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Merchant YP, Shetty SS, Shetty R. Comment on "Gland-sparing neck dissection: oncological and functional outcomes in oral cancer patients". Int J Oral Maxillofac Surg 2023; 52:1106-1107. [PMID: 36872217 DOI: 10.1016/j.ijom.2023.02.002] [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: 01/03/2023] [Revised: 01/11/2023] [Accepted: 02/13/2023] [Indexed: 03/06/2023]
Affiliation(s)
- Y P Merchant
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, Maharashtra, India.
| | - S S Shetty
- Department of Oral and Maxillofacial Surgery, Manipal College of Dental Sciences, Mangalore, A constituent unit of MAHE, Manipal, Karnataka, India.
| | - R Shetty
- Deparment of Head and Neck Surgical Oncology, ACTREC, TMC, Navi Mumbai, Maharashtra, India
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Merchant YP, Shetty R. Comment on: "Intraosseous carcinoma of the anterior maxilla identified as the occult primary tumour of carcinoma of unknown primary". Int J Oral Maxillofac Surg 2023; 52:1015-1016. [PMID: 36792422 DOI: 10.1016/j.ijom.2023.01.015] [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: 12/30/2022] [Accepted: 01/24/2023] [Indexed: 02/16/2023]
Affiliation(s)
- Y P Merchant
- Department of Oral and Maxillofacial Surgery, Dr. D. Y. Patil Dental College and Hospital, Dr. D. Y. Patil Vidyapeeth, Pimpri, Pune, India.
| | - R Shetty
- Deparment of Head and Neck Surgical Oncology, ACTREC, TMC, Khargar, Navi Mumbai, India.
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Waseem S, Kyriakides J, Amiri AR, Shetty R, Shetty N, Chammaa R. Management strategies for the painless foot drop: a systematic review of the literature. Eur Spine J 2023; 32:1099-1105. [PMID: 36843147 DOI: 10.1007/s00586-023-07534-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 09/06/2022] [Accepted: 01/09/2023] [Indexed: 02/27/2023]
Abstract
PURPOSE Foot drop can uncommonly be a painless presenting symptom of degenerative spinal disorders. This systematic review aimed to summarise the literature on the management and outcomes of patients with a painless foot drop. METHODS We performed a systematic review of PubMed, EMBASE and Medline according to PRISMA guidelines. All studies published after 1980 in English referring to adult patients with a painless foot drop were included. Exclusion criteria included opinion based reports, review articles and articles in which foot drop was not caused by degenerative pathology of the thoracolumbar spine. RESULTS Of 62 included patients, 30 (48.4%) were male with an average age of 48.7 years (range 27-84). The mean duration of symptoms was 69.0 days (1-700). 98.8% were managed operatively. 46 (74.2%) patients had symptomatic improvement, with 41 (66.1%) having a post-intervention MRC power grading of 3 or above. Patients with a pre-procedure MRC 0 had a higher median increase in MRC post-procedure than those with MRC > 0. Of two studies comparing painful and painless symptoms, painless foot drop patients were less likely to recover to MRC equal to or over 3 than those with painful symptoms OR 0.31 (95% CI 0.04-2.65). CONCLUSION This systematic review and meta-analysis demonstrates a role for surgery in facilitating the neurological recovery of patients with a painless foot drop. Large randomised controlled studies are required to characterise the role of operative intervention in these patients and compare outcomes between patients with painless and painful foot drop.
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Affiliation(s)
- S Waseem
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK.
| | - J Kyriakides
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - A R Amiri
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - R Shetty
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - N Shetty
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
| | - R Chammaa
- Department of Trauma and Orthopaedics, The Whittington Hospital, Magdala Avenue, London, UK
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Nadarajah R, Ludman P, Appelman Y, Brugaletta S, Budaj A, Bueno H, Huber K, Kunadian V, Leonardi S, Lettino M, Milasinovic D, Gale CP, Budaj A, Dagres N, Danchin N, Delgado V, Emberson J, Friberg O, Gale CP, Heyndrickx G, Iung B, James S, Kappetein AP, Maggioni AP, Maniadakis N, Nagy KV, Parati G, Petronio AS, Pietila M, Prescott E, Ruschitzka F, Van de Werf F, Weidinger F, Zeymer U, Gale CP, Beleslin B, Budaj A, Chioncel O, Dagres N, Danchin N, Emberson J, Erlinge D, Glikson M, Gray A, Kayikcioglu M, Maggioni AP, Nagy KV, Nedoshivin A, Petronio AP, Roos-Hesselink JW, Wallentin L, Zeymer U, Popescu BA, Adlam D, Caforio ALP, Capodanno D, Dweck M, Erlinge D, Glikson M, Hausleiter J, Iung B, Kayikcioglu M, Ludman P, Lund L, Maggioni AP, Matskeplishvili S, Meder B, Nagy KV, Nedoshivin A, Neglia D, Pasquet AA, Roos-Hesselink JW, Rossello FJ, Shaheen SM, Torbica A, Gale CP, Ludman PF, Lettino M, Bueno H, Huber K, Leonardi S, Budaj A, Milasinovic (Serbia) D, Brugaletta S, Appelman Y, Kunadian V, Al Mahmeed WAR, Kzhdryan H, Dumont C, Geppert A, Bajramovic NS, Cader FA, Beauloye C, Quesada D, Hlinomaz O, Liebetrau C, Marandi T, Shokry K, Bueno H, Kovacevic M, Crnomarkovic B, Cankovic M, Dabovic D, Jarakovic M, Pantic T, Trajkovic M, Pupic L, Ruzicic D, Cvetanovic D, Mansourati J, Obradovic I, Stankovic M, Loh PH, Kong W, Poh KK, Sia CH, Saw K, Liška D, Brozmannová D, Gbur M, Gale CP, Maxian R, Kovacic D, Poznic NG, Keric T, Kotnik G, Cercek M, Steblovnik K, Sustersic M, Cercek AC, Djokic I, Maisuradze D, Drnovsek B, Lipar L, Mocilnik M, Pleskovic A, Lainscak M, Crncic D, Nikojajevic I, Tibaut M, Cigut M, Leskovar B, Sinanis T, Furlan T, Grilj V, Rezun M, Mateo VM, Anguita MJF, Bustinza ICM, Quintana RB, Cimadevilla OCF, Fuertes J, Lopez F, Dharma S, Martin MD, Martinez L, Barrabes JA, Bañeras J, Belahnech Y, Ferreira-Gonzalez I, Jordan P, Lidon RM, Mila L, Sambola A, Orvin K, Sionis A, Bragagnini W, Cambra AD, Simon C, Burdeus MV, Ariza-Solé A, Alegre O, Alsina M, Ferrando JIL, Bosch X, Sinha A, Vidal P, Izquierdo M, Marin F, Esteve-Pastor MA, Tello-Montoliu A, Lopez-Garcia C, Rivera-Caravaca JM, Gil-Pérez P, Nicolas-Franco S, Keituqwa I, Farhan HA, Silva L, Blasco A, Escudier JM, Ortega J, Zamorano JL, Sanmartin M, Pereda DC, Rincon LM, Gonzalez P, Casado T, Sadeghipour P, Lopez-Sendon JL, Manjavacas AMI, Marin LAM, Sotelo LR, Rodriguez SOR, Bueno H, Martin R, Maruri R, Moreno G, Moris C, Gudmundsdottir I, Avanzas P, Ayesta A, Junco-Vicente A, Cubero-Gallego H, Pascual I, Sola NB, Rodriguez OA, Malagon L, Martinez-Basterra J, Arizcuren AM, Indolfi C, Romero J, Calleja AG, Fuertes DG, Crespín Crespín M, Bernal FJC, Ojeda FB, Padron AL, Cabeza MM, Vargas CM, Yanes G, Kitai T, Gonzalez MJG, Gonzalez Gonzalez J, Jorge P, De La Fuente B, Bermúdez MG, Perez-Lopez CMB, Basiero AB, Ruiz AC, Pamias RF, Chamero PS, Mirrakhimov E, Hidalgo-Urbano R, Garcia-Rubira JC, Seoane-Garcia T, Arroyo-Monino DF, Ruiz AB, Sanz-Girgas E, Bonet G, Rodríguez-López J, Scardino C, De Sousa D, Gustiene O, Elbasheer E, Humida A, Mahmoud H, Mohamed A, Hamid E, Hussein S, Abdelhameed M, Ali T, Ali Y, Eltayeb M, Philippe F, Ali M, Almubarak E, Badri M, Altaher S, Alla MD, Dellborg M, Dellborg H, Hultsberg-Olsson G, Marjeh YB, Abdin A, Erglis A, Alhussein F, Mgazeel F, Hammami R, Abid L, Bahloul A, Charfeddine S, Ellouze T, Canpolat U, Oksul M, Muderrisoglu H, Popovici M, Karacaglar E, Akgun A, Ari H, Ari S, Can V, Tuncay B, Kaya H, Dursun L, Kalenderoglu K, Tasar O, Kalpak O, Kilic S, Kucukosmanoglu M, Aytekin V, Baydar O, Demirci Y, Gürsoy E, Kilic A, Yildiz Ö, Arat-Ozkan A, Sinan UY, Dagva M, Gungor B, Sekerci SS, Zeren G, Erturk M, Demir AR, Yildirim C, Can C, Kayikcioglu M, Yagmur B, Oney S, Xuereb RG, Sabanoglu C, Inanc IH, Ziyrek M, Sen T, Astarcioglu MA, Kahraman F, Utku O, Celik A, Surmeli AO, Basaran O, Ahmad WAW, Demirbag R, Besli F, Gungoren F, Ingabire P, Mondo C, Ssemanda S, Semu T, Mulla AA, Atos JS, Wajid I, Appelman Y, Al Mahmeed WAR, Atallah B, Bakr K, Garrod R, Makia F, Eldeeb F, Abdekader R, Gomaa A, Kandasamy S, Maruthanayagam R, Nadar SK, Nakad G, Nair R, Mota P, Prior P, Mcdonald S, Rand J, Schumacher N, Abraheem A, Clark M, Coulding M, Qamar N, Turner V, Negahban AQ, Crew A, Hope S, Howson J, Jones S, Lancaster N, Nicholson A, Wray G, Donnelly P, Gierlotka M, Hammond L, Hammond S, Regan S, Watkin R, Papadopoulos C, Ludman P, Hutton K, Macdonald S, Nilsson A, Roberts S, Monteiro S, Garg S, Balachandran K, Mcdonald J, Singh R, Marsden K, Davies K, Desai H, Goddard W, Iqbal N, Chalil S, Dan GA, Galasko G, Assaf O, Benham L, Brown J, Collins S, Fleming C, Glen J, Mitchell M, Preston S, Uttley A, Radovanovic M, Lindsay S, Akhtar N, Atkinson C, Vinod M, Wilson A, Clifford P, Firoozan S, Yashoman M, Bowers N, Chaplin J, Reznik EV, Harvey S, Kononen M, Lopesdesousa G, Saraiva F, Sharma S, Cruddas E, Law J, Young E, Hoye A, Harper P, Balghith M, Rowe K, Been M, Cummins H, French E, Gibson C, Abraham JA, Hobson S, Kay A, Kent M, Wilkinson A, Mohamed A, Clark S, Duncan L, Ahmed IM, Khatiwada D, Mccarrick A, Wanda I, Read P, Afsar A, Rivers V, Theobald T, Cercek M, Bell S, Buckman C, Francis R, Peters G, Stables R, Morgan M, Noorzadeh M, Taylor B, Twiss S, Widdows P, Brozmannová D, Wilkinson V, Black M, Clark A, Clarkson N, Currie J, George L, Mcgee C, Izzat L, Lewis T, Omar Z, Aytekin V, Phillips S, Ahmed F, Mackie S, Oommen A, Phillips H, Sherwood M, Aleti S, Charles T, Jose M, Kolakaluri L, Ingabire P, Karoudi RA, Deery J, Hazelton T, Knight A, Price C, Turney S, Kardos A, Williams F, Wren L, Bega G, Alyavi B, Scaletta D, Kunadian V, Cullen K, Jones S, Kirkup E, Ripley DP, Matthews IG, Mcleod A, Runnett C, Thomas HE, Cartasegna L, Gunarathne A, Burton J, King R, Quinn J, Sobolewska J, Munt S, Porter J, Christenssen V, Leng K, Peachey T, Gomez VN, Temple N, Wells K, Viswanathan G, Taneja A, Cann E, Eglinton C, Hyams B, Jones E, Reed F, Smith J, Beltrano C, Affleck DC, Turner A, Ward T, Wilmshurst N, Stirrup J, Brunton M, Whyte A, Smith S, Murray V, Walker R, Novas V, Weston C, Brown C, Collier D, Curtis K, Dixon K, Wells T, Trim F, Ghosh J, Mavuri M, Barman L, Dumont C, Elliott K, Harrison R, Mallinson J, Neale T, Smith J, Toohie J, Turnbull A, Parker E, Hossain R, Cheeseman M, Balparda H, Hill J, Hood M, Hutchinson D, Mellows K, Pendlebury C, Storey RF, Barker J, Birchall K, Denney H, Housley K, Cardona M, Middle J, Kukreja N, Gati S, Kirk P, Lynch M, Srinivasan M, Szygula J, Baker P, Cruz C, Derigay J, Cigalini C, Lamb K, Nembhard S, Price A, Mamas M, Massey I, Wain J, Delaney J, Junejo S, Martin K, Obaid D, Hoyle V, Brinkworth E, Davies C, Evans D, Richards S, Thomas C, Williams M, Dayer M, Mills H, Roberts K, Goodchild F, Dámaso ES, Greig N, Kundu S, Donaldson D, Tonks L, Beekes M, Button H, Hurford F, Motherwell N, Summers-Wall J, Felmeden D, Tapia V, Keeling P, Sheikh U, Yonis A, Felmeden L, Hughes D, Micklewright L, Summerhayes A, Sutton J, Panoulas V, Prendergast C, Poghosyan K, Rogers P, Barker LN, Batin P, Conway D, Exley D, Fletcher A, Wright J, Nageh T, Hadebe B, Kunhunny S, Mkhitaryan S, Mshengu E, Karthikeyan VJ, Hamdan H, Cooper J, Dandy C, Parkinson V, Paterson P, Reddington S, Taylor T, Tierney C, Adamyan M, Jones KV, Broadley A, Beesley K, Buckley C, Hellyer C, Pippard L, Pitt-Kerby T, Azam J, Hayes C, Freshwater K, Boyadjian S, Johnson L, Mcgill Y, Redfearn H, Russell M, Alyavi A, Alyavi B, Uzokov J, Hayrapetyan H, Azaryan K, Tadevosyan M, Poghosyan H, Kzhdryan H, Vardanyan A, Huber K, Geppert A, Ahmed A, Weidinger F, Derntl M, Hasun M, Schuh-Eiring T, Riegler L, Haq MM, Cader FA, Dewan MAM, Fatema ME, Hasan AS, Islam MM, Khandoker F, Mayedah R, Nizam SU, Azam MG, Arefin MM, Jahan J, Schelfaut D, De Raedt H, Wouters S, Aerts S, Batjoens H, Beauloye C, Dechamps M, Pierard S, Van Caenegem O, Sinnaeve F, Claeys MJ, Snepvangers M, Somers V, Gevaert S, Schaubroek H, Vervaet P, Buysse M, Renders F, Dumoulein M, Hiltrop N, De Coninck M, Naessens S, Senesael I, Hoffer E, Pourbaix S, Beckers J, Dugauquier C, Jacquet S, Malmendier D, Massoz M, Evrard P, Collard L, Brunner P, Carlier S, Blockmans M, Mayne D, Timiras E, Guédès A, Demeure F, Hanet C, Domange J, Jourdan K, Begic E, Custovic F, Dozic A, Hrvat E, Kurbasic I, Mackic D, Subo A, Durak-Nalbantic A, Dzubur A, Rebic D, Hamzic-Mehmedbasic A, Redzepovic A, Djokic-Vejzovic A, Hodzic E, Hujdur M, Musija E, Gljiva-Gogic Z, Serdarevic N, Bajramovic NS, Brigic L, Halilcevic M, Cibo M, Hadžibegic N, Kukavica N, Begic A, Iglica A, Osmanagic A, Resic N, Grgurevic MV, Zvizdic F, Pojskic B, Mujaric E, Selimovic H, Ejubovic M, Pojskic L, Stimjanin E, Sut M, Zapata PS, Munoz CG, Andrade LAF, Upegui MPT, Perez LE, Chavarria J, Quesada D, Alvarado K, Zaputovic L, Tomulic V, Gobic D, Jakljevic T, Lulic D, Bacic G, Bastiancic L, Avraamides P, Eftychiou C, Eteocleous N, Ioannou A, Lambrianidi C, Drakomathioulakis M, Groch L, Hlinomaz O, Rezek M, Semenka J, Sitar J, Beranova M, Kramarikova P, Pesl L, Sindelarova S, Tousek F, Warda HM, Ghaly I, Habiba S, Habib A, Gergis MN, Bahaa H, Samir A, Taha HSE, Adel M, Algamal HM, Mamdouh M, Shaker AF, Shokry K, Konsoah A, Mostafa AM, Ibrahim A, Imam A, Hafez B, Zahran A, Abdelhamid M, Mahmoud K, Mostafa A, Samir A, Abdrabou M, Kamal A, Sallam S, Ali A, Maghraby K, Atta AR, Saad A, Ali M, Lotman EM, Lubi R, Kaljumäe H, Uuetoa T, Kiitam U, Durier C, Ressencourt O, El Din AA, Guiatni A, Bras ML, Mougenot E, Labeque JN, Banos JL, Capendeguy O, Mansourati J, Fofana A, Augagneur M, Bahon L, Pape AL, Batias-Moreau L, Fluttaz A, Good F, Prieur F, Boiffard E, Derien AS, Drapeau I, Roy N, Perret T, Dubreuil O, Ranc S, Rio S, Bonnet JL, Bonnet G, Cuisset T, Deharo P, Mouret JP, Spychaj JC, Blondelon A, Delarche N, Decalf V, Guillard N, Hakme A, Roger MP, Biron Y, Druelles P, Loubeyre C, Lucon A, Hery P, Nejjari M, Digne F, Huchet F, Neykova A, Tzvetkov B, Larrieu M, Quaino G, Armangau P, Sauguet A, Bonfils L, Dumonteil N, Fajadet J, Farah B, Honton B, Monteil B, Philippart R, Tchetche D, Cottin M, Petit F, Piquart A, Popovic B, Varlot J, Maisuradze D, Sagirashvili E, Kereselidze Z, Totladze L, Ginturi T, Lagvilava D, Hamm C, Liebetrau C, Haas M, Hamm C, Koerschgen T, Weferling M, Wolter JS, Maier K, Nickenig G, Sedaghat A, Zachoval C, Lampropoulos K, Mpatsouli A, Sakellaropoulou A, Tyrovolas K, Zibounoumi N, Argyropoulos K, Toulgaridis F, Kolyviras A, Tzanis G, Tzifos V, Milkas A, Papaioannou S, Kyriazopoulos K, Pylarinou V, Kontonassakis I, Kotakos C, Kourgiannidis G, Ntoliou P, Parzakonis N, Pipertzi A, Sakalidis A, Ververeli CL, Kafkala K, Sinanis T, Diakakis G, Grammatikopoulos K, Papoutsaki E, Patialiatos T, Mamaloukaki M, Papadaki ST, Kanellos IE, Antoniou A, Tsinopoulos G, Goudis C, Giannadaki M, Daios S, Petridou M, Skantzis P, Koukis P, Dimitriadis F, Savvidis M, Styliadis I, Sachpekidis V, Pilalidou A, Stamatiadis N, Fotoglidis A, Karakanas A, Ruzsa Z, Becker D, Nowotta F, Gudmundsdottir I, Libungan B, Skuladottir FB, Halldorsdottir H, Shetty R, Iyengar S, Bs C, G S, Lakshmana S, S R, Tripathy N, Sinha A, Choudhary B, Kumar A, Kumar A, Raj R, Roy RS, Dharma S, Siswanto BB, Farhan HA, Yaseen IF, Al-Zaidi M, Dakhil Z, Amen S, Rasool B, Rajeeb A, Amber K, Ali HH, Al-Kinani T, Almyahi MH, Al-Obaidi F, Masoumi G, Sadeghi M, Heshmat-Ghahdarijani K, Roohafza H, Sarrafzadegan N, Shafeie M, Teimouri-Jervekani Z, Noori F, Kyavar M, Sadeghipour P, Firouzi A, Alemzadeh-Ansari MJ, Ghadrdoost B, Golpira R, Ghorbani A, Ahangari F, Salarifar M, Jenab Y, Biria A, Haghighi S, Mansouri P, Yadangi S, Kornowski R, Orvin K, Eisen A, Oginetz N, Vizel R, Kfir H, Pasquale GD, Casella G, Cardelli LS, Filippini E, Zagnoni S, Donazzan L, Ermacora D, Indolfi C, Polimeni A, Curcio A, Mongiardo A, De Rosa S, Sorrentino S, Spaccarotella C, Landolina M, Marino M, Cacucci M, Vailati L, Bernabò P, Montisci R, Meloni L, Marchetti MF, Biddau M, Garau E, Barbato E, Morisco C, Strisciuglio T, Canciello G, Lorenzoni G, Casu G, Merella P, Novo G, D'Agostino A, Di Lisi D, Di Palermo A, Evola S, Immordino F, Rossetto L, Spica G, Pavan D, Mattia AD, Belfiore R, Grandis U, Vendrametto F, Spagnolo C, Carniel L, Sonego E, Gaudio C, Barillà F, Biccire FG, Bruno N, Ferrari I, Paravati V, Torromeo C, Galasso G, Peluso A, Prota C, Radano I, Benvenga RM, Ferraioli D, Anselmi M, Frigo GM, Sinagra G, Merlo M, Perkan A, Ramani F, Altinier A, Fabris E, Rinaldi M, Usmiani T, Checco L, Frea S, Mussida M, Matsukawa R, Sugi K, Kitai T, Furukawa Y, Masumoto A, Miyoshi Y, Nishino S, Assembekov B, Amirov B, Chernokurova Y, Ibragimova F, Mirrakhimov E, Ibraimova A, Murataliev T, Radzhapova Z, Uulu ES, Zhanyshbekova N, Zventsova V, Erglis A, Bondare L, Zaliunas R, Gustiene O, Dirsiene R, Marcinkeviciene J, Sakalyte G, Virbickiene A, Baksyte G, Bardauskiene L, Gelmaniene R, Salkauskaite A, Ziubryte G, Kupstyte-Kristapone N, Badariene J, Balciute S, Kapleriene L, Lizaitis M, Marinskiene J, Navickaite A, Pilkiene A, Ramanauskaite D, Serpytis R, Silinskiene D, Simbelyte T, Staigyte J, Philippe F, Degrell P, Camus E, Ahmad WAW, Kassim ZA, Xuereb RG, Buttigieg LL, Camilleri W, Pllaha E, Xuereb S, Popovici M, Ivanov V, Plugaru A, Moscalu V, Popovici I, Abras M, Ciobanu L, Litvinenco N, Fuior S, Dumanschi C, Ivanov M, Danila T, Grib L, Filimon S, Cardaniuc L, Batrinac A, Tasnic M, Cozma C, Revenco V, Sorici G, Dagva M, Choijiljav G, Dandar E, Khurelbaatar MU, Tsognemekh B, Appelman Y, Den Hartog A, Kolste HJT, Van Den Buijs D, Van'T Hof A, Pustjens T, Houben V, Kasperski I, Ten Berg J, Azzahhafi J, Bor W, Yin DCP, Mbakwem A, Amadi C, Kushimo O, Kilasho M, Oronsaye E, Bakracheski N, Bashuroska EK, Mojsovska V, Tupare S, Dejan M, Jovanoska J, Razmoski D, Marinoski T, Antovski A, Jovanovski Z, Kocho S, Markovski R, Ristovski V, Samir AB, Biserka S, Kalpak O, Peovska IM, Taleska BZ, Pejkov H, Busljetik O, Zimbakov Z, Grueva E, Bojovski I, Tutic M, Poposka L, Vavlukis M, Al-Riyami A, Nadar SK, Abdelmottaleb W, Ahmed S, Mujtaba MS, Al-Mashari S, Al-Riyami H, Laghari AH, Faheem O, Ahmed SW, Qamar N, Furnaz S, Kazmi K, Saghir T, Aneel A, Asim A, Madiha F, Sobkowicz B, Tycinska A, Kazimierczyk E, Szyszkowska A, Mizia-Stec K, Wybraniec M, Bednarek A, Glowacki K, Prokopczuk J, Babinski W, Blachut A, Kosiak M, Kusinska A, Samborski S, Stachura J, Szastok H, Wester A, Bartoszewska D, Sosnowska-Pasiarska B, Krzysiek M, Legutko J, Nawrotek B, Kasprzak JD, Klosinska M, Wiklo K, Kurpesa M, Rechcinski T, Cieslik-Guerra U, Gierlotka M, Bugajski J, Feusette P, Sacha J, Przybylo P, Krzesinski P, Ryczek R, Karasek A, Kazmierczak-Dziuk A, Mielniczuk M, Betkier-Lipinska K, Roik M, Labyk A, Krakowian M, Machowski M, Paczynska M, Potepa M, Pruszczyk P, Budaj A, Ambroziak M, Omelanczuk-Wiech E, Torun A, Opolski G, Glowczynska R, Fojt A, Kowalik R, Huczek Z, Jedrzejczyk S, Roleder T, Brust K, Gasior M, Desperak P, Hawranek M, Farto-Abreu P, Santos M, Baptista S, Brizida L, Faria D, Loureiro J, Magno P, Monteiro C, Nédio M, Tavares J, Sousa C, Almeida I, Almeida S, Miranda H, Santos H, Santos AP, Goncalves L, Monteiro S, Baptista R, Ferreira C, Ferreira J, Goncalves F, Lourenço C, Monteiro P, Picarra B, Santos AR, Guerreiro RA, Carias M, Carrington M, Pais J, de Figueiredo MP, Rocha AR, Mimoso J, De Jesus I, Fernandes R, Guedes J, Mota T, Mendes M, Ferreira J, Tralhão A, Aguiar CT, Strong C, Da Gama FF, Pais G, Timóteo AT, Rosa SAO, Mano T, Reis J, Selas M, Mendes DE, Satendra M, Pinto P, Queirós C, Oliveira I, Reis L, Cruz I, Fernandes R, Torres S, Luz A, Campinas A, Costa R, Frias A, Oliveira M, Martins V, Castilho B, Coelho C, Moura AR, Cotrim N, Dos Santos RC, Custodio P, Duarte R, Gomes R, Matias F, Mendonca C, Neiva J, Rabacal C, Almeida AR, Caeiro D, Queiroz P, Silva G, Pop-Moldovan AL, Darabantiu D, Mercea S, Dan GA, Dan AR, Dobranici M, Popescu RA, Adam C, Sinescu CJ, Andrei CL, Brezeanu R, Samoila N, Baluta MM, Pop D, Tomoaia R, Istratoaie O, Donoiu I, Cojocaru A, Oprita OC, Rocsoreanu A, Grecu M, Ailoaei S, Popescu MI, Cozma A, Babes EE, Rus M, Ardelean A, Larisa R, Moisi M, Ban E, Buzle A, Filimon G, Dobreanu D, Lupu S, Mitre A, Rudzik R, Sus I, Opris D, Somkereki C, Mornos C, Petrescu L, Betiu A, Volcescu A, Ioan O, Luca C, Maximov D, Mosteoru S, Pascalau L, Roman C, Brie D, Crisan S, Erimescu C, Falnita L, Gaita D, Gheorghiu M, Levashov S, Redkina M, Novitskii N, Dementiev E, Baglikov A, Zateyshchikov D, Zubova E, Rogozhina A, Salikov A, Nikitin I, Reznik EV, Komissarova MS, Shebzukhova M, Shitaya K, Stolbova S, Larina V, Akhmatova F, Chuvarayan G, Arefyev MN, Averkov OV, Volkova AL, Sepkhanyan MS, Vecherko VI, Meray I, Babaeva L, Goreva L, Pisaryuk A, Potapov P, Teterina M, Ageev F, Silvestrova G, Fedulaev Y, Pinchuk T, Staroverov I, Kalimullin D, Sukhinina T, Zhukova N, Ryabov V, Kruchinkina E, Vorobeva D, Shevchenko I, Budyak V, Elistratova O, Fetisova E, Islamov R, Ponomareva E, Khalaf H, Shaimaa AA, Kamal W, Alrahimi J, Elshiekh A, Balghith M, Ahmed A, Attia N, Jamiel AA, Potpara T, Marinkovic M, Mihajlovic M, Mujovic N, Kocijancic A, Mijatovic Z, Radovanovic M, Matic D, Milosevic A, Savic L, Subotic I, Uscumlic A, Zlatic N, Antonijevic J, Vesic O, Vucic R, Martinovic SS, Kostic T, Atanaskovic V, Mitic V, Stanojevic D, Petrovic M. Cohort profile: the ESC EURObservational Research Programme Non-ST-segment elevation myocardial infraction (NSTEMI) Registry. Eur Heart J Qual Care Clin Outcomes 2022; 9:8-15. [PMID: 36259751 DOI: 10.1093/ehjqcco/qcac067] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/07/2022] [Accepted: 10/11/2022] [Indexed: 11/12/2022]
Abstract
AIMS The European Society of Cardiology (ESC) EURObservational Research Programme (EORP) Non-ST-segment elevation myocardial infarction (NSTEMI) Registry aims to identify international patterns in NSTEMI management in clinical practice and outcomes against the 2015 ESC Guidelines for the management of acute coronary syndromes in patients presenting without ST-segment-elevation. METHODS AND RESULTS Consecutively hospitalised adult NSTEMI patients (n = 3620) were enrolled between 11 March 2019 and 6 March 2021, and individual patient data prospectively collected at 287 centres in 59 participating countries during a two-week enrolment period per centre. The registry collected data relating to baseline characteristics, major outcomes (in-hospital death, acute heart failure, cardiogenic shock, bleeding, stroke/transient ischaemic attack, and 30-day mortality) and guideline-recommended NSTEMI care interventions: electrocardiogram pre- or in-hospital, pre-hospitalization receipt of aspirin, echocardiography, coronary angiography, referral to cardiac rehabilitation, smoking cessation advice, dietary advice, and prescription on discharge of aspirin, P2Y12 inhibition, angiotensin converting enzyme inhibitor (ACEi)/angiotensin receptor blocker (ARB), beta-blocker, and statin. CONCLUSION The EORP NSTEMI Registry is an international, prospective registry of care and outcomes of patients treated for NSTEMI, which will provide unique insights into the contemporary management of hospitalised NSTEMI patients, compliance with ESC 2015 NSTEMI Guidelines, and identify potential barriers to optimal management of this common clinical presentation associated with significant morbidity and mortality.
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Affiliation(s)
- Ramesh Nadarajah
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
| | - Peter Ludman
- Institute of Cardiovascular Sciences, University of Birmingham, Birmingham, UK
| | - Yolande Appelman
- Department of Cardiology, Amsterdam UMC-Vrije Universiteit, Amsterdam Cardiovascular Sciences, Amsterdam, Netherlands
| | - Salvatore Brugaletta
- Hospital Clinic de Barcelona, Barcelona, Spain.,Institut d'Investigacions Biomèdiques August Pi i Sunyer, Barcelona, Spain
| | - Andrzej Budaj
- Department of Cardiology, Center of Postgraduate Medical Education, Grochowski Hospital, Warsaw, Poland
| | - Hector Bueno
- Cardiology Department, Hospital Universitario 12 de Octubre and Instituto de Investigación Sanitaria Hospital 12 de Octubre (imas12), Madrid, Spain.,Centro Nacional de Investigaciones Cardiovasculares (CNIC), Madrid, Spain.,Facultad de Medicina, Universidad Complutense de Madrid, Madrid, Spain
| | - Kurt Huber
- 3rd Medical Department, Cardiology and Intensive Care Medicine, Clinic Ottakring (Wilhelminenhospital), Vienna, Austria.,Medical Faculty, Sigmund Freud University, Vienna, Austria
| | - Vijay Kunadian
- Translational and Clinical Research Institute, Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK.,Cardiothoracic Centre, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK
| | - Sergio Leonardi
- University of Pavia, Pavia, Italy.,Fondazione IRCCS Policlinico S.Matteo, Pavia, Italy
| | - Maddalena Lettino
- Cardio-Thoracic and Vascular Department, San Gerardo Hospital, ASST-Monza, Monza, Italy
| | - Dejan Milasinovic
- Department of Cardiology, University Clinical Center of Serbia and Faculty of Medicine, University of Belgrade, Belgrade, Serbia
| | - Chris P Gale
- Leeds Institute for Cardiovascular and Metabolic Medicine, University of Leeds, LS2 9JT Leeds, UK.,Leeds Institute of Data Analytics, University of Leeds, LS2 9JT Leeds, UK.,Department of Cardiology, Leeds Teaching Hospitals NHS Trust, LS1 3EX Leeds, UK
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Wildenbeest JG, Billard MN, Zuurbier RP, Korsten K, Langedijk AC, van de Ven PM, Snape MD, Drysdale SB, Pollard AJ, Robinson H, Heikkinen T, Cunningham S, O'Neill T, Rizkalla B, Dacosta-Urbieta A, Martinón-Torres F, van Houten MA, Bont LJ, Billard MN, Zuurbier R, Korsten K, van Houten M, Langedijk A, van de Ven P, Bont L, Drysdale S, McGinley J, Lin GL, Snape M, Pollard A, Ives A, Wolfenden H, Salgia S, Shetty R, Dacosta-Urbieta A, Rivero-Calle I, Gómez-Carballa A, Pischedda S, Rodriguez-Tenreiro C, Martinón-Torres F, Heikkinen T, Cunningham S, Nair H, Campbell H, O'Neill T, Miller M, Baggott J, Beveridge C, McKernan R, Rizkalla B, Beutels P, Openshaw P, Meijer A, Kølsen Fischer T, van den Berge M, Giaquinto C, Abram M, Swanson K, Aerssens J, Vernhes C, Gallichan S, Kumar V, Molero E. The burden of respiratory syncytial virus in healthy term-born infants in Europe: a prospective birth cohort study. Lancet Respir Med 2022; 11:341-353. [PMID: 36372082 PMCID: PMC9764871 DOI: 10.1016/s2213-2600(22)00414-3] [Citation(s) in RCA: 51] [Impact Index Per Article: 25.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/26/2022] [Revised: 10/13/2022] [Accepted: 10/17/2022] [Indexed: 11/12/2022]
Abstract
BACKGROUND Respiratory syncytial virus (RSV) is a major cause of hospitalisation in infants. The burden of RSV infection in healthy term infants has not yet been established. Accurate health-care burden data in healthy infants are necessary to determine RSV immunisation policy when RSV immunisation becomes available. METHODS We performed a multicentre, prospective, observational birth cohort study in healthy term-born infants (≥37 weeks of gestation) in five sites located in different European countries to determine the health-care burden of RSV. The incidence of RSV-associated hospitalisations in the first year of life was determined by parental questionnaires and hospital chart reviews. We performed active RSV surveillance in a nested cohort to determine the incidence of medically attended RSV infections. The study is registered with ClinicalTrials.gov, NCT03627572. FINDINGS In total, 9154 infants born between July 1, 2017, and April 1, 2020, were followed up during the first year of life and 993 participated in the nested active surveillance cohort. The incidence of RSV-associated hospitalisations in the total cohort was 1·8% (95% CI 1·6-2·1). There were eight paediatric intensive care unit admissions, corresponding to 5·5% of 145 RSV-associated hospitalisations and 0·09% of the total cohort. Incidence of RSV infection in the active surveillance cohort confirmed by any diagnostic assay was 26·2% (24·0-28·6) and that of medically attended RSV infection was 14·1% (12·3-16·0). INTERPRETATION RSV-associated acute respiratory infection causes substantial morbidity, leading to the hospitalisation of one in every 56 healthy term-born infants in high-income settings. Immunisation of pregnant women or healthy term-born infants during their first winter season could have a major effect on the health-care burden caused by RSV infections. FUNDING Innovative Medicines Initiative 2 Joint Undertaking, with support from the EU's Horizon 2020 research and innovation programme and European Federation of Pharmaceutical Industries and Associations.
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Affiliation(s)
- Joanne G Wildenbeest
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Marie-Noëlle Billard
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Roy P Zuurbier
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands,Spaarne Gasthuis Academy, Hoofddorp and Haarlem, Netherlands
| | - Koos Korsten
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands,Department of Medical Microbiology and Infection Prevention, Amsterdam University Medical Centre, Amsterdam University, Amsterdam, Netherlands
| | - Annefleur C Langedijk
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands
| | - Peter M van de Ven
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands,Department of Data Science and Biostatistics, University Medical Center Utrecht, Utrecht, Netherlands
| | - Matthew D Snape
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Simon B Drysdale
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK,Centre for Neonatal and Paediatric Infection, Institute for Infection and Immunity, St George's, University of London, London, UK
| | - Andrew J Pollard
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Hannah Robinson
- Oxford Vaccine Group, Department of Paediatrics, University of Oxford, and the NIHR Oxford Biomedical Research Centre, Oxford, UK
| | - Terho Heikkinen
- Department of Pediatrics, University of Turku and Turku University Hospital, Turku, Finland
| | - Steve Cunningham
- Centre for Inflammation Research, University of Edinburgh, Edinburgh, UK
| | - Thomas O'Neill
- Children's Clinical Research Facility, Royal Hospital for Children and Young People, NHS Lothian, Edinburgh, UK
| | | | - Ana Dacosta-Urbieta
- Translational Paediatrics and Infectious Diseases, Paediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain,Genetics, Vaccines and Infections Research Group, Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Spain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | - Federico Martinón-Torres
- Translational Paediatrics and Infectious Diseases, Paediatrics Department, Hospital Clínico Universitario de Santiago de Compostela, Santiago de Compostela, Spain,Genetics, Vaccines and Infections Research Group, Instituto de Investigación Sanitaria de Santiago, University of Santiago de Compostela, Spain,Centro de Investigación Biomédica en Red de Enfermedades Respiratorias, Instituto de Salud Carlos III, Madrid, Spain
| | | | - Louis J Bont
- Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, Utrecht, Netherlands,Correspondence to: Prof Louis J Bont, Department of Pediatric Infectious Diseases and Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht, 3584EA Utrecht, Netherlands
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Bhat CS, Shetty R, Sundaram B, Ramanan AV. Immunomodulatory therapy in dengue: need for clinical trials and evidence base. Arch Dis Child 2022; 108:451-452. [PMID: 35680407 DOI: 10.1136/archdischild-2022-324100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/05/2022] [Accepted: 05/17/2022] [Indexed: 11/04/2022]
Affiliation(s)
- C S Bhat
- Paediatric Rheumatology Services, Rainbow Children's Hospital, Bangalore, India
| | - R Shetty
- Paediatric Intensive Care Services, Rainbow Children's Hospital, Bangalore, India
| | | | - A V Ramanan
- Department of Paediatric Rheumatology, Bristol Royal Hospital for Children, Bristol, UK
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7
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Mridha N, Younger J, Shetty R. Absent Left Main Stem With Unusual Morphology of Single Coronary Artery. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.558] [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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8
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Shetty R, Singh I, Sumayli HA, Jafer MA, Abdul Feroz SM, Bhandi S, Raj AT, Patil S, Ferrari M. Effect of prosthetic framework material, cantilever length and opposing arch on peri-implant strain in an all-on-four implant prostheses. Niger J Clin Pract 2021; 24:866-873. [PMID: 34121735 DOI: 10.4103/njcp.njcp_398_20] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Aim To evaluate the effect of prosthetic framework material and cantilever length on peri-implant strain in mandibular all-on-four implant-supported prostheses with different types of arch antagonist forces. Materials and Methods Models simulating a completely edentulous mandibular arch fabricated in heat-cured acrylic resin were used. On the acrylic models, four implants were placed at regions 34, 32, 42, and 44 simulating all-on-four implant placements. Implant-supported screw-retained fixed prosthesis frameworks were fabricated using three different materials (cobalt-chromium, zirconia, and polyetheretherketone) and with three different cantilever lengths (zero mm, 15 mm, and 25 mm). Strain gauges were attached on the model at the buccal and lingual positions of each implant. Forces simulating opposing natural dentition, conventional complete denture, and the parafunctional habit were applied to the models. The peri-implant strain in each strain gauge was recorded. Results Least peri-implant strains (67 microstrains) were observed when forces simulating conventional complete dentures were applied on the models and the highest peri-implant strains (9091 microstrains) were observed when forces simulating parafunctional habit were applied. One-way ANOVA test followed by Tukey's post hoc analysis was performed to compare the mean deformation scores between different materials at 50 N load. The level of significance [P-value] was set at P < 0.05. Tests showed significant differences between zero mm and the other types in all the different materials, and also between 1.5 x AP and 2.5 x AP for Zirconia and Peek material at P = 0.02 & P = .008, respectively. The results showed that the type of framework material, cantilever length, and occlusal forces from the opposing arch influence the peri-implant strain in the bone in all-on-four implant-supported prostheses. Conclusion Rehabilitation of a single, completely edentulous arch with implant-supported prostheses should consider the situation of the opposing arch. The choice of framework material, as well as the cantilever length, should be altered based on the forces from the opposing arch.
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Affiliation(s)
- R Shetty
- Department of Prosthodontics, KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
| | - I Singh
- Department of Prosthodontics, KLE Society's Institute of Dental Sciences, Bengaluru, Karnataka, India
| | | | - M A Jafer
- Department of Preventive Dentistry, College of Dentistry, Jazan University, Saudi Arabia; Health Promotion Department, Maastricht University, The Netherlands
| | - S M Abdul Feroz
- Department of Prosthetic Dental Sciences, College of Dentistry, Jazan University, Saudi Arabia
| | - S Bhandi
- Department of Restorative Dental Sciences, Division of Operative Dentistry, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - A T Raj
- Department of Oral Pathology and Microbiology, Sri Venkateswara Dental College and Hospital, Chennai, Tamil Nadu, India
| | - S Patil
- Department of Maxillofacial Surgery and Diagnostic Sciences, Division of Oral Pathology, College of Dentistry, Jazan University, Jazan, Saudi Arabia
| | - M Ferrari
- Department of Prosthodontics and Dental Materials and Dean, School of Dental Medicine, University of Siena, Italy
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9
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Karrasch A, Shetty R, Younger J. Cardiac Tamponade and Focal Atrial Tachycardia in an Adult Secondary to Central Venous Catheterisation. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.408] [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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10
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Shetty R, Dwarakanath S, Veena Kumari H, Sampath S, Chandramouli B. A Comparative Evaluation of Risk Factors and Various Antibiotic Regimens in Postoperative Neurosurgical Infections: A Prospective Randomized Controlled Study. IJNS 2017. [DOI: 10.1055/s-0036-1581977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
Abstract
Introduction Postoperative neurosurgical infections are a major problem, and the importance of keeping them to an absolute minimum cannot but be overemphasized. In this prospective study, we plan to evaluate the efficacy of three antibiotic regimens designed keeping the availability, affordability, and efficacy upon the common bacterial flora isolated at our center. We will also analyze the incidence and evaluate the risk factors of surgical site infections following clean, nonimplant, fresh, elective craniotomies.
Material and Methods This prospective randomized control study was conducted at our institute, a tertiary referral center, for a period of 2 years. The study cohort included all patients undergoing clean, nonimplant, fresh, elective craniotomies at our institute. The antibiotic protocol was chosen according to the current bacterio-epidemiological data based on the prevalence of infectious agent. One of the three drug regimens was chosen.
Results The results of univariate analysis revealed that there are multiple factors that are significantly associated with postoperative surgical site infection. In the multivariate analysis, only the presence of cerebrospinal fluid leak was the most significant factor associated with postoperative infections. Among the three different antibiotic regimens, cefazolin and amoxicillin–clavulanic acid were much better prophylactic agents for preventing surgical site infections when compared with cefotaxime.
Conclusion The present study has provided an insight into the incidence and risk factors contributing to surgical site infections as well as the efficacious antibiotic regimen protocols. The present study is one of the few studies to compare the efficacy of different antibiotic regimen protocols and also prospectively analyze the factors contributing to postoperative infections. This study will help us in optimizing the prophylaxis protocols and prevent emergence of multidrug-resistant strains, especially in a country like India.
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Affiliation(s)
- R. Shetty
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India
| | - S. Dwarakanath
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India
| | - H.B. Veena Kumari
- Department of Neuromicrobiology, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India
| | - S. Sampath
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India
| | - B.A. Chandramouli
- Department of Neurosurgery, National Institute of Mental Health and Neurosciences (NIMHANS), Hosur Road, Bengaluru, Karnataka, India
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Solanki I, Parihar P, Shetty R, Parihar MS. Synaptosomal and mitochondrial oxidative damage followed by behavioral impairments in streptozotocin induced diabetes mellitus: restoration by Malvastrum tricuspidatum. Cell Mol Biol (Noisy-le-grand) 2017; 63:94-101. [DOI: 10.14715/cmb/2017.63.7.16] [Citation(s) in RCA: 5] [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] [Received: 08/21/2017] [Indexed: 11/18/2022]
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12
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Dani S, Parikh K, Shetty R, Prathapkumar N, Shah D. P6074Clinical outcomes following the treatment of sirolimus coated balloon in coronary artery stenosis in real world population: results from nanolute registry. Eur Heart J 2017. [DOI: 10.1093/eurheartj/ehx493.p6074] [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: 11/13/2022] Open
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13
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Parihar P, Shetty R, Ghafourifar P, Parihar MS. Increase in oxidative stress and mitochondrial impairment in hypothalamus of streptozotocin treated diabetic rat: Antioxidative effect of Withania somnifera. Cell Mol Biol (Noisy-le-grand) 2016; 62:73-83. [PMID: 26828992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Accepted: 01/16/2016] [Indexed: 06/05/2023]
Abstract
Hypothalamus, the primary brain region for glucose sensing, is severely affected by oxidative stress in diabetes mellitus. Oxidative stress in this region of brain may cause severe impairment in neuronal metabolic functions. Mitochondria are prominent targets of oxidative stress and the combination of increased oxidative stress and mitochondrial dysfunctions may further decline hypothalamic neuronal functions. In the present study we examined the oxidative damage response, antioxidative responses and mitochondrial membrane permeability transition in hypothalamus of streptozotocin-treated diabetic rats. Our results show that streptozotocin significantly increases hypothalamic lipid peroxidation, protein carbonyl content while glutathione peroxidase and reduced glutathione were declined. Mitochondrial impairment marked by an increase in mitochondrial membrane permeabilization was seen following streptozotocin treatment in the hypothalamus. The oral administration of Withania somnifera root extract stabilized mitochondrial functions and prevented oxidative damage in the hypothalamus of diabetic rat. These findings suggest an increase in the oxidative stress and decline in antioxidative responses in the hypothalamus of streptozotocin treated diabetic rats. Withania somnifera root extract was found useful in reducing oxidative stress and mitochondrial impairment in hypothalamus of diabetic rat.
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Affiliation(s)
- P Parihar
- Vikram University School of Studies in Zoology & Biotechnology Ujjain India
| | - R Shetty
- Vikram University School of Studies in Zoology & Biotechnology Ujjain India
| | - P Ghafourifar
- Tri-State Institute of Pharmaceutical Sciences Huntington USA
| | - M S Parihar
- Vikram University School of Studies in Zoology & Biotechnology Ujjain India
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Rajiv Kumar N, Ghosh A, Shetty R, Pahuja N. Analysis of molecular mechanisms that predispose patients to develop post-PRK haze. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N. Rajiv Kumar
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
| | - A. Ghosh
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
| | - R. Shetty
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
| | - N. Pahuja
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
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Pahuja N, Rajiv Kumar N, Shetty R, Shroff R, Ghosh A. Differential molecular signature of ectatic and non-ectatic areas from Keratoconus patient corneas. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- N. Pahuja
- Narayana Nethralaya; Cornea; Bangalore India
| | | | - R. Shetty
- Narayana Nethralaya; Cornea; Bangalore India
| | - R. Shroff
- Narayana Nethralaya; Cornea; Bangalore India
| | - A. Ghosh
- Narayana Nethralaya; GROW Lab; Bangalore India
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16
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Shroff R, Shetty R, Kumar D, Ghosh A, Kumar S, Pahuja N, Ghosh A. Corneal lenticules as an ex-vivo model to study keratocyte biology. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- R. Shroff
- Narayana Nethralaya; Cataract - Refractive and Cornea; Bangalore India
| | - R. Shetty
- Narayana Nethralaya; Cornea and Refractive Services; Bangalore India
| | - D. Kumar
- Narayana Nethralaya; Grow Lab; Bangalore India
| | - A. Ghosh
- Narayana Nethralaya; Grow Lab; Bangalore India
| | - S. Kumar
- Narayana Nethralaya; Grow Lab; Bangalore India
| | - N. Pahuja
- Narayana Nethralaya; Cataract - Refractive and Cornea; Bangalore India
| | - A. Ghosh
- Narayana Nethralaya; Grow Lab; Bangalore India
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Rajiv Kumar N, Ghosh A, Shetty R, Pahuja N. Analysis of molecular mechanisms that predispose patients to develop post-PRK haze. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1543] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N. Rajiv Kumar
- Narayana Nethralaya Foundation; Grow Research Laboratory; Bangalore India
| | - A. Ghosh
- Narayana Nethralaya Foundation; Grow Research Laboratory; Bangalore India
| | - R. Shetty
- Narayana Nethralaya Foundation; Grow Research Laboratory; Bangalore India
| | - N. Pahuja
- Narayana Nethralaya Foundation; Grow Research Laboratory; Bangalore India
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18
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Shroff R, Shetty R, Kumar D, Kumar S, Pahuja N, GHOSH A. Corneal lenticules as an ex-vivo model to study keratocyte biology. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.1568] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- R. Shroff
- Narayana Nethralaya; Cataract - Refractive and Cornea; Bangalore India
| | - R. Shetty
- Narayana Nethralaya; Cornea and refractive Services; Bangalore India
| | - D. Kumar
- Narayana Nethralaya; Grow Lab; Bangalore India
| | - S. Kumar
- Narayana Nethralaya; Grow Lab; Bangalore India
| | - N. Pahuja
- Narayana Nethralaya; Cataract - Refractive and Cornea; Bangalore India
| | - A. GHOSH
- Narayana Nethralaya; Grow Lab; Bangalore India
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Sureshbabu V, Mallipatna A, Guha N, SA D, Lateef S, Gundimeda S, Padmanabhan A, Shetty R, Ghosh A. Integrated multi-omic analysis of human retinoblastoma identifies novel regulatory networks. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0544] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
Affiliation(s)
- V. Sureshbabu
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
| | - A. Mallipatna
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
| | - N. Guha
- Agilent Technologies India; LSCI; Bangalore India
| | - D. SA
- Agilent Technologies India; LSCI; Bangalore India
| | - S. Lateef
- Agilent Technologies India; LSCI; Bangalore India
| | - S. Gundimeda
- Agilent Technologies India; LSCI; Bangalore India
| | | | - R. Shetty
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
| | - A. Ghosh
- Grow Research Laboratory; Narayana Nethralaya Foundation; Bangalore India
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20
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Pahuja N, Rajiv Kumar N, Shetty R, Shroff R, Ghosh A. Differential molecular signature of ectatic and non-ectatic areas from Keratoconus patient corneas. Acta Ophthalmol 2015. [DOI: 10.1111/j.1755-3768.2015.0552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- N. Pahuja
- Cornea; Narayana Nethralaya; Bangalore India
| | | | - R. Shetty
- Cornea; Narayana Nethralaya; Bangalore India
| | - R. Shroff
- Cornea; Narayana Nethralaya; Bangalore India
| | - A. Ghosh
- GROW Lab; Narayana Nethralaya; Bangalore India
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21
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Singh JV, Kamath V, Shetty R, Kumar V, Prasad R, Saluja T, Dhingra MS. Retrospective surveillance for intussusception in children aged less than five years at two tertiary care centers in India. Vaccine 2015; 32 Suppl 1:A95-8. [PMID: 25091688 DOI: 10.1016/j.vaccine.2014.03.007] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
BACKGROUND A rotavirus vaccine could soon become part of India's national immunization program. However the occurrence of intussusception due to rotavirus vaccine is a potential safety concern. This surveillance aimed at the collection of baseline data on childhood intussusception which would facilitate the monitoring of intussusception cases after the introduction of rotavirus vaccines. METHODS We retrospectively reviewed medical records of confirmed intussusception cases in children under the age of five, treated during 2007-2012 at two tertiary care hospitals attached to medical schools in India. Demographic, clinical, diagnostic and treatment practices data were obtained from hospital records. RESULTS Over a five to six year observation period, we identified 187 confirmed cases of intussusception, of which 75% were males. The median age of intussusception was 8 months, and we observed a possible trend in the distribution of cases with the highest number of cases being reported in the month of April and lowest in the month of October. The most common diagnostic methods used were ultrasonography and abdominal radiography with most cases being treated surgically (71%). The median length of hospital stay was 8 days (range 1-40) and mean was 10.2 days. Records of any fatality due to intussusception were not found during the review of the records. CONCLUSIONS This analysis provides an estimate of the baseline data of childhood intussusception prior to the introduction of the rotavirus vaccination as a part of routine immunization in India. A prospective surveillance system using a standardized case definition is needed in order to better examine the incidence of intussusception in developing countries.
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Affiliation(s)
- J V Singh
- CSM Medical University, Lucknow, India
| | - V Kamath
- Kasturba Medical College, Manipal University, Manipal, India
| | - R Shetty
- Kasturba Medical College, Manipal University, Manipal, India
| | - V Kumar
- Kasturba Medical College, Manipal University, Manipal, India
| | - R Prasad
- Shantha Biotechnics Ltd., Hyderabad, India
| | - T Saluja
- Shantha Biotechnics Ltd., Hyderabad, India
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22
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Shetty R, Reddy K, Inam S, Khera K. Impact of Medication Adherence by Using Indian Version Compliance Questionnaire Rheumatology (Cqr) and Medication Adherence Report Scale (Mars) Tools on Quality of Life of Patients With Rheumatoid Arthritis. Value Health 2014; 17:A385. [PMID: 27200868 DOI: 10.1016/j.jval.2014.08.2639] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- R Shetty
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - K Reddy
- Manipal Univiersity, Manipal, India
| | - S Inam
- Manipal Univiersity, Manipal, India
| | - K Khera
- Manipal College of Pharmaceutical Sciences, Manipal, India
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Doddapaneni S, Shetty R, Sabih I, Maddali K, Khera K. Assessment of Medication Adherence in Rheumatoid Arthritis Patients in a Tertiary Care Hospital. Value Health 2014; 17:A774. [PMID: 27202860 DOI: 10.1016/j.jval.2014.08.336] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/05/2023]
Affiliation(s)
- S Doddapaneni
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - R Shetty
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - I Sabih
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - K Maddali
- Manipal College of Pharmaceutical Sciences, Manipal, India
| | - K Khera
- Manipal College of Pharmaceutical Sciences, Manipal, India
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Dabir S, Mangalesh S, Kumar KA, Kummelil MK, Sinha Roy A, Shetty R. Variations in the cone packing density with eccentricity in emmetropes. Eye (Lond) 2014; 28:1488-93. [PMID: 25277309 DOI: 10.1038/eye.2014.229] [Citation(s) in RCA: 16] [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] [Received: 01/13/2014] [Accepted: 08/10/2014] [Indexed: 11/09/2022] Open
Abstract
AIM To describe the parafoveal cone arrangement in emmetropic subjects and its variations with eccentricity, meridians and change in axial length in Indian eyes. METHODS We imaged 25 subjects using compact adaptive optics (AO) retinal camera prototype, the rtx1. Imaging was done at 1, 2, and 3° eccentricity from the fovea in four meridians: nasal, temporal, superior, and inferior. RESULTS A statistically significant drop in the cone packing density was observed from 2 to 3° (2° eccentricity=25 350/mm(2) (5300/mm(2), 8400-34 800/mm(2)) 3° eccentricity=20 750/mm(2) (6000 mm(2), 9000-33 670/mm(2))) P<0.05. The spacing correspondingly increased with increase in distance from the fovea (2° eccentricity=6.9 μm (0.70 μm, 5.95-11.6 μm)) and 3°eccentricity=7.80 μm (1.00 μm, 6.5-13.5 μm) P<0.05. As the axial length increases, the cone density significantly decreases. Interocular variations were noted. CONCLUSION With the advent of AO, visualization at the cellular level is now possible. Understanding the photoreceptor mosaic in the parafoveal space in terms of its density, spacing, and arrangement is crucial so as to detect early pathology and intervene appropriately. Newer therapeutic modalitites that are targeted at the cellular level like yellow micropulse laser, stem cells, gene therapy and so on may be better monitored in terms of safety and efficacy.
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Affiliation(s)
- S Dabir
- Department of Retina, Narayana Nethralaya, Bangalore, India
| | - S Mangalesh
- Department of Retina, Narayana Nethralaya, Bangalore, India
| | - K A Kumar
- Department of Retina, Narayana Nethralaya, Bangalore, India
| | - M K Kummelil
- Department of Cataract & Refractive Surgery, Narayana Nethralaya, Bangalore, India
| | - A Sinha Roy
- Department of Imaging & Biomechanics, Narayana Nethralaya, Bangalore, India
| | - R Shetty
- Department of Cornea & Refractive Surgery, Narayana Nethralaya, Bangalore, India
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Shetty SR, Kamat G, Shetty R. Wetting characteristics of addition silicon materials subjected to immersion disinfection--an in-vitro study. Eur J Prosthodont Restor Dent 2013; 21:98-104. [PMID: 24261100] [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: 06/02/2023]
Abstract
An in-vitro study was conducted to assess wetting characteristic of four brands of addition silicon materials subjected to immersion disinfection using four different disinfectants. Among the non-disinfected specimens, the lowest contact angle was recorded for Aquasil ultra (21.63), followed by Imprint II (29.06), Aquasil LV (44.10) and Take 1 (44.55). While 5.25% phenol increased the contact angle of all the silicon materials; 0.05% iodophor increased the angle of Take 1 and Imprint II and 0.5% sodium hypochlorite increased the angle of Imprint II and decreased for Aquasil ultra. However, 2% glutaraldehyde did not significantly change the contact angle of any of the four impression materials.
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Affiliation(s)
- S R Shetty
- Department of Prosthodontics, Dr. D.Y. Patil Vidyapeeth's-Dr. D. Y. Patil Dental College and Hospital, Maharashtra, India.
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Ojukwu N, Jain R, Wijayatilake S, Bellini A, Shetty R, Khan J, De la Cerda G. Correlation between the timing of endovascular coiling or microsurgical clipping and long-term outcomes of patients after aneurysmal subarachnoid haemorrhage. Crit Care 2013. [PMCID: PMC3642715 DOI: 10.1186/cc12281] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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Lewinsohn B, Panchatsharam S, Wijayatilake S, Billini A, Delacedra G, Jain R, Khan J, Shetty R, Lewinsohn A. National survey of current protocols and management of the traumatic brain injury patients in UK ICUs. Crit Care 2013. [PMCID: PMC3642649 DOI: 10.1186/cc12264] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Abstract
Pharmaceutical care signifies a shift of practice in pharmacy from being drug product-oriented to the one that is patient-oriented to achieve definite outcomes that improves patients’ quality of life. In order to achieve pharmaceutical care, pharmacists have to assume the role of caregiver, communicator, decision-maker, teacher, researcher, life-long learner, leader, and manager, which will help him to provide individualized care. As the patients visit community pharmacists more often, they can play a major role in providing individual care to the patients especially in the management of chronic noncommunicable diseases (NCDs). Community pharmacists have to upgrade their expertise in drug product orientation to that of clinical orientation to provide patient oriented care. Hence pharmacists have a larger role to play in managing NCDs which are rapidly increasing in India.
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Affiliation(s)
- A Tumkur
- Department of Pharmacy Management, Manipal College of Pharmaceutical Sciences, Manipal University, Manipal, India
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Unnikrishnan AG, Wangnoo SK, Joshi SR, Banerjee S, Kumar A, Kalra S, Channabasavaiah R, Shetty R. Physician perceptions and practices in management of diabetes in India: Results from the IMPROVE Control program. Indian J Endocrinol Metab 2012; 16:S428-S429. [PMID: 23565453 PMCID: PMC3603101 DOI: 10.4103/2230-8210.104118] [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] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION The impact of IMPROVE Control Training program was evaluated by a non-interventional study and validated by a physician perception questionnaire. From a survey on 1086 physicians providing diabetes care in India, we report their practices and perceptions about diabetes care and insulin therapy. MATERIALS AND METHODS The responses were collected using a questionnaire validated by the IMPROVE Control Steering Committee. RESULTS Majority [558 (51.4%)] of the physicians accepted the ADA defined HbA1c target of <7% as the standard for good glycemic control in their practice. However, 541 (49.8%) of the physicians agreed that only 20-40% of their patients were able to achieve this target. For patients who do not achieve the glycemic control with oral anti-diabetic drugs (OADs) within 6 months of initiation of therapy, initiation of an optimal insulin regimen was the preferred choice for 492 (45.3%) of the participating physicians. Premixed insulin was preferred for initiating insulin therapy in patients with type 2 diabetes, by 676 (62.2%) of the participants [as compared to basal by 375 (34.5%) participants]. Once daily premixed insulin, intensified to twice daily was preferred as most optimal insulin regimen for initiation and subsequent intensification of insulin therapy [487 (44.8%) participants]. Most of the participants preferred adopting a multi-targeted approach for treating diabetes, hypertension, and dyslipidemia. CONCLUSIONS Physicians prefer treatment goals similar to those recommended in the current guidelines of the American Diabetes Association for managing their patients with diabetes. Premixed insulin is preferred for initiation and intensification of insulin therapy.
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Affiliation(s)
- A. G. Unnikrishnan
- Department of Endocrinology, Amrita Institute of Medical Sciences, Kochi, India
| | - S. K. Wangnoo
- Endocrinologist, Indraprastha Apollo Hospitals, New Delhi, India
| | - S. R. Joshi
- Consultant Endocrinologist at Joshi Clinic, Lilavati & Bhatia Hospitals, Mumbai, India
| | - S. Banerjee
- Department of Medicine, Vivekananda Institute of Medical Sciences, Kolkata, India
| | - A. Kumar
- Diabetes Care and Research Centre, Patna, India
| | - S. Kalra
- Bharti Hospital & B.R.I.D.E., Karnal, India
| | | | - R. Shetty
- Novo Nordisk India Private Limited, Bangalore, India
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Kalra S, Moses CRA, Seshiah V, Sahay BK, Kumar A, Asirvatham AJ, Balaji V, Das AK, Akhtar S, Shetty R. Physicians' perceptions of a national consensus guideline on insulin therapy: Data from the IMPACT study. Indian J Endocrinol Metab 2012; 16:S426-S427. [PMID: 23565452 PMCID: PMC3603100 DOI: 10.4103/2230-8210.104117] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
Abstract
INTRODUCTION The effectiveness and impact of the Indian insulin guideline in clinical practice was evaluated by the Improving Management Practices and Clinical Outcomes in Type 2 Diabetes (IMPACT) Study. The study also evaluated the participating physicians' perceptions on the use of IIG versus RCP for management of diabetes. MATERIALS AND METHOD This 26 week multicenter, open label, randomized, prospective study aimed to evaluate effectiveness of Indian insulin guideline (IIG) versus routine clinical practice (RCP) in patients with type 2 diabetes (T2D). RESULTS Out of 426 physicians who completed the physicians' perception questionnaire, 189 (44.4%) felt that it was "easy" to initiate insulin in their patients using IIG. Cost of therapy (52.3%), followed by poor adherence (40.3%), and lack of motivation among physicians (40.4%) were the most important reasons cited for delay in initiation of insulin therapy. Two hundred and thirty three (54.7%) physicians felt that insulin titration was made "easy" in their patients using IIG, while 104 (24.4%) had a neutral approach. A total of 222 physicians (52.1%) felt it was "convenient" applying IIG in their practice, and 239 (67.8%) physicians felt "satisfied" with using IIG for achieving the targeted HbA1c <7%. One hundred and seventy seven (41.5%) physicians felt that there was scope for improving the IIG further by simplifying and revising the titration charts [117 (27.5%)]. CONCLUSION Primary care physicians in India have perceived the IIG to be easy algorithm to initiate and titrate insulin therapy. These results will encourage the use and facilitate future revision of the guideline.
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Affiliation(s)
| | - C. R. A. Moses
- Institute of Diabetology, Madras Medical College, Chennai, India
| | - V. Seshiah
- Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India
| | | | - A. Kumar
- Diabetes Care and Research Centre, GCIB, Patna, India
| | - A. J. Asirvatham
- Department of Diabetology, Government Rajaji Medical College, Madurai, India
| | - V. Balaji
- Diabetes Care & Research Institute, P.H. Road, Aminjikarai, Chennai, India
| | - A. K. Das
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India
| | - S. Akhtar
- Novo Nordisk India Pvt. Ltd, Bangalore, Karnataka, India
| | - R. Shetty
- Novo Nordisk India Pvt. Ltd, Bangalore, Karnataka, India
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Moses CRA, Seshiah V, Sahay BK, Kumar A, Asirvatham AJ, Balaji V, Kalra S, Akhtar S, Shetty R, Das AK. Baseline results indicate poor glycemic control and delay in initiation and optimization of insulin therapy: results from the improving management practices and clinical outcomes in type 2 diabetes study. Indian J Endocrinol Metab 2012; 16:S432-S433. [PMID: 23565455 PMCID: PMC3603103 DOI: 10.4103/2230-8210.104120] [Citation(s) in RCA: 7] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
INTRODUCTION Improving management practices and clinical outcomes in type 2 diabetes (IMPACT), was a prospective, open-label, 26- week, comparative, multi-center study to compare efficacy and safety of the Indian insulin guideline (IIG) group versus routine clinical practice (RCP) group in patients with type 2 diabetes. MATERIALS AND METHODS A total of 20,653 patients from 885 centers across India were enrolled and treated with premixed insulin therapy as per IIG or routine care. RESULTS Most of the participating centers (81.7%) reported following a diabetes guideline in their practice routinely but only 20.4% targeted HbA1c <7%. Very few of the physicians (2.7%) reported that most of their patients (>75%) achieved an HbA1c <7%. Most of the physicians (39.8%) also agreed that only 10-25% of the patients agree to start insulin therapy at the first counseling. Mean duration of diabetes before initiating insulin in patients using oral anti-diabetic drugs (OADs) was 7 years, indicating a delay in initiating insulin therapy. The difference in mean daily dose of insulin at initiation vs. at 26 weeks was only 0.8 U (25.8 ± 11.3 at initiation compared to 26.6 ± 9.5, respectively, p = ns) suggesting lack of treatment optimization. Weekly titration till achieving HbA1c <7% was done in 51.1% of the patients and only 8.9% performed self-titration. CONCLUSION Baseline glycemic control in these patients was poor and reflects a delay in initiating insulin therapy. Data also reflect a lack of optimization of insulin doses.
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Affiliation(s)
| | - V. Seshiah
- Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Aminjikarai, Chennai, India
| | - B. K. Sahay
- Department of Medicine, Osmania Medical College, Ameerpet, Hyderabad, India
| | - A. Kumar
- Diabetes Care and Research Centre, GCIB, Patna, India
| | - A. J. Asirvatham
- Department of Diabetology, Government Rajaji Medical College, Madurai, India
| | - V. Balaji
- Diabetes Care and Research Institute, Aminjikarai, Chennai, India
| | - S. Kalra
- Bharti Hospital and B.R.I.D.E., Karnal, India
| | - S. Akhtar
- Novo Nordisk India Pvt. Ltd, Bangalore, Karnataka, India
| | - R. Shetty
- Novo Nordisk India Pvt. Ltd, Bangalore, Karnataka, India
| | - A. K. Das
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education and Research, Pondicherry, India
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Das AK, Seshiah V, Sahay BK, Kumar A, Asirvatham AJ, Balaji V, Kalra S, Channabasavaiah R, Shetty R, Moses CRA. Improving management practices and clinical outcomes in type 2 diabetes study: Prevalence of complications in people with type 2 diabetes in India. Indian J Endocrinol Metab 2012; 16:S430-S431. [PMID: 23565454 PMCID: PMC3603102 DOI: 10.4103/2230-8210.104119] [Citation(s) in RCA: 7] [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] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
INTRODUCTION Diabetes is the fourth leading cause of disease-related death and almost 80% of diabetes-related deaths occur in developing countries. Optimal glycemic control, in particular HbA1c level less than 7% with effective management of dyslipidemia and hypertension can reduce development of diabetes-related complications. Delay in initiating/or optimizing appropriate anti-diabetic therapy including insulin could be a possible cause of the increase in complications. METHOD Improving management practices and clinical outcomes in type 2 diabetes (IMPACT) was a prospective, open-label, 26-week, comparative, multi-center study to compare efficacy and safety of the Indian insulin guideline (IIG) group versus routine clinical practice (RCP) group in type 2 diabetes patients. A total of 20,653 subjects from 885 centers across India were enrolled. RESULTS A total of 4695 patients (22.7%) (IIG, 4113 [22.6%]; RCP, 582 [23.5%]) had macrovascular complications and 8640 patients (41.8%) (IIG, 7486 [41.2%]; RCP, 1154 [46.6%]) had microvascular complications. Of 4695 patients with macrovascular complications, 2850 patients (60.7%) had coronary heart disease followed by 1457 patients (31.0%) with peripheral vascular disease. Of all the microvascular complications recorded, 5627 patients (65.1%) had peripheral neuropathy followed by 3313 patients (38.3%) with retinopathy. CONCLUSION The rates of complications were high in patients with type 2 diabetes at the time of being initiated on insulin therapy in India.
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Affiliation(s)
- Ashok Kumar Das
- Department of Medicine, Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India
| | - V. Seshiah
- Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Aminjikarai, Chennai, India
| | - B. K. Sahay
- Department of Medicine, Osmania Medical College, Ameerpet, Hyderabad, India
| | - A. Kumar
- Diabetes Care and Research Centre, GCIB, Patna, India
| | - A. J. Asirvatham
- Department of Diabetology, Government Rajaji Medical College, Madurai, India
| | - V. Balaji
- Diabetes Care & Research Institute, Aminjikarai, Chennai, India
| | - S. Kalra
- Bharti Hospital & B.R.I.D.E., Karnal, India
| | | | - R. Shetty
- Novo Nordisk India Pvt. Ltd., Bangalore, Karnataka, India
| | - C. R. A. Moses
- Institute of Diabetology, Madras Medical College, Chennai, India
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Sharma SK, Seshiah V, Sahay BK, Das AK, Rao PV, Shah S, Akhtar S, Shetty R. Baseline characteristics of the IMPROVE control study population: A study to evaluate the effectiveness of a standardized healthcare professionals training program. Indian J Endocrinol Metab 2012; 16:S471-S473. [PMID: 23565470 PMCID: PMC3603118 DOI: 10.4103/2230-8210.104135] [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] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/07/2023] Open
Abstract
INTRODUCTION The IMPROVE Control Training program was designed by Indian Academy of Diabetes (IAD), and a non-intervention study was conducted to evaluate the effectiveness of this standardized healthcare professionals (HCPs) training program on achieving treatment goals in patients with diabetes mellitus and its impact on standard of care. MATERIALS AND METHODS This multi-center, parallel group, open-label, non-randomized, non-intervention study included patients with type 2 diabetes who had an HbA1c >9 at time of diagnosis or an HbA1c >7% even after 6 months of initiation of therapy with anti-diabetic agents (Oral anti diabetic agents (OADs) and/or insulin). The data recorded at baseline included demographic characteristics, medical history, and the treatment regimens. RESULTS The study included 20,493 patients with diabetes, of which 13,295 (64.9%) were men. The mean [standard deviation (SD)] duration of diabetes was 6.4 (4.2) years and 6608 (32.2%) reported complications of diabetes. Poor glycemic control [HbA1c = 9.4 (1.3), FPG (mg/dl) = 181.2 (45.7); mean (SD)] was observed. The postprandial glucose was also high [post-breakfast, lunch, and dinner values in mg/dl were 263.6 (68.5), 278.1 (69.6), and 250.2 (63.7), respectively] in these patients. Failure of OADs was the most common reason cited for initiation of insulin. Premixed insulin was rated the regimen of choice for initiating therapy by the physicians (62.2% vs. 34.5% who preferred basal insulin). CONCLUSION The baseline results confirm the poor glycemic control and the delayed initiation and/or inadequacy of treatment in subjects with type 2 diabetes. These results also highlight the need for early and optimal insulin-based therapy.
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Affiliation(s)
- S. K. Sharma
- Dr. S. K. Sharma's Diabetes Thyroid & Endocrine Centre, Jaipur, India
| | - V. Seshiah
- Dr. V. Seshiah Diabetes Research Institute and Dr. Balaji Diabetes Care Centre, Chennai, India
| | - B. K. Sahay
- Formerly at Osmania University, 6-3-852/A, Ameerpet, Hyderabad, India
| | - A. K. Das
- Jawaharlal Institute of Postgraduate Medical Education & Research, Pondicherry, India
| | - P. V. Rao
- Nizam's Institute of Medical Sciences, Hyderabad, India
| | - S. Shah
- Bhatia Hospital, Bombay Mutual Terrace, Mumbai, India
| | - S. Akhtar
- Novo Nordisk India Pvt. Ltd., Bangalore, India
| | - R. Shetty
- Novo Nordisk India Pvt. Ltd., Bangalore, India
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Affiliation(s)
- V Asopa
- Whittington Hospital NHS Trust, UK.
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Shetty R, Vivek G, Nayak S, Dias L. A mysterious visitor to the heart. Case Reports 2012; 2012:bcr-03-2012-6005. [DOI: 10.1136/bcr-03-2012-6005] [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: 11/03/2022] Open
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Gupta MK, Shetty R, Pande N, Shenoy P. Isolated bilateral upper lobar anomalous pulmonary venous connection - a rare anomaly confirmed on CT imaging. Case Reports 2012; 2012:bcr.11.2011.5112. [DOI: 10.1136/bcr.11.2011.5112] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Stewart ZA, Shetty R, Nair R, Reed AI, Brophy PD. Case report: successful treatment of recurrent focal segmental glomerulosclerosis with a novel rituximab regimen. Transplant Proc 2012; 43:3994-6. [PMID: 22172885 DOI: 10.1016/j.transproceed.2011.10.051] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/17/2011] [Accepted: 10/24/2011] [Indexed: 12/12/2022]
Abstract
Focal segmental glomerulosclerosis (FSGS) is the cause of renal failure in more than 10% of pediatric patients undergoing renal transplantation. Recurrent FSGS is a major cause of pediatric allograft failure, with the risk increasing for patients undergoing retransplantation. Standard therapy for recurrent posttransplantation FSGS includes the use of intensive plasmapheresis (PP) in conjunction with cyclophosphamide or high-dose cyclosporine. However, many patients exhibit refractory disease, with rapid progression to allograft loss despite these interventions. Prior studies have reported conflicting data on the efficacy of adding rituximab therapy to the standard treatment regimen for recurrent posttransplantation FSGS. Here we present a successful therapeutic protocol with rapid elimination of PP after initiation of rituximab therapy for an adolescent patient with recurrent FSGS in the immediate postoperative period. The patient has maintained excellent allograft function through 12 months posttransplantation.
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Affiliation(s)
- Z A Stewart
- Department of Surgery, University of Iowa Hospitals and Clinics, Iowa City, Iowa 52242, USA.
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Haddadzadeh M, Maiya A, Kumar RP, Borkar S, Kamath G, Devasia T, Kansal N, Raman V, Shetty R. 217 Effectiveness of early cardiac rehabilitation on functional capacity in post-ptca patients: A randomized controlled trial. Can J Cardiol 2011. [DOI: 10.1016/j.cjca.2011.07.157] [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: 10/16/2022] Open
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Abstract
We present a rare case of right parietal sinus pericranii in a 2-year-old female child who presented with a compressible swelling on the right side of the scalp since 3 months of age, with a large head. Magnetic resonance imaging along with venography and conventional angiogram was performed, which confirmed the diagnosis.
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Affiliation(s)
- R B Kamble
- Department of Radiology and Neurosurgery, BGS Global Hospital, Uttarahalli Road, Kengeri, Bangalore - 560 098, India
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Shetty R, Reid K. Assessment of delirium in intensive care using the CAM-ICU. Crit Care 2011. [PMCID: PMC3067011 DOI: 10.1186/cc9757] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Abstract
Necrotising fasciitis is a rare but severe infection of soft-tissue associated with rapid progression, systemic toxicity and high mortality. Monomicrobial necrotising fasciitis caused by Pseudomonas aeruginosa is exceptionally uncommon with only 12 cases reported in the literature. We describe a fatal case with an atypical presentation in a patient following spinal decompression for a metastasis from prostate cancer.
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Affiliation(s)
- A. S. Lota
- Department of Trauma and Orthopaedic Surgery
| | - F. Altaf
- Department of Trauma and Orthopaedic Surgery
| | - R. Shetty
- Department of Trauma and Orthopaedic Surgery
| | | | - P. Mckenna
- Department of Trauma and Orthopaedic Surgery
| | - S. Iyer
- Department of Microbiology Royal Berkshire Hospital NHS Foundation Trust, London Road, Reading RG1 5AN, UK
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Vincent A, Kemmanu V, Shetty R, Anandula V, Madhavarao B, Shetty B. Variable expressivity of ocular associations of foveal hypoplasia in a family. Eye (Lond) 2009; 23:1735-9. [DOI: 10.1038/eye.2009.180] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
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Chaudhry A, Shetty R, Crimmin S, Singh-Ranger R. Biosynthetic Graft Repair of Mycotic Aneurysm of the Common Femoral Artery. Eur J Vasc Endovasc Surg 2009. [DOI: 10.1016/j.ejvs.2008.11.022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Shetty R, Pibarot P, Audet A, Janvier R, Dagenais F, Perron J, Couture C, Voisine P, Després JP, Mathieu P. Lipid-mediated inflammation and degeneration of bioprosthetic heart valves. Eur J Clin Invest 2009; 39:471-80. [PMID: 19490057 DOI: 10.1111/j.1365-2362.2009.02132.x] [Citation(s) in RCA: 59] [Impact Index Per Article: 3.9] [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: 01/20/2023]
Abstract
BACKGROUND The durability of bioprosthetic valves is limited by structural valve degeneration (SVD) leading to bioprostheses (BPs) stenosis or regurgitation. We hypothesized that a lipid-mediated inflammatory mechanism is involved in the SVD of BPs. MATERIAL AND METHODS Eighteen Freestyle stentless BP valves were explanted for SVD at a mean time of 5.9 +/- 3 years after implantation and were analysed by immunohistochemistry and transmission electron microscopy (TEM). RESULTS The mean age of the patients was 65 +/- 8 years and there were 11 male and seven female patients. Two of the 18 BPs had macroscopic calcification, whereas the other valves had minimal or no macroscopic calcification. Tears at the commissures leading to regurgitation was present in 16 BPs. Immunohistochemistry showed the presence of oxidized low-density lipoprotein (ox-LDL) and glycosaminoglycans in the fibrosa layer of 13 BPs. Areas with ox-LDL were infiltrated by macrophages (CD68(+)) co-expressing the scavenger receptor CD36 and metalloproteinase-9 (MMP-9). Zymogram showed the active form of MMP-9 within explanted BPs. EM studies revealed the presence of lipid-laden cells featuring foam cells and fragmented collagen. Nonimplanted control BPs obtained from the manufacturer (n = 4) had no evidence of lipid accumulation, inflammatory cell infiltration or expression of MMP9 within the leaflets. CONCLUSIONS These results support the concept that lipid-mediated inflammatory mechanisms may contribute to the SVD of BPs. These findings suggest that modification of atherosclerotic risk factors with the use of behavioural or pharmacological interventions could help to reduce the incidence of SVD.
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Affiliation(s)
- R Shetty
- Laval University, Quebec, QC, Canada
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Jyothula S, Seethamraju H, Kopas L, Shetty R, Dronavalli G, Noon G, Loebe M, Lafuente J, Scheinin S, Kesavan R. A RARE PULMONARY VASCULAR COMPLICATION IN LUNG TRANSPLANT RECIPIENTS. Chest 2008. [DOI: 10.1378/chest.134.4_meetingabstracts.p48002] [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: 11/01/2022] Open
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Palanivelu C, Shetty R, Jani K, Sendhilkumar K, Rajan PS, Maheshkumar GS. Laparoscopic distal pancreatectomy: results of a prospective non-randomized study from a tertiary center. Surg Endosc 2006; 21:373-7. [PMID: 17180289 DOI: 10.1007/s00464-006-9020-z] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2006] [Revised: 06/05/2006] [Accepted: 07/05/2006] [Indexed: 12/21/2022]
Abstract
BACKGROUND Though laparoscopic distal pancreatectomy for benign conditions was first described in the early 1990s, it has not become as popular as other laparoscopic surgeries. Published literature on this topic consists of several case reports and a handful of small series. We present our experience, which, to the best of our knowledge, is the largest series reported to date. METHODS Since 1998, 22 patients have undergone distal pancreatectomy at our institute. The technique of distal pancreatosplenectomy, as well as spleen-preserving distal pancreatectomy, is described. RESULTS Four males and 18 females in the age range of 12-69 years underwent operation. Splenic preservation was possible in 7 patients. The tumor diameter ranged from 2.1 cm to 7.4 cm. The mean operating time was 215 min. The mean length of incision required for specimen retrieval was 3.4 cm. All patients were started on a liquid diet on the first postoperative day. The median hospital stay was 4 days. One patient developed a pancreatic fistula that was managed conservatively. At the end of an average follow-up of 4.6 years, no recurrence has been reported. CONCLUSIONS Laparoscopic distal pancreatectomy is a safe procedure, with minimal morbidity, rapid recovery, and short hospital stay. In appropriate cases, splenic preservation is feasible.
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Affiliation(s)
- C Palanivelu
- Department of GI & Minimal Access Surgery, Gem Hospital, Coimbatore, Tamilnadu, India
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Charest A, Pépin A, Shetty R, Côté C, Voisine P, Dagenais F, Pibarot P, Mathieu P. Distribution of SPARC during neovascularisation of degenerative aortic stenosis. Heart 2006; 92:1844-9. [PMID: 16709694 PMCID: PMC1861285 DOI: 10.1136/hrt.2005.086595] [Citation(s) in RCA: 65] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 05/09/2006] [Indexed: 12/29/2022] Open
Abstract
OBJECTIVE To examine the hypothesis that degenerative aortic stenosis (AS) is associated with the development of blood vessels and the expression of the secreted protein, acidic and rich in cysteine/osteonectin (SPARC), a matricellular protein that is involved in ossification, the modulation of angiogenesis and the production of metalloproteinases. METHODS 30 surgically excised AS valves and 20 normal aortic valves were studied. RESULTS Blood vessels were detected in the aortic valves from patients with degenerative AS, whereas normal valves were avascular structures. Blood vessels in AS valves expressed endothelial nitric oxide synthase, CD34 and von Willebrand factor (vWF). Blood vessels were located in three distinct regions: near calcified nodules, under the leaflet border and in rich cellular areas forming cell islands. Blood vessels were predominantly present in early and intermediate grades of calcification. Cell islands were densely populated by CD45-positive cells where endothelial cells (CD34+, vWF+) forming cord-like structures were present. Immunoblotting detected SPARC only in AS valves and immunohistological analysis located SPARC in mature blood vessels. The proportion of blood vessels positive for SPARC was higher in valves with a lower grade of calcification. In cell islands, SPARC was distributed to mature blood vessels and to macrophages, where it co-located with matrix metalloproteinase-9, whereas no expression was detected in endothelial cells forming cord-like structures. CONCLUSION The localisation of SPARC to mature blood vessels and its predominant expression in AS valves with a lower calcification grade suggest that the spatial and temporal distribution of this matricellular protein is tightly controlled to participate in the neovascularisation of AS valves.
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Affiliation(s)
- A Charest
- Laval Hospital Research Center/Quebec Heart Institute, Department of Surgery, Laval University, Ste-Foy, Quebec, Canada
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Hegde RJ, Shetty R. Nasopalatine duct cyst. J Indian Soc Pedod Prev Dent 2006; 24 Suppl 1:S31-2. [PMID: 16891748] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 03/08/2023] Open
Abstract
Nasopalatine duct cyst is an intraossseous developmental cyst of the midline of the anterior palate. Management of a case of nasopalatine duct cyst in a 10 yr old male child is reported.
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Affiliation(s)
- Rahul J Hegde
- Department of Pediatric and Preventive Dentistry, YMT Dental College and Hospital, Kharghar, Navi Mumbai 410 210, India
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Abstract
OBJECTIVE To test the hypothesis that valve allograft (VA) calcification results from an ossification process in which bone-regulatory proteins are expressed. METHODS 15 VA that were explanted at the time of surgery for dysfunction were studied. VA were analysed and compared with normal aortic valves (n = 20). RESULTS All the VA (5 aortic, 10 pulmonary) exhibited heavy calcification and important fibrosis. Immunohistochemistry studies showed that the bone-specific transcription factor Cbfa-1 was expressed by stromal cells. Bone alkaline phosphatase was expressed in calcified regions. Immunostaining for alpha smooth muscle (alpha-SM) actin was increased in VA compared with normal valves and in 6 of the 15 valves formed cellular clusters close to the calcified nodules. In VA osteopontin and osteonectin were expressed by stromal cells, whereas osteocalcin was closely associated with the calcified regions. Furthermore, analysis of the bone-regulatory proteins that control bone resorption showed that receptor activator of nuclear factor kappaB ligand (RANKL), receptor activator of nuclear factor kappaB (RANK) and osteoprotegerin (OPG) were differentially expressed in calcified VA and normal valves. Normal valve leaflets expressed OPG, whereas OPG expression was absent or faint in calcified VA. RANKL and RANK were not detected in normal valves, whereas calcified VA expressed RANKL and RANK. CONCLUSION These data suggest that calcification of VA results from an ossification process, which relies on tight control of bone-regulatory protein expression. The expression pattern of the RANKL/RANK/OPG system suggests that it may have a regulatory role not only in osteoclastogenesis but also in the calcification of human VA.
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Affiliation(s)
- R Shetty
- Le Centre de Recherche de l'Hôpital Laval, Institut de Cardiologie de Québec, Département de Chirurgie, Université Laval, Ste-Foy, Quebec, Canada
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Palanivelu C, Shetty R, Jani K, Rajan PS, Sendhilkumar K, Parthasarthi R, Malladi V. Laparoscopic lateral pancreaticojejunostomy: a new remedy for an old ailment. Surg Endosc 2006; 20:458-61. [PMID: 16424983 DOI: 10.1007/s00464-005-0680-x] [Citation(s) in RCA: 32] [Impact Index Per Article: 1.8] [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: 10/07/2005] [Accepted: 11/08/2005] [Indexed: 11/26/2022]
Abstract
BACKGROUND Lateral pancreaticojejunostomy is considered as the standard surgery for chronic pancreatitis. Yet there are very few reports of this procedure being done laparoscopically. We present our experience with laparoscopic lateral pancreaticojejunostomy till date and describe our technique. MATERIAL AND METHOD Since 1997, we have done 12 laparoscopic lateral pancreatojejunostomies. There were 9 females and 3 males and the average age was 29.3 years. The indication for surgery in all patients was intractable abdominal pain and significant weight loss. Additionally, two patients were also suffering from pancreatic ascites. RESULTS The average diameter of the pancreatic duct was 14.7 mm. We used a four-port technique. All surgeries were completed without any conversion to open surgery. Post-operatively, there were no major morbidity and nil mortality. The average operating time was 172 minutes. Post-operative stay was short (average 5 days) and on median follow-up of 4.4 years, 83.3% patients had complete pain relief while 16.7% had partial relief. All patients had significant weight gain. CONCLUSIONS Laparoscopic lateral pancreaticojejunostomy is safe, effective and feasible in experience hands. Mastery of intracorporeal knotting and suturing techniques is mandatory before embarking on this surgery.
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Affiliation(s)
- C Palanivelu
- Gem Hospital, 45 A, Coimbatore 641045, Tamilnadu, India
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