to evaluate the role of Magnetic Resonance Imaging in the diagnosis of cervical disc herniation. A total of 40 patients having clinical features of cervical disc herniation with neck pain referred to the Department of Radiology & Imaging for MRI of their cervical spine were included in the study. At first all the patients were evaluated by detail history and clinical examination with special emphasis on clinical features. Then subsequently MRI of cervical spine was performed in all cases. The MRI report was checked by a competent radiologist of the department of Radiology and imaging DMCH. Among these 40 patients 11 were operated in department of neurosurgery, DMCH and 29 were operated in spine surgery unit, Department of Orthopaedic, BSMMU, Dhaka. The MRI and peroperative findings of these 40 patients were analyzed for the study. MRI findings correlated well in most of the cases with preoperative findings. Sensitivity, specificity, positive predictive value, negative predictive value and accuracy of MRI in the diagnosis of cervical disc herniation were 94.12%, 83.33%, 96.97%, 71.43% and 92.5% respectively. Therefore it can be concluded that MRI may be used as a reliable tool with which we can assess the level, type and position of cervical disc herniation and can plan the subsequent appropriate management in majority of cases.

Diabetic retinopathy is a vascular disorder affecting the microvasculature of retina. It is caused by changes in the blood vessels of retina. If untreated, it may lead to blindness. Therefore if diagnosed and treated promptly, blindness is usually preventable. In ophthalmology, Colour Doppler Imaging is a new method that enables us to assess the orbital vasculature. Duplex color Doppler ultrasonography is the investigation of choice to assess retinal arterial flow velocities very quickly without any invasive procedure for qualitative and quantitative assessment of blood flow velocities. This study was performed to observe the difference between Doppler flow velocity indices of retinal artery in Type-II Diabetics subjects without retinopathy and those of normal control subjects. This case-control study was carried out in the Radiology department, BIRDEM for two years. All the selected subjects underwent Duplex Doppler ultrasonography of both eyes using 5 to 7.5 MHz linear phase transducer. Findings included spectral analysis, those were PSV, EDV and RI. Unpaired ttest was done to compare blood flow velocity indices of retinal artery in type-II diabetic patients without retinopathy and that of healthy control adult subjects and a P value <0.05 was taken as significant. Majority (42.5%) of patients were in 4th decade in diabetic subjects with male predominant, which was 58.7%. The mean duration of diabetes was 4.56 + 2.1 years. In the current study, it was found that the mean resistive index (RI) in 80 diabetic patients without retinopathy was (0.75 + 0.04) ranging 0.66-0.81. And that of 80 healthy subjects was (0.64 + 0.02) ranging 0.600.70.1n this study the mean differences of retinal arterial RI in diabetic eyes without retinopathy and healthy control eyes was statistically significant (p<0-05) in unpaired 't' test. From the result of present study it can be concluded that, there is statistically significant increased retinal arterial resistivity index of type-II diabetic patients without retinopathy. Higher RI in type-II diabetics may predict the early haemodynamic changes in the retinal artery of these patients before the clinical onset of retinopathy. DOI: http://dx.doi.org/10.3329/bmjk.v47i1-2.22555 Bang Med J (Khulna) 2014; 47 : 7-11

Background & objective: Ultrasonogram (USG) and computed tomography (CT) are often used in the evaluation of gall-bladder carcinoma. Thepresent study was conducted to determine the usefulness of USG and CT scan in diagnosing gallbladder carcinoma. Materials & Methods:This cross-sectional observational study was conducted at Department of Radiology and Imaging, BIRDEM in collaboration with the Departments of Hepato-biliary Surgery, and Histopathology of the same institute over a period of 3 years fromJuly 2004 to June 2006. A total of 42 patients (ranging from 40-80 years) were initially included on the basis of signs and symptoms of gallbladder carcinoma and underwent USG and CT scan for preoperative radiological diagnosis, its extension and operability. Following operation all the resected specimens were sent for histopathological evaluation. The diagnostic accuracies of USG and CT scan were then compared against histopathological diagnoses by using Kappa statistics. Result:In the present study, the mean age of the patients was 60 (range: 40-80) years with female preponderance. About 40% of the gall-bladder were contracted and reduced in size and 32.5% large and distended on USG examination, while 45% of the gall-bladder were contracted and reduced in size and 25% distended and large on CT examination. Approximately 40% had irregularly thickened wall and 21.2% diffusely thickened wall on USG and 30% of gallbladder wall were diffusely thickened and 45% irregularly thickened on CT scan. The present study showed hepatic parenchymal invasion to be 22.5% on USG and 42.5% on CT scan. The sensitivity and specificity of USG in diagnosing GB carcinoma were 93.9 and 71.4% respectively. Similarly, the sensitivity and specificity of CT scan in detecting GB carcinoma were 97.1 and 83.3% respectively. The test of agreement (Kappa test) revealed an almost 90% agreement between the two procedures meaning that the two diagnostic modalities are almost comparable in diagnosing gall bladder carcinoma (p<0.001). Conclusion:The study findings indicate that both USG and CT scan are ideal,non-invasive, safe imaging modalities for diagnosis of gallbladder carcinoma. CT scan has an additional advantage in defining the extension of the disease and involvement of surrounding structures including lymph nodes and hepatoduodenal ligament. gallbladder wall thickening. The mass replacing the gallblader fossa is the most common appearance. CT scan can differentiate between complicated cholecystitis and advanced gallbladder carcinoma by few specific findings 3 .In this country, gallbladder carcinoma is not uncommon. Ultrasonography and CT scan are two important diagnostic tools available in our country to evaluate the hepatobilliary system. By utilization of these advanced imaging modalities, carcinoma gallbladder can be detected early when these tumors are still localized. Thus survival time of the patients can be increased by early removal of tumors. To the best of our knowledge, no published data are available in this country in the field of ...

Secretory carcinoma is an extremely rare subtype of low grade invasive breast carcinoma and occurs infrequently in adults showing belligerent clinical course than in children. Surprisingly, it is the only epithelial carcinoma of breast representing characteristic balanced translocation.This paper reports a case of secretory breast carcinoma in an elderly post-menopausal woman in Bangladesh which is diagnosed by core needle biopsy. The majority of the case reports claimed this tumor to be a triple negative breast carcinoma, whereas our case report reveals a slightly different status in immunohistochemical context. A 78-years old, post-menopausal female presented with the chief complaints of painless, slowly enlarging lump in her left breast over nine months. Breast examination revealed a 2x1.5cm, well-delineated, firm, non-tender and mobile mass in the lower-outer quadrant of the left breast. Microscopically, the tumor was composed of cells containing PAS positive, diastase resistant and mucicarmine positive intra and extra-cellular secretory material and Alcian blue positive secretion was found extracellularly. The tumor cells showed strongly positive immunohistochemical reactivity for cytokeratin, EMA, E-cadherin and vimentin and focal positive reaction for S-100 protein and estrogen receptor but negative for both progesterone receptor and human epidermal growth factor receptor. Ki-67 proliferative index was about 4%. Hence, the diagnosis of secretory breast carcinoma (SBC) was made. The patient underwent modified radical mastectomy with axillary clearance without any axillary lymphnode involvement in an external center. The patient has not received any radio or chemotherapy. The patient was under continuous follow-up for 3-months.Unfortunately, owing to the nation-wide lockdown for dreadful COVID-19 pandemic, the patient couldn’t arrive at the hospital for further follow-up evaluation. Immunohistochemical (IHC) analysis has been proven to be an alternative potential method as gene analysis. Immunoprofiling of secretory breast carcinomas may play the pivotal role for selecting therapeutic strategies and predicting prognostic outcome of the disease process. Comprehending the immunohistochemical expression would make scope for applying targeted therapy in SBC patients in future. J Dhaka Medical College, Vol. 28, No.2, October, 2019, Page 216-223

A 20‐year‐old man presented in the Department of Urology, with the complaint of left‐sided lower abdominal lump for past 9 months. The patient denied of having any constitutional symptoms including weight loss.