International Journal of Scientific Reports

Gender-based evaluation of atherogenic indices in ischemic stroke: a retrospective study in a neuropsychiatric facility

2026-07-22T07:16:36+0530

Background: An ischemic stroke is a condition that causes permanent damage to brain tissues and neurological disorders when blood flow to the brain is blocked. The lipid profiles can provide the baseline data, but more precise predictions of patient recovery can be affected by researchers studying some ratios between the lipoproteins called atherogenic indices. The research will help evaluate and determine the dependence of atherogenic indices of lipids on predictive value on ischemic stroke and to investigate potentially existing gender differences in the predictive value.

Methods: This was a retrospective cohort study conducted from June 2025 to January 2026 in one of the tertiary Neuropsychiatric centers in Northern India and followed up on 80 cases of ischemic stroke patients (20-90) in 6 months. The research participants were divided into two groups (with and without stroke), and those who had hemiplegia caused by a stroke. Lipid profile data was used to calculate atherogenic indices: Atherogenic index of plasma (AIP=log[TG/HDLc]), Castelli risk indices I and II (CRI-I=TC/HDLc and CRI-II=LDLc/HDLc), and atherogenic coefficient (AC=[TC–HDLc]/HDLc). Indices were evaluated separately for males and females.

Results: Males were reportedly seen to associate significantly with stroke and hemiplegia (p=0.027). There were more males affected by hypertension (p=0.046), but no significant gender difference in diabetes. A statistically significant difference found between genders in AIP (p=0.032). In males, CRI-II was the highest-predicting variable (AUC=0.503; CI=0.373-0.632), but it was not significant.

Conclusions: AIP and CRI-II could be useful as gender-sensitive predictors of ischemic stroke, as they provide cost-effective tools in clinical risk assessment.

Dynamic GIF generation in WebGIS applications: addressing connectivity constraints in offshore and remote environments

2026-07-22T07:11:42+0530

This paper examines the practical case for dynamically generating graphics interchange format (GIF) outputs within web geographic information system (WebGIS) platforms as a response to a concrete operational problem: the difficulty of delivering large, complex geospatial datasets — particularly NetCDF and JSON files — to users operating in bandwidth-constrained or offline environments such as deep ocean voyages and remote maritime deployments. The proposed approach involves server-side rendering of time-series geospatial data into animated GIF sequences that users can download in advance and consult without any live network connection. Key findings indicate that this method significantly extends the practical reach of WebGIS platforms, improves operational safety for navigators and researchers at sea, and does so at substantially lower bandwidth cost than raw data transfer. The paper further establishes the technical, compatibility, and intellectual property considerations that govern effective GIF deployment.

Anaesthetic dilemma of controlled hypotensive anaesthesia and systemic effects of topical adrenaline during functional endoscopic sinus surgery

2026-07-22T07:11:41+0530

Functional endoscopic sinus surgery (FESS) frequently requires controlled hypotensive anaesthesia and topical adrenaline to minimize intraoperative bleeding and improve surgical visualization. However, the concurrent use of these techniques may result in significant haemodynamic instability due to systemic absorption of adrenaline. This case report highlights the haemodynamic challenges encountered during FESS for a 45-year-old male with bilateral nasal polyposis under general anaesthesia. Controlled hypotension was achieved using propofol infusion. Following the application of a large amount of adrenaline-soaked gauze at 1:1,000 concentrations by the surgeon bilaterally, which precipitated a haemodynamic crisis marked by profound hypotension (80/40 mmHg), rebound hypertension (180/110 mmHg), and tachycardia (150 bpm), with consequent deterioration of the surgical field leading to poor visibility. Prompt substitution with a diluted 1:10,000 preparations restored haemodynamic stability. The patient recovered uneventfully and remained symptom-free at one-year follow-up. The anaesthetic dilemma of combining controlled hypotensive anaesthesia with topical adrenaline during FESS remains a significant challenge. Topical adrenaline use may cause profound systemic cardiovascular effects; however, vigilant monitoring, prompt recognition of haemodynamic disturbances, and the use of lower adrenaline concentrations are essential to ensure patient safety.

Pantothenate kinase associated neurodegeneration in late adulthood: an atypical case from India

2026-07-22T07:11:40+0530

Pantothenate kinase associated neurodegeneration (PKAN) is a rare autosomal recessive disorder and the most common subtype of neurodegeneration with brain iron accumulation (NBIA). While classical PKAN typically presents in childhood, atypical forms may manifest later in life with heterogeneous neurological and psychiatric features, often resulting in diagnostic delay. We report a case of atypical PKAN in a 45-year-old woman who presented with a three-year history of progressive dysarthria, involuntary tongue protrusion, sialorrhea, difficulty in jaw closure, and involuntary movements of the right upper limb. Neurological examination revealed spastic dysarthria, oromandibular dystonia, orolingual chorea, rigidity, resting tremor, hyperreflexia, and a positive Hoffmann sign. Psychiatric manifestations included anxiety, depressive episodes, and impulsivity. Routine laboratory investigations were unremarkable except for mild iron deficiency anaemia. Magnetic resonance imaging of the brain demonstrated the characteristic bilateral “eye of the tiger” sign in the globus pallidus, strongly supporting the diagnosis of PKAN. The patient was treated with trihexyphenidyl, tetrabenazine, botulinum toxin injections, and supportive therapy. This case highlights the importance of considering PKAN in the differential diagnosis of adult onset movement disorders with psychiatric manifestations. Recognition of its characteristic neuroimaging features is essential for timely diagnosis, appropriate symptomatic management, and genetic counselling. The rarity of adult onset PKAN and its diverse clinical presentation underscore the need for greater awareness among clinicians.