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EPO monotherapy reduces the risk of death or disability in term neonates with moderate or severe encephalopathy.

Purpose To assess the influence of various patient-, lesion-, and procedure-related variables on the occurrence of pneumothorax as a complication of CT-guided percutaneous transthoracic needle biopsy. Material and methods In a total of 208 patients, 215 lung/mediastinal lesions (seven patients were biopsied twice) were sampled under CT guidance using coaxial biopsy set via percutaneous transthoracic approach. Incidence of post procedure pneumothorax was seen and the influence of various patient-, lesion-, and procedure-related variables on the frequency of pneumothorax with special emphasis on procedural factors like dwell time and needle-pleural angle was analysed. Results Pneumothorax occurred in 25.12% (54/215) of patients. Increased incidence of pneumothorax had a statistically significant correlation with age of the patient ( p = 0.0020), size ( p = 0.0044) and depth ( p = 0.0001) of the lesion, and needle-pleural angle ( p = 0.0200). Gender of the patient ( p = 0.7761), emphysema ( p = 0.2724), site of the lesion ( p = 0.9320), needle gauge ( p = 0.7250), patient position ( p = 0.9839), and dwell time ( p = 0.9330) had no significant impact on the pneumothorax rate. Conclusions This study demonstrated a significant effect of the age of the patient, size and depth of the lesion, and needle-pleural angle on the incidence of post-procedural pneumothorax. Emphysema as such had no effect on pneumothorax rate, but once pneumothorax occurred, emphysematous patients were more likely to be symptomatic, necessitating chest tube placement. Gender of the patient, site of the lesion, patient position during the procedure, and dwell time had no statistically significant relation with the frequency of post-procedural pneumothorax. Surprisingly, needle gauge had no significant effect on pneumothorax frequency, but due to the small sample size, non-randomisation, and bias in needle size selection as per lesion size, further studies are required to fully elucidate the causal relationship between needle size and post-procedural pneumothorax rate. The needle should be as perpendicular as possible to the pleura (needle-pleural angle close to 90°), to minimise the possibility of pneumothorax after percutaneous transthoracic needle biopsy.

The results from the present study suggest promising role of SWI in the discrimination of tuberculomas from metastatic brain lesions and gliomas with the presence of a complete and regular peripheral hypointense ring favoring the diagnosis of tuberculomas.

Aim:To evaluate the role of USG in the preoperative localization of parathyroid adenomas in patients with symptomatic hyperparathyroidism and to compare its usefulness with that of scintigraphy scan and postoperative findings.Material and methods:Twenty-five patients with symptomatic primary hyperparathyroidism were subjected to USG of the neck and nuclear scintigraphy, followed by surgery. The results were independently analyzed and compared with per-operative findings.Results:The 25 patients had a total of 28 abnormal glands: 22 solitary adenomas, and 6 multiple adenomas (two each in three patients). USG detected 20 out of 22 solitary adenomas and three out of six multiple adenomas. USG missed five abnormal glands, two of which were in the neck and three in the mediastinum. Scintigraphy was positive in 26 abnormal glands, out of which 22 were single and four were multiple. Two abnormal glands were missed: one in the neck and one in the mediastinum.Conclusion:As limited neck dissection for primary hyperparathyroidism becomes increasingly popular, USG has been found to be a sensitive, specific, and easily available noninvasive investigation for parathyroid localization. It can be easily offered to patients as a method for preoperative localization prior to limited parathyroid surgery outside tertiary care settings.

64-slice multiphase CT-EG is a useful investigation in the evaluation of both occult and overt OGIB.

Traumatic pseudoaneurysm of the middle meningeal artery is rare and is associated with high mortality. Skull fracture is usually an associated feature of this entity. An elderly male was brought to our hospital in a stage of coma. The details of ictus were not known. The Glasgow coma scale score was 9/15. Examination revealed a pseudo-aneurysm arising from the posterior branch of the left middle meningeal artery which was excised. The case is presented for its rarity and its characteristic radiology. Traumatic pseudoaneurysm of middle meningeal artery is rare. It is important to recognize this treatable entity. KeywOrds: Skull fracture, Extradural hematoma, Pseudoaneurysm, Middle meningeal artery ÖZOrta meninjial arterin travmatik psödoanevrizması nadir görülmekle beraber yüksek mortalite ile seyreden bir olaydır. Kafatasında kırık görülmesi orta meninjial arterin travmatik psödoanevrizmasının bir özelliğidir. Yaşlı erkek hasta hastanemize koma halinde getirildi. Hastanın bilinç kaybı ile ilgili bir bilgi elde edilemedi. Hastanın Glasgow Koma ölçeği 9/15'di. Hastanın muayenesinde sol orta meninjial arterin arka dalından kesilmiş olduğu görüldü. Olgu nadir görülmesi ve karakteristik radyolojik özelliği nedeni ile sunulmuştur. Orta meninjial arterin psödoanevrizması nadir görülen ve tanı konulunca tedavi edilebilen bir patolojidir.

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