Computed Tomography Characteristics of Intracranial Ring-enhancing Lesions

Introduction: Ring-enhancing computed tomography (CT) lesions are those which consist of focal area of hypodensity on plain CT scan on which contrast administration shows ring-like enhancement. CT scan has largely replaced previous radiological procedures such as plain roentgenograms, pneumoencephalogram, cerebral angiography, and myelography. Purpose: The purpose of the study was to determine the various CT morphological characteristics of ring-enhancing lesions in various intracranial pathological entities. Materials and Methods: This is a cross-sectional study conducted in the department of radiology in a tertiary care center in Mangalore, Karnataka, from July 2015 to November 2016. A total of 30 patients were included in this study whose CT scan showed ring-enhancing lesion or lesions after contrast administration and with a final diagnosis following surgery or complete cure. The morphological features of the lesions observed were tabulated and analyzed using SPSS software version 16. Various morphological features are expressed as percentages. Conclusions: CT morphology characteristics of ring lesion are strongly suggestive of the diagnosis such as tuberculoma, brain abscess, glioma, metastases, and nerocysticercosis; however, they have to be corroborated by clinical history, laboratory investigation, and histopathological examination to arrive at a definite diagnosis.

Facial Nerve Schwannoma – A Diagnostic and Surgical dilemma: A Case Report

Facial nerve schwannomas are rare facial nerve tumors that can arise anywhere along the course of the nerve where Schwanncells are present. The clinical presentation and symptoms differ not only due to the location of tumor but also due to theneighboring anatomical structures it involves. Delay in diagnosis can increase the morbidity of the condition for the patient.Surgical excision is the definitive treatment and often it can be challenging to the surgeon. Our case demonstrates an unusualpresentation of this relatively uncommon tumor that mimicked cholesteatoma causing lower motor neuron facial palsy whichturned out to be a facial schwannoma later by biopsy

Occupational stress among female police officers in an urban setting in South Kerala

Background: Occupational stress is regarded as one of the major health hazards of modern workplace, with policing (law enforcement) being no exception. Women police officers are gradually increasing in numbers in the country and they are believed to experience more stress than their male counterpart. Hence this study was conducted with the objectives of estimating prevalence of occupational stress among female police personals in terms of operational and organizational stress and to identify the causes for these stress as perceived by them.Methods: A cross sectional study was conducted among 50 female police officers working in various police stations of Thiruvananthapuram city, selected by simple random sampling, during the period May 2018 to July 2018,using a pre tested semi structured questionnaire based on operational police stress questionnaire (PSQ-OP) and organizational police stress questionnaire (PSQ-ORG). The data was properly coded and entered in Microsoft excel and analyzed using SPSS version 16.0.Results: Mean age of the study population was 38.07 years (SD=5.714 years) and majority (64%) belonged to middle socioeconomic class. Perceived organizational and operational stress prevalence among the study population was as high as 80% (40 % experienced moderate stress and 40% experienced high stress) and 90% (high stress reported by 70 % and moderate stress by 20%) respectively. The most common stressor reported for organizational stress was staff shortage (74%) and that for operational stress was finding time to stay in good physical condition (76%).Conclusions: High prevalence of occupational stress calls for immediate attention from the officials.

Infected Epiglottic Cyst Presenting With Stridor in an Adult: A Case Report

Epiglottic cyst is a benign tumour that can occur at all ages. Considering that the diameter of the respiratory tract is smaller in infants and children, an epiglottic cyst may easily obstruct the airway and large cysts may present as stridor, cyanosis with feeding and respiratory difficulty. On the other hand most adult epiglottic cysts remain benign and asymptomatic. Rarely they may progress to epiglottitis or epiglottic abscess, leading to airway obstruction and respiratory arrest. We report the case of a 20 year old male patient who presented to us with abrupt onset of dyspnoea and stridor. Our foremost priority was to secure the airway and emergency tracheostomy was done. Laryngoscopic examination revealed a large cyst occupying lingual surface of epiglottis including the free margin. Contrast enhanced CT scan of neck demonstrated prominent epiglottis with hypodense lesions suggestive of abscess within it. The patient underwent microlaryngoscopy with marsupialization of the cyst wall. Patient was subsequently decannulated and on follow up showed no recurrences of cyst.

Factors influencing status of undernutrition among children (0-5 years) in a rural area of Delhi: a cross-sectional study.

Background: Although more than one-third of under six year children in Delhi slums are undernourished; but what is the situation in rural areas of Delhi - a capital of India, it is not very clear. Moreover the research in rural area on topic has also not received much focus in past. Methods: The study was done in the Narela area (a Rural ICDS project in Delhi). All the eligible 450 children between the age group 0-5 years as found in the survey register of ICDS project for 2 Anaganwadi Centre’s (AWC-A & AWC-B) at the time of data collection, were included in the study. The prevalence of undernutrition in 2 AWCs was determined and it was compared with records of 2 AWCs. The primary and secondary data was triangulated to confirm pattern scenario of undernutrition. Results: In Rural ICDS Block, the prevalence of underutrition came out 57.8%.The difference in nutritional grades of undernutrition in the study were not statistically significant (P >0.05) as per their the registration status at AWCs in ICDS scheme. The type of family and family income of household however were statistically significantly associated with the nutritional status of child (P <0.01). Conclusions: The undernutrition is prevailing in rural area of Delhi (India), despite the presence of ICDS scheme; suggesting that other host factors in family are also important and service delivery factors in nutrition and health programmes also needs radical relook for tackling undernourished children in Delhi.

Social determinants and polio 'endgame': a qualitative study in high risk districts of India.

OBJECTIVES: To understand the perceptions and likely determinants that facilitate or act as barriers in implementing additional strategies for polio eradication: (a) accelerated delivery of mOPV1 (monovalent polio vaccine type 1); (b) use of IPV (inactivated polio vaccine); and (c) provision of incentives. DESIGN: QUALITATIVE. Rapid appraisal procedures (RAP) were adopted to derive the reality by synthesizing multiple sources of information; search for opinions, motivations, behaviors and attitudes of key stakeholders within their organizational and socio-cultural matrix. SETTING: Two districts of Uttar Pradesh - Moradabad and J P Nagar. SUBJECTS: Total 244 interactions were conducted; 33 interviews and 4 focussed group discussions (FGD) conducted with providers; 33 mothers (<5 years) and 10 leaders were interviewed; 8 FGD were conducted with mothers of under-fives. Informal interactions (156) were also conducted with village pradhans, religious leaders, parents, businessmen, journalists (Hindi and Urdu media), mobilizers, vaccinators and supervisors. RESULTS: Providers expressed reservation regarding accelerated rounds of OPV; scientific rationale of accelerated rounds is not clear to parents and leaders. Although technical advantages of introducing IPV exist, issues of logistical difficulties and injection safety emerged strongly. Providers and communities indicated a clear 'no' to the cash incentives but argued for developmental issues. Resistance to the program has declined over time but still the program is perceived as the "government's need, not ours". CONCLUSION: The polio eradication program is critically poised, an opportunity to intensify efforts for reducing inequities in health services and improve access of all children to the PHC services. Ongoing dialogue with local communities and strong political commitment would be essential to translate the technological innovations into a sustainable program.