Browsing by Author "Singh, Sohan"

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    Prognostication in Traumatic Brain Injury- A Prospective Study of 100 Patients in Tertiary Care Hospital in Rural Area.
    (Akshantala Enterprises Private Limited, 2020-02) Rohilla, Devanshu; Tyagi, Sandeep; Singh, Sohan; Narula, Harneet; Bansal, Tanu; Yadav, Narender; Garg, Shankey; Jain, Amit
    Traumatic brain injury is a major health issue responsible for considerable mortality and morbidity worldwide especially in subjects under the age of 40 yrs. It is important to assess and grade the TBI as soon as possible to guide management and decrease the comorbidities. Various guidelines have been issued by the neurosurgical societies to immediately assess and intervene when ever required. In this study, we have tried to assess the role of basal cisternal effacement in the management and prognosis of RTA patients, and hence tried to simplify the prognostication process and improve the patient management.METHODS100 subjects were studied who were having history of traumatic head injury. NCCT was done for all the patients using 128 slice Multidetector CT- Ingenuity (Philips Medical Systems, USA). Other parameters like pupillary reaction, GCS at the time of presentation, midline shift and associated fractures and bleed were assessed. All the patients were followed up till the time of discharge. The data so obtained was analysed.RESULTSParameters like age, pupillary reflex, GCS at presentation, associated intracranial bleed, associated cranial vault fractures and presence or absence of midline shift correlated well with the final outcome with p value consistently <0.05. We analysed that the degree of obliteration of perimesencephalic cistern was a good prognostic marker in traumatic head injury patients. 36% of patients had favourable outcome out of which none of the patients had obliterated perimesencephalic cistern or interpeduncular cisterns. 64% patients had unfavourable outcome out of which 60% and 48% had obliterated or partially obliterated perimesencephalic cisterns and interpeduncular cisterns respectively, and only 4% and 16% had normal perimesencephalic cisterns and interpeduncular cisterns respectively.CONCLUSIONSIt is important to investigate, grade and prognosticate traumatic head injury patients at the earliest. Our study and various other studies prove that various clinical predictors including age, Glasgow coma scale, and pupil reactivity correlate with outcome of patient. Presence of midline shift, intraventricular haemorrhage, and obliteration of cisterns in patients of traumatic brain injury also correlate with the outcome and can be used; thus, making the prognostication process much easier. These findings can be used on the first day of admission itself.
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    Role of risk of malignancy index 4 in evaluation of adnexal masses
    (Medip Academy, 2020-09) Kaur, Amarjeet; Sharma, Sujata; Singh, Sohan
    Background: The discrimination between benign and malignant adnexal masses is important for clinical management and surgical planning in such patients. Various combined methods of evaluation adnexal mass have also been proposed. Risk of malignancy index (RMI) is a combined parameter which is simple, preclinical and highly sensitive, and more specific. Risk of malignancy index 4 (RMI 4) is calculated as a product of ultrasound score (U)×menopausal score (M)×CA 125×tumor size. Objective of this study was to determine if the RMI (RMI 4) can distinguish between benign and malignant adnexal masses.Methods: A prospective study was conducted on 30 women with an adnexal mass presenting in the OPD and emergency and RMI-4 calculated. Cut off level of 450 was set to differentiate between benign and malignant mass.Results: In this study, the value of RMI-4 is less than 450 in 17 patients with benign disease and 3 patients with malignant disease. The value is more than 450 in 2 patients with benign disease and 8 patients with malignant disease. RMI-4 >450 had a sensitivity of 72.73% and specificity is 89.47%. The positive predictive value is 80% and negative predictive value is 85%. The p-value for RMI-4 in this study is 0.001 which is highly significant.Conclusions: RMI is a reliable, simple, easy to use and cost-effective method in differentiating benign from malignant adnexal masses.
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    Role of Spiral Computed Tomography Scan in Evaluation of Retroperitoneal Pathologies.
    (2014-01) Chander, Ramesh; Singh, Sohan; Singh, Arvinder; Singh, Bhupinder
    The study role of Spiral Computed Tomography Scan in evaluation of Retroperitoneal Pathologies was done in 50 patients with clinically suspected retroperitoneal mass in the Department of Radiodiagnosis and Imaging of Govt. Medical College, Amritsar during the year 2012-2013. All patients underwent routine investigations followed by CT examination of the abdomen. Final diagnosis was achieved by operative findings / FNAC / histopathology or by other investigations. The sensitivity of CT to detect presence / Absence of mass was 100%, to identify organ of origin the sensitivity was 98% and for characterization of mass sensitivity was 82%.