A Comparison of Hand Traced Conventional Lateral Cephalogram with Digital Lateral Cephalogram Using Different Calibration Techniques of Dolphin Imaging (Version 11.5).

Objective:The purpose of the study was to evaluate and compare hand tracings on conventional lateral cephalograms with different calibration techniques available in dolphin imaging on digital lateral cephalogram. Materials and Methods:50 Conventional lateral cephalogram and 50 digital lateral cephalogram were taken in (NHP) at same period of timeon the same patient. Two angular measurements Facial Axis Angle and ANB angle two linear measurements Sella to Nasion and Sella to articulare have been taken. The digital images were traced by calibration 3 techniques Ruler, DPI and Land mark available in Dolphin Imaging Software Version 11.5.The conventional were traced on lead acetate paper and data has been collected.Results: In measurement of Facial Axis Angle conventional when compared with different calibration techniques Ruler Land Mark technique show <0.001significantvalue. In measurement of ANB angle shows no significant values. In measurement of S-N length Ruler compared with DPI has shown significant p value <0.001. DPI compared with conventional shows 0.001. S-AR length has shown significant value p value 0.006, DPI compared with Landmark shows 0.007,Landmark compared with conventional shows 0.003. Conclusion: According to our study conventional when compared with calibration techniques ruler has show only one significant value DPI and land mark has shown two significant values so our study conclude that using ruler is the better option for calibration of digital radiograph. As ruler is more accurate to conventional we compare DPI and Landmark techniques to ruler, landmark shows less variation with ruler so according to our study the second option for calibration of digital radiograph is landmark and last option comes DPI.

Magnitude and determinants of refractive error among school children of two districts of Kathmandu, Nepal

The purpose of this study is to assess the magnitude and determinants of refractive error among school children of Lalitpur and Bhaktapur districts in Kathmandu Valley of Nepal. A descriptive study was carried out in 2003 in four schools; two in each district. A detailed ocular examination was conducted of all children attending these schools and that included visual acuity testing, slit lamp examination, fundus evaluation, retinoscopy cycloplegic refraction and subjective refraction. Myopia was defined as more than -0.5 D and hypermetropia was defined as error of more than +1 D. A total of 2000 students of 5-16 years of age were examined. The prevalence of refractive error was 8.60% [95% confidence interval [CI] 7.37-9.83]. The prevalence of myopia was 6.85% [95% CI 5.74-7.96]. The best-corrected visual acuity was 6/9 or less in the eye of 12.8% children with refractive error. Refractive error is of public health magnitude among school children of 14-16 years of age. School screening program in countries like Nepal for early detection of treatable disease is useful to detect and correct refractive error in older students

Noninvasive prediction of large esophageal varices in chronic liver disease patients

Esophageal varices [EVs] are a serious consequence of portal hypertension in patients with liver diseases. Several studies have evaluated possible noninvasive markers of EVs to reduce the number of unnecessary endoscopies in patients with cirrhosis but without varices. This prospective study was conducted to evaluate noninvasive predictors of large varices [LV]. The study analyzed 106 patients with liver diseases from January 2007 to March 2008. Relevant clinical parameters assessed included Child-Pugh class, ascites and splenomegaly. Laboratory parameters like hemoglobin level, platelet count, prothrombin time, serum bilirubin, albumin and ultrasonographic characteristics like splenic size, splenic vein size, portal vein diameter were assessed. Univariate and multivariate analysis was done on the data for predictors of large EVs. Incidence of large varices was seen in 41%. On multivariate analysis, independent predictors for the presence of LV were palpable spleen, low platelet count, spleen size >13.8 mm, portal vein >13 mm, splenic vein >11.5 mm. The receiver operating characteristic [ROC] curve showed 0.883 area under curve. Platelet spleen diameter ratio 909 had a sensitivity and specificity of 88.5%, 83% respectively. Thrombocytopenia, large spleen size, portal vein size and platelet spleen diameter ratio strongly predicts large number of EVs

Chronic abdominal pain: imaging of bowel

A 70-year-old-man was evaluated as an outpatient for chronic abdominal pain for the last two years. The pain was intermittent and not severe enough for him to seek immediate medical attention. There was no history of vomiting, abdomen distension, or of similar episodes in the past. He gave no history of any change in his bowel habits. There was no significant past medical history. On examination, his vital signs were stable. Abdominal examination was normal. An upper gastrointestinal series with small-bowel follow-through and a double contrast barium enema was performed, which clinched the diagnosis [Figures 1 and 2]. What is your diagnosis?