: Despite documented correlation between glioma grades and dynamic contrast-enhanced (DCE) magnetic resonance (MR) perfusion-derived parameters, and its inherent advantages over dynamic susceptibility contrast (DSC) perfusion, the former remains underutilized in clinical practice. Given the inherent spatial heterogeneity in high-grade diffuse glioma (HGG) and assessment of different perfusion parameters by DCE (extravascular extracellular space volume [Ve] and volume transfer constant in unit time [k-trans]) and DSC (rCBV), integration of the two into a protocol could provide a holistic assessment. Considering therapeutic and prognostic implications of differentiating WHO grade 3 from 4, we analyzed the two grades based on a combined DCE and DSC perfusion.
View Article and Find Full Text PDFMed J Armed Forces India
November 2022
Pulmonary alveolar proteinosis (PAP) is a rare disease which involves the accumulation of insoluble lipoproteinaceous material in the alveoli leading to impaired gas exchange and even respiratory failure. Autoimmune PAP is the most common type and is characterized by the presence of anti-granulocyte-monocyte colony stimulating factor (anti GM-CSF) antibody. Whole lung lavage has been traditionally used as first-line management of PAP but there is a lack of clarity especially in the treatment of relapsing cases of PAP.
View Article and Find Full Text PDFMed J Armed Forces India
September 2022
SARS-COV2 pandemic has spread like wildfire and has affected all the countries worldwide. The virus mainly affects the lungs and has numerous manifestations. The development of spontaneous pneumatocele and pneumothorax has rarely been reported in the literature, especially in spontaneously breathing patients.
View Article and Find Full Text PDFBackground: Intrapleural fibrinolytic therapy (IPFT) has been used as an effective agent since 1949 for managing complicated pleural effusion and empyema. Several agents, such as streptokinase, urokinase (UK), and recombinant tissue plasminogen activator (rt-PA), have been found to be effective with variable effectiveness. However, a head-tohead controlled trial comparing the efficacy of the most frequently used agents, i.
View Article and Find Full Text PDFMed J Armed Forces India
December 2023
Purpose: The study was undertaken to look into the clinicodemographic profile, management, and clinical outcomes of advanced retinoblastoma at a tertiary care center.
Methods: A prospective cohort study was conducted from Jan 2019 to Dec 2022. Forty-two patients of intraocular advanced retinoblastoma were assessed.
Tuberculosis is a leading cause of death in our country. Multidrug-resistant tuberculosis increases the morbidity and mortality due to severe manifestations and difficult and prolonged medications. Newer antitubercular drugs like delamanid have been approved by WHO in management of these cases, but the real-world experience of this drug is lacking in our country.
View Article and Find Full Text PDFThe data pertaining to selecting an optimal first-line strategy (stent retriever [SR] vs. contact aspiration [CA]) based on noncontrast computed tomography (NCCT) in cases of acute ischemic stroke consequent to large vessel occlusion (LVO) is lacking. This article studies the influence of hyperdense vessel sign (HVS) in selecting optimal first-line strategy, with intention of increasing first-pass recanalization (FPR).
View Article and Find Full Text PDFThe current COVID-19 pandemic has spread like wildfire worldwide and has affected millions of people. The novel corona virus mainly affects the lungs leading to life threatening disease like acute respiratory distress syndrome (ARDS). The aftermath of the disease in form of pulmonary fibrosis is upcoming cause of further increase in morbidity and mortality.
View Article and Find Full Text PDFMed J Armed Forces India
July 2021
Background: Pulmonary embolism (PE) has been identified as one of the deadliest complications of coronavirus disease 2019 (COVID-19), especially in patients admitted to the intensive care unit (ICU). Western literature reminds us of the high prevalence of PE in COVID. Here, we report a series of 13 cases of PE diagnosed and managed at our hospital.
View Article and Find Full Text PDFBackground: Coronavirus disease 2019 (COVID-19) continues to be a significant health problem worldwide. The unprecedented surge of mucormycosis in patients with COVID-19 is a new emerging challenge. Although a few studies documenting high incidence of mucormycosis in COVID -19 patients have recently emerged in literature, data pertaining to treatment outcomes in such cohorts is lacking.
View Article and Find Full Text PDFIntroduction: Organizing pneumonia (OP) is an idiopathic interstitial pneumonia characterized radiologically by the patchy peripheral areas of ground-glass opacities and consolidation. It is commonly associated with a variety of conditions such as connective tissue diseases (CTD), drugs, infections, malignancy, radiation exposure, post-transplant, and other interstitial pneumonia. There are no specific clinical manifestations unless there is an underlying etiology.
View Article and Find Full Text PDFObjectives: Aim of present study is to compare audiological and surgical outcomes in prelingual deaf children with Mondini's dysplasia (MD) and those with normal inner ear anatomy.
Materials And Methods: Retrospective data was collected from Jan 2008 to Dec 2016. Children with bony IEM other than MD, syndromic association, multiple disabilities, those lost to follow up, and perilingual or postlingual deafness were excluded from study.
Background: Scalp arteriovenous malformation (SAVM) is primarily treated by surgery and reports on endovascular treatment are scarce. We report the results of an endovascular-first approach in the treatment of SAVM. We also have proposed a simple dichotomized classification using the angiographically determined morphology findings and discussed its effect on therapeutic decision-making and outcomes.
View Article and Find Full Text PDFBackground: The definitive treatment of perimedullary arteriovenous fistulas (PMAVFs) is warranted in view of the progressive neurologic decline noted with the conservative mode of management. The treatment options include microsurgical excision, endovascular embolization, or a multimodal approach. Because of the relatively larger size of the feeding arteries in type B and C PMAVFs, an endovascular approach is usually feasible.
View Article and Find Full Text PDFBackground: Subcallosal artery (ScA) infarction is a well-recognized but uncommon complication of surgical treatment of anterior communicating artery aneurysms.
Case Description: An elderly man presented with massive subarachnoid hemorrhage due to left posterior communicating artery aneurysm with thick clots in the anterior interhemispheric fissure. The aneurysm was coiled with balloon protection, and later, on the fifth day of ictus, the patient became acutely confused and developed memory disturbances.
Int J Appl Basic Med Res
February 2015
Internal jugular vein (IJV) phlebectasia is rare in occurrence and is frequently misdiagnosed and managed inappropriately. It commonly presents as a unilateral neck swelling which typically increases in size with valsalva maneuver. Although, the most common cause of a focal neck swelling, which increases in size with valsalva maneuver is laryngocele, the possibility of phlebectasia of IJV should always be borne in mind, especially in child.
View Article and Find Full Text PDFIndian J Radiol Imaging
October 2014
Hypertrophic olivary degeneration is a trans-synaptic neuronal degeneration associated with hypertrophy of the inferior olivary nucleus due to a lesion in the triangle of Guillain-Mollaret. Familiarity with this entity on magnetic resonance imaging (MRI) is essential to avoid other erroneous ominous diagnoses. We present a case of bilateral hypertrophic olivary degeneration and discuss the etiopathogenesis and MRI findings in this entity.
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