AVID triad: a case report

Asymmetric ventriculomegaly, interhemispheric cyst and dysgenesis of the corpus callosum (AVID) constitutes a rare imaging triad. Additional findings include subcortical and subependymal heterotopia, polymicrogyria, fused thalami, deficient falx, and hydrocephalus. The knowledge of this triad helps us to diagnose prenatally by sonography and fetal MRI. In this case report authors present MRI Imaging findings in a case of AVID syndrome in a 6year old male child presenting with history of seizures and delayed milestones

The role of computed tomography in the evaluation of cerebrovascular accidents

Background:Cerebrovascular accidents (CVA) or stroke ranks first in frequency and important among all the neurological diseases of adult life. 50% of neurological disorders in a hospital are of this type. It is the third leading cause of death throughout the world. The prolonged morbidity and extended hospitalization required by these patients makes the disease one of the most devastating in medicine. The purpose of the present study was to document the presence or absence of hemorrhage or infarct, to determine the size, location of infarct, reasonably assessing the territory to blood vessels involved and to detect the incidence of negative cases of clinically suspected stroke.Methods:100 cases admitted to KIMS, Hubli and those referred to the NMR scan centre, Hubli with the clinical diagnosis of acute stroke were taken up for the study. The study was done from May 2010 to April 2012.Results:Out of 100 patients clinically suspected of CVA, submitted for CT scan study of the brain, 69 patients had infarcts, 21 patients had hemorrhage, 8 patients had CVT, 1 patient had SAH and 1 patient had normal scans. Infarcts (69%) formed the major group of the CVA cases involving most commonly the LMCA territory in 10 (14.49%) patients. Hemorrhage (21%) formed the second major group of CVA cases involving most commonly the RMCA territory 9 (42.85%) patients.Conclusions:CT scanning is a gold standard technique for the diagnosis and management of stroke and can be ideally done in all cases.The role of computed tomography in the evaluation of                cerebrovascular accident

Organoaxial volvulus of descending colon: a case report

“Colonic volvulus” refers to the twisting of colon, which most commonly involves sigmoid colon causing obstruction, ischemia and gangrene. But very rarely segment of descending colon can be involved. This is a case of 42 year old male with vomiting, abdomen pain and distension since one day, showing organoaxial volvulus of descending colon loop with a twist of mesentery

An Unusual Presentation of “Two-Thirds Tumor” in the Mandible – A Diagnostic Quandary with a Review of the Literature

An adenomatoid odontogenic tumor (AOT) is an uncommon benign tumor of the oral cavity commonly found in the maxillary anterior region and is associated with impacted canines in young females. It rarely occurs in the mandibular region with no impacted or missing teeth. A 21-year-old female reported to the clinic with swelling on the right side of the face for the past six months with no history of pain. Radiographic features such as unilocular radiolucency with thinning of the cortical borders and considerable buccal cortical expansion, as well as some evidence of radiopaque specks were noted. Histopathological examination revealed cells with hyperchromatic nuclei, rosette-like structures with focal areas of calcified mass, and concentric rings resembling Liesegang rings, suggestive of AOT. The tumor was treated surgically by enucleation and cauterization. Although follicular type is a common variant, the tumor presented in this case was of extrafollicular type noted in the mandibular canine and premolar regions of a young female patient with no related impacted tooth

Flow regime mapping in gas-liquid flow in micro-channels

Experiments were conducted in a micro-channel with square cross-section with each side being 3 mm.nbsp Gas-liquid flow is employed for determining the flow patterns with water being liquid phase and nitrogen being gas phase.nbsp Over a wide range of gas and liquid velocities the flow patterns were studied using visual inspection technique.nbsp It is found that four types of flow regimes occurred within the range of variables considered in the present study.nbsp These are bubble flow, slug flow, channel flow and transient flow.nbsp A flow regime map is also constructed

Gene effects for grain iron and zinc in sorghum (sorghum bicolor L. Moench)

Sorghum bicolor L. Moench is a major food crop in African and Asian countries. Eradication of hidden hunger through fortification of food consumed is an easy way. Iron and Zinc deficiencies are widespread across the world.Thus the present investigation was carried out in sorghum to determine the gene action involved in the inheritance of grain iron and zinc concentrations and other related traits using generation mean analysis. Two crosses viz., ICSB 52 × IS 13211, ICSB 52 × SPV 1359, were made using diverse parents with varied levels of grain iron and zinc concentrations. Six generations viz., P1, P2, F1, F2, B1 and B2 were developed for the above crosses and were evaluated during post-rainy season, 2012- 13 at ICRISAT, Patancheru. The results of generation mean analysis revealed the predominant role of additive gene action and additive × additive component of epistasis was found responsible in the crosses ICSB 52 × IS 13211 and ICSB 52 × SPV 1359 in governing grain iron and zinc concentrations and days to 50 % flowering. For remaining traits viz., plant height, panicle length, panicle width, grain yield plant -1, 100- grain weight had dominance component and found responsible than additive. Among the interactions, dominance × dominance component was of higher value than the remaining in governing the traits under concern. For all the traits, the magnitude of interactions was of higher value than their respective direct effects

Retrieving back plastic wastes for conversion to value added petrochemicals: opportunities, challenges and outlooks

Plastic production and its unplanned management and disposal, has been shown to pollute terrestrial, aquatic, and atmospheric environments. Petroleum-derived plastics do not decompose and tend to persist in the surrounding environment for longer time. Plastics can be ingested and accumulate into the tissues of both terrestrial and aquatic animals, which can impede their growth and development. Petrochemicals are the primary feedstocks for the manufacture of plastics. The plastic wastes can be retrieved back for conversion to value added petrochemicals including aromatic char, hydrogen, synthesis gas, and bio-crude oil using various technologies including thermochemical, catalytic conversion and chemolysis. This review focusses on technologies, opportunities, challenges and outlooks of retrieving back plastic wastes for conversion to value added petrochemicals. The review also explores both the technical and management approaches for conversion of plastic wastes to petrochemicals in regard to commercial feasibility, and economic and environmental sustainability. Further, this review work provides a detailed discussion on opportunities and challenges associated with recent thermochemical and catalytic conversion technologies adopted for retrieving plastic waste to fuels and chemicals. The review also recommends prospects for future research to improve the processes and cost-efficiency of promising technologies for conversion of plastic wastes to petrochemicals. It is envisioned that this review would overcomes the knowledge gaps on conversion technologies and further contribute in emerging sustainable approaches for exploiting plastic wastes for value-added products

Why Are Outcomes Different for Registry Patients Enrolled Prospectively and Retrospectively? Insights from the Global Anticoagulant Registry in the FIELD-Atrial Fibrillation (GARFIELD-AF).

Background: Retrospective and prospective observational studies are designed to reflect real-world evidence on clinical practice, but can yield conflicting results. The GARFIELD-AF Registry includes both methods of enrolment and allows analysis of differences in patient characteristics and outcomes that may result. Methods and Results: Patients with atrial fibrillation (AF) and ≥1 risk factor for stroke at diagnosis of AF were recruited either retrospectively (n = 5069) or prospectively (n = 5501) from 19 countries and then followed prospectively. The retrospectively enrolled cohort comprised patients with established AF (for a least 6, and up to 24 months before enrolment), who were identified retrospectively (and baseline and partial follow-up data were collected from the emedical records) and then followed prospectively between 0-18 months (such that the total time of follow-up was 24 months; data collection Dec-2009 and Oct-2010). In the prospectively enrolled cohort, patients with newly diagnosed AF (≤6 weeks after diagnosis) were recruited between Mar-2010 and Oct-2011 and were followed for 24 months after enrolment. Differences between the cohorts were observed in clinical characteristics, including type of AF, stroke prevention strategies, and event rates. More patients in the retrospectively identified cohort received vitamin K antagonists (62.1% vs. 53.2%) and fewer received non-vitamin K oral anticoagulants (1.8% vs . 4.2%). All-cause mortality rates per 100 person-years during the prospective follow-up (starting the first study visit up to 1 year) were significantly lower in the retrospective than prospectively identified cohort (3.04 [95% CI 2.51 to 3.67] vs . 4.05 [95% CI 3.53 to 4.63]; p = 0.016). Conclusions: Interpretations of data from registries that aim to evaluate the characteristics and outcomes of patients with AF must take account of differences in registry design and the impact of recall bias and survivorship bias that is incurred with retrospective enrolment. Clinical Trial Registration: - URL: http://www.clinicaltrials.gov . Unique identifier for GARFIELD-AF (NCT01090362)

Improved risk stratification of patients with atrial fibrillation: an integrated GARFIELD-AF tool for the prediction of mortality, stroke and bleed in patients with and without anticoagulation.

OBJECTIVES: To provide an accurate, web-based tool for stratifying patients with atrial fibrillation to facilitate decisions on the potential benefits/risks of anticoagulation, based on mortality, stroke and bleeding risks. DESIGN: The new tool was developed, using stepwise regression, for all and then applied to lower risk patients. C-statistics were compared with CHA2DS2-VASc using 30-fold cross-validation to control for overfitting. External validation was undertaken in an independent dataset, Outcome Registry for Better Informed Treatment of Atrial Fibrillation (ORBIT-AF). PARTICIPANTS: Data from 39 898 patients enrolled in the prospective GARFIELD-AF registry provided the basis for deriving and validating an integrated risk tool to predict stroke risk, mortality and bleeding risk. RESULTS: The discriminatory value of the GARFIELD-AF risk model was superior to CHA2DS2-VASc for patients with or without anticoagulation. C-statistics (95% CI) for all-cause mortality, ischaemic stroke/systemic embolism and haemorrhagic stroke/major bleeding (treated patients) were: 0.77 (0.76 to 0.78), 0.69 (0.67 to 0.71) and 0.66 (0.62 to 0.69), respectively, for the GARFIELD-AF risk models, and 0.66 (0.64-0.67), 0.64 (0.61-0.66) and 0.64 (0.61-0.68), respectively, for CHA2DS2-VASc (or HAS-BLED for bleeding). In very low to low risk patients (CHA2DS2-VASc 0 or 1 (men) and 1 or 2 (women)), the CHA2DS2-VASc and HAS-BLED (for bleeding) scores offered weak discriminatory value for mortality, stroke/systemic embolism and major bleeding. C-statistics for the GARFIELD-AF risk tool were 0.69 (0.64 to 0.75), 0.65 (0.56 to 0.73) and 0.60 (0.47 to 0.73) for each end point, respectively, versus 0.50 (0.45 to 0.55), 0.59 (0.50 to 0.67) and 0.55 (0.53 to 0.56) for CHA2DS2-VASc (or HAS-BLED for bleeding). Upon validation in the ORBIT-AF population, C-statistics showed that the GARFIELD-AF risk tool was effective for predicting 1-year all-cause mortality using the full and simplified model for all-cause mortality: C-statistics 0.75 (0.73 to 0.77) and 0.75 (0.73 to 0.77), respectively, and for predicting for any stroke or systemic embolism over 1 year, C-statistics 0.68 (0.62 to 0.74). CONCLUSIONS: Performance of the GARFIELD-AF risk tool was superior to CHA2DS2-VASc in predicting stroke and mortality and superior to HAS-BLED for bleeding, overall and in lower risk patients. The GARFIELD-AF tool has the potential for incorporation in routine electronic systems, and for the first time, permits simultaneous evaluation of ischaemic stroke, mortality and bleeding risks. CLINICAL TRIAL REGISTRATION: URL: http://www.clinicaltrials.gov. Unique identifier for GARFIELD-AF (NCT01090362) and for ORBIT-AF (NCT01165710)

Two-year outcomes of patients with newly diagnosed atrial fibrillation: results from GARFIELD-AF.

AIMS: The relationship between outcomes and time after diagnosis for patients with non-valvular atrial fibrillation (NVAF) is poorly defined, especially beyond the first year. METHODS AND RESULTS: GARFIELD-AF is an ongoing, global observational study of adults with newly diagnosed NVAF. Two-year outcomes of 17 162 patients prospectively enrolled in GARFIELD-AF were analysed in light of baseline characteristics, risk profiles for stroke/systemic embolism (SE), and antithrombotic therapy. The mean (standard deviation) age was 69.8 (11.4) years, 43.8% were women, and the mean CHA2DS2-VASc score was 3.3 (1.6); 60.8% of patients were prescribed anticoagulant therapy with/without antiplatelet (AP) therapy, 27.4% AP monotherapy, and 11.8% no antithrombotic therapy. At 2-year follow-up, all-cause mortality, stroke/SE, and major bleeding had occurred at a rate (95% confidence interval) of 3.83 (3.62; 4.05), 1.25 (1.13; 1.38), and 0.70 (0.62; 0.81) per 100 person-years, respectively. Rates for all three major events were highest during the first 4 months. Congestive heart failure, acute coronary syndromes, sudden/unwitnessed death, malignancy, respiratory failure, and infection/sepsis accounted for 65% of all known causes of death and strokes for <10%. Anticoagulant treatment was associated with a 35% lower risk of death. CONCLUSION: The most frequent of the three major outcome measures was death, whose most common causes are not known to be significantly influenced by anticoagulation. This suggests that a more comprehensive approach to the management of NVAF may be needed to improve outcome. This could include, in addition to anticoagulation, interventions targeting modifiable, cause-specific risk factors for death. CLINICAL TRIAL REGISTRATION: http://www.clinicaltrials.gov. Unique identifier: NCT01090362