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Tyagi A, Nigam C, Malhotra RK, Bodh P, Deep S, Singla A. The minimum effective dose (ED 90) of prophylactic oxytocin infusion during cesarean delivery in patients with and without obesity: an up-down sequential allocation dose-response study. Int J Obstet Anesth 2024; 57:103962. [PMID: 38103940 DOI: 10.1016/j.ijoa.2023.103962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 11/14/2023] [Accepted: 11/27/2023] [Indexed: 12/19/2023]
Abstract
BACKGROUND Obesity is associated with greater oxytocin requirement during labor induction or augmentation. There are scant data exploring the intra-operative requirement during cesarean delivery in patients with obesity, and none comparing it with those without obesity. We evaluated the minimum effective dose (ED90) of an oxytocin infusion to achieve adequate uterine tone during cesarean delivery in patients with and without obesity. METHODS Patients (body mass index ≥30 kg/m2 represented patients with obesity) undergoing cesarean delivery using subarachnoid block were included. This prospective dual-arm dose-finding study used a 9:1 biased sequential allocation design. Oxytocin infusion was initiated at 13 IU/h at cord clamping in the first patient of each group. Uterine tone was graded as satisfactory or unsatisfactory by the obstetrician four minutes after initiation of the infusion. The dose of oxytocin infusion for subsequent patients was determined according to the response of the previous patient in the group. Oxytocin-associated side effects were evaluated. Dose-response data for the groups was evaluated using log-logistic function and ED90 estimates derived from fitted equations using the delta method. RESULTS The ED90 of oxytocin was significantly higher for patients with obesity (n = 40) compared with those without obesity (n = 40) [25.7 IU/h, 95% CI 18.6 to 32.9) vs. 16.6 IU/h, 95% CI 14.9 to 18.3)]; relative ratio 1.55 [95% CI 1.09 to 2.01] (P = 0.019). CONCLUSIONS Patients with obesity require a higher intra-operative oxytocin infusion dose rate to achieve a satisfactorily contracted uterus after fetal delivery when compared with patients without obesity.
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Affiliation(s)
- A Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India.
| | - C Nigam
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - R K Malhotra
- Delhi Cancer Registry, Dr BR Ambedkar Institute-Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - P Bodh
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - S Deep
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Delhi, India
| | - A Singla
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and GTB Hospital, Delhi, India
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Javed A, Qadir MO, Lee S, Mitra A, Tyagi A, Sharma A, Lett K, Ch'ng S. Rethinking the urgency priority system in round hole detachments, which should be done first? Macula on or macula off. Eye (Lond) 2024:10.1038/s41433-024-02930-8. [PMID: 38279039 DOI: 10.1038/s41433-024-02930-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2023] [Revised: 12/18/2023] [Accepted: 01/09/2024] [Indexed: 01/28/2024] Open
Affiliation(s)
- A Javed
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK.
| | - M O Qadir
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - S Lee
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Mitra
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Tyagi
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - A Sharma
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - K Lett
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
| | - S Ch'ng
- Vitreo-Retinal Department, Birmingham Midlands Eye Unit, Birmingham City Hospital, Birmingham, UK
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Mohta M, Kumari S, Malhotra RK, Tyagi A, Agarwal R. Calculation of effective dose of phenylephrine bolus for treatment of post-spinal hypotension in pre-eclamptic patients undergoing caesarean section - a non-randomised controlled trial. Int J Obstet Anesth 2023; 56:103929. [PMID: 37826881 DOI: 10.1016/j.ijoa.2023.103929] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Revised: 08/10/2023] [Accepted: 09/03/2023] [Indexed: 10/14/2023]
Abstract
BACKGROUND Patients with pre-eclampsia require smaller vasopressor doses compared with those with normotension for management of post-spinal hypotension during caesarean section. However, the literature has little evidence as to the phenylephrine dose required for patients with pre-eclampsia. METHODS Fifty patients, with either pre-eclampsia or normotension, and developing post-spinal hypotension during caesarean section under spinal anaesthesia, were studied. Women in both groups did not receive prophylactic vasopressors. The first patient in each group received phenylephrine 50 µg to treat the first episode of hypotension, defined as fall of systolic blood pressure ≥20% from baseline or an absolute value <100 mmHg. If hypotension was corrected within one minute it was considered a 'success'. The doses for the subsequent patients were determined by responses to all previous patients, according to a variation of Narayana's rule for the up-down sequential allocation method. RESULTS The 95% effective dose (ED95) and 50% effective dose (ED50) of phenylephrine was 41.7 µg (95% CI 33.8 to 49.6 µg) and 29.1 µg (95% CI 26.0 to 32.2 µg) respectively in the pre-eclampsia group, and 64.9 µg (95% CI 54.1 to 75.7 µg) and 47.3 µg (95% CI 39.7 to 54.9 µg) respectively in the normotensive group. The proportionate reduction in phenylephrine dose ranged from 33% (95% CI 18 to 44%) to 40% (95% CI 19 to 52%). CONCLUSION Patients with pre-eclampsia may need a 33% to 40% reduction in the first phenylephrine bolus dose, compared with patients with normotension, for the treatment of the first episode of post-spinal hypotension.
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Affiliation(s)
- M Mohta
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
| | - S Kumari
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R K Malhotra
- Cancer Registry, Dr. BRAIRCH, All India Institute of Medical Sciences, Delhi, India
| | - A Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - R Agarwal
- Department of Obstetrics and Gynaecology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Tyagi A, Sharma S, Ali S, Gaikwad K. Crosstalk between H 2 S and NO: an emerging signalling pathway during waterlogging stress in legume crops. Plant Biol (Stuttg) 2022; 24:576-586. [PMID: 34693601 DOI: 10.1111/plb.13319] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/16/2021] [Accepted: 07/04/2021] [Indexed: 06/13/2023]
Abstract
In legumes, waterlogging is a major detrimental factor leading to huge yield losses. Generally, legumes lack tolerance to submergence, and conventional breeding to develop tolerant varieties are limited due to the lack of tolerant germplasm and potential target genes. Moreover, our understanding of the various signalling cascades, their interactions and key pathways induced during waterlogging is limited. Here, we focus on the role of two important plant signalling molecules, viz. hydrogen sulphide (H2 S) and nitric oxide (NO), during waterlogging stress in legumes. Plants and soil microbes produce these signalling molecules both endogenously and exogenously under various stresses, including waterlogging. NO and H2 S are known to regulate key physiological pathways, such as stomatal closure, leaf senescence and regulation of numerous stress signalling pathways, while NO plays a pivotal role in adventitious root formation during waterlogging. The crosstalk between H2 S and NO is synergistic because of the resemblance of their physiological effects and proteomic functions, which mainly operate through cysteine-dependent post-translational modifications via S-nitrosation and persulfidation. Such knowledge has provided novel platforms for researchers to unravel the complexity associated with H2 S-NO signalling and interactions with plant stress hormones. This review provides an overall summary on H2 S and NO, including biosynthesis, biological importance, crosstalk, transporter regulation as well as understanding their role during waterlogging using 'multi-omics' approach. Understanding H2 S and NO signalling will help in deciphering the metabolic interactions and identifying key regulatory genes that could be used for developing waterlogging tolerance in legumes.
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Affiliation(s)
- A Tyagi
- ICAR - National Institute for Plant Biotechnology, New Delhi, India
| | - S Sharma
- ICAR - National Institute for Plant Biotechnology, New Delhi, India
| | - S Ali
- Department of Biotechnology, Yeungnam University, Gyeongsan Gyeongbuk, Republic of Korea
| | - K Gaikwad
- ICAR - National Institute for Plant Biotechnology, New Delhi, India
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Sharma R, Rana A, Sharma V, Mehrotra A, Babu H, Gupta S, Singh R, Tyagi A, Sethi N, Bhatt P, Yadav V, Chopra P, Upadhyay D. Clinical correlation and assessment of olfactory dysfunction with n-butanol in COVID-19 patients: our experience. RHINOL 2022. [DOI: 10.4193/rhinol/21.055] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Background: Studies showed olfactory disturbances in COVID patients. This has attracted focus of clinicians as an easy clinical screening tool in suspected population. Material and methods: 70 mild and moderate category COVID-19 RT-PCR positive patients, more than 10 years of age were tested on day of admission for olfaction with serial dilution of n-butanol and asked to grade severity of their olfactory dysfunction according to visual analogue score from 1-10. Results: Fatigue 42 (93.33%), sore throat 37 (82.22%), fever 36 (80%) and dyspnea 23 (51.11%) were the most common symptoms in moderate patients. Diabetes, hypertension and allergy were the three prominent risk factors. At time of admission, n-butanol diagnosed 20 patients having olfactory dysfunction compared to 11 by VAS. Patients tend to grade their dysfunction higher on VAS whereas the n-butanol test classified their olfactory dysfunction lower. Viral load and high CRP were not found to be significantly related with olfactory dysfunction. d-Dimer and LDH levels were found statistically associated with higher grading of olfactory dysfunction detected by n-butanol. Conclusion: The majority of cases developed hyposmia before they were admitted to hospital even before they realized that they were having hyposmia as revealed by n-butanol testing. We should go for objective tests of olfaction.
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Tyagi A, Khan A, Thatte P, Ramakrishnan U. Genome‐wide
SNP
markers from fecal samples reveal anthropogenic impacts on connectivity: case of a small carnivore in the central Indian landscape. Anim Conserv 2022. [DOI: 10.1111/acv.12770] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- A. Tyagi
- National Centre for Biological Sciences Tata Institute of Fundamental Research Bangalore India
- SASTRA Deemed to be University Thanjavur India
| | - A. Khan
- National Centre for Biological Sciences Tata Institute of Fundamental Research Bangalore India
| | - P. Thatte
- National Centre for Biological Sciences Tata Institute of Fundamental Research Bangalore India
- World Wide Fund for Nature‐India New Delhi India
| | - U. Ramakrishnan
- National Centre for Biological Sciences Tata Institute of Fundamental Research Bangalore India
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Das S, Gupta C, Jain C, Rai G, Alqumber MAA, Singh PK, Sharma R, Tyagi A, Salhotra R, Narang S, Singh NP, Dar SA. Utility of serum Galactomannan in diagnosing COVID-19 patients with suspected IPA: an observational study in resource limited settings. Eur Rev Med Pharmacol Sci 2022; 26:710-714. [PMID: 35113446 DOI: 10.26355/eurrev_202201_27897] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
OBJECTIVE To study the utility of Galactomannan (GM) antigen as a screening marker for diagnosing invasive pulmonary aspergillosis (IPA) in coronavirus disease 2019 (COVID-19) patients. PATIENTS AND METHODS The serum samples from patients with severe COVID-19 diseases admitted to the Critical Care Unit were collected on the 5th day of admission for GM screening. The samples were analysed by enzyme linked immune sorbent assay (ELISA) and GM index of more than 1 was considered as positive. All GM positive patients were serially followed until discharge or death. RESULTS The GM was raised in serum of 12 out of 38 patients, indicating an incidence of possible COVID-19 associated IPA (CAPA) in 31.57% of patients. The median age of these CAPA patients was 56.5 years, males were significantly more affected than females. The inflammatory marker serum ferritin was raised in all 12 patients (median value of 713.74 ng/ml), while IL-6 was raised in 9 patients (median value of 54.13 ng/ml). None of these patients received antifungals. Their median length of hospital stay was 20 days (IQR: 12, 34 days). All these patients succumbed to the illness. CONCLUSIONS The serum GM appears to be sensitive diagnostic tool to identify early IPA in COVID-19 patients and pre-emptive antifungal therapy could play a role in salvaging these patients.
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Affiliation(s)
- S Das
- Department of Microbiology, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
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Castro M, Ganti A, Grover H, Kumar A, Mohapatra S, Basu K, Sahu D, Tyagi A, Nair P, Prasad S, Kumari P, Mundkur N, Patel S, Sauban M, Behura L, Kulkarni S, Patil M, Narvekar Y, Ghosh A, Ullal Y, Amara A, Kapoor S, Velcheti V. P12.06 Computational Omics Biology Model (CBM) Identifies PD-L1 Immunotherapy Response Criteria Based on Genomic Signature of NSCLC. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.328] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Fathy RA, McMahon DE, Lee C, Chamberlin GC, Rosenbach M, Lipoff JB, Tyagi A, Desai SR, French LE, Lim HW, Thiers BH, Hruza GJ, Fassett M, Fox LP, Greenberg HL, Blumenthal K, Freeman EE. Varicella-zoster and herpes simplex virus reactivation post-COVID-19 vaccination: a review of 40 cases in an International Dermatology Registry. J Eur Acad Dermatol Venereol 2021; 36:e6-e9. [PMID: 34487581 PMCID: PMC8656951 DOI: 10.1111/jdv.17646] [Citation(s) in RCA: 44] [Impact Index Per Article: 14.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2021] [Accepted: 09/02/2021] [Indexed: 01/23/2023]
Affiliation(s)
- R A Fathy
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - D E McMahon
- Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - C Lee
- Department of Dermatology, Las Vegas School of Medicine, University of Nevada, Las Vegas, NV, USA
| | - G C Chamberlin
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - M Rosenbach
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - J B Lipoff
- Department of Dermatology, University of Pennsylvania, Philadelphia, PA, USA
| | - A Tyagi
- Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
| | - S R Desai
- The University of Texas Southwestern Medical Center, Dallas, TX, USA.,Innovative Dermatology, Plano, TX, USA
| | - L E French
- Department of Dermatology, University Hospital, Munich University of Ludwig Maximilian, Munich, Germany.,Dr. Philip Frost, Department of Dermatology and Cutaneous Surgery, University of Miami Miller School of Medicine, Miami, FL, USA
| | - H W Lim
- Department of Dermatology, Henry Ford Health System, Detroit, MI, USA
| | - B H Thiers
- Department of Dermatology and Dermatologic Surgery, Medical University of SC, Charleston, SC, USA
| | - G J Hruza
- Department of Dermatology, St. Louis University, St. Louis, MO, USA
| | - M Fassett
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | - L P Fox
- Department of Dermatology, University of California San Francisco, San Francisco, CA, USA
| | | | - K Blumenthal
- Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA
| | - E E Freeman
- Harvard Medical School, Massachusetts General Hospital, Boston, MA, USA.,Medical Practice Evaluation Center, Mongan Institute, Massachusetts General Hospital, Boston, MA, USA
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Seejore K, Alavi SA, Pearson SM, Robins JMW, Alromhain B, Sheikh A, Nix P, Wilson T, Orme SM, Tyagi A, Phillips N, Murray RD. Post-operative volumes following endoscopic surgery for non-functioning pituitary macroadenomas are predictive of further intervention, but not endocrine outcomes. BMC Endocr Disord 2021; 21:116. [PMID: 34112169 PMCID: PMC8194144 DOI: 10.1186/s12902-021-00777-8] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2021] [Accepted: 05/04/2021] [Indexed: 02/03/2023] Open
Abstract
BACKGROUND Transsphenoidal surgery (TSS) remains the treatment of choice for non-functioning pituitary macroadenomas (NFPMA). The value of measuring tumour volumes before and after surgery, and its influence on endocrine outcomes and further treatment of the residual or recurrent tumour are unknown. METHODS Data from patients who underwent endoscopic TSS for a NFPMA (2009-2018) in a UK tertiary centre were analysed for pre- and post-operative endocrine and surgical outcomes. RESULTS Of 173 patients with NFPMA, 159 (61% male) were treatment naïve. At presentation, 76.2% (77/101) had ≥1 pituitary axis deficit. Older age (p = 0.002) was an independent predictor for multiple hormonal deficiencies. Preoperative tumour volume did not correlate with degree of hypopituitarism. Postoperative tumour volume and extent of tumour resection were not predictive of new onset hypopituitarism. Hormonal recovery was observed in 16 patients (20.8%) with impaired pituitary function, with the greatest recovery in the hypothalamic-pituitary-adrenal axis (21.2%, 7/33). A larger residual tumour volume was predictive of adjuvant radiotherapy (3.40 vs. 1.24 cm3, p = 0.005) and likelihood for repeat surgery (5.40 vs. 1.67cm3, p = 0.004). CONCLUSION Pre- and post-operative NFPMA volumes fail to predict the number of pituitary hormone deficits, however, greater post-operative residual volumes increase the likelihood of further intervention to control tumour growth.
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Affiliation(s)
- K Seejore
- Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - S A Alavi
- Department of Neurosurgery, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S M Pearson
- Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK
| | - J M W Robins
- Department of Neurosurgery, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - B Alromhain
- Department of Neurosurgery, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Sheikh
- Department of Neurosurgery, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - P Nix
- Department of Ear, Nose and Throat (ENT) Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - T Wilson
- Department of Ear, Nose and Throat (ENT) Surgery, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - S M Orme
- Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Tyagi
- Department of Neurosurgery, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - N Phillips
- Department of Neurosurgery, Leeds Centre for Neurosciences, Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - R D Murray
- Leeds Centre for Diabetes & Endocrinology, St James's University Hospital, Leeds Teaching Hospitals NHS Trust, Leeds, UK.
- Leeds Institute of Cardiovascular and Metabolic Medicine, University of Leeds, Leeds, UK.
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Kontorinis G, Tyagi A. Potential association between recurrent facial nerve palsy and migraines. J Laryngol Otol 2020; 134:1-4. [PMID: 32940194 DOI: 10.1017/s0022215120001905] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
OBJECTIVE This study aimed to investigate the possible association between recurrent facial nerve palsy and migraines. METHOD This study was a prospective case series with a two-year follow-up at an academic, tertiary referral centre and included patients with at least four episodes of recurrent lower motor neuron facial nerve palsy. All patients underwent standardised diagnostic tests. RESULTS Four patients fulfilled the inclusion criteria. The patients were all female with an average age at presentation of 40.75 years (range, 33-60 years) and an average age at the initial episode of 14 years (range, 12-16 years). The number of episodes varied between six and nine. All patients had at least one episode of facial nerve palsy on the contralateral side. Two patients were diagnosed and treated for migraine with aura remaining asymptomatic following prophylactic medication for migraines. CONCLUSION The results raise the possibility of an association between recurrent facial nerve palsy and migraines. Prospective studies in patients with even fewer episodes of facial nerve palsy could shed more light on this association.
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Affiliation(s)
- G Kontorinis
- Department of Otolaryngology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
| | - A Tyagi
- Department of Neurology, Institute of Neurological Sciences, Queen Elizabeth University Hospital, Glasgow, Scotland, UK
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Radhakrishna V, Tyagi A, Narendranath S, Vadodariya K, Yadav R, Singh B, Balaji G, Satya N, Shetty A, Suresha Kumar HN, Kumar ., Vaishali S, Pillai NS, Tadepalli S, Raghavendra V, Sreekumar P, Agarwal A, Valarmathi N. Chandrayaan-2 Large Area Soft X-ray Spectrometer. CURR SCI INDIA 2020. [DOI: 10.18520/cs/v118/i2/219-225] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Kaushik S, Punia R, Tyagi A. Study of Dosimetric Properties of Flattening Filter Free Photon Beam Passing through Cadmium Free Compensator Alloy. J Biomed Phys Eng 2019; 9:647-652. [PMID: 32039095 PMCID: PMC6943851 DOI: 10.31661/jbpe.v0i0.745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/25/2017] [Accepted: 03/22/2017] [Indexed: 06/10/2023]
Abstract
BACKGROUND This study aims to investigate radiation beam geometry of Cyberknife beam and change in dosimetric characteristics of six megavoltage (6MV) flattening filter free (FFF) beam after passing through high density cadmium free compensator alloy. MATERIAL AND METHODS In this experimental study, changes in FFF beam dosimetric characteristics after passing through compensator alloy was measured. Transmitted intensity of FFF beam was measured in air by an ion chamber at a source to detector distance (SDD) of 800mm. Extended SDD measurement also has been performed at a distance of 1270mm to analyze scattering due to compensator. Linear attenuation coefficient (µeff) was measured for cadmium free compensator alloy using simple exponential attenuation model. Percentage depth doses (PDDs) have been measured by a radiation field analyzer with compensator material to observe the beam hardening and change in surface doses and depth doses. RESULTS Linear attenuation coefficient of compensator alloy was measured 0.042 (Standard Deviation ±0.00099) mm-1 and it was found that there is no change with increase in collimator size. Even after increasing distance source from detector, µeff has no change. PDDs were found to increase with thickness of compensator. PDD from a 60mm collimator size increased by 5% and 6% at a depth of 100mm and 200mm, respectively in water. PDD also increased with collimator size less significantly. Surface dose was found to decrease with increase in compensator thickness. CONCLUSION Cyberknife beam has been found to be narrow beam geometry. FFF beam contains lesser scattered photons. Presence of high density compensator filters out the soft x-ray photon causes significant dosimetric changes.
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Affiliation(s)
- S Kaushik
- PhD, DRP, Guru Jambheshwar University of Science and Technology, Hisar, Haryana, India
| | - R Punia
- PhD, Maharishi Dayanand University, Rohtak, Haryana, India
- PhD, Chaudhary Ranbir Singh University, Jind, Haryana, India
| | - A Tyagi
- PhD, DRP, BLK Super Speciality Hospital, New Delhi India
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Gaur V, Chaudhary S, Tyagi A, Bakhshi S, Sharma P, Kumar S. Differential expression of various miRNAs in pediatric cytogenetically normal acute myeloid leukemia (CN-AML). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.069] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Mohta M, Dubey M, Malhotra R, Tyagi A. Comparison of the potency of phenylephrine and norepinephrine bolus doses used to treat post-spinal hypotension during elective caesarean section. Int J Obstet Anesth 2019; 38:25-31. [DOI: 10.1016/j.ijoa.2018.12.002] [Citation(s) in RCA: 23] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/13/2018] [Revised: 11/11/2018] [Accepted: 12/06/2018] [Indexed: 11/30/2022]
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Mukherjee S, Sivakumar G, Goodden J, Tyagi A, Chumas P. FP2-1 Prognostic value of leucocytosis in paediatric traumatic brain injury. J Neurol Psychiatry 2019. [DOI: 10.1136/jnnp-2019-abn.80] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
ObjectivesWe assessed leucocytosis and evaluated its prognostic value in isolated paediatric traumatic brain injury (TBI).DesignRetrospective analysis.Subjects106 consecutive paediatric patients with isolated TBI admitted between June 2008 and June 2016.MethodsInitial blood leucocyte count (WCC), Glasgow Coma Score (GCS), computed tomographic (CT) findings, duration of hospital stay, and Paediatric Cerebral Performance Category Scale (PCPCS) scores were analysed.ResultsMean age was 4.2 years. For patients with GCS 3–8, 9–13 and 14–15, WCC was 20, 15.9 and 10.7 × 109/L respectively. Differences in WCC were significant between the different GCS groups (p<0.01). Length of hospital stay, extent of midline shift on CT and poor 6 month PCPCS rating were each significantly correlated with WCC (p<0.05). Multivariate regression analysis revealed a cut-off WCC of 16.1 × 109/L, above which GCS, CT findings, length of hospital stay and PCPCS were less favourable. Application of the International Mission on Prognosis and Analysis of randomized Controlled Trials in TBI (IMPACT) adult TBI prediction model to our paediatric cohort, using area under the operating curve (AUROC) and coefficient analyses, demonstrated increased accuracy with incorporation of WCC as a risk factor.ConclusionsHigh initial leucocytosis (>16.1×109/L) is predictive for poor GCS, severe CT findings, lengthy hospital stay and poor PCPCS in isolated paediatric TBI. Incorporating WCC into TBI prediction models may increase the accuracy of prognostication.
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Vartak A, Tyagi A, Talwar R, Pradeep J, Mukherjee D. Institutional experience of post mastectomy single stage implant based reconstruction with modified dual plane technique in carcinoma breast patients. Breast 2019. [DOI: 10.1016/s0960-9776(19)30386-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Abstract
Rate-dependent left bundle branch block during general anaesthesia is rare. Its occurrence makes electrocardiographic diagnosis of acute myocardial ischaemia or infarction difficult. It can also be confused with a slow rate ventricular tachycardia. We present a case of rate-dependent left bundle branch block in a patient with no previous history of ischaemic heart disease. Carotid sinus massage resulted in a decrease in heart rate and reversion to normal sinus rhythm.
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Affiliation(s)
- A Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and GTB Hospital, Shahadra, Delhi, India
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Karanam S, Dasari R, Kumar A, Tyagi A, Kumar S, Lakshmi AY. Hemodialysis arteriovenous fistula maturation and role of perioperative vascular mapping. J NTR Univ Health Sci 2019. [DOI: 10.4103/jdrntruhs.jdrntruhs_55_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Tyagi A, Luthra A, Kumar M, Das S. Epidemiology of acute kidney injury and the role of urinary [TIMP-2]·[IGFBP7]: a prospective cohort study in critically ill obstetric patients. Int J Obstet Anesth 2018; 36:77-84. [PMID: 30245258 DOI: 10.1016/j.ijoa.2018.08.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/04/2018] [Revised: 06/15/2018] [Accepted: 08/03/2018] [Indexed: 11/16/2022]
Abstract
BACKGROUND There are few data regarding acute kidney injury in critically-ill obstetric patients. A combination of urinary cell cycle arrest markers, tissue inhibitor of metalloproteinase-2 (TIMP-2) and insulin-like growth factor binding protein7 (IGFBP7), is validated for the early prediction of acute kidney injury in non-obstetric patients. METHODS We evaluated the epidemiology of acute kidney injury in critically-ill obstetric patients and the role of the biomarker combination in predicting acute kidney injury and mortality. Acute kidney injury, its severity and risk factors, were assessed using Kidney Disease: Improving Global Outcomes (KDIGO) guidelines during the intensive care unit stay. An ELISA technique measured TIMP-2 and IGFBP7 in urine samples collected at the time of admission there. RESULTS Results for 66 patients showed an overall incidence of acute kidney injury of 40/66 (61%), with 50%, 10% and 40% being in stage 1, 2 and 3 respectively. Patients with acute kidney injury showed significantly greater sepsis and shock; longer stay and higher mortality during intensive care (33% vs 0%) and in hospital (38% vs 0%) compared to those without (P <0.05). The area-under-the receiver operating characteristics curve was <0.5 for urinary [TIMP-2]·[IGFBP7] as a predictor of kidney injury and mortality (P >0.05). CONCLUSIONS Acute kidney injury is common in critically-ill obstetric patients, increasing mortality and duration of hospitalization. It was significantly more common in patients with septic shock. Previously validated results of urinary [TIMP-2]·[IGFBP7] that successfully predict early acute kidney injury or mortality are not applicable to obstetric patients.
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Affiliation(s)
- A Tyagi
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India.
| | - A Luthra
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India
| | - M Kumar
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India
| | - S Das
- Department of Microbiology, University College of Medical Sciences & GTB Hospital, Delhi 110095, India
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Affiliation(s)
- A. Tyagi
- University College of Medical Sciences and GTB Hospital; Delhi India
| | - M. Ramanujam
- University College of Medical Sciences and GTB Hospital; Delhi India
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Solanki RK, Sharma P, Tyagi A, Singh C. Serum Levels of Neuroactive Steroids in First-episode Antipsychotic-naïve Schizophrenic Patients and Its Correlation with Aggression: A Case-control Study. East Asian Arch Psychiatry 2017; 27:79-84. [PMID: 28652501] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BACKGROUND The evidence of hypothalamic-pituitary-adrenal axis dysfunction in schizophrenia has been reviewed in the context of the stress-diathesis model. Overactivation of this axis leads to altered blood levels of cortisol and dehydroepiandrosterone sulfate (DHEA-S). These neurosteroids in turn act on the hippocampus and interact with gamma-aminobutyric acid and N-methyl-D-aspartate receptors leading to neurotoxicity and may be involved in the neurobiology of aggression. This study aimed to explore the blood level of these neurosteroids and ascertain its correlation with state aggression and psychopathology in first-episode antipsychotic-naïve schizophrenic patients. METHODS A total of 30 patients with first-episode schizophrenia along with 20 age- and gender-matched healthy controls participated in the study. Both groups were subjected to serum cortisol and DHEA-S measurement after assessment of psychopathology and aggression on a standardised psychometric scale. RESULTS Serum DHEA-S level was significantly higher in the patient group (p = 0.001). No difference was noted between males and females in the patient group (p = 0.93) but female controls had a significantly lower serum DHEA-S level than male controls (p < 0.01). Serum DHEA-S inversely correlated with scores on Modified Overt Aggression Scale (p = 0.01) but not with Positive and Negative Syndrome Scale (p = 0.39) or Clinical Global Impression Scale (p = 0.28). CONCLUSION The first-episode antipsychotic-naïve schizophrenic patients showed a significantly higher blood level of DHEA-S compared with healthy controls. Serum DHEA-S level has an inverse relationship with aggression and may serve as a biological adaptive mechanism to antagonise the neuronal damage caused by cortisol.
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Affiliation(s)
- R K Solanki
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - P Sharma
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - A Tyagi
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - C Singh
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
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Tyagi A, Singh S, Kumar M, Sethi AK. Intra-abdominal pressure and intra-abdominal hypertension in critically ill obstetric patients: a prospective cohort study. Int J Obstet Anesth 2017; 32:33-40. [PMID: 28619279 DOI: 10.1016/j.ijoa.2017.05.005] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2017] [Revised: 04/15/2017] [Accepted: 05/04/2017] [Indexed: 11/16/2022]
Abstract
BACKGROUND Critically ill obstetric patients may have risk factors for intra-abdominal hypertension. This study evaluated the intra-abdominal pressure and its effect on organ function and the epidemiology of intra-abdominal hypertension. METHODS Obstetric patients admitted to an Intensive Care Unit, with an anticipated stay greater than 24hours, were included. Intra-abdominal pressure was measured daily via a Foley catheter, based on intravesical pressure. RESULTS One-hundred-and-one patients were enrolled. The intra-abdominal pressure was 5-7mmHg in 34%; 7-12mmHg in 60%; and ≥12mmHg (intra-abdominal hypertension) in 6%. All six patients with intra-abdominal hypertension were pregnant at the time of admission. The intra-abdominal pressure in four patients normalized to <12mmHg following delivery, but in the remaining two it persisted ≥12mmHg and both these patients died. Correlation between intra-abdominal pressure and organ dysfunction was weak (r=0.211). Statistical comparison between patients with and without intra-abdominal hypertension for risk factors, daily intra-abdominal pressures, and Sequential Organ Failure Assessment score could not be done due to the disproportionately small number of patients with intra-abdominal hypertension as opposed to those without (6 versus 95). Intra-abdominal pressure did not significantly differ between survivors and non-survivors (8.5±1.1 vs 7.9±1.7mmHg, P=0.079). CONCLUSIONS The incidence of intra-abdominal hypertension in critically ill obstetric patients was lower than previously defined for mixed Intensive Care Unit populations, with an association with the pregnant state. Normalization of intra-abdominal pressure after delivery was associated with better survival. There was no correlation between intra-abdominal pressure and organ function or mortality.
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Affiliation(s)
- A Tyagi
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India.
| | - S Singh
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India
| | - M Kumar
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India
| | - A K Sethi
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & GTB Hospital, Delhi 110095, India
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Tyagi A, Kaushik S, Punia R, Singh M. SU-F-T-533: Study of Dosimetric Properties of Cadmium Free Alloy Used in Compensator Based IMRT. Med Phys 2016. [DOI: 10.1118/1.4956718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Srivastava R, Batra A, Tyagi A, Dhawan D, Ramakrishnan L, Bakhshi S. Adiponectin correlates with obesity: A study of 159 childhood acute leukemia survivors from India. Indian J Cancer 2016; 52:195-7. [PMID: 26853401 DOI: 10.4103/0019-509x.175824] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Acute lymphoblastic leukemia survivors are predisposed to obesity. However, the exact underlying mechanisms are not known. AIMS The study was done to assess the role of biomarkers of obesity in acute leukemia survivors. SETTINGS AND DESIGNS This is a cross-sectional study conducted at All India Institute of Medical Sciences in survivors of acute leukemia who had completed treatment at least 1 year before enrollment in this study. MATERIALS AND METHODS Obesity was studied by determining the body mass index. Potential biomarkers were studied by assessing serum leptin, resistin, and adiponectin by enzyme-linked immunosorbant assay, and the results were compared in obese versus nonobese survivors. STATISTICAL ANALYSIS Descriptive analysis for baseline demographic factors and Student's t-test for comparing the mean levels of biomarkers among the obese and nonobese survivors. RESULTS One hundred and fifty-nine acute leukemia patients were enrolled in this study with a median follow-up of 36.8 months. The median age was 10 (range: 3-18) years, and 123 (77.3%) patients were males. The overall prevalence of overweight/obesity was 26.4%, and this was similar in acute myeloid leukemia and acute lymphoblastic leukemia sub-groups (26.2% vs. 27.3%, P = 0.9). Mean serum leptin and resistin were similar in obese and nonobese leukemia survivors (3.7 vs. 2.85 pg/mL, P = 0.064; 8.01 vs. 9.33 ng/mL, P = 0.36). However, mean serum adiponectin was significantly lower in obese leukemia survivors (7.97 vs. 11.5 μg/mL, P = 0.023). CONCLUSIONS Obese leukemic survivors had lower serum adiponectin levels than nonobese survivors. However, serum resistin and leptin levels were similar in the two groups.
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Affiliation(s)
| | | | | | | | | | - S Bakhshi
- Department of Medical Oncology, Dr. B. R. A. Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Nix P, Tyagi A, Phillips N. Evolution of a UK endoscopic anterior skull base pituitary service - the first one hundred and twenty-three patients: Our Experience. Clin Otolaryngol 2016; 41:289-93. [DOI: 10.1111/coa.12514] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/20/2015] [Indexed: 11/27/2022]
Affiliation(s)
- P. Nix
- Department of Otolaryngology; Leeds Teaching Hospitals; Leeds UK
| | - A. Tyagi
- Department of Neurosurgery; Leeds Teaching Hospitals; Leeds UK
| | - N. Phillips
- Department of Neurosurgery; Leeds Teaching Hospitals; Leeds UK
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Ansel S, Rae A, Tyagi A. Efficacy of epidural blood patches for spontaneous low-pressure headaches: a case series. J R Coll Physicians Edinb 2016; 46:234-237. [DOI: 10.4997/jrcpe.2016.404] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
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Tripathi R, Soni A, Tyagi A, Mehta S, Gupta S. Comparative Study of Neurological Soft Signs in Patients with Schizophrenia or Obsessive-compulsive Disorder, and Healthy Controls. East Asian Arch Psychiatry 2015; 25:64-72. [PMID: 26118745] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
OBJECTIVE The primary objective of this study was to examine neurological soft signs in patients with obsessive-compulsive disorder compared with patients with schizophrenia and a control group in the Indian setting. The secondary objective was to find any correlation between age at onset and neurological soft signs scores, as well as that between severity of obsessive-compulsive disorder symptoms (total Yale-Brown Obsessive Compulsive Scale score) and neurological soft signs scores. METHODS This was a cross-sectional hospital-based study of 135 individuals (45 patients with schizophrenia, 45 patients with obsessive-compulsive disorder who were attending the psychiatric outpatient department of Sawai Man Singh Medical College, Jaipur, India, and 45 matched healthy controls) from 20 June 2013 to 22 December 2014. After applying strict inclusion and exclusion criteria, the participants completed the study instruments (Cambridge Neurological Inventory [Part 2] and Yale-Brown Obsessive Compulsive Scale). Their socio-demographic data were also recorded. RESULTS The neurological soft signs total score and domain scores (motor coordination, sensory integration, and disinhibition) were significantly higher in patients with schizophrenia (p < 0.05) than in the obsessive-compulsive disorder group or the control group. The obsessive-compulsive disorder group did not significantly differ from the control group in terms of neurological soft signs scores. No correlation was found between neurological soft signs scores and age at onset as well as that between neurological soft signs scores and total Yale-Brown Obsessive Compulsive Scale score. CONCLUSION Neurological soft signs assessed by the Cambridge Neurological Inventory and Yale-Brown Obsessive Compulsive Scale, which discriminate patients with schizophrenia from controls, appear to be relatively specific to schizophrenia. Further studies are required to explore neurological soft signs in patients with obsessive-compulsive disorder.
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Affiliation(s)
- R Tripathi
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
| | - A Soni
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
| | - A Tyagi
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
| | - S Mehta
- Navjeevan Hospital, Hisar, Haryana, India
| | - S Gupta
- Department of Psychiatry, Sawai Man Singh Medical College, Jaipur, India
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Amoaku W, Cackett P, Tyagi A, Mahmood U, Nosek J, Mennie G, Rumney N. Redesigning services for the management of vitreomacular traction and macular hole. Eye (Lond) 2015; 28 Suppl 1:S1-10. [PMID: 25008433 PMCID: PMC4097190 DOI: 10.1038/eye.2014.125] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Vitreomacular traction (VMT) and VMT with macular hole (MH) are serious conditions, being associated with visual disturbance, for example, metamorphopsia, and diminished visual acuity (VA). Pars plana vitrectomy is the routine treatment for symptomatic VMT and VMT+MH. However, ocriplasmin has demonstrated favourable efficacy and safety in specific patient groups with VMT/MH and is now recommended as a treatment option for certain patients by the National Institute of Health and Care Excellence. This means that services for managing patients with VMT/MH may need to be revised, as patients can now potentially receive treatment earlier in the course of the disease. VMT triage clinics could provide a more efficient way of managing VMT/MH patients. Patient assessment should always include high-definition optical coherence tomography, as this is the most accurate means of assessing abnormalities in the vitreoretinal (VR) interface, and an accurate measurement of best-corrected VA. It has been proposed that patients with VMT+MH be managed as a routine 6-week referral, with the complete patient journey—from initial referral to treatment—taking no longer than 6 months. It is important that patients are entered onto VR surgical lists so that there is no delay if ocriplasmin treatment is unsuccessful. Patients will need appropriate counselling about the expected outcomes and possible side effects of ocriplasmin treatment. One-year follow-up data should be collected by treatment centres in order to evaluate the new VMT service.
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Affiliation(s)
- W Amoaku
- Faculty of Medicine and Health Sciences, Queen's Medical Centre, University of Nottingham, Nottingham, UK
| | - P Cackett
- Princess Alexandra Eye Pavilion, Edinburgh, UK
| | - A Tyagi
- Birmingham and Midlands Eye Centre and Sandwell General Hospital, Birmingham, UK
| | - U Mahmood
- University Hospital of North Staffordshire, Stoke-on-Trent, UK
| | - J Nosek
- Wolverhampton Eye Infirmary, Wolverhampton, UK
| | - G Mennie
- Gloucestershire Clinical Commissioning Group, Brockworth, UK
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Mehta S, Tyagi A, Swami MK, Gupta S, Kumar M, Tripathi R. Onset of acute and transient psychotic disorder in India: a study of socio-demographics and factors affecting its outcomes. East Asian Arch Psychiatry 2014; 24:75-80. [PMID: 24986202] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
OBJECTIVE Acute and transient psychotic disorder has been accepted as a distinct diagnostic entity in the ICD-10. However, there are few studies delineating its demographics and factors affecting its outcome. This study aimed to examine the socio-demographic profile of patients with acute and transient psychotic disorder and the variables associated with the onset of illness and their effect on illness outcome in an Indian setting. METHODS This was a retrospective study in which case notes of patients admitted from 1 January to 31 December 2012 and diagnosed with acute and transient psychotic disorder (according to the ICD-10 diagnostic criteria) were analysed. Socio-demographic variables and variables associated with the onset of illness were noted. Duration of hospital stay was used as a proxy measure for clinical outcome. RESULTS A total of 185 patient records were analysed. Overall, 49% of the patients were males and 51% were females. Most of the cases (60%) were aged between 20 and 39 years. The majority was married, unemployed, educated up to middle school, living in a nuclear family, and had a rural background. Age (p = 0.05) and marital status (p = 0.03) significantly affected the outcome. Overall, 46% of the patients had stress as a precipitating factor, 27% reported substance use, and 23% had a family history of psychiatric illness prior to the onset of their illness. The onset of illness was from May to October in 54% of the patients, with the duration of untreated illness ranging from 7 to 15 days in 38% of the patients. The clinical outcome was significantly affected by duration of untreated illness (p = 0.05). CONCLUSIONS Acute and transient psychotic disorders show slight female preponderance and occur in early adulthood. There is no precipitating stress in most cases and shorter duration of untreated illness predicts favourable clinical outcome.
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Affiliation(s)
- S Mehta
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - A Tyagi
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - M K Swami
- Department of Psychiatry, BPS Government Medical College for Women, Sonepat, Haryana, India
| | - S Gupta
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - M Kumar
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
| | - R Tripathi
- Department of Psychiatry, SMS Medical College, Jaipur, Rajasthan, India
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Sclafani R, Agarwal R, Tyagi A, Siriwardana S, Takahata T, Frederick B, Raben D. Chemoprevention by Resveratrol in Head-and-Neck Cancer. Int J Radiat Oncol Biol Phys 2014. [DOI: 10.1016/j.ijrobp.2013.11.154] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Abstract
Abstract
Long fiber reinforced thermoplastic composites are one of the fastest growing segments experiencing 30% growth per year, over the last decade. This study describes the development of long fiber reinforced thermoplastic (LFRT) composites and the effect of fiber length on mold and process parameters of injection molding process. LFRT pellets of different sizes were prepared by an extrusion process using a specially designed impregnation die and palletized into different lengths. These pellets were injection molded to develop LFRT composites. Fiber length distributions were analyzed using a profile projector and an image analyzer software system. Maleic anhydride grafted polypropylene (MA-g-PP) was added to improve the adhesion between glass fibers and polypropylene. Improvement in mechanical properties were analyzed for different pellet sizes with different fiber content for long fiber reinforced polypropylene (LFPP) and long fiber reinforced polyamide (LFPA) composite.
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Affiliation(s)
- K. S. Kumar
- Centre for Polymer Science and Engineering, Department of Mechanical Engineering Indian Institute of Technology, New Delhi, India
| | - V. Patel
- Centre for Polymer Science and Engineering, Department of Mechanical Engineering Indian Institute of Technology, New Delhi, India
| | - A. Tyagi
- Centre for Polymer Science and Engineering, Department of Mechanical Engineering Indian Institute of Technology, New Delhi, India
| | - N. Bhatnagar
- Centre for Polymer Science and Engineering, Department of Mechanical Engineering Indian Institute of Technology, New Delhi, India
| | - A. K. Ghosh
- Centre for Polymer Science and Engineering, Department of Mechanical Engineering Indian Institute of Technology, New Delhi, India
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Miller S, Overell J, Jampana R, Gorrie G, Tyagi A, Gilles C, McKenzie M. A giant cause of a low pressure headache. J Headache Pain 2013. [PMCID: PMC3620303 DOI: 10.1186/1129-2377-14-s1-p165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Miller S, Overell J, Jampana R, Gorrie G, Tyagi A, Gilles C, McKenzie M. A giant cause of a low pressure headache. J Headache Pain 2013. [DOI: 10.1186/1129-2377-1-s1-p165] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Abstract
Epidural volume extension is a technical modification of the combined spinal epidural block. It involves the epidural injection of normal saline or a small volume of local anaesthetic after an intrathecal injection, aiming to augment the post-spinal sensory level. Although the consequent sensory block augmentation has been adequately documented, the probable factors influencing epidural volume extension and its implications for clinical practice are not well defined. This article reviews published literature relating to the probable factors affecting epidural volume extension, its clinical implications, case reports of its successful clinical application and summarises its unexplored effects.
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Affiliation(s)
- A Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahadra, Delhi, India.
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Khatua S, Brown R, Pearlman M, Vats T, Satge D, Stiller C, Rutkowski S, von Bueren AO, Lacour B, Sommelet D, Nishi M, Massimino M, Garre ML, Moreno F, Hasle H, Jakab Z, Greenberg M, von der Weid N, Kuehni C, Zurriaga O, Vicente ML, Peris-Bonet R, Benesch M, Vekemans M, Sullivan S, Rickert C, Fisher PG, Von Behren J, Nelson DO, Reynolds P, Fukuoka K, Yanagisawa T, Suzuki T, Koga T, Wakiya K, Adachi JI, Mishima K, Fujimaki T, Matsutani M, Nishikawa R, Gidding C, Schieving J, Wesseling P, Ligtenberg M, Hoogerbrugge N, Jongmans M, Crosier S, Nicholson SL, Robson K, Jacques T, Wharton S, Bown N, Michalski A, Pizer B, Clifford S, Sanden E, Visse E, Siesjo P, Darabi A, Nousome D, Lupo PJ, Scheurer ME, Nulman I, Barrera M, Maxwell C, Koren G, Gorelyshev S, Matuev K, Lubnin A, Laskov M, Lemeneva N, Mazerkina N, Khuhlaeva E, Muller K, Bruns F, Pietsch T, Rutkowski S, Kortmann RD, Krishnatry R, Shirsat N, Kunder R, Epari S, Gupta T, Kurkure P, Vora T, Arora B, Moiyadi A, Jalali R, Swieszkowska E, Dembowska-Baginska B, Drogosiewicz M, Filipek I, Perek-Polnik M, Grajkowska W, Perek D, Johnston D, Cyr J, Strother D, Lafay-Cousin L, Fryer C, Scheinemann K, Carret AS, Fleming A, Larouche V, Bouffet E, Friedrich C, Gnekow AK, Fleischhack G, Kramm CM, Fruehwald MC, Muller HL, Calaminus G, Kordes U, Faldum A, Pietsch T, Warmuth-Metz M, Kortmann RD, Jung I, Kaatsch P, Rutkowski S, Caretti V, Bugiani M, Boor I, Schellen P, Vandertop WP, Noske DP, Kaspers G, Wurdinger T, Wesseling P, Robinson G, Chingtagumpala M, Adesina A, Dalton J, Santi M, Sievert A, Wright K, Armstrong G, Boue D, Olshefski R, Scott S, Huang A, Cohn R, Gururangan S, Bowers D, Gilbertson R, Gajjar A, Ellison D, Chick E, Donson A, Owens E, Smith AA, Madden JR, Foreman NK, Bakry D, Aronson M, Durno C, Hala R, Farah R, Amayiri N, Alharbi Q, Shamvil A, Ben-Shachar S, Constantini S, Rina D, Ellise J, Keiles S, Pollet A, Qaddoumi I, Gallinger S, Malkin D, Bouffet E, Hawkins C, Tabori U, Trivedi M, Goodden J, Chumas P, Tyagi A, O'kane R, Trivedi M, Goodden J, Chumas P, Tyagi A, O'Kane R, Crimmins D, Picton S, Elliott M. EPIDEMIOLOGY. Neuro Oncol 2012. [DOI: 10.1093/neuonc/nos100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Li KKW, Pang JCS, Ng HK, Massimino M, Gandola L, Biassoni V, Spreafico F, Schiavello E, Poggi G, Casanova M, Pecori E, De Pava MV, Ferrari A, Meazza C, Terenziani M, Polastri D, Luksch R, Podda M, Modena P, Antonelli M, Giangaspero F, Ahmed S, Zaghloul MS, Mousa AG, Eldebawy E, Elbeltagy M, Awaad M, Massimino M, Gandola L, Biassoni V, Antonelli M, Schiavello E, Buttarelli F, Spreafico F, Collini P, Pollo B, Patriarca C, Giangaspero F, MacDonald T, Liu J, Munson J, Park J, Wang K, Fei B, Bellamkonda R, Arbiser J, Gomi A, Yamaguchi T, Mashiko T, Oguro K, Somasundaram A, Neuberg R, Grant G, Fuchs H, Driscoll T, Becher O, McLendon R, Cummings T, Gururangan S, Bourdeaut F, Grison C, Doz F, Pierron G, Delattre O, Couturier J, Cho YJ, Pugh T, Weeraratne SD, Archer T, Krummel DP, Auclair D, Cibulkis K, Lawrence M, Greulich H, McKenna A, Ramos A, Shefler E, Sivachenko A, Amani V, Pierre-Francois J, Teider N, Northcott P, Taylor M, Meyerson M, Pomeroy S, Potts C, Cline H, Rotenberry R, Guldal C, Bhatia B, Nahle Z, Kenney A, Fan YN, Pizer B, See V, Makino K, Nakamura H, Kuratsu JI, Grahlert J, Ma M, Fiaschetti G, Shalaby T, Grotzer M, Baumgartner M, Clifford S, Gustafsson G, Ellison D, Figarella-Branger D, Doz F, Rutkowski S, Lannering B, Pietsch T, Fiaschetti G, Shalaby T, Baumgartner M, Grotzer M, Fleischhack G, Siegler N, Zimmermann M, Rutkowski S, Warmuth-Metz M, Kortmann RD, Pietsch T, Faldum A, Bode U, Yoon JH, Kang HJ, Park KD, Park SH, Phi JH, Kim SK, Wang KC, Kim IH, Shin HY, Ahn HS, Faria C, Golbourn B, Smith C, Rutka J, Greene BD, Whitton A, Singh S, Scheinemann K, Hill R, Lindsey J, Howell C, Ryan S, Shiels K, Shrimpton E, Bailey S, Clifford S, Schwalbe E, Lindsey J, Williamson D, Hamilton D, Northcott P, O'Toole K, Nicholson SL, Lusher M, Gilbertson R, Hauser P, Taylor M, Taylor R, Ellison D, Bailey S, Clifford S, Kool M, Jones DTW, Jager N, Hovestadt V, Schuller U, Jabado N, Perry A, Cowdrey C, Croul S, Collins VP, Cho YJ, Pomeroy S, Eils R, Korshunov A, Lichter P, Pfister S, Northcott P, Shih D, Taylor M, Darabi A, Sanden E, Visse E, Siesjo P, Harris P, Venkataraman S, Alimova I, Birks D, Cristiano B, Donson A, Foreman N, Vibhakar R, Bertin D, Vallero S, Basso ME, Romano E, Peretta P, Morra I, Mussano A, Fagioli F, Kunkele A, De Preter K, Heukamp L, Thor T, Pajtler K, Hartmann W, Mittelbronn M, Grotzer M, Deubzer H, Speleman F, Schramm A, Eggert A, Schulte J, Bandopadhayay P, Kieran M, Manley P, Robison N, Chi S, Thor T, Mestdagh P, Vandesomple J, Fuchs H, Durner VG, de Angelis MH, Heukamp L, Kunkele A, Pajtler K, Eggert A, Schramm A, Schulte JH, Ohe N, Yano H, Nakayama N, Iwama T, Lastowska M, Perek-Polnik M, Grajkowska W, Malczyk K, Cukrowska B, Dembowska-Baginska B, Perek D, Othman RT, Storer L, Grundy R, Kerr I, Coyle B, Hulleman E, Lagerweij T, Biesmans D, Crommentuijn MHW, Cloos J, Tannous BA, Vandertop WP, Noske DP, Kaspers GJL, Wurdinger T, Bergthold G, El Kababri M, Varlet P, Dhermain F, Sainte-Rose C, Raquin MA, Valteau-Couanet D, Grill J, Dufour C, Burchill C, Hii H, Dallas P, Cole C, Endersby R, Gottardo N, Gevorgian A, Morozova E, Kazantsev I, Youhta T, Safonova S, Kozlov A, Punanov Y, Afanasyev B, Zheludkova O, Packer R, Gajjar A, Michalski J, Jakacki R, Gottardo N, Tarbell N, Vezina G, Olson J, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Malbari F, Atlas M, Friedman G, Kelly V, Bray A, Cassady K, Markert J, Gillespie Y, Taylor R, Howman A, Brogden E, Robinson K, Jones D, Gibson M, Bujkiewicz S, Mitra D, Saran F, Michalski A, Pizer B, Jones DTW, Jager N, Kool M, Zichner T, Hutter B, Sultan M, Cho YJ, Pugh TJ, Warnatz HJ, Reifenberger G, Northcott PA, Taylor MD, Meyerson M, Pomeroy SL, Yaspo ML, Korbel JO, Korshunov A, Eils R, Pfister SM, Lichter P, Pajtler KW, Weingarten C, Thor T, Kuenkele A, Fleischhack G, Heukamp LC, Buettner R, Kirfel J, Eggert A, Schramm A, Schulte JH, Friedrich C, von Bueren AO, von Hoff K, Gerber NU, Benesch M, Kwiecien R, Pietsch T, Warmuth-Metz M, Faldum A, Kuehl J, Kortmann RD, Rutkowski S, Lupo P, Scheurer M, Martin A, Nirschl C, Polanczyk M, Cohen KJ, Pardoll DM, Drake CG, Lim M, Manoranjan B, Hallett R, Wang X, Venugopal C, McFarlane N, Sheinemann K, Hassell J, Singh S, Venugopal C, Manoranjan B, McFarlane N, Whitton A, Delaney K, Scheinemann K, Singh S, Manoranjan B, Hallett R, Venugopal C, McFarlane N, Hassell J, Scheinemann K, Dunn S, Singh S, Garcia I, Crowther AJ, Gama V, Miller CR, Deshmukh M, Gershon TR, Garcia I, Crowther AJ, Gershon TR, Gerber NU, von Hoff K, Friedrich C, von Bueren AO, Treulieb W, Benesch M, Faldum A, Pietsch T, Warmuth-Metz M, Rutkowski S, Kortmann RD, Zin A, De Bortoli M, Bonvini P, Viscardi E, Perilongo G, Rosolen A, Connolly E, Zhang C, Anderson R, Feldstein N, Stark E, Garvin J, Shing MMK, Lee V, Cheng FWT, Leung AWK, Zhu XL, Wong HT, Kam M, Li CK, Ward S, Sengupta R, Kroll K, Rubin J, Dallas P, Milech N, Longville B, Hopkins R, Vergiliana JVD, Endersby R, Gottardo N, von Bueren AO, Gerss J, Hagel C, Cai H, Remke M, Hasselblatt M, Feuerstein BG, Pernet S, Delattre O, Korshunov A, Rutkowski S, Pfister SM, Baudis M, Lee C, Fotovati A, Triscott J, Dunn S, Valdora F, Freier F, Seyler C, Brady N, Bender S, Northcott P, Kool M, Jones D, Coco S, Tonini GP, Scheurlen W, Boutros M, Taylor M, Katus H, Kulozik A, Zitron E, Korshunov A, Lichter P, Pfister S, Remke M, Shih DJH, Northcott PA, Van Meter T, Pollack IF, Van Meir E, Eberhart CG, Fan X, Dellatre O, Collins VP, Jones DTW, Clifford SC, Pfister SM, Taylor MD, Pompe R, von Bueren AO, von Hoff K, Friedrich C, Treulieb W, Lindow C, Deinlein F, Kuehl J, Rutkowski S, Gupta T, Krishnatry R, Shirsat N, Epari S, Kunder R, Kurkure P, Vora T, Moiyadi A, Jalali R, Cohen K, Perek D, Perek-Polnik M, Dembowska-Baginska B, Drogosiewicz M, Grajkowska W, Lastowska M, Chojnacka M, Filipek I, Tarasinska M, Roszkowski M, Hauser P, Jakab Z, Bognar L, Markia B, Gyorsok Z, Ottoffy G, Nagy K, Cservenyak J, Masat P, Turanyi E, Vizkeleti J, Krivan G, Kallay K, Schuler D, Garami M, Lacroix J, Schlund F, Adolph K, Leuchs B, Bender S, Hielscher T, Pfister S, Witt O, Schlehofer JR, Rommelaere J, Witt H, Leskov K, Ma N, Eberhart C, Stearns D, Dagri JN, Torkildson J, Evans A, Ashby LS, Zakotnik B, Brown RJ, Dhall G, Portnow J, Finlay JL, McCabe M, Pizer B, Marino AM, Baryawno N, Ekstrom TP, Ostman A, Johnsen JI, Robinson G, Parker M, Kranenburg T, Lu C, Pheonix T, Huether R, Easton J, Onar A, Lau C, Bouffet E, Gururangan S, Hassall T, Cohn R, Gajjar A, Ellison D, Mardis E, Wilson R, Downing J, Zhang J, Gilbertson R, Robinson G, Dalton J, O'Neill T, Yong W, Chingtagumpala M, Bouffet E, Bowers D, Kellie S, Gururangan S, Fisher P, Bendel A, Fisher M, Hassall T, Wetmore C, Broniscer A, Clifford S, Gilbertson R, Gajjar A, Ellison D, Zhukova N, Martin D, Lipman T, Castelo-Branco P, Zhang C, Fraser M, Baskin B, Ray P, Bouffet E, Alman B, Ramaswamy V, Dirks P, Clifford S, Rutkowski S, Pfister S, Bristow R, Taylor M, Malkin D, Hawkins C, Tabori U, Dhall G, Ji L, Haley K, Gardner S, Sposto R, Finlay J, Leary S, Strand A, Ditzler S, Heinicke G, Conrad L, Richards A, Pedro K, Knoblaugh S, Cole B, Olson J, Yankelevich M, Budarin M, Konski A, Mentkevich G, Stefanits H, Ebetsberger-Dachs G, Weis S, Haberler C, Milosevic J, Baryawno N, Sveinbjornsson B, Martinsson T, Grotzer M, Johnsen JI, Kogner P, Garzia L, Morrisy S, Jelveh S, Lindsay P, Hill R, Taylor M, Marks A, Zhang H, Rood B, Williamson D, Clifford S, Aurtenetxe O, Gaffar A, Lopez JI, Urberuaga A, Navajas A, O'Halloran K, Hukin J, Singhal A, Dunham C, Goddard K, Rassekh SR, Davidson TB, Fangusaro JR, Ji L, Sposto R, Gardner SL, Allen JC, Dunkel IJ, Dhall G, Finlay JL, Trivedi M, Tyagi A, Goodden J, Chumas P, O'kane R, Crimmins D, Elliott M, Picton S, Silva DS, Viana-Pereira M, Stavale JN, Malheiro S, Almeida GC, Clara C, Jones C, Reis RM, Spence T, Sin-Chan P, Picard D, Ho KC, Lu M, Huang A, Bochare S, Khatua S, Gopalakrishnan V, Chan TSY, Picard D, Pfister S, Hawkins C, Huang A, Chan TSY, Picard D, Ho KC, Huang A, Picard D, Millar S, Hawkins C, Rogers H, Kim SK, Ra YS, Fangusaro J, Toledano H, Nakamura H, Van Meter T, Pomeroy S, Ng HK, Jones C, Gajjar A, Clifford S, Pfister S, Eberhart C, Bouffet E, Grundy R, Huang A, Sengupta S, Weeraratne SD, Phallen J, Sun H, Rallapalli S, Amani V, Pierre-Francois J, Teider N, Cook J, Jensen F, Lim M, Pomeroy S, Cho YJ. MEDULLOBLASTOMA. Neuro Oncol 2012; 14:i82-i105. [PMCID: PMC3483339 DOI: 10.1093/neuonc/nos093] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/15/2023] Open
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Yang QY, Chen ZP, Hayase T, Gomi A, Higaki A, Kawahara Y, Kobari T, Fukuda T, Kashii Y, Morimoto A, Sakatani T, Momoi MY, Murray M, Hale J, Heinemann K, Saran F, Calaminus G, Nicholson J, Murray M, Heinemann K, Hale J, Saran F, Nicholson J, Calaminus G, Martinez S, Khakoo Y, Gilheeney S, Kramer K, Wolden S, Souweidane M, Dunkel I, Brichtova E, Pavelka Z, Bobekova A, Magnova O, Kren L, Svoboda T, Sprlakova A, Slampa P, Zitterbart K, Sterba J, Campen CJ, Ashby D, Fisher PG, Monje M, Dagri J, Torkildson J, Cheng J, Wang RX, Yock T, Banerjee A, Dhall G, Finlay J, Yanagisawa T, Fukuoka K, Suzuki T, Kohga T, Wakiya K, Adachi J, Mishima K, Fujimaki T, Matsutani M, Nishikawa R, Matsutani M, Calaminus G, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran FH, Nicholson J, Calaminus G, Nicholson J, Alapetite C, Kortmann RD, Garre ML, Ricardi U, Saran FH, Frappaz D, Czech T, Nicholson J, Frappaz D, Kortmann RD, Alapetite C, Garre ML, Ricardi U, Saran FH, Calaminus G, Walker R, Hale J, Koga T, Suzuki T, Nishikawa R, Yanagisawa T, Fukuoka K, Matsutani M, Legault G, Allen J, Geludkova O, Mushinskaya M, Kushel Y, Korshunov A, Melikyan A, Shishkina L, Oserova V, Oserov S, Maserkina N, Borodina I, Kumirova E, Boyarchuk N, Gorbatyh S, Popova E, Sherbenko O, Zelinskaya N, Shammasov R, Privalova L, Chulkov O, Kosel Y, Cappellano AM, Paiva P, Cavalheiro S, Dastoli P, Seixas MT, Silva NS, Chan GCF, Shing MMK, Yuen HL, Li RCH, Li CK, Ha SY, Li CK, Chen HH, Chang FC, Chen YW, Wong TT, Yarascavitch B, Stein N, Ribeiro L, Whitton A, Duckworth J, Scheinemann K, Singh S, Geludkova O, Shishkina L, Ozerov S, Gorelyshev S, Maserkina N, Trunin Y, Mushinskaya M, Boyarchuk N, Borodina I, Kagawa N, Fujimoto Y, Hirayama R, Chiba Y, Kijima N, Arita H, Kinoshita M, Hashimoto N, Maruno M, Yoshimine T, Guerra GP, Oscanoa M, Cavero L, Yabar A, Ugarte E, Trivedi M, Tyagi A, Goodden J, Chumas P, Elliott M, Picton S, Robison N, Prabhu S, Sun P, Chi S, Kieran M, Manley P, Cohen L, Goumnerova L, Smith E, Scott M, London W, Ullrich NJ. GERM CELL TUMORS. Neuro Oncol 2012; 14:i49-i55. [PMCID: PMC3483347 DOI: 10.1093/neuonc/nos101] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/21/2023] Open
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Rana MS, Tyagi A, Hossain SA, Tyagi A. Effect of tanniniferous Terminalia chebula extract on rumen biohydrogenation, ∆9-desaturase activity, CLA content and fatty acid composition in longissimus dorsi muscle of kids. Meat Sci 2012; 90:558-63. [DOI: 10.1016/j.meatsci.2011.09.016] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2011] [Revised: 07/21/2011] [Accepted: 09/19/2011] [Indexed: 12/14/2022]
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Abstract
The potential advantages of pressure-controlled over volume-controlled ventilation during laparoscopic surgery have yet to be proven. We randomly assigned 42 patients with BMI <30 kg.m(-2) scheduled for laparoscopic cholecystectomy to receive either pressure- or volume-controlled ventilation. Compared with volume-controlled ventilation, pressure-controlled ventilation resulted in a significant decrease in mean (SD) peak airway pressure at 10 min (20.4 (2.7) vs 24.0 (4.7)cmH₂O, p=0.004) and 30 min (20.7 (3.0) vs 23.9 (4.9)cmH₂O, p=0.015) and an increase in mean airway pressure at 10 min (10.5 (0.9) vs 9.6 (1.1)cmH₂O, p=0.007) and 30 min (10.5 (1.1) vs 9.6 (1.2)cmH₂O, p=0.016) after the start of surgery. Gas exchange and haemodynamic stability were similar. We conclude that pressure-controlled ventilation is a safe alternative and offers some advantages to volume-controlled ventilation during laparoscopic cholecystectomy in non-obese patients.
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Affiliation(s)
- A Tyagi
- Department of Anaesthesiology & Critical Care, University College of Medical Sciences & Guru Teg Bahadur Hospital, Shahadra, Delhi, India.
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Mohta M, Janani SS, Sethi AK, Agarwal D, Tyagi A. Comparison of phenylephrine hydrochloride and mephentermine sulphate for prevention of post spinal hypotension. Anaesthesia 2011; 65:1200-5. [PMID: 21182601 DOI: 10.1111/j.1365-2044.2010.06559.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
This study compared the effects of intravenous infusions of phenylephrine and mephentermine on the prevention of maternal hypotension and neonatal outcome in patients receiving spinal anaesthesia for caesarean section. Sixty ASA 1-2 patients with term, uncomplicated singleton pregnancy undergoing caesarean section under spinal anaesthesia were randomly divided into two groups of 30 each, to receive a prophylactic intravenous infusion of either phenylephrine or mephentermine. The incidence of hypotension was statistically similar in the two groups. However, in patients receiving phenylephrine, 7 (23%) developed bradycardia and 6 (20%), reactive hypertension. Neonatal outcome, in terms of Apgar scores and umbilical artery pH, was similar in both the groups. To conclude, phenylephrine and mephentermine infusions are equally effective in preventing post spinal hypotension in patients undergoing caesarean section and are associated with a similar neonatal outcome.
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Affiliation(s)
- M Mohta
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India.
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Tyagi A, Supe S, Kaushik S, Singh M. Influence of Photon Energy on Carcinoma of Cervix IMRT Plans. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.1762] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Tyagi A, Penzkofer A, Mathes T, Hegemann P. Photophysical characterisation and photo-cycle dynamics of LOV1-His domain of phototropin from Chlamydomonas reinhardtii with roseoflavin monophosphate cofactor. J Photochem Photobiol B 2010; 101:76-88. [PMID: 20655238 DOI: 10.1016/j.jphotobiol.2010.06.014] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Revised: 06/29/2010] [Accepted: 06/29/2010] [Indexed: 11/19/2022]
Abstract
The wild-type phototropin protein phot from the green alga Chlamydomonas reinhardtii with the blue-light photoreceptor domains LOV1 and LOV2 has flavin mononucleotide (FMN) as cofactor. For the LOV1-His domain from phot of C. reinhardtii studied here, the FMN chromophore was replaced by roseoflavin monophosphate (8-dimethylamino-8-demethyl-FMN, RoFMN) during heterologous expression in a riboflavin auxotropic Escherichia coli strain. An absorption and emission spectroscopic characterisation of the cofactor exchanged-LOV1-His (RoLOV1) domain was carried out in aqueous pH 8 phosphate buffer. The fluorescence of RoLOV1 is quenched by photo-induced charge transfer at room temperature. The photo-cyclic dynamics of RoLOV1 was observed by blue-light induced hypochromic and bathochromic absorption changes which recover on a minute timescale in the dark. Photo-excited RoFMN is thought to cause reversible protein and cofactor structural changes. Prolonged intense blue-light exposure caused photo-degradation of RoFMN in RoLOV1 to fully reduced flavin and lumichrome derivatives. Photo-cycle schemes of RoLOV1 and LOV1 are presented, and the photo-degradation dynamics of RoLOV1 is discussed.
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Affiliation(s)
- A Tyagi
- Fakultät für Physik, Universität Regensburg, Universitätsstrasse 31, D-93053 Regensburg, Germany
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Bhargava D, Bartlett P, Russell J, Liddington M, Tyagi A, Chumas P. Construction of titanium cranioplasty plate using craniectomy bone flap as template. Acta Neurochir (Wien) 2010; 152:173-6. [PMID: 19533018 DOI: 10.1007/s00701-009-0394-2] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/25/2008] [Accepted: 04/23/2009] [Indexed: 10/20/2022]
Abstract
In recent times a steady rise in cranioplasty operations has been noted because of increasing utilisation of decompressive craniectomy for trauma as well as stroke patients. A variety of techniques have been utilised for cranioplasty, with their own benefits and limitations. Titanium cranioplasty is one of the well-established and widely used techniques, with most centres utilising computer-assisted reconstruction for manufacture of titanium plates. In this paper we present a novel method for making titanium cranioplasty plates using the craniectomy bone flap as a template and the results of our experience. To date we have performed 51 cranioplasties using this method. The surgical results have been comparable to those obtained using the computer-assisted model technique. The construction cost for titanium cranioplasty plates using this method has been pound 360 cheaper per plate compared with the computer-assisted method. In addition, the CT workload and radiation exposure have been reduced.
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Abstract
There are a number of case reports describing accidental subdural block during the performance of subarachnoid or epidural anaesthesia. However, it appears that subdural drug deposition remains a poorly understood complication of neuraxial anaesthesia. The clinical presentation may often be attributed to other causes. Subdural injection of local anaesthetic can present as high sensory block, sometimes even involving the cranial nerves due to extension of the subdural space into the cranium. The block is disproportionate to the amount of drug injected, often with sparing of sympathetic and motor fibres. On the other hand, the subdural deposition can also lead to failure of the intended block. The variable presentation can be explained by the anatomy of this space. High suspicion in the presence of predisposing factors and early detection could prevent further complications. This review aims at increasing awareness amongst anaesthetists about inadvertent subdural block. It reviews the relevant anatomy, incidence, predisposing factors, presentation, diagnosis and management of unintentional subdural block during the performance of neuraxial anaesthesia.
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Affiliation(s)
- D. Agarwal
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - M. Mohtaf
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A. Tyagi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
| | - A. K. Sethi
- Department of Anaesthesiology and Critical Care, University College of Medical Sciences and Guru Teg Bahadur Hospital, Delhi, India
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Slyusareva E, Sizykh A, Tyagi A, Penzkofer А. Spectral and photophysical properties of fluorone dyes in bio-related films and methanol. J Photochem Photobiol A Chem 2009. [DOI: 10.1016/j.jphotochem.2009.09.006] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Tyagi A, Zirak P, Penzkofer A, Mathes T, Hegemann P, Mack M, Ghisla S. Absorption and emission spectroscopic characterisation of 8-amino-riboflavin. Chem Phys 2009. [DOI: 10.1016/j.chemphys.2009.08.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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