Motor unit number estimation (MUNE): Where are we now?

Estimation of the number of motor units (MUNE) in specific muscles is important to monitor outcome in progressive neurogenic disorders, with potential application in clinical trials. However, in spite of recent developments to identify the most convenient technique for MUNE, all current methods have individual shortcomings. It is essential to understand the scientific concepts that support MUNE and the many methods already proposed. In particular, the core role of the compound muscle action potential (CMAP) size in the estimation process is undervalued. Operator-dependent variation in CMAP amplitude or area is the main factor underlying MUNE stability. At present, MUNIX, as standardized in many centers, is probably the best accepted method. Future developments should be based on full understanding of the neurophysiological concepts underlying the MUNE calculation, in order to find a quick, well-tolerated, operator-friendly and reliable method to apply more universally in clinical practice.     

Independent urban effect on hypertension of older Indians: identification of a knowledge gap from a Study on Global AGEing and Health

Among older Indians, more cardiovascular diseases and risk factors are observed in the city dwellers than in the rural population. Clustering of socioeconomic privileges and consequent obesity in the Indian cities are known to underlie this phenomenon. But, it is unclear whether an independent urban effect exists on age-related ailments, unexplained by concentration of privileges and excess weight in the Indian cities. Hence, we aimed to estimate the independent urban effect on hypertension among older Indians after controlling for these factors. Nationally representative data of Indians aged 50 years and older (n = 7273) were collected by Study on global AGEing and health. Hypertension was defined as systolic and/or diastolic blood pressure >139 and > 89 mm Hg, respectively, and/or someone receiving antihypertensive medications. Permanent place of residence (urban/rural) during interview was recorded. Socioeconomic determinants included caste, occupation, assets, and education. Body mass index, abdominal circumference, smoking, alcohol, and physical activity were also controlled. The age- and sex-adjusted odds ratio of hypertension for urban residents was 1.64 (146–1.83), which partially attenuated to 1.22 (1.07–1.38) after controlling for all the covariates. This study highlights 22% excess odds of hypertension among the older Indian city dwellers, unexplained by the greater urban concentration of socioeconomic privileges and obesity. Future research should explore the constituents of this urban effect.     

Common and uncommon imaging features of abdominal tuberculosis

Despite the advances in the medical care, tuberculosis (TB) still remains an important health problem. This is particularly relevant to the developing countries as well as the immunocompromised population in the developed world. Multidrug resistance poses another challenge and may be responsible for increasing incidence of TB, to some extent. The respiratory system is the most commonly involved, although any organ system may be affected. Abdominal involvement occurs in 11–12% of the patients with extrapulmonary TB. The clinical features of abdominal TB are nonspecific. Imaging plays an important role in the diagnosis of abdominal TB. Although a few imaging features strongly favour the possibility of TB, abdominal TB is a greater masquerader. In this review, we highlight the entire spectrum of the manifestations of abdominal tuberculosis (excluding the genitourinary involvement) with an emphasis on imaging findings.