Role of Lung Ultrasonography in Acute Respiratory Distress in Pediatric Age Group: A Prospective Single-Centre Study.

Introduction Lung diseases are the most frequently encountered form of diseases primarily affecting infants under one year of age. Although the chest X-ray is the first modality of choice, ultrasonography (USG) has emerged as an alternative. Lung ultrasound (LUS) finds its application in the evaluation of several pediatric lung diseases. Objective To assess the use of LUS in acute lower respiratory infections and assess the correlation between etiological diagnosis and radiological diagnosis. Methods This was a hospital-based prospective observational study conducted with children presenting with upper respiratory infections. Around 97 children were included in the study. Clinical diagnosis was made by the pediatrician. LUS was performed by a trained radiologist, using the two-dimensional (2D) ultrasound mode and motion mode (M mode) to assess the LUS in the respective areas of the chest, thereby assessing bilateral lung fields for these patients. Results The majority of our study participants were under one year old (87%), and more than half were male (55%). Bronchiolitis and lower respiratory tract infections (LRIs) were the most commonly seen clinical diagnoses. The distribution of USG findings was statistically significant across the clinical diagnosis (p-value < 0.05). Conclusion Our study found that LUS can serve as an important tool for diagnosing several acute respiratory diseases. It also showed that LUS can replace X-rays in cases of children diagnosed with acute respiratory diseases.

Candidate Gene Expression in Regional Population and Its Relevance for Radiation Triage.

Quantification of gene expression signatures has been substantiated as a potential and rapid marker for radiation triage and biodosimetry during nuclear emergencies. Similar to the established biodosimetry assays, the gene expression assay has drawbacks such as being highly dynamic and transient, not specific to ionizing radiation, and also influenced by confounding factors such as gender, health status, lifestyle, and inflammation. In view of that, prior knowledge of baseline expression of certain candidate genes in a population could complement the discrimination of the unexposed from the exposed individuals without the need for individual pre-exposure controls. We intended to establish a baseline expression of reported radiation-responsive genes such as CDKN1A, DDB2, FDXR, and PCNA in the blood samples of healthy human participants and then compare it with diabetic/hypertension participants (as a chronic inflammatory condition) drawn from south Indian population. Further, we have examined the appropriateness of the assay for radiation triage-like situations; i.e., the expression profiles of those genes were examined in the participants who underwent X-ray-based medical imaging. Acute inflammation induced by lipopolysaccharide exposure in the blood significantly increased the fold expression of those genes (p < 0.0001) compared to the control. Whereas the basal expression level of those genes among the participants with the inflammatory condition is marginally higher than those observed in the healthy participants; despite the excess, the fold increase in those genes between the groups did not differ significantly. Consistent with the inflammatory participants, the basal expression level of those genes in the blood sample of participants who received X-radiation during neuro-interventional and computed tomography imaging is marginally higher than those observed in the pre-exposure of respective groups. Nevertheless, the fold increase in those genes did not differ significantly as the fold change fell within the two folds. Thus, overall results suggest that the utility of CDKN1A, DDB2, FDXR, and PCNA gene expression for radiation triage specific after very low-dose radiation exposure needs to be interpreted with caution for a much more reliable triage.

The Role of Computed Tomography Perfusion in Various Focal Liver Lesions.

Background This study aims to identify the potential advantages of quantitative determination of various focal liver pathologies, identify lesion hemodynamics, and distinguish benign and malignant pathologies based on CT perfusion (CTP) parameters. Methodology In this study, we examined 36 patients using contrast-enhanced CT (CECT) and proposed inclusion and exclusion criteria. Of the 36 patients, 18 had malignant lesions and 14 had benign lesions. CTP was performed on patients comprising cases of hepatocellular carcinoma (HCC), metastasis, hemangiomas, hepatic cysts, and hepatic abscess. Images were post-processed and analyzed to calculate various perfusion parameters such as blood flow (BF), blood volume (BV), permeability surface (PS), mean transit time (MTT), the hepatic arterial fraction (HAF), and induced residue fraction time of onset (IRFTO). Parameters were compared between benign and malignant lesions, and descriptive analysis was performed for individual lesions. Results Data were analyzed with IBM SPSS Statistics (IBM Corp., Armonk, NY, USA). IRFTO showed the area of the curve (AOC) = 0.659, P-value = 0.040, sensitivity 66.7%, and specificity 64.3%. BV showed AOC = 0.659, P-value = 0.040, with a cutoff value of 1.26, sensitivity of 66.7%, and specificity of 64.3%. BF showed AOC = 0.786 and P-value = 0.006, with a cutoff value of 171.2, sensitivity of 83.3%, and specificity of 78.6%. MTT showed AOC = 0.778 and P-value = 0.008, with a cutoff value of 6.94, sensitivity of 77.8%, and specificity of 78.6%. Statistically significant changes were observed in the perfusion parameters in the BV, BF, MTT, and IRFTO. Conclusions The noninvasive CT liver perfusion technique makes it possible to compare the hemodynamic changes in healthy and sick liver tissues, identify focal liver lesions, and evaluate the effectiveness of tumor therapy.

Intramuscular haemangioma with diagnostic challenge: a cause for strange pain in the masseter muscle.

Intramuscular hemangiomas are unique vascular tumors which are benign in nature, most commonly occurring in the trunk and extremities. When present in head and neck, they most frequently involve the masseter and trapezius muscles, accounting for less than 1% of all hemangiomas. Most of these lesions present with pain and discomfort and some patients may demonstrate progressive enlargement. Due to their infrequency, deep location, and unfamiliar presentation, these lesions are seldom correctly diagnosed clinically. Our report is a clinically misdiagnosed case of a painful soft tissue mass in the right side masseteric region of a 23-year-old female patient, confirmed as intramuscular hemangioma based on imaging studies and histopathologic examination, treated by surgical excision which had no recurrence after a 3-year followup.