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Background: There are numerous causes of epilepsy. A neuroimaging study should be done to exclude a structural brain abnormality. The present study was undertaken to find the role of Computed Tomography (CT) scan in patients presenting to our hospital with seizure disorders. Methods: Adult patients who presented to our hospital with history of seizures underwent non-contrast CT scan. Assessment of a radiologist were noted. Results: A total of 90 patients were included, 51% had Simple Partial Seizure (SPS), 21% had Complex Partial Seizure and 28% had Generalized Tonic Clonic (GTC) type. No abnormality was found in 37.8% of the patients. Space occupying lesions were diagnosed in 24.4% of the patients, vascular lesions in eight patients, gliosis and encephalitis in seven patients each, tumours and trauma related lesions in six and four patients respectively. Half of all SPS were localised to the frontal lobe. CPS were similarly distributed in the frontal and occipital, had more than one lobe involvement and included bilateral cerebral hemispheres. GTC more commonly involved occipital lobe than frontal or parietal lobe. More than one lobe involvement or bilateral cerebral hemispheres were most common in GTC, as compared to SPS or CPS. Space occupying lesions manifested mainly as SPS or CPS, and none as GTC. Vascular lesions presented as partial seizures only. In those with a normal CT appearance, SPS was most common. Conclusions: CT scan provides an easier and cheaper means to diagnose a number of organic lesions which may cause seizure disorders
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Solitary fibrous tumour is an uncommon mesenchymal neoplasm diagnosis of which is difficult because of non-specific clinical and radiological features. A 76 year old male presented with complaints of nausea and vomiting. Physical examination revealed firm mass in the right hypochondrium and epigastrium. CT scan revealed a heterogeneous, lobed and some vascularized mass of size 17.6 x 12.8 cm, situated in the right lobe. After surgery the mass was found to measure 19 cm x 13 cm x 10 cm. Histopathological examination found the tumour cells to be strongly positive for vimentin and CD34, confirming our diagnosis. Microscopic examination revealed haphazard arrangement of spindle cells and collagen bundles between the tumour cells with mild nuclear pleomorphism, and the mitotic count was 0-1/10 high power field. The post-operative course was uncomplicated and the patient was discharged home. After 16 months of follow up examinations, there was no recurrence of disease, local or distant metastasis and the patient remained asymptomatic. The clinical presentation and the radiological imaging can be very non-specific. Suggestive features on CT scan are a single, large, well-circumscribed, heterogeneously enhancing hepatic mass.
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The present study demonstrates that curcumin acts as pro-oxidant and sensitizes human lung adenocarcinoma epithelial cells (A549) to apoptosis via intracellular redox status mediated pathway. Results indicated that curcumin induced cell toxicity (light microscopy and MTT assay) and apoptosis (AnnexinV-FITC/PI labeling and caspase-3 activity) in these cells. These events seem to be mediated through generation of reactive oxygen species (ROS) and superoxide radicals (SOR) and enhanced levels of lipid peroxidation. These changes were accompanied by increase in oxidized glutathione (GSSG), reduced glutathione (GSH) and -glutamylcysteine synthetase (-GCS) activity, but decrease in GSH/GSSG ratio. The induction of apoptosis and decrease in GSH/GSSG ratio was also accompanied by sustained phosphorylation and activation of p38 mitogen activated protein kinase (MAPK). On the other hand, addition of N-acetyl cysteine (NAC), an antioxidant, blocked the curcumin-induced ROS production and rescued malignant cells from curcumin-induced apoptosis through caspase-3 deactivation. However, L-buthionine sulfoximine (BSO), a GSH synthesis blocking agent, further enhanced curcumin-induced ROS production and apoptosis in A549 cells. Decreased GSH/GSSG ratio seems to be a crucial factor for the activation of MAPK signaling cascade by curcumin. The study therefore, provides an insight into the molecular mechanism involved in sensitization of lung adenocarcinoma cells to apoptosis by curcumin.
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Background & objectives: The prevalence of multidrug-resistant tuberculosis (MDR-TB) is increasing throughout the world. Although previous treatment for TB is the most important risk factor for development of MDR-TB, treatment-naïve patients are also at risk due to either spontaneous mutations or transmission of drug-resistant strains. We sought to ascertain the prevalence of MDR-TB among new cases of sputum-positive pulmonary TB. Methods: This was a prospective, observational study involving newly diagnosed cases of sputum-positive pulmonary tuberculosis diagnosed between 2008 and 2009 carried out in New Delhi, India. All sputum-positive TB cases were subjected to mycobacterial culture and first-line drug-susceptibility testing (DST). MDR-TB was defined as TB caused by bacilli showing resistance to at least isoniazid and rifampicin. Results: A total of 218 cases of sputum-positive pulmonary tuberculosis were enrolled between 2008 and 2009. Of these, 41 cases had negative mycobacterial cultures and DST was carried out in 177 cases. The mean age of the patients was 27.8 ± 10.2 yr; 59 patients (27%) were female. All patients tested negative for HIV infection. Out of 177 cases, two cases of MDR-TB were detected. Thus, the prevalence of MDR-TB among newly diagnosed pulmonary tuberculosis patients was 1.1 per cent. Interpretation & conclusions: MDR-TB prevalence is low among new cases of sputum-positive pulmonary TB treated at primary care level in Delhi. Nation-wide and State-wide representative data on prevalence of MDR-TB are lacking. Efforts should be directed towards continued surveillance for MDR-TB among newly diagnosed TB cases.