Imaging & neuropsychological changes in brain with spiritual practice: A pilot study.

BACKGROUND & OBJECTIVES: Some studies have systematically assessed the effects of spiritual practice (SP) on the brain using combined neuropsychological testing and functional imaging. The objective of the present study was to compare imaging and neuropsychological changes in healthy individuals after SP and those with only physical exercise. METHODS: Healthy adult male volunteers, aged 25-45 yr were randomized into two groups. Group 1 (SP group) underwent the SP and group 2 (controls) did brisk walk for 30 min daily. Detailed neuropsychological evaluation, resting-state functional magnetic resonance imaging (fMRI) and brain 99mTc ethyl cysteinate dimer single-photon emission computed tomography (SPECT) were carried out for both groups before and three months after intervention. RESULTS: Post-intervention, resting state fMRI showed increased connections of left precuneus (in the posterior cingulate cortex area of default mode network) in group 1 and increased left frontal connections in group 2. The neuropsychological tests showed significant improvement in 'Speed of Processing' (Digit Symbol Test) in group 1 and in Focused Attention (Trail Making A) in group 2. The SPECT data in group 1 showed significant improvement in perfusion of the frontal areas, with relatively lesser improvement in parietal areas. Group 2 showed significant improvement in perfusion predominantly in parietal areas, as compared to frontal areas. In addition, significantly improved mood was reported by group 1 and not by group 2. INTERPRETATION & CONCLUSIONS: This pilot study shows important functional imaging and neuropsychological changes in the brain with SP.

18F-fludeoxyglucose positron emission tomography computed tomography-guided diagnosis of prostatic and leptomeningeal tuberculosis.

Genitourinary tuberculosis contributes to 10%-14% of extrapulmonary TB. Prostate tuberculosis is rare and usually found incidentally following transurethral resection of the prostate for benign prostatic hyperplasia. We report a case of an immunocompetent patient with pyrexia of unknown origin, on evaluation with whole-body 18F-fludeoxyglucose positron emission tomography computed tomography scan found to have suspicious prostatic primary, with hypermetabolic abnormalities involving the brain. Histopathological diagnosis was established as multifocal tuberculosis involving prostate, meninges, and intracranial tuberculomas.

An Unusual Appearance of Meckel's Diverticulum as a Site of Bleed on Gastrointestinal Bleeding Scan.

Lower gastrointestinal (GI) hemorrhage is a frequently encountered and challenging clinical problem. GI bleeding scans are extremely useful for localizing the source of GI bleeding before interventional radiology procedures. It is essential that physicians understand the numerous possible pitfalls when interpreting these scans. Understanding the potential causes of false-positive scan interpretation eliminates unnecessary procedures for the patient and minimizes costs. We report a rare case of an 8-year-old boy who presented with GI bleeding. Upper and lower GI endoscopy did not reveal a source of bleeding. We emphasize case of Meckel's diverticulum appearing as a proximal jejunum false-positive site of bleed on bleeding scan. In addition, we reinforce the criteria needed for diagnosis of GI bleeding site on the nuclear bleeding scan. A high index of suspicion is the most important diagnostic aid that can prevent the nuclear medicine physicians from misdiagnosing the site of lower GI hemorrhage.

Technetium-99m-methylene Diphosphonate Uptake in Hepatic Necrosis Secondary to Respiratory Failure.

Tc-99m methylene diphosphonate (MDP) bone scintigraphy has long been used for the evaluation of benign as well as malignant skeletal conditions. However, non-osseous tracer uptake on a bone scan is an unusual finding. On one hand, there is a need for awareness of the pathophysiologic basis underlying such uptake, as it may be of critical clinical relevance in the evaluation of the patient. On the other hand, some alterations in biodistribution may be of little clinical significance, but have deleterious consequences on the quality of the bone study. Recognition of these abnormalities will reduce errors and provide important clinical information. We described a case of 57-year-old male patient with history of carcinoma base of tongue, where a 99mTc-MDP bone Scintigraphy was performed for metastasis survey. It revealed avascular necrosis of head of right femur. In addition incidentally demonstrated diffuse increased pathologic uptake of Tc-99m-MDP in the liver and multiple foci in bilateral lungs. This article reviews several possible reasons for such diffuse hepatic uptake. In the present case diffuse hepatic necrosis secondary to respiratory failure due to bilateral miliary pulmonary metastasis is considered to be the cause of the diffuse liver uptake of 99mTc-MDP.

Bone scanning in the adductor insertion avulsion syndrome.

A thigh splint (adductor insertion avulsion syndrome) is a relatively uncommon diagnosis analogous to shin splints. This article reports a 19-year-old female patient NOT a regular athlete who presented with groin pain. Physical examination was non-specific; magnetic resonance imaging pelvis did not reveal any abnormality. Patient referred for whole body bone scan, especially to locate any abnormality in the spine. This study highlights the role of whole body bone scan in the evaluation of groin pain and importance of evaluation of whole lower extremity.