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Introduction: Hansen's disease (HD) is a major public health problem in developing countries. It causes peripheral neuropathy, and if left untreated, it leads to deformities. It is important to diagnose such cases early, and prompt treatment should be given to patients to preserve nerve function. Materials and Methods: A total of 40 patients with HD who were already on multi-drug therapy (MDT) or treatment-naive were included in this study. These were clinically diagnosed cases of HD as per the Ridley–Jopling classification, and these patients were subjected to high-resolution ultrasonography (HRUS). A total of 19 controls were also included. The patients were clinically evaluated, and HRUS of bilateral ulnar nerves (UNs) was performed in all cases and controls. The other peripheral nerves, if clinically thickened, were evaluated using HRUS. Results: The cross-sectional area (CSA) of the UN in cases was significantly thickened as compared to controls. There was no difference in the CSA of patients on MDT as compared to treatment naïve patients. In two patients with pure neuritic HD, the clinical examination missed the bilateral nerve enlargement, and only unilateral nerve thickening was clinically appreciated. However, bilateral thickening was detected on HRUS. Conclusion: HRUS is a non-invasive and sensitive diagnostic tool that gives significant information on nerve structure and morphology. HRUS adds a new dimension to diagnosing HD, particularly the pure neuritic type, with the assessment of early nerve damage, which can prevent disabilities. HRUS is an objective diagnostic tool that can complement the clinical examination.

BACKGROUND: Accurate staging of disease severity and its serial monitoring thus is central to the effective management protocols of interstitial lung disease (ILD). PURPOSE: The aim is to evaluate the effectiveness of semi-quantitative parameters of lung ultrasound (LUS) in patients of ILD as a means of staging disease severity. MATERIALS AND METHODS: LUS of 47 patients of ILD and 20 age-matched controls was performed, and findings such as B-line distance, pleural thickening, subpleural changes, decreased lung sliding, and fragmented pleural lining were charted, and an LUS score was done using these parameters. Findings were compared with the Modified Medical Research Council (MMRC) dyspnea grade and spirometry parameters. RESULTS: The presence of B-lines and fragmented pleural lining were the most common findings observed in patients of ILD. Predicted forced vital capacity (FVC) and predicted forced expiratory volume in 1 s (FEV1) showed a good correlation with all the LUS parameters. B-line distance was the most significant LUS parameter to predict the variability in predicted FEVI, FVC, and MMRC dyspnea score. LUS severity score also showed good negative correlation with predicted FEV1 (r = −0.674, P < 0.001) and predicted FVC (r = −0.65, P < 0.001). LUS severity score of 4 or more predicted MMRC dyspnea score of > 3 with 82% sensitivity and 70% specificity. CONCLUSION: Semi-quantitative LUS score and B-line distance can provide a simple but effective estimate of disease severity in ILD.

Background: Isolated anterior cruciate ligament (ACL) reconstruction is frequently associated with anterolateral ligament injury (ALL) and results in residual instability at follow-up. It was hypothesized that patients who underwent combined ACL and lateral extra-articular tenodesis (LET) reconstruction would exhibit less residual laxity, better clinical outcomes, and better graft incorporation on follow-up magnetic resonance imaging (MRI) as well. Patient and Methods: Sixty-four patients with concomitant ACL and ALL injuries who were operated over a period of 2 years were enrolled between 2016 and 2018. Two groups of patients were evaluated prospectively. Eighteen patients in control Group B underwent anatomical ACL reconstruction alone, and 20 in test Group A underwent ACL reconstruction combined with LET. Exclusions were multiligament injuries, chondral injury, meniscus tear, and ramp lesion. Follow-up by Lysholm and modified Cincinnati knee rating was done and MRI for status of graft at least 1-year postoperative. Results: After excluding dropout or inadequate follow-up, Group A (n = 20) with ACL + LET was compared with Group B (n = 18), with isolated ACL reconstruction, at final median follow-up of 18 months. There were no significant differences between groups regarding gender, age, and duration of injury. Regarding functional outcome scores, patients in the LET group presented better results on both the clinical scoring (P < 0.0001). In addition, patients in the LET group had better graft uptake on MRI and no pivoting at physical examination. Regarding graft failures, the isolated ACL reconstruction group had 5 and the LET group had 1 failure. Conclusion: The combined ACL and LET reconstruction in patients with ACL injury is an effective and safe solution and leads to good functional outcomes with no increase in complications and aids in early return to preinjury activities with a surviving healthy graft.

Background: Mural lesions of gallbladder on ultrasound (US) are often difficult to characterize as benign or malignant. Purpose: The aim of the study was to evaluate the role of contrast-enhanced US (CEUS) in characterization of gallbladder (GB) wall lesions and making distinction between benign wall thickening and GB adenocarcinoma, utilizing both quantitative and qualitative parameters. Methods: A total of 26 patients with GB wall lesions detected on sonography underwent CEUS. Lesions were evaluated on the basis of morphological imaging features, enhancement pattern, dynamic real-time contrast uptake, and intralesional vascularity. Results: Overall, 19 patients had final diagnosis of GB adenocarcinoma, whereas seven patients had benign etiology. CEUS has enabled the differentiation of nonenhancing tumefactive sludge from enhancing mural lesions, thus improving the accuracy of morphological assessment of lesions. The intactness of outer wall was better assessed on CEUS. The dynamic postcontrast assessment showed that carcinoma showed early washout of contrast compared to benign thickening (P = 0.002). Nonlayered mural enhancement or thick enhancing inner layer with nonenhancing thin outer layer was associated with adenocarcinoma. The classification of intralesional vascularity on CEUS was not helpful in distinguishing benign lesions and adenocarcinoma. Conclusion: CEUS can increase the diagnostic confidence in differentiation between benign mural lesions and adenocarcinoma of GB.

India is a land of spices and medicinal plants. Ayurvedic medications and methods are commonly practised in India for curing several ailments. Lepidium sativum (garden cress) is an important herb that belongs to Brassicaceae family. It is believed that the plant has its origin in Ethiopia but is now cultivated throughout the world. The plant is well-known in Ayurveda for its beneficial properties it holds. The present study describes the fracture healing property of the methanolic and aqueous extract of Lepidium sativum seeds. For the study, 21 Charles foster rats were used. They were grouped into three groups each containing seven rats: control, methanolic, and aqueous group. Rats were anesthetized using ether vapors and fractures were induced in each rat from all the three groups using hand held three-point bending technique. The broken bone fragments were then stabilized using splints. The control group was administered with normal saline, along with food and water, post-fracture. The methanolic group was administered with the methanolic extract of Lepidium sativum seeds at dose of 400 mg/kg given orally, post-fracture along with food and water. The third group received aqueous extract of the seeds in doses of 550 mg/kg orally, along with daily food and water intake for a period of 8 weeks. The results were evaluated both radiologically and biochemically. X-rays were done on day 0, 2nd week, and 4th week post-fractures to look for the callus formation and serum levels for calcium, phosphorus, and alkaline phosphatases were evaluated on 0 day, 1 week, 2nd week, 4th week, 6th week, 8th week, and 10th week post-injury. It was observed at the end of the study period that the methanolic group had significant callus formation starting at the 2nd week itself post-fracture. The serum levels of calcium, phosphorus, and alkaline phosphatases at 4th, 6th, and 8th weeks had significant P values in the methanolic group rats.