ABSTRACT
Background: Acute appendicitis is one of the most common abdominal surgical emergencies requiring accurate diagnosis. Itis characterized by obstruction of its lumen, leading to inflammation and finally perforation. To define its prognosis, choose anappropriate surgical procedure and to decide non-surgical treatment, the pre-operative diagnosis of perforated or non-perforatedappendicitis is very important.Aim of the Study: This study aims to analyze the diagnostic accuracy of computed tomography (CT) scan abdomen indifferentiating perforated from non-perforated appendicitis using histopathology as the final diagnosis.Materials and Methods: Aprospective, cross-sectional analytical study, wherein 85 patients diagnosed with acute appendicitisreferred to the radiological department for CT scan abdomen were included in the study. Patients aged between 15 and 70 yearswere included in the study. CT scan abdomen with and without contrast was performed on a Toshiba 64 Multislice CT scanner(Toshiba Medical Systems Corp., Tokyo, Japan) which was used for all the patients. All the CT scans were interpreted by the sameconsultant radiologists with a minimum of 5 years of experience. The radiological features for the diagnosis of non-perforatedacute appendicitis by CT were based on swollen appendix, thickened enhancing wall, and smudging of surrounding fat planes,whereas the radiological features for perforated appendicitis used were, with abscess formation, phlegmon, extraluminal air,extraluminal appendicolith, and focal defect in the appendicular wall. Histopathology of the specimen collected following surgerywas undertaken by the hospital consultant pathologist of more than 5-year experience.Observations and Results: Among the 85 patients included in this study for the analysis of CT scan abdomen features, therewere 57 (67.05%) males and 28 (32.94%) females with a male-to-female ratio of 2.03:1. The mean age of the patients was38.90 ± 6.70 years. The incidence of non-perforated appendicitis was 66/85 (77.64%) including males 44/85 (51.76%) andfemales 22/85 (25.88%). The incidence of perforated appendicitis was 19/85 (22.35%) and males were 12/85 (14.11%) and 7/85(8.23%) were female. Patients aged 15–45 years of both genders constituted to 63/85 (74.11%) of the total patients. Amongthese patients, presenting with non-perforated appendicitis was 51/85 (60%) and perforated appendicitis was 12/85 (14.11%).Conclusions: Multislice CT scan abdomen was considered as the modality of choice for acute appendicitis not only to confirmthe diagnosis but also it plays an important role in assessment of appendicular complication, particularly in the detection ofperforated appendix. Using one or more of the five radiological signs of CT scan abdomen to identify appendicular perforationraised the sensitivity significantly reaching 94.12%.
ABSTRACT
Background: In the recent past, cardiac computed tomography (CT) angiography is being performed for the diagnosis and treatment of coronary artery disease (CAD) and congestive heart failure. The differentiation of ischemic from non-ischemic cardiomyopathy, characterization of hypertrophic cardiomyopathy, and delineation of congenital heart defects are its primary diagnostic applications. Aim of the Study: The aim was to study the clinical applications of coronary CT angiography (CCTA) in patients with suspected CAD and identify factors that affect CCTA findings. Materials and Methods: Two hundred and fourteen patients diagnosed with CAD were included in the study. Patients aged between 36 and 76 years were included. Patients with chest trauma and prior thoracic surgery (coronary stenting or coronary artery bypass grafts) were excluded. Demographic data of the patients were recorded including age, gender, blood pressure, body mass index, smoking habits, intake of alcohol, previous history of angina, diabetes, and hypertension were recorded. The duration of symptoms was classified into five groups: <1 week, 1 week to 1 month, 1–3 months, 3–6 months, and more than 6 months. All the patients were investigated with lipid profile, serum creatinine, and blood glucose levels. All the patients were subjected to CCTA. The percentage of abnormal CCTA was observed and recorded. Abnormality of coronary arteries was expressed as atherosclerotic changes identified on CCTA scans, which is reflected in either an involvement of the right coronary artery (RCA), or the left coronary artery (LCA), or both of RCA and LCA. Significant coronary stenosis indicates that more than 50% lumen stenosis due to the presence of plaques was considered. Observations and Results: Two hundred and fourteen patients with diagnosed CAD were included in the study, aged between 36 and 76 years. The mean age was 56 ± 2.10 years. There were 153 (71.49%) males and 61 (28.50%) were female, with a male-to-female ratio of 3.44:1. The youngest patient was aged 37 years and the eldest patient was 75 years with a mean age of 56 ± 2.10 years. There were 114/214 (53.27%) patients with abnormal CCTA scans and among them 84/114 (73.68%) were male and 30/114 (26.31%) were female. The most common symptom of presentation was pain in the chest elicited in 139 (64.95%) of the patients in this study, followed by history of hypertension in 89 (41.58%) patients. It was observed that there was no significant difference in the percentage of abnormal CCTA findings between male and female patients (P = 0.19), (with P value taken as statistically significant at <0.05). Similarly, no significant difference was found between the sex (male/female) and duration of symptoms (P = 0.71). Conclusions: CCTA is a non-invasive, outpatient-based procedure suitable in patients without actionable CAD, obviating unnecessary invasive examination of coronary vessels. CT angiography findings are directly related to patient age and duration of symptoms, with increased abnormal findings reported in elderly population with the duration of symptoms more than 6 months. Moreover, there was a direct correlation between the involvement of coronary arteries and the patient age.
ABSTRACT
Background: Ultrasonography (USG) is a simple and noninvasive diagnostic tool that gives lots of data to accurately characterize most of the ovarian mass lesions with a sensitivity and specificity of 88–96% and 90–96%, respectively. However, the presence of significant variability in the terminology and definition of USG findings has led to the need for more standardization and uniformity in adnexal USG. Computed tomography (CT) scan is used primarily in patients with ovarian malignancies, either to assess disease extent before surgery or as a substitute for second-look laparotomy. Moreover, spiral CT has several advantages such as its rapidity and possibility of identifying all potential sites of peritoneal implants or lymphadenopathy as well as of the primary tumor site. Aim of the Study: The study was to the clinical findings of both USG and CT scan of abdomen and pelvis in the accurate diagnosis of ovarian mass lesions. Materials and Methods: A total of 104 patients with mass lesions of the ovary were included and subjected to USG and CT scan of abdomen and pelvis. Transabdominal and transvaginal USG studies were undertaken in all the patients. USG findings and CT scan findings were observed recorded and analyzed. Ovarian pathologies were categorized as benign, malignant, and metastasized and the results of CT and USG were compared. Observations and Results: A total of 104 patients with ovarian mass lesions attending the Radiology Department of a Tertiary Teaching Hospital in Kerala were included in the study; patients were aged between 18 and 68 years with a mean age of 42.46 ± 5.70 years. Patients aged between 19 and 58 years accounted for more than 80% of the entire subjects. Hemorrhagic cyst was the most common mass lesion diagnosed in this study and accounted for 28 (26.92%) patients. Tubo-ovarian abscess accounted for 19/104 (18.26%) of the total cases. This was followed by mucinous cystadenoma 17/104 (16.34%), serous cystadenoma in 13/104 (12.50%) cases, polycystic ovarian disease in 11/104 (10.57%), mature cystic teratoma in 7/104 (6.73%), simple cyst in 6 (5.76%), Brenner tumor in 2/104 (1.92%), and endometrioma in 1/104 (0.96%) patients. Conclusions: CT scan and USG are two excellent noninvasive methods to differentiate ovarian mass lesions from benign and malignant lesions and both imaging techniques seemed to be comparable in differentiating malignant from benign ovarian tumors. CT scan was more sensitive than USG, but sonography is more specific than CT scan in diagnosis of malignant lesions. USG has high positive predictive value as compared to CT scan to diagnose malignant lesions.
ABSTRACT
Reactive nodular fibrous pseudotumor (RNFP) is a recently described non-neoplastic mesenchymal lesion arising from the gastrointestinal tract, mesentery, or retroperitoneum. It is a rare entity with only a few cases reported in literature so far and is less aggressive when compared to other mesenchymal lesions such as gastrointestinal stromal tumor (GIST) or fibromatosis. Here, we present the case of a 20-year-old female who presented with a huge abdominal mass. Contrast-enhanced computed tomography was suggestive of pseudopapillary tumor of the pancreas. The patient underwent exploratory laparotomy and excision of the mass in toto along with sleeve gastrectomy and splenectomy. Post-operative histopathology confirmed the entity to be RNFP. This case illustrates the need for keeping RNFP in mind as a differential diagnosis in a case of large abdominal mass as it has a fairly good prognosis with no reported recurrence after surgical excision.
ABSTRACT
Background: Diabetes is almost growing health concern worldwide and now emerging as an epidemic world over. Recently, full attention is being paid to the study of natural products as potential antidiabetics. Objective of the study was to evaluate the antidiabetic effect of hydroalcoholic leaf extract of Annona squamosa (HAEAS) plant in alloxan monohydrate induced diabetic albino rats.Methods: Almost a 30 Albino rats with 150- 200 grams weight were weighed and grouped into 5 equal groups taking 6 rats in every group. Group A served as normal control, Group B as diabetic control, received alloxan monnohydrate. Group C and D was received alloxan + HAEAS suspension at 350 and 700 mg/kg doses orally respectively, Group E was given alloxan + standard drug (Glibenclamide 5mg/kg) suspension for 28 successive days and the effect of HAEAS on blood sugar(BS) levels was measured at regular intervals. At the end portion of this investigational research study samples of blood were collected from all rats on 0day (initial), after 72 hrs and after 28th day (29thday) of given test drug HAEAS treatment for biochemical estimation of BS and the BS values were observed.Results: The present research study revealed that HAEAS leaves has antidiabetic effect against alloxan monohydrate induced diabetic rats on i.p. alloxan injection at 150mg/kg.b.w. and confirms that on i.p. alloxan injection causes a significant rise off BS in untreated albino rats when compared to control group. Diabetic rats treatment with HAEAS leaves for 28 days caused dose a dependent fall in BS values. Glibenclamide treated diabetic rats also showed a significant (P <0.00) fall in BS content after 28 days of treatment.Conclusions: This research study confirms that HAEAS leaves has shown significant antidiabetic effect at 350 and 700 mg/kg. b.w. doses in alloxan monohydrate induced diabetic rats.
ABSTRACT
Background: Diabetes prevalence is estimated to increase annually. Numerous people use traditional medicine, such as India also considered as the diabetic capital in the world. Diabetes is a metabolic disorder characterized by disturbances in lipid, carbohydrate and protein metabolism. The present study to evaluate the antidiabetic potential of coriandrum sativum. linn fruits methanolic extract in streptozocin induced diabetic wistar albino rats model.Methods: Diabetes induction in wistar albino rats by administration of streptozocin (50mg/kg, i.p.) in citrate buffer. 30 wistar albino rats were divided into 5 groups (A, B, C, D, E). Group A: served as normal control, whereas Group B: diabetic control, Group C, D methanolic coriandrum sativum Linn. fruits extract (CSFME) at a dose of 100, 200mg/kg orally, Group E was given standard drug Glibenclamide (0.5mg/kg) orally. All groups are administered for the period of 14 consecutive days and blood sugar levels was measured at regular intervals up to end of the study.Results: This present research study confirms that the test drug compound CSFME has sustained oral hypoglycaemic activity and statistically significant (p ?0.05) and which is comparable with standard drug Glibenclamide.Conclusions: This research study confirms that the CSFME has antidiabetic activity against streptozocin induced wistar diabetic albino rats. It could be a novel antidiabetic agent and also a dietary adjunct in the type 2 diabetes management and its complication. Further studies are necessary required to confirm the antidiabetic activity of individual phytochemical compounds of Coriandrum sativum.
ABSTRACT
Selection which is the basis of every breeding programme operates only on variation which is of genetic nature. A wide range of variability present in any crop always provides the better chances of selecting desired types. A field experiment was carried out at Vegetable Research Farm, Department of Horticulture, Institute of Agricultural Sciences, Banaras Hindu University during 2012 to evaluate the diverse genotypes of tomato. Analysis of variance indicated highly significant differences among the genotypes for all the characters. The highest GCV and PCV were observed with the character fruit yield per plant followed by number of seeds per fruit. Whereas, the lowest GCV and PCV were recorded by the character days to 50% fruiting followed by days to 50% flowering. The heritability estimates were high for all the characters except number of branches per plant which showed moderate heritability. The maximum heritability was observed for number of seeds per fruit and average fruit weight. High GCV and heritability coupled with high genetic advance was observed for fruit yield per plant followerd by number of seeds per fruit indicating that they are governed by additive genes and could be effectively improved through selection.
ABSTRACT
Background. Families living below the poverty line in countries which do not have universal healthcare coverage are drawn into indebtedness and bankruptcy. The state of Andhra Pradesh in India established the Rajiv Aarogyasri Community Health Insurance Scheme (RACHIS) in 2007 with the aim of breaking this cycle by improving the access of below the poverty line (BPL) families to secondary and tertiary healthcare. It covered a wide range of surgical and medical treatments for serious illnesses requiring specialist healthcare resources not always available at district-level government hospitals. The impact of this scheme was evaluated by a rapid assessment, commissioned by the government of Andhra Pradesh. The aim of the assessment was to explore the contribution of the scheme to the reduction of catastrophic health expenditure among the poor and to recommend ways by which delivery of the scheme could be improved. We report the findings of this assessment. Methods. Two types of data were used for the assessment. Patient data pertaining to 89 699 treatment requests approved by the scheme during its first 18 months were examined. Second, surveys of scheme beneficiaries and providers were undertaken in 6 randomly selected districts of Andhra Pradesh. Results. This novel scheme was beginning to reach the BPL households in the state and providing access to free secondary and tertiary healthcare to seriously ill poor people. Conclusion. An integrated model encompassing primary, secondary and tertiary care would be of greater benefit to families below the poverty line and more cost-effective for the government. There is considerable potential for the government to build on this successful start and to strengthen equity of access and the quality of care provided by the scheme.
Subject(s)
Adult , Female , Health Services Accessibility , Health Services Needs and Demand/economics , Humans , India , Insurance, Health/economics , Male , Middle Aged , Poverty/economics , Program Evaluation , Public Health/economics , Surveys and QuestionnairesABSTRACT
Larvicidal effect of neem (Azadirachta indica) and karanja (Pongamia glabra) oil cakes (individuals and combination) was studied against mosquito species. Both the oil cakes showed larvicidal activity against the mosquito species tested. The combination of neem and karanja oil cakes in equal proportion proved to have better effect than the individual treatments. The combination of the two oil cakes recorded an LC95 of 0.93, 0.54 and 0.77% against the mosquitoes, Culex quinquefasciatus, Aedes aegypti and Anopheles stephensi respectively The increase in efficacy of the combination treatment over individuals in all the mosquito larvae tested was found to range about 4 to 10 fold in terms of LC50 and 2 to 6 fold in terms of LC95.