Knowledge and attitude towards home quarantine instructions and associations with history of Covid-19 infection in Malaysia.

INTRODUCTION: Although COVID-19 has entered the endemic phase, individuals infected with COVID-19 are required to adhere to home quarantine measures. By exploring the public's knowledge and attitude towards recommended home quarantine measures, their readiness in containing potential COVID-19 outbreak can be determined. This study aimed to assess the public knowledge and attitude towards home quarantine instructions and their association with history of COVID-19 infections. METHODS: This was a web-based cross-sectional study conducted among the public in Malaysia between August to October 2022. All Malaysian adults over 18 years of age were included. Knowledge on home quarantine instructions and COVID-19 warning signs were measured using "True," "False," or "I'm not sure", while attitude towards home quarantine instructions was measured using a five-point Likert Scale. The questionnaire was initially constructed in English and then translated into the national language, Bahasa Malaysia. Face and content validation were performed. The internal consistency of the questionnaire was found to be satisfactory. RESULTS: 1,036 respondents were analyzed, comprised mostly of females (743, 71.6%) with a history of COVID-19 (673, 64.9%). In the knowledge domain, more than 80% of the respondents answered 9 out of 11 home quarantine instructions statements correctly. 457 (44.1%) were unaware or unsure about the minimum distance of the infected individual's bed from the rest of the occupants in a shared bedroom. The respondents reported relatively weaker knowledge in identifying uncommon warning signs of COVID-19 deterioration, including anuria (162, 44.5%), ingestion problems (191, 52.5%), and immobility (195, 53.6%). In the attitude domain, more than 90% of respondents answered correctly in 8 out of 9 questions. Respondents with a previous history of COVID-19 infections had better knowledge than COVID-19 infection-naïve individuals towards both home quarantine instructions and COVID-19 warning signs. CONCLUSION: Most respondents had good knowledge and attitude towards home quarantine instructions, with those previously infected with COVID-19 showing greater awareness of uncommon warning signs. However, there was a notable lack of awareness regarding physical distancing within shared rooms, appropriate disinfectant use and mobility limitation within the household. This study highlights the knowledge gaps to be improved in future educational campaigns.

Cognition improvement strategies, study behaviours and stress among medical students of Dow University of Health Sciences: A cross-sectional study.

OBJECTIVE: To determine the effects of cognition improvement strategies on academic performance, stress and sleep quality of medical students. METHODS: The cross-sectional study was conducted at the Dow University of Health Sciences, Karachi, from March 2019 to March 2020, and comprised medical students regardless of gender and academic year. Academic performance was assessed through grade point average, while stress and sleep were assessed using the Perceived Stress Scale and Pittsburgh Sleep Quality Index. Data was analysed using SPSS 25. RESULTS: Of the 770 subjects, 748(97%) formed the final sample with mean age 20.32±1.49 years; 619(82.7%) females and 129(17.2%) males. Overall, there were 655(87.6%) consumers of cognitive enhancers and 93(12.4%) non-cunsumers. The mean Pittsburgh Sleep Quality Index score of consumers was 6.05±3.306, while that of non-consumers was 5.80±3.701. The respective mean Perceived Stress Scale scores were 21.18±6.09 and 20.5±6.8. There was no significant association of consumption of cognitive enhancers with academic performance and stress levels (p>0.05), but it was significant with sleep quality (p<0.05). CONCLUSIONS: Majority of the students were found to be consuming cognitive enhancers, but no significant association of the stimulants was found with either academic performance or stress.

The influence of feeding low and high level of Brachiaria decumbens diets on the hematology, serum biochemistry, and acute phase proteins of sheep.

The present study aims to determine the hematology, serum biochemistry, and acute phase proteins (APPs) responses of both serum and cerebrospinal fluid (CSF) in sheep fed with low and high levels of Brachiaria decumbens (B. decumbens) diets at different time phases. A total of 30 6-month-old male Dorper cross sheep were randomly divided into three treatment groups consisted of 10 sheep each. Treatment 1 (control) sheep were fed with Pennisetum purpureum and concentrates as the basal diet, whereas Treatments 2 and 3 sheep were fed with low (10%) and high (60%) level of B. decumbens, respectively. The hematology results revealed that there were significant differences (p < 0.05) in the red blood cells, mean corpuscular volume, mean corpuscular hemoglobin concentration, white blood cells, neutrophils, monocytes, eosinophils, basophils, platelets, and plasma proteins between groups. Except for packed cell volume, there were also significant differences in all hematology parameters at different time phases. All biochemistry parameters except creatinine revealed significant differences among treatment groups. However, there were significant differences in all parameters between time. On the other hand, APPs results showed significant differences in the serum haptoglobin and serum amyloid A in both serum and CSF between groups and time.

Atypical Presentation of Cutaneous Squamous Cell Carcinoma of the Head and Neck: A Case Report.

Tumors of the head and neck can spread by direct extension, hematogenous spread, or lymphatic dissemination. However, a process known as perineural invasion (PNI) allows nerves to act as a direct conduit for tumor growth away from the primary site. Perineural invasion is a rare, atypical presentation of cutaneous squamous cell carcinoma of the head and neck that affects about 2.5%-14% of the population. It is known to be associated with an increased risk of local recurrent and distant metastasis, thus adversely affecting the patient's prognosis. The majority of PNI cases are asymptomatic, often discovered during pathological evaluation. We report the case of a patient who presented with a 1-year history of right-sided face pain and symptoms suggestive of trigeminal facial neuralgia. A skin biopsy taken from a lesion on his right cheek showed PNI secondary to cutaneous squamous cell carcinoma of the head and neck. We treated the patient with radiotherapy and chemotherapy and his clinical condition improved significantly. We are publishing this case report to increase awareness of practicing physicians and nurses to PNI as an atypical presentation of squamous cell carcinoma that may affect selection of treatment modality and the patient's prognosis.

Motor improvement in Parkinson's disease patients receiving caffeine adjuvants: A double-blind randomized controlled trial in Indonesia.

Parkinson's disease (PD) manifests as a movement and brain function disorder characterized by symptoms such as resting tremors, rigidity, bradykinesia, and postural instability, leading to disability among patients. The use of psychostimulants such as caffeine has been associated with the improvement of motor symptoms in PD patients; however, studies regarding the effect of caffeine adjuvant therapy on motor function among PD patients in the Indonesian population are lacking. The aim of this study was to evaluate motor improvement as measured by the change in scores of the Movement Disorder Society - Unified Parkinson's Disease Rating Scale Part III (MDS-UPDRS-III) among PD patients receiving caffeine adjuvant. A double-blind randomized controlled trial (RCT) was conducted among PD patients at Dr. Soetomo General Academic Hospital and Universitas Airlangga Hospital, Surabaya, Indonesia, from April to August 2023. A total of 27 patients were enrolled and randomly assigned to an intervention (receiving caffeine adjuvant, n=15) and control group (receiving placebo, n=12). Motor improvement was measured using the UPDRS III score prior to intervention and three weeks after. The Chi-squared test was used to analyze the difference in UPDRS III scores between the two groups. Motor improvement, as demonstrated by a reduction in the UPDRS III score, was observed in patients receiving caffeine adjuvant compared to those receiving placebo (80.0% vs 16.7%; p=0.004). Regarding the safety profile, only four out of 15 (26.6%) patients treated with caffeine reported minor adverse events. These conditions improved over time during the intervention. None of the 12 patients in the placebo reported adverse events. This study provides valuable insights into the initial dosage of caffeine that improves motor function in PD patients with minimum adverse effects.

Pathological Hip Dislocation in a Neurofibromatosis Patient Secondary to Capsular Hemangioma.

Neurofibromatosis is an autosomal-dominant multi-system disease affecting the nervous, integumentary, ocular, and musculoskeletal systems. In the small number of reported cases, the cause was either atraumatic or an intra-articular neurofibroma. Only a couple of articles in medical literature have reported synovial and capsular hemangioma originating within the hip joint. In this article, we present a rare case of pathological hip dislocation in a neurofibromatosis patient secondary to capsular hemangioma that would be reported for the first time in medical literature. We present the case of a 20-year-old female, resident of Karachi, who presented to the outpatient clinic with pain in the left hip join and inability to bear weight on left leg for 1 week. Diagnosed as a case of posterior hip dislocation after physical examination and imaging, her dislocation was reduced by the Allis method. This maneuver, however, was unsuccessful. Ultimately, the joint was reduced with open reduction via Steinmann pin because post-reduction hip joint was unstable to be contained into the acetabulum; therefore, Steinmann pin was used. The biopsy specimen taken from joint capsule and femoral neck during the surgery revealed cavernous hemangioma within the capsule. Hence, the etiology of posterior hip dislocation was attributed to the presence of capsular hemangioma within the hip joint. The surgery proved successful. The patient had remarkable recovery. The Steinmann pin was removed at 6 weeks, full weight-bearing started at 3 months, and range of motion extended from 0 to 90 degrees at 1 year with imaging studies showing a normally placed hip joint. The presented case reports an unusual etiology of a rare pathology occurring in association with a common genetic disease. It focuses on the importance of thorough examination and extensive relevant investigations in patients presenting with rare pathologies. These practices not only expedite the diagnosis and treatment of such patients, but can also reveal unusual etiologies responsible for uncommon pathologies. This case would help widen the differential diagnosis and treatment strategies of the physicians while dealing with neurofibromatosis patients with pathological hip dislocation. Level of Evidence This is a case report having Level of Evidence 4 in accordance with the levels developed by the Centre of Evidence Based Medicine (CEBM) for treatment.

Limb shaking movement as a rare manifestation of transient ischemic attacks caused by carotid stenosis disease: A case report.

A limb shaking TIA is a less common form of TIA that manifests as involuntary movement and is frequently confused with focal motor epilepsy. A 64-year-old female presented with a 7-month history of episodic involuntary shaking movements affecting her left arm and leg before admission. These attacks primarily occurred after she rose from a sitting or lying down position to a standing position, and were relieved by simply returning to a sitting or lying position. A neurological examination revealed no motor or sensory deficits in either extremity. Her magnetic resonance angiogram (MRA) and carotid Doppler revealed right ICA stenosis in her brain. It is important to distinguish this limb shaking TIA from other conditions such as focal motor seizures. Importantly, early detection and treatment of the associated carotid artery occlusion can not only prevent the patient's TIA episode, but also lower the risk of future stroke.

Structural magnetic resonance imaging in Parkinson disease with freezing of gait: A systematic review of literature.

Objective: This review aims to the existing structural neuroimaging literature in Parkinson disease presenting with freezing of gait. The summary of this article provides an opportunity for a better understanding of the structural findings of freezing of gait in Parkinson disease based on MRI. Methods: This systematic review of literature follows the procedures as described by the guideline of Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Initial searches yielded 545 documents. After exclusions, 11 articles were included into our study. Current findings of structural MRI on freezing of gait in Parkinson disease are associated with structural damage between sensorimotor-related cortical grey matter structures and thalamus, but not cerebellum and smaller systems, as well as extensive injuries on white matter connecting between those structures. Conclusion: Current findings of structural MRI on freezing of gait in Parkinson disease are associated with structural damage between sensorimotor-related cortical grey matter structures and thalamus, but not cerebellum and smaller systems, as well as extensive injuries on white matter connecting between those structures.

Delayed Cerebral Ischemia after Embolization in Ruptured Spinal Arteriovenous Fistula with Subarachnoid Hemorrhage : A Case Report.

Delayed cerebral ischemia (DCI) remains a devastating complication in subarachnoid hemorrhage (SAH), however, there were no present reports that is associated with a ruptured spinal arteriovenous fistula (sAVF). We would like to present a rare case of DCI following embolization of a ruptured perimedullary sAVF. Initially, the patient clinical symptoms mimic a SAH caused by a ruptured intracranial aneurysm. Further evaluation revealed that the SAH was caused by a ruptured perimedullary sAVF and the patient's condition improved following the embolization procedure. Three days later, the patient developed an acute left-sided facial and motor weakness, which persisted until the patient was discharged on the day-15 onset. A magnetic resonance imaging and angiography is performed 1.5 years after discharge and revealed no signs of cerebral infarction and hemorrhage. In this paper, we reported DCI after embolization in a ruptured sAVF with SAH, supported by evidence from the current literature. We would like to also stress the importance of complete spinal and cerebral vessel imaging to reveal the underlying abnormalities and determine the most appropriate intervention.

Digestibility, Growth Performance, Body Measurement and Hormone of Sheep Fed with Different Levels of Brachiaria decumbens Diets.

Limited data are available regarding the effects of Brachiaria decumbens on sheep's growth performance at different times. Therefore, this current study focused on sheep's nutrient apparent digestibility, feed efficiency, body index, and growth hormone when they are fed with low and high levels of B. decumbens diets. A total of 30 six-month-old male Dorper cross sheep were divided randomly into three treatment groups with 10 sheep per treatment. Treatment 1 (control) sheep were fed with Pennisetum purpureum and pellets as the basal diet, whereas Treatment 2 and 3 sheep were fed with feed mixed with low (10%) and high (60%) levels of B. decumbens, respectively. The study was conducted in two phases consisting of short-term feeding (seven days) and long-term feeding (90 days). Throughout the experiment, daily fecal voided were collected in the morning for seven days continuous before the end of each feeding phases for the determination of nutrient apparent digestibility. The amount of feed offered and refusals plus body weight gain were recorded daily to determine the feed efficiency (FE). Besides, the body measurements of each sheep from every treatment were measured weekly and blood samples were collected for the analysis of growth hormone (GH) concentration. There were significant differences (p < 0.05) in the nutrient apparent digestibility, growth performance, body measurement, and GH concentration among treatment sheep throughout the study period. Treatment 3 sheep fed with 60% of B. decumbens diet revealed the lowest dry matter (DM), crude protein (CP), neutral detergent fiber (NDF), and acid detergent fiber (ADF) digestibility during the long-term feeding. Likewise, Treatment 3 (T3) sheep had the lowest total bodyweight gain, average daily gain, total feed intake, and daily feed intake among treatment sheep. The heart girth index (HGI) of T3 sheep was also significantly lower during the short-term feeding. Moreover, the GH concentration of T3 sheep was significantly lower as compared to the control that decreases steadily throughout the study period. In conclusion, high levels of B. decumbens showed the most significant results out of all three treatments indicating the presence of saponins, which produce negative effects on the sheep's overall performance.

Data tersedia mengenai kesan jumlah Brachiaria decumbens yang berbeza terhadap prestasi pertumbuhan biri-biri pada tempoh masa yang berbeza adalah terhad. Oleh itu, kajian semasa ini memberi tumpuan kepada kebolehcernaan ketara nutrien, kecekapan makanan, indeks badan, dan hormon pertumbuhan bebiri yang diberi makan dengan diet B. decumbens pada tahap rendah dan tinggi. Sebanyak 30 ekor bebiri Dorper jantan berumur 6 bulan dibahagikan secara rawak kepada 3 kumpulan rawatan dengan 10 ekor bebiri setiap kumpulan. Rawatan 1 (kawalan) bebiri diberi makan dengan Pennisetum purpureum dan pelet sebagai diet asas, manakala bebiri Rawatan 2 dan 3 masing-masing diberi makan dengan campuran B. decumbens pada tahap rendah (10%) dan tinggi (60%). Kajian ini dijalankan dalam dua fasa yang terdiri daripada pemakanan jangka pendek (7 hari) dan panjang (90 hari). Sepanjang eksperimen, najis harian yang dibuang dikumpulkan pada waktu pagi selama 7 hari berterusan sebelum tamat setiap fasa pemakanan untuk menentukan kebolehcernaan ketara nutrien. Jumlah makanan yang diberi, sisa makanan, dan penambahan berat badan direkodkan setiap hari untuk menentukan kecekapan makanan (FE). Selain itu, ukuran badan setiap bebiri daripada setiap rawatan diukur setiap minggu serta sampel darah diambil untuk analisis kepekatan hormon pertumbuhan (GH). Terdapat perbezaan yang signifikan (p < 0.05) dalam kebolehcernaan ketara nutrien, prestasi pertumbuhan, ukuran badan, dan kepekatan GH di kalangan bebiri rawatan sepanjang tempoh kajian. Bebiri rawatan 3 (T3) yang diberi makan dengan 60% diet B. decumbens menunjukkan kebolehcernaan bahan kering (DM), protein kasar (CP), gentian detergen neutral (NDF), dan gentian detergen asid (ADF) yang paling rendah semasa pemberian makanan jangka panjang. Bebiri T3 mempunyai jumlah penambahan berat badan, purata kenaikan harian, jumlah pengambilan makanan, dan pengambilan makanan harian yang paling rendah di kalangan bebiri rawatan. Indeks lilitan jantung (HGI) bebiri T3 juga jauh lebih rendah semasa pemberian makanan jangka pendek. Selain itu, kepekatan GH bebiri T3 adalah jauh lebih rendah berbanding dengan bebiri kawalan yang menurun secara berterusan sepanjang tempoh kajian. Kesimpulannya, tahap B. decumbens yang tinggi menunjukkan keputusan yang paling ketara daripada ketiga rawatan yang menunjukkan kehadiran saponins boleh menghasilkan kesan negatif terhadap prestasi keseluruhan bebiri.

Development of hydrogel-forming microneedles for transdermal delivery of albendazole from liquid reservoir.

Albendazole (ABZ) is an anthelmintic agent from the benzimidazole group, known as the broad-spectrum antiparasitic drug. ABZ is commonly used to treat human intestinal and systemic infections. Orally administered ABZ tends to have limited efficacy due to its poor solubility. In order to enhance its delivery to the therapeutic target, polyvinyl alcohol-based hydrogel-forming microneedles (HFMs) was developed. HFMs can effectively deliver drugs loaded in the reservoir through the transdermal route with fewer side effects and longer therapeutic duration. In addition, to enhance ABZ's solubility, the drug can be loaded as a liquid reservoir using water-miscible solvents, which will effectively enhance the solubility of ABZ, resulting in higher bioavailability. In this study, HFMs was successfully developed with high swelling abilities, more than 400%. Moreover, the penetration result showed HFMs could penetrate up to 63% into the skin with only a 7.14% of height decrease. The skin integrity test also showed HFMs permeation into the skin, causing no changes in skin integrity after 24 h of application. Incorporated with the liquid reservoir, the ex vivo permeation test showed that the cumulative amount of ABZ permeated through the skin was about 971.23 ± 11.77 µg/cm2. In conclusion, this innovation has a huge potential to overcome the limitations of ABZ in oral preparations and potentially enhance its therapeutic effect through the transdermal route.

Comparison of the Administration Route of Stem Cell Therapy for Ischemic Stroke: A Systematic Review and Meta-Analysis of the Clinical Outcomes and Safety.

Stem cell treatment is emerging as an appealing alternative for stroke patients, but there still needs to be an agreement on the protocols in place, including the route of administration. This systematic review aimed to assess the efficacy and safety of the administration routes of stem cell treatment for ischemic stroke. A systematic review was performed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. A comprehensive literature search was undertaken using the PubMed, Scopus, and Cochrane databases. A total of 21 publications on stem cell therapy for ischemic stroke were included. Efficacy outcomes were measured using the National Institutes of Health Stroke Scale (NIHSS), the modified Rankin Scale (mRS), and the Barthel index (BI). Intracerebral administration showed a better outcome than other routes, but a greater number of adverse events followed due to its invasiveness. Adverse events were shown to be related to the natural history of stroke not to the treatment. However, further investigation is required, since studies have yet to compare the different administration methods directly.

Correlation Between Neutrophil-to-Lymphocyte Ratio and Motoric Deterioration in Patients With Guillain-Barre Syndrome.

BACKGROUND AND PURPOSE: Guillain-Barre syndrome (GBS) is a common cause of inflammation-related acute flaccid paralysis, and is characterized by acute onset, rapid progression, and symmetrical weakness. GBS is an emergency with high morbidity and long-term disability rates. It is important to determine the prognostic factors for GBS in order to improve the disease outcomes. This study aimed to identify the correlation between the neutrophil-to-lymphocyte ratio (NLR) on day 1 of hospitalization (D1) and motor deterioration in GBS patients. METHODS: This observational analytical study applied a cross-sectional analysis to the medical records of GBS patients who were hospitalized at Dr. Soetomo General Hospital Surabaya from January 2018 to March 2020. The analysis used the chi-square bivariate test, multivariate analysis with logistic regression, and correlation analysis with the Spearman test. RESULTS: The study included 61 subjects. Statistical tests showed that there was no correlation between NLR and changes in the Medical Research Council sum scores (ΔMRC sum scores) during D1-D3, D1-D7, D1-D14, and D1 to the day of discharge (p>0.05). There was a significant correlation between NLR and the Erasmus GBS outcome score (EGOS) (p=0.006). NLR values differed significantly within each treatment group (p=0.001). Therefore, a subanalysis within each treatment group was conducted, which revealed a significant negative correlation (p<0.05) between NLR and the ΔMRC sum score during D1-D14 in the group treated without immunotherapy. CONCLUSIONS: There was no correlation between NLR and motor deterioration in patients with GBS during hospitalization. However, NLR was significantly correlated with EGOS, and there was a negative correlation between NLR and motor deterioration during D1-D14 in GBS patients treated without immunotherapy.

Bilateral asymptomatic common carotid artery stenosis: Mouse model for stroke research.

Background: Asymptomatic carotid artery stenosis has become more prevalent worldwide and is often associated with a poor prognosis. Numerous guidelines highlighted surgical interventions as treatment for carotid artery stenosis, but only a few recommendations were made regarding non-surgical interventions due to its limited data. Aims: This study aims to develop a mice model for research in non-surgical interventions of asymptomatic carotid artery stenosis. Methods: Adult male Rattus norvegicus, Wistar strain models with bilateral asymptomatic common carotid artery stenosis (BACAS) were created by ligating the common carotid artery with a 0.6 mm diameter needle and then removing the needle. The mice's body weight, clinical signs and symptoms, and post-mortem brain analysis were compared between the sham-operated group and the BACAS group. Results: The mortality rate among the BACAS group is 11.11%. There is no significant difference in mean body weight before surgery, after the observation period, and percentage of weight decrease between sham-operated and BACAS groups (p = 0.710, 0.632, and 0.806, respectively). None of the surviving mice in this study exhibit signs of motor paralysis. Gross examination of the brain reveals no signs of infarction or hemorrhage. Conclusion: We have established a novel BACAS mouse model which is cost-efficient, easy to produce, and with no significant alteration in body weight, clinical parameters, and brain morphology.

The Effect of Green Tea with EGCG Active Compound in Enhancing the Expression of M2 Microglia Marker (CD206).

Background: Stroke is a neurological deficit due to vascular disorders. Microglia are the first line of defense against brain injury. Anti-inflammatory cytokines activate M2 microglia, which upregulate CD206. EGCG is abundant in green tea, which has an anti-inflammatory effect. Objective: To know the effect of green tea with its active compound EGCG on CD206 expression. Settings and Design: True experimental trial design. Material and Methods: Rattus Novergicus were divided into six groups: a negative control group (Sham), a positive control group (P0), MCAO mice given 10 mg/kg BW EGCG (P1), 20 mg/kg BW EGCG (P2), 30 mg/kg BW EGCG (P3), and 30 mg/kg BW standardized green tea extract (P4). CD206 expression was measured using immunohistochemistry and scored according to the Allred scoring guidelines. Statistical Analysis Used: Descriptive test, Levine test, Kolmogorov-Smirnoff test, Independent sample t test, Pearson correlation test. Results: We discovered that there is a significant difference in CD206 expression between the Sham and P0 groups (P < 0.05). In addition, there are significant differences in expression between the sham group and the other two groups (P1 and P2) (P < 0.05). Furthermore, when we compared the P0 group with each treatment group, we found that CD206 expression between P0-P2, P0-P3, P0-P4 are significantly different. There is a significant correlation between green tea with its active compound EGCG and CD206 expression enhancement. The correlation is positive. Conclusions: Green tea with EGCG active compound increases CD206 expression as an M2 marker in the Rattus norvegicus with MCAO model.

The effect of Camellia sinensis (green tea) with its active compound EGCG on neuronal cell necroptosis in Rattus norvegicus middle cerebral artery occlusion (MCAO) model.

OBJECTIVES: To determine the inhibition effect of epigallocatechin gallate (EGCG) and green tea extract on neuronal necroptosis based on necroptosis morphology. METHODS: In vivo study was performed on male Rattus norvegicus middle cerebral artery occlusion (MCAO) model divided into five groups, MCAO-control groups, EGCG 10 mg/kg BW/day, EGCG 20 mg/kg BW/day, EGCG 30 mg/kg BW/day, and green tea extract 30 mg/kg BW/day for 7 days treatment. MCAO model was made by modification method using Bulldog clamp. After 7 days of treatment, all R. norvegicus were sacrificed. After that, examination using Hematoxylin-Eosin stain was conducted to look at necroptosis morphology in each group. RESULTS: We found that there are significant differences between control group and the other three groups (EGCG 20 mg/kg BW/day, EGCG 30 mg/kg BW/day, and green tea extract (p<0.05). There is a significant correlation between the number of neuron cell necroptosis and both EGCG and green tea extract (p<0.05). The correlation is negative, which means both EGCG and green tea extract will decrease the number of neuron cell necroptosis. EGCG will decrease neuron cell necroptosis starting from the dose of 20 mg/kg BW/day. EGCG 30 mg/kg BW/day produces the best result compared to other doses. CONCLUSIONS: Camellia sinensis (green tea) with its active compound EGCG decreases neuronal necroptosis morphology in MCAO models.

VIM Line Technique for Determining the Ventral Intermediate Location.

AIM: To prove that VIM line technique created by using a mathematical model, can be used to identify the location of the ventral intermediate nucleus of the thalamus (VIM) MATERIAL and METHODS: Eleven patients with Parkinson?s disease (PD) were assessed. To determine the VIM location, 3-T magnetic resonance imaging and stereotactic protocol 128-slice computed tomography were used. The VIM line technique was performed by drawing a line from the end-point of the right external globus pallidus to that of the left external globus pallidus in the intercommissural plane. PD severity was measured using the Unified Parkinson?s Disease Rating Scale (UPDRS). RESULTS: A mathematical model was constructed to describe the VIM line technique for determining the VIM location. UPDRS scores before and after thalamotomy showed a significant decreasing trend (p=0.003). CONCLUSION: The VIM line technique using the mathematical model can be considered a referential method to determine the VIM location. Its effectiveness was demonstrated by decreased UPDRS scores in patients after VIM thalamotomy.

Filling the gap of Brachiaria decumbens (signal grass) research on clinico-pathology and haemato-biochemistry in small ruminants: A review.

Brachiaria decumbens (signal grass) is a highly productive tropical grass that is widespread in some tropical countries due to its adaptation to a wide range of environments and soil types. However, a limiting factor for the use of this grass is its toxicity from steroidal saponins. Sporadic outbreaks of hepatogenous photosensitization in ruminants grazing on this grass have been reported. Sheep are more susceptible than other animal species and the young are more susceptible than adults. This review article will critically shed light on the B. decumbens profile, its toxic compounds, mechanisms, clinical responses, blood profile alterations, pathological changes, and acute phase responses related to signal grass intoxication. Further research is needed to integrate new findings on B. decumbens intoxication with previous preventive and therapeutic trials to minimize or remove its deleterious toxic effect.

Vim line technique thalamotomy for Parkinson tremor: Case series.

INTRODUCTION: The ventral intermediate (Vim) nucleus of the thalamus is difficult to identify even with 3 T magnetic resonance imaging. Stereotactic Vim thalamotomy is a usual procedure to control Parkinson tremor. Successful relieving of the tremor depends on the accuracy of defining the Vim location. PRESENTATION OF CASES: Three patients with Parkinson tremor were subjected to stereotactic thalamotomy using the Vim line technique (VLT) so as to precisely determine the Vim location. All patients showed good results, with improved tremors, as indicated by the UPDRS score, without any complications. DISCUSSION: The precise targeting of the Vim nucleus is crucial importance for the successful Vim thalamotomy. Various method has been developed to determine Vim location. Atlas based and Guiot's technique routinely used by neurosurgeon. VLT is a new technique that has been developed to determine the Vim location on MRI. CONCLUSION: VLT is useful for the determination of the Vim location. However, further research is warranted to prove its effectiveness.

Implementation and Outcomes of a Molecular Tumor Board at Herbert-Herman Cancer Center, Sparrow Hospital.

OBJECTIVE: This paper describes our experience and outcomes from 54 cases presented to the (Molecular tumor board) MTB. METHODS: 54 Cases presented between July 2017 and April 2018 were included in this analysis. These patients had different types of cancers that had either failed standard therapy or were expected to fail and physicians were looking for future options for anticipated progression. Patients who had obvious mutations and were candidates for Targeted Agent and Profiling Utilization Registry or Molecular Analysis for Treatment Choice clinical trials were not included. Oncologists presented the cases virtually and Foundation Medicine scientific and clinical team discussed the molecular pathways to find targeted options or trials. Tumor board attendees included oncologists, nurses, pharmacists, mid-level providers, residents and staff of the Cancer Center. RESULTS: Amongst the 54 cases presented 81% had one or more potentially actionable alteration. 12 (22%) patients received genomically matched therapy as per MTB recommendations. Additional 13 (24%) patients have options available when they progress. Out of 12 patients who got treatment six are alive at the time of this analysis. Genomically matched therapy or Clinical Trials option were offered to the 46% of patients based on the MTB discussion. CONCLUSION: More widespread use of molecular diagnostics, better physician education and multidisciplinary collaboration between the staff involved in diagnosis and treatment, as well as third party payers are necessary for consensus on treatment and care of oncology patients.