Neurointerventional Radiology: History, Present and Future
Published on: 20th June, 2023
Neurointerventional Radiology (NIR), encompassing neuroendovascular surgery, endovascular neurosurgery, and interventional neurology, is an innovative and rapidly evolving multidisciplinary specialty focused on minimally invasive therapies for a wide range of neurological disorders. This review provides a comprehensive overview of NIR, discussing the three routes into the field, highlighting their distinct training paradigms, and emphasizing the importance of unified approaches through organizations like the Society of Neurointerventional Surgery (SNIS).The paper explores the benefits of co-managed care and its potential to improve patient outcomes, as well as the role of interdisciplinary collaboration and cross-disciplinary integration in advancing the field. We discuss the various contributions of neurosurgery, radiology, and neurology to cerebrovascular surgery, aiming to inform and educate those interested in pursuing a career in neurointervention. Additionally, the review examines the adoption of innovative technologies such as robotic-assisted techniques and artificial intelligence in NIR, and their implications for patient care and the future of the specialty. By presenting a comprehensive analysis of the field of neurointervention, we hope to inspire those considering a career in this exciting and rapidly advancing specialty, and underscore the importance of interdisciplinary collaboration in shaping its future.
Amniotic Fluid Ischemia Modified Albumin as a Novel Prenatal Diagnostic Marker for Down Syndrome: A Prospective Case-Control Study
Published on: 21st June, 2023
Aims: There is no study in the literature about ischemia-modified albumin (IMA) and hepatocyte growth factor (HGF) levels in amniotic fluid for Down syndrome cases. The aim of this study was to investigate the changes of IMA and HGF in Down syndrome cases at 16-20 weeks of gestation compared to normal fetuses.Methods: For this prospective case-control study, following reaching the number of 20 women (study group) who had the prenatal diagnosis of Down syndrome, maternal and gestational age-matched pregnant women with normal constitutional karyotype were selected for the control group (n = 74) from the stored amniotic fluid samples. Results: Mean women and gestational ages were comparable between the two groups. Amniotic fluid IMA (1.32 ± 0.13 vs. 1.11 ± 0.11 ABSU, respectively, p < 0.001) and HGF (2743.53 ± 1389.28 vs. 2160.12 ± 654.63 pg/mL, respectively, p = 0.008). Levels were significantly higher in pregnant women having Down syndrome fetuses compared with women having normal fetuses. The amniotic fluid IMA levels for the diagnosis of Down syndrome, and the sensitivity and specificity were calculated as 95.0% and 71.6% for the limit value 1.171 cm3, respectively. Conclusion: In cases with suspected Down syndrome, the diagnosis of Down Syndrome may be made in approximately 1 hour with high sensitivity and specificity by measuring the IMA level in the amniotic fluid sample taken for fetal karyotyping.
Surgical Management of Uterine Fibroids at the Teaching Hospital of Angre Abidjan Cote d’Ivoire: 193 Cases Report
Published on: 20th June, 2023
Objective: To evaluate the surgical management of myomas at the Teaching Hospital of Angré according to the FIGO (International Federation of Gynecology and Obstetrics) classification.Patients and methods: This was a cross-sectional study at the Teaching Hospital of Angre from January 1, 2020, to December 31, 2022. Patients whose operative indication was clearly identified were included in the study. Incomplete files were not included. The variables studied were anthropometric parameters, clinical characteristics of myomas, and surgery. Due to the large size and multifocal location of uterine myomas, the therapeutic option remained surgery by laparotomy.Results: Most patients were over 35 years old (71.5%) and nulliparous (52.8%). The first indication for surgery was menometrorrhagia (88.6%), followed by the desire for motherhood (37.8%) and dysmenorrhoea (20.2%) for myomas most often FIGO type 4 (p = 0.0031). Myomectomy under cervical-isthmic tourniquet was the most common procedure for FIGO type 4 myomas (66.1%; p = 0.0543). Hysterectomy was most frequently performed for FIGO type 7 myomas (43.9%; p = 0.0543). For myomectomy, the first complication was anaemia (3.5%) followed by uterine suture haemorrhage (1.7%) (p = 0.5139).Conclusion: Our surgical practice at the Teaching Hospital of Angre is in accordance with FIGO recommendations. However, an effort should be made to promote the minimally invasive surgical approach (laparoscopic, hysteroscopic, transvaginal ablation) for small fibroids (≤ 5 cm) or FIGO type 0 to 3, which is not very frequent in our current practice.
The Role of Advanced Imaging in Paediatric Cardiology: Basic Principles and Indications
Published on: 24th June, 2023
Tissue Doppler Imaging and Speckle Tracking Echocardiography are newer echo-cardiographic modalities, that assess myocardial and valvular function in congenital and acquired heart diseases in childhood. In addition, cross-sectional imaging including Cardiac Magnetic Resonance (CMR) and Cardiac Computed Tomography has been widely used over the last decade in paediatric cardiology, in order to evaluate intra-cardiac and extra-cardiac anatomy. Cardiac Magnetic Resonance particularly allows detailed analysis of myocardial function, and shunt quantification and has applications even in fetal life. This mini-review summarizes the basic principles of the above-advanced modalities and highlights their main indications and clinical applications in childhood.
Vitamin D Deficiency and its Correlation with the Severity of Heart Disease in Dilated Cardiomyopathy Patients
Published on: 20th June, 2023
Background: Cardiomyopathy is primarily a disorder of the cardiac muscle that causes myocardial dysfunction and is not the result of disease or dysfunction of other cardiac structures, systemic arterial hypertension and valvular stenosis or regurgitation. Aim: The present study aimed to determine the prevalence of vitamin D deficiency and its correlation with the severity of heart disease in patients with dilated cardiomyopathy (DCMP). Method: 70 ECHO-proven DCMP cases were enrolled from the medicine/ cardiology department of LHMC & associated hospitals and ABVIMS & Dr. RML Hospital, New Delhi from November 2019 to October 2021. DCMP patients with ages more than 18 years who were willing to give consent and does not meet any of the exclusion criteria were enrolled in this study. Results: Mean age of idiopathic DCMP patients was 48.3 ± 15.2. There were more males 48 (69%) than females 22 (31%). The mean ejection fraction was 26.6 ± 7.3, while the mean fractional shortening was 17.6 ± 3.1. Vitamin D deficiency was observed in 90% of patients, among which 68.5% were having moderate vitamin D deficiency and 10% were having severe vitamin D deficiency. Conclusion: In our study, vitamin D levels were inversely correlated with the severity of heart disease in DCMP patients.
Haemodynamic, Biochemical and Respiratory Implications of total Bronchoalveolar Lavage in Pulmonary Alveolar Proteinosis
Published on: 17th June, 2023
Introduction: Total bronchoalveolar lavage (BAL) continues to be the treatment of choice for alveolar proteinosis (AP), facilitating the removal of lipoprotein material. The purpose of this article is to evaluate the impact of haemodynamic, biochemical, and respiratory parameters, as well as the complications and evolution of patients undergoing this procedure. Methods: Retrospective, observational, and descriptive study of BAL. The technique was performed in the Intensive Care Unit. Blood gases, blood pressure, central venous pressure, body temperature, and fluid balance were analyzed. Results: Including eight patients, thirty-eight BAL were performed from 2008 to 2021. The mean instillation of saline at each session was 13.464 ± 4.002 ml per lung. No significant changes were observed before and after BAL in heart rate and blood pressure. Mean central venous pressure increased by 2.59 cm H20. The pO2 initial was 126 mmHg with a final mean of 69.7 mmHg, with statistical significance. The pCO2, HCO3 and pH parameters remained stable. Complications were observed during fifteen of the thirty-eight BAL (nine with arterial hypotension, three with glottic oedema, one acute pulmonary oedema, one pneumothorax, and one cardiorespiratory arrest). In terms of evolution, one case had a clinical-radiological resolution, one case of exits, one required lung transplantation, and the remaining five remained stable. Conclusion: This study demonstrates that the procedure, is well tolerated haemodynamically and that the biochemical alterations to which the patient is subjected are not compromised. With few complications and good results in delaying the progression of AP.
Anticancer Activity of Genistin: A Short Review
Published on: 16th June, 2023
Genistein is an isoflavone glycoside that provides a variety of health advantages. The possibility of cancer chemopreventive drugs derived from natural sources, such as polyphenols, may constitute a novel, cost-effective strategy to reduce the rising burden of cancer throughout the world. A soy-rich diet was linked to cancer prevention in several epidemiological studies, which was explained by the presence of the phenolic component genistein in soy-based foods. Inhibiting metastasis and changing apoptosis, the cell cycle, and angiogenesis are the key ways that genistin fights various cancers. It acts as a chemotherapeutic agent against different types of cancer, mainly by altering apoptosis, the cell cycle, and angiogenesis and inhibiting metastasis. This study critically evaluates the literature that is currently available on the therapeutic benefits of genistin for various cancers.
Human Monkeypox Virus Severity
Published on: 16th June, 2023
Monkeypox is a sylvatic zoonotic sickness that initially affected tropical rainforest areas in the west and vital Africa earlier than spreading to other places. Its miles carried with the aid of the Monkeypox virus member of orthopoxvirus circle of relatives. The clinical features of the infection resembles to smallpox. The primary animal to human transmission is the cause of most people of human Monkeypox ailments. Severe rodent species and non-human primates function hosts for the virus. Transmission can manifest with infected people, animals or objects into contact with bodily fluids, sores on the skin or inner mucosal surfaces just like the mouth or throat, or breathing droplets. The incubation length for Monkeypox usually lasts 6 to 13 days, even though it could last as long as 21 days. The ailment is often self-proscribing, with signs and symptoms generally clearing up on their own inside 14 to 21 days. Signs can range from moderate to extreme, and lesions may be itchy or painful. Due to the discontinuation of recurring smallpox vaccination which supplied some pass- safety in past, populations have become more liable to Monkey pox. The outbreak of Monkeypox virus due to the fact that may additionally, 2022 has created a worldwide risk of the virus. In the present review, Monkeypox epidemiology, severity, therapeutics, vaccination and its transmission to non-endemic countries has been considered. Special care and guidelines may help in the containing in the spread of the infections to the non endemic countries.
Validating the ORACollect for the detection of cytomegalovirus
Published on: 16th June, 2023
Targeted screening for Cytomegalovirus (CMV) in Deaf and Hard of Hearing (DHH) children is now internationally recommended. With newborn genomic screening for DHH children a future possibility, the commercially-available human genomic DNA collection kit (ORACollect, Oragene OCR-100) could enable one single sample to screen for CMV and genetic causes of deafness at scale with minimal additional costs. Our pilot study validated ORACollect against Copan FLOQswabs® (gold standard clinical procedure) for detecting CMV using 15 sets of saliva samples from 14 infants/children, comparing CMV PCR results using different testing protocols. ORACollect stored at room temperature had high sensitivity (up to 89%), specificity (up to 80%) and percent agreement (up to 86%) in detecting CMV DNA compared to FLOQswabs®. This suggests that ORACollect is an appropriate alternative to FLOQswabs® for collecting viral CMV DNA for PCR testing, independent of the DNA extraction approach. This could be revolutionary in facilitating dual genomic and viral screening in newborns and would enable CMV screening in non-tertiary hospital settings where laboratory facilities are not available.
Perceptions of Adolescent Mothers on Feeding and Nutrition of their Children aged 0-3 Years in Rural Bangladesh
Published on: 16th June, 2023
Proper feeding practices at an early age are the key to improving a child’s overall health and achieving developmental milestones. In Bangladesh, a large portion of rural girls become mothers before the age of 18. Past records show that most interventions are designed to improve infant and young child feeding practices targeting older mothers. That is why, this study has been designed with an aim to explore the perceptions and practices of infant and young children feeding among rural Bangladeshi mothers aged <19 years old. Data was collected through in-depth interviews and group discussions with a total of 40 adolescent mothers who have children aged 0-3 years. Data has revealed that the majority of the mothers hold very limited knowledge of nutrition and child nutrition but those who are educationally a bit ahead hold a little better knowledge. Participants are aware of breastfeeding but they all misinterpret the term ‘exclusive breastfeeding’ with other liquid food. It has also emerged that most of the mothers know the ideal timing of starting complementary feeding but very few of them actually understand what to feed children. In spite of having misconceptions and superstation rural adolescent mothers practice responsive feeding instead of force-feeding. No gender discrimination has been found regarding child feeding. The findings of the study pinpointed that mothers are unable to practice proper infant and child feeding due to a lack of knowledge and limited affordability. Educating girls & young mothers and improving financial security could be an effective way to promote improved infant feeding practices.
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