cognition

Background: Early-onset sarcoidosis is a rare systemic inflammatory granulomatous disease, distinguished by onset before the age of 4 and notably lacking pulmonary involvement. Unfortunately, the condition often shows clinical features similar to juvenile idiopathic arthritis, resulting in the misdiagnosis of numerous patients. This case report delves into the challenges associated with the delayed diagnosis of early-onset sarcoidosis, with a particular focus on the diagnostic methods employed to address this delayed recognition.Case presentation: A 15-year-old girl presented with a history of recurrent fever since infancy, accompanied by rash, arthritis, and joint deformity. Previously misdiagnosed with juvenile idiopathic arthritis, she underwent management with steroids and methotrexate, yielding no improvement. The diagnosis of early-onset sarcoidosis was made during adolescence based on serial examinations, comprehensive laboratory and radiological evaluations, and subsequent histopathology findings. Presently, the patient is receiving treatment with low-dose steroids and biologic therapy (Tocilizumab) and experiencing no disease progression.Conclusion: This case report underscores the importance of considering early-onset sarcoidosis in the differential diagnosis of pediatric patients exhibiting persistent arthritis from an early age. Early detection and treatment are crucial in averting complications and enhancing the overall quality of life. 

Maternal cardiac arrests are rare but serious events where recognition and prompt initiation of resuscitation are crucial. Obesity is a common risk factor encountered in disorders of pregnancy as well as maternal cardiac arrests. Cardiac arrest algorithms should be followed with some changes to accommodate maternal and fetal health. We present a case of a 32-year-old pregnant patient who had a perimortem caesarean section due to maternal cardiac arrest.

Cells have emerged as highly promising vehicles for delivering drugs due to their unique advantages. They have the ability to bypass immune recognition, navigate biological barriers, and reach difficult-to-access tissues through sensing and active movement. Over the past couple of decades, extensive research has been conducted to understand how cell carriers can overcome biological barriers and influence drug effectiveness. This has resulted in the development of engineered cells for targeted drug delivery to specific tissues. Despite the presence of exciting developments, a comprehensive understanding of the challenges and potential strategies is necessary for the effective clinical application of cell-based drug carriers. This review provides an overview of recent progress and novel concepts in cell-based drug carriers, as well as their potential for translation into clinical practice. Additionally, we delve into important factors and emerging strategies for designing the next generation of cell-based delivery technologies, with a particular emphasis on achieving greater accuracy and targeted drug administration.

This study compares the effect of imipramine and amitriptyline on learning and memory. Thirty-five (35) healthy Swiss white (CD1) mice of both sexes weighing 18 g - 30 g were randomly divided into 5 groups (n = 7). Mice in group 1 (control) were administered 0.9% normal saline orally, while mice in groups 2 and 3 were treated with low (1.8 mg/kg) and high (3.7 mg/kg) doses of imipramine, groups 4 and 5 were treated with low (1.8 mg/kg) and high (3.7 mg/kg) of amitriptyline respectively. Treatment was for 21 days before tests. All animals were tested using the Morris Water Maze (MWM) and Novel Object Recognition Task (NORT) to assess visuospatial learning and memory as well as cognitive learning and memory. The results obtained from the Morris Water Maze during the acquisition training showed that the swim latencies were significantly lower (p < 0.05) in the amitriptyline low-dose group compared to the control group. During the reversal training, the swim latencies were significantly lower (p < 0.05) in the test groups compared to the control group. The result for the retention quadrant in the probe trials showed a significant decrease (p < 0.05) in the northeast quadrant in the test groups compared to the control group, with no significant difference in the visible platform day of the Morris Water Maze in the test groups compared to the control group. In the novel object recognition task, the short-term index of habituation was significantly lower (p < 0.05) in the low-dose imipramine and low-dose amitriptyline compared to the control group, the results also showed a significant increase (p < 0.05) in amitriptyline high dose group compared to imipramine and amitriptyline low dose group and the control group. The index of discrimination showed no significant difference among all groups. The long-term index of habituation and discrimination in the memory test showed a significant decrease (p < 0.05) in all the test groups compared to the control group. The results suggest that imipramine and amitriptyline impaired cognitive memory and enhanced visuospatial learning and memory functions.

A 51-year-old female with a history of multinodular goitre presented with vomiting, abdominal discomfort, and generalized tiredness. Investigations revealed hypercalcemia (ionized calcium 1.41 mmol/L), hypokalaemia, suppressed parathyroid hormone, and significantly elevated free thyroxine (> 7.77 ng/dL) with a suppressed thyroid-stimulating hormone level consistent with hyperthyroidism. Further, the workup confirmed Graves’ disease as the underlying aetiology. Hyperthyroidism is occasionally associated with mild to moderate hypercalcemia, but severe hypercalcemia or hypercalcaemic crisis is an extremely rare complication. Prompt recognition and treatment are crucial to prevent life-threatening complications. The patient was treated with intravenous fluids, a low-calcium diet, zoledronic acid, carbimazole, and a beta-blocker, leading to improvement in her condition. This case highlights a rare occurrence of hypercalcaemic crisis in a patient with thyrotoxicosis due to Graves’ disease. Hyperthyroidism-induced hypercalcemia requires prompt recognition and multidisciplinary management involving endocrinologists, internists, and critical care specialists to prevent potentially life-threatening complications. Healthcare providers should consider the hypercalcaemic crisis in the differential diagnosis of hypercalcemia in the context of hyperthyroidism.

Carfilzomib, a highly selective proteasome inhibitor, is commonly used in the treatment of multiple myeloma and AL amyloidosis. While its efficacy is well-established, there is increasing recognition of its association with cardiovascular adverse events, including hypertension, heart failure, and arrhythmias. However, cases of carfilzomib-induced pericardial disease remain rare. Here, we present a case of a 78-year-old female with multiple myeloma who experienced two episodes of hemorrhagic pericardial effusion following carfilzomib therapy, highlighting the importance of vigilant cardiovascular monitoring during treatment.

Introduction: Pneumothorax is a life-threatening condition that requires prompt recognition and therapy to prevent deterioration. Radiologist workload often precludes rapid assessment of the usual diagnostic modality, the chest radiograph, particularly after hours. The aim was to develop a deep learning model using a segmentation-based Deep Convolutional Neural Network (DCNN) to detect pneumothorax on chest radiographs to provide rapid and accurate pneumothorax diagnosis.Methods: This is a retrospective study of spontaneous pneumothorax at a single center, containing 130 positive and 70 negative radiographs. Subsequent manual contour mapping was performed to draw a mask of the pneumothorax. These image pairs were used to train a DCNN model (a modified AlexNet) after pretraining on the ImageNet dataset.Results: The DCNN achieved an accuracy of 0.83, with sensitivity of 98.1%, and specificity of 68.5%.Conclusion: This segmentation-based DCNN accuracy is comparable to previous categorization-based CDNN models, despite using a smaller sample size for training, while including the benefits of visual representation for clinician feedback. Segmentation-based DCNNs show promise in the development of accurate and clinically useful models for medical imaging.

Verrucous hyperplasia is a wart-like lesion that can develop on amputation stumps, often due to poor-fitting prostheses, venous stasis, friction, and bacterial infections. While surgical excision is sometimes necessary for intractable cases, many instances can be managed non-surgically. We present the case of a 35-year-old male with a slowly growing verrucous plaque on his amputated stump that had caused repeated infections. His prosthesis was loose, allowing the stump to hang loosely inside the socket. After histological confirmation of verrucous hyperplasia, he was advised to change his prosthesis and use compression bandaging. Over 5 months, the lesion resolved without surgery. Early recognition and non-surgical management, including proper prosthetic fit, compression, and hygiene, can often successfully treat verrucous hyperplasia of amputation stumps. This avoids the need for excision in many cases. Patients and clinicians should be aware of this condition and the importance of prosthetic fit and limb care to prevent and treat it.

Dentistry has much to offer in the detection and solution of crime or civil proceedings. Forensic dentistry requires an interdisciplinary knowledge of dental science, and it is the role of the Forensic Odontologist to establish a person's identity. Teeth, with their physiologic variations, pathosis record information that remains throughout life and beyond. Forensic Odontology has an important role in the recognition of abuse among children. Teeth may also be used as a weapon against children, and physical evidence such as DNA, bite marks, fingerprints may objectively link suspects to a crime and develop important investigative leads. Gender identification and sex determination by analyzing the pulp tissue in primary teeth can be regarded as an effective tool in providing valuable forensic information. The rights of children and their aspirations are of paramount importance, and the Pediatric dentist can contribute immensely to the field of Forensic Odontology in providing justice to these unfortunate children.