HYBRID BONE SCINTIGRAPHY IN GASTROINTESTINAL MALIGNANCIES – INSTITUTIONAL EXPERIENCE

Objective: Bone metastases in gastrointestinal (GI) malignancies are uncommon and known to be predominantly lytic thus rendering a limited role for conventional bone scintigraphy. The aim of the study is to review Tc99m MDP bone scans performed in patients with known GI malignancy and the utility of Single-photon emission computed tomography (SPECT)/CT in characterization of bone lesions.Methods: Retrospective review of bone scans was done from June 2014 to December 2016 in patients with known GI malignancy, using electronic Hospital Information System.Results: A total of 110 patients (60 males, 50 females; Age range: 22–84 years, Mean Age 51.4 years with SD of 14.8) had bone scan over a period of 30 months. The commonest indications for referral were suspected bone metastasis on other imaging modalities including [CT (n = 56), Magnetic resonance imaging (n = 10), Positron emission tomography/CT (n = 6)], musculoskeletal pain (n = 37), pathological fracture (n = 1), neurological symptoms (n = 1), hypercalcemia (n = 1) and others (n =14) including restaging workup etc. Metastatic lesions were identified in 32 (29%) patients whereas 78 (71%) patients had benign non-aggressive lesions leading to normal bone scans. Among 32 patients with osseous metastasis, 8 (25%) patients had unifocal lesion; axial skeleton (n = 2) appendicular skeleton (n = 6), 24 (75%) patients had multifocal lesions; axial skeleton (n = 6), appendicular skeleton (n = 6) and both axial + appendicular (n = 12). Four (12%) patients had concurrent visceral metastases. In our cohort, based on the location of primary tumour, the frequencies of osseous metastasis were; esophagus = 15 out of 43 (35%), gastric = 7 out of 18 (39 %), gastro-esophageal junction = 1 out of 8 (1.5%) and colorectal = 9 out of 40 (22.5). SPECT/CT was acquired in 29 out of 110 patients, which characterized metastatic lesions (n = 12) and benign looking non-aggressive entities (n =17). Overall, bone scan upstaged disease in 31% and down staged 15% patients.Conclusion: Bone metastases in GI malignancies, though uncommon, show an aggressive pattern, with axial and appendicular involvement, and can be readily identified with hybrid bone scintigraphy in symptomatic patients. Key words: Hybrid imaging, Tc99m MDP, bone metastases, gastrointestinal malignancie

INTRAOSSEOUS HAEMANGIOMAS ON HYBRID IMAGING: A PICTORIAL REVIEW

Osseous haemangiomas are benign skeletal tumours, usually identi ed as incidental ndings on different imaging modalities. Bone scan is the most frequent radionuclide procedure performed as metastatic workup in patients with various malignancies. Not every hotspot on a staging bone scan is malignant. Haemangiomas with variable degree of radiotracer uptake on technetium-99m (Tc-99m) bone scintigraphy may be falsely labelled as metastases in background of known malignancy. The addition of single-photon emission computed tomography computed tomography (SPECT-CT) enhances the specificity of bone scan which allows accurate detection and anatomical localisation of scintigraphic findings. We present a case series as pictorial review of osseous haemangiomas identi ed on Tc-99m methylene diphosphonate SPECT CT at our department. Key words: Haemangioma, methylene diphosphonate, bone scan, single-photon emission computed tomography- computed tomograph

Chipless RFID Tag for Touch Event Sensing and Localization.

A novel Radio Frequency Identification (RFID) based sensor supporting touch detection and localization features is proposed in this work. The formulated sensor leverages chipless variant of RFID technology for the design of a passive fully-printable frequency domain-based sensor-incorporated tag. The sensor is composed of square resonators arranged in a peculiar fashion laid down across a 3×2 grid. The proposed sensor incorporated-tag readily keeps track of human-digit position, allowing for tracking of finger-swipes which, in turn, can potentially be used for recognition of unlock patterns and security codes. Performance of the sensor is analyzed using its Radar Cross Section (RCS) response observable in the spectral domain. Each constituent resonant-element making up the sensor resonates at a single frequency represented by a distinct dip in the RCS response. The spectral dip drifts well outside of its allocated band upon occurrence of a touch event. A functional prototype of the sensor tag is fabricated on a 0.508 mm thick Rogers RT/Duroid ® 5880 laminate is scrutinized of its electromagnetic performance. The sensor possesses a compact physical footprint equal to 45 mm ×55 mm. The obtained results solidify the suitability of the proposed sensor for deployment in secure access control settings prevalent in smart cities and connected home applications

Frequency of Myocardial Infarction in Type 2 Diabetic Patients with Peripheral Arterial Disease

Objective:  This study aimed at determining the frequency of MI in diabetic Pakistani patients with PAD in a Pakistani tertiary care hospital. Methodology: A cross-sectional study carried out at Diabetes Research Centre, Nishtar Hospital Multan for six months from July 10, 2018 to January 09, 2019. The study was approved from the institutional ethics committee. As per study inclusion/exclusion criteria, the patients suffering from DM with PAD were enrolled, after signing the study informed consent. Each patient underwent electrocardiogram (ECG) recording under PI supervision. Patients having pathological Q waves (0.04 seconds wide and 2 mm deep) in two relevant leads were labeled as having myocardial infarction. Results: A total of 290 patients (men: 56.2% and women: 43.8%) were included in the study. Mean age of the patients was 51.29 ± 8.54 years with age range of 40-85 years. There were 71 (24%) smokers and 219 (76%) non-smoker patients. Fifty percent of the total patients were obese. Mean duration of diabetes was 7.39 ± 0.36 years whereas mean duration of peripheral arterial disease was 1.604 ± 0.005 years. The frequency of MI among diabetic patients with PAD was 14.8%. Conclusion: Prevalence of 14.8% MI in the present study alarms to diagnose and treat diabetes and PAD patients at earlier stage

Hypertension-related knowledge, medication adherence and health-related quality of life (HRQoL) among hypertensive patients in Islamabad, Pakistan

Purpose: To determine knowledge regarding hypertension, adherence to medication and HealthRelated Quality of Life (HRQoL), and their associations in hypertensive patients in Pakistan. Methods: A cross-sectional study was conducted among 384 hypertensive patients attending a tertiary health care public sector hospital in Islamabad, Pakistan. Data were collected using knowledge questionnaire regarding hypertension, Morisky Medication Adherence Scale, and EuroQol (EQ-5D) scale. Results: The mean systolic and diastolic blood pressures of the 384 patients were 140.39 ± 15.485 and 88.74 ± 10.683 mmHg, respectively. The coefficient of correlation between knowledge regarding hypertension and adherence was 0.638 (p < 0.001), showing a positive association. The correlation coefficient between knowledge and HRQoL was 0.709 (p < 0.001), suggesting a good association. The correlation coefficient between adherence to medication and HRQoL was 0.545 (p < 0.001), which indicated a positive correlation. Conclusion: These results indicate that there are statistically significant associations between hypertension knowledge and HRQoL, hypertension knowledge and medication adherence, and between adherence and HRQoL in the hypertensive patients studied

Comparative bioavailability analysis of oral alendronate sodium formulations in Pakistan

Alendronate sodium, a bisphosphonate drug, it is used to treat osteoporosis and other bone diseases. The present study was designed to conduct comparative bioavailability analysis of oral formulations of alendronate sodium through an open-label, randomized, 2-sequence, 2-period crossover study. Healthy adult male Pakistani volunteers received a single 70 mg dose of the test or reference formulation of alendronate sodium followed by a 7 day washout period. Plasma drug concentrations were determined using a validated HPLC post column fluorescence derivatization method. AUC0-t, AUC0-8, Cmax and Tmax were determined by non-compartmental analysis and were found within the permitted range of 80% to 125% set by the US Food and Drug Administration (FDA). Results show that both in vitro and in vivo assays of all test brands were within the specification of the US Pharmacopoeial limits and were statistically bioequivalent. No adverse events were reported in this study

Role of Flavonoids as Wound Healing Agent

Flavonoids are found as the most abundant bioactive compounds all around the world. It is found in a number of medicinal plants that are used as wound healing agents in traditional medicinal uses such as Buddleja globosa, Moringa oleifera, Lam, Butea monosperma, Parapiptadenia rigida and Ononis spinosa. Flavonoids nowadays are being used in different formulation and wound healing dressings. Inflammation, proliferation and reepithelialization are involved in wound healing. Most of the wound healing medicinal plants possess multiple flavonoids that act as synergistic effect or combined effect. This chapter briefly reviews the role of flavonoids as wound healing agent in traditional and modern medicine

Effective extraction of cephalosporin C from whole fermentation broth of Acremonium chrysogenum utilizing aqueous two phase systems

The downstream processing of biotechnological products from fermentation broth is an important step of production and development of cost effective, efficient downstream processing of many biotechnological products. The present study was conducted by employing aqueous two phase systems (ATPSs) for the extraction of cephalosporin C (CPC) from whole fermentation broth of Acremonium chrysogenum. The biphasic system was prepared by mixing equal aliquots of 15% w/w polyethylene glycol (PEG) 3350 with 15% (NH4)2SO4. The effects of pH, neutral salts, temperature and centrifugal force on partitioning in ATPS to develop efficient extraction system for recovery of CPC from fermentation broth were also examined. The extraction efficiency was improved by enhancing the centrifugal force. Similarly centrifugation for 12.5 min also gave the maximum extraction. Improvement in the recovery yield was also observed by the addition of 0.1% NaCl. The concentration of CPC was determined by high performance liquid chromatography (HPLC). Slight modifications in the mobile phase from 10 to 5% MeOH improved CPC resolution. Further development of more inexpensive systems for extraction can be the future target of research.Keywords: Cephalosporin C, Acremonium chrysogenum, fermentation, aqueous two phase system (ATPS

Texture representation through overlapped multi-oriented tri-scale local binary pattern

This paper ideates a novel texture descriptor that retains its classification accuracy under varying conditions of image orientation, scale, and illumination. The proposed Overlapped Multi-oriented Tri-scale Local Binary Pattern (OMTLBP) texture descriptor also remains insensitive to additive white Gaussian noise. The wavelet decomposition stage of the OMTLBP provides robustness to photometric variations, while the two subsequent stages – overlapped multi-oriented fusion and multi-scale fusion – provide resilience against geometric transformations within an image. Isolated encoding of constituent pixels along each scale in the joint histogram enables the proposed descriptor to capture both micro and macro structures within the texture. Performance of the OMTLBP is evaluated by classifying a variety of textured images belonging to Outex, KTH-TIPS, Brodatz, CUReT, and UIUC datasets. The experimental results validate the superiority of the proposed method in terms of classification accuracy when compared with the state-of-the-art texture descriptors for noisy images