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Sharma P, Sharma RK, Tewari S, Gill PS, Tanwar N, Arora R, Kaur M. Impact of subgingival instrumentation on systemic inflammation and serum bone resorption marker in premenopausal women with periodontitis: a prospective interventional study. Quintessence Int 2024; 55:108-118. [PMID: 38224106 DOI: 10.3290/j.qi.b4867855] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/16/2024]
Abstract
OBJECTIVES Inflammatory disorders including periodontitis have been investigated for their impact on systemic inflammation and bone health. The present study was conducted with an aim to evaluate impact of control of periodontal inflammation through subgingival instrumentation on serum interleukin 6 and serum C-terminal telopeptide of type I collagen (CTX) in premenopausal females with stage II and III periodontitis. METHOD AND MATERIALS In this single-arm prospective study, periodontal parameters, serum interleukin 6, serum CTX, and hematologic parameters (total leukocyte count, differential leukocyte count, platelet count, mean platelet volume, and platelet distribution width) were assessed at baseline. Subgingival instrumentation was done, and oral hygiene instructions were given. At week 4, professional plaque control was performed, and oral hygiene instructions were reinforced. Serum and hematologic parameters were reassessed at 8 weeks after subgingival instrumentation, in individuals meeting the clinical endpoints (ie, bleeding on probing < 10%). RESULTS There was significant reduction in serum interleukin 6 of 0.168 ± 0.164 pg/mL (P = .000), and serum CTX of 17.459 ± 4.363 pg/mL (P = .000) at 8 weeks after subgingival instrumentation. There was significant decrease in eosinophil count (P = .018) and mean platelet volume (P = .016) at 8 weeks after subgingival instrumentation; however, no significant change was found in other hematologic parameters. CONCLUSION Following subgingival instrumentation, biomarkers of both systemic inflammation (interleukin 6) and bone turnover (CTX) were observed to reduce significantly. This finding hints towards a positive impact of periodontal intervention on bone health.
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Mayr R, Iltchev A, Bonatti A, Forstner B, Fritz J, Gassner E, Arora R. [Trauma emergency room cases before and during the COVID-19 pandemic : Data from an alpine trauma center]. Unfallchirurgie (Heidelb) 2023; 126:960-966. [PMID: 36534361 PMCID: PMC9761024 DOI: 10.1007/s00113-022-01268-8] [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] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Accepted: 11/17/2022] [Indexed: 12/23/2022]
Abstract
INTRODUCTION The COVID-19 pandemic had a strong impact on the work of trauma medical teams. The aim of the study was to compare the trauma emergency room (TER) incidence and trauma mechanisms before and during the pandemic at a level I trauma center. OBJECTIVE The TER incidence before and during the pandemic should be assessed to be prepared for future pandemics or new COVID-19 outbreaks. MATERIAL AND METHODS Medical charts from all TER patients from March 2019 to February 2021 were analyzed. The incidence and trauma mechanisms of the 12 months before and the 12 months during the pandemic were compared. The trauma distribution and severity were described by the AIS and ISS, and the patients' country of residency was noted. RESULTS The TER cases decreased from 694 before the COVID-19 pandemic to 477 cases during the pandemic (Incidence rate 0.69). The strongest decrease in trauma cases was noted in sports injuries (0.55), followed by suicide attempts (0.63), traffic accidents (0.71) and leisure accidents (0.76). The rate of patients with severe injuries (ISS ≥ 16) was comparable with 40% before the pandemic and 44% during the pandemic. Foreign residency of TER patients shifted from 37% before the pandemic to 16% during the pandemic. The number of foreign patients was significantly reduced during the pandemic (257 vs. 77). DISCUSSION The TER incidence significantly decreased during the pandemic due to the imposed lockdowns during the peak winter tourism season. The rate of foreign TER patients changed during the pandemic, while the rate of severely injured patients remained stable.
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Affiliation(s)
- R Mayr
- Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich.
| | - A Iltchev
- Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - A Bonatti
- Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - B Forstner
- Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
| | - J Fritz
- Department für Medizinische Statistik, Informatik und Gesundheitsökonomie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - E Gassner
- Universitätsklinik für Radiologie, Medizinische Universität Innsbruck, Innsbruck, Österreich
| | - R Arora
- Universitätsklinik für Orthopädie und Traumatologie, Medizinische Universität Innsbruck, Anichstr. 35, 6020, Innsbruck, Österreich
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Malhotra S, Tewari S, Sharma R, Sharma RK, Tanwar N, Arora R. Clinical evaluation of root coverage in Miller class III/RT2 labial gingival recession treated with interdisciplinary periodontal-orthodontic therapy: a randomized controlled clinical trial. J Periodontal Implant Sci 2023; 53:53.e55. [PMID: 38290996 DOI: 10.5051/jpis.2204100205] [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: 10/13/2022] [Revised: 03/21/2023] [Accepted: 04/30/2023] [Indexed: 02/01/2024] Open
Abstract
PURPOSE The aim of current study was to evaluate percentage root coverage (RC%) in isolated Miller class III/RT2 labial gingival recession (GR) associated with malaligned mandibular anteriors, using interdisciplinary periodontal-orthodontic treatment as compared to mucogingival surgery alone. METHODS Thirty-six systemically healthy patients having isolated Miller class III/RT2 GR with respect to malaligned mandibular anteriors, were randomly divided into test group: mucogingival surgery using subepithelial connective tissue graft followed by orthodontic treatment and control group: mucogingival surgery alone. Primary clinical parameters included (RC%), recession depth, keratinized tissue width, mid-labial clinical attachment level, interdental clinical attachment level (iCAL), periodontal phenotype (PP), gingival thickness (GT), root coverage esthetics score (RES) and hypersensitivity. Total duration of follow up was 12 months. RESULTS Mean RC% was significantly more achieved in test group (66.67%±40.82%) in comparison to control group (39.93%±31.41%) at the end of study (P=0.049). Further, complete root coverage was attained in 5/8 cases of test group versus 1/2 cases of control group after 3/12 months respectively. RES and hypersensitivity, showed statistically significant improvement after complete follow up period in both the groups. An ideal RES score of 10 was achieved in 4/7 cases of test group while in 1/2 cases of control group after 3/12 months respectively. Correlation analysis revealed significant negative correlation between RC% and iCAL. Correlation of RC% with GT and PP was non-significant. CONCLUSIONS Interdisciplinary periodontal-orthodontic approach may be more beneficial in terms of achieving improved RC%, esthetic and resolution of hypersensitivity in the management of Miller class III/RT2 GR in malaligned mandibular anteriors. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT04255914.
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Affiliation(s)
- Sakshi Malhotra
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Shikha Tewari
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India.
| | - Rekha Sharma
- Department of Orthodontics and Dentofacial Orthopaedics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Rajinder Kumar Sharma
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Nishi Tanwar
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
| | - Ritika Arora
- Department of Periodontics, Post Graduate Institute of Dental Sciences, Rohtak, India
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Sahni A, Sharma RK, Tewari S, Gill PS, Arora R. Impact of supragingival scaling on the outcomes of subgingival instrumentation completed after 1 week: a split-mouth randomized clinical trial. Quintessence Int 2023; 54:724-733. [PMID: 37334784 DOI: 10.3290/j.qi.b4168461] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/20/2023]
Abstract
OBJECTIVE To investigate the impact of supragingival scaling on the clinical outcomes of subgingival instrumentation completed after 1 week. METHOD AND MATERIALS In 27 patients with Stage II and Stage III periodontitis, pairs of contralateral quadrants were randomly assigned into test group 1 (single sitting scaling and root planing) and test group 2 (supragingival scaling followed by subgingival instrumentation after 1 week). Periodontal parameters were recorded at baseline, 2, 4, and 6 months; Gingival crevicular fluid vascular endothelial growth factor (VEGF) estimation was done at baseline in both groups and 7 days after supragingival scaling in test group 2. RESULTS At 6 months, significantly better improvement in test group 1 at sites with periodontal probing depth (PPD) > 5 mm; (∆PPD = 2.32 mm vs 1.41 mm, P = .001; ∆clinical attachmen level [CAL] = 2.34 mm vs 1.39 mm, P = .001) was observed. Supragingival scaling resulted in significant reduction in gingival crevicular fluid VEGF (42.46 to 27.88 pg/site) after 1 week. Regression analysis explained 14% variance in VEGF to baseline PPD at sites with PPD > 4 mm; and 21% variance in CAL improvement to VEGF at sites with PPD > 5 mm. The percentage of sites with PPD = 5 to 8 mm reaching the clinical endpoint was 52% and 40% for test group 1 and test group 2, respectively. Better results were noticed in bleeding on pocket probing-positive sites in both groups. CONCLUSION The sites with PPD > 5 mm where supragingival scaling was followed by subgingival instrumentation after 1 week resulted in less favourable treatment outcomes. (Clinical trial registry NCT05449964).
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Woess C, Huck CW, Badzoka J, Kappacher C, Arora R, Lindtner RA, Zelger P, Schirmer M, Rabl W, Pallua J. Raman spectroscopy for postmortem interval estimation of human skeletal remains: A scoping review. J Biophotonics 2023; 16:e202300189. [PMID: 37494000 DOI: 10.1002/jbio.202300189] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/24/2023] [Revised: 07/19/2023] [Accepted: 07/22/2023] [Indexed: 07/27/2023]
Abstract
Estimating postmortem intervals (PMI) is crucial in forensic investigations, providing insights into criminal cases and determining the time of death. PMI estimation relies on expert experience and a combination of thanatological data and environmental factors but is prone to errors. The lack of reliable methods for assessing PMI in bones and soft tissues necessitates a better understanding of bone decomposition. Several research groups have shown promise in PMI estimation in skeletal remains but lack valid data for forensic cases. Current methods are costly, time-consuming, and unreliable for PMIs over 5 years. Raman spectroscopy (RS) can potentially estimate PMI by studying chemical modifications in bones and teeth correlated with burial time. This review summarizes RS applications, highlighting its potential as an innovative, nondestructive, and fast technique for PMI estimation in forensic medicine.
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Affiliation(s)
- C Woess
- Institute of Forensic Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Christian W Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - J Badzoka
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - C Kappacher
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innsbruck, Austria
| | - R Arora
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - R A Lindtner
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
| | - Philipp Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Innsbruck, Austria
| | - M Schirmer
- Department of Internal Medicine, Clinic II, Medical University of Innsbruck, Innsbruck, Austria
| | - W Rabl
- Institute of Forensic Medicine, Medical University of Innsbruck, Innsbruck, Austria
| | - Johannes Pallua
- Department of Orthopaedics and Traumatology, Medical University of Innsbruck, Innsbruck, Austria
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Majid U, Hussain SAS, Zahid A, Haider MH, Arora R. Mental health outcomes in health care providers during the COVID-19 pandemic: an umbrella review. Health Promot Int 2023; 38:7125522. [PMID: 37067168 DOI: 10.1093/heapro/daad025] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/18/2023] Open
Abstract
As we head into the third year of the COVID-19 pandemic, there is an increasing need to consider the long-term mental health outcomes of health care workers (HCWs) who have experienced overwhelming work pressure, economic and social deprivation, burnout, and post-traumatic stress disorder (PTSD). This scoping umbrella review summarizes the mental health outcomes of published evidence syntheses on HCWs worldwide. We analyzed 39 evidence syntheses representing the findings from 1297 primary studies. We found several persistent fears and concerns (job-related fears, fear of stigmatization, worries about the pandemic, and infection-related fears) that shaped HCW experiences in delivering health care. We also describe several risk factors (job-related, social factors, poor physical and mental health, and inadequate coping strategies) and protective factors (individual and external factors). This is the first scoping umbrella review comprehensively documenting the various risk and protective factors that HCWs have faced during the COVID-19 pandemic. HCWs continue to fear the risk that they may infect their family and friends since they regularly interact with COVID-19 patients. This places HCWs in a precarious situation requiring them to balance risk to their family and friends and potential social deprivation from isolation.
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Affiliation(s)
- Umair Majid
- Institute of Health Policy, Management, and Evaluation, University of Toronto, Ontario, Canada
- The Methodologists (TMT) Corp. Toronto, Ontario, Canada
| | | | - Anas Zahid
- Department of Internal Medicine, Azra Naheed Medical College, Lahore, Pakistan
| | | | - Ritika Arora
- Department of Health Research Methods, Evidence and Impact, McMaster University, Ontario, Canada
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Kaur M, Sharma RK, Tewari S, Arora R, Tanwar N, Sangwan A. Effect of antibiotics as an adjuvant to subgingival instrumentation on systemic inflammation in patients with periodontitis - A randomized clinical trial. Quintessence Int 2023; 0:0. [PMID: 36876718 DOI: 10.3290/j.qi.b3942249] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 03/07/2023]
Abstract
OBJECTIVES The aim of the present study was to evaluate effect of subgingival instrumentation (SI) with or without antibiotics on systemic inflammation. Moreover, systemic parameters were compared between periodontally healthy (PH) individuals and periodontitis patients. METHOD AND MATERIALS Patients with generalized periodontitis: stage III and PH individuals were recruited. Forty eight periodontitis patients were randomly allocated to each treatment group; systemic antibiotics for seven days after completion of SI (AB group), or SI alone (SI group). Periodontal parameters, serum high-sensitivity C-reactive protein (hsCRP), and haematological parameters were assessed at baseline and at 8th week. Multivariate analysis was applied to analyze predictive effect of treatment allocated and improvement in periodontal parameters on change in systemic parameters. RESULTS At baseline, hsCRP, total leukocyte count (TLC), neutrophil, and monocyte count were significantly higher in periodontitis patients. There was comparable reduction in neutrophil count in both treatment groups. At 8th week, change in periodontal parameters was similar in treatment groups, except for probing pocket depth (PPD). Improvement in both PPD and clinical attachment level (CAL) and CAL alone was predictive of change in TLC and lymphocyte count respectively. CONCLUSION This study failed to demonstrate the significant benefit of systemic antibiotics as an adjuvant to SI on improvement in periodontal inflammation and systemic inflammatory parameters, despite significantly higher reduction in PPDs.
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Wurm A, Kühn J, Kugel K, Putzer D, Arora R, Coraça-Huber DC, Zelger P, Badzoka J, Kappacher C, Huck CW, Pallua JD. Raman microscopic spectroscopy as a diagnostic tool to detect Staphylococcus epidermidis in bone grafts. Spectrochim Acta A Mol Biomol Spectrosc 2022; 280:121570. [PMID: 35779474 DOI: 10.1016/j.saa.2022.121570] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [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: 03/10/2022] [Revised: 06/02/2022] [Accepted: 06/26/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION Raman microscopic spectroscopyis a new approach for further characterization and detection of molecular features in many pathological processes. This technique has been successfully applied to scrutinize the spatial distribution of small molecules and proteins within biological systems by in situ analysis. This study uses Raman microscopic spectroscopyto identify any in-depth benefits and drawbacks in diagnosing Staphylococcus epidermidis in human bone grafts. MATERIAL AND METHODS 40 non-infected human bone samples and 10 human bone samples infected with Staphylococcus epidermidis were analyzed using Raman microscopic spectroscopy. Reflectance data were collected between 200 cm-1 and 3600 cm-1 with a spectral resolution of 4 cm-1 using a Senterra II microscope (Bruker, Ettlingen, Germany). The acquired spectral information was used for spectral and unsupervised classification, such as principal component analysis. RESULTS Raman measurements produced distinct diagnostic spectra that were used to distinguish between non-infected human bone samples and Staphylococcus epidermidis infected human bone samples by spectral and principal component analyses. A substantial loss in bone quality and protein conformation was detected by human bone samples co-cultured with Staphylococcus epidermidis. The mineral-to-matrix ratio using the phosphate/Amide I ratio (p = 0.030) and carbonate/phosphate ratio (p = 0.001) indicates that the loss of relative mineral content in bones upon bacterial infection is higher than in non-infected human bones. Also, an increase of alterations in the collagen network (p = 0.048) and a decrease in the structural organization and relative collagen in infected human bone could be detected. Subsequent principal component analyses identified Staphylococcus epidermidis in different spectral regions, respectively, originating mainly from CH2 deformation (wagging) of protein (at 1450 cm-1) and bending and stretching modes of C-H groups (∼2800-3000 cm-1). CONCLUSION Raman microscopic spectroscopyis presented as a promising diagnostic tool to detect Staphylococcus epidermidis in human bone grafts. Further studies in human tissues are warranted.
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Affiliation(s)
- A Wurm
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - J Kühn
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - K Kugel
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - D Putzer
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - R Arora
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - D C Coraça-Huber
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria
| | - P Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - J Badzoka
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - C Kappacher
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - C W Huck
- Institute of Analytical Chemistry and Radiochemistry, Innsbruck, Austria
| | - J D Pallua
- University Hospital for Orthopaedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020, Innsbruck, Austria.
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Arora R, Kaur M, Tewari S, Sharma R, Tanwar N, Sangwan A. Impact of scaling and root planing on association of site- and tooth-specific factors with bleeding on pocket probing. Quintessence Int 2022; 53:752-761. [PMID: 35976751 DOI: 10.3290/j.qi.b3314979] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
OBJECTIVES This study was conducted to elucidate the link of site-specific, tooth-related, and patient-associated factors with bleeding on pocket probing (BOPP) and the impact of scaling and root planing over these factors. METHOD AND MATERIALS This cross-sectional study comprised of 50 untreated periodontitis patients and 50 periodontitis patients who had received scaling and root planing in the last 6 to 12 months and were on supportive periodontal therapy. Multilevel modeling was applied to data, with BOPP being the dichotomous outcome variable. Variables that revealed a significant association with BOPP in multilevel modeling were analyzed further to find the influence of the treatment group (untreated periodontitis and treated periodontitis) on the association between predictor variables and BOPP. RESULTS Odds ratio (OR) for BOPP in untreated periodontitis versus treated periodontitis was 1.493, and in molars versus anterior teeth this was 1.439. Untreated periodontitis had an OR of 3.500 compared to treated periodontitis, in anterior teeth with Plaque Index 0. This was 2.795 and 7.734 in treated periodontitis and 5.106 and 12.762 in untreated periodontitis at Plaque Index 1 and 2, respectively. Bleeding on marginal probing had an OR of 6.984 for BOPP. Bleeding on marginal probing negative sites had higher OR in untreated periodontitis irrespective of the probing pocket depth. CONCLUSION Plaque control is more effective in controlling periodontal inflammation after scaling and root planing. The probability of BOPP in the absence of bleeding on marginal probing is higher in untreated patients. The scope of influence of marginal inflammation on periodontal inflammation in shallow pockets is more in untreated periodontitis as compared to treated periodontitis; however, the trend reverses in deep pockets.
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Labit E, Sinha S, Kutluberk E, Jaffer A, Arora R, Cao L, Shin W, Rosin N, Yipp B, Biernaskie J. 753 Preferential recruitment of immature neutrophils enables robust skin regeneration. J Invest Dermatol 2022. [DOI: 10.1016/j.jid.2022.05.766] [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: 10/17/2022]
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Brunner A, Schmidt VM, Zelger B, Woess C, Arora R, Zelger P, Huck CW, Pallua J. Visible and Near-Infrared hyperspectral imaging (HSI) can reliably quantify CD3 and CD45 positive inflammatory cells in myocarditis: Pilot study on formalin-fixed paraffin-embedded specimens from myocard obtained during autopsy. Spectrochim Acta A Mol Biomol Spectrosc 2022; 274:121092. [PMID: 35257987 DOI: 10.1016/j.saa.2022.121092] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/24/2021] [Revised: 02/17/2022] [Accepted: 02/25/2022] [Indexed: 06/14/2023]
Abstract
INTRODUCTION To implement Hyperspectral Imaging (HSI) as a tool for quantifying inflammatory cells in tissue specimens by the example of myocarditis in a collective of forensic patients. MATERIAL AND METHODS 44 consecutive patients with suspected myocardial inflammation at autopsy, diagnosed between 2013 and 2018 at the Institute of ForensicMedicine, Medical University of Innsbruck, were selected for this study. Using the IMEC SNAPSCAN camera, visible and near infrared hyperspectral images were collected from slides stained with CD3 and CD45 to assess quantity and spatial distribution of positive cells. Results were compared with visual assessment (VA) and conventional digital image analysis (DIA). RESULTS Finally, specimens of 40 patients were evaluated, of whom 36 patients (90%) suffered from myocarditis, two patients (5%) had suspected healing/healed myocarditis, and two did no have myocarditis (5%). The amount of CD3 and CD45 positive cells did not differ significantly between VA, HSI, and DIA (pVA/HSI/DIA = 0.46 for CD3 and 0.81 for CD45). Coheńs Kappa showed a very high correlation between VA versus HSI, VA versus DIA, and HSI versus DIA for CD3 (Coheńs Kappa = 0.91, 1.00, and 0.91, respectively). For CD45 an almost as high correlation was seen for VA versus HSI and HSI versus DIA (Coheńs Kappa = 0.75 and 0.70) and VA versus DIA (Coheńs Kappa = 0.89). CONCLUSION HSI is a reliable and objective method to count inflammatory cells in tissue slides of suspected myocarditis. Implementation of HSI in digital pathology might further expand the possibility of a sophisticated method.
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Affiliation(s)
- A Brunner
- Innsbruck Medical University, Institute of Pathology, Neuropathology, and Molecular Pathology, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - V M Schmidt
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria
| | - B Zelger
- Innsbruck Medical University, Institute of Pathology, Neuropathology, and Molecular Pathology, Muellerstrasse 44, 6020 Innsbruck, Austria
| | - C Woess
- Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria.
| | - R Arora
- University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
| | - P Zelger
- University Clinic for Hearing, Voice and Speech Disorders, Medical University of Innsbruck, Anichstrasse 35, Innsbruck, Austria
| | - C W Huck
- Institute of Analytical Chemistry and Radiochemistry, University of Innsbruck, Innrain 80-82, Innsbruck, Austria
| | - J Pallua
- Innsbruck Medical University, Institute of Pathology, Neuropathology, and Molecular Pathology, Muellerstrasse 44, 6020 Innsbruck, Austria; Institute of Forensic Medicine, Medical University of Innsbruck, Muellerstraße 44, 6020 Innsbruck, Austria; University Hospital for Orthopedics and Traumatology, Medical University of Innsbruck, Anichstraße 35, 6020 Innsbruck, Austria
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Arora R, Alam F, Zaka-Ur-Rab A, Maheshwari V, Alam K. 32P Neutrophil to lymphocyte ratio (NLR) as a surrogate clinical marker for Ki-67 in breast cancer. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.03.047] [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: 11/01/2022] Open
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Mehta L, Tewari S, Sharma R, Sharma RK, Tanwar N, Arora R. Assessment of the effect of orthodontic treatment on the stability of pre-orthodontic recession coverage by connective tissue graft: a randomized controlled clinical trial. Quintessence Int 2022; 53:236-248. [PMID: 34881844 DOI: 10.3290/j.qi.b2407815] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
OBJECTIVE To compare the changes in periodontal parameters after orthodontic treatment in patients having isolated gingival recession treated with and without pre-orthodontic gingival recession coverage. METHOD AND MATERIALS Thirty-six patients requiring orthodontic treatment with a facially positioned mandibular anterior tooth with labial recession were randomly allocated to either test group: root coverage by subepithelial connective tissue graft (SCTG) followed by orthodontic treatment, or control group (orthodontic treatment only). Primary clinical parameters included recession depth, keratinized tissue width, root coverage, root esthetic score, and gingival phenotype. The patients were followed up for at least 1 year. RESULTS Level of gingival margin attained in test group teeth after SCTG were maintained at end of orthodontic treatment (P = .727). Root coverage achieved was 69.33 ± 30.74% versus 22.36 ± 27.70% in test and control group, respectively (P = .000), and gain in keratinized tissue width was 1.59 ± 0.73 mm in test versus 0.41 ± 0.49 mm in control group (P = .000). The number of teeth with improved gingival phenotype and decreased hypersensitivity was also observed to be statistically significant in the test group (P = .049, P = .002). CONCLUSION Root coverage procedure may be performed before the planned orthodontic treatment as graft stability is preserved throughout the course of orthodontic treatment.
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Stoev S, Dimitrov K, Zarkov I, Mircheva T, Zapryanova D, Valchev I, Denev S, Chobanova S, Stefanov M, Arora R. Some Indian herbs have protective effects against deleterious effects of ochratoxin A in broiler chicks. WORLD MYCOTOXIN J 2021. [DOI: 10.3920/wmj2020.2657] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
A protective effect of two herbs, Glycyrrhiza glabra and Tinospora cordifolia, given as feed additives was observed against the growth inhibitory effect of ochratoxin A (OTA) and associated immunosuppression and biochemical or pathomorphological changes. The feed levels of 3 mg/kg OTA and fine powder of one of both herbs were given during a period of 32 days to female broiler chicks divided into 3 experimental and 1 control groups (14 chicks per group). The observed pathological and biochemical changes, the changes in relative organs’ weight and body weight, and the decrease of antibody titer against Newcastle disease were more pronounced in the OTA-treated chicks without herbal supplementation, and less pronounced in the chicks treated additionally with G. glabra or T. cordifolia as was shown by the better feed performance and the higher body weight in the chicks treated with the herbs. The higher relative weight of lymphoid organs of the chicks supplemented with both herbs revealed their beneficial effects on the immune system. The hepatoprotective effect of both herbs was evident, being stronger in the chicks additionally supplemented with G. glabra shown by the pathomorphological findings and by the lower levels of aspartate transaminase (131.1 U/l) compared to chicks given only OTA (156.0 U/l). A protective effect of T. cordifolia on the bone marrow and kidneys was found as was shown by the lower levels of uric acid (382.9 μmol/l) compared to chicks given only OTA (466.9 μmol/l).
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Affiliation(s)
- S.D. Stoev
- Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Students Campus, 6000 Stara Zagora, Bulgaria
| | - K. Dimitrov
- Department of General and Clinical Pathology, Faculty of Veterinary Medicine, Trakia University, Students Campus, 6000 Stara Zagora, Bulgaria
| | - I. Zarkov
- Department of Veterinary Microbiology, Infectious and Parasitic Diseases, Faculty of Veterinary Medicine, Trakia University, Students Campus, 6000 Stara Zagora, Bulgaria
| | - T. Mircheva
- Department of Biochemistry, Faculty of Veterinary Medicine, Trakia University, Students Campus, 6000 Stara Zagora, Bulgaria
| | - D. Zapryanova
- Department of Biochemistry, Faculty of Veterinary Medicine, Trakia University, Students Campus, 6000 Stara Zagora, Bulgaria
| | - I. Valchev
- Department of Internal non-communicable diseases, Faculty of Veterinary Medicine, Trakia University, Students Campus, 6000 Stara Zagora, Bulgaria
| | - S. Denev
- Department of Biochemistry and Microbiology, Faculty of Agriculture, Trakia University, Students campus, 6000 Stara Zagora, Bulgaria
| | - S. Chobanova
- Department of Biochemistry and Microbiology, Faculty of Agriculture, Trakia University, Students campus, 6000 Stara Zagora, Bulgaria
| | - M. Stefanov
- Department of Morphology, physiology and nutrition, Faculty of Agriculture, Trakia University; Students campus, 6000 Stara Zagora, Bulgaria
| | - R. Arora
- Phytochemistry and Analytical Toxicology Division, Department of Nutrition, Biochemistry, Exercise Physiology and Yoga, Defence Institute of Physiology and Allied Sciences, Defence Research and Development Organization (DRDO), Lucknow Road, Timarpur, Delhi 110054, India
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15
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Shapiro J, Ray JG, McArthur E, Jeyakumar N, Chanchlani R, Harel Z, Arora R, Meraz-Munoz A, Garg AX, Hladunewich M, Wald R. Risk of Acute Kidney Injury After Hypertensive Disorders of Pregnancy: A Population-Based Cohort Study. Am J Kidney Dis 2021; 79:561-569. [PMID: 34487795 DOI: 10.1053/j.ajkd.2021.07.017] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 07/16/2021] [Indexed: 11/11/2022]
Abstract
RATIONALE & OBJECTIVE Even though studies have demonstrated a relationship between hypertensive disorders of pregnancy (HDPs) and chronic kidney disease, there are limited data on the risk of acute kidney injury (AKI) following HDPs. We examined the risk of AKI following the occurrence of HDPs. STUDY DESIGN Retrospective population-based cohort study. SETTING & PARTICIPANTS Pregnant women in Ontario, Canada, aged 14-50 years, who delivered at ≥20 weeks' gestation between April 1, 2002, and March 31, 2015. EXPOSURE Preeclampsia, gestational hypertension, or neither. OUTCOMES The primary outcome was AKI with receipt of dialysis (AKI-D) ≥90 days after delivery. The main secondary outcome was AKI based on a hospitalization with a diagnostic code for AKI ≥90 days after delivery. ANALYTICAL APPROACH Time-dependent Cox proportional and cause-specific hazards models were used to evaluate the relationship between HDP and outcomes of interest. Models were adjusted for baseline and time-varying covariates. RESULTS Our cohort comprised 1,142,656 women and 1,826,235 deliveries, of which 1.7% were associated with gestational hypertension and 4.4% with preeclampsia. After a mean follow-up of 6.7 years, there were 322 episodes of AKI-D (0.41 per 10,000 person-years) and 1,598 episodes of AKI based on diagnostic codes (2.04 per 10,000 person-years). After adjustment, neither preeclampsia nor gestational hypertension was associated with AKI-D. Preeclampsia was associated with AKI (HR, 1.22 [95% CI, 1.03-1.45]), but gestational hypertension was not. LIMITATIONS Retrospective design and possible unmeasured confounding. Cases of HDPs and AKI may have been undetected. CONCLUSIONS Preeclampsia was a risk factor for AKI occurring ≥90 days after delivery. Our findings suggest the potential importance of obtaining a pregnancy history as part of a comprehensive risk profile for acute kidney disease and suggest that women with a history of HDP may benefit from monitoring of kidney function.
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Affiliation(s)
| | - Joel G Ray
- Departments of Medicine, Toronto; University of Toronto Divisions of General Internal Medicine, Toronto; Li Ka Shing Knowledge Institute, Toronto; ICES (Institute of Clinical Evaluative Sciences), London, Ontario, Canada
| | - Eric McArthur
- ICES (Institute of Clinical Evaluative Sciences), London, Ontario, Canada
| | | | - Rahul Chanchlani
- Division of Pediatric Nephrology, McMaster University, Hamilton; ICES (Institute of Clinical Evaluative Sciences), London, Ontario, Canada
| | - Ziv Harel
- Departments of Medicine, Toronto; Nephrology, Toronto; Li Ka Shing Knowledge Institute, Toronto; ICES (Institute of Clinical Evaluative Sciences), London, Ontario, Canada
| | | | | | - Amit X Garg
- ICES (Institute of Clinical Evaluative Sciences), London, Ontario, Canada; Division of Nephrology, London Health Sciences Centre and Western University, London, Ontario, Canada
| | - Michelle Hladunewich
- Departments of Medicine, Toronto; St. Michael's Hospital Division of Nephrology, Sunnybrook Health Sciences Centre, Toronto
| | - Ron Wald
- Departments of Medicine, Toronto; Nephrology, Toronto; Li Ka Shing Knowledge Institute, Toronto; ICES (Institute of Clinical Evaluative Sciences), London, Ontario, Canada.
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16
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Naftalin J, Bean E, Saridogan E, Barton-Smith P, Arora R, Jurkovic D. Imaging in gynecological disease (21): clinical and ultrasound characteristics of accessory cavitated uterine malformations. Ultrasound Obstet Gynecol 2021; 57:821-828. [PMID: 32770812 DOI: 10.1002/uog.22173] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/13/2020] [Revised: 07/27/2020] [Accepted: 07/29/2020] [Indexed: 06/11/2023]
Abstract
OBJECTIVE To describe the clinical and ultrasound characteristics of accessory cavitated uterine malformations (ACUMs). METHODS This was a single-center observational study of consecutive patients diagnosed with an ACUM, who had undergone an ultrasound examination by an experienced ultrasound examiner between January 2013 and May 2019, identified retrospectively from medical records. ACUM was diagnosed when a cavitated lesion with a myometrial mantle and echogenic contents was seen within the anterolateral wall of the myometrium beneath the insertion of the round ligament. In all women, presenting symptoms and clinical history were recorded along with detailed descriptions of the lesions and any concomitant pelvic abnormalities. RESULTS Twenty patients diagnosed with an ACUM were identified. Median age was 29.2 (interquartile range, 25.0-35.8) years. None of the women was premenarchal or postmenopausal. All of the women reported painful periods or pelvic pain and none of them reported subfertility. Twelve of the ACUMs were in the right anterolateral myometrium and eight were in the left anterolateral myometrium. Both a myometrial mantle and a fluid-filled cavity were considered to be defining features on ultrasound. The fluid contained within the cavity was either echogenic with a ground-glass appearance or hyperechoic. All of the lesions were spherical in shape. The Doppler flow seen in the outer rim was not markedly different from that of the surrounding myometrium, and the content of the cavity was avascular on Doppler examination. The mean outer cavity diameter of the ACUMs was 22.8 (95% CI, 20.9-24.8) mm and the mean internal cavity diameter was 14.1 (95% CI, 12.2-16.1) mm. Four women opted for transvaginal ultrasound-guided alcohol sclerotherapy. Surgical excision was carried out in eight cases, and the diagnosis was confirmed on histopathological examination in all of them. CONCLUSIONS ACUMs are a uterine abnormality with a distinct ultrasound appearance, which are associated with dysmenorrhea and chronic pelvic pain. Knowledge of their typical appearance on ultrasound could facilitate early detection and treatment. There are several treatment options for ACUM, ranging from simple analgesia to complete excision. Further prospective and longitudinal studies are required to study the prevalence and natural history of this condition. © 2020 International Society of Ultrasound in Obstetrics and Gynecology.
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Affiliation(s)
- J Naftalin
- Institute for Women's Heath, University College Hospital, London, UK
| | - E Bean
- Institute for Women's Heath, University College Hospital, London, UK
| | - E Saridogan
- Institute for Women's Heath, University College Hospital, London, UK
| | | | - R Arora
- Department of Cellular Pathology, University College London NHS Trust, London, UK
| | - D Jurkovic
- Institute for Women's Heath, University College Hospital, London, UK
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17
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RAHMANI W, Sinha S, Chung H, Arora R, Jaffer A, Biernaskie J, Chun J. POS-389 PODOCYTE MATURATION IN HUMAN KIDNEY ORGANOIDS IS ACCELERATED WITH RENIN-ANGIOTENSIN SYSTEM ACTIVATION. Kidney Int Rep 2021. [DOI: 10.1016/j.ekir.2021.03.407] [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] Open
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18
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Soygur B, Jaszczak RG, Fries A, Nguyen DH, Malki S, Hu G, Demir N, Arora R, Laird DJ. Intercellular bridges coordinate the transition from pluripotency to meiosis in mouse fetal oocytes. Sci Adv 2021; 7:7/15/eabc6747. [PMID: 33827806 PMCID: PMC8026130 DOI: 10.1126/sciadv.abc6747] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2020] [Accepted: 02/18/2021] [Indexed: 05/14/2023]
Abstract
Meiosis is critical to generating oocytes and ensuring female fertility; however, the mechanisms regulating the switch from mitotic primordial germ cells to meiotic germ cells are poorly understood. Here, we implicate intercellular bridges (ICBs) in this state transition. We used three-dimensional in toto imaging to map meiotic initiation in the mouse fetal ovary and revealed a radial geometry of this transition that precedes the established anterior-posterior wave. Our studies reveal that appropriate timing of meiotic entry across the ovary and coordination of mitotic-meiotic transition within a cyst depend on the ICB component Tex14, which we show is required for functional cytoplasmic sharing. We find that Tex14 mutants more rapidly attenuate the pluripotency transcript Dppa3 upon meiotic initiation, and Dppa3 mutants undergo premature meiosis similar to Tex14 Together, these results lead to a model that ICBs coordinate and buffer the transition from pluripotency to meiosis through dilution of regulatory factors.
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Affiliation(s)
- B Soygur
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Reproductive Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
- Department of Histology and Embryology, Akdeniz University School of Medicine, Antalya, Turkey
| | - R G Jaszczak
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Reproductive Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - A Fries
- Biological Imaging Development Center, University of California, San Francisco, San Francisco, CA, USA
| | - D H Nguyen
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Reproductive Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA
| | - S Malki
- Epigenetics and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - G Hu
- Epigenetics and Stem Cell Biology Laboratory, National Institute of Environmental Health Sciences, Durham, NC, USA
| | - N Demir
- Department of Histology and Embryology, Akdeniz University School of Medicine, Antalya, Turkey
| | - R Arora
- Department of Obstetrics, Gynecology and Reproductive Biology, The Institute for Quantitative Health Science and Engineering, College of Human Medicine, Michigan State University, East Lansing, MI, USA
| | - D J Laird
- Department of Obstetrics, Gynecology and Reproductive Sciences, Center for Reproductive Sciences, Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, University of California, San Francisco, San Francisco, CA, USA.
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19
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Tieges Z, MacLullich AMJ, Anand A, Cassaroni M, O'Connor M, Ryan D, Saller T, Arora R, Chang Y, Agarwal K, Taffet G, Quinn T, Shenkin S, Galvin R. 33 Diagnostic Test Accuracy of the 4AT for Delirium Detection: Systematic Review and Meta-Analysis. Age Ageing 2021. [DOI: 10.1093/ageing/afab029.12] [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] Open
Abstract
Abstract
Introduction
Detection of delirium in hospitalised older adults is recommended in national and international guidelines. The 4 ‘A’s Test (4AT; www.the4AT.com) is a short (<2 min) instrument for delirium detection that is used internationally as a standard tool in clinical practice. We performed a systematic review and meta-analysis of diagnostic test accuracy of the 4AT for delirium detection.
Methods
We searched the following electronic databases through Ovid: MEDLINE, Embase, and PsycINFO. Additional databases were searched: CINAHL (EBSCOhost), clinicaltrials.gov and Cochrane Central Register of Controlled Trials from 2011 (4AT publication) until 21 December 2019. Inclusion criteria: older adults (≥65) across any setting of care except critical care; validation study of the 4AT against a delirium reference standard (standard diagnostic criteria or validated tool). Two reviewers independently screened abstracts and papers and performed the data extraction. Pooled estimates of sensitivity and specificity were generated from a bivariate random effects model.
Results
17 studies (n = 3,701 observations) were included. Various settings including acute medicine, surgery, stroke wards and the emergency department were represented. The overall prevalence of delirium was 24.2% (95% CI 17.8–32.1%; range 10.5–61.9%). The pooled sensitivity was 0.88 (95% CI 0.80–0.93) and the pooled specificity was 0.88 (95% CI 0.82–0.92). The methodological quality of studies was mostly good.
Conclusions
The 4AT is now supported by a substantial evidence base comparable to other well-studied tools such as the Confusion Assessment Method (CAM). The strong pooled sensitivity and specificity findings for the 4AT in this meta-analysis along with its brevity and lack of need for specific training provide support for its use as an effective assessment tool for delirium.
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Affiliation(s)
- Z Tieges
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - A M J MacLullich
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - A Anand
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - M Cassaroni
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - M O'Connor
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - D Ryan
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - T Saller
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - R Arora
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - Y Chang
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - K Agarwal
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - G Taffet
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - T Quinn
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - S Shenkin
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
| | - R Galvin
- Geriatric Medicine, University of Edinburgh; Cardiovascular Sciences, University of Edinburgh; Health Research Institute, University of Limerick; Ageing & Therapeutics, University Hospital Limerick; Emergency Department, University Hospital Limerick; Max Rady College of Medicine, University of Manitoba; Section of Geriatrics, Baylor College of Medicine, Houston, USA; Houston Methodist Hospital, H
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20
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Kaiser P, Brueckner G, Kastenberger T, Schmidle G, Stock K, Arora R. Mid-term follow-up of surgically treated and healed scaphoid fractures. Hand Surg Rehabil 2021; 40:288-292. [PMID: 33549698 DOI: 10.1016/j.hansur.2020.12.006] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 12/02/2020] [Accepted: 12/02/2020] [Indexed: 01/16/2023]
Abstract
The aim of this study was to evaluate the mid-term results of surgically treated scaphoid fractures since we were concerned that good results might deteriorate over time due to osteoarthritis or functional impairment. Thirty-three out of 121 surgically treated patients (isolated scaphoid fractures n = 23; scaphoid fractures with concomitant injuries n = 10) were evaluated retrospectively (47-138 months). Five patients (4%) had a non-union after internal fixation and were excluded because of additional treatment. The remaining 83 patients were not available for a follow-up examination. Patients with an isolated scaphoid fracture had a mean extension-flexion of 68°-0°-64°, a radial-ulnar deviation of 27°-0°-41° and a grip strength of 39 kg (corresponding to 87-98% of the uninjured contralateral wrist), while patients with concomitant injuries had a mean extension-flexion of 60°-0°-44°, radial-ulnar deviation of 22°-0°-38° and a grip strength of 42 kg (corresponding to 73-98% of the uninjured contralateral wrist). The Michigan Hand Questionnaire score was 85 and 75 and the Patient-Rated Wrist Evaluation score was 8 and 21, respectively. Fifteen patients had radiological signs of radiocarpal osteoarthritis with a significantly higher occurrence in those who had concomitant injuries compared to those with isolated scaphoid fractures (p < 0.01). There was no significant group difference in scaphotrapeziotrapezoid (STT) osteoarthritis (p = 0.968). One STT osteoarthritis case occurred after plate fixation, one after antegrade screw fixation and 10 after retrograde screw fixation. Surgical treatment of an acute isolated scaphoid fracture has excellent clinical, functional, and radiologic mid-term results, while scaphoid fractures with concomitant wrist injuries have slightly inferior results.
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Affiliation(s)
- P Kaiser
- Department for Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
| | - G Brueckner
- Department for Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
| | - T Kastenberger
- Department for Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
| | - G Schmidle
- Department for Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
| | - K Stock
- Department for Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
| | - R Arora
- Department for Orthopaedics and Traumatology, Medical University Innsbruck, Anichstr. 35, 6020 Innsbruck, Austria.
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21
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Pant S, Dimri A, Arora R, Bachani S, Raisuddin S, Siraj F, Rastogi S. Chlamydia trachomatis infection predisposes to ectopic pregnancy by regulating expression of tetraspanins in fallopian tube: A pilot study. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1171] [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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22
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Arora R, Kazemi G, Hsu T, Levine O, Basi SK, Henning JW, Sussman J, Mukherjee SD. Implementing changes to a residency program curriculum before competency-based medical education: a survey of Canadian medical oncology program directors. Curr Oncol 2020; 27:e614-e620. [PMID: 33380877 PMCID: PMC7755432 DOI: 10.3747/co.27.6659] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Background Postgraduate medical education is undergoing a paradigm shift in many universities worldwide, transitioning from a time-based model to competency-based medical education (cbme). Residency programs might have to alter clinical rotations, educational curricula, assessment methods, and faculty involvement in preparation for cbme, a process not yet characterized in the literature. Methods We surveyed Canadian medical oncology program directors on planned or newly implemented residency program changes in preparation for cbme. Results Prior to implementing cbme, all program directors changed at least 1 clinical rotation, most commonly making hematology/oncology (74%) entirely outpatient and eliminating radiation oncology (64%). Introductory rotations were altered to focus on common tumour sites, and later rotations were changed to increase learner autonomy. Most program directors planned to enhance resident learning with electronic teaching modules (79%), new training experiences (71%), and academic half-day changes (50%). Most program directors (64%) planned to change assessment methods to be entirely based on entrustable professional activities. All programs had developed a competence committee to review learner progress, and most (86%) had integrated academic coaches. Conclusions Transitioning to cbme led to major structural and curricular changes within medical oncology training programs. Identifying these commonly implemented changes could help other programs transition to cbme.
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Affiliation(s)
- R Arora
- Division of Medical Oncology, McMaster University, Hamilton
| | - G Kazemi
- Division of Medical Oncology, McMaster University, Hamilton
| | - T Hsu
- Division of Medical Oncology, University of Ottawa, Ottawa, ON
| | - O Levine
- Division of Medical Oncology, McMaster University, Hamilton
| | - S K Basi
- Division of Medical Oncology, University of Alberta, Edmonton
| | - J W Henning
- Division of Medical Oncology, University of Calgary, Calgary, AB
| | - J Sussman
- Division of Radiation Oncology, McMaster University, Hamilton, ON
| | - S D Mukherjee
- Division of Medical Oncology, McMaster University, Hamilton
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23
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Dimri A, Pant S, Arora R, Bachani S, Parvez S, Siraj F, Rastogi S. Differential expression of Chlamydia trachomatis heat shock protein 60-encoding genes in tubal ectopic pregnancy. Int J Infect Dis 2020. [DOI: 10.1016/j.ijid.2020.09.1166] [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: 11/17/2022] Open
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24
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Gumber B, Sharma RK, Tewari S, Arora R, Tanwar N. Clinical evaluation of impact of periodontal phenotype on the outcome of open flap debridement in patients with chronic periodontitis: A comparative interventional study. J Periodontol 2020; 92:1171-1180. [PMID: 33152127 DOI: 10.1002/jper.19-0668] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2019] [Revised: 09/22/2020] [Accepted: 10/20/2020] [Indexed: 01/26/2023]
Abstract
BACKGROUND Several studies have implicated the role of periodontal phenotype (PP) in the outcome of various periodontal interventions. However investigations have not been performed to estimate such impact on the outcome of open flap debridement (OFD) for the management of chronic periodontitis. METHODS A total of 73 individuals with chronic periodontitis underwent scaling and root planing (SRP). Eight weeks following SRP, modified Widman flap (MWF) surgery was performed in 40 patients (20 of either PP) presenting with probing depth (PD) ≥4 mm and gingival index (GI) ≥1 at ≥4 sites distributed over ≥2 anterior teeth with radiographic evidence of horizontal bone loss. PD, clinical attachment level (CAL), gingival recession, plaque index, GI, and bleeding on probing (BOP) were recorded at baseline, 3 and 6 months. PP was assessed using transparency of periodontal probe through the gingival margin at midfacial level. RESULTS A total of 34 patients were re-evaluated after intervention. All periodontal parameters improved in both groups after periodontal surgery. PD & PP were found to have positive correlation with CAL gain in ≥7 mm probing sites. Attachment gain of >2 mm was observed in more percentage of sites in thick PP than in thin PP. CONCLUSION PP can be an important factor influencing CAL gain in OFD.
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Affiliation(s)
- Bhumika Gumber
- Department of Periodontology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, India
| | - Rajinder K Sharma
- Department of Periodontology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, India
| | - Shikha Tewari
- Department of Periodontology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, India
| | - Ritika Arora
- Department of Periodontology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, India
| | - Nishi Tanwar
- Department of Periodontology, Post Graduate Institute of Dental Sciences (PGIDS), Rohtak, Haryana, India
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Arora R, Mukherjee SD. Improving formative assessments in Canadian medical oncology residency training. Curr Oncol 2020; 27:e524-e525. [PMID: 33173393 PMCID: PMC7606034 DOI: 10.3747/co.27.6885] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Medical oncology is a subspecialty of internal medicine that involves the treatment of cancer with a variety of complex systemic therapies [...]
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Affiliation(s)
- R Arora
- Juravinski Cancer Centre, Hamilton, ON
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Lodewyks C, Hiebert B, Prior H, Kumar K, Ouzounian M, Tangri N, Arora R, Yamashita M. LONG TERM SEX SPECIFIC OUTCOMES IN PATIENTS WITH THORACIC AORTIC DISEASE. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.193] [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: 11/25/2022] Open
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27
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Aguiar C, MacLeod J, Hiebert B, Arora R, Legare J, Hassan A. THE IMPACT OF CARDIAC SURGERY START TIME ON POST-OPERATIVE RESOURCE UTILIZATION. Can J Cardiol 2020. [DOI: 10.1016/j.cjca.2020.07.204] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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28
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Franceschi AM, Arora R, Wilson R, Giliberto L, Libman RB, Castillo M. Neurovascular Complications in COVID-19 Infection: Case Series. AJNR Am J Neuroradiol 2020; 41:1632-1640. [PMID: 32527844 PMCID: PMC7583125 DOI: 10.3174/ajnr.a6655] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/04/2020] [Accepted: 05/22/2020] [Indexed: 01/28/2023]
Abstract
We present a series of 10 hospitalized patients with confirmed coronavirus 2019 infections who developed severe neurovascular complications and discuss the possible reasons for these findings and their relationship to the novel Severe Acute Respiratory Syndrome coronavirus 2 infection.
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Affiliation(s)
| | - R Arora
- Departments of Radiology and Neurology (R.A., L.G., R.B.L.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York
| | - R Wilson
- Neuroradiology Section (R.W., M.C.), Department of Radiology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina
| | - L Giliberto
- Departments of Radiology and Neurology (R.A., L.G., R.B.L.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York
| | - R B Libman
- Departments of Radiology and Neurology (R.A., L.G., R.B.L.), Donald and Barbara Zucker School of Medicine at Hofstra/Northwell Health, Manhasset, New York
| | - M Castillo
- Neuroradiology Section (R.W., M.C.), Department of Radiology, The University of North Carolina School of Medicine, Chapel Hill, North Carolina
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Sharma H, Dureja D, Arora R. Re-invigoration of Pink Esthetics by a Novel Minimally Invasive Technique: A Report of Two Cases. Contemp Clin Dent 2020; 10:668-671. [PMID: 32792828 PMCID: PMC7390426 DOI: 10.4103/ccd.ccd_135_19] [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] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Abstract
The importance of pink esthetics as well as increased patient comfort has been gaining its pace in dentistry. Moreover, when it comes to the treatment of gingival recession, the ideologies of the periodontists have changed over time, i.e., from “extension to prevention;” it has now become “conserve to preserve.” Utilizing this same principle, pinhole technique was introduced comprising sutureless surgery with minimal surgical intervention, thus providing maximum comfort to the patient while undergoing treatment and postoperatively. This article presents a case report of two cases who were treated with a minimally invasive pinhole surgical technique, with complete root coverage and minimal complications.
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Affiliation(s)
- Himani Sharma
- Department of Periodontology, School of Dental Sciences, Sharda University, Greater Noida, Uttar Pradesh, India
| | - Divya Dureja
- Department of Periodontology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Ritika Arora
- Department of Periodontology, MDU Post Graduate Institute of Dental Science, Rohtak, Haryana, India
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Arora R, Shapiro H, Liu K, Arthur R, Cruickshank B, Sharma P, Glass K, Baratz A, Librach C, Greenblatt EM. Safety and Assisted Reproductive Technology Outcomes of Hysteroscopic Tubal Microinserts Versus Laparoscopic Proximal Tubal Occlusion or Salpingectomy for Hydrosalpinges Treatment. J Obstet Gynaecol Can 2020; 42:779-786. [PMID: 32224160 DOI: 10.1016/j.jogc.2019.11.065] [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: 08/07/2019] [Revised: 11/11/2019] [Accepted: 11/14/2019] [Indexed: 11/30/2022]
Abstract
OBJECTIVE This study sought to answer the following question: What are the complications and assisted reproductive technology outcomes among women with hydrosalpinges managed by hysteroscopic microinsert tubal occlusion compared with women with hydrosalpinges managed by laparoscopic proximal tubal occlusion or salpingectomy? METHODS This was a retrospective cohort study conducted from January 2009 to December 2014 at two academic, tertiary care, in vitro fertilization centres in Toronto, Ontario. All patients (n = 52) who underwent hysteroscopic tubal occlusion for hydrosalpinges were identified. Patients who proceeded with embryo transfer cycles after hysteroscopic microinsert (n = 33) were further age matched to a cohort of patients who underwent embryo transfer after laparoscopic proximal tubal occlusion or salpingectomy (n = 33). Main outcome measures were clinical pregnancy rate per patient and per embryo transfer cycle. RESULTS Among 33 patients, there were 39 fresh and 37 frozen embryo transfer cycles in the hysteroscopic group (group A); among 33 patients in the laparoscopic group (group B), there were 42 fresh and 29 frozen embryo transfer cycles. The cumulative clinical pregnancy rate in group A and group B was similar (66.7% vs. 69.7%, respectively; P = 0.8). The clinical pregnancy rate per embryo transfer cycle was also similar in both groups (28.9% in group A vs. 32.4% in group B; P = 0.6). There were two incidents of ectopic pregnancy in the laparoscopic group and no ectopic pregnancy in the hysteroscopic group. There were three major complications: tubo-ovarian abscess, distal migration of the coil after microinsert placement, and an acute abdomen following the hysteroscopic procedure. CONCLUSION Pregnancy outcomes after hysteroscopic placement of a microinsert for hydrosalpinx management before embryo transfer were comparable to those following laparoscopic proximal tubal occlusion or salpingectomy. However, caution is advised regarding microinsert placement for hydrosalpinges before proceeding with assisted reproductive technology.
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Affiliation(s)
- Ritika Arora
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON
| | - Heather Shapiro
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Kimberly Liu
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Rebecca Arthur
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Barbara Cruickshank
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON
| | - Prati Sharma
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Karen Glass
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Ari Baratz
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Clifford Librach
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; CReATe Fertility Centre, Toronto, ON
| | - Ellen M Greenblatt
- Department of Obstetrics and Gynaecology, University of Toronto, Toronto, ON; Mount Sinai Fertility, Mount Sinai Hospital, Toronto, ON.
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Chung J, Lodewyks C, Forbes T, Chu M, Peterson M, Lindsay T, Arora R, Ouzounian M. PREVENTION AND MANAGEMENT OF SPINAL CORD ISCHEMIA FOLLOWING AORTIC SURGERY: A NATIONWIDE SURVEY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.315] [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: 10/25/2022] Open
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32
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Eikelboom R, Arora R, Manji R. IDENTIFYING A GAP BETWEEN CANADIAN INTEREST AND INVOLVEMENT IN HUMANITARIAN CARDIAC SURGERY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.534] [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] Open
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Abstract
Mutations in EGFR have been implicated in the pathogenesis of various types of cancer, and therefore antibody therapy directed against the epidermal growth factor receptor (egfr) is increasingly being used in the management of various cancers. Currently, anti-egfr antibodies are used mainly in the management of cancers of the head and neck and metastatic colorectal cancers. Because of this increasing use, we would like to inform the oncology community in North America of a rare, but life-threatening, toxicity associated with anti-egfr antibody therapy. Although cases in white and Japanese men have been documented, we present the first known North American report of panitumumab-induced pulmonary toxicity in a white woman.
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Affiliation(s)
- R Arora
- Medical Oncology, Department of Oncology, McMaster University, Hamilton, ON
| | - M Kisiel
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON
| | - C MacColl
- Department of Pathology and Molecular Medicine, McMaster University, Hamilton, ON
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Tripathi R, Tarai B, Arora R. Descriptive Epidemiology Including Outcomes Of Gram Negative Bacteria Sepsis In Children With Cancer In India. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.164] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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35
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Seth R, Kapoor G, Arora R, Verma N, Kumar A, Mahajan A, Mandal P, Kumari P, Das A, Venkatraman R, Gupta V, Jain P, S S, Kakadia P. The indian childhood cancer survivorship study (c2s study): after treatment completion registry of childhood cancers: phase – i. An inpog-le-16-01 study. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.020] [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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36
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Seth R, Kapoor G, Arora R, Verma N, Kumar A, Mahajan A, Mandal P, Kumari P, Das A, Venkatraman R, Gupta V, Jain P, S S, Kakadia P. The indian childhood cancer survivorship study (C2S study): after treatment completion registry of childhood cancers - phase – I. AN INPOG-LE-16-01 STUDY. Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.052] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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37
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Sharma H, Gupta C, Arora R. Is drug substitution always a solution? Phenytoin induced gingival enlargement – A case report. J Oral Res Rev 2019. [DOI: 10.4103/jorr.jorr_19_18] [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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38
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Mahajan A, Arora R, Dinand V, Kalra M, Jain S, Bakhshi S, Singh M, Seth R, Verma N, Kumar A, Radhakrishnan V, Mandal P, Kapoor G, Phulkar S, Arora A, Taluja A, Chandra J. Empirical Anti-tubercular Treatment given to children with Hodgkin Lymphoma: does it impact outcomes? Pediatric Hematology Oncology Journal 2019. [DOI: 10.1016/j.phoj.2019.08.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022] Open
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39
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Arora R, Shukla S. Injectable-Platelet-Rich Fibrin-Smart Blood with Stem Cells for the Treatment of Alopecia: A Report of Three Patients. Int J Trichology 2019; 11:128-131. [PMID: 31360042 PMCID: PMC6580805 DOI: 10.4103/ijt.ijt_73_18] [Citation(s) in RCA: 10] [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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
Hair loss or alopecia in males is very common, and so is its treatment. Until now, platelet-rich plasma has been in use for hair regeneration, which has shown results but lacks regenerative potential as compared to platelet-rich fibrin (PRF). Injectable-PRF (i-PRF) is advanced version of PRF in liquid form which can be injected and contains stem cells with high regenerative potential. Hair regeneration in Type VI and Type VII was observed which are difficult to treat. Hair growth with i-PRF has better regenerative potential. All cases reported showed improvement in hair growth.
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Affiliation(s)
- Ritika Arora
- Department of Periodontology, Vedic Dental College, Daman, Daman and Diu, India
| | - Sagrika Shukla
- Department of Dentistry and Maxillofacial Surgery, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India
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de Souza RJ, Gauvin L, Williams NC, Lear SA, Oliveira AP, Desai D, Corsi DJ, Subramanian SV, Rana A, Arora R, Booth GL, Razak F, Brook JR, Tu JV, Anand SS. Environmental health assessment of communities across Canada: contextual factors study of the Canadian Alliance for Healthy Hearts and Minds. ACTA ACUST UNITED AC 2018. [DOI: 10.1080/23748834.2018.1548071] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Affiliation(s)
- R. J. de Souza
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton, Canada
| | - L. Gauvin
- Centre de recherche du Centre hospitalier de l’Université de Montréal, Montreal, Canada
- Département de médecine sociale et préventive, École de santé publique de l’université de Montréal, Montreal, Canada
| | - N. C. Williams
- Department of Medicine, McMaster University, Hamilton, Canada
| | - S. A. Lear
- Faculty of Health Sciences, Simon Fraser University, Burnaby, Canada
| | - A. P. Oliveira
- Department of Medicine, McMaster University, Hamilton, Canada
| | - D. Desai
- Population Health Research Institute, Hamilton, Canada
- Hamilton Health Sciences Corporation, Hamilton, Canada
| | - D. J. Corsi
- Ottawa Hospital Research Institute, Ottawa, Canada
| | - S. V. Subramanian
- Department of Social and Behavioral Sciences, Harvard T.H. Chan School of Public Health, Boston, MA, USA
- Harvard Center for Population and Development Studies, Harvard University, Cambridge, MA, USA
| | - A. Rana
- Faculty of Medicine, University of Toronto, Toronto, Canada
| | - R. Arora
- Faculty of Health Sciences, McMaster University, Hamilton, Canada
| | - G. L. Booth
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
- Institute of Health Policy, Management and Evaluation, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
| | - F. Razak
- Li Ka Shing Knowledge Institute, St. Michael’s Hospital, Toronto, Canada
| | - J. R. Brook
- Dalla Lana School of Public Health, University of Toronto, Toronto, Canada
| | - J. V. Tu
- Faculty of Medicine, University of Toronto, Toronto, Canada
- Institute for Clinical Evaluative Sciences, Toronto, Canada
- Sunnybrook Research Institute Toronto, Canada
| | - S. S. Anand
- Department of Health Research Methods, Evidence, and Impact, Faculty of Health Sciences, McMaster University, Hamilton, Canada
- Population Health Research Institute, Hamilton, Canada
- Department of Medicine, McMaster University, Hamilton, Canada
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McIntosh P, Kass M, Arora R, Yamashita M, Kumar K, Kent D, Hiebert B, Toleva O. E-QUALITY - ELDERLY PROJECT FOR QUALITY OF LIFE POST-TRANSCATHETER VALVE IMPLANTATION (TAVI). Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.173] [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] Open
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42
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Arora R, Rahman R, Joe W, Bakhshi S, Radhakrishnan V, Mahajan A, Chinnaswamy G, Bhattacharya A, Swami A, Manglani M, Seth R, Singh A, De S, MS L, Raj R, Borker A, Martiniuk A, Tsimicalis A. Families of Children Newly Diagnosed With Cancer Incur Significant Out-of-Pocket Expenditure for Treatment: Report of a Multi-Site Prospective Longitudinal Study From India (INPOG-ACC-16-01). J Glob Oncol 2018. [DOI: 10.1200/jgo.18.42400] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Background: Diagnosis of cancer in a child places considerable economic burden on families. The health expenditures are more catastrophic in resource limited countries like India where GDP spend on health is just over 1% and financing of treatment is usually out-of-pocket (OOP). Consequently parents may abandon their child's cancer treatment to ensure financial sustainability of the family. Research in this area is mostly from resource rich countries and OOP expenditure burden remains unknown in India. Aim: The objective of this study is to describe the OOP expenditure incurred by families of children (< 18 years age) with cancer being treated in India prior to and during cancer directed treatment. Methods: A prospective cost of illness study from a family household perspective was conducted in 14 centers (5 public, 5 private and 4 charitable trust sector) in 4 cities in India from 2016-2018. Baseline family demographic and socioeconomic data were collected followed by OOP expenditure incurred prior to start of treatment. For the duration of the child's treatment, a social worker contacted parents at regular intervals to record their expenditure on cancer directed treatment. Data collection was stopped when one of these happened - completion of treatment or death or progression/relapse or abandonment or transfer. Data were described descriptively and a univariate/multivariate analysis using logistic regression was done to detect factors associated with OOP expenditure. Results: 394 children (63% male, median age 5 years) with cancer (64% leukemia/lymphoma, 33% solid tumors, 3% CNS tumors) were enrolled from public (45%), charitable trust (28%) and private (27%) sector hospitals. They were symptomatic for a median duration of 6 weeks (range 0 to 104 weeks). 88% had no insurance and 73% were from families with monthly income of ≤ 10,000 rupees (≤ 159 US$). Mean OOP expenditure was Rs 209,500 (3325 US$) which is 195% of per capita income (1706 US$) of India. OOP expenditure from onset of symptoms to start of treatment was Rs 53,104 (843 US$) of which 77% was medical (15% laboratory tests, 11% medicines, 9% hospital bed costs) and 23% nonmedical (12% travel, 6% food, 3% lodging). OOP expenditure on cancer directed treatment was Rs 156,396 (2482 US$) of which 64% was medical (9% hospital bed costs, 9% supportive care drugs, 8% laboratory tests) and 36% nonmedical (19% food, 9% travel, 6% lodging). On univariate analysis age, gender, city, type of treatment facility, insurance, type of cancer, driving time and distance were significantly associated with OOP expenditure but only insurance and type of treatment facility were found significant on multivariate analysis. Conclusion: Families of children with cancer incur significant OOP expenditure prior to and during cancer directed treatment, which includes a significant portion on nonmedical expenses. Expenditure varied significantly by insurance and type of treatment facility.
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Affiliation(s)
- R. Arora
- Max Super Speciality Hospital, New Delhi, India
| | - R.U. Rahman
- Max Super Speciality Hospital, New Delhi, India
| | - W. Joe
- Max Super Speciality Hospital, New Delhi, India
| | - S. Bakhshi
- Max Super Speciality Hospital, New Delhi, India
| | | | - A. Mahajan
- Max Super Speciality Hospital, New Delhi, India
| | | | | | - A. Swami
- Max Super Speciality Hospital, New Delhi, India
| | - M. Manglani
- Max Super Speciality Hospital, New Delhi, India
| | - R. Seth
- Max Super Speciality Hospital, New Delhi, India
| | - A. Singh
- Max Super Speciality Hospital, New Delhi, India
| | - S. De
- Max Super Speciality Hospital, New Delhi, India
| | - L. MS
- Sri Ramachandra Medical College and Research Institute, Chennai, India
| | - R. Raj
- Apollo Speciality Cancer Hospital, Chennai, India
| | - A. Borker
- Asian Institute of Oncology, Mumbai, India
| | - A. Martiniuk
- The George Institute for Global Health, Sydney, Australia
- University of Sydney, Faculty of Medicine, Sydney, Australia
| | - A. Tsimicalis
- Ingram School of Nursing, McGill University, Montreal, Canada
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Cloutier J, Kass M, Arora R, Yamashita M, Kumar K, Hiebert B, Lauck S, Toleva O. IMPROVING CARE AND REDUCING COSTS: THE MULTIDISPLINARY, MINIMALIST, ACCELERATED CARE PATHWAY FOR PATIENTS UNDERGOING TRANSCATHETER AORTIC VALVE IMPLANTATION. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.180] [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] Open
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44
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Spence J, Belley-Côté E, Jacobsohn E, Syed S, Whitlock R, Lee S, Bangdiwala S, Arora R, Sarkaria A, MacIsaac S, Girling L, LeManach Y, Lamy A, Devereaux P, Connolly S. BENZODIAZEPINE-FREE CARDIAC ANESTHESIA FOR REDUCTION OF DELIRIUM (B-FREE): A TWO-CENTRE PILOT STUDY TO DETERMINE THE FEASIBILITY OF A MULTI-CENTRE, RANDOMIZED, CLUSTER CROSSOVER TRIAL. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.07.297] [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] Open
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45
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Spence J, Belley-Cote E, Jacobsohn E, Syed S, Whitlock R, Lee SF, Bangdiwala S, Arora R, Sarkaria A, MacIsaac S, Girling L, Lemanach Y, Lamy A, Devereaux PJ, Connolly S. P836Benzodiazepine-free cardiac anesthesia for reduction of delirium (B-Free): a two-centre pilot study to determine the feasibility of a multi-centre, randomized, cluster crossover trial. Eur Heart J 2018. [DOI: 10.1093/eurheartj/ehy564.p836] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
- J Spence
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - E Belley-Cote
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - E Jacobsohn
- St. Boniface General Hospital, Department of Anesthesia, Winnipeg, Canada
| | - S Syed
- McMaster University, Department of Anesthesia, Hamilton, Canada
| | - R Whitlock
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - S F Lee
- Population Health Research Institute, Hamilton, Canada
| | - S Bangdiwala
- Population Health Research Institute, Hamilton, Canada
| | - R Arora
- Institute of Cardiovascular Sciences, Department of Surgery, Section of Cardiac Surgery, Winnipeg, Canada
| | - A Sarkaria
- Population Health Research Institute, Hamilton, Canada
| | - S MacIsaac
- Population Health Research Institute, Hamilton, Canada
| | - L Girling
- St. Boniface General Hospital, Department of Anesthesia, Winnipeg, Canada
| | - Y Lemanach
- McMaster University, Department of Anesthesia, Hamilton, Canada
| | - A Lamy
- Population Health Research Institute, Hamilton, Canada
| | - P J Devereaux
- Population Health Research Institute, Perioperative Medicine and Surgical Research Group, Hamilton, Canada
| | - S Connolly
- Population Health Research Institute, Hamilton, Canada
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Erhart S, Toth S, Kaiser P, Kastenberger T, Deml C, Arora R. Comparison of volarly and dorsally displaced distal radius fracture treated by volar locking plate fixation. Arch Orthop Trauma Surg 2018; 138:879-885. [PMID: 29696363 DOI: 10.1007/s00402-018-2925-x] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.5] [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: 11/06/2017] [Indexed: 10/17/2022]
Abstract
INTRODUCTION In case of distal radius fractures (DRF) the distal fragment generally displaces either dorsally or volarly. Scientific literature however, seldom differentiates between volarly and dorsally displaced DRFs when reporting results. It is no clear, if the direction of displacement has an influence on the clinical and radiological outcome. This study was intended to evaluate the influence of displacement direction in adult patients with surgically treated Colles or Smith type fractures. PATIENTS AND METHODS After a mean follow up (FU) time of above 5 years, 50 patients who underwent open reduction and internal fixation for DRFs (25 Smith type fractures, 25 Colles type fractures) were included. Upon FU, standard X-rays and a clinical evaluation as well as evaluation scores were raised and analysed. RESULTS Clinical evaluation showed no difference between the Colles and the Smith group. Radiologic and clinical results for the Colles group showed diminished flexion compared to the healthy wrist, decreased radial inclination and dorsal tilt during FU and progression of osteoarthritis. For the Smith group decreased grip strength compared to the healthy wrist and osteoarthritis-progression was found. For both groups there was no correlation between radiologic values, grip strength, arthrosis grading, disability of arm, shoulder and hand score and patient rated wrist evaluation score. DISCUSSION Decreased flexion in combination with a decreased dorsopalmar tilt might hint towards a mechanical inhibition in the Colles group. Altogether, the study showed good clinical outcome with satisfactory radiological result. As all patients showed arthrosis progression, the fracture per se is to be seen as a prearthrotic factor. It still remains unclear which measures could be taken to prevent this.
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Affiliation(s)
- S Erhart
- Department for Trauma Surgery, Tirol Kliniken, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria.
| | - S Toth
- Department for Trauma Surgery, Tirol Kliniken, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - P Kaiser
- Department for Trauma Surgery, Tirol Kliniken, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - T Kastenberger
- Department for Trauma Surgery, Tirol Kliniken, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - C Deml
- Department for Trauma Surgery, Tirol Kliniken, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
| | - R Arora
- Department for Trauma Surgery, Tirol Kliniken, Medical University Innsbruck, Anichstrasse 35, 6020, Innsbruck, Austria
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Ha V, Keating B, Arora R, Tieu T, Noori A, Banfield L, Beyene J, Anand S, de Souza R. Assessing the Consistency and Quality of the Evidence for the Association Between Dietary Factors and Gestational Diabetes Mellitus: A Systematic Review and Meta-Analysis of Prospective Cohort Studies and Randomized Controlled Trials. Can J Cardiol 2018. [DOI: 10.1016/j.cjca.2018.01.082] [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] Open
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Arora R, Sharma A, Dimri D, Sharma H. Methimazole-Induced Neutropenic Gingival Ulcerations and Necrosis in a Middle-Aged Female: A Case Report with Clinical Management. J Midlife Health 2018; 9:106-109. [PMID: 29962811 PMCID: PMC6006798 DOI: 10.4103/jmh.jmh_18_18] [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] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
Abstract
One of the major manifestations of methimazole-induced neutropenia or agranulocytosis is diffuse gingival ulceration and necrosis. The aim of this case report is to be familiar with drug-induced neutropenia and its associated oral manifestations and the healing of the gingiva after proper treatment.
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Affiliation(s)
- Ritika Arora
- Department of Periodontology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Anamika Sharma
- Department of Periodontology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Deepakshi Dimri
- Department of Periodontology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
| | - Himani Sharma
- Department of Periodontology, Subharti Dental College and Hospital, Meerut, Uttar Pradesh, India
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Sarova N, Ahlawat S, Grewal A, Sharma R, Arora R. Differential promoter methylation of DAZL gene in bulls with varying seminal parameters. Reprod Domest Anim 2018; 53:914-920. [PMID: 29604148 DOI: 10.1111/rda.13187] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2017] [Accepted: 03/03/2018] [Indexed: 12/19/2022]
Abstract
In India, cross-breeding of indigenous cattle with exotic cattle such as Holstein Friesian and Jersey has been going on since last four decades to improve milk production. Although it has led to increased milk yield, the subfertility in male cross-bred progeny has remained a significant problem. Epigenetic modifications (DNA methylation, histone modifications and chromatin remodelling) are regarded as key players influencing gene expression. DAZL gene plays an important role in germline development and gametogenesis. The methylation and mRNA expression level of this gene have been significantly negatively correlated in the testes of cattle-yak hybrids and their parents. This study analysed the methylation profile of DAZL gene promoter in bull spermatozoa in an attempt to speculate its role in cross-bred cattle subfertility. Semen samples from Sahiwal, Holstein Friesian and Frieswal bulls (Sahiwal X Holstein Friesian) with varying semen motility parameters were collected, and DNA was isolated. Methylation-specific primers were used to amplify part of promoter and exon 1 of DAZL gene using bisulphite-converted DNA. The amplified products were sequenced after cloning in pTZ57R/T vector. Sequence analysis revealed significantly higher DNA methylation of DAZL gene in Frieswal bulls with poor motility (28.26%) as compared to medium (15.21%) and high motility phenotype (6.52%). In pure-bred counterparts, Sahiwal and Holstein Friesian, epigenetic marks were more in the former (15.21%) than the latter (4.34%), but in both cases, the values were lower as compared to the poor motility Frieswal bulls. This suggests that differential hypermethylation of the CpG islands could possibly influence reproductive parameters in bovines.
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Affiliation(s)
- N Sarova
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - S Ahlawat
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - A Grewal
- University Institute of Engineering and Technology, Kurukshetra, India
| | - R Sharma
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
| | - R Arora
- ICAR-National Bureau of Animal Genetic Resources, Karnal, India
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