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Sonthalia N, Roy A, Jajodia S, Goenka U, Sutradhar A, Tewari A, Goenka MK. Definitive Role of Contrast-enhanced Endoscopic Ultrasound (EUS) in the Diagnosis of Hepatocellular Carcinoma With Non-diagnostic Cross-sectional Imaging: A Case Report. J Clin Exp Hepatol 2024; 14:101307. [PMID: 38235294 PMCID: PMC10790079 DOI: 10.1016/j.jceh.2023.101307] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/05/2023] [Accepted: 11/22/2023] [Indexed: 01/19/2024] Open
Abstract
The diagnosis of hepatocellular carcinoma is usually centered around cross-sectional imaging (CSI) modalities. However, in some instances focal hepatic lesions may be missed on CSI. Endoscopic ultrasound (EUS) has an evolving role in hepatology and have been shown to be useful in diagnosing focal lesions with advantages of tissue acquisition. We report a case hepatitis B-related cirrhosis presenting with acute decompensation, wherein EUS was used to identify HCC and perform tissue acquisition as CSI was non-diagnostic.
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Affiliation(s)
- Nikhil Sonthalia
- Department of Gastroenterology, Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
| | - Akash Roy
- Department of Gastroenterology, Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
| | - Surabhi Jajodia
- Department of Radiology and Imaging, Apollo Multispeciality Hospitals, Kolkata, India
| | - Usha Goenka
- Department of Radiology and Imaging, Apollo Multispeciality Hospitals, Kolkata, India
| | - Arpita Sutradhar
- Department of Pathology, Apollo Multispeciality Hospitals, Kolkata, India
| | - Awanish Tewari
- Department of Gastroenterology, Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
| | - Mahesh K. Goenka
- Department of Gastroenterology, Institute of Gastrosciences and Liver Transplantation, Apollo Multispeciality Hospitals, Kolkata, India
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Goenka MK, Goenka U, Patil VU, Das SS, Afzalpurkar S, Jajodia S, Mukherjee M, Shah BB, Moitra S. Kinetics of Covid-19 antibodies in terms of titre and duration among healthcare workers: A longitudinal study. Natl Med J India 2023; 35:201-205. [PMID: 36715043 DOI: 10.25259/nmji_109_21] [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] [Indexed: 01/05/2023]
Abstract
Background Most individuals with Covid-19 infection develop antibodies specific to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, the dynamics of these antibodies is variable and not well-studied. We aimed to determine the titres of naturally acquired antibodies over a 12-week follow-up. Methods We recruited healthcare workers who had tested positive on a specific quantitative reverse transcription-polymerase chain reaction (qRT-PCR) for SARS-CoV-2, and then tested for the presence of immunoglobulin G (IgG) antibody against the same virus at baseline and again at 6 and 12 weeks. The antibody titre was determined by a semi-quantitative assay based on signal/cut-off ratio. Healthcare workers with antibody positivity were divided into those with high titre (ratio ≥12) and low titre (<12). Their demographic details and risk factors were surveyed through a Google form and analysed in relation to the antibody titres at three time-points. Results Of the 286 healthcare workers, 10.48% had high antibody titres. Healthcare workers who had tested positive by qRT-PCR and those who had received the Bacille Calmette-Guérin (BCG) vaccination or other immune-boosters had a higher frequency of high antibody titres. While there was a significant decline in antibody titres at 6 and 12 weeks, 87.46% of individuals positive for IgG antibody persisted to have the antibody even at 12 weeks. Conclusion Healthcare workers who tested positive for SARS-CoV-2 on qRT-PCR had a high positivity for the specific antibody, which continued to express in them even at 12 weeks. Further follow-up is likely to enhance our understanding of antibody kinetics following SARS-CoV-2 infection.
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Affiliation(s)
- Mahesh Kumar Goenka
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Usha Goenka
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Vikram Uttam Patil
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Sudipta Sekhar Das
- Department of Transfusion Medicine and Blood Bank, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Shivaraj Afzalpurkar
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Surabhi Jajodia
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Muhuya Mukherjee
- Department of Biostatistics, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Bhavik Bharat Shah
- Department of Clinical Imaging and Interventional Radiology, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
| | - Saibal Moitra
- Department of Allergy and Asthma Research Centre, Apollo Multispeciality Hospitals, Institute of Gastrosciences and Liver, Kolkata, West Bengal, India
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Rodge GA, Goenka U, Jajodia S, Agarwal R, Afzalpurkar S, Roy A, Goenka MK. Psoas Muscle Index: A Simple and Reliable Method of Sarcopenia Assessment on Computed Tomography Scan in Chronic Liver Disease and its Impact on Mortality. J Clin Exp Hepatol 2023; 13:196-202. [PMID: 36950487 PMCID: PMC10025677 DOI: 10.1016/j.jceh.2022.12.002] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Accepted: 12/02/2022] [Indexed: 03/24/2023] Open
Abstract
Objectives Psoas muscle parameters have been proposed as a simple and quick method for sarcopenia assessment. The aim of this study was to assess sarcopenia in cirrhotics by psoas muscle on computed tomography and its impact on mortality. Methods One hundred and fifty patients (75 cirrhotics, 75 subjects) were assessed for psoas muscle on CT scan. Psoas muscle index (PMI) was calculated as 'total psoas muscle area/(height of subject)2'. Cut off values for sarcopenia diagnosis were derived from local subjects (n = 75) who did not have cirrhosis/other causes of sarcopenia. Results Sarcopenia assessed by PMI was seen in 36% (n = 27) of the cirrhotics. Sarcopenia was significantly higher in patients having Child-Pugh C. Ascites, hepatic encephalopathy (HE) and gastro-intestinal bleed were seen in 48%, 18.7% and 24%, respectively. Sarcopenia was significantly associated with ascites and HE (P < 0.05). Out of the 75 cases, 53 cases completed the follow-up period of 1 year. Among the 20 cases who had sarcopenia, 35% (n = 7) succumbed to liver-related illness during 1 year follow-up, and out of the 33 cases without sarcopenia, only 6% (n = 2) died. The association of sarcopenia and 1 year mortality was statistically significant (P = 0.01). Conclusions The PMI, a simple method for sarcopenia assessment detected sarcopenia in 36% of cirrhotics. Patients with sarcopenia had a significantly higher 1 year mortality rate and appropriate prognostication of such patients is needed.
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Key Words
- CLD, Chronic Liver Disease
- CT scan
- CT, Computed Tomography
- GI, Gastro-Intestinal
- HBV, Hepatitis B Virus
- HCV, Hepatitis C Virus
- HE, Hepatic Encephalopathy
- HG, Hand Grip
- L3SMI
- MAC, Mid-Arm Circumference
- MAMC, Mid-Arm Muscle Circumference
- MELD, Model for End Stage Liver Disease
- NASH, Non-Alcoholic Steato-Hepatitis
- PBC, Primary Biliary Cholangitis
- PMI, Psoas Muscle Index
- PMTH, Psoas Muscle Thickness by Height of subject
- SMI, Skeletal Muscle Index
- TST, Tricep Skin fold Thickness
- chronic liver disease
- psoas muscle index
- sarcopenia
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Affiliation(s)
- Gajanan A. Rodge
- Institute of Gastrosciences & Liver, Apollo Multispeciality Hospital, Kolkata, India
| | - Usha Goenka
- Department of Interventional Radiology & Clinical Imaging, Apollo Multispeciality Hospital, Kolkata, India
| | - Surabhi Jajodia
- Department of Interventional Radiology & Clinical Imaging, Apollo Multispeciality Hospital, Kolkata, India
| | - Rachit Agarwal
- Department of Gastroenterology, Orange City Hospital & Research Hospital, Nagpur, India
| | - Shivaraj Afzalpurkar
- Institute of Gastrosciences & Liver, Apollo Multispeciality Hospital, Kolkata, India
| | - Akash Roy
- Institute of Gastrosciences & Liver, Apollo Multispeciality Hospital, Kolkata, India
| | - Mahesh K. Goenka
- Institute of Gastrosciences & Liver, Apollo Multispeciality Hospital, Kolkata, India
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Goenka U, Jajodia S, Jash D, Ghosh S, Bandyopadhyay S. Acute exogenous lipoid pneumonia: Unusual presentation as cavitating lung disease with pneumothorax. Respir Med Case Rep 2022; 36:101593. [PMID: 35145844 PMCID: PMC8818583 DOI: 10.1016/j.rmcr.2022.101593] [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] [Received: 09/16/2021] [Revised: 12/14/2021] [Accepted: 01/24/2022] [Indexed: 11/30/2022] Open
Abstract
Acute lipoid pneumonia is quite uncommon and is associated with oily or lipid contents within the alveoli. Exogenous lipoid pneumonia due to kerosene poisoning, manifests with a wide clinical spectrum ranging from subtle chemical pneumonitis to marked severe pulmonary and systemic inflammation. We present an interesting case of an adult male with kerosene poisoning. He manifested with severe cavitating lung disease. In addition, he developed spontaneous pneumothorax. Both cavitating lung disease and pneumothorax are unusual manifestations of acute exogenous lipoid pneumonia and perhaps follow severe lung injury following high volume kerosene exposure.
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Jajodia S, Goenka U, Jash D, Tiwary I, Goenka MK. Endovascular management of massive hemoptysis due to covid-19 related pulmonary artery pseudoaneurysm: A rare entity. Radiol Case Rep 2021; 16:3597-3601. [PMID: 34466180 PMCID: PMC8390365 DOI: 10.1016/j.radcr.2021.08.048] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [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: 08/10/2021] [Revised: 08/17/2021] [Accepted: 08/19/2021] [Indexed: 12/12/2022] Open
Abstract
Pulmonary artery pseudoaneurysms are rare causes of massive hemoptysis, even less common in setting of COVID-19 pneumonia. We describe and discuss an index case of cavitating COVID-19 pneumonia complicated by a pulmonary artery pseudoaneurysm without concomitant pulmonary thromboembolism. The patient presented with severe hemoptysis and was managed by endovascular coil embolization. Good technical and clinical success was achieved with complete resolution of hemoptysis.
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Affiliation(s)
- Surabhi Jajodia
- Department of Clinical imaging and Interventional Radiology, Apollo Multi Speciality Hospitals, 58, Canal circular road, Kolkata 700054, India
- Corresponding author. S. Jajodia.
| | - Usha Goenka
- Department of Clinical imaging and Interventional Radiology, Apollo Multi Speciality Hospitals, 58, Canal circular road, Kolkata 700054, India
| | - Debraj Jash
- Department of Pulmonary Medicine, Apollo Multi Speciality Hospitals, Kolkata, India
| | - Indrajeet Tiwary
- Institute of Gastro-sciences, Apollo Multi Speciality Hospitals, Kolkata, India
| | - Mahesh Kumar Goenka
- Institute of Gastro-sciences, Apollo Multi Speciality Hospitals, Kolkata, India
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Jajodia S, Khandelwal AH, Khandelwal R, Kapoor AK, Baijal SS. Endovascular management of portal steal syndrome due to portosystemic shunts after living donor liver transplantation. JGH Open 2021; 5:599-606. [PMID: 34013061 PMCID: PMC8114994 DOI: 10.1002/jgh3.12540] [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] [Subscribe] [Scholar Register] [Received: 11/17/2020] [Revised: 02/21/2021] [Accepted: 03/21/2021] [Indexed: 11/20/2022]
Abstract
Background and Aim After liver transplant, pre‐existent porto‐systemic shunts (PSS) may persist, causing “portal steal,” leading to graft dysfunction, hepatic encephalopathy (HE), and eventual rejection. In recipients of small‐for‐size transplant liver grafts, shunts may be created intraoperatively, facilitating diversion of portal flow to systemic circulation to avoid ill‐effects of portal overperfusion. These iatrogenic shunts may also subsequently lead to portal steal. We aim to evaluate safety and efficacy of endovascular techniques in management of portal steal due to PSSs in living donor liver transplantation (LDLT) recipients. Methods Between 2013 and 2020, we encountered five LDLT recipients with large PSS, who presented with graft dysfunction and/or HE. One patient had a surgically created shunt and four had spontaneous shunts, not surgically ligated during transplant. Endovascular techniques including plug‐assisted or balloon‐occluded retrograde transvenous obliteration (PARTO/BRTO) or covered inferior vena cava (IVC) stent grafts were to occlude these PSS and counter the portal steal in all patients. Technical success and clinical outcomes at 1‐year‐follow‐up were assessed. Results Imaging showed large PSS causing portal steal syndrome in all five patients. IVC stent graft was used to isolate the shunt in two patients and PARTO/BARTO was performed in three patients. One patient had guarded prognosis due to multiple organ dysfunction and died 5 days after endovascular procedure. At 1‐year follow up, graft functions normalized in four patients with no recurrence of HE. No procedure‐related complications were seen. Conclusion Endovascular techniques can be safely and effectively used to counter portal steal syndrome in LDLT recipients, thus avoiding surgical re‐exploration in these patients.
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Affiliation(s)
- Surabhi Jajodia
- Department of Clinical Imaging and Interventional Radiology Apollo Hospitals Kolkata India.,Department of Interventional Radiology Medanta - The Medicity, Gurugram Haryana India
| | - Anubhav H Khandelwal
- Department of Interventional Radiology Medanta - The Medicity, Gurugram Haryana India
| | - Rohit Khandelwal
- Department of Interventional Radiology Medanta - The Medicity, Gurugram Haryana India
| | - Abhay K Kapoor
- Department of Interventional Radiology Medanta - The Medicity, Gurugram Haryana India
| | - Sanjay S Baijal
- Department of Interventional Radiology Medanta - The Medicity, Gurugram Haryana India
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Kumar Goenka M, Bharat Shah B, Goenka U, Das SS, Afzalpurkar S, Mukherjee M, Patil VU, Jajodia S, Rodge GA, Khan U, Bandopadhyay S. COVID-19 prevalence among health-care workers of Gastroenterology department: An audit from a tertiary-care hospital in India. JGH Open 2021; 5:56-63. [PMID: 33490614 PMCID: PMC7812452 DOI: 10.1002/jgh3.12447] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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] [Received: 10/06/2020] [Revised: 10/19/2020] [Accepted: 10/20/2020] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND AIM In the present coronavirus disease-19 (COVID-19) era, health-care workers (HCWs) warrant special attention because of their higher risk and potential to transmit the disease. Gastroenterology services include emergency and critical care along with the endoscopy procedures, which have aerosol-generating potential. This study was aimed at auditing the COVID-19 impact on HCWs working in the Gastroenterology department of our hospital. METHODS The COVID-19 status of 117 HCWs was collected using either polymerase chain reaction (PCR) or Immunoglobulin G (IgG) seroassay. COVID-19 positivity was correlated with demographic characteristics, job profile, area of work, and medical history. RESULTS Thirty-eight HCWs (32.48%) showed evidence of COVID-19 using PCR (23.93%) or only IgG assay (8.55%). Endoscopy technicians (68.75%) exhibited significantly higher (P = 0.003) COVID-19 incidence compared to doctors (20.69%). Those working in the critical care units exhibited a trend toward higher COVID-19 incidence (42.86%). None of the six HCWs who received adequate hydroxychloroquine prophylaxis developed evidence of COVID-19. All the HCWs with COVID-19 disease recovered. However, there was a considerable loss of "man-days." CONCLUSIONS In our setting, we observed a high COVID-19 risk for HCWs working in the Gastroenterology department, with the highest risk among the endoscopy technicians. A more stringent triaging and pretesting of patients, as well as HCWs, might decrease the risk of COVID-19. Further multicenter studies are needed to evaluate the risk and related parameters.
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Affiliation(s)
- Mahesh Kumar Goenka
- Institute of Gastrosciences and LiverApollo Gleneagles HospitalsKolkataIndia
| | - Bhavik Bharat Shah
- Institute of Gastrosciences and LiverApollo Gleneagles HospitalsKolkataIndia
| | - Usha Goenka
- Department of Clinical Imaging and Interventional RadiologyApollo Gleneagles HospitalsKolkataIndia
| | - Sudipto S Das
- Department of Transfusion Medicine and Blood BankApollo Gleneagles HospitalsKolkataIndia
| | | | - Mohuya Mukherjee
- Department of BiostatisticsApollo Gleneagles HospitalsKolkataIndia
| | - Vikram U Patil
- Institute of Gastrosciences and LiverApollo Gleneagles HospitalsKolkataIndia
| | - Surabhi Jajodia
- Department of Clinical Imaging and Interventional RadiologyApollo Gleneagles HospitalsKolkataIndia
| | - Gajanan A. Rodge
- Institute of Gastrosciences and LiverApollo Gleneagles HospitalsKolkataIndia
| | - Ujjaini Khan
- Department of MicrobiologyApollo Gleneagles HospitalsKolkataIndia
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Khandelwal AH, Batra S, Jajodia S, Gupta S, Khandelwal R, Kapoor AK, Mishra SK, Baijal SS. Radiofrequency Ablation of Parathyroid Adenomas: Safety and Efficacy in a Study of 10 Patients. Indian J Endocrinol Metab 2020; 24:543-550. [PMID: 33643872 PMCID: PMC7906106 DOI: 10.4103/ijem.ijem_671_20] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/05/2020] [Revised: 11/18/2020] [Accepted: 12/16/2020] [Indexed: 12/30/2022] Open
Abstract
PURPOSE To evaluate safety and effectiveness of ultrasound-guided percutaneous radiofrequency ablation of parathyroid adenoma in surgically unfit patients with hypercalcemia because of hyperparathyroidism. MATERIALS AND METHODS A retrospective review of hospital records from Jan 2012 to Dec 2018 revealed 10 patients, who had undergone ablation for solitary parathyroid adenoma. All 10 patients suffered from hyperparathyroidism because of parathyroid adenoma, resulting in hypercalcemia. These patients were surgically unfit because of comorbidities. Pre-ablation serum calcium and serum parathormone levels were measured and compared with the levels after the ablation. RESULTS Mean serum calcium level decreased significantly from 2.81 ± 0.17 mmol/L pre-ablation to 2.42 ± 0.17 mmol/L 72 h after ablation and parathyroid hormone levels became normal in all patients within 7 days. Seven patients remained normo-calcaemic at 6 months follow-up with no signs and symptoms of hyperparathyroidism. One patient with pancreatitis died after 15 days because of pre-existing multi-organ failure. Two patients were lost to follow-up before 6 months. CONCLUSION Radiofrequency ablation of parathyroid adenoma is a safe and effective alternate treatment method for symptomatic hypercalcemia in surgically unfit patients suffering from primary hyperparathyroidism because of parathyroid adenoma.
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Affiliation(s)
| | - Smarth Batra
- Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Surabhi Jajodia
- Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Saurabh Gupta
- Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Rohit Khandelwal
- Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Abhay Kumar Kapoor
- Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India
| | - Sunil Kumar Mishra
- Department of Endocrinology and Metabolism, Medanta-The Medicity, Gurugram, Haryana, India
| | - S. S. Baijal
- Department of Interventional Radiology, Medanta-The Medicity, Gurugram, Haryana, India
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Goenka M, Afzalpurkar S, Goenka U, Das SS, Mukherjee M, Jajodia S, Shah BB, Patil VU, Rodge G, Khan U, Bandyopadhyay S. Seroprevalence of COVID-19 Amongst Health Care Workers in a Tertiary Care Hospital of a Metropolitan City from India. J Assoc Physicians India 2020; 68:14-19. [PMID: 33187030] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
BACKGROUND Seroprevalence studies for COVID-19 evaluate the extent of undetected transmission in a defined community, with special significance among health care workers (HCW) owing to their greater exposure and potential to transmit. METHODS A total of 1122 HCW (approximately 25% of the employees) of a large tertiary care hospital in India were recruited for this cross-sectional study. COVID PCR-positive HCW were excluded. Based on their risk-assessment, participants were grouped into three categories. A questionnaire was administered and they were tested for SARS-CoV-2-IgG antibodies using the chemiluminescence. RESULTS The overall seroprevalence among workers was 11.94%, which included 19.85% in COVID units, 11.09% in non-COVID units, and 8% in administrative workers (p=0.007). Antibody prevalence was highest in the department of gastroenterology (11.94%), followed by oncology (10.53%), pathology (10.26%), emergency medicine (7.84%) and critical care medicine (7%). Housekeeping staff, food and beverage staff, lab assistants and technicians had higher seroprevalence rate than doctors and nurses (p < 0.0001). HCW with a history of BCG vaccination in childhood and those who received an adequate prophylactic dose of hydroxychloroquine (HCQ) had a lower seroprevalence as compared to those who did not (7.31% vs. 16.8% and 1.30% vs. 11.25% respectively). CONCLUSION BCG vaccination, HCQ prophylaxis, and the job profile influence the seroprevalence rate in HCW. Seroprevalence rate and follow-up evaluation of its durability may help hospitals to triage their staff at risk, rationalize their placement, prioritize the use of PPE, thereby potentially reducing the risk.
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Affiliation(s)
- Mahesh Goenka
- Director and Head, Medicine, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Shivaraj Afzalpurkar
- Registrar, Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Usha Goenka
- Director and Head, Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Sudipta Sekhar Das
- Senior Consultant and Head, Department of Transfusion Medicine, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Mohuya Mukherjee
- Clinical Data Analyst, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Surabhi Jajodia
- Consultant, Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Bhavik Bharat Shah
- Consultant, Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Vikram Uttam Patil
- Registrar, Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Gajanan Rodge
- Registrar, Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Ujjwayini Khan
- Consultant, Department of Microbiology, Apollo Gleneagles Hospitals, Kolkata, West Bengal
| | - Syamasis Bandyopadhyay
- Senior Consultant, Department of Internal Medicine, Apollo Gleneagles Hospitals, Kolkata, West Bengal
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Goenka M, Afzalpurkar S, Jajodia S, Shah BB, Tiwary I, Sengupta S. Dual purpose easily assembled aerosol chamber designed for safe endoscopy and intubation during the COVID pandemic. VideoGIE 2020; 5:505-506. [PMID: 33020747 PMCID: PMC7527309 DOI: 10.1016/j.vgie.2020.05.018] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/25/2023] Open
Affiliation(s)
- Mahesh Goenka
- Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, India
| | - Shivaraj Afzalpurkar
- Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, India
| | - Surabhi Jajodia
- Institute of Interventional Radiology and Clinical Imaging, Apollo Gleneagles Hospitals, Kolkata, India
| | - Bhavik Bharat Shah
- Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, India
| | - Indrajeet Tiwary
- Institute of Gastrosciences and Liver, Apollo Gleneagles Hospitals, Kolkata, India
| | - Saikat Sengupta
- Department of Anesthesia, Apollo Gleneagles Hospitals, Kolkata, India
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Malpani Dhoot N, Goenka U, Ghosh S, Jajodia S, Chand R, Majumdar S, Ramasubban S. Assigning computed tomography involvement score in COVID-19 patients: prognosis prediction and impact on management. BJR Open 2020; 2:20200024. [PMID: 33178981 PMCID: PMC7583351 DOI: 10.1259/bjro.20200024] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Revised: 08/05/2020] [Accepted: 08/06/2020] [Indexed: 12/24/2022] Open
Abstract
OBJECTIVE Chest CT can provide a simple quantitative assessment of the extent of the parenchymal opacities in COVID-19 patients. In this study, we postulate that CT findings can be used to ascertain the overall disease burden and predict the clinical outcome. METHODS In this prospective study undertaken from March 28, 2020, until May 20, 2020, 142 patients with CT features suggestive of viral pneumonia, and positive RT-PCR for COVID-19 were enrolled. A dedicated spiral CT scanner was used for all COVID-19 suspects. CT features were reported as typical, indeterminate, or atypical for COVID-19 pneumonia. A CT involvement score (CT-IS) was given to each scan and assigned mild, moderate, or severe category depending on the score range. The patients were followed up for at least 15 days. RESULTS Ground glass opacity was present in 100% of the patients. There was a significant association between CT-IS and the final outcome of the patients. A statistically significant increasing trend of mortality and requirement of critical medical attention was observed with the rising value of CT-IS in COVID-19. CONCLUSION The severe CT-IS score group has a high mortality. The CT-IS score could be valuable in predicting clinical outcome and could also be useful in triage of patients needing hospital admission. In situations where healthcare resources are limited, and patient load high, a more careful approach for patients with higher CT-IS scores could be indispensable. ADVANCES IN KNOWLEDGE CT-IS is a simple quantitative method for assessing the disease burden of COVID-19 cases. It can be invaluable in places with limited resources and high patient load to segregate patients requiring critical medical attention.
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Affiliation(s)
- Nilu Malpani Dhoot
- Department of Clinical Imaging and Intervention Radiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Usha Goenka
- Department of Clinical Imaging and Intervention Radiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Somali Ghosh
- Department of Clinical Imaging and Intervention Radiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Surabhi Jajodia
- Department of Clinical Imaging and Intervention Radiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
- Department of Critical Care, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Rashmi Chand
- Department of Clinical Imaging and Intervention Radiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Sanjib Majumdar
- Department of Clinical Imaging and Intervention Radiology, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
| | - Suresh Ramasubban
- Department of Critical Care, Apollo Gleneagles Hospital, Kolkata, West Bengal, India
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Goenka MK, Shah BB, Rai VK, Jajodia S, Goenka U. Mucosal Changes in the Small Intestines in Portal Hypertension: First Study Using the Pillcam SB3 Capsule Endoscopy System. Clin Endosc 2018; 51:563-569. [PMID: 30300988 PMCID: PMC6283757 DOI: 10.5946/ce.2018.041] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/21/2018] [Accepted: 07/18/2018] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND/AIMS To evaluate patients with portal hypertension (PH) of varied etiologies for portal hypertensive enteropathy (PHE) using the PillCam SB3 capsule endoscopy (CE) system. METHODS Consecutive patients with PH presenting with unexplained anemia and/or occult gastrointestinal bleeding were evaluated using the PillCam SB3 CE system. Abnormal findings were categorized as vascular or non-vascular. The patients with ongoing bleeding caused by PHE were treated. The correlation of the CE scores of PHE with the clinical, laboratory, and endoscopic features was determined. RESULTS Of the 43 patients included in the study, 41 (95.3%) showed PHE findings. These included varices (67.4%), red spots (60.5%), erythema (44.2%), villous edema (46.5%), telangiectasia (16.3%), and polyps (16.3%). The CE scores varied from 0 to 8 (mean±standard deviation, 4.09±1.8). Five patients (11.6%) showed evidence of ongoing or recent bleeding due to PHE. Three of these five patients underwent endotherapy, and one patient underwent radiological coil placement. CONCLUSION The PillCam SB3 CE system revealed a high prevalence of PHE in the patients with PH. Using this system, evidence of bleeding due to PHE was found in a small but definite proportion of the patients.
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Affiliation(s)
| | - Bhavik Bharat Shah
- Institute of Gastro-Sciences, Apollo Gleneagles Hospitals, Kolkata, India
| | - Vijay Kumar Rai
- Institute of Gastro-Sciences, Apollo Gleneagles Hospitals, Kolkata, India
| | - Surabhi Jajodia
- Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, India
| | - Usha Goenka
- Department of Clinical Imaging and Interventional Radiology, Apollo Gleneagles Hospitals, Kolkata, India
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