Brain herniation and subsequent complications following partial resection of high-grade glioma: A case report.

Key Clinical Message: This case highlights the need for tailored strategies to address issues like brain herniation, subdural hygroma, and cerebrospinal fluid leak, which, if not managed promptly, can lead to long-term neurological deficits. Additionally, the role of specialized facilities in delivering highly specialized care for managing such intricate cases cannot be understated. Abstract: Decompressive craniectomy-induced subdural hygroma (SDH) frequently coexists with external cerebral herniation, resulting in neurological impairments. The incidence of brain herniation through a craniectomy defect postoperatively is 25%. Brain herniation (BH), SDH, and cerebrospinal fluid leak require urgent neurosurgical management as they can lead to irreversible long-term neurological deficits. We report a case of a 42-year-old male who presented with headache and grand mal seizures. He was diagnosed with herniation of brain parenchyma through the surgical defect with a displacement of the bone flap by a heterogeneously enhancing lesion in the left parietal lobe along with SDH in the left frontoparietal region post partial resection of high-grade glioma. In this report, we discuss the pathogenesis and management strategies of brain herniation, wound infection, cerebrospinal fluid (CSF) leak, ipsilateral SDH, floating bone flap, and communicating hydrocephalus in an adult patient following partial resection of high-grade glioma. This particular case emphasizes the value of an individualized patient-centered surgical approach to minimize the risk of postoperative complications.

Effectiveness of virtual reality in managing pain and anxiety in adults during periprocedural period: a systematic review and meta-analysis.

PURPOSE: Patients undergoing medical procedures often experience pain and anxiety. These periprocedural outcomes can be overcome by providing a distraction using virtual reality (VR), decreasing their perception. VR has proved effective in reducing pediatric pain and anxiety; however, limited studies have confirmed its effectiveness in adults. We performed a systematic review and meta-analysis on the effectiveness of VR, as opposed to standard care, in reducing periprocedural pain and anxiety in adults. METHODS: A systematic search of randomized controlled trials was conducted using the databases of MEDLINE, Cochrane CENTRAL, and Scopus. Trials involving patients (> 18 years) undergoing elective medical procedures conducted with or without local anesthesia and participating in VR therapy were included. Primary outcomes were pre-procedural anxiety, post-procedural anxiety, and intra-procedural pain. Pre-procedural pain, post-procedural pain, and intra-procedural anxiety were secondary outcomes. RESULTS: Data from 10 studies shortlisted for inclusion revealed no significant association between the use of VR and lower pre-procedural anxiety compared to standard care (p > 0.05) (SMD = -0.02, 95% CI = -0.18 - 0.14, P = 0.81) but demonstrated that the use of VR was significantly associated with a reduction in post-procedural anxiety (SMD = -0.73, 95% CI = -1.08 - -0.39, P < 0.0001), intra-procedural pain (SMD = -0.61, 95% CI = -1.18 - -0.04, P = 0.04), and post-procedural pain (SMD = -0.25, 95% CI = -0.44 - -0.05, P = 0.01). CONCLUSION: The use of VR caused a significant reduction in post-procedural anxiety, intra-procedural pain, and post-procedural pain in adults undergoing medical procedures, although the findings were insignificant concerning pre-procedural anxiety.

Taurine as a potential anti-ageing therapy: the key to reversing the ageing process? Short communication.

Taurine supplementation may be a viable solution to the problem of our cells manufacturing potentially hazardous by-products known as 'free radicals'. Some of these chemicals serve crucial biological activities, but excessive amounts can harm internal cell structures, reducing the cells' capacity to operate. The regulatory systems that contribute to maintaining a healthy balance of reactive oxygen species in the body deteriorate with age. Thus, in this article, we examine how the amino acid taurine could be used in anti-ageing therapy, as well as its mechanism of action, consequences and suggestions.

The floods of 2022: Economic and health crisis hits Pakistan.

Pakistan is currently going through the worst-ever recorded flood crisis. The 2022 floods have created unprecedented destruction, especially in the coastal regions of the country. Almost one-third of Pakistan has drowned, merely as a consequence of climate change which is impacting many countries around the globe, with the South Asian countries at the greatest risk due to their proximity to the equator. The National Disaster Management Authority (NDMA) has reported millions of people to be affected by the catastrophic floods. The country is also going through a major economic crisis due to livestock and agriculture being destroyed, which has led to severe food shortages resulting in the flood victims being vulnerable to malnutrition as well. Health care has also been severely affected, with a serious outbreak of waterborne diseases including diarrhea, dengue fever, malaria. Thousands of pregnant women are unable to access maternity services and menstrual hygiene products are also unavailable in flood-stricken areas. The Government of Pakistan should address this urgent matter as a priority and necessary steps should be taken to try and contain this catastrophe.

Surface-enhanced Raman spectral investigation of antibacterial activity of zinc 3-chlorobenzoic acid complexes against Gram-positive and Gram-negative bacteria.

BACKGROUND: Raman spectroscopy is an effective tool for determining the antibacterial actitivites of organometallic compounds against different bacterial strains. OBJECTIVES: The purpose of current study is to check the anibacterial activites of ligand (3-chlorobenzoic acid) and its respective zinc complex against gram positive and gram-negative bacterial strains by using surface enhanced Raman spectroscopy (SERS). METHODS: The ligand (3-chlorobenzoic acid) and its respective zinc complex caused different biochemical changes in gram-positive and gram-negative bacterial strains such as lipid contents, DNA/RNA contents, proteins contents, peptidoglycan contents and bacterial spore contents which can be observed with different SERS spectral features. Furthermore, PCA was employed for differentiating the mechanism of action of zinc complexes against gram-positive bacterial strain and gram-negative bacterial strain. RESULTS: Surface enhanced Raman spectroscopy (SERS) has been employed for analyzing the antibiotic activities of 3-chlorobenzoic acid ligands and their respective zinc complexes against Escherichia coli (gram-negative) and Bacillus subtilis (gram-positive) bacterial strains. The bioactivity assay and SERS spectral results clearly show that the complex causes more degradation in both bacterial cells (E. coli and B. subtilis) as compared to ligand. Furthermore, PCA was employed for differentiating the mechanism of action of zinc complexes against gram-positive bacterial strain and gram-negative bacterial strain. CONCLUSION: SERS technique along with chemometric tools have successfully differentiated the antibiotic activities of 3-chlorobenzoic acid ligands and their respective zinc complexes against Escherichia coli (gram-negative) and Bacillus subtilis (gram-positive) bacterial strains.

Surface-enhanced Raman spectroscopic analysis of centrifugally filtered HBV serum samples.

BACKGROUND: Raman spectroscopy is an effective tool for detecting and discriminating centrifugally filtered hepatitis B virus serum and centrifugally filtered control serum. OBJECTIVES: The purpose of current study is to separate high molecular weight fractions from low molecular weight fractions present hepatitis B serum to increase the disease diagnostic ability of surface enhanced Raman spectroscopy (SERS). METHODS: Clinically diagnosed centrifugally filtered serum samples of hepatitis B patients are subjected for surface enhanced Raman spectroscopy (SERS) in comparison with centrifugally filtered serum samples of healthy individuals by using silver nanoparticles (Ag-NPs) as SERS substrates. Some SERS spectral features are solely observed in centrifugally filtered serum samples of hepatitis B and some SERS spectral are solely observed in centrifugally filtered serum samples of healthy individuals. The diagnostic ability of SERS is further enhanced with different statistical techniques like principal component analysis (PCA), partial least square discriminant analysis (PLS-DA) and partial least square regression analysis (PLSR) have applied. RESULTS: The disease biomarkers of hepatitis B are more pronounced after their centrifugation as compared with uncentrifuged form. Statistical tools like principal component analysis (PCA) and partial least square discriminant analysis (PLS-DA) clearly differentiated centrifugally filtered serum samples of hepatitis B from centrifugally filtered serum samples of healthy individuals. Furthermore, partial least square regression analysis (PLSR) has been applied for predicting unknown viral load of centrifugally filtered serum sample of hepatitis B. CONCLUSION: SERS technique along with chemometric tools have successfully differentiated centrifugally filtered serum samples of hepatitis B from centrifugally filtered serum samples of healthy individuals. The centrifugal filtration process has increased the differentiation accuracy of PLS-DA in terms of percentage 98% and regression accuracy of PLSR regression analysis in terms of RMSEP (0.30 IU/mL) of this diagnostic method as compared with that of uncentrifuged method.

Barriers to Colorectal Cancer Screening in Pakistan.

Background The prevalence of colorectal cancer (CRC) is growing in Pakistan; however, there are no national screening programs or guidelines in place to curb its development. This study was conducted with the aim of ascertaining public awareness and attitudes regarding CRC and current screening practices. Furthermore, the study assessed perceived barriers which could impact future screening processes. Methods A cross-sectional, questionnaire-based study was conducted among urban dwellers of Karachi, Pakistan. We excluded any individuals belonging to the medical profession, those diagnosed previously with CRC or having any significant co-morbidity. The validated and pre-tested questionnaire was administered among the study participants to record demographic information, awareness of CRC risk factors, symptoms and screening tests. Attitudes towards screening and perceived barriers to screening were also assessed. Data were analyzed using Statistical Package for Social Sciences (SPSS version 20.0) (IBM Corp., Armonk, NY). A knowledge score, out of a total of 14 points was calculated to reflect a participant's overall knowledge regarding CRC risk factors and signs/symptoms. Results The prevalence of CRC screening in eligible individuals (50 years or older) was 2.6% in our study population. Positive attitudes towards CRC management and screening were observed, with 75.1% (n = 296) acknowledging the preventive role of screening tests. Despite this only 14.9% (n = 58) of study participants expressed a future desire to undergo screening. Major barriers to screening were reported to be "a lack of knowledge regarding the screening procedure", a "lack of screening facilities" and that the "screening procedure is too expensive". A majority (n = 285, 72.3%) of the participants expressed a greater willingness to undergo screening if their doctor recommended it. Conclusion A national CRC screening and awareness program should be launched to promote awareness and facilitate screening in risk groups. General practitioners are needed to play a key role in counseling patients and endorsing healthy screening practices.