Abstracts from the 7th annual neurology research day, shifa international hospital, islamabad

:It\u27s a cross sectional study conducted at CP clinic of Armed Forces institute of Rehabilitation medicine Rawalpindi from Jan 2012 to Jan 2013. All cerebral palsy children above 2 years of age and both genders were included in study. SPSS version 17 was used for data analysis

The fundamental interactions between deposits and surfaces at nanoscale using atomic force microscopy

The objective of this research was to investigate adhesion of different fouling deposits with different contact surfaces using atomic force microscopy (AFM). In this thesis, AFM has been employed to measure: (i) The adhesive interactions between a colloidal silica microparticle and stainless steel, PTFE-coated stainless steel, glass and ceramic surfaces, in the presence of a number of solutions and suspensions of ingredients found in commercially available toothpaste. (ii) To compare the measurements from the AFM and micromanipulation to see the differences and similarities. The micromanipulation technique was developed to measure the adhesive strength of different deposits. The method uses a T-shaped probe made of stainless steel chip, dimension 30 x 6 x 1 mm connected to the output aperture of a transducer (Model BG-1000, Kulite Semiconductor, Leonia, NJ. USA) which was itself mounted on a three dimensional micromanipulator (MicroInstruments, Oxon, UK). The two measurement methods are capable of giving quantitative results for the strength of the forces involved in adhesion; fast moving consumer goods (FMCG) deposits, toothpaste and confectionary stimulant deposits have been studied, and their interactions with stainless steel, glass and PTFE surfaces measured. (iii) Further investigation of AFM adhesion measurements, with caramel, whey protein and sweet condensed milk (SCM) deposits after heating at 30ºC, 50ºC, 70ºC, and 90ºC. The two selected spherical microparticles used were stainless steel and PTFE, which were attached to the end of an AFM tip. The data shows that, for removal in all cases using micromanipulation, the pulling energy increases with increasing height above the surface and the slope of the lines of pulling energy versus thickness is similar. Stainless steel shows the highest pulling energy with slightly higher energies than glass and PTFE, whilst PTFE show the lowest interaction. For the AFM data, PTFE again gives much lower adhesion forces. This is due to the different molecular interactions between different surfaces and caramel. There is thus partial agreement between the two methods. The micromanipulation method measures a range of parameters – such as the deformation and flow of the deposits, and so it might not be expected that there would be complete agreement. Here stainless steel and glass show very similar behaviour, as opposed to the differences seen using AFM; the different surface roughness of the two materials might also be expected to have an effect. At different temperatures the results from the different contact positions on the deposits; with an approach speed to the deposits for all experiments was 3μm/s, then a 5 second pause on the deposit and then the rate of retract was 0.25μm/s. Significant (more than an order of magnitude) differences are seen between forces for the same and different deposits, and between different surfaces for the same deposits. Lower forces are seen at 90ºC in all cases; at the higher temperature, the force between surface and deposit is less. To design systems to resist fouling, these results suggest that measurements at different process temperatures are needed; data at room temperature has overpredicted the interactions. The results suggest that the AFM force curve measurement technique could be used to study a variety of food deposits that have undergone different processing conditions. The method can help in optimising removal of food deposits in terms of food cleaning protocols. AFM could be a valuable technique in measuring surface properties, and in relating behaviour to surfaces. The capability of the AFM to provide better understanding of materials structure, surface characteristics and the interactive forces at the meso- and nanoscale level. The AFM will enhance the understanding of large-scale engineering processes, especially as materials are increasingly being designed down to the submicrometre level.EThOS - Electronic Theses Online ServiceGBUnited Kingdo

RADIOLOGICAL AND PATHOLOGICAL CORRELATION OF LUNG NODULES IN A BACKGROUND OF METASTATIC DISEASE

Background: Computed tomography (CT) imaging has improved the chances of detecting small indeterminate (<1 cm) lung nodules. The determination of the underlying malignant or benign nature of a lung nodule poses a great diagnostic challenge and depends on a number of factors, including the radiographic appearance of nodule, the presence of non-pulmonary metastases, characteristics of growth and histological criteria. Methods: The medical records of 89 patients admitted to our specialist cancer centre between 2008 and 2013 were reviewed. Patients of all age groups and tumour category were included in the study. Clinical data of these patients were collected and the following parameters were analysed: Radiographic diagnosis, location, size, laterality and number of nodules and histological impression. The radiological findings were then correlated with histopathological findings. The nodules were sub-classified into groups on the basis of size (A = 0–0.5 cm; B = 0.5–0.9 cm; C = 1.0–1.5 cm and D = >1.5 cm). Results: CT scan reports of 89 patients with lung nodules were reviewed. On radiology, 73/89 (82%) were reported to be malignant nodule. Histopathological review of the biopsies of these 89 nodules confirmed malignancy in 50/89 (56.2%) patients. CT scan was found to be highly sensitive (94%, 95% confidence interval [CI]: 83.43–98.68%) but with a very low specificity (33.3%, 95% CI: 19.10–50.22%). CT scan was found to have a higher negative predictive value (81.2%, 95% CI: 54.34–95.73%) and a lower positive predictive value 64.4% (95% CI: 52.31–75.25%) when correlated with histopathological findings. Pathology of these nodules included metastatic sarcoma (27/89; 30.3%) and carcinoma (18/89; 20.2%). The frequency of the biopsy-proven malignant nodules on the right side was 26/45 (57.8%) and on the left side was 24/44 (54.5%) (P = 0.832). Malignant nodules were more frequent in lower lobes (28/43, 65.1%) than in upper lobes (14/32, 43.8%). These two sites combined accounted for 84% of all malignant nodules. There was a significant correlation between nodule size and likelihood of underlying malignancy. The overall prevalence of malignancy in the larger nodules (C and D) was much higher (23/30 and 76.7%) compared to the smaller sized (A and B) nodules (27/58 and 46.8%), P < 0.05.Conclusion: CT scan is a useful tool in the initial clinical assessment of indeterminate lung nodules with high sensitivity (94%) and a high negative predictive value (81.2%).Key words: Computed tomography, fibrosis, indeterminate lung nodule, infection, lung nodule, malignancy, metastase

SOLITARY FIBROUS TUMOR OF BREAST

Solitary fibrous tumours (SFTs) are fibroblastic mesenchymal tumour primarily identified in the pleura but are now being reported in other anatomic sites as well. SFT is generally characterised as a radiologically confined neoplasm composed of a proliferated spindle cells arranged in patternless manner. Intervening tissue shows prominent haemangiopericytoma-like vessels. Stroma is usually fibrous. Tumour is positive for CD34. SFT has a specific translocation representing fusion NAB2 with STAT6 genes. This translocation can be highlighted with very good specificity and sensitivity using STAT6 immunohistochemical stain. Some cases of SFTs have also been described in the breast. Rarely, SFT can show aggressive behaviour. SFT enters the differential diagnoses of benign and malignant spindle cell tumours of breast and it is, therefore, important that its clinical, radiological and pathological features are known to clinicians and diagnosticians. Key words: CD34, myofibroblastoma, NAB2-STAT6, solitary fibrous tumou

2-(4-Methyl­benzene­sulfonamido)-2-phenyl­acetic acid

In the title compound, C15H15NO4S, the dihedral angle between the phenyl and benzene rings is 46.0 (3)° and a weak intra­molecular N—H⋯O inter­action is present. The crystal structure is stabilized by inter­molecular O—H⋯O, N—H⋯O and C—H⋯O hydrogen bonds

Comparison of oxybutynin and tolterodine in treatment of detrusor overactivity associated with upper motor neuron lesions, based on changes in urodynamic parameters

To compare efficacy of oxybutynin and tolterodine in managing Detrusor Overactivity (DO) in Pakistani patients with different upper motor neuron lesions. Methods: A randomized controlled trial was carried out at Armed Forces Institute of Rehabilitation Medicine, Rawalpindi from January to August 2015 including individuals with a diagnosis of DO as a result of upper motor neuron lesions. Maximal detrusor pressure (MDP) and maximal cystometric capacity (MCC) were measured at baseline and at four months post-treatment. Group-A was treated with tolterodine and group-B with oxybutynin. Results: A total of 60 individuals (mean age: 43.9 ± 15 years) were included. Majority (83.3%) were male and had spinal cord injury as the commonest etiology (56.7%). Group-A had a mean pre-treatment MCC of 188.3 ± 48.2 ml, and a mean post-treatment MCC of 281.5 ± 49.1 ml (p\u3c 0.001). The mean pre-treatment MDP was 83.6 ± 9.5 cm of H2O, and the mean post-treatment value was 40.9 ± 10.2 cm of H2O (p\u3c 0.001). Group-B had a mean pre-treatment MCC of 209.8 ± 60.5 ml, and mean post-treatment MCC of 308.7 ± 65 ml (p\u3c 0.001). The mean pre-treatment MDP was 80.7 ± 10.6 cm of H2O, and the mean post-treatment value was 40.7 ± 10.1 cm of H2O (p\u3c 0.001). The difference in mean reduction in MCC and MDP produced by tolterodine and oxybutynin was statistically insignificant. Conclusions: Both oxybutynin and tolterodine showed similar efficacy in the treatment of DO based on measurable urodynamic outcomes

Synovial Lipomatosis; A Clinicopathological Study of a Rare Entity

Objective: This study was conducted to analyse the clinicopathological and radiological features associated with Synovial lipomatosis.Patients and Methods: Cases diagnosed as Synovial lipomatosis from 2008 to 2018 were retrieved and clinical information and histology were reviewed.Results: Thirteen cases of Synovial lipomatosis were diagnosed between 2008 and 2018. Most common site was knee joint and mean age of presentation was 28.6. About 62% of subjects were males and mostly presented with joint pain and swelling. Two of the subjects had significant history of trauma and disease was bilateral in one of the cases. Microscopically, villous proliferation of synovium with infiltration of mature adipocytes was noted. Focal synovial hyperplasia and inflammatory infiltrate were other findings in some of the cases.Conclusion: Synovial lipomatosis should be considered in the differential diagnosis of joint pain and swelling and should be distinguished from Pigmented villonodular synovitis, Synovial haemangioma and intra-articular synovial lipoma (IASL) using radiological and histological features

A methodological evaluation and predictive in silico investigation into the multi-functionality of arginine in directly compressed tablets

The acceleration of solid dosage form product development can be facilitated by the inclusion of excipients that exhibit poly-/multi-functionality with reduction of the time invested in multiple excipient optimisations. Because active pharmaceutical ingredients (APIs) and tablet excipients present diverse densification behaviours upon compaction, the involvement of these different powders during compaction makes the compaction process very complicated. The aim of this study was to assess the macrometric characteristics and distribution of surface charges of two powders: indomethacin (IND) and arginine (ARG); and evaluate their impact on the densification properties of the two powders. Response surface modelling (RSM) was employed to predict the effect of two independent variables; Compression pressure (F) and ARG percentage (R) in binary mixtures on the properties of resultant tablets. The study looked at three responses namely; porosity (P), tensile strength (S) and disintegration time (T). Micrometric studies showed that IND had a higher charge density (net charge to mass ratio) when compared to ARG; nonetheless, ARG demonstrated good compaction properties with high plasticity (Y=28.01MPa). Therefore, ARG as filler to IND tablets was associated with better mechanical properties of the tablets (tablet tensile strength (σ) increased from 0.2±0.05N/mm2 to 2.85±0.36N/mm2 upon adding ARG at molar ratio of 8:1 to IND). Moreover, tablets' disintegration time was shortened to reach few seconds in some of the formulations. RSM revealed tablet porosity to be affected by both compression pressure and ARG ratio for IND/ARG physical mixtures (PMs). Conversely, the tensile strength (σ) and disintegration time (T) for the PMs were influenced by the compression pressure, ARG ratio and their interactive term (FR); and a strong correlation was observed between the experimental results and the predicted data for tablet porosity. This work provides clear evidence of the multi-functionality of ARG as filler, binder and disintegrant for directly compressed tablets

Soft Tissue Tumours with Epithelioid Morphoogy

 To study the morphologicalfindings of soft tissue sarcomas with epithelioidmorphology and their distribution with respect tothe age, gender and location