Water as neutral oral contrast agent in abdominopelvic CT: comparing effectiveness with Gastrografin in the same patient

Introduction: Positive oral contrast is no longer deemed necessary for abdominopelvic computed tomography (CT) scans. Studies have shown water to be an equally effective oral contrast agent. However, to our knowledge no study has compared effectiveness between gastrografin and water in the same patient, which will provide a more objective evaluation of the two oral contrast agents. We aim to make a head-to-head comparison of water as neutral oral contrast (OC) against gastrografin as positive OC for abdominopelvic CT scans in the same patient. Methods: A retrospective review of 206 abdominopelvic CT scans of 103 patients was performed. The scans were reviewed in consensus by two blinded radiologists. The ability to visualise each abdominopelvic organ, contrastassociated artefacts and small bowel wall delineation, was qualitatively scored on a 5-point scale. Each patient had two sets of scores, one with water and another with gastrografin as OC. Paired scores from the two OCs were evaluated by Wilcoxon signed rank test to determine any significant difference in performance between the two OCs for visualisation of abdominopelvic anatomy on CT. Results: There was significantly better delineation of duodenal wall (p<0.001) and overall visualisation of the duodenum (p=0.011) using water as OC compared to gastrografin. No statistically significant differences were demonstrated between water and gastrografin for visualisation of the rest of the abdominopelvic organs, walldelineation of the rest small bowel and contrast-associated artefacts. Conclusions: Water can be used in place of gastrografin as oral contrast in abdominopelvic CT without compromising visualization of abdominopelvic organs.

Studies on Phytochemistry of 100 Plants in Chennai, India.

Aims: Knowledge on the plant phytochemistry provides a fundamental use of plants as a reservoir of chemical agents. Hence, the study on the presence of Phytochemicals in the aqueous extract of 100 different plant species belonging to 44 families collected from Chennai, India was detected. Place and Duration: Plants distributed in the Chennai district of Tamil Nadu state in India were studied. The study was conducted during the period of November 2012 to January 2013. Methods: Leaves of around 100 plant species belonging to different habit like trees, shrubs, herbs and creepers or climbers from Chennai and its surround districts of India were collected. The aqueous extract of air dried, pulverized leaf samples of collected plants were examined for the presence of Tannins, Phlobatannins, Saponins, Flavonoids, Terpenoids, Cardiac glycosides and Steroids using the standard techniques proposed by Evans (1996). The presence of individual secondary metabolites was calculated in percentage and their prevalence in different plant habit was studied. Results: Around 29%, 20%, 23%, 48%, 22%, 30% and 44% of plants showed the presence of Tannins, Phlobatannins, Saponins, Flavonoids, Terpenoids, Cardiac glycosides and Steroids in that order. Further, the presence of secondary metabolites according to the plant habit like, tree, shrub, herb and creeper or climber was detected. Conclusion: It was evident that the presence of Tannin, Phlobatannin, Flavonoids and Cardiac glycosides are found prevalent in trees, Steroids in herbs and Terpenoids in shrubs. However, further study on this aspect is recommended.

Caffeine in children with obstructive sleep apnea

Children with obstructive sleep apnea [OSA] have a higher rate of adverse post-extubation respiratory events, such as laryngospasm, upper airway obstruction, apnea, desaturation and/or need for re-intubation. They are overly sensitive to sedatives and narcotics. Although the etiology of OSA is primarily obstruction [mechanical or neuromuscular], a central element may contribute to OSA. Caffeine citrate has been shown to be effective in treating apnea of prematurity. This study evaluated whether the administration of caffeine benzoate to children with OSA decreases the number of children who experience adverse post-extubation respiratory events. In a randomized, double-blind and placebo-controlled study, children with OSA scheduled for adenotonsillectomy [T and A] received either caffeine benzoate, 20 mg/kg IV, [caffeine group, n = 36] or saline [placebo group, n = 36]. The primary outcome evaluated the number of children who developed adverse post-extubation respiratory events, and the secondary outcome was the incidence of those events. The results demonstrated the two groups differed in the number of children who developed adverse post-extubation respiratory events [p = 0.032]. The overall incidence of adverse postoperative respiratory events was less in the caffeine group than the placebo group [p = 0.0196]. In children with OSA scheduled for T and A, administration of caffeine benzoate, 20 mg/kg IV, decreased the number of children who developed adverse post-extubation respiratory events and decreased the overall incidence of adverse post-extubation respiratory events. PACU duration, hospital discharge time and postoperative delirium did not differ between groups

Intravenous glucose tolerance test in Macaca radiata radiata.

A reliable method for performing sensitive intravenous glucose tolerance tests in monkeys has been standardized. This helps in assessment of beta cell function. A normal curve for glucose disposal is constructed. A high variability in insulin levels is also documented.

Xenographic transplantation of monkey pancreatic islets into rats.

Islets of Langerhans were isolated from the monkey pancreatic by collagenase digestion method. Freshly isolated monkey pancreatic islets were transplanted under the renal capsule of normal rats. Treated group of rats received Cyclosporine A injections and the control group of rats did not receive any drug. In Cyclosporine A treated rats the monkey islets were not destroyed. They maintained their normal structural integrity with occasional neutrophils surrounding the islets. In the untreated rats dense infiltration of neutrophils destroyed the islets in three days. On the seventh day dense infiltration of lymphocytes was seen. Granulomas composed of epitheloid cells and occasional multinucleated Langerhans type giant cells were seen on the fourteenth day.

Assessment of iodine deficiency disorders using the 30 cluster approach in the National Capital Territory of Delhi.

OBJECTIVE: Iodine Deficiency Disorders (IDD) are a major public health problem in India. The National Capital Territory (NCT) of Delhi is a known iodine deficiency endemic area. The Delhi Government banned the sale of non-iodised salt since 1989. The present study was conducted to assess the status of IDD after 7 years of salt iodisation programme in the state. DESIGN: Cross sectional. METHODOLOGY: The recent indicators recommended by the World Health Organization-United Nations Childrens Fund-International Council for the Control of Iodine Deficiency Disorders (WHO-UNICEF-ICCIDD) were utilized for the assessment of IDD. A total of 30 clusters were selected using population proportionate to size cluster sampling procedure. In each identified cluster, one primary school was selected using random sampling. A total of 6911 school children in the age group of 8-10 years were included for the study. RESULTS: The total goiter prevalence rate was 8.6% while 2.1, 8.4, 17.6 and 71.9% of the children had urinary iodine excretion levels of < 2, 2-4.9, 5-9.9 and 10 and above mcg/dl, respectively. The median urinary iodine excretion was 17 mcg/dl. Of the 1854 salt samples analyzed, salt with a nil iodine content was consumed only by 1.4% of the beneficiaries. Forty one per cent of families consumed salt with an iodine content of less than 15 ppm. CONCLUSION: IDD continues to be a public-health problem in the NCT of Delhi. There is a need of strengthening the existing monitoring system for the quality of iodised salt.