Identification of anticholinesterase active compounds from ethylacetate fraction of hydroalcoholic extract of Itrifal Sana using TLC-bioautography-MS and its validation using in silico molecular approach.

Background: Traditional formulations are used extensively throughout the world due to their holistic approach to health and wellness with the fewest possible adverse effects. Itrifal Sana is a traditional unani polyherbal formulation, a unique combination that makes it synergistically potent, capable of providing dual benefits for health and well-being. Even though the formulation is frequently utilised, there is no scientific evidence to support its therapeutic efficiency.

A systematic review of middle meningeal artery embolization for minimally symptomatic chronic subdural haematomas that do not require immediate evacuation.

Introduction: Embolization of the Middle Meningeal Artery (EMMA) is an emerging treatment option for patients with Chronic Subdural Haematoma (CSDH).

Questions: (1) Can EMMA change the natural history of untreated minimally symptomatic CSDH which do not require immediate evacuation? (2) What is the role of EMMA in the prevention of recurrence following surgical treatment? (3) Can the procedure be performed under local anaesthetic?

Material And Methods: Systematic literature review. No randomised clinical trials available on EMMA for meta-analysis.

Middle meningeal artery embolisation for chronic subdural haematomas: the first prospective UK study.

MMA embolisation has emerged in recent years as a safe endovascular treatment for chronic subdural haematoma. We report the first UK series of endovascular treatment of chronic subdural haematomas. Prospective case series.

Validity of Sequential Organ Failure Assessment and Quick Sequential Organ Failure Assessment in Assessing Mortality Rate in the Intensive Care Unit With or Without Sepsis.

Introduction Sepsis and septic shock (sepsis-induced hypotension not improved by adequate fluid resuscitation) are among the most common reasons for admission to an intensive care unit (ICU) and display high mortality rates. Different scoring systems are used to diagnose and predict the mortality of patients having sepsis. This study aims to validate the prognostic accuracy of Sequential Organ Failure Assessment (SOFA) and Quick Sequential Organ Failure Assessment (qSOFA) in determining the mortality of both septic and non-septic patients.

Reversible cerebral vasoconstriction syndrome secondary to caffeine withdrawal.

We describe a 39-year-old man who developed thunderclap headaches during a hospital admission for accidental superficial burns. His magnetic resonance brain imaging was normal expect for diffuse segmental vasoconstriction. Prior to admission, he was consuming excessive amounts of caffeine which was restarted and slowly tapered and stopped over weeks.

Alteplase versus tenecteplase for thrombolysis after ischaemic stroke (ATTEST): a phase 2, randomised, open-label, blinded endpoint study.

Background: In most countries, alteplase given within 4·5 h of onset is the only approved medical treatment for acute ischaemic stroke. The newer thrombolytic drug tenecteplase has been investigated in one randomised trial up to 3 h after stroke and in another trial up to 6 h after stroke in patients selected by advanced neuroimaging. In the Alteplase-Tenecteplase Trial Evaluation for Stroke Thrombolysis (ATTEST), we aimed to assess the efficacy and safety of tenecteplase versus alteplase within 4·5 h of stroke onset in a population not selected on the basis of advanced neuroimaging, and to use imaging biomarkers to inform the design of a definitive phase 3 clinical trial.

Ultrasound for primary imaging of congenital hypothyroidism.

Objective: The purpose of this study was to retrospectively evaluate the use of sonography as the primary imaging modality for congenital hypothyroidism (CH).

Materials And Methods: From our regional registry, we reviewed the cases of patients for whom either sonography or (99m)Tc-pertechnetate scanning was performed for CH between 2003 and 2010. Ultrasound studies were reviewed for presence, size, echotexture, vascularity, and location of the thyroid gland.

Myocardial perfusion and exercise capacity 12 years after arterial switch surgery for D-transposition of the great arteries.

Peak exercise myocardial perfusion was evaluated in patients with D-transposition of the great arteries 12 years after the arterial switch operation (SWITCH) to evaluate coronary perfusion. Gas-exchange measurements were used to assess cardiac limiting factors to exercise capacity in SWITCH patients when compared to healthy gender-matched controls (CON). Peak myocardial perfusion was evaluated in 42 patients 12 years post-SWITCH, using technetium-99 m (Tetrofosmin).

The role of pelvic magnetic resonance in evaluating nonhip sources of infection in children with acute nontraumatic hip pain.

We retrospectively identified all children with acute hip pain who underwent pelvic magnetic resonance (MR). Children with septic hip or history of trauma were excluded; the remaining children with signs of infection (fever, >38 degrees C; leukocytosis, >12 x 10(9)/L; or elevated erythrocyte sedimentation rate [ESR], >30 mm/h) comprised the study group. Thirty-three children (9 girls; age, 0.

Time course to hypothyroidism after fixed-dose radioablation therapy of Graves' disease in children.

Objective: To characterize the development of hypothyroidism in pediatric patients who receive a fixed dose of radioactive iodine (RAI).

Study Design: Medical records of children treated with fixed-dose RAI for Graves'disease between 1993 and 2001 were reviewed. Multiple variables including sex, age, thyroid hormone levels, thyroid-stimulating immunoglobulin titer, antithyroid medication use, and 24-hour radioiodine uptake were investigated as possible predictive factors for the development of hypothyroidism after treatment.

Painful os styloideum in a child.

Os styloideum is an immobile bone protrusion, located on the dorsum of the wrist between the trapezoid, capitate, and the second and third metacarpals, which may be associated with wrist pain. It usually presents in adults after degenerative changes occur. We report a case of a 12-year-old girl who presented with os styloideum.