Development of skin hypopigmentation in a patient with metastatic papillary carcinoma thyroid treated with Sorafenib.

Background: Sorafenib can be considered as the effective option of treatment in patients with metastatic radioiodine refractory differentiated thyroid cancers. The cutaneous manifestations of Sorafenib include rash, desquamation, hand foot skin reactions, pruritus, alopecia and erythema. We report the first case of hypopigmentation related to sorafenib therapy. Case presentation: We report the case of a middle aged gentleman with metastatic papillary carcinoma of thyroid diagnosed in 2005. He was managed with total thyroidectomy, radioactive iodine and TSH suppressive therapy. Despite receiving radioactive iodine 530 mci cumulative dose, patient had persistant disease with lung metastasis. Therefore a TKI, sorafenib, was started. He developed hypopigmentation of the skin more prominent on face six weeks after starting sorafenib treatment.He also developed diarrhea, desquamation of hands and feet, hair loss over scalp, eye brows and moustache. Sorafenib treatment was discontinued. His diarrhea stopped in one week and after four weeks his skin became normalized whereas he regained his hairs in six weeks. Conclusion: To our knowledge, hypopigmentation in our patient appears to be the first reported of its kind in the literature to date. Sorafenib is used in Renal cell carcinoma, Hepatcellular carcinoma and radioactive iodine refractory thyroid carcinoma therefore it is very important to be aware of hypopigmentation as a potential side effect for both physicians and patients

Extracranial Meningioma: an Unusual Presentation of a Mass Over Inner Canthus of Left Eye

ABSTRACT Meningiomas are commonly encountered as intracranial brain tumours, but extracranial meningiomas do occur although seen rarely. Here we present a case of extracranial meningioma presenting as a mass over the medial canthus of left eye and the glabella with extension into the left ethmoid sinuses, without any neurological symptoms or signs. The patient underwent surgical excision, plastic surgical reconstruction and adjuvant radiotherapy after 3-dimensional conformal treatment planning

Giant cell reparative granuloma of temporal bone: Case report of a 62-year-old male

Giant cell reparative granuloma (GCRG) is an uncommon non‑neoplastic reactive tumor which occurs almost exclusively within the mandible and maxilla. GCRG of the temporal bone is a rare condition. It has been found to affect predominantly adolescents and adults (age: 10‑25 years). We report a case of a 62‑year‑old male with GCRG of left temporal bone who presented to us with progressive left temporal swelling for 3 months. It was associated with hearing loss. There was no history of trauma. A non‑contrast computed tomography scan brain showed a locally destructive lesion involving squamous temporal bone closely related to the left temporal lobe and infratemporal fossa. Magnetic resonance imaging brain with contrast showed a hypointense lesion on T1 and with peripheral contrast enhancement after gadolinium injection. Patient underwent left temporal craniotomy with atticotomy, mastoidectomy, duraplasty, and opening of middle ear and temporomandibular joint. A bone graft was then taken from right iliac crest and used to repair the resulting defect. Final histopathology report confirmed GCRG. We discuss radiological and histopathological features of lesion in this case report

Analytical study of reaction diffusion Lengyel-Epstein system by generalized Riccati equation mapping method

In this study, the Lengyel-Epstein system is under investigation analytically. This is the reaction–diffusion system leading to the concentration of the inhibitor chlorite and the activator iodide, respectively. These concentrations of the inhibitor chlorite and the activator iodide are shown in the form of wave solutions. This is a reaction†“diffusion model which considered for the first time analytically to explore the different abundant families of solitary wave structures. These exact solitary wave solutions are obtained by applying the generalized Riccati equation mapping method. The single and combined wave solutions are observed in shock, complex solitary-shock, shock singular, and periodic-singular forms. The rational solutions also emerged during the derivation. In the Lengyel-Epstein system, solitary waves can propagate at various rates. The harmony of the system’s diffusive and reactive effects frequently governs the speed of a single wave. Solitary waves can move at a variety of speeds depending on the factors and reaction kinetics. To show their physical behavior, the 3D and their corresponding contour plots are drawn for the different values of constants

Numerical study of diffusive fish farm system under time noise

In the current study, the fish farm model perturbed with time white noise is numerically examined. This model contains fish and mussel populations with external food supplied. The main aim of this work is to develop time-efficient numerical schemes for such models that preserve the dynamical properties. The stochastic backward Euler (SBE) and stochastic Implicit finite difference (SIFD) schemes are designed for the computational results. In the mean square sense, both schemes are consistent with the underlying model and schemes are von Neumann stable. The underlying model has various equilibria points and all these points are successfully gained by the SIFD scheme. The SIFD scheme showed positive and convergent behavior for the given values of the parameter. As the underlying model is a population model and its solution can attain minimum value zero, so a solution that can attain value less than zero is not biologically possible. So, the numerical solution obtained by the stochastic backward Euler is negative and divergent solution and it is not a biological phenomenon that is useless in such dynamical systems. The graphical behaviors of the system show that external nutrient supply is the important factor that controls the dynamics of the given model. The three-dimensional results are drawn for the various choices of the parameters

Necrotizing fasciitis of head & neck: the Pakistani experience

Necrotizing fasciitis is a potentially life threatening, rapidly spreading polymicrobial infection rarely seen in the head and neck region. We present our experience of managing five patients with necrotizing fasciitis of head and neck at the Aga Khan University Hospital, Karachi, Pakistan. One patient had necrotizing fasciitis of the facial region only; three had necrotizing fasciitis of the neck region; and one patient had necrotizing fasciitis of the neck with extension to the chest. None of these patients was immunocompromised. Dental foci of infection was the root cause in three of the patients. Imaging was not only diagnostic but also helped to identify the extent of the disease. All five patients had early extensive multiple debridments, and received multiple antibiotic therapy and intensive care support. Four patients survived. We conclude that necrotizing fasciitis is a very aggressive infection, which may be misdiagnosed unless imaging examination is performed early. Aggressive medical and surgical treatment results in good survival but extension of disease beyond the neck into the chest carries a poor prognosis

Unlocking the secrets of pressure-driven physical properties of NaNbO3 perovskite-oxide: A computational insight

The current investigation presents the various pressure-induced properties such as structural, elastic, mechanical, optical, and electronic features of NaNbO3 across a pressure range of 0.0–100 GPa. Utilizing the CASTEP tool alongside GGA-PBE based on DFT, comprehensive calculations are conducted. The material displays an indirect energy bandgap, with its magnitude increasing from 1.633 to 2.223 eV under rising pressure. Analysis reveals a covalent character in O–Nb bonds, while O–O and Na–O interactions exhibit an ionic nature. As pressure rises, both lattice parameters and volume exhibit a tendency to decrease. Interestingly, the material exhibits anisotropic behaviour and maintains mechanical stability, transitioning from brittleness at 0.0 GPa to ductility between 10 and 100 GPa. Additionally, it demonstrates superhard characteristics at 0.0–20 GPa and progresses to an ultrahard state from 30 to 100 GPa. Optical properties display a trend of sharpening peaks with a slight shift towards higher energy in the curves. Notably, the material's indirect bandgap renders it suitable for prolonged photocatalysis applications

Pressure-induced physical properties of KNbO3 using first-principles calculations for photocatalytic application

The current research work theoretically presents various pressure-induced physical properties of potassium niobate with a cubic structure of 2 × 2 × 2 optimized supercell. The employed exchange-correlation function is GGA with the PBE approach in the DFT-based CASTEP simulation tool. The noted bandgap exhibits a rising trend from 1.518 eV to 2.013 eV with an indirect semiconductor nature and this energy bandgap nature remains the same throughout under the external isotropic static pressure effect. The pressure-induced total and partial density of states were studied to confirm the degree of localized electrons in various bands. Moreover, according to Born stability criteria potassium niobate is found mechanically stable and possesses an anisotropic nature. It exhibits brittle nature at 0.00 GPa and 10 GPa whereas it is found ductile from 20 GPa to 100 GPa. It exhibits a super-hard nature from 0.0 to 30 GPa and an ultra-hard nature from 40 to 100 GPa. The Debye temperature and melting temperature increase as pressure rises. Furthermore, several optical features were examined under the effect of pressure, and it was observed that the optical curves slightly shifted toward higher energies with increasing pressure. The overall analysis exhibits that KNbO3 is a promising material for long-term photocatalytic activity

A DFT study for physical properties and hydrogen storage capability of indium-based hydride perovskites XInH3 (X = Li, K) for hydrogen storage application

The physical properties and hydrogen storage capability of indium-based hydride perovskites XInH3 (X = Li, K) have been assessed in the present study. The HSE06 hybrid functional inside the CASTEP code based on DFT is used for the investigation of both materials. Both the compounds are found thermodynamically stable which is confirmed by the phonon dispersion curves. The negative values of the cohesive energy also show that both the materials are thermodynamically stable. Both the materials have zero band gap and possess metallic nature with the lattice constant values of 4.37 and 4.32 Å for LiInH3 and KInH3, respectively. The spin polarized band structure and density of states show that both the materials have antiferromagnetic nature. The optical properties show that both materials have a higher absorption and conductivity in the lower energy region. LiInH3 possesses higher values of static reflectivity and refractive index than KInH3. Both the materials are found mechanically stable, anisotropic, hard, and ductile in nature. The value of gravimetric ratio is found to be 2.42% and 1.92% for LiInH3 and KInH3, respectively. Both the materials can store sufficient hydrogen, however, LiInH3 is recommended as a preferred material for hydrogen storage application