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Femia G, Pender P, Tang S, Koh E, Delaney G, Thomas L, Holloway L, Rai R, Liney G, Otton J. Effects of Breast Radiotherapy on Right Ventricular Systolic Function. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Tang S, Otton J, Koh E, Rai R, Delaney G, Tran D, Thomas L, Holloway L, Liney G. Longitudinal Results of Cardiac MRI Left Ventricular Mapping Following Tangential Left Breast Radiotherapy. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.288] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Thapa BD, Regmi MC, Rai R. Risk Factors for Adverse Outcome in Pregnant Women with Obstructed Labor. NEPAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 2018. [DOI: 10.3126/njog.v13i1.21614] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: The aim of the study was to assess the risk factors for adverse outcomes in pregnancy with obstructed labor.Methods: It was a prospective descriptive study conducted at BP Koirala Institute of Health sciences (BPKIHS).The patients with obstructed labour were managed and followed up until delivery and six weeks postpartum from Jan to Dec 2012.Results: There were 57 (0.6%) cases of obstructed labour out of 9500 deliveries. The main cause was cephalopelvic disproportion in 36 (63.2%). The majority of the cases were from rural areas, low socioeconomic status, non salaried and illiterate. Risk for maternal mortality, peripartum hysterectomy and perinatal mortality as adverse outcomes was significantly associated with low socioeconomic status (AOR 12.5, P=0.02) and literacy status (AOR 21.9, P=0.001). If only the risk of perinatal mortality is taken as an adverse outcome, it is significantly associated with booking status (AOR 7, P=0.001), low socioeconomic status (AOR 9.62, P=0.037) and literacy of the patient (AOR 15, P=0.001). Perinatal mortality rate was 100 per 1000 live births in women with obstructed labour. The case fatality rate was 1.2%.
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Tang S, Koh E, Rai R, Otton J, Herschtal A, Tran D, Delaney G, Holloway L, Thomas L, Schmitt B, Liney G, Ananthapadmanachan S. Changes in Cardiac MRI Derived Left Ventricular Segmental Strain in Left Sided Breast Cancer Patients Treated with Tangential Radioation Therapy Alone Correlated with Dose. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1682] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Pant A, Kumar R, Wani NA, Verma S, Sharma R, Pande V, Saxena AK, Dixit R, Rai R, Pandey KC. Allosteric Site Inhibitor Disrupting Auto-Processing of Malarial Cysteine Proteases. Sci Rep 2018; 8:16193. [PMID: 30385827 PMCID: PMC6212536 DOI: 10.1038/s41598-018-34564-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2017] [Accepted: 10/16/2018] [Indexed: 02/08/2023] Open
Abstract
Falcipains are major haemoglobinases of Plasmodium falciparum required for parasite growth and development. They consist of pro- and mature domains that interact via 'hot-spot' interactions and maintain the structural integrity of enzyme in zymogen state. Upon sensing the acidic environment, these interactions dissociate and active enzyme is released. For inhibiting falcipains, several active site inhibitors exist, however, compounds that target via allosteric mechanism remains uncharacterized. Therefore, we designed and synthesized six azapeptide compounds, among which, NA-01 & NA-03 arrested parasite growth by specifically blocking the auto-processing of falcipains. Inhibitors showed high affinity for enzymes in presence of the prodomain without affecting the secondary structure. Binding of NA-03 at the interface induced rigidity in the prodomain preventing structural reorganization. We further reported a histidine-dependent activation of falcipain. Collectively, for the first time we provide a framework for blocking the allosteric site of crucial haemoglobinases of the human malaria parasite. Targeting the allosteric site could provide high selectivity and less vulnerable to drug resistance.
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Liney GP, Dong B, Weber E, Rai R, Destruel A, Garcia-Alvarez R, Manton DJ, Jelen U, Zhang K, Barton M, Keall P, Crozier S. Imaging performance of a dedicated radiation transparent RF coil on a 1.0 Tesla inline MRI-linac. ACTA ACUST UNITED AC 2018; 63:135005. [DOI: 10.1088/1361-6560/aac813] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
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Oar A, Rai R, Jameson M, Deshpande S, Liney G, Juresic E, Veneran J, Dinsdale G, Elwadia D, Kumar S, Lee M. OC-0295: The feasibility of volumetric 4DMRI in upper abdominal radiation therapy treatment planning. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30605-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bhatta RD, Rijal P, Pradhan T, Chhetri S, Rai R, Uprety DK. A Profile of Patients with Molar Pregnancy. NEPAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 2017. [DOI: 10.3126/njog.v11i2.17461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims: This study was done to determine the incidence, modes of presentation and prognosis of molar pregnancy at B. P. Koirala Institute of Health Sciences.Methods: This was a prospective study done among patients with molar pregnancy admitted at BPKIHS from January 2010 to January 2011. The study was conducted after ethical clearance from Institutional Ethical Review Board of BPKIHS. Written informed consent was taken for enrollment in the study. Baseline information like age, address, race and patient’s presenting complaints, period of gestation and serial serum beta human chorionic gonadotropin (βhCG) were collected and analyzed after entering in excel sheet.Results: Total 48 cases of molar pregnancy were diagnosed during the study period. The incidence of molar pregnancy was found to be 5.58 per 1000 deliveries. The most common mode of presentation was per vaginal bleeding i.e. in 64.58% of cases. Majority of the patients were in the age group of 20-34 years (62.5%). Mean time for normalization of βhCG after suction evacuation was 10.19 weeks.Conclusions: Molar pregnancy is a pregnancy related problem which most commonly presents with per vaginal bleeding during first and second trimester. Most of the patients are treated with suction and evacuation but some develop persistent gestational trophoblastic disease.
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Nguyen K, Min M, Holloway L, Jameson M, Rumley C, Fowler A, Lee M, Forstner D, Rai R, Liney G. PO-0615: Can diffusion-weighted MRI predict for xerostomia and QoL in head and neck patients receiving RT? Radiother Oncol 2017. [DOI: 10.1016/s0167-8140(17)31052-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Liney GP, Dong B, Begg J, Vial P, Zhang K, Lee F, Walker A, Rai R, Causer T, Alnaghy SJ, Oborn BM, Holloway L, Metcalfe P, Barton M, Crozier S, Keall P. Technical Note: Experimental results from a prototype high-field inline MRI-linac. Med Phys 2017; 43:5188. [PMID: 27587049 DOI: 10.1118/1.4961395] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE The pursuit of real-time image guided radiotherapy using optimal tissue contrast has seen the development of several hybrid magnetic resonance imaging (MRI)-treatment systems, high field and low field, and inline and perpendicular configurations. As part of a new MRI-linac program, an MRI scanner was integrated with a linear accelerator to enable investigations of a coupled inline MRI-linac system. This work describes results from a prototype experimental system to demonstrate the feasibility of a high field inline MR-linac. METHODS The magnet is a 1.5 T MRI system (Sonata, Siemens Healthcare) was located in a purpose built radiofrequency (RF) cage enabling shielding from and close proximity to a linear accelerator with inline (and future perpendicular) orientation. A portable linear accelerator (Linatron, Varian) was installed together with a multileaf collimator (Millennium, Varian) to provide dynamic field collimation and the whole assembly built onto a stainless-steel rail system. A series of MRI-linac experiments was performed to investigate (1) image quality with beam on measured using a macropodine (kangaroo) ex vivo phantom; (2) the noise as a function of beam state measured using a 6-channel surface coil array; and (3) electron contamination effects measured using Gafchromic film and an electronic portal imaging device (EPID). RESULTS (1) Image quality was unaffected by the radiation beam with the macropodine phantom image with the beam on being almost identical to the image with the beam off. (2) Noise measured with a surface RF coil produced a 25% elevation of background intensity when the radiation beam was on. (3) Film and EPID measurements demonstrated electron focusing occurring along the centerline of the magnet axis. CONCLUSIONS A proof-of-concept high-field MRI-linac has been built and experimentally characterized. This system has allowed us to establish the efficacy of a high field inline MRI-linac and study a number of the technical challenges and solutions.
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Bagga R, Rai R, Kalra J, Saha PK, Singh T. An Unusual Cause of Postabortal Fever Requiring Prompt Surgical Intervention: A Pyomyoma and its Imaging Features. Oman Med J 2017; 32:73-76. [PMID: 28042408 PMCID: PMC5187398 DOI: 10.5001/omj.2017.14] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2015] [Accepted: 03/02/2016] [Indexed: 11/03/2022] Open
Abstract
Pyomyoma is an unusual complication of leiomyoma, occurring most commonly in the postpartum, postabortal, and post-menopausal periods. It develops due to infection in necrotic foci within leiomyoma, which is more common during pregnancy due to rapid growth, and in postmenopausal women due to vascular insufficiency. Other contributing factors are curettage, gynecological surgery, cervical stenosis, immunodeficiency, and recently, uterine artery embolization. It presents with a typical triad of sepsis, leiomyoma, and absence of any apparent source of infection. We report a case of persistent postabortal fever in a 26-year-old female due to a pyomyoma, which resolved after a myomectomy. Pyomyoma may become life threatening in the event of intraperitoneal rupture resulting in pyoperitoneum and septic shock. Hence, gynecologists should consider this diagnosis in women with a leiomyoma and sepsis in the absence of any apparent source of infection.
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Rijal P, Pradhan T, Agrawal A, Rai R, Bhatta R, Chhetri S. Assessment of Risk Factors, Feasibility and Acceptability of VIA for Cervical Cancer Screening and Prevention. NEPAL JOURNAL OF OBSTETRICS AND GYNAECOLOGY 2016. [DOI: 10.3126/njog.v11i1.16289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Aims – To assess feasibility of visual inspection with acetic acid and treatment with cryotherapy for cervical cancer screening and prevention and assess risk factors for cervical cancer in the screened population.Methods – A prospective analysis of all patients enrolled for cervical cancer screening by visual inspection, meeting the eligibility criteria for screening and treatment as per national guidelines 2011 was analyzed form March 2012 to April 2013.Results – A total of 4138 met the eligibility criteria and were counseled for screening, 33 rejected for screening. Out of 4105 screened 241 were visual inspection with acetic acid positive, 211 were treated with cryotherapy, 25 treated with LEEP, 5 rejected to treatment. Mean age of patient in year’s ± SD 41.48 ± 9.72. The visual inspection with acetic acidpositivity rate was 5.9 %Conclusion – Single visit approach is a feasible and acceptable form of cervical cancer screening strategy in our population.
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Guest J, Rai R, Cartwright E. Do coinfection patients with HIV/HCV respond differently to new hepatitis C treatments than HCV monoinfected patients? Data from HAVACS and the Atlanta Veterans Affairs Medical Center. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.11.198] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Tallawi M, Dippold D, Rai R, D'Atri D, Roether J, Schubert D, Rosellini E, Engel F, Boccaccini A. Novel PGS/PCL electrospun fiber mats with patterned topographical features for cardiac patch applications. MATERIALS SCIENCE & ENGINEERING. C, MATERIALS FOR BIOLOGICAL APPLICATIONS 2016; 69:569-76. [DOI: 10.1016/j.msec.2016.06.083] [Citation(s) in RCA: 42] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/21/2016] [Revised: 05/24/2016] [Accepted: 06/25/2016] [Indexed: 10/21/2022]
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Ipsen S, Blanck O, Lowther NJ, Liney GP, Rai R, Bode F, Dunst J, Schweikard A, Keall PJ. Towards real-time MRI-guided 3D localization of deforming targets for non-invasive cardiac radiosurgery. Phys Med Biol 2016; 61:7848-7863. [DOI: 10.1088/0031-9155/61/22/7848] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
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Park J, Parakh S, Mendis S, Rai R, Lo S, Haydon A, Andrews M, Cebon J, Guminski A, Kefford R, Long G, Menzies A, Klein O, Carlino M. Efficacy of anti-PD-1 therapy in patients with melanoma brain metastases. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw379.09] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Keall P, Dong B, Vial P, Walker A, Zhang K, Begg J, Rai R, Holloway L, Barton M, Crozier S, Liney G. TH-AB-BRA-12: Experimental Results From the First High-Field Inline MRI-Linac. Med Phys 2016. [DOI: 10.1118/1.4958064] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ganesan B, Prakasarao A, Palraj T, Rai R, Singaravelu G. SU-F-T-473: Evaluation of Off-Axis And Peripheral Dose Using Different Detectors. Med Phys 2016. [DOI: 10.1118/1.4956658] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ganesan B, Prakasarao A, Palraj T, Rai R, Singaravelu G. SU-F-T-474: Evaluation of Dose Perturbation, Temperature and Sensitivity Variation With Accumulated Dose of MOSFET Detector. Med Phys 2016. [DOI: 10.1118/1.4956659] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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De Leon J, Rivest-Henault D, Keats S, Jameson M, Rai R, Arumugam S, Wilton L, Ngo D, Martin J, Sidhom M, Holloway L. PV-0328: Rectal immobilisation device in stereotactic prostate treatment: intrafraction motion and dosimetry. Radiother Oncol 2016. [DOI: 10.1016/s0167-8140(16)31577-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Rai R, Saha SC, Jain A, Bagga R, Kumar P, Marwaha N. Anti-M Alloimmunization in Pregnancy: An Unusual Cause of Bad Obstetric History. J Obstet Gynaecol India 2016; 66:607-609. [PMID: 27803521 DOI: 10.1007/s13224-015-0822-6] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Accepted: 11/23/2015] [Indexed: 11/29/2022] Open
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Rohilla M, Rai R, Yanamandra U, Chaudhary N, Malhotra P, Varma N, Jain V, Prasad GRV, Kalra J, Varma SC. Obstetric Complications and Management in Chronic Myeloid Leukemia. Indian J Hematol Blood Transfus 2016; 32:62-6. [PMID: 26855508 PMCID: PMC4733674 DOI: 10.1007/s12288-015-0519-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2015] [Accepted: 02/18/2015] [Indexed: 10/23/2022] Open
Abstract
Chronic myeloid leukaemia (CML) is amongst the most common haematological malignancies encountered in adults. The younger age of onset and increased incidence of CML in Indians leads to higher chances of encountering it in pregnancy. Pregnancy in CML is a complex situation as first line therapy with tyrosine kinase inhibitors (TKI), is fraught with multiple fetal safety issues. The fetal aspects have been elucidated in literature, but there is scarcity of information on the obstetric outcome per se in presence of CML, excluding the influence of TKI. Obstetric outcomes of 5 pregnancies in four patients with CML are being reported. Literature on interplay of CML and bleeding or thrombotic manifestations is reviewed. The major complications encountered were antepartum (APH) and postpartum haemorrhage (PPH), preterm labour, intrauterine growth retardation and intrauterine fetal death. Patients in the reproductive age group with diagnosis of CML should be carefully counseled regarding the effect of disease and TKI on the maternal-fetal health. Bleeding complications, particularly APH and PPH may be encountered in CML patients. Close coordination of the obstetrician, haematologist, and neonatologist is required in managing these cases successfully. The need for absolute contraception till the remission of disease needs to be emphasized for further pregnancies.
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Rai R, Zhang F, Colavita K, Leu NA, Kurosaka S, Kumar A, Birnbaum MD, Győrffy B, Dong DW, Shtutman M, Kashina A. Arginyltransferase suppresses cell tumorigenic potential and inversely correlates with metastases in human cancers. Oncogene 2015; 35:4058-68. [PMID: 26686093 PMCID: PMC4916053 DOI: 10.1038/onc.2015.473] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 11/09/2015] [Accepted: 11/14/2015] [Indexed: 02/07/2023]
Abstract
Arginylation is an emerging post-translational modification mediated by arginyltransferase (ATE1) that is essential for mammalian embryogenesis and regulation of the cytoskeleton. Here, we discovered that Ate1-knockout (KO) embryonic fibroblasts exhibit tumorigenic properties, including abnormally rapid contact-independent growth, reduced ability to form cell-cell contacts and chromosomal aberrations. Ate1-KO fibroblasts can form large colonies in Matrigel and exhibit invasive behavior, unlike wild-type fibroblasts. Furthermore, Ate1-KO cells form tumors in subcutaneous xenograft assays in immunocompromised mice. Abnormal growth in these cells can be partially rescued by reintroduction of stably expressed specific Ate1 isoforms, which also reduce the ability of these cells to form tumors. Tumor array studies and bioinformatics analysis show that Ate1 is downregulated in several types of human cancer samples at the protein level, and that its transcription level inversely correlates with metastatic progression and patient survival. We conclude that Ate1-KO results in carcinogenic transformation of cultured fibroblasts, suggesting that in addition to its previously known activities Ate1 gene is essential for tumor suppression and also likely participates in suppression of metastatic growth.
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Rai R, Sikka P, Aggarwal N, Shankaregowda SA. Gangrenous Cystitis in A Woman Following Vaginal Delivery: An Uncommon Occurrence - A Case Report. J Clin Diagn Res 2015; 9:QD13-4. [PMID: 26676158 DOI: 10.7860/jcdr/2015/12676.6822] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/24/2014] [Accepted: 08/07/2015] [Indexed: 11/24/2022]
Abstract
Gangrenous cystitis is now a rare condition with the advent of antibiotics and better obstetric services. It has a multifactorial causation manifesting as urosepsis or peritonitis. We report a case of 24-year-old lady who presented at day 12 postpartum with abdominal distension and vomitings. History of prolonged labour was present. Peritoneal tap was suggestive of pyoperitoneum. Hence she was taken up for emergency laparotomy and incidentally found to have bladder necrosis. Partial cystectomy was done and patient was discharged in a satisfactory condition after 2 weeks.
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