Incidental finding of Psuedomyxoma Peritonei in Malignant Peripheral Nerve Sheath Tumour.

Psuedomyxoma peritonei is an infrequent clinical entity characterised by intraperitoneal mucinous/gelatinous ascites produced by the cancerous cells. It has been associated with gastrointestinal, gynaecological, lung and breast tumours. It is commonly asymptomatic and is most often detected incidentally on abdominopelvic imaging or laparoscopy. Higher histological grade of the tumour shows increased metabolic activity on 18F-Fluorodeoxyglucose (FDG) positron-emission tomography (PET) computed tomography (CT). It has been rarely reported in patients with sarcoma. We hereby present an interesting case of incidentally diagnosed pseudomyxoma peritonei on 18FDG PET-CT scan of a patient with soft tissue sarcoma of peripheral nerve sheath.

Arsenic Levels and Seasonal Variation in Pasture Soil, Forage and Horse Blood Plasma in Central Punjab, Pakistan.

The present study aimed to determine the accumulation levels of arsenic in pasture soil, forage and animals. An atomic absorption spectrophotometer was used to determine the concentration of metals in the samples of soil, forage and blood plasma of horses. The level of arsenic ranged between 4.26 mg/kg (summer) and 4.66 mg/kg (winter) in soil samples and 2.67 mg/kg (summer) and 2.94 mg/kg (winter) in forage samples. In blood plasma samples, the mean arsenic (As) values varied between 1.38 and 1.52 mg/L. In the blood plasma samples, the mean As values varied between 1.38 and 1.52 mg/L. No statistically significant changes were observed for arsenic concentrations in plasma samples of horses for sampling seasons (p > 0.05). A positive correlation was observed for forage and blood plasma to a certain degree for arsenic but for other media, arsenic correlations were negative and insignificant. It is therefore suggested that regular monitoring of heavy metals in soils/plants/animals is essential to prevent excessive build-up of arsenic.

I-131 Avid Tumor Thrombus in a Case of Poorly Differentiated Thyroid Cancer.

Intravenous tumor extension is a well-recognized phenomenon occurring in various malignancies but is a relatively rare entity in thyroid carcinoma. In patients with poorly differentiated thyroid cancer (pDTC), I-131 avid superior vena cava tumor (SVC) thrombus at initial presentation is infrequent and potential life threatening. Tumor thrombus can form either due to direct vascular extension of the primary mass or by hematogenous spread. Hybrid nuclear imaging can differentiate the two entities, which can impact the treatment plan of the patient. We present images of an interesting case of evolution of SVC thrombus in a 46-year-old woman with diagnosed pDTC over the span of two years.

Nuclear Medicine-A Name for Now and the Future.

ABSTRACT: Our article addresses the prevailing trend of new terminology introduced alongside the progress being made in nuclear medicine. Our article provides a historic, current, and future perspective.

Superscan on 18F-FDG PET-CT imaging for lymphoma: How frequent is it?

This retrospective study was conducted to evaluate the frequency of PET superscan in baseline staging scans of lymphoma patients.The study was conducted at the Shaukat Khanum Memorial Cancer Hospital, Lahore, from October 1, 2018 to August 31, 2019. A retrospective review of baseline PET-CT scans of 203 lymphoma patients, performed during the period of October 1, 2017 to August31,2018, was done from the institutional database. Out of these 203 patients, PET superscan pattern was observed in 13 (6.4%) patients, 08 (61.5%) males and 05 (38.5%) females. Eight (61.5%) patients had Non-Hodgkin's lymphoma, while 05 (38.5%)had Hodgkin's lymphoma. Based on TNM staging 10 (76.9%) patients had stage IV disease, 01 (07.6%) had stage III disease, and 2 (15.4%) had stage II disease. PET-CT superscan pattern is uncommon and is not dependent on the stage of the disease. It should be recognised in clinical practice as it suggests a poor prognosis.

Efficacy of Radioiodine Therapy in Patients With Primary Hyperthyroidism: An Institutional Review From Pakistan.

Background Radioactive iodine (RAI) is the treatment of choice for most patients with primary hyperthyroidism. The most common etiologies of hyperthyroidism are Graves' disease (GD), toxic adenoma (TA), and toxic multinodular goiter (TMNG). A single dose of RAI is usually sufficient to cure hyperthyroidism. The aim of this study was to assess the effectiveness of RAI therapy for patients diagnosed with primary hyperthyroidism. Methods and materials Patients diagnosed with hyperthyroidism who received RAI therapy between 2008 and 2018 were included in the study. The data was acquired from the hospital's electronic medical record system. Following the RAI treatment, a cure was defined as the development of euthyroidism or hypothyroidism after a single fixed-dose without antithyroid medication within one year of RAI therapy. In addition, a simple logistics regression model was used to identify the prognostic factors that may lead to better outcomes. Results A total of 112 patients diagnosed with hyperthyroidism with a mean age of 47 ± 14 were included in this study. The majority of the patients were female, 79 (70.5%). Within one year of RAI therapy, 84 (75%) patients achieved a cure that is either hypothyroid or euthyroid status. RAI dose was higher in responsive patients (18.50 ± 4.10 millicurie [mCi] versus 16.50 ± 4.10 mCi) than in non-responsive patients. The mean RAI doses were 16.05 ± 2.99 mCi in GD, 19.81 ± 4.40 mCi in TMNG, and 20.50 ± 3.30 mCi in TA, with a statistically significant p-value of 0.001. In the univariable logistic regression model, RAI dose was a significant prognostic factor of the responsive group (OR: 1.15, CI [1.01-1.31], p-value 0.03). Conclusion Our data presented that RAI therapy is effective for primary hyperthyroidism. We achieved remission with a single fixed-dose in the majority of patients. Most of our patients were cured within three months of RAI therapy. In addition, the RAI dose was higher in the responsive group as compared to the non-responsive group.

Neuroendocrine liver metastases - 'doughnut box sign' on SPECT/CT.

A 76 year old patient was referred for Indium111 Octreotide scan to look for primary tumour and extent of neuroendocrine metastases. Indium 111 Octreotide scan showed a liver packed with centrally necrotic metastases like doughnuts packed in a box. No primary lesion was identified in this scan.

Accentuated 123ImIBG uptake by the left lobe of the liver - A clue to nowhere.

A 57-year-old male was imaged with 123I mIBG for left sided suprarenal mass. The planar and SPECT-CT acquisitions revealed features consistent with a left sided pheochromocytoma. There was physiological and high uptake in the hypertrophied left lobe of the liver which was normal at both MRI and non-contrast CT. Asymmetrical increased 123I mIBG uptake in the left lobe of the liver as compared to the right lobe is a known physiological finding with no obvious cause or significance.

Lymphoma involving the brain and adrenals: A chicken and egg situation.

Primary cerebellar diffuse large B-cell lymphoma (DLBCL) is a rare entity, which manifests with neurological symptoms. It is aggressive in nature with high rate of recurrence and short survival period. It commonly presents with local invasion and rarely spreads outside the central nervous system. Chemotherapy with radiation is the preferred treatment; however, surgery can be done for solitary lesions. Likewise, adrenal lymphoma as primary site of disease is rare but can present as extra-nodal disease. We present an unusual case of cerebellar DLBCL with bilateral adrenal involvement detected incidentally on 18-Fluorodeoxyglucose positron emission tomography (18F FDG PET-CT) scan.

Transfer of metal element in soil plant chicken food chain: health risk assessment.

This investigation was done for the assurance of potassium amassing in four assortments of maize (grains, shoot and root), soil, and water and in seven tissues of chickens (kidney, liver, heart, bone, gizzard, breast meat). The analysis of variance showed significant differences for potassium concentration in water in all sources of water; however, the season and variety significantly influenced the quantity of potassium in cereals. The corn varieties MMRI, Sadaf, and Pearl behaved differently when treated with water from various sources. Water taken from sewage had a higher concentration of potassium compared to canal and groundwater that is why the maize plants irrigated with this water had a higher grouping. Data regarding potassium concentration in different body parts of chicken showed that season and treatment have a significant effect on the potassium concentration in chicken organs. The variety was non-significant for the potassium concentration only in the bone. Season × Variety interaction was only significant in blood, meat heart, and gizzard. Season × Treatment and Variety × Treatment interactions were significant in the heart, kidney, and gizzard. The potassium contents were higher in the chicken body parts that were reared on grains irrigated with sewage water as compared to other groups. The potassium contents were higher in the chicken meat (96.23 ± 0.00) reared on grains of the Pearl variety raised with the sewage water. In a nutshell, the irrigation of grains with sewage water led to accumulation of nutrients greater than those irrigated with ground or canal water.

Appraisal of iron accumulation in soil, forages, and blood plasma of sheep and goats: a case study in different districts of Punjab, Pakistan.

Minerals are essential for ruminants affecting significantly the production of grazing livestock. Iron level in forages, soil, and blood plasma of the small ruminants (goat and sheep) was investigated in three districts of Punjab. Atomic absorption spectrophotometer was used to determine the concentration of iron in collected samples. The results revealed that the mean Fe concentrations in soil of districts Sargodha, Mianwali, and Bhakhar were significantly varied and ranged from 21.85 to 23.78, 28.45 to 31.2, and 18.079 to 24.33 mg/kg, respectively. The Fe level in soil of Mianwali significantly varied and was higher than Sargodha and Bhakkar. The mean Fe concentration in forages which were used for feeding purpose were significantly varied and found between 10.95-14.49, 23.63-25.65, and 6.616-9.45 mg/kg for Sargodha, Mianwali, and Bhakhar, respectively. The mean Fe concentrations in blood plasma of goat which consumed the contaminated forages were 8.5026-11.763 mg/L in district Sargodha, 19.77-20.19 mg/L in Mianwali, and 5.508-5.858mg/L in Bhakkar. In blood plasma of sheep, the residual levels of Fe in districts Sargodha, Mianwali, and Bhakhar were ranged from 9.987 to 12.455, 15.8 to 19.785, and 3.425 to 6.383 mg/L, respectively. This study provides the data of metals effected by different sites and also their mobility from low to higher trophic level which enables us to study the iron toxicity in different trophic levels, and we recommend different safe limits and treatment in case of low and high metal profile.

Monitoring of copper accumulation in water, soil, forage, and cows impacted by heavy automobiles in Sargodha, Pakistan.

The instant endeavor was undertaken to monitor copper (Cu) contents in water, soil, forage, and cow's blood impacted by heavy automobiles in Sahiwal town of district Sargodha, Pakistan. The samples were collected in triplicates with a total of 120 soil and water samples with corresponding forage samples. For the analysis of metal concentration in cows, 60 blood samples were collected from the cows feeding on these forages on selected sites. Metal contents were analyzed by atomic absorption spectrophotometry. The results showed that water samples contained mean values of Cu concentration ranged from 1.01 to 0.444 mg/kg at all sites. It was maximum at site 3 and minimum at site 6. The soil samples of all the forage fields showed Cu mean values concentration ranged from 1.94 to 0.286 mg/kg at all sites. It was maximum in Trifolium alexandrinum grown field at site 2, and minimum in Avena sativa at site 2. All the forage samples showed the mean value of Cu concentration ranged from 0.151 to 1.86 mg/kg at all sites. The concentration of Cu was maximum in Zea mays grown at site 5 and minimum in Trifolium alexandrinum at site 4. The cow blood samples showed the mean concentration of Cu ranged from 1.368 to 0.53 mg/kg at all sites. It was maximum at site 2 and minimum at site 6. Owing to the results of pollution index and transfer factors, metal content was found to be in permissible range in forages as well as animal samples.

Complete splenic vein tumour thrombus in primary gastric malignancy on F18-fluorodeoxyglucose positron emission tomography-computed tomography.

Tumour thrombus is an uncommon complication with ominous outcomes. F18 FDG PET-CT scan helps in differentiating tumour thrombus from venous thrombus owing to its metabolic uptake similar to the tumour. We discuss an interesting case of gastric malignancy with complete splenic vein tumour thrombosis on initial presentation.

Evaluation of toxicity potential of cobalt in wheat irrigated with wastewater: health risk implications for public.

The use of wastewater in irrigation weakens the beneficial properties of the soil and leads to a threat to food safety standards. The present research was designed to explore the cobalt toxicity associated with the ingestion of wastewater irrigated wheat. Wheat plants of five different varieties were collected from 7 different sites of Punjab, Pakistan, which were irrigated with three different sources of water. The sampling was done in two cropping years. The cobalt values in water, soil and wheat samples (root, shoot, grain) ranged from 0.46 to 1.24 mg/l, 0.15 to 1.20, 0.29 to 1.30, 0.08 to 0.76 and 0.12 to 0.57 mg/kg, respectively. All the water samples showed high cobalt concentration than the maximum permissible value. However, all the soil and wheat plant samples were found within the maximum allowable range. The high cobalt concentration in irrigating water showed that the continuous usage of such type of water may lead to cobalt toxicity in living organisms with the passage of time and may results in severe health risks.

Bioaccumulation of cadmium in different genotypes of wheat crops irrigated with different sources of water in agricultural regions.

The study was carried out to evaluate the health risks associated with accumulation of cadmium in the different genotypes of wheat, grown in agricultural regions of Punjab, Pakistan. Five genotypes irrigated with three varied water sources were selected randomly from each region. Among all sources of water, types of soil, and grain samples, the cadmium (Cd) quantities were found (2.24-2.82 mg/L, 1.75-4.16 mg/kg, 0.86-1.90, respectively), exceeding the maximum permissible limits (0.01 mg/L, 1.1 mg/kg, 0.2 mg/kg, respectively) described by FAO/WHO. The pollution load index (PLI) exhibited by all of the samples was higher than 1.00, the permissible limit; however, other factors including bioaccumulation, translocation, bio-concentration, daily intake, and enrichment values of Cd were less than 1.00. Moreover, the health risk index for cadmium in all types of wheat grain samples was less than 1.00. The study concluded that the continuous use of wastewater resources may lead to the accumulation of cadmium in the vital body organs that may cause severe health hazards.

Effects of organic and chemical fertilizers on the growth, heavy metal/metalloid accumulation, and human health risk of wheat (Triticum aestivum L.).

The aim of this study was to determine and compare the effect of the chemical fertilizer and organic fertilizers such as cow manure and poultry manure applications on the heavy metal/metalloid accumulation in the wheat samples. A field experiment was conducted using a complete randomized block design with three replicates per treatment to observe the impact of organic and chemical fertilizers on the heavy metal/metalloid accumulation in a wheat variety (Lasani-08). Heavy metal/metalloid concentrations in the root, shoot, and grains of wheat samples were determined using an atomic absorption spectrophotometer (AAS). In addition, the growth parameters of wheat samples were assigned. Results indicated that morphological parameters showed maximum growth under chemical fertilizer treatment. The heavy metal/metalloid concentrations in the wheat grains ranged from 12.95 to 25.83, 1.03 to 1.11, 16.83 to 20.26, 0.92 to 0.98, 0.504 to 1.997, 2.24 to 5.98, and 0.493 to 1.154 mg/kg for Zn, Co, Fe, Cd, Pb, Cu, and Cr, respectively. All heavy metal/metalloid values in the present study were within the safe limits reported by the FAO/WHO except for Pb. However, the health risk index determined for all metals are higher in the wheat grown with chemical fertilizer applications, but it has been shown that the consumption of wheat grown with organic and chemical applications is not hazardous for health.