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Prologo J, Mittal A, Knight J, Hsu D, Dolan R, Corn D. Abstract No. 579 Percutaneous CT-guided cryoablation for the management of pudendal neuralgia: long-term outcomes. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.624] [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: 10/17/2022] Open
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Affiliation(s)
| | - Jonathan S. Leventhal
- Correspondence to: Jonathan S. Leventhal, MD, 15 York Street, LMP 5040, New Haven, CT 06510.
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Singal S, Mittal A, Zaman M, Singal R. A critical role of ultrasonography in management of liver abscesses. Bangladesh J Med Sci 2018. [DOI: 10.3329/bjms.v17i2.35881] [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] [Indexed: 11/05/2022] Open
Abstract
Aims and objectives: to see the efficacy of ultrasonography in the management of amoebic liver abscess. We assessed whether patient required surgery or can be managed with drainage procedure on ultrasonography basis.Materials and Methods: This is a prospective study done from July 2014 to May 2015, in a medical college in remote area. A total of 88 patients diagnosed with liver abscess were included in the study for ultrasound-guided percutaneous aspiration or pigtail drainage management. All patients had been treated with antibiotics or antimicrobials for at least 2 weeks if treated conservatively and were still being continued for another 6 weeks.Results: A total of 88 patients with liver abscess were successfully treated, consisting 79 males and 9 female. The age ranged from 18 to 82 years with a mean of 43.6 years. A total number of 76 (86.36%) cases undergone percutaneous catheter drainage and 12 (13.6%) underwent needle aspiration. A total of 73 (82.95%) patients had single large abscess, while 8 (9%) had two and 7 (7.9%) had multiple abscesses. The abscesses were commonly located on the right lobe of liver. The Pigtail catheters of sizes 10 F to 18 F was introduced either directly under the guidance of the guide wire with safety precautions. The volume of pus aspirated averaged from 70 - 1200 ml, while the period of catheter drainage ranged from 7 to 24 days with the follow up on ultrasonography.Conclusion: This study shows a success rate of ultrasonography almost 98 % by avoiding unnecessary surgical intervention. It was confirmed that needle aspiration in small abscesses and catheter drainage in large abscesses offers the safest and best modality.Bangladesh Journal of Medical Science Vol.17(2) 2018 p.258-262
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Jindal G, Singal S, Nagi B, Mittal A, Mittal S, Singal R. Role of Multidetector Computed Tomography (MDCT) in Evaluation of Gallbladder Malignancy and its Pathological Correlation in an Indian Rural Center. Maedica (Bucur) 2018; 13:55-60. [PMID: 29868141 PMCID: PMC5972789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
OBJECTIVES Clinically or sonographically suspected gallbladder carcinoma was evaluated on multidetector computed tomography. Based on the spectrum of multidetector computed tomography findings, staging of gallbladder carcinoma was done. Multidetector computed tomography diagnosis was compared with pathological diagnosis. MATERIAL AND METHODS This is a prospective study carried out in 100 patients at a rural Indian center between May 2012 and June 2015. Multidetector computed tomography was performed in all the cases and the findings were observed. Based on the radiological spectrum, staging of gallbladder carcinoma was done. The diagnosis was confirmed by ultrasound guided fine needle aspiration cytology/histopathological examination of surgical specimens. RESULTS The most common multidetector computed tomography findings noted by us were mass replacing gallbladder, followed by diffuse/focal gallbladder wall thickening and polypoidal mass. Other findings noted were cholelithiasis, liver infiltration, intra hepatic biliary dilatation, liver metastases, portal vein invasion, antroduodenal and hepatic flexure involvement. Ultrasonography guided fine needle aspiration cytology done in all cases was positive in 92 cases and inconclusive in eight cases. Surgery was performed in only 22 patients, and histopathological findings were correlated with multidetector computed tomography findings. CONCLUSION Multidetector computed tomography is also reliable in detection of extension of tumor and lymph nodes. multidetector computed tomography plays a major role in evaluating and staging of carcinoma gallbladder. It also guides the surgeons for operatibility and resectability of tumour.
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Affiliation(s)
- Gunjan Jindal
- Department of Radio Diagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Samita Singal
- Department of Radio Diagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Birinder Nagi
- Dept of Radio Diagnosis and Imaging, Post Graduate Institute (PGI, Chandigarh), M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Amit Mittal
- Department of Radio Diagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Shallini Mittal
- Department of Radio Diagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Rikki Singal
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
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Gupta A, Kediege S, Mittal A, Jain K, Gupta S, Chaudhry S. Amnion and Chorion Membranes in the Treatment of Gingival Recession and their Effect on Gingival Biotype: A Clinical and Ultrasonographic Study. J Clin Diagn Res 2018. [DOI: 10.7860/jcdr/2018/27765.11307] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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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106
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Bishnoi I, Singh D, Bishnoi S, Mewada T, Sachdeva D, Mittal A, Odugora S. Ring graft technique for microvascular decompression. Neurol India 2018; 66:1687-1691. [DOI: 10.4103/0028-3886.246282] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [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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107
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Abstract
Annular pancreas is a developmental anomaly that can be associated with other conditions such as Down syndrome, duodenal atresia, and Hirschsprung disease. A band of pancreatic tissue, in continuity with the pancreatic head, completely or incompletely encircles the descending duodenum, sometimes assuming a "crocodile jaw" configuration. We present the case of an adult who presented with epigastric pain and vomiting and was found to have annular pancreas.
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Affiliation(s)
- Shallini Mittal
- Departments of Radiodiagnosis and Imaging (Mittal, Jindal, Mittal, S. Singal) and Surgery (R. Singal), M. M. Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Gunjan Jindal
- Departments of Radiodiagnosis and Imaging (Mittal, Jindal, Mittal, S. Singal) and Surgery (R. Singal), M. M. Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Amit Mittal
- Departments of Radiodiagnosis and Imaging (Mittal, Jindal, Mittal, S. Singal) and Surgery (R. Singal), M. M. Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Rikki Singal
- Departments of Radiodiagnosis and Imaging (Mittal, Jindal, Mittal, S. Singal) and Surgery (R. Singal), M. M. Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Samita Singal
- Departments of Radiodiagnosis and Imaging (Mittal, Jindal, Mittal, S. Singal) and Surgery (R. Singal), M. M. Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
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108
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Gupta R, Mittal P, Mittal A, Sekhon PS, Sachdeva V, Mirchia S. MDCT Depiction of Spontaneous Rupture of Hepatic Hydatid Cyst with Peritoneal Hydatidosis. J Assoc Physicians India 2017; 65:93-94. [PMID: 29327528] [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] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Affiliation(s)
| | | | | | - Preetparkash Singh Sekhon
- Resident, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana
| | - Vanie Sachdeva
- Resident, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana
| | - Sana Mirchia
- Resident, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana
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109
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Gupta R, Mittal P, Sekhon PS, Mittal A, Kaur H, Aamir M. Acute post traumatic portal venous thrombosis associated with shattered spleen: A case report. Indian J Radiol Imaging 2017; 27:310-313. [PMID: 29089680 PMCID: PMC5644325 DOI: 10.4103/ijri.ijri_262_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Post-traumatic portal venous thrombosis is a rare event, and is usually seen in association with penetrating injuries. Portal venous thrombosis following blunt abdominal trauma is extremely rare with only few reports in the literature, some associated with underlying coagulation disorders. We report multidetector computed tomography findings in a case of blunt abdominal trauma with otherwise normal coagulation profile, which showed shattered spleen and MDCT evidence of acute thrombosis in the right branch of the portal vein. To the best of our knowledge, this is the first documented report of acute portal venous thrombosis in association with shattered spleen.
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Affiliation(s)
- Ranjana Gupta
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Puneet Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Preetparkash S Sekhon
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Harkirat Kaur
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Mohammad Aamir
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
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Kerry G, Gokani S, Ash J, Rasasingam D, Zargaran A, Mittal A, Mobasheri M, King D, Darzi A, Purkayastha S. The use of Digital Education for Patients on the Bariatric Surgery Pathway. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.048] [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: 10/18/2022]
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111
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Sharma SK, Chaubey J, Singh BK, Sharma R, Mittal A, Sharma A. Drug resistance patterns among extra-pulmonary tuberculosis cases in a tertiary care centre in North India. Int J Tuberc Lung Dis 2017; 21:1112-1117. [DOI: 10.5588/ijtld.16.0939] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [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)
- S. K. Sharma
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi, Department of Molecular Medicine, Jamia Hamdard Institute of Molecular Medicine, Hamdard University, New Delhi, Departments of General Medicine and Pulmonary
Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha
| | - J. Chaubey
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi
| | - B. K. Singh
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi
| | - R. Sharma
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi
| | - A. Mittal
- Department of Internal Medicine, All India Institute of Medical Sciences, New Delhi
| | - A. Sharma
- Department of Dermatology, Venerology and Leprology, Teerthankar Mahavir University, Moradabad, India
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Mittal A, Colegio OR. Skin Cancers in Organ Transplant Recipients. Am J Transplant 2017; 17:2509-2530. [PMID: 28556451 DOI: 10.1111/ajt.14382] [Citation(s) in RCA: 107] [Impact Index Per Article: 15.3] [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: 12/28/2016] [Revised: 05/05/2017] [Accepted: 05/19/2017] [Indexed: 02/06/2023]
Abstract
Long-term utilization of immunosuppression in organ transplant recipients (OTRs) leads to decreased immune-mediated tumor surveillance and development of malignant tumors. A delicate balance needs to be maintained in the intensity of immunosuppression to keep the risk of malignancy low without jeopardizing life-saving graft function. OTRs are prone to developing skin cancers that exhibit unique epidemiologic, pathophysiologic, and prognostic characteristics. In this review, we discuss the most commonly reported skin cancers in OTRs: squamous cell carcinoma (SCC), basal cell carcinoma (BCC), Kaposi sarcoma, Merkel cell carcinoma, and malignant melanoma (MM). Tumors in this high-risk population are aggressive and may respond poorly to standard therapies; however, new targeted therapies are promising. Checkpoint inhibitor antibodies have been used for treatment of cutaneous SCC, Merkel cell carcinoma, and MM; epidermal growth factor receptor inhibitors have been used for cutaneous SCC; hedgehog pathway inhibitors have been used for BCC; and BRAF and MEK inhibitors are being used increasingly in the management of MM. Guidelines for dermatologic screening are variable and primarily based on expert opinion. Prospective evidence-based trials by multidisciplinary groups are needed to better define surveillance schedules for pre- and posttransplant cutaneous malignancies.
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Affiliation(s)
- A Mittal
- Departments of Dermatology, Yale University School of Medicine, New Haven, CT
| | - O R Colegio
- Departments of Dermatology, Yale University School of Medicine, New Haven, CT.,Departments of Pathology, Yale University School of Medicine, New Haven, CT.,Departments of Surgery, Yale University School of Medicine, New Haven, CT.,Yale Cancer Center, Yale University School of Medicine, New Haven, CT.,Yale-New Haven Transplantation Center, Yale University School of Medicine, New Haven, CT
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113
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Mittal A, Vidyarthi A, Colegio O. LB983 Characterizing tumor-associated macrophages in the cutaneous squamous cell carcinoma tumor microenvironment. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.062] [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: 10/18/2022]
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114
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Bhatia D, Mittal A, Malik DK. Rapid biosynthesis of PVP coated silver nanoparticles by Kocuria rosea and their antimicrobial activity. Microbiology (Reading) 2017. [DOI: 10.1134/s0026261717050046] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
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115
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Singal R, Bhatia G, Mittal A, Singal S, Zaman M. To compare the efficacy of tamsulosin and alfuzosin as medical expulsive therapy for ureteric stones. Avicenna J Med 2017; 7:115-120. [PMID: 28791244 PMCID: PMC5525465 DOI: 10.4103/ajm.ajm_87_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/05/2022] Open
Abstract
Aims and Objectives: This study aims to evaluate the efficacy of tamsulosin and alfuzosin for the distal ureteral stone. This study assessed the spontaneous passage and expulsion of the stone. Materials and Methods: The study was conducted in the Department of Surgery at Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, from May 2013 to May 2014. A total number of 136 patients diagnosed as distal ureteric stone (US) of size <10 mm were included in this study. It was divided into two groups (I and II) out of which 36 cases were excluded. Group I received tablet tamsulosin 0.4 mg/day, and Group II received alfuzosin 10 mg/day. The efficacy of tamsulosin and alfuzosin as an adjunctive medical therapy was determined. Results: Both the drugs can be safely used for the distal USs. The stone expulsion rate was seen in 36 patients (72.0%) in Group I, and in 34 patients (68.0%) in Group II (P = 0.545). The passage of stones noticed by 32 patients in each Groups I and II (P = 1.000). The mean number of pain attacks was 2.91 ± 1.01 for Group I, and 1.8 ± 0.83 for Group II (P < 0.001 and P < 0.001). Thus, we propagate the use of alfuzosin significantly lower number of pain attacks. The drug-related side-effects were postural hypertension (four in Group I and one in Group II) and retrograde ejaculation (eight in Group I, and one in Group II). Thus, the difference was statistically significant in terms of retrograde ejaculation but insignificant for postural hypotension. Conclusion: There is no difference between both medications in term of efficacy (passing stones) for the management of distal ureteral stones. Both medications are safe and effective. In addition, alfuzosin was better tolerated than tamsulosin as it has fewer side effects.
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Affiliation(s)
- Rikki Singal
- Department of Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Gaurav Bhatia
- Department of Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis and Imaging, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Samita Singal
- Department of Radiodiagnosis and Imaging, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Muzzafar Zaman
- Department of Surgery, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
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Pankaj A, Mittal A, Chawla A. The validity and reproducibility of cross table radiographs compared with CT scans for the measurement of anteversion of the acetabular component after total hip arthroplasty. Bone Joint J 2017; 99-B:1006-1011. [DOI: 10.1302/0301-620x.99b8.bjj-2016-1158.r2] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/04/2016] [Accepted: 03/24/2017] [Indexed: 11/05/2022]
Abstract
Aims The aim of this study was to assess the reproducibility and validity of cross table radiographs for measuring the anteversion of the acetabular component after total hip arthroplasty (THA) and to compare it with measurements using CT scans. Patients and Methods A total of 29 patients who underwent THA between June 2010 and January 2016 were included. There were 17 men and 12 women. Their mean age was 43 years (26 to 65). Seven patients underwent a bilateral procedure. Thus, 36 THAs were included in the study. Lateral radiographs and CT scans were obtained post-operatively and radiographs repeated three weeks later. The anteversion of the acetabular component was measured using the method described by Woo and Morrey and the ischiolateral method described by Pulos et al and these were compared with the results obtained from CT scans. Results The mean anteversion was 18.35° (3° to 38°) using Woo and Morrey’s method, 51.45° (30° to 85°) using the ischiolateral method and 21.22° (2° to 48°) using CT scans. The Pearson correlation coefficient was 0.754 for Woo and Morrey’s method and 0.925 for the ischiolateral method. There was a linear correlation between the measurements using the ischiolateral method and those using CT scans. We derived a simple linear equation between the value of the CT scan and that of ischiolateral method to deduce the CT scan value from that of ischiolateral method and vice versa. Conclusion The anteversion of the acetabular component measured using both plain radiographic methods was consistently valid with good interobserver reproducibility, but the ischiolateral method which is independent of pelvic tilt was more accurate. As CT is costly, associated with a high dose of radiation and not readily available, the ischiolateral method can be used for assessing the anteversion of the acetabular component. Cite this article: Bone Joint J 2017;99-B:1006–11.
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Affiliation(s)
- A. Pankaj
- Fortis Hospital, A
Block, Shalimar Bagh, Opposite
Kela Godam, New Delhi, Delhi 110088, India
| | - A. Mittal
- Guru Teg Bahadur Hospital, House
No. S4, Block 2, Type
2, Kalyan Vas, Delhi, 110091, India
| | - A. Chawla
- Fortis Hospital, A
Block, Shalimar Bagh, Opposite
Kela Godam, New Delhi, Delhi 110088, India
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Mittal A, Subtil A, Leventhal JS. Ulcerative Plaques and Nodules on the Lower Extremity: A Quiz. Acta Derm Venereol 2017; 97:866-867. [PMID: 28350040 DOI: 10.2340/00015555-2659] [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: 11/16/2022] Open
Affiliation(s)
- Amit Mittal
- Department of Dermatology, Yale University School of Medicine, 15 York Street, LMP 5040, New Haven, CT 06510, USA
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118
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Gupta D, Garg P, Mittal A. Computed Tomography in Craniofacial Fibrous Dysplasia: A Case Series with Review of Literature and Classification Update. Open Dent J 2017; 11:384-403. [PMID: 28839487 PMCID: PMC5543691 DOI: 10.2174/1874210601711010384] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [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: 09/30/2016] [Revised: 12/07/2016] [Accepted: 12/14/2016] [Indexed: 02/06/2023] Open
Abstract
Introduction: Fibrous dysplasia (FD) is a fibroosseous lesion of the osseous structures of the body. It is not a commonly reported lesion yet it is considered as an important lesion which can affect the maxillofacial region as well. As a result, it can cause deformity of the jaw bones which can further lead to severe facial asymmetry. Craniofacial fibrous dysplasia (CFD) is one of the subtypes of FD that can affect the bones of the craniofacial complex, including the mandible and maxilla. It can also present as facial asymmetry and can be investigated with the help of Maxillofacial Radiology and Imaging. The radiographic findings may vary according to the extent and degree of the disease. Although conventional radiographs provide a good clue regarding the lesion, advanced maxillofacial imaging is capable of providing detailed extent of the disease. Furthermore the classification of CFD is not very clear in the literature. Case Report: This particular paper attempts to document and report the CT appearance of CFD with an attempt to propose a better classification system for the same. Four different patients are reported which presented with FD with involvement of bones of craniofacial region. Working diagnosis of CFD was made with the help of clinical features as well as with radiographic assessment. Advanced imaging included CT scan of the lesions. The article highlights the importance of computed tomography in diagnosis as well as assessment of extent of the disease. Conclusion: It can be concluded that the Dental professionals must be aware regarding the different radiographic appearances of CFD. Advanced imaging modality like CT can provide with exact diagnosis as well as extent of the lesions like FD. Further collaboration of researchers is required to incorporate this proposed change in classification of CFD.
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Affiliation(s)
- Deepak Gupta
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Preeti Garg
- Department of Oral Medicine and Radiology, M.M. College of Dental Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
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Itchins M, Arena J, Nahm CB, Rabindran J, Kim S, Gibbs E, Bergamin S, Chua TC, Gill AJ, Maher R, Diakos C, Wong M, Mittal A, Hruby G, Kneebone A, Pavlakis N, Samra J, Clarke S. Retrospective cohort analysis of neoadjuvant treatment and survival in resectable and borderline resectable pancreatic ductal adenocarcinoma in a high volume referral centre. Eur J Surg Oncol 2017; 43:1711-1717. [PMID: 28688722 DOI: 10.1016/j.ejso.2017.06.012] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [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: 04/04/2017] [Revised: 05/28/2017] [Accepted: 06/09/2017] [Indexed: 02/07/2023] Open
Abstract
BACKGROUND Pancreatic ductal adenocarcinoma (PDAC) is a deadly disease. Neoadjuvant therapy (NA) with chemotherapy (NAC) and radiotherapy (RT) prior to surgery provides promise. In the absence of prospective data, well annotated clinical data from high-volume units may provide pilot data for randomised trials. METHODS Medical records from a tertiary hospital in Sydney, Australia, were analysed to identify all patients with resectable or borderline resectable PDAC. Data regarding treatment, toxicity and survival were collected. RESULTS Between January 1 2010 and April 1 2016, 220 sequential patients were treated: 87 with NA and 133 with upfront operation (UO). Forty-three NA patients (52%) and 5 UO patients (4%) were borderline resectable at diagnosis. Twenty-four borderline patients received NA RT, 22 sequential to NAC. The median overall survival (OS) in the NA group was 25.9 months (mo); 95% CI (21.1-43.0 mo) compared to 26.9 mo (19.7, 32.7) in the UO; HR 0.89; log-ranked p-value = 0.58. Sixty-nine NA patients (79%) were resected, mOS was 29.2 mo (22.27, not reached (NR)). Twenty-two NA (31%) versus 22 UO (17%) were node negative at operation (N0). In those managed with NAC/RT the mOS was 29.0 mo (17.3, NR). There were no post-operative deaths with NA within 90-days and three in the UO arm. DISCUSSION This is a hypothesis generating retrospective review of a selected real-world population in a high-throughput unit. Treatment with NA was well tolerated. The long observed survival in this group may be explained by lymph node sterilisation by NA, and the achievement of R0 resection in a greater proportion of patients.
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Affiliation(s)
- M Itchins
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia.
| | - J Arena
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - C B Nahm
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - J Rabindran
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - S Kim
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia
| | - E Gibbs
- National Health and Medical Research Council Clinical Trial Centre (NHMRC CTC), The University of Sydney, Australia
| | - S Bergamin
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia
| | - T C Chua
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia
| | - A J Gill
- Sydney Medical School (Northern), The University of Sydney, Australia; Cancer Diagnosis and Pathology, Kolling Institute, Royal North Shore Hospital, Sydney, Australia
| | - R Maher
- Department of Radiology, Royal North Shore Hospital, Australia
| | - C Diakos
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia; Northern Cancer Institute, Sydney, NSW, Australia
| | - M Wong
- Department of Medical Oncology, Gosford Hospital, New South Wales, Australia
| | - A Mittal
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - G Hruby
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - A Kneebone
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - N Pavlakis
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia; Northern Cancer Institute, Sydney, NSW, Australia
| | - J Samra
- Upper GI Surgical Unit, Department of Gastrointestinal Surgery, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia
| | - S Clarke
- Department of Oncology, Royal North Shore Hospital, Sydney, NSW, Australia; Sydney Medical School (Northern), The University of Sydney, Australia; Northern Cancer Institute, Sydney, NSW, Australia
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Affiliation(s)
- Puneet Mittal
- Residential complex, Maharishi Markandeshwar University, Haryana, India. E-mail:
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Kumar R, Kumar Airon R, Mittal A, Singal R, Sharma K, Singal S. Evaluation of Multidetector Computed Tomography in Haematuria. Maedica (Bucur) 2017; 12:87-94. [PMID: 29090027 PMCID: PMC5649039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
AIMS AND OBJECTIVES (1) To study the role of multidetector computed tomography in patients with haematuria. (2) To correlate multidetector computed tomography findings with clinical outcome/laboratory findings/FNAC and/or operative findings (wherever performed). MATERIAL AND METHODS The present study was carried out in the Department of Radiodiagnosis, M.M. Institute of Medical Sciences and Research, Mullana, Ambala, from April 2014 to 2016. Fifty patients with complaint of haematuria, referred from various wards and outpatient departments of this institution, were included. Multidetector computed tomography was performed in ultrasonography positive cases, in symptomatic patients with negative ultrasonography scans and in those with suboptimal ultrasonography scans. The equipment used in our study was a HD 11 XE (Philips medical systems) ultrasound unit with convex and linear probes and a 128 slice Multidetector CT (Philips Ingenuity). RESULTS Maximum number of patients (30%) in the 51-60 years age group with a male preponderance. The prevalence of malignancy in patients with haematuria in this study was 28% which included bladder urothelial carcinoma (18%), renal cell carcinoma (6%), UTUC (4%), prostatic carcinoma (2%) and one case of TCC which turned out to be non-Hodgkin's lymphoma on histopathology. Calculi were more prevalent in the younger age group and overall constituted 20% of the causes of haematuria. Other causes of haematuria detected on multidetector computed tomography were pyelonephritis, renal trauma (grade V renal injury), bladder diverticulum, benign prostatic hyperplasia and cystitis. CONCLUSIONS Multidetector computed tomography by using its multiplanar and 3D capabilities is highly accurate and specific in detecting the causes of haematuria. It can demonstrate the exact site of involvement in very high percent of cases. In addition to haematuria, multidetector computed tomography can detect various associated and incidental findings which may not be suspected clinically.
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Affiliation(s)
- Ranjan Kumar
- Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt -Ambala), Haryana, India
| | - Raj Kumar Airon
- Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt -Ambala), Haryana, India
| | - Amit Mittal
- Maternal and Childhood Obesity Research Center, Urmia University of Medical Sciences, Urmia, Iran
| | - Rikki Singal
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana (Distt -Ambala), Haryana, India
| | - Kamal Sharma
- Department of Urology, M.M. Institute of Medical Sciences and Research, Mullana (Distt -Ambala), Haryana, India
| | - Samita Singal
- Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research, Mullana (Distt -Ambala), Haryana, India
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Mittal A, Bomar JD, Jeffords ME, Huang MT, Wenger DR, Upasani VV. Response to Comment on Mittal et al: Defining the lateral edge of the femoroacetabular articulation: correlation analysis between radiographs and computed tomography. J Child Orthop 2017; 11:242. [PMID: 28828072 PMCID: PMC5548044 DOI: 10.1302/1863-2548.11.170035] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Affiliation(s)
- A. Mittal
- Department of Orthopedics, University of California, San Diego, CA, USA
| | - J. D. Bomar
- Department of Orthopedics, Rady Children’s Hospital, San Diego, CA, USA
| | - M. E. Jeffords
- Department of Orthopedics, Rady Children’s Hospital, San Diego, CA, USA
| | - M-T. Huang
- National Cheng Kung University Hospital, Tainan City, Taiwan
| | - D. R. Wenger
- Department of Orthopedics, University of California, and Department of Orthopedics, Rady Children’s Hospital, San Diego, CA, USA
| | - V. V. Upasani
- Department of Orthopedics, University of California, and Department of Orthopedics, Rady Children’s Hospital, San Diego, CA, USA,Correspondence should be sent to Dr V. V. Upasani, Department of Orthopedics, Rady Children’s Hospital, San Diego, CA, USA. E-mail:
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Agrawal A, Mittal A, Kohali GB, Sampley S, Singh S. Extensive traumatic thalamic contusions in a child. Asian J Neurosurg 2017; 12:151-152. [PMID: 28413564 PMCID: PMC5379796 DOI: 10.4103/1793-5482.145107] [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: 11/05/2022] Open
Affiliation(s)
- Amit Agrawal
- Department of Neurosurgery, MM Institute of Medical Sciences and Research, Mullana (Ambala), Harayana, India
| | - Amit Mittal
- Department of Radiology, MM Institute of Medical Sciences and Research, Mullana (Ambala), Harayana, India
| | - G B Kohali
- Department of Anesthesiology, MM Institute of Medical Sciences and Research, Mullana (Ambala), Harayana, India
| | - Sunil Sampley
- Department of Surgery, MM Institute of Medical Sciences and Research, Mullana (Ambala), Harayana, India
| | - Satendra Singh
- Department of Surgery, MM Institute of Medical Sciences and Research, Mullana (Ambala), Harayana, India
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Singh D, Bodeliwala S, Singh H, Jagetia A, Mittal A. Postmyelotomy Closure of Spinal Cord—“Zip Lock Technique”: An Initial Experience. World Neurosurg 2017; 100:261-266. [DOI: 10.1016/j.wneu.2017.01.002] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2016] [Revised: 12/31/2016] [Accepted: 01/02/2017] [Indexed: 11/17/2022]
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Mittal A, Mittal BB. Raynaud's of the tongue following chemoradiation for squamous cell carcinoma of the oropharynx. Mol Clin Oncol 2017; 6:187-188. [PMID: 28357090 DOI: 10.3892/mco.2016.1103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 08/12/2016] [Accepted: 11/09/2016] [Indexed: 11/06/2022] Open
Abstract
Raynaud's of the tongue following radiation alone or chemoradiotherapy (CRT) is a rare occurrence. The present study reports a case where typical symptoms and signs of Raynaud's phenomenon involving the tongue occurred ~18 months following CRT treatment in a 53-year-old female, who was a smoker prior to CRT with stage T2N2cM0 local-regional advanced stage IV oropharyngeal cancer. The patient was treated using cisplatin chemotherapy and intensity-modulated radiation with a dose of 70 Gray (Gy). The intermittent episodes of painful discoloration of the tongue were exacerbated due to the cold and emotional stress. No definite clinical or laboratory evidence of connective tissue disorder was identified. To the best of our knowledge, this is the first reported case of Raynaud's of the tongue following CRT without primary Raynaud's of the digits. The possible pathogenesis involving vascular and neural mechanism is discussed in the case report.
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Affiliation(s)
- Amit Mittal
- Department of Dermatology, Yale University School of Medicine, New Haven, CT 06510, USA
| | - Bharat B Mittal
- Department of Radiation Oncology, Northwestern University, Feinberg School of Medicine, Chicago, IL 60611, USA
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Mittal P, Gupta R, Mittal A, Taneja A, Sekhon PS, Gupta S. Magnetic Resonance Imaging (MRI) Depiction of Robert's Uterus: A Rare Müllerian Duct Anomaly Presenting with Cyclical Pain in Young Menstruating Woman. Pol J Radiol 2017; 82:134-136. [PMID: 28348653 PMCID: PMC5352017 DOI: 10.12659/pjr.900436] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [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: 07/05/2016] [Accepted: 07/21/2016] [Indexed: 11/10/2022] Open
Abstract
Background Robert’s uterus is a very rare müllerian duct anomaly which is characterised by septate uterus with obstruction of a one-sided cavity and formation of hematometra. Therefore, patients present with cyclical abdominal pain during menstruation along with normal menstrual flow. Case Report We present magnetic resonance imaging (MRI) findings in a case of Robert’s uterus in a young woman. Conclusions Robert’s uterus is a very rare anomaly which can be very well characterized by magnetic resonance imaging (MRI). MRI can also show any associated hematometra and endometriomas complicating this condition and aid in the institution of appropriate management in such cases.
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Affiliation(s)
- Puneet Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Ranjana Gupta
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Arpit Taneja
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Preetparkash Singh Sekhon
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
| | - Sharad Gupta
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research, Mullana, Ambala, Haryana, India
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Singal R, Mittal A, Garg M, Zaman M, Chaudhry M, Singal S, Sharma BP. Unusual location of primary hydatid cyst diagnosed on aspiration cytology. J Cosmet Dermatol 2017; 16:e42-e44. [PMID: 28191725 DOI: 10.1111/jocd.12316] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/03/2017] [Indexed: 11/28/2022]
Abstract
Hydatid cyst (HC) is a parasitic infection caused by Echinococcus granulosus. It occurs frequently in liver and lungs. Hydatid cyst of neck is extremely rare occurrence, and here, we report it with this unusual location. A 25-year-old male nonhypertensive and nondiabetic presented with slowly growing painless swelling in right side of neck for 4-5 years. The swelling measured 5 × 3 cm and was of soft to firm consistency. Fine needle aspiration cytology yielded fluid aspirate and smear showed features suggestive of HC. The intact cyst was removed surgically, and histopathological examination confirmed the diagnosis of hydatid cyst.
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Affiliation(s)
- Rikki Singal
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
| | - Amit Mittal
- Department of Radiology, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
| | - Monika Garg
- Department of Pathology, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
| | - Muzzafar Zaman
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
| | - Manish Chaudhry
- Department of Pathology, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
| | - Samita Singal
- Department of Radiology, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
| | - Bhanu Pratap Sharma
- Department of Surgery, M.M. Institute of Medical Sciences and Research, Mullana, (Distt-Ambala), Haryana, India
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Affiliation(s)
- S.B. Verma
- Department of Dermatology Nirvana Skin Clinic Vadodara Gujarat India
| | - A. Mittal
- Department of Dermatology RNT Medical College Udaipur Rajasthan India
| | - U. Wollina
- Department of Dermatology and Allergology Academic Teaching Hospital Dresden Germany
| | - G.H. Eckstein
- Institute of Human Genetics Helmholtz Zentrum München Germany
| | - K. Gohel
- Department of Nephrology Muljibhai Patel Urology Hospital Nadiad Gujarat India
| | - K. Giehl
- Institute of Human Genetics Helmholtz Zentrum München Germany
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Mittal S, Singal S, Mittal A, Singal R, Jindal G. Identification of foramen of Huschke with reversible herniation of temporomandibular joint soft tissue into the external auditory canal on multidetector computed tomography. Proc (Bayl Univ Med Cent) 2017; 30:92-93. [PMID: 28127148 DOI: 10.1080/08998280.2017.11929544] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
The foramen of Huschke, or foramen tympanicum, is a developmental defect in the bony part of the external auditory canal (EAC) due to a defect in ossification of normal bone in the first 5 years of life. Seen in the anteroinferior part of the EAC, it can be asymptomatic or present with salivary discharge into the EAC during mastication or as soft tissue swelling in the EAC in the absence of any inflammation, tumor, or trauma. We present a case of a man who presented with herniation of soft tissues of the temporomandibular joint into the EAC through a persistent foramen tympanicum.
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Affiliation(s)
- Shallini Mittal
- Department of Radiodiagnosis and Imaging, M. M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Samita Singal
- Department of Radiodiagnosis and Imaging, M. M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis and Imaging, M. M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Rikki Singal
- Department of Radiodiagnosis and Imaging, M. M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
| | - Gunjan Jindal
- Department of Radiodiagnosis and Imaging, M. M. Institute of Medical Sciences and Research, Mullana (Distt-Ambala), Haryana, India
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Abstract
Background Portal annular pancreas is a rare pancreatic developmental anomaly which is often overlooked at imaging, and often diagnosed retrospectively when it is detected incidentally at the time of surgery. Although the anomaly itself is asymptomatic, it becomes important in cases where pancreatic resection/anastomosis is planned, because of varying ductal anatomy, risk of ductal injury and increased risk of postoperative pancreatic fistula formation. Case Report We present imaging findings in a case of portal annular pancreas in a 45-year-old male patient. Conclusions Portal annular pancreas is a rare and often neglected pancreatic anomaly due to a lack of awareness of this entity. With the advent of MDCT and MRI, accurate preoperative diagnosis of this condition is possible.
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Affiliation(s)
- Puneet Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, Haryana, India
| | - Ranjana Gupta
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences & Research, Mullana, Ambala, Haryana, India
| | - Arshad Ahmed
- Department of Radiodiagnosis, Maharishi Markandeshwar Medial College & Hospital, Kumarhatti, Solan, Himachal Pradesh, India
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Gupta R, Mittal P, Mittal A, Gupta S, Mittal K, Taneja A. Spectrum of MDCT Findings in Bowel Obstruction in a Tertiary Care Rural Hospital in Northern India. J Clin Diagn Res 2017; 10:TC01-TC04. [PMID: 28050471 DOI: 10.7860/jcdr/2016/21186.8781] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 05/06/2016] [Accepted: 08/04/2016] [Indexed: 01/07/2023]
Abstract
INTRODUCTION Multidetector Computed Tomography (MDCT) provides clinically and surgically important information in bowel obstruction. It can depict the severity, level and cause of obstruction. AIM To depict the spectrum of MDCT findings in cases of small and large bowel obstruction. MATERIALS AND METHODS Contrast enhanced MDCT examination of 50 patients were retrospectively included in the study who had evidence of clinical as well as MDCT evidence of bowel obstruction and in whom surgical/clinical follow-up for final diagnosis was available. CT scan was done in all the patients with Ingenuity CT (128 slice MDCT, Philips Medical Systems). The axial sections were reconstructed in coronal and sagital planes to determine site and cause of bowel obstruction. RESULTS There were 34 males and 16 females patients in this study with mean age of 28.4 years. The level of obstruction was in small bowel in 39 patients (76.67%) and large bowel in 11 patients (23.33%). Adhesive bands were the cause of Small Bowel Obstruction (SBO) in 17 patients (43.5% of SBO patients). The most common CT signs in adhesive band SBO were beak sign (seen in 70.6% patients) and fat notch sign (52.9% patients). Five cases of SBO were secondary to benign stricture. Matted adhesions were the cause of obstruction in 3 patients. All these patients showed transition zone in pelvis with positive small bowel faeces sign. Two patients with SBO due to adhesive band had evidence of closed loop obstruction with evidence of gangrenous gut on surgery. Large Bowel Obstruction (LBO) was seen in 11 patients. Most common cause of LBO was primary colonic malignancy, accounting for 7 patients (63.6%). In one patient, the cause was direct invasion of hepatic flexure by carcinoma of gall bladder. Other causes of LBO were pelvic adhesions, faecal impaction and ischaemic stricture. CONCLUSION SBO is more common than LBO with adhesive bands being the most common cause of SBO. MDCT is very useful for depicting site and cause of obstruction and any associated complications.
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Affiliation(s)
- Ranjana Gupta
- Associate Professor, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Puneet Mittal
- Associate Professor, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Professor and Head, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Sharad Gupta
- Resident, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Kapish Mittal
- Resident, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Arpit Taneja
- Resident, Department of Radiodiagnosis, Maharishi Markandeshwar Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
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Affiliation(s)
- A. Mittal
- UIET, Panjab University, Chandigarh 160014, India
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Mittal P, Garg P, Gupta R, Mittal A. Multidetector computed tomography depiction of foramen of huschke with reversible herniation of temporomandibular joint soft tissue into external auditory canal. J Mahatma Gandhi Inst Med Sci 2017. [DOI: 10.4103/jmgims.jmgims_60_15] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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Singal R, Mehta SK, Bala J, Zaman M, Mittal A, Gupta G, Rudra S, Singal S. A Study of Evaluation and Management of Rare Congenital Breast Diseases. J Clin Diagn Res 2016; 10:PC18-PC24. [PMID: 27891392 DOI: 10.7860/jcdr/2016/21077.8648] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [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: 05/02/2016] [Accepted: 09/16/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Polymastia and polythelia may be asymptomatic or cause pain, restriction of arm movement, milk discharge, cosmetic problems or anxiety. Cosmesis is the main indication for surgical excision of accessory breasts in axilla. In addition it also confirms the diagnosis and allays the patient's fear of harbouring a malignancy. AIM To evaluate the presentation of symptoms, investigations required for diagnosis and the management to improve the treatment protocols in patients with breast diseases. MATERIALS AND METHODS This retrospective study on breast diseases presenting as supernumerary breasts and nipples was conducted in the Department of Surgery between January 2013 and January 2016 at MMIMS Research and hospital, Mullana, Ambala. Patients were evaluated for breast diseases, either benign or malignant in both genders. A total of 32 cases diagnosed as accessory breasts disease were retrieved from the hospital archive. The clinical and radiological evaluation was done in the form of ultrasound and mammography wherever necessary. Accessory breast tissues were excised under general anesthesia and histopathological examinations were done. RESULTS Out of 32 cases: 1(3.125%) male patient had unilateral and 1(3.125%) male had bilateral accessory nipple, 7 (21.87%) females had unilateral and 1(3.125%) had bilateral accessory nipple, 1 (3.125%) diagnosed as accessory axillary fibroadenoma in female, 16(50%) presented as unilateral and 5 (15.62%) had bilateral swelling in the axilla as accessory breast. Patients underwent surgical excision and in 8(25%) cases z- shaped incision was made in view of better cosmesis. Patients were followed up upto 6 months postoperatively. There were no residual swelling and movements of the arm over the shoulder joint were normal. In 3(9.37%) cases, wound dehiscence occurred; in 2 (6.25%) cases lymphoedema formation was seen. These were successfully managed conservatively. CONCLUSION As breast swellings either fibroadenoma or carcinoma are common entities to come across everywhere but accessory breasts are rarely encountered especially in rural areas because of less awareness. The study found that there was tendency to neglect the swelling as there were minimal symptoms present. We also came across a rare entity, accessory breast and accessory nipples. A clinician should not ignore such cases taking as simple swelling because of chances of discovering a malignancy can occur.
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Affiliation(s)
- Rikki Singal
- Professor, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Sudhir Kumar Mehta
- Associate Professor, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Jyoti Bala
- Professor, Department of Patholgy, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Muzzafar Zaman
- Assistant Professor, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Amit Mittal
- Professor and Head, Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Guarav Gupta
- Head of the Department, Department of Surgery, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Samer Rudra
- Head of the Department, Department of Gynaecology and Obstrectics, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
| | - Samita Singal
- Assistant Professor, Department of Radiodiagnosis and Imaging, M.M. Institute of Medical Sciences and Research , Mullana, Ambala, Haryana, India
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Shah A, Loomba P, Singh H, Mittal A, Srivastava S, Singh D. Peroral Extrusion of Ventriculoperitoneal Shunt: An Unusual Complication and Review of Literature. IJNS 2016. [DOI: 10.1055/s-0036-1584586] [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: 10/20/2022] Open
Affiliation(s)
- Ankit Shah
- Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Poonam Loomba
- Department of Microbiology, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Hukum Singh
- Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Amit Mittal
- Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Siddharth Srivastava
- Department of Gastroenterology, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
| | - Daljit Singh
- Department of Neurosurgery, G. B. Pant Institute of Post Graduate Medical Education and Research (GIPMER), New Delhi, India
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Singal R, Zaman M, Mittal A, Singal S, Sandhu K, Mittal A. No Need of Fascia Closure to Reduce Trocar Site Hernia Rate in Laparoscopic Surgery: A Prospective Study of 200 Non-Obese Patients. Gastroenterology Res 2016; 9:70-73. [PMID: 27785329 PMCID: PMC5040548 DOI: 10.14740/gr715w] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 08/26/2016] [Indexed: 01/12/2023] Open
Abstract
Background Laparoscopy is widely practiced and offers realistic benefits over conventional surgery. Port closure is important after a laparoscopic procedure to prevent port site incisional hernia. Larger port size and increasing numbers of ports needed to perform more complex laparoscopic procedures are likely to increase the incidence of port site hernias (PSHs). PSHs tend to develop more frequently at umbilical and midline port sites due to the thinness of the umbilical skin and weaknesses in the linea alba. More than 90% of PSHs occur through 10 mm and large ports can occur through 5 mm ports also. The aim was to study the outcomes and complications in laparoscopic surgery without fascial sheath closure of port site. We compared the results with another group in which fascial closure was done by a standard method. Methods This was a prospective study carried out in the Department of Surgery, MMIMSR, Mullana, Ambala, from August 2013 to 2015 in a single unit by a single surgeon. A total of 200 patients were selected randomly for the different laparoscopic procedures. Patients were divided into group A (only skin closure was done without fascia closure) and group B (fascial closure of the port in addition to skin closure). In both groups, we used blunt trocar for the 10 mm port. Skin of the 5 mm port was closed simply. The results in two groups were compared in terms of complications like PSH, bleeding, and wound infection. Results The outcomes in two groups were compared with and without fascia closure of 10 mm trocar port site. Patients operated for lap cholecystectomy were 170 (85%), 10 (5%) for lap appendicectomy, and 20 (10%) for lap hernia. The study compared the results in two groups mainly for PSH formation. The P value was insignificant and Fischer’s exact test result came as 1.00. There were no significant differences between the two groups in terms of PSH, bleeding and infection in non-obese cases. Conclusion In both groups, blunt trocar was introduced into the abdomen. We concluded that this is safe, without visceral injury, and no bleeding was seen in both the groups. We had not encountered any case with PSH formation in follow-up of 6 - 8 months. There was no infection over the port site.
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Affiliation(s)
- Rikki Singal
- Department of Surgery, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Muzzafar Zaman
- Department of Surgery, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Amit Mittal
- Department of Radiodiagnosis and Imaging, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Samita Singal
- Department of Radiodiagnosis and Imaging, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Karamjot Sandhu
- Department of Surgery, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
| | - Anshu Mittal
- Department of SPM, Maharishi Markandeshwer Institute of Medical Sciences and Research, Mullana, Distt-Ambala, Haryana, India
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Aggarwal HK, Jain D, Mittal A, Dabas G. Isolated oculocutaneous sarcoidosis in a teenage male: a rare case report. Reumatismo 2016; 68:100-3. [PMID: 27608799 DOI: 10.4081/reumatismo.2016.867] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2016] [Revised: 05/21/2016] [Accepted: 07/12/2016] [Indexed: 11/22/2022] Open
Abstract
Sarcoidosis is an inflammatory disease with multisystem involvement characterized by the presence of noncaseating granulomas. It can affect virtually every organ of the body, with lung involvement being most common occurring in >90% of patients. Other organs affected are skin, eye and liver. Skin involvement is common, affecting 25-35%. Here we present a rare case of a 15 year-old male with isolated oculocutaneous sarcoidosis without systemic involvement.
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Affiliation(s)
- H K Aggarwal
- Department of Medicine, Sharma University of Health Sciences, Rohtak.
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Abstract
PURPOSE Whilst situs inversus is associated with intestinal malrotation and volvulus particularly in infants, this is the first known report of acute intestinal obstruction in an adult patient with a situs anomaly specifically due to a congenital transmesenteric hernia. CASE A 54-year-old woman presented with a 12-h history of progressive abdominal pain. Contrast-enhanced computed tomography scan of the abdomen revealed an incidental finding of situs inversus abdominus, ischemic small bowel obstruction and a potential occlusive thrombus of the superior mesenteric artery. At operation, the cause of intestinal obstruction was found to be secondary to herniation of the intestine through a congenital mesenteric defect. The hernia was reduced and a strong pulse was subsequently felt in the distal superior mesenteric artery. The patient required resection of a segment of compromised small bowel, and was later anastomosed at a planned second laparotomy. Her laparostomy was closed using an absorbable BioA mesh. CONCLUSION A high index of suspicion and low threshold for exploratory surgery should be maintained in patients with major congenital abdominal anomalies presenting with an acute abdomen.
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Affiliation(s)
- K M Brown
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW, 2065, Australia.
| | - J S Gundara
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW, 2065, Australia
| | - A Mittal
- Upper Gastrointestinal Surgical Unit, Royal North Shore Hospital, University of Sydney, St Leonards, Sydney, NSW, 2065, Australia
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Mittal A, Malhotra D, Jain P, Kalia A, Shunmugaperumal T. Studies on Aspirin Crystals Generated by a Modified Vapor Diffusion Method. AAPS PharmSciTech 2016; 17:988-94. [PMID: 26729528 DOI: 10.1208/s12249-015-0432-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2015] [Accepted: 10/08/2015] [Indexed: 11/30/2022] Open
Abstract
The objectives of the current investigation were (1) to study the influence of selected two different non-solvents (diethylether and dichloromethane) on the drug crystal formation of a model drug, aspirin (ASP-I) by the modified vapor diffusion method and (2) to characterize and compare the generated crystals (ASP-II and ASP-III) using different analytical techniques with that of unprocessed ASP-I. When compared to the classical vapor diffusion method which consumes about 15 days to generate drug crystals, the modified method needs only 12 h to get the same. Fourier transform-infrared spectroscopy (FT-IR) reveals that the internal structures of ASP-II and ASP-III crystals were identical when compared with ASP-I. Although the drug crystals showed a close similarity in X-ray diffraction patterns, the difference in the relative intensities of some of the diffraction peaks (especially at 2θ values of around 7.7 and 15.5) could be attributed to the crystal habit or crystal size modification. Similarly, the differential scanning calorimetry (DSC) study speculates that only the crystal habit modifications might occur but without involving any change in internal structure of the generated drug polymorphic form I. This is further substantiated from the scanning electron microscopy (SEM) pictures that indicated the formation of platy shape for the ASP-II crystals and needle shape for the ASP-III crystals. In addition, the observed slow dissolution of ASP crystals should indicate polymorph form I formation. Thus, the modified vapor diffusion method could routinely be used to screen and legally secure all possible forms of other drug entities too.
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Aggarwal HK, Jain D, Mittal A, Rao A, Yadav RK, Jain P. Systemic lupus erythematosus presenting as fulminant lupus pneumonitis: a rare case report. Reumatismo 2016; 68:48-52. [PMID: 27339374 DOI: 10.4081/reumatismo.2016.846] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2015] [Revised: 04/04/2016] [Accepted: 04/29/2016] [Indexed: 11/23/2022] Open
Abstract
We report a case of 19 year-old female patient diagnosed as systemic lupus erythematosus (SLE) presented with fever and diffuse cutaneous lesions. During the hospital stay she had acute pneumonia, pleural effusion and respiratory failure, which required intensive care unit (ICU) care and mechanical ventilator support. A fulminant course of the disease, decreased values of complement levels and positive antinuclear antibodies (ANA) in pleural fluid and repeated negative sputum for acid-fast bacillus, blood cultures enabled diagnosis of fulminant lupus pneumonitis. Fulminant lupus pneumonitis is a rare but potentially life threatening complication of SLE. Management requires involvement of multiple specialties and rigorous efforts in reviving the patient.
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Affiliation(s)
- H K Aggarwal
- Department of Medicine, Pt. B.D. Sharma University of Health Sciences, Rohtak.
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Gupta R, Mittal A, Mittal P, Kaur H, Sachdeva V, Mirchia K. Miniature brain in spine: the ‘mini brain sign’ in vertebral plasmacytoma. Postgrad Med J 2016; 92:745-746. [DOI: 10.1136/postgradmedj-2016-134197] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2016] [Revised: 05/16/2016] [Accepted: 05/24/2016] [Indexed: 11/03/2022]
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Mittal A, Tandon S, Singla SK, Tandon C. In vitro studies reveal antiurolithic effect of Terminalia arjuna using quantitative morphological information from computerized microscopy. Int Braz J Urol 2016; 41:935-44. [PMID: 26689519 PMCID: PMC4756970 DOI: 10.1590/s1677-5538.ibju.2014.0547] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [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: 10/29/2014] [Accepted: 02/16/2016] [Indexed: 01/25/2023] Open
Abstract
PURPOSE For most cases, urolithiasis is a condition where excessive oxalate is present in the urine. Many reports have documented free radical generation followed by hyperoxaluria as a consequence of which calcium oxalate (CaOx) deposition occurs in the kidney tissue. The present study is aimed to exam the antilithiatic potency of the aqueous extract (AE) of Terminalia arjuna (T. arjuna). MATERIALS AND METHODS The antilithiatic activity of Terminalia arjuna was investigated in vitro nucleation, aggregation and growth of the CaOx crystals as well as the morphology of CaOx crystals using the inbuilt software 'Image-Pro Plus 7.0' of Olympus upright microscope (BX53). Antioxidant activity of AE of Terminalia arjuna bark was also determined in vitro. RESULTS Terminalia arjuna extract exhibited a concentration dependent inhibition of nucleation and aggregation of CaOx crystals. The AE of Terminalia arjuna bark also inhibited the growth of CaOx crystals. At the same time, the AE also modified the morphology of CaOx crystals from hexagonal to spherical shape with increasing concentrations of AE and reduced the dimensions such as area, perimeter, length and width of CaOx crystals in a dose dependent manner. Also, the Terminalia arjuna AE scavenged the DPPH (2, 2-diphenyl-1-picrylhydrazyl) radicals with an IC50 at 13.1µg/mL. CONCLUSIONS The study suggests that Terminalia arjuna bark has the potential to scavenge DPPH radicals and inhibit CaOx crystallization in vitro. In the light of these studies, Terminalia arjuna can be regarded as a promising candidate from natural plant sources of antilithiatic and antioxidant activity with high value.
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Affiliation(s)
- A Mittal
- Department of Biotechnology and Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan 173234, Himachal Pradesh, India
| | - S Tandon
- Amity Institute of Molecular Medicine and Stem Cell Research (AIMMSCR), Amity University Uttar Pradesh, Noida
| | - S K Singla
- Department of Biochemistry, Panjab University, Chandigarh - 160014, India
| | - C Tandon
- Amity Institute of Biotechnology, Amity University Uttar Pradesh, Sector - 125, Noida, U.P., 201313 India
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Mittal A, Tandon S, Singla SK, Tandon C. Erratum to: In vitro inhibition of calcium oxalate crystallization and crystal adherence to renal tubular epithelial cells by Terminalia arjuna. Urolithiasis 2016; 44:287. [PMID: 27142167 DOI: 10.1007/s00240-016-0884-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Mittal
- Department of Biotechnology and Bioinformatics, Jaypee University of Information Technology, Waknaghat, Solan, Himachal Pradesh, 173234, India
| | - S Tandon
- Amity University Uttar Pradesh, Sector ‑ 125, Noida, 201313, India
| | - S K Singla
- Department of Biochemistry, Panjab University, Chandigarh, 160014, India
| | - C Tandon
- Amity University Uttar Pradesh, Sector ‑ 125, Noida, 201313, India.
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Chen R, Desai NR, Ross JS, Zhang W, Chau KH, Wayda B, Murugiah K, Lu DY, Mittal A, Krumholz HM. Publication and reporting of clinical trial results: cross sectional analysis across academic medical centers. BMJ 2016; 352:i637. [PMID: 26888209 PMCID: PMC4768882 DOI: 10.1136/bmj.i637] [Citation(s) in RCA: 131] [Impact Index Per Article: 16.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
OBJECTIVE To determine rates of publication and reporting of results within two years for all completed clinical trials registered in ClinicalTrials.gov across leading academic medical centers in the United States. DESIGN Cross sectional analysis. SETTING Academic medical centers in the United States. PARTICIPANTS Academic medical centers with 40 or more completed interventional trials registered on ClinicalTrials.gov. METHODS Using the Aggregate Analysis of ClinicalTrials.gov database and manual review, we identified all interventional clinical trials registered on ClinicalTrials.gov with a primary completion date between October 2007 and September 2010 and with a lead investigator affiliated with an academic medical center. MAIN OUTCOME MEASURES The proportion of trials that disseminated results, defined as publication or reporting of results on ClinicalTrials.gov, overall and within 24 months of study completion. RESULTS We identified 4347 interventional clinical trials across 51 academic medical centers. Among the trials, 1005 (23%) enrolled more than 100 patients, 1216 (28%) were double blind, and 2169 (50%) were phase II through IV. Overall, academic medical centers disseminated results for 2892 (66%) trials, with 1560 (35.9%) achieving this within 24 months of study completion. The proportion of clinical trials with results disseminated within 24 months of study completion ranged from 16.2% (6/37) to 55.3% (57/103) across academic medical centers. The proportion of clinical trials published within 24 months of study completion ranged from 10.8% (4/37) to 40.3% (31/77) across academic medical centers, whereas results reporting on ClinicalTrials.gov ranged from 1.6% (2/122) to 40.7% (72/177). CONCLUSIONS Despite the ethical mandate and expressed values and mission of academic institutions, there is poor performance and noticeable variation in the dissemination of clinical trial results across leading academic medical centers.
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Affiliation(s)
- Ruijun Chen
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Nihar R Desai
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT 06510, USA
| | - Joseph S Ross
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT 06510, USA Section of General Internal Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
| | - Weiwei Zhang
- Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT 06510, USA
| | - Katherine H Chau
- Department of Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Brian Wayda
- Division of General Medicine, Department of Internal Medicine, Columbia University Medical Center, New York, NY, USA
| | - Karthik Murugiah
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Daniel Y Lu
- Department of Medicine, University of Pennsylvania Health System, Philadelphia, PA, USA
| | - Amit Mittal
- Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA
| | - Harlan M Krumholz
- Section of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA Center for Outcomes Research and Evaluation, Yale-New Haven Hospital, New Haven, CT 06510, USA Robert Wood Johnson Foundation Clinical Scholars Program, Department of Internal Medicine, Yale School of Medicine, New Haven, CT, USA Department of Health Policy and Management, Yale School of Public Health, New Haven, CT, USA
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Chua T, de Reuver P, Staerkle R, Neale M, Arena J, Mittal A, Shanbhag S, Gill A, Samra J. Transverse closure of mesenterico-portal vein after vein resection in pancreatoduodenectomy. Eur J Surg Oncol 2016; 42:211-8. [DOI: 10.1016/j.ejso.2015.08.167] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/09/2015] [Revised: 07/23/2015] [Accepted: 08/17/2015] [Indexed: 10/23/2022] Open
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Bodeliwala S, Agrawal A, Mittal A, Singh D, Vageesh BG, Singh H. Transanal protrusion of ventriculoperitoneal shunt via appendicular perforation: A rare case report. J Pediatr Neurosci 2016; 11:274-276. [PMID: 27857807 PMCID: PMC5108141 DOI: 10.4103/1817-1745.193383] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [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] [Indexed: 11/04/2022] Open
Abstract
Perforation of abdominal viscera and protrusion of the distal end of ventriculoperitoneal shunt (VPS) through natural orifice is well known but rare complication. We report a case of a transanal protrusion of distal end of VPS through appendix perforation without any symptomatology of prior appendicitis. To the best of our knowledge, no case of such kind has been reported in literature yet. The management plan of these patients should be looked in a different way because they may have underlying inflammation of the appendix and distal end of shunt removal should be done by proper surgical exploration followed by added appendicectomy.
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Affiliation(s)
- Shaam Bodeliwala
- Department of Neurosurgery, G. B. Pant Institute of Postgraduate Education and Research, New Delhi, India
| | - Atul Agrawal
- Department of Neurosurgery, G. B. Pant Institute of Postgraduate Education and Research, New Delhi, India
| | - Amit Mittal
- Department of Neurosurgery, G. B. Pant Institute of Postgraduate Education and Research, New Delhi, India
| | - Daljit Singh
- Department of Neurosurgery, G. B. Pant Institute of Postgraduate Education and Research, New Delhi, India
| | - B G Vageesh
- Department of Gastrointestinal Surgery, G. B. Pant Institute of Postgraduate Education and Research, New Delhi, India
| | - Hukum Singh
- Department of Neurosurgery, G. B. Pant Institute of Postgraduate Education and Research, New Delhi, India
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Mittal P, Gupta R, Garg P, Mittal A, Kaur H, Gupta S. CT and MRI findings in a case of infantile form of GM2 gangliosidosis: Tay-Sachs disease. Neurol India 2016; 64:1372-1373. [DOI: 10.4103/0028-3886.193818] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [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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Mittal P, Mittal K, Gupta S, Mittal A, Gupta R, Rao D. Uterus didelphys with obstructed hemivagina and ipsilateral renal anomaly syndrome: A rare cause of cyclic abdominal pain in a young female. Int J Adv Med Health Res 2016. [DOI: 10.4103/2350-0298.184679] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [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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