ABSTRACT
BACKGROUND:Before advent of cross section imaging radiologists were of limited help in diagnosis of neck lesions, especially those involving deep neck spaces of suprahyoid neck (SHN). AIM:Aim of our study is to characterise neck lesion by its morphological characteristics and enhancement pattern, outlining the extent, assessment of lymphadenopathy, look for criteria for operability and histopathological confirmation. METHODS & MATERIALS:In this study 100 cases of neck masses were evaluated retrospectively in our department. The CTscan was performed prior to the treatment in all these patients. CTimaging feature includes location, size/diameter, degree & pattern of enhancement, intraluminal/exophytic, internal necrosis & hemorrhage, local spread, nodal & distant metastasis.RESULTS:Out of 100 patients studied 27% were benign and 73% were malignant neck lesions, overall there was a male preponderance with a male to female ratio of 2.1:1. Benign lesion were common in the age group of 16-45 yrs. while malignant lesions were more common in the elderly age group of >45 years. Most of the benign (26%) and malignant lesions (81%) showed heterogeneous enhancement pattern. Bone invasion seen in 15% benign lesions, 19% of malignant lesions and cartilage invasion seen in 7% of malignant lesions. On correlation with HPE, among malignant lesions most common was Squamous cell carcinoma (48%) and among benign lesions most common was nonspecific inflammation. The sensitivity and specificity of study is 95.7% & 77.5% respectively, with positive predictive value and negative predictive value of 90.4% & 88.9% respectively and Accuracy is 90%.
ABSTRACT
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.
ABSTRACT
Introduction: Data on the efficacy of hydroxyurea (HU) in Indian children with sickle cell anaemia (SCA) is limited. Hence, we have evaluated the efficacy of fixed low dose HU in Indian children. Methods: The study cohort consisted of 144 children (<18 years of age) with SCA having severe manifestations (≥3 episodes of vasocclusive crisis or blood transfusions, or having ≥1 episode of acute chest syndrome or cerebrovascular stroke or sequestration crisis) who were started on fixed low dose HU (10 mg/kg/day). They were followed up for two years and monitored for the hematological and clinical efficacy and safety. Results: There was significant increase in the fetal hemoglobin level (HbF%), total hemoglobin and mean corpuscular volume. Vasoocclusive crises, blood transfusions, acute chest syndrome, sequestration crises and hospitalizations decreased significantly. Baseline HbF% had significant positive correlation with HbF% at 24 months. There was significant negative correlation between baseline HbF% and change in HbF% from baseline to 24 months. No significant correlation was found between HbF% at baseline and clinical event rates per year after HU. No major adverse events occurred during the study period. Conclusion: Fixed low dose HU is effective and safe in Indian children with SCA.
ABSTRACT
The authors describe a case of primary mucinous carcinoma of urachus in 65 years old male. Patient presented with hematuria with suprapubic mass. The patient underwent total cystectomy with en bloc excision of the tumor mass and umbilicus. Histological examination showed features of mucinous carcinoma of urachus. A clinicopathological study and brief review of literature is presented.