Diagnostic Accuracy of Two Softwares for Detection of Intra-Bony Lesions in Multi-Detector Computed Tomography

Background: Bony jaw lesions have varied radiographic appearance and may pose difficulty in establishing radiographicdifferential diagnosis. Computed tomography is a useful tool to facilitate the correct diagnosis of these bony lesions.Objectives: To compare the volumetric measurement of bony lesions of the jaw using two commercially available softwaresfor the evaluation of CT imaging. Material and Methods: All patients were subjected for multi-slice CT scanning. Thevolumetric measurements were performed using two softwares; Myrian and Siemens. Results: This study was conducted on15 patients of both genders; males (66.7%) and females (33.3%), where 21 diagnosed lesions with an intra-bony spaceaffecting one or both of the jaws were included in the measurements. Myrian software showed statistically lower mean ofvolumetric measurement than Somatom (P-value <0.001). Conclusion: Although, Myrian software showed statisticallylower mean of volumetric measurement than Somatom. The clinicalrelevance of these finding still needs to be determined infuture studies. Thus, both softwares can still be useful diagnostic tool for volumetric measurements.

protective effect of magnesium on the neurocognitive function in hypothermic circulatory arrest and retrograde cerebral perfusion for aortic arch surgery

Background: Neuropsychological dysfunction is a major complication of thoracic aortic surgery with hypothermic circulatory arrest [HCA]. Magnesium has been shown to have neuroprotectant effect in acute stroke and in short term neurological dysfunction after cardiopulmonary bypass. We sought to study the effect of magnesium on the neuropsychological function after HCA for aortic arch surgery using retrograde cerebral perfusion [RCP]

Methods: Forty patients scheduled for elective thoracic aortic surgery including the arch using HCA with RCP were randomly assigned to two equal groups. The magnesium group received magnesium sulfate to increase plasma magnesium level between 1.5 to 2 folds throughout the operation and for 24 hours, while the placebo group received normal saline over the same period as a control. The patients' neurocognitive state was assessed by cognitive P300 visual evoked potentials and the revised Wechsler Adult Intelligence Scale done the day before the operation and 2 weeks postoperatively. P300 was assessed as area under the curve [AUC] between 280 and 600 ms and center of this area [Ct [time], Cv [voltage]]. The ratio of these parameters acquired by target [TG] and non-target [NTG] stimulus [TG/NTG], was calculated to assess concentration on TG stimulus and defined as concentration index [CI: CI[AUC], CI[Ct], and CI[Cv]]

Results: There were no stroke, seizure, or hospital mortality in either group. Preoperatively, in the magnesium group, AUC and Cv acquired by TG stimulus in both Cz and Fz leads were significantly altered postoperatively [P value <0.05]. In the placebo group, no significant postoperative change was observed in all leads on TG stimulus. Postoperative CI [Ct] in the placebo group, were significantly impaired in all leads. The revised Wechsler Adult Intelligence Scale shows significant decline between baseline and postoperative scores in three subtests [digit span P value <0.05, arithmetic, and picture completion P value <0.01] for magnesium group and four [digit span, arithmetic, picture completion, and picture arrangement P value <0.01] for placebo group. Statistical difference between groups in test score changes was found in one subtest [picture arrangement P value <0.05]

Conclusion: Magnesium administration in patients undergoing aortic arch surgery with hypothermic circulatory arrest using retrograde cerebral perfusion did not affect the neurocognitive outcome assessed by cognitive P300 visual evoked potentials and the revised Wechsler Adult Intelligence Scale, further work is needed to prove any protective value for magnesium in this context

Anaemia in diabetes mellitus

Eighty five patients with diabetes mellitus and 25 normal controls were studied clinically together with evaluation of their red cell values, bone marrow picture, serum iron and liver function tests. Normochromic normocytic anaemia was found to be a characterstic feature of diabetics having chronic complications or infections. Macrocytic normochromic anaemia was present in diabetics having ketoacidosis. Possible underlying mechanisms for the present anaemia was discussed. In non complicated diabetics anaemia was not present and serum iron was within normal limits. Conclusion was reached that the presence of anaemia in a diabetic patient is a sign of diabetic complications

Blood viscosity in diabetes mellitus

Eight five diabetics and 25 normal controls of matched age and sex were studied. Estimation of the whole blood viscosity by using the U-shaped viscometer tube was made. Significantly higher blood viscosity was a constant feature for diabetics. Correlation of viscosity to diabetic complications and type of diabetes was carried out. Hyperlipidemia, hyperfibrinogenaemia, increased alpha[2] and beta globulins showed a linear relation to the blood viscosity. Conclusions were reached that the estimation of blood viscosity in diabetics is a rapid, simple and reliable prognostic test for diabetics especially in complicated cases