Background: Nephrostomy performed as an emergency procedure to drain the obstructed calyceal system is a lifesaving procedure. Posterolateral approach is usually done to access the avascular plane of Brodel to avoid hemorrhage. This study evaluates the feasibility and complications in percutaneous nephrostomies placed at mid and anterior axillary line entry sites as it was found to be easier approach.Methods: A prospective study with 126 percutaneous nephrostomies performed with Ultrasound guidance, using single puncture technique and 8.5F pigtail catheter.  The complications rates were analyzed according to WHO guidelines. Results: The technical success rate was 98.4%. Three hemorrhagic complications (2.38%) were recorded without any major interventions. Increased incidence (11.9%) of transient hematuria was observed with five cases (3.9%) of infection at entry site. One case (0.79%) of peritoneal breech recorded with no significant intraperitoneal collection. Conclusions: Placement of Percutaneous Nephrostomy tube at mid or the anterior axillary line appears to be a feasible and easy approach, as its complications rates are within acceptable limits with an advantage of increased patient comfort.

Background: In the recent years High-resolution ultrasonography (HRUS) has geared up as a new diagnostic tool in the work-up of peripheral nerve diseases. As most of the peripheral nerves run a superficial course over a long tract, especially in the arms and legs which could be easily visualised using ultrasonogram. Aim: To assess the morphology of tibial nerve using ultrasonogram and correlate it with the glycemic score among the diabetes mellitus patients Methodology: A cross-sectional study was conducted for a period of 6 months in the radiology department. A non-random quota sampling was followed to select the sample size and based on that 50 subjects were taken as our study sample. All known type II diabetes patients with a history of peripheral neuropathy were included as our study subjects. Ultrasonography was performed for all study subjects with USG Samsung Accuvix XG Linear probe 5-12 MHz. The maximum thickness of the nerve fascicle was calculated by the largest antero-posterior dimension and the lateral dimension of the largest hypoechoic area in the short axis view of the tibial nerve. Results: Correlation between the HbA1C levels and the maximum thickness of nerve fascicles measurements shows that there was statistically significant positive correlation exist between the two parameters, as the levels of HbA1c increases the thickness of nerve fascicles also increases and similarly a statistical significant association was observed between the duration of diabetes and maximum thickness of nerve fascicles. Conclusion:Ultrasonography is an excellent diagnostic tool for detecting morphological changes in the tibial nerves in diabetic patients.

SummaryBackgroundAgenesis requires an extensive work-up as a number of associated other vascular and nonvascular anomalies can be expected. In this scenario, an associated ipsilateral basal ganglia bleeding with subarachnoid haemorrhage with no aetiology is uncommon. We present such a case of moderate ipsilateral ganglio-capsular bleed of unknown cause with associate aortic arch vessel anomaly.Case ReportA 45-year-old diabetic man of Indian origin with complaints of a sudden onset of giddiness, left-sided weakness and slurring of speech. Motor system examination revealed power of grade 2. Computed tomography scan revealed a moderate bleeding in the basal ganglia and the right temporo-parietal lobe. Angiography revealed unilateral aplasia of the internal carotid artery.Patient improved symptomatically with a motor system power of grade 4 after hematoma evacuation and treatment with antibiotics, anti-edema measures and neuroprotective drugs.ConclusionsDevelopmental anomalies of the carotid and aortic arch with intracranial bleeding is a rare occurrence and any arterial anomaly requires extensive evaluation.