Purnachandra Lamghare - Academia.edu (original) (raw)

Papers by Purnachandra Lamghare

Research paper thumbnail of Creating Order Out of Chaos – Role of Antenatal Ultrasound in Diagnosis

Polish Journal of Radiology, 2017

Background: Congenital high airway obstruction syndrome (CHAOS) is a rare fetal anomaly character... more Background: Congenital high airway obstruction syndrome (CHAOS) is a rare fetal anomaly characterized by obstruction of the higher fetal airway. This could be either complete or incomplete and is more commonly seen at the subglottic level, resulting in a spectrum of characteristic secondary features.

Research paper thumbnail of Role of Multiparametric Magnetic Resonance Imaging in the Evaluation of Prostatic Pathologies on 3 Tesla Machine

International Journal of Medical Reviews and Case Reports, 2022

In patients with negative mpMRI consideration could be given for surveillance. • MpMRI may add va... more In patients with negative mpMRI consideration could be given for surveillance. • MpMRI may add valuable information for the optimal treatment selection.

Research paper thumbnail of Anterior cruciate ligament (ACL) injury: correlation with MRI morphometry

Egyptian Journal of Radiology and Nuclear Medicine

Background This study aims to investigate the association between bony morphological features and... more Background This study aims to investigate the association between bony morphological features and ACL injury and to identify potential risk factors for the identification and prevention of ACL injuries. The study used knee MRIs to examine the distal femoral and proximal tibia morphology of 500 patients aged 19–50, including 250 cases with an injured ACL and 250 controls with a non-injured ACL. Previous literature has shown that ACL injuries are a common occurrence in sports and can have serious long-term consequences. Several risk factors have been identified, including anatomical variations in the bony structures of the knee. However, the relationship between bony morphology and ACL injury is not well understood, and there is a need to investigate the potential role of these factors in the identification and prevention of ACL injuries. This study was necessary because of the high incidence of ACL injuries and the potential long-term consequences, such as osteoarthritis, associated ...

Research paper thumbnail of Rare Occurrence of Double Outlet Right Ventricle and Cardiomyopathy on Dynamic Contrast-Enhanced Cardiac MRI: A Case Report

Research paper thumbnail of Neuroimaging Spectrum of Intracranial Lipomas

Cureus

Background: Intracranial lipomas are rare congenital malformations at characteristic sites. Thoug... more Background: Intracranial lipomas are rare congenital malformations at characteristic sites. Though largely asymptomatic, some cause significant morbidity. We are studying this for the local population. Objectives: The purpose of this article is to analyze the spectrum of intracranial lipomas, determine their distribution at characteristic locations, and assess their associations.

Research paper thumbnail of Facial Swelling as a Presenting Sign of Cholangiocarcinoma

EMJ Radiology

Cholangiocarcinoma is a rare primary malignancy of the biliary tree, which usually presents late ... more Cholangiocarcinoma is a rare primary malignancy of the biliary tree, which usually presents late in the course of disease with jaundice, upper right quadrant pain, and cachexia. They frequently metastasise in the lungs, liver, bones, adrenals, peritoneum, and retroperitoneal lymph nodes. The incidence of cutaneous dissemination from cholangiocarcinoma is extremely rare, with the scalp being the commonest distant site of skin metastasis. The authors report the case of a 44-year-old female with Stage IV hilar cholangiocarcinoma, who presented primarily with tender facial swelling, prompting investigation and subsequent diagnosis. To the authors’ knowledge, this case is the first report of a cholangiocarcinoma presenting as facial metastasis. It highlights the need for early characterisation of cutaneous lesions, which are likely to be of neoplastic origin using histology, immunohistochemistry, and PET-CT scans, and reminds that biliary tree neoplasms are possible primary malignancies ...

Research paper thumbnail of Evaluating the Association Between Comorbidities and COVID-19 Severity Scoring on Chest CT Examinations Between the Two Waves of COVID-19: An Imaging Study Using Artificial Intelligence

Cureus

Background Coronavirus disease 2019 (COVID-19) has accounted for over 352 million cases and five ... more Background Coronavirus disease 2019 (COVID-19) has accounted for over 352 million cases and five million deaths globally. Although it affects populations across all nations, developing or transitional, of all genders and ages, the extent of the specific involvement is not very well known. This study aimed to analyze and determine how different were the first and second waves of the COVID-19 pandemic by assessing computed tomography severity scores (CT-SS). Methodology This was a retrospective, cross-sectional, observational study performed at a tertiary care Institution. We included 301 patients who underwent CT of the chest between June and October 2020 and 1,001 patients who underwent CT of the chest between February and April 2021. All included patients were symptomatic and were confirmed to be COVID-19 positive. We compared the CT-SS between the two datasets. In addition, we analyzed the distribution of CT-SS concerning age, comorbidities, and gender, as well as their differences between the two waves of COVID-19. Analysis was performed using the SPSS version 22 (IBM Corp., Armonk, NY, USA). The artificial intelligence platform U-net architecture with Xception encoder was used in the analysis. Results The study data revealed that while the mean CT-SS did not differ statistically between the two waves of COVID-19, the age group most affected in the second wave was almost a decade younger. While overall the disease had a predilection toward affecting males, our findings showed that females were more afflicted in the second wave of COVID-19 compared to the first wave. In particular, the disease had an increased severity in cases with comorbidities such as hypertension, diabetes mellitus, bronchial asthma, and tuberculosis. Conclusions This assessment demonstrated no significant difference in radiological severity score between the two waves of COVID-19. The secondary objective revealed that the two waves showed demographical differences. Hence, we iterate that no demographical subset of the population should be considered low risk as the disease manifestation was heterogeneous.

Research paper thumbnail of Observer performance evaluation of the feasibility of a deep learning model to detect cardiomegaly on chest radiographs

Acta Radiologica Open

Background Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter o... more Background Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR (>0.55) is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. Purpose We propose a deep learning (DL)-based model for automatic CTR calculation to assist radiologists with rapid diagnosis of cardiomegaly and thus optimise the radiology flow. Material and Methods The study population included 1012 posteroanterior CXRs from a single institution. The Attention U-Net DL architecture was used for the automatic calculation of CTR. An observer performance test was conducted to assess the radiologist’s performance in diagnosing cardiomegaly with and without artificial intelligence assistance. Results U-Net model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], specificity >99%, precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0...

Research paper thumbnail of Validation of a Deep Learning Model to aid in COVID-19 Detection from Digital Chest Radiographs

IntroductionUsing artificial intelligence in imaging practice helps ensure study list reprioritiz... more IntroductionUsing artificial intelligence in imaging practice helps ensure study list reprioritization, prompt attention to urgent studies, and reduces the reporting turn-around time.PurposeWe tested a deep learning-based artificial intelligence model that can detect COVID-19 pneumonia patterns from digital chest radiographs.Material and MethodsThe deep learning model was built using the enhanced U-Net architecture with Spatial Attention Gate and Xception Encoder. The model was named DxCOVID and was tested on an external clinical dataset. The dataset included 2247 chest radiographs comprising CXRs from 1046 COVID-19 positive patients (positive on RT-PCR) and 1201 COVID-19 negative patients.ResultsWe compared the performance of the model with three different radiologists by adjusting the model’s sensitivity as per the individual radiologist. The area under the curve (AUC) on the receiver operating characteristic (ROC) of the model was 0.87 [95% CI: 0.85, 0.89].ConclusionWhen compared...

Research paper thumbnail of Role of ultrasonography and computed tomography in stomach and bowel diseases

International journal of health sciences

Background-In this study we compared ultrasound with CT in detecting causes of Common stomach and... more Background-In this study we compared ultrasound with CT in detecting causes of Common stomach and bowel pathologies such as appendicitis, diverticulitis, volvulus in patients presenting at the department with acute abdominal pain in the majority of cases. Methods- A cross-sectional study was conducted in our institute from September 2019 to August 2021 following approval from the Ethical committee of the hospital. All clinically suspected lesions involving stomach and bowel patients included patients who were clinically evaluated at OPD & the emergency department by the surgeon. All those who fulfilled the inclusion criteria were explained the purpose of the study. After clinical assessment, all consenting patients underwent ultrasound and computed tomography (CT) within a few hours of presentation. Results- A total of 100 patients with stomach and bowel disorders were studied using ultrasound and multidetector CT scan. 25 patients were diagnosed with appendicular pathologies, 25 c...

Research paper thumbnail of Inflammatory Subcutaneous Pseudotumour due to Migrating Foreign Body through Concealed Colonic Perforation: A Case Report

Journal of Clinical and Diagnostic Research, 2022

Foreign body ingestion though a common occurrence, rarely leads to bowel perforation. Thus, forei... more Foreign body ingestion though a common occurrence, rarely leads to bowel perforation. Thus, foreign body migration presents a diagnostic challenge. The author presents a case report of a 75-year-old female with a inflammatory subcutaneous pseudotumour due to migrating foreign body through a concealed colonic perforation. The patient presented with insidious abdominal pain and fever since two months, with local tenderness and palpable lumbar in right lumbar region on examination. The diagnosis was initially made on ultrasound and confirmed on Computed Tomography (CT). Surgical removal of the foreign body was done.

Research paper thumbnail of Moyamoya Syndrome with Recurrent Stroke in a Splenectomised Patient with Beta- Thalassaemia Major: A Case Report

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021

Research paper thumbnail of Role of Late Gadolinium Enhancement in the Assessment of Myocardial Viability

Cureus, 2022

Background: Prior to any revascularization procedure for coronary artery disease, it is essential... more Background: Prior to any revascularization procedure for coronary artery disease, it is essential to identify viable myocardium which will likely benefit from it. In such a situation, delayed enhanced cardiac MRI is beneficial. Methods: Our study consisted of 50 patients with at least a one-month prior history of myocardial infarction (MI), abnormal findings on electrocardiography (ECG), and 2D-echocardiography (2D-ECHO), who were subjected to cardiac MRI performed on a 3T MRI machine. The MRI scans were evaluated for anatomical and especially functional characteristics of the heart, such as wall motion. On late gadolinium enhancement (LGE), the diseased segments were classified into two categories: < 50% LGE (viable) and > 50% LGE (nonviable). Results: Of the 378 diseased segments detected on LGE, 137 (36.2%) segments showed < 50% LGE and 241 (63.8%) segments showed > 50% LGE. The segments showing < 50% LGE showed normokinesia or hypokinesia, with none of the segments showing akinesia or dyskinesia, whereas the segments showing > 50% LGE showed akinesia or dyskinesia predominantly. This was found to be statistically highly significant (p-value < 0.001). Conclusion: Delayed enhanced-cardiac magnetic resonance (DE-CMR) imaging in patients with ischemic heart disease (IHD) helps evaluate the severity of the infarcted myocardium by classifying the diseased myocardium into viable and non-viable, as viable myocardium is more likely to regain functional recovery than non-viable myocardium. It also predicts the functional recovery of the myocardium after revascularization therapy.

Research paper thumbnail of A case of carotid web: Cause of stroke in healthy and young patients

South African Journal of Radiology, 2022

Research paper thumbnail of Role of Magnetic Resonance Imaging in the Evaluation of Rotator Cuff Tears

Cureus, 2022

Background Magnetic resonance imaging (MRI), with the advent of surface coils, is becoming the mo... more Background Magnetic resonance imaging (MRI), with the advent of surface coils, is becoming the modality of choice for imaging soft tissues around the shoulder joint. Good knowledge regarding the MR characteristics of rotator cuff tendons, acromion, and the abnormalities in these tendons is necessary for appropriate diagnosis. Methods This was a hospital-based descriptive, analytical and prospective study conducted at our tertiary care hospital. The study was performed on 50 patients with rotator cuff lesions detected on MRI of the shoulder joint. Results The age distribution found in the study is between 19 and 66 years with mean being 43 ± 14.8 years. The peak incidence was found in the fifth and sixth decades of life. Gender-wise distribution of rotator cuff pathologies has shown no significant gender variation. The pain was the most common presenting complaint. An abnormal supraspinatus tendon was seen in 82% of the 50 study patients, making it the most commonly affected tendons, followed by subscapularis and infraspinatus tendons. No apparent teres minor pathology was identified in the study patients. The most common pathology affecting the supraspinatus tendon was tendinosis (38%) closely followed by a partial tear (36%). Among the partial tears, the articular surface type of tear was the most common. About 52% patients had type II (curved) acromion; making it the most common type of acromion followed by type III (hook), supraspinatus tendinopathy was more common in type II acromion. A reduction in the acromiohumeral distance can cause supraspinatus tendinosis and also makes it more susceptible to tear. About 45.5% showed supraspinatus tendon tears when the acromiohumeral distance was less than 8mm as compared to 13.6% when more than 10mm. Only 4.2% had normal supraspinatus tendon in patients with this distance less than 7mm. Conclusion MRI provides valuable information to the orthopaedic surgeon regarding the status of tendons, bones, and joints. In order to choose the appropriate course of action, it is crucial first to identify the issue and report relevant data from rotator cuff imaging. A full grasp of the rotator cuff's architecture and function, as well as the repercussions of rotator cuff diseases, is required.

Research paper thumbnail of Arachnoid Cyst in Middle Cranial Fossa With Intraorbital Cyst (Orbital Meningocele)

Cureus, 2021

Intracranial arachnoid cysts are extra-axial non-enhancing cerebrospinal fluid (CSF) density lesi... more Intracranial arachnoid cysts are extra-axial non-enhancing cerebrospinal fluid (CSF) density lesions. These are usually incidental findings on radiological investigations. Usually, the patients with arachnoid cysts are asymptomatic until the cyst grows large while symptomatic patients present with headaches, seizures, and focal neurological deficits. The adjacent calvarial bone may show remodeling and scalloping. Magnetic resonance imaging (MRI) stands superior in soft-tissue contrast and multiplanar imaging in excluding other lesions from the arachnoid cyst. Arachnoid cysts follow CSF signals in all pulse sequences with no gadolinium enhancement. Intraorbital extension of the intracranial arachnoid cyst (intraorbital meningocele) is rarely reported in the literature and occurs through the small bony defect. We report a case of a 20-year-old male presenting with proptosis who was detected to have an arachnoid cyst in the middle cranial fossa with intraorbital extension through a small bony defect in the lateral wall of orbit with the resultant orbital cyst.

Research paper thumbnail of Correlation Between CT Severity Scoring and Diabetes Mellitus in Patients With COVID-19 Infection

Cureus, 2021

Background and objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caus... more Background and objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China in December 2019. Since then, It has spread across multiple countries and was declared a pandemic by WHO in March 2020. Patients with underlying diabetes mellitus (DM) are deemed at-risk for developing severe COVID-19 infection. In light of this, we aimed to evaluate the correlation between DM and chest CT severity scores (CTSS) in COVID-19 patients. Methods This was a hospital-based descriptive, analytical retrospective study conducted at our tertiary care hospital. A quantitative severity score was calculated among 220 patients with COVID-19 infection based on the degree of lung lobe involvement on CT chest scans. Based on CTSS, the patients were classified into groups of mild, moderate, and severe lung involvement. The association between DM and CTSS was evaluated using the chi-square test. Results The severity of lung involvement was higher among COVID-19 patients with a co-diagnosis of DM (29.3%) compared to those without DM (11.7%). This association of severe lung involvement with DM was statistically significant (p=0.002). Conclusion Based on our findings, diabetic patients are at an increased risk of developing the severe form of COVID-19 with a higher CT lung involvement score compared to non-diabetic patients.

Research paper thumbnail of Creating Order Out of Chaos – Role of Antenatal Ultrasound in Diagnosis

Polish Journal of Radiology, 2017

Background: Congenital high airway obstruction syndrome (CHAOS) is a rare fetal anomaly character... more Background: Congenital high airway obstruction syndrome (CHAOS) is a rare fetal anomaly characterized by obstruction of the higher fetal airway. This could be either complete or incomplete and is more commonly seen at the subglottic level, resulting in a spectrum of characteristic secondary features.

Research paper thumbnail of Role of Multiparametric Magnetic Resonance Imaging in the Evaluation of Prostatic Pathologies on 3 Tesla Machine

International Journal of Medical Reviews and Case Reports, 2022

In patients with negative mpMRI consideration could be given for surveillance. • MpMRI may add va... more In patients with negative mpMRI consideration could be given for surveillance. • MpMRI may add valuable information for the optimal treatment selection.

Research paper thumbnail of Anterior cruciate ligament (ACL) injury: correlation with MRI morphometry

Egyptian Journal of Radiology and Nuclear Medicine

Background This study aims to investigate the association between bony morphological features and... more Background This study aims to investigate the association between bony morphological features and ACL injury and to identify potential risk factors for the identification and prevention of ACL injuries. The study used knee MRIs to examine the distal femoral and proximal tibia morphology of 500 patients aged 19–50, including 250 cases with an injured ACL and 250 controls with a non-injured ACL. Previous literature has shown that ACL injuries are a common occurrence in sports and can have serious long-term consequences. Several risk factors have been identified, including anatomical variations in the bony structures of the knee. However, the relationship between bony morphology and ACL injury is not well understood, and there is a need to investigate the potential role of these factors in the identification and prevention of ACL injuries. This study was necessary because of the high incidence of ACL injuries and the potential long-term consequences, such as osteoarthritis, associated ...

Research paper thumbnail of Rare Occurrence of Double Outlet Right Ventricle and Cardiomyopathy on Dynamic Contrast-Enhanced Cardiac MRI: A Case Report

Research paper thumbnail of Neuroimaging Spectrum of Intracranial Lipomas

Cureus

Background: Intracranial lipomas are rare congenital malformations at characteristic sites. Thoug... more Background: Intracranial lipomas are rare congenital malformations at characteristic sites. Though largely asymptomatic, some cause significant morbidity. We are studying this for the local population. Objectives: The purpose of this article is to analyze the spectrum of intracranial lipomas, determine their distribution at characteristic locations, and assess their associations.

Research paper thumbnail of Facial Swelling as a Presenting Sign of Cholangiocarcinoma

EMJ Radiology

Cholangiocarcinoma is a rare primary malignancy of the biliary tree, which usually presents late ... more Cholangiocarcinoma is a rare primary malignancy of the biliary tree, which usually presents late in the course of disease with jaundice, upper right quadrant pain, and cachexia. They frequently metastasise in the lungs, liver, bones, adrenals, peritoneum, and retroperitoneal lymph nodes. The incidence of cutaneous dissemination from cholangiocarcinoma is extremely rare, with the scalp being the commonest distant site of skin metastasis. The authors report the case of a 44-year-old female with Stage IV hilar cholangiocarcinoma, who presented primarily with tender facial swelling, prompting investigation and subsequent diagnosis. To the authors’ knowledge, this case is the first report of a cholangiocarcinoma presenting as facial metastasis. It highlights the need for early characterisation of cutaneous lesions, which are likely to be of neoplastic origin using histology, immunohistochemistry, and PET-CT scans, and reminds that biliary tree neoplasms are possible primary malignancies ...

Research paper thumbnail of Evaluating the Association Between Comorbidities and COVID-19 Severity Scoring on Chest CT Examinations Between the Two Waves of COVID-19: An Imaging Study Using Artificial Intelligence

Cureus

Background Coronavirus disease 2019 (COVID-19) has accounted for over 352 million cases and five ... more Background Coronavirus disease 2019 (COVID-19) has accounted for over 352 million cases and five million deaths globally. Although it affects populations across all nations, developing or transitional, of all genders and ages, the extent of the specific involvement is not very well known. This study aimed to analyze and determine how different were the first and second waves of the COVID-19 pandemic by assessing computed tomography severity scores (CT-SS). Methodology This was a retrospective, cross-sectional, observational study performed at a tertiary care Institution. We included 301 patients who underwent CT of the chest between June and October 2020 and 1,001 patients who underwent CT of the chest between February and April 2021. All included patients were symptomatic and were confirmed to be COVID-19 positive. We compared the CT-SS between the two datasets. In addition, we analyzed the distribution of CT-SS concerning age, comorbidities, and gender, as well as their differences between the two waves of COVID-19. Analysis was performed using the SPSS version 22 (IBM Corp., Armonk, NY, USA). The artificial intelligence platform U-net architecture with Xception encoder was used in the analysis. Results The study data revealed that while the mean CT-SS did not differ statistically between the two waves of COVID-19, the age group most affected in the second wave was almost a decade younger. While overall the disease had a predilection toward affecting males, our findings showed that females were more afflicted in the second wave of COVID-19 compared to the first wave. In particular, the disease had an increased severity in cases with comorbidities such as hypertension, diabetes mellitus, bronchial asthma, and tuberculosis. Conclusions This assessment demonstrated no significant difference in radiological severity score between the two waves of COVID-19. The secondary objective revealed that the two waves showed demographical differences. Hence, we iterate that no demographical subset of the population should be considered low risk as the disease manifestation was heterogeneous.

Research paper thumbnail of Observer performance evaluation of the feasibility of a deep learning model to detect cardiomegaly on chest radiographs

Acta Radiologica Open

Background Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter o... more Background Cardiothoracic ratio (CTR) is the ratio of the diameter of the heart to the diameter of the thorax. An abnormal CTR (>0.55) is often an indicator of an underlying pathological condition. The accurate prediction of an abnormal CTR chest X-rays (CXRs) aids in the early diagnosis of clinical conditions. Purpose We propose a deep learning (DL)-based model for automatic CTR calculation to assist radiologists with rapid diagnosis of cardiomegaly and thus optimise the radiology flow. Material and Methods The study population included 1012 posteroanterior CXRs from a single institution. The Attention U-Net DL architecture was used for the automatic calculation of CTR. An observer performance test was conducted to assess the radiologist’s performance in diagnosing cardiomegaly with and without artificial intelligence assistance. Results U-Net model exhibited a sensitivity of 0.80 [95% CI: 0.75, 0.85], specificity >99%, precision of 0.99 [95% CI: 0.98, 1], and a F1 score of 0...

Research paper thumbnail of Validation of a Deep Learning Model to aid in COVID-19 Detection from Digital Chest Radiographs

IntroductionUsing artificial intelligence in imaging practice helps ensure study list reprioritiz... more IntroductionUsing artificial intelligence in imaging practice helps ensure study list reprioritization, prompt attention to urgent studies, and reduces the reporting turn-around time.PurposeWe tested a deep learning-based artificial intelligence model that can detect COVID-19 pneumonia patterns from digital chest radiographs.Material and MethodsThe deep learning model was built using the enhanced U-Net architecture with Spatial Attention Gate and Xception Encoder. The model was named DxCOVID and was tested on an external clinical dataset. The dataset included 2247 chest radiographs comprising CXRs from 1046 COVID-19 positive patients (positive on RT-PCR) and 1201 COVID-19 negative patients.ResultsWe compared the performance of the model with three different radiologists by adjusting the model’s sensitivity as per the individual radiologist. The area under the curve (AUC) on the receiver operating characteristic (ROC) of the model was 0.87 [95% CI: 0.85, 0.89].ConclusionWhen compared...

Research paper thumbnail of Role of ultrasonography and computed tomography in stomach and bowel diseases

International journal of health sciences

Background-In this study we compared ultrasound with CT in detecting causes of Common stomach and... more Background-In this study we compared ultrasound with CT in detecting causes of Common stomach and bowel pathologies such as appendicitis, diverticulitis, volvulus in patients presenting at the department with acute abdominal pain in the majority of cases. Methods- A cross-sectional study was conducted in our institute from September 2019 to August 2021 following approval from the Ethical committee of the hospital. All clinically suspected lesions involving stomach and bowel patients included patients who were clinically evaluated at OPD & the emergency department by the surgeon. All those who fulfilled the inclusion criteria were explained the purpose of the study. After clinical assessment, all consenting patients underwent ultrasound and computed tomography (CT) within a few hours of presentation. Results- A total of 100 patients with stomach and bowel disorders were studied using ultrasound and multidetector CT scan. 25 patients were diagnosed with appendicular pathologies, 25 c...

Research paper thumbnail of Inflammatory Subcutaneous Pseudotumour due to Migrating Foreign Body through Concealed Colonic Perforation: A Case Report

Journal of Clinical and Diagnostic Research, 2022

Foreign body ingestion though a common occurrence, rarely leads to bowel perforation. Thus, forei... more Foreign body ingestion though a common occurrence, rarely leads to bowel perforation. Thus, foreign body migration presents a diagnostic challenge. The author presents a case report of a 75-year-old female with a inflammatory subcutaneous pseudotumour due to migrating foreign body through a concealed colonic perforation. The patient presented with insidious abdominal pain and fever since two months, with local tenderness and palpable lumbar in right lumbar region on examination. The diagnosis was initially made on ultrasound and confirmed on Computed Tomography (CT). Surgical removal of the foreign body was done.

Research paper thumbnail of Moyamoya Syndrome with Recurrent Stroke in a Splenectomised Patient with Beta- Thalassaemia Major: A Case Report

JOURNAL OF CLINICAL AND DIAGNOSTIC RESEARCH, 2021

Research paper thumbnail of Role of Late Gadolinium Enhancement in the Assessment of Myocardial Viability

Cureus, 2022

Background: Prior to any revascularization procedure for coronary artery disease, it is essential... more Background: Prior to any revascularization procedure for coronary artery disease, it is essential to identify viable myocardium which will likely benefit from it. In such a situation, delayed enhanced cardiac MRI is beneficial. Methods: Our study consisted of 50 patients with at least a one-month prior history of myocardial infarction (MI), abnormal findings on electrocardiography (ECG), and 2D-echocardiography (2D-ECHO), who were subjected to cardiac MRI performed on a 3T MRI machine. The MRI scans were evaluated for anatomical and especially functional characteristics of the heart, such as wall motion. On late gadolinium enhancement (LGE), the diseased segments were classified into two categories: < 50% LGE (viable) and > 50% LGE (nonviable). Results: Of the 378 diseased segments detected on LGE, 137 (36.2%) segments showed < 50% LGE and 241 (63.8%) segments showed > 50% LGE. The segments showing < 50% LGE showed normokinesia or hypokinesia, with none of the segments showing akinesia or dyskinesia, whereas the segments showing > 50% LGE showed akinesia or dyskinesia predominantly. This was found to be statistically highly significant (p-value < 0.001). Conclusion: Delayed enhanced-cardiac magnetic resonance (DE-CMR) imaging in patients with ischemic heart disease (IHD) helps evaluate the severity of the infarcted myocardium by classifying the diseased myocardium into viable and non-viable, as viable myocardium is more likely to regain functional recovery than non-viable myocardium. It also predicts the functional recovery of the myocardium after revascularization therapy.

Research paper thumbnail of A case of carotid web: Cause of stroke in healthy and young patients

South African Journal of Radiology, 2022

Research paper thumbnail of Role of Magnetic Resonance Imaging in the Evaluation of Rotator Cuff Tears

Cureus, 2022

Background Magnetic resonance imaging (MRI), with the advent of surface coils, is becoming the mo... more Background Magnetic resonance imaging (MRI), with the advent of surface coils, is becoming the modality of choice for imaging soft tissues around the shoulder joint. Good knowledge regarding the MR characteristics of rotator cuff tendons, acromion, and the abnormalities in these tendons is necessary for appropriate diagnosis. Methods This was a hospital-based descriptive, analytical and prospective study conducted at our tertiary care hospital. The study was performed on 50 patients with rotator cuff lesions detected on MRI of the shoulder joint. Results The age distribution found in the study is between 19 and 66 years with mean being 43 ± 14.8 years. The peak incidence was found in the fifth and sixth decades of life. Gender-wise distribution of rotator cuff pathologies has shown no significant gender variation. The pain was the most common presenting complaint. An abnormal supraspinatus tendon was seen in 82% of the 50 study patients, making it the most commonly affected tendons, followed by subscapularis and infraspinatus tendons. No apparent teres minor pathology was identified in the study patients. The most common pathology affecting the supraspinatus tendon was tendinosis (38%) closely followed by a partial tear (36%). Among the partial tears, the articular surface type of tear was the most common. About 52% patients had type II (curved) acromion; making it the most common type of acromion followed by type III (hook), supraspinatus tendinopathy was more common in type II acromion. A reduction in the acromiohumeral distance can cause supraspinatus tendinosis and also makes it more susceptible to tear. About 45.5% showed supraspinatus tendon tears when the acromiohumeral distance was less than 8mm as compared to 13.6% when more than 10mm. Only 4.2% had normal supraspinatus tendon in patients with this distance less than 7mm. Conclusion MRI provides valuable information to the orthopaedic surgeon regarding the status of tendons, bones, and joints. In order to choose the appropriate course of action, it is crucial first to identify the issue and report relevant data from rotator cuff imaging. A full grasp of the rotator cuff's architecture and function, as well as the repercussions of rotator cuff diseases, is required.

Research paper thumbnail of Arachnoid Cyst in Middle Cranial Fossa With Intraorbital Cyst (Orbital Meningocele)

Cureus, 2021

Intracranial arachnoid cysts are extra-axial non-enhancing cerebrospinal fluid (CSF) density lesi... more Intracranial arachnoid cysts are extra-axial non-enhancing cerebrospinal fluid (CSF) density lesions. These are usually incidental findings on radiological investigations. Usually, the patients with arachnoid cysts are asymptomatic until the cyst grows large while symptomatic patients present with headaches, seizures, and focal neurological deficits. The adjacent calvarial bone may show remodeling and scalloping. Magnetic resonance imaging (MRI) stands superior in soft-tissue contrast and multiplanar imaging in excluding other lesions from the arachnoid cyst. Arachnoid cysts follow CSF signals in all pulse sequences with no gadolinium enhancement. Intraorbital extension of the intracranial arachnoid cyst (intraorbital meningocele) is rarely reported in the literature and occurs through the small bony defect. We report a case of a 20-year-old male presenting with proptosis who was detected to have an arachnoid cyst in the middle cranial fossa with intraorbital extension through a small bony defect in the lateral wall of orbit with the resultant orbital cyst.

Research paper thumbnail of Correlation Between CT Severity Scoring and Diabetes Mellitus in Patients With COVID-19 Infection

Cureus, 2021

Background and objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which caus... more Background and objective Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which causes coronavirus disease 2019 (COVID-19), was first identified in Wuhan, China in December 2019. Since then, It has spread across multiple countries and was declared a pandemic by WHO in March 2020. Patients with underlying diabetes mellitus (DM) are deemed at-risk for developing severe COVID-19 infection. In light of this, we aimed to evaluate the correlation between DM and chest CT severity scores (CTSS) in COVID-19 patients. Methods This was a hospital-based descriptive, analytical retrospective study conducted at our tertiary care hospital. A quantitative severity score was calculated among 220 patients with COVID-19 infection based on the degree of lung lobe involvement on CT chest scans. Based on CTSS, the patients were classified into groups of mild, moderate, and severe lung involvement. The association between DM and CTSS was evaluated using the chi-square test. Results The severity of lung involvement was higher among COVID-19 patients with a co-diagnosis of DM (29.3%) compared to those without DM (11.7%). This association of severe lung involvement with DM was statistically significant (p=0.002). Conclusion Based on our findings, diabetic patients are at an increased risk of developing the severe form of COVID-19 with a higher CT lung involvement score compared to non-diabetic patients.