Autoimmune Hepatitis Leading to Liver Cirrhosis: A Case Report

Autoimmune hepatitis is a rare form of chronic liver inflammation that begins as acute hepatitis and progresses to chronic liver disease. It presents with varied clinical features from acute hepatitis to chronic liver diseases like chronic viral hepatitis and alcoholic liver disease, making it difficult to diagnose in the absence of a high index of suspicion and adequate laboratory support. Autoimmune hepatitis is divided into two categories autoimmune hepatitis-1 and autoimmune hepatitis-2 based on the antibodies involved. We discuss the case of a 37-year-old woman who developed autoimmune hepatitis-1, with swelling and epigastric pain. These symptoms later progressed to liver cirrhosis leading to the death of the patient. Autoimmune hepatitis is extremely sensitive to immunosuppressive medication, it is necessary to maintain a high suspicion index for the disease because a prompt diagnosis can be an integral step toward a better prognosis of the disease

Summer paleohydrology during the Late Glacial and Early Holocene based on δ2H and δ18O from Bichlersee, Bavaria.

Isotope-based records provide valuable information on past climate changes. However, it is not always trivial to disentangle past changes in the isotopic composition of precipitation from possible changes in evaporative enrichment, and seasonality may need to be considered. Here, we analyzed δ2H on n-alkanes and δ18O on hemicellulose sugars in sediments from Bichlersee, Bavaria, covering the Late Glacial and Early Holocene. Our δ2Hn-C31 record documents past changes in the isotopic composition of summer precipitation and roughly shows the isotope pattern known from Greenland. Both records show lower values during the Younger Dryas, but at Bichlersee the signal is less pronounced, corroborating earlier suggestions that the Younger Dryas was mainly a winter phenomenon and less extreme during summer. δ18Ofucose records the isotopic composition of the lake water during summer and is sensitive to evaporative enrichment. Coupling δ2Hn-C31 and δ18Ofucose allows calculating lake water deuterium-excess and thus disentangling changes in the isotopic composition of precipitation and evaporative enrichment. Our deuterium-excess record reveals that the warm Bølling-Allerød and Early Holocene were characterized by more evaporative enrichment compared to the colder Younger Dryas. Site-specific hydrological conditions, seasonality, and coupling δ2H and δ18O are thus important when interpreting isotope records

Development of embedded atom method interatomic potentials for Ge-Sn-Si ternary and constituent binary alloys for modeling material crystallization

Group IV elements based nanoelectronics devices (mainly Si and Ge based devices) have been developed and improved over a long period of time and are the most influencing materials of semiconductor electronics, but due to their indirect bandgap their use in optoelectronics is limited. Alternatively, new Group IV alloys comprised of Ge, Si, and Sn semiconductor materials have emerged as attractive options for various electronic and optoelectronic applications. The binary and ternary alloys provide strain and energy bandgap engineering by controlling element content, a route for realizing direct-transition semiconductors, improvement in interface and defect properties, and a reduction of the process temperature related to the crystal growth. However, there are many obstacles and challenges for the crystal growth of Ge-Sn alloy on the Silicon or Germanium substrate. One of the problems in Ge-Sn growth is Sn precipitation from Ge-Sn. Theoretical calculation predicts that Ge transitions from an indirect semiconductor to a direct semiconductor by incorporation of Sn on Ge matrix. For tensile strained Ge-Sn alloys, the transition is predicted at 6.3% Sn concentration. This is the main driving force for the growth of epitaxial Ge-Sn crystals on Si substrates. The epitaxial growth of Ge-Sn is very challenging because of huge lattice mismatch between Ge and Sn and, the strong surface segregation of Sn on Ge and extremely low equilibrium solubility of Sn on Ge. In the recent past, a lot of progress has been made for the development of epitaxial growth techniques. Besides other techniques like MBE for the deposition of Ge-Sn on the substrate of Si, chemical vapor deposition has been achieved. Similarly, pulsed laser-induced epitaxy is also another technique for the deposition. Besides the experimental efforts to study the Ge-Sn-Si elemental binary and ternary alloys, Molecular Dynamics (MD) modeling provides insight into atomic configurations and structural dynamics, which requires the accurate inter-atomic potential for Ge-Sn-Si binary and ternary system. Present work is an effort to generate Embedded Atom Method (EAM) potential for this system, which can then be used with the MD method to study epitaxial growth. The work presented here uses classical molecular dynamics approach and EAM potential fitting code to develop the EAM potential, which can be used to study the properties of Ge-Sn, Ge-Si, Si-Sn, and Ternary Ge-Sn-Si system. Density Functional Theory (DFT) calculations are performed for each binary pair - Ge-Sn, Ge-Si and Si-Sn using Vienna Ab initio Simulation Package, better known as VASP for a range of temperatures in the range of 1200K- 1500K. The interatomic potential fitting code, MEAMfit, is used to fit EAM potentials to energies and atomic forces generated from DFT calculations. The data to be fitted are directly read from “vasprun.xml” files from VASP. Three different methods were used to test the accuracy of developed potentials, namely, testing the fit for its predictability of DFT energies in the testing set; computing elastic properties, and crystal properties such as phonon band-structure with fitted potential and comparing those with direct DFT calculations

Chronic ulcerating genital herpes simplex virus infection: A diagnosis mislead by HIV infection

We report a case of chronic herpes simplex in a 27 year old lady presenting with a history of persistent verrucous ulcer in the natal cleft of nine months duration. The patient was diagnosed and treated initially as a case of Tuberculosis Verrucosa Cutis (TVC) based on the chronicity of the ulcer, negative HIV serological tests and histopathological findings. The diagnosis had to be revised as the lesion was increasing in size and the patient was not responding to treatment even after completing antituberculous treatment for six months. Repeat histopathological examination and immunohistochemistry showed DNA of herpes simplex. Based on this finding a repeat HIV serology was sent which was positive. The ulcer healed after a course of acyclovir. The case is being reported to highlight the importance of considering chronic herpes simplex infection in a case of chronic genital ulcer. In addition this case reminds us the nature of HIV infection to mislead the diagnosis by altering the natural course of the disease process

Depression among Adolescents of Rural Nepal: A Community-Based Study

This community-based study is aimed at finding out the prevalence of depression, and its correlates among adolescents of rural Nepal. Data were collected among adolescents after multistage stratified proportionate random sampling by using the Patient Health Questionnaire (PHQ-9) to assess the depression among adolescent. Chi-square test and logistic regression model were applied. The prevalence of depression was found to be 27%. Adolescents who were not satisfied with their academic performance were 2.4 times more likely to have the risk of depression (AOR=2.417, CI: 1.097-5.326). Likewise, tobacco users were almost fourteen times (AOR=13.858, CI: 2.090-91.90), who intended to harm themselves were two times (AOR=2.323, CI: 1.078-5.005), sleep deprivation were fifteen folds (AOR=14.911, CI: 7.376-30.145), often scolded by their parents was almost three times (AOR=2.931, CI: 1.195-7.436), and having poor relationship with friends were 2.4 times more likely (AOR=2.371, CI: 1.078-5.215) of having depression. Sleep deprivation has a long-term negative impact on health leading depression