Introduction: Human Immunodeficiency Virus/Acquired Immune Deficiency Syndrome (HIV/AIDS) can involve almost any organ system. The study was aimed to assess the various bone marrow abnormalities seen in HIV/AIDS patients with haematologic abnormalities. Materials and Methods: 43 HIV infected patients were included in the study. Baseline haematological investigations included full blood count, CD4 positive lymphocyte counts, and absolute lymphocyte count. Bone marrow aspiration and trephine biopsy were done in all patients. Bone marrows of these patients were carefully evaluated for any abnormalities. HIV positive patients were classified into AIDS group (76%) and non-AIDS (24%) group using National AIDS Control Organisation (NACO) criteria. Results: Normocytic normochromic anaemia was the most common peripheral haematological finding occurring in 72% of patients. The AIDS group had statistically significant lower platelet counts (p=0.004) but no differences in the other parameters. Bone marrow was normocellular in 63.6% in the AIDS group and 100% in the non-AIDS group. Dysplasia was observed in 37.2% of patients, predominantly affecting granulocytic series. Myelodysplasia was statistically associated with a low platelet count. Reduced marrow lymphoid precursors (CD4+) were seen in 37.2% of patients. Conclusions: Bone marrow abnormalities were common in HIV/AIDS patients with haematological abnormalities. The AIDS group had a statistically significant lower platelet count. Myelodysplasia was found in 37.2% of patients with HIV disease and was also statistically associated with a lower CD4+ lymphocyte count.

Androgen doping in power sports is undeniably rampant worldwide. There is strong evidence that androgen administration in men increases skeletal muscle mass, maximal voluntary strength and muscle power. However, we do not have good experimental evidence to support the presumption that androgen administration improves physical function or athletic performance. Androgens do not increase specific force or whole body endurance measures. The anabolic effects of testosterone on the skeletal muscle are mediated through androgen receptor signaling. Testosterone promotes myogenic differentiation of multipotent mesenchymal stem cells and inhibits their differentiation into the adipogenic lineage. Testosterone binding to androgen receptor induces a conformational change in androgen receptor protein, causing it to associate with beta-catenin and TCF-4 and activate downstream Wnt target genes thus promoting myogenic differentiation. The adverse effects of androgens among athletes and recreational bodybuilders are under reported and include acne, deleterious changes in the cardiovascular risk factors, including a marked decrease in plasma high-density lipoproteins (HDL) cholesterol level, suppression of spermatogenesis resulting in infertility, increase in liver enzymes, hepatic neoplasms, mood and behavioral disturbances, and long term suppression of the endogenous hypothalamic-pituitary-gonadal axis. Androgens are often used in combination with other drugs which may have serious adverse events of their own. In spite of effective methods for detecting androgen doping, the policies for screening of athletes are highly variable in different countries and organizations and even existing policies are not uniformly enforced.
Androgens ; adverse effects ; pharmacology ; physiology ; Doping in Sports ; Humans ; Sports ; Weight Lifting

INTRODUCTIONEnteric fever is a common infection in endemic areas; however, there are few reports describing the computed tomography (CT) manifestations of enteric fever. We aim to describe and illustrate CT findings in enteric fever in this study.

MATERIALS AND METHODSA retrospective search of medical records in our institute for patients with positive blood cultures for Salmonella typhi, and Salmonella paratyphi organisms yielded 39 cases. Among these patients, 12 had undergone a CT study of the abdomen. The CT images, laboratory and clinical findings of these 12 patients were reviewed.

RESULTSThe most common clinical presentation was fever (100%). Typical features of gastroenteritis were present in only over half of the patients. Liver function tests were abnormal in all patients. The most common abdominal manifestations on CT were the presence of mesenteric lymphadenopathy and splenomegaly (75%). Other features were circumferential small bowel wall thickening (58.3%) and free intraperitoneal fluid (50%). Three patients were found to have complications; one with bleeding from terminal ileal ulceration, another with an ileal perforation and the third with renal abscess formation.

CONCLUSIONCT is useful in evaluating enteric fever in patients with severe forms of presentation, a longer clinical course or less specific symptoms. Although the imaging features overlap with other abdominal infections, when combined with clinical features, travel history to endemic areas and presence of transaminitis, the diagnosis of enteric fever should be considered. CT in particular, is useful for the detection of complications such as perforation, bleeding and abscess formation.

Abscess ; diagnostic imaging ; Adolescent ; Adult ; Aged ; Ascitic Fluid ; diagnostic imaging ; Child ; Child, Preschool ; Female ; Humans ; Intestine, Small ; diagnostic imaging ; Lymphatic Diseases ; diagnostic imaging ; Male ; Middle Aged ; Paratyphoid Fever ; diagnostic imaging ; Radiography, Abdominal ; Retrospective Studies ; Salmonella paratyphi A ; Salmonella paratyphi B ; Salmonella typhi ; Splenomegaly ; diagnostic imaging ; Tomography, X-Ray Computed ; Typhoid Fever ; diagnostic imaging

INTRODUCTIONPreoperative staging is essential for the optimal treatment and surgical planning of colorectal cancers. This study was aimed to evaluate the accuracy of colorectal cancer staging done using contrast-enhanced multidetector computed tomographic colonography (CEMDCTC).

METHODSWe recruited 25 patients with 28 proven colorectal cancers. A 16-slice multidetector computed tomography scanner was used to generate two-dimensional multiplanar reformatted sagittal, coronal and oblique coronal images, and three-dimensional virtual colonography (endoluminal) images. Axial and reformatted views were analysed, and TNM staging was done. Patients underwent surgery and conventional colonoscopy, and surgical histopathological correlation was obtained.

RESULTSThe diagnostic accuracies for TNM colorectal cancer staging were 92.3% for T staging, 42.3% for N staging and 96.1% for M staging using CEMDCTC. There was excellent positive correlation for T staging between CEMDCTC and both surgery (κ-value = 0.686) and histopathology (κ-value = 0.838) (p < 0.0001), and moderate positive correlation for N staging between CEMDCTC and surgery (κ-value = 0.424; p < 0.0001). The correlation between CEMDCTC and histopathology for N staging was poor (κ-value = 0.186; p < 0.05); the negative predictive value was 100% for lymph node detection. Moderate positive correlation was seen for M staging between CEMDCTC and both surgery (κ-value = 0.462) and histopathology (κ-value = 0.649). No false negatives were identified in any of the M0 cases.

CONCLUSIONCEMDCTC correlated well with pathologic T and M stages, but poorly with pathologic N stage. It is an extremely accurate tool for T staging, but cannot reliably distinguish between malignant lymph nodes and enlarged reactive lymph nodes.

Adolescent ; Adult ; Aged ; Aged, 80 and over ; Colonography, Computed Tomographic ; methods ; standards ; Colorectal Neoplasms ; diagnosis ; pathology ; surgery ; Contrast Media ; Female ; Humans ; Lymph Nodes ; pathology ; Male ; Middle Aged ; Multidetector Computed Tomography ; standards ; Neoplasm Staging ; methods ; Prospective Studies ; Reproducibility of Results ; Young Adult

Cerebral Palsy is a common and devastating neurological disorder, with no medical treatment apart from physiotherapy regimes to alleviate the functional disability. Regenerative medicine using stem cells has gained momentum in recent years as a possible strategy to repair the injured brain. Present study was undertaken in a open label series to evaluate the safety, feasibility and observe for any benefi cial effects of intra-arterial infusion of autologous bone marrow derived mononuclear cells in patients with cerebral palsy with moderate disability. Functional improvement was assessed using the motor power and spasticity scales, dystonia and abnormal movements scale and the activities of daily living scales by modifi ed Barthel Index and modifi ed Rankin Scores. Serial structural imaging with MRI and functional imaging with FDG-PET scans were done. Of the 30 patients injected with an average of 10-30 million cells into each carotid artery, improvements were observed in all clinical scales, and predominantly in the disability scores. No adverse events were noted on a 12 months follow up.