Neurobrucellosis presenting as an infected cerebellopontine cistern epidermoid cyst.

Neurobrucellosis is a rare complication of brucella infection which presents as meningitis, meningoencephalitis, subdural empyema, brain abscess, myelitis, and radiculo- neuritis. We report the first case of neurobrucellosis presenting as an infected cerebellopontine cistern epidermoid cyst in a young immunocompetent male who presented with fever and acute raised intracranial pressure. MRI brain showed an extra-axial mass in the right cerebellopontine angle cistern with peripheral rim enhancement and diffusion restriction. Emergency surgery unveiled a well-encapsulated lesion containing thick pus and keratinous material, confirming an infected epidermoid cyst. Intriguingly, the culture revealed Brucella infection, but the source of the infection remained unclear.

Bibliometric Analysis and Visualization of Scientific Literature on Heart Disease Classification Using a Logistic Regression Model.

With the advancement in artificial intelligence, the use of machine learning algorithms for clinical prediction has increased tremendously. Logistic regression is one of the powerful machine learning algorithms that can be used to predict the probability of a variable. Logistic regression is very popular among medical researchers owing to its simplicity, interpretability, and solid statistical foundation. This study aims to investigate the research productivity of heart disease classification using a logistic regression model to analyze the current patterns and potential future trends through bibliometric analysis. Additionally, it aims to highlight the impact and quality of research in the area, identify prominent research groups, the countries actively contributing to the field, which will help the researchers and healthcare professionals to pinpoint research gaps, influential authors, and make informed decisions and invest resources accordingly. The data is collected from a database of Scopus spanning from 2019 to 2023. We have used two bibliometric software, Biblioshiny (Aria and Cuccurullo, 2017) and VOSviewer (Centre for Science and Technology Studies (CWTS), Leiden University, the Netherlands), to analyze the bibliographic data regarding the citation count, contribution of authors, publication count, the contribution of institutions, etc. There are 2331 documents under study which were fed into both software to analyze the data. With 700 documents, China topped the list of most productive countries indicating the vast contribution of the country followed by India and the United States. Contributions of the Harvard Medical School, Boston, MA, United States are found to be the greatest with six papers. The most productive author is Wang Y with 73 documents. Analysis of trending topics reveals that the field progressing towards using support vector machines (SVM), k-nearest neighbours (KNN), and naïve Bayes algorithms. The article has only considered data from Scopus excluding literature indexed in other databases which limits the potential coverage of the data. Also, the work focuses on recent developments excluding older literature from 2019 which could be a limitation. Furthermore, since the study is a bibliometric analysis targeting the use of logistic regression for heart disease prediction, powerful techniques such as SVM, decision trees, random forests, neural networks and deep learning have not been included, which could be another limitation.

Mapping the Landscape of Electronic Health Records and Health Information Exchange Through Bibliometric Analysis and Visualization.

The adoption of Electronic Health Records (EHRs) and the establishment of Health Information Exchange (HIE) systems have significantly transformed healthcare delivery and management. This study presents a comprehensive bibliometric analysis and visualization of the landscape surrounding EHRs and HIE to provide insights into the current state and emerging trends in this field. Leveraging advanced bibliometric methodologies, including co-citation analysis, keyword co-occurrence analysis, and network visualization techniques, we systematically map the scholarly literature spanning several decades. Our analysis reveals key thematic clusters, influential publications, prolific authors, and collaborative networks within the domain of EHRs and HIE. Furthermore, we identify significant research gaps and areas for future exploration, including interoperability challenges, privacy concerns, and the integration of emerging technologies such as artificial intelligence and blockchain. The findings of this study offer valuable insights for researchers, policymakers, and healthcare practitioners seeking to navigate and contribute to the ongoing evolution of EHRs and HIE systems, ultimately enhancing the quality, efficiency, and accessibility of healthcare services.

En bloc resection followed by gluteal advancement flap for sacral Ewing's sarcoma: A novel technique.

Ewing's sarcoma is a rare and highly aggressive bone tumor primarily affecting children and adolescents. It commonly presents in the pelvic and axial skeleton, with sacral involvement posing unique challenges due to its intricate anatomical location. This report details the case of an 18-year-old male with sacral Ewing's sarcoma, emphasizing the diagnostic, surgical, and reconstructive aspects of management. The patient presented with lower back pain, lower limb weakness, and urinary incontinence, which prompted an extensive diagnostic evaluation. Magnetic resonance imaging and computed tomography scans revealed a large lytic mass extending from the S2 vertebra to the coccyx invading the presacral space. Biopsy confirmed the diagnosis of Ewing's sarcoma, characterized by the EWS-FLI1 type 1 translocation. A multidisciplinary team comprising neurosurgeons, colorectal surgeons, and plastic surgeons was formulated. En bloc resection of the tumor, lumbopelvic fixation, and soft-tissue reconstruction using bilateral gluteus maximus advancement flaps were successfully performed. The procedure aimed to address both the oncological and functional aspects of the patient's condition. Chemotherapy and radiotherapy were administered as adjuvant therapies. At 2-year follow-up, the patient was ambulating independently with no residual tumor on imaging. This case highlights the complex nature of sacral Ewing's sarcoma and underscores the importance of a multidisciplinary approach. The described surgical technique, including the innovative use of gluteus maximus advancement flaps for soft-tissue reconstruction, contributes to reducing wound complications and promoting successful patient outcomes. The presented approach serves as a valuable addition to the armamentarium of treatment options for this challenging malignancy.

Recurrent post-operative extradural and subdural collections due to intracranial hypotension following a lumbar subarachnoid drain.

Intracranial hypotension (IH) represents a syndrome secondary to low cerebrospinal fluid pressure. This case of IH following a lumbar drain inserted before the excision of a left intraconal lesion, leading to recurrent post-operative unilateral subdural and extradural collections, was treated successfully with the evacuation of the collection and simultaneous epidural blood patch (EBP) injection. Our report provides an important perspective on the management of IH with recurrent intracranial collections and reiterates that IH should be considered when dealing with recurrent unilateral intracranial collections in the post-operative period. Evacuation with a simultaneous EBP is an effective strategy for managing IH.