Magnetic Resonance Imaging (MRI) has been the primary imaging modality and has revolutionized the imaging of brain tumors. MRI can display accurate multi planer imaging without interfering of adjacent structures specially for posterior fossa mass lesion. MRI is the imaging modality of choice for cerebollo-pontine (CP) angle Schwannoma. The study was performed to determine, the diagnostic accuracy of MRI in the evaluation of intracranial extra axial CP angle Schwannoma. MRI scan of brain was done on 42 consecutively selected patients referred for the evaluation of CP Acoustic Schwannoma. The age range from 21-60 years and the mean age was 42.85(+9.5) years. Highest incidence of cerebollo-pontine angle (CPA) mass were found 42.86% in 41-50 age group of patients. Male and Female ratio was 1.083:1. The most common presenting feature of the patients with CP angle Acoustic Schwannoma were headache 90.48%. Acoustic Schwannoma is T 1 hypointense 100%, T 2 hyper intense 84.61% and heterogeneously hyper intense 92.30% in FLAIR image. After giving contrast agents, homogeneous enhancement 57.69% and heterogeneous 42.31% cases of Acoustic Schwannoma. Overall 61.54% Acoustic Schwannoma strong contrast enhancement was observed. Dural tail was observed in 26.92% cases. Perilesional edema was observed 38.46% cases. Mass effect was observed in 76.92%. After complete MRI evaluation 61.9% had Acoustic Schwannoma. Histopathologicaly proved cases showed out of all patients Acoustic Schwannoma 59.52%. The overall sensitivity of MRI to diagnose Acoustic Schwannoma were found, Sensitivity-96%, Specificity-88.2%, PPV-92.31%, NPV-93.75% and Acceuracy 92.86%. Test is significant with p<0.0001 level. It is conceivable that MRI is a highly accurate, sensitive and Gadolinium enhanced MRI is more sensitive in detection of acoustic Schwannoma. MR imaging is the study of choice for the examination of the patient of cerebellopontine angle Schwannoma because of its high sensitivity specially after use of contrast material.
Fine needle aspiration (FNA) is a method of taking cytology sample by means of a fine needle attached with a syringe. Fine needle aspiration cytology (FNAC) is a diagnostic technique which involves study of the cell smears prepared from FNA material. [4][5][6] Ultrasound guided FNAC has been used as a diagnostic procedure of peripheral lung masses 7-9 but deep intrathoracic masses cannot be imaged by ultrasonography.CT guided biopsy was first reported in 1976 and since then numerous reports have shown CT guided transthoracic FNAC to be an accurate
Abstract:Wilson's disease is an inborn error of copper metabolism caused by a mutation to the copper-transporting gene ATP7B. Epidemiologic clustering of mutations to the ATP7B gene based on ethnicity has been observed. Diagnosis of the condition is made primarily on the basis of clinical findings, presence of the Kayser-Fleischer ring, and biochemical and radiological parameters. The young patient's usual presentation is through liver involvement. Uncommonly the young group can present with
Objective: Metabolic syndrome is the cluster of vascular risk factors including insulin resistance, elevated bloodpressure, hyperlipidemia, and obesity. Metabolic syndrome is strongly associated with cardiovascular andcerebrovascular disease. The aim of this study is to find out association between stroke and metabolic syndrome inour population.Methods: In this observational study, a total number of fifty randomly selected patients were studied from July2009 to December 2009 at Medicine ward of Dhaka Medical College Hospital. Definition of metabolic syndromewas taken from the guidelines by the National Cholesterol Education Program Adult Treatment Panel III.Results: Among the study population 46% had metabolic syndrome. This study estimated that Ischaemic stroke ismore common among metabolic syndrome patients (65.2%), but patient without metabolic syndrome had morehaemorrhagic stroke (55.6%).Only 12% patient was found obese. With or without metabolic syndrome most of thepatient had elevated TG (64%) and raised blood pressure (64%).Conclusion: Without obesity, metabolic syndrome is an important risk factor for cerebrovascular disease. Majorityof the patients with metabolic syndrome present as ischemic stroke.Keywords: Stroke; Metabolic syndrome; hypertension; fasting blood sugar; hyperlipidaemia.DOI: 10.3329/jom.v11i2.5453J MEDICINE 2010; 11 : 124-127
Introduction and objectives: Congenital ureteropelvic junction obstruction (UPJO) is the most common cause of hydronephrosis. Management protocols are based on the presence of symptoms and when the patient is asymptomatic the function of the affected kidney determines the line of treatment. Percutaneous nephrostomy (PCN) became a widely accepted procedure in children in the 1990s. The aim of the study was to evaluate the results of performing percutaneous nephrostomy (PCN) in all patients with UPJO and split renal function (SRF) of less than 10% in the affected kidney, because the management of such cases is still under debate. Methods:This prospective clinical trial was carried out at Dhaka Medical College Hospital from January 2014 to December 2016. Eighteen consecutive patients who underwent PCN for the treatment of unilateral UPJO were evaluated prospectively. In these children, ultrasonography was used for puncture and catheter insertion. Local anesthesia with sedation or general anesthesia was used for puncture. Pig tail catheters were employed. The PCN remained in situ for at least 4 weeks, during which patients received low-dose cephalosporin prophylaxis. Repeat renography was done after 4 weeks. When there was no significant improvement in split renal function (10% or greater) and PCN drainage (greater than 200 ml per day) then nephrectomies were performed otherwise pyeloplasties were performed. The patients were followed up after pyeloplasty with renograms at 3 months and 6 months post operatively. Results: All the patients had severe hydronephrosis during diagnosis and 14 patients with unilateral UPJO were improved after PCN drainage and underwent pyeloplasty. The rest four patients that did not show improvement in the SRF and total volume of urine output underwent nephrectomy. In the patients with unilateral UPJO who improved after PCN drainage, the SRF was increased to 26.4% ±8.6% (mean± SD) after four weeks and pyeloplasty was performed. At three and six months follow-up, SRF value was 29.2% ±8.5% and 30.8.2% ±8.8% respectively. Conclusion: Before planning of nephrectomy in poorly functioning kidneys (SRF < 10%) due to congenital UPJO, PCN drainage should be done to asses improvement of renal function. Bangladesh Journal of Urology, Vol. 20, No. 2, July 2017 p.61-64
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