Journal of Neurosciences in Rural Practice, Feb 23, 2023
Objectives: The objectives of the study were to compare the clinico-radiological profile, optical... more Objectives: The objectives of the study were to compare the clinico-radiological profile, optical coherence tomography (OCT) parameters and outcome in Myelin Oligodendrocyte Glycoprotein-IgG-associated disorders (MOGAD) and Neuromyelitis Optica Spectrum disorder subtypes. Materials and Methods: This prospective study involved collection of data regarding neurological assessment, neuroimaging, cerebrospinal fluid analysis, OCT parameters, treatment and outcome. Disease severity and disability were assessed using Expanded Disability Status Scale and modified Rankin scale. Patients were categorized into aquaporin-4 (AQP4+), MOGAD, and double negative (DN; both AQP4 and MOG negative). Results: Among 31 patients included, 42% were AQP4+, 32.2% were MOGAD, and 25.7% were DN. The median age at onset was comparable (AQP4+ vs. MOGAD vs. DN = 28 years vs. 24.4 years vs. 31.5years; P = 0.31). Females predominated in AQP4+ compared to MOGAD group (76.9% vs. 30%; P = 0.02). Majority of patients (73.5%) had a relapsing course with a median of two (range = 1–9) relapses. Ninety-nine demyelinating events occurred: Transverse myelitis (TM) in 60/99 (60.6%), optic neuritis (ON) in 43/99 (43.4%), area postrema (AP) syndrome in 20/99 (20.1%), and optico-spinal syndrome in 10/99 (10.1%). ON was common in MOGAD than AQP4+ patients (58.6% vs. 32.1%; P = 0.03). Spinal cord and brain lesions on magnetic resonance imaging (MRI) were seen in 90.3% and 54.8% patients, respectively. A significantly higher proportion of AQP4+ patients showed longitudinally extensive transverse myelitis as compared to MOGAD group (69.2 % vs. 20 %; P = 0.04), specifically involving dorsal cord (92.3% vs. 50%; P = 0.02). MRI brain lesions, especially involving AP, was frequent in DN than MOGAD (47.1% vs. 6.9%; P = 0.003) and AQP4+ (47.1% vs. 18.9%; P = 0.03) patients. AQP4+ group showed significant nasal RNFL thinning on OCT (P = 0.04). Although 6-month good functional outcome was better in MOGAD than DN and AQP4+ (80% vs. 71.4% vs. 41.7%) groups, they were comparable (P = 0.13). Conclusion: Nearly three-fourth of our patients showed a relapsing course, with TM being the most common clinical presentation. AQP4+ group showed female preponderance, frequent dorsal cord longitudinally extensive transverse myelitis, less frequent ON, and greater nasal RNFL thinning compared to MOGAD group. MRI brain lesions were more common in DN patients. All three groups exhibited good response to pulse corticosteroids and showed a comparable functional outcome at 6-month follow-up.
INTRODUCTION Vertebral Arterio-venous fistulas (VAVFs) are uncommon lesions that can arise sponta... more INTRODUCTION Vertebral Arterio-venous fistulas (VAVFs) are uncommon lesions that can arise spontaneously or secondarily to iatrogenic or mechanical trauma. Among spontaneous cases, it is most commonly found to be associated with Neurofibromatosis type 1 (NF1). EVIDENCE ACQUISITION We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities and outcome of VAVFs associated with NF1. A literature search was performed by using databases PubMed Central, Embase, Cochrane Library, and Ovid MEDLINE. Also, the grey area search was done using the "Google Scholar" search engine. On screening of the original full-text English language articles, a total of 48 cases were considered suitable for inclusion in this review. EVIDENCE ANALYSIS VAVFs in NF1 commonly present between 3rd and 6th decade of life affecting females 2.4 times more than males. Left-sided fistulae were more common than the right side and most seen in the upper V2 segment of the vertebral artery. Most VAVFs in NF 1 patients were treated with constructive (occlusion of fistula only) endovascular therapy (n =26) with a high success rate. Moreover, Pooled proportion of the outcome data have shown significant difference between the endovascular constructive and destructive procedure. CONCLUSIONS The spontaneous VAVF, commonly associated with NF-1, often requires treatment. Awareness of the coexistence between NF1 and VAVF is crucial to avoid diagnostic delays and unnecessary surgical intervention leading to disastrous outcomes. Endovascular treatment is the preferred treatment approach while open surgical treatment is required in some complex fistulae and failure of endovascular techniques.
Chordomas are most commonly of extradural origin and are associated with bone destruction. Extra-... more Chordomas are most commonly of extradural origin and are associated with bone destruction. Extra-osseous intradural chordomas are extremely rare and most of the cases described are located near the clivus. We report an extremely rare case of multiple extra-osseous intraspinal chordomas in a 36-year-old male patient with autopsy findings. This case highlights that behaviour of spinal intradural chordomas is not universally low grade, but is variable and aggressive.
Journal of Gastrointestinal and Abdominal Radiology
Midgut malrotation is usually present in the early neonatal period with intestinal obstruction an... more Midgut malrotation is usually present in the early neonatal period with intestinal obstruction and bilious vomiting. However, sometimes it may present later in childhood and adolescence with atypical features and then may remain undiagnosed for long, adversely affecting the growth and development of the child. Here we describe three cases of intestinal malrotation with various atypical presentation and imaging findings.
Tarsal tunnel syndrome is an uncommon condition which can be painfully debilitating. This clinica... more Tarsal tunnel syndrome is an uncommon condition which can be painfully debilitating. This clinical diagnosis is often enhanced by electro diagnostic tests. Causes are both extrinsic and intrinsic. Initial treatment is usually non-operative, but at times surgical intervention is indicated at the outset. The surgery is difficult and the literature suggests patient selection is crucial for positive surgical outcomes. Surgical success rates are highest when cause is extrinsic and surgery is performed within 12 months of symptom onset.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venou... more Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dim...
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venou... more Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dim...
Purpose: Virtual endoscopy is a postprocessing method using three-dimensional computed tomography... more Purpose: Virtual endoscopy is a postprocessing method using three-dimensional computed tomography (CT), which produces views of the inner surfaces of the human body like those produced by fibreoptic endoscopy. To evaluate and categorise patients who require medical or endoscopic band ligation to prevent oesophageal variceal bleed, a less invasive, less expensive, better tolerated, and more sensitive modality is required, as well as to reduce the use of invasive procedures in the follow-up of patients who do not require endoscopic variceal band ligation. Material and methods: A cross-sectional study was conducted in the Department of Radiodiagnosis in association with the Department of Gastroenterology. The study was conducted over a period of 18 months from July 2020 to January 2022. The sample size was calculated as 62 patients. Patients were recruited on the basis of inclusion and exclusion criteria after giving informed consent. CT virtual endoscopy was performed through a dedicated protocol. Classification of variceal grading was done independently by a radiologist and endoscopist who were blinded to each other's findings. Results: The diagnostic performance of oesophageal varices detection by CT virtual oesophagography was good, with sensitivity: 86%, specificity: 90%, PPV: 98%, NPV: 56%, and diagnostic accuracy: 87%. There was substantial agreement between the 2 methods, and this agreement was statistically significant (Cohen's k = 0.616, p ≤ 0.001). Conclusions: Based on our findings, we conclude that the current study has the potential to change the way chronic liver disease is managed, as well as generate similar medical research endeavours. A multicentric study with a large number of patients is needed to improve the experience with this modality.
IntroductionThe COVID-19 pandemic has posed a serious threat to global health, with developing na... more IntroductionThe COVID-19 pandemic has posed a serious threat to global health, with developing nations like India being amongst the worst affected. Chest CT scans play a pivotal role in the diagnosis and evaluation of COVID-19, and certain CT features may aid in predicting the prognosis of COVID-19 illness.MethodsThis was a single-centre, hospital-based, cross-sectional study conducted at a tertiary care centre in Northern India during the second wave of the COVID-19 pandemic from May-June 2021. The study included 473 patients who tested positive for COVID-19. A high-resolution chest CT scan was performed within five days of hospitalization, and patient-related information was extracted retrospectively from medical records. Univariable and Multivariable analysis was done to study the predictors of poor outcome.ResultsA total of 473 patients were included in the study, with 75.5% being males. The mean total CT score was 29.89 ± 9.06. Fibrosis was present in 17.1% of patients, crazy p...
Vascular origin tumors of bone are rare entities. Epithelioid hemangioendothelioma (EHE) is a rar... more Vascular origin tumors of bone are rare entities. Epithelioid hemangioendothelioma (EHE) is a rare tumor representing <1% of primary bone tumors and is considered a low to intermediate grade malignancy. Literature describes cases which were either a part of multicentric disease or were metastatic. In this study, we reported a case of a 23-year-old female with biopsy-proven EHE with prior history of resection, presenting with recurrence of disease. Radiographs showed a lytic lesion involving the left calceneum and other tarsal bones with extensive soft-tissue component. Magnetic resonance imaging revealed an ill-defined, enhancing, lobular, and lytic lesion with adjacent soft-tissues component. Computed tomography confirmed extensive destruction of the involved tarsal bones. EHE is treated with wide surgical excision and recurrence is rare; however, our case presented with recurrence as well as thoracic metastasis which posed a great clinical challenge. The patient was treated wit...
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venou... more Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dim...
Periosteal chondroma or juxtacortical chondroma is a rare benign bone tumor of cartilaginous orig... more Periosteal chondroma or juxtacortical chondroma is a rare benign bone tumor of cartilaginous origin. It arises from the periosteum, particularly that of the long tubular bones. We present an interesting case of periosteal chondroma involving the phalanx of the right hand presenting as a palpable mass in a 22-year-old male. The slowly growing mass lesion was investigated in our institute. Characteristic imaging findings on the radiograph and MRI were correlated with histopathological findings to confirm the diagnosis. Establishment of benignity of the lesion guided the surgical management of the patient.
Supplemental Material, Supplementary_File for Magnetic Resonance Spectroscopy in Children With De... more Supplemental Material, Supplementary_File for Magnetic Resonance Spectroscopy in Children With Developmental Delay: Time to Look Beyond Conventional Magnetic Resonance Imaging (MRI) by Nikhil Rajvanshi, Rahul Bhakat, Sudhir Saxena, Jitendra Rohilla, Sriparna Basu, Khanak Kumar Nandolia, Sonam Agrawal, Nowneet Kumar Bhat and Swathi Chacham in Journal of Child Neurology
Colonopleurobronchial fistula (CPBF) is a rare complication which occurs due to diversified cause... more Colonopleurobronchial fistula (CPBF) is a rare complication which occurs due to diversified causes. Expectoration of the faecal material is the classical clinical symptom which suggests the diagnosis. Various causes include infection of pulmonary or abdominal origin, inflammatory bowel disease, colonic malignancy, diaphragmatic hernia and colonic interposition. Crohn’s disease is the frequent underlying pathology, colonic malignancy accounts for rare cause. Due to the presence of liver in right upper quadrant, most of the fistulas are on the left side. Here we describe a rare case of a 38-year-old man presented with right-sided CPBF due to underlying colonic malignancy. Bronchial block was done, however the patient succumbed to death.
Journal of Neurosciences in Rural Practice, Feb 23, 2023
Objectives: The objectives of the study were to compare the clinico-radiological profile, optical... more Objectives: The objectives of the study were to compare the clinico-radiological profile, optical coherence tomography (OCT) parameters and outcome in Myelin Oligodendrocyte Glycoprotein-IgG-associated disorders (MOGAD) and Neuromyelitis Optica Spectrum disorder subtypes. Materials and Methods: This prospective study involved collection of data regarding neurological assessment, neuroimaging, cerebrospinal fluid analysis, OCT parameters, treatment and outcome. Disease severity and disability were assessed using Expanded Disability Status Scale and modified Rankin scale. Patients were categorized into aquaporin-4 (AQP4+), MOGAD, and double negative (DN; both AQP4 and MOG negative). Results: Among 31 patients included, 42% were AQP4+, 32.2% were MOGAD, and 25.7% were DN. The median age at onset was comparable (AQP4+ vs. MOGAD vs. DN = 28 years vs. 24.4 years vs. 31.5years; P = 0.31). Females predominated in AQP4+ compared to MOGAD group (76.9% vs. 30%; P = 0.02). Majority of patients (73.5%) had a relapsing course with a median of two (range = 1–9) relapses. Ninety-nine demyelinating events occurred: Transverse myelitis (TM) in 60/99 (60.6%), optic neuritis (ON) in 43/99 (43.4%), area postrema (AP) syndrome in 20/99 (20.1%), and optico-spinal syndrome in 10/99 (10.1%). ON was common in MOGAD than AQP4+ patients (58.6% vs. 32.1%; P = 0.03). Spinal cord and brain lesions on magnetic resonance imaging (MRI) were seen in 90.3% and 54.8% patients, respectively. A significantly higher proportion of AQP4+ patients showed longitudinally extensive transverse myelitis as compared to MOGAD group (69.2 % vs. 20 %; P = 0.04), specifically involving dorsal cord (92.3% vs. 50%; P = 0.02). MRI brain lesions, especially involving AP, was frequent in DN than MOGAD (47.1% vs. 6.9%; P = 0.003) and AQP4+ (47.1% vs. 18.9%; P = 0.03) patients. AQP4+ group showed significant nasal RNFL thinning on OCT (P = 0.04). Although 6-month good functional outcome was better in MOGAD than DN and AQP4+ (80% vs. 71.4% vs. 41.7%) groups, they were comparable (P = 0.13). Conclusion: Nearly three-fourth of our patients showed a relapsing course, with TM being the most common clinical presentation. AQP4+ group showed female preponderance, frequent dorsal cord longitudinally extensive transverse myelitis, less frequent ON, and greater nasal RNFL thinning compared to MOGAD group. MRI brain lesions were more common in DN patients. All three groups exhibited good response to pulse corticosteroids and showed a comparable functional outcome at 6-month follow-up.
INTRODUCTION Vertebral Arterio-venous fistulas (VAVFs) are uncommon lesions that can arise sponta... more INTRODUCTION Vertebral Arterio-venous fistulas (VAVFs) are uncommon lesions that can arise spontaneously or secondarily to iatrogenic or mechanical trauma. Among spontaneous cases, it is most commonly found to be associated with Neurofibromatosis type 1 (NF1). EVIDENCE ACQUISITION We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities and outcome of VAVFs associated with NF1. A literature search was performed by using databases PubMed Central, Embase, Cochrane Library, and Ovid MEDLINE. Also, the grey area search was done using the "Google Scholar" search engine. On screening of the original full-text English language articles, a total of 48 cases were considered suitable for inclusion in this review. EVIDENCE ANALYSIS VAVFs in NF1 commonly present between 3rd and 6th decade of life affecting females 2.4 times more than males. Left-sided fistulae were more common than the right side and most seen in the upper V2 segment of the vertebral artery. Most VAVFs in NF 1 patients were treated with constructive (occlusion of fistula only) endovascular therapy (n =26) with a high success rate. Moreover, Pooled proportion of the outcome data have shown significant difference between the endovascular constructive and destructive procedure. CONCLUSIONS The spontaneous VAVF, commonly associated with NF-1, often requires treatment. Awareness of the coexistence between NF1 and VAVF is crucial to avoid diagnostic delays and unnecessary surgical intervention leading to disastrous outcomes. Endovascular treatment is the preferred treatment approach while open surgical treatment is required in some complex fistulae and failure of endovascular techniques.
Chordomas are most commonly of extradural origin and are associated with bone destruction. Extra-... more Chordomas are most commonly of extradural origin and are associated with bone destruction. Extra-osseous intradural chordomas are extremely rare and most of the cases described are located near the clivus. We report an extremely rare case of multiple extra-osseous intraspinal chordomas in a 36-year-old male patient with autopsy findings. This case highlights that behaviour of spinal intradural chordomas is not universally low grade, but is variable and aggressive.
Journal of Gastrointestinal and Abdominal Radiology
Midgut malrotation is usually present in the early neonatal period with intestinal obstruction an... more Midgut malrotation is usually present in the early neonatal period with intestinal obstruction and bilious vomiting. However, sometimes it may present later in childhood and adolescence with atypical features and then may remain undiagnosed for long, adversely affecting the growth and development of the child. Here we describe three cases of intestinal malrotation with various atypical presentation and imaging findings.
Tarsal tunnel syndrome is an uncommon condition which can be painfully debilitating. This clinica... more Tarsal tunnel syndrome is an uncommon condition which can be painfully debilitating. This clinical diagnosis is often enhanced by electro diagnostic tests. Causes are both extrinsic and intrinsic. Initial treatment is usually non-operative, but at times surgical intervention is indicated at the outset. The surgery is difficult and the literature suggests patient selection is crucial for positive surgical outcomes. Surgical success rates are highest when cause is extrinsic and surgery is performed within 12 months of symptom onset.
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venou... more Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dim...
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venou... more Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dim...
Purpose: Virtual endoscopy is a postprocessing method using three-dimensional computed tomography... more Purpose: Virtual endoscopy is a postprocessing method using three-dimensional computed tomography (CT), which produces views of the inner surfaces of the human body like those produced by fibreoptic endoscopy. To evaluate and categorise patients who require medical or endoscopic band ligation to prevent oesophageal variceal bleed, a less invasive, less expensive, better tolerated, and more sensitive modality is required, as well as to reduce the use of invasive procedures in the follow-up of patients who do not require endoscopic variceal band ligation. Material and methods: A cross-sectional study was conducted in the Department of Radiodiagnosis in association with the Department of Gastroenterology. The study was conducted over a period of 18 months from July 2020 to January 2022. The sample size was calculated as 62 patients. Patients were recruited on the basis of inclusion and exclusion criteria after giving informed consent. CT virtual endoscopy was performed through a dedicated protocol. Classification of variceal grading was done independently by a radiologist and endoscopist who were blinded to each other's findings. Results: The diagnostic performance of oesophageal varices detection by CT virtual oesophagography was good, with sensitivity: 86%, specificity: 90%, PPV: 98%, NPV: 56%, and diagnostic accuracy: 87%. There was substantial agreement between the 2 methods, and this agreement was statistically significant (Cohen's k = 0.616, p ≤ 0.001). Conclusions: Based on our findings, we conclude that the current study has the potential to change the way chronic liver disease is managed, as well as generate similar medical research endeavours. A multicentric study with a large number of patients is needed to improve the experience with this modality.
IntroductionThe COVID-19 pandemic has posed a serious threat to global health, with developing na... more IntroductionThe COVID-19 pandemic has posed a serious threat to global health, with developing nations like India being amongst the worst affected. Chest CT scans play a pivotal role in the diagnosis and evaluation of COVID-19, and certain CT features may aid in predicting the prognosis of COVID-19 illness.MethodsThis was a single-centre, hospital-based, cross-sectional study conducted at a tertiary care centre in Northern India during the second wave of the COVID-19 pandemic from May-June 2021. The study included 473 patients who tested positive for COVID-19. A high-resolution chest CT scan was performed within five days of hospitalization, and patient-related information was extracted retrospectively from medical records. Univariable and Multivariable analysis was done to study the predictors of poor outcome.ResultsA total of 473 patients were included in the study, with 75.5% being males. The mean total CT score was 29.89 ± 9.06. Fibrosis was present in 17.1% of patients, crazy p...
Vascular origin tumors of bone are rare entities. Epithelioid hemangioendothelioma (EHE) is a rar... more Vascular origin tumors of bone are rare entities. Epithelioid hemangioendothelioma (EHE) is a rare tumor representing <1% of primary bone tumors and is considered a low to intermediate grade malignancy. Literature describes cases which were either a part of multicentric disease or were metastatic. In this study, we reported a case of a 23-year-old female with biopsy-proven EHE with prior history of resection, presenting with recurrence of disease. Radiographs showed a lytic lesion involving the left calceneum and other tarsal bones with extensive soft-tissue component. Magnetic resonance imaging revealed an ill-defined, enhancing, lobular, and lytic lesion with adjacent soft-tissues component. Computed tomography confirmed extensive destruction of the involved tarsal bones. EHE is treated with wide surgical excision and recurrence is rare; however, our case presented with recurrence as well as thoracic metastasis which posed a great clinical challenge. The patient was treated wit...
Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venou... more Acute exacerbation of chronic obstructive pulmonary disease (AECOPD) carries a high risk of venous thromboembolism (VTE). Pulmonary embolism (PE) and AECOPD increase the mortality and morbidity risk associated with each other. Racial and ethnic differences in VTE risk have been documented in multiple studies. However, there is a dearth of reliable Indian data on the same. This study was planned to find the prevalence of VTE in the setting of severe AECOPD in a tertiary care hospital in India and to identify the clinical, laboratory and radiological characteristics of VTE in severe AECOPD. A total of 156 consecutive patients admitted with severe AECOPD and meeting the specified inclusion and exclusion criteria were recruited. Thorough workup of all patients was done including ABG, serum D dimer, ECG, compression ultrasound of lower limbs and 2-D echocardiography. Patients with high pre-test probability score, or intermediate pre-test probability score at presentation with serum D dim...
Periosteal chondroma or juxtacortical chondroma is a rare benign bone tumor of cartilaginous orig... more Periosteal chondroma or juxtacortical chondroma is a rare benign bone tumor of cartilaginous origin. It arises from the periosteum, particularly that of the long tubular bones. We present an interesting case of periosteal chondroma involving the phalanx of the right hand presenting as a palpable mass in a 22-year-old male. The slowly growing mass lesion was investigated in our institute. Characteristic imaging findings on the radiograph and MRI were correlated with histopathological findings to confirm the diagnosis. Establishment of benignity of the lesion guided the surgical management of the patient.
Supplemental Material, Supplementary_File for Magnetic Resonance Spectroscopy in Children With De... more Supplemental Material, Supplementary_File for Magnetic Resonance Spectroscopy in Children With Developmental Delay: Time to Look Beyond Conventional Magnetic Resonance Imaging (MRI) by Nikhil Rajvanshi, Rahul Bhakat, Sudhir Saxena, Jitendra Rohilla, Sriparna Basu, Khanak Kumar Nandolia, Sonam Agrawal, Nowneet Kumar Bhat and Swathi Chacham in Journal of Child Neurology
Colonopleurobronchial fistula (CPBF) is a rare complication which occurs due to diversified cause... more Colonopleurobronchial fistula (CPBF) is a rare complication which occurs due to diversified causes. Expectoration of the faecal material is the classical clinical symptom which suggests the diagnosis. Various causes include infection of pulmonary or abdominal origin, inflammatory bowel disease, colonic malignancy, diaphragmatic hernia and colonic interposition. Crohn’s disease is the frequent underlying pathology, colonic malignancy accounts for rare cause. Due to the presence of liver in right upper quadrant, most of the fistulas are on the left side. Here we describe a rare case of a 38-year-old man presented with right-sided CPBF due to underlying colonic malignancy. Bronchial block was done, however the patient succumbed to death.
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Papers by Sudhir Saxena