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Context: Mandibular third molars are the most commonly impacted teeth, and their surgical removal can be associated with inferior alveolar nerve (IAN) injury. To avoid the deleterious complication of nerve injury on patients, a thorough visualization of IAN and its localization are essential. Aims and Objectives: The aims and objectives of this study were to evaluate the efficacy of two conventional localization techniques in determining the relationship of mandibular third molars to IAN and to assess its reliability in comparison with computed tomography (CT). Settings and Design: Panoramic radiograph (PR) was taken using Kodak 8000C Digital Panoramic and Cephalometric system. Intraoral periapical radiographs (IOPAs) were taken using Kodak 2200 Intraoral X-ray machine. CT scan images were taken using multidetector CT scans. Materials and Methods: Two IOPAs (0° and −20° vertical angulation) and PR and CT scan images of thirty mandibular third molars were taken. Two combinations were used (i) a combination of two IOPAs and (ii) a combination of PR and IOPA (−20°). Tube-shift localization technique was applied to both these combinations to derive the relation between third molar and IAN canal as “in contact,” “separate,” “buccal,” “lingual,” and “in line with the apex” and the results were compared with CT images. Statistical Analysis: Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated using SPSS software version 15.0. Results: The combination of PR and IOPA radiographs showed 14 teeth to be in contact with IAN. This gave a sensitivity of 100%, specificity of 94.1%, PPV of 92.9%, and a NPV of 100% in determining the relation as “in contact” or “separate.” 78.3%, 85.7%, 94.7%, and 54.5% were the sensitivity, specificity, PPV, and NPV in localizing it as “buccal,” “lingual,” or “in line with apex.” These results were better than that of the combination of the two IOPAs. Conclusions: Localization using PR and IOPA could better deduce the relation between IAN and mandibular third molar.

Aims: The aim of this study was to correlate serum uric acid (SUA) levels and carotid intima-media thickness (CIMT) in patients with type 2 diabetes mellitus (DM). Settings and Design: This study was a cross-sectional observational study on 103 diabetic patients conducted from September 2015 to May 2017. Subjects and Methods: We screened 103 patients with type 2 DM between the ages of 30–65 years. SUA levels and the CIMT were measured. The patients were divided into quartiles based on uric acid level. The CIMT of the quartiles is compared and analyzed. Statistical Analysis Used: Chi-squared test, Analysis of Variance, and Pearson's correlation. Results: Uric acid levels were positively associated with CIMT (P = 0.001). The association remained significant after further adjustment for potential confounders. Strong correlation was found among them as depicted by correlation coefficient (r = 0.779). Conclusions: Carotid atherosclerosis as measured by IMT is associated with SUA levels in patients with type 2 DM.

Background: Interventions involving the middle meatus are commonly performed because the majority of the paranasal sinuses open into the osteomeatal complex. Therefore, the aim of the present study was to locate the level of maxillary sinus ostium (MSO), to measure the distances between MSO and different anatomical landmarks, to measure the different dimensions of maxillary sinus and to compare the morphology of maxillary sinus between the right and the left sides. Materials and Methods: The study involved 50 computed tomography (CT) images of normal paranasal sinus anatomy in coronal and sagittal planes from the Department of Radiodiagnosis. The location of the sinus ostium (upper, middle, or lower third) was observed. Perpendicular distance from the sinus ostium to the lower border of inferior turbinate and hard palate were measured. The maximum vertical, transverse, and antero-posterior diameters of the maxillary sinus were measured. Results: Of 50 CT images, the MSO was located in the upper third in 40 cases while in 10 it was located in the middle third. The most common location of MSO was in the upper third. The dimensions of the maxillary sinus indicated bilateral symmetry. Conclusion: The dimensions of the maxillary sinus indicated bilateral symmetry, and there were no significant gender differences when compared. However, the distances of the MSO from the major anatomical landmarks were significantly different between males and females which are seldom reported earlier. This knowledge about the variations in the lateral wall of the nasal cavity is crucial during the endoscopic interventions and for functional endoscopic sinus surgeries.

Purpose : To determine and compare the diagnostic performance of Dopler sonography of fetal middle cerebral artery (MCA), descending abdominal aorta (DAA), umbilical artery (UA), umbilical vein (UV) and inferior vea cava (IVC) for predictoin of adverse perinatal outcome in suspected intrauterine growth retardation (IUGR) and pre-eclampsia (PET). Materials ad Methods : Fifty-eight Singleton pregnancies beyond 30 weeks of gestation complicated by intrauterine growth restriction and severe pre-eclampsia or both were prospectively examined with Doppler US of the UA, MCA, DAA, UV and IVC. Results : Thirty-six patients of the 58 included in the study population had at least one major or minor adverse outcome. Major adverse outcome criteria included perinatal deaths - includinag intrauterine and early neonatal deaths, hypoxic ischemic encephalopathy, intraventricular hemorrhage, periventricular leukomalacia, pulmonary hemorrhage and necrotizing enterocolitis. Minor outcomes included cesarean delivery for fetal distress, APGAR score below 7 at 5 minutes, admission to neonatal intensive care unit (NICU) for treatment. Conclusion S/D ratio of MCA/UA is the most sensitive and specific index in predicting major perinatal adverse outcome (83% and 75%), while umbilical artery S/D ratio is the most sensitive index (66.6%) in predicting any adverse perinatal outcome i.e. including both major and minor outcome. MCA pulsatility index (P.I) is the most specific index (90.9%) for predicting in any adverse perinatal outcome. The sensitivity of the Doppler studies can be significantly increased by studying multiple vessels (91.6%). Hence we conclude that Doppler studies of multiple vessels in the fetoplacental circulation can help in the monitoring of compromised fetus and can help us predicting neonatal morbidity. This may be helpful in determining the optimal time of delivery in complicated pregnancies.

Introduction: Perianal tumours are a rare site of malignancy, and tumours primarily involving the perineal body without vaginal and anal canal involvement are uncommon. Case summary: A 67-year-old woman presented with a lesion involving the perineum and rectovaginal septum without extension into vaginal or anorectal mucosa and with skip lesions in the vulva. Biopsy was confirmative of squamous cell carcinoma, with p16 positive. A complete metastatic workup with MRI of the pelvis and CECT thorax and abdomen was done. She was diagnosed with perianal carcinoma stage cT2N0M0 Stage II (American Joint Committee on Cancer 8th Edition of Cancer Staging) since the lesion reached the anal verge. Given the location of the tumour (perineal body), comorbidities and advanced age, she received radical radiotherapy with an intensity-modulated radiotherapy technique - 56 Gy in 28 fractions with the intention of organ preservation. The response assessment with MRI at 3 months showed a complete tumour response. She has been disease-free for 3 years and is on regular follow-ups. Conclusion: Isolated perineal body squamous cell carcinomas are unusual, and synchronous vulvar skip lesion makes this case unique. Radical radiotherapy achieved organ preservation with tumour control and minimal toxicity in an elderly frail patient. [ABSTRACT FROM AUTHOR]

We propose a basis splines-based based active contour method for the segmentation of lumen boundary and media adventitia boundary from transverse and longitudinal B-mode ultrasound images. Basis-spline has $M$ knots in the shape template and five free parameters i.e., a pair of center coordinates, scaling in the horizontal and vertical directions, and the rotation angle. The segmentation of the region of interest in ultrasound images is done by minimizing the local energy function using gradient descent technique. Further optimization is carried out using Green’s theorem. Automatic localization poses an equal importance as segmentation and is achieved using sum of absolute difference method. The result of experimental validation has been done on the Signal Processing Lab, Brno University’s database of transverse and longitudinal B-mode ultrasound images consisting of 971 and 84 images, respectively. We attained accurate segmentation of the lumen boundary from transverse and longitudinal B-mode ultrasound images with an accuracy of 99.68% and 96.98% and Dice index of 93.33% and 91.70%, respectively. In addition, we attained an accuracy of 99.29% with Dice index of 91.78% for the segmentation of media adventitia boundary from transverse B-mode ultrasound images, which is the highest among the previously proposed methods.