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Melon (Cucumis melo) seeds are rich source of oil, protein and possess numerous medicinal properties; however, these are normally treated as waste. Present study was conducted to characterize the melon seed oil and to assess its potential to improve bread quality characteristics. For the purpose melon seed oil was extracted, analyzed regarding different parameters and utilized in bread manufacturing at various concentrations (T0=5% Shortening (control), T1=4 % melon seed oil, T2=5 % melon seed oil, T3= 6 % melon seed oil, T4=7 % melon seed oil). The results showed that melon seeds contain 29.86% oil. Iodine and saponification values were found as 118.8±3.57 (mg Iodine g -1), 188.83±5.37 (mg KOH g -1) respectively. Fatty acid profile revealed that linoleic acid was found in higher concentration i.e. 62.95g/100g. The oleic acid, palmitic acid, steric acid and cis-5, 8, 11, 14, 17 eicosapentanoic acid methyl esters were present in concentrations of 20.35, 4.96, 3.01 and 1.89g/100g, respectively. It was found, the melon seed oil improved bread quality characteristics like volume, relative volume, specific volume and density when it was applied at the level of 5% (T2). It improved sensory attributes of bread samples with the best results produced by T2. [ABSTRACT FROM AUTHOR]

Carbon dioxide (CO2) is the major cause of global warming. Many countries including Pakistan have signed the Kyoto Protocol agreement under the United Nations Framework Convention on Climate Change (UNFCC) and agreed to control the release of CO2 and to increase the CO2 sequestration. Agroforestry sector can contribute efficiently in carbon sequestration. This study was carried out to determine the status and potential of agroforestry and its role in carbon sequestration under semi-arid conditions. Data was collected through a multi-objective and pre-tested questionnaire from 250 village farmers in tehsil Sumandri, Pakistan. Height and girth of trees were measured from 250 randomly selected 0.405 ha farm plots. Soil samples from each cropping pattern were collected and analyzed. The whole study area has 2069.19 Mt of above ground carbon stocks and has sequestered a total of 7579.46 Mt of carbon dioxide at the rate of 186201.85 t CO2 yr-1. Furthermore, the study area has the potential of stocking 3607.61 Mt and sequestering 13214.67 Mt of CO2 at the rate of 327232.46 t CO2 per year. According to calculations, increasing the number of farm trees/ha, average CO2 sequestration rate of the study area can be increased from 2.05 t CO2 ha-1yr-1 to 3.59 t CO2 ha-1 yr-1. The role of agroforestry as C sink in not negligible and it should be given a dire consideration in policies, especially, in low forest countries like Pakistan to meets the melinium goals of atmospheric C reduction. [ABSTRACT FROM AUTHOR]

This study was conducted in Cholistan rangelands to collect information about the palatability and nutritive potential of browses that remained available throughout the year for livestock. Results revealed that ten browse species consisting of seven shrubs and three trees were observed to have preference, accessibility and abundance for grazing animals. Based on palatability Prosopis cineraria and Acacia nilotica were highly palatable, Calligonum polygonoides, Suaeda fruticosa, Salsola baryosma, Haloxylon recurvum, Capparis decidua, Calotropis procera and Tamarix aphylla were moderately palatable whereas Haloxylon salicornicum was less palatable. Free grazing animals were consisting of mix herds of sheep, goat, cattle and camel. They preferred different plants and their parts like leaf, shoot, flower, and fruits. Forage quality assessment showed significant differences (p<0.05) in nutrient values among selected species. The mean values of dry matter, crude protein, ether extract, crude fiber, total ash, nitrogen free extract, neutral detergent fibers, acid detergent fibers, hemicellulose and acid detergent lignin were 93.58%, 11.54%, 1.87%, 4.36%, 13.44%, 48.79%, 40.17%, 23.47%, 16.70%, and 7.22%, respectively which indicate fair level of nutrients. Consequently, this preliminary study has shown that identified browses have good palatability and feed potential for ruminants in the arid rangelands of Cholistan desert. [ABSTRACT FROM AUTHOR]

The browse vegetation in Cholistan rangelands of Pakistan have been on decline due to climatic extremes, overgrazing and anthropogenic pressure. Study area is hot arid desert where vegetation grow after rainfall but over grazing, extreme weather, and local comunity pressure for fire wood, timber, and harvesting of plants for varius purposes causing the decline of browse species. Therefore, a study was carried to investigate forage productivity, carrying capacity and palatability of browses. Multiple surveys were conducted from 2011-2012 at twenty range stands and 25 browse species belonging to 12 families were identified. Results revealed that browse productivity was high (8029.1 kg/ha) in wet season as compared to dry season (5422.9 kg/ha), correspondingly carrying capacity was high during wet season (16 ha/AU/Y) than dry season (24 ha/AU/Y). Moreover, during dry season, mostly stands were observed to be overgrazed while in wet season maximum stands were moderately grazed. High carrying capacity and good grazing status of stands in wet season was due to better forage production. Based on palatability classification, 22 species were found to have palatability to varying degree and 3 species were nonpalatable. In palatable species, leaves of 14 species; shoot/stem of 13 species, flower of 4 species, and fruit of 3 species were grazed by livestock, whereas cattle were observed to graze on 7 species; goat and sheep like 10 species each while camel prefer 20 species. The findings of this study indicate that overall the browse productivity of Cholistan rangelands was low and vary according to seasonal rainfall. Therefore, protection, suitable stocking rate and planned grazing is vital to conserve browses ultimately for sustainability of Cholistan rangelands. [ABSTRACT FROM AUTHOR]

The dominant spider species of order Araneae include Oxyopes javanus (Family Oxyopidae), Araenidae spp. (Family Araenidae), Pardosa oakleyi and Hippasa partita (Family Lycosidae) at cotton-wheat zone were studied for their predatory potential against three aphid species of canola crop under laboratory experiment. For laboratory experimentation, three species of aphids viz. Lipaphis erysimi, Myzus persicae, Brevicoryne brassicae, and worms were used. The results showed that spider consumed all the preys with different proportions offered in multiple and single prey feeding experiments. Oxyopes javanus was ravenous predator followed by Aranidae spp. on foliage and Pardosa oakleyi and Hippasa partita on ground with female consumed high number of preys as compared to male. Field observation showed seasonal variation in aphid population which in turn affect the diet of predators. The present study suggest that dominant spider species consumed aphids when they are at peak which may help in containing aphid population and this results in successful pest management in canola crop. [ABSTRACT FROM AUTHOR]

Accidental ingestion of fish bones can lead to serious complications, such as gastrointestinal perforation and hepatic abscesses. This case series presents three instances where fish bone ingestion led to secondary GI tract perforation and the development of hepatic abscesses. It also emphasizes the importance of prompt diagnosis and intervention to prevent serious consequences., Competing Interests: The authors declare no conflicts of interest., (© 2024 The Author(s). Clinical Case Reports published by John Wiley & Sons Ltd.)

Acetochlor is frequently applied to various food crops in agriculture sector, and long-term exposure can cause significant endocrine-disrupting effects in exposed animals including impacts on human health. This study aimed to evaluate the effects of acetochlor on the growth, hematology, serum biochemistry, and histopathological alterations in Japanese quail. Eighty male quail were obtained and divided into four groups (A-D) and given acetochlor orally for the period of 45 days. Group A was served as the control, while groups B, C, and D received 20mg/kg, 30mg/kg, and 40mg/kg acetochlor, respectively. The study found that Japanese quail administered higher doses of acetochlor exhibited reduced frequency of crowing and foam production. The results showed that increased concentrations of acetochlor led to adverse effects on the growth parameters of Japanese quail. Hematology analysis indicated that birds exposed to higher concentrations of acetochlor experienced a significant decrease in red blood cell count, hemoglobin concentration, hematocrit (HCT), mean corpuscular volume (MCV) and mean corpuscular hemoglobin concentration (MCHC), along with a significant increase in white blood cell count compared to the control group. Additionally, higher concentrations of acetochlor led to a significant increase in various serological indices including urea, creatinine, alanine aminotransferase (ALT), and aspartate aminotransferase (AST), while the values of total proteins, albumin, and plasma proteins declined. The histopathology results of treated Japanese quail exposed to higher concentrations of acetochlor showed a range of pathological lesions in the testes, heart, and brain. The study concluded that even low concentrations of acetochlor can cause slight to significant changes in Japanese quail, affecting their physical, hematological, histopathological and serum biochemical parameters., Competing Interests: The authors have declared that no competing interests exist., (Copyright: © 2024 Arshad et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.)

Abiotic stresses, such as high temperature and drought conditions, greatly influence the development of plants and the quality and quantity of products. Barley ( Hordeum vulgare L.) crop production is largely impacted by drought, affecting growth, yield, and ultimately the productivity of the crop in hot arid/semi-arid conditions. The current pot experiment was directed to observe the outcome of nicotinic acid (NA) treatments on barley's physiological, biochemical, and production attributes at two capacity levels, i.e., 100% normal range and withholding water stress. Randomized complete block design (RCBD) was used during the experimentation with the two-factor factorial arrangement. NA was applied exogenously by two different methods, i.e., foliar and soil application (fertigation). NA solution contained various application levels, such as T1 = control, foliar applications (T2 = 0.7368 gL -1 , T3 = 1.477 gL -1 , T4 = 2.2159 gL -1 ), and soil applications (T5 = 0.4924 gL -1 , T6 = 0.9848 gL -1 , and T7 = 1.4773 gL -1 ). Results depicted that, overall, foliar treatments showed better effects than control and soil treatments. Plant growth was preeminent under T4 treatment, such as plant height (71.07 cm), relative water content (84.0%), leaf water potential (39.73-MPa), leaf area index (36.53 cm 2 ), biological yield (15.10 kgha -1 ), grain yield (14.40 kgha -1 ), harvest index (57.70%), catalase (1.54 mmolg -1 FW -1 ), peroxidase (1.90 g -1 FWmin -1 ), and superoxide dismutase (52.60 µgFW -1 ) were superior under T4 treatment. Soil plant analysis development (54.13 µgcm -2 ) value was also higher under T4 treatment and lowest under T7 treatment. In conclusion, NA-treated plants were more successful in maintaining growth attributes than non-treated plants; therefore, the NA foliar treatment at the rate of 2.2159 gL -1 is suggested to find economical crop yield under drought conditions. The present study would contribute significantly to improving the drought tolerance potential of barley through exogenous NA supply in water deficit areas.

Being sessile organisms, plants cannot escape unwanted changes in the environment. The rapid human population explosion caused significant environmental problems. Heavy metals produced through various sources can cause severe damage to living organisms. The study was planned to evaluate four grass species' morpho-physiological growth characteristics and phytoremediation capabilities under chromium (Cr) and lead stress (Pb) in the arid climate. Typha angustifolia , Tragus roxburghii , Aeluropus logopoides , and Cenchrus ciliaris grass species were used for the study. One-year-old stubbles from the Cholistan desert were used for the experiment. Cr treatments in the form of K 2 Cr 2 O 7 were applied at 0, 20, 40, and 80 mg L -1 , whereas Pb was applied as PbCl 2 at 0, 50, 200, and 500 mg L -1 as control, low, moderate and high-stress, respectively. After 6 weeks of heavy metals treatments, plants were harvested and analyzed for growth performance and phytoremediation capabilities. Results depicted that, regarding morphological attributes, T. angustifolia performed better, followed by C. ciliaris ; no clear pattern was observed for T. roxburghii and A. logopoides . The CO 2 assimilation rate (Co 2 d) and water use efficiency (WUE) increased as the heavy metal stress increased in all species under both metals. In contrast, total chlorophyll content was higher under low stress. Other physiological parameters, such as relative humidity (RHd), net photosynthetic rate (A), transpiration rate (E), stomatal conductance (Gs), leaf internal CO2 concentration (Ci) and membrane stability index (MSI) gradually decreased as the Cr, and Pb stress levels increased among all the species. Moreover, Cr and Pb absorption contents of T. angustifolia were higher than the other three species at each stress level. Overall, T. angustifolia thrived against heavy metals stress and showed higher biomass, maximum photosynthetic measurements, WUE and higher metal absorption among all the selected species. Results concluded that although all the selected species behaved fine under stress conditions, T. angustifolia performance was better; thus, it can be used to remediate the soil near industrial estates., Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. The handling editor declared a past co-authorship with one of the author RS., (Copyright © 2022 Farooq, Rafay, Basit, Shakoor, Shabbir, Riaz, Ali, Kumar, Qureshi and Jaremko.)

The current study was performed under controlled conditions to study the effects of exogenous potassium application on carotenoid contents and drought tolerance in Camelina. Water deficit levels such as 100% FC (control) and 40% FC (drought stress) were imposed after germination of Camelina plants grown to maturity, and different treatments of exogenous K+ were applied at the vegetative stage. We have reported 17 traits of plant growth, physiology, antioxidant enzyme activity, focusing on carotenoids in Camelina to explore their potential yield and yield components. For this purpose, we used multivariate analysis techniques (descriptive statistics, correlation matrix, analysis of variance [ANOVA] and principal components analysis [PCA] to determine the best relation between potassium and studied traits). The results showed a large number of variations in the studied trait under control and water deficit condition. Plant fresh weight (g) was negatively correlated with shoot length and SOD insignificantly correlated with plant fresh weight (g) under water deficit conditions. Potassium loading predicted that foliar application (3 mM K 2 SO 4 ), foliar application (6 mM KNO 3 ), foliar application (12 mM KNO 3 ) and foliar application (12 mM K 2 SO 4 ) are the important doses that contribute the most to enhance the growth, physiological and biochemical activities and carotenoids to improve the Camelina yield under water deficit condition. These doses should be considered in the future to improve the Camelina yield under semi-arid conditions with increased genetic diversity (varietal selection)., (© 2022 Scandinavian Plant Physiology Society.)

Melatonin, being an endogenous signaling molecule plays important role in plant growth and stress alleviation. The present study was conducted to evaluate the ameliorative role of melatonin against Cr toxicity in maize seedlings. The Cr toxicity (50, 100 and 200 µM) severely affected hydroponically grown seedlings growth in a dose-dependent manner; however, the melatonin (0.5 and 1.0 µM) application markedly restored toxicity-induced growth retardation. Higher dose of melatonin (1.0 µM) was more effective in case of lower Cr toxicity (50 and 100 µM). Exposure of 200 µM Cr caused 45% and 43% reduction in shoot and root lengths and more than 80% reduction in biomass. In case of 200 µM Cr toxicity, application of 1.0 µM MT effectively restored shoot and root lengths reduction (from 45 to 30%) and biomass decline (from 80 to around 60%). Biomass restoration by 1.0 µM melatonin under 50 and 100 µM Cr was even more pronounced bringing it near to control plants having no Cr exposure. Further, both melatonin levels also improved root tips, root diameter, root volume and root surface area that had been damaged by Cr exposure. The melatonin also alleviated Cr-induced chlorophyll and carotenoids inhibition, improved relative water content, and markedly lowered proline and MDA content in shoots. Lower accumulation of MDA and proline, and greater membrane stability indices indicate that the melatonin conferred better plant growth by playing the role of antioxidant and detoxifying oxidative stress creating substances. Although antioxidant enzymes viz. SOD, POD, CAT and APX activities were also elevated by MT, this increase was not significantly different in the most of cases. No significant difference in NPK contents of shoot was observed by Cr and melatonin application indicating the growth retardation being caused directly by Cr intrinsic toxicity and not by nutrients deficiency. The melatonin-based amelioration of Cr toxicity in maize seedlings seems as the result of its nature as antioxidant, and not by activation/elevation of antioxidative enzymatic system., (© 2021. The Author(s), under exclusive licence to Springer Nature B.V.)

Introduction: Chiari malformations are a group of clinicopathological entities with a variety of clinical presentations, different pathophysiology, and variable outcomes. It has a typical set of clinical presentation. In this study is to observe the different clinical presentations of the patients with Chiari malformation in our population. As the time of initial presentation is delayed that might change the sign and symptoms with which patient initially presents., Materials and Methods: This was a cross-sectional observational study with prospectively collected data of 46 patients with Chiari malformation. The duration of the study is from 2017 to 2020. Patient's data will be compiled and analyzed through Statistical Package for Social Sciences (SPSS) Version 25. Qualitative variables are presented as frequencies and percentages. Quantitative variables are presented as mean ± standard deviation. Effect modifiers are controlled through stratification. The Chi-square test is used for finding association between categorical variables. P ≤ 0.05 is considered as statistically significant., Results: According to our data 36% of our patients presented with motor weakness which is followed by sensory deficit, however in previous literature headache was the commonest clinical presentation., Conclusion: Clinical presentation in our population differs from other studies and the reason behind this is the delayed presentation of the patient and lack of awareness of disease and ultimately it will alter the outcome of disease and treatment., Competing Interests: There are no conflicts of interest., (Copyright: © 2021 Asian Journal of Neurosurgery.)

Wastewater used as irrigation water is causing heavy metal accumulation in the agro-ecosystems. A greenhouse study was conducted to compare the phytoaccumulation ability of four agroforestry tree species under different wastewater treatments. Three-month-old potted seedlings of Morus alba , Acacia nilotica , Acacia ampliceps , and Azadirachta indica were irrigation with tap water (C), municipal wastewater (MWW), and industrial wastewater (IWW). Results showed that MWW had a positive and IWW had a negative impact on biomass production in all the species. Acacia ampliceps showed the highest increment (65%) and showed the lowest decrease (5%) in total biomass under both MWW and IWW treatment. Pb concentration was also found highest in the leaves, stem and roots of Azadirachta indica (108.5, 46.2, 180.5 mg kg -1 , respectively) under IWW. Production of H 2 O 2 was highest in IWW treatment with almost 148% increase observed in Azadirachta indica . Similarly, the production of antioxidative enzymes (Superoxide dismutase, Catalase and Peroxidase) was also highest in Azadirachta indica under IWW. Therefore, results suggest that along with high increment in total biomass, both Acacia ampliceps and Azadirachta indica showed high Pb concentration and an effective antioxidative defense mechanism and thus, can be used for planting in soils irrigated with MWW and IWW.

Background: The prevalence of cancer among children with stroke is unknown. This study sought to evaluate cancer- and tumor-associated childhood ischemic stroke in a multinational pediatric stroke registry., Methods: Children aged 29 days to less than 19 years with arterial ischemic stroke or cerebral sinovenous thrombosis enrolled in the International Pediatric Stroke Study between January 2003 and June 2019 were included. Data including stroke treatment and recurrence were compared between subjects with and without cancer using Wilcoxon rank sum and chi-square tests., Results: Cancer or tumor was present in 99 of 2968 children (3.3%) with arterial ischemic stroke and 64 of 596 children (10.7%) with cerebral sinovenous thrombosis. Among children in whom cancer type was identified, 42 of 88 arterial ischemic stroke cases (48%) had brain tumors and 35 (40%) had hematologic malignancies; 45 of 58 cerebral sinovenous thrombosis cases (78%) had hematologic malignancies and eight (14%) had brain tumors. Of 54 cancer-associated arterial ischemic stroke cases with a known cause, 34 (63%) were due to arteriopathy and nine (17%) were due to cardioembolism. Of 46 cancer-associated cerebral sinovenous thrombosis cases with a known cause, 41 (89%) were related to chemotherapy-induced or other prothrombotic states. Children with cancer were less likely than children without cancer to receive antithrombotic therapy for arterial ischemic stroke (58% vs 80%, P = 0.007) and anticoagulation for cerebral sinovenous thrombosis (71% vs 87%, P = 0.046). Recurrent arterial ischemic stroke (5% vs 2%, P = 0.04) and cerebral sinovenous thrombosis (5% vs 1%, P = 0.006) were more common among children with cancer., Conclusions: Cancer is an important risk factor for incident and recurrent childhood stroke. Stroke prevention strategies for children with cancer are needed., (Copyright © 2020 Elsevier Inc. All rights reserved.)

Background: Traumatic brain injuries represent a significant cause of morbidity and mortality worldwide and road traffic crashes account for a significant proportion of these injuries. It is one of the leading causes of death, especially among young adults, and, according to the World Health Organization, this will surpass many diseases as the major cause of death and disability by the year 2020 and lifelong disability is common in those who survive. It is also known as the silent epidemic. Many CT scan scoring systems for brain injury have been developed but none of them are validated. These scores are based on structural findings of CT scan to predict the prognosis. Marshall and Rotterdam are the two most widely used scoring systems., Method: This was an observational study with prospectively collected data. 903 consecutive patients with TBI. This study aimed to compare the Helsinki CT scoring system with the Rotterdam scoring system to find out the better score for the prognostic purpose by using the Glasgow outcome score., Results: Helsinki CT scoring system was found to be the most accurate score among the others in predicting the outcome of the patient based on morphological findings in CT scan. These scores also guided us regarding the treatment plan and patients with the good prognostic outcome are usually treated aggressively. Also these scores guide clinicians whether to opt for a conservative approach or any intervention., Conclusion: In this study we compared, Rotterdam vs. Helsinki CT Scoring System. We observed that the Helsinki score was a better outcome predictor for TBI than the Rotterdam score and can be used as a single validated score in predicting outcome and guiding the treatment., (Copyright © 2020 Elsevier B.V. All rights reserved.)

Conocarpus lancifolius is a fast-growing and drought tolerant tree species with phytoremediation potential in arid environments. The present study was conducted to evaluate the phytoaccumulation potential under wastewater treatment. The experiment was performed in a greenhouse where 3-month-old seedlings were irrigated with industrial wastewater and growth, biomass and physiological parameters were measured. Concentrations of zinc (Zn), lead (Pb), and cadmium (Cd) in leaves, shoots, and roots along with translocation and tolerance index were also determined. The results showed that under wastewater treatment total biomass increased from 24.2 to 31.5 g, net CO 2 assimilation rate increased from 9.93 to 13.3 μmol m -2 s -1 , and water use efficiency increased from 1.7 to 2.42. Similarly, heavy metals (Zn, Pb, and Cd) accumulation in stem, leaves, and roots increased significantly under wastewater treatment where the highest concentration of Zn, Pb and Cd was found in roots followed by leaves and stem, respectively. Tolerance index was found >1, and translocation factor of all heavy metals was found >1. The study revealed that phytoaccumulation potential of C. lancifolius was mainly driven by improved net CO 2 assimilation rate and water use efficiency.

The production of leafy vegetables such as Brassica chinensis L. in cadmium (Cd)-polluted soil causes serious threats to human health and food safety around the globe. A pot culture was established to examine the efficacy of rice-straw induced biochar (applied to soil at the rate of 0%, 2.5% and 5%, w/w) on growth, gaseous exchange attributes, antioxidative capacities and Cd uptake in pak choi (Brassica chinensis L.), when soil was spiked with Cd (CdCl 2 ) at 0, 5, 10 and 20 mg kg -1 soil. The results revealed that Cd stress significantly (P < 0.05) reduced plant biomass and physiological attributes, and accumulated higher Cd concentrations in plant tissues with the increasing rate of Cd concentration in the soil. However, incorporation of biochar at 5% application rate prominently increased the shoot (98.27%) and root (85.96%) dry biomass, net photosynthesis (45.52%), transpiration rate (161.34%), stomatal activity (111.76%) and intracellular CO 2 concentration (32.25%) when Cd was added at 20 mg kg -1 soil, relative to the respective treatment without biochar. Whereas, incorporation of biochar at 5% significantly reduced the bioavailable Cd by 16.64% under 20 mg kg -1 soil, compared to respective Cd treatment without biochar.Similarly, Cd accumulation in shoots and roots was decreased by 42.49% and 29.23%, and thereby reduced leaf MDA and H 2 O 2 contents by 21.45% and 31.28%, respectively, at 20 mg Cd kg -1 spiked soil relative to without biochar amended soil. An increment was noticed in the activities of guaiacol peroxidase (POD), superoxide dismutase (SOD), ascorbate peroxidase (APX), catalase (CAT) and glutathione (GSH) by 37.31%, 66.35%, 115.94%, 122.72% and 59.96%, respectively, with 5% biochar addition in 20 mg kg -1 Cd spiked soil. Moreover, biochar induced a synergistic impact on plants by increasing soil alkalinization and thereby reducing Cd phytotoxicity throughimmobilization. Overall, results proposed that rice-straw biochar has an ability to restore Cd polluted soil and increased pak choi production and thereby reduced food security risks in polluted soil., (Copyright © 2019 Elsevier Ltd. All rights reserved.)

Primary intracranial squamous cell carcinoma represents a rare entity. However, few cases have been reported in the literature so far. We report the case of a 32-year-old male who presented with a history of severe headache and vertigo for 3 weeks. Magnetic resonance imaging brain with contrast was done that showed a lesion measuring 5 cm × 4.8 cm in the left cerebellum near the midline which was hyperintense on T2 and hypointense on T1. It also showed ring-like heterogeneous contrast enhancement causing midline shift as well as pressure over the brainstem causing severe obstructive hydrocephalus. After emergency ventriculoperitoneal shunt placement, the patient subsequently underwent left paramedian suboccipital craniotomy and excision of space-occupying lesion. Intraoperatively, a well-demarcated capsule was identified. The entire lesion consisting of areas of calcification and hair particles was removed except the part of capsule which was adherent to the brainstem. Histopathology of the lesion showed infiltrating malignant neoplasm exhibiting papillary architecture with thick fibrovascular cores lined by stratified squamous cells. In order to rule out the possibility of metastases, systemic workup was done which yielded negative results., Competing Interests: There are no conflicts of interest.

Background and Objectives: Lipid-based self-nanoemulsifying drug delivery systems (SNEDDS) have resurged the eminence of nanoemulsions by modest adjustments and offer many valuable opportunities in drug delivery. Chlorpromazine, an antipsychotic agent with poor aqueous solubility-with extensive first-pass metabolism-can be a suitable candidate for the development of SNEDDS. The current study was designed to develop triglyceride-based SNEDDS of chlorpromazine to achieve improved solubility, stability, and oral bioavailability. Materials and Methods: Fifteen SNEDDS formulations of each short, medium, and long chain, triglycerides were synthesized and characterized to achieve optimized formulation. The optimized formulation was characterized for several in vitro and in vivo parameters. Results: Particle size, zeta potential, and drug loading of the optimized SNEDDS (LCT 14 ) were found to be 178 ± 16, -21.4, and 85.5%, respectively. Long chain triglyceride (LCT 14 ) showed a 1.5-fold increased elimination half-life (p < 0.01), up to 6-fold increased oral bioavailability, and 1.7-fold decreased plasma clearance rate (p < 0.01) compared to a drug suspension. Conclusion: The findings suggest that SNEDDS based on long-chain triglycerides (LCT 14 ) formulations seem to be a promising alternative for improving the oral bioavailability of chlorpromazine., Competing Interests: The authors declare no conflict of interest.

The 2017 update of The Canadian Stroke Best Practice Recommendations for the Secondary Prevention of Stroke is a collection of current evidence-based recommendations intended for use by clinicians across a wide range of settings. The goal is to provide guidance for the prevention of ischemic stroke recurrence through the identification and management of modifiable vascular risk factors. Recommendations include those related to diagnostic testing, diet and lifestyle, smoking, hypertension, hyperlipidemia, diabetes, antiplatelet and anticoagulant therapies, carotid artery disease, atrial fibrillation, and other cardiac conditions. Notable changes in this sixth edition include the development of core elements for delivering secondary stroke prevention services, the addition of a section on cervical artery dissection, new recommendations regarding the management of patent foramen ovale, and the removal of the recommendations on management of sleep apnea. The Canadian Stroke Best Practice Recommendations include a range of supporting materials such as implementation resources to facilitate the adoption of evidence to practice, and related performance measures to enable monitoring of uptake and effectiveness of the recommendations. The guidelines further emphasize the need for a systems approach to stroke care, involving an interprofessional team, with access to specialists regardless of patient location, and the need to overcome geographic barriers to ensure equity in access within a universal health care system.

Aim: Our aim was to inhibit trypanothione reductase (TR) and P-gp efflux pump of Leishmania by the use of thiolated polymers. Thus, increasing the intracellular accumulation and therapeutic effectiveness of antimonial compounds., Methods: Mannosylated thiolated chitosan and mannosylated thiolated chitosan-polyethyleneimine graft were synthesized and characterized. Meglumine antimoniate-loaded nanoparticles were prepared and evaluated for TR and P-gp efflux pump inhibition, biocompatibility, macrophage uptake and antileishmanial potential., Results: Thiomers inhibited TR with Ki 2.021. The macrophage uptake was 33.7- and 18.9-fold higher with mannosylated thiolated chitosan-polyethyleneimine graft and mannosylated thiolated chitosan nanoparticles, respectively, as compared with the glucantime. Moreover, the in vitro antileishmanial activity showed 14.41- and 7.4-fold improved IC 50 for M-TCS-g-PEI and M-TCS, respectively as compared with glucantime., Conclusion: These results encouraged the concept that TR and P-gp inhibition by the use of thiomers improves the therapeutic efficacy of antimonial drugs.

Antioxidants acts as a defense mechanism that protects against oxidative damage caused by free radicals produced in the body. Medicinal plants are preferably used for various diseases in many countries. The studies were conducted to determine the antioxidant capacity of the ethanolic leaves and fruits extracts of Physalis minima, Withania somnifera, Datura inoxia, Solanum nigrum and Kigelia africana by 1, 1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging assay. Quercetin was used as a standard antioxidant which shows 93.66% inhibition. Among the five selected plant species, the percentage of antioxidant activity of leaves extracts was found in order: P. minima > W. somnifera > S. nigrum > K. africana > D. inoxia and fruits extracts was in order: W. somnifera ≥ D. inoxia > P. minima > K. africana > S. nigrum respectively.

Intramacrophage parasite 'Leishmania' has developed various mechanisms for proficient uptake into macrophages and phagosome regulation to avoid macrophage's oxidative burst induced by peroxide, hydroxyl radical, hypochlorous acid and peroxynitrite production. One major barrier for impairing the accession of old fashioned anti-Leishmanial drugs is intrinsic incapability to pass through cell membranes and limiting their abilities to ultimately destroy intracellular pathogens. Receptor-mediated targeted drug delivery to the macrophages by using nanoparticles emerges as promising strategy to improve therapeutic efficacy of old-fashioned drug. Receptor-mediated targeted nanoparticles can migrate across the cell membrane barriers and release enclosed drug cargo at sites of infection. This review is focusing on Leishmania-macrophage signaling alterations, its association with drug resistance and role of nanoparticles for receptor mediated macrophage targeting.

Background: The purpose of this article is to aid practitioners in choosing appropriate neuroimaging for children who present with symptoms that could be caused by stroke., Methods: The Writing Group members participated in one or more pediatric stroke neuroimaging symposiums hosted by the Stroke Imaging Laboratory for Children housed at the Hospital for Sick Children in Toronto, Ontario, Canada. Through collaboration, literature review, and discussion among child neurologists with expertise diagnosing and treating childhood stroke and pediatric neuroradiologists and neuroradiologists with expertise in pediatric neurovascular disease, suggested imaging protocols are presented for children with suspected stroke syndromes including arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke., Results: This article presents information about the epidemiology and classification of childhood stroke with definitions based on the National Institutes of Health Common Data Elements. The role of imaging for the diagnosis of childhood stroke is examined in depth, with separate sections for arterial ischemic stroke, cerebral sinovenous thrombosis, and hemorrhagic stroke. Abbreviated neuroimaging protocols for rapid diagnosis are discussed. The Writing Group provides suggestions for optimal neuroimaging investigation of various stroke types in the acute setting and suggestions for follow-up neuroimaging. Advanced sequences such as diffusion tensor imaging, perfusion imaging, and vessel wall imaging are also discussed., Conclusions: This article provides protocols for the imaging of children who present with suspected stroke., (Copyright © 2017 Elsevier Inc. All rights reserved.)

Stroke rehabilitation is a progressive, dynamic, goal-orientated process aimed at enabling a person with impairment to reach their optimal physical, cognitive, emotional, communicative, social and/or functional activity level. After a stroke, patients often continue to require rehabilitation for persistent deficits related to spasticity, upper and lower extremity dysfunction, shoulder and central pain, mobility/gait, dysphagia, vision, and communication. Each year in Canada 62,000 people experience a stroke. Among stroke survivors, over 6500 individuals access in-patient stroke rehabilitation and stay a median of 30 days (inter-quartile range 19 to 45 days). The 2015 update of the Canadian Stroke Best Practice Recommendations: Stroke Rehabilitation Practice Guidelines is a comprehensive summary of current evidence-based recommendations for all members of multidisciplinary teams working in a range of settings, who provide care to patients following stroke. These recommendations have been developed to address both the organization of stroke rehabilitation within a system of care (i.e., Initial Rehabilitation Assessment; Stroke Rehabilitation Units; Stroke Rehabilitation Teams; Delivery; Outpatient and Community-Based Rehabilitation), and specific interventions and management in stroke recovery and direct clinical care (i.e., Upper Extremity Dysfunction; Lower Extremity Dysfunction; Dysphagia and Malnutrition; Visual-Perceptual Deficits; Central Pain; Communication; Life Roles). In addition, stroke happens at any age, and therefore a new section has been added to the 2015 update to highlight components of stroke rehabilitation for children who have experienced a stroke, either prenatally, as a newborn, or during childhood. All recommendations have been assigned a level of evidence which reflects the strength and quality of current research evidence available to support the recommendation. The updated Rehabilitation Clinical Practice Guidelines feature several additions that reflect new research areas and stronger evidence for already existing recommendations. It is anticipated that these guidelines will provide direction and standardization for patients, families/caregiver(s), and clinicians within Canada and internationally., (© 2016 World Stroke Organization.)

Background: Techniques for pectus excavatum repair are based on sternal support using various implants that have been reported to cause complications including migration and perforation of adjacent vital organs. Thus the search for an ideal sternal support is ongoing. This study aimed to assess the feasibility and fate of allogenic bone grafts as a durable sternal support for pectus excavatum repair., Methods: Pectus excavatum deformities in 3 men were corrected by modified Ravitch repair using allogeneic bone grafts for sternal support. Postoperatively, the patients were followed up for 3 years. Chest computed tomography and bone scans were performed to identify radiological features relevant to the stability, viability, and fate of the bone grafts., Results: The postoperative course was uneventful in all patients. Cosmetic correction was rated as very good with patient satisfaction. Bone scans showed progressively increasing activity in the graft, indicating an ongoing process of neovascularization. Chest computed tomography showed not only bone resorption, new bone formation, and remodeling but also incorporation of the graft into the sternum and corresponding ribs through newly generated, normally configured sternocostal segments., Conclusions: As seen radiologically, this technique offers a model for sternal support that has the potential to incorporate into the host tissue through newly generated, normally configured sternocostal segments, without restriction of chest wall expansion, features that have not been previously reported., (© The Author(s) 2015.)

Objective: To evaluate public knowledge regarding predisposing factors, fatality and prevention of Tetanus and Rabies and attitudes toward vaccination and post-exposure prophylaxis., Methods: A population-based, cross-sectional survey was conducted in all the 18 towns of Karachi, the largest metropolitan city of Pakistan, from December 2007 to January 2008. Men and women of more than 18 years of age were included in the study which used a self-reporting questionarre as its tool., Results: There were 1201 people interviewed by the study. The majority of respondents had known or heard about Tetanus (n = 973; 81%) and rabies (n = 699; 58%). There were 29 (2.5%) reported dog bites on the subjects themselves and 218(18%) respondents reported dog bites among their family members during the preceeding one year. Only three (11%) of these dog bite victims received some kind of vaccine or post-exposure prophylaxis. The majority of the participants were not aware of the fatality of these diseases and the importance of vaccination and post-exposure prophylaxis. Of the total respondents, 563 (47%) reported an injury or wound during the preceeding one year. Of them, 426 (76%) received a Tetanus injection. Out of the total study population, 1019 (85%) respondents did not know that Tetanus could be a fatal disease, and 844 (70%) did not know that Tetanus could affect and kill newborns. Literate people and males were more likely to have adequate knowledge on multivariate analysis., Conclusion: Minor injuries and dog bites are a common occurrence in Karachi. Only a small proportion of these patients received post-exposure treatment. Most of the participants were not aware of the fatality of these diseases and the importance and affordability of vaccination in case of dog bites and minor trauma.

Vigabatrin, a gamma-aminobutyric acid (GABA) aminotransferase- inhibiting drug used for seizure control, has been associated with white matter vacuolation and intramyelinic edema in animal studies. Similar pathological lesions have never been described in the central nervous system of human participants treated with the drug. Described here is a child with quadriparetic cerebral palsy secondary to hypoxic-ischemic brain injury following premature birth, who received vigabatrin for the treatment of infantile spasms at 9 months of age. A severe deterioration of neurologic function immediately followed the initiation of vigabatrin, and the child died 3 weeks later. Neuropathological examination revealed white matter vacuolation and intramyelinic edema. This represents the first reported case of vigabatrin-induced intramyelinic edema in humans. It validates the concerns regarding vigabatrin safety in infants and individuals with preexisting abnormalities of myelin.

Objective: The value of thymectomy in management of myasthenia gravis (MG) is well recognized. Plasmapheresis (PMP) before thymectomy appears to improve the postoperative outcome. As PMP has its own complications, selective use of PMP preoperatively for patients at risk of post-thymectomy complications would improve the postoperative outcome, and decreases the PMP-related complications. The aim of this study is to evaluate the effectiveness and safety of routine versus selective use of PMP before thymectomy., Material and Methods: We performed a retrospective analysis of two different protocols in two institutions comparing the routine (group I) versus selective use (group II) of prethymectomy PMP. The computerized database and the medical records of 164 patients diagnosed with MG who underwent thymectomy between 1998 and 2007, were reviewed., Results: In group I, 74 patients were treated with PMP before thymectomy. In group II (90 patients), 35 patients were identified as high-risk and were treated with PMP before thymectomy, and in 55 patients, thymectomy was performed without preoperative PMP. There was significant difference in the recorded PMP-related complications between group I and group II; 25.7% (19 patients) versus 8.9% (8 patients), respectively. There was no difference between the two groups as regards the duration of postoperative mechanical ventilation, intensive care unit (ICU) stay and hospital stay., Conclusion: This study demonstrated that selective use of PMP before thymectomy may reduce the incidence of PMP-related complications without affecting the overall outcome.

Video-assisted thoracoscopic exploration of the right hemithorax in a 37-year-old woman with recurrent catamenial pneumothorax revealed multiple diaphragmatic fenestrations. She underwent successful plication of the diaphragm, with no recurrence of pneumothorax after 4 years of follow-up.

Objective: To evaluate the utilization of positron emission tomography (PET) scan with fluorine-18 fluorodeoxyglucose (FDG) in thymic pathology., Methods: Twenty-five consecutive patients with thymic pathology underwent FDG-PET after being evaluated by computed tomography (CT). The indication for CT was myasthenia gravis in 10, anterior mediastinal mass in 7, and recurrent thymic tumor after surgical excision in 8 patients. The results of PET were compared with results obtained by CT, and histopathologic examination of the surgical specimens., Results: All mediastinal abnormal thymic tissue showed FDG uptakes. FDG-PET managed to differentiate between thymic hyperplasia and thymoma in myasthenia gravis group (n=10) in which CT images were questionable in two patients. There was one case of ectopic thymic tissue which was not diagnosed preoperatively. There were no false-negative results for both CT and FDG-PET in seven patients with thymoma presented as anterior mediastinal mass. However, PET scan predicted thymic carcinoma in one patient. PET was superior to CT scan in localization of recurrent thymoma in two patients, and equal to CT in detecting metastatic lesions in six patients during the follow-up after thymoma excision., Conclusions: In myasthenia gravis, selective use of FDG-PET is useful in differentiating thymoma from hyperplasia, especially when CT scan is controversial, but fails to recognize ectopic thymic tissue. FDG-PET may differentiate thymoma from thymic carcinoma. FDG-PET is also useful in follow-up patients, who underwent thymoma excision, when there is suspicion of recurrence or metastasis.

Few reports describe the use of intraarterial recombinant tissue plasminogen activator to treat intracranial thrombosis in children. A 17-year-old girl with a history of prior venous thrombosis developed a left middle cerebral artery thrombus during diagnostic cerebral angiogram. Therapy with intra-arterial tissue plasminogen activator was initiated. An immediate follow-up angiogram demonstrated recanalization, and diffusion-weighted magnetic resonance imaging 9 hours later showed no evidence of infarction. Following the angiogram, femoral artery thrombosis developed. Treatment with supratherapeutic levels of heparin, localized delivery of intra-arterial tissue plasminogen activator, embolectomy, danaparoid, and dipyridamole failed to re-establish perfusion to the lower leg, and below the knee amputation was required. Neurologic examination remained normal 1 year later. Cerebral damage was avoided with the use of emergency intra-arterial tissue plasminogen activator for cerebral artery thrombosis in this child.

The ideal classification system for bronchiectasis continues to be debated. As an alternative to the present morphologic classification, a hemodynamic-based functional classification is proposed. This study examines the rationale for and outcome of surgery based on this classification in patients with unilateral or bilateral bronchiectasis. Between July 1987 and January 1997 the morphologic and hemodynamic features in 85 bronchiectatic patients were examined: 18 with bilateral bronchiectasis and 67 with unilateral disease. A policy of unilateral lung resection of the nonperfused bronchiectasis and preservation of the perfused type was adopted in all patients. The mean age at operation was 29.4 +/- 9.7 years (range 6-55 years) with a mean follow-up period of 45.2 +/- 21.0 months (range 2-120 months). Left-sided predominance of bronchiectasis was evident in this series both in frequency and severity. In those with unilateral disease, bronchiectasis was left-sided in 49 (73.1%) patients and right-sided in 18 (26.9%). The left lung was totally bronchiectatic in 11 (16.4%) patients and the right in 3 (4.4%). Moreover, among the patients with bilateral bronchiectasis, 14 of 18 (77.7%) patients had the left lung more severely involved. Based on the morphologic and hemodynamic features in the investigated patients, two types of bronchiectasis were recognized: a perfused type with intact pulmonary artery flow and a nonperfused type with absent pulmonary artery flow. Lobectomy was performed in 55 patients, basal segmentectomy and preservation of the apical segment in 16, and pneumonectomy in 14. There was no mortality in this series. Altogether 63 patients (74.1%) achieved excellent results, 19 (22.4%) scored good results, and 3 (3.5%) patients had not benefited from surgery at last follow-up. In the face of the general criticism of the traditional morphologic classification, the proposed classification not only predicts whether the involved lung will have a measure of respiratory function with regard to gas exchange but reflects the degree of severity of the disease process. Thus the question of which side to resect and which to preserve is defined more precisely. This classification was found to be logical, physiologically sound, and of proven benefit.