Intramedullary cavernoma with extralesional haemorrhage

Intramedullary cavernomas are rare lesions constituting 5 to 12% of all intramedullary tumours. They are more recognized after introduction of magnetic resonance imaging and detection rates have improved by advance techniques. They may be solitary or multiple or may have associated cranial lesions. They may present with gradual neurological decline or with acute loss of spinal function. In addition neurological deficit depends on the location of the lesion within the spinal cord. We are reporting the case of a 45 year old male who presented with neck pain and progressive right arm weakness with numbness. MRI cervical spine with contrast showed intramedullary lesion with peripheral T2 hypointense rim and extralesional haemorrhage consistent with cavernoma. Patient underwent successful surgery and his symptoms markedly improved with mild residual grip weakness in right hand

Intrauterine growth retardation - small events, big consequences

Intrauterine growth retardation refers to a rate of growth of a fetus that is less than normal for the growth potential of a fetus (for that particular gestational age). As one of the leading causes of perinatal mortality and morbidity, intrauterine growth retardation has immense implications for the short term and long term growth of children. It is an important public health concern in the developing countries. Health statistics encompassing parameters for maternal and child health in the Indian subcontinent have shown improvement in the past few years but they are still far from perfect. Maternal health, education and empowerment bears a strong influence on perinatal outcomes including intrauterine growth retardation and should be the primary focus of any stratagem targeted at reducing the incidence of intrauterine growth retardation. A concerted liaison of various medical and social disciplines is imperative in this regard

Polypoid adenomyoma of the uterus.

Polypoid adenomyoma is a rare uterine endometrial polypoid tumor of mixed epithelial and mesenchymal origin. Although the clinical and pathologic features of polypoid adenomyomas have been described extensively, imaging findings for these tumors have not been frequently reported in the literature. On imaging, their features may be confused with prolapsed leiomyomas or malignancy. Hemorrhagic cystic spaces in a prolapsed uterine tumor within the vagina should raise consideration of a diagnosis of polypoid adenomyoma. Such blood-containing cystic spaces would be unusual findings in leiomyomas and malignancy. Diagnosing polypoid adenomyoma is vital because it can potentially be managed by hysteroscopic resection, unlike an ordinary form of adenomyosi

Congenital diaphragmatic hernia presenting in the sixth decade mimicking pneumonia

Congenital diaphragmatic hernia presentation in adults is extremely rare. Patients who present with late diaphragmatic hernias complain of a wide variety of symptoms and diagnosis can be difficult. We report a case of a 64 year old male who presented with a six month history of cough, shortness of breath and weight loss. The most common strategy to treat a Bochdalek hernia is via a thoracotomy or laparotomy or both. In our patient the repair was performed with a thoracotomy

Ruptured hydatid cyst presenting as pneumothorax.

Patients with echinococcus infection are mostly asymptomatic. The documented rates of simple pneumothorax in Patients with pulmonary hydatidosis ranged from 2.4% - 6.2%. We report a case of a forty-year-old male Patient who was referred to our hospital for management of recurrent pneumothorax. A video assisted thoracoscope (VATS) was first introduced which showed a large amount of pus in the pleural cavity and a perforated hydatid cyst. The VATS was converted to an open thoracotomy and decortication was done with removal of the ruptured hydatid. The Patient made an unremarkable recovery and was discharged after one week with empyema tubes. The empyema tubes were gradually removed over a period of six weeks. An extraordinary number of management options for pulmonary hydatid disease have been offered. This case report highlights surgical treatment as the management opti

Spontaneous uterine rupture secondary to morbidly adherent placenta in an unscarred uterus

We report a case of spontaneous uterine rupture in a primigravida with an unscarred uterus, which was secondary to morbidly adherent placenta proven on surgery and histology. Although rare, uterine rupture should be considered as a differential diagnosis of acute abdominal pain in pregnancies, especially when associated with free fluid, even with the absence of vaginal bleeding. Abnormal placentation is associated with spontaneous antepartum uterine rupture even in early pregnancy. Most cases in the literature have advocated emergency hysterectomy to arrest life-threatening hemorrhage

Interobserver reliability of the renal nephrometry scoring system: Experience from a developing nation

Introduction: The RENAL (radius, exophytic/endophytic properties, nearness of tumor to the collecting system or sinus in millimeters, anterior/posterior, location relative to polar lines) nephrometry score (RENAL-NS) has been described as a structured and quantifiable method to describe a renal tumor’s relevant anatomic features as they relate to the complexity of the lesion. We aim to evaluate a tumor’s RENAL-NS and to assess the reproducibility of the score among different observers.Methods: This retrospective study included 49 patients diagnosed with renal cell carcinoma (RCC) who had complete computed tomography (CT) data, RENAL-NS, and histopathology results. All patients underwent renal surgery/intervention at our center between January 2008 and December 2018. The radius of the lesion, exophytic/endophytic properties, nearness to the collecting system, anterior or posterior description, and location relative to the polar lines was used to calculate the score. Tumor complexity was graded as low, intermediate, or high. Two body imaging radiologists evaluated the data independently.Results: Interobserver agreement for each of the RENAL-NS parameters, respectively, and overall complexity was calculated. The total agreement was 82%, 51%, 84%, 69%, 73%, and 90%, corresponding to Kappa values of 0.72, 0.33, 0.44, 0.49, 0.58, and 0.83, respectively. The radius, nearness to the collecting system, and total complexity showed the best agreement. Exophytic properties of the lesion showed the least agreement. For cases that were discordant in terms of the final score, no major implications in surgical planning were observed.Conclusion: The results of this study show that the RENAL-NS is a useful tool to assess the anatomical features of renal tumors and it is easily reproducible, even for less experienced radiologists in a developing nation

Ameliorative effects of alpha lipoic acid, quercetin and ascorbic acid against zinc oxide nanoparticles induced hepatic damage : in vivo

The current study envisioned to evaluate time related protective effect of quercetin, alpha lipoic acid and ascorbic acid on liver of mice against sub-acute exposure of zinc oxide (ZnO-NP) nanoparticle. Male Swiss albino mice (n=72) were randomly divided into eight groups (n=9, each group). G1 received saline solution 0.9%; G2 received quercetin (100 mg/kg b.w); G3 received alpha lipoic acid (100 mg/kg b.w); G4 received ascorbic acid (100 mg/kg b.w); G5 received ZnO-NPs (50 mg/kg b.w); G6 received ZnO-NPs with quercetin; G7 received ZnO-NPs with Alpha lipoic acid and G8 co-treated with ZnO-NPs and ascorbic acid for 21 consecutive days. Body weight, hepatosomatic index and plasma biochemical parameters (total protein, albumin, globulin, total cholesterol, triglycerides, high density lipoproteins, low density lipoprotein, aspartate aminotransferase, alanine transaminase, alkaline phosphatase & bilirubin) were estimated. ZnO showed significant increase in body weight and cause alterations in all biochemical parameters. Co-administration of quercetin (100 mg/kg b.w), alpha lipoic acid and ascorbic acid daily along with ZnONPs, significantly ameliorate the dramatic alteration in biochemical parameters and hepatocellular necrosis caused by ZnO nanoparticles. Brine shrimp larvae cytotoxicity assay of ZnO nanoparticles showed 0% mortality. Present study concluded that all three active ingredients showed hepatoprotective effects against nanoparticles induced time dependent toxicity

Real-Time Analysis of a Sensor’s Data for Automated Decision Making in an IoT-Based Smart Home

IoT devices frequently generate large volumes of streaming data and in order to take advantage of this data, their temporal patterns must be learned and identified. Streaming data analysis has become popular after being successfully used in many applications including forecasting electricity load, stock market prices, weather conditions, etc. Artificial Neural Networks (ANNs) have been successfully utilized in understanding the embedded interesting patterns/behaviors in the data and forecasting the future values based on it. One such pattern is modelled and learned in the present study to identify the occurrence of a specific pattern in a Water Management System (WMS). This prediction aids in making an automatic decision support system, to switch OFF a hydraulic suction pump at the appropriate time. Three types of ANN, namely Multi-Input Multi-Output (MIMO), Multi-Input Single-Output (MISO), and Recurrent Neural Network (RNN) have been compared, for multi-step-ahead forecasting, on a sensor’s streaming data. Experiments have shown that RNN has the best performance among three models and based on its prediction, a system can be implemented to make the best decision with 86% accuracy

Assessment of the normal pediatric pineal gland – MR findings of a single center retrospective study

Objective: To analyse the size and morphology of the normal pineal gland in the paediatric age group using magnetic resonance imaging. Method: The retrospective study was conducted at the Aga Khan University Hospital, Karachi, and comprised data of patients aged <18 years who had magnetic resonance imaging done between 2007 and 2017. Pineal size was estimated measuring its largest anteroposterior and supero-inferior diameters on sagittal T2-weighted sequences on any slice with maximal diameter. The width of pineal gland was measured on axial or coronal T2 sequences. The volume, morphology and enhancement patterns of the gland were also assessed. Data was analysed using SPSS 21. Results: Of the 200 patients, 116(58%) were males and 84(42%) were females. The overall mean age was 7.8±5.5 years. The mean anteroposterior dimension was 4.85±1.46mm, height 3.31±0.95mm, width 4.16±1.19, and volume 39.54±38.12 mm3. Mean size of cyst was 2.77±1.4mm (range: 1.2-7.5mm). No significant differences in the pattern of enhancement were found in different age groups (p>0.05). Conclusion: Comprehensive knowledge of the size of the typical pineal organ is useful for radiologists in the identification of pineal gland anomalies and the exclusion of neoplastic lesions. Key Words: Magnetic resonance imaging, Pineal gland, Pineoblastoma, Tumours, Cysts, Size