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1
ORiginal Article : Sonographic Evaluation of Gallbladder Motility in Children with Chronic Functional Constipation

( Rakesh Mehra ),( Kushaljit Singh Sodhi ),( Akshay Saxena ),( Br Thapa ),( Niranjan Khandelwal ) The Editorial Office of Gut and Liver 2015 Gut and Liver Vol.9 No.3
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  KISS
Background/Aims: Studies in adults suggest that constipation may not be a purely colonic pathology and may be a component of a generalized gastrointestinal (GI) motor disorder in which proximal GI motility can be impaired. Pediatric data are scarce, and the natural history of the disorder remains undefined. We aimed to evaluate gallbladder motility in a subset of Asian children with chronic functional constipation. Methods: Abdominal ultrasound was performed on 105 children, including 55 patients (aged 3 to 13 years) with chronic functional constipation who met the inclusion criteria and 50 age- and gender-matched controls. The gallbladder contractility index was calculated based on the preprandial and postprandial gallbladder areas. Preprandial and postprandial values for gallbladder volume and wall thickness were evaluated. Results: The mean value of the contractility index for the patients (15.77±24.68) was significantly lower than the mean value for the controls (43.66±11.58) (p=0.001). The mean postprandial gallbladder volumes and areas were larger in children with gallbladder hypomotility (p<0.05). The mean duration of constipation (4.8 months) was significantly higher (p=0.004) in the children with gallbladder hypomotility. Conclusions: Gallbladder motility is significantly impaired in children with chronic functional constipation. This study contributes to the understanding of the underlying pathophysiology, which will enable advancement in and improved management of children with chronic constipation and associated gallbladder hypomotility. (Gut Liver 2015;9:388-394)
2
Evaluation of low-dose dual energy computed tomography for in vivo assessment of renal/ureteric calculus composition

Harshavardhan Mahalingam,Anupam Lal,Arup K Mandal,Shrawan Kumar Singh,Shalmoli Bhattacharyya,Niranjan Khandelwal 대한비뇨의학회 2015 Investigative and Clinical Urology Vol.56 No.8
Purpose: This study aimed to assess the accuracy of low-dose dual-energy computed tomography (DECT) in predicting the compositionof urinary calculi. Materials and Methods: A total of 52 patients with urinary calculi were scanned with a 128-slice dual-source DECT scanner byuse of a low-dose protocol. Dual-energy (DE) ratio, weighted average Hounsfield unit (HU) of calculi, radiation dose, and imagenoise levels were recorded. Two radiologists independently rated study quality. Stone composition was assessed after extractionby Fourier transform infrared spectroscopy (FTIRS). Analysis of variance was used to determine if the differences in HU values andDE ratios between the various calculus groups were significant. Threshold cutoff values to classify the calculi into separate groupswere identified by receiver operating characteristic curve analysis. Results: A total of 137 calculi were detected. FTIRS analysis differentiated the calculi into five groups: uric acid (n=17), struvite(n=3), calcium oxalate monohydrate and dihydrate (COM-COD, n=84), calcium oxalate monohydrate (COM, n=28), and carbonateapatite (n=5). The HU value could differentiate only uric acid calculi from calcified calculi (p<0.001). The DE ratio could confidentlydifferentiate uric acid, struvite, calcium oxalate, and carbonate apatite calculi (p<0.001) with cutoff values of 1.12, 1.34, and 1.66,respectively, giving >80% sensitivity and specificity to differentiate them. The DE ratio could not differentiate COM from COM-CODcalculi. No study was rated poor in quality by either of the observers. The mean radiation dose was 1.8 mSv. Conclusions: Low-dose DECT accurately predicts urinary calculus composition in vivo while simultaneously reducing radiation exposurewithout compromising study quality.
3
Metastatic carcinoma of cervix mimicking psoas abscess on imaging: a case report

Naveen Kalra,Senthilkumar Aiyappan,Raje Nijhawan,S.C. Sharma,Niranjan Khandelwal 대한부인종양학회 2009 Journal of Gynecologic Oncology Vol.20 No.2
Cervical cancer can be presented as an unusual and aggressive manner in human immunodeficiency virus (HIV)- positive women. There are case reports of psoas abscess which mimick metastasis from cervical carcinoma in HIV-positive patients. However, such cases are very rare in HIV-negative women with only few case reports available in the literature. We report one case of psoas abscess mimicking metastasis in a HIV-negative woman, which was initially diagnosed as spinal tuberculosis. Cervical cancer can be presented as an unusual and aggressive manner in human immunodeficiency virus (HIV)- positive women. There are case reports of psoas abscess which mimick metastasis from cervical carcinoma in HIV-positive patients. However, such cases are very rare in HIV-negative women with only few case reports available in the literature. We report one case of psoas abscess mimicking metastasis in a HIV-negative woman, which was initially diagnosed as spinal tuberculosis.