Background: Rotator cuff pathology accounts for 10% causes of shoulder pain. A gamut of imaging techniques comprising of ultrasonography (USG), Magnetic Resonance Imaging (MRI) and MR arthrography (MRA) have been commonly used for the characterisation of rotator cuff (RC) disorders. With the advent of high-end USG machines, accuracy rates of USG is comparable to that of MRI in evaluation of rotator cuff pathologies. Materials and Methods: 50patients who had presented with symptoms of rotator cuff injuries and were referred to Department of Radiodiagnosis JSS Medical College and Hospital, Mysuru during the period August 2017 to September 2019 for Ultrasound and MRI of the shoulder. Results: Diagnostic accuracy of USG in correlation to MRI showed 93% sensitivity and 97% specificity for supraspinatus, 88% sensitivity and 96% specificity for detecting the infraspinatus tears; 74% sensitivity and 86%specificity for subscapularis indicating detection of supraspinatus was comparatively easier than subscapularis in ultrasound. Conclusion: MRI was more superior and sensitive tool than ultrasound in detecting and delineating the musculoskeletal injury in terms of grading the partial tear & tendinopathy, however accuracy of ultrasound in initial evaluation of rotator cuff injuries is comparable to MRI. Anatomical delineation of the rotator cuff injury which is of prime value for treating surgeon is better visualized by MRI.

The use of OTC drugs is alarmingly high in Bangalore East. Pharmacists have to be trained and educated regarding rationale dispensing of drugs. The need for promoting the appropriate use of drugs in the Indian health care system is important. This can be achieved through educational, regulatory and managerial strategies.

Background: Dengue is a major international health concern that is prevalent in tropical and sub-tropical countries. It is estimated that worldwide nearly 2.5 billion people continue to live at risk of contracting the infection while 50 million cases and 24,000 deaths tend to occur in 100 endemic countries. Hepatic dysfunction is common in dengue fever and the degree of liver dysfunction in children varies from mild injury with to severe injury.Methods: Prospective and descriptive study was conducted on all the laboratory confirmed cases of dengue fever in children admitted at SIMS and RC over a period of 1 year from Dec 2015 to Nov 2016 both clinically and biochemically.Results: This study reveals, the prevalence of hepatic dysfunction in 30.6% (174/568) of the cases. Among the gender and age, majority of the hepatic dysfunction were seen in males 55.7% (97/174) and in the age group of 10-18 years 44.2% (77/174). Based on the severity, majority of hepatic dysfunction was seen in severe dengue cases 59.2% (103/174). Among clinical findings, most common symptom was jaundice 27.5% (48/174) and commonest sign was hepatomegaly 39.6% (69/174). The commonest liver function test altered was AST level in 45.4% (79/174) of the cases. Commonest abdominal USG finding was gall bladder edema in 90.8% (156/174) of the cases. The mortality was nil in this study.Conclusions: This study concludes prevalence of hepatic dysfunction was seen 30.6%, most of them seen in severe dengue 59.2% of the cases suggesting any febrile child with hepatic dysfunction, dengue infection should be suspected.

Background: Dengue is a major international health concern and is a major health problem in India which constantly threatens the health care system. The objective of the present study was to study the clinical profile of dengue fever in children.Methods: Prospective and descriptive study was conducted on all the laboratory confirmed cases of dengue fever in children admitted at SIMS and RC over a period of 1 year from December 2015 to November 2016. Results: Among 568 children studied, majority of them were males 63.3% and in the age group of 10-18 years 39.4%. The most common symptoms noticed were fever 90.1% followed by myalgia 88.3%,decreased appetite 88.2%, retroorbital pain in 84.5%, vomiting 84.1% and the least common symptoms noticed were convulsions 0.8% and altered sensorium 1%. The most common signs were skin rash 65.4% and ascites 31.6% and least common sign was spleenomegaly 8.4%. The most common complications seen were hepatic dysfunction 30.6% followed by shock 18.6% and pleural effusion 15.8%. The least complication noticed was encephalitis 0.7%. Death was nil in our study.Conclusions: This study concludes male children in the age group of 10 - 18 years were more affected. The common symptoms observed were fever, myalgia, decreased appetite and headache and commonest signs were skin rash and ascites. The common complications presented were hepatic dysfunction and shock with no mortality indicating the presence of less virulent organisms.

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R ickettsial fever is a re-emerging disease of south East Asian countries [1,2]. A high index of suspicion is necessary to diagnose them. Many children have nonspecific manifestations like viral illness and may present without classical rashes or eschar. Rickettsial fever is endemic in north Karnataka, Tamil Nadu, and Andhra Pradesh [3-6]. In Karnataka, the cases have been reported from both rural as well as urban areas [7-10]. There are numerous clinical manifestations such as fever, headache, rashes, gastrointestinal, and respiratory symptoms [3,10,11]. Difficulty in diagnosis is due to variations in the antigenicity of infecting strains [7,12,13]. Oriental tsutsugamushi has several antigenic types because of the variation in the 56-kDa protein on the outer membrane [14-16]. Rickettsial diseases are Zoonoses where human beings are accidentally involved in a chain of transmission between chiggers and animals. Endemic habitats are rice fields, deserts, and riverbanks as these ecological patches attract the natural host of mite [17]. Children commonly present with fever, calf muscle pain, and gastrointestinal symptoms. The classic triad is fever, rashes, and unremitting headache. Initially, the rashes are discrete, after several days, there may be petechiae, ecchymosis, or necrosis [9]. Eschar is seen in a few cases in the hidden areas of the body [18-20]. MATERIALS AND METHODS This was a hospital-based descriptive study carried out at a tertiary care teaching hospital, in south India, including all clinical and laboratory-confirmed cases of children with Rickettsial fever admitted during the period from December 2018 to November 2019. Purposive sampling technique was used with a total sample size of 103. The inclusion criteria were children in the age group 0-18 years, admitted with symptoms suggestive of Rickettsial fever based on RATHI criteria, immunoglobulin (Ig)M scrub typhus antibody-positive cases by ELISA technique and Weil Felix test. Children with dengue, Malaria, and other PUO were excluded from the study. Ethical committee clearance was obtained from the institutional ethical committee and consent was taken before the study (Table 1). Data collection was done using a structural protocol, including symptoms, signs, complications, relevant investigations, treatment, duration of stay, and outcomes. These were the primary outcome variables assessed.

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Aim: To evaluate the solid focal liver lesions by Shear Wave Sonoelastography (SWE) and correlate Shear Wave Sonoelastography findings with that of FNAC. Methods: 50 patients who were diagnosed to have solid focal liver lesions on sonography during the period August 2017 to September 2019 at JSS Medical College and Hospital, Mysuru underwent Shear Wave Sonoelastography [SWE], following which patient underwent ultrasound guided FNAC for histological evaluation. Results: Benign vs. malignant hepatic lesions could be differentiated using a cut off value of 25 kPa. The overall sensitivity & specificity of SWE was found to be 66% and 30% respectively as a standalone technique, however the predicative accuracy of SWE in conjunction with gray scale sonographic findings was 91.4%. Conclusion: Shear wave elastography can be used as an adjunct in routine sonological practice to evaluate solid focal lesions of the liver. It can help to categorize benign versus malignant lesions.