Spinal extradural meningioma: Report of two cases.

Purely extradural spinal meningiomas are rare and often confused with metastases and schwannomas. Only a few cases have been described in the literature, and they are located mainly in the cervical and dorsal regions. We present two cases of extradural meningiomas, one well-defined nodular growth present at a cervicodorsal junction that was confused with schwannoma preoperatively and the other typical meningioma extending both intra and extradurally in the upper dorsal spine.

Opuntia ficus-indica (L.) Mill. - anticancer properties and phytochemicals: current trends and future perspectives.

Cancer is a leading cause of mortality worldwide, and conventional cancer therapies such as chemotherapy and radiotherapy often result in undesirable and adverse effects. Natural products have emerged as a promising alternative for cancer treatment, with comparatively fewer side effects reported. Opuntia ficus-indica (L.) Mill., a member of the Cactaceae family, contains a diverse array of phytochemicals, including flavonoids, polyphenols, betalains, and tannins, which have been shown to exhibit potent anticancer properties. Various parts of the Opuntia plant, including the fruits, stems/cladodes, and roots, have demonstrated cytotoxic effects against malignant cell lines in numerous studies. This review comprehensively summarizes the anticancer attributes of the phytochemicals found in Opuntia ficus-indica (L.) Mill., highlighting their potential as natural cancer prevention and treatment agents. Bibliometric metric analysis of PubMed and Scopus-retrieved data using VOSviewer as well as QDA analysis provide further insights and niche to be explored. Most anticancer studies on Opuntia ficus-indica and its purified metabolites are related to colorectal/colon cancer, followed by melanoma and breast cancer. Very little attention has been paid to leukemia, thyroid, endometrial, liver, and prostate cancer, and it could be considered an opportunity for researchers to explore O. ficus-indica and its metabolites against these cancers. The most notable mechanisms expressed and validated in those studies are apoptosis, cell cycle arrest (G0/G1 and G2/M), Bcl-2 modulation, antiproliferative, oxidative stress-mediated mechanisms, and cytochrome c. We have also observed that cladodes and fruits of O. ficus-indica have been more studied than other plant parts, which again opens the opportunity for the researchers to explore. Further, cell line-based studies dominated, and very few studies were related to animal-based experiments. The Zebrafish model is another platform to explore. However, it seems like more in-depth studies are required to ascertain clinical utility of this biosustainable resource O. ficus-indica.

A Review on Green Synthesis of Silver Nanoparticles and its Role against Cancer.

Cancer is a fatal disease with a collection of related diseases in various body parts. The conventional therapies cannot show the desired results of treatment due to their imprecise targeting, deprived drug delivery, and side effects. Therefore, it is required to make the drug engineered so that it can target only cancerous cells and inhibit its growth and proliferation. Nanotechnology is a technology that can target and differentiate between cancerous cells and the body's normal cells. Silver itself is a good anticancer and antibacterial agent and employing it with phytochemicals with anticancer properties, and nanotechnology can give the best approach for the treatment. The synthesis of silver nanoparticles using plant extracts is an economical, energy-efficient, low-cost approach, and it doesn't need any hazardous chemicals. In the present review, we discussed different methods of synthesis of silver nanoparticles using herbal extracts and their role against cancer therapy along with the synergistic role of silver and plant extracts against cancer in the formulation.

Anti-acne Treatment using Nanotechnology based on Novel Drug Delivery System and Patents on Acne Formulations: A Review.

BACKGROUND: Acne is one of the most infectious diseases related to human skin. This disease of acne is of higher prevalence in adults. The main causative organism involved in the acne vulgaris is Propionibacterium acne, which leads to sebum production and follicular hyperkeratinization. METHODS: The scientific data shows inflammatory mediators of genetic factors, stress, physiological factor, androgens and hormonal changes; all these factors play a major part in the pathophysiology of acne. Several drugs are currently available for the treatment of Acne like bactericidal, antibiotic and several others which are directly or indirectly involved in the eradication of acne. RESULTS: Nanocarrier systems including liposomes, niosomes, microsponges, nano-emulsion and micro-emulsion, microspheres and solid lipid nanoparticles have emerged as a successful treatment for acne. In this article, the authors have laid special emphasis on these nanocarriers and the study of various patents based on novel technologies in this field. The entrapment of the anti-acne drug molecule into a particular nanocarrier system has been shown to enhance patient compliance and reduction in side-effects. CONCLUSION: The present review article provides an overview of the mechanism, advantages, drawbacks and various patents associated with the nanocarrier systems involved in acne treatment. Some state of the art patented and novel technologies such as stem cell secretion technology, sol-gel technology incorporating microcapsules and ultrasound delivery of nanoparticles for acne treatment, are also briefly discussed. The patent study on these nanocarriers was done through the worldwide database of the United States patent office, European patent office and several other official patent information websites.

Primary amenorrhea due to empty sella: an underestimated entity.

We report a 16-year-old girl who had stunted growth and primary amenorrhea presenting with headache and vomiting. MRI of brain showed posterior fossa dermoid cyst with hydrocephalus and empty sella. Growth hormone (GH), Leutinizing hormone (LH) and Follicular stimulating hormone (FSH) were grossly reduced on endocrinological work-up. She underwent suboccipital midline craniectomy and complete excision of dermoid cyst .She had no additional deficit after the surgery. She had menarche six months after the surgery and developed adequate secondary sexual characters, however her height remains subnormal at follow-up after 2 years as compared to age matched controls. We briefly review the radiological features, pathogenesis and outcome of this underestimated entity.

Giant cell tumor of dorsal vertebral body.

A 30-year-old female patient presented with complaints of backache, weakness in both lower limbs and bladder/bowel dysfunction. Imaging showed an osteolytic lesion at tenth dorsal (D10) vertebra with anterior compression on the spinal cord. Complete intralesional tumor excision with reconstruction was carried out using the anterolateral extrapleural approach. Histopathological examination was suggestive of giant cell tumor (GCT). Because of complete intralesional tumor excision and fear of post-radiation osteonecrosis of bone used for delayed bony union, a conservative approach was used, and radiation therapy was not given. After one year of follow-up patient is doing well without any recurrence of the tumor and is ambulant with support. GCT of dorsal vertebral body is an uncommon entity and total en bloc excision is difficult. Therefore, the treatment strategy is not well-defined. We discuss in brief about incidence, presentation and various treatment modalities available for spinal GCT.

Diabetes insipidus associated with a thickened pituitary stalk in a case of Langerhans Cell Histiocytosis.

Diabetes insipidus (DI) associated with a thickened pituitary stalk is a diagnostic challenge in the pediatric population. Langerhans Cell Histiocytosis (LCH) is a rare cause of this entity. A 4-year-old male child presented with central DI of 1-year duration, associated with a thickened pituitary stalk. The etiology for the same remained elusive as the patient had no other manifestation to suggest LCH. A year later, the patient developed a left frontal scalp swelling. Neuroradiology demonstrated multiple punched out osteolytic lesions in both the frontal bones. The infundibulum was thickened and showed post-contrast enhancement. Histology and immunohistochemistry (IHC) of the biopsy specimen confirmed LCH. The child was administered chemotherapy according to LCH protocol, which resulted in 33% reduction in the size of the skull lesions. The DI was controlled with medical management. The present case highlights the need for serial follow-up and magnetic resonance (MR) imaging that led to a diagnosis of LCH. The clinical presentation and management of central DI and a thickened pituitary stalk is presented and the relevant literature is discussed.

Multicompartmental cerebrospinal fluid dissemination of cerebellar pilocytic astrocytoma at presentation.

A 26-year-old male presented with a rare cerebellar pilocytic astrocytoma with multicompartmental subarachnoid metastases. Cerebrospinal fluid dissemination of low grade astrocytoma at presentation is rare in adults. In the present patient, clinical and neuroradiological follow-up at 4 years, without adjuvant treatment, revealed non progression of tumors. The occurrence of benign dormancy, low grade tumor histology and multifocal involvement of the neuraxis is rare. Close clinical observation is the best approach for management of such a patient. The relevant literature is discussed.

Spontaneous tension pneumocephalus in a patient with subdural empyema.

We report a 45-year old male who developed subdural empyema (SE) with tension pneumocephalus. The patient was admitted unconscious with tonic extensor response to pain. A "gas-forming" organism, Escherichia coli, was detected. Surgical evacuation of the pus and treatment with the appropriate antibiotic did not result in amelioration of his symptoms and the patient died. We identified a rare clinical situation when the SE cavity had a relatively large air loculus that was clearly related to gas-forming bacteria. It appeared that the patient had developed tension pneumocephalus related to the air produced by the pathogen. To our knowledge, this is the first report of a gas-forming organism in an abscess cavity that resulted in tension pneumocephalus and related symptoms.

Infratorcular meningoencephalocele with dermoid cyst.

Encephalocele represents one end of the spectrum of open neural tube defects. We report an infant with Chiari type 3 malformation manifesting as infratorcular occipital meningoencephalocele with dermoid cyst. To our knowledge, this is the first time that this association is described. The pathogenesis, surgical treatment, prognosis and management difficulties are also being discussed.

Supratentorial glioblastoma multiforme with spinal metastases.

Glioblastoma multiforme is the most common malignant brain tumor in adults. Metastasis of intracranial glioblastoma via the cerebrospinal fluid to the spine is a rare occurrence. We present two cases of glioblastoma multiforme with spinal leptomeningeal spread who presented with back pain and paraparesis.