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Gliomas are among the most common primary neoplasms in children and adults. Management plan for gliomas greatly depends on their grade. Based on their grade, pre or post-surgical radiation or chemotherapy may be advocated. The objective of our study was to evaluate the role of Magnetic Resonance Spectroscopy in differentiating grades of glioma and to assess the relationship of brain metabolite ratios. Material and methods: Magnetic Resonance Spectroscopy was performed in 27 patients with gliomas which were histologically proven. Brain metabolite ratios were calculated at intermediate / long Echo Time. Tumours were graded as low grade or high grade gliomas by experienced radiologist based on Magnetic resonance imaging and Magnetic Resonance Spectroscopy findings. Post-surgery, the histologic grade of glioma was correlated with that of imaging grade. Results: Overall sensitivity, specificity, positive and negative predictive values for classifying glioma into grades using Magnetic Resonance Imaging and Magnetic Resonance Spectroscopy was found to be 83%, 66%, 66% and 83% respectively. Among the metabolite ratios, Choline-to-Creatine was found to be most useful in grading gliomas as low and high grade. Conclusion: Magnetic Resonance Spectroscopy is a useful tool in diagnosing gliomas. Various metabolite ratios can be used in grading gliomas by considering the peri tumoral spread and nature of tumour composition. Further studies on Magnetic Resonance Spectroscopy metabolites are required to improve the sensitivity and specificity of the diagnosing tools in grading gliomas.

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Background Functional endoscopic sinus surgery is a common surgery done in otorhinolaryngology, but it is also riddled with complications. The most dangerous complication is the injury to the skull base leading to cerebrospinal fluid leak, meningitis or damage to intracerebral vessels. Lateral lamella of the cribriform plate is the most common site of injury. Keros described the depth of the olfactory fossa in detail and divided them into three types. This study aims to assess the anatomical variations of type of ethmoid roof and depth of olfactory fossa as per Keros classification Methods Descriptive study where CT scans were evaluated from the radiology department from 29 September 2018 to 20 May 2020. All the CT films were assessed according to the observation checklist. Results Our study included 256 patients. Males constituted 54.3% of patients, and 45.7% of patients were females. Type 2 Keros was the most common followed by type 1 and type 3. Type 3 was seen more in males, and it was statistically significant too. Conclusion The study evaluated the depth categorization of the ethmoid roof and its variations on the basis of age and gender. In our study, the most common type was Keros type 2, but there was a noteworthy difference between the two sides in the same individual. Therefore, extra care must be taken during surgery to note the type of Keros on each side.

Introduction: Superior attachment of uncinate process is the most important anatomical landmark in frontal recess surgery. The uncinate process is an integral struc­ture of osteomeatal complex and prevents the direct contact of the inspired air with the maxillary sinus. It acts as a shield and also plays a role in muco-ciliary activity. Anatomic variations of the uncinate process have surgical implications. Aim: This study was done to know the different variations of superior attachment of uncinate process. Materials and Methods: In this retrospective observational descriptive study, Computed Tomography (CT) scans of Para Nasal Sinuses (PNS) of 256 patients from Sept 2018 to May 2020 were studied. The results were expressed in percentages and proportions. Results: Among 256 CT images, 139 belonged to males and 117 females. In the CT films examined, on the right side, the most common attachment of uncinate was to lamina papyracea which was (64.8%) followed by skull base (19.5%) and to the middle turbinate(15.6%). Similar findings were seen on left side. Conclusion: Uncinate process shows different variations in its superior attachment. Superior attachment to lamina papyracea was the most common attachment of uncinate in our study.