Background/AimsColorectal cancer has long been considered disease of the West, typically occurring in old age; however, the incidence is rising in Asia. The pattern of disease is quite different in Asia, occurring at a younger age and at an advanced stage. Recognition of disease at an early stage is still a challenge for physicians. Few data are available regarding young-onset colorectal cancer in Pakistan. We conducted this study to fill this gap and provide deeper insight into clinical symptoms and histopathological features of young-onset colorectal cancer.MethodsWe collected data regarding clinical features by directly interviewing patients and obtaining histopathological data from hospital records. Patients aged less than 50 years were included in the study. Statistical analysis was performed using IBM SPSS version 20.0.ResultsResults in 105 patients showed mean age at diagnosis was 35.90±9.39, with male predominance; the majority of patients had no family history of colorectal cancer. Most patients had left-sided tumors with advance stage and intermediate grade (grade 2). Mucinous histology was common. Rectal bleeding was the first symptom for left-sided tumors, whereas most of the right-sided lesions presented with sudden obstruction.ConclusionsPainless rectal bleeding in the early thirties should alert physicians to advise appropriate investigation, as the majority of young-onset colorectal cancer patients develop painless bleeding 2 to 3 years before appearance of other symptoms.

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Background: Carpal tunnel syndrome (CTS) is the most common nerve entrapment neuropathy caused by compression of median nerve at wrist as it passes through osseofibrous canal known as carpal tunnel. Epidemiological statistics shows one in every ten people develops the disease at any stage of life. CTS mostly affect females than males with mean age of 50. Clinical features are considered to be enough for establishing the diagnosis of carpal tunnel syndrome. However, nerve conduction studies give quantitative information regarding median nerve function therefore good at predicting outcome of intervention. Ultrasound being easily available, cost effective and real time is a promising modality for diagnosis and grading carpal tunnel syndrome. Methods: This correlational study was conducted in collaboration of Neurology and Radiology Department of Pakistan Institute of Medical Sciences, Islamabad from January 2018 to January 2019. Total 50 patients with 85 wrists involved were included in the study. All patients with positive nerve conduction study were included. Patient with history of wrist trauma were not included. Detailed history and clinical features were recorded. All patients with positive result on nerve conduction studies underwent ultrasound examinations. Fifty control wrists were also included to establish the normal median nerve cross sectional area value in our study population. Results were recorded. Data was analyzed and appropriate statistical tests were applied by using SPSS v20. Results: Mean cross sectional area of median nerve for controls was 6.34±1.23. Mean cross sectional area of median nerve for mild CTS was 8.05±1.72, moderate CTS was 11.15±2.32, severe was 17.49±4.93. Strong correlation was found between (r=0.76, p-value <0.0001) between increased cross-sectional area on Ultrasonography and severity of CTS on NCS. Other finding on Ultrasonography included flattening in 4 and fluid in 10 affected wrists. Conclusion: Increased cross-sectional area on Ultrasonography and severity of carpal tunnel syndrome on nerve conduction studies are very strongly correlated.

Elastomers are employed in the field of acoustics as sound enhancers and making tissue‐mimicking phantoms for ultrasound imaging due to their good viscoelastic properties. Polyglycerol sebacate (PGS) is a relatively new biocompatible, biodegradable elastomer with low elastic modulus prepared via two‐step melt condensation reaction. The first step yields a soluble pre‐polymer while the second results in a cured insoluble tough elastomer. The elasticity of polymer is dependent upon curing time. Attractive aspects of pre‐PGS to be used as ultrasound contrast agent lie in its excellent viscoelastic properties, that is, low elastic modulus, near to lipids. This can give it acoustic properties of lipid microbubbles while keeping a stable response of polymeric microbubbles. In this study, pre‐PGS was synthesized via the melt‐condensation method and characterized by FTIR, NMR, TGA, melt flow index, contact angle, titration, and uniaxial compressive testing. Viscosity was measured by the Ostwald technique. These viscoelastic measurements were used to predict the acoustic response of pre‐PGS shell‐based microbubbles by running equations in MATLAB. Pre‐PGS showed an elastic modulus of 1.26 MPa and thermal stability up to 100°C. PGS showed much more elasticity than commercially available Sonovue ultrasound contrast agent, also it has low viscosity (0.016 Pa s) and density (1186 kg/m), due to which it has a low damping coefficient (4.32 × 106) compared to Sonovue (7.63 × 107), giving better oscillations in an acoustic field with higher scattering cross‐sectional area than standard Sonovue microbubbles. Based on these simulations pre‐PGS with 50%–60% degree of esterification showed excellent viscoelastic properties which make it an ideal material for microbubble ultrasound contrast agent.

The magnetic microbubbles with phase convertible PFP core encapsulated by lecithin shell loaded with OA-SPIONs can serve as a potential bimodal contrast agent for both ultrasound (US) and magnetic resonance imaging (MRI).