A dataset of unmanned aerial vehicle multispectral images acquired over a field to identify nitrogen requirements.

The technique of detecting and tracking an area's physical properties from a distance by measuring its reflected and emitted radiation is known as remote sensing. It gathered data accurately in near real-time. For this purpose, multispectral cameras mounted on UAVs that capture images with different bands can be used to generate vegetation indexes (NDVI, NDRE), which are useful in precision agriculture. In this study UAV image dataset contains 336 multispectral images from a 0.06 ha paddy field with three different phonological cycles of the crop (vegetative, reproductive, and ripening) in the north-western province of Sri Lanka. The selected sample rice variety is BG300. The images were taken over five days, starting from August 14 to October 5, 2023. The UAV flight took place at 30 m from the canopy level with the multispectral camera titled at an angle of 900. The SPAD Chlorophyll Meter was used to collect ground truth data, which is proportional to the nitrogen level of the leaf. There were 50 randomly selected readings throughout the paddy field. Relevant climate data for five days was provided by the Rice Research and Development Institute, Bathalagoda, which belongs to the paddy field. The purpose of this data creation was to aid researchers who are generally interested in disease diagnosis. Moreover, this dataset allows for studying the effect of using different tilt angles on the 3D reconstruction of the paddy fields and the generation of orthomosaics.

Pulmonary Onset of Adult Onset Still's Disease Complicated with Kikuchi Lymphadenitis.

BACKGROUND: Adult onset Still's disease (AOSD) is a rare inflammatory disorder with a variety of clinical presentations. Even though pneumonitis and pleurisy are known to occur in AOSD, pulmonary onset presentations are exceedingly rare. Case Presentation. We present a 40-year-old male, presenting with fever and bilateral alveolar shadows with pleural effusions mimicking community-acquired severe pneumonia. He was initially treated as severe pneumonia with poor response to broad spectrum antibiotics. Subsequently, he was managed as AOSD-induced pneumonitis, as he fulfilled Yamaguchi criteria. Few weeks later, he developed macular rash and arthralgia with generalized lymphadenopathy with lymph node histology, showing Kikuchi lymphadenitis. He responded well to steroids and had a complete recovery. CONCLUSION: Non-infective causes of pneumonitis should be suspected in the setting of poorly resolving pneumonias, especially when microbiological and serological investigations does not support an infective etiology. Presence of systemic symptoms with arthralgia, rash, and disproportionately elevated ferritin level supports the diagnosis of AOSD. Kikuchi lymphadenitis is a reported association with AOSD, and there could be a causal link between the two disorders.

Frequently Relapsing Anterior Nodular Scleritis as the Initial Presentation of a Lethal Systemic Infection: Disseminated Tuberculosis with HIV Coinfection.

BACKGROUND: Scleritis is a painful inflammatory ocular disease often associated with an underlying systemic illness mostly having an autoimmune aetiology. Tuberculosis usually presents as pulmonary infection, and the ocular presentation is considered to be rare. Case presentation. We present a male who developed prolonged pyrexia following systemic steroids while being investigated for a frequently relapsing anterior scleritis. Biopsy of sclera demonstrated acid-fast bacilli, and histology of sclera and lymph node showed granulomatous inflammation with caseation. Contrast CT demonstrated mediastinal and visceral lymphadenopathy with pulmonary changes suggesting disseminated tuberculosis. Later, Western blot confirmed coinfection with HIV with a CD4 count of 71 cells/mm3. He was treated with antituberculous medications, and then HAART was initiated within two months. He showed good response and showed a partial resolution of scleritis at the end of two months. CONCLUSION: Tuberculosis tends to occur in unusual sites when coinfected with HIV. Scleritis is a rare extrapulmonary manifestation of tuberculosis. High degree of suspicion is critical in making diagnosis and commencing early treatment.

Severe Disabling Myalgia as an Initial Presentation of Polyarteritis Nodosa.

BACKGROUND: Polyarteritis nodosa (PAN) is a form of necrotizing vasculitis affecting medium or small blood vessels with multiorgan involvement. Although myalgia is a clinical feature of PAN, severe disabling myalgia as the initial presentation is rarely noted. CASE PRESENTATION: We present a case of 54-year-old male with recently detected chronic kidney disease admitted with progressive severe disabling muscular pains predominantly over calves with constitutional symptoms for seven weeks. He was weak to mobilize out of the bed. Later, he developed a vasculitic rash, unilateral ulnar claw, and bilateral foot drop. His skin and muscle biopsies showed evidence of vasculitis. His renal and mesenteric artery CT angiogram revealed stenosed segment of the celiac artery without evidence of visible aneurysms elsewhere. He completed six cycles of intravenous cyclophosphamide pulse therapy with high-dose oral prednisolone with good response. With continuation of aggressive immunosuppression and rehabilitation for five months, the patient improved and was able to walk without support. CONCLUSION: Musculoskeletal predominant PAN, even though rare, needs to be considered in patients presenting with disabling muscle pain and weakness. These features may herald over days to months along with constitutional symptoms before other systems getting affected. Early recognition of such symptoms and initiating specific treatment would be important for better outcomes.

Doxycycline Usage for Prevention of Leptospirosis among Farmers and Reasons for Failure to Use Chemoprophylaxis: A Descriptive Study from Southern Sri Lanka.

BACKGROUND: Leptospirosis causes substantial morbidity and mortality in Sri Lanka. Health authorities have implemented a chemoprophylaxis programme for prevention of disease for farmers who are at a high risk of leptospirosis. Only 39% of general population is aware of chemoprophylaxis. Awareness on chemoprophylaxis and its usage among the risk population and the reasons for non-usage was uncertain. Our aim was to assess the chemoprophylaxis usage for prevention of leptospirosis among farmers and reasons for failure to use such preventive strategy. METHODS: Cross-sectional descriptive study was conducted on farmers in community setting in Galle District. Multi-stage cluster sampling method was used. Out of the seventeen "Ministry of Health" (MOH) divisions within the Galle district, nine divisions were randomly selected and, subsequently, two subdivisions ("Public Health Midwife" divisions) were randomly selected from each MOH division. From each PHM division (total of 18), a cluster who does farming as the main source of income was selected. From these farmers, details on demographics, knowledge on leptospirosis and knowledge and practice on chemoprophylaxis usage were obtained through an interviewer administered open-ended questionnaire. From those who have not properly taken chemoprophylaxis, the reasons for non-usage were explored by semistructured interviews. RESULTS: We recruited 319 (77%-males) farmers to the study. Eighteen (5.6%) have already had leptospirosis. Majority (86.8%) of farmers were aware that doxycycline can be used to prevent the disease occurrence. Only 31% knew about correct recommendations of chemoprophylaxis usage adopted by the national guidelines. Only 28.5% (91) used doxycycline prophylaxis. Out of those, only 60 farmers (65.9%) continued the prophylaxis throughout the contact and followed national recommendations. Themes responsible for non-usage were elicited such as lack of awareness of chemoprophylaxis usage, false sense of security from the disease by perceived "immunity" due to prolong exposure or due to low prevalence of disease, lack of motivation, lack of availability of medication, and fear of side effects. CONCLUSIONS: Awareness of leptospirosis is better among farmers compared to the general population. Usage of chemoprophylaxis among farmers was highly inadequate. Individual and health system related hypotheses and myths exist for non-usage of chemoprophylaxis. Thus, an urgent concerted campaign aimed at increasing awareness within the target group through education and making medicines effectively distributed is essential for better prevention of the disease.

Bilateral Sensorineural Deafness in a Young Pregnant Female Presenting with a Fever: A Rare Complication of a Reemerging Disease-Spotted Fever Group Rickettsioses.

BACKGROUND: Rickettsial illnesses are a group of arthropod-borne remerging diseases. They are subdivided into three groups as typhus, spotted fever, and scrub typhus group. Complications such as reversible bilateral deafness due to spotted fever rickettsioses are infrequently reported in the literature. CASE PRESENTATION: We present a young pregnant female who developed bilateral sensorineural deafness on the fifth day of an acute febrile illness with a maculopapular rash. Rickettsia conorii IgG (>1/450) became highly positive, and she received oral azithromycin for ten days with complete resolution of fever and rash. The sensorineural deafness slowly improved over several months. CONCLUSION: Sensorineural deafness is a rare complication of spotted fever group rickettsioses. Since usage of doxycycline is controversial in pregnancy, azithromycin gave a favourable recovery of fever. Sensorineural deafness took several months to resolve after completion of antibiotics.

Corrigendum to "Metastatic Renal Cell Carcinoma Presenting as Prolonged Pyrexia and Stauffer's Syndrome: Can a Routine Ultrasound Scan Fail to Detect a Renal Cell Carcinoma?"

[This corrects the article DOI: 10.1155/2018/4215041.].

Bilateral Hypoglossal Nerve Palsy due to Brainstem Infarction: A Rare Presentation of Presumed Pyogenic Meningitis.

BACKGROUND: Cranial nerve palsies are well-known complications of basal meningitis, especially in patients with tuberculous meningitis. However, a minority of bacterial meningitis gets complicated with cranial nerve palsies. Although cerebral infarctions are known to occur with acute bacterial meningitis, infarctions occurring in the brainstem are infrequently described. CASE PRESENTATION: We report a 46-year-old healthy female who presented with dysarthria with fever, headache, and vomiting and was diagnosed to have acute pyogenic meningitis complicated with a brainstem infarction resulting in bilateral hypoglossal palsy. Her MRI revealed an infarction in the lower part of the medulla oblongata, probably involving the bilateral hypoglossal nuclei. CONCLUSION: Isolated bilateral hypoglossal nerve palsy is an extremely rare cranial nerve palsy, secondary to pyogenic meningitis. To our knowledge, this should be the first reported case of isolated bilateral hypoglossal nerve palsy due to a brainstem infarct in the background of pyogenic meningitis.

Tuberculous Pachymeningitis Presenting as a Diffused Dural Thickening in a Patient with Chronic Headache and Recurrent Neurological Abnormalities for More than a Decade: A Case Report and a Review of the Literature.

BACKGROUND: Tuberculous pachymeningitis is a rare form of extrapulmonary tuberculosis usually suspected from the detection of thickening of the dura in contrast-enhanced magnetic resonance imaging. Progressive nature of the disease can lead to chronic headache with focal neurological signs due to compression from the thickened dura. CASE REPORT: We report a 40-year-old female who presented with chronic headache over a decade associated with recurrent neurological abnormalities including optic neuritis, hemisensory loss, migraine, facial nerve palsy, and recurrent vertigo. Although there was an initial perceived response to steroids, the patient had a subsequent progressive course. On investigations, she was found to have a diffused dural thickening on contrast MRI with a strongly positive Mantoux test with caseating necrotizing granulomatous inflammation on dural histology. With initiation of antituberculous medication with steroids, the patient markedly improved, and the medication for tuberculosis was continued for a year with good response. CONCLUSION: Primary tuberculous pachymeningitis should be suspected in a patient complaining of prolonged headache with focal neurological signs when MRI evidence of dural thickening is detected, and another focus of tuberculosis was not found. Prompt suspicion with image-guided dural biopsy for histology would help to confirm the diagnosis.

Metastatic Renal Cell Carcinoma Presenting as Prolonged Pyrexia and Stauffer's Syndrome: Can a Routine Ultrasound Scan Fail to Detect a Renal Cell Carcinoma?

Background: Prolonged pyrexia and weight loss are recognised paraneoplastic manifestations of renal cell carcinoma (RCC). Stauffer's syndrome is a rarely described paraneoplastic manifestation, which is described early in the course of RCC. We report a patient who presented with unresolving fever with multiple pulmonary opacities with biochemical evidence of hepatic choleastasis and was later diagnosed to have metastatic RCC with Stauffer's syndrome. Case Presentation: We report a 54-year-old female who was investigated for a poorly resolving fever and recent weight loss for two months. During her course of illness, she developed bilateral multiple opacifications in the chest radiograph with negative pyogenic, mycobacterial microbiological studies. Despite intravenous antibiotics, her fever continued. She was found to have elevated alkaline phosphatase and gamma-glutamyl transferase and she underwent imaging with ultrasound scan of abdomen twice, which did not reveal demonstrable abnormalities. Later, contrast CT of abdomen and chest was performed and detected a renal cell carcinoma of the right upper pole of the kidney with multiple lung metastases, which was concluded as a metastatic RCC with paraneoplastic Stauffer's syndrome. Conclusion: Prolonged pyrexia with loss of weight and Stauffer's syndrome could be features to suggest renal cell carcinoma in the absence of positive microbiological studies. Isoechoic RCC could be missed in routine ultrasonography. When a RCC is suspected in the setting of a pyrexia of unknown origin, ultrasound with doppler or a contrast CT should be requested to aid diagnosis.

A Rare Case of Eosinophilic Granulomatosis with Polyangiitis Associated with Cryoglobulinemia Presenting with a Bullous Skin Eruption of the Lower Limbs.

BACKGROUND: Eosinophilic granulomatosis with polyangiitis (EGPA) is an antineutrophil cytoplasmic antibody- (ANCA-) associated small vessel vasculitis with multisystem involvement. It is characterized with asthma, eosinophilia, and renal and peripheral nervous system involvement. However, EGPA presenting with bullous skin eruption is an uncommon dermatological manifestation. We report a rare case of EGPA overlapped with mixed essential cryoglobulinemia presenting with a bullous skin eruption. CASE PRESENTATION: A 49-year-old female presented with bilateral lower limb erythematous bullous rash with bilateral lower limb numbness. She had bilateral ankle edema with frothyuria and a recent onset wheeze. Blood investigations revealed a marked peripheral eosinophilia with positive P-ANCA. Skin biopsy was suggestive of leukocytoclastic vasculitis. She also had positive cryoglobulins with a high rheumatoid factor titre. The patient was diagnosed of having EGPA with overlapping mixed essential cryoglobulinemia. Her skin eruptions and systemic manifestations improved with prednisolone and cyclophosphamide therapy. CONCLUSION: EGPA can rarely present with a bullous skin eruption and may rarely associate with secondary cryoglobulinemia. Early recognition of these rare manifestations and prompt treatment would prevent further complications and death.

Role of Plasmapheresis and Extracorporeal Membrane Oxygenation in the Treatment of Leptospirosis Complicated with Pulmonary Hemorrhages.

INTRODUCTION: Leptospirosis is an emerging infectious disease associated with multiorgan involvement and significant morbidity and mortality. Although pulmonary hemorrhage due to leptospirosis has a high fatality, specific treatment options are limited and their efficacy is not adequately proven. We opted to find out the current evidence on plasmapheresis and extracorporeal membrane oxygenation (ECMO) in pulmonary hemorrhages due to leptospirosis. METHODS: The first search was conducted in PubMed, OVID, Google Scholar, and Cochrane clinical trial registry using keywords "leptospirosis" OR "Leptospira" OR "Weil's disease" AND "plasmapheresis" OR "plasma exchange" AND "pulmonary hemorrhage" OR "alveolar hemorrhage" OR "lung hemorrhage" and the second search was done using keyword "leptospirosis" OR "Leptospira" OR "Weil's disease" AND "ECMO" OR "Extracorporeal membrane oxygenation." The searches were not limited by study design or the date of publication. Only articles written in English were reviewed. Although we intended to include only clinical trials, it was decided later to include other information such as case reports and case series which addressed these treatment modalities. Two authors selected articles independently in a blinded manner using a set of inclusion and exclusion criteria and discrepancies were solved after discussions. RESULTS: The information found was very limited. This included one clinical trial which showed a significant survival benefit with plasmapheresis but the study design had many limitations. Two case reports described the benefit of plasmapheresis in severe leptospirosis with pulmonary hemorrhages. There were eight case reports where ECMO was performed and out of all only one patient has died. One retrospective study on patients with severe leptospirosis mentioned that four out of five patients with pulmonary hemorrhages survived after being treated with ECMO. CONCLUSIONS: Current evidence is insufficient to recommend the routine use of plasmapheresis or ECMO for patients presenting with pulmonary hemorrhages due to leptospirosis. ECMO may be a promising mode of treatment in acute respiratory failure in leptospirosis related pulmonary hemorrhages. These treatment modalities, however, can be applied based on the availability of resources and expertise at the discretion of the clinician in charge, considering patient related factors such as cardiovascular stability and derangement of coagulation profile. Clinical trials conducted adhering to standard procedures are urgently required to establish the efficacy of these treatment modalities.

Targeting postprandial blood sugar over fasting blood sugar: A clinic based comparative study.

INTRODUCTION: Recent studies indicate that modulation of post prandial blood sugar (PPBS) plays an important role in the long term glycemic control. Measurement of PPBS is more convenient for patients attending outpatient clinics than fasting blood sugar (FBS) as the former needs only two hours of fasting from the last meal. OBJECTIVE: To assess the value of PPBS monitoring in optimization of long term glycemic control among diabetic patients attending an outpatient clinic. METHODS: A total of 240 patients with type 2 diabetes (T2DM) attending an out-patient medical clinic were randomized to either PPBS or FBS monitoring. Those who selected to PPBS-group underwent blood sugar measurement 2-h after last meal on the day of their clinic visits and those in the FBS group underwent blood sugar measurement after fasting overnight (8-10h) in the morning of their clinic visits. Treating team was asked to optimize the anti-diabetic medications based on the available PPBS or FBS results. All patients were followed up monthly for six months. Glycemic control was assessed with glycosylated hemoglobin (HbA1c) at baseline and six months later. RESULTS: Baseline characteristics of the two arms including age, gender, and duration of T2DM were not significantly different. Mean HbA1c (SD) of FBS and PPBS arms at baseline were 7.20 (0.45), and 7.33 (0.43) and were not significantly different (P=0.115). During the study period, HbA1c dropped by 0.20 in FBS arm compared to 0.25 drop in PPBS arm (p=0.59). Incidence of hypoglycemia was similar in FBS (2.42%) and PPBS arms (2.70%). CONCLUSION: Monitoring of PPBS is a safe and effective alternative to FBS to optimize glycemic control in managing patients with T2DM attending outpatient clinics.