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Sadangi S, Saraiya H, Salunke AA, Bharwani N, Patel K, Pandya S, Warikoo V, Pandya S. The surgical management and oncologic outcomes of patients with fungating soft tissue sarcoma treated at a tertiary cancer centre and review of literature. J Orthop 2024; 53:94-100. [PMID: 38495576 PMCID: PMC10940886 DOI: 10.1016/j.jor.2024.02.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/06/2023] [Accepted: 02/09/2024] [Indexed: 03/19/2024] Open
Abstract
Background Currently there is limited literature available on fungating soft tissue sarcoma and its effect of outcomes. In the current study we evaluated the surgical management and oncologic outcomes of patient with fungating soft tissue sarcoma. Materials and methods This was a retrospective observational study of patients with fungating sarcoma between January 2015 till January 2019 at a tertiary cancer care centre. A total of 59 patients were considered of which 16 had metastasis at presentation. The duration of symptoms prior to presentation averaged 10.2 months (median, 7.2months; range, 1-57 months). Median tumor length was 10 cm. Results 56% patients underwent amputation and 44% were treated with limb salvage. Following limb salvage surgery in10 cases primary closure of defect was performed and 6 cases required skin grafting for closure of defect. In 6 patients local flap was used for coverage of defect and 4 patients required free flap surgery. Two-year overall survival (OS) of the study cohort were 52.2% and 58% respectively. Two-year disease free survival (DFS) and OS in 43 non metastatic patients at presentation was seen in 58%(95% CI,38%-74%) and 66.5%(95% CI,42%-81%) respectively. The two-year disease OS in 16 patients with metastasis at presentation was 33.2 %. On univariate analysis, tumor size and metastatic at presentation had significant effect on survival. Conclusion Tumor size and metastatic at presentation has significant impact on survival in these patients. The oncologic outcomes including Disease free survival, overall survival and local recurrence rates similar amongst the two surgical modalities (amputation versus limb salvage). Amputation rates are more amongst fungating soft tissue sarcoma but limb salvage can be attempted whenever feasible keeping tumor free surgical margins under consideration.
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Affiliation(s)
- Sudam Sadangi
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
| | - Hemant Saraiya
- Department of Onco-Plastic Surgery, The Gujarat Cancer and Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - Abhijeet Ashok Salunke
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
| | - Nandlal Bharwani
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
| | - Keval Patel
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
| | - Shivam Pandya
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
| | - Vikas Warikoo
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
| | - Shashank Pandya
- Department of Surgical Oncology, The Gujarat Cancer and Research Institute (GCRI) Ahmedabad, Gujarat, India
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Shukla S, Salunke AA, Trivedi M, Patel K, Pandya S, Suthar R, Reddy T, Kapoor K, Yala P, Krishna G, Bharwani N, Pandya S. Clinicopathological and oncological outcomes in upper extremity Ewing's sarcoma: A single institutional experience. J Orthop 2024; 49:148-155. [PMID: 38682008 PMCID: PMC11043629 DOI: 10.1016/j.jor.2023.12.005] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/02/2023] [Revised: 12/06/2023] [Accepted: 12/11/2023] [Indexed: 05/01/2024] Open
Abstract
Background Ewing's sarcoma is highly aggressive bone tumor having predilection for younger age groups with t (11,22) translocation, recombines the FLI-1 and EWS genes on chromosome 22. This disease requires multi-disciplinary treatment withneo-adjuvant chemotherapy followed by surgery or radiotherapy and adjuvant chemotherapy. This study was aimed to assess the demographic distribution, clinical behaviour and oncological outcome of Ewings Sarcoma involving upper extremity. Methods From 2015 to 2022, 45 patients of upper extremity Ewing's sarcoma underwent treatment at a territory cancer centre. A total of 26 patients treated with surgical management were included in the study comprising 15 males (57.7 %) and 11 females (42.3 %). Mean age of presentation was 26 years (3-43 years). The most common site for Ewings sarcoma of upper extremity was Humerus(42 %) followed by Scapula(27 %), Radius(15 %), Ulna(8 %), Metacarpals(4 %) and Clavicle(4 %). Out of 26 cases, 19 (73%) underwent limb salvage surgery and 7 (27%) underwent ampuation surgery. Results In limb salvage group reconstruction with Extra-corporeal radiotherapy (ECRT), Ulna centralization, Megaprosthesis and 3D printed scapula was performed following wide resection of tumor. In Amputation group ray resection in one case and forequarter amputation was performed in six cases. Mean serum LDH value was 335 IU/L (2.3X Normal value) and serum albumin was 4.04 gm/dl. Mean tumour necrosis after neo-adjuvant chemotherapy was 68 %. Out of 26 cases, 19(73 %) cases underwent limb salvage and 7 patients underwent amputation surgery. Out of 26, 13 (50 %) patients developed metastasis on follow up. The Event free survival (EFS) in current study was 70 % at 12 months and 40 % at 24 months. Mean Event free survival (EFS) in current study was 33.5 months (22.3-44.6) and Median Event free survival (EFS) in current study was 25 months (19.7-30.2). Conclusion This study characterises demographic and oncologic outcomes of upper extremity ewings sarcoma in Indian subpopulation. Pain and swelling were prominent clinical findings at presentation in patients with upper extremity Ewing's sarcoma. The survival rate following limb salvage surgery in Ewings sarcoma of upper extremity was comparable to that of patients with amputation surgery. Ewings sarcoma of upper extremity was associated with higher LDH level which was raised more than twice the normal range and can led to worse oncologic outcomes. A comparative study on upper extremity and lower extremity ewings sarcoma will be of help to improve literature on this rare disease.
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Affiliation(s)
- Shivang Shukla
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | | | - Maharshi Trivedi
- Gujarat Cancer and Research Institute, (Medical Oncology), Ahmedabad, Gujarat, India
| | - Keval Patel
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Shivam Pandya
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Ritesh Suthar
- Gujarat Cancer and Research Institute, (Nuclear Medicine), Ahmedabad, Gujarat, India
| | - Tarun Reddy
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Kanika Kapoor
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Poojitha Yala
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Geetha Krishna
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Nandlal Bharwani
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
| | - Shashank Pandya
- Gujarat Cancer and Research Institute, (Surgical Oncology), Ahmedabad, Gujarat, India
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Sandeep KS, Rathod P, Dalvi R, Pawar A, Thottiyen S, Pandya S, Sharma M, Patel S, Warikoo V, Pandya S. Osteosarcoma of Head and Neck Region: Tertiary Cancer Care Center Experience. Indian J Otolaryngol Head Neck Surg 2024; 76:581-586. [PMID: 38440650 PMCID: PMC10908908 DOI: 10.1007/s12070-023-04216-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/24/2023] [Accepted: 09/04/2023] [Indexed: 03/06/2024] Open
Abstract
Head and neck osteosarcoma is an uncommon yet aggressive tumor which presents therapeutic challenges to get favourable results. Surgery remained the most effective treatment modality in this entity eventhough chemoradiotherapy have been tried in various studies for better outcome but still not yet becomes the standard in the management of these cases unlike in extremity osteosarcoma. We present our experience in the management of this uncommon yet lethal malignant tumor, i.e. head and neck osteosarcoma. To study the clinicopathological and prognostic features of Osteosarcoma in head and neck subsite. Retrospective study of patients diagnosed with head and neck osteosarcoma between 2003 and 2019. Total of 25 patients were included in our study. Mean age of our population is 27.5 years with slight male predominant. Mandible is the most commonly involved site. Multimodal treatment applied with surgical resection forms the main part in the management. Median DFS and OS were 16 and 36 months respectively with 5 year overall survival of 42%. Out of the various factors studied, absence of surgery, margin positivity are the principle features affecting the prognosis. Head and neck osteosarcoma is generally a jaw bone tumor commonly occurs in young adults with poor outcome. Since there is no universal guidelines to address this uncommon tumor, multiple studies have shown various results in the management. Till date, surgery remained the curative modality with mixed response on the role of chemotherapy and radiotherapy.
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Affiliation(s)
- K. S. Sandeep
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | | | - Raisha Dalvi
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Ajinkya Pawar
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | | | | | - Mohit Sharma
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | | | - Vikas Warikoo
- Gujarat Cancer and Research Institute, Ahmedabad, India
| | - Shivam Pandya
- Gujarat Cancer and Research Institute, Ahmedabad, India
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Suthar R, Bharwani N, Pareek P, Salunke AA, Patel K, Shukla S, Aron J, Kapoor K, Yalla P, Rathod P, Pandya S, Pandya S. Role of bone scintigraphy (bone scan) in skeletal osteosarcoma: A retrospective audit and review from tertiary oncology centre. J Orthop 2024; 48:20-24. [PMID: 38059218 PMCID: PMC10696193 DOI: 10.1016/j.jor.2023.11.038] [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: 08/12/2023] [Accepted: 11/14/2023] [Indexed: 12/08/2023] Open
Abstract
Introduction Bone scan is a investigation which uses radionuclide phosphonate compound for whole skeletal survey. In this current study we have done the analysis of the role of bone scan in skeletal osteosarcoma at tertiary oncology care centre. Material & methods This is a retrospective study conducted in a tertiary oncology centre from January 2022 to February 2023. A total of 92 patients with skeletal OGS were included in our study undergone 99 mTCcMDP whole body bone scan. 99 mTc MDP was prepared freshly every morning and dose for each patient were calculated as per EANM guidelines. Images were acquired 2-3 h of post injection. All images were acquired at GE infinia dual head machine with peak setting at 140Kev and LEAP collimator. Suspicious lesions on planer bone scan were correlated with SPECT fused with CT. All the bone scans were reviewed retrospectively by two independent nuclear medicine physicians. Results In this study group, 86 patients with biopsy proven skeletal OGS underwent 99 mTCcMDP bone scan of which 63 were males and 23 were females (2.7:1) with age of study group ranging from 7years to 48years. Patients referred for bone scan were retrospectively categorized in two groups, first group patients (52) were referred for initial staging of disease and second group of patients (34) were referred for follow-up or re-staging of the disease. Total 09 patients showed distant skeletal metastases on bone scan, out of which 05 were in initial staging group and 04 in follow up group. Conclusion Osteosarcoma has propensity to metastasize to many sites in the body however most common site being lung followed by skeletal, nodal and rarely soft tissue metastasis. Bone scan enjoys a optimal sensitivity in case of osteosarcoma to detect skeletal metastasis but have low specificity. However being a cost effective and faster investigation makes it a wise investigation of choice in case of osteosarcoma for skeletal metastasis evaluation.
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Affiliation(s)
- Ritesh Suthar
- Nuclear Medicine, Gujarat Cancer Research Institute(GCRI), Ahemdabad, Gujarat, India
| | - Nandlal Bharwani
- Orthopedic Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Pravin Pareek
- Nuclear Medicine, Gujarat Cancer Research Institute(GCRI), Ahemdabad, Gujarat, India
| | - Abhijeet Ashok Salunke
- Orthopedic Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Keval Patel
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Shivang Shukla
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Jebin Aron
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Kanika Kapoor
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Poojitha Yalla
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Priyank Rathod
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Shivam Pandya
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
| | - Shashank Pandya
- Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
- Gujarat Cancer Research Institute (GCRI), Ahemdabad, Gujarat, India
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Mithi MT, Sharma M, Puj K, Devarajan JA, Joshi N, Pandya SJ, Patel S, Warikoo V, Rathod P, Pandya S, Salunke A, Patel K, Garg V. Surgery for lung cancer: insight from a state cancer centre in India. Indian J Thorac Cardiovasc Surg 2024; 40:50-57. [PMID: 38125328 PMCID: PMC10728424 DOI: 10.1007/s12055-023-01590-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 12/23/2023] Open
Abstract
Purpose Lung cancer is one of the most common cancers in India. However, less than half receive treatment with a curative intent and very few undergo surgery amongst them. We present our surgical experience with non-small cell lung cancer. Methods A retrospective analysis of a cohort of 92 non-small cell lung cancer patients operated with curative intent. Results Less than 2% patients of lung cancer were operated on at our centre. Adenocarcinoma was the most common histological subtype. Right upper lobectomy was the most common surgery performed. Two- and 3-year overall survival was 74.3% and 70.6% respectively. Two- and 3- year disease-free survival was 65.4% and 60.8% respectively. Conclusion The fraction of patients who are operated for lung cancer is very less. There is a definite missed window of opportunity. We have comparable survival to international data.
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Affiliation(s)
- Mohamed Taher Mithi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohit Sharma
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Ketul Puj
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Jebin Aaron Devarajan
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Nilang Joshi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shashank J. Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shailesh Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vikas Warikoo
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Priyank Rathod
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shivam Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Abhijeet Salunke
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Keval Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vasudha Garg
- Department of Medicine, BJ Medical College, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
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Pawar A, Rathod P, Warikoo V, Sharma M, Salunke A, Pandya S, Pandya S, Aaron J, Thottiyen S, Trivedi S, Kapur K, Bande V, Patel N, Yalla P, Joshi G. 'AJ's Orbicularis Oris Stitch: A Novel and Simple Technique of Reconstructing Central Arch Mandibular Defects in Resource-Constrained Set Up'. Indian J Otolaryngol Head Neck Surg 2023; 75:3703-3710. [PMID: 37974779 PMCID: PMC10645984 DOI: 10.1007/s12070-023-04044-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/28/2023] [Accepted: 06/26/2023] [Indexed: 11/19/2023] Open
Abstract
Lip and oral cavity SCC account for 2nd highest incidence of cancers and 3rd most common cause of mortality from cancer in India. Reconstruction of defects of central arch invading cancers results in poor cosmetic and functional outcomes if free flaps are not used. 30 patients with Oral SCC in the age group 20-75 years requiring central arch segmental mandibulectomy were included. Reconstruction was done with pedicled bipaddled PMMC flap with 'AJ's orbicularis oris stitch' using Fiber wire. Patients were divided into 4 groups according to extent of lip and skin loss post excision of primary tumour. Patients were evaluated with subjective scores for drooling, oral competence and cosmesis. There were 4, 12, 9 and 5 patients in Group A, B, C and D respectively. Mean subjective scores using our technique for drooling, oral competence and cosmesis were 3.75/4,3.75/4 and 3.5/4 for group A, 3.45/4, 3.36/4 and 3.09/4 for group B, 2.8/4, 2.6/4 and 2.3/4 for group C defects and 2.5/4, 3/4 and 2.5/4 for group D defects respectively. Over all scores for all patients were 3.2/4, 3.14/4 and 2.84/4 for drooling, oral competence and cosmesis. This simple, quick and inexpensive technique of reconstruction of central mandibular arch defects can drastically improve cosmetic and functional outcomes in a resource restrained set up. However, long term results and comparison studies are required for standardisation of the technique.
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Affiliation(s)
| | - Priyank Rathod
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Vikas Warikoo
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Mohit Sharma
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | | | - Shashank Pandya
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Shivam Pandya
- Department of Surgical Oncology, GCRI, 1, Krushnapark Society, Karelibaig, Vadodara, Ahmedabad, Gujarat 390018 India
| | - Jebin Aaron
- MCh Surgical Oncology, GCRI, Ahmedabad, India
| | | | | | | | - Vivek Bande
- MCh Surgical Oncology, GCRI, Ahmedabad, India
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Trivedi S, Salahuddin T, Mithi MT, Rathod P, Bandi A, Pandya SJ, Sharma M, Patel S, Warikoo V, Puj K, Salunkhe A, Patel K, Pandya S. Medullary Thyroid Carcinoma: A Single Institute Experience. Indian J Otolaryngol Head Neck Surg 2023; 75:2884-2889. [PMID: 37974849 PMCID: PMC10645935 DOI: 10.1007/s12070-023-03867-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2023] [Accepted: 05/04/2023] [Indexed: 11/19/2023] Open
Abstract
Medullary thyroid carcinoma is a rare tumour that is anatomically located in the thyroid gland but is functionally a neuroendocrine tumour. It is usually a disease of older age group but manifests in a young patient in familial form. It is derived from parafollicular c cells and has a predilection for lymph node metastasis. It is associated with slow growth in thyroid gland with early nodal metastasis. Serum calcitonin is useful as a preoperative marker of disease burden and prognosis. In the preoperative period serum levels of calcitonin can guide regarding the need for compartment wise lymph node dissection and the possibility of distant metastasis. It is used as a tool of surveillance in the postoperative period. The levels of serum CEA and calcitonin and their doubling time is a useful guide in the detection of early recurrence or distant metastasis. Imaging modality useful for diagnosis is USG in a majority of patients. Thus, the initial diagnosis and preoperative assessment of medullary thyroid carcinoma is similar to other forms of thyroid cancer but further management of disease differs significantly form other forms of differentiated thyroid carcinoma or even anaplastic carcinoma. Prognosis however differs according to age, gender, presence or absence of lymph node metastasis at presentation, metastatic disease at presentation and levels of biochemical markers.
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Affiliation(s)
- Sonal Trivedi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - T. Salahuddin
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohamed Taher Mithi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Priyank Rathod
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Arpit Bandi
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shashank J. Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Mohit Sharma
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shailesh Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Vikas Warikoo
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Ketul Puj
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Abhijeet Salunkhe
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Keval Patel
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
| | - Shivam Pandya
- Department of Surgical Oncology, Gujarat Cancer Research Institute, Civil Hospital Campus, Asarwa, Ahmedabad, Gujarat 380016 India
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Shukla S, Rathod PV, Pandya S, Sharma M, Patel S, Warikoo V, Salunke A, Puj K, Pandya S. Secretory Carcinoma of Salivary Glands: A Case Series and Review of Literature. Indian J Otolaryngol Head Neck Surg 2023; 75:2645-2649. [PMID: 37636750 PMCID: PMC10447787 DOI: 10.1007/s12070-023-03560-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/10/2023] [Accepted: 01/31/2023] [Indexed: 03/06/2023] Open
Abstract
Mammary analogue of secretory carcinoma is a recently described entity in WHO 2017 classification of head and neck tumours. It resembles secretory carcinoma of breast. It usually affects the salivary glands and has an indolent behaviour. We reviewed five cases of Mammary analogue of secretory carcinoma in our institute and compared our results with existing literature. All the patients underwent surgical resections and appropriate adjuvant treatment. Immunohistochemistry is an alternative cost effective tool as compared to genetic testing to differentiate secretory carcinoma from its mimickers. Surgery with adequate margins followed by adjuvant therapy is the treatment of choice.
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Affiliation(s)
- Shivang Shukla
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Priyank V. Rathod
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Shashank Pandya
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Mohit Sharma
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Shailesh Patel
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Vikas Warikoo
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Abhijeet Salunke
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Ketul Puj
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
| | - Shivam Pandya
- Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat India
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Badwe R, Parmar V, Nair N, Hawaldar R, Joshi S, Pawar S, Kadayaprath G, Borthakur B, Rao S, Pandya S, B S, Chitale P, Neve R, Harris C, Srivastava A, Siddique S, Vanmali V, Dewade A, Gaikwad V, Gupta S. 137MO Effect of peri-tumoral infiltration of local anaesthetic prior to surgery on survival in early breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.07.172] [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: 11/24/2022] Open
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Kania T, Pandya S, Demissie S, Abdelhalim D, Governo C, Hawkins S, Younan D, Atanassov K, Gave A. Physical exam is not an accurate predictor of injury in geriatric patients with low-energy blunt trauma - A retrospective cohort study. Ann Med Surg (Lond) 2022; 81:104503. [PMID: 36147051 PMCID: PMC9486729 DOI: 10.1016/j.amsu.2022.104503] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Revised: 08/20/2022] [Accepted: 08/21/2022] [Indexed: 11/30/2022] Open
Abstract
Background When evaluating trauma patients, many centers perform computed tomography of the head, cervical spine, chest, abdomen, and pelvis, the so-called “pan-scan.” Here, we evaluate the utility of physical exam against pan-scan in geriatric patients who sustained ground-level falls. Methods We performed a single-centered retrospective cohort review of consecutive patients from the trauma registry of a large, urban Level 1 trauma center. Inclusion criteria were registration during the 2019 calendar year, age ≥65, mechanism of fall from either sitting or standing, and performance of “pan-scan” at time of assessment. The sensitivity, specificity, positive and negative predictive values of the physical exam for significant injuries were calculated. The effect of such injuries on disposition from the emergency department and hospital were determined. Results An initial query for patients age ≥65 yielded 1280 patients. After exclusion of patients who did not undergo pan-scan or who had GCS <14, 751 patients were included in analysis. Median age was 84 years old. 351 patients had at least one injury identified on pan-scan. Physical exam was determined to have a sensitivity of 0.69 when compared to pan-scan as a gold standard. Patients with injury identified on CT scan had significantly more admissions, mortalities, and ICU and OR requirements. Conclusion Approximately half of all patients were found to have at least one injury on pan-scan. Physical examination was insensitive at identifying such injuries which ultimately altered patient management, disposition, and outcomes. Pan-scan is recommended in this vulnerable population. A selective approach to CT scan may not be appropriate for elderly patients with low-energy blunt falls. Approximately half of all elderly patients who fall from sitting or standing have at least one traumatic injury. Traumatic injuries alter the hospital course and disposition of elderly fall patients. Physical exam is neither sensitive nor specific enough to detect these injuries.
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Affiliation(s)
- T. Kania
- Staten Island University Hospital/Hofstra Northwell Zucker School of Medicine, United States
- Corresponding author.475 Seaview Ave. Staten Island, NY, 10305, United States.
| | - S. Pandya
- Staten Island University Hospital/Hofstra Northwell Zucker School of Medicine, United States
| | - S. Demissie
- Staten Island University Hospital/Hofstra Northwell Zucker School of Medicine, United States
| | - D. Abdelhalim
- Touro College of Osteopathic Medicine, United States
| | - C. Governo
- Staten Island University Hospital/Hofstra Northwell Zucker School of Medicine, United States
| | - S. Hawkins
- Hackensack University Medical Center, United States
| | - D. Younan
- Staten Island University Hospital/Hofstra Northwell Zucker School of Medicine, United States
| | - K. Atanassov
- Staten Island University Hospital/Hofstra Northwell Zucker School of Medicine, United States
| | - A. Gave
- Hackensack Meridian Health JFK University Medical Center, United States
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Salunke AA, Nandy K, Puj K, Kamani M, Pathak S, Shah J, Bhalerao RH, Jain A, Sharma M, Warikoo V, Patel K, Rathod P, Bhatt S, Tank T, Pandya S. A proposed "Radiological Evaluation Score for Bone Tumors" (REST): An objective system for assessment of a radiograph in patients with suspected bone tumor. Musculoskelet Surg 2021; 106:371-382. [PMID: 33982208 DOI: 10.1007/s12306-021-00711-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2021] [Accepted: 05/01/2021] [Indexed: 11/24/2022]
Abstract
BACKGROUND Although radiographs have been widely used in the evaluation of patients with suspected bone tumors, the lack of an objective radiological assessment method leads to a challenge in reaching correct diagnosis. The study aimed to propose a Radiological Evaluation Score for Bone Tumors (REST) which includes eight radiological factors [characteristics, content, cortical breach, distinctiveness, distribution, periosteal reaction, fracture, and soft tissue swelling] to form a single score along with its validation by multidisciplinary observers. METHODS We reviewed the radiographs of 100 patients with a primary bone tumor which were selected at random from the database between January 2017 and January 2019 of a tertiary cancer center. Four reviewers (two orthopedic oncologists and two surgical oncologists) independently assessed the radiographs, based on the reporting system of REST. We constituted two groups according to the probable diagnosis of bone tumor (suspected benign tumor and suspected malignant tumor). RESULTS The mean score in the suspected benign tumor group was 1.1 (range 0-3, 95% CI 0.8-1.3) and in malignant tumor group was 6.1 (range 2-8, 95% CI 5.8-6.4). A receiver operator characteristic (ROC) curve for REST was with a cutoff of 3.5, with the most diagnostic value area under curve (AUC) of 0.99. The sensitivity was 98% and specificity was 100% with a positive predictive value of 100% and a negative predictive value of 98%. The inter-observer correlation coefficient was 0.985 (p value < 0.05), and Fleiss kappa value for the prediction of the benign or malignant lesion was 0.97 (p value < 0.05). The characteristics and content of tumor, cortical erosion, distinctiveness, distribution, periosteal reaction, and soft tissue mass had a significant correlation with the aggressiveness of bone lesion p value < 0.05. CONCLUSIONS The Radiological Evaluation Score for Bone Tumors (REST) is a structured reporting and objective method for the assessment of radiographs in patients with suspected bone tumors. This method is a reliable and helpful tool for clinicians in their outdoor patient department to differentiate a radiograph of a suspected benign tumor from a malignant bone tumor.
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Affiliation(s)
- A A Salunke
- Department of Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - K Nandy
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - K Puj
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - M Kamani
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - S Pathak
- Department of Orthopedics, MM Institute of Medical Sciences & Research, Ambala, India
| | - J Shah
- Osteo Care - Ortho Onco Clinic, Ahmedabad, Gujarat, India
| | - R H Bhalerao
- Department of Electrical Engineering and Computer Science, Institute of Infrastructure, Technology, Research And Management, Ahmedabad, Gujarat, India
| | - A Jain
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - M Sharma
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - V Warikoo
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - K Patel
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - P Rathod
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - S Bhatt
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - T Tank
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
| | - S Pandya
- Department of Anesthesia, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India
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Salunke AA, Nandy K, Kamani M, Puj K, Pathak S, Patel K, Bhalerao RH, Jain A, Sharma M, Warikoo V, Bhatt S, Rathod P, Pandya S. A proposed ''A to Z RAM (Radiograph Assessment Method)'' for triage of patients with a suspected bone tumour. Radiography (Lond) 2021; 27:823-830. [PMID: 33487526 DOI: 10.1016/j.radi.2021.01.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2020] [Revised: 12/19/2020] [Accepted: 01/01/2021] [Indexed: 11/24/2022]
Abstract
INTRODUCTION We propose a ''A to Z RAM (Radiograph Assessment Method)'' for evaluation of Radiograph of patients with a suspected bone tumour. METHODS In the current study, ten radiological features with letters 'A, B, C, D, E, F and Z' were used and which included the age of the patient, involved part of the bone, characteristics, content, distinctiveness, the exterior of the bone, fracture, and zone of transition. Four independent observers (orthopaedic oncologists and surgical oncologists) evaluated a set of 30 radiographs of bone tumour selected at random from our hospital database based on A to Z RAM. We classified the lesions into two groups according to the traffic signal system; Green (suspected benign lesion) and Red (suspected malignant lesion). RESULTS There were 18 (60%) benign bone lesions and 12 (40%) malignant lesions in the current study. 91.6% of malignant tumours and 88.8% of the benign tumours were identified correctly by the four observers. The inter-observer variability with Fleiss kappa was 0.884 (95% CI 0.7-1.03 p-value < 0.05), suggestive of agreement not by chance. These radiographs were again reassessed by the four observers after 3 months. The interobserver variability by Fleiss kappa was 1.0 (95% CI 0.8-1.1) suggesting complete agreement amongst the observers. Both orthopaedic oncologists had intra-observer kappa as 1.0 each and both surgical oncologists had 0.795 and 0.930 respectively. CONCLUSION The proposed A to Z RAM is an easy to use and reproducible method for reviewing radiographs in the out-patient department along with clinical findings for better management of patients with suspected bone lesions. The A to Z RAM can be a medical triage tool and subdivide bone lesions into two subgroups i.e. suspected benign lesion with a suggestion of further investigations with MRI and biopsy and suspected malignant lesion with a suggestion of MRI or early referral to a tertiary cancer center with expertise in orthopaedic oncology. IMPLICATIONS FOR PRACTICE The A to Z RAM (Radiologic Assessment Method) is a reproducible method for reviewing radiographs in the out-patient department and can be an aid for better management of patients. A to Z RAM is useful as a medical triage system, subdividing patients according to the probable diagnosis into a suspected benign lesion and suspected malignant lesion.
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Affiliation(s)
- A A Salunke
- Department of Surgical Oncology, Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - K Nandy
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - M Kamani
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - K Puj
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - S Pathak
- Department of Orthopedics, MM University, Ambala, India.
| | - K Patel
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - R H Bhalerao
- Deptartment of Electrical Engineering, IITRAM, Ahmedabad, Gujarat, India.
| | - A Jain
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - M Sharma
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - V Warikoo
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - S Bhatt
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - P Rathod
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
| | - S Pandya
- Gujarat Cancer Research Institute (GCRI), Ahmedabad, Gujarat, India.
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Tan K, Jones SH, Lake BB, Chousal JN, Shum EY, Zhang L, Chen S, Sohni A, Pandya S, Gallo RL, Zhang K, Cook-Andersen H, Wilkinson MF. The role of the NMD factor UPF3B in olfactory sensory neurons. eLife 2020; 9:e57525. [PMID: 32773035 PMCID: PMC7452722 DOI: 10.7554/elife.57525] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/17/2020] [Accepted: 08/09/2020] [Indexed: 12/13/2022] Open
Abstract
The UPF3B-dependent branch of the nonsense-mediated RNA decay (NMD) pathway is critical for human cognition. Here, we examined the role of UPF3B in the olfactory system. Single-cell RNA-sequencing (scRNA-seq) analysis demonstrated considerable heterogeneity of olfactory sensory neuron (OSN) cell populations in wild-type (WT) mice, and revealed that UPF3B loss influences specific subsets of these cell populations. UPF3B also regulates the expression of a large cadre of antimicrobial genes in OSNs, and promotes the selection of specific olfactory receptor (Olfr) genes for expression in mature OSNs (mOSNs). RNA-seq and Ribotag analyses identified classes of mRNAs expressed and translated at different levels in WT and Upf3b-null mOSNs. Integrating multiple computational approaches, UPF3B-dependent NMD target transcripts that are candidates to mediate the functions of NMD in mOSNs were identified in vivo. Together, our data provides a valuable resource for the olfactory field and insights into the roles of NMD in vivo.
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Affiliation(s)
- Kun Tan
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
| | - Samantha H Jones
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
| | - Blue B Lake
- Department of Bioengineering, University of California, San DiegoSan DiegoUnited States
| | - Jennifer N Chousal
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
| | - Eleen Y Shum
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
| | - Lingjuan Zhang
- Department of Dermatology, University of California, San DiegoSan DiegoUnited States
| | - Song Chen
- Department of Bioengineering, University of California, San DiegoSan DiegoUnited States
| | - Abhishek Sohni
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
| | - Shivam Pandya
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
| | - Richard L Gallo
- Department of Dermatology, University of California, San DiegoSan DiegoUnited States
| | - Kun Zhang
- Department of Bioengineering, University of California, San DiegoSan DiegoUnited States
| | - Heidi Cook-Andersen
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
- Division of Biological Sciences, University of California, San DiegoSan DiegoUnited States
| | - Miles F Wilkinson
- Department of Obstetrics, Gynecology, and Reproductive Sciences, School of Medicine University of California, San DiegoSan DiegoUnited States
- Institute of Genomic Medicine, University of California, San DiegoSan DiegoUnited States
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Enganti B, Chiruvella M, Bendigeri M, Ghouse S, Ragoori D, Reddy P, Pandya S. Double-face augmentation urethroplasty for bulbar urethral strictures-dorsal versus ventral approach: Technical implications and short-term outcomes. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)34237-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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15
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Kutubudin F, Pandya S, Nazareth D, Walshaw M. ePS4.02 The weight of the problem: obesity in people with cystic fibrosis. J Cyst Fibros 2020. [DOI: 10.1016/s1569-1993(20)30312-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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16
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Jain N, Pandya S, Srivastava P, Chotalia P, Moorthy A. AB0694 IS THERE ANY HETEROGENEITY OF SPONDYLOARTHRITIS DISEASE MANIFESTATIONS BETWEEN TWO ETHNIC SUBGROUPS?:A MULTICENTRE INTERNATIONAL COMPARATIVE STUDY BETWEEN INDIA AND UK. Ann Rheum Dis 2020. [DOI: 10.1136/annrheumdis-2020-eular.6497] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Pathogenesis of Spondyloarthritis (SpA) multifactorial and remains unclear. Various hypothesis have been postulated genetics, HLAB27, IL17, Gut microbiome and Biomechanical stress. Many of these factors can be attributed to ethnic background and environment. HLAB27 accounts for 20–25 % of total heritability and 40% of genetic risk while <10% of HLA-B27 carriers in general population develop SpA1. Higher faecal calprotectin levels in SpA compared to control point towards microscopic gut inflammation2. Thus dietary habits and geographical factors can influence pathogenesis of disease. We looked in clinical manifestations of SpA patients of two very different ethnic background Caucasians and Indians from UK and India to shed more light in understanding the diseaseObjectives:To study any differences in the clinical manifestations of SpA patients of two ethnic groupsTo compare outcome measure (BASDAI and ASDAS) between Caucasians and IndiansTo study the difference in disease activity between Indian patients and British AsiansMethods:Multicentre observation study where data of SpA patients attending rheumatology clinics from two major teaching hospitals collected. In India data collected from Sheth VS Hospital and NHL Medical College, Gujarat and in United Kingdom from University Hospitals Leicester, NHS trust. Leicester has a multi-ethnic demography wherein almost 30%3of population is of south Asian ethnicity, making this study unique.Baseline demographic and clinical data was collected. Clinical and outcome measures compared to see any heterogeneity in disease manifestations. SPSS software usedResults:Total 200 patients analysed with 148 Indians and 52 Caucasians. The Indian cohort was subdivided into British Asians (second generation Indians) and those form Gujarat, IndiaWe found Indian subgroups were younger with shorter disease duration. Comparison in Table 1Table 1.CaucasianIndianPAge45.9±1231±12<0.001M:F34:193:10.74TDI years9.6 ±5.93.5± 5.2<0.001BASDAI4.05±2.173.1±1.70.002ASDAS2±0.82.4±1.20.02CRP12.8±23.624±12<0.001HLAB2767%26%<0.001Uveitis25%12%0.02IBP78%90%0.03Enthesitis21%60%<0.001Peripheral Arthritis19%36%0.02Dactylitis2%10%0.07Psoriasis10%20%0.1IBD2%5%0.35Comparing British Asians to Indians, Gujarat no significant difference in clinical parameters. (Table 2)British AsianIndianPBASDAI5.16±2.763.1±1.70.006ASDAS2.53±1.32.4±1.20.74CRP15.2 ±15.424±12<0.001Conclusion:We found Caucasians had more HLAB27 positivity and extra-articular manifestation of uveitis however the Indian population has more enthesitis and peripheral arthritis. Enthesitis is initiated during a mechano-sensation and the cultural difference including style of footwear could probably be one of the factors explaining our findings inflammatory back pain has been reported to be higher in Indians compared to Caucasians which could be due to life styleThe fact that ASDAS CRP behaves similarly in Indian patients across the two countries and is more when compared to Caucasians might point towards overall higher burden of disease in Indian populationTo our knowledge this is a first study comparing clinical manifestations of SpA between Indians and CaucasiansReferences:[1]Brown MAet al. Susceptibility to ankylosing spondylitis in twins: the role of genes, HLAand environment.Arthritis Rheum 1997;40: 1823–8[2]J Simione, et al. Fecal Calprotectin, GutInflammation and SpA Archives of Medical Research. 2019;50:41-46[3]http://www.ons.gov.uk/censusDisclosure of Interests:Nibha Jain: None declared, Sapan Pandya: None declared, Puja Srivastava: None declared, Prashant Chotalia: None declared, Arumugam Moorthy Speakers bureau: Abbvie, Novartis,UCB,MSD
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Ochota A, Frost F, Pandya S, Foster K, Walshaw M. WS11-3-1 BMI: a predictor of bone mineral density in adult people with cystic fibrosis. J Cyst Fibros 2019. [DOI: 10.1016/s1569-1993(19)30180-8] [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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18
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Zhang S, Nguyen TD, Hurtado Rúa SM, Kaunzner UW, Pandya S, Kovanlikaya I, Spincemaille P, Wang Y, Gauthier SA. Quantitative Susceptibility Mapping of Time-Dependent Susceptibility Changes in Multiple Sclerosis Lesions. AJNR Am J Neuroradiol 2019; 40:987-993. [PMID: 31097429 DOI: 10.3174/ajnr.a6071] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Received: 01/29/2019] [Accepted: 04/17/2019] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE MR imaging studies have demonstrated that magnetic susceptibility in multiple sclerosis lesions is dependent on lesion age. The objective of this study was to use quantitative susceptibility mapping to determine whether lesions with a hyperintense rim, indicative of iron-laden inflammatory cells (rim+), follow a unique time-dependent trajectory of susceptibility change compared with those without (rim-). MATERIALS AND METHODS We studied patients with MS with at least 1 new gadolinium-enhancing lesion and at least 3 longitudinal quantitative susceptibility mapping scans obtained between 1.1 and 6.1 years. Lesions were classified as rim+ if a hyperintense rim appeared on quantitative susceptibility mapping at any time. A multilevel growth curve model compared longitudinal susceptibility among rim+ and rim- lesions. RESULTS Thirty-two new gadolinium-enhancing lesions from 19 patients with MS were included, and 16 lesions (50%) were identified as rim+. Quantitative susceptibility mapping rim+ lesions were larger than rim- lesions with gadolinium enhancement (P < .001). Among all lesions, susceptibility increased sharply after enhancement to a peak between 1 and 2 years followed by a decrease. The overall susceptibility curve height for rim- lesions was 4.27 parts per billion lower than that for rim+ lesions (P = .01). Rim- lesions demonstrated a higher linear slope relative to rim+ lesions (P = .023) but faster cubic decay relative to rim+ lesions (P = .005). Rim- lesions started decaying approximately 2 years earlier compared with rim+ lesions. CONCLUSIONS There was a marked difference in the susceptibility temporal trajectory between rim+ and rim- lesions during the first 6 years of lesion formation. Most rim+ lesions retain iron for years after the initial lesion appearance.
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Affiliation(s)
- S Zhang
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.).,Department of Radiology (S.Z.), Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China
| | - T D Nguyen
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.)
| | - S M Hurtado Rúa
- Department of Mathematics and Statistics (S.M.H.R.), College of Science and Health Professions, Cleveland State University, Cleveland, Ohio
| | | | - S Pandya
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.)
| | - I Kovanlikaya
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.)
| | - P Spincemaille
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.)
| | - Y Wang
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.).,Department of Biomedical Engineering (Y.W.), Cornell University, Ithaca, New York
| | - S A Gauthier
- From the Departments of Radiology (S.Z., T.D.N., S.P., I.K., P.S., Y.W., S.A.G.) .,Neurology (U.W.K., S.A.G.).,Feil Family Brain and Mind Research Institute (S.A.G.), Weill Cornell Medicine, New York, New York
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19
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Pandya S, Zeighami Y, Freeze B, Dadar M, Collins DL, Dagher A, Raj A. Predictive model of spread of Parkinson's pathology using network diffusion. Neuroimage 2019; 192:178-194. [PMID: 30851444 PMCID: PMC7180066 DOI: 10.1016/j.neuroimage.2019.03.001] [Citation(s) in RCA: 40] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/05/2018] [Revised: 01/20/2019] [Accepted: 03/01/2019] [Indexed: 02/03/2023] Open
Abstract
Growing evidence suggests that a "prion-like" mechanism underlies the pathogenesis of many neurodegenerative disorders, including Parkinson's disease (PD). We extend and tailor previously developed quantitative and predictive network diffusion model (NDM) to PD, by specifically modeling the trans-neuronal spread of alpha-synuclein outward from the substantia nigra (SN). The model demonstrated the spatial and temporal patterns of PD from neuropathological and neuroimaging studies and was statistically validated using MRI deformation of 232 Parkinson's patients. After repeated seeding simulations, the SN was found to be the most likely seed region, supporting its unique lynchpin role in Parkinson's pathology spread. Other alternative spread models were also evaluated for comparison, specifically, random spread and distance-based spread; the latter tests for Braak's original caudorostral transmission theory. We showed that the distance-based spread model is not as well supported as the connectivity-based model. Intriguingly, the temporal sequencing of affected regions predicted by the model was in close agreement with Braak stages III-VI, providing what we consider a "computational Braak" staging system. Finally, we investigated whether the regional expression patterns of implicated genes contribute to regional atrophy. Despite robust evidence for genetic factors in PD pathogenesis, NDM outperformed regional genetic expression predictors, suggesting that network processes are far stronger mediators of regional vulnerability than innate or cell-autonomous factors. This is the first finding yet of the ramification of prion-like pathology propagation in Parkinson's, as gleaned from in vivo human imaging data. The NDM is potentially a promising robust and clinically useful tool for diagnosis, prognosis and staging of PD.
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Affiliation(s)
- S Pandya
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA.
| | - Y Zeighami
- Montreal Neurological Institute, Brain Imaging Centre, McGill University, Canada
| | - B Freeze
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA
| | - M Dadar
- Montreal Neurological Institute, Brain Imaging Centre, McGill University, Canada
| | - D L Collins
- Montreal Neurological Institute, Brain Imaging Centre, McGill University, Canada
| | - A Dagher
- Montreal Neurological Institute, Brain Imaging Centre, McGill University, Canada
| | - A Raj
- Department of Radiology, Weill Medical College of Cornell University, New York, NY, USA; Department of Radiology, UCSF School of Medicine, San Francisco, CA, USA.
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Xu R, Liu S, Saremi S, Gao R, Wang JJ, Hong Z, Lu H, Ghosh A, Pandya S, Bonturim E, Chen ZH, Chen LQ, Rappe AM, Martin LW. Kinetic control of tunable multi-state switching in ferroelectric thin films. Nat Commun 2019; 10:1282. [PMID: 30894533 PMCID: PMC6427024 DOI: 10.1038/s41467-019-09207-9] [Citation(s) in RCA: 32] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2018] [Accepted: 02/20/2019] [Indexed: 11/09/2022] Open
Abstract
Deterministic creation of multiple ferroelectric states with intermediate values of polarization remains challenging due to the inherent bi-stability of ferroelectric switching. Here we show the ability to select any desired intermediate polarization value via control of the switching pathway in (111)-oriented PbZr0.2Ti0.8O3 films. Such switching phenomena are driven by kinetic control of the volume fraction of two geometrically different domain structures which are generated by two distinct switching pathways: one direct, bipolar-like switching and another multi-step switching process with the formation of a thermodynamically-stable intermediate twinning structure. Such control of switching pathways is enabled by the competition between elastic and electrostatic energies which favors different types of ferroelastic switching that can occur. Overall, our work demonstrates an alternative approach that transcends the inherent bi-stability of ferroelectrics to create non-volatile, deterministic, and repeatedly obtainable multi-state polarization without compromising other important properties, and holds promise for non-volatile multi-state functional applications. The use of ferroeletric materials for multi-state device applications is still challenging. Here, the authors present a mechanism to stabilize non-volatile polarization states by populating volume fractions of two domain structures in PbZr0.2Ti0.8O3 via kinetic control of switching pathways.
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Affiliation(s)
- R Xu
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - S Liu
- Extreme Materials Initiative, Geophysical Laboratory, Carnegie Institution for Science, Washington, DC, 20015, USA
| | - S Saremi
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - R Gao
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - J J Wang
- Department of Materials Science and Engineering, Pennsylvania State University, State College, PA, 16802, USA
| | - Z Hong
- Department of Materials Science and Engineering, Pennsylvania State University, State College, PA, 16802, USA
| | - H Lu
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - A Ghosh
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - S Pandya
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - E Bonturim
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA
| | - Z H Chen
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA.,School of Materials Science and Engineering, Harbin Institute of Technology, 518055, Shenzhen, China
| | - L Q Chen
- Department of Materials Science and Engineering, Pennsylvania State University, State College, PA, 16802, USA
| | - A M Rappe
- Department of Chemistry, University of Pennsylvania, Philadelphia, PA, 19104-6323, USA
| | - L W Martin
- Department of Materials Science and Engineering, University of California, Berkeley, CA, 94720, USA. .,Materials Sciences Division, Lawrence Berkeley National Laboratory, Berkeley, CA, 94720, USA.
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21
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Kasbekar P, Goel P, Aravind S, Shukla H, Pandya S. The margin ratio hypothesis in cancer of buccal mucosa. Eur J Surg Oncol 2019. [DOI: 10.1016/j.ejso.2018.10.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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22
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Merja M, Kasbekar P, Pandya S. Impact of Induction Chemotherapy on Nodal and Distal Disease Control in Locally Advanced Buccal Mucosa Cancer. J Glob Oncol 2018. [DOI: 10.1200/jgo.18.99000] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Buccal mucosa squamous cell cancer is the most common cancer in India. Majority of them presenting in advanced stage whose prognosis after surgery depends significantly upon the regional and distal spread. We studied the impact of neoadjuvant chemotherapy (NACT) on nodal and distal control of disease in operated cases of advanced buccal mucosa cancer. Aim: A retrospective study to evaluate the impact of induction chemotherapy (NACT) on nodal and distal failure in locally advanced buccal mucosa cancer. Methods: A total of 224 patients of advanced buccal mucosal cancer who underwent surgery between 2014 and 2015 were evaluated retrospectively with a follow-up of two years. Total 111 of the above had received NACT prior to surgery while 113 patients underwent upfront surgery. The CT scans and histologic reports were then compared for evaluation and analysis. Results: Among patients with T4a disease, 45.85% in upfront surgery group compared with 54% in NACT group showed metastatic pathologic nodes, while in T4b patients, the rates were 83.33% compared with 49.18% respectively. In patients with clinical/radiologic positive neck nodes at presentation, 87.5% in upfront surgery group as compared with 55.55% in NACT group showed metastatic nodes in histopathologic evaluation. 13.27% patients in the upfront surgery group had nodal and/or distal failure in the two years follow-up, whereas only 3.6% patients in the NACT group. 25% patients with peri-nodal extension in upfront surgery group showed nodal and/or distal failure, while only 6% in NACT group. The results in different nodal-ratio strata was evaluated. It showed that NACT has equal failure rate as in upfront group in nodal-ratio > 50, which is considered as very advanced and aggressive tumor. But in patients with nodal-ratio < 50, NACT group showed lesser failure rate than upfront group. Conclusion: We show regressional effect of NACT on nodal metastases. This study also shows NACT to be having a significantly positive impact on nodal and distal control. Hence role of induction chemotherapy needs to be considered in advanced cases of buccal mucosa cancer with nodal metastases.
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23
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Yao Y, Nguyen TD, Pandya S, Zhang Y, Hurtado Rúa S, Kovanlikaya I, Kuceyeski A, Liu Z, Wang Y, Gauthier SA. Combining Quantitative Susceptibility Mapping with Automatic Zero Reference (QSM0) and Myelin Water Fraction Imaging to Quantify Iron-Related Myelin Damage in Chronic Active MS Lesions. AJNR Am J Neuroradiol 2017; 39:303-310. [PMID: 29242359 DOI: 10.3174/ajnr.a5482] [Citation(s) in RCA: 30] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2017] [Accepted: 10/13/2017] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE A hyperintense rim on susceptibility in chronic MS lesions is consistent with iron deposition, and the purpose of this study was to quantify iron-related myelin damage within these lesions as compared with those without rim. MATERIALS AND METHODS Forty-six patients had 2 longitudinal quantitative susceptibility mapping with automatic zero reference scans with a mean interval of 28.9 ± 11.4 months. Myelin water fraction mapping by using fast acquisition with spiral trajectory and T2 prep was obtained at the second time point to measure myelin damage. Mixed-effects models were used to assess lesion quantitative susceptibility mapping and myelin water fraction values. RESULTS Quantitative susceptibility mapping scans were on average 6.8 parts per billion higher in 116 rim-positive lesions compared with 441 rim-negative lesions (P < .001). All rim-positive lesions retained a hyperintense rim over time, with increasing quantitative susceptibility mapping values of both the rim and core regions (P < .001). Quantitative susceptibility mapping scans and myelin water fraction in rim-positive lesions decreased from rim to core, which is consistent with rim iron deposition. Whole lesion myelin water fractions for rim-positive and rim-negative lesions were 0.055 ± 0.07 and 0.066 ± 0.04, respectively. In the mixed-effects model, rim-positive lesions had on average 0.01 lower myelin water fraction compared with rim-negative lesions (P < .001). The volume of the rim at the initial quantitative susceptibility mapping scan was negatively associated with follow-up myelin water fraction (P < .01). CONCLUSIONS Quantitative susceptibility mapping rim-positive lesions maintained a hyperintense rim, increased in susceptibility, and had more myelin damage compared with rim-negative lesions. Our results are consistent with the identification of chronic active MS lesions and may provide a target for therapeutic interventions to reduce myelin damage.
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Affiliation(s)
- Y Yao
- From the Department of Radiology (Y.Y., Y.Z.), Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China.,Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.)
| | - T D Nguyen
- Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.)
| | - S Pandya
- Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.)
| | - Y Zhang
- From the Department of Radiology (Y.Y., Y.Z.), Tongji Hospital, Tongji Medical College, Huazhong University of Science & Technology, Wuhan, China
| | - S Hurtado Rúa
- Department of Mathematics (S.H.R.), Cleveland State University, Cleveland, Ohio
| | - I Kovanlikaya
- Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.)
| | - A Kuceyeski
- Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.)
| | - Z Liu
- Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.).,Department of Biomedical Engineering (Z.L., Y.W.), Cornell University, Ithaca, New York
| | - Y Wang
- Departments of Radiology (Y.Y., T.D.N., S.P., I.K., A.K., Z.L., Y.W.).,Department of Biomedical Engineering (Z.L., Y.W.), Cornell University, Ithaca, New York
| | - S A Gauthier
- Neurology (S.A.G.), Weill Cornell Medicine, New York, New York
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24
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Patel RH, Pandya S, Nanjappa S, Greene JN. A Case of Refractory Pulmonary Coccidioidomycosis Successfully Treated with Posaconazole Therapy. J Fam Med 2017; 4:1130. [PMID: 29938709 PMCID: PMC6010061 DOI: 10.26420/jfammed.2017.1130] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
Coccidioidomycosis is an endemic fungal infection caused by the inhalation of the spores of Coccidioides species. Patients with underlying immunosuppressive illness can contract chronic or disseminated disease which requires prolonged systemic therapy. Pulmonary coccidioidomycosis remains as an illusory and abstruse disease, with increased prevalence that poses as a challenge for clinicians in developing an effective strategy for treatment. Here, we report successful treatment of a refractory case of chronic relapsing pulmonary coccidioidomycosis in a 50-year old woman with a thin-walled cavitary lung lesion who was ultimately treated with posaconazole.
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Affiliation(s)
- R H Patel
- Undergraduate Student, University of South Florida, USA
| | - S Pandya
- Chief Infectious Diseases Fellow, University of South Florida, Morsani College of Medicine, USA
| | - S Nanjappa
- Assistant Member, Department of Internal Hospital Medicine, H. Lee Moffitt Cancer Center and Research Institute, Department of Oncologic Sciences, University of South Florida, Morsani College of Medicine, USA
| | - J N Greene
- Chief, Infectious Diseases and Hospital Epidemiologist, H. Lee Moffitt Cancer Center and Research Institute, USA
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25
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Chiang GC, Mao X, Kang G, Chang E, Pandya S, Vallabhajosula S, Isaacson R, Ravdin LD, Shungu DC. Relationships among Cortical Glutathione Levels, Brain Amyloidosis, and Memory in Healthy Older Adults Investigated In Vivo with 1H-MRS and Pittsburgh Compound-B PET. AJNR Am J Neuroradiol 2017; 38:1130-1137. [PMID: 28341718 PMCID: PMC5471116 DOI: 10.3174/ajnr.a5143] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2016] [Accepted: 01/19/2017] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND PURPOSE Oxidative stress has been implicated as an important pathologic mechanism in the development of Alzheimer disease. The purpose of this study was to assess whether glutathione levels, detected noninvasively with proton MR spectroscopy, are associated with brain amyloidosis and memory in a community-dwelling cohort of healthy older adults. MATERIALS AND METHODS Fifteen cognitively healthy subjects were prospectively enrolled in this study. All subjects underwent 1H-MR spectroscopy of glutathione, a positron-emission tomography scan with an amyloid tracer, and neuropsychological testing by using the Repeatable Battery for the Assessment of Neuropsychological Status. Associations among glutathione levels, brain amyloidosis, and memory were assessed by using multivariate regression models. RESULTS Lower glutathione levels were associated with greater brain amyloidosis in the temporal (P = .03) and parietal (P = .05) regions, adjusted for apolipoprotein E ε4 carrier status. There were no significant associations between glutathione levels and cognitive scores. CONCLUSIONS This study found an association between cortical glutathione levels and brain amyloidosis in healthy older adults, suggesting a potential role for 1H-MR spectroscopy measures of glutathione as a noninvasive biomarker of early Alzheimer disease pathogenesis.
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Affiliation(s)
- G C Chiang
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - X Mao
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - G Kang
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - E Chang
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - S Pandya
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - S Vallabhajosula
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
| | - R Isaacson
- Neurology (R.I., L.D.R.), Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York
| | - L D Ravdin
- Neurology (R.I., L.D.R.), Weill Cornell Medical College, NewYork-Presbyterian Hospital, New York, New York
| | - D C Shungu
- From the Departments of Radiology (G.C.C., X.M., G.K., E.C., S.P., S.V., D.C.S.)
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26
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Ochota A, lurd M, Pandya S, Walshaw M. 190 Use of a treatment algorithm to improve vitamin D status in cystic fibrosis – a review. J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30428-3] [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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27
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Jurd M, Pandya S, Sobanska A, Walshaw M. 165 How do CF patients cope with transition from Creon 40,000®? J Cyst Fibros 2016. [DOI: 10.1016/s1569-1993(16)30403-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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28
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Agar JC, Damodaran AR, Okatan MB, Kacher J, Gammer C, Vasudevan RK, Pandya S, Dedon LR, Mangalam RVK, Velarde GA, Jesse S, Balke N, Minor AM, Kalinin SV, Martin LW. Highly mobile ferroelastic domain walls in compositionally graded ferroelectric thin films. Nat Mater 2016; 15:549-556. [PMID: 26878312 DOI: 10.1038/nmat4567] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/21/2015] [Accepted: 01/18/2016] [Indexed: 06/05/2023]
Abstract
Domains and domain walls are critical in determining the response of ferroelectrics, and the ability to controllably create, annihilate, or move domains is essential to enable a range of next-generation devices. Whereas electric-field control has been demonstrated for ferroelectric 180° domain walls, similar control of ferroelastic domains has not been achieved. Here, using controlled composition and strain gradients, we demonstrate deterministic control of ferroelastic domains that are rendered highly mobile in a controlled and reversible manner. Through a combination of thin-film growth, transmission-electron-microscopy-based nanobeam diffraction and nanoscale band-excitation switching spectroscopy, we show that strain gradients in compositionally graded PbZr1-xTixO3 heterostructures stabilize needle-like ferroelastic domains that terminate inside the film. These needle-like domains are highly labile in the out-of-plane direction under applied electric fields, producing a locally enhanced piezoresponse. This work demonstrates the efficacy of novel modes of epitaxy in providing new modalities of domain engineering and potential for as-yet-unrealized nanoscale functional devices.
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Affiliation(s)
- J C Agar
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
- Department of Materials Science and Engineering, University of Illinois, Urbana-Champaign, Urbana, Illinois 61801, USA
| | - A R Damodaran
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - M B Okatan
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - J Kacher
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
- National Center for Electron Microscopy, Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - C Gammer
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
- National Center for Electron Microscopy, Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - R K Vasudevan
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - S Pandya
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - L R Dedon
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - R V K Mangalam
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
| | - G A Velarde
- Department of Materials Science and Engineering, University of Illinois, Urbana-Champaign, Urbana, Illinois 61801, USA
| | - S Jesse
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - N Balke
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - A M Minor
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
- National Center for Electron Microscopy, Molecular Foundry, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
| | - S V Kalinin
- Center for Nanophase Materials Sciences, Oak Ridge National Laboratory, Oak Ridge, Tennessee 37831, USA
| | - L W Martin
- Department of Materials Science and Engineering, University of California, Berkeley, California 94720, USA
- Materials Science Division, Lawrence Berkeley National Laboratory, Berkeley, California 94720, USA
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29
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Hall D, Todorova-Koteva K, Pandya S, Bernard B, Ouyang B, Walsh M, Pounardjian T, Deburghraeve C, Zhou L, Losh M, Leehey M, Berry-Kravis E. Neurological and endocrine phenotypes of fragile X carrier women. Clin Genet 2015. [PMID: 26212380 DOI: 10.1111/cge.12646] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Women who carry fragile X mental retardation 1 (FMR1)gene premutation expansions frequently report neurological or endocrine symptoms and prior studies have predominantly focused on questionnaire report of medical issues. Premutation carrier (PMC) women (n = 33) and non-carrier controls (n = 13) were recruited and evaluated by a neurologist, neuropsychologist, and endocrinologist. Blood and skin biopsies were collected for molecular measures. Scales for movement disorders, neuropathy, cognitive function, psychiatric symptoms, sleep, and quality of life were completed. The average age of the women was 51 years (n = 46) and average CGG repeat size was 91 ± 24.9 in the FMR1 PMC women. Seventy percent of the PMC women had an abnormal neurological examination. PMC women had significantly higher scores on the Fragile X-Associated Tremor Ataxia Syndrome (FXTAS) rating scale, more neuropathy, and difficulty with tandem gait compared to controls. Central sensitivity syndromes, a neuroticism profile on the NEO Personality Profile, and sleep disorders were also prevalent. Discrepancies between subject report and examination findings were also seen. This pilot study suggests that women with the FMR1 premutation may have a phenotype that overlaps with that seen in FXTAS. Additional research with larger sample sizes is warranted to better delineate the clinical features.
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Affiliation(s)
- D Hall
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | | | - S Pandya
- Rush Medical College, Rush University, Chicago, IL, USA
| | - B Bernard
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | - B Ouyang
- Department of Neurological Sciences, Rush University, Chicago, IL, USA
| | - M Walsh
- Rush Medical College, Rush University, Chicago, IL, USA
| | - T Pounardjian
- Rush Medical College, Rush University, Chicago, IL, USA
| | - C Deburghraeve
- Department of Anesthesia, University of Illinois, Chicago, IL, USA
| | - L Zhou
- Department of Biochemistry, Rush University, Chicago, IL, USA
| | - M Losh
- Roxelyn and Richard Pepper Department of Communication Sciences and Disorders, Northwestern University, Evanston, IL, USA
| | - M Leehey
- Department of Neurology, University of Colorado, Aurora, CO, USA
| | - E Berry-Kravis
- Department of Neurological Sciences, Rush University, Chicago, IL, USA.,Department of Biochemistry, Rush University, Chicago, IL, USA.,Department of Pediatrics, Rush University, Chicago, IL, USA
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Pandya S, Clem M, Cullum M, Woon F. B-24Predicting Progression from Mild Cognitive Impairment to Dementia with CAIDE Dementia Risk Score. Arch Clin Neuropsychol 2015. [DOI: 10.1093/arclin/acv047.120] [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: 11/14/2022] Open
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31
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Sharma SK, Bharathi P, Prahlad V, Patel PJ, Choksi B, Jana MR, Bansal LK, Qureshi K, Sumod CB, Vadher V, Thakkar D, Gupta LN, Rambabu S, Parmar S, Contractor N, Sahu AK, Pandya B, Sridhar B, Pandya S, Baruah UK. Characteristics of the positive ion source at reduced gas feed. Rev Sci Instrum 2014; 85:113504. [PMID: 25430113 DOI: 10.1063/1.4901596] [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] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
The neutral beam injector of steady state superconducting tokamak (SST1-NBI) at IPR is designed for injecting upto 1.7 MW of neutral beam (Hº, 30-55 keV) power to the tokamak plasma for heating and current drive. Operations of the positive ion source (PINI or Plug-In-Neutral-Injector) of SST1-NBI were carried out on the NBI test stand. The PINI was operated at reduced gas feed rate of 2-3 Torr l/s, without using the high speed cryo pumps. Experiments were conducted to achieve a stable beam extraction by optimizing operational parameters namely, the arc current (120-300 A), acceleration voltage (16-40 kV), and a suitable control sequence. The beam divergence, power density profiles, and species fractions (H(+):H2(+):H3(+)) were measured by using the diagnostics such as thermal calorimetry, infrared thermography, and Doppler shift spectroscopy. The maximum extracted beam current was about 18 A. A further increase of beam current was found to be limited by the amount of gas feed rate to the ion source.
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Affiliation(s)
- S K Sharma
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - P Bharathi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - V Prahlad
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - P J Patel
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Choksi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - M R Jana
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - L K Bansal
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - K Qureshi
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - C B Sumod
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - V Vadher
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - D Thakkar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - L N Gupta
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Rambabu
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Parmar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - N Contractor
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - A K Sahu
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Pandya
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - B Sridhar
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - S Pandya
- Institute for Plasma Research, Bhat, Gandhinagar, India
| | - U K Baruah
- Institute for Plasma Research, Bhat, Gandhinagar, India
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Pandya S, Clem M, Horton D, Lacritz L, Woon F. A-29 * Psychiatric Symptoms in Individuals Reverting to Normal Cognition from Mild Cognitive Impairment. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.29] [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: 11/13/2022] Open
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Horton D, Ream D, Pandya S, Clem M, Hynan L, Rossetti H, Lacritz L, Cullum M. A-70 * An Abbreviated MoCA to Differentiate Normal Cognition, Mild Cognitive Impairment, and Alzheimer's Disease. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.70] [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: 11/12/2022] Open
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34
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Horton D, Ream D, Pandya S, Clem M, Ruchinskas R, White J, Cullum C. A-69 * Neuropsychological Change in Normal Pressure Hydrocephalus following Lumbar Drain. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.69] [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: 11/12/2022] Open
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Clem M, Pandya S, Horton D, Hynan L, Lacritz L, Woon F. A-80 * Neuropsychological Prediction of Diagnostic Stability of Mild Cognitive Impairment. Arch Clin Neuropsychol 2014. [DOI: 10.1093/arclin/acu038.80] [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: 11/14/2022] Open
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Ridall L, Gralla J, Mourani P, Czaja A, Yang M, Cunniff C, Donnelly J, Ciafaloni E, Oleszek J, Pandya S, Price E, Auerbach S. Progression of Left Ventricular Dysfunction in Duchenne and Becker Muscular Dystrophies. J Heart Lung Transplant 2014. [DOI: 10.1016/j.healun.2014.01.824] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Eichinger K, Dilek N, Dekdebrun J, Martens W, Heatwole C, Thornton C, Moxley R, Pandya S. P.18.3 Test–retest reliability of strength measurements of the long finger flexors (LFF) in patients with myotonic dystrophy type 1. Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.672] [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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Pandya S, Caspers K, Eichinger K, Mathews K, Romitti P. P.7.6 Needs of caregivers/families affected by Duchenne and Becker Muscular Dystrophy (DBMD): Data from the Muscular Dystrophy Surveillance, Tracking and Research Network (MD STARnet). Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.487] [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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Pandya S, Kumar A, James K, Westfield C, Ciafaloni E, Cunniff C, Romitti P, Moxley R, STARnet NMD. P.7.5 Sociodemographic and health related profile of adults with Duchenne/Becker Muscular Dystrophy (DBMD): Data from the Muscular Dystrophy Surveillance, Tracking and Research Network (MD STARnet). Neuromuscul Disord 2013. [DOI: 10.1016/j.nmd.2013.06.486] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kaufman I, Pandya S, Powell R, Fredrick J, Bossenberger T, Ramirez E, Yan Y, Solberg T, Burmeister J. Single Fraction Stereotactic Body Radiation Therapy (SBRT) for Spine Metastasis: A Dosimetric Comparison of Multiple Treatment Delivery Systems. Int J Radiat Oncol Biol Phys 2013. [DOI: 10.1016/j.ijrobp.2013.06.1950] [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: 10/26/2022]
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Ochota A, Pandya S, Walshaw M. 286 Is there a place for CTX with cystic fibrosis? J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60427-0] [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: 10/26/2022]
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Pandya S, Ochota A, Walshaw M. WS16.4 Treatment algorithm for vitamin D deficiency – A review a year on. J Cyst Fibros 2013. [DOI: 10.1016/s1569-1993(13)60098-3] [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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Ochota A, Pandya S, Walshaw M. 270 Factors associated with vitamin K deficiency in adults with cystic fibrosis. J Cyst Fibros 2012. [DOI: 10.1016/s1569-1993(12)60439-1] [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: 11/26/2022]
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Eichinger K, Dilek N, Dekdebrun J, Martens W, Heatwole C, Thornton C, Moxley R, Pandya S. Relationships between Upper Extremity Strength and the Purdue Pegboard Test and the Jebsen-Taylor Hand Function Test in Patients with Myotonic Dystrophy Type 1 (P05.187). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pandya S, Eichinger K, Dilek N, Dekdebrun J, Martens W, Heatwole C, Thornton C, Moxley R. Correlation between Biomarkers and Surrogate Markers in Patients with Myotonic Dystrophy Type 1 (DM-1): Data from the Study of Pathogenesis and Progression in DM (STOPP DM) (P05.185). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.185] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pandya S, Eichinger K, Dilek N, Dekdebrun J, Martens W, Heatwole C, Thornton C, Moxley R. Symptoms of Myotonia as Reported by Patients with Myotonic Dystrophy Type 1: Location, Description and Severity- Implications for Clinical Trials (P05.184). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p05.184] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Pandya S, Campbell K, Andrews J, Meaney F, Cunniff C, Druschel C, Miller L, Romitti P. P1.53 Rehabilitation therapy services received by patients with Duchenne/Becker muscular dystrophy (DBMD): Data from the muscular dystrophy surveillance, tracking and research network (MDSTARNet). Neuromuscul Disord 2011. [DOI: 10.1016/j.nmd.2011.06.813] [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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Romitti P, Puzhankara S, Zamba G, Nabukera S, James K, Andrews J, Fox D, Cunniff C, Ciafaloni E, Druschel C, Mathews K, Matthews D, Miller L, Pandya S, Au S, Scollon S, Adams M, Street N. P2-260 Population-based prevalence of Duchenne/Becker muscular dystrophy (DBMD) in the USA. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976j.93] [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]
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Abstract
Ondansetron is a serotonin 5HT3 antagonist; anti-emetic drug. Bitter taste of the ondansetron is a major problem in ensuring patient compliance. The study was designed to formulate tasteless complexes of ondansetron with ion exchange resin and evaluate molecular properties of drug complex. The drug-loading process was carried out using various resins and was optimized using different drug:resin ratio and pH. Resinates were characterized by infrared spectroscopy, thermal analysis, and X-ray powder diffraction (XRPD). Indion 234 gave the best loading efficiency at drug resin ratio of 1:1.5. pH had no effect on drug loading. XRPD studies revealed that drug is in amorphous state in complex. The Infrared studies revealed complexation of secondary amine group of drug with carboxylic functional group of resin. Taste evaluation by using semiquantitative method found resonates as tasteless and agreeable. The release of drug from resinates in simulated gastric fluid was complete in 30 min. Thus, ion exchange resinates offer an effective tool for masking of bitterness and improve drug release.
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Affiliation(s)
- S Shah
- Department of Pharmaceutical Technology, Pioneer Pharmacy Degree College, Vadodara, India
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