A Case of Metastatic CNS Melanoma of Unknown Primary Presenting with Seizures

Seizures are a common occurrence. The goal of evaluating a seizure is to identify the etiology and to determine the likelihood of recurrence as well as guide management. We present a unique presentation of a 47-year-old female that presented with late onset seizures admitted due to status epilepticus. Brain magnetic resonance indicated diffuse supratentorial hemorrhagic lesions. Neurological workup including brain vessel imaging, CT chest, abdomen, and pelvis as well as CSF and serological workup for vasculitis failed to demonstrate the cause of her brain lesions. Ultimately, a brain biopsy showed metastatic melanoma of unknown primary origin.

Shahadah 'Ilmy; Integrating Fiqh and Astronomy Paradigm in Determining The Arrival of Lunar Months in Indonesia

Formulating the fixed methodology for determining the beginning of Ramadan month and Islamic Feast in Indonesia is still ongoing. This article attempts to offer an integration between sharia and scientific views through 1) the concept of shahadah (witnessing) in the paradigm of fiqh and astronomy, and 2) the integration of those paradigms in determining the beginning of lunar months, particularly Ramadan and Syawal. This study uses qualitative methods in gaining the data then analyzes it using the approach of Miles & Huberman on interdisciplinary study. The findings of this research are as follows: 1) the concept of shahadah in the paradigm of fiqh is based on religious vows and factual evidence, while the astronomical paradigm perceives it from the certainty of external factors (weather, climate, environment, etc.). 2) Integration of those two paradigms results in better methods. It can turn the shahadah into the quality of qat'i (fixed) while the astronomic perspective gains more legitimacy. The integration is therefore called shahadah-'ilmi which potentially integrates the criteria of crescent visibility (imkan al-rukyah) in Indonesia to minimize the common occurrence on differences in determining those days. (Penetapan awal bulan Ramadhan dan Hari Raya di Indonesia masih terus dirumuskan metodologinya. Artikel ini menawarkan integrasi antara sudut pandang syari’ah dan saintifik melalui kajian atas 1) konsep syahadah dalam paradigma fiqh dan astronomi, 2) integrasi paradigma fiqh dan astronomi dalam menetapkan awal bulan Islam, utamanya Ramadhan dan Syawal. Penelitian ini menggali data dengan metode kualitatif kemudian menganalisisnya dengan pendekatan Miles & Huberman tentang kajian interdisipliner. Temuan penelitian ini adalah sebagai berikut: 1) Konsep shahadah dalam paradigma fiqh adalah penglihatan yang disertai dengan sumpah dan bukti faktual, sementara dalam paradigma astronomi, shahadah didasarkan pada kepastian ukuran dari faktor–faktor eksternal meliputi cuaca, iklim dan lingkungan. 2) Integrasi dua paradigma tersebut menghasilkan metode yang lebih baik dalam penentuan awal Ramadhan dan Syawal. Shahadah dalam sudut pandang fiqh berubah menjadi qath’i (pasti), sementara hasil persaksian astronomi semakin memperoleh legitimasi. Integrasi kedua paradigma melahirkan konsep shahadah-'ilmi yang dapat digunakan untuk menentukan tampaknya hilal (rukyah hilal) awal Ramadhan dan Syawal di Indonesia sehingga perbedaan yang kerap terjadi dalam menentukan dua awal bulan tersebut dapat diminalisir.)

Hydrothermal Activities on C-Complex Asteroids Induced by Radioactivity

C-complex asteroids, rich in carbonaceous materials, are potential sources of Earth’s volatile inventories. They are spectrally dark resembling primitive carbonaceous meteorites, and thus, C-complex asteroids are thought to be potential parent bodies of carbonaceous meteorites. However, the substantial number of C-complex asteroids exhibits surface spectra with weaker hydroxyl absorption than water-rich carbonaceous meteorites. Rather, they best correspond to meteorites showing evidence for dehydration, commonly attributed to impact heating. Here, we report an old radiometric age of 4564.7 million years ago for Ca carbonates from the Jbilet Winselwan meteorite analogous to dehydrated C-complex asteroids. The carbonates are enclosed by a high-temperature polymorph of Ca sulfates, suggesting thermal metamorphism at >300°C subsequently after aqueous alteration. This old age indicates the early onset of aqueous alteration and subsequent thermal metamorphism driven by the decay of short-lived radionuclides rather than impact heating. The breakup of original asteroids internally heated by radioactivity should result in asteroid families predominantly consisting of thermally metamorphosed materials. This explains the common occurrence of dehydrated C-complex asteroids.

Pathogenesis, Immunology and Management of Dermatophytosis

Dermatophytic infections of the skin and appendages are a common occurrence. The pathogenesis involves complex interplay of agent (dermatophytes), host (inherent host defense and host immune response) and the environment. Infection management has become an important public health issue, due to increased incidence of recurrent, recalcitrant or extensive infections. Recent years have seen a significant rise in incidence of chronic infections which have been difficult to treat. In this review, we review the literature on management of dermatophytoses and bridge the gap in therapeutic recommendations.

Impact of Challenging Behavior on Marginalized and Minoritized Caregivers of Children With Disabilities

Challenging behavior (CB) is a common occurrence in early childhood and frequently occurs in young children with disabilities. CB is also culturally perceived and includes differences in how caregivers understand and define the topography of CB. Despite the cultural interpretation, CB is known to impact the child and their family but there has been little exploration of what marginalized caregivers perceive as the impact of the CB that their young children with disabilities exhibit. We used semi-structured interviews to explore the perceptions of 24 caregivers, who identified as Black, Mexican American, and White, about the impact of their child’s CB. Caregivers shared how the CB impacted themselves, their families, their child, and others. Although much of the impact was similar among caregivers, we discuss nuanced differences across ethnic groups.

Forehead Tactile Hallucination Is Augmented by the Perceived Risk and Accompanies Increase of Forehead Tactile Sensitivity

Tactile hallucinations frequently occur after mental illnesses and neurodegenerative diseases like Alzheimer’s and Parkinson’s disease. Despite their common occurrence, there are several complicating factors that make it difficult to elucidate the tactile hallucinations. The forehead tactile hallucination, evoked by the physical object approaching to the forehead, can be easily and consistently evoked in healthy-bodied subjects, and therefore it would help with investigating the mechanism of tactile hallucinations. In this pilot study, we investigated the principles of the forehead tactile hallucination with eight healthy subjects. We designed the experimental setup to test the effect of sharpness and speed of objects approaching towards the forehead on the forehead tactile hallucination, in both a physical and virtual experimental setting. The forehead tactile hallucination was successfully evoked by virtual object as well as physical object, approaching the forehead. The forehead tactile hallucination was increased by the increase of sharpness and speed of the approaching object. The forehead tactile hallucination also increased the tactile sensitivity on the forehead. The forehead tactile hallucination can be solely evoked by visual feedback and augmented by the increased perceived risk. The forehead tactile hallucination also increases tactile sensitivity. These experimental results may enhance the understanding of the foundational mechanisms of tactile hallucinations.

A COMPARATIVE CLINICAL STUDY FOR THE EVALUATION OF SNUHI KSHEERA-HARIDRA CHOORNA LEPA AND DEVADALYADI LEPA IN ARSHAS (2ND DEGREE HAEMORRHOID

Today Ano-rectal diseases have emerged as a quite common occurrence with progressive nature. According to the Ayurvedic concept, the aetiology of Arsha is interconnected with Mandagni of the patients. Arsha is a kind of disease that is most unkind towards mankind. A few important causes are sedentary lifestyle, irregular bowel habit, low fibre diet, prolonged straining, sedentary job, suppression of natural urges is some of the causative factors at present. It is a Mamsakeela that obstructs the Gudamarga and thus tortures the patient like an enemy. It can be co-related to haemorrhoids in modern science, the most common ailments of the rectum and anal canal. Intermittent symbolization and embarrassment make people neglect the early stages of haemorrhoids and ultimately end up in complications. The four therapeutic measures of Arshas include Bheshaja chikistha, Shastra karma, Kshara karma, and Agnikarma. Lepa is the foremost effective Bheshaja Chikistha yet less practised and demands further exploration. So based on Arsha Adhyaya of Susrutha Samhita and Arshoghnaadhyaya of Rasa ratnasamucchaya, the present study is intended to evaluate Snuhi ksheera – Haridra Choorna Lepa and Devadalyadi lepa in Arshas. Keywords: Haemorrhoids, Arshas, Snuhi Ksheera- Haridra Choorna Lepa, Devadalyadi Lepa