Double trouble: insights from a rare case of extranodal composite lymphoma in an elderly man, with comprehensive literature review.

Composite lymphoma (CL) is a rare cancer characterized by the concurrent occurrence of more than one type of lymphoma within the same organ or tissue in an individual. Its occurrence at extranodal sites is exceptional, with only a few cases documented in the literature. A 62-year-old gentleman presented with dystonia, dysphagia, and irregular enlargement of the right tonsil for the last three months. Based on a clinical suspicion of tonsillar malignancy, tonsillectomy was done. The histopathologic examination revealed effacement of the architecture by large irregular lymphoid nodules with interfollicular expansion. The nodules showed sheets of small atypical lymphoid cells, while the interfollicular areas showed large atypical lymphoid cells with scattered typical binucleate Reed-Sternberg cells. Immunohistochemistry confirmed mantle cell lymphoma (MCL) in the nodules and classical HL (cHL) in the interfollicular areas. Based on these features, a diagnosis of composite MCL with cHL was rendered. He was treated with bendamustine and rituximab chemotherapy and remained in complete remission for five years when he presented with significant right-sided neck swelling. Percutaneous fine needle aspiration and subsequent flow cytometry confirmed a relapse of the MCL component of the CL. The index report documents an exceptional case of CL, comprising MCL and cHL, presenting at an uncommon extranodal site. In addition, it also emphasizes the importance of adequate sampling and the simultaneous use of immunochemistry and/or flow cytometry to confirm the presence of more than a single type of lymphoma, which may be easily overlooked on microscopy alone.

Hyaline cartilage at the portal plate and gallbladder in biliary atresia.

Biliary atresia (BA) is a fibro-obliterative cholestatic disease of infancy. The presence of cartilage in the resected tissue is an uncommon finding. We documented the presence of both mature and immature hyaline cartilage in the portal plate and the wall of the gallbladder in a 2-month-old girl infant with BA who had undergone Kasai portoenterostomy. The presence of cartilage could be part of a heterotopia or an uncommon connective tissue metaplasia. The presence of immature cartilage with the merging of the perichondrium with the soft tissue highlights a metaplastic etiology in the index case.

Hyaline cartilage at the portal plate and gallbladder in biliary atresia

ABSTRACT Biliary atresia (BA) is a fibro-obliterative cholestatic disease of infancy. The presence of cartilage in the resected tissue is an uncommon finding. We documented the presence of both mature and immature hyaline cartilage in the portal plate and the wall of the gallbladder in a 2-month-old girl infant with BA who had undergone Kasai portoenterostomy. The presence of cartilage could be part of a heterotopia or an uncommon connective tissue metaplasia. The presence of immature cartilage with the merging of the perichondrium with the soft tissue highlights a metaplastic etiology in the index case.

Adsorption of water on C sites vacancy defected graphene/h-BN: First-principles study.

Heterostructures (HS), vacancy defects in HS, and molecular adsorption on defected HS of 2D materials are fervently inspected for a profusion of applications because of their aptness to form stacked layers that confer approach to an amalgamation of favorable electronic and magnetic properties. In this context, graphene (Gr), hexagonal boron nitride (h-BN), HS of graphene/h-BN (Gr/h-BN), and molecular adsorption on Gr/h-BN offer promising prospects for electronic, spintonic, and optoelectronic devices. In this study, we investigated the structural, electronic, and magnetic properties of C sites vacancy defects in Gr/h-BN HS and adsorption of water molecule on defected Gr/h-BN HS materials by using first-principles calculations based on spin-polarized density functional theory method within van der Waals (vdW) corrections DFT-D2 approach. We found that these considered materials are stable 2D vdW HS. Based on band structure calculations, they are semimetallic, and on density of states and partial density of states analysis, they are magnetic materials. The magnetic moment developed in these defected systems is due to the unpaired up-spin and down-spin states in the orbitals of atoms present in the materials created by the vacancy defects.

Complete agenesis of the corpus callosum in paranoid schizophrenia-a case report.

Corpus callosum agenesis is a rare condition and is sometimes associated with schizophrenia. The co-existence of these two conditions adds value to the neurodevelopmental theory of schizophrenia.

First-principles study of structure, electronic, and magnetic properties of C sites vacancy defects in water adsorbed graphene/MoS2 van der Waals heterostructures.

We have studied structure, electronic, and magnetic properties of water adsorbed vdW heterostructure graphene/MoS2 (w-(HS)G/MoS2) and its C sites vacancy defects materials (w-Catoms-vacancy-(HS)G/MoS2) by using a spin polarized density functional theory (DFT) method of calculations within DFT-D2 approach to take in to account of vdW interactions. All the structures are optimized and relaxed by BFGS method using computational tool Quantum ESPRESSO package. By structural analysis, we found that both w-(HS)G/MoS2 and w-Catoms-vacancy-(HS)G/MoS2 are stable materials. The stability and compactness of these materials decrease with an increase in their defects concentrations. From band structure calculations, our findings show that w-(HS)G/MoS2 has a metallic nature, and there is formation of n-type Schottky contact of barrier height 0.42 eV. Also, the left 1C atom vacancy defects in w-(HS)G/MoS2 (L1C-w-(HS)G/MoS2) and center 1C atom vacancy defects in w-(HS)G/MoS2 (C1C-w-(HS)G/MoS2) materials have no band gap for up and down spin electronic states, indicating that they have also a metallic nature. On the other hand, 2C atom vacancy defects in w-(HS)G/MoS2 (2C-w-(HS)G/MoS2) has a small band gap for up spins states and no band gap for down spin electronic states which means that the band structure resembles with half metallic nature. Thus, the endowment of metallic nature decreased with increase in the concentrations of defects in structures. To study the magnetic properties in materials, DOS and PDOS calculations are used, and we found that non-magnetic w-(HS)G/MoS2 material changes to magnetic in all the three different L1C-w-(HS)G/MoS2, C1C-w-(HS)G/MoS2, and 2C-w-(HS)G/MoS2 materials with vacancy. L1C-w-(HS)G/MoS2, C1C-w-(HS)G/MoS2, and 2C-w-(HS)G/MoS2 have magnetic moments of + 0.21 µB/cell, + 0.26 µB/cell, and - 2.00 µB/cell, respectively. The spins of electrons in 2s and 2p orbitals of C atoms give a principal effect of magnetism in w-Catoms-vacancy-(HS)G/MoS2 materials.

Predictors of In-hospital Mortality of Acute Ischemic Stroke in Adult Population.

INTRODUCTION: Stroke is the second most common cause of mortality worldwide. Data regarding the predictors of mortality of acute ischemic stroke are widely discordant. Identifying the predictors and providing the utmost care to a high-risk patient is still an unmet need in middle- to low-income countries. We did this study to identify the predictor of in-hospital mortality of acute ischemic stroke. MATERIALS AND METHODS: We conducted a retrospective study of patients with acute ischemic stroke presented to the tertiary care center in eastern Nepal from January 2012 to December 2016. We enrolled patients of age 18 years and older with acute ischemic stroke in this study. The primary outcome of the study was in-hospital mortality of enrolled patients. Predictors of mortality were analyzed by comparing the patients with acute ischemic stroke who had mortality with those who survived. RESULTS: The mean age of enrolled patients was 66 years. Among 257, the in-hospital mortality rate was 20.5%. The patients with in-hospital mortality had lower Glasgow coma scale (GCS) score (9 vs. 12, P < 0.001) compared to those who survived. During admission, a patient with in-hospital mortality had significantly lower arterial oxygen saturation (92 vs. 95, P < 0.001), higher pulse rate (91 vs. 83, P = 0.009), and higher respiratory rate (24 vs. 21, P < 0.001) than those patients with acute ischemic stroke who survived. CONCLUSION: Lower GCS score, baseline higher pulse rate, higher respiratory rate, and lower arterial oxygen saturation are the predictors of in-hospital mortality of adult with acute ischemic stroke.