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Koul R. Hypsarrhythmia and triphasic waves seem to be akin(similar) age-dependent responses of the brain to different insults. J Neurosci Rural Pract 2024; 15:156-158. [PMID: 38476411 PMCID: PMC10927049 DOI: 10.25259/jnrp_319_2023] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/10/2023] [Accepted: 09/30/2023] [Indexed: 03/14/2024] Open
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2
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Koul R, Maiwall R, Sarin SK, Bhatia V, Deshmukh A, Kumar C, Khajuria R, Rudra OS, Papneja S, Kantale P, Pamecha V. Unusual Facial Movements (Ictal Blinking, Oculogyric Crises, and Jaw Seizure) in Severe Liver Disease: A Case Series. J Clin Exp Hepatol 2023; 13:1149-1155. [PMID: 37975048 PMCID: PMC10643264 DOI: 10.1016/j.jceh.2023.05.004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2023] [Accepted: 05/10/2023] [Indexed: 11/19/2023] Open
Abstract
Background Seizures are reported in about one-third of patients with severe liver disease in association with acute or chronic liver failure. The majority of the seizures are of focal type. Occasionally generalized tonic-clonic seizures are seen when there is ethanol withdrawal. Not much is known about ictal blinking (IB) in severe liver disease. IB is the rare form of seizures and was reported in severe liver disease recently from this institute. Oculogyric crisis (OGC) is rarely reported in relation to the severe liver disease. OGC was also noted first time in our intensive care unit. Methods At the Institute of Liver and Biliary Sciences (ILBS), data on patients with IB and OGC were analyzed from October 2018 to January 2023 (52 months). All the patients had video electroencephalograph (video-EEG) recording after proper permission/consent. The patients were followed up later for the course of the illness. Results A total of 16 (12M:4F) patients were seen. Majority 12 (75%) were IB and 3 OGC. EEG was abnormal in nine (75.0%) of IB patients. Brain imaging had nonspecific findings. The outcome was based on the severity and recovery of the underlying liver disease. Conclusions Unusual facial movements in the form of IB and OGC are reported, which are most of the time missed. This report highlights the importance of recognition of these events and proper in time management to improve the outcome.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Shiv K. Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Vikram Bhatia
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Akhil Deshmukh
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Chandan Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Rahul Khajuria
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Omkar S. Rudra
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Sangam Papneja
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Priyanka Kantale
- Department of Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
| | - Vineyndra Pamecha
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, 110070, India
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Koul R, Thapar S, Khanna R, Alam S. Longitudinal Extensive Transverse Myelitis in a Four-Year-Old Boy Liver Transplant Recipient. Sultan Qaboos Univ Med J 2023; 23:421-422. [PMID: 37655081 PMCID: PMC10467549 DOI: 10.18295/squmj.5.2023.023] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2023] [Revised: 03/23/2023] [Accepted: 04/04/2023] [Indexed: 09/02/2023] Open
Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of liver and biliary sciences, New Delhi, India
| | - Shalini Thapar
- Department of Radiology, Institute of liver and biliary sciences, New Delhi, India
| | - Rajeev Khanna
- Department of Pediatric Hepatology, Institute of liver and biliary sciences, New Delhi, India
| | - Seema Alam
- Department of Pediatric Hepatology, Institute of liver and biliary sciences, New Delhi, India
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Koul R, Kumar S, Maiwall R. Spike wave complexes riding T-waves in generalized and focal pattern in two patients with hepatic encephalopathy. J Neurosci Rural Pract 2023; 14:384-385. [PMID: 37181166 PMCID: PMC10174135 DOI: 10.25259/jnrp_47_2022] [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] [Received: 11/05/2022] [Accepted: 01/11/2023] [Indexed: 02/25/2023] Open
Affiliation(s)
- Roshan Koul
- Department of Neurology, ILBS, New Delhi, India
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Yadav KK, Chouhan N, Thubstan R, Norlha S, Hariharan J, Borwankar C, Chandra P, Dhar VK, Mankuzhyil N, Godambe S, Sharma M, Venugopal K, Singh KK, Bhatt N, Bhattacharyya S, Chanchalani K, Das MP, Ghosal B, Godiyal S, Khurana M, Kotwal SV, Koul MK, Kumar N, Kushwaha CP, Nand K, Pathania A, Sahayanathan S, Sarkar D, Tolamati A, Koul R, Rannot RC, Tickoo AK, Chitnis VR, Behere A, Padmini S, Manna A, Joy S, Nair PM, Jha KP, Moitra S, Neema S, Srivastava S, Punna M, Mohanan S, Sikder SS, Jain A, Banerjee S, . K, Deshpande J, Sanadhya V, Andrew G, Patil MB, Goyal VK, Gupta N, Balakrishna H, Agrawal A, Srivastava SP, Karn KN, Hadgali PI, Bhatt S, Mishra VK, Biswas PK, Gupta RK, Kumar A, Thul SG, Kalmady R, Sonvane DD, Kumar V, Gaur UK, Chattopadhyay J, Gupta SK, Kiran AR, Parulekar Y, Agrawal MK, Parmar RM, Reddy GR, Mayya YS, Pithawa CK. Commissioning of the MACE gamma-ray telescope at Hanle, Ladakh, India. CURR SCI INDIA 2022. [DOI: 10.18520/cs/v123/i12/1428-1435] [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: 01/25/2023]
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Cheng J, Buduhan G, Venkataraman S, Bashir B, Ahmed N, Tan L, Kidane B, Sasaki D, Rathod S, Sivananthan G, Koul R, Leylek A, Butler J, McCurdy B, Kim J. Endobronchial Implanted Real-Time Radiofrequency (RF) Transponder Beacon Guided, Respiratory-Gated, Stereotactic Body Radiotherapy for Moving Lung Tumors: Interim Analysis of a Prospective Phase I/II Cohort Study. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Mitera G, Tsang D, Wright P, Sussman J, Craig T, Thompson R, Tyldesley S, Foxcroft S, Goddard K, Greenland J, Koul R, McCurdy B, Milosevic M, Morneau M, Morrison A, Pan L, Pantarotto J, Rutledge R, Warde P, Patel S. First Pan-Canadian Consensus Recommendations for Proton Beam Therapy Access in Canada. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.1439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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8
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Koul R, Kumar NM, Naheed D, Sarin SK. Chronic liver disease and hepatic encephalopathy patients with new-onset focal motor status epilepticus: Indicates herpetic encephalitis. J Neurosci Rural Pract 2022; 13:764-767. [PMID: 36743766 PMCID: PMC9893930 DOI: 10.25259/jnrp-2021-6-30(1812)] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2021] [Accepted: 10/15/2021] [Indexed: 11/07/2022] Open
Abstract
Seizures are not common in cases with chronic liver disease. Overall seizures have been reported in 20-30% of cases in chronic liver disease associated with hepatic encephalopathy. We report two cases of chronic liver disease patients who presented with new-onset refractory focal status epilepticus (SE). Both patients had encephalitis and seizures which responded only when acyclovir was added to the treatment with antiepileptic medication. Herpes encephalitis should be considered as a possible diagnosis in new-onset focal seizures or focal SE in patients with chronic liver disease with or without hepatic encephalopathy, pending further investigations.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Navin M. Kumar
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Darakshan Naheed
- Department of Neurology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Shiv K. Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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Venugopal B, Kakumanu S, Dubey A, Bashir B, Koul R, Rathod S. EP08.02-024 Research Efforts in Systemic Therapy of Lung Cancer With Brain Metastasis From 2015-21: A clinicaltrial.gov Registry Analysis. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Koul R, Maiwall R, Alam S, Pamecha V, Tevethia HV, Sarin SK. Ictal Blinking in Hepatic Encephalopathy Pre- and Post-Liver Transplant: Report of Eight Patients. J Neurosci Rural Pract 2022; 13:476-482. [PMID: 35971395 PMCID: PMC9375689 DOI: 10.1055/s-0042-1750136] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
Abstract
Objective Seizures are reported in 20 to 30% of cases with chronic liver disease in association with hepatic encephalopathy. Majority of these are focal seizures. Ictal blinking is reported first time in these patients pre- and post-liver transplant. Methods From November 2018 to October 2021, retrospective data was analyzed in patients with end-stage liver disease and hepatic encephalopathy, both pre- and post-liver transplant. Results Eight patients had ictal blinking, four were pre-transplant and four post-transplant. Five patients (four after liver transplant and one pre-transplant) were seizure free, three died of liver disease and multiorgan dysfunction, and one did not follow-up. Conclusion Ictal blinking in relation to liver disease and hepatic encephalopathy is reported, often missed and requires short duration antiepileptic medications.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences (ILBS), Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), Delhi, India
| | - Seema Alam
- Department of Pediatric Hepatology, Institute of Liver and Biliary Sciences (ILBS), Delhi, India
| | - Vineynder Pamecha
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences (ILBS), Delhi, India
| | | | - Shiv K Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences (ILBS), Delhi, India
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11
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Koul R, Vijay P, Khanna R, Alam S. Focal Ballismus (Right Arm) in a Boy with Wilson's Disease. Journal of Pediatric Neurology 2021. [DOI: 10.1055/s-0040-1715519] [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: 10/23/2022]
Abstract
AbstractBallismus is defined as rapid, forceful, shaking or throwing involuntary movement of the extremities, mainly proximal parts. When it affects half of the body (upper and lower limbs on one side), it is called hemiballismus. If it affects one limb, it could be labeled as focal or one limb ballismus. Any lesion (vascular, trauma, tumor, deposition, and demyelination) in the subthalamic nucleus of the basal ganglia results in ballismus. A rare entity such as copper deposition in Wilson's disease can manifest as ballismus. In this case report, we described a boy with Wilson's disease with focal ballismus of the right arm.
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Affiliation(s)
- Roshan Koul
- Department of Neurology and Paediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Priti Vijay
- Department of Neurology and Paediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Rajeev Khanna
- Department of Neurology and Paediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Seema Alam
- Department of Neurology and Paediatric Hepatology, Institute of Liver and Biliary Sciences, New Delhi, India
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12
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Koul R, Lal BB, Pamecha V, Sarin S, Alam S. Liver Transplantation Reverses Hepatic Myelopathy in 2 Children With Hepatitis A Infection. Child Neurol Open 2021; 8:2329048X20983763. [PMID: 33490305 PMCID: PMC7804343 DOI: 10.1177/2329048x20983763] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/04/2020] [Revised: 11/12/2020] [Accepted: 12/06/2020] [Indexed: 01/28/2023] Open
Abstract
Objectives To report 2 children with acute hepatic myelopathy after hepatitis A infection who recovered completely after living donor liver transplantation. Methods All the children admitted into liver intensive care unit (LICU) from November 1st 2018 to 31st October 2019, were evaluated for the neurological features. The data was collected from the admission register of the LICU unit in children below 15 years age. Medical records of these children were reviewed and data collected. Established clinical criteria were used to categorize the various grades of hepatic encephalopathy/myelopathy. Results 37 children were seen over 1-year period between 6 months to 15 years age. There were 24 male(64.9%) and 13 females. Acute liver failure was seen in 19 (51.3%) and acute on chronic liver failure in 18 (48.7%). There were 10 cases of hepatitis A in acute liver failure group,10 of 19 cases (52.6%), while Wilson's disease and undetermined etiology group formed the chronic group. 2 cases of hepatic myelopathy were seen in acute liver failure following hepatitis A infection. Both these children underwent live liver donor transplantation and recovered completely. Further in hepatitis A group,3 children had spontaneous recovery, 4 died and 1 child was discharged with end of life care. Overall out of all 37 children with liver failure,20 (54%) were discharged, 6 (16.2%) were advised end of life care and 11 (29.8%) died. Conclusion Two cases (10.5%) of reversible hepatic myelopathy were seen in acute liver failure group of 19 cases. 18 out of 37 (48.6%) children had residual neurological features at discharge time.
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Affiliation(s)
- Roshan Koul
- Pediatric Neurology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Bikrant Bihari Lal
- Pediatric Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Viniyendra Pamecha
- Hepatobiliary Surgery, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Shiv Sarin
- Pediatric Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Seema Alam
- Pediatric Hepatology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
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13
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Sarin R, Somsekhar SP, Kumar R, Pawan G, Sumeet J, Pramoj J, Vaishali Z, Firoz P, Parikh PM, Aggarwal S, Koul R. Practical consensus recommendations for tumor margins and breast conservative surgery. South Asian J Cancer 2020; 7:72-78. [PMID: 29721467 PMCID: PMC5909299 DOI: 10.4103/sajc.sajc_105_18] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
My suggestion: There is no difference in survival of breast cancer patients treated with either mastectomy or with breast conservation therapy combined with external beam radiotherapy. A positive margin (s) is an important factor contributing to the increased risk of local recurrence. However, in published literature, there is a lack of consensus on the definition of acceptable margin (s). As a result decision process about need for re-excision after positive margins remains uncrear.
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Affiliation(s)
- R Sarin
- Department of Surgical Oncology, Apollo Indraprastha Hospital, New Delhi, India
| | - S P Somsekhar
- Department of Surgical Oncology, Manipal Hospital, Bengaluru, Karnataka, India
| | - R Kumar
- Department of Surgical Oncology, Rajiv Gandhi Cancer Hospital, New Delhi, India
| | - Gupta Pawan
- Department of Surgical Oncology, Jaypee Hospital, Noida, Uttar Pradesh, India
| | - Jain Sumeet
- Department of Surgical Oncology, Fortis Hospital, Mohali, Punjab, India
| | - Jindal Pramoj
- Department of Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Zamre Vaishali
- Department of Surgical Oncology, Max Hospital, New Delhi, India
| | - Pasha Firoz
- Department of Surgical Oncology, Apollo Indraprastha Hospital, New Delhi, India
| | - P M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - R Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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Somsekhar SP, Geeta K, Jain R, Nayyer R, Halder S, Malik VK, Parikh P, Aggarwal S, Koul R. Practical consensus recommendations regarding role of mastectomy in metastatic breast cancer. South Asian J Cancer 2020; 7:79-82. [PMID: 29721468 PMCID: PMC5909300 DOI: 10.4103/sajc.sajc_106_18] [Citation(s) in RCA: 6] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Whether to recommend mastectomy in metastatic disease or not has been a matter of debate. Is local therapy, such as mastectomy, of any benefit in advanced breast cancer is the main question. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- S P Somsekhar
- Department of Surgical Oncology, Manipal Hospital, Bengaluru, Karnataka, India
| | - K Geeta
- Department of Surgical Oncology, Max Hospital, New Delhi, India
| | - R Jain
- Department of Surgical Oncology, Action Cancer Hospital, New Delhi, India
| | - R Nayyer
- Department of Surgical Oncology, Asian Institute of Medical Sciences, Faridabad, Haryana, India
| | - S Halder
- Department of Radiation Oncology, BLK Super Specialty Hospital, New Delhi, India
| | - V K Malik
- Department of Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Purvish Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - R Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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Singh D, Saini G, Koul R, Gupta V, Abrol D, De S, Kulshrestha P, Hukku SN, Lakshmi SJ, Parikh PM, Aggarwal S. Practical consensus recommendations regarding role of postmastectomy radiation therapy. South Asian J Cancer 2020; 7:87-90. [PMID: 29721470 PMCID: PMC5909302 DOI: 10.4103/sajc.sajc_108_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
The use of radiation therapy after mastectomy (PMRT) has been limited to those patients who are at significant risk of cancer recurring in the chest wall or in the nodal basins. The use of PMRT has been widely accepted for patients with four or more positive lymph nodes,[1],[2] but there is still controversy regarding the value of PMRT for those with one to three positive nodes. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at these practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- D Singh
- Department of Radiation Oncology, Max Hospital, Noida, Uttar Pradesh, India
| | - G Saini
- Department of Radiation Oncology, Max Hospital, Noida, Uttar Pradesh, India
| | - R Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - V Gupta
- Department of Surgical Oncology, BLK Super Specialty Hospital, New Delhi, India
| | - D Abrol
- Department or Radiation Oncology, Jammu Medical College, Jammu, Jammu and Kashmir, India
| | - S De
- Department of Radiation Oncology, Jaypee Hospital, Noida, Uttar Pradesh, India
| | - P Kulshrestha
- Department of Radiation Oncology, Metro Hospital and Cancer Institute, New Delhi, India
| | - S N Hukku
- Department of Radiation Oncology, BLK Super Specialty Hospital, New Delhi, India
| | - S J Lakshmi
- Department of Radiation Oncology, Artemis Hospital, Gurugram, Haryana, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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Gupta S, Singh M, Vora A, Babu G, Walia M, Nautial V, Saha R, Smruti BK, Sharma JB, Koul R, Parikh PM, Aggarwal S. Practical consensus recommendations on duration of adjuvant hormonal therapy in breast cancer. South Asian J Cancer 2020; 7:142-145. [PMID: 29721482 PMCID: PMC5909293 DOI: 10.4103/sajc.sajc_122_18] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
Optimization of adjuvant systemic therapy in women with early-stage hormone receptor-positive breast cancer includes the consideration of chemotherapy and duration of hormone therapy. Adjuvant hormonal therapy significantly improves long-term survival of breast cancer patients with hormone receptor-positive disease. Despite the proven clinical efficacy of tamoxifen and aromatase inhibitors, many breast cancer survivors either fail to take the correct dosage at the prescribed frequency (adherence) or discontinue therapy (persistence). Expert oncologist discussed on the duration of adjuvant hormonal therapy for improvement of OS and quality of life of breast cancer patients by providing reduction in recurrence and mortality. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- S Gupta
- Department of Medical Oncology, Tata Memorial Center, Mumbai, Maharashtra, India
| | - M Singh
- Department of Medical Oncology, Mahaveer Cancer Sansthan, Patna, Bihar, India
| | - Amish Vora
- Department of Medical Oncology, Hope Clinic, New Delhi, India
| | - G Babu
- Department of Medical Oncology, KMIO, Bengaluru, Karnataka, India
| | - M Walia
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - V Nautial
- Department of Medical Oncology, Jolly Grant Himalayan Institute, Dehradoon, Uttarakhand, India
| | - R Saha
- Department of Medical Oncology, Max Hospital, New Delhi, India
| | - B K Smruti
- Department of Medical Oncology, Bombay Hospital, Mumbai, Maharashtra, India
| | - J B Sharma
- Department of Medical Oncology, Action Balajee Cancer Hospital, New Delhi, India
| | - R Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - Purvish M Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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Abstract
Introduction: A retrospective analysis of 151 patients with hepatic encephalopathy (HE) who were admitted to the liver intensive care unit (LICU) and liver transplant intensive care unit (TICU) and underwent electroencephalographic (EEG) testing was performed. We describe a method of grading the EEGs of patients with HE and predicting their subsequent outcomes. Methods: All liver failure patients with HE who underwent routine EEG testing in the LICU or TICU between October 1, 2018 and March 31, 2019, at the Institute of Liver and Biliary Sciences (ILBS) were enrolled in this analysis. The data was analyzed using Statistical Package for the Social Sciences (SPSS). The patients were divided into four grades of HE based on established EEG criteria (HE-EEG). Results: One hundred fifty-one patients [127 Male (84%), 24 Female (16%)] with HE who underwent EEG testing were enrolled. Ages ranged from 3 to 74 years, with a mean age of 48.34 years and median interquartile range (IQR) of 49 years (38-60 years). Ninety-five patients (62.9%) had grade 1 and 2 hepatic encephalopathy, with a statistically significant, worse outcome seen in grades 3 and 4 HE patients. Seizures were seen in 30 (20.1%) of HE patients. Fifteen of 30 patients with seizures (50%) were in the ethanol and nonalcoholic steatohepatitis (NASH) groups. Forty-four of 59 (74.6%) MRIs and 35 of 60 (58.3%) CTs demonstrated some type of brain abnormality in these patients. Imaging abnormalities and the presence of seizures did not contribute to a statistically worse outcome. Conclusion: EEG has an important role in predicting the outcome and prognosis in HE. Patients with grade 3 or 4 HE-EEG, or with progressive worsening of HE-EEG grading were associated with the highest mortality rates.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences , New Delhi, India
| | - Rakhi Maiwall
- Department of Hepatology, Institute of Liver and Biliary Sciences , New Delhi, India
| | - Archana Ramalingam
- Department of Epidemiology, Institute of Liver and Biliary Sciences , New Delhi, India
| | - Satyendra Kumar
- Department of Neurology, Institute of Liver and Biliary Sciences , New Delhi, India
| | | | - Viniyendra Pamecha
- Department of Hepatobiliary Surgery, Institute of Liver and Biliary Sciences , New Delhi, India
| | - Shiv Kumar Sarin
- Department of Hepatology, Institute of Liver and Biliary Sciences , New Delhi, India
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18
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Adu-Quaye M, Dube S, Rathod S, Dubey A, Bashir B, Lambert P, Bucher O, Kim J, Leylek A, Ahmed N, Chowdhury A, Koul R. Impact of Pre-treatment Immunologic Parameters on the Outcomes of Early-Stage Non-Small Cell Lung Cancer (NSCLC). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.1249] [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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19
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Sanghera K, Kim J, Ghosh S, McDonald M, Ong A, Koul R, Dubey A, Ahmed S, Quon H, Yee D, Sivananthan G, Danielson B, Rowe L, Rose J, Hunter W, Usmani N. Interim Analysis of a Phase II Multi-institution Randomized Placebo-controlled Trial the PREMIUM trial (PREvention of Metabolic Syndrome and Increased weight Using Metformin concurrent to ADT and EBRT for locally advanced adenocarcinoma of the prostate). Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.2104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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20
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Koul R. Shuddering Attacks in an Infant. Journal of Pediatric Epilepsy 2020. [DOI: 10.1055/s-0040-1718524] [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: 10/23/2022]
Abstract
AbstractShuddering attacks are rare benign nonepileptic paroxysmal events (NEPEs) seen in infancy and early childhood. These movements may look like myoclonus or infantile spasms. Recognition of these movements is important to avoid elaborate workup and antiepileptic medications. Shuddering attacks disappear by the age of 2 years in most of these children. NEPEs are almost as common as epilepsy. It is easy to differentiate the common NEPEs from epilepsy. However, it is difficult to diagnose the rare benign NEPEs not seen before. Shuddering attacks are one of these rare NEPEs. It is commonly diagnosed as infantile spasms/myoclonus unless one observes the actual event or video very carefully.
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Affiliation(s)
- Roshan Koul
- Department of Pediatric Neurology, Institute of Liver and Biliary Sciences, New Delhi, India
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21
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Kim JO, Hanumanthappa N, Chung YT, Beck J, Koul R, Bashir B, Cooke A, Dubey A, Butler J, Nashed M, Hunter W, Ong A. Does dissemination of guidelines alone increase the use of palliative single-fraction radiotherapy? Initial report of a longitudinal change management campaign at a provincial cancer program. Curr Oncol 2020; 27:190-197. [PMID: 32905177 PMCID: PMC7467795 DOI: 10.3747/co.27.6193] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
Background Despite level 1 evidence demonstrating the equivalence of single-fraction radiotherapy (sfrt) and multiple-fraction radiotherapy (mfrt) for the palliation of painful bone metastases, sfrt remains underused. In 2015, to encourage the sustainable use of palliative radiation oncology resources, CancerCare Manitoba disseminated, to each radiation oncologist in Manitoba, guidelines from Choosing Wisely Canada (cwc) that recommend sfrt. We assessed whether dissemination of the guidelines influenced sfrt use in Manitoba in 2016, and we identified factors associated with mfrt. Methods All patients treated with palliative radiotherapy for bone metastasis in Manitoba from 1 January 2016 to 31 December 2016 were identified from the provincial radiotherapy database. Patient, treatment, and disease characteristics were extracted from the electronic medical record and tabulated by fractionation schedule. Univariable and multivariable logistic regression analyses were performed to identify risk factors associated with mfrt. Results In 2016, 807 patients (mean age: 70 years; range: 35-96 years) received palliative radiotherapy for bone metastasis, with 69% of the patients having uncomplicated bone metastasis. The most common primary malignancies were prostate (27.1%), lung (20.6%), and breast cancer (15.9%). In 62% of cases, mfrt was used-a proportion that was unchanged from 2015. On multivariable analysis, a gastrointestinal [odds ratio (or): 5.3] or lung primary (or: 3.3), complicated bone metastasis (or: 4.3), and treatment at a subsidiary site (or: 4.4) increased the odds of mfrt use. Conclusions Dissemination of cwc recommendations alone did not increase sfrt use by radiation oncologists in 2016. A more comprehensive knowledge translation effort is therefore warranted and is now underway to encourage increased uptake of sfrt in Manitoba.
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Affiliation(s)
- J O Kim
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | | | - Y T Chung
- Rady Faculty of Health Sciences, University of Manitoba, Winnipeg
| | - J Beck
- Medical Physics, CancerCare Manitoba, Winnipeg
| | - R Koul
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - B Bashir
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - A Cooke
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - A Dubey
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - J Butler
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - M Nashed
- Radiation Oncology, CancerCare Manitoba, Winnipeg
| | - W Hunter
- Radiation Oncology, Western Manitoba Cancer Centre, Brandon, MB
| | - A Ong
- Radiation Oncology, CancerCare Manitoba, Winnipeg
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22
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Koul R, Naiha Al Harousi SS, AlNabhani S, AlFutaisi A. Vincristine Neuropathy in Children: Squatting (Sitting Cross Legged) Predisposes Common Peroneal Nerves to Be More Severely Affected than Tibial Nerves. Journal of Pediatric Neurology 2020. [DOI: 10.1055/s-0039-1697584] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Abstract
Objective The main objective of this article was to evaluate vincristine neuropathy effect on common peroneal and tibial nerves.
Methods A retrospective study was conducted in children with vincristine neuropathy between August 2006 and January 2016 at Sultan Qaboos University Hospital.
Results Twenty-eight children (15 females and 13 males) were included in the study. The compound muscle action potential of common peroneal nerves was significantly reduced relative to the tibial nerves (p < 0.05)). There was no difference in latency and nerve conduction velocity between the two nerves.
Conclusion Children receiving vincristine demonstrate severe peroneal neuropathy compared with tibial nerves. We conclude that squatting posture effects peroneal nerves and postulate that the peroneal nerves are affected more due to the squatting posture. This squatting posture stretches the nerves that are already affected by the toxic effect of vincristine.
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Affiliation(s)
- Roshan Koul
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
- Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Saleem Saleh Naiha Al Harousi
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Sousan AlNabhani
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Amna AlFutaisi
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
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23
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Koul R, Hora R. Repetitive Arm and Hand Movements (Complex Motor Stereotypy) in a Six-Year Boy. Journal of Pediatric Epilepsy 2020. [DOI: 10.1055/s-0040-1712162] [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: 10/23/2022]
Abstract
AbstractAbnormal movements are not uncommon in children. Most of these abnormal movements can be defined by the available criteria. Abnormal movements are easily diagnosed in adults. Most of these abnormal movements are well categorized and diagnosed by the defined characteristics. Sometimes it is difficult to diagnose an unusual movement disorder in children, particularly if it is rare and there are no investigations to prove the diagnosis. Repetitive arm and hand movements (complex motor stereotypy) is one such disorder which is rare and difficult to diagnose unless seen before. In this case report, we described a 6-year-old boy with this disorder, in whom it took 6 years to diagnose.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences, New Delhi, India
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24
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Koul R, AlFutaisi A, Mani R, Abdelrahim R, AlAdi A. Gratification Phenomena in Infancy: A Report of Twenty-Nine Children. Journal of Pediatric Neurology 2020. [DOI: 10.1055/s-0039-1679902] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
AbstractTwenty-nine children with gratification phenomena seen in last 10 years (January 2008 to December 2017) were analyzed retrospectively. A proper history, eyewitness account, and video recordings of the event helped in making the diagnosis. Twenty-seven out of 29 (93%) children with gratification phenomena were females. Four patterns of gratification phenomena were seen. Three of these patterns not described before are reported. A typical gratification phenomenon was seen in 16 of 29 (55%) children. At the time of referral, 24% of these children were labeled epileptic and were on antiepileptic medication. This benign condition has to be recognized and extensive investigations should be avoided.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver Disease and Biliary Sciences, New Delhi, India
- Department of Child Health Neurology, Sultan Qaboos University Hospital SQUH, College of Medicine and Health Sciences, Muscat, Oman
| | - Amna AlFutaisi
- Department of Child Health Neurology, Sultan Qaboos University Hospital SQUH, College of Medicine and Health Sciences, Muscat, Oman
| | - Renjith Mani
- Department of Child Health Neurology, Sultan Qaboos University Hospital SQUH, College of Medicine and Health Sciences, Muscat, Oman
| | - Rana Abdelrahim
- Department of Child Health Neurology, Sultan Qaboos University Hospital SQUH, College of Medicine and Health Sciences, Muscat, Oman
| | - Azza AlAdi
- Department of Child Health Neurology, Sultan Qaboos University Hospital SQUH, College of Medicine and Health Sciences, Muscat, Oman
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25
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Johnstone DL, Al-Shekaili HH, Tarailo-Graovac M, Wolf NI, Ivy AS, Demarest S, Roussel Y, Ciapaite J, van Roermund CWT, Kernohan KD, Kosuta C, Ban K, Ito Y, McBride S, Al-Thihli K, Abdelrahim RA, Koul R, Al Futaisi A, Haaxma CA, Olson H, Sigurdardottir LY, Arnold GL, Gerkes EH, Boon M, Heiner-Fokkema MR, Noble S, Bosma M, Jans J, Koolen DA, Kamsteeg EJ, Drögemöller B, Ross CJ, Majewski J, Cho MT, Begtrup A, Wasserman WW, Bui T, Brimble E, Violante S, Houten SM, Wevers RA, van Faassen M, Kema IP, Lepage N, Lines MA, Dyment DA, Wanders RJA, Verhoeven-Duif N, Ekker M, Boycott KM, Friedman JM, Pena IA, van Karnebeek CDM. PLPHP deficiency: clinical, genetic, biochemical, and mechanistic insights. Brain 2020; 142:542-559. [PMID: 30668673 DOI: 10.1093/brain/awy346] [Citation(s) in RCA: 53] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2018] [Revised: 10/30/2018] [Accepted: 11/13/2018] [Indexed: 12/20/2022] Open
Abstract
Biallelic pathogenic variants in PLPBP (formerly called PROSC) have recently been shown to cause a novel form of vitamin B6-dependent epilepsy, the pathophysiological basis of which is poorly understood. When left untreated, the disease can progress to status epilepticus and death in infancy. Here we present 12 previously undescribed patients and six novel pathogenic variants in PLPBP. Suspected clinical diagnoses prior to identification of PLPBP variants included mitochondrial encephalopathy (two patients), folinic acid-responsive epilepsy (one patient) and a movement disorder compatible with AADC deficiency (one patient). The encoded protein, PLPHP is believed to be crucial for B6 homeostasis. We modelled the pathogenicity of the variants and developed a clinical severity scoring system. The most severe phenotypes were associated with variants leading to loss of function of PLPBP or significantly affecting protein stability/PLP-binding. To explore the pathophysiology of this disease further, we developed the first zebrafish model of PLPHP deficiency using CRISPR/Cas9. Our model recapitulates the disease, with plpbp-/- larvae showing behavioural, biochemical, and electrophysiological signs of seizure activity by 10 days post-fertilization and early death by 16 days post-fertilization. Treatment with pyridoxine significantly improved the epileptic phenotype and extended lifespan in plpbp-/- animals. Larvae had disruptions in amino acid metabolism as well as GABA and catecholamine biosynthesis, indicating impairment of PLP-dependent enzymatic activities. Using mass spectrometry, we observed significant B6 vitamer level changes in plpbp-/- zebrafish, patient fibroblasts and PLPHP-deficient HEK293 cells. Additional studies in human cells and yeast provide the first empirical evidence that PLPHP is localized in mitochondria and may play a role in mitochondrial metabolism. These models provide new insights into disease mechanisms and can serve as a platform for drug discovery.
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Affiliation(s)
- Devon L Johnstone
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Hilal H Al-Shekaili
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Maja Tarailo-Graovac
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Institute of Physiology and Biochemistry, Faculty of Biology, The University of Belgrade, Belgrade, Serbia.,Departments of Biochemistry, Molecular Biology, and Medical Genetics, Cumming School of Medicine, Alberta Children's Hospital Research Institute, University of Calgary, Calgary, AB, Canada
| | - Nicole I Wolf
- Department of Child Neurology, Amsterdam University Medical Centres, Amsterdam Neuroscience, Amsterdam, The Netherlands
| | - Autumn S Ivy
- Division of Child Neurology, Department of Neurology and Neurological Sciences, Stanford University School of Medicine, CA, USA
| | - Scott Demarest
- Departments of Pediatrics and Neurology, University of Colorado School of Medicine, Children's Hospital Colorado, CO, USA
| | - Yann Roussel
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Jolita Ciapaite
- Department of Genetics, Center for Molecular Medicine, University Medical Center, Utrecht, The Netherlands
| | - Carlo W T van Roermund
- Department of Pediatrics and Clinical Chemistry, Laboratory Division, Laboratory Genetic Metabolic Diseases, Amsterdam University Medical Centres, Amsterdam, The Netherlands
| | - Kristin D Kernohan
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Ceres Kosuta
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Kevin Ban
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Yoko Ito
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Skye McBride
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | - Khalid Al-Thihli
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - Rana A Abdelrahim
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Roshan Koul
- Paediatric Neurology Unit, Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Amna Al Futaisi
- Paediatric Neurology Unit, Child Health Department, Sultan Qaboos University Hospital, Muscat, Oman
| | - Charlotte A Haaxma
- Department of Pediatric Neurology, Amalia Children's Hospital and Donders Institute of Brain, Cognition and Behaviour, Radboud University Nijmegen Medical Center, Nijmegen, The Netherlands
| | - Heather Olson
- Department of Neurology, Division of Epilepsy and Clinical Neurophysiology, Boston Children's Hospital, Boston, MA, USA
| | - Laufey Yr Sigurdardottir
- Department of Neurology, University of Central Florida, Nemours Children's Hospital, Orlando, FL, USA
| | - Georgianne L Arnold
- Department of Pediatrics, University of Pittsburgh Medical Center, Pittsburg, PA, USA
| | - Erica H Gerkes
- Department of Genetics, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M Boon
- Department of Neurology, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - M Rebecca Heiner-Fokkema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Sandra Noble
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Marjolein Bosma
- Department of Genetics, Center for Molecular Medicine, University Medical Center, Utrecht, The Netherlands
| | - Judith Jans
- Department of Genetics, Center for Molecular Medicine, University Medical Center, Utrecht, The Netherlands.,United for Metabolic Diseases, The Netherlands
| | - David A Koolen
- Department of Human Genetics, Radboud Institute for Molecular Life Sciences and Donders Institute for Brain, Cognition and Behaviour, Radboud University Medical Center, Nijmegen, The Netherlands
| | | | - Britt Drögemöller
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Colin J Ross
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,Faculty of Pharmaceutical Sciences, University of British Columbia, Vancouver, BC, Canada
| | - Jacek Majewski
- McGill University and Genome Quebec Innovation Centre, Montreal, QC, Canada.,Department of Human Genetics, McGill University, Montreal, QC, Canada
| | | | | | - Wyeth W Wasserman
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Tuan Bui
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Elise Brimble
- Department of Neurology and Neurological Sciences, Stanford Medicine, Stanford, CA, USA
| | - Sara Violante
- Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Sander M Houten
- Department of Genetics and Genomic Sciences and Icahn Institute for Genomics and Multiscale Biology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Ron A Wevers
- United for Metabolic Diseases, The Netherlands.,Translational Metabolic Laboratory, Department Laboratory Medicine, Radboud University Medical Center, Nijmegen, The Netherlands
| | - Martijn van Faassen
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Ido P Kema
- Department of Laboratory Medicine, University of Groningen, University Medical Center Groningen, Groningen, The Netherlands
| | - Nathalie Lepage
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada
| | | | - Matthew A Lines
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Division of Metabolics and Newborn Screening, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - David A Dyment
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Medical Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Ronald J A Wanders
- Department of Pediatrics and Clinical Chemistry, Laboratory Division, Laboratory Genetic Metabolic Diseases, Amsterdam University Medical Centres, Amsterdam, The Netherlands.,United for Metabolic Diseases, The Netherlands
| | - Nanda Verhoeven-Duif
- Department of Genetics, Center for Molecular Medicine, University Medical Center, Utrecht, The Netherlands.,United for Metabolic Diseases, The Netherlands
| | - Marc Ekker
- Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Kym M Boycott
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Medical Genetics, Children's Hospital of Eastern Ontario, Ottawa, ON, Canada
| | - Jan M Friedman
- Department of Medical Genetics, University of British Columbia, Vancouver, BC, Canada.,British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada
| | - Izabella A Pena
- Children's Hospital of Eastern Ontario Research Institute, Ottawa, ON, Canada.,Department of Biology, University of Ottawa, Ottawa, ON, Canada
| | - Clara D M van Karnebeek
- British Columbia Children's Hospital Research Institute, Vancouver, BC, Canada.,United for Metabolic Diseases, The Netherlands.,Departments of Pediatrics and Clinical Genetics, Amsterdam University Medical Centres, Amsterdam, The Netherlands.,Centre for Molecular Medicine and Therapeutics, Department of Pediatrics, University of British Columbia, Vancouver, Canada
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26
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Al Shibli N, Al-Maawali A, Elmanzalawy A, Al-Nabhani M, Koul R, Gabr A, Al Murshedi F. A Novel Splice-Site Variant in SLC12A6 Causes Andermann Syndrome without Agenesis of the Corpus Callosum. J Pediatr Genet 2020; 9:293-295. [PMID: 32765936 DOI: 10.1055/s-0039-1700975] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2019] [Accepted: 12/06/2019] [Indexed: 10/25/2022]
Abstract
Andermann syndrome, otherwise known as agenesis of the corpus callosum with peripheral neuropathy (ACCPN), is an autosomal recessive motor and sensory neuropathy known to be associated with ACC and mild-to-moderate intellectual disability. We present a 7-year-old girl with infantile-onset hypotonia, mild intellectual disability, and severe motor and sensory demyelinating peripheral neuropathy. Brain magnetic resonance imaging showed intact corpus callosum. Whole exome sequencing showed a novel splice-site pathogenic variant in the SLC12A6 gene. We confirm that ACC is not a mandatory feature and suggest that the term ACCPN may be misleading.
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Affiliation(s)
- Naema Al Shibli
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Almundher Al-Maawali
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman.,Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Alaa Elmanzalawy
- Department of Radiology and Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | - Maryam Al-Nabhani
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences, Vasant Kunj, New Delhi, India
| | - Ahlam Gabr
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.,Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - Fathiya Al Murshedi
- Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman.,Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
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27
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Abstract
Objective
Pyridoxine responsive seizures (PDRs) are characterized by early-onset seizures and epileptic encephalopathy (neonates and infants) which respond to pyridoxine. Any type of seizures can be the first presentation of PDRs in these children. The aim of this 20-year retrospective study was to report the profile of 35 children with PDRs.
Materials and Methods
Neonatal and infantile seizures responding to pyridoxine were analyzed retrospectively from 1998 to 2018. Depending on the clinical features, laboratory results, and genetic study, they were divided into following four groups: (A) responders with α-aminoadipic semialdehyde dehydrogenase 7A1 (
ALDH7A1
) mutation, (B) responders with pyridoxal phosphate homeostasis protein (PLPHP) mutation, (C) responders with none of these two known mutations, (D) and responders in combination with antiepileptic medications.
Results
Sixteen of 35 children had genetic mutation, 4 with
ALDH7A1
mutation, and 12 with PLPHP mutation recently described. Nineteen of 35 children had no genetic positivity.
Conclusion
A large number of children with pyridoxine response do not have known genetic confirmation. Over time, new genes, responsible for pyridoxine dependency, may be identified or an unknown metabolic disorder may be seen in these children.
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Affiliation(s)
- Roshan Koul
- Department of Neurology, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Amna Alfutaisi
- Child Neurology, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Rana Abdelrahim
- Child Neurology, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Khalid Altihilli
- Department of Genetics, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
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28
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Al-Futaisi A, Ahmad F, Al-Kasbi G, Al-Thihli K, Koul R, Al-Maawali A. Missense mutations in SLC25A1 are associated with congenital myasthenic syndrome type 23. Clin Genet 2019; 97:666-667. [PMID: 31808147 DOI: 10.1111/cge.13678] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2019] [Revised: 11/14/2019] [Accepted: 11/18/2019] [Indexed: 01/19/2023]
Affiliation(s)
- Amna Al-Futaisi
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Faraz Ahmad
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Ghalia Al-Kasbi
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Khalid Al-Thihli
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.,Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
| | - Roshan Koul
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman
| | - Almundher Al-Maawali
- Department of Genetics, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman.,Genetic and Developmental Medicine Clinic, Sultan Qaboos University Hospital, Muscat, Oman
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29
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Koul R, Al-Fuitaisi A, Macki N, Patel PK, Al-Balushi H, Al-Abaidani I, Al-Abri SS. Incidence of Guillain–Barre's Syndrome in Children under 15 Years of Age in Oman. J Pediatr Neurol 2019. [DOI: 10.1055/s-0038-1660838] [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: 10/28/2022]
Abstract
Objective Guillain–Barre's syndrome (GBS) is an acute immune-mediated polyradiculoneuropathy seen in all ages but mostly in the adult population. We aim to report the incidence of GBS in children under 15 years of age in Oman, a Gulf country.
Materials and Methods All children with GBS under 15 years of age were included in the study from January 2002 to December 2016. The data were compiled in Microsoft Excel format and analysis was performed using SPSS, version 17.0. Population-based age- and sex-specific rates of GBS were calculated using the estimated population for each 5-year period based on 2004, 2009, and 2014 mid-year population, respectively. Relative risk and 95% confidence intervals of GBS at different age categories were calculated using the overall incidence of GBS in those under 15 years as reference.
Results The average annual incidence in those under 15 years was 3.1/100,000. Age-specific incidence was 4.0/100,000 in the age group 0 to 9 years and 4.7/100,000 in age group 0 to 4 years. Sixty percent had evidence of preceding infections, and the male to female ratio was 1.8:1. Fifty percent had cranial nerve involvement and 18% needed mechanical ventilation. Five percent had residual weakness. Intravenous immunoglobulins (IVIGs) were used in all, and 3.3% required plasmapheresis when they did not improve with IVIG. Clinical profile of the GBS was not different from the rest reported in the literature.
Conclusion The incidence of GBS in Oman was 3.1/100,000 (range: 2.7–3.5 cases/100,000) in children under 15 years of age. The GBS is a smaller proportion among the total acute flaccid paralysis cases.
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Affiliation(s)
- Roshan Koul
- Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Amna Al-Fuitaisi
- Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Nabil Macki
- Child Health (Neurology), Royal Hospital, Muscat, Oman
| | | | - Haleema Al-Balushi
- Ministry of Health (MoH), Director General for Disease Surveillance and Control
| | - Idris Al-Abaidani
- Ministry of Health (MoH), Director General for Disease Surveillance and Control
| | - Seif Salem Al-Abri
- Ministry of Health (MoH), Director General for Disease Surveillance and Control
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Turner D, Navaratnam S, Surenthirakumaran R, Koul R, Unruh H, Gadhok A, O'Conaill C. Global Health Strategy for Cancer: Think Globally, Act Locally! Building a Collaborative Partnership Between Manitoba (Canada) and Jaffna (Sri Lanka). J Glob Oncol 2018. [DOI: 10.1200/jgo.18.36500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background and context: The number of people diagnosed with cancer worldwide is estimated to double by 2035. The greatest increase is expected in low- and middle-income countries (LMIC) due to demographic changes, such as ageing and growing populations, and increasing exposure to risk factors. Approximately 8.8 million people die each year of cancer, or one in 6 deaths globally. The Canadian government has recently renewed its commitment as a progressive global citizen with efforts including improvement of global health equity. CancerCare Manitoba is the provincial agency responsible for cancer and blood disorders, including the delivery of a wide range of clinical services from prevention to screening to treatment and supportive services, as well as cancer surveillance, research, and education. CancerCare Manitoba has identified potential partnerships with governments, nongovernmental organizations, academic institutions, and funders to address current and future challenges related to global cancer control. This includes several LMIC partners who have expressed an interest in working with Manitoba on cancer-related issues. In this presentation, we will describe our plans and early experience with a team from the University of Jaffna, the northern region of Sri Lanka. With a focus initially on surveillance and cancer control planning, there is an excellent opportunity for mutual learning and advancement of programs for cancer surveillance and planning. Aim: To establish a local partnership by connecting Manitoba, Canada with an engaged team from the University of Jaffna, Sri Lanka to advance cancer surveillance and planning, and contribute to the “global war on cancer”. Strategy/Tactics: A phased approach is being taken to address locally identified needs for cancer control. CancerCare Manitoba staff will be part of the mentorship team working with local partners in Jaffna to ensure development of local capacity. Specifically, we will: initiate cancer surveillance and establish a cancer registry in Jaffna (building from a cross-sectional study → hospital based registry → regional registry); analyze data and report on patterns; and establish a strategic plan for cancer control. Program/Policy process: Early planning is underway, involving collaborators from Manitoba and Jaffna. A project proposal has been developed to provide scope and acquire seed funding. Outcomes: Success will be determined based on the context of each program, including: establishing a framework for cancer surveillance; satisfaction of local and international partners (e.g., the Global Cancer Surveillance unit at the International Agency for Research in Cancer); and production of reports as a basis for cancer control. What was learned: Early learnings include the importance of local engagement and dedicated mentorship to advance global health equity, manage challenges around (sustained) funding, and establish a foundation of motivated partners.
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Affiliation(s)
- D. Turner
- CancerCare Manitoba, Population Oncology, Winnipeg, Canada
- University of Manitoba, Community Health Sciences, Winnipeg, Canada
| | | | | | - R. Koul
- CancerCare Manitoba, Radiation Oncology, Winnipeg, Canada
| | - H. Unruh
- CancerCare Manitoba, Surgical Oncology, Wiinnipeg, Canada
| | - A. Gadhok
- CancerCare Manitoba, Winnipeg, Canada
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Koul R, Al-Futaisi A, Abdelrahim R, Mani R, Abdwani R, Al-Asmi A. Rituximab Treatment in Myasthaenia Gravis: Report of two paediatric cases. Sultan Qaboos Univ Med J 2018; 18:e223-e227. [PMID: 30210856 DOI: 10.18295/squmj.2018.18.02.018] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/17/2017] [Revised: 01/17/2018] [Accepted: 03/08/2018] [Indexed: 12/19/2022] Open
Abstract
Myasthaenia gravis (MG) is an auto-immune disease involving the postsynaptic receptors in the neuromuscular junction. The condition is characterised by fatigable weakness of the skeletal muscles and is uncommon in children. Acetylcholinesterase inhibitors and immune-modifying medications are usually considered the mainstay of treatment. However, these medications have to be given on a lifelong basis so that patients remain in remission; furthermore, drug-related side-effects can have a major impact on quality of life. We report two paediatric cases who were treated for MG at the Sultan Qaboos University Hospital, Muscat, Oman, in 2007 and 2008, respectively. Rituximab was eventually administered to each patient after their condition failed to improve despite several years of standard treatment with acetylcholinesterase inhibitors and immune-modifying medications. Overall, rituximab resulted in complete remission in one case and significant clinical improvement in the other case.
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Affiliation(s)
- Roshan Koul
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Amna Al-Futaisi
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Rana Abdelrahim
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Renjith Mani
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Reem Abdwani
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Abdullah Al-Asmi
- Department of Medicine, Sultan Qaboos University Hospital, Muscat, Oman
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Gaurav A, Gupta V, Koul R, Dabas S, Sareen R, Geeta K, Arora V, Parikh PM, Aggarwal S. Practical consensus recommendatons for Paget's disease in breast cancer. South Asian J Cancer 2018; 7:83-86. [PMID: 29721469 PMCID: PMC5909301 DOI: 10.4103/sajc.sajc_107_18] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Paget's disease of the breast is a rare type of cancer of the nipple-areola complex and that is often associated with an underlying in situ or invasive carcinoma. Diagnosis and treatment of Paget's disease is controversial. Expert oncologists discuss on the update on the approaches of Paget's disease diagnosis and its treatment options. This expert group used data from published literature, practical experience and opinion of a large group of academic oncologists to arrive at this practical consensus recommendations for the benefit of community oncologists.
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Affiliation(s)
- A. Gaurav
- Department of Endocrinology and Surgery, SGPGI, Lucknow, Uttar Pradesh, India
| | - V. Gupta
- Department of Surgical Oncology, BLK Super Specialty Hospital, New Delhi, India
| | - R. Koul
- Department of Surgical Oncology, Sir Ganga Ram Hospital, New Delhi, India
| | - S. Dabas
- Department of Surgical Oncology, Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - R. Sareen
- Department of Surgical Oncology, Indraprastha Apollo Hospital, New Delhi, India
| | - K. Geeta
- Department of Surgical Oncology, Max Hospital, New Delhi, India
| | - V. Arora
- Department of Surgery, Sir Ganga Ram Hospital, New Delhi, India
| | - Purvish M. Parikh
- Department of Oncology, Shalby Cancer and Research Institute, Mumbai, Maharashtra, India
| | - S. Aggarwal
- Department of Medical Oncology, Sir Ganga Ram Hospital, New Delhi, India
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Koul R, Al-Futaisi A, Al-Thihli K, Bruwer Z, Scott P. Segmental Spinal Muscular Atrophy Localised to the Lower Limbs: First case from Oman. Sultan Qaboos Univ Med J 2017; 17:e355-e357. [PMID: 29062563 DOI: 10.18295/squmj.2017.17.03.018] [Citation(s) in RCA: 2] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2017] [Revised: 03/19/2017] [Accepted: 05/04/2017] [Indexed: 11/16/2022] Open
Abstract
Spinal muscular atrophy (SMA) is a genetic lower motor neuron disease. It usually involves all of the skeletal muscles innervated by the anterior horn cells of the spinal cord. In rare cases, there is also localised involvement of the spinal cord. We report a 10-year-old boy who presented to the Sultan Qaboos University Hospital, Muscat, Oman, in 2015 with muscle weakness restricted to the lower limbs. The presence of a homozygous deletion within the survival of motor neuron 1 gene confirmed the diagnosis of SMA. To the best of the authors' knowledge, this is the first report of an Omani patient with segmental SMA involving only the lower limbs. Treatment for this rare and relatively benign form of SMA is symptomatic and includes physiotherapy.
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Affiliation(s)
- Roshan Koul
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Amna Al-Futaisi
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Khalid Al-Thihli
- Departments of Genetics, Sultan Qaboos University Hospital, Muscat, Oman
| | - Zandre Bruwer
- Departments of Genetics, Sultan Qaboos University Hospital, Muscat, Oman
| | - Patrick Scott
- Departments of Genetics, Sultan Qaboos University Hospital, Muscat, Oman
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Koul R, Alfutaisi AM, Mani R, Abdel Rahim RA, Sankhla DK, Al Azri FM. Longitudinal extensive transverse myelitis (LETM) in children: A twenty-year study from Oman. Neurosciences (Riyadh) 2017; 22:127-130. [PMID: 28416784 PMCID: PMC5726818 DOI: 10.17712/nsj.2017.2.20160352] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 10/05/2016] [Indexed: 06/07/2023]
Abstract
OBJECTIVE The data on children with diagnosis of idiopathic transverse myelitis (ITM) was searched to find the pattern of myelitis in Oman. METHODS A retrospective study was carried out from January1995 to December 2014. Electronic medical records and patient medical files were seen to get the complete data of the children with ITM. This work was carried out at Sultan Qaboos University hospital, Muscat, Oman. The ethical committee of the hospital had approved the study. The diagnosis was based on the established criteria. Other causes of myelopathy were excluded. RESULTS 19 children with idiopathic transverse myelitis were found. There were 18 out of 19 (94.6%) children with longitudinal extensive transverse myelitis (LETM). CONCLUSION Longitudinal transverse extensive myelitis is the most common form of ITM in Oman.
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Affiliation(s)
- Roshan Koul
- Department of Child Health, College of Medicine and Health Sciences, Sultan Qaboos University, Muscat, Oman. E-mail:
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35
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Koul R, Alfutaisi A. Diaphragmatic myoclonus. Indian Pediatr 2017; 54:326. [DOI: 10.1007/s13312-017-1096-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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36
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Dubey A, Johnson K, Sasaki D, Rickey D, Harris C, Boyer T, Butler J, Leylek A, Sharma A, Koul R. Innovative Approach for Generating Soft Silicone Bolus Using 3-Dimensional Printing for Electron Treatment of Skin Cancers in Areas With Irregular Contours. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.2149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Koul R, Al-Futaisi A, Sankhla D, Al-Azri F. ‘Papaya Seed’ Appearance of Subependymal Nodules on Magnetic Resonance Imaging in a Patient with Tuberous Sclerosis. Sultan Qaboos Univ Med J 2016; 16:e385-6. [DOI: 10.18295/squmj.2016.16.03.025] [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] [Received: 11/04/2015] [Revised: 01/27/2016] [Accepted: 02/25/2016] [Indexed: 11/16/2022] Open
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Koul R, Al Futaisi A, Prabhakaran V, Almashaikhi T. Rub Evoked Reflex Epilepsy in an Infant With Cerebellar Hypoplasia. Pediatr Neurol 2016; 58:e1-2. [PMID: 27268764 DOI: 10.1016/j.pediatrneurol.2015.12.014] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2015] [Revised: 12/19/2015] [Accepted: 12/19/2015] [Indexed: 11/30/2022]
Affiliation(s)
- Roshan Koul
- Child Neurology, Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman.
| | - Amna Al Futaisi
- Child Neurology, Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Talal Almashaikhi
- Department of Neurology and Epileptology, Sultan Qaboos University Hospital, Muscat, Oman
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39
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Koul R, Al-Omairi AHM, Rahim RA, Mani R, Sankhla D. Magnetic Resonance Imaging Abnormalities in a Child with Acute Cerebellitis. Sultan Qaboos Univ Med J 2015; 15:e563-4. [PMID: 26629389 DOI: 10.18295/squmj.2015.15.04.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2014] [Revised: 01/13/2015] [Accepted: 03/15/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Roshan Koul
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Anwar H M Al-Omairi
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Rana A Rahim
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Renjith Mani
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Dilip Sankhla
- Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
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40
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Al-Nabhani S, Al-Abri H, Al-Abri I, Venugopal P, Koul R. Common Peroneal Nerve Mononeuropathy due to an Amniotic Constriction Band. Sultan Qaboos Univ Med J 2015; 15:e565-6. [DOI: 10.18295/squmj.2015.15.04.023] [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] [Received: 02/05/2015] [Revised: 04/27/2015] [Accepted: 04/30/2015] [Indexed: 11/16/2022] Open
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41
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Koul R, Rahim RA, Kariyattil R, Sankhla D. Anterior Inferior Cerebellar Artery Loop-Induced Paroxysmal Otalgia in a Child. Sultan Qaboos Univ Med J 2015; 15:e438-9. [PMID: 26357565 DOI: 10.18295/squmj.2015.15.03.023] [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] [Received: 11/25/2014] [Revised: 01/29/2015] [Accepted: 02/19/2015] [Indexed: 11/16/2022] Open
Affiliation(s)
- Roshan Koul
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Rana A Rahim
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Dilip Sankhla
- Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
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Koul R, Sankhla D, Al-Jahdhami S, Mani R, Rahim RA, Al-Yaarubi S, Al-Kindy H, Al-Thihli K, Al-Futaisi A. Rigid Spine Syndrome among Children in Oman. Sultan Qaboos Univ Med J 2015; 15:e364-9. [PMID: 26357557 DOI: 10.18295/squmj.2015.15.03.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2014] [Revised: 01/20/2015] [Accepted: 04/09/2015] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Rigidity of the spine is common in adults but is rarely observed in children. The aim of this study was to report on rigid spine syndrome (RSS) among children in Oman. METHODS Data on children diagnosed with RSS were collected consecutively at presentation between 1996 and 2014 at the Sultan Qaboos University Hospital (SQUH) in Muscat, Oman. A diagnosis of RSS was based on the patient's history, clinical examination, biochemical investigations, electrophysiological findings, neuro-imaging and muscle biopsy. Atrophy of the paraspinal muscles, particularly the erector spinae, was the diagnostic feature; this was noted using magnetic resonance imaging of the spine. Children with disease onset in the paraspinal muscles were labelled as having primary RSS or rigid spinal muscular dystrophy. Secondary RSS was classified as RSS due to the late involvement of other muscle diseases. RESULTS Over the 18-year period, 12 children were included in the study, with a male-to-female ratio of 9:3. A total of 10 children were found to have primary RSS or rigid spinal muscular dystrophy syndrome while two had secondary RSS. Onset of the disease ranged from birth to 18 months of age. A family history was noted, with two siblings from one family and three siblings from another (n = 5). On examination, children with primary RSS had typical features of severe spine rigidity at onset, with the rest of the neurological examination being normal. CONCLUSION RSS is a rare disease with only 12 reported cases found at SQUH during the study period. Cases of primary RSS should be differentiated from the secondary type.
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Affiliation(s)
- Roshan Koul
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Dilip Sankhla
- Radiology & Molecular Imaging, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Renjith Mani
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Rana A Rahim
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Saif Al-Yaarubi
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Hussein Al-Kindy
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | | | - Amna Al-Futaisi
- Departments of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
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Al Futaisi A, Alzri F, Jain R, Koul R. Rasmussen's encephalitis: A case report. J Pediatr Neurol 2015. [DOI: 10.3233/jpn-2010-0393] [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: 11/15/2022]
Affiliation(s)
- Amna Al Futaisi
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
| | - Faisal Alzri
- Department of Radiology , Sultan Qaboos University Hospital, Muscat, Oman
| | - Rajeev Jain
- Department of Radiology , Sultan Qaboos University Hospital, Muscat, Oman
| | - Roshan Koul
- Department of Child Health, Sultan Qaboos University Hospital, Muscat, Oman
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Al-Futaisi A, Abdwani R, Fathalla M, Zakwani I, Javad H, Al-Zuhaibi S, Ganesh A, Koul R. Idiopathic intracranial hypertension in Omani children. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Amna Al-Futaisi
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Raghad Abdwani
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Mahmoud Fathalla
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Ibrahim Zakwani
- Department of Pharmacy, Sultan Qaboos University Hospital, Oman
| | - Hashem Javad
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Sana Al-Zuhaibi
- Department of Ophthalmology, Sultan Qaboos University Hospital, Oman
| | - Anuradha Ganesh
- Department of Ophthalmology, Sultan Qaboos University Hospital, Oman
| | - Roshan Koul
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
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Abdwani R, Koul R, Al Azri F, AL-Futaisi A. Anasarca as the presenting feature of juvenile dermatomyositis. J Pediatr Neurol 2015. [DOI: 10.3233/jpn-2010-0421] [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: 11/15/2022]
Affiliation(s)
- Reem Abdwani
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Roshan Koul
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Faisal Al Azri
- Department of Radiology & Molecular Imaging, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Amna AL-Futaisi
- Department of Child Health, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
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Al-Futaisi A, Jain R, Koul R, Abdwani R. Juvenile dermatomyositis complicated by calcinosis universalis: Importance of early disease recognition. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Amna Al-Futaisi
- Department of Child Health, Sultan Qaboos University Hospital, Al-Khod, Sultanate of Oman
| | - Rajeev Jain
- Department of Radiology, Sultan Qaboos University Hospital, Al-Khod, Sultanate of Oman
| | - Roshan Koul
- Department of Child Health, Sultan Qaboos University Hospital, Al-Khod, Sultanate of Oman
| | - Reem Abdwani
- Department of Child Health, Sultan Qaboos University Hospital, Al-Khod, Sultanate of Oman
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Al-Othmani F, Alfutaisi A, Alabri M, Alzakwani I, Koul R. Narcolepsy-cataplexy in children: Report of two cases. J Pediatr Neurol 2015. [DOI: 10.3233/jpn-2009-0326] [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: 11/15/2022]
Affiliation(s)
- Farhana Al-Othmani
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Amna Alfutaisi
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Mohammed Alabri
- Department of Sleep Medicine and Clinical Physiology, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Ibrahim Alzakwani
- Department of Pharmacy, Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
| | - Roshan Koul
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, College of Medicine and Health Sciences, Muscat, Oman
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Al-Futaisi A, Al-Busaidi M, Al-Abdwani R, Javad H, Koul R. Acute disseminated encephalomyelitis in the Arabian Peninsula: A retrospective study from Oman. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Amna Al-Futaisi
- Department of Child Health (Neurology) Sultan Qaboos University Hospital, Muscat, Oman
| | - Mujahid Al-Busaidi
- Department of Child Health (Neurology) Sultan Qaboos University Hospital, Muscat, Oman
| | - Raghad Al-Abdwani
- Department of Child Health (Neurology) Sultan Qaboos University Hospital, Muscat, Oman
| | - Hashim Javad
- Department of Child Health (Neurology) Sultan Qaboos University Hospital, Muscat, Oman
| | - Roshan Koul
- Department of Child Health (Neurology) Sultan Qaboos University Hospital, Muscat, Oman
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Al-Futaisi A, Koul R. Levetiracetam induced weight loss in two children. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557462] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Amna Al-Futaisi
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
| | - Roshan Koul
- Department of Child Health (Neurology), Sultan Qaboos University Hospital, Muscat, Oman
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50
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Koul R. Recurrent familial cerebellar syndrome associated with pyrexia. J Pediatr Neurol 2015. [DOI: 10.1055/s-0035-1557277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Affiliation(s)
- Roshan Koul
- Sultan Qaboos University Hospital, BW-1, PO Box 38, Alkhod 123, Oman
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