Sandra Thair Al-Aish

Introduction The Callosomarginal artery (CMA) is a terminal branch of the anterior cerebral artery (ACA). It is the main branch and the largest artery branching off from the pericallosal artery and coursing in parallel to it. Its course is posterior to or within the cingulate sulcus of the brain. The Callosomarginal artery (CMA) has several anatomical variations and established neurosurgical applications. The Callosomarginal artery (CMA) is poorly described in the standard anatomical textbooks. Therefore, we conducted this study as an overview to illustrate a complete picture of the anatomical variations and their implications in the neurosurgical field. Method We conducted a literature review in Google Scholar and PubMed medical databases to review the literature discussing the CMA, its anatomical variations, and neurosurgical applications. Results We identified 40 articles that discuss the CMA’s anatomical variations and neurosurgical applications. We noticed the CMA’s anatomical variations in origin, course, diameter, branches, depth, and distance from the associated structures. While reviewing the available articles and original works regarding CMA, we also discussed certain applications of CMA and its importance in neurosurgical bypass, embolization, and aneurysms. Conclusion Comprehending the anatomy of the CMA is crucial for neurosurgeons to safely and effectively perform procedures such as bypass and embolization. In addition, knowledge of the anatomical variations of the CMA and its clinical significance can help surgeons anticipate potential challenges and tailor their approach accordingly.

Introduction: Deep brain stimulation (DBS) has emerged as a promising therapeutic approach, offering targeted neuromodulation for movement disorders refractory to medical management or stereotactic surgery. However, assessing its benefits against potential risks is essential. This meta-analysis aims to evaluate the efficacy and safety of DBS in movement disorders, shedding light on its role as an alternative therapeutic option. Methods: A comprehensive search of databases after systemic review yielded studies published in English from 2000 to the present. Data selection, screening, extraction, and risk of bias assessment were performed meticulously. Statistical analysis was conducted using RevMan 2.0, with significant heterogeneity addressed through appropriate methods. Results: Our meta-analysis included 40 studies assessing the Unified Parkinson’s Disease Rating Scale Part III, revealing a significant improvement in motor symptoms (mean difference [MD]: −18.05, 95% confidence interval [CI] [−20.17, −15.93], P < 0.00001). Hoehn and Yahr Stage analysis demonstrated a reduction in disease severity (MD: −0.58, 95% CI [−1.05, −0.12], P = 0.01). Tremor severity (MD: −8.22, 95% CI [−12.30, −4.15], P < 0.0001), overall tremor (MD: −2.68, 95% CI [−4.59, −0.77], P = 0.006), gait velocity (MD: 0.13, 95% CI [0.08, 0.18], P < 0.00001), and Yale Global Tic Severity Scale score (MD: −9.75, 95% CI [−14.55, −4.96], P < 0.0001) also showed significant improvements with DBS. Conclusion: DBS demonstrates efficacy in improving motor symptoms, disease severity, tremor, gait, and tic severity in movement disorders. However, further research is needed to elucidate long-term efficacy and safety outcomes.

Background: Endophthalmitis is a rare but severe eye inflammatory disorder caused by bacterial infection that can occur after cataract surgery. Most bacteria are part of the patient’s natural flora, and even with antibiotic treatment, it causes considerable ocular morbidity and vision loss. Purpose: To investigate the preoperative conjunctival flora and their antibiotic susceptibility in patients undergoing cataract surgery at Ibn Al-Haitham Teaching Eye Hospital, a tertiary ophthalmology center in Baghdad, Iraq. Methods: This cross-sectional, single-center study based on conjunctival swabs of patients prior to cataract surgery and cultured using blood agar, chocolate agar, MacConkey agar, and Sabouraud agar. Bacterial isolates were identified using Gram staining and biochemical tests, and antibiotic sensitivity was determined using the disc diffusion method according to CLSI guidelines. Statistical analysis was done by SPSS Statistics Version 23. Results: A total of 200 patients (200 conjunctival swabs of consecutive 200 eyes) scheduled for cataract surgery were included. Positive cultures were found in 45 (24%) patients. Coagulase-negative Staphylococcus epidermidis was the most frequently isolated microorganism (75% of isolates), followed by Staphylococcus aureus (14.58%), Aspergillus species (6.25%), and E. coli (4.17%). S. epidermidis showed the highest sensitivity to ofloxacin (97.2%) and chloramphenicol (94.4%) and the lowest sensitivity to fusidic acid (11.1%) and ceftazidime (5.6%). S. aureus exhibited the highest sensitivity to chloramphenicol (100%) and tobramycin (85.7%) but was completely resistant to ceftazidime and fusidic acid (100% resistance). E. coli isolates were 100% sensitive to ciprofloxacin, ofloxacin, and chloramphenicol. Conclusion: The study revealed conjunctival microbial colonization in 24% of cataract surgery candidates, with S. epidermidis being the most prevalent isolate. Chloramphenicol, ofloxacin, Tobramycin, and Ciprofloxacin showed high sensitivity. Fusidic acid and Ceftazidime exhibited negligible sensitivity.

Background: Heart failure (HF) is a highly prevalent disease, among the primary factors contributing to morbidity and death. One of its types is heart failure with preserved ejection fraction (HFpEF) comprising 40%–50% of newly diagnosed HF cases. Despite the high prevalence of HFpEF, there is still a lack of knowledge regarding the best drugs and treatment approaches to be used. However, the sodium-glucose co-transporter 2 (SGLT2) inhibitors could be a promising treatment. Objectives: To examine SGLT2 inhibitors’ effect on hospitalization, cardiovascular death, and estimated glomerular filtration rate (eGFR) in HFpEF patients. Search methods: We conducted searches for randomized controlled trials (RCTs) in PubMed, Embase, Scopus, and Web of Science up to July 2024. Selection criteria: We chose RCTs that examined the effects of SGLT2 inhibitors and placebo in individuals with higher than 40% ejection fraction (HFpEF). Data collection and analysis: The methodology for the systematic review and meta-analysis was in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analysis. Main results: We included 8 studies with 16,509 participants. Drugs examined in our paper included empagliflozin, dapagliflozin, sotogliflozin, and ertugliflozin. Various outcomes were analyzed in different papers. However, different SGLT2 inhibitors lead to a decreased risk of cardiovascular hospitalization and kidney injury. Our meta-analysis showed a decreased risk of cardiovascular hospitalization but not death due to cardiovascular causes or other causes. These results were regardless of baseline status of eGFR, systolic blood pressure, atrial fibrillation or flutter, diabetes mellitus, sex, body mass index, and nt-proBNP. The included studies were of moderate to high quality. Conclusion: For individuals with HFpEF, SGLT2 inhibitors have been proven to be a safe and effective medication. However, more studies are needed for longer durations, reporting adverse events, effects on exercise tolerance, and other secondary outcomes.

Multiple sclerosis (MS) is a chronic inflammatory disease that damages the myelin sheath around the axons of the central nervous system. While there are periods of inflammation and remyelination in MS, the latter can sometimes be insufficient and lead to the formation of lesions in the brain and spinal cord. Environmental factors such as vitamin D deficiency, viral or bacterial infections, tobacco smoking, and anxiety have been shown to play a role in the development of MS. Dysbiosis, where the composition of the microbiome changes, may also be involved in the pathogenesis of MS by affecting the gut’s microbial population and negatively impacting the integrity of the epithelia. While the cause of MS remains unknown, genetic susceptibility, and immunological dysregulation are believed to play a key role in the development of the disease. Further research is needed to fully understand the complex interplay between genetic, environmental, and microbial factors in the pathogenesis of MS.