A PACS alternative for transmitting DICOM images in a high latency environment

Picture Archiving and Communication System(PACS) is responsible for storing Digital Imaging and Communication in Medicine (DICOM) images fromradiology modalities into its database, images takes a lot of time to transfer to remote location through WAN due to large file size and slow transfer protocol. A PACS alternative system has been developed which performs basic functions of a generic PACS. Images directly from modalities are large in size by default transfer syntax of these images is Endian Explicit syntax. Changing this transfer syntax to lossless JPEG 2000 decreases the file size and because of lossless compression quality of image is still same as original image. These compressed images are then copied into Network Attached Storage working as PACS alternative. A series of test conducted in lab with multiple transfer protocol on Network Attached Storage (NAS) to find out which transfer protocol is faster under moderate speed and high latency network

Study on drug use pattern in the management of the cardiovascular diseases and with comorbidities

Background: Cardiovascular drugs are the number one cause of death globally; more people die annually from CVDs then from any other cause CVD. The purpose of this study to identify the rationality of drug prescribed for cardiovascular diseases with its comorbidities. Along with medication adherence and cost analysis. To assess the drug use pattern and to observe the drug related complications in patients with cardiovascular diseases.Methods: A hospital based prospective observational study was conducted at department of medicine in RMMCH. A total of 79 patients were enrolled based on inclusion criteria and the data was collected using designed data collection form.Results: Data of 79 patients were collected over 6 months mean age of patients with 19.95-60.5. Male to female ratio was 1.43:1. In cardiovascular diseases, most common disease conditions are systemic hypertension and acute coronary syndrome seen in our study population. Average drugs prescribed per patient was 4-9. Most frequently prescribed drug classes were beta blocker, antiplatelet, hypolipidemic agent. In these few minor drug interactions have been found. Study has no adverse drug reaction. The average cost of drugs was prescribed for 2500-3200 IND. Before patient counseling medication adherence and outcomes were less after counseling, medication adherence and outcomes are increased from 5% to 65%.Conclusions: The study concludes that most of the drugs were prescribed rationally according to world health organization/ESC guidelines. As behalf of this study, we could provide the information about the risk factor, leading commodities. Importance of medication adherence and cost of medications to cardiovascular drugs

LARVICIDAL AND ENZYME INHIBITORY EFFECTS OF ACALYPHA FRUTICOSA (F.) AND CATHARANTHUS ROSEUS L (G) DON. LEAF EXTRACTS AGAINST CULEX QUINQUEFASCIATUS (SAY.) (DIPTERA: CULICIDAE)

ABSTRACTObjective: The prime objective of this study is to evaluate the larvicidal and enzyme inhibitory effects of Acalypha fruticosa and Catharanthus roseusleaf extracts against Culex quinquefasciatus.Methods: Insecticidal susceptibility tests were carried out using the World Health Organization standard method, and the mortality was observedafter 24 hrs exposure.Results: The tested extracts showed a significant larvicidal activity depending on the dose of the plant extracts. However, maximum larval mortalitywas detected in ethyl acetate extract of A. fruticosa with a lethal concentration (LC50) value of 253.08 ppm and (LC90) value of 455.40 ppm followedby hexane extract of C. roseus with LC50 value of 645.33 ppm and LC90 value of 1452.88 ppm against the larvae of C. quinquefasciatus. In control, therewere five different fractions of α-carboxylesterases resolved in the gel with the mobilities ranging between 0.14 and 0.66. β-carboxylesterase isozymeprofile of larvae treated with hexane extract of A. fruticosa showed higher enzyme activities by way of intense staining of fractions both at 1/4 and1/10 LC50 value of 48 hrs treatments. A. fruticosa ethyl acetate extract, and C. roseus hexane extract exposed larvae indicated increased quantitiesof β-Est4/5 isozymes in the concentration of 1/4 and 1/10 of LC50 value of 24 hrs treatment when compared to control. The protein quantity in themajority of treatments decreased compared to control.Conclusion: The results revealed that the organic leaf extract of A. fruticosa and C. roseus had significant larvicidal and enzyme inhibitory effectsagainst C. quinquefasciatus.Keywords: Acalypha fruticosa, Catharanthus roseus leaves extract, β-carboxylesterase, Culex quinquefasciatus, Lethal concentration50

An interesting case of neurocutaneous syndrome

Neuroichthyosis is a group of rare genetically determined disease with cutaneous and neurological manifestations due to abnormalities in any of the following: lipid metabolism, glycoprotein synthesis, or intracellular vesicle trafficking. There are about 16 disorders with known genetic aetiology like Sjogren Larssons syndrome (SLS), Refsum disease, Gauchers disease type 2, ELOVL4 deficiency etc. Among the various neuroicthyosis syndromes, Sjogren Larsson syndrome is the most common entity characterised by ichthyosis, spastic diplegia or tetraplegia, cognitive dysfunction, seizures, and a maculopathy with glistening white dots. We hereby report a case of neuroichthyosis disease who presented to us with developmental delay, spastic paraplegia, seizure and ichthyosis, whose genetic testing showed homozygous mutation in ALDH3A2, suggestive of Sjogren Larsson syndrome

A COMPARATIVE STUDY OF CONJUNCTIVAL AUTOGRAFT AND BARE SCLERA TECHNIQUES IN THE TREATMENT OF PTERYGIUM

Objective: Pterygium is a fibrovascular growth encroaching from the conjunctiva into the cornea. This study deals with the comparison of conjunctival autograft and bare sclera technique as treatment options for pterygium. Methods: This study was done in the ophthalmology department of Saveetha Medical College, Thandalam, Chennai. A total of 100 patients were diagnosed of pterygium was taken for the study, out of which 60 patients were operated on with conjunctival autograft and 40 patients were operated with bare sclera technique. Patients with hypertension, diabetes mellitus were excluded. Post-operative complications and recurrence were noted. All the patients were between the age group of 20-65 y. Results: The mean age of patients operated with conjunctival autograft was 43.6, whereas in bare sclera technique was 46.625. The maximum age was 63 and the minimum age was 23 in conjunctival autograft whereas in bare sclera technique, the maximum age was 64 and the minimum age was 22. The recurrence rate of pterygium in conjunctival autograft was 1 and the recurrence rate of pterygium in bare sclera technique was 4. Conclusion: The present study revealed that conjunctival autograft was a better treatment option compared to the bare sclera technique for excision of pterygiu

Steroids Up-Regulate p66Shc Longevity Protein in Growth Regulation by Inhibiting Its Ubiquitination

p66Shc, an isoform of Shc adaptor proteins, mediates diverse signals, including cellular stress and mouse longevity. p66Shc protein level is elevated in several carcinomas and steroid-treated human cancer cells. Several lines of evidence indicate that p66Shc plays a critical role in steroid-related carcinogenesis, and steroids play a role in its elevated levels in those cells without known mechanism.In this study, we investigated the molecular mechanism by which steroid hormones up-regulate p66Shc protein level. In steroid-treated human prostate and ovarian cancer cells, p66Shc protein levels were elevated, correlating with increased cell proliferation. These steroid effects on p66Shc protein and cell growth were competed out by the respective antagonist. Further, actinomycin D and cyclohexamide could only partially block the elevated p66Shc protein level by steroids. Treatment with proteasomal inhibitors, but not lysosomal protease inhibitor, resulted in elevated p66Shc protein levels, even higher than that by steroids. Using prostate cancer cells as a model, immunoprecipitation revealed that androgens and proteasomal inhibitors reduce the ubiquitinated p66Shc proteins.The data collectively indicate that functional steroid receptors are required in steroid up-regulation of p66Shc protein levels in prostate and ovarian cancer cells, correlating with cell proliferation. In these steroid-treated cells, elevated p66Shc protein level is apparently in part due to inhibiting its ubiquitination. The results may lead to an impact on advanced cancer therapy via the regulation of p66Shc protein by up-regulating its ubiquitination pathway

Computed Tomography With Intravenous Contrast Alone: The Role of Intra‐abdominal Fat on the Ability to Visualize the Normal Appendix in Children

Background Computed tomography ( CT ) with enteric contrast is frequently used to evaluate children with suspected appendicitis. The use of CT with intravenous ( IV ) contrast alone ( CT IV ) may be sufficient, however, particularly in patients with adequate intra‐abdominal fat ( IAF ). Objectives The authors aimed 1) to determine the ability of radiologists to visualize the normal (nondiseased) appendix with CT IV in children and to assess whether IAF adequacy affects this ability and 2) to assess the association between IAF adequacy and patient characteristics. Methods This was a retrospective 16‐center study using a preexisting database of abdominal CT scans. Children 3 to 18 years who had CT IV scan and measured weights and for whom appendectomy history was known from medical record review were included. The sample was chosen based on age to yield a sample with and without adequate IAF . Radiologists at each center reread their site's CT IV scans to assess appendix visualization and IAF adequacy. IAF was categorized as “adequate” if there was any amount of fat completely surrounding the cecum and “inadequate” if otherwise. Results A total of 280 patients were included, with mean age of 10.6 years (range = 3.1 to 17.9 years). All 280 had no history of prior appendectomy; therefore, each patient had a presumed normal appendix. A total of 102 patients (36.4%) had adequate IAF . The proportion of normal appendices visualized with CT IV was 72.9% (95% confidence interval [ CI ] = 67.2% to 78.0%); the proportions were 89% (95% CI  = 81.5% to 94.5%) and 63% (95% CI  = 56.0% to 70.6%) in those with and without adequate IAF (95% CI for difference of proportions = 16% to 36%). Greater weight and older age were strongly associated with IAF adequacy (p < 0.001), with weight appearing to be a stronger predictor, particularly in females. Although statistically associated, there was noted overlap in the weights and ages of those with and without adequate IAF . Conclusions Protocols using CT with IV contrast alone to visualize the appendix can reasonably include weight, age, or both as considerations for determining when this approach is appropriate. However, although IAF will more frequently be adequate in older, heavier patients, highly accurate prediction of IAF adequacy appears challenging solely based on age and weight. Resumen Tomografía Computarizada Únicamente con Contraste Intravenoso: El Papel de la Grasa Intrabadominal en la Capacidad para Visualizar el Apéndice Normal en los Niños Introduction La tomografía computarizada ( TC ) con contraste entérico es usada frecuentemente para evaluar a los niños con sospecha de apendicitis. El uso de la TC únicamente con contraste intravenoso ( TC IV ) puede ser suficiente, especialmente en pacientes con adecuada grasa intrabdominal ( GIA ). Objetivos 1) Determinar la capacidad de los radiólogos para visualizar el apéndice normal (sin enfermedad) con TC IV en niños, y valorar si la cantidad de GIA afecta a esta capacidad; y 2) valorar la asociación entre la idoneidad de la GIA y las características del paciente. Metodología Estudio retrospectivo de 16 hospitales que utilizó una base de datos prexistente de TC abdominales. Se incluyó a los niños entre 3 y 18 años que tenían una TC IV , una medida del peso e historia de apendectomía conocida por la revisión de la historia clínica. La muestra se eligió en base a la edad con el fin de conseguir una muestra con y sin GIA adecuada. Los radiólogos de cada centro releyeron las TC IV de sus centros para valorar la visualización del apéndice y la adecuación de la GIA . La GIA se clasificó como “adecuada” si había cualquier cantidad de grasa completamente alrededor del ciego e “inadecuada” si era de otra manera. Resultados Se incluyeron 280 pacientes, con una media de edad de 10,6 años (rango 3,1 a 17,9 años). Ninguno tenía historia previa de apendectomía; por lo tanto todos los pacientes tuvieron un apéndice presumiblemente normal. Ciento dos pacientes (36,4%) tuvieron GIA adecuada. El porcentaje de apéndices normales visualizados con TC IV fue de 72,9% ( IC 95% = 67,2% a 78,0%); la proporción fue 89% ( IC 95% = 81,5% a 94,5%), y 63% ( IC 95% = 56,0% a 70,6%) en aquéllos con y sin GIA adecuada ( IC 95% para la diferencia de proporciones = 16% a 36%). El mayor peso y la mayor edad se asociaron fuertemente con la adecuación de la GIA (p < 0,001), y el peso resultó ser el mayor factor predictivo, especialmente en mujeres. Aunque se asoció estadísticamente, se vio un solapamiento en los pesos y edades de aquéllos con y sin GIA adecuada. Conclusiones Los protocolos que usan la TC IV para visualizar el apéndice pueden razonablemente incluir el peso, la edad, o ambas como consideraciones para determinar cuándo esta aproximación es apropiada. Sin embargo, aunque la cantidad de GIA será frecuentemente más apropiada en los pacientes más mayores y de mayor peso, la predicción certera de adecuación de GIA es altamente desafiante si se basa sólo en la edad y el peso.Peer Reviewedhttp://deepblue.lib.umich.edu/bitstream/2027.42/99695/1/acem12185.pd