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BACKGROUND Erdheim-Chester disease (ECD) is a clonal disease characterized by histiocytic infiltration of multiple organ systems. As ECD is a rare disorder with variable presentations, its diagnosis and management can present a significant clinical challenge. The diagnosis of ECD requires several clinical, radiological, and histological criteria. Since approximately 75% of ECD patients harbor a mutation in the proto-oncogene BRAF V600E, inhibition of BRAF activation by BRAF inhibitors has significantly improved the management of ECD. Vemurafenib was approved by the U.S. Food and Drug administration for treatment of BRAF-mutated ECD. Another BRAF inhibitor, dabrafenib, has been used in some cases as a single agent and was associated with a lower toxicity profile. CASE REPORT We report the case of a 30-year-old Saudi Arabian woman who initially presented with a history of diffuse abdominal pain and fever. The patient had elevated inflammatory markers, and radiological investigations revealed hypermetabolic regions in the frontoparietal brain lobe, anterior pericardium, kidneys, and the anterior abdominal wall. Histological investigations from the right perinephric soft-tissue mass revealed foamy histiocytes associated with mild chronic inflammation. Furthermore, BRAF V600E was mutated in the biopsy sample, leading to a diagnosis of BRAF-mutated ECD. The patient began single-agent dabrafenib therapy at 75 mg twice daily and experienced an excellent clinical and radiological response with no reported toxicity. CONCLUSIONS Single-agent dabrafenib is effective and well tolerated among ECD patients; therefore, it might be considered as a first-line option for the treatment of BRAF-mutated ECD.

Massive amounts of limestone waste are produced by the stone processing industry worldwide. Generally, it is believed that 60% to 70% of the stone is wasted in processing in the form of fragments, powder and slurry out of which around 30% is in the form of fine powder [1]. This waste has no beneficial usage and poses environmental hazards. Use of this waste product in the construction industry can largely reduce the amount of waste to be disposed off by the local municipalities in addition to reducing large burden on the environment. Some basic research on use of limestone dust as cement/ concrete filler has been carried out in the recent past but high strength/ high performance concretes have not been investigated yet [2] [3]. The concrete industry is among the largest consumer of raw materials worldwide and has been investigated for use of various types of waste materials like crushed brick, rice husk and straw ash as either aggregates for concrete or as partial cement substitutes. Use of limestone dust as filler material in concrete can consume a huge amount of this waste material which has to be disposed off otherwise, creating large burden on the environment. This experimental study aimed at evaluating the properties of high performance concretes made from Portland cement, natural aggregates and sand. Limestone dust was added by replacing sand in the percentages of 10% and 20%. Wide ranging investigations covering most aspects of mechanical behavior and permeability were carried out for various mixes for compressive strengths of 60 N/mm2, 80 N/mm2 and 100 N/mm2. Compressive strengths of concrete specimen with partial replacement of sand with 10% and 20% limestone dust as filler material for 60 N/mm2, 80N/mm2 and 100 N/mm2 were observed to be higher by about 4% to 12% than the control specimen. Flexural strengths were also observed to be higher by 12% - 13%. Higher elastic moduli and reduced permeability were observed along with better sulphate and acid resistance. Better strengths and improved durability of such high-performance concretes make it a more acceptable material for major construction projects.

Massive amounts of brick waste are obtained from demolition of old buildings and structures around the world. With the increased stress on sustainable construction, and environmentally friendly materials and greener concreting practices, a large proportion of such waste bricks are crushed and mixed with normal aggregates for use in concrete. The performance of concrete containing waste brick aggregates partially replacing normal aggregates have not been investigated for their performance. This paper covers investigations carried out on concrete with such aggregates obtained from demolition waste and mixed with varying proportions of normal aggregates to produce concrete. Two types of crushed brick aggregates were mixed with gravel in the ratios of 30:70 and 40:60 by weight and specimen were cast for investigations. Two w/c ratios were investigated. Various tests were carried out to assess the compressive strength of cubes and cylinders of mixed aggregates concrete along with f1exural strength, stress/strain behavior, moduli of elasticity, ultrasonic pulse velocity determination, densities, surface absorption, shrinkage and frost resistance. The values obtained from these tests were compared with the values of concrete with normal aggregates (gravel) with similar w/c ratios. While the strength tests and durability tests more or less gave satisfactory results however the larger moisture absorption by the waste brick aggregates reduces the frost resistance capacity somewhat thereby care needs to be exercised in using these mixes in regions/areas susceptible to frost.

Extensive growth in the developing countries due to infrastructure development is resulting into massive consumption of concrete thereby increasing the demand on concrete materials. Quite large amounts of fine aggregates are required for concrete in developing countries thus shortages of quality river sand is putting pressure on availability of fine aggregates. To fulfill the high demand of fine aggregates, a search for alternative materials is in process. Stone crushing and processing industry is a large industry which generates large amounts of stone dust and slurry which is a waste produced from this process. Tons of such waste generated has no useful purpose except as landfill material. Some preliminary studies have been conducted into use of marble/ limestone waste for use in concrete [1] [2]. This study aims at using stone dust as partial replacement of sand in concrete to observe its effects on workability and other mechanical properties. This would result in useful consumption of this waste product thereby eliminating environmental issues related to its disposal. Partial replacement of 10% and 20% sand replacement with stone dust is carried out with the use of self-compacting concrete with blended cement. Blended cement used contains 50% rice husk ash and 50% Portland cement. Such high strength SCC with blended cement containing 50% rice husk ash and 50% Portland cement has already been tested to provide better quality concrete [3]. Wide ranging investigations covering most aspects of mechanical behavior and permeability were carried out for various mixes for compressive strengths of 60 MPa & 80 MPa. Compressive strengths of high strength SCC with blended cements and 10% and 20% replacement of sand with stone dust for 60 MPa and 80 MPa were observed to be higher by about 10% to 13% than the control specimen. Higher elastic moduli and reduced permeability were observed along with better sulphate and acid resistance. Better strengths and improved durability of such high strength SCC make it a more acceptable material for major construction projects thereby reducing the burden on environment and use of such waste product for a useful purpose promoting sustainable construction.