MULTIPLE SYSTEM ATROPHY: CASE OF ATYPICALPARKINSON WITH PARKINSON PREDOMINANT PRESENTATION AND PROGRESSIVE CEREBELLAR DEGENERATION WITH EXTRAPYRAMIDAL AND AUTONOMIC INVOLVEMENT

ABSTRACT BACKGROUND Multiple System Atrophy is a rapidly progressive neurodegenerative disease. Symptoms tend to appear in 50s and advance rapidly over the course of 5-10 years with progressive loss of motor and autonomic function. Some of the common symptoms include frequent falls with or without tremors and b/l akinetic rigidity with involvement of the axial muscles. Postural tremor, severe stridor and cranio cervical dystonia may be seen. Alpha synnuclenopathies are generally characterized by REM behavioral disorders and severe dysautonomia years before the onset of the disease. Individuals with MSA typically do not have sustained improvement in their symptoms with levodopa. Currently, there are no treatments to delay the progressive neurodegeneration in MSA and there is no cure. However symptomatic treatment like drugs to improve orthostatic hypotension or anticholinergics for bladder control or compression stockings to overcome fainting can be adopted.[1] CASE DESCRIPTION A 60 year old male patient with known history of type 2 DM and HTN presented to JSS hospital with history of difficulty in speaking, walking and multiple episodes of falls, giddiness and involuntary movements of the hand and loss of bladder control progressing over a period of two years which was confirmed to be a case of Multiple System Atrophy (MSA-P) with progressive cerebellar degeneration, extrapyramidal and autonomic involvement. CONCLUSION The case report presents a progressive neurodegenerative condition which is a type of Atypical Parkinson with difficult diagnosis in the early stages due to its presenting complaints being very similar to Parkinson itself but progresses more rapidly

Endometrial hyperplasia and tubal ectopic: a correlation

Anovulation due to polycystic ovarian syndrome (PCOS) is one of the causes of endometrial hyperplasia in infertile women. Tubal ectopic apart from tubal factors can also be the result of hampered endometrial receptivity in these women which could be due to disturbed hormonal mileu, endometrial hyperplasia at cornua thereby interfering with transport of embryo from fallopian tube to uterus, or could be because of mechanical damage caused while taking endometrial biopsy. We are presenting case series of eight women of PCOS who presented to infertility clinic within two years with history of ectopic pregnancy or had subsequent ectopic pregnancy (after taking endometrial biopsy) with histopathology report of endometrial hyperplasia with or without atypia were enrolled. Out of 1200 PCOS women presenting to infertility clinic, eight women had coexistence of both endometrial hyperplasias and ectopic pregnancy. It is rare to find endometrial hyperplasias causing ectopic pregnancy. The causative factor in these cases could be the faulty endometrium by not being receptive thereby causing the embryo to implant in the fallopian tube or the tubes due to subtle infection secondary to repeated endometrial evaluation

Hepatitis update program: need of the situation to co-manage viral hepatitis and COVID-19

Background: Government of India has taken several initiatives towards combating viral hepatitis but due to sudden surge in COVID-19 cases resulted in suspension of viral hepatitis program related activities. Moreover, COVID-19 has several liver related complications hence more special precautions are required to manage patients with known liver diseases. Nurses play an important role in management of any disease. However, there is limited knowledge among nurses on co-management of COVID-19 and viral hepatitis. With this background, two-day training program for nursing professionals was conceptualized under the project PRAKASH to educate and train the nurses about co-management of COVID-19 and viral hepatitis.        Methods: A pre-post study was undertaken among nurses who have registered for hepatitis update program. The online link to 25-knowledge related questions along with demographic variables was shared with the registered participants. Paired t test and other statistical analyses were done using SPSS v-21. Level of significance was taken at p<0.05Results: A total of 1151 responses were received out of 1477 trained participants. The mean age of the nursing participants was 32.5±6.95 years. The overall mean knowledge score in the pre-assessment was found to be 15.47±4.13 out of 25, which further increased to 20.72±3.81 in the post-assessment. Gender, type of facility, education, willingness to get trained and prior training related to viral hepatitis were found to be independently associated with pre-knowledge score.Conclusions: Training programs should be encouraged for diseases which are of public health importance and can’t be ignored with respect to increasing burden of COVID-19 cases

Investigating star formation activity in the Sh 2-61 H II region

Using the multiwavelength data sets, we studied the star formation activity in H II region Sh 2-61 (hereafter S61). We identified a clustering in the region and estimated the membership using the Gaia proper motion data. The physical environment of S61 is inspected using infrared to radio wavelength images. We also determined the Lyman continuum flux associated with the H II region and found that the H II region is formed by at least two massive stars (S1 and S2). We also analyzed the 12CO (J =3-2) JCMT data of S61, and a shell structure accompanying three molecular clumps are observed towards S61. We found that the ionized gas in S61 is surrounded by dust and a molecular shell. Many young stellar objects and three molecular clumps are observed at the interface of the ionized gas and the surrounding gas. The pressure at the interface is higher than in a typical cool molecular cloud.Comment: Paper is accepted for the publication in the Journal of Astrophysics and Astronom

Structural Analysis of Open Cluster Bochum 2

We present the results from our deep optical photometric observations of Bochum 2 (Boc2) star cluster obtained using the $1.3$m Devasthal Fast Optical Telescope along with archival photometric data from Pan-STARRS2/2MASS/UKIDSS surveys. We also used high-quality parallax and proper motion data from the $Gaia$ Data Release 3. We found that the Boc2 cluster has a small size ($\sim$1.1 pc) and circular morphology. Using $Gaia$ parallax of member stars and isochrone fitting method, the distance of this cluster is estimated as $3.8\pm0.4$ kpc. We have found that this cluster holds young ($\sim5$ Myr) and massive (O$7-$O$9$) stars as well as an older population of low mass stars. We found that the massive stars have formed in the inner region of the Boc2 cluster in a recent epoch of star formation. We have derived mass function slope ($\Gamma$) in the cluster region as $-2.42\pm0.13$ in the mass range $\sim0.72<$M/M$_{\odot}<2.8$. The tidal radius of the Boc2 cluster ($\sim7-9$) is much more than its observed radius ($\sim1.1$ pc). This suggests that most of the low-mass stars in this cluster are the remains of an older population of stars formed via an earlier epoch of star formation.Comment: accepted for publication in Journal of Astrophysics and Astronom

Dissecting the morphology of star forming complex S193

We have studied a star-forming complex S193 using near-infrared (NIR) observations and other archival data covering optical to radio wavelengths. We identified stellar clusters in the complex using the NIR photometric data and estimated the membership and distance of the clusters. Using the mid-infrared (MIR) and far-infrared (FIR) images, the distribution of the dust emission around H\,{\sc ii} regions is traced in the complex. The $Herschel$ column density and temperature maps analysis reveal 16 cold dust clumps in the complex. The H$\alpha$ image and 1.4 GHz radio continuum emission map are employed to study the ionised gas distribution and infer the spectral type and the dynamical age of each H\,{\sc ii} region/ionised clump in the complex. The $^{12}$CO(J =3$-$2) and $^{13}$CO(J =1$-$0) molecular line data hint at the presence of two velocity components around [-43,-46] and [-47,-50] km/s, and their spatial distribution reveals two overlapping zones toward the complex. By investigating the immediate surroundings of the central cluster [BDS2003]57 and the pressure calculations, we suggest that the feedback from the massive stars seems responsible for the observed velocity gradient and might have triggered the formation of the central cluster [BDS2003]57.}Comment: Accepted for publication in MNRAS, 20 pages, 15 figure

Optical spectroscopy of Gaia detected protostars with DOT: can we probe protostellar photospheres?

Optical spectroscopy offers the most direct view of the stellar properties and the accretion indicators. Standard accretion tracers, such as $H\beta$, $H\alpha$, and, Ca II triplet lines, and most photospheric features, fall in the optical wavelengths. However, these tracers are not readily observable from deeply embedded protostars because of the large line of sight extinction (Av $\sim$ 50-100 mag) toward them. In some cases, however, it is possible to observe protostars at optical wavelengths if the outflow cavity is aligned along the line-of-sight that allows observations of the photosphere, or the envelope is very tenuous and thin such that the extinction is low. In such cases, we can not only detect these protostars at optical wavelengths but also follow up spectroscopically. We have used the HOPS catalog (Furlan et al. 2016) of protostars in Orion to search for optical counterparts for protostars in the Gaia DR3 survey. Out of the 330 protostars in the HOPS sample, an optical counterpart within 2" is detected for 62 of the protostars. For 17 out of 62 optically detected protostars, we obtained optical spectra { (between 5500 to 8900 $\AA$) using the Aries-Devasthal Faint Object Spectrograph \& Camera (ADFOSC) on the 3.6-m Devasthal Optical Telescope (DOT) and Hanle Faint Object Spectrograph Camera (HFOSC) on 2-m Himalayan Chandra Telescope (HCT)}. We detect strong photospheric features, such as the TiO bands in the spectra {(of 4 protostars)}, hinting that photospheres can form early on in the star formation process. We further determined the spectral types of protostars, which show photospheres similar to a late M-type. Mass accretion rates derived for the protostars are similar to those found for T-Tauri stars, in the range of 10$^{-7}$ to 10$^{-8}$ $M_\odot$/yr.Comment: 9 pages, 5 figures accepted in Journal of Astrophysics and Astronomy as part of the "Star formation studies in the context of NIR instruments on 3.6m DOT" special issu

Post-outburst evolution of bonafide FUor V2493 Cyg: A Spectro-photometric monitoring

We present here the results of eight years of our near-simultaneous optical/near-infrared spectro-photometric monitoring of bonafide FUor candidate `V2493 Cyg' starting from 2013 September to 2021 June. During our optical monitoring period (between October 16, 2015 and December 30, 2019), the V2493 Cyg is slowly dimming with an average dimming rate of $\sim$26.6 $\pm$ 5.6 mmag/yr in V band. Our optical photometric colors show a significant reddening of the source post the second outburst pointing towards a gradual expansion of the emitting region post the second outburst. The mid infra-red colors, on the contrary, exhibits a blueing trend which can be attributed to the brightening of the disc due to the outburst. Our spectroscopic monitoring shows a dramatic variation of the H$\alpha$ line as it transitioned from absorption feature to the emission feature and back. Such transition can possibly be explained by the variation in the wind structure in combination with accretion. Combining our time evolution spectra of the Ca II infra-red triplet lines with the previously published spectra of V2493 Cyg, we find that the accretion region has stabilised compared to the early days of the outburst. The evolution of the O I $\lambda$7773 \AA~ line also points towards the stabilization of the circumstellar disc post the second outburst.Comment: 34 pages, 12 figures, 6 tables, accepted for publication in Ap