Unveiling the Uncommon: Glial Fibrillary Acidic Protein Autoimmune Meningitis with Myelitis Mimicking Infectious Etiologies.

A 25-year-old previously healthy female presented with a week-long history of headache, fever, bilateral lower limb weakness, and urinary retention. Initial examination and investigations pointed toward an infectious cause, with magnetic resonance imaging (MRI) suggestive of leptomeningitis with myelitis, and cerebrospinal fluid (CSF) analysis revealing lymphocytic pleocytosis and a low glucose ratio. Empirical treatment for meningoencephalitis was initiated, including broad-spectrum antibiotics and high-dose steroids for myelitis.

Simulated Emergency Room Sign-outs: What They Tell Us About Diagnostic Accuracy and Opportunities for Improvement.

Objective: Emergency department (ED) sign-outs provide continuity of care for patients at shift changes. However, these periods have been associated with communication breakdowns and medical errors. We explored information factors (stage-of-the-case and the explicitness of the sign-out narrative) to determine their impact on clinicians' diagnostic accuracy and confidence.

Inflammasome-resistant IPSC-derived myeloid-derived suppressor cells ameliorate xenogeneic graft-versus-host disease.

Front-line pharmaceutical treatment for treatment of acute graft-versus-host disease (aGVHD) is not uniformly effective and has toxic side effects. Myeloid-derived suppressor cells (MDSCs) are a heterogeneous population of immature myeloid cells with potent in vitro and in vivo immunosuppressive functions. Clinical translation of in vitro generated MDSCs has been limited by the need for high MDSC:T cell ratios, multiple infusions to reduce inflammation and a relatively low peripheral blood-derived MDSC (PB-MDSCs) yield.

Cola-colored Cerebrospinal Fluid: A Case of Reversible Cerebral Vasoconstriction Syndrome.

Reversible cerebral vasoconstriction syndrome (RCVS) is characterized by recurrent thunderclap headache and multifocal cerebral arterial constriction, which can be associated with pregnancy and exposure to certain vasoactive agents. It is usually evoked by triggering agents in 80% of cases. RCVS can present with focal deficits or new-onset seizure in 8-43% and 1-17% of cases, respectively.

A Case of Moyamoya Vasculopathy Presenting as Simultaneous Ischemic and Hemorrhagic Strokes.

Background: Moyamoya disease (MMD) is a rare pathological state characterized by progressive stenosis of the terminal portion of the internal carotid arteries (ICA). Complications include both ischemic and hemorrhagic strokes, for which there is no curative treatment for MMD. Early diagnosis with surgical intervention is vital for there is no definitive treatment.

Evaluating no fixation, endoscopic suture fixation, and an over-the-scope clip for anchoring fully covered self-expandable metal stents in benign upper GI conditions: a comparative multicenter international study (with video).

Background And Aims: Fully covered self-expandable metal stents (FCSEMSs) are widely used in benign upper GI conditions, but stent migration remains a limitation. An over-the-scope clip (OTSC) device (Stentfix {SF], Ovesco Endoscopy) for stent anchoring has recently been developed. The aim of this study was to evaluate the effect of OTSC fixation on FCSEMS migration rate.

Fundus-to-Antrum Ratio Measured with Fluoroscopy within One Week after Endoscopic Sleeve Gastroplasty Predicts Total Body Weight Loss over Time.

: Endoscopic sleeve gastroplasty (ESG) is a minimally invasive bariatric procedure to induce weight loss through restrictive physiology. This study was designed to evaluate the fluoroscopic measurement of gastric dimensions after ESG as a predictor of Total Body Weight Loss (TBWL) over time. : Post-ESG patients were enrolled prospectively between August 2013 and August 2019.

Correlation of non-invasive parameters with upper gastrointestinal endoscopy findings for presence and grading of gastroesophageal varices in liver cirrhosis patients.

Background: Development of esophageal varices is one of the major complications of liver cirrhosis, and endoscopy is used to see the presence, grading, and long-term monitoring of esophageal varices which is an invasive and unpleasant procedure. There is no adequate data available showing noninvasive methods can be used for the same.

Methods: Seventy patients with liver cirrhosis participated in the study.

Endoscopic vacuum therapy for nonhealing cavity with fistulous tract after peroral endoscopic myotomy for Zenker's diverticulum.

Video 1Endoscopic vacuum therapy for nonhealing cavity with fistulous tract after peroral endoscopic myotomy for Zenker diverticulum.

Through-the-scope suturing for closure of contained leak after cricopharyngeal peroral endoscopic myotomy.

Video 1.

Two endoscopic suturing techniques for the prevention of percutaneous gastrojejunostomy tube retrograde migration.

Video 1Two suturing techniques for the fixation of percutaneous gastrojejunostomy tubes.

Over-the-bar peroral endoscopic myotomy for the therapy of treatment-refractory cricopharyngeal dysphagia.

Video 1Over-the-bar peroral endoscopic myotomy for the therapy of cricopharyngeal dysphagia.

A Tale of 2 Tics: Endoscopic Treatment of Perforated Periampullary Diverticulum Within a Giant Duodenal Diverticulum.

Periampullary diverticulum presenting with severe complications, such as perforations, is associated with high morbidity and mortality. Traditionally, only surgical or conservative management has been warranted. In this case, we present a 76-year-old woman with a spontaneously perforated periampullary diverticulum, located within a larger duodenal diverticulum, who achieved complete recovery with endoscopic closure after an initial unsuccessful attempt at surgical management.

Prevalence of visual impairment, uncorrected refractive errors and effective refractive error coverage in Koshi Province, Nepal - Rapid Assessment of Refractive Errors.

Background/objective: To determine the prevalence of visual impairment (VI), uncorrected refractive errors (URE), and effective refractive error coverage among individuals aged 15-50 years in Koshi Province, Nepal.

Methods: A population-based cross-sectional study was conducted in Koshi Province in which 4800 participants were selected from 80 clusters. The study teams visited the selected households and conducted eye examinations.

Differences in radiopacity among CT contrast agents and concentrations: A quantitative study.

Background And Purpose: Several studies in the literature have attempted to subjectively assess the degree of visualization of different neurovascular structures using different contrast agents and concentrations. Given the recent contrast shortages, we aim to objectively compare the radiopacity achieved with four angiographic contrast agents used in clinical practice.

Methods: Isovue 370, Visipaque 320, Omnipaque 300, and Isovue 300 were each drawn up at 25%, 50%, 75%, and 100% concentrations and compared against normal saline and air syringes.

Clinical outcomes of endoscopic submucosal dissection for superficial esophageal neoplasia in close proximity to esophageal varices: a multicenter international experience.

Unlabelled: BACKGROUND : There are limited data on the feasibility of endoscopic submucosal dissection (ESD) for superficial esophageal neoplasia (SEN) located at or adjacent to esophageal varices. We aimed to evaluate the outcomes of ESD in these patients.

Methods:  This multicenter retrospective study included cirrhotic patients with a history of esophageal varices with SEN located at or adjacent to the esophageal varices who underwent ESD.

Good outcome associated with blood-brain barrier disruption and lower blood pressure after endovascular therapy.

Objectives: To evaluate the association between post-endovascular thrombectomy (EVT) blood-brain barrier (BBB) disruption on MRI or CT and average systolic blood pressure (SBP) with favorable 90-day functional outcome. Observational studies have found elevated SBP associated with worse outcomes post-EVT, while recent randomized trials found no difference in targeted BP reduction. There may be a subgroup of patients who benefit from targeted BP reduction post-EVT.

A novel through-the-scope helix tack-and-suture device for mucosal defect closure following colorectal endoscopic submucosal dissection: a multicenter study.

Background: Complete closure of large mucosal defects following colorectal endoscopic submucosal dissection (ESD) with through-the-scope (TTS) clips is oftentimes not possible. We aimed to report our early experience of using a novel TTS suturing system for the closure of large mucosal defects after colorectal ESD.

Methods: We performed a retrospective multicenter cohort study of consecutive patients who underwent attempted prophylactic defect closure using the TTS suturing system after colorectal ESD.

Effect of doxycycline and doxycycline with carica papaya on thrombocytopenia and leucopenia in acute dengue fever patients.

Background: Dengue fever is a mosquito borne disease commonly manifest leucopoenia and thrombocytopenia. Dengue fever and its complications like bleeding manifestation can be life threatening. This study was conducted to study the effect of doxycycline and doxycycline with carica papaya on thrombocytopenia and leucopoenia in acute dengue fever patients.