Associated Radiologists

Background: Acute pancreatitis (AP) is an acute inflammatory condition of the pancreas with a wide spectrum of clinical severity, ranging from mild disease to severe forms associated with complications and mortality. Early assessment of disease severity is essential for effective management. Contrast-enhanced computed tomography and the CT Severity Index are widely used imaging tools for evaluating pancreatic inflammation, necrosis, and predicting clinical outcomes. Objective: To evaluate the role of CECT in patients with acute pancreatitis and determine its prognostic correlation with the CT Severity Index. Methods: This prospective observational study was conducted in the Department of Radiology, Sadar Hospital, Lakhisarai, Bihar, India and Sonoscan Pvt.Ltd, Malda, West Bengal, India. over a period of 8 months. A total of 80 patients diagnosed with acute pancreatitis based on clinical and laboratory findings were included. All patients underwent CECT abdomen within 72 hours of symptom onset. CT findings were assessed for pancreatic inflammation, necrosis, and peripancreatic complications, and CTSI scores were calculated. Clinical outcomes including hospital stay, organ failure, ICU admission, and mortality were recorded and correlated with CTSI. Results: Gallstones (45%) and alcohol (35%) were the most common etiological factors. Most patients had mild to moderate diseases based on CTSI. Higher CTSI scores were significantly associated with longer hospital stay, increased complications, ICU admission, and mortality. Conclusion: CECT with CTSI is a reliable imaging modality for early diagnosis, severity assessment, and prognostic evaluation in acute pancreatitis, aiding clinicians in risk stratification and appropriate management.

A 54-years-old man presented with 3 days history of fever and headache followed by acute confusion. He was a known case of hypertension and diabetes mellitus for 10 years. He was obese; neck rigidity was noted; Glasgow Coma Scale was 9/15 (E3,V1, M5). Cerebrospinal fluid examination showed high protein, low normal sugar with cells predominantly neutrophils compatible with pyogenic meningitis; Streptococcus agalactiea was detected in CSF. It was complicated by metabolic acidosis, acute kidney injury, transaminitis, DIC and ARDS. He passed away 58 hours after hospitalization. Autopsy findings were discussed. Article Details

situs inversus with dextrocardia is a rare congenital anomaly. This is a reverse isomeric form of the thoracic and abdominal viscera or the complete mirror image. Acquired mitral valve disease that requires surgery in a patient with dextrocardia and situs inversus is an exceptional finding. The transseptal approach for mitral valve surgery in dextrocardia represents a technical challenge owing to its anatomic particulars. Here, biatrial cannulation was performed with the surgeon standing on the patient's right side, and mitral valve replacement using a transseptal approach was performed with the surgeon standing on the patient's left side. In this case report, we emphasize the rarity of mitral valve disease in a patient with dextrocardia and the inherent potential difficulty that appears in this particular anatomic condition.

Objective: To determine the correlation of mean Bone age (BA), estimated with Greulich-Pyle(GP) method, with Chronological age (CA) in Pakistani individuals. Study Design: Cross-sectional study. Place and Duration of Study: Department of Diagnostic Radiology, KRL General Hospital, Islamabad, 06 months (April to September 2017). Methodology: A cross-sectional, observational study was done in Islamabad, comprising 250 individuals of both genders, selected through a non-probability consecutive sampling. Data were gathered on a prescribed proforma, and analysed by SPSS version 23. Results: Total of 250 individuals participated in this study. Skeletal age (SA) was estimated by observation of hand-wrist radiographs, using the GP atlas. Pearson correlation showed a significant correlation of SA & CA (r = 0.91; p-value < 0.0005). Stratification analysis was performed. Pearson correlation was found to be positive and highly significant for different CAs, gender and ethnicity groups. Conclusion: A positive correlation was found between GP atlas method in assessing SA and CA in the population of Pakistan. It can be used as quick, inexpensive and reliable method for SA estimation. Keywords: Chronological age, Greulich-Pyle method, Skeletal age.

Pelayanan prima dalam bidang radiografi sangat penting untuk meningkatkan kepuasan pasien dan efisiensi pelayanan kesehatan. Pelayanan prima dalam bidang kesehatan menjadi salah satu faktor penting dalam meningkatkan kualitas layanan kepada pasien. Radiografer sebagai tenaga kesehatan yang bertanggung jawab dalam pemeriksaan radiologi memiliki peran signifikan dalam memberikan pelayanan yang optimal. Namun, masih ditemukan berbagai kendala dalam pelayanan radiologi, seperti kurangnya komunikasi efektif, empati, serta pemahaman terhadap kebutuhan pasien. Oleh karena itu, pelatihan pelayanan prima bagi calon radiografer menjadi suatu kebutuhan yang mendesak. Program ini bertujuan untuk memberikan pelatihan mengenai pelayanan prima kepada calon radiografer. Pelatihan meliputi komunikasi efektif, etika profesi, dan teknik pelayanan berkualitas. Pelatihan ini juga bertujuan meningkatkan kompetensi calon radiografer dalam memberikan pelayanan prima, baik dari aspek komunikasi, keterampilan teknis, maupun sikap profesionalisme. Metode yang digunakan dalam pelatihan ini mencakup teori, studi kasus, serta simulasi praktik langsung dengan pasien. Hasil menunjukkan peningkatan signifikan dalam keterampilan pelayanan peserta pelatihan. Hasil dari pelatihan juga menunjukkan adanya peningkatan pemahaman dan keterampilan peserta dalam memberikan pelayanan yang lebih ramah, efisien, dan berorientasi pada kepuasan pasien. Umpan balik dari peserta pelatihan menunjukkan bahwa metode pembelajaran yang interaktif dan berbasis praktik sangat membantu dalam memahami konsep pelayanan prima. Kesimpulannya, pelatihan ini berkontribusi dalam meningkatkan kesiapan calon radiografer dalam menghadapi tantangan di dunia kerja dan meningkatkan kualitas pelayanan radiologi di fasilitas kesehatan.

The urgency for climate action is recognized by international government and healthcare organizations, including the United Nations (UN) and World Health Organization (WHO). Climate change, biodiversity loss, and pollution negatively impact all life on earth. All populations are impacted but not equally; the most vulnerable are at the highest risk, an inequity further exacerbated by differences in access to healthcare globally.The delivery of healthcare exacerbates the planetary health crisis through greenhouse gas emissions, largely due to combustion of fossil fuels for medical equipment production and operation, creation of medical and non-medical waste, and contamination of water supplies. As representatives of radiology societies from across the globe who work closely with industry, and both governmental and non-governmental leaders in multiple capacities, we advocate together for urgent, impactful, and measurable changes to the way we deliver care by further engaging our members, policymakers, industry partners, and our patients. Simultaneous challenges, including global health disparities, resource allocation, and access to care, must inform these efforts.Climate literacy should be increasingly added to radiology training programs. More research is required to understand and measure the environmental impact of radiological services and inform mitigation, adaptation and monitoring efforts. Deeper collaboration with industry partners is necessary to support innovations in the supply chain, energy utilization, and circular economy. Many solutions have been proposed and are already available, but we must understand and address barriers to the implementation of current and future sustainable innovations. Finally, there is a compelling need to partner with patients, to ensure that trust in the excellence of clinical care is maintained during the transition to sustainable radiology.By fostering a culture of global cooperation and rapid sharing of solutions amongst the broader imaging community, we can transform radiological practice to mitigate its environmental impact, adapt and develop resilience to current and future climate and environmental threats, and simultaneously improve access to care.Key PointsQuestionWhat actions can professional societies take to improve the environmental sustainability of radiology?FindingsBetter understanding of resource usage in radiology is needed; action is required to address regional and global disparities in access to care which stand to be exacerbated by climate change.Clinical relevanceRadiological societies need to advocate for urgent, impactful, and measurable changes to mitigate the environmental impact of radiological practice. Research and education, as well as adaptation and resilience to current and future climate and environmental threats, must be prioritized while simultaneously improving access to care.Graphical

Percutaneous renal biopsy is widely used for diagnosis, prognosis, and management of nephropathies. Early identication and embolization of the involved artery aids in effective management of the vascular complications and defers the need for nephrectomy. In this study, we aimed to evaluate various vascular injuries after renal biopsy requiring interventions. Pseudoaneurysm was the most common form of arterial injury. Target vessel was identied by angiography and successful embolization was done deferring nephrectomy. Deaths occurred due to haemorrhage.

Objective: To evaluate the role of dual-energy CT (DECT) and contrast enhancement in differentiating benign from malignant gallbladder (GB) diseases. Methods: Ninety patients (21–70 years) with GB wall thickening >3 mm or GB mass on ultrasonography undergoing cholecystectomy were enrolled. CT was performed using a 384-slice Siemens SOMATOM Force dual-source DECT scanner. Non-ionic contrast (iopromide, Ultravist 370) was administered, and attenuation images were acquired at 80 and 140 kVp. Parameters assessed included wall thickening and its pattern, presence and extent of polypoidal mass, iodine uptake in GB wall and pericholecystic liver parenchyma, attenuation pattern, pericholecystic invasion, and lymphadenopathy. DECT diagnoses were made by consensus of two radiologists. Histopathological examination (HPE) served as the reference standard. Data were analyzed using SPSS 21.0, with chi-square and independent t-tests applied. Diagnostic performance indices of DECT were calculated. Results: On HPE, 51 cases (56.7%) were benign and 39 (43.3%) malignant. Malignant cases had significantly higher mean age (51.13±11.80 years) than benign (41.18±10.01 years) (p<0.001). Most patients were female (71.1%) and from rural areas (63.3%). No significant association of clinicodemographic factors with HPE diagnosis was noted. On DECT, focal irregular wall thickening, mass replacing GB, increased iodine uptake in GB wall and pericholecystic liver, invasion, and lymphadenopathy were significantly linked to malignancy, whereas regular circumferential thickening suggested benignity. DECT diagnosed malignancy in 36 cases (40%) and benign disease in 54 (60%). Sensitivity, specificity, positive predictive value, negative predictive value, and accuracy of DECT were 79.5%, 90.2%, 86.1%, 85.2%, and 85.6%, respectively.Conclusion: Dual-energy CT is a reliable tool for distinguishing malignant from benign GB diseases, with good diagnostic accuracy. Its wider application may improve early detection, though further exploration is warranted.