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Key Clinical Message: To rule out underlying developmental brain defects such as schizencephaly, pediatric seizures necessitate a thorough examination. Adults who receive a diagnosis later in life may face severe management and prognosis difficulties. To avoid underdiagnosis of developing brain abnormalities, imaging should be a part of the workup for pediatric seizures. Imaging is critical to the diagnosis and therapy of such cases. Closed‐lip schizencephaly with the absence of the septum pellucidum is a rare congenital malformation of the brain that can be associated with a variety of neurological conditions. We report the case of a 25‐year‐old male with left hemiparesis who presented with recurrent seizures from childhood, poorly controlled with medications, and increased tremors. He has been taking anticonvulsant for the last 7 years and is under symptomatic management. Magnetic resonance imaging of the brain revealed closed‐lip schizencephaly with absent septum pellucidum. [ABSTRACT FROM AUTHOR]

Abstract Big Data and Deep Learning algorithms combined with enormous computing power have paved ways for significant technological advancements. Technology is evolving to anticipate, understand and address our unmet needs. However, to fully meet human needs, machines or computers must deeply understand human behavior including emotions. Emotions are physiological states generated in humans as a reaction to internal or external events. They are complex and studied across numerous fields including computer science. As humans, on reading "Why don't you ever text me!" , we can either interpret it as a sad or an angry emotion and the same ambiguity exists for machines as well. Lack of facial expressions and voice modulations make detecting emotions in text a challenging problem. However, in today's online world, humans are increasingly communicating using text messaging applications and digital agents. Hence, it is imperative for machines to understand emotions in textual dialogue to provide emotionally aware responses to users. In this paper, we propose a novel Deep Learning based approach to detect emotions - Happy, Sad and Angry in textual dialogues. The essence of our approach lies in combining both semantic and sentiment based representations for more accurate emotion detection. We use semi-automated techniques to gather large scale training data with diverse ways of expressing emotions to train our model. Evaluation of our approach on real world dialogue datasets reveals that it significantly outperforms traditional Machine Learning baselines as well as other off-the-shelf Deep Learning models. Highlights • Emotion Detection in text finds several practical applications such as modulation of responses for real-world chat-bot. • Combining Sentiment and Semantic information in a text improves emotion detection system. • Our approach learns diverse ways of expressing emotions and significantly outperforms methods described in literature. [ABSTRACT FROM AUTHOR]

Left ventricular noncompaction is a rare form of cardiomyopathy, which results from multiple trabeculations in the left ventricular myocardium. The clinical presentation is highly variable, and spectrum includes asymptomatic patients diagnosed during family screening on one end to patients with depressed systolic function, heart failure, thromboembolic complications, and cardiac arrhythmias on the other (Kim et al in J Am Coll Cardiol 53: 2009, 2009). Further, the progression of the condition is highly variable. Hence, these patients require close follow-up, and management for each patient needs to be individualized and periodically reevaluated. Here, we present a series of five cases that have been followed in our practice and present our experience. A literature review of this rare form of congenital cardiomyopathy is also presented. [ABSTRACT FROM AUTHOR]

Aims: Seventeen Y-STR loci (DYS19, DYS389I, DYS389II, DYS390, DYS391, DYS392, DYS393, DYS385a/b, DYS437, DYS438, DYS439, DYS448, DYS456, DYS458, DYS635 and Y-GATA-H4) were analysed in 173 males belonging to the central Indian population with the aim of studying genetic diversity and adding to the population database. Methods: Multiplexed PCR amplifications of the 17 Y STR loci were performed using AmpFlSTR® Yfiler® Kit. Amplified products were genotyped using a multi capillary electrophoresis with POP-4 polymer in ABI Prism 3100 Genetic Analyzer. Population genetic diversity and allele frequencies were calculated. The haplotype data obtained in the study was compared with the Y-STR haplotypes reference database (YHRD,http://www.yhrd.org) and with previously published population data using the AMOVA tool and visualised in two-dimensional multidimensional scaling (MDS) plots. Results: A total of 147 haplotypes were observed, out of which 125 were unique. Haplotype diversity and discriminating capacity were found to be 0.9979 and 0.8497, respectively. The gene diversity at the loci ranged from 0.398–0.785. Genotype diversity at the locus DYS385a/b was found to be 0.869. Conclusions: The population of central India was found to be significantly different (p < 0.05) when compared with populations from other parts of the Indian sub-continent and the population data of other countries. The population data generated in this study are useful for forensic, anthropological and demographic studies. [ABSTRACT FROM AUTHOR]

Predicting financial trends of stock indexes is important for investors to reduce risk on investment and efficient decision making if the prediction is made accurately. Researchers, in recent times have applied deep learning approaches in this field which have essentially beaten conventional machine learning approaches. To overcome the issue of overfitting we presented a new data augmentation approach in our GRU based StockNet model consisting of two modules. Injection module to prohibit overfitting and Investigation module for stock index forecasting. The proposed approach has been validated on Indian stock market (CNX-Nifty). Proposed StockNet-c model produces 65.59%, 27.30% and 14.89 % less test loss in terms of RMSE, MAE and MAPE respectively, in comparison to TargetNet model where overfitting prohibition injection module is missing. • Stock index prediction with data augmentation approach to prohibit overfitting. • StockNet model with GRU network with injection and investigation modules. • Proposed models shows the best result in CNX Nifty dataset. • The prediction results of the proposed model have statistical significance. [ABSTRACT FROM AUTHOR]

Repair for tetralogy of Fallot (TOF) with complete atrioventricular septal defect (CAVSD) has been reported with good early and intermediate outcomes. Morbidity, however, remains significantly high. To date, repair of CAVSD/TOF using a pulmonary valve-sparing technique (PVS) and freedom from valve reoperation are not well defined. A study was undertaken to investigate outcomes. This study was conducted in as a retrospective investigation. Between January 1988 and December 2008, 13 consecutive patients with CAVSD/TOF were identified, and their records were reviewed retrospectively. Of these 13 patients, 9 had Rastelli type C CAVSD. Trisomy 21 was present in 9 cases (69 %; 7 with type C). Five patients had received a systemic-to-pulmonary shunt (SPS) before complete repair at a mean age 1.7 ± 0.6 months. All the patients survived until complete repair. At complete CAVSD/TOF repair, AVSD was corrected with a two-patch technique in all patients. For eight patients (61.5 %), PVS was used. The remaining five patients had transannular patch (TAP) repair. The mean age at complete repair was 6.3 ± 2.4 months. At complete repair, the mean cardiopulmonary bypass time was 173.5 ± 30.6 min, and the cross-clamp time was 134.7 ± 28.8 min. There was one hospitalization and no late deaths. The median follow-up period was 9.2 years [interquartile range (IQR), 4.7-13.3 years]. The actuarial survival was 90.0 ± 9.5 % at 1 year, 90 ± 9.5 % at 5 years, and 90 ± 9.5 % at 8 years. Of the 12 survivors, 6 had some reintervention during the follow-up period. Within the first 11 years after complete repair, two patients underwent left atrioventricular (AV) valve repair, and one patient had right AV valve repair. Two patients had residual VSD closure. Four patients underwent the first right ventricular outflow tract (RVOT) reintervention for critical insufficiency or stenosis at a mean interval of 6 ± 21) months. One patient had a second RVOT reoperation. Findings showed that CAVSD/TOF with PVS was related to significantly higher freedom from RVOT reintervention (100 % at 1, 5, and 8 years compared with 80 ± 17.9 % at 1 year, 60 ± 21.9 % at 5 years, and 40 ± 21.9 % at 8 years for CAVSD/TOF using TAP; P < 0.05). No patient who underwent PVS had left ventricular outflow tract obstruction requiring reoperation. Overall freedom from any reintervention was 90.9 ± 8.6 % at 1 year, 71.6 ± 14.0 % at 5 years, and 53.7 ± 8.7 % at 8 years in this group of patients. Correction of TOF with CAVSD can be performed at low risk with favorable intermediate-term survival and satisfactory freedom from reoperation. Use of TAP can be avoided in almost two thirds of patients and may influence freedom from early RVOT reintervention. [ABSTRACT FROM AUTHOR]

Premature closure or restriction of foramen ovale (FO) is a rare but known entity. FO diameter <2 mm and Doppler velocity >120 cm/s, diameter <3 mm with Doppler velocity measured gradient >5 mmHg have all being used by various authors to describe this entity. Some neonates with restrictive FO have been noted to have severe pulmonary hypertension with no clinical signs or symptoms and with spontaneous resolution without any intervention. Seven consecutive neonates were indentified in the database between 01/01/2003 and 06/30/2010 with diagnosis of restrictive PFO (diameter <2 mm) with structurally normal heart and their initial and follow-up echocardiogram as well as hospital medical records were reviewed. As a control, seven neonates with diagnosis of pulmonary hypertension and respiratory distress syndrome or meconium aspiration syndrome were randomly selected. Eighty-six percent of the patients in the control group were symptomatic and required treatment as compared to 14% in the restrictive FO group ( p = 0.03). Further, the fall in the peak instantaneous pulmonary artery pressure on follow-up echocardiogram was greater in the restrictive FO group compared with the non-restrictive group ( p = 0.03). Patients with pulmonary hypertension and a restrictive FO with no other associated congenital heart disease and/or lung pathology behave differently when compared to neonates with non-restrictive FO and pulmonary hypertension with associated lung disease. They seldom manifest symptoms requiring intervention and tend to show a faster drop in their pulmonary artery pressure toward the normal. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Identifying pulmonary pathology while evaluating electrolyte disorders is crucial for optimal patient management. Physicians working in endemic regions of tuberculosis should consider this pathology as a differential for electrolyte imbalances. Hyponatremia, a common electrolyte imbalance, can arise from various underlying etiologies such as diuretics, diarrhea, vomiting, congestive heart failure, and liver and renal disease. We present a case report of a 74‐year‐old man highlighting the association between pulmonary tuberculosis (TB) and the development of hyponatremia. GeneXpert assay of the patient's sputum sample led to the identification of underlying active pulmonary TB as the cause of hyponatremia. The patient was started on anti‐TB therapy, and concurrent fluid restriction and sodium supplementation were initiated to correct the electrolyte imbalance. Over the next 3 days, the patient demonstrated clinical improvement with the resolution of hyponatremia. This case also highlights the importance of considering TB as a potential etiology in patients presenting with hyponatremia, especially in endemic areas. Further research is warranted to explore the mechanistic pathways linking pulmonary TB and hyponatremia, aiding in the development of targeted therapeutic interventions. [ABSTRACT FROM AUTHOR]

Key Clinical Message: The nicotinic symptom in Organo‐Phosphate (OP) poisoning is an unusual presentation in an adult, as in our case of a 38‐year‐old man who also experienced decreased motor power of all limbs and diffuses fasciculation of the tongue and lower limbs. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Understanding the circumstances, leading to unmasking of hidden Brugada syndrome is essential for the practicing clinician and the patients so that they are informed adequately to seek prompt medical attention. Brugada syndrome is a genetic arrhythmia syndrome characterized by a coved type of ST‐segment elevation in the ECG. The patients are usually asymptomatic, with unmasking of the disease under certain conditions. We are reporting the case of a patient diagnosed with Brugada syndrome, which was unmasked during an attack of dengue fever. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Meningiomas are slow‐growing tumors that develop from the arachnoid cap cells' meningothelial cells. Males are more likely to develop intra‐parenchymal meningiomas, which also manifest earlier than ordinary meningiomas and are uncommon. Meningiomas are slow‐growing neoplasms which arise from the meningothelial cells of the arachnoid cap cells. Unlike other meningiomas, intra‐parenchymal meningiomas do not originate from dura. Intra‐parenchymal meningiomas are more common in males and develop earlier than regular meningiomas. Because of the rare occurrence the intra‐parenchymal meningiomas, they are commonly misdiagnosed. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Chronic kidney disease (CKD) and tuberculoma are two distinct medical conditions. Nonetheless, they can be related in very rare cases. The purpose of this case report is to consider screening tests such as IGRA (interferon gamma release assay) and TST (tuberculin skin test), for tuberculosis in CKD patients with a risk of infection, thereby increasing the awareness of tuberculoma in CKD and ensuring early treatment which would eventually decrease the morbidity and mortality rates in such patients. Chronic kidney disease (CKD) associated with tuberculoma represents one of the rarest conditions occurring worldwide. Among tuberculous patients, only 1% show central nervous system involvement. We present a case of a 45‐year‐old male with CKD who presented with a seizure and was diagnosed to have tuberculoma. [ABSTRACT FROM AUTHOR]

Key Clinical Message: Identifying any potential comorbidity such as bulimia nervosa (BN) and ADHD in trichotillomania patients is essential for a thorough treatment plan. Combining a multidisciplinary approach was found to be feasible and effective in the treatment. Trichotillomania is frequently considered an isolated disorder; nevertheless, emerging evidence suggests that other psychiatric conditions, including obsessive‐compulsive disorder (OCD), eating disorders, and attention‐deficit/hyperactivity disorder (ADHD), are often found to coexist. Several studies showed that eating disorders, such as bulimia nervosa, were found in chronic hair‐pullers, while OCD was considered a factor in predicting the prevalence of eating disorders, as well as the severity of trichotillomania in the populations. While the relationship between trichotillomania and OCD has been quite well‐documented, the evidence of its association with bulimia nervosa and ADHD remains limited. Here, we report a case of trichotillomania with comorbid bulimia nervosa, major depressive disorder, and ADHD. [ABSTRACT FROM AUTHOR]

Key clinical Message: Human subcutaneous dirofilariasis is an infection caused by filarial worms. Due to the recent rise of human disease, it is considered as an emerging zoonosis. Most of the cases in children recorded in India had ocular infection; very few subcutaneous cases of dirofilariasis have been reported in children. [ABSTRACT FROM AUTHOR]

Trauma or surgery to the lower limbs can cause fat from the marrow within the leg bones to enter the bloodstream and form an embolus. However, if there is cerebral involvement without any pulmonary or dermatological manifestations at diagnosis, it could delay identifying cerebral fat embolism (CFE). [ABSTRACT FROM AUTHOR]

Key Clinical Message: Lung cancer can present with unilateral atypical facial pain, a rare symptom due to vagus nerve involvement or paraneoplastic syndrome. This manifestation is usually missed, delaying the diagnosis and prognosis. We discuss a case of a 45‐year‐old male who presented with right‐sided hemifacial pain and with normal neurological investigations. [ABSTRACT FROM AUTHOR]

Takayasu arteritis is a primary systemic vasculitides occurring among women in the childbearing age group. This interaction between TA and pregnancy is an area of interest that has to be addressed. Preconception and antepartum management of arterial hypertension and TAK disease activity is important to improve maternal and fetal outcomes. [ABSTRACT FROM AUTHOR]

Aims: Genotypic polymorphism studies at 15 highly polymorphic short tandem repeat (STR) loci were carried out in Bhil tribal population of Madhya Pradesh, in central region of India. Methods: The analysis of 15 autosomal STR loci (TH01, D3S1358, vWA, D21S11, TPOX, D7S820, D19S433, D5S818, D2S1338, D16S539, CSF1PO, D13S317, FGA, D18S51, D8S1179) was done in 183 unrelated individuals of the Bhil tribe. Results: Heterozygosity among the studied 15 autosomal STR loci ranged from 63.5–86.5%. The loci D2S1338 and FGA were found to be mostly polymorphic. All loci fall under Hardy–Weinberg equilibrium, except loci D18S51 and D7S820. These STR loci were highly informative and discriminating, with CPD > 0.99999. Conclusion: The clustering pattern of the NJ tree and the PCA plot showed grouping of the Bhil population with previously reported tribes of central India. [ABSTRACT FROM PUBLISHER]

Antimicrobial resistance (AMR) is a global health concern. Targetting AMR, we present an in situ lactonization mechanism generating 4-nitroisobenzofuran-1(3H)-one (IITK2020), an exclusive S. aureus inhibitor at 2–4 μg mL−1 MIC including multidrug-resistant S. aureus clinical strains, that prevents peptidoglycan biosynthesis. [ABSTRACT FROM AUTHOR]

Introduction Socio-economic differences in the society have been a major cause for the discrepancy in disease and behavioural patterns in society. With 360 million people (32 million children) in the world suffering from disabling hearing losses, it is imperative to gain an insight into the impact of differences in socio-economic strata on children's ear health issues, their knowledge of ear ailments and attitude towards ear health so as to suggest policies addressing ear health issues. Methods The study was carried out in two different school types namely government schools and private schools which represent wide difference in the socio-economic status of the students studying there. A questionnaire was administered to students aged 10 to 13 years to assess the current ear care practices, knowledge regarding ear ailments, attitude towards hearing and their adaptability to reform. Results The children belonging to higher socio-economic status were found to have lesser incidence of ear diseases and ear abuse, more referrals for ear ailments, lesser indulgence in risky ear health behaviours, better knowledge pool, positive attitude towards ear health and hearing and were more adaptable to change for better hearing. Conclusion Structures of social disparity are essential determinants of ear health acting both independently and through their influence on behavioural determinants of health. Increasing awareness of ear health issues at the school level itself should be one of the goals of health care providers. [ABSTRACT FROM AUTHOR]

The analysis of 12 X STR loci (DXS10103, DXS8378, DXS7132, DXS10134, DXS10074, DXS10101, DXS10135, DXS7423, DXS10146, DXS10079, HPRTB and DXS10148) belonging to four linkage group was done in 183 (100 males and 83 females) unrelated members of Bhil population. Heterozygosity among the studied 12 X STR loci showed a distribution of from 59.7% to 92.8%. No significant difference was recorded in the allele frequencies of males and females. The loci DXS10135 and DXS10101 were found to be most polymorphic. Haplotype diversity was found to be higher than 0.990 for all the four linkage groups. A total of 86, 69, 71 and 71 haplotypes were observed for linkage group I, II, III and IV, respectively. The results showed departure from Hardy–Weinberg equilibrium with respect to three loci DXS10079, DXS10135 and DXS10101. This is first report on these 12 X STR markers from India. All the loci in the Argus X 12 kit were fairly informative in the Bhil population and the population showed significant genetic variation with all the compared populations from other parts of the world. [ABSTRACT FROM AUTHOR]

The Kepler satellite has provided photometric timeseries data of unprecedented length, duty cycle and precision. To fully analyse these data for the tens of thousands of stars observed by Kepler, automated methods are a prerequisite. Here, we present an automated procedure to determine the period spacing of gravity modes in red giant stars ascending the red giant branch. The gravity modes reside in a cavity in the deep interior of the stars and provide information on the conditions in the stellar core. However, for red giants the gravity modes are not directly observable on the surface, hence this method is based on the pressure-gravity mixed modes that present observable features in the Fourier power spectrum. The method presented here is based on the vertical alignment and symmetry of these mixed modes in a period echelle diagram. We find that we can obtain reliable results for both model frequencies and observed frequencies. Additionally, we carried out Monte Carlo tests to obtain realistic uncertainties on the period spacings with different set of oscillation modes (for the models) and uncertainties on the frequencies. Furthermore, this method has been used to improve mode detection and identification of the observed frequencies in an iterative manner. [ABSTRACT FROM AUTHOR]

Transcatheter patent ductus arteriosus (PDA) closure (TCPC) utilizing transthoracic echocardiogram (TTE) as the sole imaging guide could simplify care. This single-center study compares PDA dimensions obtained from the TTE and angiogram images of patients who underwent attempted TCPC at Stead Family Children’s Hospital from 10/01/2019 to 10/31/2020. Blinded investigators measured these dimensions solely for this study and had no impact on clinical care. Also, a hypothetical Piccolo device size was chosen based on the TTE dimensions and another on the angiographic dimensions, and then the correlation was analyzed. Sixty-two patients underwent TCPC attempts. TTE tends to overestimate the PDA narrowest dimension and underestimate the PDA length and aortic end dimension. Linear regression analysis revealed a weak correlation between the length and aortic diameter (R = 0.37 and 0.21, respectively). A modest correlation was observed for the smallest dimension without color Doppler (R = 0.57) and with color Doppler, which was utilized when needed (R = 0.6). Bland–Altman analysis revealed a smaller mean difference between the TTE and angiogram measurements of the narrowest diameter without color Doppler (0.4 mm) and with color Doppler (used as needed) (0.4 mm). However, the mean difference is larger for the aortic end (− 1.64 mm) and the length (− 1.73 mm). TTE accurately predicted the Piccolo device size in 43 (72%) patients and overestimated the size in 17 (28%) patients to the next size. Our findings should be verified with further studies, and additional development of protocols is needed to use TTE to guide TCPC without fluoroscopy. [ABSTRACT FROM AUTHOR]

The use of medications plays a pivotal role in the management of children with heart diseases. Most children with increased pulmonary blood flow require chronic use of anticongestive heart failure medications until more definitive interventional or surgical procedures are performed. The use of such medications, particularly inotropic agents and diuretics, is even more amplified during the postoperative period. Currently, children are undergoing surgical intervention at an ever younger age with excellent results aided by advanced anesthetic and postoperative care. The most significant of these advanced measures includes invasive and noninvasive monitoring as well as a wide array of pharmacologic agents. This review update provides a medication guide for medical practitioners involved in care of children with heart diseases. [ABSTRACT FROM AUTHOR]