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Layman D, Raja J, Parkhurst W, Huang J, Caridi T. Abstract No. 253 Assigning Objective Value to Consultative Interventional Radiology. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.317] [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: 02/26/2023] Open
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Patel P, Thomas R, Hamady M, Hague J, Raja J, Tan T, Bloom S, Richards T, Weiss C, Prechtl C, Smith C, Thiagarajah S, Fiorentino F, Markakis H, Ahmed AR. O102 We know about left gastric artery embolisation and will embio provide the next solution to treat obesity? Br J Surg 2022. [DOI: 10.1093/bjs/znac242.102] [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: 11/05/2022]
Abstract
Abstract
Introduction
Left gastric artery embolisation (LGAE) is a minimally invasive procedure which has shown promising results for weight loss in recent studies and could play a key role as a treatment option in-between our current tier-3 and tier-4 services. Imperial College NHS Trust will sponsor the EMBIO trial, the first multi-centre double blinded randomised controlled trial comparing LGAE vs Placebo procedure to evaluate its efficacy on weight loss and obesity related comorbidities over a 12 month follow up period. Here, we perform a systematic review of the existing literature.
Methods
9 studies were reviewed. Studies which investigated weight loss as a % +- Ghrelin % change at 3,6 and 12 months were included as these pre-defined time points correlate with the EMBIO protocol. 6 studies met our inclusion criteria, 5 single arm studies and 1 single blinded RCT.
Results
N=62 patients were included in our analysis. Mean weight loss reported was 8.5%, 8.8% and 10% at 3, 6 and 12 months respectively post LGAE. Ghrelin levels reduced by 36%, 16.2% and 16.5% at 3, 6 and 12 months respectively post LGAE. To date, the only reported adverse events recorded include superficial gastric erosions healed on endoscopy by day 90 and one case of subclinical pancreatitis.
Conclusion
LGAE potentially offers a day case procedure under local anaesthesia and sedation to treat obesity and its metabolic complications. The EMBIO trial will provide level 1 evidence to confirm if LGAE is a viable intervention for obesity and evaluate its safety profile.
Take-home message
Left gastric artery embolisation could be the perfect solution to treat obesity in between existing tier-3 and tier-4 treatments.
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Affiliation(s)
| | | | | | | | - J Raja
- University College Hospital
| | | | | | - T Richards
- University of Western Australia , Perth , Australia
| | - C Weiss
- Johns Hopkins University , Baltimore, Maryland USA
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Raja J, Muthusamy S, Ng CM. AB0458 SURVIVAL OF SCLERODERMA PATIENTS WITH INTERSTITIAL LUNG DISEASE: OBSERVATION DATA FROM A MALAYSIAN TERTIARY CENTRE. Ann Rheum Dis 2021. [DOI: 10.1136/annrheumdis-2021-eular.3830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background:Interstitial lung disease (ILD) is the leading cause of death in scleroderma (SSc) with decline in FVC as a predictor of mortality in patients with SSc-ILD, especially in the early course of the disease.Objectives:The aim of this study is to determine the survival rate of SSc-ILD in a Malaysian cohort of patients from University Malaya Medical Centre (UMMC).Methods:61 patients clinically diagnosed with SSc-ILD were identified and prospectively recruited. Baseline demographic data were collected. Kaplan-Meier analysis was used to estimate the survival.Results:Females were predominant (56, 91.8%). 39 (64%) had limited cutaneous SSc. Majority were ethnicity Chinese 30 (49.2%), followed by Malays 20 (32.8%), Indians 7 (11.4%) and others 4 (6.6%). Mean age was 56.25 (SD ± 12.5) years while mean duration of disease (non-Raynaud’s disease onset) was 10.5 years (SD ± 9.2) (range of 1 year to 44 years) years. 29 (47.5%) patients were positive for anti-ScL-70, whereas 6 (9.8%) patients were anti-centromere positive. There were 16 (26.2%) deaths. Median survival was 24 years. Patients had a sharper drop in survival probability for the first 10 years compared to the next 20 years (Figure 1). Median survival in limited subset was 24 years whereas in diffuse subset was 11 years. Patients from the limited subset appeared to have higher chance of surviving for 10 years and above, compared to those in the diffuse subset (Figure 2).Conclusion:The results demonstrate the poor survival in SSc-ILD patients. The survival rate tends to be worse in the first 10 years of SSc disease duration. Survival rate was poorer in patients with diffuse cutaneous subset.References:[1]Parelas A et al. Lancet Resp Med 2020[2]Goh NS et al. Am J Respir Crit Care Med 2008Disclosure of Interests:JASMIN RAJA Speakers bureau: For Boehringer Ingelheim for topic on Scleroderma-ILD, Grant/research support from: From Boehringer Ingelheim for scleroderma research, Shantini Muthusamy: None declared., CHOUNG MIN NG: None declared.
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Moonan A, Raja J, Issa R, Campbell A. Race associated disparities in men after radical prostatectomy. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.593] [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: 10/28/2022]
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Raja J, Ghodadra A, Gettinger S, Kluger H, Sznol M, Kim H. 3:30 PM Abstract No. 345 Safety and feasibility of immuno-cryotherapy. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.383] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
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Sachithanandham J, Ramalingam VV, Raja J, Abraham OC, Pulimood SA, Kannangai R. Expression of cytokine-mRNA in peripheral blood mononuclear cell of human immunodeficiency virus-1 subtype C infected individuals with opportunistic viral infections from India (South). Indian J Med Microbiol 2016; 34:76-81. [PMID: 26776123 DOI: 10.4103/0255-0857.174118] [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: 11/04/2022]
Abstract
Human immunodeficiency virus (HIV) disease progression is associated with a marked change in the level of plasma cytokines. The study reported here investigated the level of mRNA expression of different cytokines: Tumour necrosis factor-alpha (TNF-α), interferon (INF)-gamma, interleukin-10 (IL-10) and IL-21 in the peripheral blood mononuclear cell among the antiretroviral therapy naive subtype C HIV-1 infected individuals and normal healthy controls by real time polymerase chain reaction. The mRNA expressions of all the 4 cytokines in HIV-1 infected individuals were significantly higher compared to healthy controls (P value range 0.0004-0.01). The mean level of IL-10, INF-gamma and TNF-α were higher in HIV infected individuals with low CD4 counts (<300 cells/μl). The IL-10 expression showed a significant negative correlation with CD4 counts (r=-0.25, P=0.04) while IL-21 showed a positive correlation with CD4 counts (r=0.26, P=0.03). There was a significant negative correlation between the cytomegalovirus (CMV) viral load and IL-21 expression. Cytokine levels by mRNA detection avoids the inherent problem of measuring plasma level and this study also provide information on the cytokine levels and CD4+ T cell level among HIV-1 subtype C infected individuals with opportunistic viral infections like CMV.
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Affiliation(s)
| | | | | | | | | | - R Kannangai
- Department of Clinical Virology, Christian Medical College, Vellore, Tamil Nadu, India
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Bruni C, Raja J, Denton CP, Matucci-Cerinic M. The clinical relevance of sexual dysfunction in systemic sclerosis. Autoimmun Rev 2015; 14:1111-5. [PMID: 26235995 DOI: 10.1016/j.autrev.2015.07.016] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2015] [Accepted: 07/24/2015] [Indexed: 12/18/2022]
Abstract
Systemic sclerosis is a chronic multi-organ autoimmune disease, leading to important clinical and psychological implications. Among organ complications, sexual dysfunction is a major issue for both male and female gender, with high prevalence and great impact on quality of life, although frequently not addressed by both clinicians and patients. While erectile dysfunction is the most common cause of sexual problems in males, genital tract and general physical changes are major contributors to sexual impairment in females. This review presents current state of the art on this topic, discussing published data on presentation, evaluation and therapeutic options.
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Affiliation(s)
- C Bruni
- Dept Clinical and Experimental Medicine, Div Rheumatology, AOU Careggi, Firenze, Italy.
| | - J Raja
- Division of Rheumatology, Department and Faculty of Medicine, University of Malaya, Kuala Lumpur, Malaysia; Centre for Rheumatology and Connective Tissue Diseases, UCL Medical School, Royal Free Campus, London, United Kingdom
| | - C P Denton
- Centre for Rheumatology and Connective Tissue Diseases, UCL Medical School, Royal Free Campus, London, United Kingdom
| | - M Matucci-Cerinic
- Dept Clinical and Experimental Medicine, Div Rheumatology, AOU Careggi, Firenze, Italy
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Raja J, Nihtyanova S, Ong V, Denton C. FRI0470 An Observational Study of Intravenous Immunoglobulin therapy in the Treatment of Gastrointestinal Involvement in Systemic Sclerosis. Ann Rheum Dis 2015. [DOI: 10.1136/annrheumdis-2015-eular.5204] [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]
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Raja J, Clyne S, Levine J, Tebbit C, Mair E. Otorhinolaryngology management of seven patients with iatrogenic penetrating injuries from GlideScope®: Our experience. Clin Otolaryngol 2014; 39:251-4. [DOI: 10.1111/coa.12266] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 05/05/2014] [Indexed: 11/28/2022]
Affiliation(s)
- J. Raja
- Ross University School of Medicine; Miramar FL USA
| | - S. Clyne
- Charlotte Eye Ear Nose & Throat Associates; Charlotte NC USA
| | - J. Levine
- Charlotte Eye Ear Nose & Throat Associates; Charlotte NC USA
| | - C. Tebbit
- Charlotte Eye Ear Nose & Throat Associates; Charlotte NC USA
| | - E. Mair
- Charlotte Eye Ear Nose & Throat Associates; Charlotte NC USA
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Raja J, Sabu N. Two-Dimensional Approximation of Piezoelectric Shallow Shells with Variable Thickness. Proc Natl Acad Sci , India, Sect A Phys Sci 2014. [DOI: 10.1007/s40010-013-0108-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Sabu N, Raja J. Erratum to: Justification of Koiter’s Shell Model Using Gamma Convergence. Proc Natl Acad Sci , India, Sect A Phys Sci 2014. [DOI: 10.1007/s40010-013-0104-6] [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: 11/30/2022]
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Ambler G, Boyle J, Cousins C, Hayes P, Metha T, See T, Varty K, Winterbottom A, Adam D, Bradbury A, Clarke M, Jackson R, Rose J, Sharif A, Wealleans V, Williams R, Wilson L, Wyatt M, Ahmed I, Bell R, Carrell T, Gkoutzios P, Sabharwal T, Salter R, Waltham M, Bicknell C, Bourke P, Cheshire N, Franklin I, James A, Jenkins M, Tyrrell M, Wilkins C, Bown M, Choke E, McCarthy M, Sayers R, Tamberaja A, Farquharson F, Serracino-Inglott F, Davis M, Hamilton G, Brennan J, Canavati R, Fisher R, McWilliams R, Naik J, Vallabhaneni S, Hardman J, Black S, Hinchliffe R, Holt P, Loftus I, Loosemore T, Morgan R, Thompson M, Agu O, Bishop C, Boardley D, Cross J, Hague J, Harris P, Ivancev K, Raja J, Richards T, Simring D, Fisher A, Smith D, Copeland G. Early Results of Fenestrated Endovascular Repair of Juxtarenal Aortic Aneurysms in the United Kingdom. Circulation 2012; 125:2707-15. [PMID: 22665884 DOI: 10.1161/circulationaha.111.070334] [Citation(s) in RCA: 129] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
| | | | | | | | - T. Metha
- Addenbrooke's Hospital, Cambridge
| | - T.C. See
- Addenbrooke's Hospital, Cambridge
| | - K. Varty
- Addenbrooke's Hospital, Cambridge
| | | | - D.J. Adam
- Birmingham Heartlands Hospital, Birmingham
| | | | | | | | - J.D. Rose
- Freeman Hospital, Newcastle upon Tyne
| | - A. Sharif
- Freeman Hospital, Newcastle upon Tyne
| | | | | | - L. Wilson
- Freeman Hospital, Newcastle upon Tyne
| | | | - I. Ahmed
- Guy's & St. Thomas' Hospital, London
| | - R.E. Bell
- Guy's & St. Thomas' Hospital, London
| | | | | | | | - R. Salter
- Guy's & St. Thomas' Hospital, London
| | | | | | | | | | | | - A. James
- Imperial College Hospitals, London
| | | | | | | | - M. Bown
- Leicester Royal Infirmary, Leicester
| | - E. Choke
- Leicester Royal Infirmary, Leicester
| | | | - R. Sayers
- Leicester Royal Infirmary, Leicester
| | | | | | | | | | | | | | - R. Canavati
- Royal Liverpool University Hospital, Liverpool
| | - R.K. Fisher
- Royal Liverpool University Hospital, Liverpool
| | | | - J.B. Naik
- Royal Liverpool University Hospital, Liverpool
| | | | | | | | | | - P. Holt
- St. George's Hospital, London
| | | | | | | | | | - O. Agu
- University College London Hospital, London
| | - C. Bishop
- University College London Hospital, London
| | | | - J. Cross
- University College London Hospital, London
| | - J. Hague
- University College London Hospital, London
| | | | - K. Ivancev
- University College London Hospital, London
| | - J. Raja
- University College London Hospital, London
| | | | - D. Simring
- University College London Hospital, London
| | - A.C. Fisher
- Globalstar on-line database IT support, University of Liverpool, Liverpool
| | - D. Smith
- Globalstar on-line database IT support, University of Liverpool, Liverpool
| | - G.P. Copeland
- POSSUM advice, Warrington General Hospital, Warrington
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Morgan-Rowe L, Simring D, Raja J, Agu O, Richards T, Ivancev K. The Use of an Endovascular Stent Graft with ‘Home-made’ Fenestrations to Treat an Infected Aortic Endograft in an Emergency Setting: A Short Report. Eur J Vasc Endovasc Surg 2011. [DOI: 10.1016/j.ejvs.2011.07.001] [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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Laverick S, Kazmi S, Ahktar S, Raja J, Perera S, Bokhari A, Meraj S, Ayub K, da Silva A, Pye M, Anser M, Pye J. Asian earthquake: report from the first volunteer British hospital team in Pakistan. Emerg Med J 2007; 24:543-6. [PMID: 17652673 PMCID: PMC2660074 DOI: 10.1136/emj.2006.037333] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [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: 11/04/2022]
Abstract
At 8:52 am on 8 October 2005 a massive earthquake wracked northern Pakistan and Kashmir. Various teams were sent to Islamabad and the disaster region from the UK. We discuss the types of injury patterns seen and recommend that a central register of volunteers should be created to deal with similar situations in the future.
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Affiliation(s)
- S Laverick
- Regional Maxillofacial Unit, University Hospital Aintree, Liverpool, UK.
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Skippage P, Raja J, McFarland R, Belli AM. Endovascular repair of iliac artery injury complicating lumbar disc surgery. Eur Spine J 2007; 17 Suppl 2:S228-31. [PMID: 17712578 PMCID: PMC2525903 DOI: 10.1007/s00586-007-0470-3] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/30/2007] [Revised: 07/11/2007] [Accepted: 07/27/2007] [Indexed: 10/22/2022]
Abstract
Vascular injury as a complication of disc surgery was first reported in 1945 by Linton and White. It is a rare but potentially fatal complication. The high mortality rate (40-100%) is attributed to a combination of rapid blood loss and the failure to recognise the cause of the deteriorating patient. Early diagnosis and treatment is essential. Treatment has traditionally been by open vascular surgical repair, however with modern imaging and endovascular techniques, minimally invasive treatment should be considered first line in patients who are stable. We present the case of a 51-year-old woman who sustained common iliac artery injury during lumbar spinal surgery that was treated successfully using a covered stent.
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Affiliation(s)
- P Skippage
- Department of Interventional Radiology, St George's Hospital, Blackshaw Road, Tooting, London, SW17 0QT, UK.
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Raja J, Ramachandran N, Munneke G, Patel U. Current status of transrectal ultrasound-guided prostate biopsy in the diagnosis of prostate cancer. Clin Radiol 2006; 61:142-53. [PMID: 16439219 DOI: 10.1016/j.crad.2005.10.002] [Citation(s) in RCA: 64] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2005] [Revised: 09/11/2005] [Accepted: 10/07/2005] [Indexed: 11/18/2022]
Abstract
In contemporary practice, most prostate cancers are either invisible on ultrasound or indistinguishable from concurrent benign prostatic hyperplasia. Diagnosis therefore rests on prostate biopsy. Biopsies are not simply directed at ultrasonically visible lesions, as these would miss many cancers; rather the whole gland is sampled. The sampling itself is systematic, using patterns based on prostate zonal anatomy and the geographical distribution and frequency of cancer. This review explains the evolution of the prostate biopsy technique, from the classical sextant biopsy method to the more recent extended biopsy protocols (8, 10, 12, >12 and saturation biopsy protocols). Extended protocols are increasingly being used to improve diagnostic accuracy, especially in those patients who require repeat biopsy. This trend has been facilitated by the ongoing improvement in safety and acceptability of the procedure, particularly with the use of antibiotic prophylaxis and local anaesthesia. The technical details of these extended protocols are discussed, as are the current data regarding procedure-related morbidity and how this may be minimized.
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Affiliation(s)
- J Raja
- Department of Radiology, St George's Hospital, Tooting, London, UK.
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Abstract
Establishing the diagnosis of a groin lump may be difficult, largely due to the large number of potential differential diagnoses. Indeed, this case was originally referred as a strangulated hernia. Despite the final diagnosis being infection of an undescended testicle, the patient did not report that he only ever had one scrotal testicle despite his 78 years of age.
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Affiliation(s)
- S Overstall
- Department of Surgery, St George's Hospital, Tooting, London, UK
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