Overall Performance Investigation and Optimization of a Multi-fuel Operated Compression Ignition Engine Using Coupled Taguchi and Grey Relational Analysis.

Biofuels are regarded as the best diesel fuel substitute due to their low sulfur concentration, reduced aromatic hydrocarbon content, renewable nature, and higher oxygen content. In this research article, the impact of producer gas, Calophyllum inophyllum oil, diesel, and a blend of C. inophyllum-producer gas fuel on a variable compression ratio (VCR) compression ignition (CI) engine, and the performance and emission parameters are evaluated. Several test runs are undertaken at a constant speed of 1500 rpm to predict the performance and emission characteristics of the test engine by changing input parameters such as engine load, CR, and fuel mode of operation. The brake thermal efficiency, BTE, is considered the performance characteristic, and CO, HC, NO X , and opacity are considered the emission characteristics for the present study. The biofuel, or producer gas, employed in this study is prepared from waste biomasses, such as leaves, small tree branches, vegetable waste, and cow dung, aiding waste management for a sustainable environment. In addition, a coupled Taguchi-Grey relational analysis technique is used to predict the best possible combination of control factors for optimizing the overall output responses. 12 kg load, a CR of 18, and diesel fuel are found to be the optimum input parameters of an engine toward optimum performance. A confirmation test is performed at the end to validate the outcome of the experiment. An enhancement in performance of 22.75% is observed with the considered Grey relational grade model.

Spontaneous extradural and subgaleal hematoma: A rare neurosurgical crisis of sickle cell disease.

Extradural hematoma (EDH) in absence of trauma is a rare entity with only few cases reported in literature. The various causes reported include: Vascular malformation of dura, coagulopathies, sinus infection, middle ear or orbital infection, and tumor. Occurrence of spontaneous EDH as a complication of sickle cell disease is even much rarer. We report a case with sickle cell disease who presented with spontaneous extradural and subgaleal hematomas following an episode of vaso-oclusive crisis. He was managed successfully with surgery. The association of epidural hematomas in sickling hemoglobinopathies is reviewed. In all cases, we noticed one episode of sickle cell crisis just before the occurrence of spontaneous EDH. Perhaps this crisis puts an extra demand over the hematopoietic skull tissue disrupting inner and outer skull margins leading to spontaneous EDH and subgaleal hematoma.

Primary cerebellopontine angle glioblastoma in an adult.

Supratentorial glioblastoma is the most frequent primary intracranial tumor in adults. Its localization in the cerebellum is extremely rare and such tumor presenting as cerebellopontine angle (CPA) mass in an adult is even rarer. We report the case of primary cerebellar glioblastoma in a 52-year-old woman who presented clinically and radiologically as CPA mass. Its clinical presentation, radiological findings, and treatment instituted are discussed in view of pertinent literature.

Intraventricular glioblastoma multiforme mimicking meningioma and review of the literature.

Glioblastoma multiforme (GBM) is the most common primary brain tumor and is usually found in aged persons in the cerebral hemispheres particularly the frontotemporal region. But intraventricular GBM is rare and only few cases have been reported in the literature. We report a case of a 27-year-old man who presented with headache, vision loss in both eyes, and other signs and symptoms of increased intracranial pressure. Computed tomography and magnetic resonance imaging showed an intraventricular, well-circumscribed lesion with homogeneous enhancement of contrast, suggestive of meningioma that is more common than GBM in this location. The patient underwent surgical removal through transcortical route. The final pathologic diagnosis was GBM. We present the clinical features, radiological findings, and surgical management of this case and discuss the pathogenesis and review of the literature of intraventricular GBM.

Recurrence of spinal schwannoma: Is it preventable?

Spinal schwannomas account for about 25% of primary intradural spinal cord tumors in adult. The prognosis for spinal schwannomas is excellent in most cases. Complete resection is curative. However following subtotal removal, recurrence develops after several years. We describe a case of recurrent spinal schwannoma who had been operated twice before for same disease. The possible cause of recurrence and difficulties in reoperation are discussed.

Malignant peripheral nerve sheath tumor presenting as orbito temporal lump: Case report and review of literature.

Malignant peripheral nerve sheath tumor (MPNST) is a rare soft tissue sarcoma. The most common anatomical sites include the upper and lower extremities and trunk and less commonly the head and neck. To our knowledge, few patients with a cranial or facial MPNST have been reported. We report such a lesion in a 35-year-old woman who presented with left sided rapidly progressive proptosis and visual loss due to an orbital lump extending up to the temporal lobe. Cranial imaging showed a huge mass invading the orbital wall and temporal bone. The presumptive diagnosis was a malignant orbital tumor. Preoperative fine needle aspiration cytology of the orbital mass came to be neurofibroma. Near total resection of the tumor was done. Histopathology revealed MPNST which was subsequently confirmed on the basis of immunopositivity for S-100. The patient recovered uneventfully and was discharged 8 days after surgery with an advice to attend cancer institute for possible radiotherapy.

Primary extradural spinal ganglioneuroblastoma: a case report.

We report a case of ganglioneuroblastoma of the spinal cord in a 25-year-old man. Clinical history was short with paraparesis and bladder involvement. The MRI picture was that of an extradural solid tumor with extension to both intervertebral foramina, more suggestive of nerve sheath tumour rather than malignant embryonal tumour. Diagnosis was established by histopathological study. We could not find such a presentation of spinal ganglioneuroblastoma as an extradural, primary tumour in the literature. We discuss the radio-pathological features, surgical management and post-operative outcome.

Intracerebral pial arteriovenous fistula with large venous varix: A rare case report.

BACKGROUND: Intracerebral pial arteriovenous fistulas (AVFs) are rare vascular lesions of the brain. These lesions are composed of one or more direct arterial connection to a single venous channel without true intervening nidus and usually have associated venous varix or giant venous aneurysms. Intracerebral varices are occasionally associated with high-flow AVF, and usually treated by interrupting the feeding arteries leaving the varices intact. CASE DESCRIPTION: We report a rare case of a 24-year-old male with a single-channel pial AVF of the left cerebral hemisphere, which was fed by the left anterior cerebral artery (ACA) and was associated with large venous varix and continuous varicose venous dilatation. This superficially located varix was over 6 cm in diameter posing significant mass effect and had calcified walls. Direct surgical flow disconnection followed by removal of large varix resulted in complete disappearance of pial AVF without complication. CONCLUSION: Though endovascular occlusion of feeding arteries offers a simple and safe option, direct surgical removal should be considered in rare cases of intracerebral superficially located large AVF with calcified wall and mass effect.

Review of spinal neuroectodermal tumor.

Primary spinal primitive neuroectodermal tumors (PNETs) are rare tumors. Most of these tumors occur in children and young adults. To date, 47 cases of primary spinal PNET have been reported in the literature. These tumors are highly aggressive with rapid growth. Review of the literature shows that the overall prognosis of PNETs of spinal cord is very poor even with adequate surgery, radiotherapy and chemotherapy. All the cases reported to date are reviewed in terms of surgical treatment, adjuvant therapy and outcome and the experience with two of these cases are described. Both cases were thoracic extradural ones with intrathoracic extension through intervertebral foramina resembling neurofibroma. Both cases underwent gross total removal of intraspinal and thoracic component. Post-operatively both underwent cranio-spinal radiotherapy. One patient died after a post-operative period of 4 months and the other one is still alive 8 months after surgery, radiotherapy and chemotherapy.

Pineal epidermoid.

BACKGROUND: Tumors of pineal region are uncommon, accounting for ≤1% of intracranial tumors in adults and 3-8% of pediatric brain tumors. Epidermoid cysts account for 0.2-1% of all intracranial tumors. The majority occur in and around the cerebellopontine angle and suprasellar area. Getting an epidermoid in pineal region is very rare. CASE DESCRIPTION: We report a case of pineal epidermoid, which was diagnosed correctly as epidermoid depending on computed tomography (CT) and magnetic resonance imaging (MRI) findings. Knowing its benign nature, we accordingly planned for its near-total removal. CONCLUSION: Most cases of pineal tumors present as obstructive hydrocephalus. They either require pre- or postoperative ventriculoperitoneal (VP) shunt. If properly planned, many benign pineal tumors may be successfully excised and, most importantly, postoperative VP shunt could be avoided.

A rare case of primary extranodal, extradural histiocytic sarcoma of the thoracic spine and review of literature.

BACKGROUND: Histiocytic sarcoma (HS) is a rare aggressive malignant neoplasm of hematopoietic cell origin showing features of fever, weight loss, adenopathy, hepatosplenomegaly, and pancytopenia. Primary histiocytic sarcoma of spine without involvement of lymph nodes, bone marrow or systemic features is very rare. Due to highly malignant, aggressive behavior and frequent local and distant metastases, prognosis of histocytic sarcoma is poor. CASE DESCRIPTION: We report a case of primary extranodal variety of histiocytic sarcoma without involvement of bone marrow at extradural location of thoracic spine. Immunohistochemistry panel ruled out other more common lesions in this location. We could not find such presentation of extradural histiocytic sarcoma at the thoracic region in the literature. CONCLUSION: Primary involvement of extradural space by histiocytic sarcoma could arise from the proliferation of multipotent hematopoietic stem cells which are left in this space embroyologically.

Management of chronic subdural haematoma in a case of idiopathic thrombocytopenic purpura.

Intracranial hemorrhage is a rare devastating complication of idiopathic thrombocytopenic purpura (ITP), mostly presenting as intraparenchymal or subarachnoid haemorrhage. Isolated chronic subdural haematoma (SDH) is still very rare and the optimal management is unsettled. Spontaneous resolution of chronic SDH in patients with idiopathic thrombocytopenic purpura is possible. We report a case of spontaneous chronic SDH in a patient with ITP with hemiparesis where the haematoma significantly decreased in size with complete resolution of hemiparesis as a result of platelet transfusions and continuing therapy with steroids. Surgical treatment of subdural haematoma with consequent bleeding complications can be avoided in this scenario.