Postoperative Seizure Control in Adult Diffuse Insular Gliomas Presenting with Seizures: A Retrospective Single-Center Experience and Proposal of a Novel Risk Scoring System.

Background: Studies on insular gliomas (IGs) generally focus on the oncological endpoints with a relative scarcity of literature focusing on the seizure outcomes. Objectives: To study the predictors of long-term postoperative seizure control in IG and propose a novel risk scoring system. Methods: Histopathologically proven, newly diagnosed adult IGs (>18 years) operated over a 10-year period were studied for postoperative seizure control as per International League Against Epilepsy (ILAE) grades at 6 weeks and at last follow-up (minimum of 6 months, median 27 months). Logistic regression analysis was performed and regression coefficients with nearest integers were used to build a risk prediction model. Receiver operator curve (ROC) analysis determined the predictive accuracy of this model. Results: The 6-week postoperative seizure freedom dropped to 41% at the last follow-up. The seizure-free group lived longer (100.69 months, 95% CI = 84.3-116.99 (60%)) than those with persistent postoperative seizures (27.92 months, 95% CI = 14.99-40.86). Statistically significant predictors (preoperative seizure control status, extent of resection, tumor extension to temporal lobe, and lack of postoperative adjuvant therapy) were used to compute a risk score, the score ranging from 0 to 9. A score of four most optimally distinguished the risk of postoperative seizures with an area under the ROC of 91.4% (95% CI: 84.1%, 98.7%, P < 0.001). Conclusion: In our experience, around 60% of patients obtained seizure freedom after surgery, which reduces over time. Control of seizures paralleled survival outcomes. Our proposed scoring system may help tailor management strategies for these patients.

Benthic foraminifera as an environmental proxy for pollutants along the coast of Chennai, India.

Benthic foraminifera are increasingly used as an indicator of environmental disturbance. Their sensitivities to pollutants can be reflected by changes in assemblage, which can provide useful information about ecosystem health. This study aimed to investigate the impact of organic and inorganic pollutants on the benthic ecology of the Chennai coast, with a focus on the 2017 oil spill caused by the collision of two ships. Sediment samples collected from five distinct zones along the coast were analysed for pollutants such as polycyclic aromatic hydrocarbons (PAHs), total petroleum hydrocarbons (TPH), heavy metals (Cr, Cd, Pb) and total organic carbon (TOC). The maximum concentrations of Cr (137 µg/g), Cd (6.93 µg/g) and Pb (34.2 µg/g), as well as TPH (84.3 µg/g) and PAHs (227 ng/g), were observed. A total of 47 species of foraminifera were identified in this study, of which 12 were morphologically abnormal. In the low-impact zone, the species diversity index (H') was higher. TPH and PAH concentrations were positively associated with abnormal species. Pollution-resistant foraminifera species include Ammonia tepida, Elphidium discoidale, and Quinqueloculina lamarckiana, while opportunistic foraminifera include Pararotalia curryi, Nonionella stella, Rosalina globularis, and Spirillina vivipara. PAHs and heavy metals were adversely correlated with foraminiferal abundance, while TPH was positively correlated. To assess the response of the benthic ecosystem to hydrocarbon pollution, indices such as the Foraminiferal Index of Environmental Impact (FIEI), Exponential (H'bc) index and the Foraminiferal Abnormality Index (FAI) were used as environmental health proxies. FIEI, exp(H'bc) and FAI values show the impact of hydrocarbon pollution to an extent along the northern Chennai coast.

Microplastic pollution in fragile coastal ecosystems with special reference to the X-Press Pearl maritime disaster, southeast coast of India.

Microplastics (MPs) are a global environmental concern and pose a serious threat to marine ecosystems. This study aimed to determine the abundance and distribution of MPs in beach sediments (12 beaches), marine biota (6 beaches) and the influence of microbes on MPs degradation in eco-sensitive Palk Bay and Gulf of Mannar coast. The mean MP abundance 65.4 ± 39.8 particles/m2 in beach sediments; 0.19 ± 1.3 particles/individual fish and 0.22 ± 0.11 particles g-1 wet weight in barnacles. Polyethylene fragments (33.4%) and fibres (48%) were the most abundant MPs identified in sediments and finfish, respectively. Histopathological examination of fish has revealed health consequences such as respiratory system damage, epithelial degradation and enterocyte vacuolization. In addition, eight bacterial and seventeen fungal strains were isolated from the beached MPs. The results also indicated weathering of MPs due to microbial interactions. Model simulations helped in tracking the fate and transboundary landfall of spilled MPs across the Indian Ocean coastline after the X-Press Pearl disaster. Due to regional circulations induced by the monsoonal wind fields, a potential dispersal of pellets has occurred along the coast of Sri Lanka, but no landfall and ecological damage are predicted along the coast of India.

Management of a spontaneously conceived live unilateral twin ectopic pregnancy in Australia: A case report.

INTRODUCTION: Unilateral twin ectopic pregnancies are exceedingly rare, occurring in one in every 250,000 pregnancies. While clear guidelines exist regarding the management of singleton ectopic pregnancies, no such recommendations exist for multi-gestational ectopic pregnancies. CASE PRESENTATION: A 36-year-old woman, gravida 3 para 1, presented to the emergency department at 6 weeks and 4 days of gestation with a live twin ectopic pregnancy diagnosed on a dating ultrasound scan. Given the high likelihood of rupture, she underwent a laparoscopic salpingectomy and was discharged home the following day. The patient was followed-up with weekly serum ß-hCG tests, to ensure there was no remaining pregnancy. DISCUSSION: While the morbidity and mortality associated with singleton ectopic pregnancies has gradually declined, the risk of rupture is higher in twin ectopic pregnancies and rupture is estimated to occur in 30-50% of cases. Surgical intervention remains the mainstay of treatment for these pregnancies.

Microplastic contamination in salt pans and commercial salts - A baseline study on the salt pans of Marakkanam and Parangipettai, Tamil Nadu, India.

We studied the abundance of microplastics from commercial table salts and table salts from salt pans at Marakkanam and Parangipettai, Tamil Nadu, India. Microplastic abundance in the salts collected from salt pans had a range of 3.67 ± 1.54 to 21.33 ± 1.53 nos./10 g of salt which were higher than the microplastics retrieved from the commercial salts which ranged from 4.67 ± 1.15 to 16.33 ± 1.53 nos./10 g of salt. All the microplastics retrieved were fibers which were secondary in origin. Black, red, blue, green, white, brown, and colorless microplastics were observed in the samples. FT-IR results showed that 4 types of polymers, namely, Nylon, Polypropylene (PP), Low Density Polyethylene (LDPE), and Polyethylene Terephthalate (PET) were present in the samples. Domestic and municipal wastewater discharges into the estuaries may contribute to microplastics in the table salts. Our study proves that table salts (processed and unprocessed) are prone to microplastic contamination.

Assessment of malocclusion severity and orthodontic treatment needs in 12-15-year-old school children of Namakkal District, Tamil Nadu, using Dental Aesthetic Index.

OBJECTIVES: The present study was aimed to assess the severity of malocclusion and orthodontic treatment needs among 12-15-year-old schoolchildren in rural area of Namakkal district, Tamil Nadu, India, using the Dental Aesthetic Index (DAI). MATERIALS AND METHODS: A cross-sectional study was conducted among a sample of 1078 schoolchildren (12-15 years of age) who were selected by two-stage cluster sampling technique. Severity of malocclusion and orthodontic treatment needs were assessed according to the DAI using a specially designed survey pro forma with the aid of the WHO's Oral Health Survey: Basic Methods. Based on the distribution of data, analysis of variance and unpaired student t-test were used. RESULTS: Out of the total of 1078 children examined, 528 (49%) were males and 550 (57%) were females. The results indicate that 82.74% of the schoolchildren were found with little or no malocclusion requiring no orthodontic treatment. The gender-wise distribution of DAI score among children aged 12 years had significant difference between males (20.43 ± 3.67) and females (21.62 ± 4.335) (P = 0.015) and children aged 15 years also showed highly significant difference among gender (P = 0.000). CONCLUSION: Malocclusion not only impacts the appearance of the person but also affects the self-esteem and psychological well-being. This is the first step in understanding the treatment need so that further steps can be taken in preventive and interceptive care.

A comparative evaluation of mandibular incisor decrowding with coaxial and optiflex arch wires and their load-deflection rates.

AIM: The aim of this study is to determine and compare the load-deflection rate of optiflex arch wire with that of coaxial arch wire and to determine and compare the decrowding efficiency of optiflex arch wire with coaxial arch wire within a period of 45 days. MATERIALS AND METHODS: Load-deflection rates of optiflex and coaxial wires were found using the INSTRON (4300) machine. A steady load was given to the wire to make it deflect, and the load required to deflect the wire for every 1 mm up to 5 mm, were noted and tabulated. A total of 10 patients, 10-25 years of age (seven males and three females) were selected. All patients had angles Class I malocclusion with a crowding discrepancy of 3-9 mm (according to little's index). All patients required first premolar extraction. Pre (0 day) and post (45(th) day) treatment study models and lateral cephalograms were taken for all patients and evaluated. RESULTS: Optiflex had a low load-deflection when compared to coaxial wire. Clinically, optiflex and coaxial wire had similar decrowding efficiency. In both, study model and cephalometric analysis, there was no statistically significant value when comparing their mean variables. CONCLUSION: Optiflex is an appropriate wire for patients seeking esthetics during fixed appliance therapy as it combines esthetics and efficiency by delivering light continuous forces.

Interdisciplinary approach for improved esthetic results.

This clinical report describes an interdisciplinary (orthodontic, prosthodontics and operative dentist) approach for the coordinated treatment of an adult patient diagnosed with severely mutilated dentition secondary to caries lesion warranting restorative procedures that was facilitated with orthodontic treatment. The patient's specific esthetic expectation for the anterior teeth and improved smile were successfully met through planned treatment, including orthodontic tooth movement, restoration and porcelain conversion crowns. Such coordinated interdisciplinary evaluations and treatment are necessary for improved esthetics.