Tissue characterization using A-mode ultrasound for beef quality grading, 1992-1995

Many of the modern medical diagnostic and material characterization technologies are a direct result of clever use of ultrasound. Ultrasound, for example, is used very widely as a tool for characterizing tissue in medical applications. It is also used extensively in other applications such as nondestructive testing and fluid flow measurements. The objective of the research described in this thesis is to develop a computer based ultrasound system for characterizing beef tissue for quality grading. Extensive research has been performed with regard to tissue characterization in medical applications. Similar work has also been carried out using ultrasound for structural analysis in material science applications. However, little has been done in applying ultrasound for characterizing beef tissue (quality grading). Thus, the requirements of an ultrasound system and the data processing algorithms are unknown. However, since beef tissue has physical properties that are similar to human tissue, the instrumentation and algorithms for analysis should be similar. This thesis describes the work and results obtained to date in attempting to achieve the stated objective

Visual Diaries: Towards Art History as Storytelling

This essay examines variants of what I refer to as “visual diaries” – or thinking through images and written or oral language – as important “worldmaking” exercises, essential for students of color, women, sexual minorities, or other marginalized subjects. I provide my reflections on assigning this dynamic and student-centered, practice-based assignment in my contemporary art courses at a Hispanic-serving institution (HSI) of higher education and a summer art residency program unaffiliated with a university. Besides my reflections on my pedagogy, I also share student feedback from unsolicited testimonials and answers to questionnaires. I argue that visual diaries transform students into veritable storytellers of art history. Thinking of art history as storytelling empowers students to create the histories they deserve and may not see in the classroom. There can always be another story, another way of looking at seemingly the same set of assumptions (or “facts”)

ROLE OF ORAL PANCREATIC ENZYME SUPPLEMENTATION IN PANCREATIC EXOCRINE DEFICIENCY

Objectives: The present study was carried out to study the role of oral pancreatic enzyme supplementation in pancreatic exocrine deficiency. Methods: This study included 50 consecutive cases of pancreatic exocrine deficiency. Diagnosis of pancreatic exocrine deficiency was made based on history, clinical examination, and contrast-enhanced computed tomography findings. Each patient was supplied with oral pancreatic enzyme supplements. Each patient was followed up for 1 year with three visits (3 months, 6 months, and 12 months) to assess changes in clinical features of pancreatic exocrine deficiency, change in nutritional status of the patient, and compliance with therapy. Results: At first follow-up visit (3 months), abdominal discomfort reduced in 17 previously symptomatic patients. Mean stool frequency reduced from 3.18 per day to 2.34 per day. Stool consistency improved with only 18 patients (36%) having liquid consistency stool in comparison to 76% at the time of initial presentation. Average body mass index (BMI) improved from baseline value of 20.648 kg/sqm to 20.674 kg/sqm. Average hemoglobin improved from 10.40 g/dL to 10.52 g/dL and average serum albumin remained static at 3.0 g/dL. At second follow-up visit (6 months), abdominal discomfort reduced in 20 previously symptomatic patients. Mean stool frequency reduced from 3.18 per day (primary survey) to 1.7 per day. Stool consistency improved with only 12 patients (24%) having liquid consistency stool in comparison to 76% at the time of initial presentation. Average BMI improved from baseline value of 20.648 kg/sqm to 21.062 kg/sqm. Average hemoglobin improved from 10.40 g/dL to 10.69 g/dL and average serum albumin improved from 3.0 g/dL at primary survey to 3.1 g/dL. At third follow-up visit (12 months), abdominal discomfort reduced in 30 previously symptomatic patients. Mean stool frequency reduced from 3.18 per day (primary survey) to 1.6 per day. Stool consistency improved with only 9 patients (18%) having liquid consistency stool in comparison to 76% at the time of initial presentation. Average BMI improved from baseline value of 20.648 kg/sqm to 21.402 kg/sqm. Average hemoglobin improved from 10.40 g/dL to 10.76 g/dL and average serum albumin improved from 3.0 g/dL at primary survey to 3.3 g/dL. Conclusion: In follow-up visits, there was an improvement in symptoms over 12 months. Abdominal discomfort and stool frequency reduced. Stool consistency improved. Nutritional parameters showed statistically significant improvement. Mean BMI of the study sample, mean hemoglobin, and serum albumin increased. The study provides rationale for using these clinical symptoms as surrogate markers for the efficacy of Pancreatic Enzyme Replacement Therapy in patients with pancreatic exocrine insufficiency

A comparative study of ferric carboxymaltose and iron sucrose as a parenteral iron treatment in iron deficiency anaemia during pregnancy

Background: Iron deficiency anemia during pregnancy is a serious global concern specially in developing country, which is preventable with effective measures. In women who cannot tolerate oral iron or have moderate to severe anemia, parenteral iron in the form of iron sucrose or ferric carboxymaltose can be very much useful. This study aimed to compare efficacy and safety of iron sucrose and ferric carboxymaltose in iron deficiency anemia during pregnancy.Methods: This prospective interventional comparative study was conducted during May 2016 to April 2018 at tertiary care hospital and total 100 antenatal women from 28 to 34 weeks of gestation having moderate to severe anemia were included in this study and all women were divided in to 2 groups randomly and were given either iron sucrose or ferric carboxymaltose according to iron requirement. Rise in haemoglobin and serum ferritin were noted and data analysed statistically.Results: The mean rise of haemoglobin with iron sucrose was 1.8 gm% and with ferric carboxymaltose was 2.6 gm%. The mean rise of serum ferritin with iron sucrose was 82.4 ng/ml and with ferric carboxymaltose was 100.9 ng/ml. Other than minimal local reaction one woman had developed severe anaphylactic reaction after receiving iron sucrose.Conclusions: Intravenous ferric carboxymaltose is better and safe molecule than iron sucrose and it has advantage of ability to administer large dose in single sitting which reduce overall cost of therapy.  Hence ferric carboxymaltose is a drug of choice as parenteral iron therapy in iron deficiency anemia during second trimester of pregnancy.

Subaxial Cervical Spine Trauma: Evaluation And Surgical Decision-making.

Study Design Literature review. Objective To discuss the evaluation and management of subaxial cervical spine trauma (C3-7). Methods A literature review of the main imaging modalities, classification systems, and nonsurgical and surgical treatment performed. Results Computed tomography and reconstructions allow for accurate radiologic identification of subaxial cervical spine trauma in most cases. Magnetic resonance imaging can be utilized to evaluate the stabilizing discoligamentous complex, the nerves, and the spinal cord. The Subaxial Injury Classification (SLIC) is a new system that aids in injury classification and helps guide the decision-making process of conservative versus surgical treatment. Though promising, the SLIC system requires further validation. When the decision for surgical treatment is made, early decompression (less than 24 hours) has been associated with better neurologic recovery. Surgical treatment should be individualized based on the injury characteristics and surgeon's preferences. Conclusions The current state of subaxial cervical spine trauma is one of great progress. However, many questions remain unanswered. We need to continue to account for the individual patient, surgeon, and hospital circumstances that effect decision making and care.463-7

Diagnosis, risk factors, and management of sacral and pelvic fractures after instrumented lumbar fusions: a systematic review

To evaluate risk factors, diagnosis, and management of sacral and pelvic fractures (SPFs) after instrumented fusions. A systematic review following the PRISMA (Preferred Reporting Items for Systematic Reviews and Meta-Analyses) guidelines was performed using the PubMed database. Articles with patients with an SPF after a lumbar instrumented fusion were included. The articles addressing specifically proximal junctional kyphosis were excluded. Eleven small cases series (level of evidence IV) were reviewed. The incidence of SPF was 1.86% in one study. The risk factors reported were elderly patients, multilevel surgery, long fusions stopping at L5 or S1 instead of the ilium, osteoporosis, obesity, and sagittal imbalance. Computed tomography scan was the preferential image modality for diagnosing. Nonsurgical treatment may be used in patients with tolerable pain and nondisplaced fracture. Persistent pain was an indication for surgery, as well as fracture displacement. The most common surgical treatment reported was an extension of the fusion to the iliac using iliac screws. SPFs after lumbar instrumented fusion are rare but clinically meaningful complications. The risk factors, diagnosis, and management of SPFs are described in our review.9554054

A study of vaginismus in patients presenting with infertility

Background: Vaginismus is an uncommonly reported entity, most of the patients present to the gynaecologist with complaint of inability to conceive. Female sexual dysfunctions are a common entity but difficult to diagnose and treat, Vaginismus is one of the categories of female sexual dysfunction.Methods: Total 25 patients out of 900 patients attending the outdoor of Shivanjali Women’s Hospital for infertility from the year 2008 to 2016 were found to be having vaginismus. With couple’s consent females were treated for vaginismus. This is a retrospective study of 25 patients identified having vaginismus.Results: Maximum 11 patients were in age group of 20 to 25 years. Forty percent 10 patients improved with counselling and education, lubricant gel and analgesic gel. Total 84% (21) patients conceived with different modes of treatment.Conclusions: Vaginismus is uncommonly reported. With proper history and counselling of the couple vaginismus can be revealed, managed and conception can be achieved

A rare case of cervical ectopic pregnancy: complicated by haemorrhagic shock

Cervical ectopic pregnancy is a rare condition that accounts for less than 0.1% of all ectopic pregnancies with high morbidity and mortality rate. We present a case of a 25 years old G5P3L2A1D1 with history of 9 weeks amenorrhoea and previous 3 caesarean sections (CS) presented with bleeding per vaginum for 2 days. Ultrasound examination revealed a ballooned-out cervical canal with a gestational sac containing foetus with cardiac activity present and an empty uterus with thickened endometrium with a typical hour-glass configuration of the uterus. Thus, the diagnosis of cervical ectopic pregnancy was made. Patient was complicated by haemorrhagic shock. Immediately hysterectomy was performed. Inj. PCV 4 unit and FFP 6 units were given and post-op- patient was shifted to ICU on ventilation support. In ICU, patient was kept on ventilation support for 4 days with vasopressor supports. Antibiotics, antacids, antiemetics, IV fluids, supportive care given. Patient was discharged on post-op day-7 with stable hemodynamics and healthy vaginal vault and stitch line. Improved ultrasound resolution and earlier detection has led to the development of more conservative treatments in non-severe cases that attempt to limit morbidity and preserve fertility

Current Imaging Techniques in Renal Cell Carcinoma

Renal cancers are one of the 10 most commonly seen cancers in both sexes. The incidence of renal cancers is high in Western developed countries and lower in Eastern and developing countries. The overall incidence of malignancy has been increasing in recent times. Ultrasound (USG) is very commonly used imaging technique; however recent advances like contrast enhanced ultrasound helps to differentiate various cystic renal masses. Availability of newer imaging techniques such as Computed tomography scan (CT scan) and Magnetic resonance imaging (MRI) and their various applications may play a role in better and early diagnosis of such lesions. Due to its highly metastatic nature, accurate staging is more important to facilitate proper treatment. Fluoro-deoxyglucose positron emission tomography (FDG PET) is widely applied in detection, staging/restaging and surveillance of such lesions. In this chapter, we will try to cover the recent advances in various modalities for detection of renal cancers, particularly renal cell carcinoma (RCC)