Browsing by Author "Arvind Srivastava"

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Antral follicle count in normal (fertility-proven) and infertile Indian women
(Georg Thieme Verlag, 2014) Arjit Agarwal; Ashish Verma; Shubhra Agarwal; Ram Chandra Shukla; Madhu Jain; Arvind Srivastava
Background: Antral follicle count (AFC) has been labeled as the most accurate biomarker to assess female fecundity. Unfortunately, no baseline Indian data exists, and we continue using surrogate values from the Western literature (inferred from studies on women, grossly different than Indian women in morphology and genetic makeup). Aims: (1) To establish the role of AFC as a function of ovarian reserve in fertility-proven and in subfertile Indian women. (2) To establish baseline cut-off AFC values for Indian women. Settings and Design: Prospective observational case-control study. Materials and Methods: Thirty patients undergoing workup for infertility were included and compared to equal number of controls (women with proven fertility). The basal ovarian volume and AFC were measured by endovaginal. USG the relevant clinical data and hormonal assays were charted for every patient. Statistical Analysis Used: SPSS platform was used to perform the Student's t-test and Mann-Whitney U-test for intergroup comparisons. Correlations were determined by Pearson's ranked correlation coefficient. Results: Regression analysis revealed the highest correlation of AFC and age in fertile and infertile patients with difference in mean AFC of both the groups. Comparison of the data recorded for cases and controls showed no significant difference in the mean ovarian volume. Conclusions: AFC has the closest association with chronological age in normal and infertile Indian women. The same is lower in infertile women than in matched controls. Baseline and cut-off values in Indian women are lower than that mentioned in the Western literature.
Bimanual compression therapy of uterine Pseudoaneurysm
(2011) Ashish Verma; Madhavi Verma; Shivi Jain; Ram Chandra Shukla; Anuradha Khanna; Sonali Gupta; Shikha Sachan; Arvind Srivastava
[No abstract available]
Chemical Shift Artifact on Steady-State MRI Sequences for Detection of Vesical Wall Invasion in Placenta Percreta
(Federation of Obstetric and Gynecologycal Societies of India, 2016) Ishan Kumar; Ashish Verma; Shivi Jain; Madhu Jain; R.C. Shukla; Arvind Srivastava
Background: Antenatal diagnosis of the invasiveness of a placenta percreta helps in planning the surgical approach, reducing blood loss and morbidity. Doppler sonography is the mainstay diagnostic modality with a sensitivity of 80–95 %. With the advent of high magnetic field MRI techniques, there has been recent interest in evaluation of placenta by MRI. On an extensive PUBMED search, we could not find any citations describing imaging, ultrasound, or MRI features to evaluate vesical wall invasion by placenta percreta. Purpose: We attempt to evaluate transmyometrial vesical wall invasion by placenta percreta using chemical shift artifact as a marker of intact bladder-myometrial interface on steady-state MRI sequences. Materials and Methods: This is a prospective observational study, conducted at a university hospital. We have compiled clinico-radiological criteria for diagnosis of invasive placentae based on the existing body of evidences, in four patients. We further go on to analyze a specific proposed sign on a newly introduced MR imaging sequence i.e., loss of chemical shift artifact (India ink line) on steady-state GRE sequence (TrueFISP), to diagnose transmyometrial vesical invasion in placenta percreta. Results: Though the sample size is small, the sensitivity, specificity, positive, and negative predictive value of the proposed sign for the purpose was 100 %. Conclusions(s): Loss of chemical shift artifact (India ink line) on steady-state GRE sequences at the vesico-myometrial junction in case of invasive placentae confirms vesical wall invasion, a prospective diagnoses of which can help in planning the surgical protocol and preventing potentially fatal blood loss. © 2015, Federation of Obstetric & Gynecological Societies of India.
Clinical spectrum of neural tube defects with special reference to karyotyping study
(2012) Vijayendra Kumar; Anutosh Singh; Shiv Prasad Sharma; Arvind Srivastava; Ajit Saxena; Ajay Narayan Gangopadhyay
Background: Neural tube defects are common congenital malformations of the central nervous system. Despite years of intensive epidemiological, clinical, and experimental research, the exact etiology of NTD remains rather complex and poorly understood. The present study attempted to look into the association of occurrence of NTD with reference to folic acid levels, along with karyotyping status. Materials and Methods: Detailed history was taken with emphasis on age of the baby and mother, parity, antenatal folic acid intake. Five milliliters of blood was drawn from all the babies and their mothers and divided equally in preheparinized vials (for karyotyping) and plain vials (for folic acid estimation). The total duration was 2 years. Results: The total number (n) in the study group was 75. The folic acid level was less in affected babies and their mother when compared to matched controls. Chromosomal defect was observed in nine of the 75 patients. Karyotyping defects were higher in children born to mothers of the age group 31-40 years and when their birth order was second. Conclusion: Folic acid supplementation needs to be continued to prevent the occurrence of NTD, and the perinatal identification of NTD should alert one to the possibility of chromosomal abnormalities and prompt a thorough cytogenetic investigation and genetic counseling.
Comparison of Ranson, Glasgow, MOSS, SIRS, BISAP, APACHE-II, CTSI Scores, IL-6, CRP, and procalcitonin in predicting severity, organ failure, pancreatic necrosis, and mortality in acute pancreatitis
(2013) Ajay K. Khanna; Susanta Meher; Shashi Prakash; Satyendra Kumar Tiwary; Usha Singh; Arvind Srivastava; V.K. Dixit
Background. Multifactorial scorings, radiological scores, and biochemical markers may help in early prediction of severity, pancreatic necrosis, and mortality in patients with acute pancreatitis (AP). Methods. BISAP, APACHE-II, MOSS, and SIRS scores were calculated using data within 24 hrs of admission, whereas Ranson and Glasgow scores after 48 hrs of admission; CTSI was calculated on day 4 whereas IL-6 and CRP values at end of study. Predictive accuracy of scoring systems, sensitivity, specificity, and positive and negative predictive values of various markers in prediction of severe acute pancreatitis, organ failure, pancreatic necrosis, admission to intensive care units and mortality were calculated. Results. Of 72 patients, 31 patients had organ failure and local complication classified as severe acute pancreatitis, 17 had pancreatic necrosis, and 9 died (12.5%). Area under curves for Ranson, Glasgow, MOSS, SIRS, APACHE-II, BISAP, CTSI, IL-6, and CRP in predicting SAP were 0.85, 0.75, 0.73, 0.73, 0.88, 0.80, 0.90, and 0.91, respectively, for pancreatic necrosis 0.70, 0.64, 0.61, 0.61, 0.68, 0.61, 0.75, 0.86, and 0.90, respectively, and for mortality 0.84, 0.83, 0.77, 0.76, 0.86, 0.83, 0.57, 0.80, and 0.75, respectively. Conclusion. CRP and IL-6 have shown a promising result in early detection of severity and pancreatic necrosis whereas APACHE-II and Ranson score in predicting AP related mortality in this study. © 2013 Ajay K. Khanna et al.
Diagnostic value of diffusion tensor imaging derived metrics as biomarkers of cerebral changes in developmental delay
(Wolters Kluwer Medknow Publications, 2015) Ashish Verma; Narendra C. Sagar; Ashok Kumar; Arvind Srivastava
Context: Children with developmental delay (DD) can be rehabilitated if an early diagnosis and intervention is done. A negative magnetic resonance imaging (MRI) study utilizing routine sequences makes it difficult for the clinician to convince the family toward a long-term rehabilitation schedule. Diffusion tensor imaging (DTI) can demonstrate deranged myelination in developmentally delayed children having normal routine MRI. Aim: To evaluate the role of DTI-derived metrics for assessment of deranged myelination in developmentally delayed children having normal routine MRI. Study Setting and Design: Prospective case control observational study conducted over a cross-section of referrals at a university-based teaching institute over a period of 2 years. Patients and Methods: Fifty cases of DD and 15 age-sex matched controls (age group of 2-12 years) were included from those presenting voluntarily to the pediatric out-patient services. Routine MRI and DTI were performed in both the groups following a standard protocol. Apparent diffusion coefficient (ADC) and fractional anisotropy (FA) were calculated in certain pre-defined regions. Statistical Analysis: Central tendency was measured for each of the metrics using mean. Inter- and intra-group comparisons were performed using t-test. Results: Twenty-three regions of interest with 46 variables were included in the final analysis. Nineteen (82.60%) regions of interest showed at least one statistically significant variable, while 24 out of 46 (54.34%) variables showed statistical significance for future consideration. The important regions to be evaluated in a case of DD are the corpus callosum, bilateral forceps minor and forceps major, bilateral parietal lobes, bilateral post-central gyrus, and bilateral posterior limb internal capsule (PLIC). The regions which did not show any significance are bilateral pars triangularis and right frontal lobe. Other regions remained indeterminate and need further evaluation. Conclusion: DTI demonstrates myelination abnormality in children with DD, having a normal routine MRI.
Disseminated cysticercosis in a child
(2012) Rajniti Prasad; Kanika Kapoor; Deepak Mishra; M.K. Singh; Arvind Srivastava; Om Prakash Mishra
[No abstract available]
Dizziness and collapse? It's a steal!
(Elsevier B.V., 2009) Vishal Khurana; Inderjeet Singh Gambhir; Arvind Srivastava; Dhiraj Kishore
[No abstract available]
Duodenojejunal junction web masquerading as Wilkie's syndrome: Report of a case
(2011) Somprakas Basu; Vivek Srivastava; Pramod Kumar Singh; Arvind Srivastava; Vijay Kumar Shukla
Wilkie's syndrome (superior mesenteric artery syndrome) is a rare cause of obstruction to the third part of duodenum due to compression between the superior mesenteric artery and the abdominal aorta. Pathologies like malignant growth in the mesenteric root, the presence of a lymph nodal mass compressing the terminal duodenum, dissecting aortic aneurysm, and intestinal malrotation may mimic the condition, but are not true etiologies of the syndrome. A duodenojejunal web causing narrowing of the duodenojejunal junction and mimicking Wilkie's syndrome has not been described before in the literature. We herein report a case of gastroduodenal obstruction due to a web in the duodenojejunal junction in a young female patient, which closely mimicked Wilkie's syndrome but was finally diagnosed postoperatively. We highlight the first case of its kind in an adult and discuss the challenges in both the diagnosis and management. © Springer 2011.
Encephalitis following purified chick embryo rabies vaccination
(2012) Rajniti Prasad; Abhilasa Marothiya; O.P. Mishra; Arvind Srivastava
Encephalitis following purified chick embryo rabies vaccination is rare and only a few cases have been reported. A 6-year-old boy is reported who developed features consistent with encephalitis following a third dose of the vaccine and made a complete recovery. © W. S. Maney & Son Ltd 2012.
Hodgkin disease with spinal cord compression
(2009) Vineeta Gupta; Arvind Srivastava; Baldev Bhatia
Hodgkin disease is a nodal disease. Spinal cord or root compression is a rare complication and usually seen in the setting of progressive, advanced disease. We report 2 cases of Hodgkin disease in pediatric patients who presented with neurologic signs. One patient had paravertebral masses and involvement of thoracic vertebrae, which was initially misdiagnosed as spinal tuberculosis. The second patient who presented with paraplegia and bladder and bowel involvement had an epidural mass with collapse of thoracic vertebra. Lymph node biopsy revealed Hodgkin disease, mixed cellularity in both the cases. Both were treated with chemotherapy followed by radiotherapy. © 2009 by Lippincott Williams & Wilkins.
Hydrocele of the canal of Nuck-Rare differential for vulval swelling
(Georg Thieme Verlag, 2014) Anubha Pandey; Shivi Jain; Ashish Verma; Madhu Jain; Arvind Srivastava; Ram C. Shukla
Patent canal of Nuck is one of the rare developmental entities in females, presenting clinically as an inguino-labial swelling. The usual content of this sac is fluid being secreted by the peritoneal mesothelium. In rare cases, ovary alone or with fallopian tube may prolapsed out into the sac. We report the rationale use of diagnostic algorithm in a case of ovarian hernia into the patent canal of Nuck, to differentiate it from more common clinical mimics. Furthermore, in the present case, a knowledge of the entity and targeted scrutiny, led to a correct identification of the prolapsed ovary, preventing an unwarranted oophorectomy in the garb of neoplasia.
Imaging of trichoptysis - How a radiologist can help?
(Wolters Kluwer Medknow Publications, 2014) Ashish Upadhyay; Ashish Verma; Jeetendra Sharma; Ram C. Shukla; Arvind Srivastava
Trichoptysis is a rare symptom, but pathognomonic of a teratoma having a bronchial communication. Thoracic teratomas are usually located within the anterior mediastinum, but rarely present with trichoptysis, as transpleural erosion of a mediastinal teratoma into lung and hence bronchial tree is exceedingly rare. We report the characteristic radiological and clinical features in one such case with ruptured mature mediastinal teratoma having a bronchial communication leading to trichoptysis. Only nine cases of trichoptysis have been reported in the literature as yet, but a fistulous communication with the bronchial tree on computed tomography, as seen in the present report, has not been demonstrated in any of these preceding reports. Histopathological sample obtained during the surgery further confirmed the presence of a mediastinal teratoma with transpleural broncho-pulmonary communication.
Invasive placental disorders: A prospective US and MRI comparative analysis
(SAGE Publications Inc., 2017) Ishan Kumar; Ashish Verma; Ritu Ojha; Ram C. Shukla; Madhu Jain; Arvind Srivastava
Background Invasive placental disorders are potentially life-threatening. Its diagnosis and evaluation of degree of invasiveness is vital in surgical and treatment planning. Purpose To compare the role of various imaging modalities used in current practice for evaluation of invasive placental disorders, and evaluate the validity of certain imaging signs for prediction of invasive placenta. Material and Methods Twenty-two patients, which were clinically stratified as a risk group for underlying invasive placental abnormality, underwent Doppler sonography and magnetic resonance imaging (MRI). Abnormal placental invasiveness was assessed using various Doppler sonography and MRI signs described in the existing literature. We systematically evaluated the utility of each of these modalities and signs, and compared the roles played by them separately and in combination. All the cases were correlated with surgical and pathological findings. Results Nine patients had surgical and pathological confirmation of placental adhesive disorders, of which eight were predicted correctly by MRI (true positive) while one was misdiagnosed as normal placenta (false negative). All the nine cases were correctly identified by Doppler sonography. MRI was more accurate in predicting bladder invasion, identifying 5/6 cases. Conclusion Both MRI and Doppler sonography are useful for detection of invasive placental disorders. However, MRI is a better predictor of bladder invasion. © The Foundation Acta Radiologica.
Lateral cephalometric evaluation in cleft palate patients
(Infor-Press, 2009) Pradeep Jain; Anand Agarwal; Arvind Srivastava
The aim of the study. The lateral cephalometric study in children with cleft palate was carried out to find out the cause of maxillary retrusion and to see if there were other changes induced by this entity in the maxillofacial morphology Material and methods. Lateral cephalometric evaluation of 28 patients with un-operated cleft palate (group A), 12 patients with operated cleft palate (group B) and 10 controls (group C) was done by tracing the lateral cephalographs, marking the various landmarks and taking the mean of each measurements made thrice Results. It showed significant decrease in maxillary length and S-N-ANS angle indicating maxillary hypoplasia in all group A patients, significantly so in 16-20 years age group. Group B patients having undergone palatal repair in their childhood revealed significant increase in lower anterior facial height, the other parameters being insignificantly altered when compared with control Conclusions. The findings suggest an intrinsic deficiency not only in maxilla but contrary to the past belief also in mandible. There was no significant difference in the cephalometric measurements between un-operated and operated cleft palate patients.
Magnetic Resonance Fistulogram Demonstration of Urethrovesicovaginal Fistula in a Case of Müllerian Agenesis Due to Traumatic Urethral Coitus
(2012) Ashish Verma; Surabhi Vyas; Sriram Patwari; Madhvi Verma; Arvind Srivastava; Ram Chandra Shukla
Vesicovaginal fistula is not uncommon in women of childbearing age, and can occur due to a multitude of causes, the chief ones being infection and neoplasia. An extensive PUBMED search yielded only a few reports describing causation of such a lesion due to traumatic urethral coitus. The classic method to demonstrate such fistulas is by direct contrast-enhanced fistulography. Herein we report a case of urethrovesicovaginal fistula with müllerian agenesis caused by traumatic urethral coitus, as demonstrated using indirect magnetic resonance fistulography. © 2012 AAGL.
Magnetic resonance neurographic confirmation of extensive Plexiform neurofibroma in neurofibromatosis-1 presenting as ambiguous genitalia
(Wolters Kluwer Medknow Publications, 2016) Ishan Kumar; Ashish Verma; Ritu Ojha; Priyanka Aggarwal; Ram Shukla; Arvind Srivastava
Genitourinary involvement of neurofibromatosis is uncommon and genital neurofibromatosis is even rarer. Involvement of clitoris by neurofibroma can lead to clitoromegaly masquerading as a male penis. We report such a case of ambiguous genitalia in a 7-year-old female child presenting with clitoromegaly since birth, in which magnetic resonance imaging (MRI) revealed the presence of extensive neurofibromatosis in the clitoris and lumbosacral regions. We emphasize the central role of MRI in evaluation of hormonal and non-hormonal causes of ambiguous genitalia. We further discuss the merits of including MR neurography in the imaging protocol for comprehensive delineation of neurofibromatosis. © 2016 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.
MRI detection of posterior urethral diverticulum following surgical repair of anorectal malformations
(Elsevier B.V., 2017) Ishan Kumar; Ashish Verma; Vaibhav Pandey; Priyanka Aggarwal; Ram Chandra Shukla; Arvind Srivastava
Aim To identify and to assess imaging and clinical features of Posterior urethral diverticula (PUD) in a single-centre series and include a brief review of literature. Materials and method Post operative MRI of 140 children from north India were retrospectively reviewed who underwent surgical repair for anorectal malformation (ARM) along with the Hospital records. Results Ten cases had MRI features of posterior urethral diverticulum. All of these patients had undergone primary abdominoperineal pull through (APPT) procedure. The lesions ranged between 6 mm and 38 mm in size. Two of these lesions were missed in the post operative MRI report. Only one of these patients was symptomatic and presented with dribbling of urine and gross bilateral vesicoureteric reflux in which the diverticulum was excised surgically. Conclusion PUD is an under-recognised entity and can be identified in preclinical stage on MRI. Careful assessment of urethra and periurethral structures should be a mandatory step in MRI evaluation of post repair ARM cases. An observational conservative approach in selected asymptomatic patients can be an effective management strategy. © 2017 The Egyptian Society of Radiology and Nuclear Medicine
Multiple Cavernous Malformations with Hemorrhage of Brain
(Springer, 2014) Rajniti Prasad; Sujoy Saha; Om Prakash Mishra; Arvind Srivastava
[No abstract available]
Myelopathy in adult aortic coarctation: Causes and caveats of an atypical presentation
(Wolters Kluwer Medknow Publications, 2016) Chandan Mourya; Ashish Verma; Anand Bansal; Ram C. Shukla; Arvind Srivastava
A 57-year-old female presenting with acute-onset paraplegia was referred for magnetic resonance imaging (MRI) of cervico-dorsal spine. On MRI, multiple tortuous dilated vessels were noted in the epidural space with long segment cord compression and imaging features of compressive myelopathy. Associated small acute cervico-dorsal epidural hematoma was also noted in the same region. Computed tomography (CT) angiography was performed subsequently which revealed post-ductal coarctation of aorta with multiple arterial collaterals in the chest wall and spinal canal. An extensive review of English language literature pertaining to the clinical presentations of adult aortic coarctation revealed only few reports of acute compressive myelopathy due to spinal epidural collateral vessels. Further, presentation at such a late age has not been reported before. In the present case, apart from a hypertrophied anterior spinal artery and perispinal collaterals, an anterior epidural hematoma was an additional important factor in the causation of myelopathy.