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Colloid cysts are mucous- or hyaloid-filled lesions with an outer fibrous layer. These are rare developmental and nonneoplastic malformation. They may be found incidentally, while some cases may present with intermittent headache, rapid neurologic deterioration, drop attacks, and even sudden death. Early recognition of this disease may result in lesser mortality. Here, we present a 22-year-old male with a history of fall while driving his two-wheeler. A diagnosis of colloid cyst of the third ventricle with a head injury was made. Colloid cyst presenting with a head injury is exceedingly rare with only five case reports in the literature. This report may help to support surgical intervention in an asymptomatic patient, as the cyst can predispose head injury with serious consequences. It also stresses the importance of a high degree of suspicion when there is any well-defined radiological abnormality in the region of the third ventricle. A colloid cyst may easily be confused with intracranial hemorrhage due to hyperdensity in head trauma. It can be distinguished by the presence of an accompanying traumatic lesion. The cyst usually has well-defined round margins, and the morphologic appearance and density do not change on a follow-up computed tomography (CT) scan, whereas in hemorrhage the density usually regresses with clinical improvement on serial imaging.

Aim: Awake craniotomy has been proven to be safe and effective. It has generally been used for non-edematous conditions. If done in edematous states, large craniotomies are advised. Here, we report the combined use of techniques of awake anaesthesia and focussed craniotomy for dealing with large/edematous brain lesions. Materials and Methods: This was a prospective single-centre study from May to October 2019. Included were adult cooperative patients presenting with edematous brain lesions. A completely awake cycle was used using ring scalp block, Dexmedetomidine loading, and maintenance infusion, and use of Midazolam and Fentanyl. The dural flap was lifted limited to the lesion, and sometimes in stages to tackle the bulging brain. Data was collected for resection volume, pain scores using visual analogue scale (VAS) during the surgery, seizures, complications, new deficits, blood loss, duration of surgery, ICU, and postoperative hospital stay. Results: Fifteen patients underwent the procedure. Pathologies were high-grade gliomas (7), low-grade gliomas (3), tuberculoma (2), metastasis (1), ependymoma (1), and meningioma (1). Fourteen patients underwent total, and one underwent subtotal excision. Brain bulge could be handled with the staged opening of the dura and intratumoral decompression. No patient required postoperative ventilatory support. Intraoperative pain scores ranged from 2-3. The duration of surgery ranged from 60-280min. Blood loss ranged from 75-300ml. Postoperative stay varied from 3-20 days. There were two intraoperative seizures (managed), two CSF leaks, and two infections. Two patients developed transitory motor deficits. Conclusion: Awake focussed craniotomy was found safe and effective for large/edematous brain lesions in appropriately selected patients.

Aim: The aim of our study was to compare the angiographic changes in 53 nondiabetic patients, 54 type 2 diabetic patients of less than 5 years of duration, 41 patients with 5–10 years of diabetes, and 27 with more than 10 years of diabetic duration. Methods: In this cross-sectional study, 175 patients, who underwent coronary angiogram for the evaluation of the coronary artery disease (CAD), were recruited. Based on the angiographic findings, syntax score, vessel score, and coronary collaterals grading were analyzed. The biochemical analysis was done by using the auto analyzer. Results: A significant increase in the mean syntax score (p = 0.019), vessel score (p = 0.007), and coronary collateral grade (p = 0.008) was observed in the patients with 5–10 years of diabetes when compared to those with less than 5 years of diabetic duration. There was no significant difference in the mean syntax score (p = 0.979), vessel score (p = 0.299), and collateral grade (p = 0.842) between the patients with 5–10 years and more than 10 years of diabetes. The difference in the mean syntax score (p = 0.791), vessel score (p = 0.098), and collateral grade (p = 0.661) between the nondiabetic and the patients with less than 5 years of diabetes was not significant. Conclusion: A significant structural change in the coronary arteries was found among the patients with 5–10 years of diabetes.

Background: Electrocardiogram has been widely applied as a diagnostic tool for cardiovascular disease. The concept of the cardiac vector is crucial for the clinical application in ECG interpretation. Methods: A prospective cross-sectional study was conducted among 116 male subjects, aged 18-25 years, comprising students and staff of Gandaki Medical College Teaching Hospital and Research Center, Pokhara, Nepal, over the period from June to September 2023. Electrocardiograms (ECGs) were recorded using a standard ECG machine with conventional limb leads. The mean electrical axis of the heart for each individual was determined by plotting the net voltage of the QRS complex in Lead-I and Lead-III. The study aimed to analyze the correlation between the cardiac vector and physical measurements, such as height, weight, Body Surface Area (BSA), and Body Mass Index (BMI). Data analysis was performed using SPSS version 27.0. Results: The normal mean electrical axis of the healthy male subjects was observed as 57.88±24.55°. There was significant positive correlation of cardiac vector with height (p< 0.05), whereas negative correlation was observed with weight and BMI (p< 0.01). However, there was no significant correlation with BSA. In our study we observed the maximum left axis cardiac vector as -10° and right axis as 90° among 116 male subjects. Conclusion: We established a cardiac vector with values differing from those reported in other studies, using standard bipolar limb leads in normal, healthy male subjects. It is also examined that greater BMI has shifted the electrical activity of the ventricles to the left.

Background: Coronavirus disease 2019 (COVID-19) is a novel infectious disease caused by SARS CoV-2 that emerged in Wuhan, China, and has rapidly spread worldwide. The mortality rate of critically ill COVID-19 patients is high. The objective of the study was to assess the COVID-19 disease severity and outcome among COVID-19 positive patients admitted before and after vaccination. Methodology: A prospective observational study conducted among all patients aged more than 18 years were included in the study. The patients who were positive before vaccination and received at least one dose of vaccine and positive after receiving two doses of vaccination included in the study. Disease severity was assessed in terms of high-resolution computed tomography (HRCT) score, intensive care unit (ICU) admission, SpO2 maintained, oxygen, plasma exchange, steroids received and on mechanical ventilation, and outcome was assessed on prognosis and stabilized/discharged to home. Results: A total of 172 were participated in the study with 101 (58.7%) males and 71 (41.3) females, respectively. Amongst them, 92 were affected before vaccination and 80 were affected before vaccination. The patients admitted in the ICU were 56 (32.6%) and 116 (67.4%) were not admitted in the ICU; among the patient admitted in ICU 42 (45.7%) before vaccination, and 14 (17.5%) were after vaccination, and difference was statistically significant with P- value 10 litres given and mechanical ventilation were positively associated with the vaccine received and disease severity with P- value

Colloid cysts are mucous- or hyaloid-filled lesions with an outer fibrous layer. These are rare developmental and nonneoplastic malformation. They may be found incidentally, while some cases may present with intermittent headache, rapid neurologic deterioration, drop attacks, and even sudden death. Early recognition of this disease may result in lesser mortality. Here, we present a 22-year-old male with a history of fall while driving his two-wheeler. A diagnosis of colloid cyst of the third ventricle with a head injury was made. Colloid cyst presenting with a head injury is exceedingly rare with only five case reports in the literature. This report may help to support surgical intervention in an asymptomatic patient, as the cyst can predispose head injury with serious consequences. It also stresses the importance of a high degree of suspicion when there is any well-defined radiological abnormality in the region of the third ventricle. A colloid cyst may easily be confused with intracranial hemorrhage due to hyperdensity in head trauma. It can be distinguished by the presence of an accompanying traumatic lesion. The cyst usually has well-defined round margins, and the morphologic appearance and density do not change on a follow-up computed tomography (CT) scan, whereas in hemorrhage the density usually regresses with clinical improvement on serial imaging. [ABSTRACT FROM AUTHOR]

The lack of clarity in many parameters used in ecological models is due to the constant changes in nature. The fundamental predator–prey model discussed in this article takes into account several ecological parameters as parametric-functional interval numbers. It discusses the dynamic characteristics of the model within the context of an uncertain environment. To account for this uncertainty, the model incorporates the concepts of bionomic equilibria and maximum sustainable yield (MSY). The article explores the optimal harvesting policy by applying Pontryagin’s maximum principle in an imprecise and uncertain environment. The proposed imprecise model formulation includes two additional variables: the influence of fear on prey population growth rate and the harvesting of prey and juvenile predator populations. The system of interval differential equations governs the interactions between these imprecise species, allowing for mathematical analysis of the proposed system. The aim of this study is to evaluate the robustness of an imprecise prey–predator model within an unpredictable environment. The article concludes by presenting rigorous numerical simulations that support all the analytical findings.