Multimodality Imaging Approach For The Early Diagnosis Boerhaave Syndrome.

Boerhaave's syndrome is a spontaneous transmural rupture or perforation of the oesophagus or post-emesis oesophageal rupture. Boerhaave's syndrome has a high risk of morbidity and mortality, and early, definitive diagnosis leading to prompt management improves outcomes. Definitive diagnosis of this syndrome is made with imaging, including x-ray, USG and computed tomography Scan. This is a case of a 50-year male with history of sudden onset of epigastric pain after an episode of forceful emesis was referred for Ultrasound (USG) abdomen. His USG examination demonstrated fluid collection with internal free floating and linear echoes in left pleural cavity consistent with hemo-pneumothorax his further imaging workup was done with suspicious of Boerhaave's Syndrome which conformed the suspected diagnosis.

MRI Findings In Acute Wernicke's Encephalopathy, Caused By Hyperemesis Gravidarum.

A 25-year old pregnant female with history of confusion and drowsiness for 02 days was referred by neurophysician for MRI brain. MRI demonstrated T2W/FLAIR hyper intensities in medial thalami, periaqueductal areas with variable diffusion restriction, apparent as hyper intense signal on DWI and no signal change on ADC mapping that was typically consistent with Wernicke's encephalopathy. A high index of suspicion is necessary, as delayed or lack of treatment can lead to high morbidity and mortality.

CAN ULTRASOUND ABDOMEN HELP IN EARLY DIAGNOSIS OF DIABETES MELLITUS? AN OBSERVATIONAL STUDY.

BACKGROUND: Diabetes mellitus is a common disease. Similarly, ultrasound findings of fatty change and renal crystals are commonly seen on ultrasound. In the personal observation of the main author over the past so many years it was noticed that Diabetes Mellitus, Fatty liver and renal crystals all sit well together. This study tries to establish a relationship between diabetes mellitus renal echogenic foci and fatty liver. This study is first of its kind, as nobody has ever before investigated an association between the renal echogenic foci and fatty liver in relation to diabetes mellitus. METHODS: This cross-sectional, observational study was conducted at Radiology Department Combined Military Hospital, Kohat From 2nd June 2013 to 30th May 2014. Three hundred patients were collected on the basis of having fatty liver and renal echogenic foci on ultrasound and three hundred more patients were collected who had no fatty liver or renal echogenic foci on ultrasound. Their labs were done for diabetes mellitus. RESULTS: The patients having renal echogenic foci together with fatty liver had 83% positive rate of being diabetics, while patients with no fatty liver and no echogenic foci on ultrasonography had only 0.6% Positive rate of being diabetics. CONCLUSION: Our results provided the first demonstration of an association between renal echogenic foci together with fatty liver with the diabetes mellitus. Thus ultrasound examination of abdomen can be helpful in its early diagnosis if we make a protocol of doing fasting and random blood sugars in all those patients who have positive renal echogenic foci and fatty liver on their ultrasound examination.

1-(2-(2-(2-(1-Aminoethyl)phenyl)diselanyl)phenyl)ethanamine: an amino organoselenium compound with interesting antioxidant profile.

Free radical scavenging and antioxidant activities of 1-(2-(2-(2-(1-aminoethyl)phenyl)diselanyl)phenyl)ethanamine (compound A) and diphenyl diselenide (PhSe)2 were examined and compared for inhibition of Fe(II) and sodium nitroprusside (SNP) stimulated lipid peroxidation in rat brain, interaction with 1,1-diphenyl-2-picrylhydrazyl (DPPH) stable free radical and their glutathione peroxidase (GPx) like antioxidant activities with H2O2 or tBuOOH as substrates and with PhSH as thiol co-substrates as well as their ability to oxidize mono- and di-thiols were also evaluated. This study revealed that an amino group in amino diselenide drastically enhances their catalytic activities in the aromatic thiol (PhSH) assay system. Compound A was ~2-fold more active than (PhSe)2 in both tBuOOH and H2O2 assay systems. In addition, the present results showed that (PhSe)2 exhibited an increased ability to oxidize di-thiols, compound A was not a good substrate for the oxidation of thiol used namely DTT, cystine and DMPS. The antioxidant potency against Fe(II) and SNP-induced brain TBARS were in this order [(compound A); IC50 2 µM and 4 µM]>[(PhSe)2; IC50 19 µM and 27.5 µM. Compound A showed DPPH radical-scavenging activity. This study provides in vitro evidence anti-oxidant action of the tested organoselenium compounds, that the nitrogen atom in the organochalcogens can have a profound effect on their antioxidant activity.

Caffeic acid treatment alters the extracellular adenine nucleotide hydrolysis in platelets and lymphocytes of adult rats.

This study evaluated the effects of caffeic acid on ectonucleotidase activities such as NTPDase (nucleoside triphosphate diphosphohydrolase), Ecto-NPP (nucleotide pyrophosphatase/phosphodiesterase), 5'-nucleotidase and adenosine deaminase (ADA) in platelets and lymphocytes of rats, as well as in the profile of platelet aggregation. Animals were divided into five groups: I (control); II (oil); III (caffeic acid 10 mg/kg); IV (caffeic acid 50 mg/kg); and V (caffeic acid 100 mg/kg). Animals were treated with caffeic acid diluted in oil for 30 days. In platelets, caffeic acid decreased the ATP hydrolysis and increased ADP hydrolysis in groups III, IV and V when compared to control (P<0.05). The 5'-nucleotidase activity was decreased, while E-NPP and ADA activities were increased in platelets of rats of groups III, IV and V (P<0.05). Caffeic acid reduced significantly the platelet aggregation in the animals of groups III, IV and V in relation to group I (P<0.05). In lymphocytes, the NTPDase and ADA activities were increased in all groups treated with caffeic acid when compared to control (P<0.05). These findings demonstrated that the enzymes were altered in tissues by caffeic acid and this compound decreased the platelet aggregation suggesting that caffeic acid should be considered a potentially therapeutic agent in disorders related to the purinergic system.

Effects of caffeic acid on behavioral parameters and on the activity of acetylcholinesterase in different tissues from adult rats.

Acetylcholinesterase (AChE) is distributed throughout the body in both neuronal and non-neuronal tissues and plays an important role in the regulation of physiological events. Caffeic acid is a phenolic compound that has anti-inflammatory and neuroprotective properties. The aim of this study was to investigate in vitro and in vivo whether caffeic acid alters the AChE activity and behavioral parameters in rats. In the in vitro study, the concentrations of 0, 0.1, 0.5, 1.0, 1.5, and 2mM of caffeic acid were used. For the in vivo study, five groups were evaluated: group I (control); group II (canola oil), group III (10mg/kg of caffeic acid); group IV (50mg/kg of caffeic acid) and group V (100mg/kg of caffeic acid). Caffeic acid was diluted in canola oil and administered for 30 days. In vitro, the caffeic acid increased the AChE activity in the cerebral cortex, cerebellum, hypothalamus, whole blood, and lymphocytes at different concentrations. In muscle, this compound caused an inhibition in the AChE activity at concentrations of 0.5, 1.0, 1.5, and 2mM when compared to the control (P<0.05). In vivo, 50 and 100mg/kg of caffeic acid decreased the AChE activity in the cerebral cortex and striatum and increased the activity of this enzyme in the cerebellum, hippocampus, hypothalamus, pons, lymphocytes, and muscles when compared to the control group (P<0.05). The amount of 100mg/kg of caffeic acid improved the step-down latencies in the inhibitory avoidance. Our results demonstrated that caffeic acid improved memory and interfered with the cholinergic signaling. As a natural and promising compound caffeic acid should be considered potentially therapeutic in disorders that involve the cholinergic system.

Fe(II) and sodium nitroprusside induce oxidative stress: a comparative study of diphenyl diselenide and diphenyl ditelluride with their napthyl analog.

Here, we compare the influence of molecular structural modifications of diphenyl diselenide (DPDS) and diphenyl ditelluride (DPDT) with their naphthalene analogs, 1-dinapthyl diselenide (1-NapSe)2, 2-dinapthyl diselenide (2-NapSe)2, 1-dinapthyl distelluride (1-NapTe)2, and 2-dinapthyl ditelluride (2-NapTe)2. Fe(II)-induced hepatic thiobarbituric acid reactive species (TBARS) was in the order [(2-NapTe)2] > [(2-NapSe)2] > [(DPDS)] > [(1-NapSe)2] > [(1-NapTe)2]> [(DPDT)]. For sodium nitroprusside (SNP)-induced hepatic TBARS, the order was [(2-NapTe)2] > [(DPDT)] > [(1-NapSe)2] > [(2-NapSe)2] > [(1-NapTe)2] > [(DPDS)]. For Fe(II) and SNP-induced renal TBARS, the orders were [(2-NapTe)2] > [(1-NapTe)2] = [(DPDT)] > [(1-NapSe)2] > [(2-NapSe)2] > [(DPDS)] and [(2-NapTe)2] > [(1-NapTe)2] > [(1-NapSe)2] > [(2-NapSe)2] > [(DPDS)] > [(DPDS)], respectively. The present investigation shows that DPDS was less potent and the change in the organic moiety from an aryl to napthyl group dramatically changed the potency of diselenides. These results suggest that minor changes in the organic moiety of aromatic diselenides can profoundly modify their antioxidant properties. In view of the fact that the pharmacological properties of organochalcogens are linked, at least in part, to their antioxidant properties, it becomes important to explore the pharmacological properties of dinaphtyl diselenides and ditellurides.