Gray scale and color Doppler sonography in the diagnosis of carpal tunnel syndrome

AbstractPurposeTo determine the diagnostic accuracy of gray scale and color Doppler sonography in the diagnosis of patients with carpal tunnel syndrome.Patients and methodsA total of 53 wrists in 41 consecutive patients with clinical suspicion of carpal tunnel syndrome, referred from the Department of Physical medicine, Rheumatology & Rehabilitation were examined with ultrasonography using a 12MHz linear array transducer. The presence of median nerve edema, swelling, and bowing of the flexor retinaculum was evaluated by gray scale sonography, while intraneural hypervascularity was evaluated by color Doppler sonography. Sensitivity and specificity were calculated for each sonographic feature and compared with electrodiagnostic test (EDT) results.ResultsElectrodiagnostic tests confirmed carpal tunnel syndrome in 48 wrists. A median nerve cross sectional area (CSA) of 11mm2 was calculated as a definition of median nerve swelling. In comparison with electrodiagnostic tests, median nerve swelling showed the highest accuracy (89%) among the gray scale sonographic criteria, and the presence of median nerve hypervascularization showed the highest accuracy (94%) among all sonographic criteria. Median nerve edema and bowing of the flexor retinaculum showed accuracies of 81% and 77% respectively.ConclusionMedian nerve intraneural hypervascularity detected by color Doppler sonography is more accurate in detection of median nerve involvement than gray scale sonography criteria in patients with suspected carpal tunnel syndrome

Role of CT enterography in assessment of Crohn's disease activity: Correlation with histopathologic diagnosis

AbstractAimTo evaluate the radiological signs of gastro-intestinal inflammation at CT enterography and to assess its accuracy in determining the degree of activity in patients with Crohn's disease (CD).MethodsCT enterography was performed in 26 CD patients and evaluated for the following parameters: mucosal enhancement, abnormal wall thickening, engorged vasa recta, increased density of the mesenteric fat and enlarged mesenteric lymph nodes. Correlations between CT findings and histopathologic results were made using McNemar test.ResultsThere was no significant statistical difference in mucosal enhancement and wall thickening between moderate and severe disease (P=0.631 and 0.138, respectively) whereas engorged vasa recta, fat edema and lymph node enlargement had successfully discriminated between moderate and severe histological findings (P=0.009, <0.001 and 0.045, respectively). Moderate disease was diagnosed correctly by CTE in 50% of cases while severe disease was diagnosed in 100% of cases. When we reconditioned the presence of two CTE severity criteria to diagnose severe disease, the sensitivity to predict moderate disease activity increased to 80%.ConclusionCT enterography is a sensitive and specific non-invasive imaging modality for evaluating the degree of activity of Crohn's disease, and should be considered in its diagnostic and management algorithms

National policy-makers speak out: are researchers giving them what they need?

The objective of this empirical study was to understand the perspectives and attitudes of policy-makers towards the use and impact of research in the health sector in low- and middle-income countries. The study used data from 83 semi-structured, in-depth interviews conducted with purposively selected policy-makers at the national level in Argentina, Egypt, Iran, Malawi, Oman and Singapore. The interviews were structured around an interview guide developed based on existing literature and in consultation with all six country investigators. Transcripts were processed using a thematic-analysis approach. Policy-makers interviewed for this study were unequivocal in their support for health research and the high value they attribute to it. However, they stated that there were structural and informal barriers to research contributing to policy processes, to the contribution research makes to knowledge generally, and to the use of research in health decision-making specifically. Major findings regarding barriers to evidence-based policy-making included poor communication and dissemination, lack of technical capacity in policy processes, as well as the influence of the political context. Policy-makers had a variable understanding of economic analysis, equity and burden of disease measures, and were vague in terms of their use in national decisions. Policy-maker recommendations regarding strategies for facilitating the uptake of research into policy included improving the technical capacity of policy-makers, better packaging of research results, use of social networks, and establishment of fora and clearinghouse functions to help assist in evidence-based policy-makin

Exploration on ability of printable modified papers for the application in heat sublimation transfer printing of polyester fabric

Abstract In this work heat transfer papers were loaded with a new core–shell pigment based on precipitating thin shell of titanium dioxide on a core of rice husk silica ash TiO2/RHSA to be applied in dye sublimation printing of textile fabrics. Besides, 0.1% (w/w) cationic polyacrylamide (CPAM) and 1% (w/w) bentonite (Bt) were also added sequentially to improve drainage and filler retention of the paper hand-sheets made from bleached kraft bagasse pulps. The effect of the new core–shell pigment on the mechanical and barrier properties, thermal stability and surface morphology of modified paper sheets were investigated. In addition, the study of transfer printability and ease of dye release from paper to fabric in this heat transfer printing of polyester fabrics using silk-screen printing under different transfer parameters were studied. Also, fastness measurements including washing, light and perspiration of printing polyester fabric were also estimated

National policy-makers speak out: Are researchers giving them what they need?

10.1093/heapol/czq020Health Policy and Planning26173-82HPOP