The ultrasonic changes in maturing placenta in pregnancy complicated with hypertension and its correlation with neonatal outcome

Background: Hypertension is the most common medical problem encountered during pregnancy, complicating 2-3% of pregnancies. Obstetric ultrasound provides a cornerstone to other modalities used for assessing hypertensive disorders of pregnancy. This study was designed to detect the placental changes in hypertensive disorders of pregnancy and correlation with neonatal outcome.Methods: The study group comprised of 42 patients with pregnancy complicated with hypertension with period of gestation above 20 weeks and B.P. more than 140/90 mm of Hg measured on two occasions 6 hours or more apart. The control group consists of 42 normotensive patients matched with age and parity. One ultrasonic examination were performed between 28 weeks and 34 weeks and another after 34 weeks till term. Apart from routine parameters i.e. BPD, AC, FL, Amniotic fluid index, EBW and gestational age routine placental grading were performed according to the classification proposed by Grannum and associates. To evaluate perinatal outcome following measurement were studied – birth weight immediately after delivery, mode of delivery, perinatal morbidity and mortality , APGAR  score , presence of fetal distress.Results: In 97.62%  cases (41 out of 42 ) of control group showed Grade–II changes as opposed to 57.14% of cases (24 out of 42) in study group before 34 weeks.Conclusions: Accelerated maturation of placenta in pregnancy complicated with hypertension are more common in the hypertensive group

Casual Compressive Sensing for Gene Network Inference

We propose a novel framework for studying causal inference of gene interactions using a combination of compressive sensing and Granger causality techniques. The gist of the approach is to discover sparse linear dependencies between time series of gene expressions via a Granger-type elimination method. The method is tested on the Gardner dataset for the SOS network in E. coli, for which both known and unknown causal relationships are discovered

Allergic bronchopulmonary aspergillosis: a comparative evaluation of computed tomography with plain chest radiography

Computed tomography (CT) was done in 15 consecutive patients with allergic bronchopulmonary aspergillosis (ABPA). When compared with chest X-ray, CT was found to be superior in the diagnosis of bronchlectasis in patients with ABPA. Of the 90 lobes studied, CT detected bronchiectasis in 57 lobes and plain chest X-ray in 44 lobes. In addition to central bronchiectasis, peripheral bronchiectasis was diagnosed with CT in 18 of the 57 lobes. Follow-up CT was done in two patients after treatment for detection of progression or regression of bronchiectatic lesions. One patient showed radiological as well as clinical improvement, while the other patient presented with a recurrence of symptoms 4 months after stopping treatment. Computed tomography showed radiological progression of bronchiectasis and the patient was successfully treated with corticosteroids (thus preventing further bronchial damage). It is concluded from this study that CT is superior to plain chest X-ray in the diagnosis of bronchiectasis in patients with ABPA. Being non-invasive, it is also helpful in monitoring the course of bronchiectasis in these patients

Tropical pulmonary eosinophilia: a comparative evaluation of plain chest radiography and computed tomography

Plain chest radiography and computed tomography (CT) of the chest were performed on 10 patients with tropical pulmonary eosinophilia (TPE). Chest radiographs revealed bilateral diffuse lesions in the lungs of all the patients with relative sparing of lower lobes in one patient. However, computed tomography revealed bilateral diffuse lung lesions in all of the patients with relative sparing of lower lobes in three patients. In seven (70%) of the 10 patients, CT provided additional information. Computed tomography was found to be superior for the detection of reticulonodular pattern, bronchiectasis, air trapping, calcification and mediastinal adenopathy. No correlation was found between pulmonary function and gas exchange data using CT densities. There was also no correlation between the absolute eosinophil count (AEC) and the radiological severity of lesions. In six patients, high-resolution CT (HRCT) was performed in addition to conventional CT (CCT), and nodularity of lesions was better appreciated in these patients. It is concluded from this study that CT is superior to plain radiography for the evaluation of patients with TPE. However, more work needs to be done to substantiate the results of the present study

Bilateral giant juvenile fibroadenoma of breasts

An 11-year-old girl with rapidly enlarging bilateral breast lumps is reported. It was diagnosed as a case of juvenile fibroadenoma following fine needle aspiration cytology and confirmed on histopathological examination of the excised specimens

Bilateral giant juvenile fibroadenoma of breasts

An 11-year-old girl with rapidly enlarging bilateral breast lumps is reported. It was diagnosed as a case of juvenile fibroadenoma following fine needle aspiration cytology and confirmed on histopathological examination of the excised specimens

Economic evaluation of a surveillance program of hepatocellular carcinoma (HCC) in India

Purpose: Surveillance of patients of cirrhosis of liver is practiced for early detection of HCC. No data from any developing country on cost-effectiveness of such a program are available. Methods: economic evaluation of HCC surveillance was embedded in a prospective study undertaken to estimate the incidence of HCC in 194 cirrhotics. The protocol consisted of 6 monthly abdominal ultrasound (US) and serum alphafetoprotein (AFP) estimation, and yearly triple phase CT. Cost was estimated from the hospital and patient perspectives. Cost-effectiveness ratios for detecting a case of HCC were estimated. Modeling was done to estimate cost effectiveness with different combinations of diagnostic tests. Results Cost-effectiveness ratios of HCC surveillance program per HCC case detected were estimated as US$280 from the hospital perspective. From patient perspective, these were US$ 9,965 for outstation and US$2,808 for local patients. Cost-effectiveness ratio for direct medical cost per case of HCC detected by 6 monthly US and AFP, the EASL protocol, was estimated to be US$ 1,510 in the private sector. Conclusion: the cost of HCC surveillance program is exorbitant for India (gross national income per capita US$ 620) and possibly other low/middle income countries

Evaluating patients with cirrhosis for hepatocellular carcinoma: value of clinical symptomatology, imaging and alpha-fetoprotein

Objective: This study was undertaken to assess the value of clinical symptomatology, abdominal ultrasound (US), triple-phase CT (TPCT) and serum alpha-fetoprotein (AFP) estimation in predicting presence of hepatocellular carcinoma (HCC) among patients with cirrhosis. Materials and Methods: In this cross-sectional study, Child's A/B cirrhosis patients were subjected to clinical evaluation, US, TPCT and serum AFP estimation. Sensitivity and specificity of clinical symptoms and of AFP at different cut-off levels were determined. Detection rate of HCC and agreement between US and TPCT was estimated. Results: A high proportion of enrolled subjects had HCC at first presentation (40.7%). Significantly higher prevalence of abdominal pain, weight loss, and anorexia was seen in patients with cirrhosis with HCC compared to those without HCC. Sensitivity and specificity of any of these symptoms was 73 and 79%, respectively (positive and negative predictive values of 65 and 85%, respectively). A 100% agreement between TPCT and US was observed for diagnosing HCC cases. However, TPCT detected a greater number of smaller HCCs. Sensitivity of AFP at 400 ng/ml cut-off was only 25.7%, too low to be useful. Best mix of sensitivity (77.2%) and specificity (78.1%) of AFP was found to be at 10.7 ng/ml cut-off which falls within the conventional limits of normalcy. Conclusion: The study highlights the importance of symptomatology of weight loss, abdominal pain or anorexia as markers for HCC in patients with cirrhosis. AFP was not found to be a useful screening test. TPCT should be undertaken in all cirrhotics presenting to the hospital for the first time