Caturviṃśati-Mūrti forms of Viṣṇu: Additional notes on Daśāvatāra and Dvādaśa

The Acta Orientalia (2012, 2015) in the recent volumes has published blue-ribbon articles on the Daśāvatāra-10 and the Dvādaśa-12 with special reference to the Tamil bhakti literature. An elaborate codification of the assemblage of iconographical forms of Viṣṇu is perfected in the Caturviṃśati-24. Philosophies, āgamas and [śilpa/vāstu]-śāstras may speculate on concepts of coagulated (cf. Stietencron 1977: 127, 137) forms of the gods (e.g. Ekādaśa-Rudras) and the goddesses (Sapta Mātṛkās and Yoginīs-64). Are they represented in the pictorial arts (Jeyapriya 2015: 101)? Daśāvatāra and Dvādaśa, the Mātṛkas and the Yoginīs have been supported by archaeological and art historical evidences. Do we find any visual corroboration for Caturviṃśati? The present article is an eye-opener. I am not concerned with Śiva and Devī

Osmotic myelinolysis: Does extrapontine myelinolysis precede central pontine myelinolysis? Report of two cases and review of literature

Osmotic myelinolysis is an acute, rare, demyelinating process. After the initial description of the condition by Adam and colleagues in 1959, many case series have been published describing the central and extrapontine myelinolysis. Imaging has a definitive role in establishing the diagnosis of osmotic myelinolysis in vivo and diffusion-weighted imaging reveals earliest changes in affected brain parenchyma. We report two cases of patients with proven malignancy who developed extrapontine myelinolysis after treatment for hyponatremia and progressed to central pontine myelinolysis within a week. This was confirmed with magnetic resonance (MR) imaging and clinical assessment. This temporal progression of MR features, especially on diffusion-weighted imaging, from extrapontine to central pontine myelinolysis in osmotic injury has not been described in literature to the best of our knowledge. An early MRI of the brain in suspected/high-risk cases of osmotic myelinolysis may show features of extrapontine myelinolysis in the form of restricted diffusion in bilateral basal ganglia and may serve as a guide for predicting progression, prognosticating and deciding further treatment of pontine myelinolysis. We propose that in a significant number of cases, central pontine myelinolysis may be predicted by doing an early MRI of the brain with diffusion-weighted imaging, when extrapontine symptoms start to develop. This can potentially increase the window period and possibilities for therapeutic intervention and may even help in prevention

Unusual continuous intra-abdominal spread of primary testicular lymphoma along the spermatic cord and gonadal vessels: Report of 2 cases

AbstractPrimary testicular lymphoma (PTL) is an uncommon neoplasm (<5% of all testicular tumors). Testicular lymphoma presents with homogeneous mass, hyperintense on T1-weighted images, and iso-to-hypointense on T2-weighted images with strong diffusion restriction and homogeneous contrast enhancement. Seminoma testis, a close differential due to T2 hypointensity and homogeneousity, can be differentiated by its lower diffusion restriction and younger age group. Involvement of spermatic cord and epididymis is rare with seminoma. Intra-abdominal extension along the gonadal vein is not reported. PTL disseminates to extranodal sites. However, extension of PTL along the spermatic cord and gonadal vein up to the inferior vena cava is a rare phenomenon. We report 2 cases of PTL with involvement of epididymis and spermatic cord and further continuous extension along the gonadal vein up to the inferior vena cava. These findings are very rare and when present may help to differentiate testicular lymphoma from other testicular tumors

Unusual continuous intra-abdominal spread of primary testicular lymphoma along the spermatic cord and gonadal vessels: Report of 2 cases

Primary testicular lymphoma (PTL) is an uncommon neoplasm (<5% of all testicular tumors). Testicular lymphoma presents with homogeneous mass, hyperintense on T1-weighted images, and iso-to-hypointense on T2-weighted images with strong diffusion restriction and homogeneous contrast enhancement. Seminoma testis, a close differential due to T2 hypointensity and homogeneousity, can be differentiated by its lower diffusion restriction and younger age group. Involvement of spermatic cord and epididymis is rare with seminoma. Intra-abdominal extension along the gonadal vein is not reported. PTL disseminates to extranodal sites. However, extension of PTL along the spermatic cord and gonadal vein up to the inferior vena cava is a rare phenomenon. We report 2 cases of PTL with involvement of epididymis and spermatic cord and further continuous extension along the gonadal vein up to the inferior vena cava. These findings are very rare and when present may help to differentiate testicular lymphoma from other testicular tumors