Acne Vulgaris and Metabolic Syndrome: A Possible Association.

Introduction Acne vulgaris is an androgen-dependent disorder with excessive sebum production and proliferation of Propionibacterium acnes. Metabolic syndrome (MetS) is a multisystem disorder that increases the risk of diabetes mellitus, stroke, and cardiovascular diseases. ​This study aims to analyze the association of MetS with acne vulgaris. Methods A cross-sectional study was conducted with 65 cases of acne vulgaris and 65 age and sex-matched controls. We used the system provided by the Indian authors for grading acne according to the clinical severity. In addition, the criteria updated according to the joint consensus of 2009 were employed for the diagnosis of MetS. Results On clinical examination, grade 2 was the most prevalent grade of acne. We observed an increased incidence of abnormal waist circumference, triglyceride, HDL, and fasting blood glucose among the cases (p<0.05). Consequently, an increased occurrence of MetS was observed in the case group (p=0.011). While comparing the mean values of the parameters, we noted a significant difference in terms of waist circumference and HDL values. An increased mean value of waist circumference was noted in the case group while an increased mean value of HDL was reported from the control group (p<0.05).  Conclusion Patients with acne vulgaris have a greater chance of developing MetS. Hence, an in-depth examination of clinical, anthropometric, and biochemical parameters that may lead to the development of MetS is necessary.

High resolution T2∗ mapping in assessment of knee articular cartilage on 3T MRI.

OBJECTIVE: To evaluate the spectrum of T2∗ values in healthy cartilage of young asymptomatic adults on high resolution 3T MRI. METHODS: A total of 50 asymptomatic adult volunteers with age ranging from 18 to 35 years were enrolled for the study with the purpose of assessing T2∗ values in healthy cartilage without any degenerative changes. The articular cartilage was assessed on two sections, one each through the medial and lateral compartments. The cartilage was segmented into 8 regions through the tibio-femoral and patella-femoral joints. Further post processing was done using multiple ROI placement to delineate ROI areas for calculation of full thickness and zonal (superficial and deep) T2∗ values. Thus, a total of 1200 ROI areas (50 volunteers, 8 segments, and 3 areas for each segment) were assessed. RESULTS: The results revealed a superior bulk T2∗ value of 29.2 ± 3.6 ms from the posterior medial femoral cartilage and 26.1 ± 3.1 ms from the patellar region. Intermediate values were obtained from posterior lateral femoral cartilage, central femoral cartilage, and trochlea. The tibial plateau cartilage had the lowest values - 19.6 ± 2.6 ms for the medial tibial plateau and 20.6 ± 2.8 ms for lateral tibial plateau. The study demonstrated substantial regional physiological variation existing in the T2∗ values across various regions of the knee joint, which could be attributed to varying amounts of shearing forces across the joint. No significant differences were noted in bulk T2∗ values between the two genders, with only the trochlear segment revealing significantly increased values in males (p = 0.007). All the cartilage segments revealed significantly increased T2∗ values in the superficial zone as compared to the deep zone. CONCLUSION: There is a significant regional difference in the bulk T2∗ values of articular cartilage in a normal physiological state across various joint segments. A zonal gradient with increasing values from the deep to the superficial zone also exists. These findings can prove invaluable in assessing changes in T2∗ values occurring in diseased/degenerative cartilage.

Role of Magnetic Resonance Imaging in the Evaluation of Rotator Cuff Tears.

Background Magnetic resonance imaging (MRI), with the advent of surface coils, is becoming the modality of choice for imaging soft tissues around the shoulder joint. Good knowledge regarding the MR characteristics of rotator cuff tendons, acromion, and the abnormalities in these tendons is necessary for appropriate diagnosis. Methods This was a hospital-based descriptive, analytical and prospective study conducted at our tertiary care hospital. The study was performed on 50 patients with rotator cuff lesions detected on MRI of the shoulder joint. Results The age distribution found in the study is between 19 and 66 years with mean being 43 ± 14.8 years. The peak incidence was found in the fifth and sixth decades of life. Gender-wise distribution of rotator cuff pathologies has shown no significant gender variation. The pain was the most common presenting complaint. An abnormal supraspinatus tendon was seen in 82% of the 50 study patients, making it the most commonly affected tendons, followed by subscapularis and infraspinatus tendons. No apparent teres minor pathology was identified in the study patients. The most common pathology affecting the supraspinatus tendon was tendinosis (38%) closely followed by a partial tear (36%). Among the partial tears, the articular surface type of tear was the most common. About 52% patients had type II (curved) acromion; making it the most common type of acromion followed by type III (hook), supraspinatus tendinopathy was more common in type II acromion. A reduction in the acromiohumeral distance can cause supraspinatus tendinosis and also makes it more susceptible to tear. About 45.5% showed supraspinatus tendon tears when the acromiohumeral distance was less than 8mm as compared to 13.6% when more than 10mm. Only 4.2% had normal supraspinatus tendon in patients with this distance less than 7mm. Conclusion MRI provides valuable information to the orthopaedic surgeon regarding the status of tendons, bones, and joints. In order to choose the appropriate course of action, it is crucial first to identify the issue and report relevant data from rotator cuff imaging. A full grasp of the rotator cuff's architecture and function, as well as the repercussions of rotator cuff diseases, is required.

Case of Orbital Cysticercosis Presenting as Recurrent Cellulitis Diagnosed on Multi-Modality Imaging.

Cysticercosis results in humans when infected with the larval stage of taenia solium which is called cysticercus cellulosae. The target organs usually involved are the brain, eyes, spine, and skeletal muscles. The ocular form of cysticercosis can affect the intra-ocular structures or involve the orbital adnexa. Intraocular involvement is relatively common and is readily diagnosed owing to its obvious visibility on a basic slit-lamp examination, however, affection of orbital adnexa is infrequent. Moreover, solitary involvement of one of the extraocular muscles is rare and difficult to diagnose as it presents with a spectrum of non-specific symptoms. We report a rare case of orbital cysticercosis with a solitary left superior rectus muscle involvement, who presented with recurrent on and off lid swelling extending for two years with double vision and restriction of downward gaze.