Hydrogeochemical characterization of groundwater in transboundary aquifers of Gurdaspur district, Punjab India.

Interpretation of spatial variations in chemistry of groundwater is necessary to appraise the pathways of groundwater and ascertain the most valuable strategies for the conservation and sustainable use of groundwater resources. Multivariate statistics and, in particular, factor analysis can efficiently support spatial variations in hydrogeochemical data providing an understanding of natural and anthropogenic effects on quality of groundwater. The present paper illustrates the integrated approach of hydrogeochemical methods and multivariate statistical investigation of the groundwater along transboundary aquifers in 5 blocks of Gurdaspur District, Punjab, India. Assessment of hydrochemistry diagrams indicated that the foremost water categories were Ca, Mg-HCO3. Outcomes of factor evaluation indicated that the weathering activities and agricultural practices were the dominant controlling factors in the study area. Even though, maximum of the groundwater samples was within the permitted limits of drinking standards, few of the samples cross them and some of the samples were quite close to permissible limits representing that the groundwater quality may deteriorate in immediate future. This infers the necessity of appropriate monitoring of quality of water for the sustainable protection and safeguarding of groundwater resources in the region

Temporal instability of a power-law viscoelastic nanofluid layer

The stability of the interface formed by a viscoelastic nanofluid and viscous incompressible fluid is examined here. The layout is taken in such a way that the viscoelastic nanofluid lies above the viscous fluid, and therefore, the interface experiences Rayleigh–Taylor type instability. The power-law viscoelastic liquid is considered for the linear stability analysis and the potential flow theory of viscous fluids is enforced to solve the mathematical equations. This theory includes the viscosity of the fluids in the analysis, while the flow is considering as irrotational. The stress balance equation at the interface contains normal viscous stresses and their difference is neutralized by interfacial tension. An algebraic equation of second degree is achieved and stability/instability is discussed based on the negative/positive roots of this equation. The response of flow parameters is studied by the various plots based on the growth rate parameter. It is found that the perturbation grows rapidly in the case of viscoelastic nanofluid when compared with the Newtonian nanofluid

A Study of Sexually Transmitted Infections Among Patients Attending Suraksha Clinic & Targeted Intervention Clinics In Nainital District: A Cross-Sectional Survey

Background: Sexually transmitted infections (STIs) pose a global health threat, particularly among vulnerable populations. Aligned with the National AIDS Control Program, this study focuses on estimating the prevalence of STIs in India, targeting Chlamydia trachomatis, Neisseria gonorrhoeae, Treponema pallidum, and Trichomonas vaginalis. The aim is to identify gaps, understand factors influencing STI screening, and propose improvements. Objectives: Uncover barriers in STI screening, diagnosis, and management at Suraksha and targeted intervention clinics. Identify socio-demographic factors associated with screening barriers. Methodology: Sample unit: Patients at Suraksha and TI clinics. Sample size: 577 participants, including community-surveyed and health camp attendees. Sampling design: Complete enumeration. Cross-sectional survey in specified Haldwani and Nainital clinics. Results: Age group 20-40 exhibits higher symptomatic individuals, underscoring the need for screening in young and middle-aged adults. Only 55% of positive cases sought treatment, citing stigma, mild symptoms, and unawareness. Health workers, especially spouses, play a crucial role in testing and counseling. Delayed presentation at health facilities due to long waiting times, mild symptoms, lack of awareness, and distance. Conclusions: While the program succeeds in various aspects, infrastructure improvement, heightened awareness, and addressing stigma are crucial. Recommendations include more staff, wider service publicity, and better availability of essential resources

Value of Minimum Apparent Diffusion Coefficient on Magnetic Resonance Imaging as a Biomarker for Predicting Progression of Disease Following Surgery and Radiotherapy in Glial Tumors from a Tertiary Care Center in Northern India

Purpose: Studies have shown that cellularity of glial tumors are inversely correlated to minimum apparent diffusion coefficient (ADC) values derived on diffusion-weighted imaging (DWI). The purpose of this prospective exploratory study was to evaluate whether temporal change in “minimum ADC” values during follow-up predict progressive disease in glial tumors post radiotherapy and surgery. Materials and Methods: Adult patients of glial tumors, subjected to surgery followed by Radiotherapy (RT), were included in the study. Serial conventional magnetic resonance imaging with DWI at the following time points – presurgery, pre-RT, post-RT imaging at 3, 7, and 15 months were done. For “minimum ADC” values, multiple regions of interest (ROI) were identified on ADC maps derived from DWI. A mean of 5 minimum ADC values was chosen as “minimum ADC” value. The correlation was drawn between histology and minimum ADC values and time trends were studied. Results: Fourteen patients were included in this study. Histologies were low-grade glioma (LGG) - 5, anaplastic oligodendroglioma (ODG) -5, and glioblastoma multiforme (GBM) - 4. Minimum ADC values were significantly higher in LGG and GBM than ODG. Presurgery, the values were 0.812, 0.633, and 0.787 × 10−3 mm2/s for LGG, ODG, and GBM, respectively. DWI done at the time of RT planning showed values of 0.786, 0.636, 0.869 × 10−3 mm2/s, respectively. During follow-up, the increasing trend of minimum ADC was observed in LGG (P = 0.02). All these patients were clinically and radiologically stable. Anaplastic ODGs, however, showed an initial increase followed by the fall of minimum ADC in all the 5 cases (P = 0.00). Four of the five cases developed progressive disease subsequently. In all the 4 GBM cases, a consistent fall of minimum ADC values was observed (P = 0.00), and they all progressed in spite of RT. Conclusions: The DWI-derived minimum ADC values are an important yet simple quantitative tool to assess the treatment response and disease progression before they are evident on conventional imaging during the follow-up of glial tumors

Dynamic susceptibility contrast and dynamic contrast-enhanced MRI characteristics to distinguish microcystic meningiomas from traditional Grade I meningiomas and high-grade gliomas

OBJECTIVE Microcystic meningioma (MM) is a meningioma variant with a multicystic appearance that may mimic intrinsic primary brain tumors and other nonmeningiomatous tumor types. Dynamic susceptibility contrast (DSC) and dynamic contrast-enhanced (DCE) MRI techniques provide imaging parameters that can differentiate these tumors according to hemodynamic and permeability characteristics with the potential to aid in preoperative identification of tumor type. METHODS The medical data of 18 patients with a histopathological diagnosis of MM were identified through a retrospective review of procedures performed between 2008 and 2012; DSC imaging data were available for 12 patients and DCE imaging data for 6. A subcohort of 12 patients with Grade I meningiomas (i.e., of meningoepithelial subtype) and 54 patients with Grade IV primary gliomas (i.e., astrocytomas) was also included, and all preoperative imaging sequences were analyzed. Clinical variables including patient sex, age, and surgical blood loss were also included in the analysis. Images were acquired at both 1.5 and 3.0 T. The DSC images were acquired at a temporal resolution of either 1500 msec (3.0 T) or 2000 msec (1.5 T). In all cases, parameters including normalized cerebral blood volume (CBV) and transfer coefficient (kTrans) were calculated with region-of-interest analysis of enhancing tumor volume. The normalized CBV and kTrans data from the patient groups were analyzed with 1-way ANOVA, and post hoc statistical comparisons among groups were conducted with the Bonferroni adjustment. RESULTS Preoperative DSC imaging indicated mean (± SD) normalized CBVs of 5.7 ± 2.2 ml for WHO Grade I meningiomas of the meningoepithelial subtype (n = 12), 4.8 ± 1.8 ml for Grade IV astrocytomas (n = 54), and 12.3 ± 3.8 ml for Grade I meningiomas of the MM subtype (n = 12). The normalized CBV measured within the enhancing portion of the tumor was significantly higher in the MM subtype than in typical meningiomas and Grade IV astrocytomas (p < 0.001 for both). Preoperative DCE imaging indicated mean kTrans values of 0.49 ± 0.20 min−1 in Grade I meningiomas of the meningoepithelial subtype (n = 12), 0.27 ± 0.12 min−1 for Grade IV astrocytomas (n = 54), and 1.35 ± 0.74 min−1 for Grade I meningiomas of the MM subtype (n = 6). The kTrans was significantly higher in the MM variants than in the corresponding nonmicrocystic Grade 1 meningiomas and Grade IV astrocytomas (p < 0.001 for both). Intraoperative blood loss tended to increase with increased normalized CBV (R = 0.45, p = 0.085). CONCLUSIONS An enhancing cystic lesion with a normalized CBV greater than 10.3 ml or a kTrans greater than 0.88 min−1 should prompt radiologists and surgeons to consider the diagnosis of MM rather than traditional Grade I meningioma or high-grade glioma in planning surgical care. Higher normalized CBVs tend to be associated with increased intraoperative blood loss

Diffusion Tensor and Dynamic Contrast-Enhanced Magnetic Resonance Imaging Correlate with Molecular Markers of Inflammation in the Synovium

Objectives: It is difficult to capture the severity of synovial inflammation on imaging. Herein we hypothesize that diffusion tensor imaging (DTI) derived metrics may delineate the aggregation of the inflammatory cells and expression of inflammatory cytokines and dynamic contrast-enhanced (DCE) imaging may provide information regarding vascularity in the inflamed synovium. Patients and methods: Patients with knee arthritis (&gt;3-months duration) underwent conventional (T2-weighted fast spin echo and spin echo T1-weighted images) as well as DTI and DCE MRI and thereafter arthroscopic guided synovial biopsy. DCE and DTI metrics were extracted from the masks of the segments of the inflamed synovium which enhanced on post-contrast T1-weighted MRI. These metrics were correlated with immunohistochemistry (IHC) parameters of inflammation on synovium. Statistical analysis: Pearson&rsquo;s correlation was performed to study the relationship between DTI- and DCE-derived metrics, IHC parameters, and post-contrast signal intensity. Linear regression model was used to predict the values of IHC parameters using various DTI and DCE derived metrics as predictors. Results: There were 80 patients (52 male) with mean age 39.78 years and mean disease duration 19.82 months. Nineteen patients had tuberculosis and the rest had chronic undifferentiated monoarthritis (n = 31), undifferentiated spondyloarthropathy (n = 14), rheumatoid arthritis (n = 6), osteoarthritis (n = 4), reactive arthritis (n = 3), ankylosing spondylitis (n = 2), and juvenile idiopathic arthritis (n = 1). Fractional anisotropy (FA), a metric of DTI, had significant correlation with number of immune cells (r = 0.87, p &lt; 0.01) infiltrating into the synovium and cytokines (IL-1&beta;, r = 0.55, p &lt; 0.01; TNF-&alpha;, r = 0.42, p &lt; 0.01) in all patients and also in each group of patients and adhesion molecule expressed on these cells in all patients (CD54, r = 0.51, p &lt; 0.01). DCE parameters significantly correlated with CD34 (blood flow, r = 0.78, p &lt; 0.01; blood volume, r = 0.76, p &lt; 0.01) in each group of patients, a marker of neo-angiogenesis. FA was the best predictor of infiltrating inflammatory cells, adhesion molecule and proinflammatory cytokines. Amongst the DCE parameters, blood volume, was best predictor of CD34. Conclusion: DTI and DCE metrics capture cellular and molecular markers of synovial inflammation in patients with chronic inflammatory arthritis

Revisiting epidermal growth factor receptor in glioblastoma multiforme: Does it play a role in response to therapy?

Background and Aim: Glioblastoma multiforme (GBM) are the most aggressive class of cancer of central nervous system with hallmark characteristics that include rampant proliferation, necrosis, and endothelial proliferation. Epidermal growth factor receptor (EGFR) has been implicated as the primary contributor to glioblastoma initiation and succession. The present study was designed to evaluate EGFR protein expression in GBM as predictor of response to therapy and survival. Materials and Methods: Epidermal growth factor receptor was assessed by immunohistochemistry as a percentage of positive tumor cells in hot spots (10 high-power fields). The study group comprised of 35 cases of GBM. All cases underwent surgical resection and subsequently underwent radiotherapy (n = 17) or radiotherapy with adjuvant temozolomide chemotherapy (n = 18). Immediate response to therapy was assessed at 3 months using World Health Organization response evaluation criteria in solid tumors criteria and cases followed up for survival. Results: Twenty-four cases (68.6%) expressed EGFR while 11/35 (31.4%) cases were negative. Response to therapy was evident in 21/35 cases (60.0%) and 14/35 were (40.0%) nonresponders. Mean EGFR protein expression in responders was 37.23 ± 33.70 and in nonresponders was 59.5 ± 39.46 (P = 0.542). The percentage of responders which were EGFR negative was 72.7% and while response in EGFR positive cases was observed in 54.2%. Mean survival in EGFR positive and negative GBM was 394.37 ± 189.11 and 420.54 ± 191.23 days, respectively. Conclusion: The EGFR negative cases appear to respond better to therapy, however, the difference is not statistically significant (P = 0.298). Further, EGFR protein expression does not play a definitive role in predicting survival. This is an original study evaluating EGFR in terms of therapeutic response

Utility of multiparametric 3-T MRI for glioma characterization

BACKGROUND AND PURPOSE: Accurate grading of cerebral glioma using conventional structural imaging techniques remains challenging due to the relatively poor sensitivity and specificity of these methods. The purpose of this study was to evaluate the relative sensitivity and specificity of structural MRI and MR measurements of perfusion, diffusion, and spectroscopic parameters for glioma grading. A secondary objective was to evaluate a whole-brain MR spectroscopic imaging method for evaluation of brain tumors. MATERIALS AND METHODS: Fifty six patients with radiologically suspected untreated glioma were studied with T1- and T2-weighted MR imaging, DCE-MR imaging, DTI, and volumetric whole-brain MR spectroscopic imaging. ROC analysis was performed using the relative CBV, ADC, FA, and multiple spectroscopic parameters to determine optimum thresholds for tumor grading and to obtain the sensitivity, specificity, PPV, and NPV for identifying high-grade gliomas. Logistic regression was performed to analyze all the parameters together. RESULTS: The relative CBV individually classified glioma as low and high grade with a sensitivity and specificity of 100% and 88% respectively based on a threshold value of 3.34. On combining all parameters under consideration, the classification was achieved with 2% error and sensitivity and specificity of 100% and 96% respectively. CONCLUSION: Individually, CBV measurement provides the greatest diagnostic performance for predicting glioma grade; however, the most accurate classification can be achieved by combining all of the imaging parameters. The whole-brain MR spectroscopic imaging method provided data from of a large fraction of the tumor volumes