An analysis of 2800 CT Head scans in patients with chronic headache

Introduction: Chronic headache is a common health problem in general medical practice and there is increasing demand of CT scan from specialist as well as non-specialist doctors to refer patients for CT head scan. Patients and methods: The present study was done on 2800 CT head scans of patients with problem of chronic headache. While patients in Group 1 (n=1900) had only chronic headache without any neurological findings, Group B comprised of cases (n=900) referred by specialist doctors after neurological examination. CT scan was done by trained technicians and contrast was injected where necessary. Results: Present study showed majority of patients in both group 1 and group 2 (90% and 87.7% respectively) had normal CT findings or insignificant findings. However, difference was not significant in both groups when significant findings (10.0% Gr. A and 12.2% Group B) were compared. Discussion: Our findings are consistent with other studies concluding that routine CT scan may not provide clinically useful information in chronic headache.

Retrospective analysis of chest x-ray of patients from eastern Uttar Pradeshpresenting in Radiology department ofHind Institute Medical Sciences, Barabanki Uttar Pradesh

Introduction: Chest Xray is one of the most frequently asked radiological examination in patients with heart or lung problems in general medical practice. There are many studies on correlation of CXR findings and other tools of investigations like CT scan, MRI and laboratory investigations like spirometry and sputum examinations etc. The present study aims at establishing a possible correlation in rural population of Eastern Uttar Pradesh. Methods: We have done a cross sectional study in a period of six months including 2500 patients coming for CXR. Patients were followed up to a point where radiological diagnosis was confirmed or otherwise after other investigations and clinical response. Results: There was fairly good correlation in patients with COPD (73.15%), tuberculosis (85.8%), interstitial lung disease (63.9%) and congestive heart failure (68.6%). Conclusion: We conclude that CXR is tool of reasonable sensitivity however there is sizeable possibility of false positive and negative cases.

Prevalence of hepatitis B virus and hepatitis C virus co-infection in human immunodeficiency virus positive patients: a study from tribal area of central India.

Background: AIDS was first recognized in the United States in 1981, in homosexual men in New York. In 1983, human immunodeficiency virus (HIV) was isolated from a patient with lymphadenopathy, and by 1984 it was shown that causative agent of AIDS. Human immunodeficiency virus (HIV), hepatitis B virus (HBV), and hepatitis C virus (HCV) are major public health concerns. Because of shared routes of transmission, HIV HCV co-infection and HIV-HBV co-infection and/or both are common. HIV-positive individuals are a risk of co-infection with HBV and HCV and/or both infections. Co-infections of HBV and HCV with HIV have been associated with reduced survival, with an increased risk of progression to severe liver diseases and an increased risk of hepatotoxicity associated with antiretroviral therapy. Methods: The present study was conducted duration from September 2011 to October 2013. A total of 100 AIDS patients of different age groups including 68 males and 32 females were enrolled in the study attending outdoor or admitted in wards of Department of Medicine, Dr. B. R. A. Hospital Raipur (C.G.). 50 HIV negative healthy controls are also included in the study to minimize the observer and instrumental bias. Results: In our study most common occupation of patients were 24 (24 %) labour. Most common mode of transmission was heterosexual seen in 93 (93%) of patients. The prevalence of HbsAG in HIV seen in 6 (6%) of cases .The prevalence of HCV in HIV seen in 2 (2%) of cases and all patients were male and found to be age group between 30-40 year The co-prevalence of HbsAG & HCV in HIV seen in 1 (1%) of cases and it was female patient and age group was 30 to 40 years. There is incidence of deranged liver function tests in HBsAg for S. Bilirubin, SGOT, SGPT and alkaline phosphatase was 6, 4, 3 and 2 patients respectively in HCV SGOT in 1 patients. The incidence of deranged liver function tests was 5 among the co-infected patients with CD4<200 compared to 2 in those with CD4>200. The mean CD4 count was 193.6 /mm. Maximum patient seen in grade 1 (88.8 %) liver enzyme elevation. Most common opportunistic infection in both HBsAG & HCV were pulmonary tuberculosis. Conclusions: Prevalence of hepatotoxicity is more common in HIV patient than other & co prevalence of either HBsAG or HCV accelerates the progression of liver disease which further causing liver derangement and increase morbidity & mortality of the patients. Mild to moderate hepatotoxicity is common as compared to severe hepatotoxicity. Screening of HIV with HBsAg & HCV and early diagnosis & treatment of disease will decrease the morbidity and mortality of the patients.

Retinopathy in Newly Diagnosed Type 2 Diabetics with a special stress on the importance of glycemic control.

Background: Diabetes mellitus (DM) is a major health problem with long-term microvascular and macrovascular complications responsible for the majority of its mortality and morbidity. The development and progression of diabetic complications are strongly related to the degree of glycemic control. The purpose of this study was to study, the incidence of retinopathy in newly diagnosed diabetics and its association with various risk factors with a special stress on role of HbA1c levels. Methods: We analysed 300 newly diagnosed type2 diabetics (diagnosed within 6 months). Patients were subject to detailed history, examination (including retinal examination), and investigations including serum creatinine, urinary micro-albumin, 24 hours urinary protein, HbA1c and ultrasonography. Results: Incidence of retinopathy in newly diagnosed type 2 diabetics was 30% (91/300). With increase in HbA1c, the incidence of retinopathy increased. All results were statistically proven. Conclusion: Incidence of retinopathy in newly diagnosed type2 diabetics is as high as 30%. Glycemic control is the an important factor contributing to development of this microvascular complications in diabetic patients.

Spleen preserving distal pancreatectomy for blunt abdominal trauma--a case report.

The case of a 22-year-old male who underwent spleen preserving distal pancreatectomy (SPDP) for pancreatic trauma is briefly reported. SPDP was performed by preserving the splenic vessels to maintain a reliable splenic blood flow post-operatively. Although technically demanding, this procedure can be performed safely and easily in the emergency, and avoids splenectomy-related problems in the post-operative period.