Shaik Ismail Bux

A comparison between low-dose and standard-dose non-contrasted multidetector CT scanning of the paranasal sinuses.

Purpose To compare the image quality of the low-dose to the standard-dose protocol of MDCT scanning of the paranasal sinuses, based on subjective assessment and determine the radiation doses to the eyes and thyroid gland and dose reduction between these two protocols. Materials and Methods 31 adult patients were scanned. Prior to scanning, thermoluminescent dosimeters (TLDs) were placed at 4 sites: outer canthus of right eye, outer canthus of left eye, inner canthus and anterior neck (thyroid gland). Every patient was scanned twice using the standard-dose protocol (100mAs) followed by the low-dose protocol (40mAs). The images were reviewed by 3 radiologists. Wilcoxon test was used as the test of significance for the image quality assessments. The paired sample t-test was used as the test of significance for the analysis of the radiation doses measured by the TLDs. Results Of the 30 patients selected for analysis, this study showed no significant difference in the scores for the diagnostic image quality and the anatomical structures assessments between the two protocols. The average calculated mean entrance surface doses and standard deviation for the standard-dose and low-dose protocols were 12.40±1.39 mGy and 5.53±0.82 mGy respectively to the lens and 1.03±0.55 mGy and 0.63±0.53 mGy respectively to the thyroid gland. Conclusion The reduction of mAs from 100 to 40 resulted in a significant reduction of the radiation doses to the lens and thyroid gland by 55.4% and 38.8% respectively without causing any significant effect to the diagnostic image quality and assessment of the anatomical structures.

Does Helicobacter pylori infection affect gastric emptying in patients with functional dyspepsia

The objectives of the study were first, to determine if gastric emptying was altered in patients with functional dyspepsia with and without Helicobacter pylori infection compared with normal healthy volunteers; and second, to determine if there were further alterations in gastric emptying when the infection was eradicated. Gastric emptying was measured using a 99mtechnetium radiolabelled solid meal and gastric emptying time was measured as t1/2, viz. time taken for half the radiolabelled meal to be emptied from the stomach. The mean gastric emptying time for H. pylori‐positive patients (n= 20) was 56.4±24.8 min; H. pylori‐negative patients (n= 19) 67.8±31.8 min; and normal controls (n= 20) 58.8 ± 18.8 min. No significant difference was obtained between the groups (ANOVA; P= 0.348). Thirteen of 18 H. pylori‐positive patients successfully eradicated the infection following treatment with omeprazole 40 mg o.m. and amoxycillin 500 mg t.d.s. for 2 weeks. The mean difference in the gastric emptying time before and H. pylori eradication was 23.9 + 13.2 min (P= 0.556). There was no significant difference in the frequency of specific dyspeptic symptoms as well as the overall mean symptom score between the H. pylori‐positive and ‐negative patients. Gastric emptying was not different between patients with functional dyspepsia and normal controls. Helicobacter pylori infection does not appear to affect gastric emptying in patients with functional dyspepsia.

A giant mastoid cholesteatoma with posterior cranial extension causing mass effect and obstructive hydrocephalus.

Cholesteatoma is a benign, keratinizing lesion with prolifertion of epithelial cells in the middle ear. Cholesteatomas are ivided into acquired and congenital (primary) subtypes. Acquired holesteatomas usually occur in the middle ear with rare extenion to the petroux apex unlike congenital cholesteatomas. These esions are postulated to be ectopic rests of embryologic epithelial issue in the petrous apex, which failed to undergo involution. As nternal desquamation occurs from the stratified squamous epitheium, keratinized debris accumulates centrally and forms a highly rganized structure. The advancing epithelium combined with host nflammatory response results in surrounding bone resorption [1]. he chronicity of this benign process may cause adjacent bone emodeling and mass effect without early clinical signs. We describe a rare case of giant mastoid cholesteatoma in an dult with consequent deleterious intracranial complications.

Hemorrhagic Cardiac Tamponade: Rare Complication of Radiofrequency Ablation of Hepatocellular Carcinoma

Local treatment for hepatocellular carcinoma (HCC) has been widely used in clinical practice due to its minimal invasiveness and high rate of cure. Percutaneous radiofrequency ablation (RFA) is widely used because its treatment effectiveness. However, some serious complications can arise from percutaneous RFA. We present here a rare case of hemorrhagic cardiac tamponade secondary to an anterior cardiac vein (right marginal vein) injury during RFA for treatment of HCC.

A magnetic resonance imaging study on the articulatory and acoustic speech parameters of Malay vowels

The phonetic properties of six Malay vowels are investigated using magnetic resonance imaging (MRI) to visualize the vocal tract in order to obtain dynamic articulatory parameters during speech production. To resolve image blurring due to the tongue movement during the scanning process, a method based on active contour extraction is used to track tongue contours. The proposed method efficiently tracks tongue contours despite the partial blurring of MRI images. Consequently, the articulatory parameters that are effectively measured as tongue movement is observed, and the specific shape of the tongue and its position for all six uttered Malay vowels are determined.Speech rehabilitation procedure demands some kind of visual perceivable prototype of speech articulation. To investigate the validity of the measured articulatory parameters based on acoustic theory of speech production, an acoustic analysis based on the uttered vowels by subjects has been performed. As the acoustic speech and articulatory parameters of uttered speech were examined, a correlation between formant frequencies and articulatory parameters was observed. The experiments reported a positive correlation between the constriction location of the tongue body and the first formant frequency, as well as a negative correlation between the constriction location of the tongue tip and the second formant frequency. The results demonstrate that the proposed method is an effective tool for the dynamic study of speech production.

College of Radiology, Academy of Medicine of Malaysia position on whole body screening CT scans in healthy asymptomatic individuals (2008)

To date, the College of Radiology (CoR) does not see any clear benefit in performing whole body screening computed tomography (CT) examinations in healthy asymptomatic individuals. There are radiation risk issues in CT and principles of screening should be adhered to. There may be a role for targeted cardiac screening CT that derives calcium score, especially for asymptomatic medium-risk individuals and CT colonography when used as part of a strategic programme for colorectal cancer screening in those 50 years and older. However, population based screening CT examinations may become appropriate when evidence emerges regarding a clear benefit for the patient outweighing the associated radiation risks.

Endoscopic decompression may not relieve biliary obstruction caused by polycystic liver disease. Report of a case from malaysia

A 55‐year‐old man with known adult polycystic kidney and liver disease presented to us with a gradual onset of cholestatic jaundice. Gross polycystic disease was noted on liver imaging and endoscopic retrograde cholangiopancreatography (ERCP) confirmed external compression of intrahepatic bile ducts with some dilatation. Despite a well‐placed biliary stent, the jaundice continued to deteriorate until percutaneous aspiration of two of the largest cysts, followed by ethanol injection. His jaundice resolved subsequently and has not recurred to date. The merits of ERCP, biliary decompression and percutaneous cyst drainage in this rare complication of polycystic liver disease are discussed. We conclude that endoscopic biliary drainage is of little value and that cyst drainage with ethanol ablation in the initial stage should be the treatment of choice.