Subarachnoid hemorrhage mimicking an acute migraine attack: A case report.

Subarachnoid hemorrhage is a neurological emergency in which arterial blood accumulates in the subarachnoid space with cerebral aneurysmal rupture being the most common cause. Subarachnoid hemorrhage is often misdiagnosed in the emergency department and mortality rates range from 8% to 67%. It may be the manifestation of the chronicity of the migraine. The difference in severity or quality compared to previous headaches, and other symptoms, particularly neck stiffness, but also seizure, syncope, focal neurological deficit, and vomiting are the key factors differentiating subarachnoid hemorrhage from the migraine. We report a case of a 37-year-old female with a previous history of migraines who presented with acute onset of excruciating headaches in the occiput associated with nausea, vomiting, and photophobia in whom a non-contrast computed tomography scan of the head showed hyper-densities involving the bilateral cerebral cortical sulcus and Sylvian fissure and the cerebral angiography showed a complex aneurysm in anterior communicating artery.

Renal vein thrombosis in a patient secondary to high-grade rhabdoid renal cell carcinoma: a case report and review of literature.

Introduction: Renal cell carcinoma, a common kidney tumour which is often incidentally discovered on imaging, can manifest with atypical symptoms. Renal cell carcinoma with rhabdoid features is a rare occurrence and even rarer in case of adults. Renal cell carcinoma has the tendency to form thrombus that can migrate to renal vein, inferior vena cava and even right atrium. Case presentation: The authors report a case of an 81-year-old male with rhabdoid renal cell carcinoma presenting with persistent cough for 6-7 months. with tumour thrombus extending into the renal vein and hepatic inferior vena cava. The patient was found feeble for the surgery and hence was treated on anticancer drugs pembrolizumab and axitinib. Conclusion: Renal cell carcinoma has the tendency to form tumour thrombus in renal vein and inferior vena cava. Prognosis without surgical intervention in these conditions is very poor.

Occurrence and temporal overlap of sympatric jungle cats and leopard cats in Parsa‒Koshi Complex, Nepal.

Co-occurrence and spatial and temporal overlap of sympatric jungle and leopard cats are influenced by habitat preferences, and interspecific competition. Understanding these factors influence is crucial for developing effective conservation strategies. We conducted a camera survey in Parsa‒Koshi Complex (PKC), Nepal during December 2022-March 2023 to investigate factors influencing occupancy and spatial and temporal overlap between jungle cats (Felis chaus) and leopard cats (Prionailurus bengalensis). The mean detection probability (t = 0.664, p = 0.507) did not differ between jungle cats (p = 0.500 ± 0.289) and leopard cats (p = 0.501 ± 0.288); however, occupancy (t = 31.008, p < 0.001) was greater for jungle cats (ψ = 0.247 ± 0.020) than leopard cats (ψ = 0.178 ± 0.019). Jungle cats and leopard cats were positively associated with large predators, and jungle cats were positively associated with human presence and negatively associated with canopy cover. We observed high diel overlap between leopard cats and jungle cats (Dhat1 = 0.802, norm0CI: 0.720-0.884), with both species largely nocturnal. Co-existence of jungle cats and leopard cats in PKC appears to be facilitated by spatial segregation. These findings provide valuable insights into the complex ecological dynamics and interactions between sympatric jungle and leopard cats.

Factors affecting the occupancy of sloth bear and its detection probability in Parsa-Koshi Complex, Nepal.

Understanding factors associated with coexistence of human and wildlife in human-dominated landscapes is crucial for effective species conservation. Among the wildlife species, the sloth bears Melursus ursinus are found both inside and outside the protected areas of Nepal, and with increasing cases of human and bear conflicts in both areas. This highlights the necessity for a comprehensive understanding of anthropogenic and ecological factors that affect the occurrence of sloth bear. The understanding of these factors is important for its coexistence and conservation in human-dominated areas through establishing management and conservation action plan. We studied the sloth bear's occupancy and their coexistence in human-dominated environments with other large predators in the Parsa-Koshi Complex of Nepal using camera traps from December 2022 to March 2023. We identified the occupancy and detection probability of the sloth bear as 0.12 and 0.31, respectively. Our analysis reveals a positive relationship between sloth bear occurrence and the presence of large predators (ßpredators = 3.104 ± 0.968), such as tigers (Panthera tigris) and leopards (Panthera pardus), as well as the number of humans detected (ßhuman = 1.428 ± 1.216) and canopy cover percentage (ßcc = 1.002 ± 0.737). However, the number of livestock detected shows a negative interaction with the occurrence of sloth bears (ßlivestock = -2.240 ± 1.467). There was insignificant interaction between sloth bear occupancy and distance to human settlements, roads, and water bodies. These findings underscore the complex dynamics between sloth bears, humans, large predators, and livestock in human-dominated landscapes. To ensure the long-term survival of sloth bear populations and promote species conservation, comprehensive conservation strategies that account for both ecological and socio-economic factors are essential.

A Comprehensive Literature Review on Managing Systemic Lupus Erythematosus: Addressing Cardiovascular Disease Risk in Females and Its Autoimmune Disease Associations.

This review aimed to evaluate the mechanism of premature cardiovascular disease (CVD) in systemic lupus erythematosus (SLE) patients, particularly in the female population, and emphasize the need for early management interventions; explore the association between SLE and two autoimmune diseases, myasthenia gravis (MG) and antiphospholipid antibody syndrome (APS), and their management strategies; and evaluate the effectiveness of pharmacological and non-pharmacological interventions in managing SLE, focusing on premenopausal females, females of childbearing age, and pregnant patients. We conducted a comprehensive literature review to achieve these objectives using various databases, including PubMed, Google Scholar, and Cochrane. The collected data were analyzed and synthesized to provide an evidence-based overview of SLE, its management strategies as an independent disease, and some disease associations. The treatment should be focused on remission, preventing organ damage, and improving the overall quality of life (QOL). Extensive emphasis should also be focused on diagnosing SLE and concurrent underlying secondary diseases timely and managing them appropriately.

Identifying the environmental and anthropogenic causes, distribution, and intensity of human rhesus macaque conflict in Nepal.

Reducing conflict between humans and wildlife is considered a top conservation priority. However, increasingly human-induced disturbances across natural landscapes have escalated encounters between humans and wildlife. In Nepal, forests have been destroyed, fragmented, and developed for human settlements, agricultural production, and urban centers for decades. As a result, human-wildlife conflict, in the form of crop-raiding, livestock predation, and injuries to humans and wildlife, is common throughout the country. In particular, crop-raiding by macaques is an increasingly common form of human-wildlife conflict. Rhesus macaques (Macaca mulatta) have been identified as a top ten crop-raiding wildlife species in Nepal. In order to better understand the nationwide distribution and intensity of human-rhesus macaque conflict (HRMC), we conducted an extensive literature review of reported incidences of HRMC during the period 2000 to 2021 in Nepal. We also created an online survey to obtain nationwide data on the location and severity of HRMC, and modeled the set of ecological factors that affect habitat suitability for rhesus macaques. An ensemble of three different species distribution model (SDM) algorithms were used to analyze these data. We found that almost 44% of Nepal's land area contains suitable habitat for rhesus macaques, with less than 8% of all suitable habitat located in protected national parks. As humans continue to alter and fragment natural landscapes, HRMC in Nepal has intensified. At present, nearly 15% of the country's land area in which human settlements are permitted, is characterized by moderate or high rates of HRMC. We argue that prioritizing programs of forest restoration, strategic management plans designed to connect isolated forest fragments with high rhesus macaque population densities, creating government programs that compensate farmers for income lost due to crop-raiding, and educational outreach that informs local villagers of the importance of conservation and protecting biodiversity, offer the most effective solutions to reduce HRMC in Nepal.

Factors affecting the crop raiding behavior of wild rhesus macaques in Nepal: Implications for wildlife management.

In many areas of South Asia and Southeast Asia, macaques inhabiting agricultural landscapes are considered serious crop pests by local farmers. In Nepal, for example, the expansion of monocultures, increased forest fragmentation, the degradation of natural habitats, and changing agricultural practices have led to a significant increase in the frequency of human-macaque conflict. In order to more fully understand the set of factors that contribute to macaque crop raiding, and the set of preventive measures that can be put in place to avoid human-macaque conflict, we examined patterns of crop raiding by a group of 52 rhesus macaques (Macaca mulatta) in the Kavrepalanchok district, Nepal. We present data on macaque inflicted crop damage in 172 agricultural plots (each plot measuring 380 m2) from August to October 2019. Our results indicate that farmland invasions by macaques were principally affected by crop type (maize was preferred over rice), nearness of farmland to both the forest edge and the major travel route used by the macaques, and the mitigation efforts applied by farmers to discourage crop raiding. We found that as the proportion of maize farmland in the most direct path from the macaque's main travel route to nearby crop raiding sites increased, the amount of maize damage decreased. This is likely explained by the fact that macaques traveling across several adjacent maize fields encounter multiple farmers protecting their crops. We estimated that the financial cost to individual farmer households of macaque maize and rice raiding was on average US$ 14.9 or 4.2% of their annual income from cultivating those two crops. As human-macaque conflict is one of the most critical challenges faced by wildlife managers in South Asia and Southeast Asia, studies of macaque crop raiding behavior provide an important starting point for developing effective strategies to manage human-macaque conflict while promoting both primate conservation and the economic well-being of the local community.

The influence of phylogeny, social style, and sociodemographic factors on macaque social network structure.

Among nonhuman primates, the evolutionary underpinnings of variation in social structure remain debated, with both ancestral relationships and adaptation to current conditions hypothesized to play determining roles. Here we assess whether interspecific variation in higher-order aspects of female macaque (genus: Macaca) dominance and grooming social structure show phylogenetic signals, that is, greater similarity among more closely-related species. We use a social network approach to describe higher-order characteristics of social structure, based on both direct interactions and secondary pathways that connect group members. We also ask whether network traits covary with each other, with species-typical social style grades, and/or with sociodemographic characteristics, specifically group size, sex-ratio, and current living condition (captive vs. free-living). We assembled 34-38 datasets of female-female dyadic aggression and allogrooming among captive and free-living macaques representing 10 species. We calculated dominance (transitivity, certainty), and grooming (centrality coefficient, Newman's modularity, clustering coefficient) network traits as aspects of social structure. Computations of K statistics and randomization tests on multiple phylogenies revealed moderate-strong phylogenetic signals in dominance traits, but moderate-weak signals in grooming traits. GLMMs showed that grooming traits did not covary with dominance traits and/or social style grade. Rather, modularity and clustering coefficient, but not centrality coefficient, were strongly predicted by group size and current living condition. Specifically, larger groups showed more modular networks with sparsely-connected clusters than smaller groups. Further, this effect was independent of variation in living condition, and/or sampling effort. In summary, our results reveal that female dominance networks were more phylogenetically conserved across macaque species than grooming networks, which were more labile to sociodemographic factors. Such findings narrow down the processes that influence interspecific variation in two core aspects of macaque social structure. Future directions should include using phylogeographic approaches, and addressing challenges in examining the effects of socioecological factors on primate social structure.

Diet and Activity of Macaca assamensis in Wild and Semi-Provisioned Groups in Shivapuri Nagarjun National Park, Nepal.

Studying the behavioural flexibility and adaptability of macaques to different habitats is one approach to designing a conservation plan. To determine the activity budget and feeding behaviour and evaluate the effects of seasonality in wild and human- altered habitats of Assamese macaques (Macaca assamensis), we conducted this study in the Nagarjun forest of Shivapuri-Nagarjun National Park (SNNP) in central Nepal. We also updated the list of plant food items of Assamese macaques in the SNNP. Using scan and all-occurrence sampling, we recorded the diets and activities of Assamese macaques in 2 social groups, a wild-feeding group (WG) and a semi-provisioned group (SPG), throughout the year from August 2013 to July 2014. Both groups spent most of their time in feeding activities and were quite arboreal, but there were significant differences in the activity budgets and diets between the groups. Human food was the main component of the diet for the SPG, whereas it was fruit for the WG, indicating a normally frugivorous diet. Furthermore, the activity budget and diet composition varied in response to the season. These results indicate that provisioning alters the activity and feeding behaviour of macaques, and can also increase human-macaque conflict and disease transmission.