Home > Use of Magnetic Resonance Spectroscopy Mrs to Improve Magnetic Resonance Imaging Mri in the Diagnosis of Intracranial Pathology, Done at Aga Khan University
Use of Magnetic Resonance Spectroscopy Mrs to Improve Magnetic Resonance Imaging Mri in the Diagnosis of Intracranial Pathology, Done at Aga Khan University
Introduction: Magnetic Resonance Spectroscopy (MRS)is a potentially useful adjunct to Magnetic Resonance Imaging (MRI) in thecharacterization of focal brain lesions. This study was aimed at showing that by the additional use of MRS (MRI, MRS), the characterization of a focal brain lesion into neoplastic, or non- neoplastic (infective, or degenerative) can be improved, as compared to the use of MRI alone.
Study question: Does the additional use of MRS improve MRI differentiation of neoplastic from non- neoplastic (infective or degenerative) focal brain lesions?
Methods: The design was prospective, analytical and comparative. 80 consecutive patients were enrolled. Conventional MRI of the brain was performed then a single voxel proton MRS spectrum was applied to a focal brain lesion. A similar MRS spectrum was subsequently acquired from the contra-lateral normal area of the brain, for comparison. The MRI examination, followed by the MRI, MRS examination was then interpreted by two consultant radiologists and a resident radiologist in consensus. Kappa measurement of agreement was used to determine the agreement between the MRI and MRI, MRS with the final diagnosis. Sensitivity, specificity, positive predictive values and accuracy of the two tests were calculated. The difference between the number of indeterminate lesions in the two tests was noted.
Logistic regression demonstrated the role of confounding factors in the diagnostic use of MRS.
Results: Of the eighty patients initially recruited, seventy four (92.5%) were analyzed, and six were lost to follow- up. According to the final diagnosis, 33% of the lesions were infections, 29% neoplastic, 37% degenerative and, 1% were indeterminate.
On the basis of the kappa analysis, MRI, MRS had an increase in agreement of 7.4% compared to MRI and the confidence levels of the two tests did not overlap. The sensitivity of MRI, MRS was 4.82 times greater than that of MRI. MRI, MRS had a 1.7% increase in accuracy. The combined test reduced the indeterminate MRI lesions by 5.4%. Logistic regression showed that for lesions which were enhancing, MRS yield was more helpful if the voxel position included the enhancing part.
Conclusion: The additional use of single voxel MRS improves the MRI characterization of neoplastic from non- neoplastic (infectious or degenerative) focal brain lesions. It is most useful as an additional protocol to conventional MRI in the characterization of neoplastic from non- neoplastic brain lesions.
کائنات کے اندر اللہ تعالیٰ نے مختلف صلاحیتوں کے حامل افراد کو پیدا فرمایا ہے۔انہی صلاحیتوں کی بنا پر معاشرے میں ہر شخص کی پہچان اور مقام و مرتبہ ہے۔ہر انسان کے بات سنانے یا بات کرنے کا اپنا اپنا انداز ہوتا ہے۔کوئی دھیمے لہجے میں بات کرتا ہے۔تو کوئی انتہائی جارہانہ لہجے میں دو ٹوک الفاظ میں بات کرنے کا عادی ہوتا ہے۔کوئی شخص اپنی بات کی مثالیں دے کر گھما پھرا کر بات کرتا ہے۔انداز کوئی بھی اپنایا جائے مقصد اپنی بات کو دوسرے فرد تک پہنچانا ہوتا ہے۔ہزاروں لوگوں میں کوئی شخص ایسا بھی ہوتا ہے جس کا بات کرنے کا الگ ہی انداز ہوتا ہے۔جب وہ گفتگو کرتا ہیتودھنک کے رنگ بکھیر دیتا ہے۔باتوں سے خوشبو آتی ہے ایسا ہی ایک شخص "عامر خان وسیر" بھی ہے جو اپنے خوبصورت انداز بیان سے نہ صرف لوگوں کے دلوں میں جگہ بنا لیتا ہے بلکہ مسحور کن باتوں سے کسی کو بور بھی نہیں ہونے دیتا۔
عامر خان وسیر کو اللہ تعالیٰ نے جہاں بہت سی صلاحیتوں سے نوازا ہے وہاں ایک صلاحیت شاعری کی بھی بخشی ہے۔جہاں تک میں نے انکی شاعری پڑھی ہے۔انکی شاعری میں ہر رنگ نظر آتا ہے۔انکی غزلیات،نظموں ،قطعات اور فردیات پر مشتمل شاعری ’’مجھے مان تجھ سے وفا کا تھا‘‘ کے روپ میں چھپ کر سامنے آئی ہے۔ان کی شاعری کا یہ پہلا مجموعہ ہے۔اس مضمون فردیات کے موضوعات اور سراپا نگاری پر بحث ہوگی۔
سراپا نگاری شاعری کا ایک ایسا موضوع ہے جس پر ہر شاعر طبع آزمائی کرتا نظر آتا ہے۔اپنے محبوب کی تعریف کرنا ہر شخص کو اچھا لگتا ہے۔اچھا کیوں نہ لگے کیوں کہ وہ اپنے محبوب کے پیار میں اس قدر ڈوب جاتا ہے کہ اسے اپنے محبوب سے...
To evaluate the feasibility of a business venture, both financial and non-financial factors are taken into consideration. The assessment of feasibility involves analyzing non-financial elements, with a specific focus on production and marketing aspects. The financial aspects of Tofu and Tempeh Sukses Jaya's commercial production were analyzed using metrics such as payback period (PP), net present value (NPV), internal rate of return (IRR), and profitability index (PI) to determine its overall feasibility. Based on the analysis, it was concluded that the business is feasible due to its advantageous location and convenient accessibility. The Tofu and Tempeh Sukses Jaya business appears to be viable due to its strategic and easily accessible location, modern technology, and straightforward production process. Feasibility is ensured by high product quality, imported raw materials, competitive pricing, extensive distribution channels, and effective promotional efforts by the owner to ensure consumer awareness. The financial analysis suggests that the Tempeh Tofu business could be viable over a 10-year project duration with a 10 percent discount rate. According to the evaluation criteria, the business has a 6-month payback period (PP), a net present value (NPV) of IDR 161,565,200, a profitability index (PI) of 1.6%, and an internal rate of return (IRR) of 30%, all of which indicates the business's financial feasibility.
The work in this dissertation describes the bioassay-guided isolation, and structure elucidation of sixteen compounds isolated from the fruit part of Aristolochia indica Linn. The dichloromethane, and butanolic fractions of the plant material exhibited activities against prostrate (PC-3), and cervical (HeLa) cancer cell lines. The dichloromethane fraction afforded three new compounds, including aristoloquinone (1), aristolocenone (2), and aristoloanoide (3), while the known compounds were identified as dshamirone (4), chrysophanol (5), 4,8-dihydroxy-6-methoxy-2-methylanthraquinone (6), b -sitosterol (7), oleanolic acid (8), ursolic acid (9), 2-(hydroxymethyl)-3 O furaldehyde (10), hydroquinone (11), and 4 -(acetoxy) phenyl acetate (12). The butanolic fraction of the plant yielded three new constituents, aristoloside A (13), aristoloside B (14), and aristoloside C (15), along with a known compound which was identified as butyl 3-O-β- D-glucopyranosyl-(3R), 4-dihydroxy-butanoate (16). The structures of these constituents were elucidated by using modern spectroscopic techniques, including UV, IR, MS, 1D, and 2D-NMR. HO The isolated compounds were tested for their in vitro cytotoxicity against cancer cell lines. Compounds 8, 9, and 11 showed high sensitivity towards the cervical and prostrate cancer cell lines, as compared to the standard drug, doxorubicin. The other natural/ synthetic compounds were also evaluated for their antitumor activity. Among the natural compounds, physalin derivatives showed a potent activity, whereas among synthetic compounds, organotin (IV) carboxylate, and imidazole derivatives exhibited an excellent activity against the cancer cell lines.