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Sengupta S, Tubio CR, Pinto RS, Barbosa J, Silva MM, Gonçalves R, Kundu M, Lanceros-Mendez S, Costa CM. Ternary composites of poly(vinylidene fluoride-co-hexafluoropropylene) with silver nanowires and titanium dioxide nanoparticles as separator membranes for lithium-ion batteries. J Colloid Interface Sci 2024; 668:25-36. [PMID: 38669993 DOI: 10.1016/j.jcis.2024.04.149] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/14/2024] [Revised: 04/12/2024] [Accepted: 04/21/2024] [Indexed: 04/28/2024]
Abstract
In the realm of polymer composites, there is growing interest in the use of more than one filler for achieving multifunctional properties. In this work, a composite separator membrane has been developed for lithium-ion battery application, by incorporating conductive silver nanowires (AgNWs) and titanium dioxide (TiO2) nanoparticles into a poly(vinylidene fluoride-co-hexafluoropropylene) (PVDF-HFP) polymer matrix. The composite membranes were manufactured by solvent casting and thermally induced phase separation, with total filler content varying up to 10 wt%. The ternary composites composites present improved mechanical characteristics, ionic conductivity and lithium transfer number compared to the neat polymer matrix. On the other hand, the filler type and content within the composite has little bearing on the morphology, polymer phase, or thermal stability. Once applied as a separator in lithium-ion batteries, the highest discharge capacity value was obtained for the 5 wt% AgNWs/5 wt% TiO2/PVDF-HFP membrane at different C-rates, benefiting from the synergetic effect from both fillers. This work demonstrates that higher battery performance can be achieved for next-generation lithium-ion batteries by using separator membranes based on ternary composites.
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Affiliation(s)
- S Sengupta
- Electrochemial Energy Storage Laboratory, Department of Chemistry, SRM Institute of Science and Technology, Chennai, India
| | - C R Tubio
- BCMaterials, Basque Center for Materials, Applications and Nanostructures, UPV/EHU Science Park, 48940 Leioa, Spain
| | - R S Pinto
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal; Centre of Physics Universities of Minho and Porto, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal
| | - J Barbosa
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal
| | - M M Silva
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal
| | - R Gonçalves
- Centre of Chemistry, University of Minho, 4710-057 Braga, Portugal
| | - M Kundu
- Electrochemial Energy Storage Laboratory, Department of Chemistry, SRM Institute of Science and Technology, Chennai, India; International Iberian Nanotechnology Laboratory (INL), Av. Mestre Jose Veiga, 4715-330 Braga, Portugal.
| | - S Lanceros-Mendez
- BCMaterials, Basque Center for Materials, Applications and Nanostructures, UPV/EHU Science Park, 48940 Leioa, Spain; Centre of Physics Universities of Minho and Porto, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal; Laboratory of Physics for Materials and Emergent Technologies, LapMET, University of Minho, Braga 4710-057, Portugal; Ikerbasque, Basque Foundation for Science, 48009 Bilbao, Spain
| | - C M Costa
- Centre of Physics Universities of Minho and Porto, University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal; Laboratory of Physics for Materials and Emergent Technologies, LapMET, University of Minho, Braga 4710-057, Portugal; Institute of Science and Innovation for Bio-Sustainability (IB-S), University of Minho, Campus de Gualtar, 4710-057 Braga, Portugal.
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Agarwal A, Menia NK, Markan A, Sallam AB, Habib A, Mansour A, Iovino C, Peiretti E, Demirel S, Tawfiq MA, Hanout M, Gupta V, Ghazi N, Sengupta S. Outcomes after giant peripheral retinotomy and anterior flap retinectomy for rhegmatogenous retinal detachments with advanced proliferative vitreoretinopathy using small gauge vitrectomy. Indian J Ophthalmol 2024:02223307-990000000-00174. [PMID: 38622862 DOI: 10.4103/ijo.ijo_2840_23] [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] [Received: 10/25/2023] [Accepted: 01/19/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE To analyze the visual and anatomical outcomes for eyes with rhegmatogenous retinal detachment (RRD) and advanced proliferative vitreoretinopathy (PVR) undergoing giant peripheral retinotomy (GPR) using 25-gauge pars plana vitrectomy (PPV). METHODS In this retrospective multi-center study, patients with RRD with either anteroposterior or circumferential retinal shortening and advanced PVR requiring more than 90-degree GPR with/without relaxing retinotomy were included. Subjects of either gender, any age group, and with complete surgical notes were included. Outcome measures of the study included anatomical success (i.e. complete retinal re-attachment) at 6 months using survival analysis, visual outcomes, and post-operative complications. RESULTS Forty-one eyes of 41 patients (33 males) with a mean age of 44.9 ± 21.4 years were included. At 6 months follow-up, anatomical success was seen in 29 eyes (70.7%) with a cumulative re-attachment rate of 66% (95% confidence interval = 48 = 79%). All re-detachments occurred at ≤6 months with a peak at 4-6 months (n = 9). Twenty-three eyes (56%) achieved ambulatory vision (5/200) or better. Direct perfluorocarbon liquid-silicone oil exchange was performed in 20 eyes. Intra-operative complications included persistent retinal folds (2 eyes), subretinal air (1 eye), and subretinal bleed (1 eye). Eleven eyes (26.8%) developed secondary glaucoma (2 eyes required a drainage device), and hypotony of ≤6 mmHg was noted in 3 eyes (7.3%). Corneal decompensation was noted in 8 eyes (19.5%), and 3 eyes (7.3%) underwent re-surgery for re-RRD. CONCLUSION After GPR using small gauge PPV, two-thirds achieve anatomical success, and over half have ambulatory vision, but overall post-operative complications can occur in more than half of the eyes.
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Affiliation(s)
- Aniruddha Agarwal
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates (UAE)
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
- Department of Ophthalmology, Maastricht University Medical Center+, Maastricht, The Netherlands
| | - Nitin Kumar Menia
- Department of Ophthalmology, All India Institute of Medical Sciences (AIIMS), Jammu, India
| | - Ashish Markan
- Department of Ophthalmology, Eye7 Chaudhary Eye Center, New Delhi, India
| | - Ahmed B Sallam
- Department of Ophthalmology, Harvey and Bernice Jones Eye Institute, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | - Ahmed Habib
- Department of Ophthalmology, Ain Shams University, Vitreoretinal Service, Al Mashreq Eye Hospital, Cairo, Egypt
| | - Ahmed Mansour
- Department of Ophthalmology, Ain Shams University, Vitreoretinal Service, Al Mashreq Eye Hospital, Cairo, Egypt
| | - Claudio Iovino
- Eye Clinic, Multidisciplinary Department of Medical, Surgical and Dental Sciences, University of Campania Luigi Vanvitelli, Naples, Italy
| | - Enrico Peiretti
- Eye Clinic, Department of Surgical Sciences, University of Cagliari, Cagliari, Italy
| | - Sibel Demirel
- Ankara University Faculty of Medicine, Department of Ophthalmology, Ankara, Turkey
| | | | - Mostafa Hanout
- Princess Margaret Cancer Center/University Health Network, Department of Ophthalmology and Visual Sciences, University of Toronto, Toronto, ON, Canada
| | - Vishali Gupta
- Advanced Eye Center, Department of Ophthalmology, Post Graduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Nicola Ghazi
- The Eye Institute, Cleveland Clinic Abu Dhabi, Abu Dhabi, United Arab Emirates (UAE)
- Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio, USA
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Chakraborty D, Mondal S, Sengupta S, Maiti A, Boral S, Das A, Sinha TK, Nandi K. Aflibercept vs. dexamethasone implant for recalcitrant diabetic macular edema in pseudophakic eyes - 1-year outcomes from a quazi-randomized study in India. Indian J Ophthalmol 2024:02223307-990000000-00161. [PMID: 38622856 DOI: 10.4103/ijo.ijo_1447_23] [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] [Received: 06/03/2023] [Accepted: 01/04/2024] [Indexed: 04/17/2024] Open
Abstract
PURPOSE To assess the safety and efficacy of intravitreal Aflibercept (IVA) versus dexamethasone (DEX) implant for treating recalcitrant diabetic macular edema (DME) in pseudophakic eyes at 1-year follow-up. DESIGN Retrospective comparative case series. PARTICIPANTS Data of all patients diagnosed with DME between January 2019 and December 2021, who underwent 4-monthly doses of intravitreal ranibizumab but had persistent DME [central macular thickness (CMT) within 10% of baseline value] were extracted from a computerized database. Of these, only pseudophakic eyes that underwent either IVA or DEX implant and had at least 1-year follow-up were included for analysis. METHODS DEX implant was preferred before December 2020 and IVA after this time point. In the IVA group, patients were followed up every month while DEX were followed at least every 3 months. Reinjections were considered when vision dropped by at least 1 Snellen's line or CMT increased by at least 10% from the previous visit in both groups. MAIN OUTCOME MEASURES Comparison of change in vision and CMT at 1-year follow-up in DEX versus IVA groups. RESULTS Eighty-four eyes of 84 patients aged 54.4 + 4.4 years were included, 39 (46%) received DEX and 45 (54%) received IVA. Groups were comparable for baseline vision and CMT. Vision improved equally in both groups from 0.83 + 0.15 logMAR to 0.52 + 0.10 logMAR at 3 months (P < 0.01) and then stabilized till 1 year. However, eyes in the IVA group were 6.5 times more likely (Odds ratio = 6.45, 95% CI = 1.3 - 31.9) to achieve >3-line improvement in vision. The CMT reduction was also comparable between groups (-169 + 51 in DEX vs. -174 + 49 in IVA, P = 0.67). More eyes in the IVA group required >3 injections (91% vs. 69% in DEX, P = 0.01). The IOP was significantly higher at 6 and 9 months in the DEX group and 5 eyes (13%) required IOP lowering medications. CONCLUSION In pseudophakic eyes with recalcitrant DME not responding to ranibizumab, switching to IVA or DEX implant results in equal visual improvement and CMT reduction. Though >3-line improvement occurs more frequently with IVA, this comes at the expense of a greater number of injections and follow-up visits.
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Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreo-Retina Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal, India
| | - Soumen Mondal
- Department of Vitreo-Retina Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Department of Retina, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Aniruddha Maiti
- Department of Retina, Global Eye Hospitals, Salt Lake, Kolkata, West Bengal, India
| | - Subhendu Boral
- Department of Vitreo-Retina Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal, India
| | - Arnab Das
- Department of Vitreo-Retina Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal, India
| | - Tushar K Sinha
- Department of Vitreo-Retina Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal, India
| | - Krishnendu Nandi
- Department of Retina, Nethralayam Superspeciality Eye Care, EM Bye Pass, Kolkata, West Bengal, India
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Shah RP, Dabre ZG, Sengupta S. An outbreak of subhyaloid hemorrhage after accidental laser exposure during an Indian festival. Indian J Ophthalmol 2024; 72:S144-S147. [PMID: 38131557 PMCID: PMC10833159 DOI: 10.4103/ijo.ijo_499_23] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2023] [Revised: 07/01/2023] [Accepted: 07/27/2023] [Indexed: 12/23/2023] Open
Abstract
PURPOSE To report the clinical manifestations and outcomes of patients who experienced retinal damage due to accidental laser exposure during a festival in Kolhapur, Maharashtra. METHODS Consecutive patients who presented with sudden loss of vision following exposure to laser lights during a religious Indian festival (Ganapati festival) on the same day (9 September 2022) at the same location (idol visarjan procession) were identified from the medical records of various eye hospitals in Kolhapur district of Maharashtra. Eyes with persistent subhyaloid hemorrhage (SHH) were taken up for neodymium-doped yttrium aluminum garnet (Nd: YAG) posterior hyaloidotomy. Patients were examined at weekly intervals up to 1 month. RESULTS Thirty-four eyes of 34 men were identified with age ranging from 18 to 27 years. The mean duration of exposure to the laser projections was 4.9 ± 1.7 h, and the mean distance from the laser source was 7.3 ± 2.7 feet. All presented with SHH involving the macula. SHH had a median size of 3 disc diameters or larger in 30 eyes (88%), and 29 (97%) of these required hyaloidotomy while one patient underwent pars plana vitrectomy. The mean visual acuity improved from 1.45 ± 0.5 log of minimum angle of resolution (logMAR; 20/560 Snellen) to 0.11 ± 0.19 logMAR (20/25 Snellen) (P < 0.001). One eye showed full-thickness macular hole with visual acuity of 20/200. CONCLUSION We report a large number of patients experiencing laser-induced SHH, resembling an outbreak, due to exposure to a malfunctioning high-powered recreational laser during a religious festival.
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Upadhyay R, Elguindy AN, Sengupta S, Wang K, Beyer S, Thomas EM, Raval R, Palmer JD. Initial Report of Boswellia Serrata for Management of Cerebral Radiation Necrosis after Stereotactic Radiosurgery for Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:S172-S173. [PMID: 37784429 DOI: 10.1016/j.ijrobp.2023.06.639] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Radiation necrosis (RN) is a concerning late toxicity after radiation therapy (RT) for brain metastases. Oral corticosteroids are the mainstay of management; however, they are not optimal for long-term use given multiple side effects and drug interactions, particularly with the emergence of immunotherapy for several cancers. Boswellia serrata (BS) is an over-the-counter supplement used for its anti-inflammatory properties and has been recently shown to reduce cerebral edema after brain RT. We evaluated the response rates with BS in a series of patients with brain metastases treated with stereotactic radiosurgery (SRS) who developed RN. MATERIALS/METHODS We included patients who developed RN after SRS for brain metastases at our institution from 2020-2022 and were treated with BS. Patients were prescribed over the counter BS 4.2-4.5g daily in divided doses. Follow-up MRI imaging was obtained every 2-3 months after starting BS. Response was assessed using Response Assessment in Neuro-Oncology (RANO) criteria. Primary endpoint was ≥25% decrease in edema volume on T2-FLAIR MRI from baseline. Patients were censored if they had tumor progression or repeat RT to necrotic area, or death. Kaplan-Meier curves were used for survival estimates. RESULTS A total of 50 patients received BS for Grade 1-3 CTCAE v5.0 RN (G1 = 11, G2 = 36, and G3 = 3). Median age was 62.8 years (range 36.9 - 50) and median RT dose was 24 Gy in 3 fractions. Median time to RN after SRS was 10 months(m). Median follow-up after starting BS was 6m and 40 patients had at least 1 follow up MRI available to evaluate response. The best response was complete response (CR) in 15% patients and partial response (PR) in 40% while 35% had stable disease (SD) and 10% had progressive disease. Median time to CR was 9m (6-12m) and PR was 6m (3-12m). Percentage of patients who had any response (CR or PR) at 3, 6, 9 and 12 months was 25%, 60%, 43% and 50%, respectively. 56% patients had symptomatic RN, of which 35.7% had improvement in symptoms with BS alone, while 64% required steroid use. Overall, median duration of response in patients with CR, PR or SD was 7.5m(range 2-31m). Salvage treatment for RN was steroids (33), surgery (4), Bevacizumab (5) or hyperbaric oxygen therapy (1). No patients had any CTCAE grade 3 or higher toxicities. 3 patients (6%) had any side-effects all of whom had Grade 1-2 gastrointestinal intolerance or diarrhea. 2 patients stopped treatment due to enrolment on an immunotherapy clinical trial. Overall, 39 patients remained on BS at last follow-up or death. CONCLUSION We observed >50% response rates with use of BS in our cohort of patients with Grade 1-3 RN after SRS. More than 1/3rd patients with symptomatic RN were able to avoid long-term steroid use. BS is an easily available over-the-counter drug that appears to be a safe and promising treatment option for RN, and can potentially decrease steroid dependence in these patients, reducing the risk of several side-effects. Further prospective studies to compare Boswellia with placebo is warranted.
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Affiliation(s)
| | - A N Elguindy
- The James Cancer Center, Ohio State University Wexner Medical Center, Columbus, OH
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - S Beyer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - E M Thomas
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - R Raval
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
| | - J D Palmer
- Department of Radiation Oncology, The Ohio State University Wexner Medical Center, Columbus, OH
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Hall J, Wang K, Lui KP, Darawsheh R, Shumway JW, Carey LA, Hayes KR, Lee CB, Moschos S, Sengupta S, Chaudhary R, Yogendran L, Struve TD, Vatner RE, Pater LE, Breneman JC, Weiner AA, Shen C. Safety and Efficacy of Stereotactic Radiosurgery with Concurrent Targeted Systemic Therapy for Brain Metastases. Int J Radiat Oncol Biol Phys 2023; 117:e107. [PMID: 37784639 DOI: 10.1016/j.ijrobp.2023.06.882] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Data describing the safety and efficacy of central nervous system (CNS)-active targeted systemic therapies in combination with stereotactic radiosurgery (SRS, 1 fraction) and/or radiotherapy (SRT, 3-5 fractions) for brain metastases are emerging but limited. We report rates of local and intracranial failure and radiation necrosis in patients receiving CNS-active targeted systemic therapy and SRS/SRT. MATERIALS/METHODS We retrospectively identified patients with intact brain metastases at two institutions from 2009-2022 who were treated with SRS/SRT and CNS-active targeted systemic therapy in any sequence. Patients were followed for a minimum of 3 months after SRS/SRT with brain MRI. Patients typically stopped the targeted agent 2-4 days prior to radiation and resumed 2-4 days after. Targeted therapies included inhibitors of ALK/ROS1 (Alectinib, Ceritinib, Crizotinib, Lorlatinib), EGFR (Afatinib, Erlotinib, Gefitinib, Osimertinib), BRAF (Dabrafenib, Encorafenib, Vemurafenib), MEK (Binimetinib, Trametinib), CDK 4/6 (Abemaciclib, Palbociclib, Ribociclib), HER2 (Afatinib, Lapatinib, Neratinib, Pertuzumab, Trastuzumab, T-DM1, T-DXd, Tucatinib), KRAS (Adagrasib and Sotorasib), PARP (Niraparib, Olaparib), VEGF(R) (Axitinib, Bevacizumab, Ramucirumab), and less-selective tyrosine (receptor) kinase inhibitors (Bosutinib, Brigatinib, Entrectinib, Lenvatinib, Pazopanib, Sorafenib, Sunitinib). Local failure (LF) and radiation necrosis were determined radiographically with clinical impression (grade 2 (symptomatic) or higher (G2+)) and compared between different systemic agents. RESULTS The study included 95 patients with 310 metastases (SRS 246, SRT 64 metastases). Most common primary histologies were non-small cell lung cancer (36% 34/95), breast cancer (28% 27/95), and melanoma (16% 15/95). Overall survival at 1 and 2 years was 80% (76/95) and 55% (52/95), respectively. Median follow-up was 16.6 (range 3-91) months. Median tumor size was 7mm (range 1-75mm). Median number of brain metastases per patient was 2.5 (range 1-12). The G2+ radiation necrosis rate was 5.8% (18/310) while the LF rate was 9.7% (30/310) per metastasis. There was no significant difference in G2+ radiation necrosis by class of targeted therapy. Sixty-two percent (59/95) of patients experienced distant intracranial failure. Median intracranial progression free survival (PFS) was 8.0 (range 0.4-61.4) months. CONCLUSION Although heterogeneous, patients treated with SRS/SRT and ongoing CNS-active targeted systemic therapies have on average >6 month intracranial PFS and little evidence of significant toxicity. We observed <6% G2+ radiation necrosis for this cohort, and no particular class of agent was associated with a significantly higher rate of G2+ radiation necrosis.
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Affiliation(s)
- J Hall
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - K P Lui
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R Darawsheh
- University of North Carolina, Chapel Hill, NC
| | - J W Shumway
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - L A Carey
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - K Reeder Hayes
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - C B Lee
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - S Moschos
- Division of Oncology, University of North Carolina, Chapel Hill, NC
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - R Chaudhary
- Division of Oncology, University of Cincinnati, Cincinnati, OH
| | - L Yogendran
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - T D Struve
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R E Vatner
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - L E Pater
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J C Breneman
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - A A Weiner
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
| | - C Shen
- Department of Radiation Oncology, University of North Carolina, Chapel Hill, NC
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MacDonald T, Sackett JJ, Gaskill-Shipley M, Rao R, Chaudhary R, Curry R, Forbes J, Andaluz N, Zuccarello M, Yogendran L, Sengupta S, Struve Iii TD, Vatner RE, Pater LE, Mascia AE, Breneman JC, Wang K. Neurologic Events and Outcomes in Patients Receiving Proton and Photon Reirradiation for High Grade Non-Codeleted Gliomas. Int J Radiat Oncol Biol Phys 2023; 117:e133-e134. [PMID: 37784697 DOI: 10.1016/j.ijrobp.2023.06.936] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Patients undergoing reirradiation (ReRT) for high grade glioma are at risk for tumor progression, pseudoprogression, and radiation necrosis. We investigated factors associated with neurologic events and disease control after re-irradiation with protons and photons at a single academic center. MATERIALS/METHODS We reviewed records and MRIs of patients receiving scanning beam proton (since center opening in 2016) and photon (since 2015) reirradiation in ≥10 fractions for grade 3 anaplastic astrocytoma (AA) and grade 4 glioblastoma (GBM), excluding 1p19q co-deleted oligodendrogliomas and extensive multifocal/leptomeningeal disease. The primary endpoint was time from ReRT to ≥ grade 2 pseudoprogression or radiation necrosis (PsP/RN, grade 2: moderate symptoms requiring outpatient steroids/bevacizumab, grade 3: severe symptoms leading to admission or surgical intervention). Dose was converted to EQD2 using a/b = 3. Cox proportional hazards model was used to calculate survival and time to PsP/RN. RESULTS A total of 53 patients were included (26 protons, 27 photons, median KPS 80). Patients receiving protons had more favorable features. Compared to the photons, the proton group was younger (48 vs. 58) and more likely to have AA (46% vs. 22%) and resection within 3 months (42% vs 26%). The proton group also had a longer interval from prior RT (57 vs. 39 months) and were less likely to receive bevacizumab at reRT (15% vs. 59%). CTV was 130 cc for protons vs 99 cc for photons, and most had active disease at time of ReRT identified on planning MRI (76% protons, 85% photons). Median OS was 10.5 months (14.1 months protons, 8.1 months photons), with time from initial RT the only significant factor on multivariate analysis. Median PFS was 9.4 months (9.8 months protons, 6.2 months photons). 9 patients (18%) had ≥ grade 3 PsP/RN (8 proton, 1 photon) and 21 patients (41%) had ≥ grade 2 PsP/RN (16 proton, 5 photon). Grade 3 events included 1 seizure (photon group), 1 hemorrhage, 1 thalamic stroke, 1 shunt placement, 1 re-resection, and PSP4 4 PsP/RN requiring admission. Protons were associated shorter time to ≥ grade 2 PsP/RN (4 months vs. not reached, p = 0.027). When accounting for bevacizumab use at time of reRT, the association between protons and PsP/RN lost significance but there remained a trend (grade 2, p = 0.095, HR 2.4; grade 3, p = 0.105, HR 5.8). CTV, MGMT status, EQD2, and interval from prior RT were not associated with PsP/RN. CONCLUSION High grade neurologic events were common in patients with predominantly active, unresected high grade gliomas receiving ReRT. Though ascertainment and survival bias are significant limitations, pseudoprogression and necrosis appeared to be more prominent in patients receiving protons. These results contribute to ongoing efforts to both optimize ReRT for high grade glioma and investigate biologic effects of proton therapy.
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Affiliation(s)
- T MacDonald
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J J Sackett
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | | | - R Rao
- Cincinnati Children's Hospital Medical Center, Cincinnati, OH
| | - R Chaudhary
- Division of Oncology, University of Cincinnati, Cincinnati, OH
| | - R Curry
- CTI Clinical Trial and Consulting Services, Covington, KY
| | - J Forbes
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH
| | - N Andaluz
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH
| | - M Zuccarello
- Department of Neurosurgery, University of Cincinnati, Cincinnati, OH
| | - L Yogendran
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - S Sengupta
- Department of Neurology, University of Cincinnati, Cincinnati, OH
| | - T D Struve Iii
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - R E Vatner
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - L E Pater
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - A E Mascia
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - J C Breneman
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - K Wang
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
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Chakraborty D, Mondal S, Sengupta S, Abbas Z, Chandra K, Boral S, Maiti A, Roy S, Mukherjee A, Das A, Chakraborty S, Nag P. Incidence, clinical features, risk factors, and outcomes of Intraocular inflammation following Brolucizumab in Indian eyes - A multicentric study. Indian J Ophthalmol 2023; 71:1979-1985. [PMID: 37203069 PMCID: PMC10391460 DOI: 10.4103/ijo.ijo_2688_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Abstract
Purpose To report the incidence, clinical features, potential risk factors, and outcomes of intraocular inflammation (IOI) following brolucizumab in Indian eyes. Methods All consecutive patients diagnosed with brolucizumab-induced IOI from 10 centers in eastern India between October 2020 and April 2022 were included. Results Of 758 injections given during the study period across centers, 13 IOI events (1.7%) were recorded attributable to brolucizumab. The IOI occurred after the first dose in two eyes (15%) (median 45 days after brolucizumab), second dose in six eyes (46%) (median = 8.5 days), and third dose (39%) in the remaining five eyes (median 7 days). Reinjections of brolucizumab were administered at a median interval of 6 weeks (interquartile range = 4-10 weeks) in the 11 eyes, where IOI occurred after the second or third dose. Eyes that experienced IOI after the third dose had received a significantly greater number of previous antivascular endothelial growth factor injections (median = 8) compared to those who developed it after the first or second dose (median = 4) (P = 0.001). Anterior chamber cells were seen in almost all eyes (n = 11, 85%), while peripheral retinal hemorrhages were seen in two eyes, and one eye showed branch artery occlusion. Two-thirds of patients (n = 8, 62%) recovered with a combination of topical and oral steroids, while remaining recovered with topical steroids alone. Irreversible visual loss was not seen in any eye, and median vision recovered to pre-IOI levels by 3 months' time point. Conclusion Brolucizumab-induced IOI was relatively rare, occurring in 1.7% of eyes, was more common after the second or third injection, especially in those who required frequent reinjections every 6 weeks, and occurred earlier with increasing number of previous brolucizumab injections. Continued surveillance is necessary even after repeated doses of brolucizumab.
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Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreo Retina Services, Disha Eye Hospitals, Barrackpore, Kolkata, West Bengal, India
| | - Soumen Mondal
- Department of Vitreo Retina Services, Disha Eye Hospitals, Barrackpore, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Department of Vitreo-Retina Services, Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Zahir Abbas
- Department of Retina Services, Consultant Vitreoretinal Surgeon, Apollo Gleneagles Medical Centre, Fortis Medical Centre, Kolkata, West Bengal, India
| | - Khushboo Chandra
- Department of Vitreo Retina Services, Disha Eye Hospitals, Barrackpore, Kolkata, West Bengal, India
| | - Subhendu Boral
- Department of Vitreo Retina Services, Disha Eye Hospitals, Barrackpore, Kolkata, West Bengal, India
| | - Aniruddha Maiti
- Department of Vitreo Retina Services, Global Eye Hospitals, Kolkata, West Bengal, India
| | - Sangeeta Roy
- Department of Vitreo Retina Services, Global Eye Hospitals, Kolkata, West Bengal, India
| | - Angshuman Mukherjee
- Department of Vitreo Retina Services, Disha Eye Hospitals, Barrackpore, Kolkata, West Bengal, India
| | - Arnab Das
- Department of Vitreo Retina Services, Disha Eye Hospitals, Barrackpore, Kolkata, West Bengal, India
| | - Somnath Chakraborty
- Deptt of Vitreo-Retina Services, Retina Institute of Bengal, Siliguri, West Bengal, India
| | - Pinaki Nag
- Deptt of Ophthalmology, Diptakshi Eye Surgery and Medical Centre, Hooghly, West Bengal, India
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Sengupta S. The recipe to growing a journal: My experiences as the Associate Editor of the Indian Journal of Ophthalmology. Indian J Ophthalmol 2023; 71:1669-1670. [PMID: 37203014 PMCID: PMC10391488 DOI: 10.4103/ijo.ijo_1079_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/20/2023] Open
Affiliation(s)
- Sabyasachi Sengupta
- Vitreoretina Services, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
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10
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Shroff S, Rao DP, Savoy FM, Shruthi S, Hsu CK, Pradhan ZS, Jayasree PV, Sivaraman A, Sengupta S, Shetty R, Rao HL. Agreement of a Novel Artificial Intelligence Software With Optical Coherence Tomography and Manual Grading of the Optic Disc in Glaucoma. J Glaucoma 2023; 32:280-286. [PMID: 36730188 DOI: 10.1097/ijg.0000000000002147] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 06/26/2022] [Accepted: 11/19/2022] [Indexed: 02/03/2023]
Abstract
PRCIS The offline artificial intelligence (AI) on a smartphone-based fundus camera shows good agreement and correlation with the vertical cup-to-disc ratio (vCDR) from the spectral-domain optical coherence tomography (SD-OCT) and manual grading by experts. PURPOSE The purpose of this study is to assess the agreement of vCDR measured by a new AI software from optic disc images obtained using a validated smartphone-based imaging device, with SD-OCT vCDR measurements, and manual grading by experts on a stereoscopic fundus camera. METHODS In a prospective, cross-sectional study, participants above 18 years (Glaucoma and normal) underwent a dilated fundus evaluation, followed by optic disc imaging including a 42-degree monoscopic disc-centered image (Remidio NM-FOP-10), a 30-degree stereoscopic disc-centered image (Kowa nonmyd WX-3D desktop fundus camera), and disc analysis (Cirrus SD-OCT). Remidio FOP images were analyzed for vCDR using the new AI software, and Kowa stereoscopic images were manually graded by 3 fellowship-trained glaucoma specialists. RESULTS We included 473 eyes of 244 participants. The vCDR values from the new AI software showed strong agreement with SD-OCT measurements [95% limits of agreement (LoA)=-0.13 to 0.16]. The agreement with SD-OCT was marginally better in eyes with higher vCDR (95% LoA=-0.15 to 0.12 for vCDR>0.8). Interclass correlation coefficient was 0.90 (95% CI, 0.88-0.91). The vCDR values from AI software showed a good correlation with the manual segmentation by experts (interclass correlation coefficient=0.89, 95% CI, 0.87-0.91) on stereoscopic images (95% LoA=-0.18 to 0.11) with agreement better for eyes with vCDR>0.8 (LoA=-0.12 to 0.08). CONCLUSIONS The new AI software vCDR measurements had an excellent agreement and correlation with the SD-OCT and manual grading. The ability of the Medios AI to work offline, without requiring cloud-based inferencing, is an added advantage.
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Affiliation(s)
- Sujani Shroff
- Department of Glaucoma, Narayana Nethralaya, Rajajinagar
| | - Divya P Rao
- Remidio Innovative Solution Inc., Glen Allen, VA
| | - Florian M Savoy
- Medios Technologies, Remidio Innovative Solutions Pvt Ltd, Singapore
| | - S Shruthi
- Department of Glaucoma, Narayana Nethralaya, Rajajinagar
| | - Chao-Kai Hsu
- Medios Technologies, Remidio Innovative Solutions Pvt Ltd, Singapore
| | - Zia S Pradhan
- Department of Glaucoma, Narayana Nethralaya, Rajajinagar
| | - P V Jayasree
- Department of Glaucoma, Narayana Nethralaya, Rajajinagar
| | - Anand Sivaraman
- Remidio Innovative Solution Pvt Ltd, Bengaluru, Karnataka, India
| | | | - Rohit Shetty
- Department of Glaucoma, Narayana Nethralaya, Rajajinagar
| | - Harsha L Rao
- Department of Glaucoma, Narayana Nethralaya, Bannerghatta Road
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11
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Sengupta S. Perspectives on Evolving Gene Therapy for X-Linked Retinitis Pigmentosa. JAMA Ophthalmol 2023; 141:283-284. [PMID: 36757711 DOI: 10.1001/jamaophthalmol.2022.6436] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/10/2023]
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12
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Hayne D, Stockler M, Martin A, Mccombie S, Zebic D, Krieger L, Anderson P, Bastick P, Beardsley E, Blatt A, Frydenberg M, Green W, Grummet J, Hawks C, Ischia J, Mitterdorfer A, Patel M, Roberts M, Sengupta S, Srivastav R, Winter M, Redfern A, Davis I. Adding Mitomycin to BCG as adjuvant intravesical therapy for high-risk, non-muscle-invasive -bladder cancer: A randomised phase 3 trial: The BCG+MM Study (ANZUP1301). Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)00567-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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13
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Prajapati V, Choudhary T, Chauhan W, Shah S, Handa R, Jahan B, Malviya S, Sengupta S. Efficacy of a biosimilar ranibizumab monotherapy for the treatment of retinopathy of prematurity. Indian J Ophthalmol 2023; 71:411-415. [PMID: 36727329 DOI: 10.4103/ijo.ijo_973_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/03/2023] Open
Abstract
Purpose To evaluate the efficacy of a biosimilar ranibizumab (Razumab) on outcomes of retinopathy of prematurity (ROP) for the first time. Methods This retrospective study included infants presenting with stage 3+ ROP either in zone 1 or zone 2 posterior or aggressive posterior ROP (APROP). All eligible infants received intravitreal razumab (0.25 mg/0.025 ml) monotherapy. Follow-up was continued monthly till complete retinal vascularization was achieved while retreatment with razumab was given when recurrent neovascularization was noted. In case of no recurrence but incomplete vascularization, laser photocoagulation was done to the residual avascular retina. Results We included 118 eyes of 59 infants with a median gestational age of 30 weeks and median birth weight of 1250 grams. At presentation, APROP was found in 28 eyes (24%) of 14 babies while stage 3 disease was seen in zone 1 in another 28 eyes (24%) and the remaining 62 eyes (52%) had stage 3 ROP in zone 2 posterior region. Complete resolution of ROP along with complete vascularization was seen in 22 eyes (19%) at a median of 55 days (IQR = 31-56 days) and 42 eyes (35%) showed a recurrent neovascularization at a median of 51 days post razumab (IQR = 42-55 days). The cumulative incidence of recurrence of neovascularization (21%, 95% CI = 14%-29%) peaked at seven weeks and was significantly higher in eyes with APROP (43%, 95% CI = 27%-63%) compared to eyes without APROP (13.4%, 95%CI, 8%-22%) (P < 0.001). Conclusion Razumab appears to be safe and effective in treating ROP, with about a third requiring reinjection at seven weeks after the first dose.
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Affiliation(s)
- Vipul Prajapati
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Tanvi Choudhary
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Wilhemina Chauhan
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Sonali Shah
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Ramya Handa
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Bushra Jahan
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Sheetal Malviya
- M and J Western Regional Institute of Ophthalmology, Civil Hospital, Ahmedabad, Gujarat, India
| | - Sabyasachi Sengupta
- Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, India
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14
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Sengupta S. Lessons learnt from the International Peer Review Week 2022 with the theme - "Research Integrity: Creating and supporting trust in research". Indian J Ophthalmol 2022; 70:4099-4100. [PMID: 36453293 PMCID: PMC9940577 DOI: 10.4103/ijo.ijo_2920_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Sabyasachi Sengupta
- Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India. E-mail:
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15
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Verma L, Agarwal A, Sengupta S, Ravindran RD, Honavar SG. Response to comments on: All India Ophthalmological Society (AIOS) task force guidelines to prevent intraocular infections. Indian J Ophthalmol 2022; 70:4457-4458. [PMID: 36453368 PMCID: PMC9940512 DOI: 10.4103/ijo.ijo_2247_22] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022] Open
Affiliation(s)
- Lalit Verma
- Department of Ophthalmology, Consultant Ophthalmologist, Centre for Sight, Safdarjung Enclave, New Delhi, India,Correspondence to: Dr. Lalit Verma, Consultant Ophthalmologist, Vitreoretinal Services, Centre for Sight, B-5/24, Safdarjung Enclave, New Delhi - 110 029, India. E-mail:
| | - Aniruddha Agarwal
- Department of Ophthalmology, Eye Institute, Cleveland Clinic Abu Dhabi, Al Maryah Island, Abu Dhabi, UAE,Department of Ophthalmology, Cleveland Clinic Lerner College of Medicine, Case Western Reserve University, Cleveland, OH, USA,Department of Ophthalmology, University of Maastricht Medical Center+, Maastricht, The Netherlands
| | - Sabyasachi Sengupta
- Department of Ophthalmology, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - R D Ravindran
- Department of Ophthalmology, Aravind Eye Hospital, Chennai, Tamil Nadu, India
| | - Santosh G Honavar
- Department of Ophthalmology, Consultant, Centre for Sight, Hyderabad, Telangana, India
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16
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Sengupta S, Bose S. 396 A Rare Encounter of “Forgotten Disease”. Br J Surg 2022. [DOI: 10.1093/bjs/znac269.130] [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: 11/06/2022]
Abstract
Abstract
With the advent and prompt use of antibiotics after throat infections, the rare entity of Necrobacillosis has almost disappeared in clinical practice. Here we present a case of a fit and well 27-year-old lady who was brought into A&E with septic shock, DIC and MODS after initial diagnosis of a sore throat 4 days ago which was treated by oral antibiotics. She was found to have bilateral patchy consolidations which later became necrotic cavities, empyema thoracis, peritonitis and abscess cavities in abdomen with evolving splenic abscess, prolonged QT and ectopics and type 2 respiratory failure. She was resuscitated, intubated, and transferred to the ICU. With an isolate of Fusobacterium necrophorum from blood culture Meropenem, clindamycin and metronidazole were started. However, over the next few days of treatment, lack of clinical response prompted antibiotics changing, and surgical drainage of abscesses in chest and abdomen. Eventually after a considerable period of abdominal abscess drainage and about 3 weeks of metronidazole and other antibiotics followed by Piperacillin and tazobactam for another 3 weeks the patient recovered from sepsis and was stepped down to ward. This case though rare is a good example of the benefits of surgical drainage and prolonged antibiotics for septic patients with collections. A rapid weaning only results in re-collection and clinical deterioration, or recurrent collection as happened to this patient. This is a rare case of Lemierre's syndrome which depicts the surgical difficulties faced due to recurrent abscess cavities formed in this condition.
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Affiliation(s)
- S Sengupta
- Frimley Park Hospital , Camberley , United Kingdom
| | - S Bose
- Salford Royal NHS Foundation Trust , Manchester , United Kingdom
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17
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Rao DP, Sindal MD, Sengupta S, Baskaran P, Venkatesh R, Sivaraman A, Savoy FM. Towards a Device Agnostic AI for Diabetic Retinopathy Screening: An External Validation Study. Clin Ophthalmol 2022; 16:2659-2667. [PMID: 36003071 PMCID: PMC9393096 DOI: 10.2147/opth.s369675] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2022] [Accepted: 07/11/2022] [Indexed: 11/23/2022] Open
Affiliation(s)
- Divya Parthasarathy Rao
- Artificial Intelligence R&D, Remidio Innovative Solutions Inc, Glen Allen, VA, USA
- Correspondence: Divya Parthasarathy Rao, Artificial Intelligence R&D, Remidio Innovative Solutions Inc, 11357 Nuckols Road, #102, Glen Allen, VA, 23059, USA, Tel +1 855 513-3335, Email
| | - Manavi D Sindal
- Vitreoretinal Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Sabyasachi Sengupta
- Department of Retina, Future Vision Eye Care and Research Center, Mumbai, India
| | - Prabu Baskaran
- Vitreoretinal Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Chennai, India
| | - Rengaraj Venkatesh
- Vitreoretinal Services, Aravind Eye Hospitals and Postgraduate Institute of Ophthalmology, Pondicherry, India
| | - Anand Sivaraman
- Artificial Intelligence R&D, Remidio Innovative Solutions Pvt Ltd, Bangalore, India
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Shukla V, Gera B, Ganju S, Varma S, Maheshwari N, Guchhait P, Sengupta S. Application of CFD model for Passive Autocatalytic Recombiners to formulate an empirical correlation for integratral containment analysis. Nuclear Engineering and Technology 2022. [DOI: 10.1016/j.net.2022.06.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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19
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Sengupta S, Handoo A, Mehta S, Kaushik M. T105 POCT in critical care: An accuracy check! Clin Chim Acta 2022. [DOI: 10.1016/j.cca.2022.04.573] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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20
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Sørli JB, Sengupta S, Jensen ACØ, Nikiforov V, Clausen PA, Hougaard KS, Højriis S, Frederiksen M, Hadrup N. Risk assessment of consumer spray products using in vitro lung surfactant function inhibition, exposure modelling and chemical analysis. Food Chem Toxicol 2022; 164:112999. [PMID: 35427705 DOI: 10.1016/j.fct.2022.112999] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2021] [Revised: 03/14/2022] [Accepted: 04/05/2022] [Indexed: 11/26/2022]
Abstract
Consumer spray products release aerosols that can potentially be inhaled and reach the deep parts of the lungs. A thin layer of liquid, containing a mixture of proteins and lipids known as lung surfactant, coats the alveoli. Inhibition of lung surfactant function can lead to acute loss of lung function. We focused on two groups of spray products; 8 cleaning and 13 impregnation products, and in the context of risk assessment, used an in vitro method for assessing inhibition of lung surfactant function. Original spray-cans were used to generate aerosols to measure aerodynamic particle size distribution. We recreated a real-life exposure scenario to estimate the alveolar deposited dose. Most impregnation products inhibited lung surfactant function at the lowest aerosolization rate, whereas only two cleaning products inhibited function at the highest rates. We used inhibitory dose and estimated alveolar deposition to calculate the margin of safety (MoS). The MoS for the inhibitory products was ≤1 for the impregnation products, while much larger for the cleaning products (>880). This risk assessment focused on the risk of lung surfactant function disruption and provides knowledge on an endpoint of lung toxicity that is not investigated by the currently available OECD test guidelines.
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Affiliation(s)
- J B Sørli
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - S Sengupta
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - A C Ø Jensen
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - V Nikiforov
- Norwegian Institute for Air Research (NILU), Tromsø, Norway.
| | - P A Clausen
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - K S Hougaard
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark; Department of Public Health, University of Copenhagen, Copenhagen, Denmark.
| | - Sara Højriis
- COWI, Parallelvej 2, Kgs, Lyngby, Denmark; DHI A/S, Agern Allé 5, Hørsholm, Denmark.
| | - M Frederiksen
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
| | - N Hadrup
- National Research Centre for the Working Environment (NFA), 105 Lersø Parkallé, Copenhagen Ø, Denmark.
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21
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Chakraborty D, Maiti A, Sengupta S, Mondal S, Nandi K, Chakraborty S. Initial experience in treating polypoidal choroidal vasculopathy with brolucizumab in Indian eyes - A multicenter retrospective study. Indian J Ophthalmol 2022; 70:1295-1299. [PMID: 35326038 PMCID: PMC9240502 DOI: 10.4103/ijo.ijo_2513_21] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [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: 11/15/2022] Open
Abstract
Purpose: To report the initial experience of managing treatment-resistant and treatment-naïve eyes with polypoidal choroidal vasculopathy (PCV) by using brolucizumab 6 mg. Methods: This was a retrospective multicentric series of all consecutive eyes with PCV treated with brolucizumab. Treatment resistance was defined as taking at least six prior anti-VEGF injections over the past 1 year and showing persistent disease activity in the form of intra (IRF) or subretinal fluid (SRF) or both. All patients were treated on a pro re nata (PRN) basis and followed up monthly. Retreatment was considered when either SRF or IRF were present at any time point during the study. Results: We included 21 eyes of 21 patients with PCV with a mean age of 65.1 ± 9.9 years, of which 16 eyes (76%) were treatment-resistant. The mean follow-up period from receiving the first brolucizumab was 27.3 ± 3.3 weeks. Of the 21 eyes, seven eyes (33%) received three injections during follow-up, 13 eyes (62%) received two injections, and one eye received one injection. The mean injection-free interval was 12 ± 1.2 weeks. The median pretreatment vision was 0.6 logMAR (IQR = 0.47–1 logMAR) and improved to 0.3 logMAR (IQR = 0.25–0.6 logMAR), whereas the mean macular thickness improved from 443 ± 60 mm at baseline to 289 ± 25 mm (P < 0.001) at the last follow-up period. None of the eyes experienced any intraocular inflammation across 48 injection sessions Conclusion: Brolucizumab is safe and effective in controlling PCV disease in both treatment-resistant and treatment-naïve eyes.
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Affiliation(s)
| | - Aniruddha Maiti
- Netralayam Super Speciality Eye Care Centre, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Vitreo-Retina Services, Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Soumen Mondal
- Vitreo-Retina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
| | - Krishnendu Nandi
- Netralayam Super Speciality Eye Care Centre, Kolkata, West Bengal, India
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22
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O'Brien J, Manning T, Kelly B, Chen K, Merrilees D, Joseph J, Sengupta S, Goad J, Bolton D, Lawrenstchuk N. Sealing the leak: A 10-year multicentre experience managing refractory post retroperitoneal lymph node dissection chylous ascites. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00647-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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23
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Shah R, Hirwe S, Ashar J, Sengupta S. Utilization rate of corneal tissue obtained from donors over 75 years of age in Western India for keratoplasty. Indian J Ophthalmol 2022; 70:511-515. [PMID: 35086227 PMCID: PMC9023935 DOI: 10.4103/ijo.ijo_1329_21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: To examine the utilization patterns of cornea procured from diseased individuals ≥75 years of age at an eye bank in western India. Methods: In this retrospective study, data from 1,217 eyes of 653 donors with age ≥75 years were reviewed from October 2008 to December 2019. Donor age, lens status, endothelial cell count (ECD), utilization of the tissue for transplantation or non-clinical purposes (e.g., research, training/discarded), and causes of non-utilization were noted. Results: The mean age of the donors was 80.9 ± 4.6 years and the tissue utilization rate was 36.5% (445 out of 1,217 eyes). The eyes used for keratoplasty procedures had a lower donor age (79.6 ± 5.7 vs. 81.5 ± 5.1; P < 0.001), a higher endothelial cell count (2493 ± 531 vs. 2034 ± 581; P < 0.001), and were more often phakic (61% vs. 36.6%) compared to the unused group. A multivariable logistic regression analysis showed that the likelihood of tissue utilization for keratoplasty was 13% higher with every 100-cell increment in donor ECD (odds ratio [OR] = 1.13, 95% CI = 1.10–1.16, P < 0.001) and 33% lower with having a pseudophakic status in the donor eye (OR = 0.67, 95% CI = 0.52–0.87, P = 0.03). Age was not a significant determinant of tissue utilization when used in the same multivariable model. Conclusion: More than one-third of the eyes (36.5%) can be utilized even when the donors are above 75 years of age. Eyes that were more likely to be utilized for keratoplasty were phakic and had a significantly higher ECD; age was not a determinant in tissue utilization.
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Affiliation(s)
- Rakesh Shah
- Swaraashi Netralaya, Mumbai, Maharashtra, India
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Chakraborty D, Sengupta S, Mondal S, Boral S, Das A, Sinha TK, Bhattacharya R, Maitra R. Comparison of Innovator vs. Biosimilar Ranibizumab in Treating Diabetic Macular Edema: A Multicenter Retrospective Study. Ophthalmol Ther 2022; 11:629-638. [PMID: 35075621 PMCID: PMC8927574 DOI: 10.1007/s40123-022-00463-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/18/2021] [Accepted: 01/11/2022] [Indexed: 11/26/2022] Open
Abstract
Introduction To compare the efficacy of innovator ranibizumab (iRBZ—Accentrix, Novartis, India) vs. biosimilar ranibizumab (bRBZ, Razumab-Intas, India) in eyes with diabetic macular edema (DME) in an Indian population. Methods Data of patients with DME who underwent at least three injections of iRBZ or bRBZ and had a minimum of 6 months follow-up were obtained from an electronic database. Choice of injection depended upon the patient. Pro re nata (PRN) protocol from baseline was used with reinjections advised if the central macular thickness (CMT) was at least 300 μm and best corrected visual acuity (BCVA) was 20/40 or worse. Primary outcome measure was comparison of change in BCVA at 6 months between iRBZ and bRBZ. Results We included 264 eyes in the iRBZ group and 69 eyes in bRBZ group, which were comparable for baseline characteristics. Mean BCVA improved from 0.64 ± 0.39 logMAR to 0.47 ± 0.31 logMAR (p < 0.001) in the iRBZ group and from 0.71 ± 0.42 logMAR to 0.50 ± 0.29 logMAR in the bRBZ group (p < 0.001) at 6 months. There were no differences in BCVA between the two groups (p > 0.05 for all time points). The CMT reduction in the iRBZ group (120 ± 196 µm) was comparable to that in the bRBZ group at 6 months (105 ± 187 µm) (p = 0.69). There was no difference in the mean number of injections taken (3.81 ± 1.2 in iRBZ vs. 3.55 ± 1.2 in bRBZ) (p > 0.05) between groups. Vision at baseline was the only factor associated with vision at last follow-up after adjusting for CMT at baseline, type of injection, and number of injections. Conclusions Biosimilar RBZ is similar to innovator RBZ in improving vision and reducing CMT in eyes with DME in the short term.
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Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal 700120 India
| | | | - Soumen Mondal
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal 700120 India
| | - Subhendu Boral
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal 700120 India
| | - Arnab Das
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal 700120 India
| | - Tushar Kanti Sinha
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal 700120 India
| | - Ranabir Bhattacharya
- Department of Vitreo-Retinal Services, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, West Bengal 700120 India
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Sarkar B, Munshi A, Shahid T, Sengupta S, Bhaskar R, Ganesh T, Paul A, Bhattacharjee B, Pun R, Imbulgoda N, Biswal S, Rastogi K, Bansal K, Baba A, Yasmin T, Bhattacharya J, Ghosh T, De A, Chatterjee P, Pradhan A. Growth Characteristics of Woman Radiation Oncologists in South Asia: Assessment of Gender Neutrality and Leadership Position. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.1027] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Venkatesh R, Kenia H, Sengupta S, Gopalakrishna M, Au Eong KG. Effect of intravenous sedation on patients' visual experience and vital signs during cataract surgery under topical anesthesia: A randomized controlled trial. Adv Ophthalmol Pract Res 2021; 1:100006. [PMID: 37846396 PMCID: PMC10577815 DOI: 10.1016/j.aopr.2021.100006] [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] [Figures] [Subscribe] [Scholar Register] [Received: 06/18/2021] [Revised: 08/19/2021] [Accepted: 09/05/2021] [Indexed: 10/18/2023]
Abstract
Purpose Effect of intravenous sedation on patients' visual experience and vital signs during cataract surgery under topical anesthesia: a randomized controlled trial. Design Prospective, double masked, randomized controlled trial. Methods 150 eyes of 150 patients undergoing phacoemulsification and IOL implantation under topical anesthesia were randomized to receive either intravenous midazolam (0.015 mg/kg) or normal saline. The patients' experience was evaluated using a questionnaire. Vital signs including blood pressure and heart rate were measured before, during and after surgery. Mean arterial pressure (MAP) was calculated. Results Both groups were comparable except that fewer patients in the control group were pseudophakic in the fellow eye (25.3% vs. 41.3%). More patients in the control group perceived hand movements (p < 0.01), surgeon/medical staff (p = 0.04) and sudden increase in vision during surgery (p < 0.01) compared to midazolam group. More control group patients experienced fear (p < 0.001), pain (p = 0.06) and unpleasant surgical experience (20.3% vs. 1.3%, p < 0.001). They also experienced greater fluctuation in MAP (16.9 ± 7.9 vs.7.2 ± 5.3, p < 0.001) and this was accentuated in hypertensives. After adjusting for age, gender, hypertension status and other eye lens status, multivariable logistic regression analysis revealed that subjects in the control arm (OR = 11.7, 95% [CI] = 1.3-108, p = 0.03), had a longer duration of surgery, experienced pain and more likely to report unpleasant experience. Adjusting for similar covariates, multivariable linear regression analysis showed that control group patients (β = 8.5 mmHg, 95% CI = 6.2-10.8, p = 0.03) had hypertension, experienced fear during surgery and greater fluctuations in the MAP. Conclusions A sedative dose of intravenous midazolam during phacoemulsification under topical anesthesia significantly reduces patients' visual experience, fear and fluctuations in MAP and improves overall surgical experience.
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Affiliation(s)
| | | | | | | | - Kah-Guan Au Eong
- International Eye Cataract Retina Center, Mount Elizabeth Medical Center and Farrer Park Medical Center, Singapore
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Sengupta S, Sindal MD, Shanmugam PM, Bhende P, Ratra D, Nagpal M, Narayanan R, Rajendran A, Saravanan V, Kelkar A, Maiti A, Chakraborty D, Dogra M, Behera S. A Delphi method based consensus statement for surgical management of proliferative diabetic retinopathy in India. Indian J Ophthalmol 2021; 69:3308-3318. [PMID: 34708794 PMCID: PMC8725119 DOI: 10.4103/ijo.ijo_1265_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Purpose To derive consensus statements for surgical management of proliferative diabetic retinopathy (PDR) for vitreoretinal (VR) surgeons. Methods Thirteen prolific VR surgeons representing all regions of India were invited to participate in a 42-point questionnaire based on the Delphi methodology describing various surgical scenarios commonly encountered in PDR. Consensus was derived using predefined robust analytics. Scenarios that returned a moderate consensus in round 1 were taken to round 2 as per the Delphi methodology. After considering all inputs, the final consensus criteria were developed. Results A strong consensus was derived about waiting for 4 weeks before considering vitrectomy. In treatment-naïve eyes with fresh vitreous hemorrhage (VH), the wait time was slightly shorter for extramacular tractional retinal detachment (2-4 weeks) and longer (4-6 weeks) for eyes treated previously with laser or anti-VEGF agents. The expert panel recommended using preoperative anti-VEGF only in eyes with large membranes requiring extensive dissection. For post vitrectomy VH, while a conservative approach was recommended for the first episode of VH, experts recommended immediate vitreous lavage for recurrent episodes of VH. In eyes with iris neovascularization, the panel recommended immediate anti-VEGF injection followed by early vitreous lavage in nonresponsive eyes. A strong consensus was derived for stopping antiplatelet agents before surgery, while there was only a moderate consensus for performing vitrectomy for recalcitrant macular edema unresponsive to anti-VEGF injections in the absence of traction. Conclusion This study provides valuable consensus on managing the different scenarios encountered during surgical management of PDR and should help guide the VR surgeons in clinical decision-making.
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Affiliation(s)
- Sabyasachi Sengupta
- Vitreoretinal Services, Future Vision Eye Care, Borivali (East), Mumbai, Maharashtra, India
| | - Manavi D Sindal
- Viitreoretinal Services, Aravind Eye Hospital, Puducherry, India
| | - P Mahesh Shanmugam
- Vitreoretinal and Oncology Service, Sankara Eye Hospital, Kundalahalli Gate, Airport, Varthur Road, Bengaluru, Karnataka, India
| | - Pramod Bhende
- Shri Bhagawan Mahavir Vitreo-Retinal Services, Medical Research Foundation, (Sankara Nethralaya), Chennai, Tamil Nadu, India
| | - Dhanashree Ratra
- Shri Bhagawan Mahavir Vitreo-Retinal Services, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Manish Nagpal
- Vitreo Retinal Consultant, Retina Foundation, Ahmedabad, Gujarat, India
| | - Raja Narayanan
- Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Anand Rajendran
- Vitreoretinal Services, Aravind Eye Hospital, Chennai, Tamil Nadu, India
| | | | - Aditya Kelkar
- Vitreo-Retinal Services, National Institute of Ophthalmology, Pune, Maharashtra, India
| | - Aniruddha Maiti
- Vitreoretinal Services, Susrut Eye Foundation and Research Centre, Kolkata, West Bengal, India
| | - Debdulal Chakraborty
- Vitreo- Retina Service, Disha Eye Hospital, Barackpore, Kolkata, West Bengal, India
| | - Mohit Dogra
- Vitreoretina and Uveitis Service, Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sourabh Behera
- Viitreoretinal Services, Aravind Eye Hospital, Puducherry, India
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Chakraborty D, Maiti A, Kelkar A, Sengupta S, Roy S, Bolisetty M, Kothari A, Majumder J. Outcomes of preoperative bevacizumab in diabetics with nonclearing vitreous hemorrhage without tractional detachment - A quasi-randomized retrospective study. Indian J Ophthalmol 2021; 69:3283-3287. [PMID: 34708788 PMCID: PMC8725105 DOI: 10.4103/ijo.ijo_1264_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Purpose: To assess whether preoperative bevacizumab (BVZ) in treatment-naïve eyes with proliferative diabetic retinopathy (PDR) and vitreous hemorrhage (VH) without tractional retinal detachment (TRD) leads to lesser macular edema and better visual outcome compared to eyes that do not receive BVZ. Methods: This quasi-randomized retrospective study included 217 treatment-naïve eyes with nonclearing VH without TRD that had vitrectomy with or without BVZ and had a minimum 6-months follow-up. Postoperative variables, including visual acuity (BCVA), central macular thickness (CMT) at 1 month, and need for additional anti-VEGF injections till 6 months follow-up, were recorded for analysis. Results: Of the 217 eyes, 107 eyes (49%) received preoperative BVZ and 110 (51%) did not. Groups were comparable in terms of preoperative characteristics. At 1 month, mean CMT was significantly higher in eyes without BVZ (310 ± 33 μ vs. 246 ± 34μ; P < 0.001). The likelihood of developing center-involving DME at 1 month after vitrectomy was 67% lower if the eye received preoperative BVZ (OR = 0.33, 95%CI = 0.18–2.54, P = 0.56). Though BCVA improved significantly in both groups at 1 month, it was 1/3rd of a line better in the BVZ group (β coefficient = −0.035 logMAR, 95%CI = −0.04 to −0.008 logMAR, P = 0.01). Conclusion: Preoperative BVZ in treatment-naïve eyes with PDR and VH but without TRD lead to better macular status and marginally improved vision at 1 month, which was maintained at 6 months. In view of these results, patients may be offered BVZ only when it is readily affordable to them.
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Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreo-Retina, Disha Eye Hospitals, 88 Ghosh Para Road Barrackpore, Kolkata, India
| | - Aniruddha Maiti
- Department of Vitreo-Retina, Susrut Eye Hospital, Salt Lake, Kolkata, India
| | - Aditya Kelkar
- Department of Vitreo-Retina, National Institute of Ophthalmology,(NIO), Pune, Maharashtra, India
| | - Sabyasachi Sengupta
- Department of Vitreo-Retina, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Sangeeta Roy
- Department of Vitreo-Retina, Susrut Eye Hospital, Salt Lake, Kolkata, India
| | - Mounika Bolisetty
- Department of Vitreo-Retina, National Institute of Ophthalmology,(NIO), Pune, Maharashtra, India
| | - Akshay Kothari
- Department of Vitreo-Retina, National Institute of Ophthalmology,(NIO), Pune, Maharashtra, India
| | - Jaydeep Majumder
- Department of Vitreo-Retina, Susrut Eye Hospital, Salt Lake, Kolkata, India
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Sengupta S, Prendergast B, Furnaz S, Ronderos R, Almaghraby A, Asch FM, Blechova K, Zaky H, Dworakowski R, Izumi C, Lancellotti P, Habib G. Socio-economic variations in the clinical presentation, etiology and outcome of infective endocarditis in the ESC-EORP EURO-ENDO (European Infective Endocarditis) registry: a prospective cohort study. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Infective endocarditis (IE) is a life threatening disease associated with high mortality and morbidity worldwide. We sought to determine how socio-economic factors may influence variations in epidemiology, clinical presentation, investigation and management (and their consequence upon clinical outcomes) in a large international multi-centre registry.
Methods
The ESC-EORPEURO-ENDO registry comprises a prospective cohort of 3116 adult patients admitted to 156 hospitals in 40 countries with IE between January 2016 and March 2018. We analysed the complete dataset to assess potentially important determinants of variation according to World Bank economic stratification (high income (Group 1) [73.8%]; upper-middle income (Group 2) [17.1%]; lower-middle income (Group 3)[9.1%]).
Results
Patients in Group 3 were younger (median age [IQR]: Group 1 - 66 [54–75] years; Group 2 - 57 [40–68] years; Group 3 - 33 [26–43] years; p<0.001) with a higher prevalence of smoking, intravenous drug use and human immunodeficiency virus (HIV) infection (all p<0.001). Group 3 patients with IE presented later (median [IQR) days since symptom onset: Group 1 - 12 [3–35]; Group 2 - 20 [6–51]; Group 3 - 31 [12–62]; p<0.001) and were more likely to develop congestive heart failure (13.6%; 11.3%; and 22.6%, respectively; p<0.001), septic shock (8.3%; 11.1%; 13.4%; p=0.007), and persistent fever for greater than 7 days (9.6%; 14.4%; 27.9%; p<0.001) following hospital admission. Surgery was performed less frequently in Group 3 (75.4%, 76.8% and 51.3% in Groups 1, 2 and 3, respectively; p<0.001) and mortality was highest in the poorest countries (14.6%; 23.6% and 23.7%, respectively; p<0.001).
Conclusion
Socio-economic factors influence the clinical profile of patients presenting with IE across the world. Despite being younger, patients from the poorest countries presented with more frequent complications and higher mortality associated with delayed diagnosis and less frequent use of surgery.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Sengupta
- Sengupta Hospital and Research Institute, Nagpur, India
| | | | - S Furnaz
- National Institute of Cardiovascular Diseases, Karachi, Pakistan
| | - R Ronderos
- Institute of Cardiological Research UBA-CONICET, Buenos Aires, Argentina
| | - A Almaghraby
- Alexandria University hospital, Alexandria, Egypt
| | - F M Asch
- Medstar Research Institute, Washington, DC, United States of America
| | | | - H Zaky
- Dubai Hospital and Rashid Hospital, Dubai, United Arab Emirates
| | | | - C Izumi
- National Cerebral & Cardiovascular Center, Suita, Japan
| | | | - G Habib
- Hospital La Timone of Marseille, Marseille, France
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Sengupta S, Mohan J, MacGowan G, Jakovljevic D. Peak atrial longitudinal strain predicts exercise tolerance in heart failure with preserved ejection fraction. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0742] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Purpose
The present study i) determined left atrial (LA) and left ventricular (LV) strains at rest and in response to exercise in patients with heart failure with preserved ejection fraction (HFpEF) and heart failure with reduced ejection fraction (HFrEF), and ii) assessed the relationship between LA and LV strains and exercise tolerance.
Methods
Forty HFpEF patients (age 59±7 yrs; 25 females), 40 stable HFrEF patients (age 57+6 yrs, 15 females) and 20 controls (age 56+6 yrs, 13 females) underwent baseline clinical and biochemical assessment, resting and exercise stress transthoracic echocardiography using modified Bruce protocol. Speckle-tracking echocardiography was performed to define peak atrial longitudinal strain (PALS) and left ventricular global longitudinal strain (LVGLS). LA stiffness index and LV stiffness index were also derived.
Results
Compared to healthy controls, HFpEF and HFrEF showed significantly lower PALS at rest (34.03±1.85 vs. 23.06±4.69 vs. 11.51±1.44%, p<0.01) and after exercise (34.41±1.24 vs. 18.48±3.51 vs 10.47±1.49, p<0.01 for both). In response to exercise, the PALS significantly reduced in HFpEF by 26%, but only 8% in HFrEF and remained unchanged in controls. LA stiffness index was higher in HFpEF and HFrEF compared to healthy controls at rest (0.57±0.22 vs. 1.19±0.63 vs. 0.27±0.06, p<0.01) and in response to exercise (0.83±0.46 vs. 1.37±0.63 vs. 0.33±0.04, p<0.01). Compared to healthy controls, HFpEF and HFrEF demonstrated significantly lower LVGLS at rest (−20.27±0.98 vs. −15.89±2.72 vs.-11.14±3.40%, p<0.01) and after exercise (−19.9±0.8 vs.-15.5±3.18 vs.-11.01±2.6%, p<0.01). LV stiffness index was significantly higher in HFpEF and HFrEF compared to healthy controls at rest (0.16±0.05 vs. 0.14±0.07 vs. 0.11±0.02, p<0.01) and in response to exercise (0.18±0.07 vs. 0.15±0.06 vs. 0.13±0.02, p<0.01). Exercise tolerance i.e. exercise duration was significantly lower by 28% and 30% in HFpEF and HFrEF compared with controls (363±152 vs. 352±91 vs. 505±42, p<0.01). There was a significant relationship between peak atrial longitudinal strain and exercise tolerance in HFpEF (r=0.32, p=0.04).There was no significant relationship between exercise tolerance and LVGLS (r=0.058, p=0.72), LA stiffness (r=−0.17, p=0.3), LV stiffness (r=0.88, p=.59). There was no significant relationship between exercise tolerance and PALS (r=0.021, p=0.89) or LVGLS (r=0.12, p=0.48) in HFrEF.
Conclusion
HFpEF and HFrEF are associated with reduced left atrial and left ventricular strains and increased arial and ventricular stiffness.Peak atrial longitudinal strain is a significant determinant of exercise tolerance in HFpEF but not in HFrEF.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Sengupta
- Sengupta Hospital and Research Institute, Nagpur, India
| | - J.C Mohan
- Jaipur Golden Hospital, New Delhi, India
| | - G.A MacGowan
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Translational, Clinical & Biosciences Research Institutes, Faculty of Medical Sciences, Newcastle Upon Tyne, United Kingdom
| | - D.J Jakovljevic
- The Newcastle Upon Tyne Hospitals NHS Foundation Trust, Translational, Clinical & Biosciences Research Institutes, Faculty of Medical Sciences, Newcastle Upon Tyne, United Kingdom
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Phadnis S, Sengupta S, Chakraborty A. Work From Home, Mental Health and Employee Needs: A pilot study in selected information technology organizations in India. APJHM 2021. [DOI: 10.24083/apjhm.v16i3.977] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Introduction: The Coronavirus (COVID-19) pandemic has impacted the economy and has resulted in changes to the working arrangements of employees who are based at home and may continue to work from home (WFH). Organizations are expected to develop an inclusive policy for their employees to promote mental health whilst working from home. The aim of this study was to document the impact of WFH on mental health and determine the expectations of employees from their organizations regarding occupational health policy.
Methodology: A cross-sectional study was conducted on the impact of work from home on mental health and to document the mental health support needs of employees. Google form was floated through social media platform to receive the responses. A total of 74 responses were received. Descriptive analysis was conducted using Microsoft Excel, while qualitative answers were manually analysed.
Results: About 67% employees (n=45) mentioned that their workload has increased significantly during work from home. Thirty five percent (n=26) felt lonely and lost and 47% (n= 34) felt disconnected from the real world, indicating the mental health impact of work from home. Fifty three percent employees (n=40) mentioned that there were no efforts made by their organization to reduce the mental health impact of work from home.
Conclusion: The results of this study indicate that there is an urgent need to create a comprehensive occupational health and safety policy inclusive of strategies to improve mental health by the organizations in light of “work from home” as a “new-normal”.
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Chakraborty D, Sengupta S, Mukherjee A, Majumdar S. Response to comment on: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:2910-2911. [PMID: 34571690 PMCID: PMC8597517 DOI: 10.4103/ijo.ijo_1559_21] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreoretina Services, Disha Eye Hospitals, 88 Ghosh Para Road, Barrackpore, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Angshuman Mukherjee
- Department of Vitreoretina Services, Disha Eye Hospitals, 88 Ghosh Para Road, Barrackpore, Kolkata, West Bengal, India
| | - Saptorshi Majumdar
- Department of Vitreoretina Services, Disha Eye Hospitals, 88 Ghosh Para Road, Barrackpore, Kolkata, West Bengal, India
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Chakraborty D, Sengupta S, Mukherjee A, Majumdar S. Response to comment on: Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:2912. [PMID: 34571693 PMCID: PMC8597486 DOI: 10.4103/ijo.ijo_1558_21] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Affiliation(s)
- Debdulal Chakraborty
- Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
| | - Sabyasachi Sengupta
- Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
| | - Angshuman Mukherjee
- Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
| | - Saptorshi Majumdar
- Department of Vitreoretina Services, Disha Eye Hospitals, Kolkata, West Bengal, India
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Sarkar B, Shahid T, Indira G, Biswal S, Sengupta S, Biswas L, Goswami S, Pusarla C, de A, Ghosh T, Mukherjee M, Samanta A, Raj R, Bhattacharya J. PO-1123 Post mastectomy RT planning on institutional, RTOG & ESTRO contouring guidelines comparison. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07574-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sen M, Honavar SG, Bansal R, Sengupta S, Rao R, Kim U, Sharma M, Sachdev M, Grover AK, Surve A, Budharapu A, Ramadhin AK, Tripathi AK, Gupta A, Bhargava A, Sahu A, Khairnar A, Kochar A, Madhavani A, Shrivastava AK, Desai AK, Paul A, Ayyar A, Bhatnagar A, Singhal A, Nikose AS, Bhargava A, Tenagi AL, Kamble A, Nariani A, Patel B, Kashyap B, Dhawan B, Vohra B, Mandke C, Thrishulamurthy C, Sambare C, Sarkar D, Mankad DS, Maheshwari D, Lalwani D, Kanani D, Patel D, Manjandavida FP, Godhani F, Agarwal GA, Ravulaparthi G, Shilpa GV, Deshpande G, Thakkar H, Shah H, Ojha HR, Jani H, Gontia J, Mishrikotkar JP, Likhari K, Prajapati K, Porwal K, Koka K, Dharawat KS, Ramamurthy LB, Bhattacharyya M, Saini M, Christy MC, Das M, Hada M, Panchal M, Pandharpurkar M, Ali MO, Porwal M, Gangashetappa N, Mehrotra N, Bijlani N, Gajendragadkar N, Nagarkar NM, Modi P, Rewri P, Sao P, Patil PS, Giri P, Kapadia P, Yadav P, Bhagat P, Parekh R, Dyaberi R, Chauhan RS, Kaur R, Duvesh RK, Murthy R, Dandu RV, Kathiara R, Beri R, Pandit R, Rani RH, Gupta R, Pherwani R, Sapkal R, Mehta R, Tadepalli S, Fatima S, Karmarkar S, Patil SS, Shah S, Shah S, Shah S, Dubey S, Gandhi S, Kanakpur S, Mohan S, Bhomaj S, Kerkar S, Jariwala S, Sahu S, Tara S, Maru SK, Jhavar S, Sharma S, Gupta S, Kumari S, Das S, Menon S, Burkule S, Nisar SP, Kaliaperumal S, Rao S, Pakrasi S, Rathod S, Biradar SG, Kumar S, Dutt S, Bansal S, Ravani SA, Lohiya S, Rizvi SWA, Gokhale T, Lahane TP, Vukkadala T, Grover T, Bhesaniya T, Chawla U, Singh U, Une VL, Nandedkar V, Subramaniam V, Eswaran V, Chaudhary VN, Rangarajan V, Dehane V, Sahasrabudhe VM, Sowjanya Y, Tupkary Y, Phadke Y. Epidemiology, clinical profile, management, and outcome of COVID-19-associated rhino-orbital-cerebral mucormycosis in 2826 patients in India - Collaborative OPAI-IJO Study on Mucormycosis in COVID-19 (COSMIC), Report 1. Indian J Ophthalmol 2021; 69:1670-1692. [PMID: 34156034 PMCID: PMC8374756 DOI: 10.4103/ijo.ijo_1565_21] [Citation(s) in RCA: 201] [Impact Index Per Article: 67.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2021] [Revised: 06/06/2021] [Accepted: 06/07/2021] [Indexed: 12/15/2022] Open
Abstract
Purpose COVID-19-associated rhino-orbital-cerebral mucormycosis (ROCM) has reached epidemic proportion during India's second wave of COVID-19 pandemic, with several risk factors being implicated in its pathogenesis. This study aimed to determine the patient demographics, risk factors including comorbidities, and medications used to treat COVID-19, presenting symptoms and signs, and the outcome of management. Methods This was a retrospective, observational study of patients with COVID-19-associated ROCM managed or co-managed by ophthalmologists in India from January 1, 2020 to May 26, 2021. Results Of the 2826 patients, the states of Gujarat (22%) and Maharashtra (21%) reported the highest number of ROCM. The mean age of patients was 51.9 years with a male preponderance (71%). While 57% of the patients needed oxygen support for COVID-19 infection, 87% of the patients were treated with corticosteroids, (21% for > 10 days). Diabetes mellitus (DM) was present in 78% of all patients. Most of the cases showed onset of symptoms of ROCM between day 10 and day 15 from the diagnosis of COVID-19, 56% developed within 14 days after COVID-19 diagnosis, while 44% had delayed onset beyond 14 days. Orbit was involved in 72% of patients, with stage 3c forming the bulk (27%). Overall treatment included intravenous amphotericin B in 73%, functional endoscopic sinus surgery (FESS)/paranasal sinus (PNS) debridement in 56%, orbital exenteration in 15%, and both FESS/PNS debridement and orbital exenteration in 17%. Intraorbital injection of amphotericin B was administered in 22%. At final follow-up, mortality was 14%. Disease stage >3b had poorer prognosis. Paranasal sinus debridement and orbital exenteration reduced the mortality rate from 52% to 39% in patients with stage 4 disease with intracranial extension (p < 0.05). Conclusion : Corticosteroids and DM are the most important predisposing factors in the development of COVID-19-associated ROCM. COVID-19 patients must be followed up beyond recovery. Awareness of red flag symptoms and signs, high index of clinical suspicion, prompt diagnosis, and early initiation of treatment with amphotericin B, aggressive surgical debridement of the PNS, and orbital exenteration, where indicated, are essential for successful outcome.
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Affiliation(s)
| | | | | | | | - Raksha Rao
- Narayana Netralaya, Bengaluru, Karnataka, India
| | - Usha Kim
- Aravind Eye Care, Madurai, Tamil Nadu, India
| | | | | | - Ashok K Grover
- Department of Ophthalmology, Sir Ganga Ram Hospital and Vision Eye Centres, New Delhi, India
| | - Abhidnya Surve
- Department of Ophthalmology, Dr. Hedgewar Rugnalaya, Aurangabad, Maharashtra, India
| | - Abhishek Budharapu
- Department of Head and Neck Surgery, Apollo Cancer Hospital, Hyderabad, Telangana, India
| | - Abhishek K Ramadhin
- Department of Otorhinolaryngology, Dr Abhishek K. Ramadhin Hospital and Avyaan Research Centre, Ranchi, Jharkhand, India
| | | | - Adit Gupta
- Mumbai Eye Plastic Surgery, Maharashtra, India
| | - Aditya Bhargava
- Department of Otorhinolaryngology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Animesh Sahu
- Retina Speciality Hospital, Indore, Madhya Pradesh, India
| | - Anjali Khairnar
- Department of Ophthalmology, Shree Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Anju Kochar
- Department of Ophthalmology, Sardar Patel Medical College, Bikaner, Rajasthan, India
| | - Ankita Madhavani
- Department of Ophthalmology, Pandit Deendayal Upadhyay Medical College, Rajkot, Gujarat, India
| | - Ankur K Shrivastava
- Department of Ophthalmology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Anuja K Desai
- Department of Ophthalmology, Kusum Dhirajlal Hospital, Ahmedabad, Gujarat, India
| | - Anujeet Paul
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | | | - Aparna Bhatnagar
- Department of Ophthalmology, Apollo Specialty Hospitals, Chennai, Tamil Nadu, India
| | - Aparna Singhal
- Department of Ophthalmology, Maharaja Agrasen Medical College, Agroha, Haryana, India
| | - Archana Sunil Nikose
- Department of Ophthalmology, NKP Salve Institute of Medical Sciences and Research Centre, Nagpur, Maharashtra, India
| | - Arun Bhargava
- Retina Speciality Hospital, Indore, Madhya Pradesh, India
| | - Arvind L Tenagi
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Karnataka Lingayat Education Academy of Higher Education and Research, Belagavi, Karnataka, India
| | - Ashish Kamble
- Department of Ophthalmology, Kingsway Hospital, Nagpur, Maharashtra, India
| | - Ashiyana Nariani
- Department of Ophthalmology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, Maharashtra, India
| | - Bhavin Patel
- Department of Otorhinolaryngology, Kiran Super Multi-Speciality Hospital, Surat, Gujarat, India
| | | | - Bodhraj Dhawan
- Department of Ophthalmology, Alexis Hospital, Nagpur, Maharashtra, India
| | - Busaraben Vohra
- Department of Ophthalmology, Medical College Baroda and Sir Sayajirao General Hospital, Vadodara, Gujarat, India
| | - Charuta Mandke
- Department of Ophthalmology, Hinduhridaysamrat Balasaheb Thackeray Medical College & Dr. R. N. Cooper Municipal Hospital, Mumbai, Maharashtra, India
| | - Chinmayee Thrishulamurthy
- Department of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Chitra Sambare
- Department of Ophthalmology, Jehangir Hospital, Pune, Maharashtra, India
| | - Deepayan Sarkar
- Department of Ophthalmology, All India Institute of Medical Sciences, Bhopal, Madhya Pradesh, India
| | | | - Dhwani Maheshwari
- Department of Ophthalmology, Sir Sayajirao Gaekwad Hospital, Vadodra, Gujarat, India
| | | | - Dipti Kanani
- Department of Ophthalmology, Pandit Deendayal Upadhyay Medical College, Rajkot, Gujarat, India
| | - Diti Patel
- Department of Ophthalmology, Medical College Baroda and Sir Sayajirao General Hospital, Vadodara, Gujarat, India
| | | | - Frenali Godhani
- Department of Ophthalmology, Jagjivan Ram Railway Hospital, Mumbai, Maharashtra, India
| | - Garima Amol Agarwal
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Gayatri Ravulaparthi
- Department of Ophthalmology, Mamata Academy of Medical Sciences, Hyderabad, Telangana, India
| | | | | | - Hansa Thakkar
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Hardik Shah
- Department of Otorhinolaryngology, Kusum Dhirajlal Hospital, Ahmedabad, Gujarat, India
| | | | - Harsha Jani
- Department of Ophthalmology, Pramukh Swami Medical College, Karamsad, Gujarat, India
| | - Jyoti Gontia
- Department of Ophthalmology, Maharaja Yeshwantrao Hospital, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
| | - Jyotika P Mishrikotkar
- Department of Ophthalmology, Mahatma Gandhi Mission Medical College and Hospital, Aurangabad, Maharashtra, India
| | | | - Kamini Prajapati
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Kavita Porwal
- Department of Ophthalmology, Convenient Hospitals Limited (CHL) – Hospitals, Indore, Madhya Pradesh, India
| | - Kirthi Koka
- Sankara Nethralaya, Chennai, Tamil Nadu, India
| | | | - Lakshmi B Ramamurthy
- Department of Ophthalmology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | | | - Manorama Saini
- Department of Ophthalmology, Maharaja Agrasen Medical College, Agroha, Haryana, India
| | | | - Mausumi Das
- Department of Ophthalmology, Mahatma Gandhi Medical College and Research Institute, Puducherry, India
| | - Maya Hada
- Department of Ophthalmology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | - Mehul Panchal
- Department of Microbiology, Kiran Super Multi-Speciality Hospital, Surat, Gujarat, India
| | | | | | | | - Nagaraju Gangashetappa
- Department of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Neelima Mehrotra
- Department of Ophthalmology, Shri Ram Murti Smarak Institute of Medical Sciences, Bareilly, Uttar Pradesh, India
| | - Neha Bijlani
- Vision Care & Research Centre, Bhopal, Madhya Pradesh, India
| | | | - Nitin M Nagarkar
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Palak Modi
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Parveen Rewri
- Department of Ophthalmology, Maharaja Agrasen Medical College, Agroha, Haryana, India
| | - Piyushi Sao
- Department of Ophthalmology, Shri Mallanagouda Basanagouda Patil Medical College, BLDE University, Vijayapura, Karnataka, India
| | - Prajakta Salunkhe Patil
- Department of Ophthalmology, Krishna Institute of Medical Sciences, Karad, Maharashtra, India
| | - Pramod Giri
- Max Vision Eye Hospital, Nagpur, Maharashtra, India
| | - Priti Kapadia
- Department of Ophthalmology, Government Medical College, Surat, Gujarat, India
| | - Priti Yadav
- Department of Ophthalmology, Maharaja Yeshwantrao Hospital, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
| | - Purvi Bhagat
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Ragini Parekh
- Department of Ophthalmology, Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, Maharashtra, India
| | - Rajashekhar Dyaberi
- Department of Ophthalmology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - Rajender Singh Chauhan
- Regional Institute of Ophthalmology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Rajwinder Kaur
- Department of Ophthalmology, Adesh Institute of Medical Sciences and Research, Bhatinda, Punjab, India
| | - Ram Kishan Duvesh
- Department of Ophthalmology, Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
| | | | - Ravi Varma Dandu
- Department of Neuroradiology, Citi Neuro Centre, Hyderabad, Telangana, India
| | - Ravija Kathiara
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Renu Beri
- Department of Ophthalmology, Civil Hospital Ambala Cantonment, Haryana, India
| | - Rinal Pandit
- Department of Ophthalmology, Choithram Hospital & Research Centre, Indore, Madhya Pradesh, India
| | - Rita Hepsi Rani
- Department of Ophthalmology, Tirunelveli Medical College, Tirunelveli, Tamil Nadu, India
| | | | - Ruchi Pherwani
- Department of Ophthalmology, SMBT Institute of Medical Sciences and Research Centre, Nashik, Maharashtra, India
| | - Rujuta Sapkal
- Department of Ophthalmology, Mahatma Gandhi Mission Medical College and Hospital, Aurangabad, Maharashtra, India
| | - Rupa Mehta
- Department of Otorhinolaryngology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
| | - Sameeksha Tadepalli
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Samra Fatima
- Sarojini Devi Eye Hospital, Hyderabad, Telangana, India
| | - Sandeep Karmarkar
- Department of Otorhinolaryngology, Ruby Hall Clinic, Pune, Maharashtra, India
| | | | - Sanjana Shah
- Department of Ophthalmology, Medical College Baroda and Sir Sayajirao General Hospital, Vadodara, Gujarat, India
| | - Sankit Shah
- Department of Ophthalmology, Kiran Super Multi-Speciality Hospital, Surat, Gujarat, India
| | - Sapan Shah
- Department of Ophthalmology, Kusum Dhirajlal Hospital, Ahmedabad, Gujarat, India
| | - Sarika Dubey
- Department of Ophthalmology, Sawai Man Singh Medical College, Jaipur, Rajasthan, India
| | | | - Savitha Kanakpur
- Department of Ophthalmology, Karnataka Institute of Medical Sciences, Hubli, Karnataka, India
| | - Shalini Mohan
- Department of Ophthalmology, Ganesh Shankar Vidyarthi Memorial Medical College, Kanpur, Uttar Pradesh, India
| | | | - Sheela Kerkar
- Department of Ophthalmology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, Maharashtra, India
| | - Shivani Jariwala
- Department of Ophthalmology, Government Medical College, Surat, Gujarat, India
| | - Shivati Sahu
- Department of Ophthalmology, Maharaja Yeshwantrao Hospital, Mahatma Gandhi Memorial Medical College, Indore, Madhya Pradesh, India
| | | | - Shruti Kochar Maru
- Department of Ophthalmology, Convenient Hospitals Limited (CHL) – Hospitals, Indore, Madhya Pradesh, India
| | - Shubha Jhavar
- Department of Ophthalmology, Government Medical College, Aurangabad, Maharashtra, India
| | - Shubhda Sharma
- Department of Ophthalmology, Medanta - The Medicity, Gurugram, Haryana, India
| | - Shweta Gupta
- Sankara Eye Foundation, Indore, Madhya Pradesh, India
| | - Shwetha Kumari
- Department of Ophthalmology, Bowring and Lady Curzon Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Sima Das
- Dr. Shroff Charity Eye Hospital, New Delhi, India
| | - Smita Menon
- Department of Ophthalmology, King Edward Memorial Hospital and Seth Gordhandas Sunderdas Medical College, Mumbai, Maharashtra, India
| | - Snehal Burkule
- Department of Ophthalmology, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India
| | | | - Subashini Kaliaperumal
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Subramanya Rao
- Department of Otorhinolaryngology, Rangadore Memorial Hospital, Bengaluru, Karnataka, India
| | - Sudipto Pakrasi
- Department of Ophthalmology, Medanta - The Medicity, Gurugram, Haryana, India
| | - Sujatha Rathod
- Department of Ophthalmology, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Sunil G Biradar
- Department of Ophthalmology, Shri Mallanagouda Basanagouda Patil Medical College, BLDE University, Vijayapura, Karnataka, India
| | - Suresh Kumar
- Department of Ophthalmology, Government Medical College, Chandigarh, India
| | - Susheen Dutt
- Department of Otorhinolaryngology, Rangadore Memorial Hospital, Bengaluru, Karnataka, India
| | - Svati Bansal
- Department of Ophthalmology, Medanta - The Medicity, Gurugram, Haryana, India
| | - Swati Amulbhai Ravani
- M and J Western Regional Institute of Ophthalmology, Byramjee Jeejeebhoy Medical College, Ahmedabad, Gujarat, India
| | - Sweta Lohiya
- Department of Otorhinolaryngology, Kingsway Hospital, Nagpur, Maharashtra, India
| | - Syed Wajahat Ali Rizvi
- Department of Ophthalmology, Jawaharlal Nehru Medical College, Aligarh Muslim University, Aligarh, Uttar Pradesh, India
| | - Tanmay Gokhale
- Department of Ophthalmology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India
| | - Tatyarao P Lahane
- Department of Ophthalmology, Grant Medical College and Sir Jamshedjee Jeejeebhoy Group of Hospitals, Mumbai, Maharashtra, India
| | | | - Triveni Grover
- Department of Ophthalmology, Fortis Hospital, Shalimar Bagh, New Delhi, India
| | - Trupti Bhesaniya
- Department of Ophthalmology, Government Medical College, Surat, Gujarat, India
| | - Urmil Chawla
- Regional Institute of Ophthalmology, Post Graduate Institute of Medical Sciences, Rohtak, Haryana, India
| | - Usha Singh
- Advanced Eye Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Vaishali L Une
- Department of Ophthalmology, Shree Bhausaheb Hire Government Medical College, Dhule, Maharashtra, India
| | - Varsha Nandedkar
- Department of Ophthalmology, Government Medical College, Aurangabad, Maharashtra, India
| | | | - Vidya Eswaran
- Department of Ophthalmology, Bowring and Lady Curzon Hospital, Bangalore Medical College and Research Institute, Bengaluru, Karnataka, India
| | - Vidya Nair Chaudhary
- Department of Ophthalmology, Aakash Healthcare Super-Specialty Hospital, New Delhi, India
| | | | - Vipin Dehane
- Department of Oral and Maxillofacial Surgery, Kingsway Hospital, Nagpur, Maharashtra, India
| | - Vivek M Sahasrabudhe
- Department of Ophthalmology, Dr. Shankarrao Chavan Government Medical College, Nanded, Maharashtra, India
| | | | - Yashaswini Tupkary
- Department of Medicine, Dr. Hedgewar Rugnalaya, Aurangabad, Maharashtra, India
| | - Yogita Phadke
- Department of Ophthalmology, Mahatma Gandhi Mission Medical College and Hospital, Aurangabad, Maharashtra, India
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Affiliation(s)
- Raja Narayanan
- LV Prasad Eye Institute, Srimati Kanuri Santhamma Centre for Vitreo Retinal Diseases, LV Prasad Eye Institute, Hyderabad, Telangana, India
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Chakraborty D, Sengupta S, Mukherjee A, Majumdar S. Anatomical and functional outcomes one year after vitrectomy and retinal massage for large macular holes. Indian J Ophthalmol 2021; 69:895-899. [PMID: 33727455 PMCID: PMC8012922 DOI: 10.4103/ijo.ijo_1680_20] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [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: 11/04/2022] Open
Abstract
Purpose The aim of this study was to report results of macular hole closure, visual benefit and longitudinal changes in foveal architecture over 1 year following macular hole surgery with retinal massage. Methods Records of patients with full thickness macular hole (FTMH) with minimum basal diameter of 550 μ who underwent vitrectomy, internal limiting membrane (ILM) peeling and retinal massage were drawn up. Retinal massage was performed after dye assisted ILM peeling, using a 27G flute needle with a long and soft silicone tip under air in a centripetal direction around the FTMH. At the end, 10% C3F8 gas was used as tamponade. The foveal contour at 1 year follow up was recorded based on its cross sectional appearance on OCT and was classified into U, V and irregular types of closure as previously described. Results Forty-one eyes of 41 patients with a mean age of 70.4 ± 6.9 years were included. The mean preoperative vision was 0.99 ± 0.07 logMAR and mean maximum basal diameter of the FTMH was 835 ± 208 μ. Macular hole closure was seen in all patients at 1-month follow up. The BCVA improved to 0.5 ± 0.1 log MAR at 6 months (P < 0.001) and then stabilized. The U shaped closure was the commonest pattern (n = 22, 54%), followed by V-shaped closure (n = 16, 39%) while irregular closure was seen in 3 eyes (7%). Conclusion Retinal massage after ILM peeling is a very simple, and as yet under-utilized manoeuvre that may improve hole closure rates and lead to potentially greater improvement in vision compared to existing techniques for large holes.
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Affiliation(s)
| | - Sabyasachi Sengupta
- Consultant Vitreoretinal Surgeon, Future Vision Eye Care and Research Centre, Mumbai, India
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Affiliation(s)
- Sabyasachi Sengupta
- Future Vision Eye Care, Paras Business Centre, Borivali East, Mumbai, Maharashtra, India
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Moitra S, Moitra S, Ghosh AK, Sengupta S, Das PK, Das A, Mitra R, Murgia N, Usmani OS. Reference values of impulse oscillometry (IOS) for healthy Indian adults. Int J Tuberc Lung Dis 2021; 24:536-539. [PMID: 32398207 DOI: 10.5588/ijtld.19.0796] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- Subhabrata Moitra
- ISGlobal, Barcelona, Spain, CIBER Epidemiologia y Salud Publica (CIBERSP), Barcelona, Spain, Universitat Pompeu Fabra, Barcelona, Spain
| | - Saibal Moitra
- Division of Pulmonary Medicine, Charnock Hospital, Kolkata, India, Department of Pneumology, Allergy & Asthma Research Centre, Kolkata, India
| | - A K Ghosh
- Department of Statistics, Presidency University, Kolkata, India
| | - S Sengupta
- Division of Pulmonary Medicine, Charnock Hospital, Kolkata, India
| | - P K Das
- Division of Pulmonary Medicine, Charnock Hospital, Kolkata, India, Department of Pneumology, Allergy & Asthma Research Centre, Kolkata, India
| | - A Das
- Department of Respiratory Medicine, Rabindranath Tagore International Institute of Cardiac Sciences, Kolkata, India
| | - R Mitra
- Department of Pulmonary Medicine, Institute of Post Graduate Medical Education & Research and SSKM Hospital, Kolkata, India
| | - N Murgia
- Department of Medicine, University of Perugia, Perugia, Italy
| | - O S Usmani
- National Heart and Lung Institute, Imperial College London, London, UK, ,
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Sindal MD, Sathe T, Sengupta S, Yadav D. Proportion of diabetic retinopathy among diabetics presenting for the first time to a tertiary eye institute in South India. Int Ophthalmol 2021; 41:2789-2796. [PMID: 33813650 DOI: 10.1007/s10792-021-01835-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 03/29/2021] [Indexed: 11/28/2022]
Abstract
PURPOSE To detect the proportion of diabetic retinopathy (DR) among diabetics visiting a tertiary eye care institute and correlate presenting symptoms to clinical diagnosis. METHODS The study recruited 1000 eyes of 1000 diabetics visiting a tertiary eye care institute in South India for the first time. Along with basic demographic data and systemic history, details of presenting complaints and clinical diagnosis were noted. RESULTS Data from 956 cases were analyzed. There were 29 (3%) newly diagnosed diabetics and 927 (97%) known diabetics. The commonest reason for the hospital visit was diminution of vision (66%) followed by "visiting for a routine checkup" (22.3%). Diabetic retinopathy was seen in 492 (51.5%), cataract in 161(17%) and refractive error in 240 patients (79.2%). Vision-threatening DR was present in 216 cases (22.59%) and clinically significant macular edema in 73 cases (7.63%) at first presentation itself. CONCLUSION The cohort from a tertiary eye care institute has higher proportion of diabetic retinopathy, with vision-threatening DR at presentation. These data emphasize the need for more robust screening for DR, along with population awareness programs.
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Affiliation(s)
- Manavi D Sindal
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Thavalakuppam, Cuddalore Main Road, Pondicherry, 605007, India.
| | - Tejashree Sathe
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Thavalakuppam, Cuddalore Main Road, Pondicherry, 605007, India
| | | | - Divya Yadav
- Aravind Eye Hospital and Postgraduate Institute of Ophthalmology, Thavalakuppam, Cuddalore Main Road, Pondicherry, 605007, India
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Mahammedi A, Ramos A, Bargalló N, Gaskill M, Kapur S, Saba L, Carrete H, Sengupta S, Salvador E, Hilario A, Revilla Y, Sanchez M, Perez-Nuñez M, Bachir S, Zhang B, Oleaga L, Sergio J, Koren L, Martin-Medina P, Wang L, Benegas M, Ostos F, Gonzalez-Ortega G, Calleja P, Udstuen G, Williamson B, Khandwala V, Chadalavada S, Woo D, Vagal A. Brain and Lung Imaging Correlation in Patients with COVID-19: Could the Severity of Lung Disease Reflect the Prevalence of Acute Abnormalities on Neuroimaging? A Global Multicenter Observational Study. AJNR Am J Neuroradiol 2021; 42:1008-1016. [PMID: 33707278 DOI: 10.3174/ajnr.a7072] [Citation(s) in RCA: 12] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2020] [Accepted: 01/04/2021] [Indexed: 12/21/2022]
Abstract
PURPOSE Our aim was to study the association between abnormal findings on chest and brain imaging in patients with coronavirus disease 2019 (COVID-19) and neurologic symptoms. MATERIALS AND METHODS In this retrospective, international multicenter study, we reviewed the electronic medical records and imaging of hospitalized patients with COVID-19 from March 3, 2020, to June 25, 2020. Our inclusion criteria were patients diagnosed with Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2) infection with acute neurologic manifestations and available chest CT and brain imaging. The 5 lobes of the lungs were individually scored on a scale of 0-5 (0 corresponded to no involvement and 5 corresponded to >75% involvement). A CT lung severity score was determined as the sum of lung involvement, ranging from 0 (no involvement) to 25 (maximum involvement). RESULTS A total of 135 patients met the inclusion criteria with 132 brain CT, 36 brain MR imaging, 7 MRA of the head and neck, and 135 chest CT studies. Compared with 86 (64%) patients without acute abnormal findings on neuroimaging, 49 (36%) patients with these findings had a significantly higher mean CT lung severity score (9.9 versus 5.8, P < .001). These patients were more likely to present with ischemic stroke (40 [82%] versus 11 [13%], P < .0001) and were more likely to have either ground-glass opacities or consolidation (46 [94%] versus 73 [84%], P = .01) in the lungs. A threshold of the CT lung severity score of >8 was found to be 74% sensitive and 65% specific for acute abnormal findings on neuroimaging. The neuroimaging hallmarks of these patients were acute ischemic infarct (28%), intracranial hemorrhage (10%) including microhemorrhages (19%), and leukoencephalopathy with and/or without restricted diffusion (11%). The predominant CT chest findings were peripheral ground-glass opacities with or without consolidation. CONCLUSIONS The CT lung disease severity score may be predictive of acute abnormalities on neuroimaging in patients with COVID-19 with neurologic manifestations. This can be used as a predictive tool in patient management to improve clinical outcome.
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Affiliation(s)
- A Mahammedi
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - A Ramos
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - N Bargalló
- Neurology (S.S., D.W.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - M Gaskill
- Departments of Neuroradiology (L.O., N.B.), Hospital Clínic de Barcelona, Sunyer Biomedical Research Institute, Barcelona, Spain
| | - S Kapur
- Cardiopulmonary Imaging, (S.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - L Saba
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - H Carrete
- Department of Neuroradiology (H.C.), Escola Paulista de Medicina, Federal University of São Paulo, São Paulo, Brazil
| | - S Sengupta
- Neurology (S.S., D.W.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - E Salvador
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - A Hilario
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - Y Revilla
- Cardiopulmonary Imaging (Y.R., M.P.-N.) Hospital Universitario 12 de Octubre, Madrid, Spain
| | - M Sanchez
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - M Perez-Nuñez
- Cardiopulmonary Imaging (Y.R., M.P.-N.) Hospital Universitario 12 de Octubre, Madrid, Spain
| | | | | | - L Oleaga
- Departments of Neuroradiology (L.O., N.B.), Hospital Clínic de Barcelona, Sunyer Biomedical Research Institute, Barcelona, Spain
| | - J Sergio
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - L Koren
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Martin-Medina
- Departments of Neuroradiology (A.R., E.S., A.H., L.K., P.M.-M.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - L Wang
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - M Benegas
- Department of Neuroradiology (L.S.), Azienda Ospedaliero Universitaria di Cagliari, Monserrato (Cagliari), Italy
| | - F Ostos
- Neurology (F.O., G.G.-O., P.C.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Gonzalez-Ortega
- Neurology (F.O., G.G.-O., P.C.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - P Calleja
- Neurology (F.O., G.G.-O., P.C.), Hospital Universitario 12 de Octubre, Madrid, Spain
| | - G Udstuen
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - B Williamson
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - V Khandwala
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | | | - D Woo
- Neurology (S.S., D.W.), University of Cincinnati Medical Center, Cincinnati, Ohio
| | - A Vagal
- From the Departments of Neuroradiology, (A.M., A.V., M.G., L.W., G.U., B.W., V.K.), University of Cincinnati Medical Center, Cincinnati, Ohio
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Sosale B, Sosale AR, Murthy H, Sengupta S, Naveenam M. Medios- An offline, smartphone-based artificial intelligence algorithm for the diagnosis of diabetic retinopathy. Indian J Ophthalmol 2020; 68:391-395. [PMID: 31957735 PMCID: PMC7003589 DOI: 10.4103/ijo.ijo_1203_19] [Citation(s) in RCA: 25] [Impact Index Per Article: 6.3] [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: 12/17/2022] Open
Abstract
Purpose: An observational study to assess the sensitivity and specificity of the Medios smartphone-based offline deep learning artificial intelligence (AI) software to detect diabetic retinopathy (DR) compared with the image diagnosis of ophthalmologists. Methods: Patients attending the outpatient services of a tertiary center for diabetes care underwent 3-field dilated retinal imaging using the Remidio NM FOP 10. Two fellowship-trained vitreoretinal specialists separately graded anonymized images and a patient-level diagnosis was reached based on grading of the worse eye. The images were subjected to offline grading using the Medios integrated AI-based software on the same smartphone used to acquire images. The sensitivity and specificity of the AI in detecting referable DR (moderate non-proliferative DR (NPDR) or worse disease) was compared to the gold standard diagnosis of the retina specialists. Results: Results include analysis of images from 297 patients of which 176 (59.2%) had no DR, 35 (11.7%) had mild NPDR, 41 (13.8%) had moderate NPDR, and 33 (11.1%) had severe NPDR. In addition, 12 (4%) patients had PDR and 36 (20.4%) had macular edema. Sensitivity and specificity of the AI in detecting referable DR was 98.84% (95% confidence interval [CI], 97.62–100%) and 86.73% (95% CI, 82.87–90.59%), respectively. The area under the curve was 0.92. The sensitivity for vision-threatening DR (VTDR) was 100%. Conclusion: The AI-based software had high sensitivity and specificity in detecting referable DR. Integration with the smartphone-based fundus camera with offline image grading has the potential for widespread applications in resource-poor settings.
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Affiliation(s)
- Bhavana Sosale
- Department of Diabetology, Diacon Hospital, Retina Institute of Karnataka, Mumbai, Maharashtra, India
| | - Aravind R Sosale
- Department of Diabetology, Diacon Hospital, Retina Institute of Karnataka, Mumbai, Maharashtra, India
| | - Hemanth Murthy
- Department of Vitreo-Retinal Surgery, Retina Institute of Karnataka, Mumbai, Maharashtra, India
| | - Sabyasachi Sengupta
- Department of Vitreo-Retinal Surgery, Future Vision Eye Care, Mumbai, Maharashtra, India
| | - Muralidhar Naveenam
- Department of Vitreo-Retinal Surgery, Retina Institute of Karnataka, Mumbai, Maharashtra, India
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Nandurkar R, Sluka P, Li M, Wardan H, Davis I, Sengupta S. Lytic Effects of Water on Bladder Cancer Cell Lines – Implications for Clinical Use of Water Irrigation to Reduce Recurrence. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.037] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Li M, Toniolo J, Nandurkar R, Papa N, Lawrentschuk N, Davis ID, Sengupta S. Continuous Bladder Irrigation after Transurethral Resection of Non-Muscle Invasive Bladder Cancer for Prevention of Tumour Recurrence – A Systematic Review. Urol Oncol 2020. [DOI: 10.1016/j.urolonc.2020.10.036] [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]
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Ho H, Ng M, Guerrieri M, Tan A, Bolton D, Chan Y, Lawrentschuk N, Cham C, McMillan K, Sengupta S, Koufogiannis G, Cokelek M, Spencer S, Liu M, Pham T, Lim Joon D, Foroudi F, Tacey M, Khor R, Ding W, Subramanian B, Chao M. Low Dose Rate Brachytherapy and Long-Term Treatment Outcomes In Patients Less Than 60 Years of Age. Int J Radiat Oncol Biol Phys 2020. [DOI: 10.1016/j.ijrobp.2020.07.528] [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]
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Niazi T, Williams S, Davis I, Stockler M, Martin A, Bracken K, Roncolato F, McJannett M, Horvath L, Sengupta S, Hughes S, McDermott R, Catto J, Kelly P, Vapiwala N, Parulekar W, Morgan S, Rendon R, Sweeney C. 694TiP DASL-HiCaP: Darolutamide augments standard therapy for localised very high-risk cancer of the prostate (ANZUP1801). A randomised phase III double-blind, placebo-controlled trial of adding darolutamide to androgen deprivation therapy and definitive or salvage radiation. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.2088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Affiliation(s)
- Sabyasachi Sengupta
- Associate Editor, Indian Journal of Ophthalmology, Future Vision Eye Care and Research Centre, Mumbai, Maharashtra, India
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Li M, Cheung K, Sengupta S. A systematic review and meta-analysis of negative predictive value of multi-parametric MRI as a pre-biopsy triage tool. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33743-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022] Open
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Madanagopalan VG, Sriram Gopal MR, Sengupta S. Perspectives of physicians in general and ophthalmologists in particular about restarting services post-COVID-19 lockdown. Indian J Ophthalmol 2020; 68:1401-1406. [PMID: 32587176 PMCID: PMC7574103 DOI: 10.4103/ijo.ijo_1221_20] [Citation(s) in RCA: 4] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/30/2020] [Revised: 05/28/2020] [Accepted: 06/04/2020] [Indexed: 01/31/2023] Open
Abstract
PURPOSE To assess the perspectives of physicians in general and ophthalmologists in particular about restarting elective out-patient (OP) and operating (OT) services after relaxation of lockdown for COVID-19. METHODS An online survey, containing 31 questions, was conducted among medical doctors using a secure Google forms link. The survey was open for 48 hours from 16th-18th April 2020. RESULTS Responses were received from 556 physicians (including 266 ophthalmologists). About a third (n = 205) wanted to start OP immediately after lockdown. In OP, mask of any kind for patient (60.8%), 3-ply for assistants (52.7%) and N95 for doctors (72.7%) were most common preferences. In OP, 31.5% and 46.6% felt full PPE and gloves alone were sufficient respectively. Ophthalmologists were more likely to start immediately after lockdown compared to other specialists (P = 0.004). Among 299 surgeons, an almost equal number (27%) wanted to start routine OT services immediately and 2 weeks post lockdown. A large majority (76.9%) would mandate COVID-19 tests before elective surgeries. In OT, 34.1% wanted N95 for surgical team and 3-ply for patient, 23.4% wanted 3-ply masks for everyone. 40.5% felt additional personal protective equipment (PPE) is not required and 33.1% felt that full PPE is required for everyone in OT. Ophthalmic surgeons preferred 3-ply masks and were less inclined to use full PPE (P < 0.001). CONCLUSION Perspectives of doctors vary, especially with regarding to timing of restarting services and precautions to be taken in the OT. Ophthalmologists may tend to err on the side of taking lesser stringent precautions when restarting services post lockdown.
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Affiliation(s)
- V G Madanagopalan
- Vitreoretinal Services, JB Eye Care & Retina Centre, Salem, Tamil Nadu, India
| | - M R Sriram Gopal
- Vitreoretinal Services, Athreya Retinal Centre, Tiruchirapalli, Tamil Nadu, India
| | - Sabyasachi Sengupta
- Vitreoretinal Services, Future Vision Eye Care & Sengupta's Research Academy, Mumbai, India
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Sengupta S, Honavar SG, Sachdev MS, Sharma N, Kumar A, Ram J, Shetty R, Rao GS, Ramasamy K, Khanna R, Jain E, Bhattacharjee K, Agarwal A, Natarajan S, Lahane TP. All India Ophthalmological Society - Indian Journal of Ophthalmology consensus statement on preferred practices during the COVID-19 pandemic. Indian J Ophthalmol 2020; 68:711-724. [PMID: 32317433 PMCID: PMC7350466 DOI: 10.4103/ijo.ijo_871_20] [Citation(s) in RCA: 77] [Impact Index Per Article: 19.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2020] [Revised: 04/06/2020] [Accepted: 04/06/2020] [Indexed: 02/06/2023] Open
Abstract
The COVID-19 pandemic has taken tragic proportions and has disrupted lives globally. In the wake of governmental lockdowns, ophthalmologists need practical and actionable guidelines based on advisories from national health departments on how to conduct their duties during nationwide lockdowns and after these are lifted. In this paper, we present a preferred practice pattern (PPP) based on consensus discussions between leading ophthalmologists and health care professionals in India including representatives from major governmental and private institutions as well as the All India Ophthalmological Society leadership. In this document, the expert panel clearly defines the range of activities for Indian ophthalmologists during the ongoing lockdown phase and precautions to be taken once the lockdown is lifted. Guidelines for triage, governmental guidelines for use of personal protective equipment from ophthalmologists' point of view, precautions to be taken in the OPD and operating room as well as care of various ophthalmic equipment have been described in detail. These guidelines will be applicable to all practice settings including tertiary institutions, corporate and group practices and individual eye clinics and should help Indian ophthalmologists in performing their professional responsibilities without being foci of disease transmission.
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Affiliation(s)
- Sabyasachi Sengupta
- Future Vision Eye Care and Research Centre, and Associate Editor Indian Journal of Ophthalmology, Mumbai, Maharashtra, India
| | - Santosh G Honavar
- Editor, Indian Journal of Ophthalmology, Centre for Sight, Hyderabad, Telangana, India
| | - Mahipal S Sachdev
- President, All India Ophthalmological Society, Chairman, Centre for Sight, New Delhi, India
| | - Namrata Sharma
- Secretary, All India Ophthalmological Society, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Atul Kumar
- Chief, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India
| | - Jagat Ram
- Director, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Rohit Shetty
- Vice Chairman, Narayana Nethralaya Eye Institute, Bangalore, Karnataka, India
| | - Girish S Rao
- President, Medical Research Foundation, Sankara Nethralaya, Chennai, Tamil Nadu, India
| | - Kim Ramasamy
- Chief Medical Officer, Aravind Eye Care System, Madurai, Tamil Nadu, India
| | - Rohit Khanna
- LV Prasad Eye Institute, Hyderabad, Telangana, India
| | - Elesh Jain
- Administrator, Sadguru Netra Chikitsalaya, Chitrakoot, Madhya Pradesh, India
| | | | - Ashvin Agarwal
- Executive Director, Dr Agarwal's Eye Hospital, Chennai, Tamil Nadu, India
| | - S Natarajan
- Chairman, Aditya Jyot Eye Hospital, President, Organised Medicine Academic Guild, and Immediate Past President, All India Ophthalmological Society, Mumbai, Maharashtra, India
| | - Tatyarao P Lahane
- Director of Medical Education and Research of Maharashtra State, Mumbai, Maharashtra, India
| | - the Writing Committee on behalf of the All India Ophthalmological Society – Indian Journal of Ophthalmology Expert Group for COVID-19 Practice Guidelines
- Composition of the All India Ophthalmological Society – Indian Journal of Ophthalmology Expert Group for COVID-19 Practice Guidelines includes the Writing Committee (as listed) and the following members (in alphabetical order by the first name): Anand Vinekar, Narayana Nethralaya Eye Institute, Bangalore , Karnataka and Secretary, Indian Retinopathy of Prematurity Society; Aniruddha Agarwal, Post Graduate Institute of Medical Education and Research, Chandigarh; Arshi Singh, Bababsaheb Ambedkar Hospital New Delhi; Arup Chakrabarti, Chakrabarti Eye Care Centre, Thiruvanathapuram, Kerala and Editor Proceedings, All India Ophthalmological Society; Ashok K Grover, Sir Gangaram Hospital, New Delhi; Astha Jain, Aditya Jyot Eye Institute, Mumbai, Maharashtra; Barun Kumar Nayak, P. D. Hinduja National Hospital and Medical Research Centre, Mumbai, Maharashtra and President Elect, All India Ophthalmological Society; Chitra Ramamurthy, The Eye Foundation, Coimbatore, Tamil Nadu and Chairman, Academic and Research Committee, All India Ophthalmological Society; Debasish Bhattacharya, Disha Eye hospital, Kolkata, West Bengal; Jatinder Bali, Hindu Rao Hospital and NDMC Medical College, New Delhi; Kirti Singh, Gurunanak Eye Centre, Maulana Azad Medical College, New Delhi; Lalit Verma, Centre for Sight, New Delhi and Vice President, All India Ophthalmological Society; Lingam Gopal, National University Hospital, Singapore; Mandeep Jot Singh, Centre for Sight, New Delhi; Nandini Sharma, Community Medicine, Maulana Azad Medical College, New Delhi; T. Nirmal Fredrick, Nirmal's Eye Hospital, Chennai, Tamil Nadu and Hospital Accreditation Expert, Chennai; Partha Biswas, BB Eye Foundation, Kolkata, West Bengal and Chairman, Scientific Committee, All India Ophthalmological Society; Priya Narang, Narang Eye Care and Laser Centre, Ahmedabad, Gujarat; Rajesh Sinha, Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi and Treasurer, All India Ophthalmological Society; Raj Vardhan Azad, Professor Emeritus Regional Institute of Ophthalmology, Indira Gandhi Institute of Medical Sciences, Patna , Bihar and President, Indian Retinopathy of Prematurity Society; Ramamurthy D, The Eye Foundation, Coimbatore, Tamil Nadu; Savitri Sharma, Ocular Microbiology, LV Prasad Eye Institute, Hyderabad, Telangana; Soosan Jacob, Dr Agarwal's Eye Hospital, Chennai, Tamil Nadu. All authors have contributed equally and hence carry equal authorship credit
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