Cost benefit analysis of computerized radiography system in a tertiary care hospital

Background: Computed radiography (CR) has presently proven to be both efficient and cost effective as against conventional radiography. Cost benefit and cost effectiveness analysis of a newly installed computerized radiography system in comparison with Conventional radiography set-up in a tertiary care hospital.Methods: Costs incurred under major heads were calculated and compared for both Computerized and Conventional radiography systems. A brief survey regarding the overall clinician and patients response towards the newly installed CR system was carried out and results were calculated.Results: CR system proves to be highly efficient tool in the department of radiology to provide not only better quality images and faster means of image acquisition and archiving but also higher rates of satisfaction amongst radiology staff, clinicians and patients. Overall cost-effectiveness as well as the consumer satisfaction of the new technology is good as compared to conventional radiography. CR reduces repetition of images due to artifacts caused by dark room procedures and due to the provision of multiple images on a single film an average reduction in film expenditure. It reduces waiting period for patients and increases level of satisfaction in clinicians working in critical care dept. and A&E dept. due to early processing of urgent films.Conclusions: cost benefit analysis of CR over conventional radiography proved overall running costs are comparable to the conventional system with a breakeven point achievement in a couple of years since installation especially in a high turnover tertiary care health setup

Neuroimaging in pediatric seizures

Background: Accurate etiological diagnosis of seizures in children is important to begin an effective treatment. MRI is an excellent neuroimaging tool that is highly accurate. It helps in diagnosis, determining the treatment protocol and predicting the outcome. Dedicated studies in paediatric population using MRI brain have been even fewer till date in India. Current study aims to find the common etiology of pediatric seizures on MRI in a developing country like India.Methods: Hospital based retrospective study. 105 cases in age group between 0 months to 12 years. Seen between 2014 till date included in the study. All cases underwent MRI.Results: Most common imaging findings were inflammatory granuloma in 10 (9.5%). Other findings were- Hypoxic ischemic encephalopathy (HIE) in 5 (4.7%), cerebral atrophy in 2 (1.9%), focal dysmyelination in 3 (2.8%), calcifying granuloma in 3 (2.8%) and periventricular leucomalacia in 2 (1.9%). Uncommon findings were that of lissencephaly, dysgenesis of corpus callosum, mesial temporal sclerosis, AV malformation, periventricular hemorrhage, schizencephaly, abscess and infarction in one child each (0.9% each). 69 children had no abnormal findings in brain.Conclusions: The commonest etiology of seizures is inflammatory granuloma. Early recognition of potentially treatable diseases helps in timely treatment and arrest of progression of disease. It is highly recommended to use MRI as primary investigation for seizures. Every effort should be made to provide facility of MRI for management of seizures in all parts of India

Constraints on electromagnetic form factors of sub-GeV dark matter from the Cosmic Microwave Background anisotropy

We consider dark matter which have non-zero electromagnetic form factors like electric/magnetic dipole moments and anapole moment for fermionic dark matter and Rayleigh form factor for scalar dark matter. We consider dark matter mass $m_\chi > \cal{ O}({\rm MeV})$ and put constraints on their mass and electromagnetic couplings from CMB and LSS observations. Fermionic dark matter with non-zero electromagnetic form factors can annihilate to $e^+ e^-$ and scalar dark matter can annihilate to $2\gamma$ at the time of recombination and distort the CMB. We analyze dark matter with multipole moments with Planck and BAO observations. We find upper bounds on anapole moment $g_{A}<7.163\times 10^{3} \text{GeV}^{-2}$, electric dipole moment ${\cal D}<7.978\times 10^{-9} \text{e-cm}$, magnetic dipole moment ${\mu}<2.959\times 10^{-7} \mu_B$, and the bound on Rayleigh form factor of dark matter is $g_4/\Lambda_4^2<1.085\times 10^{-2}\text{GeV}^{-2}$ with $95\%$C.L.Comment: Version to appear in Physical Review

Ultrasound of abdomen in acute viral hepatitis and its role as a prognostic marker

Background: To assess the extent of Ultrasound (USS) abdomen findings in acute viral hepatitis and further assess the role of USS as a prognostic marker.Methods: From May 2013 to September 2016, a total of 220 patients of acute Enterogenic viral hepatitis were studied by routine USS within first seven days of onset of symptoms, followed by routine USS between 10 to 15 days and follow up scan after 12 weeks. Only patients with acute Enterogenic viral hepatitis (Hepatitis A and Hepatitis E) were included. All patients with chronic liver disease and other form of acute hepatitis i.e. Hepatitis B, C and D were excluded from the study.Results: Among 220 patients of acute viral hepatitis routine USS findings including hepatomegaly, bright liver and thickened GB wall and periportal adenopathy were in isolation or in combination up to varying degrees. The commonest routine USS finding in acute phase was thickened GB wall (80%). 14 patients exhibited triad of enlarged Portal Vein (PV), Splenomegaly and Ascites. These 14 patients had prolonged stay in hospital and 11 patients had deranged liver function tests at 12 wks. interval and three patients developed hepatic encephalopathy including one patient who went into fulminant hepatic failure. Out of the patients who did not exhibit this triad 72 patients still had deranged LFT at 12 weeks and maximum of these patients had a combination of USS markers at presentation.Conclusions: USS has very little if any role in the diagnosis of acute viral hepatitis. It can however play an important role as a prognostic marker during the acute phase where it can detect enlarged portal vein, splenomegaly and ascites. This triad of USS findings is suggestive of transient portal hypertension likely due to hepatic congestion. Also, other USS markers if seen in combination at presentation can reliably predict a poorer prognosi

Cell Biology in Rheumatoid Arthritis

Rheumatoid arthritis (RA) is a systemic autoimmune disease, which affects about 0.33 to 2.65% of the population. In RA Synovium contain various type of immune cell. In which only one cell population cannot cause rheumatoid arthritis that requires more than one cell population. In normal condition, they act as a switch (active or inactive the cell signaling). It controls cell growth, proliferation or metastasizes. In an autoimmune disorder such as rheumatoid arthritis, the immune system mistakenly attacks and destroys the body's cells and tissues. Mostly cells are present in limited numbers in normal human synovium, but in rheumatoid arthritis and other inflammatory joint diseases, this population can expand to constitute 5-20% or more of all synovial cells. Recent investigations in a murine model have demonstrated that cells can have a critical role in the generation of inflammation within the joint. Keyword: Cell Biology in rheumatic arthritis; Dendrite cell; T-cell; Mast cell; Fibroblastic cell; Macrophages cell

Incorporation of Whole Spine Screening in Magnetic Resonance Imaging Protocols for Low Back Pain: A Valuable Addition

Study DesignA retrospective review of lumbar magnetic resonance imaging (MRI) studies conducted at the Department of Radiodiagnosis & Imaging of a Tertiary Care Armed Forces Hospital between May 2014 and May 2016.PurposeTo assess the advantages of incorporating sagittal screening of the whole spine in protocols for conventional lumbar spine MRI for patients presenting with low back pain.Overview of LiteratureAdvances in MRI have resulted in faster examinations, particularly for patients with low back pain. The additional detection of incidental abnormalities on MRI helps to improve patient outcomes by providing a swifter definitive diagnosis. Because low back pain is extremely common, any change to the diagnostic and treatment approach has a significant impact on health care resources.MethodsWe documented all additional incidental findings detected on sagittal screenings of the spine that were of clinical significance and would otherwise have been undiagnosed.ResultsA total of 1,837 patients who met our inclusion criteria underwent MRI of the lumbar spine. The mean age of the study population was 45.7 years; 66.8% were men and 33.2% women. Approximately 26.7% of the patients were diagnosed with incidental findings. These included determining the level of indeterminate vertebrae, incidental findings of space-occupying lesions of the cervicothoracic spine, myelomalacic changes, and compression fractures at cervicothoracic levels.ConclusionsWe propose that T2-weighted sagittal screening of the whole spine be included as a routine sequence when imaging the lumbosacral spine for suspected degenerative pathology of the intervertebral discs

A novel tissue-specific meta-analysis approach for gene expression predictions, initiated with a mammalian gene expression testis database

<p>Abstract</p> <p>Background</p> <p>In the recent years, there has been a rise in gene expression profiling reports. Unfortunately, it has not been possible to make maximum use of available gene expression data. Many databases and programs can be used to derive the possible expression patterns of mammalian genes, based on existing data. However, these available resources have limitations. For example, it is not possible to obtain a list of genes that are expressed in certain conditions. To overcome such limitations, we have taken up a new strategy to predict gene expression patterns using available information, for one tissue at a time.</p> <p>Results</p> <p>The first step of this approach involved manual collection of maximum data derived from large-scale (genome-wide) gene expression studies, pertaining to mammalian testis. These data have been compiled into a Mammalian Gene Expression Testis-database (MGEx-Tdb). This process resulted in a richer collection of gene expression data compared to other databases/resources, for multiple testicular conditions. The gene-lists collected this way in turn were exploited to derive a 'consensus' expression status for each gene, across studies. The expression information obtained from the newly developed database mostly agreed with results from multiple small-scale studies on selected genes. A comparative analysis showed that MGEx-Tdb can retrieve the gene expression information more efficiently than other commonly used databases. It has the ability to provide a clear expression status (transcribed or dormant) for most genes, in the testis tissue, under several specific physiological/experimental conditions and/or cell-types.</p> <p>Conclusions</p> <p>Manual compilation of gene expression data, which can be a painstaking process, followed by a consensus expression status determination for specific locations and conditions, can be a reliable way of making use of the existing data to predict gene expression patterns. MGEx-Tdb provides expression information for 14 different combinations of specific locations and conditions in humans (25,158 genes), 79 in mice (22,919 genes) and 23 in rats (14,108 genes). It is also the first system that can predict expression of genes with a 'reliability-score', which is calculated based on the extent of agreements and contradictions across gene-sets/studies. This new platform is publicly available at the following web address: <url>http://resource.ibab.ac.in/MGEx-Tdb/</url></p