Chance-type flexion-distraction fracture of lumbar spine

A case of a twenty years old male who had been hit by a van at the lower back, presented two weeks later with complete paraplegia and double incontinence is presented. Radiological imaging revealed shearing of spine with fracture line slicing through the second lumbar (L2) vertebra going across all the three vertebral columns with complete retrolisthesis of upper fragment. He was managed conservatively with immobilization and rehabilitation

Isolated Sacral Metastasis Mimicking a Chordoma Presenting as a First Manifestation of Thyroid Malignancy: Case Report

Fifty-nine years old female presented with the clinical manifestations of lumbosacral plexopathy. MR imaging revealed a large destructive pelvic mass of sacral origin, mimicking a sacral chordoma. Histopathological findings are suggestive of follicular variant of papillary carcinoma of thyroid origin. There was no clinically palpable thyroid lesion or any clinical feature suggestive of thyroid dysfunction. This report describes an isolated sacral metastasis of thyroid origin without prior clinical features of thyroid malignancy. Keywords:  Sacral metastasis, Thyroid metastasis, sacral chordoma, spinal metastasis, sacral tumor, pelvic tumors

Primary chiasmal sarcoid granuloma masquerading as glioma of the optic chiasm

A 37-year-old woman presented with a 6 months history of headaches and memory impairment. Examination showed no neurological deficit with normal vision. MRI scans showed an enlarged optic chiasm. There was no dural or leptomeningeal enhancement or hydrocephalus. Open biopsy of the suprasellar mass showed non-caseating chronic granulomatous inflammation compatible with sarcoidosis. Systemic features of sarcoid were absent. Patient showed marked improvement on steroid therapy

Peritumoral cystic meningioma

A case of 39 years old male is described who presented with headache, right-sided focal fits and decreased power in the right hand. CT scan brain showed a left fronto-parietal cystic lesion with centrolateral intramural nodule with homogenous enhancement. At surgery, the extra-axial lesion with cyst containing xanthochromic fluid had a well-defined capsule that could easily be separated from the peri-lesional cortical surface. The dural-based nodule with its cyst wall was resected in toto. The histopathology of mural nodule was reported as meningioma while the cyst wall histology revealed meningothelial cells

Chemically synthesized CdSe quantum dots inhibit growth of human lung carcinoma cells via ROS generation

Quantum dots (QDs), semiconducting materials have potential applications in the field of electronic and biomedical applications including cancer therapy. In present study, cadmium selenide (CdSe) QDs were synthesized by chemical method. Octadecene was used as non-coordinating solvent which facilitated the formation of colloidal solutions of nanoparticles. CdSe QDs were characterized by UV-vis spectrometer and transmission electron microscope (TEM). The size measured by TEM was varied between 2-5 nm depending upon temperature. The cytotoxic activity of QDs was monitored by MTT assay, nuclear condensation, ROS activity and DNA fragmentation assay on human lung epithelial A549 cell line. Cells were treated with different concentrations of varying size of CdSe QDs for 24 h. CdSe QDs induced significant (p < 0.05) dose dependent cytotoxicity and this was comparable to the sizes of particles. Smaller particles were more cytotoxic to the large particles. Fluorescence microscopic analysis revealed that QDs induced oxidative stress generating significant ROS level and consequently, induced nuclear condensation and DNA fragmentation. Study suggested the cytotoxicity of CdSe QDs via ROS generation and DNA fragmentation depending upon particles size

Craniocerebral aspergillosis in immunocompetent hosts: Surgical perspective

Craniocerebral aspergillosis is a rare but dangerous variety of central nervous system infections. Surgery is being widely recognized as the cornerstone of management. Due to the rarity of the disease, difficulty and delay in diagnosis and poor outcome, there is very little in the literature regarding the various surgical strategies that may be adopted in these patients. Early aggressive surgery followed by chemotherapy offers the best chances. Surgical planning would depend upon the type and location of the disease process as well as the condition of the patient. Perioperative care holds immense importance and knowledge of possible complications is essential. Aspergillosis of the central nervous system is difficult to diagnose and equally difficult to treat. Surgery remains the cornerstone of management followed by systemic antifungal medications. Results are better in immunocompetent patients as compared to those who are immunocompromised

Probabilistic measures of HIV-1 transmission in different HIV-1 key population groups of Larkana, Pakistan

Objective: To estimate the probability of human immunodeficiency virus (HIV)-1 transmission from different key HIV population groups using probabilistic modelling.Methods: This study was conducted in December 2020. A probabilistic model was used to estimate the probability of HIV-1 transmission from different key HIV population groups in Larkana. Our model was run on three probabilistic assumptions: 1) each replication gave two conceivable results: \u27true\u27 or \u27false\u27; 2) the chance of giving a \u27true\u27 result is the same for each replication; and 3) the replications are independent - \u27true\u27 in one will not impact the likelihood of \u27true\u27 in another.Results: The results estimated the probability of HIV transmission in key HIV population groups in Larkana to range between 0.42-0.54 per trial, where the highest probability of transmission was predicted for men who have sex with men (MSM; 0.54 per trial), followed by transgender (TG; 0.46 per trial) and people who inject drugs (PWID; 0.457 per trial).Conclusions: Our results suggest that there is a high likelihood of HIV transmission by key population groups in Larkana, such as MSM, TG, and PWID. Mathematic models, such as one proposed in our study can aid the HIV and acquired immunodeficiency syndrome (AIDS) control programmes in evaluating and optimising the strategies in controlling transmission of HIV from the key population groups

Effects of antiplatelet therapy on stroke risk by brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases: subgroup analyses of the RESTART randomised, open-label trial

Background Findings from the RESTART trial suggest that starting antiplatelet therapy might reduce the risk of recurrent symptomatic intracerebral haemorrhage compared with avoiding antiplatelet therapy. Brain imaging features of intracerebral haemorrhage and cerebral small vessel diseases (such as cerebral microbleeds) are associated with greater risks of recurrent intracerebral haemorrhage. We did subgroup analyses of the RESTART trial to explore whether these brain imaging features modify the effects of antiplatelet therapy

Prognostic model to predict postoperative acute kidney injury in patients undergoing major gastrointestinal surgery based on a national prospective observational cohort study.

Background: Acute illness, existing co-morbidities and surgical stress response can all contribute to postoperative acute kidney injury (AKI) in patients undergoing major gastrointestinal surgery. The aim of this study was prospectively to develop a pragmatic prognostic model to stratify patients according to risk of developing AKI after major gastrointestinal surgery. Methods: This prospective multicentre cohort study included consecutive adults undergoing elective or emergency gastrointestinal resection, liver resection or stoma reversal in 2-week blocks over a continuous 3-month period. The primary outcome was the rate of AKI within 7 days of surgery. Bootstrap stability was used to select clinically plausible risk factors into the model. Internal model validation was carried out by bootstrap validation. Results: A total of 4544 patients were included across 173 centres in the UK and Ireland. The overall rate of AKI was 14·2 per cent (646 of 4544) and the 30-day mortality rate was 1·8 per cent (84 of 4544). Stage 1 AKI was significantly associated with 30-day mortality (unadjusted odds ratio 7·61, 95 per cent c.i. 4·49 to 12·90; P < 0·001), with increasing odds of death with each AKI stage. Six variables were selected for inclusion in the prognostic model: age, sex, ASA grade, preoperative estimated glomerular filtration rate, planned open surgery and preoperative use of either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Internal validation demonstrated good model discrimination (c-statistic 0·65). Discussion: Following major gastrointestinal surgery, AKI occurred in one in seven patients. This preoperative prognostic model identified patients at high risk of postoperative AKI. Validation in an independent data set is required to ensure generalizability