ICRI White Paper: An Update on Role of Conventional Radiography in Imaging of Pediatric Gastrointestinal Tract.

Plain abdominal radiographs and gastrointestinal contrast studies remain the first line of investigation for the evaluation of several conditions due to their easy availability and ease of use in pediatric patients. A systematic approach to evaluating the plain radiograph for pediatric abdomen can lead the radiologist to a relevant differential diagnosis in most cases. In other cases, it leads the radiologist to the next line of investigation. The plain radiograph of the abdomen is requested for several conditions ranging from abdominal pain, vomiting, failure to pass meconium, abdominal distension, perforation, mass or for suspected obstruction. The radiation dose involved in abdominal radiography, although significant, the diagnostic information provided outweighs the risk. Dose reduction techniques should be employed to reduce the radiation dose to infants and children. Spectrum of atresias and stenosis from the esophagus up to the rectum, Hirschsprung disease, small left colon syndrome, and anorectal malformations can be identified with a detailed and systematic contrast study. They act as an adjunct in the diagnosis of conditions such as intussusception and hypertrophic pyloric stenosis. Inflammatory conditions such as acute appendicitis, necrotizing enterocolitis, and acute conditions such as pneumoperitoneum are also well appreciated on plain abdominal radiographs.

Multiple Cranial Nerve Involvement as a Presentation of Primary Central Nervous System Lymphoma: A Case-Based Review.

Central nervous system (CNS) lymphoma is of two types: primary and secondary (more common). Primary CNS lymphoma usually presents as parenchymal lesions having characteristic imaging findings and may be associated with leptomeningeal involvement. Involvement of multiple cranial nerves as the initial manifestation of primary CNS lymphoma with the development of typical parenchymal lesions on follow-up is a rare entity. This nerve involvement is termed as neurolymphomatosis. We present the magnetic resonance imaging features of five patients presenting with neurolymphomatosis due to non-Hodgkin's lymphoma.

TIPIC-A Newly Recognized Syndrome: Multimodality Imaging of a Rare Clinicoradiological Entity.

Carotidynia is a controversial clinicopathological entity vastly described in Western literature as neck pain in the region of carotid bifurcation secondary to an underlying inflammatory etiology. Radiologically, this appears as perivascular inflammation and has recently been designated as transient perivascular inflammation of the carotid artery (TIPIC) syndrome. The authors of this report discuss the multimodality imaging features of a rare case of this disease in our country to familiarize radiologists with the imaging findings and to encourage the inclusion of TIPIC syndrome as a differential diagnosis for focal neck pain.

Decoding the neonatal chest radiograph: An insight into neonatal respiratory distress.

Respiratory distress is one of the leading causes of neonatal morbidity and mortality. Factors such as gestational age at birth, pulmonary maturity, and congenital factors are peculiar to this demographic. Clinical evaluation accompanied by chest radiography is the standard protocol for evaluating the underlying causative factors. Knowledge of the radiographic appearances of various pathologies and associations with certain congenital factors is quintessential for radiologists and primary neonatal care providers to steer the management in the right direction.

Chest radiography in adult critical care unit: A pictorial review.

Patients in the intensive care units suffer from a myriad of cardiopulmonary processes for which portable chest radiography is the most utilized imaging modality. A pragmatic approach toward evaluating the nearly similar radiographic findings seen in most of the pathologies with comparative review and strong clinical acumen can help the radiologists and clinicians achieve a rapid and precise diagnosis.

Association of Genetic Polymorphisms of CYP2C9 and VKORC1 with Bleeding Following Warfarin: A Case-Control Study.

INTRODUCTION: Various factors have been shown to increase the risk of bleeding with warfarin. This study aimed to assess the association of CYP2C9 and VKORC1 with the development of bleeding following warfarin. STUDY METHODS: A case control study was initiated after obtaining institutional ethics committee clearance and written informed consent from patients. Cases were defined as those who bled within three months of warfarin initiation and controls as those who did not have any episode of bleeding within three months. Genotyping for CYP2C9 (*1, *2, *3) and VKORC1 1639 (GG, GA and AA) was performed by PCRRFLP. Chi square test was used to find out the association and trend of CYP2C9 and VKORC1 genotypes with odds ratio (95% CI) for strength of association. A binary logistic regression model was developed associating age, body weight, sex, CYP2C9 and VKORC1 status with risk of bleeding. RESULTS: A total of 100 controls and 38 cases were studied from Oct 2009 to July 2011. A significant association (P < 0.0001) and trend (P = 0.027) of mutant alleles of CYP2C9 and VKORC1 were noted with bleeding with odds ratios of 7.8 [3.4, 17.9] and 2.7 [1.3, 5.7] respectively. Weekly dose requirement was significantly lower with the presence of *3 allele relative to *1 in CYP2C9 (P < 0.001). The regression model showed an accuracy of 80% and could explain 35.3% of the variability. CONCLUSION: A significant association between CYP2C9 (*1,*2,*3) genotype and VKORC1 (1639 G>A) haplotype status has been found with increased bleeding tendency to warfarin. This may help to individualize therapy.