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Varsi F, Ahmad S, Chakraborty M, Chandra A, Dugad SR, Goswami UD, Gupta SK, Hariharan B, Hayashi Y, Jagadeesan P, Jain A, Jain P, Kawakami S, Kojima H, Lipari P, Mahapatra S, Mohanty PK, Moharana R, Muraki Y, Nayak PK, Nonaka T, Oshima A, Pant BP, Pattanaik D, Paul S, Pradhan GS, Rameez M, Ramesh K, Reddy LV, Saha S, Sahoo R, Scaria R, Shibata S, Zuberi M. Evidence of a Hardening in the Cosmic Ray Proton Spectrum at around 166 TeV Observed by the GRAPES-3 Experiment. Phys Rev Lett 2024; 132:051002. [PMID: 38364164 DOI: 10.1103/physrevlett.132.051002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/18/2023] [Revised: 10/16/2023] [Accepted: 01/04/2024] [Indexed: 02/18/2024]
Abstract
We present the measurement of the cosmic ray proton spectrum from 50 TeV to 1.3 PeV using 7.81×10^{6} extensive air shower events recorded by the ground-based GRAPES-3 experiment between 1 January 2014 and 26 October 2015 with a live time of 460 day. Our measurements provide an overlap with direct observations by satellite and balloon-based experiments. The electromagnetic and muon components in the shower were measured by a dense array of plastic scintillator detectors and a tracking muon telescope, respectively. The relative composition of the proton primary from the air shower data containing all primary particles was extracted using the multiplicity distribution of muons which is a sensitive observable for mass composition. The observed proton spectrum suggests a spectral hardening at ∼166 TeV and disfavors a single power law description of the spectrum up to the Knee energy (∼3 PeV).
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Affiliation(s)
- F Varsi
- Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - S Ahmad
- Aligarh Muslim University, Aligarh 202002, India
| | - M Chakraborty
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - A Chandra
- Aligarh Muslim University, Aligarh 202002, India
| | - S R Dugad
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - U D Goswami
- Dibrugarh University, Dibrugarh 786004, India
| | - S K Gupta
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - B Hariharan
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - Y Hayashi
- Graduate School of Science, Osaka Metropolitan University, Sugimoto, Sumiyoshi, Osaka 558-8585, Japan
| | - P Jagadeesan
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - A Jain
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - P Jain
- Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - S Kawakami
- Graduate School of Science, Osaka Metropolitan University, Sugimoto, Sumiyoshi, Osaka 558-8585, Japan
| | - H Kojima
- College of Engineering, Chubu University, Kasugai, Aichi 487-8501, Japan
| | - P Lipari
- INFN, Sezione Roma "Sapienza", Piazzale Aldo Moro 2, 00185 Roma, Italy
| | | | - P K Mohanty
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - R Moharana
- Indian Institute of Technology Jodhpur, Jodhpur 342037, India
| | - Y Muraki
- Institute for Space-Earth Environmental Research, Nagoya University, Nagoya 464-8601, Japan
| | - P K Nayak
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - T Nonaka
- Institute for Cosmic Ray Research, Tokyo University, Kashiwa, Chiba 277-8582, Japan
| | - A Oshima
- College of Engineering, Chubu University, Kasugai, Aichi 487-8501, Japan
| | - B P Pant
- Indian Institute of Technology Jodhpur, Jodhpur 342037, India
| | - D Pattanaik
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
- Utkal University, Bhubaneswar 751004, India
| | - S Paul
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - G S Pradhan
- Indian Institute of Technology Indore, Indore 453552, India
| | - M Rameez
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - K Ramesh
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - L V Reddy
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
| | - S Saha
- Indian Institute of Technology Kanpur, Kanpur 208016, India
| | - R Sahoo
- Indian Institute of Technology Indore, Indore 453552, India
| | - R Scaria
- Indian Institute of Technology Indore, Indore 453552, India
| | - S Shibata
- College of Engineering, Chubu University, Kasugai, Aichi 487-8501, Japan
| | - M Zuberi
- Tata Institute of Fundamental Research, Homi Bhabha Road, Mumbai 400005, India
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Jain K, Prakash A, Kumar J, Pradhan GS. Unravelling the Complex Relationship Between Frontal Sinus Pneumatization and Paranasal Sinus Anatomical Variants: Insights from CT Imaging. Indian J Otolaryngol Head Neck Surg 2024; 76:827-841. [PMID: 38440656 PMCID: PMC10909050 DOI: 10.1007/s12070-023-04287-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Accepted: 10/14/2023] [Indexed: 03/06/2024] Open
Abstract
The aim of this study was to analyse the relationship between frontal sinus pneumatization and its effect on various variations of paranasal sinuses on paranasal sinus CT scan. A total number of 100 patients (51 males, 49 females) were included in this study. Patients were divided into three groups on the basis of their frontal sinus pneumatization extent on paranasal sinus CT as Type 1 pneumatization (aplasia and hypoplasia), Type 2 pneumatization (medium) and Type 3 pneumatization (hyperplasia). The prevalence of various variations like pneumatization of upper and middle turbinate, presence of agger nasi, Haller and Onodi cell, maxillary sinus hypoplasia, extent of sphenoid sinus pneumatization, pneumatization of anterior clinoid process, pterygoid process and greater wing of sphenoid sinus, dehiscence and protrusion of internal carotid artery and optic nerve types were ascertained and compared within each group. The prevalence of Onodi cell, anterior clinoid process and greater wing of sphenoid pneumatization and optic nerves type 3 and 4 were higher in Type 3 frontal sinus pneumatization group as compared with other groups. Excessive pneumatization of frontal sinus has various effects on paranasal sinus variations. Surgeons dealing with endoscopic sinus surgery, maxillofacial and skull base surgery must be vigilant of association between these variations preoperatively for avoiding complications.
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Affiliation(s)
- Kaustav Jain
- Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Anjali Prakash
- Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Jyoti Kumar
- Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
| | - Gaurav Shanker Pradhan
- Department of Radiodiagnosis, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India
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Gautam S, Kumar R, Bhadoria DP, Mawari G, Kumar N, Daga MK, Pandit S, Anuradha S, Pradhan GS, Garg S, Sharma G, Raghu RV, Ritchie N, Jayamsulekha D. Clinical profile of hospitalised moderate category COVID-19 patients: Short study from a Tertiary Care Centre in Delhi. J Family Med Prim Care 2023; 12:1644-1653. [PMID: 37767420 PMCID: PMC10521840 DOI: 10.4103/jfmpc.jfmpc_2245_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2022] [Revised: 04/28/2023] [Accepted: 05/29/2023] [Indexed: 09/29/2023] Open
Abstract
Background The clinical profile of hospitalized moderate-category COVID-19 patients has been understudied globally and in India. Aim The present study was conducted to study the clinical profile and assess the proportions of patients who progressed to severe disease and its predictors among moderate COVID-19 patients. Materials and Methods In this single-center observational study, 100 moderate-category COVID-19 patients as per Ministry of Health and Family Welfare (MoHFW) criteria of age ≥18 years of either sex, excluding pregnant females from February to November 2021, were studied by analyzing their clinical profiles and assessing Quick Sequential Organ Failure Assessment (qSOFA), National Early Warning Score 2 (NEWS-2), and chest computed-tomography severity score (CTSS) to predict progression to severe disease. Severe disease was defined as per MoHFW criteria. Results Out of 100 moderate-category COVID-19 patients, progression to severe disease was seen in 11 patients (11%), among which eight patients had expired, three patients were discharged, and the rest of the 89 patients (89%) who did not progress to severe disease were discharged. A higher age (62.2± 19.5 vs 54.8 ± 14.6 years), along with multivariate analysis revealing male sex (1.25 times), chronic kidney disease (2.86 times), leukocytosis (6.10 times), thrombocytopenia (1.04 times), anemia (9.3 times), a higher qSOFA score (3.6 times), and a higher NEWS-2 score on admission (1.56 times) had higher odds of progression to severe disease. A significant correlation (P < .05) of qSOFA score with serum LDH, ferritin, and hs-CRP levels; CT severity score with the serum ferritin, IL-6, and LDH levels; and NEWS-2 with serum LDH, hs-CRP, and ferritin levels were found. Moreover, the NEWS-2 score was found slightly better than qSOFA on receiver operating characteristic (ROC) curve analysis, with an area under the curve of 85.8% and 83.2%, respectively, predicting progression to severe disease. Conclusion Our study revealed male gender, chronic kidney disease, leukocytosis, anemia, thrombocytopenia, a higher qSOFA and NEWS-2 score on admission, and further, NEWS-2 score better than qSOFA on ROC curve analysis, with an area under the curve of 85.8% and 83.2%, respectively, in predicting severe disease among hospitalized moderate COVID-19 patients.
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Affiliation(s)
- Sachin Gautam
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Rahul Kumar
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Dharam Pal Bhadoria
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Govind Mawari
- Department of Centre for Occupational and Environmental Health (COEH), Maulana Azad Medical College, New Delhi, India
| | - Naresh Kumar
- Department of Pulmonary Medicine, Maulana Azad Medical College, New Delhi, India
| | - Mradul K. Daga
- Department of Internal Medicine and Infectious Disease, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Sanjay Pandit
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - S. Anuradha
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | | | - Sandeep Garg
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Gaurav Sharma
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - RV Raghu
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Nupur Ritchie
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
| | - Dasari Jayamsulekha
- Department of Internal Medicine, Maulana Azad Medical College, New Delhi, India
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Gautam R, Dixit R, Pradhan GS. Venous Malformation in the Breast: Imaging Features to Avoid Unnecessary Biopsies or Surgery. J Radiol Case Rep 2023; 17:1-8. [PMID: 37600844 PMCID: PMC10435260 DOI: 10.3941/jrcr.v17i5.4635] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/22/2023] Open
Abstract
Venous malformations are now categorised under the broad heading of slow flow vascular malformations. They comprise abnormally dilated venous channels that fail to involute. These may be superficial or deep in location. We describe two cases of venous malformation in breast. Both the patients presented with focal pain in one breast. On mammography, they appeared as equal density well circumscribed soft tissue masses. No sonographic correlate was found on initial ultrasound examination. Subsequent ultrasonography performed by an experienced radiologist with minimal probe pressure revealed dilated veins. On the basis of imaging findings, the diagnosis of venous malformation was established.
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Affiliation(s)
- Richa Gautam
- Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, G.I.P.M.E.R. and G.N.E.C. Hospitals, New Delhi, Delhi-110002 India
| | - Rashmi Dixit
- Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, G.I.P.M.E.R. and G.N.E.C. Hospitals, New Delhi, Delhi-110002 India
| | - Gaurav Shanker Pradhan
- Department of Radiodiagnosis, Maulana Azad Medical College and Associated Lok Nayak, G.I.P.M.E.R. and G.N.E.C. Hospitals, New Delhi, Delhi-110002 India
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Dixit R, Gupta A, Prakash A, Pradhan GS. Magnetic resonance imaging of rhino-orbito-cerebral mucormycosis: a pictorial review. Acta Radiol 2022; 64:1641-1649. [PMID: 36254401 DOI: 10.1177/02841851221132788] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
Rhino-orbito-cerebral mucormycosis is a potentially fatal disease requiring early magnetic resonance imaging (MRI) for disease evaluation and timely detection of intracranial complications. Angio-invasive nature leading to necrosis and infarction is the hallmark of mucormycosis. The disease follows a fulminant course extending from the paranasal sinuses to involve the orbit, deep neck spaces, skull base, facial bones, and intracranial compartment. Loss of vision either due to direct extension into the orbit or optic nerve infarction adds to disease morbidity. Prompt MRI using dedicated sequences can help in assessing the exact disease extent including early osseous and intracranial changes, which aid in precise disease management.
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Affiliation(s)
- Rashmi Dixit
- Department of Radiodiagnosis, 28862Maulana Azad Medical College, New Delhi, India
| | - Akarshi Gupta
- Department of Radiodiagnosis, 28862Maulana Azad Medical College, New Delhi, India
| | - Anjali Prakash
- Department of Radiodiagnosis, 28862Maulana Azad Medical College, New Delhi, India
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Ebinesh A, Ashta A, Satyam, Pradhan GS, Sharma R, Das P. Incidentally Diagnosed Extraluminal Leiomyosarcoma of Infrarenal Inferior Vena Cava: A Case Report and Literature Review from a Radiologist's Perspective. Acta Med Litu 2022; 29:258-270. [PMID: 37733410 PMCID: PMC9799014 DOI: 10.15388/amed.2022.29.2.12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 10/04/2022] [Accepted: 10/10/2022] [Indexed: 01/05/2023] Open
Abstract
Background Vascular leiomyosarcoma is a rare but most common vascular tumor of the inferior vena cava. Case presentation We present the case of an incidentally diagnosed extraluminal leiomyosarcoma of the inferior vena cava in a 62 year old patient who presented with abdominal pain following blunt trauma. Ultrasonography showed a lobulated hypoechoic lesion in the upper abdomen. Computed tomography (CT) and magnetic resonance imaging (MRI) showed a circumscribed lobulated near homogeneously enhancing retroperitoneal lesion in anterior relation to the infrarenal inferior vena cava, right paramedian in location with imperceptible vena caval lumen at the site of maximum contact. In positron emission tomography (PET) CT the lesion showed mild fluorodeoxyglucose (FDG) uptake with no distant metastases. CT guided biopsy with immunohistochemical analysis showed leiomyosarcoma. Patient underwent surgical resection with inferior vena cava reconstruction. Conclusions Leiomyosarcoma of the inferior vena cava is a rare tumor of vascular origin. Imaging plays an imperative role in the diagnosis and preoperative evaluation. This article also provides a comprehensive literature review of the radiological features of inferior vena caval leiomyosarcoma that would aid in optimal preoperative characterization and evaluation.
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Affiliation(s)
- A Ebinesh
- Department of Radiodiagnosis, Maulana Azad Medical College and associated hospitals, Jawahar Lal Nehru Marg, New Delhi, India
| | - Aanchal Ashta
- Department of Radiology, Maulana Azad Medical College and associated hospitals, Jawahar Lal Nehru Marg, New Delhi, India
| | - Satyam
- Department of Radiodiagnosis, Maulana Azad Medical College and associated hospitals, Jawahar Lal Nehru Marg, New Delhi, India
| | - Gaurav Shanker Pradhan
- Department of Radiodiagnosis, Maulana Azad Medical College and associated hospitals, Jawahar Lal Nehru Marg, New Delhi, India
| | - Rohin Sharma
- Department of Radiodiagnosis, Maulana Azad Medical College and associated hospitals, Jawahar Lal Nehru Marg, New Delhi, India
| | - Prince Das
- Department of Radiology, Maulana Azad Medical College and associated hospitals, Jawahar Lal Nehru Marg, New Delhi-110002, India
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Pandey NN, Pradhan GS, Manchanda A, Garg A. Diagnostic Value of Acoustic Radiation Force Impulse Quantification in the Differentiation of Benign and Malignant Thyroid Nodules. Ultrason Imaging 2017; 39:326-336. [PMID: 28468574 DOI: 10.1177/0161734617706170] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
The objective of this study was to evaluate the role of ultrasound elastography using acoustic radiation force impulse (ARFI) quantification in characterizing and differentiating malignant versus benign thyroid nodules. A total of 40 thyroid nodules were evaluated with conventional sonography and ultrasound elastography using ARFI quantification. The final diagnosis was obtained from histologic findings. A total of 14 malignant and 26 benign nodules were diagnosed on the basis of histologic examination. Majority of the malignant thyroid nodules demonstrated presence of intranodular vascular flow, hypoechoic echotexture, absent halo, irregular margins and microcalcifications. However, a considerable overlap was noted in the sonographic features of malignant and benign thyroid nodules. On ARFI quantification, the mean shear wave speed (SWS) values ( M ± SD) of malignant and benign thyroid nodules were 3.131 ± 0.921 m/s and 1.691 ± 0.513 m/s, respectively. A significant difference was observed between the mean SWS values of malignant thyroid nodules and benign thyroid nodules ( p < 0.0001). Applying a cutoff value of 2.53 m/s, the sensitivity, specificity, and the area under the receiver operating characteristic curve for the differentiation were 85.71%, 96.15%, and 0.922, respectively. ARFI quantification is a promising elastography technique that provides quantitative information about tissue stiffness. It provides additional information and complements sonography as an effective diagnostic tool in characterizing and differentiating benign from malignant thyroid nodules.
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Affiliation(s)
- Niraj Nirmal Pandey
- 1 Department of Radio-Diagnosis, Lok Nayak Hospital, Maulana Azad Medical College, New Delhi, India
| | - Gaurav Shanker Pradhan
- 1 Department of Radio-Diagnosis, Lok Nayak Hospital, Maulana Azad Medical College, New Delhi, India
| | - Alpana Manchanda
- 1 Department of Radio-Diagnosis, Lok Nayak Hospital, Maulana Azad Medical College, New Delhi, India
| | - Anju Garg
- 1 Department of Radio-Diagnosis, Lok Nayak Hospital, Maulana Azad Medical College, New Delhi, India
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Singh K, Sunku R, Rathi A, Pradhan GS. Predicting outcome of advanced head and neck cancer by measuring tumor blood perfusion in patients receiving neoadjuvant chemotherapy. J Clin Oncol 2014. [DOI: 10.1200/jco.2014.32.15_suppl.e17006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
| | - Rubu Sunku
- Dr B Borooah Cancer Institute,, Gwuahati, India
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