bluuebunny/crossref_metadata_2025 huggingface dataset:
Effect of Sealing Treatment of Modified Aluminum Phosphate Sealing Agent on Corrosion Resistance of Fe-Based Amorphous Coating
Authors: Li Cheng Fei , Yang Xiao Jun , He Ding Yong
Published: January 2022

A modified aluminum phosphate sealing agent was prepared by using aluminum dihydrogen phosphate and silica sol as raw materials, and was used for sealing treatment of iron-based amorphous coating. The phase of sealing agent was analyzed by XRD. SEM and TG-DSC were used to characterize the surface morphology of the coating before and after sealing and the heat resistance of the sealing agent. The corrosion resistance of the sealing coating was evaluated by electrochemical measurements. The results show that the modified aluminum phosphate sealing agent has good heat resistance, and fine and close sealing layer was obtained, thus the corrosion resistance is significantly improved.
Conductivity Tensor in Cylindrical Quantum Wire with Parabolic Potential for the Case of Electron-Acoustic Phonon Scattering
Authors: Ngoc Hoang Van
Published: January 2022

Conductivity tensor is an important concept in materials, this work studies conductivity tensors in cylindrical quantum wires with parabolic potential in the presence of two external fields, a linearly polarized electromagnetic wave, and a laser field. This work is also only considered for the case of electron-acoustic phonon scattering. Research results are obtained by using quantum kinetic equations for the carrier system in a quantum wire. The conductivity tensor is calculated by solving the quantum kinetic equation of the system, which is a function of the external field frequency, the external field amplitude, the temperature of the helium, and parameters specific to the quantum wire. Results will also be examined and plotted for quantum wire GaAs / GaAsAl.
Numerical Simulation of Friction Stir Spot Welding of Aluminium-6061 and Magnesium AZ-31B
Authors: Baruah Arindom , Murugesan Jayaprakash , Borkar Hemant
Published: January 2022

Friction stir spot welding process is a solid state joining process which has attracted great attention due to its ability to join low melting point light weight alloys such as aluminium and magnesium with high efficiency. In order to understand the complex thermo-mechanical joining process involved with friction stir spot welding, a numerical simulation study was done using ABAQUS finite element software. The simulation primarily aims to interpret the effect of a set of process parameters and tool geometry on the workpiece plates. Johnson-Cook damage criteria model was used to obtain the stress and strain distribution on the workpiece consisting of aluminium 6061 and magnesium AZ-31B placed in a lap configuration. Temperature distribution of the workpiece was obtained by simulating a penalty based frictional contact between the tool and the plate. The thermal results showed that the maximum temperatures attained were significantly lower than the melting points of the base materials indicating that the material mixing and joining occurred as a result of superplastic deformation process instead of melting. Change in material flow behaviour was also observed by the model as pin and shoulder geometries changed.
Effect of Using Ground Granulated Blast Furnace Slag in Rigid Pavement Overlays
Authors: Guruprasad H.C. , Sridhar R. , Ravi Kumar R.
Published: January 2022

Cement is replaced with Ground Granulated Blast Furnace Slag (GGBS), to produce a cost effective concrete and to gain effective compressive strength. It is produced in iron manufacturing industries. It has pozzolanic properties and has particle size less than 90μ. In this experimental study, cubes of size 150×150×150 mm and cylinders of 150 mm dia and 300 mm height were casted byreplacing GGBS from dosage of 8% up to 65% for curing period of 7days, 14days, 28days and 56days for M 40 grade concrete. Also, Alccofines were added in addition in varying percentage of 3%, 6%, 9% and 12% in order to gain high early strength and increase the workability. Hyper-Plasticizers were also added in order to reduce the water-content of the concrete. The results of GGBSCC were compared with that of normal concrete results.
The Influencing Factors on the Production of Alcoholic Drinking from Jackfruit (Artocarpus heterophyllus L.)
Authors: An Vo Ngoc , Pham Van Thinh , Do Vinh Long , Duy Nguyen Quoc , Dang Thu Thuy , Hien Tran Thien
Published: January 2022

The large amount of jackfruit (Artocarpus heterophyllus Lam) harvested and their short use time caused many difficulties for the farmers. Fortunately, the high sugar content in jackfruit meat is a hopeful substance for wine production. This study aimed to consider the effect of yeast strains and their concentration on fermented jackfruit solution. Jackfruit juice with 14 °Brix is ​​fermented using 0.005 to 0.015% (w/v) Saccharomyces cerevisiae RV002, Mauri Instant Dry Yeast yeast under anaerobic conditions for 1 to 4 days at 30 °C. Survey samples were checked once a day to analyze the indicators. The functional report of the sugar in the fermentation time, shows that the higher incidence of yeast cultures and the initial sugar concentration inhibited yeast growth. The results showed that fermentation from jackfruit meat with 25 °Brix using Saccharomyces cerevisiae RV002 yeast with concentration of 0.01% for 3 days is the best to create a good quality with ethanol content 4,9% and characteristic aroma of jackfruit.
Production Process of a Carbonated Drink from Red Flesh Dragon Fruit (Hylocereus polyrhizus)
Authors: Mai Ho Thi Quynh , Pham Van Thinh , Do Vinh Long , Phuc Tran Bui , Truc Tran Thanh , Ngan Tran Thi Kim
Published: January 2022

The purpose of this study is to present a suitable production process of a carbonated drink from ingredients originated from red flesh dragon fruits. Additionally, optimal parameters in the hydrolysis and pasteurization stages of the juice were determined so that the product could retain the highest bioactive ingredients while still maintaining favorable color. The investigated parameters of pectinase hydrolysis process included hydrolysis temperature (35, 40, 45 and 50oC), hydrolysis time (1 hour, 2 hours, 3 hours and 4 hours), concentration pectinase enzyme level (0.4; 0.6, 0.8 and 1%) and enzyme pectinase content (0.2, 0.4, 0.6 and 0.8%). Outcomes which were considered in optimization processes included polyphenol content, vitamin C content and DPPH scavenging activity. The results are expected to aid in diversification of products from dragon fruit raw materials to meet the increasing demand of consumers.
The Initial Study on the Application of Sewage Sludge for Agriculture on the Laboratory Scale
Authors: Tran Thanh , Giang Lam Van , Loc Ho Huu , Hong Le Thi Anh , Thi Van Doan , Tan Lam Van
Published: January 2022

Chemical fertilizers currently poison arable agriculture, so organic fertilizers are now a new trend for soil improvement. This study investigates the appropriate ratio of fertilizer use and materials mixed with sewage sludge in the anaerobic co-digestion treatment method, which will best support agriculture. In the study, bio-organic fertilizer was composted of the co-digestion anaerobic with sewage sludge and agricultural wastes such as rice husk, rice husk charcoal, water hyacinth, cassava peel, and then tested on rice. The specific criteria of fertilizers such as total organic (TOC), total nitrogen (TN), and effective phosphorus (P2O5) and plant growth parameters such as germination rate (%), tillering rate, total weight (g) were evaluated. Initial results show the untreated sludge can be impacted negatively on plant development. The concentration of nutrients in the co-digestion composts was meet the requirements of the Ministry of Agriculture’s standards of organic fertilizer. These bio-fertilizers will play an important role in soil productivity and sustainability. Hence, the widespread use of organic fertilizers from waste to partially replace chemical fertilizers will open up opportunities to reduce farming costs for farmers and develop agriculture sustainably.
Effects of Storage Conditions on Quality Change of Minimally Dried Jackfruit (Artocarpus heterophyllus Lam.) Bulbs
Authors: Van Chi Khang , Pham Van Thinh , Nhan Nguyen Phu Thuong , Nguyen Nguyen Hong Khoi , Nguyen Manh Khong , Do Vinh Long , Quoc Nguyen Tan
Published: January 2022

Quality of minimally processed jackfruit bulb was evaluated during storage at different storage times, temperatures, and types of packaging. The jackfruit pulps were first dried at 45 °C, stored in polypropylene plastics, zipper bags and plastic boxes. Quality parameters were evaluated every 5 days and based on phytochemical changes such as vitamin C, polyphenol, and antioxidant activity. Results revealed that polypropylene plastics were the best packaging product for retention of vitamin C content (5.837 mg/100g) antioxidant activity (7.458%) and phenolic compounds (2526.603mg/100g) after 30 days of storage. Figures for plastic boxes were 5.641 mg/100g, 5.249% and 2361.657 mg/100g, respectively. Similarly, zipper bags were 5.32 mg/100g, 5.895 % and 2173.867 mg/100g respectively. Sensory evaluation in terms of taste, color, texture, and overall acceptability showed that polypropylene packaging gave favorable scores and the products were highly accepted by trained evaluators.
Bioremediation of pesticide-contaminated soil: a review on indispensable role of soil bacteria
Authors: Randika J. L. P. C. , Bandara P. K. G. S. S. , Soysa H. S. M. , Ruwandeepika H. A. D. , Gunatilake S. K.
Published: January 2022

Purpose: Scientists have identified a plenty of bacterial strains having ability to degrade pesticide residues accumulated in the environment. Due to wide variation of chemical properties of pesticides, a single strain may not be versatile. Hence, identification of bioremediation ability of various bacteria is important. This review focused on understanding and explaining the role of soil bacteria having pesticide detoxification ability. Research Method: Previous research articles, book chapters and literature on bioremediation ability of different soil bacteria were reviewed and various strains of soil bacteria having bioremediation ability, mechanisms behind microbial bioremediation, factors affecting bioremediation and limitations and recent advancements of bioremediation were identified. Based on identified research gaps, further perspectives were introduced. Findings: The results revealed that plenty of soil bacteria having a bioremediation potential have been identified worldwide. As the major mechanism of bioremediation, the microorganisms consume pesticide-contaminated in the soil as their energy or nutrient sources. Various factors such as Bioavailability, Substrate and Environmental factors effect on bioremediation potential. Biostimulation, Bioaugmentation, Biopiling, Composting, Bioreactors and Land farming are identified as popular bioremediation methods suitable for the bioremediation of pesticide contaminants. However, this technique still remains partially developed due to the lack of versatile microorganisms for detoxifying variety of different pesticides. Originality/Value: As this is still a developing area, conducting further researches is timely important. Hence, reviewing literature and identifying already covered areas are important in mitigating the research gap. Therefore, focusing further research goals for the researchers is greatly helpful.
Effect of High Temperature Storage on AC Characteristics of Polymer Tantalum Capacitors
Authors: Teverovsky Alexander
Published: January 2022

Replacement of MnO2 with conductive polymers as cathode materials in chip tantalum capacitors allows for a substantial reduction of the equivalent series resistance (ESR), improvement of frequency characteristics, and elimination of the possibility of ignition during failures. One of the drawbacks of chip polymer tantalum capacitors (CPTCs) is a relatively poor long-term stability at high temperatures. In this work, variations of capacitance, dissipation factor, and ESR in different types of capacitors including automotive grade parts from three manufacturers have been monitored during storage at temperatures from 100°C to 175°C for up to 18,000 h. Results show that ESR is the most and capacitance the least sensitive to degradation parameter. Times to parametric failures have been simulated using a Weibull-Arrhenius model that allowed for assessments of activation energies of the degradation and prediction of times to failure at the use temperature. Degradation of CPTCs was explained by thermo-oxidative processes in conductive polymers that result in exponential increasing of the resistivity with time of ageing. This process starts after a certain incubation period that depends on packaging materials and design and corresponds to the time that is necessary to form delamination between the encapsulating molding compound and lead frame. The effectiveness of the existing qualification procedures to assure stable operation of CPTCs is discussed.
THE EFFECT OF ALPHA THALASSEMIA, HBF and HBC ON HAEMATOLOGICAL PARAMETERS OF SICKLE CELL DISEASE PATIENTS IN IBADAN, NIGERIA.
Authors: ATINUKE FASOLA
Published: January 2022

Background: Sickle cell disease is a protean disease with limited data on the phenotypic and genetic variants in Nigeria. This study was conducted to provide baseline data on these variants by characterizing the existing forms of sickle cell disease and correlating these with basic hematological parameters.

Methods: Adult and pediatric patients with SCD were recruited from a tertiary health centre in Nigeria. Patients were age and sex matched with healthy controls. Blood samples were obtained for Full Blood Count, phenotyping by High Performance Liquid Chromatography and genotyping for alpha thalassemia by multiplex gap polymerase chain reaction. Data analysis was done using IBM SPSS statistics version 23.

Results: A total of 130 patients with sickle cell disease and 117 controls were studied. Alpha thalassemia in the study population was due to a 3.7kb deletion in the alpha globin gene cluster at a prevalence of 45.4% in the patients and 47% in controls. The prevalence of the various existing forms of SCD genotype was: Homozygous S without alpha gene deletion (HbSS)- 39.2%; HbSC - 10.8%; HbSα+1- 35.4%; HbSα+2 - 6.9% and HbSF- 7.7%. HbA2 was significantly elevated in individuals with two alpha gene deletions (HbSα+2). HbF and HbA2 were negatively correlated with each other (r= -0.587, p < 0.001). Individuals with the HbSC genotype followed by HbSα+2 had the best hematological parameters.

Conclusions: Hematological parameters varied with hemoglobin genotype. The C hemoglobin and homozygous alpha thalassemia deletion had better ameliorating effect on SCD hematological parameters than the F hemoglobin in this population.
MECHANISM OF SARS-COV-2 INVASION INTO THE LIVER AND HEPATIC INJURY IN PATIENTS WITH COVID-19
Authors: Zhang XiaoTian , Yu Yanhui , Zhang Chao , Zhao Lijuan , Wang Hongrui , Wang Guoqing , Yang Ming
Published: January 2022

A large number of studies have shown that patients with Coronavirus disease 2019 (COVID-19) have different degrees of liver injury. However, the mechanisms of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) invasion into the liver are still not fully understood. This review mainly summarizes the recently published works on the abnormal liver biochemical indicators and the mechanism of viral invasion with liver injury in COVID-19 patients. Generally, SARS-CoV-2 infection of the liver was caused by blood circulation or retrograde infection of digestive tract, which led to the liver injury through direct cytopathic effect induced by virus or immunopathological effect caused by excessive inflammation. Besides these, hypoxia, endothelial injury and drug-induced jury were also the main reasons of liver injury in COVID-19 patients. In the liver function indicators, elevated alanine aminotransferase, aspartate aminotransferase, alkaline phosphatase, gamma-glutamyl transpeptidase, and lactate dehydrogenase levels with reduced albumin levels were observed in COVID-19 patients.
TRANSFUSION PRACTICE, POST-TRANSFUSION COMPLICATIONS AND RISK FACTORS IN SICKLE CELL DISEASE IN SENEGAL, WEST AFRICA.
Authors: Seck Moussa , Senghor Alioune Badara , Loum Mossane , Touré Sokhna Aissatou , Faye Blaise Félix , Diallo Alioune Badara , Keita Mohamed , Bousso Elimane Seydi , Guèye Sérigne Mourtalla , Gadji Macoura , Sall Abibatou , Touré Awa Oumar , Diop Saliou
Published: January 2022

Context and Objectives: Blood transfusions (BT) remain a mainstay of therapy for patients with sickle cell disease (SCD), but pose significant clinical challenges. We aim to assess infectious markers, red cell alloimmunization and iron overload secondary to BT in SCD patients.

Materials and Methods: This is a case-control study included 253 SCD (153 SCD-transfused and 100 SCD non-transfused). We evaluated the transfusion practice (modalities, indications), post-transfusion complications (infections, alloimmunization, iron overload) and risk factors of these complications (socio-demographic, clinical, biological).

Results: Median age was 28.5 years (5 - 59). Sex ratio was 0.86. Homozygous SCD was more common (95.3%). Simple BT was performed in 92.8% and transfusion exchange in 18.9%. Transfusion indications were dominated by acute anemia (57.06%) and vaso-occlusive crisis (VOCs) (14%). Red blood cell concentrates (RBC) were administered to 93.46%. Median number of RBC received per patient was 10 (2 - 48). The prevalence of VHC in SCD-transfused was 1.33% and 2% for VHB. Anti-HIV antibodies were not found. Red cell alloimmunization frequency was 16%. The most common alloantibodies were anti-rhesus (34.19%) and anti-Kell (23.67%). Iron overload was detected in 7.84%. The number of RBC transfused was the only risk factor for alloimmunization (p = 0.03) and iron overload (p = 0.023). BT frequency was not related to infectious transmission.

Conclusion: Despite advances in blood safety, BT therapy is still a risk for SCD polytransfused patients. Although infectious transmission has rare, the risk of alloimmunization and iron overload is high in these patients.
ASSESSMENT OF CONGENITAL NEUTROPENIA IN CHILDREN: COMMON CLINICAL SCENERIES AND CLUES FOR MANAGEMENT
Authors: Lazzareschi Ilaria , Rossi Elena , Curatola Antonietta , Capozio Giovanna , Benacquista Luca , Iezzi Ludovica , Rigante Donato
Published: January 2022

A disparate group of rare hematological diseases characterized by impaired maturation of neutrophil granulocytes defines congenital neutropenias. Neutropenic patients are prone to recurrent infections beginning in the first months of life. Of interest is “cyclic neutropenia”, an ultra-rare disorder revealed by sinusoidal variations of the neutrophil count and periodically-recurring infections every 21 days. Diagnosis of these disorders is frequently obscured by the multiple causes of recurrent fevers in children. Aim of this overview is to outline the physical assessment of children presenting with early-onset symptomatic neutropenia, identify the disease between the many medical conditions and even emergencies which should enter in differential diagnosis, hint at the potential management with granulocyte-colony stimulating factor, define the risk of evolution to hematologic malignancy, and summarize inter-professional team strategies for improving care coordination and outcomes of such patients.
Gravity-guided stereotactic brain biopsy
Authors: Wong Albert , Chen Vincent
Published: January 2022

Introduction: This study describes a technique using gravity for guidance in stereotactic brain biopsy. This will be especially useful in hospitals where the stereotactic equipment is unavailable. Objectives: The aim of this study is to describe the technique, develop a formula to define its limits of accuracy, and report on its clinical application. Methods: Using the positioning laser grid lines on the computed tomography scanner, a small metallic marker is placed on the scalp at the intended biopsy site. The distance between the tumor and the inner table of the bone is measured. In the operating theater, the patient is positioned such that the tip and the bridge of the nose are aligned in a horizontal position. The patient's two eyebrows or the orbital canthi are aligned in a vertical line. Simultaneously, the posterior borders of the two pinnae are aligned vertically. Gravity is used to guide the biopsy needle through the marked burr hole into the target. Seven patients had biopsies. One was for targeting the craniopharyngioma cyst to place an Ommaya catheter. The fraction of error or error fraction (EF), E/a=x/a tan α - 1 was developed for verification of its limits of accuracy. Results: All the biopsies were diagnostic and the Ommaya catheter was correctly sited. The EFs at α = 5° were all predictive of the limits of accuracy of this technique. Conclusion: This is the first reported gravity-guided stereotactic brain surgery. The outcome in all the eight cases showed that it was within the limits of its accuracy. EF can be calculated to ensure accuracy. This technique is helpful if a commercial stereotactic system is not available.
Paraneoplastic nephrotic syndrome in a patient with planum sphenoidale meningioma
Authors: Sardhara Jayesh , Shukla Mukesh , Jamdar Janmejay , Jaiswal Awadhesh , Jaiswal Sushila , Kaul Anupma , Bhaisora Kamlesh , Das Kuntal , Mehrotra Anant , Behari Sanjay
Published: January 2022

A 60-year-old homemaker presenting with pedal edema and ascites was found to have a planum sphenoidale meningioma concurrently with nephrotic syndrome. On renal biopsy, the patient was found to have membranous glomerulonephritis. There was complete remission of nephropathy after excision of the meningioma. Nephrotic syndrome has been commonly found in association with malignancies and blood disorders but the association with a meningioma is extremely rare, and only one case has been previously reported as per our knowledge.
Effect of mannitol irrigation on brain edema in a live rat model
Authors: Velho Vernon , Bhide Anuj , Ansari Sameer
Published: January 2022

Background: Mannitol has been used intravenously for decreasing cerebral edema since decades. The study was performed to evaluate the effect of its irrigation on edema in live rats. Edema was induced by artificial brain injury. We hereby present our results on the same using live rats and confirm its beneficial effect on reducing edema when used as irrigation. Aims: The aim of this study is to evaluate the effect of mannitol irrigation in reducing cerebral edema in rat brain after induction of artificial trauma and to compare the results with standard normal saline irrigation using randomized controlled study. Settings and Design: This study was a prospective randomized controlled trial. Materials and Methods: A total of 20 fully grown Albino Wistar rats were subjected to artificial trauma after a burr hole and divided randomly into two groups of ten rats each. One group was subjected to mannitol irrigation after durotomy and the other was subjected to normal saline. Tissue biopsy was sent at the end of 1 h to check for the status of edema and was classified into three grades. Statistical Analysis Used: Comparison of proportions test. Results: Mannitol irrigation produced a statistically significant difference (P = 0.022) in the grade of edema at the end of 1 h as compared to normal saline. Conclusions: Mannitol irrigation can be used during neurosurgical procedures instead of normal saline to reduce postoperative brain edema.
Relationship between abducens nerve palsy and local hematoma in a case series of ruptured vertebral artery dissecting aneurysm
Authors: Shunsaku Goto , Tomotaka Ohshima , Yamamoto Taiki , Toshihisa Nishizawa , Shinji Shimato , Kyozo Kato
Published: January 2022

Background: Abducens nerve palsy associated with subarachnoid hemorrhage (SAH) has rarely been reported. Its frequency, mechanism of palsy, association with aneurysmal location, and clinical course are poorly described. The purpose of our study was to evaluate patients with abducens nerve palsy caused by SAH occurring from ruptured vertebral artery (VA) dissecting aneurysm and to find aneurysmal location using initial computed tomography (CT) and its association with clinically detected cranial nerve palsy. Methods: Fourteen patients of SAH due to ruptured VA dissecting aneurysm were treated at our hospital from January 2011 to May 2015. The clinical courses and CT findings were reviewed retrospectively. Results: Abducens nerve palsy was observed in 77.8% of cases after excluding patients with decreased levels of consciousness. Clots within the prepontine cistern were significantly thicker in cases of VA dissecting aneurysm than in case of supratentorial aneurysm (P = 0.002). Conclusion: The findings of our study indicated that ruptured VA dissecting aneurysms, even in cases of angio-negative SAH, are likely to present with abducens nerve palsy.
Utility of computed tomography-guided biopsy in evaluation of metastatic spinal lesions
Authors: Feroz Imza , Makhdoomi Rumana , Khursheed Nayil , Shaheen Feroze , Shah Parveen
Published: January 2022

Introduction: Computed tomography (CT)-guided biopsy of spine is currently a valuable diagnostic tool and effective technique for diagnosing and planning a proper therapeutic strategy for certain spinal lesions. The reported diagnostic accuracy of core biopsy ranges from 77% to 97%. Materials and Methods: We included all patients with spinal lesions suspicious of metastasis on magnetic resonance imaging, who presented between May 2012 and April 2014 and underwent CT-guided biopsy in our study. A total of thirty patients with spinal lesions were evaluated. Results: Majority presented in the seventh decade of their life (average age = 53.93; age range = 10–72 years). Male:female ratio was 1.5:1. Pain was the most common presenting symptom (100%). Lumbar spine was the most common site of lesion followed by dorsal spine. Biopsy is the gold standard in histopathological evaluation of spinal lesions. Metastatic lesion was diagnosed in 12 (40%) cases, plasmacytoma in 12 (40%) cases, non-Hodgkin's lymphoma in 2 (6.66%) cases, small round cell tumor in 1 (3.33%) case, nonspecific chronic inflammation in two patients, and necrosis with no viable cells in one patient. The most common malignancy to metastasize to spine was adenocarcinoma. The most common primary tumor of spine was plasmacytoma - multiple myeloma. Conclusion: CCT-guided biopsy is a safe procedure, and no procedure-related complication was seen in any patient.
Primary giant cerebral hydatid cyst in an 8-year-old girl
Authors: Alomari Mashael , Almutairi Mohammed , Alali Hamza , Elwir Jamal , Alola Sulaiman , Alfattoh Nora , Alharthy Nesrin , Azzubi Moutasem
Published: January 2022

Echinococcosis, also called hydatid disease, is a parasitic disease that passes from animals to humans. Literature reports suggest very rare cases of cerebral hydatid cysts. Brain involvement with hydatid disease occurs in 1%–2% of all Echinococcus infections. In this report, we aim to emphasize the presentation of such an isolated primary cerebral hydatid cyst, discuss its radiological features, Emergency department management, inpatient medical management, referral to neurosurgery, consequent operative procedures, postoperative care, and outcome.
Efficacy of amantadine in improving cognitive dysfunction in adults with severe traumatic brain injury in Indian population: A pilot study
Authors: Ghate Prajakta , Bhanage Ashok , Sarkar Hrishikesh , Katkar Anand
Published: January 2022

Background: Severe traumatic brain injury (TBI) is associated with disabling cognitive impairment. Currently available options to improve the cognitive function have been futile. However, recently, commonly used medicine for Parkinson's disease, amantadine, has been shown to assist in the improvement of cognitive function. Methodology: We conducted a single institution-based observational study in adult Indian population. Fifty consecutive patients with documented static or declining cognitive function at 2 months of severe TBI fulfilling the inclusion/exclusion criteria received amantadine 200 mg/day (100 mg twice a day) orally or through enteral feeding tube for the duration of 4 weeks. The functional assessment done with Full Outline of Unresponsiveness (FOUR) score, Disability Rating Scale (DRS), and Glasgow Outcome Scale (GOS) during 4 weeks of treatment and 2 weeks posttreatment was assessed. Results: The cognitive function improved progressively during the 4-week treatment interval as shown by significant improvement on FOUR score, DRS, and GOS. However, after discontinuation of the drug, the speed of recovery slowed down significantly, but the achieved recovery was not lost. Out of fifty, eight patients had convulsions as an adverse effect of amantadine, of which five patients required discontinuation of the drug with treatment for convulsions. Conclusions: This study indicates the safety and efficacy of amantadine in partial reversal of cognitive dysfunction in adults with severe TBI in adult Indian population.
Malignant conversion to glioblastoma in neurofibromatosis type I-associated pleomorphic xanthoastrocytoma: Unknown predictors of favorable outcome
Authors: Singla Navneet , Kapoor Ankur , Radotra B , Chatterjee Debajyoti
Published: January 2022

Pleomorphic xanthoastrocytoma (PXA) is a benign glial tumor, the association of which with neurofibromatosis type I (NF-1) has been often reported in the literature. Although malignant conversion to glioblastoma may be seen in 5%–10% of PXA, the same has been reported only once in the presence of NF-1. We report, so far known to be only the second such case all over. A 25-year-old male, a known case of NF-1, underwent frontal craniotomy for a superficially located right frontal lesion, histology of which suggested PXA. Two years later, the lesion recurred and the subsequent surgery revealed malignant conversion to glioblastoma. After adjuvant radiotherapy, the patient now continues to do well and is free of disease after another 3 years of follow-up. We believe that if low levels of neurofibromin are seen in such cases with malignant conversion, subsequently increased neurofibromin levels may be responsible for better overall survival in these patients.
Foramen magnum chordoid meningioma in a 22-year-old female
Authors: Kumar Abhishek , Bhaskar S , Bhardwaj Minakshi , Gupta L
Published: January 2022

Chordoid meningioma is a rare variety of meningioma (0.5%–1%) with high rate of recurrence. They are grouped in WHO Grade II tumors. They are mainly distributed in the supratentorial location. There has been a single report of foramen magnum chordoid meningioma in a 3-year, 6-month-old child. Our patient, a 22-year-old female, admitted with progressive spastic quadriparesis with bowel and bladder involvement. She was operated with tumor resection done; postoperatively, patient showed dramatic improvement in the motor power as well as bowel and bladder function. Histopathology was suggestive of chordoid meningioma. She received 54 Gy of radiotherapy. She is doing well with no neurological deficits and no recurrence at 2-year follow-up.
Aneurysmal subarachnoid hemorrhage: Geography has a role
Authors: Ramnarayan Ramachandran , Anto Dominic , Alapatt Jacob
Published: January 2022

Background: The incidence of aneurysmal subarachnoid hemorrhage (SAH) reported in the literature has been very variable. Many authors have proposed a geographical variation in incidence, but others have dismissed this as being due to insufficient pickup rate. In India also, these arguments abound. Our aim was to find out if geographical variations exist in the incidence of aneurysmal SAH and whether the incidence of aneurysmal SAH was truly less in India as compared to the literature. Materials and Methods: The data from 182 consecutive cases of SAH admitted to this institution between March 1999 and July 2003 were used for this study. Results: There were 84 females and 98 males in this study. More than half of the patients were hypertensive. Four-vessel angiogram was done in 113 patients, of whom sixty-nine were normal. Of the patients with hypertension, 92% had angiogram done and was normal in 65% of cases. Conclusions: This study from a large general hospital in South India shows that the incidence of aneurysmal rupture as a cause of SAH is much less in India and probably in the Indian subcontinent in comparison with the western literature thus demonstrating geographical variations in the incidence of aneurysmal SAH. It is concluded that aneurysms as a cause of SAH are still less in India and that we are not missing anything. This study is intended to help target scarce, expensive resources toward more common pathologies.
The benefits of decision tree to predict survival in patients with glioblastoma multiforme with the use of clinical and imaging features
Authors: Nematollahi Mohtaram , Jajroudi Mahdie , Arbabi Farshid , Azarhomayoun Amir , Azimifar Zohreh
Published: January 2022

Background: Machine learning is a type of artificial intelligence which aims to improve machine with the ability of extracting knowledge from the environment. Glioblastoma multiforme (GBM) is one of the most common and aggressive primary malignant brain tumors in adults. Due to a low rate of survival in patients with these tumors, machine learning can help physicians for better decision-making. The aim of this paper is to develop a machine learning model for predicting the survival rate of patients with GBM based on clinical features and magnetic resonance imaging (MRI). Materials and Methods: The present investigation is an observational study conducted to predict the survival rate in patients with GBM in 12 months. Fifty-five patients who were registered in five Iranian Hospitals (Tehran) during 2012–2014 were selected in this study. Results: This study used Cox and C5.0 decision tree models based on clinical features and combined them with MRI. Accuracy, sensitivity, and specification parameters used to evaluate the models. The result of Cox and C5.0 for clinical feature was <32.73%, 22.5%, 45.83%>, <72.73%, 67.74%, 79.19%>, respectively; also, the result of Cox and C5.0 for both features was <60%, 48.58%, 75%>, <90.91%, 96.77%, 88.33%>, respectively. Conclusion: Using C5.0 decision tree model in both survival models including clinical features, both the imaging features and the clinical features as the covariates, shows additional predictive values and better results. The tumor width and Karnofsky performance status scores were determined as the most important parameters in the survival prediction of these types of patients.
Pediatric suprasellar atypical teratoid rhabdoid tumor arising from the third ventricle: A rare tumor at a very rare location
Authors: Das Joe , Abraham Mathew , Nandeesh Bevinahalli , Nair Suresh
Published: January 2022

Atypical teratoid rhabdoid tumor (ATRT) is a rare, highly malignant tumor of the central nervous system, commonly affecting children below 3 years of age, with around 300 cases reported in the literature. Suprasellar area is a very rare location for such tumor in the pediatric population, with technical difficulties in complete excision. Third ventricular ATRT is very rare. Here, we report the case of a 2-year-old male child who presented with lethargy and vomiting. He had features of raised intracranial pressure with reduced vision in both eyes. Magnetic resonance imaging of the brain revealed a heterogeneously enhancing lobulated giant lesion in the suprasellar location, occupying the third ventricle and hypothalamus with encasement of both carotids. He underwent pericoronal parasagittal craniotomy, interhemispheric transcallosal interforniceal approach and gross total excision of the lesion. Postoperatively, the child had altered sensorium and diabetes insipidus, both of which recovered over a span of 10 days. Histopathological examination of the specimen was consistent with the diagnosis of World Health Organization Grade IV ATRT. In spite of all our efforts, he succumbed to his illness 5 months postoperatively.
Rupture of persistent primitive trigeminal artery-basilar artery aneurysm managed with stent-assisted coiling
Authors: Zenteno Marco , Lee Angel , Moscote-Salazar Luis
Published: January 2022

Persistent primitive trigeminal artery (PPTA), a fetal carotid-basilar anastomosis, is the most common embryological vascular remnant persisting into adult age. However, reported cases associated with cerebral aneurysms are rare. A 33-year-old female presented with an extremely rare PPTA-basilar artery (PPTA-BA) aneurysm manifesting as subarachnoid hemorrhage. Computed tomography revealed subarachnoid bleeding in the prepontine cistern, and cerebral angiography disclosed a PPTA-BA aneurysm. The aneurysm was managed with stent-assisted coiling technique to achieve complete obliteration. The patient was discharged without neurological deficits 2 weeks later. At 6 months follow-up, the patient is doing well and has returned to her previous daily activities. PPTA-BA aneurysms usually present with cranial nerve palsy and sometimes with carotid-cavernous fistulae if they rupture. Their deep seating favors interventional management as a first option and this case illustrates the efficacy and safety of endovascular treatment. This case adds to the evidence that endovascular techniques are a safe and effective tool in managing aneurysms of the primitive trigeminal artery. Even in cases where the anastomosis itself is not preserved, the patient can be managed satisfactorily, provided that the patency of the basilar and the carotid artery are kept, like in our patient.
Dissecting aneurysm of vertebral artery involving the origin of posteroinferior cerebellar artery treated with retrograde stent placement and coil embolization in the era of flow diverter
Authors: Mahajan Anshu , Goel Gaurav , Das Biplab , Narang Karanjit
Published: January 2022

Ruptured vertebral artery (VA) dissecting aneurysm carries high risk of rerupture and mortality if not treated immediately. Dissecting aneurysm of the VA involving the posteroinferior cerebellar artery (PICA) origin is difficult to treat by surgical and endovascular route. With the availability of flow diversion device for reconstructive procedure, endovascular treatment has now become easy to treat difficult aneurysm while maintaining the patency of the PICA. However, instead of using flow diverter (FD) in our case, we successfully treated dissecting VA aneurysm involving the PICA origin with retrograde stent placement from distal right VA to the left PICA to maintain the patency of PICA and occlusion of dissecting aneurysm of VA with detachable coils instead of performing surgical bypass and FD placement.
Feasibility of a fourth ventriculopleural shunt for diversion of an isolated fourth ventricle: A technical note
Authors: Lewis Courtney , Chang Ki-Eun , Bakhsheshian Joshua , Strickland Ben , Pham Martin
Published: January 2022

Isolated fourth ventricle syndrome is an uncommon entity due to obstruction of both inlet and outflow foramina. The resulting mass effect from the progressively expanding fourth ventricle may cause symptoms from both cerebellar and brainstem compression. Although a variety of treatment modalities have been advocated for this condition, an in-depth description of placement of a fourth ventriculopleural (VPL) shunt from a single-stage prone approach has not yet been published in the literature. We describe here a case of successful placement of a fourth VPL shunt in a 22-year-old female with a history of a prior posterior fossa pilocytic astrocytoma resection who presented with symptomatic isolated fourth ventricular hydrocephalus
Impact of epidermal growth factor receptor T790M testing in relapsed non-small cell lung cancer
Authors: Prabhash Kumar , Batra Ullas
Published: January 2022

Reflex testing for the T790M mutation is important in patients with non-small cell lung cancer (NSCLC) who progress on first- or second-generation tyrosine kinase inhibitors (TKIs). Reflex testing, initiated by the treating medical oncologist, allows for the faster identification of patients who are eligible to receive a third-generation TKI such as osimertinib, which is the only TKI to report favorable outcomes in patients with T790M mutation. International guidelines and the Indian consensus guidelines recommend tissue rebiopsy as the gold standard to source genetic material for the testing of molecular biomarkers. As a result of its non-invasiveness, although liquid profiling is currently preferred as a starting point for diagnosing T790M mutations, in the case of inconclusive results, repeat tissue biopsy and reflex tissue-based T790M testing are deemed essential because of higher diagnostic certainty. Medical oncologists along with interventional radiologists and pathologists play a critical role in ensuring the feasibility of repeat tissue biopsy in patients with advanced NSCLC. Reflex tissue testing has the potential to identify acquired T790M mutation in patients with lung cancer at progression. We conducted a literature search in Embase and PubMed for the relevant articles to be included in this review. We also referred to the international and local guidelines to develop the testing algorithm. This narrative review provides a practical algorithm for reflex tissue testing and explains the significance of tissue rebiopsy in improving treatment outcomes in patients with NSCLC post-disease progression.
Spontaneous Skull Fracture in a Term Infant
Authors: Mawlana Wegdan , Gharib Mohamed , Osman Asmaa
Published: January 2022

Instrumental delivery is the most common cause of skull fracture in neonates. We report a depressed fracture with massive intracranial hemorrhage in a term female infant born by unassisted cesarean section after unremarkable pregnancy.
Accuracy of Neonatal Venous Blood Glucose Measurements using Blood Gas Analyzer Compared with Central Laboratory Chemistry Analyzer
Authors: Janjindamai Waricha , Tiwawatpakorn Nichanan , Thatrimontrichai Anucha , Dissaneevate Supaporn , Maneenil Gunlawadee , Phatigomet Manapat
Published: January 2022

Background:

Hypoglycemia is a serious problem in infants at risk and creates long-term consequences. Therefore, rapid and accurate measurement of blood glucose is of clinical importance.

Objectives:

The objective of this study was to evaluate the agreement of venous blood glucose measurements from hypoglycemic high-risk neonates, using blood gas analyzer (BGA), compared to central laboratory chemistry analyzer (CL).

Methods:

A prospective study of all high-risk neonates for hypoglycemia and neonatal intensive care units (NICUs) was enrolled. Point-of-care glucose was performed, and if <40 mg/dL, venous blood would be collected for CL and ABG. For analysis of the agreement of CL and BGA, Bland–Altman (BA) analysis, with multiple observations per individual, including limits of agreement (limits of agreement [LOA] ±1.96 standard deviation [SD]), was used.

Results:

One hundred and forty-five paired glucose values were analyzed. There were strong correlations between CL and BGA in all glucose measurements and hypoglycemic range (r = 0.81, P < 0.001, and 0.73, P < 0.01, respectively). A weak correlation was demonstrated in hyperglycemic ranges (r = 0.35, P = 0.15). For BA analysis of all glucose measurements and hypoglycemic ranges, LOA (±1.96 SD) of CL and BGA were −9.5 (±46.5) mg/dL and −11.1 (±10.9) mg/dL, respectively. The hyperglycemic range illustrated higher LOA, with LOA (±1.96 SD) of −32.9 (±124) mg/dL.

Conclusions:

In NICU settings where normoglycemic and hypoglycemic ranges are targeted, venous BGA glucose could be used as a reliable test instead of CL. No similar correlation was found in the hyperglycemic range.
Early Initiation of Breastfeeding
Authors: Mahfouz Ismaiel Abu , Asali Fida , Khalfieh Tasneem , Saleem Heba Abu , Diab Sereen , Samara Batool , Jaber Hatim M.
Published: January 2022

Introduction:

The World Health Organization recommends early initiation of breastfeeding (EIBF). This is because breastfeeding is important for the child's development and has maternal benefits. Current literature has focused on sociodemographic factors, and the evidence supporting antenatal, peripartum, and neonatal variables is limited and contradicting. The main aim of this study is to report the rates of early breastfeeding initiation and their antenatal, peripartum, and neonatal correlates.

Materials and Methods:

A prospective observational study of pregnant women who attended the labor ward of the Specialty Hospital in Amman, Jordan between September 1, 2019, and June 1, 2020, was conducted. Inclusion criteria required women to be 18 years of age or more. Demographic, antenatal, peripartum, and neonatal data were collected. The timing of breastfeeding initiation was recorded in the 1st h and between 1 and 24 h and then data were analyzed.

Results:

A total of 300 women were recruited with mean age of 29.5 years and mean gestational age being 38.6 weeks. In addition, breastfeeding initiation rates were 26.3% and 65.5% within the 1st h and between 1 and 24 h, respectively. Antenatal, peripartum, and neonatal variables that were associated with lower rates of EIBF (P < 0.05) include antenatal obstetrics complications, induction of labor, assisted vaginal delivery, caesarean section (CS), CS performed on maternal request, CS under general anesthesia, surgical site pain, mother's perception of inadequate pain management, preterm delivery, low Apgar scores, low birth weight, neonatal intensive care unit admission, and less frequent rooming-in.

Conclusion:

Rates of breastfeeding initiation within the first hour and between 1 and 24 h of delivery were 26.3% and 65.5%, respectively. Compared to antenatal variables, the peripartum and neonatal variables are more likely to have significant effects on EIBF. Therefore, more obstetric attention should focus on these factors to improve rates of initiating breastfeeding early.
A Bullous Purpura Triggered by Warming in a Newborn with Congenital Cytomegalovirus Infection
Authors: Bonadies Luca , Doglioni Nicoletta , Cuppini Elena , Minotti Chiara , Baraldi Eugenio
Published: January 2022

A newborn with microcephaly presented hemorrhagic bullous purpura triggered by heat in the 1st h of life. Doppler arterial and venous ultrasound excluded vascular complications. Cytomegalovirus was detected in blood, urine, and serum of the lesions. The final diagnosis was cytomegalovirus congenital infection due to reactivation in an immune mother, with associated purpuric rash, confirmed by cerebral magnetic resonance imaging.