Characterization of Hepatobiliary Masses: A Comparative Study of Ultrasound versus Computed Tomography

Detecting and characterization of hepatobiliary masses is one of the most confusing and controversial challenges in imaging today. Aims and objectives: To evaluate the role of Ultrasound and Computed Tomography in hepatobiliary masses and know the exact site of origin of lesion and its extension into surrounding structures. Methods: In this study, 100 cases of hepatobiliary masses were subjected to with USG and CECT abdomen. Imaging findings were evaluated and tabulated and correlated with the histopathological findings, surgical findings and follow up. The findings were checked and statistically tabulated. Results: Out of a total 100 patients included for study, most patients were in age range of 51 – 60 years. Males : Females ratio was 55 : 45. Out of 100 cases 73% were hepatic masses, 18% gall bladder masses and 8% common bile duct masses. 51 being true benign and 49 lesions being true malignant. Sensitivity (%) and Specificity (%) of diagnosing these lesions on USG was 84.5% and on 86.6% respectively. Sensitivity (%) and Specificity (%) of diagnosing these lesions on CT was 92.2% and on 94.8% respectively. Conclusion: Hepatobiliary masses remain a diagnostic challenge. These lesions are frequently caused by benign, malignant and metastatic etiologies. We conclude that USG plays an important role as an initial screening modality and as an adjunct to CECT and Triphasic CT in the evaluation of hepatobiliary masses.

A Prospective Comparative Study of High Resolution Ultrasound and MRI in the Diagnosis of Rotator Cuff Tears

Aim: Comparing the role and finding sensitivity and specificity of ultrasonography with that of conventional MRI techniques in patients presenting with rotator cuff injury. Methods: 50 patients who presented with shoulder pain and/or disability and clinically suspected rotator cuff tears in orthopedic out patient department (OPD) of Guru Nanak Dev Hospital, Amritsar, referred to department of Radiodiagnosis and imaging for ultrasonography and magnetic resonance imaging. Results: USG shows sensitivity of 83.7%,specificity of 100%,PPV of 100% and NPV of 68.4% for partial thickness tear and 100% sensitivity,specificity ,PPV and NPV in complete thickness tear. The strength of agreement between USG and MRI for diagnosis of rotator cuff tear was found to be (k= 1.0) for full thickness tears (very good agreement) and good agreement for partial thickness tears. Conclusions: From our study, USG is proven to be an effective imaging modality with results comparable with MRI in patients presenting with shoulder pain and /or disability and clinically suspected case of rotator cuff tendon tears.ultrasound by an experienced radiologist should be considered as a primary diagnostic tool for imaging the rotator cuff pathologies. At present, MRI can be reserved for patients with suspicious USG results.

Hypolipidemic Activity Of Cassia Tora Seeds In Hyperlipidemic Rats

The hypolipidemic activity of Cassia tora (Chakvat, Chakunda) (Family: Caesalpiniaceae) seeds extract has been studied in two hyperlipidemic models of rat. These are triton injected and cholesterol rich HFD fed model of hyperlipidemia. In triton WR-1339 induced hyperlipidemia, feeding with root extract (500 mg/ kg body wt/ day p.o. ) exerted lipid lowering effect as assessed by reversal of plasma levels of total cholesterol (TC), phospholipids (PL), triglyceride (TG) and reactivation of Post Heparin Lipolytic Activity (PHLA) of plasma. The other model was fed with cholesterol rich HFD and seeds extract of Cassia tora (500 mg/ kg body wt/ day p.o.) simultaneously for 30 days. This also caused lowering of lipid levels in plasma and liver homogenate and reactivation of plasma post heparin lipolytic activity, hepatic total lipoprotein lipase activity. The hypolipidemic activity of Cassia tora seeds was compared with a standard drug guggulipid (200 mg/ kg body wt/ day p.o.), a known lipid lowering drug in both models.

Role of Spiral Computed Tomography Scan in Evaluation of Retroperitoneal Pathologies.

The study role of Spiral Computed Tomography Scan in evaluation of Retroperitoneal Pathologies was done in 50 patients with clinically suspected retroperitoneal mass in the Department of Radiodiagnosis and Imaging of Govt. Medical College, Amritsar during the year 2012-2013. All patients underwent routine investigations followed by CT examination of the abdomen. Final diagnosis was achieved by operative findings / FNAC / histopathology or by other investigations. The sensitivity of CT to detect presence / Absence of mass was 100%, to identify organ of origin the sensitivity was 98% and for characterization of mass sensitivity was 82%.

Prevalence and Determinants of Low Birth Weight in Sirte City of Libya.

This study was undertaken to find out the prevalence and determinants of Low birth weight neonates in Sirte city of Libya. This was a crossectional study including 269 newborn babies delivered in Ibnsena hospital, (which caters the Sirte city for deliveries). The study was conducted in the first fortnight of January 2011. Out of 269 neonates 11 were VLBW < 1.5kgs 74 were with low birth weight (1.5 kg to 2.5 kg). The mean weight, standard deviation, standard error and variance was 2.63, 0.59, 0.036 and 0.35 respectively. Association of mothers age with birth weight was insignificant p > .05 ; but highly significant with hypertension , p < .01 at 99% CI . Similarly association of LBW with different variable of mother like anemia, smoking, life style, birth spacing, BMI, parity ,and toxemia of pregnancy was in between significant and highly significant (p < .05 to< .01 at 95/99 % CI at respective DF's. The variables of LBW are addressable to reduce this menace in developing and under developed countries.

Hypolipidemic and antioxidant activity of Anthocephalus indicus (Kadam) root extract.

The present study was carried out to explore the anti-diabetic, anti-dyslipoproteinemic and anti-oxidant activities of Anthocephalus indicus root extract in alloxan-induced (150 mg/kg body wt.) diabetic rats. A marked increase in plasma levels of glucose and lipid peroxides accompanied with an elevation in the lipids and apoprotein levels of serum very low density lipoprotein (VLDL) and low density lipoprotein (LDL) following decrease in lipid and protein constituents of high density lipoprotein (HDL) were observed. The alterations in lipoprotein pattern was associated with inhibition of lipolytic and antioxidant enzymes. Oral administration of root extract (500 mg/kg body wt.) for 30 days in dyslipidemic animals resulted in significant decrease in plasma glucose, total cholesterol, phospholipids, triglyceride and lipid peroxides. The decrease of lipids and apoprotein levels of VLDL and LDL were followed by stimulation of plasma post-heparin lipolytic activity and lecithin cholesterol acyltransferase as well as hepatic superoxide dismutase and catalase activities. Lipid and apoprotein levels of HDL were also recovered partially on treatment with root extract.

Hypolipidemic activity of Hibiscus rosa sinensis root in rats.

The hypolipidemic activity of Hibiscus rosa sinensis (family Malvaceae) root extract was studied on triton and cholesterol-rich high fat diet (HFD) induced models of hyperlipidemia in rats. In triton WR-1339-induced hyperlipidemia, feeding with root extract (500 mg/kg body wt/day p.o.) exerted lipid-lowering effect, as assessed by reversal of plasma levels of total cholesterol (TC), phospholipids (PL) and triglycerides (TG) and reactivation of post-heparin lipolytic activity (PHLA) of plasma. The other model was fed with cholesterol-rich HFD and root extract (500 mg/kg body wt/ day p.o.) simultaneously for 30 days. This also caused lowering of lipid levels in plasma and liver homogenate and reactivation of plasma PHLA and hepatic total lipoprotein lipase activity. The hypolipidemic activity of Hibiscus rosa sinensis root was compared with a standard drug guggulipid (200 mg/kg body wt/day p.o.), a known lipid- lowering agent in both models. Histopathological findings in rat liver supported the protective role of H. rosa sinensis root extract in preventing cholesterol-rich HFD-induced hepatic steatosis.

Prodigiosins: a novel family of immunosuppressants with anti-cancer activity.

Prodigiosins (PrGs) are a family of promising therapeutic molecules, isolated mostly from Gram-negative bacteria and characterized by a common pyrryldipyrrylmethene structure with varying side chains. They show a broad spectrum of activities such as anti-microbial, anti-malarial, anti-cancer and immunosuppressive. PrGs are attracting increasing attention due to the ongoing research for less toxic, but effective agents for cancer chemotherapy and immunosuppression for preventing allograft rejection and autoimmunity. Different analogues have been synthesized and evaluated. This review discusses the immunosuppressive and anti-cancer activities of this class of compounds, as both involve inhibition of cell proliferation. The main focus is on the in vitro and in vivo immunosuppressive activity of the different PrGs and the mechanisms involved. PrGs primarily target the T cells, though some effects are observed on other cell types also. Unlike the well-known immunosuppressant cyclosporin A, PrGs do not inhibit the secretion of IL-2 but inhibit the mitogenic signaling from IL-2, suggesting a different mechanism of action. Janus tyrosine kinase 3 (Jak3) that associates with IL-2R upon activation is considered as the molecular target for PrGs. Its restricted expression makes Jak3 as an attractive target for immunosuppressive therapy. However, the available literature suggests that some other pathways are also influenced by the PrGs. These may be important for the anti-cancer activity, as well as immunosuppressive action. Therefore, PrGs appear to be potential candidates for pharmaceutical development as immunosuppressants and also as anti-cancer agents.

In vivo model for dyslipidemia with diabetes mellitus in hamster.

Due to similarities in lipid metabolism to those in humans, hamster is considered as a good model for the study of regulatory mechanisms of plasma lipoproteins in response to cholesterol or fatty acid-enriched diet. This model of hyperlipidemia has been modified to produce dyslipidedmia with diabetes complexities by feeding with high fat diet added with 9% (w/w) fructose. Feeding this diet to hamster for 10 days markedly increases plasma levels of triglyceride, cholesterol, fatty acids followed by a significant increase in glycerol, beta lipoproteins, high density lipoprotein, glucose and glycosylated proteins. This model is being used for research and development of lipid lowering drugs with hypoglycemic activity in collaboration with Novo Nordisk, Denmark. The modified high fat diet formulation has now been prepared (Research diet D.99122211) and supplied by Research Diets Inc, Burnswick USA.

Cholesterol binding reserve of hyperlipemic rat serum lipoproteins in chronic ethanol administration.

Chronic administration of ethanol in rats caused the reduction of serum cholesterol binding reserve. The very low density and high density lipoproteins, main serum cholesterol binding reserves, were slightly increased with corresponding increases in their lipid and protein components during initial stage of alcohol consumption. However, these capacities get deminished during reversal of hyperlipemia induced by prolonged action of ethanol. This situation may be an early indicator for the initiation of hepatic damage and a variety of secondary effects of ethanol.

Lipid peroxidation of hyperlipemic rat serum lipoproteins in chronic ethanol and acetaldehyde administration.

The levels of lipid peroxides in circulatory lipoproteins increased with chronic administration of ethanol or acetaldehyde. Low density lipoprotein showed a greater increase in its content of lipid peroxides than very low density lipoprotein or high density lipoprotein. However, very low density lipoprotein was more prone to lipid peroxidation in vitro than low density lipoprotein or high density lipoprotein. The effect of acetaldehyde was more marked than that of ethanol. Lipoproteins of control and hyperlipemic groups were partially protected against peroxidation by butyrated hydroxytoluene and serum high density lipoprotein of normal rats.

Lipoprotein-X in hyperlipemic rat serum in chronic ethanol and acetaldehyde administration.

The levels of lipoprotein-X in circulation increased with chronic administration of ethanol or acetaldehyde. A similar profile was seen in rat serum with alkaline phosphatase activity and bilirubin content. Total cholesterol, phospholipids and triglyceride contents increased followed by a decrease by progressive feeding with ethanol or acetaldehyde. The effect of acetaldehyde was more pronounced than that of ethanol.