Spatial distribution of drinking and irrigation water quality indices of Ghizer River Basin, northern Pakistan.

Determining the water contamination of a river that threatens the dependent ecological community is a pillar for sustainable management. For this purpose, the present study aimed to examine the water quality of the Ghizer River Basin (GRB), Gilgit-Baltistan, northern Pakistan, for drinking and irrigation. Water samples (n = 55) were collected from the GRB and analyzed for physicochemical parameters. Water basic parameters and anions were measured using the multi-parameter analyzer (CONSORT 6030, Belgium) and cations by the atomic absorption spectrophotometer (AAS, AAnalyst 700, PerkinElmer, USA). Physiochemical parameters such as pH, electrical conductivity (EC), total dissolved solids (TDS), iodide (I), chloride (Cl), fluoride (F), nitrate (NO3), sulfate (SO4), bicarbonate (HCO3), turbidity, calcium (Ca), magnesium (Mg), potassium (K), and sodium (Na) were noted to be within the drinking water permissible limits set by the World Health Organization (WHO). However, pH and turbidity surpassed their respective limits in 2% and 48% of water samples, respectively. Samples were assessed for water quality index (WQI) and irrigation water quality (IWQ) indices. The WQI values for most samples in the GRB were noted in the excellent (38.2%), good (58.2%), and poor (3.6%) categories. Similarly, most IWQ indices revealed that water is suitable and recommended for irrigation. Gibbs plots showed that most water samples in the GRB were noted in the precipitation dominance zone. The piper plot revealed the calcium-chloride (Ca-Cl) dominant hydrochemical facies.

Rhombencephalitis Possibly Caused By Mycoplasma Pneumoniae.

We report a rare case of encephalitis that is not often described in clinical settings in neurology. Our case was 11-year-old female patient who had presented with features of meningoencephalitis, but not responded to the conventional treatment. Her magnetic resonance imaging revealed lesions in thalami, cerebellum and brainstem. The differentials in this age were infective and inflammatory causes of meningoencephalitis and acute disseminated encephalomyelitis (ADEM). Paraneoplastic was another differential. Mycoplasma serology came out positive. As a result, diagnosis of mycoplasma pneumoiae associated Rhombencephalitis was made based on diagnosis of exclusion.

The Spectrum of Movement Disorders in Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis Both in Children and Adults: An Experience From a Single Tertiary Care Center.

Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is a form of autoimmune encephalitis. The characteristic clinical features include seizure, psychosis-like symptoms, abnormal movements, and autonomic disturbances. Patients with anti-NMDAR encephalitis can present with various types of movement disorders. Typically, the movement disorders start following intervals of psychiatric and prodromal manifestations in young adults; however, in children, these might be an early presentation of anti-NMDAR encephalitis. The disease is under-recognized and underdiagnosed in Pakistan. Early recognition of the disease is important to commence timely treatment leading to a better prognosis. Here we present a collection of anti-NMDAR encephalitis patients, specifically focussing on the different types of movement disorders and the differences in clinical manifestations between children and adults.

Klippel-Feil Syndrome With Auxiliary Anterior Cervical Meningomyelocele and Thoracic Syringomyelia: A Case Report.

STUDY DESIGN: Case report. OBJECTIVE: Since this is the first ever case of a male patient with Klippel-Feil syndrome (KFS) with anterior cervical meningomyelocele and syringomyelia. All four previously reported cases were female patients. This makes this case unique. SUMMARY OF BACKGROUND DATA: KFS with auxiliary anterior cervical meningomyelocele is a rare entity. To the best of our knowledge so far only four cases are reported. METHODS: A 22-year-old male patient was presented to neurology outpatient department with 2-year history of left hand paresthesia and progressive weakness. The diagnostic evaluation showed KFS with auxiliary anterior cervical meningomyelocele and thoracic syringomyelia. RESULTS: Patient was sent to neurosurgery department for intervention. After discussing the possible risks and complications of intervention he opted for conservative therapy and declined the surgery. CONCLUSION: The paucity of data is the key reason for any recommended protocol for management of such patients but the available literature recommends neurosurgical intervention in symptomatic patients. LEVEL OF EVIDENCE: 5.