Browse publications by year: 2025

  1. Bhandari D, Robinson E, Pollock W, Watterson J, Su TT, Lokmic-Tomkins Z
    iScience, 2025 Mar 21;28(3):111914.
    PMID: 40092619 DOI: 10.1016/j.isci.2025.111914
    Anthropogenic climate change attributed increases in air pollution, rising temperatures, and extreme weather events are linked to a higher risk of adverse pregnancy and birth outcomes, necessitating interventions to protect maternal and child health. This scoping review mapped multilevel adaptation strategies implemented to protect maternal and child health from climate change effects. Eighteen unique adaptation strategies we identified included educational interventions, risk communication, air purifiers, air cleaning strategies, nutrition supplementation, cash transfer, employment guarantee scheme, community health worker program, chemoprophylaxis, insecticide-treated nests, home and environmental remediation, and bioethanol cooking fuel. Our findings suggest that these adaptation strategies are generally nonspecific and fail to address the specialized needs and unique health risks faced by pregnant women and young children. Prioritizing the involvement of pregnant women, mothers of young children and local healthcare services in developing tailored adaptation interventions is crucial to support climate change adaptation, resilience, and reducing maternal and child health risks.
  2. Nadeem M, Majid H, Ansari MD, Ahmad FJ, Parvez S, Akhtar M, et al.
    ACS Omega, 2025 Mar 11;10(9):9132-9153.
    PMID: 40092812 DOI: 10.1021/acsomega.4c09072
    Alzheimer's disease (AD) presents a significant challenge due to cognitive decline resulting from nerve cell degeneration. Shatavarin IV, a prominent bioactive compound fromAsparagus racemosus and Piracetam, has been investigated for its neuroprotective potential. This study examines the molecular docking, formulation, and characterization of a nanoemulsion containing Piracetam and Shatavarin IV for treating AD. The in silico study demonstrated that Shatavarin IV exhibited strong binding affinities with multiple AD-related targets, including TNF-α (-7.29 kcal/mol), the GSK-3 axin complex (-9.6785 kcal/mol), amyloid-β (-6.8326 kcal/mol), and GSK-3 β (-8.8243 kcal/mol). The extraction of Shatavarin IV from Asparagus racemosus roots yielded 401.1 ± 2.3 mg with a purity of 66%, as confirmed by HPTLC. A combination index study revealed a synergistic effect with a CI value of 0.10843 at a 1:1 ratio of Piracetam and Shatavarin IV. The nanoemulsion was optimized using a Box-Behnken design, with oil concentration, surfactant mixture (S mix), and sonication time as key factors. The optimized formulation exhibited a particle size of 183.6 nm and a PDI of 0.194. Characterization techniques, including TEM and DSC, confirmed the uniformity, stability, and incorporation of the drugs in the nanoemulsion. The in vitro drug release study revealed a significantly higher release profile (84.30 ± 1.03% in 24 h) for the nanoemulsion than the drug suspension. Ex vivo studies demonstrated a superior permeability rate for the nanoemulsion (56.35 ± 1.19%) compared to the conventional suspension. Additionally, the nanoemulsion showed enhanced antioxidant activity compared with the pure extract. Stability studies indicated that the formulation remained stable with only minor changes in particle size, PDI, and zeta potential over time. This nanoemulsion presents a promising therapeutic strategy for AD.
  3. Boon WJ, Azman M, Baki MM, Shakri NM
    Indian J Otolaryngol Head Neck Surg, 2025 Mar;77(3):1225-1229.
    PMID: 40093426 DOI: 10.1007/s12070-024-05295-2
    Endolaryngeal microsurgery is a well-established procedure, with proper laryngeal exposure is critical for success. However, there are instances where achieving complete visualization of the laryngeal inlet, particularly the anterior commissure, can be challenging, termed as difficult laryngeal exposure (DLE). The Laryngoscore, introduced in 2014, can accurately predict DLE and assist in preoperative planning. We report a case of DLE encountered during transoral laser microsurgery in a 50-year-old obese woman with bilateral vocal fold paralysis following total thyroidectomy and describe the maneuvers applied, which led to successful surgery. This case underscores the importance of the role of Laryngoscore in preoperative assessment and discusses the useful maneuvers in managing DLE.
  4. Boon WJ, Tan GC, Hamizan AKW
    Indian J Otolaryngol Head Neck Surg, 2025 Mar;77(3):1603-1606.
    PMID: 40093428 DOI: 10.1007/s12070-024-05303-5
    Angioleiomyoma is a rare benign smooth muscle tumor that is uncommonly encountered within the nasal cavity and presents with non-specific symptoms. Biopsy with histopathology examination is required to establish the diagnosis. The primary therapy for nasal angioleiomyoma is total surgical excision and follow up is recommended to identify local recurrence. Here, we present a case of angioleiomyoma found in the inferior turbinate and provide an overview of the relevant literature.
  5. Vengathajalam S, Goh BS
    Indian J Otolaryngol Head Neck Surg, 2025 Mar;77(3):1454-1460.
    PMID: 40093440 DOI: 10.1007/s12070-025-05361-3
    Supraglottoplasty is performed in children diagnosed with laryngomalacia experiencing persistent respiratory difficulties and failure to thrive. The objective of this study is to assess the impact of comorbidities and synchronous airway lesions to post-operative recovery and overall patient well-being during follow up. This is a retrospective review on the outcomes of supraglottoplasty performed at a tertiary pediatric hospital from May 2023 to August 2024. A total of 11 patients included, majority having comorbidities and synchronous airway lesions. Results showed that despite higher surgical risks, all patients achieved substantial improvements with 50% or greater in respiratory function at follow-up. Although some experienced delayed extubation and required prolonged feeding support, all were gradually weaned off oxygen post-operatively. The choice of surgical instrument did not affect outcomes. Supraglottoplasty outcomes are complex in patients with comorbidities due to increased surgical risks and extended post-operative care, including delayed extubation, prolonged respiratory and feeding assistance. Despite these challenges, all patients achieved at least 50% improvement in respiratory symptoms within 3 months post-surgery. Although presence of synchronous airway lesions prolonged recovery time but significant improvements was seen in breathing. While children without comorbidities typically had the best outcomes, those with comorbidities also benefited from surgery when managed by multidisciplinary team. The choice of surgical instruments did not significantly impact outcomes, highlighting that post-operative care and patient factors are key to recovery. Supraglottoplasty increases risks in patients with comorbidities and synchronous airway lesions but benefits of surgery outweigh these risks. This study emphasizes importance of multidisciplinary approach and post-operative care for achieving successful outcomes in this population.
  6. Jeong JH, Saniasiaya J, Neeff M
    Indian J Otolaryngol Head Neck Surg, 2025 Mar;77(3):1664-1667.
    PMID: 40093457 DOI: 10.1007/s12070-025-05374-y
    Intratympanic cholesteatoma (ITC) is a rare keratinous epithelial cyst of the tympanic membrane. A girl in her early childhood was referred to the otorhinolaryngology clinic following concerns about a pearly white mass in the pars tensa in the left ear. Enucleation of the lesion was performed under a general anaesthetic with a Rosen needle. A histological analysis confirmed cholesteatoma. A comprehensive assessment by an otolaryngologist is important in determining appropriate, timely surgical intervention and minimising complications such as tympanic membrane perforation and progression of cholesteatoma.
  7. Zulkiflee NR, Aziz A, Ismail H
    Indian J Otolaryngol Head Neck Surg, 2025 Mar;77(3):1336-1340.
    PMID: 40093463 DOI: 10.1007/s12070-025-05335-5
    Bilateral congenital dacryocystocele is a rare, congenital anomaly of the lacrimal drainage system in a newborn. Herein, we report a case of infected congenital bilateral dacryocystocele in a newborn. The case was determined to be a bilateral dacryocystocele after an endoscopic examination and confirmed by a magnetic resonance imaging (MRI) scan. Awareness of this entity is important, as it may cause a delay in referral to an otorhinolaryngology (ORL) specialist and subsequently, a delay in diagnosis. Therefore, it should be considered when there is unusual swelling present between the eyes of a newborn and it does not improve with medical treatment.
  8. Ahmad Radzi MA, Malakun CP, Shuang TY
    Indian J Otolaryngol Head Neck Surg, 2025 Mar;77(3):1638-1641.
    PMID: 40093468 DOI: 10.1007/s12070-025-05348-0
    A rare benign vascular disease also known as intravascular papillary endothelial hyperplasia (IPEH), sometimes referred to as Masson's tumor, is characterized by abnormal endothelial cell proliferation within blood vessels. Although it frequently appears extremities, it can also appear in uncommon locations such as the neck. A 26-year-old lady had a painless neck tumor that turned out to be IPEH by histological examination. This example emphasizes how crucial histology is in identifying IPEH because of its lack of specific clinical and radiographic characteristics. IPEH is primarily treated with complete surgical excision with clear margins. In most cases, this method is curative, and recurrence is rare.
  9. Wong SY, Li J
    MethodsX, 2025 Jun;14:103220.
    PMID: 40093574 DOI: 10.1016/j.mex.2025.103220
    With the rapid growth of photovoltaic installed capacity, photovoltaic hydrogen production can effectively solve the problem of electricity mismatch between new energy output and load demand. Photovoltaic electrolysis systems pose unique challenges due to their nonlinear, multivariable, and complex nature. This paper presents a thorough investigation into the control methodologies for such systems, focusing on both Maximum Power Point Tracking (MPPT) and electrolysis cell control strategies. Beginning with a comprehensive review of MPPT techniques, including classical, intelligent, optimization, and hybrid approaches, the study delves into the intricate dynamics of Proton Exchange Membrane Electrolysis Cells (PEMEL). Considering the nonlinear and time-varying characteristics of PEMEL, various control strategies such as Proportional-Integral-Derivative (PID), robust, Model Predictive Control (MPC), and Fault Tolerant Control (FTC) are analyzed. Evaluation metrics encompass stability, accuracy, computational complexity, and response speed. This paper provides a comparative analysis, encapsulating the strengths and limitations of each MPPT and PEM control technique.
  10. Akter S, Ahmad SU, Bhuiyan MA, Dewan I, Reza R, Morshed N, et al.
    Drug Des Devel Ther, 2025;19:1753-1782.
    PMID: 40093644 DOI: 10.2147/DDDT.S489113
    BACKGROUND: Diabetic wounds are a significant clinical challenge due to impaired healing processes often exacerbated by elevated matrix metalloproteinases (MMPs). Cinnamomum zeylanicum, known for its anti-inflammatory and antioxidant properties, has shown potential in promoting wound healing. This study investigates the molecular docking and experimental validation of Cinnamomum zeylanicum's effects on diabetic wound healing, focusing on its interaction with matrix metalloproteinases-8 (MMP-8) and 9 (MMP-9).

    METHODS: Molecular docking studies were performed to predict the binding affinity of Cinnamomum zeylanicum compounds to MMP-8 and MMP-9. Diabetic wound healing was evaluated using in vivo models where wounds were induced and treated with Cinnamomum zeylanicum extract. Various parameters were measured, including wound contraction, hydroxyproline content, superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), and malondialdehyde (MDA) levels. Biochemical analyses included glucose levels, fasting blood glucose (FBG), oral glucose tolerance test (OGTT), and histomorphological examination of skin tissues.

    RESULTS: Molecular docking results indicated a high binding affinity of Cinnamomum zeylanicum's bioactive compounds with MMP-8 and MMP-9, suggesting potential inhibition. Experimental validation showed significant improvement in wound contraction and increased hydroxyproline content, indicating enhanced collagen synthesis. Antioxidant enzyme activities (SOD, GPx, CAT) were significantly elevated, while MDA levels were reduced, reflecting decreased oxidative stress. Biochemical analysis demonstrated improved glucose homeostasis with reduced FBG and enhanced OGTT responses. Histomorphological studies revealed improved tissue architecture and re-epithelialization in treated wounds.

    CONCLUSION: Cinnamomum zeylanicum exhibits promising potential in diabetic wound healing by modulating MMP-8 and MMP-9 activities, enhancing antioxidant defenses, and improving glucose regulation. These findings support its therapeutic application for diabetic wounds, providing a foundation for further clinical investigations.

    MeSH terms: Animals; Diabetes Mellitus, Experimental/drug therapy; Male; Rats, Wistar; Rats; Molecular Docking Simulation*
  11. Goh SM, Jasrul D, Lee MY, Vermeulen JJ, Liew TS
    Zookeys, 2025;1230:99-154.
    PMID: 40093685 DOI: 10.3897/zookeys.1230.136906
    This study highlights the diversity of land snails in Penang Hill, a non-limestone hill in Peninsular Malaysia. A systematic survey of land snails in Penang Hill was conducted, inventoried, and compared with those specimens collected by Stoliczka (1872, 1873) in 1869. Based on the 33 sampling plots established in this study, the differences in species composition along the elevation gradient (75 m to 770 m a.s.l.) and between three different habitats on Penang Hill were examined: disturbed forests with anthropogenic activities, undisturbed forests, and orchards with various crops. A total of 54 species were recorded from the sampling plots and random observations, of which only 20 overlapped with Stoliczka's list; 34 were new records for Penang Hill, and 12 previously recorded species were not found in this study. Most of the new records were micro-snails smaller than 5 mm. Species richness was highest in disturbed forests and showed no correlation with elevation. There was no clear grouping of plots by species composition across habitat types, except for those in orchards. Indicator species analysis revealed strong associations between a few land snail species and disturbed forests and orchards. The number of species in Penang Hill increased from 32 to 66, with species richness comparable to the high numbers usually found in limestone habitats and higher mountains in Malaysia.
  12. Lim GS, Cheong AT, Lee PY, Siti Maisarah SM
    PMID: 40093921 DOI: 10.51866/oa.729
    INTRODUCTION: Many Malaysians with diabetes lack sufficient knowledge about diabetes selfmanagement. With the widespread adoption of smartphones, mobile health (mHealth) solutions could help empower patients with diabetes to self-manage their condition effectively. This study aimed to determine the intention of patients with diabetes to use diabetes self-management applications (DSMAs) and its associated factors in a primary care setting.

    METHODS: A cross-sectional study was conducted at a government health clinic in the Federal Territory of Kuala Lumpur from 1 July to 30 September 2019. We recruited 723 patients with diabetes using systematic random sampling. A validated self-administered questionnaire was used to evaluate patients' intention to use DSMAs and its associated factors were determined via multiple logistic regression.

    RESULTS: Among 719/723 patients with diabetes included in the analysis, 49.9% intended to use DSMAs. Those who had a household income of >RM 6000 (adjusted odds ratio [AOR] = 10.652, 95% confidence interval [CI] = 1.709-66.398, P<0.011), agreed (AOR=8.959, 95% CI=3.327- 24.128, P<0.001) or neutrally agreed (A0R=3.403, 95% CI= 1.188-9.749, P=0.023) with the perceived usefulness of DSMAs, did not have resistance to change (A0R=2.458, 95% CI= 1.2934.672, P=0.006) and had a facilitating condition (A0R=9.454, 95% CI=2.718-32.881, P<0.001) had higher odds of intending to use DSMAs than their counterparts.

    CONCLUSION: Nearly half of patients with diabetes intend to use DSMAs, indicating the potential of DSMAs as alternative tools for assisting in diabetes self-management. Education focusing on the usefulness of DSMAs and exploring facilitating conditions with patients can help increase the intention of patients to use DSMAs.

  13. Pattanayak S, Dutta S, Basu M, Basu SS, Manna S
    PMID: 40093922 DOI: 10.51866/oa.562
    INTRODUCTION: Non-communicable diseases (NCDs) are considered the leading causes of death globally, accounting for 60% of all deaths. Measures such as stopping tobacco use, increasing physical activity, reducing alcohol consumption and improving diet can extend longevity and enhance the Quality of Life (QoL). This study aimed to assess the overall health behaviours and QoL of adults with NCDs residing in the urban field practice area of a teaching hospital in Kolkata and determine the association of their sociodemographic characteristics and health behaviours with their overall QoL.

    METHODS: A cross-sectional study was conducted in the outpatient department of the Urban Primary Health Centre-81 among 106 adults recruited via consecutive sampling. Face-to-face interviews were conducted using a predesigned, pretested and structured schedule. Data were analysed using the Statistical Package for the Social Sciences version 25.0. Descriptive and inferential statistics were employed to interpret the data.

    RESULTS: Among the participants, 45.3% were consuming tobacco, while only 6% were consuming alcohol following the diagnosis of NCDs. The majority (81%) undertook brisk walking, and 37% reported additional salt intake with meals. The overall perceived QoL was poor in 54.7% of the participants. The participants aged 41-60 years and the male participants had lower odds of having a poor QoL than their counterparts.

    CONCLUSION: More than half of adults with NCDs report a poor QoL. Extensive interventions are needed to raise awareness in the community regarding the potential benefits of lifestyle modifications following the diagnosis of any NCD and thereby improve the QoL of patients.

  14. Suhaimi HK, Badlishah-Sham SF, Jamil AT
    PMID: 40093923 DOI: 10.51866/oa.754
    INTRODUCTION: Specific physical activity advice delivered to patients with non-communicable diseases (NCDs) improves physical activity levels and health outcomes. This study aimed to develop a physical activity advice tool and determine the physical activity level of primary care physicians, prevalence of physical activity advice delivered to patients and its associated factors.

    METHODS: During phase 1 of the study, a valid and reliable tool was developed to assess physical activity advice delivered by primary care physicians. Phase 2 was a cross-sectional study conducted at 12 primary care clinics using an online questionnaire assessing sociodemographic characteristics, physical activity level (Global Physical Activity Questionnaire) and physical activity advice delivered. Multiple logistic regression was used to identify the factors associated with specific physical activity advice delivered.

    RESULTS: More than half of the primary care physicians (53.7%) were physically inactive. Most (79.3%) delivered specific physical activity advice to their patients. The primary care physicians who were women (odds ratio [OR]=4.54, 95% confidence interval [CI] = 1.78, 11.56), possessed postgraduate qualifications (OR=6.72, 95% CI=1.48, 30.51), received formal training in physical activity advice (OR=2.79, 95% CI=1.01, 7.79) and were physically active (OR=2.67, 95% CI=1.17, 6.10) were more likely to deliver specific physical activity advice.

    CONCLUSION: Primary care physicians should be encouraged to pursue postgraduate studies, be given training in how to deliver physical activity advice and be physically active to be able to deliver specific physical activity advice to patients seen in NCD clinics.

  15. Alamsyah A, Dewi FST, Anggraeni VY, Maududdy IS
    PMID: 40093924 DOI: 10.51866/rv.789
    INTRODUCTION: This study aimed to explore various models of health coaching used for blood pressure control in patients visiting primary care settings, along with the underlying theories. Additionally, the study sought to identify individuals serving as health coaches and the effect of health coaching on blood pressure control and risk factors.

    METHODS: This scoping review followed the PRISMA-ScR guidelines and utilised several databases including PubMed, ScienceDirect, ProQuest, Scopus and Web of Science. The search focused on articles published from January 2012 to July 2024. Eligible articles were examined to identify the forms of health coaching, the backgrounds and roles of health coaches and the outcomes of health coaching.

    RESULTS: An initial search yielded 963 articles, of which 16 were selected for the review. Most studies (n=10) showed that health coaching was used in conjunction with other strategies (multicomponent). The most frequently applied approach was phone coaching (n=9). The majority of the interventions were completed within 6 months (n=4). Eight studies indicated that most health coaches came from health backgrounds including nurses, pharmacists and family doctors. Positive clinical outcomes, such as decreased systolic and diastolic blood pressures or systolic or diastolic blood pressure alone, were documented in all included investigations. The non-clinical outcomes varied.

    CONCLUSION: Health coaching is a promising approach for controlling blood pressure in primary care settings. This study highlights the importance of designing the form, time and staff for conducting effective health coaching in primary care settings.

  16. Ismail MP, Zon EM, W Adnan WF, Mohamad N, Sapiai NA, Tuan Shariff SE
    PMID: 40093925 DOI: 10.51866/cr.646
    Abdominal wall endometriosis (AWE) is a rare type of endometriosis, with an incidence ranging from 0.1% to 0.4%. It requires a high index of suspicion to avoid delays in diagnosis and treatment. This case is rather special because AWE occurred without a history of abdominal surgery or pelvic endometriosis. Herein, we report the case of a 48-year-old para-3 woman with localised cyclical abdominal pain associated with abdominal distension. On assessment during menstruation, there were localised tenderness at the right suprapubic area and a non-tender suprapubic mass corresponding to a 14-week-sized gravid uterus. An ultrasound revealed the presence of a heterogeneous hypoechoic lesion at the subcutaneous layer of the right suprapubic region sized 1.8×3.2×4.4 cm with poor demarcation. There were also multiple uterine fibroids varying in size and location. She underwent exploratory laparotomy, total abdominal hysterectomy with bilateral salpingo-oophorectomy and abdominal wall mass resection. Intraoperatively, the right abdominal wall mass measuring 6x5 cm and involving the subcutaneous layer was found to adhere to the rectus sheath with some chocolate-stained areas without connection to the peritoneal cavity. Additionally, multiple uterine fibroids were noted. There was no pelvic endometriosis, and the other pelvic organs were normal. The histopathological diagnosis of the abdominal wall mass was endometriosis. AWE should be one of the differential diagnoses even in the absence of previous surgery when encountering a patient with an abdominal wall mass especially when it is related to the menstrual cycle.
  17. Yew TT, Cheah WL, Koa AJ, Chow HB
    PMID: 40093926 DOI: 10.51866/oa.634
    INTRODUCTION: This study aimed to evaluate the prevalence and risk factors of non-alcoholic fatty liver disease (NAFLD) among Dayak communities in Malaysia, shedding light on an underexplored population.

    METHODS: A cross-sectional study was undertaken among Dayak villagers in Sarawak aged 18 years and above using an interview-based questionnaire, followed by an anthropometric measurement, a blood test and an abdominal ultrasound.

    RESULTS: A total of 324 participants met the inclusion criteria. Among them, 42.9% were men, and the mean age was 49.85±14.9 years. The prevalence of NAFLD was substantially high at 58%, with 43.1% of the participants having mild fatty liver (grade 1). NAFLD was closely associated with waist circumference and body mass index (BMI) (P<0.001). Central obesity, as indicated by waist circumference and BMI, emerged as a potent risk factor, with higher values correlating with an increased likelihood of NAFLD. A higher prevalence of NAFLD was observed in the participants with an advancing age, an elevated triglyceride level (66.7%) and a lower high-density lipoprotein cholesterol level (81.6%). However, these associations did not remain significant in the multivariate analysis. Gallstones, which share common risk factors with NAFLD, were not significantly associated with NAFLD in this population (P=0.853).

    CONCLUSION: This study defines the prevalence and association of NAFLD with sociodemographic characteristics, health profiles and gallstone disease among indigenous villages in Dayak communities. A high BMI and central obesity are found to be independent risk factors of NAFLD.

  18. Ahmad Sahli Mahzuz I, Shaiful Bahari I, Yaacob LH
    PMID: 40093927 DOI: 10.51866/cr.748
    Ergotism is a rare but potentially serious condition characterised by peripheral vasospasm. Its diagnosis is challenging because the presentation varies depending on the type and location of the affected blood vessels. Ergot alkaloids, including ergotamine, are metabolised by the cytochrome P450 isoenzyme CYP3A4. Concurrent use of ergotamine with CYP3A4 inhibitors can significantly increase the risk of ergotism. However, this potentially dangerous drug interaction is often underestimated in general practice. Herein, we report the case of a middle- aged woman with a history of migraine headaches, who was treated with Cafergot (ergotamine tartrate and caffeine). After the initiation of human immunodeficiency virus therapy with Kaletra (lopinavir/ritonavir), she experienced recurrent episodes of bluish discoloration, livedo reticularis and tingling sensation in her upper and lower extremities over several years. Despite multiple hospital visits and extensive diagnostic workups, including normal blood investigations and biopsy, the correct diagnosis of ergotism-induced vasospasm due to ritonavir-ergotamine interaction was delayed. This diagnosis was supported by CT angiography, which demonstrated vasospasm of the femoral arteries. The patient's symptoms significantly resolved following ergotamine discontinuation. Ergotism is a self-limiting condition that can be fatal if not recognised and treated promptly. This case highlights the importance of awareness, particularly in primary care settings, on the potential drug interaction, principally in patients receiving drugs that inhibit CYP3A4, such as protease inhibitors. Clinicians should have a low threshold for suspecting ergotism in patients with recurrent or unexplained limb pain, numbness and skin changes, especially if they have a history of ergot alkaloid use.
  19. Garling RJ, Mallari RJ, Kanesen D, Hontiveros B, Sivakumar W, Kelly DF, et al.
    PMID: 40094389 DOI: 10.1227/ons.0000000000001529
    BACKGROUND AND OBJECTIVES: In endoscopic endonasal surgery, the Doppler probe has proven useful for localizing the paraclival and cavernous internal carotid arteries (ICA) and avoiding ICA injury. Similarly, during transcranial brain tumor removal, the Doppler probe may help avoid major vascular injury, particularly for tumors encasing or adherent to Circle of Willis branches. In this study, we describe the technique, outcomes, and potential neurovascular benefits of real-time navigation using the Doppler probe during craniotomy for brain tumor removal.

    METHODS: Patients from 2015 to 2022 who underwent craniotomy for brain tumor resection and the Doppler probe was used were retrospectively analyzed. Data collection included demographics, tumor pathology, incidence of major/minor vascular injury, MRI-confirmed stroke/infarction, and extent of tumor resection.

    RESULTS: In total, 695 patients underwent 840 craniotomies for brain tumor resection; in 501 craniotomies (59.6%), the Doppler was used. One major vascular injury (0.2%) of a supraclinoid ICA was directly attributed to non-Doppler probe use immediately before vessel injury, leading to stroke and severe neurological decline. There were 7 strokes (1.4%) leading to permanent neurological deficit attributable to vasospasm or small vessel injury and 26 asymptomatic infarctions/strokes (5.2%) attributable to unrecognized vascular injury or spasm at the time of surgery.

    CONCLUSION: In this series of 501 craniotomies for brain tumor removal where the Doppler probe was used, the rate of direct large vessel injury was under 1%. Although our data show that smaller vessel injuries can still occur and may lead to permanent neurological deficits, routine Doppler probe use may help guide tumor dissection and aggressiveness of removal, avoiding inadvertent major arterial injury. Our experience suggests that it is most useful as tumor dissection progresses as the resulting brain shift makes stereotactic neuronavigation less reliable. We recommend routine Doppler probe use during transcranial brain tumor removal, particularly for tumors encasing or adherent to major arteries.

  20. Pey Adum KS, Haron NH, Md Toha Z, Arsad H
    J Asian Nat Prod Res, 2025 Mar 17.
    PMID: 40094535 DOI: 10.1080/10286020.2025.2469691
    Clinacanthus nutans (C. nutans) is a well-known herb in tropical Asia. Previous studies have reported the anticancer activity of C. nutans but the molecular mechanisms on cervical cancer are not fully understood. Therefore, our study aims to explore its effects on HeLa line and analyse the molecular interactions. Firstly, the RNA-Seq reads were processed for differentially expressed analyses. With Ingenuity Pathway Analysis (IPA) method, five cell death-related pathways with three significant genes (CASP9, FOXO4, TNFSF15) were identified. This study provides insight into the potential role of the DCM fraction of C. nutans mediating cell death mechanism in cervical cancer.
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