Novel Approach to Landfill Wastewater Treatment Fouling Mitigation: Air Gap Membrane Distillation with Tin Sulfide-Coated PTFE Membrane.

This study addressed the fouling issue in membrane distillation (M.D.) technology, a promising method for water purification and wastewater reclamation. To enhance the anti-fouling properties of the M.D. membrane, a tin sulfide (TS) coating onto polytetrafluoroethylene (PTFE) was proposed and evaluated with air gap membrane distillation (AGMD) using landfill leachate wastewater at high recovery rates (80% and 90%). The presence of TS on the membrane surface was confirmed using various techniques, such as Field Emission Scanning Electron Microscopy (FE-SEM), Fourier Transform Infrared Spectroscopy (FT-IR), Energy Dispersive Spectroscopy (EDS), contact angle measurement, and porosity analysis. The results indicated the TS-PTFE membrane exhibited better anti-fouling properties than the pristine PTFE membrane, and its fouling factors (FFs) were 10.4-13.1% compared to 14.4-16.5% for the PTFE membrane. The fouling was attributed to pore blockage and cake formation of carbonous and nitrogenous compounds. The study also found that physical cleaning with deionized (DI) water effectively restored the water flux, with more than 97% recovered for the TS-PTFE membrane. Additionally, the TS-PTFE membrane showed better water flux and product quality at 55 °C and excellent stability in maintaining the contact angle over time compared to the PTFE membrane.

Pancreatic Carcinoid Tumor in a Pediatric Patient.

BACKGROUND Carcinoid tumors are well-differentiated tumors that develop from neuroendocrine cells. They are rare tumors and occur most commonly in the gastrointestinal tract, followed by the pulmonary system. They usually present with abdominal pain or cough or persistent pneumonia. They are usually diagnosed with computed tomography (CT) or magnetic resonance imaging (MRI) of the chest or abdomen. The cornerstone of treatment is surgical resection. There are rare reported cases of carcinoid tumor presenting in the pancreas as gastrinoma or insulinoma and are associated with multiple endocrine neoplasia type 1 (MEN1). CASE REPORT We report a case of an otherwise healthy 9-year-old girl who presented with manifestations of Cushing syndrome (easy fatigability, weakness, back pain, easy bruising, hirsutism, acne, skin discoloration [pigmentation], and blurred vision). She was diagnosed with incidental carcinoid tumor in the pancreas based on hypertension and typical stigmata. She underwent distal pancreatectomy and splenectomy. The histopathology showed a well-differentiated neuroendocrine tumor with G2. The diagnosis of concurrent Cushing syndrome and carcinoid syndrome can be challenging, as it is rare. It is important to screen for MEN syndrome when Cushing syndrome occurs in a child, as there is a high rate of transition to malignancy. They are usually diagnosed with ACTH, cortisol, and imaging. CONCLUSIONS Incidental hypertension in children is not common and mandates further investigation and clinical work-up to look for endocrinopathies such as Cushing syndrome and carcinoid syndrome. As the literature on such cases is scant, further reporting of cases is needed.

Comprehensive Analysis of Genes Associated With Sudden Infant Death Syndrome.

Background: Sudden infant death syndrome (SIDS) is a tragic incident which remains a mystery even after post-mortem investigation and thorough researches. Methods: This comprehensive review is based on the genes reported in the molecular autopsy studies conducted on SIDS so far. A total of 20 original studies and 7 case reports were identified and included in this analysis. The genes identified in children or adults were not included. Most of the genes reported in these studies belonged to cardiac channel and cardiomyopathy. Cardiac channel genes in SIDS were scrutinized for further analysis. Results: After screening and removing the duplicates, 42 unique genes were extracted. When the location of these genes was assessed, it was observed that most of these belonged to Chromosomes 11, 1 and 3 in sequential manner. The pathway analysis shows that these genes are involved in the regulation of heart rate, action potential, cardiac muscle cell contraction and heart contraction. The protein-protein interaction network was also very big and highly interactive. SCN5A, CAV3, ALG10B, AKAP9 and many more were mainly found in these cases and were regulated by many transcription factors such as MYOG C2C1 and CBX3 HCT11. Micro RNA, "hsa-miR-133a-3p" was found to be prevalent in the targeted genes. Conclusions: Molecular and computational approaches are a step forward toward exploration of these sad demises. It is so far a new arena but seems promising to dig out the genetic cause of SIDS in the years to come.

Intradural Extramedullary Lesions in the Cervical Spine in Neurofibromatosis.

BACKGROUND Neurofibromatosis (NF) is categorized into 3 diseases: neurofibromatosis type 1, type 2, and schwannoma. NF2 is associated with a mutation in gene 22q11.2. It is present in about 1/25 000 to 33 000 births, and it is passed in an autosomal dominant fashion. Diagnosis is made based on clinical and radiological features. A few clinical features have been characterized and included in the Manchester criteria. A few neurofibromatosis type 2 patients have been diagnosed with over 25 cervical lesions. We report a case of an intradural extramedullary cervical lesion in a patient later diagnosed with neurofibromatosis type 2. CASE REPORT The patient was 30-year-old man admitted through the emergency unit, presenting with gradual onset and progressive spastic quadriparesis of 6 months duration. An MRI spine showed intradural extramedullary masses in the right side of C4 and left side of C6. He underwent cervical intradural excision of 2 masses under general anesthesia with neuromonitoring. The tumor was sent to histopathology and reported as neurofibromatosis 2. CONCLUSIONS Neurofibromatosis is a common entity, but the diagnosis of a cervical mass is judicious to avoid any misfortune in neurological function. It requires a multidisciplinary approach and screening modalities.

Cerebellar Mutism Treated Successfully With Zolpidem in a Patient With Learning Difficulties.

Posterior fossa tumors constitute the most common brain tumor in pediatrics with 25% development postresection. Cerebellar mutism can manifest as neurobehavioral abnormalities that can occur within days to months after surgery but usually peak on the third postoperative day. It can be caused by discontinuation of dento-thalamo-cortical pathway in the vermian lesion, due to edema, tumors, and hypoperfusion. We report a seven-year-old patient with posterior fossa lesion (pilocytic astrocytoma in histopathology) and learning difficulties with symptoms of urinary retention, pseudobulbar palsy, and motor incoordination that were treated successfully with zolpidem 2.5 mg with regain of function by the third month.