INTRODUCTION: The most recent local study on the incidence of histological subtypes of all brain and spinal tumours treated surgically was published in 2000. In view of the outdated data, we investigated the presenting characteristics, histological subtypes and outcomes of adult patients who underwent surgery for brain or spinal tumours at our institution. METHODS: A single-centre retrospective review of 501 patients who underwent surgery for brain or spinal tumours from 2016 to 2020 was conducted. The inclusion criteria were (a) patients who had a brain or spinal tumour that was histologically verified and (b) patients who were aged 18 years and above at the time of surgery. RESULTS: Four hundred and thirty-five patients (86.8%) had brain tumours and 66 patients (13.2%) had spinal tumours. Patients with brain tumours frequently presented with cranial nerve palsy, headache and weakness, while patients with spinal tumours frequently presented with weakness, numbness and back pain. Overall, the most common histological types of brain and spinal tumours were metastases, meningiomas and tumours of the sellar region. The most common complications after surgery were cerebrospinal fluid leak, diabetes insipidus and urinary tract infection. In addition, 15.2% of the brain tumours and 13.6% of the spinal tumours recurred, while 25.7% of patients with brain tumours and 18.2% of patients with spinal tumours died. High-grade gliomas and metastases had the poorest survival and highest recurrence rates. CONCLUSION This study serves as a comprehensive update of the epidemiology of brain and spinal tumours and could help guide further studies on brain and spinal tumours.
Humans ; Retrospective Studies ; Female ; Male ; Middle Aged ; Adult ; Aged ; Central Nervous System Neoplasms/pathology* ; Brain Neoplasms/pathology* ; Treatment Outcome ; Postoperative Complications ; Young Adult ; Spinal Neoplasms/pathology* ; Neoplasm Recurrence, Local ; Aged, 80 and over ; Adolescent

Methods: In this prospective study, a total of 1,120 pedicle screws were placed in the freehand group (n=175), 1,250 in the fluoroscopyassisted group (n=172), and 1,225 in the robotic-assisted group (n=180). Surgical parameters and screw accuracy were analyzed between the three groups. The preoperative plan overlapped with the postoperative O-arm scan to determine if the screws were executed as planned. Results: The frequency of clinically acceptable screw placement (Gertzbein-Robbins grades A and B) in the freehand, fluoroscopy-assisted, and robotic-assisted groups were 97.7%, 98.6%, and 99.34%, respectively. With robotic assistance, an experience-neutralizing effect implied that surgeons with varying levels of experience achieved comparable pedicle screw accuracy, blood loss, O-arm time, robot time, and time per screw. No significant difference in these parameters was found between surgeries commencing before and after 2 PM. No significant differences were noted between the planned and executed screw trajectories in the robotic-assisted group irrespective of surgical experience. Conclusions The third-generation robotic-assisted pedicle screw placement system used in conjunction with intraoperative threedimensional O-arm imaging consistently demonstrates safe and accurate screw placement with an experience-neutralizing effect.

This review addresses new reporting systems for lung and pancreatobiliary cytopathology as well as the most recent edition of The Bethesda Reporting System for Thyroid Cytopathology. The review spans past, present, and future aspects within the context of the intricate interplay between traditional morphological assessments and cutting-edge molecular diagnostics. For lung and pancreas, the authors discuss the evolution of reporting systems, emphasizing the bridge between past directives and more recent collaborative efforts of the International Academy of Cytology and the World Health Organization in shaping universal reporting systems. The review offers a brief overview of the structure of these novel systems, highlighting their strengths and pinpointing areas that require further refinement. For thyroid, the authors primarily focus on the third edition of The Bethesda System for Reporting Thyroid Cytopathology, also considering the two preceding editions. This review serves as an invaluable resource for cytopathologists, offering a panoramic view of the evolving landscape of cytopathology reporting and pointing out the integrative role of the cytopathologist in an era of rapid diagnostic and therapeutic advancements.

INTRODUCTION: We report outcomes of patients with oesophageal cancer treated with neoadjuvant chemoradiotherapy (NACRT) plus surgery or definitive chemoradiotherapy (chemoRT) at our institution. METHODS: We retrospectively reviewed patients who underwent chemoRT from 2005 to 2017. The primary outcome was overall survival (OS). Secondary outcomes were disease-free survival (DFS) and toxicities. RESULTS: We identified 96 patients with median age of 64 years and squamous cell carcinoma in 82.3%. Twenty-nine patients (30.2%) received NACRT plus surgery, 67 patients (69.8%) received definitive chemoRT. Median follow-up was 13.5 months. The 3/5-year OS were 26.4%/13.4%, and 59.6%/51.6% in the definitive chemoRT and NACRT plus surgery groups, respectively. The 3/5-year DFS were 19.3%/12.3%, and 55.7%/37.2% in the definitive chemoRT and NACRT plus surgery groups, respectively. NACRT plus surgery significantly improved OS (hazard ratio [HR] 0.40, 95% confidence interval [CI] 0.22-0.72, CONCLUSION NACRT plus surgery improved OS and DFS. However, in view of treatment-related complications, careful selection of patients is warranted. With the predominant histology of our cohort being squamous cell carcinoma (SCC), our results may be more relevant for those with SCC.
Chemoradiotherapy ; Esophageal Neoplasms/pathology* ; Humans ; Middle Aged ; Neoadjuvant Therapy ; Neoplasm Recurrence, Local ; Neoplasm Staging ; Retrospective Studies

The purpose of this review is to assess the surgical outcomes of two different treatment modalities, endoscopic and open resection, for the management of sinonasal malignancies by comparing the effectiveness of these two methods. A wide search was carried out considering various electronic databases for English language articles from 2013 to 2018 using keywords such as sinonasal malignancies, endoscopic surgery, open resection for sinonasal malignancies, and endoscopic versus open surgery. One thousand articles were identified from the literature for screening. After a thorough systematic assessment and based on the selection criteria, 10 articles with 4,642 patients were included in this quantitative analysis. With a total of 4,642 patients, 1,730 patients were operated on using endoscopic resection and 2,912 patients were operated on using open resection. The endoscopic approach was found to have a shorter hospital stay compared to open surgical resection (P<0.05). The rate of positive margins and the recurrence rate for open surgical resection were both smaller compared to those for endoscopic resection (P>0.05), and the endoscopic approach had smaller complication rates and a higher survival rate compared to open resection (P>0.05). Though endoscopic resection and open surgical resection have comparable postoperative benefits, preoperative evaluation of cases presenting with sinonasal malignancies is necessary for determining the right treatment method to obtain the best possible results postoperatively.

The purpose of this review is to assess the surgical outcomes of two different treatment modalities, endoscopic and open resection, for the management of sinonasal malignancies by comparing the effectiveness of these two methods. A wide search was carried out considering various electronic databases for English language articles from 2013 to 2018 using keywords such as sinonasal malignancies, endoscopic surgery, open resection for sinonasal malignancies, and endoscopic versus open surgery. One thousand articles were identified from the literature for screening. After a thorough systematic assessment and based on the selection criteria, 10 articles with 4,642 patients were included in this quantitative analysis. With a total of 4,642 patients, 1,730 patients were operated on using endoscopic resection and 2,912 patients were operated on using open resection. The endoscopic approach was found to have a shorter hospital stay compared to open surgical resection (P<0.05). The rate of positive margins and the recurrence rate for open surgical resection were both smaller compared to those for endoscopic resection (P>0.05), and the endoscopic approach had smaller complication rates and a higher survival rate compared to open resection (P>0.05). Though endoscopic resection and open surgical resection have comparable postoperative benefits, preoperative evaluation of cases presenting with sinonasal malignancies is necessary for determining the right treatment method to obtain the best possible results postoperatively.

The unprecedented resurgence and geographical expansion of arboviral infections such as dengue, Chikungunya, yellow fever, and Zika have a significant impact on human health and pose a serious threat to public health globally in recent years. Zika virus is a Flavivirus and is transmitted to humans through an infected mosquito bite. The Zika virus has been identified in many countries in Africa, Asia, and Pacific islands and sporadic human cases have been reported since 1947. The non-specific clinical symptoms of Zika fever are often misdiagnosed with other arboviral infections, especially dengue and chikungunya. Till now, there is no vaccine or specific antiviral treatment for Zika infection. The recent emergence of Zika is alarming and highlights the need for arboviral research to develop an effective treatment. Here in this review, we discussed the epidemiology of Zika, which has re-emerged in the recent decade and caused international concern.

A number of re-emerging and emerging infectious diseases including chikungunya, West Nile, yellow fever, Zika, dengue, Japanese encephalitis, and others have increased in recent years, which threaten the public health across the globe. Chikungunya is a neglected re-emerging arboviral infection caused by chikungunya virus. Arboviral infections such as chikungunya, Zika and dengue have similar epidemiology, transmission cycles and clinical symptoms, which makes it difficult to diagnose these three infections. Moreover, there is no commercial vaccine or licensed therapy available for chikungunya infection, thus causing severe burden worldwide. Vector control may reduce the disease risk; however, this remains a challenge due to many factors including, but not limited to, evolution of insecticide resistance in mosquitoes, gaps in vector control tools, urbanization, environmental and demographic changes. Effective integrated vector control strategies and surveillance measures along with affordable vaccine development or anti-viral therapy are essential to control the infection. In this review, we discuss the epidemiology of mosquito-borne infection chikungunya which has re-emerged as an international concern in recent decades.

OBJECTIVE To study the bioactive phytochemicals in the leaves of A.ilicifolius against Hepatocellular carcinoma (HCC) through in silico, in vitro and in vivo studies. METHODS A. ilicifolius leaves were collected from Cuddalore District,Tamil Nadu,India.Authenticated by the Botanical Survey of India. The fresh leaves of A. ilicifolius were washed and shade dried at room temperature (28 ± 2)℃. The dried leaves were powdered by electrical blender.25 gms of A.ilicifolius leaf powder was used for methanol extraction in the Soxhlet apparatus.The Phytochemical compounds were analyzed by GC-MS and the structure was retrieved from PubChem.Totally,seven HCC target proteins were collected from literature, ligand and proteins were prepared for in silico molecular docking. HepG2 cell lines were used for in vitro (MTT assay). BALB/c mice were used for in vivo studies, the biochemical parameters and histopathological studies were carried out with standard procedure. RESULTS The phytochemical 26.27-Di (nor)-cholest-5, 7, 23-trien-22-ol, 3-methoxymethoxy exhibited maximum docking score against the HCC target protein C-Jun N-terminal kinase 1 (JNK 1) (-6.839798). MTT assay revealed that the extract at a concentration of 200 μg·mL-1,caused 60% cell death in HepG2 cell lines.Further animal studies using to injecting HCC induced BALB/c mice,restoration of haematological parameters and cells to normal was observed after 15 days of oral administration of the extract.These findings suggest the possibility of using A.ilicifolius leaves in the treatment of HCC.CONCLUSION The in silico,in vitro and in vivo studies indicated that the A.ilicifolius leaves had anticancereous activity against Hepatocellular carcinoma.There can be a possibility of synergistic activity of phytochemicals together against HCC.

No abstract available.
Subarachnoid Hemorrhage*