Subacute sclerosing panencephalitis resembling Rasmussen’s encephalitis on magnetic resonance imaging

Subacute sclerosing panencephalitis (SSPE) is a rare, slowly progressing but invariably fatal disease that is related to a prior measles virus infection and most commonly affects paediatric patients. Magnetic resonance (MR) imaging is the modality of choice for determining such changes in white matter. SSPE typically demonstrates bilateral but asymmetric periventricular and subcortical white matter involvement. We herein report a rare case of unilateral white matter involvement in a 13-year-old boy with SSPE that closely simulated Rasmussen’s encephalitis. To the best of our knowledge, this is the first report of an atypical presentation on MR imaging in which SSPE was a rare cause of unilateral brain parenchymal involvement in a patient with intractable seizures.     

Formulation and optimization of potassium iodide tablets

The use of potassium iodide (KI) as a protective agent against accidental radioactive exposure is well established. In this study, we aimed to prepare a KI tablet formulation using a direct compression method. We utilized Design of Experiment (DoE)/mixture design to define the best formulation with predetermined physical qualities as to its dissolution, hardness, assay, disintegration, and angle of repose. Based on the results from the DoE, the formulation had the following components (%w/w): Avicel 48.70%, silicon dioxide 0.27%, stearic acid (1.00%), magnesium stearate 2.45%, and dicalcium phosphate 18.69%, in addition to potassium iodide 28.89% (130 mg/tablet). This formulation was scaled-up using two tablet presses, a single-punch press and a rotary mini tablet press. The final scaled-up formulation was subjected to a variety of quality control tests, including photo-stability testing. The results indicate that potassium iodide tablets prepared by a rotary mini tablet press had good pharmaceutical characteristics and a shelf-life of 25 days when stored at room temperature protected from light.     

A Study of Dermatoglyphic Patterns in Epileptic Patients

The aim of study was to establish a relation of dermatoglyphic patterns of palm in epileptic and normal subjects so that it may be used as a diagnostic tool for identifying cases at risk. The dermatoglyphic study was carried out on 50 patients of epilepsy and 50 normal subjects. The dermatoglyphic traits, which presented a significant difference, were a-b ridge count, lateral deviation, c-line pattern, palmar pattern and finger tip pattern. Mean values of a-b ridge count were more in epileptic patients, especially in left hand, than controls. The ratio of ulnar and radial lateral deviation in control was 1:3 while in epileptic it was 1:5. C-line pattern presented less frequency of proximal and ulnar type patterns in cases. Radial type of C-line pattern was higher in cases. On the other hand this pattern was absent in 29% of controls than cases (8%). Arch type of palmar patterns were showing a very significant difference between controls (79%) and cases (2%). Frequency of loops were much more and vestiges were absolutely absent in cases. The frequency of Arch type of finger tip pattern was more in control. These findings suggest that antenatal factors may contribute to the etiology of epilepsy. A considerable progress in dermatoglyphics has been established as a useful diagnostic and research tool in medicine.     

Portal vein variations in 1000 patients: surgical and radiological importance

Objective:

The purpose of the study was to evaluate the spectrum and incidence of intrahepatic portal vein (PV) variations on triphasic abdomen multidetector CT (MDCT) and to discuss the surgical and radiological implications.

Methods:

A retrospective review of 1000 triphasic MDCT abdomen scans was performed in patients sent for various liver and other abdominal pathologies between January 2014 and August 2014. A total of 967 patients (N = 967) were included in the study. The variations in branching pattern of PV were classified according to classification used by Covey et al (Covey AM, Brody LA, Getrajdman GI, Sofocleous CT, Brown KT. Incidence, patterns, and clinical relevance of variant portal vein anatomy. AJR Am J Roentgenol 2004; 183: 1055–64) and Koç et al (Koç Z, Oğuzkurt L, Ulusan S. Portal vein variations: clinical implications and frequencies in routine abdominal CT. Diagn Interv Radiol 2007; 13: 75–80).

Results:

Normal anatomy (Type I) was seen in 773 patients (79.94%) out of 967 patients in our study. Trifurcation (Type II) anomaly was seen in 66 (6.83%) of cases. Right posterior vein as first branch of main PV (Type III) anomaly was seen in 48 (4.96%) of cases. Type IV anomaly and Type V anomaly was seen in 26 (2.69%) and 13 (1.34%) cases, respectively. 19 cases showed other types of variations.

Conclusion:

Variations in the hepatic PV branching patterns are commonly seen that are similar to variations in hepatic artery and biliary anatomy. Knowledge of these variations is extremely important for transplant surgeons and intervention radiologists.

Advances in knowledge:

Awareness of the variations in PV branching patterns is essential for intervention radiologists and vascular surgeons and avoids major catastrophic events.     

Dynamic 3 T MRI of temporomandibular joint in diagnosing a stuck disk

Magnetic resonance imaging (MRI) is the imaging modality of choice in the evaluation of internal derangement of the temporomandibular joint (TMJ). Dynamic MRI including the open and close mouth views in sagittal plane determine the exact position of articular disk and thus help to evaluate the joint for internal derangement. We also highlight the role of dynamic MRI of TMJ in diagnosis of stuck disk in a 17-year-old male who presented with symptoms of pain and difficulty in opening the mouth.     

Silicone nasal prosthesis retained by an intranasal stent: A clinical report

Nasal defects after tumor excision can leave a patient functionally and esthetically impaired. Loss of nasal septal cartilage support causes the soft tissue to collapse or undergo stenosis, further compounding the problem. Intranasal stents can be used to maintain the patency of such nasal defects. This clinical report describes the use of an acrylic resin nasal stent bonded to a silicone nasal prosthesis to rehabilitate a patient with a nasal defect.