Unruptured unilateral twin ectopic pregnancy: a rare case report

Unilateral twin ectopic pregnancy is a rare entity with an incidence of 1 in 125,000 pregnancies. This is a case of a 26-year-old primigravida with a spontaneous unilateral twin ectopic gestation, diagnosed on transvaginal ultrasound, treated laparoscopically by doing unilateral salpingectomy and confirmed with histopathology. The doubt for ectopic pregnancy was raised when the serum β-HCG level was constantly >1500 mIU/ml and serum progesterone level was <5 pg/ml and no intrauterine pregnancy was seen. On a follow-up scan, twin gestational sac was noted in right adnexa along with a large haemorrhagic cyst in the right ovary. On post-surgery follow-up, patient was found to have had complete recovery. This case report discusses the incidence and rarity, yet possibility of twin ectopic gestations, the need for early diagnosis and its management

Primary lymphoepithelioma-like carcinoma of the lung in an adolescent girl with unusual presentation

Primary lymphoepithelioma-like carcinoma (LELC) of lung is a rare tumour of lung mostly reported from south-east Asia. It occurs in middle aged persons of either sex and presents with the complaint of cough and haemoptysis.  We report a case of primary LELC of lung in a young girl with unusual presentation

Daksha: On Alert for High Energy Transients

We present Daksha, a proposed high energy transients mission for the study of electromagnetic counterparts of gravitational wave sources, and gamma ray bursts. Daksha will comprise of two satellites in low earth equatorial orbits, on opposite sides of earth. Each satellite will carry three types of detectors to cover the entire sky in an energy range from 1 keV to >1 MeV. Any transients detected on-board will be announced publicly within minutes of discovery. All photon data will be downloaded in ground station passes to obtain source positions, spectra, and light curves. In addition, Daksha will address a wide range of science cases including monitoring X-ray pulsars, studies of magnetars, solar flares, searches for fast radio burst counterparts, routine monitoring of bright persistent high energy sources, terrestrial gamma-ray flashes, and probing primordial black hole abundances through lensing. In this paper, we discuss the technical capabilities of Daksha, while the detailed science case is discussed in a separate paper.Comment: 9 pages, 3 figures, 1 table. Additional information about the mission is available at https://www.dakshasat.in

Science with the Daksha High Energy Transients Mission

We present the science case for the proposed Daksha high energy transients mission. Daksha will comprise of two satellites covering the entire sky from 1~keV to $>1$~MeV. The primary objectives of the mission are to discover and characterize electromagnetic counterparts to gravitational wave source; and to study Gamma Ray Bursts (GRBs). Daksha is a versatile all-sky monitor that can address a wide variety of science cases. With its broadband spectral response, high sensitivity, and continuous all-sky coverage, it will discover fainter and rarer sources than any other existing or proposed mission. Daksha can make key strides in GRB research with polarization studies, prompt soft spectroscopy, and fine time-resolved spectral studies. Daksha will provide continuous monitoring of X-ray pulsars. It will detect magnetar outbursts and high energy counterparts to Fast Radio Bursts. Using Earth occultation to measure source fluxes, the two satellites together will obtain daily flux measurements of bright hard X-ray sources including active galactic nuclei, X-ray binaries, and slow transients like Novae. Correlation studies between the two satellites can be used to probe primordial black holes through lensing. Daksha will have a set of detectors continuously pointing towards the Sun, providing excellent hard X-ray monitoring data. Closer to home, the high sensitivity and time resolution of Daksha can be leveraged for the characterization of Terrestrial Gamma-ray Flashes.Comment: 19 pages, 7 figures. Submitted to ApJ. More details about the mission at https://www.dakshasat.in

Inpatient re-rupture of a middle meningeal arteriovenous fistula after traumatic brain injury

We present a case of a spontaneous second intraparenchymal hemorrhage (IPH) following patient admission for a traumatic brain injury with an initial traumatic IPH. After a subsequent review of all imaging, it was concluded that the patient had a traumatic middle meningeal associated dural arterial venous fistula (MMAVF) which re-ruptured during admission, and the MMAVF was overlooked as a potential contributor to the initial traumatic IPH for which the patient was admitted. A 49-year old man presented with right temporal IPH following an ATV accident and was found to have a right MMAVF on cerebral angiography. The MMAVF appeared on angiography to be unruptured, and therefore was not immediately treated. Later in admission, the patient suffered a new spontaneous IPH ipsilateral to the MMAVF, suggesting a re-rupture. Endovascular transarterial embolization with ethyl vinyl alcohol resulted in complete obliteration of the MMAVF. The patient tolerated treatment well and went on to make a good recovery as of last post-operative imaging at 8 months. Hence, MMAVFs may be present in the setting of IPH following a traumatic brain injury which warrants maintaining a high level of suspicion and low threshold for intervention as they can cause secondary spontaneous intracranial hemorrhage. The absence of notable subdural or extradural hemorrhage on imaging should not exclude rupture. Transarterial embolization with an ethylene vinyl alcohol copolymer is an effective treatment modality

Understanding non-stationarity of hydroclimatic extremes and resilience in Peninsular catchments, India.

Climate change significantly impacts the global hydrological cycle, leading to pronounced shifts in hydroclimatic extremes such as increased duration, occurrence, and intensity. Despite these significant changes, our understanding of hydroclimatic risks and hydrological resilience remains limited, particularly at the catchment scale in peninsular India. This study aims to address this gap by examining hydroclimatic extremes and resilience in 54 peninsular catchments from 1988 to 2011. We initially assess extreme precipitation and discharge indices and estimate design return levels using non-stationary Generalized Extreme Value (GEV) models that use global climate modes (ENSO, IOD, and AMO) as covariates. Further, hydrological resilience is evaluated using a convex model that inputs simulated discharge from the best hydrological model among SVM, RVM, random forest, and a conceptual model (abcd). Our analysis shows that the spatial patterns of mean extreme precipitation indices (R1 and R5) mostly resemble with extreme discharge indices (Q1 and Q5). Additionally, all extreme indices, including R1, Q1, R5, and Q5, demonstrate non-stationary behavior, indicating the substantial influence of global climate modes on extreme precipitation and flooding across the catchments. Our results indicate that the random forest model outperforms the others. Furthermore, we find that 68.52% of the catchments exhibit low to moderate hydrological resilience. Our findings emphasize the importance of understanding hydroclimatic risks and catchment resilience for accurate climate change impact predictions and effective adaptation strategies

Dysphagia as initial presentation of primary amyloidosis

Amyloidosis involves all parts of the gastrointestinal tract including the esophagus. The esophageal involvement in amyloidosis has been reported to vary from 13% in a radiology study to 22% in an autopsy series; however, such patients have symptoms of gastroesophageal reflux. Dysphagia is an uncommon presentation of amyloidosis. We report a 64-year-old patient who presented with progressive dysphagia of 4 months duration which was confirmed to be due to primary amyloidosis with multiple myeloma. The esophageal involvement by amyloidosis was confirmed by esophageal mucosal biopsies, and 22-channel high-resolution manometry

Bayesian Estimation for Logarithmic Transformed Exponential Distribution under Different Loss Functions

The aim of the present article is to find the better estimator for the parameter of logarithmic transformed exponential distribution using informative and non-informative prior under squared error, linex and general entropy loss functions. The performances of these proposed estimators have been compared based on their simulated risk

Retrieval of cloud ice water path using SAPHIR on board Megha-Tropiques over the tropical ocean

The SAPHIR sensor onboard Megha-Tropiques (MT) measures the earth emitted radiation at frequencies near the water vapor absorption band. SAPHIR operates in six frequencies ranging from 183 +/- 0.1 to 183 +/- 11 GHz. These frequencies have been used to retrieve cloud ice water path (IWP) at a very high resolution. A method to retrieve IWP over the Indian ocean region is attempted in this study. The study is in two parts, in first part a radiative transfer based simulation is carried out to give an insight of using SAPHIR frequency channels for IWP retrieval, in the next part the real observations of SAPHIR and TRMM-TMI was used for IWP retrieval. The concurrent observations of SAPHIR brightness temperatures (Tbs) and TRMM TMI IWP were used in the development of the retrieval algorithm. An Eigen Vector analysis was done to identify weight of each channel in retrieving IWP; following this a two channel regression based algorithm was developed. The SAPHIR channels which are away from the water vapor absorption band were used to avoid possible water vapor contamination. When the retrieval is compared with independent test dataset, it gives a correlation of 0.80 and RMSE of 3.5%. SAPHIR derived IWP has been compared with other available global IWP products such as TMI, MSPPS, Cloud Sat and GPM-GMI qualitatively as well as quantitatively. PDF comparison of SAPHIR derived IWP found to have good agreement with CloudSat. Zonal mean comparison with recently launched GMI shows the strength of this algorithm. (C) 2017 COSPAR. Published by Elsevier Ltd. All rights reserved