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Raj S, Sarawagi Gupta R, Malik R, Yunus M, Chouksey P, Shrivastav A, Nagar M, Agrawal A. Objective triaging of traumatic brain injury patients with a novel machine learning powered near-infrared spectroscopy-based biomarker at different time-intervals post injury. World Neurosurg X 2024; 22:100304. [PMID: 38435433 PMCID: PMC10904977 DOI: 10.1016/j.wnsx.2024.100304] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 02/21/2024] [Indexed: 03/05/2024] Open
Affiliation(s)
- Sumit Raj
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Radha Sarawagi Gupta
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Rajesh Malik
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Md Yunus
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Pradeep Chouksey
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Adesh Shrivastav
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Manoj Nagar
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal 462020, Madhya Pradesh India
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Mlv SK, Mahmood A, Vatsya P, Garika SS, Mittal R, Nagar M. Demographic characteristics of patients who underwent anterior cruciate ligament reconstruction at a tertiary care hospital in India. World J Clin Cases 2023; 11:3464-3470. [PMID: 37383898 PMCID: PMC10294183 DOI: 10.12998/wjcc.v11.i15.3464] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/16/2023] [Revised: 02/16/2023] [Accepted: 04/17/2023] [Indexed: 05/25/2023] Open
Abstract
BACKGROUND Anterior cruciate ligament (ACL) tears are common sports-related injuries. Their incidence is not the same either for all the sports or for the same sport across various nations. This information is maintained by many sports leagues in their registries. However, very few nationwide registries exist for such injuries. This study is carried out to know the demographic characteristics of patients who underwent ACL reconstruction at our hospital in India.
AIM To know the demographic characteristics of patients who underwent ACL reconstruction at a tertiary care hospital in India.
METHODS All the patients who underwent ACL reconstruction from January 2020 to December 2021 were retrospectively studied. Patients with multi-ligament injuries or a history of previous knee surgery were excluded. The patients’ history was obtained from the hospital records, they were interviewed telephonically, and online questionnaires were given. Their demographic data was analyzed and compared to the existing literature.
RESULTS A total of 124 patients were operated on for ACL reconstruction during this period. The mean age of the patients was 27.97 years. One hundred and thirteen patients (91.1%) were male and 11 (8.9%) were female. The majority of the patients (47.6%) sustained this injury by road traffic accidents (RTA) followed by sports-related injuries (39.5%). The commonest presenting complaint was giving way of the knee in 118 patients (95.2%). The mean duration from the injury to the first hospital visit among the patients was 290.1 d. The mean duration from the injury to surgery was 421.8 d.
CONCLUSION ACL patients’ demography is different in developing nations as compared to the developed world. RTA are the leading cause of ACL injuries and are followed by recreational sports as a cause. There is delayed access to healthcare leading to delayed diagnosis as well as even greater time to surgery. This, in turn, leads to poorer prognosis and longer rehabilitation. National registries for developing nations are the need of the hour due to the different demographics of ACL injuries in developing countries.
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Affiliation(s)
- Sai Krishna Mlv
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Asjad Mahmood
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Pulak Vatsya
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Siva Srivastava Garika
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Ravi Mittal
- Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi 110029, India
| | - Manoj Nagar
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal 462020, India
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Jain A, Nagar M, Jain S, Barasker SK. Suprascapular nerve block is faster and as effective as hydrodistension in relieving frozen shoulder-associated pain and disability: A prospective, single-blind observational study with a follow-up of 24 weeks. J Anaesthesiol Clin Pharmacol 2023; 39:45-50. [PMID: 37250252 PMCID: PMC10220177 DOI: 10.4103/joacp.joacp_114_21] [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: 03/11/2021] [Revised: 04/09/2021] [Accepted: 07/20/2021] [Indexed: 03/21/2023] Open
Abstract
Background and Aims Hydrodistension (HD) and suprascapular nerve block (SSNB) have been shown to reduce pain and improve shoulder function in frozen shoulder (FS). The aim of this study was to compare the efficacy of HD and SSNB in the treatment of idiopathic FS. Material and Methods This was a prospective observational study. A total of 65 patients with FS were treated with SSNB or HD. The functional outcome was evaluated by Shoulder Pain and Disability Index (SPADI) score and active shoulder range of motion (ROM) measured at 2 weeks, 6 weeks, 12 weeks, and 24 weeks. Parametric data were analyzed using an independent sample T-test. Nonparametric data were analyzed using the Mann-Whitney test and Wilcoxon test. A P value less than 0.05 was considered significant. Result At the end of 24 weeks, the two-group improved significantly from the baseline and the improvement was comparable between the two groups. ROM also improved significantly in both groups. At 2nd week, SPADI score was significantly less in SSNB group (P < 0.05). About 43% of patients considered HD extremely painful. Conclusion Both HD and SSNB are almost equally effective in reducing pain and improving shoulder function. However, SSNB leads to a faster improvement.
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Affiliation(s)
- Anuj Jain
- Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Manoj Nagar
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Suruchi Jain
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | - Swapnil Kumar Barasker
- Department of Anesthesia and Critical Care, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
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Nagar M, Geevarughese NM, Mishra R, Joshi A, Galwankar S, Yunus M, Bhoi S, Sinha TP, Agrawal A. Body-mass index COVID-19 severity: A systematic review of systematic reviews. J Family Med Prim Care 2022; 11:5351-5360. [PMID: 36505599 PMCID: PMC9731002 DOI: 10.4103/jfmpc.jfmpc_396_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2022] [Revised: 03/16/2022] [Accepted: 03/24/2022] [Indexed: 12/15/2022] Open
Abstract
Objectives Conflicting studies have resulted in several systematic reviews and meta-analyses on the relationship between COVID-19 and body mass index (BMI). Methods This systematic review of systematic reviews followed an umbrella review design, and preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines; Medical literature analysis and retrieval system online (MEDLINE) and SCOPUS databases were searched for systematic reviews on the topic. A predefined screening and selection procedure was done for the retrieved results based on the population, intervention/interest, comparator, outcome, study (PICOS) framework. Results The search strategy yielded 6334 citations. With the predefined selection and screening process, 23 systematic reviews were retrieved for inclusion in the present study. Twenty-three (n = 23) systematic reviews met the inclusion criteria. As expected, there was overlap across the reviews in the included primary studies. Available evidence suggests that Class III obesity (morbid obesity) is strongly associated with increased mortality risk in patients with Covid-19. It is difficult to draw a firm conclusion about Class I and Class II obesity due to conflicting outcomes of metanalyses. Increased obesity was consistently associated with increased risk of invasive mechanical ventilation (IMV) in all the reviews with low to moderate heterogeneity. Conclusions Available evidence suggests that Class III obesity (morbid obesity) is strongly associated with increased mortality risk in patients with Covid-19. Increased BMI is positively associated with the risk of IMV and the severity of COVID- care.
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Affiliation(s)
- Manoj Nagar
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
| | - Nikku Mathew Geevarughese
- Department of Orthopaedics, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
| | - Rakesh Mishra
- Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi, Uttar Pradesh, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
| | - Sagar Galwankar
- Florida State University Emergency Medicine Residency Program, Sarasota Memorial Hospital, Sarasota, Florida, USA
| | - Md Yunus
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India
| | - Sanjeev Bhoi
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Tej P. Sinha
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences, New Delhi, India
| | - Amit Agrawal
- Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal, Madhya Pradesh, India,Address for correspondence: Dr. Amit Agrawal, Department of Neurosurgery, All India Institute of Medical Sciences, Saket Nagar, Bhopal - 462 020, Madhya Pradesh, India. E-mail:
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Mohammed Muzzamil, Choudhary M, Nagar M, Vishnoi SK, Choudhary S, Jora R, Kothari S. Prevalence of Helicobacter Pylori infection in children with iron deficiency anemia admitted in tertiary care hospital. Asian J Med Sci 2022. [DOI: 10.3126/ajms.v13i5.41176] [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: 11/18/2022] Open
Abstract
Background: Iron deficiency anemia (IDA) can result from both physiological and pathological events, the etiology of underlying IDA should be determined. Helicobacter pylori infection in children has mostly been associated with recurrent abdominal pain, gastric dyspepsia, or duodenal-ulcer. Other extra-digestive tract conditions such as iron deficiency or IDA have been recently related to the H. pylori infection.
Aims and Objectives: To find out the prevalence of H. pylori infection in children aged 2–18 years with IDA in a tertiary care hospital.
Materials and Methods: Across-sectional observational study was carried out in the Department of Paediatrics, Dr. S.N. Medical College, Jodhpur for a period of 1 year. A total of 52 children aged between 2 and 18 years with anemia (as per the WHO criteria of anemia) were evaluated for complete blood count, peripheral blood film and serum ferritin, serum iron, total iron-binding capacity (TIBC), Upper gastrointestinal endoscopy and two biopsy specimen evaluated for H. pylori and histopathological changes. Normally distributed data means were compared using student’s t-test unpaired and paired. Proportions were compared using Chi-square or Fisher’s exact test.
Results: The prevalence of H. pylori in our study population was 32.69%. In children with H. pylori infection mean S.iron was 25.78±10.24 μg/dl, mean S.TIBC 544.66±91.68 μg/dl, and mean S.ferritin was 6.07±3.00 μg/dl. There was statistically significant difference in serum iron, S.TIBC and S.ferritin between children having H. pylori infection and without H. pylori infection(P<0.001).
Conclusion: There is an association of IDA and H. pylori infection. Therefore prevention and eradication of H. pylori infection might be helpful to prevent IDA, especially in those patients who are not responding to usual treatment.
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Nagar M, Tiwari V, Joshi A, Ahmed M, Patel M. A cadaveric morphometric analysis of coracoid process with reference to the Latarjet procedure using the "congruent arc technique". Arch Orthop Trauma Surg 2020; 140:1993-2001. [PMID: 32870335 DOI: 10.1007/s00402-020-03579-0] [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] [Received: 12/25/2019] [Accepted: 08/16/2020] [Indexed: 10/23/2022]
Abstract
INTRODUCTION Congruent arc Latarjet procedure involves rotating the coracoid process so that its inferior surface is flush with the glenoid face, owing to their matching radius of curvature (ROC). However, there has been no cadaveric study to actually measure and compare the ROC of coracoid with glenoid, especially in Indian population. MATERIALS AND METHODS 44 shoulders were dissected in 24 cadavers to measure usable length of coracoid process, width, height, ROC of coracoid and glenoid as well as ulnar length (as proxy of cadaver height). Critical coracoid height and length were estimated based on screw sizes of 2.7 mm, 3.5 mm, 4 mm and 4.5 mm, and pair concordance between height and length calculated. ROC of coracoid and glenoid were compared to measure extent of congruency. RESULTS The mean usable length of coracoid process, width and height at mid-point were 21.8 mm, 13.7 mm and 8.6 mm, respectively. Out of the different screw sizes, 2.7 mm screws were found safe in 82% shoulders. 24 coracoid-glenoid pairs fulfilled the operational definition (≤ 5 mm) of congruency while rest 20 were seemingly incongruent chiefly due to coracoid variations, with mean ROC difference 4.13 mm (95% CI 1.51-6.74 mm). The ulnar length was significantly smaller in the incongruent ROC group (p = 0.0002). CONCLUSIONS The available length as well as height of the transferred coracoid must be considered when deciding optimum diameter fixation screws in Latarjet procedure. Owing to smaller anatomic dimensions of coracoid in Indian population, 2.7-mm screws provide the safest fixation option. Also, the ROC of coracoid and glenoid does not match in substantial proportion of the cadavers. Pre-operative planning should include a CT-based assessment of glenoid and coracoid dimensions to decide the technique of Latarjet procedure and the optimum diameter fixation screws required.
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Affiliation(s)
- Manoj Nagar
- Department of Trauma and Emergency (Orthopaedics), All India Institute of Medical Sciences, Bhopal, India
| | - Vivek Tiwari
- Department of Orthopaedics, All India Institute of Medical Sciences, Nagpur, India.
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, India
| | - Mohtashim Ahmed
- Department of Anatomy, All India Institute of Medical Sciences, Bhopal, India
| | - Manmohan Patel
- Department of Anatomy, All India Institute of Medical Sciences, Bhopal, India
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Yadav MS, Nagar M, Joshi A, Gupta A. Performance validation of different trauma scoring systems among polytrauma patients having predominantly blunt abdominal trauma. J Family Med Prim Care 2020; 9:2866-2870. [PMID: 32984140 PMCID: PMC7491821 DOI: 10.4103/jfmpc.jfmpc_377_20] [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: 03/20/2020] [Revised: 04/25/2020] [Accepted: 05/08/2020] [Indexed: 11/04/2022] Open
Abstract
Introduction Blunt abdominal trauma substantially contributes to mortality and morbidity in patients with polytrauma. Appropriate clinical assessment is important in setups lacking facilities of advanced diagnostics (abdominal computed tomography scans and ultrasonography) to decide if the patients' needs exceed the facilities available. This study aimed to assess the utility of the commonly used trauma scores in predicting the outcome (favorable or unfavorable) in patients with predominantly blunt abdominal trauma. Study Design and Methods In this prospective observational study of 12-month duration, we calculated three scores (Glasgow Coma Scale [GCS], Revised Trauma Score [RTS], and Injury Severity Score [ISS]) in patients brought to emergency department and fulfilling the inclusion criteria. These patients were categorized into two categories (favorable and unfavorable) depending on their treatment outcome. The difference in the mean scores for both outcomes in each score was calculated and further inferences were obtained by using the unpaired t test. A receiver-operating characteristic curve for each score was drawn to understand the trade-off between sensitivity and specificity at each cutoff value and for determining area under curve (AUC) for all three scores. Result A total of 103 patients were recruited in the study (88 men and 15 women) with the mean age of 31.03 (±13.40) years and 34.47 (±18.04) years, respectively. The difference in the scores was maximum for ISS and minimal for RTS. The visual impression, as well as AUC values, shows that ISS performed well to discriminate between the favorable and unfavorable outcomes in each cutoff values (AUC -0.806, lower bound 0.678 to upper bound 0.934) compared to GCS and RTS scores. The Youden's J statistic for ISS value of 42 was maximum (0.298) and corresponding sensitivity and specificity were 0.651 and 0.647. Conclusion ISS is superior as compared to GCS and RTS in predicting outcome in polytrauma patients with a blunt abdominal injury. ISS value of <42 predicts a favorable outcome.
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Affiliation(s)
- Moorat Singh Yadav
- Department of Surgery, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Manoj Nagar
- Department of Trauma and Emergency Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
| | - Achal Gupta
- Department of General Surgery, Gaja Raja Medical College, Gwalior, Madhya Pradesh, India
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Nagar M, Joshi A, Sahu S, Nagar V, Mitra A. Concordance and Discordance of Orthopedicians with Revised National Tuberculosis Control Program with Reference to Musculoskeletal Tuberculosis: A Qualitative Inquiry. Indian J Orthop 2020; 54:711-719. [PMID: 32850037 PMCID: PMC7429663 DOI: 10.1007/s43465-020-00068-9] [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: 02/04/2023]
Abstract
BACKGROUND Musculoskeletal tuberculosis (TB) continues to share the major burden of extrapulmonary TB. This burden up to some extent may be attributed to the implementation gap which is reasonably broadest at the level of the immediate point of care. As an orthopedic physician is an important stakeholder at this juncture, it is imperative to recognize their experiences, perceptions, and anticipations to fill this gap. This qualitative inquiry tries to explore these attributes in the context of the recent development at the policy level in Revised National Tuberculosis Control Program. METHODOLOGY Type of Study Qualitative inquiry with framework approach. SETTINGS Orthopedic surgeons working in different work settings. SAMPLING METHOD Purposive sampling. An iterative topic guide for an in-depth interview was prepared by reviewing the literature and expert opinions. The questions were contextual, diagnostic, evaluative, and strategic. This study adopted a framework approach as the issue was near to evaluative and strategic policy research. The recorded interviews were transcribed and coded into axial and serial codes. A framework matrix was created and thematic mapping was done to understand the phenomena and to offer the solution framework. RESULTS The investigators detected an element of unawareness of the current context coupled with the perceived previous stringency of the program. This is in conjunction with already multifaceted diagnostic and prognostic complexity. This leads to mutual dissociation and skepticism. CONCLUSION This qualitative inquiry explored an element of dissociation between programmatic objectives and individualistic concerns of the caregivers. An integrated ecosystem which may take care of synergistic reciprocation among the two is imperative for successful implementation.
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Affiliation(s)
- Manoj Nagar
- Department of Trauma and Emergency, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Saurabh Sahu
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Vivek Nagar
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
| | - Arun Mitra
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh India
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Verma V, Nagar M, Jain V, Santoshi JA, Dwivedi M, Behera P, Selvanayagam R, Pal D, Singh K. Adapting Policy Guidelines for Spine Surgeries During COVID-19 Pandemic in View of Evolving Evidences: An Early Experience From a Tertiary Care Teaching Hospital. Cureus 2020; 12:e9147. [PMID: 32789084 PMCID: PMC7417187 DOI: 10.7759/cureus.9147] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Introduction The recent novel coronavirus disease 2019 (COVID-19) pandemic has brought the world to a standstill. This outbreak not only affected healthcare systems but the resultant economic losses were also enormous. COVID-19 has demanded that the health care systems globally evolve, develop new strategies, identify new models of functioning, and at times, fall back on the old conservative methods of orthopedic care to decrease the risk of disease transmission. Although, the majority of hospitals are refraining from performing elective surgeries, emergent and urgent procedures cannot be delayed. Various strategies have been developed at the institute level to reduce the risk of infection transmission among the theatre team from an unsuspected patient (asymptomatic and presymptomatic) during the perioperative period. Material and methods The present study is a part of an ongoing project which is being conducted in a tertiary level hospital after obtaining research review board approval. All patients admitted either for vertebral fracture or spinal cord compression from February 2020 to May 2020 were included. The present study included 13 patients (nine males and four females) with an average age of 35.4 years The oldest patient was of 63 years which is considered a risk factor for developing severe COVID-19 infection. Results Eight patients (61.5%) presented with spinal cord injury (SCI) due to vertebral fracture with fall from height (87.5%) as the most common etiology. Among the traumatic SCI patients, six (75%) were managed surgically with posterior decompression and instrumented fusion with pedicle screws while two patients (25%) were managed conservatively. There were four patients (30.8%) of tuberculosis of the spine of whom two (50%) were managed with posterior decompression, debridement, and stabilization with pedicle screws, samples for culture, biopsy, and cartridge-based nucleic acid amplification test (CBNAAT) were collected during the procedure; for the remaining two patients (50%), a trans-pedicular biopsy was performed to confirm the diagnosis for initiation of anti-tubercular therapy. Prolapsed intervertebral disc causing cauda equina syndrome was the reason for emergency surgery in one patient (7.7%). COVID-19 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) reverse transcription-polymerase chain reaction (RT-PCR) test was performed in four patients (30.8%), in whom the most common symptom was fever (two patients (50%)). These patients were residents of high prevalence area for COVID-19 infection. Sore throat (25%), fatigue (25%), and low oxygen saturation (25%) were present in one patient which prompted us to get the COVID-19 test. All patients were reported negative for COVID-19. Conclusion The structural organization and the management protocol we describe allowed us to reduce infection risk and ultimately hospital stay, thereby maximizing the already stretched available medical resources. These precautions helped us to reduce transmission and exposure to COVID-19 in health care workers (HCW) and patients in our institute. The aim of this article is that our early experience can be of value to the medical communities that will soon be in a similar situation.
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Affiliation(s)
- Virendra Verma
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Manoj Nagar
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Vaibhav Jain
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - John A Santoshi
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Manish Dwivedi
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Prateek Behera
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | | | - Dharm Pal
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Kuldeep Singh
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
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Verma V, Santoshi JA, Jain V, Patel M, Dwivedi M, Nagar M, Selvanayagam R, Pal D. Thoracic Pedicle Morphometry of Dry Vertebral Columns in Relation to Trans-Pedicular Fixation: A Cross-Sectional Study From Central India. Cureus 2020; 12:e8148. [PMID: 32550067 PMCID: PMC7294881 DOI: 10.7759/cureus.8148] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [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] [Indexed: 11/08/2022] Open
Abstract
Introduction Trans-pedicular screw fixation is one of the main modalities of spinal instrumentation today. It is particularly challenging in the thoracic spine due to the narrow pedicle dimensions especially in the upper and mid-thoracic levels. We aimed to study the anatomical variations like pedicle dimensions and angulation in transverse and sagittal planes. Material and methods We conducted an anatomical investigation on 20 dry vertebral columns (14 male and six female), from T1 to T12 levels. The measurements included pedicle width, height, and transverse and sagittal angles of the pedicle. Numerical variables were summarized using mean and standard deviation. Results T12 vertebra was found to have the widest pedicle width (mean 7.89 ± 0.70 mm) and the widest pedicle height (mean 15.45±0.78 mm) while T5 vertebra (mean 3.65±0.40 mm) had the narrowest pedicle width. T1 vertebra had the maximum transverse angle of the pedicle (mean 30.37±2.56 degree); whereas, T2 vertebra had the maximum sagittal angle (mean 19.22±2.24 degree). Conclusion We have reported detailed pedicle measurements including their angulation for the thoracic spine in dry vertebral columns of central India. The pedicles are directed more medially from T1 to T10 levels and are almost neutral at T11 and T12 levels. These findings would not only be of immense help to the spinal surgeons but also help in designing implants and instrumentations specific for the thoracic spine for the central Indian population as well as aiding surgeons to perform more precise and, therefore, safe surgical procedures.
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Affiliation(s)
- Virendra Verma
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - John A Santoshi
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Vaibhav Jain
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Manmohan Patel
- Anatomy, All India Institute of Medical Sciences, Bhopal, IND
| | - Manish Dwivedi
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | - Manoj Nagar
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
| | | | - Dharm Pal
- Orthopaedics, All India Institute of Medical Sciences, Bhopal, IND
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Selvanayagam R, Jain V, Verma VK, Santoshi JA, Nagar M. Comparison of plate, calcanealplasty and external fixation in the management of calcaneal fractures Giovanni Vicentia, Massimiliano Carrozzoa, Giuseppe Solarinoa, Gianni Caizzia, Angelo De Crescenzoa, Mauro Portalurib, Claudio Maria Moria, Donato Vittorea, Biagio Moretti. Injury 2020; 51:1144-1145. [PMID: 32113745 DOI: 10.1016/j.injury.2020.02.064] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Accepted: 02/08/2020] [Indexed: 02/02/2023]
Affiliation(s)
| | - Vaibhav Jain
- Department Of Orthopaedics, AIIMS Bhopal , Address - 99 Chawni Road Mangalwara, Bhopal, Madhya Pradesh, 462001, India.
| | - Virendra K Verma
- Department of Orthopaedics, AIIMS Bhopal, Academic Block, Bhopal, India.
| | - John A Santoshi
- Department of Orthopaedics, AIIMS Bhopal, Academic Block, Bhopal, India.
| | - Manoj Nagar
- Department Of Trauma and emergency, AIIMS Bhopal, Bhopal, India.
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Tiwari V, Nagar M, Behera P, Santoshi JA. Letter to the Editor on "The Role of Perioperative Statin Use in the Prevention of Delirium After Total Knee Replacement Under Spinal Anesthesia". J Arthroplasty 2019; 34:397-398. [PMID: 30442466 DOI: 10.1016/j.arth.2018.10.019] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/07/2018] [Accepted: 10/15/2018] [Indexed: 02/01/2023] Open
Affiliation(s)
- Vivek Tiwari
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
| | - Manoj Nagar
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
| | - Prateek Behera
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
| | - John A Santoshi
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
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Affiliation(s)
- Vivek Tiwari
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
| | - Alpesh Goyal
- Department of Endocrinology, All India Institutes of Medical Science, New Delhi, India.
| | - Manoj Nagar
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
| | - John A Santoshi
- Department of Orthopaedics, All India Institute of Medical Sciences, Bhopal, India
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Raj H, Tiwari V, Nagar M, Joshi A, Santoshi JA. Letter to the editor regarding "Single versus double column fixation in transverse fractures of the acetabulum: A randomised controlled trial". Injury 2018; 49:2094-2095. [PMID: 30201179 DOI: 10.1016/j.injury.2018.09.001] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/28/2018] [Accepted: 09/02/2018] [Indexed: 02/02/2023]
Affiliation(s)
- Hemanth Raj
- Department of Orthopaedics, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462024, India
| | - Vivek Tiwari
- Department of Orthopaedics, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462024, India.
| | - Manoj Nagar
- Department of Orthopaedics, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462024, India
| | - Ankur Joshi
- Department of Community and Family Medicine, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462020, India
| | - John A Santoshi
- Department of Orthopaedics, All India Institute of Medical Sciences, Saket Nagar, Bhopal, 462024, India
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Dhingra N, Manoharan R, Gill S, Nagar M. Peripapillary schisis in open-angle glaucoma. Eye (Lond) 2016; 31:499-502. [PMID: 27834967 DOI: 10.1038/eye.2016.235] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2016] [Accepted: 09/22/2016] [Indexed: 11/09/2022] Open
Abstract
PurposeTo report clinical features, topographic findings and outcome of 10 eyes with peripapillary schisis in open-angle glaucoma.Patients and methodsA retrospective review of patients with open-angle glaucoma who were noted to have peripapillary schisis on optical coherence tomography (OCT) were included. Serial peripapillary and macula infrared and OCT images, visual acuity, visual fields, and schisis appearance were reviewed.ResultsTen eyes of nine patients with open-angle glaucoma were detected to have the presence of peripapillary schisis. Nerve fibre layer schisis was detected in all eyes and one eye had an associated macular schisis. None of the eyes had an acquired pit of the optic nerve or pathological myopia. The mean intraocular pressures at detection was 18.3±4.3 mm Hg and the schisis resolved in four eyes after a mean follow-up of 21.2±8.8 months. Visual field worsening was noted in 4 of the 10 eyes and the resolution of schisis resulted in significant reduction in the retinal nerve fibre layer (RNFL) thickness.ConclusionsPeripapillary schisis detected during the normal course of open-angle glaucoma can resolve spontaneously and rarely involves the macula. Its resolution leads to reduction in RNFL thickness; therefore, caution is advised while interpreting serial scans.
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Affiliation(s)
- N Dhingra
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - R Manoharan
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - S Gill
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
| | - M Nagar
- Pinderfields Hospital, Mid Yorkshire NHS Trust, Wakefield, UK
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Marcu-Malina V, Garelick D, Peshes-Yeloz N, Wohl A, Zach L, Nagar M, Amariglio N, Besser MJ, Cohen ZR, Bank I. Peripheral blood-derived, γ9δ2 t cell-enriched cell lines from glioblastoma multiforme patients exert anti-tumoral effects in vitro. J BIOL REG HOMEOS AG 2016; 30:17-30. [PMID: 27049073] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Abstract
The goal of this work was to assess the potential of T cells expressing Vγ9Vδ2+ T cell receptors (TCR, γ9δ2T cells) present in peripheral blood (PB) m ononuclear cells (MC, PBMC) of glioblastoma multiforme (GBM) patients to act as anti-tumoral agents. We found that γ9δ2T cell levels were decreased in patients' PB relative to a cohort of healthy donors (HD) (respectively 0.52±0.55%, n=16, vs 1.12±0.6%, n=14, p=0.008) but did not significantly correlate with postoperative survival (R=0.6, p=0.063). Importantly, however, the γ9δ2T cells could be expanded in vitro to consist 51±23% of the cultured lymphocytes (98% CD3+). This was achieved after 14 days of culture in medium containing the amino-bisphosphonate (ABP) Zoledronate (Zol) and interleukin (IL)-2, resulting in γ9δ2T cell-enriched lines (gdTCEL) similar to those of HD derived gdTCEL (54±19%). Moreover, gdTCEL from patients and HD mediated cytotoxicity to GBM-derived cell lines (GBMDCL), which was abrogated by immune-magnetic removal of the γ9δ2T cells. Furthermore, low level interferon (IFN) γ secretion was induced by gdTCEL briefly co-cultured with GBMDCL or autologous - tumor-derived cells, which was greatly amplified in the presence of Zol. Importantly, IFNγ secretion was inhibited by mevastatin but enhanced by cross-linking of butyrophilin 3A1 (CD277) on a CD277+ GBMDCL (U251MG) or by pretreatment of GBMDCL with temozolomide (TMZ). Taken together, these data suggest that γ9δ2T cells in PB of GBM patients can give rise to gdTCEL that mediate anti-tumoral activities.
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Affiliation(s)
- V Marcu-Malina
- Laboratory for Immunoregulation, Sheba Medical Center, Tel Hashomer, Israel; Institute of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - D Garelick
- Department of Medicine F, Sheba Medical Center, Tel Hashomer, Israel
| | - N Peshes-Yeloz
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel
| | - A Wohl
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel
| | - L Zach
- Institute of Oncology and Radiotherapy, Sheba Medical Center, Tel Hashomer, Israel
| | - M Nagar
- Institute of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - N Amariglio
- Cancer Research Center, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
| | - M J Besser
- Sackler School of Medicine, Tel Aviv University, Israel; Ella Institute for Melanoma, Sheba Medical Center, Tel Hashomer, Israel
| | - Z R Cohen
- Department of Neurosurgery, Sheba Medical Center, Tel Hashomer, Israel
| | - I Bank
- Laboratory for Immunoregulation, Sheba Medical Center, Tel Hashomer, Israel; Department of Medicine F, Sheba Medical Center, Tel Hashomer, Israel; Sackler School of Medicine, Tel Aviv University, Israel
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Abstract
INTRODUCTION The morphometry of distal end radius (DER) comprises the four necessary parameters: radial inclination, palmer tilt, radial height, and ulnar variance. The unblemished intellect about the morphometry is urged for the management of fracture of DER. The goal of our study was to determine the values of morphometric parameters of the DER from the adult Indian. MATERIALS AND METHODS It was a single hospital- based observational cross-sectional, prospective study. Radial inclination, radial height, and ulnar variance were measured on posteroanterior view, and the measurement of palmer tilt was accomplished on the lateral view. All the statistical analysis was done by Microsoft XL 2007 (data add in function were installed for data analysis). T-test was used for comparing the means of the parameters. RESULTS Two hundred and forty two (n = 242) X-rays were included in this study to analyze. The mean value (n = 242) of radial inclination was 23.27°± (standard deviation [SD]) 7.42° (range: 11.3-42.1°), palmer tilt 10.07° ± (SD) 5.28° (range: 1-16.9°), radial height 11.31 mm ± (SD) 4.9 mm (range: 7.1-30.4 mm), and ulnar variance 0.66 mm ± (SD) 2.46 mm (range: -2.4 to +4.1). CONCLUSION This study may provide an inauguratory plinth to prosecute the further analytical research in the Indian population. Moreover, the data may also be used as a reference data for the anatomical alignment while treating the injuries of the DER in the Indian population.
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Affiliation(s)
- Pankaj Kumar Mishra
- Department of Orthopaedics, G.M.C, and Hamidia Hospital, Bhopal, Madhya Pradesh, India,Address for correspondence: Dr. Pankaj Kumar Mishra, Department of Orthopaedics, G.M.C and Hamidia Hospital, Bhopal, Madhya Pradesh, India. E-mail:
| | - Manoj Nagar
- Department of Orthopaedics, Chirayu Medical College and Hospital, Bhopal, Madhya Pradesh, India
| | - Suresh Chandra Gaur
- Department of Orthopaedics, M.L.N. Medical College, Allahabad, Uttar Pradesh, India
| | - Anuj Gupta
- Department of Orthopaedics, Priti Nursing Home, Allahabad, Uttar Pradesh, India
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Langer B, Davidovitch N, Nakash O, Nagar M, Lurie I, Shoham S. Exposure to traumatic experiences among asylum seekers from Eritrea and
Sudan during migration to Israel. Ann Glob Health 2015. [DOI: 10.1016/j.aogh.2015.02.916] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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White H, Deprez L, Corbisier P, Hall V, Lin F, Mazoua S, Trapmann S, Aggerholm A, Andrikovics H, Akiki S, Barbany G, Boeckx N, Bench A, Catherwood M, Cayuela JM, Chudleigh S, Clench T, Colomer D, Daraio F, Dulucq S, Farrugia J, Fletcher L, Foroni L, Ganderton R, Gerrard G, Gineikienė E, Hayette S, El Housni H, Izzo B, Jansson M, Johnels P, Jurcek T, Kairisto V, Kizilors A, Kim DW, Lange T, Lion T, Polakova KM, Martinelli G, McCarron S, Merle PA, Milner B, Mitterbauer-Hohendanner G, Nagar M, Nickless G, Nomdedéu J, Nymoen DA, Leibundgut EO, Ozbek U, Pajič T, Pfeifer H, Preudhomme C, Raudsepp K, Romeo G, Sacha T, Talmaci R, Touloumenidou T, Van der Velden VHJ, Waits P, Wang L, Wilkinson E, Wilson G, Wren D, Zadro R, Ziermann J, Zoi K, Müller MC, Hochhaus A, Schimmel H, Cross NCP, Emons H. A certified plasmid reference material for the standardisation of BCR-ABL1 mRNA quantification by real-time quantitative PCR. Leukemia 2014; 29:369-76. [PMID: 25036192 PMCID: PMC4320294 DOI: 10.1038/leu.2014.217] [Citation(s) in RCA: 62] [Impact Index Per Article: 6.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/31/2014] [Revised: 05/21/2014] [Accepted: 06/25/2014] [Indexed: 11/14/2022]
Abstract
Serial quantification of BCR–ABL1 mRNA is an important therapeutic indicator in chronic myeloid leukaemia, but there is a substantial variation in results reported by different laboratories. To improve comparability, an internationally accepted plasmid certified reference material (CRM) was developed according to ISO Guide 34:2009. Fragments of BCR–ABL1 (e14a2 mRNA fusion), BCR and GUSB transcripts were amplified and cloned into pUC18 to yield plasmid pIRMM0099. Six different linearised plasmid solutions were produced with the following copy number concentrations, assigned by digital PCR, and expanded uncertainties: 1.08±0.13 × 106, 1.08±0.11 × 105, 1.03±0.10 × 104, 1.02±0.09 × 103, 1.04±0.10 × 102 and 10.0±1.5 copies/μl. The certification of the material for the number of specific DNA fragments per plasmid, copy number concentration of the plasmid solutions and the assessment of inter-unit heterogeneity and stability were performed according to ISO Guide 35:2006. Two suitability studies performed by 63 BCR–ABL1 testing laboratories demonstrated that this set of 6 plasmid CRMs can help to standardise a number of measured transcripts of e14a2 BCR–ABL1 and three control genes (ABL1, BCR and GUSB). The set of six plasmid CRMs is distributed worldwide by the Institute for Reference Materials and Measurements (Belgium) and its authorised distributors (https://ec.europa.eu/jrc/en/reference-materials/catalogue/; CRM code ERM-AD623a-f).
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Affiliation(s)
- H White
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - L Deprez
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - P Corbisier
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - V Hall
- National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK
| | - F Lin
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - S Mazoua
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - S Trapmann
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - A Aggerholm
- Department of Haematology, Aarhus University Hospital, Aarhus, Denmark
| | - H Andrikovics
- Hungarian National Blood Transfusion Service, Budapest, Hungary
| | - S Akiki
- Regional Genetics Laboratory, Birmingham Women's NHS Foundation Trust, Birmingham, UK
| | - G Barbany
- Department of Molecular Medicine and Surgery, Clinical Genetics Karolinska Institutet, Stockholm, Sweden
| | - N Boeckx
- 1] Department of Laboratory Medicine, UZ Leuven, Belgium [2] Department of Oncology, KU Leuven, Belgium
| | - A Bench
- Molecular Malignancy Laboratory and Haemato-Oncology Diagnostic Service, Cambridge University Hospitals NHS Foundation Trust, Cambridge, UK
| | - M Catherwood
- Haematology Department, Belfast City Hospital, Belfast, UK
| | - J-M Cayuela
- Haematology Laboratory and EA3518, University Hospital Saint-Louis, AP-HP, University Paris Diderot, Paris, France
| | - S Chudleigh
- Department of Molecular Haematology, Yorkhill NHS Trust, Glasgow, UK
| | - T Clench
- Molecular Haematology, Bristol Royal Infirmary, Bristol, UK
| | - D Colomer
- Hematopathology Unit, Hospital Clinic, IDIBAPS, Barcelona, Spain
| | - F Daraio
- Department of Clinical and Biological Science, University of Turin, Turin, Italy
| | - S Dulucq
- Laboratoire Hematologie, CHU Bordeaux, Hematopoiese Leucemique et Cibles Therapeutiques, INSERM U1035, Universite Bordeaux, Bordeaux, France
| | - J Farrugia
- Combined Laboratories, Derriford Hospital, Plymouth, UK
| | - L Fletcher
- Department of Genetics and Molecular Pathology, SA Pathology, Adelaide, SA, Australia
| | - L Foroni
- Imperial Molecular Pathology, Centre for Haematology, Imperial College London, London, UK
| | - R Ganderton
- Molecular Pathology, University Hospitals Southampton NHS Foundation Trust, Southampton, UK
| | - G Gerrard
- Imperial Molecular Pathology, Centre for Haematology, Imperial College London, London, UK
| | - E Gineikienė
- Hematology, Oncology and Transfusion Medicine Center, Vilnius University Hospital Santariskiu Clinics, Vilnius, Lithuania
| | - S Hayette
- Laboratory of Molecular Biology and UMR5239, Centre Hospitalier Lyon-Sud, Hospices Civils de Lyon, Pierre Bénite, France
| | - H El Housni
- Medical Genetics Department, Erasme Hospital, Brussels, Belgium
| | - B Izzo
- Department of Clinical Medicine and Surgery, University 'Federico II' of Naples, Naples, Italy
| | - M Jansson
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
| | - P Johnels
- Department of Clinical Genetics, University and Regional Laboratories, Lund, Sweden
| | - T Jurcek
- Department of Internal Medicine-Hematology and Oncology, Masaryk University and University Hospital Brno, Brno, Czech Republic
| | - V Kairisto
- Turku University Hospital, TYKSLAB, Laboratory of Molecular Genetics, Turku, Finland
| | - A Kizilors
- Laboratory for Molecular Haemato-Oncology, Kings College Hospital, London, UK
| | - D-W Kim
- Cancer Research Institute, The Catholic University of Korea, Seoul, South Korea
| | - T Lange
- Abteilung für Hämatologie und internistische Onkologie, Universität Leipzig, Leipzig, Germany
| | - T Lion
- Children's Cancer Research Institute/LabDia Labordiagnostik and Medical University, Vienna, Austria
| | - K M Polakova
- Institute of Hematology and Blood Transfusion, Prague, Czech Republic
| | - G Martinelli
- Department of Experimental, Diagnostic and Specialty Medicine, University of Bologna, Bologna, Italy
| | - S McCarron
- Cancer Molecular Diagnostics, St James's Hospital, Dublin, Ireland
| | - P A Merle
- VU Medical Centre, Department of Haematology, Amsterdam, The Netherlands
| | - B Milner
- Department of Medical Genetics, NHS-Grampian, Aberdeen, UK
| | | | - M Nagar
- Laboratory of Hematology, Sheba Medical Center, Tel Hashomer, Israel
| | - G Nickless
- Molecular Oncology Diagnostics Unit, Guy's Hospital, London, UK
| | - J Nomdedéu
- Lab Hematologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain
| | - D A Nymoen
- Division of Pathology, Rikshospital, Oslo University Hospital, Oslo, Norway
| | - E O Leibundgut
- Molecular Diagnostics Laboratory, Department of Hematology, University Hospital Bern, Bern, Switzerland
| | - U Ozbek
- Genetics Department, Institute of Experimental Medicine (DETAE), Istanbul University, Istanbul, Turkey
| | - T Pajič
- Specialized Haematology Laboratory, Division of Internal Medicine, Department of Haematology, University Medical Centre, Ljubljana, Slovenia
| | - H Pfeifer
- Department of Internal Medicine, Hematology/Oncology, Goethe University, Frankfurt, Germany
| | - C Preudhomme
- Laboratoire d'hématologie, CHU Lille, Lille, France
| | - K Raudsepp
- United Laboratories of Tartu University Hospitals, Tartu, Estonia
| | - G Romeo
- Molecular Haematology Laboratory, PathWest Laboratory Medicine, Royal Perth Hospital, Perth, WA, Australia
| | - T Sacha
- Hematology Department, Jagiellonian University, Krakow, Poland
| | - R Talmaci
- Hematology Department, Fundeni Clinical Institute, University of Medicine and Pharmacy 'Carol Davila', Bucharest, Romania
| | - T Touloumenidou
- Hematology Department and HCT Unit, G. Papanicolaou Hospital, Thessaloniki, Greece
| | | | - P Waits
- Bristol Genetics Laboratory, Southmead Hospital, Bristol, UK
| | - L Wang
- Department of Haematology, Royal Liverpool University Hospital, Liverpool, UK
| | - E Wilkinson
- HMDS, Leeds Institute of Oncology, St James's University Hospital, Leeds, UK
| | - G Wilson
- Sheffield Diagnostic Genetics Service, Sheffield Children's NHS Foundation Trust, Sheffield, UK
| | - D Wren
- Molecular Diagnostics, The Royal Marsden NHS Foundation Trust, Sutton, UK
| | - R Zadro
- Department of Laboratory Diagnostics, Clinical Hospital Center, Zagreb University School of Medicine, Zagreb, Croatia
| | - J Ziermann
- Department of Hematology/Oncology, Jena University Hospital, Jena, Germany
| | - K Zoi
- Haematology Research Laboratory, Biomedical Research Foundation, Academy of Athens, Athens, Greece
| | - M C Müller
- III. Medizinische Klinik, Medizinische Fakultät Mannheim der Universität Heidelberg, Mannheim, Germany
| | - A Hochhaus
- Department of Hematology/Oncology, Jena University Hospital, Jena, Germany
| | - H Schimmel
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
| | - N C P Cross
- 1] National Genetics Reference Laboratory (Wessex), Salisbury District Hospital, Salisbury, UK [2] Faculty of Medicine, University of Southampton, Southampton, UK
| | - H Emons
- European Commission, Joint Research Centre, Institute for Reference Materials and Measurements, Geel, Belgium
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Nagar M, Forrest N, Maceachern CF. Utility of follow-up radiographs in conservatively managed acute fifth metatarsal fractures. Foot (Edinb) 2014; 24:17-20. [PMID: 24502979 DOI: 10.1016/j.foot.2014.01.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/15/2013] [Revised: 11/02/2013] [Accepted: 01/05/2014] [Indexed: 02/04/2023]
Abstract
Fifth metatarsal fractures are the most common fracture of the foot, with the majority being managed conservatively. A variety of treatment methods are described in the literature. Follow-up radiographs are taken to identify fracture displacement, and subsequently to assess for bony union throughout treatment. We assessed the utility of serial radiographic assessment in management of these fractures. Clinical notes and radiographs of 79 patients with fifth metatarsal fractures were analysed retrospectively. Serial radiographs were studied to identify displacement and the last X-ray was reviewed for evidence of fracture union. 96% of fractures were managed conservatively. 29% showed radiological healing at last clinic visit, the rest being discharged as were considered clinically healed. Similar fracture types were managed differently. 3 fractures were surgically treated after failed conservative management. 1 fracture showed displacement from initial radiographs, and was successfully managed conservatively. Without clear guidelines, these injuries are managed differently from a radiological perspective. Follow-up radiographs taken before 6-8 weeks do not appear to alter patient management. Based on the current study we present our recommendations for radiographic assessment of acute fifth metatarsal fractures.
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Affiliation(s)
- Manoj Nagar
- Aberdeen Royal Infirmary and Woodend Hospital, Aberdeen, UK.
| | - Neil Forrest
- Aberdeen Royal Infirmary and Woodend Hospital, Aberdeen, UK.
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Davidov T, Nagar M, Kierson M, Chekmareva M, Chen C, Lu S, Lin Y, Chernyavsky V, Potdevin L, Arumugam D, Barnard N, Trooskin S. Carbonic Anhydrase 4 (CA4) and Crystallin Alpha-B (CRYAB) Immunoreactivity May Distinguish Benign From Malignant Thyroid Nodules in Patients With Indeterminate Thyroid Cytology. J Surg Res 2014. [DOI: 10.1016/j.jss.2013.11.475] [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: 10/25/2022]
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Nagar M, Radisic A, Strubbe K, Vereecken P. The effect of cupric ion concentration on the nucleation and growth of copper on RuTa seeded substrates. Electrochim Acta 2013. [DOI: 10.1016/j.electacta.2013.01.037] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
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Nagar M, Luhishi E, Shah N. Intraocular pressure control and fluctuation: the effect of treatment with selective laser trabeculoplasty. Br J Ophthalmol 2008; 93:497-501. [DOI: 10.1136/bjo.2008.148510] [Citation(s) in RCA: 66] [Impact Index Per Article: 4.1] [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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Nagar M, Ogunyomade A, O'Brart DPS, Howes F, Marshall J. A randomised, prospective study comparing selective laser trabeculoplasty with latanoprost for the control of intraocular pressure in ocular hypertension and open angle glaucoma. Br J Ophthalmol 2005; 89:1413-7. [PMID: 16234442 PMCID: PMC1772946 DOI: 10.1136/bjo.2004.052795] [Citation(s) in RCA: 178] [Impact Index Per Article: 9.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
Abstract
AIM To compare 90 degrees , 180 degrees , and 360 degrees selective laser trabeculoplasty (SLT, 532 nm Nd:YAG laser) with latanoprost 0.005% for the control of intraocular pressure (IOP) in ocular hypertension (OHT) and open angle glaucoma (OAG). METHODS A prospective, randomised clinical trial in the Department of Ophthalmology, St Thomas's Hospital, London, and Clayton Eye Centre, Wakefield, West Yorkshire. 167 patients (167 eyes) with either OHT or OAG were randomised to receive 90 degrees , 180 degrees , and 360 degrees SLT or latanoprost 0.005% at night and were evaluated at 1 hour, 1 day, 1 week and 1, 3, 6, and 12 months. RESULTS The mean follow up was 10.3 months (range 1--12 months). Early, transient, complications such as postoperative ocular pain, uveitis, and 1 hour IOP spike occurred in a number of eyes after SLT, with pain being reported more frequently after 360 degrees than 90 degrees treatments (p>0.001). Success rates defined in terms of both a 20% or more and a 30% or more IOP reduction from baseline measurements with no additional antiglaucomatous interventions were better with latanoprost than 90 degrees (p<0.001) and 180 degrees SLT (p<0.02) treatments. Differences in success rates between latanoprost and 360 degrees SLT did not reach statistical significance (p<0.5). Success rates were greater with 180 degrees and 360 degrees compared to 90 degrees SLT (p<0.05). With 360 degrees SLT, 82% of eyes achieved a >20% IOP reduction and 59% a >30% reduction from baseline. Although success rates were better with 360 degrees than 180 degrees SLT treatments, differences did not reach statistical significance. There were no differences with regard to age, sex, race, pretreatment IOP, OHT versus OAG, laser power settings, and total laser energy delivered between eyes which responded, in terms of a >20% and a >30% IOP reduction, and those that did not respond with 180 degrees and 360 degrees SLT treatments. CONCLUSIONS Success rates were higher with latanoprost 0.005% at night than with 90 degrees and 180 degrees SLT treatments. 90 degrees SLT is generally not effective. 360 degrees SLT appears to be an effective treatment with approximately 60% of eyes achieving an IOP reduction of 30% or more. Transient anterior uveitis with associated ocular discomfort is not unusual in the first few days after SLT. Late complications causing ocular morbidity after SLT were not encountered.
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Affiliation(s)
- M Nagar
- Department of Ophthalmology, St Thomas's Hospital, Lambeth Palace Road, London SE1 7EH, UK
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Abstract
The purpose of this study was to estimate the average angle of femoral neck anteversion in an Indian population. A total of 300 dry femora were classified by standard anatomical norms into male and female types and left-side and right-side types. They were evaluated by the Kingsley Olmsted and parallelograph methods, and the data were statistically analyzed. The average angles of anteversion obtained were 8.1 degrees and 8.3 degrees by the Kingsley Olmsted and parallelograph methods, respectively. The average female-type bone showed about 3 degrees more anteversion than the male-type bone. The average left-sided bone showed about 1.6 degrees more anteversion than the right-sided bone. A statistically significant difference existed between the sexes and the sides. The Kingsley Olmsted and parallelograph methods were found to be comparable with a correlation coefficient of 0.99. Altogether, 42.33%, 57.66%, and 79.00% of bones had readings of 5 degrees -10 degrees, 0 degrees -10 degrees, and 0 degrees -15 degrees, respectively. Thus, femoral neck anteversion has been found to be less in the Indian population than in Western populations.
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Affiliation(s)
- A K Jain
- Department of Orthopaedics, University College of Medical Sciences and Guru Teg Bahadur Hospital, Shahdara, Delhi 110095, India
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Dubey AK, Nagar M, Gupta A, Sahu D, Mishra S. Xeroderma pigmentosum (case report). Indian J Ophthalmol 1990; 38:94-6. [PMID: 2387609] [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: 12/31/2022] Open
Abstract
Xeroderma pigmentosum is a rare, hereditary and fatal disease of the skin. Ocular involvement is known to occur in 80% of cases. A case with typical cutaneous and ocular lesions is reported.
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