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Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, female, 50 years, Clinical History: 50 year old female presented with progressive dementia, worsening psychiatric symptoms and tremors of two months duration.She was also ataxic. No history of fever, exposure to toxins or any metabolic abnormality. Biochemical investigations were unremarkab... Final Diagnosis: Creutzfeldt-Jacob Disease (Sporadic Type-sCJD)

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, male, 49 years, Clinical History: 49 year old male patient was brought to neurology emergency unit with a history of fits and becoming unconscious.He had been resuscitated after suffering from a cardiac arrest at a regional hospital two days ago. Initial non contrast brain CT had be... Final Diagnosis: Hypoxic ischemic brain injury

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, female, 49 years, Clinical History: 49-year-old, previously healthy lady presented with a 2-month history of episodic weakness of right lower limb and falls. She also had non-specific on and off headache together with recent onset urinary incontinence. Final Diagnosis: Intra-axial epidermoid (biopsy-proven)

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, female, 37 years, Clinical History: A 37-year-old female patient presented with an acute onset severe occipital headache of two weeks duration. She had a history of malignant melanoma of vaginal vault and had undergone hysterocolpectomy, salphyngo-oophorectomy, omentectomy and pelvic lympha... Final Diagnosis: Intraventricular brain metastases from malignant melanoma associated with haemorrhage

Clinical History Image Findings Discussion Find Diagnosis Differential Diagnosis, female, 3 years, Clinical History: A three year old girl presented with difficulty in walking and ataxia. There was a history of delayed motor development but speech and cognition were unimpaired. She had an uncomplicated birth history, born to non-consanguineous parents. Her other sibling... Final Diagnosis: Megalencephalic leukoencephalopathy with subcortical cysts (Van Der Knaap Syndrome)

Objective was to survey procedures and protocols in paediatric computed tomography (CT) in 40 less resourced countries. Under a project of the International Atomic Energy Agency, 146 CT facilities in 40 countries of Africa, Asia, Europe and Latin America responded to an electronic survey of CT technology, exposure parameters, CT protocols and doses. Modern MDCT systems are available in 77 % of the facilities surveyed with dedicated paediatric CT protocols available in 94 %. However, protocols for some age groups were unavailable in around 50 % of the facilities surveyed. Indication-based protocols were used in 57 % of facilities. Estimates of radiation dose using CTDI or DLP from standard CT protocols demonstrated wide variation up to a factor of 100. CTDI(vol) values for the head and chest were between two and five times those for an adult at some sites. Sedation and use of shielding were frequently reported ; immobilisation was not. Records of exposure factors were kept at 49 % of sites. There is significant potential for improvement in CT practice and protocol use for children in less resourced countries. Dose estimates for young children varied widely. This survey provides critical baseline data for ongoing quality improvement efforts by the IAEA.

Recognizing the lack of information on image quality and patient doses in most countries in Asia, the International Atomic Energy Agency (IAEA) initiated a project to assess the status of imaging technology, practice in conventional radiography, mammography, computed tomography (CT) and interventional procedures, and to implement optimisation actions. A total of 20 countries participated. Obsolete practices of use of fluoroscopy for positioning, photofluorography, chest fluoroscopy and conventional tomography were reported by 4 out of 7 countries that provided this information. Low-kV technique for chest radiography is in use in participating countries for 20-85% of cases, and manual processing is in 5-85% of facilities in 5 countries. Instances of the use of adult CT protocol for children in three participating countries were observed in 10-40% of hospitals surveyed. After implementation of a Quality Control programme, the image quality in conventional radiography improved by zero to 13 percentage points in certain countries and dose reduction was from 10% to 85%. In mammography, poor quality, ranging from 10 to 29% of images in different countries was observed. The project increased attention to dose quantities and dose levels in computed tomography, although doses in most cases were not higher than reference levels. In this study 16-19% of patients in interventional cardiology received doses that have potential for either stochastic risk or tissue reaction. This multi-national study is the first of its kind in the Asia, and it provided insight into the situation and opportunities for improvement. (c) 2012 Elsevier Ireland Ltd. All rights reserved.

OBJECTIVE. The purpose of this study was to assess the frequency of pediatric CT in 40 less-resourced countries and to determine the level of appropriateness in CT use. MATERIALS AND METHODS. Data on the increase in the number of CT examinations during 2007 and 2009 and appropriate use of CT examinations were collected, using standard forms, from 146 CT facilities at 126 hospitals. RESULTS. The lowest frequency of pediatric CT examinations in 2009 was in European facilities (4.3%), and frequencies in Asia (12.2%) and Africa (7.8%) were twice as high. Head CT is the most common CT examination in children, amounting to nearly 75% of all pediatric CT examinations. Although regulations in many countries assign radiologists with the main responsibility of deciding whether a radiologic examination should be performed, in fact, radiologists alone were responsible for only 6.3% of situations. Written referral guidelines for imaging were not available in almost one half of the CT facilities. Appropriateness criteria for CT examinations in children did not always follow guidelines set by agencies, in particular, for patients with accidental head trauma, infants with congenital torticollis, children with possible ventriculoperitoneal shunt malfunction, and young children ( LT 5 years old) with acute sinusitis. In about one third of situations, nonavailability of previous images and records on previously received patient doses have the potential to lead to unnecessary examinations and radiation doses. CONCLUSION. With increasing use of CT in children and a lack of use of appropriateness criteria, there is a strong need to implement guidelines to avoid unnecessary radiation doses to children.

Objectives: to establish whether review articles provide consistent conclusions on associations between workplace psychosocial factors and musculoskeletal pain and, if differences exist, to explore whether this is related to the methods used.Methods: reviews, reported up to February 2007, that included consideration of workplace psychosocial factors and upper limb, back or knee pain were identified through searches of multiple databases. The specific work-related psychosocial factors considered were job demands, support, job autonomy and job satisfaction. The conclusions of each review on one or more of the psychosocial/musculoskeletal pain associations were extracted.Results: 15 review articles were identified that considered one or more of the regional pain syndromes included in the study. For back pain, the most consistent conclusions (four reviews positive out of six) were with high job demands and low job satisfaction. The studies of upper limb pain were exclusively related to shoulder and/or neck pain, and the most consistent positive conclusions were with high and low job demands (four reviews positive out of six and two reviews positive out of three, respectively). For knee pain, only a single review was identified. For individual reviews of back and upper limb pain, there were marked differences in the number of associations concluded to be positive between reviews.Conclusions: the reasons for reviews coming to different conclusions included that they were often evaluating different bodies of evidence (according to their search criteria, the year when the review was conducted, the role that quality assessment played in whether studies contributed to evidence, and the combination of risk factors addressed in individual studies), but more important was whether the review specified explicit criteria for making conclusions on strength of evidence. These conclusions emphasise the importance of developing standardised methods for conducting such evaluations of existing evidence and the importance of new longitudinal studies for clarifying the temporal relationship between psychosocial factors and musculoskeletal pain in the workplace

Although many irrigation systems in the dry zone of Sri Lanka have water shortage problems, water consumption is very high during land preparation. This paper analyzes the impact of institutional interventions on efficient water management, especially during the land preparation period. It provides a comprehensive understanding of the factors behind prolonged periods of land preparation so that system managers and farmers communities can develop appropriate interventions to reduce water consumption.

Introduction: Fits are common indications for MRI since it is regarded as the modality of choice in epilepsy imaging. However, no evaluation regarding the efficacy and usefulness of MRI in epilepsy has been performed in Sri Lanka. We intend to demonstrate clinical and demographic details in patients referred for fits, correlating with their MRI findings. Material & Methods : Data from consecutive patients with fits who underwent MRI brain from June 2012 to March 2013 were analyzed (n=231). Patients with other indications (n=1397) were excluded. Patients' data were obtained from the local database and MRI forms. All MRI’s were assessed with the Radiologist Reports. Results were analyzed using Excel 2007. Results: There were 54.5% (n=126) males and 45.5% (n=105) were females. 1- 15yrs age group consisted of 39.4% (n=91). Majority, 67 % had generalized tonic clonic (GTC) seizures. There were 225 newly diagnosed fits and 6 follow-up cases. MRI findings were abnormal in 57.6% (n=133).Findings in 36.8% were cerebral tumors, out of which 48.9% were gliomas and 16.3% were meningiomas. >15 year group had neoplasms in 48.5% compared to 8.1% in 1-15 year group. Regarding co-morbidities, 9% (n=21) had congenital/perinatal conditions versus 8.2% (n=19) with malignancy Conclusion: MRI helps in establishing an underlying cause for fits and in management decision-making. MRI findings vary in relation to seizure type, age group etc. DOI: http://dx.doi.org/10.4038/sljr.v1i0.2 Sri Lanka Journal of Radiology Vol.1 2015: 6-12

Aim: To ensure radiation safety, the design of X-ray Rooms require consideration of various aspects including size of the room, shielding requirements, wall thickness, distance from focal spot to operator, the warning light, lead lined doors etc. Methods: Data was collected from sixty three X-ray rooms in twenty seven hospitals. Results: Results show 89% of X-Rooms are larger than recommended size of 20 m 2 . 64 % had sufficient wall thickness. Only 12.5% had warning lights but 95.3% had lead lined doors. TLD and protective aprons were available in majority of hospitals. Conclusion: Therefore, some of the plain X-ray rooms surveyed need design improvements to comply with recommended guidelines. A larger detailed study is needed to assess overall impact from these findings on general population. DOI: http://dx.doi.org/10.4038/sljr.v1i0.3 Sri Lanka Journal of Radiology Vol.1 2015: 13-18

This paper analyzes irrigation operational problems, and their institutional causes, on a new irrigation system in southern Sri Lanka, based on research during disastrous drought. The authors offer a number of suggestions for improving the management of this system.

This paper analyzes irrigation operational problems, and their institutional causes, on a new irrigation system in southern Sri Lanka, based on research during disastrous drought. The authors offer a number of suggestions for improving the management of this system.