Focal dystonia and ataxic hemiparesis as the initial presentation of a thalamic tuberculoma: a diagnostic challenge in an immunocompetent pediatric patient

Background: Central nervous system (CNS) tuberculomas are rare and account for approximately 1% of all tuberculosis (TB) cases. These intracranial lesions are more commonly observed in immunocompromised individuals, often as part of disseminated miliary TB or after latent infection reactivation. This case report presents the occurrence of a thalamic tuberculoma in an immunocompetent girl. Case Description: An 11-year-old girl presented with a 3-month history of progressive right-sided ataxic hemiparesis, hand dystonia/thalamic hand, and headache. There was only a mildly elevated erythrocyte sedimentation rate (25 mm/h.), and her remaining biochemistry and vitals were unremarkable. Magnetic resonance imaging (MRI) brain revealed an ill-defined intra-axial heterogeneous lobulated lesion with crenated margins involving the thalamus and the posterior limb of the internal capsule with significant vasogenic edema. Given the clinical picture, the working diagnosis was a high-grade brain tumor. Due to the absence of a viable operative corridor for a meaningful resection and the diagnostic uncertainty, a stereotactic biopsy was performed, and histopathological analysis confirmed the presence of granulomas consistent with TB. A human immunodeficiency virus test (negative) and interferon-gamma release assay (positive) were then obtained. The patient was commenced on a regimen of anti-TB drugs with a tapering steroid dose. At 8 months, her most recent MRI showed a significant reduction in the size of her tuberculoma, and there is a complete resolution of her hand dystonia and hemiparesis to allow for independence in her activities of daily living. Conclusion: This report emphasizes the importance of considering causes other than degenerative, vascular, or neoplasms in patients with hemiparesis with dystonia. CNS tuberculomas can present as such without prior history or specific clinical symptoms of TB, making them a diagnostic challenge. In cases with such uncertainty regarding the nature of an intracranial lesion and the role of resection, a stereotactic biopsy is invaluable

Enhancement on science teachers\u27 pedagogical content knowledge

Pedagogical content knowledge (Shulman 1986, 1987) is a knowledge base for teachers to learn to teach subject matter knowledge effectively. Gaining depth in pedagogical content knowledge leads teachers to the three perspective areas of teacher development that is, personal, social, and professional. Teacher development could take place more effectively through collaborative actions. A collaborative action research strategy under the qualitative research paradigm was undertaken to explore the ways to enhance the science teachers\u27 pedagogical content knowledge. In order to gain understanding in depth of teachers\u27 existing teaching practices, and to explore the possible ways of enhancement of pedagogical content knowledge following tools of data collection were used: field notes, semi-structured interviews, reflections of teachers and audiotape recordings of post conferences. In this study two teachers were involved, one from the primary and one from the lower secondary including myself. The study has revealed encouraging and promising insights of teachers\u27 enhancement of pedagogical content knowledge and teacher development. The collaborative actions helped the teachers to reflect critically upon their teaching practices in order to teach subject matter more effectively. It helped the teachers to look more critically at the processes of students\u27 learning of science, curriculum development, and knowledge of the environment. The study shared some key areas for teachers to enhance their ways of learning. This study illustrates that teachers can become teacher researchers if they are given support and opportunities at their workplaces

Differential expression of micro RNA-29 family in non-diabetic adults of diabetic and non-diabetic parents.

OBJECTIVE: MicroRNAs are known to regulate 60% of genes at post translational level. MicroRNAs including Micro RNA-29 family play a vital role in cellular activities and have validate role in numerous metabolic disorders inclusive of diabetes mellitus and its complications. While micro RNA profile changes years before the occurrence of disease. This cross-sectional study was conducted in non-diabetic adults of diabetic and non-diabetic parents to explore the early changes in expression of micro RNA-29 family as it can be served as early biomarker of type 2 diabetes in non-diabetic adults. This study was conducted from January 2019 to January 2021. Micro RNA was extracted from plasma of 50 participants and expression was compared through qPCR. While data was analyzed through SPSS version 21.0. RESULTS: 29a and 29b had lower expression in participants with family history of DM compared to those having no family history of DM (P \u3c 0.0001). While micro RNA 29c was found to be significantly higher in participants with positive family history of type 2 diabetes as compared to those without family history of diabetes (P = 0.001)