Browsing by Author "Usha, M"
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Item Accuracy of the smartphone-based nonmydriatic retinal camera in the detection of sight-threatening diabetic retinopathy(All India Ophthalmological Society, 2020-02) Prathiba, V; Rajalakshmi, R; Arulmalar, S; Usha, M; Subhashini, R; Gilbert, CE; Anjana, RM; Mohan, VPurpose: To evaluate the sensitivity and specificity of smartphone-based nonmydriatic (NM) retinal camera in the detection of diabetic retinopathy (DR) and sight-threatening DR (STDR) in a tertiary eye care facility. Methods: Patients with diabetes underwent retinal photography with a smartphone-based NM fundus camera before mydriasis and standard 7-field fundus photography with a desktop mydriatic fundus camera after mydriasis. DR was graded using the international clinical classification of diabetic retinopathy system by two retinal expert ophthalmologists masked to each other and to the patient's identity. The sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) to detect DR and STDR by NM retinal imaging were assessed. Results: 245 people had gradable images in one or both eyes. DR and STDR were detected in 45.3% and 24.5%, respectively using NM camera, and in 57.6% and 28.6%, respectively using mydriatic camera. The sensitivity and specificity to detect any DR by NM camera was 75.2% (95% confidence interval (CI) 68.1–82.3) and 95.2% (95%CI 91.1–99.3). For STDR the values were 82.9% (95% CI 74.0–91.7) and 98.9% (95% CI 97.3–100), respectively. The PPV to detect any DR was 95.5% (95% CI 89.8–98.5) and NPV was 73.9% (95% CI 66.4–81.3); PPV for STDR detection was 96.7% (95% CI 92.1–100)) and NPV was 93.5% (95% CI 90.0–97.1). Conclusion: Smartphone-based NM retinal camera had fairly high sensitivity and specificity for detection of DR and STDR in this clinic-based study. Further studies are warranted in other settings.Item Left-sided giant adrenal myelolipoma secreting catecholamine.(2012-07) Udupa, Sujatha; Usha, M; Visweswara, R N; Desai, M GAdrenal myelolipoma (AML) is a rare benign tumor composed of mature adipose and hematopoietic tissue. Most of these patients are asymptomatic and the tumors are non-secreting. We present a case with a large functional adrenal myelolipoma, wherein the patient was hypertensive and biochemistry revealed increase in 24 hours urinary Vanillylmandelic Acid (VMA), a metabolite of catecholamine. The mass was removed surgically and diagnosed as adrenal myelolipoma on histopathological examination. Both his blood pressure and urinary VMA returned to normal following surgery, which suggested that the mass was functioning and was secreting catecholamine. To the best of our knowledge, a catecholamine secreting adrenal myelolipoma has been reported in the literature only once previously. The association of hypertension and adrenal myelolipoma may not be entirely coincidental, as it may be associated with secreting catecholamine, as seen in our case. We also review the literature on functioning adrenal myelolipoma.Item Thyroid Lesions: FNAC and Histopathology Correlation in Our Experience.(2016-03) Usha, M; Jasuja, Avnika; Rashmi, K; Reginald, Sharon; Rakshitha, H B; Kumar, Aneesha AsokBackground: Fine needle aspiration cytology is considered the gold standard diagnostic test for the diagnosis of thyroid nodules. Fine needle aspiration cytology is a cost effective procedure that provides a specific diagnosis rapidly with minimal complications. Based on the cytology findings, patients can be followed up in cases of benign diagnosis and subjected to surgery in cases of malignant diagnosis thereby decreasing the rate of unnecessary surgery. The purpose of the present study was to correlate the fine needle aspiration cytology findings with histopathology of excised specimens. Methods: This was a prospective study conducted on 310 consecutive patients between June 2012 and May 2015. All patients with clinically diagnosed thyroid nodule were included in the study. Results: In our study sensitivity of the thyroid FNAC ranges from 93.02% to 100% and its specificity from 60.42% to 96.62% respectively. Positive predictive value is 94.44% and negative predictive value is 100%. Commonest benign condition is multinodular goiter and malignancy is papillary carcinoma. Most difficult thyroid lesions to be reported are those in the intermediate category as cytomorphological features are overlapping.Conclusion: Fine needle aspiration cytology is a simple, easy to perform, cost effective, and easily repeated procedure for the diagnosis of thyroid cancer. It is recommended as the first line investigation for the diagnosis of thyroid nodules.Item Treatment of severely mutilated incisors: a challenge to the pedodontist.(2007-03-06) Usha, M; Deepak, V; Venkat, S; Gargi, MDental caries is the single most common chronic childhood disease. In early childhood caries, there is early carious involvement and gross destruction of the maxillary anterior teeth. This leads to difficulty in speech, decreased masticatory efficiency, development of abnormal tongue habits and subsequent malocclusion and psychological problems if esthetics are compromised. The restoration of severely decayed primary incisors is often a difficult procedure that presents a special challenge to pediatric dentists. This case report documents the restoration of severely mutilated lateral incisors in a patient with early childhood caries.