A 36-year-old man presented 2 months back with complaints of dyspnea on exertion (class 3), cough, low-grade fever, anorexia, and weight loss. He was diagnosed as a case of pulmonary tuberculosis and was put on antitubercular therapy. However, he did not responded to therapy and discontinued treatment himself. Presently he was admitted with severe dyspnea, signs of right-sided heart failure, profuse sweating, and episode of transient blurring of vision. Initially transthoracic echocardiography was performed followed by transesophageal echocardiography (Figs. 1 and 2), which revealed a large heterogeneous sessile mass approximately 10 × 8 cm in right atrium, adherent to right atrial free wall, occupying most of right atrium extending into right ventricle and pericardial space, patent foramen ovale with left to right shunt and pulmonary hypertension. The echocardiographic findings explained the cause of signs of right-sided heart failure, which were due to mass effect, transient ischemic attack due to paradoxical embolization across patent foramen ovale, and pulmonary hypertension due to pulmonary embolism. Contrast-enhanced computed tomography of chest (Fig. 3) was performed, which also revealed same findings as transesophageal echocardiography. Right atrial angiosarcoma was the most probable diagnosis, which was further confirmed after biopsy. In our case transesophageal echocardiography turned out to be valuable and accurate modality in assessing cardiac mass, so timely assessment can help in early diagnosis and treatment. Figure 1. Transesophageal ultrasound demonstration at 0 degree. 1 = PFO (patent foramen ovale); 2 = large right atrial mass occupying right atrium; 3 = mass prolapsing through tricuspid valve orifice into right ventricle; 4 = infiltration of mass into pericardium. RA = right atrium; RV = right ventricle; LA = left atrium; LV = left ventricle; IAS = interatrial septum; IVS = interventricular septum; MV = mitral valve.

A 2-year-old female child was brought to the emergency department after she was accidentally shot by her father, while cleaning his air rifle loaded with the pointed type 0.22 (5.5 mm) caliber pellet. The pellet hit the front of chest from a distance of about 10-15 m. On physical examination, it was found that there was entrance wound in right lower parasternal area but no exit wound. She was hemodynamically stable with normal auscultatory findings. Chest roentgenogram (Fig. 1) demonstrated a bullet overlying cardiac silhouette with no other findings. Two-dimensional transthoracic echocardiography (Figs, 2, 3, and movie clip 1) showed an echogenic density in the interventricular septum just beneath the insertion of tricuspid and mitral leaflets. The atrioventricular valves appear normal with no regurgitation. The biventricular function also appeared normal with no regional wall motion abnormalities. There was no pericardial effusion present. The echogenicity is most likely the pellet that punctured the chest wall and continued inward to lodge in the interventricular septum. Computed tomographic scan of the chest showed an intracardiac foreign body without other abnormalities. Up to 11 months, repeated scans have shown no changes. She will continue to receive ongoing follow-up to assess for late complications (migration, erosion, conduction, disturbance, etc.) To the best of our knowledge, she may be the youngest living patient having cardiac trauma with clinically stable presentation and asymptomatic short-term follow-up.

Posterior reversible encephalopathy syndrome(PRES) is a proposed reversible cliniconeuroradiological entity characterized by headache, altered mental status, cortical blindness, seizures, focal neurological signs and a diagnostic magnetic resonance image showing multiple hyperintense signal in cortical and subcortical white matter. We report a case of 25 year female who presented 2 days postdelivery with posterior reversible encephalopathy syndrome. Early diagnosis with MRI showing bilateral parietal and occipital hyperintensities and treatment with manitol, antiepileptics and supportive measure, the syndrome was fully reversible. Clinicians as well as radiologists should be familiar with this clinically frightening, underdiagnosed condition to assure timely diagnosis and treatment to prevent persistent neurological deficits.

Pandemics and epidemics have plagued humanity throughout history. The modern world faced one such devastating disease in 2019 called Coronavirus. As the world is still trying to recover from Coronavirus, an epidemic that might not see its end anytime soon. This study focuses on analyzing and predicting the future  hospital admissions that arise due to Covid-19 .For this study, the choice of country is the United Kingdom. The data has been procured from reliable internet sources to carry out all necessary experiments. The data set contains daily hospitalisations due to Covid-19 in the United Kingdom. To carry out the time-series forecasting, the predictive model is built using a special Recurrent Neural Network, also known as Long Short-Term Memory (LSTM) . The final model was built using a Stacked LSTM to predict the number of hospitalisations due to Covid-19 that may arise in the United Kingdom for the next twenty days from the last day of the dataset used. The results of this study show a clear indication that a spike in the number of hospitalisations may arise in the upcoming days.

Background: It is more than two decades the presence of HIV virus has created a pandemic in human community. The current study was designed to study the levels of mannose receptors on vaginal epithelial cells of female partners of seronegative couple and of seronegative wife of seropositive husband.Methods: It is a case control observational study.in the study,30 controls: seronegative couples- husband seronegative and wife seronegative and 30 cases (study group): serodiscordant couples-husband seropositive and wife seronegative were included. The gynecological examination of the female partner was carried out, both per speculum (PS) and per vaginal (PV). Any lesions or inflammation was noted. the area was cleaned, and smear was collected. The smear was immediately fixed with 1:1 ether alcohol. The gynecological examination of the female partner was carried out, both per speculum (PS) and per vaginal (PV). Any lesions or inflammation was noted. the area was cleaned, and smear was collected. The smear was immediately fixed with 1:1 ether alcohol.Results: Although sexual mode of transmission is highest in India, large numbers of couples are serodiscordant. In this study, the discordant couples were married for an average of 19.3 years. Their youngest child had a mean age of 8.34 years. The mother being seronegative, all children were seronegative. The Husband’s qualified for ART at the time of detection of HIV status depending on their CD4 value. It means that they were harboring the virus for more than 10 years. Despite unprotected sex, the virus was not transmitted to the wife. Search for alternate pathway of HIV entry through vaginal mucosa showed: The females in control group revealed >98% epithelial cells had mannose receptors in almost all the females. As against serodiscordant females had mannose receptors in < 10% vaginal epithelial cells. There is a significant difference (p<0.01) between the control group and study group. Thus, the absence of mannose receptors probably prevents the HIV transmission.Conclusions: This observation will be helpful in developing effective microbicide and will open new frontiers for drug development which will halt sexual transmission of HIV and will also help in vaccine development.