Moyamoya disease: an elusive diagnosis

Moyamoya disease is an idiopathic vasculopathy, affecting vessels of Circle of Willis.1 It usually manifests as stroke, but can also cause seizures and cognitive impairment.2 Ischemic strokes are common in children and hemorrhagic strokes in adults.1 We describe our experience with moyamoya disease in four patients who presented with ischemic strokes, at an academic tertiary care center and emphasize that this diagnosis should be considered in young patients, especially children, who present with stroke

Cost of acute stroke care at a tertiary care hospital in Karachi, Pakistan

Objective:To evaluate cost of acute stroke care and its determinants at a tertiary care hospital in Karachi and to find out predictors of high cost care. Acute stroke is a leading cause of morbidity and mortality. Cost of care is the single most important determinant in availability of acute stroke care at a tertiary care hospital in Pakistan.It is also an important factor in development of public health policies and medical insurance plans. Average nnual income in Pakistan is 4881 rupees (U$85). Methods: Medical and billing records of 443 patients with acute stroke were retrospectively reviewed from 1998-2001 at The Aga Khan University Hospital (AKUH), Karachi. Acute stroke care at AKUH usually includes routinelaboratory investigation including Lipid profile, Magnetic resonance imaging/angiography (MRI/MRA),Echocardiogram, Carotid Doppler\u27s ultrasound and medical management in the Stroke care unit. Results:443 patients were included in study. Age range was 25-98 years (Mean 58 years). 269 (61$1179) whichincluded average radiology cost; 12,507 rupees (U$208), average laboratory cost; 8365 rupees (U$139),average pharmacy cost; 13,320 rupees (U$222) and average bed/room charges; 27, 552 rupees (U$459).Length of hospital stay is the most important determinant of cost. Average total cost for patients who stayed for1 day was 19,597 rupees (U$326), 2-3 days; 25,568 rupees (U$426), 4-7 days; 49,705 rupees (U$828), 8-30 days; 153,586 rupees (U$2559), more than 30 days; 588,239 rupees (U$9804). Average cost for general wardwas 60,574 rupees (U$1010), private ward was 74,880 rupees (U$1248) and intensive care unit was 155,010rupees (U$2583). Conclusion: Cost of acute stroke care is extremely high as compared to average national income at ourhospital. Most important determinant of cost is length of hospital stay. Cost cutting measures and increasedfunding from state are necessary to increase the availability of acute stroke care (JPMA 53:552;2003)

Diagnosis of Faulty Sensors in Antenna Array using Hybrid Differential Evolution based Compressed Sensing Technique

In this work, differential evolution based compressive sensing technique for detection of faulty sensors in linear arrays has been presented. This algorithm starts from taking the linear measurements of the power pattern generated by the array under test. The difference between the collected compressive measurements and measured healthy array field pattern is minimized using a hybrid differential evolution (DE). In the proposed method, the slow convergence of DE based compressed sensing technique is accelerated with the help of parallel coordinate decent algorithm (PCD). The combination of DE with PCD makes the  minimization faster and precise. Simulation results validate the performance to detect faulty sensors from a small number of measurements

Effect of spinning variables on packing density of cotton yarn

In this study, fibre distribution through the cross-sections of ring-spun yarns and their packing density values has been investigated to provide a better understanding of the internal structures of ring-spun yarns manufactured by changing different spinning variables. After the yarn manufacturing process, diameter, IPI index, uniformity index, single yarn strength, density and hairiness are tested and then evaluation of tests is done on the Minitab and Microsoft Excel. The impact of TPI, spindle speed, count, hairiness and diameter has been analyzed using yarn packing density as a response variable. The aim of present study is to produce a yarn with improved packing density so that the yarn properties could be predetermined. The study shows that the increase in yarn count, TPI and spindle speed increase the yarn packing density

Localizing introgression on the chromosome of rice by genomic in situ hybridization (GISH)

Genomic in situ hybridization was used to detect introgressed segment from Oryza australinesis onto the chromosomes of introgression line derived from the hybrid O. sativa x O. australinesis. Genomic DNA from Oryza australinesis was labeled with biotin and hybridized to the homologous sequences on the O. sativa chromosomes. The probe hybridization fluoresced green and non labeled O. sativa chromosomes appeared red or blue due to counterstaining with propidium iodide (PI) or 4,6-diamidino-2-phenylindole (DAPI). This differential painting of chromosomes unequivocally detected the introgressedsegment. Among the 200 cells analyzed, 6.5% of the cells showed  hybridization signal. Signal appeared on one chromosome in 5%, on two homologous chromosomes in 1% and on sister chromatids in 0.5%of the cells. Hybridization was seen on the short arm of the chromosome 12 of the introgression line

SARS-CoV-2 epitopes inform future vaccination strategies

All currently approved COVID-19 vaccines utilize the spike protein as their immunogen. SARS-CoV-2 variants of concern (VOCs) contain mutations in the spike protein, enabling them to escape infection- and vaccination-induced immune responses to cause reinfection. New vaccines are hence being researched intensively. Studying SARS-CoV-2 epitopes is essential for vaccine design, as identifying targets of broadly neutralizing antibody responses and immunodominant T-cell epitopes reveal candidates for inclusion in next-generation COVID-19 vaccines. We summarize the major studies which have reported on SARS-CoV-2 antibody and T-cell epitopes thus far. These results suggest that a future of pan-coronavirus vaccines, which not only protect against SARS-CoV-2 but numerous other coronaviruses, may be possible. The T-cell epitopes of SARS-CoV-2 have gotten less attention than neutralizing antibody epitopes but may provide new strategies to control SARS-CoV-2 infection. T-cells target many SARS-CoV-2 antigens other than spike, recognizing numerous epitopes within these antigens, thereby limiting the chance of immune escape by VOCs that mainly possess spike protein mutations. Therefore, augmenting vaccination-induced T-cell responses against SARS-CoV-2 may provide adequate protection despite broad antibody escape by VOCs

Clinical factors associated with fatigue over time in paediatric oncology patients receiving chemotherapy

The purpose of this study was to investigate the relationships between clinical factors (including haemoglobin value, chemotherapeutic agents, and corticosteroid use) and changing patterns of fatigue before and for the next 10 days following the start of a new round of chemotherapy in children with cancer. A prospective longitudinal design was used to collect data from 48 paediatric oncology patients who were about to begin a new round of chemotherapy and their parents. Fatigue levels were assessed using multidomain questionnaires with three categories of patient self-report (including ‘General Fatigue', ‘Sleep/Rest Fatigue', and ‘Cognitive Fatigue') and four categories of parent proxy-report (including ‘Lack of Energy', ‘Unable to Function', ‘Altered Sleep', and ‘Altered Mood'). The findings suggest that fatigue from both patient self-report and parent proxy-report changed significantly over time. The major findings from this study are that patients have more problems with fatigue in the first few days after the start of a cycle of chemotherapy. Corticosteroid use and haemoglobin value were associated with significant increases in fatigue that were sustained for several days and reached the highest level of fatigue at day 5 for those receiving concurrent steroids. The association of chemotherapeutic agents with fatigue varied between patient self-report and parent report, but the type of chemotherapeutic agents used was not associated with most changes in fatigue