Several studies have documented the role of hyper-activation of extracellular signal-regulated kinases (ERK) in Autism pathogenesis. Alpha-mangostin (AMG) is a phytoconstituents with anti-oxidants, anti-inflammatory, and ERK inhibition properties in many diseases. Our research aims to investigate the neuroprotective effect of AMG in the rat model of intracerebroventricular-propionic acid (ICV-PPA) induced autism with a confirmation of its effect on the ERK signaling. Autism was induced in Wistar rats (total 36 rats; 18 male/18 female) by multiple doses of PPA through ICV injection for 11 days. Actophotometer and beam walking tasks were used to evaluate animals’ motor abilities, and the Morris water maze task was utilized to confirm the cognition and memory in animals. Long term administration of AMG100 mg/kg and AMG200 mg/kg continued from day 12 to day 44 of the experiment. Before that, animals were sacrificed, brains isolated, morphological, gross pathological studies were performed, and neurochemical analysis was performed in the brain homogenates. Cellular and molecular markers, including ERK, myelin basic protein, apoptotic markers including caspase-3, Bax, Bcl-2, neuroinflammatory markers, neurotransmitters, and oxidative stress markers, have been tested throughout the brain. Thus, AMG reduces the overactivation of the ERK signaling and also restored autism-like behavioral and neurochemical alterations.

Background: Severe traumatic brain injury (TBI) is a significant cause of death and disability. The objective of this study was to provide an overview of whether adherence to brain trauma foundation (BTF) guidelines improved outcomes following TBI utilizing intracranial pressure (ICP) monitoring. Methods: This cohort study between 2000 and 2013 involved 1848 patients who sustained severe blunt TBI. Outcomes were correlated with whether or not ICP monitoring was utilized based on BTF guidelines. Results: The BTF guideline adherence rate for utilizing ICP monitoring in patients with TBI was 30% in 1848 patients. Adherence rates positively correlated with younger age, high injury severity scores, lower Glasgow Coma Scores, abnormal computed tomography scans of the head, performance of a craniotomy, neurocritical care unit admission, the lack of alcohol intoxication, and the absence of a cardiac arrest. Greater adherence to BTF guidelines was associated with higher mortality rates (OR 2.01, 95% CI: 1.56–2.59, P < 0.001), and increase ICU and hospital lengths of stay (P < 0.001). Conclusion: Adherence rates to BTF guidelines for ICP monitoring in patients with severe TBI were low. Further, these rates varied across centers and were correlated with higher mortality and morbidity rates. Although ICP insertion may be an indicator of TBI severity, the current BTF criteria for insertion of ICP monitors may fail to identify patients likely to benefit.

Background: Mycotic aneurysms are a rare in the pediatric population. The natural history of these lesions and their appropriate management strategies is controversial. Case Description: A 13-year-old male presented with the sudden onset of a headache, vomiting, and fever. Inflammatory markers were elevated, and the blood culture was positive for Streptococcus viridans. When the computed tomography angiography (CTA) showed a ruptured mycotic aneurysm accompanied by multiple small unruptured aneurysms, he was started on antibiotics and underwent an urgent craniotomy. Despite negative blood cultures, the follow-up CTA showed further enlargement of the previously diagnosed aneurysms and a new right frontal aneurysm. The second and third craniotomies were, respectively, performed to resect the additional aneurysms. Pathologically, both aneurysmal walls were markedly inflamed and attenuated, suggesting the imminent risk of aneurysmal rupture. Following the total of three craniotomies, the patient had an uneventful postoperative course. Within 2 weeks, he regained baseline neurological function. Conclusion: Mycotic aneurysms in children may follow a very malignant course. Aneurysms may grow, new ones may form, and repeated CTAs are required to direct further follow-up treatment.

Adults,anxiety,depression,mental health,prevalence,Saudi Arabia,selfstigma,stress

Background: In most hospitals, inpatient urgent surgery is triaged based on the degree of urgency and time of surgical booking. A longer wait for semi-urgent surgery due to sharing resources between specialties might impact the postoperative course. The objective of this study is to determine the effect of length time to semi- urgent surgery on postoperative hospital length of stay among neurosurgical patients. Methods: A retrospective cohort study was conducted included all admitted adult patients placed on semi-urgent University of Alberta Hospital surgical list between 2008 and 2013. Linear and logistic regression analyses were performed. The main exposure variable was time from surgical booking to the time of surgery, and the outcome variable was time from surgery to discharge. Results: A total of 1367 neurosurgical cases were included in the study. The mean age was 54.3 years. The mean length of time in the hospital before and after surgery was 1.2 and 12.5 days, respectively. Overall, the time from booking to surgery did not affect the time from surgery to discharge. Increased age, higher ASA score, and surgeries performed after 24 h from booking in the group of patients who were discharged to another facility were associated with a longer postoperative stay. Conclusion: Neurosurgery patients booked for surgery to be done within 24 h waited longer to have their procedure completed. Overall, there was no significant association between length of time waiting for surgery and postoperative stay, although there was an increase in postoperative stays among patients who were discharged to another facility and had their surgeries performed after 24 h.