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Spencer EE, Nostrand SV, Arya S. Group B Streptococcus Brain Abscess in a Neonate with Bilateral Otorrhea. AJP Rep 2024; 14:e106-e110. [PMID: 38586436 PMCID: PMC10994689 DOI: 10.1055/a-2275-9482] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2024] [Accepted: 02/19/2024] [Indexed: 04/09/2024] Open
Abstract
Introduction Group B streptococcus (GBS) is the leading cause of bacterial sepsis and meningitis in neonates worldwide, but brain abscess secondary to GBS is extremely rare. While temporal brain abscesses have been described as a sequelae of otogenic infections in children and adults, such a presentation has not been described in neonates. Case Description An 8-day-old female infant presented with a fever and irritability along with bilateral purulent otorrhea. Maternal GBS screening was negative, but the delivery was complicated by chorioamnionitis. Workup revealed neutrophilic pleocytosis in the cerebrospinal fluid and culture of the ear drainage was positive for GBS. Magnetic resonance imaging showed a circular lesion with rim enhancement within the left temporal lobe concerning for an abscess. The infant was treated with 14 days of intravenous vancomycin, cefepime, and metronidazole followed by 10 weeks of intravenous ampicillin. The hospital course was complicated by seizures and obstructive hydrocephalus requiring multiple neurosurgical interventions. Conclusion Brain abscess can occur as a sequela of GBS meningitis in neonates, but they are rare. Otogenic infections require prompt evaluation and treatment as they can progress to serious central nervous infections in neonates.
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Affiliation(s)
- Emily E. Spencer
- Department of Pediatrics, Wright State University Boonshoft School of Medicine, Fairborn, Ohio
| | - Sarah Van Nostrand
- Department of Neonatal-Perinatal Medicine, Wright State University Boonshoft School of Medicine, Dayton Children's Hospital and Pediatrix Neonatology of Ohio, Dayton, Ohio
| | - Shreyas Arya
- Department of Neonatal-Perinatal Medicine, Wright State University Boonshoft School of Medicine, Dayton Children's Hospital and Pediatrix Neonatology of Ohio, Dayton, Ohio
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Kim J, Villarreal M, Arya S, Hernandez A, Moreira A. Bridging the Gap: Exploring Bronchopulmonary Dysplasia through the Lens of Biomedical Informatics. J Clin Med 2024; 13:1077. [PMID: 38398389 PMCID: PMC10889493 DOI: 10.3390/jcm13041077] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/28/2023] [Revised: 02/07/2024] [Accepted: 02/12/2024] [Indexed: 02/25/2024] Open
Abstract
Bronchopulmonary dysplasia (BPD), a chronic lung disease predominantly affecting premature infants, poses substantial clinical challenges. This review delves into the promise of biomedical informatics (BMI) in reshaping BPD research and care. We commence by highlighting the escalating prevalence and healthcare impact of BPD, emphasizing the necessity for innovative strategies to comprehend its intricate nature. To this end, we introduce BMI as a potent toolset adept at managing and analyzing extensive, diverse biomedical data. The challenges intrinsic to BPD research are addressed, underscoring the inadequacies of conventional approaches and the compelling need for data-driven solutions. We subsequently explore how BMI can revolutionize BPD research, encompassing genomics and personalized medicine to reveal potential biomarkers and individualized treatment strategies. Predictive analytics emerges as a pivotal facet of BMI, enabling early diagnosis and risk assessment for timely interventions. Moreover, we examine how mobile health technologies facilitate real-time monitoring and enhance patient engagement, ultimately refining BPD management. Ethical and legal considerations surrounding BMI implementation in BPD research are discussed, accentuating issues of privacy, data security, and informed consent. In summation, this review highlights BMI's transformative potential in advancing BPD research, addressing challenges, and opening avenues for personalized medicine and predictive analytics.
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Affiliation(s)
- Jennifer Kim
- Division of Neonatology, Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX 78229, USA; (J.K.); (M.V.); (A.H.)
| | - Mariela Villarreal
- Division of Neonatology, Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX 78229, USA; (J.K.); (M.V.); (A.H.)
| | - Shreyas Arya
- Division of Neonatal-Perinatal Medicine, Dayton Children’s Hospital, Dayton, OH 45404, USA
| | - Antonio Hernandez
- Division of Neonatology, Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX 78229, USA; (J.K.); (M.V.); (A.H.)
| | - Alvaro Moreira
- Division of Neonatology, Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX 78229, USA; (J.K.); (M.V.); (A.H.)
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Moreira AG, Arora T, Arya S, Winter C, Valadie CT, Kwinta P. Leveraging transcriptomics to develop bronchopulmonary dysplasia endotypes: a concept paper. Respir Res 2023; 24:284. [PMID: 37968635 PMCID: PMC10648631 DOI: 10.1186/s12931-023-02596-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Accepted: 11/07/2023] [Indexed: 11/17/2023] Open
Abstract
IMPACT Bronchopulmonary dysplasia has multiple definitions that are currently based on phenotypic characteristics. Using an unsupervised machine learning approach, we created BPD subclasses (e.g., endotypes) by clustering whole microarray data. T helper 17 cell differentiation was the most significant pathway differentiating the BPD endotypes. INTRODUCTION Bronchopulmonary dysplasia (BPD) is the most common complication of extreme prematurity. Discovery of BPD endotypes in an unbiased format, derived from the peripheral blood transcriptome, may uncover patterns underpinning this complex lung disease. METHODS An unsupervised agglomerative hierarchical clustering approach applied to genome-wide expression of profiling from 62 children at day of life five was used to identify BPD endotypes. To identify which genes were differentially expressed across the BPD endotypes, we formulated a linear model based on least-squares minimization with empirical Bayes statistics. RESULTS Four BPD endotypes (A, B,C,D) were identified using 7,319 differentially expressed genes. Across BPD endotypes, 5,850 genes had a p value < 0.05 after multiple comparison testing. Endotype A consisted of neonates with a higher gestational age and birthweight. Endotypes B-D included neonates between 25 and 26 weeks and a birthweight range of 640 to 940 g. Endotype D appeared to have a protective role against BPD compared to Endotypes B and C (36% vs. 62% vs. 60%, respectively). The most significant pathway focused on T helper 17 cell differentiation. CONCLUSION Bioinformatic analyses can help identify BPD endotypes that associate with clinical definitions of BPD.
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Affiliation(s)
- Alvaro G Moreira
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA.
| | - Tanima Arora
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Shreyas Arya
- Division of Neonatology, Dayton Children's Hospital, Cincinnati, OH, USA
| | - Caitlyn Winter
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Charles T Valadie
- Department of Pediatrics, Division of Neonatology, University of Texas Health San Antonio, San Antonio, TX, USA
| | - Przemko Kwinta
- Neonatal Intensive Care Unit, Department of Pediatrics, Jagiellonian University Medical College, Kraków, Poland
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Valadie CT, Arya S, Arora T, Pandillapalli NR, Moreira A. A bioinformatics approach towards bronchopulmonary dysplasia. Transl Pediatr 2023; 12:1213-1224. [PMID: 37427053 PMCID: PMC10326754 DOI: 10.21037/tp-23-133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/02/2023] [Accepted: 05/31/2023] [Indexed: 07/11/2023] Open
Abstract
Background and Objective Bronchopulmonary dysplasia (BPD) is the most common morbidity associated with prematurity and remains a significant clinical challenge. Bioinformatic approaches, such as genomics, transcriptomics, and proteomics, have emerged as novel methods for studying the underlying mechanisms driving BPD pathogenesis. These methods can be used alongside clinical data to develop a better understanding of BPD and potentially identify the most at risk neonates within the first few weeks of neonatal life. The objective of this review is to provide an overview of the current state-of-the-art in bioinformatics for BPD research. Methods We conducted a literature review of bioinformatics approaches for BPD using PubMed. The following keywords were used: "biomedical informatics", "bioinformatics", "bronchopulmonary dysplasia", and "omics". Key Content and Findings This review highlighted the importance of omic-approaches to better understand BPD and potential avenues for future research. We described the use of machine learning (ML) and the need for systems biology methods for integrating large-scale data from multiple tissues. We summarized a handful of studies that utilized bioinformatics for BPD in order to better provide a view of where things currently stand, identify areas of ongoing research, and concluded with challenges that remain in the field. Conclusions Bioinformatics has the potential to enable a more comprehensive understanding of BPD pathogenesis, facilitating a personalized and precise approach to neonatal care. As we continue to push the boundaries of biomedical research, biomedical informatics (BMI) will undoubtedly play a key role in unraveling new frontiers in disease understanding, prevention, and treatment.
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Affiliation(s)
| | - Shreyas Arya
- Department of Pediatrics, Dayton Children’s Hospital, Dayton, OH, USA
| | - Tanima Arora
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX, USA
| | | | - Alvaro Moreira
- Department of Pediatrics, University of Texas Health San Antonio, San Antonio, TX, USA
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Adejuyigbe EA, Agyeman I, Anand P, Anyabolu HC, Arya S, Assenga EN, Badhal S, Brobby NW, Chellani HK, Chopra N, Debata PK, Dube Q, Dua T, Gadama L, Gera R, Hammond CK, Jain S, Kantumbiza F, Kawaza K, Kija EN, Lal P, Mallewa M, Manu MK, Mehta A, Mhango T, Naburi HE, Newton S, Nyanor I, Nyako PA, Oke OJ, Patel A, Phlange-Rhule G, Sehgal R, Singhal R, Wadhwa N, Yiadom AB. Evaluation of the impact of continuous Kangaroo Mother Care (KMC) initiated immediately after birth compared to KMC initiated after stabilization in newborns with birth weight 1.0 to < 1.8 kg on neurodevelopmental outcomes: Protocol for a follow-up study. Trials 2023; 24:265. [PMID: 37038239 PMCID: PMC10088121 DOI: 10.1186/s13063-023-07192-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2022] [Accepted: 02/20/2023] [Indexed: 04/12/2023] Open
Abstract
BACKGROUND Preterm birth or low birth weight is the single largest cause of death in newborns, however this mortality can be reduced through newborn care interventions, including Kangaroo Mother Care (KMC). Previously, a multi-country randomized controlled trial, coordinated by the World Health Organization (WHO), reported a significant survival advantage with initiation of continuous KMC immediately after birth compared with initiation of continuous KMC a few days after birth when the baby is considered clinically stable. Whether the survival advantage would lead to higher rates of neurodevelopmental morbidities, or the immediate KMC will also have a beneficial effect on cognitive development also, has not been investigated. We therefore propose to test the hypothesis that low-birth-weight infants exposed to immediate KMC will have lower rates of neurodevelopmental impairment in comparison to traditional KMC-treated infants, by prospectively following up infants already enrolled in the immediate KMC trial for the first 2 years of life, and assessing their growth and neurodevelopment. METHODS This prospective cohort study will enroll surviving neonates from the main WHO immediate KMC trial. The main trial as well as this follow-up study are being conducted in five low- and middle-income countries in South Asia and sub-Saharan Africa. The estimated sample size for comparison of the risk of neurodevelopmental impairment is a total of 2200 children. The primary outcome will include rates of cerebral palsy, hearing impairment, vision impairment, mental and motor development, and epilepsy and will be assessed by the age of 3 years. The analysis will be by intention to treat. DISCUSSION Immediate KMC can potentially reduce low-birth-weight-associated complications such as respiratory disease, hypothermia, hypoglycemia, and infection that can result in impaired neurocognitive development. Neuroprotection may also be mediated by improved physiological stabilization that may lead to better maturation of neural pathways, reduced risk of hypoxia, positive parental impact, improved sleep cycles, and improved stress responses. The present study will help in evaluating the overall impact of KMC by investigating the long-term effect on neurodevelopmental impairment in the survivors. TRIAL REGISTRATION Clinical Trials Registry-India CTRI/2019/11/021899. Registered on 06 November 2019. Trials registration of parent trial: ACTRN12618001880235; Clinical Trials Registry-India: CTRI/2018/08/015369.
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Affiliation(s)
- E A Adejuyigbe
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - I Agyeman
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - P Anand
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - H C Anyabolu
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - S Arya
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - E N Assenga
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - S Badhal
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - N W Brobby
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - H K Chellani
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India.
| | - N Chopra
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - P K Debata
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - Q Dube
- Queen Elizabeth Central Hospital, Blantyre, Malawi
| | - T Dua
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
| | - L Gadama
- Department of Obstetrics and Gynaecology, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - R Gera
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - C K Hammond
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - S Jain
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - F Kantumbiza
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - K Kawaza
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - E N Kija
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - P Lal
- Atal Bihari Vajpayee Institute of Medical Sciences &, Dr Ram Manohar Lohia Hospital, New Delhi, 110001, India
| | - M Mallewa
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - M K Manu
- Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - A Mehta
- Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - T Mhango
- Department of Paediatrics and Child Health, Kamuzu University of Health Sciences, Blantyre, Malawi
| | - H E Naburi
- Department of Paediatrics and Child Health, School of Medicine, Muhimbili University of Health and Allied Sciences, Dar Es Salaam, 255, Tanzania
| | - S Newton
- School of Public Health, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
| | - I Nyanor
- Research and Development, Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - P A Nyako
- Department of Psychiatry, Child And Adolescent Mental Health, Komfo Anokye Teaching Hospital, P.O. Box 1934, Adum, Kumasi, Ghana
| | - O J Oke
- Department of Paediatrics and Child Health, Obafemi Awolowo University, Ile-Ife, 220005, Nigeria
| | - A Patel
- Department of Mental Health and Substance Use, World Health Organization, Geneva, Switzerland
- Division of Epilepsy & Clinical Neurophysiology, Boston Children's Hospital, Harvard Medical School, Boston, USA
| | - G Phlange-Rhule
- Clinical Development Services Agency (CDSA), Translational Health Science and Technology Institute (THSTI), NCR Biotech Science Cluster, PO Box #04, Faridabad, 121001, India
| | - R Sehgal
- Department of Pediatrics, Vardhman Mahavir Medical College and Safdarjung Hospital, Ansari Nagar, New Delhi, 110029, India
| | - R Singhal
- Translational Health Science and Technology Institute (THSTI), NCR Biotech Science Cluster, PO Box #04, 121001, Faridabad, India
| | - N Wadhwa
- Faridabad-Gurgaon Expressway, Translational Health Science and Technology Institute, NCR Biotech Science Cluster, 3Rd MilestonePost Box #04, Faridabad, Haryana, 121001, India.
| | - A B Yiadom
- Department of Child Health, Komfo Anokye Teaching Hospital, Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
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Arora T, Arya S, Valadie C, Moreira A. A genomic analysis to create bronchopulmonary dysplasia endotypes. Am J Med Sci 2023. [DOI: 10.1016/s0002-9629(23)00746-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
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Clark EE, Walton M, Chow LML, Boyd JT, Yohannan MD, Arya S. Disseminated Juvenile Xanthogranuloma with a Novel MYH9-FLT3 Fusion Presenting as a Blueberry Muffin Rash in a Neonate. AJP Rep 2023; 13:e5-e10. [PMID: 36816441 PMCID: PMC9937778 DOI: 10.1055/a-2015-1080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Accepted: 12/19/2022] [Indexed: 01/20/2023] Open
Abstract
Juvenile xanthogranuloma (JXG) is a benign proliferative histiocytic disorder of the dendritic cell phenotype. It mostly presents in the pediatric age group as a solitary skin lesion. We describe a rare case of an infant born with disseminated JXG who presented with a blueberry muffin rash at birth. A term infant was noted to have multiple petechiae, purple nodules, and macules (1 mm-2 cm in diameter) and hepatosplenomegaly, at the time of birth. Further investigations revealed thrombocytopenia and direct hyperbilirubinemia and a magnetic resonance imaging showed scattered tiny foci of restricted diffusion in multiple areas of the brain. Patient received multiple platelet transfusions in the first few weeks with gradual improvement in thrombocytopenia. Ultimately, a biopsy of one of the lesions revealed the diagnosis of disseminated JXG with notable atypical features. Somatic mutation analysis showed a novel MYH9-FLT3 fusion, but a bone marrow biopsy was negative. The lesions faded over time, relative to patient's growth and normal neurodevelopment was noted at 18 months of age. JXG should be considered in the differentials of blueberry muffin rash in an infant. Although, JXG is mostly a self-limited condition, congenital disseminated JXG may be associated with significant morbidity and mortality.
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Affiliation(s)
- Emily E Clark
- Department of Neonatology, Dayton Children's Hospital, Dayton, Ohio
| | - Mollie Walton
- Department of Pediatric Cardiology, Children's Mercy Kansas City, Overland Park, Kansas
| | - Lionel M L Chow
- Department of Pediatric Hematology/Oncology, Wright State University Boonshoft School of Medicine and Dayton Children's Hospital, Dayton, Ohio
| | - J Todd Boyd
- Department of Pathology and Laboratory Medicine, Wright State University Boonshoft School of Medicine and Dayton Children's Hospital, Dayton, Ohio
| | - M David Yohannan
- Department of Neonatology, Dayton Children's Hospital, Dayton, Ohio.,Department of Neonatal-Perinatal Medicine, Wright State University Boonshoft School of Medicine and Dayton Children's Hospital, Dayton, Ohio
| | - Shreyas Arya
- Department of Neonatology, Dayton Children's Hospital, Dayton, Ohio.,Department of Neonatal-Perinatal Medicine, Wright State University Boonshoft School of Medicine and Dayton Children's Hospital, Dayton, Ohio
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Arya S, Uzoma A, Robinson A, Moreira AG, Jain SK. Impact of Intrauterine Growth Restriction and Placental Insufficiency on Nutritional Outcomes of Extremely Low Birth Weight Infants. Cureus 2022; 14:e31611. [PMID: 36408302 PMCID: PMC9671266 DOI: 10.7759/cureus.31611] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 11/18/2022] Open
Abstract
Introduction The aim of our study was to assess the impact of intrauterine growth restriction (IUGR) and placental insufficiency (PI) on the nutritional outcomes of extremely low birth weight (ELBW) infants. Methods We conducted a six-year retrospective case-control study that included 117 ELBW infants. Of these, 58 infants had IUGR and 59 were born appropriate-for-gestational age (AGA). Infants with IUGR were further divided based on the presence or absence of PI, as determined by umbilical arterial doppler velocimetry on serial ultrasounds. Results IUGR infants with PI had the lowest enteral calorie intake at 28 days of life (DOL) (median intake- IUGR+PI: 32 vs IUGR-PI: 93 vs AGA: 110 kcal/kg/day; p-value 0.011) and at 36 weeks corrected gestational age (CGA) (median intake- IUGR+PI: 102 vs IUGR-PI: 125 vs AGA: 119 kcal/kg/day; p-value 0.012). These infants also trended towards requiring a longer duration of total parenteral nutrition (TPN) (median duration - IUGR+PI: 35 vs IUGR-PI: 25 vs AGA: 21 days; p-value 0.054) and higher incidence of conjugated hyperbilirubinemia (IUGR+PI: 43% IUGR-PI: 29% vs AGA: 16%; p-value 0.058), but these results did not reach statistical significance. Despite challenges with enteral nutrition, IUGR infants with PI showed good catch-up growth and had higher growth velocities over the first month of life, compared to AGA controls. Conclusion IUGR in the presence of PI is associated with significantly poorer enteral nutritional outcomes in ELBW infants. However, with the support of optimal parenteral nutrition these infants showed good catch-up growth.
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O'Mahony CJ, Reynolds IS, Arya S, Ryan ER, Martin ST. Management of Cylindrical Battery Ingestion. Ir Med J 2022; 115:657. [PMID: 36327988] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/16/2023]
Abstract
Presentation A female presented to the Emergency Department following ingestion of an unknown number of cylindrical batteries. Diagnosis Abdominal X-ray confirmed the presence of multiple batteries located throughout the abdomen. Treatment A trial of conservative management was pursued, and five AA batteries were successfully passed per rectum. Serial X-rays over three weeks revealed that the majority of batteries failed to pass. A decision was made to perform a laparotomy, and 46 cylindrical batteries were removed from the stomach through a small gastrotomy. Four batteries located in the colon were milked into the rectum and removed via the transanal route. Discussion Using daily clinical exams and weekly plain films of the abdomen, conservative management is possible if a small number of batteries are ingested and make it to the stomach. However, the potential of cylindrical batteries to result in acute surgical emergencies should not be underestimated.
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Affiliation(s)
- C J O'Mahony
- Department of Colorectal Surgery, St. Vincent's University Hospital, Dublin 4, Ireland
| | - I S Reynolds
- Department of Colorectal Surgery, St. Vincent's University Hospital, Dublin 4, Ireland
| | - S Arya
- Department of Colorectal Surgery, St. Vincent's University Hospital, Dublin 4, Ireland
| | - E R Ryan
- Department of Radiology, St. Vincent's University Hospital, Dublin 4, Ireland
| | - S T Martin
- Department of Colorectal Surgery, St. Vincent's University Hospital, Dublin 4, Ireland
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Alemao NNG, Gowda S, Jain A, Singh K, Piplani S, Shetty PD, Dhawan S, Arya S, Chugh Y, Piplani S. Leigh's disease, a fatal finding in the common world: A case report. Radiol Case Rep 2022; 17:3321-3325. [PMID: 35855859 PMCID: PMC9287779 DOI: 10.1016/j.radcr.2022.06.060] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Revised: 06/11/2022] [Accepted: 06/21/2022] [Indexed: 11/21/2022] Open
Abstract
Leigh syndrome is a neurodegenerative mitochondrial disorder of childhood characterized by symmetrical spongiform lesions in the brain. The clinical presentation of Leigh's syndrome can vary significantly. However, in the majority of cases, it usually presents as a progressive neurological disease involving motor and cognitive development. It is common to see signs and symptoms of the midbrain and brainstem involvement. Limited data are present on the brain processes occurring in Leigh's syndrome which can be attributed to fatal respiratory failure. Raised lactate levels in the blood and/or cerebrospinal fluid are noted. Magnetic resonance imaging (MRI) findings such as necrotic, symmetrical lesions in the BG/brain stem are helpful in arriving at the diagnosis of Leigh's syndrome. It's of utmost importance to determine whether fatal respiratory failure can be predicted based on clinical characteristics and findings on MRI. In our report, we presented 3 cases from rural India, including a 2-year-old male child presenting with UMN lesion signs, a 3-month-old female infant with delayed developmental milestones with lab results suggestive of Leigh's disease, and a 12-year-old female child with epistaxis and generalized weakness. As discussed above, all 3 cases presented differently with a variety of signs and symptoms and would have gone undiagnosed without the use of brain imaging. The study concluded with the impression that while MRI is essential to the initial diagnosis of Leigh's disease, MRI alone cannot be used to predict fatal respiratory failure in patients with Leigh's disease. In any dilemma regarding diagnosis even with MRI, molecular studies remain the gold standard.
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Affiliation(s)
| | - Suraj Gowda
- Department of Radiology, MVJ Medical College and Research Hospital, Hoskote, Karnataka, 562 114, India
| | - Arpit Jain
- Department of Medicine, KAHER's Jawaharlal Nehru Medical College, Belagavi, Karnataka, 590 010, India
| | - Kamaldeep Singh
- Department of Medicine, KAHER's Jawaharlal Nehru Medical College, Belagavi, Karnataka, 590 010, India
| | - Saloni Piplani
- Department of Audiology and Speech Language Pathology, Sawai Man Singh Medical College and Attached Hospitals, Jaipur, Rajasthan, 302 004, India
| | | | - Samarth Dhawan
- Department of Liver Transplant, Montefiore Moses Hospital, Albert Einstein College of Medicine, Bronx, NY 10467, USA
| | - Shreyas Arya
- Department of Neonatal/Perinatal Medicine, Dayton's Children Hospital, Wright State University Boonshoft School of Medicine, Dayton, OH, USA
| | - Yashasvi Chugh
- Department of Cardiology, Abbott Northwestern Hospital, Minneapolis Heart Institute, Minneapolis, MN 55407, USA
| | - Shobhit Piplani
- Department of Medicine, KAHER's Jawaharlal Nehru Medical College, Belagavi, Karnataka, 590 010, India
- Corresponding author.
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Arya S, George AJ. Trivialization of Aggression Against Women in India: An Exploration of Life Writings and Societal Perception. Front Psychol 2022; 13:923753. [PMID: 35874423 PMCID: PMC9301204 DOI: 10.3389/fpsyg.2022.923753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2022] [Accepted: 06/23/2022] [Indexed: 11/13/2022] Open
Abstract
Purpose Aggression, or an action that intend to harm, encompasses different forms with varying intensity, impact, and salient features. Globally and in Indian context specifically, aggression against women is often normalized if there is no physical aggression involved as the hurt caused tends to be invisible. The current study explored the perceived intensity of physical, verbal, and sexual aggression among south Indian adults. Method Aggressive instances from the life writings of two south Indian women were chosen and were rated by five independent coders to check inter-coder reliability. The select narratives disclose instances of domestic aggression. Ten instances with highest ratings were chosen as the material for data collection. Adults (N = 145) from two southern states had reported the perceived intensity of aggression in each context. Textual analysis and ANOVA were the analytic techniques adopted. Results The results indicate trivialization of verbal aggression compared to physical and sexual aggression. Further, the instances of verbal or more subtle aggression were perceived as even more trivial when the respondents got exposed to the instances of explicit physical and sexual aggressions first. Conclusions The findings indicate trivialization of verbal and implicit forms of aggression, particularly when exposed along with physical and explicit forms of aggression. Consequences of different forms of aggression were not considered significant by the respondents. Suggestions for further studies, changes in policy-making, and law-enforcement were made based on the current results.
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Affiliation(s)
- S. Arya
- Department of English, School of Humanities and Languages, Central University of Karnataka, Gulbarga, India
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Ghanem A, Maahs L, Gutta R, Tang A, Gilbert M, Arya S, Saheli Z, Tam S, Sheqwara J, Siddiqui F. Does Cetuximab Reduce the Risk of Anemia in Patients Undergoing Radiation Therapy for Head and Neck Cancers? Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2021.12.141] [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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Retiz K, Althouse A, Meyer J, Arya S, Goodney P. Association of Smoking With Postprocedural Complications Following Open and Endovascular Interventions for Intermittent Claudication. J Vasc Surg 2022. [DOI: 10.1016/j.jvs.2021.12.003] [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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14
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Mukthapuram S, Beebe J, Tkach JA, Arya S, Haberman B, Peiro J, Lim FY, Woods JC, Kingma PS. Magnetic Resonance Imaging Assessment of Pulmonary Vascularity in Infants with Congenital Diaphragmatic Hernia: A Novel Tool for Direct Assessment of Severity of Pulmonary Hypertension and Hypoplasia. J Pediatr 2021; 239:89-94. [PMID: 34339729 DOI: 10.1016/j.jpeds.2021.07.059] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/05/2021] [Revised: 07/23/2021] [Accepted: 07/26/2021] [Indexed: 11/25/2022]
Abstract
OBJECTIVES To assess the feasibility of magnetic resonance imaging (MRI) for postnatal assessment of pulmonary vascularity in infants with congenital diaphragmatic hernia (CDH). STUDY DESIGN Infants with prenatally diagnosed CDH (n = 24) received postnatal pulmonary MRI. Infants with nonpulmonary birth defects served as controls (n = 5). Semiautomatic segmentation was performed to obtain total vascular volume using time of flight images to assess vascularity. RESULTS Average vascular density (vascular volume/lung volume) in control infants was 0.23 ± 0.06 mm3/mm3 compared with 0.18 ± 0.06 mm3/mm3 in infants with CDH is (P = .09). When stratified further based on CDH severity, the difference between control infants and moderate CDH group was statistically significant. (0.23 mm3/mm3 vs 0.15 mm3/mm3, P = .01). Ipsilateral vascular density on MRI in infants with CDH significantly correlated with the prenatal pulmonary hypertensive index (P = .0004, Spearman R = +0.87) and with number of days on mechanical ventilation (P = .04, Spearman R = -0.44), total days on inhaled nitric oxide (P = .02, Spearman R = -0.47), use of epoprostenol for acute pulmonary hypertension (PH) (0.14 mm3/mm3 vs 0.20 mm3/mm3, P = .005), and use of sildenafil for chronic PH (0.15 mm3/mm3 vs 0.19 mm3/mm3, P = .03). CONCLUSIONS Our results suggest that postnatal pulmonary vascularity assessed by MRI strongly correlates with prenatal and postnatal markers of PH severity and that pulmonary vascularity may serve as a direct measure of pulmonary vascular hypoplasia in infants with CDH.
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Affiliation(s)
- Shanmukha Mukthapuram
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jessica Beebe
- Department of Physiology and Biophysics, Case Western Reserve School of Medicine, Cleveland, OH
| | - Jean A Tkach
- Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Shreyas Arya
- Department of Newborn Medicine, Dayton Children's Hospital, Dayton, OH
| | - Beth Haberman
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jose Peiro
- Fetal Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Foong-Yen Lim
- Fetal Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Surgery, University of Cincinnati College of Medicine, Cincinnati, OH
| | - Jason C Woods
- Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Paul S Kingma
- The Perinatal Institute, Section of Neonatology, Perinatal and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Department of Pediatrics, University of Cincinnati College of Medicine, Cincinnati, OH; Center for Pulmonary Imaging Research, Division of Pulmonary Medicine and Department of Radiology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH; Fetal Care Center, Cincinnati Children's Hospital Medical Center, Cincinnati, OH.
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Devi KJ, Singh M, Maan AS, Thomas O, Kaur G, Arya S, Kaur J. Effect of type 1 tympanoplasty on the quality of life of patients suffering from chronic otitis media (safe type). Niger J Clin Pract 2021; 24:1641-1644. [PMID: 34782502 DOI: 10.4103/njcp.njcp_23_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Chronic otitis media (COM) remains a major public health issue and is associated with relentless discharge from the ear, pain, significant functional limitation of hearing, leading to communication problems and frequent specialist visits. Aims To assess the improvement in quality of life of patients of COM (safe type) and surgical success in terms of graft uptake and improvement in hearing. Patients and Methods A prospective questionnaire-based outcome study was directed in 100 patients with COM who were treated with Type I Tympanoplasty at our institution between May 2018 and May 2020. All patients were asked to fill Modified Chronic Otitis Media 4 (COM-4) survey before operation and 3 months after operation. Preoperative and postoperative total ear scores, audiological results, postoperative graft uptake were assessed. Results The correlation between preoperative and postoperative assessment by questionnaire was statistically critical (P < 0.001). There was significant improvement in hearing postoperatively (P < 0.001). Effective graft uptake was seen in 80%. Conclusion The current study emphasizes that Type 1 Tympanoplasty fundamentally improves quality of life of patients in terms of physical suffering, hearing loss, emotional distress postoperatively.
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Affiliation(s)
- K J Devi
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
| | - M Singh
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
| | - A S Maan
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
| | - O Thomas
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
| | - G Kaur
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
| | - S Arya
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
| | - J Kaur
- Department of Otorhinolaryngology, Government Medical College, Amritsar, Punjab, India
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Rajkumar E, Mitra J, Yadav R, Hareesh PV, Gangadharan A, Gopika MC, Christa AB, George AJ, Gopi A, John R, Arya S, Abraham J, Rajashekaran L. Family violence during COVID-19 and its impact on mental health of children: A systematic review. J Child Adolesc Ment Health 2021; 33:75-89. [PMID: 38041435 DOI: 10.2989/17280583.2023.2261992] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2023]
Abstract
Purpose: The COVID-19 pandemic posed unanticipated challenges that could impact how the family system operates across the world. Restrictions imposed to control the rapid spread of the virus substantially increased violence in families. The current study aims to review violence in the family and its impact on the mental health of children during the pandemic.Method: A systematic search was conducted using keywords in the electronic databases PubMed, PsycINFO, and Web of Science, and a manual search was conducted on Google Scholar for articles from January 2020 to January 2021. Of the 50 records identified, seven studies that met eligibility criteria were selected for final analysis.Results: Results revealed that family violence during the pandemic has escalated the mental health problems of children, including aggressive and self-harming behaviours. Lockdown restrictions, social detachment, financial instability, fear of infection, and unemployment led to increased parental stress. Parents with a higher level of stress were more likely to maltreat their children.Conclusions: Exposure to short and long-term family violence can adversely impact the mental health of children and can negatively affect a child's present and future life. Recommendations for researchers, mental health practitioners, public health authorities, and other service providers are also outlined.
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Affiliation(s)
- Eslavath Rajkumar
- Department of Liberal Arts, Indian Institute of Technology Bhilai, Chattisgarh, India
| | - Jayashree Mitra
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - Reethika Yadav
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - P V Hareesh
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | | | - M C Gopika
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - Anamika Ben Christa
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - Allen Joshua George
- Liberal Arts & Sciences, Indian Institute of Management, Ranchi, Jharkhand, India
| | - Aswathy Gopi
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - Romate John
- Department of Psychology, Central University of Karnataka, Kalaburagi, Karnataka, India
| | - S Arya
- Amity Institute of English Studies & Research, Ranchi, Jharkhand, India
| | - John Abraham
- Department of Family Medicine/Geriatrics, St. Johns National Academy of Health Sciences, Bangalore, Karnataka, India
| | - L Rajashekaran
- Department of Folklore & Tribal Studies, Central University of Karnataka, Kalaburagi, Karnataka, India
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Arya S, Subramani T, Vennila G, Karunanidhi D. Health risks associated with fluoride intake from rural drinking water supply and inverse mass balance modeling to decipher hydrogeochemical processes in Vattamalaikarai River basin, South India. Environ Geochem Health 2021; 43:705-716. [PMID: 31853770 DOI: 10.1007/s10653-019-00489-y] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/02/2019] [Indexed: 05/21/2023]
Abstract
Preliminary investigation reveals that fluorosis is reported due to the continuous intake of fluoride-rich groundwater in Vattamalikarai River basin, Tamil Nadu, India. A detailed study was attempted for evaluating the health risks associated with the intake of fluoride-rich groundwater supplied to the rural community. Groundwater samples were collected from 60 and 58 dug and tube wells during winter and southwest (SW) monsoon seasons respectively. The samples were analyzed for the determination of fluoride and other chemical parameters to examine the fitness for drinking water. Spatio-temporal variation maps reveal that fluoride concentration is high during SW monsoon season when compared with the winter season in this region. The fluoride bearing minerals present in hornblende-biotite gneiss and charnockite rock formations leached into the groundwater during rock-water interaction. To understand the subsurface hydrogeochemical reactions, inverse mass balance model was developed using NETPATH code. The model output indicates that calcite dilution, silicate (hornblende and biotite) weathering, ion exchange (Ca/Na and Mg/Na) and illite precipitation are the dominant processes controlling the groundwater chemistry along the flow paths. Non-carcinogenic risks to children and adults (women and men) were evaluated by working out intake exposure of groundwater. Hazard quotient (HQ) based on fluoride intake was calculated for children and adults. It varied from 0.08 to 2.21 with an average of 1.07 for adults. For children, it varied from 0.01 to 2.99 with the mean of 1.44. About 78%, 69% and 61% of the samples fall under the risk category for children, women and men during winter season. However, more number of samples possessed health risks (83% of samples for children, 73% of samples for women and 64% of samples for men) during SW monsoon season.
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Affiliation(s)
- S Arya
- Public Works Department (PWD), Government of Tamil Nadu, Tirunelveli, India.
| | - T Subramani
- Department of Geology, CEG, Anna University, Chennai, 600025, India.
| | - G Vennila
- Department of Civil Engineering, K. S. Rangasamy College of Technology, Tiruchengode, 637211, India
| | - D Karunanidhi
- Department of Civil Engineering, Sri Shakthi Institute of Engineering and Technology (Autonomous), Coimbatore, 641062, India
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Barrett K, Habib Bedwani N, Arya S, Bhargava A. Colorectal cancer referrals during the COVID-19 pandemic - a model for the faster diagnosis standard? Br J Surg 2020; 107:e531-e532. [PMID: 32871025 PMCID: PMC7929102 DOI: 10.1002/bjs.12008] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Subscribe] [Scholar Register] [Received: 07/23/2020] [Accepted: 07/27/2020] [Indexed: 11/21/2022]
Affiliation(s)
- K Barrett
- Department of Surgery, Digestive Diseases Centre, King George Hospital, Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT), Barley Lane, Goodmayes, London, IG3 8YB
| | - N Habib Bedwani
- Department of Surgery, Digestive Diseases Centre, King George Hospital, Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT), Barley Lane, Goodmayes, London, IG3 8YB
| | - S Arya
- Department of Surgery, Digestive Diseases Centre, King George Hospital, Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT), Barley Lane, Goodmayes, London, IG3 8YB
| | - A Bhargava
- Department of Surgery, Digestive Diseases Centre, King George Hospital, Barking Havering and Redbridge University Hospitals NHS Trust (BHRUT), Barley Lane, Goodmayes, London, IG3 8YB
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English W, Vulliamy P, Banerjee S, Arya S. Surgical training during the COVID-19 pandemic - the cloud with a silver lining? Br J Surg 2020; 107:e343-e344. [PMID: 32662537 PMCID: PMC7404654 DOI: 10.1002/bjs.11801] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2020] [Accepted: 05/26/2020] [Indexed: 02/06/2023]
Affiliation(s)
- W English
- Surgical Trainee Year 4 (ST4), N.E. Thames Higher Surgical Training Programme, London, UK.,National Bowel Research Centre, London, UK
| | - P Vulliamy
- Surgical Trainee Year 6 (ST6), N.E. Thames Higher Surgical Training Programme, London, UK.,Centre for Trauma Sciences, London, UK
| | - S Banerjee
- Consultant Colorectal and General Surgeon, Endoscopy and Joint Gastoenterology Lead, SAC (Liason Member) JCST, Royal College Surgical Tutor, ISTP Clinical Lead, London, UK
| | - S Arya
- Surgical Trainee Year 8 (ST8), N.E. Thames Higher Surgical Training Programme, London, UK
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Arya S, Ahmadkhaniha H, Arya B. Metabolic Syndrome in Patients with Bipolar Disorder Treated with Atypical Antipsychotics, their First-degree Relatives and Control Group. Eur Psychiatry 2020. [DOI: 10.1016/j.eurpsy.2017.01.1888] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
Introduction and objectivePatients with serious mental illness have lower life expectancy and higher prevalence of metabolic syndrome compared to normal population. Although, we have little evidence about their first-degree relatives.AimsTo compare metabolic syndrome in patients with bipolar disorder treated with atypical antipsychotics, their first degree relatives and healthy subjects in two age groups: under and over 40.MethodsThis cross-sectional study was conducted on 100 patients with bipolar disorder treated with atypical antipsychotics, 50 first degree relatives and 135 healthy subjects. The prevalence of metabolic syndrome was assessed based on National Cholesterol Education Program (NCEP).ResultsUnder the age of 40, the prevalence of metabolic syndrome was 15.4% in patients with Bipolar disorder, 17.6% in first degree relatives and 7% in healthy subjects. Systolic blood pressure was significantly higher in bipolar disorder patients (P = 0.004). In those over 40, the prevalence of metabolic syndrome was 31.8% in patients with bipolar disorder, 33.3% in first-degree relatives and 32.8% in healthy subjects. Serum levels of HDL were significantly lower in bipolar disorder patients (P = 0.002).ConclusionPatients with bipolar disorder and their first-degree relatives have greater chance for cardiovascular disease due to higher metabolic syndrome. Further investigations are needed for evaluating serious mental illness patients and their relatives.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Roy MP, Bhatt M, Maurya V, Arya S, Gaind R, Chellani HK. Changing trend in bacterial etiology and antibiotic resistance in sepsis of intramural neonates at a tertiary care hospital. J Postgrad Med 2019; 63:162-168. [PMID: 28272077 PMCID: PMC5525480 DOI: 10.4103/0022-3859.201425] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Background: Septicemia is an important cause of neonatal morbidity and mortality. However, organized data on causative organisms and their resistant pattern are scanty from developing countries. The changing trend in causative organisms and their antibiotic resistance is yet to be documented in India. The present study examines the trends in bacterial profile and antibiotic resistance of the organisms causing sepsis in hospitalized neonates. Materials and Methods: A retrospective laboratory-based analysis of blood cultures obtained from Neonatal Intensive Care Unit of a tertiary care hospital in New Delhi was done for the period of 1999–2014, divided into five phases. Results: A total of 4700 isolates were considered. Over time, Gram-negative organisms have replaced Gram-positives as frequent isolates. Initially, there was predominance of Klebsiella pneumoniae, then of Staphylococcus aureus which recently has been changed with coagulase negative-Staphylococcus and Acinetobacter. Growing resistance against the first and second line of drugs has been noted, including methicillin-resistant S. aureus and vancomycin-resistant Enterococcus. Conclusion: The etiological profile of neonatal sepsis has changed tremendously in the past 15 years. High resistance against common drugs necessitates continued surveillance and review of empirical antibiotic policy for neonatal sepsis. These steps are important to effectively curtail the surge of further antibiotic resistance.
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Affiliation(s)
- M P Roy
- Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi, India
| | - M Bhatt
- Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi, India
| | - V Maurya
- Department of Microbiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - S Arya
- Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi, India
| | - R Gaind
- Department of Microbiology, VMMC and Safdarjung Hospital, New Delhi, India
| | - H K Chellani
- Department of Pediatrics, VMMC and Safdarjung Hospital, New Delhi, India
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Arya S, Melton K. Case 2: Seizures, Apnea, Lethargy, and Persistent Hiccups in a Full-Term Newborn. Neoreviews 2019; 20:e295-e297. [PMID: 31261082 DOI: 10.1542/neo.20-5-e295] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Affiliation(s)
- Shreyas Arya
- Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - Kristin Melton
- Neonatology and Pulmonary Biology, Cincinnati Children's Hospital Medical Center, Cincinnati, OH
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Gupta G, Sharma S, Arya S, Jinagal J. Bilateral lens subluxation in Marfan syndrome. QJM 2019; 112:383-384. [PMID: 30517757 DOI: 10.1093/qjmed/hcy285] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- G Gupta
- Advanced Eye Centre, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Sharma
- Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - S Arya
- Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India
| | - J Jinagal
- Department of Ophthalmology, Government Medical College and Hospital, Sector 32, Chandigarh, India
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Nanda S, Arya S, Tiwari V, Srikumar V, Kumar U, Bhatia R. Transcranial Magnetic Stimulation (TMS) induced Motor Evoked Potential (MEP) in Chronic Pain Patients. Brain Stimul 2019. [DOI: 10.1016/j.brs.2018.12.623] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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Verma K, Engineer R, Ostwal V, Kumar S, Arya S, Desouza AL, Saklani AP. Persistent involvement of anterior mesorectal fascia in carcinoma rectum - extended resection of rectum vs total pelvic exenteration: results from a single-centre retrospective study. Colorectal Dis 2018; 20:1070-1077. [PMID: 29985547 DOI: 10.1111/codi.14336] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/12/2018] [Accepted: 06/13/2018] [Indexed: 12/21/2022]
Abstract
AIM Involvement of the anterior mesorectal fascia (iAMRF) after neoadjuvant treatment leads to either resection of the involved organ alone [extended resection of the rectum (ERR)] or total pelvic exenteration (TPE). The purpose of this study was to compare the rate of recurrence and survival of patients undergoing ERR or TPE for iAMRF after neoadjuvant treatment. The outcome of patients who underwent total mesorectal excision after downstaging was also compared. METHOD This was a retrospective study of primary rectal cancer patients. RESULTS Of 237 patients, 61 (21.5%) patients with nonmetastatic carcinoma rectum had iAMRF at baseline. Ten patients defaulted before completion of neoadjuvant chemoradiotherapy. After neoadjuvant chemoradiotherapy, 22 patients (43.1%) developed systemic metastases, seven patients (13.8%) were downstaged to free anterior mesorectal fascia and underwent total mesorectal excision (anterior resection/abdominoperineal resection) and the remaining 22 patients (43.1%) had persistent iAMRF. Thirteen patients with persistent iAMRF underwent ERR, whereas nine patients underwent TPE. The median duration of hospital stay in the TPE group was 13 days (10-26), whereas it was 7 days (5-21) in the ERR group. A clear circumferential resection margin, R0 resection, was achieved in all patients with TPE and ERR. After a median follow-up of 31.6 months, five patients with TPE (55.6%), four patients with ERR (30.7%) and three patients in the downstaged group (42.9%) developed systemic recurrence. None of the patients with TPE and the downstaged group developed local recurrence, whereas three patients with ERR (23.1%) developed local recurrence. Median disease-free survival was 12.3 months in the TPE group, 18.9 months in the ERR group and 10.6 months in the downstaged group, whereas mean overall survival was 36.2, 32.8 and 27.9 months, respectively. CONCLUSION Although there is no significant difference in the overall survival and disease-free survival, ERR is associated with a high risk of local recurrence compared to TPE and the downstaged group.
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Affiliation(s)
- K Verma
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - R Engineer
- Department of Radiation Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - V Ostwal
- Department of Medical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - S Kumar
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - S Arya
- Department of Radiodiagnosis, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A L Desouza
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
| | - A P Saklani
- Department of Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
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Chaukar DA, Dandekar M, Kane S, Arya S, Purandare N, Rangarajan V, D'Cruz AK. Invasion of the mandible in gingivobuccal complex cancers: Histopathological analysis of routes of tumour entry and correlation with preoperative assessment. Oral Oncol 2018; 86:181-187. [DOI: 10.1016/j.oraloncology.2018.09.022] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2018] [Revised: 07/25/2018] [Accepted: 09/16/2018] [Indexed: 01/18/2023]
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Arya S, Bhargava V, Richardson J, Hawkins HK. Diffuse Chorangiomatosis as a Cause of Cardiomegaly, Microangiopathic Hemolytic Anemia and Thrombocytopenia in a Newborn. Fetal Pediatr Pathol 2017; 36:457-464. [PMID: 29227711 DOI: 10.1080/15513815.2017.1379041] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
INTRODUCTION The hallmark of diffuse chorangiomatosis is capillary dysvasculogenesis, diffusely involving the placenta. It can cause massive placental enlargement and may have adverse fetal effects. CASE REPORT A 32 weeks gestation male infant was born via cesarean section and had a placenta weighing 900 g. There was diffuse vascular proliferation involving the stem villi and intermediate villi. Short Nucleotide Polymorphism (SNP) microarray analysis of the placenta showed no biparental mosaicism or loss of heterozygosity, ruling out placental mesenchymal dysplasia. The infant also had cardiomegaly, microangiopathic hemolytic anemia and thrombocytopenia which spontaneously improved over time. CONCLUSION Diffuse chorangiomatosis can be associated with hemolysis, thrombocytopenia and cardiomegaly in the newborn. However, once delivered, these findings can spontaneously resolve over time.
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Affiliation(s)
- Shreyas Arya
- a Cincinnati Children's Hospital Medical Center , Cincinnati , Ohio , United States
| | - Vidit Bhargava
- b University of Texas Medical Branch at Galveston , Galveston , Texas , United States
| | - Joan Richardson
- b University of Texas Medical Branch at Galveston , Galveston , Texas , United States
| | - Hal K Hawkins
- b University of Texas Medical Branch at Galveston , Galveston , Texas , United States
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Arya S, Ahmadkhaniha H, Alavi K, Arya B, Zarei Z. C-reactive protein and parathyroid hormone in acute severe psychotic disorders (schizophrenia, bipolar disorder and methamphetamine-induced psychotic disorder). Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.2104] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/19/2022] Open
Abstract
Introductionand objectives Schizophrenia accompanies with elevated C-reactive protein (CRP) and vitamin D deficiency. However, there are scarce documentations regarding bipolar disorder and methamphetamine-induced psychotic disorder.AimTo compare serum levels of vitamin D, parathyroid hormone (PTH), calcium, phosphorus and CRP levels in psychotic disorder patients and control group.MethodsA case-control study was conducted on four groups: acute phase of schizophrenia, acute manic episode of bipolar disorder, methamphetamine-induced psychotic disorder and healthy control subjects. Sample size was 45 in each group. Weekly duration of sun exposure, monthly vitamin D intake and serum levels of vitamin D, calcium, phosphorus, PTH and CRP were assessed. Brief Psychiatric Rating Scale (BPRS) was used to evaluate psychotic symptoms.ResultsDuration of sun exposure and monthly vitamin D intake were comparable among groups. Serum levels of vitamin D, calcium and phosphorus were not statistically different between groups (P = 0.463, P = 0.086 and P = 0.339, respectively). Serum levels of PTH were significantly higher in control group (P < 0.001). CRP levels were significantly lower in control subjects (P < 0.001). The levels of serum vitamin D and CRP did not show statistically significant difference among three groups of patients.ConclusionAcute psychotic disorders seem to be associated with higher CRP and lower PTH levels. Clinical importance of the findings and relation of these differences to the metabolic and inflammatory bases of psychosis are not clear yet.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Mahajan A, Vaish R, Sable N, Arya S, Kane S, D'Cruz A. 391P Incremental value of preoperative CT in the surgical management of papillary thyroid cancer. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw587.033] [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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Mahajan A, Vaish R, Sable N, Arya S, Kane S, D'Cruz A. 391P Incremental value of preoperative CT in the surgical management of papillary thyroid cancer. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00549-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Noronha V, Patil V, Joshi A, Muddu V, Bhattacharjee A, Juvekar S, Arya S, Chaturvedi P, Chaukar D, Pai PS, Dcruz AK, Prabhash K. Is taxane/platinum/5 fluorouracil superior to taxane/platinum alone and does docetaxel trump paclitaxel in induction therapy for locally advanced oral cavity cancers? Indian J Cancer 2016; 52:70-3. [PMID: 26837979 DOI: 10.4103/0019-509x.175604] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Cisplatin and 5 fluorouracil drug combination is inferior to the combination of taxane with these 2 drugs. However, often in clinical practice at our center giving TPF (docetaxel, cisplatin, 5 fluorouracil) is difficult in view of logistics and tolerance issues. In such a scenario, we prefer to use the 2 drugs combination of platinum and taxane. However, no study has addressed whether a 2 drugs combination, which includes taxane is inferior to the 3 drugs combination and which the taxane of choice is in the 2 drugs combination of taxane and platinum. METHODS This is a retrospective analysis of prospectively collected data of patients undergoing induction chemotherapy (IC) in oral cavity cancers from 2010 to 2012. We chose for analysis those patients who had a baseline scan done within 4 weeks of starting therapy and a follow-up scan done within 2 weeks of completion of the second cycle of IC. Response was scored in accordance with RECIST version 1.1. Chi-square analysis was done to compare response rates (RRs) between regimens. RESULTS Two hundred and forty-five patients were identified. The median age was 45 years (24-70 years), 208 (84.9%) were male patients, and 154 patients (62.9%) had primary in the Buccal mucosa. The regimens received were TPF 22 (9%), docetaxel + cisplatin 97 (39.6%), paclitaxel + cisplatin 89 (36.3%), docetaxel + carboplatin 16 (6.5%) and paclitaxel + carboplatin 21 (8.6%). The overall RRs were complete response, partial response, stable disease and progressive disease in 4 (1.6%), 56 (22.9%), 145 (59.2%) and 40 (16.3%). The 3 drugs regimen (TPF) had 50% RR as compared to 22% RR with 2 drugs regimen (P = 0.004). Docetaxel containing regimens had 30.3% RR as compared to 17.2% RR with paclitaxel containing regimens (P = 0.094). CONCLUSIONS TPF has better RR than a 2 drugs taxane-containing regimen and docetaxel leads to a better RR than paclitaxel for IC in locally advanced oral cavity cancers.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | | | | | - K Prabhash
- Department of Medical Oncology, Surgical Oncology, Tata Memorial Centre, Mumbai, Maharashtra, India
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Dasgupta S, Arya S, Choudhary S, Jain SK. Amniotic fluid: Source of trophic factors for the developing intestine. World J Gastrointest Pathophysiol 2016; 7:38-47. [PMID: 26909227 PMCID: PMC4753188 DOI: 10.4291/wjgp.v7.i1.38] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/27/2015] [Revised: 10/20/2015] [Accepted: 01/07/2016] [Indexed: 02/06/2023] Open
Abstract
The gastrointestinal tract (GIT) is a complex system, which changes in response to requirements of the body. GIT represents a barrier to the external environment. To achieve this, epithelial cells must renew rapidly. This renewal of epithelial cells starts in the fetal life under the influence of many GIT peptides by swallowing amniotic fluid (AF). Development and maturation of GIT is a very complex cascade that begins long before birth and continues during infancy and childhood by breast-feeding. Many factors like genetic preprogramming, local and systemic endocrine secretions and many trophic factors (TF) from swallowed AF contribute and modulate the development and growth of the GIT. GIT morphogenesis, differentiation and functional development depend on the activity of various TF in the AF. This manuscript will review the role of AF borne TF in the development of GIT.
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Pradhan A, Rekhi B, Gulia A, Desai S, Arya S. Utility of fine needle aspiration cytology in detecting metastatic deposits in an uncommon case of malignant transformation in a giant cell tumour of bone. Cytopathology 2015; 27:505-507. [PMID: 26614564 DOI: 10.1111/cyt.12278] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- A Pradhan
- Department of Surgical Pathology, Tata Memorial Hospital, Parel, Mumbai, India
| | - B Rekhi
- Department of Surgical Pathology, Tata Memorial Hospital, Parel, Mumbai, India
| | - A Gulia
- Department of Surgical Oncology (Bone and Soft Tissues), Tata Memorial Hospital, Parel, Mumbai, India
| | - S Desai
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, India
| | - S Arya
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai, India
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Arya S, Richardson CJ, Jain S, Swischuck LE. Early Vitamin K Deficiency Bleeding in a Neonate Associated with Maternal Acute Fatty Liver of Pregnancy. AJP Rep 2015; 5:e193-5. [PMID: 26495183 PMCID: PMC4603847 DOI: 10.1055/s-0035-1557107] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Accepted: 05/28/2015] [Indexed: 11/15/2022] Open
Abstract
Introduction Acute fatty liver of pregnancy (AFLP) is a rare but potentially fatal condition occurring in the third trimester or early postpartum period. It is characterized by microvesicular fatty infiltration of the liver. Clinically, the three most prominent derangements in women with AFLP are hepatic dysfunction, renal insufficiency, and impaired coagulation. AFLP is associated with an increased incidence of morbidity and mortality in neonates, though the exact cause for this remains unclear. Deficiency of vitamin K in patients with liver disease has been widely reported. Case Description We present a unique case of severe intracranial bleeding because of the early vitamin K deficiency in a neonate whose mother had AFLP along with accompanying renal insufficiency. Conclusion We suggest that monitoring infants born to mothers with AFLP, for vitamin K deficiency bleeding will help reduce morbidity and mortality in these infants.
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Affiliation(s)
- Shreyas Arya
- Department of Pediatrics, University of Texas Medical Branch Galveston, Galveston, Texas
| | - Carol J Richardson
- Department of Pediatrics, Division of Neonatology, University of Texas Medical Branch Galveston, Galveston, Texas
| | - Sunil Jain
- Department of Pediatrics, Division of Neonatology, University of Texas Medical Branch Galveston, Galveston, Texas
| | - Leonard E Swischuck
- Department of Radiology, University of Texas Medical Branch Galveston, Galveston, Texas
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Kane S, Patil VM, Joshi A, Noronha V, Muddu V, Dhumal S, Juvekar S, Arya S, D'Cruz A, Bhattacharjee A, Prabhash K. Neoadjuvant Chemotherapy in Technically Unresectable Oral Cancers: Does Human Papillomavirus Make a Difference? Clin Oncol (R Coll Radiol) 2015; 27:751-3. [PMID: 26412438 DOI: 10.1016/j.clon.2015.09.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2015] [Revised: 08/14/2015] [Accepted: 09/08/2015] [Indexed: 11/24/2022]
Affiliation(s)
- S Kane
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - V M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - A Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - V Muddu
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - S Dhumal
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
| | - S Juvekar
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - S Arya
- Department of Radiodiagnosis, Tata Memorial Hospital, Mumbai, India
| | - A D'Cruz
- Department of Surgical Oncology, Tata Memorial Hospital, Mumbai, India
| | - A Bhattacharjee
- Division of Clinical Research and Biostatistics, Tata Memorial Hospital, Mumbai, India; Malabar Cancer Centre, Kerala, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, India
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Wiggins T, Markar SR, Arya S, Hanna GB. Anastomotic reinforcement with omentoplasty following gastrointestinal anastomosis: A systematic review and meta-analysis. Surg Oncol 2015; 24:181-6. [PMID: 26116395 DOI: 10.1016/j.suronc.2015.06.011] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/06/2015] [Revised: 06/08/2015] [Accepted: 06/14/2015] [Indexed: 10/23/2022]
Abstract
Anastomotic leak is a potentially devastating complication following gastrointestinal anastomosis. Some surgeons believe that reinforcing the anastomosis with omentum reduces the incidence and severity of anastomotic leak. A comprehensive electronic search of EMBASE, Medline, Web of Science and Cochrane databases was performed. Pooled odds ratios (POR) were calculated for discrete variables. There were six studies investigating esophageal anastomosis and 3 studies investigating colorectal anastomosis identified by the literature search. A total of 2296 patients were included, 1073 with omentoplasty and 1223 without. In esophageal surgery omentoplasty significantly reduced the rate of anastomotic leak (2.9% vs 10.5% (POR = 0.28; 95% CI = 0.17 to 0.47; P < 0.0001), but there was no significant effect upon in-hospital mortality (2.3% vs. 2.5%; POR = 0.911 [95% CI 0.439-1.887]; P = 0.802) or anastomotic stricture between the two groups (6.6% vs 9.1%; POR = 0.842 [95% CI 0.331 to 2.145]; P = 0.720). In colorectal surgery there was no significant difference in anastomotic leak rate (5.0% vs 8.4%; POR: 0.50; 95% CI 0.21 to 1.17) or in-hospital mortality (4.2% vs 4.1%; POR: 0.90; 95% CI 0.34 to 2.41). The results of this analysis show that omentoplasty significantly reduced the rate of anastomotic leak following esophageal anastomosis but these results were not observed in colorectal anastomosis. Omentoplasty could be used as an adjunct technique to reduce the incidence of anastomotic leak in oesophageal anastomosis.
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Affiliation(s)
- T Wiggins
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, London, W2 1NY, United Kingdom
| | - S R Markar
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, London, W2 1NY, United Kingdom
| | - S Arya
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, London, W2 1NY, United Kingdom
| | - G B Hanna
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, South Wharf Road, London, W2 1NY, United Kingdom.
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Yadav S, Manglani MV, Narayan DA, Sharma S, Ravish HS, Arora R, Castells VB, Arya S, Oster P. Safety and immunogenicity of a quadrivalent meningococcal conjugate vaccine (MenACYW-DT): a multicenter, open-label, non-randomized, phase III clinical trial. Indian Pediatr 2015; 51:451-6. [PMID: 24986280 DOI: 10.1007/s13312-014-0435-7] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To assess the safety and immunogenicity of a quadrivalent meningococcal (groups A,C,Y,W) polysaccharide diphtheria toxoid conjugate vaccine (MenACYW-DT) in India. DESIGN Open-label, descriptive, non-randomized study. SETTING Three medical college hospitals, one each in New Delhi, Bengaluru and Mumbai, India. PARTICIPANTS 300 healthy, vaccine-naïve participants (100 children aged 2-11 years, 100 adolescents aged 12-17 years, and 100 adults aged 18-55 years). INTERVENTION One dose (0.5 mL) of MenACYW-DT administered intramuscularly. MAIN OUTCOME MEASURES Serum bactericidal antibody titers against A, C, Y, and W were measured before and after MenACWY-DT vaccination. Safety data were also collected. RESULTS Thirty days post-vaccination, geometric mean titers rose across all serogroups. Most participants had protective titers >8 (1/dil) across the four serogroups. The percentage (95% CI) achieving >8 (1/dil) in the Adolescent Group was typical - A: 96.9% (91.2%; 99.4%); C: 96.9% (91.2%; 99.4%); Y:100% (96.3%; 100%); W:100% (96.3%; 100%). In general, solicited reactions were mild and short-lived. Unsolicited events were uncommon and unrelated to vaccination. CONCLUSIONS MenACYW-DT was well tolerated and elicited a robust and protective immune response 30 days post-vaccination against meningococcal serogroups A, C, Y, and W-135 in the Indian study participants aged 2-55 years.
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Affiliation(s)
- Sangeeta Yadav
- Departments of Pediatrics, Maulana Azad Medical College and Lok Nayak Hospital, New Delhi, India; #Lokmanya Tilak Municipal Medical College and General Hospital; Mumbai, India; Community Medicine, Kempegowda Institute of Medical Sciences (KIMS), Bangalore, India; Sanofi Pasteur India Pvt Ltd, Mumbai, India; and Sanofi Pasteur, Lyon, France. Correspondence to: Dr Rohit Arora, Sanofi Pasteur India Pvt Ltd, 54/A, Sir Mathuradas Vasanji Road, Andheri East, Mumbai 400 093, India.
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Engineer R, Gupta P, Chopra S, Patil P, Ostwal V, Dsouza A, Saklani A, Arya S, Shrivastava S. PO-0708: Achieving further response in poor responders to NACRT in by chemotherapy in rectal cancers - prospective study. Radiother Oncol 2015. [DOI: 10.1016/s0167-8140(15)40700-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Arya S, Agarwal N. Letter to the editor concerning: "Immunisation coverage of adults: a vaccination counselling campaign in the pharmacies in Switzerland". Swiss Med Wkly 2015; 145:w14023. [DOI: 10.4414/smw.2015.14023] [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: 11/19/2022] Open
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Arya S, Datta S, Chaturvedi P. Staging the clinically negative neck in T1-T2 oral cancers: USgFNAC and sentinel node biopsy. Cancer Imaging 2014. [PMCID: PMC4242755 DOI: 10.1186/1470-7330-14-s1-s10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Deshpande SS, Thakur MH, Dholam K, Mahajan A, Arya S, Juvekar S. Osteoradionecrosis of the mandible: through a radiologist's eyes. Clin Radiol 2014; 70:197-205. [PMID: 25446325 DOI: 10.1016/j.crad.2014.09.012] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/15/2014] [Revised: 09/01/2014] [Accepted: 09/17/2014] [Indexed: 02/08/2023]
Abstract
Head and neck malignancies constitute a major cause of morbidity and mortality all over the world. Radiotherapy plays a pivotal role in the management of these tumours; however, it has associated complications, with mandibular osteoradionecrosis (ORN) being one of the gravest orofacial complications. Early diagnosis, extent evaluation, and detection of complications of ORN are imperative for instituting an appropriate management protocol. ORN can closely mimic tumour recurrence, the differentiation of which has obvious clinical implications. The purpose of the present review is to acquaint the radiologist with the imaging features of mandibular ORN and the ways to differentiate ORN from tumour recurrence.
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Affiliation(s)
- S S Deshpande
- Department of Radiology, Lokmanya Tilak Municipal Medical College and General Hospital, Sion, Mumbai 400022, India
| | - M H Thakur
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, India
| | - K Dholam
- Department of Dental and Prosthetic Surgery, Tata Memorial Hospital, Parel, Mumbai 400012, India.
| | - A Mahajan
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, India
| | - S Arya
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, India
| | - S Juvekar
- Department of Radiodiagnosis, Tata Memorial Hospital, Parel, Mumbai 400012, India
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Arya S, Rane P, Deshmukh A. Oral cavity squamous cell carcinoma: Role of pretreatment imaging and its influence on management. Clin Radiol 2014; 69:916-30. [DOI: 10.1016/j.crad.2014.04.013] [Citation(s) in RCA: 71] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/05/2013] [Revised: 03/31/2014] [Accepted: 04/15/2014] [Indexed: 11/28/2022]
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Patil VM, Prabhash K, Noronha V, Joshi A, Muddu V, Dhumal S, Arya S, Juvekar S, Chaturvedi P, Chaukar D, Pai P, Kane S, Patil A, Agarwal JP, Ghosh-Lashkar S, Dcruz A. Neoadjuvant chemotherapy followed by surgery in very locally advanced technically unresectable oral cavity cancers. Oral Oncol 2014; 50:1000-4. [PMID: 25130412 DOI: 10.1016/j.oraloncology.2014.07.015] [Citation(s) in RCA: 82] [Impact Index Per Article: 8.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2014] [Revised: 07/23/2014] [Accepted: 07/24/2014] [Indexed: 01/16/2023]
Abstract
BACKGROUND The median survival of technically unresectable oral-cavity cancers (T4a and T4b) with non surgical therapy is 2-12 months. We hypothesized that neoadjuvant chemotherapy (NACT) could reduce the tumour size and result in successful resection and ultimately improved outcomes. We present a retrospective analysis of consecutive patients who received NACT at our centre between January 2008 and August 2012. PATIENTS AND METHODS All patients with technically unresectable oral cancers were assessed in a multidisciplinary clinic and received 2 cycles of NACT. After 2 cycles, patients were reassessed and planned for either surgery with subsequent CTRT or nonsurgical therapy including CT-RT, RT or palliation. SPSS version 16 was used for analysis of locoregional control and overall survival (OS). Univariate and multivariate analysis was done for factors affecting the OS. RESULTS 721 patients with stage IV oral-cavity cancer received NACT. 310 patients (43%) had sufficient reduction in tumour size and underwent surgical resection. Of the remaining patients, 167 received chemoradiation, 3 radical radiation and 241 palliative treatment alone The locoregional control rate at 24 months was 20.6% for the overall cohort, 32% in patients undergoing surgery and 15% in patients undergoing non surgical treatment (p=0.0001). The median estimated OS in patients undergoing surgery was 19.6 months (95% CI, 9.59-25.21 months) and 8.16 months (95%, CI 7.57-8.76) in patients treated with non surgical treatment (p=0.0001). CONCLUSION In our analysis, NACT led to successful resection and improved overall survival in a significant proportion of technically unresectable oral-cancer patients.
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Affiliation(s)
- V M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - K Prabhash
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India.
| | - V Noronha
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - A Joshi
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - V Muddu
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - S Dhumal
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai 400012, India
| | - S Arya
- Department of Radio Diagnosis, Tata Memorial Hospital, Mumbai, India
| | - S Juvekar
- Department of Radio Diagnosis, Tata Memorial Hospital, Mumbai, India
| | - P Chaturvedi
- Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - D Chaukar
- Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - P Pai
- Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
| | - S Kane
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - A Patil
- Department of Pathology, Tata Memorial Hospital, Mumbai, India
| | - J P Agarwal
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
| | - S Ghosh-Lashkar
- Department of Radiation Oncology, Tata Memorial Hospital, Mumbai, India
| | - A Dcruz
- Department of Head and Neck Surgery, Tata Memorial Hospital, Mumbai, India
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Arya S, Pareek P, Nehra A, Mercy A, Chaudhury AR, Bera A, Srivastava V, Ghosh SK, Sharma RK. Experimental evaluation of electron gun, PPM focusing and collector for Ka Band TWT. 2014 Tenth International Vacuum Electron Sources Conference (IVESC) 2014. [DOI: 10.1109/ivesc.2014.6891942] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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Ketley A, Chen C, Li X, Arya S, Robinson T, Granados-Riveron J, Udosen I, Morris G, Holt I, Furling D, Chaouch S, Haworth B, Southall N, Shinn P, Zheng W, Austin C, Hayes C, Brook J. P22 High content screening identifies small molecules that remove nuclear foci, affect MBNL distribution and CELF1 protein levels via a PKC independent pathway in myotonic dystrophy cell lines. Neuromuscul Disord 2014. [DOI: 10.1016/s0960-8966(14)70038-0] [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: 11/24/2022]
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Abstract
Delayed emptying of the gastric conduit following esophagectomy can be associated with an increased incidence of complications including aspiration pneumonia and anastomotic leak. The aim of this systematic review is to evaluate the current modalities of pyloric drainage following esophagectomy and their impact on anastomotic integrity and postoperative morbidity. Medline, Web of Science, Cochrane library, trial registries, and conference proceedings were searched. Five pyloric management strategies following esophagectomy were evaluated: no intervention, botulinum toxin (botox) injection, finger fracture, pyloroplasty, and pyloromyotomy. Outcomes evaluated were hospital mortality, anastomotic leak, pulmonary complications, delayed gastric emptying, and the late complication of bile reflux. Twenty-five publications comprising 3172 patients were analyzed. Pooled analysis of six comparative studies published after 2000 revealed pyloric drainage to be associated with a nonsignificant trend toward a reduced incidence of anastomotic leak, pulmonary complications, and delayed gastric emptying. Overall, the current level of evidence regarding the merits of individual pyloric drainage strategies remains very poor. There is significant heterogeneity in the definitions of clinical outcomes, in particular delayed gastric emptying, which has prevented meaningful assessment and formulation of consensus regarding the management of the pylorus during esophagectomy. Pyloric drainage procedures showed a non-significant trend toward fewer anastomotic leaks, pulmonary complications, and reduced gastric stasis when employed following esophagectomy. However, the ideal technique remains unproven suggesting that further collaborative investigations are needed to determine the intervention that will maximize the potential benefits, if any, of pyloric intervention.
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Affiliation(s)
- S Arya
- Division of Surgery, Department of Surgery and Cancer, Imperial College London, St Mary's Hospital, London, UK
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Patil VM, Noronha V, Joshi A, Muddu VK, Gulia S, Bhosale B, Arya S, Juvekar S, Chatturvedi P, Chaukar DA, Pai P, D'cruz A, Prabhash K. Induction chemotherapy in technically unresectable locally advanced oral cavity cancers: does it make a difference? Indian J Cancer 2013; 50:1-8. [PMID: 23713035 DOI: 10.4103/0019-509x.112263] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Locally advanced and unresectable oral cavity cancers have a poor prognosis. Induction might be beneficial in this setting by reducing tumor bulk and allowing definitive surgery. AIM To analyze the impact of induction chemotherapy on locally advanced, technically unresectable oral cavity cancers. MATERIALS AND METHODS Retrospective analysis of patients with locally advanced oral cavity cancers, who were treated with neoadjuvant chemotherapy (NACT) during the period between June 2009 and December 2010. Data from a prospectively filled database were analyzed for information on patient characteristics, chemotherapy received, toxicity, response rates, local treatment offered, patterns of failure, and overall survival. The statistical analysis was performed with SPSS version 16. RESULTS 123 patients, with a median age of 42 years were analyzed. Buccal mucosa was the most common subsite (68.30%). Three drug regimen was utilized in 26 patients (21.10%) and the rest received two drug regimen. Resectability was achieved in 17 patients treated with 3 drug regimen (68.00%) and 36 patients receiving 2 drug regimen. Febrile neutropenia was seen in 3 patients (3.09%) receiving 2 drug regimen and in 9 patients (34.62%) receiving 3 drug regimen. The estimated median OS was not reached in patients who had clinical response and underwent surgery as opposed to 8 months in patients treated with non-surgical modality post NACT (P = 0.0001). CONCLUSION Induction chemotherapy was effective in converting technically unresectable oral cavity cancers to operable disease in approximately 40% of patients and was associated with significantly improved overall survival in comparison to nonsurgical treatment.
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Affiliation(s)
- V M Patil
- Department of Medical Oncology, Tata Memorial Hospital, Mumbai, Maharashtra, India
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Arya S, Rane P, Sable N, Juvekar S, Bal M, Chaukar D. Retromolar trigone squamous cell cancers: A reappraisal of 16 section MDCT for assessing mandibular invasion. Clin Radiol 2013; 68:e680-8. [DOI: 10.1016/j.crad.2013.08.001] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 07/21/2013] [Accepted: 08/06/2013] [Indexed: 11/30/2022]
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Ambady P, Holdhoff M, Ferrigno C, Grossman S, Anderson MD, Liu D, Conrad C, Penas-Prado M, Gilbert MR, Yung AWK, de Groot J, Aoki T, Nishikawa R, Sugiyama K, Nonoguchi N, Kawabata N, Mishima K, Adachi JI, Kurisu K, Yamasaki F, Tominaga T, Kumabe T, Ueki K, Higuchi F, Yamamoto T, Ishikawa E, Takeshima H, Yamashita S, Arita K, Hirano H, Yamada S, Matsutani M, Apok V, Mills S, Soh C, Karabatsou K, Arimappamagan A, Arya S, Majaid M, Somanna S, Santosh V, Schaff L, Armentano F, Harrison C, Lassman A, McKhann G, Iwamoto F, Armstrong T, Yuan Y, Liu D, Acquaye A, Vera-Bolanos E, Diefes K, Heathcock L, Cahill D, Gilbert M, Aldape K, Arrillaga-Romany I, Ruddy K, Greenberg S, Nayak L, Avgeropoulos N, Avgeropoulos G, Riggs G, Reilly C, Banerji N, Bruns P, Hoag M, Gilliland K, Trusheim J, Bekaert L, Borha A, Emery E, Busson A, Guillamo JS, Bell M, Harrison C, Armentano F, Lassman A, Connolly ES, Khandji A, Iwamoto F, Blakeley J, Ye X, Bergner A, Dombi E, Zalewski C, Follmer K, Halpin C, Fayad L, Jacobs M, Baldwin A, Langmead S, Whitcomb T, Jennings D, Widemann B, Plotkin S, Brandes AA, Mason W, Pichler J, Nowak AK, Gil M, Saran F, Revil C, Lutiger B, Carpentier AF, Milojkovic-Kerklaan B, Aftimos P, Altintas S, Jager A, Gladdines W, Lonnqvist F, Soetekouw P, van Linde M, Awada A, Schellens J, Brandsma D, Brenner A, Sun J, Floyd J, Hart C, Eng C, Fichtel L, Gruslova A, Lodi A, Tiziani S, Bridge CA, Baldock A, Kumthekar P, Dilfer P, Johnston SK, Jacobs J, Corwin D, Guyman L, Rockne R, Sonabend A, Cloney M, Canoll P, Swanson KR, Bromberg J, Schouten H, Schaafsma R, Baars J, Brandsma D, Lugtenburg P, van Montfort C, van den Bent M, Doorduijn J, Spalding A, LaRocca R, Haninger D, Saaraswat T, Coombs L, Rai S, Burton E, Burzynski G, Burzynski S, Janicki T, Marszalek A, Burzynski S, Janicki T, Burzynski G, Marszalek A, Cachia D, Smith T, Cardona AF, Mayor LC, Jimenez E, Hakim F, Yepes C, Bermudez S, Useche N, Asencio JL, Mejia JA, Vargas C, Otero JM, Carranza H, Ortiz LD, Cardona AF, Ortiz LD, Jimenez E, Hakim F, Yepes C, Useche N, Bermudez S, Asencio JL, Carranza H, Vargas C, Otero JM, Bartels C, Quintero A, Restrepo CE, Gomez S, Bernal-Vaca L, Lema M, Cardona AF, Ortiz LD, Useche N, Bermudez S, Jimenez E, Hakim F, Yepes C, Mejia JA, Bernal-Vaca L, Restrepo CE, Gomez S, Quintero A, Bartels C, Carranza H, Vargas C, Otero JM, Carlo M, Omuro A, Grommes C, Kris M, Nolan C, Pentsova E, Pietanza M, Kaley T, Carrabba G, Giammattei L, Draghi R, Conte V, Martinelli I, Caroli M, Bertani G, Locatelli M, Rampini P, Artoni A, Carrabba G, Bertani G, Cogiamanian F, Ardolino G, Zarino B, Locatelli M, Caroli M, Rampini P, Chamberlain M, Raizer J, Soffetti R, Ruda R, Brandsma D, Boogerd W, Taillibert S, Le Rhun E, Jaeckle K, van den Bent M, Wen P, Chamberlain M, Chinot OL, Wick W, Mason W, Henriksson R, Saran F, Nishikawa R, Carpentier AF, Hoang-Xuan K, Kavan P, Cernea D, Brandes AA, Hilton M, Kerloeguen Y, Guijarro A, Cloughsey T, Choi JH, Hong YK, Conrad C, Yung WKA, deGroot J, Gilbert M, Loghin M, Penas-Prado M, Tremont I, Silberman S, Picker D, Costa R, Lycette J, Gancher S, Cullen J, Winer E, Hochberg F, Sachs G, Jeyapalan S, Dahiya S, Stevens G, Peereboom D, Ahluwalia M, Daras M, Hsu M, Kaley T, Panageas K, Curry R, Avila E, Fuente MDL, Omuro A, DeAngelis L, Desjardins A, Sampson J, Peters K, Ranjan T, Vlahovic G, Threatt S, Herndon J, Boulton S, Lally-Goss D, McSherry F, Friedman A, Friedman H, Bigner D, Gromeier M, Prust M, Kalpathy-Cramer J, Poloskova P, Jafari-Khouzani K, Gerstner E, Dietrich J, Fabi A, Villani V, Vaccaro V, Vidiri A, Giannarelli D, Piludu F, Anelli V, Carapella C, Cognetti F, Pace A, Flowers A, Flowers A, Killory B, Furuse M, Miyatake SI, Kawabata S, Kuroiwa T, Garciarena P, Anderson MD, Hamilton J, Schellingerhout D, Fuller GN, Sawaya R, Gilbert MR, Gilbert M, Pugh S, Won M, Blumenthal D, Vogelbaum M, Aldape K, Colman H, Chakravarti A, Jeraj R, Dignam J, Armstrong T, Wefel J, Brown P, Jaeckle K, Schiff D, Brachman D, Werner-Wasik M, Tremont-Lukats I, Sulman E, Mehta M, Gill B, Yun J, Goldstein H, Malone H, Pisapia D, Sonabend AM, Mckhann GK, Sisti MB, Sims P, Canoll P, Bruce JN, Girvan A, Carter G, Li L, Kaltenboeck A, Chawla A, Ivanova J, Koh M, Stevens J, Lahn M, Gore M, Hariharan S, Porta C, Bjarnason G, Bracarda S, Hawkins R, Oudard S, Zhang K, Fly K, Matczak E, Szczylik C, Grossman R, Ram Z, Hamza M, O'Brien B, Mandel J, DeGroot J, Han S, Molinaro A, Berger M, Prados M, Chang S, Clarke J, Butowski N, Hashimoto N, Chiba Y, Tsuboi A, Kinoshita M, Hirayama R, Kagawa N, Oka Y, Oji Y, Sugiyama H, Yoshimine T, Hawkins-Daarud A, Jackson PR, Swanson KR, Sarmiento JM, Ly D, Jutla J, Ortega A, Carico C, Dickinson H, Phuphanich S, Rudnick J, Patil C, Hu J, Iglseder S, Nowosielski M, Nevinny-Stickel M, Stockhammer G, Jain R, Poisson L, Scarpace L, Mikkelsen T, Kirby J, Freymann J, Hwang S, Gutman D, Jaffe C, Brat D, Flanders A, Janicki T, Burzynski S, Burzynski G, Marszalek A, Jiang C, Wang H, Jo J, Williams B, Smolkin M, Wintermark M, Shaffrey M, Schiff D, Juratli T, Soucek S, Kirsch M, Schackert G, Kakkar A, Kumar S, Bhagat U, Kumar A, Suri A, Singh M, Sharma M, Sarkar C, Suri V, Kaley T, Barani I, Chamberlain M, McDermott M, Raizer J, Rogers L, Schiff D, Vogelbaum M, Weber D, Wen P, Kalita O, Vaverka M, Hrabalek L, Zlevorova M, Trojanec R, Hajduch M, Kneblova M, Ehrmann J, Kanner AA, Wong ET, Villano JL, Ram Z, Khatua S, Fuller G, Dasgupta S, Rytting M, Vats T, Zaky W, Khatua S, Sandberg D, Foresman L, Zaky W, Kieran M, Geoerger B, Casanova M, Chisholm J, Aerts I, Bouffet E, Brandes AA, Leary SES, Sullivan M, Bailey S, Cohen K, Mason W, Kalambakas S, Deshpande P, Tai F, Hurh E, McDonald TJ, Kieran M, Hargrave D, Wen PY, Goldman S, Amakye D, Patton M, Tai F, Moreno L, Kim CY, Kim T, Han JH, Kim YJ, Kim IA, Yun CH, Jung HW, Koekkoek JAF, Reijneveld JC, Dirven L, Postma TJ, Vos MJ, Heimans JJ, Taphoorn MJB, Koeppen S, Hense J, Kong XT, Davidson T, Lai A, Cloughesy T, Nghiemphu PL, Kong DS, Choi YL, Seol HJ, Lee JI, Nam DH, Kool M, Jones DTW, Jager N, Northcott PA, Pugh T, Hovestadt V, Markant S, Esparza LA, Bourdeaut F, Remke M, Taylor MD, Cho YJ, Pomeroy SL, Schuller U, Korshunov A, Eils R, Wechsler-Reya RJ, Lichter P, Pfister SM, Krel R, Krutoshinskaya Y, Rosiello A, Seidman R, Kowalska A, Kudo T, Hata Y, Maehara T, Kumthekar P, Bridge C, Patel V, Rademaker A, Helenowski I, Mrugala M, Rockhill J, Swanson K, Grimm S, Raizer J, Meletath S, Bennett M, Nestor VA, Fink KL, Lee E, Reardon D, Schiff D, Drappatz J, Muzikansky A, Hammond S, Grimm S, Norden A, Beroukhim R, McCluskey C, Chi A, Batchelor T, Smith K, Gaffey S, Gerard M, Snodgras S, Raizer J, Wen P, Leeper H, Johnson D, Lima J, Porensky E, Cavaliere R, Lin A, Liu J, Evans J, Leuthardt E, Dacey R, Dowling J, Kim A, Zipfel G, Grubb R, Huang J, Robinson C, Simpson J, Linette G, Chicoine M, Tran D, Liubinas SV, D'Abaco GM, Moffat B, Gonzales M, Feleppa F, Nowell CJ, Gorelick A, Drummond KJ, Morokoff AP, O'Brien TJ, Kaye AH, Loghin M, Melhem-Bertrandt A, Penas-Prado M, Zaidi T, Katz R, Lupica K, Stevens G, Ly I, Hamilton S, Rostomily R, Rockhill J, Mrugala M, Mandel J, Yust-Katz S, de Groot J, Yung A, Gilbert M, Burzynski S, Janicki T, Burzynski G, Marszalek A, Pachow D, Kliese N, Kirches E, Mawrin C, McNamara MG, Lwin Z, Jiang H, Chung C, Millar BA, Sahgal A, Laperriere N, Mason WP, Megyesi J, Salehi F, Merker V, Slusarz K, Muzikansky A, Francis S, Plotkin S, Mishima K, Adachi JI, Suzuki T, Uchida E, Yanagawa T, Watanabe Y, Fukuoka K, Yanagisawa T, Wakiya K, Fujimaki T, Nishikawa R, Moiyadi A, Kannan S, Sridhar E, Gupta T, Shetty P, Jalali R, Alshami J, Lecavalier-Barsoum M, Guiot MC, Tampieri D, Kavan P, Muanza T, Nagane M, Kobayashi K, Takayama N, Shiokawa Y, Nakamura H, Makino K, Hideo T, Kuroda JI, Shinojima N, Yano S, Kuratsu JI, Nambudiri N, Arrilaga I, Dunn I, Folkerth R, Chi S, Reardon D, Nayak L, Omuro A, DeAngelis L, Robins HI, Govindan R, Gadgeel S, Kelly K, Rigas J, Reimers HJ, Peereboom D, Rosenfeld S, Garst J, Ramnath N, Wing P, Zheng M, Urban P, Abrey L, Wen P, Nayak L, DeAngelis LM, Wen PY, Brandes AA, Soffietti R, Peereboom DM, Lin NU, Chamberlain M, Macdonald D, Galanis E, Perry J, Jaeckle K, Mehta M, Stupp R, van den Bent M, Reardon DA, Norden A, Hammond S, Drappatz J, Phuphanich S, Reardon D, Wong E, Plotkin S, Lesser G, Raizer J, Batchelor T, Lee E, Kaley T, Muzikansky A, Doherty L, LaFrankie D, Ruland S, Smith K, Gerard M, McCluskey C, Wen P, Norden A, Schiff D, Ahluwalia M, Lesser G, Nayak L, Lee E, Muzikansky A, Dietrich J, Smith K, Gaffey S, McCluskey C, Ligon K, Reardon D, Wen P, Bush NAO, Kesari S, Scott B, Ohno M, Narita Y, Miyakita Y, Arita H, Matsushita Y, Yoshida A, Fukushima S, Ichimura K, Shibui S, Okamura T, Kaneko S, Omuro A, Chinot O, Taillandier L, Ghesquieres H, Soussain C, Delwail V, Lamy T, Gressin R, Choquet S, Soubeyran P, Maire JP, Benouaich-Amiel A, Lebouvier-Sadot S, Gyan E, Barrie M, del Rio MS, Gonzalez-Aguilar A, Houllier C, Tanguy ML, Hoang-Xuan K, Omuro A, Abrey L, Raizer J, Paleologos N, Forsyth P, DeAngelis L, Kaley T, Louis D, Cairncross JG, Matasar M, Mehta J, Grimm S, Moskowitz C, Sauter C, Opinaldo P, Torcuator R, Ortiz LD, Cardona AF, Hakim F, Jimenez E, Yepes C, Useche N, Bermudez S, Mejia JA, Asencio JL, Carranza H, Vargas C, Otero JM, Lema M, Pace A, Villani V, Fabi A, Carapella CM, Patel A, Allen J, Dicker D, Sheehan J, El-Deiry W, Glantz M, Tsyvkin E, Rauschkolb P, Pentsova E, Lee M, Perez A, Norton J, Uschmann H, Chamczuck A, Khan M, Fratkin J, Rahman R, Hempfling K, Norden A, Reardon DA, Nayak L, Rinne M, Doherty L, Ruland S, Rai A, Rifenburg J, LaFrankie D, Wen P, Lee E, Ranjan T, Peters K, Vlahovic G, Friedman H, Desjardins A, Reveles I, Brenner A, Ruda R, Bello L, Castellano A, Bertero L, Bosa C, Trevisan E, Riva M, Donativi M, Falini A, Soffietti R, Saran F, Chinot OL, Henriksson R, Mason W, Wick W, Nishikawa R, Dahr S, Hilton M, Garcia J, Cloughesy T, Sasaki H, Nishiyama Y, Yoshida K, Hirose Y, Schwartz M, Grimm S, Kumthekar P, Fralin S, Rice L, Drawz A, Helenowski I, Rademaker A, Raizer J, Schwartz K, Chang H, Nikolai M, Kurniali P, Olson K, Pernicone J, Sweeley C, Noel M, Sharma M, Gupta R, Suri V, Singh M, Sarkar C, Shibahara I, Sonoda Y, Saito R, Kanamori M, Yamashita Y, Kumabe T, Watanabe M, Suzuki H, Watanabe T, Ishioka C, Tominaga T, Shih K, Chowdhary S, Rosenblatt P, Weir AB, Shepard G, Williams JT, Shastry M, Hainsworth JD, Singer S, Riely GJ, Kris MG, Grommes C, Sanders MWCB, Arik Y, Seute T, Robe PAJT, Leijten FSS, Snijders TJ, Sturla L, Culhane JJ, Donahue J, Jeyapalan S, Suchorska B, Jansen N, Wenter V, Eigenbrod S, Schmid-Tannwald C, Zwergal A, Niyazi M, Bartenstein P, Schnell O, Kreth FW, LaFougere C, Tonn JC, Taillandier L, Wittwer B, Blonski M, Faure G, De Carvalho M, Le Rhun E, Tanaka K, Sasayama T, Nishihara M, Mizukawa K, Kohmura E, Taylor S, Newell K, Graves L, Timmer M, Cramer C, Rohn G, Goldbrunner R, Turner S, Gergel T, Lacroix M, Toms S, Ueki K, Higuchi F, Sakamoto S, Kim P, Salgado MAV, Rueda AG, Urzaiz LL, Villanueva MG, Millan JMS, Cervantes ER, Pampliega RA, de Pedro MDA, Berrocal VR, Mena AC, van Zanten SV, Jansen M, van Vuurden D, Huisman M, Hoekstra O, van Dongen G, Kaspers GJ, Schlamann A, von Bueren AO, Hagel C, Kramm C, Kortmann RD, Muller K, Friedrich C, Muller K, von Hoff K, Kwiecien R, Pietsch T, Warmuth-Metz M, Gerber NU, Hau P, Kuehl J, Kortmann RD, von Bueren AO, Rutkowski S, von Bueren AO, Friedrich C, von Hoff K, Kwiecien R, Muller K, Pietsch T, Warmuth-Metz M, Kuehl J, Kortmann RD, Rutkowski S, Walker J, Tremont I, Armstrong T, Wang H, Jiang C, Wang H, Jiang C, Warren P, Robert S, Lahti A, White D, Reid M, Nabors L, Sontheimer H, Wen P, Yung A, Mellinghoff I, Lamborn K, Ramkissoon S, Cloughesy T, Rinne M, Omuro A, DeAngelis L, Gilbert M, Chi A, Batchelor T, Colman H, Chang S, Nayak L, Massacesi C, DiTomaso E, Prados M, Reardon D, Ligon K, Wong ET, Elzinga G, Chung A, Barron L, Bloom J, Swanson KD, Elzinga G, Chung A, Wong ET, Wu W, Galanis E, Wen P, Das A, Fine H, Cloughesy T, Sargent D, Yoon WS, Yang SH, Chung DS, Jeun SS, Hong YK, Yust-Katz S, Milbourne A, Diane L, Gilbert M, Armstrong T, Zaky W, Weinberg J, Fuller G, Ketonen L, McAleer MF, Ahmed N, Khatua S, Zaky W, Olar A, Stewart J, Sandberg D, Foresman L, Ketonen L, Khatua S. NEURO/MEDICAL ONCOLOGY. Neuro Oncol 2013; 15:iii98-iii135. [PMCID: PMC3823897 DOI: 10.1093/neuonc/not182] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 08/14/2023] Open
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Quraishi S, Arya S. A case of paraplegia post treatment for acute coronary syndrome. Br J Hosp Med (Lond) 2013; 74:231. [PMID: 23571403 DOI: 10.12968/hmed.2013.74.4.231] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- S Quraishi
- Department of Cardiology, Croydon University Hospital, Surrey, UK.
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