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52. Role of Pigtail Catheter Drainage Versus Percutaneous Needle Aspiration in the Management of Liver Abscess: A Retrospective Analysis

Author

Kumar, Saurabh, Midha, Naresh K, Ahari, Kamlesh, Kumar, Deepak, Gopalakrishnan, Maya, Kumar, Bharat, Bohra, Gopal K, Garg, Pawan, Sureka, Binit, and Garg, Mahendra Kumar

Subjects
pigtail catheter drainage, pyogenic, Gastroenterology, General Engineering, Infectious Disease, percutaneous needle aspiration, amoebic, bacterial infections and mycoses, Family/General Practice, liver abscess
Abstract

Introduction A liver abscess is an important health concern in tropical countries. Effective management of liver abscesses includes appropriate antibiotics and drainage of the abscess cavity. Percutaneous abscess drainage by pigtail catheterization is now gaining popularity. We analyzed the role of pigtail catheter drainage over percutaneous aspiration in the treatment of liver abscesses. Methods and material This was a retrospective analytical study conducted in a tertiary care center in western India. Patients of age ≥ 18 years admitted with the diagnosis of liver abscess were included in this study. To find the effectiveness of different treatment modalities, data were analyzed in three groups: Group A (Conservative treatment), Group B (Percutaneous needle aspiration), and Group C (Pigtail catheter drainage). Results A total of 64 patients with a liver abscess were analyzed. There was male predominance (93.75%). Mean abscess volume in Group C (307.9 ± 212.8 ml) was significantly higher when compared to Group A (130.8 ± 72.9 ml, p = 0.03) and Group B (177.2 ± 129.5; p = 0.024). The duration of hospital stay and residual abscess volume at the time of discharge did not show a statistically significant difference between treatment groups. Pigtail catheterization of abscesses with volume >150 ml shortened the hospital stay, whereas it prolonged the hospital stay in patients with abscess volume 150 ml improved the clinical outcome.

Published
2021
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59. Magnetic Resonance Imaging in Coronavirus Disease - 2019 Associated Rhino-Orbital-Cerebral Mucormycosis (CA-ROCM) - Imaging Analysis of 50 Consecutive Patients

Author

Yadav, Taruna, primary, Tiwari, Sarbesh, additional, Gupta, Aanchal, additional, Garg, Pawan Kumar, additional, Khera, Pushpinder Singh, additional, Rajagopal, Rengarajan, additional, Goyal, Amit, additional, Soni, Kapil, additional, Chugh, Ankita, additional, Jain, Vidhi, additional, Sureka, Binit, additional, Elhence, Poonam, additional, and Misra, Sanjeev, additional

Published
2022
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62. Neuroendocrine tumors of the urinary bladder – Report of two cases

Author

Rao, Meenakshi, Dubey, Apoorvi, Pandey, Himanshu, Sureka, Binit, Garg, Pawan Kumar, Bohra, Harishkumar, and Elhence, Poonam

Subjects
Paraganglioma, Urinary bladder neoplasms, Carcinoma, Small Cell
Abstract

Primary paraganglioma and small cell neuroendocrine carcinoma of the urinary bladder are rare tumors, comprising 0.05% of all bladder tumors and

Published
2021

63. Predictors of Clinical Outcomes in Adult COVID-19 Patients Admitted to a Tertiary Care Hospital in India: an analytical cross-sectional study

Author

Chauhan, Nishant Kumar, Shadrach, Benhur Joel, Garg, Mahendra Kumar, Bhatia, Pradeep, Bhardwaj, Pankaj, Gupta, Manoj Kumar, Dutt, Naveen, Jalandra, Ram Niwas, Garg, Pawan, Nag, Vijaya Lakshmi, Sharma, Praveen, Bohra, Gopal Krishna, Kumar, Deepak, Elhence, Poonam Abhay, Banerjee, Mithu, Mathur, Deepti, Purohit, Abhishek HL, Gadepalli, Ravisekhar, Sureka, Binit, and Misra, Sanjeev

Subjects
Adult, Predictors, SARS-CoV-2, COVID-19, India, Outcomes, Prognosis, Original Investigations / Commentaries, Tertiary Care Centers, Cross-Sectional Studies, ROC Curve, D-dimer, Humans, SOFA score, Aged, Retrospective Studies
Abstract

Background: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has resulted in exponential rise in the number of patients getting hospitalised with corona virus disease 2019 (COVID-19). There is a paucity of data from South East Asian Region related to the predictors of clinical outcomes in these patients. This formed the basis of conducting our study. Methods: This was an analytical cross-sectional study. Demographic, clinical, radiological and laboratory data of 125 patients was collected on admission. The study outcome was death or discharge after recovery. For univariate analysis, unpaired t-test, Chi-square and Fisher’s Exact test were used. Receiver operating characteristic (ROC) curves were plotted for Sequential Organ Failure Assessment (SOFA) score and few laboratory parameters. Logistic regression was applied for multivariate analysis. Results: Elderly age, ischemic heart disease and smoking were significantly associated with mortality. Elevated levels of D-dimer and lactate dehydrogenase (LDH) and reduced lymphocyte counts were the predictors of mortality. The ROCs for SOFA score curve showed a cut-off value ≥ 3.5 (sensitivity- 91.7% and specificity- 87.5%), for IL-6 the cut-off value was ≥ 37.9 (sensitivity- 96% and specificity- 78%) and for lymphocyte counts, a cut off was calculated to be less than and equal to 1.46 x 109 per litre (sensitivity- 75.2% and specificity- 83.3%). Conclusion: Old age, smoking history, ischemic heart disease and laboratory parameters including elevated D-dimer, raised LDH and low lymphocyte counts at baseline are associated with COVID-19 mortality. A higher SOFA score at admission is a poor prognosticator in COVID-19 patients. (www.actabiomedica.it)

Published
2021

67. Rapid Response Preparedness for Management of Post-Covid Invasive Rhino-Orbito-Cerebral Fungal Infections: Experience from a Tertiary Care Government Institute in India

Author

Goyal, Amit, primary, Soni, Kapil, additional, Sharma, Vidhu, additional, Choudhury, Bikram, additional, Verma, Aman, additional, Kumar, Deepak, additional, Khichar, Satyendra, additional, Chugh, Ankita, additional, Sureka, Binit, additional, Srinivasan, Srikanth, additional, Bhardwaj, Pankaj, additional, Kamal, Manoj, additional, Agarwal, Ashwini, additional, Bhatnagar, Kavita, additional, Bhatia, Pradeep Kumar, additional, Garg, Mahendra Kumar, additional, and Misra, Sanjeev, additional

Published
2021
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70. American college of radiology thyroid imaging reporting and data system score has high diagnostic value in the diagnosis of malignant thyroid nodules: A prospective single-center cross-sectional study.

Author

Biswas, Souvik, Sureka, Binit, Kaushal, Darwin, Elhence, Poonam, Goyal, Amit, Yadav, Taruna, Goel, Akhil, and Khera, Pushpinder

Subjects
*THYROID cancer, *THYROID gland, *THYROID nodules, *CROSS-sectional method, *INDIANS (Asians), *NEEDLE biopsy
Abstract

Introduction: A palpable thyroid swelling is a very common finding and is seen in almost 12% of Asian Indian population. Thyroid imaging reporting and data system (TI-RADS) can be used as a risk stratification system to determine malignant or benign thyroid nodules and necessity of further intervention. Objective: The objective of this study was to determine the positive predictive value (PPV) of TI-RADS category/ultrasound using TI-RADS categories in the diagnosis of malignancy in clinically suspected thyroid nodule and necessity for further intervention in the case of malignant thyroid nodules. Materials and Methods: We conducted a prospective study evaluating 110 patients (140 thyroid nodules) from March 2018 to April 2020 including patients with thyroid swelling. Ultrasound was performed by a radiologist on the patients, and targeted fine-needle aspiration cytology from thyroid nodules was interpreted by an experienced pathologist. Ultrasound features and TI-RADS category were compared with cytology and surgical histopathology. Sensitivity, specificity, PPV, and positive likelihood ratio in different categories of TI-RADS nodules were calculated. Results: A total of 113 thyroid nodules were assessed. Out of 113 nodules (right lobe – 64, isthmus – 6, and left lobe – 43), 84 nodules were benign and 29 nodules were malignant. Eleven (10%) patients were found to have metastatic cervical lymphadenopathy. There was no significant difference in the occurrence of malignant nodules according to gender, location of the nodule, or size of the nodule. The mean anteroposterior and transverse diameter of benign nodule was 14.1 ± 6.9 mm and 20.9 ± 9.9 mm, respectively, whereas in the case of malignant nodules, it was 15.6 ± 7.1 mm and 19.5 ± 9.0 mm, respectively. A TI-RADS score of ≥4 had 84% PPV for malignancy. The PPV for malignancy was 32.2%, 49.1%, and 100% for TI-RADS 2, 3, and 5 categories. Conclusion: TI-RADS is a simple, practical, and cost-effective tool for assessing the malignancy rates of thyroid nodules. TI-RADS categories 4 and 5 have high PPV for malignancy in thyroid nodules. [ABSTRACT FROM AUTHOR]

Published
2022
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71. Acute Postoperative Pancreatitis after Craniotomy for Excision of Insular Glioma: A Classic Case of Whodunit.

Author

Ruparelia, Jigish, Gosal, Jaskaran Singh, Kumari, Kamlesh, Varshney, Vaibhav Kumar, Sureka, Binit, Bhaskar, Suryanarayanan, and Kaur, Manbir

Subjects
PANCREATITIS diagnosis, STEROIDS, GLIOMAS, HEADACHE, HEMIPLEGIA, ABDOMINAL pain, CRANIOTOMY, SURGICAL complications, PANCREATITIS, PROPOFOL, SEIZURES (Medicine), ANTICONVULSANTS, DISEASE risk factors
Abstract

Acute pancreatitis (AP) has been reported following abdominal surgeries. There are rare reports of AP developing following operations remote to the pancreas. We report a case of postoperative AP following craniotomy for tumor excision. A 15-year-old girl presented with a history of one episode of seizure, headache, and recent left-sided hemiparesis. She was found to have a right frontal glial lesion with extensive white matter tract edema. Craniotomy and excision was done. On the first postoperative day, she developed acute abdominal pain, with guarding and tenderness on examination. Radiological and biochemical evidence for AP was found. AP is a rare, but life-threatening complication. A number of drugs commonly used in neurosurgical practice can cause AP, which include steroids, antiepileptics, and propofol which are extensively used during surgery and for sedation in the intensive care area. [ABSTRACT FROM AUTHOR]

Published
2022
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72. Epithelioid angiomyolipoma with tumor thrombus in IVC and right atrium

Author

Gupta, Deepika, Vishwajeet, Vikarn, Pandey, Himanshu, Singh, Mahendra, Sureka, Binit, and Elhence, Poonam

Subjects
Histology, Angiomyolipoma, Epithelioid Cells, Kidney, Immunohistochemistry
Abstract

Epithelioid angiomyolipoma is an uncommon subtype of renal angiomyolipoma associated with potentially malignant behavior and is considered a distinct entity by the World Health Organization classification of renal tumors. We present a case of an epithelioid variant of angiomyolipoma with extension into the renal vein, inferior vena cava reaching up to the right atrium. Pre-operatively, a diagnosis of renal cell carcinoma was considered based on imaging findings. Intra-operatively due to extensive adhesions, surgical resection was not performed and only tissue sampling was performed for histopathology. Microscopic examination revealed short fascicles of spindle cells and perivascular epithelioid cells. A differential diagnosis of renal cell carcinoma with sarcomatoid differentiation was considered. The immunohistochemical profile showed tumor cells that express Melan-A and smooth muscle actin, while they were negative for pan-cytokeratin, PAX8, CK7, CD117 and CD34. Therefore a diagnosis of epithelioid angiomyolipoma was rendered. The presence of intravascular thrombi on radiological investigation and carcinoma-like growth pattern on light microscopy may compound an erroneous diagnosis of renal cell carcinoma. Hence, it is prudent for the urologist to consider differential diagnosis other than renal cell carcinoma when confronted with a renal neoplasm presenting with intravascular thrombi. In these cases, a core biopsy should be planned pre-operatively and diagnosis should be made with aid of appropriate immunohistochemical markers.

Published
2020

73. Transverse vaginal septum presenting as secondary amenorrhoea: a rare clinical presentation

Author

Neha Agrawal, Pratibha Singh, Sureka Binit, and Garima Yadav

Subjects
Infertility, Adult, endocrine system, medicine.medical_specialty, Abdominal pain, endocrine system diseases, media_common.quotation_subject, Vaginal Diseases, Physical examination, 030218 nuclear medicine & medical imaging, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Gynecologic Surgical Procedures, Medicine, Humans, Transverse vaginal septum, Amenorrhea, Menstrual cycle, media_common, 030219 obstetrics & reproductive medicine, Unusual Presentation of More Common Disease/Injury, medicine.diagnostic_test, business.industry, General Medicine, CELL DEBRIS, medicine.disease, Surgery, Vagina, Female, Differential diagnosis, medicine.symptom, business, Secondary amenorrhoea
Abstract

Transverse vaginal septum is one of the variants of Mullerian duct anomaly, caused as a result of defective fusion or recanalisation of vaginal and Mullerian organs. At an early age, it commonly presents as primary amenorrhea along with cyclical abdominal pain while later on usually it presents as dyspareunia and infertility. Our 22-year-old patient presented with secondary amenorrhea. It is very unusual for a transverse vaginal septum to cause secondary amenorrhea. MRI and clinical examination raised the suspicion of transverse vaginal septum causing secondary amenorrhea. She attained regular menstrual cycle after septum excision. The proposed theory behind it is obliteration of microperforated transverse vaginal septum because of menstrual blood and cell debris. Thus, a rare possibility of transverse vaginal septum should also be considered as a differential diagnosis of secondary amenorrhea.

Published
2020

74. Retrograde Transvenous Obliteration of Gastric Varices using Sodium Tetradecyl Sulphate: Technical Considerations and Results from a Single Institution Retrospective Study

Author

Khera, Pushpinder S., additional, Garg, Pawan K., additional, Tiwari, Sarbesh, additional, Bhargava, Narendra, additional, Yadav, Taruna, additional, Sureka, Binit, additional, Ghosh, Tushar, additional, Babu, Santhosh, additional, Dadhich, Sunil, additional, and Singh, Surjit, additional

Published
2021
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78. Can combined multiparametric magnetic resonance imaging of the prostate and prostate-specific antigen density improve the detection of clinically significant prostate cancer: A prospective single-center cross-sectional study

Author

Sureka, Binit, primary, Yadav, Kuldeep, additional, Elhence, Poonam, additional, Choudhary, GautamRam, additional, Pandey, Himanshu, additional, Garg, PawanKumar, additional, Yadav, Taruna, additional, and Khera, PushpinderSingh, additional

Published
2021
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80. Comparison between International Ovarian Tumor Analysis (IOTA)—simple rules and risk malignancy indices in differentiating benign and malignant adnexal masses—prospective comparative study

Author

Solanki, Vrushti, primary, Singh, Pratibha, additional, Shekhar, Shashank, additional, Ghuman, Navdeep Kaur, additional, Yadav, Garima, additional, Kathuria, Priyanka, additional, Gothwal, Meenakshi, additional, Sharma, Charu, additional, and Sureka, Binit, additional

Published
2021
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91. Clinical Outcome, Viral Response and Safety Profile of Chloroquine in COVID-19 Patients—Initial Experience

Author

Niwas, Ram, primary, Shahul S, Aneesa, additional, Garg, M. K., additional, Nag, Vijaya Lakshmi, additional, Bhatia, Pradeep Kumar, additional, Dutt, Naveen, additional, Chauhan, Nishant, additional, Charan, Jaykaran, additional, Asfahan, Shahir, additional, Sharma, Praveen, additional, Bhardwaj, Pankaj, additional, Banerjee, Mithu, additional, Garg, Pawan, additional, Sureka, Binit, additional, Bohra, Gopal Krishna, additional, Gopalakrishnan, Maya, additional, and Misra, Sanjeev, additional

Published
2020
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100. Computed tomography perfusion (CTP) in primary lung cancer: Results from a tertiary care centre.

Author

Arimbrakkunnan, Mufeed, Garg, Pawan, Khera, Pushpinder, Sureka, Binit, Elhence, Poonam, Pareek, Puneet, Chauhan, Nishant, and Yadav, Taruna

Subjects
COMPUTED tomography, LUNG cancer, BOX plots (Graphs), TERTIARY care, PEARSON correlation (Statistics)
Abstract

Context: Lung cancer is the leading cause of cancer-related deaths in the world. Computed tomography perfusion (CTP) parameters can be used to evaluate the vascular flow dynamics of lung tumours. We set out to evaluate the CTP parameters in lung cancer and correlate them with histopathological subtype and other characteristics of patients with Lung Cancer. Settings and Design: This prospective study was conducted at a tertiary care referral hospital in western India. Methods: Between January 2019 and July 2020, CTP was performed in 46 patients of lung cancer with histopathological confirmation. The CTP parameters were evaluated in detail and correlated with histopathological subtypes, staging and immunohistochemistry (IHC) markers. Analysis of variance (ANOVA) test, receiver operator characteristic (ROC) curve, Box and whiskers plot graph and Pearson correlation tests were used for statistical analysis. Results: The most common subtype was adenocarcinoma (AC) in 21 patients, followed by squamous cell carcinoma (SCC) in 15 patients and others in 10 patients. Statistically significant difference in blood flow (BF) (f = 5.563, P = 0.007), blood volume (BV) (f = 3.548, P = 0.038) and permeability/flow extraction (FE) (f = 3.617, P = 0.036) were seen in different histopathological subtypes of lung cancer. BF is the main perfusion parameter for differentiation of AC from SCC. P63 positive lesions showed statistically significant lower BF, BV and FE parameters compared to P63 negative lesions (P = 0.013, 0.016 and 0.014, respectively). Different T stages showed statistically significant differences in BF (f = 3.573, P = 0.037), BV (f = 5.145, P = 0.010) and in FE (f = 4.849, P = 0.013). Conclusion: CTP is a non-invasive imaging method to assess the vascular flow dynamics of the tumours that may predict the histopathological subtypes in lung cancer. It can be used to target large-sized lesions during biopsy and to predict the chemotherapy response. [ABSTRACT FROM AUTHOR]

Published
2022
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