The use of a laser-based optical system and wavelet transforms is explored for the detection of changes in the properties of cantilevered aluminum beams as a result of damage. The beams were modeled using the ANSYS 5.3 finite-element method and the first six mode shapes for the damaged and the undamaged cases obtained. Damage was simulated by a reduction in the stiffness of one element. Gaussian white noise was added externally to simulate field conditions. The results show that a spatially-localized abnormality in the mode shape could be represented uniquely by a small set of wavelet coefficients while the white noise was uniformly spread throughout the wavelet space. It was observed that the damage clearly manifested in the sixth-order detail of certain modes only. A different finite-element model was used as a test beam to validate the proposed method. An actual aluminum beam, fabricated with dimensions similar to the test beam, was excited and the mode shapes recorded with the scanning laser vibrometer. Damage was created by machining a notch in the beam of the same dimensions as the finite-element test beam. An image of the damage location was obtained from the continuous wavelet transform coefficients. The magnitude of the wavelet coefficients at the damage location showed a close correlation to the severity of damage. It was observed to increase with increasing damage. The finite-element test beam results showed a close correlation to the corresponding experimental beam results. The method benefits from the fact that the undamaged mode shapes were not used to evaluate the condition of the beam, which in most field conditions is not feasible.

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Background Herpes simplex virus encephalitis (HSVE) is one of the most common infectious cause of sporadic encephalitis. COVID-19 has been associated with immune dysregulation of the host which might increase the risk of infections like HSVE following SARS-CoV-2 infection. There is paucity of literature on post COVID-19 HSVE. This study was conducted with the aim of analysing the clinical presentation, brain imaging, and outcome of patients presenting with HSVE within six weeks of COVID-19 and providing a comprehensive review on the possible mechanisms of post COVID-19 HSVE. Methods This observational study included patients who had laboratory confirmed HSVE (type 1 or type 2) and a history of COVID-19 within the previous six weeks. Patients were followed up for 3 months. Results Eight patients were included and all of them had type 1 HSVE. The mean latency of onset of neurological symptoms from being diagnosed with COVID-19 is 23.87 days and majority of the patients have received injectable steroids with a mean duration of 6.5 days. Behavioral abnormality was the commonest neurological presentation and typical brain imaging involved T2 FLAIR hyperintensities of the medial temporal lobes. All patients received intravenous acyclovir 10mg/kg every eight hourly for atleast 14 days. One patient with concomitant rhinocerebral mucormycosis succumbed while majority had complete recovery. Conclusion Possible immune dysregulation in COVID-19 may increase the susceptibility of HSVE in patients with history of recent SARS-CoV-2 infection. The clinical manifestations and laboratory findings of HSVE in such patients are similar to typical HSVE.

Background: Cognitive postscripts of COVID-19, codenamed as ‘cognitive COVID’ or ‘brain fog,’ characterized by multidomain cognitive impairments, are now being reckoned as the most devastating sequelae of COVID-19. However, the impact on the already demented brain has not been studied. Objective: We aimed to assess the cognitive functioning and neuroimaging following SARS-CoV-2 infection in patients with pre-existing dementia. Methods: Fourteen COVID-19 survivors with pre-existing dementia (four with Alzheimer’s disease, five with vascular dementia, three with Parkinson’s disease dementia, and two with the behavioral variant of frontotemporal dementia) were recruited. All these patients had detailed cognitive and neuroimaging evaluations within three months before suffering from COVID-19 and one year later. Results: Of the 14 patients, ten required hospitalization. All developed or increased white matter hyperintensities that mimicked multiple sclerosis and small vessel disease. There was a significant increase in fatigue (p = 0.001) and depression (p = 0.016) scores following COVID-19. The mean Frontal Assessment Battery (p <  0.001) and Addenbrooke’s Cognitive Examination (p = 0.001) scores also significantly worsened. Conclusion: The rapid progression of dementia, the addition of further impairments/deterioration of cognitive abilities, and the increase or new appearance of white matter lesion burden suggests that previously compromised brains have little defense to withstand a new insult (i.e., ‘second hit’ like infection/dysregulated immune response and inflammation). ‘Brain fog’ is an ambiguous terminology without specific attribution to the spectrum of post-COVID-19 cognitive sequelae. We propose a new codename, i.e., ‘FADE-IN MEMORY’ (i.e., Fatigue, decreased Fluency, Attention deficit, Depression, Executive dysfunction, slowed INformation processing speed, and subcortical MEMORY impairment).

Hydatid cyst may be found in almost any part of the body, but most often in the liver and the lungs. Other organs affected occasionally include the brain, muscle, kidney, heart, pancreas, adrenal, and thyroid gland. Hydatidosis located in the thyroid is an infrequent finding, even in endemic regions. This report documents a rare case with a cystic nodule in the thyroid detected by ultrasonography. The patient was a 30-year-old woman with an euthyroid multinodular goitre. Ultrasonography revealed a cystic nodule, and the ultrasonic appearance of the cyst liquid showed multiple echoes, suggesting that the nodule could be a hydatid cyst. The histopathologic examinations confirmed this to be a primary hydatid cyst of thyroid. During the differential diagnosis of the cystic thyroid lesions, hydatid disease of the thyroid gland should be considered in endemic areas. Chemotherapy is necessary to avoid recurrence. DOI: http://dx.doi.org/10.3126/ajms.v5i2.8830 Asian Journal of Medical Science, Volume-5(2) 2014: 143-145

Background Liver biopsy is indicated in both diagnosis and prognosis of diffuse liver diseases. Conventionally, percutaneous liver biopsy (PLB) is used, as it is easily available, affordable and has a shorter procedure time, whereas transjugular liver biopsy (TJLB) is used in the setting of ascites and coagulopathy. Our aim is to evaluate the diagnostic yield of TJLB in comparison to PLB with tract embolization. Our secondary aims were to evaluate whether there is any difference in rate of major and minor complications between the two procedures and evaluate whether there is any correlation between diagnostic yield of TJLB and hepatic venous pressure gradient (HVPG). Methods In this retrospective study, we included a total of consecutive 123 patients who underwent liver biopsy through percutaneous (n = 97) and transjugular route (n = 26). We compared the yield of the specimen based on the number of complete portal tracts (CPT). Results There was no significant difference between mean CPT in TJLB and PLB specimens (mean CPT of TJLB and PLB were 10.9 ± 2.7 and 11.6 ±2.5, respectively [p = 0.566]). There was a moderate but significant negative correlation between the total number of CPT and HVPG in the TJLB group (Spearman’s rho − 0.58) (p = 0.002). There was no statistically significant difference in minor complication between the two procedures. Only one patient who underwent PLB developed major complication and none of TLJB procedure had any major complication. Conclusion Yield of tissue and complication rates are comparable in TJLB and PLB groups. Yield of tissue in TJLB have intermediate but significant negative correlation with HVPG.

Background and Aim: Saroglitazar, a dual PPAR α/γ agonist, is useful in management of NAFLD and diabetic dyslipidemia. Here, we report the safety and efficacy of saroglitazar in NAFLD patients with or without diabetes including compensated cirrhosis. Methods: Patients, started on saroglitazar 4 mg were prospectively evaluated for 52 weeks in a tertiary care center in Eastern India. Effectiveness was measured in terms of anthropometric measurements, fasting blood glucose, LFT, lipid profile, HbA1c, and elastography parameters (LSM and CAP) measured at baseline, 24, and 52 weeks. Adverse drug reactions were monitored. Results: A total of 112 patients were enrolled in the study, of whom 63 patients were taken up for per-protocol analysis. Mean age was 49.11 AE 11.09 years and 46(73%) were male. Thirty-four (54%) were nondiabetic. Eleven patients had compensated cirrhosis. There was significant improvement of LSM from baseline (11.03 AE 7.19 kPa) to 24-week (9.29 AE 6.39 kPa) and 52-week (8.59 AE 6.35 kPa) values respectively (P < 0.001). Significant reduction was also seen in CAP values, ALT, AST, HbA1c, LDL, total cholesterol, and triglyceride values. There was no significant weight change along the study interval. Pruritus occurred in one patient who required treatment discontinuation and another patient had mild symptomatic loose motion. Conclusions: Saroglitazar is effective and safe in improving biochemical parameters and LSM and CAP values irrespective of weight reduction. It may be used in compensated cirrhotics with close monitoring for side effects.