Objectives: To investigate the doppler parameters of ophthalmic and central retinal artery in type 2 diabetes mellitus patients with colour doppler imaging (CDI) and compare the results with non-diabetic controls. Materials and methods: This prospective study included 30 type 2 diabetic patients and 15 controls. Diabetic patients were further divided into subjects with no retinopathy ( n = 15) and subjects with retinopathy ( n = 15). CDI was performed using GE Logitech P9 ultrasound. The peak systolic velocity (PSV), end-diastolic velocity (EDV), resistivity index (RI) and pulsatile index (PI) of ophthalmic (OA) and central retinal artery (CRA) along with central retinal vein (CRV) were recorded. Results: RI in the ophthalmic artery was significantly higher in both diabetic groups than the control group ( P = 0.001,). Diabetics without retinopathy had decreased blood flow velocity (PSV and EDV) in OA compared to controls ( P = 0.002 and P = 0.0011, respectively). Diabetics with retinopathy had significantly reduced EDV and PSV and increased RI in CRA compared to diabetics without retinopathy ( P = 0.001). Significant correlation was noted among the groups. Pearson’s coefficient analysis analysed that RI of OA has a positive corelation with glycosylated haemoglobin and duration of diabetes. Conclusion: Significant changes in resistivity index and flow velocities were observed in the ophthalmic artery and central retinal artery in diabetics compared to controls. CDI could be useful to predict individuals at higher risk for developing severe DR.

This is a rare case report of a large abdominal aortic aneurysm with mural thrombosis and chronic haematoma with signs of impending rupture. Rupture of an aortic aneurysm is a catastrophic event with high mortality rate. Hence, knowledge of the signs of impending rupture are very crucial to know. Hyperdense crescent sign and focal discontinuation of intimal calcifications are one of the many signs.

Objective: To compare the diagnostic performance of CT and MRI for local staging of pediatric renal tumours. Materials and Methods: The study population was derived from our hospital Medical College Kolkata and Hospital. Baseline abdominal imaging performed with both CT and MRI.A retrospective review was done with 50 renal tumour cases selected and planned for nephrectomy over a study period of one year from October 2020 to November 2021. Each case was evaluated for capsular penetration, lymph node metastasis, tumour thrombus, preoperative tumour rupture, and synchronous contralateral lesions. The surgical and pathological findings were the reference gold standard. Results: The sensitivity of CT and MRI for detecting capsular penetration was 70% and 60%, respectively (P=0.73), while specificity was 84.3% and 84% (P=1.0). The sensitivity of CT and MRI for detecting lymph node metastasis was 80% and 53% (P=0.22), and specificity was 88% and 92% (P=1.0). Synchronous contralateral lesions were identified by CT in 5/12 cases and by MRI in 8/12 cases. Conclusion: CT and MRI have similar diagnostic performance for detection of lymph node metastasis and capsular penetration. MRI was more accurate in detecting contralateral synchronous lesions; how-ever these were observed in a very a smaller number of cases. Hence either modality can be used for initial loco–regional staging of paediatric renal tumours

ObjectivesTreatment by percutaneous biliary drainage and stenting plays an important role in the management of the patients of obstructive biliary pathologies presenting in poor general condition and inoperable state. Drainage or stenting in patients with malignant biliary obstruction not only can relieve the symptoms and signs of obstructive jaundice but also optimizes the patient’s condition for surgical resection or for receiving palliative chemotherapy or radiotherapy, bringing about an improvement in their quality of life, even if only for a matter of weeks or months. In this study we have retro-spectively evaluated the efficiency of percutaneous transhepatic biliary stent implantation in management of obstructive biliary pathologies presented in our institute. Methods:A retrospective study was done at our institute between February 2018 to February 2019. 16 patients of obstructive jaundice due to obstructive biliary pathologies admitted at our institute were included in the study after they met the inclusion criteria. Results:In our study, the average age of male patients was 62 years and that of female patients was 56 years. The overall average age was 58.6±2.8 years. As our institute has a regional cancer centre, most of the patients admitted had malignant biliary obstruction ( 87.5% ) . Among them, bile duct involvement of most of them (57.1%) was of Bismuth Type 1. Most (42.8%) of the malignant biliary strictures were due to cholangiocarcinoma. The most striking result of our study was that all the PTBD with SEMS implantation cases were successful and in each of the cases the direct bilirubin level came to subclinical level within 3 weeks. Conclusion:PTBD with stent implantation offers a safe and effective method in providing palliative treatment for patients with biliary obstruction. At times, it can be considered as an alternative of endoscopic stent placement in a hospital with well equipped IR set up due to its shorter on table time, shorter post operative hospital stay, ability and effectivity in management of biliary obstruction at different levels.

Primitive neuroectodermal tumor of adrenal gland is a rare malignant neoplasm. It is categorised under peripheral primitive neuroectodermal tumors (pPNET). They have aggressive course with very poor prognosis. A 10-year-old male patient was being evaluated for left loin pain. Ultrasonography showed a large mass in left lumber region with heterogenous echotexture and increased vascularity on colour Doppler. Computed tomography showed the mass was arising from left suprarenal gland. PET-CT scan revealed the mass was metabolically active. Biopsy from that mass showed histopathological features consistent with primitive neuroectodermal tumor of adrenal origin

Uterine AVM is an abnormal connection between the uterine arteries & veins. It can be congenital or acquired(traumatic). Congenital AVM is very rare but acquired cases are increasing due to D&C, cervical or endometrial carcinoma, trophoblastic disease .Some patients may present with profuse vaginal bleeding endangering the life. Treatment depends on age, symptoms, desire for conception, localization& size of lesion. In this case embolization of uterine artery is the 1 st choice as the patient is young, in the reproductive age group with desirous of future pregnancy. Here we report a case of acquired AVM following D&C which was treated successfully with uterine artery embolization.

ABSTRACT:- Objectives- Subarachnoid hemorrhage from ruptured intracranial aneurysm is a serious condition, which can only be prevented by early diagnosis and treatment before rupture. In this study, we have assessed the performance of CTA and MRA in detecting, localizing and sizing intracranial aneurysms in patients of aneurysmal subarachnoid haemorrhage compared to 3D DSA and effects of above parameters on the sensitivity of these imaging modalities, taking DSA as gold standard. Methods: - We investigated 25 consecutive patients of subarachnoid haemorrhage referred to our department between November 2017 and April 2018 after they met the inclusion criteria. Each patients underwent CTA, MRA and conventional rotational digital substraction angiography from which three dimentional reconstructed images were obtained and the findings were recorded and analysed. Results: - We found that the sensitivity of each of CTA and MRA for identification of intracranial aneurysms is 57.1 % in small, 88.8 % in medium and 100% in large sized aneurysms. Overall, both CTA and MRA were 20% less sensitive than 3D DSA in detection of intracranial aneurysms, specially for small and medium sized ones. Conclusion:- Hence, 3D DSA is more sensitive and accurate for evaluation of aneurysmal subarachnoid hemorrhagethan CTA and MRA.

Childhood arterial ischemic stroke is a rare disease with an estimated incidence of 2-13/100000 per year 1,13 . Variability in the clinical presentation, the inability of children to effectively communicate their symptoms, lack of early clinical suspicion and overlapping of symptoms with many other diseases gives rise to delay in the diagnosis and delayed treatment. This leads to multiple long term co morbidity, disability and socioeconomic dependency with affected quality of life. The causes and risk factors of childhood ischemic stroke are manifold and inter related, differing greatly from that of adult ischemic stroke and needs a comprehensive diagnostic work up. The etiology should be accurately deduced since future recurrence rates depend on the etiology and so are the specific treatments with medical management like steroids for vasculitis or surgery or minimally invasive endovascular options for stenotic lesions.