scholarly journals Neuro-radiology: a new gold standard investigation for management of central nervous system tuberculosis

2016 ◽  
Vol 4 (1) ◽  
pp. 14
Author(s):  
Vinod Gautam
Keyword(s):  
Drug Sensitivity ◽  
Therapeutic Interventions ◽  
Drug Resistant ◽  
Biochemical Tests ◽  
Sensitivity Testing ◽  
Radiological Investigation ◽  
Ct Guided ◽  
Ct Guided Biopsy

<p>Treatment of CNS TB is challenging due to lack of specific biochemical tests and inability to get the pathological sample from deeply located eloquent areas of CNS without causing any neurological deficit. Moreover, it is unnecessary to operate for biopsy in a patient who has presented with a very small granulomatious lesion in brain or spinal cord. In such as situations neuro-radiology helps in managing CNS TB and it may be the only source of establishing diagnosis and evaluating treatment response.</p><p>Role of radiological investigation has expanded from the initial diagnosis to the therapeutic interventions. In some Muli-drug- resistant (MDR) CNS TB cases, Stereotaxy or USG or CT guided biopsy helps in obtaining pathological sample and drug sensitivity testing. A regular clinical and neuro-radiological follow-up is mandatory during the entire course of anti tuberculous therapy to take prompt decisions to change ATT and to reduce morbidity and mortality associated with CNS TB.</p>

Epileptogenic role of occult temporal encephalomeningocele

Neurology ◽  
2018 ◽  
Vol 90 (14) ◽  
pp. e1200-e1203 ◽  
Author(s):  
Sara Gasparini ◽  
Edoardo Ferlazzo ◽  
Giuseppe Pustorino ◽  
Michele Ascoli ◽  
Vittoria Cianci ◽  
...  
Keyword(s):  
Drug Sensitivity ◽  
Case Control Study ◽  
Brain Mri ◽  
Unknown Origin ◽  
Unknown Etiology ◽  
Drug Resistant ◽  
Temporal Lobes ◽  
Control Study

ObjectiveThe purpose of this case-control study is to evaluate the prevalence of occult temporal encephalomeningocele (OTE) in patients with temporal lobe epilepsy (TLE) of unknown etiology presenting to an epilepsy center, independently from drug sensitivity.MethodsWe studied 95 patients with TLE (51 female, mean age 49.4 ± 17.1 years) and 151 controls (88 female, mean age 54.1 ± 21.0 years) using a 1.5T brain MRI, including balanced steady-state gradient echo sequences, targeted to the temporal lobes.ResultsOTE was found in 5.2% of the TLE population (9.5% of drug-resistant TLE) and in none of the controls (p = 0.008). Two patients with OTE and drug-resistant TLE became seizure-free after lesionectomy (follow-up 18–24 months).ConclusionOTE is not a rare finding in unselected patients with TLE of unknown origin, provided that it is carefully searched. The absence of OTE in a large group of nonepileptic controls adds evidence to its epileptogenic role.

Role of routine nephrectomy for non-functioning kidneys due to genitourinary tuberculosis: Data from an Indian subcontinent

2021 ◽  
pp. 205141582098766
Author(s):  
Pradeep Prakash ◽  
Prabhjot Singh ◽  
Amlesh Seth ◽  
Rishi Nayyar ◽  
Brusabhanu Nayak
Keyword(s):  
Indian Subcontinent ◽  
Disease Recurrence ◽  
Drug Resistant ◽  
Second Line ◽  
Sensitivity Testing ◽  
Level Of Evidence ◽  
Lower Blood ◽  
Anti Tubercular Therapy ◽  
Open Nephrectomy

Objective: To evaluate the role of routine nephrectomy for tuberculous non-functioning kidney (TNFK) after receiving anti-tubercular therapy (ATT) by demonstrating whether live tubercle bacilli persist in nephrectomy specimens after treatment or not. Materials and methods: Patients with TNFK who underwent nephrectomy after completion of at least 6 months of ATT were included in this prospective cohort study. We sent tissue/pus from a nephrectomy specimen for acid-fast bacilli (AFB) staining, polymerase chain reaction (PCR) and culture to look for live bacilli. Bacilli were considered alive only if AFB culture was positive. Results: Twenty-four patients underwent nephrectomy for TNFK between April 2015 and October 2017 (18 laparoscopic and 6 open nephrectomy). Laparoscopic nephrectomy was associated with lower blood loss (225 ml versus 408 ml, p = 0.0003) and shorter hospital stay (3 versus 3.8 days, p = 0.06) compared with open nephrectomy; however, mean operative time and overall complications were similar. Eight specimens were AFB smear and/or tuberculosis PCR positive, out of which three showed viable bacilli upon culture. Drug sensitivity testing showed multi-drug resistant strain in all three patients who were treated with second-line ATT. Conclusion: It is preferable to do routine nephrectomy for TNFKs as they are more likely to harbour live bacilli and lead to disease recurrence. Viability testing for AFB must be performed on all operated specimens to identify drug resistant bacilli so that patients may be treated with second-line therapy if required. Level of evidence: 4.

scholarly journals The Potential Impact of Up-Front Drug Sensitivity Testing on India’s Epidemic of Multi-Drug Resistant Tuberculosis

PLoS ONE ◽  
2015 ◽  
Vol 10 (7) ◽  
pp. e0131438 ◽  
Author(s):  
Kuldeep Singh Sachdeva ◽  
Neeraj Raizada ◽  
Radhey Shyam Gupta ◽  
Sreenivas Achuthan Nair ◽  
Claudia Denkinger ◽  
...  
Keyword(s):  
Drug Sensitivity ◽  
Drug Resistant ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Drug Sensitivity Testing ◽  
Resistant Tuberculosis ◽  
Multi Drug Resistant Tuberculosis ◽  
Potential Impact

The role of percutaneous CT-guided biopsy of an adrenal lesion in patients with known or suspected lung cancer

2020 ◽  
Author(s):  
E. McDermott ◽  
A. Kilcoyne ◽  
A. O’Shea ◽  
A. M. Cahalane ◽  
S. McDermott
Keyword(s):  
Lung Cancer ◽  
Adrenal Lesion ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

scholarly journals A Case of Radiation Fibrosis Appearing as Mass-Like Consolidation after SBRT with Elevation of Serum CEA

2010 ◽  
Vol 2010 ◽  
pp. 1-4 ◽  
Author(s):  
Kotaro Terashima ◽  
Yoshiyuki Shioyama ◽  
Satoshi Nomoto ◽  
Saiji Ohga ◽  
Takeshi Nonoshita ◽  
...  
Keyword(s):  
Local Recurrence ◽  
Short Interval ◽  
Primary Lung Cancer ◽  
Dorsal Side ◽  
Ct Guided ◽  
Radiation Fibrosis ◽  
Ct Guided Biopsy ◽  
Serum Cea ◽  
The Right

We report a case of radiation fibrosis appearing as mass-like consolidation, which was difficult to distinguish from local recurrence. A 72-year-old woman was diagnosed as having primary lung cancer (cT1N0M0 stage IA) in the right upper lobe and was treated with SBRT of 48 Gy in 4 fractions. After 12 months, mass-like consolidation appeared around the irradiated area, and after 13 months, it had increased in size. FDG-PET revealed high uptake (SUVmax=5.61) for the consolidation. CT-guided biopsy was performed, but we could not confirm the diagnosis. Considering her poor respiratory function and her age, short-interval follow-up was performed. After 15 months, the consolidation enlarged at the dorsal side, and carcinoembryonic antigen (CEA) became elevated (14.6 ng/mL). Serum KL-6 (436 U/mL) and SP-D (204 ng/mL) were also elevated. However, after 16 months, serum CEA slightly decreased. The consolidation gradually retracted on follow-up CT images. CEA, KL-6, and SP-D were also decreased by degrees. After 40 months, there is no evidence of local recurrence.

scholarly journals Role of Ultrasonography in Otolaryngology

2016 ◽  
Vol 24 (2) ◽  
pp. 80-87
Author(s):  
Rezaul Karim
Keyword(s):  
Thyroid Nodules ◽  
American Association ◽  
Clinical Endocrinology ◽  
Therapeutic Interventions ◽  
Standard Protocol ◽  
Imaging Tool ◽  
The Masses ◽  
Fair Degree

Ultrasonography (US) is frequently requested by the otolaryngologists in their day to day practice. Though US assessment is sensitive and in many situations, specific investigation for prognosis and management of patients, FNAC and Ultrasonography carries more predictive value. Ultrasonography is very useful for assessment of neck nodes and in combination with CT scan is an excellent imaging tool for follow up of head and neck cancers. Inflammatory neck nodes vary in characteristics from neoplastic nodes and US can classify them with fair degree of predictability. Thyroid nodules should strictly follow standard protocol of management, as most of the masses are benign and unnecessary diagnostic or therapeutic interventions are not required. Kim’s criteria and American Association for Clinical Endocrinology recommendations are sensitive and specific for offering systematic guidance for management of thyroid nodules. US have limited roles in the assessments of sialadenitis, Sialolithiasis and salivary tumors. US is an effective tool in guiding biopsies and aspirations for diagnostic and therapeutic purposes.

scholarly journals Status of antituberculosis drug resistance in Saudi Arabia 1979-98

2021 ◽  
Vol 8 (4-5) ◽  
pp. 664-670
Author(s):  
K. K. Abu Amero
Keyword(s):  
Saudi Arabia ◽  
Drug Sensitivity ◽  
National Policy ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
First Line ◽  
Sensitivity Testing ◽  
Drug Resistant Tuberculosis ◽  
Resistant Tuberculosis ◽  
Multidrug Resistant Tuberculosis

All published material on the prevalence of drug-resistant tuberculosis within Saudi Arabia over the period 1979-98 was reviewed. The prevalence of single-drug-resistant tuberculosis ranged from 3.4% to 41% for isoniazid, 0% to 23.4% for rifampicin, 0.7% to 22.7% for streptomycin and 0% to 6.9% for ethambutol. The prevalence of multidrug-resistant tuberculosis [defined by WHO as resist1qance to two or more first-line antituberculosis drugs] ranged from 1.5% to 44% in different regions. No strong conclusions could be drawn owing to variations in the populations studied, geographical origins, site of Mycobacterium tuberculosis isolation [pulmonary or extrapulmonary] and drug sensitivity testing. However, the need to develop a standardized national policy for surveillance of drug-resistant tuberculosis in Saudi Arabia is clear

scholarly journals A STUDY ON NON-RESOLVING PNEUMONIA: ROLE OF FIBEROPTIC BRONCHOSCOPY AND CT-GUIDED BIOPSY

2019 ◽  
Vol 6 (35) ◽  
pp. 2397-2401
Author(s):  
Surapaneni Vineela ◽  
Alla Bhagyaraj ◽  
Yelkoti Sushma Laxmi ◽  
Rachakonda Ramakrishna ◽  
Talatam Aruna
Keyword(s):  
Fiberoptic Bronchoscopy ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Ct Guided Biopsy

scholarly journals Aggressive Vertebral Hemangiomas Causing Compression Fracture with Neurological Deficits: A Retrospective Cohort Study

2020 ◽  
Author(s):  
Hongming Rao ◽  
Guishuang Li ◽  
Limin Liu ◽  
Yuming Huang ◽  
Zhengquan Xu ◽  
...  
Keyword(s):  
Clinical Outcomes ◽  
Body Height ◽  
Compression Fracture ◽  
Neurological Deficits ◽  
Ct Guided ◽  
Guided Biopsy ◽  
Estimated Blood Loss ◽  
Ct Guided Biopsy ◽  
Vertebral Hemangiomas

Abstract Background:In rare instances, aggressive vertebral hemangiomas (VHs) can cause compression fracture, resulting in severe pain and neurological deficits. But the diagnosis and treatment of these aggressive lesions are challenging because of these lesions are rare and atypical. This study aimed to evaluate the safety and efficacy of surgical management for aggressive VHs with vertebral compression fracture by a modified multimodality surgery.Methods:We retrospectively reviewed 6 cases suffering from aggressive VHs with compression fracture and neurological deficits in our department from July 2011 to April 2016. These patients were treated by the multimodality surgery, includingpreoperative embolization, intraoperative injection of gelfoam mixed with cement, and laminectomy decompression.The follow-up period was at least 3 years. Perioperative parameters, clinical outcomes, and radiographical data were collected and analyzed.Results: The 6 patients involved 1 male and 5 females (mean age, 52.3 years).The levels involved were: in thoracic spine (5 cases) and lumbar spine (1 case).Preoperative CT-guided biopsy was conducted in all patients, with 5 patients had definitive pathologic diagnosis. All patients were treated successfully with the multimodal surgery, with no cement leakage and other severe complications. The mean operation time was 182.2 minutes, and the estimated blood loss was 908.3 ml.At an average follow-up of 49.8 months, clinical outcomes assessed by the visual analogue scale and Frankel grade were significantly improved. The vertebral body height and kyphosis angle of the fractured vertebra were also corrected postoperatively. No affected vertebra re-fracture and adjacent vertebral fracture were developed, and none of the patients experienced recurrence of tumor at final follow-up.Conclusions:In cases of aggressive VHs causing compression fracture with neurological deficits, CT-guided biopsy is indicated for the diagnosis. The multimodality surgery (preoperative embolization, intraoperative injection of gelfoam mixed with bone cement combined laminectomy decompression) is effective and safe, and can be considered as an acceptable surgical choice.

scholarly journals Tuberculous Spondylitis of the Craniovertebral Junction

2016 ◽  
Vol 1 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Panayiotis D. Megaloikonomos ◽  
Vasilios Igoumenou ◽  
Thekla Antoniadou ◽  
Andreas F. Mavrogenis ◽  
Konstantinos Soultanis
Keyword(s):  
Craniovertebral Junction ◽  
Tuberculous Spondylitis ◽  
Mycobacterium Tuberculosis Infection ◽  
Halo Vest ◽  
Ct Guided ◽  
Antituberculous Treatment ◽  
Ct Guided Biopsy ◽  
Bony Lesions ◽  
Infection Recurrence

Abstract. Craniovertebral junction tuberculosis is rare, accounting for 0.3 to 1% of all tuberculous spondylitis cases. MR imaging is the modality of choice to detect bone involvement, abscess formation and subligamentous spreading of the pus, to differentiate from other lesions affecting the craniovertebral junction, and to determine the efficacy of treatment. Given the fact that surgical treatment of patients with craniovertebral junction tuberculosis has been associated with a high mortality rate ranging up to 10% and recurrence rate ranging up to 20%, conservative is the standard of treatment for most patients.This article presents a patient with craniovertebral junction Mycobacterium tuberculosis infection diagnosed with CT-guided biopsy. A halo vest was applied and antituberculous treatment with rifampicin, isoniazid and ethambutol was initiated. At 6-month follow-up, the patient was asymptomatic; CT of the cervical spine showed healing of the bony lesions. The halo vest was removed and physical therapy was recommended. Antituberculous treatment was continued for a total of 18 months, without any evidence of infection recurrence

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