Role of multidetector computed tomography in evaluation of retroperitoneal masses

Background: Diagnostic imaging plays an important role in the evaluation of abdominal masses. Many imaging modalities are available ranging from conventional modalities to the cross-sectional modalities like USG, CT and MRI. The main principles of imaging are to determine the origin of mass, its measurement, extent, characterisation and assessment of its effect on contiguous organs. In the past, the mainstay was conventional imaging modalities like plain radiograph, Gastrointestinal contrast studies and I.V.U. Modern imaging modalities allow an early and accurate pre-operative diagnosis resulting in a higher rate of surgical resection and improvement of survival.Methods: A Cross-sectional observational study was done in 30 patients. Patients of either sex of any age group who had presented with involvement of retroperitoneal organs detected by routine ultrasound and postoperative patients with recurrence were included in our study.Results: Ultrasound is the initial imaging modality of choice since it is inexpensive, easy to perform and no radiation exposure. On USG, the retroperitoneal masses are classified as solid or cystic or mixed. Since most of the retroperitoneal masses have hetroechoic/mixed pattern, they cannot be characterized by ultrasound alone and hence need further evaluation.Conclusions: Multidetector computed tomography is the imaging modality of choice for further evaluation and characterization. CT protocol for evaluation of the retroperitoneum consisted of both non-enhanced and contrast-enhanced scans for localisation and characterisation of the masses. Multiplanar reconstructions allowed the images to be viewed in any plane chosen including a curved plane thus helping in defining the exact location and extent of the lesion. With MIP and volume rendered images, the relationship of the vessels with the mass lesions was clearly visualized

Role of multi detector computed tomography (MDCT) in evaluation of renal masses

Background: Due to rapid pace in development of imaging techniques and increasing number of investigations being done, more number of renal masses are discovered incidentally during evaluation of unrelated or unspecific symptoms. Hence it is vital to differentiate neoplastic and non-neoplastic masses. Among the neoplastic masses, there is a need to differentiate benign and malignant masses so that appropriate treatment strategies like nephron sparing surgery, radio frequency ablation etc. can be planned at an early stage and avoiding unnecessary radical treatments for improved patients survival.Methods: A Cross-sectional Observational study was done in 35 patients. Patients of either sex in any age group who had presented with suspected renal mass by clinical signs and symptoms (palpable renal angle mass, renal angle pain, hematuria) confirmed on USG examination or an incidental Renal mass diagnosed on USG/CT examination were included in our study.Results: Ultrasound is the initial imaging modality of choice since it is inexpensive, easy to perform and no radiation exposure. On USG, the renal lesions are classified as solid or cystic. Anechoic, thin walled cyst without any septations or solid components is usually Bosniak I cyst (simple cyst) and does not need any further evaluation. Rest of the cystic and solid lesions cannot be characterized by ultrasound and hence need further evaluation.Conclusions: Multidetector Computed Tomography is the imaging modality of choice for further evaluation and characterization. CT is done in four phases viz., unenhanced, corticomedullary, nephrographic and excretory phase especially in cases of malignancy while in benign conditions like angiomyolipoma and abscess, evaluation with unenhanced and single phase post contrast in portovenous phase is sufficient

Evaluation of diffuse lung diseases by high resolution computed tomography of chest

Background: Diffuse lung diseases describe a heterogeneous group of disorders of the lower respiratory tract characterized by inflammation and derangement of the interstitium and loss of functional alveolar units. The disease is not restricted to the interstitium only, as it involves epithelial, endothelial and mesenchymal cells with the disease process extending into the alveoli, acini and bronchioles. Thus, the entire pulmonary parenchyma is involved. The objective of the study was to evaluate diffuse lung diseases by high resolution computed tomography of chest.Methods: A cross-sectional observational study was done in 30 patients. Adult patients of either sex of age group 18 and above showing reticular opacities on chest X-ray and those patients who were incidentally diagnosed as cases of diffuse lung diseases on HRCT chest were included in present study.Results: Reticular opacities were the most common roentgenographic finding followed by reticulonodular opacities. On HRCT, intra and interlobular septal thickening was the most common finding in Idiopathic interstitial pneumonia (usual interstitial pneumonia).Conclusions: High resolution computed tomography (HRCT) is superior to the plain chest X-ray for early detection and confirmation of suspected diffuse lung diseases. In addition, HRCT allows better assessment of the extent and distribution of disease, and it is especially useful in the investigation of patients with a normal chest radiograph. Coexisting disease is often best recognized on HRCT scanning

Histomorphometry of human vermiform appendix

Background: Acute Appendicitis is one of the most common acute abdominal conditions. Advances in modern radiographic imaging have improved diagnostic accuracy, however the diagnosis of appendicitis remains essentially an enigmatic challenege. Though much work has been done on morphometry but there is less work done on variation of histomorphometric features of appendix. Hence the study was carried out by keeping the following objectives in mind. Aim was to study the general histomorphology and measure the histomorphometric parameters of human vermiform appendix. And also, to study diagnostic significance of histomorphology and histomorphometric parameters in causing appendicitis.Methods: The study was conducted in the Department of Anatomy. Specimens of appendix were obtained from embalmed cadavers. Serial sections were taken at different levels and slides were prepared. The slides were then examined using Nikon Trinocular Research microscope under magnification power of 40x for various parameters, after staining with H&E.Results: The mean luminal diameter varied from 1.32±0.65mm at base to 1.22±0.72mm from base. Diffuse lymphatic tissue was seen in both mucosa and sub-mucosa.Conclusions: Definitely there is a relationship between lymphoid follicle diameter and mucosal-serosal thickness on one hand and that between the luminal diameter and lymphoid follicle diameter on the other hand. Since our study was restricted to geriatric age group so studies need to be done in different age groups to highlight any further relationship

Saline infusion sonography in evaluation of uterine cavity abnormalities in infertility: a comparative study

Background: Infertility is defined as one year of unprotected intercourse without pregnancy. Female factor is responsible for 40-50% of cases of infertility. Uterine pathologies are the cause of infertility in as many as 15% of couples seeking treatment. The objective of this study was to evaluate the accuracy of trans-vaginal sonography (TVS) and saline infusion sonography (SIS) for detection of uterine cavity abnormalities in patients of infertility taking hysteroscopy as gold standard.Methods: A prospective comparative study was done in 60 patients of infertility. Patients were selected from gynaecology OPD of a tertiary care hospital. Patient selected underwent TVS and SIS followed by hysteroscopy for presence of uterine cavity abnormalities. The presence of uterine cavity abnormality and its type (endometrial polyp, submucous myoma, intrauterine synechiae or any other) was noted. The results of TVS and SIS were compared with hysteroscopy.Results: In 60 infertile patients, hysteroscopy revealed intrauterine pathology in 22 patients (36.7%). Among them eight had endometrial polyp and another eight patients had intrauterine synechiae. Submucous myoma was detected in five patients and one patient had thin endometrium. SIS detected eight out of 22 uterine cavity abnormalities indicating sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) of 36.4%, 100%, 100% and 73.1% respectively. In comparison TVS showed abnormalities in six patients only and thus had sensitivity, specificity, PPV and NPV of 27.35%, 100%, 100% and 70.4 % respectively. Sensitivity of SIS for specific lesion was least for intrauterine synechiae (12.5%) and maximum for submucous myoma (60%).Conclusions: The sensitivity of both TVS and SIS for detection of uterine cavity abnormalities in patients of infertility was low in the present study and they cannot be recommended as replacement for hysteroscopy

Role of MRI and ultrasonography in evaluation of multifidus muscle in chronic low back pain patients

Background: Low back pain (LBP) is a condition that will affect 60-80% of the population at some stage in their life. Epidemiological studies have shown that simple backache has point prevalence and a 1-month prevalence of 15-30% and 30-40% respectively. Studies that have been performed state that LBP is a self-limiting condition, but many people who have suffered from LBP will experience recurring episodes, which could lead to the development of chronic LBP. The objective of the study was to assess the role of MRI and USG in evaluating degenerative changes in multifidus muscle in chronic low back pain patients.Methods: A Cross-sectional Observational study was done in 30 patients. Adult patients of either sex who presented with low back pain for 6 weeks or more and Grade 1 and grade 2 degenerative intervertebral disc changes as seen on plain skiagrams of L-S spine, A-P and lateral views were subjected to MRI and Ultrasound.Results: Multifidus and paraspinal muscle atrophy and fatty degeneration should be considered in association with the clinical presentation and other abnormalities seen in MRI examination.Conclusions: Whether LBP duration, severity and associated functional disability affect the degree of paraspinal muscle degenerative changes remains unclear. Possible reasons underlying the discrepant findings include variations among the age and symptoms of duration of the studied populations and small sample size

Allelic diversity of butyrophilin (BTN1A1) gene in Indian bovines

Indian milch bovines comprises of 58.56% of total livestock population (512.05 million) in the country and primarily includes native and crossbred cattle (37.28%) and water buffaloes (21.28%). Milk and milk products are essential food items of Indian diet especially in children, old and senile. Milk fat is an important constituent of milk and has an economic value and its percentage in milk varies betweem species and breeds within species. Butyrophilin (BTN1A1) a membrane protein regulates secretion of lipids and size of a fat globule in milk. Present study was conducted in 538 bovines of 11 breeds/populations adapted to different parts of India, with an aim to screen and determine the major allele of BTN1A1 gene using PCR-RFLP based test. Results indicate that exon 8 of BTN1A1 gene is polymorphic in Tharparkar, Sahiwal, Jhari and Belahi populations of native cattle and Holstein Friesian and Jersey crossbreds where as the same exon was monomorphic in Murrah, Chilika, Gojri, Chhattisgarhi and Bargur populations of water buffalo. We conclude that variations in BTN1A1 gene can serve as an excellent genetic marker while selecting cows for higher milk fat and can be applied while formulating their breeding plans

Formulation Development And Pharmacological Evaluation Of Polyherbal Gel Containing Extract Of Sesbania Grandiflora Flower, Eclipta Alba L. Leaf, And Allium Cepa L. Bulb

Even in places where access to modern medicine is available, interest in using herbal therapies has grown dramatically in recent years. Since medicinal plants are the main source of the bioactive molecules used in both conventional and modern medicine, phytochemicals and herbal medicines have recently attracted a lot of attention. In this study, polyherbal gel, including extracts of Sesbania grandiflora flower, Eclipta alba leaf, and Allium cepa bulb, will be made and tested. The ethanolic extracts were made using the maceration method. The following step included continuously swirling as each ingredient was properly mixed and the Carbopol 934 gel was made. The formulation's physical and chemical characteristics, including colour, aroma, pH, spreadability, extrudability, consistency, solubility, and washability, were assessed once it had been completed. The formulation was tested for physicochemical properties when it was finished, including colour, odour, pH, spreadability, extrudability, consistency, solubility, and washability. The formulation's further stability testing at various temperatures revealed no changes in irritancy, spreadability, or diffusion. It might therefore develop into a vehicle for effectively and conveniently using the medicinal benefits of polyherbal gel that contains extracts from the sesbania grandiflora flower, eclipta alba leaf, and allium cepa bulb

Applications of ultrasound in the low and middle income countries

With the easy availability, portability and durability of ultrasound, rapid improvement in bedside and Radiologist-performed ultrasound is seeing increasing use in rural, underdeveloped parts of the world. Physicians, and medical officers have demonstrated the ability to perform and interpret a large variety of ultrasound exams, and a growing body of literature supports the use of point-of-care ultrasound in developing nations. We review, by countries, the existing literature in support of ultrasound use in the countries with low and middle income group and training guidelines currently in use, and highlight indications for emergency ultrasound