The Experts below are selected from a list of 4206 Experts worldwide ranked by ideXlab platform
Sudha Suri - One of the best experts on this subject based on the ideXlab platform.
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computed tomography in Abdominal Tuberculosis
British Journal of Radiology, 1999Co-Authors: Sudha Suri, Sanjay Gupta, Rajeev SuriAbstract:The diagnosis of Abdominal Tuberculosis is often difficult because of its protean clinical manifestations and non-specific laboratory investigations. In the abdomen, Tuberculosis may affect the intestinal tract, lymph nodes, peritoneum and solid viscera in varying combinations. CT, with its ability to provide a comprehensive overview of Abdominal structures, is the imaging modality of choice for evaluation of such patients. This pictorial review illustrates the spectrum of CT appearances of Abdominal Tuberculosis which includes intestinal, lymph nodal, peritoneal, mesenteric, hepatic, splenic and pancreatic disease.
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ultrasound guided fine needle aspiration cytology in Abdominal Tuberculosis
British Journal of Radiology, 1998Co-Authors: Rajeev Suri, Sanjay Gupta, S K Gupta, K Singh, Sudha SuriAbstract:Although barium studies and CT are useful in assessing Abdominal pathology in Tuberculosis, imaging findings are not always specific and a histopathological or bacteriological confirmation is often required. The aim of the present study was to evaluate the role of ultrasound (US) guided fine needle aspiration cytology (FNAC) in the diagnosis of Abdominal Tuberculosis in patients with non-palpable lesions detected on US/CT. FNAC was performed on 31 sites in 30 patients. The sites included enlarged lymph nodes (n = 14), focal lesions in liver (n = 2) and spleen (n = 8), and thickened bowel in the ileocaecal region (n = 7). The results were classified cytomorphologically into four groups: (1) definite evidence of Tuberculosis; (2) presumptive evidence of Tuberculosis; (3) suggestive of Tuberculosis; and (4) negative for Tuberculosis. 18 of the 31 FNACs (58%) revealed a positive diagnosis of Tuberculosis (definite evidence in nine patients and presumptive evidence in nine patients). 13 of the 31 FNACs (42%) s...
Rajeev Suri - One of the best experts on this subject based on the ideXlab platform.
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computed tomography in Abdominal Tuberculosis
British Journal of Radiology, 1999Co-Authors: Sudha Suri, Sanjay Gupta, Rajeev SuriAbstract:The diagnosis of Abdominal Tuberculosis is often difficult because of its protean clinical manifestations and non-specific laboratory investigations. In the abdomen, Tuberculosis may affect the intestinal tract, lymph nodes, peritoneum and solid viscera in varying combinations. CT, with its ability to provide a comprehensive overview of Abdominal structures, is the imaging modality of choice for evaluation of such patients. This pictorial review illustrates the spectrum of CT appearances of Abdominal Tuberculosis which includes intestinal, lymph nodal, peritoneal, mesenteric, hepatic, splenic and pancreatic disease.
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ultrasound guided fine needle aspiration cytology in Abdominal Tuberculosis
British Journal of Radiology, 1998Co-Authors: Rajeev Suri, Sanjay Gupta, S K Gupta, K Singh, Sudha SuriAbstract:Although barium studies and CT are useful in assessing Abdominal pathology in Tuberculosis, imaging findings are not always specific and a histopathological or bacteriological confirmation is often required. The aim of the present study was to evaluate the role of ultrasound (US) guided fine needle aspiration cytology (FNAC) in the diagnosis of Abdominal Tuberculosis in patients with non-palpable lesions detected on US/CT. FNAC was performed on 31 sites in 30 patients. The sites included enlarged lymph nodes (n = 14), focal lesions in liver (n = 2) and spleen (n = 8), and thickened bowel in the ileocaecal region (n = 7). The results were classified cytomorphologically into four groups: (1) definite evidence of Tuberculosis; (2) presumptive evidence of Tuberculosis; (3) suggestive of Tuberculosis; and (4) negative for Tuberculosis. 18 of the 31 FNACs (58%) revealed a positive diagnosis of Tuberculosis (definite evidence in nine patients and presumptive evidence in nine patients). 13 of the 31 FNACs (42%) s...
Vishal Sharma - One of the best experts on this subject based on the ideXlab platform.
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defining satisfactory response to therapy in Abdominal Tuberculosis a work in progress
Infectious disorders drug targets, 2020Co-Authors: Vishal Sharma, Harjeet Singh, Harshal S MandavdhareAbstract:Abdominal Tuberculosis is difficult to diagnose due to low sensitivity of microbiological tests and the low histological yield. Satisfactory response to therapy has long been used a criteria for the diagnosis of Abdominal Tuberculosis. However, the appropriate definitions of response to therapy in Abdominal Tuberculosis have remained unclear. Recent evidence suggests that mucosal healing of ulcers at the end of therapy or at two months (early mucosal response) is a helpful criteria of response to therapy. This also helps in exclusion of multidrug resistant Tuberculosis and alternative diagnosis like Crohn's disease. Further limited literature suggests the use of some biomarkers like C-reactive protein in the follow-up of patients with peritoneal or intestinal Tuberculosis.
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use of steroids for Abdominal Tuberculosis a systematic review and meta analysis
Infection, 2019Co-Authors: Hariom Soni, Harjeet Singh, Harshal S Mandavdhare, Balaji L Bellam, Raghavendra K Rao, Praveen M Kumar, Usha Dutta, Vishal SharmaAbstract:The role of adjunctive steroids in Abdominal Tuberculosis is unclear. To evaluate effect of adjunctive use of steroids for Abdominal Tuberculosis in reducing/preventing complications. We searched electronic databases (Medline, Embase, CENTRAL, Scopus, Web of Science, CINAHL) from inception to 25th June 2018 using the terms “Abdominal Tuberculosis” OR “intestinal Tuberculosis” OR “peritoneal Tuberculosis” OR “tuberculous peritonitis” AND steroids OR methylprednisolone OR prednisolone. Bibliography of potential articles was also searched. We included studies comparing adjunctive steroids to antitubercular therapy (ATT) alone. We excluded non-English articles, case reports, reviews and unrelated papers. The primary outcome was a comprehensive clinical outcome including need for surgery or the presence of symptomatic stricture (Abdominal pain or intestinal obstruction). Quality assessment of included studies was done using ROBINS-I tool. Random-effects model was used to calculate the summary effect for all the outcomes. Of total 633 records, three studies on peritoneal Tuberculosis were included in meta-analysis. These papers were of poor quality (one quasi-randomised study and two retrospective cohort studies). Meta-analyses showed adjunctive steroids, with ATT is more effective than ATT alone in tuberculous peritonitis patients for the prevention of composite end point (RR 0.15 [0.04, 0.62], p = 0.008), symptomatic stricture(RR 0.15 [0.04–0.62] p = 0.008) and intestinal obstruction (RR 0.18 [0.03–0.99] p = 0.05). The data on use of steroids for Abdominal Tuberculosis are limited to peritoneal Tuberculosis. Although steroids seem to have some benefit in patients of tubercular peritonitis, the poor quality of studies limits the generalisability of the findings. CRD42016047347.
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common and uncommon imaging features of Abdominal Tuberculosis
Journal of Medical Imaging and Radiation Oncology, 2019Co-Authors: Pankaj Gupta, Saroj K Sinha, Vishal Sharma, Harshal S Mandavdhare, Usha Dutta, Suresh Kumar, Narender Dhaka, Rakesh KochharAbstract:Despite the advances in the medical care, Tuberculosis (TB) still remains an important health problem. This is particularly relevant to the developing countries as well as the immunocompromised population in the developed world. Multidrug resistance poses another challenge and may be responsible for increasing incidence of TB, to some extent. The respiratory system is the most commonly involved, although any organ system may be affected. Abdominal involvement occurs in 11-12% of the patients with extrapulmonary TB. The clinical features of Abdominal TB are nonspecific. Imaging plays an important role in the diagnosis of Abdominal TB. Although a few imaging features strongly favour the possibility of TB, Abdominal TB is a greater masquerader. In this review, we highlight the entire spectrum of the manifestations of Abdominal Tuberculosis (excluding the genitourinary involvement) with an emphasis on imaging findings.
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role of ultrasound guided fine needle aspiration cytology of omentum in diagnosis of Abdominal Tuberculosis
Surgical Infections, 2019Co-Authors: Suresh Kumar, Saroj K Sinha, Vishal Sharma, Harshal S Mandavdhare, Usha Dutta, Pankaj Gupta, Anmol Bhatia, Narender Dhaka, Radhika Srinivasan, Rakesh KoccharAbstract:Abstract Aim: To evaluate the efficacy of ultrasound-guided (USG) fine-needle aspiration cytology examination (FNAC) of the omentum in the diagnosis of Abdominal Tuberculosis (TB). Methods: Retrosp...
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serial c reactive protein measurements in patients treated for suspected Abdominal Tuberculosis
Digestive and Liver Disease, 2017Co-Authors: Vishal Sharma, Harjeet Singh, Harshal S Mandavdhare, Sandeep Lamoria, Amit KumarAbstract:Abstract Background Response to treatment is often used as a criterion for the diagnosis of Abdominal Tuberculosis. Aim To determine utility of serum C reactive protein (CRP) in assessment of response to anti-tubercular therapy (ATT) in Abdominal Tuberculosis (ATB). Methods We retrospectively analysed the database of patients with suspected ATB (intestinal and/or peritoneal). Response to ATT was assessed using subjective and objective (ulcer healing or ascites resolution) parameters. Serum CRP levels were estimated at baseline and then at 2 months and 6 months of ATT. Results One hundred and twelve patients were included in the analysis. The mean age was 36.57 ± 15.04 years and 54.46% (61/112) were males. Sixty-six patients (58.92%) had intestinal, 28 (25%) had peritoneal and 18 (16.07%) had both. Eleven patients had a normal CRP at baseline while 101 had elevated levels. The CRP levels declined in 94 patients at 6 months. One patient with increased levels at 2 months had multi-drug resistant TB. Seven patients showed elevated or plateaued CRP levels on follow-up. These patients had underlying Crohn’s disease (3 patients), peritoneal carcinomatosis (1), inter-current infection (1), lymphoma (1) and non-healing ulcers (1). Conclusion Lack of decline in CRP may suggest alternative diagnosis or drug-resistant Tuberculosis.
Harshal S Mandavdhare - One of the best experts on this subject based on the ideXlab platform.
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defining satisfactory response to therapy in Abdominal Tuberculosis a work in progress
Infectious disorders drug targets, 2020Co-Authors: Vishal Sharma, Harjeet Singh, Harshal S MandavdhareAbstract:Abdominal Tuberculosis is difficult to diagnose due to low sensitivity of microbiological tests and the low histological yield. Satisfactory response to therapy has long been used a criteria for the diagnosis of Abdominal Tuberculosis. However, the appropriate definitions of response to therapy in Abdominal Tuberculosis have remained unclear. Recent evidence suggests that mucosal healing of ulcers at the end of therapy or at two months (early mucosal response) is a helpful criteria of response to therapy. This also helps in exclusion of multidrug resistant Tuberculosis and alternative diagnosis like Crohn's disease. Further limited literature suggests the use of some biomarkers like C-reactive protein in the follow-up of patients with peritoneal or intestinal Tuberculosis.
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use of steroids for Abdominal Tuberculosis a systematic review and meta analysis
Infection, 2019Co-Authors: Hariom Soni, Harjeet Singh, Harshal S Mandavdhare, Balaji L Bellam, Raghavendra K Rao, Praveen M Kumar, Usha Dutta, Vishal SharmaAbstract:The role of adjunctive steroids in Abdominal Tuberculosis is unclear. To evaluate effect of adjunctive use of steroids for Abdominal Tuberculosis in reducing/preventing complications. We searched electronic databases (Medline, Embase, CENTRAL, Scopus, Web of Science, CINAHL) from inception to 25th June 2018 using the terms “Abdominal Tuberculosis” OR “intestinal Tuberculosis” OR “peritoneal Tuberculosis” OR “tuberculous peritonitis” AND steroids OR methylprednisolone OR prednisolone. Bibliography of potential articles was also searched. We included studies comparing adjunctive steroids to antitubercular therapy (ATT) alone. We excluded non-English articles, case reports, reviews and unrelated papers. The primary outcome was a comprehensive clinical outcome including need for surgery or the presence of symptomatic stricture (Abdominal pain or intestinal obstruction). Quality assessment of included studies was done using ROBINS-I tool. Random-effects model was used to calculate the summary effect for all the outcomes. Of total 633 records, three studies on peritoneal Tuberculosis were included in meta-analysis. These papers were of poor quality (one quasi-randomised study and two retrospective cohort studies). Meta-analyses showed adjunctive steroids, with ATT is more effective than ATT alone in tuberculous peritonitis patients for the prevention of composite end point (RR 0.15 [0.04, 0.62], p = 0.008), symptomatic stricture(RR 0.15 [0.04–0.62] p = 0.008) and intestinal obstruction (RR 0.18 [0.03–0.99] p = 0.05). The data on use of steroids for Abdominal Tuberculosis are limited to peritoneal Tuberculosis. Although steroids seem to have some benefit in patients of tubercular peritonitis, the poor quality of studies limits the generalisability of the findings. CRD42016047347.
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common and uncommon imaging features of Abdominal Tuberculosis
Journal of Medical Imaging and Radiation Oncology, 2019Co-Authors: Pankaj Gupta, Saroj K Sinha, Vishal Sharma, Harshal S Mandavdhare, Usha Dutta, Suresh Kumar, Narender Dhaka, Rakesh KochharAbstract:Despite the advances in the medical care, Tuberculosis (TB) still remains an important health problem. This is particularly relevant to the developing countries as well as the immunocompromised population in the developed world. Multidrug resistance poses another challenge and may be responsible for increasing incidence of TB, to some extent. The respiratory system is the most commonly involved, although any organ system may be affected. Abdominal involvement occurs in 11-12% of the patients with extrapulmonary TB. The clinical features of Abdominal TB are nonspecific. Imaging plays an important role in the diagnosis of Abdominal TB. Although a few imaging features strongly favour the possibility of TB, Abdominal TB is a greater masquerader. In this review, we highlight the entire spectrum of the manifestations of Abdominal Tuberculosis (excluding the genitourinary involvement) with an emphasis on imaging findings.
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role of ultrasound guided fine needle aspiration cytology of omentum in diagnosis of Abdominal Tuberculosis
Surgical Infections, 2019Co-Authors: Suresh Kumar, Saroj K Sinha, Vishal Sharma, Harshal S Mandavdhare, Usha Dutta, Pankaj Gupta, Anmol Bhatia, Narender Dhaka, Radhika Srinivasan, Rakesh KoccharAbstract:Abstract Aim: To evaluate the efficacy of ultrasound-guided (USG) fine-needle aspiration cytology examination (FNAC) of the omentum in the diagnosis of Abdominal Tuberculosis (TB). Methods: Retrosp...
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serial c reactive protein measurements in patients treated for suspected Abdominal Tuberculosis
Digestive and Liver Disease, 2017Co-Authors: Vishal Sharma, Harjeet Singh, Harshal S Mandavdhare, Sandeep Lamoria, Amit KumarAbstract:Abstract Background Response to treatment is often used as a criterion for the diagnosis of Abdominal Tuberculosis. Aim To determine utility of serum C reactive protein (CRP) in assessment of response to anti-tubercular therapy (ATT) in Abdominal Tuberculosis (ATB). Methods We retrospectively analysed the database of patients with suspected ATB (intestinal and/or peritoneal). Response to ATT was assessed using subjective and objective (ulcer healing or ascites resolution) parameters. Serum CRP levels were estimated at baseline and then at 2 months and 6 months of ATT. Results One hundred and twelve patients were included in the analysis. The mean age was 36.57 ± 15.04 years and 54.46% (61/112) were males. Sixty-six patients (58.92%) had intestinal, 28 (25%) had peritoneal and 18 (16.07%) had both. Eleven patients had a normal CRP at baseline while 101 had elevated levels. The CRP levels declined in 94 patients at 6 months. One patient with increased levels at 2 months had multi-drug resistant TB. Seven patients showed elevated or plateaued CRP levels on follow-up. These patients had underlying Crohn’s disease (3 patients), peritoneal carcinomatosis (1), inter-current infection (1), lymphoma (1) and non-healing ulcers (1). Conclusion Lack of decline in CRP may suggest alternative diagnosis or drug-resistant Tuberculosis.
Saroj K Sinha - One of the best experts on this subject based on the ideXlab platform.
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common and uncommon imaging features of Abdominal Tuberculosis
Journal of Medical Imaging and Radiation Oncology, 2019Co-Authors: Pankaj Gupta, Saroj K Sinha, Vishal Sharma, Harshal S Mandavdhare, Usha Dutta, Suresh Kumar, Narender Dhaka, Rakesh KochharAbstract:Despite the advances in the medical care, Tuberculosis (TB) still remains an important health problem. This is particularly relevant to the developing countries as well as the immunocompromised population in the developed world. Multidrug resistance poses another challenge and may be responsible for increasing incidence of TB, to some extent. The respiratory system is the most commonly involved, although any organ system may be affected. Abdominal involvement occurs in 11-12% of the patients with extrapulmonary TB. The clinical features of Abdominal TB are nonspecific. Imaging plays an important role in the diagnosis of Abdominal TB. Although a few imaging features strongly favour the possibility of TB, Abdominal TB is a greater masquerader. In this review, we highlight the entire spectrum of the manifestations of Abdominal Tuberculosis (excluding the genitourinary involvement) with an emphasis on imaging findings.
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role of ultrasound guided fine needle aspiration cytology of omentum in diagnosis of Abdominal Tuberculosis
Surgical Infections, 2019Co-Authors: Suresh Kumar, Saroj K Sinha, Vishal Sharma, Harshal S Mandavdhare, Usha Dutta, Pankaj Gupta, Anmol Bhatia, Narender Dhaka, Radhika Srinivasan, Rakesh KoccharAbstract:Abstract Aim: To evaluate the efficacy of ultrasound-guided (USG) fine-needle aspiration cytology examination (FNAC) of the omentum in the diagnosis of Abdominal Tuberculosis (TB). Methods: Retrosp...
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Abdominal Tuberculosis of the gastrointestinal tract revisited
World Journal of Gastroenterology, 2014Co-Authors: Uma Debi, Vasudevan Ravisankar, Kaushal K Prasad, Saroj K Sinha, Arun SharmaAbstract:Abdominal Tuberculosis is an increasingly common disease that poses diagnostic challenge, as the nonspecific features of the disease which may lead to diagnostic delays and development of complications. This condition is regarded as a great mimicker of other Abdominal pathology. A high index of suspicion is an important factor in early diagnosis. Abdominal involvement may occur in the gastrointestinal tract, peritoneum, lymphnodes or solid viscera. Various investigative methods have been used to aid in the diagnosis of Abdominal Tuberculosis. Early diagnosis and initiation of antituberculous therapy and surgical treatment are essential to prevent morbidity and mortality. Most of the patients respond very well to standard antitubercular therapy and surgery is required only in a minority of cases. Imaging plays an important role in diagnosis of Abdominal Tuberculosis because early recognition of this condition is important. We reviewed our experience with the findings on various imaging modalities for diagnosis of this potentially treatable disease.
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development and evaluation of multiplex pcr in rapid diagnosis of Abdominal Tuberculosis
Diagnostic Microbiology and Infectious Disease, 2013Co-Authors: Vinaykumar Hallur, Saroj K Sinha, Meera Sharma, Sunil Sethi, Kusum Sharma, Abhishek Mewara, Sunil Kumar Dhatwalia, Rakesh Yadav, Deepak K Bhasin, S V RanaAbstract:The clinical features of Abdominal Tuberculosis (TB) are non-specific and establishing a diagnosis remains a challenge. A delay in diagnosis is likely to increase the morbidity in these patients. We developed a multiplex polymerase chain reaction (PCR) using 16SrRNA, IS6110, and devR, and evaluated it in comparison with other conventional tests in clinical suspects of Abdominal TB. A total of 183 patients with clinical suspicion of Abdominal TB (96 patients with intestinal TB and 87 with peritoneal TB) were enrolled for the study. Endoscopic or intraoperative biopsies were collected from patients suspected of intestinal TB and ascitic fluid was collected from patients with a suspicion of peritoneal TB. Of the intestinal Tuberculosis group, there were 40 confirmed cases and 56 controls, while of the peritoneal Tuberculosis group there were 37 confirmed cases and 50 controls. Multiplex PCR showed a high sensitivity and specificity in both the intestinal TB and peritoneal TB groups. When combined with histopathology, multiplex PCR could detect 97.5% of all the cases in the intestinal Tuberculosis group, while in combination adenosine deaminase levels (ADA) in cases of peritoneal Tuberculosis it increased the specificity of diagnosis of peritoneal Tuberculosis to 95%. In combination with histopathology in suspected intestinal TB cases, and ADA testing in suspected peritoneal TB cases, it can be used as a highly sensitive, specific, and rapid diagnostic tool with the ability to supplement the limitations of other diagnostic modalities.
