Transient Global Amnesia as the First Clinical Symptom for Malignant B-Cell Lymphoma with Central Nervous System Involvement

We present the case of an elderly male who was diagnosed with transient global amnesia (TGA), only to be diagnosed with B-cell lymphoma with central nervous system involvement a few weeks later. This is the first ever case reported in literature with lymphoma presenting as TGA. Literature review and pertinent points regarding high-yield imaging protocol for presumed TGA patients are discussed

Exploring cucumber extract for skin rejuvenation

This study was designed to develop a topical skin-care cream water in oil (w/o) emulsion of 3% cucumber extracts versus its vehicle (Base) as control and evaluates its effects on skin-melanin, skin erythema, skin moisture, skin sebum and transepidermal water loss (TEWL).  Hydroalcohol.c cucumber (Cucumis sativus) fruit extract was entrapped in the inner aqueous phase of w/o emulsion. Base containing no extract and a formulation containing 3% concentrated extract of C. sativus was formulated. The odour was adjusted with few drops of lemon oil. Both the base and formulation were stored at different storage conditions for a period of 4 weeks to predict their stability. Different stability parameters that is: Physical stability, centrifugation and pH were monitored at different time intervals. Both the base and formulation were applied to the cheeks of 21 healthy human volunteers for a period of 4 weeks. The expected pharmaceutical stability of creams was achieved from 4 weeks in vitro study period. Odour disappeared with passage of time due to volatilization of lemon oil. The base showed insignificant (p > 0.05) effects on all skin parameters except sebum that was not significant, whereas the formulation showed statistically significant (p.0.05) effects on skin sebum secretion. TEWL and erythema was increased while skin melanin and skin hydration level was decreased by formulation. However these effects were statistically insignificant (p > 0.05). The results showed a good stability over 4 weeks of observation period of both base and formulation and the formulation has anti sebum secretion, bleaching and moisturizing effects.Key words: Cucumber extract, melanin, skin moisture, skin sebum, transepidermal water loss (TEWL)

Unusual Atypical Language Lateralization

Determining the language-dominant hemisphere is essential for planning epilepsy surgery. A 60-year-old righthanded woman with epilepsy since age 16 failed a partial right anterior lobectomy at age 21. Later, a brain MRI found extensive right-sided cortical dysplasia and periventricular heterotopia. Subsequently, prolonged videoEEG monitoring localized her seizures to the right temporoparietal region. Functional MRI was inconclusive in lateralizing her language, prompting a Wada test, which strongly lateralized language to the right. This unique case of atypical language representation in a right-handed individual with an extensive right-hemispheric congenital malformation and seizure focus illustrates the important thorough presurgical language assessment

Pharmacokinetics of Caffeic Acid from Methanol Seed Extract of Syzygium cumini L in Rats

Purpose: To describe caffeic acid-based pharmacokinetics of methanol extract of seed of Syzygium cumini L. in rats.Methods: A dose of the extract (500 mg, equivalent to 37.135 mg caffeic acid) was administered orally to 6 male Wister rats, weighing 200 ± 10 g. Blood samples (0.5 mL), collected from the tail vein at 0, 15, 30, 60, 120, 240 and 720 min, were processed and analyzed using high performance liquid chromatography and detected with florescent light detector (FLD).Results: Following the administration of the extract, caffeic acid achieved maximum plasma concentration (5.96 ± 0.49 μg/mL) in 1.0 h which was also the time to achieve maximum concentration (Tmax). Mean resident time (MRT) and half-life (t1/2) were 4.092 ± 0.94 h and 0.14 ± 0.01 h, respectively.Conclusion: The results indicate that absorption of caffeic acid from the oral route is fast, but lower amounts are absorbed. The method developed for the extraction of caffeic acid from the plasma and HPLC determination may be useful in establishing phyto-bioequivalence between Syzygium cumini seed products.Keywords: Caffeic acid, Pharmacokinetics, Syzygium cumini, Phytobioequivalence, Absorptio

Sustainable and Resilient Smart Water Grids: A Solution for Developing Countries

According to a United Nations report, the world population will increase from 7 billion to 9 billion by 2050. Further, the water stress level is more than 70% in 22 countries while in another 31 countries it is between 25% and 70%. More than 2 billion people live in these 53 countries which are all underdeveloped. Water use has increased by 1% per year since the 1980s, so global demand is expected to rise by 30% by 2050. Thus, efficient water grid management is imperative to ensure there is sufficient water for the future. Information and Communication Technology (ICT) can be used to create smart water grids to optimize water distribution, reduce waste and leakage, and resolve quality and overuse issues. In this work, a low cost, real-time, reliable and sustainable IoT based solution called SmartTubewell is proposed for smart water grid management. It is composed of two components, a sensor node installed at tube wells and an application layer on Amazon Web Services (AWS) for data analysis, storage and processing. The sensor node is based on a Raspberry Pi with integrated current and voltage sensors and a local database. The sensor data is transmitted to AWS using a cellular (GPRS) network. A comparison between the proposed system and SCADA is presented which shows that SmartTubewell has a much lower cost. A field test with multiple tube wells in Peshawar, Pakistan indicates that this is a suitable solution for developing countries

Erectile dysfunction: prevalence, risk factors and involvement of antihypertensive drugs intervention

Purpose: To explore the literature regarding prevalance, risk factors and the involvement of antihypertensive drugs in erectile dysfunction (ED).Methods: Original research articles, reviews, editorials and case reports published in English language on the prevalence of sexual/erectile dysfunction in hypertensive men taking antihypertensive drugs and risk factors were identified through a search of four bibliographic databases, namely, PubMed, EMBASE, CINAHL and EBSCO Health.Results: Recent analyses suggest that hypertensive men of almost all age groups suffer from ED but it is more prevalent in elderly male patients. The involvement of β-blockers was found to be controversial. Nevertheless, some evidence had been found regarding the use of propranolol in high doses.Conclusion: The present review indicates the need for research to unravel the role of β-blockers in the manifestation of ED in hypertensive males, whom there are no contributory factors such as sedentary lifestyle, aging, stress and anxiety, etc.Keywords: Hypertension, Antihypertensive drugs, β-Blockers, Propranolol, Erectile dysfunction, Life style, Risk factor

Arsenic Induced Toxicity in Broiler Chicks and Its Amelioration with Ascorbic Acid: Clinical, Hematological and Pathological Study

This study was conducted to observe the arsenic (As) toxicity lesions in birds and to know either Vit C ameliorates these toxic effects or not. One-day-old broilers chicks (n=72) procured from a local hatchery were randomly divided into four equal groups. First group was kept as control and second group was given As (50 mg/kg BW) via crop tubing. Third group received in addition to As, Vit C (250 mg/kg BW) whereas fourth group received only Vit C. Killing by neck dislocation of randomly selected six birds from each group was carried out on experimental days 0, 16 and 32 for collection of blood and tissues specimens. Arsenic treated birds showed clinical signs of toxicity throughout the experiment than all other groups. These clinical signs included decreased body weight and feed intake, dullness, open mouth breathing, increased thirst, ruffled feathers, pale comb, skin irritation and watery diarrhea which were not significant in any other group. As treated group showed a significant (P<0.05) decrease in hematological parameters. Severe gross and histopathological changes were observed in intestines, spleen and lungs of birds fed with As than all other groups. Decreased height of villi of middle portion of small intestines was also observed in As treated birds. Villi height in Vit C treated group increased as compared to control group. It was concluded that As induces severe toxic effects in broiler birds; however, these toxic effects can be partially ameliorated by Vit C

Inter-observer variability in diagnosing radiological features of aneurysmal subarachnoid hemorrhage; a preliminary single centre study comparing observers from different specialties and levels of training

BACKGROUND: A noncontrast computed tomography (CT) scan remains the initial radiological investigation of choice for a patient with suspected aneurysmal subarachnoid hemorrhage (aSAH). This initial scan may be used to derive key information about the underlying aneurysm which may aid in further management. The interpretation, however, is subject to the skill and experience of the interpreting individual. The authors here evaluate the interpretation of such CT scans by different individuals at different levels of training, and in two different specialties (Radiology and Neurosurgery). METHODS: Initial nonontrast CT scan of 35 patients with aSAH was evaluated independently by four different observers. The observers selected for the study included two from Radiology and two from Neurosurgery at different levels of training; a resident currently in mid training and a resident who had recently graduated from training of each specialty. Measured variables included interpreter's suspicion of presence of subarachnoid blood, side of the subarachnoid hemorrhage, location of the aneurysm, the aneurysm's proximity to vessel bifurcation, number of aneurysm(s), contour of aneurysm(s), presence of intraventricular hemorrhage (IVH), intracerebral hemorrhage (ICH), infarction, hydrocephalus and midline shift. To determine the inter-observer variability (IOV), weighted kappa values were calculated. RESULTS: There was moderate agreement on most of the CT scan findings among all observers. Substantial agreement was found amongst all observers for hydrocephalus, IVH, and ICH. Lowest agreement rates were seen in the location of aneurysm being supra or infra tentorial. There were, however, some noteworthy exceptions. There was substantial to almost perfect agreement between the radiology graduate and radiology resident on most CT findings. The lowest agreement was found between the neurosurgery graduate and the radiology graduate. CONCLUSION: Our study suggests that although agreements were seen in the interpretation of some of the radiological features of aSAH, there is still considerable IOV in the interpretation of most features among physicians belonging to different levels of training and different specialties. Whether these might affect management or outcome is unclear

Types and clinical presentation of stroke

Background: Stroke is one of the leading causes of mortality and morbidity worldwide. In this study, authors worked on clinical presentation and types of stroke. The two main types of strokes are ischemic and haemorrhagic. Brain infarction is caused by decrease blood flow due to either narrowing of artery or complete obstruction to blood flow owing to embolism. While haemorrhage is caused by rupture of artery or aneurysms leading to accumulation of blood in the brain parenchyma.Methods: Cross sectional study of group of patients in Nishtar hospital Multan, Pakistan who presented with variety of neurological symptoms who were subsequently diagnosed as non-traumatic stroke. All patients were subjected to a detailed history and thorough clinical examination and investigations after obtaining informed consent.Results: Of 122 patient, 66 patients were male and 56 were female. Ischemic stroke was more common: present in 76 patients as compared to 46 patients with hemorrhagic stroke. Hypertension was present in 40.9% of ischemic stroke and 27.8% of hemorrhagic strokes. Most of the patients (67.2%) had altered sensorium at presentation followed by hemiplegia in 39.3 % of patients.Conclusions: Prevalence of ischemic strokes is higher than that of haemorrhagic stroke. Hypertension is associated with both types of these strokes. Moreover, hyperglycaemia and high blood pressure are common in early phase of stroke. Vomiting in stroke favors haemorrhagic stroke

(2S)-3-(1H-Indol-3-yl)-2-(4-methyl­benzene­sulfonamido)­propionic acid monohydrate

In the title compound, C18H18N2O4S·H2O, the indole and toluene ring systems are oriented at a dihedral angle of 84.51 (9)°. In the crystal, the components are linked by N—H⋯O, O—H⋯O, C—H⋯O and N—H⋯π inter­actions. These include a short link from the α-C atom of the amino acid fragment