Recent Cyclones Causing an Increased Incidence of Intracranial Haemorrhage in India — A Cross-sectional Study

Background : Seasonal variations in the incidence of Intracerebral Haemorrhage (ICH) have been extensively evaluated in the studies conducted in various parts of the world. The prevalence per 100,000 person-years of spontaneous cerebral haemorrhage is regularly highest in the winter and lowest in the summer. However, these seasonal variations of ICH in India have not been comprehensively described in any published literature. Methodology : In this retrospective cross-sectional study, data of 15000 patients were collected from various State Government-owned Hospitals of India of the months April, May and June. The present study examined the association between temperature variations and spontaneous ICH incidence during recent severe Cyclonic Storms ‘Yaas’, and ‘Tauktae’ in India with the brain’s Computed Tomography (CT) scans. A CT brain persists in being the investigation of choice in the initial diagnosis of ICH, as it is readily available, accessible and fast. Results : During these Cyclones, there was a significant temperature drop associated with an increased incidence of ICH in the specified time. Conclusion : Sudden temperature drop during a Cyclone can cause spontaneous Hypertension, which causes rupture of arteries in the brain and results in Stroke. The Government, Physicians and the general public need to be made aware of such associations

CT evaluation of anatomical variations of paranasal sinus region and their clinical importance

Background: Paranasal sinuses are air filled spaces present within the skull and facial bones. Paranasal sinuses region anatomy is highly variable. Knowledge of these variations is very important for radiologists as well as endoscopic surgeons for preoperative evaluation to avoid damage to adjacent vital structures. CT is the best modality to delineate the sinus anatomy as well as soft tissue structures. Thus, this study was undertaken to evaluate the anatomical variations of paranasal sinus region and ascertain their clinical importance.Methods: A total of 142 patients, those referred from various outdoor/indoor departments with the symptoms related to nose and paranasal sinuses were included. Detailed history, appropriate clinical examinations, biochemical investigations and X-ray PNS were recorded. Unenhanced CT scan of the PNS was performed for these patients in the axial planes and reformatted coronal planes. Observation was made and analysed using descriptive tools and scientific methods.Results: Deviated nasal septum was the most common variation followed by middle concha bullosa, Paradoxical middle turbinate, curved uncinate process, overpneumatized ethmoidal bulla, superior concha bullosa, prominent Agger Nasi cells, haller cells, onodi cells, maxillary sinus septae and pneumatization of uncinate process. Incidence of anatomical variation was 75% among the patients showing PNS mucosal changes while it was 94% among patients showing no mucosal changes. Chi square statics revealed that presence of anatomical variation does not mean a predisposition to mucosal changes.Conclusions: The presence of anatomical variants does not indicate predisposition to sinus pathology but may predispose to increased risk of intraoperative complications. It is important to pay close attention to anatomical variations in the preoperative evaluation to avoid possible complications.