Mesial temporal sclerosis

Mesial temporal sclerosis is closely related to temporal lobe epilepsy, a type of partial (focal) epilepsy in which the seizure initiation point can be identified within the temporal lobe of the brain. Mesial temporal sclerosis is the loss of neurons and scarring of the deepest portion of the temporal lobe and is associated with certain brain injuries. We present a case of a 40year old male who was presented with generalized seizures and was diagnosed with mesial temporal sclerosis

Trigeminal nerve schwannoma

Trigeminal schwannomas are uncommon slow growing encapsulated tumours composed of schwann cells. Trigeminal schwannomas are the second most common type of schwannoma, after the far more common acoustic schwannoma. In this case definite diagnosis could not be made after 1 CT (computerized tomography) scan and 3 MRI (magnetic resonance imaging) (outside hospital) but finally after proper clinical examination and discussion with radiologist about the best diagnostic imaging in this case we reached to a diagnosis of trigeminal nerve schwannoma after MRI brain with contrast

Study of electrocardiographic differentiation between RCA and LCx occlusion in isolated inferior wall myocardial infarction

Background: Inferior myocardial infarctions account for 40 to 50% of all acute myocardial infarctions and are generally viewed as having a more favorable prognosis than anterior wall infarctions. The management, and in some instances, prevention of these complications, may be facilitated by early differentiation between AMI caused by RCA versus left circumflex coronary artery occlusion. These can be diagnosed from the electrocardiography (ECG) which remains a valuable and most widely used rational modality to diagnose and risk stratifying in an acute setting. The present study helps in Electrocardiographic differentiation between right coronary and the left circumflex coronary arterial occlusion in isolated inferior wall myocardial infarction.Methods: The present study entitled “Electrocardiographic differentiation between right coronary and the left circumflex coronary arterial occlusion in isolated inferior wail myocardial infarction” was conducted from June 2007 to November 2009 at the Department of Medicine and Cardiology, Dr. D.Y. Patil Hospital and Research Center, Nerul, Navi Mumbai, Maharashtra, India.Results: Out of 52 patients of acute inferior wall myocardial infraction, 41 were males and 11 were females. Thus the male to female ratio is 3.72:1. In the above table, the ST segment elevation in lead III was more than lead ii in42 patients. All these 42 patients were found to have RCA as the culprit vessel. The St Segment elevation in lead II was more than lead III in 9 patients. All these 9 patients were found to have LCx as the culprit vessel.Conclusions: The incidence of acute inferior wall myocardial infarction is highest in age group of 50 to 59 years. The ST segment elevation in acute isolated inferior wall myocardial infarction was greater in lead III than in lead II when right coronary artery was the culprit vessel and vice versa when the left circumflex coronary artery was the culprit vessel. ST segment depression in lead I was common when the right coronary artery was the culprit vessel and not seen with left circumflex coronary artery occlusion. An upright T wave in lead V4R in acute isolated inferior wall myocardial infarction was common when the right coronary artery was the culprit vessel and not seen with left circumflex coronary artery occlusion.

Portal vein thrombosis with protein C-S deficiency in a non-cirrhotic patient

There are several conditions that can lead to portal vein thrombosis (PVT), including including infection, malignancies, and coagulation disorders. Anew condition of interest is protein C and S deficiencies, associated with hypercoagulation and recurrent venous thromboembolism. We report the case of a non-cirrhotic 24-year-old male diagnosed with acute superior mesenteric vein thrombosis and PVT and combined deficiencies in proteins C and S

Scalable Range Locks for Scalable Address Spaces and Beyond

Range locks are a synchronization construct designed to provide concurrent access to multiple threads (or processes) to disjoint parts of a shared resource. Originally conceived in the file system context, range locks are gaining increasing interest in the Linux kernel community seeking to alleviate bottlenecks in the virtual memory management subsystem. The existing implementation of range locks in the kernel, however, uses an internal spin lock to protect the underlying tree structure that keeps track of acquired and requested ranges. This spin lock becomes a point of contention on its own when the range lock is frequently acquired. Furthermore, where and exactly how specific (refined) ranges can be locked remains an open question. In this paper, we make two independent, but related contributions. First, we propose an alternative approach for building range locks based on linked lists. The lists are easy to maintain in a lock-less fashion, and in fact, our range locks do not use any internal locks in the common case. Second, we show how the range of the lock can be refined in the mprotect operation through a speculative mechanism. This refinement, in turn, allows concurrent execution of mprotect operations on non-overlapping memory regions. We implement our new algorithms and demonstrate their effectiveness in user-space and kernel-space, achieving up to 9$\times$ speedup compared to the stock version of the Linux kernel. Beyond the virtual memory management subsystem, we discuss other applications of range locks in parallel software. As a concrete example, we show how range locks can be used to facilitate the design of scalable concurrent data structures, such as skip lists.Comment: 17 pages, 9 figures, Eurosys 202

Thyroid dysfunctions in patients with chronic renal failure

Background: Chronic renal failure (CRF), or end-stage renal disease (ESRD), is a progressive, irreversible deterioration in renal function in which the body’s ability to maintain metabolic and fluid and electrolyte balance fails, resulting in the development of clinical symptoms like uraemia or azotemia. Thyroid hormones have an important role in regulating metabolism, development of the kidney, maintenance of water and electrolyte homeostasis, protein synthesis and influencing other hormone function. Tri-iodothyronine (T3) and thyroxin (T4) are the two main hormones produced by the thyroid. The patients with chronic renal failure often exhibit clinical features and laboratory findings which are indicative of thyroid dysfunction, since, kidney is involved in the metabolism and elimination of TH.Methods: This was a cross sectional single centre descriptive study, including 50 patients of either gender between the age of 45-70 years.Results: Present study found a significant positive correlation between the TSH levels and Zulewski score in patients with CRF.Conclusions: Since there was found to be a correlation between the TSH levels and Zulewski score, the evaluation of symptoms and signs with Zulewski score in addition to thyroid function testing in patients with thyroid dysfunction is essential, since it can be a marker for CRF

Unusual case of tuberculosis

Though commonly encountered, extrapulmonary tuberculosis (TB) can sometimes present with variable clinical picture intricating the diagnosis. The nonspecific symptoms include pyrexia of unknown origin, hepatosplenomegaly, lymphadenopathy, meningitis, and, rarely, variety of hematological abnormalities, namely, anemia, pancytopenia, and leukemoid reaction. When it presents with bone marrow (BM) involvement, prognosis is usually poor. We, hereby, report a case of unusual TB presentation with a 4 month history of fever associated with fatigability, and diarrhea. During the hospital stay and follow up, the patient showed a spectrum of interesting hematological findings, including pancytopenia on peripheral smear, caseating granulomas consistent with TB on bone marrow examination. The patient showed a good clinical as well as hematological response to anti-tuberculosis treatment. This paper highlights the significance of a hematological picture in the final confirmation of TB, which may otherwise be passed off as nutritional or other unrelated causes

Sequence determinants of human gene regulatory elements

Analysis of massively parallel reporter assays measuring the transcriptional activity of DNA sequences indicates that most transcription factor (TF) activity is additive and does not rely on specific TF-TF interactions. Individual TFs can have different gene regulatory activities. DNA can determine where and when genes are expressed, but the full set of sequence determinants that control gene expression is unknown. Here, we measured the transcriptional activity of DNA sequences that represent an similar to 100 times larger sequence space than the human genome using massively parallel reporter assays (MPRAs). Machine learning models revealed that transcription factors (TFs) generally act in an additive manner with weak grammar and that most enhancers increase expression from a promoter by a mechanism that does not appear to involve specific TF-TF interactions. The enhancers themselves can be classified into three types: classical, closed chromatin and chromatin dependent. We also show that few TFs are strongly active in a cell, with most activities being similar between cell types. Individual TFs can have multiple gene regulatory activities, including chromatin opening and enhancing, promoting and determining transcription start site (TSS) activity, consistent with the view that the TF binding motif is the key atomic unit of gene expression.Peer reviewe

Structural insights into the DNA-binding specificity of E2F family transcription factors

The mammalian cell cycle is controlled by the E2F family of transcription factors. Typical E2Fs bind to DNA as heterodimers with the related dimerization partner (DP) proteins, whereas the atypical E2Fs, E2F7 and E2F8 contain two DNA-binding domains (DBDs) and act as repressors. To understand the mechanism of repression, we have resolved the structure of E2F8 in complex with DNA at atomic resolution. We find that the first and second DBDs of E2F8 resemble the DBDs of typical E2F and DP proteins, respectively. Using molecular dynamics simulations, biochemical affinity measurements and chromatin immunoprecipitation, we further show that both atypical and typical E2Fs bind to similar DNA sequences in vitro and in vivo. Our results represent the first crystal structure of an E2F protein with two DBDs, and reveal the mechanism by which atypical E2Fs can repress canonical E2F target genes and exert their negative influence on cell cycle progression.Peer reviewe