A Clinical Audit – Magnetic Resonance Imaging Knee Image Acquisition Adequacy

Objective: The objective of the study was to evaluate the adequacy of magnetic resonance imaging (MRI) scans of knee, performed at the Radiology Department of Dr. D Y Patil Medical College, Hospital and Research Centre, Pimpri, Pune, according to the American College of Radiologist guidelines. Type of Study: This study was a clinical audit. Place and Duration of Study: This study was conducted at Dr. D Y Patil Medical College, Hospital and Research Centre, Pimpri, Pune, from January 2018 to July 2018. Materials and Methods: Retrospective study of approximate 40 patients who underwent MRI of knee in January 2018 for assessment of the quality of images obtained in the initial audit. Depending on the results of this first audit, a suggestion was made and reaudit was done 6 months later in July 2018 to look for improvement quality in local practice. Results: In the initial audit, images were acquired in all the three necessary planes and the sagittal and coronal images had appropriate slice thickness as well as adequate anatomical coverage in all the patients. However, field of view (FOV) was inappropriately set in 34% of cases in axial plane, 90% in sagittal plane, and 95% in coronal plane. Furthermore, the anatomical coverage was not up to the mark in axial plane with 13 studies (66%) having adequate superior coverage, and 16 cases (80%) having recommended inferior anatomical coverage. The reaudit performed 6 months later showed improvement with 100% compliance to standards. Conclusion: Initially, the first audit showed few lackings in acquiring of MRI knee images specifically with FOV to reduce the decrease in all planes and slight increase in anatomical coverage in the axial plane. These shortcomings and recommendations were made in departmental meetings and reaudit was done after 6 months. This reaudit showed 100% compliance.

A study of bacteriological profile and outcome of babies born to mother with Premature rupture of membrane and its correlation with blood and gastric culture

Background: PROM, a condition that occurs when fetal membranes are ruptured at least one hour before onset of labor. While PROM is observed in 10% of all pregnancies, 60-80% of PROM is observed in term and 20-40% in pregnancies less than 37th gestational week. PROM is the most significant reason for preterm labor. The three causes of neonatal death associated with PROM are prematurity, sepsis and pulmonary hypoplasia. Infants born with sepsis have a mortality rate four times higher than those without sepsis. Objective of the study was correlation of blood and gastric culture positive sepsis in PROM newborns. It helps to find out the incidence of PROM in our locality.Methods: This retrospective study enrolled 90 neonates born to healthy mothers with history of PROM more than 18 hours duration, admitted in SNCU/ward at a tertiary care hospital for six months duration from 1st January 2017 to 30 June 2017. Clinical profile of these Newborn with history of PROM was noted such as birth weight, gender, gestation, duration of membrane rupture, history of maternal fever. For all newborns with PROM, sepsis screen had been sent. The neonatal outcome was also recorded, and the data was collected and analyzed by using frequency and percentages.Results: Gram negative bacilli were the commonest cause of neonatal sepsis and male neonates were more prone to infection. PROM and low birth weight especially, ELBW and VLBW are the common high-risk factors for early onset sepsis. Most common organisms isolated in blood and gastric culture were Klebsiella and Staphylococcus aureus respectively.Conclusions: PROM is a high-risk obstetric condition. Active management is needed to enable delivery within 24 hours of PROM as it offers better neonatal outcome. Morbidity and mortality increase as the duration of PROM increases. This can be reduced by early diagnosis, specific treatment and strict infection control practices in neonatal units.

Stability indicating RP HPLC method for determination of levitiracetam in pharmaceutical formulation.

The article reports on a development of RP-HPLC method for the quantitative determination of Levetiracetam in tablet dosage forms. The chromatographic separations were performed using Phenomenex C18 (250 mm x 4.6 mm i.d, 5 μm particle size) column at 40 ºC temperatures. The optimum mobile phase consisted of methanol, water and acetonitrile in the ratio of 30:10:60. Auto sampler 20 μl was used and kept at 15 ºC temperature. Analysis was done with flow rate of 1.0 ml/min at 212 nm ( max of Levetiracetam) wavelength by using photodiode array (PDA) detector. The drug was analyzed for acid, alkaline, oxidative, hydrolytic, photolytic and thermal degradation studies. The standard calibration curve was plotted for the drug and results showed that the drug was linear (r2 = 0.999) in the concentration range between 0.01 – 1.5 μg/ml. The results of stress testing undertaken according to the International Conference on Harmonization (ICH) guidelines reveal that the selected method is selective and stability-indicating for determination of levitiracetam in pharmaceutical formualtion.

Primary intratesticular sarcoma.

Primary intratesticular sarcoma that is neither associated with germ cell elements nor paratesticular elements is a unique subset of intrascrotal sarcoma. It is a rare indolent tumor with potential for distant metastases. Although few data are available it is generally assumed to be quite uncommon. The definitive treatment recommendation are yet to be laid down. Four cases are reported.