Isolated hydatid cyst of adrenal gland with hypertension mimicking Conn’s syndrome: a very rare case

Hydatid cyst of the adrenal gland is one of the rare conditions caused by the larval stage of Echinococcus granulosus. The incidence of adrenal gland involvement is less than 1% of all hydatid disease in humans and isolated adrenal involvement is extremely rare. Hydatid disease is frequent in endemic regions and sheep farming areas with equal sex distribution. Here, a case of 23 year old female with isolated adrenal gland hydatid cyst is presented, that was evaluated clinically, investigated radiographicaly and by blood investigations and finally histopathology confirmed the diagnosis. No complications occurred at peri and postoperative period. The patient was given 6 cycles of albendazole (10 mg/kg in two divided doses), each for a period of four weeks followed by a week’s rest. The patient is on regular follow-up without recurrence in last 1 year

Percutaneous nephrolithotripsy for renal pelvis stone in a crossed fused ectopic kidney: a case report

Crossed renal ectopia is the second most common fusion anomaly of the kidney after horseshoe kidney. The incidence of both fused and unfused cases is 1 in 7000 in autopsies. Percutaneous nephrolithotripsy (PCNL) is a well-established technique in the surgical management of nephrolithiasis. The conventional fluoroscopic guidance of PCNL will be of limited value in ectopic anomalous kidneys due to the abnormal anatomical landmarks with consequent compromise of the procedure’s safety.  A 30-year old male patient, previously healthy, presented to our urology outpatient clinic complaining of dull flank pain of six month duration with tenderness in the right renal area and an enlarged right kidney and 1 episode of gross haematuria. Radiological investigations showed left side crossed ectopia with nephrolithiasis. Patient was managed successfully by fluoroscopic guided percutaneous nephrolithotripsy. The position of the stone-containing ectopic kidney can make it easy to reach the pelvis of the target kidney without injuring any adjoining structure. The superimposition of the different soft tissue densities in the radiologic view may limit the ability of the operator to distinguish between different tissue identities. Laparoscopic guidance can represent as a practical solution to this technical problem

Variation of Sensitivity of a MEMS Capacitive Accelerometer Based Microphone with Suspension System Topology

The present research seeks to improve a highly sensitive MEMS capacitive accelerometer as a probable completely implantable hearing aid microphone. The research analyses the effect of different suspension system topologies on accelerometer efficiency. The topology of folded beam suspension is considered to be the most suitable for the proposed system. The design factors such as weight, height and resonant frequency are considered to make the accelerometer an effective biomedical system which can be completely implanted with COMSOL MULTIPHYSICS 4.2 the optimized system is simulated and validated. The accelerometer occupies 1mm2 of sensing area and achieves a nominal capacitance of 5.30 pF and an optimized capacitive sensitivity of 6.89fF

Groundwater recharge sources in the Gandak alluvial aquifer, NE India : how important is leakage from irrigation canals?

Alluvial sediments in the Indo-Gangetic Basin (IGB) form one of the world’s largest and most heavily used aquifer systems. There is clear evidence for overabstraction and/or groundwater contamination in some parts of the IGB, but not in others. The hydrogeology and external influences on groundwater across the aquifer are complex and diverse. Of these influences, the role of leakage from irrigation canals is now a fundamental part of groundwater dynamics in the IGB aquifer. In some areas, aquifer recharge contains a high proportion of canal leakage (Joshi et al. 2018), but in others it is much less (Lapworth et al. 2015). The Gandak, in NE India, is a sub catchment of the IGB and provides an excellent laboratory for studying the evolution of groundwater-river-canal dynamics in the centre of the basin. Our study, carried out as part of the joint UK-India funded CHANSE project, is the first detailed investigation of the hydrochemistry, stable isotopes and residence time of groundwater in the Gandak aquifer, to quantify the contribution of recharge to the aquifer from canal leakage, the Gandak River and local monsoon rainfall; and to characterise groundwater flow and mixing behaviour

Coordinating across chaos: The practice of transnational internet security collaboration

This dissertation explores transnational security provisioning on/for the internet. A unique framework of analysis is established that melds traditional understandings of security drawn from computing disciplines with levels of analysis from international relations (IR) theory. This helps bridge the gap between IR security literature that often places the State at the center of analysis with the system of distributed agency often called a “patchwork” that underlies security provisioning on/for the Internet. This results in the Information Centered IR Security Model (ICIRS pronounced Icarus). The recognition and remediation of large-scale issues on/for the Internet is shown to be a form of social practice which has instantiated a community of practice. Data across cases of malware recognition and remediation are used to establish a historical context for the provisioning of security on/for the Internet and to analyze the modern provisioning context. It is concluded that an information security community of practice has arisen as consequence of the Internet’s early structure while evolving through various important security events. That community is embedded within the functional structure of the Internet and, through the maintenance of professional social relations, individuals within the community can act both as sensors to recognize emerging threats and as agents to remediate such threats thus wielding an important dimension of power in a connected world.Ph.D

Combined scleral buckling and phacoemulsification

Aims: To analyze the outcome of combined scleral buckling and phacoemulsification for primary rhegmatogenous retinal detachment and visually significant cataract. Settings and Design: Retrospective, interventional case series. Materials and Methods: Retrospective review of patients with primary rhegmatogenous detachment with or without proliferative vitreoretinopathy (PVR) changes and visually significant cataract who underwent combined scleral buckling and phacoemulsification with or without intraocular lens (IOL) implantation between 1991 and 2006. Of the ten eyes, all underwent phacoemulsification and five eyes had posterior chamber Intraocular lens (PC IOL) implantation. All eyes underwent scleral buckling with solid silicone explant combined with #240 encircling band. Subretinal fluid (SRF) drainage was done in five eyes Results: Four eyes improved to better than 6/12 at a mean follow-up of 9 months. Anatomical success was achieved in all eyes (100%). Conclusion: Combined scleral buckling and phacoemulsification is a safe and effective procedure that spares the patient the burden of repeated surgeries. It may be considered as a treatment option in selected cases of rhegmatogenous retinal detachment with significant cataract with/without early PVR

Percutaneous nephrolithotripsy for renal pelvis stone in a crossed fused ectopic kidney: a case report

Crossed renal ectopia is the second most common fusion anomaly of the kidney after horseshoe kidney. The incidence of both fused and unfused cases is 1 in 7000 in autopsies. Percutaneous nephrolithotripsy (PCNL) is a well-established technique in the surgical management of nephrolithiasis. The conventional fluoroscopic guidance of PCNL will be of limited value in ectopic anomalous kidneys due to the abnormal anatomical landmarks with consequent compromise of the procedure’s safety.  A 30-year old male patient, previously healthy, presented to our urology outpatient clinic complaining of dull flank pain of six month duration with tenderness in the right renal area and an enlarged right kidney and 1 episode of gross haematuria. Radiological investigations showed left side crossed ectopia with nephrolithiasis. Patient was managed successfully by fluoroscopic guided percutaneous nephrolithotripsy. The position of the stone-containing ectopic kidney can make it easy to reach the pelvis of the target kidney without injuring any adjoining structure. The superimposition of the different soft tissue densities in the radiologic view may limit the ability of the operator to distinguish between different tissue identities. Laparoscopic guidance can represent as a practical solution to this technical problem

Exploring the Immunomodulatory Aspect of Mesenchymal Stem Cells for Treatment of Severe Coronavirus Disease 19

Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) is an enveloped, positive sense, single stranded RNA (+ssRNA) virus, belonging to the genus Betacoronavirus and family Coronaviridae. It is primarily transmitted from infected persons to healthy ones through inhalation of virus-laden respiratory droplets. After an average incubation period of 2–14 days, the majority of infected individuals remain asymptomatic and/or mildly symptomatic, whereas the remaining individuals manifest a myriad of clinical symptoms, including fever, sore throat, dry cough, fatigue, chest pain, and breathlessness. SARS-CoV-2 exploits the angiotensin converting enzyme 2 (ACE-2) receptor for cellular invasion, and lungs are amongst the most adversely affected organs in the body. Thereupon, immune responses are elicited, which may devolve into a cytokine storm characterized by enhanced secretion of multitude of inflammatory cytokines/chemokines and growth factors, such as interleukin (IL)-2, IL-6, IL-7, IL-8, IL-9, tumor necrosis factor alpha (TNF-α), granulocyte colony-stimulating factor (GCSF), basic fibroblast growth factor 2 (bFGF2), monocyte chemotactic protein-1 (MCP1), interferon-inducible protein 10 (IP10), macrophage inflammatory protein 1A (MIP1A), platelet-derived growth factor subunit B (PDGFB), and vascular endothelial factor (VEGF)-A. The systemic persistence of inflammatory molecules causes widespread histological injury, leading to functional deterioration of the infected organ(s). Although multiple treatment modalities with varying effectiveness are being employed, nevertheless, there is no curative COVID-19 therapy available to date. In this regard, one plausible supportive therapeutic modality may involve administration of mesenchymal stem cells (MSCs) and/or MSC-derived bioactive factors-based secretome to critically ill COVID-19 patients with the intention of accomplishing better clinical outcome owing to their empirically established beneficial effects. MSCs are well established adult stem cells (ASCs) with respect to their immunomodulatory, anti-inflammatory, anti-oxidative, anti-apoptotic, pro-angiogenic, and pro-regenerative properties. The immunomodulatory capabilities of MSCs are not constitutive but rather are highly dependent on a holistic niche. Following intravenous infusion, MSCs are known to undergo considerable histological trapping in the lungs and, therefore, become well positioned to directly engage with lung infiltrating immune cells, and thereby mitigate excessive inflammation and reverse/regenerate damaged alveolar epithelial cells and associated tissue post SARS-CoV-2 infection. Considering the myriad of abovementioned biologically beneficial properties and emerging translational insights, MSCs may be used as potential supportive therapy to counteract cytokine storms and reduce disease severity, thereby facilitating speedy recovery and health restoration