Schizencephaly diagnosed after an episode of seizure during labor: A case report

Abstract Schizencephaly, an extremely rare anomaly of the cortex, is characterized by abnormal clefts in the cerebral cortex. Very often, this condition is diagnosed early in the childhood period but few instances exist in literature where schizencephaly‐associated seizures and hemiparesis have presented later in life too. Here, we report a rare case scenario of a lady in her late 30s who initially presented to us with obstetric concerns wherein schizencephaly remained an incidental finding despite the significantly large cortical cleft along with lobar holoprosencephaly and lissencephaly

INTEGRATED PRODUCTION-DISTRIBUTION PLANNING OPTIMIZATION USING NEUTROSOPHIC PROGRAMMING

Consideration and management of uncertainties are critical in effective decision-making in production-distribution planning problems. Further, these decisions often involve multiple objectives which are conflicting in nature. More importantly, the decisions represented by these objective functions are often based on imprecise or uncertain data either due to unavailability or lack of objectivity of information, therefore cannot be solved by classical deterministic modeling techniques. To that end, this paper presents a neutrosophic programming-based approach to solve an integrated production-distribution planning problem in a two-echelon supply chain by considering uncertainties and indeterminateness in the data. The problem is formulated as a tri-objective mixed-integer linear programming model considering important features of production-distribution planning decisions. The three objectives considered are to minimize: total cost, delivery time, and backorder level. These objectives are represented by membership functions of the neutrosophic set, i.e., truth, indeterminacy, and falsity. The efficacy of the proposed methodology is illustrated by considering problem instances inspired by a real-world case in the automotive industry. A Pareto optimality test performed on the proposed neutrosophic model shows the existence of a strong optimal solution of the proposed neutrosophic model

The first reported case of Creutzfeldt-Jakob disease from Nepal

Creutzfeldt-Jakob disease (CJD) can also be diagnosed in a resource-limited setting through good clinical analysis. The diagnosis of CJD should be considered in patients with rapidly evolving neurological signs associated with cognitive disturbances even in countries with limited available sophisticated tools and where CJD was never reported before

[In Press] Mental health first aid training with the Nepalese community in Australia : an evaluation of effects on knowledge, confidence, intentions, willingness to have contact and stigmatizing attitudes

The aim of this study was to evaluate the effectiveness of Mental Health First Aid (MHFA) training amongst the Nepalese community in Australia by exploring the impact on knowledge about mental health first aid, confidence and intentions to help, willingness to have contact and stigmatizing attitudes towards people with mental illness. We hypothesized that since MHFA has been extensively evaluated with other communities and has been found to be effective, it would therefore be effective with this community as well. MHFA training was conducted by an accredited Nepalese-Australian MHFA Instructor with 162 participants from the Nepalese community in four states of Australia. Participants completed an evaluation questionnaire prior to the training (pre-test) and at the end of the training (post-test). The evaluation questionnaire assessed participants? knowledge about what was taught in the course, ability to recognize depression as described in a vignette, confidence in providing help, intentions to provide help, and willingness to have contact and stigmatizing attitudes towards people with mental illness. There were large improvements from pre-test to post-test in knowledge, confidence and intentions to help, medium improvements in willingness to have contact, small-to-medium improvements in stigmatizing attitudes and small improvements in recognition of depression. Participants gave high ratings of the course and the instructor. MHFA training produced improvements in knowledge, confidence, intentions, willingness to have contact and stigmatizing attitudes. The training was also well received. Further research is needed to assess persistence of these effects following the course and any changes in mental health first aid provided to the community

Ibrutinib in Refractory or Relapsing Primary Central Nervous System Lymphoma: A Systematic Review

Primary Central Nervous System Lymphoma (PCNSL) is a rare variant of Non-Hodgkin Lymphoma (NHL) representing 1-2% of all NHL cases. PCNSL is defined as a lymphoma that occurs in the brain, spinal cord, leptomeninges, or eyes. Efforts to treat PCNSL by traditional chemotherapy and radiotherapy have generally been unsuccessful as a significant proportion of patients have frequent relapses or are refractory to treatment. The prognosis of patients with Refractory or Relapsed (R/R) PCNSL is abysmal. The optimal treatment for R/R PCNSL is poorly defined as there are only a limited number of studies in this setting. Several studies have recently shown that ibrutinib, a Bruton tyrosine kinase (BTK) inhibitor, has promising results in the treatment of R/R PCNSL. However, these are preliminary studies with a limited sample size. In this systematic review, we explored and critically appraised the evidence about the efficacy of the novel agent ibrutinib in treating R/R PCNSL