Publications by authors named "Rakesh Kumar Gupta"

159 Publications

Transversus abdominis release for complex incisional hernias-a case report.

J Surg Case Rep 2021 Jul 14;2021(7):rjab281. Epub 2021 Jul 14.

Department of Surgery, Nepal Army Institute of Health Science (NAIHS), Kathmandu, Nepal.

Complex ventral hernia repair has been a challenging task of difficulty in primary closure of the defects. Transversus abdominis muscle release (TAR) procedure, as a type of posterior component separation, is a new myofascial release technique in complex ventral hernia repair. TAR creates immense retro muscular plane and allows bilaminar ingrowth of the mesh, allowing primary closure of defect. Owing to its favorable outcome, suitability of TAR technique in treatment of complex ventral hernia could be explored further where closure of the primary defect is difficult.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jscr/rjab281DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8279692PMC
July 2021

Role of intra-operative squash cytology in rosette-forming glio-neuronal tumor of the fourth ventricle; A case report.

Int J Neurosci 2021 Jul 19:1-5. Epub 2021 Jul 19.

Department of Neurosurgery, G B Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.

Rosette-forming glioneuronal tumor (RGNT) of the 4 ventricle is a newly described WHO grade I brain tumor included in recent WHO classification of CNS tumors. It is a biphasic tumor thought to originate from pluripotent progenitor cells of subependymal plate. Intra-operative diagnosis plays an important role, as complete surgical excision is the treatment of choice. We are reporting a case of RGNT in a 19 years-old young male emphasizing the intra-operative pathological pointers and their role in accurate diagnosis for the suitable surgical intervention.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1080/00207454.2021.1955880DOI Listing
July 2021

A Giant Nondural-Based Lumbosacral Clear Cell Meningioma Mimicking Schwannoma: A Case Report and Review of the Literature.

Asian J Neurosurg 2021 Jan-Mar;16(1):44-50. Epub 2021 Feb 23.

Department of Neurosurgery, AIIMS, Raipur, Chhattisgarh, India.

Spinal clear cell meningiomas (CCMs) are rare and dural-based lesion usually affecting the younger population. We report the rare case of giant nondural-based spinal CCM mimicking schwannoma and review the literature. A literature search was performed at PubMed and Embase until January 1, 2020. A total of 19 cases of nondural-based spinal CCM was reported. The following relevant data were extracted: authors, publication year, patient and tumor characteristics, treatment, and outcome. The mean age of the presentation was 20.58 years. Twelve (63.16%) were female and seven patients (36.84%) were male. The most common location was lumbosacral region 15 (79%). Fifteen (79%) tumors had cranio-caudal dimension ≤2 vertebral level, and only four (21%) tumors had dimension ≥2 vertebral level. Gross total resection (GTR) was performed in 18 (95%) patients and subtotal resection (STR) in 1 patient. Recurrences were reported in five (26.14%) patients. Four of them showed recurrences within 6 months; earliest at 2.3 months in the patient had undergone STR. Our patient is 19-year-old male diagnosed with a lumbosacral intradural lesion. Craniocaudal dimension is ≥2 vertebral level shows the foraminal extension and vertebral scalloping. GTR is performed. Intraoperatively, the tumor has foraminal extension and shows attachment with right S1S2 nerve root. No dural attachment is found. Six-month follow-up magnetic resonance image shows no evidence of disease. Nondural-based spinal CCMs are extremely rare and should be kept as a differential diagnosis in young patients with giant intradural tumor, and whose radiological features suggesting of schwannoma. It affects young patients and usually involves more than one vertebral level. The chances of recurrences and metastasis are always high even after GTR; hence, close follow-up of the entire neuraxis is warranted.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/ajns.AJNS_385_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8202374PMC
February 2021

Isolated duodenal injury presenting as Fournier's gangrene: A case report.

Clin Case Rep 2021 Jun 22;9(6):e04232. Epub 2021 Jun 22.

Department of Surgery B P Koirala Institute of Health Sciences Dharan Nepal.

Isolated duodenal injury is rare as they are usually associated with other visceral injuries. Diagnosis of a duodenal injury is difficult, and its management is challenging. Hence, it is important to timely recognize such injuries for better outcome.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/ccr3.4232DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8218324PMC
June 2021

Degradation of chlorpyriphos and polyethylene by endosymbiotic bacteria from citrus mealybug.

Saudi J Biol Sci 2021 Jun 27;28(6):3214-3224. Epub 2021 Mar 27.

Department of Biotechnology, College of Sciences, Taif University, Taif 21944, Saudi Arabia.

Chlorpyriphos is one of the major organophosphorus pesticides used widely to control a range of insect pests across several crops. This insecticide is hazardous to the environment and toxic to mammals, thus, it is essential to remove the same from the environment. Similarly, use of polythene is also increasing day by day. Therefore, it is highly important to identify ways to degrade chlorpyriphos and other pesticides from the environment. We studied the degradation of chlorpyriphos and polyethylene by Citrus mealybug () bacterial endosymbionts such as and . This investigation revealed that bacterial endosymbionts use the polythene as a source of carbon and solubilize them by their enzymatic machinery. The degradation of polyethylene by endosymbionts showed a significant reduction in weight of polyethylene sheet after 15, 30 and 45 days of treatment. The SEM images showed localized degradation of the polyethylene around the bacterial cells in the biofilm. Further, the tensile strength (percentage elongation) was significantly reduced after 45 days of incubation. The weight of paraffin wax showed significant reduction in . A significant reduction in total amount of chlorpyriphos in soil was observed at an interval of 7, 14 and 21 days after treatment by the bacterial isolates. Among the bacteria, and were found to be most effective. The results from this study show that endosymbionts can be significantly implicated in degrading chlorpyriphos and polyethylene from the environment.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.sjbs.2021.03.058DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8176133PMC
June 2021

miRNA-149 targets PARP-2 in endometrial epithelial and stromal cells to regulate the trophoblast attachment process.

Mol Hum Reprod 2021 May;27(6)

Female Reproductive Biology Laboratory, Division of Endocrinology, CSIR-Central Drug Research Institute, Lucknow, India.

Embryo implantation is a highly complex process involving many regulatory factors, including several micro RNAs (miRNAs/miRs). One miRNA present in the stromal cells of normal endometrium is miR-149, which targets poly (ADP-ribose) polymerase 2 (PARP-2), a gene involved in endometrial receptivity for trophoblast implantation. However, the precise role of miR-149 in the endometrial receptivity during blastocyst implantation is still unknown. We studied miR-149-dependent PARP-2 regulation during trophoblast attachment to endometrial epithelial cells. Using FISH, we found that miR-149 is expressed in mouse endometrial epithelial and stromal cells at implantation and inter-implantation sites. Endometrial receptivity for embryo implantation and attachment is inhibited by the upregulation of miR-149 in the endometrium. Our RT-PCR analysis revealed downregulation of miR-149 in the implantation region of the uterus during the receptive stage (Day 5, 0500 h, p.c.) in the mouse. Under in-vitro conditions, miR-149 overexpression in human endometrial epithelial cells (hEECs) abrogated the human trophoblastic cells spheroid and mouse blastocyst attachment. Subsequently, miR-149 also regulates transformed human endometrial stromal cell (T-hESCs) decidualization by downregulating PARP-2 and upregulating caspase-8 proteins. Overexpression of miR-149 in hEECs and downregulated PARP-2 protein expression, reconfirming that PARP-2 is a downstream target of miR-149 in endometrial cells as well. miR-149 is also able to alter the expression of caspase-8, another PARP-2 regulator. In conclusion, our data indicate that miR-149 is one of the regulators of endometrial receptivity and decidualization for trophoblast implantation, and it exerts the effects by acting on the downstream targets PARP-2 and caspase-8.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/molehr/gaab039DOI Listing
May 2021

Editorial for "Serum Ceruloplasmin Depletion is Associated With the Widespread Accumulation of Brain Iron in Parkinson's Disease".

J Magn Reson Imaging 2021 May 11. Epub 2021 May 11.

Department of Radiology and Imaging, Fortis Memorial Research Institute, Gurugram, Haryana, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/jmri.27694DOI Listing
May 2021

Precise Implantation of an Archimedean [email protected] Cuboctahedron into a Platonic CuBis(diphenylphosphino)hexane Tetrahedron.

ACS Nano 2021 May 28;15(5):8733-8741. Epub 2021 Apr 28.

School of Chemistry and Chemical Engineering, State Key Laboratory of Crystal Materials, Shandong University, Ji'nan 250100, People's Republic of China.

Precision loading of nanoclusters in confined spaces, which has been enthusiastically pursued in the scientific realm, is still associated with some mysteries of "how", "when", and "why". Here, we isolated two similar heterometallic cluster-in-cage compounds, [[email protected]@Cu(dpph)]X (X = OH, and X = PF, ; = ), by use of an antigalvanic reaction between organometallic [PhC≡CCu] and PhCSH with elemental silver. Both compounds are formed by fitting an Archimedean [email protected] cuboctahedral cluster into a Platonic Cu(dpph) tetrahedral cage [dpph = bis(diphenylphosphino)hexane]. The [email protected] cluster is a hollow cuboctahedral Cu cage filled with a central Ag atom, and all eight triangular faces of the [email protected] cuboctahedron are triply capped by eight S ions, four of which in a tetrahedral array further internally pillar four Cu vertices of the outer Cu(dpph) tetrahedron, fixing the cluster in the cage. Both compounds can be deemed as molecular fragments excised from porous nanomaterials filled with discrete nanoclusters, thus providing more details for understanding the confined growth of atomically precise nanoclusters. Electrospray ionization mass spectrometry (ESI-MS) reveals that the AgCu cluster is quite stable in CHCl and can stepwise lose dpph ligand in the gas phase under increased collision energy. This work not only presents a precise aggregation of metal atoms in a confined cavity to form a cluster-in-cage compound but also provides deep insights into the binding and geometry matching between clusters and cages in one entity.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acsnano.1c00942DOI Listing
May 2021

Penumbra quantification from MR SWI-DWI mismatch and its comparison with MR ASL PWI-DWI mismatch in patients with acute ischemic stroke.

NMR Biomed 2021 Jul 20;34(7):e4526. Epub 2021 Apr 20.

Centre for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.

In acute-ischemic-stroke patients, penumbra assessment plays a significant role in treatment outcome. MR perfusion-weighted imaging (PWI) and diffusion-weighted imaging (DWI) mismatch ratio can provide penumbra assessment. Recently reported studies have shown the potential of susceptibility-weighted imaging (SWI) in the qualitative assessment of penumbra. We hypothesize that quantitative penumbra assessment using SWI-DWI can provide an alternative to the PWI-DWI approach and this can also reduce the overall scan-time. The purpose of the current study was to develop a framework for accurate quantitative assessment of penumbra using SWI-DWI and its validation with PWI-DWI-based quantification. In the current study, the arterial-spin-labelling (ASL) technique has been used for PWI. This retrospective study included 25 acute-ischemic-stroke patients presenting within 24 hours of the last noted baseline condition of stroke onset. Eleven patients also had follow-up MRI within 48 hours. MRI acquisition comprised DWI, SWI, pseudo-continuous-ASL (pCASL), FLAIR and non-contrast-angiography sequences. A framework was developed for the enhancement of prominent hypo-intense vein signs followed by automatic segmentation of the SWI penumbra ROI. Apparent-diffusion-coefficient (ADC) maps and cerebral-blood-flow (CBF) maps were computed. The infarct core ROI from the ADC map and the ASL penumbra ROI from CBF maps were segmented semiautomatically. The infarct core volume, SWI penumbra volume (SPV) and pCASL penumbra volume were computed and used to calculate mismatch ratios and . The Dice coefficient between the SWI penumbra ROI and ASL penumbra ROI was 0.96 ± 0.07. correlated well (r = 0.90, p < 0.05) with , which validates the hypothesis of accurate penumbra assessment using the SWI-DWI mismatch ratio. Moreover, a significant association between high SPV and the presence of vessel occlusion in the MR angiogram was observed. Follow-up data showed salvation of penumbra tissue (location and volumes predicted by proposed framework) by treatments. Additionally, functional-outcome analysis revealed 93.3% of patients with > 1 benefitted from revascularization therapy. Overall, the proposed automated quantitative assessment of penumbra using the SWI-DWI mismatch ratio performs equivalently to the ASL PWI-DWI mismatch ratio. This approach provides an alternative to the perfusion sequence required for penumbra assessment, which can reduce scan time by 17% for the protocol without a perfusion sequence.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/nbm.4526DOI Listing
July 2021

Male breast fibromatosis.

Indian J Pathol Microbiol 2021 Apr-Jun;64(2):430-432

Department of Pathology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India.

View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/IJPM.IJPM_649_19DOI Listing
April 2021

Rhinosporidiosis in Central India: A cross-sectional study from a tertiary care hospital in Chhattisgarh.

Trop Parasitol 2020 Jul-Dec;10(2):120-123. Epub 2021 Jan 25.

Department of Otorhinolaryngology, Chhattisgarh Institute of Medical Sciences, Bilaspur, Chhattisgarh, India.

Background And Aims: Chhattisgarh is an endemic region for rhinosporidiosis infection in Central India. This high prevalence can be explained by suitable hot tropical environment as well as social practice of common bathing of public with animals outdoor, mainly in ponds and river. There are more than 200 ponds in and around Bilaspur district, mainly in Ratanpur region. However, due to limited literature describing rhinosporidiosis from this part of India, it remains neglected and still not recognized as a serious health-care issue and any definite government or private measures/initiatives are not taken to counter this problem.

Materials And Methods: It is a retrospective demographic study analyzing 113 consecutive biopsies received from different clinical departments in a tertiary care center with a histological diagnosis of rhinosporidiosis over a period of 7 years from January 2011 to December 2017.

Results: Most of the patients presented in the otorhinolaryngology (86.7%) department, followed by ophthalmology (10.6%). The mean age of the patients was 23.4 years, with a range of 3-70 years. A male-to-female ratio of about 3:2 was noted. Nasal cavity was the most common site of involvement (90/113), followed by conjunctiva (7/113), nasal cavity with oropharynx (6/113), and eyelid (3/113). Patients' complaints showed a varying range from nasal block, nasal mass, bleeding, bleed on touch, difficulty in breathing, and conjunctival mass. Two of the cases presented as recurrent rhinosporidiosis.

Conclusion: Rhinosporidiosis is endemic and possesses a great health-care burden in Chhattisgarh. The socioeconomic status, outdoor bathing, and cultural practice in rural areas are the major factors contributing to newer cases. An urgent government initiative to decontaminate public water bodies and public health education through health-care workers and nongovernment organizations is the need of the hour to curtail the incidence of rhinosporidiosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/tp.TP_63_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7951080PMC
January 2021

Healthcare professionals' knowledge, attitudes, and practices on coronavirus disease in Western Uttar Pradesh.

J Educ Health Promot 2020 29;9:359. Epub 2020 Dec 29.

Department of Pediatrics, GIMS, Greater Noida, Uttar Pradesh, India.

Background And Objectives: The ongoing coronavirus disease pandemic caused by a novel genetically-mutated strain of coronavirus has posed a tremendous challenge to healthcare professionals, worldwide. This study aimed to explore the healthcare professionals' knowledge, attitudes, and practices (KAP) related to coronavirus disease in Western Uttar Pradesh and provide data to improve awareness about this disease and remove the knowledge gap, if any, by disseminating the updated information to the corona warriors.

Materials And Methods: A cross-sectional survey was conducted in the form of a structured 28-item online questionnaire using SurveyMonkey software. The qualitative data were coded numerically, and the KAP score was calculated. Pearson Chi-square test was used to study the association, among variables.

Results: Of 509 respondents, 296 (58.19%) were males and 213 (41.81%) were females. The median age bracket of the sample was 20-40 years. By profession, 255 (50.10%) were doctors, 167 (32.74%) were medical students, 80 (15.78%) were other healthcare workers, and a minority 7 (1.38%) were the nursing staff. Educational status covered a range from secondary (2.01%) to senior secondary (17.51%) to bachelors and equivalent (29.18%) to masters and equivalent (51.31%). The average KAP scores were 54%, and the score was highest among doctors as compared to other healthcare professionals ( < 0.001).

Conclusions: In light of these study findings, we conclude that healthcare professionals are aware of coronavirus disease. However, the overall KAP score regarding its clinical course, preventive strategies, and judicious use of personal protective equipment was less than expected. There is a need to address all misconceptions and empower the corona warriors with the right information through effective mass media communication and reinforcement through seminars and workshops in the medical institutes and hospitals. The healthcare professionals are a cornerstone to prevent the nosocomial and community spread of this pandemic.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jehp.jehp_622_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7871925PMC
December 2020

Effect of offset-frequency step size and interpolation methods on chemical exchange saturation transfer MRI computation in human brain.

NMR Biomed 2021 04 4;34(4):e4468. Epub 2021 Feb 4.

Center for Biomedical Engineering, Indian Institute of Technology Delhi, New Delhi, India.

Chemical exchange saturation transfer (CEST) MRI is a non-invasive molecular imaging technique with potential applications in pre-clinical and clinical studies. Applications of amide proton transfer-weighted (APT-w), glutamate-weighted (Glu-w) and creatine-weighted (Cr-w) CEST, among others, have been reported. In general, CEST data are acquired at multiple offset-frequencies. In reported studies, different offset-frequency step sizes and interpolation methods have been used during B inhomogeneity correction of data. The objective of the current study was to evaluate the effects of different step sizes and interpolation methods on CEST value computation. In the current study, simulation (Glu-w, Cr-w and APT-w) and experimental data from the brain were used. Experimental CEST data (Glu-w) were acquired from human volunteers at 7 T and brain tumor patients (APT-w) at 3 T. During B inhomogeneity correction, different interpolation methods (polynomial [degree-1, 2 and 3], cubic-Hermite, cubic-spline and smoothing-spline) were compared. CEST values were computed using asymmetry analysis. The effects of different step sizes and interpolation methods were evaluated using coefficient of variation (CV), normalized mean square error (nMSE) and coefficient of correlation parameters. Additionally, an optimum interpolation method for APT-w values was selected based upon fitting accuracy, T-test, receiver operating characteristic analysis, and its diagnostic performance in differentiating low-grade and high-grade tumors. CV and nMSE increase with an increase in step size irrespective of the interpolation method (except for cubic-Hermite and cubic-spline). The nMSE of Cr-w and Glu-w CEST values were least for polynomial (degree-2 and 3). The quality of Glu-w CEST maps became coarse with the increase in step size. There was a significant difference (P < .05) between low-grade and high-grade tumors using polynomial interpolation (degree-1, 2 and 3); however, linear interpolation outperforms other methods for APT-w data, providing the highest sensitivity and specificity. In conclusion, depending upon the saturation parameters and field strength, optimization of step size and interpolation should be carried out for different CEST metabolites/molecules. Glu-w, Cr-w and APT-w CEST data should be acquired with a step size of between 0.2 and 0.3 ppm. For B inhomogeneity correction, polynomial (degree-2) should be used for Glu-w and Cr-w CEST data at 7 T and linear interpolation should be used for APT-w data at 3 T for a limited frequency range.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1002/nbm.4468DOI Listing
April 2021

Comparative evaluation of intracranial oligodendroglioma and astrocytoma of similar grades using conventional and T1-weighted DCE-MRI.

Neuroradiology 2021 Aug 19;63(8):1227-1239. Epub 2021 Jan 19.

Department of Radiology, Fortis Memorial Research Institute, Sector 44, Gurgaon, Haryana, 122002, India.

Purpose: This retrospective study was performed on a 3T MRI to determine the unique conventional MR imaging and T1-weighted DCE-MRI features of oligodendroglioma and astrocytoma and investigate the utility of machine learning algorithms in their differentiation.

Methods: Histologically confirmed, 81 treatment-naïve patients were classified into two groups as per WHO 2016 classification: oligodendroglioma (n = 16; grade II, n = 25; grade III) and astrocytoma (n = 10; grade II, n = 30; grade III). The differences in tumor morphology characteristics were evaluated using Z-test. T1-weighted DCE-MRI data were analyzed using an in-house built MATLAB program. The mean 90th percentile of relative cerebral blood flow, relative cerebral blood volume corrected, volume transfer rate from plasma to extracellular extravascular space, and extravascular extracellular space volume values were evaluated using independent Student's t test. Support vector machine (SVM) classifier was constructed to differentiate two groups across grade II, grade III, and grade II+III based on statistically significant features.

Results: Z-test signified only calcification among conventional MR features to categorize oligodendroglioma and astrocytoma across grade III and grade II+III tumors. No statistical significance was found in the perfusion parameters between two groups and its subtypes. SVM trained on calcification also provided moderate accuracy to differentiate oligodendroglioma from astrocytoma.

Conclusion: We conclude that conventional MR features except calcification and the quantitative T1-weighted DCE-MRI parameters fail to discriminate between oligodendroglioma and astrocytoma. The SVM could not further aid in their differentiation. The study also suggests that the presence of more than 50% T2-FLAIR mismatch may be considered as a more conclusive sign for differentiation of IDH mutant astrocytoma.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00234-021-02636-8DOI Listing
August 2021

Perfusion magnetic resonance imaging in contouring of glioblastoma patients: Preliminary experience from a single institution.

J Cancer Res Ther 2020 Oct-Dec;16(6):1488-1494

Department of Radiation Oncology, Fortis Memorial Research Institute, Gurgaon, Haryana, India.

Purpose: T1-contrast and T2-flair images of magnetic resonance imaging (MRI) are commonly fused with computed tomography (CT) and used for delineation of postoperative residual tumor and bed after surgery in patients with glioblastoma multiforme (GBM). Our prospective study was aimed to see the feasibility of incorporating perfusion MRI in delineation of brain tumor for radiotherapy planning and its implication on treatment volumes.

Methods: Twenty-four patients with histopathologically proven GBM were included in the study. All patients underwent radiotherapy planning with a contrast CT scan. In addition to radiotherapy (RT) planning protocol, T1-perfusion MRI was also done in all patients in the same sitting. Perfusion imaging was processed on the in-house-developed JAVA-based software. The images of CT and MRI were sent to the iPlan planning system (Brainlab AG, GmbH) using a Digital Imaging and Communications in Medicine - Radiation Therapy (DICOM-RT) protocol. A structure of gross tumor volume (GTV)-perfusion (GTV-P) was delineated based only on the MRI perfusion images. Subsequently, GTV-P and GTV were fused together to make GTV-summated (GTV-S). Using existing guidelines, GTV-S was expanded to form clinical target volume-summated (CTV-S) and planning target volume-summated (PTV-S). The increment in each of the summated volumes as compared to baseline volume was noted. The common overlap volume (GTVO) between GTV and GTV-P was calculated using intersection theory (GTV n GTV-P = GTVO [Overlap]).

Results: Mean ± standard deviation (cc) for GTV, GTV-P, and GTVO was 46.3 ± 33.4 cc (range: 5.2 cc-108.0 cc), 26.0 ± 26.2 (range: 6.6 cc-10.3.0 cc), and 17.5 ± 22.3 cc (range: 10.0 cc-92 cc), respectively. Median volume (cc) for GTV, GTV-P, and GTVO was 40.8 cc, 17.2 cc, and 8.0 cc, respectively. Mean absolute and relative increments from GTV to that of GTV-S were 8.5 ± 8.2 cc and 27.2 ± 30.9%, respectively. Average CTV volume (cc) was 230.4 ± 115.3 (range: 80.8 cc-442.0 cc). Mean and median CTV-S volumes were 262.0 ± 126.3 cc (range: 80.8 cc-483.0 cc) and 221.0 cc, respectively. The increment in the mean CTV volume (with respect to CTV created from GTV-S) was 15.2 ± 15.9%. Mean and median PTV volumes created on the summated CTV were 287.1 ± 134.0 cc (range: 118.9 cc-576.0 cc) and 258.0 cc, respectively. Absolute and relative increments in PTV volume, while incorporating the perfusion volume, were 31.3 ± 28.9 cc and 12.5 ± 13.3%, respectively. Out of the total of 24 patients, perfusion scanning did not do any increment in GTV in five patients.

Conclusions: Our study is the first to present the feasibility and the outcome of contouring on perfusion imaging and its overlay on regular MRI images. The implications of this on long-term outcome and control rates of glioblastoma patients need to be seen in future studies.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jcrt.JCRT_1151_19DOI Listing
December 2020

Infected congenital lumbosacral dermal sinus tract with conus epidermoid abscess: a rare entity.

Childs Nerv Syst 2021 03 27;37(3):741-747. Epub 2020 Nov 27.

Department of Neurosurgery, AIIMS, Raipur, 492099, India.

Purpose: Dermal sinus is more commonly associated with intradural dermoid than an epidermoid cyst. Conus epidermoid cyst with dermal sinus is a rare entity. We are presenting a rare case of infected conus epidermoid cyst along with the dermal sinus in an 18-month-old girl presented with flaccid paraparesis with sphincter dysfunction and timely intervention leads to complete recovery. We had searched PubMed for previously reported similar cases and did a case-based review of the literature.

Case Report: This 18-month-old girl with discharging lumbosacral sinus with fever since 3 days presented with flaccid paraparesis with sphincter dysfunction. Preoperative magnetic resonance imaging (MRI) showed a large enhancing lesion from L1-S1 along with the dermal sinus tract. Complete excision of the cyst along with the sinus tract, followed by long-term antibiotic therapy. The excision of the infected cyst was done through myelotomy under neuromonitoring, while some part of the capsule densely adherent to the neural tissue was left behind. The patient gradually improved following surgery and motor power of the lower limbs were [Formula: see text] while going home. Histopathology revealed epidermoid cyst with secondary inflammatory tissue. Follow-up MRI of the spine showed excision of the dermal sinus tract and cyst with postoperative changes. At 1-year follow-up, the patient was asymptomatic without any focal deficits.

Conclusion: Early surgical intervention followed by long-term antibiotic therapy is a must for good functional recovery in patients of an infected dermal sinus tract with associated cyst. While excising cyst through myelotomy, some part of the capsule densely adherent to neural tissue may be left behind. Regular follow-up in the first year of surgery is essential to look for the recurrence of the lesion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1007/s00381-020-04987-8DOI Listing
March 2021

Pudendal flap-a good option for creating neo-scrotum after Fournier's gangrene: a case series.

J Surg Case Rep 2020 Nov 14;2020(11):rjaa414. Epub 2020 Nov 14.

General Surgery and MIS Unit, BPKIHS, Dharan, Nepal.

Scrotal skin loss following Fournier's gangrene is very distressing to the patients. The management is complex and challenging shown by the multiplicity of flaps and techniques described in the literature. We included a total of 14 patients with the diagnosis of Fournier's gangrene over a period of 1 year in our department. We used a modified pudendal thigh flap to reconstruct neo-scrotum in patients with scrotal defects resulting from excision and debridement of Fournier's gangrene. The average age group of the patients in our study was 41.8 years. The average body mass index in our study was 22.36 kg/m. The average defect size in our study was 7.05 × 13.07 cm. There was a single case of flap necrosis. Modified pudendal thigh flap produces a neo-scrotum that looks natural in appearance, provides good quality skin cover and cushion to the testes as well as protective sensation.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jscr/rjaa414DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7666589PMC
November 2020

Association Between FeNO, Total Blood IgE, Peripheral Blood Eosinophil and Inflammatory Cytokines in Partly Controlled Asthma.

J Asthma Allergy 2020 29;13:533-543. Epub 2020 Oct 29.

Department of Dental Education, College of Dentistry, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.

Background: Fractional exhaled nitric oxide (FeNO) is a convenient to use biomarker of airway inflammation. However, the mutual relationship between FeNO, peripheral blood eosinophil, total immunoglobulin E (IgE) and inflammatory cytokines showed some controversy.

Objective: This study was carried out to determine the accuracy of peripheral blood eosinophil and total IgE to detect eosinophilic airway inflammation as determined by two FeNO cutoff points. The correlation between FeNO, peripheral blood eosinophil, total IgE and certain inflammatory cytokines was also examined.

Methods: Seventy-six patients with partly controlled asthma performed the following tests on the same day: FeNO, pulmonary function tests (PFTs), peripheral blood eosinophils, total IgE, and inflammatory cytokine assay. The correlation between these markers was investigated and the diagnostic accuracy of peripheral blood eosinophils and total IgE to identify eosinophilic asthma phenotype was calculated using receiver operating characteristics area under the curve (ROC AUC).

Results: FeNO was positively correlated with percentage of blood eosinophils (=0.276, =0.017) and total blood IgE (=0.3647; =0.0013). No relationship between FeNO and serum inflammatory cytokines was detected. AUC of blood eosinophils and total IgE were 57% and 64% at FeNO ≥25 ppb and were 67% and 64% at FeNO >50, respectively. The higher predictive ability was detected at FeNO >50 ppb where the best cutoff point for blood eosinophil % was ≥4.0% (sensitivity 66.7%, specificity 60.0%) and the best cutoff point for total IgE was ≥350 (sensitivity 66.7%, specificity 63.6%).

Conclusion: In patients with partly controlled asthma, peripheral blood eosinophil and total IgE showed equal useful accuracy in predicting eosinophilic airways. However, higher predictive values were reported at FeNO level >50 ppb. FeNO was positively correlated with peripheral blood eosinophil, total IgE but not with any of the studied cytokines.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.2147/JAA.S274022DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7605921PMC
October 2020

Amyand's hernia in a 5-year-old child: a case report and literature review.

J Surg Case Rep 2020 Sep 9;2020(9):rjaa302. Epub 2020 Sep 9.

General Surgery and MIS Unit, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

Amyand's hernia in a child is a very rare entity. It poses a diagnostic challenge to the surgeon due to its variety of presentation. We are presenting a case of a 5-year-old child who presented to our institute with right-sided irreducible inguinal hernia. On exploration, the content of the hernia was caecum with normal appendix for which herniotomy with appendectomy was done.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jscr/rjaa302DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7479644PMC
September 2020

Anatomy of Rouviere's Sulcus and Its Association with Complication of Laparoscopic Cholecystectomy.

Minim Invasive Surg 2020 24;2020:3956070. Epub 2020 Aug 24.

MIS Division, Department of Surgery, BPKIHS, Dharan, Nepal.

Methods: This is a prospective observational study involving patients of age ≥16 years who underwent laparoscopic cholecystectomy for uncomplicated gall stone at BPKIHS between May and July 2019.

Result: 230 cases were analyzed, and RS was present in 90.4%. Open sulcus type was the commonest (54%), followed by scar type (22.9%), closed sulcus type (12.5%), and slit type (10.6%), respectively. In 59.1% of cases, it was oblique to the anterior, inferior, and external edge of the liver, while in the remaining cases, it was transverse. The mean ± SD values for operative time and duration of hospital stay in the RS visible and the RS not visible groups were 29.16 ± 8.736 and 42.9 ± 23.646 minutes, and 1.26 ± 0.440 and 1.90 ± 0.910 days, respectively ( value ≤0.001). One complication occurred in each group: RS initially visible group and RS visible on the adhesion release group, while 3 complications occurred in the RS not visible group. Only one complication occurred in the RS not visible group.

Conclusion: Identification of RS by operating surgeons is a predictor of safe laparoscopic cholecystectomy.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1155/2020/3956070DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7463368PMC
August 2020

Appendiculo-cecal intussusception: a case report and literature review.

J Surg Case Rep 2020 Aug 24;2020(8):rjaa246. Epub 2020 Aug 24.

Department of General & Minimal Access Surgery, B.P. Koirala Institute of Health Sciences, Dharan, Nepal.

Intussusception of the appendix is a rare disease that constitutes a diagnostic challenge to the surgeon. Intussusception is defined as the telescoping of a segment of the gastrointestinal tract into an adjacent one. We are reporting a case of a 14-year-old boy who presented in our institution with the features of acute appendicitis. On exploration appendiculo-cecal intussusception was found for which right hemicolectomy with ileotransverse colon anastomosis was done.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1093/jscr/rjaa246DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7444313PMC
August 2020

Utility of circulating cell-free Mycobacterium tuberculosis DNA for the improved diagnosis of abdominal tuberculosis.

PLoS One 2020 26;15(8):e0238119. Epub 2020 Aug 26.

Department of Experimental Medicine and Biotechnology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

Abdominal tuberculosis (ATB) continues to pose a major diagnostic challenge for clinicians due to its nonspecific clinical presentation, variable anatomical location and lack of sensitive diagnostic tools. In spite of the development of several assays till date; no single test has proved to be adequate for ATB diagnosis. In this study, we for the first time report the detection of circulating cell-free Mycobacterium tuberculosis (M. tuberculosis) DNA (cfMTB-DNA) in ascitic fluid (AF) samples and its utility in ATB diagnosis. Sixty-five AF samples were included in the study and processed for liquid culture, cytological, biochemical and molecular assays. A composite reference standard (CRS) was formulated to categorize the patients into 'Definite ATB' (M. tuberculosis culture positive, n = 2), 'Probable ATB' (n = 16), 'Possible ATB' (n = 13) and 'Non-TB' category (n = 34). Two molecular assays were performed, namely, the novel cfMTB-DNA qPCR assay targeting M. tuberculosis devR gene and Xpert MTB/RIF assay (Xpert), and their diagnostic accuracy was assessed using CRS as reference standard. Clinical features such as fever, loss of weight, abdominal distension and positive Mantoux were found to be strongly associated with ATB disease (p<0.05). cfMTB-DNA qPCR had a sensitivity of 66.7% (95% CI:40.9,86.7) with 97.1% specificity (95% CI:84.7,99.9) in 'Definite ATB' and 'Probable ATB' group collectively. The sensitivity increased to 70.9% (95% CI:51.9,85.8) in the combined 'Definite', 'Probable' and 'Possible' ATB group with similar specificity. The cfMTB-DNA qPCR assay performed significantly better than the Xpert assay which demonstrated a poor sensitivity of ≤16.7% with 100% (95% CI:89.7,100) specificity (p<0.001). We conclude that cfMTB-DNA qPCR assay is an accurate molecular test that can provide direct evidence of M. tuberculosis etiology and has promise to pave the way for improving ATB diagnosis.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://journals.plos.org/plosone/article?id=10.1371/journal.pone.0238119PLOS
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449497PMC
October 2020

Evaluation of 'TBDetect' sputum microscopy kit for improved detection of Mycobacterium tuberculosis: a multi-centric validation study.

Clin Microbiol Infect 2021 Jun 21;27(6):911.e1-911.e7. Epub 2020 Aug 21.

Translational Health Science and Technology Institute, NCR Biotech Science Cluster, Faridabad, India; Department of Biotechnology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address:

Objectives: The present study aimed to evaluate the performance of the 'TBDetect' kit-based bio-safe fluorescent microscopy filter (BioFM-Filter) microscopy in comparison with direct smear microscopy and culture for the detection of pulmonary tuberculosis (TB) in a multi-centric setting in India.

Methods: The TBDetect kit enables sputum concentration through filtration using the BioFM-Filter for improved and bio-safe smear microscopy. We evaluated the performance of the TBDetect kit in a six-site multi-centric validation study on sputum collected from 2086 presumptive TB patients.

Results: The combined positivity of TBDetect microscopy performed on these sputum samples was 20% (n = 417/2086) vs 16.1% of light-emitting diode fluorescence microscopy (LED-FM, n = 337/2086) and 16% of Ziehl Neelsen (ZN) smear microscopy (n = 333/2086). The increment in positivity of TBDetect over both LED-FM and ZN smears was significant (p < 0.001). The overall sensitivity of TBDetect for six sites was ~55% (202/367, 95% confidence interval (CI): 50, 60%) vs 52% (191/367, 95% CI: 47, 57%) for LED-FM (p 0.14) and 50.9% (187/367, 95% CI: 46, 56%) for ZN smear (p < 0.05), using Mycobacterium Growth Indicator Tube culture (MGIT, n = 1949, culture positive, n = 367) as the reference standard. A bio-safety evaluation at six sites confirmed efficient sputum disinfection by TBDetect; 99.95% samples (1873/1874) were sterile after 42 days of incubation. Scientists and technicians at the study sites indicated the ease of use and convenience of TBDetect microscopy during feedback.

Conclusions: TBDetect added value to the smear microscopy test due to its improved performance, convenience and user safety. These findings indicate that equipment-free TBDetect technology has the potential to improve TB diagnosis in basic laboratory settings by leveraging on the existing nationwide network of designated microscopy centres and primary healthcare centres.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1016/j.cmi.2020.08.020DOI Listing
June 2021

Does IgG4 level evaluation in pancreatic mass play role in avoiding major surgery in uncertain presentation: A case report.

Indian J Pathol Microbiol 2020 Apr-Jun;63(2):282-285

Department of Gastro-intestinal Surgery, G B Pant Institute of Postgraduate Medical Education and Research, New Delhi, India.

A 66-year-old male presented with chief complaints of anorexia associated with mild dull, intermittent epigastric pain for 6 months. The patient was a known diabetic on oral hypoglycemic and on routine checkup was found to have deranged liver function profile. On radiology, an ill-defined hypoechoic enhancing lesion involving head, neck, and uncinate process of pancreas was noted. Whipple's pancreaticodudenectomy was done and reported as IgG4-related autoimmune pancreatitis. Later, IgG (slightly) and IgG4 were found to be markedly raised. We report this case to highlight the importance of IgG4 evaluation prior to major surgery in uncertain pancreatic mass.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/IJPM.IJPM_289_19DOI Listing
January 2021

An Octanuclear Cobalt Cluster Protected by Macrocyclic Ligand: In Situ Ligand-Transformation-Assisted Assembly and Single-Molecule Magnet Behavior.

Inorg Chem 2020 Apr 10;59(8):5683-5693. Epub 2020 Apr 10.

Key Laboratory of Colloid and Interface Chemistry, Ministry of Education, School of Chemistry and Chemical Engineering, Shandong University, Jinan 250100, People's Republic of China.

Macrocyclic molecules with multiple coordination sites have been widely used as promising ligands to build polynuclear metal clusters; however, cyclic silsesquioxane-based metal clusters are still rare. Herein, we report a new octanuclear Co-silsesquioxane cluster [Co(OH){(MeSiO)}(bpy)(Obpy)] (; SD = SunDi), wherein the Co disc-like core is sandwiched by two hexamethylcyclohexasiloxanolate ligands (MeSiO) at two poles and finally encircled by two bpy (bpy = 2,2'-bipyridine) and two Obpy (HObpy = 6-hydroxy-2,2'-bipyridine) ligands at the equatorial region. Interestingly, both MeSi(OMe) and bpy undergo in situ transformations to generate hexameric cyclic (MeSiO) and Obpy, respectively. The unusual hydroxylation of bpy and the OH anion in the center of Co core provide additional binding sites to induce the formation of the larger cluster instead of the traditional hexanuclear cluster. The solution stability and fragmentation route in the gas phase were studied by cold-spray ionization and collision-induced dissociation mass spectrometry, respectively. Both results reveal that the Co core is quite stable in solution as well as in the gas phase, even with increased collision voltage. Magnetic susceptibility studies of show the slow magnetization relaxation indicative of single-molecule magnet (SMM) behavior. This work not only presents the multiple in situ ligand-transformation-assisted assembly of polynuclear cobalt cluster but also provides some new insights into the magnetism-structure relationship for SMMs.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acs.inorgchem.0c00449DOI Listing
April 2020

Polymorphism in Atomically Precise Cu Nanocluster Incorporating Tetrahedral [Cu] Kernel.

J Am Chem Soc 2020 Mar 13;142(12):5834-5841. Epub 2020 Mar 13.

Key Laboratory of Colloid and Interface Chemistry, Ministry of Education, School of Chemistry and Chemical Engineering, State Key Laboratory of Crystal Materials, Shandong University, Jinan 250100, People's Republic of China.

Because of the typical instability of copper nanoclusters, atom-precise structural elucidation of these nanoclusters has remained elusive. Herein, we report an air- and moisture-stable 23-copper nanocluster ( or ) isolated from the reaction of Cu(CFCOO), BuC≡CH, Cu powder, and PhSiH using a gradient reduction (Cu → Cu → Cu) strategy (GRS), which is competent for controlling the kinetics of the reduction reaction, thus avoiding formation of pure Cu complexes or large Cu nanoparticles. The solid-state structure of the Cu nanocluster shows a rare [Cu] tetrahedral kernel surrounded by an outer Cu shell, which is protected by BuC≡C and CFCOO ligands. The Cunanocluster is a rare four-electron superatom with a 1S1P electronic shell closure and can be crystallized in two polymorphs (3 and 3̅) depending on the solvent used. The crystallization of in the 3 space group is mainly governed by van der Waals forces and C-H···F interactions, whereas additional intermolecular C-H···Cl interactions are responsible for the 3̅ space group of . This work not only shows the ingenuity of a gradient reduction strategy for the synthesis of copper nanoclusters but also provides a better fundamental understanding of how to produce the polymorphic copper nanoclusters in a precisely tunable fashion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/jacs.0c01053DOI Listing
March 2020

Structural Diversity of Copper(I) Cluster-Based Coordination Polymers with Pyrazine-2-thiol Ligand.

Inorg Chem 2020 Mar 20;59(5):2680-2688. Epub 2020 Feb 20.

Key Laboratory of Colloid and Interface Chemistry, Ministry of Education, School of Chemistry and Chemical Engineering, and State Key Laboratory of Crystal Materials Shandong University, Jinan, 250100, P. R. China.

Six novel copper(I) cluster-based coordination polymers (CPs) [Cu(pzt)Cl] (), [Cu(pzt)Cl] (), [Cu(pzt)Br] (), [Cu(pzt)] (), [Cu(pzt)I] (), and [Cu(pzt)I] () were solvothermally synthesized using Hpzt (Hpzt = pyrazine-2-thiol) ligand and well-characterized by elemental analysis, infrared (IR) spectroscopy, powder X-ray diffraction (PXRD), and single-crystal X-ray diffraction (SCXRD). Six CPs exhibit either 2D ( and ) or 3D (-, and ) network based on diverse multinuclear {CuS} clusters. The structural evolutions of - are greatly influenced by types of metal halides and the ligand-to-metal molar ratio used in the reaction. Among them, compound displays interesting temperature-dependent photoluminescence arising from triplet cluster-centered (CC) excited state from the cluster metal core. Compounds - also exhibit photocurrent responses upon visible-light illumination (λ = 420 nm) in the order > > > > > . This work not only shows the structural diversity of {CuS} clusters-based CPs but also provides an interesting insight into structural modulation using crystal engineering concept.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acs.inorgchem.9b02919DOI Listing
March 2020

Transfusion-Related Acute Lung Injury due to Iatrogenic IVIG Overdose in Guillain-Barre Syndrome.

J Pediatr Neurosci 2019 Jul-Sep;14(3):140-142. Epub 2019 Sep 27.

Department of Paediatrics, Dr. Baba Saheb Ambedkar Medical College and Hospital, Rohini, New Delhi, India.

Transfusion-related acute lung injury (TRALI) is a transfusion-related adverse effect associated with high mortality, manifesting with acute respiratory distress and with features of non-cardiogenic pulmonary edema. It is rarely reported following intravenous immunoglobulin (IVIG) infusion and is even rarer in pediatric population. We here present a 12-year-old female child who presented as a case of acute flaccid paralysis and was diagnosed clinically as Guillain-Barre syndrome. As per protocol, she was given IVIG for 4 of the 5 days therapy at the dose of 0.4mg/kg/day before the patient went to another hospital. Subsequently in the next 1 week, she received two more courses of IVIG in two different hospitals following which she developed respiratory distress and was again admitted in our hospital. A diagnosis of TRALI was leveled on clinical ground because of IVIG overdose. Patient subsequently improved on high-flow oxygen therapy and conservative management. This unfortunate case of iatrogenic IVIG overdose just reinforces the fact of proper documentation of treatment to avoid such mishap and also prompt diagnosis and management of this least recognized entity of TRALI.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.4103/jpn.JPN_47_19DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6798284PMC
September 2019

Hexadecanuclear MnMn Molecular Torus Built from Tandem Ligand Transformations.

Inorg Chem 2019 Nov 24;58(21):14331-14337. Epub 2019 Oct 24.

State Key Laboratory for Physical Chemistry of Solid Surfaces and Department of Chemistry, College of Chemistry and Chemical Engineering , Xiamen University , Xiamen , 361005 , P. R. China.

A mixed-valent hexadecanuclear manganese cluster, [MnMn(trz)(thetach)(μ-O)(HO)](ClO) (), containing two Mn and 14 Mn ions, is constructed from mixed generated ligands, 1,2,3-triazole (Htrz) and 1,3,5-tri(2-hydroxyethyl)-1,3,5-triazacyclohexane (Hthetach). Remarkably, both ligands were not initially added into the reaction system, and their formations involve the ligand decomposition and subsequent condensation reactions. The core of is an elongated torus comprised of eight Mn atoms and four [MnO] subunits bridged by oxo or alkoxide. The high-resolution electrospray ionization mass spectrometry (HR-ESI-MS) of dissolved in CHCN indicates its structure remains intact as +3 and +4 species. Temperature and field dependent magnetization revealed predominantly antiferromagnetic exchange interactions within the cluster. The work provides one-pot synthesis of high-nuclearity manganese clusters using the ligands generated by reactions in a tandem fashion.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.1021/acs.inorgchem.9b01549DOI Listing
November 2019

Cotyledonoid dissecting leiomyoma: an uncommon form of a common disease.

Obstet Gynecol Sci 2019 Sep 26;62(5):362-366. Epub 2019 Jul 26.

Department of Pathology, All India Institute of Medical Sciences, Phulwari Sharif, Patna, Bihar, India.

Leiomyomas are benign uterine smooth muscle neoplasms with varied morphology that are well known to undergo secondary changes. Cotyledonoid dissecting leiomyoma is a rare and distinct form of leiomyoma that poses a diagnostic challenge for clinicians, radiologists, and pathologists and can be confused with malignant uterine neoplasms. Only a few cases have been reported so far in the literature. Here we report a case of a cotyledonoid dissecting leiomyoma in a 60-year-old woman, emphasize its gross and histological features, and provide a review of the literature.
View Article and Find Full Text PDF

Download full-text PDF

Source
http://dx.doi.org/10.5468/ogs.2019.62.5.362DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6737059PMC
September 2019
-->