A Case of Multiple Sclerosis Presenting as Eight and Half Syndrome.

Multiple sclerosis (MS) is a chronic disease characterized by inflammation, demyelination, gliosis (scarring), and neuronal loss; the course can be relapsing-remitting or progressive. Manifestations of MS vary from a benign illness to a rapidly evolving and incapacitating disease requiring profound lifestyle adjustments. We report a 24 year old female who presented with right internuclear ophthalmoplegia with right lower motor neuron facial nerve palsy which is called eight and half syndrome. The etiology in our patient was multiple sclerosis which was confirmed by radio-imaging studies. Patient improved on pulse therapy of methyl prednisolone and tapering dose of steroids

An in vitro study of the effect of design of repair surface on the transverse strength of repaired acrylic resin using autopolymerizing resin

Statement of Problem: The fracture of complete denture is a common occurrence in the field of prosthodontics. Often if all other criteria are met such as good aesthetics, occlusion, and functionality; denture repair is acceptable. Once denture fractures, we would want the joint surface strength to be as good as original.Purpose: The purpose of this study was to determine the effect of different repair surface design on the transverse strength of repaired acrylic denture resin.Materials and Methods: Sixty specimens of heat‑cured acrylic resin of dimension 65 mm × 20 mm × 2.5 mm were prepared using a special die. Transverse strength of 15 samples was calculated which serves as a control group. Three different types of joint surface contours were prepared each having 15 samples each as butt, round, and rabbet joint. Transverse strength of three joint contours was then compared with control group and also they were compared with each other and result was statistically analyzed with one‑way analysis of variance (ANOVA) and Post‑hoc ANOVA Tukey’s HSD test at 5% level of significance. Z‑test of proportion was also done for types of failures.Result: Transverse strength of original specimen was higher than that of repaired specimens. Transverse strength of round joint was higher than the butt and rabbet joint.Conclusion: Methods of repair have significant effect on strength of repaired denture. Round joint design of repair technique was far superior.Key words: Autopolymerizing resin, rabbet joint, transverse strengt

Himalayan P waves in COPD - A Rare Feature

Himalayan or giant P-waves (amplitude =5 mm) are often known to be classically associated with congenital heart diseases with right to left shunt like tricuspid atresia, Ebstein anomaly, combined tricuspid and pulmonic stenosis, etc, where they indicate a dilated right atrium and tend to be persistent. These type P waves are rarely seen in chronic obstructive pulmonary disease (COPD) and in this condition it may be due to structural right atrial changes or hypoxemia or combination of both. Here we report a case of COPD with Himalayan P waves which is a rare entity

Hirayama Disease - A Variant of Motor Neuron Disease and Role of Flexion MRI in Diagnosis

Hirayama disease is a monomyelic variant of motor neuron disease (MND) and has distinctive features of male predominance, asymmetric involvement of upper extremities with a self limiting course. Flexion MRI (magnetic resonance imaging) forms the main stay for diagnosis of this condition. Here we report such an unusual case of Hirayama disease in a male patient of 20 years who presented with weakness and atrophy in right upper limb. Careful clinical examination will help to use the flexion MRI studies for the diagnosis of this condition as done in our case

Otalgia and eschar in the external auditory canal in scrub typhus complicated by acute respiratory distress syndrome and multiple organ failure

<p>Abstract</p> <p>Background</p> <p>Scrub typhus, a mite-transmitted zoonosis caused by <it>Orientia tsutsugamushi</it>, is an endemic disease in Taiwan and may be potentially fatal if diagnosis is delayed.</p> <p>Case presentations</p> <p>We encountered a 23-year-old previously healthy Taiwanese male soldier presenting with the right ear pain after training in the jungle and an eleven-day history of intermittent high fever up to 39°C. Amoxicillin/clavulanate was prescribed for otitis media at a local clinic. Skin rash over whole body and abdominal cramping pain with watery diarrhea appeared on the sixth day of fever. He was referred due to progressive dyspnea and cough for 4 days prior to admission in our institution. On physical examination, there were cardiopulmonary distress, icteric sclera, an eschar in the right external auditory canal and bilateral basal rales. Laboratory evaluation revealed thrombocytopenia, elevation of liver function and acute renal failure. Chest x-ray revealed bilateral diffuse infiltration. Doxycycline was prescribed for scrub typhus with acute respiratory distress syndrome and multiple organ failure. Fever subsided dramatically the next day and he was discharged on day 7 with oral tetracycline for 7 days.</p> <p>Conclusion</p> <p>Scrub typhus should be considered in acutely febrile patients with multiple organ involvement, particularly if there is an eschar or a history of environmental exposure in endemic areas. Rapid and accurate diagnosis, timely administration of antibiotics and intensive supportive care are necessary to decrease mortality of serious complications of scrub typhus.</p

Differential expression of collectins in human placenta and role in inflammation during spontaneous Labor.

© 2014 Yadav et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.Collectins, collagen-containing Ca2+ dependent C-type lectins and a class of secretory proteins including SP-A, SP-D and MBL, are integral to immunomodulation and innate immune defense. In the present study, we aimed to investigate their placental transcript synthesis, labor associated differential expression and localization at feto-maternal interface, and their functional implication in spontaneous labor. The study involved using feto-maternal interface (placental/decidual tissues) from two groups of healthy pregnant women at term (≥37 weeks of gestation), undergoing either elective C-section with no labor ('NLc' group, n = 5), or normal vaginal delivery with spontaneous labor ('SLv' group, n = 5). The immune function of SP-D, on term placental explants, was analyzed for cytokine profile using multiplexed cytokine array. SP-A, SP-D and MBL transcripts were observed in the term placenta. The 'SLv' group showed significant up-regulation of SP-D (p = 0.001), and down-regulation of SP-A (p = 0.005), transcripts and protein compared to the 'NLc' group. Significant increase in 43 kDa and 50 kDa SP-D forms in placental and decidual tissues was associated with the spontaneous labor (p<0.05). In addition, the MMP-9-cleaved form of SP-D (25 kDa) was significantly higher in the placentae of 'SLv' group compared to the 'NLc' group (p = 0.002). Labor associated cytokines IL-1α, IL-1β, IL-6, IL-8, IL-10, TNF-α and MCP-1 showed significant increase (p<0.05) in a dose dependent manner in the placental explants treated with nSP-D and rhSP-D. In conclusion, the study emphasizes that SP-A and SP-D proteins associate with the spontaneous labor and SP-D plausibly contributes to the pro-inflammatory immune milieu of feto-maternal tissues.Funding provided by BT/PR15227/BRB/10/906/2011) Department of Biotechnology (DBT), Government of India http://dbtindia.nic.in/index.asp (TM) and Indian Council of Medical Research (ICMR) Junior Research Fellowship (JRF)/Senior Research Fellowship (SRF), Government of India, www.icmr.nic.in (AKY)

Gadolinium oxide nanocrystal nonvolatile memory with HfO2/Al2O3 nanostructure tunneling layers

In this study, Gd2O3 nanocrystal (Gd2O3-NC) memories with nanostructure tunneling layers are fabricated to examine their performance. A higher programming speed for Gd2O3-NC memories with nanostructure tunneling layers is obtained when compared with that of memories using a single tunneling layer. A longer data retention (< 15% charge loss after 104 s) is also observed. This is due to the increased physical thickness of the nanostructure tunneling layer. The activation energy of charge loss at different temperatures is estimated. The higher activation energy value (0.13 to 0.17 eV) observed at the initial charge loss stage is attributed to the thermionic emission mechanism, while the lower one (0.07 to 0.08 eV) observed at the later charge loss stage is attributed to the direct tunneling mechanism. Gd2O3-NC memories with nanostructure tunneling layers can be operated without degradation over several operation cycles. Such NC structures could potentially be used in future nonvolatile memory applications

Genome-wide association study for type 2 diabetes in Indians identifies a new susceptibility locus at 2q21

Meta-AnalysisThis is the final version of the article. Available from the American Diabetes Association via the DOI in this record.Indians undergoing socioeconomic and lifestyle transitions will be maximally affected by epidemic of type 2 diabetes (T2D). We conducted a two-stage genome-wide association study of T2D in 12,535 Indians, a less explored but high-risk group. We identified a new type 2 diabetes-associated locus at 2q21, with the lead signal being rs6723108 (odds ratio 1.31; P = 3.32 × 10⁻⁹). Imputation analysis refined the signal to rs998451 (odds ratio 1.56; P = 6.3 × 10⁻¹²) within TMEM163 that encodes a probable vesicular transporter in nerve terminals. TMEM163 variants also showed association with decreased fasting plasma insulin and homeostatic model assessment of insulin resistance, indicating a plausible effect through impaired insulin secretion. The 2q21 region also harbors RAB3GAP1 and ACMSD; those are involved in neurologic disorders. Forty-nine of 56 previously reported signals showed consistency in direction with similar effect sizes in Indians and previous studies, and 25 of them were also associated (P < 0.05). Known loci and the newly identified 2q21 locus altogether explained 7.65% variance in the risk of T2D in Indians. Our study suggests that common susceptibility variants for T2D are largely the same across populations, but also reveals a population-specific locus and provides further insights into genetic architecture and etiology of T2D.The major funding for this work comes from Council for Scientific and Industrial Research, Government of India, in the form of the grant “Diabetes mellitus—New drug discovery R&D, molecular mechanisms, and genetic and epidemiological factors” (NWP0032-19). R.T. received a postdoctoral fellowship from the Fogarty International Center and the Eunice Kennedy Shriver National Institute of Child Health and Human Development at the National Institutes of Health (D43-HD-065249)

Azimuthal anisotropy and correlations at large transverse momenta in p+pp+p and Au+Au collisions at sNN\sqrt{s_{_{NN}}}= 200 GeV

Results on high transverse momentum charged particle emission with respect to the reaction plane are presented for Au+Au collisions at $\sqrt{s_{_{NN}}}$= 200 GeV. Two- and four-particle correlations results are presented as well as a comparison of azimuthal correlations in Au+Au collisions to those in $p+p$ at the same energy. Elliptic anisotropy, $v_2$, is found to reach its maximum at $p_t \sim 3$ GeV/c, then decrease slowly and remain significant up to $p_t\approx 7$ -- 10 GeV/c. Stronger suppression is found in the back-to-back high-$p_t$ particle correlations for particles emitted out-of-plane compared to those emitted in-plane. The centrality dependence of $v_2$ at intermediate $p_t$ is compared to simple models based on jet quenching.Comment: 4 figures. Published version as PRL 93, 252301 (2004