Role of diffusion weighted MR imaging in differentiating benign from malignant prostate lesions

Background: The purpose of the study was to determine the diagnostic accuracy of diffusion weighted MR imaging and to propose a cut off ADC value in differentiating benign from malignant prostatic lesions considering histopathology as gold standard.Methods: It is a descriptive type of observational study done on 40 patients with clinical suspicion of prostate carcinoma and elevated PSA level more than 4ng/ml. The patients underwent Multiparametric prostate MRI and ADC values were calculated using ADC maps.Results: Of the 40 cases included in the study histopathology revealed a diagnosis of abscess (1), chronic prostatitis (2), BPH with chronic prostatitis (4), BPH (12), and malignancy (21). The mean and standard deviation (SD) of ADC values for the abscess (0.59), CP (0.83+0.16), BPH with CP (0.94+0.22), BPH (1.14+0.14) and malignancy (0.72+0.15) (x10-3mm2/s) were found in our study. The mean ADC value of malignant lesion was lower (0.727+0.149) as compare to benign lesion (1.034+0.216) and this difference was found to be statistically significant with p<0.001. By using ROC curve, ADC cut off value was calculated as 0.92 x 10-3mm2/s and sensitivity, specificity at this cut off value of ADC were 95.24% and 73.68% respectively. The PPV, NPV, diagnostic accuracy of at this cut off value of ADC were 80%, 93.33%, 85% respectively.Conclusions: Our study shows that DWI with ADC calculation helps in differentiation of Benign from Malignant prostatic lesions with high accuracy and this quantitative analysis should be incorporated in routine MRI evaluation of prostatic lesion

A Comparative Study of Fraxinus Excelsior Plus Vitamin-E with Vitamin-E Alone on Liver Function in Non-Alcoholic Fatty Liver Disease (NAFLD) Patients

Aims and Objectives: To find the effect of fraxinus excelsior plus vitamin-E with vitamin-E alone on liver function in non-alcoholic fatty liverdisease (NAFLD) patients. Material and Methods: This was a hospital based observational study. The study was conducted on 270 patients,diagnosed with NAFLD by Ultra sonography (USG) with baseline deranged LFT and lipid profile then were divided in two groups of patients.Each group consist of 135 patients, group 1 subjects received Vitamin E alone and group 2 subjects received Vitamin E plus Fraxinus Excelsior.LFT, lipid profile and steatohepatitis grade were investigated in four visits (day1st, day 30 th day, 60th and day90th). Results: In this study baselineLFT and lipid profile of the patients were deranged in both groups but statistically no significant difference in baseline LFT and lipid profilebetween both groups. During 2nd (day 30th), 3rd (day60th) and 4th (day90th) visits mean AST, ALT, ALP, TC, LDL were improved in both groupsincluding steatohepatitis grade, but more improvement was occurred in group 2 who received combination of Vitamin E + Frexinus excelsior.There was no statistically significant difference in the mean value of LFT and lipid profile between both group at 30th day but statisticalsignificance found between both group at 60th day and at 90th day. Steatohepatitis grades were improved in both groups. At 30day, grade 2 wasseen maximum in both groups i.e. 70 (51.9%) and 62 (45.9%) in group 1 and group 2 respectively followed by grade 3. At 60th day steatohepatitisgrade was improved in both groups, grade 2 was seen maximum in both groups i.e. 58 (43%) and 52 (38.4%) in group 1 and group 2 respectivelyfollowed by one. And 90th day steatohepatitis grade was improved in both groups grade 2 was seen maximum in groups 1 i.e. 63 (46.7%)followed by grade 1 i.e. 40 (29.6%) and in group 2, grade 1 was seen maximum i.e.54 (40%) followed by no grade in 45(33.3%). Conclusion: Inthis study, it was observed that consumption of fraxinus excelsior and vitamin E is associated with statistically significant improvement in LFT,lipid profile and steatohepatitis grade as com- pared to consumption of vitamin E alone