Syndrome of Inappropriate Antidiuretic Hormone Secretion (SIADH) Complicated by Generalized Tonic-Clonic Seizures After a Course of Antibiotics: A Case Report.

Nitrofurantoin and cephalexin are commonly used antibiotics for treating urinary tract infections. Hyponatremia secondary to syndrome of inappropriate antidiuretic hormone secretion (SIADH) has been reported as a rare side effect of nitrofurantoin but has never been a reported side effect of cephalexin. We report a case of a 48-year-old female who developed severe hyponatremia complicated by generalized tonic-clonic seizures after a course of antibiotics (nitrofurantoin followed by cephalexin) used for treating a urinary tract infection. She presented to the emergency department with a one-week history of dizziness, nausea, fatigue, and listlessness. She also had a two-week history of persistent urinary frequency despite completing a course of nitrofurantoin followed by a course of cephalexin. While in the emergency department waiting room, she had two episodes of generalized tonic-clonic seizures. Immediate post-ictal blood test results revealed severe hyponatremia and lactic acidosis. Results were consistent with severe SIADH and she was subsequently managed with hypertonic saline and fluid restriction. She was discharged after 48 hours of admission when her serum sodium levels normalized. Though we believe that nitrofurantoin was the culprit drug, we still asked the patient to avoid future use of both nitrofurantoin and cephalexin. Healthcare providers need to be aware of antibiotic-induced SIADH when assessing patients with hyponatremia.

Recurrent Gestational Thrombocytopenia Affecting Four Consecutive Pregnancies: A Case Report.

Gestational thrombocytopenia is the commonest cause of thrombocytopenia in pregnancy, accounting for 70-80% of cases. It is a benign condition that recovers completely in the postpartum period. Although the cause is not fully understood, it is thought that pregnancy-related hemodilution and increased platelet consumption play a significant contributory role. Several life-threatening causes of thrombocytopenia in pregnancy make up the remaining 20-30% of cases. There are reports of recurrence of GT in women, but not many case reports document more than three consecutive episodes. We present a case of a young woman who had gestational thrombocytopenia during the third trimester of her four consecutive pregnancies, followed by complete recovery after each pregnancy. We ruled out other sinister and life-threatening causes of thrombocytopenia in pregnancy. During her four consecutive pregnancies, her platelet count fell below normal at the beginning of the third trimester, with a nadir towards the end. The other hematological indices, generally used as markers of hemodilution, remained in the normal pregnancy-specific reference range during each of her four pregnancies. This case argues against pregnancy-related hemodilution being a major factor in gestational thrombocytopenia. A systematic approach is paramount when differentiating the several causes of thrombocytopenia in pregnancy.

Separation of closely related monoclonal antibody charge variant impurities using poly(ethylenimine)-grafted cation-exchange chromatography resin.

The removal of protein charge variants due to complex chemical and enzymatic modifications like glycosylation, fragmentation and deamidation presents a significant challenge in the purification of monoclonal antibodies (mAb) and complicates downstream processing. These protein modifications occur either in vivo or during fermentation and downstream processing. The presence of charge variants can lead to diminished biological activity, differences in pharmacokinetics, pharmacodynamics, stability and efficacy. Therefore, these different product variants should be appropriately controlled for the consistency of product quality and to ensure patient safety. This investigation focuses on the development of a chromatography step for the removal of the charge variants from a recombinant single-chain variable antibody fragment (scFv-Fc-Ab). Poly(ethyleneimine)-grafted cation-exchange resins (Poly CSX and Poly ABX) were evaluated and compared to traditional macroporous cation-exchange and tentacle cation-exchange resins. Linear salt gradient experiments were conducted to study the separation efficiency of scFv-Fc-Ab variants using different resins. A classical thermodynamic model was used to develop a mechanistic understanding of the differences in charge variant retention behaviour of different resins. High selectivity in separation of scFv-Fc-Ab charge variants is obtained in the Poly CSX resin.

A Rare Case of Severe Hemolytic Anemia and Pulmonary Embolism Secondary to Mycoplasma pneumoniae Infection.

A 27-year-old woman was admitted with a history of dry cough, breathlessness, fever, lethargy, and nausea and vomiting. On examination, she was febrile, jaundiced, and hypoxic. Blood tests revealed severe leucocytosis and severe hemolytic anemia. The chest imaging demonstrated coexisting pneumonia and pulmonary embolism. An initial blood transfusion worsened the hemolytic anemia to the point that critical care review was required. Subsequent blood tests revealed cold agglutinin hemolytic anemia due to Mycoplasma pneumoniae infection. The patient's condition improved after receiving a warm-blood transfusion, antibiotics, and steroid therapy. The patient also received anticoagulant therapy for 6 months. Our case is unique in that the patient had very severe anemia and very severe leucocytosis, making us suspect a hematologic malignancy at initial presentation. This case emphasizes the importance of prompt evaluation of hemolytic anemia and the use of warm blood transfusion for cold agglutinin disease.

Cone-Beam Computed Tomography Assessment of Canal-Centering Ability for Traditionally Used Nickel Titanium and Nickel Titanium Files with Reciprocating Hand Piece and Wave-One Files.

AIM OF THE STUDY: Need for our study was to evaluate a comparison between canal preparation ability of nickel-titanium (NiTi) hand files with step-back manual technique, of NiTi files installed on a reciprocating hand piece and of Wave-One files utilizing noninvasive cone-beam computed tomography (CBCT) technique. MATERIALS AND METHODS: Thirty extracted intact single-rooted human mandibular premolars were used in the study, segregated in three sets of 10 specimens each, where canal instrumentation was done by different methods using NiTi in step-back technique, using reciprocating hand piece with NiTi files and using primary file with the use of Wave-One reciprocating system. Later, evaluation of centering ability was conducted using the references through CBCT images. RESULTS: Hand NiTi files showed even less canal centering ability as compared to other two sets. Mesiodistal diameter at 9 mm length of the prepared canal was 1.06 and later was 0.98, which shows excessive preparation in case of Set I versus Set II. In case of comparison between Set III and Set I, mesiodistal diameter at 9 mm length of the prepared canal was 0.99, and later was 1.06, depicting better canal shaping ability with Wave-One file. CONCLUSION: The use of hand NiTi files installed on a reciprocating hand piece would be economically beneficial producing the similar results as that of wave one without any deviation from the original canal anatomy.

Active and Recyclable Gold Metal Nanoparticles Catalyst Supported on Nitrogen-Doped Mesoporous Carbon for Chemoselective Hydrogenation of Cinnamaldehyde to Cinnamyl Alcohol.

Several supported gold metal catalysts with different Au nanoparticles sizes were prepared and evaluated for the chemoselective hydrogenation of cinnamaldehyde (CA) to cinnamyl alcohol (CAL). To investigate the structure-activity relationship, stability of catalyst, heterogeneity and recyclability, the structural characteristics of materials and Au catalysts (fresh and spent catalysts) were studied by employing variety of physico-chemical techniques. The interrelationship among Au nanoparticles size (nm) with turnover frequency (h-1 ) of Au catalysts has also been explored. Among the various Au catalysts tested, nitrogen-doped mesoporous carbon (NMC) supported Au catalyst having homogeneously dispersed (78.8%) Au nanoparticles (1.6 nm) synthesized by sol-immobilization method (Au-NMC-SI) demonstrated improved catalytic activity affording 78% CAL selectivity and 94.2% CA conversion without using any promoter. Moreover, Au-NMC-SI catalyst exhibited good recyclability and stability. The catalyst synthesis approach described in this investigation opens up a novel strategy for the design of highly efficient metal nano-catalysts supported on NMC materials.

Biochemical transition during triphasic postpartum thyroiditis: confusion with central hypothyroidism.

SUMMARY: Hypothyroidism occurring in the postpartum period can be due to pituitary or hypothalamic disease as in Sheehan's syndrome and postpartum autoimmune hypophysitis or due to a primary thyroid disease as in postpartum thyroiditis. It is important that the correct diagnosis is ascertained because hypothalamic or pituitary disorders are often associated with other pituitary hormone deficiencies, especially life-threatening adrenal insufficiency or adrenal crisis. A combination of various symptoms and biochemical markers, especially serum thyroid-stimulating hormone levels dictate the initial diagnostic pathway. We present a case of a woman who presented with a 2-month history of tiredness and neck discomfort following delivery. A thyroid function test demonstrated results, which we initially interpreted as central hypothyroidism. Follow-up results indicated that this was in fact the transition period between the thyrotoxic phase and hypothyroid phases of postpartum thyroiditis. This case highlights the potential for diagnostic confusion between central hypothyroidism and postpartum thyroiditis. LEARNING POINTS: Postpartum thyroiditis affects one in twenty mothers within 12 months of delivery. The majority of patients have transient thyrotoxicosis only, some have transient hypothyroidism only, and the rest has a triphasic pattern (thyrotoxic, hypothyroid then a euthyroid phase). During the transition from the thyrotoxic phase to hypothyroid phase, when serum TSH is still suppressed, the biochemical results can resemble that of central hypothyroidism. If central hypothyroidism is suspected, then urgent diagnostic investigations should be carried out along with the assessment of adrenal function. There is a potential for diagnostic confusion between postpartum central hypothyroidism and postpartum thyroiditis; however, the obstetric history, clinical symptoms, and signs (headaches, breastfeeding, goitre, etc.) and serum adrenocorticotropic levels should help with the differential diagnosis.

Technoeconomic Investigation of Amine-Grafted Zeolites and Their Kinetics for CO2 Capture.

Solid adsorbents with precise surface structural chemistry and porosity are of immense interest to decode the structure-property relationships and maintain an energy-intensive path while achieving high activity and durability. In this work, we reported a series of amine-modified zeolites and their CO2 capture efficiencies. The amine impregnated molecular zeolite compounds were characterized and systematically investigated for CO2 adsorption capacity through thermogravimetric analysis for the occurrence of atmospheric pure CO2 gas at 75 °C with diethylenetriamine (DETA), ethylenediamine (EDA), monoethanolamine (MEA), and triethanolamine (TEA)-loaded zeolite 13X, 4A, and 5A adsorbents. The kinetics of the adsorption study indicated that the adsorption capacity for CO2 adsorption was improved with amine loading up to a certain concentration over 13X-DETA-40, showing an adsorption capacity of 1.054 mmol of CO2 per gram of zeolite in a very short amount of time. The result was especially promising in terms of the initial adsorption capacity of zeolite, which adsorbed approximately 0.8 mmol/g zeolite within the first two minutes of experimentation. A detailed flow chart that includes a brief look into the process adopted for adsorption was included. Lagergren pseudo-first- and pseudo-second-order models of 40 wt % DETA zeolite 13X gave CO2 adsorption capacities of 1.055 and 1.058 mmol/g and also activation energies of 86 and 76 kJ/mol, respectively. The CO2 adsorption capacity of 13X-DETA-40 in a lab-scale reactor was found to be 1.69 mmol/g. A technoeconomic study was conducted for the solid amine zeolites to understand the investment per ton of CO2 adsorbed. This study was used as a basis to improve cost estimates from a microscale to a lab-scale reactor. The cost of investment for 13X-DETA-40 was reduced by 84% from $49,830/ton CO2 adsorbed in a microscale reactor to $7,690/ton of CO2 adsorbed in a lab-scale reactor.

Bilateral Testicular Epidermoid Cysts in a Man with Klinefelter Syndrome: A Case Report.

Klinefelter syndrome is a rare chromosomal disorder with at least one extra X chromosome in males resulting in male hypogonadism, androgen deficiency and impaired spermatogenesis. It is associated with an increased risk of certain malignancies; including leukemia, breast cancer, non-Hodgkin's lymphoma and mediastinal germ cell tumors, however, testicular tumors are rare in men with Klinefelter syndrome. Testicular epidermoid cysts are rare benign tumors affecting the testes. We report a case of bilateral testicular epidermoid cysts in a 30-year-old man known to have Klinefelter syndrome. He had an incidental finding of bilateral hard irregular-surfaced testes during routine assessment for testosterone replacement therapy. Biochemical investigation confirmed primary hypogonadism and ultrasound imaging demonstrated bilateral solid testicular masses with no blood flow seen within the lesions. The patient went on to have a right-sided radical orchiectomy with left-side sparing. The histology revealed features in keeping with that of a testicular epidermoid cyst with no evidence of malignancy. The patient was commenced on testosterone replacement therapy. This case emphasizes the importance of routine physical examination of the male external and internal genitalia when considering testosterone replacement therapy.

Normosmic idiopathic hypogonadotropic hypogonadism due to a novel GNRH1 variant in two siblings.

SUMMARY: Hypogonadotropic hypogonadism is characterised by insufficient secretion of pituitary gonadotropins resulting in delayed puberty, anovulation and azoospermia. When hypogonadotropic hypogonadism occurs in the absence of structural or functional lesions of the hypothalamic or pituitary gland, the hypogonadism is defined as idiopathic hypogonadotropic hypogonadism (IHH). This is a rare genetic disorder caused by a defect in the secretion of gonadotropin releasing hormone (GNRH) by the hypothalamus or a defect in the action of GNRH on the pituitary gland. Up to 50% of IHH cases have identifiable pathogenic variants in the currently known genes. Pathogenic variants in the GNRHR gene encoding the GNRH receptor are a relatively common cause of normosmic IHH, but reports of pathogenic variants in GNRH1 encoding GNRH are exceedingly rare. We present a case of two siblings born to consanguineous parents who were found to have normosmic idiopathic hypogonadotropic hypogonadism due to homozygosity of a novel loss-of function variant in GNRH1. Case 1 is a male who presented at the age of 17 years with delayed puberty and under-virilised genitalia. Case 2 is a female who presented at the age of 16 years with delayed puberty and primary amenorrhea. LEARNING POINTS: IHH is a genetically heterogeneous disorder which can be caused by pathogenic variants affecting proteins involved in the pulsatile gonadotropin-releasing hormone release, action, or both. Currently known genetic defects account for up to 50% of all IHH cases. GNRH1 pathogenic variants are a rare cause of normosmic IHH. IHH is associated with a wide spectrum of clinical manifestations. IHH can be challenging to diagnose, particularly when attempting to differentiate it from constitutional delay of puberty. Early diagnosis and gonadotrophin therapy can prevent negative physical sequelae and mitigate psychological distress with the restoration of puberty and fertility in affected individuals.

A rare coexistence of Behcet's disease and Graves' thyrotoxicosis in a young man: a case report.

Behcet's disease is a recurrent systemic vasculitic disorder. It manifests most commonly in the form of skin lesions, oral and genital ulcers and uveitis. Graves' thyrotoxicosis is an autoimmune disorder characterized by excessive production of thyroid hormones. We present a case of a 41-year-old male of Turkish descent who had symptoms of arthralgia, rash, palpitations and weight loss. Bloods tests showed raised inflammatory markers and biochemical evidence of severe autoimmune thyrotoxicosis. The patient was HLA-B51-negative, and pathergy test was inconclusive. A diagnosis of Behcet's disease was made on constellation of clinical symptoms. The patient was treated with carbimazole and prednisolone followed by azathioprine. The coexistence of Behcet's disease and Graves' disease in the same patient is very rare. Further studies are required to determine if there is a pathological association between these two conditions.

Leucine-rich glioma-inactivated protein 1 (LGI-1) mediated limbic encephalitis associated with syndrome of inappropriate antidiuretic hormone secretion: a case report.

Autoantibodies to leucine-rich glioma-inactivated protein 1 (LGI-1) are associated with inflammation of the limbic system. Faciobrachial dystonic seizures are pathognomonic for LGI1-antibiodies and their treatment with immunotherapy is effective in seizure control with a potential to prevent cognitive decline. We report a 57-year-old man who presented to the emergency department with recurrent seizures, visual hallucinations and severe memory impairment over a seven-week period; he reported a background of alcohol excess. Initial investigations revealed hyponatremia, indicating syndrome of inappropriate anti-diuretic hormone secretion. Magnetic resonance imaging of the brain revealed bilateral asymmetrical high-T2 and low-T1 signal in the medial temporal lobes. Serum immunofluorescence assay tested positive for LGI-1 antibody. Patient responded to treatment with levetiracetam, intravenous methylprednisolone and five plasma exchange sessions. Patient remains on a maintenance dose of prednisolone and azathioprine. It is imperative that clinicians recognize signs of autoimmune encephalitis in order to curb long-term sequelae and improve clinical outcomes.

A novel CASR variant in a family with familial hypocalciuric hypercalcaemia and primary hyperparathyroidism.

SUMMARY: Familial hypocalciuric hypercalcaemia (FHH) is a dominantly inherited, lifelong benign disorder characterised by asymptomatic hypercalcaemia, relative hypocalciuria and variable parathyroid hormone levels. It is caused by loss-of-function pathogenic variants in the calcium-sensing receptor (CASR) gene. Primary hyperparathyroidism (PHPT) is characterised by variable hypercalcaemia in the context of non-suppressed parathyroid hormone levels. Unlike patients with FHH, patients with severe hypercalcaemia due to PHPT are usually symptomatic and are at risk of end-organ damage affecting the kidneys, bone, heart, gastrointestinal system and CNS. Surgical resection of the offending parathyroid gland(s) is the treatment of choice for PHPT, while dietary adjustment and reassurance is the mainstay of management for patients with FHH. The occurrence of both FHH and primary hyperparathyroidism (PHPT) in the same patient has been described. We report an interesting case of FHH due to a novel CASR variant confirmed in a mother and her two daughters and the possible coexistence of FHH and PHPT in the mother, highlighting the challenges involved in diagnosis and management. LEARNING POINTS: Familial hypocalciuric hypercalcaemia (FHH) and primary hyperparathyroidism (PHPT) can coexist in the same patient. Urinary calcium creatinine clearance ratio can play a role in distinguishing between PHPT and FHH. Genetic testing should be considered in managing patients with PHPT and FHH where the benefit may extend to the wider family. Family segregation studies can play an important role in the reclassification of variants of uncertain significance. Parathyroidectomy has no benefit in patients with FHH and therefore, it is important to exclude FHH prior to considering surgery. For patients with coexisting FHH and PHPT, parathyroidectomy will reduce the risk of complications from the severe hypercalcaemia associated with PHPT.

Polyethylenimine-Modified Zeolite 13X for CO2 Capture: Adsorption and Kinetic Studies.

A class of high molecular weight polyethylenimine (PEI)-modified zeolite 13X adsorbents were synthesized by varying the concentration of imines and screened for preliminary investigation of CO2 capture studies. The impregnated molecular amine zeolite composite was characterized and CO2 adsorption performance was investigated through TGA in the presence of atmospheric pure CO2 gas at 25, 50, 75, and 100 °C, respectively, using 20-80 wt % of PEI-loaded zeolite 13X adsorbents. This paper reports on the effects of temperature and amine (PEI) loading on CO2 adsorption capacity and estimated kinetic parameters through modeling of selected models which represent the reaction rate and diffusion rate models. The studied adsorbents showed the highest adsorption capacity at 75 °C with 60 wt % PEI loading. Thus, the optimum temperature of 75 °C and optimal loading of 60 wt % was observed from the current studies for CO2 capture. From modeling study, it was found that Avrami's fractional order and dual kinetic models (DKM) described well the adsorption behavior of CO2 on PEI-impregnated zeolite 13X at all temperatures accurately and up to 75 °C, respectively. Besides, intraparticle diffusion was found to be the rate-limiting step when compared with the film diffusion model.

Selective removal of closely related clipped protein impurities using poly(ethylenimine)- grafted anion-exchange chromatography resin.

Proteolytic degradation is a serious problem that complicates downstream processing during production of recombinant therapeutic proteins. It can lead to decreased product yield, diminished biological activity, and suboptimal product quality. Proteolytic degradation or protein truncation is observed in various expression hosts and is mostly attributed to the activity of proteases released by host cells. Since these clipped proteins can impact pharmacokinetics and immunogenicity in addition to potency, they need to be appropriately controlled to ensure consistency of product quality and patient safety. A chromatography step for the selective removal of clipped proteins from an intact protein was developed in this study. Poly(ethylenimine)-grafted anion- exchange resins (PolyQUAT and PolyPEI) were evaluated and compared to traditional macroporous anion-exchange and tentacled anion-exchange resins. Isocratic retention experiments were conducted to determine the retention factors (k') and charge factors (Z) were determined through the classical stoichiometric displacement model. High selectivity in separation of closely related clipped proteins was obtained with the PolyQUAT resin. A robust design space was established for the PolyQUAT chromatography through Design-Of-Experiments (DoE) based process optimization. Results showed a product recovery of up to 63% with purity levels >99.0%. Approximately, one-log clearance of host cell protein and two-logs clearance of host cell DNA were also obtained. The newly developed PolyQUAT process was compared with an existing process and shown to be superior with respect to the number of process steps, process time, process yield, and product quality.

Difficult-to-treat Syndrome of Inappropriate Antidiuretic Hormone Secretion in a Patient with Secondary Central Nervous System Lymphoma.

The syndrome of inappropriate antidiuretic hormone secretion (SIADH) is defined as hyponatremia with inappropriately concentrated urine in a euvolemic patient. SIADH is associated with a wide spectrum of clinical conditions. In the hospital, hyponatremia carries significant mortality with a prolonged duration of inpatient stay. It is imperative that the underlying cause is appropriately investigated and such patients are closely monitored. This article presents a case of difficult-to-treat hyponatremia secondary to SIADH in a patient with a rare isolated central nervous system (CNS) relapse from a non-Hodgkin's lymphoma (NHL). A relapse, particularly affecting the CNS, carries a poor prognosis. The patient was started on dexamethasone and offered treatment with methotrexate but declined. The hyponatremia failed to respond to fluid restriction and demeclocycline. The hyponatremia responded to a single dose of tolvaptan. Clinicians should have a low index of suspicion for a relapse of lymphoma as a cause of difficult to treat hyponatremia in any patient who has previously had remission from lymphoma treatment.

An unexpected phase transformation of ceria nanoparticles in aqueous media.

Cerium oxide Nanoparticles (CNPs) are of significant interest to the scientific community due to their wide spread applications in a variety of fields. It is proposed that size dependent variations in the extent of Ce3+ and Ce4+ oxidation states of cerium in CNPs determines the performance of CNPs in application environments. To obtain greater molecular and structural understanding of chemical state transformations previously reported for ceria ≈ 3 nm nanoparticles (CNPs) in response to changing ambient conditions, microXRD and Raman measurements were carried out for various solution conditions. The particles were observed to undergo a reversible transformation from a defective ceria structure to a non-ceria amorphous oxy-hydroxide/peroxide phase in response to the addition of 30% hydrogen peroxide. For CNPs made up of ~8 nm crystallites, a partial transformation was observed and no transformation was observed for CNPs made up of ~ 40 nm crystallites. This observation of differences in size dependent transition behavior may help explain the benefits of using smaller CNPs in applications requiring regenerative behavior.

An algorithmic approach for clinical management of low back pain.

BACKGROUND: Low back pain is caused by a variety of conditions. When conventional imaging failed, single-photon emission computed tomography (SPECT) was superior to scintigraphy in identifying the pathology. Injection therapies are often helpful in treating the pathology. AIM: To determine the cause of chronic low backache in individuals with normal conventional imaging (radiographs, computed tomography and magnetic resonance imaging), to determine the specific pathology using scintigraphic studies and diagnostic blocks; and, to treat the individuals with various spinal injection techniques and determine their efficacy. MATERIAL AND METHODS: All the patients having chronic back pain on presentation in the outpatient clinic from April 2013 to October 2014 were prospectively evaluated. RESULTS: The 40 patients included in the study were followed up pre- and post operatively with various pain scales (visual analogue scale [VAS], Oswestry disability index [ODI] and short form health survery 36 [SF36]). The mean age at presentation was 41.3 years. Female patients formed the predominant subgroup in the study (57.5% female and 42.5% male patients). Pain indices like VAS and ODI were helpful in assessing the efficacy of spinal injections. Preoperative and postoperative pain scale assessment, supplemented by a SPECT evaluation of the sacroiliac and facet joints, showed a statistically significant difference, which correlated with clinically significant pain relief. CONCLUSIONS: SPECT imaging is helpful in diagnosing sacroiliac joint syndrome and facetal syndrome. Epidural injections were a better choice in cases of low backache, where clinically, the patient had no signs of sacroiliac joint syndrome and facetal syndrome. Spinal injections with steroid and local anaesthetic had better relief. Radiotracer uptake at the pain generating area is a good predictor of outcome. Image guided spinal injection improves the accuracy of the injection.

Patterning highly ordered arrays of complex nanofeatures through EUV directed polarity switching of non chemically amplified photoresist.

Given the importance of complex nanofeatures in the filed of micro-/nanoelectronics particularly in the area of high-density magnetic recording, photonic crystals, information storage, micro-lens arrays, tissue engineering and catalysis, the present work demonstrates the development of new methodology for patterning complex nanofeatures using a recently developed non-chemically amplified photoresist (n-CARs) poly(4-(methacryloyloxy)phenyl)dimethylsulfoniumtriflate) (polyMAPDST) with the help of extreme ultraviolet lithography (EUVL) as patterning tool. The photosensitivity of polyMAPDST is mainly due to the presence of radiation sensitive trifluoromethanesulfonate unit (triflate group) which undergoes photodegradation upon exposure with EUV photons, and thus brings in polarity change in the polymer structure. Integration of such radiation sensitive unit into polymer network avoids the need of chemical amplification which is otherwise needed for polarity switching in the case of chemically amplified photoresists (CARs). Indeed, we successfully patterned highly ordered wide-raging dense nanofeatures that include nanodots, nanowaves, nanoboats, star-elbow etc. All these developed nanopatterns have been well characterized by FESEM and AFM techniques. Finally, the potential of polyMAPDST has been established by successful transfer of patterns into silicon substrate through adaptation of compatible etch recipes.