213 results on '"Sureka B"'
Search Results
2. The association of vitamin D binding protein levels and genotypes with type 1 diabetes in the black South African population
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Eleanor M Cave, Sureka Bhola, Nigel J Crowther, and Carolyn J Padoa
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Type 1 diabetes ,Black South African ,Vitamin D binding protein ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Background Vitamin D deficiency and the vitamin D pathway have previously been associated with type 1 diabetes (T1D). The majority of vitamin D is transported through the blood bound to the vitamin D binding protein (VDBP). Two polymorphisms in the VDBP gene (rs4588 and rs7041) result in different VDBP variants and have been associated with T1D, however the results are not consistent. The association of VDBP levels and its polymorphisms with T1D have not been investigated in the black South African population. Therefore, this study aimed to determine whether rs4588, rs7041 or serum VDBP levels were associated with T1D in this population. Methods Participants with type 1 diabetes and controls were recruited from the greater Johannesburg area, South Africa. Participants were genotyped for rs4588 and rs7041 using PCR-RFLP and serum VDBP levels were determined by ELISA. Results There was no difference in VDBP allelic or genotypic frequencies between participants with T1D and controls (rs4588 C allele frequency 0.92 vs. 0.94; p = 0.390 and rs7041 T allele frequency 0.95 vs. 0.95; p = 0.890). In univariate analysis, the rs4588 CC genotype was associated with increased serum VDBP levels, however, this association was lost with multivariate analysis. The VDBP genotypes were not associated with any other study variables. In logistic regression analysis, higher VBDP levels were associated with T1D (OR: (95% CI): 6.58 (1.45–29.9); p = 0.015), and within a linear regression analysis, T1D disease status was found to be associated with 0.044 mg/ml higher VDBP levels (p = 0.028). Conclusions These data suggest that serum VDBP levels are positively associated with the presence of T1D in the African population. Whether VDBP lies in the causal pathway or its elevation is an effect of T1D is uncertain and requires further investigation.
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- 2022
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3. Advanced pancreatic adenocarcinoma: CT evaluation before and after neoadjuvant treatment with fluorouracil, leucovorin, oxaliplatin and irinotecan and correlation with histopathology
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Boninsegna, Enrico, Sureka, B., Negrelli, Riccardo, Di Paola, Valerio, Avesani, Giacomo, Mehrabi, Sara, Manfredi, Riccardo, and POZZI MUCELLI, Roberto
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tumour imaging ,technical advances ,Pancreas:, technical advances, tumour imaging ,Pancreas - Published
- 2016
4. Congenital Anomalies of Kidney and Ureter
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Mukul Sinha, BB Thukral, MK Mittal, Sureka B, Mittal A, and Mehta
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High rate ,Kidney ,medicine.medical_specialty ,medicine.diagnostic_test ,business.industry ,Intravenous urography ,Magnetic resonance imaging ,General Medicine ,medicine.disease ,Bioinformatics ,Ureterocele ,Ureter ,medicine.anatomical_structure ,Radiological weapon ,General screening ,medicine ,Radiology ,business - Abstract
The kidney is a common site for congenital anomalies which may be responsible for considerable morbidity among young patients. Radiological investigations play a central role in diagnosing these anomalies with the screening ultrasonography being commonly used as a preliminary diagnostic study. Intravenous urography can be used to specifically identify an area of obstruction and to determine the presence of duplex collecting systems and a ureterocele. Computed tomography and magnetic resonance (MR) imaging are unsuitable for general screening but provide superb anatomic detail and added diagnostic specificity. A sound knowledge of the anatomical details and familiarity with these anomalies is essential for correct diagnosis and appropriate management so as to avoid the high rate of morbidity associated with these malformations.
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- 2016
5. Body packer syndrome
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Sureka, B., Kumar, M., Mittal, A., and Mukul, S.
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Cocaine industry -- Health aspects ,Diagnosis, Radioscopic -- Methods ,Ethnic, cultural, racial issues/studies ,Social sciences ,Women's issues/gender studies - Abstract
Byline: B. Sureka, M. Kumar, A. Mittal, S. Mukul Dear Editor, We read with great interest the article on body packer syndrome by Kulkarni et al. , published in the [...]
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- 2013
6. Renal lymphangiectasia: One disease, many names!
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Sureka, B, primary, Bansal, K, additional, Pargewar, S, additional, and Arora, A, additional
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- 2016
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7. Dense renal medulla sign
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Sureka, B, primary, Bansal, K, additional, and Arora, A, additional
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- 2016
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8. Zinc transporter 8 (ZnT8) autoantibody prevalence in black South African participants with type 1 diabetes
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Sureka Bhola, Eleanor M Cave, Sindeep Bhana, Nigel J Crowther, and Carolyn J Padoa
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ZnT8 ,Autoantibody ,Type 1 diabetes ,Black South African ,Prevalence ,Diseases of the endocrine glands. Clinical endocrinology ,RC648-665 - Abstract
Abstract Background Autoantibodies to β-cell specific antigens are markers of type 1 diabetes. The most recently identified autoantibodies are targeted to the zinc transporter 8 (ZnT8) protein located in the membrane of β-cell insulin secretory granules. The prevalence of ZnT8 autoantibodies in newly diagnosed participants with type 1 diabetes has been found to range from 33 to 80 %. Due to the lack of data on the immunological aetiology of type 1 diabetes in African populations, this study aimed to determine the prevalence of ZnT8 autoantibodies in black South Africans with type 1 diabetes and whether ZnT8 autoantibody positivity was associated with age at diagnosis and disease duration. Methods Participants with type 1 diabetes and controls were recruited from the greater Johannesburg area, South Africa. Positivity for ZnT8, GAD65 and IA2 autoantibodies was determined by ELISA. Results Participants with type 1 diabetes (n = 183) and controls (n = 49) were matched for age (29.1 ± 9.53 vs. 27.3 ± 7.29, respectively; p = 0.248). The mean age at diagnosis for participants with type 1 diabetes was 20.8 ± 8.46 years. The prevalence of ZnT8 autoantibody positivity was 17.5 % (32 of 183) in participants with type 1 diabetes with a median disease duration of 7.00 [2.00; 11.0] years. ZnT8 autoantibody prevalence in newly diagnosed participants (
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- 2021
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9. Supernumerary horseshoe kidneys
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Sureka, B, primary, Bansal, K, additional, and Arora, A, additional
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- 2015
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10. Bouquet of flowers: Clue to medullary sponge kidneys
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Sureka, B, primary, Bansal, K, additional, Jain, V, additional, and Arora, A, additional
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- 2015
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11. Bilateral xanthogranulomatous pyelonephritis: Morphologically rotund, functionally lame!
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Sureka, B, primary, Jain, V, additional, Arora, A, additional, and Bansal, K, additional
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- 2015
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12. Obstructive uropathy: Is it always urolithiasis?
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Sureka, B, primary, Bansal, K, additional, Arora, A, additional, and Jain, V, additional
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- 2015
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13. Looking beyond vesical calculi
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Sureka, B, primary, Mittal, MK, additional, Sinha, M, additional, and Thukral, BB, additional
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- 2014
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14. Giant migratory enterolith mimicking vesical calculus
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Sureka, B, primary, Singh, V, additional, Ranga, A, additional, and Mittal, MK, additional
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- 2014
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15. Cystic partially differentiated nephroblastoma: A rare renal tumor
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Sureka, B, primary, Sinha, M, additional, Thukral, BB, additional, and Mittal, MK, additional
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- 2013
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16. Unilateral xanthogranulomatous pyelouretritis with a functioning kidney
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Sureka, B, primary, Sinha, M, additional, Thukral, BB, additional, and Mittal, MK, additional
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- 2013
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17. Thymic masses: A radiological review.
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Mittal, M. K., Sureka, B., Sinha, M., Mittal, A., and Thukral, B. B.
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HYPERPLASIA ,CANCER ,CYSTS (Pathology) ,LYMPHOMAS ,SARCOMA ,THYMUS tumors ,CONTINUING education units - Abstract
Various thymic masses and their normal variations have different pathological and management consequences. Radiologists and clinicians should be aware of these entities so that appropriate and timely treatment can be given. [ABSTRACT FROM AUTHOR]
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- 2013
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18. Emphysematous infections of the urinary tract: A radiological perspective.
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Sureka, B. and Thukral, B. B.
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DIABETES complications , *TOMOGRAPHY , *DIFFERENTIAL diagnosis , *PYELONEPHRITIS , *ULTRASONIC imaging , *URINARY tract infections , *CONTRAST media , *THERAPEUTICS - Abstract
The article discusses the radiological perspective of emphysematous infections of the urinary tract. According to the authors, emphysematous pyelonephritis (EPN) is characterized by gas formation within or surrounding the kidneys which is life threatening since it causes necrotizing infection of the upper urinary tract. The predisposing factors include diabetes mellitus, low immune status, chronic alcoholics, and post renal transplant.
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- 2012
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19. Atypical lytic lesions of skull: Clinical and radiological correlation
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Sureka Binit, Mahesh Kumar Mittal, Aliza Mittal, and Brij Bhushan Thukral
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Lytic lesion ,skull ,soft tissue ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Imaging alone cannot differentiate various isolated atypical lytic lesions involving the skull. Clinical and radiological correlation is mandatory in reaching to a diagnosis. Histopathology remains the gold standard. We describe few atypical cases presenting as isolated lytic lesions of skull with characteristic imaging findings and a brief clinical approach to reach towards the diagnosis.
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- 2015
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20. Renal lymphangiectasia: One disease, many names!
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Bansal, K., Sureka, B., Pargewar, S., and Arora, A.
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LYMPHANGIECTASIA , *CYSTIC kidney disease , *KIDNEY disease diagnosis , *LYMPHATIC abnormalities , *ABDOMINAL abscess , *ABDOMINAL pain , *COMPUTED tomography , *HEMOGLOBINS , *MAGNETIC resonance imaging , *DIAGNOSIS - Abstract
The article describes the case of a 40 year old female presented with pain in bilateral flank and lower abdomen for the past year. A previous ultrasound suggested bilateral hydronephrosis due to mass effect of bulky uterus and she underwent imaging to assess the cause of abdominal pain and distension. Magnetic resonance imaging confirmed findings of multicystic collections in bilateral peripelvic spaces consistent with renal pelvic lymphangiectasia.
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- 2016
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21. Bilateral xanthogranulomatous pyelonephritis: Morphologically rotund, functionally lame!
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Bansal, K., Sureka, B., Jain, V., and Arora, A.
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BLOOD testing , *DIABETES , *DIFFERENTIAL diagnosis , *INFLAMMATION , *PHYSICAL diagnosis , *PYELONEPHRITIS , *TOMOGRAPHY , *URINALYSIS , *EARLY diagnosis , *DIAGNOSIS - Abstract
The article describes the case of a 54 year old diabetic male presented with pain in both flanks, recurrent fever and malaise for the past few months. Ultrasound abdomen showed bilateral enlarged hydronephrotic kidneys with papery-thin renal parenchyma and an associated perinephric, juxtahilar and parapelfic fat proliferation suggest bilateral diffuse xanthogranulomatous pyelonephritis (XGP), a serious chronic inflammatory disorder characterized by destruction of renal parenchyma.
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- 2015
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22. Obstructive uropathy: Is it always urolithiasis?
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Jain, V., Sureka, B., Bansal, K., and Arora, A.
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KIDNEY disease diagnosis , *DIABETES , *BLOOD testing , *SURGICAL stents , *TOMOGRAPHY , *ULTRASONIC imaging , *URINALYSIS , *SOCIAL services case management , *HISTORY - Abstract
The article discusses the case of a 54 year old diabetic female presented with left lank pain and high grade fever. A histopathologic examination confirmed necrosed papilla with calcification and she was discharged on postoperative day 2 on oral antibiotics. Topics discussed include renal papillary necrosis (RPN) as a clinical condition arising from impairment of blood circulation to papillary tip of renal medulla due to diabetes mellitus and CT urography as more informative in diagnosing RPN.
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- 2015
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23. Cystic partially differentiated nephroblastoma: A rare renal tumor.
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Mittal, M. K., Sureka, B., Sinha, M., and Thukral, B. B.
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NEPHROBLASTOMA , *BLOOD testing , *DIFFERENTIAL diagnosis , *PATHOLOGY , *PHYSICAL diagnosis , *TOMOGRAPHY , *ULTRASONIC imaging , *URINALYSIS , *DIAGNOSIS - Abstract
The article explores the case of 2-year-old female child who was diagnosed with cystic partially differentiated nephroblastoma (CPDN). The patient presented with gradually increasing painless mass on the left side of the abdomen, but she has no history of fever, hematuria, weight loss or burning micturation. VV Joshi and JB Beckwith cited well-defined multicystic mass, presence of thin septa and embryonal stroma or epithelium element as diagnostic criteria for CPDN.
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- 2013
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24. Unilateral xanthogranulomatous pyelouretritis with a functioning kidney.
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Mittal, M. K., Sureka, B., Sinha, M., and Thukral, B. B.
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KIDNEY disease diagnosis , *TOMOGRAPHY , *BIOPSY , *BLOOD testing , *HEMATURIA , *KIDNEY diseases , *MAGNETIC resonance imaging , *PHYSICAL diagnosis , *ULTRASONIC imaging , *URINALYSIS , *CONTRAST media , *SEVERITY of illness index , *THERAPEUTICS - Abstract
The article describes a case of unilateral xanthogranulomatous pyelouretritis with a functioning kidney in a 36-year-old male. The patient presented with left flank pain, intermittent hematuria and dysuria for 20 days. Ultrasonography results showed a large calculus in the renal pelvis. The histopathological report following left nephroureterectomy indicated xanthogranulomatous pyelouretritis in the patient.
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- 2013
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25. Gallbladder perforation: Diagnostic accuracy of new CT difficulty score in predicting complicated laparoscopic cholecystectomy.
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Vs VR, Sureka B, Yadav T, Varshney VK, Sharma N, Chaudhary R, Rodha MS, Banerjee M, Elhence P, and Khera PS
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- Humans, Male, Female, Middle Aged, Prospective Studies, Adult, Aged, Gallbladder Diseases diagnostic imaging, Gallbladder Diseases surgery, Sensitivity and Specificity, Predictive Value of Tests, Aged, 80 and over, Gallbladder diagnostic imaging, Gallbladder injuries, Contrast Media, Cholecystectomy, Laparoscopic, Tomography, X-Ray Computed methods
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Purpose: To formulate and evaluate the diagnostic performance and utility of a new CT difficulty score in predicting difficult laparoscopic surgery in cases of gallbladder (GB) perforation., Methods: This prospective single centre study included a total of 48 diagnosed cases of GB perforation on CT between December 2021 and June 2023, out of which 24 patients were operated. A new 6-point CT difficulty scoring system was devised to predict difficult laparoscopic approach, based on patterns of inflammation around the perforated GB that were found to be surgically relevant. The pre-operative imaging findings on CT were studied in detail and correlation coefficients of various imaging findings were calculated to predict difficult surgery., Results: On CECT, the type of perforation, according to the revised Niemeier's classification could be exactly delineated in all 48 patients. A CT difficulty score of ≥ 3 was found to a good predictor difficult laparoscopic approach, with statistical significance (p = 0.001), sensitivity of 94.44%, specificity of 83.33%, PPV of 94.44% and NPV of 83.33%. Inflammatory changes around duodenum showed maximum correlation coefficient of 0.744 (p = 0.0001), around colon showed a correlation coefficient of 0.657 (p = 0.0005), and in the omentum had a correlation coefficient of 0.5 (p = 0.013)). Inter-observer agreement was also calculated for various findings and it was found to have moderate to strong agreement (κ value 0.5-1.0)., Conclusion: The CT difficulty scoring system can be an effective tool in predicting difficult laparoscopic surgery in cases of GB perforation in an emergency setting which can help in decision making and improved patient outcome., (© 2024. The Author(s), under exclusive licence to American Society of Emergency Radiology (ASER).)
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- 2024
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26. Case Report: Salmonella typhi Iliopsoas Abscess with Concomitant Sacroiliitis in a Young Immunocompetent Male: A Rare Case.
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Kumar B, Agarwal D, Meena DS, Kumar D, and Sureka B
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- Humans, Male, Adolescent, Typhoid Fever drug therapy, Typhoid Fever complications, Typhoid Fever diagnosis, Typhoid Fever microbiology, Levofloxacin therapeutic use, Immunocompetence, Psoas Abscess microbiology, Psoas Abscess drug therapy, Psoas Abscess diagnostic imaging, Sacroiliitis microbiology, Sacroiliitis drug therapy, Sacroiliitis diagnostic imaging, Salmonella typhi isolation & purification, Anti-Bacterial Agents therapeutic use, Ceftriaxone therapeutic use
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Iliopsoas abscess is an infrequent condition characterized by the collection of pus in the iliopsoas compartment. The prevalence of the disease has been increasing in recent years with the emergence of various comorbidities and risk factors. The availability of newer imaging modalities has also improved the detection of new cases. Salmonellosis is an uncommon etiology in iliopsoas abscess and sacroiliitis. Most cases reported in the literature are associated with Staphylococcus aureus, Streptococci species, and Escherichia coli. Diabetes, hematological malignancies, HIV, and other immunocompromised states are important comorbidities/risk factors for iliopsoas abscess. We report a case of an 18-year-old male who presented with a history of fever and right hip pain for 10 days. Radioimaging revealed right sacroiliitis and iliopsoas abscess. Blood culture revealed pan-sensitive Salmonella typhi. After the prolonged course of antibiotics (intravenous ceftriaxone followed by oral levofloxacin), the patient improved with no further relapse in symptoms. Salmonella typhi should be an important differential of iliopsoas abscess in endemic regions after ruling out the common etiology such as S. aureus and Mycobacterium tuberculosis.
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- 2024
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27. Revamping Resident Education: A Step toward "Amrit Kaal" in Indian Radiology.
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Rajagopal R and Sureka B
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Competing Interests: Conflict of Interest None declared.
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- 2024
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28. 3D CT based age estimation from the pubic symphyseal surface in an Indian population using the Chen et al. method.
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Vempalli SR, Meshram V, Singh Shekhawat R, Sureka B, Shedge R, Akbar M N J, Setia P, and Kanchan T
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- Humans, Female, Male, India, Adult, Middle Aged, Aged, Young Adult, Imaging, Three-Dimensional methods, Adolescent, Aged, 80 and over, Pubic Symphysis diagnostic imaging, Pubic Symphysis anatomy & histology, Age Determination by Skeleton methods, Tomography, X-Ray Computed methods
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The pubic symphyseal surface is one of the reliable parameters used to estimate age, as it consistently shows degenerative observational variations throughout the lifespan, particularly from the 3
rd decade onwards. These changes have been extensively studied to generate population-specific models for forensic age estimation. In the past, there have been many studies used to estimate age at death from the pubis symphysis using skeletal remains. However, due to dearth of contemporary skeletal repositories, and the resource intensive maceration process required for obtaining examination quality bones, studies on cadaver are difficult to conduct. Moreover, due to recent advancements in the science of medical imaging, newer radiological modalities like computed tomography (CT) can be used to visualize previously inaccessible areas such as the pubic symphysis in cadavers and the living alike, and subsequent age estimation is feasible. Recently, Chen et al. (2008, 2011) conducted a study on the cadaveric Chinese Han population in both males and females separately by using nine morphological changes and scoring them according to the changes that occurred. The present study aimed to estimate an individual's age using CT images of the pubic symphysis, by applying the scoring method for its morphological changes given by Chen et al. The present study was conducted on 263 randomly selected participants (Males = 154, Females = 109), who came for diagnostic purposes to the hospital. The CT images of these individuals were collected after obtaining ethical approval and proper consent from the study participants. Each of the morphological indicators was assessed, and appropriate scores were given according to criteria given by Chen et al. In the present study, both linear and multiple regression models to estimate age using the pubic symphyseal morphological changes were developed. From the results of the present study, it was concluded that the Chen et al. scoring method can be used to accurately estimate age from 3DCT images of the living, and the models derived in the present study could be applicable to individuals from the Indian subcontinent.- Published
- 2024
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29. Air Everywhere without Bowel Injury.
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Bhatia S, Sureka B, and Banerjee N
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Competing Interests: There are no conflicts of interest.
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- 2024
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30. Comparison between abdominal CT findings in intensive care unit (ICU) and non-ICU patients with Covid-19: experience from a tertiary care hospital.
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Goyal H, Sureka B, Mangaraj N, Agarwal A, Kothari N, Garg MK, Banerjee M, Agarwal A, Garg P, Yadav T, and Khera P
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- Humans, Male, Female, Retrospective Studies, Middle Aged, Adult, India epidemiology, Mucormycosis diagnostic imaging, Mucormycosis epidemiology, Aged, Abdomen diagnostic imaging, COVID-19 complications, COVID-19 diagnostic imaging, Tomography, X-Ray Computed, Tertiary Care Centers, Intensive Care Units statistics & numerical data, SARS-CoV-2
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Background: 16-66% of COVID-19 positive patients may have abdominal symptoms and findings in abdominal CT. The yield of abdominal CT scan in patients having abdominal complaints is not known., Objectives: The aim of this study was to explore the various abdominal imaging manifestations of COVID-19 and COVID-19 associated Mucormycosis (CAM) and to identify the relevant clinical and laboratory features associated with severity of the symptoms., Methods: A retrospective single centre observational study was performed at a tertiary care hospital in Northwest India. All consecutive patients who had COVID positive RT-PCR report and had undergone abdominal Computed Tomography scan from March 2020 to November 2021 for various abdominal complaints were included. Demographic data, CT images and reports and all relevant lab parameters were collected., Results: Out of 75 patients, positive abdominal findings were seen in 65 patients. Hepatobiliary findings were seen in 41.3% (31 of 75; OR=1.9) and bowel abnormalities were found in 37.3% (28 of 75; OR=2.1) of COVID-19 patients. 7 patients who had renal infarcts or bowel ischemia were found to have COVID-19 associated Mucormycosis on histopathology., Conclusion: Chest CT severity score was positively correlated with most of the abdominal manifestations in patients requiring ICU admission. Elevated D-dimer levels were significantly associated with abdominal symptoms., (© 2023 Himanshu G et al.)
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- 2023
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31. The Varieties of Ignorance: Imaging of Congenital Variants of Pancreas and Its Ductal System-A Pictorial Review.
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Sharma S, Sureka B, Yadav T, Panda A, and Khera PS
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Congenital variants of the pancreas are being increasingly detected with the widespread use of modern imaging techniques. The underlying embryologic aberration predicts the final appearance of pancreatic development. It is essential to recognize these congenital variants, as many of these have been proven to be associated with pancreatic diseases like recurrent pancreatitis and chronic abdominal pain. Cross-sectional techniques like multidetector computed tomography and magnetic resonance cholangiopancreatography are the most used imaging techniques for the pancreas, where a radiologist comes across these variants. This pictorial aims to classify the type of variant anatomy of the pancreas, their imaging appearances, and their clinical significance., Competing Interests: Conflicting Interest None declared., (Indian Radiological Association. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. ( https://creativecommons.org/licenses/by-nc-nd/4.0/ ).)
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- 2023
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32. MDCT evaluation of Dorsal Pancreatic Artery and Intrapancreatic arcade anatomy.
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Sharma S, Sureka B, Varshney V, Soni S, Yadav T, Garg PK, and Khera PS
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Objective: The purpose of the study was to analyze the anatomy and variations in the origin of the dorsal pancreatic artery, greater pancreatic artery and to study the various types of arterial arcades supplying the pancreas on multidetector CT (MDCT)., Methods: A retrospective analysis of 747 MDCT scans was performed in patients who underwent triple phase or dual phase CT abdomen between December 2020 and October 2022. Variations in origin of Dorsal pancreatic artery (DPA), greater pancreatic artery (GPA), uncinate process branch were studied. Intrapancreatic arcade anatomy was classified according to Roman Ramos et al. into 4 types-small arcades (type I), small and large arcades (type II), large arcades (type III) and straight branches (type IV)., Results: The DPA was visualized in 65.3% (n = 488) of cases. The most common origin was from the splenic artery in 58.2% (n = 284) cases. The mean calibre of DPA was 2.05 mm (1.0-4.8 mm). The uncinate branch was seen in 21.7% (n = 106) with an average diameter of 1.3 mm. The greater pancreatic artery was seen in 57.3% (n = 428) predominantly seen arising from the splenic artery. The most common arcade anatomy was of Type II in 52.1% (n = 63) cases., Conclusion: Pancreatic arterial variations are not very uncommon in daily practice. Knowledge of these variations before pancreatic surgery and endovascular intervention procedure is important for surgeons and interventional radiologist., (© 2023. The Author(s), under exclusive licence to Springer-Verlag France SAS, part of Springer Nature.)
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- 2023
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33. Pulmonary Tuberculosis Presenting As Septic Shock in an Immunocompetent Patient: Revisiting an Old Disease With New Perspectives.
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Malik M, Lodha N, Meena DS, and Sureka B
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Septic shock due to Mycobacterium tuberculosis (M. tuberculosis) in immunocompromised patients (particularly HIV) is a well-recognized clinical entity. However, tubercular sepsis in the immunocompetent is still underdiagnosed and under-discussed. Moreover, sepsis is usually associated with gram-negative and other gram-positive microorganisms that can cause similar pulmonary and disseminated disease and can further convolute the diagnosis. We herein discuss a case of an elderly female who presented with acute onset fever, cough, and altered talk from the last seven days. Her initial clinical and laboratory examination revealed features of lower respiratory tract infection with septic shock. She was started on broad-spectrum antibiotics based on severe community-acquired pneumonia management guidelines. Her blood and urine cultures were sterile. She did not respond to initial antibiotics. Furthermore, sputum production was not possible, which compelled us for gastric aspirate analysis, which came positive for cartridge-based nucleic acid amplification test (CBNAAT). In repeated blood cultures, M. tuberculosis was also isolated. She was started on antitubercular treatment; on the 12th day of antitubercular treatment, she developed acute respiratory distress and eventually succumbed to her illness on the 19th day of hospitalization. We highlighted the importance of early diagnosis and prompt antitubercular therapy in tubercular septic shock. We also discuss the possibility of tubercular-immune reconstitution inflammatory syndrome (IRIS) in such patients, which could be a contributing factor to mortality., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2023, Malik et al.)
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- 2023
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34. Evaluation of Diaphragmatic Thickness and Dysfunction by Ultrasonography in Mechanically Ventilated Children for Assessment of Extubation Success.
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Vadivelu S, Khera D, Choudhary B, Toteja N, Sureka B, Singh K, and Singh S
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- Humans, Child, Airway Extubation, Prospective Studies, Ultrasonography, Atrophy, Ventilator Weaning, Respiration, Artificial adverse effects, Diaphragm diagnostic imaging
- Abstract
Objectives: This study aimed to evaluate diaphragm thickness (DT) and diaphragmatic thickening fraction (DTF) in mechanically ventilated children, and study the association of these measurements with extubation success., Methods: Consecutive children aged one month to 18 years, who required mechanical ventilation (MV) for more than 24 hours at our institution, were enrolled between April, 2019 to October, 2020. Ultrasonographic measure-ments of DT were documented, and DTF was calculated from baseline (within 24 hours of MV) until 14 days of MV, and up to three days post-extubation., Results: Of the 54 children-enrolled, 40 underwent planned extubation trial, of which 9 (22.5%) had extubation failure. Pre-extubation and post-extubation DTF between children in extubation-success and extubation-failure groups were comparable (P=0.074). There was no significant difference in the diaphragm atrophy rate between the two groups (P=0.819). Binary logistic regression showed significantly decreased probability of successful extubation with total ventilation duration (P=0.012) and mean DTF% before extubation (P=0.033)., Conclusion: Despite evidence of diaphragmatic atrophy in critically ill children receiving mechanical ventilation, there was no significant difference in DTF between extubation success and failure groups.
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- 2023
35. Cutoff values of body fat composition to predict metabolic risk factors with normal waist circumference in Asian Indian population.
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Sureka B, George T, Garg MK, Banerjee M, Deora S, Sukhla R, Goel A, Garg PK, Yadav T, and Khera PS
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- Male, Female, Humans, Waist Circumference, Cross-Sectional Studies, Prospective Studies, Adipose Tissue diagnostic imaging, Adipose Tissue metabolism, Body Composition, Intra-Abdominal Fat diagnostic imaging, Risk Factors, Body Mass Index, Metabolic Syndrome epidemiology, Metabolic Syndrome complications, Metabolic Syndrome diagnosis
- Abstract
Objectives: The aim of the study is to see if visceral fat volume (VFV), subcutaneous fat volume (SFV), and visceral-subcutaneous fat ratio (VSR) can be used to detect metabolically obese normal weight individuals in Asian Indian population., Methods: This is a single center prospective cross-sectional study and 80 cases having either hypertension, diabetes, or hyperlipidemia with normal waist circumference and 80 controls having normal metabolic parameters with normal waist circumference were evaluated. Visceral and subcutaneous fat volumes and visceral to subcutaneous fat ratios were determined by computed tomography (CT) at L4-L5 level with a slice thickness of 5 mm., Results: Visceral fat volume, subcutaneous fat volume, and VSR are significantly higher in patients with metabolic risk factors as compared to those without risk factors. Volume of subcutaneous fat is significantly higher in females as compared to males. VSR is higher in males in our study. The cutoff values for VFV, SFV, and VSR to predict at least one metabolic syndrome are 8.5 cm
3 , 15.7 cm3 , and 0.61 in males and 7.0 cm3 , 16.5 cm3 , and 0.44 in females., Conclusions: For individuals with normal waist circumference, VFV, SFV, and VSR can effectively predict the presence of one metabolic risk factor., Key Points: • Visceral fat volume, subcutaneous fat volume, and visceral-subcutaneous fat ratio can predict individuals at risk of metabolic syndrome having normal waist circumference. • Higher VSR in Indian population is due to low reservoir of primary adipose tissue fat compartment which leads to diversion of adipocytes into the secondary adipose tissue fat compartment. • This data can be used as a screening tool in preventive radiology for identifying individuals at risk of developing metabolic syndrome., (© 2022. The Author(s), under exclusive licence to European Society of Radiology.)- Published
- 2023
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36. Emergency Uterine Bleeding: A Pictorial Essay of Imaging and Endovascular Management.
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Khera PS, Garg PK, Yadav T, Tiwari S, Ghosh TS, Sureka B, and Rajagopal R
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- Angiography, Female, Humans, Endovascular Procedures methods, Uterine Hemorrhage diagnostic imaging, Uterine Hemorrhage etiology, Uterine Hemorrhage therapy
- Abstract
Abnormal uterine bleeding is a common presentation in the emergency department. A spectrum of uterine vascular abnormalities can lead to potentially fatal hemorrhage. Radiology plays a crucial role in the early diagnosis of the cause of bleeding with the role of an interventional radiologist being pivotal in the management of these cases. This article provides a pictorial review of angiographic appearance of various uterine vascular abnormality and their management by endovascular technique., (Copyright © 2022 Elsevier Inc. All rights reserved.)
- Published
- 2022
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37. Point-of-Care Thoracic Ultrasound in Children with Bronchiolitis.
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Krishna D, Khera D, Toteja N, Sureka B, Choudhary B, Ganakumar VM, and Singh K
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- Child, Humans, Infant, Lung diagnostic imaging, Oxygen, Ultrasonography methods, Bronchiolitis diagnostic imaging, Bronchiolitis therapy, Point-of-Care Systems
- Abstract
Objective: To characterize thoracic (lung and diaphragm) ultrasound findings in children < 2 y with bronchiolitis, evaluate correlation between lung ultrasound severity score (USS) and bronchiolitis severity score (BSS), and study the interobserver agreement of USS between study pediatrician and radiologist., Methods: In this prospective observational study, thoracic ultrasound was performed on children with bronchiolitis by the study pediatrician and USS score was assigned. A radiologist blinded to all clinical information, performed an independent thoracic ultrasound. Demographics, clinical course, and other relevant details were recorded., Results: Fifty-three children were enrolled; 29/53 patients (54.7%) were classified as mild bronchiolitis and 24/53 (45.2%) had moderate bronchiolitis as per clinical score; 13.2% (7/53) patients had both anterior and posterior subpleural consolidation and went on to require higher respiratory support either in the form of continuous positive airway pressure in 71.4% (5/7), oxygen for > 24 h in 14.2% (1/7), or heated humidified high-flow nasal cannula in 14.2% (1/7). These results were statistically significant (p < 0.001). A statistically significant correlation was found between the USS and type and duration of respiratory support (p value 0.002) and with the mean duration of hospital stay (p value < 0.001). There was significant correlation between the BSS and USS (p < 0.001). There was a very good agreement between the ultrasound findings of study pediatrician and radiologist (kappa 0.83)., Conclusion: The findings of lung ultrasound (LUS) are not specific for bronchiolitis. However, LUS can be used as a good prognostic tool in patients with bronchiolitis., (© 2022. Dr. K C Chaudhuri Foundation.)
- Published
- 2022
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38. Rapid Response Preparedness for Management of Post-Covid Invasive Rhino-Orbito-Cerebral Fungal Infections: Experience from a Tertiary Care Government Institute in India.
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Goyal A, Soni K, Sharma V, Choudhury B, Verma A, Kumar D, Khichar S, Chugh A, Sureka B, Srinivasan S, Bhardwaj P, Kamal M, Agarwal A, Bhatnagar K, Bhatia PK, Garg MK, and Misra S
- Abstract
Sudden surge of Post Covid-19 Rhino-orbito-mucormycosis cases has left entire ENT fraternity in the center of a war room. We present a quick administrative preparedness for this situation in a tertiary care Government Institute in India. This model may serve as a reference for other centers., (© Association of Otolaryngologists of India 2021.)
- Published
- 2022
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39. 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.
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Biswas S, Sureka B, Kaushal D, Elhence P, Goyal A, Yadav T, Goel A, and Khera PS
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- Humans, United States, Prospective Studies, Cross-Sectional Studies, Thyroid Nodule diagnostic imaging, Thyroid Nodule pathology, Radiology
- 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., Competing Interests: None
- Published
- 2022
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40. Thick crusted plaques on the periorificial area in a young woman.
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Pathania YS, Budania A, Mudugal R, Sureka B, and Khera S
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- Female, Glycated Hemoglobin, Humans, Blood Glucose, Pemphigus pathology
- Abstract
We report a young woman with periorificial erosions and thick crusts mimicking pemphigus foliaceous, who was found to have an underlying pancreatic malignancy with normal blood glucose and glycosylated haemoglobin levels. Click here for the corresponding questions to this CME article., (© 2022 British Association of Dermatologists.)
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- 2022
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41. Comparison of clinical characteristics and outcome in RT-PCR positive and false-negative RT-PCR for COVID-19: A Retrospective analysis.
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Meena DS, Kumar B, Kachhwaha A, Kumar D, Khichar S, Bohra GK, Sharma A, Kothari N, Garg P, Sureka B, Banerjee M, Garg MK, and Misra S
- Abstract
Cases with SARS-CoV-2 RT-PCR negative pneumonia are an understudied group with uncertainty remaining regarding their treatment approach. We aimed to compare the clinical and radiological characteristics of RT-PCR positive and clinically diagnosed RT-PCR negative COVID-19. This was a single-centre retrospective study conducted at a tertiary care hospital in Western India. All patients (age ≥18 years) with suspicion of COVID-19 with SARI (severe acute respiratory infections) who were subjected to RT-PCR testing (nasal/oropharyngeal swab) were included. Based on RTPCR results, patients were categorized and compared for demographic, clinical, and biochemical characteristics and outcomes. Out of 500 patients, 339 (67.8%) found RT-PCR positive. Except for the radiological findings, both groups differ in clinical presentation, disease severity (inflammatory markers), and outcome. RT-PCR-positive patients had raised ferritin, NLR (Neutrophil-Lymphocyte ratio), LDH, and high mortality compared to the swab-negative group. In-hospital mortality was also significantly high in RT-PCR positive group (HR=1.9, 95% CI=1.4-2.5, p=0.001). On multivariate analysis, NLR, ferritin, and d-dimer were the independent predictors of mortality in RT-PCR-positive (p=0.038, 0.054, and 0.023). At the same time, raised TLC (total leukocyte count) and procalcitonin were the risk factors for poor outcomes in RT-PCR-negative patients (p=0.041 and 0.038). We found significantly raised ferritin, NLR, and LDH levels and increased mortality in RT-PCR positive patients compared to RT-PCR negative. Incorporating clinical features, radiological, and biochemical parameters could be prudent while managing the RT-PCR-negative patients., Competing Interests: Conflicts of interest The authors declare that they have no conflict of interest., (Copyright © 2016 - 2022 InfezMed.)
- Published
- 2022
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42. Inhibin B Secreting Ovarian Fibroma.
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Yadav G, Aggarwal I, Nalwa A, and Sureka B
- Abstract
Background: Nearly 90% of all the hormone-producing ovarian tumours are sex cord-stromal tumours (SCSTs). The Ovarian fibroma is a hormonally inactive variant of SCST. It is composed of spindle, oval, round cells producing collagen and accounts for approximately 4% of all ovarian neoplasms. Amongst the other SCSTs, Inhibin B is an important tumour marker. It is a heterodimeric glycoprotein hormone that is secreted primarily by the granulosa cells of the developing follicles. High levels of Inhibin-B can hamper follicular recruitment, leading to amenorrhea in a reproductive age woman., Finding: In this case report, we describe a rare case of a reproductive age female presenting with secondary amenorrhea, having an Ovarian Fibroma, producing massive amounts of Inhibin B., Significance: Although some pathological variants of ovarian fibromas like cyst-adeno-fibroma and ovarian fibro-thecoma are known to secrete inhibin B, benign /pure ovarian fibromas rarely do so., Competing Interests: Conflict of interestThe authors declare that they have no conflict of interest., (© Federation of Obstetric & Gynecological Societies of India 2022.)
- Published
- 2022
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43. Threads and Streaks Sign.
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Chawla S, Sureka B, and Birda CL
- Abstract
Competing Interests: Conflict of Interest The authors declare no conflict of interest in this work.
- Published
- 2022
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44. A lumpy bumpy stomach: The more the murkier.
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Sureka B, Chawla S, Khera S, Agarwal A, Birda CL, and Bairwa S
- Abstract
This report describes the radiological and endoscopic findings in a 54-year-old male who presented with epigastric pain. The patient underwent an upper gastrointestinal (GI) barium study followed by axial imaging, which demonstrated nodular gastric wall thickening. The classic findings of aggressive primary gastric diffuse large B-Cell lymphoma are presented with a brief review differentiating the pathological subtypes, important for patient prognostication and planning of therapy., Competing Interests: The authors declare that they have no financial or personal relationships that may have inappropriately influenced them in writing this article., (© 2022. The Authors.)
- Published
- 2022
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45. Computed tomography perfusion (CTP) in primary lung cancer: Results from a tertiary care centre.
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Arimbrakkunnan M, Garg PK, Khera PS, Sureka B, Elhence P, Pareek P, Chauhan NK, and Yadav T
- 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., Competing Interests: None
- Published
- 2022
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46. Mirizzi Syndrome With Bouveret Syndrome: A Rare Amalgam.
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Varshney VK, Hussain S, Selvakumar B, Vignesh N, and Sureka B
- Abstract
Mirizzi and Bouveret syndromes are uncommon but important complications of calculous cholecystitis. Mirizzi syndrome commonly presents with jaundice due to extrinsic compression on the common bile duct by an impacted stone at the gall bladder infundibulum, whereas Bouveret syndrome presents with gastric outlet obstruction due to a large stone in the duodenum. Our case is a 65-year-old lady who presented with pain in the right upper abdomen associated with nausea and vomiting. Contrast-enhanced computed tomography and MRI of the abdomen were suggestive of calculus in the infundibulum of the gall bladder with compression over the common bile duct and a large stone in the first part of the duodenum. Upper gastrointestinal endoscopy confirmed the findings but could not retrieve the stone. Cholecystectomy with the retrieval of calculus from the infundibulum and duodenum was performed with the closure of the fistulous opening. The patient did well in the post-operative period and is doing well after nine months of follow-up. Chronic calculus cholecystitis can present in varied forms, and one should be aware of such rare complications and their management., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Varshney et al.)
- Published
- 2022
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47. Diffusion-Weighted Magnetic Resonance Imaging Is an Ideal Imaging Method to Detect Infection in Pancreatic Collections: A Brief Primer for the Gastroenterologists.
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Sureka B, Rai B, Varshney VK, Nag VL, Garg MK, Garg P, Yadav T, and Khera PS
- Abstract
Background: The development of infection in pancreatitis significantly increases the mortality rate up to 100% in the absence of any intervention. Therefore, it is extremely important to diagnose these cases at an early stage. The objectives of this study were to assess the diagnostic performance of computed tomography (CT) and diffusion-weighted MR imaging (DW-MRI) in the diagnosis of infection in pancreatic collections., Materials and Methods: Prospective observational study of abdominal collections due to pancreatitis that underwent both CT and DW-MRI from August 2018 to July 2020 were enrolled in the study. The collections were analysed for infections - air foci in CT and diffusion restriction on DW-MRI., Results: Of the 39 patients recruited in the study, infected collections were present in 17, and 22 cases had sterile collections. On CT, air foci within the collection were present only in seven of the cases in our study (sensitivity 35%, specificity 95.4%, PPV 85.7%, NPV 65.6%). DW-MRI detected infection in all 17 cases (sensitivity 100%, specificity 72.7%, PPV 74%, NPV 100%)., Discussion: Thirteen out of 17 collections suspicious for infection on DW-MR showed microbiological growth on culture examination. We believe that this is likely due to the patient's prior antibiotic use, which might have altered the micro-environment or inflammatory cell and bacterial content of the collection., Conclusion: DW-MRI is complementary and superior to CT in detecting infection in pancreatic collections. CT may be used to detect disease burden, extent and vascular complication., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Sureka et al.)
- Published
- 2022
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48. Eosinophilic Solid and Cystic Renal Cell Carcinoma: From Unclassified to Classified, A Case Report.
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Sharma R, Thirunavukkarasu B, Elhence P, Rodha MS, and Sureka B
- Subjects
- Aged, Biomarkers, Tumor, Female, Humans, Kidney pathology, Male, Carcinoma, Renal Cell pathology, Kidney Neoplasms pathology, Tuberous Sclerosis
- Abstract
Eosinophilic solid and cystic renal cell carcinoma (ESC RCC) is a novel tumour with unique morphological and immunohistochemical features. It is a recently described entity after the 2016 World Health Organization Classification of Tumours of the Urinary System and Male Genital Organs and is characterised by a solid cystic tumour composed of polygonal cells with voluminous eosinophilic cytoplasm and CK20 positivity. This tumour has uncertain malignant potential and also has an association with tuberous sclerosis complex (TSC). Sarcomatoid differentiation has not been reported in ESC RCC till now. ESC RCC poses a diagnostic challenge as many eosinophilic/oncocytic renal tumours are included in the differentials. We present a case of ESC RCC with sarcomatoid differentiation in an elderly female without any clinical features of TSC and discuss the differential diagnosis of oncocytic renal tumours.
- Published
- 2022
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49. Magnetic Resonance Imaging in Coronavirus Disease - 2019 Associated Rhino-Orbital-Cerebral Mucormycosis (CA-ROCM) - Imaging Analysis of 50 Consecutive Patients.
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Yadav T, Tiwari S, Gupta A, Garg PK, Khera PS, Rajagopal R, Goyal A, Soni K, Chugh A, Jain V, Sureka B, Elhence P, and Misra S
- Subjects
- Humans, Magnetic Resonance Imaging, Retrospective Studies, SARS-CoV-2, COVID-19, Mucormycosis diagnostic imaging, Orbital Diseases diagnostic imaging
- Abstract
Background and Purpose: Rhino-orbital-cerebral mucormycosis has emerged as a major opportunistic infection in patients with COVID-19. High clinical suspicion and prompt imaging are crucial for early diagnosis and management. Our study evaluates imaging characteristics of patients with COVID-19 associated Rhino-orbital-cerebral Mucormycosis (CA-ROCM) in a tertiary care hospital in India., Materials and Methods: A retrospective analysis of clinical and imaging data of patients with CA-ROCM who presented between December 2020 to June 2021 was performed. All patients had microbiologically or histologically proven sino-nasal mucormycosis along with documented SARS-CoV-2 positive RT-PCR test and/or classical lung imaging features of COVID-19 infection. The extent of sinus involvement, bony erosions, extra-sinus soft tissue extension, orbital-intracranial invasion, perineural spread, and vascular complications were assessed., Results: Fifty patients were included for the final analysis. Diabetes was the most common associated comorbidity. Seven patients presented with stage I disease, 18 patients with stage II, and 25 patients with stage III disease. The stage of disease showed a positive statistical correlation with HbA1c levels using Pearson's correlation. The common imaging features were "Black turbinate sign" and nonenhancing sino-nasal mucosa (82%), orbital involvement (76%), and diffusion restriction in the optic nerve (24%). Intracranial involvement was seen as perineural extension into the brain (42%), cerebritis (30%), and internal carotid artery involvement (16%)., Conclusions: CA-ROCM is an acute invasive fungal sinusitis with an aggressive clinical course. Black-turbinate sign and peri-antral soft tissue infiltration are early features, whereas extra-nasal tissue infarction, optic nerve diffusion restriction, and vascular invasion are seen with advanced disease., Competing Interests: Declaration of Competing Interest None, (Copyright © 2021 Elsevier Inc. All rights reserved.)
- Published
- 2022
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50. Role of Pigtail Catheter Drainage Versus Percutaneous Needle Aspiration in the Management of Liver Abscess: A Retrospective Analysis.
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Kumar S, Midha NK, Ahari K, Kumar D, Gopalakrishnan M, Kumar B, Bohra GK, Garg P, Sureka B, and Garg MK
- 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. Conclusion Percutaneous pigtail catheterization would be an operative decision for the management of liver abscess. We concluded that the use of pigtail catheterization of patients with abscess volume > 150 ml improved the clinical outcome., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2021, Kumar et al.)
- Published
- 2021
- Full Text
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