaccharides) on growth performance, carcasses, and antibody titer in broilers. A total number of 360-day-old Ross broiler chicks were randomly divided into 9 groups in a 3 × 3 factorial arrangement. Nine broiler starter (0-21 d) and finisher (21-35 d) diets were formulated by using 3 levels of probiotics (0, 1, and 2 g/kg of feed) and 3 levels of MOS (0, 1, and 1.5 g/kg of feed) and were randomly allotted to 9 groups. Feed intake was not affected by interaction of treatments during all phases (P > 0.05). Feed intake was improved due to the main effect of probiotic (P = 0.0001) or MOS (P = 0.005). No interaction (P > 0.05) was observed for weight gain in the starter, finisher, and overall phases. While, during the starter and finisher phases, weight gain was increased by probiotics (P = 0.028 or 0.04, respectively). Dietary supplementation of MOS improved weight gain (P = 0.01) and feed conversion ratio (FCR) (P = 0.03) during the overall period, but during starter and finisher periods, weight gain and FCR were not affected by prebiotics. Apart from dressing percentage, no interaction or individual effect of probiotics and prebiotics was observed for carcass, breast, thigh, heart, liver, and gizzard weight. Antibody titer for infectious bursal disease (IBD) was improved (P = 0.026) by the interaction effect between probiotics and prebiotics, when compared with the control group. Antibody titer against Newcastle disease (ND) was not affected by probiotics or prebiotics or their interactions (P > 0.05). It could be concluded that supplementation of prebiotics or probiotics can improve the growth performance of broilers. It may also be helpful in improving the antibody titer against IBD in broilers fed antibiotic-free diets.

Antenatal management of pulmonary hyperplasia (congenital cystic adenomatoid malformation).

A 26-year-old lady was seen in antenatal clinic. Her anomaly scan at 20 weeks showed significant fetal abdominal ascites and an enlarged echo bright right lung with cardiac displacement. These findings were consistent with recognised type III congenital cystic adenomatoid malformation (CCAM). An induction of labour was undertaken at 32 weeks' gestation due to increasing maternal morbidity. Labour was complicated by abdominal dystocia and a fetal paracentesis was performed, draining 800 ml. A bradycardia developed and the baby was ultimately stillborn. Post mortem examination the right lower lobe bronchus was atretic. The features were typical of those traditionally described as type III CCAM, but in the context of bronchial atresia, are better described as pulmonary hyperplasia.

Primary epiploic appendagitis: an etiology of acute abdominal pain.

Primary epiploic appendagitis has a nonspecific clinical presentation but pathognomonic appearance on computerized tomography. We report a patient who was promptly diagnosed and treated with conservative management, and review the literature. This entity has not been well described in the general medical literature. Epiploic appendagitis should be considered in the differential diagnosis of atypical presentations of acute abdominal pain. Integration of a patient's history and physical exam with laboratory and computerized tomography findings allows a timely and confident diagnosis. Surgery is not necessary, but close follow-up is required.