Benign pituitary adenoma with multiple intracranial metastases-a case report and review of the literature.

Metastatic benign pituitary adenomas (PAs), also known as pituitary carcinomas (PCs), represent 0.1-0.2% of all intracranial lesions. They are rare and challenging pathologies. We present the case of a 34-year-old female, who presented to the clinic with headache and visual loss. She was diagnosed with PA with multiple extra-axial metastases. Debulking and biopsy of the lesions was done. Postoperatively, there was gross residual disease, and the patient's visual disturbances did not improve. Only 165 cases of PCs have been reported in the current literature. Existing consensus on management of these uncommon lesions is based on trial and previously published case reports and surgery appears to be the only definitive treatment. Further research regarding any non-surgical expectant management is warranted.

Developmental delay in a patient with single cerebral varix.

Background: Cerebral varices are intracranial venous anomalies that are characterized as thin-walled vessels, with a single layer of endothelium lining it and a thin lamina or fibrous connective tissue surrounding it. These varices are usually associated with vascular abnormalities such as arteriovenous malformations or developmental venous anomalies, but may rarely be found as isolated lesions as well. Diagnosis of these isolated lesions on imaging is a challenge, because it is a rare entity and can mimic a space occupying lesion in the brain. The patients with isolated cerebral varix can present with neurological symptoms; however, majority are asymptomatic with the diagnosis made incidentally. Case Description: The aim of this study is to report a case of a 21-month-old boy who was diagnosed with an isolated cerebral varix and had presented with delayed milestones in addition to seizures. His MRI scans showed a solid-cum-cystic lesion with contrast enhancing walls that was excised through craniotomy. Postoperatively, he regained his milestones. Conclusion: The patients with isolated cerebral varix can present with neurological symptoms; however, majority are asymptomatic with the diagnosis made incidentally. These patients have a low risk of bleeding and are treated conservatively, with surgical intervention indicated only in symptomatic patients.

Awake Craniotomy for Resection of Cerebral Arteriovenous Malformation: Initial Experience From a Low- and Middle-Income Country.

Global health has shown progress over the years; however, neurosurgical care has not followed the same trajectory due to it being presumably resource intensive. Awake craniotomy (AC) is a neurosurgical technique that can improve neurological outcomes, can potentially reduce costs and hospital stay, and can be easily employed in low- and middle-income countries (LMICs). It has proven to be beneficial in surgical resection of tumors located in the critical areas of the brain, but there is limited literature to support AC for resection of arteriovenous malformations (AVM). We present four cases of AVM that were successfully treated surgically under awake settings in a developing country. Two of the AVMs were Spetzler-Martin grade (SMG) 3, one was SMG 4, and one was SMG 1. All the patients underwent successful excision of AVMs, and the postoperative digital subtraction angiography (DSA) was negative for any residual. They had a total hospital stay of three to five days with a mean postoperative stay of two days. Only one patient showed transient conductive dysphasia, which resolved on subsequent follow-ups, and none of the patients developed any long-term neurological deficit. There are limited data from LMICs regarding the benefits of using AC for AVMs. However, our cases show that this technique can be applied for AVM resection, particularly in eloquent areas of the brain (parts of the cerebral cortex that control vision, language, sensory, and motor functions), to minimize potential neurological deficits. Even though it requires careful selection of cases, and needs a higher level of microsurgical and neuro-anesthesia expertise, it can lead to better postoperative outcomes, lesser morbidity, and a shorter hospital stay, contributing to low resource utilization, making it feasible in a resource-limited setting.

Assess the knowledge of dentists regarding Hepatitis B serological profile: a cross-sectional study.

INTRODUCTION: The primary aim of the study was to determine the knowledge of dental practitioners regarding HBV serological markers. Second objective was to determine prevalence of occupational exposures to HBV amongst dentists. METHODOLOGY: A questionnaire was constructed pertaining to various aspects of HBV serology; validated by an expert panel; and piloted at 49 dentists. A Cronbach-alpha value of 0.7 was attained and thus extensive survey was conducted among dentists in routine practise treating hepatitis B patients at dental teaching hospitals in Peshawar, KP. The data was analysed using SPSS v.22. RESULTS: A response rate of 58% (a total of 290 respondents) was attained. All respondents were vaccinated against HBV. Over 50% reported not to follow Standard precautions for every patient. Overall, 20.3% experienced HBV exposure, eight were administered PEP. Fifty-four percent of FYs; 74.5% PGTs and 71.6% of faculty dentists correctly answered: HBsAg to be the 'serological hallmark of HBV infection'; this was the most correctly answered question. Sixty-four percent dentists failed to identify the infectious carrier phase. Over 50% of dentists in each category failed to correctly answer 5/8 of the HBV serology. CONCLUSIONS: Over 20% reported HBV occupational exposure but zero transmissions. Majority of dentists did not have correct information on HBV serological profile which may jeopardise cross-infection control. Further education on HBV serological markers and its clinical relevance to dentistry along with stringent adherence to Standard precautions is recommended.

Interfacial Reactions of Tetraphenylporphyrin with Cobalt-Oxide Thin Films.

We have studied the adsorption and interfacial reactions of 2H-tetraphenylporphyrin (2HTPP) with cobalt-terminated Co3 O4 (111) and oxygen-terminated CoO(111) thin films using synchrotron-radiation X-ray photoelectron spectroscopy. Already at 275 K, we find evidence for the formation of a metalated species, most likely CoTPP, on both surfaces. The degree of self-metalation increases with temperature on both surfaces until 475 K, where the metalation is almost complete. At 575 K the porphyrin coverage decreases drastically on the reducible cobalt-terminated Co3 O4 (111) surface, while higher temperatures are needed on the non-reducible oxygen-terminated CoO(111). The low temperature self-metalation is similar to that observed on MgO(100) surfaces, but drastically different from that observed on TiO2 (110), where no self-metalation is observed at room temperature.

Investigating the molecular mechanism of staphylococcal DNA gyrase inhibitors: A combined ligand-based and structure-based resources pipeline.

Appropriate therapeutic solutions against Staphylococcal infections are currently limited. To work out the complex task of challenging drug resistance in Staphylococcus aureus, new compounds with novel modes of action are required. In this study, we performed target-driven virtual screening to filter exhaustive phytochemical libraries that can inhibit the activity of S. aureus DNA Gyrase B (Gyr B). Three top-ranked hit molecules (Mangostenone E, Candenatenin A and 2,4,4'-trihydroxydihydrochalcone) were identified from comprehensive molecular docking studies based on their strong spatial affinity with key catalytic residues of the binding pocket of DNA GyrB, especially with the well-known crucial residue Asp81. Molecular dynamics (MD) simulations were performed for these identified hit molecules for better understanding of their dynamical and structural profiles throughout the MD simulations. These compounds can be explored as future lead optimization molecules to discover a new class of antibiotics against resistant Staphylococcus aureus strains.

In-silico identification and evaluation of plant flavonoids as dengue NS2B/NS3 protease inhibitors using molecular docking and simulation approach.

Dengue infection is prevailing among the people not only from the developing countries but also from the developed countries due to its high morbidity rate around the globe. Hence, due to the unavailability of any suitable vaccine for rigorous dengue virus (DENV), the only mode of its treatment is prevention. The circumstances require an urgent development of efficient and practical treatment to deal with these serotypes. The severe effects and cost of synthetic vaccines simulated researchers to find anti-viral agents from medicinal plants. Flavonoids present in medicinal plants, holds anti-viral activity and can be used as vaccine against viruses. Therefore, present study was planned to find anti-viral potential of 2500 flavonoids inhibitors against the DENVNS2B/NS3 protease through computational screening which can hinder the viral replication within the host cell. By using molecular docking, it was revealed that flavonoids showed strong and stable bonding in the binding pocket of DENV NS2B/NS3 protease and had strong interactions with catalytic triad. Drug capability and anti-dengue potential of the flavonoids was also evaluated by using different bioinformatics tools. Some flavonoids effectively blocked the catalytic triad of DENV NS2B/NS3 protease and also passed through drug ability evaluation. It can be concluded from this study that these flavonoids could act as potential inhibitors to stop the replication of DENV and there is a need to study the action of these molecules in-vitro to confirm their action and other properties.

Interfacial interactions between CoTPP molecules and MgO(100) thin films.

We have investigated the interactions between cobalt(ii)-tetraphenylporphyrin (CoTPP) molecules and MgO(100) thin films on Ag(100) by means of Synchrotron Radiation X-Ray and Ultra-Violet Photoelectron Spectroscopy (SR-XPS and SR-UPS). At room temperature, the CoTPP monolayer consists of two different species. A minority of molecules exhibits a strong electronic interaction with the substrate, whereas for the majority a similar spectroscopic signature as for multilayer molecules is observed. Based on the lateral inhomogeneity of the surface electronic structure, we tentatively suggest that the strongly interacting molecules adsorb with their metal center directly above oxygen ions. Unlike for metal substrates, where a monolayer can be prepared upon heating to above 500 K, most of the monolayer on MgO desorbs at 550 K together with the multilayers. This indicates either a weaker molecule-substrate bond than for most metal surfaces or a higher activation energy barrier for dehydrogenation. The remaining molecules are presumably MgTPP molecules, originating from a 2HTPP impurity in CoTPP.

Coverage- and temperature-dependent metalation and dehydrogenation of tetraphenylporphyrin on Cu(111).

Using temperature-programmed desorption, supported by X-ray photoelectron spectroscopy and scanning tunneling microscopy, a comprehensive overview of the main reactions of 5,10,15,20-tetraphenyl-21H,23H-porphyrin (2HTPP) on Cu(111) as a function of coverage and temperature is obtained. Three reactions were identified: metalation with Cu substrate atoms, stepwise partial dehydrogenation, and finally complete dehydrogenation. At low coverage the reactions are independent of coverage, but at higher coverage metalation becomes faster and partial dehydrogenation slower. This behavior is explained by a weaker interaction between the iminic nitrogen atoms and the Cu(111) surface in the high-coverage checkerboard structure, leading to faster metalation, and the stabilizing effect of T-type interactions in the CuTPP islands formed at high coverage after metalation, leading to slower dehydrogenation. Based on the amount of hydrogen released and the appearance in STM, a structure of the partially dehydrogenated molecule is suggested.