Bioleaching of heavy metals from harbor sediment using sulfur-oxidizing microflora acclimated from native sediment and exogenous soil

Abstract

The harbor sediment containing high concentration of heavy metals may pose serious impacts on the marine ecosystem and environmental quality. The bioleaching process has been considered as an environmentally friendly and cost-effective alternative for removing heavy metals from contaminated sediments. In this study, a series of experiments were performed to investigate the feasibility of bioleaching process for removing heavy metals from the contaminated harbor sediments. The performance of the bioleaching process inoculated with sulfur-oxidizing microflora acclimated from the native harbor sediment was compared with that acclimated from the exogenous soil. In the bioleaching experiment with inoculants from native sediment, the efficiency of Zn, Cu, Cr, Pb, and Ni (30 days) reached 39–100%, 21–94%, 8–63%, 5–74%, and 19–77%, respectively. While 59–100% of Zn, 22–100% of Cu, 0–95% of Cr, 0–100% of Pb, and 22–100% of Ni were respectively removed in the bioleaching experiment with inoculants from exogenous soil after 30 days of reaction time. The results show that the rate and efficiency of metal removal in the bioleaching process decreased with an increase of sediment solid content from 10 to 40 g/L. The efficiency of metal removal in the bioleaching process with inoculants from the native sediment was lower than those from the exogenous soil due to the bacterial activity. By the fractionation of metal in the harbor sediment, exchangeable, carbonate-bound, and Fe/Mn oxide-bound metals (mobile fractions) were found to be apparently reduced and even organic matter/sulfide-bound and residual metals (stable fractions) were slightly removed after the bioleaching experiment.

from Energy Ecology Environment Ambio via Terpsi Hori on Inoreader http://bit.ly/2RICgmV

Methylenetetrahydrofolate reductase C677T polymorphism and diabetic retinopathy risk: a meta-analysis of the Chinese population

Journal of International Medical Research, Ahead of Print.


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Magnetic Resonance Imaging

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select article MRI visualization of shiitake mycelium growing in woodchip blocks used for shiitake mushroom cultivation

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MRI visualization of shiitake mycelium growing in woodchip blocks used for shiitake mushroom cultivation

Kuniyasu Ogawa, Takeshi Yashima

In Press, Accepted Manuscript, Available online 11 January 2019

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Abstract

Abstract

In order to eliminate woodchip blocks where unwanted fungi have grown and select only blocks where shiitake mycelium are growing well, there is a need to develop a visualization technique for shiitake mycelium growing in woodchip blocks, and MRI is an obvious candidate technique. From the results of measurements of the woodchip bed in a small bottle (26 mm inside diameter) where shiitake mycelium was growing, the T1 relaxation time constant immediately after inoculation was 77.9 ± 5.5 ms, and the value after about 10 to 20 days increased to 135.0 ± 9.8 ms (the increase rate was 73%). The T1 maps of the wood-chip block (130 mm length, 75 mm height and 55 mm thickness) in which shiitake mycelium grew were calculated from T1 weighted images measured by changing TR from 28 to 400 ms. From the T1 maps of time series, it was found that the shiitake mycelium extended from the right-hand side to the left-hand side of the woodchip block in a planar manner. Furthermore, in a woodchip block in which penicillium was generated, since the T1 relaxation time constant of only the shiitake mycelium became longer, it was possible to visualize the shiitake mycelium distinctly from penicillium.

select article Quantification of pathophysiological alterations in venous oxygen saturation: A comparison of global MR susceptometry techniques

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Quantification of pathophysiological alterations in venous oxygen saturation: A comparison of global MR susceptometry techniques

Paula L. Croal, Jackie Leung, Charly L. Phillips, Malambing G. Serafin, Andrea Kassner

In Press, Accepted Manuscript, Available online 11 January 2019

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Abstract

Abstract

The purpose of this study was to compare the Infinite Cylinder and Forward Field methods of quantifying global venous oxygen saturation (Yv) in the superior sagittal sinus (SSS) from MRI phase data, and assess their applicability in systemic cerebrovascular disease.15 children with sickle cell disease (SCD) and 10 healthy age-matched controls were imaged on a 3.0 T MRI system. Anatomical and phase data around the superior sagittal sinus were acquired from a clinically available susceptibility weighted imaging sequence and converted to Yv using the Infinite Cylinder and Forward Field methods. Yv was significantly higher when calculated using the Infinite Cylinder method compared to the Forward Field method in both patients (p = 0.003) and controls (p < 0.001). A significant difference in Yv was observed between patients and controls for the Forward Field method only (p = 0.006). While various implementations of Yv quantification can be used in practice, the results can differ significantly. Simplistic models such as the Infinite Cylinder method may be easier to implement, but their dependence on broad assumptions can lead to an overestimation of Yv, and may reduce the sensitivity to pathophysiological changes in Yv.

select article The use of a binary chelate formulation: Could gadolinium based linear contrast agents be rescued by the addition of zinc selective chelates?

Research articleAbstract only

The use of a binary chelate formulation: Could gadolinium based linear contrast agents be rescued by the addition of zinc selective chelates?

Wendell Gibby, Wes Parish, Ray M. Merrill, Diego Fernandez, ... Ryan Parr

In Press, Accepted Manuscript, Available online 10 January 2019

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Abstract

Abstract

Tissue and bone retention of gadolinium based contrast agents (GBCAs) has become a clinical concern because of the potential short and long term toxic effects of free gadolinium. This is a critical problem for most open-chain agents that more readily transmetallate in vivo, in comparison to macrocyclic compounds. Gadoliniumdiethylene tri-aminepentaacetic acid bis-glucosamide (Gd-DTPA-BIGA) is an experimental, open-chain contrast agent which has a significantly increased relaxivity coefficient in comparison to other GBCAs. This results in greater signal intensity and improved contrast enhancement. These superior imaging qualities initiated a search for a solution to the transmettalation of this agent. Plasma zinc is a well-known GBCA transmettalation agent. Since the base chelate of Gadodiamide (Gd-DPTA-Bis-Methylamide or Omniscan), DTPA-Bis-Methylamide (DTPA-BMA), readily transmettalates with and binds serum zinc, we hypothesized that a plasma "zinc sink," may significantly reduce transmettalation of linear agents. 5% DTPA-BMA was added to a formulation of Gd-DTPA-BIGA, which was tested against the original formulation of Gd-DTPA-BIGA with 0.2% of the base chelate DTPA-BIGA. These formulations, including gadodiamide, were labeled with 153GdCl3 followed by infusion into cohorts of Sprague Dawley rats which were sacrificed at 1, 30 and 60 days. Internal organs were harvested, along with blood, skin and femur, and analyzed for residual gadolinium. A subset of tissues were also interrogated with ICP-MS. Labeled Gadodiamide and saline where used as controls.

Conclusion: The addition of 5% DTPA-BMA, as a zinc binding agent, reduced the transmetallation of the linear agent Gd-DTPA-BIGA, in comparison to its original formulation supplemented with 0.2% BIGA. This result indicates that supplementing linear GBCAs with ancillary chelates may hold promise for reducing, or eliminating the biological archiving of gadolinium in tissues. In addition, this paper provides valuable animal data on the long term retention of gadolinium from linear based contrast agents.

select article NMR-based analysis of shear strength of weakly expansive clay in sodium chloride solution

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NMR-based analysis of shear strength of weakly expansive clay in sodium chloride solution

Haihao Yu, De'an Sun, Huihui Tian

In Press, Accepted Manuscript, Available online 7 January 2019

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Abstract

Abstract

A series of direct shear and nuclear magnetic resonance (NMR) tests were performed on a compacted weakly expansive clay saturated by sodium chloride (NaCl) solutions with different concentrations to study the effect of NaCl solution on the shear strength and its mechanism. Results from the direct shear tests show that the shear strength decreases slightly with increasing the NaCl solution concentration when the concentration is less than 1.0 mol/L. The results of NMR tests show that the smaller transverse relaxation times (T2) of specimens saturated by NaCl solutions with concentrations of 0.5 and 1.0 mol/L are less than that of the specimen saturated by deionized water. This means that the amount of smaller pores in the specimens saturated by deionized water is greater than that in specimens by NaCl solutions. That is, the specimen saturated by deionized water is denser than those by NaCl solutions under the same vertical pressure, and thus the shear strength of weakly expensive clay decreases with increasing the NaCl solution concentration.

select article Slow component apparent diffusion coefficient for prostate cancer: Comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging

Research articleAbstract only

Slow component apparent diffusion coefficient for prostate cancer: Comparison and correlation with pharmacokinetic evaluation from dynamic contrast-enhanced MR imaging

Akio Ogura, Fumie Maeda, Seiji Yahata, Daisuke Koyama, ... Kenichiro Yamamura

In Press, Accepted Manuscript, Available online 7 January 2019

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Abstract

Abstract

Purpose

Dynamic contrast enhancement (DCE)-MRI has high diagnostic performance of prostate cancer. However, it is preferable to avoid the use of MRI contrast media. A study reported that the diagnosability of the wash-in index of DCE-MRI was equivalent to the intravoxel incoherent motion of the diffusion weighted image.

The purpose of this study was to examine the correlation between the slow component apparent diffusion coefficient (ADC) and the wash-out index of the DCE.

Materials and methods

Thirty-eight patients diagnosed with prostate cancer by biopsy were enrolled in this study. The fast and slow component ADCs of the DWI were calculated for 76 points of the tumor and the contralateral normal parts. Furthermore, the wash-in and wash-out indices of the DCE-MRI were calculated. The correlations for each calculated index were compared.

Results

There was a significant difference between the tumor and the contralateral normal parts for both fast (p = 0.03) and slow component (p < 0.01) ADCs. In addition, the slow component ADC was correlated with the wash-out index (r = 0.64).

Conclusion

The slow component ADC was correlated with the wash-out index, and may, therefore, be a suitable substitute for DCE-MRI.

select article Using functional magnetic resonance imaging to evaluate an acute allograft rejection model in rats

Research articleAbstract only

Using functional magnetic resonance imaging to evaluate an acute allograft rejection model in rats

Song Zeng, Lu Liang, Qiang Zhang, Yue Xu, ... Xiaopeng Hu

In Press, Accepted Manuscript, Available online 7 January 2019

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Abstract

Abstract

Purpose

To assess the longitudinal changes of allograft pathophysiology by intravoxel incoherent motion (IVIM) and blood oxygen level-dependent (BOLD) MRI in a rat model of acute renal allograft rejection.

Materials and methods

Acute rejection (AR) was induced by transplantation of Dark Agouti donor kidneys into Lewis recipients (n = 18). A Lewis-Lewis rat syngeneically transplanted (sTX) model served as the control (n = 6). Acute tubular necrosis (n = 6) and acute calcineurin inhibitor toxicity (n = 6) groups were established using Lewis rats. MRI was performed on postoperative day (POD) 1, 4 and 7 in the allogeneically transplanted (aTX) group and on POD4 in the other groups. Histological evaluation and PCR were performed.

Results

After the allogenic transplantation, all MRI parameters of allograft further decreased until POD7, and the D and ADC values in the cortex were significantly lower than that in the sTX group (1.03 ± 0.09 vs 1.52 ± 0.09 × 10−3 mm2/s, Padj < 0.05; 1.21 ± 0.03 vs 1.78 ± 0.07 × 10−3 mm2/s, Padj < 0.05). The D*, f and R2* values of the aTX group in the cortex and medulla were significantly lower than those in the sTX group on POD7 (cortex, D*: 25.60 ± 4.78 vs 69.32 ± 9.79 × 10−3 mm2/s, Padj < 0.05; f: 7.84 ± 1.83 vs 20.34 ± 3.08%, Padj < 0.05; R2*: 16.61 ± 4.18 vs 31.48 ± 6.43 1/s, Padj < 0.05; medulla, D*: 13.59 ± 6.08 vs 62.75 ± 9.20 × 10−3 mm2/s, Padj < 0.05; f: 7.46 ± 1.62 vs 14.68 ± 2.05%, Padj < 0.05; R2*: 21.59 ± 3.45 vs 39.53 ± 4.34 1/s, Padj < 0.05). AR grafts presented serve interstitial inflammation, tubulitis and infiltration of T-lymphocytes and macrophages. The MRI parameters, including D, ADC, D*, f and R2*, were significantly correlated with the histological changes, cell infiltration and inflammatory cytokine mRNA levels.

Conclusions

IVIM coupled with BOLD MRI allows longitudinal assessment of allograft diffusion, perfusion and oxygen consumption impairment caused by acute renal allograft rejection in rat model.

select article Water mobility spectral imaging of the spinal cord: Parametrization of model-free Laplace MRI

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Water mobility spectral imaging of the spinal cord: Parametrization of model-free Laplace MRI

Dan Benjamini, Peter J. Basser

In Press, Corrected Proof, Available online 22 December 2018

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Abstract

Abstract

Diffusion magnetic resonance imaging (dMRI) of biological systems most often results in non-monoexponential signal, due to their complexity and heterogeneity. One approach to interpreting dMRI data without imposing tissue microstructural models is to fit the signal to a multiexponential function, which is sometimes referred to as an inverse Laplace transformation, and to display the coefficients as a distribution of the diffusivities, or water mobility spectra. Until recently, this method has not been used in a voxelwise manner, mainly because of heavy data requirements. With recent advancements in processing and experimental design, voxelwise Laplace MRI approaches are becoming feasible and attractive. The rich spectral information, combined with a three-dimensional image, presents a challenge because it tremendously increases the dimensionality of the data and requires a robust method for interpretation and analysis. In this work, we suggest parameterizing the empirically measured water mobility spectra using a bimodal lognormal function. This approach allows for a compact representation of the spectrum, and it also resolves overlapping spectral peaks, which allows for a robust extraction of their signal fraction. We apply the method on a fixed spinal cord sample and use it to generate robust intensity images of slow- and fast-diffusion components. Using the parametric variables, we create novel image contrasts, among them the information entropy of the water mobility spectrum, which pack unique features of the individual diffusion regimes in the investigated system.

select article Two-dimensional nuclear magnetic resonance method for wettability determination of tight sand

Research articleAbstract only

Two-dimensional nuclear magnetic resonance method for wettability determination of tight sand

Can Liang, Lizhi Xiao, Cancan Zhou, Yan Zhang, ... Zijian Jia

In Press, Corrected Proof, Available online 5 December 2018

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Abstract

Abstract

The wettability of reservoir rocks is important for oil recovery and reserve calculations. However, current methods for evaluating the wettability of rocks are time-consuming and expensive. Previous work has shown that low-field nuclear magnetic resonance (NMR) is a potentially useful and non-invasive technique for rock wettability determination. However, for rocks with strong internal magnetic field gradients, the current method is less efficient. In this study, the bipolar pulsed field gradient (PFG)-Carr-Purcell-Meiboom-Gill (CPMG) pulse sequence was applied to the study of rock wettability. This method can suppress the effect of the internal magnetic field gradient in rocks and accurately extract wettability information. The diffusion-transverse relaxation time (D-T2) method was employed to quantitatively estimate the wettability of rocks. Results of Amott wettability tests and NMR T1-T2 maps were combined to provide a more complete wettability characterization of tight sand. The results demonstrate the feasibility of the new method for characterizing wettability. The proposed method and workflow is of significance to the development of oil fields.

select article Influence of excess ligand on Nephrogenic Systemic Fibrosis associated with nonionic, linear gadolinium-based contrast agents

Research articleAbstract only

Influence of excess ligand on Nephrogenic Systemic Fibrosis associated with nonionic, linear gadolinium-based contrast agents

Richard C. Semelka, John P. Prybylski, Miguel Ramalho

In Press, Accepted Manuscript, Available online 22 November 2018

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Abstract

Abstract

Background

The molecular structure, charge, thermodynamic and kinetic stability are approximately the same for gadodiamide and gadoversetamide, the main substantive difference is that gadodiamide is manufactured with 5% free ligand to form Omniscan® and gadoversetamide with 10% free ligand to form OptiMARK®.

Purpose

To determine the relative risk of Nephrogenic Systemic Fibrosis (NSF) between gadodiamide (Omniscan®) and gadoversetamide (OptiMARK®) and to explore the potential contribution of the amount of excess ligand added to their commercial formulations.

Materials and methods

In this retrospective observational study, the number of doses and NSF cases associated with these agents were calculated based on two different approaches: the number of doses was determined based on pharmaceutical companies' information, and the number of unconfounded NSF cases was obtained from the previously published literature based on a legal database. A second analysis estimates the number of doses and NSF cases from the Food and Drug Administration (FDA) Adverse Event Reporting System (FAERS).

Results

Approximately 87 million and 12 million doses of Omniscan® and OptiMARK®, respectively, have been administered worldwide since their original approval for use in the various countries throughout the world. A total of 197 and 8 unconfounded cases of NSF have been reported with Omniscan® and OptiMARK®, rendering an incidence of 2.3/million and 0.7/million for these agents, respectively. The FAERS analysis suggested reported incidences of 13.1/million and 5.0/million.

Conclusion

There is an approximately 3-fold greater incidence of NSF from Omniscan® than OptiMARK®. The difference in incidence might reflect the lesser quantity of added free ligand to the formulation of Omniscan®.

select article Optimising sampling patterns for bi-exponentially decaying signals

Research articleAbstract only

Optimising sampling patterns for bi-exponentially decaying signals

A. Reci, M.I. Ainte, A.J. Sederman, M.D. Mantle, L.F. Gladden

In Press, Corrected Proof, Available online 6 November 2018

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Abstract

Abstract

A recently reported method, based on the Cramér-Rao Lower Bound theory, for optimising sampling patterns for a wide range of nuclear magnetic resonance (NMR) experiments is applied to the problem of optimising sampling patterns for bi-exponentially decaying signals. Sampling patterns are optimised by minimizing the percentage error in estimating the most difficult to estimate parameter of the bi-exponential model, termed the objective function. The predictions of the method are demonstrated in application to pulsed field gradient NMR data recorded for the two-component diffusion of a binary mixture of methane/ethane in a zeolite. It is shown that the proposed method identifies an optimal sampling pattern with the predicted objective function being within 10% of that calculated from the experiment dataset. The method is used to advise on the number of sampled points and the noise level needed to resolve two-component systems characterised by a range of ratios of populations and diffusion coefficients. It is subsequently illustrated how the method can be used to reduce the experiment acquisition time while still being able to resolve a given two-component system.

select article Editorial: The Fourteenth International Bologna Conference on Magnetic Resonance in Porous Media (MRPM14)

EditorialNo access

Editorial: The Fourteenth International Bologna Conference on Magnetic Resonance in Porous Media (MRPM14)

Clifford R. Bowers, Sergey Vasenkov

In Press, Corrected Proof, Available online 1 November 2018

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select article High temperature/pressure MAS-NMR for the study of dynamic processes in mixed phase systems

Research articleOpen access

High temperature/pressure MAS-NMR for the study of dynamic processes in mixed phase systems

Ali Chamas, Long Qi, Hardeep S. Mehta, Jesse A. Sears, ... David W. Hoyt

In Press, Corrected Proof, Available online 25 October 2018

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Abstract

Abstract

A new MAS-NMR rotor (the WHiMS rotor) has been developed which can reach pressures of 400 bar at 20 °C or 225 bar at 250 °C. These rotors are ideal for mixed phase systems such as a reaction using a solid catalyst with a liquid/supercritical solvent topped with high pressure gas in the head space. After solid and liquid portions of the sample are loaded, the rotor is capped with an o-ring equipped polymer bushing that snaps into a mating groove in the rotor. The bushings incorporate a check valve into the sealing mechanism which allows for pressurization without mechanical manipulation – they will allow gas to flow in but not out. This WHiMS rotor design has enabled experiments on a wide variety of biotic and abiotic mixed-phase systems. Geochemical systems have also been studied, for example, adsorption and confinement studies of supercritical methane/CO2 in clays and other minerals which display pressure dependent 13C chemical shifts. Example data from other mixed-phase chemical and microbial systems are reported. These include monitoring metabolite conversion of extremophilic bacteria found in subsurface systems at elevated pressures and real-time operando reactions in catalysis systems - with liquid-quality resolution for 1H and 13C NMR spectra.

select article Preliminary evaluation of accelerated microscopic diffusional kurtosis imaging (μDKI) in a rodent model of epilepsy

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Preliminary evaluation of accelerated microscopic diffusional kurtosis imaging (μDKI) in a rodent model of epilepsy

Yang Ji, Dongshuang Lu, Limin Wu, Bensheng Qiu, ... Phillip Zhe Sun

In Press, Corrected Proof, Available online 20 October 2018

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Abstract

Abstract

Purpose

Our study aimed to develop accelerated microscopic diffusional kurtosis imaging (μDKI) and preliminarily evaluated it in a rodent model of chronic epilepsy.

Methods

We investigated two μDKI acceleration schemes of reduced sampling density and angular range in a phantom and wild-type rats, and further tested μDKI method in pilocarpine-induced epilepsy rats using a 4.7 Tesla MRI. Single slice average μDapp and μKapp maps were derived, and Nissl staining was obtained.

Results

The kurtosis maps from two accelerated μDKI sampling schemes (sampling density and range) are very similar to that using fully sampled data (SSIM > 0.95). For the epileptic models, μDKI showed noticeably different contrast from those obtained with conventional DKI. Specifically, the average μKapp was significantly less than that of the average of Kapp (0.15 ± 0.01 vs. 0.47 ± 0.02) in the ventricle.

Conclusions

Our study demonstrated the feasibility of accelerated in vivo μDKI. Our work revealed that μDKI provides complementary information to conventional DKI method, suggesting that advanced DKI sequences are promising to elucidate tissue microstructure in neurological diseases.

select article A novel MRI phantom to study interstitial fluid transport in the glymphatic system

Research articleAbstract only

A novel MRI phantom to study interstitial fluid transport in the glymphatic system

M.E. Komlosh, D. Benjamini, N.W. Williamson, F. Horkay, ... P.J. Basser

In Press, Corrected Proof, Available online 19 October 2018

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Abstract

Abstract

The glymphatic system is a recently discovered transport system, mediated by cerebral spinal fluid (CSF), that clears metabolic and cellular waste products in the brain. This system's function in the brain is analogous to that of the lymphatic system in the rest of the mammalian body. It is hypothesized that CSF clears harmful chemicals from the brain by flowing through interstitial spaces in the brain during sleep. While there is growing recognition of the critical role the glymphatic system plays in maintaining normal brain health and in explaining pathology, there are few noninvasive imaging methods that measure and characterize the efficacy of glymphatic transport in vivo. In this study we designed, constructed, and tested a glymphatic transport magnetic resonance imaging (MRI) flow phantom, which combines regions that mimic CSF-filled ventricles and brain interstitial space. We tested high- and low-q space diffusion MRI and diffusion tensor imaging (DTI) acquisitions to determine if they could detect, measure, and map interstitial glymphatic flows. The results suggest that, under certain flow conditions, diffusion-weighted MRI can detect the enhanced mixing that occurs during glymphatic clearance.

select article The downhole circumferential scanning magnetic resonance imaging tool

Research articleAbstract only

The downhole circumferential scanning magnetic resonance imaging tool

Wei Liu, Lizhi Xiao, Guangzhi Liao, Yan Zhang, Sihui Luo

In Press, Corrected Proof, Available online 19 October 2018

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Abstract

Abstract

The downhole circumferential scanning magnetic resonance logging is able to image saturation distribution and fluid properties of stratum around a borehole, thus providing relevant and abundant information for formation evaluation. The device employs a phase-controlled excitation device based on combined array structure to accomplish three dimensional data acquisition from axial, radial and circumferential directions. This paper focuses on the design principle of device and the structure of electronic control system. A mutual coupling analysis with array antenna was carried out using inductance coupling principle, and realize the decoupling and energy discharge compensation of array antennas. The circumferential scanning nuclear magnetic resonance technique has a potential of overcoming the weakness of two dimensional measurements and raising new applications that it determines the azimuth of the fluid in the borehole and realizes the imaging measurement of the pore structure and the reservoir fluid.

select article Characterization of porous media by <em>T</em>₂-<em>T</em>₂ correlation beyond fast diffusion limit

Research articleAbstract only

Characterization of porous media by T2-T2 correlation beyond fast diffusion limit

Zhou Yu, Yan Zhang, Lizhi Xiao, Guangzhi Liao

In Press, Corrected Proof, Available online 19 October 2018

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Abstract

Abstract

Pore size distribution and surface relaxivity are two important properties of porous media such as rock samples and can be obtained by NMR methods. However, it is difficult to obtain these information beyond the fast diffusion limit. Here we present a new method to directly characterize the averaged pore size of a porous sample with a narrow pore size distribution. This method is based on the parallel plates pore model and the T2-T2 correlation sequence. The pore size (a) - surface relaxivity (ρ) correlation maps were obtained using the non-negative least squares method. Three kinds of glass bead samples were measured and the averaged pore size and surface relaxivity were extracted.

select article Credit-card sized field and benchtop NMR relaxometers using field programmable gate arrays

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Credit-card sized field and benchtop NMR relaxometers using field programmable gate arrays

J. Beau W. Webber, Pavel Demin

In Press, Corrected Proof, Available online 18 October 2018

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Abstract

Abstract

The tools for developing systems for NMR improve each year. Some firmware based designs based on Field Programmable Gate Arrays (FPGAs) have been developed to implement both the core and peripheral apparatus for NMR Relaxometers and NMR Cryoporometers. Hand held in size they are particularly suitable for desktop, mobile and field use.

Software tools now enable the writing of firmware that enable the rapid design of digital and digitised R.F. data and control systems. This firmware can then be loaded into and run on hardware that often is only the size of a credit-card. These devices can include a single-chip Linux computer with an FPGA capable of processing digital RF on the same chip. These can generate RF signals digitally, process RF signals for up- and down-conversion, and can provide an on chip NMR pulse sequencer.

An extremely well tested NMR digital transmitter has been upgraded to use the latest surface-mount Bipolar and Field Effect Transistors. The circuitry is now the size of a book of matches, and interfaces to credit-card sized FPGA modules for RF generation, phase shifting and drive signals. This NMR transmitter design uses digital logic principles rather than conventional tuned R.F. techniques Offering both active-damping and active-quench, a very square R.F. Pulse with fast turn off is achieved, with Mark 1 giving 2.6 μs π/2 and 4.8 μs π pulses into a 5 mm diameter NMR sample (2.7 mT B1) at 20 MHz for Protons. T1ρ pulses are stable and consistent.

select article New magnet array design for downhole NMR azimuthal measurement

Research articleAbstract only

New magnet array design for downhole NMR azimuthal measurement

Sihui Luo, Lizhi Xiao, Xin Li, Guangzhi Liao, ... Yangyang Xu

In Press, Corrected Proof, Available online 16 October 2018

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Abstract

Abstract

In low-field NMR, depth information and radial profile information of downhole formation can be easily acquired with the help of static gradient magnetic field produced by permanent magnets, called downhole NMR imaging. Based on the hypothesis that the formation is homogeneous, average signals detected by centralized or decentralized sensors can provide enough information for petrophysical parameters. In fact, the inhomogeneity of formation may have serious impact on description of the characteristics of formation and oil/gas location which is rarely studied in NMR well-logging. To improve this, we design and implement a new quadrupolar magnet array aimed at achieving azimuthal measurement in this paper. A new quadrupolar magnet array is consisted of four bread-shaped magnets combined with additional small hexangular magnets to produce enough strength and high homogeneity of static field along with circumferential direction at deeper DOI (depth of investigation). Azimuthal measurements are achieved by using coil array combined with quadrupolar magnet array.

select article Investigating mobility of crude oil adsorbates on mineral surfaces by NMR

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Investigating mobility of crude oil adsorbates on mineral surfaces by NMR

Henrik N. Sørgård, Christian Totland, Willy Nerdal, John Georg Seland

In Press, Corrected Proof, Available online 15 October 2018

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Abstract

Abstract

We have applied diffusion and relaxation Nuclear Magnetic Resonance experiments to investigate the translational and rotational mobility of adsorbents on quartz and calcite mineral surfaces. On both surfaces it was found that water is the dominant molecule. On the quartz surface the majority of water molecules have a relatively high degree of both rotational and translational mobility, while a minor fraction of water molecules, and all hydrocarbon molecules, have a significantly lower mobility. On the calcite surface the translational mobility is very low for all the adsorbed molecules, while there is a large diversity in rotational mobility, indicating that the hydrocarbon molecules are strongly attached to the surface, but that some part of each molecule still have a large degree of rotational mobility. Diffusion and relaxation experiments give a detailed description of both the molecular mobility of adsorbed species on these mineral surfaces, which leads to new insight with respect to aging processes on a molecular level.

select article Under-sampling and compressed sensing of 3D spatially-resolved displacement propagators in porous media using APGSTE-RARE MRI

Research articleAbstract only

Under-sampling and compressed sensing of 3D spatially-resolved displacement propagators in porous media using APGSTE-RARE MRI

Daan W. de Kort, Stefan A. Hertel, Matthias Appel, Hilko de Jong, ... Lynn F. Gladden

In Press, Corrected Proof, Available online 15 October 2018

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Abstract

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Psammomatoid juvenile ossifying fibroma of maxilla

: An uncommon neoplasm p. 191
Jyotsna Naresh Bharti, Ashok Singh, Jitendra Singh Nigam
DOI:10.4103/ccij.ccij_8_18  
Juvenile ossifying fibroma (JOF) is a rare variant of ossifying fibroma. JOF is classified into two distinct clinicopathological variants: Trabecular and psammomatoid JOF. Based on the age group involved, most common site of occurrence and clinical behavior, JOF differs from the larger group of ossifying fibromas. We report a case of psammomatoid JOF of maxilla in a 10-year-old female who presented with a swelling over the right side of the face.
http://www.ccij-online.org/currentissue.asp?sabs=y

Carcinosarcoma of the submandibular gland with a rhabdomyosarcoma component

: A case report and review of the literature p. 187
Suma M Narayana, Smrita Singh, Rekha V Kumar
DOI:10.4103/ccij.ccij_83_18  
Carcinosarcoma of the salivary gland is a rare and aggressive malignancy with a poor prognosis. These neoplasms are composed of malignant epithelial and mesenchymal elements. This report describes a new case of carcinosarcoma arising in the submandibular gland, which had a rhabdomyosarcoma component, without clinical or histological evidence of a preexisting pleomorphic adenoma. Till date, only two case reports have described the occurrence of carcinosarcoma with a rhabdomyosarcoma component in the salivary gland, to the best of our knowledge. Histological and immunohistochemical results are presented. The literature is reviewed, and the possible histogenesis and pathogenesis of carcinosarcoma (true malignant mixed tumor) of the salivary gland are briefly discussed.
http://www.ccij-online.org/currentissue.asp?sabs=y

Years with anxiety and headache

Recurrent pilocytic astrocytoma after 5 years with anxiety and headache p. 184
Mazaher Ramezani, Shima Jalalvandi, Zahra Torkchin, Masoud Sadeghi
DOI:10.4103/ccij.ccij_66_18  
Pilocytic astrocytomas (PAs) account for 25% of all pediatric brain tumors and commonly occur in the first two decades of life. Recurrence and/or regrowth of residual tumors are not common and mostly occur within 4–5 years of the first surgery. Herein, we reported a 16-year-old male adolescent with neurological symptoms and signs that pathologic specimens confirmed the diagnosis of PA. The patient underwent 27 sessions of radiotherapy without surgery. After 5 years, at the age of 21, the patient readmitted with anxiety and headache and the recurrence of the same tumor with the same grade. We suggest follow-up of the patient after initial treatment for at least 5 years with considering any neurological symptoms including behavioral changes.
http://www.ccij-online.org/currentissue.asp?sabs=y

Apoptotic indices are useful in distinguishing between benign and malignant squamous lesions

Operational role of apoptotic index in premalignant and malignant squamous lesions: An apprise p. 180
Sheetal Arora, Deepshikha Rana, Indrani Dhawan, Rashmi Arora
DOI:10.4103/ccij.ccij_80_17  
Background: The aim of the study was to evaluate the role of apoptotic index (AI) in premalignant and malignant squamous lesions of different sites on light microscopy. Materials and Methods: Retrospective study of 75 cases of premalignant and malignant squamous epithelial lesions of different sites was done. All slides were H and E stained, screened for apoptosis under ×40. AI was calculated as the number of apoptotic cells and apoptotic bodies, expressed as percentage of total number of tumor cells counted in each case. Results: On statistical analysis, it was found that the difference in the apoptotic indices in all the subgroups of dysplasia was not statistically significant. However, the significant statistical difference was found within the malignant group, P value between well-differentiated squamous cell carcinoma (SCC) and moderately differentiated SCC (MDSCC) was <0.0001. P value obtained between MDSCC and poorly differentiated SCC was 0.0006. Conclusion: We conclude that apoptotic indices are useful in distinguishing between benign and malignant squamous lesions. Several indices such as proliferating index (Ki-67) and AgNOR count are not routinely available in various hospitals, especially in developing countries. The advantage of this technique is that it can be calculated in routine H and E stained sections, and so it saves time. Although it is labor-intensive, it is cost-effective method which can benefit the patient as it correlates well with tumor aggressiveness and thereby increasing the prognosis of the patients.
http://www.ccij-online.org/currentissue.asp?sabs=y

Computed tomography-guided fine-needle aspiration and concurrent core biopsy

 in diagnosis of intrathoracic mass: An evaluation of 54 cases in a tertiary care hospital p. 176
Rajashree Pradhan, Sajeeb Mondal, Subrata Pal, Mrinal Sikder, Biswajit Biswas
DOI:10.4103/ccij.ccij_81_17  
Introduction: Fine-needle aspiration cytology (FNAC) is a simple, safe, and effective tool for cytological diagnosis of different neoplastic lesions. Computed tomography (CT)-guided core biopsy is also essential for tissue diagnosis. Aims and Objectives: The aim of this study is to assess the diagnostic value and limitations of fine-needle aspiration and core biopsy in diagnosis of intrathoracic lesions; we have done this retrospective study. Materials and Methods: In all 54 cases with mean age of 57.37 years, CT-guided FNAC and core biopsy were performed on same sittings. 20–22 G Chiba needle was used for FNAC, and core biopsy was performed by 18–20 G coaxial automated cutting needle. The cytological and histological evaluations were done in our cytology and histopathology laboratory. Complications were managed by pulmonologists. Results: On the evaluation of FNAC smears, diagnosis was done in 44 cases and 10 cases were inconclusive. In core biopsy, five cases were inconclusive. Most of the tumors were of epithelial origin (43 cases, 87.75%) and 95.59% cases were malignant in our series. Sensitivity and diagnostic accuracy of core biopsy (90.38% and 90.74, respectively) were higher than FNAC (84.62% and 85.18%, respectively). Conclusion: CT-guided core biopsy was more effective and accurate in diagnosis and tumor classification than FNAC in spite of higher complication rate.
http://www.ccij-online.org/currentissue.asp?sabs=y

Significance of Earlier Initiation of Chemotherapy for Lung Cancer Complicated with Primary or Secondary Nephrotic Syndrome following Its Appropriate Differential Diagnosis

We encountered a case of primary lung cancer complicated with membranous nephropathy as primary nephrotic syndrome. Because treatment approaches vary greatly for primary and secondary nephrotic syndrome, a renal biopsy was performed for diagnosis. Much time was required to make a definitive diagnosis of primary nephrotic syndrome, as opposed to paraneoplastic nephrotic syndrome. Consequently, the subsequent chemotherapy was ineffective and caused significant toxicity due to reduced performance status (PS) and progression of hypoalbuminemia. Therefore, it is imperative that a diagnosis be made and treatment be initiated without delay before PS declines and hypoalbuminemia progresses.
Case Rep Oncol 2019;12:53–58

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Successful Treatment with Taxane-Based Chemotherapy in Advanced Sebaceous Carcinoma: A Case Report and Literature Review

For sebaceous carcinoma (SC), a rare malignant tumor, no standard chemotherapy regimen for patients with distant metastasis has been studied. We experienced a case of eyelid SC with multiple lung metastases that responded to combination chemotherapy with carboplatin and paclitaxel with 11-month progression-free survival (PFS). This patient also responded to second-line treatment with docetaxel, another taxane, with 7-month PFS, resulting in at least 18 months of survival at the time of reporting. This report shows that taxane-based chemotherapy may be effective for advanced SC, for which no standard therapy has been established.
Case Rep Oncol 2019;12:47–52

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Ultrasound-guided fine-needle aspiration cytology of head and neck masses

: Experience in Ado-Ekiti, Southwestern Nigeria p. 171
Abidemi Emmanuel Omonisi, Olufunso Simisola Aduayi, John Adetunji Omotayo, Ganiyu Olusola Akanbi, Olusola Olusoga Akute
DOI:10.4103/ccij.ccij_87_17  
Background: A multidisciplinary approach to the evaluation of head and neck masses is crucial to achieving optimum patient care and enhancing diagnostic accuracy for definitive treatment. This is exemplified by the clinical and radiopathologic correlation of head and neck masses subjected to diagnostic evaluation using ultrasound-guided fine-needle aspiration cytology (FNAC) in a tertiary health institution. Subjects and Methods: A prospective study was carried out on 51 patients with head and neck lesions referred to the FNAC Clinic of the Department of Anatomic Pathology of Ekiti State University Teaching Hospital, Ado-Ekiti, Nigeria. The study was conducted over a period of 2 years between February 2014 and January 2016. The FNAC was done under imaging guidance with a 7.5 MHz ultrasound probe. Clinical, radiological, and pathological findings were correlated. The data were analyzed using SPSS version 15. Results: The study population consisted of 12 (23.5%) males and 39 (76.5%) females. The age range was 2–80 years with a mean age of 44.7 ± 18.4 years. A significant proportion (80.4%) of the masses was located in the anterior neck. Multinodular goiter (n = 22, 43.1%) was the predominant clinical diagnosis. On ultrasonography, the predominant echotexture of the masses was heterogeneous (n = 29, 56.9%), only 4 (7.84%) of the masses had internal calcifications while the predominant composition of the masses was a mixture of solid and cystic portions (n = 30, 58.8%). There was a strong radiopathologic correlation (Spearman correlation value of 0.910). Conclusion: Ultrasound-guided FNAC of head and neck masses provides a synergistic approach to patient care and should be encouraged in our setting for optimum diagnostic yields.
http://www.ccij-online.org/currentissue.asp?sabs=y

Latex-related symptoms and sensitization

Prevalence and associated factors of latex-related symptoms and sensitization at a multispecialty hospital: A cross-sectional study p. 122
Jandhyala Sridhar, Rahul Ray
DOI:10.4103/jmms.jmms_58_18  
Background and Aim: Upsurge in usage of latex gloves over the last few decades, coupled with the proliferation of medical latex products at the workplace, has led to a higher incidence of latex-related symptoms among health-care workers (HCWs). This study aimed to assess the prevalence and associated factors of latex glove-related symptoms and sensitization among HCW at a multispecialty hospital. Materials and Methods: The study included all the paramedical personnel and nurses employed at a multispecialty hospital where powdered latex gloves were in use. Consenting participants were evaluated by a questionnaire for symptoms of latex allergy, followed by a skin prick test (SPT) for evaluating sensitization to latex allergen. Statistical Analysis Used: Mean, standard deviation, and Student's t-test were used for continuous data. Categorical data were analyzed using the Chi-square test. Odds ratios and 95% confidence intervals were calculated. Results: Latex glove-related symptoms were present in 25 (10.91%) HCWs. Symptoms suggestive of Type I latex allergy were reported in 11 (4.8%), while those of contact dermatitis were reported in 17 (7.42%) HCWs. Of the 229 HCWs, 37 (16.16%) had a personal history of atopy; 14 (6.11%) were SPT positive to latex allergen. Conclusions: In this study among Indian HCW, there was a significant correlation of latex glove-related symptoms with the duration of glove use, personal atopy, and SPT positivity to latex allergen. Questionnaire-based evaluation of allergic symptoms along with SPT positivity was found to be a useful identifier of true latex allergy.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y

Inhibition of HGF/MET signaling decreases overall tumor burden and blocks malignant conversion in Tpl2-related skin cancer

Inhibition of HGF/MET signaling decreases overall tumor burden and blocks malignant conversion in Tpl2-related skin cancer

Inhibition of HGF/MET signaling decreases overall tumor burden and blocks malignant conversion in <i>Tpl2</i>-related skin cancer, Published online: 10 January 2019; doi:10.1038/s41389-018-0109-8

Inhibition of HGF/MET signaling decreases overall tumor burden and blocks malignant conversion in Tpl2-related skin cancer

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Cullin 5 is a novel candidate tumor suppressor in renal cell carcinoma involved in the maintenance of genome stability

Cullin 5 is a novel candidate tumor suppressor in renal cell carcinoma involved in the maintenance of genome stability

Cullin 5 is a novel candidate tumor suppressor in renal cell carcinoma involved in the maintenance of genome stability, Published online: 09 January 2019; doi:10.1038/s41389-018-0110-2

Cullin 5 is a novel candidate tumor suppressor in renal cell carcinoma involved in the maintenance of genome stability

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Estrogen receptor-α regulation of microRNA-590 targets FAM171A1—a modifier of breast cancer invasiveness

Estrogen receptor-α regulation of microRNA-590 targets FAM171A1—a modifier of breast cancer invasiveness

Estrogen receptor-α regulation of microRNA-590 targets <i>FAM171A1</i>—a modifier of breast cancer invasiveness, Published online: 09 January 2019; doi:10.1038/s41389-018-0113-z

Estrogen receptor-α regulation of microRNA-590 targets FAM171A1—a modifier of breast cancer invasiveness

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Histone demethylase KDM6B has an anti-tumorigenic function in neuroblastoma by promoting differentiation

Histone demethylase KDM6B has an anti-tumorigenic function in neuroblastoma by promoting differentiation

Histone demethylase KDM6B has an anti-tumorigenic function in neuroblastoma by promoting differentiation, Published online: 04 January 2019; doi:10.1038/s41389-018-0112-0

Histone demethylase KDM6B has an anti-tumorigenic function in neuroblastoma by promoting differentiation

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Osseous choristoma of the eye

epibulbar osseous choristoma p. 157
AS Parihar, Shelly Verma, Arti Trehan, Prashant Vashisht
DOI:10.4103/jmms.jmms_29_18  
Osseous choristoma of the eye is a rare entity with few case reports being published in the literature. We report one such case in a 14-year old female who had a small growth in the right eye present since birth, which gradually increased in size. Excision biopsy was done. Histologically, the mass was composed of mature bone with surrounding benign adipocytes.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y

Postoperative visual disturbance,Postoperative complication resulting from perforation of the uterus, air/gas embolism, and fluid with electrolyte imbalance. Glycine 1.5%, as an irrigating fluid, is being commonly used and on increased systemic absorption can lead to a wide array of complications

Postoperative visual disturbance: "A peril related to glycine toxicity" p. 159
Deepak Dwivedi, Saurabh Sud, Sadhan Sawhney, Ashutosh Gupta
DOI:10.4103/jmms.jmms_24_18  
Hysteroscopic gynecological surgeries are now commonly employed in the clinical practice. It has the potential to increase morbidity due to the complication resulting from perforation of the uterus, air/gas embolism, and fluid with electrolyte imbalance. Glycine 1.5%, as an irrigating fluid, is being commonly used and on increased systemic absorption can lead to a wide array of complications. We present a case of transient visual loss after increased absorption of the irrigating fluid, thereby highlighting the factors governing in its genesis and prevention.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y

Spontaneous cerebrospinal fluid rhinorrhoea,Anteromedial temporal encephalocele

Anteromedial temporal encephalocele: A rare cause for spontaneous cerebrospinal fluid rhinorrhoea p. 162
Saikat Bhattacharjee, Deepak Chandra Reddy, Samar Chatterjee, Bikram Choudhury
DOI:10.4103/jmms.jmms_12_18  
Spontaneous cerebrospinal fluid (CSF) rhinorrhea in an adult without prior history of head trauma is a rare occurrence. Neuroimaging is done to ascertain the site of bony defects in the cranium and breach in the continuity of dura to localize the site of CSF leakage. Encephaloceles into the sphenoid sinus occurring through congenital bony defects in the walls of the sinus are an extremely rare cause for CSF rhinorrhea. We present a case of spontaneous, nontraumatic CSF rhinorrhea due to an anteromedial encephalocele where the temporal lobe was seen herniating into the right sphenoid sinus through a congenital bony defect in the wall of the sinus. A review of the present literature is also presented.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y

H1N1 influenza-associated organizing pneumonia

A rare case of H1N1 influenza-associated organizing pneumonia p. 165
Manjit S Tendolkar, Rahul Tyagi, Gautam Mullick, Vikas Chauhan
DOI:10.4103/jmms.jmms_15_18  
H1N1 influenza A was responsible for global pandemic in 2009. Since then H1N1 continues to be responsible for epidemics frequently. H1N1 influenza causing organizing pneumonia (OP) is extremely rare, and only 6 cases have been reported till date. Here, we report a case of H1N1 presenting as an OP. The significance of diagnosing OP in appropriate clinical and radiological setting is being highlighted along with its prompt response to treatment.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y

Multiple exuberant pustular and ulcerative lesions over the face and trunk associated with systemic symptoms in the form of fever, polyarthralgia, and osteolytic bone lesions

acne fulminans p. 175
Preema Sinha, Durga Madhab Tripathy, Subramaniyan Radhakrishnan, Pankaj Das
DOI:10.4103/jmms.jmms_68_18  
Acne fulminans (AF) is a rare yet the most severe inflammatory form of acne. It predominantly affects prepubertal boys in the form of multiple exuberant pustular and ulcerative lesions over the face and trunk associated with systemic symptoms in the form of fever, polyarthralgia, and osteolytic bone lesions. In spite of multiple mentioned triggering agents, till date, no direct cause has been ascertained. Drugs like isotretinoin for acne and anabolic steroids are known to precipitate this condition. Due to systemic symptoms, the patient may sometimes require an aggressive inpatient treatment to prevent any systemic complications and grossly morbid scarring as a result of the disease. Herein, we report a rare case of AF in a 16-year-old female with predominantly facial involvement who was managed with oral corticosteroids and isotretinoin with excellent response.
http://www.marinemedicalsociety.in/currentissue.asp?sabs=y

Marine Medical Society

Ethics in medicine and research: Responsibilities of a medical scientist Sougat Ray, Sheila Samanta Mathai Journal of Marine Medical Society 2018 20(2):93-95

2 hourly versus 3 hourly feeding schedule in very low birth weight preterm neonates Neha Anushree, Subhash Chandra Shaw, Vandana Negi Journal of Marine Medical Society 2018 20(2):96-99 Objective: Very low birth weight (VLBW) preterm neonates are fed every 2 hourly (2H) or 3 hourly (3H), but there is not sufficient evidence to determine the best feeding schedule. The study objectives were to compare the effects of 2H or 3H feeding schedule in neonates weighing <1500 g at birth, on the incidence of feed intolerance, apnea, necrotizing enterocolitis (NEC), hypoglycemia, and time to attain full feeds. Design and Setting: This longitudinal observational study was conducted in a level III neonatal unit of a teaching hospital in North India between October 2012 and March 2014. Materials and Methods: All stable intramural neonates born <1500 g were eligible for the study. Neonates with major malformations, congenital heart diseases, gastrointestinal anomalies, and those contraindicated for enteral feeding as decided by the treating clinicians were excluded. Sixty VLBW preterm neonates were assigned to 2H or 3H feeding groups. The incidence of feed intolerance, apnea, NEC, hypoglycemia, and time to attain full feeds was assessed. Results: There was no difference in incidence of feed intolerance between the two groups (30% vs. 23.3%, P = 0.56). The incidence of apnea, NEC, hypoglycemia, and time to attain full feeds was also similar between the two groups. Conclusion: 3H feeding is possibly as good as 2H feedings for VLBW neonates.

Original report: Transtibial and transportal techniques of anterior cruciate ligament reconstruction provide similar functional outcome: A comparative study conducted at an armed forces hospital Ajaydeep Sud, Munish Sood, Rohit Vikas Journal of Marine Medical Society 2018 20(2):100-103 Background: The debate about the best arthroscopic technique for the anterior cruciate ligament (ACL) reconstruction surgery using semitendinosus (ST) quadruple graft is still unresolved. The aim of the present study was to compare the results of arthroscopic ACL reconstruction surgery techniques (transtibial [TT] and anteromedial portal [AMP]) using ST quadruple graft in terms of functional outcome. Materials and Methods: A total of 50 male patients with ACL tear were operated using the arthroscopic technique. The patients were divided into two groups (TT group and AMP group) and studied prospectively. The TT group (n = 24) included the patients in which femoral tunnel was prepared using the tibial tunnel. While the AMP group B (n = 26) included the patients in which femoral tunnel was prepared through the anteromedial arthroscopic portal. All these patients were assessed regularly and at follow-up of 1 year functionally using Lysholm Knee Score. Two groups were matched in terms of age, mode of injury, and side involved. Results: The average age of the patients in Group TT and AMP was 31.2 years (range: 22–43 years) and 30.6 years (range: 21–45 years), respectively. The mean Lysholm score improved significantly (P < 0.001) from 55.19 (range: 38–66) preoperatively to 82.65 (range 69–100) at the final follow-up in Group TT and 53.54 (range: 38–66) preoperatively to 82.04 (range: 59–100) at the final follow-up in group AMP. However, there was no significant difference in the mean Lysholm score while comparing the two groups at the final follow-up. Conclusion: ACL reconstruction surgery using ST quadruple graft with TT and transportal techniques provide similar functional outcome at 1-year follow-up.

Medical management of patients with benign prostatic hyperplasia: A study in Indian population Amit Kumar Shah, Anand Srivastava, SC Karan Journal of Marine Medical Society 2018 20(2):104-110 Introduction: At present, the geriatric population has formed a large clientele for medical services, with an increased incidence of lifestyle diseases. Approach to lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) is an upcoming challenge, especially with management showing a paradigm shift toward medical management. This study was basically designed to study the outcome of medical management of BPH on Indian population following the recommendations based on recent guidelines on medical management of BPH. Materials and Methods: With a calculated sample size of 131 based on the prevalence of BPH, a total of 170 patients were enrolled, and their complete profile with clinical examination, imaging and International Prostatic Symptom Score details were taken as per proforma and were followed up while on medical management and assessed on a cross-sectional basis at regular intervals. Results: The mean age in the study group was 64.61 years. We recorded that all patients had some formal education. These patients were prescribed α-1ablockers as monotherapy or combination therapy as per the protocol of the study. They showed improvement while on medical management with significant improvement. Adverse reactions of medical management were not significant enough to warrant discontinuation of therapy. Forty-one patients out of 170 underwent surgery for no response or worsening quality of life. This group was further analyzed which revealed that comorbid condition, prostate size, and body mass index had no association with the outcome. Conclusion: There is sufficient evidence to support the paradigm shift in the management of BPH. The present guideline is to initiate medical management with monotherapy for patients with BPH and prostate size <30 g and combination therapy for larger prostate sized >30 g. Surgery is advised for patients who do not respond to medical therapy and for the subgroup of patients with absolute indication for surgery in BPH.

Frequency and associated factors of instrument-specific dermatoses among musicians in a military band: A cross-sectional study Jandhyala Sridhar, Rahul Ray Journal of Marine Medical Society 2018 20(2):111-115 Background and Aim: Continual contact with musical instruments may cause distinctive skin conditions among musicians. The site and degree of contact with the instrument may determine the type of presentation, further influenced by the amount of time spent in training. These conditions may be severe enough to even compromise musicians' careers. Since data on the subject are lacking in India, a study was conducted to assess the frequency and factors associated with the occurrence of instrument-related skin disorders among musicians in a military band. Materials and Methods: This was a cross-sectional study. A universal sample comprising all the members of a military band was included. A total of 162 musicians were evaluated using a questionnaire that included questions related to age, instrument played, current skin disorders, and the impact of skin symptoms on music making. Dermatological examination was done for all the participants. Statistical Analysis Used: Mean, median, and frequencies; Pearson's Chi-square test. Results: Of 162 musicians, 49 (30.2%) had at least one skin disease not correlated with instrument playing. Instrument-specific dermatoses were found in 55 (34%) of the 162 musicians and correlated with years of experience and the time spent in musical activity. Conclusions: Wind instrumentalists had the highest risk of developing skin problems. The occurrence of the tear trough deformity and lip dyschromia correlated significantly with the playing of a wind instrument. The impact of vibratory stress of wind instruments on the facial tissues needs further inquiry. Although not life-threatening, instrument-specific dermatoses may lead to impaired performance, occupational risk, and cosmetic disfigurement.

Role of "bladder care bundle" and "infection control nurse" in reducing catheter-associated urinary tract infection in a peripheral hospital Parli Raghavan Ravi, MC Joshi Journal of Marine Medical Society 2018 20(2):116-121 Background: Care bundles are an effective means of reducing catheter-associated urinary tract infection (CAUTI) when they are implemented with high impact interventions. Care bundle approach only works when every element of the bundle is implemented for every appropriate patient, every time and with high impact. Aim: This study aims to study the efficacy of CAUTI Care Bundle and of infection control nurse (ICN) in reducing the incidence of CAUTI in a zonal hospital. Materials and Methods: The study was with an initial baseline phase (observational) of 8 months followed by an intervention Phase of 21 months. The intervention phase was further divided into intervention Phase I (8 months) and intervention Phase II (13 months). Intervention Phase I included a multidimensional approach of education and training of health-care staff for catheter management and prevention of CAUTI and implementation of catheter care bundle. In intervention Phase II education of health-care workers and implementation of catheter care bundle was done under constant supervision and guidance of ICN. Results: We recorded a total of 834 urinary catheter days: 309 in baseline phase, 314 in intervention Phase I, and 211 in intervention Phase II. It was found that the incidence rate of CAUTI, measured as episodes per 1000 catheter days is 64.72 in baseline phase, 25.47 in intervention Phase I, and 18.95 in intervention Phase II. The catheter care bundle approach along with education of the staff reduced the CAUTI incidence by 60.64 and when the same was applied under the constant supervision of ICN for the CAUTI reduction rate was clinically significant with 70.72. Conclusions: The catheter care bundle approach along with the education of the staff reduced the CAUTI incidence by 60.64 episodes/1000 catheter days and when the same was applied under constant supervision of ICN for the CAUTI reduction rate was clinically significant with 70.72

Prevalence and associated factors of latex-related symptoms and sensitization at a multispecialty hospital: A cross-sectional study Jandhyala Sridhar, Rahul Ray Journal of Marine Medical Society 2018 20(2):122-126 Background and Aim: Upsurge in usage of latex gloves over the last few decades, coupled with the proliferation of medical latex products at the workplace, has led to a higher incidence of latex-related symptoms among health-care workers (HCWs). This study aimed to assess the prevalence and associated factors of latex glove-related symptoms and sensitization among HCW at a multispecialty hospital. Materials and Methods: The study included all the paramedical personnel and nurses employed at a multispecialty hospital where powdered latex gloves were in use. Consenting participants were evaluated by a questionnaire for symptoms of latex allergy, followed by a skin prick test (SPT) for evaluating sensitization to latex allergen. Statistical Analysis Used: Mean, standard deviation, and Student's t-test were used for continuous data. Categorical data were analyzed using the Chi-square test. Odds ratios and 95% confidence intervals were calculated. Results: Latex glove-related symptoms were present in 25 (10.91%) HCWs. Symptoms suggestive of Type I latex allergy were reported in 11 (4.8%), while those of contact dermatitis were reported in 17 (7.42%) HCWs. Of the 229 HCWs, 37 (16.16%) had a personal history of atopy; 14 (6.11%) were SPT positive to latex allergen. Conclusions: In this study among Indian HCW, there was a significant correlation of latex glove-related symptoms with the duration of glove use, personal atopy, and SPT positivity to latex allergen. Questionnaire-based evaluation of allergic symptoms along with SPT positivity was found to be a useful identifier of true latex allergy.

Postgraduate residents' awareness of organ transplantation protocols – Survey at a teaching hospital Sujan Pudippedi, Biju K Varghese, CS Naidu Journal of Marine Medical Society 2018 20(2):127-131 Introduction: Much as the techniques have progressed to make organ transplantations safe and effective, the legal and ethical tangle surrounding the process has necessitated strict regulations and protocols to be followed. This paper studies a cross-sectional survey conducted on 198 postgraduate residents from various specialties with the aim of determining awareness of (a) legal and ethical requirements, (b) organ donation possibilities, and (c) technical details including brain-death criteria. Methods: A cross-sectional survey was conducted among postgraduate residents of all specialties in a tertiary care teaching institution. The survey instrument was a questionnaire with multiple choice questions aimed at evaluating awareness of the residents in the three knowledge domains. The mean scores of residents from each specialty and groups of specialties with similar work exposure were calculated and compared, with statistical significance tested using the ANOVA. Results: There was no statistically significant difference between the year-wise mean scores between residents of 1st, 2nd, and 3rd years. No significant difference in scores was obtained between groups of residents from similar specialties. Scores obtained by residents of specialties routinely managing patients in intensive care unit did not show any statistically significant difference with year of training. There was significantly lesser score obtained by anesthesiology residents in the domain concerning the possibility of donation of specific organs compared with surgery residents. There were significantly high mean scores in the knowledge domain related to brain death criteria and transplant techniques for medicine and surgery residents, respectively. Conclusion: The low levels of scientific knowledge regarding organ donation protocols and associated legalities among resident doctors are a matter of concern. These findings may merit consideration to include these protocols as part of teaching curriculum.

Dietary changes adopted by overweight candidates desirous of joining armed forces: A food frequency questionnaire-based study Shrajana Singh, Anil S Menon, Narendra Kotwal Journal of Marine Medical Society 2018 20(2):132-134 Background: Young male adults wishing to join armed forces have to comply with age-matched height and weight standards. Aim: This study aimed to examine the dietary changes adopted by young male adults declared overweight at initial medical examination. Settings and Designs: This was a cross-sectional observational study of candidates reporting for Appeal Medical Board (AMB). Materials and Methods: Nutrient information was collected using a 24-h semiquantitative food frequency questionnaire for food intake both before being declared unfit and before appearing for AMB. Calorie intake and macronutrient consumption were calculated using the Indian Council of Medical Research charts. Statistical Analysis: Microsoft Excel 2016 was used to analyze sample frequencies, percentage, mean (± standard deviation), and median (range), and paired t-test was used for comparing pre- and postdata. Results: Twenty-five male candidates participated in this study. They had reduced weight by a mean of 6.5 ± 2.7 kg by reducing caloric intake from 2884 ± 587.8 kcal to 1624.4 ± 327 kcal. The daily intake of carbohydrates was reduced from 510.2 ± 120.7 to 284.2 ± 67.0 g and fats from 60.46 ± 14.06 to 20.3 ± 3.0 g, whereas protein intake was increased from 64.4 ± 10.7 to 74.6 ± 11.8 g. The candidates had switched to a diet containing fruit, vegetable salad, mung dal, and oatmeal. Amount of calories expended by exercise was approximately 350 kcal/day. Majority had sourced the Internet for information. Conclusions: Young male adults being made unfit for overweight during initial medical examination reduce weight by adopting a low-fat diet.

A comparative study of the results of endoscopic dacryocystorhinostomy with and without stent placement Mohan G Raghav, Rahul Naga, Dilip Raghavan Journal of Marine Medical Society 2018 20(2):135-137 Background: Nasolacrimal duct (NLD) obstruction is a common clinical entity encountered both by ophthalmologists as well as otorhinolaryngologists. Endoscopic dacryocystorhinostomy (DCR) has emerged as a gold standard surgery for treatment of this disorder. Silicone stents are often promoted as agents to maintain patency of surgically created fistula during postoperative period in this surgery. Aim: The aim of this study is to evaluate and compare the outcomes of endoscopic DCR with and without silicone stenting. Materials and Methods: A prospective observational study was conducted. Totally 50 patients with acquired NLD obstruction were enrolled in the study and were randomly assigned to two groups: Group I underwent the surgery with silicone stent placement while the Group II underwent the surgery without stent placement. The patients were evaluated in terms of relief of symptoms and postoperative complications. Results: The overall success rate for endoscopic DCR in this study was 90&#37; which is comparable with the reports in the literature. Success rate for patients with placement of stent was 92&#37; and without stenting was 88&#37;. However, there was no significant statistical difference between the two groups. Conclusion: Use of silicone stents does not influence results of Endoscopic DCR. EDITORIAL   Ethics in medicine and research: Responsibilities of a medical scientist  p. 93 Sougat Ray, Sheila Samanta Mathai DOI:10.4103/jmms.jmms_78_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta ORIGINAL ARTICLES 2 hourly versus 3 hourly feeding schedule in very low birth weight preterm neonates p. 96 Neha Anushree, Subhash Chandra Shaw, Vandana Negi DOI:10.4103/jmms.jmms_18_18   Objective: Very low birth weight (VLBW) preterm neonates are fed every 2 hourly (2H) or 3 hourly (3H), but there is not sufficient evidence to determine the best feeding schedule. The study objectives were to compare the effects of 2H or 3H feeding schedule in neonates weighing <1500 g at birth, on the incidence of feed intolerance, apnea, necrotizing enterocolitis (NEC), hypoglycemia, and time to attain full feeds. Design and Setting: This longitudinal observational study was conducted in a level III neonatal unit of a teaching hospital in North India between October 2012 and March 2014. Materials and Methods: All stable intramural neonates born <1500 g were eligible for the study. Neonates with major malformations, congenital heart diseases, gastrointestinal anomalies, and those contraindicated for enteral feeding as decided by the treating clinicians were excluded. Sixty VLBW preterm neonates were assigned to 2H or 3H feeding groups. The incidence of feed intolerance, apnea, NEC, hypoglycemia, and time to attain full feeds was assessed. Results: There was no difference in incidence of feed intolerance between the two groups (30% vs. 23.3%, P = 0.56). The incidence of apnea, NEC, hypoglycemia, and time to attain full feeds was also similar between the two groups. Conclusion:3H feeding is possibly as good as 2H feedings for VLBW neonates. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Original report: Transtibial and transportal techniques of anterior cruciate ligament reconstruction provide similar functional outcome: A comparative study conducted at an armed forces hospital p. 100 Ajaydeep Sud, Munish Sood, Rohit Vikas DOI:10.4103/jmms.jmms_55_17   Background: The debate about the best arthroscopic technique for the anterior cruciate ligament (ACL) reconstruction surgery using semitendinosus (ST) quadruple graft is still unresolved. The aim of the present study was to compare the results of arthroscopic ACL reconstruction surgery techniques (transtibial [TT] and anteromedial portal [AMP]) using ST quadruple graft in terms of functional outcome. Materials and Methods: A total of 50 male patients with ACL tear were operated using the arthroscopic technique. The patients were divided into two groups (TT group and AMP group) and studied prospectively. The TT group (n = 24) included the patients in which femoral tunnel was prepared using the tibial tunnel. While the AMP group B (n = 26) included the patients in which femoral tunnel was prepared through the anteromedial arthroscopic portal. All these patients were assessed regularly and at follow-up of 1 year functionally using Lysholm Knee Score. Two groups were matched in terms of age, mode of injury, and side involved. Results: The average age of the patients in Group TT and AMP was 31.2 years (range: 22–43 years) and 30.6 years (range: 21–45 years), respectively. The mean Lysholm score improved significantly (P < 0.001) from 55.19 (range: 38–66) preoperatively to 82.65 (range 69–100) at the final follow-up in Group TT and 53.54 (range: 38–66) preoperatively to 82.04 (range: 59–100) at the final follow-up in group AMP. However, there was no significant difference in the mean Lysholm score while comparing the two groups at the final follow-up. Conclusion: ACL reconstruction surgery using ST quadruple graft with TT and transportal techniques provide similar functional outcome at 1-year follow-up. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Medical management of patients with benign prostatic hyperplasia: A study in Indian population p. 104 Amit Kumar Shah, Anand Srivastava, SC Karan DOI:10.4103/jmms.jmms_22_18   Introduction: At present, the geriatric population has formed a large clientele for medical services, with an increased incidence of lifestyle diseases. Approach to lower urinary tract symptoms due to benign prostatic hyperplasia (BPH) is an upcoming challenge, especially with management showing a paradigm shift toward medical management. This study was basically designed to study the outcome of medical management of BPH on Indian population following the recommendations based on recent guidelines on medical management of BPH. Materials and Methods: With a calculated sample size of 131 based on the prevalence of BPH, a total of 170 patients were enrolled, and their complete profile with clinical examination, imaging and International Prostatic Symptom Score details were taken as per proforma and were followed up while on medical management and assessed on a cross-sectional basis at regular intervals. Results: The mean age in the study group was 64.61 years. We recorded that all patients had some formal education. These patients were prescribed α-1ablockers as monotherapy or combination therapy as per the protocol of the study. They showed improvement while on medical management with significant improvement. Adverse reactions of medical management were not significant enough to warrant discontinuation of therapy. Forty-one patients out of 170 underwent surgery for no response or worsening quality of life. This group was further analyzed which revealed that comorbid condition, prostate size, and body mass index had no association with the outcome. Conclusion:There is sufficient evidence to support the paradigm shift in the management of BPH. The present guideline is to initiate medical management with monotherapy for patients with BPH and prostate size <30 g and combination therapy for larger prostate sized >30 g. Surgery is advised for patients who do not respond to medical therapy and for the subgroup of patients with absolute indication for surgery in BPH. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Frequency and associated factors of instrument-specific dermatoses among musicians in a military band: A cross-sectional study p. 111 Jandhyala Sridhar, Rahul Ray DOI:10.4103/jmms.jmms_41_18   Background and Aim: Continual contact with musical instruments may cause distinctive skin conditions among musicians. The site and degree of contact with the instrument may determine the type of presentation, further influenced by the amount of time spent in training. These conditions may be severe enough to even compromise musicians' careers. Since data on the subject are lacking in India, a study was conducted to assess the frequency and factors associated with the occurrence of instrument-related skin disorders among musicians in a military band. Materials and Methods: This was a cross-sectional study. A universal sample comprising all the members of a military band was included. A total of 162 musicians were evaluated using a questionnaire that included questions related to age, instrument played, current skin disorders, and the impact of skin symptoms on music making. Dermatological examination was done for all the participants. Statistical Analysis Used: Mean, median, and frequencies; Pearson's Chi-square test. Results: Of 162 musicians, 49 (30.2%) had at least one skin disease not correlated with instrument playing. Instrument-specific dermatoses were found in 55 (34%) of the 162 musicians and correlated with years of experience and the time spent in musical activity. Conclusions:Wind instrumentalists had the highest risk of developing skin problems. The occurrence of the tear trough deformity and lip dyschromia correlated significantly with the playing of a wind instrument. The impact of vibratory stress of wind instruments on the facial tissues needs further inquiry. Although not life-threatening, instrument-specific dermatoses may lead to impaired performance, occupational risk, and cosmetic disfigurement. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Role of "bladder care bundle" and "infection control nurse" in reducing catheter-associated urinary tract infection in a peripheral hospital p. 116 Parli Raghavan Ravi, MC Joshi DOI:10.4103/jmms.jmms_8_18   Background: Care bundles are an effective means of reducing catheter-associated urinary tract infection (CAUTI) when they are implemented with high impact interventions. Care bundle approach only works when every element of the bundle is implemented for every appropriate patient, every time and with high impact. Aim:This study aims to study the efficacy of CAUTI Care Bundle and of infection control nurse (ICN) in reducing the incidence of CAUTI in a zonal hospital. Materials and Methods: The study was with an initial baseline phase (observational) of 8 months followed by an intervention Phase of 21 months. The intervention phase was further divided into intervention Phase I (8 months) and intervention Phase II (13 months). Intervention Phase I included a multidimensional approach of education and training of health-care staff for catheter management and prevention of CAUTI and implementation of catheter care bundle. In intervention Phase II education of health-care workers and implementation of catheter care bundle was done under constant supervision and guidance of ICN. Results: We recorded a total of 834 urinary catheter days: 309 in baseline phase, 314 in intervention Phase I, and 211 in intervention Phase II. It was found that the incidence rate of CAUTI, measured as episodes per 1000 catheter days is 64.72 in baseline phase, 25.47 in intervention Phase I, and 18.95 in intervention Phase II. The catheter care bundle approach along with education of the staff reduced the CAUTI incidence by 60.64 and when the same was applied under the constant supervision of ICN for the CAUTI reduction rate was clinically significant with 70.72. Conclusions: The catheter care bundle approach along with the education of the staff reduced the CAUTI incidence by 60.64 episodes/1000 catheter days and when the same was applied under constant supervision of ICN for the CAUTI reduction rate was clinically significant with 70.72 [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Prevalence and associated factors of latex-related symptoms and sensitization at a multispecialty hospital: A cross-sectional study p. 122 Jandhyala Sridhar, Rahul Ray DOI:10.4103/jmms.jmms_58_18   Background and Aim: Upsurge in usage of latex gloves over the last few decades, coupled with the proliferation of medical latex products at the workplace, has led to a higher incidence of latex-related symptoms among health-care workers (HCWs). This study aimed to assess the prevalence and associated factors of latex glove-related symptoms and sensitization among HCW at a multispecialty hospital. Materials and Methods: The study included all the paramedical personnel and nurses employed at a multispecialty hospital where powdered latex gloves were in use. Consenting participants were evaluated by a questionnaire for symptoms of latex allergy, followed by a skin prick test (SPT) for evaluating sensitization to latex allergen. Statistical Analysis Used: Mean, standard deviation, and Student's t-test were used for continuous data. Categorical data were analyzed using the Chi-square test. Odds ratios and 95% confidence intervals were calculated. Results: Latex glove-related symptoms were present in 25 (10.91%) HCWs. Symptoms suggestive of Type I latex allergy were reported in 11 (4.8%), while those of contact dermatitis were reported in 17 (7.42%) HCWs. Of the 229 HCWs, 37 (16.16%) had a personal history of atopy; 14 (6.11%) were SPT positive to latex allergen. Conclusions: In this study among Indian HCW, there was a significant correlation of latex glove-related symptoms with the duration of glove use, personal atopy, and SPT positivity to latex allergen. Questionnaire-based evaluation of allergic symptoms along with SPT positivity was found to be a useful identifier of true latex allergy. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Postgraduate residents' awareness of organ transplantation protocols – Survey at a teaching hospital p. 127 Sujan Pudippedi, Biju K Varghese, CS Naidu DOI:10.4103/jmms.jmms_60_18   Introduction: Much as the techniques have progressed to make organ transplantations safe and effective, the legal and ethical tangle surrounding the process has necessitated strict regulations and protocols to be followed. This paper studies a cross-sectional survey conducted on 198 postgraduate residents from various specialties with the aim of determining awareness of (a) legal and ethical requirements, (b) organ donation possibilities, and (c) technical details including brain-death criteria. Methods: A cross-sectional survey was conducted among postgraduate residents of all specialties in a tertiary care teaching institution. The survey instrument was a questionnaire with multiple choice questions aimed at evaluating awareness of the residents in the three knowledge domains. The mean scores of residents from each specialty and groups of specialties with similar work exposure were calculated and compared, with statistical significance tested using the ANOVA. Results:There was no statistically significant difference between the year-wise mean scores between residents of 1st, 2nd, and 3rd years. No significant difference in scores was obtained between groups of residents from similar specialties. Scores obtained by residents of specialties routinely managing patients in intensive care unit did not show any statistically significant difference with year of training. There was significantly lesser score obtained by anesthesiology residents in the domain concerning the possibility of donation of specific organs compared with surgery residents. There were significantly high mean scores in the knowledge domain related to brain death criteria and transplant techniques for medicine and surgery residents, respectively. Conclusion: The low levels of scientific knowledge regarding organ donation protocols and associated legalities among resident doctors are a matter of concern. These findings may merit consideration to include these protocols as part of teaching curriculum. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Dietary changes adopted by overweight candidates desirous of joining armed forces: A food frequency questionnaire-based study p. 132 Shrajana Singh, Anil S Menon, Narendra Kotwal DOI:10.4103/jmms.jmms_13_18   Background: Young male adults wishing to join armed forces have to comply with age-matched height and weight standards. Aim: This study aimed to examine the dietary changes adopted by young male adults declared overweight at initial medical examination. Settings and Designs: This was a cross-sectional observational study of candidates reporting for Appeal Medical Board (AMB). Materials and Methods: Nutrient information was collected using a 24-h semiquantitative food frequency questionnaire for food intake both before being declared unfit and before appearing for AMB. Calorie intake and macronutrient consumption were calculated using the Indian Council of Medical Research charts. Statistical Analysis: Microsoft Excel 2016 was used to analyze sample frequencies, percentage, mean (± standard deviation), and median (range), and paired t-test was used for comparing pre- and postdata. Results: Twenty-five male candidates participated in this study. They had reduced weight by a mean of 6.5 ± 2.7 kg by reducing caloric intake from 2884 ± 587.8 kcal to 1624.4 ± 327 kcal. The daily intake of carbohydrates was reduced from 510.2 ± 120.7 to 284.2 ± 67.0 g and fats from 60.46 ± 14.06 to 20.3 ± 3.0 g, whereas protein intake was increased from 64.4 ± 10.7 to 74.6 ± 11.8 g. The candidates had switched to a diet containing fruit, vegetable salad, mung dal, and oatmeal. Amount of calories expended by exercise was approximately 350 kcal/day. Majority had sourced the Internet for information. Conclusions: Young male adults being made unfit for overweight during initial medical examination reduce weight by adopting a low-fat diet. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A comparative study of the results of endoscopic dacryocystorhinostomy with and without stent placement p. 135 Mohan G Raghav, Rahul Naga, Dilip Raghavan DOI:10.4103/jmms.jmms_31_18   Background: Nasolacrimal duct (NLD) obstruction is a common clinical entity encountered both by ophthalmologists as well as otorhinolaryngologists. Endoscopic dacryocystorhinostomy (DCR) has emerged as a gold standard surgery for treatment of this disorder. Silicone stents are often promoted as agents to maintain patency of surgically created fistula during postoperative period in this surgery. Aim: The aim of this study is to evaluate and compare the outcomes of endoscopic DCR with and without silicone stenting. Materials and Methods: A prospective observational study was conducted. Totally 50 patients with acquired NLD obstruction were enrolled in the study and were randomly assigned to two groups: Group I underwent the surgery with silicone stent placement while the Group II underwent the surgery without stent placement. The patients were evaluated in terms of relief of symptoms and postoperative complications. Results: The overall success rate for endoscopic DCR in this study was 90% which is comparable with the reports in the literature. Success rate for patients with placement of stent was 92% and without stenting was 88%. However, there was no significant statistical difference between the two groups. Conclusion: Use of silicone stents does not influence results of Endoscopic DCR. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta MILITARY MEDICINE - ORIGINAL ARTICLE Clinico-epidemiological study of an adult mumps outbreak in a naval training establishment p. 138 Prabhat Chauhan, Arun Gupta, Amitabh Mohan, Anmol Sharma DOI:10.4103/jmms.jmms_20_18   Introduction: Outbreaks of mumps are known in places of high population density because of close contact. Studies on mumps outbreak in adults have rarely been documented in India, although globally an epidemiological shift is noticed in the disease from children to young adults because of vaccination against the disease in childhood. Materials and Methods: This outbreak investigation was conducted at a sailor training center of the Indian Navy. All cases of fever with parotitis, orchitis, or features suggestive of mumps were included in the study. The clinical, epidemiological, and demographic data of all the positive cases were analyzed using a standardized questionnaire and review of medical records. Results: A total of 58 cases reported over 3 months. Forty-two cases were from a single division and 13 cases from the same dormitory as the index case. Parotitis (89.7%) was the most common presentations, and orchitis (13.8%) was the most common complication. The attack rate (AR) within the division was 15.46%, with overall AR of 2.32%. The incidence was 23.2 per 1000 per year. Case fatality rate of the disease was nil. Recommendations: Surveillance, early diagnosis, and prompt isolation remain the key to prevent the transmission of illness during an outbreak. Other preventive measures include health education of recruits and their instructors. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta MEDICAL HISTORY Unknown facets of "not so well-known scientist" Dr. Y Subbarow: A great scientist, who did not receive the Nobel Prize p. 141 Vasant S Dixit DOI:10.4103/jmms.jmms_69_18   Dr. Subbarow (January 12, 1895–August 08, 1948) had obtained admission to MBBS course but was awarded Licentiate of Medicine and Surgery instead of the MBBS degree. He went to the USA in October 1923 where he was admitted to the Harvard School of Tropical Medicine. After receiving a diploma from the school, he became interested in biochemistry. He discovered the function of adenosine triphosphate as an energy source in the cell. Despite the path-breaking discovery, Subbarow was denied tenure at Harvard. Subbarow felt that the giant pharmaceutical firms might offer greater scope for research than universities. Hence, in 1940, he joined the world-renowned Lederle Laboratories as Director of Research and spent the rest of his life in the USA. He would lead some of America's most important medical research during World War II. His output and contributions to human biology and medicine are seminal and phenomenal. His creativity is evident in the trail-blazing discoveries in the fields of biochemistry, nutritional science, pharmacology, microbiology, and oncology. Subbarow had craved for fame but was never in the limelight. He pushed into limelight those whose dedication most nearly matched his own. He was proud of the brilliant members of his research teams. He was quick to share successes with colleagues and was known for his acts of generosity. Subbarow said, "Victories of science are rarely won single handedly. No one man should get the (entire) credit." [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta COMMENTARY Deceased organ donation is growing at a slow pace in developing countries: A matter of serious concern? p. 145 Amit Kumar Shah DOI:10.4103/jmms.jmms_77_18   [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta REVIEW ARTICLE Changing paradigm in intravenous fluid resuscitation in sepsis and critical illnesses  p. 148 Prabhakar Gupta, Kuldeep Kumar Ashta DOI:10.4103/jmms.jmms_9_18   Intravenous (IV) fluid resuscitation, pioneered in 1832, is now one of the most common medical interventions in hospitalized patients. Up until the end of the 20th century, IV fluid prescriptions have been considered ancillary, benign interventions and rarely tested in good-quality randomized clinical trials (RCTs). Robust clinical research evidence emerging in the past decade and a half, however, has revealed counterintuitive findings. The emerging research has consistently demonstrated harm, including higher mortality, and questionable clinical benefits associated with protocolized aggressive fluid resuscitation, as espoused in the early goal-directed therapy. Conservative fluid management has been shown to be associated with better outcomes in most clinical settings. Recent RCTs have also revealed clinically relevant pharmacological differences between types of IV fluids, especially pertaining to predictable harms associated with some commonly used IV fluids. Concerns have emerged over risks of metabolic acidosis and renal failure associated with the use of normal saline. Balanced solutions have been found to be safe across a wide spectrum of conditions. Better understanding of the complex pathophysiology of sepsis and critical illnesses and recognition of newer concepts such as profound disruption of the endothelial glycocalyx layer leading to profound leakiness of vessels question the basic premise of injection of large quantities of IV fluids during resuscitation. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta CASE REPORTS Case series: Two rare cases of primary jejunal adenocarcinoma with different clinical presentation p. 153 Gurjeet Singh Chowdhary, Purvesh Agrawal DOI:10.4103/jmms.jmms_39_18   Small bowel tumors are rare, accounting for <5% of gastrointestinal neoplasms, 1%–2% of these being malignant. The most common histological subtype is adenocarcinoma. Small bowel adenocarcinoma (SBA) is challenging to diagnose, often presents at a late stage, and has a poor prognosis. Therefore, a high index of clinical suspicion is required to diagnose such patients, and a better outcome with early-stage detection is expected. We report here two cases of jejunal adenocarcinoma. (a) A 53-year-old male presenting with iron deficiency anemia. (b) An 81-year old-female presenting with subacute intestinal obstruction. Diagnosis of SBA remains a challenge. A physician's suspicion and awareness are crucial in such patients. The early diagnosis will affect overall survival and mortality rate. Because the incidence of SBA is very low, there is a need for further studies to evaluate the possible application of newer investigative agents and strategies to obtain a better outcome. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A case of epibulbar osseous choristoma p. 157 AS Parihar, Shelly Verma, Arti Trehan, Prashant Vashisht DOI:10.4103/jmms.jmms_29_18   Osseous choristoma of the eye is a rare entity with few case reports being published in the literature. We report one such case in a 14-year old female who had a small growth in the right eye present since birth, which gradually increased in size. Excision biopsy was done. Histologically, the mass was composed of mature bone with surrounding benign adipocytes. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Postoperative visual disturbance: "A peril related to glycine toxicity" p. 159 Deepak Dwivedi, Saurabh Sud, Sadhan Sawhney, Ashutosh Gupta DOI:10.4103/jmms.jmms_24_18   Hysteroscopic gynecological surgeries are now commonly employed in the clinical practice. It has the potential to increase morbidity due to the complication resulting from perforation of the uterus, air/gas embolism, and fluid with electrolyte imbalance. Glycine 1.5%, as an irrigating fluid, is being commonly used and on increased systemic absorption can lead to a wide array of complications. We present a case of transient visual loss after increased absorption of the irrigating fluid, thereby highlighting the factors governing in its genesis and prevention. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta Anteromedial temporal encephalocele: A rare cause for spontaneous cerebrospinal fluid rhinorrhoea p. 162 Saikat Bhattacharjee, Deepak Chandra Reddy, Samar Chatterjee, Bikram Choudhury DOI:10.4103/jmms.jmms_12_18   Spontaneous cerebrospinal fluid (CSF) rhinorrhea in an adult without prior history of head trauma is a rare occurrence. Neuroimaging is done to ascertain the site of bony defects in the cranium and breach in the continuity of dura to localize the site of CSF leakage. Encephaloceles into the sphenoid sinus occurring through congenital bony defects in the walls of the sinus are an extremely rare cause for CSF rhinorrhea. We present a case of spontaneous, nontraumatic CSF rhinorrhea due to an anteromedial encephalocele where the temporal lobe was seen herniating into the right sphenoid sinus through a congenital bony defect in the wall of the sinus. A review of the present literature is also presented. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A rare case of H1N1 influenza-associated organizing pneumonia p. 165 Manjit S Tendolkar, Rahul Tyagi, Gautam Mullick, Vikas Chauhan DOI:10.4103/jmms.jmms_15_18   H1N1 influenza A was responsible for global pandemic in 2009. Since then H1N1 continues to be responsible for epidemics frequently. H1N1 influenza causing organizing pneumonia (OP) is extremely rare, and only 6 cases have been reported till date. Here, we report a case of H1N1 presenting as an OP. The significance of diagnosing OP in appropriate clinical and radiological setting is being highlighted along with its prompt response to treatment. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A rare case of invasive pituitary tumor mimicking nasal mass p. 168 Inderdeep Singh, Shruti Anil Sharma, SGS Dutta, Gurpreet Kaur, D Phogat DOI:10.4103/jmms.jmms_52_18   Pituitary apoplexy is a rare condition more often seen in large pituitary adenomas. It is preceded by an abrupt expansion of infarcted/hemorrhagic pituitary adenoma extending into the cavernous sinus or superiorly compressing the optic chiasm. An invasive pituitary tumor extends into the suprasellar cistern by stretching and fenestrating the diaphragma sellae and arachnoids layer. It is labeled as invasion of the cavernous sinus when the percentage of encasement of the internal carotid artery by the tumor is 67% or greater or for Grade 3 or 4 of Knosp classification. A 51-year-old male presented with headache, vomiting, and bleeding from the nose for 3-day duration and blurring of vision for 2-day duration. Contrast-enhanced magnetic resonance imaging of the brain revealed an enhancing sellar and suprasellar lesion with characteristic expansion into the cavernous sinus and extension into the sphenoid sinus and nasopharynx. The patient underwent endoscopic transnasal transsphenoidal excision of the mass followed by three-dimensional conformational radiotherapy and hormone replacement therapy with a favorable clinical outcome. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A case of laparoscopic extraction of a displaced intrauterine contraceptive device p. 172 Manoj Mukund Paprikar, Anurav Yadav DOI:10.4103/jmms.jmms_51_18   Intrauterine Contraceptive Devices (IUCD) are commonly used in India as a means of contraception. It is a safe, effective and economical method. The complications include menorrhagia, expulsion, migration and ectopic pregnancy. Displaced IUCDs after uterine perforation can be located at many sites like pelvis, adnexa, bowel, bladder, abdominal cavity. They can have an unusual presentation. They require surgical removal preferably laparoscopically, although conversion to open surgery especially in abdominal cavity is quiet common. Here we present a case which had an unusual presentation and was found close to umbilicus embedded in omentum. The IUCD was successfully extracted out laparoscopically. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta A rare case of acne fulminans p. 175 Preema Sinha, Durga Madhab Tripathy, Subramaniyan Radhakrishnan, Pankaj Das DOI:10.4103/jmms.jmms_68_18   Acne fulminans (AF) is a rare yet the most severe inflammatory form of acne. It predominantly affects prepubertal boys in the form of multiple exuberant pustular and ulcerative lesions over the face and trunk associated with systemic symptoms in the form of fever, polyarthralgia, and osteolytic bone lesions. In spite of multiple mentioned triggering agents, till date, no direct cause has been ascertained. Drugs like isotretinoin for acne and anabolic steroids are known to precipitate this condition. Due to systemic symptoms, the patient may sometimes require an aggressive inpatient treatment to prevent any systemic complications and grossly morbid scarring as a result of the disease. Herein, we report a rare case of AF in a 16-year-old female with predominantly facial involvement who was managed with oral corticosteroids and isotretinoin with excellent response. [ABSTRACT]  [HTML Full text]  [PDF]  [Mobile Full text]  [EPub]  [Sword Plugin for Repository]Beta