Aim: To evaluate the frequency and patterns of different cutaneous granulomatous lesions. Materia... more Aim: To evaluate the frequency and patterns of different cutaneous granulomatous lesions. Materials and Methods: The present cross-sectional observational study was conducted in the Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India from December 2019 to May 2020. This cross-sectional study enrolled 120 cases of skin biopsies after histopathological confirmation of granulomatous lesions. Results: Among 120 cases that were studied , male predominance was noted with 73(60.84%) cases and females constituted 47(39.16%) case providing M: F ratio of 1.5:1. Most of the patients were in age group of 20 to 30 years i.e. 45(37.5%) cases followed by 23 (19.17%) case in 30 to 40 years. 85% of cases were seen below 50 years of age in our study. Infectious granulomatous dermatoses were very common. Only 2 cases of sarcoidosis were found. Most cases of infectious dermatoses were noted in 20 to 30 years comprising 45(37.5%) cases. Leprosy rem...
Agenesis of the dorsal pancreas is a rare entity and is caused due to the defective embryological... more Agenesis of the dorsal pancreas is a rare entity and is caused due to the defective embryological development of the pancreas. The clinical manifestations may range from diabetes mellitus, pancreatitis, and abdominal pain to no symptoms at all. We here present a case series of 10 cases with complete or partial agenesis of the dorsal pancreas. To correlate the clinical symptoms in the patients with the dorsal agenesis of the pancreas, to study any biochemical abnormality present with the dorsal agenesis of the pancreas, and to look for other coexistent finding in the patients. We observed that out of 10 patients, six were males and four were females. Four had symptoms related to the pancreas and six were discovered incidentally. Diabetes mellitus was present in five patients, seven patients had pain in the abdomen, and jaundice was seen in three patients. Out of 10 patients, four had complete agenesis and six had partial agenesis of the dorsal pancreas. We conclude that the diagnosis of this rare entity and establishing its association with clinical conditions like diabetes mellitus and non-specific abdomen pain with the aid of cross-sectional imaging helps in the better evaluation and management of the patients.
We aim to study the spectrum of imaging findings in patients with rhino-oculo-cerebral mucormycos... more We aim to study the spectrum of imaging findings in patients with rhino-oculo-cerebral mucormycosis (ROCM). This retrospective descriptive study was performed in histopathologically confirmed cases of rhino-oculocerebral mucormycosis in a tertiary care center in Bihar, India. The case records of patients with radiological, cultural, and histological evidence of acute invasive ROCM were retrospectively evaluated for relevant radiological and clinical data between May 2021 and June 2022. The radiological evaluation included computed tomography (CT) and magnetic resonance imaging (MRI) scans done on 52 patients. The patient's average age was 48 years. The ethmoid sinus was involved in 51 (98%) cases and the maxillary sinus in 50 (96%) cases. Bilateral sinus involvement (45, 86%) was the most common, followed by pansinus involvement (27, 52%). The orbit was involved in 39 (75%) cases, the face in 25 (47%) cases, and retroantral fat stranding in 24 (46%) cases. Mucosal thickening (91%) was the most common pattern of involvement, followed by complete opacification (77%). Osseous involvement was seen in 17 of 44 patients who had CT scans, and the majority of patients had extrasinus extension with intact bone. MRI revealed variable T2SI, with T2 hyperintensity being the most common pattern. Heterogeneous enhancement in post-contrast imaging was the most common. ROCM is a life-threatening invasive fungal infection, especially in an immunocompromised state. ROCM is characterized by a variety of imaging abnormalities on CT and MRI, although nonspecific. Imaging aids in suspicion or early diagnosis in appropriate clinical contexts, particularly in an immunocompromised state, and in determining the degree of involvement and complications. Early detection of ROCM and its complications enables proper treatment, which can lower the cost of care, morbidity, and mortality.
The posterior fossa is situated between the tentorium cerebelli above and the foramen magnum belo... more The posterior fossa is situated between the tentorium cerebelli above and the foramen magnum below. Vital structures like the cerebellum, the pons, and the medulla are situated within it; hence, tumors within the posterior fossa are considered one of the most critical brain lesions. Children are more likely to develop posterior fossa tumors than adults. Diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) sequences along with the conventional MRI help in providing additional information in the characterization of the various posterior fossa tumors. We hereby present a series of 30 patients with clinically suspected posterior fossa masses who underwent preoperative MRI. This study aims to differentiate the neoplastic from non-neoplastic posterior fossa mass by evaluating the diffusion restriction pattern on DWI, quantifying the apparent diffusion coefficient (ADC) map in various posterior fossa tumors, and comparing the different metabolites of various posterior fossa tumors on MRS. Out of the 30 patients with posterior fossa lesions, 18 were males and 12 were females. Eight of them were in the pediatric age group, while twenty-two of them were adults. Metastasis was the most common posterior fossa lesion in our study sample and was found in six patients (20%), followed by vestibular schwannomas (17%) and arachnoid cysts (13%), meningiomas, medulloblastoma, and pilocytic astrocytoma (10% each) and epidermoid, ependymoma, and hemangioblastoma (7% each). The mean ADC value of benign tumors was higher than that of malignant tumors, and this difference was found to be significant (p = 0.012). The cut-off ADC value 1.21x 10 -3 mm 2 /s had a sensitivity of 81.82% and specificity of 80.47%. MRS metabolites played an additional role in differentiating benign from malignant tumors. A combination of conventional MRI, DWI, ADC values, and MRS metabolites showed good diagnostic accuracy to differentiate between the various posterior fossa neoplastic tumors both in adults and children.
ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 mill... more ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 million births . It was first described by Cockayne in 1936, and till now, around 150 cases have been reported in literature . CS is associated with mutations in the gene CS Type A (CSA)/excision-repair cross-complementing protein (ERCC) 8 or CS Type B (CSB)/ERCC6 which provide instructions for repairing damaged DNA . Clinically, three types of CS have been described in literature as classical, milder, and severe form depending on the time of presentation and severity of the clinical symptoms and final outcome . The classical features of CS are progressive loss of subcutaneous fat and muscle, mental retardation, premature ageing, dwarfism, facial abnormalities, microcephaly, retinopathy, protruding neck, hearing loss, dental changes, large extremities, joints contracture, photosensitivity, dry skin, and hair . Intracranial calcification and brain atrophy are seen in most of the individuals. Progression of syndrome leads to functional disability and bedridden in the 2 nd decade of life and patients lastly die . Early diagnosis is very important for patient management and proper parental genetic counseling. We present a case which is still worth important as a rare entity with its important clinical and radiological findings. CS is an autosomal recessive disorder with incidence around 1 case per 2.77 million births . The basic pathology is deficient DNA repair mechanism due to mutation in gene CSA/ERCC8 and CSB/ ERCC6 located on the chromosomes 5 and 10, respectively . Despite these, principle genes sensitivity of the patient fibroblasts
Journal of advances in medicine and medical research, Nov 12, 2022
Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than child... more Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than children. They are mostly retroperitoneal. Primary adrenal teratomas are even rarer. Objective: We report an unusual case of primary adrenal teratoma in a young adult. Case Summary: A 29 year old male presented with complains of intermittent right sided flank pain for 6 months, dull aching, radiating to groin. On CT Abdomen a large heterogenous mass was seen having predominantly fat component and punctuate calcification in right suprarenal region. Histopathology confirmed a diagnosis of adrenal teratoma. Conclusions: Adrenal teratomas are difficult to diagnose clinically or on imaging as these mimic other lipomatous lesions. Although rare this should be considered as a differential diagnosis for adrenal tumors.
Journal of Advances in Medicine and Medical Research
Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than child... more Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than children. They are mostly retroperitoneal. Primary adrenal teratomas are even rarer. Objective: We report an unusual case of primary adrenal teratoma in a young adult. Case Summary: A 29 year old male presented with complains of intermittent right sided flank pain for 6 months, dull aching, radiating to groin. On CT Abdomen a large heterogenous mass was seen having predominantly fat component and punctuate calcification in right suprarenal region. Histopathology confirmed a diagnosis of adrenal teratoma. Conclusions: Adrenal teratomas are difficult to diagnose clinically or on imaging as these mimic other lipomatous lesions. Although rare this should be considered as a differential diagnosis for adrenal tumors.
Journal of Evolution of medical and Dental Sciences, 2021
BACKGROUND Prolonged fever can be defined as fever of more than 14 days duration. It can be cause... more BACKGROUND Prolonged fever can be defined as fever of more than 14 days duration. It can be caused by infection, non-infectious inflammatory diseases, malignancy, miscellaneous causes and undiagnosed causes. The present study was undertaken to study the clinical profile as well as aetiology of prolonged fever. METHODS A cross sectional study was conducted among patients of prolonged fever admitted in general medicine ward at IGIMS, Patna, Bihar. Patients were selected as per inclusion and exclusion criteria. A detailed history was taken followed by physical examination, systemic examination and investigations to find out the underlying aetiology. RESULTS Male patients were more than females. Most commonly affected age group was of 21 to 30 years comprising 25 patients followed by 13 patients in less than 20 years age group, 11 patients in 41 – 50 years age group, 10 patients in 51 – 60 years age group, 8 patients in 31 – 40 years age group, 7 patients in 61 - 70 years age group and ...
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND The term renal mass includes a large number of expansile entities, which are aggregate... more BACKGROUND The term renal mass includes a large number of expansile entities, which are aggregates of non-functional renal parenchyma. Renal masses can be neoplastic, non-neoplastic or normal variants. Aims and Objectives-To study the role of computed tomography in defining the nature of renal masses. MATERIALS AND METHODS 50 patients irrespective of age and sex, suspicious of malignant renal masses were included in this study. Toshiba 128-slice Computed Tomography Scan was used for scanning of all patients, plain and contrast both studies were performed and collected data was analysed. RESULTS Computed tomography was a very useful investigation for malignant renal masses, because it has got the ability to better characterise the lesions and it is accurate for pre-operative staging. CONCLUSION This can be concluded from our study that contrast CT scan is an investigation of choice for pre-operative staging of malignant renal masses due to its ability in demonstrating perinephric extension, invasion of renal fascia, evaluation of retroperitoneum and detection of distant metastases.
Aim and objectives Aim To study the spectrum of imaging findings in patients Rhino-occulo-cerebra... more Aim and objectives Aim To study the spectrum of imaging findings in patients Rhino-occulo-cerebral mucormycosis (ROCM). Objectives l To study the demographic profile of patients with ROCM l To detect the associated extrasinus complications of ROCM l To aid in clinical diagnosis of ROCM Materials & methods This retrospective descriptive study was performed in histopathologically confirmed cases of ROCM. The case records of patients with radiological, culture and histological evidence of acute invasive rhinocerebral mucormycosis were retrospectively evaluated for relevant radiological and clinical data between May 2021 to June 2022. Results The radiological evaluation included CT and MRI scans were done in 52 patients. The patient's average age was 48 years. The ethmoid sinus was involved in 46 cases (88%) and the maxillary sinus in 27 cases (52%). Biltaral (45, 86%) and pansinus (27, 52%) involvement were the most common. The orbit was involved in 39 cases (75%), the face in 25 c...
Egyptian Journal of Radiology and Nuclear Medicine
Background This study aims to characterize the spectrum of imaging findings in patients of Mayer–... more Background This study aims to characterize the spectrum of imaging findings in patients of Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome presenting with primary amenorrhoea. Objectives (1) To aid in clinical diagnosis of MRKH syndrome. (2) To detect the associated non gynecological anomalies. (3) To arrive at optimal management options. Results This prospective observational study was performed in 14 subjects who presented with primary amenorrhoea and diagnosed as MRKH on MRI from 1st January, 2021 to 30 June, 2022. Out of 14 patients, 4 patients showed hypoplastic uterus while remaining 10 showed complete uterine agenesis. Mean volume of hypoplastic uterus was 5.3 ml. Out of 10 patients with complete uterine agenesis, 9 showed bilateral rudimentary uterine buds connected by a fibrous band while 1 showed unilateral bud. 3 uterine buds showed three layered zonal differentiation of which 2 showed blood within lumen suggesting functioning endometrium. 1 uterine bud was located outside...
Journal of Gastrointestinal and Abdominal Radiology, 2022
Objective The purpose of this study was to find out the incidence of typical and atypical radiolo... more Objective The purpose of this study was to find out the incidence of typical and atypical radiological imaging findings of hepatocellular carcinoma (HCC) on multiphase multidetector computed tomography (MDCT) scans in histologically proven cases. Materials and Methods A multiphase computed tomography study of 73 patients with histologically proven HCC was evaluated by a radiologist. Our multiphasic protocol was composed of precontrast, arterial, portal, and delayed venous phases. The reviewers analyzed the CT images for tumor size, enhancement patterns of HCC in different phases, relative timing of washout, internal cystic changes, and presence of dysmorphic intratumoral vessel aneurysms or arteriovenous shunt. Results Most of the cases (95.9%) showed typical enhancement patterns in MDCT, i.e., enhancements in the arterial phase with the portal or delayed venous phase contrast washout. Three cases (4.9%) out of 73 HCC showed enhancements in the portal phase and washout in the delaye...
Background: An atresia is a congenital defect of a hollow viscus that results in complete obstruc... more Background: An atresia is a congenital defect of a hollow viscus that results in complete obstruction of the lumen. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn and can occur at any point in the gastrointestinal tract. This study was undertaken to study the histomorphological findings of intestinal atresia and to correlate it with different subtypes and clinico-radiological feature. Material and methods: This was a prospective observational study conducted in 24 months on the resected gastrointestinal tract of 40 neonatal intestinal obstruction cases admitted in Pediatric surgery ward received in the Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna. Control Group- A total of 5 cases of vitello-intestinal duct patency were taken as control and compared with the study group. Results: With respect to total 40 cases, there were six, i.e. 15.0% female babies and 34, i.e. 85.0% male babies studied. Out of that, 15 i.e...
International journal of scientific research, 2019
Neurocysticercosis (NCC) is the most common parasitic disease of the nervous system with varied c... more Neurocysticercosis (NCC) is the most common parasitic disease of the nervous system with varied clinical and imaging spectrum. This study was conducted to describe the clinical , CT finding and response to therapy of NCC. Materials: Hundred (100) patients of NCC presenting in department of medicine, PMCH, Patna were evaluated on preset proforma containing detailed demographic data, dietary habits, clinical features and neuroimaging findings and its therapeutic response. Patients were treated with 28 days course of albendazole and repeat CT scan was done in 2 months after treatment. Results: Out of 100 patients of NCC, 56 (56%) were male with most common age group being 21-30 years (36%). Only Seizure is the most common presentation followed by Seizure with featuers of increased intracranial pressure (70 and 14% respectively). Multiple ring enhancing lesions either alone or in combination were seen on computerised tomography scans in 56 (56%) cases and parietal lobe involvement is the commonest site. Complete resolution of CT scan lesions in 72 (72%) and partial resolution occurred in rest of patients. Conclusions: Neurocysticercosis is common public health problem and one of the common cause of seizure. It has varied imaging finding being ring enhancement is most common. Albendazole is highly effective therapy and should be started at earliest to prevent morbidity and mortality.
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Pelvic organ prolapse is a common problem among women in developing countries. It i... more Introduction: Pelvic organ prolapse is a common problem among women in developing countries. It is the herniation of uterus into or beyond the vagina often accompanied by prolapse of vaginal walls involving the bladder or rectum or both. This study was done to determine its prevalence and identify the risk factors so that advice could be given to prevent its occurance and also to find out the current management practices in uterine prolapse. Material and methods: During the study period (2014-2018) a total of 224 cases of prolapse reported in Gynaecology OPD. Prevalence was calculated to be 1.05% of the total OPD registrations of our department. Results: The mean age of patients in this study was 49.5 years. The most common presenting complaint was something coming out per vaginum (73.1%). Majority had parity between 2 to 6. 84.5% had vaginal home delivery and 15.4% had hospital vaginal delivery. Most patients presented with third degree uterovaginal prolapse (58.7%). Vault prolapse constituted 11.3%. Associated cystocele was present in 35.7%, and rectocele in 14.2% of cases. The most common predisposing factor identified was unsupervised home delivery. Pessary application(n=25) and Kiegel's exercise advice (n=102) were done on OPD basis. Conclusion: Improvement in general health, proper contraception and institutional delivery is required to prevent prolapse.Treatment should be tailored according to age and requirement.
Calcified pseudoneoplasm of neural axis (CAPNON) is rare non-neoplastic non-inflammatory heavily ... more Calcified pseudoneoplasm of neural axis (CAPNON) is rare non-neoplastic non-inflammatory heavily calcified lesions of neural axis which can be intra-parenchymal or extra-axial and have been reported within brain and spinal cord with equal frequency. Here we describe unique radiological (CT &MRI) Imaging finding of CAPNON in left hippocampus on CT scan and MRI.
C ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 mi... more C ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 million births [1]. It was first described by Cockayne in 1936, and till now, around 150 cases have been reported in literature [2]. CS is associated with mutations in the gene CS Type A (CSA)/excision-repair cross-complementing protein (ERCC) 8 or CS Type B (CSB)/ERCC6 which provide instructions for repairing damaged DNA [3]. Clinically, three types of CS have been described in literature as classical, milder, and severe form depending on the time of presentation and severity of the clinical symptoms and final outcome [4]. The classical features of CS are progressive loss of subcutaneous fat and muscle, mental retardation, premature ageing, dwarfism, facial abnormalities, microcephaly, retinopathy, protruding neck, hearing loss, dental changes, large extremities, joints contracture, photosensitivity, dry skin, and hair [5]. Intracranial calcification and brain atrophy are seen in most of the individuals. Progression of syndrome leads to functional disability and bedridden in the 2 nd decade of life and patients lastly die [6]. Early diagnosis is very important for patient management and proper parental genetic counseling. We present a case which is still worth important as a rare entity with its important clinical and radiological findings. DISCUSSION CS is an autosomal recessive disorder with incidence around 1 case per 2.77 million births [1]. The basic pathology is deficient DNA repair mechanism due to mutation in gene CSA/ERCC8 and CSB/ ERCC6 located on the chromosomes 5 and 10, respectively [3]. Despite these, principle genes sensitivity of the patient fibroblasts
Aim: To evaluate the frequency and patterns of different cutaneous granulomatous lesions. Materia... more Aim: To evaluate the frequency and patterns of different cutaneous granulomatous lesions. Materials and Methods: The present cross-sectional observational study was conducted in the Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India from December 2019 to May 2020. This cross-sectional study enrolled 120 cases of skin biopsies after histopathological confirmation of granulomatous lesions. Results: Among 120 cases that were studied , male predominance was noted with 73(60.84%) cases and females constituted 47(39.16%) case providing M: F ratio of 1.5:1. Most of the patients were in age group of 20 to 30 years i.e. 45(37.5%) cases followed by 23 (19.17%) case in 30 to 40 years. 85% of cases were seen below 50 years of age in our study. Infectious granulomatous dermatoses were very common. Only 2 cases of sarcoidosis were found. Most cases of infectious dermatoses were noted in 20 to 30 years comprising 45(37.5%) cases. Leprosy rem...
Agenesis of the dorsal pancreas is a rare entity and is caused due to the defective embryological... more Agenesis of the dorsal pancreas is a rare entity and is caused due to the defective embryological development of the pancreas. The clinical manifestations may range from diabetes mellitus, pancreatitis, and abdominal pain to no symptoms at all. We here present a case series of 10 cases with complete or partial agenesis of the dorsal pancreas. To correlate the clinical symptoms in the patients with the dorsal agenesis of the pancreas, to study any biochemical abnormality present with the dorsal agenesis of the pancreas, and to look for other coexistent finding in the patients. We observed that out of 10 patients, six were males and four were females. Four had symptoms related to the pancreas and six were discovered incidentally. Diabetes mellitus was present in five patients, seven patients had pain in the abdomen, and jaundice was seen in three patients. Out of 10 patients, four had complete agenesis and six had partial agenesis of the dorsal pancreas. We conclude that the diagnosis of this rare entity and establishing its association with clinical conditions like diabetes mellitus and non-specific abdomen pain with the aid of cross-sectional imaging helps in the better evaluation and management of the patients.
We aim to study the spectrum of imaging findings in patients with rhino-oculo-cerebral mucormycos... more We aim to study the spectrum of imaging findings in patients with rhino-oculo-cerebral mucormycosis (ROCM). This retrospective descriptive study was performed in histopathologically confirmed cases of rhino-oculocerebral mucormycosis in a tertiary care center in Bihar, India. The case records of patients with radiological, cultural, and histological evidence of acute invasive ROCM were retrospectively evaluated for relevant radiological and clinical data between May 2021 and June 2022. The radiological evaluation included computed tomography (CT) and magnetic resonance imaging (MRI) scans done on 52 patients. The patient's average age was 48 years. The ethmoid sinus was involved in 51 (98%) cases and the maxillary sinus in 50 (96%) cases. Bilateral sinus involvement (45, 86%) was the most common, followed by pansinus involvement (27, 52%). The orbit was involved in 39 (75%) cases, the face in 25 (47%) cases, and retroantral fat stranding in 24 (46%) cases. Mucosal thickening (91%) was the most common pattern of involvement, followed by complete opacification (77%). Osseous involvement was seen in 17 of 44 patients who had CT scans, and the majority of patients had extrasinus extension with intact bone. MRI revealed variable T2SI, with T2 hyperintensity being the most common pattern. Heterogeneous enhancement in post-contrast imaging was the most common. ROCM is a life-threatening invasive fungal infection, especially in an immunocompromised state. ROCM is characterized by a variety of imaging abnormalities on CT and MRI, although nonspecific. Imaging aids in suspicion or early diagnosis in appropriate clinical contexts, particularly in an immunocompromised state, and in determining the degree of involvement and complications. Early detection of ROCM and its complications enables proper treatment, which can lower the cost of care, morbidity, and mortality.
The posterior fossa is situated between the tentorium cerebelli above and the foramen magnum belo... more The posterior fossa is situated between the tentorium cerebelli above and the foramen magnum below. Vital structures like the cerebellum, the pons, and the medulla are situated within it; hence, tumors within the posterior fossa are considered one of the most critical brain lesions. Children are more likely to develop posterior fossa tumors than adults. Diffusion-weighted imaging (DWI) and magnetic resonance spectroscopy (MRS) sequences along with the conventional MRI help in providing additional information in the characterization of the various posterior fossa tumors. We hereby present a series of 30 patients with clinically suspected posterior fossa masses who underwent preoperative MRI. This study aims to differentiate the neoplastic from non-neoplastic posterior fossa mass by evaluating the diffusion restriction pattern on DWI, quantifying the apparent diffusion coefficient (ADC) map in various posterior fossa tumors, and comparing the different metabolites of various posterior fossa tumors on MRS. Out of the 30 patients with posterior fossa lesions, 18 were males and 12 were females. Eight of them were in the pediatric age group, while twenty-two of them were adults. Metastasis was the most common posterior fossa lesion in our study sample and was found in six patients (20%), followed by vestibular schwannomas (17%) and arachnoid cysts (13%), meningiomas, medulloblastoma, and pilocytic astrocytoma (10% each) and epidermoid, ependymoma, and hemangioblastoma (7% each). The mean ADC value of benign tumors was higher than that of malignant tumors, and this difference was found to be significant (p = 0.012). The cut-off ADC value 1.21x 10 -3 mm 2 /s had a sensitivity of 81.82% and specificity of 80.47%. MRS metabolites played an additional role in differentiating benign from malignant tumors. A combination of conventional MRI, DWI, ADC values, and MRS metabolites showed good diagnostic accuracy to differentiate between the various posterior fossa neoplastic tumors both in adults and children.
ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 mill... more ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 million births . It was first described by Cockayne in 1936, and till now, around 150 cases have been reported in literature . CS is associated with mutations in the gene CS Type A (CSA)/excision-repair cross-complementing protein (ERCC) 8 or CS Type B (CSB)/ERCC6 which provide instructions for repairing damaged DNA . Clinically, three types of CS have been described in literature as classical, milder, and severe form depending on the time of presentation and severity of the clinical symptoms and final outcome . The classical features of CS are progressive loss of subcutaneous fat and muscle, mental retardation, premature ageing, dwarfism, facial abnormalities, microcephaly, retinopathy, protruding neck, hearing loss, dental changes, large extremities, joints contracture, photosensitivity, dry skin, and hair . Intracranial calcification and brain atrophy are seen in most of the individuals. Progression of syndrome leads to functional disability and bedridden in the 2 nd decade of life and patients lastly die . Early diagnosis is very important for patient management and proper parental genetic counseling. We present a case which is still worth important as a rare entity with its important clinical and radiological findings. CS is an autosomal recessive disorder with incidence around 1 case per 2.77 million births . The basic pathology is deficient DNA repair mechanism due to mutation in gene CSA/ERCC8 and CSB/ ERCC6 located on the chromosomes 5 and 10, respectively . Despite these, principle genes sensitivity of the patient fibroblasts
Journal of advances in medicine and medical research, Nov 12, 2022
Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than child... more Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than children. They are mostly retroperitoneal. Primary adrenal teratomas are even rarer. Objective: We report an unusual case of primary adrenal teratoma in a young adult. Case Summary: A 29 year old male presented with complains of intermittent right sided flank pain for 6 months, dull aching, radiating to groin. On CT Abdomen a large heterogenous mass was seen having predominantly fat component and punctuate calcification in right suprarenal region. Histopathology confirmed a diagnosis of adrenal teratoma. Conclusions: Adrenal teratomas are difficult to diagnose clinically or on imaging as these mimic other lipomatous lesions. Although rare this should be considered as a differential diagnosis for adrenal tumors.
Journal of Advances in Medicine and Medical Research
Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than child... more Introduction: Extragonadal teratomas are uncommon tumors and are less common in adults than children. They are mostly retroperitoneal. Primary adrenal teratomas are even rarer. Objective: We report an unusual case of primary adrenal teratoma in a young adult. Case Summary: A 29 year old male presented with complains of intermittent right sided flank pain for 6 months, dull aching, radiating to groin. On CT Abdomen a large heterogenous mass was seen having predominantly fat component and punctuate calcification in right suprarenal region. Histopathology confirmed a diagnosis of adrenal teratoma. Conclusions: Adrenal teratomas are difficult to diagnose clinically or on imaging as these mimic other lipomatous lesions. Although rare this should be considered as a differential diagnosis for adrenal tumors.
Journal of Evolution of medical and Dental Sciences, 2021
BACKGROUND Prolonged fever can be defined as fever of more than 14 days duration. It can be cause... more BACKGROUND Prolonged fever can be defined as fever of more than 14 days duration. It can be caused by infection, non-infectious inflammatory diseases, malignancy, miscellaneous causes and undiagnosed causes. The present study was undertaken to study the clinical profile as well as aetiology of prolonged fever. METHODS A cross sectional study was conducted among patients of prolonged fever admitted in general medicine ward at IGIMS, Patna, Bihar. Patients were selected as per inclusion and exclusion criteria. A detailed history was taken followed by physical examination, systemic examination and investigations to find out the underlying aetiology. RESULTS Male patients were more than females. Most commonly affected age group was of 21 to 30 years comprising 25 patients followed by 13 patients in less than 20 years age group, 11 patients in 41 – 50 years age group, 10 patients in 51 – 60 years age group, 8 patients in 31 – 40 years age group, 7 patients in 61 - 70 years age group and ...
Journal of Evolution of Medical and Dental Sciences, 2017
BACKGROUND The term renal mass includes a large number of expansile entities, which are aggregate... more BACKGROUND The term renal mass includes a large number of expansile entities, which are aggregates of non-functional renal parenchyma. Renal masses can be neoplastic, non-neoplastic or normal variants. Aims and Objectives-To study the role of computed tomography in defining the nature of renal masses. MATERIALS AND METHODS 50 patients irrespective of age and sex, suspicious of malignant renal masses were included in this study. Toshiba 128-slice Computed Tomography Scan was used for scanning of all patients, plain and contrast both studies were performed and collected data was analysed. RESULTS Computed tomography was a very useful investigation for malignant renal masses, because it has got the ability to better characterise the lesions and it is accurate for pre-operative staging. CONCLUSION This can be concluded from our study that contrast CT scan is an investigation of choice for pre-operative staging of malignant renal masses due to its ability in demonstrating perinephric extension, invasion of renal fascia, evaluation of retroperitoneum and detection of distant metastases.
Aim and objectives Aim To study the spectrum of imaging findings in patients Rhino-occulo-cerebra... more Aim and objectives Aim To study the spectrum of imaging findings in patients Rhino-occulo-cerebral mucormycosis (ROCM). Objectives l To study the demographic profile of patients with ROCM l To detect the associated extrasinus complications of ROCM l To aid in clinical diagnosis of ROCM Materials & methods This retrospective descriptive study was performed in histopathologically confirmed cases of ROCM. The case records of patients with radiological, culture and histological evidence of acute invasive rhinocerebral mucormycosis were retrospectively evaluated for relevant radiological and clinical data between May 2021 to June 2022. Results The radiological evaluation included CT and MRI scans were done in 52 patients. The patient's average age was 48 years. The ethmoid sinus was involved in 46 cases (88%) and the maxillary sinus in 27 cases (52%). Biltaral (45, 86%) and pansinus (27, 52%) involvement were the most common. The orbit was involved in 39 cases (75%), the face in 25 c...
Egyptian Journal of Radiology and Nuclear Medicine
Background This study aims to characterize the spectrum of imaging findings in patients of Mayer–... more Background This study aims to characterize the spectrum of imaging findings in patients of Mayer–Rokitansky–Kuster–Hauser (MRKH) syndrome presenting with primary amenorrhoea. Objectives (1) To aid in clinical diagnosis of MRKH syndrome. (2) To detect the associated non gynecological anomalies. (3) To arrive at optimal management options. Results This prospective observational study was performed in 14 subjects who presented with primary amenorrhoea and diagnosed as MRKH on MRI from 1st January, 2021 to 30 June, 2022. Out of 14 patients, 4 patients showed hypoplastic uterus while remaining 10 showed complete uterine agenesis. Mean volume of hypoplastic uterus was 5.3 ml. Out of 10 patients with complete uterine agenesis, 9 showed bilateral rudimentary uterine buds connected by a fibrous band while 1 showed unilateral bud. 3 uterine buds showed three layered zonal differentiation of which 2 showed blood within lumen suggesting functioning endometrium. 1 uterine bud was located outside...
Journal of Gastrointestinal and Abdominal Radiology, 2022
Objective The purpose of this study was to find out the incidence of typical and atypical radiolo... more Objective The purpose of this study was to find out the incidence of typical and atypical radiological imaging findings of hepatocellular carcinoma (HCC) on multiphase multidetector computed tomography (MDCT) scans in histologically proven cases. Materials and Methods A multiphase computed tomography study of 73 patients with histologically proven HCC was evaluated by a radiologist. Our multiphasic protocol was composed of precontrast, arterial, portal, and delayed venous phases. The reviewers analyzed the CT images for tumor size, enhancement patterns of HCC in different phases, relative timing of washout, internal cystic changes, and presence of dysmorphic intratumoral vessel aneurysms or arteriovenous shunt. Results Most of the cases (95.9%) showed typical enhancement patterns in MDCT, i.e., enhancements in the arterial phase with the portal or delayed venous phase contrast washout. Three cases (4.9%) out of 73 HCC showed enhancements in the portal phase and washout in the delaye...
Background: An atresia is a congenital defect of a hollow viscus that results in complete obstruc... more Background: An atresia is a congenital defect of a hollow viscus that results in complete obstruction of the lumen. Intestinal atresia is one of the most frequent causes of bowel obstruction in the newborn and can occur at any point in the gastrointestinal tract. This study was undertaken to study the histomorphological findings of intestinal atresia and to correlate it with different subtypes and clinico-radiological feature. Material and methods: This was a prospective observational study conducted in 24 months on the resected gastrointestinal tract of 40 neonatal intestinal obstruction cases admitted in Pediatric surgery ward received in the Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna. Control Group- A total of 5 cases of vitello-intestinal duct patency were taken as control and compared with the study group. Results: With respect to total 40 cases, there were six, i.e. 15.0% female babies and 34, i.e. 85.0% male babies studied. Out of that, 15 i.e...
International journal of scientific research, 2019
Neurocysticercosis (NCC) is the most common parasitic disease of the nervous system with varied c... more Neurocysticercosis (NCC) is the most common parasitic disease of the nervous system with varied clinical and imaging spectrum. This study was conducted to describe the clinical , CT finding and response to therapy of NCC. Materials: Hundred (100) patients of NCC presenting in department of medicine, PMCH, Patna were evaluated on preset proforma containing detailed demographic data, dietary habits, clinical features and neuroimaging findings and its therapeutic response. Patients were treated with 28 days course of albendazole and repeat CT scan was done in 2 months after treatment. Results: Out of 100 patients of NCC, 56 (56%) were male with most common age group being 21-30 years (36%). Only Seizure is the most common presentation followed by Seizure with featuers of increased intracranial pressure (70 and 14% respectively). Multiple ring enhancing lesions either alone or in combination were seen on computerised tomography scans in 56 (56%) cases and parietal lobe involvement is the commonest site. Complete resolution of CT scan lesions in 72 (72%) and partial resolution occurred in rest of patients. Conclusions: Neurocysticercosis is common public health problem and one of the common cause of seizure. It has varied imaging finding being ring enhancement is most common. Albendazole is highly effective therapy and should be started at earliest to prevent morbidity and mortality.
International Journal of Contemporary Medical Research [IJCMR], 2019
Introduction: Pelvic organ prolapse is a common problem among women in developing countries. It i... more Introduction: Pelvic organ prolapse is a common problem among women in developing countries. It is the herniation of uterus into or beyond the vagina often accompanied by prolapse of vaginal walls involving the bladder or rectum or both. This study was done to determine its prevalence and identify the risk factors so that advice could be given to prevent its occurance and also to find out the current management practices in uterine prolapse. Material and methods: During the study period (2014-2018) a total of 224 cases of prolapse reported in Gynaecology OPD. Prevalence was calculated to be 1.05% of the total OPD registrations of our department. Results: The mean age of patients in this study was 49.5 years. The most common presenting complaint was something coming out per vaginum (73.1%). Majority had parity between 2 to 6. 84.5% had vaginal home delivery and 15.4% had hospital vaginal delivery. Most patients presented with third degree uterovaginal prolapse (58.7%). Vault prolapse constituted 11.3%. Associated cystocele was present in 35.7%, and rectocele in 14.2% of cases. The most common predisposing factor identified was unsupervised home delivery. Pessary application(n=25) and Kiegel's exercise advice (n=102) were done on OPD basis. Conclusion: Improvement in general health, proper contraception and institutional delivery is required to prevent prolapse.Treatment should be tailored according to age and requirement.
Calcified pseudoneoplasm of neural axis (CAPNON) is rare non-neoplastic non-inflammatory heavily ... more Calcified pseudoneoplasm of neural axis (CAPNON) is rare non-neoplastic non-inflammatory heavily calcified lesions of neural axis which can be intra-parenchymal or extra-axial and have been reported within brain and spinal cord with equal frequency. Here we describe unique radiological (CT &MRI) Imaging finding of CAPNON in left hippocampus on CT scan and MRI.
C ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 mi... more C ockayne syndrome (CS) is a rare autosomal recessive disorder occurs in about 1 case per 2.77 million births [1]. It was first described by Cockayne in 1936, and till now, around 150 cases have been reported in literature [2]. CS is associated with mutations in the gene CS Type A (CSA)/excision-repair cross-complementing protein (ERCC) 8 or CS Type B (CSB)/ERCC6 which provide instructions for repairing damaged DNA [3]. Clinically, three types of CS have been described in literature as classical, milder, and severe form depending on the time of presentation and severity of the clinical symptoms and final outcome [4]. The classical features of CS are progressive loss of subcutaneous fat and muscle, mental retardation, premature ageing, dwarfism, facial abnormalities, microcephaly, retinopathy, protruding neck, hearing loss, dental changes, large extremities, joints contracture, photosensitivity, dry skin, and hair [5]. Intracranial calcification and brain atrophy are seen in most of the individuals. Progression of syndrome leads to functional disability and bedridden in the 2 nd decade of life and patients lastly die [6]. Early diagnosis is very important for patient management and proper parental genetic counseling. We present a case which is still worth important as a rare entity with its important clinical and radiological findings. DISCUSSION CS is an autosomal recessive disorder with incidence around 1 case per 2.77 million births [1]. The basic pathology is deficient DNA repair mechanism due to mutation in gene CSA/ERCC8 and CSB/ ERCC6 located on the chromosomes 5 and 10, respectively [3]. Despite these, principle genes sensitivity of the patient fibroblasts
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Papers by Umakant Prasad