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Introduction: Contrast-induced acute kidney injury (AKI) is one of the most common causes of hospital-acquired AKI. Objectives: To determine the incidence of contrast induced nephropathy (CIN), to identify significant risk factors associated with CIN and to compare the variations in serum creatinine levels with and without contrast exposure. Patients and Methods: A total of 222 patients (124 males and 98 females with mean age of 48.96 ± 16.74 years) who received iodinated contrast agents during different procedures over a period of 18 months were included in the study. CIN was defined as a relative increase of >25% or an absolute increase of > 0.5 mg/dL in serum creatinine levels 4 days post-procedure. 148 patients (82 males and 66 females with mean age of 47.48 ± 17.21 years) who did not receive any contrast agent were included as controls to determine the frequency with which the variations in serum creatinine levels fulfilled the definition of CIN. Results: The overall incidence of CIN was 12.6%. Incidence of CIN was 32.6% after percutaneous coronary intervention (PCI) and 7.38% after IV contrast exposure (P < 0.0001). Multivariate logistic regression analysis of risk factors revealed heart failure (P = 0.001), pre-procedure serum creatinine level ≥ 1.5 mg/dL (P = 0.005) and nature of contrast agent (P = 0.001), as independent risk factors of CIN. 2.02% patients in control group showed variations in serum creatinine levels within the range corresponding to the definition of CIN. Conclusion: Heart failure, pre-procedural serum creatinine of ≥ 1.5 mg/dL and the nature of contrast agent are independent predictors of CIN.

Objective The treatment of cystic craniopharyngioma in children is varied. The treatment ranges from radical excision to direct radiotherapy. As the morbidity of excision is high, more conservative approaches are used. Transventricular endoscopy is a minimally invasive treatment for cystic craniopharyngiomas. The objective of this study is to compare the outcome of microscopic versus endoscopic transventricular approach for cystic craniopharyngioma. Methods This is a retrospective study of series of children managed with microscopic excision and endoscopic transventricular approach for suprasellar cystic craniopharyngiomas. Operative details, visual outcome, endocrinological outcome, tumor-related cyst recurrence rate, and complication were compared between microscopic and endoscopic groups. Results A total of 28 children underwent microscopic excision and 14 children underwent endoscopic procedure. The anesthesia time was significantly lower with endoscopic as compared to microscopic group (p = 0.0001) as well as blood loss during surgery (p = 0.0001). Hospital stay after surgery was shorter in endoscopic group. Incidence of diabetes insipidus was more in microscopic group (25%) compared to endoscopic group (7.14%). Visual outcome was almost same with approaches. Requirement of hormone replacement was more in microscopic group than in endoscopic group (p = 0.006). Incidence of cyst recurrence was more in microscopic (39.3%) compared to endoscopic group (7.7%). Conclusion Endoscopic transventricular approach is a safe alternative for initial treatment of suprasellar cystic craniopharyngioma in children.

International Journal of Case Reports and Images (IJCRI) is an international, peer reviewed, monthly, open access, online journal, publishing high-quality, articles in all areas of basic medical sciences and clinical specialties.Aim of IJCRI is to encourage the publication of new information by providing a platform for reporting of unique, unusual and rare cases which enhance understanding of disease process, its diagnosis, management and clinico-pathologic correlations. Case Report: A case of 20-year-old female, primigravida, in 22nd week of pregnancy who presented to our hospital with a three-day history of colicky abdominal pain, few episodes of vomiting and obstipation. Ultrasound showed a single live intrauterine fetus and a dilated gut loop extending from left hypochondrium to the left iliac fossa. T2-weighted TRUFI and HASTE MR Images in axial and coronal plane showed radiological signs highly suggestive of sigmoid volvulus. The radiological findings were confirmed on laparotomy and detorsion of the sigmoid loop with decompression followed by sigmoidopexy was performed. No maternal or fetal complications occurred in the perioperative period. Conclusion: Sigmoid volvulus is a rare non-obstetric complication of pregnancy which requires an early diagnosis and prompt intervention to prevent maternal and fetal complications. Magnetic resonance imaging scan can provide an accurate diagnosis of sigmoid volvulus and its use is safe in pregnancy with respect to the risks of radiation exposure in pregnancy. IJCRI publishes

Vertebral arteriovenous fistula is an abnormal communication between the vertebral artery and adjacent venous structures. The most common cause of vertebral arteriovenous fistula is trauma, however, spontaneous occurrence is also known. We report a case of traumatic pseudoaneurysm with associated vertebral arteriovenous fistula which occurred following stab injury to the left vertebral artery. The diagnosis was suspected clinically and on CT angiography. Digital subtraction angiography confirmed the diagnosis, and a covered stent was placed in the left vertebral artery at the site of the injury following which there was complete closure of the pseudoaneurysm and fistula and anterograde flow was restored in the vertebral artery.