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Goswami B, Nanda V, Kataria S, Kataria D. Prediction of In-Hospital Mortality in Patients With Traumatic Brain Injury Using the Rotterdam and Marshall CT Scores: A Retrospective Study From Western India. Cureus 2023; 15:e41548. [PMID: 37554592 PMCID: PMC10405023 DOI: 10.7759/cureus.41548] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 07/07/2023] [Indexed: 08/10/2023] Open
Abstract
Objective Head trauma of any severity, including concussions and skull fractures, can cause a traumatic brain injury (TBI). Prognostication plays a vital role in the scenario of urgency put forth by TBI. The application of CT-based scoring systems developed by the Rotterdam CT score and Marshall classification system appears to be appropriate for the early and precise prediction of clinical outcomes in TBI patients. The present study was designed to determine the predictive value of the Rotterdam CT score and Marshall classification system for in-hospital mortality in patients with TBI. Methods All adult patients (≥ 18 years) with acute traumatic brain injury presented over a period from February 2019 to November 2022 were included. Only those patients who had undergone a plain CT scan of the brain during the initial presentation at the emergency department (ED) were considered. Patients who presented with penetrating brain injury as well as those who died on arrival or who died prior to the initial CT scan of the brain were excluded. A total of 127 patients were included in the final data analysis. Based on initial CT-scan findings, the Rotterdam CT score and Marshall classification system were calculated in order to predict in-hospital mortality. Results The study was dominated by male patients (85.8%) as compared to female patients (14.2%). The overall mortality rate was 32.3% (n = 41). The mortality rate among males and females was 30.3% (33/109) and 44.4% (8/18), respectively. As per the Glasgow Coma Scale (GCS) classification, the severity of the injury was mild in 12.6% of the study subjects, moderate in 22%, and severe in 65.4%. The mortality rate among the patients with mild severity was 12.5% (2/16), while it was 28.6% in moderate (8/28) and 37.3% (31/83) in the severe category group. The best cut-off point of the Rotterdam score for predicting mortality was >4 (as per the Youden Index), which had a sensitivity and specificity of 60.98% and 90.70%, respectively, while the cut-off point of the Marshall CT classification for predicting mortality was >3 (as per the Youden Index), which had a sensitivity of 82.93% and a specificity of 75.58%. There was only a minor difference in the area under the curve (AUC) value of the receiver operating characteristic curve (ROC) curve between the Rotterdam CT score (0.827) and the Marshall classification system (0.833). Conclusion The Rotterdam and Marshall CT scores have demonstrated significant independent prognostic value and may serve as a useful initial evaluation tool for risk stratification of in-hospital mortality among patients with TBI.
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Affiliation(s)
- Brijesh Goswami
- Department of Emergency Medicine, Apex Emergency Hospital, Ahmedabad, IND
| | - Vivek Nanda
- Department of Emergency Medicine, Kusum Dhirajlal (KD) Hospital, Ahmedabad, IND
| | | | - Deeti Kataria
- Department of Medicine, Marengo Care Institute of Medical Sciences (CIMS) Hospital, Ahmedabad, IND
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Soni A, Jadhav GK, Manocha S, Chauhan S, Goswami B, Verma M. Comparative evaluation of hypofractionated radiotherapy versus conventionally fractionated radiotherapy for patients with intermediate and high risk prostate cancer. Rep Pract Oncol Radiother 2022; 27:1001-1009. [PMID: 36632300 PMCID: PMC9826658 DOI: 10.5603/rpor.a2022.0116] [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: 09/21/2022] [Accepted: 10/28/2022] [Indexed: 12/12/2022] Open
Abstract
Background The purpose of this study was to comparatively evaluate an efficacy and toxicity profile of hypofractionated radiotherapy (67.5 Gy in 25 fractions) to conventionally fractionated radiotherapy (78 Gy in 39 fractions) in prostate cancer patients with intermediate and high-risk disease. Materials and methods From January 2015 to December 2018, 168 patients were randomized to hypofractionated radiation treatment and conventional fractionated radiation treatment schedules of volumetric modulated arc therapy (VMAT) to the prostate and seminal vesicles. All the patients also received androgen deprivation therapy (ADT) and radiation therapy started after ADT. Results The median (range) follow-up was 51 (31-63) and 53 (33-64) months in the hypofractionated and conventionally fractionated regimes, respectively. The 3-year biochemical no evidence of disease (bNED) rates were 86.9% and 73.8% in the hypofractionated and conventionally fractionated groups, respectively (p = 0.032, significant). The 3-year bNED rates in patients at a high risk [i.e., pretreatment prostate-specific antigen (PSA) > 20 ng/mL, Gleason score ≥ 8, or T ≥ 2 c], were 87.9% and 73.5% (p = 0.007, significant) in the hypofractionated and conventionally fractionated radiotherapy groups, respectively. No statistically significant difference was found for late toxicity between the two groups, with 3-year grade 2 gastrointestinal toxicity rates of 19% and 16.7% and 3-year grade 2 genitourinary toxicity rates of 15.5% and 11.9% in the hypofractionated and conventionally fractionated radiotherapy groups, respectively. Conclusion Hypofractionated schedule is superior to the conventional fractionation schedule of radiation treatment in terms of bNED in intermediate and high grade prostate cancer patients. Also, the late toxicity is found to be equivalent between the two treatment groups.
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Affiliation(s)
- Abhishek Soni
- Department of Radiation Oncology, PT Bhagwat Dayal Sharma, Rohtak, India
| | - Ganesh K Jadhav
- Department of Radiation Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - Sapna Manocha
- Department of Radiation Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - Sunil Chauhan
- Department of Radiation Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - Brijesh Goswami
- Department of Radiation Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - Monica Verma
- Department of Radiation Oncology, PT Bhagwat Dayal Sharma, Rohtak, India
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Khurana V, Goswami B, Kaushik S. W182 Association between nutritional and inflammatory biomarkers in COVID-19 patients with chronic kidney disease. Clin Chim Acta 2022. [PMCID: PMC9182873 DOI: 10.1016/j.cca.2022.04.940] [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: 11/08/2022]
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Das J, Goswami B, Goswami S, Deka K, Bora G, Das L. PO-1547 Dosimetric study of Adaptive radiotherapy (ART) for locally advanced head and neck cancer. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07998-6] [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]
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Salles G, Goswami B, Bagnardi V, Dey D, Winderlich M, Ambarkhane S, Huang D, Nowakowski GS. ESTIMATION OF LONG‐TERM SURVIVAL WITH TAFASITAMAB + LENALIDOMIDE (LEN) IN RELAPSED/REFRACTORY DIFFUSE LARGE B‐CELL LYMPHOMA (R/R DLBCL). Hematol Oncol 2021. [DOI: 10.1002/hon.90_2880] [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: 11/11/2022]
Affiliation(s)
- G Salles
- Memorial Sloan Kettering Cancer Center Department of Medicine New York USA
| | - B Goswami
- MorphoSys AG, Biostatistics and Data Management Planegg Germany
| | - V Bagnardi
- University of Milan‐Bicocca Department of Statistics and Quantitative Methods Milan Italy
| | - D Dey
- MorphoSys AG, Biostatistics and Data Management Planegg Germany
| | - M Winderlich
- MorphoSys AG, Biostatistics and Data Management Planegg Germany
| | - S Ambarkhane
- MorphoSys AG Clinical Development Planegg Germany
| | - D Huang
- MorphoSys AG, Biostatistics and Data Management Planegg Germany
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Yadav S, Singh OP, Choudhary S, Saroj DK, Yogi V, Goswami B. Estimation and comparison of integral dose to target and organs at risk in three-dimensional computed tomography image-based treatment planning of carcinoma uterine cervix with two high-dose-rate brachytherapy sources: 60Co and 192Ir. J Cancer Res Ther 2021; 17:191-197. [PMID: 33723154 DOI: 10.4103/jcrt.jcrt_199_19] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [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: 11/04/2022]
Abstract
Background Iridium-192 (192Ir) has been a widely accepted radioisotope for high-dose-rate (HDR) brachytherapy. Recently, Cobalt-60 (60Co) radioisotope with a longer half-life (5.26 years) has been gaining popularity due to economic and logistical reasons as compared with the traditional 192Ir. Aim This study aimed to evaluate and compare the integral dose (ID) to the target and organs at risk (OARs) with two HDR brachytherapy sources in brachytherapy treatment of carcinoma uterine cervix to find appropriate HDR radioisotopes for clinical benefit. Materials and Methods This is a retrospective analysis of 52 computed tomography image-based brachytherapy plans of 52 patients who have received intracavitary treatment with 192Ir HDR source. For each patient plan, one additional set of plan was created using 60Co source in place of 192Ir source keeping the same dwell position, and again dose was optimized. The volume and mean dose for target, OARs, and volume structures of 400%, 200%, 150%, 100%, and 50% were recorded for the estimation and comparison of ID. Results The mean ID to high-risk clinical target volume was significantly higher by 5.84% in 60Co plan than that in 192Ir plan. For OARs, the mean ID to the rectum was significantly higher by 2.60% in 60Co plan as compared to 192Ir plan, whereas for bladder and sigmoid colon, it was lower in 60Co plan than that in 192Ir plan. The mean ID of central dose volume structures of 400%, 200%, 150%, 100%, and 50% was higher by 12.97%, 9.77%, 8.16%, 6.10%, and 3.22%, respectively, in 60Co plan than that of 192Ir plan. Conclusion The results of our study concluded that 192Ir HDR radioisotope should be preferred for intracavitary brachytherapy due to its ideal physical characteristics for better clinical outcomes.
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Affiliation(s)
- Suresh Yadav
- Department of Radiotherapy, Gandhi Medical College, Bhopal; Department of Physics, Rabindranath Tagore University, Raisen, Madhya Pradesh, India
| | - O P Singh
- Department of Radiotherapy, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - S Choudhary
- Department of Physics, Rabindranath Tagore University, Raisen, Madhya Pradesh, India
| | - Dinesh Kumar Saroj
- Department of Radiotherapy, Chirayu Medical College and Hospital, Bhopal, India
| | - Veenita Yogi
- Department of Radiotherapy, Gandhi Medical College, Bhopal, Madhya Pradesh, India
| | - Brijesh Goswami
- Department of Radiotherapy, Indraprastha Apollo Hospital, New Delhi, India
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Goswami B, Yadav S, Jain RK, Goswami P. Volumetric Modulated Arc Therapy for Head and Neck Cancer: A Dosimetric and Treatment Planning Comparison with Intensity Modulated Radiotherapy Techniques. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/47503.14661] [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: 11/24/2022]
Abstract
Introduction: Traditional Intensity Modulated Radiotherapy (IMRT) techniques used many beam angles; the result of this is significant increase in beam on time as well as Monitor Units (MU) also. Due to all of these there is a need of faster treatment modality to increase the patient comfort and lesser organ movement. Aim: To compare the triple arc RapidArc technique with nine field IMRT techniques for different head and neck cancer, focusing on target coverage and dose received by the Organs At Risk (OARs). Materials and Methods: Retrospectively, Computed Tomography (CT) datasets of 20 patients of Squamous Cell Carcinoma (SCC) of the Oro-pharynx and Hypo-pharynx treated during January 2019 to December 2019 were chosen for this study. For every patient, two different treatment plans were created, one by using the triple arc RapidArc technique and others by using nine fixed fields IMRT technique. For Planning Target Volume (PTV), the dose volume parameters D98% and D2% (dose received by the 98%, and 2% of the volume), homogeneity index, and Conformity Index (CI) were evaluated for dosimetric comparison. For OARs, the analysis included the mean dose, the maximum dose expressed as D2%. Additionally, the Beam On Time (BOT) and the number of MUs were analysed. A paired two-tailed t-test was performed to compare the RapidArc technique with the IMRT technique for radiotherapy treatment of different head and neck cancers. The p-value <0.05 was considered for the significance of statistical inferences. Results: Comparable target coverage and better sparing of OARs were achieved with the RapidArc technique in comparison to IMRT. Homogeneity and conformity were also in favour of the RapidArc plan. The dosimetric results with I’MatriXX measurements of RapidArc plans were similar to IMRT plans. All detector points passed 3 mm and 3% gamma criteria for IMRT plans and also for RapidArc plans. Conclusion: RapidArc is a faster and precise treatment technique. RapidArc provides better target coverage with good OARs sparing. Most significant change occurs in the number of MUs and treatment time, which is much lesser in RapidArc.
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Yadav S, Yogi V, Chandel S, Singh O, Goswami B, Ghosh G, Choudhary S. Dosimetric comparison of two type's applicator geometry in the three-dimensional computed tomography image-based intracavitary brachytherapy treatment planning of carcinoma uterine cervix. J Radiat Cancer Res 2021. [DOI: 10.4103/jrcr.jrcr_71_20] [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
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Goswami B, Jain RK, Yadav S, Kumar S, Oommen S, Manocha S, Jadhav GK. A Dosimetric Study of Volumetric Arc Modulation with RapidArc Versus Intensity-modulated Radiotherapy inCervical Cancer Patients. J Clin Diagn Res 2021. [DOI: 10.7860/jcdr/2021/48635.14863] [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: 11/24/2022]
Abstract
Introduction: The method of radiotherapy has moved away from two-dimensional and three-dimensional conformal radiotherapy towards Volumetric-Modulated Arc Therapy (VMAT) for advanced carcinomas. VMAT treatments often result in significant clinical advantage, particularly when concave dose distributions are required as is often the situation since these tumours are in close proximity to several critical structures. Aim:To investigate the potential clinical role of volumetric arc therapy on cervical cancer patients and its comparison with fixed-field Intensity-Modulated Radiotherapy (IMRT) was used as a benchmark. Materials and Methods: Retrospectively, radiotherapy treatment plans of fifteen cervical cancer patients were selected for this study. These patients were previously treated with sliding window IMRT techniques during January 2020 to November 2020. For dosimetric comparison of sliding window IMRT techniques with RapidArc, a new set of plans were created using VMAT/RapidArc technique. For each patient two plans were generated and in this way total 30 plans were analysed. The prescription dose to Planning Target Volume (PTV) was 50.4 Gy in 28 fractions (1.8Gy/fraction) for the 6 MV photon beam. Comparison of each plan done on the basis of Organs At Risk (OARs) sparing, coverage index (C), Conformity Index (CI), Homogeneity Index (HI), dose Gradient Index (GI), and Unified Dosimetry Index (UDI). This study utilised UDI scoring for evaluation and comparison of RapidArc and IMRT plans. Treatment Time (TT) for patient comfort and the number of Monitor Units (MUs) for long-term side-effects was also taken into consideration. A paired two-tailed t-test was executed for the dosimetric study of volumetric arc modulation with RapidArc and its comparison with the IMRT technique in the radiotherapy treatment of cervical cancer patients. All the collected data was analysed using Statistical Package for Social Sciences (SPSS) version 20.0. The (p-value<0.05) was contemplated for the level of statistical significance. Results: Comparable target coverage and better sparing of OARs were achieved with the RapidArc technique in comparison to IMRT. As was evident with results of present study, the values of CI (1.55±0.07), HI (1.07±0.07), GI (0.98±0.01) and UDI (1.25±0.11) of RapidArc technique showed significant difference from respective values of IMRT Technique (1.67±0.06, 1.10±0.06, 0.96±0.01 and 1.38±0.13). Values of MUs (1560.47±52.16) and treatment time (3.71±0.73 mins) were significantlly high in IMRT technique as compared to RapidArc technique (542.33±51.09 and 2.39±0.35 mins respectively). Conclusion: From this study, it is clear that a similar planning goal can be achieved by RapidArc in comparison to fixed-field IMRT with less normal organ toxicity. RapidArc is a faster and precise treatment technique. The most significant change comes to see in the number of MUs and TT, which is much lesser in RapidArc.
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Jain R, Kumar S, Goswami B, Chakraborty R, Singh M, Kumar A. Effects of He–Ne laser on etching parameters of lexan (polycarbonate) plastic track detector irradiated with fission fragments. RADIAT MEAS 2020. [DOI: 10.1016/j.radmeas.2020.106442] [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: 10/23/2022]
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Singh M, Krishnan R, Goswami B, Choudhury AD, Swapna P, Vellore R, Prajeesh AG, Sandeep N, Venkataraman C, Donner RV, Marwan N, Kurths J. Fingerprint of volcanic forcing on the ENSO-Indian monsoon coupling. Sci Adv 2020; 6:6/38/eaba8164. [PMID: 32948581 PMCID: PMC7500933 DOI: 10.1126/sciadv.aba8164] [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] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/08/2020] [Accepted: 07/31/2020] [Indexed: 06/11/2023]
Abstract
Coupling of the El Niño-Southern Oscillation (ENSO) and Indian monsoon (IM) is central to seasonal summer monsoon rainfall predictions over the Indian subcontinent, although a nonstationary relationship between the two nonlinear phenomena can limit seasonal predictability. Radiative effects of volcanic aerosols injected into the stratosphere during large volcanic eruptions (LVEs) tend to alter ENSO evolution; however, their impact on ENSO-IM coupling remains unclear. Here, we investigate how LVEs influence the nonlinear behavior of the ENSO and IM dynamical systems using historical data, 25 paleoclimate reconstructions, last-millennium climate simulations, large-ensemble targeted climate sensitivity experiments, and advanced analysis techniques. Our findings show that LVEs promote a significantly enhanced phase-synchronization of the ENSO and IM oscillations, due to an increase in the angular frequency of ENSO. The results also shed innovative insights into the physical mechanism underlying the LVE-induced enhancement of ENSO-IM coupling and strengthen the prospects for improved seasonal monsoon predictions.
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Affiliation(s)
- M Singh
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
- IDP in Climate Studies, Indian Institute of Technology, Bombay, India
| | - R Krishnan
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India.
| | - B Goswami
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Cluster of Excellence "Machine Learning in Science", University of Tübingen, Tübingen, Germany
| | - A D Choudhury
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - P Swapna
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - R Vellore
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - A G Prajeesh
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - N Sandeep
- Centre for Climate Change Research, Indian Institute of Tropical Meteorology, Ministry of Earth Sciences, Pune, India
| | - C Venkataraman
- IDP in Climate Studies, Indian Institute of Technology, Bombay, India
| | - R V Donner
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Magdeburg-Stendal University of Applied Sciences, Magdeburg, Germany
| | - N Marwan
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
| | - J Kurths
- Potsdam Institute for Climate Impact Research, Potsdam, Germany
- Lobachevsky State University Nizhny Novgorod, Nizhny Novgorod, Russia
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Roy M, Goswami B, Goswami S, Jadhav A, Agarwal S. Dosimetric plan evaluation of hypofractionated 3-dimensional conformal radiotherapy (3DCRT) and 2-dimensional (2D) simulator planning in whole breast irradiation after breast conserving surgery. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy427.009] [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: 11/14/2022] Open
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Santoro A, Su WC, Navarro A, Simonelli M, Yang JH, Ardizzoni A, Barlesi F, Kang J, Didominick S, Abdelhady A, Goswami B, Crystal A, Felip E. Dose-determination results from a phase Ib/II study of ceritinib (CER) + ribociclib (RIB) in ALK-positive (ALK+) non-small cell lung cancer (NSCLC). Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.015] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [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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Goswami B, Narang P, Mishra PS, Narang R, Narang U, Mendiratta DK. Drug susceptibility of rapid and slow growing non-tuberculous mycobacteria isolated from symptomatics for pulmonary tuberculosis, Central India. Indian J Med Microbiol 2016; 34:442-447. [DOI: 10.4103/0255-0857.195375] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Ayalasomayajula S, Han Y, Langenickel T, Malcolm K, Zhou W, Hanna I, Alexander N, Natrillo A, Goswami B, Hinder M, Sunkara G. In vitro and clinical evaluation of OATP-mediated drug interaction potential of sacubitril/valsartan (LCZ696). J Clin Pharm Ther 2016; 41:424-31. [PMID: 27321165 DOI: 10.1111/jcpt.12408] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.4] [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: 01/27/2016] [Accepted: 05/17/2016] [Indexed: 12/29/2022]
Abstract
WHAT IS KNOWN AND OBJECTIVE Sacubitril/valsartan (LCZ696) has been recently approved for the treatment of heart failure (HF) patients with reduced ejection fraction. Several HF patients receive statins as co-medication. METHODS Because clearance of statins is meditated via OATP1B1/1B3, the inhibition potential of these transporters by LCZ696 analytes was evaluated in vitro. Furthermore, an open-label, fixed-sequence clinical study was conducted to determine the effect of LCZ696 on the exposure of simvastatin and its active metabolite simvastatin acid. In this clinical study, 26 healthy subjects received simvastatin 40 mg alone or in combination with LCZ696 or after 1 or 2 h of LCZ696 dosing. RESULTS AND DISCUSSION Although no significant inhibition by LBQ657 (an active metabolite of sacubitril) and valsartan was observed, sacubitril inhibited OATP1B1 and OATP1B3 in vitro, with IC50 of 1·91 and 3·81 μm, respectively. Upon co-administration of simvastatin with LCZ696, the Cmax of simvastatin and simvastatin acid decreased by 7% and 13%, respectively. When administered 1 h after LCZ696 dosing, the corresponding Cmax of simvastatin and simvastatin acid decreased by 16% and 4%, respectively. When administered 2 h after LCZ696 dosing, the Cmax of simvastatin decreased by 33% and that of simvastatin acid increased by 16%. However, no notable changes were observed in the AUCs of simvastatin or simvastatin acid upon co-administration or time-separated administration with LCZ696. No notable impact of simvastatin co-administration was observed on the pharmacokinetics of LCZ696 analytes. LCZ696 and simvastatin were generally well tolerated when administered alone or in combination. WHAT IS NEW AND CONCLUSIONS Overall, the results of this study suggest that although sacubitril inhibited OATP1B1 and OATP1B3 in vitro, it does not translate into any clinically relevant in vivo effect.
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Affiliation(s)
- S Ayalasomayajula
- Translational Medicine, Drug Metabolism and Pharmacokintinetics, NIBR, East Hanover, NJ, USA
| | - Y Han
- Translational Medicine, Drug Metabolism and Pharmacokinetics, NIBR, Shanghai, China
| | - T Langenickel
- Translational Medicine, Clinical Pharmacology and Profiling, NIBR, Basel, Switzerland
| | - K Malcolm
- CS&I, Novartis Institutes for Biomedical Research, Cambridge, MA, USA
| | - W Zhou
- Translational Medicine, Drug Metabolism and Pharmacokintinetics, NIBR, East Hanover, NJ, USA
| | - I Hanna
- Translational Medicine, Drug Metabolism and Pharmacokintinetics, NIBR, East Hanover, NJ, USA
| | - N Alexander
- Translational Medicine, Drug Metabolism and Pharmacokintinetics, NIBR, East Hanover, NJ, USA
| | - A Natrillo
- Translational Medicine, Drug Metabolism and Pharmacokintinetics, NIBR, East Hanover, NJ, USA
| | - B Goswami
- Biostatistical Sciences, Novartis Healthcare Private Limited, Hyderabad, India
| | - M Hinder
- Translational Medicine, Clinical Pharmacology and Profiling, NIBR, Basel, Switzerland
| | - G Sunkara
- Translational Medicine, Drug Metabolism and Pharmacokintinetics, NIBR, East Hanover, NJ, USA
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Bandyopadhyay A, Dalui R, Pal S, Bhattacharjee I, Goswami B, Roy AS. Pulmonary function in young females of Kolkata, India - Revisited. Physiol Int 2016. [PMID: 28639867 DOI: 10.1556/036.103.2016.2.6] [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: 11/19/2022]
Abstract
Rapid economic and industrial growths imposed significant impact on human health including the pulmonary health. Questions were raised regarding the validity of the existing prediction norms of pulmonary function tests (PFTs) in a particular population. The present study was conducted to investigate the applicability of the existing norms for PFTs in young healthy non-smoking female university students of Kolkata, India. Significant difference was noted in vital capacity (VC), forced vital capacity (FVC), and forced expiratory volume in 1 s (FEV1) when the present data were compared with the earlier study in similar population. Correlation statistic revealed significant relationship of age and body height with all the PFT parameters. Body mass had significant correlation with VC, FVC, FEV1 as a percentage of FVC (FEV1%), and peak expiratory flow rate (PEFR). Regression equations have been computed for predicting PFTs from age and body height. There has been a change of PFTs in the studied population for the last couple of decades due to increased environmental pollution in the course of economical and industrial developments. Regression equations computed in this study are not only recommended to predict PFT parameters in the studied population, but they are also considered more reliable owing to their substantially smaller standard error of estimate than those proposed in the previous study.
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Affiliation(s)
- A Bandyopadhyay
- Sports and Exercise Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology , Kolkata, India
| | - R Dalui
- Sports and Exercise Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology , Kolkata, India
| | - S Pal
- Sports and Exercise Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology , Kolkata, India
| | - I Bhattacharjee
- Sports and Exercise Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology , Kolkata, India
| | - B Goswami
- Sports and Exercise Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology , Kolkata, India
| | - A S Roy
- Sports and Exercise Physiology Laboratory, Department of Physiology, University of Calcutta, University College of Science and Technology , Kolkata, India
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Tayal D, Goswami B, Tyagi S, Chaudhary M, Mallika V. Interaction between dyslipidaemia, oxidative stress and inflammatory response in patients with angiographically proven coronary artery disease. Cardiovasc J Afr 2016; 23:23-7. [PMID: 22331247 PMCID: PMC3721930 DOI: 10.5830/cvja-2010-092] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/10/2010] [Accepted: 09/07/2010] [Indexed: 11/06/2022] Open
Abstract
INTRODUCTION Coronary artery disease (CAD) is emerging as the biggest killer of the 21st century. A number of theories have been postulated to explain the aetiology of atherosclerosis. The present study attempts to elucidate the interaction, if any, between inflammation, oxidative stress and dyslipidaemia in CAD. METHODS A total of 753 patients undergoing angiography were evaluated and 476 were included in the study. The parameters studied included complete lipid profile, and apolipoprotein B, ferritin and nitric oxide (NO) levels. Statistical analysis was carried out to determine the interrelationship between these parameters and the best predictor of CAD risk. Cut-off points were determined from the receiver operating characteristics curves, and the specificity, sensitivity, positive predictive value, negative predictive value, odds ratio and confidence intervals were calculated. RESULTS The levels of the parameters studied increased with the stenotic state and a positive correlation was observed between ferritin, NO and apolipoprotein B. NO emerged as the most reliable predictor of CAD, with an area under the curve of 0.992 and sensitivity and specificity of 97 and 98%, respectively. CONCLUSION Environmental and genetic risk factors for CAD interact in a highly complex manner to initiate the atherosclerotic process. These risk factors should be considered mutually inclusive, not exclusive when devising pharmacological interventions, as multi-factorial risk management is the cornerstone of CAD management.
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Affiliation(s)
- D Tayal
- Department of Biochemistry, GB Pant Hospital, New Delhi, India
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Abd. Rahni AA, Lewis E, Guy MJ, Goswami B, Wells K. A Particle Filter Approach to Respiratory Motion Estimation in Nuclear Medicine Imaging. IEEE Trans Nucl Sci 2011; 58:2276-2285. [DOI: 10.1109/tns.2011.2162158] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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Goswami B, Rajappa M, Singh B, Kumar S, Mallika V. 529 COMPARISON OF THE VARIOUS LIPID RATIOS AND INDICES FOR RISK ASSESSMENT IN PATIENTS OF MYOCARDIAL INFARCTION. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70530-x] [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]
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Goswami B, Tayal D, Tyagi S, Mallika V. 422 ASSESSMENT OF INSULIN RESISTANCE, DYSLIPIDEMIA, OXIDATIVE STRESS AND INFLAMMATORY RESPONSE IN MALE PATIENTS WITH ANGIOGRAPHICALLY PROVEN CORONARY ARTERY DISEASE. ATHEROSCLEROSIS SUPP 2011. [DOI: 10.1016/s1567-5688(11)70423-8] [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: 10/18/2022]
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Goswami B, Tayal D, Tyagi S, Mallika V. Assessment of insulin resistance, dyslipidemia and inflammatory response in North Indian male patients with angiographically proven coronary artery disease. Minerva Cardioangiol 2011; 59:139-147. [PMID: 21242950] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
AIM Coronary artery disease (CAD) is a leading cause of morbidity and mortality in the developed world and is rapidly assuming epidemic proportions in developing countries, including India. Extensive research has proven the role of multiple etiologies such as dyslipidemia, inflammation, endothelial dysfunction and insulin resistance in the pathogenesis of CAD. The following study was undertaken to determine a possible inter-relationship between insulin resistance, inflammation and dyslipidemia, which are important risk factors for CAD in the atherosclerosis-prone north Indian male population. METHODS The present study was conducted in 100 patients of myocardial infarction diagnosed on electrocardiographic and biochemical criteria, who subsequently underwent coronary angiography and 100 age matched healthy controls. The parameters that were evaluated include lipid profile, hsCRP, apolipoprotein B, insulin levels and HOMA-IR. RESULTS Significantly higher serum levels of cholesterol, triglycerides, LDL and apolipoprotein B was observed in the patients as compared to the controls. On further classification, the dyslipidemia was marked in the patients with triple vessel disease as compared to single and double vessel disease. Similar pattern was observed for insulin resistance and CRP. Upon plotting the ROC curves, hsCRP emerged as the strongest predictor for CAD followed by apolipoprotein B. A significantly positive correlation was discerned between apolipoprotein B, CRP and HOMA-IR. CONCLUSION The present study illustrates interplay between insulin resistance, inflammation and dyslipidemia in the CAD prone north Indian population. It also highlights the superiority of hs CRP in risk stratification of patients with angiographically proven CAD.
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Affiliation(s)
- B Goswami
- Department of Biochemistry, Lady Hardinge Medical College, New Delhi, India -
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Rahni AAA, Lewis E, Guy MJ, Goswami B, Wells K. Performance evaluation of a particle filter framework for respiratory motion estimation in Nuclear Medicine imaging. IEEE Nuclear Science Symposuim & Medical Imaging Conference 2010. [DOI: 10.1109/nssmic.2010.5874276] [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: 09/02/2023]
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Abstract
The effect of thyroid status on insulin sensitivity is of great interest but despite various studies there is conflicting data on this subject. The study group comprised of 25 female subjects each with subclinical hypothyroidism, overt hypothyroidism and euthyroid controls. Serum samples of all the patients were assayed for thyroid profile, Insulin and lipid profile. Homeostasis model of assessment (HOMA-IR) was employed to assess the level of insulin resistance. Patients with hypothyroidism demonstrated insulin resistance and dyslipidemia as observed by the higher HOMA-IR and cholesterol and triglyceride levels respectively as compared to the controls. A significantly positive correlation between TSH and HOMA-IR level was also observed in the hypothyroidism group. Thyroid dysfunction leads to alterations in glucose and lipid metabolism which is an important risk factor for cardiovascular diseases. The dyslipidemia and insulin resistance should be managed aggressively to reduce the impending risk.
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Affiliation(s)
- Bhawna M Singh
- Department of Biochemistry, G B Pant Hospital, New Delhi, India ; Department of Biochemistry, G B Pant Hospital, Room No 418, New Delhi, 110002 India
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Das M, Ghosh R, Goswami B, Chandra AK, Balasubramanian R, Luksch P, Gupta A. Multi-loop networked process control: a synchronized approach. ISA Trans 2009; 48:122-131. [PMID: 19028386 DOI: 10.1016/j.isatra.2008.10.004] [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] [Subscribe] [Scholar Register] [Received: 05/03/2008] [Revised: 08/27/2008] [Accepted: 10/03/2008] [Indexed: 05/27/2023]
Abstract
Modern day process control uses digital controllers which are based on the principle of distributed rather than centralized control. Distributing controllers, sensors and actuators across a plant entails considerable wiring which can be reduced substantially by integrating the components of a control loop over a network. The other advantages include greater flexibility and higher reliability with lower hardware redundancy. The controllers and sensors are on a network and can take over the function of a failed component automatically, without the need of manual reconfiguration, thus eliminating the need of having a redundant component for each and every component. Though elaborate techniques have been developed for Single Input Single Output (SISO) systems, the major challenge lies in extending these ideas to control a practical process plant where de-centralized control is actually achieved through control of individual SISO control loops derived through de-coupling of the original system. Multiple loops increase network load and hence the sampling times associated with the control loops and makes synchronization difficult. This paper presents a methodology by which network based process control can be applied to practical process plants, with a simple direct synchronization mechanism.
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Affiliation(s)
- M Das
- Power Engineering Department, Jadavpur University, Kolkata, India
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Goswami B, Christmas W, Kittler J. Robust Statistical Estimation Applied to Automatic Lip Segmentation. Pattern Recognition and Image Analysis 2009. [DOI: 10.1007/978-3-642-02172-5_27] [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: 10/20/2022]
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Goswami B, Rajappa M, Sharma M, Sharma A. Inflammation: its role and interplay in the development of cancer, with special focus on gynecological malignancies. Int J Gynecol Cancer 2007; 18:591-9. [PMID: 17944921 DOI: 10.1111/j.1525-1438.2007.01089.x] [Citation(s) in RCA: 56] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
The relationship between inflammation and cancer is intriguing. Mechanisms contributing to the pathobiology of carcinogenesis are multiple and complex. Many aspects still elude researchers and are subjects of intense speculation and debate, for example, the triggering factor for malignant transformation in inflammation. A comprehensive literature search was conducted from the Web sites of the National Library of Medicine and Pubmed Central, the US National Library of Medicine's digital archive of life sciences literature. The data were accessed from books and journals that published recent articles in this field. Several recent studies have identified nuclear factor-kappa B as a key modulator in driving inflammation to cancers. An inflammatory microenvironment inhabiting various inflammatory cells and a network of signaling molecules is essential for the malignant progression of transformed cells. This is attributed to the mutagenic predisposition of persistent infection-fighting agents at sites of chronic inflammation. The appreciation of the role of inflammation in carcinogenesis provides a mechanistic framework to understand clinical benefits of newer therapeutic strategies An in-depth knowledge about various pathogenic mechanisms involved in cancer will help clinicians in better management of the disease.
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Affiliation(s)
- B Goswami
- Department of Biochemistry, Maulana Azad Medical College, New Delhi, India
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Das M, Banerjee A, Ghosh R, Goswami B, Balasubramanian R, Chandra AK, Gupta A. A study on multivariable process control using message passing across embedded controllers. ISA Trans 2007; 46:247-53. [PMID: 17368639 DOI: 10.1016/j.isatra.2006.08.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2006] [Accepted: 08/09/2006] [Indexed: 05/14/2023]
Abstract
Multivariable process control forms an important part of modern day control. While hardwired controllers still constitute the basic component of such control systems, with reducing communication latencies, controllers on the network are being mooted as a viable alternative. These controllers promise a large number of advantages in terms of reduction in wiring and greater flexibility in implementing supervisory control systems. In this paper, a study is presented which shows that UDP (User Datagram Protocol) can actually be used for real-time multivariable process control. Latency reduction algorithms used in high performance message passing systems have been used.
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Affiliation(s)
- M Das
- Department of Power Engg., Jadavpur Univ., India.
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Santwani PM, Vachhani JH, Jessalpara K, Goswami B. Malignant pericardial effusion and cutaneous metastasis - an initial presentation of adenocarcinoma of lung. J Cytol 2007. [DOI: 10.4103/0970-9371.41896] [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
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Goswami B, Basu SK, Mitra TK. Mapping of phase response properties of monopolar ECG voltages. Int J Biomed Comput 1995; 38:3-7. [PMID: 7705911 DOI: 10.1016/0020-7101(94)01027-x] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
In the present investigation an attempt has been made to study the phase response properties of monopolar chest lead ECG voltages. Using a generator model of the heart an equivalent circuit of ECG network has been developed. The equivalent impedance between WCT and probe electrode has been determined by reduction techniques. From this equivalent impedance the phaser characteristics of monopolar ECG voltages have been analysed for change in probe electrode locations. The source of the generated voltage, i.e., the heart, will develop a different voltage for its different condition. There will also be a change in impedances. Thus for the normal subject the distribution of the phaser of the ECG voltages will be different from that of the abnormal one. A software tool has been developed to evaluate the relative phase response of ECG voltages. The data acquisition of monopolar ECG records of chest leads V1 to V6 from chart recorder has been done with the help of AutoCAD application package. The harmonic constituents of ECG voltages have been evaluated at each harmonic plane and the phase characteristics have been studied in polar coordinate for normal subjects as well as for a typical case. An interesting result has been observed in typical cases which are indicated in the paper.
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Affiliation(s)
- B Goswami
- Department of Applied Physics, University College of Technology, University of Calcutta, India
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Goswami B, Mitra M, Nag B, Mitra TK. The polar phase response property of monopolar ECG voltages using a Computer-Aided Design and Drafting (CAD)-based data acquisition system. Int J Biomed Comput 1993; 33:209-17. [PMID: 8307653 DOI: 10.1016/0020-7101(93)90036-6] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/29/2023]
Abstract
The present paper discusses a Computer-Aided Design and Drafting (CAD) based data acquisition and polar phase response study of the ECG. The scalar ECG does not show vector properties although such properties are embedded in it. In the present paper the polar phase response property of monopolar chest lead (V1 to V6) ECG voltages has been studied. A software tool has been used to evaluate the relative phase response of ECG voltages. The data acquisition of monopolar ECG records of chest leads V1 to V6 from the chart recorder has been done with the help of the AutoCAD application package. The spin harmonic constituents of ECG voltages are evaluated at each harmonic plane and the polar phase responses are studied at each plane. Some interesting results have been observed in some typical cases which are discussed in the paper.
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Affiliation(s)
- B Goswami
- Department of Applied Physics, University College of Science and Technology, University of Calcutta, India
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Goswami B, Goswami BK, Kahali B, Ghosh SN. A study on caesarean section in a rural hospital. J Indian Med Assoc 1985; 83:404-6. [PMID: 3836259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
Two cases of middle aortic syndrome in children are described along with two other cases reported earlier. In childhood, this disease may present as incipient or overt cardiac failure. Surgical treatment should be undertaken based on an objective assessment of the severity of the stricture and after taking into account the future growth of the child.
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Abstract
This is the case of an Indian woman who was hospitalized after a diagnosis of chronic inversion of the uterus with a vesicovaginal fistula. She suffered from urinary incontinence for 40 years, the condition having developed following a difficult labor. Ultimately, she proved to have a complete inversion of the bladder through a vesicovaginal fistula.
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Gupta S, Goswami B, Sarkar S, Saha PK. Congenital and acquired coarctation of aorta. J Indian Med Assoc 1978; 70:148-51. [PMID: 690456] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
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