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G S Gulati

Publications and source records attributed to G S Gulati.

5 recordsLinked to original sources
PubMed2004

Pericardial abscess occurring after tuberculous pericarditis: image morphology on computed tomography and magnetic resonance imaging.

AIM: To study the image morphology on computed tomography (CT) and magnetic resonance imaging (MRI) of pericardial abscess, an uncommon complication of tuberculous pericarditis. MATERIAL AND METHODS: In a 9-year period, 120 patients with clinical and imaging features of constrictive pericarditis were retrospectively reviewed. Of them, 13 patients (age range, 1-51 years; seven females, six males), who had a pericardial mass on echocardiography, and were subjected to CT (11 patients) and MRI (7 patients), were included as subjects of the present study. Five patients underwent both the investigations. The intra-lesional morphology, location, extent, mass effect on adjacent cardiac chambers, secondary effects on the atria and venae cavae, and pericardial thickness were studied. Histopathological confirmation of tubercular infection was available in nine patients. In the remaining four patients, the diagnosis was based on typical extra-cardiac manifestations of tuberculosis. RESULTS: A total of 15 abscesses were detected. CT showed a lesion with a hypodense core and an enhancing rim in all patients. On spin-echo T1-weighted MRI, 57% of the paients had a lesion with a hyperintense core, suggesting an exudative process. Seventy-one percent of patients showed a lesion with a hyperintense core on T2-weighted MRI, while one lesion was hypointense. Post-gadolinium MRI was performed in two patients and showed an enhancing rim in both, with enhancing septa in one. The predominant site of involvement was in the right atrioventricular (AV) groove (77%). Localized tamponade, suggested by the presence of mass effect on an adjacent cardiac chamber, was noted in nine (69%) cases, with proximal atrial dilatation in 78% of them. Four other patients (31%) had atrial dilatation without a localized mass effect. CONCLUSION: Pericardial abscess is an uncommon complication of constrictive pericarditis. Tuberculosis was responsible for abscess formation in all cases in this study. The majority of the lesions are located in the right AV groove with imaging features suggestive of localized tamponade. The presence of a hypointense core on T2-weighted MRI may suggest a tubercular aetiology.

Abscess↗
PubMedDate not supplied

Liver herniation into the pericardium: an unusual cause of massive pericardial effusion with intrapericardial mass in a neonate.

In neonates presenting with massive pericardial effusion and pericardial mass, liver herniation into the pericardium is a rare diagnosis. Echocardiogram and CT scan are useful investigations in the diagnosis of pericardial masses. Continuation of the mass with the liver with the same texture as the liver helps to make the diagnosis of intrapericardial herniation of liver. Correct diagnosis of this condition is important because the surgical approach needed for management of this condition is different from that used for other pericardial masses.

Echocardiography↗
PubMedDate not supplied

Atherosclerosis in Asian Indians with systemic lupus erythematosus.

OBJECTIVES: Atherosclerosis has emerged as an important late complication of systemic lupus erythematosus (SLE). Asian Indians, as an ethnic group, are known to be metabolically predisposed to development of early atherosclerosis. No data on this aspect of SLE are available from Asia. This study was undertaken to find the frequency of atherosclerosis in Indian lupus patients and the factors affecting such an occurrence. METHODS: Carotid artery intimo-medial thickness (IMT) and plaque were used as markers of atherosclerosis. High-resolution B-mode ultrasonography was used to compare carotid IMT and plaque in 50 patients with SLE and 50 age- and sex-matched healthy controls. RESULTS: Patients with lupus (age 31.6+/-10.05, median 30.5 years; disease duration 52.3+/-36.7, median 46 months) exhibited a significantly greater IMT than controls (0.417+/-0.07 vs. 0.362+/-00.07 mm; p = 0.003). Carotid plaques were seen in seven (14%) cases. None of the control population had plaques (p = 0.006). On bivariate analysis, the IMT was significantly affected by age, systolic blood pressure (SBP), disease duration and menopausal status. On multivariate analysis, the only factor significantly affecting IMT was SBP. The Systemic Lupus International Collaborating Clinics/American College of Rheumatology (SLICC/ACR) score was the sole factor found to significantly affect the occurrence of plaque. CONCLUSIONS: Asian Indian lupus patients in our study, despite being relatively young and with shorter disease duration, exhibited premature atherosclerosis in the form of significantly thicker intimo-media and plaque. The factors found to affect accelerated atherosclerosis in our cohort were age, SBP, disease duration, postmenopausal status and the SLICC/ACR score.

Adolescent↗