Echocardiographic Evaluation of Right Heart in Patients of Chronic Obstructive Pulmonary Disease

Cardiac involvement in Chronic Obstructive Pulmonary Disease (COPD) is a significant cause of morbidity, mortality, and even death. We aimed to study the echocardiographic evaluation, especially of the right heart, in patients of COPD and to co-relate findings of echocardiography with the clinical profile and severity of COPD of such patients.METHODSWe performed a cross-sectional study for a period of 2 years. The patients were subjected to necessary investigations and transthoracic echocardiography for evaluating the right heart parameters. Data was entered in MS Excel spreadsheet and analysis was done using Statistical Package for Social Sciences (SPSS) version 21.0. A p value of <0.05 was considered statistically significant. RESULTSOf the 50 COPD cases studied, the majority (22) fulfilled GOLD stage IV criteria followed by 14 cases in GOLD stage II. Right atrial pressure was increased in 52% study subjects. Pulmonary artery systolic pressure had values of more than 25 mmHg in 68% of patients. RV thickness was >5 mm in 56% subjects. TAPSE was measured to be <17 mm in 50% COPD cases. A significant association was seen between severity of COPD and RA pressure, RV size, RV pressure/pulmonary artery pressure, RV thickness and TAPSE.CONCLUSIONSSignificant prevalence of right heart dysfunction is found in COPD and there was a significant association of cardiac parameters with severity of COPD. Thus it is recommended that all patients of COPD should undergo right heart evaluation by echocardiography so that treatment modalities can be changed to minimize morbidity and mortality

Dysembryonic neuro-epithelial tumors.

Introduction: Dysembryonic Neuro-Epithelial Tumors are mixed neuro-epithelial tumors affecting most commonly the temporal lobe. They usually result in epilepsy which is intractable in nature. Children and young adults are much more prone to exhibit these Dysembryonic Neuro-Epithelial Tumors. Case presentation: Here, we present a case series of two male patients who presented to the department of radiodiagnosis at Dr. Vasant Rao Pawar Medical College and Research Centre for MRI evaluation with complaints of epilepsy. Conclusion: Dysembryonic Neuro-Epithelial Tumors are a mixed neuronal glial neoplasm, mainly affecting the temporal lobe and is a very common cause of epilepsy. They are usually benign tumors with no or mild contrast enhancement.

Ultrasound findings in abdominal tuberculosis: usual and unusual appearances.

Introduction: Tuberculosis is a major health problem in developing countries. Abdominal tuberculosis is not an uncommon manifestation of extra pulmonary tuberculosis. Recognition of its usual and unusual findings is important for diagnosis of the disease. Material and Methods: This retrospective study involved 150 abdominal tuberculosis patients over a period of 5 years in rural & urban population of Nashik district in Maharashtra. Abdominal ultrasound using Siemens (Accuson X500) and Philips HD 11 with convex & linear probes was done to find out the intestinal and extraintestinal disease involvement and appearances. Results: Abdominal tuberculosis was found to be more common in rural population and had a slight female predominance. In extraintestinal involvement; ascites was found in 44% cases, peritoneal thickening was found in 15 % cases, tubercles were found in 5% cases and thick swollen mesentery in 7% cases. Lymphadenopathy was seen in 47% cases. In intestinal involvement, isolated bowel wall thickening (30%), bowel ulceration (3%), bowel lump with pseudo kidney appearance (11%), matting and clumping of bowel loops (16.5%) and complex bowel mass (8.5%) were seen. Some of the unusual patterns like “club sandwich appearance” (11%) and “multilayered sandwich appearance”(2%) were also seen. Conclusion: Because of nonspecific symptoms abdominal Tuberculosis is mostly under diagnosed or misdiagnosed for chronic acidity, gastritis /colitis or chronic appendicitis. Knowledge of both usual and unusual findings is essential to diagnose abdominal tuberculosis. Hence abdominal ultrasound should be used as a primary cost effective screening modality for diagnosis which helps in management of abdominal tuberculosis.