ABSTRACT
Aim of this prospective study is evaluation of role of computed tomography to detect & determine the cause, type, severity and etiopathogenesis of hydrocephalus in pediatric age group. Study was conducted in the department of Radiodiagnosis, Pt. J.N.M. Medical College, Raipur (C.G.). 50 consecutive cases of hydrocephalus in pediatric age group were evaluated by CT Scan. Pediatric cases who were having large head, convulsion, sign of raised intra–cranial tension, neurological deficit and evidence of ventriculomegaly by USG were taken for the study. Result – Out of 50 cases of hydrocephalus, majority of cases were less than 5 years of age (78%). The male to female ratio was 3:2. Maximum cases were of acquired type (62%) followed by congenital type (38%). In acquired type, infective lesions were predominant with 22 case (44%) and 9 cases (18%) were of neoplastic variety. Meningitis was commonest cause of hydrocephalus in acquired Varity. In congenital hydrocephalus, Aqueductal stenosis was the commonest cause (73%), followed by 4 cases (21%) of Dandy–Walker malformation and 1 case (5%) of type II Arnold Chiari malformation. Out of 50 cases there were 14 cases (28%) of communicating type and 32 cases (62%) were non–communicating and 4 cases (8%) cases of dandy walker cyst. Moderate degree of hydrocephalus were predominating being 50%. Conclusion: Computed Tomography is a valuable tool with very high diagnostic sensitivity and it helps for early detection of hydrocephalus with its cause and severity with precision.
ABSTRACT
Objective: To study the clinical profile and assess the utility of the procedures performed for the diagnosis of extra" pulmonary TB (EPTB) in HIV patients. Design: Prospective observational study of HIV patients suspected to have EPTB. Results: Two hundred and thirty HIV-infected patients were enrolled over 18 months. Of them, 87 cases had active TB, 60 (69%) of whom were of EPTB. Major presenting symptoms were fever (93.3%), weight loss (80%) and cough (61.6%). The most common site of active EPTB was the abdomen (70%), which could be detected due to routine use of abdominal ultrasonography, followed by CT scans in inconclusive cases. Peripheral lymph node (22% ), pleura (15%), CNS involvement (3%) and one case each of psoas abscess and mediastinal lymphadeopathy were the other extra-pulmonary sites seen. Diagnosis of peripheral lymph node and pleural TB was based on cytological and mycobacterial examinations. Direct smear examinations were positive for AFB in 11 of 24 samples and mycobacterial cultures were positive in five of 18 samples. The median CD4 ceH count in our HIV-EPTB cases was 126 cells/ml3 (IQR-79.5-205.75). There was no statistical difference in the baseline CD4 ceH counts in patients with PTB vs EPTB (p-0.70), single vs multiple extra-pulmonary site involvement (p-0.57), and AFB positive vs AFB negative EPTB cases (p-0.51). Conclusions: EPTB is the most common form of TB in HIV patients with low CD4 cell counts. Fever, weight loss and cough are common presenting symptoms of EPTB. Routine abdominal ultrasonography followed by an abdominal CT scan in inconclusive cases can significantly increase the detection of abdominal TB.