Browsing by Author "A.N.D. Dwivedi"

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Biological behavior and disease pattern of carcinoma gallbladder shown on 64-slice CT scanner: A hospital-based retrospective observational study and our experience
(2012) A.N.D. Dwivedi; M. Pandey; R.C. Shukla; V.K. Shukla; S. Gaharwar; B.N. Maurya
Purpose: The aim of this diagnostic observational study was to assess the spread and biological behavior of gallbladder cancer using 64-slice computerized tomography (CT) scanner in this particular geographic belt (eastern Uttar Pradesh, western Bihar, and northern Madhya Pradesh provinces of North India). Indians are ethnically and culturally different from their Western counterparts among whom the incidence of this disease is comparatively low. Subjects and Methods: After systemic examination, all patients (87) were subjected to ultrasonographic examination. All cases were histopathologically proven. Confirmed cases were subjected to volumetric CT examination of abdomen and pelvis, plain, post contrast and delayed phase. Results: Majority of the cases were adenocarcinoma. There was female preponderance with majority belonging to fifth and sixth decades. Commonest presentation was diffuse, irregular, enhancing wall thickening in 49.4%. Majority had invasion of liver parenchyma (74.7%). Cholelithiasis was seen in 48.3% cases. Invasion of biliary radicals was high (13.8-18.4%). Eleven cases had invasion of portal vein and tumor thrombus, with hepatic artery invasion in one case. In two cases, both hepatic artery and portal vein invasion was seen. Portal and peripancreatic nodal metastasis was seen in 58.5%. Distant metastasis was reported. Conclusion: Few studies involving the Indian population have attempted to use multi-row detector CT to define the biological behavior of carcinoma gallbladder. The opinion whether the pathology is operable or non-operable can reasonably be given. This large-scale, single-center study gives insight about the epidemiology and biological behavior of carcinoma gallbladder. Dwivedi AND 1 Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi Pandey M 2 Department of Surgery, Institute of Medical Sciences, BHU, Varanasi Shukla R 3 Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi Shukla V 4 Department of Surgery, Institute of Medical Sciences, BHU, Varanasi Gaharwar S 5 Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi Maurya B 6 Department of Radiodiagnosis and Imaging, Institute of Medical Sciences, BHU, Varanasi Shukla VK, Khandelwal C, Roy SK, Vaidya MP. Primary carcinoma of gall bladder: A review of a 16-year period at the university hospital. J Surg Oncol 1985;28:32-5. National Cancer registry Programme: Consolidated report of the population based cancer registries 1990-1996, Incidence and distribution of cancer, New Delhi: Indian Council of Medical Research, ICMR; 2001. p. 52-3. Kapoor VK, Mc Michael AJ. Gall Bladder Cancer: An ′Indian" disease. Natl Med J India 2003;16:209-13. Maram ES, Ludwig J, Kurland LT, Brian DD. Carcinoma of the gallbladder and extrahepatic biliary ducts in Rochester, Minnesota, 1935-1971. Am J Epidemiol 1979;109:152-75. Nervi F, Duarte I, Gomez G, Rodreguez G, Delpino G, Ferrerio O, et al. Frequency of the gallbladder cancer in Chile. Int J Cancer 1988;41:657. Soira M, Aro K, Pamilo M, Palvansalo M, Suramo I, Taavitsainen M. ultrasonography in carcinoma of gall bladder. Acta Radiol 1987;28:711-4. Palma LD, Rizzatto G, Pozzi-Mercerri RS, Bazzoccbi M. Gray scale ultrasonography in the evaluation of the carcinoma of the gall bladder. Br J Radiol 1980;53:662-7. Itai Y, Araki T, Yoshikawa K, Fureri S, Yashiro N, Tasaka A. Computed tomography of gall bladder carcinoma. Radiology 1980;137:713-8. Zatonski WA, La Vecchia C, Przewozniak K, maisonneuve P, Lowenfels AB, Boyle P. Risk factors for gall bladder cancer: A polish case control study. Int J Cancer 1992;51:707-11. Strom BL, Soloway RD, Rioz-Palenz JL, Rodriguez-Martinez HA, West SL, Kinman JL, et al. Risk factors for gallbladder cancer. Cancer 1995;76:1747-56. Zatonski WA, Lowenfels AB, Boyle P, Maisonneuve P, Bruno De Mesquita HB, Ghadirian P, et al. Epidemiologic aspects of gall bladder cancer. A case control study of the search programme of the International agency for Research on Cancer. J Natl Cancer Inst 1997;89:1132-8. Kats K, Akai S, Tominaga S, Kato I. A case control study of biliary tract cancer in Nigata Prefecture, Japan. Jpn J Cancer Res 1989;80:932-8. Waterhouse J, Muir C, Correa P, Powell J, editors. Cancer incidence in five continents, Vol 3, IARC Publication No. 15. Lyon: IARC; 1976. Zeman RK, Burrell Ml, editors. Gallbladder and Bile Duct Imaging: A clinical radiologic approach. New York: Churchill Livingstone; 1987. p. 292-307. Chaurasia P, Thakur MK, Shukla HS. What causes cancer gallbladder?: A review. HPB Surg 1999;11:217-24. Furlan A, Ferris JV, Hosseinzadeh K, Borhani AA. Gallbladder carcinoma update: Multimodality imaging evaluation, staging and treatment options. AJR Am J Roentgenol 2008;191:1440-7. Nakayama F. Recent progress in the diagnosis and gtreatment of carcinoma of gall bladder: Introduction. World J Surg 1991;15:313-4. Piehler JM, crichlow RW. Primary carcinoma of gall bladder. A collective review. Surg Gynecol Obstet 1978;147:929-42. Pandey M, Gautam A, Shukla VK. ABO and Rh blood groups in patients with cholelithiasis and carcinoma of the gall bladder. Br Med J 1995;310:1639. Shukla VK, Shukla PK, Pandey M, Rao BR, Roy SK. Lipid peroxidation products in bile from patients with carcinoma of the gall bladder. A preliminary study. J Surg Oncol 1994;54:258-62. Pandey M, Shukla PK, Gautam A, Rao BR, Roy SK, Shukla VK. Increased peroxidation of polyunsaturated fatty acids: A possible link in the peroxidant pathogenesis of carcinoma of the gallbladder with cholelithiasis. Proc. UICC XVI International Cancer Congress, Monduzzi Editore, Roma, Italy 1994; 3: 2055-8.. Shukla VK, Tiwari SC, Roy SK. Biliary bile acids in cholelithiasis and carcinoma of the gall bladder. Eur J Cancer Prev 1993;2:155-60. Kaplan EL, Meier P. Nonparametric estimation from incomplete observations. J Am Stat Assoc 1958;53:457-81. Silk YN, Dougras HO Jr, Nava HR, Driscoll DL, Tartarian G. Carcinoma of the gall bladder. The Rosewerr Park experience. Ann Surg 1989;210:751-7. Pandey M, Pathak AK, Gautam A, Aryya NC, Shukla VK. Digestive diseases and sciences. Dig Dis Sci 2001;46:1145-51. Yoshimitsu K, Honda H, Shinozaki K, Aibe H, Kuroiwa T, Irie H, et al. Helical CT of the local spread of carcinoma of the gall bladder: Evaluation of the gall bladder: Evaluation according to the TNM system in patients who underwent surgical resection. AJR Am J Roentgenol 2002;179:423-8. Grand D, Horton MK, Fishman EK. CT of the gall bladder: Spectrum of disease. AJR Am J Roentgenol 2004;183:163-70. Rckert JC, Rckert RI, Gellert K, Hecker K, Mller JM. Surgery for carcinoma of the gallbladder. Hepatogastroenterology 1996;43:527. Fong Y, Wagman L, Gonen M, Crawford J, Reed W, Swanson R, et al. Evidence-based gallbladder cancer staging: Changing cancer staging by analysis of data from the National Cancer Database. Ann Surg 2006;243:767. Kiran RP, Pokala N, Dudrick SJ. Incidence pattern and survival for gallbladder cancer over three decades-an analysis of 10301 patients. Ann Surg Oncol 2007;14:827. Kapoor VK, Pradeep R, Haribhakti SP, Sikora SS, Kaushik SP. Early carcinoma a of gall bladder: An elusive disease. J Surg Oncol 1996;62:284-7.
Colour Doppler evaluation of uterine and ovarian blood flow in patients of polycystic ovarian disease and post-treatment changes
(W.B. Saunders Ltd, 2020) A.N.D. Dwivedi; V. Ganesh; R.C. Shukla; M. Jain; I. Kumar
AIM: To assess the morphology and colour Doppler parameters in patients with polycystic ovarian syndrome (PCOS) and also to assess the changes in Doppler parameters in follow-up patients, who underwent treatment. MATERIALS AND METHODS: The study was conducted on 50 women of reproductive age who had clinical and biochemical findings suggestive of PCOS. Clinico-hormonal parameters were recorded. Ultrasound and colour Doppler flow measurements of bilateral ovaries were performed in the early proliferative phase of the menstrual cycle. After assessment of the bilateral ovaries, colour Doppler ultrasound was used to evaluate the main uterine artery at the cervico-uterine junction. Follow-up imaging after 3 months was undertaken in patients who underwent treatment (metformin) and changes in the imaging and hormonal parameters were correlated. RESULTS: The mean value of luteinising hormone (LH) and the ratio of LH: follicle-stimulating hormone (FSH) was significantly higher in PCOS patients. Ultrasound parameters were significantly higher in PCOS patients. Ovarian stromal vessels in PCOS patients had a significantly higher peak systolic velocity (PSV), low resistance index (RI), and pulsatility index (PI). The PSV of uterine arteries were significantly decreased and the RI and PI were significantly increased. On follow-up patients revealed changes in hormonal parameters. CONCLUSION: PCOS is a heterogeneous disorder and is a convergence of multisystem endocrine derangements. Ultrasound is good diagnostic tool for PCOS and the use of Doppler aids in the evaluation of haemodynamic changes in small vessels of utero-ovarian circulation and in response assessment. © 2020 The Royal College of Radiologists
CT coronary angiography as an alternative imaging method to ascertain cardiac output and its correlation with echocardiography
(W.B. Saunders Ltd, 2023) A.N.D. Dwivedi; A. Varshney; D. Jain; G. Singh
AIM: To assess the feasibility and accuracy of cardiac output (CO) obtained using a test bolus in patients scanned with single-source prospective-gated cardiac computed tomography (CT), and comparing it with CO obtained from unenhanced two-dimensional (2D) echocardiography using biplane Simpson's method. MATERIALS AND METHODS: In the present study, 100 patients with a mean age of 55 ± 12 years who underwent coronary CT angiography with prospective electrocardiogram (ECG)-gated CT in which the scan delay was evaluated using a test bolus. The time–attenuation curves obtained from the test bolus were used to calculate the CO of the patients. The CO obtained was then compared with that obtained after follow-up 2D echocardiography using biplane modified Simpson method. RESULTS: Linear regression was calculated between the CO and contrast enhancement: CO = –0.16(HUmax) + 7.65. The study showed good correlation between the two methods with r=0.77, p<0.001. On Bland–Altman analysis, no significant difference was noted between the two methods. CONCLUSION: This less researched method for CO estimation appears feasible; however, the clinical usefulness of this parameter is uncertain in absence of further clinical and reference standard validation. © 2023
Cutaneous T-cell lymphomas and their management strategies
(Wolters Kluwer Medknow Publications, 2014) S.S. Pandey; S. Garg; A.N.D. Dwivedi; R. Tripathi; K. Tripathi; M. Bansal
Cutaneous T-cell lymphomas (CTCLs) comprise a heterogeneous group of lymphoproliferative disorders characterized by the proliferation of skin-homing post-thymic T-cells. It is the second most common extranodal non-Hodgekin′s lymphoma. Many variants of mycosis fungoides and CTCLs are known to date, differing in clinical, histological, and immunophenotypic characteristics. Oral involvement has also been reported rarely in CTCLs. Treatment depends on the disease stage or the type of variant. New insights into the disease and the number of emerging novel therapeutic options have made it an interesting area for dermatologists and medical oncologists.
Randomized key-based gmo-bcs image encryption for securing medical image
(Blue Eyes Intelligence Engineering and Sciences Publication, 2019) Vineet Kumar Singh; Achintya Singhal; Kabindra Nath Rai; Abhishek Kumar; A.N.D. Dwivedi
An essential security requirement while transmitting and receiving medical images is to maintain confidentiality and authorization of these medical images. This paper contains a proposal of an enhanced lossless image encryption algorithm that provides security to Digital Imaging and Communications in Medicine (DICOM) images by producing a random key with using enhanced group modulo based bit circular shift (GMO-BCS) technique. Random key production is the backbone of this technique to provide robust security of medical images that transfer over a network. In the encryption process, we randomly generate a key for each and every pixel of the DICOM image. Group theory is used in this process to create circular shifting in 8-bit pixel values while the security enhancement employs the random key for encryption. This technique is more suitable for medical image encryption either by direct transmission or multimedia app-based transmission under telemedicine and others. © BEIESP.
The longest tumor diameter in one dimension as a predictor for skeletal metastasis in renal cell carcinoma
(Medknow Publications, 2016) A.N.D. Dwivedi; A. Srinivasan; S. Kumar; S. Trivedi; V.K. Shukla; R.C. Shukla
INTRODUCTION: Renal cell carcinoma (RCC) comprises a diverse group of malignant neoplasms that have multifarious histopathological features and biological behavior. One-Third of RCC patients develops skeletal metastasis with a poor 5-year survival rate. Data explaining how some of these tumors show sooner bony metastasis than expected is sparse. The objective of this study was to identify whether tumor size can act as a predictor of bony metastases among patients of RCC. MATERIALS AND METHODS: We retrospectively reviewed contrast enhanced computed tomography (CECT) scan and clinical records of 66 patients with RCC, who fulfilled specified inclusion criteria. Patients who had bony metastasis at the time of presentation were selected as case and those without skeletal metastasis were referred to as controls. Receiver operating characteristic (ROC) curve analysis was used to determine the appropriate cut-off value for tumor size, which was measured as the longest tumor diameter (LTD) in one-dimensional (1D). RESULTS: Of the 66 patients selected, 30% developed bone metastasis. The tumor size of RCCs significantly correlated with the presence of skeletal metastasis in our study. None of the patients with 1D LTD <4.8 cm on CECT were found to have skeletal metastasis. ROC analysis revealed that the accuracy of the LTD in predicting bone metastasis was high with an area under ROC curve of 0.823. A cut-off value of 7.5 cm had a sensitivity of 78.9% and specificity of 80.9%. CONCLUSION: The 1D LTD with a cut-off value of 7.5 cm, at the time of presentation is an important predictor of skeletal metastasis. The result of this study may have role in triage of patients into a subgroup which mandates more aggressive treatment and monitoring.