Clinico-radiological Profile Research Articles

Evaluation of the Clinicoradiological Profile in Cases of Allergic Bronchopulmonary Aspergillosis: An Original Research.

A complicated hypersensitive reaction to inhaled fungal antigens results in allergic bronchopulmonary aspergillosis (ABPA), an immunologic pulmonary disease. ABPA complicates nearly 2% of instances of persistent asthma as well as nearly 10% of chronic cases of steroid-dependent asthma, and it occurs most frequently in immunocompetent patients. The purpose of the current research was to analyze the radiological and clinical features of the participants as well as the serological association of ABPA. From April 2020 to April 2021, a retrospective investigation was conducted. The study included patients based on the International Society for Human and Animal Mycology's criteria for ABPA confirmation. Analysis was done on the demographic information and pathological and radiological test results of the patients. The patients' pre-bronchodilator and post-bronchodilator spirometry was compared, and asthmatic control was estimated. A total of 50 patients were investigated at in this study. Demographic findings indicated young subjects and aa female predominance. Cough was the most prevalent symptom in 84% of patients. Asthma of the bronchi was a risk factor for all of the patients. The mean serum immunoglobulin E level and the mean absolute eosinophil count were 533 cells/L and 2269 UI/mL, respectively. Spirometry results from the study's participants indicated an obstructive pattern in about 80% of cases. The most typical radiological abnormality observed was bronchiectasis, followed by parenchymal opacities. In conclusion, when treating asthma that is challenging to control, the diagnosis of ABPA must be taken into account. Delay in diagnosis might result in declining lung function, worsening asthma control, possibly irreversible alterations, greater treatment costs, and declined quality of life.

A COMPARATIVE STUDY OF SEVERITY OFPULMONARY TUBERCULOSIS AMONG DIBETICS AND NON DIBETICS PATIENTS IN TERTIARY CARE HOSPITAL

Aim: To assess the clinical and radiological profile of pulmonary tuberculosis patientswith and without diabetics in order to understand the various presenting modalities, etiological pattern, severity of TB and clinical-radiological connection of the study population. Design: Comparative cross-sectional study. Materials & Methods:This is a hospital based cross sectional study conducted at a tertiary care hospital. We were enrolled total of 100 patients with pulmonary tuberculosis and screen them for diabetes militants. To obtain data, a predesigned and pretested questionnaire was used. A clinico-radiological profile of pulmonary tuberculosis between with and without diabetes patients were compared. Results:We recruited 100 pulmonary tuberculosis patients among them 32% werediabetes and 68% without diabetes.The most common clinical presentation among both with and without diabetes mellitus group was expectoration, it was slightly more common in non-diabetes group (84%) as compared todiabetes (79%). This followed by evening rise in fever which was slightly more common in non-diabetes group (78%) as compared diabetes group (74%).The most common radiological presentation among both with and without diabetes mellitus group was Infiltrations, however, it was more common in diabetes group (90.6%) as compared to non-diabetes group (70.6%). This followed by cavitary which was again more common in diabetesgroup (78.1%) as compared non-diabetesgroup (50%).Most of non-diabetic patients were falling into1+ and 2+ category. In both sample the severity of the disease 3+ was more in diabetes patients than non- diabetes. Conclusion:Diabetic patients were more likely to get a serious pulmonary infection. More over 40 years of age has more chance of this twin morbidity. Detection and treatment of DM among TBpatients may have a beneficial impact on TB control.

1364-P: Cinicoradiological and Microbial Spectrum of Skull Base Osteomyelitis and Its relation to Diabetes Mellitus

Skull base osteomyelitis (SBO) is a rare life-threatening disease, which is on the increase specifically the incidence of fungal skull base osteomyelitis. Objectives: To describe the demographic, and clinicoradiological profile, and to assess the outcome of skull base osteomyelitis. Methodology: A prospective study from a tertiary care centre, in Kerala from 1st February 2018 to 31st August 2019 with a minimum follow-up of 6 months. All patients diagnosed with skull base osteomyelitis were included. The demographic profile and relevant investigations, radiological correlations and treatment outcomes were analysed. Results and Discussions: 30 patients (23 males and 7 females) were studied. Incidence was found to be high in the age group 51-60 years. The mean (SD) of Age (Years) was 62.02 (14.21), ranging from 1.5-78 years. The most common presentation was a nocturnal earache (86.7%).13.3% of patients presented with headache alone, these cases were diagnosed to be central skull base osteomyelitis and had a significant association with clival erosion. All the patients were having diabetes mellitus except 1.5 yrs old who had congenital cyclic neutropenia. We could see an association between uncontrolled blood glucose and the severity of the disease (P value <0.001). 63.3% of the participants had Cranial Nerve Palsy at the presentation. The culture yielded Pseudomonas followed by staphylococcus aureus, MRSA & Aspergillus. The ESR and CRP levels were reliable for the detection, progression and resolution of disease status in SBO. All patients were treated with third-generation cephalosporins and fluoroquinolones for a minimum of 6 weeks and of which, 12 patients with fungal SBO were given antifungals also. Conclusions: Skull base osteomyelitis is an entity that requires a lifelong commitment. A high index of suspicion, early diagnosis, and prompt and aggressive management are critical for a positive outcome. Uncontrolled diabetes mellitus was the risk factor recognised. Disclosure S.Radhakrishnan: None. D.C: None. V.Dahiya: None. C.R: None.

A Study of Clinico-Radiological Profile and Outcomes of Cerebral Venous Thrombosis

ABSTRACT Background: Cerebral venous thrombosis (CVT) includes highly variable clinical presentations ranging from headache to coma. It often affects young to middle-aged patients. Early diagnosis and treatment improve outcomes. Outcome determinant factors are the extent of the disease, jugular occlusion, spread to deep or cortical veins, level of sensorium at onset, background factors, and presence of raised intracranial pressure. Objectives: This study aims to study the clinical profile, radiological features, and outcomes of CVT. Materials and Methods: Fifty-seven patients admitted to SSIMS&RC, Davangere, clinically suspected of CVT, were subjected to neuroimaging techniques, patients with a confirmed diagnosis of CVT (radiologically) were recruited by simple random sampling, and data collected was analyzed by correlational studies. Follow-up was done until 6 months. Results: Of the 57 patients, 30 (53%) were females and 27 (47%) were males, with a maximum incidence of 84% in the age group 18–40 years. The most common symptoms were headache (86%), seizures (65%), focal deficits (58%), and altered sensorium (52.6%). Radiologically, the most common sinus involved was the superior sagittal sinus 72%. In total, out of 57 patients, 6 patients died during hospitalization. Out of the surviving patients, 39 patients (70%) had a complete recovery. Poor prognostic factors were stupor and coma on admission and evidence of hemorrhagic infarction in the primary computed tomography (CT) scan. Conclusion: Compared to the previous studies, the prevalence of CVT was higher in women. Clinical manifestations, prognostic factors, “commonly involved sinuses,” and “image findings of this study” were similar to those of other studies. The overall prognosis was good, but a small percentage of patients died.

Clinical and radiological profile of cavernous sinus syndrome: a study from eastern part of India

BackgroundCavernous sinus syndrome (CSS) consists of a variable combination of involvement of the 3rd-to-6th cranial nerves. The etiologies vary across studies, and it has a significant impact on the outcome. This study was done to delineate the etiology, clinico-radiological profile and outcome of CSS. In this prospective study, patients were recruited consecutively over 2 years, and were followed up for at least 6 months. MRI of the brain and orbit with contrast was done, and other relevant investigations were performed to arrive at a specific etiology. Tolosa-Hunt Syndrome (THS) was defined in accordance with the second edition of the International Classification of Headache Disorders (ICHD-II).ResultsOf the 92 patients studied, THS was the predominant diagnosis, followed by Tuberculosis, fungal infection, aneurysm, neoplastic and Sjögren’s syndrome. Cranial nerves commonly involved were 3rd, 4th, 6th and 5th. The optic nerve was affected in 54.3% of patients. The non-THS patients showed the greater occurrence of proptosis, complete ophthalmoplegia, involvement of optic nerve and cranial nerves 7th–10th. Nasal blockage was present in fungal infection. MRI revealed more frequent involvement of orbit in non-THS cases. Bony erosions, ICA narrowing, intracranial extension and involvement of paranasal sinus were seen in fungal infection and neoplasm. THS patients improved with corticosteroid therapy, although, there was recurrence in 8 patients.ConclusionsTHS and tuberculosis were the most common cause of CSS. Clinical and radiological features were useful in distinguishing among the etiologies. Most of the patients responded to treatment, although, recurrence was seen in THS.

Clinico-Radiological Profile of Patients with Connective Tissue Disease (CTD) Associated Interstitial Lung Disease (ILD) At a Tertiary Care Center in India

Interstitial lung diseases (ILDs) are a group of heterogenous disorders characterized by varying degree of fibrosis in lung [1]. Work-up for connective tissue diseases (CTDs) is an important component of evaluation of a patient with ILD. CTDs affect connective tissue in various organs resulting from poorly controlled autoimmune responses, and associated inflammation. Overall ILD has been documented in up-to 15% of patients with CTD, with rates as high as 26% in Systemic Sclerosis (SS) [2]. Lung involvement contributes to mortality in CTDs, and the management of ILDs depends on the presence and severity of underlying CTDs. Hence it is necessary to understand the clinical presentation of CTD-ILDs

Profile of COVID-19 Patients with Persistent Respiratory Symptoms

Background and objective: COVID pandemic struck the entire world causing high mortality and morbidity. After-effects of the infection were manifested in various clinical forms for the varying duration. As the pandemic waxes and wanes, COVID has become one of the differential diagnoses for various clinical and radiological pictures and triggers for respiratory diseases. While COVID sequelae are still much to explore, this study aimed to assess the clinicoradiological profile of COVID-19 patients who have persistent symptoms pertaining to the respiratory system. Materials and methods: This prospective study was conducted for 1 year from December 2020 to December 2021. COVID-19 patients aged between 10 and 85 years with persistent respiratory symptoms were included in this study. Results: There were a total of 90 patients. The mean age was 50.79 years. Forty-eight (53.3%) patients were males and 42 (46.7%) were females. Among these patients, eight patients (8.9%) had an asymptomatic or minimal symptomatic gap of at least 2 weeks from the date of positivity to the development of full-blown symptoms. The maximum duration of symptoms reported was more than 1 year and continuing. Dyspnea on exertion was the predominant symptom, in 59 patients (65.6%). Hypoxia at rest was seen in 35 (38.9%) patients, whereas seven patients with normal oxygen saturation showed exertional desaturation. Out of the 33 patients with post-COVID changes in computed tomography (CT) of the thorax, ground-glass opacities were seen in all 33 patients (100%), consolidation in 18 patients (54.5%), septal thickening in 18 patients (54.5%), and fibrosis in 15 patients (45.4%). Predominant CT finding was that of organizing pneumonia, but a few had fibrotic picture similar to usual interstitial pneumonia (UIP) or fibrotic nonspecific interstitial pneumonia (fibrotic NSIP). Hypoxia severity was significantly associated with diabetes (p = 0.028), hypertension (p = 0.028), chronic kidney disease (p = 0.027), chronic obstructive pulmonary disease (p = 0.001), obesity (p = 0.000), and smoking (p = 0.004). CT severity scoring was significantly associated with hypoxia severity. Conclusion: After the initial weeks, COVID patients can present with varying respiratory symptoms. They can present with respiratory failure as late as 1 month after the test positivity. Although CT picture was predominantly that of organizing pneumonia, COVID lung sequelae can masquerade as UIP or fibrotic NSIP as in idiopathic pulmonary fibrosis and connective tissue disease-associated interstitial lung disease, whereas atypical infections and malignancy can masquerade as COVID lung. Irreversible changes like honeycombing can occur as early as 2nd month after COVID.

Clinical profile and mortality predictors in hospitalised patients of tuberculous meningitis

Background& Objective: Tuberculous meningitis (TBM) is a serious public health problem in developing countries like India as it leads to significant mortality and neurological sequelae. Aim of study was to describe clinico-radiological profile of TBM and determine predictors of mortality. Methods: This was a prospective study and data collected including demographic details, clinical, laboratory parameters and neuroimaging finding. Diagnosis of TBM was based according to a standard case definition proposed by Marais et al.(2010). Results: One hundred and forty two TBM patients were recruited with 54.93% males and 45.07% females. Fever was most common symptom followed by headache, vomiting, altered sensorium and seizure. Most common cranial nerve palsy was of 6th cranial nerve followed by 2nd cranial nerve. Cerebrospinal fluid (CSF)study in 77.46% of patients showed protein >100 mg/dL, 61.27% patients had CSF sugar <40 mg/dL while 87.32% of patients had total cell count >10 cells/cumm. Most common Neuroimaging finding was meningeal enhancement followed by hydrocephalus, infarcts, basal exudates and tuberculoma. In-hospital mortality was 17.61%. Higher age, low Glasgow Coma Scale (GCS) score, absence of headache, seizure, altered sensorium, anemia, low CSF glucose, infarct, hydrocephalus, and British medical research council (BMRC) Stage III at presentation were predictors of in-hospital mortality. Conclusions:. Age, GCS score, absence of headache, seizure, altered sensorium, anemia, low CSF glucose, infarct, hydrocephalus, and BMRC Stage III at presentation were predictors of in-hospital mortality based on this study from Bihar, India.

Comparison of clinico-radiological profile, optical coherence tomography parameters, and outcome in MOGAD and Neuromyelitis optica spectrum disorder subtypes: A prospective observational study.

The objectives of the study were to compare the clinico-radiological profile, optical coherence tomography (OCT) parameters and outcome in Myelin Oligodendrocyte Glycoprotein-IgG-associated disorders (MOGAD) and Neuromyelitis Optica Spectrum disorder subtypes. This prospective study involved collection of data regarding neurological assessment, neuroimaging, cerebrospinal fluid analysis, OCT parameters, treatment and outcome. Disease severity and disability were assessed using Expanded Disability Status Scale and modified Rankin scale. Patients were categorized into aquaporin-4 (AQP4+), MOGAD, and double negative (DN; both AQP4 and MOG negative). Among 31 patients included, 42% were AQP4+, 32.2% were MOGAD, and 25.7% were DN. The median age at onset was comparable (AQP4+ vs. MOGAD vs. DN = 28 years vs. 24.4 years vs. 31.5years; P = 0.31). Females predominated in AQP4+ compared to MOGAD group (76.9% vs. 30%; P = 0.02). Majority of patients (73.5%) had a relapsing course with a median of two (range = 1-9) relapses. Ninety-nine demyelinating events occurred: Transverse myelitis (TM) in 60/99 (60.6%), optic neuritis (ON) in 43/99 (43.4%), area postrema (AP) syndrome in 20/99 (20.1%), and optico-spinal syndrome in 10/99 (10.1%). ON was common in MOGAD than AQP4+ patients (58.6% vs. 32.1%; P = 0.03). Spinal cord and brain lesions on magnetic resonance imaging (MRI) were seen in 90.3% and 54.8% patients, respectively. A significantly higher proportion of AQP4+ patients showed longitudinally extensive transverse myelitis as compared to MOGAD group (69.2 % vs. 20 %; P = 0.04), specifically involving dorsal cord (92.3% vs. 50%; P = 0.02). MRI brain lesions, especially involving AP, was frequent in DN than MOGAD (47.1% vs. 6.9%; P = 0.003) and AQP4+ (47.1% vs. 18.9%; P = 0.03) patients. AQP4+ group showed significant nasal RNFL thinning on OCT (P = 0.04). Although 6-month good functional outcome was better in MOGAD than DN and AQP4+ (80% vs. 71.4% vs. 41.7%) groups, they were comparable (P = 0.13). Nearly three-fourth of our patients showed a relapsing course, with TM being the most common clinical presentation. AQP4+ group showed female preponderance, frequent dorsal cord longitudinally extensive transverse myelitis, less frequent ON, and greater nasal RNFL thinning compared to MOGAD group. MRI brain lesions were more common in DN patients. All three groups exhibited good response to pulse corticosteroids and showed a comparable functional outcome at 6-month follow-up.

Clinical, Biochemical, and Radiological Correlation in the Severity of Acute Pancreatitis: A Retrospective Study.

To analyze the etiologies and the varying clinical presentationsand to validate the clinical, biochemical, and radiological signs with severity and prognosis of acute pancreatitis. A retrospective study of 1316 patients diagnosed with acute pancreatitis in an industrial hospital inJamshedpur, Jharkhand, was conducted, and their clinicoradiological profiles, etiological factors, and outcomes were studied. A total of 1316 cases were enrolled, out of which maximum cases (411 [31.23%]) were from the age group of 30-44 years, and the mean and median age were 44.54 and47 years, respectively. A total of 731 (55.45%) patients had social habits (i.e., alcohol and smoking), and 585 (44.45%) patients did not have any social habits. Based on the etiology of acute pancreatitis (AP), the majority of cases were due to alcoholism (710 [53.95%]) followed by gallstone (343 [26.06%]) and idiopathicpancreatitis(217 [16.48%]). As per the severity of AP, most patients showed mild pancreatitis (937 [71.20%]) followed by moderate (312 [23.71%])and severe pancreatitis (67 [05.09%]). Mild and moderate pancreatitis patients were shown in 85 and 28 cases,respectively, suggestive of chronic pancreatitis after repeated episodes of AP. But severe pancreatitis shown in 19 cases had hypocalcemia + shock + multi-organ dysfunction syndrome (MODS). In mild, moderate, and severe AP, the mortality rateswere 19 (02.03%), 44 (14.10%), and 21 (31.34%), respectively. Overall, 1232 (93.62%) of AP cases recovered and were discharged in stable condition, but 84 (06.38%) cases expired. AP is a common cause of acute abdomen in patients presenting to the surgical emergency department. The management is mainly conservative with surgery limited to only a few selected cases, depending upon the severity of the disease.

Clinico-Radiological Spectrum of Non-Compressive Myelopathies

Objective: To study the etiology and clinico-radiological profile of non-compressive myelopathies. Methods: 40 consecutive admissions of non-compressive myelopathy were studied for clinical and radiological profile. Statistical methods: Descriptive statistics, linear regression and independent t-test using SPSS 20. Results: Age of the studied population ranged from 2 years to 55 years with a median age of 32.35 years and male:female ratio of 2:1. 87.5% of cases had an acute to subacute presentation. Complete cord syndrome was the most common presentation followed by anterior cord syndrome, central cord syndrome and mixed pattern. LETM was seen in nearly two-thirds of cases. Lesions involving more than two-thirds of the cross section of spinal cord were seen in more than 60% of cases, thereby accounting for significant disability at onset. Most of the lesions were hyperintense on T2 and STIR images and isointense on T1 with only 18.91% showing contrast enhancement. Optic neuritis was recorded with an overall prevalence of 28.26%. EDSS at presentation varied among the subgroups with ADEM, NMOSD and LETM form of ITM having EDSS scores of 9.5,8.0 and 7.5 respectively whereas in MS and Non-LETM form of ITM, EDSS score was 4.0 and 2.5 respectively. Conclusion: Demyelinating disorders contribute to nearly 80% cases of non-compressive myelopathies with NMOSD being the most common pathology. CSF cell count, cross-sectional involvement of spinal cord, pattern of myelitis and aquaporin-4 seropositivity were found to be predictive of the severity at onset i.e., EDSS at presentation with the initial 3 factors also showing predictability of EDSS at last visit.

Socio-demographic factors, clinico-radiological profile of patients with traumatic cervical spine injury in South India, and its association with short-term clinical outcome.

Spinal cord injury is a devastating condition to an individual and his/her family imposing an economic burden on the family, society, and the country. Finding out the demographic and morbidity profile of cervical spine injuries is essential for formulating means and ways for its prevention and treatment. This study aimed at assessing the clinico-radiological and socio-demographic profile of cervical spine injury patients and their association with short-term clinical outcomes. This was a prospective observational study that included 120 patients with cervical spine/cord injury. Social, demographic, clinical, and radiological parameters of the study participants were recorded. Improvement, worsening, and neurological stability at 2 weeks follow-ups were considered as a short-term outcome. The association of neurological outcomes with clinico-radiological profile and socio-demographic characteristics was analyzed to study the level of significance. The study found that nearly 81% of the study participants were involved in heavy physical activity, and 45% of the cases sustained cervical spine injury because of falls from height. About 37% and 55% of patients had complete and incomplete cord injury, respectively. Computerized tomography of the spine injury patients showed a fracture, subluxation, and locked facets. Magnetic resonance imaging showed disco-ligamentous injury and cord contusion in these patients. Nearly 29% of patients showed motor improvement, and around 4% of patients had a worsening of their neurological status after 2 weeks. Most of the people who sustain cervical spine injuries are involved in heavy physical work. Female gender, incomplete cord injury, and unilateral locked facet in subluxation are associated with good neurological outcomes. This study will form a preliminary base to build a larger database on spinal cord injury at the regional and national levels.

Clinicoradiological profile and predictors of postcoronavirus disease syndrome – Lessons learned and the way forward

Clinicoradiological profile and predictors of postcoronavirus disease syndrome – Lessons learned and the way forward

Clinicoradiological profile and outcome of cavernous sinus syndrome with coronavirus disease-2019-associated rhino-orbito-cerebral mucormycosis.

With coronavirus disease 2019 (COVID-19) pandemic across the world, there had been an exponential increase in rhino-orbito-cerebral mucormycosis (ROCM). Extension of infection to cavernous sinus leads to cavernous sinus syndrome (CSS). This study aims to describe incidence, clinicoradiological profile, and outcome of CSS positive along with comparative analysis of CSS negative COVID-19-associated ROCM. This was a prospective and observational study conducted from May 1, 2021, to July 31, 2021. Subjects included ROCM with active or recovered COVID-19 (past 6 weeks) and were categorized and staged. CSS was defined as involvement of two or more of third, fourth, fifth, or sixth cranial nerve with one each direct and indirect qualitative neuroradiological features. Clinicoradiological features of CSS-positive and negative COVID-19-associated ROCM groups were compared. Incidence of CSS with COVID-19-associated ROCM was 28%. Mean age of subjects was 44 ± 15 years with 60% being males and 73% were proven ROCM. Significant differences seen across the CSS-positive and negative groups were ocular, nasal, and cerebral findings including eyelid and periocular discoloration, ptosis, proptosis, ophthalmoplegia, nasal discharge, mucosal inflammation, and fever. Oculomotor, trochlear, and abducens nerves were significantly involved more in CSS-positive group. Significant radiological findings across two groups included indirect features in orbit, nose, and paranasal sinuses along with direct features in cavernous sinus. Surgical intervention was more common in CSS-positive group. Mortality in CSS-positive group at 8-24 weeks was 13 and 27%, respectively. Extension of ROCM to CSS was more common in young males in advanced stages of proven ROCM with concurrent COVID-19. CSS-positive group had significant difference in clinicoradiological features involving orbit, nose, paranasal sinuses, and central nervous system as compared to CSS-negative group. This study highlights the need to develop an objective scoring system considering clinical and radiological features for diagnosis of CSS with COVID-19-associated ROCM.

Clinico-radiological Profile and Outcome of Children with Viral Pneumonia admitted to Paediatric Intensive Care Unit in the pre COVID 19 period

Introduction: Viruses are common etiological agents of severe acute respiratory illness in under five children. Very few studies are available considering the profile of children with viral pneumonia admitted to paediatric intensive care unit (PICU) in our setting. Hence this study was done to describe the clinico- radiological profile and outcome of children diagnosed with viral pneumonia admitted to PICU. Methods: This was a retrospective descriptive study done in the PICU of a tertiary care hospital in South India. The presenting clinical features, blood parameters, chest radiography findings, course during the hospital stay and outcome of children with viral pneumonia (RT- PCR Positive) admitted to PICU were studied. Results: The aetiological profile of 28 children included - Influenza virus - 14 cases, Respiratory Syncytial Virus - 6 cases, Adeno virus - 4 cases, Human Boca virus - 2 cases, Human Rhino Virus - 1 case and Human metapneumo Virus - 1 case. Majority of children (50%) presented with severe respiratory distress. Predominant radiological picture included bilateral interstitial infiltrates followed by patchy alveolar consolidation. Eight children required mechanical ventilation. Complications included septic shock and MODS (n = 5), pneumothorax (n = 2), myocarditis (n = 2), pleural effusion (n = 1), ventilator associated pneumonia (n = 2) and pulmonary artery hypertension (n = 2). Mortality was observed in seven (25%) children. SpO2 / FiO2 ratio < 300, shock at admission, neutrophil leucocyte ratio > 2 and hypoalbuminemia were found to be significant predictors of mortality. Conclusions: Malnutrition and iron deficiency analmia were the common risk factors. Patchy alveolar consolidation is also a common radiological finding along with interstitial infiltrates. Hypoalbuminemia was a common finding among non-survivors.

Evaluation of Clinico-Radiological and Functional Profile of Patients with Bronchiectasis According to FACED Score

Evaluation of Clinico-Radiological and Functional Profile of Patients with Bronchiectasis According to FACED Score

Clinico-Radiological Profile of Patients With Lateral Medullary Syndrome: A Five Years Observation From a Single-Centered Tertiary Hospital in Nepal.

Objective: We aim to correlate the prevalence of symptoms of the lateral medullary syndrome (LMS) based on radiological classification.Methods: A five-year record of 41 patients diagnosed with LMS and admitted to a tertiary care center in Nepal was reviewed. We used chi-square tests to compare symptoms between rostral and caudal groups and different horizontal subtypes.Results: The subtype prevalence in the horizontal classification of LMS was large (31.7%), lateral (22%), dorsal (19.5%), typical (14.6%), and ventral (12.2%). The most common symptoms in the typical subtype of the horizontal classification were: pain/temperature loss in the contralateral body (7.3%) and dysphagia (7.3%); in the ventral subtype, swaying on the Romberg test (12.2%), dysarthria (9.8%) and dizziness (9.8%); in the dorsal subtype, headache (12.2%) and vomiting (12.2%). Whereas headache (22.2%) and lateropulsion on standing (14.6%), swaying on the Romberg test (14.6%), nausea/vomiting (14.6%) were common in the large subtype, and nausea/vomiting (19.5%) and headache (17.1%) in the lateral subtypes. Whereas, in rostrocaudal classification, the rostral subtype (61%) was more common than the caudal subtype (31%). There was no significant variation in symptoms based on the rostrocaudal classification of LMS.Conclusion: The common clinical manifestations are different for different radiological subtypes of LMS. Further comprehensive studies are essential to understand the prevalence of symptoms in different radiological subtypes and the clinical-radiologic correlation in LMS.

Histopathological Patterns of Lung Cancer along with Clinico-Radiological Correlation in a Tertiary Care Hospital in Bangladesh

Background: Lung cancer is the most common fatal neoplastic disease and the leading cause of cancerrelated deaths worldwide. In Bangladesh, lung cancer has been on the rise, possibly due to an increase in smoking and air pollution. So, it is essential to understand the natural history of this disease. Aim: This study aimed to find out the correlation between Clinico-radiological profiles with histopathological patterns of lung cancer in Bangladesh. Material and Methods: A total of 100 confirmed cases of lung cancer were included in this crosssectional observational study between January 1, 2021, to December 31, 2021. The complete sociodemographic characteristics, smoking status, previous history of COPD, details of radiological imaging findings, pathological characteristics of the tumor, and the performance status of patients were recorded in this study. Data were entered and analyzed using SPSS software. Results: A total of 100 (86 male, and 14 female) confirmed lung cancer patients were included in our study with a mean ± SD age of 59.57±10.41 years. Cough (87%), breathlessness (61%), and chest pain (58%) were the most common symptom and mass lesions (83%) followed by collapse (8%) was the most common radiological presentation. Among the histopathological types adenocarcinoma (48%) was the most common type followed by squamous cell carcinoma (35%). Correlation showed that mass lesion was the most common radiological finding in both adenocarcinoma and squamous cell carcinoma. ECOG performance status 2, and status 3 were about 36% and 35% respectively. Multivariate logistic regression analysis shows male gender with COPD independently had a 1.681-fold risk of developing lung cancer. Conclusion: The Clinico-histopathological pattern of lung cancer has changed recently. The incidence of adenocarcinoma is increasing, and becoming the most common cause in both smokers and non-smokers. J MEDICINE 2022; 23: 126-131

Sarcoidosis in North Indian Population: A Retrospective Study

Sarcoidosis is a systemic granulomatous disease of unknown origin most commonly involving the lungs. Sarcoidosis is frequently misdiagnosed due to its clinico-radiological resemblance to tuberculosis (TB). Hence, the present study was undertaken with the aim of studying the clinico-radiological profile of sarcoidosis in the Indian context. We retrospectively studied 146 patients diagnosed to have sarcoidosis during the period 2001-2010 at one of the respiratory units at Vallabhbhai Patel Chest Institute. Majority of them (70%) were more than 40 years of age; females comprised 58.2% of the patients. Before coming to our clinic, 30% patients had been misdiagnosed to have TB. Cough (89.7%) was the most common presenting symptom; joint symptoms (28.8%) and end inspiratory crepitations at lung bases (49.3%) were other salient manifestations. Cutaneous involvement and digital clubbing were rarely seen. Pulmonary function testing showed restriction with impaired diffusion in 72.7% patients. The most common radiological feature was bilaterally symmetrical hilar lymphadenopathy. Transbronchial lung biopsy (TBLB) had a very high diagnostic yield (90.8%). Sarcoidosis is often misdiagnosed as TB in India. Transbronchial lung biopsy has high diagnostic yield in sarcoidosis.

Clinico-radiological features of cerebral proliferative angiopathy: A large case series from India.

Based on angiographic features, a rare subgroup, different from classical brain AVMs, called cerebral proliferative angiopathy (CPA) was suggested by Lasjaunias et al. in 1989. There are only few reports of CPA described from Asia. Liu et al. has described 5 cases of CPA from China. The objective of study was to evaluate the clinico-radiological features of patients with CPA in our cohort and to find out the differences between our study and the study by Lasjaunias and Liu et al. We retrospectively analysed cases of CPA from March 2012 to April 2020. All radiological images of the patients with AVMs were studied and findings suggestive of CPA were identified. We found 10 patients with CPA out of 272 cases of AVM (10/272) and described the various demographic and clinico-radiological features. The age of the patients with CPA in our series varied from 14 to 53years and the mean age was 28.6years. There was male preponderance (60%) with male to female ratio of 3:2. The most common presentation was seizure (70%). Intracranial haemorrhage was present in five patients. One patient had cerebral infarction. There were substantial differences in clinico-radiological profile of patients with CPA in our cohort as compared to the study by Lasjaunias et al. and Liu et al. in form of male dominance, higher rate of ICH and seizure. In our knowledge, this is the second largest series of CPA worldwide and the first largest series in Asia.