Waqas Ullah

Top 100 cited articles in cardiovascular magnetic resonance: a bibliometric analysis

BackgroundWith limited health care resources, bibliometric studies can help guide researchers and research funding agencies towards areas where reallocation or increase in research activity is warranted. Bibliometric analyses have been published in many specialties and sub-specialties but our literature search did not reveal a bibliometric analysis on Cardiovascular Magnetic Resonance (CMR). The main objective of the study was to identify the trends of the top 100 cited articles on CMR research.MethodsWeb of Science (WOS) search was used to create a database of all English language scientific journals. This search was then cross-referenced with a similar search term query of Scopus® to identify articles that may have been missed on the initial search. Articles were ranked by citation count and screened by two independent reviewers.ResultsCitations for the top 100 articles ranged from 178 to 1925 with a median of 319.5. Only 17 articles were cited more than 500 times, and the vast majority (n = 72) were cited between 200–499 times. More than half of the articles (n = 52) were from the United States of America, and more than one quarter (n = 21) from the United Kingdom. More than four fifth (n = 86) of the articles were published between the time period 2000–2014 with only 1 article published before 1990. Circulation and Journal of the American College of Cardiology made up more than half (n = 62) of the list. We found 10 authors who had greater than 5 publications in the list.ConclusionOur study provides an insight on the characteristics and quality of the most highly cited CMR literature, and a list of the most influential references related to CMR.

A tough scope to swallow: endoscopic retrograde cholangiopancreatography through percutaneous endoscopic gastrostomy

We are presenting a case of oral cancer with choledocholithiasis that was successfully treated with transgastric endoscopic retrograde cholangiopancreatography (ERCP). A 76-year-old female with past medical history of squamous cell cancer of the oral cavity status post hemiglossectomy with left anterolateral free flap, bilateral neck dissections, tracheostomy, and decannulation with gastrostomy tube placement, chemotherapy and radiation therapy presented with epigastric pain for 5 days. She experienced pain was radiating to the right upper quadrant and right flank, which was associated with nausea. Her vital signs were stable. Abdominal examination showed positive Murphy’s sign; 18-French (Fr) gastrostomy tube was present in left upper quadrant.

A Bibliometric Analysis of the Top 100 Cited Articles on Hepatic Magnetic Resonance Imaging.

The purpose of this study is to guide the readers to the impact of the articles published on hepatic magnetic resonance imaging (MRI). We searched Scopus using 10 different search terms for hepatic MRI. The selected studies were thoroughly reviewed by two independent authors and any disagreement was sorted out by mutual consensus. The list of articles and journals was downloaded into an excel spreadsheet. Only the top 100 cited articles were selected by mutual consensus among all the authors. These articles were further read in the full-text form and were further categorized into subgroups. Three authors independently reviewed the top 100 selected articles, and subsequently data was extracted from them and analyzed. Our study showed that the highest number of top 100 cited articles on hepatic MRI were from Radiology (30 articles) followed by European Radiology (14 articles). The American Journal of Roentgenology, Radiographics, and Journal of Magnetic Resonance had seven articles each. The United States had the highest number of articles by region. Nineteen other journals contributed only one article each to the list of top 100 cited articles. The contribution of authors to the top 100 cited articles was reviewed; all the authors contributing with more than two articles to the highly cited articles are given in Table 3 in the supplementary material. The maximum number of articles were published during 2009 (14 articles), and for a five-year period, the maximum contribution was made during 2008-2013 (44 articles). Our analysis gives an insight on the frequency of citations of top articles on hepatic MRI, categorizes the subtopics, the timeline of the publications, and contributions from different geographic distributions.

Spontaneous Lung Herniation Leading to Extensive Subcutaneous Emphysema, Pneumothorax, Pneumomediastinum, and Pneumopericardium.

Spontaneous lung herniation is a rare phenomenon in which the lung parenchyma along with the pleural membranes protrudes outside their usual boundaries and can lead to a wide variety of complications. We are reporting a case of a middle-aged male who presented with chronic obstructive pulmonary disease (COPD) exacerbation with severe bouts of cough. Initial computed tomography (CT) chest was unrevealing, but two days later, he developed spontaneous lung herniation, which was initially managed conservatively, but later it progressed to pneumothorax, pneumomediastinum, with striking CT scan images showing extensive subcutaneous emphysema. Blowhole incisions were done on the anterior chest wall which led to ultimate recovery.

Lafora Disease Masquerading as Hepatic Dysfunction

Lafora disease is fatal intractable progressive myoclonic epilepsy. It is frequently characterized by epileptic seizures, difficulty walking, muscle spasms, and dementia in late childhood or adolescence. We chronicle here an unusual case of an asymptomatic young male soccer player who presented with elevated liver enzymes. Neurological examination was unremarkable. The diagnostic workup for hepatitis, infectious etiologies, autoimmune disorders, hemochromatosis, Wilsons disease, alpha-1 antitrypsin deficiency, and other related diseases was inconclusive. He subsequently underwent an uneventful percutaneous liver biopsy. Based on the pathognomonic histopathological findings, Lafora disease was considered the likely etiology. The present study is a unique illustration of this rare disorder initially manifesting with abnormal liver enzymes. It underscores the importance of clinical suspicion of Lafora disease in cases with unexplained hepatic dysfunction. Prompt liver biopsy and genetic testing should be performed to antedate the onset of symptoms in these patients.

Acute oesophageal necrosis: a rare but potentially fatal association of cocaine use

Acute oesophageal necrosis (AON), also known as ‘black oesophagus’, is a rare condition characterised by the necrosis of the oesophagus usually involving the distal part. It has been associated with various conditions, and the pathogenesis is thought to involve hypovolaemia combined with decreased function of oesophageal protective mucosal barriers and may be compounded by the effect of gastric secretions on oesophageal mucosa. The hallmark of this condition is characteristic circumferential black discolouration of the distal oesophagus that may extend proximally. We present a case of a man who presented with haematemesis associated with cocaine abuse. Oesophagogastroduodenoscopy confirmed black oesophagus. The patient was managed with intravenous fluids, packed red blood cell transfusions, proton pump inhibitors and sucralfate suspension; however, he failed to recover. We have also reviewed the previous reported cases of AON in association with cocaine use.

Primary peritoneal hepatoid adenocarcinoma: a diagnostic and therapeutic conundrum in patients with gastrointestinal bleeding

A 50-year-old man with a history of iron-deficiency anaemia and fatty liver disease presented to the emergency department complaining of black tarry stools with associated weakness and shortness of breath for 1 week. At presentation, contrast-enhanced CT revealed multiple hypervascular masses in the abdomen and pelvis with the largest lesion located in the right lower quadrant, abutting the right psoas muscle (figure 1). Laboratory evaluation demonstrated a haemoglobin level of 5.5 g/dL (normal, 13.5–17.5 g/dL). Upper endoscopy showed a mass, which was making an extrinsic impression into the stomach (figure 2). Colonoscopy was unremarkable for abnormalities. Endoscopic ultrasound-guided fine-needle aspiration (FNA) of the lesion adjacent to the stomach was performed using a 22-gauge needle (Expect Slimline; Boston Scientific, Natick, Massachusetts, USA). The FNA was positive for metastatic carcinoma with hepatic features. Furthermore, capsule endoscopy identified blood clots surrounding the multiple, small intestinal masses. These lesions were subsequently identified as the metastatic hepatoid adenocarcinoma (HAC) …

Invasive Mucormycosis Induced Pneumopericardium: A Rare Cause of Pneumopericardium in an Immunocompromised Patient

Mucor and Rhizopus cause life-threatening infections primarily involving the lungs and sinuses, which disseminate very rapidly by necrosis and infarction of the contiguous tissues. We present a case of a 64-year-old African American posttransplant patient who presented with a productive cough and weight loss. He had a past surgical history of renal transplant for renal cell carcinoma and was on dual immunosuppressive therapy, that is, mycophenolate and tacrolimus. During his hospital stay, he developed a pneumopericardium due to the direct extension of a lung lesion. The diagnosis was made by radiological imaging and PCR result which was consistent with Mucor species. He was treated with antifungal therapy. The purpose of this report is to highlight the unusual association of mucormycosis with pneumopericardium.

Dieulafoy’s lesion of the colon and rectum: a case series and literature review

Dieulafoy’s lesion is a dilated, aberrant, submucosal vessel that erodes the overlying epithelium without obvious ulceration. It is most commonly located in the lesser curvature of the stomach but rare occurrences in extragastric sites have also been reported. Herein, we describe a case series of three patients who presented with lower gastrointestinal bleeding. Colonoscopy revealed a caliber-persistent tortuous submucosal artery protruding into the lumen of the colon or rectum. The patients were diagnosed with Dieulafoy’s lesion and primary haemostasis was achieved with the endoscopic haemoclip application. The purpose of this review is to summarise the available data on the pathophysiology, epidemiology, clinical presentation, diagnosis and management of patients with Dieulafoy’s lesion of the colon and rectum.

Serum Apo A-1 and Its Role as a Biomarker of Coronary Artery Disease

Objectives To evaluate the role of apolipoprotein(Apo A-1) as a biomarker of coronary artery disease (CAD) and its comparison with the traditional marker high-density lipoprotein (HDL). Methodology One hundred patients proven to have coronary artery disease by angiography were recruited and their serum biomarkers were compared with 100 normal individuals adjusted for age and sex. Result The mean +/-standard deviation (SD) value of plasma Apo A-1 levels in the normal individuals were observed to be 207.42 +/- 41.35 (mg/dL) against 90.69 +/- 20.77 (mg/dL) in the cardiac patients. On the other hand the serum HDL levels were 52.93 +/-33.58 (mg/dL) in the normal individuals and 37.86 +/- 23.19 (mg/dL) in the cardiac patients. Both of these differences were statistically significant (p < 0.001). For Apo A-1, a large proportion of patients (85%) were found to be in the abnormal range when compared to the control group in which only 7% had an abnormal value. For HDL, a majority (70%) of the cardiac patients had abnormal values while 40% of the normal individuals also had abnormal values. The sensitivity of Apo A-1 for detecting CAD was 85%, while for HDL, it was only 69%. Similarly, the specificity of Apo A-1 for detecting CAD was 93%, while for HDL, it was 60%. When plotted on a receiver operating characteristic (ROC) curve, Apo A-1 had a much larger area under the curve when compared to HDL. Conclusion This study suggests that Apo A-1 may, in fact, be more sensitive than HDL as a predictor of CAD. However, to completely elucidate its role as a biomarker, to set target serum levels and to increase its clinical use, further studies are required.