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Purpose: Pancreatitis is associated with a broad spectrum of findings causing significant morbidity and mortality and substantial use of health care resources. Optimal management of pancreatitis requires meticulous imaging protocol. Ultrasonography (USG) and Computed Tomography (CT) has afforded rapid, accurate and non-invasive evaluation of pancreatitis & complications. Both of these offer modalities offer advantages of their own at different stages.Material and Methods: 50 consecutive patients referred with clinical suspicion of pancreatitis were subjected to USG and contrast enhanced CT scan. The findings of acute and chronic pancreatitis and their complications’ on both the modalities were tabulated and correlated. Results: CT had overall excellent visualisation of pancreas in all the cases and better delineation of per pancreatic inflammatory changes. Extrapancreatic and vascular complications were readily identifiable on CT. Ultrasound had better visualisation of pancreas as compared to the previous studies. However, the gland was not completely visualised in all the cases due to interference from the bowel gas. Ultrasound also proved to be more effective in the evaluation of gall stones, in the characterisation of contents within the per pancreatic collections & guiding interventions. Conclusion: Ultrasonography is non-invasive, quick, inexpensive widely available screening tool in the early diagnosis and follow up of pancreatitis. It has certain limitation due to bowel gas which may hinder the visualization of Pancreas. CT has a role in firmly establishing the diagnosis of pancreatitis and its complications. Thus it is seen that both USG and CT have complementary roles to play in the early diagnosis and follow up of patients of pancreatitis.

Background: Rotator cuff pathology accounts for 10% causes of shoulder pain. A gamut of imaging techniques comprising of ultrasonography (USG), Magnetic Resonance Imaging (MRI) and MR arthrography (MRA) have been commonly used for the characterisation of rotator cuff (RC) disorders. With the advent of high-end USG machines, accuracy rates of USG is comparable to that of MRI in evaluation of rotator cuff pathologies. Materials and Methods: 50patients who had presented with symptoms of rotator cuff injuries and were referred to Department of Radiodiagnosis JSS Medical College and Hospital, Mysuru during the period August 2017 to September 2019 for Ultrasound and MRI of the shoulder. Results: Diagnostic accuracy of USG in correlation to MRI showed 93% sensitivity and 97% specificity for supraspinatus, 88% sensitivity and 96% specificity for detecting the infraspinatus tears; 74% sensitivity and 86%specificity for subscapularis indicating detection of supraspinatus was comparatively easier than subscapularis in ultrasound. Conclusion: MRI was more superior and sensitive tool than ultrasound in detecting and delineating the musculoskeletal injury in terms of grading the partial tear & tendinopathy, however accuracy of ultrasound in initial evaluation of rotator cuff injuries is comparable to MRI. Anatomical delineation of the rotator cuff injury which is of prime value for treating surgeon is better visualized by MRI.

Excessive ingestion of the common analgesic acetaminophen (APAP) leads to severe hepatotoxicity. Here we identify G protein β5 (Gβ5), elevated in livers from APAP overdose patients, as a critical regulator of cell death pathways and autophagic signaling in APAP-exposed liver. Liver-specific knockdown of Gβ5 in mice protected the liver from APAP-dependent fibrosis, cell loss, oxidative stress, and inflammation following either acute or chronic APAP administration. Conversely, overexpression of Gβ5 in liver was sufficient to drive hepatocyte dysfunction and loss. In hepatocytes, Gβ5 depletion ameliorated mitochondrial dysfunction, allowed for maintenance of ATP generation and mitigated APAP-induced cell death. Further, Gβ5 knockdown also reversed impacts of APAP on kinase cascades (e.g. ATM/AMPK) signaling to mammalian target of rapamycin (mTOR), a master regulator of autophagy and, as a result, interrupted autophagic flux. Though canonically relegated to nuclear DNA repair pathways, ATM also functions in the cytoplasm to control cell death and autophagy. Indeed, we now show that Gβ5 forms a direct, stable complex with the FAT domain of ATM, important for autophosphorylation-dependent kinase activation. These data provide a viable explanation for these novel, G protein-independent actions of Gβ5 in liver. Thus, Gβ5 sits at a critical nexus in multiple pathological sequelae driving APAP-dependent liver damage.

Summary Background Optic nerve sheath diameter (ONSD) evaluated in CT imaging as well as Rotterdam CT Score (RCTS) are proven independent predictors of outcome in patients with traumatic brain injury (TBI). To date, no study has correlated ONSD on admission CT scan with RCTS. Material/Methods Retrospective cohort study comprised of consecutive patients undergoing CT imaging for traumatic brain injury recruited between January and October 2015. Bilateral ONSD was measured 3 mm behind the eyeball in axial and sagittal planes and mean value was calculated. RCTS was assessed on the same CT images, bias was eliminated by blinding RCTS to ONSD measurement. Results 150 patients were included; mean age in the group was 42.94±16.7 years. ONSD in mild TBI, RCTS 2 and 3 were 3.3 mm (SD 0.39 mm) and 4.1 mm (0.047 mm), respectively. Mean ONSD in moderate and severe TBI (RCTS score 4 and above) was 4.83 mm and above, SD 0.4 mm. Mean ONSD correlated with occurrence of diffuse cerebral oedema, presence of subdural and extradural hematoma; however in isolation there was no statistical significance. Conclusions Higher ONSD was observed in patients with moderate and severe TBI, correlating with admission RCTS of 4 and above. Subsequent increase in ONSD was also found with increase in RCTS. ONSD could serve as an initial triage tool in the emergency department as well as a method of determining the need for sequential CT in patients with mild TBI.

Ultrasonography(US) of the scrotum has been demonstrated to be useful in the diagnosis of fluid in the scrotal sac. Grayscale US characterizes the lesions as testicular or extratesticular and, with color Doppler, power Doppler and pulse Doppler, any perfusion can also be assessed. Cystic or encapsulated fluid collections are relatively common benign lesions that usually present as palpable testicular lumps. Most cysts arise in the epidydimis, but all anatomical structures of the scrotum can be the site of their origin. US may suggest a specific diagnosis for a wide variety of intrascrotal cystic and fluid lesions and appropriately guide therapeutic options. The paper reviews the current knowledge of ultrasound in conditions with fluid in the testis and scrotum. The review presents the applications of ultrasonography in the diagnosis of hydrocele, testicular cysts, epididymal cysts, spermatoceles, tubular ectasia, hernia and hematoceles. The aim of this paper is to provide a pictorial review of the common and uncommon presentation of fluid within the scrotal spaces.

Ultrasound of the abdomen is a commonly requested investigative procedure. By the use of different probes and varying maneuvers, a remarkable range of views can be obtained. Imaging of the liver is done using four views which can identify most pathological conditions. Being aware of the possible artifacts helps in avoiding a wrong diagnosis. Gallbladder (GB) imaging is useful in detecting gallstones and inflammation of the GB. When inflamed, the pancreas enlarges in size and is bulky, with peripancreatic fluid, which is suggestive of acute pancreatitis.