US and MRI were useful in the diagnosis of placenta accreta with lacunae and an abnormal color Doppler imaging pattern are the most helpful findings. MRI is most clearly indicated when US findings are ambiguous or there is a posterior placenta.

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Background and purpose: Chest trauma is a significant cause of mortality and morbidity, especially in the younger population. The purpose of this study was to evaluate the role of multidetector computed tomography (MDCT) in the assessment of patients with blunt chest trauma. Patients and methods: A prospective study was conducted on thirty (30) patients with blunt chest trauma (21 males and 9 females, aged from 6 to 62 years) and 29 control patients presented with any trauma other than blunt chest trauma (23 males and 6 females, aged from 10 to 68 years) at the Emergency Department, Tanta University Hospital, from January 2013 to February 2014. Cases were subjected to clinical evaluation and radiological assessment of the chest using conventional chest X-ray (CXR) and multi-detector computed tomography. Results: The most common mode of injury was motor vehicle accidents (56.7%). On MDCT scan, the frequency of chest injuries were; chest wall injuries (86.7%), pleural injuries (80%), parenchymal injuries (56.7%), mediastinal injuries (30%) and finally the dorsal spine injuries (16.7%). MDCT is more sensitive, specific, and accurate than CXR in the assessment of blunt chest trauma and management of patients. Conclusion: MDCT is the modality of choice for rapid assessment of emergency chest trauma patients, when chest X-ray was inconclusive.

Background White matter hyperintensities (WMHs) is the most frequent type of cerebral small vessel diseases and a common incidental finding in MRI films of the geriatric population. The objectives of this work were to study the existence of occult cognitive and balance impairments in subjects with accidentally discovered WMHs. Methods The study was conducted on 44 subjects with accidentally discovered WMHs and 24 non-WMHs subjects submitted to the advanced activity of daily living scale (AADLs), a neurocognitive battery assessing different cognitive domains, Berg balance test (BBT), computerized dynamic posturography (CDP), and brain MRI diffusion tensor tractography (DTT). Results WMHs subjects showed a significant decrease in AADLs as well as visual and vestibular ratios of CDP. Regarding the neurocognitive battery, there were significant decreases in MoCA as well as arithmetic test and block design of Wechsler adult intelligence scale-IV in WMHs compared to non-WMHs subjects’ groups (p value < 0.001). Concerning Wisconsin Card Sorting subtests, each preservative response, preservative errors, non-preservative errors and trials to complete the 1st category showed a highly significant increase in WMHs compared to non-WMHs subjects (p values < 0.001). DTT showed a substantial reduction in fractional anisotropy (FA) of each corticospinal tract, thalamocortical connectivity, and arcuate fasciculi. Conclusion Subjects with WMHs have lower cognitive performance and subtle balance impairment which greatly impair their ADLs.

Objective: The aim of this work was to evaluate the role of ultrasound-guided steroids injection for carpal tunnel syndrome (CTS). Study design: This is a prospective study done on thirty patients with carpal tunnel syndrome with mild to moderate severity. Patients were divided into two groups; group I of fifteen patients `wrists injected by steroids using ultrasound guidance and group II of another fifteen patients injected blindly-as control-with the same material .Results: There was significant improvement in symptoms and ultrasound findings, after steroid injection, in both groups, being more in group I than group II, with shorter average time to symptom relief, in group I than group II. Moreover, the complications were significantly lower in group I than group II. Conclusions: Ultrasound guided steroids injection is more effective in reducing the symptoms and improving function of CTS with lower risk of nerve injury than blind local steroid injection.