Locus coeruleus (LC) and substantia nigra pars compacta (SNpc) degrade with normal aging, but not much is known regarding how these changes manifest in MRI images, or whether these markers predict aspects of cognition. Here, we use high-resolution diffusion-weighted MRI to investigate microstructural and compositional changes in LC and SNpc in young and aged cohorts, as well as their relationship with cognition. In LC, the older cohort exhibited a significant reduction in mean and radial diffusivity, but a significant increase in fractional anisotropy compared to the young cohort. We observed a significant correlation between the decrease in LC mean and radial diffusivities and measured examining delayed recall. This observation suggests that LC is involved in retaining cognitive abilities. In addition, we observed that iron deposition in SNpc occurs early in life and continues during normal aging. Since neuronal loss occurs in both LC and SNpc in Parkinson's disease, but occurs only in the LC in Alzheimer's disease, our results may lead to early stage imaging biomarkers for these diseases.

Of 460 interns from five Pakistani teaching hospitals surveyed, only 22% correctly identified the estimated number of new TB cases in Pakistan. The majority (96%) knew that droplet infection was the usual mode of transmission. Only 38% considered sputum smears for acid-fast bacilli as the best test for diagnosis of pulmonary TB and 43.5% for follow-up during TB treatment. The recommended four-drug anti-TB regimen was prescribed by 56.5% in the initiation phase and the recommended two-drug combination in the continuation phase by 52%. Most interns (82%) were unable to identify a single component of directly observed treatment short course (DOTS) strategy. Our study reflects poor awareness of and low compliance to the World Health Organization/National Tuberculosis Programme guidelines among interns. For effective control of TB, immediate action to improve undergraduate and continuing medical education is essential, with special emphasis on national guidelines.

Introduction: Locus coeruleus (LC) is the primary source of norepinephrine to the brain and its efferent projections innervate many brain regions, including the thalamus. LC degrades with normal aging, but not much is known regarding whether its structural connectivity evolves with age or predicts aspects of cognition.Methods: Here, we use high-resolution diffusion tensor imaging (DTI)-based tractography to examine structural connectivity between LC and the thalamus in younger and older adults.Results: We found LC projections to be bundled in a fiber tract anatomically consistent with the central tegmental tract (CTT) and branch from this tract into the thalamus. The older cohort exhibited a significant reduction in mean and radial diffusivity within CTT as compared to the young cohort. We also observed a significant correlation between CTT mean, axial, and radial diffusivities and memory performance (delayed recall) in the older adult cohort.Discussion: These observations suggest that although LC projections degrade with age, the degree of degradation is associated with cognitive abilities in older adults.

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