Sahil Shah

Introduction: Diagnosing and stage breast cancer with an easy and widely useable method that can be employed worldwide in the poorest and wealthiest settings is important. Mammography is a technique that might not be available in faraway clinics and it is technically challenging whereas USG can be available in most remote areas and small hospitals far from tertiary care hospitals. Even a trainee Radiology resident can use USG BIRADS and can be used diagnostically for that, it is important to define its, diagnostic accuracy with Sensitivity, Specificity and other diagnostic parameters. Aims: - To determine the Diagnostic accuracy of USG BIRADS compared to the gold standard Histopathology report Methodology A Retrospective cohort study was conducted at a tertiary care hospital. a total of 84 female patients presenting to Surgical OPD with complaints of a breast lump or pain were enrolled from their records. Their Breast USG results were analysed to correctly identify their BIRADS stage and then their corresponding Histopathology report was taken into account as the gold standard to compare the USG results against. Excel, SPSS and Revman were used to conduct analysis and create results. Results: - 36 of these 84 patients belonged to BIRADS 1, 2, and 5 where Sensitivity, Specificity and PPV were calculated at 100%. No one was diagnosed with BIRADS III from USG reports. For USG BIRADS 4, in total 48 patients Sensitivity was 0.667, specificity was 0.883, and PPV was 0.364. Conclusion: - Patients whose USG show Benign growth or can be diagnosed in BIRADS 1, 2, 3, and 5 can be counted as accurate and precise. When the USG diagnosis describes the patient to be in BIRADS 4, the sensitivity and PPV show poor results showing a very low probability of the patient being truly positive when the diagnosis gives a positive result.

Introduction:ASPECTS (Alberta Stroke Program Early CT Score) help in detecting early ischemic changes in stroke patients. This scoring system helps in predicting the stroke outcome, treatment options like thrombolysis and prognosis. It is a 10-point scaling system based on anatomical regions supplied by the middle cerebral artery and each point is subtracted for areas with ischemic changes. Aims and objectives:To study the effectiveness of the ASPECTS scoring in the assessment of the anterior and posterior cerebral circulation stroke. Materials and methods:A retrospective study was performed on stroke patients referred to our institute for an NCCT scan. 40 stroke patients with a mean age of 59+/-3 years were selected and patients with intracranial hemorrhage or hemorrhagic transformation of infarct were excluded. Scans were performed on a 128-slice multidetector CT PHILIPS Perspective scanner. The ASPECTS score was determined using standardised axial CT cuts. Result: In this case series study of 40 patients, a total of 28 patients (70%) had a score of 7 or more and these patients had better prognoses with proper treatment and follow-up.The remaining 12 patients (30%) had a score of less than 7 and even with treatment and sequential follow-up, they had no neurological recovery. Conclusion: Thus, it can be concluded that the ASPECTS can be used as a tool for predicting treatment outcomes in stroke patients. A score of 7 or more is associated with a good prognosis.

Diabetic striatopathy (DS) is characterized by a hyperglycaemic state associated with chorea/ballism, and/or striatal hyper density on computed tomography, or hyperintensity on T1-weighted magnetic resonance imaging. To date, there have been only a few case series reported in the literature on this topic. We present an acute case of DS which delineates the clinical presentation, imaging and instrumental examinations, typical radiological findings, and therapeutic approach of this condition. The purpose of this case report is to to remind clinicians to consider DS when poor-controlled diabetic patients present with symptoms such as altered sensorium, sudden-onset choreiform and ballistic movements.

This report elucidates a case of papillary carcinoma of the Thyroglossal Duct Cyst in a 19-year-old female. The swelling at presentation was suprahyoid, fixed and non-mobile with deglutition or tongue protrusion. Papillary carcinoma was diagnosed post-op through histopathological examination and a follow-up total thyroidectomy was planned. As the origin of TGDC papillary carcinoma is highly debated, no evidence-based guidelines yet exist as to the best line of treatment, however, Sistrunk’s procedure followed by total/near total thyroidectomy is widely considered the standard management practice in such cases.

Mesothelioma of the peritoneum is the second most prevalent type. The peritoneum, the membrane lining the abdomen and abdominal organs, is affected in this type of cancer. A common risk factor is exposure to asbestos. There isn’t a cure, but surgery, chemotherapy, and palliative care can improve your prognosis and quality of life. Here we present a case of a 47-year-old female with peritoneal mesothelioma.

Subacute sclerosing panencephalitis (SSPE) is a progressive neurological complication that affects the central nervous system. It occurs as a late complication of the measles infection the young children and adolescents who are commonly affected present with personality changes and neurological deficits. The diagnosis can be done via clinical features, electroencephalography, and cerebrospinal fluid analysis. At present, there is no cure for SSPE. The immunisation against measles is the main strategy in preventing this condition. Here, we present a case of a 22-year-old Indian male diagnosed with Subacute sclerosing panencephalitis.

Presenting a rare case of adult-onset mature cystic teratoma of the spinal cord in the thoracolumbar spinal cord in a 54-year-old male whose chief complaint was lower back pain radiating to both legs while other findings were normal. X-ray images of the thoracolumbar spine showed early degenerative changes and unfused posterior elements noted in lower sacral vertebral levels. Magnetic resonance images of the lumbar spine showed a well-defined non-enhancing intramedullary altered intensity lesion noted at the level of conus at the L1-L2 vertebral level. The resected tumour was histopathologically diagnosed as a mature cystic teratoma. The patient's symptoms improved following the surgery.

Diastematomyelia, also known as split cord syndrome, is a congenital disorder of the spinal cord. As the name suggests, the spinal cord is split into two resulting in neurological complaints associated with cutaneous symptoms. Although the diagnosis can be done clinically, for disease confirmation, various radiological investigations are used for the diagnosis of this condition. Here, we present a case of a 54-year-old Indian female diagnosed with diastematomyelia. The clinical features, diagnostic modalities, treatment options and prognosis of this condition have been discussed.

A rare neurological condition known as Dyke-Davidoff-Masson syndrome (DDMS) is characterized by cerebral hemiatrophy, facial asymmetry, contralateral motor impairment, and seizures. Cerebral hypoplasia, ventriculomegaly, paranasal sinus hyper-pneumatization, and compensatory osseous expansion are classic imaging findings. The relationship between clinical and neuroimaging findings provides the basis for the diagnosis of DDMS. DDMS is treated with anticonvulsant medication and physical therapy. This is the case of a 26-year-old male, with a known case of cerebral palsy and on antiepileptics for 15 years, who presented with complaints of generalized weakness, vomiting, difficulty walking, recurrent convulsions, and a recent episode of generalized tonic-clonic seizures. Neuroimaging revealed findings significant of Dyke Davidoff Masson Syndrome. Understanding its imaging and clinical characteristics facilitates prompt and precise diagnosis, permitting appropriate management.

Rhombencephalosynapsis (RES) is a rare, congenital developmental disorder of the central nervous system. Even after many years of its identification, the etiology and pathogenesis of RES remain unclear. It occurs in combination with many syndromes and thus has overlapping symptoms. The clinical presentation of this disorder varies depending on the severity of the maldevelopment of vermis. Here, we present a case of a 60-year-old Indian female diagnosed with Rhombencephalosynapsis. Clinical and MRI characteristics of RES along with treatment options have been discussed.