An atypical manifestation of lateral medullary syndrome

Lateral medullary syndrome is a common brainstem stroke associated with a classical triad of Horner's Syndrome, ipsilateral ataxia and hypalgesia and thermoanasthesia of ipsilateral face.We report a case of a 49-year-old diabetic, non-hypertensive, postmenopausal female who presented with symptoms involving the left dorsal medulla along with right sided hemiparesis and left UMN-type facial palsy. Contralateral hemiparesis was explained by caudal extension of infarct involving the pyramids before decussation at the medulla, known as Babinski-Nageotte Syndrome. UMN-type facial palsy was attributed to involvement of hypothetical supranuclear aberrant corticobulbar fibres of facial nerve which descend down in the contralateral ventromedial medulla, decussate at level of upper medulla and then ascend in the dorsolateral medulla to reach the facial nerve nucleus. Association of these two entities with Wallenberg's Syndrome have been reported separately in literature, but not together as in this case. © The Author(s) 2019

Is Attention always needed? A Case Study on Language Identification from Speech

Language Identification (LID) is a crucial preliminary process in the field of Automatic Speech Recognition (ASR) that involves the identification of a spoken language from audio samples. Contemporary systems that can process speech in multiple languages require users to expressly designate one or more languages prior to utilization. The LID task assumes a significant role in scenarios where ASR systems are unable to comprehend the spoken language in multilingual settings, leading to unsuccessful speech recognition outcomes. The present study introduces convolutional recurrent neural network (CRNN) based LID, designed to operate on the Mel-frequency Cepstral Coefficient (MFCC) characteristics of audio samples. Furthermore, we replicate certain state-of-the-art methodologies, specifically the Convolutional Neural Network (CNN) and Attention-based Convolutional Recurrent Neural Network (CRNN with attention), and conduct a comparative analysis with our CRNN-based approach. We conducted comprehensive evaluations on thirteen distinct Indian languages and our model resulted in over 98\% classification accuracy. The LID model exhibits high-performance levels ranging from 97% to 100% for languages that are linguistically similar. The proposed LID model exhibits a high degree of extensibility to additional languages and demonstrates a strong resistance to noise, achieving 91.2% accuracy in a noisy setting when applied to a European Language (EU) dataset.Comment: Accepted for publication in Natural Language Engineerin

BRUCELLAR UVEITIS IN EASTERN INDIA

Objective: Brucellosis- one of the major zoonotic diseases, still remains an uncontrolled problem, in regions of high endemicity. Ophthalmic brucellosis is not studied and overlooked in most developing countries.  Considering the severe outcome of undiagnosed ophthalmic brucellosis, in this paper we made attempts to find out whether this disease still remains a health problem in a South East Asian developing country, where study of this disease is largely neglected.  Methods This study was carried out over a one year period from January 2015 to December 2015. Blood samples were collected from clinically confirmed cases of uveitis and they were subjected to five serological and one genus specific molecular investigations, for the detection of Brucella infection.Results Out of 20 uveitis cases, 4 (20%) cases confirmed as brucellar uveitis, by serological tests followed by PCR confirmation. After treatment of brucellosis all the four patients were recovered uneventfully.Conclusion: Brucella infection involving the eye is still a significant problem in South East Asian countries; hence in all uveitis cases in this reason brucellosis should be excluded by available laboratory tests.Government of India (Dept. of Biotechnology the major zoonotic diseases, still remains an uncontrolled problem, in regions of high endemicity. Ophthalmic brucellosis is not studied and overlooked in most developing countries.  Considering the severe outcome of undiagnosed ophthalmic brucellosis, in this paper we made attempts to find out whether this disease still remains a health problem in a South East Asian developing country, where study of this disease is largely neglected.   Methods This study was carried out over a one year period from January 2015 to December 2015. Blood samples were collected from clinically confirmed cases of uveitis and they were subjected to five serological and one genus specific molecular investigations, for the detection of Brucella infection.Results Out of 20 uveitis cases, 4 (20%) cases confirmed as brucellar uveitis, by serological tests followed by PCR confirmation. After treatment of brucellosis all the four patients were recovered uneventfully.Conclusion: Brucella infection involving the eye is still a significant problem in South East Asian countries; hence in all uveitis cases in this reason brucellosis should be excluded by available laboratory tests

Leptospirosis complicated with meningoencephalitis and pancreatitis – A case report

In severe leptospirosis multi organ involvement is common. Pancreatitis and meningo encephalitis are two\ud uncommon manifestations of leptospirosis. Our patient presented with fever, jaundice, altered sensorium and\ud subsequently developed severe pain abdomen. He was finally diagnosed as having icteic leptospirosis\ud complicated with pancreatitis and meningoencephalitis. Simultaneous presence of these two complications in a\ud patient of leptospirosis probably not been documented before

Certified Organization, Volume3, Special Issue 6

ABSTRACT: This paper illustrates the designing of microstrip patch antenna utilizing defected ground structure. The major purpose of designing such kind of antenna is to attain multiband purpose which is vital for requirement of technology nowadays. Initiation of such kind of antenna with imperfect structure of ground increases the antenna functioning. In this case the ground element of the recommended antenna is regarded as defected ground structure (DGS). Moreover the optimization of this kind of antenna is made so as to achieve a return loss of -10db. Furthermore in comparison to simple ground, the recommended design augments the bandwidth and develops the input return loss of the antenna. The antenna design parameters and performances have been studied by means of simulations. The substrate utilized behind designing is of glass with a dielectric constant of 2.2. Moreover the design invariants of antenna consist of single layer thickness of 2mm as well as operating frequency of 4 GHz. The design was optimized so that we can get the finest probable effect. To conclude the microstrip antenna without DGS effects in narrow bandwidth with high return loss. In contrast, microstrip antenna with DGS offers higher operating bandwidth with less return loss

Management Outcomes of Large Renal Angiomyolipoma Presenting with Wunderlich Syndrome—Experience from a Tertiary Center

Renal angiomyolipoma is an uncommon, benign-mixed mesenchymal tumor consisting of thick-walled blood vessels, smooth muscles, and mature adipose tissues. Twenty percent of these tumors are associated with tuberous sclerosis. Wunderlich syndrome (WS), an acute nontraumatic spontaneous perirenal hemorrhage, can be a presentation of large angiomyolipoma. This study evaluated the presentation, management, and complications of renal angiomyolipoma with WS in eight patients who presented to the emergency department between January 2019 and December 2021. The presenting symptoms included flank pain, palpable mass, hematuria, and bleeding in the perinephric space on computerized tomography. Demographic data, symptoms at presentation, comorbidities, hemodynamic parameters, the association with tuberous sclerosis, transfusion requirements, need for angioembolization, surgical management, Clavien–Dindo complication, duration of hospital stay, and 30-day readmission rates were evaluated. The mean age of presentation was 38 years. Of the eight patients, five (62.5%) were females and 3(37.5%) were males. Two (25%) patients had tuberous sclerosis with angiomyolipoma, and three (37.5%) patients presented with hypotension. The mean packed cell transfusion was three units, and the mean tumor size was 7.85 cm (3.5–25 cm). Three of them (37.5%) required emergency angioembolization to prevent exsanguination. Embolization was unsuccessful in one patient (33%) who underwent emergency open partial nephrectomy, and one (33%) patient developed post-embolization syndrome. A total of six patients underwent elective surgery—four underwent partial nephrectomy (laparoscopic - 1, robotic - 1, open - 2) and two underwent open nephrectomy. Three patients encountered Clavien–Dindo complications (Grade 1, n = 2 and IIIA, n = 2). WS is a rare, life-threatening complication in patients with large angiomyolipoma. Judicious optimization, angioembolization, and prompt surgical intervention will help deliver better outcomes

Cerebral infarction: an unusual manifestation of viper snake bite

Snake envenomation causes significant mortality and morbidity. Viper bite usually present with local cellulites, renal failure and bleeding disorders. Thrombotic manifestation of snake bite is rarely reported and early administration of Anti-Snake Venom Serum (ASV) also reduces the risk of thrombotic complications. Cerebral infarction in case of viper bite may be due to hypotension, hypercoagulability or direct action of venom on vessel wall. We report a rare case of viper bite, presented with renal failure and cerebral infarction in spite of early ASV institution. The thrombotic manifestation in this case was possibly due to disseminated intravascular coagulation