Introduction: Nail involvement in psoriasis occurs in up to 30–50% of patients, and 5–10% may have isolated nail disease. Onychoscopy, a noninvasive tool, might obviate the need for nail biopsy, which is a diagnostic gold standard. Objective: The aim of this study was to evaluate onychoscopic features of nail unit in patients with nail psoriasis. Methods: Fifty-five patients with clinically diagnosed and histologically documented nail psoriasis were recruited. Onychoscopy was performed for each nail (excluding the 5th toenail). Clinically, 443/550 fingernails and 101/440 toenails were involved. The frequency distributions of various onychoscopic features was assessed and compared using the χ² test (p value <0.05 was considered significant). Results: With onychoscopy, additional 52 fingernails and 64 toenails showed psoriatic involvement. Pitting was the commonest finding in fingernails (60.5%) followed by subungual hyperkeratosis (SUH) (52.8%), onycholysis (40.8%), and dotted capillaries in hyponychium, proximal, and lateral nail folds (38.6 vs. 35.8 vs. 35.8%). In toenails, we observed SUH (85.1%), nail plate thickening (82.1%), onycholysis (77.2%), and dotted capillaries in hyponychium and nail folds (59.4 vs. 53.4 vs. 45.5%). Fuzzy lunula was a novel onychoscopic finding noted in 33.6% fingernails and 4.95% toenails (p < 0.00001). Limitations: Small sample size. Conclusions: Onychoscopy may aid in diagnosing nail lesions even before the clinical signs are apparent.

<strong>Introduction:</strong> Intrauterine growth restriction is the second most common cause of perinatal mortality and morbidity after prematurity. Etiologies can be maternal, fetal or placental. The correct detection of compromised IUGR fetus to allow timely intervention is a main objective of antenatal care. Many of IUGR patients presents in their third trimester for the first time for antenatal examination. Such patients warrant a highly sensitive and specific diagnostic test which can be noninvasively applied on a large scale. Apart from various other non-invasive tests like USG, NST, Doppler flow studies give us vital information regarding the fetus in utero. Hence the present study is aimed at exploring the association of colour Doppler and non-stress test findings with the perinatal outcome in the fetuses with IUGR. <strong>Aim:</strong> To study relationship of Doppler and NST with perinatal outcome in IUGR cases. <strong>Material and Methods:</strong> A Prospective observational study was conducted on 70 patients of IUGR from August 2013 to November 2015 in Department of Obstetrics and Gynaecology , Dr. Vasantrao Pawar Medical College, Hospital &amp; Research Center. Inclusion criteria: Patients with diagnosed singleton pregnancies with IUGR at gestational age more than 32weeks not in labour. Exclusion criteria: Patients with congenital anomalous fetus, diabetes or acute placental insult. Patients were followed up with serial Umbilical artery Doppler and NST. Perinatal outcome was correlated with the last Doppler and NST within 7days prior to delivery. <strong>Results:</strong> Perinatal outcome is worst in patients with both NST and Doppler are abnormal and best among patients with both normal NST and Doppler. <strong>Conclusion:</strong> Doppler predicts fetal compromise earlier as compared to NST.

Pediatric benign osteocytic tumors include osteoma, enostosis, osteoid osteoma, and osteoblastoma. In pediatric populations, benign bone tumors are more common than malignancies. Benign osteocytic tumors may have a unique clinical presentation that helps narrow the differential diagnosis. A systemic imaging approach should be utilized to reach the diagnosis and guide clinicians in management. Radiographs are the most prevalent and cost-effective imaging modality. Cross-sectional imaging can be utilized for tissue characterization and for evaluation of lesions involving complex anatomical areas such as the pelvis and spine. Computed Tomography (CT) is the modality of choice for diagnosis of osteoid osteoma. CT scan can also be utilized to guide radiofrequency ablation, which has been found to be highly effective in treating osteoid osteoma and osteoblastoma. Enostosis is a no-touch lesion. Osteoma is commonly located in the paranasal sinuses. Osteoma needs an excision if it causes complications due to a mass effect.

In this article, we emphasize the usefulness and cost-effectiveness of non-contrast MRI as the primary imaging modality in the evaluation of non-febrile pediatric seizure, illustrate the MR spectrum of different structural lesions causing pediatric seizures, and finally describing the main MR imaging features of these disorders. Among 366 cases of pediatric epilepsy studied over a period of fifteen years the commonly detected structural malformations are mesial temporal sclerosis unilateral and bilateral, heterotopias, cortical dysplasia, neurocutaneous syndromes and few neoplasms. MRI showed hippocampal atrophy and increased signal intensity of the hippocampus on T2-weighted images in mesial temporal sclerosis, cortical thickness and sulcation are decreased in microcephaly, enlarged dysplastic cortex in hemimegalencephaly, and focal cortical dysplasia shows ipsilateral focal cortical thickening with radial hyperintense bands. MRI detects smooth brain in classic lissencephaly, the ectopic position of gray matter in heterotopias, and the nodular cortex with cobblestone cortex in congenital muscular dystrophy. MRI can detect polymicrogyria and the related syndromes, as well as schizencephaly types. In conclusion, MR imaging is essential to demonstrate the morphology, distribution, and extent of different disorders causing seizures in children as well as the associated anomalies and related syndromes to guide patient for further surgical treatment and counseling.

Levetiracetam has been associated with aggressive behavior and mania. We are reporting a case of agitation and aggressive behavior following levetiracetam monotherapy for focal seizure prophylaxis. A 48 years old man, who presented to the neurology department with history of four episodes of sudden onset abnormal body movements. Patient was diagnosed with focal seizures with secondary generalization and was prescribed tablet levetiracetam 500 mg twice a day for seizure prophylaxis. Three weeks later patient presented with complaints of excessive sleepiness during daytime, agitation and aggressive behavior, though seizure free. According to World Health Organization Uppsala monitoring Centre (WHO-UMC) causality assessment system the case was classified as probable/likely for levetiracetam-induced altered behavior. Levetiracetam was discontinued, and tablet carbamazepine controlled-release 300 mg twice daily was substituted. Within 2 days of switching therapy the agitation and aggression reduced substantially. Although levetiracetam has fewer side effects than traditional antiepileptic medications, but it is imperative to continuously monitor the patient for infrequent adverse effects also, so that required modifications to drug label may be done.

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The human lungs are organs of respiration present in the greater part of thoracic cavity on each side of heart in the mediastinum resting on diaphragm. The right lung is classically divided into three lobes namely superior, middle and inferior by the oblique and horizontal fissures. The left lung is divided into superior and inferior lobes by a single deep oblique fissure. The fissures help in expansion of lungs during respiration. During the routine dissection of thoracic region of human cadaver, bilobed right lung with absent horizontal fissure was observed. The right lung was divided into superior and inferior lobe by a single oblique fissure. The left lung had normal anatomy in this case. The variations in the fissures and lobar pattern of lungs are common and are due to altered developmental process during intrauterine life. The anatomical knowledge of these disparities in fissures is important for clinicians prior to performing any pulmonary surgical procedures and to prevent postoperative complications.

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