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BACKGROUND Despite proven benefits, the use of single‐purpose mobile stroke units (MSUs) has raised concerns about their effective and cost‐efficient integration into clinical practice, especially when considered for operation in nonurban areas. The MSU concept may benefit from opening the indication spectrum to include frequent stroke mimics and additional emergencies. METHODS The current observational study evaluated benefits for the treatment and triage decision‐making of use of an MSU with extended capabilities (Hybrid‐MSU), also including radiography, ultrasonography, extended point‐of‐care laboratory, ECG, electroencephalography, and advanced medications. Apart from patients with a dispatch code for “stroke”, the ambulance was also dispatched to those with codes for “seizures”, “falls with head trauma”, “headache”, “unconsciousness”, “infection and pandemic”, “chest pain”, and “breathing problems”. RESULTS For 250 patients treated by the Hybrid‐MSU, but not for 250 conventionally treated patients, the prehospital diagnostic workup allowed, apart from treatment with stroke thrombolytics (n=15), prehospital administration of specific anticonvulsants (n=15), antibiotics (n=5), early secondary stroke prophylaxis with aspirin (n=49), and the Sepsis Six bundle (n=2). Prehospital diagnosis avoided 215 (86.0%) admissions to the emergency department, either by management at home (n=116, 46.4%) or by directly transferring patients to the required specialized wards (n=99, 39.6%). CONCLUSION The current study demonstrates the feasibility of the use of a Hybrid‐MSU and indicates its potential benefits for prehospital treatment and triage decision‐making. Opening the indication spectrum, together with an act‐alone ability, could be a key in the future integration of MSUs into routine health care.

CONTEXTPerinatal asphyxia happens in 2 to 10 per 1000 newborns that are born at term, and more for those that are born prematurely and making one of the leading cause of death worldwide. AIMTo study the pattern of involvement of brain in HIE influenced by nature of insult and to assess the severity of brain injury by MR imaging and correlate with clinical staging (Sarnat criteria). METHODOLOGY43 cases with history of perinatal asphyxia were included in this study by applying the inclusion criteria and exclusion criteria. Signal changes in T1 and T2 weighted images and diffusion weighted were assessed and recorded. RESULTS AND INTERPRETATIONSAfter MR imaging, most of the Sarnat Stage I and II patients were mild and stage III patients were severe. Of the all clinically diagnosed having HIE, 25.6% cases were normal. Patients with clinically mild hypotension >1/2 (54.2%) of them were found to be normal after imaging. Patients with clinically moderate hypotension, 20% were normal at MRI; and >1/2 (52%) of them showed only mild changes and 12% showed severe involvement. Term babies with mild encephalopathy shows more involvement of periventricular white matter than subcortical white matter. Clinically severe encephalopathy correlates with abnormal basal ganglia -thalamic lesions in term babies and germinal matrix haemorrhage in preterm babies. Clinically moderate encephalopathy correlates with signal changes in posterior limb of internal capsule and perirolandic white matter. Prematurity increases the susceptibility of brain to changes caused by hypoxia. No significant association noted between sex and birth weight with abnormal MR imaging findings. The low Apgar score shows significant association with severity of brain involvement. Seizure and its onset also appears to be a deciding parameter in severity of brain injury.

BACKGROUNDShoulder joint is the most commonly dislocated joint and it is most commonly dislocated anteriorly. Based on aetiology and age, there are associated injuries like injury to anterior-inferior labroligamentous restraints (in young people with traumatic aetiology) and to bony restraints (in elderly people). Injury to labroligamentous structures are best visualised using MRI and MR arthrography. Instability can be anterior, posterior and inferior or multidirectional. Anterior instability are associated with Bankart's lesion and variants of it and injuries to anterior part of Inferior Glenohumeral Ligament (IGHL). With posterior instability lesions expected are reverse Bankart's and reverse Hill-Sachs lesions.

BACKGROUNDAnterior cruciate ligament injuries contribute to the major ligament injuries involving the knee. What we thought of isolated anterior cruciate ligament (ACL) injuries were not isolated injuries, there are associated posterolateral, posteromedial, anterolateral corner injuries and meniscal injuries. Identifying these injuries is of paramount importance to prevent the knee from developing arthritic changes in the future. Objectives-To know the spectrum of posterolateral corner injuries in ACL injured knee.