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Harrison C, Parekh V. Sexual violence in patients with psychiatric conditions: Factors for consideration in case management. J Forensic Leg Med 2022; 86:102303. [PMID: 34999299 DOI: 10.1016/j.jflm.2022.102303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2021] [Revised: 12/20/2021] [Accepted: 01/02/2022] [Indexed: 11/17/2022]
Abstract
Patients with underlying psychiatric conditions are vulnerable to the experience of sexual violence. Barriers and facilitators to disclosure exist, at the level of the individual, healthcare system, legal system and society in general. Management requires a trauma-informed approach with a focus on avoidance of stigma, optimisation of pre-existing psychiatric conditions and appropriate treatment of psychological sequalae. Preventive strategies by the patient, practitioner and healthcare system, may assist to reduce the risk of future sexual violence.
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Affiliation(s)
- C Harrison
- Department of General Practice, School of Public and Preventive Medicine, Monash University, Melbourne, Australia.
| | - V Parekh
- ANU Medical School, ANU College of Health and Medicine, Australia
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Trum N, Zain J, Martinez X, Parekh V, Afkhami M, Abdulla F, Carson K, Rosen S, Bennett C, Querfeld C. Mogamulizumab efficacy is underscored by its associated rash that mimics cutaneous T-cell lymphoma: a retrospective single-centre case series. Br J Dermatol 2022; 186:153-166. [PMID: 34427917 PMCID: PMC8738116 DOI: 10.1111/bjd.20708] [Citation(s) in RCA: 16] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/21/2021] [Indexed: 01/03/2023]
Abstract
BACKGROUND Mogamulizumab is a humanized antibody against chemokine receptor type 4. It was recently approved by the US Food and Drug Administration for relapsed or refractory mycosis fungoides (MF) and Sézary syndrome (SS). The most commonly reported adverse event in the phase III licensing trial was drug eruption (28%), now termed mogamulizumab-associated rash (MAR). Clinical recommendations about MAR and its treatment differ between the current package insert and postapproval insights reported from two single-centre studies that focused on its characterization, but less so on outcomes and clinicopathological differentiation from cutaneous T-cell lymphoma (CTCL). OBJECTIVES To describe our experience in the diagnosis of MAR and treatment of patients with CTCL with mogamulizumab. METHODS This is a single-centre retrospective case series study. RESULTS We found a higher incidence of MAR in patients with CTCL (17 of 24, 68%) than previously reported. MAR development is associated with complete (11 of 17) or partial (four of 17) responses, with an overall response rate of 88%, compared with 29% (two of seven) in patients without MAR. Diagnosis of MAR may be obscured by its ability to mimic key CTCL features both clinically and histologically, but an absence of T-cell-receptor clonality and relatively decreased CD4 : CD8 ratio compared with baseline lesions strongly favour MAR over recurrent disease. CONCLUSIONS MAR has the potential to create a significant management problem for patients on mogamulizumab. Misidentification of MAR as recurrent CTCL may detrimentally result in the premature discontinuation of mogamulizumab in patients whose disease is historically hard to treat. Thorough clinicopathological investigation of new lesions during treatment with mogamulizumab is required to inform ideal treatment decisions and achieve better outcomes.
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Affiliation(s)
- N.A. Trum
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Sackler Faculty of Medicine, Tel Aviv University, Ramat Aviv 69978, Israel
| | - J. Zain
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - X.U. Martinez
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - V. Parekh
- Department of Pathology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - M. Afkhami
- Department of Pathology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - F. Abdulla
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - K.R. Carson
- Division of Hematology, Oncology, and Stem Cell Transplant, Rush University, 600 S. Paulina St., Chicago, Illinois 60612, United States
| | - S.T. Rosen
- Department of Hematology and Hematopoietic Cell Transplantation, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Beckman Research Institute, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
| | - C.L. Bennett
- Department of Comparative Medicine and Evidence Based Medicine, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Beckman Research Institute, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,College of Pharmacy, University of South Carolina
| | - C. Querfeld
- Division of Dermatology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Department of Pathology, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States,Beckman Research Institute, City of Hope Comprehensive Cancer Care Center, 1500 E Duarte Rd, Duarte, CA 91010, United States
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Noshirwani A, Drewniak K, Parekh V, Patel S, Mandal A, Shokrollahi K. 100 Assessing the Admission Proforma: A Multi-Cycle Audit Evaluating the Quality of Documentation of The Burnsadmission Proforma At the Regional Mersey Burn Unit. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Introduction
A thoroughly completed Burns Proforma can provide vital information for the effective management of a burn and enables the sharing of information with other members of the multidisciplinary team.
Aim
We aimed to assess the quality of record-keeping of the new Burns Proforma, compared it with the previous cycle, and identified areas of improvement.
Method
Data on 76 fields on version 4.0 of the Mersey Burns Proforma was collected for 92 patients between January and February 2020. The data was compared to cycle 1of the audit collected in July 2019.
Results
Assessing the 61 comparable fields between audit cycles, 58 fields (95%) improved while 3 (5%) deteriorated. 21 fields achieved a completion rate greater than 80%. Vital information such as history, comorbidities, and drug history achieved 100% completion, up from 94%, 94%, and 95%, respectively. Total body surface area (TBSA) increased to 93% from 83%, the use of the Lund & Browder chart remained the same, treatment plan documentation increased to 95% from 91%, documentation of admission increased from 24% to 51%, consultant confirmation of TBSA increased to 10% from 5%, but this requires further improvement. Comments stated the proforma was clearer and provided a flowchart layout which made documentation easier.
Conclusions
The Burns Admission Proforma has made significant improvements. Working with the nursing staff and consultant body, we aim to improve our completion rates of vital information further. It sets a high standard for data collection and presents itself as a useful tool for other Burns Units across the United Kingdom.
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Affiliation(s)
- A Noshirwani
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - K Drewniak
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - V Parekh
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - S Patel
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - A Mandal
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - K Shokrollahi
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
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Noshirwani A, Phillips B, Hosain M, Drewniak K, Parekh V, Bell D. 99 Perfecting the Proforma – A Full-Cycle Audit on The Quality of Documentation of The Hand Trauma Proforma At the Regional Plastic Surgery Department. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.005] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Aim
We aimed to assess the quality of record-keeping of the departments hand trauma proforma, identify areas of improvement, and to implement and assess the quality of an updated proforma.
Method
Data from 101 parameters was collected for 20 patients undergoing surgery for an upper limb injury in November 2019. An updated proforma was implemented and a further 20 patients were analysed in February 2020. All fields were compared between two audit cycles and comments were collected.
Results
The overall completion rate increased. Documentation of the responsible consultant increased to 100%, along with an increase in documenting of hobbies and injury mechanism. X-ray findings (55% to 85%) and antibiotic plan (35% to 80%) increased. Implementation of a free text box resulted in written descriptions of injury to compliment sketches. In the operation note, documentation of anaesthetic type used increased, along with tourniquet use and time. There was clearer documentation of the injury, findings, and procedure, with greater use of diagrams to illustrate the repair. There was a drop in the recording of post-op plans (100% to 85%), post-op antibiotics (90% to 75%), and follow-up plan (95% to 60%). Clinicians commented to increase the size of the free-text box and hand diagram on the operative page to facilitate easier drawings.
Conclusions
The Hand Trauma Proforma has made good progress from its original version but requires further adjustments to ensure complete data input. It sets a high standard for data collection and presents itself as a useful tool for units across the United Kingdom.
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Affiliation(s)
- A Noshirwani
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - B Phillips
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - M Hosain
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - K Drewniak
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - V Parekh
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
| | - D Bell
- Department of Burns and Plastic Surgery, Whiston Hospital, Liverpool, United Kingdom
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Patel S, Parekh V, Patel K, Jha S. Plant Growth-promoting Activities of Penicillium sp. NAUSF2 Ameliorate Vigna radiata Salinity Stress in Phosphate-deficient Saline Soil. APPL BIOCHEM MICRO+ 2021. [DOI: 10.1134/s000368382104013x] [Citation(s) in RCA: 1] [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: 01/24/2023]
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Chen X, Parekh V, Peng L, Chan M, Soike M, McTyre E, Jacobs M, Kleinberg L. External Validation Of A Radiomics-Based Machine Learning Model For Distinguishing Radiation Necrosis From Progression Of Brain Metastases Treated With Stereotactic Radiosurgery. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.107] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Zheng Q, Capell B, Parekh V, O'Day C, Atillasoy C, Shim E, Prouty S, Seykora J. 159 Precision RNA-sequencing of squamous cell carcinoma in situ identifies therapeutic targets. J Invest Dermatol 2019. [DOI: 10.1016/j.jid.2019.03.235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Capell B, Parekh V, O'Day C, Attilasoy C, Shim E, Zheng Q, Seykora J. 125 RNA sequencing of squamous cell carcinoma in situ and epidermis identifies early drivers of carcinogenesis. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.02.139] [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: 10/19/2022]
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Parekh V, Jacobs MA. SU-F-R-05: Multidimensional Imaging Radiomics-Geodesics: A Novel Manifold Learning Based Automatic Feature Extraction Method for Diagnostic Prediction in Multiparametric Imaging. Med Phys 2016. [DOI: 10.1118/1.4955777] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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Ahir B, Parekh V, Katyayan MK, Katyayan PA. Smear layer removal efficacy of different irrigating solutions: a comparative scanning electron microscope evaluation. Indian J Dent Res 2014; 25:617-22. [PMID: 25511062 DOI: 10.4103/0970-9290.147107] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
AIMS Comparative evaluation of cleaning efficacy of smear layer removal by different irrigating solutions such as 2.5% sodium hypochlorite (NaOCl), 17% ethylenediaminetetraacetic acid (EDTA) with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline Hydrochloride (HCl) with 2.5% NaOCl for smear layer removal in the apical third of root canal. SETTINGS AND DESIGN In vitro material science study. MATERIALS AND METHODS Seventy-five single rooted permanent maxillary central incisor teeth were subjected to standardized root canal instrumentation (crown down technique). The teeth were randomly divided into five groups with 15 teeth in each groups: (1) Normal saline (n = 15) (2) 2.5% NaOCl (n = 15) (3) 17% EDTA + 2.5% NaOCl (n = 15) (4) 10% citric acid + 2.5% NaOCl (n = 15) (5) 1.0% tetracycline HCL + 2.5% NaOCl (n = 15). After final irrigation, the teeth were prepared for scanning electron microscope analysis to evaluate the cleaning of apical third of radicular dentine to determine the presence or absence of smear layer. STATISTICAL ANALYSIS USED The results were analyzed by nonparametric statistical analysis techniques. Kruskal-Wallis test, Mann-Whitney test and Chi-square tests were carried out. RESULTS There was no significant statistical difference in the efficacy of smear layer removal when 2.5% NaOCl was compared with 17% EDTA with 2.5% NaOCl, 10% citric acid with 2.5% NaOCl and 1% tetracycline HCl with 2.5% NaOCl in apical third of root canals. CONCLUSIONS The present study suggests that irrigating agents, citric acid and tetracycline HCl can be used as an alternative to EDTA for the removal of smear layer in endodontics.
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Affiliation(s)
| | | | - M K Katyayan
- Department of Dentistry, GMERS Medical College and Hospital, Gandhinagar, Gujarat, India
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Parekh V. 66. MENAGE A TRIOS: SEXUAL HEALTH, SEXUAL ASSAULT AND FORENSIC MEDICINE. Sex Health 2007. [DOI: 10.1071/shv4n4ab66] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
Abstract
Objectives: Small jurisdictions often require clinicians to work in more than one speciality. The aim of this paper is to explore the commonalities between sexual health, sexual assault and forensic medicine that make this possible.
Methods: Exploration of (1) common attributes of clinicians who provide these services, (2) characteristics the client groups, (3) administrative aspects and (4) gains for participating clinicians.
Results: Clinicians in all three specialties practice within a public health model of care, have a good understanding of confidentiality, sexual wellbeing, other intimate concerns and social justice issues. They have experience working with non-medical groups and are experienced in teaching students and non-clinicians.
Clients attending all three of services are commonly victims, vulnerable, marginalised, poor and less able to access traditional medical services. They commonly exhibit high-risk behaviours pertaining to sex and drug and alcohol use.
Administrative systems commonly found in sexual health centres such as independently held and secured files and coded filing systems and protocols and practices concerning confidentiality and appropriate interactions with other services allow clinical forensic medicine to be easily incorporated.
Clinicians gain from participating in these services by refreshing and developing specialist skills in the management of simple injuries, acute drug and alcohol withdrawal and in the law (forensic evidence collection, minors and custody issues).
Conclusions: The similarities between the practise of sexual health, sexual assault and forensic medicine make the transition between the specialties smooth and relatively easy. Indeed the practice of one enhances the other two for clients and clinicians alike.
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Parekh V, Parmar G, Gohil KS. Sealing abilities of intermediate restoratives used in endodontics an in vitro study. Endodontology 1992. [DOI: 10.4103/0970-7212.347227] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Lemont H, Parekh V. Superficial fascia--an appropriate anatomic boundary for excising warts on the foot. J Dermatol Surg Oncol 1989; 15:710-1. [PMID: 2745841 DOI: 10.1111/j.1524-4725.1989.tb03616.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
When performing wart surgery of the foot, it is necessary to excise the lesion to the level where the superficial fascia is visible. This approach minimizes painful scar formation and ensures complete removal of the wart.
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Affiliation(s)
- H Lemont
- Department of Medicine, Pennsylvania College of Podiatric Medicine, Philadelphia 19107
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Saxinger C, Polesky H, Eby N, Grufferman S, Murphy R, Tegtmeir G, Parekh V, Memon S, Hung C. Antibody reactivity with HBLV (HHV-6) in U.S. populations. J Virol Methods 1988; 21:199-208. [PMID: 2846612 DOI: 10.1016/0166-0934(88)90066-3] [Citation(s) in RCA: 125] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023]
Abstract
500 sera representing healthy blood donors and a random representation of the U.S. population collected 10 years ago were screened by ELISA for antibody reactivity with purified, disrupted HBLV virions. In each group, the ELISA results were normally distributed with no evidence of bimodality. All sera were subsequently retested after preincubation of each with well-characterized preparations of disrupted HSB-2 cells or HBLV-infected HSB-2 cells. Sera showing significant levels of HBLV-specific neutralization (50% or more) were found in Minneapolis, Kansas City, and in a random population survey (81, 88 and 97% of donors, respectively). Mean ELISA test values were the same for all groups and for males and females within the same group. Sera from these normal donors reacted preferentially with viral antigens of 120 and 58 kDa by Western blot. In a hospital-based prevalence study, frequent IgM and IgG seroconversions were apparent among infants less than 1 year old, and mean ELISA test values reached the adult level before school age. Antigen preparations used in blocking experiments showed no competitive cross-reactivity with antisera against EBV, CMV, HSV, VZV, HIV, or adenovirus type 2 at levels which reduced antibody binding to HBLV by more than 90%. Antibody cross-reactivities towards HBLV and other human herpesviruses were assessed by cross-correlation of viral antibody titers against all of the viruses and by cross-absorptions of antisera against the other viruses with HBLV. In these experiments no antibody cross-reactivity between HBLV and other human herpesviruses were detected. The significance of these findings with respect to health/disease status is presently unknown. Further seroepidemiologic studies of quantitative levels of HBLV antibody reactivity to measure the age of primary infection and progressive changes in healthy and selected disease populations are needed to determine the risk of disease associated with HBLV infection.
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Affiliation(s)
- C Saxinger
- Laboratory of Tumor Cell Biology, NIH, Bethesda, MD 20892
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