A dual functional asymmetric plasmonic silver nanostructure for temperature and magnetic field sensing.

Many diverse technological applications, such as soft robotics and flexible electronics, demand the development of intelligent sensors that can simultaneously detect different physical parameters. Taking advantage of plasmonic structures, which can experience minute variations in physical parameters upon close contact, herein, a dual channel based silver nanostructure of concentric square rings and disks on an SiO2 substrate is proposed for the synchronized detection of magnetic field (H) and temperature (T). The thermometric polydimethylsiloxane (PDMS) and ferromagnetic Fe3O4 were placed in two channels of the nanostructure, forming the sensor. The structure modeling and electromagnetic study were carried out using the finite element method (FEM). The simultaneous detection of H and T was realized through the sensing matrix, which solved the problem of cross-sensitivity caused by a variation in temperature. Furthermore, the impact of structural asymmetry on the performance of the sensor was studied by tuning its geometrical parameters, such as disk length and ring length, separately and together. Asymmetry and the channel size significantly enhanced the performance, where disk optimization increased the temperature and magnetic field sensitivity by about 760 and 8319 times using 70% and 80% asymmetric systems, respectively. Also, the smallest ΔW (5 nm) provided a sufficiently high channel separation factor of about 7.47 µm during multi-parameter sensing. In addition, asymmetric sensing toward a single parameter was tested by placing PDMS/Fe3O4 on both channels. Multiple peaks were displayed with high sensitivity and CH-factor, making the detection more specific. Thus, the system possessing a combination of narrow channels and unique channel asymmetry exhibited excellent multi- and single-sensing for the detection of temperature and magnetic field.

Monoclonal Gammopathy of Renal Significance (MGRS) - Case Series from a Tertiary Center in Kerala.

Monoclonal gammopathy of renal significance (MGRS) has gained importance because identifying the monoclonal deposit and addressing it, rather than treating renal dysfunction as the primary pathology, has salvaged the patients from progressing into end-stage renal disease. Since it affects elderly population, there could be a propensity to misdiagnose them with cardiorenal syndrome. We present four patients of MGRS diagnosed from our center. They presented with proteinuria or unexplained renal dysfunction. Three of the patients were diagnosed to have amyloidosis, of which two had lambda-type and one had kappa amyloidosis. The fourth patient had fibrillary glomerulonephritis with kappa restriction, further evaluation of which led to diagnosis of chronic lymphocytic leukemia. Absence of "M" band in protein electrophoresis and a normal bone marrow study should not stop physicians from further evaluation. Quantitative serum immunofixation electrophoresis and electron microscopic examination of renal biopsy have become a comprehensive diagnostic tool in such patients.

Epidural extension of dorsal vertebral D1-D7 hemangiomas with congenital cutaneous hemangiomas: Case report and literature review.

BACKGROUND: There are only rare reports of simultaneous multiple thoracic vertebral, epidural, and congenital cutaneous hemangiomas occurring at the same levels. CASE DESCRIPTION: A 24-year-old male presented with a progressive paraparesis attributed to multiple vertebral hemangiomas (MVH) with epidural extension (i.e. resulting in D1-D3 significant cord compression.), plus congenital cutaneous lesions at the D2-D7 levels. Following preoperative angioembolisation, a D1-D7 laminectomy was performed along with a C7-D8 pedicle screw fixation. Pathologically the bone and cutaneous lesions were spinal cavernous hemangiomas. Postoperatively, the patient regained normal function. As complete excision was not feasible, he subsequently received radiotherapy to prevent tumor recurrence. CONCLUSION: MVH with multilevel epidural extension resulting in significant cord compression and congenital cutaneous lesions should undergo attempted tumor excision followed by radiation therapy where complete removal is not feasible.

Outcome of Philadelphia Positive Acute Lymphoblastic Leukemia With or Without Allogeneic Stem Cell Transplantation in a Retrospective Study.

Philadelphia positive ALL (Ph + ALL) is an aggressive leukemia associated with lower remission rates and poor survival. Current treatment approach for Ph + ALL is chemotherapy along with TKI and CNS directed therapy followed by Allogeneic stem cell transplantation (Allo-SCT). To analyze outcome of Ph + ALL with or without Allo-SCT in the era of universal TKI uses. Retrospectively reviewed medical records of 267 patients who were diagnosed and treated for ALL during study period at our centre. Fifty-one Ph + ALL patients (males = 31, females = 20) out of a total of 267 ALL patients were eligible for the study. Post induction 48 patients achieved complete remission while 1 died during induction. Forty-six patients received further treatment with TKI + CNS directed therapy and thereafter the consolidation therapy with Allo-SCT (n = 16) or chemotherapy + TKI (n = 30).Overall mortality was 7/51 (13.9%) (6/16 transplant related mortalities due to GVHD and infections and 1 induction death). Fifteen out of 46 patients (32.6%) had relapse (1/10 relapse after Allo-SCT vs. 14/24 after chemotherapy) on or after consolidation therapy. At a median follow-up of 17.5 months (2-58 months) of cohort, the median EFS was 22 months (95% CI 10.4-33.5 months). The estimated 4 year EFS and PFS in Allo-SCT versus chemotherapy only group was 36.0 ± 17.9 versus 27.3 ± 9.1% (p = 0.21) and 75 ± 21.7 versus 34.1 ± 10.9% (p = 0.02) respectively. Allo-SCT groups has a better progression free survival than chemotherapy group only. Preventing treatment related mortality can further improve outcome after Allo-SCT Ph + ALL.