Despite advancement in the diagnosis and treatment of intestinal helminthiasis, ascariasis remains the most common cause of helminthic infections in the developing countries. Ultrasound offers a rapid, safe, and noninvasive approach to the diagnosis of intestinal ascariasis. Ultrasound is also the modality of choice for diagnosis of hepatobiliary ascariasis, which is relatively rare and is due to migration of intestinal worms through the papilla of Vater. We present an imaging spectrum of hepato-pancreatico-biliary and intestinal ascariasis.Main messages• Ascariasis refer to infestation by the round worm ascaris lumbricoides.• Ascaris eggs are excreted in faeces and are infective to humans.• Eggs hatch to larva, travel to the lungs and mature to adult worms.• Intestinal obstruction can be caused by multiple ascariasis forming bag of worms.
Background:
Takayasu’s arteritis (TA) is a large vessel vasculitis with diverse clinical presentations and arterial vascular bed involvement. It is characterized by chronic, nonspecific inflammation of all layers of the vessel wall, which results in stenosis, occlusion, dilatation, or aneurysm formation in the involved blood vessels.
Methods:
The study included 36 patients of TA. All patients fulfilled the modified Ishikawa’s diagnostic criteria for TA. All patients were evaluated for clinical presentation, angiographic findings, and severity of the disease. The disease activity was assessed based on Erythrocyte sedimentation rate (ESR) and C-reactive protein (CRP) and also by CT angiography (CTA)/Magnetic resonance angiography (MRA) imaging. The angiographic types were classified based on the International TA Conference in Tokyo, 1994 angiographic classification.
Results:
total of 36 patients were included in the study, 86% were females and a mean age of 21.6 years. Hypertension (78%) was the most common clinical presentation. Type V was the most common angiographic type (42%), followed by type III (25%), type IV (14%), type IIb (11%), type I (5%) and type IIa (3%). Among the aortic arch branches, the left subclavian artery (50%), right subclavian artery (38.8%), left vertebral artery (33.3%) and left common carotid artery (27.7%) were the most commonly involved arteries. Disease activity based on CT/MR imaging showed a significant statistical correlation with elevated ESR and positive CRP (p < 0.0001). Mediastinal lymphadenopathy was seen in 21 patients, out of which 11 had active disease. However, no significant correlation was found between mediastinal lymphadenopathy and disease activity.
Conclusions:
TA presents varied symptomatology and differing vascular involvement. CT/MR angiography is effective in diagnosis and accurately predicted the active stage of the disease.
Spontaneous pneumomediastinum is a rare but potentially life-threatening condition, the incidence of which has showed an increase in patients with SARS-CoV-2 pneumonia, especially when they are on positive pressure ventilation. None of the reported cases of covid related pneumomediastinum had an associated tracheal diverticulum. Also, to the best of our knowledge, tracheal diverticulum has not been reported in patients on NIV. We report 2 cases of COVID-19 pneumonia on NIV with pneumomediastinum, which also had associated tracheal diverticulum, one of which developed after NIV. Though the establishment of causality needs further research, early detection of a tracheal diverticulum, which might be a harbinger of pneumomediastinum, can be a timely alarm to prompt titration of the pressure settings and judicious use of NIV. The role of inverted grey scale CT images in mediastinal window is a simple, yet hardly utilised radiological tool to increase detection of ‘mediastinal air’, let it be free air or air within a diverticulum. Through this case report, we would like to highlight the role of conventional and inverted CT imaging of pneumomediastinum and tracheal diverticulum in general and in SARS-CoV-2 pneumonia in particular, and to call for more objective research to throw light on the plausible relationship between pneumomediastinum and tracheal diverticulum.
Introduction: Doppler ultrasound is the commonest diagnostic tool used to evaluate the internal, external and common carotid arteries (CCA). Peak systolic velocity (PSV) is the best Doppler parameter for quantifying carotid artery degree of stenosis. Materials and methods: Normal Doppler waveforms of 24 CCA from 12 healthy individuals of age 22e28 years were analysed in the department of radiology, NEIGRIHMS, Shillong. PSV, EDV and RI at 9 MHz transducer frequencies and variable DR of 35,45,55,65,75 &85 Decibels (dB) were compared. Statistical analysis: One-Way repeated measures ANOVA; parameters expressed as Mean AE SEM. p value significant at <0.05. Aim: To study the effect of variable dynamic ranges (DR) on the PSV, end diastolic velocity (EDV) and resistive index (RI) of CCA. Results: For PSV of the right CCA at 9 MHz, there was significant differences on variable DR as determined by One-Way repeated measures ANOVA [F (5, 55) Z 5.54, p < 0.05]. There was however no significant differences in the PSV of the left CCA; EDV and RI at variable dynamic ranges in both the right and left CCA. Summarised mean value for all PSV of both sides shows significant difference between variable dynamic ranges as determined by One-Way repeated measures ANOVA [F (5, 115) Z 2.85, p < 0.05] and Post-hoc analysis revealed that there was a significant difference only between 35 dB to 55 dB and 85 dB.
scite is a Brooklyn-based organization that helps researchers better discover and understand research articles through Smart Citations–citations that display the context of the citation and describe whether the article provides supporting or contrasting evidence. scite is used by students and researchers from around the world and is funded in part by the National Science Foundation and the National Institute on Drug Abuse of the National Institutes of Health.