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Even though first described in 1923, the syndrome of pancreatic encephalopathy is an uncommon complication of acute pancreatitis. A multiple organ dysfunction syndrome, it generally occurs in early stage of severe acute pancreatitis and carries a high mortality of up to 57% and more. The syndrome must be distinguished from Wernicke encephalopathy, which may follow as a part of neurological complications in the last or restoration stage of acute pancreatitis, and occurs as a result of long fasting, hyperemesis and total parenteral nutrition without thiamine. Poorly recognized by clinicians, a large dose of Vitamin B1 is effective in the management of Wernicke encephalopathy. The present article draws attention to the two lesser recognized complications of acute pancreatitis and briefly dwells on their pathogenesis and management.

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Spinal lesions are broadly categorized as lesions encountered in the spine and epidural space, lesions of spinal meninges, lesions of spinal nerve roots, and lesions of spinal cord. These are further sub classified into congenital malformations, inflammatory disorders, degenerative and reactive processes, cystic lesions, vascular malformations, and neoplasms. This pictorial essay highlights the histopathology of these lesions along with the clinical and radiology findings, where relevant.

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Derived from the Latin term ule, which means scarring, ulegyria is a manifestation of hypoxic ischemic encephalopathy. Recognizable on the magnetic resonance imaging sequences because of its characteristic features, the diagnosis is critical from the standpoint of clinical management. Seizures caused by ulegyria are refractory to pharmacotherapy and often do well with surgery.

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Background: While the hardships faced by children with cerebral palsy are well known, there is a crying need to understand if their caregivers also suffer both mentally and physically due to the disability of the children. Aim: To study the physical and mental health of the caregivers of children with cerebral palsy and how various factors may influence the same. Settings and Design: This was a descriptive study and was conducted in the Department of Physical Medicine and Rehabilitation, All India Institute of Medical Sciences, New Delhi. Materials and Methods: Study sample consisted of 65 primary caregivers of children with cerebral palsy. Questionnaires about physical and mental health from family burden scale were used. Descriptive statistics and multiple regressions were used for data analysis. Results: Both physical and mental health of the caregivers were affected to some extent. A significant association was found between physical health of caregivers and duration of knowing the diagnosis, seizures, and mental retardation in the children. Moreover, impact on mental health was significantly associated with total number of children, duration of care giving, knowing the diagnosis, speech disturbance, seizures, and mental retardation in children. Conclusions: Caregivers of children with cerebral palsy experience some effects on their physical and mental health, which are associated with various factors. Therefore, healthcare professionals should also provide care and support to these caregivers, so that they can effectively and efficiently care for their children with cerebral palsy.

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Objective: The objectives of our study were to evaluate the role of conventional radiography, computed tomography (CT), and magnetic resonance imaging (MRI) in the detection of sacroiliitis in ankylosing spondylitis (AS), along with the radiological spectrum of disease. Materials and Methods: Thirty-six patients with symptoms of inflammatory back pain (IBP) were evaluated with conventional radiography, CT, and MRI. The sacroiliac (SI) joints were evaluated for joint margins, joint space, sclerosis, and bone marrow changes. Imaging findings were analyzed for correlation with multiple clinical characteristics and comparison among different imaging modalities. Results: CT and MRI are extremely useful in the absence of alterations or minimal changes on plain radiographs. CT is comparable to MRI for joint space alteration, however, itis superior for evaluating bone sclerosis and erosion, and is indicated especially for detecting chronic alterations. The capability of MRI to distinguish between acute and chronic changes and estimate the degree of disease activity and damage present at diagnosis can be beneficial in monitoring the effect of pharmacological treatment. The administration of Gadolinium did not provide any additional information for the diagnosis of sacroiliitis and the evaluation of the features of active inflammation. Conclusions: Between radiography, CT and MRI, MRI outscores the others in being able to delineate the inflammatory changes of early sacroiliitis in AS. Therefore, if early sacroiliitis is suspected clinically, MRI should be the preferred imaging modality for evaluating the SI joint. However, CT is more sensitive than radiography and MRI in detailing the structural changes of sacroiliitis in AS.

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Shoulder joint pain is one of the most common complaints that are encountered in orthopedic outpatient department. Clinical examination of the shoulder joint does not provide adequate cause of the shoulder pain. Although magnetic resonance imaging (MRI) is said to be the gold standard for imaging of shoulder joint, with the recent advances in ultrasonography, results of imaging of shoulder joint pathologies are similar or in some cases more precise for the diagnosis compared to MRI. In this pictorial essay, we are presenting a spectrum of various positive findings in patients with painful shoulder based on high-resolution sonographic study of 90 patients at our institute.

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Dental anomalies are formative defects caused by genetic disturbances during tooth morphogenesis.Taurodontism is one such anomaly. Taurodontism can be defined as as “a tendency for the body of the tooth to enlarge at the expense of the roots.” Whereas Witkop defined it as “teeth with large pulp chambers in which the bifurcation or trifurcation is displaced apically and hence that the chamber has greater apico-occlusal height than in cynodont teeth and lacks the constriction at the level of cemento-enamel junction (CEJ). The distance from the trifurcation or bifurcation of the root to the CEJ is greater than the occluso-cervical distance.

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Purpose: We aimed to evaluate the efficacy of staging of laryngeal tumors by clinical and radiological parameters and role of computed tomography (CT) and magnetic resonance imaging (MRI) in the detection of cartilage invasion. We have done a randomized, cross-sectional study. Materials and Methods: The study comprised 33 patients (29 males and 4 females) and included patients who were clinically diagnosed patients of laryngeal masses, were first evaluated under indirect laryngoscopy and then sent for CT and MRI. Postimaging biopsy was undertaken via direct laryngoscopy. Patients who had contraindications to magnetic resonance (MR) evaluation (pacemakers, claustrophobia, metallic implants) and intravenous administration to contrast material (renal impairment) and patients who were unable to restrain movement and pregnant women were excluded from the study. Results: The sensitivity and specificity in cartilage invasion were as follows: thyroid cartilage (91.7% vs. 71.4%); cricoid cartilage (85.7% vs. 75%); and arytenoid cartilage (91.7% vs. 71.4%). The accuracy rate of MRI in detection of cartilage invasion was thyroid cartilage 84.2%; arytenoid cartilage 84%; cricoid cartilage 78.9%. Diagnostic accuracy of CT staging versus histopathological staging showed sensitivity 60.0%, specificity 85.7%, positive predictive value (PPV) 60.0%, negative predictive value (NPV) 85.7%, accuracy 78.9% (P = 0.084). Diagnostic accuracy of MR staging versus histopathological staging showed sensitivity 80.0%, specificity 92.9%, PPV 80.0%, NPV 92.9%, accuracy 89.5% (P = 0.006). Conclusion: MRI is significantly more sensitive but less specific than CT in detecting neoplastic cartilage invasion. MRI offers higher staging accuracy as compared to CT (89.5% vs. 78.0%) with better soft-tissue resolution and multiplanar imaging.

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Lichen planus is a relatively common mucocutaneous disorder in adults, but it is rarely reported in children. Much less data is available regarding lichen planus in children. This is a report with intraoral lesions of lichen planus. Lichen planus, although reportedly rare in childhood, should be considered in the diagnosis of hyperkeratotic or erosive lesions of oral mucosa in children.

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Hemangiomas are the most common vascular tumors. Lymphatic, capillary, venous, and arteriovenous malformations make up the majority of vascular malformations. Intramuscular hemangioma (IMH) is a relatively rare benign tumor of vascular origin accounting for less than 1% of all hemangiomas. The possible sites of occurrence in oral cavity are lips, tongue, buccal mucosa, and palate. IMH arises most frequently in the masseter and trapezius muscle. Due to its location, it is often mistaken for a parotid swelling and rarely is an accurate preoperative diagnosis achieved clinically. The intra-masseteric site also creates special problem in terms of proximity to the facial nerve. Despite its benign origin and behavior, it is always of clinical importance to the dental profession and requires appropriate management. This article reports an unusual case of a 19-year-old female patient with IMH involving the buccal mucosa, treated with complete surgical excision.

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We report a rare case of Type II first branchial cleft cyst (FBCC) that presented as a preauricular cyst attached to the root of helix. Rarity and varied presentations of the FBCCs have led to frequent misdiagnosis. High index of suspicion is required. Complete excision along with attached cartilage is the main treatment.

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