Environmental contamination of arsenic: pathway analysis through water-soil-feed-livestock in Nadia District (India) and potential human health risk.

This study investigated arsenic (As) concentrations in diverse environmental components and their potential impact on the health risks faced by residents of the arsenic (As)-contaminated Nadia district in West Bengal, India. A random selection of 182 cattle and 255 goats from 40 livestock farmers in the district revealed that both animals and humans were naturally exposed to elevated arsenic levels through contaminated drinking water, foods, grasses, concentrate feeds, various fodder tree leaves, and other food/feed resources. The mean As concentration in roughages (483.18 µg/kg DM) was significantly higher (p < 0.001) than in tree leaves (391.53 µg/kg DM), and concentrate feed/ingredients (186.66 µg/kg DM). Pond water exhibited higher arsenic levels (106.11 µg/L) compared to shallow tube well water (47.96 µg/L) and deep tube well water/tap water (10.64 µg/L and 10.04 µg/L, respectively). The mean arsenic concentration in soils DM of fodder fields, crop fields, and grassland was 10.25, 10.58, and 10.20 mg/kg, respectively. It was observed that protein-rich feeds had lower levels of arsenic accumulation (p < 0.048), while fiber-rich feeds containing more cellulose, hemicellulose, and lignin had higher arsenic levels (p < 0.017). Goats consumed 73.46% more arsenic per kg body weight compared to dairy cows. Although chronic and sub-chronic arsenic exposure in the district did not typically manifest symptoms or visible signs in ruminant animals, concentrations in the hair and feces of both cattle and goats exceeded normal values. Cattle feces had significantly higher arsenic (410.43 µg/kg DM) levels (p < 0.001) than goat feces (227.00 µg/kg DM), and arsenic concentration in cattle hair (1917.74 µg/kg DM) was also significantly greater (p < 0.001) than goat hair (1435.74 µg/kg DM). Arsenic levels in milk samples from both species were below 10 µg/kg. Liver (356.02 µg/kg DM) and kidney (317.22 µg/kg DM) contained significantly higher (p < 0.001) levels of arsenic compared to muscle (204.23 µg/kg DM), and bone (161.98 µg/kg DM) in local meat-type adult male goats. The skin accumulated the highest amount of arsenic (576.24 µg/kg DM) among the non-edible parts of the goat carcass. The cumulative cancer risk value for adults was 4.96 × 10-3, exceeding the threshold value (1 × 10-6). This suggests a significant risk of cancer development for the population in arsenic-affected areas. Non-cancer risks (hazard indexes) were estimated at 11.01 for adults. Our observations revealed that the highest bioaccumulation of arsenic occurred in the hair of cows, and goats in the examined localities. The biotransformation factor (BTF) for hair was much higher compared to other excreted samples from both species. The calculated BTF followed the order: hair > feces > milk for cows and goats. Livestock farmers in Nadia district are advised to carefully select feed resources, prioritizing those high in crude protein and low in neutral detergent fiber, and they should provide drinking water from deep aquifers to ensure the safety of milk and meat for human consumption.

Deciphering cleaner and sustainable frontiers in scientific cow waste valorization: a review.

The forecasted global population growth is poised to create a greater exigency for livestock-derived food production, leading to a significant waste generation from the industrial-scale livestock operations, which necessitates to develop sustainable waste management solutions. The heightened demand for livestock and dairy products has driven a surge in cow waste (CW) production. While CW is typically used as organic fertilizer or solid fuel, improper disposal poses potential environmental hazards. Anaerobic digestion and composting transform CW into valuable products, such as biofuels and organic fertilizers, with the potential for electricity and heat generation, biochar production, and advanced friction materials. The CW contains essential inorganic and organic compounds vital for plant functions, including lignin, cellulose, hemicellulose, nitrogen, and minerals such as potassium, sulfur, iron, magnesium, copper, cobalt, and manganese. Additionally, the rich microbial diversity in cow dung drives the production of bioenergy carriers like biomethane and biohydrogen, promoting cost-effective energy generation and environmental sustainability. This review employs bibliometric analysis to explore the latest trends in CW applications, with a particular focus on innovative applications such as cellulose extraction, biochar production, microbial fuel cells, and nanoparticle synthesis. It further evaluates the environmental impacts of these technologies and assesses their potential to advance sustainable and cleaner frontiers in the valorization of CW.

Use of ketamine in Super Refractory Status Epilepticus: a systematic review.

OBJECTIVE: This review specifically investigates ketamine's role in SRSE management. METHODS: PubMed, EMBASE, and Google Scholar databases were searched from inception to May 1st, 2023, for English-language literature. Inclusion criteria encompassed studies on SRSE in humans of all ages and genders treated with ketamine. RESULTS: In this systematic review encompassing 19 studies with 336 participants, age ranged from 9 months to 86 years. Infections, anoxia, and metabolic issues emerged as the common causes of SRSE, while some cases had unknown origins, termed as NORSE (New Onset RSE) or FIRESs (Febrile Infection-Related Epilepsy Syndrome). Most studies categorized SRSE cases into convulsive (N = 105) and non-convulsive (N = 197). Ketamine was used after failed antiepileptics and anesthetics in 17 studies, while in others, it was a first or second line of treatment. Dosages varied from 0.5 mg/kg (bolus) and 0.2-15 mg/kg/hour (maintenance) in adults and 1-3 mg/kg (bolus) and 0.5-3 mg/kg/hour (maintenance) in pediatrics, lasting one to 30 days. Ketamine was concurrently used with other drugs in 40-100% of cases, most frequently propofol and midazolam. Seizure resolution rate varied from 53.3 to 91% and 40-100% in larger (N = 42-68) and smaller case series (N = 5-20) respectively. Seizure resolution occurred in every case of case report except in one in which the patient died. Burst suppression in EEG was reported in 12 patients from two case series and two case reports. Recurrence was reported in 11 patients from five studies. The reported all-cause mortality varied from 38.8 to 59.5% and 0-36.4% in larger and smaller case series., unrelated directly to ketamine dosage or duration. SIGNIFICANCE: Ketamine demonstrates safety and effectiveness in SRSE, offering advantages over GABAergic drugs by acting on NMDA receptors, providing neuroprotection, and reducing vasopressor requirement.

Conch Shell (Turbinella pyrum) Powder: A Potential Marine Biological Source of Calcium and Some Trace Minerals for Growing Crossbred Calves.

The present study was conducted to evaluate the effect of feeding conch shell (Turbinella pyrum) powder (either fresh or calcined) as a marine organic source of calcium (Ca) supplemented in the diet of crossbred calves on voluntary intake, growth performance, and blood biochemistry in growing crossbred Jersey calves. A growth trial of 90 days was conducted on 15 Jersey crossbred female calves (Av. weight, 70.68 ± 2.90 kg; Av. age, 197.73 ± 12.40 days), equally divided into three groups of 5 animals each, i.e., control (T0), treatment 1 (T1), and treatment 2 (T2). All animals were fed total mixed ration (TMR) prepared with a concentrate mixture, chaffed paddy straw, and green fodder at the ratio of 40:30:30 on DM basis. Calves under the control group were fed with TMR containing a standard mineral mixture having dicalcium phosphate (DCP) as a Ca source. Calves under T1 group were supplemented with TMR containing fresh conch shell powder (FCSP), and T2 calves were fed with TMR containing conch shell calcined powder (CSCP) as Ca source. We observed 11.66% increase (p < 0.01) in Ca concentration in CSCP compared to FCSP. The concentration of minerals like Mg, Co, Mn, and Fe was enhanced in CSCP compared to the FCSP. However, the calcination process of fresh conch shell powder (FCSP) reduced the concentration of Cu, and Zn. The Ca/P ratio was estimated as 2.11, 2.06, and 2.10 in T0, T1, and T2 diets, which could be considered ideal for calf ration. Calves under T1, and T2 groups consumed significantly (p < 0.001) greater amounts (g/kg W0.75) of DM and CP compared to T0. However, increased voluntary intake did not translate into increased body weight gain (kg), and feed conversion ratio (kg DMI/kg gain) in T1 and T2 groups in comparison to T0. We observed similar blood glucose, urea, alkaline phosphatase (ALP), aspartate aminotransferase (AST), and alanine transaminase (ALT) concentration among the three treatments. Ca, and P levels in blood plasma were also identical among the three groups. The digestibility of Ca was increased significantly (p = 0.01) in FCSP (T1)- and CSCP (T2)-treated calves compared to control (T0) calves. Similarly, T1 and T2 enhanced P digestibility compared to T0. This first report with short-term experimentation depicted some promising scope for the use of locally available conch shell powder (fresh or calcined form) as a potential source of Ca for feeding to livestock, because these new sources of Ca did not affect intake, digestibility of Ca and P, growth performance, blood chemistry, and liver enzymes negatively in weaned crossbred calves.

Disseminated appendicular lymphoma presenting as acute appendicitis: a case report.

Introduction and importance: Acute appendicitis is a common surgical emergency marked by appendix inflammation, presenting as acute abdominal pain and typically treated with appendectomy. The authors report a rare case of disseminated appendicular lymphoma presenting as acute appendicitis. Acute appendicitis is a common surgical emergency. Case presentation: This case involved a 75-year-old male patient who underwent appendectomy, revealing an enlarged appendix with lymphomatous nodules. Clinical discussion: Lymphoma involvement in the appendix is extremely rare, and lymphomas presenting as acute appendicitis are even more exceptional. Imaging investigations, including ultrasound and CECT scan of the abdomen, are recommended to aid in diagnosis. On computed tomography, appendiceal lymphoma is characterized by markedly diffuse mural soft-tissue thickening with preserved vermiform morphology and occasional aneurysmal dilatation of the lumen. Conclusion: This case underscores the importance of considering unusual etiologies in atypical appendicitis presentations.

Neurological manifestations and complications of COVID-19 in patients admitted to a tertiary care center in Nepal during the second wave.

Neurological symptoms and signs of Coronavirus disease-19 (COVID-19) can accompany, follow, or precede respiratory symptoms and signs; hence, they are important in the diagnosis and management of COVID-19 patients. In this retrospective study conducted during the second wave of COVID-19, we included all patients diagnosed with COVID-19 using real-time polymerase chain reaction and admitted to the Tribhuvan University Teaching Hospital between June 2021 and October 2021. The patients were categorized into 2 groups: group A (with neurological manifestations or complications) and Group-B (without neurological manifestations or complications). The 2 groups were compared in terms of intensive care unit (ICU) admission, need for ventilatory support, length of hospital stay, and various outcomes. The study included 235 participants ranging in age from 13 to 102 years (mean age = 54 years, standard deviation = 18). Among the participants, 54.50% were male. The proportion of individuals in group A was higher (59.15%, N = 139) than that in Group-B (40.85%, N = 96). Notably, a significantly greater number of patients were admitted to the ICU in Group B than in Group A. However, there were no statistically significant differences in the need for ventilatory support or hospital stay between the 2 groups. Interestingly, group A showed a higher rate of improvement (Z = -3.1145, P = .00188, 95% CI), while Group-B had a higher rate of mortality (Z = 4.5562, P < .00001, 95% CI). Altered mental status and stroke have been specifically linked to poorer outcomes, whereas typical neurological manifestations, such as hyposmia, hypogeusia, dizziness, headache, and myalgia, are associated with better outcomes.

Retroperitoneal hydatid cyst challenging the diagnosis: Case report with review of literature.

INTRODUCTION: Hydatid cyst is a zoonotic disease caused by a tapeworm, Echinococcus granulosus. A retroperitoneal hydatid cyst is extremely rare and its diagnosis can be challenging, particularly in the early stage as it can mimic several regional pathologies like pancreatic pseudocyst, pancreatic neoplasm, and other retroperitoneal cystic lesions. PRESENTATION OF CASE: We report a rare case of 39-year-old Nepalese male with a left retroperitoneal hydatid cyst who presented with pain and feeling of mass in the left flank region for 6 months. Diagnosis was made by abdominal computed tomography and magnetic resonance imaging and management was done by partial cystectomy. DISCUSSION: Retroperitoneal hydatid cysts can present with chronic pain, mass, and symptoms resulting from the mass effect which varies according to the different retroperitoneal locations. Diagnosis of the retroperitoneal cyst can be challenging clinically and radiologically in its early stages. Even in the late stage, ultrasonography may not suffice and additional imaging techniques such as computed tomography or magnetic resonance imaging are required for the diagnosis. CONCLUSION: In endemic areas, hydatid cyst should be considered while dealing with a retroperitoneal swelling for early diagnosis and prevention of rupture. With a high level of clinical suspicion and radiological findings, retroperitoneal hydatid cyst can be diagnosed and surgery is the principal method of treatment.

Scientific characterization methods for better utilization of cattle dung and urine: a concise review.

Cattle are usually raised for food, manure, leather, therapeutic, and draught purposes. Biowastes from cattle, such as dung and urine, harbor a diverse group of crucial compounds, metabolites/chemicals, and microorganisms that may benefit humans for agriculture, nutrition, therapeutics, industrial, and other utility products. Several bioactive compounds have been identified in cattle dung and urine, which possess unique properties and may vary based on agro-climatic zones and feeding practices. Therefore, cattle dung and urine have great significance, and a balanced nutritional diet may be a key to improved quality of these products/by-products. This review primarily focuses on the scientific aspects of biochemical and microbial characterization of cattle biowastes. Various methods including genomics for analyzing cattle dung and gas chromatography-mass spectroscopy for cattle urine have been reviewed. The presented information might open doors for the further characterization of cattle resources for heterogeneous applications in the production of utility items and addressing research gaps. Methods for cattle's dung and urine characterization.

Post-COVID-19 acute disseminated encephalomyelitis in a 51-year-old female from Nepal: A case report with literature review.

There have been a growing number of acute disseminated encephalomyelitis cases following coronavirus disease-19 (COVID-19) infection. Given the rare occurrence, studies eliciting the clinical features, treatment response, and outcomes are still limited. In patients recovering from COVID-19, multifocal neurologic symptoms in the presence or absence of encephalopathy must be closely evaluated by neurologists and physicians. Early radiographic evaluation using magnetic resonance imaging and timely administration of glucocorticoid-based treatment reduces mortality and leads to satisfactory outcomes.

Mapping of QTLs for morphophysiological and yield traits under water-deficit stress and well-watered conditions in maize.

Maize productivity is significantly impacted by drought; therefore, improvement of drought tolerance is a critical goal in maize breeding. To achieve this, a better understanding of the genetic basis of drought tolerance is necessary. Our study aimed to identify genomic regions associated with drought tolerance-related traits by phenotyping a mapping population of recombinant inbred lines (RILs) for two seasons under well-watered (WW) and water-deficit (WD) conditions. We also used single nucleotide polymorphism (SNP) genotyping through genotyping-by-sequencing to map these regions and attempted to identify candidate genes responsible for the observed phenotypic variation. Phenotyping of the RILs population revealed significant variability in most of the traits, with normal frequency distributions, indicating their polygenic nature. We generated a linkage map using 1,241 polymorphic SNPs distributed over 10 chromosomes (chrs), covering a total genetic distance of 5,471.55 cM. We identified 27 quantitative trait loci (QTLs) associated with various morphophysiological and yield-related traits, with 13 QTLs identified under WW conditions and 12 under WD conditions. We found one common major QTL (qCW2-1) for cob weight and a minor QTL (qCH1-1) for cob height that were consistently identified under both water regimes. We also detected one major and one minor QTL for the Normalized Difference Vegetation Index (NDVI) trait under WD conditions on chr 2, bin 2.10. Furthermore, we identified one major QTL (qCH1-2) and one minor QTL (qCH1-1) on chr 1 that were located at different genomic positions to those identified in earlier studies. We found co-localized QTLs for stomatal conductance and grain yield on chr 6 (qgs6-2 and qGY6-1), while co-localized QTLs for stomatal conductance and transpiration rate were identified on chr 7 (qgs7-1 and qTR7-1). We also attempted to identify the candidate genes responsible for the observed phenotypic variation; our analysis revealed that the major candidate genes associated with QTLs detected under water deficit conditions were related to growth and development, senescence, abscisic acid (ABA) signaling, signal transduction, and transporter activity in stress tolerance. The QTL regions identified in this study may be useful in designing markers that can be utilized in marker-assisted selection breeding. In addition, the putative candidate genes can be isolated and functionally characterized so that their role in imparting drought tolerance can be more fully understood.

Occurrence of osmotic demyelination syndrome in diabetes mellitus: A case report and literature review of various etiologies for osmotic demyelination syndrome.

Osmotic demyelination syndrome is a rare condition reported mainly in the case of rapid correction of hyponatremia, but it can occur even in the case of complicated diabetes mellitus either during rapid correction of hyperglycemia or anytime during the complicated diabetes mellitus. We report a case of complicated diabetes mellitus developing osmotic demyelination syndrome. The patient had presented with altered sensorium and seizure, which was initially diagnosed as hyperglycemia, but during his treatment, the magnetic resonance imaging of brain revealed central pontine myelinolysis. Our search on the causes of osmotic demyelination syndrome other than rapid correction of hyponatremia has revealed several other causes like autoimmune liver disease, Sjogren's syndrome and non-Hodgkin's lymphoma in addition to diabetes mellitus.

Elevated CO2 and Water Stress in Combination in Plants: Brothers in Arms or Partners in Crime?

The changing dynamics in the climate are the primary and important determinants of agriculture productivity. The effects of this changing climate on overall productivity in agriculture can be understood when we study the effects of individual components contributing to the changing climate on plants and crops. Elevated CO2 (eCO2) and drought due to high variability in rainfall is one of the important manifestations of the changing climate. There is a considerable amount of literature that addresses climate effects on plant systems from molecules to ecosystems. Of particular interest is the effect of increased CO2 on plants in relation to drought and water stress. As it is known that one of the consistent effects of increased CO2 in the atmosphere is increased photosynthesis, especially in C3 plants, it will be interesting to know the effect of drought in relation to elevated CO2. The potential of elevated CO2 ameliorating the effects of water deficit stress is evident from literature, which suggests that these two agents are brothers in arms protecting the plant from stress rather than partners in crime, specifically for water deficit when in isolation. The possible mechanisms by which this occurs will be discussed in this minireview. Interpreting the effects of short-term and long-term exposure of plants to elevated CO2 in the context of ameliorating the negative impacts of drought will show us the possible ways by which there can be effective adaption to crops in the changing climate scenario.

Plant Nutrition: An Effective Way to Alleviate Abiotic Stress in Agricultural Crops.

By the year 2050, the world's population is predicted to have grown to around 9-10 billion people. The food demand in many countries continues to increase with population growth. Various abiotic stresses such as temperature, soil salinity and moisture all have an impact on plant growth and development at all levels of plant growth, including the overall plant, tissue cell, and even sub-cellular level. These abiotic stresses directly harm plants by causing protein denaturation and aggregation as well as increased fluidity of membrane lipids. In addition to direct effects, indirect damage also includes protein synthesis inhibition, protein breakdown, and membranous loss in chloroplasts and mitochondria. Abiotic stress during the reproductive stage results in flower drop, pollen sterility, pollen tube deformation, ovule abortion, and reduced yield. Plant nutrition is one of the most effective ways of reducing abiotic stress in agricultural crops. In this paper, we have discussed the effectiveness of different nutrients for alleviating abiotic stress. The roles of primary nutrients (nitrogen, phosphorous and potassium), secondary nutrients (calcium, magnesium and sulphur), micronutrients (zinc, boron, iron and copper), and beneficial nutrients (cobalt, selenium and silicon) in alleviating abiotic stress in crop plants are discussed.

Low-dose alteplase for the management of acute ischemic stroke in South Asians: A systematic review on cost, efficacy and safety.

INTRODUCTION: South Asia is responsible for more than 40% of the stroke burden and stroke mortality in the developing world. South Asia, which is home to one-fourth of the world's population, is the most densely populated and one of the poorest regions. The majority of patients in this region are unable to afford intravenous thrombolysis (IVT) for acute ischemic stroke (AIS). If low-dose alteplase proves effective and safe in South Asians, it may be a more cost-effective treatment option. METHODS: The study was conducted according to the PRISMA (Preferred Reporting Items for Systematic Reviews and meta-Analyses) guideline. Researchers searched PubMed, EMBASE, and Google Scholar for English literature from 2005 to 2021. END, ENI, good functional outcome, SICH, and all-cause mortality were used to assess efficacy and safety. RESULTS: In the low-dose alteplase treated patients, different studies reported 32 to 57% ENI 24 h after IVT, and 7% to 9.7% END. At 3 months follow-up, good functional outcome was achieved by 48%-76.92% of low-dose alteplase treated patients. SICH rates ranged from 0% to 16.6% across studies. Asymptomatic ICH occurred in 5-14% of patients. The mortality rate in all included studies varied from none to 25%. CONCLUSION: Our systematic review demonstrates that the use of low-dose alteplase for AIS in the South Asians offer comparable efficacy and reduced risk of SICH at a significantly lower cost than standard alteplase dose. Future well-randomized clinical trials are necessary to validate the findings of our study.

The effect of four different intracanal medicaments on the push-out bond strength of root canal sealers.

This study aimed to compare the effect of 4 different intracanal medicaments on the push-out bond strength of two sealers (AH Plus and MTA Fillapex). 100 single-rooted extracted premolar teeth were divided into 5 groups, with 20 samples in each group, one group being the control group. After cleaning and shaping procedures, the canals were filled with 4 different medicaments: calcium hydroxide, tri-antibiotic paste (TAP), Metapex, or Chlorhexidine (2%) gel for 2 weeks. Following this, the medicaments were rinsed away, and the samples in those sub-groups were obturated with gutta-percha/AH Plus or MTA Fillapex sealers. After 2 weeks of incubation, a 2-mm-thick middle section from each root was evaluated to test push-out strength. The obtained data were tabulated, and appropriate statistical analysis was performed (two-way ANOVA and LSD test). When comparing the average values, the bond strength values of AH Plus were significantly higher than those of MTA Fillapex (p<0.05) in all medicament groups. Based on the findings, we concluded that AH Plus had comparatively higher bond strength than MTA Fillapex. We also observed that AH Plus had higher bond strength in the presence of calcium hydroxide, whereas MTA Fillapex in the presence of Chlorhexidine. A comparison of the push-out bond strength shows that irrespective of the root canal segment or the final irrigant used, AH Plus showed higher values among all groups. The limitation of the current study was that the effect of TAP on the bond strength of endodontic sealers was not negative.

Adenocarcinoma among Patients Diagnosed with Lung Cancer in a Tertiary Care Centre: A Descriptive Cross-sectional Study.

Introduction: Lung cancer is the leading cause of cancer deaths all over the world and adenocarcinoma is the most common type. Diagnosis is made usually at an advanced stage of lung cancer in patients, making it nearly impossible to cure. The aim of this study is to find out prevalence of adenocarcinoma among patients diagnosed with lung cancer in a tertiary care centre. Methods: A descriptive cross-sectional study was carried out in the Department of Pulmonary Medicine of a tertiary care centre among 69 patients from October, 2018 to September, 2019. Ethical approval was taken from the Institutional Review Committee of a tertiary care hospital (Reference number: 54/2018). A convenience sampling technique was used. Data were entered and analysed using the Statistical Package for the Social Sciences version 21.0. Point estimate at 90% Confidence Interval and descriptive statistics were interpreted as frequency, percentage, or as mean and standard deviations. Results: Among 69 lung cancer patients, adenocarcinoma was seen in 27 (39.13%) (29.47-48.79 at 90% Confidence Interval). Out of 27, 10 (37.04%) were male and 17 (62.96%) were female. Chronic obstructive pulmonary disease was the major comorbidity seen among 17 (62.96%) patients. Conclusions: The prevalence of adenocarcinoma was similar to other studies done in similar settings. Keywords: adenocarcinoma; lung cancer; Nepal; smoking.

Safety and efficacy of intravenous thrombolysis in acute ischemic stroke patients with a history of intracranial hemorrhage: A systematic review and meta-analysis.

Acute ischemic stroke (AIS) is a fatal and debilitating condition killing 2.7 million people each year worldwide. The most commonly used treatment modality for AIS is intravenous thrombolysis (IVT) with alteplase which is indicated for those presenting within 4.5 h of onset. Due to a lack of reliable evidence on harm or benefit, the 2019 American Heart Association/American Stroke Association (AHA/ASA) guidelines consider a history of previous intracranial hemorrhage (ICH) as potentially harmful and no longer an absolute contraindication for IVT in patients with AIS, and the U.S. Food and Drug Administration (FDA) removed chronic ICH as a specific contraindication for IVT from the label in 2015. Despite a shift in guidelines, physicians frequently face the dilemmatic choice whether to administer IVT in this subset of patients due to the risk of symptomatic intracranial hemorrhage (SICH). The benefit of IVT in such patients has not been thoroughly investigated, and there are only a few studies on the subject in the literature to date. We conducted the present meta-analysis in an aim to provide solid evidence on the efficacy and safety of IVT for treating AIS in patients with a history of remote ICH. Our meta-analysis found that IVT improves functional outcomes in AIS patients with prior remote ICH without increasing SICH or all-cause mortality. These findings may contribute to the decision-making process for IVT administration in AIS patients.

Pseudohypoparathyroidism type 1 B mimicking Fahr's disease in a 28-year-old female: A case report.

In virtue of precise clinical history, physical examinations, and biochemical/radiological investigations, pseudohypoparathyroidism can be effectively diagnosed, and its types can be differentiated even without exorbitant tests.

Keratosis obturans: A rare cause of facial nerve palsy.

Keratosis obturans, caused by the deposition of desquamated keratin plug in the external auditory canal can present with facial palsy. Young patients presenting with facial palsy, earache, and gradual hearing loss should be suspected for Keratosis obturans.