Coexistence of proboscis lateralis and multiple craniofacial, neurological, cardiac and spinal deformities: a one-of-a-kind case report.

BACKGROUND: Proboscis lateralis (PL) is an uncommon congenital facial deformity marked by the protrusion of a primitive tubular structure made up of skin and soft tissue that generally emerges from the eye's medial canthus and is associated with some craniofacial deformities. We report the first case of PL with multiple craniofacial, neurological, cardiac, and spinal anomalies. CASE PRESENTATION: A full-term female baby delivered by cesarean section cried immediately at birth. The mother reported having a normal pregnancy but has a history of x-ray during her first trimester. The baby was born with a rare presentation of proboscis lateralis which was accompanied by multiple anomalies, including but not limited to bilateral colpocephaly, corpus callosum agenesis, complex cyanotic congenital heart disease, and hemivertebra of the T10 body. CONCLUSION: PL is an uncommon congenital condition that causes a variety of craniofacial abnormalities. Multiple additional defects affecting various organ systems should also be evaluated in a person diagnosed with PL.

The Clinical Manifestations and Efficacy of Different Treatments Used for Nephrogenic Systemic Fibrosis: A Systematic Review.

Aim: Nephrogenic systemic fibrosis (NSF) is a rare disorder that occurs in association majorly with chronic kidney disease (CKD). The lack of collective quantitative data on its clinical manifestations and the different treatment options' efficacy, call the need for our investigation. Methods: A systematic review was conducted covering a timeline from inception up to July 2022 without any restrictions. Article screening and data extraction were performed independently on PubMed, Google Scholar, ScienceDirect, and Cochrane Library. The keywords that we used were CKD, NSF, Gadolinium enduced fibrosis, etc; shortlisted articles were assessed for risk of bias. Data were presented as frequencies and percentages, with a confidence interval of 95%. A chi-square test was also done to find significant relationships, with a p-value <0.05 considered significant. Results: We had 83 patients in this review consisting of 44 (55.7%) females with a mean age of 51.4±14.6 years. Sixty-nine (83.1%) patients had chronic kidney disease predisposition to NSF. Previous exposure to gadolinium-based contrast dyes was seen in 66 (79.5%) patients). The most common symptom in patients was cutaneous lesions in 69 (83.1%) patients. The most used treatments were ultraviolet therapy, renal transplant, and extracorporeal photopheresis; in 13.3% of the patients each. Condition in most patients either improved (67.1%) or remained stable (11.8%). Chi-square testing found that the treatments offered were also seen to be significantly related to outcome (p=0.015). Conclusion: The findings in this study provide a quantitative measurement of NSF's presentations and treatment efficacies. This serves to make way for researchers to form comprehensive guidelines on the presentation-based treatment of NSF.

Storage of Na in 2D SnS for Na ion batteries: a DFT prediction.

The high demand for renewable and clean energy has driven the exploration of advanced energy storage systems. Sodium-ion batteries (SIBs) are considered to be potential substitutes for Li-ion batteries (LIBs) because they are manufactured from raw materials that are cheap, less toxic, and abundantly available. Recent developments have demonstrated that two-dimensional (2D) materials have gained increasing interest as electrode candidates for efficient SIBs because of their enormous surface area and sufficient accommodating sites for the storage of Na ions. Herein, we explore the binding and diffusion mechanisms of Na on a 2D SnS sheet using density functional theory (DFT). The outcomes reveal that Na has a strong binding strength with SnS as well as charge transfer from Na to SnS, which affirms an excellent electrochemical performance. A transition from semiconducting (1.4 eV band gap) to metallic has been noted in the electronic structure after loading a minor amount of Na. In addition, a low open-circuit voltage (OCV) of 0.87 V and a high storage capacity of 357 mA h g-1 show the suitability of the SnS monolayer for SIBs. In addition, the low activation barrier for Na migration (0.13 eV) is attractive for a fast sodiation/desodiation process. Henceforth, these encouraging outcomes suggest the application of the SnS sheet as an excellent anode for next-generation SIBs.

New-Onset Refractory Status Epilepticus Secondary to COVID-19 Infection in Adults: A Systematic Review.

Background: New-onset refractory status epilepticus (NORSE) has been reported in the scientific literature as a phenomenon associated with the COVID-19 infection. Given the resurgence of the newer variants of COVID-19 added with its multi-system manifestations, this project was conducted to study the clinical picture of NORSE secondary to COVID-19 infection. Methods: Three electronic databases were searched using an extensive search strategy from November 2019 to December 2021. Patients reporting NORSE secondary to COVID-19 were included in this review. The status epilepticus severity score (STESS) was calculated by the study authors for individual patients. Statistical analysis was performed using SPSS version 26 with a p-value <0.05 as statistically significant. Results: After screening, 12 patients were included in this study with a mean age of 61.6 ± 19.0-year olds. The most common type of status epilepticus reported in our study population was non-convulsive status epilepticus (NCSE) (7 out of 12 patients, 58.3%). The linear regression model revealed that STESS scores were significantly influenced by patients' age (p = 0.004) and intra-hospital occurrence (IHO) of status epilepticus (p = 0.026). Overall, 8 patients (66.7%) were discharged without complications. Conclusion: Given the observed association of STESS with the aging population and IHO of status epilepticus, special attention is due to the caretakers of this population, while further studies are needed to further build upon this review.

Association of increased pain intensity, daytime sleepiness, poor sleep quality, and quality of life with mobile phone overuse in patients with migraine: A multicenter, cross-sectional comparative study.

BACKGROUND: The number of regular smartphone users has increased dramatically worldwide. Headaches, followed by sleep difficulties, forgetfulness, dizziness, and other ailments, are among the most prevalent complaints among smartphone users during or after use. In addition, migraine is a debilitating disease and is the world's second leading cause of disability. Hence, we performed this study to determine how smartphone overuse influenced migraine patients' level of disability, pain intensity, sleep quality, and overall quality of life. METHODS: In this observational study, the patients were divided into two groups high mobile phone use group (HMPUG) and the low mobile phone user group (LMPUG) using the Mobile Phone Problematic Use Scale. We assessed, for each group, patients' level of disability, pain intensity, sleep quality, daytime sleepiness, and quality of life through the Migraine Disability Assessment Scale, Visual Analogue Scale, Pittsburgh Sleep Quality Index, Epworth Sleepiness Scale, and 24-h Migraine Quality of Life Questionnaire, respectively. RESULTS: Our study showed that the respondents' average age was  27.59 (9.79) years. The average number of family members was 5.98 (2.3251). A total of 65.8% (n = 263) of the 400 participants were female, while 34.3 % (n = 137) were male. Greater pain intensity, poor sleep quality, and reduced medication effectivity were found in HMPUG compared to LMPUG (p < .05). However, increased duration of migraine and medication intake was reported in the LMPUG (p < .05). CONCLUSION: We observed that smartphone overuse could worsen pain, sleep, and reduce treatment efficacy in individuals with migraine. Therefore, controlled smartphone use is recommended to avoid worsening symptoms.

New-onset Parkinsonism as a Covid-19 infection sequela: A systematic review and meta-analysis.

Background: There remains a scarcity of literature regarding COVID-19 and its neurological sequelae. This study highlights Parkinsonism as a post-COVID-19 sequela and helps us understand a possible link between the two. Methods: A literature search covering relevant databases was conducted for studies reporting the development of Parkinsonism in patients recovering from COVID-19 infection. A quality assessment tool developed by The Joanna Briggs Institute Critical Appraisal tools for the assessment of case reports was utilized. Fisher's exact test was used to explore the factors associated with COVID-19 and Parkinsonism as its complication. Results: Ten studies were included in our study. The median age of patients was 60.0, with an interquartile range of 42.5-72.0. There were 8 males (61.5%) patients, and 53.8% of cases were reported to have at least one comorbidity. Cogwheel rigidity was the most common symptom of Parkinsonism in 11 patients. While the most standard treatment modality used was Levodopa in 76.9% of cases. Using the Fisher's Exact test, it was identified that 10 patients (76.9%) with bradykinesia made a full recovery. Conclusion: Despite presumed "recovery" from COVID-19, patients still face a wide range of neurological complications. One of these complications presenting as Parkinsonism requires health care professionals to be on the lookout for the long-term effects of COVID-19. Hence, our study provides information on the possible likely hood of a link between COVID-19 and the development of Parkinsonism as post-COVID neurological sequelae.

Relationship between cerebrospinal fluid protein level and electrophysiologic abnormalities in the acute inflammatory demyelinating polyradiculoneuropathy variant of Guillain-Barré syndrome.

Objective: Guillain-Barré syndrome (GBS) is an autoimmune disease characterized by weakness in limbs or cranial nerve innervated muscles. Acute inflammatory demyelinating polyradiculoneuropathy (AIDP) is the most common variant. Electrophysiologic abnormalities and elevated cerebrospinal fluid (CSF) protein are frequently present in AIDP, but the relationship between these two parameters is not well known. We aimed to fill this gap by studying this relationship. Methods: This was a prospective cross-sectional study conducted for two years in the Department of Neurology, Dr. Ruth K. M. Pfau Civil Hospital, Karachi, Pakistan. All 90 adult patients with the AIDP variant of GBS were selected. Nerve conduction studies were performed to determine the degree of demyelination through the four electrophysiologic demyelination criteria. The CSF sample was sent to lab immediately after lumbar puncture. SPSS version 20.0 was used. The CSF protein level was measured with mean ±SD. Demyelination criteria were measured in frequency and percentages. Chi-square test was applied to a number of demyelination criteria and T-test/ANOVA was applied on mean CSF protein level. Results: We found a mean CSF protein of 37.41 mg/dl (±3.69) with one demyelination criterion, 81.87 mg/dl (±17.39) with two demyelination criteria, 119.75 mg/dl (±31.42) with three demyelination criteria, and 134.00 mg/dl (±42.87) with four demyelination criteria (P-value <0.001). Conclusion: This study demonstrates a significant relationship between CSF protein levels and degree of demyelination in the AIDP variant of GBS. This is an under-researched area in GBS and this study adds favorably to limited data in this regard.

Controlling transport properties at LaFeO3/SrTiO3interfaces by defect engineering.

The formation of conductive LaFeO3/SrTiO3interfaces is first time reported by pulsed laser deposition via controlling the defects of SrTiO3, which are closely related to the surface of substrate. It is found that the interfaces grown on SrTiO3substrates without terraces exhibit the two dimensional electron gas. Moreover, the conductive interfaces show a resistance upturn at low temperatures which is strongly diminished by light irradiation. These interfaces favor the persistent photoconductivity, and the enormous value of relative change in resistance, about 60 185.8%, is also obtained at 20 K. The experimental results provide fundamental insights into controlling the defects at conductive interfaces of oxides and paving a way for complex-oxides based optoelectronic devices.

Revealing the Photocharge-Transfer Mechanism at Manganite-Buffered LaAlO3/SrTiO3 Interfaces by Giant Photoresponse.

The photoinduced phase transition at complex oxides remains one of the very important issues because of the emergent physics and potential applications. In particular, the mechanism of charge transfer at interfaces under irradiation is challenging. Herein, the photoinduced properties of manganite-buffered LaAlO3/SrTiO3 interfaces with different thicknesses of the buffer layer are systematically investigated. The giant photoresponse is observed, and its relative change in resistance is about 6.24 × 106% at T = 20 K for the sample with a buffer layer thickness of 4.8 nm. Moreover, the transition temperature is enhanced by increasing the thickness of the buffer layer. More importantly, the dead layer effect at the interfaces has been suppressed by using light. All these results are attributed to the charge transfer because of the octahedral tilting at low temperatures and provide a new kind of oxide-based optical devices, such as ultraviolet detectors. This piece of work will pave the way toward two-dimensional electron gas-based optoelectronic devices.

Effects Of Cardiovascular Conditioning Exercises On Quality Of Life In Patients With Dilated Ardiomyopathy In Pakistan.

BACKGROUND: Dilated Cardiomyopathy (DCM) is the most frequently diagnosed cardiomyopathy in Pakistan and patients have significant muscles dysfunction which affects their quality of life (QOL). Available evidence have supported the role of moderate intensity exercise for improving QOL but no such studies have been conducted in Pakistan so far. METHODS: A single blinded randomized controlled trial was conducted in two different hospitals of Rawalpindi from September 2016-February 2017. Both genders clinically stable DCM patients with ejection fraction <40% were selected through purposive non-probability sampling and randomized to Training group and Control group (n=30 each). Training group protocol included bicycling on lower limb ergometer 4days/week on alternate days for 8 weeks. Patients in control group received usual care. Patients were assessed thrice during 8-week protocol. The tools used included structured questionnaire with different standard scales like 6 Minute Walk Test, Modified Medical Research Council Scale, Modified Borg Scale and Minnesota Living with Heart Failure Questionnaire. Data was analysed on SPSS 21 software. RESULTS: Prior to conditioning in training group, 6 (21%) patients reported good and 23 (79%) have poor QOL whereas in control group 14 (56%) have good and 11 (44%) have poor QOL on MLHFQ score. After 8 weeks in training group, 28 (96%) patients reported excellent QOL and in control group, 11 (44%) reported good and 14(56%) have poor QOL on MLHFQ score. Between the groups analysis depicted highly significant p-values for QOL and New York Heart Association (NYHA) class (p<0.001). CONCLUSION: Supervised cardiac conditioning program significantly improves Quality of life and NYHA functional class in dilated cardiomyopathy.

Dispersing upconversion nanocrystals in PMMA microfiber: a novel methodology for temperature sensing.

This paper reports the synthesis of a ß-NaYF4:Yb3+/Tm3+ phosphor by a thermal decomposition method and focuses on the fabrication of microfibers by the co-doping of nanocrystals with PMMA solution via a facile drawing method. The structural characteristics of the nanocrystals are studied by XRD and TEM techniques. Meanwhile, the optical properties of the microfibers are probed by wave guiding performance and upconversion spectroscopy. With the excitation of a 980 nm laser source, the microfiber presented blue upconversion emission of Tm3+ ions. The fluorescence intensity ratio (FIR) method is utilized for the non-thermally coupling transition (1D2 → 3F4 (452 nm) and 1G4 → 3H6 (476 nm)) levels to carry out the optical thermometry. The maximum sensitivity is recorded at 298 K and is 0.00157 K-1. The results suggest that the microfibers have potential applications in thermometry with high sensitivity.

Pb2+ ions mobility perturbation by iron particles during electrokinetic remediation of contaminated soil.

Electrokinetic (EK) remediation is one of the most useful approaches for de-contamination of soils. However, it is unclear that how and when the electrokinetic remediation gives advantages over other remediation techniques in soil. This study was designed to find the influence of Fe2+ particles on the mobility of Pb2+ ions, during electrokinetic remediation, in soil contaminated purposely by lead nitrate Pb(NO3)2. Two types of electrokinetic experiments were performed, by using iron and graphite electrodes. The Fe2+ ions from the iron electrodes, produced due to acidic environment in anode compartment, affected the mobility of lead particles by precipitating as Fe(OH)2. Fe2+ ions enhance the adsorption of lead ions in soil. The results show Fe2+ ions of lower ionic conductivity decreased mobility of other particles in soil. Electrokinetic remediation for up to 120 h with iron electrodes is shown to be less effective for removal of lead. In contrast, graphite electrodes were 15 times more effective in lead removal from soil.