Background
Primary nerve sheath tumor of cranial nerve is a rare intracranial space occupying lesion that most commonly involves vestibular nerve. Oculomotor nerve schwannoma, without ...neurofibromatosis, is an extremely uncommon entity especially in children. Though any cranial nerve can be involved by schwannoma except I and II nerve as these cranial nerves lack a Schwann cell sheath.
Case presentation
We herein report a 14-year-old boy presenting with an oculomotor schwannoma in the absence of features of neurofibromatosis, manifesting as progressive diplopia, ptosis, and blurring of vision.
Conclusions
Most similar previous case reports in literature reported oculomotor schwannoma in adults, unlike our case. The detection rate of such rare lesions has, however, increased in the last two decades due to neuroimaging advances.
A 39-year-old male without any preceding medical ailment presented with 12 day history of fever followed by behavioral changes with left sided weakness. He was found to have Herpes Simplex Virus-1 ...encephalitis (polymerase chain reaction positive) and with Magnetic Resonance Imaging finding of asymmetrical frontotemporoparietal (right side affected more than left side) involvement with patchy enhancement with atypical nodular enhancement and subtle diffusion restriction. Nodular enhancement is rare in acute inflammations and is reported mainly with chronic granulomatous infections.
Background
Eosinophilic granulomatosis with polyangiitis (EGPA) is associated with vasculitic neuropathy and being rare can present as subacute symmetric sensorimotor quadriparesis mimicking ...Guillain–Barre syndrome (GBS). It warrants timely diagnosis as treatment for both conditions is different and vasculitic neuropathy needs long-term immunosuppression. Nerve biopsy of our patient showed eosinophilic infiltration along with mononuclear infiltrate. Typical histopathological presentations of EGPA are different among different organs and eosinophilic infiltration is rarely observed in peripheral nerve and kidney involvements.
Case presentation
A 49-year-old female with a history of asthma with 3-week duration of acute onset ascending weakness, preceded by severe pain and burning in glove and stocking pattern. Nerve conduction studies could not rule out Guillain–Barre syndrome initially, but subsequent studies show axonal affection and she received intravenous immunoglobulin (IVIg) but her weakness progressed after slight improvement. Her bloodwork revealed marked eosinophilia (> 50%) with computed tomography (CT) paranasal sinuses showing pansinusitis with background history of asthma led us towards eosinophilic granulomatosis with polyangiitis and later antineutrophil cytoplasmic antibodies came out positive with nerve biopsy showing perivascular mononuclear inflammation with eosinophils. She was started on steroids immediately and then received intravenous rituximab in view of long-term immunosuppression with maintenance steroids and on follow-up she improved.
Conclusion
Eosinophilic granulomatosis with polyangiitis is a small-vessel vasculitis associated with antineutrophil cytoplasmic antibodies with significant paranasal sinuses involvement. Mononeuritis multiplex is the most common presentation of vasculitic neuropathy of eosinophilic granulomatosis with polyangiitis, but they can mimic Guillain–Barre syndrome and should always be considered in the differential diagnosis, since the treatment strategies for these conditions are radically different.
In a world where biodiversity is on the decline, examples of conservation success especially of large carnivores are of interest to policy makers and conservation practitioners. Herein, we elucidate ...the conservation actions that have been responsible for the recovery of tigers and their ecosystems in India; a feat many range countries are struggling to achieve.
Demand‐driven poaching resulted in extinctions at two prestigious Tiger Reserves. India's Prime Minister constituted a Tiger Task Force that led to the formation of the National Tiger Conservation Authority, the Wildlife Crime Control Bureau, scientific monitoring of tiger populations and incentivized voluntary relocation of human settlements from tiger reserves. Tiger Conservation Plans, cognizant of constraints imposed by small reserves embedded in human land uses, aimed to create source populations within tiger reserves with corridor links between sources and to sink habitats. Metapopulation management enhanced occupancy and long‐term viability of tiger populations. Tiger Protection Force and technology like MSTrIPES, E‐eye and drones effectively reduced poaching. Community support was attempted through profit sharing, mitigating human–tiger conflict with a fast, fair and transparent compensation process and removal of problem tigers. Reintroduction and reinforcement of tigers and prey assisted natural recovery. Political will ensured resources.
Tigers were monitored using Spatially Explicit Capture–Recapture with camera traps and ecological covariates. In 2018–2019 from 381,000 km2 of tiger habitat, 89,000 km2 was occupied. Currently, 50 tiger reserves cover 72,750 km2 and harbour 65% of India's ~3,000 tigers. Tiger reserves are managed with an annual investment of ~1,000 USD/km2 with one staff per 6.5 km2. Tiger reserves were regularly evaluated for Management Effectiveness. Tiger reserves were valued to have benefit flows between 76,900 and 292,300 US$ km−2year−1.
In the Anthropocene it is unlikely that tigers will survive without targeted conservation investments. Political commitment and resources can become available for conservation when people and tigers benefit simultaneously. Conscious balance by governments between development for rapid economic prosperity and long‐term ecological security will ensure that wild tigers and their intact ecosystems will survive for future generations.
A free Plain Language Summary can be found within the Supporting Information of this article.
सार
एक ऐसी दुनिया में जहाँ जैव विविधता घट रही हैं, विशेष रूप से बड़े मांसाहारी जानवरों के संरक्षण की सफलता के उदाहरण नीति निर्माता और संरक्षण कर्ताओं के लिए रूचि रखते है| इस लेख में, हम उन संरक्षण कार्यों को स्पष्ट कर रहे हैं जो भारत में बाघों और उनकी परिस्थिति तंत्र की बहाली के लिए जिम्मेदार हैं| यह एक ऐसी उपलब्धी है जो बाघों के इलाके वाले देश हांसिल करने के लिए संघर्ष कर रहे हैं| हाल ही में वैश्विक मांग से प्रेरित अवैध शिकार के कारण दो बाघ संरक्षण क्षेत्रों से बाघ विलुप्तह हो गए, इस कारण भारत के प्रधान मंत्री ने एक बाघ कार्यकारणी बल का घट्न किया| इस कार्यकारणी बल ने राष्ट्र बाघ संरक्षण प्राधिकरण, वन्य जीव अपराध नियंत्रण ब्यूरो, बाघों की आबादी की वैज्ञानिक निगरानी और बाघों के संरक्षण क्षेत्रों से मानव बस्तियों के स्वेच्छिक पुनर्वास को प्रोत्साहित करने का कार्य किया| बाघ संरक्षण योजना इसको ध्यान में रख कर बनाई गयी, के बाघ की ज़्यादातर जनसंख्या छोटे क्षेत्रों में बिखरी हुई है| जिसके लिए जन संख्या क्षेत्रों को गलियारों से जोड़ना जरूरी है| मेटापापुलेशन प्रबंधन को अपनाने से बाघों के आबादी को संरक्षण क्षेत्रों में अधिक समय तक जीवित रहने लायक बनाया| बाघ संरक्षण बल और तकनीकी का उपयोग, जैसे, एम् स्ट्राइप्स, इ‐ऑय, और ड्रोन्स ने प्रभावी रूप से अवैध शिकार को काम करने में मदद की| लोगों से सामुदायिक समर्थन का प्रयास इस प्रकार किया गया, जैसे लोगों को संरक्षण से होने वाले लाभ में हिस्से दारी हो, मुआवजा निष्पक्ष और पारदर्शी हो, मानव बाघ संघर्ष को काम करने के उपाय कारगर हो| बाघों और चौपायों के पुनर्स्थापन और बचाव से प्राकृतिक बहाली हुई| राजनीतिक सुनिश्चिता ने संसाधन मुहैय्या कराने में मदद की|
बाघों की जनसंख्या कैमेरा ट्राप द्वारा स्पेश्यली‐ एक्सप्लीसिट‐ कैप्चर‐रीकैप्चर पद्धती से एवं पारस्थितिक सहसमानयोजकों का इस्तमाल कर की गयी| २०१८‐१९ में ३८१,००० वर्ग की|मी| वन क्षेत्र में कार्य किया गया, जिसमें ५० बाघ संरक्षण क्षेत्रों का ७२,२१८ वर्ग की.मी. भी शामिल है| इन बाघ संरक्षण क्षेत्रों में देश के ३,००० बाघों में से ६५% इन क्षेत्रों में पाए जाते है| बाघ संरक्षण क्षेत्रों के प्रभंधन में
१००० यू यस $/ की.मी. का व्यय प्रति वर्ष होता है एवं प्रति ६0.५ वर्ग की.मी. में एक सरकारी कर्मचारी इन क्षेत्रों की देखभाल करता है| बाघ संरक्षण क्षेत्रों का नियमित रूप से प्रभंधन मूल्यांकन उनकी प्रभावशीलता मापने के लिए किया जाता है| बाघ संरक्षण क्षेत्रों से लगभग ७६,९०० से २९२,३०० यू यस $ प्रति वर्ग की.मी. का फायदा समाज को होता है|
आज के मानव आधारित युग में यह संभावना नहीं है की लक्षित संरक्षण निवेश के बिना बाघ जीवित रहेंगे| राजनीतीक प्रतिभद्धता और सनसाधन संरक्षण तभी उपलब्ध हो सकते है जब लोग और बाघ एक साथ लाभवंतित हो| आर्थिक समृद्धि और दीर्घकालिक परिस्थितिक सुरक्षा के विकास के लिए, सरकारों द्वारा संतुलन सुनिश्चित करेगा की जंगली बाघ और उनके परिस्थितिक तंत्र भविष्य की पीढ़ी के लिए जीवित रहेंगे|
A free Plain Language Summary can be found within the Supporting Information of this article.
Aims
To assess retinal nerve fiber layer thickness by optical coherence tomography (OCT) in various central nervous system demyelinating diseases.
Methods and Material
A total of 40 patients were ...selected. There were 8 patients of multiple sclerosis, 12 patients of neuromyelitis optica spectrum disorders (NMOSD), 9 patients of optic neuritis, and 11 patients of longitudinally extensive transverse myelitis (LETM). The fast retinal nerve fiber layer (RNFL) thickness protocol was used to compute the overall average RNFL thickness for each eye. Average RNFL thickness for 360° around the optic disk, for the superior, nasal, inferior, and temporal quadrants around the optic disk as well as in the twelve 30° segments (with 3 o'clock position as nasal) were recorded.
Results
Average RNFL thicknesses were lower in NMOSD group. Superior, inferior, and temporal quadrants are the preferentially affected while 8 o'clock position RNFL was the thinnest. MS involved 8 o'clock position and temporal quadrant. Of 9 o'clock position and temporal quadrant were the thinnest in LETM. In idiopathic optic neuritis, lowest RNFL value was recorded in the nasal quadrant. In 3 o'clock position, maximum thinning was noted in idiopathic ON. At 9 o'clock position, maximum thinning was seen in LETM patients.
Conclusions
Most o'clock positions and superior, inferior, and temporal quadrants were affected in NMOSD. MS mainly involved 8 o’clock position and temporal quadrant. LETM preferentially affected 9 o’clock position and the temporal quadrant. Hence, observing the pattern of RNFL thinning with OCT in CNS demyelinating diseases can intimate the etiological cause. However, larger studies are needed further to confirm the same.
Background
Cerebral arterial thromboses or ischemic strokes may be caused by cumulative or independent effects of a variety of risk factors. High factor VIII level is one of those important but less ...known risk factors for arterial and venous thrombosis. We hereby provide a comprehensive review of the role of high factor VIII levels as a risk factor of arterial thrombosis. Moreover, we present our views on inclusion of factor VIII testing in the etiology workup protocol of young patients with ischemic strokes and their treatment with anticoagulant therapy.
Case presentation
We illustrate a case of 32-year-old North Indian female patient with Ischemic stroke whose only identifiable risk factor was revealed to be an elevated factor VIII level. She was treated with oral anticoagulant with an uneventful follow-up of 6 months.
Conclusions
Elevated factor VIII levels have their independent and additive effects in causation and prognosis of arterial strokes. We herein discuss the mechanism of this association, the feasibility and yield of routine testing, appropriate cut-off levels, and further treatment protocol especially in young stroke patients.
Syringomyelia is described as a fluid-filled cavity within the spinal cord devoid of an ependymal lining. It is best visualized on magnetic resonance imaging (MRI), with the cavity being low ...intensity on T1-weighted and high intensity on T2-weighted images. The association of syringomyelia with dystonia has been infrequently reported in the medical literature. We herein describe a case of syringomyelia with Chiari 1 malformation and hydrocephalus having writer’s cramp and pseudoathetosis, which as per our review, is a yet undescribed manifestation in previously published literature. Also, we emphasize on the usefulness of spinal MRI in a case of focal dystonia/writer’s cramp if cause is not apparent after initial evaluation and more so if associated with proprioceptive sensory impairment and pseudoathetosis.
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