COMPARISON OF SURFACE RADIATION DOSE TO THE GONADS BY RADIOGRAPHIC EXAMINATION OF THE LUMBAR SPINE USING COMPUTED RADIOGRAPHY AND DIRECT DIGITAL RADIOGRAPHY

Objectives: The objectives are aimed to study the comparison of SRD to the gonads by radiographic examination of the lumbar spine using computed radiography (CR) and direct digital radiography (DR) and to evaluate dose differences according to gender.Methods: A total of 120 subjects with an equal number of males and females referred for lumbar spine anteroposterior (AP) and lateral was included in the study. Sixty patients had undergone X-ray in CR X-ray unit and 60 in DR X-ray unit. SRD to gonads from a radiographic examination of the lumbar spine was measured in CR and DR using Mult-O-Meter, and obtained value of SRD was in μGy. Statistical analysis was performed using Statistical Package for the Social Sciences. Data were represented as a median and interquartile range. Mann–Whitney U-test was used for the comparison of SRD to gonads. Two-way analysis of variance (ANOVA) test was used to find out the statistically significant difference in SRD to the gonads according to gender from radiography of lumbar spine taken using CR and direct DR.Results: There was a statistically significant difference in SRD to gonads from radiography of lumbar spine AP and lateral taken using CR and direct DR (p<0.001). There was no statistically significant difference in SRD to the gonads in males and females from radiography of lumbar spine AP (p=0.577) and lateral (p=0.164) taken using CR and direct DR.Conclusion: It was found that SRD to gonads from lumbar spine AP was 54% lower in direct DR and SRD to gonads from lumbar spine lateral was 68% lower in direct DR than CR

HYPERTROPHIC CARDIOMYOPATHY WITH PARTIAL ANOMALOUS PULMONARY VENOUS CONNECTION AND ATRIAL SEPTAL DEFECT: A RARE PRESENTATION

Hypertrophic cardiomyopathy (HOCM) is characterized by heterogeneous clinical expression, unique pathophysiology, and diverse natural history.Coexistence of arterial septal defect and partial anomalous pulmonary venous connection (PAPVC) is very rare. Since HOCM is a congenital defect,coexistence of other congenital defects should be kept in mind when we treat the patients. Only very few cases of HOCM with coexisting congenitalanomalies have been reported so far in medical literature. Hence, we report a case of HOCM with atrial septal defect and PAPVC in a 49-year-old malepatient

Anticonvulsant activity of gap-junctional blocker carbenoxolone in albino rats

Background: Gap junctions (GJs) are clusters of channels that connect the interiors of adjoining neurons and mediate electrical/electrotonic coupling by transfer of ions and small molecules. Electrotonic coupling between principal neurons via GJs is increasingly recognized as one of the mechanisms in the pathogenesis of the abnormal neuronal synchrony that occurs during seizures. Carbenoxolone the succinyl ester of glycyrrhetinic acid obtained from liquorice has been shown to have the property of blocking gap junctional intercellular communication. The objectives were to study if carbenoxolone has in-vivo anticonvulsive activity in pentylenetetrazole (PTZ) and maximal electroshock (MES) seizure models and to probe the functional role of GJs in seizures.Methods: Carbenoxolone was tested for anticonvulsive effect in albino rats subjected to seizures by the PTZ and MES at three doses 100 m/kg, 200 m/kg, 300 m/kg. In the PTZ model parameters observed were seizure protection, seizure latency and seizure duration. In the MES model parameters observed were seizure protection and seizure duration.Results: The results showed that the carbenoxolone has anticonvulsant activity in both PTZ and MES induced seizures with better protection in the PTZ induced seizures. In the PTZ model carbenoxolone produced a statistically significant increase in seizure latency, decrease in seizure duration and seizure protection. In the MES model carbenoxolone produced a statistically significant decrease in seizure duration.Conclusions: Carbenoxolone has in-vivo anticonvulsive effect and could be useful in both petitmal (absence) seizures and grand mal (generalized tonic-clonic epilepsy) seizures. The protective effect of carbenoxolone could be due to blockade of GJ channels that mediate electro tonic coupling and thereby prevent the neural synchronization that is characteristic of seizures. The study also supports the view that GJs have a functional role in the electrophysiology of seizures and GJ blockers have potential as a new class of antiepileptic drugs

ASSESSMENT OF LEFT ATRIAL FUNCTION IN PATIENTS WITHMITRAL VALVE DISEASES

ABSTRACTObjective:To observe and assess left atrial (LA) function by observing the differences in conventional Doppler echo parameters of left ventricular inflow, Left atrial appendage, among patients with mitral valve disease.Methods: Forty three mitral valve disease subjects appearing consecutively for echocardiogram (ECHO) test at the cardiology department in a tertiary care hospital were recruited into the study as per the pre-set inclusion and exclusion criteria. The data from the ECHO was pooled using Microsoft excel and analyzed using SPSS software by application of appropriate statistical tests.Results:Of the 43 objects, 39 had MS, 3 had MR and 2 of them were found to have both MS and MR. The major presenting symptom as observed in 33 subjects, was dyspnea. LA maximum volume was found to be 91±59 ml and minimum was 66±51 ml. Left atrial expansion index was 128±91. Left atrial active emptying fraction was 29±13 and passive emptying fraction was 31±15. No significant change in LA global strain among groups with MR and without MR was observed. Further, no significant difference was observed in left atrial indices like left atrial emptying fraction, left atrial passive emptying fraction, atrial fraction, Left atrial expansion index among   groups having MR and no MR.Conclusion:LA contractile, reservoir and conduit function was significantly reduced in mitral valve diseases due to increased hemodynamic load. No significant difference was noted in global LA strain irrespective of MS or MR.Key Words: Valvular disease; Left atria; Strain; Contractile functio

HEREDITORY GINGIVAL FIBROMATOSIS IN A 7-YEAR-OLD GIRL: A CASE REPORT

ABSTRACTThis paper presents a case of hereditary gingival fibromatosis, a rarely reported disorder and addresses the complex nature of oral diagnosis,treatment and long-term case management in the hereditary form of recurrent gingival fibromatosis. Case management is discussed in relation toa 7-year-old girl who presented with recurrent, progressive gingival enlargement requiring consecutive periodontal treatment. The initial course oftreatment included 4-quadrant gingivectomy with excisional bevel incisions, followed by microscopic examination of the gingivectomy specimenswhich supported the clinical diagnosis. 1 year later, recurrence of the condition was observed in all quadrants. It is recommended that patients withthis condition be monitored closely after gingivectomy so that the treatment requirements of localized areas can be addressed as needed.Keywords: Heredity, Genome, Phenotype, Chromosome, Autosomal inheritance

USE OF TISSUE DOPPLER IMAGING TO DETECT RIGHT VENTRICULAR MYOCARDIAL DYSFUNCTION IN PATIENTS WITH CHRONIC OBSTRUCTIVE PULMONARY DISEASE

Objective: To determine the utility of tissue Doppler imaging (TDI) in detecting early right ventricle (RV) myocardial dysfunction, given its prognostic implications in patients with chronic obstructive pulmonary disease (COPD).Methods:  A prospective case-control study was carried out involving 36 COPD patients in an acute exacerbated state as cases and 34 healthy subjects serving as controls. Each subject underwent a baseline echocardiography using various methods ranging from m-mode and 2-dimensional measures for analyzing RV geometry to strain and strain rate using Tissue Doppler Imaging to measure RV deformation. The cases underwent a subsequent echocardiogram 1month later once the respiratory symptoms subsided.Results: A significant difference was observed in RV tissue annular velocities ( E', A', S) between cases and the controls at baseline. However no significant increase was observed in tissue annular velocities among cases during remission states from baseline. Peak systolic strain in COPD group was significantly reduced in comparison to controls, but not significantly increased during remission when compared to baseline in cases. FEV1/VC did not bear any significant correlation with RV strain. Tei index had a negative linear correlation with peak systolic strain of RV, which was statistically significant.Conclusion: TDI parameters revealed that RV dysfunction remains unaltered even in remission state of COPD, despite pulmonary arterial pressure normalizing. In light of it bearing a negative prognosis in COPD, RV dysfunction merits assessment in COPD patients, both in acute exacerbations as well as in remission. Â

Identification of Contrast Induced Nephropathy (CIN) with intravenous iso-Osmolar contrast media in renal failure patients with and without additional comorbidities undergoing Computed Tomography

Aim: To identify contrast induced nephropathy with intravenous iso-osmolar contrast media in renal failure patients with additional comorbidities undergoing computed tomography. Study design: Hospital based observational study. Methods: A retrospective study was conducted on 207 patients with pre-existing renal failure and comorbidities. In this study we collected pre-contrast creatinine values available within 3 weeks and post-contrast creatinine value was collected on 2nd and 5th day following CM injection in order to check early and late contrast induced nephropathy (CIN). Rate of CIN with and without comorbid conditions in CKD patients were calculated. Then we assessed the incidence of CIN with different amount of CM administered. We also calculated the relation of CIN with pre-contrast creatinine and eGFR range, which was categorized as 1.4- 2.0 mg/dL, 2.0-3.0 mg/dL and >3 mg/dL and >60ml and <60 mL/min per 1.73 m2 respectively. Results: Rate of CIN was relatively higher in renal failure patients and also in patients with comorbidities especially diabetes mellitus. Risk of CIN development was possible on 5th day also which was considered as delayed CIN. It was shown in the study that as the amount of contras media increases, rate of CIN also increases which was prominent in case of patients administered with >80ml of contrast media. CIN risk was better determined by eGFR than Creatinine value. Conclusion: CIN rate was clinically significant in CKD patients with comorbidities who received an iso-osmolar contrast media

Risk of diabetes among patients with osteoarthritis

Research Background: Diabetes mellitus (DM) and osteoarthritis (OA) are common diseases that are predicted to increase in prevalence in the US and worldwide. Although a higher prevalence of osteoarthritis (OA) has been reported among diabetes mellitus (DM) patients, discrepancy and limitations of observational studies have precluded a decisive association. Objective: The objective of this study was to investigate the relationship between osteoarthritis (OA) and the incidence of diabetes mellitus (DM).  Methods: Study were conducted on Osteoarthritis subjects from both sex’s male and female from different age group during January 2020 to January 2022, at NIMS Super specialty Hospital Shobha Nagar,Jaipur (Rajasthan) India. OA of areas were finding out using the American College of Rheumatology classification criteria. Sociodemographic characteristics, health-related behaviors, comorbidities and DM clinical manifestations and laboratory parameters were determined. Result:  We were included 90 osteoarthritis patients in this study from both sex’s males (53.33%) and females (46.66%).&nbsp