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Globally and in India, lung cancer is one of the leading malignancies in terms of incidence and mortality. Smoking and environmental pollution are the common risk factors for developing lung cancer. Traditionally, lung cancer is divided into small cell and nonsmall cell types, with nonsmall cell carcinomas including squamous cell carcinoma, adenocarcinoma, and large cell carcinoma.In this review article, we describe the imaging recommendations and findings in the diagnosis, staging, and management of lung cancer, including the imaging of treatment-related complications.

History A 38-year-old man who had been in a motor vehicle collision was referred to our institute. He was suspected of having left-sided pneumothorax. This necessitated intercostal drainage with a chest tube, which had been placed elsewhere prior to his arrival. Paraparesis was noted on the initial clinical examination, with adequately maintained vital signs, while the blood work-up revealed a mildly reduced hemoglobin level of 10.1 mg/dL (normal range, 13.8-17.2 mg/dL); however, the rest of the laboratory values were within normal limits (Figs 1-5). The patient was then immediately referred for further evaluation with CT of the brain, cervical spine, and thorax. Thereafter, serial chest radiography was performed for follow-up.

Natural deoxyanthraquinones synthesized using a chemoenzymatic approach and tested for cell viability shows less toxicity compared to the respective anthraquiones.

Self-assembled peptide-based nanostructures, comprised of naturally occurring amino acids, display excellent biocompatibility, biodegradability, flexible responsiveness, and synthetic feasibility and can be customized for various biomedical applications. However, the lack of inherent optical properties of peptide-based nanoparticles is a limitation on their use as imaging probes or drug delivery vehicles. To overcome this impediment, we generated Boc protected tyrosine-tryptophan dipeptide-based nanoparticles (DPNPs) with structure rigidification by Zn(ii), which shifted the peptide's intrinsic fluorescent properties from the ultraviolet to the visible range. These DPNPs are photostable, biocompatible and have visible fluorescence signals that allow for real-time monitoring of their entry into cells. We further show that two DPNPs (PS1-Zn and PS2-Zn) can encapsulate the chemotherapeutic drug doxorubicin (Dox) and facilitate intracellular drug delivery resulting in cancer cell killing actions comparable to the unencapsulated drug. Finally, we chemically modified our DPNPs with an aptamer directed toward the epithelial cell surface marker EPCAM, which improved Dox delivery to the lung cancer epithelial cell line A549. In contrast, the aptamer conjugated DPNPs failed to deliver Dox into the cardiomyocyte cell line AC16. Theoretically, this strategy could be employed

Introduction: Significant increase in plasma leakage is characteristic of severe dengue. This results in collection of fluid in serous cavities. Gall bladder wall thickening (GBWT) often precedes the development of pleural effusion and ascites. Early detection of plasma leakage and management is shown to reduce mortality in dengue illness. Ultrasonography is a point of care investigation to identify GBWT. The aim of this study was to determine the cut-off value of GBWT to predict severe dengue in the early phase of the illness. Methods: This was a prospective study done on 310 children with dengue illness. Abdomen and chest ultrasound was done in all these children between third and sixth day of illness. GBWT of more than 3.5 mm was taken as a thickened gall bladder wall. Maximum severity of the illness was considered for categorising the severity of dengue. Results: Out of 310 children, 160 (51.6%) were categorized as dengue fever, 91 (29.4%) as dengue with warning signs and 59 (19%) as severe dengue. The incidence of thickened gall bladder wall was 27.5% in DF (Dengue fever), 68% in DF with warning signs and 96.6% in severe dengue. The odds of finding thickened gall bladder wall in severe dengue are 3.5 times that of dengue fever. GBWT increases as the severity of the illness increases. GBWT of 5 mm has sensitivity of 93.7% and specificity of 70% to predict progress to severe dengue. There was a fair correlation of 46% between thickened gall bladder wall and thrombocytopenia. Gall bladder wall thickness of 2.5 mm had sensitivity of 86.3% and specificity of 80% for ascites. GBWT of 3.5 mm had a sensitivity of 77.6% and specificity of 85% for pleural effusion. Conclusions: GBWT assessment by ultrasonography in early phase of illness can be used as a point of care modality to predict severe dengue. The sensitivity and specificity to predict the progression to severe dengue is 93.7% & 70% respectively for the cut-off value of five mm of GBWT.

Dose-limiting cardiotoxicity remains a major limitation in the clinical use of cancer chemotherapeutics. Here, we describe a role for Regulator of G protein Signaling 7 (RGS7) in chemotherapy-dependent heart damage, the demonstration for a functional role of RGS7 outside of the nervous system and retina. Though expressed at low levels basally, we observed robust up-regulation of RGS7 in the human and murine myocardium following chemotherapy exposure. In ventricular cardiomyocytes (VCM), RGS7 forms a complex with Ca 2+ /calmodulin-dependent protein kinase (CaMKII) supported by key residues (K412 and P391) in the RGS domain of RGS7. In VCM treated with chemotherapeutic drugs, RGS7 facilitates CaMKII oxidation and phosphorylation and CaMKII-dependent oxidative stress, mitochondrial dysfunction, and apoptosis. Cardiac-specific RGS7 knockdown protected the heart against chemotherapy-dependent oxidative stress, fibrosis, and myocyte loss and improved left ventricular function in mice treated with doxorubicin. Conversely, RGS7 overexpression induced fibrosis, reactive oxygen species generation, and cell death in the murine myocardium that were mitigated following CaMKII inhibition. RGS7 also drives production and release of the cardiokine neuregulin-1, which facilitates paracrine communication between VCM and neighboring vascular endothelial cells (EC), a maladaptive mechanism contributing to VCM dysfunction in the failing heart. Importantly, while RGS7 was both necessary and sufficient to facilitate chemotherapy-dependent cytotoxicity in VCM, RGS7 is dispensable for the cancer-killing actions of these same drugs. These selective myocyte-intrinsic and myocyte-extrinsic actions of RGS7 in heart identify RGS7 as an attractive therapeutic target in the mitigation of chemotherapy-driven cardiotoxicity.

BACKGROUND Globally, radiodiagnosis is considered as one of the most sought after specialty in the field of medicine, based on the perceived notion that it is a high income, risk-averse, white-collared job. Radiologists are touted as being one of the highest paid specialists with defined work-hours; however, the ground reality appears to be in contradiction, particularly in the Indian context. The purpose of this study was to objectively assess the current day situation amongst the Indian radiologists. This gender-neutral survey not only dispels many of the prevailing assumptions but also brings to clear light the issues that assail the radiologist on a day to day basis. METHODS A cross-sectional descriptive study was performed with Google survey forms and collected data was obtained from 370 radiologists regarding various parameters, such as the workplace, years of experience, work hours per day, monthly income, peer, and work-related pressures, and their overall perceived happiness quotient. Issues concerning threats to radiology, the need for super or subspecialty training were also addressed. RESULTS Most of the young radiologists opted to work in either diagnostic centers or corporate hospitals as salary drawn was considerably higher than their counterparts in medical colleges. Nearly half the radiologists working at medical colleges augmented their income by working in diagnostic centers. Nearly 2/3rds of the young radiologists work for an average of 10 hours per day, six days a week with a take home salary of approximately 1 – 2 lakhs per month. Only 5 % of the radiologists stated that they were most happy with their work environment, nearly 57 % of them had some kind of occupational hazard and this was directly related to the years of work. Burn out predominated amongst the upcoming radiologists with less than 5 years of work experience and this was found to be compounded by work hours, work pressure and inadequate compensation. CONCLUSIONS Today, young radiologist is caught in a whirlpool of change that has not only threatened the “concept of a settled, satisfied, specialist”, furtherance to this, commoditization of radiology has led to increase in work hours, work pressure, leading to dissatisfaction and early burn out. KEY WORDS Radiologist, Psychosocial Aspects, Burn Out, Artificial Intelligence.

BACKGROUND Celiac trunk (CT) is the first major abdominal branch of the aorta. Anatomic variations and accessory vessels have been reported with variable percentages. We report here a particularly rare variant involving absence of the celiac trunk in association with trifurcation of the common hepatic artery (CHA). The purpose of this study was to report the pattern of the celiac trunk and its anatomic variations in a sample of Mysore population. METHODS Celiac trunk dissection was performed in 10 fresh cadavers and 50 cases of contrast enhanced computed tomography (CECT) images of Mysore based subjects at JSS Medical College and Hospital aged 18 years and above were included. Celiac trunk variations, length, diameter, accessory vessels, and vertebral level of origin were described. RESULTS The branching pattern of coeliac trunk was observed in 60 cases (37 males, 23 females) by dissection and CECT scan method. Type I was found in 48 cases (80 %), Type I form 2a was found in 2 cases (3.3 %). Type II form 1 in 6 cases (10 %). Type III was observed in 1 case and in another case left hepatic artery (LHA) arising from coeliac trunk, Type VII was found in 2 cases (3.3 %). The length and diameter of coeliac trunk were analysed using descriptive statistics and mean ± SD for length was 1.8 ± 0.4 and diameter 0.5 ± 0.2 respectively. CONCLUSIONS Awareness of CT variations is important in surgical resection, transplantation, and interventional radiology procedure. KEY WORDS Celiac Trunk, Variations, Morphometry, Contrast Enhanced Computed Tomography Scan Method

Purpose: Pancreatitis is associated with a broad spectrum of findings causing significant morbidity and mortality and substantial use of health care resources. Optimal management of pancreatitis requires meticulous imaging protocol. Ultrasonography (USG) and Computed Tomography (CT) has afforded rapid, accurate and non-invasive evaluation of pancreatitis & complications. Both of these offer modalities offer advantages of their own at different stages.Material and Methods: 50 consecutive patients referred with clinical suspicion of pancreatitis were subjected to USG and contrast enhanced CT scan. The findings of acute and chronic pancreatitis and their complications’ on both the modalities were tabulated and correlated. Results: CT had overall excellent visualisation of pancreas in all the cases and better delineation of per pancreatic inflammatory changes. Extrapancreatic and vascular complications were readily identifiable on CT. Ultrasound had better visualisation of pancreas as compared to the previous studies. However, the gland was not completely visualised in all the cases due to interference from the bowel gas. Ultrasound also proved to be more effective in the evaluation of gall stones, in the characterisation of contents within the per pancreatic collections & guiding interventions. Conclusion: Ultrasonography is non-invasive, quick, inexpensive widely available screening tool in the early diagnosis and follow up of pancreatitis. It has certain limitation due to bowel gas which may hinder the visualization of Pancreas. CT has a role in firmly establishing the diagnosis of pancreatitis and its complications. Thus it is seen that both USG and CT have complementary roles to play in the early diagnosis and follow up of patients of pancreatitis.

In sickle cell disease (SCD), the clinical manifestations are due to episodes of vascular occlusion and haemolysis. Most of the children experience vaso-occlusive pain episodes by the age of six years. Renal injury in sickle cell disease referred to as sickle cell nephropathy is a frequent yet under-recognised complication. Renal papillary necrosis (RPN) as the first presentation in SCD is rare. We are reporting a 12 year old child with no prior vaso-occlusive episodes, presenting with renal papillary necrosis due to Sickle Beta and Thalassemia.

A 38-year-old man who had been in a motor vehicle collision was referred to our institute. He was suspected of having left-sided pneumothorax. This necessitated intercostal drainage with a chest tube, which had been placed elsewhere prior to his arrival. Paraparesis was noted at the initial clinical examination, with adequately maintained vital signs, while the blood work-up revealed a mildly reduced hemoglobin level of 10.1 mg/dL (normal range, 13.8-17.2 mg/dL); however, the rest of the laboratory values were within normal limits. The patient was then immediately referred for further evaluation with CT of the brain, cervical spine, and thorax. Thereafter, serial chest radiography was performed for follow-up.

BackgroundAdenoid cystic carcinoma is a rare malignancy. Tumours of palatal region with minor salivary gland origin do not generally present at an early stage as the tumour is submucosal with symptoms prevalent only when there is evidence of perineural spread of the tumour. We report a case of adenoid cystic carcinoma of the palate with rare presentation of left ear discharge and diplopia on left lateral gaze. We discuss the case with emphasis on imaging evaluation mimicking a case of infective etiology with adjacent skull base osteomyelitis on initial presentation. However, on follow-up and further evaluation the patient was diagnosed as adenoid cystic carcinoma of hard palate on left side.Case presentationA 25-year-old male patient has presented to Jagadguru Sri Shivarathreeswara Hospital in August 2019 with complaints of left ear discharge and diplopia on left lateral gaze since 1 week. The clinical and imaging findings was suggestive of infective etiology and the patient was treated for the same with IV antibiotics. Repeat magnetic resonance imaging was then done which revealed definitive reduction in the severity of inflammation suggestive of response to therapy. Patient was then discharged and was followed up. Three months later, the patient came with complaints of mass in left nasal cavity. Patient was then referred for contrast enhanced computed tomography neck strongly suggestive of neoplastic etiology. The patient was then operated and histopathological examination of the biopsy revealed adenoid cystic carcinoma.ConclusionsTumours of palatal region with minor salivary gland origin do not generally present at an early stage as the tumour is submucosal with symptoms prevalent only when there is evidence of perineural spread of the tumour. In our case patient presented with lateral rectus palsy, involvement of meckel’s cave, trigeminal nerve involvement and cavernous sinus involvement which are strong indicators of the perineural and locoregional spread of the tumour. Hence, it is important for the radiologist and clinician to strongly suspect and evaluate for a primary lesion of the head and neck when such a radiological presentation has been demonstrated.

Development of drug carriers, which can chaperone xenobiotics directly to their site of action, is an essential step for the advancement of precision medicine. Cationic nanoparticles can be used as a drug delivery platform for various agents including chemotherapeutics, oligonucleotides, and antibodies. Self-assembly of short peptides facilitates the formation of well-defined nanostructures suitable for drug delivery, and varying the polarity of the self-assembly medium changes the nature of noncovalent interactions in such a way as to generate numerous unique nanostructures. Here, we have synthesized an ultrashort cell-penetrating tetrapeptide (sequence Lys-Val-Ala-Val), with Lys as a cationic amino acid, and studied the self-assembly property of the BOC-protected (L1) and -deprotected (L2) analogues. Spherical assemblies obtained from L1/L2 in a 1:1 aqueous ethanol system have the ability to encapsulate small molecules and successfully enter into cells, thus representing them as potential candidates for intracellular drug delivery. To verify the efficacy of these peptides in the facilitation of drug efficacy, we generated encapsulated versions of the chemotherapeutic drug doxorubicin (Dox). L1- and L2-encapsulated Dox (Dox-L1 and Dox-L2), similar to the unencapsulated drug, induced upregulation of regulator of G protein signaling 6 (RGS6) and Gβ5, the critical mediators of ATM/p53-dependent apoptosis in Dox-treated cancer cells. Further, Dox

Background: To evaluate the diagnostic accuracy of Doppler in neonates with hypoxic-ischemic encephalopathy (HIE) in correlation with MRI. Materials & Methods: During the period September 2017 to October 2019, term neonates with clinical evidence of HIE who underwent MRI were enrolled for the study. Two-dimensional duplex and color Doppler ultrasound were performed, resistive index of the middle cerebral artery was documented, and findings were correlated with MRI. Results: Of 40 consecutive neonates (29 boys and 11girls), 29 neonates with mild-moderate HIE, 7 neonates had severe HIE and 4 were normal. Accuracy of Duplex ultrasound in mild HIE is limited, however in neonates with moderate hypoxia the predictive accuracy of duplex scan as 77%, with 100% accuracy in all neonates with severe HIE. All neonates with severe HIE had increased resistance index of cerebral arteries. Conclusion: Duplex ultrasound can be used as a point of care tool not only in diagnosis of HIE, but also as a tool distinguish the grades of HIE thus aid in prognostication.

Ensure that from the above theoretical review on administrative context and employee productivity in higher education and there is a positive association between work engagement of faculty members and administrative staff motivate the employees in accomplishing their work regardless of any result that they are more productive. Researchers argue the fact that the physical environment of the institutional and administrative, employees effect job perception attitudes and job satisfaction which is in sequence affects the job performance and employee productivity. Improving the work environment in higher educational institution there is a dissatisfaction and complaints of employee while increasing their productivity the more satisfied employee are with their jobs in high performance and productivity.

Throughout the years, scientists have produced an overflow of work and information that includes esteem in the field of initiative examination. In spite of the fact that initiative is only an expression that is regularly utilized as a part of discussion and is every now and again depicted by different modifiers, for example, great administration, compelling authority, viable initiative, poor initiative and awful authority. Most researchers have arrived at the conclusion that the idea of administration does not credit to one particular definition. Despite the fact that an absence of amicability keeps on existing around a definite importance for administration, the vast majority of the analysts concur that initiative is an impact relationship between the pioneers and the supporter who have their mutual purposes and the pioneer accomplishes objectives through ceaseless motivation and inspiration of their adherents and there must adopt the leadership styles in to make impact on the faculty members. From the findings of the study we can assume that the respondents didn’t recognize the differences among the styles and so they have lack of knowledge about the leadership styles. The poor information about the leadership styles that for the respondents could not able to recognize the preferred style. The above two conclusions seems that the leaders themselves are not following specific style, so it’s difficult to indicate which style is adopted in management process in math departments

This empirical study show that the impact of all styles was well moderate. The means of effect of all styles were less than 3 out of 5. It means the expected impact of transformational affect upon the all dimensions of the activities, are not expected due to the traditional styles of leadership and the lack of information about the transformational leadership styles which can guide leaders to use such styles in the organization which may be this results due to lack of trained leaders and necessary knowledge with the leaders in all universities about transformational styles the traditional form of the leadership styles which used by the university leaders affect the communication between all levels of the administration and the faculty members which has consequence because decrease in motivation and a self-consideration from the administration.

Background: Rotator cuff pathology accounts for 10% causes of shoulder pain. A gamut of imaging techniques comprising of ultrasonography (USG), Magnetic Resonance Imaging (MRI) and MR arthrography (MRA) have been commonly used for the characterisation of rotator cuff (RC) disorders. With the advent of high-end USG machines, accuracy rates of USG is comparable to that of MRI in evaluation of rotator cuff pathologies. Materials and Methods: 50patients who had presented with symptoms of rotator cuff injuries and were referred to Department of Radiodiagnosis JSS Medical College and Hospital, Mysuru during the period August 2017 to September 2019 for Ultrasound and MRI of the shoulder. Results: Diagnostic accuracy of USG in correlation to MRI showed 93% sensitivity and 97% specificity for supraspinatus, 88% sensitivity and 96% specificity for detecting the infraspinatus tears; 74% sensitivity and 86%specificity for subscapularis indicating detection of supraspinatus was comparatively easier than subscapularis in ultrasound. Conclusion: MRI was more superior and sensitive tool than ultrasound in detecting and delineating the musculoskeletal injury in terms of grading the partial tear & tendinopathy, however accuracy of ultrasound in initial evaluation of rotator cuff injuries is comparable to MRI. Anatomical delineation of the rotator cuff injury which is of prime value for treating surgeon is better visualized by MRI.

Service sector in India consists of a wide variety of services such as electricity, water supply, road, rail and air transport etc which provides a vast opportunities for HRD. Indian Railways is the backbone of service sector and one of the biggest employers in India. Indian Railways is one of the gigantic public undertakings enriched with fixed assets. The universe constitutes the PWD employees of South Central Railway. The total universe of the organization is 1120 employees of various departments shown in table. The sample size taken from the universe for the study is 50% i.e. 560 respondents. The analysis results that the most of the respondents are neutral in opinion in all the aspects of potential appraisal, career development and job rotation. They disagree with some of the aspects of training and development, performance appraisal and promotions and transfers. Keywords: Service Sector, Indian Railways, Human Resource Development.

Self-assembly of molecular building blocks is a simple and useful approach to generate supramolecular structures with varied morphologies and functions. By studying the chemical properties of the building blocks and tuning the parameters of their self-assembly process, the resultant supramolecular assemblies can be optimized for the required downstream applications. To this end, in the present study we have designed and synthesized three different molecular building blocks composed of two diphenylalanine (FF) units connected to each other through three different linkers: ethylenediamine, succinic acid, or terephthalaldehyde. Under identical conditions, all the three building blocks self-assemble into supramolecular architectures with distinct morphologies. However, by varying the polarity of the self-assembly medium, the nature of the non-covalent interactions changes in such a way as to generate additional self-assembled structures unique to each building block. Utilizing microscopic and spectroscopic techniques, we characterized the morphological variety generated by each building block/linker combination. These data represent the first report analysing the diversity of nanostructures that can be generated from identical dipeptide-based molecular backbones simply by varying the chemical linker. We also demonstrate that the spherical assemblies and nanorod structures fabricated from these dipeptide/linker pairs can act as drug delivery systems. More specifically, the spherical assembly generated by two FF dipeptides linked via ethylenediamine and nanorods fabricated from terephthalaldehyde linked FF dipeptides were able to encapsulate the cancer chemotherapeutic agent doxorubicin (DOX) and chaperone the drug into cells. Thus, these supramolecular assemblies represent a new platform for the development of efficient and effective intracellular drug delivery systems.

Purpose: To ascertain the role of optic nerve sheath diameter (ONSD) in the evaluation of cerebral venous sinus thrombosis (CVST). Material and methods: A retrospective study with convenient sampling was done during the period November 2018 to January 2020. Forty-one patients across all age groups with magnetic resonance venography (MRV) diagnosis of CVST and 82 gender-matched controls were included in the study. ONSD was measured on axial T2-weighted magnetic resonance images. CVST was identified on axial TOF-MRV including the stage, degree, and location. Intraparenchymal infarction and haemorrhage were also noted with their stage and size. The distribution of values for ONSD was tested for equality of variances using independent samples t-test. A cut-off value for ONSD was derived using ROC analysis. Results: The mean difference between ONSD of cases and controls was 0.84 mm (95% CI: 0.61-1.06) and was statistically significant at p < 0.001. Mean ONSD in cases was 5.33 ± 0.66, and in the control group it was 4.49 ± 0.31. The cut-off value for ONSD was taken as 4.57 mm, derived using the ROC analysis (AUC was 0.876 suggesting good diagnostic accuracy). ONSD showed a sensitivity of 87% and a negative predictive value of 89% in predicting CVST. However, we found no statistical significance between ONSD in patients with acute or chronic thrombosis or in those with neuroparenchymal complications. Conclusions: ONSD is a valid triage tool with high sensitivity and negative predictive value, and it can be used in the evaluation of CVST.

Background The typical CT manifestations of COVID-19 pneumonia include ground-glass opacity (GGO) with or without consolidation and superimposed interlobular septal thickening. These are often rounded in morphology and frequently bilateral, multilobar, posterior, peripheral, and basilar in distribution. The various atypical CT features of COVID-19 are seldom described in the literature. The study aims to enumerate the atypical pulmonary CT features in patients with COVID-19 pneumonia in correlation with the disease severity. Results A total of 298 confirmed cases of COVID-19 pneumonia with positive reverse transcription polymerase chain reaction (RT-PCR) who underwent chest CT scans were retrospectively evaluated. The cohort included 234 (78.5%) men and 64 (21.5%) women and the mean age was 53.48 ± 15.74 years. The most common presenting symptoms were fever [n = 197 (66.1%)] and cough [n = 139 (46.6%)]. Out of 298 cases of COVID-19 pneumonia, 218 cases (73.1%) showed typical CT features while 63 cases (21.1%) showed atypical CT features with concurrent classical findings and the remaining 17 cases (5.8%) were normal. Among the atypical CT features, the most common was pulmonary cysts [n = 27 (9%)]. The other features in the order of frequency included pleural effusion [n = 17 (5.7%)], nodules [n = 13 (4.3%)], bull’s eye/target sign[n = 4 (1.3%)], cavitation [n = 3 (1.0%)], spontaneous pneumothorax [n = 2 (0.6%)], hilar lymphadenopathy [n = 2 (0.6%)], spontaneous pneumo-mediastinum with subcutaneous emphysema [n = 1 (0.3%)], Halo sign [n = 1 (0.3%)], empyema [n = 1 (0.3%)] and necrotizing pneumonia with abscess [n = 1 (0.3%)]. Conclusion CT imaging features of COVID-19 pneumonia while in a vast majority of cases is classical, atypical diverse patterns are also encountered. A comprehensive knowledge of various atypical presentations on imaging plays an important role in the early diagnosis and management of COVID-19.

Introduction: Chest Computed Tomography (CT) plays an important role in the diagnosis and management of Corona Virus Disease (COVID-19) infection. A better understanding of the chest CT imaging findings in COVID-19 disease may help in accurate diagnosis and staging of the disease. The temporal changes in the chest CT imaging findings follows a specific pattern which helps in identification of disease progression or recovery from the illness. Aim: To evaluate the chest CT imaging findings of COVID-19 patients during the course of disease. Materials and Methods: This was a retrospective observational study in which 110 hospitalised patients with COVID-19 disease were evaluated for chest CT imaging findings and severity of the infection. Chest CT findings with respect to duration of symptoms onset were divided into early phase disease (12 days of symptom onset). Based on visual assessment, CT severity score was given depending on the percentage of each lobe involved in bilateral lung parenchyma. Descriptive statistics were expressed using percentage, range, means and Standard Deviation (mean±SD). Results: A total of 110 COVID-19 positive patients (79 males and 31 females) with mean age of 48.33±9.18 years (range between 22-84 years) were included in the study. CT chest was performed during the different time periods of hospital stay ranging from 2 to 16 days. Early phase disease constituted 53 (48.18%) patients, 21 (19.09%) patients in the intermediate phase and 36 (32.72%) patients were in the late phase. Nineteen (17.27%) patients in the early phase disease (

Summary Background Optic nerve sheath diameter (ONSD) evaluated in CT imaging as well as Rotterdam CT Score (RCTS) are proven independent predictors of outcome in patients with traumatic brain injury (TBI). To date, no study has correlated ONSD on admission CT scan with RCTS. Material/Methods Retrospective cohort study comprised of consecutive patients undergoing CT imaging for traumatic brain injury recruited between January and October 2015. Bilateral ONSD was measured 3 mm behind the eyeball in axial and sagittal planes and mean value was calculated. RCTS was assessed on the same CT images, bias was eliminated by blinding RCTS to ONSD measurement. Results 150 patients were included; mean age in the group was 42.94±16.7 years. ONSD in mild TBI, RCTS 2 and 3 were 3.3 mm (SD 0.39 mm) and 4.1 mm (0.047 mm), respectively. Mean ONSD in moderate and severe TBI (RCTS score 4 and above) was 4.83 mm and above, SD 0.4 mm. Mean ONSD correlated with occurrence of diffuse cerebral oedema, presence of subdural and extradural hematoma; however in isolation there was no statistical significance. Conclusions Higher ONSD was observed in patients with moderate and severe TBI, correlating with admission RCTS of 4 and above. Subsequent increase in ONSD was also found with increase in RCTS. ONSD could serve as an initial triage tool in the emergency department as well as a method of determining the need for sequential CT in patients with mild TBI.

In most countries, only high-risk women are screened for gestational diabetes mellitus (GDM). In addition, a onetime early screening test may miss GDM as it may be diagnosable between 24 and 28 weeks. Thus, it is preferable to have alternative tests to classify women as high risk for GDM and keep them under regular follow-up. A total of 120 women with singleton pregnancies and established maternal and/or pregnancy-related risk factors for GDM and who provided informed consent were subjected to an obstetric ultrasound scan at/or after 24 weeks' gestation followed by administration of a 2-hour 75-g oral glucose tolerance test. Various ultrasound markers were determined/measured. Each ultrasound GDM marker was assigned 1 point to create the ultrasound gestational diabetes screening (UGDS) score. All ultrasound GDM markers positively correlated to the disease (P < 0.0001). The strongest independent predictor of GDM was an immature appearance of placenta (relative risk, 49.09; 95% confidence interval, 7.04-342.28; P < 0.0001). Receiver operator characteristics showed an area under the curve of 96.9%, confirming good ability of the UGDS to discriminate between positive and negative oral glucose tolerance test. A UGDS score of 4, providing diagnostic efficiency of 92%, sensitivity of 93.2%, specificity of 92%, positive predictive value of 85.4%, and negative predictive value of 96.4%, is proposed by this study. This study suggests that ultrasound markers significantly vary in GDM compared with normal pregnancy women and that UGDS is a good predictor of GDM. The UGDS may be considered an adjunct to current screening tools for GDM.

Introduction: About 10 million women develop pre-eclampsia per year. Intra-Uterine Growth Restriction (IUGR) is a common complication of Hypertensive disorders of pregnancy, due to failure of normal placental invasion and development. Identification of the pregnancies at risk for preventable perinatal morbidity and mortality is a primary goal of obstetric care. Doppler flow studies are an important adjunct to fetal biometry in identifying the fetus at risk of adverse outcome. Cerebro-Placental Ratio (CPR) incorporates data of both Umbilical artery and Middle cerebral artery and is a better index than using either of them alone for predicting adverse perinatal outcome. Aim: To determine the role of CPR in women with Hypertensive disorders of pregnancy, so as to assess the fetus at greater risk of adverse perinatal outcome. Materials and Methods: This cohort study was done in JSS Hospital, Mysore on subjects satisfying inclusion and exclusion criteria. The study period was from November 2016 to November 2018. A total of 128 antenatal women of >32 weeks of gestation were selected for the study; preliminary data were recorded and subjected to ultrasound scan. Association between CPR and other categorical variables were analysed using chi-square test. Pearson’s Correlation coefficient was used to show correlation between CPR and other quantitative variables. Results: Among pregnancy-related hypertension, preeclampsia was the most common cause (71.1%), followed by eclampsia (20.3%). The five minute APGAR score was ≤7 in 21.8% while the rest had a score of >7 (78.2%). There was significant association between CPR and the Ultrasonographic gestational age, birth weight and fetal outcome. Lower APGAR score at 5th minute was associated with abnormal CPR values, especially the babies with APGAR score of ≤7 at 5 minutes. Conclusion: Abnormal CPR is valuable in predicting the outcome of hypertensive disorders in pregnancy. Perinatal outcomes namely, preterm delivery, caesarean section and fetal compromise like low birth weight, lower APGAR at 5 minutes, requirement of NICU care can be predicted with lower CPR.

Background: Biliary obstruction is caused by various diseases. In a suspected case of biliary obstruction with clinical and laboratory findings suggestive of obstructive jaundice, the main aim of radiologist is to confirm the presence of obstruction identify its location, extent and probable cause. 3D MRCP virtually demonstrates anatomy of the biliary and pancreatic ducts in 3 Tesla MRI system. Ultrasonography still remains the first imaging modality for obstructive jaundice. The aim of the study was to evaluate the diagnostic efficacy of USG vs. MRCP with 3 Tesla MRI in patients of obstructive jaundice. Subjects and Methods: After institutional ethical committee approval, 90 patients confirmed to have features of obstructive jaundice referred for Ultrasonography and MRCP and subsequently underwent ERCP / Surgery were evaluated. It was a Prospective correlational study. Inclusion Criteria were patients with clinical diagnosis of obstructive jaundice referred for Ultrasonography and MRCP and subsequently underwent ERCP / Surgery. Exclusion Criteria were patients non compatible for MRI and other modalities (ERCP), Patients in whom histological diagnosis was not available, Patients unwilling for MRCP / ERCP / Surgery. Results: Accuracy of ultrasound was 75 % and MRCP 98 % in detection and delineation of obstructive biliary pathologies. Sensitivity, specificity and accuracy for choledocholithiasis is 80%, 100% & 80% respectively for Ultrasonography and 100% for MRCP. The Sensitivity and Specificity for Ultrasonography was 71% and 100% in detection of biliary obstruction secondary to biliary strictures and for MRCP, the sensitivity and specificity was 100%. Sensitivity and specificity for malignant pathologies in this study was 73 % and 100% respectively on Ultrasonography, while that on MRCP was 93.3% and 100% respectively. Conclusion: Ultrasonography as a screening modality is useful to confirm or exclude biliary dilatation and to choose patients for MRCP examination. MRCP is an important non-invasive imaging investigation in the pre-operative evaluation of patients with obstructive jaundice. Magnetic resonance (MR) cholangiopancreatography, combines the advantages of projectional imaging with those of cross-sectional imaging, is an established diagnostic technique. Technical advances over the past decade, including the refinement of 3.0-T imaging capabilities, have added to the usefulness of this noninvasive method. Though MRCP can be considered as the gold standard for diagnostic non-invasive evaluation of the pancreaticobiliary system in cases of obstructive jaundice, ultrasound will always remain the first choice.

The aims of the study were to redefine the criteria used to grade varicoceles, based on reflux times that correlate with Dubin and Amelar clinical grading by overcoming the limitations of clinical grading and to include the less known entity of intratesticular varicoceles in the grading. Prospective correlative study was undertaken at JSS Hospital, Mysore, India during the period from July 2010 to October 2014. All patients with clinical suspicion of varicocele were clinically graded by Dubin and Amelar grading system and were later subjected to duplex ultrasound examination. The duration of the reflux obtained during the Valsalva maneuver was measured in milliseconds. Patients with intratesticular varicocele were noted and they were subgraded. One hundred patients were examined as per the methodology.The mean reflux times obtained as per the clinically graded varicoceles were as follows: subclinical varicocele, 835 ms; grade 1 varicocele, 1907 ms; grade 2 varicocele, 3108 ms; and grade 3 varicocele, 4508 ms.Based on the results obtained, we propose a modified radiological grading of the varicocele that is based on reflux times at Valsalva maneuver for each clinical grade. The presence of an intratesticular varicocele with any of the above grades is to be suffixed with "I.".

This paper investigates the quality of work life variables of educators in Lebanese French university Erbil Kurdistan region of Iraq. This research study highlights the quality of work life of educators under various dimensions. New Challenges can be faced with educator’s nature of job role, work environment, Career Growth and Development, General Well- Being in achieving organizational goals. This study helps the educators to know the level of perception towards QWL and to enhance the same by the educational administrators. Quality of Work Life is the essential concept of favorable situations in a working environment. The Quality of Work Life facilitates employee’s training opportunities, job satisfaction and working conditions. A better Quality of Work Life improves the growth of the employee’s along with the organization growth. The universe of the study includes 4 colleges educators located within the Lebanese French university campus, i.e., college of engineering and sciences, college of education and languages, college of law and international relations and college of administration and economics. A sample of 50 respondents was collected from the universe. The collected data after being coded were analyzed using Statistical Package for Social sciences Research (SPSS) and various statistical tests were applied based on hypotheses and matching variables. It shows Quality of Work Life of Lebanese French University educators is in high level.

e19190 Background: Upfront docetaxel is now standard of care for men with newly diagnosed metastatic hormone naïve prostate cancer .After disease progression following upfront docetaxel, various treatment agents including further lines of chemo or novel hormonal agents are used but there have been no convincing evidence or consensus opinion about optimal sequencing. Methods: We have conducted a national study in the UK by approaching oncologists who treat prostate cancer with systemic therapies. The oncologists were requested to complete a web based survey about their treatment decisions . Aim were to gain an insight about current practice following docetaxel in the UK and to identify the various disease and patients related factors which could influence the decision-making process. Results: 114 oncologists were invited and 59 have responded, 80% clinical oncologist and 20% medical oncologists respectively. At the point of castrate-resistant disease progression, following docetaxel, abiraterone was most commonly used agents (63%), followed by Enzalutamide (29%), cabazitaxel (6%) and docetaxel re-challenge respectively. Time difference between finishing docetaxel and disease progression was considered the most important deciding factor to choose next agents. Other important factors as per responders were volume of the disease, patients current symptoms, co morbidities and site of metastases . Most oncologists felt initial PSA and Gleason scores were two least important deciding factors. Patients with low volume disease, 92 % oncologist preferred abiraterone or enzalutamide as opposed to chemotherapy. When disease progressed within 6 months of completion of docetaxel, only one fifth of responder would use further chemo in next line .After novel hormone agents, cabazitaxel was the most commonly prescribed agents. 81% of clinicians would consider re-challenging with Docetaxel at some point of treatment sequencing; of these the majority would only consider this after a minimal interval of 12-18 months following upfront treatment. Conclusions: Our study has demonstrated a wide variation of practice in the UK. It has reflected that the decision is complex and there is clear need for further evidence or guideline for sequencing.

Ultrasonography(US) of the scrotum has been demonstrated to be useful in the diagnosis of fluid in the scrotal sac. Grayscale US characterizes the lesions as testicular or extratesticular and, with color Doppler, power Doppler and pulse Doppler, any perfusion can also be assessed. Cystic or encapsulated fluid collections are relatively common benign lesions that usually present as palpable testicular lumps. Most cysts arise in the epidydimis, but all anatomical structures of the scrotum can be the site of their origin. US may suggest a specific diagnosis for a wide variety of intrascrotal cystic and fluid lesions and appropriately guide therapeutic options. The paper reviews the current knowledge of ultrasound in conditions with fluid in the testis and scrotum. The review presents the applications of ultrasonography in the diagnosis of hydrocele, testicular cysts, epididymal cysts, spermatoceles, tubular ectasia, hernia and hematoceles. The aim of this paper is to provide a pictorial review of the common and uncommon presentation of fluid within the scrotal spaces.

This is a submission for the contest to select the official symbol for the Indian rupee. Related resources: A contest to find a sign for Indian rupee | India News - Times of India (indiatimes.com) Indian rupee sign - Wikipedia Contest to finalise Rupee symbol down to final five - The Economic Times (indiatimes.com) (24) What was your design if you have taken part in 'Rupee Symbol Design Contest' by Government of India? - Quora Meet Udaya Kumar, the man who designed the unique rupee sign - The Hindu

Ultrasound of the abdomen is a commonly requested investigative procedure. By the use of different probes and varying maneuvers, a remarkable range of views can be obtained. Imaging of the liver is done using four views which can identify most pathological conditions. Being aware of the possible artifacts helps in avoiding a wrong diagnosis. Gallbladder (GB) imaging is useful in detecting gallstones and inflammation of the GB. When inflamed, the pancreas enlarges in size and is bulky, with peripancreatic fluid, which is suggestive of acute pancreatitis.

A 50-year-old man with esophageal carcinoma developed severe, refractory, retrosternal chest pain. The diagnosis was made four days later when contrast studies showed an intramural dissecting hematoma of the esophagus. The patient responded to conservative management.