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Aim: To study if there is an increase in the serum levels of Glial Fibrillary Acidic Protein (GFAP) in patients with glioblastoma so that it can be used as a diagnostic biomarker for these cases. Design: Prospective observational study. Material and Methods: We prospectively examined 193 patients, out of which 25 were controls (patients with degenerative spinal disease or CV junction anomaly), 79 were tumors other than glioma, 45 were histologically proven gliomas except glioblastoma and 44 were histologically proven glioblastomas. Serum was taken from the patients in the pre-operative period. Serum GFAP levels were determined using a biotin-labeled antibody-based sandwich enzyme immunoassay for the quantitative measurement of GFAP in ng/ml. Statistical Analysis: Data analysis was performed by using SPSS (Statistical Package for Social Sciences) version 20:0. Statistical significance was defined as P value < 0.05. Receiver operating characteristic (ROC) curve analysis was used to find the cut-off value of serum GFAP for glioblastoma patients. Results: In Group A (25 controls) and Group B (79 patients with non-glial brain tumors), no patient had detectable levels of GFAP in their serum. Out of the 45 patients with histologically proven gliomas except glioblastoma (Group C), 12 patients had raised serum GFAP levels. Out of the 44 patients with histologically proven glioblastomas (Group D), 38 patients had raised serum GFAP levels while in the remaining 6, the levels of serum GFAP were not detectable. The sensitivity of serum GFAP levels in diagnosing glioblastoma patients was 86.36% and the specificity was 91.95%. The diagnostic accuracy of the test was 90.67%. Conclusions: Serum GFAP is a sensitive and specific marker for glioblastoma and can be a useful pre-operative serum biochemical investigation in differentiating glioblastoma cases from other brain tumors.

Tennis leg is caused by a rupture of the medial head of the gastrocnemius muscle, usually at its distal musculotendinous junction region. However, tears in this muscle and its tendon are also included under the term ′tennis leg′. It is seen regularly in practice and is an important cause of a painful calf. The common USG findings include: disruption of the pinnate pattern of the distal medial gastrocnemius, usually near the junction of the triceps surae (which is the echogenic line between the gastrocnemius, the soleus, and the plantaris muscles), fluid tracking along the fascia, adjacent hematoma, and intramuscular tears as well as hematomas. USG is useful for confirming the diagnosis, excluding other causes of a painful calf, for assessing the severity of the disease, and in follow-up.

Several case reports regarding complications of ventriculoperitoneal (VP) shunt have been published, but peroral extrusion of shunt tube is unusual and reported less frequently. A 4-year-old male child with previous history of VP shunt insertion for congenital hydrocephalus along with shunt revisions twice presented with peritoneal end of shunt tube protruding through the mouth following an acute episode of vomiting. He was conscious without any signs of infection or neurologic deficits. The distal portion of the tube was removed uneventfully with the help of upper GI endoscope that, in addition to removal, provided better views for the identification of site and size of perforation. Peroral extrusion of the shunt tube needs immediate treatment that includes removal of extruded shunt tube, treatment of underlying infection, and attention to perforated viscus. We review the possible pathogenesis of this entity and various treatment options.

Colloid cysts are benign cystic lesions characteristically arising from the third ventricle roof close to the foramen of Monro. Although incredibly rare, hemorrhage within a third ventricular colloid cyst is sparsely reported. To the best of our knowledge, no cases of hemorrhage within the fourth ventricle colloid have ever been documented. Here, we present an interesting case describing a hemorrhagic colloid cyst situated within the fourth ventricle of a 55-year-old female patient who presented with symptoms of headache, vomiting, and gait imbalance. The cyst was excised during surgery via a suboccipital microscopic telovelar approach. Our findings led us to the conclusion that, despite being extremely rare, colloid cysts in the fourth ventricle can present with hemorrhagic episodes, which can exacerbate symptoms and hasten neurological decline. As a result, the presence of unusual radiological characteristics in a fourth ventricle lesion should prompt medical practitioners to suspect an atypical colloid cyst. This consideration can be pivotal in making informed surgical decisions. Expedited management and a microsurgical approach are recommended strategies for a better outcome.

Due to very less bioavailability (20%) of Rosuvastatin calcium, an attempt was made to develop and optimize microemulsion formulation. Capmul MCM, Tween 20 and PEG 400 were selected as oil, surfactant and cosurfactant respectively as the drug is having higher solubility in them. 3:1% w/w S:CoS was selected as it gave higher microemulsion area. Optimized batch (ME-1) was selected having 5% Capmul MCM, 50% Tween 20:PEG 400 and 45% water based on evaluation parameters globule size, zeta potential, PDI, % transmittance. [ABSTRACT FROM AUTHOR]