Impacting Career Choices of Historically Underserved Secondary Students by Designing Near-Peer Directed Acid-Base Thematic Laboratory Activities to Enhance STEM Interest.

The current study describes preliminary findings from the Xavier University of Louisiana Mobile Outreach for Laboratory Enrichment (XULA-MOLE) project, which is a collaboration between Xavier University of Louisiana (XULA), a Historically Black and Catholic University, and participating 9th-12th grade classrooms in the central New Orleans area with a historically underserved student population. The project described here is geared toward providing laboratory enrichment to enhance student learning and impact student career interest in STEM fields, especially in classrooms with a much-needed "hands-on" laboratory experience which is unavailable due to a lack of resources. In this case study, we will present and discuss the inquiry-based laboratory modules for the topic area of acids and bases. These modules were created with careful thought and revision by XULA undergraduate STEM students. The experimental modules were based on the curriculum that participating teachers were discussing in the high-school classroom during the semester. The active-learning efforts were carried out during 6 weeks of the semester to provide a sustained and impactful resource for the participating classrooms. Since both groups of students (XULA-MOLE students and the high school students) were from underrepresented groups there was a strong sense of shared interest and dynamic near-peer mentorship. The project outcomes were measured using both formative and summative assessments indicative of preliminary successes in impacting career interests and increasing the content knowledge of participating high-school students.

Rete mirabile of the ICA: Report of three cases.

Carotid rete mirabile is an arterial meshwork, occurring at the cavernous portion of the internal carotid artery (ICA). Rete mirabile in humans is not present during normal development of the intracranial circulation and hence is considered as a collateral pathway that develops as a consequence of segmental agenesis of the ICA. We report three cases of this rare entity encountered at our institute.

Intrafamilial phenotypic variations in familial cases of cervical flexion induced myelopathy/Hirayama disease.

Hirayama disease is generally considered to be a sporadic disorder, except for a few reports of familial occurrence. In this study, we describe eight patients from four families with cervical flexion induced myelopathy (CFIM)/Hirayama disease (HD) and intra-familial phenotypic variations. All underwent clinical and electrophysiological evaluation, while seven of them had contrast MR imaging of cervical spine in flexion. There was significant intra-familial variability: distal bimelic form in four patients, classical monomelic form in three and proximo-distal form in one. Irrespective of the clinical phenotype, MRI showed characteristic dynamic changes of posterior dural detachment with prominent epidural enhancement extending variably from C3 vertebral level to dorsal spine in six patients. One patient with 28 years of illness, had only lower cervical cord atrophy without dynamic changes while another patient demonstrated forward dural displacement with epidural enhancement even after 38 years of disease duration.

Association of presenile cataract with galactose-1-phosphate uridyl transferase gene mutations.

BACKGROUND: Presenile cataract is commonly idiopathic in origin. However, patients with presenile cataract could have an underlying genetic abnormality of galactose metabolism. We studied the association, if any, between idiopathic presenile cataract and galactose-1 -phosphate uridyl transferase (GALT) gene mutation. METHODS: We selected 50 patients with idiopathic presenile cataract, <45 years of age, and 50 age- and sex-matched controls for the study. Mutations in the GALT gene were determined by polymerase chain reaction restriction fragment length polymorphism. The classical galactosaemia was characterized by Q188R and K285N mutations, whereas Duarte galactosaemia by N314D mutations (Duarte-2: N314D with IVS5-24G >A and Duarte-1: N314D without IVS5- 24G>A). RESULTS: The most common mutation observed was the N314D (Duarte) mutation. The frequencies of classical and N31 4D alleles in patients with presenile cataract (16%) and controls (26%) were not statistically different (p=0.32, OR 0.54, 95% CI 0.20-1.45). Similarly, there was no statistically significant difference in the frequency distribution of Duarte-1 (p=0.77, OR 0.77, 95% CI 0.23-0.24) and Duarte-2 (p=0.44, OR 0.38, 95% CI 0.07-2.03) galactosaemia mutations in patients and controls. CONCLUSION: Duarte galactosaemia, a milder form of the disease, is more common than classical galactosaemia in the Indian population. Duarte galactosaemia is unlikely to be a causative factor in presenile cataract.

Purtscher-like retinopathy in acute alcoholic pancreatitis.

A 23-year-old man with a history of alcoholism presented with vomiting, fever, and sharp epigastric pain radiating to the back and flanks. He was diagnosed as a case of acute alcoholic pancreatitis on the basis of clinical findings and investigations. On the next day of presentation, he developed sudden bilateral visual loss. His best-corrected visual acuity was finger counting at one-foot distance in both eyes. He had diffuse whitening in the circumpapillary area, haloes around the retinal vessels (Purtscher flecken) and intra-retinal hemorrhages on ophthalmoscopic examination. Optical coherence tomography revealed bilateral macular edema. These findings were characteristic of Purtscher-like retinopathy. The patient showed systemic and visual improvement at 8 weeks follow-up after receiving the conventional treatment for acute alcoholic pancreatitis. This case emphasizes the importance of fundus examination by an ophthalmologist in the diagnosis of this rare under-diagnosed entity.

Proximal and proximo-distal bimelic amyotrophy: Evidence of cervical flexion induced myelopathy.

This report aims at describing two new clinical phenotypes associated with classical features of cervical flexion induced myelopathy (CFIM). The description is of a prospective case series of six young males presenting with progressive bilateral proximal/proximo-distal amyotrophy of upper limbs and demonstrating the typical MRI characteristics of Hirayama disease. All underwent detailed clinical, electrophysiologcal and imaging studies. The affected muscles were shoulder girdles and arms in proximal form (n = 2) and the entire upper limbs in proximo-distal form (n = 4). The mean age at onset was 21.0 ± 3.3 years, duration of illness was 6.7 ± 3.4 years, period of progression was 39.0 ± 27.3 months followed by a stable phase of 45.0 ± 50.0 months. All had severe wasting and weakness of affected muscles leading to significant disability. Nerve conduction studies revealed grossly reduced compound muscle action potential amplitudes with neurogenic pattern on electromyography of affected muscles. On MRI all revealed evidence of cervical cord atrophy with signal changes, dural detachment and extensive posterior epidural enhancement (variably from C1 to T2 level). Altered cervical curvature was prominent. In conclusion, hitherto unreported, we describe two additional clinical phenotypes (proximal and proximo-distal forms) of Hirayama disease demonstrating the cardinal imaging features of CFIM.

Novel imaging findings in two cases of biotinidase deficiency-a treatable metabolic disorder.

Biotinidase deficiency is one of the few treatable inborn errors of metabolism. We describe unique MRI features in two patients with biotinidase deficiency. Brain MRI in case one demonstrated symmetrical diffusion restriction in bilateral hippocampi, parahippocampal gyri, central tegmental tracts, and cerebellar white matter besides other structures that have been reported previously. The second patient was noted to have bilateral symmetrical T2 hyperintensities involving the anterior, lateral and posterior columns of the entire spinal cord on MRI. Knowledge of the varied MRI features of biotinidase deficiency will aid the prompt diagnosis and treatment of a potentially disabling illness, especially in countries where newborn screening is not routinely performed.

Management of paradoxical response in pediatric tubercular meningitis with methylprednisolone.

Paradoxical response to anti-tubercular drugs remains a diagnostic dilemma. In India where tuberculosis is quite prevalent, paradoxical response to anti-tubercular treatment (ATT) is either misdiagnosed or under-diagnosed. We report two cases of optochiasmatic arachnoiditis due to paradoxical response in children suffering from tuberculous meningitis. Visual acuity was recorded as no light perception in all eyes of both patients while they were taking 4-drug ATT (isoniazid, rifampicin, pyrazinamide and ethambutol). However their systemic conditions did not worsen. They were treated with intravenous methylprednisolone for five days followed by systemic corticosteroids on a tapering dose for four weeks along with ATT. This case report highlights the importance of early recognition of this sight-threatening complication and timely, effective treatment to prevent permanent blindness.

Technique to assess the alveolar bone width for immediate implant placement in fresh extraction sockets.

AIM: To determine labial and lingual plate width at extraction site, using extracted tooth. MATERIALS AND METHODS: Pre-extraction ridge mapping and arch impression using putty consistency elastomeric impression material is recorded, followed by atraumatic tooth extraction, extracted tooth is cleaned and reoriented in the earlier recorded elastomeric putty impression. The cast obtained is used to measure bone width. RESULTS: The amount of available labial and palatal bone of an extracted socket can be assessed accurately. CONCLUSION: This technique will help the surgeon understand the thickness of labial plate especially the apical region without reflecting the flap, also aid in selection of proper dimension of dental implant, and if bone graft is needed.

Further structure-activity relationship studies on 8-substituted-3-[2-(diarylmethoxyethylidenyl)]-8-azabicyclo[3.2.1]octane derivatives at monoamine transporters.

The synthesis and structure-activity relationships of 8-substituted-3-[2-(diarylmethoxyethylidenyl)]-8-azabicyclo[3.2.1]octane derivatives were investigated at the dopamine transporter (DAT), the serotonin transporter (SERT) and norepinephrine transporter (NET). The rigid ethylidenyl-8-azabicyclic[3.2.1]octane skeleton imparted modestly stereoselective binding and uptake inhibition at the DAT. Additional structure-activity studies provided a transporter affinity profile that was reminiscent of the structure-activity of GBR 12909. From these studies, the 8-cyclopropylmethyl group has been identified as a unique moiety that imparts high SERT/DAT selectivity. In this study the 8-cyclopropylmethyl derivative 22e (DAT K(i) of 4.0 nM) was among the most potent compounds of the series at the DAT and was the most DAT selective ligand of the series (SERT/DAT: 1060). Similarly, the 8-chlorobenzyl derivative 22g (DAT K(i) of 3.9 nM) was found to be highly selective for the DAT over the NET (NET/DAT: 1358).

Synthesis and monoamine transporter affinity of 3alpha-arylmethoxy-3beta-arylnortropanes.

A series of 3-arylnortrop-2-enes and 3alpha-arylmethoxy-3beta-arylnortropanes were synthesized and evaluated for binding affinity at monoamine transporters. The 3-(3,4-dichlorophenyl)nortrop-2-ene (6e) exhibited high affinity for the SERT (K(i)=0.3 nM). The 3alpha-arylmethoxy-3beta-arylnortropanes were generally SERT selective with the 3alpha-(3.4-dichlorophenylmethoxy)-3betaphenylnortrop-2-ene (7c) possessing subnanomolar potency (K(i)=0.061 nM). However, 3alpha-(3,4-dichlorophenylmethoxy)-3beta-phenylnortrop-2-ene (7b) exhibited high affinity at all three transporters [(DAT K(i)=22 nM), (SERT K(i)=6 nM) and (NET K(i)=101 nM)].

N-(4-Hydroxy-phen-yl)-2-(1,1,3-trioxo-2,3-di-hydro-1,2-benzothia-zol-2-yl)-acet-amide.

In the title compound, C(15)H(12)N(2)O(5)S, the benzisothia-zole group is approximately planar (r.m.s. deviation excluding H atoms and the two O atoms bonded to S = 0.023 Å). The dihedral angle between the benzisothia-zole ring and the terminal phenol ring is 84.9 (1)°. In the crystal, mol-ecules are joined by N-H⋯O and O-H⋯O hydrogen bonds, and π-stacking inter-actions are observed between alternating phenol and benzisothia-zole rings [centroid-centroid distances = 3.929 (3) and 3.943 (3) Å].