Nasal septal angle deviation: effect on lateral wall in nasal obstruction

Background: Deviation of the nasal septum (DNS) refers to the convexity of the septum to one side disturbing the nasal physiology with obstructed nasal breathing leading to lateral nasal wall abnormalities and paranasal sinuses (PNS) mucosal disease. Knowledge of nasal morphological parameters plays an important role in planning successful nasal surgery. Our aim was to evaluate the angle of septal deviation (ASD) on CT scan and study its influence on the lateral nasal wall abnormalities and PNS mucosal disease.Methods: A prospective cross-sectional observational study was conducted on 130 patients with clinical evidence of DNS and chronic sinusitis. The direction and severity of DNS was recorded on CT scan along with evaluation of lateral nasal wall and sinus mucosal abnormalities.Results: Increasing ASD had statistically significant correlation with the lateral nasal wall abnormalities, most commonly, contralateral middle and inferior turbinate hypertrophy (p-value <0.0001). No significant association was found with the incidence of ipsilateral or contralateral osteomeatal complex (OMC) obstruction and sinus mucosal disease.Conclusions: The direction and severity of septal deviation has significant impact on contralateral middle and inferior turbinate hypertrophy. The analysis of these ancillary pathologies can be of great help to the surgeon in better management of patients with nasal obstruction

Relationship between grey scale sonographic grades of fatty liver and shear wave elastographic values: an observational study

Background: Due to the growing public health menace of metabolic syndrome, the Non-Alcoholic Fatty Liver Disease (NAFLD) has been recording a burgeoning global rise. The prognosis of NAFLD is largely depends upon its histological stage. Simple steatosis has a fairer prognosis, while Non-Alcoholic Steatohepatitis (NASH) has a poorer prognosis with tendency to progression into fibrosis and end stage liver disease. Until now, the diagnosis of varying grades of NAFLD has been dependent upon liver biopsy, which is indisputably the most reliable tool to distinguish between simple steatosis, steatohepatitis, and end stage liver disease. The sonographic grading of NAFLD is primarily based on subjective findings, the results of which may vary between different observers. Hence, there is a need to identify a reliable non-invasive objective substitute. To compare the sonographic grades of fatty liver on gray scale with liver stiffness (Kpa) values of shear wave elastography. Also, an attempt to establish objective criteria for grading of fatty liver with improved accuracy and increased specificity.Methods: Cross sectional, observational study comprising of 240 adults referred for routine abdominal sonography. All patient underwent gray scale sonography and shear wave elastography and results were analysed.Results: A significant positive correlation was found between various grades of NAFLD as assessed subjectively on grey scale sonography to the liver stiffness in kilopascal (Kpa) using shear wave elastography.Conclusions: Shear wave elastography being an objective imaging tool is a reliable modality compared to grey scale sonography in diagnosis of NAFLD and has the capacity to carry out quantitative evaluation of liver parenchyma in vivo

Diagnostic accuracy of an integrated approach using conventional ultrasonography, and Doppler and strain elastography in the evaluation of superficial soft tissue lesions

Introduction: To assess the diagnostic accuracy of an integrated approach using conventional ultrasonography, colour Doppler ultrasonography, and elastography strain ratios in tandem in the evaluation of superficial soft tissue lesions. Material and methods: Sixty-five subjects were included in this prospective cross-sectional study. Greyscale features and Doppler parameters were recorded. Strain elastography of the non-vascular and non-cystic lesions was performed and strain ratios were calculated. Fine-needle aspiration or biopsy of all the lesions was performed depending on their site and condition. Inter-rater k agreement was used to determine the strength of agreement between imaging-based diagnosis and histopathological diagnosis. A diagnostic test was used to calculate the sensitivity, specificity, positive predictive value, and negative predictive value. A p value of < 0.05 was considered statistically significant. Results: Multiple superficial soft tissue lesions were studied, the majority of which were lipomas, vascular anomalies, and epidermoid cysts. The diagnostic accuracy was very high and varied from 92.31% to 100% for various masses. The imaging-based diagnosis was in agreement with the histopathological diagnosis in 86.15% (n = 56) and disagreement in 13.85% (n = 9) of the cases (p < 0.007). There was very good inter-rater agreement between the imaging-based diagnosis and histopathological diagnosis (κ = 0.818). Conclusions: The combined use of conventional ultrasonography, colour Doppler, and elastography strain ratios provides a very effective non-invasive tool for the diagnosis of superficial soft tissue lesions and may negate the need for unnecessary biopsies. The advantage of this integrated approach using various ultrasound techniques needs no further emphasis

Irradiation Studies of LED Light Spectra on the Growth and Development of Potato (Solanum tuberosum L.)

The study aimed to explore the impacts of distinctive qualities of the LED light (such as to low power consumption, lesser production costs, longer operational lifetime and cool light emission with specific monochromatic wavelength) on potato (Solanum tuberosum L.) growth and development including plant height, number of leaves, root length, fresh and dry weight etc. The accumulation of phyto-pigments, soluble proteins and sugars, free radical scavenging activity and overall tuber yield were also evaluated. Enhanced plant height with increased diameter and branching was observed with the plant growing under the B100 and R30B70 LED light combination. Similarly, total number of leaves, leaf surface area, health index, phyto-pigments and tuber yield of potato was also significantly increased as compared to the plant growing under the W100 as control. Soluble proteins and sugar content and free radical scavenging enzyme activity were also significantly enhanced in the R30B70 LED light combination. Tubers yield per plants were also enhanced under the RB combination of the LED light. The current study indicated that the combination of R and B LED lights proved better for plant growth and development in a controlled environment and the R30B70 is the best combinational spectra for increased growth and tuber yield of potato plants. Therefore, the precise management of the irradiance and wavelength may hold promise in maximizing the economic efficiency of potato production, and quality of this important vegetables grown in controlled environments

The Effect of Phototherapy on Various Biochemical Parameters in Neonatal Hyperbilirubinemia

Phototherapy (PT) is the current modality of choice for treatment of unconjugated hyperbilirubinemia. The effects of PT onvarious biochemical parameters including serum calcium, bilirubin profile, serum total protein, albumin, urea, creatinine,serum electrolytes in neonates are a concern in current times. Like any other treatment, PT also has its own side effects.This hospital-based, prospective, comparative observational study was conducted with the objective to assess the level ofvarious biochemical parameters like serum calcium, serum sodium, serum potassium, serum chloride, serum urea and serumcreatinine, serum total protein and serum albumin in addition to serum bilirubin before PT and after completion of 48 hoursof PT in full-term neonates with unconjugated hyperbilirubinemia at a tertiary care center. On comparing biochemicalparameters, a statistically significant difference in parameters such as bilirubin, urea, creatinine, sodium, potassium, chloride,calcium, total protein and albumin was observed after PT. On the other hand, there was a statistically nonsignificant differencein corrected calcium (p = 0.945)

Parathyroid Adenoma: Sand Behind the Storm

Hyperparathyroidism is a metabolic disorder caused by increased levels of parathormone levels. Depending on underlying etiology, it can be sub-classified into primary, secondary, and tertiary types. Hyperparathyroidism can present as hyperplasia or adenoma in association with syndromes like Multiple Endocrine Neoplasia (MEN) or other familial syndromes. We are presenting a case of hyperparathyroidism due to underlying parathyroid adenoma with characteristic radiological and nuclear imaging findings

Tubercular abscess of pons in a child with quadriparesis

Tuberculous brain abscess is a rare manifestation of tuberculosis of the central nervous system. We report a case of a 6-year-old girl with a pontine tuberculous abscess, who presented with fever and quadriparesis and recovered completely after stereotactic aspiration and antituberculous treatment with four drugs (isoniazid, rifampicin, pyrazinamide, and ethambutol). Tuberculous abscess was confirmed based on findings of magnetic resonance imaging, a positive tuberculin test, and the presence of acid fast bacilli in smear and culture of abscess aspirate

Case series on phyllodes tumour of breast in young females: Unusual clinico-radiological presentations in unusual age group—Thinking beyond fibroadenomas!

Abstract Background Phyllodes tumours (PT) of the breast are rare primary breast neoplasms, mostly seen in fourth to fifth decades of life. These tumours are exceptionally rare in children and young females. The clinico-radiological features often overlap with fibroadenoma. Though imaging plays a pivotal role in providing an initial diagnostic approach, the final confirmation is dispensed on histopathology, which further classifies PT into either benign, low-grade malignant (borderline), or high-grade malignant. On reviewing the literature, only 20 cases have been reported so far in young females, with majority of them being benign and very few numbers of malignant PT. Case presentation Herein, we report the clinical and imaging features of PT in four young females, of benign, borderline and high-grade malignant categories as confirmed on histopathology, thereby adding few more numbers to the already existing cases. Additionally, our fourth case depicts rare presentation of high-grade malignant recurrent PT in adolescent female with nodal and unilateral ovarian metastases. Conclusions In conclusion, a possibility of PT should be considered in differential diagnosis in a large rapidly enlarging breast mass even in young females with characteristic imaging features, as it alters the plan of management