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Singhal P, Belasco M, Ali A, Taylor A, Wilkinson S. Re: Physician associates in interventional radiology: a new paradigm? Clin Radiol 2024; 79:e634-e635. [PMID: 38238149 DOI: 10.1016/j.crad.2023.12.013] [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] [Received: 12/12/2023] [Accepted: 12/13/2023] [Indexed: 03/09/2024]
Affiliation(s)
- P Singhal
- Junior Radiologists' Forum, Royal College of Radiologists, London, UK.
| | - M Belasco
- Junior Radiologists' Forum, Royal College of Radiologists, London, UK
| | - A Ali
- Junior Radiologists' Forum, Royal College of Radiologists, London, UK
| | - A Taylor
- Junior Radiologists' Forum, Royal College of Radiologists, London, UK
| | - S Wilkinson
- Junior Radiologists' Forum, Royal College of Radiologists, London, UK
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2
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Singhal P, Tan ALM, Drivas TG, Johnson KB, Ritchie MD, Beaulieu-Jones BK. Opportunities and challenges for biomarker discovery using electronic health record data. Trends Mol Med 2023; 29:765-776. [PMID: 37474378 PMCID: PMC10530198 DOI: 10.1016/j.molmed.2023.06.006] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Revised: 06/16/2023] [Accepted: 06/22/2023] [Indexed: 07/22/2023]
Abstract
Electronic health records (EHRs) have become increasingly relied upon as a source for biomedical research. One important research application of EHRs is the identification of biomarkers associated with specific patient states, especially within complex conditions. However, using EHRs for biomarker identification can be challenging because the EHR was not designed with research as the primary focus. Despite this challenge, the EHR offers huge potential for biomarker discovery research to transform our understanding of disease etiology and treatment and generate biological insights informing precision medicine initiatives. This review paper provides an in-depth analysis of how EHR data is currently used for phenotyping and identifying molecular biomarkers, current challenges and limitations, and strategies we can take to mitigate challenges going forward.
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Affiliation(s)
- P Singhal
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - A L M Tan
- Department of Biomedical Informatics, Harvard Medical School, Boston, MA, USA
| | - T G Drivas
- Department of Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - K B Johnson
- Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA; Department of Pediatrics, University of Pennsylvania, Philadelphia, PA, USA
| | - M D Ritchie
- Department of Genetics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA; Department of Biostatistics, Epidemiology, and Informatics, University of Pennsylvania, Philadelphia, PA, USA.
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Singhal P, Senecal JMM, Senecal JEM, Silwal P, Lynn BD, Nagy JI. Characteristics of Electrical Synapses, C-terminals and Small-conductance Ca 2+ activated Potassium Channels in the Sexually Dimorphic Cremaster Motor Nucleus in Spinal Cord of Mouse and Rat. Neuroscience 2023; 521:58-76. [PMID: 37100373 DOI: 10.1016/j.neuroscience.2023.04.013] [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: 11/15/2022] [Revised: 03/17/2023] [Accepted: 04/18/2023] [Indexed: 04/28/2023]
Abstract
Sexually dimorphic motoneurons (MNs) located in lower lumbar spinal cord are involved in mating and reproductive behaviours and are known to be coupled by electrical synapses. The cremaster motor nucleus in upper lumbar spinal cord has also been suggested to support physiological processes associated with sexual behaviours in addition to its thermoregulatory and protective role in maintaining testes integrity. Using immunofluorescence approaches, we investigated whether cremaster MNs also exhibit features reflecting their potential for electrical synaptic communication and examined some of their other synaptic characteristics. Both mice and rats displayed punctate immunolabelling of Cx36 associated with cremaster MNs, indicative of gap junction formation. Transgenic mice with enhanced green fluorescent protein (eGFP) reporter for connexin36 expression showed that subpopulations of cremaster MNs in both male and female mice express eGFP, with greater proportions of those in male mice. The eGFP+ MNs within the cremaster nucleus vs. eGFP- MNs inside and outside this nucleus displayed a 5-fold greater density of serotonergic innervation and exhibited a paucity of innervation by C-terminals arising from cholinergic V0c interneurons. All MNs within the cremaster motor nucleus displayed prominent patches of immunolabelling for SK3 (K+) channels around their periphery, suggestive of their identity as slow MNs, many though not all of which were in apposition to C-terminals. The results provide evidence for electrical coupling of a large proportion of cremaster MNs and suggest the existence of two populations of these MNs with possibly differential innervation of their peripheral target muscles serving different functions.
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Affiliation(s)
- P Singhal
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - J M M Senecal
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - J E M Senecal
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - P Silwal
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - B D Lynn
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - J I Nagy
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada.
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Singhal P, Senecal JMM, Nagy JI. Expression of the gap junction protein connexin36 in small intensely fluorescent (SIF) cells in cardiac parasympathetic ganglia of rodents. Neurosci Lett 2023; 793:136989. [PMID: 36471528 DOI: 10.1016/j.neulet.2022.136989] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2022] [Revised: 11/21/2022] [Accepted: 11/22/2022] [Indexed: 11/28/2022]
Abstract
In mammals, several endocrine cell types are electrically coupled by connexin36 (Cx36)-containing gap junctions, which mediate intercellular communication and allow regulated and synchronized cellular activity through exchange of ions and small metabolites via formation of intercellular channels that link plasma membranes of apposing cells. One cell type thought to be endocrine-like in nature are small intensely fluorescent (SIF) cells that store catecholamines in their dense-core vesicles and reside in autonomic ganglia. Here, using immunofluorescence approaches, we examined whether SIF cells located specifically in cardiac parasympathetic ganglia of adult and neonatal mice and adult rats follow patterns of Cx36 expression seen in other endocrine cells. In these ganglia, SIF cells were identified by their distinct small soma size, autofluorescence at 475 nm, and immunolabelling for their markers tyrosine hydroxylase and vesicular monoamine transporter-1. SIF cells were often found in pairs or clusters among principal cholinergic neurons. Immunofluorescence labelling of Cx36 occurred exclusively as fine puncta that appeared at contacts between SIF cell processes and somata or at somato-somatic appositions of SIF cells. These puncta were absent in cardiac parasympathetic ganglia of Cx36 null mice. Transgenic mice expressing enhanced green fluorescent protein reporter for Cx36 expression displayed labelling for the reporter in SIF cells. The results suggest that Cx36-containing gap junctions electrically couple SIF cells, which is consistent with previous suggestions that these may be classified as endocrine-type cells that secrete catecholamines into the bloodstream in a regulated manner.
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Affiliation(s)
- P Singhal
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - J M M Senecal
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada
| | - J I Nagy
- Department of Physiology and Pathophysiology, Rady Faculty of Health Sciences, Max Rady College of Medicine, University of Manitoba, Winnipeg R3E 0J9, Canada.
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Patel S, Kingsford P, Valdivia D, Singhal P, Lee R, Cunningham M, Wolfson A, Vaidya A, DePasquale E. Outcomes of Patients Bridged to Heart Transplantation with ECMO Following the UNOS Allocation Policy Change. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Valdivia D, Singhal P, Hashmi S, Patel S, Kingsford P, Lee R, Vaidya A, Wolfson A, DePasquale E. Heart Transplant Outcomes and Trends in Pre-Transplant Impella Use. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1651] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Abarca P, Patel S, Li J, Saffarian M, Singhal P, Liu G, Grazette L, Pizula J, Banankhah P, Vaidya A, Wolfson A, DePasquale E. Post-Heart Transplant Outcomes in Patients with Hypertrophic Cardiomyopathy (HCM) before and after the 2018 UNOS Heart Allocation Policy Change. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Singhal P, Genyk P, Miller S, Wolfson A, Vaidya A, DePasquale E. Comparison of Post-Heart Transplant Survival between Status 1A versus Status 1-3 Recipients before and after the UNOS Allocation Policy Change. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.724] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Genyk P, Singhal P, Onwuzurike J, Vaidya A, Wolfson A, DePasquale E. Waitlist Outcomes in Status 1A versus Status 1-3 Heart Transplant Candidates before and after the UNOS Allocation Policy Change. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.726] [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: 11/15/2022] Open
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10
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Li J, Kingsford P, Hashmi S, Onwuzurike J, Genyk P, Liu G, Saffarian M, Yang K, Abarca P, Singhal P, Sharma A, Miller S, Patel S, Miklin D, Lum C, Salimbangon A, Lee Jr R, Lee A, Nattiv J, Pizula J, Fong M, Grazette L, Rahman J, Pandya K, Wolfson A, DePasquale E, Vaidya A. One-year before and after UNOS Status Change Effect on ECMO as a Bridge to Heart Transplant. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.1943] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Miklin D, Bradley P, Lee R, Singhal P, Miller S, Genyk P, Li J, Saffarian M, Hashmi S, Kingsford P, Patel S, Lum C, Salimbangon A, Wolfson A, Vaidya A, Depasquale E. Impact of UNOS Policy Allocation Change on Waitlist Outcomes in Patients Bridged to Heart Transplant with an Intra-Aortic Balloon Pump. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.782] [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: 11/25/2022] Open
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AL QA'QA' S, Singhal P, Sainaresh Vellanki V, Garcia R, Avila-Casado C. SUN-326 ADENOVIRUS INDUCED GRANULOMATOUS TUBULOINTERSTITIAL NEPHRITIS IN A RENAL ALLOGRAFT PATIENT. Kidney Int Rep 2020. [DOI: 10.1016/j.ekir.2020.02.864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
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13
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Singhal P, Kaushik G, Patil SS, Chel A. Indian Youth Should Be Trained Regarding Traditional Foods of the Country. J Food Qual Hazards Control 2018. [DOI: 10.29252/jfqhc.5.2.2] [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: 10/31/2022] Open
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Drobni Z, Dastidar A, Rodrigues J, Johnson T, De Garate E, Singhal P, Baritussio A, Scatteia A, Strange J, Nightingale A, Baumbach A, Delgado V, Bucciarelli-Ducci C. P551The role of CMR versus conventional diagnostic markers in myocardial infarction with non-obstructed coronary arterties (MINOCA). Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx501.p551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ghosh Dastidar A, De Garate E, Drobni Z, Baritussio A, Singhal P, Biglino G, Dorman S, Strange J, Baumbach A, Johnson T, Bucciarelli-Ducci C. P2122Prognostic risk stratification in myocardial infarction with non-obstructed coronaries (MINOCA) by conventional risk factors and cardiac magnetic resonance. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx502.p2122] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Pontecorboli G, Lazzeroni D, Fierro N, Biglino G, Dastidar A, De Garate E, Singhal P, Baritussio A, Camici P, Bucciarelli-Ducci C. P4509Incremental value of CMR-derived mitral annular plane systolic excursion for atrial fibrillation risk stratification in patients with hypertrophic cardiomyopathy. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx504.p4509] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Srinivasan S, Krovi V, Singhal P, Misra S. A Quantitative System for Technical Assessment and Training of Skills (STATS) for Surgical Performance. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.127] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Srinivasan S, Singhal P, Misra S, Mclean VE, Wadhwa R. Techniques to Perform Robot-Assisted Total Laparoscopic Hysterectomy without a Uterine Manipulator in a Case of Severe Cervical Stenosis. J Minim Invasive Gynecol 2016. [DOI: 10.1016/j.jmig.2016.08.348] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Bolnick A, Jain C, Kilburn B, Singhal P, Svytka S, Bolnick J, Barrak C, Greige R, Armant D. The actions of sildenafil on trophoblast survival is dependent on HBEGF signaling. Fertil Steril 2016. [DOI: 10.1016/j.fertnstert.2016.07.1105] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Dastidar AG, De Garate E, Singhal P, Rodrigues J, Baritussio A, Scatteia A, Nightingale A, Stuart AG, Bucciarelli-Ducci C. 5 Structural predictors of atrial fibrillation in hypertrophic cardiomyopathy using cardiac magnetic resonance imaging: Abstract 5 Table 1. Heart 2016. [DOI: 10.1136/heartjnl-2016-309668.5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Dastidar AG, Rodrigues J, Johnson T, De Garate E, Singhal P, Baritussio A, Scatteia A, Strange J, Nightingale A, Baumbach A, Delgado V, Bucciarelli-Ducci C. 4 Troponin positive acute coronary syndromes and unobstructed coronary arteries: Improved diagnostic and clinical impact by performing cardiovascular magnetic resonance early after presentation. Heart 2016. [DOI: 10.1136/heartjnl-2016-309668.4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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De Garate E, Dastidar AG, Singhal P, Venuti G, Amadu A, Baritussio A, Scatteia A, Lawton C, Rodrigues J, Bucciarelli-Ducci C. 6 Prevalence and CMR characteristics of apical HCM: Abstract 6 Table 1. Heart 2016. [DOI: 10.1136/heartjnl-2016-309668.6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Lowes S, Hucker R, Jemal M, Marini JC, Rezende VM, Shoup R, Singhal P, Timmerman P, Yoneyama T, Weng N, Zimmer D. Tiered approaches to chromatographic bioanalytical method performance evaluation: recommendation for best practices and harmonization from the Global Bioanalysis Consortium harmonization team. AAPS J 2015; 17:17-23. [PMID: 25338740 PMCID: PMC4287281 DOI: 10.1208/s12248-014-9656-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [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: 04/14/2014] [Accepted: 08/04/2014] [Indexed: 11/30/2022] Open
Abstract
The A2 harmonization team, a part of the Global Bioanalysis Consortium (GBC), focused on defining possible tiers of chromatographic-based bioanalytical method performance. The need for developing bioanalytical methods suitable for the intended use is not a new proposal and is already referenced in regulatory guidance language. However, the practical implementation of approaches that differ from the well-established full validation requirements has proven challenging. Advances in technologies, the need to progress drug development more efficiently, and emerging new drug compound classes support the use of categorized tiers of bioanalytical methods. This paper incorporated the input from an international team of experienced bioanalysts to surmise the advantages and the challenges of tiered approaches and to provide recommendations on paths forward.
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Affiliation(s)
- S Lowes
- Bioanalytical and ADME Labs, Quintiles, 19 Brown Road, Ithaca, New York, 14850, USA,
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Eddib A, Hughes S, Aalto M, Eswar A, Erk M, Michalik C, Krovi V, Singhal P. Impact of Age on Surgical Outcomes after Robot Assisted Laparoscopic Hysterectomies. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/ss.2014.53018] [Citation(s) in RCA: 3] [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: 11/20/2022]
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26
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Chitgar S, Ghomi A, Danakas G, Erk M, Sathianarayanan M, Krovi V, Sharma S, Singhal P. Safety and Efficacy of Robot-Assisted Gynecologic Surgery for High Risk and Advanced Stage Endometrial Cancer. J Minim Invasive Gynecol 2013. [DOI: 10.1016/j.jmig.2013.08.264] [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: 11/27/2022]
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Abstract
Rhinosporidiosis is a chronic infestation by the fungus Rhinosporidium seeberi, which predominantly affects the mucus membranes of the nose and nasopharynx. We report a case of rhinosporidiosis with presentation as an oropharyngeal mass and a discusion about its endoscopic removal.
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Affiliation(s)
- N Sonkhya
- Department of ENT, SMS Medical College and Hospital, 7/251, Vidyadhar Nagar, 302012 Jaipur, Rajastan India
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Gupta R, Singhal P, Mahajan K, Singhal A. Fabricating feeding plate in CLP infants with two different material: a series of case report. J Indian Soc Pedod Prev Dent 2012; 30:352-5. [PMID: 23514692 DOI: 10.4103/0970-4388.108943] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Feeding is a family's biggest concerns when a child is born with cleft lip and/or palate. The goal for that child is to have as near normal feeding as possible. This report presents fabrication of feeding plates in two infants born with cleft lip and palate using two different materials.
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Affiliation(s)
- R Gupta
- Department of Prosthodontics, HP Government Dental College, Shimla, India.
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Abstract
Orofacial granulomatosis comprises a group of diseases characterized by noncaseating granulomatous inflammation affecting the soft tissues of the oral and maxillofacial region. The most common clinical presentation is persistent swelling of one or both lips. It is important to establish the diagnosis accurately because this condition is sometimes a manifestation of Crohn's disease or sarcoidosis. This article describes a case of orofacial granulomatosis.
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Affiliation(s)
- P Singhal
- Department of Pedodontics and Preventive Dentistry, HP Government Dental College, Shimla, Himachal Pradesh, India.
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30
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Mishra TD, Kurani H, Singhal P, Shrivastav PS. Simultaneous Quantitation of HIV-Protease Inhibitors Ritonavir, Lopinavir and Indinavir in Human Plasma by UPLC-ESI-MS-MS. J Chromatogr Sci 2012; 50:625-35. [DOI: 10.1093/chromsci/bms048] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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31
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Gupta N, Singhal P, Gupta DK. Population dynamics of a parasite Pallisentis in two species of fish Channa punctatus and Channa striatus. J Environ Biol 2012; 33:195-199. [PMID: 23033680] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
In an aquatic environment, there is a profound and inverse relationship between environment quality and disease status of fish. Parasites are one of the most serious limiting factors in aquaculture. Therefore, the present investigation has been undertaken to sort out the population dynamics of Pallisentis (Acanthocephala), in relation to host sex from freshwater fishes, Channa of Rohilkhand region. A total of 517 fishes (Channa punctatus, n = 198 and C. striatus, n = 319) were examined regularly from August 2006 to February 2010. Overall prevalence of Pallisentis in C. striatus was higher in females (67.78%) as compared to males (63.52%). In case of C. punctatus, overall prevalence of Pallisentis was higher in males (53.77%) as compared to females (52.17%) whereas, relative density was higher in females (61.41%) than in males (52.72%). Intensity (2-3 parasite/host, in both sexes), density (1.36 in males and 1.69 in females) and infection index (0.73 in males and 0.88 in females) were recorded.
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Affiliation(s)
- N Gupta
- Department of Animal Science, M.J.P. Rohilkhand University, Bareilly-243 006, India.
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Abstract
Osteoma is a benign osteogenic tumor arising from the proliferation of cancellous or compact bone. The osteoma can be central, peripheral, or of an extraskeletal type. Peripheral type of osteoma is most common in the lower jaws, which occurs at the surface of the cortical bone and is sessile or pedicled. The overall incidence of osteoma is low, affecting 0.01-0.04% of the population; osteomas comprise 12.1% of benign bone tumors and 2.9% of all bone tumors. Most of the osteomas occurring in the mandible are dense osteomas, and the cancellous osteoma is comparatively rare. Maxillofacial osteoma associated with cutaneous sebaceous cysts, multiple supernumerary teeth, and colorectal polyposis is known as Gardener's syndrome. However, in some cases, maxillofacial osteomas with multiple impacted and supernumerary teeth are not accompanied by a fixed complex of symptoms. We report one such case in a 15-year-old female patient.
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Affiliation(s)
- P Singhal
- Department of Pedodontics and Preventive Dentistry, HP Government Dental College, Shimla, Himachal Pradesh, India
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Abstract
The cemento-ossifying fibroma is classified as a fibro-osseous lesion of the jaws. It commonly presents as a progressively growing lesion that can attain an enormous size with resultant deformity if left untreated. The cemento-ossifying fibroma is a central neoplasm of bone as well as periodontium which has caused considerable controversy because of controversy regarding terminology and the criteria for its diagnosis. This case report describes a female patient with cemento-ossifying fibroma involving maxillary antrum. The clinical, radiographic and histological features as well as the surgical findings are presented.
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Affiliation(s)
- A Singhal
- Department of Pedodontics and Preventive Dentistry, HP Government Dental College, Shimla, Himachal Pradesh, India
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Abstract
Lingual thyroid is a rare embryological anomaly and originates from failure of the thyroid gland to descend from the foramen caecum to its normal eutopic pre-laryngeal site. The ectopic gland located at the base of the tongue is often asymptomatic but may cause local symptoms such as dysphagia, dysphonia with stomatolalia, upper airway obstruction and haemorrhage, often with hypothyroidism. One case is presented, in a 5 year-old girl patient, who complained of sensation of a foreign body and progressive dysphagia and dyspnoea caused by ectopic lingual thyroid. The diagnosis of lingual thyroid is usually made clinically and radionuclide scanning is used to confirm the diagnosis. In this case report, presentation, diagnosis and management of this condition is highlighted.
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Affiliation(s)
- P Singhal
- Department of Pedodontics and Preventive Dentistry, HP Govt Dental College, Shimla, Himachal Pradesh, India.
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Singhal P, Aziz HH, Tyler G, Marchetti D. Surgical outcomes of robot-assisted surgical staging for morbidly obese (BMI >40) patients with endometrial cancer: Technique for morbidly obese patients. Gynecol Oncol 2011. [DOI: 10.1016/j.ygyno.2010.12.317] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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36
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Yadav M, Patel C, Patel M, Mishra T, Singhal P, Shrivastav PS, Yadav M, Baxi GA. Development and Validation of a Sensitive and Rapid Method to Determine Naratriptan in Human Plasma by LC-ESI-MS-MS: Application to a Bioequivalence Study. J Chromatogr Sci 2011; 49:101-7. [DOI: 10.1093/chrsci/49.2.101] [Citation(s) in RCA: 9] [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: 11/14/2022]
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Yadav M, Rao R, Kurani H, Rathod J, Patel R, Singhal P, Shrivastav PS. Validated Ultra-Performance Liquid Chromatography Tandem Mass Spectrometry Method for the Determination of Pramipexole in Human Plasma. J Chromatogr Sci 2010; 48:811-8. [DOI: 10.1093/chromsci/48.10.811] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Yadav M, Singhal P, Goswami S, Pande UC, Sanyal M, Shrivastav PS. Selective Determination of Antiretroviral Agents Tenofovir, Emtricitabine, and Lamivudine in Human Plasma by a LC-MS-MS Method for a Bioequivalence Study in Healthy Indian Subjects. J Chromatogr Sci 2010; 48:704-13. [DOI: 10.1093/chromsci/48.9.704] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
AIM To rapidly reduce serum triglyceride to a safe serum level. Severe hypertriglyceridaemia is associated with uncontrolled diabetes, obesity and poor physical activity. Even moderate increases in triglyceride levels (> 5mmol/L) confer an increased risk of pancreatitis and coronary artery disease. We present two patients with diabetes and serum triglyceride levels of greater than 85mmol/L despite polypharmacy intervention. METHOD 72-hour intravenous insulin infusion was administered. RESULTS Serum triglyceride levels fell to 9.4 and 4.6 mmol/L respectively, without adverse events and sustained effect over several months. CONCLUSION We suggest the use of intravenous insulin infusion where lifestyle and oral drug therapies have failed can impact on severe hypertriglyceridaemia.
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Affiliation(s)
- J M Triay
- Weston Area Health Trust, Weston General Hospital, Weston-super-Mare, Somerset, UK.
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Yadav M, Gupta A, Singhal P, Shrivastav PS. Development and Validation of a Selective and Rapid LC-MS-MS Method for the Quantification of Abacavir in Human Plasma. J Chromatogr Sci 2010; 48:654-62. [DOI: 10.1093/chromsci/48.8.654] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Abstract
OBJECTIVES The objective of this study was to evaluate tooth brushing management and ability of children in relation to age and gender. MATERIALS AND METHODS The study population consisted of 45 children, who attended Department of Pedodontics and Preventive Dentistry at V.S Dental College and Hospital Bangalore. Children were divided into three groups according to age: Group I: 3-5 years, Group II: 6-8 years, and Group III: 9-11 years. Each child selected his/her favorite toothbrush and brushed his/her teeth under supervision of one instructor. The grip type during tooth brushing was recorded on a videotape and duration of tooth brushing also was noted. The data were analyzed in relation to the age and gender using the chi-square test. ANOVA was used to find if there is any significant difference between the mean brushing times in the different groups. RESULTS The results of statistical analysis showed that in all cases P> 0.05 for grip preferences and P. CONCLUSION The required manual dexterity for tooth brushing was present in younger age groups.
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Affiliation(s)
- U M Das
- Department of Pedodontics and Preventive Dentistry, V. S. Dental College and Hospital, K. R. Road, V.V. Puram, Bangalore - 560 004, Karnataka, India.
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Singhal P, Hamilton MJ, Vasudevan V, Kejriwal R, Muthukumarswamy S, Kejriwal NK. Endovascular Aortic Arch Repair after Aortic Arch Debranching for Acute Dissection. Heart Lung Circ 2009. [DOI: 10.1016/j.hlc.2009.04.066] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Singhal P, Naswa S, Marfatia YS. Pregnancy and sexually transmitted viral infections. Indian J Sex Transm Dis AIDS 2009. [PMID: 21938124 PMCID: PMC3168062 DOI: 10.4103/2589-0557.62761] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Viral infections in pregnancy are a major cause of morbidity and mortality for both mother and fetus. Viral STIs occur as surface infection and then gradually infect immunologically protected sites. Therefore, these are asymptomatic, hidden and hence underdiagnosed, persistent and difficult to treat. HSV, HPV, HBV, HIV and CMV (cytomegalovirus) are the common ones. Most of these are transmitted during intrapartum period. Proper screening, identification and treatment offered during prenatal period may help in preventing their complications. Twenty five percent of women with a history of genital herpes have an outbreak at some point during the last month of pregnancy. Acyclovir is the accepted efficacious and safe therapy for HSV in pregnancy. Globally, HPV infection is the most common sexually transmitted infection. Neonatal transmission can occur in the absence of clinically evident lesions. HPV 6 or 11 may lead to Juvenile Onset Recurrent Respiratory Papillomatosis (JORRP). TCA, liquid nitrogen, laser ablation or electrocautery can be used to treat external genital HPV lesions at any time during pregnancy. Cesarean section is recommended only if the lesions are obstructing the birth canal. Mother to child transmission (MTCT) in HIV accounts for 15-30% during pregnancy and delivery, and a further 5-20% of transmission occurs through breastfeeding. HBV infection during pregnancy does not alter the natural course of the disease. In women who are seropositive for both HBsAg and HBeAg, vertical transmission is approximately 90%. Pregnancy is not a contraindication for HBV vaccination. Cytomegalovirus (CMV) is the most common intrauterine infection. Cytomegalic inclusion disease (CID) is the most severe form of congenital CMV infection. Treatment is supportive.
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Affiliation(s)
- P. Singhal
- Department of Skin VD, Government Medical College & SSG Hospital, Vadodara, Gujarat, India
| | - S. Naswa
- Department of Skin VD, Government Medical College & SSG Hospital, Vadodara, Gujarat, India
| | - Y. S. Marfatia
- Department of Skin VD, Government Medical College & SSG Hospital, Vadodara, Gujarat, India,Address for correspondence: Dr. Y S Marfatia, Professor & Head, Department of Skin VD, Government Medical College & SSG Hospital, Vadodara, Gujarat, India. E-mail:
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Singhal P, Riordan J. Intrapericardial Haematoma: A Rare Cause of Congestive Cardiac Failure After Three Years of Coronary Artery Bypass Grafting. Heart Lung Circ 2008; 17:343-4. [PMID: 17512250 DOI: 10.1016/j.hlc.2007.03.011] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2006] [Revised: 01/24/2007] [Accepted: 03/08/2007] [Indexed: 11/29/2022]
Abstract
We present a rare case of organised intrapericardial haematoma after three years of coronary artery bypass grafting. Delayed cardiac tamponade after open heart surgery usually occurs within first few weeks of surgery. Intrapericardial organised haematoma causing localised compression of cardiac chambers after three years of open heart surgery is very rare. Under cardiopulmonary bypass and cardioplegic cardiac arrest, we removed the haematoma. It is difficult to make a clinical diagnosis. However once diagnosis is made and haematoma removed, it gives good symptomatic relief to the patient.
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Affiliation(s)
- P Singhal
- Department of Cardiothoracic Surgery, Waikato Hospital, Hamilton, New Zealand.
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Singhal P, Kejriwal N. Ascending aortic tear with severe aortic regurgitation following rugby injury. Heart Lung Circ 2008; 18:150-1. [PMID: 18242134 DOI: 10.1016/j.hlc.2007.10.015] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2007] [Revised: 10/15/2007] [Accepted: 10/31/2007] [Indexed: 11/27/2022]
Abstract
Blunt ascending aortic injuries are rare in clinical practice. Aortic valve regurgitation is an uncommon consequence of closed chest injury. It is caused by either ruptured valve cusp or when subadventitial rupture of the ascending aorta causes prolapse of subjacent valve cusp. Most of the blunt aortic injuries are secondary to high speed motor vehicle accident or falls from significant height. We report on a 33-year-old man who sustained an injury during a rugby game and presented with severe aortic regurgitation secondary to subadventitial rupture of ascending aorta on a background of asymptomatic dilated aortic root. He underwent emergency operation for torrential aortic regurgitation and severe left ventricular failure.
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Affiliation(s)
- P Singhal
- Department of Cardiothoracic Surgery, Waikato Hospital, Hamilton, New Zealand.
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Singhal P, Ullal R. Mitral valve replacement in patient with absent right superior vena cava, pectus excavatum, Marfan syndrome and severe mitral regurgitation. Heart Lung Circ 2007; 17:507-10. [PMID: 18082450 DOI: 10.1016/j.hlc.2007.09.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2007] [Accepted: 09/06/2007] [Indexed: 11/24/2022]
Abstract
Combination of persistent left superior vena cava (PLSVC) draining into right atrium via the coronary sinus with a normal right superior vena cava (RSVC) is the most common systemic venous anomaly in visceroatrial situs solitus. On the other hand, a PLSVC in absence of RSVC is an extremely rare anomaly. Cardiovascular abnormalities are frequently encountered in patients with Marfan's syndrome but absence of RSVC with PLSVC is not reported in these patients. We report on a 52-year-old man with Marfan syndrome, an absence of right superior vena cava, severe pectus excavatum and severe mitral regurgitation who underwent successful mitral valve replacement. CT scan chest revealed marked cardiac deviation to the left associated with severe pectus excavatum, absent right superior vena cava and persistent left superior vena cava. During surgery replacement of mitral valve was performed through midsternotomy successfully.
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Affiliation(s)
- P Singhal
- Department of Cardiothoracic Surgery, Waikato Hospital, Hamilton, New Zealand.
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Singhal P, Kejriwal N, Lin Z, Tsutsui R, Ullal R. Optimal surgical management of descending necrotising mediastinitis: our experience and review of literature. Heart Lung Circ 2007; 17:124-8. [PMID: 18060838 DOI: 10.1016/j.hlc.2007.08.004] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/19/2007] [Revised: 08/18/2007] [Accepted: 08/28/2007] [Indexed: 11/16/2022]
Abstract
INTRODUCTION Descending necrotising mediastinitis is a form of mediastinitis caused by odontogenic infection or deep cervical infections, which spreads to the mediastinum via the cervical fascial planes. Despite the increased use of CT scan as a diagnostic aid and the improvement in antibiotics, mortality in patients with descending necrotising mediastinitis remains high, reported between 25 and 40% in the literature. Surgical management and optimal form of mediastinal drainage remain controversial. PATIENTS AND METHODS We have treated three patients with descending necrotising mediastinitis at our institution. Two patients were male and one was female with mean age 54.3+/-12.5 years. One of the patients was a known diabetic. The primary oropharyngeal infection was Ludwig's angina, odontogenic abscess and parapharyngeal abscess. All patients underwent mediastinal drainage, one through midsternotomy and two through right thoracotomy in addition to cervical drainage. All the three patients had mixed aerobic and anaerobic infection. RESULTS There was no perioperative mortality. Mean ICU stay was 32 days (12-53 days). All three patients had septicaemic shock requiring prolonged inotropic support. Two patients required tracheostomy because of prolonged ventilation. All the patients had recurrent abscesses and collections either in neck or in chest requiring drainage either surgically or percutaneously under CT scan or ultrasound guidance, thus decreasing the need of repeated surgical procedures. CONCLUSION Descending necrotising mediastinitis is a potentially fatal condition. Early diagnosis, prompt surgical drainage, monitoring of disease process, appropriate medical management in an intensive care unit and a multi-disciplinary approach can significantly reduces the mortality in this otherwise fatal condition. Percutaneous drainage of recurrent abscesses and collections can decrease the need of repeated surgical procedures in these critically ill patients.
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Affiliation(s)
- P Singhal
- Department of Cardiothoracic Surgery, Waikato Hospital, Hamilton, New Zealand.
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Singhal P, Mahon BD, Sharma A, Riordan JP. CT02 A STUDY TO EVALUATE VARIOUS TECHNIQUES OF CORONARY ARTERY BYPASS GRAFTING. ANZ J Surg 2007. [DOI: 10.1111/j.1445-2197.2007.04115_2.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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50
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Kejriwal NK, Lin Z, Parkinson G, Ullal R, Singhal P. CT12 SURGICAL MANAGEMENT OF DESCENDING NECROTIZING MEDIASTINITIS. ANZ J Surg 2007. [DOI: 10.1111/j.1445-2197.2007.04115_12.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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