Surgical management of massive cerebellar infarction.

Massive cerebellar infarction accounts for less than 2% of strokes. Unlike massive hemispherical infarctions, in pure cerebellar infarctions, the prognosis is better. This case report discusses, a 61 year old lady who presented with atrial fibrillation and a massive cerebellar infarction. Timely surgical intervention reversed the deterioration in neurological status. The indications for surgical management, based on review of the literature, is presented.     

9p21 and 13q14 dosages in ependymomas. A clinicopathologic study of 101 cases.

Ependymomas are glial neoplasms whose clinical behavior is difficult to predict based on histology alone. Recently, a comparative genomic hybridization study identified frequent chromosome 9p and 13q losses in anaplastic ependymomas, suggesting that p16 and RB alterations may be involved in tumor progression. In order to test this hypothesis further, 101 myxopapillary, conventional, and anaplastic ependymomas (51 spinal and 50 intracranial tumors) were tested for RB and p16 deletions using fluorescence in situ hybridization. Clinical follow-up, ranging from 2 to 198 months (median 46 months), was obtained in 90 cases (91%). RB and p16 deletions were seen in 22 of 92 (24%) and 22 of 89 (25%) informative cases, respectively. Polysomies were more frequent in the grade I and II spinal tumors, consistent with prior reports of increased aneuploidy in such cases. No significant genetic associations were seen with tumor grade, recurrence, or death, suggesting that 9p and 13q deletions do not play a prominent role in the malignant progression of ependymomas, as has been implicated in other glioma subtypes.     

Child survival: maternal factors

The aim of government is to produce a healthy society through policy and practices that do not discriminate against the most vulnerable, for instance, poor pregnant women. The quality of a society can be measured by the delivery of health care and by child survival. India has been successful at industrialization and establishment of a fine infrastructure for health care delivery, yet health service delivery is poor and infant mortality and morbidity are high. Poor pregnancy outcomes are related to maternal health and health care. Under 33% of pregnancy women receive any prenatal care and under 20% receive trained assistance during delivery. Social customs that denigrate women are common. Feminism has not affected the masses of women in India, where hatred of the female gender still exists. The hatred begins at the birth of the female child. India has a high sex ratio of more males to females and has high illiteracy among females. Maternal mortality in developing countries is 200 times higher than in developed countries. The consequences are loss of life and loss of a caretaker for the children left behind. Government policies on maternal and child health care delivery have emphasized the child at the expense of maternal care. Family planning has received the bulk of funding under the Indian Family Welfare Program. Policy has focused on child survival yet ignored maternal morbidity and mortality. Child survival is affected by prenatal care, prenatal management, maternal age, maternal nutrition, the process of childbirth, treatment of obstetric emergencies, and treatment of birth injuries. The first 38 weeks of fetal development has a greater risk of danger and accident than the next 38 years following the birth. Indian women facing potential pregnancy risks walk many kilometers to a prenatal clinic and then wait for hours standing in long lines for registration; the actual examination by "experts" takes only minutes. Final determination of risk may take 2-3 visits with no assurance of admission to a hospital, or there may be early release because the bed is needed for another at-risk patient. 60-90% of births to rural mothers worldwide are attended by local trained or untrained birth attendants. Improper conduct during the delivery process and postnatal care of the infant affect the health outcome of infants. Hemorrhage, anemia, toxemia, and infections are the killers, and better management the solution.     

The psychosocial context of Black women's health

Researchers have demonstrated that Black women exhibit a disproportionate risk of ill health. We examined the relationship between psychosocial factors, including economic status, race-based social inequality, gender-based violence, and the health status of 323 Black women between the ages of 18 and 65. Black women from a community sample completed a health survey with open-ended responses. Results indicated that women in lower economic groups are more likely to be treated for allergies (p = < .05) and pelvic inflammatory disease (PID; p = < .01). Women who experienced increased incidents of race-based social inequality received more medical treatments for yeast infections, pregnancy-related problems, allergies, and PID. Those with histories of physical, psychological, and early sexual abuse are more likely to be treated for depression, allergies, yeast infections, and hypertension. In addition, qualitative data examined the process in which economic, race-based social inequality, and gender-based violence contributed to the ill health of Black women. The implications of these findings suggest that understanding the psychosocial context is essential for appropriate clinical practice. Additionally, future research should conceptualize health as a complex interaction of psychosocial risks that have a profound effect on the health status of Black women.     

Effect of Age-Hardening Temperature on Mechanical and Wear Behavior of Furnace-Cooled Al7075-Tungsten Carbide Composite

In this study, aluminum alloy (Al7075) composites with a 4% weight fraction of tungsten carbide (WC) were manufactured using a stir casting process and the developed composites were subjected to various ageing temperatures. An attempt has been made to predict the age-hardening temperature with the enhanced mechanical and wear properties of Al7075-WC. The result shows that the composite specimen aged at 250 °C offered maximum tensile strength and the Brinell hardness number was increased by 37.1% and 50.5%, respectively; the maximum impact energy was observed to be 92.2% for the 450 °C aged composites, compared to the non-aged Al7075-WC composites. The strength properties of the Al7075-WC composite decreased to 30.86%, 4.7%, and 24.9% when the composite specimens aged at 350 °C. The mechanical properties of the Al7075-WC composite were increased at the age-hardening temperatures from 150 °C to 250 °C and decreased from 250 °C to 350 °C. The wear testing pin-on-disc setup utilized to determine the wear characteristics of the prepared MMC with wear parameters of load and sliding distance and the wear resistance of the composite specimens increased due to ageing. The fractography analysis of the composite samples carried out by scanning electron microscope (SEM) images revealed that the fracture of the composite during the tensile test is a mixture of ductile and brittle modes.