Estimation of role of CT scan and MRI in diagnosis of tuberculosis of brain and spine.

Background: Tuberculosis of the brain and spine is a very severe disease and causes increased rate of mortality and morbidity. Its diagnosis is a challenge for physicians worldwide. Patients of different age groups and having varied socio-economic status suffer from neurotuberculosis which need to be evaluated successfully to help the physician with further management of the condition. Aim: To estimate role of CT scan and MRI in diagnosis of tuberculosis of brain and spine. Material and methods: Patients referred to the Radiology Department with any kind of neurological symptoms, coincidental finding of neurotuberculosis or even those with already diagnosed cases of neurotuberculosis which needed follow up radiological investigations were evaluated with either CT or MRI or sometimes both (These were performed on 1.5 T Philips MRI and Seimens 16 Slice MDCT machine). Results: Patients with intracranial tuberculosis mainly presented with tuberculous meningitis and tuberculomas. Most patients suffering from spinal infection presented with Pott’s spine. Most of the lesions were paradiscal with involvement of the articular discs. MRI is more sensitive than CT scan in the diagnosis of intracranial tuberculosis. MRI is also very sensitive in the diagnosis of intracranial. tuberculosis as compared to CT. CT had no significant role in the diagnosis of Spinal tuberculosis. Hence, MRI is the preferred choice of investigation while evaluating neurotuberculosis.

Estimation of various color doppler indices in low and high risk preterm pregnancies.

Background: Fetal arterial and venous doppler studies help in identification of the foetuses at risk for perinatal complications and may help in prediction of the fetal acid base status or neonatal complications. Aim: To estimate various color doppler indices in low and high risk preterm pregnancies. Material and methods: Study comprised of 60 patients which was an observational,descriptive hospital based study. The study was divided into 2 groups: High risk group (n=30) and Low risk group (n=30). Color doppler scanners (Philips envisor HD7, HD9 and GE logic P5 ultrasound machine), wasused with 3.5 Mhz curvilinear array and following Doppler Velocimetry were assessed- Uterine artery, Umbilical artery, Middle cerebral artery, Umbilical vein, Uterine vein and Ductus Venosus. Results: Gestational age (in weeks)at examination was (31.89+2.69) in low rsk group as compared to (29.25+1.96) in high risk group. Gestational age (in weeks) at delivery was (36.2+1.78) in low risk group as compared to (29.83+1.86) in high risk group. In low risk group uterine artery doppler show decrease in PI, RI and S/D ratio with increasing gestation as compared to increasing PI,RI and S/ratio were seen (p<0.001). Conclusion: Doppler investigation of the fetal circulation play an important role in monitoring high risk pregnancies and thereby help to determine optimal time for delivery. Hence, the use of doppler provides information that is not readily obtained from more conventional test for fetal wellbeing. Therefore it has a role to play in management of high risk pregnancies.

Case series – Slipped capital femoral epiphysis in three members of same family as an unusual presentation.

Slipped capital femoral epiphysis is a disorder of the hip that affects children in late childhood and early adolescence, characterized by medial and posterior displacement of the proximal femoral epiphysis on the metaphysis. Although the diagnosis and treatment of slipped capital femoral epiphysis have been well described, the search for its cause and a method of early identification continues. We have reported here an interesting case of a bilateral slipped capital femoral epiphysis as an unusual presentation in one family -father and two siblings, had no record of any hormonal imbalances or endocrine abnormalities; had good nutrition; and presented with atypical characteristics of slipped capital femoral epiphysis. epiphysis have been well described, the search for its cause and a method of early identification continues. We have reported here an interesting case of a bilateral slipped capital femoral epiphysis as an unusual presentation in one family-father and two siblings, had no record of any hormonal imbalances or endocrine abnormalities; had good nutrition; and presented with atypical characteristics of slipped capital femoral epiphysis.

Fine needle aspiration cytology of anterior mediastinal masses.

OBJECTIVE: The main aim of the study is to evaluate the computed tomography (CT)-guided fine needle aspiration cytology (FNAC) of anterior mediastinal mass as a diagnostic procedure. MATERIALS AND METHODS: In all 135 cases, the material was obtained by CT-guided FNAC technique followed by staining with Papanicolaou and May-Grunwald-Giemsa stains. The histological material was obtained by needle biopsies, wedge biopsies and resection specimens. Immunohistochemical stains were used to confirm diagnosis in selected cases. RESULTS: Among 135 cases, cytohistology correlation was found in 92 cases. Correct typing was done in 53.33% cases. No correlation was found in 14.81% cases. Material was unsatisfactory in 18.51% cases. The diagnostic accuracy and positive predictive values were 85.71% and 78.26%, respectively. CONCLUSION: Although there are some limitations, most lesions of the anterior mediastinum can be diagnosed on FNAC.