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Patel RK, Alagapan A, Tripathy T, Nayak HK, Pattnaik B, Dutta T, Gupta S, Mohakud S, Naik S, Deep Bag N. Bloody Bile and Rescue Intervention-A Case Series of Post-PTBD Hemorrhagic Complications With a Review of the Literature. J Clin Exp Hepatol 2024; 14:101392. [PMID: 38558862 PMCID: PMC10981119 DOI: 10.1016/j.jceh.2024.101392] [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: 12/19/2023] [Accepted: 02/29/2024] [Indexed: 04/04/2024] Open
Abstract
Percutaneous transhepatic biliary drainage (PTBD) is a routinely performed interventional radiological procedure. A myriad of complications can occur after PTBD, the most important being hemorrhagic complications that require immediate attention. Hemorrhage following PTBD may result from arterial, portal, or hepatic venous injury. A catheter or pull-back cholangiogram often demonstrates the venous injury. A computed tomogram angiogram aids in identifying bleeding sources and procedural planning. Catheter repositioning, upsizing, or clamping often suffice for minor venous bleeding. However, major venous injury necessitates tract embolization, portal vein embolization, or stent grafting. Arterial injury may lead to significant blood loss unless treated expeditiously. Transarterial embolization is the treatment of choice in such cases. Adequate knowledge about the hemorrhagic complications of PTBD will allow an interventional radiologist to take necessary precautionary measures to reduce their incidence and take appropriate steps in their management. This article entails four different hemorrhagic complications of PTBD and their interventional management. It also discusses the various treatment options to manage different kinds of post-PTBD hemorrhagic complications.
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Affiliation(s)
- Ranjan K. Patel
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Alamellu Alagapan
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Taraprasad Tripathy
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Hemant K. Nayak
- Department of Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Bramhadatta Pattnaik
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Tanmay Dutta
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Sunita Gupta
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar 751019, India
| | - Nerbadyswari Deep Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar 751019, India
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Dash PP, Mohanty P, Behura R, Behera S, Naik S, Mishra M, Sahoo H, Barick AK, Mohapatra P, Sahoo SK, Jali BR. Rapid Colorimetric and Fluorometric Discrimination of Maleic Acid vs. Fumaric Acid and Detection of Maleic Acid in Food Additives. J Fluoresc 2024; 34:1015-1024. [PMID: 37439921 DOI: 10.1007/s10895-023-03330-z] [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] [Received: 06/07/2023] [Accepted: 06/27/2023] [Indexed: 07/14/2023]
Abstract
An anthracene thiazole based Schiff base L was synthesized and employed for fluorescence switch-on detection of maleic acid in aqueous DMSO. The non-fluorescent L (10-5 M) showed an instantaneous and selective fluorescence enhancement at 506 nm upon interaction with maleic acid (10-5 M). Other potential carboxylic acids (10-5 M), such as malic acid, citric acid, acetic acid, cinnamic acid, tartaric acid, succinic acid, fumaric acid, oxalic acid and malonic acid failed to alter the chromo-fluorogenic properties of L. Probe L can be employed to detect maleic acid down to 2.74 × 10-6 M. The probe L showed good linearity from 2.97 to 6.87 µM. Analytical utility of L was examined by detecting maleic acid in various food additives and drosophila larvae.
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Affiliation(s)
- Pragyan P Dash
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India
| | - P Mohanty
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India
| | - R Behura
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India
| | - S Behera
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India
| | - S Naik
- Department of Life Science, National Institute of Technology, 769008, Rourkela, India
| | - M Mishra
- Department of Life Science, National Institute of Technology, 769008, Rourkela, India
| | - H Sahoo
- Department of Chemistry, National Institute of Technology, 769008, Rourkela, India
| | - Aruna K Barick
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India
| | - P Mohapatra
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India
| | - Suban K Sahoo
- Department of Chemistry, Sardar Vallabhbhai National Institute of Technology, 395007, Surat, Gujarat, India
| | - Bigyan R Jali
- Department of Chemistry, Veer Surendra Sai University of Technology, Burla, Sambalpur-768018, Odisha, India.
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Bhoi SK, Lahre Y, Jha M, Naik S, Purkait S, Samal P, Saharia GK, Kumar M, Behera P. From periphery to center, untold story of pure neuritic leprosy: an electrophysiological study. Acta Neurol Belg 2024:10.1007/s13760-024-02503-2. [PMID: 38438636 DOI: 10.1007/s13760-024-02503-2] [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: 06/15/2023] [Accepted: 02/08/2024] [Indexed: 03/06/2024]
Abstract
BACKGROUND Pure neuritic leprosy (PNL) is uncommon form of leprosy involving peripheral nerves. Some isolated case reports have shown imaging changes in the central nervous system (CNS) and also impairment in visual evoked potential (VEP), somatosensory evoked potential (SSEP) and brain stem auditory-evoked potentials (BAEPs) parameters in PNL, but there is lack of large study. This prospective observational study evaluates impairment in these central conduction studies among PNL patients. METHODS We screened patients with leprosy presenting with features of neuropathy and/or thickened nerves. Patients with bacilli-positive nerve biopsies were included in the study and subjected to routine tests along with nerve conduction study (NCS), VEP, tibial SSEP and BAEPs. Parameters of these studies were analyzed based on data from previous studies. RESULTS Of 76 patients screened for PNL 49 had positive findings in biopsy. Most of patients were male and mean age group was 46.35 ± 15.35 years. Mononeuritis multiplex was most common NCS pattern in 46.93% (23/49) patients. We found abnormal VEP in 13 out of 35 patients (37.14%). Similarly abnormal SSEP and BAEPs among 42.85% and 40% patients respectively. DISCUSSION This study shows that in PNL significant number of patients have subclinical CNS involvement. Exact pathophysiology of CNS involvement is not known till now but study of VEP, SSEP and BAEPs parameter may help in early diagnosis of PNL.
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Affiliation(s)
- Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India.
| | - Yuvraj Lahre
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Suvendu Purkait
- Department of Pathology and Laboratory Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Priyanka Samal
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Gautom Kumar Saharia
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Mukesh Kumar
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Pritimayee Behera
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
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Fatima K, Naik S, Jain M, Bhoi SK, Padhi S, Bag ND, Panigrahi A, Mohakud S. Diffusion-Weighted Imaging and Chemical Shift Imaging to Differentiate Benign and Malignant Vertebral Lesion: A Hospital-Based Cross-Sectional Study. Indian J Radiol Imaging 2024; 34:76-84. [PMID: 38106853 PMCID: PMC10723945 DOI: 10.1055/s-0043-1772848] [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] [Indexed: 12/19/2023] Open
Abstract
Objective The aim of this study was to evaluate the role of diffusion-weighted imaging (DWI) and chemical shift imaging (CSI) for the differentiation of benign and malignant vertebral lesions. Methods Patients with vertebral lesions underwent routine magnetic resonance imaging (MRI) along with DWI and CSI. Qualitative analysis of the morphological features was done by routine MRI. Quantitative analysis of apparent diffusion coefficient (ADC) from DWI and fat fraction (FF) from CSI was done and compared between benign and malignant vertebral lesions. Results Seventy-two patients were included. No significant difference was noted in signal intensities of benign and malignant lesions on conventional MRI sequences. Posterior element involvement, paravertebral soft-tissue lesion, and posterior vertebral bulge were common in malignant lesion, whereas epidural/paravertebral collection, absence of posterior vertebral bulge, and multiple compression fractures were common in benign vertebral lesion ( p < 0.001). The mean ADC value was 1.25 ± 0.27 mm 2 /s for benign lesions and 0.9 ± 0.19 mm 2 /s for malignant vertebral lesions ( p ≤ 0.001). The mean value of FF was 12.7 ± 7.49 for the benign group and 4.04 ± 2.6 for the malignant group ( p < 0.001). A receiver operating characteristic (ROC) curve analysis showed that an ADC cutoff of 1.05 × 10 -3 mm 2 /s and an FF cutoff of 6.9 can differentiate benign from malignant vertebral lesions, with the former having 86% sensitivity and 82.8% specificity and the latter having 93% sensitivity and 96.6% specificity. Conclusion The addition of DWI and CSI to routine MRI protocol in patients with vertebral lesions promises to be very helpful in differentiating benign from malignant vertebral lesions when difficulty in qualitative interpretation of conventional MR images arises.
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Affiliation(s)
- Kaneez Fatima
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mantu Jain
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Somnath Padhi
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ashutosh Panigrahi
- Department of Haematology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mohakud S, Das R, Bag ND, Mohapatra PR, Mishra P, Naik S. A Prospective Observational Study of Diagnostic Reliability of Semiquantitative and Quantitative High b-Value Diffusion-Weighted MRI in Distinguishing between Benign and Malignant Lung Lesions at 3 Tesla. Indian J Radiol Imaging 2024; 34:6-15. [PMID: 38106852 PMCID: PMC10723977 DOI: 10.1055/s-0043-1771530] [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] [Indexed: 12/19/2023] Open
Abstract
Aim The aim of this study was to evaluate the usefulness of high b-value diffusion-weighted imaging (DWI) to differentiate benign and malignant lung lesions in 3 Tesla magnetic resonance imaging (MRI). Materials and Methods Thirty-one patients with lung lesions underwent a high b-value (b= 1000 s/mm 2 ) DW MRI in 3 Tesla. Thirty lesions were biopsied, followed by histopathological analysis, and one was serially followed up for 2 years. Statistical analysis was done to calculate the sensitivity, specificity, and accuracy of different DWI parameters in distinguishing benign and malignant lesions. Receiver operating characteristic (ROC) curves were used to determine the cutoff values of different parameters. Results The qualitative assessment of signal intensity on DWI based on a 5-point rank scale had a mean score of 2.71 ± 0.75 for benign and 3. 75 ± 0.60 for malignant lesions. With a cutoff of 3.5, the sensitivity, specificity, and accuracy were 75, 86, and 77.6%, respectively. The mean ADC min (minimum apparent diffusion coefficient) value of benign and malignant lesions was 1. 49 ± 0.38 × 10-3 mm 2 /s and 1.11 ± 0.20 ×10-3 mm 2 /s, respectively. ROC curve analysis showed a cutoff value of 1.03 × 10-3 mm 2 /s; the sensitivity, specificity, and accuracy were 87.5, 71.4, and 83.3%, respectively. For lesion to spinal cord ratio and lesion to spinal cord ADC ratio with a cutoff value of 1.08 and 1.38, the sensitivity, specificity, and accuracy were 83.3 and 87.5%, 71.4 and 71.4%, and 80.6 and 83.8%, respectively. The exponential ADC showed a low accuracy rate. Conclusion The semiquantitative and quantitative parameters of high b-value DW 3 Tesla MRI can differentiate benign from malignant lesions with high accuracy and make it a reliable nonionizing modality for characterizing lung lesions.
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Affiliation(s)
- Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rasmibala Das
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari D. Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasanta R. Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pritinanda Mishra
- Department of Pathology and Lab Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Nayak MK, Sahoo B, Mahajan A, Naik S, Deep (Bag) N, Mishra B, Dash C. Reverse Y stenting in the management of vertebrobasilar junction fenestrated aneurysm: A novel technique. J Neurosci Rural Pract 2024; 15:126-129. [PMID: 38476428 PMCID: PMC10927056 DOI: 10.25259/jnrp_423_2023] [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] [Received: 07/31/2023] [Accepted: 10/07/2023] [Indexed: 03/14/2024] Open
Abstract
Fenestrated aneurysm at vertebrobasilar junction (VBJ) is very rare and can occur due to non-fusion of longitudinal neural axis forming basilar artery in the early stage of embryonic life. Due to defects in tunica media and weakness in its wall, these fenestrations are more likely to develop an aneurysm. Various treatment strategies are required for the management of these types of aneurysms including simple coiling, stent-assisted coiling, balloon remodeling technique, and more recently kissing flow diverters. Herein, we report the case of ruptured fenestrated VBJ aneurysm which was managed successfully with novel reverse Y stenting with coiling.
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Affiliation(s)
- Manoj Kumar Nayak
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswajit Sahoo
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anshu Mahajan
- Department of Interventional Neuroradiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep (Bag)
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswamohan Mishra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmaya Dash
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Sahoo A, Jain M, Naik S, Das G, Kumar P, Tripathy SK, Ratna HVK, Ramasubbu MK. Does indirect decompression by oblique lateral interbody fusion produce similar clinical and radiological outcomes to direct decompression by open transforaminal lumbar interbody fusion. J Neurosci Rural Pract 2024; 15:53-61. [PMID: 38476434 PMCID: PMC10927064 DOI: 10.25259/jnrp_322_2023] [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] [Received: 06/11/2023] [Accepted: 09/27/2023] [Indexed: 03/14/2024] Open
Abstract
Objectives Open transforaminal lumbar interbody fusion (O-TLIF) remains the most popular and widely practiced lumbar fusion method even today, providing direct decompression. Oblique lateral interbody fusion (OLIF) is a novel retroperitoneal approach that allows placement of a large interbody cage which provides an indirect neural decompression, and screws can be placed minimal invasively or through the Wiltse OLIF (W-OLIF) approach. We aim to find out the short-term efficacy of W-OLIF to O-TLIF in terms of radiological and clinical outcomes in patients of lumbar degenerative diseases. Materials and Methods Fifty-two patients were divided equally into two groups (group O-TLIF and group W-OLIF). Several parameters were measured, such as the spinal cord cross-sectional area (SC-CSA), foraminal cross-sectional area (F-CSA), disc height (DH), foraminal height (FH), Schizas grade for stenosis, and Meyerding's grading for olisthesis. Functional scores were measured using the visual analog scale (VAS) for low back pain (LBP) and lower limbs, Oswestry Disability Index. All parameters were repeat measured at 3 months follow-up. Statistical analysis was done using SPSS software. Results Both groups were similar in composition preoperatively. There was significant improvement in all clinical and radiological parameters post-surgery in either group. However, at 3 months, The DH, FH, FSA, and VAS (LBP) were better in the W-OLIF group than in O-TLIF. Procedure-related complications were seen in both groups (15% in the O-TLIF group and 19% in the W-TLIF group), but only one patient in O-TLIF required revision due to cage migration. Conclusion Similar improvement occurs in most of the clinical and radiological parameters in the W-OLIF group compared to the O-TLIF group. Few radiological parameters such as the DH, FH, and F-CSA and the VAS (LBP) correction are superior in the W-OLIF group in the short-term follow-up. We conclude that indirect decompression by W-OLIF provides equivalent, if not better, results than the traditional O-TLIF lumbar fusion.
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Affiliation(s)
- Auroshish Sahoo
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mantu Jain
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gurudip Das
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pankaj Kumar
- Department of Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sujit Kumar Tripathy
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Harish V. K. Ratna
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mathan Kumar Ramasubbu
- Department of Pharmacology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Gurnani H, Naik S, Dsouza A, Thakur K. Using a mobile phone-based application as an adjunct to facilitate oral hygiene practices in children with Attention Deficit Hyperactivity Disorder (ADHD). Eur J Paediatr Dent 2023; 24:267 - 271. [PMID: 37782302 DOI: 10.23804/ejpd.2023.1803] [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: 10/03/2023]
Abstract
AIM To evaluate the efficacy of a mobile phone application to facilitate oral hygiene practices in children with ADHD. METHODS This was a randomized controlled study that included 54 ADHD children after obtaining informed parental consent. The children were randomly divided into 2 groups; Group 1 (conventional) participants were instructed verbally as well as demonstrated the brushing technique on models. Group 2 (mobile phone application) participants were made to download and use the 'BRUSH DJ' app developed by Ben Underwood. At baseline, the oral hygiene index-simplified (OHI-S) [Greene and Vermillion, 1964] of each child was evaluated clinically and the parents were asked to fill a questionnaire regarding the oral hygiene practices followed by their child every day. At the end of the second, sixth, and twelfth week, the parents were asked to fill the same questionnaire in addition to the evaluation of the OHI-S index. RESULTS A significant difference was found in the brushing time, brushing frequency, and OHI-S index between group 1 and group 2 at the end of 12 weeks. (unpaired t-test, p<0.05) CONCLUSION The mobile phone application proved to be an effective tool in captivating the attention of these children and thus improving their oral health.
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Affiliation(s)
- H Gurnani
- BDS, MDS, Pediatric & Preventive Dentist, Myofunctional Therapist, Mumbai, India
| | - S Naik
- BDS, MDS, Professor & Head of the Department, Department of Pediatric and Preventive Dentistry, D.Y Patil deemed to be University - School of Dentistry, Navi Mumbai, India
| | - A Dsouza
- BDS, MDS, Department of Pediatric & Preventive Dentistry, DY Patil deemed to be University - School Of Dentistry, Navi Mumbai, India
| | - K Thakur
- BDS, MDS, Department of Pediatric & Preventive Dentistry, DY Patil deemed to be University - School Of Dentistry, Navi Mumbai, India
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Patel RK, Tripathy T, Fatima K, Suba S, Naik S, Deep Bag N. Juxtafemoral Great Saphenous Vein Aneurysm Treated with Radiofrequency Ablation through Direct Sac Puncture. J Vasc Interv Radiol 2023; 34:2040-2042. [PMID: 37549844 DOI: 10.1016/j.jvir.2023.07.031] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Revised: 07/24/2023] [Accepted: 07/30/2023] [Indexed: 08/09/2023] Open
Affiliation(s)
- Ranjan Kumar Patel
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India
| | - Taraprasad Tripathy
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India.
| | - Kaneez Fatima
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India
| | - Santanu Suba
- Department of Burn and Plastic Surgery, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India
| | - Nerbadyswari Deep Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Sijua, Patrapada, Bhubaneswar 751019, India
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Porey C, Naik S, Bhoi SK, Jha M, Samal P. A Study of Diffusion Tensor Imaging in Central Post-Stroke Pain: Traveling Beyond the Pain Pathways. Ann Indian Acad Neurol 2023; 26:889-894. [PMID: 38229624 PMCID: PMC10789392 DOI: 10.4103/aian.aian_378_23] [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: 04/30/2023] [Revised: 08/10/2023] [Accepted: 08/13/2023] [Indexed: 01/18/2024] Open
Abstract
Introduction Central post-stroke pain (CPSP), seen in the aftermath of a stroke, is an underdiagnosed entity but quite a disabling complication. All the postulated theories regarding the pathogenesis of CPSP point to its origin in the central pain pathways. However, this study attempts to demonstrate the role of other contributing areas in the generation of CPSP. Materials and Methods In this single-center tertiary care hospital-based study, 24 patients with both ischemic and hemorrhagic strokes of variable durations were recruited, and Magnetic Resonance Imaging (MRI) imaging with diffusion tensor imaging (DTI) acquisition was done. Fractional anisotropy (FA) and apparent diffusion coefficient (ADC) values of the spinothalamic tract (STT), corticospinal tract (CST), superior thalamic radiation (STR), basal ganglia (BG), and primary somatosensory cortex (SSC) were compared between normal and abnormal sides and also in extrathalamic lesions separately. Results Significant differences with lower FA were noted in STT, CST, STR, and SSC and higher ADC values in BG, STR, CST, and SSC on comparison between the normal and lesion sides. On individual sub-analysis, ischemic stroke had significant changes in the FA value of CST and the ADC value of STR and CST, while hemorrhagic stroke had significant changes in the FA and ADC values of STR and SSC, as well as the FA value of STT. In the analysis of the extrathalamic strokes, significance persisted in all the studied parameters except the BG. The CST abnormalities were evident even in patients with clinical motor improvement. On multivariate analysis, visual analogue scale score severity was correlated with thalamic lesions. Conclusion Contrary to the belief that STT is solely responsible for CPSP, the role of CST, STR, BG, and SSC as contributing areas is evident from this study and may be more well established if studied in a larger population.
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Affiliation(s)
- Camelia Porey
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Priyanka Samal
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Rath S, Jain M, Mohanty M, Naik S, Mishra B. Long-segment Continuous Multi-level Spinal Tuberculosis without Bony Destruction Leading to Rapid Paraplegia in an Immunocompetent Patient. J Orthop Case Rep 2023; 13:95-98. [PMID: 37885633 PMCID: PMC10599386 DOI: 10.13107/jocr.2023.v13.i10.3950] [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: 07/24/2023] [Revised: 08/20/2023] [Indexed: 10/28/2023] Open
Abstract
Introduction Spinal tuberculosis (STB) accounts for 1% of all tuberculosis (TB) cases and 50% of skeletal TB. The classic presentation is a paradiscal involvement leading to the destruction of bodies, progressive kyphosis that can end with neurological weakness. The advent of magnetic resonance imaging (MRI) has made detection early but at the same time, we find multilevel involvement which can be continuous/noncontinuous. Case Report A 26-year-old male, non-alcoholic, non-smoker presented with complete paraplegia involving the bladder and bowel. His clinical examination did not show any gibbus. He was started on empirical antitubercular therapy and then referred to us as he failed to show improvement. An MRI of the spine showed extensive long-segment continuous spinal involvement with epidural abscess. The patient was taken for surgery with posterior decompression and instrumentation which was proven to be TB. He received complete treatment of 1 year and had complete recovery of his sensory and incomplete recovery of motor of lower limbs (became a wheelchair ambulator) with regain of bowel and bladder control at the end of treatment. Conclusion This case report revealed that long-segment continuous STB without extensive destruction is atypical presentation. The clinical findings of paraplegia helped us to evaluate and clinch the diagnosis on MRI. However, the prognosis of rapid paraplegia remains guarded and patient had partial recovery of motor so he could become wheel chair ambulator only.
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Affiliation(s)
- Sutapa Rath
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mantu Jain
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha India
| | - Monalisa Mohanty
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mishra S, Naik S, Bhoi SK, Kumar M, Deep (Bag) N, Dey A, Mohakud S, Mahapatro S. Comparison of post contrast fluid attenuated inversion recovery, 3D T1-SPACE, and T1W MRI sequences with fat suppression in the diagnosis of infectious meningitis. Neuroradiol J 2023; 36:572-580. [PMID: 36908255 PMCID: PMC10569188 DOI: 10.1177/19714009231163563] [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: 03/14/2023] Open
Abstract
OBJECTIVE To assess the usefulness of post contrast Fluid attenuated inversion recovery (FLAIR), 3D T1-SPACE, and T1W magnetic resonance imaging (MRI) sequences with fat suppression in diagnosis of infectious meningitis. METHODS 75 patients with clinical suspicion of meningitis were evaluated with post contrast FLAIR (PC-FLAIR), post contrast T1-SPACE (PC-T1-SPACE), and post contrast T1WI (PC-T1WI). Sensitivity, specificity, positive predictive value, and negative predictive value of individual sequences were assessed. RESULTS The sensitivity of PC-FLAIR (88.4%) was greater than PC-T1-SPACE (85.5%) and PC-T1WI (82.6%), considering cerebrospinal fluid (CSF) analysis as gold standard (p < 0.05). Kappa inter-rater agreement between two radiologists was 0.921 for PC-T1-SPACE, 0.921 for PC-T1WI, and 1.0 for PC-FLAIR with a p value <0.05. Both PC-T1-SPACE and PC-FLAIR performed equally in sulcal space enhancement. PC-T1-SPACE and PC-T1WI performed better in evaluation of pachymeningeal enhancement, ependymal enhancement in cases of ventriculitis, whereas PC-FLAIR was more sensitive in assessment of basal cistern enhancement and enhancement along the cerebellar folia. CONCLUSION Meningeal enhancement could be better appreciated in PC-FLAIR image than PC-T1WI and PC-T1-SPACE. Enhancement in PC-T1-SPACE was comparable to that of PC-T1WI. Being a T1 based spin echo sequence, PC-T1-SPACE has all the advantages of PC-T1WI in addition to its ability to differentiate meningeal enhancement from leptomeningeal vessels. Hence, PC-T1WI can be replaced by PC-T1-SPACE and PC-FLAIR can be added to routine MRI protocol in suspected case of meningitis.
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Affiliation(s)
- Satyakam Mishra
- Department of Radiodiagnosis, All India Institute of Medical Sciences, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, India
| | | | - Mukesh Kumar
- Department of Neurology, All India Institute of Medical Sciences, India
| | | | - Anupam Dey
- Department of General Medicine, All India Institute of Medical Sciences, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, India
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Swarup A, Karakkandy V, Chappity P, Naik S, Behera SK, Parida PK, Grover M, Gupta G, Giri PP, Sarkar S, Pradhan P, Samal DK, Kallyadan Veetil A, Adhikari A, Nayak S. Comparing accuracy of cochlear measurements on magnetic resonance imaging and computed tomography: A step towards radiation-free cochlear implantation. J Otol 2023; 18:208-213. [PMID: 37877072 PMCID: PMC10593569 DOI: 10.1016/j.joto.2023.08.001] [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: 07/31/2023] [Revised: 08/20/2023] [Accepted: 08/21/2023] [Indexed: 10/26/2023] Open
Abstract
Objective Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are commonly employed in pre-operative evaluation for cochlear implant surgery. However, with a decrease in the age of implantation, even minor radiation exposure can cause detrimental effects on children over their lifetime. The current study compares different cochlear measurements from CT and MRI scans and evaluates the feasibility of using only an MRI scan for radiological evaluation before cochlear implantation. Methods A longitudinal observational study was conducted on 94 ears/47 children, employing CT and MRI scans. The CT and MRI scan measurements include, A value, B value, Cochlear duct length (CDL), two-turn cochlear length, alpha and beta angles to look for cochlear orientation. Cochlear nerve diameter was measured using MRI. The values were compared. Results The mean difference between measurements from CT and MRI scans for A value, B value, CDL, and two-turn cochlear length values was 0.567 ± 0.413 mm, 0.406 ± 0.368 mm, 2.365 ± 1.675 mm, and 2.063 ± 1.477 mm respectively without any significant difference. The alpha and beta angle measures were comparable, with no statistically significant difference. Conclusion The study suggests that MRI scans can be the only radiological investigation needed with no radiation risk and reduces the cost of cochlear implant program in the paediatric population. There is no significant difference between the measurements obtained from CT and MRI scans. However, observed discrepancies in cochlear measurements across different populations require regionally or race-specific standardized values to ensure accurate diagnosis and precision in cochlear implant surgery. This aspect must be addressed to ensure positive outcomes for patients.
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Affiliation(s)
- Anurita Swarup
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Vinusree Karakkandy
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Preetam Chappity
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Sanjay Kumar Behera
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Pradipta Kumar Parida
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Mohnish Grover
- Department of ENT, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - Gaurav Gupta
- Department of ENT, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Prajna Paramita Giri
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Saurav Sarkar
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Pradeep Pradhan
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Dillip Kumar Samal
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Aswathi Kallyadan Veetil
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Asutosh Adhikari
- Department of ENT and HNS, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
| | - Saurav Nayak
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, Odisha, India
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Naik S, Bhoi SK, Kumar M. Rhombencephalosynapsis: a rare congenital malformation. Acta Neurol Belg 2023; 123:2021-2022. [PMID: 36064837 DOI: 10.1007/s13760-022-02080-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2022] [Accepted: 08/24/2022] [Indexed: 11/01/2022]
Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India.
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
| | - Mukesh Kumar
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, 751019, India
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Naik S, Shri A, Sidhu S, Lahre Y, Bag ND, Bhoi SK, Mohakud S. Multidetector computed tomography evaluation of normal thymus and variations with age. J Minim Access Surg 2023:380827. [PMID: 37706407 DOI: 10.4103/jmas.jmas_25_23] [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: 09/15/2023] Open
Abstract
Background Thymus is a T-cell-producing lymphoid organ that appears prominent in the paediatric population and involutes in size with ageing. The gland shows a wide variety of appearances across different age groups. The purpose of the study is to evaluate the computed tomography (CT) appearance of thymus gland in the normal population with a focus on size, CT attenuation and fatty infiltration in different age groups. Patients and Methods This is a retrospective study done after taking approval from the Institutional Ethics Committee. Patients undergone CT scans of the thorax were identified from our database. All evaluations were done in non-contrast CT scans. Patients having underlying diseases that may have associated thymic abnormality were excluded. The appearance of thymus and the presence of fatty replacement were assessed. The size of thymus (length and thickness of right limb and left limb) and non-contrast CT Hounsfield unit (HU) value of thymic tissue were measured and compared in various age groups. Results Four hundred and fifty patients were included, 262 (58.2%) were male. Mean age was 33.6 ± 17.1 years, range (3 months-80 years). The size of thymus was observed to decrease with increasing age. The mean age of complete fatty replacement in our study was 45 years. Complete fatty replacement was noted in all cases with an age of more than 60 years. The most common shape was arrowhead, and the most common location was pre-aortic and para-aortic location. Non-contrast CT HU value was maximum in infants and gradually decreased with advancing age. Conclusion Even normal thymus can show varied appearance on CT which changes with the age of the patient being imaged. A comparison with normative data could help differentiate normal from abnormal glands to avoid unnecessary intervention.
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Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Aishvarya Shri
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Simran Sidhu
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Yuvraj Lahre
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mishra P, P S, Panda BB, Sekar A, Naik S. Bilateral Central Retinal Vein Occlusion in Recurrent Frontal Lobe Tumor. Cureus 2023; 15:e41441. [PMID: 37546071 PMCID: PMC10404118 DOI: 10.7759/cureus.41441] [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: 07/06/2023] [Indexed: 08/08/2023] Open
Abstract
Systemic malignancy can induce hypercoagulation and can cause retinal vein occlusion (RVO). Although RVO has been reported in association with breast, renal, lung, prostate, and ovarian malignancies, it has not been reported in brain tumors. We are reporting a case of bilateral central retinal vein occlusion (CRVO) associated with recurrent frontal lobe gliosarcoma. The association was established after ruling out all other systemic causes that can produce bilateral CRVO. The importance of this case report lies in the fact that, while evaluating bilateral CRVO cases, these rare associations should also be kept in mind.
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Affiliation(s)
- Priyadarshini Mishra
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Shanmugasundaram P
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Bijnya B Panda
- Ophthalmology, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Arunkumar Sekar
- Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
| | - Suprava Naik
- Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, IND
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Kumar M, Bhoi SK, Jha M, Naik S. Super refractory status epilepticus as a possible manifestation of COVID-19 disease. J Neurosci Rural Pract 2023; 14:522-524. [PMID: 37692812 PMCID: PMC10483183 DOI: 10.25259/jnrp_60_2022] [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: 11/29/2022] [Accepted: 03/14/2023] [Indexed: 09/12/2023] Open
Abstract
Coronavirus disease 2019 (COVID-19) is one of the worst pandemics in history, caused by severe acute respiratory syndrome coronavirus-2, a novel zoonotic coronavirus. COVID-19 disease can present from asymptomatic or mild infection to rapidly progressive, acute respiratory distress syndrome, and death. Neurological presentation is not so uncommon now. Super refractory status epilepticus (SRSE) can be a possible manifestation of COVID-19 disease. Here, we report a patient affected by COVID-19 who presented with SRSE.
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Affiliation(s)
- Mukesh Kumar
- Department of Neurology, AIIMS, Bhubaneswar, Odisha, India
| | | | - Menka Jha
- Department of Neurology, AIIMS, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiology, AIIMS, Bhubaneswar, Odisha, India
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Porey C, Jha M, Bhoi SK, Samal P, Naik S. A Study of Organophosphorus Induced Delayed Myelopathy: Uncommon Sequelae of a Common Poisoning. Ann Indian Acad Neurol 2023; 26:469-474. [PMID: 37970320 PMCID: PMC10645247 DOI: 10.4103/aian.aian_19_23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/07/2023] [Revised: 02/06/2023] [Accepted: 02/16/2023] [Indexed: 11/17/2023] Open
Abstract
Introduction Organophosphorus (OP) compounds, with their lipophilicity, are responsible for a spectrum comprising of acute cholinergic symptoms, intermediate syndrome, as well as delayed neurological sequelae in the form of OP-induced delayed neuropathy and subsequently, myeloneuropathy with predominantly thoracic cord affection, manifested on partial recovery of the neuropathy. The pathogenesis of this myeloneuropathy in humans is still not well perceived. Aim of Study To determine the onset and course of development of delayed myeloneuropathy in patients of OP poisoning. Materials and Methods Twelve patients of OP ingestion presenting with delayed myeloneuropathy were evaluated with prior history, examination, MR imaging, nerve conduction and electromyography studies, and various evoked potentials to elicit the pattern of disease manifestation and progression. Results Among the included patients, a majority had consumed chlorpyrifos and permethrin composition, a majority had undergone gastric lavage. Five (41.7%) had experienced acute worsening and 8 (66.7%) patients had developed intermediate syndrome. OPIDN had appeared after a median of 4 (1-8) weeks after the poisoning. All patients had lower limb hypertonia with wasting and distal more than proximal weakness with pure motor or sensorimotor involvement. MRI showed thoracic cord atrophy in 3 (25%) patients. Motor-evoked potential with reduced amplitude was noted in lower limbs on lumbar stimulation but absent on cortical stimulation. Conclusion Various animal models have shown similar patterns of neurotoxicity in OP poisoning with predominant thoracic cord pathology. Further research in humans may be undertaken to elicit the pathogenesis, thereby improving the treatment modality.
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Affiliation(s)
- Camelia Porey
- Department of Neurology, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
| | - Priyanka Samal
- Department of Neurology, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
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Jain M, Naik S, Mishra NP, Tripathy SK, Neha A, Sahu DP, KP L. Correlation of bone mineral density using the dual energy x-ray absorptiometry and the magnetic resonance imaging of the lumbar spine in Indian patients. J Orthop 2023; 40:65-69. [PMID: 37188144 PMCID: PMC10172620 DOI: 10.1016/j.jor.2023.04.011] [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: 03/01/2023] [Revised: 04/12/2023] [Accepted: 04/17/2023] [Indexed: 05/17/2023] Open
Abstract
Background Dual-energy x-ray absorptiometry (DEXA) scan is extensively used to diagnose osteoporosis. But surprisingly, osteoporosis remains an underdiagnosed condition with many fragility fracture patients who have failed to undergo DEXA or received concomitant treatment for osteoporosis. Magnetic resonance imaging (MRI) of the lumbar spine is a routine radiological investigation bring done for low back pain. MRI can detect changes in the bone marrow signal intensity on the standard T1-weighted images. This correlation can be explored to measure osteoporosis in elderly and post-menopausal patients. The present study aims to find any correlation of bone mineral density using the DEXA and MRI of the lumbar spine in Indian patients. Methods Five regions of interest (ROI) of size 130-180 mm2 were placed in the vertebral body in the mid-sagittal section and parasagittal sections on either side (four in L1-L4 and one outside body) of elderly patients who underwent MRI for back pain. They also underwent a DEXA scan for osteoporosis. Signal to Noise Ratio (SNR) was calculated by dividing the mean signal intensity obtained for each vertebra by the standard deviation of the noise. Similarly, SNR was measured for 24 controls. An MRI-based "M score" was calculated by getting the difference in SNR patients to SNR controls and then dividing it by the control's standard deviation (SD). Correlation between the T score on DEXA and M scores on MRI was found out. Results With the M score greater than or equal to 2.82, the sensitivity was 87.5%, and the specificity was 76.5%. M scores negatively correlated with the T score. With the increase in the T score, the M score decreased. The Spearman correlation coefficient for the spine T score was -0.651, with a p-value of <0.001, and the hip T score was -0.428, with a p-value of 0.013. Conclusion Our study indicates that MRI investigations are helpful in Osteoporosis assessments. Even though MRI may not replace DEXA, it can give insight into elderly patients who get an MRI routinely for back pain. It may also have a prognostic value.
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Affiliation(s)
- Mantu Jain
- Department of Orthopedics, AIIMS Bhubaneswar, Odisha, 751019, India
- Corresponding author. 102/j, Cosmopolis, Dumduma, Bhubaneswa, India.
| | - Suprava Naik
- Department of Radiodiagnosis, AIIMS Bhubaneswar, Odisha, 751019, India
| | | | | | - Aishwarya Neha
- Department of Radiodiagnosis, AIIMS Bhubaneswar, Odisha, 751019, India
| | - Dinesh Prasad Sahu
- Department of Community Medicine and Family Medicine, AIIMS Bhubaneswar, Odisha, 751019, India
| | - Lubaib KP
- Department of Orthopedics, AIIMS Bhubaneswar, Odisha, 751019, India
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Naik S, Nayak MK, Sahoo T, Bhoi SK. Deep Medullary Vein Thrombosis in a Neonate with Asymptomatic Polycythemia. Neurol India 2023; 71:613-614. [PMID: 37322787 DOI: 10.4103/0028-3886.378709] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/17/2023]
Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Manoj K Nayak
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Tanushree Sahoo
- Department of Neonatology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev K Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Naik S, Mahanty S, Bhoi SK, Lahre Y, Bag ND, Mohakud S. MRI of wrist and diffusion tensor imaging of the median nerve in patients with carpal tunnel syndrome. J Neurosci Rural Pract 2023; 14:302-307. [PMID: 37181193 PMCID: PMC10174157 DOI: 10.25259/jnrp_57_2022] [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] [Received: 11/21/2022] [Accepted: 02/25/2023] [Indexed: 05/16/2023] Open
Abstract
Objectives Diagnosis of carpal tunnel syndrome (CTS) is based on the clinical symptoms and nerve conduction study. Magnetic resonance imaging (MRI) is non-invasive objective tool for assessing the median nerve and carpal tunnel. The purpose of this study was to evaluate MRI changes in patients with CTS, and compare them with healthy subjects. Materials and Methods Forty-three CTS patients and 43 age matched control were included and scanned in a 3T MRI scanner. Cross-sectional areas (CSA) of median nerve were measured at the level of distal radio-ulnar joint level (CSA1), proximal row of carpal bone (CSA2), and hook of hamate (CSA3). Flattening ratio (FR) of median nerve, thickness of flexor retinaculum, median nerve signal intensity, and thenar muscles were assessed. Fractional anisotropy (FA), average diffusion coefficient (ADC), and radial diffusivity (RD) of median nerve of CTS patients were obtained from diffusion tensor imaging (DTI) and compared with those of controls. Results Thirty-three patients (76.7%) were female. Mean duration of the pain was 7.4 ± 2.6 months. The mean CSA1 (13.2 ± 4.2 mm2), CSA2 (12.5 ± 3.5 mm2), and CSA3 (9.2 ± 1.5 mm2) in CTS patients were significantly higher compared to control group: CSA1 (10.15 ± 1.64 mm2), CSA2 (9.38 ± 1.37 mm2), and CSA3 (8.4 ± 0.9 mm2), (P = 0.001 in all). The mean FR of median nerve and thickness of flexor retinaculum were increased in CTS patients. The mean FA was reduced in CTS patients compared to control proximal to carpal tunnel and within the tunnel. Mean ADC and RD values were higher in CTS patients as compared to control for both levels. Conclusion MRI can detect subtle changes in the median nerve and thenar muscles in CTS and may be useful in equivocal cases and to exclude secondary causes of CTS. DTI shows reduced FA and increased ADC and RD in CTS patients.
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Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Siladitya Mahanty
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Yuvraj Lahre
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep Bag
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Lei I, Huang W, Naik S, Maqsood H, He J, Tang P. The Varied Rna Transcript Isoform Landscape During Human Donor Heart Preservation. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.1551] [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: 04/05/2023] Open
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Mohanty P, Dash PP, Naik S, Behura R, Mishra M, Sahoo H, Sahoo SK, Barick AK, Jali BR. A thiourea-based fluorescent turn-on chemosensor for detecting Hg2+, Ag+ and Au3+ in aqueous medium. J Photochem Photobiol A Chem 2023. [DOI: 10.1016/j.jphotochem.2022.114491] [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: 12/23/2022]
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Manekar AA, Tripathy BB, Sahoo SK, Sable MN, Naik S, Janjala N, Mohanty MK. Prevalence of Pancreato-Biliary Maljunction in Children with Choledochal Cyst - A Prospective Observational Study. J Indian Assoc Pediatr Surg 2023; 28:137-143. [PMID: 37197231 PMCID: PMC10185032 DOI: 10.4103/jiaps.jiaps_104_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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2022] [Revised: 10/13/2022] [Accepted: 10/26/2022] [Indexed: 05/19/2023] Open
Abstract
Background Pancreatico-biliary maljunction (PBM) is often found to be associated with choledochal cysts (CCs). According to a European multicenter study, the prevalence of PBM in cases of CC is found to be 72.2%, however, there is no Indian study depicting the prevalence of PBM in Indian children with CCs, which is one of the main postulated factors in the etiopathogenesis of CC. In this study, we have attempted to observe prospectively the prevalence of PBM in children with CC and correlate this to its morphological and biochemical parameters. The association between the presence of PBM and histopathological findings such as epithelial changes of the mucosa of the CC, inflammation, metaplasia or dysplasia, and histopathology of the liver has also been evaluated. Materials and Methods We carried out a single center, prospective observational study with a single arm study group. We prospectively selected all patients of CC admitted for surgery from November 2018 to October 2020. Data on biochemical, radiological, and histopathological parameters were collected and analyzed. Results We included a total of 20 patients in our study. The mean age of the participants was 6.22 ± 4.32 years. Among them, 11 (55.0%) were male and 9 (45%) were female. Abdominal pain was the most common presenting complaint among our patients (75.0%) and had a significant association with the presence of a PBM (P = 0.001). In symptomatic children, the mean duration of symptoms was 4.50 ± 2.26 months for jaundice, 4.50 ± 1.98 months for abdominal distension, and 5.07 ± 2.02 months for abdominal pain. Among the 3 children with cholangitis, the mean number of episodes was 3.33 ± 2.08, with a median of four episodes. Fourteen (70.0%) of the children had type I a CC, 1 (5.0%) participant each for types I b, I c, II and IV a and 2 (10.0%) of them had type IV b cyst. The mean size of the cyst (cm) was 7.41 ± 3.03 with a median of 6.85 cm. Among the children, 9 (45%) showed the presence of PBM on magnetic resonance cholangiopancreatography (MRCP), with 7 (77.8%) showing Komi's C-P type and 2 (22.2%) showing Komi's PC type. The mean common channel length (mm) on MRCP was 8.11 ± 2.47 with a median length of 8.00 mm. The biochemical analysis of a bile fluid amylase and lipase is the functional indicator of the presence of a PBM. Histopathological examination showed the presence of ulceration in the walls of the CC in 10 (50.0%) of the specimens. There was a significant association of the presence of PBM and ulceration in the mucosa of the CC (P ≤ 0.001), with the median levels being the highest in the PBM present group. Conclusion Abdominal pain is the most common complaint in a child with CC, and when present, it is significantly associated with the presence of a PBM. MRCP is the gold standard tool to detect CCs and find out the morphology of PBM. The prevalence of PBM in children with CC of 45% with a mean common channel length of 8.11 mm. The biochemical analysis of a bile amylase and lipase is the functional indicator of the presence of a PBM and there is a significant association of their higher levels and presence of PBM. The presence of chronic inflammation and microscopic ulcers is significant histologic parameters depicting the presence of a PBM.
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Affiliation(s)
- Aditya Arvind Manekar
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Bikasha Bihary Tripathy
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Subrat Kumar Sahoo
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukund Namdev Sable
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Narahari Janjala
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Mangalagiri, Andhra Pradesh, India
| | - Manoj Kumar Mohanty
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Plym A, Madueke I, Naik S, Penney K, Mucci L, Khorasani R, Kibel A. Integration of Polygenic Risk Score (PRS) with multiparametric MRI in men at risk for clinically significant prostate cancer. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00127-6] [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: 02/12/2023]
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Deep N, Mohakud S, Jain M, Naik S, Baisakh M. Large Intraosseous Haemangioma of the Sacral Vertebra: The radiological imaging findings. Sultan Qaboos Univ Med J 2023; 23:125-126. [PMID: 36865413 PMCID: PMC9974040 DOI: 10.18295/squmj.3.2022.024] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2021] [Revised: 01/24/2022] [Accepted: 02/22/2022] [Indexed: 11/16/2022] Open
Affiliation(s)
- Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Mantu Jain
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Manas Baisakh
- Department of Pathology, Prolife Diagnostic, Bhubaneswar, India
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Naik S, Bhoi SK, Jha M, Kumar M. Craniospinal MRI Findings in Neuromelioidosis. Neurol India 2023; 71:113-118. [PMID: 36861583 DOI: 10.4103/0028-3886.370442] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 03/03/2023]
Abstract
Background Melioidosis is a bacterial infection caused by Burkholderia pseudomallei that is endemic in Southeast Asia, northern Australia, and Africa. Neurological involvement is rare and reported in 3-5% of total cases. Objective The purpose of this study was to report a series of cases of melioidosis with neurological involvement and a brief review of the literature. Materials and Methods We collected the data from six melioidosis patients having neurological involvement. Clinical, biochemical, and imaging findings were analyzed. Result All patients in our study were adults (age range 27 to 73 years). The presenting symptoms were fever of varying duration (range 15 days to 2 months). Altered sensorium was noted in five patients. Four cases had brain abscess, one had meningitis, and one had a spinal epidural abscess. All cases of brain abscesses were T2 hyperintense with an irregular wall showing central diffusion restriction and irregular peripheral enhancement. The trigeminal nucleus was involved in one patient, but there was no enhancement of the trigeminal nerve. Extension along the white matter tract was noted in two patients. Magnetic resonance (MR) spectroscopy done in two patients showed increased lipid/lactate and choline peak in both of them. Conclusion Melioidosis can present as multiple micro-abscesses in the brain. Involvement of the trigeminal nucleus and extension along the corticospinal tract may raise the possibility of infection by B. pseudomallei. Meningitis and dural sinus thrombosis, although rare, can be presenting features.
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Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukesh Kumar
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Singla A, Deep N, Naik S, Mohakud S, Nayak P, Sable M. Correlation of multiparametric MRI with histopathological grade of peripheral zone prostate carcinoma. J Cancer Res Ther 2023; 19:S569-S576. [PMID: 38384020 DOI: 10.4103/jcrt.jcrt_280_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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2022] [Accepted: 07/06/2022] [Indexed: 02/23/2024]
Abstract
BACKGROUND Prostatic cancer is the second most common malignant tumor in men. Preoperative grading of prostate cancer is important for its management. Our objective is to compare individual and combined detection rates of T2-weighted imaging (T2WI), diffusion weighted imaging (DWI), dynamic contrast enhanced-magnetic resonance imaging (DCE-MRI), and magnetic resonance spectroscopy (MRS) for prostate cancer with histopathological diagnosis as its golden standard. METHODS Forty-four patients with positive digital rectal examination (DRE) findings and elevated prostate specific antigen (PSA), underwent multiparametric MRI (Mp-MRI). T2WI, DWI, DCE-MRI and MRS were done in all the patients. Cognitive magnetic resonance-transrectal ultrasound (MR-TRUS) fusion biopsy was done in all the patients. Sensitivity and specificity of T2WI, DWI, DCE-MRI, and Prostate Imaging - Reporting and Data System PIRADS version 2 was obtained. Apparent diffusion coefficient (ADC) value and choline/citrate ratio were obtained for each lesion and correlated with histopathological grade. RESULTS The mean age of the patients was 68.7 ± 10.1 years, and the mean serum PSA level was 58.1 ± 22.4 ng/dL. Of the 38 lesions in peripheral zone, 33 (87%) had histopathologically proven prostate cancer. T2WI had a sensitivity and specificity of 75.8% and 80% and DWI had a sensitivity and specificity of 90.9% and 80%, respectively, for detection of malignant prostatic lesion. The mean ADC values for prostate cancer, prostatitis, and normal prostatic parenchyma were 0.702 ± 0.094 × 10-3 mm2/sec, 0.959 ± 0.171 × 10-3 mm2/sec, and 1.31 ± 0.223 × 10-3 mm2/sec, respectively. Type 3 curve has lower sensitivity (45.5%) but high specificity (80%) for diagnosing prostate cancer. CONCLUSION DWI can be useful to differentiate benign from malignant prostatic lesions, and low-grade from high-grade prostate carcinoma. ADC value has a positive correlation with histopathological grade of prostate cancer.
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Affiliation(s)
- Amit Singla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Prasant Nayak
- Department of Urology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukund Sable
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Muacevic A, Adler JR, Selvan AT, Naik S. Diagnostic Dilemma: Parasitic Ovarian Fibroma With Degeneration. Cureus 2022; 14:e32739. [PMID: 36686090 PMCID: PMC9851163 DOI: 10.7759/cureus.32739] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
An ovarian fibroma is a rare entity and a diagnostic dilemma due to its solid nature and ultrasound findings being similar to a uterine fibroid. An ovarian fibroma, being parasitic, is extremely rare. We report the case of a 35-year-old, multiparous woman who presented with a 'wandering' abdominal mass of six months duration. Clinical examination revealed a 16-week size, solid, firm, well-defined mass in the right lumbar and iliac regions, separate from the uterus on bimanual examination, suggestive of a pedunculated subserous fibroid uterus. Ultrasound abdomen with color Doppler evaluation was suggestive of the non-uterine origin of the tumor, probably a gastrointestinal stromal tumor. In view of the diagnostic dilemma, MRI was done, which showed that the lesion had features characteristic of ovarian fibroma, however, bilateral ovaries were normally visualized. An exploratory laparotomy was performed. There was a solid parasitic tumor adherent to the bladder peritoneum and attached to the right ovary by a thin band, which was excised. Histopathology confirmed ovarian fibroma. To conclude, a parasitic ovarian fibroma is rare and a careful clinical approach with imaging and surgery helps in solving this diagnostic dilemma.
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Porey C, Bhoi SK, Jha M, Naik S. MOG Antibody Disease with Non-Neurological Involvement: A Chance Coincidence or a Relevant Association. Ann Indian Acad Neurol 2022; 25:1227-1230. [PMID: 36911434 PMCID: PMC9996489 DOI: 10.4103/aian.aian_520_22] [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] [Received: 06/12/2022] [Revised: 07/17/2022] [Accepted: 07/30/2022] [Indexed: 11/21/2022] Open
Affiliation(s)
- Camelia Porey
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev K. Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Jain M, Sahoo A, Naik S, Kumar P, Mishra D. Assessment of the psoas muscle changes following the oblique lateral interbody fusion (OLIF) approach: A prospective observational study. J Orthop 2022; 33:60-65. [PMID: 35864925 PMCID: PMC9294652 DOI: 10.1016/j.jor.2022.07.007] [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: 05/25/2022] [Revised: 07/07/2022] [Accepted: 07/11/2022] [Indexed: 11/19/2022] Open
Abstract
Background Traditional open posterior fusion techniques involve stripping of the posterior paraspinal muscles with protracted retraction, which can lead to ischemia and denervation. This may result in poor clinical outcomes despite a well-performed surgery. Oblique lumbar interbody fusion (OLIF) is a minimally invasive modified retroperitoneal anterior approach in the corridor between the psoas major (PM) and great vessels. The purpose of this research was to study changes in psoas properties and clinical outcomes in terms of the loss of hip flexion in patients undergoing OLIF surgery. Methods Patients with lumbar pathologies who underwent instrumented OLIF at our center were included. These patients were examined clinically at baseline and 6 months postoperatively. The Oswestry disability index (ODI) and visual analog scale (VAS) scores for back pain and leg pain were noted. Magnetic resonance imaging (MRI) scans were obtained preoperatively and postoperatively (minimum 6 months) to compare the cross-sectional areas (CSAs) of the PM. Results In total, 17 patients (male: female = 8:9) with a mean age of 46.06 ± 10.49 years were included. The operation time was 154.94 ± 32.33 min, estimated blood loss was 190 ± 56 mL, and mean CSAs of the right and left psoas were, respectively, 9.94 ± 3.19 and 10.65 ± 3.74 cm2 preoperatively and 10.00 ± 3.06 and 8.53 ± 2.81 cm2 at follow-up. Qualitative measurements revealed that muscle atrophy on the left side (approach side) was 19.12% ± 3.14% and fatty degeneration had occurred in 13 of 17 (76.5%) patients. Postoperatively, all patients had significant improvement in the VAS (back and leg) and ODI scores. Furthermore, 3 of 17 (17.6%) patients had mild hip weakness (4/5) on the left side immediately postoperatively, but it resolved in 6 months. Moreover, 2 of 17 (11.8%) patients complained of paraesthesia. Conclusion OLIF does cause injury to the PM but it is clinically insignificant according to MRI scans and clinical evaluations.
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Affiliation(s)
- Mantu Jain
- Department of Orthopedics, AIIMS Bhubaneswar, Odisha, 751019, India
| | - Auroshish Sahoo
- Department of Orthopedics, AIIMS Bhubaneswar, Odisha, 751019, India
| | - Suprava Naik
- Department of Radiology, AIIMS Bhubaneswar, Odisha, 751019, India
| | - Pankaj Kumar
- Department of Surgery, AIIMS Bhubaneswar, Odisha, 751019, India
| | - Dipun Mishra
- Department of Orthopedics, AIIMS Bhubaneswar, Odisha, 751019, India
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Jain M, Parija D, Padhi S, Naik S. Eosinophilic Granuloma as a Solitary Lytic Lesion of the Cervical Spine in a Child. J Orthop Case Rep 2022; 12:61-64. [PMID: 36687482 PMCID: PMC9831226 DOI: 10.13107/jocr.2022.v12.i08.2966] [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: 04/22/2022] [Revised: 05/16/2022] [Indexed: 11/06/2022] Open
Abstract
Introduction Eosinophilic granuloma (EG) is a type of Langerhan cell histiocytosis (LCH) with unknown etiology. This benign tumorous lytic lesion affects mainly children or young adults, causing bone destruction. Although, the flat or the long bones are commonly affected, localized spinal involvement in pediatric age group is rare. A thorough workup is therefore necessary for this condition, which may mimic other severe conditions. Case Report A 10-year-old girl presented with neck pain for 4 months without any history of trauma, fever, or neurological weakness. An X-ray revealed radiolucency and sclerosis of the fifth cervical vertebral body, which was hypointense on T1 and heterogeneous on T2-weighted image, with mild peripheral enhancement on fat-suppressed post-contrast T1-weighted image. Biopsy histomorphology revealed a lymphohistiocytic lesion with scatted histiocytes with grooved nuclei, immunopositive for Langerin; thus consistent with LCH (EG). She was managed conservatively with a completely pain free course with full range of movement at 1-year follow-up. Her follow-up X-ray showed complete remodeling and ongoing fusion. Conclusion EG should be considered as a differential diagnosis in the evaluation of solitary lytic lesion involving spine in pediatric age group. This, although self-resolving, may occasionally need surgical intervention with or without adjuvant therapy.
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Affiliation(s)
- Mantu Jain
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha India,Address of Correspondence: Dr. Mantu Jain, Department of Orthopedics, All India Institute of Medical Sciences, 102/J, Cosmopolis, Dumduma, Bhubaneswar, Odisha, India. E-mail:
| | - Debasish Parija
- Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, Odisha India
| | - Somanath Padhi
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mohakud S, Rajasimman AS, Purkait S, Naik S. Intracranial extraosseous dural-based Ewing's sarcoma with fluid-haematocrit levels: imaging findings of a rare tumour. BMJ Case Rep 2022; 15:e247056. [PMID: 35701017 PMCID: PMC9198795 DOI: 10.1136/bcr-2021-247056] [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: 11/04/2022] Open
Abstract
Extraosseous dural-based primary Ewing's sarcoma of the central nervous system is a rare tumour posing a diagnostic challenge. On cross-sectional radiological imaging, the lesion has an extra-axial location with heterogeneous appearance. These lesions are usually multicystic with internal haemorrhage causing fluid-haematocrit levels. It mimics conditions like an aneurysmal bone cyst, microcystic meningioma, telangiectatic osteosarcoma or cystic metastasis. Exclusion of primary Ewing's sarcoma or malignancy elsewhere in the body is required to rule out a secondary. Surgery along with adjuvant chemotherapy and focal radiotherapy is the preferred mode of treatment. Due to the presence of non-specific small round blue cells on H&E stain, these tumours are also confused with lymphoma, osteosarcoma, rhabdomyosarcoma, Merkel cell carcinoma, ependymoblastoma and neuroendocrine carcinoma. Immunohistochemistry provides a definitive diagnosis. A high degree of suspicion in the preoperative scans is crucial for prognostication and early management of this aggressive tumour leading to improved patient survival.
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Affiliation(s)
- Sudipta Mohakud
- Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | | | - Suvnedu Purkait
- Pathology and Lab Medicine, AIIMS Bhubaneswar, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
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Naik S, Bhoi SK, Deep N, Mohakud S, Mishra B, Dey A, Kumar R, Saharia GK, Kumar M. Vascular Manifestations of Tuberculous Meningitis: MR Angiography and Venography Study. J Neurosci Rural Pract 2022; 13:529-536. [PMID: 35946000 PMCID: PMC9357502 DOI: 10.1055/s-0042-1748175] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/02/2022] Open
Abstract
Purpose
The purpose of this study is to evaluate magnetic resonance (MR) angiography (MRA) and venography (MRV) findings in tuberculous meningitis (TBM).
Methods
Thirty consecutive patients of clinically diagnosed TBM were enrolled. Apart from T2-weighted imaging, T1-weighted imaging (T1WI), diffusion-weighted imaging, susceptibility-weighted imaging, fluid-attenuated inversion recovery, and postcontrast T1WI, time-of-flight (TOF) MRA and postcontrast MRV were done in all the patients. MRV was done after intravenous administration of gadolinium-based contrast agent followed by postcontrast T1WI. MRA and MRV findings were analyzed.
Results
Mean age of the patients was 33.13 ± 14.93 years. Duration of symptom was 34.90 ± 33.82 (range: 10–150) days. Out of 30 patients, 11 were categorized as definite TBM and 19 probable TBM. Eighteen (60%) were grade I, 7 (23%) grade II, and 5 (16%) grade III TBM based on severity. MR abnormalities were in varying combinations of leptomeningeal enhancement in 24 (80%), pachymeningeal in 2, both in 3, tuberculomas in 13 (43.3%), ventriculitis in 1, hydrocephalus in 16 (53.3%), and infarcts in 10 (33.3%) patients out of which the tubercular zone infarct in 9 patients. TOF MRA showed arterial abnormality in 13 patients. Anterior cerebral artery and middle cerebral artery have commonly involved vessels. Dural sinus thrombosis was noted in two patients. Both were female. One patient had subacute thrombus in the posterior part of superior sagittal sinus, left transverse sinus, and proximal right transverse sinus. The second patient had a filling defect in the transverse sinus.
Conclusion
In TBM, there is predominant arterial involvement causing infarcts which are usually seen in the tubercular zone. However, occasionally, there may be venous involvement causing cerebral venous sinus thrombosis.
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Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sanjeev Kumar Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Baijayantimala Mishra
- Department of Microbiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anupam Dey
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rajesh Kumar
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Gautom Kumar Saharia
- Department of Biochemistry, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mukesh Kumar
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Bhoi SV, Naik S. Aortic aneurysm causing compressive myelopathy. J Postgrad Med 2022; 68:120-121. [PMID: 35418000 PMCID: PMC9196290 DOI: 10.4103/jpgm.jpgm_409_21] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- S V Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - S Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Bhatia R, Haldar P, Puri I, Padma Srivastava MV, Bhoi S, Jha M, Dey A, Naik S, Guru S, Singh M, Vishnu VY, Rajan R, Gupta A, Vibha D, Pandit A, Agarwal A, Salunkhe M, Singh G, Prasad D, Panda S, Anand S, Rohila A, Khera P, Tiwari S, Bhaskar S, Garg M, Kumar N, Dhar M, Tiwari A, Agrawal N, Raju G, Garg J, Ray B, Bhardwaj A, Verma A, Dongre N, Chhina G, Sibia R, Kaur R, Zanzmera P, Gamit A, Iype T, Garg R, Singh S, Kumar A, Ranjan A, Sardana V, Soni D, Bhushan B, Dhamija R, Saluja A, Bala K, Dabla S, Goswami D, Agarwal A, Shah S, Shah S, Patel M, Joshi P, Awasthi S, Nath S, Chandan S, Malik R, Chowdhury N. Study protocol: IMPETUS: Implementing a uniform stroke care pathway in medical colleges of India: IMPETUS Stroke. Ann Indian Acad Neurol 2022; 25:640-646. [PMID: 36211192 PMCID: PMC9540919 DOI: 10.4103/aian.aian_1033_21] [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: 12/01/2021] [Accepted: 12/02/2021] [Indexed: 11/14/2022] Open
Abstract
Introduction: In India, a national program for stroke (national programme for the control of cardiovascular diseases, diabetes, cancer, and stroke) and stroke management guidelines exist. Its successful implementation would need an organized system of stroke care in practice. However, many challenges exist including lack of awareness, prehospital notification systems, stroke ready hospitals, infrastructural weaknesses, and rehabilitation. We present here a protocol to investigate the feasibility and fidelity of implementing a uniform stroke care pathway in medical colleges of India. Methods and Analysis: This is a multicentric, prospective, multiphase, mixed-method, quasi-experimental implementation study intended to examine the changes in a select set of stroke care-related indicators over time within the sites exposed to the same implementation strategy. We shall conduct process evaluation of the implementation process as well as evaluate the effect of the implementation strategy using the interrupted time series design. During implementation phase, education and training about standard stroke care pathway will be provided to all stakeholders of implementing sites. Patient-level outcomes in the form of modified Rankin Scale score will be collected for all consecutive patients throughout the study. Process evaluation outcomes will be collected and reported in the form of various stroke care indicators. We will report level and trend changes in various indicators during the three study phases. Discussion: Acute stroke requires timely detection, management, and secondary prevention. Implementation of the uniform stroke care pathway is a unique opportunity to promote the requirements of homogenous stroke care in medical colleges of India.
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Nallakumarasamy A, Jain M, Panigraghi S, Sahoo A, Naik S. Gelatin Sponge-induced Early Onset Quadriparesis after the Posterior Decompression for Cervical Myelopathy Due to Ossification of a Posterior Longitudinal Ligament - A Case Report. J Orthop Case Rep 2022; 12:70-73. [PMID: 37065520 PMCID: PMC10092389 DOI: 10.13107/jocr.2022.v12.i06.2870] [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] [Received: 12/10/2021] [Revised: 02/15/2022] [Indexed: 11/30/2022] Open
Abstract
Introduction: Gelatin foam has been regularly used the complex neuro and spinal surgeries for a long time. Apart from their hemostatic properties, these are inert and provide form an inert membrane that prevents scar adhesions o vital structures such as the brain or spinal cord. Case Presentation: We present a case of cervical myelopathy due to an ossified posterior longitudinal ligament that underwent the instrumented posterior decompression and had neurological worsening 48 h after the index surgery. An magnetic resonance imaging showed a hematoma compressing the spinal cord which on exploration was confirmed to be a gelatin sponge. It represents the rare phenomenon of mass effect due to their osmotic properties, especially in a closed space causing neurologic deterioration. Conclusion: We emphasize the rare cause of early onset quadriparesis after the posterior decompression due to the swollen gelatin sponge over the neural elements. The patient recovered with timely intervention.
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Naik S, Jain M, Sethi P, Mishra N, Bhoi SK. Spontaneous Spinal Epidural Hematoma in a Near-term Pregnant Patient. J Orthop Case Rep 2022; 12:11-15. [PMID: 37056601 PMCID: PMC10088398 DOI: 10.13107/jocr.2022.v12.i12.3444] [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] [Received: 08/22/2022] [Revised: 09/13/2022] [Indexed: 03/19/2023] Open
Abstract
Introduction: Spontaneous development of spinal epidural hematoma (SEH) is rare condition with acute presentation and usually associated with some predisposing factors. Early diagnosis and management of SEH are very important because of the risk of permanent neurological deficit. Case Report: Here, we report a rare case of SEH in young pregnant female at 35 week of gestation who presented with short history of paraplegia that was diagnosed on magnetic resonance imaging (MRI) and treated successfully with delivery of the baby by caesarean section and release of cord compression by laminectomy. Conclusion: Spontaneous SEH can be rarely seen in pregnancy. MRI is the investigation of choice. Clinical suspicion is necessary for early management and better prognosis.
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Mohakud S, Sidhu S, Deep N, Naik S. Panorama of multidetector-row computed tomography findings of carcinoma gall bladder - A retrospective observational study. J Cancer Res Ther 2022; 18:661-667. [DOI: 10.4103/jcrt.jcrt_235_21] [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: 11/04/2022]
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Bhoi SK, Jha M, Naik S, Bag A, Jaiswal B, Kumar R. Atypical Presentation of Anti-MOG Ab Disease. Kans J Med 2021; 14:310-313. [PMID: 34888005 PMCID: PMC8647988 DOI: 10.17161/kjm.vol14.15494] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2021] [Accepted: 11/28/2021] [Indexed: 11/17/2022] Open
Affiliation(s)
- Sanjeev K Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arijit Bag
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Binaya Jaiswal
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rajesh Kumar
- Department of Medicine, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Patra S, Naik S, Jha M, Kumari T. Psychosis in hypoxic-ischemic brain injury: Organic or postpartum? Aust N Z J Psychiatry 2021; 55:1206-1207. [PMID: 33522251 DOI: 10.1177/0004867420982067] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Affiliation(s)
- Suravi Patra
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Menka Jha
- Department of Neurology, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Tanu Kumari
- Department of Psychiatry, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
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Bhoi SK, Naik S, Purkait S. Pure Neuritic Leprosy with Bilateral Foot Drop and Central Nervous Involvement: A Clinical, Electrophysiological, and MR Correlation. Neurol India 2021; 69:1349-1353. [PMID: 34747810 DOI: 10.4103/0028-3886.329620] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Central nervous system (CNS) involvement in leprosy is sparsely documented. Neurophysiological tests and magnetic resonance imaging (MRI) helps in demonstrating CNS involvement in the patient of pure neuritic leprosy. Objectives To demonstrate CNS involvement in pure neuritic leprosy. Methods Detailed clinical presentation and skin lesions were evaluated. Sural nerve biopsy, MRI diffusion tensor imaging of spinal cord and optic nerve were performed. Visual evoked potential and tibial somatosensory evoked potential were done. Their clinical, electrophysiological, and MRI were done at follow-up visits. Results We report three patients of pure neuritic leprosy with bilateral foot drop as the initial presentation. MRI T2W sequence of cervico dorsal cord showed dorsal column hyperintensity in two patients. Diffusion-weighted MR revealed decrease fractional anisotropy and an increase in the apparent diffusion coefficient. Similar findings were also noted in the optic nerves. The patients were managed with multidrug therapy multibacillary regimen and steroid in tapering dose. At follow-up, they showed clinical improvement in vision and power of ankle dorsiflexor. Conclusions Patients of pure neuritic leprosy may manifest with bilateral foot drop with the involvement of posterior column and cranial nerves.
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Affiliation(s)
- Sanjeev K Bhoi
- Department of Neurology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suvendu Purkait
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Agrawal K, Swaroop S, Patro PSS, Tripathy SK, Naik S, Velagada S. Comparison of bone SPECT/CT and MRI in detection of pain generator in ankle and foot pain: a retrospective diagnostic study. Nucl Med Commun 2021; 42:1085-1096. [PMID: 34075007 DOI: 10.1097/mnm.0000000000001443] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
OBJECTIVE To study the sensitivity and specificity of MRI and bone SPECT-CT in detecting the pain generator in ankle and foot pain with diagnostic dilemma. METHODS Retrospectively data of patients with ankle or foot pain who underwent both MRI and Bone SPECT-CT were analyzed. The lesions and probable pain generator sites were reported as per MRI and bone SPECT-CT findings. These lesions were correlated clinically, managed accordingly and followed up. The patients who had significant improvement in response to the treatment provided were considered to have been diagnosed accurately. The foot and ankle disability index (FADI) was used to evaluate the patient's pre- and postintervention condition. RESULTS The study included 37 patients retrospectively (18 women and 19 men). The lesions were classified into soft tissue lesions (ligaments/tendons), joint lesions (arthritis) and bony lesions (fractures/osteomyelitis/osteochondral lesions). Overall, MRI had sensitivity, specificity, positive predictive value and negative predictive value of 82, 31, 74 and 42%, respectively, and SPECT-CT had sensitivity, specificity, positive predictive value and negative predictive value of 84, 60, 84 and 60%, respectively. The mean FADI score pretreatment for all patients was 61.5 (SD = 13.8) and posttreatment 88.4 (SD = 13.01) showing significant improvement in the score (P < 0.05), suggesting that the final diagnosis of these patients was accurate. Overall, management change due to bone SPECT-CT over MRI was seen in 26% of patients. CONCLUSION Bone SPECT-CT has incremental value over MRI in the diagnosis of pain generator in foot and ankle pain. The overall specificity of bone SPECT-CT is higher than MRI in detection of pain generators. Bone SPECT-CT performed better than MRI in detection of culprit pathology in the bone, whereas MRI is better in soft tissue lesions. ADVANCES IN KNOWLEDGE There are only a few published literature with direct comparison of bone SPECT-CT scintigraphy and MRI in detection of foot and ankle pain generator. This study directly compares diagnostic utility of bone SPECT-CT scintigraphy and MRI in foot and ankle pain. In the present study, the bone SPECT-CT performed better than MRI in detection of culprit pathology in the bone, whereas MRI is better in soft tissue lesions.
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Affiliation(s)
- Kanhaiyalal Agrawal
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar
| | - Shakti Swaroop
- Department of Orthopedics, Institute of Medical Sciences & SUM Hospital
| | - P Sai Sradha Patro
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhubaneswar
| | | | - Suprava Naik
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mohakud S, Naik S, Deep N, Singh A, Mishra TS, Sinha M. Transmesenteric Internal Abdominal Hernia: Multi-detector row computed tomography findings. Sultan Qaboos Univ Med J 2021; 21:502-503. [PMID: 34522423 PMCID: PMC8407917 DOI: 10.18295/squmj.4.2021.025] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2020] [Accepted: 12/15/2020] [Indexed: 11/16/2022] Open
Affiliation(s)
- Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Arshdeep Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Tushar S Mishra
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Mithilesh Sinha
- Department of General Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Kalita J, Rahi SK, Kumar S, Naik S, Bhoi SK, Misra UK. A Study of Diffusion Tensor Imaging in Hirayama Disease. Neurol India 2021; 69:889-893. [PMID: 34507407 DOI: 10.4103/0028-3886.325338] [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: 11/04/2022]
Abstract
Background Hirayama disease (HD) is a motor neuron disease and occasionally is associated with lower limb hyper-reflexia. Corticospinal tract dysfunction can be evaluated by diffusion tensor imaging (DTI), but there is paucity of study in HD. Objective We report corticospinal tract functions using DTI in the patients with HD and correlate with clinical findings. Materials and Methods The patients with HD diagnosed on the basis of clinical and electromyography findings were included. Their age, duration of illness, side of initial involvement, and progression were noted. Presence of lower limb hyper-reflexia, and cervical spine magnetic resonance imaging (MRI) findings were noted. Cranial MRI was done and DTI findings at internal capsule, cerebral peduncle, pons, and pyramid were noted. Results In total, 10 patients with HD and 5 matched controls were evaluated. The apparent diffusion coefficient (7.03 ± 0.27 vs 6.83 ± 0.36), fractional anisotropy (0.79 ± 0.04 vs 0.82 ± 0.05), axial diffusivity (5.08 ± 0.08 vs 5.04 ± 0.07), and radial diffusivity (3.79 ± 0.05 vs 3.76 ± 0.05) between HD patients and controls were not different in internal capsule. These values were also not significantly different in cerebral peduncle, pons, and pyramid. These values were also not significantly different between the severe and less severely affected sides. The fractional anisotropy did not correlate with lower limb hyper-reflexia (P = 1.00) and spinal cord atrophy (P = 0.60). Conclusion DTI study in HD patients did not reveal corticospinal tract involvement in brain.
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Affiliation(s)
- Jayantee Kalita
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Sushil K Rahi
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Sunil Kumar
- Department of Radio Diagnosis, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Suprava Naik
- Department of Radio Diagnosis, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Sanjeev K Bhoi
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
| | - Usha K Misra
- Department of Neurology, Sanjay Gandhi Postgraduate Institute of Medical Science, Lucknow, Uttar Pradesh, India
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Jain M, Parija D, Kumar P, Naik S. Misdiagnosed sternoclavicular tuberculosis presenting as a non-healing ulcer. BMJ Case Rep 2021; 14:e244454. [PMID: 34426429 PMCID: PMC8383862 DOI: 10.1136/bcr-2021-244454] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/17/2021] [Indexed: 11/04/2022] Open
Affiliation(s)
- Mantu Jain
- Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Debasish Parija
- Department of Orthopaedics, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Pankaj Kumar
- Department of General Surgery, All India Institute of Medical Sciences - Bhubaneswar, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, India
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Padmaja MS, Bhuniya S, Naik S, Sable M, Ghosh S, Mohapatra PR. Uncommon presentation of osteosarcoma. Adv Respir Med 2021; 88:282-284. [PMID: 32706113 DOI: 10.5603/arm.2020.0121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2020] [Revised: 03/11/2020] [Accepted: 03/14/2020] [Indexed: 11/25/2022]
Affiliation(s)
- Mantha Satya Padmaja
- Pulmonary Medicine and Critical Care, All India Institute of Medical sciences, Bhubaneswar, India
| | - Sourin Bhuniya
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India.
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical sciences, Bhubaneswar, India
| | - Mukund Sable
- Department of Pathology, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sudip Ghosh
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Prasanta Raghab Mohapatra
- Department of Pulmonary Medicine and Critical Care, All India Institute of Medical Sciences, Bhubaneswar, India
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Pati AB, Mahalik SK, Naik S, Das K. Heteropagus Twins: A Tale of Two. Neurol India 2021; 68:1453-1455. [PMID: 33342890 DOI: 10.4103/0028-3886.304090] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Parasitic twin is a rare occurrence, with rachispagus being the rarest. The surgical approach and timing are not standardized. We describe the management of two cases of rachispagus and review the sparse literature on this entity. Both cases were operated early because of the social burden on the family as well as difficulty in nursing care. The first patient had associated major systemic malformations in the autosite (cerebral, spinal and cardiac), and succumbed in the postoperative period. The entity was isolated in the second who is doing well.
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Affiliation(s)
- Akash B Pati
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Santosh K Mahalik
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Kanishka Das
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Telese A, Sehgal V, Magee CG, Naik S, Alqahtani S, Lovat L, Haidry RJ. Bariatric and Metabolic Endoscopy: A New Paradigm. Clin Transl Gastroenterol 2021; 12:e00364. [PMID: 34142665 PMCID: PMC8216681 DOI: 10.14309/ctg.0000000000000364] [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] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/23/2020] [Accepted: 04/14/2021] [Indexed: 12/26/2022] Open
Abstract
The prevalence of obesity, type 2 diabetes mellitus, and metabolic syndromes is increasing globally. Minimally invasive metabobariatric (MB) endoscopic therapies are adjunct treatments that can potentially bridge the gap between surgical interventions and medical therapy. A growing number of MB techniques are becoming available, allowing for more personalized and patient-targeted treatment options for specific disease states. MB techniques are less invasive than surgery and can precisely target different parts of the gastrointestinal tract that may be responsible for the pathophysiology of obesity and metabolic syndromes such as type 2 diabetes mellitus. These alternatives should be selected on an individualized patient basis to balance the expected clinical outcomes and desired anatomical targets with the level of invasiveness and degree of acceptable risk. Each MB intervention presents great flexibility allowing for a tailored intervention and different levels of patient engagement. Patient awareness and motivation are essential to avoid therapy withdrawal and failure. Differences between MB procedures in terms of weight loss and metabolic benefit will be discussed in this review, along with the insights on clinical decision-making processes to evaluate the potential of further evolution and growth of bariatric and metabolic endoscopy.
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Affiliation(s)
- Andrea Telese
- Department of Gastrointestinal Services, University College London Hospital, London, UK;
| | - Vinay Sehgal
- Department of Gastrointestinal Services, University College London Hospital, London, UK;
| | - Cormac G. Magee
- Department of Gastrointestinal Services, University College London Hospital, London, UK;
- Centre for Obesity research, University College London, London, UK;
| | - S. Naik
- Centre for Obesity research, University College London, London, UK;
| | - S.A. Alqahtani
- Division of Gastroenterology and Hepatology, Johns Hopkins University, Baltimore, Maryland, USA;
- Liver Transplantation Unit, King Faisal Specialist Hospital and Research Center, Riyadh, Saudi Arabia
| | - L.B. Lovat
- Department of Gastrointestinal Services, University College London Hospital, London, UK;
- Division of Surgery and Interventional Science, University College London, London, UK.
| | - Rehan J. Haidry
- Department of Gastrointestinal Services, University College London Hospital, London, UK;
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David KA, Sundaram S, Kim S, Vaca R, Lin Y, Singer S, Malecek M, Carter J, Zayac A, Kim MS, Reddy N, Ney D, Habib A, Strouse C, Graber J, Bachanova V, Salman S, Vendiola JA, Hossain N, Tsang M, Major A, Bond DB, Agrawal P, Mier‐Hicks A, Torka P, Rajakumar P, Venugopal P, Berg S, Glantz M, Goldlust S, Kumar P, Ollila T, Cai J, Spurgeon S, Sieg A, Cleveland J, Epperla N, Karmali R, Naik S, Martin P, Smith SM, Rubenstein J, Kahl B, Evens AM. OLDER PATIENTS WITH PRIMARY CENTRAL NERVOUS SYSTEM LYMPHOMA (PCNSL): REAL WORLD (RW) OUTCOMES OF POST‐INDUCTION THERAPY IN THE MODERN ERA. Hematol Oncol 2021. [DOI: 10.1002/hon.69_2880] [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: 11/10/2022]
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