The term sarcopenia is derived from the Greek meaning 'poverty of flesh' and is characterized by the progressive loss of skeletal muscle mass, muscle strength, and physical performance. This term was first coined by I.H. Rosenberg to denote "ageing related loss of skeletal muscle mass and strength" 1. Sarcopenia has a biological component with the genes involved in skeletal muscle mitochondrial function, oxidative capacity, and glucose uptake showing reduced expression with ageing 2. It affects women and men equally, starting from the fourth decade and accelerating from the 6 th decade 3. It was originally described in the elderly population, and is often now defined as a geriatric syndrome associated with functional impairment, increased risk of falls, fractures, and reduced survival. Sarcopenia has been found to be a predictor of chronic disease progression, poorer functional outcomes, and postoperative complications (both infections and noninfectious complications) 4. Standardization of sarcopenia assessment, especially in diagnosis of low muscle mass, will be crucial for clinical practice and interventions in the future. Dual energy X-ray absorptiometry (DEXA), bioelectrical impedance analysis Abstract Objective: To estimate the proportion of radiologically significant (LSMI) sarcopenia and the factors associated with it among patients undergoing Computerized Tomography scan. Methods: A Cross sectional study was conducted among 152 patients underwent CT scan in the radiology department of Government medical college Thiruvananthapuram. Sarcopenia was estimated based on lumbar skeletal muscle index obtained using cross sectional areas of various abdominal muscles by CT scan. The proportion of sarcopenia was estimated and associated factors studied. Binary logistic regression model was used to adjust the confounders. Results: Out of 152 individuals, sarcopenia was present in a total of 82 (53.95%) individuals. Male gender (Adjusted OR= 8.42, 3.64-19.52 (95% CI)) was a risk factor for and a body mass index more than 25Kg/m 2 (Adjusted OR= 0.36, 0.15-0.67 (95% CI)) was a protective factor against sarcopenia. Conclusion: The burden of sarcopenia is found to be high and considering the double burden of sarcopenia and obesity in the Kerala community, newer strategies for health promotion and early detection need to be developed.

No abstract

The present study was undertaken in department of Radio-Diagnosis, Government Medical College, Kozhikode, Kerala, in 70 patients who underwent CT scan head for evaluation of head injury. CT findings in traumatic head injury patients were recorded and studied. CT findings were correlated with preoperative and postmortem findings. Sensitivity of CT in detection of various traumatic intracranial lesions and role of CT findings in predicting outcome of head injuries were assessed. The study group consisted of 64 males and 6 females between the ages of 1 to 70. Initial CT findings were evaluated. Those patients who were conservatively managed are followed up for three months, follow up CT findings and mortality was assessed. Those cases subjected to neurosurgical interventions were followed up and surgical & post procedural data are collected. Post-mortem findings in head injury deaths were collected and studied. Present study shows majority of head injuries in economically productive age group (21-30 year), in males and as a result of road traffic accidents. Skull fractures were seen in 50 % of cases. CT detection rate for linear fractures is around 90 % and for base of skull is 82 %. Most common CT finding was subarachnoid hemorrhage followed by cerebral contusions. 39 % of cases were managed conservatively and has got favorable outcome. 31 % underwent cerebral decompression procedures in which 85 % had a good post-operative outcome. Evacuation of extra axial bleed (EDH and SDH) was the common procedure undertaken. Extra axial bleed was the cause for 14 % of total mortality. Midline shift of approximately 8-10 mm corresponded to 100 ml of extra axial bleed. Present study showed a mortality rate of 32 %. Most common cause of death was multiple intra parenchymal bleeds, in which brain stem bleed was the major cause (44 %). CT detection rate for brain stem injury was around 75 %. Diffuse brain injuries were the cause in 22 % of deaths. CT detection rate for diffuse brain injury was around 70 % and mortality 60 %. Diffuse brain injuries and brain stem injuries were under diagnosed in CT. Even though some of the diffuse brain injuries were under diagnosed in CT, all the surgically correctable lesions were detected by CT.

CONTEXT: Breast cancer is the second most common cancer in the world, and the second most common in cancer in Indian women. AIMS: The aims of this study were to differentiate between benign and malignant lesions using Diffusion Weighted Imaging, T2-weighted and T1-weighted imaging, and to set a cut off value of ADC to differentiate between benign and malignant lesions. MATERIALS AND METHODS: It included 51 patients between the ages of 15 and 75 years, coming to surgical OPD, Government Medical College, Kozhikode with USG/Mammogram proven breast lesions from January 2013 to September 2014. Non contrast MR Mammography was done using 1.5 T MR system. T1WI, T2WI and Diffusion weighted imaging (b= 0, 600) were done and ADC values were calculated for all the lesions. Validity parameters were assessed for each sequence and a combination of all the sequences. ROC curve was plotted and ADC cut off was chosen with a high sensitivity and specificity. RESULTS: Twenty nine lesions were categorized as benign and twenty two lesions were categorized as malignant based on the T1, T2 and DWI. By histopathological examination of these lesions, 2 lesions characterised as malignant turned out to be benign.T1WI was not found to be helpful in differentiating between benign and malignant lesions, whereas 95% of malignant lesions appeared either intermediate signal (90%) or hypointense (5%) in T2WI, conferring a sensitivity of 90.5% and specificity of 80.6% in detection of malignant lesions using T2WI. Applying an ADC threshold of 1.255×10 −3 mm2/s benign and malignant lesions could be differentiated with 100% sensitivity and 93.5% specificity, with a PPV of 90.9% and NPV of 100%. Mean ADC value of malignant lesions was found to be 1.13±0.007 mm 2 /s. CONCLUSION: Non contrast MRI using T2WI and DWI is a useful technique for characterizing breast lesions. It is also useful in the follow up of post lumpectomy irradiated breast to detect recurrence.