ABSTRACT
Background: within 48 – 72 hours, most common disorder that occurs in neonate is respiratory distress. Post natal respiratory distress is the most important indication for chest X- ray. Clinically it is very difficult to distinguish between pulmonary and extra pulmonary causes. Aim: To show the radiographic appearances of various causes of neonatal respiratory distress, and varied appearances of each pathology. Material and methods: This was a prospective observational study that was conducted in Dhiraj General Hospital. Antero-posterior chest radiograph in supine position of (118) neonates were taken, presented with a chief complaint of respiratory distress. Chest X-ray was taken presented with a chief complaint of respiratory distress. Chest X-ray was taken with the help of portable X-ray machine in NICU department. Chest X-ray were taken on first day of admission and then follow up chest X-rays were taken. Results: The commonest cause of respiratory distress in neonates which presented with respiratory distress was transient tachypnoea of new born, which was (32.20%), followed by hyaline membrane disease (20.33%) , neonatal congenital pneumononia (16.94%), meconium aspiration syndrome (11.86%), cardiac causes (5.08%), trachea-oesophageal fistula (4.23%), congenital diaphragmatic hernia (2.54%), aspiration pneumonia (2.54%), idiopathic persistent pulmonary hypertension (1.69%), eventration of diaphragm (1.69%) followed by pneumoperitonium (0.84%). Conclusion: Any sign of respiratory distress is an indication for roentgenogram of the chest which should be taken as early as possible.
ABSTRACT
Background: Diagnosis of abdominal trauma is a real. Diagnostic tools that help the treating doctor in optimum management of abdominal trauma include; Focused Assessment with Sonography for Trauma (FAST), Diagnostic peritoneal lavage (DPL) and CT Scan. Objectives: The aim of this communication was to define the recent role of FAST and CT scan of the abdomen in the diagnosis of abdominal trauma. Material and methods: This study aimed at evaluating patients who came to the Radiology Department of Dhiraj General Hospital, by using USG and CT scan. This study comprised of 50 patients. Results: Out of 50 patients of abdominal trauma, 12 patients (24%) were in age group 21-30 years with male to female ratio of approximately 5.2: 1. The commonest mode of trauma was road trafic accident according for 54% of total cases. Spleen and liver were the most common organs injured, followed by kidney. USG showed overall sensitivity 57.48%, specificity 97.77%, positive predictive value 88.9125, negative predictive value 97.185 and accuracy of 90.75%. CT scan showed highest sensitivity of 95.35%, specificity of 100%, positive predictive value of 100%, negative predictive value 77.78% and accuracy 96%. Conclusion: FAST is useful as the initial diagnostic tool for abdominal trauma to detect intra abdominal fluid. With proper training and understanding the limitations of ultrasound, the results of FAST can be optimized. DPL is indicated to diagnose suspected internal abdominal injury when ultrasound machine is not available, there is no trained person to perform FAST, or the results of FAST are equivocal or difficult to interpret in a hemodynamically unstable patient. In contrast, in hemodynamically stable patients the diagnostic modality of choice is CT with intravenous contrast. It is useful to detect free air and intra peritoneal fluid, delineate the extent of solid organ injury, detect retroperitoneal injuries, and help in the decision for conservative treatment. Helical CT is done rapidly which reduces the time the patient stays in the CT scan room. Furthermore, this improves sagittal and coronal reconstruction images which are useful for detecting ruptured diaphragm.