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Papers by Arjun Prakash

INTERNATIONAL JOURNAL OF ANATOMY RADIOLOGY AND SURGERY

Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic, as we all know has wreaked havoc ... more Introduction: The Coronavirus Disease-2019 (COVID-19) pandemic, as we all know has wreaked havoc in many countries due to its high rate of infectivity. A High-Resolution Computed Tomography (HRCT) thorax scan is a must to determine the extent of lung involvement, which is helpful in further management. Aim: To compare the severity of lung involvement in COVID- 19 patients with double dose, single dose vaccinated and unvaccinated patients, and thus assess the role of vaccination in limiting the severity of lung involvement in infected patients. Materials and Methods: This was cross-sectional study conducted on 244 patients in the Department of Radiology of Adichunchungiri Institute of Medical Sciences, Bellur, Karnataka, India. The patients were divided into three groups based on their vaccination status. Group A constituted patients who had received two doses of vaccine, group B constituted patients vaccinated with only one dose and group C constituted unvaccinated patients. The Com...

Journal of Evidence Based Medicine and Healthcare, Dec 7, 2015

INTRODUCTION Acute abdomen is defined as the clinical condition in which the patient presents wit... more INTRODUCTION Acute abdomen is defined as the clinical condition in which the patient presents with acute severe abdominal symptoms within a period of 24 hours and where emergency medical or surgical intervention is required. A plain radiograph of the abdomen is often the first line of investigation in patients presenting with an acute abdomen, in spite of advances in other promising modalities like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI). It is important to be familiar with gas patterns to narrow down on the differential diagnoses and to make a correct diagnosis. Here we present a pictorial essay of the spectrum of gas patterns on plain radiograms.

Egyptian Journal of Radiology and Nuclear Medicine, Aug 17, 2022

Background: Respiratory distress syndrome (RDS) is a potentially fatal condition of neonate occur... more Background: Respiratory distress syndrome (RDS) is a potentially fatal condition of neonate occurring due to alveolar surfactant deficiency causing inefficient gaseous exchange and leading to hampered respiratory function. Purpose of our study is to investigate the role of Doppler indices in antenatal prediction of clinical Respiratory Distress Syndrome (RDS) in late preterm and early term foetuses using Main pulmonary artery (MPA) Doppler indices. The current study was conducted on 342 pregnant women between 34 and 39 weeks of gestational age, who came for routine third trimester ultrasound examination. The standard foetal biometric parameters, gestational age and estimated foetal weight were first obtained. The MPA Doppler indices like pulsatility index (PI), resistivity index (RI), peak systolic velocity (PSV), systolic/diastolic ratio and acceleration time/ejection time (At/Et) were recorded and correlated with the postnatal development of RDS. Results: Of the 342 foetuses, neonatal RDS was diagnosed in 47 foetuses. Foetuses diagnosed with RDS had statistically higher PI and RI values, whereas At/Et ratio and PSV were lower. At/Et ratio, PI and RI, PSV showed significant correlation with gestational age and the most statistically significant correlation was found with At/Et ratio. A cutoff value of 0.2865 (sensitivity 89.45%, specificity 94.79%) and 0.3155 (sensitivity 93.22%, specificity 96.78%) correlated strongly with development of RDS in late preterm foetuses and early term infants. Conclusion: Foetal MPA indices like PSV, RI, PI and especially Foetal At/Et ratio is a promising non-invasive tool which helps in identifying foetuses at risk and may be very useful to plan delivery in complicated pregnancies and also for better post-natal care of the neonate.

American Journal of Neuroradiology, 2018

BACKGROUND AND PURPOSE: Hirayama disease is a benign focal amyotrophy of the distal upper limbs i... more BACKGROUND AND PURPOSE: Hirayama disease is a benign focal amyotrophy of the distal upper limbs involving C7, C8, and T1 segmental myotomes with sparing of the brachioradialis and proximal muscles of the upper limb innervated by C5-6 myotomes. The objective of the present study was to study the utility of MR imaging in young patients presenting with weakness and wasting of the distal upper extremity and to evaluate the importance of the laminodural space during flexion cervical MR imaging. MATERIALS AND METHODS: This was a prospective cross-sectional study conducted from January 2014 to July 2017 in a tertiary care center from Northeast India. Forty-five patients with clinically definite Hirayama disease underwent electrophysiologic evaluation followed by MR imaging of the cervical spine. RESULTS: The mean age at recruitment was 22.8 Ϯ 5.5 years. Forty patients (88.9%) had unilateral and 5 (11.1%) had bilateral upper extremity involvement. Cervical cord T2-weighted hyperintensities were demonstrated in 16 patients (35.6%), of which 15 (33.3%) had anterior horn cell hyperintensities. Flexion MR imaging showed loss of the posterior dural attachment, forward shifting of the posterior dural sac with postcontrast enhancement, and prominent posterior epidural venous plexus in all patients. The laminodural space at maximum forward shifting of the posterior dural sac ranged from 3 to 9.8 mm, with a mean distance of 5.99 mm (95% confidence interval, 5.42-6.57 mm). CONCLUSIONS: Flexion cervical MR imaging is a very useful investigation in diagnosing Hirayama disease. The increase in the laminodural space and the presence of cervical cord flattening during flexion are essential for diagnosis.

International journal of anatomy radiology and surgery, 2021

Exclusion criteria: Subjects aged less than 18 years, those with trauma, arthritic changes and ma... more Exclusion criteria: Subjects aged less than 18 years, those with trauma, arthritic changes and masses involving the glenoid process , or with dislocation of glenohumeral joint at the time of study, infective pathology and those with sub-optimal imaging were excluded from the study.

International Journal of Anatomy Radiology and Surgery, 2019

Introduction: The hip joint is a major weight-bearing joint in the human body. It is often diffic... more Introduction: The hip joint is a major weight-bearing joint in the human body. It is often difficult to assess painful hip disorders clinically. This necessitates the need for imaging to arrive at an accurate diagnosis. Magnetic Resonance Imaging (MRI) is an imaging modality with good soft tissue contrast and resolution for evaluating hip pathologies. Aim: To identify and study the spectrum of imaging features in various hip disorders in adults and to establish a differential diagnosis using MRI. Materials and Methods: A hospital based cross-sectional study was done from June 2017 to May 2018 in a tertiary care centre of Southern India, where 70 patients who presented with unilateral or bilateral hip pain were evaluated with MRI. Demographic data including the patients age and sex was collected. The clinical features with which the patients presented were recorded. Conventional radiographic imaging of bilateral hip bone in antero-posterior and lateral views were obtained. Specialize...

International Journal of Pediatrics, 2018

Background Multicentric carpotarsal osteolysis (MCTO), a skeletal dysplasia presents in early chi... more Background Multicentric carpotarsal osteolysis (MCTO), a skeletal dysplasia presents in early childhood mimicking juvenile idiopathic arthritis (JIA). Recognition of this syndrome is essential to avoid unnecessary treatment with immunosuppressive agents because of different course and treatment. Case Report A 3-year-old boy presented with swelling and restriction of right wrist joint and left ankle joint. Possibility of Oligoarticular (or pauciarticular) JIA was considered. On evaluation his inflammatory parameters were normal. There was poor response to oral steroids and methotrexate. He was lost to follow up and presented at 9 years of age with varus deformities of hand and feet. Radiographs revealed absent carpal and tarsal bones. Based on clinical and radiological examination- MCTO was diagnosed. Oral alendronate was started and clinical improvement was noted. Conclusion Mimickers of JIA like MCTO, Farber’s disease should be actively looked when inflammatory parameters are norma...

International Journal of Contemporary Medicine, Surgery and Radiology, 2019

Introduction: Hip pain is a common diagnostic challenge for the physician. Study aimed to access ... more Introduction: Hip pain is a common diagnostic challenge for the physician. Study aimed to access the usefullness of Magnetic resonance imaging (MRI) in the diagnosis of various hip pathologies. Material and methods: This was a prospective study of 80 patients with the complaints of hip joint pain. All patients underwent the following MRI sequences-Axial T1WI, T2WI, Coronal T1WI, T2WI, STIR & PDFS, Sagittal PDFS and T1WI postcontrast axial, coronal and sagittal sequences. Data was collected and tabulated. Statistical analysis was done with the calculations of frequencies and percentages. Results: Out of 80 patients 68(85%) patients revealed abnormalities in the MRI scan. Avascular necrosis is seen in 28(35%), fractures in 8(10%), osteoarthritis in 8 (10%), Synovial effusion in 6 (7.5%), bone infarcts in 4(5%) bursitis in 4 (5%), synovitis, bone marrow oedema, infective arthritis, metastatic lesions, sacroillitis in two patients each and intramuscular abscess and femoro acetabular impingement are seen in one patient each. Conclusion: MRI is the modality of choice for the diagnosis of hip joint pain as it is safe, non-invasive and depicts accurate anatomical details. MRI is an excellent modality for the diagnosis of many hip conditions which shows nonremarkable subtle findings in radiographs and CT.

The Neuroradiology Journal

Purpose The purpose is to determine the inter-rater reliability in grading ASPECTS score, between... more Purpose The purpose is to determine the inter-rater reliability in grading ASPECTS score, between emergency medicine physician at first contact and radiologist among patients with acute ischemic stroke. Materials and Methods We conducted a prospective analysis of 765 acute ischemic stroke cases referred to the Department of Radiodiagnosis in a rural-based hospital in South India, during January 2017 to October 2021. Non-contrast computed tomography (NCCT) scans of the brain were performed using GE Bright Speed Elite 128 Slice CT Scanner. ASPECTS score was calculated separately by an emergency medicine physician and radiologist. Inter-rater reliability for total and dichotomized ASPECTS (≥6 and <6) scores were assessed using statistical analysis (ICC and Cohen ĸ coefficients) on SPSS software (v17.0). Results Inter-rater agreement for total and dichotomized ASPECTS was substantial (ICC 0.79 and Cohen ĸ 0.68) between the emergency physician and the radiologist. Mean difference in A...

Skeletal radiology, Jan 15, 2016

The aim of this study was to evaluate the safe zone for performing blind sternal procedures based... more The aim of this study was to evaluate the safe zone for performing blind sternal procedures based on computed tomography (CT) evaluation of congenital midline sternal foramina using multidetector computed tomography (MDCT). This retrospective study was carried out on 1,180 patients who underwent MDCT of the thorax from March 2015 to February 2016. The MDCT images were evaluated in axial and reformatted planes. Morphometry and prevalence of midline congenital sternal foramina (SF) and manubrio-foraminal distance (MFD) were evaluated. The safe zone was defined for a blinded intervention, based on palpable anatomical landmarks. Data were presented in terms of percentage, mean ± standard deviation and calculations were carried out using Microsoft Excel. The prevalence of SF in our study sample was 11.6 %. The majority of SF were located in a typical position in the lower sternal body at the level of fifth costo-chondral junction (CCJ) in 108 patients (78.8 %). The structure directly ben...

IOSR Journal of Dental and Medical Sciences, 2014

I. I nt roduct io n Brain tumors are the most common solid tumor of childhood and the second most... more I. I nt roduct io n Brain tumors are the most common solid tumor of childhood and the second most common malignancy after the leukemias. Primary central nervous system tumors (CNS) are the most common solid neoplasms in children. The incidence of CNS tumors is 2-5 new cases per 100000 per year, which is stable throughout the World. About 7% of the reported brain and CNS tumors occur in children aged 0-19 years .1, 2 Although infratentorial tumors predominate in children, supratentorial tumors are more common in the first 2 to 3 years of life 2. The clinical manifestations in childhood with brain tumors are largely those of increased intracranial pressure. Headache is a common early symptom. Most other symptoms are non-specific and include vomiting, cranial neuropathies and stupor and coma in late stages. 3 The largest percentage of childhood tumors (17%) are located within the frontal, temporal, parietal and occipital lobes of the brain. For children aged 0-14 years, pilocytic astrocytomas, embryonal tumors, and malignant glioma are the common tumors. The most common histologies in adolescent ages 15-19 years include tumors of the pituitary and pilocytic astrocytoma. 1 Supratentorial intraaxial tumors are not very common in children but they are histologically more varied than in adults. Although there have been several neuroradiological investigations, accurate diagnosis by imaging modalities alone remains difficult in all cases, and final diagnosis in most cases requires histological examination. However, neuroradiological information is valuable in predicting tissue character and histological type or grade, and in helping establish treatment strategies. 4, 5 The imaging modalities used are mainly CT and MR imaging with newer modalities like MR and CT perfusion, PET and SPECT. CT has become the primary imaging investigation in cases of suspected brain tumors, surpassing many other invasive imaging modalities. It has considerably high sensitivity, it is non-invasive having no hazards except ionizing radiations. CT can predict the pathological nature of a lesion with reasonable degree of accuracy. CT scan is more accurate indicator of brain tumor, yet it is not always 100% accurate. 6 MRI has its advantage of being a radiation free and multi-planar imaging facility. Hence a lesion can be seen in three planes and accurate localization of the lesion can be done. This modality provides better soft tissue characterization and can clearly demonstrate peritumoral edema, but has disadvantages like high cost , requires a long time for acquisition of the data and hence cannot be used for restless patient particularly neonates, infants or even uncooperative children. It cannot be done in patients having metallic implants for which CT is the modality of choice. 3 Newer multi-slice helical CT scanners are capable of providing highly collimated sub millimeter thickness sectional images in extremely short acquisition times and thus areas of hyperostosis or bone destruction, intratumoral calcification and early intratumoral or peritumoral hemorrhage are more completely defined with greater certainty on CT than on MRI 3 O bje c ti ve s of the St udy 1. To study the distribution of various supratentorial neoplasms in pediatric age group. 2. To study the CT features of supratentorial neoplasms in pediatric age group. 3. To localise and assess the extent of supratentorial neoplasms in pediatric age group. II. Materials and Methods This study of "CT EVALUATION OF SUPRATENTORIAL TUMORS IN PEDIATRIC AGE GROUP" was conducted on 36 patients at Assam Medical College & Hospital, Dibrugarh, with a suspicion of intracranial SOL by neurologists, pediatricians and physicians from in and around Dibrugarh over a period of three year from July 2011 to June 2014. Methodology: This was a study done to evaluate the efficacy of computed tomography in the diagnosis of supratentorial tumors in pediatric age group.

Journal of Evidence Based Medicine and Healthcare, 2016

Introduction: Cysticercosis is caused by the larval stage of Taenia solium, the pork tapeworm. It... more Introduction: Cysticercosis is caused by the larval stage of Taenia solium, the pork tapeworm. It has a relatively high prevalence in developing countries because of the co-existence of poor sanitary conditions and domestic pig raising. However lingual cysticercosis is a very rare occurrence even in countries with very high prevalence of cysticerci infections. Case presentation: We report three cases of isolated lingual cysticercosis after excluding intracranial or

CHRISMED Journal of Health and Research

Holoprosencephaly is a complex developmental abnormality of the brain arising from the failure of... more Holoprosencephaly is a complex developmental abnormality of the brain arising from the failure of cleavage of the prosencephalon. The condition termed “holoprosencephaly” includes cyclopia, cebocephaly, ethmocephaly, and median cleft. We present two cases of antenatally diagnosed alobar holoprosencephaly with multiple associations, which were confirmed after termination of pregnancy. One of them had a proboscis and a single midline eye. The other had multiple facial abnormalities such as hypotelorism, median cleft lip and palate, and preauricular skin tag.

International Journal of Health Sciences and Research, 2015

Germinomas are the most common intracranial germ cell tumors commonly found in children and adole... more Germinomas are the most common intracranial germ cell tumors commonly found in children and adolescents with a mean age of 8-10 years. Intracranial germinomas occur with a strong male predominance and approximately 95% are found in the midline in the pineal (65%) and suprasellar (about 25%) regions. We report a case of multiple midline intracranial germinomas in the pineal, suprasellar and optico-chiasmatic regions presenting in a patient aged 20 years. Synchronous lesions in suprasellar and pineal regions are very rare and are almost exclusively germinomas accounting for 2-13% of all intracranial germ cell tumors and can be concluded that no further evaluation is necessary before initiating therapy in a case of synchronous pineal and sellar lesions with typical neuroimaging features and normal serum oncoproteins Keywordsgerminoma, multiple midline tumors, oncoproteins, CSF (cerebral spinal fluid), MRI (Magnetic Resonance Imaging). INTRODUCTION Germ cell tumors most frequently arise...

International journal of current research and review, 2015

Case report: We report a rare case of traumatic diaphragmatic rupture with chest radiology and Co... more Case report: We report a rare case of traumatic diaphragmatic rupture with chest radiology and Computed tomography(CT) findings in whom emergency laparotomy was performed resulting in successful repair of diaphragmatic injury. Discussion: Traumatic diaphragmatic rupture occurs in patients who sustain blunt and penetrating thoracoabdominal injuries. The most common herniated viscera are the stomach and colon on the left side and the liver on the right side. Specific signs in X-ray and Compute tomography (CT) will help in early diagnosis. Conclusion: Traumatic diaphragmatic rupture remains a diagnostic challenge for both radiologists and surgeons. Early diagnosis and repair of diaphragmatic tears is desirable. Clinical examination coupled with meticulous radiological examinations like X-ray and Computed tomography(CT) will help in early diagnosis.