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Mani R, Gupta A, Gupta S, Goyal B, Mishra R, Tandon A, Sharma O, Rohilla KK, Kishore S, Dhar P. Expression of ER, PR, and HER-2 Neu and correlation with tumor markers in gall bladder carcinoma. J Cancer Res Ther 2023; 19:1279-1287. [PMID: 37787296 DOI: 10.4103/jcrt.jcrt_1754_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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/04/2023]
Abstract
Background Females having a large proportion of gallbladder carcinoma (GBC) and a higher incidence of gallstones pointed toward the role of sex hormones in GBC development. In this study, we evaluated the expression of Estrogen receptor (ER), Progesterone receptor (PR), and Her2/neu and their correlation with tumor markers and clinicopathological parameters in the GBC. Methods A total of 50 patients of GBC and 42 patients in control group undergoing surgery for other conditions were taken. The patient's biopsy sample's paraffin block was tested for ER, PR, and Her2/neu expression by immunohistochemistry. Results ER and PR had no significant expression in GBC and control group, but Her2/neu had 16% expression in GBC, significantly associated with the degree of differentiation with 62.5% (n-5) being well-differentiated; 75% of Her2/neu positive were in stages III and IV. Her2/neu did not correlate with tumor markers despite expression. Conclusions Her2/neu amplification is a small step in validating that option so it could be included in the treatment and prognostication of GBC.
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Affiliation(s)
- Rishit Mani
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Rahul Mishra
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Amoli Tandon
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Oshin Sharma
- Department of Surgery, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Kusum K Rohilla
- Department of Nursing, College of Nursing, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
| | - Puneet Dhar
- Department of Surgical Gastroenterology, All India Institute of Medical Science, Rishikesh, Uttarakhand, India
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2
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Dolci S, Martinazzi S, Linardi D, Mani R, Nicola VD, Sarcina SD, Decimo I, Luciani G, Rungatscher A. Nitric Oxide Administered in Oxygenator During Ecmo Improves Ventricular-Arterial Coupling and Decreases Inflammation and Oxidative Stress in an Experimental Model of Pulmonary Arterial Hypertension. J Heart Lung Transplant 2023. [DOI: 10.1016/j.healun.2023.02.184] [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: 04/05/2023] Open
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3
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Rajput D, Gupta A, Shasheendran S, Mani R, Tandon A, Krishnasamy SK, Siddeek RAT, Bhukya KS, Edem S. Laparoscopic Retrieval of a 13-Year-Old Retained Iatrogenic Metallic Foreign Body from the Pelvis: An Uncommon Case Report. Surg J (N Y) 2023; 9:e62-e66. [PMID: 36873296 PMCID: PMC9981328 DOI: 10.1055/s-0043-1764124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2021] [Accepted: 12/06/2022] [Indexed: 03/06/2023] Open
Abstract
Retained surgical foreign bodies are unanticipated events culminating from inadvertent operating room errors and may cause severe medical and legal problems between the patient and the doctor. Here, we report detecting a surgical instrument fragment 13 years after an open abdominal hysterectomy in a quadragenarian during her evaluation of a month-old complaint of lower abdominal and right thigh pain. A computed tomography scan of the abdomen demonstrated a radio-opaque linear foreign body traversing the right obturator foramen with extension into the pelvis cranially and the adductor compartment of the right thigh caudally. The metallic foreign body, identified as a fragmented handle of a uterine tenaculum forceps with a slender sharp-tip hook, could be removed laparoscopically from the pelvis after a diagnostic laparoscopy, preventing significant complications. The minimally invasive approach enabled a smooth recovery, and the patient could go home on the second postoperative day.
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Affiliation(s)
- Deepak Rajput
- Department of General Surgery, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India
| | - Amit Gupta
- Department of General Surgery, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India
| | - Sruthi Shasheendran
- Department of General Surgery, University College of Medical Sciences, Delhi, India
| | - Rishit Mani
- Department of General Surgery, All India Institute of Medical Sciences Patna, Bihar, India
| | - Amoli Tandon
- Department of General Surgery, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India
| | | | - Rohik Anjum T Siddeek
- Department of General Surgery, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India
| | - Krishna Sai Bhukya
- Department of General Surgery, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India
| | - Sanketh Edem
- Department of General Surgery, All India Institute of Medical Sciences Rishikesh, Dehradun, Uttarakhand, India
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4
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Yasen Z, Smith M, Mani R, Chung A. 537 Oro-Nasal Fistula: A Very Rare Complication Following Routine Palatal Biopsy. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.264] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Abstract
Biopsies of the palate are generally well-tolerated with known complications of pain, bleeding, or infection, that can usually be well-controlled. We report a case of a 63-year-old male who developed a rare complication following a biopsy of an ulcer on the junction between hard and soft palate. Despite an uneventful routine biopsy, the patient presented with an oro-nasal fistula and complaints of nasal discharge. The cause of the fistula was unclear, and the histopathology results excluded malignancy. The possible hypotheses considered for this very rare and unusual complication were infection, vascularity, and underlying systemic co-morbidities. We believe in this case that the cause of wound breakdown was secondary to loss of vascularity of the mucosa from his CPAP device. The patient has since been referred to a tertiary unit for consideration of surgical repair. To the author's knowledge, there are no similar published reports of such complications following routine palatal biopsy.
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Affiliation(s)
- Z Yasen
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| | - M Smith
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| | - R Mani
- Royal Albert Edward Infirmary , Wigan , United Kingdom
| | - A Chung
- Royal Albert Edward Infirmary , Wigan , United Kingdom
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5
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Gupta A, Kundal A, Mani R, Gajula B, Sindhuri G, Chennat J, Kumar U, Rajput D. Negative pressure wound therapy in surgical practice: an Institutional experience from a tertiary centre of North India. Pol Przegl Chir 2022; 95:1-5. [PMID: 36806166 DOI: 10.5604/01.3001.0015.8170] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Introduction:</b> Negative pressure wound therapy (NPWT) has been suggested as a gold standard for managing complex wounds and to reduce the time of healing and overall morbidity and mortality of the patient. </br></br> <b>Aim:</b> We have done a retrospective study to observe the outcome in patients managed with negative pressure wound therapy for varied etiologies. </br></br> <b> Methods:</b> Patients with complicated wounds including lower limb wounds post-debridement, upper limb wounds post-debridement, postoperative abdominal wound dehiscence, abdominal and chest abscess wounds post-debridement and amputation stumps, managed with negative pressure wound therapy were studied on the basis of wound outcome, total hospital stay, days of NPWT application and pressure and mode of NPWT. </br></br> <b>Results:</b> A total of 42 patients with complicated wounds were included in the study. Mean hospital stay was 16.2 days and mean NPWT application time was 8.29 days with NPWT being applied on average for 3.91 days post-procedure like debridement or amputation or after wound dehiscence in which debridement was not done. As many as 41.5% of wounds were closed with suturing, 48.8% healed by secondary intention and 9.8% were covered with split-thickness skin grafts. A significant observation was made for lower pressure being used for abdominal wound dehiscence (75 mmHg) compared to other wounds on limbs (mean 98.33 mmHg) (P < 0.001). Re-debridement after the 1st cycle of NPWT was needed in 40% of wounds managed with intermittent mode compared to 6.2% in continuous mode (P = 0.028). </br></br> <b>Conclusion:</b> NPWT can reduce and manage wound complications with improvement in the quality of life of patients when used at an appropriate time with knowledge of its mechanism and functionality.
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Affiliation(s)
- Amit Gupta
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Ashikesh Kundal
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Rishit Mani
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Bhargav Gajula
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Geetha Sindhuri
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Jaine Chennat
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Utkarsh Kumar
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
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6
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Hale L, Higgs C, Gray A, Mann J, Mani R, Sullivan T, Terry J, Keen D, Stokes T. The diabetes community exercise programme plus usual care versus usual care in patients with type 2 diabetes: A randomised, two-arm, parallel, open-label trial. EClinicalMedicine 2022; 46:101361. [PMID: 35360148 PMCID: PMC8961191 DOI: 10.1016/j.eclinm.2022.101361] [Citation(s) in RCA: 1] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/30/2021] [Revised: 02/15/2022] [Accepted: 03/03/2022] [Indexed: 11/24/2022] Open
Abstract
BACKGROUND Exercise is important in type 2 diabetes (T2D) management. Focussing on Māori and Pacific people and those from deprived circumstances, the Diabetes Community Exercise Programme (DCEP) was developed to engage people with T2D in exercise. We report the evaluation of whether being offered DCEP (plus usual care) was more effective than usual care in improving glycaemic control at 1-year. METHODS A randomised, two-arm, parallel, open-label trial with blinding of outcome assessor and data analyst. Adults (age ≥35 years) with T2D recruited from two New Zealand (NZ) communities were randomised, using opaque sealed envelopes and stratified by centre with random block lengths, to DCEP or usual care. DCEP comprises twice-weekly, two-hour sessions of exercise and education over 12-weeks, followed by a twice-weekly maintenance exercise class. The primary outcome was between-group differences in mean changes of glycated haemoglobin (HbA1c) from baseline to 1-year follow-up with intention-to treat analysis. This trial is registered with the Australian NZ Clinical Trials Registry (ANZCTR): ACTRN12617001624370p and is closed to new participants. FINDINGS From 2018 - 2019, of 294 people screened, 165 (mean age 63·8, SD16·2 years, 56% female, 78·5% European, 14% Māori, 6% Pacific, 27% most deprived) were baseline evaluated, randomised, and analysed at study end (DCEP = 83, control = 82). Multimorbidity (≥2) and polypharmacy (>5 medications) were high (82%, 69%). We found no statistically significant between-groups differences in HbA1c (mmol/mol) change at 15 months (mean 3% higher in DCEP, 95% CI 2% lower to 8% higher, p = 0·23). Twelve-week intervention adherence was good (41% attended >80% available sessions). No adverse events were reported. INTERPRETATION DCEP was not effective in improving glycaemic control, possibly due to insufficient exercise intensity. Our attendance demonstrated DCEP's cultural accessibility. DCEP might be good to engage in exercise marginalised people with high Hb1Ac levels, multimorbidity, and high polypharmacy. FUNDING Health Research Council of New Zealand.
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Affiliation(s)
- L. Hale
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
- Corresponding author.
| | - C. Higgs
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - A.R. Gray
- Biostatistics Centre, University of Otago, Dunedin, Otago, New Zealand
| | - J. Mann
- Department of Human Nutrition, University of Otago, Dunedin, New Zealand
| | - R. Mani
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - T. Sullivan
- Department of Preventive and Social Medicine, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
| | - J. Terry
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - D. Keen
- Centre of Health, Activity and Rehabilitation Research, School of Physiotherapy, University of Otago, 325 Great King Street, Dunedin 9016, PO Box 56, Dunedin 9054, New Zealand
| | - T. Stokes
- Department of General Practice and Rural Health, Dunedin School of Medicine, University of Otago, Dunedin, New Zealand
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7
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Anjum R, Kumar N, Singla T, Mani R, Karki B. A Case of Isolated Jejunal Diverticulum Presented as Free Perforation: A Rare Cause of Acute Abdomen. Cureus 2021; 13:e18809. [PMID: 34804667 PMCID: PMC8592799 DOI: 10.7759/cureus.18809] [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] [Accepted: 10/15/2021] [Indexed: 11/05/2022] Open
Abstract
Jejunal diverticulum is a very rare disease. Diagnosis of this condition is a challenge owing to non-specific complaints of the patient. Fifteen percent cases of jejunal diverticula present with acute abdomen. Approximately 77% of small bowel diverticular disease occur with multiple diverticula. Here we describe a case of complicated isolated jejunal diverticula presenting with perforation, which was successfully treated with resection of the involved segment with anastomosis.
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Affiliation(s)
- Rohik Anjum
- General Surgery, All India Institute of Medical Sciences-Rishikesh, Rishikesh, IND
| | - Navin Kumar
- General Surgery, All India Institute of Medical Sciences-Rishikesh, Rishikesh, IND
| | - Tanuj Singla
- General Surgery, All India Institute of Medical Sciences-Rishikesh, Rishikesh, IND
| | - Rishit Mani
- General Surgery, All India Institute of Medical Sciences-Rishikesh, Rishikesh, IND
| | - Bibek Karki
- General Surgery, All India Institute of Medical Sciences-Rishikesh, Rishikesh, IND
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8
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Kumar N, Anjum R, Mani R, Karki B. Neglected Gallstone Disease Presented As Gallstone Ileus: A Rare Cause of Intestinal Obstruction. Cureus 2021; 13:e18205. [PMID: 34722021 PMCID: PMC8544619 DOI: 10.7759/cureus.18205] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/22/2021] [Indexed: 11/21/2022] Open
Abstract
Gallstone ileus is a rare complication of cholelithiasis seen in patients with a long history of cholelithiasis. It occurs more in the older age group and in the female gender. These patients have poor general condition and therefore selection of appropriate treatment is difficult. The clinician has to make a decision between immediate one-stage or two-stage closure of the cholecysto-intestinal fistula or waiting for natural closure. We have discussed the management of a rare cause of small bowel obstruction due to complication of untreated cholelithiasis.
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Affiliation(s)
- Navin Kumar
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - Rohik Anjum
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - Rishit Mani
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - Bibek Karki
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
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9
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Singh SK, Gupta A, Sandhu H, Mani R, Sharma J, Kumar P, Rajput D, Kumar N, Huda F, Basu SP, Ravi B, Kant R. Surgical Diseases Management during COVID-19 Crisis at a Tertiary Care Hospital of India: Our Institutional Strategy. Surg J (N Y) 2021; 7:e366-e373. [PMID: 34977359 PMCID: PMC8714410 DOI: 10.1055/s-0041-1740452] [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: 07/11/2020] [Accepted: 07/20/2021] [Indexed: 11/03/2022] Open
Abstract
Introduction In response to the national coronavirus disease 2019 (COVID-19) pandemic, all hospitals and medical institutes gave priority to COVID-19 screening and to the management of patients who required hospitalization for COVID-19 infection. Surgical departments postponed all elective operative procedures and provided only essential surgical care to patients who presented with acute surgical conditions or suspected malignancy. Ample literature has emerged during this pandemic regarding the guidelines for safe surgical care. We report our experience during the lockdown period including the surgical procedures performed, the perioperative care provided, and the specific precautions implemented in response to the COVID-19 crisis. Materials and Methods We extracted patient clinical data from the medical records of all surgical patients admitted to our tertiary care hospital between the March 24th, 2020 and May 31st, 2020. Data collected included: patient demographics, surgical diagnoses, surgical procedures, nonoperative management, and patient outcomes. Results Seventy-seven patients were included in this report: 23 patients were managed medically, 28 patients underwent a radiologic intervention, and 23 patients required an operative procedure. In total eight of the 77 patients died due to ongoing sepsis, multiorgan failure, or advanced malignancy. Conclusion During the COVID-19 lockdown period, our surgical team performed many lifesaving surgical procedures and appropriately selected cancer operations. We implemented and standardized essential perioperative measures to reduce the spread of COVID-19 infection. When the lockdown measures were phased out a large number of patients remained in need of delayed elective and semi-elective operative treatment. Hospitals, medical institutes, and surgical leadership must adjust their priorities, foster stewardship of limited surgical care resources, and rapidly implement effective strategies to assure perioperative safety for both patients and operating room staff during periods of crisis.
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Affiliation(s)
- Sudhir Kumar Singh
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Harindra Sandhu
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishit Mani
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Jyoti Sharma
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Praveen Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Farhanul Huda
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Som Prakas Basu
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bina Ravi
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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10
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Gupta A, Gupta S, Mani R, Durgapal P, Goyal B, Rajput D, Rao S, Dhar P, Gupta M, Kishore S, Kant R. Expression of Human epidermal growth factor receptor 2, Survivin, Enhancer of zeste homolog -2, Cyclooxygenase-2, p53 and p16 molecular markers in Gall bladder carcinoma. J Carcinog 2021; 20:7. [PMID: 34321957 PMCID: PMC8312376 DOI: 10.4103/jcar.jcar_4_21] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2021] [Revised: 02/26/2021] [Accepted: 03/05/2021] [Indexed: 12/28/2022] Open
Abstract
INTRODUCTION: Gallbladder cancer exhibits striking variability in the global rates, reaching epidemic levels for some regions and ethnicities. The basis of its variability resides in differences in environmental exposure and intrinsic genetic predisposition to carcinogenesis. There is little information present regarding genetic and molecular alterations in gall bladder cancer (GBC). We, therefore, have evaluated the molecular marker expression in GBC and studied their correlation with clinicopathological staging. MATERIALS AND METHODS: This prospective observational study was conducted on newly diagnosed GBC patients from July 2017 to July 2020. After complete staging workup, the GBC biopsy samples paraffin block was tested for molecular markers estrogen receptor (ER), progesterone receptor (PR), p53, p16, Human epidermal growth factor receptor 2 (HER 2-neu), Survivin, Enhancer of zeste homolog-2 (EZH2), and Cyclooxygenase-2 (COX-2) expression by immunohistochemistry. RESULTS: Fifty newly diagnosed patients of carcinoma gall bladder were included in the present study. Age was ranged from 29 – 69 years (mean 53.42). p53 was the most common positive marker in 74% of patients, survivin in 58%, COX-2 in 44%, and p16 in 42% whereas Her 2 neu and EZH-2 were positive in 16% of patients each. None of the patients of GBC were ER or PR positive. There was a significant difference between the various groups in terms of the distribution of histological grade and Her 2 neu (χ2 = 9.886, P = 0.014) but not with other markers. Furthermore, there was a significant difference in terms of distribution of p16 and p53 with stage (χ2 = 7.017, P = 0.037 and χ2 = 5.861, P = 0.033) respectively. CONCLUSIONS: The present study shows the expression of molecular markers Her2 neu, p53, p16, survivin, COX-2, and EZH-2 in GBC. Now the time has come, and it is also the need of the day to establish early biomarkers of this highly lethal malignancy. It can be used in future for the detection of disease in the early phase and targeted therapy.
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Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Rishit Mani
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Prashant Durgapal
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Bela Goyal
- Department of Biochemistry, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Deepak Rajput
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Shalinee Rao
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Puneet Dhar
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Manoj Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Sanjeev Kishore
- Department of Pathology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
| | - Ravi Kant
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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11
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Kumar N, Anjum R, Mani R, Chezhian S, Gupta A. Retro-Ileal Conduit Small Bowel Internal Herniation After Radical Cystectomy: A Surgical Complication. Cureus 2021; 13:e14142. [PMID: 33927944 PMCID: PMC8075830 DOI: 10.7759/cureus.14142] [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] [Indexed: 11/25/2022] Open
Abstract
Intestinal obstruction is one of the most important cause of acute abdomen. An internal herniation is an uncommon yet relevant clinical entity causing an acute intestinal obstruction that can occur after major bowel surgery. Here, we describe a case of acute intestinal obstruction caused by internal herniation in a patient with muscle-invasive urinary bladder carcinoma who underwent robot-assisted radical cystectomy with an ileal conduit. We also discuss the management of adjuvant chemotherapy-induced leukopenia.
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Affiliation(s)
- Navin Kumar
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - Rohik Anjum
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - Rishit Mani
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - S Chezhian
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
| | - Amit Gupta
- General Surgery, All India Institute of Medical Sciences, Rishikesh, IND
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12
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Kumar N, Huda F, Mani R, Singla T, Kundal A, Sharma J, Gajula B. Role of hospital anxiety and depression on the healing of chronic leg ulcer: A prospective study. Int Wound J 2020; 17:1941-1947. [PMID: 32844523 DOI: 10.1111/iwj.13485] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2020] [Revised: 07/31/2020] [Accepted: 08/03/2020] [Indexed: 11/30/2022] Open
Abstract
A chronic leg ulcer is a debilitating illness, owing to the local condition of the wound and a decrease in physical activity and productivity, resulting in anxiety and depression among patients. The study aimed to find any association of anxiety and depression in the healing of chronic wounds. A total of 125 patients with chronic leg ulcers were enrolled in the study. HADS questionnaire assessment followed the local wound examination in all patients. A follow-up assessment of the ulcer was done after appropriate local treatment, and data analysed with the HADS scale. In the present study, the ROC curve showed a cutoff value of 14 for the HADS score in predicting ulcer status (non-healing vs healed) after 30 days. A total of 54.4% (68) patients had a HADS score ≥ 14 and 39% (49) were true positive for the non-healing wound at a 1-month follow-up. This study revealed a sensitivity and specificity of 83.1% and 71.2%, respectively (P-value <.001), and diagnostic accuracy of 76.8%, for HADS score > 14 in the detection of non-healing ulcers. Chronic leg ulcers should be subjected to HADS assessment and if found significant corrective measures must be instituted for improving wound healing.
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Affiliation(s)
- Navin Kumar
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
| | - Farhanul Huda
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
| | - Rishit Mani
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
| | - Tanuj Singla
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
| | - Ashikesh Kundal
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
| | - Jyoti Sharma
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
| | - Bhargav Gajula
- Department of General Surgery, AIIMS Rishikesh, Uttarakhand, India
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13
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Gupta A, Anjum R, Mani R, Kumar N, Mehan A, Gupta S, Chowdhury N, Kumar U. Small cell carcinoma of gall bladder: An uncommon
histologic entity. Pol Przegl Chir 2020; 93:50-53. [DOI: 10.5604/01.3001.0014.4878] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
<b>Introduction:</b> Gall bladder (GB) small cell carcinoma (SCC) comprises 0.5% of all gall bladder cancers. It carries a poor prognosis in view of its aggressive nature. <br><b>Case report:</b> We here report a case of small cell carcinoma of GB in a female who presented with obstructive jaundice. Examination revealed a hard lump in the right upper abdomen. Tumour markers showed raised CA 19-9. Staging CECT of the thorax and abdomen reported polypoidal enhancing wall thickening of the gall bladder with multiple metastatic deposits close to the pancreatic head encasing the main portal vein and common bile duct. Histopathology report was suggestive of small cell carcinoma, which was confirmed by immunohistochemistry. Patient was referred to the Oncology Department for palliative chemotherapy.
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Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Rohik Anjum
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Rishit Mani
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Anoushika Mehan
- Department of Pathology All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, India
| | - Nilotpal Chowdhury
- Department of Pathology All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Utkarsh Kumar
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
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14
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Gupta A, Anjum R, Mani R, Kumar N, Mehan A, Gupta S, Chowdhury N, Kumar U. Small cell carcinoma of gall bladder: An uncommon histologic entity. Pol Przegl Chir 2020; 93:1-5. [PMID: 33724227] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
<b>Introduction:</b> Gall bladder (GB) small cell carcinoma (SCC) comprises 0.5% of all gall bladder cancers. It carries a poor prognosis in view of its aggressive nature. <br><b>Case report:</b> We here report a case of small cell carcinoma of GB in a female who presented with obstructive jaundice. Examination revealed a hard lump in the right upper abdomen. Tumour markers showed raised CA 19-9. Staging CECT of the thorax and abdomen reported polypoidal enhancing wall thickening of the gall bladder with multiple metastatic deposits close to the pancreatic head encasing the main portal vein and common bile duct. Histopathology report was suggestive of small cell carcinoma, which was confirmed by immunohistochemistry. Patient was referred to the Oncology Department for palliative chemotherapy.
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Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Rohik Anjum
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Rishit Mani
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Anoushika Mehan
- Department of Pathology All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, India
| | - Nilotpal Chowdhury
- Department of Pathology All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
| | - Utkarsh Kumar
- Department of Surgery All India Institute Of Medical Sciences, Rishikesh Uttarakhand, India
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15
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Gupta A, ANJUM ROHIK, Mani R, Kumar N, Mehan A, Gupta S, Chowdhury N, Kumar U. Small cell carcinoma of gall bladder: An uncommon histologic entity. Pol Przegl Chir 2020. [DOI: 10.5604/01.3001.0014.3177] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Gall bladder small cell carcinoma (scc) comprises of 0.5% of all GB cancers. It carries a poor prognosis in view of its aggressive nature. We here report a case of small cell carcinoma GB 55-year old lady presented with features of obstructive jaundice with significant weight loss. Examination revealed hard lump in right upper abdomen with multiple scratch marks all over the body. Clinically she had jaundice. Blood investigations revealed hyperbilirubinemia. Tumour markers showed raised CA 19-9. Staging CECT thorax and Abdomen reported polypoidal enhancing wall thickening of gall bladder with multiple metastatic deposits close to pancreatic head encasing main portal vein and common bile duct. Histopathology was suggestive of small cell carcinoma. Patient was referred to Oncology department and is receiving palliative cisplatin-etoposide chemotherapy
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Affiliation(s)
- Amit Gupta
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | | | - Rishit Mani
- Junior Resident, Department of Surgery
All India Institute Of Medical Sciences, Rishikesh
Uttarakhand, India
| | - Navin Kumar
- Department of Surgery, All India Institute of Medical Sciences, Rishikesh, India
| | - Anoushika Mehan
- Junior Resident, Department of Pathology
All India Institute Of Medical Sciences, Rishikesh
Uttarakhand, India
| | - Sweety Gupta
- Department of Radiation Oncology, All India Institute of Medical Sciences, Rishikesh, India
| | - Nilotpal Chowdhury
- Additional Professor, Department of Pathology
All India Institute Of Medical Sciences, Rishikesh
Uttarakhand, India
| | - Utkarsh Kumar
- Senior Resident, Department of Surgery
All India Institute Of Medical Sciences, Rishikesh
Uttarakhand, India
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16
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Mani R, Rajgolikar G, Nunes J, Zapolnik K, Wasmuth R, Mo X, Byrd J, Lee D, Muthusamy N, Vasu S. Fc engineered anti-CD33mAb potentiates cytotoxicity of mbIL-21 expanded NK-cells against primary AML pre-treated with decitabine. Cytotherapy 2019. [DOI: 10.1016/j.jcyt.2019.03.318] [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]
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17
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Rungatscher A, Linardi D, Naseer A, Mani R, Hoxha S, Luciani G, Faggian G. Sphingosine-1-Phosphate Receptor Agonist Fingolimod Reduces Myocardial Ischemia-Reperfusion Injury and Apoptosis Increasing Long-Term Left Ventricular Function after Heart Transplantation. J Heart Lung Transplant 2019. [DOI: 10.1016/j.healun.2019.01.546] [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: 10/27/2022] Open
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18
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Ang M, Schmidt H, Mani R, Darling G, Langer D, Jain P, Treister V, Tammemagi M, Flora S. P3.11-21 The Development of a Robust Radiology Quality Assurance (QA) Program in a Provincial High-Risk Lung Cancer Screening Pilot (HRLCSP). J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1817] [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: 10/28/2022]
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19
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Subbaiyan K, Raghuram A, Ramaiah K, Mani R, Kathamuthu B, Daniel D, Nair R. Management of mechanical complications of acute myocardial infarction from a tier two city. J Cardiothorac Vasc Anesth 2018. [DOI: 10.1053/j.jvca.2018.08.133] [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: 11/11/2022]
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20
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Mani R, Cooper C, Kidd BL, Cole JD, Cawley MI. Use of Laser Doppler Flowmetry and Transcutaneous Oxygen Tension Electrodes to Assess Local Autonomic Dysfunction in Patients with Frozen Shoulder. J R Soc Med 2018; 82:536-8. [PMID: 2677369 PMCID: PMC1292299 DOI: 10.1177/014107688908200910] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [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: 11/16/2022] Open
Abstract
The laser Doppler flowmeter (LDF), which measures changes in cutaneous blood flow, and the transcutaneous oxygen electrode which measures cutaneous perfusion, were used to study reflex changes in the microcirculation of the shoulder in 38 patients with frozen shoulder and 10 normal controls. In all controls and 22 patients with frozen shoulder, a normal LDF response to inspiration/expiration was observed. In 16 patients with frozen shoulder, LDF responses were either unilaterally or bilaterally absent. Comparison between the two patient groups showed a significant association (chi 2 = 6.43, P less than 0.02) between abnormality of response and the persistence of pain. TcPO2 was in the normal range in all patients and controls. These findings suggest that the LDF together with the TcPO2 may be a useful method of studying the skin microcirculation over the shoulder.
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Affiliation(s)
- R Mani
- Department of Medical Physics, Southampton General Hospital
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21
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Abstract
Skin oxygen tension (TcPo2) was measured at 43°C on patients (n=27) with venous ulcers. Measurements were made at ulcer edge and, proximally on the same limb for control. Similar measurements were also made on healthy volunteers (n=14) in the medial aspects of the distal third of the legs. TcPo2 at ulcer edge was significantly lower (P=0.001) than control values which in turn were lower than that measured on healthy volunteers. TcPo2 reflects skin nutrition. While low TcPo2 at ulcer edges might be the result of pericapillary barriers to oxygen transport, the control values measured on apparently normal skin suggest the need for further studies.
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Affiliation(s)
- R Mani
- Department of Medical Physics, University of Southampton Hospitals
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22
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Black N, Sullivan S, Mani R. A biopsychosocial understanding of lower back pain: Content analysis of online information. Eur J Pain 2017; 22:728-744. [DOI: 10.1002/ejp.1158] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/06/2017] [Indexed: 11/06/2022]
Affiliation(s)
- N.M. Black
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy; University of Otago; Dunedin New Zealand
| | - S.J. Sullivan
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy; University of Otago; Dunedin New Zealand
| | - R. Mani
- Centre for Health, Activity and Rehabilitation Research; School of Physiotherapy; University of Otago; Dunedin New Zealand
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23
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Higgs C, Gisselman AS, Hale L, Mani R. Health outcomes of the Dunedin Community Exercise Programme for people with type 2 diabetes and prediabetes: a single-group study. European Journal of Physiotherapy 2017. [DOI: 10.1080/21679169.2017.1381316] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- C. Higgs
- School of Physiotherapy, Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - A. S. Gisselman
- School of Physiotherapy, Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - L. Hale
- School of Physiotherapy, Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
| | - R. Mani
- School of Physiotherapy, Centre for Health, Activity, and Rehabilitation Research, University of Otago, Dunedin, New Zealand
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24
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Singh KD, Singh V, Gupta P, Mani R. A rare case of bullhorn-injury associated traumatic hernia of anterior abdominal wall managed by laparoscopic sutured tissue-only repair. J Postgrad Med 2017; 64:56-58. [PMID: 29067918 PMCID: PMC5820818 DOI: 10.4103/jpgm.jpgm_14_17] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Traumatic abdominal wall hernias (TAWHs) are relatively uncommon entities. Common mechanisms that predispose to such hernias include motor vehicle accidents, seat belt injuries, fall from height, handlebar injuries, and bullfighting. Bullhorn injury leading to TAWHs is an uncommon mechanism. We report here one such patient who was managed by laparoscopic transperitoneal anatomical repair of the defect using polypropylene suture. The patient recovered well without any complication and is being followed up. Such small defects can be managed laparoscopically and tissue-only repair using a nonabsorbable suture is a feasible option. Our case is the first reported case of bullhorn-injury associated traumatic hernia managed laparoscopically and first reported case of TAWH in an adult which was managed by laparoscopic sutured tissue-only repair.
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Affiliation(s)
- K D Singh
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - V Singh
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - P Gupta
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
| | - R Mani
- Department of Surgery, Uttar Pradesh University of Medical Sciences, Saifai, Etawah, Uttar Pradesh, India
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25
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Abstract
The value of low-level laser therapy (LLLT) as a therapy for painful tennis elbow is dubious since evidence for its efficacy is conflicting. This report presents the results of a randomized, double-blind, controlled study on patients with tennis elbow (n = 29) using a gallium aluminium arsenide laser. Two different methods of assessing pain, visual analogue scores and a Marcy Wedge Pro® exerciser, were used. No significant differences were found between the treatment and placebo groups. This suggests that LLLT at the dosage and duratiion used in this study is without benefit in the short-term management of painful tennis elbow.
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Affiliation(s)
- ES Papadopoulos
- Department of Medical Physics and Medical Engineering, Southampton University Hospitals (NHS) Trust
| | - RW Smith
- Department of Rheumatology Southampton University Hospitals (NHS) Trust
| | - Mid Cawley
- Department of Rheumatology Southampton University Hospitals (NHS) Trust
| | - R. Mani
- Department of Medical Physics and Medical Engineering, Southampton University Hospitals (NHS) Trust, Southampton
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26
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Nyanzi CS, Langridge J, Heyworth JRC, Mani R. Randomized controlled study of ultrasound therapy in the management of acute lateral ligament sprains of the ankle joint. Clin Rehabil 2016. [DOI: 10.1191/026921599701532081] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Objective: To determine the efficacy of a fixed dose of ultrasound energy to treat acute lateral ligament sprains of the ankle joint. Study design: Double-blind randomised controlled trial. Setting: Accident and Emergency department of University Teaching Hospital. Subjects: Patients presenting at Accident and Emergency with ankle injuries. Intervention: Ultrasound or placebo, and Tubigrip. Outcome measures: Pain measured with visual analogue scales, swelling using a tape measure, range of movement using a fluid-filled goniometer, and weight bearing using two scales simultaneously. Results: Patients in both groups improved symptomatically. There were no statistically significant differences between groups in any outcome measure. Within groups, statistically significant differences were detected in pain perceived, and range of movement (dorsiflexion). Conclusion: At the dose and duration used, ultrasound therapy is no better than placebo in the management of lateral ligament injuries.
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Affiliation(s)
- C S Nyanzi
- Rehabilitation Research Unit, Southampton University Hospitals Trust (NHS), Southampton, UK
| | - J Langridge
- Physiotherapy Department, Southampton University Hospitals Trust (NHS), Southampton, UK
| | - J RC Heyworth
- Accident and Emergency Department, Southampton University Hospitals Trust (NHS), Southampton, UK
| | - R Mani
- Medical Physics and Bioengineering Department, Southampton University Hospitals Trust (NHS), Southampton, UK
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27
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Barnes MD, Mani R, Barrett DF, White JE. Changes in Skin Microcirculation at Periulcerous Sites in Patients with Chronic Venous Ulcers during Leg Elevation. Phlebology 2016. [DOI: 10.1177/026835559200700111] [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] [Indexed: 11/17/2022]
Abstract
Objective: To investigate the effect of limb elevation on the microcirculation of the skin in patients with venous ulceration of the leg. Design: Prospective study in patients receiving in patient treatment for venous ulceration. Setting: Health Service teaching hospital. Patients: Thirteen patients with venous ulceration of the lower limb for more than two years were investigated. Interventions: Patients were admitted to hospital and treated by bedrest with elevation of the lower limbs by 10° above the horizontal. Main outcome measures: Laser Doppler fluximetry and transcutaneous oximetry of the skin surrounding the venous ulcers was undertaken. Results: The laser Doppler fluximetry in the periculcerous region increased by 10.8 A.U. (95% CI 17 to 4.54). However, the transcutaneous oxygen measurements did not change during the period of treatment. Conclusions: Admission to hospital with elevation of the limb for patients with venous ulceration results in ***microcirculatory changes which are probably attributable to reduction in lower limb oedema.
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Affiliation(s)
- M. D. Barnes
- Departments of Medical Physics, Southampton and Cosham, UK
| | - R. Mani
- Departments of Medical Physics, Southampton and Cosham, UK
| | - D. F. Barrett
- Dermatology University of Southampton Hospitals, Southampton and Cosham, UK
| | - J. E. White
- Dermatology University of Southampton Hospitals, Southampton and Cosham, UK
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28
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Abstract
objective: To assess changes in limb volume and oedema in Patients admitted to hospital for treatment of venous ulceration. Design: Prospective study in thirteen patients. Setting: Health Service teaching hospital. Patients: Thirteen patients with venous ulceration for 2 years. Interventions: Patients were admitted to hospital for bed-rest and lower limb elevation for a period of 24 hours Main outcome measures: Limb volume was measured by water displacement and impedance plethysmography. Results: During limb elevation there was a mean reduction limb volume of 524 mls (95% CI 377–671 mls) after 24 hours of bedrest. This corresponded with a reduction in impedance measured by the impedance plethysmograph of 19–0 ohms (95% CI 24.3 to 15.6 ohms). Conclusion: Measurement of the lower limb volume by water displacement and by impedance plethysmography are likely to be useful methods in the investigation of Patients with chronic venous insufficiency.
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Affiliation(s)
- M. D. Barnes
- Department of Medical Physics, University of Southampton Hospitals, Southampton and Cosham, UK
| | - R. Mani
- Department of Medical Physics, University of Southampton Hospitals, Southampton and Cosham, UK
| | - D. F. Barrett
- Department of Dermatology, University of Southampton Hospitals, Southampton and Cosham, UK
| | - J. E. White
- Department of Dermatology, University of Southampton Hospitals, Southampton and Cosham, UK
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29
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Mani R, Yan R, Mo X, Chen CS, Phelps MA, Klisovic R, Byrd JC, Kisseberth WC, London CA, Muthusamy N. Non-immunosuppressive FTY720-derivative OSU-2S mediates reactive oxygen species-mediated cytotoxicity in canine B-cell lymphoma. Vet Comp Oncol 2016; 15:1115-1118. [PMID: 27136276 DOI: 10.1111/vco.12221] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2015] [Revised: 12/29/2015] [Accepted: 01/19/2016] [Indexed: 02/03/2023]
Abstract
OSU-2S is a FTY720 (Fingolimod) derivative that lacks immunosuppressive properties but exhibits strong anti-tumour activity in several haematological and solid tumour models. We have recently shown OSU-2S to mediate potent cytotoxicity in human mantle cell lymphoma cell lines and primary cells. We report here the pre-clinical activity of OSU-2S in spontaneous B-cell lymphoma of dogs which shares many characteristics of human lymphoma. OSU-2S mediated apoptosis in canine B-cell lines and primary B-cell lymphoma cells obtained from spontaneous lymphoma bearing dogs. OSU-2S induced reactive oxygen species (ROS) in canine lymphoma cells and inhibition of ROS partially rescued OSU-2S-mediated cell death. These studies provide a rational basis for the use of spontaneous lymphoma in pet dogs as a preclinical large animal model for the development of OSU-2S as small molecule for treating people and dogs with lymphoma.
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Affiliation(s)
- R Mani
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - R Yan
- Division of Medicinal Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - X Mo
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - C-S Chen
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Division of Medicinal Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - M A Phelps
- Division of Pharmaceutics, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - R Klisovic
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - J C Byrd
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Division of Medicinal Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, USA.,Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - W C Kisseberth
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - C A London
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Clinical Sciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - N Muthusamy
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA.,Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA.,Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
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30
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Bouguila J, Guiga B, Rejeb MB, Omezzine M, Mani R, Moatemri R, Khochtali H. Surgical treatment of Eagle's syndrome: transoral or cervical approach? Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.480] [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: 10/22/2022]
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31
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Bouguila J, Guiga B, Moatemri W, Omezzine M, Mani R, Moatemri R, Khochtali H. Osteoradionecrosis of the jaw bones at the university of sousse medical center (Tunisia). Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.575] [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]
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32
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Bouguila J, Guiga B, Elfatmi R, Omezzine M, Mani R, Moatemri R, Khochtali H. Cervicofacial cellulitis of dental origin: epidemiology, clinic and therapeutic aspects of 369 cases in Tunisia. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.574] [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: 10/22/2022]
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33
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Bouguila J, Guiga B, Ayad M, Omezzine M, Mani R, Moatemri R, Khochtali H. Submental endotracheal intubation: another route for intubation in facial surgery. Int J Oral Maxillofac Surg 2015. [DOI: 10.1016/j.ijom.2015.08.032] [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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34
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Abstract
Tubulointerstitial nephritis is an uncommon manifestation of IgG4 related disease. A case of tubulointerstitial nephritis with special features including isolated renal involvement in this multisystem disorder and the absence of response to steroid therapy in a young male is reported here. There was no nephromegaly, eosinophilia or other organ involvement. The importance of early detection and treatment for preservation of kidney function is highlighted.
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Affiliation(s)
- N. Nithyashree
- Department of Nephrology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - S. Rajagopalan
- Department of Nephrology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - R. A. Annigeri
- Department of Nephrology, Apollo Hospital, Chennai, Tamil Nadu, India
| | - R. Mani
- Department of Pathology, Apollo Hospital, Chennai, Tamil Nadu, India
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Abstract
Aim: To evaluate immunohistochemically vascular endothelial growth factor (VEGF) and Ki-67 in human gingival samples and to compare these factors between healthy and diabetic patients. Materials and Methods: A total of 50 subjects were included in the study. They were categorized into three groups: Periodontally healthy group, periodontally diseased gingiva without any systemic disease group and periodontally diseased gingiva with controlled type II diabetes mellitus (DM) group. Gingival biopsies were performed and immunohistochemical analysis were done for VEGF and Ki-67 staining in gingival samples. Results: The present study found moderate intensity staining for VEGF in periodontitis group and periodontitis with controlled type II DM group and mild intensity staining for VEGF in periodontally healthy group. With regard to Ki-67, negative staining was observed in periodontally healthy group and mild staining in periodontitis group and periodontitis with controlled type II DM group. Conclusion: Further investigation needs to be conducted to identify how VEGF and Ki-67 are involved in the tissue inflammation associated processes and the relationship between VEGF and Ki-67 in progression of periodontitis.
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Affiliation(s)
- K Kranti
- Department of Periodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - R Mani
- Department of Periodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
| | - Anjana Elizabeth
- Department of Periodontics, M S Ramaiah Dental College and Hospital, Bengaluru, Karnataka, India
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37
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Praveen J, Mani R, Adhia D, Tumilty S. Is manipulation effective in the treatment of sacroiliac joint pain and function?—a systematic review. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.2158] [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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38
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Adhia D, Tumilty S, Mani R, Milosavljevic S, Bussey M. Can a Hip Abduction–External Rotation (HABER) test discriminate for low back pain of sacroiliac joint origin? Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.146] [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: 10/23/2022]
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39
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Shields C, Baxter D, Mani R. Personal and behavioural correlates of physical activity in individuals with high risk of developing diabetes mellitus. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1797] [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: 10/23/2022]
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40
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Kenny D, Ball J, Bloxham C, Cashmore G, Dick F, Kannan P, Baxter D, Mani R. An evaluation of the psychometric properties of the STarT Back Screening Tool—a systematic review. Physiotherapy 2015. [DOI: 10.1016/j.physio.2015.03.1799] [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: 11/28/2022]
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41
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Mani R, Mao Y, Frissora FW, Chiang CL, Wang J, Zhao Y, Wu Y, Yu B, Yan R, Mo X, Yu L, Flynn J, Jones J, Andritsos L, Baskar S, Rader C, Phelps MA, Chen CS, Lee RJ, Byrd JC, Lee LJ, Muthusamy N. Tumor antigen ROR1 targeted drug delivery mediated selective leukemic but not normal B-cell cytotoxicity in chronic lymphocytic leukemia. Leukemia 2014; 29:346-55. [PMID: 24947019 PMCID: PMC4272672 DOI: 10.1038/leu.2014.199] [Citation(s) in RCA: 35] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2014] [Revised: 05/08/2014] [Accepted: 06/04/2014] [Indexed: 12/29/2022]
Abstract
Selective cytotoxicity to cancer cells without compromising their normal counterparts pose a huge challenge for traditional drug design. Here we developed a tumor antigen targeted delivery of immunonanoparticle carrying a novel non-immunosuppressive FTY720 derivative OSU-2S with potent cytotoxicity against leukemic B cells. OSU-2S induces activation of protein phosphatase 2A, phosphorylation and nuclear translocation of SHP1S591 and deregulation of multiple cellular processes in chronic lymphocytic leukemia (CLL) resulting in potent cytotoxicity. To preclude OSU-2S mediated effects on these ubiquitous phosphatases in unintended cells and avoid potential adverse effects we developed a OSU-2S targeted delivery immunonanoparticles (2A2-OSU-2S-ILP), that mediated selective cytotoxicity of CLL but not normal B cells through targeting receptor tyrosine kinase ROR1 expressed in leukemic but not normal B cells. Developing a novel spontaneous CLL mouse model expressing human ROR1 (hROR1) in all leukemic B cells, we demonstrate the therapeutic benefit of enhanced survival with 2A2-OSU-2S-ILP in-vivo. The newly developed non-immunosuppressive OSU-2S, its delivery using human CLL directed immunonanoparticles and the novel transgenic mouse model of CLL that expresses hROR1 exclusively in leukemic B cell surface are highly innovative and can be applied to CLL and other ROR1+ malignancies including mantle cell lymphoma and acute lymphoblastic leukemia.
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Affiliation(s)
- R Mani
- 1] Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA [2] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [3] Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
| | - Y Mao
- 1] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [2] Division of Pharmaceutics, College of Pharmacy, The Ohio State University, Columbus, OH, USA [3] Center for Affordable Nanoengineering of Polymeric Biomedical Devices, The Ohio State University, Columbus, OH, USA
| | - F W Frissora
- 1] Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA [2] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - C-L Chiang
- 1] Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA [2] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - J Wang
- Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA
| | - Y Zhao
- Division of Pharmaceutics, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - Y Wu
- Center for Affordable Nanoengineering of Polymeric Biomedical Devices, The Ohio State University, Columbus, OH, USA
| | - B Yu
- 1] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [2] Center for Affordable Nanoengineering of Polymeric Biomedical Devices, The Ohio State University, Columbus, OH, USA
| | - R Yan
- Division of Medicinal Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - X Mo
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - L Yu
- Center for Biostatistics, The Ohio State University, Columbus, OH, USA
| | - J Flynn
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - J Jones
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - L Andritsos
- Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA
| | - S Baskar
- Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute, Bethesda, MD, USA
| | - C Rader
- Department of Cancer Biology and Department of Molecular Therapeutics, The Scripps Research Institute, Scripps Florida, Jupiter, FL, USA
| | - M A Phelps
- 1] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [2] Division of Pharmaceutics, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - C-S Chen
- 1] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [2] Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA [3] Division of Medicinal Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - R J Lee
- 1] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [2] Division of Pharmaceutics, College of Pharmacy, The Ohio State University, Columbus, OH, USA [3] Center for Affordable Nanoengineering of Polymeric Biomedical Devices, The Ohio State University, Columbus, OH, USA
| | - J C Byrd
- 1] Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA [2] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [3] Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA [4] Division of Medicinal Chemistry, College of Pharmacy, The Ohio State University, Columbus, OH, USA
| | - L J Lee
- 1] Center for Affordable Nanoengineering of Polymeric Biomedical Devices, The Ohio State University, Columbus, OH, USA [2] Department of Chemical and Biomolecular Engineering, The Ohio State University, Columbus, OH, USA
| | - N Muthusamy
- 1] Division of Hematology, Department of Internal Medicine, College of Medicine, The Ohio State University, Columbus, OH, USA [2] Comprehensive Cancer Center, The Ohio State University, Columbus, OH, USA [3] Department of Veterinary Biosciences, College of Veterinary Medicine, The Ohio State University, Columbus, OH, USA
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Hazra N, Mani R, Desai A, Sinha S, Netravathi M, Taly AB, Satishchandra P, Ravi V. Subacute sclerosing pan encephalitis with HIV: two rare case reports. BMC Infect Dis 2014. [PMCID: PMC4080474 DOI: 10.1186/1471-2334-14-s3-o25] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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43
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Arif H, Hirsch L, LaRoche S, Gaspard N, Gerard E, Svoronos A, Herman S, Mani R, Jetté N, Minazad Y, Kerrigan J, Vespa P, Hantus S, Claassen J, Young G, So E, Kaplan P, Nuwer M, Fountain N, Drislane F. American Clinical Neurophysiology Society's standardized critical care EEG terminology: Interrater reliability and 2012 version. J Neurol Sci 2013. [DOI: 10.1016/j.jns.2013.07.066] [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: 11/29/2022]
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44
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Mahantesha, Shobha KS, Mani R, Deshpande A, Seshan H, Kranti K. Clinical and radiographic evaluation of demineralized bone matrix (grafton) as a bone graft material in the treatment of human periodontal intraosseous defects. J Indian Soc Periodontol 2013; 17:495-502. [PMID: 24174731 PMCID: PMC3800414 DOI: 10.4103/0972-124x.118323] [Citation(s) in RCA: 6] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2012] [Accepted: 07/08/2013] [Indexed: 11/04/2022] Open
Abstract
PURPOSE The purpose of this clinical trial was to evaluate the efficacy of demineralized bone matrix (DBM) as a bone graft material in the treatment of human intrabony periodontal defects as compared with control defects treated by open flap debridement (OFD) alone. MATERIALS AND METHODS A controlled clinical trial was carried out for a period of 9 months in 11 patients (4 males and 7 females) with an age group of 25-50 years, contributing to a total of 30 defects. The selected defects were then randomly divided in to experimental sites (OFD + DBM) and control sites (OFD alone). Probing depth, clinical attachment levels and position of the gingival margin were recorded at baseline 3, 6 and 9 months post-operatively. Standardized radiographs (parallel technique) were also documented at these recall intervals. RESULTS On completion of 9 months, the mean percentage of probing depth reduction achieved in the experimental sites and control sites was 61.70%, 23.86% respectively. The mean percentage of clinical attachment level gain was 61.34% and 19.37% in the experimental and control sites respectively. In the experimental sites recession was observed to a lesser extent. CONCLUSION The use of DBM was more effective than OFD in improving clinical parameters and radiographic bone fill as shown in the present study. However, there is a need for further long term studies.
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Affiliation(s)
- Mahantesha
- Department of Periodontics, M.S. Ramaiah Dental College and Hospital, MSRIT Post, MSR Nagar, Mathikere, Bangalore, Karnataka, India
| | - K. S. Shobha
- Department of Periodontics, M.S. Ramaiah Dental College and Hospital, MSRIT Post, MSR Nagar, Mathikere, Bangalore, Karnataka, India
| | - R. Mani
- Department of Periodontics, M.S. Ramaiah Dental College and Hospital, MSRIT Post, MSR Nagar, Mathikere, Bangalore, Karnataka, India
| | - Amritha Deshpande
- Department of Periodontics, M.S. Ramaiah Dental College and Hospital, MSRIT Post, MSR Nagar, Mathikere, Bangalore, Karnataka, India
| | - Hema Seshan
- Department of Periodontics, M.S. Ramaiah Dental College and Hospital, MSRIT Post, MSR Nagar, Mathikere, Bangalore, Karnataka, India
| | - K. Kranti
- Department of Periodontics, M.S. Ramaiah Dental College and Hospital, MSRIT Post, MSR Nagar, Mathikere, Bangalore, Karnataka, India
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45
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Rao R, Mani R. P380: Hospital hygiene- a neglected issue. Antimicrob Resist Infect Control 2013; 2. [PMCID: PMC3688430 DOI: 10.1186/2047-2994-2-s1-p380] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- R Rao
- Microbiology, Apollo Hospital, Jubilee Hills, Hyderabad, India
| | - R Mani
- Microbiology, Apollo Hospital, Jubilee Hills, Hyderabad, India
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46
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Rao R, Mani R. O031: Reprocessing of single-use hemodynamic catheters in cardiology-we do but how best to do it. Antimicrob Resist Infect Control 2013. [PMCID: PMC3688159 DOI: 10.1186/2047-2994-2-s1-o31] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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47
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Rao R, Mani R. P263: Infection control-uphill task in India. Antimicrob Resist Infect Control 2013. [PMCID: PMC3687942 DOI: 10.1186/2047-2994-2-s1-p263] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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48
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Abstract
A 37-year-old HIV-positive Gambian woman presented with spastic weakness of the right leg six years after receiving treatment for tuberculous meningitis (TBM). Magnetic resonance imaging (MRI) of the spine showed a multiloculated syrinx in the thoracic spinal cord extending from the T2 to the T11 level. Syringomyelia and syringobulbia have been reported as complications of TBM. We describe the first case of syringomyelia as an uncommon late complication of treated TBM in the setting of HIV infection. Early recognition of this rare entity may avoid irreversible neurological sequelae.
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Affiliation(s)
| | | | - R Mani
- Department of Genitourinary Medicine
| | | | - A J Chauhan
- Respiratory Centre, Portsmouth Hospitals NHS Trust, Portsmouth, UK
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49
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Shobha KS, Mahantesha, Seshan H, Mani R, Kranti K. Clinical evaluation of the biological width following surgical crown-lengthening procedure: A prospective study. J Indian Soc Periodontol 2011; 14:160-7. [PMID: 21760669 PMCID: PMC3100858 DOI: 10.4103/0972-124x.75910] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2009] [Accepted: 06/17/2010] [Indexed: 11/04/2022] Open
Abstract
BACKGROUND AND OBJECTIVES The purpose of this study was to evaluate the positional changes of the periodontal tissues, particularly the biological width, following surgical crown-lengthening in human subjects. MATERIALS AND METHODS A clinical trial study involving 15 patients was carried out for a period of 6 months. Sites were divided into 3 groups: treated (TT) sites, adjacent (AD) sites and nonadjacent (NAD) sites. Free gingival margin [FGM], attachment level, pocket depth, bone level, biological width [BW] were recorded at baseline, 1, 3 and 6 months. Direct bone level after flap reflection was recorded before and after osseous resection at baseline only. Level of osseous crest was lowered based on BW, and supracrestal tooth structure needed using a combination of rotary and hand instruments. STATISTICAL ANALYSIS Student t test and ANOVA were used. RESULTS Overall, apical displacement of FGM at TT, AD and NAD sites was statistically significant compared to baseline. The apical displacement of FGM at TT site was more when compared to that at AD and NAD sites at 3 and 6 months. The BW at the TT site was smaller at 1, 3 and 6 months compared to that at baseline. However, at all sites, BW was reestablished to the baseline value at the end of 6 months. INTERPRETATION AND CONCLUSION The BW at TT sites was reestablished to its original vertical dimension by 6 months. In addition, a consistent 2-mm gain of coronal tooth structure was observed at the 1, 3 and 6-month examinations.
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Affiliation(s)
- K S Shobha
- Sri Siddhartha Dental College and Hospital, Tumkur, India
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50
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Wulsin DF, Gupta JR, Mani R, Blanco JA, Litt B. Modeling electroencephalography waveforms with semi-supervised deep belief nets: fast classification and anomaly measurement. J Neural Eng 2011; 8:036015. [PMID: 21525569 DOI: 10.1088/1741-2560/8/3/036015] [Citation(s) in RCA: 126] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
Clinical electroencephalography (EEG) records vast amounts of human complex data yet is still reviewed primarily by human readers. Deep belief nets (DBNs) are a relatively new type of multi-layer neural network commonly tested on two-dimensional image data but are rarely applied to times-series data such as EEG. We apply DBNs in a semi-supervised paradigm to model EEG waveforms for classification and anomaly detection. DBN performance was comparable to standard classifiers on our EEG dataset, and classification time was found to be 1.7-103.7 times faster than the other high-performing classifiers. We demonstrate how the unsupervised step of DBN learning produces an autoencoder that can naturally be used in anomaly measurement. We compare the use of raw, unprocessed data--a rarity in automated physiological waveform analysis--with hand-chosen features and find that raw data produce comparable classification and better anomaly measurement performance. These results indicate that DBNs and raw data inputs may be more effective for online automated EEG waveform recognition than other common techniques.
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Affiliation(s)
- D F Wulsin
- Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.
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