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Muneeb A, Betancourt-Cuellar S, Palacio DM. Routine Cardiac MRI: Systematic Approach to Interpretation. Radiographics 2024; 44:e230068. [PMID: 38358936 DOI: 10.1148/rg.230068] [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: 02/17/2024]
Affiliation(s)
- Aeman Muneeb
- From the Department of Radiology, Division of Cardiothoracic Imaging, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77550 (A.M., D.M.P.); and Department of Radiology, Division of Cardiothoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Tex (S.B.C.)
| | - Sonia Betancourt-Cuellar
- From the Department of Radiology, Division of Cardiothoracic Imaging, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77550 (A.M., D.M.P.); and Department of Radiology, Division of Cardiothoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Tex (S.B.C.)
| | - Diana M Palacio
- From the Department of Radiology, Division of Cardiothoracic Imaging, University of Texas Medical Branch at Galveston, 301 University Blvd, Galveston, TX 77550 (A.M., D.M.P.); and Department of Radiology, Division of Cardiothoracic Imaging, University of Texas MD Anderson Cancer Center, Houston, Tex (S.B.C.)
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Recca K, Muneeb A, Helstern C, Lemieux B, Das S, Jessop A. Evaluation of Patient Transmission Factor Following the Administration of 177Lu-DOTATATE. Health Phys 2022; 123:00004032-990000000-00038. [PMID: 36099424 DOI: 10.1097/hp.0000000000001611] [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] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
ABSTRACT 177Lu-DOTATATE is a radionuclide therapy that is FDA approved for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors. Treatment facilities are required to determine the maximum radiation dose from such subjects to the maximally exposed member of the public, ensuring that the total effective dose equivalent (TEDE) does not exceed regulatory limits. If the calculated TEDE meets the regulatory limits, the patient is eligible for release and provided instructions with radiation precautions. This study aims to determine a mean transmission factor to the patient to improve accuracy and individualize the estimation of the TEDE.
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Affiliation(s)
| | - Aeman Muneeb
- Vanderbilt University Medical Center; Office of Clinical and Research Safety, A-0201 MCN, 1161 21st Avenue South, Nashville, TN 27232
| | - Christopher Helstern
- Vanderbilt University Medical Center; Office of Clinical and Research Safety, A-0201 MCN, 1161 21st Avenue South, Nashville, TN 27232
| | - Bryan Lemieux
- University of Kentucky HealthCare, Department of Radiology, 800 Rose St., HX 307, Lexington, KY 40536
| | - Satya Das
- Vanderbilt University Medical Center; Office of Clinical and Research Safety, A-0201 MCN, 1161 21st Avenue South, Nashville, TN 27232
| | - Aaron Jessop
- Vanderbilt University Medical Center; Office of Clinical and Research Safety, A-0201 MCN, 1161 21st Avenue South, Nashville, TN 27232
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Muneeb A, Nguyen NN, Iqbal F, Bhargava P. Meckel's diverticulum leading to ileo-ileal intussusception. Radiol Case Rep 2022; 17:1579-1582. [PMID: 35309378 PMCID: PMC8924532 DOI: 10.1016/j.radcr.2022.02.039] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/17/2022] [Accepted: 02/13/2022] [Indexed: 11/25/2022] Open
Abstract
Intussusception secondary to Meckel's diverticulum is a rare entity in adults and hence, can be a challenging to accurately diagnose preoperatively. This case illustrates the clinical, imaging, operative, and histologic manifestations of a Meckel's diverticulum leading to a long segment ileo-ileal intussusception in an adult female patient presenting with symptoms of small bowel obstruction.
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Shakil A, Muneeb A, Khan MS, Sohail AH, Ismail S, Maan MHA, Hakmi H, Sajan A, Bari V. Detection of cervical spine trauma: Are 3-dimensional reconstructed images as accurate as multiplanar computer tomography? J Med Imaging Radiat Sci 2021; 52:385-389. [PMID: 34001456 DOI: 10.1016/j.jmir.2021.04.004] [Citation(s) in RCA: 1] [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: 02/06/2021] [Revised: 04/19/2021] [Accepted: 04/20/2021] [Indexed: 11/28/2022]
Abstract
INTRODUCTION This study was conducted to assess the diagnostic accuracy of three-dimensional computed tomography (3D-CT) in detection of cervical spine injuries in symptomatic post-trauma patients using multiplanar computed tomography (MP-CT) as reference standard. APPROACH This cross-sectional study was conducted at Aga Khan University from July 2016 to January 2017. Patients were included using a non-probability, consecutive sampling. MP-CT and 3D- CT images were obtained and evaluated by a senior radiologist to identify cervical spine injuries. RESULTS 205 patients were included in the study. For fractures, 3D-CT images had sensitivity of 71%, specificity of 100%, positive predictive value (PPV) of 100%, negative predictive value (NPV) of 96.8% and diagnostic accuracy of 97%. For dislocations, 3D-CT reported sensitivity of 83.34%, specificity of 100%, positive predictive value of 100% and negative predictive value of 99.5% and diagnostic accuracy of 99.5%. CONCLUSION 3D-CT has good diagnostic accuracy for injuries of the cervical spine but must be reviewed simultaneously with multiplanar CT images.
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Affiliation(s)
- Asad Shakil
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
| | - Aeman Muneeb
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan; Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville TN; Aga Khan University Medical College, Karachi, Pakistan.
| | | | - Amir Humza Sohail
- Department of Surgery, New York University Langone Health, New York NY
| | - Sameeha Ismail
- Department of Radiology, Shifa International Hospitals Ltd, Islamabad, Pakistan
| | | | - Hazim Hakmi
- Department of Surgery, New York University Langone Health, New York NY
| | - Abin Sajan
- Department of Surgery, New York University Langone Health, New York NY
| | - Vaqar Bari
- Department of Radiology, Aga Khan University Hospital, Karachi, Pakistan
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Muneeb A, Cole HA, Sandler MP, Scherer PM. Multifocal mycotic aneurysms detected by 18F-FDG PET/CT in fever of unknown origin. IDCases 2021; 24:e01099. [PMID: 33912388 PMCID: PMC8065279 DOI: 10.1016/j.idcr.2021.e01099] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2021] [Revised: 03/28/2021] [Accepted: 03/28/2021] [Indexed: 11/28/2022] Open
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Farooq A, Sahara K, Muneeb A, Farooq K, Tsilimigras DI, Merath K, Mehta R, Paredes A, Wu L, Hyer JM, Beal E, Pawlik TM, Dillhoff ME. Analysis of Authorship in Hepatopancreaticobiliary Surgery: Women Remain Underrepresented. J Gastrointest Surg 2020; 24:2070-2076. [PMID: 31396842 DOI: 10.1007/s11605-019-04340-8] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2019] [Accepted: 07/21/2019] [Indexed: 01/31/2023]
Abstract
INTRODUCTION Given the need to increase female representation in hepatopancreatobiliary (HPB) surgery, as well as the need to increase the academic pipeline of women in this subspecialty, we sought to characterize the prevalence of female authorship in the HPB literature. In particular, the objective of the current study was to determine the proportion of women who published HPB research articles as first, second, or last author over the last decade. METHODS All articles pertaining to hepatopancreaticobiliary (HPB) surgery appearing in seven surgical journals (Annals of Surgery, British Journal of Surgery, JAMA Surgery, Annals of Surgical Oncology, HPB (Oxford), Surgery, and Journal of Gastrointestinal Surgery) were reviewed for the years 2008 and 2018. Information on sex of author, country of author's institution, and article type was collected and entered into a computerized database. RESULTS Among the 1473 index articles included in the final analytic cohort, 414 (28%) publications had a woman as the first or last author, while the vast majority (n = 1,059, 72%) had a man as the first or last author. The number of female first authors increased from 15.6% (n = 92/591) in 2008 to 25.7% (n = 227/882) in 2018 (p < 0.001). There were no differences in the proportion of second (n = 123/536, 23.0% vs n = 214/869, 24.6%, p = 0.47) or last (n = 44/564, 7.8% vs n = 88/875, 10.1%, p = 0.15) authors. Women were more likely to publish papers appearing in medium-impact journals (OR 1.40, 95% CI 1.04-1.88) and articles with a female author were more likely to be from a North American institution (referent: North America, Asia OR 0.43, 95% CI 0.31-0.59 vs Europe OR 0.67, 95% CI 0.51-0.87). CONCLUSION Women first/last authors in HPB research articles have increased over the past 10 years from 22 to 32%. Women as last authors remain low, however, as only 1 in 10 papers had a senior woman author. These data should prompt HPB leaders to find solutions to the gap in female authorship including mentorship of young female researchers and surgeons.
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Affiliation(s)
- Ayesha Farooq
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Kota Sahara
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | | | - Khadija Farooq
- Liaquat National Hospital and Medical College, Karachi, Pakistan
| | - Diamantis I Tsilimigras
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Katiuscha Merath
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Rittal Mehta
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Anghela Paredes
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Lu Wu
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - J Madison Hyer
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Eliza Beal
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Timothy M Pawlik
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA
| | - Mary E Dillhoff
- Department of Surgery, The Ohio State University Wexner Medical Center, N924 Doan Hall, 410 W 10th Ave., Columbus, OH, 43210, USA.
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Farooq SA, Muneeb A, Farooq K, Sahara K, Tsilimigras D, Merath K, Mehta R, Paredes A, Pawlik TM, Dillhoff ME. Female Authorship in Hepatopancreatobiliary Surgery. J Am Coll Surg 2019. [DOI: 10.1016/j.jamcollsurg.2019.08.385] [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: 11/16/2022]
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Waheed H, Khan MS, Muneeb A, Jahanzeb S, Ahmad MN. Radiologic Assessment of Cervical Canal Stenosis Using Kang MRI Grading System: Do Clinical Symptoms Correlate with Imaging Findings? Cureus 2019; 11:e5073. [PMID: 31511807 PMCID: PMC6726420 DOI: 10.7759/cureus.5073] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/23/2022] Open
Abstract
Introduction Magnetic resonance imaging (MRI) is widely used in the evaluation of cervical canal stenosis and spinal cord compression. Kang et al. formulated a new MRI grading system for assessing canal stenosis which takes cord signal change into account. The purpose of the study was to determine the agreement between Kang's grading system and neurological symptoms. Methods A cross-sectional study was conducted at Aga Khan University Hospital between April 2014 and December 2015. Patients meeting inclusion criteria were enrolled. T2 sagittal and T2 axial MRI images were acquired and reported by a consultant neuroradiologist, in accordance with the MRI grading system suggested by Kang et al. Neurologic clinical symptoms were acquired by the history taken by the principal investigator. More than one neurologic symptoms and Kang MRI grade 2 or 3 were taken as positive evidence of cord compression resulting from canal stenosis. Results Amongst 126 subjects, 54% were females. Mean age of patients was 50.3 ± 14.3 years (range 19-83 years). Average disease duration was 4.61 ± 3.73 (range 1-24 months). In the majority of the patients, the findings were found at the C5-C6 level. 65.1% of patients were identified positive for cervical canal stenosis by Kang grading system. Most common neurological symptoms were pain (99%) and numbness (56%). Cohen’s Kappa was run to evaluate the agreement between neurological symptoms and Kang grading system. There was a strong agreement between the two methods, K = 0.81 (95% CI 0.70-0.92), p < 0.001. Conclusion There was a substantial agreement between Kang's grading system and the presence of clinical symptoms. The agreement was greatest in females, older patients, and those with longer duration of symptoms.
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Affiliation(s)
- Hira Waheed
- Radiology, Aga Khan University Hospital, Karachi, PAK
| | | | - Aeman Muneeb
- Internal Medicine, Lincoln Medical Center, New York, USA
| | - Syed Jahanzeb
- Orthopedics, Civil Hospital Karachi, Dow University of Health Sciences, Karachi, PAK
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Muneeb A, Khan MS, Iqbal H, Shafqat G. Chest Wall Schwannoma: Case Report and a Review of Imaging Findings. Cureus 2018; 10:e3694. [PMID: 30838166 PMCID: PMC6390888 DOI: 10.7759/cureus.3694] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
A chest wall schwannoma arises from peripheral nerve sheath Schwann cells of the intercostal nerves. We describe the presentation and imaging findings of a patient who presented with a chest wall swelling. The imaging findings were highly suspicious for a chest wall schwannoma and the histopathology confirmed the diagnosis following surgical excision. Imaging findings are reviewed in detail.
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Affiliation(s)
| | | | - Hina Iqbal
- Radiology, Aga Khan University, Karachi, PAK
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Iqbal H, Khan MS, Muneeb A, Mirza WA. Diagnostic Accuracy of Ultrasound in Detecting Retained Products of Conception: A Study from a Tertiary Care Hospital in Karachi, Pakistan. Cureus 2018; 10:e3564. [PMID: 30648096 PMCID: PMC6325029 DOI: 10.7759/cureus.3564] [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: 11/22/2022] Open
Abstract
Introduction Retained products of conception (RPOC) are a known complication after abortion or childbirth. To improve clinical evaluation and avoid unnecessary surgery, transvaginal scan is performed in suspected cases. However, both RPOC and blood clots appear isoechoic on ultrasound, and false positives can lead to unnecessary intervention. In this study, the ultrasound findings have been correlated with the histopathology (as a gold standard) to determine the diagnostic value of sonography in the detection of RPOC in postpartum or post-abortion patients. Methods This cross-sectional study was carried out to determine the diagnostic accuracy of ultrasound in the detection of the retained products of conception in relation with the histopathological findings at the Department of Radiology, Aga Khan University Hospital (AKUH), Karachi. A total of 193 patients with suspicion of RPOC undergoing a transvaginal scan in the Department of Radiology, AKUH, were enrolled. The study was conducted for a period of 12 months from October 2014 to October 2015. Results Our results yielded that out of 193 cases, 113 cases (87.05%) had histopathology positive for RPOC, while 107 (55.44%) RPOC cases were identified by ultrasound as having RPOC. The mean endometrial thickness of the patients included in the study was 13.5 mm. According to our results, ultrasound has a sensitivity of 75.22%, specificity of 72.50%, a positive predictive value (PPV) of 79.44%, a negative predictive value (NPV) of 67.44%, and a diagnostic accuracy of 74.09%. Conclusion Transvaginal ultrasound is a modality that can be used for early diagnosis of the retained products of conception including fetal parts and could prove to be lifesaving. However, the operator and equipment variables need to be looked at, and a uniform criterion needs to be agreed on.
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Affiliation(s)
- Hina Iqbal
- Radiology, Aga Khan University, Karachi, PAK
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Abstract
Amyloidosis is the deposition of an extracellular fibrillar protein in the tissues leading to organ dysfunction. Laryngeal amyloidosis is a rare phenomenon. We report a case of isolated laryngeal amyloidosis which was initially suspicious for laryngeal cancer on magnetic resonance imaging (MRI) but histopathology showed the presence of amyloid. Systemic workup was negative. The patient is being managed conservatively.
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Affiliation(s)
| | - Supriya Gupta
- Radiology, Rush University Medical Center, Chicago , USA
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Abstract
The art of medicine has roots that lie deep in developing the biopsychosocial connection. Understanding a human body (both its physiology and pathology) along with components of emotional and spiritual cores can lead to provision of excellent medical care and better outcomes. The harmonization of psychosocial consequences of a biological disease is helpful not just for health care professionals but also for patients. Where it keeps the empathy and compassion alive and results in greater patient satisfaction, it also helps boost the physician's morale.Our objective is to reflect on the impact of narrative medicine on physician-patient dynamics for health care professionals in a clinical setting. This article was written after synthesizing the findings of evidence-based literature, retrieved from different sources, along with our own reflections on our encounters with patients.One could infer from the evidence-based research that the practice of narrative medicine improves one's concern and understanding toward the patient. This requires more time from the clinician, but medical care without compassion and humaneness causes high rates of dissatisfaction among both patients and health care practitioners, along with the risk of recurrent ailments. Our own patient encounters provide a testimony to this inference. The biopsychosocial model carries the same holistic approach toward patients. The mainstay of treatment in any domain of medicine should contain thoughtfulness for the sufferer rather than sole consideration of the suffering.
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Affiliation(s)
- Aeman Muneeb
- Medical Student at Aga Khan University in Karachi, Pakistan.
| | - Hena Jawaid
- Senior Instructor in the Department of Psychiatry at Aga Khan University in Karachi, Pakistan.
| | - Natasha Khalid
- Research Associate in the Department of Obstetrics and Gynecology at Aga Khan University in Karachi, Pakistan.
| | - Asad Mian
- Associate Professor in the Department of Emergency Medicine at Aga Khan University in Karachi, Pakistan.
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