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Kachewar S.G.,Rural Medical College RMC
Diagnostico Prenatal

Purpose To perform a nationwide multicentric validatation of the nomogram of fetal middle cerebral artery peak systolic velocity (MCA-PSV); previously constructed by us and to compare and contrast it with similar studies in the world for an effective output. Materials and methods Fetal MCA-PSV was measured in normal 1015 pregnant women attending the antenatal ultrasound clinic at least once between 12 and 40 weeks of gestation (35 patients per week of gestation), at this institute and a nomogram was constructed. MCA-PSV in 30 patients each at 12, 24 and 36 weeks of gestation (GA) were measured at multiple centers [other institutes by different observers] in this nation. Their mean values were compared with the mean values mentioned in the nomogram prepared by us. Similarly the linear correlation diagrams as well as the regression equations of this large local study were compared with those from other worldwide published studies. Statistical analysis was done using the SPSS 12 software. Results A nationwide comparison of the mean and standard deviation (SD) values of MCA-PSV at 12, 24 and 36 weeks of gestation calculated at 95% confidence interval, in our study with studies from different other centers, using ANOVA the calculated F value was far too high than the table value. So, null hypothesis that the nomogram previously prepared by us at this center can be comfortably followed at other centers in this nation is rejected. Comparative analysis of linear correlation between GA (weeks) and MCA-PSV (cm/s) in our study and other studies also displayed a disparity. Conclusions A significant difference was found between local study and multicentric nation wide studies, as well as between local values and worldwide values. A multicentric nationwide input for a worldwide output thus enabled us not only to construct and compare normal local reference range of fetal MCA-PSV but also to validate it effectively and to realize its limitations. Hence it is time to say goodbye to the "One Size Fits All Theory" of fetal MCA-PSV and to welcome efforts to scientifically construct regional reference range all over the world. © 2013 Asociación Española de Diagnóstico Prenatal. Source

Kachewar S.G.,Rural Medical College RMC | Kulkarni D.S.,IRural Medical College RMC
Journal of Clinical and Diagnostic Research

Soft tissue calcifications and ossifications at distant sites have been reported as a sequel to head injuries or spinal cord injuries. They are usually noticed many months after injury, when once such bedridden patients try to be ambulatory, it rarely goes. Thus, they are an uncommon, disturbing and avoidable complication in patients who have injuries to central nervous system. Therefore, this article emphasizes on pathology, treatment options and finally, the preventive aspects. Source

Kachewar S.G.,Rural Medical College RMC | Gandage S.G.,Rural Medical College RMC
Japanese Journal of Radiology

Purpose To identify, classify, and study the clinical significance of different patterns of fetal middle cerebral artery peak systolic velocity waveforms that can be seen on Doppler ultrasound. Materials and methods The patterns of fetal middle cerebral artery (MCA) velocity waveforms encountered in our study (n = 1128) conducted on a rural obstetric population were analyzed. Results Broadly, three different waveform-patterns (type I to type III) were identified from 1100 cases on which satisfactory studies were conducted. Types IA and IB were found in normal fetuses of the first (n = 254, 23.1%) and second (n = 386, 35.1%) trimesters, respectively. Type IC (n = 418, 38%) included normal fetuses in the second (n = 25) and third (n = 317) trimesters, and 76 of 118 IUGR fetuses. Type II consisted of IUGR category; 17 (1.5%) cases in type IIA, 10 (0.9%) in IIB, and 11 (1.0%) in IIC. Type III (n = 4, 0.4%) was found in the critical cases with severe anemia secondary to fetomaternal hemorrhage. Conclusion Although different patterns of uterine and umbilical artery velocity waveforms have been described in the obstetric literature, there is no mention of patterns of fetal MCA velocity waveforms. This is the first study to demonstrate, classify, and state the clinical significance of different patterns of fetal middle cerebral artery peak systolic velocity waveforms. © Japan Radiological Society 2012. Source

Kachewar S.G.,Rural Medical College RMC | Sankaye S.B.,Rural Medical College RMC
Journal of Clinical and Diagnostic Research

Diastematomyelia means sagittal division of the spinal cord into two hemi cords. It is a congenital malformation which results from an abnormal adhesion between ectoderm and endoderm. It is more common in females (3:1). This abnormal adhesion which splits the cord may be in the form of fibrous tissue or purely a calcific bar or purely an ossific bar or even a combination of the earlier mentioned entities. The health impacts of this entity are enormous, as the patients may be asymptomatic to begin with, until gradually; progressive spinal cord dysfunction sets in. Imaging plays a vital role in establishing the diagnosis and it may aid in easing the quality of life by making an early diagnosis. The affected individual and the afflicted families need psycho-social guidance and counselling. We are presenting here, imaging findings in two cases of diastematomyelia. Source

Kachewar S.G.,Rural Medical College RMC | Kulkarni D.S.,Rural Medical College RMC
Journal of Clinical and Diagnostic Research

Calcifying tendinitis of the rotator cuff is a common disorder; its underlying mechanism still remains unknown. Although details of the clinical presentation(s) and pathological changes which are associated with calcific tendinitis are available, conservative management of this condition remains a topic of debate. About 90% of the patients can be treated non - operatively, but as some are resistant to conservative treatment; newer techniques or surgery should be indicated. Rheumatologists and radiologists have often described this shoulder abnormality, leading to its progressive differentiation from other painful shoulder syndromes. The conservative treatment includes the use of non - steroidal anti - inflammatory agents, roentegen therapy, physical modalities for controlling the pain and for preventing loss of joint mobility, local steroid injections, and open or arthroscopic surgeries. Results of non - operative treatments have also been satisfactory. These include heat, cold, range of motion and pendulum exercises, diathermy, short - wave, and radiation therapy. Rest, immobilization with a sling, and oral non - steroidal and steroid anti - inflammatory medications have also been mentioned. This review aimed at looking at calcific tendinitis of the rotator cuff with a wide vision in the light of modern advances; while at the same time, not disregarding the past experiences. Source

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