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Ilangovan G, M M, Mounika V, Khan MA. Torsion of Epididymal Cyst: A Case Report With Review of Literature. Cureus 2023; 15:e51158. [PMID: 38283501 PMCID: PMC10811970 DOI: 10.7759/cureus.51158] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/25/2023] [Indexed: 01/30/2024] Open
Abstract
Torsion of an epididymal cyst is one of the rare and least-known causes of acute scrotal pain. Epididymal cysts, when large, can undergo occasional complications like infection or, rarely they might undergo torsion, needing emergency surgery. We present a case of a 37-year-old gentleman with acute scrotal pain to the scrotum. Testicular torsion was suspected clinically, but sonography revealed a normal-appearing testis and a large left-sided epididymal cyst with internal echoes and dependent debris. A diagnosis of epididymal cyst torsion was suspected based on sonographic findings. Exploratory surgery showed a reddish, inflamed epididymal cyst that had undergone torsion on its pedicle. The cyst was excised leading to symptomatic relief to the patient. Due to the rarity of this condition, such cases are often misdiagnosed clinically as testicular torsion. Ultrasonography helps in aiding the correct diagnosis and the radiologist needs to be familiar with the radiological aspects of diagnosing torsion of epididymal cysts.
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Affiliation(s)
| | - Manimaran M
- Radiodiagnosis, Tagore Medical College and Hospital, Chennai, IND
| | - Vogu Mounika
- Radiodiagnosis, Tagore Medical College and Hospital, chennai, IND
| | - Moien Ab Khan
- Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
- Primary Care, North West London - National Health Service Provider, London, GBR
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2
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Joseph R, Sathiamoorthy R, Gnanasekaran R, Gunasekaran L, Ilangovan G. A Case Report of Pseudomyxoma Peritonei Arising From Primary Mucinous Ovarian Neoplasms. Cureus 2022; 14:e29309. [PMID: 36277572 PMCID: PMC9579829 DOI: 10.7759/cureus.29309] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/19/2022] [Indexed: 11/12/2022] Open
Abstract
Pseudomyxoma peritonei (PMP) is a rare manifestation of primary mucinous neoplasms. We report two rare cases of PMP originating from mucinous primary ovarian neoplasms. The case series discusses the cases of female patients aged 86 and 52 years who presented with worsening dyspepsia, abdominal distension, pelvic pain, and altered bowel habits. Both of the patients underwent evaluation comprising cancer antigen-125 (CA-125) levels, ultrasound (US) examination of the abdomen and the pelvis, tumor markers, cytological evaluation, and contrast-enhanced computed tomography (CECT) of the pelvis and abdomen. Patients were diagnosed to have pseudomyxoma peritonei arising from mucinous ovarian tumors. Patients were referred to the surgical department and were successfully managed with repeated removal of mucinous material. The present case report highlights the significant radio-pathologic characteristics of PMP, which originated from mucinous ovarian tumors.
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Parthasarathy R, Parthasarathy EA, Rajamani A, Ilangovan G, Niranjana AK. Effectiveness of orthopedic metal artifact reduction among patients undergoing computed tomography at a tertiary setting – A cross-sectional study. Asian J Med Sci 2022. [DOI: 10.3126/ajms.v13i8.44770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Background: In computed tomography (CT), metal implants increase the inconsistencies between the measured data and the linear assumption of the radon transform made by the analytic CT reconstruction algorithm.
Aims and Objectives: The aims of this study was to evaluate the effectiveness of orthopedic metal artifact reduction (O-MAR) among patients undergoing CT at a tertiary setting.
Materials and Methods: A cross-sectional observational study was conducted on 30 subjects attending the department of radiology for CT scan for 1 year from December 2018 to 2019. The CT scan was performed in 64 detector row (PHILIPS INGENUITY CORE 128 slice) scanner. The patient was asked for the presence of metallic objects/history of implants, and the topo gram confirms it. Image noise was considered as the primary outcome variable. The statistical analysis was performed using the coGuide software and P<0.005.
Results: All the thirty participants were analyzed finally. Image noise in plain image type was 79.5 SD of Hounsfield units, and in O-MAR image type, it was 44.01 SD of Hounsfield units denoting a higher percentage of SD in plain than O-MAR images.
Conclusion: The O-MAR application helped in improving image quality of CT for patients in the aspect of metal artifact reduction and soft-tissue profile. However, it can also improve diagnostic quality in the evaluation of patients with severe metallic artifacts by decreasing the negative impacts of orthopedic metals.
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Anand R, Kieu A, Arulraj E, Ilangovan G, D A N, AshwathNarayana G, Alneyadi MA, Khan MAB. A Rare Case of an Intra-nasal Ectopic Tooth in a Young Woman. Cureus 2021; 13:e19370. [PMID: 34925978 PMCID: PMC8654137 DOI: 10.7759/cureus.19370] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [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] [Accepted: 11/08/2021] [Indexed: 11/24/2022] Open
Abstract
Teeth in non-dentate areas including the intra-sinus and intranasal teeth are rarely encountered in clinical practice. Although the majority of patients remain asymptomatic, the usual presenting complaints are nasal obstruction, epistaxis, hyposmia and headache. In this article, we present a case of an intranasal tooth in a 15-year-old female who presented with complaints of hyposmia and nasal obstruction. Computed tomography (CT) of the paranasal sinuses and nasal cavity showed a tooth-like structure in the left inferior nasal cavity extending from the hard palate. The mainstay of treatment is the surgical removal of the ectopic tooth under anaesthesia. Even in asymptomatic patients, surgical removal of the nasal tooth is advised to prevent complications. Along with a clinician’s understanding of the condition, imaging aids in the diagnosis of an ectopic tooth. Imaging, particularly with CT, also helps plan the surgical approach to treatment.
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Affiliation(s)
- Rajamani Anand
- Radiology, Chettinad Hospital and Research Institute, Chennai, IND
| | - Alexander Kieu
- Family Medicine, United Arab Emirates University, Al Ain, ARE.,Family Medicine, Kanad Hospital, Al Ain, ARE
| | - Einstein Arulraj
- Radiology, Chettinad Academy of Research and Education, Chennai, IND
| | - Gurubharath Ilangovan
- Radiology, Chettinad Hospital and Research Institute Chettinad Academy of Research and Education, Chennai, IND
| | - Narmada D A
- Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, IND
| | | | | | - Moien A B Khan
- Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE.,Primary Care, North West London - National Health Service, London, GBR
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Ilangovan G, DA N, Murugadass N, Boudi Z, Masood-Husain S, Bhagavathula AS, Varwatte P, Khan MA. Back Pain Due to Kummell's Disease. Cureus 2021; 13:e18355. [PMID: 34725607 PMCID: PMC8553234 DOI: 10.7759/cureus.18355] [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] [Accepted: 09/28/2021] [Indexed: 11/09/2022] Open
Abstract
Kummell’s disease (KD) is a delayed post-traumatic avascular osteonecrosis of the vertebral body secondary to a vertebral compression fracture that can present with back pain. We discuss the importance of an accurate diagnosis and appropriate management of Kummell’s disease. Additionally, we aim to increase awareness and promote early diagnosis and treatment to prevent serious complications. A 55-year-old man had been diagnosed with avascular necrosis (AVN) of both hips and had a history of trauma to the left hip ten years ago. Between the initial fall and subsequent presentation, he resumed independent physical activity. At approximately 10 months following his initial injury, he returned to a local emergency department with vague complaints of lower back pain. He was prescribed analgesics for pain and discharged. Subsequently, he experienced a progressive increase in pain and complained of motor deficits of the lower limbs. He presented to our emergency room with acute onset of worsening pain. Magnetic resonance imaging revealed multiple-level compression fractures and a fluid cleft in the L2 intervertebral disc. Surgery was advised, but he did not consent. Therefore, nonsurgical treatment included bed rest, wearing a brace, lumbar traction, analgesics, and medication to prevent osteoporosis. Prompt, accurate diagnosis of Kummell’s disease is important for timely, appropriate treatment, which can improve quality of life and prevent comorbidities.
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Affiliation(s)
- Gurubharath Ilangovan
- Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, IND
| | - Narmada DA
- Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, IND
| | - Nikhil Murugadass
- Radiology, Chettinad Hospital and Research Institute, Chettinad Academy of Research and Education, Chennai, IND
| | - Zoubir Boudi
- Emergency Medicine, Dr Sulaiman Al Habib Hospital, Dubai, ARE
| | | | - Akshaya S Bhagavathula
- Public Health, Institute of Public Health, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE
| | - Pooja Varwatte
- Radiology, Shri Sathya Sai Medical Hospital and Research Institute, Chennai, IND
| | - Moien Ab Khan
- Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE.,Primary Care, North West London - National Health Service Provider, London, GBR
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Abstract
Gallbladder agenesis is a rare anatomic congenital abnormality caused by the cystic bud failing to develop into the gallbladder. Gallbladder agenesis has a variable presentation, with 50% of patients presenting with symptoms mimicking biliary colic and 35% being incidentally discovered during surgery or autopsy, while another 15% can present with fatal fetal anomalies. In this article, we present a case of gallbladder agenesis in a young woman who presented with biliary-colic-like symptoms suggesting cholecystitis. The gallbladder was not well visualized on ultrasonography, simulating chronic cholecystitis due to shrunken or contracted bladder. Further imaging with computed tomography (CT) and magnetic resonance cholangiopancreatography (MRCP) helped in the successful diagnosis of gallbladder agenesis and helped prevent unnecessary surgical intervention. Due to the lack of clinical suspicion diagnosing gallbladder agenesis preoperatively is still rare. Persistent symptoms are often associated with biliary colic pain leading to surgery. Conservative management consists of using antispasmodic medications. MRCP may be required to rule out gallbladder agenesis and avoid unnecessary surgery. Gallbladder agenesis can present with symptoms similar to cholecystitis. If the gallbladder is not visualized well on the ultrasound, an additional radiological examination is required. Clinicians’ understanding of the condition helps to accurately diagnose the condition preoperatively using the appropriate investigations, thereby minimizing the operative risk to the patient.
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Affiliation(s)
- Jeffrey S Joseph
- Radiology, Chettinad Hospital and Research Institute, Chennai, IND
| | - Vinith Ramesh
- Radiology, Chettinad Hospital and Research Institute, Chennai, IND
| | - Kholoud K Allaham
- Family Medicine, College of Medicine and Health Sciences, Al Ain, ARE
| | | | - Moien Ab Khan
- Family Medicine, College of Medicine and Health Sciences, United Arab Emirates University, Al Ain, ARE.,Primary Care, North West London - National Health Service Provider, London, GBR
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Varwatte P, Ilangovan G, Balganeshan H, Baary H, Jayajothi A. Non-Enhanced CT Mimicking Contrast Enhanced CT - A Case Report on Polycythemia. J Radiol Case Rep 2019; 13:10-16. [PMID: 31565177 DOI: 10.3941/jrcr.v13i4.3481] [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: 11/15/2022] Open
Abstract
Diffuse hyperdense cerebral vasculature is sometimes encountered on nonenhanced computed tomography, and polycythemia is one of the conditions which appears the same. The current case report is of a case of 37-year-old female patient arrived with a complaint of feeling severe headache for the past 3 days which was insidious in onset, diffuse in nature and it did not respond to any medication. NECT brain study showed the hyperdense circle of Willis and cerebral venous sinuses. Contrast was not administered for computed tomography study of the brain. On blood investigations, the patient had raised hematocrit level (74%). The hyperdense vessel was due to raised hematocrit (Polycythemia Vera).
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Affiliation(s)
- Pooja Varwatte
- Department of Radidiagnosis, Shri Sathya Sai Medical College and Research Institute, Chennai, India
| | - Gurubharath Ilangovan
- Department of Radidiagnosis, Shri Sathya Sai Medical College and Research Institute, Chennai, India
| | | | - Hussain Baary
- Department of Radidiagnosis, Shri Sathya Sai Medical College and Research Institute, Chennai, India
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Abstract
A bezoar refers to a mass of undigestible foreign material found in the gastrointestinal tract, mainly stomach. The second most common bezoar is the trichobezoar, which usually occurs in the young psychiatric female patients with history of trichotillomania and trichophagia. This is a case report of a 12 -year-old female patient came with complaints of diffuse abdominal pain, vomiting, and constipation. Ultrasound, Barium X-ray and Computed Tomography scan were done, which suggested trichobezoar. Thus, trichobezoar should be considered as differential diagnosis of abdominal pain in young female patients with associated psychiatric complaints. A review is presented here, as a high index of suspicion for better diagnostic facilities which can help in timely diagnosis and intervention, to prevent further complications like intestinal obstruction, perforation and mortality in such children.
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Affiliation(s)
- Sneha Lalith
- Postgraduate Student, Department of Radiology, Shri Sathya Sai Medical College and Research Insitute, Chennai, Tamil Nadu, India
| | - Karunya Lakshmi Gopalakrishnan
- Assistant Professor, Department of Radiology, Shri Sathya Sai Medical College and Research Insitute, Chennai, Tamil Nadu, India
| | - Gurubharath Ilangovan
- Professor, Department of Radiology, Shri Sathya Sai Medical College and Research Insitute, Chennai, Tamil Nadu, India
| | - Anandapadmanabhan Jayajothi
- Senior Resident, Department of Radiology, Shri Sathya Sai Medical College and Research Insitute, Chennai, Tamil Nadu, India
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Gajendrareddy PK, Ilangovan G, Kuppusamy P, Horan MP, Eijkelkamp N, Marucha PT. 053 Psychological Stress Impairs Healing and Oxygenation in Cutaneous Wounds. Wound Repair Regen 2004. [DOI: 10.1111/j.1067-1927.2004.0abstractaz.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Chandrasekara Pillai K, Ilangovan G. Preparation and characterisation of monomeric molybdate(VI) anion-doped polypyrrole electrodes. J Solid State Electrochem 1999. [DOI: 10.1007/s100080050184] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Abstract
Accessory urethra or duplication of the urethra is a rare anomaly. The vast majority occur in the sagittal plane; however, collateral or side-by-side duplications in the absence of bladder duplication also exist. We report six cases of urethral duplications. The mode of presentation and the importance of complete examination are discussed.
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Affiliation(s)
- N Prasad
- Department of Paediatric Surgery, Institute of Child Health and Hospital for Children, Chennai Medical College (Formerly Madras Medical College), Chennai-600 008 India
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Ilangovan G, Zen JM. First Observation That Electroinactively Bound Cations in Clay Can Participate in Electrocatalytic Reaction. CHEM LETT 1999. [DOI: 10.1246/cl.1999.153] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Ilangovan G, Chandarasekara Pillai K. Unusual activation of glassy carbon electrodes for enhanced adsorption of monomeric molybdate(VI). J Electroanal Chem (Lausanne) 1997. [DOI: 10.1016/s0022-0728(97)00155-1] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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