Is there an EKC between economic growth and air pollutant emissions in SAARC countries? Evidence from disaggregated analysis.

The manufacturing and construction (M&C) sector not only plays a vital role in promoting economic growth, but is also a significant contributor to global air pollution. Growing concerns regarding air pollutant emissions necessitate a more disaggregated (i.e.

Using rapid antigen testing for early, safe return-to-work for healthcare personnel after SARS-CoV-2 infection in a healthcare system in Pakistan: A retrospective cross-sectional study.

Anticipating staff shortage during the Omicron variant surge, we modified the US Centers for Disease Control and Prevention's contingency guidelines at a healthcare system in Pakistan. Infected staff had a SARS-CoV-2 rapid antigen test after 5-7 days of isolation, to decide a safe return-to-work. This led to signifcant cost savings without compromising patient/staff safety.

Do health infrastructure and services, aging, and environmental quality influence public health expenditures? Empirical evidence from Pakistan.

Rapidly growing health expenditure is a matter of grave concern for households and governments. Every government is compelled to allocate a sufficient budget to improve people's health. This study, therefore, identifies some major factors that influence the trajectory of public health care expenditure (HCE) in Pakistan for the period 1974-2017.

Reported incidence and treatment modalities of giant cerebral aneurysms in the pediatric population: A systematic review and illustrative case report.

Giant intracranial aneurysms represent a complex pathology that pose challenges for management, especially in the pediatric population. With emerging endovascular techniques, combined endovascular and open surgical approaches may be a favorable alternative for complex cases. In this systematic review, we characterize the treatment modalities of giant aneurysms in the pediatric population and provide an update on the number of giant aneurysms reported in the literature by anatomic location.

Genetic and expression deregulation of immunoregulatory genes in rheumatoid arthritis.

Rheumatoid arthritis (RA) is one of the most common autoimmune diseases globally, and is an important public health concern, associating with early death and systemic complications. Although key development in RA treatment has already been made still RA affected individuals face comorbidity and disability. Therefore, there is a need to discover new risk factors in helping early diagnosis and treatment of RA.

Flow Diversion for Treatment of Intracranial Aneurysms in Pediatric Patients: Multicenter Case Series.

Background: Though the Pipeline Embolization Device (Medtronic) is approved for use in adults 22 yr and older, the high efficacy and long-term durability of the device is attractive for treatment of intracranial aneurysms in younger patients who often have aneurysms less amenable to traditional endovascular treatments.

Objective: To report technical, angiographic, and clinical outcomes in patients aged 21 or below undergoing flow-diversion treatment for intracranial aneurysms.

Methods: Retrospective review across 16 institutions identified 39 patients aged 21 or below undergoing 46 treatment sessions with Pipeline Embolization Device placement between 2012 and 2018.

Embolization and Open Decompression of a Giant Aneurysm Involving the P2 Segment of the Posterior Cerebral Artery.

A 5-year-old girl was brought to the clinic because of chronic intermittent left-sided headaches. The patient underwent computed tomographic angiography, which demonstrated a giant aneurysm that involved the P2 segment of the left posterior cerebral artery. Before treatment proceeded, consent was obtained from the patient's legal guardian.

Endovascular thrombectomy in pediatric patients with large vessel occlusion.

Background: Pediatric acute ischemic stroke with underlying large vessel occlusion is a rare disease with significant morbidity and mortality. There is a paucity of data about the safety and outcomes of endovascular thrombectomy in these cases, especially with modern devices.

Methods: We conducted a retrospective review of all pediatric stroke patients who underwent endovascular thrombectomy in nine US tertiary centers between 2008 and 2017.

Treatment of blood blister aneurysms of the internal carotid artery with flow diversion.

Background: Blood blister aneurysms (BBA) are a rare subset of intracranial aneurysms that represent a therapeutic challenge from both a surgical and endovascular perspective.

Objective: To report multicenter experience with flow diversion exclusively for BBA, located at non-branching segments along the anteromedial wall of the supraclinoidal internal carotid artery (ICA).

Methods: Consecutive cases of BBA located at non-branching segments along the anteromedial wall of the supraclinoidal ICA treated with flow diversion were included in the final analysis.

A Simplified Method of Accurate Postprocessing of Diffusion Tensor Imaging for Use in Brain Tumor Resection.

Background: Use of diffusion tensor imaging (DTI) in brain tumor resection has been limited in part by a perceived difficulty in implementing the techniques into neurosurgical practice.

Objective: To demonstrate a simple DTI postprocessing method performed without a neuroscientist and to share results in preserving patient function while aggressively resecting tumors.

Methods: DTI data are obtained in all patients with tumors located within presumed eloquent cortices.

A multicenter study evaluating the frequency and time requirement of mechanical thrombectomy.

Introduction: There are few published data evaluating the incidence of mechanical thrombectomy among stroke centers or the times at which they occur.

Methods: A multicenter retrospective study was performed to identify all patients undergoing emergent thrombectomy for acute ischemic stroke during a 3-month period (June through August 2016). Consultations that did not undergo thrombectomy were not included.

Vertebral artery injury in patients with isolated transverse process fractures.

We sought to assess the rate of CTA-diagnosed vertebral artery injury in patients with isolated transverse process fractures, with and without extension into the transverse foramen, in the blunt-trauma population served by our hospital. We queried our universities trauma registry between January 2009 and July 2014 for ICD-9 codes pertaining to cervical spine fractures. Of 330 patients identified, 45 patients had fractures limited to the transverse process and were selected for the study population.

Risk of failure in pediatric ventriculoperitoneal shunts placed after abdominal surgery.

OBJECTIVE Experience has led us to suspect an association between shunt malfunction and recent abdominal surgery, yet information about this potential relationship has not been explored in the literature. The authors compared shunt survival in patients who underwent abdominal surgery to shunt survival in our general pediatric shunt population to determine whether such a relationship exists. METHODS The authors performed a retrospective review of all cases in which pediatric patients underwent ventriculoperitoneal shunt operations at their institution during a 7-year period.

Use of frameless neuronavigation for bedside placement of external ventricular catheters.

Neuronavigation for placement of ventricular catheters has been described. At our institution, electromagnetic neuronavigation is frequently utilized for difficult ventricular catheter placement. In patients who develop a trapped ventricle as a result of an intraparenchymal or intraventricular mass lesion, successful catheter placement may be difficult, as the location and trajectory are unfamiliar.

Clinical significance of changes in pB-C2 distance in patients with Chiari Type I malformations following posterior fossa decompression: a single-institution experience.

OBJECT The coexistence of Chiari malformation Type I (CM-I) and ventral brainstem compression (VBSC) has been well documented, but the change in VBSC after posterior fossa decompression (PFD) has undergone little investigation. In this study the authors evaluated VBSC in patients with CM-I and determined the change in VBSC after PFD, correlating changes in VBSC with clinical status and the need for further intervention. METHODS Patients who underwent PFD for CM-I by the senior author from November 2005 to January 2013 with complete radiological records were included in the analysis.

Iatrogenic intradural arachnoid cyst following tethered cord release in a child.

Iatrogenic arachnoid cysts represent uncommon complications of intradural spinal procedures. Here we present the case of a 7-year-old girl who was found to have a symptomatic, pathologically proven, intradural arachnoid cyst 3 years following tethered cord release. The patient originally presented with abnormal urodynamics testing and was found to have fatty infiltration in her filum terminale.

Proximal ventricular shunt malfunctions in children: Factors associated with failure.

Ventricular shunt failures and subsequent revisions are a significant source of patient morbidity. We conducted a review of pediatric patients undergoing placement or revision of ventricular shunts at our institution between January 2007 and December 2008. Patients were followed through to July 2014.

Spinal cord detethering in children with tethered cord syndrome and Chiari type 1 malformations.

We discuss the association between tethered cord syndrome (TCS) and Chiari type 1 malformation (CM1), and report on the surgical outcomes of children with CM1 and TCS who underwent sectioning of the filum terminale (SFT). The relationship between TCS and CM1 is unclear. A retrospective review of 170 consecutive spinal cord detetherings between 2008 and 2012 was performed.

Operative results of keyhole supracerebellar-infratentorial approach to the pineal region.

The supracerebellar-infratentorial approach to the pineal region is typically accomplished with a craniotomy that extends to at least the rim of the foramen magnum. Minimally invasive techniques that limit the inferior extent of the craniotomy have been described for this approach but, to our knowledge, no operative results have been published demonstrating the feasibility and safety of such techniques. We present a series of patients who underwent surgical resection of pineal region lesions using the minimally invasive method at our institution.

Management of petroclival meningiomas: a review of the development of current therapy.

The surgical management of petroclival meningioma remains challenging, due to the difficulty of accessing the region and the vital structures adjacent to the origin of these tumors. Petroclival meningiomas were originally considered largely unresectable. Until the 1970s, resection carried a 50% mortality rate, with very high rates of operative morbidity if attempted.

Cervical ligamentous injury with associated hydrocephalus secondary to posterior fossa subdural hemorrhage: a case report.

Traumatic subdural hematomas (SDHs) in the posterior fossa in conjunction with cervical spinal hematomas are rare entities. In this case, we present a 22-year old man who presented to our institution with ligamentous injury at the cervicomedullary junction, associated with posterior fossa SDH not discovered initially, who on serial computed tomography scans was found to have symptomatic obstructive hydrocephalus and was successfully treated with SDH evacuation and stabilization of the cervicomedullary junction with instrumentation.