Primary central nervous system neuroblastoma mimicking a meningioma: A case report.

ABSTRACT: Neuroblastomas are the most common extracranial solid tumor in the pediatric age group (~8%-10% of childhood neoplasms). Most cases of intracranial neuroblastomas occur due to metastasis from some primary extracranial sites and are known as secondary neuroblastomas. However, the occurrence of primary central nervous system neuroblastomas (PCN-NB) is very rare, and only a few cases and case series have been reported in the literature. PCN-NB is mainly an intra-axial pathology, and extra-axial involvement is mainly due to metastasis from some extracranial primary site with involvement of the skull bone. Herein we report a case of a 23-year-old female having a large extra-axial space-occupying lesion in the right frontal region that was mimicking a meningioma, and surprisingly the histopathology was suggestive of a supratentorial neuroblastoma. A right frontal craniotomy was made, and Simpson's grade 1 excision of the tumor was done. The excised tissue was sent for histopathological examination. PCN-NB located extra-axially are extremely rare to occur. Due to inconsistent radiological imaging, it becomes very difficult to diagnose these tumors preoperatively, and these should be kept in mind as one of the differential diagnoses of extra-axial intracranial space-occupying lesions. Histopathological examination is crucial in diagnosing the intracranial neuroblastomas.

Can ferritin be a surrogate marker for CD4 cells in human immunodeficiency virus patients? A cross-sectional study of association of serum ferritin levels with immunological staging of human immunodeficiency virus patients.

Introduction: The human immunodeficiency virus (HIV)/AIDS in India came into public view in 1986 with the detection of the first case of HIV in Chennai, Tamil Nadu, and the first AIDS case in Mumbai, Maharashtra in 1987. In acute phase response, iron distribution occurs in the liver and mononuclear phagocytic system. A high prevalence of elevated serum ferritin levels is reported in HIV infection and serum ferritin levels increase with the clinical worsening of infection and with decreasing CD4 lymphocyte counts. This study is designed to find the role of acute phase reactant serum ferritin in the progression of the disease of HIV which is complicated by opportunistic infections, by finding the correlation of serum ferritin with immunological stages of HIV. Materials and Methods: This cross-sectional study was conducted on 75 patients admitted to various wards of the Department of Medicine or attending medicine outdoor or ART Centre, Maharana Bhupal Government Hospital, RNT Medical College Udaipur. Serum ferritin, total iron binding capacity, and total serum iron were analyzed in Cobas® analyzer. CD4 cells are measured using the flow cytometry technique. The results were tabulated and subjected to statistical analysis. Results and Conclusion: There was a negative correlation among serum ferritin and CD4 cells with r = -0.195 which was statistically significant (P < 0.05). As the CD4 cell count decreased incidence of serum ferritin increased. Elevation of serum ferritin levels is associated with a low count of the CD4+ in HIV-diagnosed patients. In a patient diagnosed with HIV, elevated serum ferritin indicates underlying inflammatory pathology. Serum ferritin can be used as a guide to further evaluation of underlying disease in HIV patients.

Synergistic effect of benzo triazole with polyethoxylated sorbitan monooleate in inhibiting corrosion of rebars and chloride diffusion through mortars.

It is found that mixture of 1,2,3 benzo triazole (BTAH) with polyethoxylated sorbitan monooleate, a non-ionic surface-active agent (NIS) effectively improves the properties of the cast concrete as well as significantly reduces the chloride induced corrosion of steel reinforced bars, when added in freshly prepared paste of mortar mixture. The addition of this mixture in the cast mortars is noted to reduce the water absorption in comparison to the control mortars cast using identical materials and under similar cast conditions. Electrochemical impedance spectroscopy and polarization studies of the rebars embedded in mortars and exposed in cement slurry have been performed to study the role of synergistic mixture on kinetics and mechanism of corrosion of rebars. The characterisation of corrosion products formed on the surface of rebars was carried out by X-ray diffraction, Scanning electron microscopy and EDX analysis. It is proposed that the synergistic boosting in protection is caused due to the shielding of NIS around anionic BTA-, thus minimizing their electrostatic repulsion. This facilitates the migration of additional ionic BTA towards the double layer which increases their concentration at the corroding interface leading to reduced susceptibility to corrosion.

Synergistic protection of borate and silicate salts composite for controlling the chloride-induced pitting and uniform corrosion of steel reinforcement bars embedded in mortars.

In this study, the efficacy of the combined effect of borate and silicate alkali metal salts added to mortars for controlling the chloride-induced uniform and localized corrosion of embedded steel rebars is examined. The individually added salts in mortars are found to have insignificant effects in terms of reducing the uniform corrosion rate and localized damage. However, their combination (0.50% sodium tetra borate + 0.10% sodium silicate added with respect to the weight of the binder) provides complete protection to reinforcements tested for long durations under wet/dry treatments with mortars in saline water and laboratory atmospheres. Electrochemical impedance spectroscopy, direct current cyclic polarization, polarization resistance, and visual observations are used for quantitative and qualitative evaluations of the protective effects of the tested additives. X-ray diffraction analysis, scanning electron microscopy, and energy-dispersive X-ray spectroscopy analysis of the corrosion products formed on the embedded steel surfaces help explain the possible mechanisms behind the considerable improvement in the inhibitive effects of a mixed composition of borate and silicate. This combination also improves the compressive strength and workability of the mixed concrete. The results reveal that the synergistic protection provided by a mixture of borate and silicate can be attributed to the co-deposition of an iron-boron + ferrosilicate + cortensitite (an iron-silicon phase) film on the rebar surface.

The societal economic impact of vision impairment in adults 40 years and above: findings from the National Eye Survey of Trinidad and Tobago.

BACKGROUND: Understanding and mitigating the societal economic impact of vision impairment (VI) is important for achieving the Sustainable Development Goals. AIM: To estimate the prevalent societal economic impact of presenting VI in Trinidad and Tobago using bottom-up cost and utilisation data from the 2014 National Eye Survey of Trinidad and Tobago. METHODS: We took a societal perspective to combine comprehensive, individual-level cost and utilisation data, with population-based prevalence estimates for VI, and additional data from a contemporaneous national eyecare system survey. We included direct (medical and non-medical) and indirect (productivity loss) costs, and intangible losses in total cost estimates, presented in 2014 Trinidad & Tobago (TT) dollars and UK sterling equivalent. We considered but excluded transfer payments and dead weight losses. Sensitivity analyses explored impact on total cost of parameter uncertainty and assumptions. RESULTS: Individual utilisation and cost data were available for 65.5% (n = 2792/4263) and 59.0% (n = 2516/4263) eligible participants aged ≥40 years, respectively. Participant mean age was 58.4(SD 11.8, range 40-103) years, 56.3% were female. We estimated total societal cost of VI in 2014 at UK£365,650,241 (TT$3,842,324,655), equivalent to £675 per capita (population ≥40 years). Loss of wellbeing accounted for 73.3%. Excluding this, the economic cost was UK£97,547,222 (TT$1,025,045,399), of which indirect costs accounted for 70.5%, followed by direct medical costs (17.9%), and direct non-medical costs (11.6%). CONCLUSION: This study provides a comprehensive estimate of the economic impact of vision loss in a Caribbean country, and highlights the extent to which affected individuals and their families bear the societal economic cost of vision impairment.

Rete middle cerebral artery presenting with a ruptured aneurysm.

The developmental anomaly of the middle cerebral artery (MCA) is a rare occurrence. Rete MCA, also known as "unfused," "twig-like," and aplastic MCA, is an even rarer anomaly. These immature rete vessels are prone to flow-related aneurysms which rupture themselves presenting with intraparenchymal hematoma. We here with present a case of rete MCA with a ruptured aneurysm and discuss its pathophysiology and management.

Enhancement of electro-optical response of photonic crystal fibers infiltrated with ferroelectric liquid crystal doped with titanium dioxide nanoparticles.

Light propagation has been studied in photonic crystal fibers (PCFs) doped with W212 ferroelectric liquid crystal (FLC) composites with titanium dioxide nanoparticles (TiO2 NPs) of low concentrations between 0.2 and 1 wt. % in the FLC matrix. Optical microscopy observations indicated a slight increase of transition temperature to the isotropic phase by ∼1-2°C compared to the undoped FLC sample, and the TiO2 admixture was found to decrease free ionic charge impurities in the FLC, thus improving its electro-optical parameters. The switching time measurements in the PLCFs clearly indicate that TiO2 NPs reduce switching times for low electric field intensity, even by 32% compared to the undoped PLCF.

Rapid and reliable assaying of Tc-99 in sediment samples with novel MTPN polymeric resin.

The paper describes a new method for the rapid determination of Technetium (Tc) in sediment samples using solid-phase extraction chromatography (SPEC) with a novel methyl triphenyl phosphoniumnitrate (MTPN) resin. The effectiveness of the resin in selectively recovering Tc was evaluated in both batch and column mode and exploited for rapid analysis of 'Tc'. The procedure involves the acid digestion of samples, pre-concentration of fission products in supernatant and co-precipitation of actinides with Fe(OH)3, followed by selective recovery of Tc by SPEC using a column filled with MTPN resin. The recovered Tc was then radiometrically assayed using beta counting. The method was validated using IAEA certified reference materials and was found to provide reliable and reproducible results for the activity concentration of Tc-99 in sediment samples within 24 h.

Persistent dynamic magnetic state in artificial honeycomb spin ice.

Topological magnetic charges, arising due to the non-vanishing magnetic flux on spin ice vertices, serve as the origin of magnetic monopoles that traverse the underlying lattice effortlessly. Unlike spin ice materials of atomic origin, the dynamic state in artificial honeycomb spin ice is conventionally described in terms of finite size domain wall kinetics that require magnetic field or current application. Contrary to this common understanding, here we show that a thermally tunable artificial permalloy honeycomb lattice exhibits a perpetual dynamic state due to self-propelled magnetic charge defect relaxation in the absence of any external tuning agent. Quantitative investigation of magnetic charge defect dynamics using neutron spin echo spectroscopy reveals sub-ns relaxation times that are comparable to the relaxation of monopoles in bulk spin ices. Most importantly, the kinetic process remains unabated at low temperature where thermal fluctuation is negligible. This suggests that dynamic phenomena in honeycomb spin ice are mediated by quasi-particle type entities, also confirmed by dynamic Monte-Carlo simulations that replicate the kinetic behavior. Our research unveils a macroscopic magnetic particle that shares many known traits of quantum particles, namely magnetic monopole and magnon.

Advanced machine learning-based kharif maize evapotranspiration estimation in semi-arid climate.

Accurate Crop Evapotranspiration (ETc) estimation is crucial for understanding hydrological and agrometeorological processes, yet it's challenged by multiple parameters, data variations, and lack of continuity. These limitations restrict numerical methods application. To address this, the study aims to develop and assess ML models for daily maize ETc in semi-arid areas, utilizing varied weather inputs. Five ML models viz., Category Boosting (CB), Linear Regression (LR), Support Vector Machine (SVM), Artificial Neural Network (ANN), and Stochastic Gradient Descent (SGD) were developed and validated for the ICAR-IARI, New Delhi, Research Station. Penman-Monteith (PM) model estimated ETc values are used as the standard for comparing the performance of the ML model values. Results revealed that the SVM model achieved the highest coefficient of determination (R2) among all models, with a value of 0.987. Furthermore, the SVM model exhibited the lowest model errors (MAE = 0.121 mm day-1, RMSE = 0.172 mm day-1, and MAPE = 4.37%) compared to other models. The ANN model also demonstrated promising results, comparable to the SVM model. Notably, the wind speed parameter was found most influential input parameter. In conclusion, SVM or ANN could be considered reliable alternative methods for the accurate estimation of kharif maize crop ETc in the semi-arid climate.

Prevalence and Outcomes of Depression, Obstructive Sleep Apnea, and Concurrent Anxiety (DOCA) in Stroke Survivors: Insights From a Nationwide Study.

BACKGROUND: Many individuals will also experience psychological side effects after a stroke episode, such as symptoms of depression, anxiety (generalized anxiety disorder (GAD)), and/or specific phobias, considerably decreasing their quality of life (QOL). OBJECTIVE: This study aimed to evaluate the prevalence of depression, obstructive sleep apnea (OSA), and concurrent anxiety (DOCA) and their outcomes (morbidity, disability (All Patient Refined Diagnosis Related Group (APRDRG) - loss of function), and discharge disposition) among acute ischemic stroke (AIS) hospitalizations. METHODS: A cross-sectional study used the National Inpatient Sample (NIS) from 2003-2017. Adults with hospitalizations with AIS were extracted, and DOCA was identified using ICD-9/10-CM codes. Weighted analysis using a chi-square test and mixed-effect multivariable survey logistic regression was used to assess the prevalence and role of DOCA in predicting outcomes. RESULTS: Out of 5,690,773 AIS hospitalizations, 2.7%, 3.1%, and 4.4% had depression, OSA, and GAD, respectively. In AIS patients, females had a higher prevalence of depression (3.4% vs. 2.3%) and GAD (5.9% vs. 3.0%) and a quality of life lower prevalence of OSA (2.2% vs 4.4%) in comparison to males (p<0.0001). Caucasians had a higher prevalence of depression, OSA, and GAD in comparison to others (African Americans/Hispanics/Asians/Native Americans). Depressed patients had a higher prevalence of morbidity (9% vs. 8% vs 5% vs. 7%), disability (46% vs. 46% vs. 35% vs. 37%), transfer to non-home (69% vs. 58% vs. 61% vs. 63%) in comparison with OSA, GAD, and non-DOCA patients, respectively (p<0.0001). Depression was associated with a 40% higher chance of severe disability (aOR 1.40; 95% CI 1.38-41), morbidity (1.36; 1.33-1.38), and discharge to non-home (1.54; 1.52-1.56). OSA and GAD had higher odds of non-home discharge amongst post-AIS hospitalizations. CONCLUSION: DOCA is associated with poor outcomes among post-AIS patients. Prompt recognition by screening and timely management of DOCA may mitigate the adverse outcomes.

Chemically induced ferromagnetism near room temperature in single crystal (Zn1-x Cr x )Te half-metal.

Magnetic semiconductors are at the core of recent spintronics research endeavors. Chemically doped II-VI diluted magnetic semiconductors, such as (Zn1-x Cr x )Te, provide a promising platform in this quest. However, a detailed knowledge of the microscopic nature of magnetic ground state is necessary for any practical application. Here, we report on the synergistic study of (Zn1-x Cr x )Te single crystals using elastic neutron scattering measurements and density functional calculations. For the first time, our research unveils the intrinsic properties of ferromagnetic state in a macroscopic specimen of (Zn0.8Cr0.2)Te. The ferromagnetism is onset at T C ∼ 290 K and remains somewhat independent to modest change in the substitution coefficient x. We show that magnetic moments on Zn/Cr sites develop ferromagnetic correlation in the a-c plane with a large ordered moment of µ = 3.08 µ B. Magnetic moment across the lattice is induced via the mediation of Te sites, uncoupled to the number of dopant carriers as inferred from the density functional calculation. Additionally, the ab initio calculations also reveal half-metallicity in x = 0.2 composition. These properties are highly desirable for future spintronic applications.

Identification of suitable zones and sites for rainwater harvesting using GIS and multicriteria decision analysis.

Identifying suitable zones for surface water storage and groundwater recharge is needed to enhance irrigation water availability. This study was undertaken to map rainwater harvesting (RWH) potential zones using geospatial tools and analytic hierarchy process (AHP). The suitable locations for RWH were also mapped using the Boolean logic concept. The surface runoff is a vital factor to demarcate the appropriate zones for RWH. The curve number approach was used to estimate the surface runoff potential. The runoff coefficient (RC) map was generated based on rainfall and surface runoff depth. Weights have been allocated to selected themes of RC, drainage density, and slope. The themes were integrated using geographic information system (GIS) and AHP to demarcate the suitable zones for RWH. The derived RWH potential map was categorized into zones like "very good," "good," "moderate," "poor," and "very poor" with an aerial extent of 14.3%, 24.7%, 28.3%, 20.2%, and 12.6%, respectively. The area suitable for farm ponds was found to be about 9% (408 km2), 13% (329 km2), and 4% (244 km2) in Mirzapur, Chandauli, and Sonbhadra districts, respectively. Furthermore, 22, 15, and 21 locations were found suitable for check dams in Mirzapur, Chandauli, and Sonbhadra districts, respectively. At a large scale, effective planning of water management strategies based on multicriteria decision analysis and GIS offers increased availability of surface and groundwater resources and may help for enhancing the agricultural land use options. The higher resolution maps may be further utilized to plan RWH strategies at village level.

Of Eagle's Syndrome and Finding Some Clarity on Its Management.

Eagle's Syndrome is a much discussed yet controversial and debatable diagnosis of exclusion which is treated by many specialities with often unsatisfactory results. Due to entrapment/impingement on surrounding neurovascular structures by elongated styloid process patient may present with multitude of symptoms. Treatment is controversial and opinions are divided on choice of conservative and surgical management. Aim was to study outcomes of conservative and surgical modalities of treatment of Eagle's Syndrome and bring some clarity on management, what to offer, to whom and when. This prospective observational descriptive study included 15 patients of Eagle's Syndrome, 7 were treated with conservative method and 8 underwent resection of styloid process with intraoral approach. With objectives in mind to study efficacy of both management modalities, pain visual analogue scale (VAS) scores were recorded pre-intervention, post-intervention and during follow up on 1, 3 and 6 months and compared. Conservative management resulted in up to 70% reduction in pain VAS scores till 3 months of therapy (mean pre-intervention score being 3.71, 3 months-1, 6 months-1.29), while surgical modality resulted in nearly 99% reduction in mean pain VAS scores up to 3 months and even improved after 6 months (mean pre-intervention score being 6.75, 3 months-0.5, 6 months-0.13). With this we can conclude that conservative management provide satisfactory short-term (up to 3 months) results but recurrences are known, while surgical resection of elongated styloid process gives better long-term results (6 months and beyond).

Knowledge and Awareness about Systemic Effects of Periodontal Disease among Medical, Dental and Alternate Medical Practitioners and Their Referral Practice to Periodontists.

In the past few decades, many medical professionals and dentists have paid close notice to their own fields, specializing in medicine pertaining to body and oral cavity respectively. Currently, this void is rapidly closing between all medical specialties, in presence of significant findings that supports association between periodontal disease and systemic conditions. Till now, some practitioners are not aware about the specialties of dentistry that results in improper referral practices. There are few studies on referral practice pertaining to periodontist, not with standing the fact that clear and effective communication between all health practitioners is essential for good practice. A cross-sectional study was carried out to assess the knowledge and awareness about systemic effects of periodontal disease among medical, dental and alternate medical practitioners and their referral practice to periodontist in Kanpur city. This cross-sectional study was carried out using self-reported questionnaire, distributed to 560 practitioners of various medical fields from January 2020 to August 2021. A total of 206(36.8%) Medical, 194(34.6%) Dentists and 160(28.6%) alternative practitioners participated in study. More than half participants agreed about relationship between periodontal diseases and Diabetes Mellitus, Cardio-VascularDisease and Adverse Pregnancy Outcomes. Among all 31.3% showed good knowledge level while 2.7% showed perfect level of practitioner's referral practice to periodontist. Dentists had statistically higher level of awareness compared to physicians. Referral practice to periodontist was deficit by medical and alternate medical practitioners despite of fact; they have good knowledge of relationship between periodontal disease and systemic health. Hence, interdisciplinary dental and medical training of practitioners is recommended.

Identifications of good and bad structural fragments of hydrazone/2,5-disubstituted-1,3,4-oxadiazole hybrids with correlation intensity index and consensus modelling using Monte Carlo based QSAR studies, their molecular docking and ADME analysis.

The application of QSAR along with other in silico tools like molecular docking, and molecular dynamics provide a lot of promise for finding new treatments for life-threatening diseases like Type 2 diabetes mellitus (T2DM). The present study is an attempt to develop Monte Carlo algorithm-based QSAR models using freely available CORAL software. The experimental data on the α-amylase inhibition by a series of benzothiazole-linked hydrazone/2,5-disubstituted-1,3,4-oxadiazole hybrids were selected as endpoint for the model generation. Initially, a total of eight QSAR models were built using correlation intensity index (CII) as a criterion of predictive potential. The model developed from split 6 using CII was the most reliable because of the highest numerical value of the determination coefficient of the validation set (r2VAL = 0.8739). The important structural fragments responsible for altering the endpoint were also extracted from the best-built model. With the goal of improved prediction quality and lower prediction errors, the validated models were used to build consensus models. Molecular docking was used to know the binding mode and pose of the selected derivatives. Further, to get insight into their metabolism by living beings, ADME studies were investigated using internet freeware, SwissADME.

Hypothyroxinemia in sick term neonates and its risk factors in an extramural neonatal intensive care unit: a prospective cohort study

ABSTRACT Objective: Thyroid functions in the sick newborns may be altered in the first week of life. Transient hypothyroxinemia has been reported in these babies, which could be due to the immaturity of the hypothalamic-pituitary-thyroid axis or to acute illness. We conducted this study to estimate the incidence of hypothyroxinemia and determine its risk factors in sick term newborns. Materials and methods: We analyzed free T4 (FT4) and thyroid-stimulating hormone (TSH) levels in sick term neonates (≤7 days of life) admitted to the neonatal intensive care unit. FT4 and TSH levels were estimated in the first week of life in all the enrolled neonates (N = 98) and then repeated at 14-21 days of life in 46 babies. Risk analysis was conducted using univariate and multivariate logistic regression, and numerical data was compared using the Mann-Whitney U test and t-test. Results: Hypothyroxinemia was seen in 10 (10.2%) of the admitted term babies. Male gender, vaginal delivery, presence of hypoxic ischemic encephalopathy, and need for mechanical ventilation (>24 hours) were identified as risk factors. There was a significant negative linear correlation between FT4 level in the first week of life and duration of hospital stay. Conclusion: Hypothyroxinemia is common in sick term neonates.