The objective of this study was to evaluate the role of biceps tendon sheath effusion detected on ultrasound as a diagnostic clue to rotator cuff pathology. Despite being the most common cause of shoulder pain in adults early sonographic changes of rotator cuff tendinopathy are easy to miss. A total of 31 patients out of whom 27 had unilateral shoulder pain and 4 had bilateral complaints under- went ultrasonographic examination of shoulder joint using high frequency linear array transducer. Any fluid surrounding the long head of biceps tendon was noted followed by a careful search for any associated sonographic abnormality involving the rotator cuff. Eighteen out of the 35 had presence of fluid in their biceps tendon sheath. Twelve had presence of both biceps tendon sheath effusion and rotator cuff pathologies. Among 17 patients, who had no fluid in their biceps tendon sheath, only 2 had rotator cuff involvement whereas rest 15 had neither biceps tendon sheath fluid nor rotator cuff pathologies. A significant association was found between presence of fluid in long head of biceps tendon sheath and rotator cuff pathologies. Thus the most common finding observed in association with the presence of fluid around the long head of biceps tendon sheath in this study was tendinosis of rotator cuff. On ultrasonography simple presence of fluid around the long head of biceps tendon sheath demands careful examination of rotator cuff.

Post-traumatic seizure (PTS) is the development of recurrent seizures following head trauma and has a high clinical relevance. We tried to understand the epidemiology of PTS in a multicentric pro- spective study during the period May 2010 to April 2012. We included 320 patients excluding poor Glasgow coma scale (GCS) ie, <4 and history of previous epilepsy. At a median follow-up of one year, 49 patients (15.31%) developed PTS. Incidence of immediate, early and late onset seizures were 27 (8.4%), 14 (4.4%), 9 (2.8%) respectively. In this study incidence of PTS was high in patients of the age group 20-30 years, with road traffic accident, with poor GCS ie, < 9. High incidence of PTS was associated with x- ray findings of skull fracture and abnormal CT findings. Early use of anticonvulsants is ineffective in preventing early post-traumatic epilepsy.

Headache is a common symptom in paediatric hospital practice, the causes may be primary or secondary. A study was conducted in department of paediatrics from May 2005 to February 2007 in order to find out common causes for recurrent headache in children. A total of hundred children in age range of 3-14 years were included in the study. Children with secondary headache were excluded from the study. Various clinical characteristics were studied and based on these, types of headache were categorised using International Headache Society criteria. The most common type of headache observed was migraine (46%) followed by tension headache (31%), psychogenic headache (8%), mixed migraine and tension headache (7%) and other non-specific recurrent headaches (8%). There was clear cut female preponderance in adolescent patients having migraine. Tension headache is becoming a matter of concern in paediatric age group probably due to more competitive and stressful environment.

Current literature has suggested that sentinel lymph node biopsy may replace axillary dissection as the nodal staging procedure of choice in early breast cancer. The aim of this study is to evaluate the effectiveness and accuracy of sentinel lymph node biopsy using methylene blue dye in predicting axillary nodal status in early breast cancer with clinically impalpable axillary lymph nodes. In the period between June 2005 and May 2009, 50 patients with early breast cancer and clinically impalpable axillary lymph nodes, underwent sentinel lymph node biopsy using methylene blue dye followed by completion of axillary dissection in the same setting after taking a written consent from the patients. Of the included 50 patients, sentinel lymph node biopsy was successful in 48 patients (96.0%). Accuracy of sentinel lymph node biopsy was 95.8%, sensitivity was 90.0%, false negative rate was 6.7%, negative predictive value was 93.3%.

Air travel has become so common these days that about one billion people travel in one year. A few number of the persons travelling by air have suffered or are suffering from one or more medical conditions which may increase risk to passenger himself. There may be additional risk to copassengers, crew of aircraft or safety of aircraft may be compromised. The present article evaluates different medical conditions from pregnancy to cardiovascular diseases in relation to the air travel.

Bronchiectasis is an abnormal permanent dilatation distortion and destruction of the airways with both pulmonary and extrapulmonary side-effects. The aim of the study was to find out the presenting features, aetiologies and socioeconomic factors in patients of bronchiectasis. It is a prospective observational study comprising 53 patients over aperiod of two years. Aetiologies were determined using Kuppuswamy's socioeconomic scale. Number of exacerbations and mortality were noted. The age ranged from 14 to 80 years (mean: 43.33 ± 16.37 years). There were 35 males (66%) and 18 females (34%). Clubbing was seen in 58% cases (n = 31); 11% patients (n = 6) had haemoptysis. Bilateral involvement was seen in 64% cases (n = 34). Allergic bronchopulmonary aspergillosis and post-tuberculous sequelae were the commonest causes (n = 12, 23% each). The range of household medical expenditure in these patients varied from 6% to 47%. Lower the Kuppuswamy scale poorer the follow-up (p-value < 0.05). Multiple exacerbations were seen in all classes of patients (p-value 0.09). Death occurred in 4 patients. It is concluded that bronchiectasis is a chronic illness with significant morbidity and socioeconomic implications. Lower the socio-economic scale, poorer the compliance of therapy.