Pericardial hydatid cyst: A comprehensive case report on diagnosis and multidisciplinary intervention in a young patient.

Pericardial hydatid cysts, although rare, present unique diagnostic challenges and require a multidisciplinary approach for effective management. This parasitic infection, caused by Echinococcus granulosus larvae, typically affects the liver and lungs but can manifest in the pericardium, leading to potentially life-threatening complications if untreated. The 22-year-old female's escalating dyspnea posed diagnostic challenges despite inconclusive echocardiography. Employing a multidisciplinary strategy, including preoperative albendazole therapy and surgical excision, effectively managed the condition. This case highlights the intricate diagnostic nature of pericardial hydatid cysts, emphasizing the importance of heightened clinical awareness, especially in endemic regions. The detailed clinical trajectory, imaging methodologies, and therapeutic interventions contribute significant insights to the medical community. The study aims to deepen comprehension and guide clinicians in refined diagnostic and treatment approaches for pericardial hydatid cysts, ultimately improving patient outcomes. It underscores the imperative for continued research in this niche to enhance medical understanding and optimize clinical practices.

Rare encounter: Adult-onset temporal lobe schizencephaly with septo-optic dysplasia - a case report on comprehensive diagnosis and management.

This case report presents a 21-year-old male with recurrent seizures attributed to isolated temporal lobe closed-lip schizencephaly coexisting with septo-optic dysplasia. Despite adult-onset seizures, the patient lacked motor deficits, maintaining normal developmental milestones. Comprehensive diagnostic modalities, including MRI revealing temporal lobe atrophy and associated abnormalities, contributed to the unique identification of schizencephaly. The classic triad of septo-optic dysplasia further complicated the clinical spectrum. Financial limitations influenced the predominantly conservative management, highlighting healthcare challenges. This case enhances our understanding of the rare congenital disorder, emphasizing the importance of tailored diagnostics and management strategies for diverse presentations of schizencephaly, particularly in the context of associated congenital anomalies.

Lipoma arborescens in the dorsum of the hand: a case report and a comprehensive review.

Introduction and importance: Lipoma arborescens is a rare synovial disorder, typically affecting the knee joint, with limited reports of atypical presentations. The study emphasizes the need for a multidisciplinary diagnostic approach and discusses the genetic and signalling factors associated with its pathogenesis. Case presentation: A 50-year-old male presented with a painless swelling in the dorsum of the right hand, a rare extra-articular manifestation of Lipoma arborescens. Comprehensive clinical, imaging, and histopathological evaluations confirmed the diagnosis, revealing unique features on MRI and frond-like fatty tissue infiltration on excisional biopsy. Clinical discussion: The case underscores the distinct clinical characteristics, diagnostic challenges, and differential considerations associated with atypical Lipoma arborescens presentations. Extra-articular manifestation of Lipoma arborescens involving the dorsum (extensor aspect) of the hand is rare. Imaging techniques, including MRI and ultrasound, play a crucial role in accurate diagnosis, differentiating it from other joint pathologies. The MRI findings include intra-articular fat deposits and villous proliferation of the synovial membrane. At the same time, the histopathological analysis includes frond-like infiltration of sub-synovial tissue with mature adipocytes which helps in confirming the diagnosis. Conclusion: Successful surgical excision of the extra-articular lesion highlights the importance of a comprehensive diagnostic strategy for managing this uncommon condition. The study contributes valuable insights into understanding, diagnosing, and treating atypical presentations of lipoma arborescens.

Prospective quantitative study: Doppler ultrasound in the evaluation of chronic renal allograft disease and correlation with histopathological finding.

Background and Objectives: Renal allograft biopsy is the gold standard for diagnosing chronic allograft nephropathy, but noninvasive methods are needed to avoid unnecessary biopsies. Doppler ultrasonography, particularly the resistive index (RI), correlates with renal allograft dysfunction. This study aims to assess the relationship between renal sonographic parameters and biochemical parameters in diagnosing graft interstitial fibrosis. Methods: The study evaluated 60 renal allograft recipients for sonographic renal morphological features and Doppler indices. The estimated glomerular filtration rate (eGFR) was calculated, and cortical fibrosis after the biopsy was determined using the Banff score. Continuous variables like mean and SD were calculated, and categorical variables were reported using frequencies and proportions. Associations were examined using independent sample t-tests, χ 2tests, and multivariate regression analysis. Results: The mean eGFR was 75.23±25.45 ml/min/1.73 m2. A significant correlation of eGFR with RI (r=0.341, P=0.008) was seen. A significant difference in mean RI (F=10.167; df=2,57; P<0.001) was seen among the histological grades of fibrosis. Among the histological grades of fibrosis, significant differences in RI among mild and moderate (S.E. 0.033, P=0.043), mild and severe (S.E. 0.026, P=0.001) as well as moderate and severe (S.E. 0.036, P=0.029) was seen. Conclusion: Doppler was able to noninvasively predict allograft fibrosis and could be used as a complementary imaging tool during the follow-up of renal allograft patients. Future research is needed to improve evidence, diagnostic criteria, guidelines, and long-term impact.

Insight into adult-onset metachromatic leukodystrophy with optic atrophy: A comprehensive case report.

This abstract provides an overview of metachromatic leukodystrophy (MLD), an autosomal recessive disorder stemming from arylsulfatase A deficiency. MLD leads to cerebroside sulfate accumulation, causing central and peripheral demyelination. Clinical manifestations vary by age group: late-infantile (rapid progression), juvenile (slower progression), and adult-onset (psychiatric symptoms). A case study details a 23-year-old with progressive vision impairment, motor weakness, and cognitive changes. Examination and MRI findings led to suspicion of MLD, later confirmed by enzyme testing. Optic nerve involvement is emphasized, along with diagnostic criteria involving enzyme assays, imaging, and urinary sulfatide excretion tests. While no cure exists, symptomatic and supportive care, including hematopoietic stem cell transplantation, remains key in MLD management.

Metastatic Supraclavicular Lymph Nodes among Patients with Lung Carcinoma in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Metastatic spread of lung cancer to supraclavicular lymph nodes is considered distant metastasis for treatment purposes. Detection of supraclavicular lymph node metastasis in patients with lung cancer serves for tissue diagnosis by itself and also helps avoid more invasive biopsy from the primary lung mass itself. Ultrasonography of the lower neck can detect supraclavicular lymph nodes before they are palpable and can also be used for safe sampling of these lymph nodes. The aim of this study was to find out the prevalence of metastatic supraclavicular lymph nodes among patients with lung carcinoma in a tertiary care centre. Methods: A descriptive cross-sectional study done in a tertiary care center, carried out from 15 September 2019 to 14 September 2020. Ethical approval was obtained from the Institutional Review Committee (Reference number: 84(611)E2/076/077). The study was done among 92 patients with biopsy-proven lung cancer (lung mass or supraclavicular lymph node biopsy) who were referred for evaluation, and/or percutaneous transthoracic biopsy. Convenience sampling method was used. Point estimate and 90% Confidence Interval were calculated. Results: Among 92 patients with proven lung cancer, metastatic supraclavicular lymph nodes were seen in 13 patients (14.10%) (8.17- 19.73, 90% Confidence Interval). Among 13 patients with metastatic lymph nodes, 9 (69.23%) had palpable supraclavicular lymph nodes. The majority 11 (84.61%) had round-shaped lymph nodes. All metastatic lymph nodes showed loss of echogenic fatty hilum. A total of 12 (92.30%) metastatic lymph nodes showed a peripheral disorganized pattern of vascularity. Conclusions: The prevalence of metastatic supraclavicular lymph nodes was lower than in similar studies done in international settings. Keywords: lung cancer; malignancy; ultrasonography.

Effects of physicochemical properties and co-existing zinc agrochemicals on the uptake and phytotoxicity of PFOA and GenX in lettuce.

Even though the potential toxicity and treatment methods for per- and polyfluoroalkyl substances (PFAS) have attracted extensive attention, the plant uptake and accumulation of PFAS in edible plant tissues as a potential pathway for human exposure received little attention. Our study in a hydroponic system demonstrated that perfluorooctanoic acid (PFOA) and its replacing compound, 2,3,3,3-tetrafluoro-2-(heptafluoropropoxy) propanoic acid (GenX) displayed markedly different patterns of plant uptake and accumulation. For example, the root concentration factor (RCF) of PFOA in lettuce is almost five times of that of GenX while the translocation factor (TF) of GenX is about 66.7% higher than that for PFOA. The co-presence of zinc amendments affected the phyto-effect of these two compounds and their accumulation in plant tissues, and the net effect on their plant accumulation depended on both the properties of Zn amendments and PFAS. Zinc oxide nanoparticles (ZnONPs) at 100 mg/L did not affect the uptake of PFOA in either lettuce roots or shoots; however, Zn2+ at the same concentration significantly increased PFOA accumulation in both tissues. In contrast, both Zn amendments significantly lowered the accumulation of GenX in lettuce roots, but only ZnONPs significantly hindered the GenX accumulation in lettuce shoots. The co-exposure to ZnONPs and PFOA/GenX resulted in lower oxidative stress than the plants exposed to PFOA or GenX alone. However, both zinc agrochemicals with or without PFAS led to lower root dry biomass. The results shed light on the property-dependent plant uptake of PFAS and the potential impact of co-existing nanoagrochemicals and their dissolved ions on plant uptake of PFOA and GenX.

Overlapping and stress-specific transcriptomic and hormonal responses to flooding and drought in soybean.

Flooding and drought are serious constraints that reduce crop productivity worldwide. Previous studies identified genes conferring tolerance to both water extremes in various plants. However, overlapping responses to flooding and drought at the genome-scale remain obscure. Here, we defined overlapping and stress-specific transcriptomic and hormonal responses to submergence, drought and recovery from these stresses in soybean (Glycine max). We performed comparative RNA-sequencing and hormone profiling, identifying genes, hormones and biological processes that are differentially regulated in an overlapping or stress-specific manner. Overlapping responses included positive regulation of trehalose and sucrose metabolism and negative regulation of cellulose, tubulin, photosystem II and I, and chlorophyll biosynthesis, facilitating the economization of energy reserves under both submergence and drought. Additional energy-consuming pathways were restricted in a stress-specific manner. Downregulation of distinct pathways for energy saving under each stress suggests energy-consuming processes that are relatively unnecessary for each stress adaptation are turned down. Our newly developed transcriptomic-response analysis revealed that abscisic acid and ethylene responses were activated in common under both stresses, whereas stimulated auxin response was submergence-specific. The energy-saving strategy is the key overlapping mechanism that underpins adaptation to both submergence and drought in soybean. Abscisic acid and ethylene are candidate hormones that coordinate transcriptomic energy-saving processes under both stresses. Auxin may be a signaling component that distinguishes submergence-specific regulation of the stress response.

Physiological and Molecular Traits Associated with Nitrogen Uptake under Limited Nitrogen in Soft Red Winter Wheat.

A sufficient nitrogen (N) supply is pivotal for high grain yield and desired grain protein content in wheat (Triticum aestivum L.). Elucidation of physiological and molecular mechanisms underlying nitrogen use efficiency (NUE) will enhance our ability to develop new N-saving varieties in wheat. In this study, we analyzed two soft red winter wheat genotypes, VA08MAS-369 and VA07W-415, with contrasting NUE under limited N. Our previous study demonstrated that higher NUE in VA08MAS-369 resulted from accelerated senescence and N remobilization in flag leaves at low N. The present study revealed that VA08MAS-369 also exhibited higher nitrogen uptake efficiency (NUpE) than VA07W-415 under limited N. VA08MAS-369 consistently maintained root growth parameters such as maximum root depth, total root diameter, total root surface area, and total root volume under N limitation, relative to VA07W-415. Our time-course N content analysis indicated that VA08MAS-369 absorbed N more abundantly than VA07W-415 after the anthesis stage at low N. More efficient N uptake in VA08MAS-369 was associated with the increased expression of genes encoding a two-component high-affinity nitrate transport system, including four NRT2s and three NAR2s, in roots at low N. Altogether, these results demonstrate that VA08MAS-369 can absorb N efficiently even under limited N due to maintained root development and increased function of N uptake. The ability of VA08MAS-369 in N remobilization and uptake suggests that this genotype could be a valuable genetic material for the improvement of NUE in soft red winter wheat.

The Central Negative Regulator of Flooding Tolerance, the PROTEOLYSIS 6 Branch of the N-degron Pathway, Adversely Modulates Salinity Tolerance in Arabidopsis.

Seawater intrusion in coastal regions and waterlogging in salinized lands are serious constraints that reduce crop productivity under changing climate scenarios. Under these conditions, plants encounter flooding and salinity concurrently or sequentially. Identification and characterization of genes and pathways associated with both flooding and salinity adaptation are critical steps for the simultaneous improvement of plant tolerance to these stresses. The PROTEOLYSIS 6 (PRT6) branch of the N-degron pathway is a well-characterized process that negatively regulates flooding tolerance in plants. Here, we determined the role of the PRT6/N-degron pathway in salinity tolerance in Arabidopsis. This study demonstrates that the prt6 mutation enhances salinity tolerance at the germination, seedling, and adult plant stages. Maintenance of chlorophyll content and root growth under high salt in the prt6 mutant was linked with the restricted accumulation of sodium ions (Na+) in shoots and roots of the mutant genotype. The prt6 mutation also stimulated mRNA accumulation of key transcription factors in ABA-dependent and independent pathways of osmotic/salinity tolerance, accompanied by the prominent expression of their downstream genes. Furthermore, the prt6 mutant displayed increased sensitivity to ethylene and brassinosteroids, which can suppress Na+ uptake and promote the expression of stress-responsive genes. This study provides genetic evidence that both salinity and flooding tolerance is coordinated through a common regulatory pathway in Arabidopsis.

Physiology, gene expression, and metabolome of two wheat cultivars with contrasting submergence tolerance.

Responses of wheat (Triticum aestivum) to complete submergence are not well understood as research has focused on waterlogging (soil flooding). The aim of this study was to characterize the responses of 2 wheat cultivars differing vastly in submergence tolerance to test if submergence tolerance was linked to shoot carbohydrate consumption as seen in rice. Eighteen-day-old wheat cultivars Frument (intolerant) and Jackson (tolerant) grown in soil were completely submerged for up to 19 days while assessing responses in physiology, gene expression, and shoot metabolome. Results revealed 50% mortality after 9.3 and 15.9 days of submergence in intolerant Frument and tolerant Jackson, respectively, and significantly higher growth in Jackson during recovery. Frument displayed faster leaf degradation as evident from leaf tissue porosity, chlorophylla , and metabolomic fingerprinting. Surprisingly, shoot soluble carbohydrates, starch, and individual sugars declined to similarly low levels in both cultivars by day 5, showing that cultivar Jackson tolerated longer periods of low shoot carbohydrate levels than Frument. Moreover, intolerant Frument showed higher levels of phytol and the lipid peroxidation marker malondialdehyde relative to tolerant Jackson. Consequently, we propose to further investigate the role of ethylene sensitivity and deprivation of reactive O2 species in submerged wheat.