Utility of foramen ovale electrodes in mesial temporal lobe epilepsy.

Objectives: To determine the ability of foramen ovale electrodes (FOEs) to localize epileptogenic foci after inconclusive noninvasive investigations in patients with suspected mesial temporal lobe epilepsy (MTLE).

Methods: We identified patients with medically intractable epilepsy who had undergone FOE investigation for initial invasive monitoring at our institution between 2005 and 2012. Indications for initiating FOE investigation were grouped into four categories: (1) bilateral anterior temporal ictal activity on scalp electroencephalography (EEG), (2) unclear laterality of scalp EEG onset due to muscle artifact or significant delay following clinical manifestation, (3) discordance between ictal and interictal discharges, and (4) investigation of a specific anatomic abnormality or competing putative focus.

A severely displaced metaphyseal fracture of the proximal humerus with dislocation of the shoulder in a child.

Fracture of the proximal humerus metaphysis with coexistent dislocation of the shoulder in children is a rare injury. The injury often occurs as a consequence of high velocity trauma. Most fractures of the proximal humerus commonly associated with the epiphysis in children can be treated with closed reduction.

Hallux valgus deformity of foot with tumoral calcinosis: an unusual presentation.

Tumoral calcinosis is an uncommon disorder and characterized by development of calcified masses within the soft tissues near the large joints such as the hip, elbow, and shoulder and rarely occurs in the foot. We report a case of tumoral calcinosis at the first meta-tarso-phalangeal (MTP) joint of foot with hallux valgus deformity associated with bunion which required resection. Surgical excision of the calcific mass alone, without surgery to the minimal hallux valgus, resulted in resolution of symptoms, without recurrence of the lesion.

In Vitro antimicrobial activity of Allium cepa (dry bulbs) against Gram positive and Gram negative bacteria and fungi.

The present research was carried out at the Institute of Biotechnology and Genetic Engineering, the University of Agriculture Peshawar KPK Pakistan. Analysis of the data revealed that all the extracts from dry bulbs showed different ranges of antimicrobial activities. Ethyl acetate fractions showed inhibitory activities against all tested eight microbes including bacteria and a fungus while chloroform fractions inhibited all the microbes except Pseudomonas aeruginosa.

Arthroscopic suture bridge technique for intratendinous tear of rotator cuff in chronically painful calcific tendinitis of the shoulder.

Arthroscopic removal, now the main treatment option, has almost replaced open surgery for treatment of resistant calcific tendinitis. In some cases of chronic calcific tendinitis of the shoulder, the calcific materials are hard and adherent to the tendon. Removal of these materials can cause significant intratendinous tears between the superficial and deep layers of the degenerated rotator cuff.

Real-time segmentation and tracking of brain metabolic state in ICU EEG recordings of burst suppression.

We provide a method for estimating brain metabolic state based on a reduced-order model of EEG burst suppression. The model, derived from previously suggested biophysical mechanisms of burst suppression, describes important electrophysiological features and provides a direct link to cerebral metabolic rate. We design and fit the estimation method from EEG recordings of burst suppression from a neurological intensive care unit and test it on real and synthetic data.

Arthroscopic repair of large and massive rotator cuff tears using the biceps-incorporating technique: mid-term clinical and anatomical results.

Introduction: The purpose of this study was to determine the anatomical and clinical outcomes of a biceps-incorporating rotator cuff repair without detaching the biceps origin from the glenoid in a large or massive rotator cuff tear, in which the biceps tendon could be incorporated into the cuff defect and help to provide tendon healing and prevent upward migration of the humeral head.

Materials And Methods: Thirty-five consecutive patients with a mean age of 62 years (41-81 years) had primary arthroscopic repair of their large or massive rotator cuff in which biceps tendon incorporated into the cuff defect without detaching the biceps tendon from the glenoid was performed. Functional outcome was determined by the visual analog scale (VAS) for pain during motions, simple shoulder test (SST), the University of California, Los Angeles (UCLA) score, and the American Shoulder and Elbow Surgeons scores (ASES) (mean follow-up, 24 months).

Sensitivity of compressed spectral arrays for detecting seizures in acutely ill adults.

Background: Continuous EEG recordings (cEEGs) are increasingly used in evaluation of acutely ill adults. Pre-screening using compressed data formats, such as compressed spectral array (CSA), may accelerate EEG review. We tested whether screening with CSA can enable detection of seizures and other relevant patterns.

Real-time segmentation of burst suppression patterns in critical care EEG monitoring.

Objective: Develop a real-time algorithm to automatically discriminate suppressions from non-suppressions (bursts) in electroencephalograms of critically ill adult patients.

Methods: A real-time method for segmenting adult ICU EEG data into bursts and suppressions is presented based on thresholding local voltage variance. Results are validated against manual segmentations by two experienced human electroencephalographers.

Supra-umbilical vertical midline abdominal incision in morbidly obese gynaecological oncology patients.

The prevalence of obesity is rapidly increasing globally. Female malignancies linked to obesity comprise approximately 51% of newly diagnosed cancers. Endometrial, breast, ovarian and cervical cancers have been associated with obesity.

Arthroscopic management of occult greater tuberosity fracture of the shoulder.

Purpose: The purpose of this retrospective study was to evaluate the early results of arthroscopic treatment in patients with missed occult greater tuberosity (GT) fracture of the humerus using the arthroscopic suture-bridge fixation technique.

Methods: Between January 2007 and August 2010, we used arthroscopic suture-bridge fixation in 15 cases of missed occult GT fractures, which were referred to our department with persistent symptoms following trauma, despite physical therapy. Occult GT fracture was diagnosed with bone marrow edema seen on magnetic resonance imaging in all patients.

Inferring seizure frequency from brief EEG recordings.

Routine EEGs remain a cornerstone test in caring for people with epilepsy. Although rare, a self-limited seizure (clinical or electrographic only) may be observed during such brief EEGs. The implications of observing a seizure in this situation, especially with respect to inferring the underlying seizure frequency, are unclear.

Modulation of EEG functional connectivity networks in subjects undergoing repetitive transcranial magnetic stimulation.

Transcranial magnetic stimulation (TMS) is a noninvasive brain stimulation technique that utilizes magnetic fluxes to alter cortical activity. Continuous theta-burst repetitive TMS (cTBS) results in long-lasting decreases in indices of cortical excitability, and alterations in performance of behavioral tasks. We investigated the effects of cTBS on cortical function via functional connectivity and graph theoretical analysis of EEG data.

The accuracy of three-dimensional prediction planning for the surgical correction of facial deformities using Maxilim.

The motivation for orthognathic surgery is to improve facial appearance and quality of life. This study aimed to validate a three-dimensional (3D) orthognathic planning programme (Maxilim) for predicting soft tissue changes following Le Fort I advancements. Cone beam computed tomography (CBCT) scans were taken before surgery (T(1)) and at 6-12 months after surgery (T(2)) for 13 patients.

Clinical guideline: management of gastroparesis.

This guideline presents recommendations for the evaluation and management of patients with gastroparesis. Gastroparesis is identified in clinical practice through the recognition of the clinical symptoms and documentation of delayed gastric emptying. Symptoms from gastroparesis include nausea, vomiting, early satiety, postprandial fullness, bloating, and upper abdominal pain.

Frequency of tracheobronchial foreign bodies and their management in urban population of Sindh.

Objective: To assess the common foreign bodies in urban areas of Sindh, and the presentation, problems and complications during their removal through rigid bronchoscopy.

Methods: The descriptive study was conducted at the Ear, Nose and Throat Department and the Department of Head and Neck Surgery of Liaquat University Hospital, Hyderabad, and Abbasi Shaheed Hospital, Karachi, from April 2009 to October 2010. Fifty patients with strong suspicion of foreign body inhalation in whom rigid bronchoscopy was done were included in the study.

Flow injection determination of carboxylate, phosphate, and sulfhydryl compounds using metal exchange complexation.

The determination of carboxylate, phosphorous, and sulfhydryl compounds has been studied using flow injection by measuring the decrease in absorbance of the Fe(III)-salicylate complex due to preferential ligand interaction with ferric ion. Targeted compounds include polycarboxylates such as sodium citrate, sodium oxalate, and EDTA, anionic phosphorous compounds such as sodium monofluoroorthophosphate, sodium trimetaphosphate, and sodium hexametaphosphate, and sulfhydryl compounds such as cysteine, glutathione, and captopril. Initial flow injection optimization has focused on citrate based on its ability to replace salicylate ion in the Fe(III)-salicylate complex causing a decrease in absorbance at 525 nm proportional to the citrate concentration.

Exploration and modulation of brain network interactions with noninvasive brain stimulation in combination with neuroimaging.

Much recent work in systems neuroscience has focused on how dynamic interactions between different cortical regions underlie complex brain functions such as motor coordination, language and emotional regulation. Various studies using neuroimaging and neurophysiologic techniques have suggested that in many neuropsychiatric disorders, these dynamic brain networks are dysregulated. Here we review the utility of combined noninvasive brain stimulation and neuroimaging approaches towards greater understanding of dynamic brain networks in health and disease.

Inferior paralabral ganglion cyst of the shoulder with labral tear -- a rare cause of shoulder pain.

Introduction: Paralabral ganglion cysts of the shoulder are rare, and their pathogenesis is similar to that of meniscal cysts. The paralabral cysts are most frequently reported along the posterior, superior, and anterior aspects of the glenohumeral joint and are uncommon inferiorly to the joint. These cysts rarely become evident clinically, unless they cause compression of surrounding structures, i.

Prolonged response of relapsed high grade serous ovarian carcinoma to the oral angiokinase inhibitor nintedanib in a patient with a germline BRCA1 mutation.

► Nintedanib is an anti-angiogenic agent that has demonstrated activity in relapsed ovarian cancer. ► Our patient had prolonged response to nintedanib, allowing her to have potentially curative surgery 6 years after her diagnosis. ► The relationship between angiogenesis and BRCA mutation is worth exploring in ovarian cancer.

European consensus statement on "HPV Vaccination and Colposcopy".

We have developed a Europe-wide consensus statement on "HPV Vaccination and Colposcopy" under the aegis of the European Federation for Colposcopy. We look at the historical perspective, the currently available vaccines, cervical vaccination programs, future perspectives, and the impact all this will have on cervical cancer screening and colposcopy services.