IOSR Journal of Dental and Medical Sciences is one of the speciality Journal in Dental Science and Medical Science published by International Organization of Scientific Research (IOSR). The Journal publishes papers of the highest scientific merit and widest possible scope work in all areas related to medical and dental science. The Journal welcome review articles, leading medical and clinical research articles, technical notes, case reports and others.
Obstructive uropathy presenting as primary enuresis – A case reportApollo Hospitals
An adolescent male presented with persistent nocturnal bedwetting. Confounding family history of nocturnal enuresis lead to delay in seeking medical attention. Careful history and investigations confirmed underlying obstructive uropathy and bladder dysfunction. Primary enuresis presenting beyond childhood period should be investigated to look for underlying organic cause.
Obstructive uropathy presenting as primary enuresis – A case reportApollo Hospitals
An adolescent male presented with persistent nocturnal bedwetting. Confounding family history of nocturnal enuresis lead to delay in seeking medical attention. Careful history and investigations confirmed underlying obstructive uropathy and bladder dysfunction. Primary enuresis presenting beyond childhood period should be investigated to look for underlying organic cause.
Ureteric colic is defined as a medical condition characterized by the presence of a urinary stone, leading to a severe urinary system pain. An excruciating pain that can strike without a warning, ureteric colic or renal colic is caused by dilation, stretching and spasm of the ureter.
Ureteric colic is defined as a medical condition characterized by the presence of a urinary stone, leading to a severe urinary system pain. An excruciating pain that can strike without a warning, ureteric colic or renal colic is caused by dilation, stretching and spasm of the ureter.
metabolic acidosis develops because of defects in the ability of the renal tubules to perform the normal functions required to maintain acid-base balance.
A presentation about Intravenous Urography (Also known as Intravenous Pyeography).
The presentation contains 41 slides, and is divided into 4 parts :
1 - Introduction.
2 - The procedure.
3 - Examples for abnormal findings.
4 - Studies comparing IVU accuracy with KUB & USG with CT Scan.
This presentation was prepared and presented by me in the tutorials of the Radiology Department of Sebha Medical Center.
Purpose: To assess the effectiveness of a fast track referral system from Vascular Laboratory to Interventional Radiology on
threatened vein bypass grafts in the lower limbs.
Methods: A Fast Track System (FTS) was set up in February 2011 to minimise the delay from duplex scan to intervention for bypass grafts with identifi ed signifi cant stenoses. 111 scans were performed pre - FTS over one year and compared with 190 scans which were performed post-FTS introduction over two years.
Post radical nephroureterectomy cystoscopic surveillance and usage of a nomog...NAAR Journal
Aim:Intravesical recurrence post radical nephroureterectomy (RNU) is a frequent event requiring intense cystoscopic surveillance. This study includes cystoscopic surveillance and usage of variable predictors for intravesical recurrence after radical nephroureterectomy. The current investigation objective was to recognize intravesical recurrence indicators and build up a tool to allow risk delineated methodology supporting patient advising for cystoscopic surveillance and post-operative intravesical MMC administration. Methods: We did a retrospective analysis of 324 patients with UTUC (Upper Tract Urothelial Carcinoma). Patients' demographic data, including age, gender, etiology, tumor size, previous bladder cancer, tumor location (renal pelvic or ureter), were reported. All the patients reported above were followed up for a mean period of 36 months. Computed tomography (CT), ultrasound imaging, cystoscopy, urine cytology, ureteroscopy tests were performed for each patient included in the study. The data set was divided into a development cohort of recurrent and non-recurrent patients). Multivariable and Univariable were addressed to intravesical recurrence after RNU. Predictive accuracy was quantified. Result:With a median follow-up of 36 months, intravesical recurrence occurred in 59 patients. IVR after RNU was noted in 59 patients after a median follow-up of 36 months. The probability of intravesical recurrence is 28.6%.The recurrent bladder tumors were managed with endoscopic resection and intravesical chemoimmunotherapy following the standard protocol. The recurrent bladder tumors showed the following characteristics: 3.4%, 3.4%, 8.5%, 37.3%, and 47.5% of tumors were in Ta, T1, T2, T3, and T4stages, respectively. One patient underwent radical cystectomy after a refractory muscle-invasive bladder tumor, and contralateral UTUC developed. Two patients had partial cystectomy after multiple endoscopic resections of T1 tumor, and intravesical chemotherapy failed. For 59 patients who developed bladder recurrence, the optimal cut-off point of early recurrence was determined to be six months after surgery (p=0.042). End-stage renal disease history and surgical margin positive patient has later bladder recurrence.
A Retrospective Analysis of Complications of Pelvic Exenteration - A Single I...Premier Publishers
To analyse complications in patients who underwent pelvic exenteration procedures performed in our, between January 2013 – December 2018. A retrospective analysis of the baseline characteristics, surgical outcomes, complication rates of 51 patients who had undergone pelvic exenteration procedures between January 2013 and December 2018 was made. The results analysed using chi-square test. Of the 51 patients, 38 were operated for primary malignancy and 13 underwent exenteration for recurrences. Seventeen patients were operated by laparoscopy whereas the rest underwent open procedures. The diagnosis for which exenteration had been done included cancers of cervix (37), urinary bladder (5), rectum (4), urethra (1), vagina (3), and ovary (1). Bleeding was the most common complication encountered. Hypokalaemia, surgical site infections, urine leak and sepsis were seen in early post-operative period. The morbidity rate (major) was 33.3% and the mortality rate was 5.8% in our centre. The late outcome was inadequately evaluated as most patients lost follow-up. Pelvic exenteration is the only surgical option available for advanced pelvic malignancies and the morbidity pattern differs based on diagnosis, extent of resection and the type of diversion procedure. In a high-volume centre, the morbidity and mortality rates are acceptable compared with international standards.
The presence of haematuria may be the sole symptom of an underlying disease, either benign or malignant. It is one of the most common presentations of patients with urinary tract diseases and of patients referred for urinary imaging. Painless visible haematuria (VH) is the commonest presentation of bladder cancer.
Uroflowmetry and Post-Void Urine Volume in the Initial Evaluation of Suspected Obstructive Prostatic Enlargement by Sigiberto II García-Nares in Experimental Techniques in Urology & Nephrology
With an experience over 2 decades as a radiologist, Dr. Parag Vora has dedicated 10 years of his service at Canada’s Mcmaster university at Burlington, Hamilton. This case study focuses on computed tomography associated with operative management for non strangulating small bowel obstruction. The experienced team behind this elaborative bowel study included Dr. Rakesh. R. Suri, Dr. Parag Vora, Dr. John. M. Kirby and Dr. Leyo Ruo.
Have a look at my blog, here I discussed about my medical experience and what all have been keeping me busy.
https://paragvora-mcmaster.blogspot.com/2019/01/dr-parag-vora-radiologists-blog-from.html
#drparagvora #Mcmaster #Radiology #Hamilton #Burlington #drvora #Canada #Research #medical #Radiologist #Mcmasteruniversity
This study was conducted to evaluate the safety and efficacy of retrograde intrarenal surgery (RIRS) in the treatment of kidney stones larger than 2 cm and to compare its results with percutaneous nephrolithotomy (PCNL).
Journal of the Formosan Medical Association (2011) 110, 695e70.docxcroysierkathey
Journal of the Formosan Medical Association (2011) 110, 695e700
Available online at www.sciencedirect.com
journal homepage: www.jfma-online.com
ORIGINAL ARTICLE
A multivariable logistic regression equation to
evaluate prostate cancer
Jhih-Cheng Wang a, Steven K. Huan a, Jinn-Rung Kuo b, Chin-Li Lu c,
Hung Lin a, Kun-Hung Shen a,*
a Division of Urology, Departments of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
b Division of Neurosurgery, Department of Surgery, Chi-Mei Medical Center, Tainan, Taiwan
c Department of Medical Research, Chi-Mei Medical Center, Tainan, Taiwan
Received 29 January 2010; received in revised form 14 May 2010; accepted 9 August 2010
KEYWORDS
Logistic regression;
men’s health;
probability;
prostate cancer;
risk factor;
score
* Corresponding author. Division of U
Taiwan 710.
E-mail address: [email protected]
0929-6646/$ - see front matter Copyr
doi:10.1016/j.jfma.2011.09.005
Background/Purpose: A possible means of decreasing prostate cancer mortality is through
improved early detection. We attempted to create an equation to predict the likelihood of
having prostate cancer.
Methods: Between January 2005 and May 2008, patients who received prostate biopsies were
retrospective evaluated. The relationship between the possibility of prostate cancer and the
following variables were evaluated: age; serum prostate specific antigen (PSA) level, prostate
volume, numbers of prostatic biopsies, digital rectal examination (DRE) findings, and the pres-
ence of hypoechoic nodule under transrectal ultrasonography.
Results: A multivariate regression model was created to predict the possibility of having pros-
tate cancer, and a receiver-operating characteristic (ROC) curve was drawn based on the
predictive scoring equation. Using a predictive equation, P Z 1/(1 � e�x), where X Z
�4.88, þ 1.11 (if DRE positive), þ 0.75 (if hypoechoic nodule of prostate present), þ 1.27
(when 7 < PSA � 10), þ 2.02 (when 10 < PSA � 24), þ 2.28 (when 24 < PSA � 50), þ 3.93 (when
50 < PSA), þ 1.23 (when 65 < age � 75), þ 1.66 (when 75 < age), followed by ROC curve
analysis, we showed that the sensitivity was 88.5% and specificity was 79.1% in predicting
the possibility of prostate cancer.
Conclusion: Clinicians can tailor each patient’s follow-up according to the nomogram based on
this equation to increase the efficacy of evaluating for prostate cancer.
Copyright ª 2011, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
rology, Department of Surgery, Chi-Mei Medical Center, 901 Chung Hwa Road, Yung Kang City, Tainan,
il.com (K.-H. Shen).
ight ª 2011, Elsevier Taiwan LLC & Formosan Medical Association. All rights reserved.
mailto:[email protected]
http://dx.doi.org/10.1016/j.jfma.2011.09.005
www.sciencedirect.com/science/journal/09296646
http://www.jfma-online.com
http://dx.doi.org/10.1016/j.jfma.2011.09.005
http://dx.doi.org/10.1016/j.jfma.2011.09.005
696 J.-C. Wang et al.
Prostate cancer is the most common solid malignancy ...
An Examination of Effectuation Dimension as Financing Practice of Small and M...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Does Goods and Services Tax (GST) Leads to Indian Economic Development?iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Childhood Factors that influence success in later lifeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Emotional Intelligence and Work Performance Relationship: A Study on Sales Pe...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer’s Acceptance of Internet Banking in Dubaiiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study of Employee Satisfaction relating to Job Security & Working Hours amo...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumer Perspectives on Brand Preference: A Choice Based Model Approachiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Student`S Approach towards Social Network Sitesiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Broadcast Management in Nigeria: The systems approach as an imperativeiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study on Retailer’s Perception on Soya Products with Special Reference to T...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
A Study Factors Influence on Organisation Citizenship Behaviour in Corporate ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Consumers’ Behaviour on Sony Xperia: A Case Study on Bangladeshiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Design of a Balanced Scorecard on Nonprofit Organizations (Study on Yayasan P...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Public Sector Reforms and Outsourcing Services in Nigeria: An Empirical Evalu...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Media Innovations and its Impact on Brand awareness & Considerationiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Customer experience in supermarkets and hypermarkets – A comparative studyiosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Social Media and Small Businesses: A Combinational Strategic Approach under t...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Secretarial Performance and the Gender Question (A Study of Selected Tertiary...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Implementation of Quality Management principles at Zimbabwe Open University (...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Organizational Conflicts Management In Selected Organizaions In Lagos State, ...iosrjce
IOSR Journal of Business and Management (IOSR-JBM) is a double blind peer reviewed International Journal that provides rapid publication (within a month) of articles in all areas of business and managemant and its applications. The journal welcomes publications of high quality papers on theoretical developments and practical applications inbusiness and management. Original research papers, state-of-the-art reviews, and high quality technical notes are invited for publications.
Acute scrotum is a general term referring to an emergency condition affecting the contents or the wall of the scrotum.
There are a number of conditions that present acutely, predominantly with pain and/or swelling
A careful and detailed history and examination, and in some cases, investigations allow differentiation between these diagnoses. A prompt diagnosis is essential as the patient may require urgent surgical intervention
Testicular torsion refers to twisting of the spermatic cord, causing ischaemia of the testicle.
Testicular torsion results from inadequate fixation of the testis to the tunica vaginalis producing ischemia from reduced arterial inflow and venous outflow obstruction.
The prevalence of testicular torsion in adult patients hospitalized with acute scrotal pain is approximately 25 to 50 percent
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Ve...kevinkariuki227
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
263778731218 Abortion Clinic /Pills In Harare ,sisternakatoto
263778731218 Abortion Clinic /Pills In Harare ,ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group ABORTION WOMEN’S CLINIC +27730423979 IN women clinic we believe that every woman should be able to make choices in her pregnancy. Our job is to provide compassionate care, safety,affordable and confidential services. That’s why we have won the trust from all generations of women all over the world. we use non surgical method(Abortion pills) to terminate…Dr.LISA +27730423979women Clinic is committed to providing the highest quality of obstetrical and gynecological care to women of all ages. Our dedicated staff aim to treat each patient and her health concerns with compassion and respect.Our dedicated group of receptionists, nurses, and physicians have worked together as a teamof receptionists, nurses, and physicians have worked together as a team wwww.lisywomensclinic.co.za/
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
Title: Sense of Taste
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the structure and function of taste buds.
Describe the relationship between the taste threshold and taste index of common substances.
Explain the chemical basis and signal transduction of taste perception for each type of primary taste sensation.
Recognize different abnormalities of taste perception and their causes.
Key Topics:
Significance of Taste Sensation:
Differentiation between pleasant and harmful food
Influence on behavior
Selection of food based on metabolic needs
Receptors of Taste:
Taste buds on the tongue
Influence of sense of smell, texture of food, and pain stimulation (e.g., by pepper)
Primary and Secondary Taste Sensations:
Primary taste sensations: Sweet, Sour, Salty, Bitter, Umami
Chemical basis and signal transduction mechanisms for each taste
Taste Threshold and Index:
Taste threshold values for Sweet (sucrose), Salty (NaCl), Sour (HCl), and Bitter (Quinine)
Taste index relationship: Inversely proportional to taste threshold
Taste Blindness:
Inability to taste certain substances, particularly thiourea compounds
Example: Phenylthiocarbamide
Structure and Function of Taste Buds:
Composition: Epithelial cells, Sustentacular/Supporting cells, Taste cells, Basal cells
Features: Taste pores, Taste hairs/microvilli, and Taste nerve fibers
Location of Taste Buds:
Found in papillae of the tongue (Fungiform, Circumvallate, Foliate)
Also present on the palate, tonsillar pillars, epiglottis, and proximal esophagus
Mechanism of Taste Stimulation:
Interaction of taste substances with receptors on microvilli
Signal transduction pathways for Umami, Sweet, Bitter, Sour, and Salty tastes
Taste Sensitivity and Adaptation:
Decrease in sensitivity with age
Rapid adaptation of taste sensation
Role of Saliva in Taste:
Dissolution of tastants to reach receptors
Washing away the stimulus
Taste Preferences and Aversions:
Mechanisms behind taste preference and aversion
Influence of receptors and neural pathways
Impact of Sensory Nerve Damage:
Degeneration of taste buds if the sensory nerve fiber is cut
Abnormalities of Taste Detection:
Conditions: Ageusia, Hypogeusia, Dysgeusia (parageusia)
Causes: Nerve damage, neurological disorders, infections, poor oral hygiene, adverse drug effects, deficiencies, aging, tobacco use, altered neurotransmitter levels
Neurotransmitters and Taste Threshold:
Effects of serotonin (5-HT) and norepinephrine (NE) on taste sensitivity
Supertasters:
25% of the population with heightened sensitivity to taste, especially bitterness
Increased number of fungiform papillae
Couples presenting to the infertility clinic- Do they really have infertility...Sujoy Dasgupta
Dr Sujoy Dasgupta presented the study on "Couples presenting to the infertility clinic- Do they really have infertility? – The unexplored stories of non-consummation" in the 13th Congress of the Asia Pacific Initiative on Reproduction (ASPIRE 2024) at Manila on 24 May, 2024.
Evaluation of Obstructive Uropathy with Computed Tomography Urography and Magnetic Resonance Urography - A Clinicoradiological study
1. IOSR Journal of Dental and Medical Sciences (IOSR-JDMS)
e-ISSN: 2279-0853, p-ISSN: 2279-0861.Volume 14, Issue 12 Ver. II (Dec. 2015), PP 01-05
www.iosrjournals.org
DOI: 10.9790/0853-141220105 www.iosrjournals.org 1 | Page
Evaluation of Obstructive Uropathy with Computed Tomography
Urography and Magnetic Resonance Urography - A
Clinicoradiological study
Dr.Meenakumari Ayekpam, Dr.Tseizo Keretsu, Dr.AK Kaku Singh
I. Introduction:
Obstructive uropathy refers to the presence of structural or functional changes in the urinary tract due
to obstruction to the normal flow of urine. It is due to functional or anatomic lesions that can be located
anywhere in the urinary tract, from the renal tubules to the urethral meatus.1
It has a bimodal distribution. It is
common in childhood mainly due to congenital anomalies of the urinary tract. It declines with age until late
adulthood (60 to 65 years) where the incidence rises, predominantly in men, due to prostatic hyperplasia or
cancer.2
Technologic advances in both computed tomography (CT) and magnetic resonance (MR) imaging have
resulted in the ability to image the urinary tract in ways that surpass the prior mainstay of urinary tract imaging,
the intravenous urography.
With the introduction of multidetector technology, CT urography, to date, has emerged as the initial
heir apparent to intravenous urography; many years of experience have now clearly demonstrated that CT is the
test of choice for many urologic problems, including urolithiasis, renal masses, urinary tract infection, trauma
and obstructive uropathy.3
MR urography (MRU) is also used to evaluate the urinary tract and has the advantage of not using
ionizing radiation and the potential to provide more functional information than CT.4
MRU as a technique for
assessment of the urinary tract was first described by Hennig J et al5
in 1987.
The most common MR urographic techniques for displaying the urinary tract can be divided into two
categories: static-fluid MR urography and excretory MR urography. Static-fluid MR urography makes use of
heavily T2-weighted sequences to image the urinary tract as a static collection of fluid, and can be repeated
sequentially (cine MR urography) to better demonstrate the ureters in their entirety and to confirm the presence
of fixed stenoses, and is most successful in patients with dilated or obstructed collecting systems. Excretory MR
urography is performed during the excretory phase of enhancement after the intravenous administration of
gadolinium-based contrast material. 6
This study evaluates the cause and level of urinary obstruction in patients with obstructive uropathy
using CT Urography and correlates it with the findings of MR Urography.
Aims and Objectives:
The principle objective of the study was to investigate patients with clinical suspicion of obstructive
uropathy and in patients where the cause of hydronephrosis remained undetected or inconclusive from
Intravenous Pyelogram (IVP) or Ultrasonography in the following ways:
1. To determine the cause and site of obstruction with Computed Tomography Urography and Magnetic
Resonance Urography.
2. To correlate Computed Tomography Urography findings with that of Magnetic Resonance Urography.
II. Materials and Methods:
The Cross-sectional study was carried out in the Department of Radiodiagnosis, Regional Institute of
Medical Sciences, Imphal in collaboration with the Department of Urology, RIMS, Imphal.The study
commenced from October 2013 to September 2015, for a period of two years. Study Population consisted of all
patients with obstructive uropathy attending the Department of Urology, RIMS, Imphal during the study period
who fulfill the inclusion criteria as below were included in the study.
Inclusion Criteria: All patients with clinical diagnosis of obstructive uropathy and patients where the cause of
hydronephrosis remained undetected or inconclusive from Intravenous Pyelogram (IVP) or Ultrasonography
were included in the study.
Exclusion Criteria: Patients with metallic implants in their bodies, prosthetic heart valves or pace-maker,
patients with suspected metallic foreign body in any organ of the body. Patients with known allergy or
hypersensitivity to an iodine-containing contrast agent or with severely impaired renal function (S.Creatinine> 2
mg/dl), pregnant women and patients with hyperthyroidism were excluded.
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The sample size was kept at 60. Study variables included were age, sex, socio economic status, reason of
failure of IVP, CT and MR findings.
The study was performed by using PHILIPS BRILLIANCE 64 SLICE CT and SIEMENS 1T Harmony Model-
SIEMENS 2004 A.1 TESLA MRI.
The following CT protocol was used, first a Scout film was taken followed by an initial unenhanced
scan extending from upper pole of kidney to the base of bladder. A non-ionic contrast agent (100–150mL of
300 mg I/mL at 2–4 mL/s) was administered by using Mallinckrodt Auto Injector through the 18 G IV cannula
inserted in the antecubital vein and the 3 phases- corticomedullary, nephrographic, and pyelographic phases was
taken.
The following MR sequences were used for MR Urography : HASTE (half-Fourier acquisition single-
shot turbo spin-echo) sequences, T1- weighted fat-suppressed sequence, T1- weighted FL2D sequences, T2-
weighted TRUFI sequence, T2- weighted TSE sequences.
For Statistical analysis, Kappa statistics was used for agreement. The study commenced only after the
approval of the Institutional Ethical Committee (IEC), RIMS, Imphal. Informed consent was taken from all the
participants and confidentiality was maintained.
III. Results and Observation:
A total of 60 patients suspected of obstructive etiology on the basis of clinical examination and
laboratory investigations or where the cause of hydronephrosis remained undetected or inconclusive from
Intravenous Pyelogram (IVP) or Ultrasonography were examined by CT Urography and MR Urography
for the period starting from October 2013 to September 2015. The results have been summarized
and presented in tabular forms and charts under different headings:
1. Age distribution:
Fig 1: Bar diagram showing age distribution of the respondents.
Majority of the respondents were from the age group 41-50 years of age which accounted for 48.0% of cases.
Mean age was 46.2 years with a standard deviation of 2.3 years.
2. Sex distribution
Fig 2: Pie chart showing distribution of the respondents by sex.
More than half of the respondents were male (59.6%) as shown in figure 2.
3. Evaluation of Obstructive Uropathy with Computed Tomography Urography and ….
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3. Distribution of the respondents by cause/reason of failure of IVP.
Fig 3: Bar diagram showing distribution of the respondents by cause/reason of failure of IVP.
Many had no excretion (36.5%), persistent nephrgram (30.7%) for failure of IVP and no definite diagnosis was
seen in 13.6% of cases as shown in figure 3.
4. Distribution of the respondents by cause and site of obstruction with relation between CT and MR
urography findings.
Obstruction No. of renal
units (MR)
% No. of renal
units
(CT)
% Kappa statistics
Yes 49 41.5 45 38.2 Value
=0.70
(0.237-0.378)
Stone
Renal
Upper ureter
Mid ureter
Lower ureter
26
6
5
14
1
22.0
5.1
4.2
11.9
0.8
32
8
6
15
3
27.1
6.8
5.1
12.7
2.5
Value
=0.46
(0.224-0.435)
Stricture 11 9.3 6 5.1 Value
=0.35
(0.473-0.156)
Upper Ureter 5 4.2 3 2.5
Mid Ureter 1 0.8 1 0.8
Lower Ureter 5 4.2 2 1.7
Tumour 9 7.6 4 3.4 Value
=0.54
(0.034-0.139)
Ureter 1 0.8 0 0.0
Bladder 4 3.4 2 1.7
Prostate 4 3.4 2 1.7
Extraurinary 3 2.5 3 2.5 Value=1.0
(0.427-0.559)Retroperitoneal fibrosis 2 1.7 2 1.7
Lymphocele 1 0.8 1 0.8
No Obstruction 69 58.5 73 61.8
Total 118 100.0 118 100.0
In MR urography only 26 cases of urinary stone could be identified. But in case of stricture and
tumour, most cases were identified in MR urography than CT urography. In case of extra urinary obstructions
both MR urography and CT urography could identify the same number of cases. CT urography identified 2
solitary kidneys among 60 patients giving rise to 118 renal units. Among these 118 units 32 of them (38.1%)
had obstruction; calculus in 32 renal units (27.1%) and acalculus in 13 (11.0%). Among acalculus obstruction, 6
of them were stricture, 4 of them were tumour and 3 of them were extraurinary as shown in the above table.
Overall there was substantial agreement (K=0.70) between CT urography and MR urography. There
was good agreement between stricture and tumour identification between them and excellent agreement in extra
urinary obstruction. All this finding was found to be significant (CI not crossing 1 value).
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IV. Discussion:
The study was carried out in the department of Radiodiagnosis, Regional Institute of Medical Sciences,
Imphal in collaboration with the Department of Urology, RIMS, Imphal which included 60 patients with clinical
suspicion of obstructive uropathy and patients where the cause of hydronephrosis remains undetected or
inconclusive from Intravenous Pyelogram (IVP) or Ultrasonography. Among the 60 suspected obstructive
uropathy patients, nearly half of the respondents were from the age group of 41-50 years and mean age was 46.2
years. Mean age of urinary obstruction was similar with study by Bozgeyik Z et al 7
where the mean was 45.5
years. Male patients were more common than the female patients. Most of the patients were from middle
socioeconomic status.
In this study the main cause of failure of IVP was no excretion in more than one third of the cases and
so CT and MR urography was performed. Other causes were persistent nephrogram, poor excretion and no
definite diagnosis. This finding was consistent with the study by Abou El-Ghar ME et al8
where the commonest
cause was no excretion in 26% of cases followed by persistent nephrogram, no excretion and no definite
diagnosis.
In CT urography of the 60 patients, only 118 renal units could be identified (2 patients had solitary
kidney). Obstruction was identified in 45 cases (38.2%) by CT urography : 32 cases (27.1%) of urinary stone
could be identified; 8 cases of renal, 6 cases of upper ureter, 15 cases of middle ureter and 3 cases of lower
ureter stone. Stricture could be identified in 6 cases (5.1%), tumour in 4 cases (3.4%) and extraurinary
obstruction in 3 cases (2.5%). In the study conducted by Moawad MA et al 9
fourteen (46.6%) cases was caused
by urinary tract stones, four (13.3%) with urinary bladder masses involving ureteric orifices, three (10%) with
pelviureteric junction obstruction (PUJ) obstruction, three (10%) with compression of ureters, three (10%) with
ureteric injuries, two (6.6%) with bladder neck obstruction, and one (3.3%) case with ureteric stricture could be
identified.
In case of MR urography only 26 cases of urinary stone could be identified. Same finding was observed
in Regan F et al10
MRU/KUB showed ureteric calculi in 21/29 (72%) of patients with calculi seen at CT. But in
case of stricture and tumour, more cases were identified in MR urography than CT urography. In case of extra
urinary obstructions both MR urography and CT urography could identify the same cases. Similar finding was
found in the study by Shokeir AA et al11
where Ureteral strictures were identified by NCCT in 18 of the 65
cases (28%) and by MRU in 54 of 65 (83%). NCCT and MRU could identify all extraurinary causes of
obstruction in the same study. In the study by Eassaa W et al12
both NCCT and MRU could identify all extra
urinary causes of obstruction.
In this study, the overall agreement between MR urography and CT urography was substantial (K=7.0)
and confidence interval was narrow and not crossing 1 value. Good agreement was found in the diagnosis of
stricture and tumour in between the two techniques. In case of extra urinary obstruction agreement was excellent
giving K=1 and the finding was significant (CI- 0.034- 0.139).
V. Conclusion
In this study of 60 patients with obstructive uropathy, out of 118 renal units, 45 units of obstruction
were identified as obstructed by CT urography. In case of MR urography 4 more cases of 49 obstructed units
could be identified. In calculus obstruction CT urography could identify more cases than MR urography. But
MR urography detected more cases of stricture and tumour. Overall agreement was substantial in between the
two groups with good agreement seen in detection of stricture and tumour. Excellent agreement was found in
between the two techniques for identifying extra urinary obstruction.
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