Atrial myxoma presenting as a cerebellar stroke

Primary tumors of the heart are rare. However, among them cardiac myxoma is the most common tumor accounting for half of the primary cardiac neoplasms. About 75% of cardiac myxomas are located in the left atrium, and 25% are located in the right atrium. These are thought to be arising from remnants of subendocardial vasoformative reserve cells or multipotential primitive mesenchymal cells in the fossa ovalis and surrounding endocardium, which can differentiate along a variety of cell lineages including epithelial, hematopoietic, and muscle cells. Although some cases are discovered incidentally by echocardiographic examination, it was recognized in most of the patients by various symptoms caused by the release of inflammatory cytokines such as interleukin-6 (IL-6), obstruction of intracardiac blood flow, or embolization. Cardiac myxoma has many undetermined interesting issues regarding its origin, nature as a tumor, varying clinical manifestations, and the presence of both sporadic and familial types. Recent evidence revealed that cardiac myxomas are benign neoplasms and slowly proliferating lesions. The existence of its malignant counterpart is controversial. However, recurrence after surgical excision or metastasis has been reported. We hereby present a case report of a young gentleman who presented with history of sudden onset of weakness and cerebellar signs. Urgent CT scan revealed hypodensities of bilateral occipital lobes and cerebellum suggestive of infarcts. Urgent echocardiography denoted large left atrial myxoma. The tumor was excised and the patient recovered well

Midline or Retroperitoneal Approach in Operating on a Retroperitoneal Tumour: A Surgical Dilemma

Retroperitoneal tumors are rare form of tumors arising from the retroperitoneal space and account for 10-15% of soft tissue sarcoma.1,2 Liposarcoma represent 0.1% of all cancers 3 and arise mostly from the mesenchyme usually located in muscles, fat and connective tissue. 4 It is a high grade tumor with high propensity for recurrence.1 80% of patientspresent with asymptomatic abdominal distension in their 5th - 6th decade of life.4 Liposarcoma tend to present as a huge mass posing a diagnostic and therapeutic dilemma especially with regards to its position and surgical approach

A hybrid of ant colony optimization and flux variability analysis to improve the production of l-phenylalanine and biohydrogen

In silico metabolic engineering has shown many successful results in genome - scale model reconstruction and modification of metabolic network by implementing reaction deletion strategies to improve microbial strain such as production yield and growth rate. While improving the metabolites production, optimization algorithm has been implemented gradually in previous studies to identify the near - optimal sets of reaction knockout to obtain the best results. However, previous works implemented other algorithms that differ than this study which faced with several issues such as premature convergence and able to only produce low production yield because of ineffective algorithm and existence of complex metabolic data. The lack of effective genome models is because of the presence thousands of reactions in the metabolic network caused complex and high dimensional data size that contains competing pathway of non - desirable product. Indeed, the suitable population size and knockout number for this new algorithm have been tested previously. This study proposes an algorithm that is a hybrid of the ant colony optimization algorithm and flux variability analysis (ACOFVA) to predict near - optimal sets of reactions knockout in an effort to improve the growth rates and the production rate of L - phenylalanine and biohydrogen in Saccharomyces cerevisiae and cyanobacteria Synechocystis sp PCC6803 respectively

Critical retrospective analysis of various types of neurogenic lower urinary tract dysfunction (NLUTD) at HUSM (2006-2007)

To find the true incidence of various types of Bladder dysfunction (NLUTD) among neurological, neuro surgical lesions and post OBG status during 2006-2007 at HUSM

Intravesical electrical stimulation of the bladder – animal model study in HUSM

To study the effects of intravesical eletrical stimulation of rabbit’s bladder and to apply the principle in human hypocontractile bladder as a method of bladderbiofeedback training

Trancutaneous posterior tibial nerve stimulation (tptns): a promising method of management of neurogenic overactive bladder

To determine TPTNS is effective as less invasive form of neuromodulatory method either as a direct therapy for certain overactive bladder or as a preliminary evaluation for sacral root neuromodulation as a permanent method subsequently

Autonomic dysreflexia – neurovegetative syndrome

Autonomic dysreflexia is an exaggerated uninhibited sympathetic response to afferent stimulation following spinal cord injury above T6 level

Evaluation of gut modulatory and bronchodilator activities of Amaranthus spinosus Linn.

Background The aqueous-methanolic extract of Amaranthus spinosus (A. spinosus Linn.,) whole plant, was studied for its laxative, spasmolytic and bronchodilator activities to validate some of its medicinal uses. Methods The crude extract of A. spinosus was studied in-vivo for bronchodilator and laxative activities and in-vitro using isolated tissue preparations which were mounted in tissue baths assembly containing physiological salt solutions, maintained at 37°C and aerated with carbogen, to assess the spasmolytic effect and to find out the possible underlying mechanisms. Results In the in-vivo experiments in mice, the administration of A. spinosus increased fecal output at doses of 100 and 300 mg/kg showing laxative activity. It also inhibited carbachol-induced bronchospasm in anesthetized rats at 1, 3, 10 and 30 mg/kg indicative of bronchodilator activity. When tested on isolated gut preparations, the plant extract showed a concentration-dependent (0.01-10.0 mg/ml) spasmogenic effect in spontaneously contracting rabbit jejunum and guinea-pig ileum. The spasmogenic effect was partially blocked in tissues pretreated with atropine (0.1 μM). When tested on K+ (80 mM)-induced sustained contractions in isolated rabbit jejunum, the plant extract caused complete relaxation and also produced a shift in the Ca++ concentration-response curves (CRCs) towards right, similar to diltiazem. In rabbit trachea, the plant extract completely inhibited K+ (80 mM) and carbachol (CCh, 1 μM)-induced contractions at 1 mg/ml but pretreatment of tissue with propranolol (1 μM), caused around 10 fold shift in the inhibitory CRCs of the plant extract constructed against CCh-induced contraction. The plant extract (up to 0.3 mg/ml) also increased both force and rate of spontaneous contractions of isolated guinea-pig atria, followed by relaxation at higher concentration (1.0-5.0 mg/ml). The cardio-stimulant effect was abolished in the presence of propranolol, similar to that of isoprenaline. Activity-directed fractionation revealed that the spasmolytic component(s) was separated in the organic fraction, whereas the spasmogenic component was concentrated in the aqueous fraction. Conclusion These results indicate that A. spinosus possesses laxative activity partially mediated through cholinergic action. The spasmolytic effect was mediated through calcium channel blocking (CCB), while bronchodilator activity through a combination of β-adrenergic and CCB pathways, which may explain the traditional uses of A. spinosus in gut and airways disorders

Re-infection with a different SARS-CoV-2 clade and prolonged viral shedding in a hematopoietic stem cell transplantation patient

Immunocompromised patients who have a severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection pose many clinical and public health challenges. We describe the case of a hematopoietic stem cell transplantation patient with lymphoma who had a protracted illness requiring three consecutive hospital admissions. Whole genome sequencing confirmed two different SARS-CoV-2 clades. Clinical management issues and the unanswered questions arising from this case are discussed