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India being a populous country demanding construction on large scale. The change of environment since several years are more often generating seismic waves. Around 9 major earthquakes with magnitude scale of above 6 can be observed over an decade. The present study is to focus in increase in ductility without any earthquake resistance design but with inclusion of combination of fibers like nylon and sisal. Concrete due to its brittleness is very prone in case of seismic resistance alone. Reinforcing concrete with steel bars to strengthen the ductility was the traditional approach which is followed by all over the globe. The use of steel bars to strengthen a concrete beam is confined because of its limitation which causes sudden failure in concrete. Thus, making a concrete material which is more ductile than a normal concrete is basic aim of this experimental research work. T beam are casted to study their performance mainly due to know the behavior of column beam joint during seismic evaluation. The study shows the attributes of concrete due to inclusion of hybrid fibers and even generation of mathematical model to analyze the effect and variation of concrete properties due to inclusion of hybrid fibers. To study their seismic performance cyclic loading test is performed. An trial is made to increase ductility of concrete beams mainly near column beam joint which were very prone towards seismic waves by hybridizing sisal fiber and nylon fiber and can result in increase in ductility and load carrying capacity by 22% and 31% respectively in comparison with control specimen.

Hispidulin is well-known natural bioactive flavone on behalf of its pharmacological aspects. This review contains data on isolation, synthetic methodology, pharmacokinetics and bioactivities of hispidulin. The article provides a critical assessment of present knowledge about hispidulin with some clear conclusions, perspectives and directions for future research in potential applications.

Hispidulin is well-known natural bioactive flavone on behalf of its pharmacological aspects. This review contains data on isolation, synthetic methodology, pharmacokinetics and bioactivities of hispidulin. The article provides a critical assessment of present knowledge about hispidulin with some clear conclusions, perspectives and directions for future research in potential applications.

A 52-year-old Caucasian man presented with sudden onset of difficulty in moving his tongue to the left with preceding left-sided headache with no neck pain. Earlier, he had self-limiting chest infection without rashes or tonsillar enlargement. His medical and surgical history was unremarkable with no recent trauma. Oral examination revealed difficulty in protruding his tongue to the left with muscle bulk loss and fasciculation on the same side, suggesting left hypoglossal nerve palsy. Examination of the rest of the cranial nerves and nervous system was normal. The patient's oropharyngeal and laryngeal examination was unremarkable with no cervical lymphadenopathy. He had normal laboratory investigations and cerebrospinal fluid examination. Extensive imaging of the head, neck and chest failed to reveal any pathology. Further review by an otorhinologist and rheumatologist ruled out any other underlying pathology. He made a good recovery without treatment. English literature search revealed very few cases of idiopathic, transient, unilateral hypoglossal nerve palsy.

Wegener's granulomatosis (granulomatosis with polyangitis) is a rare autoimmune disease causing necrotising vasculitis of small blood vessels, mainly affecting the upper (90%) and lower (60%) respiratory tract tissues and kidneys (75%). Central nervous system (CNS) involvement is limited to 2–8% of cases while cranial nerve involvement is seen in only 1% of cases. Most cases are due to the granulomatous involvement of meninges (pachymeningitis), resulting in cranial nerve palsies. Very rarely, CNS lesions are caused by vasculitis of small vessels. We report a case of a man who, while being treated with cyclophosphamide, presented with an acute flare of the disease affecting all the cranial nerves except the olfactory, trigeminal and facial nerves. Extensive investigations failed to show any meningeal involvement, supporting the view of extensive small vessel vasculitis. It is extremely rare to have such an extensive cranial nerve involvement with no evidence of meningeal involvement. Immunosuppressive therapy with cyclophosphamide is considered to be the mainstay of the treatment (along with steroids) with complete remission seen in a large majority of cases. However, in this case, he was refractory to cyclophosphamide and also failed to respond to alternative therapy with rituximab (a monoclonal antibody that binds to CD20). After being on a high-dose steroid therapy for nearly a year, he successfully responded to subcutaneous methotrexate therapy, thus enabling the steroid dose to be reduced significantly. A 59-year-old Caucasian man with no significant medical history was diagnosed with Wegener's granulomatosis (granulomatosis with polyangitis) when he presented with deafness, epistaxis, haemoptysis, cavitating lung lesion on chest X-ray, high inflammatory markers, a very positive …

A 65-year-old female was admitted with an 8-week history of gradual onset headache. The headache was worse in the morning and on bending forwards. This was associated with 1 week history of vomiting and 1 day history of difficulty in walking. Medical history was unremarkable apart from treated hypothyroidism. There was no history of trauma. Observations and physical examination were entirely normal. Routine blood tests including the ESR and clotting profile were normal. Given the history had red flags for headache, a CT scan was ordered and this showed bilateral subdural haematomas. The patient was referred to the regional neurosurgical centre where the haematomas were evacuated with good recovery. A follow-up MRI brain and spine did not show any source of bleeding.

A 65-year-old Caucasian woman had a 6 year history of worsening greyish blue discolouration of sun exposed areas—face, neck, arms, feet and the sclera (figs 1 and 2). She had suffered from rheumatoid arthritis for the past 20 years, with crippling disease at the onset, and was barely able to walk due to pain. After failure to respond to several disease modifying antirheumatic drugs (DMARDs), …