European Journal of Molecular & Clinical Medicine

Background - Shoulder pain is one of the commonest conditions encountered in our
orthopedic department. Accurate diagnosis is a must before undertaking any treatment. Since
clinical diagnosis cannot make an accurate diagnosis, radiological investigation is necessary
to know the exact cause of shoulder pain. There are a wide range of invasive and noninvasive
modalities that can be used to investigate these patients. Ultrasound examination is a
highly specific and sensitive modality in comparison with MRI. High-resolution real-time
USG has shown to be a cost-effective means of investigation of rotator cuff pathologies. With
recent advances with USG, results of imaging of shoulder joint pathologies are as similar or
in some cases more precise in the diagnosis than MRI.
Methods - Prospective analysis of 52 patients presenting with shoulder pain were included in
our study. A pre-formed written consent is also taken. All patients underwent a thorough
clinical examination, USG of the affected shoulder with comparison of the opposite side and
MRI of the affected shoulder for comparison.
Results - Ultrasound is equivalent in detection of rotator cuff tears in comparison with MRI.
MRI outscores ultrasound in detection of labral tears, cartilaginous lesions and subtle bony
lesions. USG examination can be used as the first line of investigating a case of shoulder pain
as it is inexpensive, real time and allows for comparison with the opposite side. MRI can be
used as a confirmatory tool.

Introduction:. The present study was conducted with an aim to assess the role of MRI for evaluation of adnexal masses and to find out the diagnostic accuracy of MRI in the diagnosis of adnexal masses against the gold standard test ‘histopathology’.
Materials and Methods: This is a prospective comparative study conducted in the Department of Radio Diagnosis, Index medical college hospital and research centre.50 women were taken in our study. These patients were first referred for ultrasonography with history of adnexal masses from gynaecological department. The magnetic resonance imaging was done using 1.5 Tesla MRI machine with patient in supine position.Then the lesion sample was taken and sent for histopathological examination. The results obtained on the MRI were evaluated against the histopathology results and the sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of MRI was calculated.
Results: Out of 50 patients, 33 (66%) adnexal masses were benign, 15 (30%) were malignant and 2 (4%) were inconclusive on ultrasonography, 35 (70%) adnexal masses were benign, 15 (30%) were malignant on magnetic resonance imaging. 37 (74%) adnexal masses were benign, 13 (26%) were malignant on histopathology. The sensitivity of MRI in the diagnosis of malignant / benign adnexal masses against the histopathology was found to be 92.31%, specificity was 91.89%, positive predictive value was 80.00%, negative predictive value was 97.14% and diagnostic accuracy was 92.00%.
Conclusion: Ultrasound is unable to differentiate adnexal masses into malignant and benign in some cases and gives inconclusive results. While MRI provides better spatial and contrast resolution in delineation of the anatomical structures as well as characterization of pathological lesions. It is highly accurate in identifying the origin of a mass, characterization and staging and helps in the treatment planning. These parameters have been found quite in agreement with the findings of histopathology

Liver abscess is a disease of frequent occurrence. Treatment modalities include both medical and surgical. However surgical drainage is the mainstay of treatment. With advent of ultrasound, percutaneous aspiration is becoming popular. Subjects from hospitals were grouped into those who underwent percutaneous aspiration and those who underwent pigtail catheter insertion. Both the groups are compared with the parameters like duration of hospital stay, duration to achieve symptomatic relief, duration of IV antibiotics required. A total of 106 subjects were studied. 52 of them underwent repeated percutaneous aspiration. 54 of them underwent pigtail catheter insertion. It is observed that pigtail catheter insertion is a better modality for larger abscess when compared to percutaneous aspiration in terms of duration of hospital stay, need for iv antibiotics and duration to achieve symptomatic relief.

Background: The shoulder arthroscopy is the gold standard of reference in most of the shoulder pathologies including Rotator cuff tears. However, it is an invasive surgical procedure with associated risks of surgery and anaesthesia. The objective of the present study is to find out how accurately the rotator cuff pathologies can be diagnosed by these imaging tests.
Aims and Objectives: To compare the Ultrasonography, MRI findings with the Arthroscopic findings of Rotator cuff pathology of the shoulder.
Materials and Methods: All patients in whom the history and clinical examination is suggestive of Rotator cuff pathology were included in the study. Patients were evaluated using high resolution Ultrasound (HRUS) Philips HD-11, Germany and 1.5-Tesla MRI [1.5 Tesla, GE, Excite HD and USA]. Ultrasonographic and MRI examination is performed by a single radiologist experienced in musculoskeletal ultrasonography and MR Imaging. A Real time high resolution USG imaging and MRI of the shoulder was performed in a standardized fashion and subsequently with therapeutic or diagnostic arthroscopy on the symptomatic shoulder. Results were analyzed.
Results: Considering arthroscopy as the final gold standard of investigation, out of the 24 patients studied, five (20.8%) had rotator cuff tendinosis/tendinopathy, four (16.6%) had PT RCT, twelve (50%) had FT RCT while the remaining three (12.6%) had normal rotator cuff. The average delay between the MRI examination and arthroscopic surgery was 6 days (range 0-27 days) but in one case, it was as long as 117 days. A total of five (20.8%) patients were in the age group < 40 years while another five (20.8%) were between 40-50 years age group. A majority of eleven (45.8%) patients were between 50-60 years old while three (12.6%) were above 60 years.
Conclusion: It should be noted that following USG of the shoulder performed by a dedicated radiologist, MRI offers little additional value, with regard to the detection of rotator cuff tears.

Introduction: Despite careful antenatal surveillance involving scrupulous examination, an issue of
considerable disappointment is that a majority of low-birth-weight infants are not diagnosed until
delivery. Low birth weight infants are susceptible to hypoxia and fetal distress, long-term handicap, and
fetal death.
Objectives: The present study will be undertaken in our institution to study the correlation of placental
thickness, measured at the level of the umbilical cord insertion, with the ultrasonographic gestational age
in normal women and fetal weight and outcome.
Methods: Present study was a single centric, observational, cohort, follow up, hospital-based study in
which 100 pregnant women who will come for ultrasound in third trimester during the study period was
recruited in the study. The relationship between placental thickness with fetal parameters, birth weight
and fetal outcome at delivery was investigated in this study. Correlation between placental thickness with
the fetal parameters, average gestational age, gestation at delivery, neonatal birth weight & APGAR
score, and placental weight was investigated during this study.
Results: Significant positive correction of placenta thickness was found with the gestation age, estimated
and actual fetal birth weight, and placenta weight. APGAR score showed negative correlation with the
placenta thickness. Positive correlation of placenta thickness was also found with the Biparietal diameter
(BPD), Head Circumference (HC), abdominal circumference (AC) and Femur length (FL).
Conclusion: Ultrasonography serves a significant role in estimating foetal weight, which is a crucial
component of prenatal care. Because of its linear association, placental thickness evaluated at the level
of umbilical cord insertion can be utilised as a reliable sonographic indication in the evaluation of. As a
result, it can be utilised as a secondary sonographic method for determining foetal weight.

Background: Hypertension is a common chronic disease worldwide and a major risk
factor for cardiovascular disease. The present study was conducted to assess awareness
towards hypertension management in general practitioners.
Materials & Methods: 125 general practitioners of both genders were enrolled. A
questionnaire was prepared and was distributed among all participants and response
was recorded.
Results: Out of 125 subjects, males were 65 and females were 60. The number of
readings of blood pressure was 1 by 15%, 2 by 40% and 3 by 35%. Cuff placement
covering 2/3 of arm at heart level was recommended by 78%. Preferred position of
patient was sitting by 48%, supine by 32% and standing and supine by 20%. The
difference was significant (P< 0.05). Investigation preferred by GP were RBS by 85%,
ECG by 96%, ultrasound of abdomen by 42%, serum creatinine by 85%, lipid profile
by 87%, serum potassium level by 70% and urine examination by 67%. The difference
was significant (P< 0.05).
Conclusion: Most of the general practitionershad sufficient awareness regarding
techniques and symptoms of hypertension.

Background: Among women, incidence rates for breast cancer significantly exceeded
those for other cancers in both transitioned and transitioning countries, it remaining as
a remaining as most commonly diagnosed cancer and the prominent cause of cancer
death in women worldwide. The present study was conducted to assess Clinico-radiopathological
Features and Biological Behavior of Breast Cancer in Young Indian
Women.
Materials and Methods: A prospective descriptive study was done among women aged
less than 40 years diagnosed with breast cancer. In patients with suspicious clinical or
ultrasound findings or if biopsy yielded malignancy, digital mammography was
performed. All the BI-RADS 4 and 5 lesions and few of the BI-RADS 3 lesions were
biopsied, and samples were sent for histopathology (HPE) and immunohistochemistry
(IHC) examinations. The data was collected on Microsoft Office Excel 2013 and
statistical analysis was performed using IBM SPSS version 21(Illinois, Chicago). P value
<0.05 was considered significant.

Background: Acute postoperative pain is a major problem, leads to undesirable outcome if not controlled probably. Therefore, appropriate management of acute perioperative pain using multimodal or balanced analgesia is crucial. The aim of the study was to compare between ultrasound guided quadratus lumborum block (QLB) and transversus abdominis plane (TAP) block as postoperative analgesia in lower abdominal surgeries. Patients & Methods: Thirty patients, aged from 21 to 50 years, ASA physical status I or II, scheduled for unilateral lower abdominal surgeries under general anesthesia were randomly divided into two equal groups of fifteen each. QLB group: patients received unilateral QLB block with 30 ml of 0.25% bupivacaine and TAP Group: Patients received unilateral TAP block with 30 ml of 0.25% bupivacaine. All patients in both groups were assessed for: Postoperative Visual analogue score (VAS), time to 1st rescue of analgesia, sensory block assessment (onset, level). In addition, total nalbuphine consumption in the first postoperative 24h and patient satisfaction were also recorded. Results: VAS was significantly higher in patients received TAP block. Patients received QLB showed rapid sensory loss with higher sensory block level in comparison to TAP block group. Time to 1st rescue of analgesia, was delayed in patients received QLB, so, this group showed longer duration of analgesia with higher satisfaction score than TAP group. In addition, the total nalbuphine consumption was higher in the first 24 hours in TAP block group compared to QLB group. Conclusion: The recently introduced QLB, may be a good option for postoperative pain relief after lower abdominal surgery with reduction of opioid consumption, prolonged duration of analgesia, and higher patient satisfaction compared to transversus abdominis plane block. We belief that if US guided QLB is performed by experienced hands; it is safe and effective technique for postoperative analgesia.

Background: The objective of the study is to develop a program of scoring for determining the degree of impairment of urodynamics and the preservation of renal function in children with obstructive uropathy on the basis of data from ultrasound - Doppler studies.
Methods: The work is based on the results of ultrasound and Doppler examination of 484 children with congenital obstructive uropathy. In accordance with the obtained data, a point assessment of the degree of impairment of urodynamics and preservation of renal function was carried out in 60 children with obstructive uropathies (30 children with congenital hydronephrosis and 30 children with congenital ureterohydronephrosis).
Results: Analysis of ultrasound and Doppler studies in congenital obstructive uropathy in children by comparing the data, depending on the severity and level of obstruction, revealed 3 degrees of congenital obstruction of the upper urinary tract in children. A comparative study of the urodynamics and state of the renal parenchyma, depending on the degree of obstruction, established a close relationship between the indicators of the functional state of the renal parenchyma and the degree of dilatation and disorders of the urodynamics of the upper urinary tract.
Conclusion: The developed program allows the safe and most informative methods to reliably determine the functional state of the renal parenchyma and the degree of urodynamic impairment in children with obstructive uropathy. Study Registration (ClinicalTrials.gov) ID NCT04605835.

gallstones are common diseases in many countries of the world , and incidence rate may reach about 20 % .Most cases of gallstones occur in females , the incidence rate may reach four times to one in comparison between women and men , mainly in fatty , fertile , age of forty female , gall stones are rare before age of 20 years ,but; may occur at any age . many cases are not diagnosed because they do not cause any signs or symptoms , and thus can only be diagnosed accidently by routine abdominal ultrasound.
The aim of study is to evaluate the relationship between age,sex and body mass index as risk factors for gallstone.
a cross sectional study was conducted in Tikrit city during the period from early of May to the end of October 2019 . 468 were enrolled in present study , and only 95 patients were diagnosed as a case of gallstone (29 male , 66 female). All patients attending private ultrasound clinic with different complains, data was collected by using certain questionnaire.
The results showed that, There was highly significant statistical relationship (P – value ≤0.05) between body mass index mean in both gallstone cases(26.628±5.808) and, in cases without gallstone(22.225±1.316). In the present study there was high statistically significant relation(P- value ≤ 0.05) between body mass index measurement above 25(31.97727273± 3.747859149) and measurement below 25(21.85882353± 1.616313889) in patients with gallstone.
The present study conclude that , Body mass index more than 25 considered as an important risk factor for gallstone.

Introduction: Leukemic involvement of the breast is extremely rare but constitutes an oncologic emergency. Imaging findings of T-Cell acute lymphoblastic leukemia (T-ALL) recurrence in the breasts have not been previously described. Case Description: Patient is a 25 year old female who presented with symptoms of superior vena cava (SVC) obstruction secondary to a mediastinal mass status post biopsy demonstrating T-ALL, which was cluster of differentiation 3 (CD3) positive and B-cell lymphoma 2 (BCL-2), and 80% Ki-67 positive. She was treated with chemotherapy and post-treatment positron emission tomography/computed tomography (PET/CT) demonstrated resolution of mediastinal mass, with no evidence of distant disease. She underwent allogeneic hematopoietic stem cell transplant (HSCT) in first remission. Seven months post-HSCT, patient presented with a large area of tender swelling of both the breasts with biopsy demonstrating relapsed T-ALL. Radiologic findings showed bilateral breast masses on ultrasound and mammogram, which were hypermetabolic on PET/CT. Conclusions: Breast involvement in leukemia recurrence, a very rare entity, can present with palpable masses. Mammographic findings in leukemia can include masses or architectural distortion, they are typically hyperechoic on ultrasound, and can have marked uptake on PET/CT. Oncologists, primary care providers and radiologists should be aware of leukemia presentations in the breast for prompt referral for urgent management.