Echocardiography in adult patients with PDA: A simplified approach

Patent ductus arteriosus is a common congenital heart anomaly in the newborn and children. It is often diagnosed and treated in childhood; however, there are a subset of patients who survive to adulthood undiagnosed, and it is present in adulthood with various clinical presentations. The clinical presentation, hemodynamics, and management of PDA presentation in adults depend on various factors, primarily the size of PDA, magnitude of shunting, and status of pulmonary vasculature. Echocardiography is often the primary imaging modality in the evaluation of adult patients with PDA and is an important tool that provides diagnostic and hemodynamic assessment for the initial evaluation and routine follow-up after PDA closure. In this review, we present a simplified approach of basic echocardiographic assessment of various types of PDA presentations in adults.     

Natural radioactivity in the soil samples of Coastal Karnataka of South India

Studies on radiation level and radionuclide distribution in the region of Coastal Karnataka, India, were undertaken. The purpose of this study is to provide baseline data on radiation level and radionuclide distribution in the region for the future assessment of the impact of the nuclear and thermal power stations that are being set up in the region. Further, this study may reveal information on the transportation of radionuclides in the environment. The external gamma dose rates in air have been measured throughout Coastal Karnataka using a sensitive plastic scintillometer. The measured dose rates include both terrestrial and cosmic ray components. The gamma dose rates in air range from 26 to 174 nGy h(-1) with a median value of 74 nGy h(-1). The activities of naturally occurring radionuclides in the soil samples of the region were measured using HPGe gamma ray spectrometry, and the resulting doses in air were calculated. The activity of 40K varies from 61.0 to 316.7 Bq kg(-1) with a median of 117.5 Bq kg(-1); the activity of 226Ra varies from 20.1 to 62.3 Bq kg(-1) with a median value 35.0 Bq kg(-1) and that of 232Th from 14.3 to 48.6 Bq kg(-1) with a median value of 29.8 Bq kg(-1). The mean absorbed dose rate in air due to naturally occurring radionuclides is found to be 41.5 nGy h(-1). In addition to this, the correlations between 226Ra and 40K, 232Th and 40K, and 226Ra and 232Th were computed from the results of the concentration of these naturally occurring radionuclides. A weak correlation was observed between 226Ra and 40K and between 232Th and 40K while a moderately good correlation was observed between 226Ra and 232Th. The results of these systematic investigations are presented and discussed in this paper.     

Patterns of emergency maxillofacial referrals and provision of services

The rising number of maxillofacial injuries in the UK requires a reappraisal of emergency services within our specialty. Although the impact of a dedicated trauma list has been reported, it has not been widely embraced, and we know of few data that help to plan the number or timing of such lists. We designed a minimum dataset to collect information about referral, cause of emergency, assessment of patients, and outcome during 2003 and 2004. Theatre data were examined retrospectively to analyse operations during the same period. We conclude that to serve a population of 2.6 million a minimum of 8 emergency lists are required each week to deal with non-complex cases; this equates to 3 lists/million population. The lists should be concentrated at weekends and early in the week.     

Otomycosis in immunocompetent and immunocompromised patients: comparative study and literature review

A comparative clinical study was carried out that included 50 cases of otomycosis in immunocompetent patients and 50 cases of otomycosis in immunocompromised patients. Clinical presentation, predisposing factors, mycologic profile, and treatment outcomes were compared. Aspergillus spp were the most commonly isolated fungi in the immunocompetent group, and Candida albicans in the immunocompromised group. Bilateral involvement was more common in the immunocompromised group. All the patients were treated with topical clotrimazole ear drops. Four patients in the immunocompromised group did not respond to treatment with clotrimazole but were treated successfully with fluconazole ear drops. Three patients had a small tympanic membrane perforation due to otomycosis.     

Melanoma of Stomach

Introduction

Melanoma of gastrointestinal tract can be either primary or secondary to metastases from other sites like skin, mucous membranes, and uvea. Primary gastrointestinal melanoma is rare and still rarer is stomach involvement.

Case Report

We report a case of primary malignant melanoma of stomach in a 50-year-old female who presented with an axillary lymphadenopathy.

Conclusion

Melanoma of stomach is rare. It has characteristic endoscopic appearance. Differentiation of primary from secondary melanoma is possible on clinical behavior and histological characteristics.     

Calcification of ulnar nerve in a patient with tuberculoid leprosy--a case report

A case of Tuberculoid Leprosy who showed Evidence of Calcification of Right Ulnar Nerve at Elbow on Radiological Examination is reported.     

Steatocystoma multiplex

A case of steatocystoma multiplex in a 45-year-old male is reported. The diagnosis was based on clinical as well as histopathological findings.     

Iron deficiency alters iron regulatory protein and iron transport protein expression in the perinatal rat brain

Iron plays an important role in numerous vital enzyme systems in the perinatal brain. The membrane proteins that mediate iron transport [transferrin receptor (TfR) and divalent metal transporter 1 (DMT-1)] and the iron regulatory proteins (IRP-1 and IRP-2) that stabilize their mRNAs undergo regional developmental changes in the iron-sufficient rat brain between postnatal day (P) 5 and 15. Perinatal iron deficiency (ID) affects developing brain regions nonhomogeneously, suggesting potential differences in regional iron transporter and regulatory protein expression. The objective of the study was to determine the effect of perinatal ID on regional expression of IRP-1, IRP-2, TfR, and DMT-1 in the developing rat brain. Gestationally iron-deficient Sprague Dawley rat pups were compared with iron-sufficient control pups at P10. Serial 12-mu coronal sections of fixed frozen brain from pups on P10 were assessed by light microscopy for IRP-1, IRP-2, DMT-1, and TfR localization. ID did not change the percentage of cells with positive staining for the four proteins in the choroid epithelium, ependyma, vascular endothelium, or neurons of the striatum. ID increased the percentage of neurons expressing the four proteins in the hippocampus and the cerebral cortex. Increased numbers of TfR- and DMT-1-positive cells were always associated with increased IRP-positive cells. The P10 rat responds to perinatal ID by selectively increasing the number of neurons expressing IRP-regulated transporters in brain regions that are rapidly developing, without any change at transport surfaces or in regions that are quiescent. Brain iron distribution during ID seems to be locally rather than globally regulated.