Metronidazole induced neurotoxicity: a case report

Metronidazole is a well-known antimicrobial agent, used for the treatment of anaerobic bacterial and protozoal infections. It is generally well tolerated with common side effects like nausea, dizziness, headache and metallic taste in the mouth. But prolonged use of metronidazole can cause neurotoxicity like ataxic gait, dysarthria, seizures and encephalopathy. Here, we are reporting a case of a 60 years old male patient who was a chronic alcoholic with liver abscess and he developed acute ataxia and dysarthria after four weeks use of metronidazole. The causality of metronidazole in this case was “probable” with score 7 as per Naranjo scale. The patient was managed by discontinuing the metronidazole and there was considerable improvement in his gait and speech after that. The case was recorded properly in adverse drug reaction reporting form and was sent to nearby adverse drug reaction (ADR) monitoring centre

Interobserver reproducibility of RENAL nephrometry score in comparison to simplified PADUA Renal nephrometry score

Introduction: Nephron-sparing surgery (NSS) is the standard of care for renal tumors, especially in the early stages. RENAL Nephrometry scores provide a comprehensive presurgical predictive module for the choice of NSS or Radical Nephrectomy. The validity and reliability of Nephrometry scores is being tested continuously with advancement in the surgical techniques. The Simplified PADUA Nephrometry score (SPARE NS) is a newer proposed score which aims to better the reproducibility of the previously established nephrometry scores. Materials and Methods: The retrospective observational study studied the comparative inter-observer reliability of RENAL (RENAL NS) and SPARE nephrometry scoring systems amongst two radiologists while assessing solid renal tumors in contrast-enhanced computed tomography scans of 42 patients. Interobserver reliability for all components of both scores, final scores and risk grading was done by Kendall's Concordance Coefficient (Tau). Results: Both RENAL NS and SPARE NS showed strong to excellent agreement (RENAL NS = 78.57% and SPARE NS = 88.09%) among observers with comparable correlation co-efficient (RENAL NS = 0.944 and SPARE NS = 0.935). Lesion radius and exophytic/endophytic properties were the most reproducible components of RENAL NS with 97.61% and 92.85% agreement, respectively. Location across polar lines was the least reproducible component with 85.71% agreement among observers. Exophytic rate (97.61%) and Rim location were the most reproducible components of SPARE NS. The final lesion risk stratification by both observers for both was concordant in 92.85% of cases. Conclusion: The SPARE system of scoring matches up to the RENAL NS in total score and risk stratification reproducibility. However, the individual components of the SPARE score are more reproducible than those of RENAL NS, bringing about better compliance among radiology consultants. Comparable reproducibility with the RENAL NS, lesser number of variables, and ease of doing make SPARE NS a plausible option for the customary preoperative assessment of renal tumors

Effect of vaccination on the HRCT profile of COVID-19 patients – A single-center experience

Introduction: Vaccination against the global pandemic coronavirus disease 2019 (COVID-19) is a promising way out of the havoc caused by the disease. The clinico-radiological profile of COVID-19 patients in relation to the vaccination status is depicted in the present study. Materials and Methods: This is a retrospective observational imaging and hospital data-based study performed on 214 confirmed and clinically suspicious patients of COVID-19 who underwent high-resolution computed tomography (HRCT) scan of the thorax at the Department of Radio-Diagnosis of a tertiary medical center in the Himalayan foothills. The present study aims to evaluate the effect of vaccination on HRCT findings of COVID-19 populations. Results: Forty-three percent of the non-vaccinated population presented with severe HRCT scores (19–25) in comparison to only 11.5% of the study population who had taken both doses of vaccine (P = 0.018). Two doses of vaccination had a negative Pearson correlation coefficient with severe HRCT scores (–0.146). Co-morbidities had a significant correlation with HRCT severity score, with 61.5% diabetics and 63.33% of hypertensive patients showing scores >19 on HRCT. Conclusion: Vaccination proves to be a game changer in the pandemic with two doses of vaccination having a significant negative correlation with COVID-19-induced severe pneumonitis on HRCT of the thorax

Advancements in Urban Environmental Studies : Application of Geospatial Technology and Artificial Intelligence in Urban Studies

Advancements in Urban Environmental Studie