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Introduction: Myocardial viability refers to a phenomenon in which dysfunctional myocardium, due to acute or chronic ischaemia, retains the potential to recover its systolic function after revascularisation. The assessment of myocardial viability using Contrast-enhanced Magnetic Resonance Imaging (CE-MRI) has become a quintessential imaging method for the guidance of treatment in patients with Myocardial Infarction (MI). Aim: To assess cardiac morphology, function, perfusion and myocardial viability in patients with chronic ischaemic heart disease, and to stratify patients into conservative and operative management based on the myocardial viability. Materials and Methods: The present hospital-based prospective observational study was conducted in the Department of Radiodiagnosis, Gauhati Medical College and Hospital, Guwahati, Assam, India, from April 2021 to October 2022. A total of 50 patients with a prior history of MI and abnormal findings on electrocardiography and echocardiography were subjected to cardiac MRI (3 Tesla). Functional parameters like wall motion and Left Ventricular Ejection Fraction (LVEF) were evaluated along with perfusion scan. On Late Gadolinium Enhancement (LGE) scan, patients were classified into two categories: ≤50% LGE (viable) and >50% LGE (non viable). The quantitative values like age and LVEF were summarised as mean and Standard Deviation (SD) based on the distribution of data. A Pearson’s correlation test was done to check the correlation between various parameters. A p-value (using Chi-square test) of less than 0.05 was considered statistically significant. Results: The mean age was 52±14 years. A total of 27 (54%) patients were males and 23 (46%) patients were females. Out of 50 patients, 17 showed an LGE score ≤50%, while 33 showed an LGE score >50%. The segments showing >50% LGE showed more severe wall motion abnormalities than those with ≤50% LGE (p-value 50% group, only 2 (6.10%) patients had clinical improvement following coronary revascularisation. Conclusion: Delayed Enhanced-Cardiac Magnetic Resonance (DE-CMR) imaging assesses severity of the infarcted myocardium and helps in predicting recovery following intervention.

Purpose: The purpose of this study is to assess the effect of dexmedetomidine on intraocular pressure (IOP) as an additive in peribulbar injections in glaucoma surgeries. Methods: A prospective, randomized, double-blind, parallel assignment interventional study was conducted for patients undergoing glaucoma surgeries at a tertiary eye care hospital in North India. Patients were randomized to two groups, Dexmed group and Placebo group. In the Dexmed group, dexmedetomidine (0.4 μg/kg body weight) was given as an additive along with peribulbar block. The primary outcome was change in IOP pre- and postperibulbar injections (IOP before the block, and after 5 and 15 min of the block). Secondary outcome measures were onset of block, adverse effects (bradycardia, hypotension, respiratory depression, and level 4 sedation), and surgeon satisfaction. Results: A total of 104 patients were randomized, 52 each in the Dexmed group and Placebo group. The percentage decrease in IOP was significantly more in the Dexmed group than in the Placebo group both at 5 and 15 min' post block (P < 0.05). At 5 min, the mean percent decrease in IOP in Dexmed group was -10.48, whereas it was 2.85 in the Placebo group. At 15 min, the mean percent decrease in IOP was -22.59 and -9.42 in the Dexmed and Placebo group, respectively. There was no significant difference between the two groups in the onset of block and adverse effects. Surgeon satisfaction was significantly greater in the Dexmed group than the Placebo group (P < 0.05). Conclusion: Dexmedetomidine lowers IOP significantly in patients undergoing glaucoma surgeries with safe hemodynamic changes and sedative effect.

Tuberous sclerosis is a complex disorder which has multisystem involvement and varied clinical manifestations. Almost half of the patients have associated angiomyolipoma which contains fat, vascular and smooth muscle components. Spontaneous pseudoaneurysm formation is a complication of angiomyolipoma. Here we present a case of a female child presenting with hematuria who after thorough clinical and radiological investigations was diagnosed as a case of tuberous sclerosis with right intrarenal pseudoaneurysm. She was successfully treated with endovascular coil embolization.

Context: Paucity of literature of portable CXR findings in COVID-19. Aims: Evaluate radiographic findings in COVID-19 patients and calculate sensitivity of radiographs with RT-PCR as gold standard. Subjects and Methods: Total 116 COVID-19 patients underwent portable CXR between April-June, 2020. Two radiologists reviewed radiographs with respect to laterality, craniocaudal, mediolateral distribution, shape, density, unifocality/multifocality and number of lung zones. Sensitivity of radiography was calculated with RT-PCR as gold standard. Statistical Analysis Used: IBM SPSS Statistics Subscription software (IBM, New York, USA). Results: Many patients 67.2% (78/116) were asymptomatic. Cough (21.5%, 25/116) and fever (17.6%, 20/116) were the most frequent symptoms. 36.2% (42/116) patients revealed COVID-19 pneumonia-like abnormalities on CXR. Sensitivity of CXR with RT-PCR as gold standard was 36.2% (CI: Confidence interval = 27.46% - 44.95%). More patients in symptomatic group (68.4%, 26/38) had abnormal CXR compared to asymptomatic group (20.5%, 16/78) [P < 0.0001]. Radiographs revealed both unilateral (57.1%, 24/42), bilateral (42.8%, 18/42), GGO (80.9%, 34/42), or consolidation (11/42, 26.1%) in a middle (57.1%, 24/42), lower zone (83.3%, 35/42) and peripheral distribution (78.5%, 33/42). Lesions were commonly patchy (88%, 37/42) and multifocal (59.5%, 25/42). Majority had single (40.4%, 17/42) or two zone (35.7%, 15/42) involvement. Conclusions: Significant number of COVID-19 patients were asymptomatic. Over 1/3rd of patients showed radiographic abnormalities. Symptomatic patients were more likely to show radiographic findings than asymptomatic patients. If radiographs identify pneumonia in appropriate clinical setting, CT can be avoided. Common radiographic abnormalities among COVID 19 patients were bilateral/unilateral, patchy, multifocal, ground glass opacity or consolidation in peripheral and middle/lower zone distribution.

Objectives To assess the effects of different types of cataract surgeries and intraocular lenses on generic as well as vision related quality of life of cataract patients, using EQ-5D and IND-VFQ 33 instruments respectively. Methods An observational, longitudinal study of patients undergoing cataract surgery was carried out at three ophthalmology centres. Patients were prospectively admitted for surgery for age-related cataract. Generic quality of life was assessed by using Euroqol’s EQ5D-5L questionnaire and vision related quality of life was assessed by the IND-VFQ-33 questionnaire. Data pertaining to vision function and quality of life were collected pre surgery and 4 weeks after the surgery. Results Out of total patients (n = 814) recruited for the study, 517 patients were interviewed for both pre-surgery and post-surgery for EQ5D and 519 patients were interviewed for both pre-surgery and post-surgery for IND VFQ 33 tool. The combined data from all three centres showed that Quality Adjusted Life Year (QALY) gains observed in patients undergoing phacoemulsification with foldable lens implantation (2.25 QALY) were significantly higher (0.57 QALY) as compared to Small Incision Cataract Surgery (SICS) with PMMA lens implantation (1.68 QALY). Highest improvement however, in all three subscales of IND-VFQ-33 tool were clearly observed for SICS with PMMA lens implantation. Conclusions The study has elicited the Health related and vision related Quality of Life scores for cataract surgeries and subsequent lens implantation. This study also offers Health State Utility Values along with visual outcomes for different surgical procedures, lenses and for the combination of surgery with lens implantation for cataract procedures providing a useful resource for future economic evaluation studies.

Background: Cervical cancer in India and many other developing countries is a public health concern affecting women of all age groups. The prognosis of cervical cancer is based on the stage, size, and histological grade of the primary tumour and the status of the lymph nodes. Assessment of the stage of disease is important in determining whether the patient may benefit from surgery or will receive radiation therapy. Currently MRI (Magnetic Resonance Imaging) due to its excellent soft-tissue contrast resolution, which exceeds that of CT (Computed Tomography) scanning and ultrasonography, is slowly gaining momentum in pre-treatment evaluation of cancer cervix. Materials and methods: The study was conducted as an analytical study comparing Clinical and MRI staging methods for carcinoma cervix using the same basic staging criteria advised by FIGO (The International Federation of Gynecology and Obstetrics). Total of 48 cases were studied. Results: MRI evaluation of cancer cervix cases with vaginal invasion, parametrial invasion, bowel and bladder invasion etc. were done and compared with histopathological findings. Conclusion: it is recommended that MRI could be included in routine staging of all cases of cancer cervix.