Ball Appearance Research Articles

Beyond the Surface: Decoding Pityriasis Versicolor Through Clinical, Dermoscopic and Microbiological Exploration

Abstract Background: Pityriasis versicolor (PV) is an asymptomatic, superficial fungal infection caused by the Malassezia species and causes discolouration of the skin leading to altered pigmentation. It is usually a clinical diagnosis, but in doubtful cases wherein potassium hydroxide (KOH) mount is unavailable, alternative modalities like dermoscopy aid in the management. Aims and Objectives: To evaluate the clinical and dermoscopic patterns in PV and correlate with the associated risk factors and study the fungal culture. Materials and Methods: A cross-sectional observational study was conducted for 12 months. A total of 115 patients clinically diagnosed with PV showing positivity on KOH mount were recruited. Dermoscopy was done, following which the scales were scraped and cultured in the laboratory on Saborauds dextrose agar and modified Dixon media, and the results were analysed after 3 weeks. Results: Among the 115 participants, on clinical evaluation, 79 patients had achromic and 36 patients had chromic lesions. The dermoscopic features were categorized into domains such as scaling, pigmentation and other features. Fine scaling was the most common feature observed in 88.7% of the patients. Pigmentary changes were noted in all the patients with non-uniform pigmentation being the most common. We have also observed and described newer dermoscopic findings such as barbed wire fence appearance of ridges and furrows, fluffy cotton ball appearance of hypopigmented perifollicular lesions and sprinkled pepper appearance of pigmented dispersion. Out of the 115 KOH mount positive cases, 51 (44.3%) showed growth on fungal culture with Malassezia furfur being the most common species to be isolated in 18 patients. Conclusions: Dermoscopy is a new, popular non-invasive diagnostic modality, which shows specific features like fine scaling, pigment alteration, ridges and furrows with perifollicular involvement, and can be used to diagnose doubtful cases of PV as an adjunct or substitute to a KOH mount.

Histological Spectrum of Post Covid Debridement Tissues: Salient Histomorphological Features With Respect to Identification Fungal Elements.

Background:Secondary bacterial and fungal infections in COVID patients have been documented during current pandemic. The present study provides detailed account of histomorphology of debridement tissue received for suspected fungal infections. The primary objective was to determine the morphological characteristics that must be recognized for the identification of fungal hyphae.Methods:The detailed histological examination of debridement tissue was performed. Demographic and clinical findings with treatment provided was recorded. Presence or absence of necrosis and lecocytoclasis was noted.Results:A total of 110 cases of debrided tissues were included in the study. Eosinophilic granular necrosis with lecocytoclasis was observed in 103cases; fungal elements were identified in 89.3% (92/103) of these. Eleven cases where necrosis was observed, strong suspicion of fungus was reported, 6 of them displayed fungus on KOH preparation, 3 on repeat biopsy. However, in 2 of these cases, neither KOH nor repeat biopsies identified the fungus. Mucor with aspergillus was observed in 7 cases and actinomyces in 3. In all these 10 cases dense fungal colonies were evident. In 7 cases careful observation revealed fruiting bodies of aspergillus. Cotton ball appearance of actinomyces was evident. Mucor infection in current disease was so rampant that aseptate ribbon like branching mucor hyphae were evident on H&E sections. Diabetes was significantly associated with fungal infection (97.2%; 70/72; P < .005). 90% [19/21] of the patients who were on room air and diagnosed with fungal infection were diabetic.Conclusions:Eosinophilic granular necrosis with the presence of neutrophilic debris in a case of suspected fungal disease suggests the presence of fungal elements. This warrants processing of the entire tissue deposited for examination, careful observation, application of fungal stains, and repeat biopsy if clinical suspicion is strong. Moreover, uncontrolled diabetes is more frequently associated with secondary fungal infection in COVID patients as compared to oxygen therapy.

White ball appearance in endoscopic ligation of colonic varices

White ball appearance in endoscopic ligation of colonic varices

Quality Evaluation of Grains, Flour and Dough of Some Varieties of Wheat (Triticum aestivum L.) for Chapati and Bread Making

Ten varieties of wheat were obtained from Economic Botanist (Rabi Cereals) Section, Department of Plant Breeding and Genetics, Chandra Shekhar Azad University of Agriculture and Technology, Kanpur for their chapati and bread making quality. The range of variability was exhibited in grain characters like test weight (37.78–44.35 g), grain hardness (10.17 to 11.30 kg/grain) and phenol colour reaction (excellent to unsuitable). The flour characteristics like contents of protein (10.30 to 13.45%), dry gluten (4.52–7.10%) and sedimentation value (7.64–21.56 ml) as well as that of dough characteristics like water absorption (60–70%) and ball dough colour and appearance (light white to creamy white) varied significantly.

Ball tracking in sports: a survey

Increase in the number of sport lovers in games like football, cricket, etc. has created a need for digging, analyzing and presenting more and more multidimensional information to them. Different classes of people require different kinds of information and this expands the space and scale of the required information. Tracking of ball movement is of utmost importance for extracting any information from the ball based sports video sequences. Based on the literature survey, we have initially proposed a block diagram depicting different steps and flow of a general tracking process. The paper further follows the same flow throughout. Detection is the first step of tracking. Dynamic and unpredictable nature of ball appearance, movement and continuously changing background make the detection and tracking processes challenging. Due to these challenges, many researchers have been attracted to this problem and have produced good results under specific conditions. However, generalization of the published work and algorithms to different sports is a distant dream. This paper is an effort to present an exhaustive survey of all the published research works on ball tracking in a categorical manner. The work also reviews the used techniques, their performance, advantages, limitations and their suitability for a particular sport. Finally, we present discussions on the published work so far and our views and opinions followed by a modified block diagram of the tracking process. The paper concludes with the final observations and suggestions on scope of future work.

Molecular Genetics of Thalassemia Syndromes

Abstract This book reviews the molecular genetics of the thalassemia syndromes, inherited hemoglobin disorders that comprise the commonest monogenic disorders globally. Thalassemias are found in high frequencies in tropical regions corresponding to the malaria belt. Beta thalassemia traits show high HbA2 by HPLC, and β-globin mutations (commonly point mutations) are detected by using ARMS-PCR, reverse dot-blot analysis and β-globin gene sequencing. Globally >300 β globin gene mutations exist, however regional mutations are limited to 5-6 common ones. Alpha globin gene defects can only be identified by molecular tests, the exception being HbH disease that shows golf ball appearance in HbH preparation, pre-integration peaks on HPLC and a fast-moving band on hemoglobin electrophoresis. Multiplex Gap-PCR identifies common α-globin gene deletions. Specific PCR across the junction caused by the unequal crossing over can detect α-gene triplication. However, heterozygosity or homozygous triplication cannot be r...

Cannon ball appearance on radiology in a middle-aged diabetic female.

Pulmonary tuberculosis is commonly presented as cavitary lesion and infiltrations. It commonly involves upper lobe. Lower lobe involvement is less common. Various atypical presentations of tuberculosis on radiology are reported like mass, solitary nodule, multi lober involvement including lower lobes. Atypical presentations are more commo in patients with immunocompromised conditions like Diabetes Mellitus, anemia, renal failure, liver diseases, HIV infection, malignancy, patients on immunosuppressive therapy. Cannon ball presentation of pulmonary tuberculosis is extremely rare and not so common. Common causes of cannon ball presentation in lung are metastasis, fungal infections, Wegener's grannulomatosis, sarcoidosis, etc. We report here a case of middle year female with diabetes mellitus presented with atypical symptoms with cannon ball appearance on radiology and found to be of tuberculosis in origin. Thus any patients with immunocompromised condition can present with atypical manifestation of tuberculosis either clinically or radiologicaly in high endemic countries for tuberculosis.

Features of silicon behavior when introduced into oxidized copper melt

The paper examines the features of silicon behavior (neat – Kr0 grade, alloy – Cu–50 % Si) when introduced into oxidized copper melt. The minimum value of oxygen content in copper was found. With this value silicon introduction leads not to deoxidation of the entire volume with silicon oxide formation, but only to surface deoxidation at the «silicon/oxidized molten copper» interface with the formation of liquid Cu–Si alloy immiscible with the main melt and shaped as a ball with a total weight of 5–10 % of the whole melt. The mechanism of such ball appearance was described. It was found that the ball formation rate is affected by the amount of oxygen in molten copper. The results obtained are valuable from a practical perspective and may be used in copper alloy production.

Isolated tension pneumopericardium in a case of acute lymphoblastic leukemia

A 6-year-old female suffering from acute lymphoblastic leukemia, who was on her induction phase regimen presented with sudden onset of NYHA class IV shortness of breath to emergency department at Osmania General Hospital, Hyderabad in September 2012. On examination she was febrile with a feeble pulse, had low intensity heart sounds and was rapidly breathing with bronchial breath sounds over her lung fields. Her chest X-ray revealed a huge amount of air in pericardial space causing compression over heart as seen in Fig. 1. A CT scan of thorax showed the same in Fig. 2. There is a radioopaque mass in left lung suggestive of fungal ball appearance of pulmonary Aspergillosis (Fig. 3). Fig. 1 Chest X-ray showing pneumopericardium. Fig. 2 CT image showing isolated pneumopericardium. Fig. 3 Left lung showing large cavity filled with mass. Patient underwent pericardiocentesis via sub xiphoid approach and a 6 Fr pigtail catheter was inserted and the air was aspirated (Fig. 4) with underwater seal and was put on intravenous antibiotics including antifungal medication. The patient improved symptomatically. Fig. 4 Post pericardiocentesis with pigtail insitu. Pneumopericardium is a well recognized entity known to occur in a number of conditions like post cardiopulmonary resuscitation, post pericardial aspiration, post cardiac surgery, trauma either blunt or penetrating injuries to chest, in patients with esophageal rupture. Most of these patients have associated pneumomediastinum. A few radiological signs like small heart sign,1 continuous hemi diaphragm sign2 have been described. This is one of the rare cases reported with isolated tension pneumopericardium with out accompanying pneumomediastinum in a cancer patient with a superimposed probable fungal infection.3

Chronic otomycosis due to Malassezia Spp

We report the case of a 31-year-old male presenting with complaints of mild pain in the right ear for three months and hypoacusis for 10 days. On otoscopic examination, a thin, papery, white material was extracted from his ear and sent for fungal identification. This material revealed presence of Malassezia spp – with characteristic “spaghetti and meat ball appearance”. The patient was treated with 2% acetic acid, hydrocortisone and Clotrimazole powder for one week and he resolved completely.

Isolated fungus ball mimicking mucocele or frontal sinus tumour: a diagnostic pitfall

To demonstrate the clinical, radiological and diagnostic pitfalls of managing an isolated frontal sinus fungus ball, and to compare with the literature. Retrospective analysis of two cases and literature review. Isolated frontal sinus fungus ball is a rare cause of frontal sinus disease. We present two cases of isolated frontal sinus fungus ball which pre-operatively were suspected to be either a tumour or a mucocele. In both cases, cheesy, clay-like material was found intra-operatively within the frontal sinus, suggesting a fungus ball. Effective treatment included surgical debridement via an exclusively endoscopic or an external approach, variously. Final histopathological and mycological analysis revealed Aspergillus fumigatus. A literature review revealed 20 reported cases of isolated frontal sinus fungus ball, confirming the low prevalence of the disease. Frontal sinus fungus ball should be considered in the differential diagnosis of chronic, nonspecific forehead symptoms. To evaluate the underlying disease, computed tomography scans should first be performed, followed by magnetic resonance imaging if malignancy is suspected. It is essential to be aware of the possibility of an atypical fungus ball appearance on computed tomography and magnetic resonance imaging scans. If bony destruction and calcification coexist on radiological images, then endoscopic biopsy is an indispensable part of the diagnostic procedure, and should be performed to collect material for both histological and mycological analysis, and to aid surgical planning. In cases of sinus fungus ball, an endoscopic approach for biopsy may be curative.

Coding of Visual Space during Motor Preparation: Approaching Objects Rapidly Modulate Corticospinal Excitability in Hand-Centered Coordinates

Defensive behaviors, such as withdrawing your hand to avoid potentially harmful approaching objects, rely on rapid sensorimotor transformations between visual and motor coordinates. We examined the reference frame for coding visual information about objects approaching the hand during motor preparation. Subjects performed a simple visuomanual task while a task-irrelevant distractor ball rapidly approached a location either near to or far from their hand. After the distractor ball appearance, single pulses of transcranial magnetic stimulation were delivered over the subject's primary motor cortex, eliciting motor evoked potentials (MEPs) in their responding hand. MEP amplitude was reduced when the ball approached near the responding hand, both when the hand was on the left and the right of the midline. Strikingly, this suppression occurred very early, at 70-80 ms after ball appearance, and was not modified by visual fixation location. Furthermore, it was selective for approaching balls, since static visual distractors did not modulate MEP amplitude. Together with additional behavioral measurements, we provide converging evidence for automatic hand-centered coding of visual space in the human brain.

WHITE BALL APPEARANCE: PREDICTOR OF EFFECTIVE VARICEAL LIGATION IN MASSIVE BLEEDING WITH AN OBSCURE BLEEDING POINT

Although a purple-colored ball-like appearance (purple ball appearance) is typically observed on ligated varices during endoscopic variceal ligation (EVL), another endoscopic appearance of ligated varices (white ball appearance), which is observed after EVL at the bleeding site, have been reported. We encountered a case of massive variceal bleeding with an obscure bleeding point, where this appearance was useful in the confirmation of effective ligation. A 66-year-old man, who had liver cirrhosis with hepatocellular carcinoma, presented with hematemesis and melena. Although emergent endoscopy revealed a fibrin-plug on the esophageal varix, massive esophageal bleeding occurred and precluded direct visualization of the bleeding point during endoscopy. After multiple EVL, one ball-like elevation with a white color (white ball appearance) and multiple ball-like elevations with a red or purple color (purple ball appearance) were observed in the esophagus. Based on the presence of the white ball appearance, a predictor of effective ligation, we confirmed the ligation of the exact site of bleeding and complete cessation of bleeding. In fact, the ligated varix with the white ball appearance contained a ruptured point. This characteristic endoscopic appearance is useful for the assessment of effective ligation in massive variceal bleeding with an obscure bleeding point.

White ball appearance in endoscopic ligation of bleeding esophageal varices

Background: Endoscopic variceal ligation is useful in the control of bleeding from esophageal varices. However, confirmation of ligation precisely at the site of bleeding is usually difficult when treating massive variceal bleeding. Characteristic endoscopic findings that appeared when ligation was performed at the site of bleeding are reported in this article Methods: Emergency endoscopic variceal ligation was performed in 14 patients with active bleeding from esophageal varices. Endoscopic findings after variceal ligation at the site of bleeding were compared with those at sites without bleeding. Results: Active bleeding ceased just after endoscopic ligation at the site of bleeding in all patients. After ligation of the bleeding site of the varix, an unusual white-colored ball-like appearance (white ball appearance) was observed in all patients. This finding was markedly different from the purple-colored ball-like appearance that is usually observed after ligation of a varix at a site without bleeding. Conclusions: White ball appearance was a characteristic finding that appeared after ligation of a varix at the site of bleeding. This finding may be useful in the confirmation of successful ligation of a varix at its bleeding site. (Gastrointest Endosc 1998;47:254-6.)