1) Choanal atresia is the most common congenital abnormality of the nasal cavity, presenting as obstruction of the posterior nasal cavity in newborns who are obligate nasal breathers.
2) Hypertrophic pyloric stenosis is the most common cause of projectile non-bilious vomiting in infants from 2-12 weeks of age. It is diagnosed using ultrasound which demonstrates thickening of the pyloric muscle.
3) Malrotation with midgut volvulus is a surgical emergency that can present anytime in infancy, causing bilious vomiting and abdominal pain due to twisting of the intestines around the superior mesenteric artery. It is diagnosed using imaging that demonstrates abnormal
By dr Rabab Hashem, MRCPCH, pediatrician at El Nasr hospital Port said.
Cranial sonography is the most widely used neuroimaging procedure in premature infants. US helps in assessing the neurologic status of the child, since clinical examination and symptoms are often nonspecific. It gives information about immediate and long term prognosis.
By dr Rabab Hashem, MRCPCH, pediatrician at El Nasr hospital Port said.
Cranial sonography is the most widely used neuroimaging procedure in premature infants. US helps in assessing the neurologic status of the child, since clinical examination and symptoms are often nonspecific. It gives information about immediate and long term prognosis.
This presentation aims at discussion of the pathophysiology , clinical presentation and management of the different types of intracranial bleeds in a neonate. Special emphasis has been laid on intraventricular hemorrhage. The germinal matrix bleed in a preterm is discussed in depth along with the various evidence based management protocols available. Radiological diagnosis of IVH in a preterm / term baby will be discussed in the upcoming presentations.
An impairment of the infants body function or structure due to adverse influences that occur at birth. Injuries to the infant may result from mechanical forces (i.e., compression, traction) during the birth process. 0.7% (Seven of every 1,000) births result in birth injuries, though most women give birth in modern hospitals surrounded by medical professionals. Birth injuries account for fewer than 2% of neonatal deaths. Infant mortality resulting from birth trauma fell from 64.2 to 7.5 deaths per 100,000 live births from 1970-1985. Birth injuries can be classified to Soft tissue injuries, Head and neck injuries, Facial injuries, Cranial nerve injuries, Spinal cord injuries, Peripheral Nerve injury, Fractures & Torticollis, Intra-abdominal injury. Proper management neccissates, early recognition of trauma, Careful physical and neurological evaluation, Establish whether additional injuries exist, Injury may result from resuscitation, Assess Symmetry of structure & function, Specific examination such as cranial nerve, joint range of motion, scalp/skull integrity.
This lecture prides 8 easy steps of scanning the neonatal brain through anterior fontanelle ,followed by examples of most commonly encountered abnormalities.
This presentation aims at discussion of the pathophysiology , clinical presentation and management of the different types of intracranial bleeds in a neonate. Special emphasis has been laid on intraventricular hemorrhage. The germinal matrix bleed in a preterm is discussed in depth along with the various evidence based management protocols available. Radiological diagnosis of IVH in a preterm / term baby will be discussed in the upcoming presentations.
An impairment of the infants body function or structure due to adverse influences that occur at birth. Injuries to the infant may result from mechanical forces (i.e., compression, traction) during the birth process. 0.7% (Seven of every 1,000) births result in birth injuries, though most women give birth in modern hospitals surrounded by medical professionals. Birth injuries account for fewer than 2% of neonatal deaths. Infant mortality resulting from birth trauma fell from 64.2 to 7.5 deaths per 100,000 live births from 1970-1985. Birth injuries can be classified to Soft tissue injuries, Head and neck injuries, Facial injuries, Cranial nerve injuries, Spinal cord injuries, Peripheral Nerve injury, Fractures & Torticollis, Intra-abdominal injury. Proper management neccissates, early recognition of trauma, Careful physical and neurological evaluation, Establish whether additional injuries exist, Injury may result from resuscitation, Assess Symmetry of structure & function, Specific examination such as cranial nerve, joint range of motion, scalp/skull integrity.
This lecture prides 8 easy steps of scanning the neonatal brain through anterior fontanelle ,followed by examples of most commonly encountered abnormalities.
Richard's aventures in two entangled wonderlandsRichard Gill
Since the loophole-free Bell experiments of 2020 and the Nobel prizes in physics of 2022, critics of Bell's work have retreated to the fortress of super-determinism. Now, super-determinism is a derogatory word - it just means "determinism". Palmer, Hance and Hossenfelder argue that quantum mechanics and determinism are not incompatible, using a sophisticated mathematical construction based on a subtle thinning of allowed states and measurements in quantum mechanics, such that what is left appears to make Bell's argument fail, without altering the empirical predictions of quantum mechanics. I think however that it is a smoke screen, and the slogan "lost in math" comes to my mind. I will discuss some other recent disproofs of Bell's theorem using the language of causality based on causal graphs. Causal thinking is also central to law and justice. I will mention surprising connections to my work on serial killer nurse cases, in particular the Dutch case of Lucia de Berk and the current UK case of Lucy Letby.
Seminar of U.V. Spectroscopy by SAMIR PANDASAMIR PANDA
Spectroscopy is a branch of science dealing the study of interaction of electromagnetic radiation with matter.
Ultraviolet-visible spectroscopy refers to absorption spectroscopy or reflect spectroscopy in the UV-VIS spectral region.
Ultraviolet-visible spectroscopy is an analytical method that can measure the amount of light received by the analyte.
Introduction:
RNA interference (RNAi) or Post-Transcriptional Gene Silencing (PTGS) is an important biological process for modulating eukaryotic gene expression.
It is highly conserved process of posttranscriptional gene silencing by which double stranded RNA (dsRNA) causes sequence-specific degradation of mRNA sequences.
dsRNA-induced gene silencing (RNAi) is reported in a wide range of eukaryotes ranging from worms, insects, mammals and plants.
This process mediates resistance to both endogenous parasitic and exogenous pathogenic nucleic acids, and regulates the expression of protein-coding genes.
What are small ncRNAs?
micro RNA (miRNA)
short interfering RNA (siRNA)
Properties of small non-coding RNA:
Involved in silencing mRNA transcripts.
Called “small” because they are usually only about 21-24 nucleotides long.
Synthesized by first cutting up longer precursor sequences (like the 61nt one that Lee discovered).
Silence an mRNA by base pairing with some sequence on the mRNA.
Discovery of siRNA?
The first small RNA:
In 1993 Rosalind Lee (Victor Ambros lab) was studying a non- coding gene in C. elegans, lin-4, that was involved in silencing of another gene, lin-14, at the appropriate time in the
development of the worm C. elegans.
Two small transcripts of lin-4 (22nt and 61nt) were found to be complementary to a sequence in the 3' UTR of lin-14.
Because lin-4 encoded no protein, she deduced that it must be these transcripts that are causing the silencing by RNA-RNA interactions.
Types of RNAi ( non coding RNA)
MiRNA
Length (23-25 nt)
Trans acting
Binds with target MRNA in mismatch
Translation inhibition
Si RNA
Length 21 nt.
Cis acting
Bind with target Mrna in perfect complementary sequence
Piwi-RNA
Length ; 25 to 36 nt.
Expressed in Germ Cells
Regulates trnasposomes activity
MECHANISM OF RNAI:
First the double-stranded RNA teams up with a protein complex named Dicer, which cuts the long RNA into short pieces.
Then another protein complex called RISC (RNA-induced silencing complex) discards one of the two RNA strands.
The RISC-docked, single-stranded RNA then pairs with the homologous mRNA and destroys it.
THE RISC COMPLEX:
RISC is large(>500kD) RNA multi- protein Binding complex which triggers MRNA degradation in response to MRNA
Unwinding of double stranded Si RNA by ATP independent Helicase
Active component of RISC is Ago proteins( ENDONUCLEASE) which cleave target MRNA.
DICER: endonuclease (RNase Family III)
Argonaute: Central Component of the RNA-Induced Silencing Complex (RISC)
One strand of the dsRNA produced by Dicer is retained in the RISC complex in association with Argonaute
ARGONAUTE PROTEIN :
1.PAZ(PIWI/Argonaute/ Zwille)- Recognition of target MRNA
2.PIWI (p-element induced wimpy Testis)- breaks Phosphodiester bond of mRNA.)RNAse H activity.
MiRNA:
The Double-stranded RNAs are naturally produced in eukaryotic cells during development, and they have a key role in regulating gene expression .
Multi-source connectivity as the driver of solar wind variability in the heli...Sérgio Sacani
The ambient solar wind that flls the heliosphere originates from multiple
sources in the solar corona and is highly structured. It is often described
as high-speed, relatively homogeneous, plasma streams from coronal
holes and slow-speed, highly variable, streams whose source regions are
under debate. A key goal of ESA/NASA’s Solar Orbiter mission is to identify
solar wind sources and understand what drives the complexity seen in the
heliosphere. By combining magnetic feld modelling and spectroscopic
techniques with high-resolution observations and measurements, we show
that the solar wind variability detected in situ by Solar Orbiter in March
2022 is driven by spatio-temporal changes in the magnetic connectivity to
multiple sources in the solar atmosphere. The magnetic feld footpoints
connected to the spacecraft moved from the boundaries of a coronal hole
to one active region (12961) and then across to another region (12957). This
is refected in the in situ measurements, which show the transition from fast
to highly Alfvénic then to slow solar wind that is disrupted by the arrival of
a coronal mass ejection. Our results describe solar wind variability at 0.5 au
but are applicable to near-Earth observatories.
This presentation explores a brief idea about the structural and functional attributes of nucleotides, the structure and function of genetic materials along with the impact of UV rays and pH upon them.
Nutraceutical market, scope and growth: Herbal drug technologyLokesh Patil
As consumer awareness of health and wellness rises, the nutraceutical market—which includes goods like functional meals, drinks, and dietary supplements that provide health advantages beyond basic nutrition—is growing significantly. As healthcare expenses rise, the population ages, and people want natural and preventative health solutions more and more, this industry is increasing quickly. Further driving market expansion are product formulation innovations and the use of cutting-edge technology for customized nutrition. With its worldwide reach, the nutraceutical industry is expected to keep growing and provide significant chances for research and investment in a number of categories, including vitamins, minerals, probiotics, and herbal supplements.
Deep Behavioral Phenotyping in Systems Neuroscience for Functional Atlasing a...Ana Luísa Pinho
Functional Magnetic Resonance Imaging (fMRI) provides means to characterize brain activations in response to behavior. However, cognitive neuroscience has been limited to group-level effects referring to the performance of specific tasks. To obtain the functional profile of elementary cognitive mechanisms, the combination of brain responses to many tasks is required. Yet, to date, both structural atlases and parcellation-based activations do not fully account for cognitive function and still present several limitations. Further, they do not adapt overall to individual characteristics. In this talk, I will give an account of deep-behavioral phenotyping strategies, namely data-driven methods in large task-fMRI datasets, to optimize functional brain-data collection and improve inference of effects-of-interest related to mental processes. Key to this approach is the employment of fast multi-functional paradigms rich on features that can be well parametrized and, consequently, facilitate the creation of psycho-physiological constructs to be modelled with imaging data. Particular emphasis will be given to music stimuli when studying high-order cognitive mechanisms, due to their ecological nature and quality to enable complex behavior compounded by discrete entities. I will also discuss how deep-behavioral phenotyping and individualized models applied to neuroimaging data can better account for the subject-specific organization of domain-general cognitive systems in the human brain. Finally, the accumulation of functional brain signatures brings the possibility to clarify relationships among tasks and create a univocal link between brain systems and mental functions through: (1) the development of ontologies proposing an organization of cognitive processes; and (2) brain-network taxonomies describing functional specialization. To this end, tools to improve commensurability in cognitive science are necessary, such as public repositories, ontology-based platforms and automated meta-analysis tools. I will thus discuss some brain-atlasing resources currently under development, and their applicability in cognitive as well as clinical neuroscience.
3. Choanal Atresia
• Atresia of posterior nasal cavity
• Buccopharyngeal membrane persistence vs.
faulty neural crest cell migration
• Most common congenital abnl. of nasal cavity
• 29% bony; 71% membranous and bony
4. Choanal Atresia
• 50 - 60% unilateral; chronic purulent rhinorrhea
• 75% bilateral cases have other anomalies
• CHARGE, DiGeorge, Aperts, Fetal ETOH,
Treacher Collins
• Bilateral cases present with severe respiratory
distress and cyanosis
• Newborns are obligate nasal breathers (6 mos.)
5. Choanal Atresia: Imaging
• High resolution non-contrast CT, bone filters
• Suction nares, nasal vasoconstrictors
• Findings:
• medial bowing and thickening of lateral nasal
wall
• enlarged posterior vomer
6.
7. Congenital Nasal Pyriform
Aperture Stenosis
• Obstructed nasal inlet
• Isolated or associated with other findings:
• solitary central maxillary incisor
• Holoprosencephaly
• Hypopituitarism
• Deletion short arm chromosome 18
8. Pyriform Aperture Stenosis:
Imaging
• Non-contrast high resolution CT, bone filters
• Findings:
• thickened anteromedial maxilla
• narrowed anterior and inferior nasal passage
• small triangular hard palate
9.
10. Esophageal Atresia
• Faulty division of foregut into tracheal and
esophageal channels, first month embryogenesis
• 1/3,000 live births
• Associations:
• Trisomy 21 [EA only], VACTREL
• cardiac (up to 49%), MSK (up to 25%)
• CCAM, DA, CDH, biliary atresia, sirenomelia
11.
12. EA +/- TEF: Imaging
• CXR:
• air filled proximal esophageal pouch
• repogle fails to pass into stomach
• Differential diagnosis:
• posterior pharyngeal perforation - look for
pneumomediastinum
13. EA +/- TEF
• KUB:
• air in gastrointestinal tract indicates presence
of distal TEF - types III, IV, V
• No air in GI tract implies either no TEF or only
a proximal TEF - types I and II
21. Isolated TEF
• Presents later: recurrent pneumonia, difficult
feeding
• Esophagram:
• NG tube, lateral position, cine study
• FOV to include glottis - carina
• Called “H” -shaped but really “N”-shaped
42. Duodenal Atresia
• #1 upper GI tract obstruction in neonates
• Failure of recanalization (vs. other atresias which
are due to vascular accidents)
• Etiology unknown
• 50% associated with other malformations
• 30%DA have Trisomy 21, 28% malrotation, 33%
annular pancreas
43.
44. Duodenal Atresia
• No distal bowel gas unless anomalous bile duct
anatomy
• Vomiting within hours of birth:
• 85% bilious, 15% non bilious
• Scaphoid abdomen
• No imaging Required
45.
46. Duodenal Stenosis/Webs
• Less common than duodenal atresia
• Failure of recanalization
• Web with pin hole lumen→ windsock
diverticulum
• Associations: Trisomy 21, malrotation, annular
pancreas, CDH, VACTREL
50. Normal Upper GI
• AP: DJJ to left of spine at level of pylorus
• Lateral: duodenum courses posterior →
inferior→ anterior→superior
• DJJ quite mobile in young children
52. Malrotation
• Abnormal fixation of small bowel mesentery
• Short mesenteric base prone to twisting along axis
of SMA (volvulus)
• Ligament of Treitz = where duodenum passes thru
transverse mesocolon and becomes
intraperitoneal
• Ladds bands : fibrous peritoneal bands, cecum to
porta hepatis
53.
54. Malrotation
• Normally bowel rotates 270 degrees
counterclockwise as it returns into the fetal
abdominal cavity
• Associations:
• CDH
• omphalocele, gastroschisis
• heterotaxy syndromes
55. Malrotation/Midgut Volvulus
• 40% present within first 10 days of life
• > 90% within first 3 months
• Vovulus can occur at any age = SURGICAL
EMERGENCY
• Symptoms:
• bilious vomiting, abdominal pain
• failure to thrive
56. Malrotation/Midgut Volvulus
• Ladd Procedure:
• reduction of volvulus
• resection of dead bowel
• transection of Ladd’s bands
• small bowel placed on right
• colon placed on left
57. Midgut Volvulus: Imaging
• Plain films:
• might be normal
• distention of stomach and proximal duodenum
• diffuse small bowel dilatation due to ischemia
• pneumatosis, pneumperitoneum, PV gas
58. Malrotation
• UGI:
• DJJ to right of midline
• DJJ too low +/- extra duodenal loops
• Jejunal loops in RUQ
• If UGI equivocal do SBFT to asses position and mobility
of cecum
• Volvulus: “corkscrew” distal duodenum/proximal jejunum
72. Omphalocele
• Herniation of abdominal viscera into base of
umbilical cord
• Failure of migration of lateral mesodermal body folds
• Increased incidence:
• advanced maternal age, in vitro fertilization,
maternal obesity, bicornuate uterus
• 50% with chromosomal abnormalities
79. Gastroschisis
• Congenital full thickness defect in paraumbilical
anterior abdominal wall - almost all right sided
• Usually small bowel herniated, occasionally
stomach, colon
• No sac → thickened bowel wall, poor peristalsis
• Not associated with chromosomal abnormalities
• Elevated 𝛂 fetoprotein
100. Meckel’s Diverticulum
• Omphalomesenteric duct remnant (vitelline duct)
• Most common malformation of GI tract
• Antimesenteric, true diverticulum, communicates with ileal
lumen
• #1 sx = painless rectal bleeding
• Obstruction, diverticulitis +/- perforation, intussusception,
stone formation, tumors (carcinoid)
• Lifetime risk sx = 5%
101. Meckel’s Diverticulum
• Rule of 2’s:
• 2% population, #♂ = 2 x ♀
• 2 feet from ileocecal valve, 2 inches long
• 2 types of ectopic mucosa (gastric, pancreatic)
• Sx usually by 2 yrs. of age
• Littre hernia = meckel’s constricted in inguinal hernia
122. Necrotizing Enterocolitis
•Usually premature, 10% term infants
•Etiologies: enteral feeds, mesenteric ischemia,
infection
•KUB - best diagnostic tool
•Pneumatosis is dx of NEC
122
173. Hirschsprungs
•Short ( 80% in rectosigmoid) or long segment,
complete aganglionosis (3%)
•Absence of myenteric and submucosal ganglion
cells
•1/5000 births, # ♂ ≻ ♀
•↑ incd. in families, Down syndrome
173
174. Hirschsprungs
•Change in colon caliber subtle
•Aganglionic segment narrower, lacks stool, and
is spastic
•corregated rectum sign 2° to dennervation
hypersensitivity
174
176. Hirschsprung Disease
• SX: distention, bilious vomiting, no meconium 24 - 48 hrs.
• 90% dx in newborns (enema might be normal)
• Contrast enema:
• neonates - water soluble; older - barium
• denervated bowel is small, spastic
• normal bowel is dilated TRANSITION ZONE
• Recto-sigmoid index < 1
• short segment, long segment, total colonic aganglionosis
• intaluminal SB calcification with total colonic HD
185. Hirschsprung Disease
• DX: suction rectal biopsy, full thickness biopsy
• RX: surgical resection
• Untreated → enterocolitis, toxic megacolon,
sepsis, death
• DDX based on KUB:
• imperforate anus, colon atresia, meconium plug-
small left colon, meconium ileum, ileal atresia
186. Meconium Plug - Small Left
Colon Syndrome
• Transient functional obstruction of newborn colon
• Same sx as H.D.
• Etiology: immature ganglion cells?
• ↑ incd. with diabetic mothers and mag. sulfate
• NOT ASSOCIATED with CYSTIC FIBROSIS
• Temporary, excellent prognosis
187. Meconium Plug - Small Left
Colon Syndrome
• Water soluble contrast enema
• Rectum > sigmoid colon (R:S ratio > 1)
• left colon small to splenic flexure (transition
zone)
• +/- meconium plugs
211. Imperforate Anus
• clinical diagnosis, no anal opening
• Low: no GU tract communication
• High: rectouretheral fistula in ♂, rectovaginal or
rectovestibular fistula in ♀
• KUB: dilated loops of bowel +/- intraluminal calcification
(especially in ♂)
• VATER or VACTREL
• Currarino Triad: abnl sacrum + ARM + presacral mass
214. Button Battery Ingestion
• Children 6 years of age or less
• Lithium batteries 20 mm or larger
• Liquification necrosis due to NaOH generated by
current at the anode surface (narrower, negative
side)
• Esophageal perforation can occur within 6 hrs
• Perforation, strictures, TEF, esophageal-aortic fistula
252. Neonatal Pneumonia
•Acquires in utero - CMV
•Acquired during birth - Herpes, Group B Strep
•CXR: Can mimic HMD with confluent areas,
pleural effusion
252
