Max Healthcare

About: Max Healthcare is a healthcare organization based out in New Delhi, India. It is known for research contribution in the topics: Population & Medicine. The organization has 391 authors who have published 410 publications receiving 14404 citations.

Can ultrasound suffice for triaging patients requiring surgical correction of rotator cuff tears—a comparative evaluation of ultrasound and magnetic resonance imaging

Abstract: Objectives: To comparatively evaluate the role of ultrasound and MRI in rotator cuff and biceps tendon pathologies and to establish ultrasound as a consistently reproducible, quick and accurate primary investigation modality sufficient to triage patients requiring surgical correction of full thickness rotator cuff tears. Methods: Fifty patients, clinically suspected to have rotator cuff and/or biceps tendon pathologies, with no contraindications to MRI, were evaluated by US and MRI, in a prospective cross-sectional observational study. US was done with high-frequency linear probe, and MRI was done on a 1.5-T scanner using T1 oblique sagittal, proton density (PD)/T2 fat-suppressed (FS) oblique sagittal, T1 axial, PD/T2 FS axial, T1 oblique coronal, T2 oblique coronal and PD FS oblique coronal sequences. Statistical testing was conducted with the statistical package for the social science system version SPSS 17.0. The sensitivity, specificity, PPV, NPV and accuracy were also calculated to analyze the diagnostic accuracy of US findings correlating with MRI findings. A p value less than 0.05 was taken to indicate a significant difference. Mean age was 45 years; 74% patients were males; 77% females and 60% males had tears. Majority of patients with rotator cuff tears were in the sixth decade of life. The frequency of tears was higher among older patients. Fourteen percent of patients had full thickness tears while 64% had partial thickness tears. US was comparable to MRI for detection of full thickness tears with overall sensitivity, specificity, PPV and accuracy of 93.8%, 100%, 100% and 98.2%, respectively (p value < 0.001). For partial thickness tears, US had overall sensitivity, specificity, PPV and accuracy of 75.6%, 82.6%, 89.5% and 78%, respectively (p value < 0.001), as compared to MRI. Subacromial-subdeltoid bursal effusion and long head of biceps tendon sheath effusion were common associated, though, non-specific findings. Ultrasound findings in our study were found to be in significant correlation with findings on MRI in detection of rotator cuff tears. US was equivalent to MRI in detection of full thickness tears and fairly accurate for partial thickness tears. Therefore, US should be considered as the first line of investigation for rotator cuff pathologies.

Advanced Lung Cancers: From Suspicion to Diagnosis

Abstract: Early detection of lung cancer by screening using low dose CT is now possible. However, advanced lung cancers continue to be seen even today. The aim of this paper is to highlight the issue of delayed diagnosis, create greater awareness amongst radiologists and clinicians alike in order to suspect and reduce the time ordinarily taken to arrive at the final diagnosis. Our study shows that once the patient reaches the specialist, the diagnosis is established faster. PET scan is a modality which not only convinces patients to undergo biopsy but also helps increase the positivity rate of biopsy. We also noted that many diseases either coexist or mimic lung cancers and mislead clinicians and radiologists alike, thereby delaying diagnosis till it is widespread. This study discusses the issues related to delayed diagnosis and the radiological findings of advanced cancers, with a view to create greater awareness and shorten response time amongst clinicians and radiologists.

Human Sperm Morphology

Abstract: Although debate about the clinical assessment of semen analysis, male fertility investigation still relies on a standardized analysis of the semen parameters. A normal spermatozoa is considered when the head has an even, oval configuration with well-defined acrosome comprising about 40–70% of the sperm head. In addition, there must be no neck, mid-piece, or tail defect and no cytoplasmic droplets of more than one half the size of the sperm head, which is considered borderline abnormal forms. To assess the morphology at least 100, but preferably 200, spermatozoa count in five different fields to ensure a more randomized evaluation. Spermatozoa with tails were classified into seven groups: normal (head and tail). Normal head but with another abnormality present, large head, small head, tapering head, amorphous head, all with or without tail, neck or mid-piece defects. There are six defects? Tail, neck, and mid-piece defect, loose head.