Predictability of 48-h delayed retention of contrast in barium enema in cases of chronic constipation

INTRODUCTION

Diagnosis of Hirschsprung's disease depends on rectal biopsy. This study was designed to find an alternate diagnostic modality to exclude Hirschsprung's disease.

AIM

The aim of this study was to find the predictive value of delayed retention of contrast in excluding Hirschsprung's disease.

MATERIALS AND METHODS

All cases of chronic constipation presenting during the study duration from June 2014 to June 2016 were included. Those without any obvious history of conservative management were excluded. Parameters considered in barium enema were initial film, routine films, and delayed retention of contrast at 24, 48, and 72 h. They were then subjected to rectal biopsy. The results of rectal biopsy and barium enema were analyzed.

RESULTS

One hundred and thirty-eight patients presented during the study duration. One hundred and twenty-eight formed the study group. The average age of presentation was 48 months (range, 1-144). The average duration of prior medical management was 8 months (range, 6-48 months). Forty-two cases were diagnosed as Hirschsprung's disease on rectal biopsy. The symptoms resolved in 31 cases after rectal biopsy and 42 cases after definitive surgery. In the remaining 55 cases, dietary modification along with laxatives was instituted, and they were kept under follow-up. The average follow-up was 12 months (range, 6-48 months). Of the various parameters in barium enema, delayed retention of contrast at 48 h had the highest negative predictive value of 99.67%.

CONCLUSION

Delayed retention of contrast at 48 h has the highest negative predictive value in excluding Hirschsprung's disease. This can safely be used to exclude Hirschsprung's disease in cases of chronic constipation.

Molecular characterization and expression profile of interferon-stimulated gene 15 (ISG15) in the endometrium of goat (Capra hircus)

Interferon-stimulated gene 15 (ISG15), a ubiquitin-like protein, is responsible for uterine receptivity, implantation and conceptus development in different ruminant species, but in goat (Capra hircus) its role is yet to be explicated. In the present study, the ISG15 gene was cloned, characterized and its temporal expression profile was examined in the endometrium of caprine (cp). A fragment of cpISG15 gene, 1033 bp in length, was amplified, cloned and sequenced from genomic DNA covering the coding region. Sequence analysis of cpISG15 gene revealed that it was comprised of two exons of 59 bp and 496 bp encoding a peptide of 157 amino acids. Complementary DNA (cDNA) and deduced amino acid sequences of cpISG15 exhibited 99 and 98, 93 and 88, 94 and 89, 76 and 66, and 73 and 62% identity with that of sheep, cattle, buffalo, human and mice, respectively. Further, relative expression of cpISG15 mRNA and protein was determined by quantitative real-time PCR (qPCR) and Western blot, respectively, in the endometrium of pregnant and cyclic does. Both cpISG15 mRNA and protein were expressed maximally (P < 0.05) in the endometrium during early stage of pregnancy (16-24 d) as compared to cyclic does, but no significant difference was observed in cpISG15 mRNA and protein expression in the endometrium between the later stage of pregnancy (25-40 d) and cyclic does. It is concluded that cpISG15 is almost similar in structure and probably in function also to other species as it has been found significantly upregulated during early pregnancy.

Dynamic Analysis of HSDB System and Evaluation of Boundary Non-linearity through Experiments

<p class="FAIMTextBody">This paper deals with mechanical design and development of high speed digital board (HSDB) system which consists of printed circuit board (PCB) with all electronic components packaged inside the cavity for military application. The military environment poses a variety of extreme dynamic loading conditions, namely, quasi static, vibration, shock and acoustic loads that can seriously degrade or even cause failure of electronics. The vibrational requirement for the HSDB system is that the natural frequency should be more than 200 Hz and sustain power spectrum density of 14.8 Grms in the overall spectrum. Structural integrity of HSDB is studied in detail using finite element analysis (FEA) tool against the dynamic loads and configured the system. Experimental vibration tests are conducted on HSDB with the help of vibration shaker and validated the FE results. The natural frequency and maximum acceleration response computed from vibration tests for the configured design were found. The finite element results show a good correlation with the experiment results for the same boundary conditions. In case of fitment scenario of HSDB system, it is observed that the influence of boundary non-linearity during experiments. This influence of boundary non-linearity is evaluated to obtain the closeout of random vibration simulation results.</p>