1
|
Khadatkar P, Niranjan B, Bansal A, Sundaramurthy S, Choudhary K, Sijeria P. A comparative evaluation of fluoride release and rechargeability in conventional GIC (type II), pediatric GIC (type IX), and Cention-N: an in vitro study. Eur Arch Paediatr Dent 2024; 25:161-168. [PMID: 38334867 DOI: 10.1007/s40368-023-00856-5] [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] [Subscribe] [Scholar Register] [Received: 02/25/2023] [Accepted: 11/15/2023] [Indexed: 02/10/2024]
Abstract
PURPOSE A comparative evaluation of fluoride release and re-chargeability in conventional glass ionomer cement (GIC) (type II), Pediatric GIC (type IX), and Cention-N-an in vitro study at an interval of first, fourteenth, and twenty first days. METHODS Three groups of test materials, each with twenty samples, were prepared. Measurements of the cumulative fluoride release [parts per million (ppm)] and re-release measured on the first, fourteenth, and twenty first days. Analysis of variance (ANOVA) was used to compare the means for different readings, and Tukey's post hoc analysis was used to compare each group with each other. RESULTS Initial and subsequent fluoride release of Cention-N at days one, fourteen, and twenty-one were all noticeably higher than those of conventional and pediatric GIC. CONCLUSION Compared to the Conventional and Pediatric GIC restorative materials, Cention-N was more effective in the initial and fluoride re-release.
Collapse
Affiliation(s)
- P Khadatkar
- Department of Pediatric and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India
| | - B Niranjan
- Department of Pediatric and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India.
| | - A Bansal
- Department of Pediatric and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India
| | - S Sundaramurthy
- Department of Chemical Engineering, Maulana Azad National Institute of Technology, Bhopal, Madhya Pradesh, 462003, India
| | - K Choudhary
- Department of Pediatric and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India
| | - P Sijeria
- Department of Pediatric and Preventive Dentistry, Rishiraj College of Dental Sciences and Research Center, Bhopal, Madhya Pradesh, India
| |
Collapse
|
2
|
Stander S, Kim BS, Guillemin I, Rhoten S, Wratten S, Brookes E, O'Malley JT, Bansal A, Msihid J, Thomas R, Bahloul D. Estimating meaningful change thresholds for Skin Pain-Numeric Rating Scale, Sleep-Numeric Rating Scale and Dermatology Life Quality Index in patients with prurigo nodularis. J Eur Acad Dermatol Venereol 2024. [PMID: 38329222 DOI: 10.1111/jdv.19800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2023] [Accepted: 11/21/2023] [Indexed: 02/09/2024]
Abstract
BACKGROUND Prurigo nodularis (PN) is characterized by intensely itchy nodules/lesions and skin pain, which can have a substantial impact on health-related quality of life (HRQoL). Treatment benefits on such symptoms and impacts are best assessed in trials using patient-reported outcome (PROs) instruments such as Skin Pain Numerical Rating Scale (NRS), Sleep-NRS and Dermatology Life Quality Index (DLQI). However, no guidance exists for interpreting meaningful changes in scores using these PROs in patients with PN. OBJECTIVES The main objective was to derive within-patient (responder definition) and between-group improvement thresholds for interpreting Skin Pain-NRS, Sleep-NRS and DLQI total scores in patients with PN. The measurement properties of the three PROs were also evaluated. METHODS Intention-to-treat (ITT), blinded and pooled data were used from the Phase 3 PRIME (NCT04183335) and PRIME2 (NCT04202679) studies evaluating the efficacy of dupilumab in adult patients with PN. Anchor- and distribution-based methods were applied to derive responder definition and between-group thresholds for Skin Pain-NRS, Sleep-NRS and DLQI. Data were additionally used to examine the instrument measurement properties, including reliability, validity and responsiveness. RESULTS A total of 311 patients (mean age 49.5 years, 65.3% female) were included in the pooled ITT population. The within-patient improvement threshold for Skin Pain-NRS was estimated as 4.0 points, 2.0 points for Sleep-NRS and 9.0 points for DLQI total score. A 1.5-point improvement in Skin Pain-NRS scores, 1.0-point in Sleep-NRS and 4.0-point in DLQI indicated a between-group meaningful change. Adequate to good psychometric properties were demonstrated for all three instruments. CONCLUSIONS The results of this study can aid interpretation of Skin Pain-NRS, Sleep-NRS and DLQI scores in patients with PN in both clinical trials and clinical practice to better understand and treat PN-related skin pain and the impact of PN on sleep quality and HRQoL.
Collapse
Affiliation(s)
- S Stander
- University Clinic Münster, Münster, Germany
| | - B S Kim
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - S Rhoten
- IQVIA, San Francisco, California, USA
| | | | | | | | - A Bansal
- Regeneron, Tarrytown, New York, USA
| | | | - R Thomas
- Regeneron, Tarrytown, New York, USA
| | | |
Collapse
|
3
|
Ks A, Bansal A, Verma PK, Bhat NK. Thurston syndrome with thalassaemia: a rare case devising a novel molecular and phenotypic variation. BMJ Case Rep 2023; 16:e253086. [PMID: 38160027 PMCID: PMC10759122 DOI: 10.1136/bcr-2022-253086] [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] [Subscribe] [Scholar Register] [Indexed: 01/03/2024] Open
Abstract
A male infant presented with progressive paleness of the body since 3 months of age. On examination, the child had pallor, microcephaly with dysmorphic facies (depressed nasal bridge, low set ears, retrognathia, high arched palate and tongue hamartoma). Postaxial polydactyly in bilateral hands and feet, broad great toes, with syndactyly of left fourth and fifth toes were present. The haemogram showed severe anaemia with a microcytic hypochromic picture. High-performance liquid chromatography (HPLC) was normal. However, the parents' HPLC was suggestive of beta thalassaemia trait. Whole-exome sequencing revealed Thurston syndrome with beta-thalassaemia in homozygous pattern with a novel mutation. It is a rare genetic syndrome exclusively found in the South Asian population. Due to the rarity, identification of this syndrome is often difficult and requires awareness among clinicians. However, it is important to diagnose the disorder accurately in order to provide appropriate genetic counselling and prognostication to the parents.
Collapse
Affiliation(s)
- Aswanth Ks
- Paediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Adity Bansal
- Dentistry, AIIMS Deoghar, Deoghar, Jharkhand, India
| | - Prashant Kumar Verma
- Paediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nowneet Kumar Bhat
- Paediatrics, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| |
Collapse
|
4
|
Reddy SG, Bansal A, Sailer HF, Reddy LV, Ghali GE, Upadya VH. Ocular Hypertelorism: Principles and Management. J Maxillofac Oral Surg 2023; 22:770-780. [PMID: 38105836 PMCID: PMC10719204 DOI: 10.1007/s12663-023-02057-5] [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] [Received: 10/07/2023] [Accepted: 10/20/2023] [Indexed: 12/19/2023] Open
Abstract
Background Ocular hypertelorism (OH) was initially considered as un-differentiated congenital cranio-facial deformity, however, I.T Jackson mentioned it as teleorbitism, considering it as increase in the inter-canthal width, inter-pupillary as well as inter-orbital distance as a result of lateralization of the orbital complex in total. Furthermore, Sailer further refined it and included the distance from the lateral orbital wall, i.e. he denoted increased inter-orbital distance along with the distance between lateral orbital walls as true hypertelorism. This condition is rare and is seen in association with midline congenital defects affecting the cranio-facial region. Classification and review of cases The ideal time for the OH correction is usually between 5 and 8 years of age. However, the management of OH is complex, and several techniques have been described in literature for the same. Here, we describe our classification of OH, along with the evolution of the surgical aspects, the key treatment principles we follow, together with the types of the osteotomies and their indications. Furthermore, we delineate the four main principles that we have set for OH management. Results Though the improvement in appearance is seen immediately post-surgery, however, this challenging surgery faces a multitude and common postoperative complications which have been represented in this article. The surgeon needs both the technical expertise and an inclination towards aesthetics for the execution of such procedures. Conclusion It is preferred that the management of OH should be individualized as per the stage of the craniofacial growth and the psychosocial needs of the patient and the parents.
Collapse
Affiliation(s)
- Srinivas Gosla Reddy
- GSR Institute of Cranio-Maxillofacial and Facial Plastic Surgery, Vinay Nagar Colony, I S Sadan Saidabad, Hyderabad, Telangana 500059 India
| | - Adity Bansal
- Department of Dentistry, All India Institute of Medical Sciences (AIIMS), Deoghar, Deoghar, Jharkhand 814152 India
| | | | - Likith V. Reddy
- Oral and Maxillofacial Surgery, Texas A&M University School of Dentistry, Dallas, USA
| | - Ghali E. Ghali
- Department of Oral and Maxillofacial Surgery, Willis-Knighton Health System, 2508 Bert Kouns Industrial Loop, Shreveport, LA 71118 USA
| | - Varsha Haridas Upadya
- Department of Oral and Maxillofacial Surgery, Yenepoya Dental College, Deralakatte, Mangalore, 575018 India
| |
Collapse
|
5
|
Ramsey SD, Bansal A, Li L, O'Donnell PV, Fuchs EJ, Brunstein CG, Eapen M, Thao V, Roth JA, Steuten L. Cost-Effectiveness of Unrelated Umbilical Cord Blood vs. HLA Haploidentical Related Bone Marrow Transplant: Evidence from BMT CTN 1101. Transplant Cell Ther 2023:S2666-6367(23)01257-5. [PMID: 37120135 DOI: 10.1016/j.jtct.2023.04.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 04/06/2023] [Accepted: 04/24/2023] [Indexed: 05/01/2023]
Abstract
BACKGROUND BMT CTN 1101 was a Phase III randomized controlled trial comparing reduced intensity conditioning followed by double unrelated umbilical cord blood (UCB) versus HLA-haploidentical related donor bone marrow (haplo-BM) transplantation for patients with high-risk hematologic malignancies. OBJECTIVE The objective of this study is to report the results of a parallel cost-effectiveness analysis. STUDY DESIGN Three hundred sixty-eight patients were randomized to unrelated UCB (n=186) or haplo-BM (n=182) transplant. We estimated healthcare utilization and costs using propensity score-matched BMT patients from the OptumLabsⓇ Data Warehouse for trial participants <65 years and Medicare claims for participants ≥65 years. Weibull models were used to estimate 20-year survival. EQ-5D surveys by trial participants were used estimate Quality-Adjusted Life Years (QALYs). RESULTS At 5-year follow-up, survival was 42% for haplo-BM versus 36% for UCB (P=.06). Over a 20-year time horizon, haplo-BM is expected to be more effective (+0.63 QALY) and more costly +$118,953) for persons under 65. For those over 65, haplo-BM is expected to be more effective and less costly. In one-way uncertainty analyses, for persons <65, the cost per QALY result was most sensitive to life years and health state utilities. For persons ≥65, life years were more influential than costs and health state utilities. CONCLUSION Compared to UCB, haplo-BM was moderately cost-effective for patients aged <65 years, and less costly and more effective for persons ≥65 years. Haplo-BM is a fair value choice for commercially insured patients with high-risk leukemia and lymphoma who require HCT. For Medicare enrollees, haplo-BM is a preferred choice when considering costs and outcomes.
Collapse
Affiliation(s)
- S D Ramsey
- Fred Hutchinson Cancer Center, Seattle, WA; University of Washington, Seattle, WA.
| | - A Bansal
- Fred Hutchinson Cancer Center, Seattle, WA; University of Washington, Seattle, WA
| | - L Li
- Fred Hutchinson Cancer Center, Seattle, WA
| | - P V O'Donnell
- Massachusetts General Hospital Cancer Center, Harvard Medical School, Boston, MA
| | - E J Fuchs
- Sidney Kimmel Comprehensive Cancer Center, Johns Hopkins University, Baltimore, MD
| | - C G Brunstein
- Division of Hematology, Oncology, and Transplantation, University of Minnesota, Minneapolis, MN
| | - M Eapen
- Division of Hematology/Oncology, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI
| | - V Thao
- Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Mayo Clinic, Rochester, MN; OptumLabs, Edina, MN
| | - J A Roth
- University of Washington, Seattle, WA; Pfizer, New York, NY
| | - Lmg Steuten
- Office of Health Economics, London, United Kingdom
| |
Collapse
|
6
|
Singal A, Bansal A. Googling "Anatomy dissection": Pre-pandemic, pandemic, and current scenario. Morphologie 2023:S1286-0115(23)00003-6. [PMID: 36781317 DOI: 10.1016/j.morpho.2023.01.003] [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] [Received: 11/09/2022] [Revised: 12/16/2022] [Accepted: 01/16/2023] [Indexed: 02/13/2023]
Abstract
OBJECTIVES The present study was proposed to assess if the online search behavior for Anatomy dissection was affected by actual dissection being performed in the labs. The interest in dissection was ascertained and compared between pre-pandemic, pandemic, and current times. METHODS Online web search behavior for key terms related to "Anatomy dissection" was noticed worldwide using Google Trends Tool. Relative search volume (RSV) was downloaded for these keywords worldwide using all categories, and web search settings during a period from January 1, 2018, to July 31, 2022. RESULTS There was almost a similar google trend for the first three months in years 2018 and 2020, with a slightly lower RSV in March and a noticeable RSV decrease from April onwards in 2020. During the pre-pandemic period, the peak for RSV in the month of May was noticed. These peaks were missing in 2020 and 2021. In May 2022, RSV again increased. The top five countries with the highest search hit for "Anatomy Dissection" web were the Philippines, the United States, Canada, Australia, and India. CONCLUSIONS There was lower search trend for "Anatomy dissection" during the pandemic period as compared to pre-pandemic period. The search trends may be associated with the closure of dissection labs and it may be concluded that Anatomy learners search for this term more often, if they are actually performing the dissections. The future integrated multi-country data and analysis from different set-ups about their ways of dissection and labs before and after the pandemic may further clarify.
Collapse
Affiliation(s)
- A Singal
- Department of Anatomy, All India Institute of Medical Sciences, Bathinda, Punjab, India.
| | - A Bansal
- Department of Internal Medicine, Cleveland Clinic, Cleveland, OHIO, USA
| |
Collapse
|
7
|
Gupta M, Bansal A, Chakrapani V, Jaiswal N, Kiran T. The effectiveness of prenatal and postnatal home visits by paramedical professionals and women's group meetings in improving maternal and child health outcomes in low and middle-income countries: a systematic review and meta-analysis. Public Health 2023; 215:106-117. [PMID: 36682079 DOI: 10.1016/j.puhe.2022.11.023] [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] [Received: 05/16/2022] [Revised: 11/22/2022] [Accepted: 11/29/2022] [Indexed: 01/21/2023]
Abstract
OBJECTIVE To assess the effectiveness of prenatal and postnatal home visits (HVs) and women group meetings (WGMs) by paramedical professionals to improve maternal and child health outcomes in low- and middle-income countries (LMICs). STUDY DESIGN Systematic review and meta-analysis. METHODS We conducted a systematic review of trials published till December 2020, as per registered protocol in The International Prospective Register of Systematic Reviews (PROSPERO) (CRD42018091968). Outcomes were neonatal mortality rate (NMR), maternal mortality ratio (MMR), the incidence of low birth weight, and still birth rate (SBR). The Cochrane Pregnancy and Childbirth Group's Trials Register, Cochrane Central Register of Controlled Trials, PubMed, and Excerpta Medica Database (EMBASE) were searched. Pooled results were estimated using random-effects meta-analysis in RevMan version 5.2. RESULTS Twenty-five trials met the inclusion criteria. HVs were the key intervention in 12, WGMs in 11, and both interventions in 2 trials. The pooled estimates have shown that NMR was significantly reduced by HVs (OR 0.77, confidence interval [CI]: 0.67-0.90, P = 0.0007, I2 = 77%) and WGMs (OR 0.76, CI: 0.65-0.90, P = 0.001, I2 = 71%). SBR was significantly reduced by HVs (OR 0.77, CI: 0.70-0.85; P < 0.001, I2 = 0%). Subgroup analysis of studies in which more than 10% of pregnant women participated in the WGMs showed significant reduction in NMR (OR 0.67, CI 0.58-0.77, P = 0.00001, I2 = 31%) and MMR (OR 0.55, CI 0.36-0.84, P = 0.005, I2 = 27%). Two studies reported improvement in birth weight by HVs. CONCLUSIONS HVs and WGMs (with >10% pregnant women) by paramedical professionals are effective strategies in reducing the NMR and MMR in LMICs. HVs were also effective in reducing SBR.
Collapse
Affiliation(s)
- M Gupta
- Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - A Bansal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Chakrapani
- Centre for Sexuality and Health Research and Policy (C-SHaRP), Chennai, India
| | - N Jaiswal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - T Kiran
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| |
Collapse
|
8
|
Biswas A, Vega-Guzman J, Bansal A, Kara AH, Aphane M, Yildirim Y, Alshehri HM. Solitary waves, shock waves and conservation laws with the surface tension effect in the Boussinesq equation. PEAS 2023. [DOI: 10.3176/proc.2023.1.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/10/2023]
|
9
|
Owusu-Addo E, Owusu-Addo SB, Bennor DM, Mensah-Odum N, Deliege A, Bansal A, Yoshikawa M, Odame J. Prevalence and determinants of sexual abuse among adolescent girls during the COVID-19 lockdown and school closures in Ghana: A mixed method study. Child Abuse Negl 2023; 135:105997. [PMID: 36528934 PMCID: PMC9750886 DOI: 10.1016/j.chiabu.2022.105997] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 04/19/2022] [Revised: 12/03/2022] [Accepted: 12/09/2022] [Indexed: 06/17/2023]
Abstract
BACKGROUND In the wake of the COVID-19 pandemic, concerns have been raised that the pandemic may derail global efforts against child sexual abuse (CSA). OBJECTIVES This study examines the prevalence and associated factors of sexual abuse among adolescent girls in the context of the COVID-19 pandemic in Ghana. PARTICIPANTS AND SETTING The sample comprised 853 adolescent girls aged 13-19 (16.03 ± 2.04 years) in Ghana. METHODS The study employed a concurrent mixed-method design. RESULTS Overall, the prevalence of CSA during the COVID-19 lockdown and school closures was 32.5 %. Protective factors for CSA were feeling safe in neighbourhood (AOR = 0.526, 95 % CI = [0.325, 0.850]) and parents often listen to opinions (AOR = 0.446, 95 % CI = [0.241, 0.826]). Risk factors for CSA were physical activity (AOR = 1.649, OR = 1.783, 95 % CIAOR = [1.093, 2.487, 95 % CIOR = [1.241, 2.561]), parents sometimes listen to opinions (AOR = 1.199, OR = 1.924, 95 % CIAOR = [0.504, 2.853], 95 % CIOR = [1.034, 3.582]), living with another relative (AOR = 2.352, OR = 2.484, 95 % CIAOR = [0.270, 20.523], 95 % CIOR = [0.317, 19.475]), Akan ethnicity (AOR = 1.576, OR = 1.437, 95 % CIAOR = [0.307, 8.091], 95 % CIOR = [0.316, 6.534]), having no disability (AOR = 1.099, OR = 1.138, 95 % CIAOR = [0.679, 1.581], 95 % CIOR = [0.786, 1.649]) and having a close relationship with parents (AOR = 1.334, OR = 1.752, 95 % CIAOR = [0.746, 2.385], 95 % CIOR = [1.096, 2.802]). CONCLUSION Knowledge of the risk and protective factors identified in this study can guide and inform the development of CSA prevention programmes during disruptive occurrences like school closures and lockdown.
Collapse
Affiliation(s)
- E Owusu-Addo
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana.
| | - S B Owusu-Addo
- Health Promotion Directorate, Ghana Health Service, Ashanti Region, Ghana
| | - D M Bennor
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - N Mensah-Odum
- Bureau of Integrated Rural Development, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - A Deliege
- UNICEF Ghana Country Office, Accra, Ghana
| | - A Bansal
- UNICEF Ghana Country Office, Accra, Ghana
| | | | - J Odame
- UNICEF Ghana Country Office, Accra, Ghana
| |
Collapse
|
10
|
Bansal A, Reddy SG, Chug A, Markus AF, Kuijpers-Jagtman AM. Nasal symmetry after different techniques of primary lip repair for unilateral complete cleft lip with or without cleft of the alveolus and palate: A systematic review. J Craniomaxillofac Surg 2022; 50:894-909. [PMID: 36635151 DOI: 10.1016/j.jcms.2022.12.006] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2021] [Revised: 11/08/2022] [Accepted: 12/31/2022] [Indexed: 01/06/2023] Open
Abstract
The aim of this systematic review was to establish the effect of different surgical repairs for the lip on nasal symmetry. PubMed, Scopus, Embase, Cochrane CENTRAL, and Ovid databases search was performed initially for only English-language articles, in patients with unilateral complete cleft lip with or without cleft alveolus and palate (UCCLAP) who were younger than 1 year of age and undergoing cleft lip repair, and are published from the earliest data available up to December 31, 2020. The primary outcome variable was nasal symmetry, with reported complications being secondary variables. A qualitative synthesis was provided. A total of 19,828 records were obtained, and 17 articles were selected for final review. Assessment of the risk of bias of the included randomized controlled trials (RCTs) (N-1) was done with the Cochrane Risk of Bias 2 (RoB-2) tool, and the ROBINS-I tool was used for non-randomized studies (n = 14). Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) was applied to evaluate the quality of the body of evidence. The majority of the included studies compared the triangular repair with the rotation advancement (RA) techniques, and preferred RA or its modifications. In terms of the nasal symmetry, the Fisher repair proved to be superior to the RA technique. Neither RA nor straight line repair was superior to one another. The Delaire technique may be preferred over the modified RA. Also, satisfactory outcomes were observed with simultaneous lip-nose repair. This systematic review examined a plethora of techniques, and the heterogeneity between studies was very high regarding type of surgery, method of nasal symmetry assessment, and length of follow-up, thus producing low-quality evidence; therefore, results should be interpreted with caution. Future research requires RCTs with larger sample sizes and appropriate length of follow-up, and surgeries preferably performed by a single experienced surgeon.
Collapse
Affiliation(s)
- Adity Bansal
- Department of Dentistry, All India Institute of Medical Sciences, AIIMS, Deoghar, Jharkhand, 814152, India.
| | - Srinivas Gosla Reddy
- GSR Institute of Cranio-Maxillofacial and Facial Plastic Surgery, Vinay Nagar Colony, I S Sadan, Saidabad, Hyderabad, Telangana, 500059, India.
| | - Ashi Chug
- Department of Dentistry, All India Institute of Medical Sciences, AIIMS, Rishikesh, Uttarakhand, 249203, India.
| | - Anthony F Markus
- Emeritus Consultant, Maxillofacial Surgeon, Poole Hospital, University of Bournemouth, University of Duisburg-Essen, Trinity College Dublin, India.
| | - Anne Marie Kuijpers-Jagtman
- Department of Orthodontics and Dentofacial Orthopedics, School of Dental Medicine/Medical Faculty, University of Bern, Freiburgstrasse 7, CH-3010 Bern, Switzerland; Department of Orthodontics, University Medical Center Groningen, University of Groningen, Hanzeplein 1, 9713 GZ, Groningen, the Netherlands; Faculty of Dentistry, Universitas Indonesia, Campus Salemba, Jalan Salemba Raya No.4, Jakarta, 10430, Indonesia.
| |
Collapse
|
11
|
Batra U, Nathany S, Sharma M, Bansal A, P A, Pasricha S, Mehta A, Dhandha S, Kumar D, Panigrahi M, Mattoo S. 395P Molecular landscape of Indian NSCLC: Is NGS the answer? Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.10.497] [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: 12/05/2022] Open
|
12
|
Paller A, Siegfried E, Xiao J, Prescilla R, Bansal A. EFFICACY OF DUPILUMAB IN INFANTS AND PRESCHOOLERS WITH ATOPIC DERMATITIS UP TO 1 YEAR. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.716] [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: 11/11/2022]
|
13
|
Paller A, Siegfried E, Marron S, Clark M, DiBenedetti D, Nelson L, Chao J, Bansal A, Sun Y, Chuang C, Wang Z. 147 Development and validation of a caregiver-reported numeric rating scale for measuring pruritus in children aged 6 months to <6 years with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.154] [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: 10/17/2022]
|
14
|
Paller A, Siegfried E, Marron S, Clark M, Harris N, Quin S, Chao J, Bansal A, Sun Y, Chuang C, Wang Z. 250 Development and validation of a caregiver-reported numeric rating scale for measuring skin pain in children aged 6 months to <6 years with atopic dermatitis. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.257] [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: 11/24/2022]
|
15
|
Ukirde V, Arora K, Bansal A, Gursale A. Abstract No. 595 Outcome of various endovascular procedures in management of Budd-Chiari syndrome. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.577] [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: 11/24/2022] Open
|
16
|
Batra U, Nathany S, Jose J, Sharma M, Mehta A, Bansal A. 160P LungMetrics India: Molecular epidemiology and testing patterns in 4,773 non squamous NSCLC patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.02.192] [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: 11/01/2022] Open
|
17
|
Mehra M, Nayak A, Morris A, Lanfear D, Nemeh H, Desai S, Bansal A, Guerrero-Miranda C, Hall S, Cleveland J, Goldstein D, Uriel N, Chen L, Bailey S, Anyanwu A, Heatley G, Chuang J, Estep J. Development and Validation of a Personalized Risk Score for Prediction of Patient-Specific Clinical Experiences with HeartMate 3 LVAD Implantation: An Analysis from the MOMENTUM 3 Trial Portfolio. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.050] [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: 11/30/2022] Open
|
18
|
Giraldo-Grueso M, Webre K, Bansal A, Parrino P, Bansal A. Does Patients with Higher Education Have Better Postoperative Results After LVAD Implantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.381] [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: 10/18/2022] Open
|
19
|
Giraldo-Grueso M, Tierney M, Bansal A, Webre K, Parrino P, Bansal A. Can Household Income Predict Postoperative Outcomes After LVAD Implantation? J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.383] [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
|
20
|
Giraldo-Grueso M, Desai S, Webre K, Bansal A, Parrino P, Bansal A. Does Open Chest After LVAD Surgery Affect Blood Transfusion Rates and PRA. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1232] [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: 11/24/2022] Open
|
21
|
Bansal A, Nagori SA, Chug A, Dixit A, Chowdhry R, Reddy SG. Reconstruction options in pediatric population with hemi or total mandibulectomy defects: A systematic review. J Oral Biol Craniofac Res 2022; 12:238-247. [DOI: 10.1016/j.jobcr.2022.03.001] [Citation(s) in RCA: 1] [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] [Received: 03/10/2021] [Revised: 02/23/2022] [Accepted: 03/14/2022] [Indexed: 12/24/2022] Open
|
22
|
Kunal S, Gupta M, Shah B, Palleda G, Bansal A, Batra V, Yusuf J, Mukhopadhyay S, Tyagi S. Subclinical left and right ventricular dysfunction in COVID-19 recovered patients using speckle tracking echocardiography. Eur Heart J Cardiovasc Imaging 2022. [PMCID: PMC9383410 DOI: 10.1093/ehjci/jeab289.073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Funding Acknowledgements Type of funding sources: None. Introduction Myocardial injury during acute COVID-19 infection is well characterised however, its persistence during recovery is unclear. Purpose We assessed left ventricle (LV) global longitudinal strain (GLS) and right ventricular (RV) free wall longitudinal strain and RV global longitudinal strain (RV-GLS) using speckle tracking echocardiography (STE) in COVID-19 recovered patients (30-45 days post recovery) and studied its correlation with various parameters. Methods Of the 245 subjects screened, a total of 53 subjects recovered from COVID-19 infection and normal LV ejection fraction were enrolled. Routine blood investigations, inflammatory markers (on admission) and comprehensive echocardiography including STE were done for all. Results All the 53 subjects were symptomatic during COVID-19 illness and were categorized as mild: 27 (50.9%), moderate: 20 (37.7%) and severe: 6 (11.4%) COVID-19 illness. Reduced LV GLS was reported in 22 (41.5%), reduced RV-GLS in 23 (43.4%) and reduced RVFWS in 22 (41.5%) patients respectively. LVGLS was significantly lower in patients recovered from severe illness (mild: -20.3 ± 1.7%; moderate: -15.3 ± 3.4%; severe: -10.7 ± 5.1%; P < 0.0001). Similarly, RVGLS (mild: -21.8 ± 2.8%; moderate: -16.8 ± 4.8%; severe: -9.7 ± 4.6%; P < 0.0001) and RVFWS (mild: -23.0 ± 4.1%; moderate: -18.1 ± 5.5%; severe: -9.3 ± 4.4%; P < 0.0001) were significantly lower in subjects with severe COVID-19. Subjects with reduced LVGLS as well as RVGLS and RVFWS had significantly higher interleukin-6, C-reactive protein, lactate dehydrogenase and serum ferritin levels during index admission. Conclusions Subclinical LV and RV dysfunction was seen in majority of COVID-19 recovered patients. Patients with severe disease during index admission had far lower LV and RVGLS as compared to mild and moderate cases. Our study highlights the need for close follow-up of COVID-19 recovered subjects in order to determine the long-term cardiovascular outcomes.
Collapse
Affiliation(s)
- S Kunal
- G B PANT HOSPITAL, Delhi, India
| | - M Gupta
- G B PANT HOSPITAL, Delhi, India
| | - B Shah
- G B PANT HOSPITAL, Delhi, India
| | | | | | - V Batra
- G B PANT HOSPITAL, Delhi, India
| | - J Yusuf
- G B PANT HOSPITAL, Delhi, India
| | | | - S Tyagi
- G B PANT HOSPITAL, Delhi, India
| |
Collapse
|
23
|
Bansal A, Garg P, Kandhari P, Maheshwari R, Chaturvedi S, Garg H, Singh A, Kumar A. Comparative analysis of perioperative complications in kidney transplant patients with coronary artery disease on dual antiplatelet drugs. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)01179-4] [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: 11/04/2022]
|
24
|
Verma P, Bansal A, Bhakat R, Chug A, Reddy S. A case of idiopathic hypogonadotropic hypogonadism with dental and orofacial defects: A key to the perception of possible molecular etiology. J Cleft Lip Palate Craniofac Anomal 2022. [DOI: 10.4103/jclpca.jclpca_7_22] [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: 11/04/2022] Open
|
25
|
Sharma M, Batra U, Nathany S, Bansal A, Pasricha S, Jain P, Mehta A. P51.07 Small Cell Transformation of Non Small Cell Lung Carcinoma: Tissue Biopsy Is Here to Stay! J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.544] [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: 10/20/2022]
|
26
|
Batra U, Nathany S, Sharma M, Bansal A, Jain P. P07.01 Usage Patterns of TKIs in EGFR Mutant NSCLC: Let's Get REAL. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.290] [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: 11/17/2022]
|
27
|
Reddy SG, Pandey A, Bansal A. Cleft surgery in India - Past, present and future and a model for global knowledge transfer. J Oral Biol Craniofac Res 2021; 11:558-562. [PMID: 34408966 DOI: 10.1016/j.jobcr.2021.08.003] [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] [Received: 07/01/2021] [Revised: 07/31/2021] [Accepted: 08/04/2021] [Indexed: 10/20/2022] Open
Abstract
This article represents the point of view and philosophy of GSR Institute of Craniomaxillofacial and Facial Plastic Surgery (GSRIFCS) in the management of craniofacial and cleft patients. GSRICFS is a 50 bedded state of art high volume cleft centre in Hyderabad which has accomplished greater than 30000 cleft surgeries. Cleft surgery in India has improved greatly over the last 70 years since the innovations of the Colombo plan to now, resulting in better healthcare facilities, research and transfer of knowledge globally. In this period, the deprivations of the past, due to lack of available, accessible or affordable care or awareness of outpatients and their parentage, of the possibilities, some of cultural origin such as various superstitions leading to isolation and social stigma, have been largely but not completely overcome. There were minimal centres in the past, which provided care, and this was partly due to scarcity of funding, lack of training and non-sustainability of skilled human recourses. Surgery for cleft requires not only a sophisticated infrastructure, but instrumentation, specialized anesthetists and high-end post-operative care along with a multidisciplinary team involving surgeons, anesthetists, paediatricians, psychologists, orthodontists and specialized nurses for optimal outcomes. The article elaborates the vision, mission and plan in establishing the GSRICFS and how it might form a model for the future of cleft care in LMICs.
Collapse
Affiliation(s)
- Srinivas Gosla Reddy
- GSR Institute of Cranio-Maxillofacial and Facial Plastic Surgery, Vinay Nagar Colony, I S Sadan, Saidabad, Hyderabad, Telangana, 500059, India
| | - Avani Pandey
- GSR Institute of Cranio-Maxillofacial and Facial Plastic Surgery, Vinay Nagar Colony, I S Sadan, Saidabad, Hyderabad, Telangana, 500059, India
| | - Adity Bansal
- Department of Dentistry (Cranio-maxillofacial Surgery), All India Institute of Medical Sciences (AIIMS), Rishikesh, Uttarakhand, 249203, India
| |
Collapse
|
28
|
Zhao Y, Wu L, Lu Q, Gao X, Zhu X, Yao X, Li L, Li W, Ding Y, Song Z, Liu L, Dang N, Zhang C, Liu X, Gu J, Wang J, Geng S, Liu Q, Guo Y, Dong L, Su H, Bai L, O'Malley JT, Luo J, Laws E, Mannent L, Ruddy M, Amin N, Bansal A, Ota T, Wang M, Zhang J. The efficacy and safety of dupilumab in Chinese patients with moderate-to-severe atopic dermatitis: a randomized, double-blind, placebo-controlled study. Br J Dermatol 2021; 186:633-641. [PMID: 34358343 PMCID: PMC9298048 DOI: 10.1111/bjd.20690] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [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] [Accepted: 08/05/2021] [Indexed: 11/28/2022]
Abstract
BACKGROUND Dupilumab is an antibody against interleukin 4 receptor α, used in treating atopic dermatitis (AD). OBJECTIVES To evaluate the efficacy and safety of dupilumab in adult Chinese patients with moderate-to-severe AD. METHODS In this randomized, double-blind, placebo-controlled, parallel-group, phase III study, conducted between December 2018 and February 2020, patients with AD received dupilumab (300mg) or placebo once every 2 weeks for 16 weeks, and were followed up for 12 weeks. The primary efficacy endpoint was the proportion of patients with both Investigator's Global Assessment (IGA) score of 0-1 and a reduction from baseline of ≥2 points at week 16. RESULTS Overall, 165 patients (mean age: 30.6 years; 71.5% male) were randomized: 82 to dupilumab and 83 to placebo. At week 16, 26.8% of patients in the dupilumab group and 4.8% of patients in the placebo group achieved the primary endpoint (difference, 22.0%; 95% confidence interval [CI], 11.37-32.65%; p<0.0001). Compared with placebo, higher proportions of patients in the dupilumab group achieved ≥75% reduction in the Eczema Area and Severity Index score (57.3% vs 14.5%; difference, 42.9%; 95% CI, 29.75-55.97%; p<0.0001) and had ≥3-point (52.4% vs 9.6%; difference, 42.8%; 95% CI, 30.26-55.34%; p<0.0001) and ≥4-point (39.0% vs 4.8%; difference, 34.2%; 95% CI, 22.69-45.72%; p<0.0001) reductions in weekly average daily peak daily pruritus numerical rating scale scores. The incidence of TEAEs during the treatment period was similar in the two groups. The incidence of conjunctivitis, allergic conjunctivitis, and injection site reaction was higher in the dupilumab group than in the placebo group. CONCLUSIONS In adult Chinese patients, dupilumab was effective in improving the signs and symptoms of AD and demonstrated a favorable safety profile.
Collapse
Affiliation(s)
- Y Zhao
- Peking University People's Hospital, Beijing, China
| | - L Wu
- Hangzhou First People's Hospital, Hangzhou, China
| | - Q Lu
- The Second Xiangya Hospital of Central South University, Changsha, China
| | - X Gao
- The First Hospital of China Medical University, Shenyang, China
| | - X Zhu
- Wuxi Second People's Hospital, Jiangsu, China
| | - X Yao
- Hospital for skin diseases, Institute of Dermatology, Chinese Academy of medical sciences, Nanjing, China
| | - L Li
- Beijing Friendship Hospital, Capital Medical University, Beijing, China
| | - W Li
- Huashan Hospital, Fudan University, Shanghai, China
| | - Y Ding
- Shanghai Skin Disease Hospital, Shanghai, China
| | - Z Song
- The Southwest Hospital of AMU, Chongqing, China
| | - L Liu
- Peking University First Hospital, Beijing, China
| | - N Dang
- Jinan Central Hospital, Jinan, China
| | - C Zhang
- Peking University Third Hospital, Beijing, China
| | - X Liu
- University of Hong Kong-Shenzhen Hospital, Shenzhen, China
| | - J Gu
- Changhai Hospital of Shanghai, Shanghai, China
| | - J Wang
- Ningbo No.2 Hospital, Ningbo, China
| | - S Geng
- The Second Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Q Liu
- Tianjin Medical University General Hospital, Tianjin, China
| | - Y Guo
- Xinhua Hospital Affiliated to Shanghai Jiaotong University School of Medicine, Shanghai, China
| | - L Dong
- Research & Development, Sanofi, Shanghai, China
| | - H Su
- Research & Development, Sanofi, Shanghai, China
| | - L Bai
- Research & Development, Sanofi, Shanghai, China
| | | | - J Luo
- Research & Development, Sanofi, Indianapolis, USA
| | - E Laws
- Research & Development, Sanofi, Bridgewater, USA
| | - L Mannent
- Research & Development, Sanofi, Paris, France
| | - M Ruddy
- Research & Development, Regeneron, New York, USA
| | - N Amin
- Research & Development, Regeneron, New York, USA
| | - A Bansal
- Research & Development, Regeneron, New York, USA
| | - T Ota
- Research & Development, Regeneron, New York, USA
| | - M Wang
- Medical, Sanofi China, Shanghai, China
| | - J Zhang
- Peking University People's Hospital, Beijing, China
| |
Collapse
|
29
|
Nagori SA, Bansal A, Jose A, Roychoudhury A. Comparison of outcomes with the single-puncture and double-puncture techniques of arthrocentesis of the temporomandibular joint: An updated systematic review and meta-analysis. J Oral Rehabil 2021; 48:1056-1065. [PMID: 34273184 DOI: 10.1111/joor.13228] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/04/2020] [Revised: 04/13/2021] [Accepted: 06/24/2021] [Indexed: 12/29/2022]
Abstract
OBJECTIVE To compare intra-operative and postoperative outcomes between the single-puncture and the standard double-puncture techniques of arthrocentesis. METHODS PubMed, Embase, ScienceDirect and CENTRAL databases were searched from inception up to 31st August 2020. Randomised controlled trials (RCTs), prospective and retrospective studies conducted on patients with temporomandibular joint disorders comparing any type of single-puncture arthrocentesis with standard double-puncture arthrocentesis and reporting intra-operative/postoperative outcomes were included. Assessment of the risk of bias was done with the Cochrane Collaboration risk assessment tool. RESULTS Thirteen studies were included (12 were RCTs). Analysis of a limited number of studies indicated no difference in pain or maximal mouth opening (MMO) between the single-puncture type-1 or type-2 and the double-puncture technique at various follow-up intervals. Pooled analysis (four studies) demonstrated that the single-puncture type-2 technique requires significantly less operating time as compared to the double-puncture method. No such difference was noted between single-puncture type-1 and double-puncture techniques. Analysis of two studies indicated significantly reduced intra-operative needle relocations with the single-puncture techniques. Studies were not of high quality with concerns of bias in randomisation, allocation concealment and blinding. CONCLUSIONS Limited data indicate no difference in pain or MMO with single- or double-puncture techniques of arthrocentesis. Amongst the three techniques, the single-puncture type-2 technique has the advantages of significantly lower operating time and reduced intra-operative needle relocations and it may be the preferred method of TMJ arthrocentesis in clinical practice.
Collapse
Affiliation(s)
| | - Adity Bansal
- Department of Oral and maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Anson Jose
- Department of Oral and Maxillofacial Surgery, Private practice, Kerela, India
| | - Ajoy Roychoudhury
- Department of Oral and maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
30
|
Bhatia M, Dwivedi LK, Banerjee K, Bansal A, Ranjan M, Dixit P. Pro-poor policies and improvements in maternal health outcomes in India. BMC Pregnancy Childbirth 2021; 21:389. [PMID: 34011316 PMCID: PMC8135986 DOI: 10.1186/s12884-021-03839-w] [Citation(s) in RCA: 25] [Impact Index Per Article: 8.3] [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] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Accepted: 04/28/2021] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Since 2005, India has experienced an impressive 77% reduction in maternal mortality compared to the global average of 43%. What explains this impressive performance in terms of reduction in maternal mortality and improvement in maternal health outcomes? This paper evaluates the effect of household wealth status on maternal mortality in India, and also separates out the performance of the Empowered Action Group (EAG) states and the Southern states of India. The results are discussed in the light of various pro-poor programmes and policies designed to reduce maternal mortality and the existing supply side gaps in the healthcare system of India. Using multiple sources of data, this study aims to understand the trends in maternal mortality (1997-2017) between EAG and non EAG states in India and explore various household, economic and policy factors that may explain reduction in maternal mortality and improvement in maternal health outcomes in India. METHODS This study triangulates data from different rounds of Sample Registration Systems to assess the trend in maternal mortality in India. It further analysed the National Family Health Surveys (NFHS). NFHS-4, 2015-16 has gathered information on maternal mortality and pregnancy-related deaths from 601,509 households. Using logistic regression, we estimate the association of various socio-economic variables on maternal deaths in the various states of India. RESULTS On an average, wealth status of the households did not have a statistically significant association with maternal mortality in India. However, our disaggregate analysis reveals, the gains in terms of maternal mortality have been unevenly distributed. Although the rich-poor gap in maternal mortality has reduced in EAG states such as Bihar, Odisha, Assam, Rajasthan, the maternal mortality has remained above the national average for many of these states. The EAG states also experience supply side shortfalls in terms of availability of PHC and PHC doctors; and availability of specialist doctors. CONCLUSIONS The novel contribution of the present paper is that the association of household wealth status and place of residence with maternal mortality is statistically not significant implying financial barriers to access maternal health services have been minimised. This result, and India's impressive performance with respect to maternal health outcomes, can be attributed to the various pro-poor policies and cash incentive schemes successfully launched in recent years. Community-level involvement with pivotal role played by community health workers has been one of the major reasons for the success of many ongoing policies. Policy makers need to prioritise the underperforming states and socio-economic groups within the states by addressing both demand-side and supply-side measures simultaneously mediated by contextual factors.
Collapse
Affiliation(s)
- M Bhatia
- Department of Health Policy, London School of Economics and Political Science, Houghton Street, London, WC2A 2AE, UK.
| | - L K Dwivedi
- International Institute for Population Sciences, Mumbai, India
| | - K Banerjee
- International Institute for Population Sciences, Mumbai, India
| | - A Bansal
- International Institute for Population Sciences, Mumbai, India
| | - M Ranjan
- Department of Statistics, Mizoram University, Pachhunga University College Campus, Aizawl, Mizoram, India
| | - P Dixit
- School of Health Systems Studies, Tata Institute of Social Sciences, Mumbai, India
| |
Collapse
|
31
|
Gosla Reddy S, Bansal A, Sharma N, Chug A. Modified anterior maxillary distraction using "Winged Osteotomy": A technical note. J Oral Biol Craniofac Res 2021; 11:435-437. [PMID: 34094843 DOI: 10.1016/j.jobcr.2021.05.005] [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] [Received: 02/25/2021] [Revised: 05/02/2021] [Accepted: 05/04/2021] [Indexed: 11/28/2022] Open
Abstract
Hypoplasia of the maxilla is common in cleft lip and palate (CLP) deformities. Orthognathic surgery has been the traditional method of correction in such developmental anomalies since 1970's, with Le-Fort I advancement as its long-established management modality, which results in significant speech alteration and relapse rate. In contrast, anterior maxillary distraction (AMD) has the advantage of lesser chances of relapse, velopharyngeal insufficiency, and alteration of speech. This modified AMD technique carries a handful of its advantages as it is an easier procedure compared to the Le-Fort I osteotomy as it gives positive soft tissue changes by improving the projection of the nose and the upper lip, normalizes naso-labial angle, and changes the facial prominence from concave to convex simultaneously as it gives nasolabial and sub-malar prominence post-operatively due to the extension of horizontal cuts up to to the zygomatic region, leading to lesser complications. Also, the hollowing caused by the conventional AMD osteotomy cuts is eliminated by the extension of the winged osteotomy.
Collapse
Affiliation(s)
- Srinivas Gosla Reddy
- Department of Dentistry (Cranio-maxillofacial Surgery), AIIMS Rishikesh, Uttarakhand, 249203. India
| | - Adity Bansal
- Department of Dentistry (Cranio-maxillofacial Surgery), AIIMS Rishikesh, Uttarakhand, 249203. India
| | - Nisha Sharma
- GSR Institute of Craniomaxillofacial and Facial Plastic Surgery, Vinay Nagar Colony, Saroor Nagar West, Saidabad, Saroornagar, Telangana, Hyderabad, 500059. India
| | - Ashi Chug
- Department of Dentistry (Cranio-maxillofacial Surgery), AIIMS Rishikesh, Uttarakhand, 249203. India
| |
Collapse
|
32
|
Yosipovitch G, Mollanazar N, Ständer S, Kwatra S, Luo J, Amin N, Mannent L, Laws E, Bansal A, O'Malley J. 434 The study design of two trials of dupilumab in patients with prurigo nodularis inadequately controlled with topical therapies: LIBERTY PN PRIME and PRIME 2. J Invest Dermatol 2021. [DOI: 10.1016/j.jid.2021.02.457] [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: 11/16/2022]
|
33
|
Bagchi A, Bansal A, Gupta MD, Girish MP, Tyagi S. MID TERM FOLLOW-UP OF ARCH VESSEL ANGIOPLASTY IN PATIENTS OF TAKAYASU ARTERITIS. J Am Coll Cardiol 2021. [DOI: 10.1016/s0735-1097(21)02585-7] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
|
34
|
Rashid N, Bansal A, Chug A. Intestinal-type Adenocarcinoma Presenting as a Mandibular Mass: An Unusual Presentation. Contemp Clin Dent 2021; 12:99-101. [PMID: 33967548 PMCID: PMC8092088 DOI: 10.4103/ccd.ccd_217_20] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2020] [Revised: 06/28/2020] [Accepted: 07/22/2020] [Indexed: 11/09/2022] Open
Abstract
Intestinal-type adenocarcinoma is an aggressive malignancy with the rare possibility of metastatic spread to the mandible. We represent a case of a 30-year-old female patient who reported with a chief complaint of a right mandibular mass for 4 months. Orthopantomogram X-ray observed an ill-defined lytic lesion with severe periosteal reaction. Incisional biopsy revealed “colonic variant of intestinal-type adenocarcinoma.” Expression of cytokeratin 20 and caudal type homeobox transcription factor 2 (CDX-2) markers was seen on immunohistochemistry. Biochemical markers such as serum cancer antigen 125, serum alkaline phosphatase, and serum carcinoembryonic antigen were raised. Contrast-enhanced computed tomography of the thorax and abdomen suggested cavitary lesions in the bilateral lungs, right adrenal gland, and mediastinum. Positron emission tomography revealed multiple lesions in the body, hence confirming the diagnosis. The patient was kept on palliative chemotherapy. It is concluded that prompt diagnosis and initiation of treatment increases the chances of survival in such cases.
Collapse
Affiliation(s)
- Nouman Rashid
- Department of Dentistry (Cranio-Maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, India
| | - Adity Bansal
- Department of Dentistry (Cranio-Maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, India
| | - Ashi Chug
- Department of Dentistry (Cranio-Maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, India
| |
Collapse
|
35
|
Batra U, Bansal A, Sharma M, Nathany S. P02.02 Pulmonary Rebiopsy is ‘Here to Stay’ in Non-Small Cell Lung Carcinoma (NSCLC) Patients with Progression on Tyrosine Kinase Inhibitors (TKIs). J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.01.350] [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: 10/21/2022]
|
36
|
Yadav P, Bhutia O, Bansal A, Lakshmanan S, Roychoudhury A. Does closed treatment of paediatric mandibular condyle fractures result in restitutional remodelling? Br J Oral Maxillofac Surg 2021; 59:798-806. [PMID: 34272113 DOI: 10.1016/j.bjoms.2021.01.016] [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] [Received: 10/19/2020] [Accepted: 01/30/2021] [Indexed: 11/25/2022]
Abstract
The treatment of paediatric mandibular condylar fracture (PMCF) is typically non-operative. The purpose of this study was to determine if non-operative management of PMCF results in a new condylar process of normal morphology to regenerate after closed treatment (restitutional remodelling). The specific aim of the study was to observe restitutional remodelling (RM) in PMCF and review the literature. The investigators designed and implemented a retrospective study on paediatric patients (age<12) with unilateral or bilateral condyle fractures treated with non-operative treatment between January 2005 and July 2015. Patients with complete records and at least 1-year follow-up were included in the study. Primary outcome variable was RM and secondary outcome variables were occlusion, maximal incisal opening (MIO), displacement, infection, facial asymmetry, and signs of temporomandibular joint ankylosis (TMJA). The study evaluated 41 patients {n=57 PMCF, (m:f-35:6)} of unilateral (n=25) and bilateral (n=16) PMCF. Fractured condyles remodelled to normal morphology in all the cases at follow-up. The Wilcoxon test revealed a statistically significant difference in MIO from the preoperative value to postoperative (p=0.001). Occlusion (except 1) was satisfactory in all cases, at follow-up with no gross facial asymmetry. There was no sign of infection at the surgical site (anterior mandible). None of the patients showed signs of TMJA at follow-up. The result of the present study demonstrates that RM of condylar fracture occurs with non-operative management. Non-operative management should be the point of care in PMCF, owing to the rapid RM, bone regeneration, and satisfactory outcome. Review of the literature also supports closed treatment.
Collapse
Affiliation(s)
- P Yadav
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - O Bhutia
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - A Bansal
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - S Lakshmanan
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - A Roychoudhury
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India.
| |
Collapse
|
37
|
Stenvinkel P, Painer J, Shiels PG, Bansal A, Fereidouni S, Natterson-Horowitz B, Johnson RJ, Miranda JJ. SARS-COV-2 and biomimetics: What saves the planet will save our health. J Intern Med 2021; 289:244-246. [PMID: 32583447 PMCID: PMC7361468 DOI: 10.1111/joim.13128] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/28/2020] [Accepted: 05/29/2020] [Indexed: 12/26/2022]
Affiliation(s)
- P Stenvinkel
- From the, Division of Renal Medicine, Department of Clinical Science, Intervention and Technology, Karolinska Institute, Stockholm, Sweden
| | - J Painer
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna, Austria
| | - P G Shiels
- Wolfson Wohl Cancer Research Centre, Institute of Cancer Sciences, University of Glasgow, Glasgow, UK
| | - A Bansal
- Division of Renal Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - S Fereidouni
- Department of Interdisciplinary Life Sciences, Research Institute of Wildlife Ecology, University of Veterinary Medicine, Vienna, Austria
| | - B Natterson-Horowitz
- Department of Human Evolutionary Biology, Harvard University, Cambridge, MA, USA.,Evolutionary Medicine Program, University of California, Los Angeles, CA, USA
| | - R J Johnson
- Division of Renal Diseases, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - J J Miranda
- School of Medicine, Universidad Peruana Cayetano Heredia, Lima, Peru
| |
Collapse
|
38
|
Thaduri A, Bansal A, Anthony ML, Narayan ML, Chug A, Garg PK. Brown tumor, parathyroid adenoma, and papillary thyroid cancer: A triple whammy. Oral Oncol 2021; 116:105159. [PMID: 33526354 DOI: 10.1016/j.oraloncology.2020.105159] [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: 12/10/2020] [Accepted: 12/16/2020] [Indexed: 11/24/2022]
Affiliation(s)
- Abhinav Thaduri
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, India
| | - Adity Bansal
- Department of Dentistry and Cranio-Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Manishi L Narayan
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Rishikesh, India
| | - Ashi Chug
- Department of Dentistry and Cranio-Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Pankaj Kumar Garg
- Department of Surgical Oncology, All India Institute of Medical Sciences, Rishikesh, India.
| |
Collapse
|
39
|
Babawale M, Gunavardhan A, Walker J, Corfield T, Huey P, Savage A, Bansal A, Atkinson M, Abdelsalam H, Raweily E, Christian A, Evangelou I, Thomas D, Shannon J, Youd E, Brumwell P, Harrison J, Thompson I, Rashid M, Leopold G, Finall A, Roberts S, Housa D, Nedeva P, Davies A, Fletcher D, Aslam M. Verification and Validation of Digital Pathology (Whole Slide Imaging) for Primary Histopathological Diagnosis: All Wales Experience. J Pathol Inform 2021; 12:4. [PMID: 34012708 PMCID: PMC8112347 DOI: 10.4103/jpi.jpi_55_20] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [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: 06/25/2020] [Revised: 07/03/2020] [Accepted: 10/01/2020] [Indexed: 11/04/2022] Open
Abstract
Aims: The study is aimed to verify Aperio AT2 scanner for reporting on the digital pathology platform (DP) and to validate the cohort of pathologists in the interpretation of DP for routine diagnostic histopathological services in Wales, United Kingdom. Materials, Methods and Results: This was a large multicenter study involving seven hospitals across Wales and unique with 22 (largest number) pathologists participating. 7491 slides from 3001 cases were scanned on Leica Aperio AT2 scanner and reported on digital workstations with Leica software of e-slide manager. A senior pathology fellow compared DP reports with authorized reports on glass slide (GS). A panel of expert pathologists reviewed the discrepant cases under multiheader microscope to establish ground truth. 2745 out of 3001 (91%) cases showed complete concordance between DP and GS reports. Two hundred and fifty-six cases showed discrepancies in diagnosis, of which 170 (5.6%) were deemed of no clinical significance by the review panel. There were 86 (2.9%) clinically significant discrepancies in the diagnosis between DP and GS. The concordance was raised to 97.1% after discounting clinically insignificant discrepancies. Ground truth lay with DP in 28 out of 86 clinically significant discrepancies and with GS in 58 cases. Sensitivity of DP was 98.07% (confidence interval [CI] 97.57–98.56%); for GS was 99.07% (CI 98.72–99.41%). Conclusions: We concluded that Leica Aperio AT2 scanner produces adequate quality of images for routine histopathologic diagnosis. Pathologists were able to diagnose in DP with good concordance as with GS. Strengths and Limitations of this Study: Strengths of this study – This was a prospective blind study. Different pathologists reported digital and glass arms at different times giving an ambience of real-time reporting. There was standardized use of software and hardware across Wales. A strong managerial support from efficiency through the technology group was a key factor for the implementation of the study. Limitations: This study did not include Cytopathology and in situ hybridization slides. Difficulty in achieving surgical pathology practise standardization across the whole country contributed to intra-observer variations.
Collapse
Affiliation(s)
- M Babawale
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - A Gunavardhan
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - J Walker
- Department of Anaesthetics, Gwynedd Hospital, Betsi Cadwaladr University Health Board, Bangor, Wales
| | - T Corfield
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - P Huey
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - A Savage
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - A Bansal
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - M Atkinson
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - H Abdelsalam
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - E Raweily
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - A Christian
- Department of Histopathology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, Wales
| | - I Evangelou
- Department of Histopathology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, Wales
| | - D Thomas
- Department of Histopathology, University Hospital of Wales, Cardiff and Vale University Health Board, Cardiff, Wales
| | - J Shannon
- Department of Histopathology, Royal Glamorgan Hospital, Cwm Taf University Health Board, Rhondda Cynon Taff, Wales
| | - E Youd
- Department of Histopathology, Royal Glamorgan Hospital, Cwm Taf University Health Board, Rhondda Cynon Taff, Wales
| | - P Brumwell
- Department of Histopathology, Royal Glamorgan Hospital, Cwm Taf University Health Board, Rhondda Cynon Taff, Wales
| | - J Harrison
- Department of Histopathology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales
| | - I Thompson
- Department of Histopathology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales
| | - M Rashid
- Department of Histopathology, Royal Gwent Hospital, Aneurin Bevan University Health Board, Newport, Wales
| | - G Leopold
- Department of Cellular Pathology, Morriston Hospital Swansea Bay University Health Board, Port Talbot, Wales
| | - A Finall
- Department of Cellular Pathology, Morriston Hospital Swansea Bay University Health Board, Port Talbot, Wales.,Abertawe Bro Morgannwg Health Board, Port Talbot, Wales
| | - S Roberts
- Department of Cellular Pathology, Singleton Hospital, Abertawe Bro Morgannwg Health Board, Port Talbot, Wales
| | - D Housa
- Department of Histopathology, Glangwilli Hospital, Hywel Dda University Health Board, Carmarthen, Wales
| | - P Nedeva
- Department of Histopathology, Glangwilli Hospital, Hywel Dda University Health Board, Carmarthen, Wales
| | - A Davies
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - D Fletcher
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| | - Muhammad Aslam
- Department of Cellular Pathology, Glan Clwyd Hospital, Betsi Cadwaladr University Health Board, Bodelwyddan, Wales
| |
Collapse
|
40
|
Bansal A, Yadav P, Bhutia O, Roychoudhury A, Bhalla AS. Comparison of outcome of open reduction and internal fixation versus closed treatment in pediatric mandible fractures-a retrospective study. J Craniomaxillofac Surg 2021; 49:196-205. [PMID: 33483246 DOI: 10.1016/j.jcms.2020.12.013] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2020] [Revised: 11/17/2020] [Accepted: 12/25/2020] [Indexed: 10/22/2022] Open
Abstract
The aim of the study was to compare the outcome and complications of open reduction and internal fixation (ORIF) with closed treatment, as well as to review the literature. This was a retrospective study on pediatric patients with mandible fracture. The primary objective was a comparison of outcomes in terms of bone healing, maximal incisal opening (MIO), and occlusion, and the secondary objective was to review complications. A total of 77 pediatric patients (age <12 years) were managed with closed treatment and 23 with ORIF. In all, 62 patients were found with a single fracture (22 patients with parasymphysis fracture and 21 with condyle fracture, followed by symphysis, angle, and body fracture) and 38 patients with more than one fracture, with symphysis and bilateral condyle fracture being the most common. Bone healing was observed in all the patients. Mean MIO was 26.9 ± 2.8 mm and 29.3 ± 1.7 mm in the closed and ORIF group, respectively, and the difference was statistically nonsignificant (p = 0.5). One patient (1.3%) had deranged occlusion, and mobility was observed in one patient (1.3%) in the closed treatment group. Infection and nerve paresthesia were not seen in any patient at follow-up. Although closed treatment is preferred, as it preserves the soft tissue and periosteum, a displaced mandible fracture especially with co-existing condylar fracture should be treated by ORIF.
Collapse
Affiliation(s)
- Adity Bansal
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Poonam Yadav
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ongkila Bhutia
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Ajoy Roychoudhury
- Department of Oral & Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ashu Seith Bhalla
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
| |
Collapse
|
41
|
Bansal A, Reddy GS, Chug A, Damaraju SC. Massive posterior cranial vault erosion and its reconstruction: A peculiar presentation of "mega cisterna magna". J Oral Biol Craniofac Res 2020; 11:13-16. [PMID: 33344155 DOI: 10.1016/j.jobcr.2020.11.010] [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] [Received: 09/21/2020] [Revised: 11/06/2020] [Accepted: 11/08/2020] [Indexed: 11/29/2022] Open
Abstract
Dandy-Walker (DW) complex is a rare central nervous system malformation, commonly associated with complex non-neurological conditions, defined by four variants with characteristic anatomic features, still inadequately known for its etiological aspects. "Mega Cisterna Magna" (MCM) is a type of DW complex which is represented by an enlarged posterior cranial fossa. Though reduction cranioplasty has been reported in enlarged posterior cranial fossa malformations, however we report a peculiar case of MCM with massive posterior cranial bone erosion, presenting completely asymptomatic at an age of 8 years, without any associated co-morbidities till date, nor with any evident occipital mass at birth. Survival of the child till this age is an exception in itself, but this can probably be explained by the presence of the giant defect of the posterior cranial bone, which must have acted like a vent and prevented the elevation of the ICP. Hence no symptoms were observed till date. Ventriculo-peritoneal (VP) shunting was done to drain the accumulated fluid, followed by massive cranioplasty, which was challenging and was performed with autologous cranial and fibular bone grafts, along with alloplastic titanium mesh, and thus achieving marked aesthetic improvement with satisfactory bone healing at a 3-year follow-up.
Collapse
Affiliation(s)
- Adity Bansal
- Department of Dentistry (Cranio-maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, 249203, India
| | - Gosla Srinivas Reddy
- Department of Dentistry (Cranio-maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, 249203, India
| | - Ashi Chug
- Department of Dentistry (Cranio-maxillofacial Surgery), AIIMS, Rishikesh, Uttarakhand, 249203, India
| | - Sriram Chandra Damaraju
- GSR Institute of Craniofacial Surgery, Vinaynagar Colony, Saidabad, Hyderabad, Telangana, 500059, India
| |
Collapse
|
42
|
Paller AS, Siegfried EC, Simpson EL, Cork MJ, Lockshin B, Kosloski MP, Kamal MA, Davis JD, Sun X, Pirozzi G, Graham NMH, Gadkari A, Eckert L, Ruddy M, Bansal A. A phase 2, open-label study of single-dose dupilumab in children aged 6 months to <6 years with severe uncontrolled atopic dermatitis: pharmacokinetics, safety and efficacy. J Eur Acad Dermatol Venereol 2020; 35:464-475. [PMID: 32893393 PMCID: PMC7894166 DOI: 10.1111/jdv.16928] [Citation(s) in RCA: 42] [Impact Index Per Article: 10.5] [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] [Received: 04/06/2020] [Accepted: 08/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Dupilumab has demonstrated efficacy and acceptable safety in adults and children (aged 6-17 years) with moderate-to-severe atopic dermatitis (AD), but effective systemic therapy with a favorable risk-benefit profile in younger children remains a significant unmet need. OBJECTIVES To determine the pharmacokinetics, safety and efficacy of single-dose dupilumab in children with severe AD aged ≥6 months to <6 years. METHODS This open-label, multicenter, phase 2, sequential, two-age cohort, two-dose level study (LIBERTY AD PRE-SCHOOL; NCT03346434) included an initial cohort of older children aged ≥2 to <6 years, followed by a younger cohort aged ≥6 months to <2 years. Pharmacokinetic sampling, safety monitoring and efficacy assessments were performed during the 4-week period after a single subcutaneous injection of dupilumab, in two sequential dosing groups (3 mg/kg, then 6 mg/kg). The use of standardized, low-to-medium potency topical corticosteroids was allowed. RESULTS Forty patients were enrolled (20/age cohort, 10/dose level within a cohort) between December 20, 2017 and July 22, 2019. Within each age cohort, pharmacokinetic exposures after a single injection of dupilumab increased in a greater than dose-proportional manner. At week 3, treatment with 3 and 6 mg/kg dupilumab reduced scores of mean Eczema Area and Severity Index by -44.6% and -49.7% (older cohort) and -42.7% and -38.8% (younger cohort), and mean Peak Pruritus NRS scores by -22.9% and -44.7% (older cohort) and -11.1% and -18.2% (younger cohort), respectively. At week 4, improvements in most efficacy outcomes diminished in both age groups, particularly with the lower dose. The safety profile was comparable to that seen in adults, adolescents and children. CONCLUSIONS Single-dose dupilumab was generally well tolerated and substantially reduced clinical signs/symptoms of AD. Slightly better responses were seen in older than younger children. The pharmacokinetics of dupilumab were non-linear, consistent with previous studies in adults and adolescents.
Collapse
Affiliation(s)
- A S Paller
- Northwestern University Feinberg School of Medicine, Chicago, IL, USA
| | - E C Siegfried
- Saint Louis University and Cardinal Glennon Children's Hospital, St. Louis, MO, USA
| | - E L Simpson
- Oregon Health and Science University, Portland, OR, USA
| | - M J Cork
- University of Sheffield, Sheffield, UK
| | - B Lockshin
- Georgetown University, Rockville, MD, USA
| | - M P Kosloski
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - M A Kamal
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - J D Davis
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - X Sun
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | | | - N M H Graham
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - A Gadkari
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | | | - M Ruddy
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - A Bansal
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| |
Collapse
|
43
|
Cork MJ, Thaçi D, Eichenfield LF, Arkwright PD, Sun X, Chen Z, Akinlade B, Boklage S, Guillemin I, Kosloski MP, Kamal MA, O'Malley JT, Patel N, Graham NMH, Bansal A. Dupilumab provides favourable long-term safety and efficacy in children aged ≥ 6 to < 12 years with uncontrolled severe atopic dermatitis: results from an open-label phase IIa study and subsequent phase III open-label extension study. Br J Dermatol 2020; 184:857-870. [PMID: 32969489 PMCID: PMC8247037 DOI: 10.1111/bjd.19460] [Citation(s) in RCA: 38] [Impact Index Per Article: 9.5] [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] [Accepted: 08/01/2020] [Indexed: 02/06/2023]
Abstract
Background Children aged ≥ 6 to < 12 years with severe atopic dermatitis (AD) have limited treatment options. In a 16‐week, randomized, placebo‐controlled, phase III trial in children, dupilumab, a monoclonal antibody inhibiting interleukin (IL)‐4/IL‐13 signalling, significantly improved signs and symptoms with acceptable safety; longer‐term safety and efficacy data are lacking. Objectives To report the pharmacokinetic profile and long‐term safety and efficacy of dupilumab in children (aged ≥ 6 to < 12 years) with severe AD. Methods Children (aged ≥ 6 to < 12 years) with severe AD were enrolled in a global, multicentre, phase IIa, open‐label, ascending‐dose, sequential cohort study and subsequent open‐label extension (OLE) study. Patients received single‐dose dupilumab 2 or 4 mg kg−1 followed by 8‐week pharmacokinetic sampling, then 2 or 4 mg kg−1 weekly for 4 weeks (phase IIa), followed by the same weekly regimen (OLE). Primary endpoints were dupilumab concentration–time profile and treatment‐emergent adverse events (TEAEs); secondary assessments included Eczema Area and Severity Index (EASI) and Peak Pruritus Numeric Rating Scale (PP‐NRS) score. Results Of 38 children enrolled, 37 completed phase IIa and 33 continued to the OLE. Nonlinear, target‐mediated pharmacokinetics characterized dupilumab concentrations (week 24–48 mean serum concentrations: 2 mg kg−1, 61–77 mg L−1; 4 mg kg−1, 143–181 mg L−1). TEAEs were mostly mild to moderate and transient; none led to treatment discontinuation. The most commonly reported TEAEs were nasopharyngitis (2 mg kg−1, 47%; 4 mg kg−1, 56%) and AD exacerbation (29% and 13%, respectively). Single‐dose dupilumab rapidly improved AD with further improvements through week 52. Mean EASI and PP‐NRS improved by −37%/−33% and −17%/−20% at week 2 (phase IIa) and −92%/−84% and −70%/−58% at week 52 (OLE), respectively. Conclusions These safety and efficacy results support the use of dupilumab as a continuous long‐term treatment for children aged ≥ 6 to < 12 years with severe AD. What is already known about this topic?Severe atopic dermatitis (AD) has a marked negative impact on patient quality of life and can cause financial burden owing to a lack of effective treatments. Dupilumab significantly improved signs and symptoms of AD with an acceptable safety profile in a 16‐week randomized, double‐blind, placebo‐controlled phase III study in children aged ≥ 6 to < 12 years with severe AD.
What does this study add?This study extends information on the safety, efficacy and pharmacokinetic profile of dupilumab treatment for up to 52 weeks in children aged ≥ 6 to < 12 years with severe AD. The results support the use of dupilumab as a continuous long‐term treatment for children aged ≥ 6 to < 12 years with severe AD.
Linked Comment: Sibbald. Br J Dermatol 2021; 184:792–793.
Collapse
Affiliation(s)
- M J Cork
- Sheffield Dermatology Research, Department of Infection, Immunity & Cardiovascular Disease, University of Sheffield, Sheffield, UK.,Sheffield Children's Hospital Clinical Research Facility, Sheffield, UK
| | - D Thaçi
- Institute and Comprehensive Center of Inflammation Medicine, University of Lübeck, Lübeck, Germany
| | - L F Eichenfield
- Departments of Dermatology, University of California San Diego School of Medicine, San Diego, CA, USA
| | - P D Arkwright
- Lydia Becker Institute of Immunology and Inflammation, University of Manchester, Manchester, UK
| | - X Sun
- Regeneron Pharmaceuticals, Inc., Basking Ridge, NJ, USA
| | - Z Chen
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - B Akinlade
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - S Boklage
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | | | - M P Kosloski
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - M A Kamal
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | | | | | - N M H Graham
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| | - A Bansal
- Regeneron Pharmaceuticals, Inc., Tarrytown, NY, USA
| |
Collapse
|
44
|
Rashid N, Subbiah V, Agarwal P, Kumar S, Bansal A, Neeraj, Reddy SG, Chug A. Comparison of piezosurgery and conventional rotatory technique in transalveolar extraction of mandibular third molars: A pilot study. J Oral Biol Craniofac Res 2020; 10:615-618. [PMID: 32963954 DOI: 10.1016/j.jobcr.2020.08.021] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2020] [Revised: 08/27/2020] [Accepted: 08/28/2020] [Indexed: 11/15/2022] Open
Abstract
Objectives To compare the postoperative outcomes in impacted mandibular third molar extraction using piezosurgery and conventional rotary technique; and to assess the stress levels in both the techniques by measuring salivary cortisol levels. Methods Ten patients with symmetrical impacted lower third molars were included in this split mouth pilot study. Measurements for mouth opening and swelling were taken preoperatively on the day of surgery and 1 week after surgery. Pain was evaluated using Visual Analog Scale (VAS) from first postoperative day for six consecutive days. Saliva collection for analysis of cortisol levels was done at four time intervals - before starting the procedure, immediately after the procedure, 20 min and 1 week later. The mean in two groups was compared using paired t-test/Wilcoxon signed rank test as applicable. Friedman test was used to compare multiple readings of pain and salivary cortisol. Results Reduction in mouth opening was more in rotary group than piezosurgery group but was not statistically significant (p = 0.092). Increase in facial swelling was more in the rotary group than piezosurgery group with statistically significant values (p = 0.020). Rotary group had higher values for postoperative pain as compared to piezosurgery on all the days and the difference was statistically significant on each day except second postoperative day. Salivary cortisol levels were elevated in both the groups with the mean values higher in group I (rotary) than in group II (Piezosurgery). Conclusion Extraction of impacted lower third molar results in more favourable outcome when carried out by piezosurgery technique. Further studies are needed to compare the salivary cortisol response in rotary and piezosurgery techniques.
Collapse
Affiliation(s)
- Nouman Rashid
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Vivekanandhan Subbiah
- Department of Biochemistry, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Padmanidhi Agarwal
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Shailesh Kumar
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Adity Bansal
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Neeraj
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Srinivas Gosla Reddy
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| | - Ashi Chug
- Department of Dentistry, Oral and Maxillofacial Surgery, All India Institute of Medical Sciences (AIIMS), Virbhadra Road, Rishikesh, Uttarakhand, India
| |
Collapse
|
45
|
Maheshwari R, Chaturvedi S, Desai P, Panwar P, Singh V, Bansal D, Bansal A, Kumar A. Comparison of outcomes between open and robot assisted kidney transplant in paediatric population - initial results. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33668-5] [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: 11/29/2022] Open
|
46
|
Singal A, Bansal A, Chaudhary P. Cadaverless anatomy: Darkness in the times of pandemic Covid-19. Morphologie 2020; 104:147-150. [PMID: 32518047 PMCID: PMC7254017 DOI: 10.1016/j.morpho.2020.05.003] [Citation(s) in RCA: 68] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/29/2020] [Revised: 05/15/2020] [Accepted: 05/18/2020] [Indexed: 11/11/2022]
Abstract
The pandemic Covid-19 is responsible for a major education crisis globally and has a drastic impact on medical training as well. The objective of the present study was to envision the present and future impact of Covid-19 on anatomy learning and research. The virtual education is the only mode of teaching in current scenario. Every anatomist is unlocking technology to deliver best education however understanding of the subject without dissections or other practical teaching aids like bones, specimens, embryology models, microscopic slides etc. is challenging. This approach misses the feel and human visual impacts. Potential educational disruption is felt currently and will be experienced even after the pandemic is over due to scarcity of cadavers. As the body donor may be carrier or died of Covid-19 and there is no proven screening to rule out this infection in donor, so the acceptance of body donations is not advisable for the safety of medical students and health care workers. To conclude, anatomy education is cadaverless currently due to Covid-19 lockdown and it is prophesied that after the pandemic, real cadavers will be replaced by virtual cadavers because of paucity of cadavers. Research in the field of anatomy will also be adversely affected.
Collapse
Affiliation(s)
- A Singal
- Department of Anatomy, All India institute of Medical Sciences, Bathinda (Punjab), 151001, India.
| | - A Bansal
- Department of Internal Medicine, Cleveland Clinic, Ohio, USA.
| | - P Chaudhary
- Department of Anatomy, All India institute of Medical Sciences, Bathinda (Punjab), 151001, India.
| |
Collapse
|
47
|
Zwintscher N, Tugulan C, Jacks D, Akhtar F, Bruno C, Bates M, Desai S, Parrino P, Bansal A. Programmatic Specialization and Pathway Development Improves Outcomes in Mechanical Circulatory Support. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.356] [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: 10/24/2022] Open
|
48
|
Bansal A, Akhtar F, Patel R. Ambulatory RVAD Using Dual Lumen Cannula-Single Center Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.1164] [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: 11/29/2022] Open
|
49
|
Bansal A, Akhtar F, Desai S. Post-Approval Experience with Fully Magnetically Levitated Continuous Flow Left Ventricular Assist Device- Single Center Experience. J Heart Lung Transplant 2020. [DOI: 10.1016/j.healun.2020.01.185] [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
|
50
|
INAMDAR N, Prabhahar A, Tomer S, Bansal A, Gorsi U, Arora S, Gupta K, Kohli H, Ramachandran R. SAT-016 ENDOTHELIAL DYSFUNCTION REVERSES WITH RENAL FUNCTION RECOVERY IN PATIENTS WITH DIALYSIS REQUIRING COMMUNITY-ACQUIRED AKI WITH SIRS. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.020] [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: 10/24/2022] Open
|