1
|
Sherwani P, Kandasamy D, Sharma R, Goel P, Jana M, Krishnan N. Benign paediatric liver tumours: The radiological maze demystified. SA J Radiol 2024; 28:2726. [PMID: 38444652 PMCID: PMC10913176 DOI: 10.4102/sajr.v28i1.2726] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Accepted: 11/15/2023] [Indexed: 03/07/2024] Open
Abstract
The trajectory from the clinical identification of a benign liver mass to establishing a precise diagnosis is perplexing and arduous. Related contributory factors are that such lesions are encountered infrequently and that there is a nonavailability of dedicated paediatric radiologists in the developing world. The objective of this study was to review the spectrum of benign liver lesions in children and their typical imaging features. Cross-sectional imaging of all paediatric patients (< 18 years) with liver lesions (single and multiple) performed in the institute from 01 January 2018 to 01 January 2019 as well as those acquired at outside institutions and referred to the institute for management was included. Ultrasound was done as the first line of investigation in all the cases with suspicious liver masses and retrospectively performed in referral cases in whom CT or MRI was already done. Images were analysed by two senior radiologists. Most of the cases were diagnosed based on clinical, biochemical and imaging findings, and biopsy was only performed in equivocal cases. Most of the benign liver lesions in the paediatric age group were hepatic haemangioma and mesenchymal hamartomas. A simplified clinical-radiologic paradigm should be established for benign liver lesions in children to assist in reaching the correct diagnosis. Contribution The article demonstrates the salient radiological findings of various benign liver lesions in the paediatric age group and the role of demographic, clinical and biochemical findings, which plays a substantial role in the diagnosis and avoids unnecessary biopsies.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Raju Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Delhi, India
| | - Prabudh Goel
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Delhi, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Delhi, India
| | - Nellai Krishnan
- Department of Paediatric Surgery, All India Institute of Medical Sciences, Delhi, India
| |
Collapse
|
2
|
Sarkar P, Sherwani P, Dev R, Tiwari A. Role of T2 relaxometry in localization of mesial temporal sclerosis and the degree of hippocampal atrophy in patients with intractable temporal lobe epilepsy: A cross sectional study. Hippocampus 2023; 33:1189-1196. [PMID: 37587770 DOI: 10.1002/hipo.23572] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/04/2023] [Revised: 07/18/2023] [Accepted: 07/30/2023] [Indexed: 08/18/2023]
Abstract
Mesial temporal lobe epilepsy is one of the most common causes of refractory epilepsy worldwide. A good percentage of patients do not have detectable hippocampal atrophy on magnetic resonance imaging (MRI). The objective of this study is to evaluate whether T2 relaxometry can identify hippocampal pathology and lateralize the epileptic focus in patients with intractable temporal lobe epilepsy (TLE). T2 relaxometry can also be used to correlate the clinical severity of the disease with the relaxometry readings in those who have hippocampal atrophy as well as those who do not. Thirty two patients having clinical and electrophysiological features of TLE were enrolled and a MRI brain with T2 relaxometry was done. Hippocampal T2 relaxometry values were calculated in the head, body, and tail of the hippocampus and average T2 relaxometry values were calculated, and a comparison was done with the controls. For patients with unilateral involvement, the contralateral side was taken as control and in cases of bilateral involvement, controls were identified from normal subjects. T2 relaxometry is found to be superior to MR visual analysis in the early detection of cases of hippocampal sclerosis where there is no atrophy on visual analysis. Nine out of 32 patients (28%) were normal on MR visual analysis; however, showed increased values on T2 relaxometry, correlating with clinical and electrophysiological diagnosis. The rest of the patients with hippocampal atrophy showed a correlation of T2 relaxometry values with the degree of atrophy. The hippocampal T2 measurement is thus more sensitive and specific. The study was clinically significant (p < .0001). There was a mild female predilection of the disease and there was no significant correlation with comorbidities. There was a strong positive correlation with patients having a history of febrile seizures in childhood. T2 relaxometry may accurately lateralize the majority of patients with persistent TLE and offers evidence of hippocampus injury in those patients who do not show evidence of atrophy on MRI and also the T2 relaxometry values correlated with the degree of atrophy. Early identification of hippocampal sclerosis is crucial for prompt management which offers better outcomes.
Collapse
Affiliation(s)
- Prasenjit Sarkar
- Department of Radiodiagnosis and Department of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Department of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Rahul Dev
- Department of Radiodiagnosis and Department of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashutosh Tiwari
- Department of Radiodiagnosis and Department of Neurology, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
3
|
Panda PK, Elwadhi A, Gupta D, Tomar A, Sherwani P, Sharawat IK. Development and validation of a predictive model assessing the risk of seizure recurrence in children with neurocysticercosis. Epilepsy Res 2023; 197:107239. [PMID: 37862917 DOI: 10.1016/j.eplepsyres.2023.107239] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 10/03/2023] [Accepted: 10/08/2023] [Indexed: 10/22/2023]
Abstract
INTRODUCTION Neurocysticercosis (NCC) is a significant factor contributing to the incidence of seizures in developing countries. While numerous studies have investigated the recurrence of seizures in NCC, their reliability is often limited. METHODS We assessed the socio-demographic, clinical, and neuroimaging details of 161 children with seizures caused by NCC. We monitored them for seizure recurrence over a 6-month follow-up period. We divided the children into two groups: those with seizure recurrence and those without. Subsequently, we identified predictive factors associated with seizure recurrence through univariate analysis, followed by multivariate binary logistic regression. We evaluated the prognostic model for discrimination and calibration and then internally validated it using the bootstrap method. RESULTS A total of 23 children experienced breakthrough seizures. In multivariate analysis, the presence of epileptiform abnormalities in electroencephalogram (EEG), more than 5 NCC lesions, the presence of perilesional edema greater than 2 cm in maximum dimension, and a cluster of seizures before presentation were significantly associated with seizure recurrence (p < 0.05). These factors were included in the final NEPC (Number of NCC lesions, Epileptiform EEG abnormality, Perilesional edema, and Cluster of seizures) score. The final model exhibited good discrimination (AUC = 89.1 %; 95 % CI=80.5-95.3 %, p < 0.001) and calibration (p = 0.54). A score of 4 appeared to be the optimal threshold for discriminating between individuals with and without seizure recurrence, with sensitivity and specificity values of 85 % and 87 %, respectively. Interrater reliability was very strong between two pediatric neurologists and strong between a pediatric neurologist and a pediatric neurology trainee resident (k = 0.92 and 0.86, respectively). CONCLUSION The NEPC score demonstrates good sensitivity and specificity in predicting seizure recurrence in pediatric children with NCC.
Collapse
Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Aman Elwadhi
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Diksha Gupta
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Apurva Tomar
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand 249203, India.
| |
Collapse
|
4
|
Sharma S, Sherwani P, Arunachalam VS, Dev R. Revisiting Rosai Dorfman disease: A rare histiocytic disorder with nodal and extranodal involvement. SA J Radiol 2023; 27:2729. [PMID: 37928929 PMCID: PMC10623647 DOI: 10.4102/sajr.v27i1.2729] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/04/2023] [Accepted: 08/27/2023] [Indexed: 11/07/2023] Open
Abstract
Rosai Dorfman disease is a rare but benign and self-limiting disorder. A case of Rosai Dorfman disease in a 16-year-old female with classic radiological and pathological findings is presented. T2W hypointense signal of the soft tissue masses was a distinguishing MRI feature. Contribution Rosai Dorfman disease is often overlooked in the differentials of lymphadenopathy and soft tissue masses on account of its rarity. This case report comprehensively discusses the imaging approach to this rare disorder.
Collapse
Affiliation(s)
- Smily Sharma
- Department of Diagnostic and Interventional Radiology, All India Institutes of Medical Sciences (AIIMS) Jodhpur, Jodhpur, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institutes of Medical Sciences (AIIMS) Rishikesh, Rishikesh, India
| | - Venkata S. Arunachalam
- Department of Imaging Sciences and Interventional Radiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Thiruvananthapuram, India
| | - Rahul Dev
- Department of Radiodiagnosis, All India Institutes of Medical Sciences (AIIMS) Rishikesh, Rishikesh, India
| |
Collapse
|
5
|
Yasam RP, Singh V, Darla NS, Pant J, Sherwani P, Garg V. A prospective study on the role of foot evertor muscle activity in recurrence of clubfoot. Foot (Edinb) 2023; 56:102025. [PMID: 37015163 DOI: 10.1016/j.foot.2023.102025] [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] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Revised: 03/23/2023] [Accepted: 03/24/2023] [Indexed: 04/06/2023]
Abstract
BACKGROUND Even after corrective casting and bracing, clubfoot recurrence is challenging throughout childhood, with around 14-40 % recurrence rates. Most of the literature on recurrence was attributed to various factors, and minimal research was conducted to know the role of foot evertor muscle activity and its stimulation benefits. This study aimed to assess the role of foot evertor muscle activity in idiopathic congenital clubfoot recurrence by using clinical, sonographic, and electromyographic parameters. METHODS A prospective cohort study was conducted at our tertiary care hospital from 2020 to 2022. The patient's demographic data, Pirani, Dimeglio, Clinical Evertor Muscle Activity scores, sonographic cross-sectional areas of leg muscle, and evertor motor activity using surface electromyography were recorded in adherence to the pre-defined intervals. RESULTS In total, 51 patients (51 feet) were included in the study, and the overall recurrence rate was 27.5 % (14/51). In this study, around 47 % (24/51) of children had mild or poor clinical evertor activity; among them, 58 % (14/24) children had a recurrence, and the insufficient clinical evertor activity and recurrence were strongly correlated (p = 0.01). Evertor muscle cross-sectional area ratio, motor unit potentials, and recruitment were comparatively less in the recurred group; however, only the cross-sectional area ratio was statistically significant (p = 0.02). CONCLUSION Early detection of evertor muscle weakness can help to individualize the treatment plans by predicting recurrence. Therefore, it should be included in routine clinical evaluations. Further research is required to determine the advantages of evertor muscle-strengthening activities in preventing idiopathic clubfoot deformity. LEVEL OF CLINICAL EVIDENCE A prospective cohort study, Level of evidence-II.
Collapse
Affiliation(s)
- Rama Priya Yasam
- Department of Orthopedics, AIIMS, Rishikesh, Uttarakhand, India, 249203
| | - Vivek Singh
- Department of Orthopedics, AIIMS, Rishikesh, Uttarakhand, India, 249203.
| | | | - Jayanti Pant
- Department of Physiology, AIIMS, Rishikesh, Uttarakhand, India, 249203
| | - Poonam Sherwani
- Department of Radiology, AIIMS, Rishikesh, Uttarakhand, India, 249203
| | - Varun Garg
- Department of Orthopedics, AIIMS, Rishikesh, Uttarakhand, India, 249203
| |
Collapse
|
6
|
Bhatia P, Sherwani P, Ahmed I, Chauhan U, Saxena S. Utility of MR lymphangiography in chylous ascites: A report of two cases. SA J Radiol 2023; 27:2703. [PMID: 37671285 PMCID: PMC10476230 DOI: 10.4102/sajr.v27i1.2703] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2023] [Accepted: 07/17/2023] [Indexed: 09/07/2023] Open
Abstract
Dynamic contrast-enhanced (DCE) lymphangiography is a novel imaging technique with a potential role in suspected cases of lymphatic leaks. A 15-year-old male with a post operative chylous leak and an 8-year-old male who developed chylous ascites secondary to disseminated tuberculosis are presented. Both children underwent MR lymphangiography. Contribution The role of DCE-MR lymphangiography in cases of chylous ascites to help guide appropriate management.
Collapse
Affiliation(s)
- Pratibha Bhatia
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Science, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Science, Rishikesh, India
| | - Intezar Ahmed
- Department of Pediatric Surgery, All India Institute of Medical Science, Rishikesh, India
| | - Udit Chauhan
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Science, Rishikesh, India
| | - Sudhir Saxena
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Science, Rishikesh, India
| |
Collapse
|
7
|
Singh M, Chawla L, Sherwani P, Maurya P, Rajaram S. Antenatal diagnosis of sympus dipus by MRI. Eur J Obstet Gynecol Reprod Biol X 2023; 18:100194. [PMID: 37151855 PMCID: PMC10160685 DOI: 10.1016/j.eurox.2023.100194] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/10/2023] [Revised: 03/31/2023] [Accepted: 04/14/2023] [Indexed: 05/09/2023] Open
Affiliation(s)
- Madhulika Singh
- Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India
| | - Latika Chawla
- Department of Obstetrics and Gynaecology, Level 6, A Block, All India Institute of Medical Sciences (AIIMS), Veerbhadra Road, Rishikesh 249203, India
- Corresponding author.
| | | | - Pratima Maurya
- Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India
| | - Shalini Rajaram
- Department of Obstetrics and Gynaecology, AIIMS Rishikesh, India
| |
Collapse
|
8
|
Kaushik A, Sherwani P, Saurya, Garnaik DK. Diagnostic dilemma in left flank mass in an infant: A rare case of intrarenal neuroblastoma. Afr J Paediatr Surg 2023; 20:152-154. [PMID: 36960513 DOI: 10.4103/ajps.ajps_124_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/05/2023] Open
Abstract
Neuroblastoma (NBL) and nephroblastoma present with abdominal mass and various imaging features help in differentiating the two; however, localisation is difficult in large masses and at times imaging features can be confusing. Here, we describe the case of large left-sided NBL arising from the adrenal and involving the left kidney with moderate hydronephrosis.
Collapse
Affiliation(s)
- Ashish Kaushik
- Departments of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Departments of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Saurya
- Departments of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Kumar Garnaik
- Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
9
|
Sherwani P, Nandolia KK, Joshi K, Lourembam R. Imaging in Van Wyk Grumbach syndrome: An uncommon presentation of hypothyroidism. SA J Radiol 2023; 27:2572. [PMID: 37065974 PMCID: PMC10091148 DOI: 10.4102/sajr.v27i1.2572] [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: 10/21/2022] [Accepted: 01/27/2023] [Indexed: 04/05/2023] Open
Abstract
Isosexual precocious puberty with ovarian masses in long-standing juvenile hypothyroidism is well described in the literature as Van Wyk Grumbach syndrome (VWGS). The present case reports this rare entity in a 4-year-old girl who was referred for imaging to evaluate the cause of non-traumatic bleeding per vagina. Antecedent history, clinical features and thyroid function tests were consistent with long-standing juvenile hypothyroidism with documented clinical response to thyroxine replacement therapy.Contribution: Typical clinical and radiological features of the syndrome are reported, which helps in the early diagnosis and management, henceforth avoiding the associated complications.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Khanak K. Nandolia
- Department of Radiodiagnosis, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Kirti Joshi
- Department of Paediatrics, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| | - Radhapyari Lourembam
- Department of Paediatrics, All India Institute of Medical Sciences Rishikesh, Rishikesh, India
| |
Collapse
|
10
|
Saini A, Sherwani P, Gupta G, Roul PK. Pituitary stalk interruption syndrome: a rare cause for poor developmental growth in children. Sudan J Paediatr 2023; 23:88-90. [PMID: 37663096 PMCID: PMC10468630 DOI: 10.24911/sjp.106-1641792629] [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: 01/10/2022] [Accepted: 02/21/2023] [Indexed: 09/05/2023]
Abstract
A 7-years–6-months old boy presented to the endocrinology clinic with complaints of poor weight and height gain, which was first observed by the parents when the child was 5 years old. The child was born out of a non-consanguineous marriage by caesarean section due to breech presentation. His birth weight was 2.35 kg. He had no perinatal complications like jaundice, dehydration or hypoglycaemia. On recent examination, his weight, height and body mass index were 15.8 kg (
Collapse
Affiliation(s)
- Aditi Saini
- All India Institute of Medical Sciences, Rishikesh, India
| | | | - Gaurav Gupta
- All India Institute of Medical Sciences, Rishikesh, India
| | | |
Collapse
|
11
|
Agarwal A, Syed A, Sherwani P, Shankar R. What is Amiss? Neurosonogram in a 36-week-old Late Preterm Neonate. J Med Ultrasound 2023; 31:76-77. [PMID: 37180623 PMCID: PMC10173837 DOI: 10.4103/jmu.jmu_111_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/06/2021] [Accepted: 09/17/2021] [Indexed: 05/16/2023] Open
Affiliation(s)
- Aakanksha Agarwal
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
- Address for correspondence: Dr. Aakanksha Agarwal, Department of Radiodiagnosis, AIIMS Rishikesh, Rishikesh, Uttarakhand, India. E-mail:
| | - Anjum Syed
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
| | - Ravi Shankar
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
12
|
Sharawat IK, Ramachandran A, Panda PK, Kumar V, Sherwani P, Bhat NK. Development and Validation of a Prognostic Model and Bedside Score for the Neurological Outcome in Children with Tuberculous Meningitis. Am J Trop Med Hyg 2022; 107:1288-1294. [PMID: 36216321 PMCID: PMC9768285 DOI: 10.4269/ajtmh.22-0253] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2022] [Accepted: 08/10/2022] [Indexed: 12/30/2022] Open
Abstract
Only a few studies have explored prognostic factors for tuberculous meningitis (TBM) in children, and an easily applicable bedside prognostic score for TBM has not been developed yet. We compared the sociodemographic, clinical, radiological, and cerebrospinal fluid parameters in the cohort of 94 TBM cases aged 1 to 18 years, with at least 6 months of completed follow-up and determined the prognostic factors associated with poor functional outcome. We assessed our proposed prognostic model using both discrimination and calibration and subsequently used the bootstrap method to validate the model internally. We finally derived an easily applicable bedside prognostic score by rounding off the regression coefficients to the nearest integers. A total of 39 (41%) and 55 (59%) patients had poor and good functional outcomes, respectively, at the end of 6 months (12 died, 13%). In multivariate analysis, a high baseline Pediatric Cerebral Performance Category (PCPC) score, brain infarction in neuroimaging, tonic motor posturing, younger age, and stage III TBM were independent predictors of poor functional outcomes. The final model showed good discrimination (area under the curve = 88.2%, P < 0.001) and good calibration (Hosmer-Lemeshow test, P = 0.53). Bootstrapping also confirmed the internal validity of this model. The PITAS (PCPC score [P], brain infarction in neuroimaging [I], tonic motor posturing [T], age [A], and stage of TBM [S]) score developed from this model has a score ranging from 0 to 12, with a higher score predicting a higher risk of poor functional outcome. The PITAS score performed better than medical research council staging alone in predicting poor functional outcomes (area under the curve = 87.1% versus 82.3%). Our study's PITAS score, developed and internally validated, has good sensitivity and specificity in predicting poor functional outcomes in pediatric TBM cases at 6 months.
Collapse
Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Aparna Ramachandran
- Department of Neurology, IQRAA International Hospital and Research Centre, Kozhikode, Kerala, India
| | - Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Vinod Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
13
|
Panda PK, Umasanker S, Sherwani P, Sharma V, Sharawat IK, Singh D, Singh M. Adolescent girl with blurry vision and pancytopaenia. J Paediatr Child Health 2022. [PMID: 36468463 DOI: 10.1111/jpc.15043] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 12/12/2022]
Affiliation(s)
- Prateek K Panda
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Swati Umasanker
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| | - Vishakha Sharma
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Indar K Sharawat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Divya Singh
- Department of Histopathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Mohit Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
14
|
Panda PK, Ramachandran A, Sharawat IK, Sherwani P, Bhat NK. Comparison of Seizure Characteristics and Recurrence Rates in Children with Viable Parenchymal Neurocysticercosis and Tuberculoma in India. Am J Trop Med Hyg 2022; 107:833-840. [PMID: 36037862 PMCID: PMC9651522 DOI: 10.4269/ajtmh.21-1298] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2021] [Accepted: 06/20/2022] [Indexed: 11/07/2022] Open
Abstract
Inflammatory granulomas (neurocysticercosis [NCC] and tuberculomas) are important causes of seizures in children and adults in the developing world. Although several studies have explored seizure characteristics individually in patients with either NCC or tuberculoma, none has compared the seizure recurrence rate between them. This study included patients aged 5 to 18 years with viable parenchymal NCC or tuberculomas who had completed regular follow-up of at least 12 months at a tertiary institute in India. Their baseline seizure and electroencephalographic characteristics, antiseizure medications (ASMs), and breakthrough seizure rates at 12, 24, and 52 weeks were noted. A total of 103 and 54 patients with active NCC and tuberculomas respectively were included. The number of patients who had at least one breakthrough seizure at 12, 24, and 52 weeks in both groups was comparable (P = 0.32, 0.27, and 0.13), and the vast majority were controlled on monotherapy (98% cases in each group). The proportion of patients who required an increase in the dose or change of ASMs or polytherapy, the proportion of children who had status epilepticus at or before 12 months, abnormal electroencephalogram at 12 months, and calcified and active granuloma in neuroimaging at 12 months were also comparable between the two groups (P > 0.05 for all). The number of patients who had ASM-related adverse events and discontinued ASM due to serious adverse events was comparable between both groups, except for hepatotoxicity in the tuberculoma group. The predictors for breakthrough seizures that were found to be statistically significant in the NCC group were the presence of perilesional edema in the baseline magnetic resonance imaging (P = 0.02) and more than five active granulomas (P = 0.01); predictors in the tuberculoma group were the presence of severe perilesional edema causing midline shift in the baseline magnetic resonance imaging (P = 0.01) and more than five active granulomas (P = 0.04). The recurrence rates of breakthrough seizures over the next 12 months in newly detected cases of active NCC and tuberculomas were comparable.
Collapse
Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Aparna Ramachandran
- Department of Neurology, IQRAA International Hospital & Research Centre, Kozhikode, Kerala, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
15
|
Sharma O, Mallik D, Ranjan S, Sherwani P, Kumar N, Basu S. Enterolith Causing Small Bowel Obstruction: Report of a Case and Review of Literature. Clin Exp Gastroenterol 2022; 15:101-104. [PMID: 35859713 PMCID: PMC9292452 DOI: 10.2147/ceg.s369640] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2022] [Accepted: 07/07/2022] [Indexed: 12/05/2022] Open
Abstract
Enterolithiasis, also known as gastro-intestinal concretions, is an uncommon medical disorder that arises from intestinal stasis. Enteroliths are commonly caused by tuberculosis-related constriction and arise from intestinal diverticula. Small bowel obstruction caused by an enterolith is extremely uncommon and might be difficult to diagnose. The mortality rate of uncomplicated enterolithiasis is relatively low, but it rises to 3% in patients who have background comorbid illness, have significant bowel obstruction, and are diagnosed late. We present a rare case of an uncomplicated partial intestinal obstruction caused by an enterolith in an elderly male patient with small bowel diverticular disease who was treated nonoperatively and did not develop further symptoms in the six-month follow-up and discuss the difficulty in diagnosis and its management.
Collapse
Affiliation(s)
- Oshin Sharma
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Dhiraj Mallik
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sukrati Ranjan
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Navin Kumar
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Somprakas Basu
- Department of General Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
16
|
Lourembam R, Gupta MK, Sherwani P, Verma PK. Spondylocostal Dysostosis with Anal Atresia and Urogenital Anomalies in a Young Infant: First Case Entity of Casamassima–Morton–Nance Syndrome from Asia. J Pediatr Genet 2022. [DOI: 10.1055/s-0042-1749367] [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] [Indexed: 10/17/2022]
Abstract
AbstractCasamassima–Morton–Nance syndrome (CMNS) includes a heterogeneous group of spondylocostal dysostosis along with anal atresia and genitourinary abnormalities. In 1981, Casamassima et al first described the syndrome in a fetus, and since then, only seven such cases have been reported so far. CMNS phenotype shows a significant clinical variability as documented in the reported cases. Etiology remains unknown yet, and it carries a poor prognosis. Here, we reported on a young female infant born out of nonconsanguineous marriage with normal karyotype and spondylocostal dysostosis, anal and genitourinary malformations suggesting CMNS. Ours is the eighth, and first case entity of CMNS reported from Asia as per the literature search. In our case, the additional feature of bilateral clubfoot has not been documented earlier in the literature. It extends the clinical spectrum of the syndrome and prompts us to consider it a close differential diagnosis to VACTERL (vertebral defects, anal atresia, cardiac malformations, tracheoesophageal fistula/esophageal atresia, renal anomalies, limb abnormalities) syndrome, which is commonly known and diagnosed. It also raises the question of whether cases of CMNS are being misdiagnosed as VACTERL syndrome due to its rarity.
Collapse
Affiliation(s)
- Radhapyari Lourembam
- Division of Medical Genetics, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manish Kumar Gupta
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant Kumar Verma
- Division of Medical Genetics, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
17
|
Saurya S, Sherwani P, Sharma G, Saxena S. Spectrum of Clinical and Radiological Presentation of Midgut Malrotation in Children and Adolescents: Case Series. Journal of Gastrointestinal and Abdominal Radiology 2022. [DOI: 10.1055/s-0042-1749674] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Midgut malrotation is usually present in the early neonatal period with intestinal obstruction and bilious vomiting. However, sometimes it may present later in childhood and adolescence with atypical features and then may remain undiagnosed for long, adversely affecting the growth and development of the child. Here we describe three cases of intestinal malrotation with various atypical presentation and imaging findings.
Collapse
Affiliation(s)
- Saurya Saurya
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Garima Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sudhir Saxena
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
18
|
Sherwani P, Singh RS, Bolia R. Splenopancreatic Fusion. Indian J Pediatr 2022; 89:720-721. [PMID: 35357644 DOI: 10.1007/s12098-022-04115-1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Accepted: 01/20/2022] [Indexed: 11/28/2022]
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Shanker Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishi Bolia
- Division of Pediatric Gastroenterology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India.
| |
Collapse
|
19
|
Sharma M, Sherwani P, Venkataram T, Sihag RK. Intraventricular Pneumocephalus: Ruptured Occipital Encephalocele. Indian J Pediatr 2022; 89:722. [PMID: 35353364 DOI: 10.1007/s12098-022-04149-5] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/07/2021] [Accepted: 01/27/2022] [Indexed: 11/30/2022]
Affiliation(s)
- Mohit Sharma
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, 249203, India.
| | - Tejas Venkataram
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rakesh Kumar Sihag
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
20
|
Affiliation(s)
- Rishi Bolia
- Division of Pediatric Gastroenterology, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| | - Deepak Kumar Garnaik
- Department of Pediatric Surgery, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
21
|
Sharawat IK, Panda PK, Kumar V, Sherwani P. Comparative Efficacy and Safety of Lacosamide and Oxcarbazepine for Seizure Control in Children with Newly Diagnosed Solitary Neurocysticercosis. J Trop Pediatr 2022; 68:6572713. [PMID: 35459951 DOI: 10.1093/tropej/fmac032] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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] [Indexed: 11/13/2022]
Abstract
BACKGROUND In newly diagnosed neurocysticercosis (NCC) with seizures, the choice of anti-seizure medication (ASM) seems to be arbitrary due to a lack of comparative studies. Although oxcarbazepine (OXC) is often considered efficacious for focal seizures in NCC, due to adverse effects, newer ASMs like levetiracetam (LCM) and lacosamide are also being explored. METHODS This study was performed by case record review of children with newly diagnosed solitary viable parenchymal NCC aged 4-18years who received lacosamide and OXC at least for 12 weeks between August 2019 and April 2021, from a prospective registry of a tertiary care teaching hospital in north India. Seizure control, electroencephalographic abnormalities, resolution of inflammatory granulomas and adverse effects were compared between two arms at 12 and 24 weeks. RESULTS Total 31 (8.3 ± 4.7 years, 19 boys) and 72 (8.6 ± 4.2 years, 43 boys) completed at least 12 weeks follow-up in LCM and OXC groups, out of which 2 and 51 completed at least 24 weeks follow-up in LCM and OXC groups, respectively. The occurrence of breakthrough seizure was comparable in both arms at 12 and 24 weeks (1/31 and 2/22 in lacosamide group vs. 2/72 and 4/51 in OXC group, p = 0.66 and 0.59, respectively). Patients receiving OXC had more frequent treatment-emergent adverse events (p = 0.0001) and four patients required discontinuation due to severe adverse events (SAEs), while none in the lacosamide group had SAEs. CONCLUSIONS Lacosamide appears to be efficacious and safe for achieving seizure freedom in patients with solitary viable parenchymal neurocysticercosis.
Collapse
Affiliation(s)
- Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh 249203, India
| | - Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh 249203, India
| | - Vinod Kumar
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh 249203, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh 249203, India
| |
Collapse
|
22
|
Agarwal A, Syed A, Sherwani P, Shankar R. What is Amiss? Neurosonogram in a 36-week-old Late Preterm Neonate. J Med Ultrasound 2022; 30:316-317. [PMID: 36844762 PMCID: PMC9944814 DOI: 10.4103/jmu.jmu_112_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/13/2021] [Revised: 07/06/2021] [Accepted: 09/17/2021] [Indexed: 12/28/2022] Open
Affiliation(s)
- Aakanksha Agarwal
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India,Address for correspondence: Dr. Aakanksha Agarwal, AIIMS, Rishikesh, Rishikesh, India. E-mail:
| | - Anjum Syed
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
| | - Ravi Shankar
- Department of Radiodiagnosis, AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
23
|
Sherwani P, Kumar KSS, Sharma P, Dua R, Layek A. Ruptured spontaneous bronchial artery pseudo aneurysm with large mediastinal hematoma and its interventional management: An acute chest emergency. Lung India 2022; 39:204-207. [PMID: 35259809 PMCID: PMC9053928 DOI: 10.4103/lungindia.lungindia_540_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
24
|
Roul PK, Kaushik AH, Sherwani P, Yadav K, Saini A, Singh OBC, Syed A, Panda PK. Predictive Value of Chest CT Score in Assessing Disease Severity and Short-term Mortality in COVID-19 Pneumonia at a Tertiary Care Centre in Northern India: A Prospective Observational Study. J Clin Diagn Res 2022. [DOI: 10.7860/jcdr/2022/51808.16168] [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: 11/24/2022]
Abstract
Introduction: Severe Acute Respiratory Syndrome-Coronavirus (SARS-CoV-2) infection, also known as Coronavirus Disease2019 (COVID-19) is the global pandemic, first described in Wuhan city of China in December of 2019. Its diagnosis depends upon real-time Reverse Transcriptase-Polymerase Chain Reaction (RT-PCR). On chest Computerised Tomography (CT), it is almost similar to other viral pneumonia with extensive parenchymal involvement. Semiquantitative scores depicting this extensiveness of involvement could correlate with disease severity, laboratory parameters, mortality, like Intensive Care Unit (ICU) admission, requirements of ventilatory support and longer hospital stay. Aim: To define role of chest CT score in determining disease severity, predicting poor prognosis and mortality of COVID-19 pneumonia in short-term follow-up. Materials and Methods: This prospective study enrolled all admitted real-time RT-PCR positive patients for COVID19 at All India Institute of Medical Sciences, Rishikesh, India between 15th April and 31st May 2021. All patients were assigned semiquantitative CT scores based on the extent of lung parenchymal involvement of 20 lung regions in chest CT. Clinical severity was matched with chest CT scoring and laboratory findings. Survival curves along with univariate and multivariate analysis were applied to define the role of CT scoring in predicting short term prognosis. Results: Total 547 subjects were included in the study, of which the chest CT score showed a significant association with clinical severities (p-value <0.001). CT score were correlating significantly with increased serum C-Reactive Protein (CRP) (p-value=0.001) and D-dimer (p-value=0.01), and decreased lymphocyte count (p-value=0.003). A CT score ≥31 was found to be associated with an increased risk of mortality in both univariate and multivariate analysis {Odd Ratio (OR)=276.8; 95% Confidence Interval (CI)= 45.21-1695.43; p-value <0.001}. Conclusion: Chest CT score can be imaging measure of disease severity and predict a higher probability of mortality in score ≥31. It can also predict other defined variables of short-term prognosis. So, it has an advantage in speedy diagnostic workflow of symptomatic cases, timely referral of patients to higher centre, and better management of critical care resources.
Collapse
|
25
|
Singhal S, Sherwani P, Nandolia K. Diversified migrational abnormalities in a child with seizure: imaging findings. Sudan J Paediatr 2022; 22:116-118. [DOI: 10.24911/sjp.106-1604464537] [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] [Received: 11/05/2020] [Accepted: 12/18/2021] [Indexed: 11/11/2022]
Abstract
Numerous migrational abnormalities can be seen in children presenting with seizures or developmental delay which depend on the time of insult and includes various anomalies including cortical malformation,schizecephaly, and heterotopia.CT has very low sensitivity in detecting these abnormalities.MRI is the investigation of choice due to its excellent soft-tissue resolution,grey-white matter differentiation, and multiplanar capability. The radiologist must prepare an algorithm for diagnosis to avoid missing these lesions and guide the clinician in the appropriate management.
Collapse
|
26
|
Agarwal A, Sherwani P, Saurya, Bhunia NS, Dhoot DK. Unusual cause of urinary retention in a child: inflammatory pseudotumor of the urinary bladder. Ann Pediatr Surg 2021. [DOI: 10.1186/s43159-021-00095-7] [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: 11/10/2022] Open
Abstract
Abstract
Background
Urinary bladder masses are uncommon in the pediatric age group and pose a diagnostic challenge, often necessitating histopathological differentiation and confirmation. An unusual mimic of neoplastic bladder mass is inflammatory pseudotumor, and timely identification and diagnosis of which prevents undue patient stress and radical treatment.
Case presentation
We present a case of a 7-year-old female child who presented with hematuria, and a urinary bladder mass was detected on ultrasound which was further characterized by magnetic resonance imaging (MRI) and diagnosed as an inflammatory pseudotumor (IPT) on histopathology.
Conclusions
This case report describes the imaging features of IPT along with a list of differential diagnoses emphasizing the need for radiologists to be aware of this surprising and rare entity.
Collapse
|
27
|
Sherwani P, Bolia R, Kaushik A, Kumar S, Kishore S, Chauhan U. An Unusual Cause of Cholestasis in an Infant: Biliary Atresia Type IIB. Indian J Radiol Imaging 2021; 31:689-692. [PMID: 34790315 PMCID: PMC8590570 DOI: 10.1055/s-0041-1736165] [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: 11/18/2022] Open
Abstract
Biliary atresia (BA) is a progressive destructive cholangiopathy of unknown etiology that presents in early infancy. It has a worldwide frequency of 1:8,000–1:15,000 and is common in Asia than in the west. Based on the level at which the lumen of the extrahepatic duct is obliterated, BA is classified into three types. Type III is the commonest (∼85%) type and has the most proximal level of obstruction in the porta hepatis, while type II in which the atresia is at the level of the common hepatic duct, is the least common (∼2.5%) and has been rarely reported. Here, we report the imaging features of an infant with type IIB biliary atresia.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishi Bolia
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ashish Kaushik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sumit Kumar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Udit Chauhan
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
28
|
Sharawat IK, Panda PK, Sherwani P, Moirangthem V. Mitochondrial Membrane Protein-associated Neurodegeneration due to Novel Homozygous Mutation in the C19orf12 Gene. Ann Indian Acad Neurol 2021; 24:417-418. [PMID: 34447009 PMCID: PMC8370141 DOI: 10.4103/aian.aian_620_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2020] [Revised: 06/17/2020] [Accepted: 06/17/2020] [Indexed: 11/23/2022] Open
Affiliation(s)
- Indar K Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prateek K Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vetoni Moirangthem
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
29
|
Bahadur A, Mundhra R, Sherwani P, Kumar S. Robot-assisted partial cystectomy for bladder endometriosis: dual approach involving cystoscopy and robotic surgery. BMJ Case Rep 2021; 14:e244342. [PMID: 34429296 PMCID: PMC8386226 DOI: 10.1136/bcr-2021-244342] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/15/2021] [Indexed: 11/04/2022] Open
Abstract
Bladder endometriosis accounts for 70%-85% cases of urinary tract endometriosis. A high index of suspicion is needed to diagnose this condition as most women have associated pelvic and menstrual complaints. The presence of cyclical haematuria along with tender anterior vaginal wall should alert the gynaecologist or urologist to consider this rare entity. Treatment is medical therapy followed by surgery when needed. Transurethral resection of endometriotic spot is the commonly used approach but to completely excise the endometriotic nodule, bladder resection at the site of nodule is needed along with repair of cut bladder margins. Herein, we describe a dual surgical approach where the margins of the endometriotic spot were delineated and cut using cystoscopy, followed by robotic approach to completely excise the nodule along with bladder repair. Robotic approach seems safer and easier in this complex surgery owing to dense adhesions in such cases.
Collapse
Affiliation(s)
- Anupama Bahadur
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rajlaxmi Mundhra
- Obstetrics and Gynaecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sunil Kumar
- Urology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
30
|
Panda PK, Sharawat IK, Singh A, Sherwani P. A Young Child with Recurrent Episodes of Headaches and Vision Loss: Diagnostic Clues? J Pediatr Neurosci 2021; 16:82-84. [PMID: 34316317 PMCID: PMC8276967 DOI: 10.4103/jpn.jpn_91_20] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 07/07/2020] [Accepted: 07/21/2020] [Indexed: 11/14/2022] Open
Abstract
MELAS is a mitochondrial cytopathy, with maternal inheritance and variable phenotype expression and severity depending on the degree of heteroplasmy. It presents with waxing and waning symptoms, in form of recurrent migrainous headache, transient loss of sight, hemianopsia, transient ischemic attack, or stroke-like episodes, focal seizures and even periods of altered sensorium. Here we present an 8-year-old boy presented with recurrent episodes of migrainous headache associated with vomiting sometimes and recurrent episodes of loss of vision for the past one year. As many of these episodes were precipitated by some febrile illness, so the child was suspected to have neurotuberculosis outside, because of Mantoux positivity. His mother also had similar episodes of recurrent headache and ultimately succumbed to cerebrovascular accident. Mitochondrial genome sequencing revealed heteroplasmic missense variation in the MT-TL1 gene (chrM:3243A>G).
Collapse
Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Avinish Singh
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiology, All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, India
| |
Collapse
|
31
|
Swain SK, Arora RK, Sharma SK, Nandolia K, Basu G, Rekhapalli R, Arora P, Rajpal G, Sherwani P, Saxena S, Mittal RS. Vertebral arteriovenous fistulae in neurofibromatosis type1: a systematic review and meta-analysis. J Neurosurg Sci 2021; 66:54-61. [PMID: 33870666 DOI: 10.23736/s0390-5616.21.05232-2] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
INTRODUCTION Vertebral Arterio-venous fistulas (VAVFs) are uncommon lesions that can arise spontaneously or secondarily to iatrogenic or mechanical trauma. Among spontaneous cases, it is most commonly found to be associated with Neurofibromatosis type 1 (NF1). EVIDENCE ACQUISITION We performed a systematic review of the literature to obtain information regarding demographics, clinical presentation, treatment modalities and outcome of VAVFs associated with NF1. A literature search was performed by using databases PubMed Central, Embase, Cochrane Library, and Ovid MEDLINE. Also, the grey area search was done using the "Google Scholar" search engine. On screening of the original full-text English language articles, a total of 48 cases were considered suitable for inclusion in this review. EVIDENCE ANALYSIS VAVFs in NF1 commonly present between 3rd and 6th decade of life affecting females 2.4 times more than males. Left-sided fistulae were more common than the right side and most seen in the upper V2 segment of the vertebral artery. Most VAVFs in NF 1 patients were treated with constructive (occlusion of fistula only) endovascular therapy (n =26) with a high success rate. Moreover, Pooled proportion of the outcome data have shown significant difference between the endovascular constructive and destructive procedure. CONCLUSIONS The spontaneous VAVF, commonly associated with NF-1, often requires treatment. Awareness of the coexistence between NF1 and VAVF is crucial to avoid diagnostic delays and unnecessary surgical intervention leading to disastrous outcomes. Endovascular treatment is the preferred treatment approach while open surgical treatment is required in some complex fistulae and failure of endovascular techniques.
Collapse
Affiliation(s)
- Srikant K Swain
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Rajnish K Arora
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India -
| | | | - Khanak Nandolia
- Department of Radiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Garga Basu
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Rajasekhar Rekhapalli
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Arora
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Rishikesh, India
| | - Girish Rajpal
- Neurointerventionist, Max Healthcare, New Delhi, India
| | - Poonam Sherwani
- Department of Radiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Sudhir Saxena
- Department of Radiology, All India Institute of Medical Sciences, Rishikesh, India
| | - Radhey S Mittal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
32
|
Bolia R, Srivastava Y, Yadav R, Sherwani P. Unusual cause of severe iron deficiency anaemia in a child: paraoesophageal hernia. BMJ Case Rep 2021; 14:14/3/e237728. [PMID: 33664026 PMCID: PMC7934762 DOI: 10.1136/bcr-2020-237728] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Iron deficiency anaemia is a known complication of a large hiatal hernia in adults. It occurs as a result of erosions on the gastric mucosa secondary to traction at the hiatus during respiration and/or gastric acid-related injuries to the mucosa. Even though anaemia occurs as a result of chronic gastrointestinal blood loss, testing for faecal occult blood is often negative and upper gastrointestinal endoscopy normal as the bleeding is intermittent. In children, a hiatus hernia as a rare cause of iron deficiency anaemia and has been described only in case reports. Here, we describe a 5-year-old boy who presented with severe transfusion-dependent iron deficiency anaemia caused by a paraoesophageal hernia. Surgical repair of the hiatus hernia led to complete resolution of anaemia. One should consider a hiatus hernia as a diagnostic possibility when evaluating a child with refractory iron deficiency anaemia.
Collapse
Affiliation(s)
- Rishi Bolia
- Pediatric Gastroenterology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | | | - Renu Yadav
- Pediatric Gastroenterology, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Radiodiagnosis, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| |
Collapse
|
33
|
Sherwani P, Choudhary M, Shrivastava Y, Sharma P. Intercostal artery aneurysm in a child with disseminated tuberculosis and coexistent takayasu arteritis: A rare case report. Indian J Respir Care 2021. [DOI: 10.4103/ijrc.ijrc_41_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
34
|
Panda PK, Sharawat IK, Mehta S, Sherwani P, Bhat NK. Anti- N-methyl- d-aspartate Receptor Encephalitis Presenting as New-onset Refractory Status Epilepticus Responding to Rituximab in an Adolescent Girl. J Pediatr Neurosci 2021; 16:307-310. [PMID: 36531781 PMCID: PMC9757525 DOI: 10.4103/jpn.jpn_194_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Revised: 10/03/2020] [Accepted: 12/20/2020] [Indexed: 02/18/2023] Open
Abstract
New-onset refractory status epilepticus (NORSE) is defined as a refractory status epilepticus (SE) in a patient, without a clear acute or active structural, toxic, or metabolic cause, previous active epilepsy, or preexisting relevant neurological disorder. Cryptogenic NORSE cases, often immunotherapy is considered empirically as a favorable response, have been documented in anecdotal case reports. More than half of children with the anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis develop seizures and SE may also occur during the clinical course. But NORSE as a presenting feature of anti-NMDAR encephalitis is extremely rare, as most children present with subacute onset neuropsychiatric and extrapyramidal features. We are describing one such case in an adolescent girl with anti-NMDAR encephalitis, in whom even intravenous anesthetic infusion and first-line immunotherapy including corticosteroid and IVIG were insufficient to achieve seizure control. Super refractory left focal SE in this child resolved after 96 h of injection rituximab, following which intravenous anesthetics could be tapered and child survived with only mild functional limitation on follow-up at 6 months. In children with cryptogenic NORSE, the clinicians need to rule out the cerebrospinal fluid anti-NMDAR antibody. Rituximab is one of the most promising second-line immunotherapy options in children with anti-NMDAR encephalitis for achieving seizure control and inducing long-term remission.
Collapse
Affiliation(s)
- Prateek Kumar Panda
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Indar Kumar Sharawat
- Pediatric Neurology Division, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India,Address for correspondence: Dr. Indar Kumar Sharawat, Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand. India. E-mail:
| | - Sonalika Mehta
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nowneet Kumar Bhat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
35
|
Sherwani P, Rakesh NR, Kumar S, Saxena S. Unusual complication of colonic carcinoma: colonopleurobronchial fistula. BMJ Case Rep 2020; 13:13/12/e237937. [PMID: 33298495 DOI: 10.1136/bcr-2020-237937] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
Abstract
Colonopleurobronchial fistula (CPBF) is a rare complication which occurs due to diversified causes. Expectoration of the faecal material is the classical clinical symptom which suggests the diagnosis. Various causes include infection of pulmonary or abdominal origin, inflammatory bowel disease, colonic malignancy, diaphragmatic hernia and colonic interposition. Crohn's disease is the frequent underlying pathology, colonic malignancy accounts for rare cause. Due to the presence of liver in right upper quadrant, most of the fistulas are on the left side. Here we describe a rare case of a 38-year-old man presented with right-sided CPBF due to underlying colonic malignancy. Bronchial block was done, however the patient succumbed to death.
Collapse
Affiliation(s)
- Poonam Sherwani
- Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nirjhar Raj Rakesh
- Department of GI surgery, AIIMS Rishikesh, Rishikesh, Uttarakhand, India
| | - Sumit Kumar
- Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sudhir Saxena
- Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
36
|
Panda PK, Umasanker S, Sherwani P, Sharma V, Sharawat IK, Singh D, Singh M. Adolescent girl with blurry vision and pancytopenia. J Paediatr Child Health 2020; 56:1986-1987. [PMID: 33351242 DOI: 10.1111/jpc.1_15043] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/10/2020] [Revised: 05/31/2020] [Accepted: 06/04/2020] [Indexed: 11/28/2022]
Affiliation(s)
- Prateek K Panda
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Swati Umasanker
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| | - Vishakha Sharma
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Indar K Sharawat
- Department of Pediatrics, All India Institute of Medical Sciences, Rishikesh, India
| | - Divya Singh
- Department of Histopathology, All India Institute of Medical Sciences, Rishikesh, India
| | - Mohit Singh
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Rishikesh, India
| |
Collapse
|
37
|
Panda PK, Sharawat IK, Sharma V, Sherwani P. Leigh Syndrome and SURF1 Gene Presenting with Febrile Seizure. Ann Indian Acad Neurol 2020; 24:251-252. [PMID: 34220073 PMCID: PMC8232513 DOI: 10.4103/aian.aian_567_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/07/2020] [Revised: 08/08/2020] [Accepted: 08/21/2020] [Indexed: 11/04/2022] Open
Affiliation(s)
- Prateek Kumar Panda
- Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Indar Kumar Sharawat
- Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Vishakha Sharma
- Department of Pediatrics, Pediatric Neurology Division, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Poonam Sherwani
- Department of Radiodiagnosis and Imaging, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
38
|
Roul PK, Kaushik A, Gupta MK, Sherwani P. Imaging pearls of the annular pancreas on antenatal scan and its diagnostic dilemma: A case report. J Neonatal Surg 2020. [DOI: 10.47338/jns.v9.669] [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: 12/01/2022] Open
Abstract
Background: Annular pancreas is an uncommon cause of duodenal obstruction and rarely causes complete duodenal obstruction. Due to its rarity of identification in the antenatal period and overlapping imaging features with other causes of duodenal obstruction; it is often misdiagnosed.
Case presentation: A 33-year-old primigravida came for routine antenatal ultrasonography at 28 weeks and 4 days of gestational age. On antenatal ultrasonography, dilated duodenum and stomach were seen giving a double bubble sign and a hyperechoic band surrounding the duodenum. Associated polyhydramnios was also present. Fetal MRI was also done. Postpartum ultrasonography demonstrated pancreatic tissue surrounding the duodenum. The upper gastrointestinal contrast study showed a non-passage of contrast beyond the second part of the duodenum. Due to symptoms of obstruction, the neonate was operated on, and the underlying cause was found to be the annular pancreas.
Conclusion: Diagnosis of duodenal obstruction due to the annular pancreas is very important in the antenatal period to plan for appropriate therapeutic interventions after birth. A double bubble sign is seen due to various etiologies however the presence of a hyperechoic band in the antenatal ultrasound may point to the diagnosis of the annular pancreas.
Collapse
|
39
|
Sherwani P, Bhalla AS, Jana M, Naranje P, Kabra SK, Gupta AK, Kandasamy D. Thoracic Manifestations of Primary Immunodeficiency Disorders. Indian J Pediatr 2020; 87:846-849. [PMID: 32385778 DOI: 10.1007/s12098-020-03289-w] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2019] [Accepted: 04/01/2020] [Indexed: 12/15/2022]
Abstract
Primary immunodeficiency disorders (PIDD) are a group of disorders presenting with recurrent infections. The authors retrospectively reviewed the imaging records of 24 proven cases of PIDD and correlated the imaging findings with the type of defect. Final diagnoses were categorized in four groups; Group I (humoral immunodeficiency), Group 2 (cell mediated immunodeficiency), Group 3 (phagocytic disorders) and Group 4 (others). Group 3 was the commonest, followed by 1 and 2. Three most common disorders encountered were chronic granulomatous disease (CGD) (7/24), hyper IgE syndrome (5/24) and common variable immunodeficiency (CVID) (4/24). Consolidation (12/24), nodules (10/24), bronchiectasis (9/24) and lymphadenopathy (8/24) were the commonest imaging findings. Although not statistically significant, some definite imaging trends could be established. Presence of consolidation and nodules; with absence of bronchiectasis was the striking finding in Group 3. Group 2 disorders predominantly showed bronchiectasis, whereas presence of consolidation, nodules, bronchiectasis all were very common in Group 1.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Manisha Jana
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Sushil K Kabra
- Department of Pediatrics, All India Institute of Medical Sciences, New Delhi, India
| | - Arun Kumar Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
| | | |
Collapse
|
40
|
Sharawat I, Sherwani P, Arora M, Panda P, Ranjan R, Saxena S. Congenital absence of internal carotid artery and complex cerebral vascular abnormalities with thalassemia intermedia: A novel association? Ann Indian Acad Neurol 2020; 23:817-819. [PMID: 33688138 PMCID: PMC7900719 DOI: 10.4103/aian.aian_60_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2020] [Revised: 02/18/2020] [Accepted: 03/06/2020] [Indexed: 11/04/2022] Open
|
41
|
Abstract
Chest is the commonest site of involvement by tuberculosis (TB) in children; lungs being the most frequently affected region, followed by nodes, pleura and chest wall. It is difficult to diagnose TB in children due to lack of overt symptoms and difficulty in obtaining samples for microbiological confirmation. Hence various imaging modalities play an important role in diagnostic algorithm as well as in follow-up after treatment. Standardization of chest radiograph reporting in context of clinically suspected TB is the need of the hour so as to suggest a proper diagnosis and avoid over-diagnosis. This article aims to discuss the imaging features of chest tuberculosis according to the site of involvement on various imaging modalities in the pediatric population.
Collapse
Affiliation(s)
- Priyanka Naranje
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
| | - Ashu Seith Bhalla
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India.
| | - Poonam Sherwani
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, 110029, India
| |
Collapse
|
42
|
Mittal M, Yadav V, Khadgawat R, Kumar M, Sherwani P. Efficacy and Safety of 90,000 IU versus 300,000 IU Single Dose Oral Vitamin D in Nutritional Rickets: A Randomized Controlled Trial. Indian J Endocrinol Metab 2018; 22:760-765. [PMID: 30766814 PMCID: PMC6330863 DOI: 10.4103/ijem.ijem_84_18] [Citation(s) in RCA: 8] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
AIM To compare efficacy and safety of 90,000 IU versus 300,000 IU oral single dose vitamin D for treatment of nutritional rickets. STUDY DESIGN Randomized controlled trial. SETTING Tertiary care hospital. PARTICIPANTS One hundred ten children (6 months to 5 years, median age 10.5 months) with rickets. Exclusion criteria were disease affecting absorption, intake of calcium/vitamin D preparation in last 6 months, abnormal renal function, and rickets other than nutritional. INTERVENTION Vitamin D3 as a single oral dose 90,000 IU (group A, n = 55) or 300,000 IU (group B, n = 55). METHODOLOGY Severity of rickets was scored on knee and wrist X-ray as per Thacher's radiographic score. Baseline serum levels of calcium, SAP, 25(OH)D, iPTH were measured. Follow up was done at 1 week, 4 weeks, and 12 weeks. OUTCOME VARIABLE Primary - Radiographic score at 3 months. Secondary - Serum levels of 25(OH)D, SAP, and iPTH at 3 months, clinical and biochemical adverse effects. RESULTS Eighty-six subjects (43 in each group) completed the study. The radiographic score reduced from 6.90 to 0.16 in group A and from 6.93 to 0.23 in group B. The levels of 25(OH)D, ALP, and PTH were similar between the groups at baseline and follow up. Hypercalciuria and hypercalcemia were seen more often in group B as was hypervitaminosis D. There were no clinical adverse events. CONCLUSIONS Single oral dose vitamin D3 90,000 IU is safe and effective in achieving healing of rickets.
Collapse
Affiliation(s)
- Medha Mittal
- Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi, India
| | - Vineeta Yadav
- Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi, India
| | - Rajesh Khadgawat
- Department of Endocrinology and Metabolism, All India Institute of Medical Sciences, New Delhi, India
| | - Manish Kumar
- Department of Pediatrics, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi, India
| | - Poonam Sherwani
- Department of Radiology, Chacha Nehru Bal Chikitsalaya, Geeta Colony, New Delhi, India
| |
Collapse
|
43
|
Abstract
Hepatic complications of malposition of umbilical venous catheter (UVC) are uncommon and occur due to extravasation of hypertonic fluids and the blood products in the liver tissue. Various hepatic complications include thrombosis of hepatic vessels, hepatic necrosis, hepatic fluid collections, and hematoma, with the intraparenchymal liver lesions seen along the course of ductus venosus. Radiologists must be aware of these complications and their imaging findings, as the timely recognition and immediate management can prevent the fatal outcome. Here, we present a rare case of intraparenchymal liver lesions associated with malposition of UVC in a preterm baby.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, Chacha Nehru Bal Chikitsalaya Hospital, New Delhi, India
| | - Adweta Vire
- Department of Radiodiagnosis, Chacha Nehru Bal Chikitsalaya Hospital, New Delhi, India
| | - Rama Anand
- Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Mamta Jajoo
- Department of Paediatrics, Chacha Nehru Bal Chikitsalaya Hospital, New Delhi, India
| |
Collapse
|
44
|
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, Chacha Nehru Bal Chikitsalya Hospital, New Delhi, India E-mail:
| | - Adweta Vire
- Department of Radiodiagnosis, Chacha Nehru Bal Chikitsalya Hospital, New Delhi, India E-mail:
| | - Rama Anand
- Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Ruchika Gupta
- Department of Pathology, Chacha Nehru Bal Chikitsalya Hospital, New Delhi, India
| |
Collapse
|
45
|
Sherwani P, Singhal S, Kumar N, Narula MK, Anand R, Pathania OP. Breast Filariasis Diagnosed by Real Time Sonographic Imaging: A Case Report. Iran J Radiol 2016; 13:e17991. [PMID: 27110331 PMCID: PMC4835870 DOI: 10.5812/iranjradiol.17991] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/23/2014] [Revised: 06/15/2014] [Accepted: 06/24/2014] [Indexed: 11/19/2022]
Abstract
A 30-year-old woman presented with a palpable subcutaneous nodule in the areolar region of the left breast. Sonomammographic examination revealed 2 cystic lesions showing typical “filarial dance” as vigorous twirling movement of multiple curvilinear echoes with mixed red blue color Doppler signals that was non-rhythmic, nonpulsatile, and the characteristic pulse Doppler trace due to irregular worm movement. Real time sonographic demonstration of these typical features is pathognomonic for filariasis, especially in endemic areas and treatment should be initiated without delay on the basis of ultrasound.
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
- Corresponding author: Poonam Sherwani, Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India. Tel: +91-9540464879, E-mail:
| | - Shweta Singhal
- Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
| | - Nidhi Kumar
- Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
| | - Mahender Kaur Narula
- Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
| | - Rama Anand
- Department of Radiodiagnosis, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
| | - Om Prakash Pathania
- Department of Surgery, Lady Hardinge Medical College, Smt Sucheta Kriplani Hospital, New Delhi, India
| |
Collapse
|
46
|
Singh GB, Arora R, Sherwani P, Garg S, Shukla S, Kumar D. A rare case of true thyroglossal fistula diagnosed by computed tomography fistulography. Journal of Oral and Maxillofacial Surgery, Medicine, and Pathology 2015. [DOI: 10.1016/j.ajoms.2014.11.005] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
47
|
Sherwani P, Anand R, Narula MK, Siddiqui AA, Aggarwal S. Concurrent nonfunctional paraganglioma of the retroperitoneum and urinary bladder: A case report with literature review. Indian J Radiol Imaging 2015; 25:198-201. [PMID: 25969646 PMCID: PMC4419432 DOI: 10.4103/0971-3026.155879] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [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: 11/15/2022] Open
Abstract
Paragangliomas are the neuroendocrine tumors which arise from the chromaffin cell. Tumors arising from the adrenal medulla are known as pheochromocytomas, while others originating from the extra-adrenal site are known as extra-adrenal paragangliomas. Paraganglioma can be multifocal which can arise synchronously or metachronously. Paragangliomas are less functionally active than the pheochromocytomas; they secrete noradrenaline and rarely dopamine, while adrenal pheochromocytomas secrete adrenaline or nor-adrenaline. Nonfunctional multifocal paragangliomas are very rare. We report a case of a 45-year-old female with multifocal nonfunctional paragangliomas of the retroperitoneum and urinarybladder which were surgically removed, and the diagnosis was confirmed on histopathology
Collapse
Affiliation(s)
- Poonam Sherwani
- Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Rama Anand
- Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Mahender Kaur Narula
- Department of Radiodiagnosis, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Azaz Akhtar Siddiqui
- Department of Surgery, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| | - Shilpi Aggarwal
- Department of Pathology, Lady Hardinge Medical College and Associated Hospitals, New Delhi, India
| |
Collapse
|
48
|
Abstract
Abdominal cerebrospinal fluid pseudocyst is an uncommon complication of ventriculoperitoneal (VP) shunt placement. We present the case of a 4 year old child in whom a VP shunt was placed for tubercular meningitis 5 months earlier. The clinical presentation, classic imaging findings and management of CSF pseudocyst in a child are discussed.
Collapse
Affiliation(s)
- Shivani Pahwa
- Assistant Professor, Department of Radiodiagnosis, Lady Hardinge Medical College, New Delhi, India
| | | | | |
Collapse
|
49
|
Dwivedi MK, Pal R, Jain M, Sherwani P, Nimbalkar N, Agrawal V. Efficacy ofFallopian tubecatheterization for treatment of infertility. Indian J Radiol Imaging 2005. [DOI: 10.4103/0971-3026.28787] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|