Rapid symptom control in neuroleptic malignant syndrome with electroconvulsive therapy: A case report

Introduction: Neuroleptic malignant syndrome (NMS), thought to arise through dopamine antagonism, is life-threatening. While prompt diagnosis of NMS is critical, it may be obscured by other diagnoses, such as malignant catatonia, with overlapping, life-threatening symptoms. Initiation of dopamine-blocking agents such as antipsychotics and abrupt cessation of dopaminergic medications such as amantadine can precipitate NMS. Once NMS is suspected, deft medical management should ensue. Multiple case reports detail electroconvulsive therapy's (ECT's) effectiveness in the treatment of NMS. While this relationship is well-documented, there is less literature regarding comparative efficacy of ECT in the acute treatment of NMS-like states precipitated by withdrawal of dopamine agonists, such as amantadine. Case: We present a 52-year-old female with schizoaffective disorder bipolar type, with a history of a lorazepam-resistant catatonic episode the prior year that had responded to amantadine. She presented febrile with altered mental status, lead pipe rigidity, mutism, grasp reflex, stereotypy, autonomic instability, and a Bush-Francis Catatonia Rating Scale (BFCRS) of 24, suggesting malignant catatonia versus NMS. There was concern over a potentially abrupt cessation of her amantadine of which she had been prescribed for the past year. Interventions: Organic etiologies were ruled out, and a presumptive diagnosis of NMS was made with central dopaminergic depletion from abrupt dopamine agonist (amantadine) withdrawal as the suspected underlying etiology. After intravenous lorazepam and reinduction of amantadine failed to alleviate her symptoms, urgent ECT was initiated. Our patient received an index series of ECT of seven treatments. After ECT #1 she was no longer obtunded, after treatment #2 her symptoms of mutism, rigidity, stereotypy, and agitation showed improvement, and by ECT #3, the NMS had rapidly dissipated as evidenced by stable vital signs, lack of rigidity, and coherent conversation. Conclusion: Brisk identification of potentially life-threatening NMS and NMS-like states, including malignant catatonia, warrants a trial of ECT. ECT's theoretical mechanisms of action coincide with the theoretical pathophysiology of the conditions. It is a viable and safe treatment option for reducing mortality. With prompt initiation of ECT, we obtained rapid control of a condition with a potentially high mortality.info:eu-repo/semantics/publishedVersio

Human lower limb activity recognition techniques, databases, challenges and its applications using sEMG signal: an overview

Human lower limb activity recognition (HLLAR) has grown in popularity over the last decade mainly because to its applications in the identification and control of neuromuscular disorders, security, robotics, and prosthetics. Surface electromyography (sEMG) sensors provide various advantages over other wearable or visual sensors for HLLAR applications, including quick response, pervasiveness, no medical monitoring, and negligible infection. Recognizing lower limb activity from sEMG signals is also challenging owing to the noise in the sEMG signal. Pre- processing of sEMG signals is extremely desirable before the classification because they allow a more consistent and precise evaluation in the above applications. This article provides a segment-by-segment overview of: (1) Techniques for eliminating artifacts from sEMG signals from the lower limb. (2) A survey of existing datasets of lower limb sEMG. (3) A concise description of the various techniques for processing and classifying sEMG data for various applications involving lower limb activity. Finally, an open discussion is presented, which may result in the identification of a variety of future research possibilities for human lower limb activity recognition. Therefore, it is possible to anticipate that the framework presented in this study can aid in the advancement of sEMG-based recognition of human lower limb activity

Operation of Circuit Breaker with the help of Password

A circuit breaker is an electrical switch use to protect an electrical circuit from damage caused by faults. Its basic function is to detect a fault condition and protect from it. Fuse operates once after that it must be replaced but a circuit breaker can be reset to resume normal condition. During the manual operation, we see inoperable electrical accidents to the line man are rises during maintenance due to improper communication between the maintenance staff and the substation staff. In order to prevent such accidents, password based circuit breaker is design so that only authentic person can operate it with a password. There is also a facility of changing the password. The system is fully controlled by the microcontroller. The password is saved in an EEPROM, interfaced to the microcontroller and the password can be changed any time. A keypad is used to submit the password and a relay to operate circuit breaker, which is indicated by a bulb. Any wrong attempt to open the circuit breaker by entering the wrong password an alert will be shown in the LCD

Development of Nickel Based Multifunctional Additive & Performance Evaluation of Photo Biodegradation

Nickel Based Multifunctional additive (Ni-MFA) different compositions (1, 2 & 3 wt %) of Ni-MFA Electron Microscopy (SEM), mechanical properties by Differential Scanning Calorimetry (DSC). incubated in the presence of the microbes such as asspergillus dump. Both living organism were capable of degrading polypropylene. was biodegraded within 45 days, %