Introduction: Image-guided percutaneous transthoracic needle biopsy of mediastinal masses is usually safe and effective technique for obtaining tissue for diagnosis and early decision can be taken for effective management. Aim: The purpose of this study was to know the efficacy of different investigative methods for diagnosis of mediastinal masses and to analyse various cytomorphological forms. Materials and Methods: This was a retrospective observational study conducted at Pandit Raghunath Murmu Medical College, Baripada from January 2019 to June 2020. Retrospective review of all Ultrasonography (USG) and Computed Tomography (CT)- guided percutaneous aspirations of the anterior mediastinum mass. Relevant data regarding patient demographics, imaging characteristics of aspirated masses, presence of complications, and subsequent surgical intervention were collected. Cytology and core biopsy pathology results were recorded. The qualitative data were compared using Chi-square test with Yate’s correction. Results: This study included 35 patients (25 male, 10 female). Highest incidence was noticed in anterior mediastinum (n=26, 74.3%) followed by superior (n=4, 11.4%) and posterior mediastinum (n=3, 8.6%). Most of the cases were malignant (n=28; 80%) and Non Hodgkin Lymphoma (NHL) was most common diagnosis (n=10; 28.6%). Radiology yielded the correct diagnosis in 25 out of 35 patients (71.4%). Core biopsy was obtained in six cases and all the cases were diagnosed cytologically with 100% accuracy. There was statistically significant difference between the radiological and cytological diagnosis. The complication rate was minimal (2/35), both were the case of pneumothorax. Conclusion: Image-guided percutaneous aspiration is a safe diagnostic procedure with high diagnostic accuracy in aspiration cytology than radiology. Highest diagnostic accuracy was seen in non hodgkins lymphoma and it can potentially obviate more invasive procedures.
Background: Diagnosis of cervical tuberculous lymphadenitis has been challenging to clinicians as it mimics multiple diseases. USG has upper hand over other diagnostic modalities as it is non- invasive, low cost, time saving and guided procedures like FNAC and core needle biopsy can be performed. Methods: This is a prospective observational study conducted in 100 patients from June 2019 to May 2020 in Dept of Pulmonary medicine, PRM Medical College and Hospital, Baripada. A complete clinical examination, routine blood investigations, CXR, USG Neck, FNAC and CBNAAT were done and data was recorded. Results: Maximum numbers of patients were in age group of 11-20 years (38%) followed by 21-30 years (32%) and presented between the duration of 1-3 months. There were 44(44%) males and 56(56%) females; male to female ratio was 1:1.3. Most of the patients (70%) did not have any constitutional symptoms and maximum number of patients i.e. 53% had matting of LN followed by discrete node 29% whereas 10% patients presented with abscess and 8% had discharging sinuses. In USG, 46 (46%) showed cervical lymphadenopathy with tubercular aetiology with sensitivity and specificity of 90% and 50% respectively with accuracy of 88%.
Aim and Introduction: To determine the association between Coronary atherosclerosis in Chronic Obstructive Pulmonary Disease and Carotid Artery Intima Media Thickness. The objective of the present case control study is to determine the association between carotid atherosclerosis in COPD patients and cardiovascular morbidity. Material and methods. It was a prospective case-control observational study. 50 COPD patients and 50 age- and gender-matched non-COPD controls were studied. Carotid artery USG scanning was carried out using B-mode duplex USG for measurement of carotid artery intima - media thickness. Results. CIMT was found to be more common in COPD group patients (78%) as compared to non-COPD group patients (26%) (P value = 0.000). The mean CIMT is 1.04 0.41 mm in the COPD group and 0.71 0.24 in the COPD group with a P value of 0.0001. The mean CIMT in Gold 3 was the highest (1.10 0.48 mm), followed by Gold 4 (1.05 0.46 mm) and the minimum in Gold 1 (0.73 0.00 mm). Conclusion. Our study shows that COPD is associated with increased CIMT, which is a preclinical predictor of coronary atherosclerosis and cardiovascular risk. However, further studies are needed.
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