Explore the vast range of titles available.

BackgroundCorpus callosum infarctions are rare due to the region’s dual vascular supply and often present with nonspecific or atypical symptoms. The resulting diagnostic delay may impact management and outcomes.Case presentationWe report a case of a female patient in her early sixties with a background of hypertension, diabetes mellitus, and stage IV chronic kidney disease. She presented with acute coronary syndrome and pulmonary edema. During hospitalization, she developed a new-onset cognitive decline, with a Mini-Mental State Examination (MMSE) score of 16/30. Neurological examination revealed no focal deficits but marked cognitive slowing. MRI of the brain showed acute infarction involving the entire corpus callosum. Workup for embolic sources and alternative diagnoses was unremarkable. The patient was managed conservatively due to comorbidities and gradually improved. Her MMSE improved to 24/30 at 1-week follow-up.ConclusionThis case highlights the importance of considering corpus callosum infarction in patients presenting with unexplained cognitive changes, especially in the presence of vascular risk factors. Neuroimaging, particularly MRI, plays a pivotal role in diagnosis. Early identification and neurorehabilitation may improve cognitive outcomes.

BackgroundBrain abscess is a potentially life-threatening condition typically developing shortly after head trauma or neurosurgery. Delayed onset, particularly more than a decade after the original insult, is exceedingly rare.Case presentationWe present the case of a 29-year-old male with a history of frontal bone fractures and cranioplasty in 2011, complicated by a persistently discharging forehead sinus. Fourteen years later, he presented with new-onset seizure and neuropsychiatric symptoms. Imaging revealed a large right frontal abscess with mass effect and midline shift, likely originating from the chronic sinus tract. He underwent urgent surgical drainage, with Staphylococcus aureus isolated from the abscess. The patient improved postoperatively and was managed with long-term intravenous antibiotics and coordinated craniofacial care. ConclusionThis case illustrates a rare but serious delayed complication of craniofacial trauma and emphasizes the importance of long-term surveillance in patients with chronic sinus tracts. Clinicians should maintain high suspicion for intracranial pathology in patients with subtle neuropsychiatric symptoms and prior neurosurgical history.

BackgroundThe incidence estimates for intracranial subdural empyema are 0.1 per 100,000 individuals, making it a rare clinical condition. It is a highly morbid and fatal illness that is most commonly the result of a primary infection somewhere else.Case presentationThe authors present a young male patient 15 years presented with 1 week history of headache, fever, confusion and seizure attack with initial negative CT head and nearly negative CSF analysis. With few days he developed left sided weakness. MRI brain showed right temporoparietal subdural fluid collection with midline shift. Urgent neurosurgical evacuation was made and revealed subdural empyema. The boy received combination therapy of vancomycin, ceftriaxone, and metronidazole. The culture of the pus was negative but 16S rRNA gene sequencing (bacterial) revealed streptococcus intermedius. He made a good recovery with no recollection or neurological deficit on follow up.ConclusionThis case highlights the possibility of occurrence of this rare infection in otherwise healthy individuals without obvious precipitating factor. It also indicates the superiority of MRI brain over CT head in detection of subdural collection. The rapid diagnosis and intervention improve the outcome of the patient.

BackgroundGuillain–Barré syndrome (GBS) is an acute, immune-mediated polyneuropathy often triggered by preceding infections. It typically presents with ascending weakness, but variants such as Miller Fisher Syndrome (MFS) manifest with descending paralysis, ophthalmoplegia, and ataxia. Viral infections, including respiratory pathogens and COVID-19, are known triggers for GBS, but relapses associated with successive infections are rare. Our case demonstrates a rare presentation of relapsing GBS with ophthalmoplegia as the main presenting symptom.Case presentationWe present a 46-year-old Middle Eastern man with no chronic illnesses who experienced recurrent episodes of Guillain–Barré Syndrome (GBS) triggered by viral infections, presenting in an unusual form. In 2017, he developed acute dysphagia, diplopia, and limb weakness following an upper respiratory tract infection, diagnosed as Miller Fisher variant GBS and treated successfully with IVIg. In 2022, after COVID-19 infection and ICU admission, he experienced a relapse with similar symptoms and responded well to IVIg. In 2024, he presented again with dysphagia, diplopia, and facial weakness with minimal limb involvement following an Influenza A infection. Despite initial deterioration requiring NGT insertion, gradual improvement occurred after 5 days of IVIg treatment. Nerve conduction studies confirmed demyelinating neuropathy.ConclusionThis case highlights the association between viral infections and recurrent GBS, presenting with descending weakness—an uncommon feature—emphasizing the importance of early recognition and management, even when clinical presentations deviate from typical patterns.

Background Acute quadriplegia due to compressive myelopathy is a rare but reversible neurological emergency, especially when diagnosed early. In patients with comorbidities such as diabetes and end-stage renal disease (ESRD), clinical presentations may be atypical, and elevated cardiac biomarkers like troponin may not reflect true myocardial ischemia. This can lead to diagnostic delays when spinal cord compression mimics cardiac conditions. Case presentation A 56-year-old male with diabetes and ESRD on hemodialysis presented with progressive quadriplegia. Three weeks prior, he had experienced chest pain and shortness of breath, prompting a diagnosis of non-ST-segment elevation myocardial infarction (NSTEMI) based on mildly elevated troponin (145 pg/mL), despite a normal ECG. He was treated for volume overload and sepsis secondary to a central line-associated bloodstream infection (CLABSI) and discharged in stable condition. One week later, he developed a weakness of his right leg, progressing to complete quadriplegia by the following week. Neurological examination revealed a sensory level at C6–C7 and motor weakness in all limbs. MRI of the spine showed compressive myelopathy at C8–T1, prompting urgent neurosurgical referral. Retrospective analysis suggested that his initial chest pain was referred pain from spinal cord compression rather than cardiac in origin. Conclusion This case highlights the importance of maintaining a broad differential diagnosis in patients with complex comorbidities. Elevated troponin in ESRD may be misleading, and clinicians must consider spinal pathology in the presence of neurological deficits, even when symptoms mimic cardiac events. Early recognition and intervention are key to preventing irreversible neurological damage.

BackgroundFunctional outcomes of patient with acute ischemic stroke are influenced by the status of the cerebral collaterals. The study aims at evaluating the influence of cerebral collaterals on clinical and radiological outcome in patients with acute anterior ischemic stroke (AAIS) treated with IV recombinant tissue plasminogen activator (IV-rtPA).ResultsIndependent predictors of good functional outcomes were in the form of low NIHSS (odds ratio = 1.23, 95%CI = 1.01–2.34, p = 0.01), ASPECT ≥ 8 (odds ratio = 4.56, 95%CI = 3.40–7.89, p < 0.001), and good collateral status by Miteff grading system (odds ratio = 1.23, 95%CI = 2.22–6.79, p < 0.001).ConclusionGood collateral status is associated with milder stroke volume and good functional outcome. Also, low NIHSS, ASPECT score ≥ 8 and good collateral status by Miteff grading system were reliable independent predictors of favorable outcome in IV-rtPA treated patients with AAIS.

Both gallic and citrate are well-established antioxidants that show promise as new selective anti-cancer drugs. Gold nanoparticles (AuNPs) as well can be developed as flexible and nontoxic nano-carriers for anti-cancer drugs. This article evaluating the efficiency and biocompatibility of gallic acid and citrate capping gold nanoparticles to be used as anti-cancer drug. The biosafety and therapeutic efficiency of prepared nano-formulations were tested on Hela and normal BHK cell line. Gold nanospheres coated with citrate and gallate were synthesized via wet chemical reduction method. The prepared nano-formulations, citrate and gallate coated gold nanospheres (Cit-AuNPs and Ga-AuNPs), were characterized with respect to their morphology, FTIR spectra, and physical properties. In addition, to assess their cytotoxicity, cell cycle arrest and flow cytometry to measure biological response were performed. Cit-Au NPs and Ga-Au NPs were shown to significantly reduce the viability of Hela cancer cells. Both G0/G cell cycle arrest and comet assay results showed that genotoxic effect was induced in Hela cells by Cit-Au NPs and Ga-Au NPs. The results of this study showed that Cit-Au NPs and Ga-AuNPs inhibit the growth of metastatic cervical cancer cells, which could have therapeutic implications.

Modern homes are experiencing unprecedented levels of convenience because of the proliferation of smart devices. In order to improve communication between smart home devices, this paper presents a novel approach that particularly addresses interference caused by different transmission systems. The core of the suggested framework is an intelligent Internet of Things (IoT) system designed to reduce interference. By using adaptive communication protocols and sophisticated interference management algorithms, the framework minimizes interference caused by overlapping transmissions and guarantees effective data sharing. This can be accomplished by creating an optimization model that takes into account the dynamic nature of the smart home environment and intelligently allocates resources. By maximizing the signal quality at the destination and optimizing the distribution of frequency channels and transmission power levels, the model seeks to minimize interference. A deep learning technique is used to augment the optimization model by adaptively learning and predicting interference patterns from real-time observations and historical data. The experimental results show how effective the suggested hybrid strategy is. While the deep learning model adjusts to shifting interference dynamics, the optimization model efficiently controls resource allocation, leading to better data reception performance at the destination. The system’s robustness is assessed in various kinds of situations to demonstrate its flexibility in responding to changing smart home settings. This work not only offers a thorough framework for interference reduction but also clarifies how deep learning and mathematical optimization can work together to improve the dependability of data reception in smart homes.

Background This study compared the analgesic effectiveness of ultrasound-guided subcostal transversus abdominis plane (STAP) block with intraperitoneal instillation of bupivacaine and dexmedetomidine after LC. Methods This prospective, randomized, double-blind trial involved 60 ASA I–II patients undergoing elective LC. At random, the patients were divided into two groups of thirty each. Group 1 was given STAP block with bupivacaine and dexmedetomidine along with intraperitoneal normal saline. Bupivacaine, dexmedetomidine was administered intraperitoneally to Group 2 along with STAP with normal saline. The Numerical Rating Scale (NRS) was used to measure postoperative pain at rest, while coughing, and for shoulder tip discomfort as a primary outcome. Patient satisfaction, sedation rating, and time to first analgesic demand were also assessed as a secondary outcome. Results At rest and while coughing, Group 1’s NRS ratings were considerably lower at all times ( p  < 0.001). Group 1 experienced considerably less shoulder tip discomfort 24 h after surgery ( p  = 0.032). Group 1 had a longer time to first analgesic demand (16.5 vs. 11.7 h, p  = 0.003). By the end of the research, 12 patients in Group 1 needed postoperative analgesia (46.2% vs. 96.4%, p  < 0.001). Group 1 had increased patient satisfaction ( p  < 0.001). Conclusion STAP block offers better postoperative analgesia than intraperitoneal instillation. Trial registration This prospective interventional double-blinded clinical trial was done at Assiut University Hospitals, Assiut, Egypt, From June, 2021 to May, 2024. The study protocol was approved by the Institutional Review Board of the Faculty of Medicine, Assiut University (IRB approval number: 17200580) and registered with ClinicalTrials.gov (ID: NCT04715165).

BACKGROUND: Despite being invasive, with serious complications, epidural blood patch (EBP) is still considered the gold standard therapy for Post Dural Puncture Headache (PDPH). The use of Peripheral nerve blocks for PDPH are studied here. OBJECTIVES: To investigate the efficacy of sphenopalatine ganglion block (SPGB) and greater occipital nerve block (GONB) to relieve PDPH and its associated symptoms. STUDY DESIGN: Randomized comparative single-blind trial. SETTING: A University hospital. METHODS: Patients who received spinal anesthesia for elective cesarean section, and then developed PDPH during hospitalization or within 5 days after dural puncture were enrolled to receive GONB (n = 47) or SPGB (n = 46) for treatment of PDPH. GONB Group: Patients received bilateral GONB using 3 mL mixture of 2 mL lidocaine 2% plus 1 mL dexamethasone 4 mg on each side of occipital region. SPGB Group: Patients received bilateral SPGB using the same mixture in each nostril. Assessments included Numeric Rating Scale (NRS) for severity of headache at supine and sitting positions, nausea NRS, neck stiffness, need for EBP, and complications. RESULTS: The supine and sitting headache NRS scores significantly decreased at 30 minutes after blocks and throughout follow-up period in both groups (P < 0.000). Clinically significant drop of NRS to < 4 was reached earlier in GONB group. There was a significant difference between groups after 2 hours in supine and sitting headache NRS scores (P = 0.020 and 0.030, respectively); however, both treatments showed similar effectiveness from the third hour afterwards (P > 0.05). Both techniques were effective in relieving neck stiffness and nausea (P < 0.000), with no adverse effects. LIMITATIONS: A limitation to this study was the small sample size. CONCLUSIONS: GONB and SPGB are equally effective in relieving symptoms of PDPH. Both techniques are safe, simple, and less invasive than EBP. KEY WORDS: Cesarean Section, epidural blood patch greater occipital nerve block, post-dural puncture headache, sphenopalatine ganglion block