Validation, dissipation kinetics and monitoring of flonicamid and dinotefuran residues in paddy grain, straw, its processed produces and bran oil using LC-MS/MS

Flonicamid and dinotefuran are highly effective insecticides in paddy but residue persistence in crop and transmission into food and feed is unknown. This study aimed to examine initial deposits and dissipation kinetics of flonicamid and dinotefuran in paddy matrices and processed products including bran oil. The method was validated following acetonitrile extraction, dispersive solid phase clean-up and finally determination using liquid chromatography-mass spectrometry/mass spectrometry. Recoveries ranged from 76.6 to 109.7 percent for the paddy matrices tested. In a field experiment, flonicamid and dinotefuran were applied to paddy crops to study dissipation patterns. The half-lives of flonicamid and dinotefuran residues in paddy ranged from 2.0 to 3.0 days. However, at harvest time paddy grain and straw samples were found free from residues. Monitoring of residues in farm gate and market samples revealed that paddy products were not contaminated with flonicamid or dinotefuran residues.

Water-efficient genotypes along with conservation measures significantly reduce the green and blue water footprints in sugarcane (Saccharum spp.)

Sugarcane crop is irrigated using surface, overhead, and drip irrigation methods. Increased water use in sugarcane is a major concern around the world, implying the need for water accounting, developing water-efficient hybrids and water-saving agro-techniques for long-term conservation and use of water. "Water Footprint (WF)" is a measure of both direct and indirect water usage accountable for any product and/or process. In praxis, 'Green Water Footprint' (GWF) and 'Blue Water Footprint' (BWF) are extremely crucial for the restoration of essential ecosystem services (ES), such as sugarcane production. The WF metric was used as a priority tool in our study to evaluate water-efficient sugarcane hybrids, germplasm clones, deficit irrigation scheduling, crop geometry, and water conservation measures. Precise and accurate WF quantification would supplement the decision-making processes for managing available water resources in sugarcane agriculture. In split plot experimental design two research investigations on water management in sugarcane were undertaken at the ICAR-Sugarcane Breeding Institute, Coimbatore, Tamil Nadu, India. The major objective of the research trails was to find out suitable sugarcane hybrids and agronomic management practices to minimise water usage in sugarcane cultivation in water stressed and drought prone areas of tropical India. Our investigation comprised two phases; the first one being assessment of the impact of deficit irrigation scheduling, planting techniques and water conservation measures in sugarcane production, while the second phase dealt with genotypic evaluation under variable irrigation scheduling. Results showed that BWF reduced significantly in the first ratoon crop due to deficit irrigation scheduling coupled with planting of two budded setts and application of sugarcane trash at the rate of 5 t ha-1. Sugarcane hybrids viz., Co 85019, Co 10026, Co 12009, Co 13014, Co 14002, Co 14025, Co 15015, and Co 15018 were more water efficient, with a lower total WF. Among the germplasm clones, Fiji 55, ISH 111, ISH 107, Pathri, and Gungera exhibited lower GWF, BWF and total WF.

Parkinson’s disease identification in homo sapiens based on hybrid ResNet-SVM and resnet-fuzzy svm models

The identification of Parkinson’s Disease (PD) is a necessary concern for reducing the occurrences of nervous disorders and brain death. The prediction of PD based on symptoms is depending on the body conditions of patients as the symptoms differ for every individual. Doctors preferably use ionized radiation-free MRI scans since they offer more precise images of soft tissues in the brain. In the recent years, deep learning is the prominently used method for performing image analysis and classification. However, the systems developed using deep learning are not able to predict the PD accurately. In order to bridge the gaps present in the existing systems, we propose a hybrid model based on neuro-fuzzy classification to detect PD more accurately. For enhancing the accuracy of PD identification, we used the ResNet-18 deep learning architecture for the classification of MRI images. In addition to this, a hybrid framework is also proposed in this paper where the softmax layer of ResNet-18 is modified using non-linear SVM and Fuzzy SVM (fSVM) classifiers. The convolution and max-pooling layers of ResNet-18 are able to learn more objective features for classification. The proposed hybrid model of ResNet-fSVM is evaluated on the neuro-MRI images from the PPMI dataset and achieved 4.4% higher accuracy than the ResNet-18 model and 2.8% higher accuracy than hybrid ResNet-SVM model. The age group based results obtained in this work has proved that the accuracy of the proposed ResNet-fSVM hybrid model is better when it is compared with ResNet-18 and hybrid ResNet-SVM models. This system effectively detects Early-onset PD through its efficiency in classification.

Opioids for Pediatric Pain Management

OBJECTIVES

To study the efficacy and adverse effects of opioids in management of pain in children.

METHODS

A descriptive study was conducted in children aged below 15 years with moderate to severe pain, and response to opioids and adverse effects were assessed at 24, 48 and 72 hours after administration.

RESULTS

100 children (68% males) with median (IQR) age of 6.5 (3.5,10) years were studied. 81% (n=81) children with moderate pain and 78.9% (n=15) with severe pain responded to opioids in 72 hours. Among children with severe pain of non-malignant origin, 80% (n=8) responded in 48 hours compared to 11.1% (n=1) with malignancy and this difference was statistically significant at 24 hours (P=0.005). Of children with severe pain 73.7% (n=14) developed adverse reactions compared to 30.9% (n=25) with moderate pain.

CONCLUSIONS

Children with moderate-severe pain, either of malignant or non-malignant origin could be managed effectively with opioids without severe adverse effects.

Novel Model for Automatic Classification of the Epileptic Seizures Using Fast Fourier Series-Haar Wavelet Transform

The disorder based on neurological can be considered as epilepsy that leads to the recurrent seizures in occurrence. The electronic characteristics of brain can be monitor by the electroencephalogram (EEG). It is most commonly used in the medical application. The function monitoring records can be non linear as well as non stationary functioning. The present work produce a novel methodology, it is depend on Fast Fourier series (FFS) and wavelet transform based on Haar. These methods are used for the various kinds of epileptic seizure the electroencephalogram based signal. The detection of boundary is occur by the representation of scale-space and it also adapted to the image segmentation of the spectrum depends on the FBSE that can be obtained with the electroencephalogram based signal and the purpose of the EWT is also used to attain the narrow sub band based signals. These image segmentation and classification process implementation by FPGA based microprocessor and systems. The FFS-HMT can produce the sub band signal from the Hilbert marginal spectrum it is represented as HMS. The HMS can be used to compute the line length and the entropy characteristics due to the corresponding various kinds of the level based oscillatory of the electroencephalogram signal. Here we apply the selected feature extraction depends on the ranking parallel vector. With the use of an electroencephalogram signal, the robust random forest is utilized to classify selected feature extraction in normal and epileptic participants. The assessment of performance based on classification can be measured in FPGA microprocessor the term of classification accuracy for different sample length of EEG. The current methodology aids neurologists in distinguishing between healthy and epileptic people using electroencephalogram signals.

An Efficient Image Segmentation Using Partial Differential Equation for Image Processing Applications

Different processing of the images, such as the image captured, saved and retrieved from another use of the specific image, must be restructured in various ways in the process. More methods such as image restoration, picture segmentation, improvement of the picture etc can be used when processing images. Reconstructed in 3D picture 2D pictures are need to be proper. Including geometric wavelets and geometric analysis the structural work focused upon a variational and a selectable differential equation to test PDE’s which is a convergence of stochastic modelling and analysis of harmonics. This paper focuses primarily on the critical reviews of the image segmentation collection with the PDE application as a mathematical method and introduces the key tool of mathematics and techniques along with the literature-based analysis.

Modeling of TST Using Biological Signals and KL-Hausdorff Distance Similarity Measure for Gene Based Parkinson’s Disease Recognition

Genetic research experienced drastic transformation since past decades, which benefits the biological area eventually for the detection of neurodegenerative ailment like Parkinson’s disease (PD). Recently, rigorous investigate had been conceded out for of PDs detection instigated through-sequence -and recessive auto-somal-of dominant-genes such as PARK2, LRRK2, SNCA, PARK7 and PINK1. Several inherent based similarity degree representations such as Cosine similarity and Hamming Distance model were introduced for the detection of these genes. However, these representations detect 2 to 3 gene sequence barely by maximum Root Mean Square Error (RMSE) and minimum accuracy rate. The ratio of misclassification is too great for prevailing scheme. To perceive PD through low RMSE and high accuracy a Kullback-Leibler Hausdroff distance (KL-H) similarity measure model is proposed so as to discover the affected patient pattern efficiently. It works in two phases, in first, protein sequence of amino acid is determined with the use of model transcription, splicing and translation (TST). The second stage in turn distinguish PD that depends on the model of similarity measure which comprise assessment of template sequence and specified sequence with the use of Hausdorff distance and KL-distance process. The property of nucleotide density in KL distance measure algorithm was employed. The result analysis and comparative study were presented among the proposed and existing system. We attained maximum accuracy of 88%, with sensitivity 67.86%, specificity 93.81%, precision 76%, F1 score 71.69%, minimum RMSE (12%) and FPR (6.19%)in comparison to the prevailing similarity measurement model.

Education-based Self-management Intervention on Awareness among Patients with Systemic Lupus Erythematosus at Tertiary Care Hospital, Chennai, India

Introduction: Education-based self-management intervention that incorporates both social support and health education have reduced pain, improved function and delayed disability among patients with lupus. Aim: To assess the effect of education-based self-management intervention on awareness among patients with Systemic Lupus Erythematosus (SLE) at tertiary care hospital. Materials and Methods: The quantitative experimental study one group pretest post-test design using purposive sampling technique was conducted on 55 patients, who were all diagnosed with SLE in Rheumatology Outpatient Department, Tertiary Care Hospital, Chennai, Tamil Nadu, India. The patients received the intervention “education-based self-management” which comprised of audio recorded powerpoint teaching on various aspects of SLE like definition, risk factors, signs and symptoms diagnostic investigations, treatment, complications and self-care measures. The investigator taught a group of 4-5 patients for 30-40 minutes using the presentation, followed by which they were provided a booklet on self-management guidelines. The pre and post-test self-management awareness determined through reliable and valid self-structured questionnaire (SLE awareness questionnaire) and their values were analysed through inferential and descriptive statistics. Results: The SLE was reported to be highest among the age group of 21-35 years (72.7%), with higher incidence in females 96.4% than male 3.6%. Majority (n=44) 80% of the patients were founds to have inadequate level of awareness in the pretest. During the post-test on 15th and 30th day, the awareness among the patients was found to be adequate with the score of 38.2% and 94.5%, respectively. There was a significant difference noted in level of awareness between pretest and post-test on 15th day at p-value=0.04 and between pretest and post-test on 30th day at p-value=0.01. Conclusion: The education-based self-management intervention is effective in improving the awareness levels among patients with SLE and it can also be effective for patients to manage their symptoms.

Leukocyte segmentation in peripheral blood images using a novel edge strength cue-based location detection method

The classification of leukocytes in peripheral blood images is an important milestone to be achieved because it can greatly assist pathologists to diagnose diseases such as leukemia, anemia, and other blood disorders. To a certain extent, a good segmentation method for identifying leukocytes from their background is the first step to the efficient functioning of the leukocytes classification system. However, the morphological structure of leukocytes, poor contrast, and the variations in their shape and size lead to the degradation of the segmentation accuracy. In this paper, we propose a new leukocyte segmentation framework that first locates and then segments leukocytes from peripheral blood images. Here, the locations of the leukocytes are first identified using a novel edge strength cue (ESc), and later, the Grabcut model is deployed to obtain the segmentation of the leukocytes. The novelty lies in the way the location of the leukocytes is detected, and this improves the leukocyte segmentation accuracy. The experimental evaluation is performed on ALL-IDB1, Cellavision, and LISC datasets for leukocyte segmentation based on the detection of the ESc location. Experimental results are evaluated using precision, recall, and F-score measures. The proposed method outperforms the state-of-the-art techniques. Additionally, the computation time of the proposed method is analyzed and presented in the study. Graphical Abstract Leukocytes Location Detection and Segmentation.

A Case Series on the Recent Nipah Epidemic in Kerala

During May 2018 there occurred an outbreak in Kerala, which started in Soopikkada Village, Changarothu Grama Panchayath in Perambra Taluk, Kozhikode district, of a febrile illness with altered sensorium and ARDS. The diagnosis was made from the second case that it is the dreaded nipah infection. Following that 18 cases tested positive for nipah virus infection of which 2 survived. Also there were four deaths with similar clinical picture but which occurred before the virus was identified. They were considered as probable cases.

Lemierres Syndrome in Pregnancy Secondary to Retropharyngeal Abscess

Lemierres syndrome (LS) refers to suppurative thrombophlebitis of internal jugular vein (IJV) secondary to oropharyngeal infection. It is caused by the anaerobic bacteria Fusobacterium necrophorum. Here we report a case of LS secondary to retropharyngeal abscess in a pregnant lady with possible underlying connective tissue disorder. A 19-year old primigravida at 6-weeks of gestation, presented with fever, cough, dyspnea, right sided neck pain and swelling. Imaging showed right lower lobe pneumonia with bilateral pulmonary infiltrates and pleural effusion. Ultrasound of the neck showed right IJV thrombosis. Magnetic resonance imaging of the neck revealed a retropharyngeal abscess extending from C1 to C4 vertebral level. She had positive ANA, SS-A and Ro-52 titres. She was treated with piperacillin-tazobactam, metronidazole, enoxaparin and short course steroids. Even though she improved initially, fever recurred and she had a massive hemoptysis with hemothorax and expired.

An unusual cause of orthopnoea-hashimoto's thyroiditis presenting as bilateral diaphragmatic palsy

We report a case of 36 yr old male without any comorbidities, who presented with a history of gradually progressive dyspnoea and orthopnoea for 6 months. Physical examination revealed bradycardia, paradoxical respiration suggestive of bilateral diaphragmatic palsy. Fluoroscopy demonstrated the presence of bilateral diaphragmatic paralysis. Etiological work up showed evidence of autoimmune hypothyroidism due to hashimoto's thyroiditis. Other possibilities were ruled out with appropriate tests. He was started on thyroxine and showed symptomatic improvement.

Primary intraosseous carcinoma of the mandible: A clinicoradiographic view

Primary intraosseous carcinoma (PIOC) or Primary intraosseous squamous cell carcinoma (PIOSCC) is a rare carcinoma, which arises within the jaws without connection to the oral mucosa and presumably develops from a remnant of odontogenic epithelium. It is a rare case which arises by direct transformation of odontogenic epithelial rests in the jawbone, including the epithelial rests found within the periodontal ligament and alveolar bone, remnants of the dental lamina, and the reduced enamel epithelium surrounding an unerupted/impacted tooth. Herein, we report a case of a 76-year-old male patient who came with a complaint of deviation of his jaws to one side which revealed resorption of total part of the condyle along with the condylar head and coronoid process on radiographic evaluation, which was histopathologically diagnosed as primary intraosseous carcinoma which is a very rare clinical entity.

Kozhikode criteria for diagnosing systemic lupus erythematosus as a hematological disorder

Systemic lupus erythematosus (SLE) is an autoimmune disease in which cells and tissues undergo damage mediated by tissue-binding autoantibodies. At its onset, it may involve one organ alone or more than one organ simultaneously; over a time, additional manifestations due to the involvement of other organs may occur. Our observations have confirmed that hematological manifestations are the commonest initial presentation in SLE. The criteria used till 2012 was the American College of Rheumatology (ACR) criteria, which is only a classification criterion and not really for diagnosis; if we rely on ACR criteria, the diagnosis is often delayed. Time required for satisfying all four of the eleven criteria is variable and prolonged. Moreover, hematological manifestations are underrepresented in the ACR criteria. Based on the clinical observations made on patients evaluated in a tertiary center in North Kerala, an alternate diagnostic criterion named the Kozhikode criteria was proposed, especially for the diagnosis of SLE when it presents with hematological manifestations alone. The present study was an attempt to validate the same and to look for any association of diet and lifestyle with the disease.

Oral lymphangioma: A rare case report

Lymphangiomas are benign hamartomatous tumors of the lymphatic channels which present as developmental malformations arising from sequestration of lymphatic tissue that do not communicate with the rest of the lymphatic channels. Lymphatic vessels are filled with a clear protein-rich fluid containing few lymph cells. It can also occur in association with hemangioma. The onset of lymphangiomas are either at birth (60% to 70%) or up to two years of age (90%) and rare in adults. Lymphangiomas have marked predilection for the head and neck region (50-70%). The most common location in the mouth is the dorsum of tongue, followed by lips, buccal mucosa, soft palate, and floor of the mouth. On tongue, they may present as a localized or a diffused growth which may enlarge to cause macroglossia, impaired speech and difficulty in mastication. Herewith, we present a rare case of lymphangioma of tongue leading to macroglossia in a 8-year-old boy.

Nanoalginate based biosorbent for the removal of lead ions from aqueous solutions: Equilibrium and kinetic studies

Population explosion, depletion of water resources and prolonged droughts and floods due to climatic change lead to scarcity of pure and hygienic drinking water in most of the developing countries. Recently nanomaterials attained considerable attention as biosorbent for water purification purpose. However difficulties in removing polymeric surfactants and organic solvents used for nanoproduction and instability of the generated nanoparticles limit the scope of this approach in water cleanup. Here, we describe a novel green method for synthesizing polysaccharide nanoparticles in aqueous medium using honey as the capping agent. The highly stable alginate nanoparticles, characterized by various microscopic and spectroscopic techniques, exhibited a maximum uptake capacity of 333 mg g (-1)of Pb(II) ions from aqueous solution. The effect of various parameters such as initial metal concentration, pH, contact time, temperature and adsorbent dose on sorption process was investigated in batch mode technique. The maximum removal percentage was 94.81 at 45 °C and at pH 4.5 in 60 min contact time. The biosorption followed Freundlich model indicating multilayer adsorption and pseudo second order kinetics. The mechanism involves both surface adsorption and pore diffusion. The positive values of ΔH°, ∆S° and the negative value of ΔG°, confirmed the endothermic nature, randomness and spontaneity of biosorption process.

Estimation of serum superoxide dismutase and serum malondialdehyde in oral submucous fibrosis: a clinical and biochemical study

BACKGROUND

To estimate the level of lipid peroxidation product (MDA) and the activities of antioxidative enzymes superoxide dismutase (SOD) and the correlation of these parameters in Oral Submucous fibrosis (OSF).

AIMS

Estimation of MDA and SOD levels in OSF patients and controls.

SETTINGS AND DESIGN

Patients above 15 years of age, who were diagnosed as OSF based upon thorough history, clinical examination and histopathological examination without any underlying systemic diseases, were included in the present study. Equal number of healthy subjects without any deleterious habits and without any clinically obvious oral lesions or systemic diseases were selected as the control group.

MATERIALS AND METHODS

The estimation of MDA in serum was done by thiobarbituric acid reactive species method. SOD was assayed by inhibition and autoxidation of adrenaline method.

STATISTICAL ANALYSIS USED

The data were analyzed with Student's t-test.

RESULTS

Comparison of MDA, SOD among the OSF group and control group showed statistically significant increased levels of malondialdehyde and decreased levels of superoxide dismutase among the OSF groups. Significant changes were not seen in MDA and SOD levels between the different grades of OSF.

CONCLUSIONS

From the present study, estimation of lipid peroxidation like MDA was done, which showed increased levels in the OSF group compared to the control group and antioxidant enzyme levels like SOD showed decreased levels in the OSF group compared to the control group. These can be considered as a subject of interest for their possible role in many of the precancerous and cancerous conditions.

Effect of social and environmental determinants on overweight and obesity prevalence among adolescent school children

BACKGROUND

Overweight and obesity among children and adolescents is a public health concern.

OBJECTIVE

To assess the prevalence of overweight and obesity and its association with social and environmental determinants among the adolescent school children of Tirupati town of Andhra Pradesh, India.

MATERIALS AND METHODS

Data was collected by interviewer-administered method from school children aged between 12 to 16 years. The sample consisted of 2258 subjects (1097 boys and 1161 girls). Overweight and obesity were defined by body mass index (BMI) based on the current method recommended by the Centre for Disease Control and Prevention 2000. Data on social and environmental determinants were collected by using a pre-tested and validated questionnaire.

RESULTS

In the present sample, 11.2 percent and 4.8 percent of boys and 10.3 percent and 4.8 percent of girls were overweight and obese. The literacy level of parents, family income and child sleep duration significantly associated with overweight. Parental level of education was a risk factor for overweight (Mother: 1.570; 95% CI: 1.048-2.354). Similarly increase in family income (OR = 1.529; 95% CI: 1.089-2.148) and child sleep duration <7 hrs per day (OR = 2.006; 95% CI: 1.194-3.371) raised children's association in gaining weight.

CONCLUSION

Our study reinforces the burgeoning prevalence of overweight and obesity among the adolescents. Interventional measures taken should consider family, school and physical environment to check the problem of overweight/obesity.

Cowden syndrome with Lhermitte- Duclos disease presenting as ataxia

Cowden syndrome or multiple hamartoma syndrome is a rare genodermatosis of autosomal dominant inheritance characterized by multiple hamartomatous lesions of ectodermal, mesodermal and endodermal origin. A 45-year-old man presented to us with a history of dural arteriovenous fistula and intracerebral bleed in the past with gradually progressive difficulty in walking. Magnetic resonance imaging (MRI) of the brain showed a heterogeneous lesion in the cerebellum which was diagnosed as adult Lhermitte-Duclos disease which is considered a component of Cowden syndrome. On examination we found florid skin and mucosal manifestations of Cowden syndrome. A family history of thyroid malignancy was also present. Using the Cleveland Clinic web calculator, the patient had an 82% chance of having a phosphatase and tensin homologue (PTEN) mutation.

Biosorption of Cd(II) from aqueous solution using xanthated nano banana cellulose: equilibrium and kinetic studies

Present study explored the biosorption capacity of xanthated nano banana cellulose (XNBC) for Cd(II) from aqueous solution. The biosorbent containing sulfur-bearing groups have a high affinity for heavy metals. Sulfur can be considered as a soft ligand group having strong affinity for cadmium. In the present study, the influence of various important parameters such as pH, time, biosorbent dose and initial Cd(II) concentration on the biosorption capacity were investigated. The maximum biosorption capacity of XNBC for Cd(II) was found to be 154.26 mg g⁻¹ at 298 K. The Cd(II) sorption of XNBC was confirmed by SEM-EDS and XRF analysis. The isotherms such as Langmuir, Freundlich, Redlich-Peterson and Tempkin were studied. The Langmuir and the Redlich-Peterson isotherms had been well fitted the biosorption of Cd(II) with xanthated nano banana cellulose. The kinetics of Cd(II) removal using XNBC was well explained by second-order kinetic model. The thermodynamic parameters were also evaluated from the biosorption measurements. Among the various desorbing agents tested, the desorbing efficiency was found to be maximum with 0.1 mol L⁻¹ HCl. It was found that XNBC is also suitable to be used under column operation.

Biosorption of Cr(VI) from aqueous solution by chemically modified potato starch: equilibrium and kinetic studies

The biosorption capacity of chemically modified potato starch (CPS) for Cr(VI) from aqueous solution was investigated. The materials derived from carbohydrates are biodegradable and are generally regarded as safe and environmentally acceptable. The hydroxyl, carboxyl and carbonyl groups are responsible for the biosorption process. In the present study, the influence of various important parameters such as pH, time, biosorbent dose and initial Cr(VI) concentration on the biosorption capacity were investigated. The isotherms such as Langmuir, Freundlich and Tempkin were studied. The Freundlich and the Redlich-Peterson isotherms had been well fitted the biosorption of Cr(VI) with chemically modified potato starch. The kinetics of Cr(VI) removal using chemically modified potato starch was well explained by second-order kinetic model. The thermodynamic parameters were also evaluated from the biosorption measurements. Among the various desorbing agents tested, 98.2 percent chromium recovery was achieved with 0.1molL(-1) NaOH.

CT imaging findings of a calcifying epithelial odontogenic tumour

We report a case of calcifying epithelial odontogenic tumour (CEOT), also known as a Pindborg tumour, with local aggressive behaviour. CT imaging showed a large expansile bone-forming lesion in the mandible, which showed the exact extent and nature of the lesion. We briefly discuss the imaging features of CEOT and the relevant literature.

A two parameter Weibull distribution method for predicting cations in the ground water of Cauvery delta of Tamilnadu

A two parameter Weibull distribution model was applied to evaluate the quality of ground water collected from 50 wells in four regions (CSB, VSB, RCA, NDA) of Thanjavur district. The data of the cations (Ca, Mg, K, Na) and EC were used to predict the ground water quality. The shape (a) and scale (b) along with mean and percentile were zoned. A hybrid approach of the Weibull distribution model was done to estimate the mean. This hybrid approach may be used to predict and forecast the ground water quality. From the study the cationic parameters in the wells were not uniform which may be attributed to contamination either by surface flow or sea water.

Giant epithelioid leiomyoblastoma of the stomach--a diagnostic dilemma

Epithelioid leiomyoblastoma (ELB) of the stomach is an uncommon slow growing smooth muscle tumour, attaining enormous size and presenting with bizzare symptoms. We report one such case which posed a diagnostic problem to both the clinician and the radiologist; the condition was diagnosed after laparotomy and histological examination.