Background and Objective:An acute scrotum is defined as acute pain with or without scrotal swelling, may be accompanied by local signs or general symptoms. Acute scrotal pain is a medical emergency. Depending on cause, the management is entirely different. Torsion of testis and strangulated hernia are surgical emergency; whereas, epididymo-orchitis is treated by medicines. Testicular trauma and obstructed hernia can be differentiated by taking history from patient. Physical examination adds only a little information. Color Doppler ultrasound (US) is the modality of choice to differentiate testicular torsion from inflammatory conditions and can thus help in avoiding unnecessary surgical explorations.Subjects and Methods:A study on 50 patients was conducted who were referred with history of acute scrotal pain to our department between January 2013 and January 2014. Trauma and scrotal mass were excluded from the study. The clinical presentation, outcome, and US results were analyzed.Results:Color Doppler sonography yielded a positive and negative predictive value (PPV and NPV) of 100% each for torsion, whereas, 93.9 and 70.6% for epididymo-orchitis, respectively; a sensitivity and specificity of 100% for torsion, whereas, for epididymo-orchitis it was found to be 86.1 and 85.7%, respectively. In cases of incomplete or early torsion, some residual perfusion may be detected leading to false-negative results.Conclusion:We therefore conclude that color Doppler sonography can reliably rule out testicular torsion and can thus help in avoiding unnecessary surgical explorations. Hence, it can significantly improve outcome and decrease morbidity of patient. It is an accurate, rapid, nonexpensive, nonionizing, important adjunct to clinical assessment of scrotum.
Introduction:One of the major causes of pediatric morbidity today at the community level is infection involving the ear, nose, and throat. Maximum of these patients respond well initially on general regular medications, but then recurrent complaints are not very uncommon. One of the major causes for such recurrence is hypertrophy of adenoids, the evaluation of which requires a battery of sophisticated investigative tools and expertise which are lacking at the community level. The aim of the study is to evaluate various symptoms related to adenoid hypertrophy and its correlation to the size of the adenoid seen in the lateral view nasopharyngeal X-ray. The aim of the study was to assess various symptoms related to adenoid hypertrophy and its correlation with the size of adenoid radiologically.Methods:A total of fifty cases of pediatric age with strong clinical suspicion of adenoid hypertrophy were included in the study. Through ENT examination was done. X-ray lateral view nasopharynx was obtained.Results:Adenoid hypertrophy was graded according to symptoms score and lateral cephalometric/radiographs. Snoring was the most frequent symptom which had a linear relation with the size of the adenoid.Conclusion:There was good agreement between symptom and the X-ray findings.
Background In today's obstetric practice, induction of labour is a common procedure. Before the imaging era, the favourability of the cervix was assessed by manual examination scored as the Bishop Score. However, subjectivity and high inter- and intra-observer variability are limitations of this approach. This necessitates the implementation of an objective method of assessment. We used transvaginal sonography (TVS) as an objective method of assessment of cervix by TVS cervical score comprising of five different parameters; cervical length, funnelling at the internal os, distance from the presenting part to the external os, and cervix position. This study aims to evaluate the role of the pre-induction transvaginal ultrasonographic (TVS) cervical score in predicting labour outcome and comparing it to the Bishop score in patients undergoing induction of labour. Methodology This observational prospective study included 100 pregnant women admitted for labour induction at a single tertiary care centre. The TVS examination which consisted of five parameters was performed after the clinical Bishop scoring. The TVS scores were compared with the Bishop scores for all patients. Labour induction was done within one hour of examination and the outcome of the induction was recorded. Results The mean age was 25.87 years [SD = 4.35]. Labour induction was successful in 74% of patients. At cut-off Scores of ≥ 4, TVS cervical Score performed better than Bishop Score (Sensitivity 93.24 vs. 67.57%, Specificity 73.08 vs. 65.38%). ROC analysis indicated that Area Under Curve (AUC) was more for TVS Score (0.91, 95% CI 0.84–0.97), compared to Bishop Score. Conclusion Transvaginal ultrasonography is an objective method of cervical assessment. We conclude from our study that the use of TVS score which consists of five different parameters in cervical assessment provides a better prediction of successful labour induction than the Bishop score, and so can prevent various complications associated with induction failure.
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