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Aim: The aim of this study is to elucidate the patterns of characteristic hypometabolism on 18F-Fluoro Deoxy-glucose (18F-FDG) Positron Emission Tomography/Computed Tomography (PET/CT) in the variants of Progressive supranuclear palsy (PSP) and its correlation with their core clinical features. Material and Methods: A retrospective analysis of 88 subjects with clinically suspected PSP was done. An institutional informed consent to participate in the study was taken from all the subjects. All the subjects had undergone a prior 99mTechnetium labeled Tropane derivative of dopamine transporter Single Photon Emission Computed Tomography (99mTc TRODAT-1 SPECT) study and had abnormal scans to confirm degenerative parkinsonism. The subjects were clinically examined by the neurologists using the Progressive Supranuclear Palsy Rating Scale proposed by the Movement Disorder Society and were further clinically segregated into eight subtypes. All the included subjects further underwent a detailed clinical analysis to obtain their individual Schwab and England activities of daily living scale and Modified Hoehn and Yahr staging by a neurologist. All the subjects underwent 18F-FDG PET/CT scan after adequate preparation. The scans were analyzed both qualitatively (visually) and quantitatively using Statistical Parametric Mapping. Results: The frontal, limbic, and sensorimotor cortices represented the common areas of hypometabolism among all the subtypes of PSP. The subcortical regions showing the most significant hypometabolism were the thalami, mid-brain, nucleus accumbens, caudate, globus pallidus, and putamen in descending order. Multiple cortical and subcortical regions of hypometabolism were identified in different subtypes of PSP. Conclusion: The characteristic patterns of hypometabolism observed in the different subgroups were more apparent on quantification and based on visual analysis alone, it may not be possible to differentiate the different subtypes of PSP. A good correlation was seen between some of the core clinical features and hypometabolic clusters.

Aim: To elucidate the patterns of characteristic hypometabolism on 18F- fluorodeoxyglucose( 18F-FDG) positron emission tomography/computed tomography (PET/CT) in multisystem atrophy (MSA) and their correlation with the patterns of uptake on dopamine transporter imaging with 99mTc TRODAT-1 SPECT. Material and Methods: A retrospective analysis of 67 patients with clinically diagnosed MSA was performed. All the subjects underwent 99mTc TRODAT-1 SPECT and 18F-FDG PET/CT scanning on two separate days. The 99mTc-TRODAT-1 scans were analyzed visually for asymmetry and rostro-caudal gradient. The FDG uptake patterns were recorded, and areas of hypometabolism that were two standard deviations from the mean were considered abnormal. Results: All the subjects had an abnormal pattern of FDG uptake on PET scan, both on a visual inspection and semiquantitative analysis. In MSA-P subjects (n = 29), diffuse predominant hypometabolism of the globus pallidus-putamen complex was noted, with relative sparing of the caudate nuclei. In MSA-C subjects (n = 25), characteristic hypometabolism was noted in the cerebellum and brainstem. In mixed subtypes (n = 13), variable involvement of the basal ganglia, cerebellum, and brainstem was noted with frontoparietal hypometabolism. A statistically significant difference between MSA-P and MSA-C for gradient reduction and asymmetry with gradient reduction was observed. Conclusion: Dopamine transporter imaging with 99mTc TRODAT-1 SPECT not only helps in confirmation of parkinsonian disorders but also demonstrates varying patterns of distribution in different subtypes of MSA. Characteristic patterns of hypometabolism in 18F-FDG PET may help in the differentiation of the subtypes of MSA in the presence of clinically overlapping symptoms.

This paper explores applicability of breakthrough marketing strategies adopted/ practiced across various sectors to the Indian paint industry in order to cater to the changing needs of the consumer and thereby increase the per capita consumption. The methodology adopted is two-fold; primary research through surveys/interviews of varied strata of consumers, manufacturers and retailers, and secondary research through review of literature on various breakthrough marketing strategies across industry verticals. Associations (empanelment) with architects and painters, through commissions on orders booked, will result in an increased word-of-mouth publicity, through multilevel marketing. A Hyper-Mart initiative will provide not only all kinds of paints but also painting solutions and paint-education, increasing the visibility of the brand. Experimentations with direct selling to large customers like housing societies and entering in symbiotic relationships with construction majors, ensuring repeat sales, whereas the construction company gains from intangible benefits. Vending machines could be employed to dispense strips of paint on a suitable base, aiding potential experiential buying. The concept of a strip to heal a 'disfiguration' can be used to tap the bottom of the pyramid, de-necessitating need to re-paint the entire wall, thereby increasing affordability. The focus is on strategies that would educate the customer, thus facilitating a wholesome buying experience. The paper studies several such strategies. With increased emphasis on differentiation and customer orientation, drawing the consumers attention to existing best-in-class products presented in a brand new, suitably customized and 'convenient' platter, so as to provide for an experiential buying, is the order of the day. [ABSTRACT FROM AUTHOR]