ABSTRACT We present an unusual case of a 13-year-old male pediatric patient with a diagnosis of sphenoid sinus mucocele. The patient suffered a progressive loss of visual acuity over three months followed by a total recovery of his visual acuity after surgery. The patient presented at the emergency room complaining of progressive loss of visual acuity in his left eye which decreased to hand motion over the preceding months. Imaging studies revealed a cystic mass, suggestive of sphenoid sinus mucocele, which was causing compressive optic neuropathy and proptosis. The patient was scheduled for a sphenoidectomy and resection of the mass. Three days after surgery, the patient’s visual acuity in the left eye was 20/20, indicating complete recovery from his symptoms. We suggest that the excellent outcome in this patient may be attributable to his age. His ongoing physical development might have been the decisive factor in the recovery of his visual acuity following compressive optic neuropathy secondary to sphenoid sinus mucocele. Further research is needed to verify this proposed explanation. 13yearold yearold 13 year old mucocele surgery mass proptosis patients s 2020 20 20/20 symptoms age explanation 1 202 2 20/2 20/

RESUMO Apresentamos um caso incomum de paciente pediátrico com diagnóstico de mucocele de seio esfenoidal, que apresentou perda progressiva da acuidade visual ao longo de três meses, resultando em recuperação total da acuidade visual após a cirurgia. Paciente do sexo masculino, 13 anos, procurou o pronto-socorro, queixando-se de perda progressiva da acuidade visual do olho esquerdo nos últimos três meses. Exames de imagem revelaram uma massa cística sugestiva de mucocele de seio esfenoidal, causando neuropatia óptica compressiva e proptose. O paciente foi agendado para esfenoidectomia e ressecção da massa. Três dias após a cirurgia, a acuidade visual do paciente no olho esquerdo era de 20/20, apresentando recuperação completa dos sintomas. Diante dos resultados de nosso paciente, sugerimos que a idade do paciente pode ser decisiva na recuperação da acuidade visual de uma neuropatia óptica compressiva secundária à mucocele de seio esfenoidal. Mais pesquisas são necessárias para verificação desses dados. esfenoidal meses cirurgia masculino 1 anos prontosocorro, prontosocorro pronto socorro, socorro pronto-socorro queixandose queixando se proptose 2020 20 20/20 sintomas dados 202 2 20/2 20/

Abstract Pilonidal sinus is the term first used by Hodges in 1880 to describe a granulomatous lesion containing hairs. It has been previously described as hair extracted from an ulcer andreferredtoasJeep’s disease, in world war days. Pilonidal sinus is the condition in which a sinus or fistula is situated at a short distance from the anus and generally contains hairs. It is commonly observed in the sacrococcygeal region and a few other sites, such as the axilla, umbilicus, face, etc. Its presence elsewhere is uncommon. Predisposing factors are traumatized, hairy skin, which leads entry of the hair inside the wound, thus forming a sinus. A 31-year-old patient presented with discharging endoanal sinus tract, which, on exploration, turned out to be an endoanal pilonidal sinus containing hair tufts, a rare case. The patient complained of recurrent pus discharge and anal pain for 45 days, reporting history of travelling around 70 km daily in a two-wheeler vehicle. On first physical evaluation, a small endoanal bulge was found. It was located at 1 o’clock in lithotomy position (anterior), with purulent discharge and anterior anal fissure. For confirmation, an endoanal ultrasonography (USG) was performed, which showed a sinus tract containing internal echoes and gas bubbles with a small amount of pus. The sinus was explored, and a wide excision was made and left open for secondary healing. Pilonidal sinus of the anal canal is a rare entity, and it can be found in hairy patients who are used to going on long, daily rides on two wheeled vehicles. 188 hairs andreferredtoasJeeps andreferredtoasJeep s disease days sites axilla umbilicus face etc uncommon traumatized skin wound 31yearold yearold 31 year old exploration tufts case 4 7 twowheeler wheeler vehicle evaluation oclock o clock anterior, , (anterior) fissure confirmation USG (USG performed explored healing entity long vehicles 18 3 (anterior

ABSTRACT Regular concrete uses a lot of cement, which is bad for the environment. Adding plastic waste to concrete as a substitute reduces pollution, but it can weaken the concrete. This study tackles this problem by creating an eco-friendly concrete alternative. The researchers mixed shredded PET plastic bottles (up to 10%) with concrete and replaced some cement (up to 10%) with nano-silica. They tested how this affected the concrete’s strength in different ways (bending, splitting, and compression). Interestingly, they found that using a specific mix (4% plastic and 4% nano-silica) actually made the concrete stronger! This suggests a promising new way to use recycled plastic to create a more sustainable and even stronger building material. environment pollution ecofriendly eco friendly alternative up 10% 10 nanosilica. nanosilica nano silica. silica nano-silica concretes s bending, bending (bending splitting compression. compression . compression) Interestingly 4 (4 material 1 (

ABSTRACT It is estimated that lymphatic malformations in children account for 6% of all benign vascular malformations. New medical therapies have been developed for the management of lymphatic orbital disease. The purpose of this article was to describe a clinical case of orbital venolymphatic malformation in a 10-year-old boy, causing proptosis and palpebral edema. The lesion was initially treated with local sclerotherapy. However, the lesion relapsed, and was successfully treated with oral sirolimus. Prospective studies are warranted to determine the appropriate dose and extend the indications of sirolimus in these patients. 6 disease 10yearold yearold 10 year old boy edema sclerotherapy However relapsed patients 1

RESUMO A incidência de malformações linfáticas em crianças é estimada em 6% de todas as malformações vasculares benignas. Têm sido desenvolvidos novos tratamento para doenças linfáticas orbitárias. Nosso objetivo é descrever um caso clínico de malformação venolinfática orbitária em um menino de 10 anos de idade, causando proptose e edema palpebral. A lesão foi tratada inicialmente com escleroterapia local. No entanto, a lesão teve recidiva e foi tratada com sucesso com sirolimo oral. Ainda são necessários estudos prospectivos para estabelecer a dose apropriada e a duração do tratamento com sirolimo nesses pacientes. 6 benignas orbitárias 1 idade palpebral local entanto oral pacientes

ABSTRACT Introduction: Primary cardiac myxomas are rare tumors. Concurrent valvular lesion is a common finding on evaluation which is thought to be due to annular dilatation secondary to tumor movement across the valve, functional obstruction across the valve, and severe pulmonary hypertension secondary to chronic obstruction. A common belief among surgeons is that excision of myxoma leads to abatement of symptoms, and further valve intervention may not be warranted. Methods: A 10-year retrospective descriptive study was designed to analyze patients who underwent excision of cardiac myxoma at our center. Data was analyzed regarding presenting features, echocardiographic findings of myxoma and valve morphology, intraoperative assessment, and postoperative outcome with/without valve repair/replacement in all patients. Results: A total of 22 patients underwent surgery for myxoma. Six patients underwent successful mitral valve repair with ring annuloplasty, two had moderate mitral regurgitation, three had severe mitral regurgitation, and one patient had no mitral regurgitation on preoperative assessment, but moderate mitral regurgitation was found intraoperatively. Four of these patients had no residual mitral regurgitation in follow-up period while two had mild residual mitral regurgitation. One patient had severe mitral stenosis of concurrent rheumatic etiology and successfully underwent mitral valve replacement. Conclusion: Cardiac myxomas are rare benign tumors commonly associated with mitral valve insufficiency. Mitral valve should be assessed intraoperatively after excision of mass as preoperative assessment might often be insufficient. Concomitant mitral valve intervention might be needed with a case-specific tailored approach, and mitral valve repair with ring annuloplasty offers best surgical outcome in such cases. Introduction symptoms warranted Methods 10year year 10 center features morphology withwithout without repairreplacement replacement Results 2 followup follow up Conclusion insufficiency insufficient casespecific case specific approach cases 1

ABSTRACT When faced with questions about artificial intelligence (AI), many surgeons respond with scepticism and rejection. However, in the realm of cardiac surgery, it is imperative that we embrace the potential of AI and adopt a proactive mindset. This systematic review utilizes PubMed® to explore the intersection of AI and cardiac surgery since 2017. AI has found applications in various aspects of cardiac surgery, including teaching aids, diagnostics, predictive outcomes, surgical assistance, and expertise. Nevertheless, challenges such as data computation errors, vulnerabilities to malware, and privacy concerns persist. While AI has limitations, its restricted capabilities without cognitive and emotional intelligence should lead us to cautiously and partially embrace this advancing technology to enhance patient care. AI, , (AI) rejection However mindset PubMed 2017 aids diagnostics outcomes assistance expertise Nevertheless errors malware persist limitations care (AI 201 20 2

Vein of Galen aneurysmal malformation (VGAM) is a rare congenital malformation characterised by arteriovenous fistulas between primitive choroidal arteries and the median prosencephalic vein, the embryonic precursor to the vein of Galen. Endovascular techniques have changed the management of these patients with improved prognosis. An eight-month-old with VGAM managed by endovascular embolisation using ethylene vinyl alcohol copolymer (EVOH) developed a chemical abscess - a rare complication. It was managed conservatively and showed promising clinical outcome. CONTRIBUTION: Chemical abscesses following EVOH embolisation are scarce - with imaging differentials, which include brain abscess and onyx granuloma. Knowledge and successful identification of this entity are essential as its management as prognoses differ. Chemical abscess is managed conservatively and has a good prognosis.

ABSTRACT Introduction: Frailty and its association with chronic kidney disease (CKD) has been established previously. The present study examined this association further by studying the distribution of frailty among groups defined by different stages of the disease. It also identified associated health deficits and explored their association with estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). Methods: A cross-sectional survey was conducted on 90 non-dialysis dependent CKD Stage 1–4 patients, recruited in three stratified groups of 30 participants each based on the stage of disease. Frailty was assessed using Fried’s frailty criteria and associated health deficits were recorded using a pre-determined list. Depression was screened using a 4-point depression scale. Results: 21.1% of the participants were frail and 43.3% were pre-frail. The proportion of frailty in CKD groups A (Stages 1 and 2), B (Stage 3a), and C (Stages 3b and 4) was 10%, 13.3%, and 40%, respectively. The association of health deficits including co-morbidities, physical parameters, mental status, daily activities, etc. with UACR, eGFR, and CKD stages was not statistically significant. Nearly one in two frail participants was depressed compared with 14% among non-frail participants. Conclusion: The skewed distribution of 21% frail subjects identified in our study indicates an association between frailty and advancing kidney disease. Frail individuals had a lower eGFR, higher UACR, were more likely to be depressed, and had higher count of health deficits and poorer performance on Barthel Index of Activities of Daily Living and WHOQOL. Early identification of depression would improve care in these patients. Introduction (CKD previously eGFR (eGFR UACR. UACR . (UACR) Methods crosssectional cross sectional 9 nondialysis non dialysis 14 4 1– patients 3 Frieds Fried s predetermined pre determined list 4point point scale Results 211 21 21.1 433 43 43.3 prefrail. prefrail frail. pre-frail Stages 2, 2 , 2) 3a, 3a 3a) b 10 10% 133 13 13.3% 40 40% respectively comorbidities, comorbidities co morbidities, morbidities co-morbidities parameters status activities etc significant nonfrail Conclusion WHOQOL (UACR 21. 43. 13.3 13.

RESUMO Introdução: Fragilidade e sua associação com DRC foram estabelecidas anteriormente. O presente estudo aprofundou esta associação, estudando distribuição da fragilidade entre grupos definidos por diferentes estágios da doença. Também identificou déficits de saúde associados e explorou sua associação com taxa de filtração glomerular estimada (TFGe) e relação albumina/creatinina urinária (RAC). Métodos: Realizou-se uma pesquisa transversal em 90 pacientes com DRC Estágios 1–4 não dependentes de diálise, recrutados em três grupos estratificados de 30 participantes cada, conforme estágio da doença. Avaliou-se fragilidade usando os critérios de fragilidade de Fried e registraram-se os déficits de saúde associados usando uma lista pré-determinada. A depressão foi verificada utilizando a escala de depressão de 4 pontos. Resultados: 21,1% dos participantes eram frágeis e 43,3% eram pré-frágeis. A proporção de fragilidade nos grupos de DRC A (Estágios 1 e 2), B (Estágio 3a), e C (Estágios 3b e 4) foi de 10%, 13,3%, 40% respectivamente. A associação de déficits de saúde, incluindo comorbidades, parâmetros físicos, estado mental, atividades diárias etc. com RAC, TFGe e estágios da DRC não foi estatisticamente significativa. Cerca de um em cada dois participantes frágeis estava depressivo comparados com 14% entre não frágeis. Conclusão: A distribuição enviesada de 21% dos indivíduos frágeis identificados em nosso estudo indica associação entre fragilidade e doença renal progressiva. Indivíduos frágeis apresentaram menor TFGe, maior RAC, eram mais propensos a depressão, tinham maior índice de déficits de saúde e desempenho inferior no Índice de Atividades da Vida Diária de Barthel e WHOQOL. A identificação precoce da depressão melhoraria o atendimento desses pacientes. Introdução anteriormente (TFGe albuminacreatinina albumina creatinina RAC. RAC . (RAC) Métodos Realizouse Realizou se 9 14 1– diálise 3 Avaliouse Avaliou registraramse registraram prédeterminada. prédeterminada pré determinada. determinada pré-determinada pontos Resultados 211 21 21,1 433 43 43,3 préfrágeis. préfrágeis pré-frágeis 2, 2 , 2) Estágio 3a, 3a 3a) b 10 10% 133 13 13,3% 40 respectivamente comorbidades físicos mental etc significativa Conclusão progressiva WHOQOL (RAC 21, 43, 13,3 13,

RESUMO Introdução: Fragilidade e sua associação com DRC foram estabelecidas anteriormente. O presente estudo aprofundou esta associação, estudando distribuição da fragilidade entre grupos definidos por diferentes estágios da doença. Também identificou déficits de saúde associados e explorou sua associação com taxa de filtração glomerular estimada (TFGe) e relação albumina/creatinina urinária (RAC). Métodos: Realizou-se uma pesquisa transversal em 90 pacientes com DRC Estágios 1–4 não dependentes de diálise, recrutados em três grupos estratificados de 30 participantes cada, conforme estágio da doença. Avaliou-se fragilidade usando os critérios de fragilidade de Fried e registraram-se os déficits de saúde associados usando uma lista pré-determinada. A depressão foi verificada utilizando a escala de depressão de 4 pontos. Resultados: 21,1% dos participantes eram frágeis e 43,3% eram pré-frágeis. A proporção de fragilidade nos grupos de DRC A (Estágios 1 e 2), B (Estágio 3a), e C (Estágios 3b e 4) foi de 10%, 13,3%, 40% respectivamente. A associação de déficits de saúde, incluindo comorbidades, parâmetros físicos, estado mental, atividades diárias etc. com RAC, TFGe e estágios da DRC não foi estatisticamente significativa. Cerca de um em cada dois participantes frágeis estava depressivo comparados com 14% entre não frágeis. Conclusão: A distribuição enviesada de 21% dos indivíduos frágeis identificados em nosso estudo indica associação entre fragilidade e doença renal progressiva. Indivíduos frágeis apresentaram menor TFGe, maior RAC, eram mais propensos a depressão, tinham maior índice de déficits de saúde e desempenho inferior no Índice de Atividades da Vida Diária de Barthel e WHOQOL. A identificação precoce da depressão melhoraria o atendimento desses pacientes.

ABSTRACT Introduction: Frailty and its association with chronic kidney disease (CKD) has been established previously. The present study examined this association further by studying the distribution of frailty among groups defined by different stages of the disease. It also identified associated health deficits and explored their association with estimated glomerular filtration rate (eGFR) and urine albumin creatinine ratio (UACR). Methods: A cross-sectional survey was conducted on 90 non-dialysis dependent CKD Stage 1–4 patients, recruited in three stratified groups of 30 participants each based on the stage of disease. Frailty was assessed using Fried’s frailty criteria and associated health deficits were recorded using a pre-determined list. Depression was screened using a 4-point depression scale. Results: 21.1% of the participants were frail and 43.3% were pre-frail. The proportion of frailty in CKD groups A (Stages 1 and 2), B (Stage 3a), and C (Stages 3b and 4) was 10%, 13.3%, and 40%, respectively. The association of health deficits including co-morbidities, physical parameters, mental status, daily activities, etc. with UACR, eGFR, and CKD stages was not statistically significant. Nearly one in two frail participants was depressed compared with 14% among non-frail participants. Conclusion: The skewed distribution of 21% frail subjects identified in our study indicates an association between frailty and advancing kidney disease. Frail individuals had a lower eGFR, higher UACR, were more likely to be depressed, and had higher count of health deficits and poorer performance on Barthel Index of Activities of Daily Living and WHOQOL. Early identification of depression would improve care in these patients.

Abstract In this piece, Rahul Rao replies to the reflections on his book Out of Time: The Queer Politics of Postcoloniality by the six scholars who contributed to the Forum. piece Time Forum

Resumo Neste artigo, Rahul Rao responde às reflexões sobre seu livro Out of Time: The Queer Politics of Postcoloniality feitas pelos seis acadêmicos que contribuíram para o Fórum. artigo Time Fórum

Rosai Dorfman disease is a rare but benign and self-limiting disorder. A case of Rosai Dorfman disease in a 16-year-old female with classic radiological and pathological findings is presented. T2W hypointense signal of the soft tissue masses was a distinguishing MRI feature. CONTRIBUTION: Rosai Dorfman disease is often overlooked in the differentials of lymphadenopathy and soft tissue masses on account of its rarity. This case report comprehensively discusses the imaging approach to this rare disorder

Abstract Exponential increase in population has led to the release of large amounts of unregulated and untreated wastewater into water bodies such as rivers, lakes, streams, and estuaries causing various environmental and health issues. Traditionally various procedures are applied for the treatment of wastewater at the local and municipality level. Due to the increased need and development of newer technologies, it is necessary to understand all the available procedures and evaluate their efficiency. In the present review, all the important methods involved in the treatment of wastewater and its monitoring have been comprehensively discussed and compared along with their advantages and disadvantages. Information will not only help in understanding the treatment of wastewater but it will also help in developing procedures for the reuse of treated water for various alternative purposes. rivers lakes streams issues level technologies efficiency review disadvantages purposes

Abstract Sericulture, often known as silk farming is the practice of rearing silkworms for production of raw silk. One of the major impediments faced by the sericulture community is the silkworm diseases that cause significant crop losses. In the present study, the efficacy of phototrophic bacteria as feed supplements in improving the economic traits as well as disease resistance in mulberry silkworm, Bombyx mori L. was assessed. A total of three phototrophic bacteria were isolated and identified as belonging to the genera Marichromatium, Rhodobacter and Rhodopseudomonas based on 16S rRNA gene sequencing analysis. Their morphological, physiological and biochemical characters were studied, grown under ambient conditions and biomass was harvested. Mulberry fortified with the aforementioned phototrophic bacteria in solitude and combinations at varying concentrations (0.5, 1, 2 and 5%) were found to be innocuous to the mulberry silkworm. The best results were observed when mulberry leaf was supplemented with Rhodopseudomonas sp. at 2% concentration which improved survival, cocoon weight, shell weight, shell%, filament length and non-breakable filament length by 5.18, 0.27, 3.86, 3.5, 1.5 and 1.2%, respectively under normal rearing conditions. Under Staphylococcus sp. infected conditions, the aforesaid diet also enhanced survival in silkworms by 16%. On the other hand, the same diet didn’t exhibit any discernible influence on survival against fungal, viral, or microsporidian infections in silkworm.

Resumen La sericultura, a menudo conocida como cultivo de la seda, es la práctica de criar gusanos de seda para la producción de seda cruda. Uno de los principales impedimentos a los que se enfrenta la sericultura son las enfermedades de los gusanos de seda que causan importantes pérdidas en la cosecha. En el presente estudio, se evaluó la eficacia de las bacterias fototróficas como suplementos alimenticios para mejorar los rasgos económicos así como la resistencia a las enfermedades en el gusano de seda de morera, Bombyx mori L. Se aislaron tres bacterias fototróficas y se identificaron como pertenecientes a los géneros Marichromatium, Rhodobacter y Rhodopseudomonas, basándose en el análisis de secuenciación del gen 16S rRNA. Se estudiaron sus caracteres morfológicos, fisiológicos y bioquímicos, se cultivaron en condiciones ambientales y se cosechó la biomasa. Se comprobó que la morera enriquecida con las mencionadas bacterias fototróficas en soledad y en combinaciones a distintas concentraciones (0, 5, 1, 2 y 5%) era inocua para el gusano de seda de la morera. Los mejores resultados se observaron cuando se complementó la hoja de morera con Rhodopseudomonas sp. a una concentración del 2%, que mejoró la supervivencia, el peso del capullo, el peso de la cáscara, el porcentaje de cáscara, la longitud del filamento y la longitud del filamento no rompible en un 5,18, 0,27, 3,86, 3,5, 1,5 y 1,2%, respectivamente, en condiciones normales de cría. En condiciones de infección por Staphylococcus sp., la citada dieta también aumentó la supervivencia de los gusanos de seda en un 16%. Por otra parte, la misma dieta no mostró ninguna influencia discernible en la supervivencia contra las infecciones fúngicas, víricas o de microsporidios en los gusanos de seda.