Discrepancy in reporting among specialist registrars and the role of a paediatric neuroradiologist in reporting paediatric CT head examinations.

AIM: To evaluate the discrepancy rate among specialist registrars (SPR) to assess whether seniority had a bearing on the discrepancy rate. To investigate which were the commonly missed abnormalities and the consequences for teaching purposes. To investigate the role of a specialist consultant neuroradiologist in reporting paediatric head computed tomography examinations. MATERIALS AND METHODS: The study was carried out over a 9-month period at the regional paediatric hospital during which time 270 CT head examinations were reported. Reporting in the department is carried out by one of the five general paediatric radiologists (GR) and also a specialist paediatric neuroradiologist (NR). The NR was considered the reference standard, who corroborated in areas of discrepancy with a second senior NR for this study. Of the 270 examinations, 260 were reported by the paediatric NR, 160 were reported by the SPR, GR, and NR, and 51 were reported by an SPR and the NR. In addition, four were reported by the GR and the NR, 45 by the NR only, seven by the GR only, and three cases were reported by the GR and an SPR. The discrepancy rates were calculated for GR versus NR, and SPR versus NR. All the discrepancies were re-evaluated by a second senior NR and confirmed in all cases. The reports of the SPR were further scrutinized. The trainees of training years 1-3 were considered junior and 4-5 were considered senior. RESULTS: There was a discrepancy in 26/164 cases (15.9%) reported by the GR and NR. There was a discrepancy in 59/211 cases (28%) reported by an SPR and NR. The chi-squared test (two-sided) showed a significant difference (p=0.005) between the two groups. There was a discrepancy in 36/118 cases (30.5%) reported by the junior SPR and NR. There was a discrepancy in 23/93 cases (24.7%) reported by a senior SPR and NR. The chi-squared test (two-sided) showed a non-significant difference (p=0.353) between the two groups. CONCLUSION: The performance of the SPR was considered to be significantly different than the GR in this study. The year of training did not have a statistically significant bearing on the discrepancy rates. This study has been useful in guiding SPR with regards to paediatric CT head examination reporting. The NR played an important role, particularly in picking up subtle fractures and congenital abnormalities, which were missed by both the SPR and GR.

Jejunal diverticulitis.

Although uncommon, jejunoileal diverticula are associated with significant morbidity and mortality. Both acute and chronic symptoms can be varied and non-specific, making jejunoileal diverticular disease a diagnostic and therapeutic challenge. We report a case of jejunal diverticular disease, complicated by acute diverticulitis, in a 75-year-old male who was successfully treated with conservative approach. The non-surgical approach was enabled by early assessment with multislice CT and active close observation.

Spectrophotometric method of determination of natural indoles by coloured complexes.

A new spectrophotometric method has been developed for quantitative determination of naturally occurring indoles via electron donor-acceptor complexes with chloranil. The method is simple, precise and convenient for routine laboratory work. The analysis of each indole can be carried out within half an hour.