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Nayak MK, Sahoo B, Mahajan A, Naik S, Deep (Bag) N, Mishra B, Dash C. Reverse Y stenting in the management of vertebrobasilar junction fenestrated aneurysm: A novel technique. J Neurosci Rural Pract 2024; 15:126-129. [PMID: 38476428 PMCID: PMC10927056 DOI: 10.25259/jnrp_423_2023] [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] [Received: 07/31/2023] [Accepted: 10/07/2023] [Indexed: 03/14/2024] Open
Abstract
Fenestrated aneurysm at vertebrobasilar junction (VBJ) is very rare and can occur due to non-fusion of longitudinal neural axis forming basilar artery in the early stage of embryonic life. Due to defects in tunica media and weakness in its wall, these fenestrations are more likely to develop an aneurysm. Various treatment strategies are required for the management of these types of aneurysms including simple coiling, stent-assisted coiling, balloon remodeling technique, and more recently kissing flow diverters. Herein, we report the case of ruptured fenestrated VBJ aneurysm which was managed successfully with novel reverse Y stenting with coiling.
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Affiliation(s)
- Manoj Kumar Nayak
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswajit Sahoo
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Anshu Mahajan
- Department of Interventional Neuroradiology, Medanta The Medicity, Gurgaon, Haryana, India
| | - Suprava Naik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Nerbadyswari Deep (Bag)
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
| | - Biswamohan Mishra
- Department of Neurology, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmaya Dash
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, Odisha, India
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Dash C, Chandra PS. Unstable Vertebral Spine Metastasis - Does the Time to Refer Matter? Neurol India 2023; 71:872-874. [PMID: 37929419 DOI: 10.4103/0028-3886.388119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2023]
Affiliation(s)
- Chinmaya Dash
- Department of Neurosurgery, AIIMS, Bhubaneswar, Odisha, India
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Dash C, Moorthy S, Garg K, Sawarkar D, Singh PK, Kaur K, Suri V, Kumar A, Gurjar H, Borkar S, Chandra PS, Kale SS. Intraventricular Pilocytic Astrocytoma: A Single Centre Experience. Neurol India 2022; 70:1468-1474. [PMID: 36076645 DOI: 10.4103/0028-3886.355185] [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: 11/04/2022]
Abstract
Background Intraventricular pilocytic astrocytomas are a rare occurrence, accounting for approximately 4% -15.6% of all pilocytic astrocytomas .The aim of the study was to describe the radiology, surgical management and outcome in 15 patients with histopathologically proven intraventricular pilocytic astrocytoma(IVPA). Objective To study the clinical presentation radiology and operative challenges in rare intra ventricular pilocytic astrocytomas. Materials and Methods Between January 2010 and August 2018, 15 patients with histopathologically proven IVPA were identified. The radiological images were obtained from PACS. Patient and surgical details were obtained from the computerized discharge summary, OT records and operative notes, whereas follow up was obtained from the record section. Results Headache with progressive loss of vision was the most common presentation. Duration of symptoms varied from 4 months to 2 years (mean 9. 88 months). Except one patient, all patients with preoperative CT scan revealed calcifications in the lesion, with extensive calcification in 3 patients. All the tumors were predominantly hypointense on T1WI and iso to hyperintense on T2WI. Lesion in all patients showed heterogenous contrast enhancement on post gadolinium images. Mean blood loss in the series was 1969 ml (range 250 ml- 4500 ml).There was one death in this series due to meningitis and septic shock. Conclusion IVPAs are rare tumors and are difficult to diagnose in the preoperative period based on the radiologic profile alone. These tumors can be extremely vascular with potential for massive blood loss. These tumors can be associated with extensive calcification and the calcified tumors have less bleeding as expected.
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Affiliation(s)
| | | | | | | | | | - Kavneet Kaur
- Department of Pathology, AIIMS, New Delhi, India
| | - Vaishali Suri
- Department of NeuroPathology, AIIMS, New Delhi, India
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Jha S, Purkait S, Dash C, Lalsangzuala C. Choroid Plexus Carcinoma with Hyaline Globules: An Uncommon Histological Finding. Fetal Pediatr Pathol 2022; 41:464-467. [PMID: 32969735 DOI: 10.1080/15513815.2020.1822966] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Background: Choroid plexus carcinoma (CPC) is a predominately pediatric CNS tumor with a variety of histologic features, with hyaline globules only reported once previously. Case report: A two-year-old male child presented with headaches, vomiting, and lower limb weakness. Radiological examination revealed a right temporoparietal intra-axial tumor. On histology, it showed features of CPC containing multiple eosinophilic intracytoplasmic and extracellular hyaline globular structures, which were PAS-positive, diastase resistant, and immunoreactive for alpha-fetoprotein (AFP). Conclusion: CPC can occasionally show AFP immune-positive hyaline globules.
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Affiliation(s)
- Shilpy Jha
- Pathology and Lab Medicine, AIIMS, Bhubaneswar, India
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Dash C, Dasukil S, Boyina KK, Panda R, Ahmad SR. A novel prefabricated patient-specific titanium cranioplasty: reconsideration from a traditional approach. Oral Maxillofac Surg 2021; 26:223-228. [PMID: 34159502 DOI: 10.1007/s10006-021-00977-5] [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: 02/01/2021] [Accepted: 05/27/2021] [Indexed: 10/21/2022]
Abstract
OBJECTIVE Patient-specific implants (PSI) for cranioplasty are expensive, and cost remains the limiting factor in low- to middle-income countries. The authors describe a novel, reproducible and cost-effective method of designing prefabricated titanium PSI cranioplasty. METHODS Ten patients from June 2018 to December 2020 were included in this retrospective study. A three-dimensional stereolithography model was made on a custom-built 3D printer with variable layer heights to produce efficient and accurate details. A certain amount of defect in the temporal region was left uncovered to avoid complications related to temporalis muscle dissection. The stereolithography model with a cranial defect was reconstructed with modelling wax. The wax model was scanned with a blue light visible scanner. The digital data was transferred to the milling machine (Jayon Surgical®, Kerala, India), where a 1-mm-thick sheet of titanium was milled according to the specifications. RFCC scoring system was used for assessing cosmetic outcome. RESULTS The mean duration of the surgery was 56.50 min, SD = 14.916 min (range 45-75 min). In 9/10 patients, the RFCC score was 4 points. No other complications were found at a minimum follow-up of 18 months in all patients. The cost per patient was approximately 30,000 INR or 400 US dollars. The average time required for us to get the PSI ready for surgery was about 15 days. CONCLUSION The authors demonstrate a novel, cost-effective and reproducible method of PSI using titanium for cranioplasty.
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Affiliation(s)
- Chinmaya Dash
- Department of Trauma and Emergency (Neurosurgery), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Saubhik Dasukil
- Department of Dentistry (Oral and Maxillofacial Surgery), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Kiran Kumar Boyina
- Department of Trauma and Emergency (Oral and Maxillofacial Surgery), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India.
| | - Ritesh Panda
- Department of Trauma and Emergency (Burns and Plastic Surgery), All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
| | - Suma Rabab Ahmad
- Department of Anesthesiology, All India Institute of Medical Sciences (AIIMS), Bhubaneswar, India
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Sharma A, Sable MN, Singla R, Dash C, Sahu RN. Lateral Ventricle Atypical Teratoid/Rhabdoid Tumor (AT/RT): Case Report and Review of Literature. Neurol India 2021; 68:1465-1468. [PMID: 33342894 DOI: 10.4103/0028-3886.304127] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
A 4-year-old male child presented with features of raised intracranial pressure due to tumor in the left lateral ventricle with shunt blockage. Ventriculoperitoneal shunt was done earlier (one month ago). Craniotomy and gross total excision of the tumor was achieved. Histopathological examination was suggestive of Atypical Teratoid/Rhabdoid tumor. Patient relatives were not compliant with the advice for adjuvant therapy and patient expired after three months of definitive surgery due to aggressive course of the disease. To the best of our knowledge only six cases of AT/RT of the lateral ventricle in pediatric population has been described in literature. The tumor may mimic radiologically with benign pathology and can have an aggressive course with poor outcome. Differential diagnosis of AT/RT must be kept in cases of lateral ventricle tumor in pediatric population.
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Affiliation(s)
- Arunav Sharma
- Department of Neurosurgery, AIIMS, Bhubaneswar, Odisha, India
| | - Mukund N Sable
- Department of Pathology, AIIMS, Bhubaneswar, Odisha, India
| | | | - Chinmaya Dash
- Department of Neurosurgery, AIIMS, Bhubaneswar, Odisha, India
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Dash C, Mohakud S, Satapathy A, Sahu RN. Simulation in Endovascular Neurosurgery Using Skull Bone: A Novel Concept. Neurol India 2021; 68:1479-1480. [PMID: 33342898 DOI: 10.4103/0028-3886.304130] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Chinmaya Dash
- Division of Neurosurgery, Department of Trauma and Emergency, AIIMS, Bhubaneswar, Odisha, India
| | | | - Ayusman Satapathy
- Division of Neurosurgery, Department of Trauma and Emergency, AIIMS, Bhubaneswar, Odisha, India
| | - Rabi N Sahu
- Division of Neurosurgery, Department of Trauma and Emergency, AIIMS, Bhubaneswar, Odisha, India
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Goyal N, Venkataram T, Dash C, Chandra PP. Letter to the Editor Regarding "Impact of COVID-19 on Neurosurgical Training in Southeast Asia". World Neurosurg 2021; 146:424-426. [PMID: 33607746 PMCID: PMC7884233 DOI: 10.1016/j.wneu.2020.10.043] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/01/2020] [Accepted: 10/07/2020] [Indexed: 12/23/2022]
Affiliation(s)
- Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India.
| | - Tejas Venkataram
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneshwar, India
| | - P Prarthana Chandra
- Department of Neurosurgery, Hamdard Institute of Medical Sciences & Research, New Delhi, India
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Tandon V, Raheja A, Mishra S, Garg K, Dash C, Borkar SA, Wellington J, Chaurasia B, Fontanella MM, Suri A, Chandra PS, Kale SS. Trends in Neurosurgical Teleconsultation Services Across the Globe During COVID-19 Pandemic. World Neurosurg 2021; 150:e645-e656. [PMID: 33757889 DOI: 10.1016/j.wneu.2021.03.070] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2021] [Revised: 03/14/2021] [Accepted: 03/15/2021] [Indexed: 10/21/2022]
Abstract
BACKGROUND Global use of telemedicine has increased rapidly during the coronavirus disease 2019 (COVID-19) pandemic to bridge the gap in existing health care services. Intercontinental trends in neurosurgeons' perception and practices of telemedicine have been sparingly reported. METHODS We conducted an online anonymized and validated survey using a structured questionnaire to gain insight into neurosurgeons' experience with telemedicine across various continents and rated its usefulness on a 5-point Likert scale. RESULTS We received 286 responses across 5 continents. There was a trend to support a major paradigm shift favoring teleconsultations during the COVID-19 pandemic in respondents from North America (P = 0.06). Signed prescriptions were e-mailed along with video-based teleconsultations preferentially in Europe and North America. In comparison, audio- or text-based teleconsultations along with unsigned prescriptions were prevalent in Asia and Africa (P = 0.0005). Acceptability and perceived usefulness for telemedicine during the pandemic were similar across the globe, regardless of neurosurgeons' experience (mean satisfaction score 3.72 ± 1.09; P = 0.62). A majority of neurosurgeons from Asia and South America complained of difficulties during teleconsultations owing to lack of appropriate infrastructure, internet connectivity/prescription-related issues, and potential risk of litigation (P = 0.0005). Approximately 46% of neurosurgeons, predominantly from Europe and North America, thought that telemedicine could play a vital role in clinical practice even after the COVID-19 pandemic subsides (mean satisfaction score 3.26 ± 1.16; P = 0.007). CONCLUSIONS Telemedicine in neurosurgery is a viable alternative to physical outpatient services during the COVID-19 pandemic and could potentially play a vital role after the pandemic.
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Affiliation(s)
- Vivek Tandon
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashwat Mishra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India.
| | - Chinmaya Dash
- Division of Neurosurgery, Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhubaneswar, India
| | - Sachin A Borkar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Jack Wellington
- School of Medicine, Cardiff University, Cardiff, United Kingdom
| | | | - Marco M Fontanella
- Unit of Neurosurgery, Department of Surgical Specialties, Radiological Sciences and Public Health, University of Brescia, Brescia, Italy
| | - Ashish Suri
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - P Sarat Chandra
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Shashank S Kale
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Dash C, Dutta D, Nandan M. Intra Cranial Hemorrhage as a Sequalae of Snakebite: A Stroke Mimicker. Neurol India 2021; 69:1886-1887. [DOI: 10.4103/0028-3886.333453] [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]
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Dash C, Venkataram T, Goyal N, Chaturvedi J, Raheja A, Singla R, Sardhara J, Gupta R. Neurosurgery training in India during the COVID-19 pandemic: straight from the horse's mouth. Neurosurg Focus 2020; 49:E16. [PMID: 33260120 DOI: 10.3171/2020.9.focus20537] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [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: 06/04/2020] [Accepted: 09/24/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE The COVID-19 pandemic has forced medical professionals throughout the world to adapt to the changing medical scenario. The objective of this survey was to assess the change in neurosurgical training in India following the COVID-19 pandemic. METHODS Between May 7, 2020, and May 16, 2020, a validated questionnaire was circulated among neurosurgical residents across India by social media, regarding changes in the department's functioning, patient interaction, surgical exposure, changes in academics, and fears and apprehensions associated with the pandemic. The responses were kept anonymous and were analyzed for changes during the COVID-19 pandemic compared to before the pandemic. RESULTS A total of 118 residents from 29 neurosurgical training programs across 17 states/union territories of the country gave their responses to the survey questionnaire. The survey revealed that the surgical exposure of neurosurgical residents has drastically reduced since the onset of the COVID-19 pandemic, from an average of 39.86 surgeries performed/assisted per month (median 30) to 12.31 per month (median 10), representing a decrease of 67.50%. The number of academic sessions has fallen from a median of 5 per week to 2 per week. The survey uncovered the lack of universal guidelines and homogeneity regarding preoperative COVID-19 testing. The survey also reveals reluctance toward detailed patient examinations since the COVID-19 outbreak. The majority of respondents felt that the COVID-19 pandemic will hamper their operative and clinical skills. Fear of rescheduling or deferring of licensing examinations was significantly higher among those closest to the examination (p = 0.002). CONCLUSIONS The adverse impact of the pandemic on neurosurgical training needs to be addressed. While ensuring the safety of the residents, institutes and neurosurgical societies/bodies must take it upon themselves to ensure that their residents continue to learn and develop neurosurgical skills during these difficult times.
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Affiliation(s)
- Chinmaya Dash
- 1Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneshwar, Orissa
| | - Tejas Venkataram
- 2Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
| | - Nishant Goyal
- 2Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
| | - Jitender Chaturvedi
- 2Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand
| | - Amol Raheja
- 3Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
| | - Raghav Singla
- 4Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh
| | - Jayesh Sardhara
- 5Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow; and
| | - Ravi Gupta
- 6Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Goyal N, Venkataram T, Dash C, Chandra PP. Letter to the Editor Regarding: 'Impact of COVID-19 on an Academic Neurosurgery Department: The Johns Hopkins Experience'. World Neurosurg 2020; 143:599-600. [PMID: 33167131 PMCID: PMC10016375 DOI: 10.1016/j.wneu.2020.07.216] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 01/16/2023]
Affiliation(s)
- Nishant Goyal
- All India Institute of Medical Sciences, Rishikesh, India.
| | | | - Chinmaya Dash
- All India Institute of Medical Sciences, Bhubaneshwar, India
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Garg K, Sharma R, Raheja A, Tandon V, Katiyar V, Dash C, Bhatnagar R, Khullar MK, Raju B, Nanda A, Kale SS. Perceptions of Indian neurosurgeons about medicolegal issues and malpractice suits. Neurosurg Focus 2020; 49:E10. [PMID: 33130628 DOI: 10.3171/2020.8.focus20592] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 06/30/2020] [Accepted: 08/19/2020] [Indexed: 11/06/2022]
Abstract
OBJECTIVE Despite the rising trend of medicolegal challenges in India, there is an absolute dearth of literature from India on this issue. The authors conducted a survey, to their knowledge a first of its kind, to assess the perceptions of Indian neurosurgeons about the medicolegal challenges faced in everyday practice. METHODS An anonymous online survey performed using Google Forms was widely circulated among neurosurgeons practicing in India via email and social media platforms. The questionnaire consisted of 38 questions covering the various aspects of medicolegal issues involved in neurosurgery practice. RESULTS A total of 221 survey responses were received, out of which 214 responses were included in the final analysis, barring 7 responders who had no work experience in India. The respondents were categorized according to their working arrangements and work experience. Out of all of the respondents, 20 (9.3%) had ≥ 1 malpractice suits filed against them. More than 90% of the respondents believed that malpractice suits are on the rise in India. Almost half of the respondents believed the advent of teleconsultation is further compounding the risk of malpractice suits, and 66.4% of respondents felt that they were inadequately trained during residency to deal with medicolegal issues. Most respondents (88.8%) felt that neurosurgeons working in the government sector had lesser chances of facing litigations in comparison to those working in the private sector. The practice of obtaining video proof of consent was more commonly reported by respondents working in freelancing and private settings (45.1%) and those with multiple affiliations (61.3%) compared to respondents practicing in government settings (22.8%) (p < 0.001). Neurosurgeons working in the private sector were more likely to alter management and refer sick patients to higher-volume treatment centers to avoid malpractice suits than their government counterparts (p = 0.043 and 0.006, respectively). The practices pertaining to legal preparedness were also found to be significantly higher among the respondents from the private sector (p < 0.001). CONCLUSIONS This survey highlights the apprehensions of neurosurgeons in India with regard to rising malpractice suits and the subsequent increase of defensive neurosurgical practices, especially in the private sector. A stronger legal framework for providing for quick redress of patient complaints, while deterring frivolous malpractice suits, can go a long way to allay these fears. There is a dire need for systematic training of neurosurgeons regarding legal preparedness, which should begin during residency.
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Affiliation(s)
- Kanwaljeet Garg
- 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
| | - Ravi Sharma
- 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
| | - Amol Raheja
- 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
| | - Vivek Tandon
- 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
| | - Varidh Katiyar
- 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
| | - Chinmaya Dash
- 2Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneswar
| | - Rishi Bhatnagar
- 3Naveen Law Firm, Advocates Supreme Court of India, New Delhi, India
| | | | - Bharath Raju
- 4Department of Neurosurgery, Rutgers New Jersey Medical School, Newark; and
| | - Anil Nanda
- 4Department of Neurosurgery, Rutgers New Jersey Medical School, Newark; and.,5Robert Wood Johnson Medical School, New Brunswick, New Jersey
| | - Shashank S Kale
- 1Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi
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Goyal N, Narula H, Chaturvedi J, Agrawal S, Dash C, Meena S, Kaistha N. Angio-invasive Cerebral Aspergillosis Resulting in Hemispheric Infarct in an Immunocompetent Man. Med Mycol J 2020; 61:49-53. [PMID: 32863328 DOI: 10.3314/mmj.20-00005] [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: 11/05/2022]
Abstract
BACKGROUND Cerebral aspergillosis usually affects immunocompromised hosts and may rarely occur in immunocompetent individuals. Due to its angio-invasive nature, Aspergillus may cause various vascular complications, particularly mycotic aneurysms and infarcts. CASE PRESENTATION A 22-year-old immunocompetent male with diagnosed case of sino-cerebral aspergillosis was taking voriconazole for two months. His headache worsened and repeat imaging showed an increase in the size of the lesion. The patient was managed with right frontal craniotomy and surgical debridement, and voriconazole was continued. After ten days of uneventful post-operative course, the patient developed left-sided hemispheric infarct. The patient is doing well at nine months' follow-up, and he is off voriconazole for three months after the follow-up imaging showed complete resolution of disease. CONCLUSION Treatment of choice for cerebral aspergillosis is voriconazole. Surgical debridement may be a useful adjunct in patients not responding to voriconazole alone.
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Affiliation(s)
- Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences
| | - Himanshu Narula
- Department of Microbiology, All India Institute of Medical Sciences
| | | | - Sanjay Agrawal
- Department of Anesthesia, All India Institute of Medical Sciences
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences
| | - Suneeta Meena
- Department of Microbiology, All India Institute of Medical Sciences
| | - Neelam Kaistha
- Department of Microbiology, All India Institute of Medical Sciences
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Venkataram T, Goyal N, Dash C, Chandra PP, Chaturvedi J, Raheja A, Singla R, Sardhara J, Singh B, Gupta R. Impact of the COVID-19 Pandemic on Neurosurgical Practice in India: Results of an Anonymized National Survey. Neurol India 2020; 68:595-602. [PMID: 32643671 DOI: 10.4103/0028-3886.289004] [Citation(s) in RCA: 26] [Impact Index Per Article: 6.5] [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 The COVID-19 pandemic has created an unprecedented challenge for medical professionals throughout the world to tackle the rapidly changing scenario. The objective of this survey was to analyze the change in neurosurgical practice in India following the COVID-19 outbreak and assess its impact on practising neurosurgeons. Materials and Methods Between May 7th and 23rd, 2020, a validated questionnaire was circulated amongst practising neurosurgeons across the country by social media and e-mails, regarding changes in the patterns of patients seen, adaptations made in their practice, effect on surgeries performed, financial burden, and impact on their personal lives. The responses were kept anonymous and were analyzed for correlations between the changes observed and independent factors such as hospital affiliations, teaching professions, and neurosurgical experience. Results Our survey showed a drastic fall in the number of neurosurgical patients seen in the outpatient department (OPD) as well as the number of surgeries performed. A drop of 76.25% was seen in OPD patients (P = 0.000) and that of 70.59% in surgeries performed (P = 0.000). There was no uniformity among the neurosurgeons in the number of COVID-19 tests being done before elective/emergency surgery and in the use of protective gear while examining patients. Private practitioners were more affected financially as compared to those in the government sector. The pandemic has affected the research work of 53.23% of all respondents, with those in the teaching profession (70.96%) more affected than those in the non-teaching profession (24.67%). Conclusions Evidence-based policies, screening COVID-19 tests with better sensitivity, and better-quality personal protective equipment kits in adequate numbers are required to protect our medical professionals from COVID-19. Mental health issues among neurosurgeons may also be an issue, this being a high risk speciality and should be closely watched for.
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Affiliation(s)
- Tejas Venkataram
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Nishant Goyal
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, Bhubaneshwar, Orissa, India
| | - Prarthana P Chandra
- Department of Neurosurgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Jitender Chaturvedi
- Department of Neurosurgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amol Raheja
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Raghav Singla
- Department of Neurosurgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Jayesh Sardhara
- Department of Neurosurgery, Sanjay Gandhi Post Graduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - Bhoopendra Singh
- Department of Neurosurgery, Hamdard Institute of Medical Sciences and Research, New Delhi, India
| | - Ravi Gupta
- Department of Psychiatry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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Dash C, Satapathy A, Bansal S, Sahu RN. Neurotrauma at the All India Institute of Medical Sciences Bhubaneswar: An Overview. IJNT 2020. [DOI: 10.1055/s-0039-3402822] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Background The All India Institute of Medical Sciences (AIIMS) Bhubaneswar was established as an Institution of National Importance through the All India Institute of Medical Sciences (Amendment) Ordinance passed on July 16, 2012. It is estimated that road traffic accidents lead to economic loss to the tune of approximately 3% of gross domestic product. Centers of excellence for neurotrauma are the need of the hour, and the Indian Government is focusing on preventive and curative aspects of road traffic accidents to a great extent in the recent years. In this article, we would like to highlight the resources (manpower, infrastructure, etc.) available for neurotrauma, challenges ahead, and vision for the future.
Trauma Audit A retrospective analysis of all the admitted patients of traumatic brain injury (TBI) was performed from November 2018 to October 2019. A total of 149 patients were admitted during this period. Of the 149 admitted patients, 88 had mild TBI, 39 had moderate TBI, and 22 had severe TBI. The mortality was highest in patients with severe TBI, with 45.45% mortality. A total of 29 patients with traumatic spine injury were admitted during this period. Of the 29 patients, 10 had cervical spine injury, 10 had dorsal spine injury, and 9 had lumbar spine injury. Of all these patients, two patients with cervical spine injury died of refractory shock.
Perceived Limitations and Challenges Lack of dedicated round-the-clock emergency operating rooms (ORs) for neurosurgical procedures, adequate number of intensive care unit (ICU) beds, various gadgets in the ICU for neurocritical care, lack of rehabilitation facilities/center, lack of various OR gadgets, and lack of manpower, especially trained nursing staff, are the limitations perceived by us.
Vision for the Future A trauma block has been approved, and work on it has begun. This shall greatly help in upgrading facilities for neurotrauma at AIIMS, Bhubaneswar.
Conclusion Facilities for neurotrauma at AIIMS Bhubaneswar are gradually being upgraded. With a core team, the services are improving gradually. However, the institution is in its early years, and a lot more needs to be done in terms of manpower, gadgets, and infrastructure to further improve neurotrauma care at AIIMS, Bhubaneswar. This article may help in formulating guidelines for strengthening neurotrauma facilities in AIIMS, Bhubaneswar and all the new AIIMS established in India.
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Affiliation(s)
- Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Ayusman Satapathy
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Sumit Bansal
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
| | - Rabi Narayan Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Orissa, India
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Tentu A, Singh S, Singh S, Singh N, Dash C, Singh V, Laxmivandana R, Warrier R. Association of metabolic syndrome in obstructive sleep apnea patients: An experience from zonal tertiary care hospital in Eastern India. Indian J Respir Care 2020. [DOI: 10.4103/ijrc.ijrc_36_19] [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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Garg K, Sharma R, Dash C, Agrawal D, Sharma BS. Spinal Intradural Extramedullary Ependymoma with Intracranial Metastasis and Leptomeningeal Spread: A Case Report and Comprehensive Review of Literature. Neurol India 2019; 67:1352-1357. [PMID: 31744975 DOI: 10.4103/0028-3886.271269] [Citation(s) in RCA: 4] [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] [Indexed: 11/04/2022]
Abstract
Dorsolumbar intradural extramedullary ependymoma is a rare entity. Spinal metastases in patients with intracranial ependymoma are well described, but it is extremely rare for a spinal ependymoma to metastasize to brain. We describe a case of aggressive dorsolumbar intradural extramedullary ependymoma mimicking arachnoid cyst radiologically, which developed intracranial metastasis.
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Affiliation(s)
- Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ravi Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Deepak Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Bhawani S Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Dash C. Cervicothoracic Junction Fractures Management: An Overview of Literature. IJNT 2019. [DOI: 10.1055/s-0039-1700621] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
AbstractThe cervicothoracic junction (CTJ) is a unique area of spine and is the junction between the mobile lordotic cervical spine and the rigid kyphotic thoracic spine. It extends from C6 through T4. The fractures of the CTJ are uncommon and not well known. The article focuses on biomechanics of cervicothoracic region, management strategies of fractures of cervicothoracic region, and reviews pertinent literature.
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Affiliation(s)
- Chinmaya Dash
- Department of Neurosurgery (T&E), All India Institute of Medical Sciences, Bhubaneswar, Bhubaneswar, Odisha, India
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Chahal A, Malla S, Dash C, Gupta D, Gamanagatti S. Erratum: Pull-Type Radiologically Inserted Gastrostomy: An Improvised Technique Using a Frugal Innovation. J Clin Interv Radiol ISVIR 2019. [DOI: 10.1055/s-0039-1688684] [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: 10/27/2022] Open
Affiliation(s)
- Anurag Chahal
- Department of Radiology, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Sundeep Malla
- Department of Radiology, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Chinmaya Dash
- Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Deepak Gupta
- Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Shivanand Gamanagatti
- Department of Radiology, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
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Satapathy A, Dash C, Sharma A, Sahu RN. Free-Hand Pedicle Screw Insertion of Thoracic Spine Using Fennell Technique: Initial Results and Review of Literature. IJNT 2019. [DOI: 10.1055/s-0039-1700605] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Aim of the Study This article aims to study the safety and feasibility of Fennell technique of free-hand pedicle screw insertion in thoracic spine.
Methods Consecutive 10 patients in whom 40 thoracic pedicle screw were inserted using Fennell’s technique were included in the study. Postoperative computed tomography scan was done in all the patients. Breach in individual pedicle was analyzed using Gertzbein classification.
Results A total of 40 screws were placed in the thoracic spine in 10 patients by free-hand technique described by Fennell et al. Out of 40 pedicle screws, 26 were placed at the D10 to D12 level, 8 screws were placed at the D7 to D9 level, and 6 screws were placed at the D1 to D6 level. There was one pedicle with grade 1 lateral breach and one pedicle with grade 1 medial breach as per Gertzbein classification. All other screws were contained within the pedicle (Gertzbein grade 0). None of the patients had any added deficits or wound complications in the postoperative period.
Conclusion Thoracic pedicle screw insertion is challenging in nature because of the anatomic variability and proximity of critical structures to the pedicles. Our experience suggests that Fennell technique is a reliable technique, which can be used to place thoracic pedicles consistently, with acceptable rates of pedicle breach. A study involving larger number of patients might prove to establish this technique as an easily reproducible and safe technique for free-hand pedicle screw insertion in thoracic spine.
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Affiliation(s)
- Ayusman Satapathy
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Arunav Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
| | - Rabi Narayan Sahu
- Department of Neurosurgery, All India Institute of Medical Sciences Bhubaneswar, Bhubaneswar, Odisha, India
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Chahal A, Malla S, Dash C, Gupta D, Gamanagatti S. Pull-Type Radiologically Inserted Gastrostomy: An Improvised Technique Using a Frugal Innovation. J Clin Interv Radiol ISVIR 2019. [DOI: 10.1055/s-0039-1681124] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
Abstract
Abstract
Purpose To describe a new technique for “pull type” radiologically inserted gastrostomy (RIG) and prospectively compare it with conventional (described) technique in terms of technical ease (fluoroscopy time, radiation dose) and safety profile.
Materials and Methods Adult patients with head injury with Glasgow coma scale (GCS) (M score) < 5, one week after decompression or those requiring nutritional support for > 4 weeks, or patients with recurrent aspiration pneumonitis on nasogastric feeding were included. Hemodynamically unstable patients or those with uncorrectable coagulopathy were excluded. Patients underwent pull-type RIG with alternate patient getting allocated to groups A (conventional technique) and B (new technique). The authors compared the technical success, complication rate, fluoroscopy time, radiation dose, and cost of hardware in these two groups.
Results The average fluoroscopy time for group A (9 patients) was 498.7 ± 145.3 seconds, whereas for group B (16 patients), it was 302.8 ± 54.1 seconds with p-value = 0.06. The mean radiation dose of group A was 74.7 ± 15.7 mGy, whereas for group B, it was 56.7 ± 14.1 mGy (p-value = 0.004). The minor complication rates were 11.1% in both the groups.
Conclusion The authors’ innovative technique using a customized snare has the potential to increase the technical ease of pull-type RIG with reduced fluoroscopy time, radiation dose, and cost with a similar safety profile.
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Affiliation(s)
- Anurag Chahal
- Department of Radiology, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Sundeep Malla
- Department of Radiology, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Chinmaya Dash
- Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Deepak Gupta
- Department of Neurosurgery, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
| | - Shivanand Gamanagatti
- Department of Radiology, Jai Prakash Narayan Apex Trauma Centre, AIIMS, New Delhi, India
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McClenathan MM, Lu J, Oppong BA, Adams-Campbell LL, Dash C. Abstract P1-02-07: Adherence to breast cancer screening recommendations among underserved participants in an urban safety net mammography clinic. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-02-07] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: The Georgetown Lombardi Comprehensive Cancer Center's Capital Breast Care Center (CBCC) is a safety net mammography screening center that uses a community-based patient navigation program to provide underserved minority women guidelines-concordant mammography screening. Given that screening navigation is designed to eliminate some established barriers such as, access, transportation, and cost, we retrospectively examined patient adherence rates to regular (annual/biennial) mammography screening. We also investigated whether patient demographics are associated with adherence to breast cancer screening.
Methods: Data were derived from medical records of patients that received a baseline mammogram at CBCC in 2011 (n = 1,637) and were followed up for 4 years. Within the study time period of 2011-2015, patients were of age 40-74 and had not received a prior breast cancer diagnosis. 10 definitive cases of breast cancer were newly diagnosed in this population during the follow-up period and were excluded from the analysis. Adherence was then calculated based on the American College of Radiology (annual screening starting at 40) and the United States Preventive Services Task Force guidelines (biennial screening starting at 50).
Results: In 2011, the mean age of women screened at CBCC was 51.25 years with 45% being 40-50 years of age. CBCC has a predominantly minority population with 48% of the women identifying as Black/African American (AA) and 41% identifying as Hispanic in 2011. Over the 4 year follow up period, 41.11% of the patients screened in 2011 did not return for another screen. The adherence rate for annual screening in the 40-74 age group was 3.3% (3.0% in Black/AA; 4.2% in Hispanic) over the 4-year follow-up. The adherence rate for biennial screening among the 50-74-year-old age group was 21% overall (20% among Black/AA; 26% among Hispanics). Approximately 40% of the participants with baseline screenings in 2011 received at least one additional screening over the 4 year follow up but their mammography schedules were not guidelines concordant and they were labeled as “partially adherent” for this analysis.
Conclusion: While the number of partially adherent patients was consistent with previous population-based adherence studies, the proportion of non-adherent patients was higher compared with other population-based studies in primarily Non-Hispanic White populations. Our analysis highlights the importance of focusing on adherence to guidelines and not just mammography initiation in underserved minority populations through educational interventions targeted to patients and providers.
Citation Format: McClenathan MM, Lu J, Oppong BA, Adams-Campbell LL, Dash C. Adherence to breast cancer screening recommendations among underserved participants in an urban safety net mammography clinic [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-02-07.
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Affiliation(s)
- MM McClenathan
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Reston Hospital Center, HCA Virginia Health System, Reston, VA
| | - J Lu
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Reston Hospital Center, HCA Virginia Health System, Reston, VA
| | - BA Oppong
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Reston Hospital Center, HCA Virginia Health System, Reston, VA
| | - LL Adams-Campbell
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Reston Hospital Center, HCA Virginia Health System, Reston, VA
| | - C Dash
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Reston Hospital Center, HCA Virginia Health System, Reston, VA
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Dash C, Moorthy S, Garg K, Singh PK, Kumar A, Gurjar H, Chandra PS, Kale SS. Management of Choroid Plexus Tumors in Infants and Young Children Up to 4 Years of Age: An Institutional Experience. World Neurosurg 2019; 121:e237-e245. [DOI: 10.1016/j.wneu.2018.09.089] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2018] [Revised: 09/10/2018] [Accepted: 09/12/2018] [Indexed: 11/17/2022]
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Mohanty CR, Jain M, Dash C, Behera SS. Postpartum Paraparesis Due to Aggressive Vertebral Hemangioma Causing Spinal Cord Compression Presenting for Emergency Cesarean Section. J Obstet Gynaecol India 2018; 69:185-187. [PMID: 30956475 DOI: 10.1007/s13224-018-1194-5] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2018] [Accepted: 11/17/2018] [Indexed: 11/24/2022] Open
Affiliation(s)
- Chitta Ranjan Mohanty
- 1Department of Trauma and Emergency, All India Institute of Medical Science, Bhubaneswar, India
| | - Mantu Jain
- 2Department of Orthopedics, All India Institute of Medical Sciences, Bhubaneswar, 751019 India
| | - Chinmaya Dash
- 1Department of Trauma and Emergency, All India Institute of Medical Science, Bhubaneswar, India
| | - Shashi Shankar Behera
- 3Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Bhubaneswar, 751019 India
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Singh S, Singh S, Singh V, Warrier R, Tentu A, Dash C. Junctional rhythm: A rare sign in leptospirosis. Indian J Crit Care Med 2018; 22:889-891. [PMID: 30662232 PMCID: PMC6311981 DOI: 10.4103/ijccm.ijccm_437_18] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
Leptospirosis is an important re-emerging infectious disease. Leptospirosis has been estimated to affect tens of millions of humans annually with a case fatality rate ranging from 5% to 25%; however, it is underreported due to the lack of clinical suspicion and barriers to diagnostic capacity. A 33-year-old healthy male presented with a history of fever of 2-day duration. His examination revealed icterus. His workup did not show any significant findings except for a mild transaminitis and a rise in serum creatinine by 0.5 mg/dl. Later, the patient developed bradycardia. An ELISA test for Leptospira antibodies was positive. The patient recovered after a course of intravenous antibiotics. Leptospirosis should be considered early in the diagnosis of any patient who presents with acute, nonspecific febrile illness with multiorgan involvement. Our case had an atypical presentation with involvement of the cardiovascular system in the form of junctional rhythm.
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Kawase T, Bishnoi I, Tanaka R, Dash C, Kato Y, Yamada Y. Study of Incidence and Factors: Risk and Preventive, of Chronic Subdural Hematoma/hygroma in Clipped Patients of Unruptured Intracranial Aneurysms - An Institutional Experience. Asian J Neurosurg 2018; 13:707-713. [PMID: 30283532 PMCID: PMC6159057 DOI: 10.4103/ajns.ajns_355_16] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Introduction One of the underreported complications of clipping of unruptured aneurysm is chronic subdural hematoma/hygroma (CSDH). It can cause sudden deterioration and might need emergency evacuation. Recently, very few papers have studied its incidence and predisposing factors. We are reporting our institutional experience of it along with the study of its risk factors and possible pathogenesis. Methodology Totally 91 postoperative patients of unruptured aneurysms were retrospectively analyzed. Totally 21 patients had CSDH who were operated. In rest seventy patients, there was no CSDH. Results Male sex, old age, anticoagulant use, presence of pneumocephalus and dead space were significantly associated with occurrence of CSDH, whereas arachnoidoplasty significantly protected against it. There was no significant relation of CSDH with Gorei-san use. Conclusions We recommend arachnoidoplasty should be carried out in all patients of clipping of unruptured aneurysm. Male patients or/and patients with dead space with pneumocephalus must be given extra attention like avoiding any dead space in postoperative period, doing arachnoidoplasty and regular follow up till 1st year.
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Affiliation(s)
- Tsukasa Kawase
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya, Japan
| | - Ishu Bishnoi
- Department of Neurosurgery, Maharaja Agrasen Medical College, Agroha, Hisar, Haryana, India
| | - Riki Tanaka
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya, Japan
| | | | - Yoko Kato
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya, Japan
| | - Yoshiru Yamada
- Department of Neurosurgery, Banbuntane Hotokukai Hospital, Fujita Health University, Otobashi, Nagoya, Japan
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Sunanda P, Panda B, Dash C, Padhy RN, Routray P. An illustration of human sperm morphology and their functional ability among different group of subfertile males. Andrology 2018; 6:680-689. [PMID: 29959832 DOI: 10.1111/andr.12500] [Citation(s) in RCA: 6] [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: 06/30/2017] [Revised: 02/22/2018] [Accepted: 04/08/2018] [Indexed: 11/30/2022]
Abstract
Condensed sperm chromatin is a prerequisite for natural fertilization. Some reports suggested the prevalence of chromatin condensation defects in teratozoospermia cases with head anomalies; conversely, earlier studies exemplified its occurrence in morphologically normal spermatozoa too. The aim of this study was to compare the condensation defects in correlation with head anomalies among different groups of subfertile males and its impact on the rate of fertilization in assisted reproduction procedures. Ultrastructure analysis of spermatozoa through scanning electron microscopy and atomic force microscopy could facilitate an in-depth evaluation of sperm morphology. Nuclear condensation defects (%) in spermatozoa were analyzed in 666 subjects, and its effect on the rate of fertilization was analyzed in 116 IVF and 90 intracytoplasmic sperm injection cases. There was no correlation of condensation defects with head anomalies (%). Student's t-test showed no significant changes in mean values of condensation defects in abnormal semen samples in comparison with the normal group. Condensation defects were observed in normal spermatozoa too, which was negatively associated with the rate of fertilization in IVF (p < 0.01), but intracytoplasmic sperm injection outcome remained unaffected. Ultrastructure study revealed sperm morphological features in height, amplitude, and three-dimensional views in atomic force microscopy images presenting surface topography, roughness property of head, and compact arrangement of mitochondria over axoneme with height profile at nanoscale. In pathological forms, surface roughness and nuclear thickness were marked higher than the normal spermatozoa. Thus, percentage of normal spermatozoa with condensation defects could be a predictive factor for the rate of fertilization in IVF. From diverse shapes of nucleus in AFM imaging, it could be predicted that defective nuclear shaping might be impeding the activity of some proteins/ biological motors, those regulate the proper Golgi spreading over peri-nuclear theca.
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Affiliation(s)
- P Sunanda
- Centre for Human Reproduction, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - B Panda
- O & G Department, Centre for Human Reproduction, IMS & SUM Hospital, SOA University, Bhubaneswar, Odisha, India
| | - C Dash
- Centre for Human Reproduction, IMS & SUM Hospital, Bhubaneswar, Odisha, India
| | - R N Padhy
- Central Research Laboratory, IMS& SUM Hospital, Bhubaneswar, Odisha, India
| | - P Routray
- Aquaculture Production and Environment Division, Central Institute of Freshwater Aquaculture, Bhubaneswar, Odisha, India
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Pasricha R, Dash C, Singh P, Borkar S, Sharma BS. Intraventricular pilocytic astrocytomas: Radiology, surgical management and outcome in a series of 8 patients. Neuro Oncol 2018. [DOI: 10.1093/neuonc/nox237.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Pasricha R, Dash C, Singh P, Sharma BS, Mahapatra AK. Choroid plexus tumors in infants and young children - Lessons learnt from an institutional review. Neuro Oncol 2018. [DOI: 10.1093/neuonc/nox237.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Mishra S, Dash C, Singla R, Agarwal M, Kumar A, Kumar H, Sharma B. Craniovertebral junction evaluation by computed tomography in asymptomatic individuals in the Indian population. Neurol India 2018; 66:797-803. [DOI: 10.4103/0028-3886.232288] [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: 11/04/2022]
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Ohshima T, Dash C, Belayev A, Yamamoto T, Goto S, Kato Y. 8-F balloon guide catheter for embolization of anterior circulation aneurysms: an institutional experience in 152 patients. Nagoya J Med Sci 2017; 79:435-441. [PMID: 29238099 PMCID: PMC5719202 DOI: 10.18999/nagjms.79.4.435] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
The use of 8-F balloon guide catheter (BGC) for proximal flow control was previously shown to prevent distal embolic complications during mechanical clot retrieval in patients with acute ischemic stroke. In this retrospective study, the utility of 8-F BGCs for proximal flow control during endovascular coiling of anterior circulation aneurysms was investigated. Patients who underwent endovascular coiling for anterior circulation aneurysms between August 2013 and December 2016 were retrospectively analyzed. Among a total of 152 patients included in this series, 64 patients presented with aneurysmal rupture, whereas the aneurysms were detected incidentally or due to mass effects in the remaining patients. 8-F BGCs were successfully navigated in all patients. The balloon was inflated during navigation in 19 patients. Inflation of the catheter balloon during coil embolization was required in 34 patients; this was performed as an emergency maneuver in six of these patients. Thromboembolic complications occurred in one patient. 8-F BGC can be effectively used for proximal flow control during endovascular treatment of anterior circulation aneurysms. The other advantages included improved navigation of tortuous arterial anatomy, coil stabilization during aneurysmal coiling, and freedom to utilize aneurysmal neck-remodeling balloons for additional adjunctive techniques or to deploy rescue stents. This novel approach might be safely and effectively used in patients undergoing endovascular treatment for anterior circulation aneurysms.
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Affiliation(s)
- Tomotaka Ohshima
- Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan
| | - Chinmaya Dash
- Department of Neurosurgery, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Andrey Belayev
- Department of Neurosurgery, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
| | - Taiki Yamamoto
- Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan
| | - Shunsaku Goto
- Department of Neurosurgery, Kariya Toyota General Hospital, Kariya, Japan
| | - Yoko Kato
- Department of Neurosurgery, Fujita Health University Banbuntane Hotokukai Hospital, Nagoya, Japan
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Kumar R, Dash C, Rani K. Ecological covariates based predictive model of malaria risk in the state of Chhattisgarh, India. J Parasit Dis 2017; 41:761-767. [PMID: 28848275 DOI: 10.1007/s12639-017-0885-7] [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: 11/21/2015] [Accepted: 01/27/2017] [Indexed: 11/28/2022] Open
Abstract
Malaria being an endemic disease in the state of Chhattisgarh and ecologically dependent mosquito-borne disease, the study is intended to identify the ecological covariates of malaria risk in districts of the state and to build a suitable predictive model based on those predictors which could assist developing a weather based early warning system. This secondary data based analysis used one month lagged district level malaria positive cases as response variable and ecological covariates as independent variables which were tested with fixed effect panelled negative binomial regression models. Interactions among the covariates were explored using two way factorial interaction in the model. Although malaria risk in the state possesses perennial characteristics, higher parasitic incidence was observed during the rainy and winter seasons. The univariate analysis indicated that the malaria incidence risk was statistically significant associated with rainfall, maximum humidity, minimum temperature, wind speed, and forest cover (p < 0.05). The efficient predictive model include the forest cover [IRR-1.033 (1.024-1.042)], maximum humidity [IRR-1.016 (1.013-1.018)], and two-way factorial interactions between district specific averaged monthly minimum temperature and monthly minimum temperature, monthly minimum temperature was statistically significant [IRR-1.44 (1.231-1.695)] whereas the interaction term has a protective effect [IRR-0.982 (0.974-0.990)] against malaria infections. Forest cover, maximum humidity, minimum temperature and wind speed emerged as potential covariates to be used in predictive models for modelling the malaria risk in the state which could be efficiently used for early warning systems in the state.
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Affiliation(s)
- Rajesh Kumar
- Child Right and You (CRY), Sayad Ul Ajab, Westend Marg, New Delhi, 110030 India
| | | | - Khushbu Rani
- Women and Child Welfare Consultant, New Delhi, India
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Pasricha R, Dash C. P10.23 Intraventricular pilocytic astrocytomas: Radiology, surgical management and outcome in a series of 8 patients. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.341] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Oppong BA, Dash C, Li Y, Makambi K, Coleman T, Adams-Campbell L. Abstract P5-10-10: Predictors of breast density among Black and Hispanic women presenting for mammographic screening. Cancer Res 2017. [DOI: 10.1158/1538-7445.sabcs16-p5-10-10] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: Increased breast density has been associated with elevated breast cancer risk and complicating mammographic interpretation. Although previous studies have investigated population variations in breast density, Black and Hispanic women are often underrepresented in these analyses. Moreover, it is unclear how breast density differs between these ethnicities. We report on the mammographic density distribution of Black and Hispanic women having breast cancer screening at the Capital Breast Care Center (CBCC) and analyze factors associated with high breast density.
Methods: Retrospective data from electronic medical records at a population-based mammography screening center were abstracted. From 2010 to 2014, data from women undergoing their first breast cancer screening were reviewed. Patient demographics including race, age at screening, education and menopausal status were abstracted in addition to body mass index (BMI) and Breast Imaging-Reporting and Data System (BI-RADS) density category:1- “fatty”, 2- “scattered fibroglandular densities”, 3- “heterogeneously dense” and 4- “extremely dense”. Logistic regression was used to investigate factors associated with breast density.
Results: Density categorization was recorded for 1747 women over the five-year period, with 855 (49%) Black and 892 (51%) Hispanic. Patient characteristics associated with high density (categories 3 and 4) were younger age, Hispanic ethnicity, nulliparity, premenopausal status, and BMI < 30 kg/m2. On multivariate logistic regression, Hispanic ethnicity, premenopausal status, and BMI < 30 kg/m2 were predictive of high mammographic density.
Conclusion: In a sample of women presenting for mammographic screening at CBCC, Hispanic women were more likely to have higher breast density compared to Black women. After controlling for ethnicity, postmenopausal and obese women were less likely to have dense breasts. Additional investigation is needed to further study the impact of obesity on breast density in underserved minority women.
Citation Format: Oppong BA, Dash C, Li Y, Makambi K, Coleman T, Adams-Campbell L. Predictors of breast density among Black and Hispanic women presenting for mammographic screening [abstract]. In: Proceedings of the 2016 San Antonio Breast Cancer Symposium; 2016 Dec 6-10; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2017;77(4 Suppl):Abstract nr P5-10-10.
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Affiliation(s)
- BA Oppong
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - C Dash
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - Y Li
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - K Makambi
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - T Coleman
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
| | - L Adams-Campbell
- MedStar Georgetown University Hospital, Washington, DC; Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC; Georgetown University, Washington, DC; Capital Breast Care Center, Washington, DC
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Dash C, Singla R. Letter to the Editor: Whole-brain CT perfusion and subarachnoid hemorrhage. J Neurosurg 2017; 126:657-658. [DOI: 10.3171/2016.7.jns161860] [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: 11/06/2022]
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Dash C, Singla R. Letter to the Editor. Unilateral or bilateral drainage for chronic subdural hematoma. J Neurosurg 2017; 126:2056-2057. [PMID: 28084913 DOI: 10.3171/2016.8.jns161915] [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: 11/06/2022]
Affiliation(s)
- Chinmaya Dash
- All India Institute of Medical Sciences, New Delhi, India
| | - Raghav Singla
- All India Institute of Medical Sciences, New Delhi, India
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Affiliation(s)
- Rajinder Kumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Mehar C Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Dash C, Garg K, Sharma BS. Letter to the Editor: Cranioplasty after decompressive craniectomy. J Neurosurg 2016; 125:1609-1610. [PMID: 27689455 DOI: 10.3171/2016.5.jns161142] [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: 11/06/2022]
Affiliation(s)
- Chinmaya Dash
- All India Institute of Medical Sciences, New Delhi, India
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Dash C, Singla R, Garg K, Sharma BS. Letter to the Editor: Enlargement of the middle meningeal artery. J Neurosurg 2016; 125:1613-1615. [PMID: 27689457 DOI: 10.3171/2016.6.jns161517] [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: 11/06/2022]
Affiliation(s)
- Chinmaya Dash
- All India Institute of Medical Sciences, New Delhi, India
| | - Raghav Singla
- All India Institute of Medical Sciences, New Delhi, India
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Dash C, Kumar A, Doddamani RS. Is complete excision the key to cure for Cladophialophora bantiana brain abscess? A review of literature. Neurol India 2016; 64:1062-4. [PMID: 27625264 DOI: 10.4103/0028-3886.190250] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ambuj Kumar
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
| | - Ramesh S Doddamani
- Department of Neurosurgery, All India Institute of Medical Sciences, New Delhi, India
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Dash C, Garg K, Sharma BS. Letter to the Editor: Reduced incidence of CSF leak following complete calvarial reconstruction of craniectomies. J Neurosurg 2016; 125:779. [PMID: 27315029 DOI: 10.3171/2016.3.jns16514] [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: 11/06/2022]
Affiliation(s)
- Chinmaya Dash
- All India Institute of Medical Sciences, New Delhi, India
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Kumar A, Battu S, Purkit S, Sharma MC, Dash C, Suri A, Singh M, Sarkar C, Suri V. CR-23CLINIOPATHOLOGICAL AND MOLECULAR CHARACTERISTICS OF PAEDIATRIC MENINGIOMAS. Neuro Oncol 2016. [DOI: 10.1093/neuonc/now068.23] [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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Dash C, Garg K, Kale SS. Letter to the Editor: Topical vancomycin use following craniotomy. J Neurosurg 2016; 125:234-5. [PMID: 27128586 DOI: 10.3171/2016.1.jns16103] [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: 11/06/2022]
Affiliation(s)
- Chinmaya Dash
- All India Institute of Medical Sciences, New Delhi, India
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Nomura SJO, Yu J, Dash C, Rosenberg L, Palmer J, Adams-Campbell L. Abstract PD4-03: Adherence to diet, physical activity and body composition guidelines and breast cancer in the black women's health study. Cancer Res 2016. [DOI: 10.1158/1538-7445.sabcs15-pd4-03] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: While breast cancer incidence rates have declined in non-Hispanic Caucasian populations, rates have remained stable in African American women, who are often affected by more aggressive subtypes. Previous studies have found that adherence to the World Cancer Research Fund/American Institute for Cancer Research (WCRF/AICR) cancer prevention recommendations, and the similar American Cancer Society (ACS) guidelines, is associated with lower incidence of breast cancer. However, few African American women were included in these studies, and guidelines are based primarily on research among Caucasian women.
Objective: To evaluate the association between adherence to the WCRF/AICR cancer prevention recommendations and breast cancer incidence among African American women.
Design: The Black Women's Health Study is an ongoing prospective study of African American women from across the United States who were 21-69 years of age at baseline in 1995. They are followed biennially through health questionnaires. Among 49,103 women who were free of cancer at baseline and who provided relevant dietary and data on the baseline questionnaire, 1,827 incident cases of breast cancer were ascertained during follow-up through 2011. Questionnaire data on physical activity, body composition and diet were used to compute adherence scores for seven WCRF/AICR recommendations involving those factors. For each individual recommendation, participants were categorized as adherent (1 point), partially adherent (0.5 points) or non-adherent (0 points). Scores were summed to a total adherence score (maximum score: 7 points) and a diet only adherence score (maximum score: 5 points). Adherence scores (categorical and continuous) based on baseline data only and on time-varying data were assessed in relation to breast cancer incidence using Cox proportional hazards regression models, with control for potential confounding factors.
Results: In the analytic cohort, 8.5% of participants had an adherence score of 4.5-7.0, while 46% had a score less than 3.0. For individual recommendations, 15.2% were adherent to body weight recommendations, 24.7% were adherent to physical activity, and 5.4% were adherent to more than 4 diet recommendations. Participants were most likely to adhere to the alcohol recommendation (94.3%). In the time varying model, higher overall adherence (per 0.5 unit increase) was associated with lower breast cancer incidence (HR: 0.90, 95% CI: 0.84-0.96), with greater adherence to diet overall, physical activity, sugar beverage intake, and red and processed meat recommendations all significantly associated with reduced risk. The adherence score based on baseline variables was not associated with significantly reduced risk (HR: 0.96, 95% CI: 0.90-1.02), although meeting physical activity recommendations was associated.
Conclusions: Our findings suggest that adherence to the WCRF/AICR guidelines may lower risk of developing breast cancer in African American women. However, body weight and alcohol, factors that are widely considered important for breast cancer prevention appear to be less relevant in this population.
Citation Format: Nomura SJO, Yu J, Dash C, Rosenberg L, Palmer J, Adams-Campbell L. Adherence to diet, physical activity and body composition guidelines and breast cancer in the black women's health study. [abstract]. In: Proceedings of the Thirty-Eighth Annual CTRC-AACR San Antonio Breast Cancer Symposium: 2015 Dec 8-12; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2016;76(4 Suppl):Abstract nr PD4-03.
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Affiliation(s)
- SJO Nomura
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Boston University Sloane Epidemiology Center, Boston, MA
| | - J Yu
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Boston University Sloane Epidemiology Center, Boston, MA
| | - C Dash
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Boston University Sloane Epidemiology Center, Boston, MA
| | - L Rosenberg
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Boston University Sloane Epidemiology Center, Boston, MA
| | - J Palmer
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Boston University Sloane Epidemiology Center, Boston, MA
| | - L Adams-Campbell
- Georgetown Lombardi Comprehensive Cancer Center, Washington, DC; Boston University Sloane Epidemiology Center, Boston, MA
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Adams-Campbell LL, Dash C, Kim BH, Hicks J, Makambi K, Hagberg J. Cardiorespiratory Fitness and Metabolic Syndrome in Postmenopausal African-American Women. Int J Sports Med 2016; 37:261-6. [PMID: 26837934 DOI: 10.1055/s-0035-1569284] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023]
Abstract
We examined the association of cardiorespiratory fitness with metabolic syndrome in overweight/obese postmenopausal African-American women. Pooled baseline data on 170 African-American women from 2 exercise trials were examined. Metabolic syndrome was defined as at least 3 of the following: abdominal obesity, glucose intolerance, hypertension, low high-density lipoprotein cholesterol (HDL-C), and high triglycerides. Cardiorespiratory fitness (VO2peak) was determined using the Bruce treadmill protocol and categorized as: Very Low (VLCRF<18 mL·kg(-1) min(-1)), Low (LCRF=18.0-220-22-22.0 mL·kg(-1) min(-1)), and Moderate (MCRF>22.0 mL·kg(-1) min(-1)). Associations of metabolic syndrome with cardiorespiratory fitness were analyzed using one-way ANOVA and linear regression. VO2peak was significantly lower in the VLCRF compared to the MCRF group. Lower cardiorespiratory fitness was associated with higher prevalence of metabolic syndrome, abdominal obesity, hypertriglyceridemia, and low HDL among overweight/obese postmenopausal African-American women. In fully adjusted models, higher waist circumference and triglycerides were associated with lower VO2peak levels (P<0.01) and higher HDL-C was associated with higher VO2peak levels (P=0.03). Overweight/obese postmenopausal African-American women with very low cardiorespiratory fitness are more likely to have metabolic syndrome, higher body mass index, and unhealthier levels of certain metabolic syndrome components than women with moderate cardiorespiratory fitness.
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Affiliation(s)
- L L Adams-Campbell
- Georgetown Lombardi Comprehensive Cancer Center, Office of Minority Health & Health Disparities Research, Washington, United States
| | - C Dash
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, United States
| | - B H Kim
- HealthCare Interactive, Inc, HealthCare Interactive, Inc, Glenwood, United States
| | - J Hicks
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, United States
| | - K Makambi
- Georgetown Lombardi Comprehensive Cancer Center, Georgetown University Medical Center, Washington, United States
| | - J Hagberg
- Department of Kinesiology, University of Maryland, College Park, United States
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Dash C, Gurjar H, Garg K, Sharma BS, Singla R. Massive life-threatening bifrontal epidural hematoma following placement of an external ventricular drain. Childs Nerv Syst 2016; 32:237-9. [PMID: 26738872 DOI: 10.1007/s00381-015-2985-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/01/2015] [Accepted: 12/18/2015] [Indexed: 11/26/2022]
Affiliation(s)
- Chinmaya Dash
- Department of Neurosurgery, All India Institute of Medical Sciences, R No- 720, 7th Floor, New Delhi, 110029, India
| | - Hitesh Gurjar
- Department of Neurosurgery, All India Institute of Medical Sciences, R No- 720, 7th Floor, New Delhi, 110029, India
| | - Kanwaljeet Garg
- Department of Neurosurgery, All India Institute of Medical Sciences, R No- 720, 7th Floor, New Delhi, 110029, India.
| | - Bhawani Shankar Sharma
- Department of Neurosurgery, All India Institute of Medical Sciences, R No- 720, 7th Floor, New Delhi, 110029, India
| | - Raghav Singla
- Department of Neurosurgery, All India Institute of Medical Sciences, R No- 720, 7th Floor, New Delhi, 110029, India
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Dash C, Singla R, Garg K, Tandon V, Sharma BS. Hypothalamic chiasmatic tuberculoma mimicking glioma. Childs Nerv Syst 2016; 32:233-5. [PMID: 26661574 DOI: 10.1007/s00381-015-2972-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2015] [Accepted: 11/23/2015] [Indexed: 01/28/2023]
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Doddamani R, Dash C, Kumar A, Rajeshwari M, Sharma M, Sharma B. Pediatric intraparenchymal meningioma: A review of literature. Neurol India 2016; 64:1351-1354. [DOI: 10.4103/0028-3886.193795] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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