Brown spinal tumour secondary to primary hyperparathyroidism, a primary entity that we should not forget: Case report

Introduction: A thorough study of lytic lesions can guide us toward a more accurate aetiology in spinal column lesions. The use of imaging techniques and blood chemistry studies is useful when considering brown tumours as part of the differential diagnosis. Clinical Case: A 43-year-old woman with multiple comorbidities presented with lumbar pain. A lytic lesion in the body of S2 was documented, and thoracoabdominal lesions were initially ruled out. However, during her stay, a malignant thyroid lesion was documented. Discussion: Hyperparathyroidism, whether primary (adenomas, hyperplasia, or carcinoma) or secondary (vitamin D deficiency or chronic kidney disease), causes skeletal alterations in approximately 16% of cases. Among its manifestations are parathyroid tumours, which primarily affect the pelvis, rib arches, facial bones, and long bones, with less frequency in the spine. Clinically, these present progressive pain and neurological deficits. Diagnosis requires paraclinical tests and imaging studies. Treatment should address the underlying cause of hyperparathyroidism, with options ranging from medical therapies to surgical interventions. Conclusion: Thyroid carcinoma as a manifestation of a brown tumour at the sacral level is a rare presentation. We consider it pertinent to perform extension studies when evaluating patients with multiple comorbidities and a single lytic lesion

Brainstem cavernomas malformations: A systematic review and metanalysis on management, concepts and outcomes

Background: Brainstem cavernous malformations (BCM) are supratentorially located vascular structures that damage the central nervous system. The rarest forms of these malformations are found in the brainstem and cerebellum, associated with venous abnormalities that appear suddenly. The aim of this study is to demonstrate the importance of proper anatomical management of cavernous malformations of the brainstem and the optimal resection, whether endoscopic endonasal, microsurgical, suboccipital approaches, or craniotomy, in terms of neurological postoperative results.Material and methods: The search was exhaustive; it spanned several databases, including ScienceDirect and PubMed/MEDLINE, and was conducted using the PRISMA guidelines, R software for systematic reviews and meta-analyses, and Excel. Search terms included "Brainstem Cavernoma Malformations" along with terms specifying surgical techniques, brainstem or brainstem rehabilitation methods, and associated pathologies. Only studies published in English up to June 2025 were included.Results: In this systematic review and meta-analysis, we included a total of 1319 patients, of which GTR, N = 269 (20.3%), and STR, N = 14 (1%), were total. Table 1-3, while in Table 1-Figure 2, we included N = 931 (70.5%) patients, GTR, N = 207 (15.6%), and one STR, N = 9 (0.6%). Conclusion: This study shows that microsurgical resection of cavernous malformations of the brainstem is not only a complex issue in terms of the treatment of this pathology. Even so, endonasal endoscopy is gaining more and more strength, since 80% of resections, even with complications, have been very effective in terms of rehabilitation and postoperative follow-up

We Need to Talk About “Sumerian Literature”

The scope and purpose of the world’s earliest extant literature remain a matter of debate. Why bother to debate, however, since Sumerologists can study Sumerian literature despite their disagreement on the very definition of their topic, or even on the need thereof? Simply because this disagreement risks to hinder the understanding that the study seeks, is my contention. My research hypothesis is that a definition of Sumerian literature can be reached that is explanatory, involving a proximal genus and a specific differentia. In order to test this hypothesis, informed by Sherma’s (2011; 2022) “hermeneutics of intersubjectivity”, I argue that Sumerian literary compositions should be defined by the specific difference of being framed as distant in space, time, manner, or any combination thereof (that is, may I say, of their being of yonder, of yore, and/or of wonder) in contrast with other Sumerian compositions. A brief discussion of this definition against the backdrop of ancient Near Eastern literature helps to situate this paper beyond Sumerology and in the theory and history of literature. Indeed, Sumerian literature has a “performative” dimension in terms of the self-transformation of its literary audience. The definition of Sumerian literature is a topic whose time has come

Mapping the Past: Exploring Memory and Liminal Subjectivity of the Post-Partition Bengali Migrants in Siddhartha Deb’s “The Point of Return”

Colonial rule in South Asia has undeniably reshaped the region’s spatial and cultural landscape. However, the tremors of colonisation’s aftermath, which include partition, genocide, refugee movements, etc., have acquired characteristics which reek distinctly of their regional epicentre. South Asian countries, as is true of most postcolonial nation-states, often posit their territorial space, defined through cartographic borders, as the most essential and fundamental factor in determining the abstract concept of nationality. Though the nationalistic discourses celebrate the sanctity and inalterability of the territorial space, this is not as fixed as discourses would lead one to believe. This article intends to examine the transience of territorial space that is continually reconfigured along linguistic and ethnic lines, which consequently determines the belongingness or alienation of an individual in the given geopolitical scenario. The ‘post-memory’ of displacement, alienation and loss that haunts the post-Partition generation of migrants and their sense of homelessness that is distinct from, yet as poignant as that of their ancestors, will be examined through the textual framework of Siddhartha Deb’s debut novel The Point of Return (2002). The article will present a nuanced study of the tension emanating from the fractured interface between nationalism and sub-nationalism, which is adroitly portrayed by Siddhartha Deb in this novel

Women Poets of the Irish Troubles: Defining Themes

Northern Ireland’s Troubles turned the 20th century into a prolonged battleground. The country was divided by religion: Protestants versus Catholics. These conflicts led to the loss of thousands of lives and terrorism throughout the country. Male authors’ writings from this period have received consistent focus. This paper seeks to explore female authors and the defining characteristics of their work as they engaged with themes of violence, nature, and individualism. Six women who lived and wrote during that period are contextualised and examined

An inexpective adult diffuse astrocytoma: Case report and literature review

Background: Diffuse gliomas in adults also include astrocytoma and isocitrate dehydrogenase deficiency, oligodendrogliomas with 1p/19q deletion, and also glioblastoma, wild type (IDH). As indicated in the European guidelines on low-grade I gliomas, early extensive surgical resection may be associated with a good prognosis.  Molecular markers show that IDH1 R132H has a prognostic role in GBM. Temozolomide chemoradiation has shown beneficial results in the survival of patients with astrocytoma. Case description: A 76-year-old woman presented to our emergency room; according to her family and emergency medical team, the patient fell at home and received a direct blow to the head with loss of consciousness. The patient had a known history of hypertension for a few years and was taking antihypertensive medications periodically. Unspecified leukaemia. Respiratory rate: 16/min; respiratory rate: regular. On clinical examination, the patient is conscious, oriented, and has right-sided weakness. Glasgow GCS (points): 11 points. after a profound, stunning. Contact is very difficult due to speech disorders. (Dysarthria). He has a right hemiparesis of 2 points, with a Positive Babinski sign on the right side. Conclusion: The case highlights the importance of multimodal management, including early surgical intervention, molecular diagnostics, and postoperative care, in improving outcomes for patients with astrocytomas. A review of prognostic factors, such as age, GCS scores, and molecular markers like IDH1 mutations, emphasises the need for individualised treatment approaches. Although advances in chemoradiation, particularly with temozolomide, have improved survival rates, astrocytomas remain associated with high morbidity and mortality. This report underscores the critical role of early diagnosis, maximal safe resection, and tailored therapeutic strategies in optimising patient outcomes and quality of life.

Cranioplasty: autologous bone graft vs. titanium mesh: Comparative cross sectional study done in single centre

Background: Cranioplasty (CP) is a neurosurgical procedure performed after decompressive craniectomy using autologous bone graft or various artificial materials.  Objective: To determine differences in complications between patients who underwent CP using an autologous bone flap versus titanium mesh and to identify significant risk factors for post-CP complications.  Study design: Comparative cross-sectional study.  Methods: A total of 38 patients, 29 males (76.4%) and 9 females (23.6%), were included in this study. All patients underwent cranioplasty with titanium mesh or autologous bone graft.  Results: The results were compared between autografts and titanium implants. Autologous bone graft was used in 76.3% of the patients and titanium implant was used in 23.7%. Different complications occurred in 5.26% of the patients in both groups, 2.63% in the autologous group and 2.63% in the titanium mesh group respectively. Infection occurred in the surgical site in 5.26% of the patients in both groups (similar). Cranioplasty infection occurred in 2.63% of the patients who underwent autologous transplantation. One patient developed a hematoma in both groups. One patient underwent autologous bone graft removal, and one patient underwent mesh removal.  Practical implication: Titanium mesh cranioplasty is an essential procedure for junior neurosurgeons to learn and achieve good results, shorten hospital stays, and save hospital resources.  Conclusion: Titanium mesh cranioplasty has similar complications to autologous bone cranioplasty.

How Novelists Use Folklore as Weapons in Contemporary Revolutions of China: With the Examples of Lu Hsun, Hsiao Hung and Dai Sijie

Folklore is often used in literature to express nostalgia and depict the everyday lives of a nation’s people. There are few studies, however, on the role of folklore within Chinese revolutionary literature. Through interpreting three female fictional characters: Sister Xianglin in Lu Hsun’s The New Year’s Sacrifice (1924), the Little Child-bride in Hsiao Hung’s Tales of Hulan River (1941), and the Little Seamstress in Dai Sijie’s Balzac and the Little Chinese Seamstress (2000), I interpret how Chinese writers differently regarded folklore as weapons, either allies or enemies, to reveal the miserable lives of women in the fight for liberty during two of China’s contemporary revolutions, the Revolution of 1911 and The Great Proletarian Cultural Revolution held between 1968 to 1978. Folklore, in the context of these novels, is manifest primarily through references to folk sorcery cures, shamanic beliefs, and folk songs. Nevertheless, through the novelists’ different attitudes to folklore, we can see the complicated and thought-provoking history of Chinese contemporary revolutions

Human dorsal pseudotail: A rare congenital anomaly case report with review of literature

There are two different types of human tails: real tails and pseudotails. While pseudotails can be an abnormal extension of the coccygeal vertebra, lipoma, teratoma, chondrodystrophy, or parasitic fetus, true tails are made of adipose tissue, connective tissue, muscles, arteries, nerves, and mechanoreceptors. We are going to present a case of dorsal pseudotail in a 06 months old infant

"Bringing off a Successful Swindle": The Educational Climate and Its Capitalist Discontents in Orwell’s “A Clergyman’s Daughter”

Compared to George Orwell’s best-known works, 1984 (1949) and Animal Farm (1945), his earlier fiction has attracted significantly less critical attention. Yet, these novels deserve attention for the way Orwell draws on his own life, lending them some autobiographical quality, and for their exploration of many of the same socio-political concerns that preoccupied him as a journalist and essayist. One such concern is his representation of the lower tier of the private school system—an interest shaped by his experience as a private school teacher. This essay examines how Orwell’s second novel, A Clergyman’s Daughter (1935), reflects the capitalist ethos that was present in the educational climate of fourth-rate schools. By tracing the milestones of the protagonist Dorothy’s teaching career, I argue that her failure to reform the curriculum and her powerless resistance to Mrs Creevy, the proprietress of Ringwood House Academy, expose deeper structural flaws within the educational institutions of suburban London in the 1930s