INTRODUCTION Polycysticovarian syndrome (PCOS) is a common endocrine disorder characterized by a variety of symptoms like hyperandrogenism, hyperinsulinaemia, menstrual dysfunction, unique ultrasonographic ovarian pattern and infertility [1]. Antral Follicle count (AFC) has been found to be reliable marker for ovarian reserve [2]. Since women with PCOS are extremely sensitive to gonadotrophin stimulation, knowledge of age related AFC normogram is clinically relevant. Wiser et al., published age-related normogram for AFC in women with PCOS using transvaginal ultrasound and found that the decline in number of AFC as the age progresses was linear and slower in PCOS when compared to infertile women without PCOS [2]. We used magnetic resonance imaging (MRI) instead of TVS, since MRI can acquire three dimensional images, not operator dependant and also it can be performed in patients for whom transvaginal ultrasound could not be performed like in unmarried women. The main objective of our study is to create an age related normogram for AFC (AFC) in women with PCOS and to compare that with women without polycystic ovarian syndrome using MRI. MATERIALS AND METHODSThis descriptive cross-sectional study was conducted after obtaining clearance from Institutional Ethics Committee between January 2013 to July 2015. The goal of the study was to create an age related normogram of AFC in women with PCOS and to compare it with those without PCOS using MRI. Women between the ages of 18 to 45 were included in the study. A total of 1500 women were examined, out of which 400 fitted the criteria for

IntrOductIOnIntermittent claudication due to peripheral arterial disease occurs in 3 to 6% of elderly population [1,2]. Clinical evaluation followed by Doppler ultrasound and CT angiogram gives the definitive diagnosis. After the advancement of CT techniques, it is possible to cover entire limbs within a few seconds. Optimization of intravenous contrast with blood flow and CT scanning gives higher spatial resolution and coverage of more than 120cm [2]. Computers with graphics project images in 3D, volume rendered images and curved planar images. Imaging of the entire arterial system is possible using CT angiography and has found excellent concordance with digital subtraction imaging [3]. As there is need of accurate, reliable and reproducible non-invasive evaluation, segmental comparison of peripheral arterial system by Doppler ultrasound (USG) and CT Angiography (CTA) is done. MAtErIALS And MEtHOdSFifty patients (median age-47.5 years, min-3, max-80; F: M=20:80) were evaluated using duplex Doppler and CT angiography for peripheral arterial system. Each arterial segment was analysed with both modalities. This study was a prospective study involving symptomatic patients of peripheral arterial disease. The study was approved by the academic and ethical committee of the institution. Subjects included were willing to undergo the protocol design after written consent. Patients who are allergic, pregnant, refused the protocol and did not give consent were excluded. After taking a brief history, Doppler USG and CTA were scheduled and instructions were given. CTA was performed after Doppler USG in all patients. The study duration of investigations for each patient was not more than 2 days.There were 14 patients with upper limb complaints (15 upper limbs) and 36 patients with lower limb complaints (72 lower limbs). One patient had unilateral above knee amputation and two had unilateral below knee amputation.Duplex DOPPLER evaluation is done using TOSHIBA NEMIO XG ultrasound system (Toshiba Medical Systems). Patients made to lie on USG couch in supine position for evaluation of iliac, femoral, tibial and dorsalis pedis arteries and popliteal artery was evaluated in prone position. Upper limbs were evaluated in supine position. Patients suspected of compression at the thoracic outlet evaluated in different provocative positions (hyperabduction, extension and deep inspiration). Using linear (6-12MHz) transducer, peripheral arteries evaluated in longitudinal and axial sections in B mode, colour flow, power and pulse wave modes in proximal to distal parts. Curvilinear (3-9MHz) transducers were used for iliac arteries. Pulse repetition frequency (PRF) was set optimally to detect best velocity and colour flow.Normal appearance of arteries was inferred when the lumen appeared clear with thin uniform walls. Areas of soft or calcified atheroma can be seen within vessel lumen. Abnormal dilatations, thrombus and luminal narrowing appreciated from B mode images. The colour image demonstrated pulsatile flow of alternating red and blue...

This was a prospective study, done in our institution from January 2016 to August 2017 with a sample size of 90, after due clearance from the institutional ethical committee. Written informed consent was obtained from all patients prior to the study procedure or data collection. Patients of all age group with ear complaints, such as hearing loss, pain, vertigo, ear discharge and tinnitus referred for HRCT temporal bone were included. Patients with a recent history A B S T R A C T Introduction: Diseases of the ear are a common clinical problem, encountered in every day. Clinical examination alone is not sufficient in present days, owing to prevalence, complications and recurrence of various pathologies of the temporal bone, imaging plays a major role in the management and influences the treatment. High-resolution computed tomography (HRCT) offers an excellent resolution, allowing a better understanding of the aetiology, pathology, disease course with early detection of complications. The prospective study aimed to study pathologies of the temporal bone along with their complications on HRCT and to correlate with their surgical findings. Material and Methods: A prospective study done with a sample size of 90 patients with ear complaints, such as hearing loss, pain, vertigo, ear discharge and tinnitus and referred for HRCT temporal bone were included. Ear trauma and head injury, pregnant women and those unwilling to give consent were excluded. HRCT was done using a GE 128 Slice CT scanner and were followed up for surgical or medical methods of management. Images are reconstructed in the ultra-sharp bone algorithm for image reconstruction, analysed for reporting. The intraoperative findings such as middle ear soft tissue density, ossicular erosion, erosion of scutum, tegmen tympani and facial canal, fistulous communication between the middle ear and lateral and posterior semicircular canal. Above findings were analyzed using standard statistical methods. Results: There is an excellent radio-surgical correlation in diagnosing and differentiating cholesteatoma from granulation tissue, identifying malleus erosion, incus erosion, tegmen tympani erosion, scutum erosion, EAC erosion, sigmoid plate dehiscence, high riding jugular bulb, mastoid status/erosion. Moderate to poor radio-surgical correlation was noted in identifying LSCC fistula, stapes erosion and facial canal erosion. Conclusion: HRCT is a valuable imaging modality through which pre-operative assessment of temporal bone pathologies can be done efficiently with reasonable accuracy, cost and precision for making surgical decisions. Hence it helps the surgeon to decide the course of action in particular clinical problem.

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Limiting irreversible ischemic insult to brain parenchyma is possible with early detection using perfusion CT. Studying time to peak (TTP), cerebral blood volume (CBV) and cerebral blood flow (CBF) in patients with stroke help to identify the risk areas. METHODS: Of the 72 patients with stroke, 20 patients with acute symptoms of less than 4 hours were selected. Non-enhanced CT (NECT) of brain, perfusion CT in the selected area of interest and immediate contrast study for major blood vessel occlusion done. Perfusion parameters were analysed in different regions of interest and analysed for statistical significance. Follow up CT brain was done after 48 hours to assess the size of hypodensity and compared with NECT. RESULTS: TTP value increased in regions of hypodensity and surrounding areas. TTP, relative CBV (rCBV) and CBV ratio showed a significant statistical difference (p<0.05) in penumbra and infarct regions. CBV values showed a significant statistical difference (p<0.05) between infarct and penumbra regions of the same hemisphere. CONCLUSION: TTP map can be used as initial map for identifying ischemic area. rCBV and CBV ratio helps in identifying reversible ischemic area.