Twofold processing for denoising ultrasound medical images.

Ultrasound medical (US) imaging non-invasively pictures inside of a human body for disease diagnostics. Speckle noise attacks ultrasound images degrading their visual quality. A twofold processing algorithm is proposed in this work to reduce this multiplicative speckle noise. First fold used block based thresholding, both hard (BHT) and soft (BST), on pixels in wavelet domain with 8, 16, 32 and 64 non-overlapping block sizes. This first fold process is a better denoising method for reducing speckle and also inducing object of interest blurring. The second fold process initiates to restore object boundaries and texture with adaptive wavelet fusion. The degraded object restoration in block thresholded US image is carried through wavelet coefficient fusion of object in original US mage and block thresholded US image. Fusion rules and wavelet decomposition levels are made adaptive for each block using gradient histograms with normalized differential mean (NDF) to introduce highest level of contrast between the denoised pixels and the object pixels in the resultant image. Thus the proposed twofold methods are named as adaptive NDF block fusion with hard and soft thresholding (ANBF-HT and ANBF-ST). The results indicate visual quality improvement to an interesting level with the proposed twofold processing, where the first fold removes noise and second fold restores object properties. Peak signal to noise ratio (PSNR), normalized cross correlation coefficient (NCC), edge strength (ES), image quality Index (IQI) and structural similarity index (SSIM), measure the quantitative quality of the twofold processing technique. Validation of the proposed method is done by comparing with anisotropic diffusion (AD), total variational filtering (TVF) and empirical mode decomposition (EMD) for enhancement of US images. The US images are provided by AMMA hospital radiology labs at Vijayawada, India.

Microarchitecture of the Palatine Tonsil in Sheep (Ovis aries) / Microarquitectura de la Tonsila Palatina en Oveja (Ovis aries)

The tissue pieces of palatine tonsil were collected from different postnatal age groups of sheep from the Corporation Slaughter House, Perambur, Chennai. The palatine tonsil consisted of a surface epithelium, capsule, tonsillar lobes, crypts, crypt epithelium and tonsillar follicles. The surface epithelium over the palatine tonsil was made up of non-keratinized stratified squamous epithelium in all the postnatal age groups studied. The palatine tonsil was clearly demarcated from the surrounding structures by a distinct connective tissue capsule and one septa dividing the tonsil into two lobes. The surface epithelium was invaginated into the substance of the tonsil to form primary and secondary crypts in each lobe. The crypt epithelium covered the regions of lymphoid follicles became lymphoepithelium. The macrophages were also observed in the epithelium. In the areas of lymphoepithelium the basement membrane was interrupted since lymphocytic infiltration was heavy into the epithelium. Numerous secondary tonsillar follicles with germinal centers separated by interfollicular areas were observed in the palatine tonsil. The tonsillar follicles consisted of a mantle zone, which was heavily populated with small darkly stained lymphocytes. These mantle zones were always oriented towards the crypts. The tonsillar follicles of young sheep showed many medium and small sized lymphocytes, lymphoblasts and also reticulocytes. The reticular cells usually appeared larger than lymphocytes and had a more abundant and organized cytoplasm with vacuoles.

Fueron recolectadas piezas de tejido desde la tonsila palatina de ovejas con diferentes edades postnatales, desde la Corporación Slaughter House, Perambur, Chennai. La tonsila palatina consistía en un epitelio de superficie, cápsula, lóbulos de las tonsilas, criptas, epitelio de las criptas tonsilares y folículos. El epitelio superficial sobre la tonsila palatina estaba compuesto, en todos los grupos estudiados, de epitelio escamoso estratificado no-queratinizado. La tonsila palatina se delimitó claramente de las estructuras circundantes por un tejido conectivo capsular y un septo dividiendo la tonsila en dos lóbulos. El epitelio superficial se invaginó dentro de de la tonsila para formar criptas primarias y secundarias en cada lóbulo. El epitelio de las criptas cubrió las regiones de folículos linfoides transfomándose en linfoepitelo. También se observaron macrófagos en el epitelio. En las áreas de linfoepitelo la membrana basal estaba interrumpida por la infiltración linfocitaria y fue mayor en el epitelio. Fueron observados numerosos folículos tonsilares secundarios con centros germinales separados por áreas interfoliculares. Los folículos tonsilares consistían en una zona del manto que estaba densamente poblada con pequeños linfocitos intensamente teñidos. Estas zonas del manto se orientaron siempre hacia las criptas. Los folículos tonsilares de las ovejas jóvenes mostraron muchos linfocitos de tamaño medianos y pequeños, linfoblastos y también reticulocitos. Las células reticulares usualmente aparecían más grandes que los linfocitos y tenían un citoplasma más abundante y organizado con vacuolas.

Protective effect of an aphrodisiac herb Tribulus terrestris Linn on cadmium-induced testicular damage.

AIM: The aim of the present study was to investigate whether Tribulus terrestris Linn (TT) could protect the cadmium (Cd)-induced testicular tissue peroxidation in rats and to explore the underlying mechanism of the same. MATERIALS AND METHODS: In vitro and in vivo studies were conducted to know the protective effect of ethanolic extract of TT (eTT) in Cd toxicity. In in vitro studies, total antioxidant and ferrous metal ion chelating activity of TT was studied. In vivo studies were conducted in rats. A total of 40 Wistar strain adult male rats were divided into four groups. Group 1 served as control, while group 2 to 4 received CdCl(2) (3 mg/kg b. wt. s/c once a week). In addition to Cd, group 3 and 4 rats also received eTT (5 mg/kg b.wt. daily as oral gavage) and α-tocopherol (75 mg/kg daily by oral gavage), respectively. At the end of 6(th) week, all the rats were sacrificed and the separated testes were weighted and processed for estimation of tissue peroxidation markers, antioxidant markers, functional markers, and Cd concentration. The testes were also subjected to histopathological screening. RESULTS: In in vitro studies, the percentage of metal ion chelating activity of 50 µg/ml of eTT and α-tocopherol were 2.76 and 9.39, respectively, and the antioxidant capacity of eTT was equivalent to 0.063 µg of α-tocopherol/µg of eTT. In in vivo studies, administration of Cd significantly reduced the absolute and relative testicular weight, antioxidant markers such as superoxide dismutase and glutathione, and functional markers such as LDH and ALP, along with significant increase in peroxidation markers such as malondialdehyde and protein carbonyls in testicular tissue. Testes of Cd only-treated group showed histological insults like necrotic changes in seminiferous tubules and interstitium, shrunken tubules with desquamated basal lamina, vacuolization and destruction of sertoli cells, and degenerating Leydig cells. This group also had higher Cd levels in testicular tissue. Co-treatment with eTT and α-tocopherol significantly reduced the Cd burden in the testes along with reversal of the Cd-induced changes. CONCLUSIONS: eTT exhibited protective effect against Cd-induced testicular damage. The protective effect appears to be mediated through inhibition of testicular tissue peroxidation by antioxidant and metal chelator activity and also, may be indirectly by stimulating the testosterone production from Leydig cells.

Protective effect of alpha-tocopheral on biochemical and histological alterations induced by cadmium in rat testes.

Cadmium (Cd) is a potential environmental pollutant and causes severe damage to reproductive organs in adults including ovary and testes. Of all antioxidants alpha-tocopheral is considered to be most potent chain breaking antioxidant. Our aim was to study the effect of alpha-tocopheral on biochemical and histological alterations induced by Cd in testes of rats. Group 1 served as control, while groups 2 and 3 received subcutaneous injections of CdCl2 (3 mg/kg b.wt) once a week for four weeks. Group 3 in addition received alpha-tocopheral (75 mg/kg b.wt.) orally, daily for six weeks. Cadmium caused testicular tissue biochemical alterations such as significant increase in MDA, a peroxidation marker, decrease in antioxidant markers viz SOD, CAT and GSH and functional markers viz ALP and LDH. Histological alteration induced by Cd consisted of desquamation of basal lamina, shrunken tubules, generalized germ cell depletion with multinucleated gaint cells, degenerating Leydig cells, vascular congestion, interstitial edema and significant reduction in spermatodynamic count. Alpha-tocopheral significantly reversed all the Cd induced alterations. These results indicate that alpha-tocopheral has a protective effect against Cd indeed biochemical and histological alterations in rat testes.

Why treat? Better prevent: adult immunization.

Immunization is a safe, effective and simple way to prevent life threatening illnesses not only in children but also in adults. Vaccines are some of the safest medicines available which can relieve suffering costs related to these preventable diseases. The reason for underutilization of vaccines in adults are 1) Low prioritization of the importance of vaccines preventable diseases among adults 2) Uncertainty or lack of knowledge about the safety and efficacy 3) Lack of universal recommendations for all adults and 4) Financial constraints, especially in developing countries. Adult immunizations are administered in primary series like previously immunized, booster doses and periodic doses. Agents include Toxoids (Diphtheria and Tetanus), Live Virus Vaccines (Measles, Mumps and Rubella), and inactivated virus vaccines (Influenza), Inactive viral particles (Hepatitis B), inactivated bacterial polysaccharide vaccine (Pneumococcal) and Conjugate / Polysaccharide vaccine (Meningococcal). And also vaccines like Hepatitis A, Polio and Varicella may be recommended in some. Since the economy and literacy rate has shown a steady rise in the South Asia and people are being aware of different health problems through the recently advanced global communication, the education and awareness for immunization not only in children but also in adults need a special consideration. Keeping in view the statistical data of suffering costs related to the non-utilization of immunization in adults, the need of hour has come for utilization of immunization to emphasize its importance.

Diagnostic delay in a multi-organ tuberculosis immunocompetent patient: a case report.

A 67-year-old immunocompetent male presented with intermittent fever for 3 months associated with urinary incontinence, altered bowel habits and history of loss of appetite and weight. He was treated as having enteric fever at various clinics in the city by different physicians. On evaluation the patient was found to have disseminated tuberculosis with involvement of the lungs, eyes, testes, brain, bone, kidneys, liver, spleen and possibly the gastrointestinal tract. This paper reports a case of disseminated tuberculosis to many organs with significant diagnostic delay more than twelve decades after the discovery of the tuberculosis bacillus by Robert Koch.

Sarcoidosis--three clinical vignettes with a short review.

Sarcoidosis is a multi system disorder of unknown cause most commonly affecting the young and middle age adults and frequently presents bilateral hilar lymph-adenopathy. The diagnosis of sarcoidosis is often delayed following the onset of symptoms. The reason being first, the disease is often sub clinical; second as the disease affects any system, the diagnosis of sarcoidosis may not be considered; third, the symptoms are not disease specific hence often treated as other chronic pulmonary diseases; finally economic issues or barriers to access for further workup may affect the timeliness of the diagnosis. No laboratory diagnosis is specific for diagnosing sarcoidosis but histological confirmation from the lymph nodes accessible for biopsy either direct or by intervention may be more specific.

Interaction between warfarin and tamoxifen: a case report.

Warfarin is a commonly used anticoagulant with documented reports of drug interactions. Tamoxifen is used in the adjuvant hormonal treatment of women with oestrogen-receptor- positive breast cancer. Warfarin and tamoxifen are known to interact with each other with a resultant increase in the bleeding tendency. These reports are mainly from the white population. We report a case of drug interaction between warfarin and tamoxifen with an acute onset. This report suggests that when these drugs are co administered, careful monitoring of the coagulation profile is needed.

Drug induced hepatitis with anti-tubercular chemotherapy: challenges and difficulties in treatment.

Tuberculosis is a major health burden worldwide. In Nepal, it is a significant cause of morbidity and mortality. Although better drugs are available for managing tuberculosis, treatment failure is one of the common problems encountered. Among the various causes which can cause treatment interruption, drug induced hepatotoxicity is a common cause. Isoniazid and Pyrazinamide are the common drugs causing hepatotoxicity. Upon occurrence of hepatotoxicity, the hepatotoxic drugs should be stopped and reintroduced as per the available guidelines. The healthcare professional should also counsel the patients for recognizing the early symptoms due to hepatotoxicity which could prevent morbidity.