Schizencephaly, i.e., split brain, is a rare, congenital cerebral malformation. Magnetic resonance imaging is the best neuroimaging modality for its diagnosis. In literature, only few cases have been reported causing symptoms in adults. Symptomatic patients present as hemiparesis, developmental deficits to seizures. This condition is usually found at birth and presents during early years. Appropriate diagnosis of the disease is necessary to avoid incorrect treatment. Here, we present a rare case of left, unilateral, open lip schizencephaly in an adult patient presenting with partial seizures but with an asymptomatic childhood.
Testicular metastases are detected incidentally in upto 4% cases after orchiectomy for Prostate Carcinoma (PCa). Most of the secondaries to testes are due to PCa, only few patients have clinically manifested metastases to bilateral testes. Metastases to bilateral testis is unusual while unilateral involvement of the testis is seen usually. We report a case of primary PCa with bilateral testicular metastases which presented with palpable mass in the right testis. A 43-year-old male patient presented with two-month history of swelling in right inguino-scrotal region. On digital rectal examination, the prostate was enlarged. The Serum Prostate-Specific Antigen (PSA) level was >100 ng/ml. Ultrasound (USG) revealed metastatic deposits in bilateral testis, however prostate was having relatively normal echo pattern. Contrast Enhanced Computed Tomography (CECT) abdomen revealed primary malignancy of prostate gland with secondary metastases in bilateral testes and metastatic lymph nodes. Transrectal biopsy from prostate and excisional biopsy of right inguinal node showed prostate gland adenocarcinoma and deposits of adenocarcinoma respectively. Patient underwent bilateral orchiectomy. Histopathology showed that bilateral testes were infiltrated by metastatic adenocarcinoma with Gleason score 8. The patient is currently on chemotherapy. This is a rare case of primary PCa with clinically manifested bilateral testicular metastases in the form of palpable mass in right testis.
Objective: To assess the knowledge, awareness and attitude of consultants about radiation hazards in diagnostic radiology and to describe their practice with regard to informing patients at risk. Methods: Prospective questionnaire based observational study performed between July and December 2013, conducted in two different university education and research centres, two private research hospitals and four outpatients' clinics of Central India. The questionnaire was administered to 220 consultants. Data was analysed using EPI INFO 2007 Results: 205 consultants (93%) completed the questionnaire. The overall mean knowledge score was 59.3%. Mean knowledge score was 60.23% for senior doctors and 56.89% for junior doctors, but this was not found to be significant (P=0.2107). Almost more than three-quarters of consultants (91.2%) underestimated the radiation dose in CT scan of abdomen. Most doctors (75%) though that one CT scan increase the life time risk of developing cancer and 25% consultants said that there was no increased cancer risk. MRI and Ultrasound was wrongly associated with ionizing radiation by 24.39% and 26.83% of consultants respectively. The frequency at which doctors would inform patients of the risk of radiation varied greatly depending on the clinical scenario. Conclusions: There was lack of awareness and relatively poor knowledge among the consultants which may lead them to request more tests and thus increasing the radiation exposure load on the patients. Consultants should receive education, and the request form should display radiation dose and associated risk.
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