Clinicoradiological Features and Long-term Cognitive and Functional Outcome in Patients with Deep Cerebral Venous Thrombosis.

Background: Deep cerebral venous thrombosis (DCVT) can have long-term functional and cognitive sequelae. Although literature exists on cognitive impairment after arterial stroke, cognitive sequelae after cerebral venous thrombosis (CVT) are much less studied. Methods: Clinical records of 29 patients diagnosed with DCVT were reviewed. The Modified Telephonic Interview for Cognitive Status (TICS-M) was adapted and validated in the regional language (Kannada) and applied to 18 patients with DCVT, at a mean follow-up duration of 5.32 years. Screening for depression was done via telephonic Patient Health Questionnaire-9 (PHQ-9)-Kannada version, and functional status was screened by applying the modified Rankin Scale (mRS). Results: DCVT had a mortality rate of 10.34% due to acute complications. mRS scores of 0-1 were achieved at follow-up in all patients who survived. Receiver operating characteristic (ROC) analysis revealed a cutoff of ≤44.5 (maximum score of 49) for the diagnosis of cognitive impairment via TICS-M (Kannada version) in DCVT patients. Evidence of cognitive dysfunction was seen in eight patients (42.10%), and three patients (16.66%) had evidence of depression. Conclusions: Survivors of acute DCVT can potentially have long-term cognitive sequelae. Screening for cognitive dysfunction, depression, and functional status can be effectively done using telephonically applied scales that are adapted to the local language. Neuropsychological evaluation and early cognitive rehabilitation can be initiated for patients in whom deficits are identified on cognitive screening.

Cerebral Venous Sinus Thrombosis Associated Subdural Hematoma: A Case Series on Clinical Presentation and Management.

Diagnosis and treatment of cerebral venous sinus thrombosis (CVT) associated with subdural hematoma (SDH) is challenging with an increased risk of rebleeding on using anticoagulation. There are no guidelines at present due to its rare presentation. In this report we describe three patients who presented with non-traumatic SDH and CVT over the last 3 years. Clinical assessment, investigations including neuroimaging, and management were reviewed both at time of admission and follow-up. These patients presented with varied CVT syndromes -isolated raised intracranial pressure (ICP), focal and diffuse encephalopathy. Neuroimaging helped in diagnosing CVT and SDH. Cases 1 and 3 had SDH alone, while case 2 had SDH along with intraparenchymal hemorrhage. Management of these patients was tailored individually as per mechanism of CVT. Case 1 was clinically stable, however, she had rebleeding after starting anticoagulation, requiring its discontinuation. Cases 2 and 3 underwent immediate neurosurgical intervention in view of deteriorated sensorium. Although CVT manifesting as SDH is rare, clinicians should have a high index of suspicion to accurately diagnose and manage these challenging cases. The decision regarding use of anticoagulation and apt time for neurosurgical intervention needs to be individualized depending on patients condition and response to treatment.

Mastoid fluid signal in acute cerebral venous thrombosis is is associated with increased clot burden.

PURPOSE: Mastoid air cell abnormalities in the form of hyperintense T2 fluid signal have been reported in cases of acute Cerebral Venous Thrombosis (CVT) without otologic infection and have been hypothesized to be a result of venous congestion rather than infectious mastoiditis. The aim of this study was to investigate a link between the spectrum of mastoid abnormalities and clot burden in patients with acute CVT. METHODS: A retrospective study of adult patients admitted to the National Institute of Mental Health and Neurosciences between 2016 and 2023 who were diagnosed with acute CVT and had no clinical evidence of active or recent ear infections was conducted. Pre- and post-contrast MR Images were analyzed to identify the dural sinuses and/or cerebral veins involved and the presence of fluid signal in the mastoid. Fluid signal in the mastoid was graded from 0 to 3 as described by Shah et al- no fluid signal (grade 0), thin curvilinear hyperintensities (grade 1), thick crescenteric hyperintensities (grade 2), and complete hyperintensity (grade 3). Clot Burden Score (CBS) was calculated by assigning one point for each sinus involved, one point for extension of thrombus into the intracranial Internal Jugular Vein (IJV), one point for thrombosis of cortical veins and one point for thrombosis of deep cerebral veins. RESULTS: A total of 89 patients with acute CVT were included in the final analysis. Median time from presentation to MRI was 2 days (range 0-13). 51 patients (57.3%) had fluid signal in the mastoid air cells on T2-weighted images, of whom 33 showed mucosal contrast enhancement. Higher grade of fluid signal in the mastoid was present ipsilateral to the side of venous thrombosis in 59 out of 60 patients with posterior fossa CVT. CBS was significantly different between patients with different grades of fluid signal (p = 0.002). Grade 2-3 fluid signal was associated with higher clot burden (CBS > 3) in both the entire study population (n = 89) - OR = 8.281, 95 %CI: 2.758-24.866 (p < 0.001) and among patients with posterior fossa CVT - OR = 4.375, 95 %CI: 1.320-14.504 (p = 0.016). Among patients with posterior fossa CVT, grade 2-3 fluid signal was associated with left sided transverse and/or sigmoid sinus thrombosis - OR = 5.600, 95 %CI: 1.413-22.188 (p = 0.014), and extension of thrombosis into the IJV - OR = 4.606, 95 %CI: 1.162-18.262 (p = 0.030). CONCLUSION: T2 fluid signal in the mastoid is associated with venous congestion in adults with acute CVT without evidence of otologic infection. Moderate-to-severe T2 fluid signal in the mastoid air cells is associated with increased clot burden.

Multi-wavelength multi-direction laser light scattering for cell characterization using machine learning-based methods.

Cell identification and analysis play a crucial role in many biology- and health-related applications. The internal and surface structures of a cell are complex and many of the features are sub-micron in scale. Well-resolved images of these features cannot be obtained using optical microscopy. Previous studies have reported that the single-cell angular laser-light scattering patterns (ALSP) can be used for label-free cell identification and analysis. The ALSP can be affected by cell properties and the wavelength of the probing laser. Two cell properties, cell surface roughness and the number of mitochondria, are investigated in this study. The effects of probing laser wavelengths (blue, green, and red) and the directions of scattered light collection (forward, side, and backward) are studied to determine the optimum conditions for distinguishing the two cell properties. Machine learning (ML) analysis has been applied to ALSP obtained from numerical simulations. The results of ML analysis show that the backward scattering is the best direction for characterizing the surface roughness, while the forward scattering is the best direction for differentiating the number of mitochondria. The laser light having red or green wavelength is found to perform better than that having the blue wavelength in differentiating the surface roughness and the number of mitochondria. This study provides important insights into the effects of probing laser wavelength on gaining information about cells from their ALSP.

Germanium photopatterning via poly(cyclogermapentene)s.

A series of air-stable poly(cyclogermapentene)s were prepared via the dehydrocoupling of 1,1-dihydrocyclogermapentene monomers. Exposure of the resulting polygermanes to UV light led to elimination of organobutadiene from the polymer side chains and deposition of germanium metal. Overall, this study introduces a mild way to obtain patterns of semiconducting Ge for optoelectronic applications.

Naphthalene diimide-based n-type small molecule organic mixed conductors for accumulation mode organic electrochemical transistors.

Organic mixed ionic-electronic conductors (OMIECs), which transport both ionic and electronic charges, development are important for progressing bioelectronic and energy storage devices. The p-type OMIECs are extensively investigated and used in various applications, whereas the n-type ones lag far behind due to their moisture and air instability. Here, we report the synthesis of the novel n-type naphthalene diimide (NDI)-based small-molecule OMIECs for organic electrochemical transistors (OECTs). The electro-active NDI molecule with the linear ethylene glycol side chains is a promising candidate for n-type channel material to obtain accumulation mode OECTs. This NDI-based small-molecule OMIEC, gNDI-Br2, demonstrates ion permeability due to the attachment of the glycol side chains with optimized ionic-electronic conductions. OECT devices with gNDI-Br2 channel material displays excellent performance in water and ambient stability. OECTs fabricated with two different concentrations, 50 mg mL-1 and 100 mg mL-1 of gNDI-Br2 demonstrate a transconductance value of 344 ± 19.7 µS and 814 ± 124.2 µS with the mobility capacitance product (µC*) of 0.13 ± 0.03 F cm-1 V-1 s-1 and 0.23 ± 0.04 F cm-1 V-1 s-1, respectively. These results demonstrate the n-type OMIEC behaviour of the NDI-based small-molecule and its applicability as an OECT channel material.

Point-of-care (POC) SARS-CoV-2 antigen detection using functionalized aerosol jet-printed organic electrochemical transistors (OECTs).

The continuous spread of coronavirus disease 2019 (COVID-19) has highlighted the need for simple and reliable diagnostic technologies for point-of-care (POC) virus detection applications. Here, we report a COVID-19 diagnostic platform based on aerosol jet-printed antibody-functionalized organic electrochemical transistors (OECTs) for rapidly identifying severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) antigens. Selective sensing of SARS-CoV-2 spike S1 protein is achieved in phosphate-buffered saline (PBS) with a detectable range of 1 fg mL-1 to 1 µg mL-1. We used the sensors to detect the antigens in unprocessed patient nasopharyngeal swab samples in universal transport medium (UTM) and achieved an overall accuracy of 70%. In addition, these patient sample tests clearly demonstrate that our OECT threshold voltage shift is correlated with the sample SARS-CoV-2 viral load. Hence, we have demonstrated an accurate POC biosensor for detecting SARS-CoV-2 antigens, which holds great promise towards developing on-site and at-home rapid SARS-CoV-2 infection screening and COVID-19 prognosis.

The h-Index: Understanding its predictors, significance, and criticism.

The h-index is an author-level scientometric index used to gauge the significance of a researcher's work. The index is determined by taking the number of publications and the number of times these publications have been cited by others. Although it is widely used in academia, many authors find its calculation confusing. There are websites such as Google Scholar, Scopus, Web of Science (WOS), and Vidwan that provide the h-index of an author. As this metrics is frequently used by recruiting agency and grant approving authority to see the output of researchers, the authors need to know in-depth about it. In this article, we describe both the manual calculation method of the h-index and the details of websites that provide an automated calculation. We discuss the advantages and disadvantages of the h-index and the factors that determine the h-index of an author. Overall, this article serves as a comprehensive guide for novice authors seeking to understand the h-index and its significance in academia.

Primary screening of cervical cancer by Pap smear in women of reproductive age group.

Introduction: Cancer cervix is a major health problem responsible for causing a higher mortality rate in women worldwide; the exponential increase in such cases can be reduced by early screening of women. The cytology-based cervical screening had a higher success rate in reducing the incidence of cervical cancer. The present study aimed to evaluate the use of Pap smear screening to find cytological abnormalities and precancerous lesions. Materials and Methods: Sexually active women over 21 years of age were enrolled for the study. A detailed history was taken on the preformed proforma, and all were subjected to vaginal examination. Samples for Pap smear were taken with the help of Ayre spatula and immediately spread over a marked grease-free glass slide and dipped into 95% ethyl alcohol fixative for cytological examination. Results: Most of the abnormality of the epithelial cells found was in the age range of 31-50 years, and most of them were multiparous. 47.92% of the women had a chief complaint of vaginal discharge, an irregular menstrual cycle in 11.07%, and abdominal pain in 7.83%, while 30.41% were asymptomatic. Women found negative for intraepithelial neoplasia were 82.94%, while 13.36% had an inflammatory smear. 0.92% atypical squamous cells of undetermined significance (ASCUS), 2.78% Low-grade squamous intraepithelial lesion (LSIL) were found, no woman had High-grade squamous intraepithelial lesion (HSIL). Conclusion: Pap smear is a simple, cost-effective, non-invasive, and easy to perform tool for early detection of precancerous lesions, and it is evident that every woman above the age of 25-30 years must be recommended for cervical screening.

Spontaneous Downbeat Nystagmus in Anti-GAD-Antibody-Associated Paraneoplastic Syndrome.

Spontaneous downbeat nystagmus and ocular flutter are rare clinical signs. Such findings are commonly related to cerebellar pathology, predominantly ischemia. In a significant percentage of patients, the cause may not be found. If these signs are associated with ataxia, cognitive decline, and seizure, anti-glutamic acid decarboxylase-associated neurological syndrome must be suspected. Background history of tumor has to be enquired. Treatment with immune modulation helps in partial recovery of such cases.

Inflammatory Myositis in a Child due to Anti-NXP2 Antibody, First Case Report from India.

We present a case of a 10-year-old boy with 1-month history of proximal more than the distal weakness of all four limbs with myalgias, contractures, and bulbar symptoms on a background history of exertional myalgias for 2 years. His power was grade two-three. Investigations showed elevated creatine phosphokinase (CPK). His auto-antibody profile showed anti- nuclear matrix protein 2 (NXP2) antibody positivity. Muscle magnetic resonance imaging (MRI) showed extensive T2 fat-saturated hyperintense signal changes in the glutei, thigh, and leg muscles suggestive of active myositis. He improved significantly with immunomodulation with steroids, intravenous immunoglobulins (Iv Ig), and mycophenolate mofetil (MMF). He was continued on monthly pulse steroids and MMF. He is on regular follow-up. This is a rare case of anti-NXP2 antibody-mediated inflammatory myositis and the first report from India.

Coping with the 'Indian summer': unique nesting cycle and nest architecture of the paper wasp, Polistes wattii.

Polistes is one of the most widely distributed and extensively studied primitively eusocial wasps. Based on where they are found, there are two established nesting cycles in this genus. The temperate wasps follow an annual cycle with diapause in winter while the tropical wasps of South America can initiate nests any time of the year and do not hibernate. Additionally, some subtropical Polistes are known to form nest free aggregations during the cold, dry, unfavorable season. Although several species of Polistes wasps are found in India, our knowledge about their biology is pitifully small and is restricted to taxonomic reports. Here, we report the unique nesting cycle of Polistes wattii, a wasp abundantly found in north India and other Asian countries. P. wattii hibernates in winter as well as forms nest-free aggregations in the dry summer season and thus has a nesting cycle with two inactive periods, which no other Polistes is known to follow. The study site in North India experiences short, cold, snow-free winters, spring, a very dry early summer, and humid late summer with intermittent rain. We found that P. wattii here shows several unique adaptations to survive the long Indian summer where it shows two rounds of nest-founding in the same year, once as overwintered, solitary foundress in spring and once with multiple foundresses during summer. To meet the demands of expanding colony in late summer, P. wattii often adds multiple combs to their nest, which are architecturally different from the multiple comb nests reported from neotropical regions and strikingly different from all temperate Polistes who make only single comb nests. This study investigates the nesting biology and natural history of P. wattii to understand how they maximize survival and fitness.

COVID-19 vaccine associated demyelination & its association with MOG antibody.

BACKGROUND: ChAdOx1-S (Covishield™/Vaxzervria, AstraZeneca) and BBV152 (Covaxin) SARS-CoV-2 vaccines are proven to be safe and effective, but rare complications have been reported. OBJECTIVE: To describe reports of central nervous system (CNS) demyelination following ChAdOx1-S and BBV152 vaccinations. METHODS & RESULTS: We report 29 (17 female; mean 38 years) cases of CNS demyelination; twenty-seven occurred in temporal association with ChAdOx1-S vaccine; two in association with BBV152 vaccine. Eleven patients had presentation with myelitis, six patients developed optic neuritis, five had acute demyelinating encephalomyelitis, three presented with brainstem demyelination, and four had multiaxial involvement. Myelin oligodendrocyte glycoprotein (MOG) antibodies were positive in ten patients. One patient with ADEM and tumefactive demyelinating lesions died after a prolonged intensive care unit stay and superimposed infection. As compared to the control group (87); the postvaccinial cases were found to have a significantly higher mean age, presence of encephalopathy (p value:0.0007), CSF pleocytosis (p value: 0.0094) and raised CSF protein (p value: 0.0062). CONCLUSIONS: It is difficult to establish a causal relationship between vaccination and neurological adverse events such as demyelination. The temporal association with the vaccination and the presence of MOG antibodies raises the possibility of an immunogenic process triggered by the vaccine in susceptible individuals.

A review: traditional herbs and remedies impacting pathogenesis of Parkinson's disease.

Parkinson's disease (PD) is characterized by progressive degeneration of dopaminergic neurons, leading to misbalance and loss of coordination. Current therapies are claimed only for symptomatic relief, on long-term use, which causes alteration in basal ganglia, and give rise to various adverse effects like dyskinesia and extra pyramidal side effects, which is reversed and proved to be attenuated with the help of various herbal approaches. Therefore, in order to attenuate the dopaminergic complications, focus of current research has been shifted from dopaminergic to non-dopaminergic strategies. Herbs and herbal remedies seems to be a better option to overcome the complications associated with current dopaminergic therapies. In recent years, various herbs and herbal remedies based on Ayurveda, traditional Chinese and Korean remedies, have become the target of various researches. These herbs and their bioactive compound are being extensively used to treat PD in India, China, Japan, and Korea. The major focus of this current review is to analyze preclinical studies with reference to various herbs, bioactive compounds, and traditional remedies for the management of Parkinson disorder, which will give an insight towards clinical trials.

In Vitro Studies Reveal that Pseudomonas, from Odontotermes obesus Colonies, can Function as a Defensive Mutualist as it Prevents the Weedy Fungus While Keeping the Crop Fungus Unaffected.

Insects that farm monocultures of fungi are canonical examples of nutritional symbiosis as well as independent evolution of agriculture in non-human animals. But just like in human agriculture, these fungal crops face constant threat of invasion by weeds which, if unchecked, take over the crop fungus. In fungus-growing termites, the crop fungus (Termitomyces) faces such challenges from the weedy fungus Pseudoxylaria. The mechanism by which Pseudoxylaria is suppressed is not known. However, evidence suggests that some bacterial secondary symbionts can serve as defensive mutualists by preventing the growth of Pseudoxylaria. However, such secondary symbionts must possess the dual, yet contrasting, capabilities of suppressing the weedy fungus while keeping the growth of the crop fungus unaffected. This study describes the isolation, identification, and culture-dependent estimation of the roles of several such putative defensive mutualists from the colonies of the wide-spread fungus-growing termite from India, Odontotermes obesus. From the 38 bacterial cultures tested, a strain of Pseudomonas showed significantly greater suppression of the weedy fungus than the crop fungus. Moreover, a 16S rRNA pan-microbiome survey, using the Nanopore platform, revealed Pseudomonas to be a part of the core microbiota of O. obesus. A meta-analysis of microbiota composition across different species of Odontotermes also confirms the widespread prevalence of Pseudomonas within this termite. These lines of evidence indicate that Pseudomonas could be playing the role of defensive mutualist within Odontotermes.

Case Report- A rare case of giant hyperplastic polyp.

Giant gastric hyperplastic polyps are the most common benign epithelial tumors in the stomach. These are non-neoplastic epithelial proliferations of the stomach which are strongly associated with inflammatory conditions like chronic gastritis, helicobacter pylori gastritis, reactive or chemical gastritis. A 60 years old gentleman presented with history of two bouts of hematemesis preceded by multiple intermittent episodes of epigastric pain, nausea and few episodes of non-bilious vomiting without any history of previous gastrointestinal bleed, loss of appetite or significant weight loss. Work up with ultrasonography of abdomen, upper gastrointestinal endoscopy, contrast enhanced computed tomography abdomen, laboratory investigations followed by biopsy and histopathology was done which confirmed the diagnosis. Giant hyperplastic polyps are benign epithelial tumor of stomach often resulting from excessive regenerative hyperplasia in areas of chronic inflammation with no site predilection and nearly no malignant potential. Usually asymptomatic, these are incidentally detected on upper gastrointestinal endoscopy with characteristic appearance of such polyps on double contrast barium study followed by upper gastrointestinal endoscopy and biopsy is definitive for diagnosis.

Are ecological communities the seat of endosymbiont horizontal transfer and diversification? A case study with soil arthropod community.

Maternally inherited endosymbionts of arthropods are one of the most abundant and diverse group of bacteria. These bacterial endosymbionts also show extensive horizontal transfer to taxonomically unrelated hosts and widespread recombination in their genomes. Such horizontal transfers can be enhanced when different arthropod hosts come in contact like in an ecological community. Higher rates of horizontal transfer can also increase the probability of recombination between endosymbionts, as they now share the same host cytoplasm. However, reports of community-wide endosymbiont data are rare as most studies choose few host taxa and specific ecological interactions among the hosts. To better understand endosymbiont spread within host populations, we investigated the incidence, diversity, extent of horizontal transfer, and recombination of three endosymbionts (Wolbachia, Cardinium, and Arsenophonus) in a specific soil arthropod community. Wolbachia strains were characterized with MLST genes whereas 16S rRNA gene was used for Cardinium and Arsenophonus. Among 3,509 individual host arthropods, belonging to 390 morphospecies, 12.05% were infected with Wolbachia, 2.82% with Cardinium and 2.05% with Arsenophonus. Phylogenetic incongruence between host and endosymbiont indicated extensive horizontal transfer of endosymbionts within this community. Three cases of recombination between Wolbachia supergroups and eight incidences of within-supergroup recombination were also found. Statistical tests of similarity indicated supergroup A Wolbachia and Cardinium show a pattern consistent with extensive horizontal transfer within the community but not for supergroup B Wolbachia and Arsenophonus. We highlight the importance of extensive community-wide studies for a better understanding of the spread of endosymbionts across global arthropod communities.

Mechanistic and physiological approaches of fecal microbiota transplantation in the management of NAFLD.

Non-alcoholic fatty liver disease (NAFLD) is a multifaceted disease allied with various metabolic disorders, obesity and dysbiosis. Gut microbiota plays an influential role in the pathogenesis of NAFLD and other metabolic disorders. However, recent scientific upsurge emphasizes on the utility of beneficial gut microbiota and bacteriotherapy in the management of NAFLD. Fecal microbiota transplantation (FMT) is the contemporary therapeutic approach with state-of-the-art methods for the treatment of NAFLD. Other potential therapies include probiotics and prebiotics supplements which are based on alteration of gut microbes to treat NAFLD. In this review, our major focus is on the pathological association of gut microbiota with progression of NAFLD, historical aspects and recent advances in FMT with possible intervention to combat NAFLD and its associated metabolic dysfunctions.