Fluorescence in neurosurgery: its therapeutic and diagnostic significance - a comprehensive review.

This review provides a comprehensive overview of the therapeutic and diagnostic implications of fluorescence imaging in neurosurgery. Fluorescence imaging has become a valuable intraoperative visualization and guidance tool, facilitating precise surgical interventions. The therapeutic role of fluorescence is examined, including its application in photodynamic therapy and tumor-targeted therapy. It also explores its diagnostic capabilities in tumor detection, margin assessment, and blood-brain barrier evaluation. Drawing from clinical and preclinical studies, the review underscores the growing evidence supporting the efficacy of fluorescence imaging in neurosurgical practice. Furthermore, it discusses current limitations and future directions, emphasizing the potential for emerging technologies to enhance the utility and accessibility of fluorescence imaging, ultimately improving patient outcomes in neurosurgery.

Global and regional mortality statistics of nipah virus from 1994 to 2023: a comprehensive systematic review and meta-analysis.

The mortality rate of Nipah virus (NiV) can vary in different regions, and its pattern across timelines has yet to be assessed. The primary objective is to perform a comparative analysis of mortality rates across different timelines and countries. Articles reporting NiV mortality from inception to November 2023 were analyzed in PubMed, Ovid Embase, Scopus, and Web of Science databases. A meta-analysis utilizing random-effects models determined the mortality rate secondary to NiV complications. The initial search strategy yielded 1213 records, of which 36 articles met the inclusion criteria, comprising 2736 NiV patients. The Global mortality rate of the Nipah virus in the 2014-2023 decade was 80.1% (CI: 68.7-88.1%), indicating a significant 24% increase compared to the preceding decade (2004-2013) with a mortality rate of 54.1% (CI: 35.5-71.6%). Among the countries analyzed for overall mortality from 1994-2023, India experienced the highest mortality rate at 82.7% (CI: 74.6-88.6%), followed by Bangladesh at 62.1% (CI: 45.6-76.2%), Philippines at 52.9% (CI: 30-74.5%), Malaysia at 28.9% (CI: 21.4-37.9%), and Singapore at 21% (CI: 8-45%). Subgroup analysis revealed that India consistently had the highest mortality rate for the past two decades (91.7% and 89.3%). The primary complication leading to mortality was encephalitis, accounting for 95% of cases. This systematic review and meta-analysis revealed a noteworthy surge in NiV mortality rates, particularly in the current decade (2014-2023). The escalation, with India reporting a concerning level of mortality of 89.3-91.7% in the past decades, signifies a pressing public health challenge.

Sublingual Epidermoid Cyst: Diagnosis, Surgical Treatment, and Follow-Up in a 22-Year-Old Male-A Case Report.

Epidermoid inclusion cysts are rare in the oral cavity, accounting for less than 0.01% of cysts found there. These cysts are defined as epidermoid if they contain only epithelial lining, dermoid if skin appendages, and teratoid if they contain other tissues such as muscle, cartilage, and bone. This case report describes a case of a plunging ranula that was later diagnosed as an epidermoid inclusion cyst. The patient is a 22-year-old male who presented with swelling in the floor of the mouth and difficulty eating solid foods for the past 4 months. Upon examination, a shiny, pink-colored mass measuring 1 cm × 5 cm was observed, which displaced the tongue upward and backward. MRI scan of the brain, face, and neck revealed a well-defined, non-enhancing cystic mass measuring 6.6 cm × 4.5 cm that extended beyond the sublingual area. Histopathological examination after surgical removal of the cyst revealed that the cyst wall was lined with stratified squamous keratinized epithelium with a retained granular layer, and the cavity was filled with lamellated keratin flakes. The patient recovered well after surgery; no recurrence was observed at the 6-month follow-up.

Noninvasive diagnosis of Ascaris lumbricoides in the common bile duct: A pediatric case report of acute pancreatitis.

Key Clinical Message: This case report highlights the importance of considering parasitic infections, particularly Ascaris lumbricoides, as a possible cause of acute pancreatitis in children, especially in endemic regions. Noninvasive imaging techniques, such as ultrasonography, can play a crucial role in the early detection and diagnosis of this unusual presentation. Timely administration of anthelmintic therapy led to the resolution of symptoms and prevented the need for invasive procedures. Healthcare providers should be vigilant about the diverse clinical manifestations of ascariasis, and regular deworming programs and health education are essential in minimizing the burden of this neglected tropical disease among children. Abstract: Ascariasis is a common public health problem globally but it is more prevalent in school-age children and it often goes undiagnosed, leading to severe complications. The purpose of this report is to spread awareness of its unusual presentation and how to judiciously use noninvasive approaches for its diagnosis. We present a case of a 10-year-old girl that was presented in pediatric emergency with gradually worsening epigastric pain. Initial lab work-up showed elevated pancreatic enzymes which lead to the diagnosis of acute pancreatitis. The patient was managed in the line of acute pancreatitis and with further evaluation by imaging techniques such as ultrasound and CT-scan abdomen, Ascaris lumbricoides (A. lumbricoides) was visualized. She was then treated with prophylactic antibiotics and antiparasitic medications, which resolved her symptoms and the child responded to the treatment. In children, parasites should be considered as a cause of acute pancreatitis by clinicians, especially in low-income countries, and before performing invasive procedures, noninvasive approaches should be considered as an initial option. This can save the patient from multiple invasive procedure and its severe complications.

Hypolipidaemic effects of methanol extract of Holoptelea integrifolia (Roxb.) Planchon bark in diet-induced obese rats.

The leaf and bark paste of Holoptelea integrifolia is traditionally used for the treatment of obesity in Asian countries. However, no scientific studies have been undertaken to reveal the actual mechanism of action. The present study aimed to investigate the hypolipidaemic effect of H. integrifolia and its mechanism in diet-induced obese rat model. After 4 weeks of oral administration, blood samples were collected for the estimation of serum lipids, lecithin: cholesterolacyltransferase (LCAT) apolipoproteins (apo) and liver for HMG-CoA reductase (HMGR) assay. The faecal samples were also collected to estimate the faecal fat content. The H. integrifolia treatment markedly lowered body weight, serum lipids and apo B and increase high-density lipoprotein-cholesterol and apo A1 concentrations. In this study, HMGR activity was enormously reduced, which helps to reduce cholesterol biosynthesis and an increase in LCAT activity was also observed. The detailed faecal analysis showed a remarkable increase in faecal lipids, which indicates the ability to inhibit intestinal fat absorption. The methanol fraction of H. integrifolia on LC-MS and tandem mass spectrometry analysis shows the presence of a compound, 3-(7-ethoxy-4-methyl-2-oxo-2H-chromen-3-yl)propanoate (C1). The result showed that the significant hypolipidaemic effect of H. integrifolia may be linked to its ability to inhibit HMGR activity and block intestinal fat absorption.

Hypolipidemic effect of methanol fraction of Aconitum heterophyllum wall ex Royle and the mechanism of action in diet-induced obese rats.

Aconitum heterophyllum is an endangered Himalayan plant included in "lekhaneyagana," a pharmacological classification mentioned by Charaka in "Charakasamhita" which means reduce excess fat. The subterranean part of the plant is used for the treatment of diseases like nervous system disorders, fever, diarrhea, obesity, etc. In the present study, we are reporting the hypolipidemic effect of methanol fraction of A. heterophyllum. The methanol extract of A. heterophyllum was orally administered in diet-induced obese rats. After four weeks treatment, blood samples were collected for the estimation of serum lipids and lecithin-cholesterol acyltransferase (LCAT). Liver was collected for the assay of HMG-CoA reductase (HMGR). The fecal samples were also collected to estimate the fecal fat content. The A. heterophyllum treatment markedly lowered total cholesterol, triglycerides and apolipoprotein B concentrations in blood serum. It also showed positive effects (increase) on serum high-density lipoprotein cholesterol (HDL-c) and apolipoprotein A1 concentrations. On the other hand, A. heterophyllum treatment lowered HMGR activity, which helps to reduce endogenous cholesterol synthesis and also activated LCAT, helping increase in HDL-c. An increase in fecal fat content is also an indication of the hypolipidemic effect of A. heterophyllum. The significant hypolipidemic effect of A. heterophyllum may be linked to its ability to inhibit HMGR activity and block intestinal fat absorption. The increase in HDL-c may be linked to its ability to activate LCAT enzyme.