Search PubMed⌕ Search

Biomedical subjects

S Sawhney

Publications and source records attributed to S Sawhney.

At least 19 recordsLinked to original sources
PubMed2005

Contrast-enhanced MR angiography (CE-MRA) in the evaluation of vascular complications of renal transplantation.

Vascular complications associated with renal transplantation merit urgent investigation since they are often correctable, and timely intervention can help salvage the graft kidney. Contrast-enhanced MR angiography (CE-MRA) is a promising non-invasive technique, uses relatively non-nephrotoxic contrast agents and can rapidly demonstrate the underlying lesion in most instances. In this pictorial review we present the spectrum of abnormalities, as well as the pitfalls of interpretation of CE-MRA, that we encountered in 41 cases where there was clinical suspicion of vascular complications of renal transplantation. We believe that CE-MRA is a valuable, non-invasive screening technique in these cases, and further investigation and management of these patients can be confidently tailored to the results of the CE-MRA study.

Acute Disease↗
PubMed2001

MR spectrum in spinal dysraphism.

Spinal dysraphism is a general term which encompasses a wide variety of anomalies of the spine, all of which result from imperfect midline fusion of the embryonic neural tube. This term refers to large defects that involve the spine and not to small vertical clefts commonly seen within the spinal process of L5 or S1. We present a spectrum of MR imaging findings selected from a retrospective review of 100 patients of spinal dysraphism evaluated at our institution.

Diagnosis, Differential↗
PubMed2001

Central nervous system complications in two cases of juvenile onset dermatomyositis.

Central nervous system (CNS) complications are rarely reported in either juvenile or adult onset inflammatory myositides, such as dermatomyositis and polymyositis. We report two children, aged 4 and 10 yr respectively, with a diagnosis of juvenile dermatomyositis, both of whom subsequently developed clinical features of severe CNS involvement, possibly consistent with cerebral vasculopathy. One child died from apparent brainstem involvement; the other developed seizures, pseudoseizures and clinical depression which responded to aggressive immunosuppression. Although the vasculopathy or vasculitis underlying this disorder is known to have a systemic distribution, CNS involvement has rarely been reported and may be under-recognized.

Cerebrovascular Disorders↗
PubMed2001

Macrophage activation syndrome: a potentially fatal complication of rheumatic disorders.

AIMS: To review the precipitating events, clinical features, treatment, and outcome of macrophage activation syndrome (MAS). METHODS: Retrospective review of cases of MAS from a prospectively collected database of children with rheumatic diseases from 1980 to 2000. RESULTS: Nine patients (eight girls) were considered to have evidence of MAS. The primary diagnosis was systemic onset juvenile idiopathic arthritis in seven, enthesitis related arthritis in one, and chronic infantile neurological cutaneous articular syndrome in one. Mean age of onset was 5.7 years, and duration prior to MAS, 4.2 years. No medication was identified as a trigger. Eight had infections prior to MAS; specific infectious agents were identified in four. High grade fever, new onset hepatosplenomegaly, and lymphadenopathy were common clinical features. Platelet counts fell dramatically, from an average of 346 to 99 x 10(9)/l. Mean erythrocyte sedimentation rate (in three patients) fell from 115 to 28 mm/h. Eight had abnormal liver function during the disease course, and six had coagulopathy. Bone marrow examination supported the diagnosis with definite haemophagocytosis in four of seven. All received high dose steroids (eight intravenous, one oral), five cyclosporin, two cyclophosphamide, and one antithymocyte globulin. Two of three patients with significant renal impairment died. CONCLUSION: MAS is a rare and potentially fatal complication of childhood rheumatic disorders. Most of our patients were female, and most cases were preceded by infection. Bone marrow studies support the diagnosis. Deranged renal function may be a poor prognostic sign. Aggressive early therapy is essential.

Adolescent↗
PubMed2000

Deep-seated thoracic and abdominal masses: usefulness of ultrasound and computed tomography guidance in fine needle aspiration cytology diagnosis.

Fine needle aspiration cytology (FNAC) was performed under ultrasound and CT guidance in 120 cases. These included abdominal masses (85 cases) and thoracic masses (35 cases) biopsied over a two and a half year period (March 1996 to September 1998). The aim of this study was to assess the contribution of clinico-imaging evaluation and image-guided FNAC to the management of patients with deep-seated mass lesions. Aspirations in the abdomen were performed from various anatomic sites such as liver (56 cases), lymph nodes (18 cases), gastrointestinal tract (three cases), pancreas (six cases), and kidney (two cases). In the thorax, biopsy was performed in the lung (19 cases) and mediastinum (13 cases). In 112 cases (93.4%) FNAC was diagnostic. Of the lesions that were successfully aspirated, 85% were < or = 5 cm in size. No major complication was encountered. All the successful aspirates could be defined as malignant or non-malignant, but tissue differentiation was possible in 63.7% of malignant lesions and 53.8% of benign lesions. Combined clinical and imaging evaluation for malignancy showed 80% sensitivity and 59% specificity. Although clinicoradiological parameters themselves have certain limitations in diagnosing benign versus malignant lesions, in conjunction with guided FNA they are very accurate and safe in diagnosing deep-seated mass lesions in the thorax and in the abdomen. However, the role of FNA in tissue differentiation of solid lesions such as lymphoma requires further study.

Abdominal Neoplasms↗
PubMed2000

Alteration of sonographic texture of the endometrium in post-menopausal bleeding. A guide to further management.

BACKGROUND: The purpose of this study was to assess the utility of transvaginal ultrasonography in the evaluation of endometrial morphology in addition to the standard criterion of endometrial thickness for selecting patients for endometrial sampling. METHODS: Two hundred and seven consecutive cases of postmenopausal bleeding were evaluated by transvaginal ultrasound. Endometrial thickness was measured as the maximum anteroposterior thickness of the endometrium including both the anterior and posterior layers, in the sagittal long axis view. The morphology of the endometrium was studied and categorized as homogeneous, focally increased echogenecity, diffusely increased echogenecity or diffusely inhomogeneous. Patients were followed up for clinical course and endometrial histopathology. RESULTS: Textural inhomogeneity was observed in all the three cases of endometrial cancers with endometrial thickness of less than 6 mm, and, in ten out of 11 cases of a more than 6 mm thick endometrium. On the other hand the endometrial texture was homogeneous in all cases of endometrial atrophy/tissue inadequate for diagnosis, with thickness of less than 6 mm. CONCLUSION: This study adds the dimension of abnormal echogenecity of the endometrium to the currently followed criterion of endometrial thickness with a view to enhance accuracy, both for a better prediction of atrophy and a higher prediction for endometrial cancer. Expectant management can be offered to patients with a homogeneous endometrium which is 6 mm thick or less. Aggressive evaluation for a malignancy must be made if there is a focal increased echogenecity or a diffuse increased echogenecity even in a thin endometrium.

Adult↗
PubMed1998

Chest wall tuberculosis simulating breast carcinoma: imaging appearance.

Tuberculosis of the breast is a rare disease. Tubercular abscesses predominantly affecting the soft tissues are also very infrequent. A case of chest wall tuberculosis secondarily involving the breast presenting as a hard, fixed lump simulating mammary carcinoma is presented here. There was no evidence of pleural or pulmonary tuberculosis.

Breast Diseases↗
PubMed1996

Mesenteric plexiform neurofibroma: computed tomography appearance.

Gastrointestinal involvement in von Recklinghausen's disease is usually in the form of neurofibromas and leiomyomas. Very rarely, plexiform neurofibromas may be seen involving the bowel wall and myenteric plexus with secondary minor involvement of the mesentery. This report describes the computed tomography morphology of a plexiform neurofibroma extensively involving the mesentery with minor involvement of the bowel wall.

Child↗
PubMed1996

Occlusive arterial disease of the upper extremity: colour Doppler as a screening technique and for assessment of distal circulation.

A prospective study was performed to evaluate the sensitivity of colour Doppler flow imaging (CDFI) in the detection of occlusive arterial disease in the upper limb (using angiography as the standard) and to quantify the severity of the disease. Twenty-one ischaemic and 15 healthy limbs were studied by intra-arterial digital subtraction angiograms (IADSA) and CDFI. Selective subclavian digital subtraction angiograms were performed by the percutaneous transfemoral route. CDFI was performed from the brachial artery superiorly to the subclavian artery origin. Special attention was paid to the study of spectral waveforms and peak systolic velocities at various levels. In each subject, IADSA and CDFI were performed by different radiologists without knowledge of the results of the other investigation. In normal limbs, all arteries demonstrated a characteristic sharp triphasic spectral pattern with mean peak systolic velocity of 105, 80 and 57 cm/s for the subclavian, axillary and brachial arteries, respectively. In ischaemic limbs, reduction in peak systolic value and broadening of the spectral trace with filling in of the spectral window were noted. More characteristic was the finding of a loss of diastolic flow reversal, which was the earliest sign of significant arterial stenosis. The pattern of diastolic blood flow correlated well with the degree of collateral formation and distal vascular runoff. In conclusion, CDFI has a high sensitivity and specificity in the detection of significant arterial stenosis and is thus an ideal, inexpensive screening procedure. Analysis of the diastolic wave-form distal to the stenosis is an indicator of the degree of collateral circulation and distal runoff and thus acts as a prognostic indicator, guiding further investigation and management.

Angiography, Digital Subtraction↗
PubMed1995

Diagnosis of abdominal tuberculosis: sonographic findings in patients with early disease.

OBJECTIVE: The diagnosis of abdominal tuberculosis is often difficult, because clinical manifestations and results of laboratory studies are nonspecific. If sonographic findings are sufficiently characteristic for diagnosis, sonography would be useful, especially in India, where abdominal tuberculosis is common and more expensive imaging techniques are not easily available. Accordingly, we performed sonography to establish the sonographic findings in cases of early tuberculosis in 56 patients with abdominal tuberculosis who had normal barium studies of the small bowel. SUBJECTS AND METHODS: Fifty-six patients with clinical features suggestive of abdominal tuberculosis (history of fever, abdominal pain, and weight loss) with no history of intestinal obstruction and normal barium studies of the small bowel had abdominal sonography. All sonograms were independently assessed by three radiologists, and the findings were tabulated by consensus. Diagnosis of tuberculosis was confirmed by sonographically guided biopsy of mesenteric lymph nodes in 19 patients, analysis of aspirated ascitic fluid in 12, and response to antituberculous chemotherapy in 25. Sonography was repeated 1, 3, 6, and 12 months after antituberculous chemotherapy was begun. Abdominal sonograms were also performed in 30 healthy volunteers, and measurements of mesenteric thickness were recorded. The mesenteric thickness was statistically compared in two groups of patients: patients at presentation with patients at the end of antituberculous chemotherapy and patients at presentation with healthy individuals. RESULTS: The mesenteric thickness in healthy individuals ranged from 5 to 14 mm. Sonographic findings in all patients with abdominal tuberculosis included an echogenic thickened mesentery (> or = 15 mm) with mesenteric lymphadenopathy. Other findings were dilated small bowel loops in 38 patients, minimal ascites in 17, matted small bowel loops in five, and omental thickening with altered echogenicity in three. Regression of these changes was noted on follow-up of all patients undergoing treatment. CONCLUSION: The characteristic sonographic features of early abdominal tuberculosis are mesenteric thickness of 15 mm or more and an increase in the mesenteric echogenicity (due to fat deposition), combined with mesenteric lymphadenopathy. Presence of dilated small bowel loops and ascites further substantiate the diagnosis.

Abdomen↗
PubMed1994

[A simple alteration in a ureteral double J stent to improve its clinical acceptability].

The authors describe a modification of the classical double J stent designed to improve its clinical acceptability. It consists of cutting the lower J so that the catheter, inserted in the ureter, does not protrude into the bladder. A loop of nonresorbable suture attached to the lower extremity of the stent is passed through the ureteric orifice, allowing its easy extraction. This procedure has been used in eight patients with no complications.

Cystoscopes↗
PubMed1993

Computed tomography of vertebral tuberculosis: patterns of bone destruction.

A retrospective analysis was performed of CT scans of 30 consecutive patients with a clinical suspicion or diagnosis of spinal tuberculosis. Four patterns of bone destruction were noted, namely, fragmentary, osteolytic, subperiosteal and well-defined lytic with sclerotic margins. The fragmentary type was most common (47%). Intervertebral disc destruction was always associated with contiguous vertebral body destruction. Associated paravertebral soft-tissue masses were seen in all patients. Epidural extension of disease was seen in 66% and showed a very good correlation with neurological signs on clinical evaluation. Bone fragments were detected in the epidural soft-tissue mass in 65% of patients with epidural extension of disease. CT appearances of bone destruction are highly suggestive of tuberculous osteomyelitis in about half the patients.

Adult↗
PubMed1993

Hemangioma of spleen with spontaneous, extra-peritoneal rupture, with associated splenic tuberculosis--an unusual presentation.

We report a case of unusual presentation of a patient with hemangioma of the spleen. The patient had presented with recurrent gastric hemorrhage and significant weight loss, due to ruptured hemangioma of the spleen and associated splenic tuberculosis. The true nature of the lesions remained a diagnostic dilemma despite complete radiological workup and review of literature.

Adult↗