Neurosarcoidosis presenting as psychiatric Symptoms: a diagnostic challenge

Among patients having neurosarcoidosis, psychiatric manifestations can be seen in 20% of the patients.Sarcoidosis is extremely rare in Asia, being almost unknown in some countries like China and Southeast Asia.Neurosarcoidosis occurs in approximately 5% of patients with sarcoidosis. Neurosarcoidosis presenting as psychiatric manifestations has rarely been reported. We report a case of a young male who presented with psychiatric symptoms,was diagnosed with neurosarcoidosisand responded well to oral steroids.His symptoms were diffuseheadaches, and feelings of movement of fluid on top of headand certain other vague somatic complaints like body aches, vertigo etc. Such patients are difficult to diagnose as sarcoidosis is rare in our part of the world and symptoms are often nonspecific. A high index of suspicion should be kept to identify these cases. We emphasize the importance of recognizing sarcoidosis in patients presenting with variable neuropsychiatric manifestations

Positive Data Visualization Using Trigonometric Function

A piecewise rational trigonometric cubic function with four shape parameters has been constructed to address the problem of visualizing positive data. Simple data-dependent constraints on shape parameters are derived to preserve positivity and assure smoothness. The method is then extended to positive surface data by rational trigonometric bicubic function. The order of approximation of developed interpolant is

Monotone Data Visualization Using Rational Trigonometric Spline Interpolation

Rational cubic and bicubic trigonometric schemes are developed to conserve monotonicity of curve and surface data, respectively. The rational cubic function has four parameters in each subinterval, while the rational bicubic partially blended function has eight parameters in each rectangular patch. The monotonicity of curve and surface data is retained by developing constraints on some of these parameters in description of rational cubic and bicubic trigonometric functions. The remaining parameters are kept free to modify the shape of curve and surface if required. The developed algorithm is verified mathematically and demonstrated graphically

NMDA encephalitis in an elderly with poor prognosis

We present a case of a 65 years old man from Islamabad who presented with six months history of psychiatric and behavioural symptoms, significant weight loss. Later on he developed difficulty swallowing and altered sensorium. This was followed by an episode of shortness of breath leading to respiratory arrest, followed by ICU stay on ventilator support, then developed focal deficit in form of left sided weakness, dysautonomia, bradycardia leading to cardiac arrest and another cardiopulmonary resuscitation, myoclonic jerks, orofacial dyskinesias, status epilepticus, coma ultimately resulting in death of the patient. Patient was found to be NMDA receptor antibody positive. CT chest and abdomen did not reveal any hidden malignancy. Patient was given intravenous pulse steroids for 5 days followed by five sessions of plasmapheresis but did not respond. He stayed on ventilator support for 40 days and did not improve. This is the second case of antibody proven NMDA encephalitis from Pakistan, the first being from Islamabad as well and published in this journal

Prevalence of Lumbosacral Transitional Vertebra in Individuals with Low Back Pain: Evaluation Using Plain Radiography and Magnetic Resonance Imaging

Study DesignDescriptive cross-sectional study.PurposeTo determine the frequency of lumbosacral transitional vertebrae (LSTV) in patients with low back pain (LBP) and the role of iliolumbar ligament (ILL) origin from L5 in LSTV cases.Overview of LiteratureTransitional vertebrae are developmental variants of the spine. LSTV is a common congenital abnormality, and failure to recognize this anomaly may result in serious consequences during surgery.MethodsAll patients aged 11–90 years of either gender with LBP for any duration, who presented for X-ray and magnetic resonance imaging (MRI) of the lumbosacral spine, were included. X-rays of the lumbosacral spine in anteroposterior and lateral views were acquired. In addition, T1- and T2-weighted sagittal and axial MRI was performed. Images were evaluated on a workstation.ResultsOf 504 patients, transitional vertebrae were observed in 75 patients (15%). Among them, 39 (52%) patients had Castellvi type III and 36 (48%) patients had Castellvi type II. However, on MRI, 42 (56%) patients had O'Driscoll type II, 18 (24%) patients had O'Driscoll type IV, and 15 patients (20%) had O'Driscoll type III. ILL origin from L5 was significantly higher (n=429, 100%) among patients with a normal lumbosacral junction than among patients with a transitional lumbosacral junction (n=22, 29.3%) (p<0.001).ConclusionsLSTV occurs at a high frequency in patients with LBP. Furthermore, in the presence of LSTV, the ILL is not a reliable marker for the identification of L5

Inducing salinity tolerance in red pepper (Capsicum annuum L.) through exogenous application of proline and L-tryptophan

Deterioration of agricultural lands due to salinity is one of the serious threats in irrigated areas of the world. Confronting the influence of salinization in agriculture is a key for achieving food security. Red pepper (Capsicum annuum L.) is not only economically but also nutritionally, important for human diet. A study was conducted to ameliorate the effect of salinity on the production and quality of red pepper by exogenous application of osmolytes. Two potential osmolytes i.e. proline and L- tryptophan were exogenously applied solely and in combination (@ 50 mM and 0.12 mM, respectively). There were three salinity levels i.e. ECe; 0.6, 4.04 and 6.11 dS m-1. Results showed that plant height, root length, plant biomass and yield were significantly decreased, while significant increase in Na+ and Na+/K+ ratio was observed with increasing level of salinity. A significant improvement in growth, yield and quality was observed when both osmolytes were exogenously applied under salinity stress. The combined use of proline and L-tryptophan was more effective for reducing the inhibitory effect of salinity as compared to sole application of these osmolytes. It is concluded that the combined application of proline and L-tryptophan (@ 50 mM and 0.12 mM, respectively) was more effective for improving growth of red pepper under normal conditions as well as salinity stressed conditions

Rational trigonometric cubic spline to conserve convexity of 2D data

Researchers in different fields of study are always in dire need of spline interpolating function that conserve intrinsic trend of the data. In this paper, a rational trigonometric cubic spline with four free parameters has been used to retain convexity of 2D data. For this purpose, constraints on two of free parameters βi and γi in the description of the rational trigonometric function are derived while the remaining two αi and δi are set free. Numerical examples demonstrate that resulting curves using the technique of the underlying paper are C1