Online ISSN: 2515-8260

Keywords : ultrasonography


CORRELATION OF ULTRASONOGRAPHIC ESTIMATED FETAL WEIGHT WITH ACTUAL BIRTH WEIGHT

Dr. Modugu Sita Reddy

European Journal of Molecular & Clinical Medicine, 2023, Volume 10, Issue 1, Pages 1229-1236

Background: The key predictor of the outcome of labour, as well as of perinatal illness, mortality, and maternal morbidity, is the weight of the foetus as determined by ultrasonography. The manner of delivery can be chosen by the obstetrician using an ultrasound estimate of the foetal weight at term. Aim: This study was conducted to correlate the ultrasonographic estimated fetal weight at term with actual birth weight in patients attending the medical college hospital. Materials and Methods: In collaboration with the radiology department, the study was carried out at OBG department. The time frame for this study's retrospective cross-sectional design was from February 2019 to November 2021. 300 pregnant women were selected in the study. Results:
The estimated foetal weight determined by ultrasonography and the actual birth weight correlated favourably. 88% of predicted weights were within ten percent of actual birth weight on average. Conclusion: The weight of the foetus at ultrasonography and the actual birth weight were closely correlated. Making decisions in the delivery room requires the use of this crucial tool.

A hospital based prospective evaluation of parenchymal thyroid diseases with multi-parametric ultrasonography

Dr.Ridhi Puri,Dr.Devanjal Kapila,Dr.Shobit Rattan, Dr. Faiz Zubair Shaikh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 3947-3951

Aim and objective:The aim of the study was to evaluate of Parenchymal Thyroid Diseases with multi-parametric Ultrasonography.
Material andMethods: This study was conducted in the Department of Radiology at Maharishi markandeshwar institute of medical sciences and research Mullana, India, for the period of 1 year. Patientsweredivided into five groups such as group I (normal); group II had first detected, early untreated Hashimoto disease(EH);groupIII comprised of chronic Hashimoto patients that are under treatment and/or follow up (H); group IV had multinodular parenchymal hyperplasia (M); and group V had nodular hyperplasia with Hashimoto (HM). They underwent spectral Doppler ultrasound and acousticradiationforce impulse. Quantitative spectral doppler parameterssuch as resistivity index (RI), acceleration time (AT) and quantitative elastography such as shear wave velocity (SWV) was recorded.
Results: Out of 250, 60% were male and 40% female most of the patients between 30-40 years 42% and followed by 40-50 years was 32% shows in Table1. The Distribution of patients based on diseases and each group had 50 patients show in table 2.The mean RI in group I was 0.59, in group II was 0.62, in group III was 0.47, in group IV was 0.53 and in group V was 0.55 mean AT in group I was 27.9, in group II was 26.8, in group III was 71.5, in group IV was 47.8 and in group V was 46.5, mean SWV in group I was 1.53, in group II was 1.72, in group III was 1.22, in group IV was 1.46 and in group V was 1.71. The difference was significant (p< 0.05).
Conclusion: we concluded that the resistivity index, acceleration time and shear wave velocity together are reliable for differential diagnosis of parenchymal thyroid diseases.
 

A Comparative Study on Diagnostic Accuracy of Ultrasonography and MRCP in Cases of Obstructive Jaundice

Prabh Preet Singh; Aseem Kaushal; Nitin Goyal; Ajay Kumar; Aparjit Singh

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 1757-1767

Background: In this study, we wanted to compare the accuracy of magnetic resonance cholangio-pancreatography (MRCP) with that of ultrasonography in cases of obstructive jaundice, and evaluate the cause of obstruction in case of obstructive jaundice.
Methods: This was a hospital based prospective study conducted among 30 patients who presented with obstructive jaundice/pancreaticobiliary disease to the surgical out-patient department (OPD) and referred for MRCP to the Department of Radiology, Adesh Medical College and Hospital, Mohri, India. The study was conducted over a period of 6 months from 1st March 2022 to 31st August 2022 after obtaining informed consent from the study participants.
Results:  For MRCP, sensitivity, specificity, positive predictive value and negative predictive value were 100 % each. Mass could be visualized in 90 % ultrasound (USG) and MRCP. Stricture was identified and localized in 90 % cases of USG while 100 % cases of MRCP. MRCP showed “double duct signs” in all the cases. MRCP was also able to comment on metastasis to lymph nodes and liver thus helping in staging and planning treatment. There was similar result between USG and MRCP in cases of periampullary carcinoma, choledochal cyst and carcinoma head of pancreas. All modalities were showing 100 % sensitivity and positive predictive value in these cases in diagnosing cause of obstruction. Overall sensitivity of USG and MRCP remained 68.57 % and 97 % respectively. Positive predictive value was 100 % with each modality.
Conclusion:  MRCP with modern apparatus can demonstrate anatomy and pathology in case of obstructive jaundice with almost equal or even better extent as compared to USG. Moreover, MRCP can better comment about entire extra luminal extent as well as lymph node metastasis in case of malignant pathologies, thus help in planning the treatment.

Systematic Review on Current Technologies for Kidney Stone Disease Detection and Management

Omar H. I. Aqel, Baha'a A. M. Alhroub

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 6678-6688

Detection of stones in the kidney through imaging is a predominant screening method and the foremost step in choosing the ideal treatment for kidney stone disease. The best first imaging modalities to employ to assess patients with suspected obstructive urolithiasis vary according to the recommendations offered by the American Urological Association (AUA), European Association of Urology (EAU) and American College of Radiology (ACR); the best definitive diagnosis is regularly made with non-contrast Computed Tomography of the abdomen and pelvis, however, doing so exposes individuals to ionizing radiation. Ultrasonography-derived compounds have less radiation than C.T. but have poorer specificity and accuracy. However, randomized controlled experiments comparing these imaging modalities revealed comparable diagnostic accuracy in the emergency unit. Each modality has benefits and drawbacks. Plain radiography of the kidney, ureter and bladder (KUB) is less beneficial in acute stones and perhaps most useful in assessing interval stone development in patients with established stone disease. Although MRI offers the prospect of 3D imaging without radioactive contamination, it is expensive, and at the moment, it is challenging to see stones. Future advancements are anticipated to improve all the imaging modalities for the diagnosis and management of stones in the kidney. Clinicians may benefit from a suggested approach for detecting patients with stone former in consideration of the recommended practices and a random control study.

Evaluation of scrotal swellings by colour doppler ultrasonography

Dr. Biplab Debbarma; Dr. Chandini Reang; Dr. Kaushik Tripura

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 7, Pages 675-680

Background and Objective: The preferred method for separating testicular torsion from inflammatory diseases is colour Doppler ultrasonography (US), which can help patients avoid needless surgical explorations.

A COMPARATIVE BACKGROUND CLINICAL, ULTRASONOGRAPHY, AND HISTOPATHOLOGY FINDINGS OF BENIGN BREAST DISEASES

Dr. Aparna Mule, Dr.T.Srinivas, Dr. A. Nagaraju, dr. Puli Vineela

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 735-746

BACK GROUND:
Breast cancer is becoming more common in today's population. Eighty percent of lesions are harmless. No clinical examination or investigation can reliably detect BBD. When clinical examination, USG breast, and FNAC/HPR are coupled, the accuracy of diagnosis improves.
AIMS & OBJECTIVES:
The purpose of this study was to examine the roles of clinical examination, ultrasonography, and histopatholgical examination in the diagnosis of benign breast illnesses.
Materials And Methods:
Female patients with breast disorders who attended O.P.D. or were admitted to wards at Department of Surgery, Govt Medical College/GGH, Mahabubnagar and research centre between June 2019 and July 2022. A detailed history of the patient was taken in order to determine the reasonable risk factor, and complaints were recorded chronologically. A clinical examination was performed to determine the various forms of presentation. The breast USG and FNAC/HPR are then performed.
RESULT: The present study indicated that the incidence of benign lumps was higher in the age group of 11-20 years. 28 patients (90 percent) reported a lump in the breast, followed by pain and drainage from the nipple. The majority of them (60%) were 3cms. Fibroadenomas were prevalent (73.34 percent). There were 16 cases of left side lesions. The majority of the lesions were isolated in 28 patients (93.34 percent ). FNAC was performed in all patients and was diagnostic (100 percent ). The USG could clearly indicate whether the tumour was cystic or solid, however further typing of the lesion had limitations, even though fibroadenoma could be reliably diagnosed.

Estimation of gestational age of fetus with the help of fetal fibular length: By real time ultrasonography

Dr. Manisha Kumari

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 6, Pages 2045-2049

Introduction: The ultrasound is a sound wave beyond the audible range of frequency. Clinical application of ultrasound in obstetrics was introduced and popularized by Donald & Glasgow in 1958, the advantage being that the ultrasound is a noninvasive technique causing minimum discomfort to the patient and practically no side effect on the fetus.
Materials and Methods: In present study an analysis will also be made of the variation in the gestational period, associated with the fibular length and socioeconomic, physical and medical factors recorded from obstetric and gynecological records. The patients included in this study were of 13 weeks to 40 weeks of fetal gestational age as diagnosed during the antenatal examination by gynecologist. The present study was conducted in the Department of Anatomy, in coordination with the Department of Radiodiagnosis, LLRM Medical College, Meerut, in pregnant women a during 2ndand 3rd trimester. Ultrasonographic measurement of fibular length was done in Radio diagnosis Department of LLRM Medical College, Meerut.
Results: At the 14 weeks of the gestation the mean calculated fibula length was 15.7mm and at 20 weeks was 29.33 mm. The mean fetal fibular length of 51.92 mm was recorded at the age of 30 weeks of gestation whereas the same was 74.51mm at 40 weeks of gestation.
Conclusions: Dating of fetus by fetal fibular length is more accurate than the other fetal parameters and it was found more predictive than other fetal parameters.

Radiological profile of dengue among infants at a tertiary care hospital with special reference to increased resistive index of middle cerebral artery: A cross sectional study

Dr Santosh Karpur Dr Anupam Bahe Dr Deepali Vagdalker Dr Mahesh Chander D

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 1594-1604

Background: Ultrasonography is readily available and is non-invasive which gives quick results. It tells about severity of dengue among infants. It is a promising tool. It can help in management and assessing severity of dengue.
Objective: To study radiological profile of dengue among infants with special reference to increased resistive index of middle cerebral artery
Methods: Retrospective study on subjects admitted with infant dengue was done for two years. Data of 98 infants admitted with Dengue were collected from medical records department. Data of infant dengue with congenital heart disease, comorbidities like sepsis and known case primary immunodeficiency were excluded. Radiological findings of ultrasound abdomen & thorax of the subjects were recorded. 

UTILITY OF DOPPLER ULTRASOUND IN EVALUATION AND MANAGEMENT OF VASCULAR MALFORMATIONS – A COMPARATIVE STUDY WITH CONVENTIONAL ANGIOGRAPHY

Dr. Kishor Sagar V, Dr. Salil Pandey, Dr. Suresh A, Dr. Muthusubramanian R, Dr. Rajan Aggarwal, Dr. Nithisha Mary Jacob, Dr. Archana S R, , Dr. Seema U

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 159-167

Introduction:
In last few years, thanks to laser technology with minimally invasive approach, there was a
growing need for treatment of oral vascular malformations inside the dental offices.
Generally, the diagnosis of oral vascular malformations is based on clinical history, clinical
examination and imaging exams. Hence the present study was designed to assess Doppler
ultrasound findings of vascular malformations and compare the findings with DSA and to
descry role of Doppler USG in management of vascular malformations.
Methods:
36 patients of clinically suspected vascular malformations were included in our study. USG
B-mode and Doppler study was done for all these patients and the findings were recorded.
USG examination was performed by two well experienced Interventional Radiologists in our
institution. Clinical details and imaging parameters were documented and analyzed. Initial
provisional imaging diagnosis was framed and treatment strategies were further formulated
depending on the diagnostic angiogram findings
Results:
Out of 36 patients included in our study, 8 patients had high flow arteriovenous
malformations, 3 patients had lymphatic malformations and 25 patients had low flow venous
malformations, with DSA being gold standard modality for confirming the diagnosis. We
observed that Doppler USG was able to diagnose all of malformations and accurately classify
them into high flow and low flow malformations. We also observed that certain key
characteristics like early draining vein and presence of nidus was better demonstrated by
conventional angiography which steered the management plan from routine sclerotherapy to
embolization
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 9, Issue 4, Winter 2022
160
Conclusion:
We conclude that the USG Doppler has diagnostic accuracy which is similar to conventional
angiography and can be a valuable adjunctive imaging tool in characterizing vascular
malformations and further categorizing the management plan; more so in cases posing with
clinical dilemma. However, further evaluation with MRI/CT may be necessary to in complex
and deep-seated lesions.

Factors predicting the operative difficulty in Laparoscopic cholecystectomy: An observational study

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 6104-6111

Background: Laparoscopic cholecystectomy is minimally invasive surgery done for removal of diseased gall bladder and considered as gold standard. It is the commonest general surgical procedures done worldwide.
Methodology: An observational study done in Hind Institute of medical Sciences, Barabanki. from June 2017 to June 2021 during which patients admitted with the plan of laparoscopic cholecystectomy were preoperatively evaluated clinically, biochemically and radiologically. LC was performed by standard 4 port technique was under GA by qualified surgeon and well-trained team. Surgery was categorised into easy, difficult and very difficult depending on the duration of surgery. Preoperative factors were then analysed and compared with the operative difficulty.

A Randomized Control Study of Comparison of Standard Care versusUltrasonography Guided Single Dose of MethylprednisoloneAcetate Injection for Planar Fasciopathy

Keshav Dev, Amar Singh Meena, Mahesh Meena, Mrinal Joshi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1344-1354

Objectives:Plantar fasciitis is a painful condition but can be self-limiting condition.
Among the different treatment which exit, physiotherapy and corticosteroid injection
are effective and popular. In this study, the author evaluated the efficacy of standard
care versus ultrasonography guided single dose of methylprednisolone acetate injection
for planar fasciopathy.
Design:This randomized clinical trial conducted in Physical Medicine & Rehabilitation
department of S M S medical college.
Method:Patients were allocated to standard care physiotherapy group (n=35) and
ultrasonography guided steroid injection group (n=35) equally. Pain and functional
ability on a visual analog scale (VAS), plantar fascia thickness and Foot Ankle
Disability Index (FADI) were evaluated at baseline and at 6 weeks after treatment.
Results:The mean age was not different between both groups (40.60±10.64 years versus
41.43±9.66 years, p=0.734). There was a reduction in VAS from baseline to weeks 6
(after treatment) (65.315±7.182 vs 32.57±4.235, respectively) (P<0.001). PF thickness at
6 weeks significantly reduced to 3.895±0.18 compared to baseline (P<0.001).FADI had a
considerable improved at week 6 (76.675±2.131) compared to baseline (62.915±1.823)
(P<0.001).
Conclusion:Both interventions caused improvement in pain and functional ability 2
months after treatment. Although inter difference were not significant.

Usefulness of high resolution ultrasonography and color doppler in diagnosis and differentiating of scrotal diseases

Dr. Alok Dwivedi, Dr Yogesh Kumar Yadav

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 1408-1412

Background: Acute scrotum is defined as acute pain with or without scrotal swelling,
may be accompanied by local signs or general symptoms. The present study was
conducted to assess usefulness of high resolution ultrasonography and color doppler in
diagnosis and differentiating of scrotal diseases.
Materials & Methods: 87 patients of scrotal diseases was included. A thorough
examination was performed and symptoms and clinical diagnosis was made. All the
patients underwent scrotal ultrasonography using 7.0- 12.0 MHZ high frequency linear
array transducer coupled with colour doppler in Esaote My Lab 40 and Phillips affinti
70G equipment. The ultrasound findings were recorded.
Results: Age group 20-30 years had 47, 31-40 years had 25 and 41-50 years had 15
patients. The difference was significant (P< 0.05). Common diagnosis was hydrocele in
25, epididymal cyst in 20, pyocele in 11, funiculitis in 4, epididymitis in 5, testicular
abscess in 8, varicocele in 8 and testicular tumour in 6 cases. The difference was
significant (P< 0.05). Left side was involved in 32, right side in 28 and both sides in 27
cases. The difference was significant (P< 0.05).
Conclusion: High frequency ultrasonography with color doppler is an efficient
diagnostic imaging modality in the evaluation of scrotal diseases.

Ultrasonography for the evaluation of hyperechoic breast lesions: a clinical and radiologic investigation

Dr Nirali Dhruv Patel, Dr Gurudatt Thakkar, Dr Manish R Shah

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 2972-2978

Aim: Ultrasonography for the evaluation of hyperechoic breast lesions.
Material and methods: The retrospective clinical study was conducted, after ethical
permission from the institution. An ultrasonographically guided core needle biopsy was
performed on 980 of 1000 subjects, with 51 percent (n=510) of lesions being benign, 41
percent (n=410) being malignant, and 8 percent (n=80) being high risk. A single
radiologist with expertise in the field performed the ultrasonographically guided core
needle biopsy, ultrasonographic imaging, and associated interpretation. Two orthogonal
views were captured for documentation. Clinical and mammography parameters and
clinical aspects, as well as additional radiologic imaging reports, were evaluated for all
research individuals.

Role of MR Imaging in Evaluation of Post Laparoscopic Cholecystectomy Biliary Duct Injuries: A Prospective Study from North India

Dr Manoj Ranjan, Dr MohitAgarwal, Dr. Rajesh Ranjan, Dr. Satin Dutta, Dr.PradipPokharia, Dr. Rajeev Ranjan

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 5396-5402

Background
Cholecystectomy can be performed as an open procedure via laparotomy, using a conventional (open)
incision (OC) or a mini-incision (MC) or using a laparoscopic procedure (LC). MR is excellent for
visualisation of the biliary tract including abnormalities as common bile duct stones, postoperative
fluid collections and bilomas, but also other pathological conditions in the abdomen such as
abscesses. The aim of this study was to use magnetic resonance cholangiopancreatography (MRCP)
as a non-invasive alternative to identify Post Laparoscopic Cholecystectomy Biliary Duct Injuries and
compare it with ERCP and post operative findings.
Methods
After receiving ethical approval, the current prospective study was conducted for two years in the
Department of Internal Medicine among patients with clinical findings suggestive of postoperative
bile duct injury who visited the OPD or were admitted to the wards and underwent MRCP followed
by ERCP. Clinical history was gathered during OPD hours or after admission, and patient-specific
and pertinent information was acquired through interviews in a structured data collection schedule.
All tests were done at a 5% level of significance; an association was considered significant if the p
value was < 0.05.
Results
In present study, the mean age of patients was 42.3 22.7 years. 82% of patients were females. Among
70% of patients’ persistent right upper quadrant pain was the clinical symptom followed by jaundice
(48%). Type II (36%) and Type III (38%) were the common observed Bismuth Injury on MRCP.
While comparing the bismuth injury on MRCP findings with intraoperative findings, it was observed
that Type II and Type II injuries were accurately diagnosed by MRCP and matches with the
intraoperative findings. Strictures with associated dilated IHBR were more accurately diagnosed by
MRCP (50% of patients) when compared with ERCP (36% of patients).
Conclusion
Our preliminary results support that MRCP is a useful diagnostic test in patients suspected to have
bile duct injury after surgery. MRCP depicts the signs of stricture and excision injury accurately and
displays the anatomy completely and accurately.

Factors predicting the operative difficulty in Laparoscopic cholecystectomy: An observational study.

Hemant Kumar Gupta, Vijay Kumar Goel, Neharika

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 9954-9961

Background: Laparoscopic cholecystectomy is minimally invasive surgery done for
removal of diseased gall bladder and considered as gold standard. It is the commonest
general surgical procedures done worldwide.
Methodology: An observational study done in Hind Institute of medical Sciences,
Barabanki. from June 2017 to June 2021 during which patients admitted with the plan
of laparoscopic cholecystectomy were preoperatively evaluated clinically, biochemically
and radiologically. LC was performed by standard 4 port technique was under GA by
qualified surgeon and well-trained team. Surgery was categorised into easy, difficult
and very difficult depending on the duration of surgery. Preoperative factors were then
analysed and compared with the operative difficulty.
Result: A total of 300 patient underwent LC in which 71.7% were females. Mean age of
patients was 41.36±13.68 years with 31.3% patients between 41-49 years. Recurrent
abdominal pain was observed in 38.3% and 4.3% patient had history of biliary
pancreatitis. Ultrasonologically, single stone was observed in 62% whereas thickened
GB wall was observed in 33%. Serum ALP was elevated in 2.3 % whereas 2.7% had
leucocytosis. Operative ease was encountered in 40% consuming < 60 minutes, whereas
56.7% was difficult (60-120 mins) and 3.3 % were very difficult (>120 mins).
Conversion rate was 1.65%, all from very difficult category. Age 40-49 years, solitary
GB calculus, GB wall thickness > 4mm, leucocytosis and history of pancreatitis has
statistically significant correlation with difficult cholecystectomy but no such association
was observed with gender, elevated serum ALP and comorbidities.
Conclusion: Difficult LC was observed in 60% patients. Age between 41-50 years,
solitary GB calculus and thickened GB wall (>4mm) with a attack of pancreatitis can be
considered as predictor for difficult cholecystectomy.

DIAGNOSTIC ROLE OF ULTRASONOGRAPHY IN TUMORS OF MAJOR SALIVARY GLANDS

Dr. Shiping Jain, Dr.Sandeep Kumar Jain, Dr. Balwant Singh Patle, Dr. Krithika T

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 11138-11148

Introduction: Major salivary glands pathologies are a significant source of morbidity in
general population. The role of ultrasonography in evaluation of salivary glands masses
is become increasingly important due to availability of high frequency probe which
permit visualization of more subtle anatomical and pathological details.
Objectives: The study was conducted to determine the diagnostic role of real-time
ultrasonography& color Doppler in diagnosis of major salivary gland tumors.
Material and methods: This study was conducted in the Radiodiagnosis,
DepartmentofGajra Raja Medical College andHospitals, Gwalior (M.P.) in USG
Machine SSD4000SV (AlokaTrivitron) from August 2011 to September2012. A total 46
patients was enrolled in study after taking detailed history and relevant clinical
examination. Subsequently the patient was subjected to real time
ultrasonographyfollowed by histological examination by On-site fine needle aspiration
cytology.
Results: According to the study out of 46 major salivary gland tumors, benign tumors
32(69.57%)were morecommon than malignant 14 (30.43%).The age distribution of the
patients with salivary gland neoplasm ranged from 1-80 years and majority of belongs
to the 30-70 years age group.Male : Female ratio for malignant tumors is 6:1 and equal
in benign tumors.
European Journal of Molecular & Clinical Medicine
ISSN 2515-8260 Volume 9, Issue 3, Winter 2022
11139
Parotid gland was the most common site accounting for 91.30% followed by
submandibular gland (8.7%) of all salivary gland tumors. On USG examination all
tumors were hypoechogenic. Most benign tumors (87.5%) had well defined borders, but
12.5% of malignant tumors also had well defined (sharp) borders. The internal
structure of tumor was not a relevant indicator of malignancy. According to the study
the commonest tumors was pleomorphic adenoma which accounted for 60.87% of all
cases followed by mucoepidermoid carcinoma( 17.4%)of all cases confirmed by
histopathological examination.
Conclusion: Ultrasonography is a highly sensitive, specific,easily available and
affordable imaging modality to assess salivary gland tumors.however it is more sensitive
for detecting benign tumors and more specific for malignant tumors.

Clinical, etiological profile and outcomes of patients with acute pancreatitis in a tertiary care hospital, South India: A cross-sectional study

Dr. Anjaney Yadur, Dr. Dhanalaxmi Neginhal, Dr. Sagar Patil

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 3, Pages 12003-12009

Background: Acute pancreatitis, characterised by inflammation, auto-destruction and activation of pancreatic enzyme is a common gastro-intestinal cause of hospital admission. Understanding the etiology, clinical profile and clinical outcomes of these patients in regional setting is key for appropriate management.
Methods: A hospital based observational study was carried out between August 2011 and July 2013 among patients above 18 years of age who presented to the outpatient department with acute pancreatitis. Patients demographic, clinical information, and laboratory findings was obtained at admission. All patients were subjected to ultrasonography and patients with severe disease were subjected to Computed Tomography. The clinical severity and outcomes were recorded. Data was summarised as mean (SD) for continuous variables and proportions for categorical variables.
Results: Among 94 subjects included in the study, about 85% were males and 69% were aged less than 45 years. Abdominal pain (88%) was the most common clinical presentation, followed by vomiting (49%). Alcohol was the most common etiological factor seen in about 60% of the subjects. Ultrasonography revealed bulky pancreas in 38% and gallbladder calculi in 33% of the subjects. Acute kidney Injury was present among 3% of the patients. About 9% had severe disease and mortality was 2.1%. There was marked increase in the levels of pancreatic enzymes, BUN and serum creatinine among patients with severe disease when compared to patients with mild/moderate disease.
Conclusions: Acute pancreatitis is a leading causes of hospitalization due to gastro-intestinal cause. Clinical assessment along with radiological findings correlates well with the disease severity and mortality. Understanding the clinical and etiological profile of patients with acute pancreatitis would be helpful to plan the management strategies for the local setting.

Prospective and observational ultrasonographic evaluation of fatty liver disease and cardiovascular diseases in type 2 diabetic patients

Dr. Pratibha Gupta, Dr. Anchal Sharma, Dr. Ranchit Narang, Dr. Govind Khatri, Dr. Aastha Makkar, Dr. Sahil Chawla

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1103-1107

Aim: To evaluate fatty liver disease and cardiovascular diseases in type 2 diabetic patients
using ultrasonography.
Methodology: The prospective and observational study was conducted in the Department of
Radiology, Maharishi Markandeshwar Medical College and Hospital, Kumarhatti, Himachal
Pradesh for the period 9 months. 300 patients diagnosed with type 2 diabetes and ultrasound
abdomen showing fatty changes in liver without any other co-morbidities were included.
Patients were divided in three groups according to the duration of the diagnosis of diabetes.
The distributions of different groups were GROUP A- less than 5 years, GROUP B-in
between 5 to 10 years and GROUP C-more than 10 years. A brief history was taken of the
patient’s complaints and then the patients Random blood sugar and BMI values, as mentioned
in the patient’s case paper were recorded and then ultrasonographic evaluation of the study
subjects was performed by a single radiologist and the following parameters were examined
after obtaining informed consent-Liver echogenicity, Portal Vein Doppler study, Mesenteric
fat pad thickness and Carotid Artery Doppler study. Study method was Interview schedule
questionnaire, OPD records, bedside tickets, physical examination and laboratory
measurements.
Results: Out of the 300 patients, 145 (48.3%) were males, and 155 (51.7%) were females.
Majority (39%) of the patients belonged to 50-60 years of age group followed by 25.7%
patients in the age group of 40-50 years. 18.3% belonged to 60-70 tears of age, 10.7% were
less than 40 years, and 6.3% belonged to more than 70 years of age. Out of the 300 cases, 225
(75%) cases had fatty liver and 75 (25%) cases had non-fatty liver. Out of the included
patients, 33.4% (100) were in group A, 40% (120) were in group B, and 26.6% (80) were in
group C. Out of 300 patients, 70 (23.3%) cases had ischemic changes, but majority of patients
(230, 76.7%) did not have ischemic changes.
Conclusion: Liver ultrasound examination should be considered in every patient with newly
diagnosed type 2 diabetes because the prevalence of NAFLD is extremely high in this group
of patients. It can be said that there was an association between cardiovascular risk factors
and NAFLD in patients with type 2 diabetes mellitus.

INTRICATE ASSESSMENT OF EFFECTIVENESS OF MRI & USG PROCEDURES FOR VARIOUS PATHOLOGIES RELATED TO FEMALE PELVIC: AN ORIGINAL RESEARCH STUDY

Dr. Sunny Goyal, Dr. Prachi Jain, Dr. Dalip Singh Dhiman, Dr. Rajender Punia, Dr. Deergha Singh, Dr. Fayaz Khan H

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 163-169

Aim: To evaluate efficiencies of magnetic resonance imaging & ultrasonographyprocedures for various pathologies related to female pelvic region.
Materials & Methods: This study was performed on total sixty patients. All patients reported for various clinical issues of pelvic region. Magnetic resonance imaging & ultrasonography procedures were used as diagnostic imaging modality. Scanning outcomes of magnetic resonance imaging & ultrasonography have been categorized as group one and group two respectively. All suggestive findings of both imaging modalities were correlated with clinical diagnosis. Based on these existences of correlations, Results thus obtained was compiled and sent for basic statistical analysis. P value less than 0.05 was considered significant (p< 0.05).   
Results: Among all sixty studied patients, females were 14 in age group of 25-28 years. 13 patients were seen in age range of 33-36 years. P value was reported to be significant for this (0.01). Magnetic resonance imaging confirmed Inborn Anomalies in 3 patients. Uterine Mutilation was confirmed in 16 patients by magnetic resonance imaging. Pathologies related to Adnexa were noted in 28 patients. P value was reported to be significant for this (0.002). Endometrial Malignancies were noted in 2 patients. P value was reported to be significant for this (0.001). Pathologies related to Adnexa were noted in 25 patients by Ultrasonography. P value was reported to be significant for this (0.010).
Conclusion: Magnetic resonance imaging was able to detect and confirm almost all studied pathologies related to female pelvic region. Ultrasonography procedure was unable to detect few of those pathologies. Therefore, magnetic resonance imaging is superior and accurate option for scanning pelvis region.

A cross-sectional prospective assessment of the sonographic morphology of pelvic masses and its correlation with the histopathological diagnosis

Dr. Govind Khatri, Dr. Monika Sharma, Dr. Aditya Kaul, Dr.Ankitaa Thakral, Dr. Pratibha Gupta, Dr. Naresh Tripathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1142-1150

Aim: To evaluate the sonographic morphology of pelvic masses and to correlate with the
histopathological diagnosis of the patients who underwent surgical intervention.
Material and Methods: A cross-sectional prospective study was conducted in the
Department of Radiology Maharishi Markandeswar Medical College and Hospital
Kumarhatti, Solan,Himachal Pradesh for the period of 1 year. Total 100 female patients with
Gynecological masses using high resolution ultrasonography and findings correlated with
histopathology or serial sonographic examination.
Results: Majority of the patients were in the age group of 40-50 years with mean age of 36.3
years. The minimum number was in the age group of below 20 years. The most common
chief complaint of female patients enrolled in our study was pelvic pain 36 (36%) followed
by pain and palpable mass 16(16%).Menstrualirregularity, menorrhagia, post-menopausal
bleeding, infertility, and amenorrhea were the other less common complaints in the female
patients of our study. Out of 100 patients evaluated by ultrasonography 25 (25%) were having
ovarian pathologies and 45(45%) were having uterine pathologies. Eleven patients presented
with localized collection in the fallopian tube pathologies. Few cases there were involvement
8(8%) of vagina. Fibroids were the most common uterine masses.
Conclusion: The USG is most commonly preferred imaging tool to evaluate gynecological
masses. It’s important to differentiate gynecological and non-gynecological masses on
sonography for accurate management of the patient.

An analytical cross-sectional study to evaluate the diagnostic accuracy of ultrasonography in detecting nasal bone fractures compared with CT as the reference standard

Dr. Naresh Tripathi, Dr. Anchal Sharma, Dr. Govind Khatri, Dr. Sahil Chawla, Dr. Aditya Kaul, Dr. Yashaswi Sharma

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1130-1134

Aim: To evaluate the diagnostic accuracy of ultrasonography in detecting nasal bone
fractures compared with CT as the reference standard.
Methodology: A cross-sectional study was conducted in the Department of Radiology,
Maharshi Medical College & Hospital, Kumarhatti, Dist. Solan, Himachal Pradesh, pin code
173229 for the period of 1 year. The study group consisted of 100 patients with nasal bone
fracture who were investigated by physical examination. These patients were then examined
by conventional radiography and sonography. Physical examination was considered as the
gold standard for the diagnosis of nasal bone fracture. All patients were investigated
radiographically by a lateral and a Waters view X-ray at the beginning. The results were
evaluated by a radiologist. The reports were then recorded as either “positive” or “negative”
according to the existence of nasal bone fracture. Then, patients were examined by
sonography. Soft tissue edema and subperiosteal hematoma was also examined as a possible
predictor to differentiate an acute from a chronic fracture. The negative and positive
likelihood ratios (LR- and LR+), NPV and PPV were calculated and used for determining the
diagnostic accuracy. The LR-of ultrasonography was lower than radiography. The LR+of
sonography for the diagnosis of nasal bone fracture was 65.20 [9.28-390.10] which represents
a large and conclusive increase in the likelihood of the fracture in the presence of positive
findings. Furthermore, LR of sonography was 0.14 [0.10-0.21] which proposed a large to
moderate decrease in the likelihood of the fracture, in the presence of negative findings. LR+
of radiography was 6.20 [2.87-6.27] which showed a small increase of the likelihood of
fracture in positive results and the LR¯ of x-ray was 0.36 [0.21-0.42] which proposed a small
decrease in the likelihood of the fractures when the findings were negative.
Results: In this study, 100 patients who had nasal bone fracture in their physical examination
were investigated by sonography and radiography. Of these patients, 31 were women and 69
were men. The mean age of patients was 24.7 years. 37 (37%) patients were between 20-30
years and 28 (28%) were between 30-40 years, and 5 (5%) patients were < 20 years of age
group, while 7 (7%) were > 50 yearsand 23 patients were between 40-50 years of age group.
The youngest patient included in the study was a 12 year old male child and the oldest
patientwas a male of 60 years of age. Of the 100 patients, 78 had nasal bone fracture
(according to physical examination) and 22 patients were found normal but were investigated
due to legal issues. Out of the 78 clinically proven nasal bone fracture cases, conventional
radiography showed a fracture line in 65 cases.

Assessment of quantitative spectral Doppler parameters; resistivity index (RI) and acceleration time (AT) together to show their reliability for differential diagnosis of parenchymal thyroid diseases

Dr. Aditya Kaul, Dr. Monika Sharma, Dr. Sidhant Lochav, Dr. Govind Khatri, Dr. Bhawna Sandhir, Dr. Ankitaa Thakral

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 1, Pages 1124-1129

Aim:To assess some quantitative spectral Doppler parameters, resistivity index (RI) and
acceleration time (AT) together to show their reliability for differential diagnosis of
parenchymal thyroid diseases.
Methods: This study was conducted in the Department of Radiology, Maharishi
Markandeshwar University, Solanfor the period of 1 year. Patientsweredivided into five
groups such as group I (normal); group II had first detected, early untreated Hashimoto
disease(EH);groupIII comprised of chronic Hashimoto patients that are under treatment
and/or follow up (H); group IV had multinodular parenchymal hyperplasia (M) and group V
had nodular hyperplasia with Hashimoto (HM). They underwent spectral Dopplerultrasound
usingPhilipsAfiniti 70 G machine by a linear 5-12 MHz probe. Quantitative spectral Doppler
parameters such as resistivity index (RI) and acceleration time (AT) were recorded.
Results: Out of 200, 62.5% were female and 37.5% male most of the patients between 30-40
years 42.5% and followed by 40-50 years was 30%. The distribution of patients was done
based on diseases. The mean RI in group I was 0.57, in group II was 0.60, in group III was
0.45, in group IV was 0.51 and in group V was 0.53. Mean AT in group I was 25.9, in group
II was 24.8, in group III was 69.5, in group IV was 45.8 and in group V was 44.5.The
difference was significant (P< 0.05).
Conclusion: The resistivity index and acceleration time together are reliable for differential
diagnosis of parenchymal thyroid diseases.

EVALUATION OF ROLE OF TRANSABDOMINAL ULTRASOUND IN UTERINE AND ADNEXAL FACTORS IN INFERTILITY

Dr Poonam Ohri, Dr Niveditha Basappa, Dr Kulwinder Kaur, Dr Manasi Kohli, Parushi Kohli, Dr Prabnoor Kaur

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 282-291

Background: The desire to procreate is universal phenomenon. Childlessness is considered
as a curse in many societies and is one of the causes of marital breakups. WHO has defined
infertility as ‘Failure to conceive over 12 months of uninterrupted sexual practice. USG has
become a well-established technique for imaging ovarian and uterine pathologies. Methods:
This is a hospital based cross sectional, observation study,included total of 51 cases. The
patients with chief complaints of infertility presenting to gynaecology OPDs were referred to
the department of Radiodiagnosis,Guru Nanak Dev Hospital, Amritsar and all patients were
subjected to transabdominal ultrasonography using 3.5 MHz sector transducer. Results: Out
of 51 cases studied, 35 were of primary infertility and 16 were of secondary infertility.
Duration of infertility varied from 1.75- 17 years in patients with primary infertility and 2-10
years in patients with secondary infertility,maximum cases between 2-4 years.. Nonspecific
enlargement of uterus on one case, 3 with fibroid, 3 with endometrial calcification, one with
infantile uterus and one bicornuate uterus. Ovaries were normal in 37 cases, abnormal in 9
cases, not visualized in 3 cases on left and 1 on right side. Left ovary enlarged in one case.
Ovarian cyst in 3 cases, T.O masses in 5 cases and PCOD in one case. Fluid in POD in 4
cases.Conclusion: It is concluded that ultrasound is very helpful in assessment of uterus and
adnexal pathologies. USG is non-invasive, cheap, acceptable, easily available modality. It can
diagnose structural abnormality and helps in making diagnosis of etiologic factor in patients
of infertility and also in management and follow up of patients of infertility.

Clinical and Ultrasonography Evaluation of Pregnancy of Unknown Location in First Trimester of Pregnancy

Dr. Ditya Kumari, Dr.Hansa thagele, Dr. Deepti Gupta

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 2975-2979

Background &Method: Present study was conducted with an aim tostudy clinical and
ultrasonography evaluation of pregnancy of unknown location in first trimester of pregnancy.
500 Pregnant patients in the first trimester of pregnancy were included in the study. Complete
clinical evaluation and general physical examination were performed and patients were then
subjected to ultrasound examination.
Result:Among 500 pregnant females almost 5% were pregnancy of unknown location. 4% of
all the pregnancy of unknown location was diagnosed to be ectopic pregnancy. 0.6% of
pregnancy of unknown location was failed PUL. 0.4% of pregnancy of unknown location was
persistent PUL. β-hCG level is best indicator for predicting ectopic pregnancy while
progesterone is best indicator for viability. Serum progesterone levels can be helpful at
determining the viability of pregnancies; however, they are not specific to pregnancy
location.
Conclusion:Ultrasonography is paramount in utility as a diagnostic tool for ANC patients.
When used in combination with clinical information and serum β-hCG levels, it can provide
diagnostic and prognostic information regarding pregnancy confirmation, viability and rapid
information regarding life-threatening conditions. One great concern of PULs is that they are
cases of ectopic pregnancy whose diagnosis might be postponed.

PREVALENCE OF ASYMPTOMATIC ROTATOR CUFF TEARS IN INDIVIDUALS WITH CONTRA LATERAL SYMPTOMATIC ROTATOR CUFF TEAR DIAGNOSED BY ULTRASONOGRAPHY IN A HOSPITAL. ORIGINAL RESEARCH ARTICLE

Dr. Ashish. S. Babhulkar, Dr. Dhananjay. D. Deshmukh, Dr. Ajinkya. N. Deshpande

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4792-4801

Shoulder disorders are the most common complaint in general population and have an unfavorable outcome in many patients. Shoulder pain is the third most common cause of musculoskeletal consultation in primary care. Degenerative rotator cuff tear is the characteristic cause of shoulder pain and most often involves the supraspinatus tendon (SSP tendon). These tears can cause the significant impact on patient’s life, marking the functional impairment of shoulder joints. Plain radiography, ultrasonography, MRI, are the imaging modalities used for the assessment of rotator cuff-related pathologies. Ultrasonography of shoulder is accepted as the investigation of choice for rotator cuff abnormality mainly because it is non-invasive, cost effective, time consuming and well tolerated imaging modality that uses high frequency transducers to diagnose rotator cuff tears.This research deals with the study of prevalence of asymptomatic rotator cuff tears and their correlation with respect to age, sex, hand dominance and diabetes mellitus.

Comparative analysis of clinical, radiological and operative findings in Acute Abdomen Cases

Dr.Sumitoj Singh, Dr. Ashok Kumar, Dr.Nandu unnikrishnan, Dr.Narinder Pal Singh, Dr Vandana Sidhu

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 3393-3401

AIM: The present study was carried out as an attempt to correlate and emphasize the
salient approaches to the diagnosis and treatment of the various acute abdominal
conditions.
Material and methods: This study was a prospective observational study consisted of 50
patients with non‑traumatic acute abdomen presenting to the ED that were clinically
diagnosed acute abdomen. Detailed history was taken followed by clinical examination
and radiological investigations for all the patients. Comparative analysis of all
investigations and clinical features were made and a provisional diagnosis was derived.
Results: The results showed that mean age of the patient is 38± 13.6 years with M: F ratio
of 1:3.5. Acute cholecystitis was the most common cause of acute abdomen, accounting
for 36% of total cases followed by perforation peritonitis (24%) which included peptic
perforation and intestinal perforation. The accuracies was recorded for clinical features,
ultrasonography andXray for acute abdomen cases.
Conclusion: We concluded that Plain X rays and ultrasonography can be used for
diagnosing acute abdominal emergencies; they are the cheaper, non-invasive, quick,
reliable and highly accurate modality in diagnosing the exact cause of pain and its origin
in a patient presenting with an acute abdomen and thus helps the physician or surgeon to
plan the timely management

EvaluationHigh-Resolution Sonography and Colour Doppler in assessment of Complicated Anterior Abdominal Wall Hernia

Yara Ibrahim Abdel Hamid, Enas Mohamed Khattab, Ahmed Abdel Azim Isamail,Sameh Saber Baioumy

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 3, Pages 4087-4096

Background: There are wide range of pathology affecting the anterior abdominal
wall which range from simple fluid collection to hernias to complex neoplasms.
Anterior abdominal wall hernias are the most common lesion of anterior
abdominal lesions. The aim of the present study was to evaluate high-resolution
sonography and colour Doppler in assessment of complicated anterior abdominal
wall hernia. Patients and methods: This study includes (48) patients were referred
for sonography due to vomiting and abdominal pain of unobvious cause. Patients
were subjected to full clinical examination and high-resolution Ultrasound and
Doppler examination and X-Ray for intestinal obstruction if needed. Results: Mean
defect size of hernia associated with bowel ischemia was 1.3±0.85 cm while the
bowel wall thickness mean was 4.1 ±0.3 mm, in contrary, the mean defect size of
hernia with non-ischemic bowel was 2.9 ±0.65 cm and the bowel wall thickness
mean was 2.2 ±0.89 mm. Among the studied group, Reduction of viable loops and
herniorrhaphy were done in 45.8 % of patients, Reduction of viable loops and
hernioplasty in 22.9% of cases, while resection and primary anastomosis were done
in (14.6) of cases. The ultrasound finding comparing with the operative data
revealed that ultrasound had 100% sensitivity, while accuracy in diagnosis of
peristalsis, bowel irreducibility, bowel thickness was ranged from 93.4% to 98.8%.
Also Doppler accuracy was 100% Conclusion:High-resolution ultrasonography
(US) is non-invasive, safe and effective and simple diagnostic tool for detecting the
presence of abdominal wall hernias and accurately detecting the contentand the
possible associated complications.