Standardized Examination Procedure Research Articles

Digital image characteristics for enhanced interpretation in child sexual violence case examinations

BACKGROUND Photography is an integrated part of standard forensic examination procedures, acting as a guide and the evidence itself. Despite its potential, no research has yet explored the use of 35mm format cameras (digital single-lens reflex [DSLR]) in sexual violence cases. This study aimed to assess the impact of DSLR camera image characteristics on the interpretation of child sexual abuse cases. METHODS This cross-sectional study used 55 digital photos selected through a convenience sampling. The samples were interpreted by two independent forensic experts who were not affiliated with this research and were compared with the results of the doctor’s examination from the medical records. RESULTS The metadata extraction results (EXIF data) indicated that all characteristic values had an abnormal distribution. The digital photos’ characteristics were associated with the use of a 50mm focal length (p = 0.011). A range of lens opening values (aperture = f7.1–f8.0), shutter speed (1/100–1/125 sec), and sensor sensitivity (ISO = 800–1600) were not associated with the experts’ interpretation conformity. Additionally, the conformity index for the overall interpretation by the two forensic experts differed in each area. CONCLUSIONS Focal length of 50mm was significantly related to interpretation conformity. The exposure triangle settings, including aperture (f7.1–f8.0), shutter speed (1/100–1/125 sec), and ISO (800–1600), can serve as fundamental guidelines for digital camera settings in examining child sexual violence cases.

European Carotid Surgical Trial-based diameter measurement using B-mode ultrasound imaging to quantify low-grade carotid artery stenosis: the QUAMUS study

BackgroundIdentification of carotid atherosclerotic lesions with no hemodynamic effect on Doppler ultrasound examination is a common situation. Although the use of B-mode ultrasound examination has been recommended to assess this type of lesion, there is no validated examination procedure to date for quantifying low-grade carotid stenosis. MethodsWe conducted a single-center prospective study (QUAntification Morphologique en UltraSonographie [QUAMUS] study) to assess the reproducibility of B-mode ultrasound quantification of low-grade internal carotid artery stenosis using the European Carotid Surgical Trial (ECST) measurement method. We included consecutive patients with <50% North American Symptomatic Carotid Endarterectomy Trial carotid stenosis identified by the University of Washington duplex criteria (ie, maximum systolic velocity of <125 cm/second at a Doppler angle of 50°-60°). The examination was carried out and interpreted independently, blindly, and successively by two operators according to a precise methodology based on the measurement of cross-sectional diameter in B-mode and calculation of the stenosis percentage according to the ECST method. The primary objective was to assess the measurement concordance of the stenosis percentage for a difference not exceeding 10% between the two operators. The secondary objective was to assess concordance in relation to examination quality. ResultsAmong the 86 patients included, 159 atherosclerotic carotid arteries were eligible and 157 could be explored (feasibility of 98.74%). The conditions were considered as good by the two operators in 69.43% of cases and poor in 2.55%. The concordance of the stenosis percentage measurement for a maximum difference of 10% between the two operators was 89.17% (95% confidence interval, 83.23-93.56) with a Lin concordance correlation coefficient of 0.87 (95% confidence interval, 0.82-0.90). Under examination conditions estimated as good, average, and poor, the concordance was 95.37%, 78.95%, and 60.00%, respectively. ConclusionsOur study shows that ECST-based B-mode ultrasound measurement of low-grade carotid stenosis is reliable and can be performed in routine practice in most patients with a measurement variation of <10% using a simple standardized examination procedure.

Analysis of Variation of Tin Filter on Noise Values in CT Scan Mastoid Protocol Using CT Scan Single Source: Phantom Study

Since its introduction in 1972, CT Scan technology has developed rapidly from year to year, especially in reducing radiation dose; various technologies have been developed, including dual-energy or dual source technology with a technique of only a quarter of the gantry rotation. The aim of this research is to find out and analyze tin filter variations on noise in the mastoid CT scan protocol using a single source CT scan: phantom study. The method used in this research is Pre-Experimental with Posttest-Only Control Design. The noise value research results showed a difference in noise and SNR values with a p-value (p&lt;0.05), and there was a reduction in radiation dose of 41.95% compared to the standard protocol. NPS values are at a frequency of 0.28, except for the Sn100 protocol. Subjective Analysis by two radiologists with a kappa value of 0.75 indicated that there was a moderate level of agreement. The Tin Filter Sn100 protocol can reduce the radiation dose, and the resulting image quality is good enough for diagnostic purposes, so the Tin Filter Sn100 protocol can be used as a Standard Operational Procedure for Mastoid CT Scan examination at Hermina Depok Hospital. This study has implications that may contribute to refining mastoid CT scanning protocols, leading to improved image quality, reduced radiation exposure, and improved diagnostic capabilities in clinical practice.

Transverse vaginal septum: a case report

Introduction: Transverse vaginal septum or known as partial vaginal agenesis, is a rare case. The most frequent causes are defects or fusion disorders of the Mullerian Ductus and defect formation of the urogenital ducts of the urogenital sinuses. The septum may obstruct the entire vaginal opening and cause hematocolpos. The diagnosis is based on a detailed physical and gynecological examination supported by ultrasound and magnetic resonance imaging (MRI). The management option is surgery which is performed as soon as possible. Case Report: An 11-year-old girl came with lower abdominal pain and amenorrhea, diagnosed with a transverse vaginal septum complicated with hematocolpos based on anamnesis, physical and gynecological examination, and imaging study by ultrasound and MRI. The management includes excision and cross-incision of the septum followed by diagnostic laparoscopy. Endometriosis was found at the broad ligament during laparoscopy and continued with endometriosis resection. Conclusion: The transverse vaginal septum is still one of the rare anomalies of the Mullerian Duct. The diagnosis was made from a history of low abdominal pain, primary amenorrhea, and a pelvic examination that revealed the vaginal septum. MRI is a gold standard examination procedure of anomalies or abnormalities involving the vagina. The management of the transverse vaginal septum is a surgical approach involving drainage of hematocolpos.

Sonographic Fracture Diagnosis in Children and Adolescents.

Clinical examination after trauma, especially in young children, often proves difficult. As a result, the majority of images show unremarkable findings in the imaging workup of trauma by radiography. Sonography represents an imaging technique without the use of X-rays. As the quality of ultrasound equipment has increased over the past 20 years, numerous studies have demonstrated that fractures in children and adolescents can be detected with very high sensitivity and specificity by sonography. This paper reviews the results obtained so far in the literature. Based on these findings, the importance of sonographic fracture diagnosis in childhood and adolescence for the most important locations is demonstrated. When examining with a high-frequency linear transducer, sensitivities and specificities of more than 90 % can be achieved for the detection of fractures. Dislocations are also reliably detected. In contrast to X-ray examination, sonography allows the diagnosis of cartilage and soft-tissue injuries. Sonography reveals callus formation earlier than radiographs. The examination causes less pain than X-ray examination. If sonographic clarification is limited purely to fracture detection or exclusion, less time is required compared to X-ray diagnosis. The procedure can be learned quickly. If the documentation follows a defined standard examination procedure, the results can also be reproduced by non-examiners. So far, sonography has only been an additive procedure in fracture diagnosis. However, there are now initial recommendations for sonographic fracture diagnosis alone, such as in skull, clavicle and non-displaced distal forearm fractures. · Sonography can be used to detect or rule out fractures very sensitively.. · Sonographic examination causes less pain than X-ray examination.. · Sonography is usually an additive procedure in fracture diagnosis.. · In the meantime, sonography alone may be sufficient for diagnosing individual fractures.. · Moritz JD. Sonografische Frakturdiagnostik im Kindes- und Jugendalter. Fortschr Röntgenstr 2023; DOI: 10.1055/a-2042-2161.

Perception of Telemedicine in Health Care Workers of a Tertiary Care Hospital

Objective: This investigation aimed to determine the feasibility of using telemedicine for screening and to observe healthcare provider’s opinion about telemedicine. In addition to that, explore the barriers in use of telemedicine Study Design and setting: A cross-sectional study was carried out at Central Park Medical College and Teaching Hospital. Methodology: The study was conducted between November, 2020 to April,2021 from 176 doctors and nurses working at Central Park Teaching Hospital using a convenience sampling technique. Convenience sampling was used because there is always a high probability of non-response or unavailability of clinical doctors and nurses. The minimum sample size was calculated as 88 for the group of doctors. The minimum sample size was doubled to collect the data from two cadres. The questionnaire was based on demographic information, general opinion about telemedicine such as reliability, comparison with standard examination procedure, nature, popularity, knowledge requirement, cost-effectiveness, designed frame and barriers for telemedicine. Results: Nearly, 80.1% of the participants were doctors with clinical experience while the remaining were nurses. Approximately 72.5% of the doctors and 58.5% of the sampled participants said that telemedicine does not fulfill the need for standard examination procedures. Conclusion: The findings of our study showed that the general opinion of healthcare professionals about telemedicine was unfavorable. Doctors had negative views but the nursing staff was optimistic. There was a mixed response about convenience. The main barrier to telemedicine was the poor communication skills of patients and availability and knowledge for using infrastructure.

Understanding and Explaining Diagnostic Paths: Toward Augmented Decision Making.

The process of finding a diagnosis in the medical domain relies on implicit knowledge and the experience of a human expert. In this article, we report on the observation of human decision making, shown by the example of pathology. By tracking the diagnostic steps, individual building blocks are identified, which not only contribute to a diagnostic finding, but can also be used in the future to train and develop artificial intelligence (AI) algorithms. This work also provides insights into the interaction of human experts regarding the observation time of so-called "hot spots," the magnification used for specific findings, and the overall observation and decision path followed. The documentation scheme yields a standardized examination procedure that shows the concept the pathologist is actually looking for as well as the possible features of findings that can be identified. This contribution indicates how important visualization is for human-centered AI, and specifically for enabling human oversight with respect to AI implementation in high-stake areas, such as medicine.

P135 Immunological correlation with clinicomycological aspects of fungal rhinosinusitis during COVID-19 pandemic

Poster session 1, September 21, 2022, 12:30 PM - 1:30 PM Background and ObjectivesTo determine the relation between disease spectrum, etiology, and immunological markers of fungal rhinosinusitis.Material and MethodsDiagnostic nasal endoscopy was used for the collection of sinus and nasal tissue samples which were processed as per standard mycological procedure for microscopy, culture and histopathological examination (HPE). Enzyme-linked immunosorbent assay was used for total IgE, serum IL-6, IL-10, TNF-α levels detection.ResultsOut of 148 samples, 70% were diagnosed as FRS. COVID-19 infection 46.9% was the most common comorbid condition. Use of steroid therapy 46.9% was the most common predisposing factor. Nasal obstruction 62.2% was the most common clinical feature but headache (P-value .002) and eye discharge were statistically significant (P-value .005). KOH mount revealed findings in 84.69% patients in this study. Combination of KOH, HPE, and fungal culture revealed findings in 62.2% cases. Rhizopus arrhizus 27.6% was the most common isolate Aspergillus flavus and Rhizopus arrhizus were statistically significant (P-value .003, .026 respectively). IL-6 59.2% was the most common serological marker raised in this study. PNS imaging revealed that 100% of the patients had single or multiple sinus involvement and maxillary sinus (P-value .038) was significantly associated. Acute invasive fungal rhinosinusitis 75.5% was the most common type of FRS. Mortality was 17.34% in this study.ConclusionFRS is an important emerging public health problem and a cause of mortality and morbidity, particularly in immunocompromised patients. Furthermore, in the current scenario of COVID-19 pandemic, FRS has become more fatal and an entity of immediate and grave concern than ever before.

An investigation of clinical characteristics and antimicrobial agent susceptibility patterns in clinical Comamonas testosteroni isolates: An increasingly prevalent nosocomial pathogen

BackgroundComamonas testosteroni is a gram-negative bacillus, known before 1987 as Pseudomonas testosteroni. Although considered as a rare pathogen, its frequency has been increasing. Data regarding its antibiotic susceptibility are insufficient. To date, forty-four cases have been reported in the literature. In this study, we identified the C. testosteroni infections observed in our hospital and evaluated their antimicrobial agent susceptibility patterns compared with cases reported in the literature. MethodsFor the purposes of the present study, patients admitted to hospital between November 2019 and December 2020 were screened. Those with clinical and laboratory signs of infection with positive C. testosteroni growth in culture were enrolled. Clinical isolates obtained from the samples processed in accordance with standard microbiological examination procedures in our laboratory were defined by MALDI-TOF mass spectrometry with 99.9% probability as C. testosteroni. ResultsC testosteroni infection was detected between November 2019 and December 2020 in eight patients in our hospital. Six of them had a bloodstream infection (BSI), one had pneumonia, and one had urinary tract infection due to C. testosteroni. Coexistence of COVID-19 was detected in four patients. Six out of the eight cases with BSI had hospital-acquired infection and all of the infections were healthcare-associated. When antimicrobial agent susceptibility results reported in the literature were evaluated in combination with the current results, ceftazidime and meropenem were found to be the most susceptible agents (96.1% and 80%, respectively). ConclusionsThe frequency of nosocomial C. testosteroni infections and resistance to antimicrobial agents are gradually increasing. While resistance to carbapenems is on the upswing, third-generation cephalosporins are still seen as suitable treatment options.

Can Location of Stiffness Measurement Impact Spleen 2-Dimensional Shear Wave Elastography Measurement?

Ultrasound-based spleen elastography is a promising surrogate to predict portal hypertension noninvasively. In contrast to defined standards for liver stiffness measurement, the standardized examination procedures for 2-dimensional (2D) shear wave elastography spleen elastography have not been established yet. The aim was to investigate the impact of location of stiffness measurement on 2D shear wave elastography spleen stiffness measurement (SSM). Patients with splenomegaly were enrolled. Both B-mode ultrasound and elastography of spleen were performed. For SSM, 3 regions were chosen for spleen measurement: lower pole region, central region, and the region between lower pole and center. Mean SSM value, success rate, and reliability predicators (standard deviation, standard deviation/mean, size of region of interest) were assessed. A total of 124 patients were included. For mean SSM value, there were no significant differences among 3 regions. Spleen stiffness measurement success rate in lower pole region, central region, and the region between them was 63.7% (79), 91.1% (113), and 78.2% (97), respectively. The success rate in the central region was significantly higher than that in the other 2 regions (P < 0.05). Reliability in the central region was also highest among the 3 regions. Location of stiffness measurement has a limited effect on SSM. Changing location of measurement will not influence mean stiffness value in spleen.

Surface Water Comparative Assessment of Physicochemical Properties of Channels Effluent and New Gusau Reservoir, Zamfara State, Nigeria

This study was undertaken from February 2019 to July 2020 to assess the surface water physicochemical quality of the New Gusau reservoir and its impact on effluent channels of Yar Dantse (YDS), Yar Dole (YDL), and Yar Rumfa (YRF), which empty their content into New Gusau Reservoir (NGR). Samples were collected using purposive sampling from nine sampling points. Insitu measurement of pH, temperature (oC), Conductivity (EC), Total dissolved solid (TDS), Dissolved oxygen (DO), and Biological oxygen demand (BOD) were conducted using a Multifunctional meter. The result was analyzed using the standard procedure for examination of water and wastewater system and one-way ANOVA technique with a significant difference set at p&lt;0.05. The result shows mean seasonal variations in surface water parameters; The pH varies from 6.89±.086 to 6.97±.073, temperature (oC) ranges from 27.26±.184 to 27.78±.234 across the effluent channels, EC fluctuated between 257.35±31.475 and 475.35±56.595, TDS in parts per million (ppm) ranges from 134.90±13.518 to 237.61±27.467, while DO varies from 6.18±.102 to 6.85±.042 and finally, BOD ranges between 2.49±.062 to 3.20±.161 in YDS, YDL, YRF, and NGR respectively. The result of all selected physicochemical parameters revealed significant (p˂0.05) seasonal sites variations except the pH and temperature which shows otherwise. Furthermore, all the parameters investigated were within the WHO acceptable limits except for EC. Therefore, the New Gusau Reservoir (NGR) is not polluted based on this finding.

PHARMACEUTICO-ANALYTICAL STUDY OF DADIMAVALEHA

Background: Bhaishajyakalpana being a deep rooted science contains many unrevealed treasure of formulations. The present era demands scientific method and standardized protocol for any preparation. Here is an opportunity to revise the science using newer technologies in cost effective manner. Dadimavaleha, one of the most commonly used formulation in practice is least explored. Attempt has been made to study the pharmaceutico analytical parameters of Dadimavaleha and thereby establishing a standard operating procedure. Aim 1.To study the pharamaceutico-analytical aspects of Dadimavaleha 2.To set a standard manufacturing procedure of Dadimavaleha. Material And Methods: The preparation of Dadimavaleha was done according to the reference of YogaratnakarJwaratisaradhyay. All the procedure was done systematically and observations were noted. Discussion: The study is aimed at setting a standard manufacturing procedure for Dadimavalehaby thorough examination of pharmaceutico analytical characteristics of thethe same. The various analytical parameters like ph, total ash, acid insoluble ash, water soluble extractive, acid soluble extractive, specific gravity, sugar content were assessed. Conclusion: The detailed pharmaceutico-analytical study of Dadimavalehain a detailed stepwise description and documentation in scientific, logical, sequential manner helps in developing a Standard Manufacturing Procedure for Dadimavaleha.Since there is no standard protocol and comparable analytical parameters available at present, this study can prove to be a milestone towards setting a standard manufacturing procedure for Dadimavaleha.

Real-life assessment of standardized contrast-enhanced ultrasound (CEUS) and CEUS algorithms (CEUS LI-RADS\xae/ESCULAP) in hepatic nodules in cirrhotic patients\u2014a prospective multicenter study

ObjectivesHepatocellular carcinoma (HCC) can be diagnosed non-invasively with contrast-enhanced ultrasound (CEUS) in cirrhosis if the characteristic pattern of arterial phase hyperenhancement followed by hypoenhancement is present. Recent studies suggest that diagnosis based on this “hyper-hypo” pattern needs further refinement. This study compares the diagnostic accuracies of standardized CEUS for HCC according to the current guideline definition and following the newly developed CEUS algorithms (CEUS LI-RADS®, ESCULAP) in a prospective multicenter real-life setting.MethodsCirrhotic patients with liver lesions on B-mode ultrasound were recruited prospectively from 04/2018 to 04/2019, and clinical and imaging data were collected. The CEUS standard included an additional examination point after 4–6 min in case of no washout after 3 min. The diagnostic accuracies of CEUS following the guidelines (“hyper-hypo” pattern), based on the examiner’s subjective interpretation (“CEUS subjective”), and based on the CEUS algorithms ESCULAP and CEUS LI-RADS® were compared.ResultsIn total, 470 cirrhotic patients were recruited in 43 centers. The final diagnosis was HCC in 378 cases (80.4%) according to the reference standard (histology 77.4%, MRI 16.4%, CT 6.2%). The “hyper-hypo” pattern yielded 74.3% sensitivity and 63% specificity. “CEUS subjective” showed a higher diagnostic accuracy (sensitivity, 91.5%; specificity, 67.4%; positive predictive value, 92%; negative predictive value, 66%). Sensitivity was higher for ESCULAP (95%) and “CEUS subjective” (91.5%) versus CEUS LI-RADS® (65.2%; p < 0.001). Specificity was highest for CEUS LI-RADS® (78.6%; p < 0.001).ConclusionsCEUS has an excellent diagnostic accuracy for the non-invasive diagnosis of HCC in cirrhosis. CEUS algorithms may be a helpful refinement of the “hyper-hypo” pattern defined by current HCC guidelines.Key Points• Contrast-enhanced ultrasound (CEUS) has a high diagnostic accuracy for the non-invasive diagnosis of hepatocellular carcinoma (HCC) in cirrhosis.• The CEUS algorithm ESCULAP (Erlanger Synopsis for Contrast-enhanced Ultrasound for Liver lesion Assessment in Patients at risk) showed the highest sensitivity, whereas the CEUS LI-RADS® (Contrast-Enhanced UltraSound Liver Imaging Reporting and Data System) algorithm yielded the highest specificity.• A standardized CEUS examination procedure with an additional examination point in the late phase, after 4–6 min in lesions with no washout after 3 min, is vital.

Infestation of wild boar meat from the Eastern Lublin province with Alaria mesocercariae

The study was aimed at assessment of the usefulness of a digestion method, a standard procedure for routine examination of wild boar meat for Trichinella, in detecting the presence of Distomum musculorum suis (DMS) in the population of wild boars from the Eastern Lublin province. The study material included 500 samples collected from the diaphragm pillars of 250 young boars (6-12 months) and 250 boars above one year of age. First, the meat was tested with the digestion method that is a referential procedure for trichinosis detection. Then, the samples in which over ten mesocercariae were found were assessed with an Alaria-Migration Technique (AMT). The digestion method confirmed the presence of Alaria mesocercariae in 42 carcasses of young boars (16.8 %) and 117 samples of animals older than one year (46.8 %). The study showed a diversified intensity of the parasite presence in the carcasses of individual animals. The invasion intensity ranged from 1 to 18 parasites in 50 g of meat in the young animals, and from 1 to 22 larvae in the older individuals. The carcasses of eight young and thirty two older animals contained over 10 parasites per 50 g of the meat, which accounted for 3.2 % and 12.8 % animals per respective age group. AMT analysis also indicated variable intensity of the parasite infestation, amounting to 32-57 mesocercariae in young animals and 31-71 larvae in the older ones. The study demonstrated an almost three times higher efficiency of the AMT method than the digestion method, which made us conclude that the former should be recommended for Alaria detection. The digestion method used for routine detection of Trichinella, despite its lower accuracy in diagnosing Alaria mesocercariae, can be also employed for the detection of DMS in the case of intensive parasite infection. Our study confirmed high prevalence of the parasite among wild boars from the Eastern Lublin Province. We also found that the invasion intensity depended on the animal age and was higher in older individuals. Considering the zoonotic nature of alariosis and its frequency, it poses an increasingly common problem for official veterinarians during the sanitary and veterinary evaluation of wild boar meat.

Detection of relevant changes in the speaking voice of women measured by the speaking voice profile

A healthy voice serves us as a basis for communication and an indispensable tool in a modern society with a growing number of vocal-intensive professions. There are indications that the average frequency of the speaking voice of women has decreased in recent years and is approaching that of men in the sense of sociophony. An epidemiological prospective cohort study will investigate the influences of age, personality traits and socio-demographic factors on the speaking voice of women. Within the framework of a standardized examination procedure, the speaking voice of 2478 voice-healthy female participants between 5 and 83 years of age was registered in 4 different intensity levels (softest voice, conversational voice, classroom voice and shouting voice). Subsequently, the collected values for frequency and loudness of the different intensity levels were examined for correlation with age and results from questionnaires on personality (FFFK and BFI-10), on (mental) health (Patient-Health-Questionnaire - PHQ) and on socio-economic status (SES). Significant age-related influences on the speaking voice could be demonstrated for all voice intensities. For the personality traits investigated, significant positive correlations between the volume of the calling and speaking voice and extraversion were found. For the frequency of the softest voice and speaking voice, significant correlations were found for the personality traits of extraversion and tolerance. While no significant associations were found between the voice parameters of the speaking voice and the PHQ, it was found that the SES has a significant influence on both frequency and intensity. In addition to age-related changes, relevant influences of personality traits and the SES on speaking voice parameters in women were confirmed, which should be considered in clinical care of dysphonia.

Post-Concussion Syndrome after a Mine Blast Injury: Neuropsychological Consequences and Changes of the Cognitive Evoked Potentials (P 300)

In 115 male patients with the post-concussion syndrome (PCS) after a mine blast injury (MBI) and 30 control healthy subjects, complex clinical and instrumental diagnostics were performed. The age of the patients varied from 18 to 45 years, the post-traumatic MBI interval was 0.5 to 3 years, and the MBIs were accompanied by an acoustic (AT) or combined acoustic/barotrauma in 92% of the cases. The standard examination procedure included MRI of the brain, recording of EEG and of auditory cognitive evoked potentials (CEP) (elicited within the oddball paradigm, with special attention to the cognitive component, wave P 300) using the Cicerone and Kalmar NSI questionnaire [7], and neurological and neuropsychological examination using the MoCA, HADS, and asthenic disorder (AD) scales. It was found that, despite a mild intensity of traumatic brain ingury (mTBI) and a rather long duration of post-traumatic period, neuropsychological consequences of the trauma are not fully compensated in a majority of the patients. Up to 90% of persons with PCS demonstrated abnormally high anxiety and depression estimates, psychasthenic disorders, and a more or less expressed decrease in the working ability (WA). These patients were characterized by noticeably longer latencies and much lower amplitudes of P 300 wave at application of the target stimuli than control subjects. Such differences in the parameters of P 300 were clearly associated with the presence of cognitive impairment, severe asthenia, depression, and drop in the WA. It was found that such associations were most intense (statistically significant) in the cases where increments in the P300 latency exceeded the upper limits of age normatives calculated for the population. As is concluded, it is expedient to use recording and analysis of CEP P 300 in the complex diagnostics of cognitive disorders in patients with PCS.

Ultrasonography in neonatal foals: Depiction and measurement of the kidneys

Aim of the study was to describe the echotexture and dimensions of the kidneys including the renal pelvis in neonatal foals using transabdominal sonography. In the course of a preliminary examination, sonographic examinations of the kidneys of 10 dead newborn foals were performed in order to determine their localization, measurement parameters, and echotexture. In subsequent necropsies, the kidneys were measured and the obtained values were compared with the sonographic measurements. A high level of agreement between the both measurement values could be demonstrated. In the main examination, 57 1- to 14-day old foals of different breeds were examined. The intercostal spaces and the fossa paralumbalis of both body halves were scanned in longitudinal direction and the topography and echotexture of the kidneys were evaluated using a standardized sonographic examination procedure. The length and width of the organ as well as the extent of the renal pelvis were measured during the same procedure. The obtained measurement values were analyzed comparatively under consideration of different breeds. The renal capsule was identified sonographically by the depiction of a fine hyperechogenic line. The renal cortex itself proved to be echogenic in the ultrasonographic image and the renal medulla hypoechogenic. The renal pelvis exhibited a hyperechogenic sound image. The mean length and width of the left kidney amounted to 7.1 ± 1.4 cm and 4.2 ± 0.7 cm, respectively. The right kidney measured 6.7 ± 1.4 cm and 3.9 ± 0.7 cm in mean length and width. The measurement of the left renal pelvis resulted in mean values of 1.3 ± 0.7 cm in length and 0.7 ± 0.4 cm in in width. Mean length and width of the right renal pelvis amounted to 1.3 ± 0.6 cm and 0.6 ± 0.4 cm, respectively. The renal pelvis displayed an anechogenic lumen on the left and right sides in 24.6 % and 64.3 % of the foals, respectively. The comparison of the measurement values under consideration of different breeds showed that body weight of the equine neonates did not exhibit a correlation with kidney size. Transabdominal sonography is a reliable diagnostic tool for the evaluation of kidneys in neonatal foals. The description of physiological renal echotexture and dimensions serves to identify pathological conditions.

Wild- edible plants of Meghalaya State in India: Nutritional, minerals, antinutritional, vitamin content and toxicity studies

Aim: The point of the present investigation planned to assess the nutritive value, minerals content, vitamin content, antinutritional properties, and toxicity studies in five wild-consumable plants, for example, Begonia hatacoa, Embelia floribunda, Artemisia vulgaris, Cardamine hirsuta, and Plantago major, devoured by the distinctive innate individuals of Meghalaya State in India as their nourishment. Materials and Methods: The proximate parameters such as protein, fat, fiber, sugar, minerals, and harmful overwhelming metals were assessed in the chose wild-eatable plants utilizing standard sustenance examination procedures. The cyanogenic glycoside, oxalates, tannins, saponins, and phytate substances were done to decide the counter wholesome properties of the considered plants. The quantitations of water-dissolvable vitamins in these plants were completed by high-performance liquid chromatography. The in vitro hemolytic measure of plant concentrates was completed on rodent erythrocytes. Appraisal of cytotoxicity of eatable plants was assessed by 3-(4,5-dimethylthiazol-2-yl)-2,5-diphenyltetrazolium bromide examine. The genotoxicity of the contemplated plants was tried by the single-cell gel electrophoresis comet assay. Results: The consequences of examination demonstrated that these plants are rich wellsprings of protein, sugar minerals, and vitamins, particularly the B gathering of vitamins. The substantial metals lead and chromium were distinguished in exceptionally low sum in all the consumable plants. The largest amount of phytate was found in P. major (0.38% ± 0.03%); oxalate was most astounding in E. floribunda (0.261% ± 0.06%) though tannin was most elevated in P. major (1.04% ± 0.12%). The estimations of antinutrients and overwhelming metals in all above-considered plants are underneath the harmful levels. Conclusion: These wild-eatable plants contribute gigantically to sustenance, nourishment security, well-being, and remedial advantages. The aftereffects of poisonous quality of every single eatable plant ensure the security at cell and genomic level and furthermore safe to expend.

1127 Hepatic Blood Flow and Oxygen Delivery in Metabolic Syndrome

INTRODUCTION: Metabolic syndrome MS is defined as the co-occurrence of metabolic risk factors for both DMII and cardiovascular disease. There is no consensus on the diagnostic criteria of the MS due to unclear pathogenesis uniting its components. We propose that compromised hepatic arterial blood supply and oxygen delivery as a response to a nutrient load in patients with MS will lead to hepatorenal activation of sympathetic overdrive, which can be the single common factor in MS pathogenesis METHODS: This prospective case-control study included patients 18-65 y/o diagnosed with MS and control healthy individuals with BMI 30-50 kg/m2. Subjects underwent an initial pre-prandial US, followed by drinking 8 oz of TwoCal high calorie drink immediately and in 15 mins. A second post-prandial US was performed 15mins after completing the second drink. US using the standard procedure for mesenteric artery examination for intestinal ischemia was performed to evaluate the diameter, velocity and flow of the superior mesenteric artery, hepatic artery, and portal vein. Both US images were interpreted by experienced diagnostic US radiologist. The results were analyzed using t-test RESULTS: Ten MS patients (age 55 ± 8) and ten control subjects (age 38 ± 11) with BMI 30-50 kg/m2 (37.6 ± 6.1) were compared. The relative change in blood flow in response to the nutrient load was reflected by the ratio of post- to pre-prandial readings. Total hepatic blood flow was calculated as the sum of HA and PV blood flow. The mean difference between post to pre-prandial ratio of total hepatic blood flow and total blood flow in all three vessels in MS group vs control group were 1.66 ± 0.57 vs 1.37 ± 0.40 (P = 0.162), 1.80 ± 0.42 vs 1.42 ± 0.27 (P = 0.025); respectively. The increase in postprandial total hepatic blood was 17.65% less in MS group. CONCLUSION: Why some obese patients develop MS while others don't raises the question of what is different between these cohorts. Excessive eating can produce obesity by causing chronic relative hypoxia in the liver. This produces sympathetic overdrive which causes insulin resistance, hypertension and dyslipidemia. Bariatric surgeries limit contact of nutrient with the GI mucosa resulting in increased splanchnic O2 delivery to the liver and preventing the hepatorenal reflex. The relative increase in total hepatic blood flow in response to a nutrient load was less in patients with MS compared to healthy obese controls. The difference was not statistically significant. Further studies with larger sample size needed.

Clinical and Radiological Evaluation of the Treatment of Cranial Cruciate Ligament Rupture in Cats with the Musculus Biceps Femoris Transposition Technique

Abstract The aim of this study was to clinically and radiologically evaluate the technique of biceps femoris muscle transposition as a new extracapsular treatment technique for cranial cruciate ligament ruptures, which are often encountered in cats. In this study, eight cats diagnosed with cranial cruciate ligament rupture were treated with the biceps femoris muscle transposition technique. The postoperative standard clinical examination procedures were applied to each cat for 90 days. In the preoperative clinical and radiological examinations of the eight cats in the study, cranial cruciate ligament rupture alone was diagnosed in seven of them. Both, the cranial cruciate ligament rupture and meniscal lesions in the same stifle joint were determined in one cat. The biceps femoris muscle transposition technique operation took approximately 20 mins in each case. The postoperative radiographs were taken on days 10, 30, 60 and 90. No complications were seen in any case during the postoperative follow-up. The Illinois University Evaluation Scale was used for a more objective evaluation. At 90 days postoperatively, there was no lameness in seven out of eight cats, and mild limping was determined in one of them due to concomitant meniscal lesion. According to the study results, the biceps femoris muscle transposition technique was found to be extremely useful as an easily applicable technique in the treatment of cranial cruciate ligament rupture in cats.