Nuclear and Infranuclear Lesions of 3,4,6 Cranial Nerve Lesions and their Clinicoradiological Correlation.

Palsies of any of the three cranial nerves supplying the extra ocular muscles have their presentations, disturbing ocular motility. Abnormalities of ocular motility help in the localization of lesions of the cerebral hemispheres, brain stem, cranial nerves (CNs), and even the striated muscle. Only one nerve may be involved or there may be a combination of the three nerves. The palsies are usually acquired. Sometimes palsies can be congenital due to the developmental defect of the nucleus or motor nerve fibers. Oculo motor fibers can be interrupted intraaxially or extraaxially. Lesions can be in the foramens or extra cranial e.g. Intraorbital. All these Oculomotor nerves can be affected in the brainstem (nucleus or fascicular portion)1, in the subarachnoid space, in the cavernous sinus, at the superior orbital fissure, or in the orbit. MRI has become the most useful diagnostic tool in the localization, diagnosis and management of the nuclear and infranuclear lesions of 3, 4, 6 cranial nerves. In conditions like vasculitis and prothrombotic states, laboratory investigations add on to radiological findings and histopathological evaluation is useful when there are therapeutic difficulties. Cranial nerves 3, 4, and 6th palsies can be due to head injury2,26. In many studies head injury is very well correlated with imaging. In this study, we have excluded the head injury patients presenting with 3, 4&6 cranial nerve palsies. CONCLUSION : 1) In this study, there was no sex preponderance. 2) Commonest age group of presentation was 30-40 years. 3) Among the 3,4 and 6 cranial nerves,commonly affected was the 3rd cranial nerve followed by 4th cranial nerve and 6thcranial nerve 4) Among the combinations of cranial nerves, Bilateral 6th nerve involvement and unilateral 3,4,6 cranial nerve involvement were the commonest presentations, followed by bilateral 3,4,6 th cranial nerve involvement. 5) The combinations of 3&4, 3&6 and 4&6 cranial nerve involvement were not found in our series. 6) MRI showed abnormal findings in 70% of the patients, whereas CT showed abnormal findings only in 25% of patients. 7) The commonest cause of nuclear and infranuclear 3.4.6 cranial nerve lesion was Diabetes Mellitus in this study. 8) The commonest cause of imaging negative etiology in this study was Diabetes Mellitus

Knowledge and practices regarding pharmacoeconomics among resident doctors in a tertiary care teaching hospital

Background: With skyrocketing health care costs, even the essential care provided by the health care service providers need to be evaluated under the lens. The development of nationwide awareness of cost-benefit, cost-utility and cost-effectiveness of services is the need of the hour. The objectives of the present study were to assess the knowledge about pharmacoeconomics among resident doctors and to assess the clinical application of pharmacoeconomics among them.Methods: A cross sectional questionnaire-based survey was conducted among resident doctors involving both interns and post-graduates of a teaching medical college. There were 20 questions; initial ten were for knowledge assessment and next ten questions assessed practical applications. Questions assessed the knowledge regarding components of pharmacoeconomics, direct and indirect medical costs, and application of pharmacoeconomics, local cost-effectiveness decisions and advantages of pharmacoeconomics.Results: Of the 118 participants who took part in the study, 42 were clinicians working in medical college hospital, 12 were clinicians working in dental college hospital, 24 medial postgraduates, 30 dental postgraduates and 10 interns. Nearly 90% of the respondents opine that concepts of pharmacoeconomics are not followed in every teaching hospital in India. Many participants (90%) opined that health economics and pharmacoeconomic are different. Nearly 94% of participants have not under gone any training regarding pharmacoeconomics. More than 95% respondents have opined that principles of pharmacoeconomics has to be introduced into current medial undergraduate curriculum.Conclusions: This study shows light on the knowledge and practices of resident doctors regarding principles of pharmacoeconomics. This study has revealed the level of awareness of younger generation regarding pharmacoeconomics

EFFECT OF GEMCITABINE ON FEMALE FERTILTY – AN ANIMAL MODEL STUDY

Background and objectives: Advances in cancer chemotherapy have led to improved survival rates and poses greater emphasis on preserving quality of life post-treatment. Gonadotoxicity is a well-recognized side effect of many cancer chemotherapeutic agents. This study was designed to evaluate the effects of gemcitabine, an antimetabolite anticancer drug, on oogenesis in Swiss albino mice and its reversibility. Methods: Thirty six inbred female Swiss albino mice in diestrous phase were selected and divided into three groups of twelve each. Groups were labelled as A, B and Control. Groups A and B received 40 mg/kg and 80 mg/kg of gemcitabine intraperitoneally. The control group received saline intraperitoneally. At the end of two weeks 6 mice were sacrificed from each group and the rest at the end of 2 months.  Ovaries were studied histologically. Results: After 2 weeks, the ovaries of experimental group mice showed more number of atretic follicles as compared to control group (p<0.01). The diameter of corpus lutea was more, though a reduction in number was recorded in experimental group (p<0.05).  Whereas after 2 months, both the experimental groups showed no difference in terms of atretic follicles, diameter and number of corpus lutea (p>0.05). Conclusions: These findings suggest that administration of gemcitabine may have profound effects on oogenesis and hence female fertility. This study also suggests that the effects are reversible. Keywords: Gemcitabine; Oogenesis; Swiss albino mice; atretic follicles; corpus luteum

Throat related symptoms and voice: development of an instrument for self assessment of throat-problems

<p>Abstract</p> <p>Background</p> <p>Symptoms from throat (sensation of globus; frequent throat clearing; irritated throat) are common in patients referred to voice clinics and to ENT specialists. The relation to symptoms of voice discomfort is unclear and in some cases patients do not have voice problems at all. Instruments for patients' self-reporting of symptoms, and assessment of handicap, such as the Voice Handicap Index (VHI), are in common use in voice clinics. Symptoms from throat are however only marginally covered. Purpose: To develop and evaluate an instrument that could make the patients' estimation of symptoms from the throat possible. Further to facilitate the consideration of the relation between throat- and voice problems with the Throat subscale together with a Swedish translation of the Voice Handicap Index. Finally to try the VHI with the Throat subscale: the VHI-T, for test-retest reliability and validity.</p> <p>Methods</p> <p>A subscale with 10 throat related items was developed for appliance with the VHI. The VHI was translated to Swedish and retranslated to English. The questionnaire was tried in two phases on a total of 23+144 patients and 12+58 voice healthy controls. The reliability was calculated with Cronbach's alpha, ICC and Pearson's correlation coefficient. The validity was estimated by independent T-test.</p> <p>Results</p> <p>The difference in VHI-T scores between the patients and the voice-healthy controls was significant (<it>p </it>= < 0,01) and there was a good correlation of the test- retest occasions. The reliability testing of the entire questionnaire showed an alpha value of <it>r </it>= 0,90 and that for the Throat subscale separately a value of <it>r </it>= 0,87 which shows a high degree of reliability.</p> <p>Conclusions</p> <p>For the estimation of self-perceived throat and voice problems the scale on throat related problems together with the present Swedish translation of the Voice Handicap Index, (VHI) the VHI-Throat, proves to be a valid and reliable instrument. The throat subscale seems to help revealing a category of symptoms that are common in our patients. These are symptoms that have not earlier been possible to cover with the questionnaires designed for use in the voice clinic.</p

Evolution of structure and composition during the synthesis of mesoporous silica SBA-15 studied by small-angle neutron scattering

In-situ time-resolved small-angle neutron scattering (SANS) has been applied for the study of the formation of mesoporous silica SBA-15. The advantage of neutron scattering, compared to X-ray scattering, is the possibility to contrast match i.e. highlight certain parts of the sample. Three different solvents with different scattering contrasts were used for each synthesis. Three different silica sources (tetramethyl orthosilicate, tetraethyl orthosilicate and tetrapropyl orthosilicate) were used and in three cases salts (sodium chloride or sodium bromide) were added prior to addition of the silica source. Hence, the effect of the silica sources and of the salts, on the formation of SBA-15 was investigated. The main focus was on the evolution of the ordered hexagonal structure i.e. investigation of the (10) Bragg peak. In synchrotron SAXS measurements the intensity of the (10) Bragg peak continuously increases during the measurement. However, in the SANS measurements the (10) Bragg peak area decreases with time. The decrease of the (10) peak is highly dependent on the solvent, a larger fraction of D2O in the solvent results in a bigger reduction. The decrease is also more pronounced when salt is present in the synthesis. The reduction of intensity reflects the chemistry in the wall and is explained by the compositional change in the wall during the maturation of the hexagonal order. (C) 2010 Elsevier Masson SAS. All rights reserved

Adaptable Handy Clench for Destitute of Vision using GSM

ABSTRACT: For those with no or limited sense of sight, navigating through the world can be a challenge. The visually impaired must rely on senses other than sight such as hearing and touch to guide them. The walking cane has been the traditional navigational tool for the bind, but it offers only a limited sense of the environment that is focused mainly on protecting the legs and feet. Our model aims at providing short texting while navigation for the destitute using GSM along with the detection of human, obstruction and fire on the way. This has the advantage of having as many degrees of freedom as the hand and requires fewer actuators and sensors compared to a head-mounted display

In Situ Observation of the Genesis of Mesoporous Silica SBA-15: Dynamics on Length Scales from 1 nm to 1 mum.

We report on the mechanism of growth of mesoporous silica (SBA-15, plane group p6m). In situ studies of the formation using ultrasmall angle X-ray scattering (USAXS) and small-angle X-ray scattering (SAXS) covering length scales from 5 to 10 000 A, complemented with UV-vis and transmission electron microscopy (TEM), provide unique data on particle growth coupled with information regarding the progression of the mesostructure formation and the micellar evolution