Evaluation of bowel by computed tomography enterography: comparing the water, mannitol and iodinated oral contrast

Background: Despite the small intestine's size and significance, disorders of it are comparatively uncommon and can pose difficulties for diagnosis and treatment. Even with the advent of cutting-edge imaging methods like double balloon endoscopy and capsule endoscopy, diagnostic tests are still unable to accurately evaluate the bowel. Recent innovations, including capsule endoscopy and MRI have emerged as an alternative small bowel imaging techniques that can be performed without ionizing radiations. In this study we have compared Water, mannitol and iodinated oral contrast for assessing intraluminal distension, mucosal fold visualization and mural enhancement. Methods: A total of 150 patients fulfilling the selection criteria were studied. All patients of age group 25 to 70 years were included in the study. Patients with ileostomy, nasogastric tube in-situ and nil by mouth., with suspected intestinal obstruction, patient presenting with acute abdomen and fever were excluded. Results: It was observed that mannitol, homogeneity and mannitol group showed better bowel distension than iodinated contrast and plain water group (p<0.001), iodinated contrast and plain water group. (p<0.001). Mannitol group showed better wall visibility than iodinated contrast and plain water group. (p<0.001). Mannitol is better endo-luminal contrast agent than, iodinated contrast in water and plain water to assess the overall image quality. Conclusions: Computed tomography (CT) enterography using mannitol is excellent technique in better visualization of small bowel loops and thus helped to provide better diagnosis for intestinal abnormalities.

The study of computed tomography angiography in the evaluation of acute stroke

Background: When it comes to residual lumen diameters and areas, calcifications, and stenose length, computed tomography angiography (CTA) offers genuinely anatomic, non-flow dependent information. Compared to traditional catheter arteriography, CTA is less costly, causes less discomfort to patients, and has a significantly lower risk of stroke and other vascular complications. Additionally, it is helpful when performing magnetic resonance (MR) is not recommended or is not possible. Generally speaking, CTA is more accessible than MR, particularly in emergency situations. As there are no limitations on the kind and quantity of related support equipment, such as intravenous pumps, ventilators, or monitoring hardware, CTA, in contrast to MR angiography (MRA), is well suited for the imaging of critically ill patients. Our goal was to assess how useful CT angiography is for determining the etiology of vessel occlusion and stroke. Methods: Non enhancing CT scan of all patients was evaluated first for significant findings, after that contrast enhanced scan was evaluated and compared with non-enhancing CT scan. Direct volume rendering (dVR) is the most sophisticated method for 3D visualization. When dVR is used to create CT angiograms, the voxels of high attenuation containing information about bony structures are selected separately from those voxels with an attenuation between 100 and 300 HU containing information about contrast- enhanced vascular structures. Results: We observed sensitivity of CTA in evaluation of acute stroke as 93.33%, specificity 80%, positive predictive value (PPV) 87.5% and negative predictive value (NPV) 88.88%. Conclusions: CT angiography, when closely correlated with patients’ clinical conditions, has the potential to become the screening method of choice for evaluating patients with significant vascular lesions amenable to acute intracranial transcatheter thrombolytic therapy.

Risk factors of cardiovascular diseases in young and middle aged Indian males: a case control study

Background: Cardiovascular diseases (CVDs) are common in India, yet there is a lack of comprehensive studies on the specific risk factors for the Indian population. Our research aimed to identify CVD risk factors in individuals under 50 and compare them with healthy controls, offering insights into preventing CVDs in this younger demographic. Methods: This study focused on newly diagnosed cases of CVDs in males under 50 and matched controls with same demographic parameters. Data on personal, medical, lifestyle and biochemical parameters was compared to identify and understand the key risk factors associated with CVDs in this specific population group. Results: Elevated body mass index (BMI) and waist-hip ratio were linked to CVD, with BMI showing a significant association. High triglyceride (TGL) levels (>150 mg/dl) and LDL cholesterol levels (>130 mg/dl) were significantly associated with CVD. The total cholesterol to HDL cholesterol ratio (>4.5) and low HDL cholesterol (<40 mg/dl) were also linked to CVD risk. Diabetes mellitus was strongly associated with CVD (OR-14.04). Stress, as assessed by a stress score >12, was associated with CVD, although the association was not very strong (OR 1.39). Physical exercise was associated with a protective effect against CVD (OR-0.28). These findings emphasize the critical role of lifestyle factors, such as diet, exercise and stress management in CVD prevention and highlight the importance of managing conditions like obesity and diabetes. Conclusions: This study not only deepens our comprehension of CVD prevention but also provides actionable guidance for fostering heart health, both within the studied population and in broader contexts.

Lymphedema with dermatitis neglecta: a rare case report

Psychodermatology, an emerging field in dermatology, investigates the complex relationship between the skin and the mind. Dermatitis neglecta, a rare disorder, manifests as the accumulation of bacteria, perspiration, corneocytes, and sebum in a localised area of skin, leading to the development of a hyperpigmented patch or verrucous plaque. This case study presents dermatitis neglect, where the condition was triggered by a deliberate disregard for personal hygiene. Upon clinical examination, the patient presented with a hyperpigmented scaly patch, which was further confirmed through spirit testing. Alcohol swabbing can be used as a therapeutic and diagnostic approach for this particular case. The medical literature and textbooks provide scarce information on dermatitis neglecta, contributing to the limited understanding of this condition. Consequently, misdiagnosis is frequent, leading to unnecessary and aggressive diagnostic and therapeutic procedures. Dermatitis Neglecta is frequently misdiagnosed. Raising awareness of this condition is crucial in order to prevent unnecessary interventions. When required, emollients should be used judiciously, and appropriate patient education on maintaining personal hygiene and the application of keratolytics should be emphasized.

Assessment Concerning the Role of Foliar Administration of Micronutrients on Growth, Yield, and Quality Characteristics of Vegetable Crops

Vegetables are one of the main elements in terms of ensuring a person's food security and nutritional well-being. Integrated application of macronutrients coupled with adequate incorporation of micronutrients is one of the key factors for quality vegetable production. For ensuring maximum vegetable production with superior quality foliar nutrition is the better alternative in the era of climate change. Foliar application is the easiest and most effective way to administer micronutrients as compared to other methods. Trace elements such as iron (Fe), zinc (Zn), manganese (Mn), molybdenum (Mo), boron (B), chlorine (Cl), copper (Cu), and nickel (Ni) are essential for vegetable crops. The primary goal of this review article is to investigate the merits of micronutrients and the production potential of various vegetable crops through foliar nutrition. Additionally, this study aims to clarify the role of micronutrients in quality vegetable production. Several studies suggested that the exogenous application of micronutrients has a tremendous effect on overall growth and quality in a variety of crops. Many researchers have demonstrated that applications of Boron @250ppm significantly influenced the fresh weight of fruit, number of fruits per plant, number of seeds per plant, germination%, vigour index and root and shoot lengths of seedlings in sweet pepper. Various researchers also concluded that the application of Zn @1000 ppm + B @200 ppm + Mo @50 ppm provides a significant impact on head diameter, volume of head, chlorophyll a, chlorophyll b and chlorophyll total in cabbage.

Kapalbhati changes cardiovascular parameters

Background and Objectives: Kapalbhati is among one of the cleansing act (shatkarma) in yogic philosophy. It is one of the popular Pranayama which has several benefits. It is highly recommended for those who have to do great deal of study and need a clean, clear mind. This study was conducted among nursing students at Janaki medical college, Janakpur, Nepal.Material and Methods: This analytical study was conducted among PCL Nursing students of Janaki Medical College, Janakpurdham, Nepal. Total 40 nursing student who gave consent and performed Kapalbhati correctly were included in the study. A detailed demographic profile with a structured questionnaire and observational checklist was filled for data collection. HR, SBP, DBP were the cardiac parameters taken. Those parameters were taken before, during, immediately after and after 1 minute, 2 minutes, 3 minutes and 5 minutes Pranayama. The data were entered in SPSS and Statistical analysis was done using version 20.Results: As in usual exercises, the HR, SBP and DBP increases significantly during Kapalbhati session but immediate post effect was surprisingly significantly fall in those parameters when compared with the value during exercises. The basal (pre-Kapalbhati) mean HR, SBP and DBP were 88.25 ± 9.02, 111.43 ± 11.28 and 73.9 ± 7.70 which increases upto 133.58 ± 35.70, 89.63 ± 23.31 and 118.55 ± 19.08 respectively during exercises and fall immediately after exercises value being 114.48 ± 21.94, 76.43 ± 15.34 and 88.6 ± 17.25 respectively.Conclusion: There is no significant difference between pre and post value of HR, SBP and DBP as in other study. There is significant rise between Pre-value and during-value of all parameters and significant fall of all parameters if compared between during-value and post-value.

Cephalic tetanus with left infranuclear facial palsy.

We report a case of 11 years old male who developed trismus associated with left infranuclear facial palsy following injury over forehead. Cephalic tetanus was diagnosed. Rarity of the case as well as mild course it ran, though the incubation period was less than seven days, is the reason for this case report.

Crossed hemifacial hyperplasia: a diagnostic dilemma.

Crossed hemifacial hyperplasia is a rare condition producing facial asymmetry and overgrowth of the extremities of the opposite side. Very few cases are reported in literature. A case of an 11-year-old female is presented here to supplement existing clinical knowledge with many of the reported clinical and orofacial findings. Emphasis is placed on diagnosis of the condition by thoughtful elimination and the necessity of a multi-disciplinary approach to its management.

Evaluation of three topical anaesthetic agents against pain: a clinical study.

AIM: To compare pain responses of children during local anaesthetic infiltration at bilateral buccal sites prepared with topical application of EMLA 5% cream, benzocaine 18% gel or lignocaine 5% ointment and also to find out the rapidity of onset of action of these agents. METHODS: 60 healthy children aged 6 to 12 years old, received bilateral buccal infiltration following application of topical anaesthetic agents applied in a double blind design. Pain responses were compared based on subject self report using visual analogue scale (VAS) and operator assessment using Sound -Eye -Motor (SEM) scale. RESULTS: Benzocaine gel had the rapidest onset of action. EMLA 5% cream proved to be superior in pain reduction compared to benzocaine and lignocaine. Taste acceptance was better with benzocaine gel. Further studies are required for EMLA cream with an improved formulation more suitable for mucosal application before its routine use in dentistry.