Moyamoya disease is a rare clinical disorder, characterized by chronic, progressive occlusion of supraclinoid internal carotid artery and proximal portions of the anterior and middle cerebral arteries, and consequent development of collateral vessels seen on imaging as puff of smoke appearance. Although the pathophysiology is unclear, various hematologic disorders have been associated with development of the moyamoya syndrome. We report a case of moyamoya syndrome in a 3 yr old girl who presented with recurrent ischemic strokes. The angiography was suggestive of moyamoya syndrome. The serum vitamin B12 level was remarkably low with bone marrow picture of megaloblastic anemia. There was also hyperhomocysteinemia. Moyamoya syndrome has not been previously reported to be associated with vitamin B12 defi ciency. We propose that vitamin B12 defi ciency with hyperhomocysteinemia could result in greater risk for arterial thrombosis and thus caused the moyamoya syndrome in our patient

Background: With greater use of social media platforms for promotions of research articles, retracted articles tend to receive approximately the same attention. We systematically analyzed retracted articles from retractionwatch.com to look at the Altmetric Attention Scores (AAS) garnered over a period of time in order to highlight the role of social media and other platforms in advertising retracted articles and its effect on the spread of misinformation. Methods: Retractionwatch.com was searched for coronavirus disease 2019 related retracted papers on November 6th, 2021. Articles were excluded based on lack of digital object identifier (DOI), if they were preprint articles, absent AAS, and incomplete AAS of pre retraction, post retraction, or both scores. Results: A total of 196 articles were found on the Retraction Watch website of which 189 were retracted papers and 7 were expression of concern (EOC). We then identified 175 articles after excluding those that did not have a DOI and 30 preprint articles were also excluded giving 145 articles. Further exclusion of articles with absent AAS and incomplete AAS resulted in a total of 22 articles. Conclusion Retracted articles receive significant online attention. Twitter and Mendeley were the most popular medium for publicizing retracted articles, therefore more focus should be given by journals and their Twitter accounts to discredit all their retracted articles.Preprints should be reconsidered as a whole by journals due to the huge risk they carry in disseminating false information.

Background: Complete peroneal nerve dysfunction associated with congenital clubfoot is uncommonly reported. Our retrospective study highlights the recognition of clinical presentation and mid-term outcomes of treatment in these patients. Methods: Eight out of 658 patients undergoing treatment for clubfoot were identified with unilateral complete peroneal nerve dysfunction associated with congenital clubfoot. Three patients presented primarily to our center; 5 were treated elsewhere initially.All patients were treated with Ponseti casts, Achilles tenotomy, and subsequent foot abduction bracing. Diagnosis of complete peroneal nerve dysfunction was confirmed using nerve conduction velocity studies in all patients. After full-time bracing, an insole polythene molded ankle foot orthosis was given. Three patients underwent tibialis posterior transfer to improve foot dorsiflexor power. Results: The mean age at presentation was 1.3 years (range, 1 week–5 years). All patients had prominence of lateral 3 metatarsal heads and dimpling of intermetatarsal spaces. At a mean follow-up of 5.1 years, mean shortening of 1.2 cm in tibia (range, 1–2.5 cm) and mean calf wasting of 4.4 cm were observed. There was no relapse of any clubfoot deformity till the final follow-up. Conclusions Prominence of lateral metatarsal heads and dimpling of intermetatarsal spaces should raise early suspicion of peroneal nerve dysfunction. Standard Ponseti protocol is useful in treatment of these patients. Tibialis posterior transfer to dorsum partially restores the ankle dorsiflexion.

No abstract available.
Female ; Humans ; Pectoralis Muscles/*diagnostic imaging ; Trigger Points/*diagnostic imaging ; Ultrasonography

Throughout the years, various classifications have evolved for the diagnosis of vascular anomalies. However, it remains difficult to classify a number of such lesions. Because all hemangiomas were previously considered to involute, if a lesion with imaging and clinical characteristics of hemangioma does not involute, then there is no subclass in which to classify such a lesion, as reported in one of our cases. The recent classification proposed by the International Society for the Study of Vascular Anomalies (ISSVA, 2014) has solved this problem by including non-involuting and partially involuting hemangioma in the classification. We present here five cases of vascular anomalies and discuss their diagnosis in accordance with the ISSVA (2014) classification. A non-involuting lesion should not always be diagnosed as a vascular malformation. A non-involuting lesion can be either a hemangioma or a vascular malformation depending upon its clinicopathologic and imaging characteristics.
Classification ; Diagnosis* ; Head* ; Hemangioma ; Neck* ; Vascular Malformations

Plagiarism is one of the most frequent forms of research misconduct in South and East Asian countries. This narrative review examines the factors contributing to research misconduct, emphasizing plagiarism, particularly in South, East and Southeast Asian countries. We conducted a PubMed and Scopus search using the terms plagiarism, Asia, South Asia, East Asia, Southeast Asia, research misconduct and retractions in January of 2022. Articles with missing abstracts, incomplete information about plagiarism, publication dates before 2010, and those unrelated to South, East, and Southeast Asian countries were excluded. The retraction watch database was searched for articles retracted between 9th January 2020 to 9th January 2022. A total of 159 articles were identified, of which 21 were included in the study using the database search criteria mentioned above. The review of articles identified a lack of training in scientific writing and research ethics, publication pressure, permissive attitudes, and inadequate regulatory measures as the primary reasons behind research misconduct in scientific publications. Plagiarism remains a common cause of unethical publications and retractions in regions of Asia (namely South, East and Southeast). Researchers lack training in scientific writing, and substantial gaps exist in understanding various forms of plagiarism, which heavily contribute to the problem. There is an urgent need to foster high research ethics standards and adhere to journal policies. Providing appropriate training in scientific writing among researchers may help improve the knowledge of different types of plagiarism and promote the use of antiplagiarism software, leading to a substantial reduction in the problem.

OBJECTIVETo study morpho-anatomical characters and physicochemical analysis of Fumaria indica (F. indica) (Hausskn.) Pugsley, (Fumariaceae), an important medicinal plant used extensively for treating a variety of ailments in various system of indigenous medicine.

METHODSEvaluation of the different parts of the plant was carried out to determine the morpho-anatomical, physicochemical, phytochemical and HPTLC fingerprinting profile of F. indica and other WHO recommended methods were performed for standardization.

RESULTSMorpho-anatomical studies showed compound and pinnatifid leaf, 4 to 6 cm in length, linear and oblong in shape and anomocytic arrangement of stomata, thin walled parenchymatous cells, scattered, sclerenchymatous, capped vascular bundles and radiating medullary rays. Physicochemical studies showed foreign matter 0.2%, loss on drying 6.8%, total ash 16.77%, alcohol and water soluble extractives 8.92% and 20.26%, respectively, sugar 17.75%, starch 22.97% and tannins 2.37%. Phytochemical evaluation revealed the presence of carbohydrate, alkaloids, flavonoids, saponins, tannins and sterol. Thin layer chromatography was carried out with different solvents and the best solvent system was chloroform and methanol in 80:20 ratio and revealed 12 spots with different Rf value under UV light 366λ.

CONCLUSIONSThe results of the study can serve as a valuable source of information and provide suitable standards for identification of this plant material for future investigations and applications.

Fumaria ; anatomy & histology ; chemistry ; cytology ; Phenotype ; Phytochemicals ; chemistry ; Plant Extracts ; chemistry ; Plant Leaves ; chemistry ; cytology ; Plant Roots ; chemistry ; cytology ; Plant Stems ; chemistry ; cytology

Thoracic impalement injuries are very rare and the majority of patients do not survive to reach a medical care facility. In this case report, we describe the successful outcome of a case of double thoracic impalement by two steel tors, of which one steel tor had impaled two patients simultaneously. The case report highlights all aspects of managing such rare and complex cases right from prehospital care; extrication process which happened under controlled environment at the trauma centre itself, till the definitive management of the impaled thoracic objects. Thoracic impalement injuries are dramatic and appear very challenging. However presence of mind of the managing team, coordinated team effort and availability of adequate facilities can lead to a successful outcome.
Humans ; Thoracic Injuries ; Wounds, Penetrating

Adult ; Anticoagulants ; therapeutic use ; Heparin, Low-Molecular-Weight ; therapeutic use ; Humans ; Male ; Upper Extremity Deep Vein Thrombosis ; diagnosis ; drug therapy

BACKGROUND: Diabetic ketoacidosis (DKA) is characterized by a biochemical triad of hyperglycemia, acidosis, and ketonemia. This condition is life-threatening despite improvements in diabetic care. The purpose of this study was to evaluate the clinical and biochemical prognostic markers of DKA. We assessed correlations in prognostic markers with DKA-associated morbidity and mortality. METHODS: Two hundred and seventy patients that were hospitalized with DKA over a period of 2 years were evaluated clinically and by laboratory tests. Serial assays of serum electrolytes, glucose, and blood pH were performed, and clinical outcome was noted as either discharged to home or death. RESULTS: The analysis indicated that significant predictors included sex, history of type 1 diabetes mellitus or type 2 diabetes mellitus, systolic blood pressure, diastolic blood pressure, total leukocyte count, Acute Physiology and Chronic Health Evaluation II (APACHE II) score, blood urea nitrogen, serum creatinine, serum magnesium, serum phosphate, serum osmolality, serum glutamic oxaloacetic transaminases, serum glutamic pyruvic transaminases, serum albumin, which were further regressed and subjected to multivariate logistic regression (MLR) analysis. The MLR analysis indicated that males were 7.93 times more likely to have favorable outcome compared with female patients (odds ratio, 7.93; 95% confidence interval, 3.99 to 13.51), while decreases in mean APACHE II score (14.83) and serum phosphate (4.38) at presentation may lead to 2.86- and 2.71-fold better outcomes, respectively, compared with higher levels (APACHE II score, 25.00; serum phosphate, 6.04). CONCLUSION: Sex, baseline biochemical parameters such as APACHE II score, and phosphate level were important predictors of the DKA-associated mortality.
Acidosis ; APACHE ; Blood Pressure ; Blood Urea Nitrogen ; Creatinine ; Diabetes Mellitus, Type 1 ; Diabetes Mellitus, Type 2 ; Diabetic Ketoacidosis* ; Electrolytes ; Female ; Glucose ; Humans ; Hydrogen-Ion Concentration ; Hyperglycemia ; Hyperglycemic Hyperosmolar Nonketotic Coma ; Ketosis ; Leukocyte Count ; Logistic Models ; Magnesium ; Male ; Mortality ; Osmolar Concentration ; Serum Albumin ; Transaminases