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Stroke is the third leading cause of mortality worldwide. Combined carotid intima-media thickness (CIMT) is a marker of atherosclerosis and is also a predictor for ischemic stroke. We determined the frequency of CIMT in patients with acute ischemic stroke and in matched controls and also the risk factors for CIMT. Sixty patients with ischemic stroke diagnosed by computer tomography (CT) scan and 50 controls matched by age, gender, diabetes, and hypertension were studied. Subjects in both groups underwent carotid duplex scanning (ACUSON 128 x P/10 machine) with a 7.5 MHz linear superficial array probe in B-mode to determine the CIMT and presence of plaques. The mean age in the patient group was 62 years and 63.3% were males. The average CIMT in the patient group was 0.798 mm and it was 0.6 mm in the control group (P < 0.0001). Patients with carotid plaque had significantly increased IMT (0.95 +/- 0.22) when compared to patients without plaques (0.71 +/- 0.12) (P < 0.001). When the differences in mean IMT were compared among the different age groups in the patient group, there was significance (P < 0.05). In this study the CIMT was independently associated with increasing age and with the presence of carotid plaques.

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Objectives:Preoperative chemotherapy plays a key role in management of bone sarcomas. Postoperative evaluation of histological necrosis has been the gold standard method of assessing response to preoperative chemotherapy. This study was done to evaluate the efficacy of static and dynamic magnetic resonance imaging (MRI) for assessing response preoperatively.Materials and Methods:Our study included 14 patients (12 osteosarcomas and 2 malignant fibrous histiocytomas) with mean age of 21.8 years, treated with preoperative chemotherapy followed by surgery. They were evaluated with static and dynamic MRI twice, before starting chemotherapy and again prior to surgery. Change in tumor volume and slope of signal intensity - time curve were calculated and correlated with percentage of histological necrosis using Pearson correlation test.Results:The change in dynamic MRI slope was significant (P = 0.001). Also, ≥60% reduction in slope of the curve proved to be an indicator of good histological response [positive predictive value (PPV) =80%]. Change in tumor volume failed to show significant correlation (P = 0.071). Although it showed high negative predictive value (NPV = 85.7%), PPV was too low (PPV = 57.14%).Conclusions:Dynamic MRI correctly predicts histological necrosis after administration of preoperative chemotherapy to bone sarcomas. Hence, it can be used as a preoperative indicator of response to neoadjuvant chemotherapy. On the other hand, volumetric assessment by static MRI is not an effective predictor of histological necrosis. This study proves the superiority of dynamic contrast-enhanced study over volumetric study by MRI.