Study of Association of Erectile Dysfunction with Metabolic Syndrome and Its Correlation with Endothelial Dysfunction in an Indian Population.

BACKGROUND: Metabolic syndrome (MS) has emerged as a new health risk, and its associated metabolic derangements have detrimental effects on the cardiovascular system. In recent years, MS has been reported to affect reproductive health in males. It has been reported to be associated with erectile dysfunction (ED) and has been attributed to be due to endothelial dysfunction. Poor endothelial function in ED usually affects small-sized vasculature, so it can be looked at as a predictor for the endothelial dysfunction of macro vasculature. The aim of the present study was to determine the association of ED in patients with MS and to determine its correlation with endothelial dysfunction. MATERIALS AND METHODS: It was a hospital-based case-control study in which 120 male patients with MS and 120 age-matched controls were enroled. Demographic profiles, anthropometry, past illnesses, and medical history of patients were obtained. MS was diagnosed according to the International Diabetes Federation (IDF) criteria and was measured using the flow-mediated dilation (FMD) method with the help of ultrasound used to assess endothelial dysfunction. Diagnosis of ED was based on the International Index of Erectile Function (IIEF) scale. RESULTS: The study participants had a mean age of 40.91 ± 11.41 years. The majority of cases (57.5%) had ≤6 months of history of MS. The prevalence of ED was 31.7% in cases compared to 5% in controls, thus showing a significant difference between cases and controls. Mean IIEF scores were significantly lower in cases (18.82 ± 5.59) compared to those in controls (23.00 ± 2.57). A moderate positive and significant correlation was observed between FMD and IIEF scores. With an increasing number of MS components, there was a significant increase in the prevalence of ED. Those with ED had significantly lower mean FMD values (5.1 ± 1.1%) compared to those not having ED (10.9 ± 3.3%). CONCLUSION: The findings of the present study showed that there is a significant association between ED and MS. We observed that the increase in components of MS increased the prevalence of ED in MS. Endothelial dysfunction measured by FMD was correlated with ED.

COVID-19 pneumonia in kyphoscoliosis: The success stories.

Coronavirus disease (COVID-19) pandemic has led to millions of deaths worldwide. Old age, immunocompromised state and multiple comorbidities are described as risk factors. Kyphoscoliosis (KS) is the most common spine abnormality and a risk factor of respiratory failure. Management of pneumonia in a patient with severe kyphoscoliosis is challenging to the intensivist. We report successful management of two patients with severe kyphoscoliosis who developed severe COVID-19 pneumonia.

Evaluation of 25-hydroxy vitamin D3 levels in patients with a fibroid uterus.

A cross sectional study was done at Era's Lucknow Medical College & Hospital, Lucknowwith the objective to evaluate 25-hydroxyVitaminD3 level in women with and without uterine fibroid. Ninety subjects (45 cases and 45 controls) were enrolled. Cases were those having at least 1 uterine fibroid ≥10 mm detected on ultrasonography, while controls were those not having any uterine pathology. Estimation of Serum 25-hydroxyvitaminD3 Level was done. The mean ± SD concentration of 25-hydroxyvitaminD3 was Significantly lower in cases compared with controls (15.10 ± 6.09 vs 26.09 ± 7.90 respectively, p < 0.001).The number of women with 25-hydroxyvitaminD3 deficiency in cases and controls was 9(20%) and 3(6.67%) respectively (p < 0.001). Uterine fibroid size increased proportionately with decrease in 25-hydroxyvitaminD3 levels, (p = 0.014). We concluded that VitaminD3 deficiency is significantly associated with the occurrence of Uterine fibroids. Further studies need to be conducted in order to evaluate the therapeutic benefits VitaminD3 supplementation in the patients of Uterine fibroid.Impact Statementwhat is already known on this subject? Vitamin D is believed to regulate cell proliferation and differentiation, inhibit angiogenesis and stimulate apoptosis. Now a days hypovitaminosis D is believed to be a major risk factor in the development of uterine fibroids. There are several ideas about the use of vitamin D in uterine fibroid prevention or as a long term treatment but ongoing clinical trials in the area remain scarce.what do the results of this study add? Our study showed that 25-hydroxivitamin d3 deficiency is significantly associated with uterine fibroid.Lower levels of 25-hydroxivitamin d3were found to have aninverse relationship with increased size of fibroid uterus.what are the implications of these findings for clinical practice and / or further reasearch? Vitamin D seems to be a promising, safe and low-cost agent for the prevention and treatment of uterine fibroids. However, further studies with larger sample size are needed to confirm our findings.

Soft Drinks Consumption and the Risk of Nonalcoholic Fatty Liver Disease.

INTRODUCTION: The increased consumption of sugar-sweetened beverages (SSBs) has been implicated in the increased incidence of obesity and metabolic syndrome Little of the research on sugar-sweetened beverage intake has examined the consumption patterns of sugared beverages by college students, despite the vulnerabilities of this population to weight gain. The current study sought to characterize sugar-sweetened beverage intake of undergraduate students who belong to high socio-economic strata and to study its correlation with presence of non-alcoholic fatty liver disease. MATERIAL AND METHODS: In a cross sectional, a self reported questionnaire based study about soft drink consumption (≥2/day, 1/day, <1/day). That included undergraduate medical students. Anthropometry and blood pressure were recorded and fasting glucose, insulin and lipid profile and abdominal ultrasonography for the presence of fatty liver was assessed. RESULTS: A total of 242 students were studied. The students in group 1 (≥2/day) had significantly higher BMI, waist circumference and diastolic blood pressure than students of other groups. They also had higher triglycerides, fasting insulin, HOMA-IR and significantly lower levels of HDL-cholesterol. Overall (40%) students had metabolic syndromes in group 1 compared to 8% and 3% in other groups while presence of NAFLD was observed in 75%, 16% and 4% in three groups respectively. Duration of soft drink consumption had positive correlation with presence of NAFLD. CONCLUSIONS: Substantial consumption of soft drinks is leading to increased obesity and cardio-metabolic risk factors in young adults. Artificially sweetened diet soft drinks have been posed as a healthier alternative due to their lack of calories but they do not guarantee protection against non-alcoholic fatty liver disease.

Simple Renal Cysts: Can They be Overlooked?

BACKGROUND / OBJECTIVE: The availability and use of abdominal ultrasonography and computed tomography for diagnostic purposes has led to frequent detection of asymptomatic renal cysts. Recent evidence suggests their association with hypertension. The aim of our study was to evaluate the presence of simple renal cysts in patients with hypertension and prehypertension. METHODS: In a hospital based cross-sectional study, all consecutive adult patients aged > 25 years were enrolled. Detailed medical history and physical examination was done in all the study participants. Abdominal ultrasonography and biochemical parameters were also performed. All the patients who had history or evidence of structural or functional kidney disease were excluded. RESULTS: A total of 6230 patients were enrolled and divided into three groups: normotension (n=3510), prehypertension (n=1850) and hypertension (n=870) groups. There were significant differences in age, gender, prevalence of diabetes, family history of hypertension, regular exercise, smoking, BMI, systolic blood pressure, diastolic pressure, fasting plasma glucose, total cholesterol, triglyceride, HDL cholesterol, creatinine, estimated glomerular filtration rate in three groups. Simple renal cysts (SRCs) were present in significantly greater numbers in patients with prehypertension and hypertension. SRCs ≥2 in number or ≥2 cm in size were significantly associated with both prehypertension and hypertension independent to other risk factors. CONCLUSIONS: The presence of SRCs should not be overlooked. In present study, SRCs ≥2 in number or ≥2 cm in size are important determinants of prehypertension and hypertension.

Endothelial Dysfunction by Flow-Mediated Vasodilatation in Chronic Kidney Disease.

INTRODUCTION: The last few years have seen a phenomenal increase in the prevalence of chronic kidney disease (CKD). Cardiovascular disease remains the most important cause of death in these patients.The present study was conducted to evaluate endothelial dysfunction in CKD patients as compared with controls. METHODS: Thirty-five patients of CKD and 32 age and sex-matched controls were included in the study. Flow-mediated vasodilatation was assessed in all individuals. Anthropometric measurements, haematological and biochemical assessment were also done. RESULTS: It was found that patients of CKD had significant endothelial dysfunction in comparison with controls as assessed by flow-mediated vasodilatation of brachial artery. It was also seen that late stages of CKD patients had significant endothelial dysfunction in comparison to early stages of CKD. CONCLUSIONS: The present study concludes that chronic kidney disease patients have significant endothelial dysfunction and this is more pronounced in the later stages of the disease.

Age-stratified Assessment of Brain Volumetric Segmentation on the Indian Population Using Quantitative Magnetic Resonance Imaging.

BACKGROUND AND PURPOSE: Automated methods for quantifying brain tissue volumes have gained clinical interest for their objective assessment of neurological diseases. This study aimed to establish reference curves for brain volumes and fractions in the Indian population using Synthetic MRI (SyMRI), a quantitative imaging technique providing multiple contrast-weighted images through fast postprocessing. METHODS: The study included a cohort of 314 healthy individuals aged 15-65 years from multiple hospitals/centers across India. The SyMRI-quantified brain volumes and fractions, including brain parenchymal fraction (BPF), gray matter fraction (GMF), white matter fraction (WMF), and myelin. RESULTS: Normative age-stratified quantification curves were created based on the obtained data. The results showed significant differences in brain volumes between the sexes, but not after normalization by intracranial volume. CONCLUSION: The findings provide normative data for the Indian population and can be used for comparative analysis of brain structure values. Furthermore, our data indicate that the use of fractions rather than absolute volumes in normative curves, such as BPF, GMF, and WMF, can mitigate sex and population differences as they account for individual differences in head size or brain volume.

A study of cardio-metabolic risk profile in patients with psoriasis.

INTRODUCTION/BACKGROUND: Psoriasis is a chronic immune mediated inflammatory disorder of the skin and joints. Recent studies have shown increased prevalence of traditional cardiovascular risk factors such as diabetes mellitus, hypertension and metabolic syndrome. Since atherosclerosis and psoriasis share a common link of inflammation, different workers have shown psoriasis to be a risk factor for atherosclerosis. The aim of our study was assessment of cardiovascular risk factors and evidence of subclinical atherosclerosis in patients of psoriasis. METHODS: In a hospital based, cross-sectional study, 96 patients with psoriasis and 100 age, sex and weight matched controls were enrolled. Prevalence of diabetes, hypertension, metabolic syndrome was studied. They were also assessed for endothelial dysfunction by brachial artery flow mediated dilatation(FMD) and carotid intima media thickness (CIMT). RESULTS: There was higher prevalence of hypertension, hypertriglyceridaemia, diabetes mellitus and metabolic syndrome in patients with psoriasis than in controls. FMD was lower in patients with psoriasis than in controls (5.6 +/- 2 vs7.5 +/- 2.8, P = 0.02). The mean CIMT was significantly increased (0.78 +/- 0.12 vs 0.62 +/- 0.08, P = 0.001) in patients with psoriasis compared with controls. In psoriasis patients, CIMT was associated with hypertension, hypertriglyceridaemia, diabetes, insulin resistance, increased severity and duration of psoriasis while in multivariate analysis insulin resistance (OR 2.8, 95% CI 1.92-6.34 P = 0.02) and increased duration of disease (OR 3.12, 95% CI 2.34-7.56) a were the independent risk factors associated with higher CIMT. CONCLUSION: Patients of psoriasis have higher prevalence of metabolic syndrome, cardiovascular risk factors and subclinical atherosclerosis than general population. As a routine, individuals with moderate to severe psoriasis of long duration should be recognised as being at increased cardio vascular risk and thus encouraged for therapeutic interventions to reduce the modifiable risk factors.

The Diagnostic Accuracy of a Novel Scoring System Using Multi-Detector Computed Tomography to Diagnose Lung Cancer.

INTRODUCTION: Lung cancer is the leading cause amongst the cancer deaths in the world. Detection of malignancy at an early stage and with precision is the utmost objective of radiological evaluation. The final diagnosis of lung cancer is histopathological evaluation of the mass. The authors hereby have tried to convert the multi-detector CT (MDCT) characteristics and patient demographics into quantitative data to formulate a scoring system that can predict lung malignancy as close to histopathology as possible. MATERIALS AND METHODS: After obtaining ethical clearance, 104 cases of suspected lung cancer by history, clinical and radiographic evaluation were enrolled in the study. These patients were undergoing CT thorax (contrast) on 384 slice siemens somatom force. After undergoing the radiological evaluation biopsy of the mass was done either by CT guided or bronchoscopy guided. Radiological and histopathological findings were correlated. Patients aged >50, lymphadenopathy, tumor volume >50 cc, enhancement >15 HU (Hounsfield unit) after contrast injection were given a score of 15 each. History of smoking, bronchus cut off, spiculated/lobulated margins, mediastinal/pleural involvement, and angiogram sign positive were given a score of 20 each. So, a maximum score of 160 can be achieved by history and MDCT evaluation. RESULTS: Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and diagnostic accuracy of MDCT by using conventional parameters against histopathology was 97.5%, 85%, 96.29%, 89.47%, and 95.0%. The sensitivity and specificity calculated through Receiver-Operating-Characteristic (ROC) for predicting malignancy were found to be 98.8% and 90.0% for a cut-off score of >97.5 out of maximum of 160.  Conclusion: MDCT serves as a tool for early diagnosis of lung cancer, and it is the utmost important tool for cases where biopsy or fine needle aspiration cytology (FNAC) is not possible. By creating a quantitative criterion to diagnose lung malignancy, the subjective nature of MDCT diagnosis can be converted into an objective based evaluation.

Sphenoclival Intraosseous Lipoma: A Typical Lesion at an Atypical Location.

In this report, we present the case of a rare tumor in the sphenoclival region and discuss the potential pitfalls in its diagnosis and management. Intraosseous lipoma is a rare benign tumor, mostly accounting for 0.1% of all bone tumors. The disease is usually asymptomatic and mainly involves the hips, vertebrae, ribs, and metaphysis of the long bones. However, the intraosseous lipoma of the skull is less common, especially with few cases having been reported to involve the sphenoid bone in the literature. We present a rare case of sphenoclival intraosseous lipoma in a 28-year-old female who presented with a history of chronic headache. A non-contrast computed tomography (NCCT) was ordered, which revealed a deviated nasal septum with thickening of bilateral ethmoidal sinuses with mastoiditis and a well-defined fat-containing intraosseous lesion in the clivus with a mean HU~ of -32 with few septations within. The risk of malignant transformation in intraosseous lipoma is very low. The differential diagnosis of intraosseous lipoma includes end stage of infection, infarct lesions, intraosseous meningioma, angiolipoma, and myxofibrous tumors.

Comparative Evaluation of Multidetector Computed Tomography and Dual-Energy Computed Tomography Findings in Gastrointestinal Tuberculosis.

AIM: To compare multidetector computed tomography (MDCT) and dual-energy computed tomography (DECT) imaging findings in gastrointestinal (GI) tuberculosis. OBJECTIVE: To study imaging findings of MDCT and DECT in GI tuberculosis. METHODOLOGY: All the patients falling in the sampling frame and fulfilling the eligibility criteria were clinically examined and demographic details, presenting complaints, medical history, history of anti-tubercular treatment (ATT) intake, personal habits, and family history of tuberculosis were noted. All the patients underwent sputum acid-fast bacilli (AFB) assessment. Outcomes of investigations like bronchoscopy and fine-needle aspiration cytology (FNAC)/biopsy were also noted wherever available. Ascitic fluid AFB and culture assessments were also performed wherever feasible. All CT scans were performed on a 384-slice dual-energy CT scanner (Somaton Force, Siemens Healthcare) and all the images were post-processed on a workstation using syngo.via software that allows the analysis of images using three material decompositions. Features like peritonitis, lymph node involvement, GI wall thickening, and solid organ involvement were focused on. Subjective assessment of images of both MDCT and DECT were assessed by two experienced radiologists to prepare the CT diagnosis. The mutual agreement of the two observers was considered final. CONCLUSIONS: The findings of the study showed that both MDCT, as well as DECT, were useful in the diagnosis of GI tuberculosis. On the basis of these findings, DECT could be considered to have an edge over MDCT in the diagnosis of GI tuberculosis. Keeping in view the small sample size and high prevalence, further studies on a larger sample size with relaxed sampling criteria are recommended to validate the findings of the present study.

Association and Correlation Between Amniotic Fluid Index and Glucose Concentration.

PURPOSE: To study the association and correlation between the amniotic fluid index, random glucose concentration, and serum glucose concentration after avoiding oral intake of sugar in a pregnant female with polyhydramnios. METHODS: The research was performed on pregnant women with polyhydramnios (n=104 ) after 28 weeks. USG was performed using a SAMSUNG HS 70A (Samsung Electronics Pvt. Ltd., Seoul, South Korea) and a GE Voluson P8 (GE Healthcare, Little Chalfont, UK). We measured amniotic fluid index and took a blood sample for hemoglobin (Hb)A1C, fasting blood glucose, post-prandial and random blood glucose, and also performed a glucose tolerance test in pregnant women. RESULTS: This is a prospective study, all 104 patients that were recruited in this study were pregnant females with polyhydramnios mainly from the urban and rural zone with different age groups (between 21 and 37 years). In our study, we observed that after avoiding oral intake of sugar in pregnant females with polyhydramnios, it was concluded that the amnionic fluid index lies towards the lower side. Polyhydramnios is more common in the urban zone and among older pregnant females. Out of 104 pregnant females with polyhydramnios, 82 were diagnosed with gestational diabetes after 28 weeks. CONCLUSION: In this study, we have concluded that the earliest and most sensitive predictor for gestational diabetes is a rise in the amniotic fluid index which could have been prevented by avoiding oral intake of sugar. Early prediction of gestational diabetes can be made by amniotic fluid index even before glucose concentration. We observed that by reducing oral intake of sugar, the amniotic fluid index drops down in pregnant females.

MRI Findings and Topographic Distribution of Lesions in Metronidazole-Induced Encephalopathy.

Purpose This study aims to describe the magnetic resonance imaging (MRI) of the brain of five patients diagnosed with metronidazole-induced encephalopathy (MIE). In addition, the aim of our study was to better define the topographic distribution of lesions in MIE. Methods We retrospectively evaluated MRI findings before and after drug cessation in five patients diagnosed with MIE at Era's Lucknow Medical College and Hospital, Lucknow, Uttar Pradesh, India. The main MRI signal changes and lesion locations were studied. Results Among the patients observed, the average age of the patients with MIE was 55 years (range: 30-70 years). Cerebellar dysfunction, mainly ataxia, and altered mental status were seen in the majority of cases. The most frequently involved sites were the dentate nucleus (cerebellum), brain stem, and corpus callosum (splenium). In diffusion-weighted imaging (DWI), most lesions did not show true restricted diffusion, except for a solitary corpus callosum lesion. Conclusion Although drug-related side effects are more common with long-term use of metronidazole, they may also occur with high doses for short durations. The dentate nucleus, the splenium in the corpus callosum, and the brain stem are the most affected structures. Apart from a solitary lesion of the corpus callosum, all identified lesions were reversible at follow-up MRI after discontinuation of metronidazole. The clinical presentation and characteristic MRI changes are highly specific and can be correlated to make a rapid and more accurate diagnosis of this potentially treatable condition. Prognosis is excellent if detected early.

An unusual presentation of Kartagener's syndrome.

Kartagener's syndrome is a rare disorder which is seen in nearly half of the cases of primary ciliary dyskinesia. We report an unusual case of Kartagener's syndrome where the patient had associated ventricular septal defect, pectus excavatum and was fertile.

Beaver Tail Liver: A Hepatic Morphology Variant.

Beaver tail liver, or else known as the sliver of liver, is a rare anatomic variation of the liver where the left lobe of the liver extends laterally to contact and enwrap the spleen. A case is presented here where a middle-aged male presented with complaints of abdominal pain, hematuria, and fever. After the routine blood and urine examinations revealed urinary tract infection, CT abdomen was done to find out the etiology, and beaver tail liver was found incidentally with the left lobe of liver encircling the spleen. Sometimes it may be difficult to differentiate liver and spleen from each other when echogenicity or density on USG and CT are equivalent. More common in females, it may imitate a splenic trauma or a subcapsular hematoma, or a perisplenic hemorrhage within the splenic parenchyma.

Von Hippel-Lindau Disease: A Rare Radiological Case Report of a Symptomatic Patient and His Asymptomatic Genetic Counterpart.

Von Hippel-Lindau (VHL) disease is an inherited syndrome manifested as a benign and malignant tumor. It is an autosomal dominant syndrome diagnosed approximately in 1 in 36,000 people. We report a case where male siblings presented with the involvement of bilateral kidneys and the multi-cystic lesion on the pancreas in both. Reverse transcription polymerase chain reaction (RT-PCR) was conducted to detect the VHL gene, which turned out to be a significant finding in our study. The rare involvement of both pancreas and kidneys was noted in the siblings with VHL in the present study. In patients with VHL-associated tumour presentations, the most frequent detection of pathogenic variants in the VHL gene is the result of directed genetic testing or inherited cancer gene panels. The presence of renal and pancreatic involvement is rare but a significant finding present within the family member who needs to be screened.

Spectrum of Chest Dual-Energy Computed Tomography Findings in COVID Patients in North India.

Purpose To study the spectrum of chest dual-energy computed tomography (DECT) imaging findings in severe acute respiratory syndrome coronavirus 2 (SARS-COV-2) or COVID-19 infected Indian patients and classify them on the basis of the Radiological Society of North America CT classification. Method A total of 110 reverse transcription-polymerase chain reaction (RT-PCR)-positive patients (subjects) in which noncontrast chest DECT was done in our COVID-19 care center (CCC) were enrolled in this study. The prevalence of various abnormalities of lung parenchyma due to SARS-COV-2 and their distribution with extent was recorded. Various types of lung parenchyma abnormalities due to COVID-19 were evaluated in all patients. Data were analyzed and various prevalent abnormalities were calculated as a percentage for each type. All the cases were also sorted into four major groups on the basis of the Radiological Society of North America CT classification of COVID patients. Result Among the total 110 patients that were enrolled in this study, 80 (72.7%) were males and 30 (27.3%) were females with a mean age of 40.5 ± 7 years (range 24-84). Out of this, we observed that 59 (53.6%) cases had abnormalities of lung parenchyma and were designated as DECT positive, whereas 51 (46.3%) cases had completely normal DECT. Only 14 (12.7%) of the patients (cases) presented with dyspnoea, 10 (9%) had hyperpnoea, whereas 12 (10.8%) had other associated comorbidities. Among the patients having abnormal DECT findings, multilobar (86%), bilateral lung field involvement (72.8%) with the ascendancy of peripheral and posterior distribution was most commonly noted. With respect to the different types of opacities noted in various patients, we found that ground-glass opacity (GGO) was the common abnormality found in almost all cases for the greatest part. Pure GGO was reported in 16 (28%), GGO admixed with a crazy-paving pattern were elicited in 17 (28.8%) and GGO mixed with consolidation was noted in 25 (42.3%) cases. Thirty-eight (64.4%) cases were having peri-lesional or intra-lesional segments or involving a small segment enlargement of the pulmonary vessel. Among the cases showing DECT positivity, the typical pattern on the basis of the Radiological Society of North America (RSNA) classification was noted in 71.2% of cases, whereas the atypical pattern was found in 1.2% percent of cases and the intermediate type was depicted in 25.4% percent of cases. Forty-six point three percent (46.3%) of the total cases that were enrolled in the study were grouped as the no pneumonia category. Conclusion The result of this study proved that the maximum number of RT-PCR-positive COVID-19 patients had mild symptoms and few comorbidities with normal chest DECT and fell under the no pneumonia category of the RSNA CT classification of COVID patients. However, out of the remaining patients, the majority of patients had GGO on DECT as a typical finding mixed with other patterns in a bilateral distribution and peripheral predominance. A preponderance of patients presented with the typical appearance of pneumonia followed by an intermediate type.

Establishment of Cephalic Index Using Cranial Parameters by Computed Tomography in a Sampled North Indian Population.

BACKGROUND: Cephalic index (CI) also called cranial index is the ratio of maximum breadth to a maximum length of head. The purpose of the study was to study anthropometry of cranial parameters using the computed tomography (CT) scans to establish the CI of the sampled population in North India. MATERIALS AND METHODS: The cross-sectional study was carried on the subjects of age group ranging from 6 to 95 years of either sex (total 1000 subjects; 540 male and 460 female) in the radio-diagnosis department of Era's Medical College Lucknow, UP, India. The measurement of maximum cranial breadth (MCB) and maximum cranial length (MCL) were taken on a CT scan machine and recorded for analysis. When associating the measures of precision for different subgroups, a one-way analysis of variance (ANOVA) was used for modest and efficient errors. Multivariate logistic regression analysis was used to identify factors affecting the CI estimation like age, interzygomatic length (IZL), orbital length (OL), MCB, and MCL. RESULT: Out of 1000 studied subjects, the majority 234 (23.4%) of the subjects belong to the 21-30 years age group. MCB of heads and MCL of heads in different ages and on applying the one-way ANOVA association was statistically significant and CI was statistically insignificant. Pearson correlation between the CI and other parameters like age, MCB of heads, and MCL of heads, and a statistically significant correlation was seen with each other. Dolichocephalic types of the skull are found more in male subjects, and brachycephalic type of skull is more common in female subjects. CONCLUSION: The average CI of our study was 76.67±3.18. This shows that northern India's dominant head shape, especially in the Lucknow region, was dolichocephaly. Thus, the CT scan is proven an essential modality in the assessment of cranial parameters in anthropometry.

Diagnostic accuracy of dual energy CT in the assessment of traumatic bone marrow edema of lower limb and its correlation with MRI.

BACKGROUND: Bone marrow edema is assumed to be caused as a result of trabecular microfractures that are detected by MRI. As MRI is not widely available in countries like India, this study aims to encourage the use of DECT in detection of bone edema as evidence with comparable efficiency to MRI. AIM: To assess the diagnostic accuracy of dual-energy CT in detecting bone marrow edema in patients of trauma of lower limb and correlate it with MRI. SETTING AND DESIGN: It is a cross-sectional study. MATERIALS AND METHODS: The study included 40 patients of age 15-70 years irrespective of sex. All the patients of lower extremity trauma underwent DECT and MRI evaluation after clinical evaluation. All the images were postprocessed on a work station and were further evaluated by a radiologist. RESULTS: Mean attenuation at fractured site observed by Dual energy CT was found to be significantly higher as compared to that at adjacent site (170.75 ± 33.99 vs. 19.73 ± 22.50 HU). The sensitivity and specificity of dual energy CT as compared to MRI in detecting bone marrow edema were 94.1% and 91.3%, respectively. Of the 40 cases enrolled in the study, agreement of MRI and Dual energy CT was observed in 37 (92.5%). CONCLUSION: Dual energy CT can be an effective alternative to MRI in the detection of bone marrow edema in patients of lower limb trauma. Dual energy CT can also be used in patients in whom MRI is contraindicated.

Diagnostic Accuracy of Color Doppler and Calcium Scoring versus Dual-Energy Computed Tomography Angiography in the Assessment of Peripheral Arterial Diseases of Lower Limb.

OBJECTIVES: Peripheral arterial disease (PAD) leads to narrowing and hardening of arteries which leads to increased risk of lower extremity amputation. Hence, the accuracy of non-invasive diagnostic methods such as calcium scoring and color Doppler needs to be assessed in comparison to the gold standard dual-energy computed tomography (DECT) angiography. This study aims to evaluate the accuracy of color Doppler and calcium scoring when compared to DECT angiography in the assessment of PAD of the lower limb. It is a cross- sectional retrospective study. MATERIAL AND METHODS: The study included 55 patients aged between 40 and 70 years. All the patients with symptoms suggestive of PAD underwent color Doppler study of lower limb arterial system. Afterward, the patient underwent CT angiography. The first plain images were taken for calcium scoring following which contrast was given and further images were taken. RESULTS: As compared to CT angiography assessment, Doppler assessment was 88.1% sensitive but only 69.2% specific with diagnostic accuracy of 83.6%. For angiographically detected atheromatous changes, color Doppler had sensitivity and specificity of 86.2% and 76.9%. The derived cutoff value >149.1 of calcium score in lower limb arteries was in 100% agreement with CT angiography detected PAD, whereas, for atheromatous changes, total calcium score at a cutoff value of >842.2 had sensitivity and specificity of 75.9% and 80.8%. CONCLUSION: Calcium scoring as compared to color Doppler has a higher diagnostic efficacy for the detection of DECT angiography confirmed PAD, whereas calcium score lacks adequate sensitivity at projected cutoff in the evaluation of atheromatous changes.