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Meckels diverticulum is a persistent remnant of the vitellointestinal duct, and is one the most commonly diagnosed congenital surgical conditions. It occurs in 2% of the population, is usually two inches long, two feet proximal from the ileocaecal junction and in approximately 20% cases it is seen to contain heterotropic epithelium. Its most common clinical presentations are usually in the form of haemorrhage, diverticulitis and rarely may complicate causing intestinal obstruction. We hereby present one such case of intestinal obstruction in a young adult male, secondary to small bowel volvulus around a vitellointestinal band extending from a meckels diverticulum to the anterior abdominal wall. The presentation and management of this case, which had presented to the Emergency Department of our hospital, is elaborated in detail.
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Background: Gestational age is a major determinant of newborn prognosis. Early identification of gestational age is a major priority to reduce global mortality from preterm birth. Therefore this study was conducted with an aim to find out an alternate simple, low cost and reliable method to identify accurate gestational ages.Methods: The cross sectional study was carried out at Rukmani Chainani Maternity and Neonatal Unit, SSGH and Medical College, Baroda from December 2019 to May 2020. Total 500 live newborns of different gestational ages within 72 hrs of birth which were appropriate for gestational age were enrolled in this study. Foot length, head circumference, crown heel length and weight were measured. Gestational age was estimated by antenatal USG, Ballard scoring and LMP. Correlation of foot length to gestational age and other anthropometric variables was done.Results: There was statistically significant positive correlation found between foot length and gestational age (correlation coefficient of 0.944 and p value of <0.0001). There was also positive correlation found between foot length and weight, head circumference and length with correlation coefficient of 0.942, 0.888 and 0.906, respectively. Using ROC curve, foot length cut-off value of 7.2 cm can be used for identifying preterm babies with sensitivity of 94.4% and specificity of 95.6%. Regression equation for gestational age calculation was GA=6.669+4.0601[FL].Conclusions: This study had demonstrated that Foot length is a simple and reliable anthropometric measurement to assess gestational age and to screen prematurity.
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Introduction: In long bones including radius, surface opening of nutrient canal is known as nutrient foramen, which transmits nutrient artery to supply cortical bone and medullary cavity. Topographical information about nutrient foramen is very crucial during various orthopedic surgical procedures. Objective: Present study was conducted to study number of nutrient foramina, its location and direction in relation to growing end of bone and to calculate foraminal index of human radius. Subjects and Methods: In present study 63(31 right and 32 left sided) radii bone of unknown age and sex were studied. Only fully intact bone without any disease were included. Surface location and direction of nutrient foramina were recorded. Total length of radius was measured with osteomatric board. Distance of nutrient foramen from proximal end was measured with digital vernier caliper. And foraminal index was calculated. All data was tabulated and analyzed statistically. Results: All radii had single nutrient foramen. Majority (82.54%) of the nutrient foramina were detected on the anterior surface, 14.29% were on posterior surface and only two bone have nutrient foramen on other surface. Zone I contained 30.16% and Zone II contained 66.67% and Zone III contained 3.17% foramina. Direction of all foramina were towards upper end of radius except two bones. Conclusion: Almost all the results coincided with previous studies from different geographical regions. Thorough knowledge of morphology of nutrient foramina is necessary for preserving circulation. Because it is very crucial in bone grafting, fracture healing, joint replacement therapy and vascularized bone micro surgeries.
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Introduction: The identification of sex in human skeletal remains is an important component of manyanthropological investigations and forensic science. Sex determination using sacrum is often considered withvarious available parameters and indices when dealing with human skeleton remains. Sacral index is the mostimportant criteria for sex determination using sacrum. Present study aims at determining the significance ofsacral index in sex determination from sacra of saurashtra region.Materials and Methods: 120 (84 male and 36 female) adult human sacra of known sex from Saurashtra regionwas included in present study. Ventral straight length and maximum breath of sacrum was measured , sacralindex calculated, Demarking points for these parameters were used for identification of sex of sacrum.Results: In males sacral index varies from 90.38 to 119.36, with mean value of 103.49 and standard deviationwas found to be 8.52. In females sacral index varies from 92.86 to 141.33, with mean value of 116.97 andstandard deviation was found to be 8.52. In statically significant range(Mean ± 3 SD) maximum value of malesacral index was 121.76 and minimum value of female index was 91.40. These two points were accepted asdemarking points.Conclusion: Significant differences has been observed in the sacral index of males and females of Saurashtraregion. Sacral index is higher in females than in males. On the basis of present study it can be concluded that inSaurashtra region sacrum having sacral index less than 91.40 is definitely of male whereas sacrum havingsacral index more than 121.76 is definitely of female. However not a single parameter could identify sex of 100%of the bones.
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Introduction: In oral smear, a small condensed mass of sex chromatin usually located just inside the nuclearmembrane of the nucleus is called Barr body. The study of Barr bodies is advantageous for sex determination bypresence or absent. Oral mucosal smear of 150 students (79 female students and 71 male students in the agegroup of 17 to 32 years) from P.D.U. Govt. medical college, Rajkot were selected with aim to study oral mucosalcells for presence of sex chromatin in oral mucosal smear and to measure efficacy of oral smear in determinationof sex by presence of sex chromatin during 2012 to 2014.Method: Oral smear was prepared for sex determination by scrapping buccal mucosa with wooden spatula andobtained turbid suspension, these were smeared on a glass slide, fixed by mixture of Methanol and Glacialacetic acid in the ratio of 3:1 for 10 min and stained by Carbol Fuschin for 15-20 min at room temperature, aftertaking informed written consent from students. Smears were examined with Compound light uniocular microscopeunder 100x magnification (Oil immersion), cells and nuclei were easily identified.Observations and Results: One hundred cells were counted in each slide. Mean value of Barr body positive cellsin male was 0.647 and Mean value of Barr body positive cells in female was 35.215 and range of percentage ofBarr body positive cells in male was 0-5% and range of percentage of Barr body positive cells in female was 0-55%. Presence of sex chromatin in oral mucosal cell of female was statistically significant. (P value < 0.05).Conclusion: Mean value of Barr body positive cells in male was 0.647 ± 1.148, Mean value of Barr body positivecells in female was 35.215 ± 10.28, range of percentage of Barr body positive cells in female was 0-55% and rangeof percentage of Barr body positive cells in male was 0-5%. Presence of sex chromatin in oral mucosal cell offemale was statistically significant. (P value<0.05) Mean values of sex chromatin positive oral mucosal cells ofmale was lower than mean value of sex chromatin positive oral mucosal cells in female, that is the supportingfact that sex chromatin is present in female in higher frequency. Sex chromatin can be used as simple and easilyavailable method for sex determination.
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Central venous access is increasingly becoming the domain of the radiologist, both in terms of the insertion of central venous catheters (CVCs) and in the subsequent management of these lines. Malposition (means catheter lies outside of Superior Vena Cava) may be associated with catheter insertion and may require immediate intervention. Despite careful placement using proper landmarks and technique, it might be associated with hematoma formation at insertion site, pneumothorax, inadvertent arterial puncture, hemothorax, chylothorax, extravasation of infusate, pleural effusions, sepsis, thrombosis and cardiac tamponades. This report highlighted a case of a malpositioned central venous catheter leading to extravasation of infusate in subcutaneous plane. Everyone should be aware of the complications and monitor consistently appropriate position of catheter tips.
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Introduction: Tuberculosis is increasing in the developing countries and re-emerging in the developed ones because of overcrowding and increase in of population. Spinal TB is the most clinically important form of extra-pulmonary tuberculosis, as it may produce serious neurological sequel due to compression of spinal cord by its excessive spread and involvement of spinal canal as a result of the disease itself, as well as the resultant deformity. Early recognition and prompt treatment are therefore necessary to minimize residual spinal deformity and or permanent neurological deficit. This retrospective study lightens and correlates the image morphology of spinal TB on MRI. Materials and methods: The study was done from January 2015 to June 2015 on 70 patients diagnosed with Tuberculosis of spine. MRI of spine was carried out in all the patients. MRI was done using a 1.5 tesla Philips system. MRI features were observed on T1W, T2W, Short tau inversion recovery (STIR) and post contrast (gadolinium) T1W sequences with sections in sagittal, coronal and axial planes. Results: This study showed that the most common clinical feature was back pain followed by deformity with most patients being afebrile. Most common vertebrae involved were dorsal followed by lumbar and the cervical with sacral being the least involved. Central type of vertebral lesion was common than paradiscal and rarely it involves posterior elements and inter vertebral disc. As compared to the other modalities soft tissue involvement, extent of lesion, type of lesion and Inter vertebral disc involvement are better visualised on MRI. Conclusion: MRI offers excellent visualization of the bone and soft tissue components of spinal tuberculosis and helps to identify disease at distant asymptomatic sites (skip lesions) before and accurately as compare to other modalities. MR imaging clearly demonstrated the extent of soft tissue Rathva A, Zala S. MRI is the gold standard investigation for early detection, extent of involvement and management of patient in Pott’s spine. IAIM, 2017; 4(1): 7-15. Page 8 involvement and its effect on the thecal sac/cord and neural foramen. It helps in early diagnosis and therefore management.
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Introduction: Spine is a longitudinal structure, and precise location of the level of a lesion from clinical examination can be difficult. MRI of spine shows the anatomy of the vertebrae that makes up the spine, as well as the discs, spinal cord and the intervertebral foramina through which the nerves pass. It also allows us to differentiate between healthy tissue and diseased tissue. Materials and methods: This study aimed at diagnosing and following up cases of spinal lesions in the department of Radio diagnosis of SBKS Medical Institute and Research Centre and Dhiraj General Hospital. The study is performed using conventional X-rays and MRI. Results: Maximum numbers of patients were between 41–50 years age group followed by 21-30 and 31-40 years of age group, whereas patients of paediatric (00-10 years) and geriatric (>70 years) age group constituted only 8% patients. Average age of patients was 42.5 years. Lumbar spine was the most commonly affected spine region. Maximum numbers of patients were of degenerative and disc lesions (49%). Conclusion: MRI by virtue of non-invasiveness, lack of radiation hazard and by ability to demonstrate structural changes is investigation of choice for spine and spinal cord pathologies. The ability to image the cord directly rather than indirectly as in myelography, the absence of bone artifact as in computed tomography, and the multiplanar capabilities indicate that MRI is the procedure of choice in the examination of the spinal cord.
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Background: CT has evolved from single–detector row scanners into multi–detector row helical volumetric acquisition techniques, and these advances have had a significant impact on imaging of the urinary tract. Aim and objectives: To evaluate the CTU compare to other imaging modalities for urinary tract abnormalities in light of present knowledge, To study the role of CTU in evaluation of various abnormalities those are not detected by conventional IVP, Benefits of CTU over IVP, To provide information about the extent of the lesions involving kidneys and its relation to surrounding structure and Characterizing the lesions whether they are benign or malignant and helping the surgeons for the further management, Grading the renal injuries. Materials and methods: Data was collected from patients who attended the surgical O.P.D. or emergency of S.S.G.H., Baroda with clinically suspected renal abnormalities. A study was conducted over a period of two years on 50 patients with clinically suspected renal abnormalities. Informed consent was taken from every patient. Patients were evaluated with Multidetector Computed Tomography (G.E. Bright Speed). Results: Our Study included 10 patients of renal stones, 8 patients of renal masses, 3 patients of pyelonephritis, 7 patients of renal injury, 5 patients of PUJ obstruction, 7 patients of ureteric stricture, 5 patients of anomalies, and 5 patients of bladder mass. Among all pathology CT urography is more helpful and gives better imaging findings as compare to conventional urography that helps in better management of patients. Conclusion: CTU gives reliable information not about the extent of lesion but also the characteristics of lesions which makes surgeons to take proper decision aboutthe further management of patients, it also avoids unnecessary laparotomy surgery in case of blunt abdominal trauma patients by giving the precious extent of renal injuries. For all these gold standard benefits of MDCTU over conventiona Rathva AM, Singla H. MDCT urography as a one stop shop for urinary tract abnormalities at present era. IAIM, 2016; 3(3): 52-64. Page 53 IVP makes MDCTU as “one stop shop” for urinary tract abnormalities and nearly completely replacing the IVP in recent era.
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Hydatid involvement of the kidney accounts for only 2–4% of all cases of hydatid disease it is very rare and again primary involvement of the kidney without involvement of liver parenchyma or lung parenchyma that makes it extremely rare. The purpose of this article is to review the imaging features of hydatid disease of the kidney and thus show the role of radiography, excretory urography, sonography, CT, and MRI in the diagnosis of Hydatidosis. Hydatiduria accompanies only 10 to 20 % of all cases of renal Hydatidosis and usually microscopic ,here we are reporting a 65 years old female with abdominal lump in right hypochondriac region with pain on USG finding suggestive of hydatid cyst of liver with indentation and possible involving right kidney but MDCT suggest it is a primary right renal hydatid large exophytic cyst having multiple daughter cysts involving upper pole of kidney with breech in the cortex and it extends to involve right renal pelvis which indenting to inferior surface of liver