The prevalence of osteopenia and osteoporosis in out-patients above 40 years of a tertiary care hospital in Delhi

Background: Osteoporosis is a common bone disorder among Indian population but is still underdiagnosed. Being a treatable disease, early diagnosis can significantly reduce osteoporotic fractures and other morbidities. Despite multiple studies globally regarding the prevalence of osteoporosis and osteopenia, the data about Indian population especially in males is limited. In this study, we aim to calculate the prevalence of osteoporosis in patients over 40 years of age attending the out-patients department of a tertiary care hospital in New Delhi.Methods: A cross-sectional study was done including 231 patients (147 females and 84 males) over the age of 40 years. Calcaneal quantitative ultrasonography (QUS) was used to measure the bone mineral density and the results were divided into normal, osteopenic and osteoporotic groups on the based on equivalent heel T score.Results: Of the total 231 patients, 78 patients had a normal bone mass density as measured by calcaneal QUS. 123 patients (53.2%) were found to be osteopenic while 30 patients (13.1%) were osteoporotic. Of the 147 females, 84 (57%) were osteopenic while 27 (18%) patients were found to be osteoporotic. Among the 84 males, 39 (46%) were osteopenic and 3 (4%) were found to be osteoporotic.Conclusions: The prevalence of osteoporosis and osteopenia in outpatients over 40 years was high in our study and similar in values with other studies involving the Indian population. Hence, we recommend regular screening and early detection of osteoporosis to reduce the burden of the disease

Superparamagnetic Nanoparticles in Exploratory Energy Research

Superparamagnetic nanoparticles are a special class of nanoparticles that exhibit hyperthermic effects when placed under an alternating magnetic field. The applications of these particles have been previously limited to biomedical fields, as an alternative to traditional cancer treatment, targeted drug delivery systems, and to enhance MRI contrast. The potential for use in energy and propulsion applications has been less explored, despite the vast promise these particles provide. The magnetic hyperthermia that results from superparamagnetism could benefit an engine’s efficiency by preheating the fuel, thus reducing the energy required to perform combustion. Two types of nanoparticles, Cu0.1Ni0.9Mn2O4 and magnetite (Fe3O4), were synthesized via the coprecipitation method and coated with oleic acid and PEG5000 to promote dispersion. These particles were then characterized using x-ray diffraction (XRD), transmission electron microscopy (TEM), scanning electron microscopy (SEM), and vibrating sample magnetometry (VSM). The heating properties were investigated through the use of an externally applied alternating magnetic field (AMF) and the measured corresponding temperature rise over time. This exploratory research shows great promise for the potential application of these nanoparticles as a fuel additive to enhance engine performance and suggests further research in this area should be conducted

Spatial Positioning and Operating Parameters of a Rotary Bell Sprayer: 3D Mapping of Droplet Size Distributions

In this study, we evaluated the fundamental physical behavior during droplet formation and flow from a rotary bell spray in the absence of an electrostatic field. The impact of a wide range of operating parameters of the rotary bell sprayer, such as flow rates, rotational speeds, and spatial positioning, on droplet sizes and size distributions using a three-dimensional (3-D) mapping was studied. The results showed that increasing the rotational speed caused the Sauter mean diameter of the droplets to decrease while increasing flow rate increased the droplet sizes. The rotational speed effect, however, was dominant compared to the effect of flow rate. An increase in droplet size radially away from the cup was noted in the vicinity of the cup, nevertheless, as the lateral distances from the cup and rotational speed were increased, the droplet sizes within the flow field became more uniform. This result is of importance for painting industries, which are looking for optimal target distances for uniform painting appearance. Furthermore, the theoretical formulation was validated with experimental data, which provides a wider range of applicability in terms of environment and parameters that could be tested. This work also provides an abundance of measurements, which can serve as a database for the validation of future droplet disintegration simulations

Delayed Spontaneous Thrombosis of Neglected Direct Carotid-Cavernous Fistula: A Case Report

Direct carotid-cavernous fistula (CCF) refers to direct communication between the cavernous portion of the internal carotid artery (ICA) and the cavernous sinus due to rent in the ICA, most commonly secondary to trauma. These are generally high-flow fistula and rarely resolve spontaneously. We report a case of a young male who developed features of direct CCF after trauma, was denied any treatment for 4 years, and then presented with spontaneous thrombosis of the fistula and a residual large pseudoaneurysm of the cavernous segment of the right ICA, which was subsequently managed with parent vessel occlusion

Impact of nicotine replacement therapy as an adjunct to anti-tuberculosis treatment and behaviour change counselling in newly diagnosed pulmonary tuberculosis patients: an open-label, randomised controlled trial.

We evaluated the impact of intensive smoking cessation activities as an adjunct to anti-tuberculosis treatment on patient-related treatment outcomes. In this open-label, randomised controlled trial, self-reporting smokers with pulmonary tuberculosis who initiated standard anti-tuberculosis treatment were randomised to either nicotine replacement therapy and behaviour change counselling (n = 400) or counselling alone (n = 400) provided at baseline and two follow-up visits. The primary outcomes were change in TBscore at 24-weeks and culture conversion at 8-weeks. Biochemical smoking quit rates defined as serum cotinine levels <10 ng/mL and/or exhaled carbon monoxide levels <6 ppm (47·8% vs 32·4%, p-value =< 0·001) and self-reported quit rates (69.3% vs 38·7%, p-value =< 0·001) were significantly higher in the intervention arm at 24-weeks. Though the TBscores at 24 weeks (95% CI) were lower in the intervention arm [2·07 (1·98, 2·17) versus 2.12 (2·02, 2·21)], the difference was not clinically meaningful. Patients in the control arm required treatment extension more often than intervention arm (6·4% vs 2·6%, p-value = 0·02). Combining nicotine replacement therapy with behaviour change counselling resulted in significantly higher quit rates and lower cotinine levels, however, impact on patient-related (TBscore) or microbiological outcomes (culture conversion) were not seen

Bone island and hand involvement A short review

Bone island or enostosis is an enigmatic lesion affecting the skeleton system. As these anomalies have limited clinical implications owing to an asymptomatic course with most cases diagnosed incidentally, the exact etiopathogenesis is not clearly understood. A lot has been studied regarding radiological features and morphology despite scarce clinical cases and relevant studies. More research is warranted to provide in-depth details of these lesions that has potential to enlighten us with newer aspects of bone metabolism and properties. These lesions might just not be an aberration and may offer important clues about bone behavior and morphogenesis. Bone islands, when in large number, are associated with equally fascinating disorder called osteopoikilosis. This review, however, does not include osteopoikilosis on purpose. Hand involvement, although rarer, has been described and a short review is attempted to acknowledge that apart from relevant facts on diagnosis and management. [Hand Microsurg 2018; 7(2.000): 93-97

Epithelioid angiomyolipoma with tumor thrombus in IVC and right atrium

Epithelioid angiomyolipoma is an uncommon subtype of renal angiomyolipoma associated with potentially malignant behavior and is considered a distinct entity by the World Health Organization classification of renal tumors. We present a case of an epithelioid variant of angiomyolipoma with extension into the renal vein, inferior vena cava reaching up to the right atrium. Pre-operatively, a diagnosis of renal cell carcinoma was considered based on imaging findings. Intra-operatively due to extensive adhesions, surgical resection was not performed and only tissue sampling was performed for histopathology. Microscopic examination revealed short fascicles of spindle cells and perivascular epithelioid cells. A differential diagnosis of renal cell carcinoma with sarcomatoid differentiation was considered. The immunohistochemical profile showed tumor cells that express Melan-A and smooth muscle actin, while they were negative for pan-cytokeratin, PAX8, CK7, CD117 and CD34. Therefore a diagnosis of epithelioid angiomyolipoma was rendered. The presence of intravascular thrombi on radiological investigation and carcinoma-like growth pattern on light microscopy may compound an erroneous diagnosis of renal cell carcinoma. Hence, it is prudent for the urologist to consider differential diagnosis other than renal cell carcinoma when confronted with a renal neoplasm presenting with intravascular thrombi. In these cases, a core biopsy should be planned pre-operatively and diagnosis should be made with aid of appropriate immunohistochemical markers