Inflammatory response of nanoparticles: Mechanisms, Consequences, and Strategies for Mitigation.

Numerous nano-dimensioned materials have been generated as a result of several advancements in nanoscale science such as metallic nanoparticles (mNPs) which have aided in the advancement of related research. As a result, several significant nanoscale materials are being produced commercially. It is expected that in the future, products that are nanoscale, like mNPs, will be useful in daily life. Despite its benefits, the widespread use of metallic nanoparticles and nanotechnology has negative effects and puts human health at risk because of their continual accumulation in closed biological systems, along with their complex and diverse migratory and transformation pathways. Once within the human body, nanoparticles (NPs) disrupt the body's natural biological processes and trigger inflammatory responses. These NPs can also affect the immune system by activating separate pathways that either function independently or interact with one another. Cytotoxic effects, inflammatory response, genetic material damage, and mitochondrial dysfunction are among the consequences of mNPs. Oxidative stress and reactive oxygen species (ROS) generation caused by mNPs depends upon a multitude of factors that allow NPs to get inside cells and interact with biological macromolecules and cell organelles. This review focuses on how mNPs cause inflammation and oxidative stress, as well as the disrupt cellular signaling pathways that support these effects. In addition, possibilities and problems to be reduced are addressed to improve future research on the creation of safer and more environmentally friendly metal-based nanoparticles for commercial acceptance and sustainable use in medicine and drug delivery.

Gamified Exercise with Kinect: Can Kinect-Based Virtual Reality Training Improve Physical Performance and Quality of Life in Postmenopausal Women with Osteopenia? A Randomized Controlled Trial.

BACKGROUND: Osteopenia, caused by estrogen deficiency in postmenopausal women (PMW), lowers Bone Mineral Density (BMD) and increases bone fragility. It affects about half of older women's social and physical health. PMW experience pain and disability, impacting their health-related Quality of Life (QoL) and function. This study aimed to determine the effects of Kinect-based Virtual Reality Training (VRT) on physical performance and QoL in PMW with osteopenia. METHODOLOGY: The study was a prospective, two-arm, parallel-design, randomized controlled trial. Fifty-two participants were recruited in the trial, with 26 randomly assigned to each group. The experimental group received Kinect-based VRT thrice a week for 24 weeks, each lasting 45 min. Both groups were directed to participate in a 30-min walk outside every day. Physical performance was measured by the Time Up and Go Test (TUG), Functional Reach Test (FRT), Five Times Sit to Stand Test (FTSST), Modified Sit and Reach Test (MSRT), Dynamic Hand Grip Strength (DHGS), Non-Dynamic Hand Grip Strength (NDHGS), BORG Score and Dyspnea Index. Escala de Calidad de vida Osteoporosis (ECOS-16) questionnaire measured QoL. Both physical performance and QoL measures were assessed at baseline, after 12 weeks, and after 24 weeks. Data were analyzed on SPSS 25. RESULTS: The mean age of the PMW participants was 58.00 ± 5.52 years. In within-group comparison, all outcome variables (TUG, FRT, FTSST, MSRT, DHGS, NDHGS, BORG Score, Dyspnea, and ECOS-16) showed significant improvements (p < 0.001) from baseline at both the 12th and 24th weeks and between baseline and the 24th week in the experimental group. In the control group, all outcome variables except FRT (12th week to 24th week) showed statistically significant improvements (p < 0.001) from baseline at both the 12th and 24th weeks and between baseline and the 24th week. In between-group comparison, the experimental group demonstrated more significant improvements in most outcome variables at all points than the control group (p < 0.001), indicating the positive additional effects of Kinect-based VRT. CONCLUSION: The study concludes that physical performance and QoL measures were improved in both the experimental and control groups. However, in the group comparison, these variables showed better results in the experimental group. Thus, Kinect-based VRT is an alternative and feasible intervention to improve physical performance and QoL in PMW with osteopenia. This novel approach may be widely applicable in upcoming studies, considering the increasing interest in virtual reality-based therapy for rehabilitation.

Urdu translation, cross-cultural validation and reliability of ECOS-16 questionnaire among post-menopausal women with osteopenia.

BACKGROUND: Escala de Calidad de vida Osteoporosis (ECOS-16) was originally developed in Spanish to evaluate the quality of life (QoL) in post-menopausal women (PMW) with osteoporosis or osteopenia based on the osteoporosis-specific QoL instruments. ECOS-16 has been translated into several languages, but the Urdu version is not yet available. OBJECTIVE: To translate the ECOS-16 Questionnaire into Urdu and determine its validity and reliability in PMW with osteopenia. METHODS: This was a linguistic validity and reliability study. ECOS-16 was translated into Urdu using Beaton's guidelines. Content validity was examined using Waltz's four-point ordinal scale. Twenty osteopenia-afflicted PMW aged 48-70 underwent pilot testing for face validity. Discriminant validity was determined by an independent T-test between PMW women with and without osteopenia. Convergent validity was assessed using Spearman's correlation coefficient. Cronbach's alpha and Intraclass correlation coefficient (ICC2,1) assessed internal consistency and test-retest reliability. The factor analysis was used to describe the factors. RESULTS: Each question's content validity ratio (CVR) was 0.83-1.00, while the scale's S-CVR was 0.96. Each question's Likert scale content validity index (CVI) was 0.91-0.93, while the scale's S-CVI was 0.91. Significant discriminant validity was found between groups in weeks I and II (p-value < 0.001). A correlation coefficient of 0.89 and 0.96 (p-value < 0.001) between Urdu ECOS-16 total score and SF-36 and EQ-5D scores suggests convergent validity. One component explained 83.86% of Urdu ECOS-16's variance in factor analysis. Excellent test-retest reliability (ICC2,1 = 0.990, 95% CI, 0.985-0.994, p-value < 0.001). Cronbach's alpha for standardized items was 0.995. CONCLUSION: ECOS-16 translated in Urdu is a valid and reliable questionnaire to assess QoL in PMW with osteopenia. It has a simple and easy language that can be understood easily by the Urdu-speaking population.

Effects of kinect-based virtual reality training on bone mineral density and fracture risk in postmenopausal women with osteopenia: a randomized controlled trial.

Osteopenia is a condition characterized by low bone mineral density (BMD) that increases fracture risk, particularly among postmenopausal women (PMW). This study aimed to determine the effects of Kinect-based VRT on BMD and fracture risk in PMW with osteopenia. The study was a prospective, two-arm, parallel-design, randomized controlled trial. The study enrolled 52 participants, 26 randomly assigned to each group. In the experimental group, Kinect-based VRT was provided thrice weekly for 24 weeks for 45 min/session. Both groups were instructed to engage in a daily 30-min walk outdoors. The fracture risk assessment tool (FRAX) was used to calculate fracture risk, and dual-energy X-ray absorptiometry was used to measure lumbar spine and femur neck BMD. Both variables were assessed at baseline and 24 weeks afterwards. After 24 weeks of Kinect-based VRT, the experimental group showed significant BMD increases in the right and left femoral necks and lumbar spine (p value < 0.001). In the control group, the BMD at the right and left femoral necks showed fewer significant changes (p value < 0.022 and 0.004, respectively). In the control group, lumbar spine BMD did not change (p = 0.57). The experimental group showed significantly lower FRAX scores for hip fracture prediction (HFP) and hip prediction of major osteoporotic (HPMO) at both femoral necks (p value < 0.001) than the control group (p = 0.05 and p = 0.01, respectively), but no significant change at the left femoral neck for HFP (p = 0.66) or HPMO (p = 0.26). These findings indicate that a Kinect-based VRT intervention resulted in significantly increased BMD and a reduced fracture risk, as predicted by HFP and HPMO measurements. These improvements were more pronounced in the experimental group than in the control group. Thus, Kinect-based VRT may be utilized as an effective intervention to improve BMD and reduce fracture risk in postmenopausal women with osteopenia.

Pattern of Bone Marrow Hypometabolism on 18 F-FDG PET CT in Systemic Lupus Erythematous-Associated Aplastic Anemia.

ABSTRACT: We present the case of a 23-year-old woman with juvenile onset systemic lupus erythematous on a background of thrombotic thrombocytopenic purpura, who was referred for 18 F-FDG PET CT scan due to pyrexia of unknown origin with raised inflammatory markers, severe thrombocytopenia, and anemia. An interesting pattern of predominantly photopenic hypometabolic bone marrow activity was demonstrated on 18 F-FDG PET CT.

Factors Leading to Diagnostic and Therapeutic Delay of Rheumatoid Arthritis and Their Impact on Disease Outcome.

Objective To identify the factors which lead to delay in diagnosis and initiation of disease-modifying anti-rheumatic drugs (DMARDs) in rheumatoid arthritis (RA) patients and their impact on disease outcome and functional ability. Methodology This cross-sectional study was conducted from June 2021 to May 2022 at the Department of Rheumatology and Immunology, Sheikh Zayed Hospital, Lahore. Inclusion criteria were patients aged >18 years who were diagnosed with RA, based on American College of Rheumatology (ACR) criteria 2010. Delay was defined as any sort of delay which leads to delay in diagnosis or initiation of treatment of more than three months. The factors and impact on disease outcome were measured by using Disease Activity Score-28 (DAS-28) for disease activity and Health Assessment Questionnaire-Disability Index (HAQ-DI) for functional disability. The collected data were analyzed with Statistical Package for Social Sciences (SPSS) version 24 (IBM Corp., Armonk, NY, USA). Results One hundred and twenty patients were included in the study. Mean delay in referral to a rheumatologist was 36.75±61.07 weeks. Fifty-eight (48.3%) patients with RA were misdiagnosed before presentation to a rheumatologist. Sixty-six (55%) patients had the perception that RA is a non-treatable disease. Delay in diagnosis of RA from onset of symptoms (lag 3) and delay in start of DMARDs from onset of symptoms (lag 4) were significantly associated with increased DAS-28 and HAQ-DI scores (p-value 0.001). Conclusion The factors which led to diagnostic and therapeutic delay were delayed consultation with a rheumatologist, old age, low education status and low socioeconomic status. Rheumatoid factor (RF) and anti-cyclic citrullinated peptide (anti-CCP) antibodies had no role in diagnostic and therapeutic delay. Many RA patients were misdiagnosed with gouty arthritis and undifferentiated arthritis before consulting a rheumatologist. This diagnostic and therapeutic delay compromises RA management leading to high DAS-28 and HAQ-DI in RA patients.

68 Ga-PSMA-Avid Intranasal Solitary Fibrous Tumor.

ABSTRACT: The utility of molecular imaging in solitary fibrous tumors has not been fully established. We present a rare case of recurrent intranasal solitary fibrous tumor incidentally localized on 68 Ga-PSMA PET/CT scan, which turned out to be metabolically inactive on 18 F-FDG PET/CT.

Correlation of Hypothyroidism With Disease Activity Score-28 in Patients of Rheumatoid Arthritis.

Introduction Rheumatoid arthritis (RA) is a chronic autoimmune disorder with variable disease course including periods of flares and remissions. High disease activity in terms of disease activity score-28 (DAS-28) results in significant morbidity. Hypothyroidism is found to be associated with higher DAS-28 scores in RA. This study is planned to determine overt and subclinical hypothyroidism and its correlation with the DAS-28 score in patients with RA. Methodology This study was conducted from June 2021 to March 2022 at the department of rheumatology and immunology at Shaikh Zayed Hospital, Lahore, Pakistan. Inclusion criteria were any male and female patients aged between 18 and 70 years. The blood samples of diagnosed patients with RA were sent for thyroid function tests (thyroxine [FT4], thyroid-stimulating hormone [TSH]), and erythrocyte sedimentation rate (ESR), and the patients were categorized as overt hypothyroidism, subclinical hypothyroidism, and non-hypothyroid. The collected data were analyzed on Statistical Package for the Social Sciences (SPSS) version 24.0 (IBM Corp., Armonk, NY). Results The mean age of patients was 38.18 ± 9.78 years. The mean duration of symptoms was 14.65 ± 1.04 months. There were 182 (91%) females and 18 (9%) males. The mean number of swollen joints was 2.26 ± 2.8, and the mean number of tender joints was 4.16 ± 5.11. Sixty patients (30%) had high disease activity, i.e., DAS-28 score > 5.1. Fifty-seven patients (28.5%) with RA had subclinical hypothyroidism, and 19 patients (9.5%) had overt hypothyroidism. Pain visual analog scale (VAS) and DAS-28 were significantly higher in hypothyroid patients. Conclusion It was concluded that patients of RA with concomitant hypothyroidism had increased disease activity with increased tender joints. Thyroid function tests should be included in the clinical evaluation of RA patients. The evaluation of thyroid functional status must be done during screening in RA patients. This will detect thyroid disorders earlier, with early treatment initiation and possibly a better prognosis.

Alleviation of cadmium toxicity in Zea mays L. through up-regulation of growth, antioxidant defense system and organic osmolytes under calcium supplementation.

Calcium (Ca) is a macronutrient and works as a modulator to mitigate oxidative stress induced by heavy metals. In this study, we investigated the role of Ca to ameliorate the Cd toxicity in Zea mays L. by modulating the growth, physio-biochemical traits, and cellular antioxidant defense system. Maize genotype Sahiwal-2002 was grown under a controlled glasshouse environment with a day/night temperature of 24 ± 4°C/14 ± 2°C in a complete randomized design with three replications and two Cd levels as (0 and 150 µM) and six regimes of Ca (0, 0.5, 1, 2.5, 5, and 10 mM). Maize seedlings exposed to Cd at 150 µM concentration showed a notable decrease in growth, biomass, anthocyanins, chlorophylls, and antioxidant enzymes activities. A higher level of Cd (150 µM) also caused an upsurge in oxidative damage observed as higher electrolyte leakage (increased membrane permeability), H2O2 production, and MDA accumulation. Supplementation of Ca notably improved growth traits, photosynthetic pigments, cellular antioxidants (APX, POD, and ascorbic acid), anthocyanins, and levels of osmolytes. The significant improvement in the osmolytes (proteins and amino acids), and enzymatic antioxidative defense system enhanced the membrane stability and mitigated the damaging effects of Cd. The present results concluded that exogenously applied Ca potentially improve growth by regulating antioxidants and enabling maize plants to withstand the Cd toxicity.

Extraction and Optimization of Active Metabolites From Cluster Bean: An In Vitro Biological and Phytochemical Investigation.

The current study aimed to explore active metabolites of locally recognized and high yielding cultivar cluster bean (BR-99) with a wide range of adaptability having antioxidant, antidiabetic, antimicrobial, and cytotoxic potential. Six solvents were used (crude methanol, n-hexane, chloroform, ethyl acetate, butanol, and aqueous) with escalating polarity for colorimetric determination of antioxidants such as total phenolic contents (TPC), total flavonoid contents (TFC), and free radical scavenging activity (FRSA) by DPPH (2, 2-diphenyl-1-picrylhydrazyl) assay. Moreover, an antidiabetic and anticancer study was conducted by α-amylase inhibition and MTT (3-(4, 5-dimethyl-2-thiazolyl)-2, 5-diphenyl-tetrazolium bromide) assay. Biological investigations were carried out against the most commonly found infectious microbial strains. The significant results (P ≤ .001) of each activity were seen among six tested solvent extracts. The ethyl acetate and methanol extract have more antioxidant potential with the highest TPC (16.38 ± .13 mg GAE/g) and TFC (8.15 ± .24 mg CE/g), respectively. Similarly, methanol extract presented the highest free radical scavenging activity (46.31 ± .91%), followed by ethyl acetate, butanol, chloroform, aqueous, and n-hexane extract. However, the maximum α-amylase inhibition (62.54 ± 1.47%) and anticancer activity against human lung cancer cells were congregated (78.31 ± 1.46%) in butanol and chloroform, respectively. A positive correlation was seen between TPC with TFC (R 2= .8356), FRSA (R 2= .8381), and anti-diabetic activity (R 2= .8082), which highlights the phenolic contents as strong anti-oxidant agents especially flavonoids. Each extract of cluster bean (BR-99) showed significant antimicrobial activities for all tested bacterial strains except B. cereus and E. coli. The profound results of maximum antibacterial activity were witnessed by chloroform extract while ethyl acetate extracts showed great antifungal potential against all tested fungal strains. The HPLC quantitative analysis results of cluster bean (BR-99) revealed the presence of active phytochemicals such as gallic acid, HB acid, vanillic acid, kaempferol, sinapic acid, ferulic acid, salicylic acid, coumarins, quercetin, rutin, p-coumaric acid, and catechin, and the variation in both phytochemical and biological spectrums envisioned the cluster bean (BR-99) used in future as a cheap, safer, and potent source of bioactive drugs.

Choline Chloride Mediates Salinity Tolerance in Cluster Bean (Cyamopsis tetragonoloba L.) by Improving Growth, Oxidative Defense, and Secondary Metabolism.

Choline chloride (CC) application enhanced the tolerance of cluster bean (Cyamopsis tetragonoloba L.) against salinity stress. The aim of the study was to determine the protective role of CC on plant growth, photosynthesis, and biochemical indicators of oxidative stress. The seeds of BR-99 (tolerant) and BR-2017 (sensitive) were surface sterilized and sown in plastic pots containing river sandy soil. The design of the experiments was completely randomized with 4 replicates per treatment. Three weeks after germination, salinity (150 mM) was imposed. Then plants were sprayed with different concentrations of CC (3, 5, and 10 mM), while normal plants were sprayed with distilled water. Salinity decreased growth attributes, relative water contents, photosynthetic attributes, total soluble proteins, total free amino acids, phenolic, flavonoids, ascorbic acid, proline, and glycine betaine and increased the levels of oxidative stress indicators. However, the application of CC (particularly 5 mM) improved growth attributes, photosynthetic pigments, and activities of antioxidant compounds by reducing the levels of H2O2, malondialdehyde in salt-stressed plants in both cluster bean varieties. BR-99 variety showed more tolerance to salinity stress than that of BR-2017 in the form of greater oxidative defense and osmotic adjustment and clear from greater plant dry masses. Thus, our results showed that the application of CC (5 mM) is an efficient strategy for field use in the areas, where salt stress soils limit agriculture production.

Computational study of therapeutic potential of phosphorene as a nano-carrier for drug delivery of nebivolol for the prohibition of cardiovascular diseases: a DFT study.

Density functional theory (DFT) calculations were utilized to assess the drug delivery efficiency of phosphorene carrier for nebivolol drug to treat cardiovascular diseases. The optimized structures, excited state, and electronic properties of nebivolol, phosphorene, and nebivolol-phosphorene (nebivolol-PH) complex were considered to determine the drug delivery ability of phosphorene at the target site. The increased dipole moment (6.08 D) results in the higher solubility of the complex in polar solvents (water). Weak interactive forces between nebivolol and phosphorene were demonstrated by the non-covalent interaction (NCI) plot that facilitated the offloading of nebivolol at the targeted area. The analysis of frontier molecular orbitals (FMOs) revealed that during excitation, the charge was transferred from nebivolol as a higher occupied molecular orbital (HOMO) to phosphorene as a lower unoccupied molecular orbital (LUMO). Thus, the charge-transfer process was further studied by charge decomposition analysis (CDA). The calculated results at the excited state for the nebivolol-PH complex exhibited that the maximum wavelength (λmax) was red-shifted by 6 nm in the gas phase. The electron-hole theory and photoinduced electron transfer (PET) processes were carried out for the exploration of different excited states of the complex. Additionally, phosphorene with + 1 and - 1 charge states indicated the minor structural changes and provide the stable nebivolol-PH complex. This theoretical study also investigated that phosphorene can be exploited as an effective carrier for the delivery of a therapeutic agent as nebivolol to treat cardiovascular diseases. This work will also encourage the researchers to investigate the other 2D nanoparticles as a nano-drug delivery system (NDDS).

Effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy.

OBJECTIVES: To determine the effectiveness of mechanical traction in supine versus prone lying position for lumbosacral radiculopathy. METHODS: A quasi experimental trial was conducted from April to September 2020 among sixty patients of chronic lumbosacral radiculopathy at Ibn e Siena Hospital, Multan. Participants were divided into two groups. Group-A (Supine) participants received lumbar traction in supine lying along with conventional treatment. Group-B (Prone) underwent the same treatment except the lumbar traction being applied in prone lying position. Participants were evaluated twice: at pre- treatment (week 0) and at the post treatment (week 2). Oswestry Disability Index and Numeric Pain Rating Scale were used as outcome measure. Data was analyzed on SPSS 23. RESULTS: The mean (±S.D) age of the patients was 39±5.7 vs. 40±5.3 years in supine vs. prone group respectively. Mean ODI score was 25.2±6.13 vs. 26.0±6.26 at the start of treatment in supine vs. prone position respectively while it was 19.45±7.12 vs. 11.05±4.40 at end of treatment in supine vs. prone position respectively. Mean NPRS score was 7.73±1.23 vs. 7.67±0.96 at start of treatment in supine vs. prone position respectively while it was 4.63±0.89 vs. 3.13±0.90 at the end of treatment in supine vs. prone position respectively. CONCLUSION: Lumbar traction in prone lying position is more effective than lumbar traction in supine lying position for the treatment of chronic lumbosacral radiculopathy.

Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan.

OBJECTIVES: To determine the Prevalence and associated risk factors among patients with overactive bladder syndrome in Pakistan. METHODS: This was a community-based, face to face, cross sectional survey to calculate the prevalence and its associated risk factors. A sample of 1058 patients, women and men aged between 35 to 60 years having symptoms of overactive bladder was selected through convenience sampling from different cities of Pakistan during September to December 2020. Data was collected by using an Overactive Bladder Scoring System (OABSS) tool for prevalence and a developed questionnaire to rule out the risk factors. RESULTS: The prevalence was 27.4% (n=289) and it increased with age. The average ages for women and men were 44.60±7.88 and 46.14±7.69 years respectively. The OAB prevalence was the lowest among the participants aged 35-43 years 15.2% (n=55) while it was highest among those who were aged 53-60 years 49.6%, (n=127). The age, body mass index, diabetes mellitus, income, family history, parity and urinary tract infection were found to be significant associated risk factors for overactive bladder with p value <0.05. CONCLUSION: The overall prevalence of overactive bladder was 27.4% and it does not differ by gender, hypertension, pelvic surgery, smoking, constipation and sleep while it has significant association with age, body mass index, diabetes mellitus, income, parity and urinary tract infections.

Predictive Relationship Of Narcissism And Psychopathy With Relational Aggression Moderated By Age Among Adolescents.

BACKGROUND: Relational aggression stresses on the application of one's link to interfere the someone else relationships. Narcissism is manifest by heavenliness, a feeling of being advantaged, and a nonappearance of compassion while psychopathy is a personality issue that is about reduced regret, debilitated sympathy, and critical reserved behaviours. Present study was designed to assess the predictive relationship of narcissism and psychopathy with relational aggression among adolescents moderated by age. METHODS: Cross-sectional correlational research design was implied. Study was conducted at department of Psychology University of Gujrat from August 10th 2017 to 5th January 2018. 612 students from diverse academic institute of Gujrat, with age range 12-19 year were selected. Urdu version of dark triad personality scale short version was used to assess narcissism and psychopathy while diverse adolescent relational aggression scale, Urdu version was used to gauge relational aggression. RESULTS: Multiple regression analysis was carried out to find out the combined effect of narcissism and psychopathy on relational aggression among adolescent students. Findings revealed significant predictive relation among the variables (p<0.01). Result further indicated that one unit in narcissism will increase the relational aggression by .333 unit (ß=.333) while on unit increase in psychopathy will increase the relational aggression by .374 unit (ß=.374). Furthermore, results support the moderating effect of age in the relation among narcissism, psychopathy and relational aggression (p<0.01). CONCLUSIONS: Narcissism and psychopathy have predictive relationship with relational aggression moreover age play moderating role in afore said association.

Clinical Features and Treatment Outcomes of Children with Anaplastic Large Cell Lymphoma.

OBJECTIVE: To describe clinical features and treatment options in pediatric patients with ALCL (Anaplastic large cell lymphoma) and their outcome over a span of 10 years. STUDY DESIGN: A retrospective-observational study. PLACE AND DURATION OF STUDY: Shaukat Khanum Memorial Cancer Hospital and Research Centre, Lahore, from January 2005 to December 2015. METHODOLOGY: Medical records of pediatric patients with anaplastic large cell lymphoma was retrospectively collected after IRB approval. Data was reviewed for patients confirmed on histopathology and age less than 20 years at the time of diagnosis to see clinical features and treatment outcomes. Descriptive statistics were applied. RESULTS: A total of 40 children, 27 males (67.5%) and 13 females (32.5%) with ALCL (CD30 +), were reviewed. B symptoms were present in 32 (80%) patients, nodal involvement in 39 (97.5%), and mediastinum involvement was present in 8 (20%) patients. Visceral (lung, liver, spleen) and cutaneous involvement was seen in 16 (40%) and 6 (15%) patients, respectively. ALK was positive in 19 patients (48%) and Bone marrow was involved in 3 patients (7.5%). Stage III was seen in 29 (72.5%). All patients were treated on ALCL 99 protocol. Five-year EFS (event-free survival) and OS (overall survival) was 30 and 60%, respectively. There were 7 relapses, 2 progressive disease, 16 death and 3 refusal for treatment. CONCLUSION: This analysis shows poor outcomes in pediatric ALCL. The most common cause of mortality was hematological toxicity and febrile neutropenia associated with it. Supportive care needs to be improved. Key Words: Clinical features, Outcomes, Anaplastic large cell lymphoma (ALCL), Children.

Before and After Treatment Characterization of Cerebrospinal Disease in Bing-Neel Syndrome Using 18F FDG PET/MRI.

Bing-Neel syndrome is a rare neurological complication of Waldenström macroglobulinemia. We present the case of a 71-year-old man who underwent prechemotherapy and postchemotherapy FDG PET/MRI scan for the evaluation of cerebrospinal disease. In light of limited literature and lack of consensus guidelines on the role of metabolic imaging, we aim to highlight the utility of FDG PET/MRI in the diagnosis and response assessment in Bing-Neel syndrome.

Towards more accurate 18F-fluorodeoxyglucose positron emission tomography (18F-FDG PET) imaging in active and latent tuberculosis.

Tuberculosis (TB) is one of the leading causes of death worldwide. Although the disease is curable and preventable, it is underdiagnosed in many parts of the world. Positron emission tomography (PET) imaging using 18 F-FDG in TB can localise disease sites and the extent of disease. 18F-FDG accumulates in the immune cells that participate in inflammation and granuloma formation, such as activated macrophages and lymphocytes. Therefore, FDG PET/CT scanning is now being evaluated for its usefulness in the diagnosis of extrapulmonary TB and in monitoring the response to treatment. FDG PET/CT imaging is positive and has high sensitivity in active TB, complementing conventional radiological imaging (X-ray, computed tomography, magnetic resonance imaging) in the diagnosis of primary pulmonary, extrapulmonary, and post-primary or miliary TB. FDG PET/CT has low specificity when it is used for solitary pulmonary nodule characterization, and its ability to differentiate TB from malignancy is limited in this setting. Dual point imaging has been proposed as a way to overcome this limitation. FDG PET/CT can reliably differentiate active from inactive disease, and there is promising evidence that it can contribute to the assessment of the response to treatment with an impact on patient management. FDG PET/CT has been found positive in cases of latent TB infection and its ability to identify activation early is currently being explored. More studies are needed to establish the utility of this method in recognizing multidrug-resistant TB cases. Furthermore, other PET radiotracers might prove useful in the functional imaging of TB infection in the future.