Introduction:Magnetic resonance imaging (MRI) is the current imaging tool of choice in the investigation of patients with seizures. The advent of high-resolution MRI with a dedicated seizure protocol has significantly increased the chances of identifying a cause, resulting in a positive clinical impact on the management of these patients.Aims:The aims of this study were to evaluate the diagnostic efficacy of standard MRI, identify whether there is an increase in the diagnostic yield with the addition of dedicated seizure protocol, and compare the diagnostic yields of MRI and electroencephalogram (EEG) individually and in combination.Subjects and Methods:This is a prospective study of 129 consecutive patients who presented with new-onset seizures over an 18-month period. The MRI scans performed on 1.5T were reviewed for their diagnostic yield and their association with abnormal electrical activity on EEG. Chi-square test of significance (P < 0.05) was used to test for the difference in proportion. The correlation between MRI brain and EEG was studied using McNemer test.Results:MRI detected potentially epileptogenic lesions in 59 patients (47%). The frequency of epileptogenic lesions was highest in patients who had focal-onset seizures (81%). The most common lesion type was infection and inflammation (28%), with neurocysticercosis being the most common, followed by mesial temporal sclerosis, ischemia, and tumor. About 37% of epileptogenic lesions were missed by standard protocol, which were detected on a dedicated seizure protocol MRI. The diagnostic yield of EEG was 31%. Abnormal MRI and EEG were concordant in 18% of patients, with EEG being normal in 37% of patients with epileptogenic lesions.Conclusions:MRI detects epileptogenic lesions in almost one half who presented with new-onset seizures and of these, more than third of them were detected using a “dedicated seizure protocol.” While almost 50% with seizures will have a cause identified on MRI, the sensitivity can be substantially improved by utilizing a dedicated seizure protocol.

Background Our study aims to compare non-invasive imaging such as topical computed tomography dacryocystography (CTD) and topical magnetic resonance dacryocystography (MRD) in patients with epiphora. Purpose To evaluate the practicability of topical contrast media during helical CTD and topical saline during MRD to reveal obstruction in the nasolacrimal drainage system (NLDS). Material and Methods Twenty participants with nasolacrimal duct obstruction were observed for two years. Ten participants underwent CTD and the other 10 participants underwent MRD. Images were analyzed by two radiologists. Participants were also asked about the level of discomfort of the contrast material versus the saline solution. Results The NLDS was seen on both CTD and MRD. Very good agreement between the two observers (κ value > 0.81) was seen according to the κ statistics. CTD multiplanar and 3D images allowed for precise diagnosis of the point of obstruction whereas, the MRD did not require any contrast material and showed the point of obstruction. Saline was more comfortable for the patients than topical contrast ( P < 0.05). Conclusion Topical CTD and MRD are non-invasive techniques that can visualize the degree and level of obstruction in the NLDS than conventional invasive cannulation dacryocystography. CTD is useful in visualizing the point of obstruction and smaller drainage structures. However, it is a source of ionizing radiation to the lens. The benefit of MRD is that it requires no contrast or radiation; however, it is poor in depicting the bone anatomy and smaller drainage structures. Finally, saline was better tolerated by patients than topical contrast

Background: Hypertension is a major public health problem worldwide, including India. Nowadays, prehypertension is common in young adults. It has genetic basis and runs in families. Parental history of hypertension increases the risk of developing hypertension, especially if both parents are hypertensive. Cause & effect relation of hypertension & autonomic dysfunction is not clear. Therefore, this study was planned to see autonomic function alterations in young adults of hypertensive parents, if any. Methodology: In this study autonomic activity was assessed in students with both parents hypertensive (n= 30), one parent hypertensive (n= 30) and both parents normotensive (n= 30). Resting heart rate and BP was measured for parasympathetic function assessment and rise in diastolic BP with hand grip dynamometer was used for sympathetic function assessment. Results: The study showed no significant difference in resting pulse rate of all the groups. BP was slightly higher in groups with hypertensive parents as compared to a group of normotensive parents, but the difference was statistically insignificant. Statistically significant rise in diastolic BP with handgrip dynamometer was observed in subjects with hypertensive parents. Conclusion: This rise in diastolic BP indicates increased sympathetic activity. Our results showed higher sympathetic activity in those with hypertensive parents. It also confirmed the genetic basis of sympathetic (vasomotor) tone. Young adults having hypertensive parents are at a greater risk of hypertension at an early age. Regular assessment of blood pressure and autonomic function with lifestyle modifications should be recommended to delay onset of hypertension in them.