COVID-19: mobilising CT as a frontline management tool.

As the COVID-19 pandemic has spread across the globe, questions have arisen about the approach healthcare systems should adopt in order to optimally manage patient influx. With a focus on the impact of COVID-19 on the NHS, we describe the frontline experience of a severely affected hospital in close proximity to London. We highlight a protocol-driven approach, incorporating the use of CT in the rapid triage, assessment and cohorting of patients, in an environment where there was a lack of readily available, onsite RT-PCR testing facilities. Furthermore, the effects of the protocol on the effective streamlining of patient flow within the hospital are discussed, as are the resultant improvements in clinical management decisions within the acute care service. This model may help other healthcare systems in managing this pandemic whilst assessing their own needs and resources.

Co-infection of Candidaparapsilosis in a Patient of Pulmonary Actinomycosis-A Rare Case Report.

The diagnosis of pulmonary actinomycosis is difficult and less than 10% of cases are diagnosed at the initial presentation. Actinomycosis is always poly-microbial flora infection in human. On the other hand, Candida parapsilosis is an emerging fungal pathogen especially in immuno-compromised patients. Combined bacterial-fungal infection increases frequency and severity of the disease. This report is a case of a Candida parapsilosis co-infection in a 23-year-old male patient having pulmonary actinomycosis. This thereby could guide the clinicians towards an appropriate therapy.

A Rare Presentation of Os Odontoideum with Multiple Vertebral Fusion in Type III Klippel-Feil Syndrome (KFS) - A Case Report.

An abnormal atlas and axis with presence of os odontoideum and fusion of multiple vertebrae were noted in an intact skeleton, in the osteology museum of the Department of Anatomy of North Bengal Medical College, West Bengal, India.These multiple abnormalities at various levels along with increased thickness of antero-posterior arch of atlas pointed towards the congenital nature of the anomalies, possibly due to Klippel-Feil syndrome (KFS). These unusual findings denote a developmental background of the manifestations.The cervical instability, resultant neurodeficit and impairment of quality of life of the affected individuals, which are inherent in such cases, reveal their clinical importance.

Role of scaphoid in the abduction and adduction movements of wrist joint.

Being a carpal bone scaphoid has an important role in wrist movements. Wrist joint is a synovial modified ellipsoid joint where movements like flexion, extension and adduction, abduction take place around two axes (transverse and anteroposterior). These movements at the wrist joint are associated with considerable range of movements at the midcarpal joint, as same group of muscles act on both of these joints. A study has been done amongst 120 persons at the Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal during the period from 1998-2000 to detect the important movements of scaphoid bone specially during the abduction and adduction of wrist joint (which occur in association with the intercarpal joints) and also to detect whether such movements have any speciality in the population of eastern part of India. It was found in this study that the scaphoid acts as a link bone between the two rows of carpal bones and prevents the buckling of midcarpal joint specially of the capitato-lunate joint interface.

Paroxysmal "funny turns" in an elderly woman--a 95-year-old with an insulinoma.

A 95-year-old woman was admitted to hospital with a fractured neck of femur following a fall. There was no past history of note other than numerous episodes of "funny turns" preceding falls some of which resulted in fractures. During her admission she had a "funny turn". Immediate investigations revealed hypoglycaemia and subsequent biochemical abnormalities, most likely due to a benign endocrine tumour--an insulinoma.