iosr-JDMS   Volume-7 ~ Issue-3

Abstract: Background: In Breast cancer there is paradigm shift towards its prevention and early detection. Self breast examination and clinical breast examination plays an important role in early detection. Currently a combination of three tests, i.e. clinical examination, radiological imaging (mammography, ultrasonography) and pathology called as triple assessment test is used as Gold standard in diagnosing all palpable breast lumps. Together they give sensitivity of 99%. The triple assessment is taken as positive if any of the three components is positive and negative only if all of its components are negative for malignancy. Materials And Methods This study was conducted in the Department of Surgery, Rama Medical College Kanpur over a period of 4 years from March 2009 to Feb.2013. A total of 400 patients with a breast lump were selected irrespective of age. A detailed history, thorough clinical examination, radiological imaging and fine-needle aspiration cytology (FNAC) were used as diagnostic tools for screening of the patients. The aim of this study was to evaluate accuracy of triple assessment in the early detection of breast carcinoma. Results The sensitivity and specificity of all the modalities used in triple assessment when combined together was100% and 99.3%, respectively. The concordance for the triple assessment was 99.3%, positive predictive value was 93.3%, negative predictive value was 100%, sensitivity was100% and specificity was 99.3%. p value was significant (0.000). Conclusion Triple assessment is a very useful diagnostic tool to evaluate patients with breast lumps and to detect patients with breast cancers with an overall accuracy of 99.3%.

Keywords: Clinical examination, Carcinoma, Fine-needle aspiration cytology,Mammography, Ultrasonography,

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Abstract: Sputum microscopy, the most commonly practiced tuberculosis (TB) diagnostic test is less sensitive in immunocompromised patients due to low bacillary load.The study was carried out in a tertiary care general hospital during 2010-12 in Mysore, Karnataka, to diagnose smear negative TB in HIV patients by culture technique.Of416 HIV patients, 162 patients with features of pulmonary/extrapulmonary TB but smear negative were included in the study.Sputum, stool, blood and other relavent clinical samplese except blood were processed as per standard protocol. The blood collected with sodium citrate was processed by lysiscentrifugation .All samples were inoculated onto Lowstein Jensen slants and incubated at 370c for 6 to 8 weeks.Of 162 HIV patients, 67(41%) were found to have TB. Extrapulmonary TB (25%) was more common than pulmonary TB (13%). Mycobacteria were recovered in 76 samples (26 sputum, 12 stool, 18 blood, 7 pleural fluid, 1 CSF, 9 FNAC, 1 ascitic fluid, 1pus ,1 ear discharge). M.tuberculosis (95%) was the predominant species isolated followed by M.avium complex (5%).Most HIV patients with TB are left undiagnosed for reasons of no advanced/high cost techniques in resource constrained settings. Thus culture could be used as a tool in diagnosing smear negative TB.

Keywords: Culture, HIV, Smear negative, Tuberculosis.

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Abstract: In a prospective study we invistigated internal derangement of knee (IDK) with High resolution ultrasound (HRUS). Aim was to determine effectiveness of ultrasound in diagnosing IDK and to compare with Arthroscopy. Ultrasound showed good sensitivity (91.3%) and specificity (90.6% ) and the figures were comparable toarthroscopic findings. We conclude that ultrasound is a simple, accurate, inexpensive and non invasive way of diagnosing knee disorders with a learning curve.

Keywords – Arthroscopy, Diagnostic Knee tests, High Resolution Ultra sound (HRUS), Internal derangement of Knee(IDK), X-rays of Knee.

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[4]. M Fusting , HR Casser . Dynamic Examination Technique In Meniscus Sonography. (Sportverletz Sportschaden 1991) 5 : 27-36.
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Abstract: Posterior Reversible Encephalopathy Syndrome (PRES) is a clinico radiological entity. Symptomatology includes cognitive and behavioural disturbances, blurred vision, seizures, headache, vomiting. MRI reveals edematous changes in white and grey matter of brain. The most common etiology of PRES is Hypertensive encephalopathy, Eclampsia, Preeclampsia, Immunosuppressant drugs and cytotoxic drugs. PRES is usually reversible and the treatment is based on the management and withdrawal of the triggering factor. We report a case of PRES, occurred after consuming alcohol while on Disulfuram which is a rare etiological entity.

Keywords: Cortical Blindness, Disulfuram and alcohol induced PRES, Focal neurological signs.

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[2] Bartynski WS. Posterior reversible encephalopathy syndrome, part 2: controversies surrounding pathophysiology of vasogenic edema. AJNR Am J Neuroradiol 2008;29: 1043-49.

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[5] Lee VH, Wijdicks EF, Manno EM, Rabinstein AA. Clinical spectrum of reversible posterior leukoencephalopathy syndrome, Arch Neurol 2008;65:205-10.

[6] McKinney AM, Short J, Truwit CL, et al. Posterior reversible encephalopathy syndrome: incidence of atypical regions of involvement and imaging findings. AJR Am J Roentgenol 2007;189:904-12.
[7] Bartynski WS, Boardman JF, Zeigler ZR, Shadduck RK, Lister J. Posterior reversible encephalopathy syndrome in infection, sepsis and shock. AJNR Am J Neuroradiol 2006;27:2179-90.