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Introduction: The purpose of this study is to evaluate the role of magnetic resonance imaging (MRI) in evaluation of tubercular spondylitis and to correlate imaging findings with clinical severity of the disease. Methods: One hundred consecutive patients, who presented with features suggestive of spinal infections, were subjected to MRI examination. T1W and STIR images were obtained followed by T2W and post-contrast T1W images. Various imaging characteristics of spinal infections were noted and correlated with the clinical severity of the disease. Results: Backache was the most common presenting symptom present in 86 %, while paraparesis was the most common sign seen in 62 %. The neurological status of the patients correlated well with MRI findings in the majority of the cases with an overall good correlation obtained in 96 % of cases. The majority of the vertebrae and intervertebral discs affected showed hypointensity or isointensity on T1W images and hyperintensity on T2W images. Epidural/dural disease was present in 74 % while 68 % of patients demonstrated decreased intervertebral disc height. Epidural extension and subligamentous spread was in 74 % and 90 % of patients respectively. Conclusions: MRI plays a vital role in early and accurate diagnosis of spinal infections. It is non-invasive and clearly demonstrates soft tissue anatomy and pathology which makes it superior to X-rays and Computed Tomography (CT). Imaging findings of tubercular spondylitis were also found to have a good correlation with the clinical status of the patients. Hence, it is of much help in the evaluation and assessment of patients presenting with features of spinal infections.  Keywords: Magnetic resonance imaging, spinal tuberculosis, tubercular spondylitis

Renal artery pseudoaneurysm, although a well-known complication in patients after penetrating trauma or iatrogenic injury, has rarely been described after blunt torso trauma. A 22-year-old man suffered an accident while on a motorcycle. Upon arrival in the Emergency Room, the patient was unconscious, hypotensive and had hematuria. Initial investigations revealed a fractured shaft of the right femur, multiple rib fractures with hemothorax, extradural haematoma on the right side and a laceration in the right kidney. After the evacuation of intracranial bleed, the patient was managed conservatively. The patient recovered well and was discharged on the 15th post-trauma day. The patient was again present in the emergency room after 6 weeks with 1-week history of gross hematuria. Ultrasonography revealed an anechoic lesion in the right kidney with pulsatile flow on colour Doppler. Further investigation with computed tomography renal angiography was done, which confirmed the pseudoaneurysm of a branch of renal artery. The patient was referred to a higher centre where he was successfully managed with selective arterial coil embolisation.

Aim: Diabetes mellitus is specifically a condition of hyperglycemia, insulin resistance, and relative impairment in insulin secretion.It is characterized by micro and macro vascular complications that lead to significant morbidity and mortality. Diabetic peripheral neuropathy is one of the most common long term complications of DM. HbA1c estimation is usually done which is indicative of glycaemic control. Nerve conduction studies (NCS) are electrodiagnostic tests used to evaluate the ability of the electrical conduction of the motor and the sensory nerves.Therefore the effect of HbA1c on the nerve conduction velocity in Type 2 Diabetes Mellitus Patients was studied.Methodology: Total number of 60 subjects (diabetic subjects and the healthy controls) were examined to assess the Diabetic neuropathy. Sensory Nerve conduction velocity (NCV) test was done along with the estimation of HbA1c levels in all the diabetic subjects (HbA1c≥6.5%) and the healthy controls. Results:The analysis showed that the nerve conduction velocity decreased in diabetic patients with apoor glycaemic control in comparison to healthy and diabetic subjects with good glycaemic control. Conclusion:In diabetic subjects there is progressive neuronal involvement which is accelerated by poor glycaemic control leading to development of diabetic neuropathy. Therefore, NCS can be employed for the early detection of neuropathy in diabetic patients.

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Introduction and Aim: Management strategies of Alcohol Withdrawal Syndrome could be optimized if patients with greater risk are identified early and treated aggressively. Studying the pattern and predictors of alcohol withdrawal syndrome was the main objective of our study.   Materials and Methods: A total of 100 consenting male patients in the age group of 18-60 years diagnosed with alcohol dependence and uncomplicated alcohol withdrawal undergoing in-patient detoxification in tertiary care center in north India were included in the study. A semi structured proforma was used to collect socio-demographic data, Alcohol Use Disorders Identification Test (AUDIT) was used as screening tool and Clinical Institute Withdrawal Assessmentfor Alcohol-revised (CIWA- Ar) was used to assess severity of withdrawal.   Results: Symptoms like difficulty in orientation, seizures and hallucinations were relatively specific for severe AWS, while tremors and anxiety were common to all the patients and were non-specific for predicting severity of AWS. The severity of AWS symptoms correlated significantly with increasing age, duration of alcohol use and AUDIT score.   Conclusion:We concluded that increasing age, longer duration of alcohol use, higher AUDIT score and symptoms related to hallucinations, orientation and seizure are linked to severe alcohol withdrawal. Prior knowledge of these predictors will help to identify the patients at risk of severe alcohol withdrawal so that individual care can be enhanced.