Performance Evaluation of High-Resolution Ultrasound versus Magnetic Resonance Imaging in Diagnosing Peripheral Nerve Pathologies.

Background High-resolution ultrasound (HRUS) and magnetic resonance neurography (MRN) are considered complementary to clinical and neurophysiological assessment for neuropathies. Aims The aim of our study was to compare the accuracy of HRUS and MRN for detecting various peripheral nerve pathologies, to choose the correct investigation to facilitate prompt patient management. Materials and Methods This prospective study was done using HRUS with 14 MHz linear-transducer and 3 or 1.5T MR in cases referred for the assessment of peripheral nerve pathologies. Image interpretation was done using a scoring system (score 0-3 confidence level) to assess for nerve continuity/discontinuity, increased nerve signal/edema, fascicular change, caliber change, and neuroma/mass lesion. We determined the accuracy, sensitivity, and specificity of these modalities compared with the diagnostic standard determined by surgical and/or histopathological, if not performed then clinical and/or electrodiagnostic evaluation. Results The overall accuracy of MRN was 89.3% (specificity: 66.6%, sensitivity: 92.6%, negative predictive value [NPV]: 57.1%, positive predictive value [PPV]: 95%) and that of HRUS was 82.9% (specificity: 100%, sensitivity: 80.4%, NPV: 42.8, PPV: 100). The confidence level for detecting nerve discontinuity and change in nerve caliber was found to be higher on ultrasonography than magnetic resonance imaging (MRI) (100 vs. 70% and 100 vs. 50%, respectively). Pathology of submillimeter caliber nerves was accurately detected by HRUS and these could not be well-visualized on MRI. Conclusion HRUS is a powerful tool that may be used as the first-line imaging modality for the evaluation of peripheral nerve pathologies, and a better means of evaluation of peripheral nerves with submillimeter caliber.

Insights into the chemical composition and bioactivities of citrus peel essential oils.

Citrus peel (CP), a by-product of the citrus fruit processing, comprises nearly forty to fifty percent of the fruit portion. Interestingly, the essential oil (EO) is primarily concentrated in the peel portion of the citrus fruit. Extraction of CP essential oil (CPEO) is an effective way of utilizing the citrus fruit processing waste. The CPEO can be more efficiently recovered from CP waste by improving the efficiency of conventional extraction processes. The main components of CPEO include monoterpenes, sesquiterpenes and their oxygenated derivatives. Specifically, limonene is the major oil component identified in the peel of different citrus species. The health promoting biological activities of CPEO are functioning as antioxidant, anti-inflammatory, analgesic, antimicrobial and anticancer agents, thereby can be used as a source of functional components and preservatives for the development of nutritionally safe newer food products. This paper provides an in-depth knowledge about the chemical constituents and bioactivities of EOs extracted from peels of different citrus species.

Quantitative Evaluation of the Diffusion Tensor Imaging Matrix Parameters and the Subsequent Correlation with the Clinical Assessment of Disease Severity in Cervical Spondylotic Myelopathy.

STUDY DESIGN: We performed a prospective observational study of 52 patients who were clinically suspected of cervical spondylotic myelopathy (CSM), based on the modified Japanese Orthopaedic Association (mJOA) score, and were referred for magnetic resonance imaging (MRI) of the cervical spine. PURPOSE: To evaluate the quantitative parameters of the diffusion tensor imaging (DTI) matrix (fractional anisotropy [FA] and apparent diffusion coefficient [ADC] values) and determine the subsequent correlation with the clinical assessment of disease severity in CSM. OVERVIEW OF LITERATURE: Conventional MRI is the modality of choice for the identification of cervical spondylotic changes and is known to have a low sensitivity for myelopathy changes. DTI is sensitive to disease processes that alter the water movement in the cervical spinal cord at a microscopic level beyond the conventional MRI. METHODS: DTI images were processed to produce FA and ADC values of the acquired axial slices with the regions of interest placed within the stenotic and non-stenotic segments. The final quantitative radiological derivations were matched with the clinical scoring system. RESULTS: Total 52 people (24 men and 28 women), mean age 53.16 years with different symptoms of myelopathy, graded as mild (n=11), moderate (n=25), and severe (n=16) as per the mJOA scoring system, underwent MRI of the cervical spine with DTI. In the most stenotic segments, the mean FA value was significantly lower (0.5009±0.087 vs. 0.655.7±0.104, p<0.001), and the mean ADC value was significantly higher (1.196.5±0.311 vs. 0.9370±0.284, p<0.001) than that in the non-stenotic segments. The overall sensitivity in identifying DTI metrics abnormalities was more with FA (87.5%) and ADC (75.0%) than with T2 weighted images (25%). CONCLUSIONS: In addition to the routine MRI sequences, DTI metrics (FA value better than ADC) can detect myelopathy even in patients with a mild grade mJOA score before irreversible changes become apparent on routine T2 weighted imaging and thus enhance the clinical success of decompression surgery.

Phenolic composition, antioxidant potential and health benefits of citrus peel.

Citrus peel (CP) forms around 40-50% of the total fruit mass but is generally thought to be a waste. However, it is a substantial source of naturally occurring health enhancing compounds, particularly phenolic compounds and carotenoids. Phenolic compounds in CP mainly comprise phenolic acids (primarily caffeic, p-coumaric, ferulic and sinapic acid), flavanones (generally naringin and hesperidin) and polymethoxylated flavones (notably nobiletin and tangeretin). It has also been noted that CP's contain more amounts of these compounds than corresponding edible parts of the fruits. Phenolic compounds present in CP act as antioxidants (by either donation of protons or electrons) and protect cells against free radical damage as well as help in reducing the risk of many chronic diseases. Owing to the more abundance of polyphenols in CP's, their antioxidant activity is also higher than other edible fruit parts. Therefore, peels from citrus fruits can be used as sources of functional compounds and preservatives for the development of newer food products, that are not only safe but also have health-promoting activities. The present review provides in-depth knowledge about the phenolic composition, antioxidant potential and health benefits of CP.

Physicochemical evaluation of corn extrudates containing varying buckwheat flour levels prepared at various extrusion temperatures.

This study analyzed the characteristics (physicochemical properties as well as antioxidant activity) of corn grit extrudates containing buckwheat flour at various levels (0, 10, 20 and 30% w/w) extruded at various temperatures (130, 150 and 170 °C). Effect of roasting (92 °C for 15 min) on the extrudates was also studied. Buckwheat incorporation at different levels mainly increased the diameter, a* value (indicating redness), phenolic content and antioxidant capacity, while decreased bulk density and water absorption index of the extruded products. On the other hand, increment in extrusion temperature primarily increased the L* values (lightness), a* values and antioxidant activity but decreased the phenolic content of extrudates. Roasting improved the flavor and texture of the extrudates which was desirable. Extrudates prepared from corn grit with incorporation of buckwheat up to 20% level and extrusion cooking at 150 °C showed best sensory scores.

Effect of chickpea and spinach on extrusion behavior of corn grit.

The present work was carried out to see the effect of blending of corn grit (CG) with varying levels of chickpea grit (CP 0-100%) and spinach leaf powder (SP 0-6%) on the characteristics [color, expansion, density, hardness, water absorption index, total phenolic content (TPC), antioxidant activity (AOA; as DPPH and ABTS free radical scavenging activities)] and sensory properties of extrudates. CP and SP were rich in proteins and minerals (Cu, Fe, Zn, Mg, Ca, K and Na). Their blending significantly influenced the physicochemical and antioxidant properties of CG extrudates. TPC and AOA of extrudates increased with the increased incorporation of CP and SP, though specific mechanical energy and extrudate expansion, generally, decreased while density and hardness increased. Sensory analysis revealed that CP and SP at incorporation levels of 25% and 4%, respectively could be blended with CG for making highly acceptable antioxidant-rich expanded snack.

Spondyloarthropathy - Is sacroiliac joint imaging sufficient? A study of 431 patients.

BACKGROUND: Sacroiliac (SI) joint involvement (sacroiliitis) is considered as major criteria for diagnosing Spondyloarthropathy (SpA), although involvement of spine and hip can also occur. The aim of our study was to assess the utility of including sagittal short-tau inversion recovery (STIR) sequence of dorsolumbar spine and coronal STIR/proton density (PD) fat saturated sequence through both hips, to routine SI joint magnetic resonance (MR) imaging protocol, in patients clinically suspected to have SpA. MATERIAL AND METHODS: A retrospective observational study was conducted between February 2013 and February 2018 on clinically suspected SpA patients referred to our department for imaging. The images obtained using this new SI joint protocol were evaluated for findings suggesting SpA diagnosis as per the Assessment of SpondyloArthritis international Society criteria. Other differentials for similar symptoms were also looked for. RESULTS: Of the 431 patients (313 M and 118 F), 255 had features confirming the diagnosis of SpA and 176 had no radiological manifestations of SpA (56 were normal and 120 had other findings to suggest clinical symptoms; e.g., degenerative SpA, Pott's spine, skeletal metastases, early AVN of hip, cysticercus, iliofemoral impingement). 19/255 patients had normal SI joints but other findings to suggest diagnosis of SpA, e.g. romanus lesions, costovertebritis/costotransversitis, pubic symphysitis, inflammatory hip arthropathy, enthesitis, iliofemoral/trochanteric bursitis. 33/61 patients with chronic sacroiliitis had disease activity in spine or hip. CONCLUSION: Inclusion of sections through dorsolumbar spine and both hips to routine SI joint protocol, helped in identifying: (a) early disease in 19 patients, who had normal SI joints and may have otherwise been missed with routine only SI joint imaging, (b) additional findings in SpA-related sacroiliitis, (c) disease activity in chronic sacroiliitis, and (d) other causes of low back pain and thus helped in further patient management.

Phenolic compounds as beneficial phytochemicals in pomegranate (Punica granatum L.) peel: A review.

Pomegranate peel (PoP), a juice byproduct often considered as a waste, comprises nearly around 30-40% portion of the fruit. Phenolic compounds (one class of bioactive phytochemicals) are primarily concentrated in the peel portion of pomegranate fruit. In PoP, the main phenolic compounds reported in the literature include flavonoids (anthocyanins such as pelargonidin, delphinidin, cyanidin along with their derivatives and anthoxanthins such as catechin, epicatechin and quercetin), tannins (ellagitannins and ellagic acid derivatives such as punicalagin, punicalin and pedunculagin) and phenolic acids (such as chlorogenic, caffeic, syringic, sinapic, p-coumaric, ferulic, ellagic, gallic and cinnamic acid). It is generally accepted that phenolic compounds can be more efficiently recovered from PoP by improving the extraction efficiency. The curative relevance of these compounds has been mainly assessed by in vitro experimentation. Therefore, conclusive clinical trials of the phenolic compounds present in PoP are essential for correct validation of their health benefits.

Phenolic composition and antioxidant potential of grain legume seeds: A review.

Legumes are a good source of bioactive phenolic compounds which play significant roles in many physiological as well as metabolic processes. Phenolic acids, flavonoids and condensed tannins are the primary phenolic compounds that are present in legume seeds. Majority of the phenolic compounds are present in the legume seed coats. The seed coat of legume seeds primarily contains phenolic acids and flavonoids (mainly catechins and procyanidins). Gallic and protocatechuic acids are common in kidney bean and mung bean. Catechins and procyanidins represent almost 70% of total phenolic compounds in lentils and cranberry beans (seed coat). The antioxidant activity of phenolic compounds is in direct relation with their chemical structures such as number as well as position of the hydroxyl groups. Processing mostly leads to the reduction of phenolic compounds in legumes owing to chemical rearrangements. Phenolic content also decreases due to leaching of water-soluble phenolic compounds into the cooking water. The health benefits of phenolic compounds include acting as anticarcinogenic, anti-thrombotic, anti-ulcer, anti-artherogenic, anti-allergenic, anti-inflammatory, antioxidant, immunemodulating, anti-microbial, cardioprotective and analgesic agents. This review provides comprehensive information of phenolic compounds identified in grain legume seeds along with discussing their antioxidant and health promoting activities.

Saponins in pulses and their health promoting activities: A review.

Saponins are a class of natural compounds present in pulses having surface active properties. These compounds show variation in type, structure and composition of their aglycone moiety and oligosaccharide chains. Saponins have plasma cholesterol lowering effect in humans and are important in reducing the risk of many chronic diseases. Moreover, they have shown strong cytotoxic effects against cancer cell lines. However, more epidemiological and clinical studies are required for the proper validation of these health promoting activities. Processing and cooking promotes the loss of saponins from foods. The effect of soaking, sprouting and cooking on the stability and bioavailability of saponins in pulses is an important area which should be thoroughly worked out for achieving desirable health benefits. In the present review, the structures, contents and health benefits of saponins present in pulses are discussed. Moreover, the effect of processing (of pulses) on the saponins is also highlighted.

Bioactive constituents in pulses and their health benefits.

Pulses are good sources of bioactive compounds such as polyphenols, phytosterols and non-digestible carbohydrates that play important physiological as well as metabolic roles. These compounds vary in concentration amongst different pulse species and varieties. Pulse seed coats are rich in water-insoluble fibres and polyphenols (having high antioxidant activities), while cotyledons contain higher soluble fibres, oligosaccharides, slowly digestible and resistant starch content. Ferulic acid is the most abundant phenolic acid present in pulses, while flavonol glycosides, anthocyanins and tannins are responsible for the seed coat colour. Sitosterol (most abundant), stigmasterol, and campesterol are the major phytosterols present in pulses. Pulse fibres, resistant starch and oligosaccharides function as probiotics and possess several other health benefits such as anti-inflammatory, anti-tumour, and reduce glucose as well as lipid levels. Beans and peas contain higher amounts of oligosaccharides than other pulses. Processing methods affect resistant starch, polyphenol composition and generally increase antioxidant activities of different pulses. In this review, the current information on pulse polyphenols, phytosterols, resistant starch, dietary fibre, oligosaccharides, antioxidant and associated health benefits are discussed.

Composition, bioactive compounds and antioxidant activity of common Indian fruits and vegetables.

The present work was undertaken to evaluate the chemical composition (proximate, minerals and dietary fibre), colour parameters, antioxidant activity and polyphenol profiles of different fruits (pomegranate, kinnow, mango, banana, jambolan, grapes and sapodilla) and vegetables (beetroot, brinjal, orange carrot, bitter gourd, mentha and spinach). The amount of insoluble dietary fibre was higher than soluble dietary fibre for all fruits and vegetables. Vegetables showed superior mineral composition (higher amounts of K, Ca and Fe) as compared to fruits. Total phenolic content (TPC) and antioxidant activity (ABTS and DPPH) ranged from 354.9 to 1639.7 mg GAE/100 g, 2.6 to 5.5 and 3.0 to 6.3 mM TE/g, respectively for different fruits, while it ranged from 179.3 to 1028.6 mg GAE/100 g, 2.1 to 4.7 and 2.0 to 5.0 mM TE/g, respectively for different vegetables. Gallic acid, protocatechuic acid, catechin, caffeic acid, ferulic acid, sinapic acid, quercetin, resveratrol and kaempferol were detected and quantified in different fruits and vegetables. The results highlighted that fruit peels could be used as valuable sources of minerals and polyphenols having high antioxidant activity.

Development of eggless gluten-free rice muffins utilizing black carrot dietary fibre concentrate and xanthan gum.

Gluten-free muffins are generally made from purified flours and starches (from non-gluten sources) which are deficient in dietary fibre and have poor quality attributes. In this regard, the present work was undertaken to explore application of black carrot pomace dietary fibre concentrate (BCF) and xanthan gum (XG) in gluten-free rice muffins. Physicochemical properties of BCF and rice flour were studied. BCF was incorporated at three levels (3, 6 and 9 %) in rice flour, while XG was added at 0.5 % level to study their effect on muffin batters and physicochemical properties of muffins. BCF showed higher water absorption and oil absorption capacities than rice flour. Incorporation of BCF and XG increased flour paste viscosities and batter viscoelasticity. Incorporation of BCF increased total dietary fibre content (TDF) and decreased the L* and b* values, water activity (aw), specific volume and firmness. On the other hand, XG improved appearance and specific volume of the rice muffins prepared with and without BCF. Muffins prepared with 6 % BCF incorporation and XG were the most acceptable. This study demonstrated that BCF and XG can be used as viable functional ingredients in the preparation of gluten-free muffins.

Bioactive compounds in banana and their associated health benefits - A review.

Banana is a very popular fruit in the world market and is consumed as staple food in many countries. It is grown worldwide and constitutes the fifth most important agricultural food crop in terms of world trade. It has been classified into the dessert or sweet bananas and the cooking bananas or plantains. It is either eaten raw or processed, and also as a functional ingredient in various food products. Banana contains several bioactive compounds, such as phenolics, carotenoids, biogenic amines and phytosterols, which are highly desirable in the diet as they exert many positive effects on human health and well-being. Many of these compounds have antioxidant activities and are effective in protecting the body against various oxidative stresses. In the past, bananas were effectively used in the treatment of various diseases, including reducing the risk of many chronic degenerative disorders. In the present review, historical background, cultivar classification, beneficial phytochemicals, antioxidant activity and health benefits of bananas are discussed.

Osteoid osteoma masquerading tubercular arthritis or osteomyelitis on MRI: Case series and review of literature.

Magnetic resonance imaging (MRI) scans for osteoid osteoma could be misleading and can be misinterpreted as tuberculosis, especially when used as the principal modality of investigation. We retrospectively reviewed cases presenting to our institute for second opinion and selected six cases that were referred to our institute with a provisional diagnosis of tubercular arthritis or osteomyelitis and were identified to have osteoid osteoma. We reviewed the literature on typical and atypical clinical and radiological presentations of osteoid osteoma depending upon their location and present radiological features on MRI that should alert the radiologists toward a correct diagnosis.

Hepatitis B & C among farmers - a seroprevalence study.

BACKGROUND: Hepatitis B & C are the two major causes of chronic liver disease, having the similar parenteral route of transmission, thereby responsible for significant morbidity and mortality. OBJECTIVE: Agriculture being the backbone of this part of country, the present study was undertaken to assess the seroprevalence of these diseases among the farmers which form the major occupation class in the Malwa belt of Punjab, India. MATERIALS AND METHODS: Screening camp was organized at Kisan Mela at the regional station of Punjab Agriculture University at Faridkot, Punjab. Blood samples were collected, and tested for HBsAg and anti-HCV. RESULTS: Total of 1219 subjects, 63% being in the age group of 30-50 years, were screened of which the seroprevalence of HCV & HBV was 5% and 0.32% respectively, and 72% of HCV positive cases were between 30-50 years of age. CONCLUSION: The study stresses on the need of safe injection practices especially in villages and control on addiction, a more effective vaccination program for HBV, strict check on commercial blood banks, and community education regarding tattooing and sexual behaviour.

Classification of Interdental Space for Different Quadrants on the Basis of Standardization through Threshold Data and Its Comparison with BMI and Socioeconomic Status.

BACKGROUND: A better knowledge about the Interdental space is important since it provides insights on the prevalence of malocclusion. To date, there is conflicting evidence on the impact of body mass index (BMI) and Socioeconomic status (SES) on interdental space. A recent review concluded that a greater understanding is required of the interdental space. Therefore, there is a need for a more comprehensive and rigorous assessments of the interdental space and impacts of BMI and SES. AIM: BMI and SES can be associated with the interdental spacing in deciduous dentition. DESIGN: The present cross-sectional study was carried out on 448 children of age group of 3 to 5 years out of which 392 were meeting our criteria. Research assessment questionnaire on demographic data was completed by the parents. Study model cast of 392 children free from malocclusion were analyzed. RESULTS: A statistically significant association between interdental spacing and BMI category was observed. Comparison of BMI with above threshold interdental space revealed that after an optimum weight there is no effect on interdental space. A significant association between SES and interdental spacing was observed for all the four locations (p < 0.01). CONCLUSION: Evolved normative value can be taken as a standard and the occlusion and interdental spaces are not two completely separate entities and they are interdependent. How to cite this article: Singh T, Singh R, Singh JP. Classification of Interdental Space for Different Quadrants on the Basis of Standardization through Threshold Data and Its Comparison with BMI and Socioeconomic Status. Int J Clin Pediatr Dent 2013;6(1):16-21.

Shoulder ultrasound: What you need to know.

Shoulder ultrasound is consistently used in the assessment of rotator cuff and is as accurate as magnetic resonance imaging in the detection of rotator cuff tear. It can be used as a focused examination providing rapid, real-time diagnosis, and treatment in desired clinical situations. This article presents a simplified approach to scanning and image-guided intervention, and discusses common sonographically apparent shoulder pathologies.