Role of CT Perfusion in Identifying the Core and the Potentially Salvageable Penumbra in Patients with Acute Non Haemorrhagic Stroke - Experience at Tertiary Care Center.

OBJECTIVES: To evaluate the role of CT Perfusion in Identifying the core and the potentially salvageable penumbra in brain infarcts by observing perfusion maps (CBV, CBF and MTT). Also to identify patients who would benefit from reperfusion therapy and to evaluate the feasibility of identifying the penumbra on noncontrast CT vide comparison with perfusion maps. MATERIALS AND METHODS: A prospective study of 50 patients who presented with acute onset neurological deficit within 6 hours of symptom onset and in whom initial NCCT revealed no evidence of cerebral hemorrhage; evaluated with CT Perfusion was done at tertiary care center in 1 calender year 2014. OBSERVATIONS: In our study, about 68 percent of patients presented within 6 hours of stroke had salvagebale penumbra, were eligible for revascularization therapy. HU less than 25 on NECT significantly correlated with infract core but not with presence of Penumbra. Presence of penumbra cannot be predicted from NECT ASPECT and CBV ASPECT Score. RESULTS AND CONCLUSION: CT Perfusions study being easily available, faster and cost effctive modality to identfy patients of acute ischemic strokes having salvagable penumbra for which further can be subjected to revasculrization therapy. It is strongly recommended that CT Perfusion should be made an integral part of acute non-haemorrhagic stroke management protocol, wherever the facility is available.

Development and validation of a noncontact spectroscopic device for hemoglobin estimation at point-of-care.

Anemia severely and adversely affects human health and socioeconomic development. Measuring hemoglobin with the minimal involvement of human and financial resources has always been challenging. We describe a translational spectroscopic technique for noncontact hemoglobin measurement at low-resource point-of-care settings in human subjects, independent of their skin color, age, and sex, by measuring the optical spectrum of the blood flowing in the vascular bed of the bulbar conjunctiva. We developed software on the LabVIEW platform for automatic data acquisition and interpretation by nonexperts. The device is calibrated by comparing the differential absorbance of light of wavelength 576 and 600 nm with the clinical hemoglobin level of the subject. Our proposed method is consistent with the results obtained using the current gold standard, the automated hematology analyzer. The proposed noncontact optical device for hemoglobin estimation is highly efficient, inexpensive, feasible, and extremely useful in low-resource point-of-care settings. The device output correlates with the different degrees of anemia with absolute and trending accuracy similar to those of widely used invasive methods. Moreover, the device can instantaneously transmit the generated report to a medical expert through e-mail, text messaging, or mobile apps.

Relevance of risk factors of breast cancer in women: An Eastern Indian scenario.

AIMS AND OBJECTIVE: Incidence of breast cancer is on the rise in developed as well as in developing countries. In India it has superseded cervical cancer as the commonest malignancy in women in urban areas. A lot of risk factors have been proposed from time to time that play a causative role in the natural course of this disease. However, they are based on data accumulated from studies conducted mostly in developed countries. Aim of this study was to find out whether these known and/or presumptive breast cancer risk factors hold true for women of developing countries like India also. MATERIALS AND METHODS: From 2008 to 2012; 1,463 breast cancer patients were compared side by side with 1,440 matched controls by predetermined questionnaire and anthropometric variables. Data were analyzed by Statistical Package for Social Sciences (SPSS) V19 software todetermine whether selected risk factors were more common in the patient group than the control group. RESULTS AND ANALYSIS: The risk factors under study were also found to be statistically significant for the study populationexcept duration of breastfeeding and family history of breast and ovarian cancers. CONCLUSION: Risk factors for breast cancer do not differ significantly between developed and developing countries. Hence appropriate time has come for developing countries to incorporate breast cancer risk factors in health education and to consider pharmacological interventions in high risk women.

Ectopic Pregnancy in caesarean section scar: A case report.

We report a rare case of ectopic pregnancy occurring in the scar of a previous caesarean section, diagnosed by ultrasonography and confirmed by 3.0-T magnetic resonance imaging of pelvis. We present the clinical details and imaging findings, followed by discussion of the etiology, pathogenesis, and imaging of this condition.

Incidence of BCR-ABL transcript variants in patients with chronic myeloid leukemia: Their correlation with presenting features, risk scores and response to treatment with imatinib mesylate.

CONTEXT: The exact role of the different transcript variants of BCR-ABL in the pathogenesis of chronic myeloid leukemia (CML) and their impact on prognosis is yet to be definitely enumerated. AIMS: In this study, we have tried to correlate the presenting features, risk scores and treatment response with the BCR-ABL variants detected in our patients. SETTINGS AND DESIGN: A cross-sectional unicentric hospital-based study on 80 patients diagnosed to have CML by bone marrow cytogenetics and confirmed by reverse transcriptase-polymerase chain reaction (RT-PCR). MATERIALS AND METHODS: RT-PCR for BCR-ABL was performed on consecutive patients with CML attending the CML clinic from January 2010 to December 2010. The medical charts of these patients were analyzed after a follow-up of 18 months in a retrospective manner. STATISTICAL ANALYSIS: Box plot and histogram was used to see the distribution of variables. t-test was performed to enumerate the difference between risk scores in two populations of patients carrying two different BCR-ABL transcript variants. RESULTS: Nearly 56.25% of patients had b3a2 (e14a2) while 41.25% of patients showed b2a2 (e13a2) transcripts. The rest 2.5% (two patients) expressed the rare e19b2 variant. Patients with b2a2 presented with higher Sokal, Hasford and European Treatment and Outcomes Study score than their b3a2 counterpart. Different parameters such as the platelet count, leukocyte count, hemoglobin and splenomegaly showed a minor difference between the groups. More patients in the b2a2 group achieved complete hematologic response at 3 months, but it was not significant. CONCLUSIONS: Patients with b2a2 variant CML tend to present with higher risk score, but do not behave in a vastly different manner than their b3a2 counterparts.