Comparative Analysis of CT and MRI in Emergency Assessment of Stroke: A Review

Objective: To compare the diagnostic accuracy of computed tomography (CT) and magnetic resonance imaging (MRI)in emergency assessment of stroke in brain imaging from the review of literature. Method: Relevant databases (PubMed, google scholar etc.) were searched and literature were reviewed from 1995 to 2019. Literature from non-Scopus and unauthorized authorizations was excluded.Result: It was observed that for MRI DWI (Diffusion-weighted imaging) is preferred and in CT, axial sections are opted. In earlier studies, it was seen that neither CT nor MRI came out to besuperior. This may be due to the previous technology used. Some studies also, suggested that Diffusion-weighted imaging is highly accurate in diagnosis of stroke and also superior to CT. Another study suggested that SWI is a new approach in visualizing the hemorrhage in acute stroke. On one hand, evidence revealed that MRI is as good as CT. While on the other hand, literature concluded that CT angiography is good for intracranial and extracranial vasculature. Some studies suggested that CT is more reliable and is readily available for stroke. Conclusion: Present study concludes that both diagnostic imaging modalities i.e., CT and MRI have their advantages in diagnosis of ischemic and hemorrhagic stroke. Also chances of stroke increases with increase in age. Other factors influencing the stroke diagnosis and treatment are type of stroke, diagnostic imaging modality available, and cost-effectiveness of diagnostic exams performed

Evaluation of Patient Radiation Doses in Skull Radiography

Purpose: Exposures to medical ionizing radiations elevate the risk of stochastic effects such as cancer in exposed individuals. It is of utmost importance to monitor the radiation doses delivered to patients and their optimization to reduce the associated radiation risks without limiting the diagnostic information. Methods: Entrance surface air kerma (ESAK) in a total of 64 adult patients in diagnostic digital Xray examinations were calculated and effective doses were estimated as per International Atomic Energy Agency (IAEA). Results: Median ESAK (mGy) and associated effective doses obtained were skull PA (0.45mGy, 0.005mSv) and skull Lat (0.25mGy, 0.003mSv). Results were compared with UK diagnostic reference levels and studies in India.Conclusion: The comparison revealed that the calculated ESAK and effective dose values wereless than the published literature. ESAK values reported in this study could further contribute toestablishing LDRLs

Operational and Performance Experience with uMI550 Digital PET-CT during Routine Quality Control Procedures

Introduction The quality control (QC) procedures for positron emission tomography (PET) scanners are covered by National Electrical Manufacturers Association and International Electrotechnical Commission. QC must be carried out at regular intervals according to the specifications of the scanner manufacturer. Daily and weekly QC plays a valuable role in monitoring positron emission tomography (PET) scanner performance changes. This study shares operational and performance experience of QC procedures that do not require a radioactive Ge-68 source to perform daily QC and experience with fluorodeoxyglucose F18 (18F-FDG) as a substitute for germanium-68/sodium-22 (Ge-68/Na-22) source for weekly QC. Method This study was performed on an uMI550 digital positron emission tomography-computed tomography (PET-CT) scanner. In this scanner daily QC checks system temperature and humidity, system count rate, data link status, and voltage. QC was performed at the console control, the position of the scanner table was in the home position pulled out from the gantry, and the room was closed during the quick QC. Weekly full QC check items include look-up table drift, energy drift, time-of-flight status, C-map status, temperature and humidity, and voltage. Weekly full QC was performed with a 18F-FDG source in a rod phantom source. Results Over 200 daily QC tests without a radioactive source Ge-68 phantom and 50 full weekly QC tests using a 18F-FDG rod phantom were performed with this scanner according to the manufacturer's instructions and a test report was generated. No daily QC errors or warnings were observed during this period. Conclusion The new approach for the daily PET QC does not expose operators to radiation. This translates into commercial and operational merits with consistent performance and results. Implications for Practice Reduction in radiation exposure to operating staff during QC procedure in PET-CT scanner

Estimates of patient doses and kerma-area product monitoring in digital radiography

The application of the kerma-area product (PKA) meter is increased rapidly in dosimetry. This study presents measurements of PKA in adherence to the International Atomic Energy Agency protocol for 300 adult patients in digital radiographic procedures. Effective doses (ED) were calculated from PKA measurements and conversion coefficients (E-103/PKA) obtained from the International Commission on radiological protection 103. In skull posteroanterior (PA), skull lateral (LAT), cervical spine anteroposterior (AP), cervical spine LAT, chest PA, abdomen AP, lumbar spine AP, pelvis AP and lumbar spine LAT, the third-quartile PKA values were found to be 0.2, 0.28, 0.33, 0.19, 0.26, 0.95, 0.93, 0.96 and 3.15 Gycm2, and estimated mean EDs were 0.005, 0.008, 0.056, 0.021, 0.037, 0.146, 0.165, 0.097 and 0.258 mSv, respectively. The third-quartile PKA values were suggested as local diagnostic reference levels (LDRLs). Results were compared with the diagnostic reference levels (DRLs) of the UK, the European Commission, previously published LDRLs in Greece and China by Metaxas et al. and Zhang and Chu, respectively. The PKA (third-quartile) value for cervical spine AP was 120% higher than UK 2010 DRLs, lumbar spine LAT was 123% higher than LDRLs given by Metaxas et al. and chest PA was 160% higher than UK 2010 DRLs and 225% higher than Metaxas et al. provided LDRLs. The PKA results were lower than the UK, and two studies in Greece by Metaxas et al. except for chest PA, cervical spine AP and lumbar spine LAT showed the need for further optimization. The LDRLs reported in this study may further contribute to establishing future national DRLs

Estimation of entrance surface air kerma in digital radiographic examinations

Purpose: Contribution of radiation doses from medical X-ray examination to collective dose is significant. Unusually, high doses may increase the risk of stochastic effects of radiations. Therefore, radiation dose assessment was performed in 241 digital X-ray examinations in the study and was compared with published dose reference levels (DRLs). Methods: Entrance surface air kerma (ESAK) was calculated in chest PA, cervical AP/Lat, abdomen AP, lumbar AP/Lat and pelvis AP digital radiographic examinations (119 male and 122 female) following the International Atomic Energy Agency recommended protocol. Initially, 270 digital examinations were selected, reject analysis was performed and final 241 examinations were enrolled in the study for dose calculations. The exposure parameters and X-ray tube output were used for dose calculations. Effective doses were estimated with the help of conversion coefficients from ICRP 103. Results: Median ESAK (mGy) and associated effective doses obtained were cervical spine AP (1.30 mGy, 0.045 mSv), cervical spine Lat (0.25 mGy, 0.005 mSv), chest PA (0.11 mGy, 0.014 mSv), abdomen AP (0.90 mGy, 0.118 mSv), lumbar spine AP (1.52 mGy, 0.177 mSv), lumbar spine Lat (7.76 mGy, 0.209 mSv) and pelvis AP (0.82 mGy, 0.081 mSv). Results were compared with the studies of UK, Oman, India and Canada. Conclusion: The calculated ESAK and effective dose values were less than or close to previously published literature except for cervical spine AP and lumbar spine Lat. The results reinforce the need for radiation protection optimization, improving examination techniques and appropriate use of automatic exposure control in digital radiography. ESAK values reported in this study could further contribute to establishing local DRLs, regional DRLs and national DRLs

Targeted phenolic profiling of Sauvignon blanc and Shiraz grapes grown in two regions of India by liquid chromatography-tandem mass spectrometry

Not AvailableThe phenolic compounds play an important role in production of quality grapes and wines. The current investigation focused on optimization of an extraction method for targeted analysis of 33 phenolic compounds in grapes by liquid chromatography tandem mass spectrometry (LC–MS/MS). The optimized method was successfully used for phenolic profiling of two wine grape varieties, Sauvignon blanc (white) and Shiraz (red) originated from Pune and Nasik regions of Maharashtra State, India. The optimized sample preparation procedure involved liquid–liquid extraction with acidified methanol by vortexing for 2 min followed by analysis on LC–MS/MS. The limit of quantification of the targeted compounds was in the range of 29 to 411 µg/L. The results indicated that skin of both varieties contained the highest amount of flavonols (69.47 ± 14.74 mg/kg in Sauvignon blanc and 129.47 ± 10.05 mg/kg in Shiraz) compared to pulp. The highest amounts of flavan-3-ols were present in grape seed collected from the Pune region (2016.84 ± 14.73 mg/kg in Sauvignon blanc and 1945.06 ± 32.69 mg/kg in Shiraz). The concentration of stilbenes was the highest in grape skin (0.13 ± 0.52 to 5.78 ± 5.45 mg/kg) compared to seed and pulp of both varities. Hydroxybenzoic acid (vanillin), hydroxycinnamic acid (p-coumaric acid) and anthocyanins (oenin, malvidin, cyanidin and kuromanin) were found only in Shiraz variety. The results of antioxidant activity (FRAP and DPPH assay) indicated the highest scavenging activity in seed (978.64 ± 56.23 to1133.38 ± 143.65 µMol TE/g DW FRAP and 594.93 ± 37.94 to 631.94 ± 56.45 µMol TE/g DW in DPPH). The phenolic contents in Sauvignon blanc and Shiraz grapes between Pune and Nasik regions did not have any significant difference.Not Availabl

An epidemiological investigation of insomnia: A survey

Sleep is commonly defined as a state in which physical activities and sensory perception are greatly reduced, and it is frequently associated with our body's recuperative period. However, research has shown that sleep is also required for other vital processes such as memory consolidation and normal physiological functioning. Extensive research has shown that the areas that control our sleeping behaviour are the hypothalamus, brain stem, midbrain, and amygdala. These areas coordinate events during the non-REM and REM phases of sleep-wake cycles. GABA and adenosine, two chemical neurotransmitters, are also involved and play an important role in our sleep cycle. Insomnia has caused a slew of psychological and physiological issues such as fatigue, decreased mental concentration, irritable nature and a higher risk of heart attacks and stroke. It has reduced the patient's quality of life of the patient and have a social impact on them. Primary insomnia is defined as the inability/absence of proper sleep and impaired daily life functioning. Secondary insomnia, on the other hand, is believed to result from pre-existing medical conditions, substance abuse, or as a side effect of certain drug therapy. Insomnia is diagnosed through physical examination and the use of electrical devices to monitor sleep behavior.&nbsp