ORIGINAL RESEARCH ARTICLE | Oct. 6, 2025
Toxicity and Histopathological Effects of Lipia alba Essential Oil on Late Instar Larvae of Anopheles gambias SL (Diptera: Culicidae)
Fawrou SEYE, El Hadji Malick FALL, Mame Awa Ndeye SY, Diouma KANE, Mady NDIAYE
Page no 376-383 |
https://doi.org/10.36348/sjls.2025.v10i09.002
In vector control, plant extracts are increasingly provided numerous sources of phytochemicals utilized on mosquito control. Essential oils such as Lippia alba have shown their effectiveness against insects. Our present study aims to show the toxicity of L. alba essential oil on Anopheles gambiae larvae and to demonstrate the histological damage. The larvae were exposed to serial concentrations from 200 ppm to 1000 ppm. Mortalities were recorded after 24 hours exposure to determine lethal doses LD50 and LD90. Larvae treated with LD90 were fixed at 6h, 12h, and 24h to show the process of histological degradation. After 24 hours exposure, the results revealed that mortalities were 6.66%, 5%, 61.33%, 91.66%, and 91.66% for respectively 200, 400, 600, 800, and 1000 ppm doses. Fisher's test revealed that there was no significant difference in mortality between the control and low doses (200 ppm and 400 ppm), (p = 1). On the other hand, mortalities were significant between the control (0 ppm) and doses ≥ 600 ppm (p = 0.0006). The lethal doses LD50 and LD90 determined using the Muller and Tinter formula were 554.4 ppm and 788.2 ppm, respectively. The histological examnition revealed that, the product acts between 6h and 24h through with progressive destruction of the nervous system, muscle tissue, adipose tissue, and digestive tract. It appears that L. alba essential oil constitutes a product with a larvicidal effect and could be evaluated in a natural breeding sites against vector mosquitoes.
REVIEW ARTICLE | Oct. 6, 2025
Structural and Biochemical Insights into CRISPR-Cas Nucleases for Therapeutic Genome Editing
Mehnaz Bibi, Salman Hassan, Tayyaba Noor, Maira Waheed, Amina Bilal, Mudasir Ali, Ummul Baneen, Ruqayyah Moiz, Mubarra Batool
Page no 362-375 |
https://doi.org/10.36348/sjls.2025.v10i09.001
CRISPR-Cas nucleases have changed the world of genetic editing because they provides specific, programmable and scalable editing possibilities. These RNA-guided nucleases were first described in the adaptive immune systems of prokaryotes, but have since enjoyed a second incarnation in eukaryotes, where they edit pathogenic mutations, control transcription, and even alter epigenetic structure. The field of structural biology has shown distinctly varied architecture among Cas nucleases, such as Cas9, Cas12, Cas13, and newly studied variants, and has shown the conserved catalytic cores, RNA guide recognition elements, and ever-changing structural dynamics of the target and the controls that modulate its cleavage effectiveness. Biochemical analyses have shed light on the mechanisms of interrogating DNA, forming R-loops, allosteric activation, and collateral activity, guiding the engineering approaches to improve fidelity and minimize off-target effects. Although substantial progress has been made, there remains the challenge of achieving single-nucleotide precision and reducing genotoxicity, as well as improving delivery efficiency to a wide variety of cell and tissue types. Advanced innovations in high-fidelity variants, base, prime editing, and Anti-CRISPR controllers have broadened their application and improved their safety profiles. While clinical trials for monogenic disorders like sickle cell disease and Leber congenital amaurosis have noted early successes, their long-term efficacy, immunogenicity, and ethical issues remain significant obstacles. This review integrates biochemistry and structural biology of CRISPR-Cas nucleases and focuses on mechanisms of their function and engineering that are central to the CRISPR-Cas Rational Design. The application of structural biology in conjunction with functional genomics and translational medicine aids in a refined and well-integrated understanding of the mechanisms guiding the evolution of CRISPR therapeutics. This review analyses the role of atomic resolution structures in guiding protein engineering, the role of kinetic and thermodynamic parameters in determining editing outcomes, and the role of evolutionary divergence in informing the selection of nucleases for specific purposes. Emerging trends, which include the use of compact CAS enzymes for viral delivery, RNA-targeting systems for the transient modulation of gene expression, and synthetic regulatory modules for the systems engineering of CRISPR, promise to augment the clinical reach of CRISPR therapeutics. These variances in application outline the junction of editing outcomes and the evolvable Technomic of CRISPR.
Development is part and parcel of the dearest gadgetry all humans hotly smoke after – be it individually oy collectively. But in our frenzy run for achieving such a dream, people more than often seem blurred with some materialistic sense, gravely paying much less attention to themselves as multi-facetted factors or genius-blessed agents. Building on a trans-disciplinary methodological plinth made up of tools from miscellaneous horizons, chiefly sociolinguistics, psycholinguistics and pragma-linguistics, the current study is meant to reveal the force of education, morality and self-confidence as developmental impetuses as are pinpointed by Ben Carson in You Have a Brain. The double-barrelled interest lurking in the study is to typically help African youth to get aware of their own in-built potentials of self-achievement so as to alleviate the depressing burden of joblessness and related sufferings, and to ignite in them as well the requisite courage to venture themselves on entrepreneurship.
Infertility is a distressing condition that can significantly affect women’s quality of life, leading to emotional, psychological, and social challenges. Women struggling with infertility often experience elevated stress levels, anxiety, and depression, which can negatively influence their overall well-being and interpersonal relationships. The impact extends beyond mental health, as diminished quality of life may also affect physical health, marital satisfaction, and social functioning. This narrative review aims to examine the psychological stress and quality of life among infertile women, while highlighting the consequences of infertility and the supportive role of nursing in enhancing care and well-being.
ORIGINAL RESEARCH ARTICLE | Oct. 6, 2025
Determinants of Household Consumption: New Evidence from Selected Sub-Sahara Africa
Ernest Simeon Odior, Adedoyin Raphael Da-Silva, Ikechukwu Peter Nwele, Darlington Uzoma AKAM
Page no 404-412 |
https://doi.org/10.36348/sjef.2025.v09i10.001
This paper investigates the macroeconomic determinants of household consumption in 37 Sub-Saharan African economies with annual time series from 2000 to 2023. The determinants include income, wealth, exchange rate, and population. Using a battery of econometric techniques, the result suggested the existence of a long-run relationship between the household consumption and its determinants. However, only income exerted positive and significant influence on household consumption in SSA countries. Therefore, the paper recommended that policymakers in the SSA countries should focus more on the improvement of households’ income base in the region. Also, since income is an important determinant of household consumption in the region, expansionary fiscal policies (such as public investment in infrastructure, tax incentives for businesses, and support for small and medium-sized enterprises (SMEs)) should be aimed at, so as to increase employment opportunities, income and wealth creation.
ORIGINAL RESEARCH ARTICLE | Oct. 6, 2025
Assessing the Psychological Impact and Quality of Life in Patients with Dilated Cardiomyopathy Attending Alshaab Teaching Hospital, Khartoum, Sudan
Ibrahim Jaffer Yousif Abdalmokrum, Fathelalim Mohammed Abdelrahim
Page no 494-500 |
https://doi.org/10.36348/sjm.2025.v10i10.001
Introduction: Cardiomyopathy refers to a group of heart conditions characterized by abnormal structure of the myocardium. Dilated cardiomyopathy is the most common cause of heart failure in Sudan. It has different implications for the quality of life and the psychological status of patients. This study aims to assess the Psychological Impact and Quality of Life in Patients with Dilated Cardiomyopathy (DCM). Methods: A descriptive cross-sectional hospital-based study was conducted in the outpatient department of Alshaab teaching hospital. A sample of 107 patients diagnosed with dilated cardiomyopathy (DCM). Using self-administered questionnaires including socio-demographic data, the Hospital Anxiety and Depression Scale (HADS), and the WHOQOL-BREF. The study assessed the quality of life and psychological symptoms of participants using descriptive statistics, t-tests, and ANOVA to explore associations between clinical and sociodemographic factors and QoL outcomes. Results: The study showed that 23 (21.5%) patients had anxiety, and 19 (17.8%) patients had depression. Regarding the four domains related to quality of life, the physical health domain had the lowest mean score (56.15), indicating significant physical limitations, while the social domain scored highest (68.55), reflecting strong social support. Most participants were middle-aged, predominantly male, married, and residing in urban areas, with the majority reporting sufficient income. Higher NYHA class and lower LVEF were significantly associated with poorer physical and psychological quality of life, emphasizing the impact of heart failure severity. Employment and sufficient income were linked to better physical, psychological, and environmental scores. Mental health issues were prevalent, with 21.5% experiencing anxiety and 17.8% depression; these conditions significantly correlated with lower psychological and social QoL scores. Conclusion: Dilated cardiomyopathy affects patients’ psychological status and their quality of life. In this study, sociodemographic and clinical factors considerably influenced the participants' quality of life, underscoring the need for comprehensive management approaches addressing both medical and psychosocial aspects.
CASE REPORT | Oct. 3, 2025
Bilateral Agenesis of Maxillary Lateral Incisors: Orthodontic Case Report with Space Opening and Prosthetic Rehabilitation
Mahmoud Qalalwa, Nadia Madhi, Ala Hajjem, Wiem Ben Amor, Ines Dallel, Samir Tobji, Adel Ben Amor
Page no 382-387 |
https://doi.org/10.36348/sjodr.2025.v10i10.003
Maxillary lateral incisor agenesis is a common dental anomaly with significant esthetic and functional repercussions. This case report describes a 17-year-old female patient presenting with bilateral agenesis of the maxillary lateral incisors (teeth 12 and 22), managed through orthodontic treatment using the Roth technique with space opening, followed by implant-prosthetic rehabilitation. The treatment outcome demonstrated a significant improvement in esthetics and function. The discussion compares possible therapeutic approaches: space closure versus space opening, and implant-supported versus resin-bonded bridge rehabilitation.
ORIGINAL RESEARCH ARTICLE | Oct. 3, 2025
Influence of Chin Position in Sagittal on Facial Profile Attractiveness through Ricketts’ E-Line in among Orthodontists and Laypeople: An Observational Study
Naela Mohamed Al-Mogahed
Page no 376-381 |
https://doi.org/10.36348/sjodr.2025.v10i10.002
Background: Understanding the perception of attractiveness in the chin position relative to the aesthetic level of the E-line is crucial for improving aesthetic outcomes in orthodontic. This study aimed to examine the extent to which changes in the chin position at sagittal plane relative to the E-line are observed in terms of attractiveness among laypeople, dentists and orthodontists. Material and methods: A digital portrait of adult woman was generated by artificial intelligence (AI) for the study. The image was digitally altered using Adobe Photoshop to create 3 images and presented to 60 orthodontists and 60 laypeople for evaluation of their perception of facial profile attractiveness on a visual value rating scale of (1 to 5). Results: The study results showed that a repeat measures ANOVA was conducted to examine the effect of chin position profile in relation to the E-line (based on three images) on facial attractiveness ratings, and whether this effect differed between orthodontists and laypeople. However, there was a significant interaction between image type and participant group (Wilks' Lambda Test). Conclusions: Orthodontists and Laypeople rated the retrusive chin as more attractive than the protrusive of the chin. Future research should further explore how demographic and cultural factors influence these aesthetic judgments.
ORIGINAL RESEARCH ARTICLE | Oct. 3, 2025
Postural Management to Enhance Impact on Life Quality for Children with Spastic Cerebral Palsy: A Nursing and Rehabilitation Approach
Majdaldeen M. I. Ashqar, Dr. Naresh Bhaskar Raj, Sadia Misbach, Dr. Akram Amrod, Dr. Wan Arfah Nadiahe
Page no 244-250 |
https://doi.org/10.36348/sjnhc.2025.v08i10.001
Postural management is a highly important issue in the treatment of children with cerebral palsy (CP), but its use has not been thoroughly examined in the Middle East. The objective of this research was to determine how proper wheelchair choice could help in improving quality of life (QoL) of children with spastic cerebral palsy in Saudi Arabia. The sample used consisted of 35 children that were in a stable medical condition and had a Gross Motor Functional Measurement (GMFM) score of 3-5. The children whose parents did not consent were also excluded as well as those children who could not respond to the questionnaires of the study. The participants were all evaluated at three points namely baseline, after two weeks, and four weeks following a postural management program based on a wheelchair recommended by WHO. The findings showed that five, out of seven, domains of QoL showed statistically significant positive changes with a p-value of less than 0.001. These results will emphasize the great advantages of proper wheelchair choice in enhancing the QoL of children with cerebral palsy. Besides, the present research highlights the need to strengthen the understanding of postural management, paediatric rehabilitation, and how physiotherapy and occupational therapy may possibly optimize the treatment of children with CP.
CASE SERIES | Oct. 3, 2025
Treatment Protocol for the Fully Edentulous Mandible with Implant-Supported Hybrid Prosthesis on Four Implants: “Full on Shorts®” Concept, Case Series
Dr. Eduardo Anitua
Page no 365-375 |
https://doi.org/10.36348/sjodr.2025.v10i10.001
Introduction: Rehabilitation of the edentulous mandible with severe atrophy remains a major clinical challenge in implant dentistry. Conventional regenerative procedures, while effective, involve high morbidity, long treatment times, and increased costs. To overcome these limitations, the “Full on Shorts®” protocol was developed, based on the placement of short and extra-short implants in posterior mandibular positions, distributed vertically and parallel to minimize cantilevers and optimize biomechanical stability without the need for regenerative surgery or tilted implants. Materials and Methods: This retrospective study included patients treated with the “Full on Shorts®” protocol and followed for a minimum of two years after implant loading. Four implants were placed in each edentulous mandible using a biological drilling protocol. All cases received immediate loading with provisional prostheses, followed by definitive prostheses after 3–4 months. Clinical and radiographic follow-up was conducted every six months, with marginal bone loss evaluated using standardized periapical radiographs. Primary outcomes were implant and prosthesis survival, insertion torque, and marginal bone changes. Results: A total of 36 implants were placed in 9 patients (mean age 64.9 ± 7.3 years). Mean alveolar crest height at implant sites was 6.57 ± 0.63 mm. The average insertion torque was 47.2 ± 13.2 Ncm, with higher values in type I bone (50.3 Ncm) compared to type III bone (37.5 Ncm). All implants were immediately loaded. After a mean follow-up of 39.1 ± 13.3 months (range 20–67), the survival rate of both implants and prostheses was 100%. Mean marginal bone loss was minimal, with 0.21 ± 0.49 mm mesially and 0.13 ± 0.48 mm distally. Only two minor prosthetic complications (screw loosening) were recorded. Conclusions: The “Full on Shorts®” protocol represents a reliable and minimally invasive approach for the rehabilitation of atrophic mandibles. The excellent implant and prosthesis survival, combined with negligible marginal bone loss and the feasibility of immediate loading, support this technique as a predictable alternative to conventional regenerative or tilted implant protocols.
ORIGINAL RESEARCH ARTICLE | Sept. 30, 2025
RP-HPLC Method Development and Validation for Estimation of Niraparib and Abiraterone
Najma Banu H, Sekar V, Krishnan R, Mohanapriya N, Venkatesan M
Page no 169-188 |
https://doi.org/10.36348/sijb.2025.v08i03.007
A simple, Accurate, precise method was developed for the simultaneous estimation of the Abiraterone and Niraparib in syrup dosage form. Chromatogram was run through AgilentC18150 x 4.6 mm, 5m. Mobile phase containing 0.01N Potassium dihydrogen ortho phosphate: Methanol taken in the ratio 60:40was pumped through column at a flow rate of 1.0ml/min. Temperature was maintained at 30°C. Optimized wavelength selected was 260nm. A simple, Accurate, precise method was developed for the simultaneous estimation of the Abiraterone and Niraparib in tablet dosage form. Retention time of Abiraterone and Niraparib were found to be 2.185 min and 2.660 min. %RSD of the Abiraterone and Niraparib were and found to be 0.6 and 0.3 respectively. %Recovery was obtained as 99.09% and 99.60% for Abiraterone and Niraparib respectively. LOD, LOQ values obtained from regression equations of Abiraterone and Niraparib were 0.26, 0.80and 0.03, 0.08 respectively. Regression equation of Niraparib is y = 90785x + 1183.6 and y = 42063x + 50388 of Abiraterone. Retention times were decreased and run time was decreased, so the method developed was simple and economical that can be adopted in regular Quality control test in Industries.
ORIGINAL RESEARCH ARTICLE | Sept. 30, 2025
Determination of Physiochemical Properties of Groundwater in Al-Abbasiya Locality, South Kordofan State, Sudan
Assim Mohammed Izirig Azrag, Abdalla Gobara, Mohammed Bahreldin Hussein, Widaa Ahamed, Wadaa Ahamed
Page no 213-218 |
https://doi.org/10.36348/sijcms.2025.v08i05.004
Groundwater is main source of drinking water in Al-Abbasiya locality. The study aimed to evaluate Physiochemical properties of ground water comparing with Sudanese Standardization Metrology Organization (SSMO) and World Health Organization (WHO). This study was conducted in 2019. 20 samples of water were randomly collected from different areas, and carefully stored. the samples were analysed using an Atomic Absorption Spectrometer (A.A.S), pH Meter, Conductivity meter (E.C), Turbidity meter. the analyses were carried out in Water Quality Lab Unesco Khartoum. the following parameters such as: pH, Electronic Conductivity (E.C), Turbidity, Total Hardness (T.H), Total Dissolved Salt (T.D.S), and total alkalinity (T.A), in addition to some cations, (Na+, Mg2+, K+, Ca2+, Mn2+, Fe2+) and anions such as: (F-, CI-, SO43-, NO32-, NO2-). The results showed that, pH ranging between (7.7-6.7), Electronic Conductivity (E.C), (3450-575 μs/cm), Turbidity (10.5 - 1.1) NTU, Total Hardness (T.H) (436-308 mg/L) and Total Dissolved Salt (T.D.S) (1170-286 mg/L), the values of alkalinity (TA) found (450 - 316 mg/L), Na+ (87-33 mg/L), K+ (2.0 -1.1 mg/L), Mg2+ (69.5-5.35 mg/L), Ca2+ (81.6- 25.8 mg/L), Mn2+ (0.9-0.02 mg/L), Fe2+ (0.08-0.03 mg/L), NH4+ (0.35- 0.10 mg/L), F- ( 2.10- 0.5 mg/L ), Cl- (23- 3.54 mg/L), NO3- (36.1- 0.03 mg/L), NO2- (11.8- 0.02 mg/L), SO42- (440- 011 mg/L), CO42- (364 - 170 mg/L), all samples revealed pH and total solubility values of salt within permissible limits according to drinking water quality guidelines of WHO and SSMO, except sample No. S10 (Al-gabal Al- ahamar), which contained slightly higher than the acceptable limit (1170 mg/L), and all showed higher electrical conductivity than the approved limit excluding samples No (S4 and S7) which were recorded values less than permitted standard (120 and 98) respectively. The hardness of the all samples were within allowed range and from analysed the values of dissolved bicarbonate, nitrate and salts were noted lower than their standard values, 0.3 mg/L. Concentration of Magnesium 25 mg/L and Calcium 45 mg/L in some samples are less than suggested range. As the result of these findings the water can be use without treatment with the exception of (S4 and S7) remained unfit for human usage due to increase in total dissolved salts.
REVIEW ARTICLE | Sept. 30, 2025
Quantum-Inspired Nano Biotechnology: Wave–Particle Duality in In Vitro and In Vivo Bioassays
Sana Yousaf, Rimza Tehreem, Awais Hameed
Page no 487-496 |
https://doi.org/10.36348/sjet.2025.v10i09.013
Quantum-inspired nanobiotechnology re-conceptualizes conventional bioassays by utilizing the waveparticle duality in quantum physics. Rather than considering photons, electrons or excitations strictly as wave or particle, the aim is to develop assays that exploit both aspects of their duality for ultra-sensitive, specific and informative bioassay designs. Wave-oriented assays utilize interference and coherence to amplify signals from a single molecule, particle-centric assays quantitatively count discrete events, such as an electron tunnelling through a nanopore, or photons emitted from a quantum dot; and correlation-centric assays exploit entanglement and quantum correlations to surpass classical noise thresholds. In total, these forms of bioassays provide powerful designs for In Vitro diagnostics, live-cell imaging and translational medicine. In this narrative review, we provide an overview of wave-centric, particle-centric, and correlation-centric bioassays, clarify their advantages and disadvantages, and point out the potential to merge and expand with artificial intelligence (AI), hybrid nanodevices that incorporate nanobiotechnologies, and nanotheranostics. We also cover health and safety, biocompatibility, ethical, and regulatory considerations that need to be considered in order to transition quantum-inspired bioassays from the lab to the clinic. Ultimately, we will suggest a roadmap for the next decade of this rapidly developing field.
ORIGINAL RESEARCH ARTICLE | Sept. 30, 2025
Comparative Effects of Two Edible Vegetable Oils in South East Nigeria on Dexamethasone Induced Dyslipidaemic Albino Wistar Rats
Abonyi Obiora Emmanuel, Egwuatu Anthony Ifeanyi, Ajima Judith Nnedimkpa
Page no 912-917 |
https://doi.org/10.36348/sjmps.2025.v11i09.016
Dyslipidaemia is a risk factor for cardiovascular diseases. A lipid profile of an organism is a direct measure of three blood components namely; total cholesterol (TC), triglycerides and high density lipoproteins cholesterol (HDL-C). Hypercholesterolemia is a lipoprotein metabolic disorder characterized by high serum low density lipoprotein and blood cholesterol and one of the most important risk factors for the development of cardiovascular diseases and lipid abnormalities. There have been many claims that most, if not all brands of vegetable oil in Nigeria is cholesterol free. Hence the study was undertaken to see the effect of vegetable oils in Nigeria on the lipid profile of albino rats induced with dyslipidaemia using dexamethasone. The phytochemical analysis and lipid profiles of albino rats treated with two vegetable oils were undertaken. Five groups of five rats were used in the study as follows: Group 1: Normal control- no induction no treatment, Group 2: Induction of dyslipidemia using dexamethasone (1 mg/kg bw) for 5 days only, Group 3: Treatment of induced dyslipidemia using a standard statin (20 mg/kg bw), Group 4: Induction + 3 ml/kg bw vegetable oil after induction, Group 5: Treatment without dyslipidemia using vegetable oil (3 ml/kg bw). The treatment lasted for 14 days and thereafter, the rats were fasted overnight and blood samples were taken through ocular puncture. The results showed various phytochemicals such as terpenoids, steroids, flavonoids, phenolics, tannins and alkaloids. The lipid profiles of the albino rats revealed that a non-significant (P>0.05) increase was observed in serum total cholesterol level of groups 3 and 5 when compared to group 2 while group 4 recorded a non-significant (P>0.05) decrease when compared to group 2. There was a non-significant (P>0.05) increase in serum triacylglycerol level of groups 3, 4, and 5 when compared to group 2. The result also showed a non-significant (P>0.05) decrease in serum HDL level in groups 3, 4, and 5 compared to group 2. Also, group 3 indicated a significant (P<0.05) increase in serum LDL level compared to group 2 while group 4 recorded a non-significant (P>0.05) decrease in serum LDL level compared to group 2. However, a significant (P<0.05) increase in serum LDL level was recorded in group 5 compared to group 2. The second vegetable oil revealed that group 3 indicated a non-significant (p>0.05) increase in total cholesterol level while groups 4 and 5 recorded a significant (p<0.05) decrease compared to group 2. Groups 3, 4 and 5 recorded a non-significant (p>0.05) increase in TAG compared to group 2. Group 3 recorded a significant (p<0.05) increase in LDL compared to group 2. Group 4 recorded a non-significant (p>0.05) decrease while group 5 recorded a significant (p<0.05) decrease in LDL compared to group 2. Groups 3, and 5 recorded a non-significant (p>0.05) decrease in HDL compared to group 2. Group 4 showed a significant (P<0.05) decrease in HDL compared to group 2. However, among the oil treated groups, TAG was found to be within range compared to the control group. Thus, the results of this present study imply that the consumption of vegetable oil for a long time could influence the risk of cardiovascular disease since they elicited an elevation of LDL-cholesterol and lowered HDL-cholesterol. Caution should, therefore, be applied on the consumption of vegetable oils as continuous use may have impact on lipid profile thereby causing dyslipidaemia.
Malignant infantile osteopetrosis is a rare hereditary bone disease characterized by defective bone resorption due to impaired osteoclast function or differentiation. This results in generalized osteosclerosis and leads to multiple complications including hematologic failure, neurological compression, skeletal deformities, dental anomalies, and facial dysmorphism. Diagnosis is based on a combination of clinical, biological, radiological, and genetic findings. The only curative treatment for severe forms is hematopoietic stem cell transplantation, which is most effective when performed early. New therapeutic strategies under investigation include gene therapy, immunomodulators, and targeted agents. Prognosis is influenced by the genetic subtype, age at diagnosis, and neurological involvement. Long-term multidisciplinary care is crucial to improve the quality of life of surviving patients.