Browsing by Author "Priyanka Aggarwal"

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A Rare Case of Multiple Intracranial Cysts
(Springer, 2019) Ishan Kumar; Srishti Sharma; Zeeshan Siddiqui; Priyanka Aggarwal; Ashish Verma
[No abstract available]
A Rare Cause of Acute Recurrent Pancreatitis in a Child
(Springer, 2024) Ishan Kumar; Sunil Meena; Pramod Kumar Singh; Priyanka Aggarwal; Ashish Verma
[No abstract available]
A Rare Cause of Iron Deficiency Anemia
(Springer, 2024) Sucheta Barnwal; Priyanka Aggarwal; Vineeta Gupta
[No abstract available]
Alterations in Bone Turnover during Chemotherapy in Children with Acute Lymphoblastic Leukemia
(Georg Thieme Verlag, 2021) Vineeta Gupta; Shalini Dash; Priyanka Aggarwal; Surya Kumar Singh
Background Disturbances of bone metabolism frequently occur in children with acute lymphoblastic leukemia (ALL), leading to increased risk of osteopenia and osteoporosis at diagnosis, during and after completion of chemotherapy. The present study was performed to evaluate alteration in bone mineral metabolism in children with ALL during chemotherapy. Method Fifty newly diagnosed patients with ALL in the age group of 2 to 14 years were included. Relapsed and refractory cases were excluded. Enrolled children were stratified into standard and high risk according to National Cancer Institute criteria. Quantitative analysis of bone resorptive marker carboxyl-terminal telopeptide of human type 1 collagen (ICTP) was assessed at baseline and 3 months after chemotherapy by the sandwich enzyme-linked immunosorbent assay technique. Results Of 50 patients enrolled, 21 were standard and 29 were high risk. The mean age was 7.75 ± 4.0 years and the male-to-female ratio was 3.5:1. ICTP levels were analyzed in 44 patients, of which 37 (84%) showed significantly increased levels. The mean ICTP level in patients at diagnosis and controls was 1.78 ± 1.39 and 0.96 ± 0.32 μg/L, respectively (p = 0.001). The mean ICTP level at 3 months after chemotherapy increased to 3.55 ± 1.40 μg/L (p = 0.000). It was significantly increased in males (p = 0.000) and in B cell ALL group (p = 0.000) in comparison to females and T cell group. Both standard and high risk groups were equally affected (p = 0.000). On multivariate analysis, no single risk factor could be identified. Conclusion The marker of bone resorption (ICTP) in children with ALL was increased at diagnosis, which further increased during chemotherapy. The disease itself and the intensive chemotherapy both contributed to the increased levels. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.
Approach to Acute Respiratory Illness in Children with Hematological Malignancy: A Prospective Study Evaluating Utility of CT Scan
(Georg Thieme Verlag, 2022) Priyanka Aggarwal; Tapish Raipa; Ishan Kumar; Ashish Verma; Ram Chandra Shukla; Vineeta Gupta
Introduction Various pulmonary complications can occur in children with hematological malignancies including both infection and malignant disease infiltration of pulmonary parenchyma. Objectives To assess the role of CT scan in determining the etiology of acute pulmonary complications in children with hematological malignancies. Materials and Methods All children < 17 years with newly diagnosed hematological malignancy with respiratory symptoms (Group A) along with children who developed fever with persistent respiratory symptoms as well as worsening chest radiographs during treatment (Group B) and underwent CECT thorax, from February 2019 to July 2020 were enrolled. The final diagnosis was made on the basis of clinical history, laboratory as well as radiological investigations and treatment response. Results Thirty-seven children with mean age of 7.5 ± 3.5 years and male to female ratio of 1.3:1 who underwent CECT thorax were included in our study. For newly diagnosed cases, i.e., Group A (n = 8), the most common cause of respiratory symptoms as identified on CECT thorax was pulmonary tumoral infiltration (n = 5) followed by tuberculosis (n = 3). However, in Group B (n = 29) the cause of persistent respiratory symptoms was identified as infection (n = 17) followed by leukemic infiltration (n = 12). Thus, chest CT could accurately identify pulmonary tuberculosis, fungal pneumonia, bacterial infection, and pulmonary tumoral infiltrates. Conclusion CT scan can be used as an adjunctive tool for prompt diagnosis and management of pulmonary complications in children with persistent respiratory symptoms as they are often non-specific. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Bone Mineral Metabolism during Chemotherapy in Childhood Acute Lymphoblastic Leukemia
(Lippincott Williams and Wilkins, 2021) Sonal Maddheshiya; Surya K. Singh; Ishan Kumar; Priyanka Aggarwal; Vineeta Gupta
Objective: The aim of this study was to evaluate levels of vitamin D, bone mineral density (BMD), and radiograph features at diagnosis and after 6 months of chemotherapy in patients with acute lymphoblastic leukemia (ALL). Vitamin D levels were also correlated with BMD and radiograph features. Materials and Methods: 25-Hydroxy vitamin D [25(OH)D] levels, BMD, and radiograph features were assessed in 50 newly diagnosed patients of ALL in the age group of 2 to 14 years. A total of 30 age-matched and sex-matched children were recruited as controls. Vitamin D deficiency was defined as 25(OH)D <10 ng/mL, Vitamin D insufficiency as 10 to 29 ng/mL, and Vitamin D sufficiency as =30 ng/mL. Enzyme immunoassay (EIA) was used for the quantitative measurement of 25(OH)D levels in plasma and a LUNAR DPX NT bone densitometer was used for the assessment of BMD. Results: The mean age of the patients was 6.3 years, with a male:female ratio of 1.38:1. The mean 25(OH)D levels were 31.90±16.90 ng/mL in patients at diagnosis against 41.63±20.50 ng/mL in controls (P=0.02). Levels were 18.50±11.10 ng/mL postchemotherapy (P=0.00). Female sex was a risk factor for deficient 25(OH)D levels. There was a significant decrease in BMD postchemotherapy in the age groups of 5 to 10 and above 10 years at the femoral neck. Osteopenic changes were observed in more number of patients after 6 months of chemotherapy. There was a significant correlation between vitamin D levels, BMD, and osteopenic changes. Conclusions: Vitamin D deficiency was common among ALL patients, which worsened after chemotherapy. This had a significant correlation with BMD and osteopenic changes in radiograph. © 2021 Lippincott Williams and Wilkins. All rights reserved.
Cardiac T2∗ magnetic resonance analysis of membranous interventricular septum in assessment of cardiac iron overload in pediatric thalassemia patients: A pilot study
(Wolters Kluwer Medknow Publications, 2019) Ishan Kumar; Priyanka Aggarwal; Vineeta Gupta; Ashish Verma; Suwen Kumar; Ram Shukla
Background: Cardiac iron deposition in transfusion-dependent thalassemia patients is patchy in distribution. Purpose: The purpose of this study is to assess the correlation between T2∗ matrices of membranous interventricular septum (MIVS) and T2∗ values of muscular interventricular septum (IVS) on magnetic resonance imaging (MRI) and to evaluate the relationship of myocardial T2∗ at these two locations with MRI-estimated liver iron concentrations (LIC) and electrocardiographic (ECG) parameters. Material and Methods: MRI of heart and liver was performed in 16 consecutive pediatric patients of transfusion-dependent thalassemia major to calculate liver iron concentration and T2∗ time of membranous and muscular IVS. ECG parameters of these patients were charted and correlated with MRI parameters. Results: No significant correlation between T2∗ values of muscular IVS and MIVS was observed. Mean T2∗ of MIVS (9.8 ms) was significantly lower than that of muscular IVS (26.9 ms). T2∗ of MIVS correlated strongly with LIC where as a weak correlation was observed between T2∗ of IVS and LIC. Significantly higher mean QTc (corrected QT interval) value (439.86 ms) was seen in patients with T2∗ IVS <20 ms. Conclusion: Addition of T2∗ analysis of MIVS to the existing MRI protocol, consisting of muscular IVS analysis, may offer a more sensitive estimation of cardiac iron overload. © 2019 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow.
Child with Intellectual Disability and Seizures
(Springer, 2022) Ishan Kumar; Manoj Ranjan; Ankur Singh; Priyanka Aggarwal; Ashish Verma
[No abstract available]
Comparison of the effects of calcium channel blockers plus iron chelation therapy versus chelation therapy only on iron overload in children and young adults with transfusion-dependent thalassemia: A randomized double-blind placebo-controlled trial
(John Wiley and Sons Inc, 2022) Vineeta Gupta; Ishan Kumar; Vibhesh Raj; Priyanka Aggarwal; Vikas Agrawal
Background: Myocardial iron deposition is a significant cause of morbidity and mortality in patients with transfusion-dependent thalassemia (TDT). Amlodipine, L-type calcium channel blocker with regular chelation therapy may reduce myocardial iron overload. Lack of randomized trials prompted this study to assess the effect of calcium channel blocker (amlodipine) in combination with iron chelation therapy on iron overload in patients with TDT. Methods: Sixty-four eligible patients were randomized to receive either amlodipine and chelation (group A) or chelation alone (group B) in double-blind placebo-controlled trial. Myocardial iron concentration (MIC) using T2* magnetic resonance imaging (MRI), liver iron concentration (LIC), left ventricular ejection fraction (LVEF), and serum ferritin were measured at baseline and 12 months. Results: In the amlodipine group, mean cardiac T2* value significantly increased from 18.11 ± 8.47 to 22.15 ± 7.61 (p =.002) at 12 months, whereas in control group, there was a nonsignificant increase (p =.62) in cardiac T2* value from 19.50 ± 8.84 to 20.03 ± 9.07. There was a significant decrease in MRI-derived MIC in the amlodipine group compared to control group (1.93 ± 1.61 to 1.29 ± 0.90, p =.01). Changes in the LVEF (p =.45), MRI-derived LIC (p =.09), and serum ferritin (p =.81) were not significant between the two groups. Conclusion: Amlodipine is safe and when combined with chelation therapy appears to be more effective in reducing cardiac iron overload than chelation only in children and young adults with TDT. © 2022 Wiley Periodicals LLC.
Complications in Transfusion-Dependent Thalassemia
(Springer, 2022) Vineeta Gupta; Priyanka Aggarwal
[No abstract available]
Congenital facial nerve aplasia: MR depiction of a rare anomaly
(Wolters Kluwer Medknow Publications, 2016) Ishan Kumar; Ashish Verma; Ritu Ojha; Priyanka Aggarwal
We report two infants presenting with unilateral congenital facial palsy since birth. Magnetic resonance imaging (MRI) in both the cases revealed complete unilateral aplasia of facial nerve. To our knowledge, this is the first reported MR depiction of nonsyndromic isolated facial nerve aplasia. Imaging features and the pertinent anatomy is discussed along with a brief review of literature. © 2016 Indian Journal of Radiology and Imaging | Published by Wolters Kluwer - Medknow
COVID-19 Infection in Children with Cancer: Not A Gloomy Picture
(Lippincott Williams and Wilkins, 2022) Vineeta Gupta; Vidya K. Saurabh; Minketan Sidar; Priyanka Aggarwal
[No abstract available]
CT-Based Definition and Structured Reporting of Abdominal Lymph Node Stations
(Georg Thieme Verlag, 2022) Ishan Kumar; Srishti Sharma; Adity Prakash; Priyanka Aggarwal; Ram C. Shukla; Ashish Verma
Background Meticulous evaluation of abdominal lymph nodes on computed tomography (CT) is a fundamental task in radiological practice especially in oncological reporting. Although various reporting systems exist to define abdominal nodal stations for malignancies of individual abdominal organs, a complete and uniform framework for radiological reporting of abdominal lymph nodes does not exist in the literature. Purpose The goal of this review was to provide a step-wise reporting template and precise definitions of the radiological anatomy of abdominal lymph nodes and to generate a CT-based illustration of the lymph node stations of the abdomen. Conclusion This CT-based illustration and reporting template will help the radiologists to aptly describe the extent of the lymph nodal diseases and will help in comparison with posttherapy scans. © 2022 Wolters Kluwer Medknow Publications. All rights reserved.
Demystifying the Radiography of Age Estimation in Criminal Jurisprudence: A Pictorial Review
(Thieme Medical Publishers, Inc., 2024) Vritika Bhardwaj; Ishan Kumar; Priyanka Aggarwal; Pramod Kumar Singh; Ram C. Shukla; Ashish Verma
Skeletal radiographs along with dental examination are frequently used for age estimation in medicolegal cases where documentary evidence pertaining to age is not available. Wrist and hand radiographs are the most common skeletal radiograph considered for age estimation. Other parts imaged are elbow, shoulder, knee, and hip according to suspected age categories. Age estimation by wrist radiographs is usually done by the Tanner-Whitehouse method where the maturity level of each bone is categorized into stages and a final total score is calculated that is then transformed into the bone age. Careful assessment and interpretation at multiple joints are needed to minimize the error and categorize into age-group. In this article, we aimed to summarize a suitable radiographic examination and interpretation for bone age estimation in living children, adolescents, young adults, and adults for medicolegal purposes. © 2024 Thieme Medical Publishers, Inc.. All rights reserved.
Disorders of sexual development: structured radiological reporting and practical approach
(Springer, 2024) Ishan Kumar; Adity Prakash; Priyanka Aggarwal; Sarita Chowdhary; Ashish Verma
Disorders of sexual development (DSD) comprise a complex group of conditions with varied clinical presentations, such as atypical genitalia, non-palpable testes, primary amenorrhea, or infertility. Besides being associated with other congenital anomalies, DSDs bear substantial ethical issues regarding assigning the sex of rearing to the child and future fertility options. Establishing the correct diagnosis is essential for the appropriate management of such cases. Various imaging modalities, such as ultrasonography, genitography, and MRI, when complemented with detailed clinical evaluation and karyotyping, are the key to diagnosing the condition. This article attempts to present a concise approach to various patterns of DSD, which will aid radiologists to solve these diagnostic dilemmas. Graphical abstract: [Figure not available: see fulltext.] © 2023, The Author(s), under exclusive licence to Springer Science+Business Media, LLC, part of Springer Nature.
Do Not Forget to Look at the Big Toe
(Springer, 2017) Ankur Singh; Rajniti Prasad; Vidya Kumari Saurabh; Priyanka Aggarwal; Om Prakash Mishra
[No abstract available]
Dutch-beta thalassemia: A rare mutation from India
(Pediatric Hematology Oncology Chapter of Indian Academy of Pediatrics, 2022) Nirali Sanghvi; Priyanka Aggarwal; Vineeta Singh; Vineeta Gupta
Background: The Dutch I β°- Thalassemia is caused by 12.6 kilo-base (kb) deletion in Hemoglobin subunit beta (HBB) gene causing variable phenotypic presentation depending upon the zygosity of the condition. Case characteristics: An 8 year old female child presented with pallor, icterus and splenomegaly without any previous history of blood transfusion. She was evaluated for the evidence of hemoglobinopathy and was found to have very high HbF and absent HbA levels on High performance liquid chromatography (HPLC). The gene mutation analysis suggested the child to have a rather scarce pathogenic large deletion in HBB gene which has never been reported from India. Message: As this pathogenic variant has been rarely reported and discussed in literature, we hereby present the clinical characteristics associated with it, as demonstrated in our patient. © 2022 Pediatric Hematology Oncology Chapter of Indian Academy of Pediatrics
Early Biomarkers of Nephropathy in Patients with Sickle Cell Disease
(Springer, 2025) Vineeta Gupta; Luv Kumar; Ragini Srivastava; Priyanka Aggarwal
[No abstract available]
Early postnatal color Doppler changes in neonates receiving delivery room resuscitation with low 5 min Apgar score—a pilot study
(Springer Nature, 2021) Ishan Kumar; Shweta Singh; Ashok Kumar; Priyanka Aggarwal; Ram C. Shukla; Ashish Verma
Aims and objectives: To evaluate the Doppler changes in the intracranial arteries of neonates exposed to perinatal hypoxic insult and compare it with normal neonates. Materials and methods: Color Doppler of bilateral anterior and middle cerebral arteries was performed within 6 h of birth in 26 healthy neonates and 50 neonates who received delivery room resuscitation (DRR) for perinatal depression and had a 5 min Apgar score <7. Comparisons of resistive index (RI) and peak systolic velocity (PSV) were made between the (a) control group (b) patients with low 5 min Apgar score <7 who without clinical features of neonatal encephalopathy at 24 h (c) neonates with perinatal depression with a clinical evidence of disturbed neurological function at 24 h of birth and examination consistent with mild, moderate, or severe encephalopathy using modified Sarnat and Sarnat’s classification. Results: Significantly higher RI was observed in the neonates with to perinatal depression compared to the normal neonates. Significantly higher RI was seen in the patients with clinical features of neonatal encephalopathy (Group C) compared to group B. RI <0.6 and >0.82 was associated with severe neonatal encephalopathy. Differences in PSV were not statistically significant in the various groups. Conclusion: The study presents the changes in early cerebral Doppler parameters observed in neonates with low 5 min Apgar score following DRR compared to the normal neonates. We also present the relations of Doppler parameters with increasing severity of neonatal encephalopathy according to Sarnat classification. © 2020, The Author(s), under exclusive licence to Springer Nature America, Inc.
Factors Affecting Short-Term Outcome of Critically Ill Children with Malignancies Admitted in Pediatric Intensive Care Unit: A Retrospective Observational Study
(Thieme Medical Publishers, Inc., 2021) Priyanka Aggarwal; Ishan Kumar; Sunil Kumar Rao; K. Pradhap; Vineeta Gupta
Introduction Pediatric cancer contributes <1% of all malignancies. Childhood cancer survival has improved dramatically with the use of more intensive chemotherapy regimens, better stratification, and improvement in supportive care with enhanced facilities in pediatric intensive care unit (PICU). Objective The aim of this study was to identify the risk factors responsible for poor outcome in critically ill children with malignancies admitted in PICU. Materials and Methods Sixty-four children with a primary diagnosis of malignancy admitted in PICU with disease or treatment related complications were enrolled retrospectively. The short-term outcome, that is, shifting from PICU to ward, was assessed in relation to the presence of febrile neutropenia, organ failure, hepatitis, acute renal failure as well as requirement of inotropes and mechanical ventilation. Death was considered as an adverse outcome in this study. Results The mean age of study population was 6.25 ± 3.91 and M:F ratio 2.4:1. The majority of children had hematological malignancies (81.25%), that is, pre-B acute lymphoblastic leukemia (ALL) (45.3%), non-Hodgkin lymphoma (21.3%), acute myeloid leukemia (12.5%), T ALL (10.9%), and Hodgkin lymphoma (3.1%). Few children also had retinoblastoma (4.7%) and Langerhans cell histiocytosis (1.6%). The mean duration of PICU stay was 3.16 ± 2.31 days. Sepsis (37.5%) was the most common indication for PICU admission, followed by metabolic disturbance (26.6%), respiratory failure (17.2%), neurological complaints (15.6%), and anaphylactic shock (3.1%). Children requiring mechanical ventilation (p < 0.001), inotrope support (p < 0.001), having acute renal failure (p = 0.001), and >1 organ failure (p < 0.001) were associated with adverse outcome. The overall survival at the time of discharge from PICU was 64%. Conclusion In the context of low- and middle-income countries, optimal resource utilization by early identification of risk factors for clinical deterioration is required to allow timely admission to PICU and delivery of life-saving therapy to salvageable patients. © 2021 Wolters Kluwer Medknow Publications. All rights reserved.