Introduction:Ocular ultrasound has gained importance as a non-invasive imaging technique in the screening, diagnosis and treatment management of intracranial hypertension. The aim of our study was to estimate the intra and interobserver variability on B-mode ocular ultrasound measurement of optic nerve sheath diameter (ONSD).Methods: ONSD of the right eye was measured by ultrasound examination among 120 healthy adult volunteers. The ONSD was assessed 3 mm behind the globe and two serial measurements were taken by two observers who were blinded to each other's findings.Results: Age of the volunteers ranged from 18 to 27 years with a mean age of 23.07 +/-SD of 2.486. The mean of ONSDs of two observers was 4.168 +/-SD of 0.54 mm. The intraclass correlation coefficient for first and second observers was 0.997 and 0.978 respectively at 95% confidence interval. The interobserver intraclass correlation coefficient was 0.977 at 95% confidence interval. No correlation of age and gender was noted with ONSD.Conclusions: B-mode transorbital ultrasound measurement of ONSD is highly reproducible with significant intra-observer and inter-observer agreement. Ultrasound measurement of ONSD measurements can serve as indispensable tool in critical care.

The sequelae of trauma to the nose include nasal deformity and nasal obstruction that can have a long term negative impact on patient's quality of life. Successful management of posttraumatic nasal obstruction relies on a detailed history, careful analysis, and accurate diagnosis. Treatment must balance the seemingly disparate goals of re-establishing structure, improving contour and esthetics, as well as restoring the nasal airway. Indications and technical steps for fabricating bilateral nasal stents are presented, for a case of surgical opening of bilateral nasal synechia necessitated due to failed initial corrective surgery, post contracture and collapse of skin grafts. The objective of nasal stent was to maintain patency of nasal passage post surgical intervention. This is achieved by support to graft and residual tissues and prevention of mouth breathing. The nasal stents were modified post insertion at regular intervals to ensure adaptation to changes in mucosal lining of nasal.

Objective: To investigate the implication of a computed tomography scan for headache with non-localizing sign. Materials and methods: One hundred and thirty six patients with headache having non-localizing signs were included in this prospective study. Patients with age > 11 years, incomplete radiological or clinical data, recent/new onset headache, any immunosuppressive state, neurological deficits at the time of presentation, history of fever, trauma, any previous surgical intervention and any malignancy were excluded from the study. Results: Among the 136 patients, 73% were females and 27% were males with age range of 11-76 years. Negative computed tomography scan was present in 91 (66.9 %) cases. Positive findings that significantly influenced the management were present in only 6 (4.4%) cases. Conclusion: Computed tomography in headache with non-localizing signs has a poor yield for a significant intracranial pathology. A careful and detailed assessment curtails the need for inadvertent imaging thus reducing the economic burden and health related hazards.

Introduction: Acute abdomen is the most common condition for patients presenting in the emergency. Ultrasound among other imaging modalities is the most common diagnostic tool employed in the diagnosis of such cases.Methods: A prospective study of consecutive patients presenting with acute abdomen fulfilling the inclusion and exclusion criteria were included in the study. Ultrasound was performed by single radiologist and findings were correlated to the clinical, pathological and surgical findings.Results: A total of 248 patients fulfilled all criteria and were included in the study. The age of patients ranged from 15-62 years with mean age of 41.3 years. There was female predominance with a male to female ratio of 1:1.8. Ultrasound accurately diagnosed 233 cases (93.9 %). Urolithiasis was the most common finding (45.16%) followed by acute appendicitis (19.35%).Conclusion: Ultrasound has pivotal role in the diagnosis and overall management of patient presenting with acute abdomen. Urolithiasis is the most common etiology for non- traumatic acute abdomen.

Objective: To investigate the spectrum of parotid pathologies on neck ultrasound and correlation with pathological findings. Materials and methods: A total of 41 patients with parotid swelling who had undergone neck ultrasound were included in this prospective study. Patients with history of previous neck ultrasound, recent surgery, bleeding diathesis or trauma, equivocal pathological findings were excluded from the study between June 2016 to May 2018. On-site fine needle aspiration cytology was performed by a pathologist who was blinded to the ultrasound findings. Results: Among the 41 patients, 41.5 % were males and58.5 % were females with age ranging from 1 to 76 years with a mean age of 37.31 years. Ultrasound was able to categorize lesions into benign and malignant with a sensitivity of 97.3 %, specificity of 50%. Pleomorphic adenoma was the most common pathology (46.3 %) followed by inflammatory conditions. Mucoepidermoid carcinoma was the most common malignant tumor constituting 7.3 % of the total cases. Conclusion: High resolution ultrasound can categorize parotid lesions with high degree of confidence in the hands of skilled radiologist. In equivocal cases, onsite fine needle aspiration by cytopathologist increases the diagnostic yield.