Annals of Medicine and Surgery最新文献

{"title":"Coexisting systemic lupus erythematosus with lupus nephritis and sickle cell trait: a case report of rare combination.","authors":"Hari Sedai, Suraj Shrestha, Roshan Aryal, Suman Acharya, Sugat Adhikari, Nabin Karki","doi":"10.1097/MS9.0000000000003291","DOIUrl":"10.1097/MS9.0000000000003291","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Systemic lupus erythematosus (SLE) and sickle cell disease (SCD) are relatively common disorders but their coexistence in an individual is rare. Because of the similarities in the musculoskeletal, central nervous system, and renal manifestations in both diseases, diagnosis of SLE in patients with SCD can be difficult to establish. Both the SCD and sickle cell trait (SCT) can have a cumulative assault in the progression of chronic kidney disease (CKD).</p><p><strong>Case presentation: </strong>We report a case of a 23-year-old female from an endemic region of SCD in Nepal who presented initially with the symptoms of urinary tract infection but was diagnosed later to have coexistent SCT with SLE. A biopsy of the kidney was done where evidence of lupus nephritis was found with no evidence of sickle cell nephropathy. She was managed with immunosuppressive medications.</p><p><strong>Clinical discussion: </strong>Although SCT and SLE are infrequently described combined, their related clinical characteristics, such as chronic progression and renal involvement, make identification more difficult. A renal biopsy is frequently necessary to distinguish between lupus nephritis, which is caused by autoimmune processes, and SCT-related kidney injury, which is associated with modest and localized sickling of red blood cells. Accurate identification of renal abnormalities is critical for guiding treatment and improving patient outcomes.</p><p><strong>Conclusions: </strong>Both SCT and SLE can have multisystem manifestations with positive anti-nuclear antibodies. The coexistence of both can accelerate the rate of kidney damage but isn't always the same as it may differ from case to case.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3906-3910"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140776/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246006","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Uncommon clinical manifestation of tracheomalacia in a 29-year-old adult: a rare case report.","authors":"George Michael Kabbabe, Basil Daradkeh, Saja Almustafa, Amal Jama, Osman Gamma, Mohamad Shbat, Raneem Ahmad","doi":"10.1097/MS9.0000000000003293","DOIUrl":"10.1097/MS9.0000000000003293","url":null,"abstract":"<p><strong>Introduction: </strong>Tracheomalacia (TM) is characterized by a high degree of compliance. Our case is unique since it is thought to be the most common congenital tracheal defect, which is uncommon in adults, with the long-lasting symptoms and the absence of classic risk factors. A wide range of symptoms, such as stridor, wheezing, barking cough, and cyanotic episodes, are indicative of TM.</p><p><strong>Case presentation: </strong>A 29-year-old male with a history of shortness of breath, hoarseness of voice, and difficulty swallowing for 8 years presented with symptoms. Upon physical examination, the patient appeared unwell but not dyspneic. A bronchoscopy showed obstruction of the tracheal lumen during expiration, narrowing of both main bronchus, and reduced peak expiratory flow, and the CT scan confirmed the diagnosis.</p><p><strong>Clinical discussion: </strong>TM was diagnosed in our 29-year-old patient despite his medical history which was free of risk factors. His clinical manifestations, alongside Bronchoscopy and CT findings, prompted doctors to consider TM, although it is extremely rare in such ages. TM can be treated with Y-shaped stents but there are currently no conclusive signs that demonstrate the necessity of surgery in management.</p><p><strong>Conclusion: </strong>This unique case highlights the need for increased awareness and early detection of such uncommon presentations in adult patients. Undoubtedly, additional case reports and research on these patients will improve our knowledge and ability to treat adult TM.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3902-3905"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140734/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246071","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Strategies for reducing child mortality due to sickle cell disease in Uganda: a narrative review.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000002981","DOIUrl":"10.1097/MS9.0000000000002981","url":null,"abstract":"<p><p>Sickle cell disease (SCD) remains a significant contributor to child mortality in Uganda, with an estimated 80% of children born with SCD dying before their fifth birthday, largely due to lack of early diagnosis and inadequate access to comprehensive care. Neonatal screening, although critical for early detection, is limited in Uganda, with coverage rates below 10%. This lack of early diagnosis often leads to delayed treatment and higher mortality rates. Data from recent studies highlight that implementing universal newborn screening could reduce SCD-related mortality by up to 50% if coupled with timely interventions such as prophylactic antibiotics, vaccination, and parental education. Comprehensive care, which includes regular health check-ups, preventive care, pain management, and access to blood transfusions, is essential for improving survival rates among children with SCD. However, in Uganda, only 30% of children with SCD receive regular follow-up care, and access to life-saving interventions like blood transfusions remains limited, especially in rural areas. A study conducted in Uganda found that children with SCD who received regular blood transfusions had a 70% lower risk of stroke and other severe complications compared to those who did not. Strengthening healthcare infrastructure and increasing access to these critical services are crucial to reducing mortality. Community engagement and education play a vital role in reducing SCD-related child mortality. Despite the high burden of SCD, awareness levels among Ugandan communities remain low, contributing to delayed healthcare-seeking behavior and high mortality rates.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3279-3288"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140782/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245991","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rising mortality in cerebral atherosclerosis-related deaths in the United States (1999-2020): a 21-year retrospective analysis of CDC-WONDER database.","authors":"Muhammad Hamza Shuja, Ali Salman, Afia Jawaid, Shafin Bin Ameen, Mishal Abid, Zoya Khemane, Maliha Edhi, Marc Fakhoury, Minal Hasan","doi":"10.1097/MS9.0000000000003292","DOIUrl":"10.1097/MS9.0000000000003292","url":null,"abstract":"<p><strong>Background: </strong>Cerebral Atherosclerosis-related mortality remains a major public health issue. This study analyzes trends in age-adjusted mortality rates (AAMR) for cerebral atherosclerosis deaths in the United States from 1999 to 2020.</p><p><strong>Methods: </strong>Mortality data from 1999 to 2020 for adults aged 25 years and older were analyzed. AAMRs were calculated, and trends were examined for the overall population, as well as by gender, urban-rural areas, race/ethnicity, and census region. Annual percentage changes (APC) were calculated to assess mortality trends.</p><p><strong>Results: </strong>A total of 146 016 deaths were recorded. The overall AAMR increased from 3.44 (95% CI: 3.36-3.53) in 1999 to 7.43 (95% CI: 7.32-7.53) in 2020. Mortality rates initially decreased from 1999 to 2006 (APC: -11.4 [95% CI: -19.7 to -7.85]), followed by a rise, with the sharpest increase from 2013 to 2016 (APC: 36.7 [95% CI: 23.0 to 45.9]). Mortality trends were similar across genders, with both males and females showing increases after an initial decline. Higher AAMRs were seen in urban areas compared to rural regions, with urban areas experiencing a steeper rise post-2013. Racial/ethnic disparities were apparent, with Hispanics showing the largest increase in mortality rates from 1999 to 2020. Regional disparities indicated the highest mortality rates in the South, with a sharp rise from 2012 to 2015.</p><p><strong>Conclusion: </strong>Cerebral Atherosclerosis-related mortality rates have significantly increased from 1999 to 2020, with notable disparities across gender, race, and geographic regions. Targeted interventions are needed to address these disparities and reduce mortality, particularly in high-risk populations.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3542-3550"},"PeriodicalIF":1.7,"publicationDate":"2025-05-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140699/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246056","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing the recurrence rate in locally advanced Luminal A patients compared to triple-negative patients in Shahid Rahimi Hospital Khorramabad in 2022: a cross-sectional study.","authors":"Mohammad Joudaki, Parya Khani, Simin Farokhi, Shahram Ahmadi Somaghian, Sarah Rahimi, Mania Beiranvand, Yaser Mokhayeri, Ali Pajouhi","doi":"10.1097/MS9.0000000000003338","DOIUrl":"10.1097/MS9.0000000000003338","url":null,"abstract":"<p><strong>Background: </strong>Breast cancer is one of the most common causes of cancer death in women both globally and in Iran. Although medical breakthroughs have improved its prognosis, different characteristics can vary locally, especially in understudied regions. Therefore, the present study was designed and carried out in 2022 to compare the rate of breast cancer recurrence in Luminal A and triple-negative patients referred to the Shahid Rahimi Hospital in Khorramabad from March 2019 to March 2020.</p><p><strong>Materials and methods: </strong>This study was a descriptive-analytical cross-sectional study designed and conducted on 59 patients diagnosed with Luminal A and triple-negative breast cancer treated at the Shahid Rahimi Hospital from March 2019 to March 2020. In this study, the data collection instrument was a researcher-designed form that included information such as age, history of recurrence, type of cancer, family history of cancer, personal history of cancer, lymph node involvement, hookah use history, smoking history, breastfeeding history, and material status. Finally, after collecting information, data was analyzed using SPSS software version 25.</p><p><strong>Results: </strong>The average age of the patients in this study was 49.45 ± 6.01 years, and the youngest and oldest patients were 35 and 62 years, respectively. Among the studied patients, 34 individuals (57.63%) had Luminal A cancer, and 25 patients (42.37%) had triple negative cancer. Recurrence was reported in 23 patients (38.98%), and lymph node involvement was reported in 21 patients (35.59%). Moreover, 14 patients (23.73%) were positive for a personal history of cancer, and 22 patients (37.29%) had a family history of cancer. In this study, the relationship between recurrence and type of cancer and involvement of lymph nodes was statistically significant (<i>P</i> < 0.05).</p><p><strong>Conclusion: </strong>The rate of recurrence in patients with Luminal A cancer was higher than in patients with triple-negative cancer, according to the results of the study. More attention and periodic examinations in terms of recurrence in patients with Luminal A cancer were necessary.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3123-3127"},"PeriodicalIF":1.7,"publicationDate":"2025-05-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140775/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245942","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"The balance between N1 and N2 neutrophils implications for breast cancer immunotherapy: a narrative review.","authors":"Emmanuel Ifeanyi Obeagu","doi":"10.1097/MS9.0000000000003361","DOIUrl":"10.1097/MS9.0000000000003361","url":null,"abstract":"<p><p>Neutrophils, essential components of the innate immune system, exhibit remarkable plasticity in the tumor microenvironment, shifting between anti-tumoral (N1) and pro-tumoral (N2) phenotypes. This functional dichotomy is particularly significant in breast cancer, where N1 neutrophils contribute to tumor suppression by enhancing cytotoxicity and immune activation, while N2 neutrophils promote tumor progression through immunosuppression, angiogenesis, and metastasis. The tumor microenvironment, driven by factors such as TGF-β, IL-6, and hypoxia, orchestrates this polarization, profoundly influencing disease progression and therapeutic outcomes. The interplay between neutrophil polarization and breast cancer immunotherapy presents both challenges and opportunities. Pro-tumoral N2 neutrophils often hinder the efficacy of immune checkpoint inhibitors and other immunotherapies by suppressing T-cell function and facilitating tumor immune evasion. Conversely, strategies to reprogram neutrophils toward the N1 phenotype, including TGF-β inhibitors, CXCR2 antagonists, and epigenetic modulators, show promise in restoring anti-tumoral activity. Novel approaches, such as nanoparticle-mediated delivery of neutrophil-targeting agents, further expand the potential for precision immunotherapy by selectively modulating neutrophil phenotypes.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3682-3690"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140754/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245998","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Examining pupil characteristics and relative afferent pupil defect prevalence in Syrian patients.","authors":"Saydjamil Alsaydjamil, Hassan Bdeiwi, Rashed Aljundi, Sedra Abu Ghedda, Mohamad Ibrahim, Husam Shawakh, Hala Sultan","doi":"10.1097/MS9.0000000000003354","DOIUrl":"10.1097/MS9.0000000000003354","url":null,"abstract":"<p><strong>Purpose: </strong>This study aims to explore pupil characteristics in a cohort of Syrian patients across different age groups and under varying luminance conditions, both pre- and post-pupil dilation. Additionally, the research seeks to ascertain the prevalence of the relative afferent pupillary defect (RAPD) within this patient population and to compare multiple test results to the established gold standard for diagnosing RAPD.</p><p><strong>Materials and methods: </strong>This is a cross-sectional study encompassing 178 patients who sought medical attention at the Al-Mowasat University Hospital clinics in Damascus, Syria, from March 1, 2020 to June 1, 2021. The research process involved a comprehensive review of the patients' complaints and medical records, coupled with measurements of pupil diameters and amplitudes under conditions of low and high luminance using the automatic pupil measurement program of the Sirius topography device. The study investigated the incidence of anisocoria, abnormal pupil size, and RAPD. Special cases were deliberated, and data were meticulously collected, organized, and analyzed using a direct statistical approach.</p><p><strong>Results: </strong>Anisocoria exceeding 2 mm or abnormal pupil size was identified in 11 (6.18%) of the patients included in this study. The average pupil diameter at low luminance pre-dilation was measured at 3.59 ± 1.36 mm, while at high luminance, it was 1.93 ± 0.80 mm. Females exhibited a higher average pupil diameter compared to males (<i>P</i> < 0.001). A significant decreasing trend in pupil diameter with age was observed across three age groups (<i>P</i> < 0.001). A very strong positive correlation was discovered between constriction amplitude and pupil diameter, both pre- and post-dilation. Moreover, the dilation amplitude was observed to increase with age alongside a decrease in pupil diameter. The incidence of RAPD based on clinical examination was determined to be 7.9%, serving as the gold standard for comparison. The pupillometer test displayed accuracy with a matching rate of 98.2% compared to the gold standard. Among RAPD patients, older individuals with larger pupil diameters predominated in the sample.</p><p><strong>Conclusions: </strong>Highlighting the size and reactivity of pupils is crucial, especially in the elderly population, as these characteristics can serve as key indicators of underlying pathologies. The objective assessment and regular monitoring of these parameters are essential for the early detection and management of potential conditions. Notably, the pupillometer demonstrates superior accuracy in detecting RAPD compared to swinging high-luminance tests both before and after dilation. This underscores the importance of incorporating advanced technology for precise and reliable evaluation of pupillary responses, particularly in clinical settings where accurate diagnostic information is critical for optimal patient care.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3194-3200"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140790/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246025","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Correspondence: Questions on the effects of supplementing extracorporeal shockwave therapy in tendinopathy treatment.","authors":"YongKang Zhang, QingZhi Zhang, YeMin Cao","doi":"10.1097/MS9.0000000000003319","DOIUrl":"10.1097/MS9.0000000000003319","url":null,"abstract":"","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3071-3072"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140784/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246011","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Diabetic ketoacidosis and cerebral edema: a rare case of infarct-like MRI findings in a pediatric patient.","authors":"Maryam Kachuei, Shayan Eghdami, Ramin Zareh, Samaneh Azimi-Souteh","doi":"10.1097/MS9.0000000000003332","DOIUrl":"10.1097/MS9.0000000000003332","url":null,"abstract":"<p><strong>Introduction and importance: </strong>Diabetic ketoacidosis (DKA) is a serious and potentially life-threatening complication of type 1 diabetes mellitus, particularly in pediatric patients. Cerebral edema (CE) is a rare but devastating consequence of DKA. Although neuroimaging findings in CE are typically nonspecific, infarct-like changes are exceedingly rare and may complicate clinical management.</p><p><strong>Case presentation: </strong>We report the case of an 11-year-old boy with a history of type 1 diabetes mellitus who presented with epigastric pain, vomiting, polydipsia, and polyuria. Despite timely initiation of standard treatment for DKA, the patient developed acute neurological deterioration consistent with CE. Brain MRI revealed restricted diffusion in the basal ganglia, corpus callosum, and internal capsule - findings suggestive of infarction rather than typical vasogenic edema.</p><p><strong>Clinical discussion: </strong>This case highlights the diagnostic and therapeutic challenges posed by DKA-associated CE with atypical imaging findings. The observed infarct-like MRI pattern is rarely reported and may reflect underlying cytotoxic edema or ischemic injury. Understanding the multifactorial pathophysiology - including osmotic shifts, inflammatory processes, and impaired cerebral autoregulation - is critical for effective management.</p><p><strong>Conclusion: </strong>Early recognition of atypical cerebral involvement in pediatric DKA is essential. Advanced neuroimaging can aid in diagnosis and guide appropriate intervention. Clinicians should remain vigilant for neurological complications even during early phases of treatment and consider infarct-like patterns in differential diagnosis.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3963-3968"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140715/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144246014","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Advances in management and treatment of tubercular meningitis - a narrative review.","authors":"Manal Arshad Malik, Aleena Kamran, Dua Ahsan, Aafia Amjad, Sara Moatter, Amna Noor, Asharib Sohaib, Maryam Shaukat, Waniyah Masood, Muhammad Hasanain, Mohammed Mahmmoud Fadelallah Eljack","doi":"10.1097/MS9.0000000000003348","DOIUrl":"10.1097/MS9.0000000000003348","url":null,"abstract":"<p><strong>Background: </strong>Tuberculosis (TB), caused by <i>Mycobacterium tuberculosis</i>, continues to be a major global health issue, particularly due to its potential to cause severe complications such as tubercular meningitis (TBM), which is a fatal condition that proves difficult to diagnose and treat effectively and often results in poor outcomes, especially in children, due to delayed diagnosis, drug resistance, and limited diagnostic techniques.</p><p><strong>Methods: </strong>This review provides a comprehensive overview of recent advancements in TBM management and treatment. A systematic search was performed across major databases, including PubMed, Google Scholar, ClinicalTrials.gov, the WHO International Clinical Trials Registry Platform, and the ISRCTN Registry. The search strategy used terms like (\"tubercular meningitis\" OR \"TBM\" OR \"TB meningitis\") AND (\"diagnosis\" OR \"treatment\" OR \"clinical trials\"). Inclusion criteria focused on studies published from January 2014 to September 2024, highlighting novel diagnostics, therapeutic advances, and clinical trials for TBM. Exclusion criteria involved studies unrelated to TBM or older than 10 years.</p><p><strong>Results: </strong>Diagnostic methods for TBM, such as microbiological and molecular techniques (Fig. 1), vary in sensitivity, with polymerase chain reaction assays being the most sensitive. While anti-TB drugs are available, drug resistance and poor cerebrospinal fluid penetration limit effectiveness. New molecular diagnostics and therapies, including anti-TNF agents, anti-inflammatory drugs, and antibiotics, show promise for improving outcomes.Figure 1.A summary of the diagnosis and management of tuberculosis meningitis.</p><p><strong>Conclusion: </strong>Despite recent advancements in TBM diagnostics and treatment, substantial challenges remain, particularly in addressing drug resistance and improving drug efficacy in the central nervous system. Continued innovation in molecular diagnostics and treatment approaches is essential to enhance TBM care and mitigate its devastating consequences.</p>","PeriodicalId":8025,"journal":{"name":"Annals of Medicine and Surgery","volume":"87 6","pages":"3673-3681"},"PeriodicalIF":1.7,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12140737/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"144245934","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}