MRI findings in tubercular radiculomyelitis.

This article aims to familiarize the reader with the MR imaging findings of tubercular radiculomyelitis (TBRM) and to identify the sources of infection. We evaluated 29 patients on a 1.5 T GE MRI in a cross-sectional study. MRI of the spine with contrast and lumbar puncture were performed in all patients. MRI brain was performed for 13 patients. The typical and atypical manifestations enlisted in this article, will enable early detection of TBRM when the clinical history is ambiguous, as TBRM can present with low backache in both retrovirus positive and negative patients.

Ultrasonographic assessment of skeletal muscle mass and diaphragm function in patients with chronic obstructive pulmonary disease: A case-control study.

BACKGROUND: Although muscle dysfunction is a major contributor to morbidity in chronic obstructive pulmonary disease (COPD), assessment of skeletal muscle, and diaphragm function is not routinely performed in COPD patients. OBJECTIVES: (1) The aim is to assess muscle dysfunction in COPD by measuring the zone of apposition of diaphragm, diaphragm excursion, thickness of diaphragm, and rectus femoris cross-sectional area (RFCSA) with ultrasonography.(2) To correlate the above assessments with spirometric parameters; notably forced expiratory volume in 1 s (FEV1). METHODS: Twenty-four consecutive stable COPD patients and 18 controls were included after obtaining written informed consent. Demographic and clinical data, spirometric values, 6-min walk distance, and sonographic parameters mentioned above were compiled for the analysis. RESULTS: All included participants were male with a mean age of 62.5 ± 8.4 years. The mean FEV1in cases was 1.12 ± 0.4 L versus 2.41 ± 0.5 L in controls. The diaphragm thickness (1.8 ± 0.5 mm vs. 2.2 ± 0.6 mm;P = 0.005) and RFCSA was significantly lower in COPD patients (4.8 ± 1.3 cm[2] vs. 6.12 ± 1.2 cm[2];P = 0.02). However, diaphragm excursion (5.35 ± 2.8 cm vs. 7 ± 2.6 cm) although lower in COPD patients, was not significantly different between the groups. Correlation between FEV1and ultrasound diaphragm measurements and RFCSA by Spearman's Rho correlation was poor (ρ= 0.2). CONCLUSION: Ultrasonographic assessment of the diaphragm and rectus femoris can be used as markers to assess skeletal muscle dysfunction in COPD as diaphragmatic function and RFCSA were lower in COPD patients.

Glypican-3 mRNA expression level in Wilms tumor: correlation with histological type, stage, and outcome.

PURPOSE: To correlate expression of Glypican-3 in Wilms tumor with histopathology, stage, and outcome. METHODS: Glypican-3 mRNA expression by real-time PCR on tumor and normal germline samples from 75 fresh nephrectomies for Wilms tumor with fold change after normalization against GAPDH was compared. Survival analysis for event-free and overall survival (EFS, OS) with 2-year follow-up for Glypican-3 overexpression (>1.5 times) and clinicopathological parameters was performed. RESULTS: Glypican-3 was overexpressed in 37/75 (49.3%). It was overexpressed in 77% (10/13) cases with blastema predominance or anaplastic histology, as compared to 44% of other histologies (27/62) (p = 0.03). OS was 73 and 93%, respectively (p = 0.016), for those with and without GPC-3 overexpression. EFS was not significantly different with Glypican-3 overexpression (p = 0.11). All 5 deaths among blastema predominant tumors and 4/5 deaths among triphasic tumors had overexpressed Glypican-3. Most deaths in Stage IV, Stage III, and Stage I + II (5/7, 3/3, 1/1) had GPC-3 overexpression. On multivariate analysis, only histology and stage were found to have independent prognostic value. CONCLUSION: Glypican-3 overexpression in Wilms tumor correlates with poor OS on univariate analysis. However, only histology and stage have independent prognostic value. Glypican-3 levels may help to stratify intermediate outcome histology (triphasic) and Stage III Wilms tumors.

Afferent loop syndrome in a patient having incomplete annular pancreas.

Afferent loop syndrome is a rare complication following a Billroth II procedure and is seen in 3/1000 cases. This case report shows the importance of radiological imaging in a patient with a past history of abdominal surgery, for which no records were available. Imaging showed incomplete annular pancreas, leading to narrowing of the second part of the duodenum, which was the indication for gastrojejunostomy in the past, now presenting with features of afferent loop syndrome.

Ureteral Reflux into an Ectopic Upper Moeity of a Duplex Kidney from the Bladder Neck with Distal Ureteral Pseudodiverticulum Formation.

Urinary incontinence is a condition causing significant psychological trauma and affects the quality of life of the affected individual. Though common causes of urinary incontinence of non-traumatic aetiology in young adults include detrusor instability and congenital conditions like meningomyelocoele, an ectopic ureter is an important surgically correctable cause of urinary incontinence. The cause of incontinence in an ectopic ureter is insertion of the ureter distal to the internal urethral sphincter. The authors describe a case report of an ectopic ureter arising from a duplex moiety with poor renal function using multiple modalities. This highlights the utility of multiple modalities in arriving at an accurate diagnosis, with adequate clinically useful information. In this case, the formation of a pseudo-diverticulum resulted in diagnostic confusion.

Process optimization for a nutritious low-calorie high-fiber whey-based ready-to-serve watermelon beverage.

Whey is a nutritious by product of some traditional Indian processed milk products and it needs to be utilized in an effective way in order to reduce environmental hazards associated with its untreated disposal. Low calorie watermelon beverage appears to be a simple, attractive and economic method of whey disposal. The experiment was designed by Central Composite Rotatable Design of Responce Surface Methodology. Three independent variables whey, Innova ® fiber and sucralose were chosen at five levels within the respective ranges of 40-60 %, 2.0-5.0 % and 0.01-0.03 %. The effect of the variables on flavour, mouthfeel, after-taste, viscosity, total soluble solids (all to be maximized) and sedimentation (to be minimized) was observed. These three were the independent variables whose effect on flavour, mouthfeel, after-taste, viscosity, total soluble solids (all to be maximized) and sedimentation (to be minimized) were evaluated. Quadratic model fitted well to all dependent variables. The R(2) values for flavour, mouthfeel, aftertaste, viscosity, sedimentation and TSS were 95.57, 98.71, 95.50, 97.87, 99.26 and 98.17 %, respectively. Response surface methodology was used to optimize the level of processing parameters. Maximum scores for flavour (7.46), mouthfeel (7.49), after-taste (7.72), viscosity (13.55 cp) and total soluble solid (15.34°Brix) and minimum score for sedimentation (1.55 ml/10 ml) were obtained when the formulation contained 51.46 % whey, 3.84 % Innova® fiber and 0.021 % sucralose.

Influence of skin-to-muscle and muscle-to-bone thickness on depth of needle penetration in adults at the deltoid intramuscular injection site.

BACKGROUND: THE OBJECTIVES OF THE STUDY WERE TO ESTIMATE THE FOLLOWING IN ADULTS OF INDIAN ORIGIN: a) Gender and side differences in the skin-to-muscle (SM) and muscle-to-bone thickness (MB) at the deltoid intramuscular injection site; b) Correlation of SM thickness with the BMI, age and gender; c) The prevalence of under and over-penetration assuming a standard needle length of 25 mm and following prescribed guidelines for IM injection. METHODS: The SM, MB and skin-to-bone (SB) thicknesses were bilaterally estimated in two hundred adult Indian subjects (100 male and 100 female) using an ultrasound probe at a pre-determined point on the upper arms of the subjects. The BMI of each subject was calculated. The unpaired sample 't' test and paired 't' test were used to analyse differences between groups. Pearson's correlation coefficient was used in correlation analysis and suitable linear regression equations were generated. RESULTS: Females had a significantly higher SM thickness and lower MB thickness. The SM thickness was significantly greater on the left side, while the SB and MB thickness were significantly greater on the right. Multiple linear regression equations for both the dominant and non-dominant arms had good model fit properties. Under-penetration would have occurred in 2 (1%) subjects while over-penetration would have occurred in 50% of the subjects. CONCLUSION: Over-penetration of deltoid IM injections is likely to be more prevalent as compared to under-penetration. Therefore, the technique of IM injection needs to be modified based on the body type of the individual patient.

Process optimization for enzyme aided clarification of watermelon juice.

Watermelon juice was exposed to the enzyme masazyme at varying enzyme concentrations (0.01-0.1 % w/w) and different time (20-120 min) and temperature (30-50 °C) combinations. The effects of the treatments on selected responses (juice recovery, total dissolved solids (TDS), viscosity, turbidity, cloud stability and L value) were determined employing a second order Box Behnken Design in combination with Response Surface Methodology. Enzymatic treatment effectively degraded polysaccharides, resulting in reduced viscosity, turbidity and absorbance value and increased juice recovery, total dissolved solids and lightness. R(2) value for all models for the dependent variables were greater than 90 %. The maximum juice recovery (86.27 %), TDS (8.7°Brix) and L value (17.57) while minimum viscosity (0.0020 Pa.s.), turbidity (39.37 NTU) and cloud stability (0.033 abs) were obtained when enzyme treatment was set up with 0.09 % w/w enzyme concentration at 46.90 °C and 117.45 min.