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Gopi G, Sarkar S, Mohakud S, Patnaik A, Bansal S, Preetam C, Sahu RN, Parida PK. Study on Closure of Skull Base Defect Post-Endoscopic Endonasal Transsphenoid Pituitary Surgery: A Novel Flap Design. J Neurol Surg B Skull Base 2019; 82:313-320. [PMID: 34026407 DOI: 10.1055/s-0039-3400224] [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: 06/10/2019] [Accepted: 09/28/2019] [Indexed: 10/25/2022] Open
Abstract
Objective This study was aimed to compare the closure of skull base defect in endoscopic endonasal transsphenoid surgery of pituitary tumors, using bipedicled nasal septal flap versus fascial closure. The study hypothesis being that bipedicled nasal septal flap is better, compared with fascial closure of skull base defect post-endoscopic endonasal transsphenoid surgery of pituitary tumors. Methods All the eligible patients were randomly divided into two groups and then randomly allocated to the surgeons. In one group, fat and fascia lata was used for closure of the skull base defect and nasal septal flap was not harvested whereas in the other, nasal septal flap was used for closure. Results There was a statistically significant difference in postoperative cerebrospinal fluid leak between the two groups. Patients who had undergone flap repair had lower incidence of postoperative cerebrospinal fluid (CSF) leak. Duration of postoperative hospital stay was also less among the group who underwent flap repair (statistically significant). Conclusion Bipedicled nasal septal flap serves an excellent cover for the skull base defect following endoscopic endonasal transsphenoidal pituitary surgery. It can prevent postoperative CSF leak even in cases where tissue glue is not used.
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Affiliation(s)
- Gokul Gopi
- All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Saurav Sarkar
- Department of ENT and HNS, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Ashis Patnaik
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - C Preetam
- Department of ENT and HNS, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Rabi Narayan Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Pradipta Ku Parida
- Department of ENT and HNS, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mohakud S, Ray B, Naik S, Deep N. Isolated Sacral Vertebral Hydatid Cyst Presenting with Pathological Fracture. J Neurosci Rural Pract 2019; 10:565-566. [PMID: 31595136 PMCID: PMC6779558 DOI: 10.1055/s-0039-1695700] [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: 10/26/2022] Open
Affiliation(s)
- Sudipta Mohakud
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswadeep Ray
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India,Address for correspondence Biswadeep Ray, MD Department of Radiodiagnosis, All India Institute of Medical SciencesBhubaneswar 751019, OdishaIndia
| | - 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
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Abstract
A 23-year-old man presented to the emergency department with a history of recurrent episodes of subacute intestinal obstruction. Palpation revealed a firm, non-tender, mobile, non-pulsatile mass of size 8-10 cm with indistinct margins and smooth surface in the hypogastrium. Contrast-enhanced CT scan of the abdomen showed clumping of the small bowel loops within a well-defined membrane-like structure without dilatation or thickening of bowel loops. The patient underwent a laparotomy with incision of the membrane and separation of all the small bowel loops inside the cocoon. Abdominal cocoon is the idiopathic variety of sclerosing encapsulating peritonitis and is an unusual cause of acute or subacute intestinal obstruction. Clinical diagnosis is difficult because of non-specific symptoms. CT has facilitated accurate preoperative diagnosis, long before the patient presents with full-fledged symptoms of acute intestinal obstruction. CT scan plays a significant role in excluding the secondary causes and helps in patient management.
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Affiliation(s)
- Sudipta Mohakud
- Radiodiagnosis, All India Institute of Medical Sciences Bhubaneswar, Odisha, India
| | - Aparna Juneja
- Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Hira Lal
- Radiodiagnosis, SGPGIMS, Lucknow, Uttar Pradesh, India
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Kumar Sinha M, Mohakud S, Mishra TS, Barman A. An unusual presentation of gastric fistula following peptic perforation repair: A case report. Int J Surg Case Rep 2019; 56:29-31. [PMID: 30818159 PMCID: PMC6393669 DOI: 10.1016/j.ijscr.2019.01.032] [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: 10/05/2018] [Revised: 01/14/2019] [Accepted: 01/23/2019] [Indexed: 12/03/2022] Open
Abstract
Late onset Gastrocutaneous fistulas are rare following the peptic perforation repair. A non-healing burst abdominal wound should be thoroughly investigated. It can be because of an underlying fistula. CT fistulogram is the investigation of choice to confirm the diagnosis. Operative intervention is difficult but the only method of cure in most of the circumstances.
Introduction Peptic perforation repair is a common stomach surgery. This surgery has not been associated with delayed onset gastrocutaneous fistula formation. However such a complication has been reported following a variety of other stomach surgeries. We are reporting this case as it is a rare complication. Also its diagnosis and management is challenging. Case summary We are presenting a case of peptic perforation repair where burst abdomen happened in the immediate post-operative period. The patient was put on conservative management. He responded well to it but his abdominal wound was not healing. After a wait of four months the wound was covered with a skin graft. The graft uptake was satisfactory but a discharging ulcer appeared on it. This condition persisted for one month. Finally a computed tomography Fistulogram (CT Fistulogram) was performed. It revealed an underlying complex gastric fistula. A repeat surgery was performed. Conclusion A gastrocutaneous fistula diagnosed at sixth month following the peptic perforation repair and causing minimal discomfort to the patient is a rare presentation. The abdominal wound following the surgery was possibly not healing because of the underlying fistula.
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Affiliation(s)
| | | | | | - Apurba Barman
- Department of Physical Medicine and Rehabilitation, AIIMS Bhubaneswar, India.
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Mohakud S, Deep N, Naik S. Acute syringomyelia: A complication of tubercular meningitis. J Pediatr Neurosci 2019; 14:57-58. [PMID: 31316647 PMCID: PMC6601118 DOI: 10.4103/jpn.jpn_16_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Naik S, Ray B, Mohakud S, Deep N. Pulmonary sequestration with aberrant arterial supply from right renal artery. Lung India 2018; 35:535-536. [PMID: 30381571 PMCID: PMC6219129 DOI: 10.4103/lungindia.lungindia_253_18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswadeep Ray
- 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
| | - Nerbadyswari Deep
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mohakud S, Priyadarshini L. Tracheomalacia with tracheal bronchus. Natl Med J India 2018; 31:57. [PMID: 30348930 DOI: 10.4103/0970-258x.243426] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Sudipta Mohakud
- Department of Radiology, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Lipsa Priyadarshini
- Department of Paediatrics, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Mishra S, Das D, Dhar S, Begum N, Das S, Patra S, Mohakud S, Mohapatra P, Parida D, Das Majumdar S. P3.01-21 Metastatic Lung Carcinoma —An Institutional Experience from Eastern India. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1581] [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: 11/25/2022]
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Mohapatra P, Bhuniya S, Panigrahi M, Patra S, Mishra P, Purkait S, Dasmajumdar S, Mohakud S, Naik S, Sahoo S, Jagaty S, Mohankudo S, Dhanurdhar Y, Panigrahi S, Rahman M, Muduly D. P3.13-16 Concomitant EML4-ALK Rearrangement and EGFR Mutation in Non-Small Cell Lung Cancer Patients: Data from Eastern Indian Hospital. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1856] [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: 10/28/2022]
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Majumdar S, Dhar S, Mishra S, Patra S, Mohakud S, Mohapatra P, Parida D. P3.CR-02 SBRT of Lung Primary After Complete Resolution of Metastatic Disease in Case of EGFR Mutated Adenocarcinoma Lung: A Case Report. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1981] [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: 11/24/2022]
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Singh S, Patnaik A, Sahu RN, Jena SS, Mohakud S, Purkait S. Rare case of meningeal tuberculoma mimicking meningioma in term pregnancy and its management. Surg Neurol Int 2018; 9:178. [PMID: 30221023 PMCID: PMC6130152 DOI: 10.4103/sni.sni_271_17] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2017] [Accepted: 02/28/2018] [Indexed: 11/05/2022] Open
Affiliation(s)
- Sweta Singh
- Department of Obstetrics & Gynecology, AIIMS, Bhubaneshwar, Odisha, India
| | - Ashis Patnaik
- Department of Neurosurgery, AIIMS, Bhubaneshwar, Odisha, India
| | - Rabi N Sahu
- Department of Neurosurgery, AIIMS, Bhubaneshwar, Odisha, India
| | - Sritam S Jena
- Department of Anesthesiology, AIIMS, Bhubaneshwar, Odisha, India
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Mohakud S, Singh A, Naik S, Deep N. Pulmonary Artery Pseudoaneurysm in a Patient of Rheumatoid Arthritis. Indian J Rheumatol 2018. [DOI: 10.4103/injr.injr_31_18] [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] Open
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Naik S, Singh A, Mohakud S, Deep N. Periureteral inferior vena caval venous ring presenting as urinary obstruction. Indian J Urol 2018; 34:87-88. [PMID: 29343922 PMCID: PMC5769260 DOI: 10.4103/iju.iju_98_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Mohapatra P, Patra S, Bhuniya S, Panigrahi M, Mishra P, Purkait S, Mohakud S, Naik S, Sahoo S, Jagaty S, Mohankudo S, Dhanurdhar Y, Majumdar SD, Kar M. P2.15-002 Pulmonary Large Cell Neuroendocrine Carcinoma (LCNEC): An Experience From Eastern Indian Hospital. J Thorac Oncol 2017. [DOI: 10.1016/j.jtho.2017.09.1394] [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: 11/28/2022]
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65
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Mohakud S, Das S, Sharma P, Das L, Naik S, Deep N. An uncommon cause of portal hypertension in a toddler. Int J Adv Med Health Res 2017. [DOI: 10.4103/ijamr.ijamr_35_17] [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] Open
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Sahoo P, Rathore RK, Awasthi R, Roy B, Verma S, Rathore D, Behari S, Husain M, Husain N, Pandey CM, Mohakud S, Gupta RK. Subcompartmentalization of extracellular extravascular space (EES) into permeability and leaky space with local arterial input function (AIF) results in improved discrimination between high- and low-grade glioma using dynamic contrast-enhanced (DCE) MRI. J Magn Reson Imaging 2013. [DOI: 10.1002/jmri.24404] [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] Open
Affiliation(s)
- Prativa Sahoo
- Department of Mathematics & Statistics; Indian Institute of Technology Kanpur; India
| | - Ram K.S. Rathore
- Department of Mathematics & Statistics; Indian Institute of Technology Kanpur; India
| | - Rishi Awasthi
- Department of Radiodiagnosis; Sanjay Gandhi Post Graduate Institute of Medical Sciences; Lucknow; India
| | - Bhaswati Roy
- Department of Radiodiagnosis; Sanjay Gandhi Post Graduate Institute of Medical Sciences; Lucknow; India
| | - Sanjay Verma
- Department of Mathematics & Statistics; Indian Institute of Technology Kanpur; India
| | - Divya Rathore
- Department of Mathematics & Statistics; Indian Institute of Technology Kanpur; India
| | - Sanjay Behari
- Department of Neurosurgery; Sanjay Gandhi Post Graduate Institute of Medical Sciences; Lucknow; India
| | - Mazhar Husain
- Departments of Neurosurgery; Sahara Hospital; Lucknow; India
| | - Nuzhat Husain
- Department of Pathology; Ram Manohar Lohia Institute of Medical Science; Lucknow; India
| | - Chandra M. Pandey
- Department of Biostatistics; Sanjay Gandhi Post Graduate Institute of Medical Sciences; Lucknow; India
| | - Sudipta Mohakud
- Department of Radiodiagnosis; Sanjay Gandhi Post Graduate Institute of Medical Sciences; Lucknow; India
| | - Rakesh K. Gupta
- Department of Radiodiagnosis; Sanjay Gandhi Post Graduate Institute of Medical Sciences; Lucknow; India
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Roy B, Gupta RK, Maudsley AA, Awasthi R, Sheriff S, Gu M, Husain N, Mohakud S, Behari S, Pandey CM, Rathore RKS, Spielman DM, Alger JR. Utility of multiparametric 3-T MRI for glioma characterization. Neuroradiology 2013; 55:603-13. [PMID: 23377234 PMCID: PMC4209475 DOI: 10.1007/s00234-013-1145-x] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2012] [Accepted: 01/21/2013] [Indexed: 10/27/2022]
Abstract
INTRODUCTION Accurate grading of cerebral glioma using conventional structural imaging techniques remains challenging due to the relatively poor sensitivity and specificity of these methods. The purpose of this study was to evaluate the relative sensitivity and specificity of structural magnetic resonance imaging and MR measurements of perfusion, diffusion, and whole-brain spectroscopic parameters for glioma grading. METHODS Fifty-six patients with radiologically suspected untreated glioma were studied with T1- and T2-weighted MR imaging, dynamic contrast-enhanced MR imaging, diffusion tensor imaging, and volumetric whole-brain MR spectroscopic imaging. Receiver-operating characteristic analysis was performed using the relative cerebral blood volume (rCBV), apparent diffusion coefficient, fractional anisotropy, and multiple spectroscopic parameters to determine optimum thresholds for tumor grading and to obtain the sensitivity, specificity, and positive and negative predictive values for identifying high-grade gliomas. Logistic regression was performed to analyze all the parameters together. RESULTS The rCBV individually classified glioma as low and high grade with a sensitivity and specificity of 100 and 88 %, respectively, based on a threshold value of 3.34. On combining all parameters under consideration, the classification was achieved with 2 % error and sensitivity and specificity of 100 and 96 %, respectively. CONCLUSION Individually, CBV measurement provides the greatest diagnostic performance for predicting glioma grade; however, the most accurate classification can be achieved by combining all of the imaging parameters.
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Affiliation(s)
- Bhaswati Roy
- Department of Radiology & Imaging, Fortis Memorial Research Institute, Gurgaon, Haryana, India 122002
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Sahoo P, Rathore RKS, Awasthi R, Roy B, Verma S, Rathore D, Behari S, Husain M, Husain N, Pandey CM, Mohakud S, Gupta RK. Subcompartmentalization of extracellular extravascular space (EES) into permeability and leaky space with local arterial input function (AIF) results in improved discrimination between high- and low-grade glioma using dynamic contrast-enhanced (DCE) MRI. J Magn Reson Imaging 2013; 38:677-88. [PMID: 23390002 DOI: 10.1002/jmri.24021] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/20/2012] [Accepted: 12/07/2012] [Indexed: 11/09/2022] Open
Abstract
PURPOSE To modify the generalized tracer kinetic model (GTKM) by introducing an additional tissue uptake leakage compartment in extracellular extravascular space (LTKM). In addition, an implicit determination of voxel-wise local arterial input function (AIF) Cp (t) was performed to see whether these changes help in better discrimination between low- and high-grade glioma using dynamic contrast-enhanced (DCE) magnetic resonance imaging (MRI). MATERIALS AND METHODS The modified model (LTKM) was explored and fitted to the concentration-time curve C(t) of each voxel, in which the local AIF Cp (t) could be estimated by a time invariant convolution approximation based on a separately measured global AIF Ca (t). A comparative study of tracer kinetic analysis was performed on 184 glioma patients using DCE-MRI data on 1.5T and 3T MRI systems. RESULTS The LTKM analysis provided more accurate pharmacokinetic parameters as evidenced by their relative constancy with respect to the length of concentration-time curve used. In addition, LTKM with local AIF resulted in improved discrimination between low-grade and high-grade gliomas. CONCLUSION LTKM with local AIF provides more accurate estimation of physiological parameters and improves discrimination between low-grade and high-grade gliomas as compared with GTKM.
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Affiliation(s)
- Prativa Sahoo
- Department of Mathematics & Statistics, Indian Institute of Technology Kanpur, India
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