Background:The staging of colorectal carcinoma using 3 modalities viz operative, histopathology and CT scan has been subject of interest in accurately defining the extent of disease. This retrospective as well as prospective study was carried out at CMC, Ludhiana, Punjab from November 2011 to May 2014.Aim:The objective of this study was to assess the usefulness and accuracy of CT scan findings to state the extent and spread of colorectal malignancy and to correlate these findings with histopathological diagnosis.Method:A total of 31 biopsy proven patients showing variable bowel wall thickening involving the colon /rectum on CECT (Contrast Enhanced Computed Tomography) were included in the study. The tumours were staged based on the CT scan findings and were compared with the operative and histopathological findings.Observations:Rectum was the most common site of involvement followed by the recto-sigmoid involvement. Metastasis was observed in 5 cases out of the 31 malignant cases. Five of the 7 cases were correctly staged as T1 & T2 lesions on CT having a sensitivity of 83.3%, specificity of 92%, and positive predictive value of 71.4% and a negative predictive value of 95.8% in the diagnosis of T1 and T2 lesions. 15 of the 16 cases were correctly staged as T3 lesions. CT had a sensitivity of 88.2%, specificity of 93.8%, and positive predictive value of 93.8% and a negative predictive value of 86.7% in the diagnosis of T3 lesions. All the 8 cases were correctly staged as T4 lesions. CT had a sensitivity of 100%, specificity of 100%, and positive predictive value of 100% and a negative predictive value of 100% in the diagnosis of T4 lesions.Conclusion:We conclude that CT scan is an excellent modality in diagnosing malignant lesions of the colon and rectum.

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The autonomic nervous system (ANS) plays a crucial role in normal functioning of the heart and is responsible for normal cardiac variability, which can be studied by recording (HRV) heart rate variability. HRV is an excellent, noninvasive tool used to show variation over time of period between consecutive heart beats and for assessment of cardiovascular regulation of ANS. Available literature is insufficient to document effect of Electroconvulsive therapy (ECT) on HRV in psychiatry patients. Aim: To explore the effect of ECT on HRV with a view to assess the safety of ECT in various age groups of patients requiring ECT. Materials and Methods: This Non-Randomized comparison study without a control was conducted at a tertiary care teaching hospital in Ludhiana Punjab in 100 cases of ECT over a period of 2 years. A detailed general physical examination as well as systemic examination was done and observations were documented. Each patient was screened for indication for the ECT by the Psychiatrist. HR prior to ECT and HRV in immediate post procedure period were noted. Observations and Results: This study indicates that heart rate increased significantly after ECT but this variation remains within the homeostatic limits. Conclusion:Although the study shows safety of ECT in psychiatric patients, it would be advisable to monitor HRV in ECT given in pre-existing cardiac illness.

This one-year prospective study was carried out at a tertiary care hospital in Ludhiana, Punjab, on patients visiting antenatal OPD (Outpatient Department) in the third trimester with clinical suspicion of IUGR (Intrauterine Growth Retardation) by using high resolution Doppler ultrasound scanner, Model EUB-450, Hitachi. The objective of this study was to evaluate the role of ultrasound in detection of intrauterine growth retardation and to assess and compare different parameters in order to determine best ultrasonic parameter to assess IUGR. The patients included were studied under two groups: Test group of patients suspected to have IUGR on obstetrical examination (n=75) and control group of 148 subjects showing signs of normal foetal development, i.e. not suspected to have IUGR clinically. Four parameters were taken into account namely the Abdominal Circumference (AC), ratio of AC and head circumference (HC:AC), ratio of AC and femur length (FL:AC) and umbilical artery systolic to diastolic ratio (S:D). The sensitivity of ultrasound in detecting IUGR was 86.9%. Umbilical artery flow velocimetry correctly identified 24 of 46 IUGR infants, but on no occasion did this technique detect IUGR, otherwise missed by real time sonography. The sensitivity and specificity of all the four parameters can be summarized as: AC -82.6% and 89.6%, HC: AC -50% and 86.2%, FL:AC -47.8% and 82.7% and umbilical artery S:D ratio -52.1% and 93.1%. Five patients showed absent diastolic flow and three patients showed reversal of diastolic flow. None of the fetus survived in whom there was reversal of flow. We conclude that sonography is a safe, reliable, non-invasive tool in assessment and management of suspected IUGR at or beyond 32 weeks of gestation for obstetrician and the neonatologist. KEYWORDS IUGR, Umbilical Artery Flow Velocimetry.HOW TO CITE THIS ARTICLE: Singla S, Gaind RK, Sagoo HS. Role of real time ultrasound and Doppler study of umbilical artery in evaluation of intrauterine growth retardation.