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Petery TL, Frankart AJ, Esslinger HR, Wu X, Rai S, Takiar V. The Effect of Package Time on Locally Advanced Oral Cavity Cancer Outcomes. Int J Radiat Oncol Biol Phys 2023; 117:e616. [PMID: 37785848 DOI: 10.1016/j.ijrobp.2023.06.1994] [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) Oral cavity cancer (OCC) with adverse pathologic features is treated with adjuvant radiation (RT) following definitive surgical resection. The 5-year overall survival (OS) in locally advanced OCC patients receiving adjuvant RT has remained stagnant at 60% for over 30 years. Although pathologic risk factors are well-established, the effect of clinical variables such as treatment package time (TPT) in the modern era of radiation and systemic agents is unclear. Examining a large, homogenous cohort of OCC patients, we hypothesized that TPT can predict OS and event free survival (EFS). MATERIALS/METHODS A retrospective review of 359 adult patients with OCC treated with surgery and adjuvant RT with or without concurrent chemotherapy from 2012-2022 was performed at a single, high-volume center. Those without definitive surgery, treated to <50 Gy, or with a history of prior RT were excluded. TPT was defined as time from surgery to completion of RT. Other variables considered were sex, race, smoking status, AJCC 8 pathologic stage, perineural invasion (PNI), lymphovascular invasion (LVI), margin positivity, extranodal extension (ENE), and hospitalization between surgery and RT. Log rank tests were performed for OS and EFS where TPT was dichotomized into short (<97.5 days) and long (>97.5 days) groups based on the median TPT of the cohort. Univariate (UVA) and multivariate (MVA) cox regression analyses were performed for OS and EFS. RESULTS A total of 234 patients met inclusion criteria. Median OS was 81.6 months. Median EFS was 50.0 months. Median OS was 51.1 months in the longer TPT group and was not reached in the shorter TPT group. Median EFS was greater with shorter TPT (72.6 vs 31.3 months). The longer TPT group had worse OS and EFS probabilities than the shorter TPT group (p = 0.006 and p = 0.059, respectively). On UVA, factors significantly associated with OS were TPT (p = 0.006), former/current smoker status (p = 0.003 and p = 0.011, respectively), pathologic stage IV (p<0.001), positive PNI (p<0.001) or LVI (p = 0.005), and ENE (p<0.001). On MVA for OS, shorter TPT (p = 0.026), former smoker status (p = 0.009), pathologic stage IV (p = 0.026), positive PNI (p = 0.009), and ENE (p = 0.05), remained significant. On UVA, factors significantly associated with EFS were former/current smoker status (p = 0.01/p = 0.04), pathologic stage IV (p<0.001), pT1/T2 (p = 0.018), positive PNI (p = 0.011) or ENE (p<0.001), and concurrent chemotherapy (p = 0.001). On MVA, former smoker status (p = 0.035) and positive PNI (p = 0.018) remained significant. Notably, of the 130 patients requiring hospitalization between surgery and radiation, 101 (78%) were prior/current smokers. CONCLUSION In this large cohort of locally advanced OCC patients, TPT <97.5 days is associated with improved OS and EFS. Smoking history should be further explored for its potential contribution to treatment delay. Multidisciplinary coordination should be encouraged to minimize TPT.
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Affiliation(s)
- T L Petery
- University of Cincinnati College of Medicine, Cincinnati, OH
| | - A J Frankart
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - H R Esslinger
- Department of Radiation Oncology, University of Cincinnati, Cincinnati, OH
| | - X Wu
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH
| | - S Rai
- Department of Environmental and Public Health Sciences, University of Cincinnati College of Medicine, Cincinnati, OH
| | - V Takiar
- University of Cincinnati College of Medicine, Cincinnati, OH; Cincinnati VA Medical Center, Cincinnati, OH
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Sankar H, Rai S, Jolly SS, Rattan V. Comparison of Efficacy and Safety of Hybrid Arch Bar with Erich Arch Bar in the Management of Mandibular Fractures: A Randomized Clinical Trial. Craniomaxillofac Trauma Reconstr 2023; 16:94-101. [PMID: 37222977 PMCID: PMC10201193 DOI: 10.1177/19433875221080019] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/20/2023] Open
Abstract
Study Design A clinical randomized control trial. Objective To compare the efficacy and safety of Hybrid arch bar (HAB) with Erich arch bar (EAB) in fracture management of the mandible. Methods In this randomized clinical trial, 44 patients were divided into 2 groups:- Group 1, N = 23 (EAB group) and Group 2, N = 21 (HAB group). The primary outcome was time taken for the application of arch bar, while the inner and outer glove puncture, operator prick, oral hygiene, arch bar stability, complications of HAB, and cost comparison were secondary outcomes. Results The time taken for the application of arch bar in group 2 was significantly shorter than group 1 (55.66 ± 17.869 min vs 82.04 ± 12.197 min) and the frequency of outer glove puncture was also significantly lesser for group 2 (0 punctures vs 9 punctures). Better oral hygiene was found in group 2. EAB was cost-effective than HAB (Rs 700 ± 239.79 vs Rs 1742.50 ± 257.14). The stability of the arch bar was comparable in both groups. Group 2 had associated complications of root injury in 2 out of 252 screws placed and the screw head got covered by soft tissue in 137 out of 252 screws placed. Conclusions Thus, HAB was better than EAB with a shorter time of application, less risk of prick injury, and improved oral hygiene.Clinical trial registry name- clinical trials registry- India, URL-http://ctri.nic.in, registration number- CTRI/2020/06/025966.
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Affiliation(s)
- Hariram Sankar
- Unit of Oral and Maxillofacial Surgery,
Oral Health Sciences Centre, Postgraduate Institute of Medical Education and
Research, Chandigarh, India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery,
Oral Health Sciences Centre, Postgraduate Institute of Medical Education and
Research, Chandigarh, India
| | - Satnam S. Jolly
- Unit of Oral and Maxillofacial Surgery,
Oral Health Sciences Centre, Postgraduate Institute of Medical Education and
Research, Chandigarh, India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery,
Oral Health Sciences Centre, Postgraduate Institute of Medical Education and
Research, Chandigarh, India
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Girardi F, Matz M, Stiller C, You H, Marcos Gragera R, Valkov MY, Bulliard JL, De P, Morrison D, Wanner M, O'Brian DK, Saint-Jacques N, Coleman MP, Allemani C, Hamdi-Chérif M, Kara L, Meguenni K, Regagba D, Bayo S, Cheick Bougadari T, Manraj SS, Bendahhou K, Ladipo A, Ogunbiyi OJ, Somdyala NIM, Chaplin MA, Moreno F, Calabrano GH, Espinola SB, Carballo Quintero B, Fita R, Laspada WD, Ibañez SG, Lima CA, Da Costa AM, De Souza PCF, Chaves J, Laporte CA, Curado MP, de Oliveira JC, Veneziano CLA, Veneziano DB, Almeida ABM, Latorre MRDO, Rebelo MS, Santos MO, Azevedo e Silva G, Galaz JC, Aparicio Aravena M, Sanhueza Monsalve J, Herrmann DA, Vargas S, Herrera VM, Uribe CJ, Bravo LE, Garcia LS, Arias-Ortiz NE, Morantes D, Jurado DM, Yépez Chamorro MC, Delgado S, Ramirez M, Galán Alvarez YH, Torres P, Martínez-Reyes F, Jaramillo L, Quinto R, Castillo J, Mendoza M, Cueva P, Yépez JG, Bhakkan B, Deloumeaux J, Joachim C, Macni J, Carrillo R, Shalkow Klincovstein J, Rivera Gomez R, Perez P, Poquioma E, Tortolero-Luna G, Zavala D, Alonso R, Barrios E, Eckstrand A, Nikiforuk C, Woods RR, Noonan G, Turner D, Kumar E, Zhang B, Dowden JJ, Doyle GP, Saint-Jacques N, Walsh G, Anam A, De P, McClure CA, Vriends KA, Bertrand C, Ramanakumar AV, Davis L, Kozie S, Freeman T, George JT, Avila RM, O’Brien DK, Holt A, Almon L, Kwong S, Morris C, Rycroft R, Mueller L, Phillips CE, Brown H, Cromartie B, Ruterbusch J, Schwartz AG, Levin GM, Wohler B, Bayakly R, Ward KC, Gomez SL, McKinley M, Cress R, Davis J, Hernandez B, Johnson CJ, Morawski BM, Ruppert LP, Bentler S, Charlton ME, Huang B, Tucker TC, Deapen D, Liu L, Hsieh MC, Wu XC, Schwenn M, Stern K, Gershman ST, Knowlton RC, Alverson G, Weaver T, Desai J, Rogers DB, Jackson-Thompson J, Lemons D, Zimmerman HJ, Hood M, Roberts-Johnson J, Hammond W, Rees JR, Pawlish KS, Stroup A, Key C, Wiggins C, Kahn AR, Schymura MJ, Radhakrishnan S, Rao C, Giljahn LK, Slocumb RM, Dabbs C, Espinoza RE, Aird KG, Beran T, Rubertone JJ, Slack SJ, Oh J, Janes TA, Schwartz SM, Chiodini SC, Hurley DM, Whiteside MA, Rai S, Williams MA, Herget K, Sweeney C, Kachajian J, Keitheri Cheteri MB, Migliore Santiago P, Blankenship SE, Conaway JL, Borchers R, Malicki R, Espinoza J, Grandpre J, Weir HK, Wilson R, Edwards BK, Mariotto A, Rodriguez-Galindo C, Wang N, Yang L, Chen JS, Zhou Y, He YT, Song GH, Gu XP, Mei D, Mu HJ, Ge HM, Wu TH, Li YY, Zhao DL, Jin F, Zhang JH, Zhu FD, Junhua Q, Yang YL, Jiang CX, Biao W, Wang J, Li QL, Yi H, Zhou X, Dong J, Li W, Fu FX, Liu SZ, Chen JG, Zhu J, Li YH, Lu YQ, Fan M, Huang SQ, Guo GP, Zhaolai H, Wei K, Chen WQ, Wei W, Zeng H, Demetriou AV, Mang WK, Ngan KC, Kataki AC, Krishnatreya M, Jayalekshmi PA, Sebastian P, George PS, Mathew A, Nandakumar A, Malekzadeh R, Roshandel G, Keinan-Boker L, Silverman BG, Ito H, Koyanagi Y, Sato M, Tobori F, Nakata I, Teramoto N, Hattori M, Kaizaki Y, Moki F, Sugiyama H, Utada M, Nishimura M, Yoshida K, Kurosawa K, Nemoto Y, Narimatsu H, Sakaguchi M, Kanemura S, Naito M, Narisawa R, Miyashiro I, Nakata K, Mori D, Yoshitake M, Oki I, Fukushima N, Shibata A, Iwasa K, Ono C, Matsuda T, Nimri O, Jung KW, Won YJ, Alawadhi E, Elbasmi A, Ab Manan A, Adam F, Nansalmaa E, Tudev U, Ochir C, Al Khater AM, El Mistiri MM, Lim GH, Teo YY, Chiang CJ, Lee WC, Buasom R, Sangrajrang S, Suwanrungruang K, Vatanasapt P, Daoprasert K, Pongnikorn D, Leklob A, Sangkitipaiboon S, Geater SL, Sriplung H, Ceylan O, Kög I, Dirican O, Köse T, Gurbuz T, Karaşahin FE, Turhan D, Aktaş U, Halat Y, Eser S, Yakut CI, Altinisik M, Cavusoglu Y, Türkköylü A, Üçüncü N, Hackl M, Zborovskaya AA, Aleinikova OV, Henau K, Van Eycken L, Atanasov TY, Valerianova Z, Šekerija M, Dušek L, Zvolský M, Steinrud Mørch L, Storm H, Wessel Skovlund C, Innos K, Mägi M, Malila N, Seppä K, Jégu J, Velten M, Cornet E, Troussard X, Bouvier AM, Guizard AV, Bouvier V, Launoy G, Dabakuyo Yonli S, Poillot ML, Maynadié M, Mounier M, Vaconnet L, Woronoff AS, Daoulas M, Robaszkiewicz M, Clavel J, Poulalhon C, Desandes E, Lacour B, Baldi I, Amadeo B, Coureau G, Monnereau A, Orazio S, Audoin M, D’Almeida TC, Boyer S, Hammas K, Trétarre B, Colonna M, Delafosse P, Plouvier S, Cowppli-Bony A, Molinié F, Bara S, Ganry O, Lapôtre-Ledoux B, Daubisse-Marliac L, Bossard N, Uhry Z, Estève J, Stabenow R, Wilsdorf-Köhler H, Eberle A, Luttmann S, Löhden I, Nennecke AL, Kieschke J, Sirri E, Justenhoven C, Reinwald F, Holleczek B, Eisemann N, Katalinic A, Asquez RA, Kumar V, Petridou E, Ólafsdóttir EJ, Tryggvadóttir L, Murray DE, Walsh PM, Sundseth H, Harney M, Mazzoleni G, Vittadello F, Coviello E, Cuccaro F, Galasso R, Sampietro G, Giacomin A, Magoni M, Ardizzone A, D’Argenzio A, Di Prima AA, Ippolito A, Lavecchia AM, Sutera Sardo A, Gola G, Ballotari P, Giacomazzi E, Ferretti S, Dal Maso L, Serraino D, Celesia MV, Filiberti RA, Pannozzo F, Melcarne A, Quarta F, Andreano A, Russo AG, Carrozzi G, Cirilli C, Cavalieri d’Oro L, Rognoni M, Fusco M, Vitale MF, Usala M, Cusimano R, Mazzucco W, Michiara M, Sgargi P, Boschetti L, Marguati S, Chiaranda G, Seghini P, Maule MM, Merletti F, Spata E, Tumino R, Mancuso P, Cassetti T, Sassatelli R, Falcini F, Giorgetti S, Caiazzo AL, Cavallo R, Piras D, Bella F, Madeddu A, Fanetti AC, Maspero S, Carone S, Mincuzzi A, Candela G, Scuderi T, Gentilini MA, Rizzello R, Rosso S, Caldarella A, Intrieri T, Bianconi F, Contiero P, Tagliabue G, Rugge M, Zorzi M, Beggiato S, Brustolin A, Gatta G, De Angelis R, Vicentini M, Zanetti R, Stracci F, Maurina A, Oniščuka M, Mousavi M, Steponaviciene L, Vincerževskienė I, Azzopardi MJ, Calleja N, Siesling S, Visser O, Johannesen TB, Larønningen S, Trojanowski M, Macek P, Mierzwa T, Rachtan J, Rosińska A, Kępska K, Kościańska B, Barna K, Sulkowska U, Gebauer T, Łapińska JB, Wójcik-Tomaszewska J, Motnyk M, Patro A, Gos A, Sikorska K, Bielska-Lasota M, Didkowska JA, Wojciechowska U, Forjaz de Lacerda G, Rego RA, Carrito B, Pais A, Bento MJ, Rodrigues J, Lourenço A, Mayer-da-Silva A, Coza D, Todescu AI, Valkov MY, Gusenkova L, Lazarevich O, Prudnikova O, Vjushkov DM, Egorova A, Orlov A, Pikalova LV, Zhuikova LD, Adamcik J, Safaei Diba C, Zadnik V, Žagar T, De-La-Cruz M, Lopez-de-Munain A, Aleman A, Rojas D, Chillarón RJ, Navarro AIM, Marcos-Gragera R, Puigdemont M, Rodríguez-Barranco M, Sánchez Perez MJ, Franch Sureda P, Ramos Montserrat M, Chirlaque López MD, Sánchez Gil A, Ardanaz E, Guevara M, Cañete-Nieto A, Peris-Bonet R, Carulla M, Galceran J, Almela F, Sabater C, Khan S, Pettersson D, Dickman P, Staehelin K, Struchen B, Egger Hayoz C, Rapiti E, Schaffar R, Went P, Mousavi SM, Bulliard JL, Maspoli-Conconi M, Kuehni CE, Redmond SM, Bordoni A, Ortelli L, Chiolero A, Konzelmann I, Rohrmann S, Wanner M, Broggio J, Rashbass J, Stiller C, Fitzpatrick D, Gavin A, Morrison DS, Thomson CS, Greene G, Huws DW, Grayson M, Rawcliffe H, Allemani C, Coleman MP, Di Carlo V, Girardi F, Matz M, Minicozzi P, Sanz N, Ssenyonga N, James D, Stephens R, Chalker E, Smith M, Gugusheff J, You H, Qin Li S, Dugdale S, Moore J, Philpot S, Pfeiffer R, Thomas H, Silva Ragaini B, Venn AJ, Evans SM, Te Marvelde L, Savietto V, Trevithick R, Aitken J, Currow D, Fowler C, Lewis C. Global survival trends for brain tumors, by histology: analysis of individual records for 556,237 adults diagnosed in 59 countries during 2000-2014 (CONCORD-3). Neuro Oncol 2023; 25:580-592. [PMID: 36355361 PMCID: PMC10013649 DOI: 10.1093/neuonc/noac217] [Citation(s) in RCA: 6] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Survival is a key metric of the effectiveness of a health system in managing cancer. We set out to provide a comprehensive examination of worldwide variation and trends in survival from brain tumors in adults, by histology. METHODS We analyzed individual data for adults (15-99 years) diagnosed with a brain tumor (ICD-O-3 topography code C71) during 2000-2014, regardless of tumor behavior. Data underwent a 3-phase quality control as part of CONCORD-3. We estimated net survival for 11 histology groups, using the unbiased nonparametric Pohar Perme estimator. RESULTS The study included 556,237 adults. In 2010-2014, the global range in age-standardized 5-year net survival for the most common sub-types was broad: in the range 20%-38% for diffuse and anaplastic astrocytoma, from 4% to 17% for glioblastoma, and between 32% and 69% for oligodendroglioma. For patients with glioblastoma, the largest gains in survival occurred between 2000-2004 and 2005-2009. These improvements were more noticeable among adults diagnosed aged 40-70 years than among younger adults. CONCLUSIONS To the best of our knowledge, this study provides the largest account to date of global trends in population-based survival for brain tumors by histology in adults. We have highlighted remarkable gains in 5-year survival from glioblastoma since 2005, providing large-scale empirical evidence on the uptake of chemoradiation at population level. Worldwide, survival improvements have been extensive, but some countries still lag behind. Our findings may help clinicians involved in national and international tumor pathway boards to promote initiatives aimed at more extensive implementation of clinical guidelines.
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Affiliation(s)
- Fabio Girardi
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK.,Division of Medical Oncology 2, Veneto Institute of Oncology IOV-IRCCS, Padua, Italy
| | - Melissa Matz
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
| | - Charles Stiller
- National Cancer Registration and Analysis Service, Public Health England, London, UK
| | - Hui You
- Cancer Information Analysis Unit, Cancer Institute NSW, St Leonards, New South Wales, Australia
| | - Rafael Marcos Gragera
- Epidemiology Unit and Girona Cancer Registry, Catalan Institute of Oncology, Girona, Spain
| | - Mikhail Y Valkov
- Department of Radiology, Radiotherapy and Oncology, Northern State Medical University, Arkhangelsk, Russia
| | - Jean-Luc Bulliard
- Centre for Primary Care and Public Health (Unisanté), University of Lausanne, Lausanne, Switzerland.,Neuchâtel and Jura Tumour Registry, Neuchâtel, Switzerland
| | - Prithwish De
- Surveillance and Cancer Registry, and Research Office, Clinical Institutes and Quality Programs, Ontario Health, Toronto, Ontario, Canada
| | - David Morrison
- Scottish Cancer Registry, Public Health Scotland, Edinburgh, UK
| | - Miriam Wanner
- Cancer Registry Zürich, Zug, Schaffhausen and Schwyz, University Hospital Zürich, Zürich, Switzerland
| | - David K O'Brian
- Alaska Cancer Registry, Alaska Department of Health and Social Services, Anchorage, Alaska, USA
| | - Nathalie Saint-Jacques
- Department of Medicine and Community Health and Epidemiology, Centre for Clinical Research, Dalhousie University, Halifax, Nova Scotia, Canada
| | - Michel P Coleman
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK.,Cancer Division, University College London Hospitals NHS Foundation Trust, London, UK
| | - Claudia Allemani
- Cancer Survival Group, London School of Hygiene and Tropical Medicine, London, UK
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Rai S, Nandy K, Bhatt S, Patel D, Mithi M, Rathod P. Surgical outcomes of T4b oral cancers: assessment of prognostic factors and a need to re-evaluate the current staging system. Int J Oral Maxillofac Surg 2023; 52:143-151. [PMID: 35610163 DOI: 10.1016/j.ijom.2022.04.015] [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: 06/23/2021] [Revised: 04/26/2022] [Accepted: 04/28/2022] [Indexed: 01/11/2023]
Abstract
T4b oral cancer is a broad umbrella term for all advanced oral cancers, the prognosis of which varies drastically for disease of the same stage, according to the extent of the masticator space involvement. This was a retrospective observational study including all consecutive T4b oral squamous cell carcinoma patients treated surgically between January 2015 and January 2016 and followed up until January 2020. The disease was classified as upper disease or lower disease based on the anatomical location in relation to an imaginary plane passing through the base of the retromolar trigone. The prime objective was to evaluate overall survival and prognostic factors affecting overall survival. The projected 5-year overall and disease-free survival rates were 40.7% and 35.6%, respectively. The assessment of prognostic factors revealed that lower disease (lower anatomical subsites), bone invasion, and lymph nodal spread significantly affected survival. Patients with disease in an upper anatomical location without bone and nodal involvement can achieve fairly good survival (projected 5-year overall survival of 64.2%) when compared to the other subsets of patients. We propose a re-evaluation of the current staging system based on the prognostic features, so that all patients are not considered under a single stage, since their survival differs significantly.
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Affiliation(s)
- S Rai
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - K Nandy
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - S Bhatt
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India.
| | - D Patel
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - M Mithi
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
| | - P Rathod
- Department of Surgical Oncology, Gujarat Cancer and Research Institute, Ahmedabad, Gujarat, India
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Sarkar P, Biswas A, Kumar R, Rai S, Jha SN, Bhattacharyya D. Role of C and B 4C barrier layers in controlling diffusion propagation across the interface of Cr/Sc multilayers. Phys Chem Chem Phys 2023; 25:3072-3082. [PMID: 36620902 DOI: 10.1039/d2cp03785h] [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: 01/10/2023]
Abstract
The optical performance of low-bilayer-thickness metallic multilayers (ML) can be improved significantly by limiting the intermixing of consecutive layers at the interfaces. Barrier layers are supposed to exhibit a decisive role in controlling diffusion across the interfaces. The element-specific grazing incidence extended X-ray absorption fine structure technique using synchrotron radiation has been used in conjunction with grazing incidence X-ray reflectivity and diffuse X-ray scattering measurements to study the impact of the two most common barrier layers, viz., C and B4C, at the interfaces of Cr/Sc MLs. The diffusion propagation is reduced by both the barrier layers; however, it is found that the improvement is more significant with the B4C barrier layer. It is seen that C forms an intermixed layer with Sc and leads to carbide formation at the interface, which then acts as shielding and prevents further interdiffusion, while B4C hardly penetrates into Sc and stops the overlap between Sc and Cr directly by wetting the corresponding interface. Thus, the above measurements reveal crucial and precise information regarding the elemental diffusion kinetics at the interfaces of Cr/Sc MLs in a non-destructive way, which is very important for technological applications of these MLs as X-ray optical devices.
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Affiliation(s)
- P Sarkar
- Atomic & Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
| | - A Biswas
- Atomic & Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
| | - Ravi Kumar
- Atomic & Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
| | - S Rai
- Synchrotron Utilisation Section, Raja Ramnna Centre for Advanced Technology, Indore 752013, India
| | - S N Jha
- Beamline Development & Applications Section Bhabha Atomic Research Centre, Mumbai 400 085, India
| | - D Bhattacharyya
- Atomic & Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400 085, India.
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6
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Kaur A, Rattan V, Rai S, Singh SP, Kalra P, Sharma S. Changes in condylar position after orthognathic surgery and its correlation with temporomandibular symptoms (TMD)- a prospective study. J Craniomaxillofac Surg 2022; 50:915-922. [PMID: 36621385 DOI: 10.1016/j.jcms.2022.12.003] [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: 04/25/2022] [Revised: 10/16/2022] [Accepted: 12/27/2022] [Indexed: 01/01/2023] Open
Abstract
The aim of the study was to assess the changes in the condylar position after orthognathic surgery (OGS) and its effect on temporomandibular disorders (TMD). A total of 37 dentofacial deformity patients included in the study who had undergone OGS were divided into three groups: Group I, Le Fort I maxillary advancement; Group II, bilateral sagittal split osteotomy (BSSO) mandibular advancement ± Le Fort I; and Group III, BSSO mandibular setback ± Le Fort I. Patients were evaluated clinically using Diagnostic Criteria for TMD and by radiography preoperatively and 6 months postoperatively. The positional changes in condyle were correlated with signs and symptoms of TMD. A total of 37 patients in three groups (Group I, 8 patients; Group II, 10 patients; and Group III, 19 patients) were evaluated. Overall, condyles had anterio-medio-inferior movement with 7 of 8 patients in Group I, 6 of 10 patients in Group II and 13 of 19 patients in Group III having ≤2 mm displacement. In angular changes, inward-anterio-medial movement was observed with 6 of 8 patients in Group I; about 5 of 10 patients, and 10 of 19 patients in Group II and III respectively had ≤5° change. Intragroup and intergroup comparisons showed insignificant changes in TMD and linear/angular movement (p ≥ 0.05). Pearson correlation coefficient was found to be nonsignificant on the radiographic and clinical comparison (p ≥ 0.05). Intrarater reliability (Kappa value) was found to be 0.83, confirming the results. Within the limitations of the study it seems that there are minimal linear and angular changes in condyle after orthognathic surgery that were not responsible for the development of temporomandibular disorders in the postoperative course.
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Affiliation(s)
- Amanjot Kaur
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
| | - Vidya Rattan
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
| | - Sachin Rai
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
| | - Satinder Pal Singh
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India.
| | - Parveen Kalra
- Centre of Excellence in Industrial and Product Design, Punjab Engineering College, Chandigarh, India.
| | - Shagun Sharma
- Centre of Excellence in Industrial and Product Design, Punjab Engineering College, Chandigarh, India.
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7
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Yadav P, Rattan V, Rai S, Jolly SS. Open Treatment with Ultrasound Activated Resorbable Pins Versus Closed Treatment of Adult Mandible Condylar Head Fractures. J Maxillofac Oral Surg 2022; 21:1369-1376. [PMID: 36896058 PMCID: PMC9989083 DOI: 10.1007/s12663-021-01631-z] [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: 06/03/2021] [Accepted: 08/08/2021] [Indexed: 11/29/2022] Open
Abstract
Purpose The purpose of the study was to investigate whether open reduction and internal fixation (ORIF) with ultrasound activated resorbable pins (UARPs) is superior to closed treatment of condylar head (CH) fractures. The investigators hypothesized that fixation with UARPs is superior to closed treatment of CH fracture. Methods It was a prospective pilot study on CH fracture patients. Patients in closed group were managed conservatively with arch bar fixation and elastic guidance. Fixation in open group was done with UARPs. Assessment was done for primary objective of stability of fixation by UARPs and secondary objectives of functional outcome and complications. Results The study sample included 20 patients (10 in each group). 10 patients (11 joints) in closed group and 9 patients (10 joints) in open group were available for final follow-up. 5 joints showed re-dislocation of fractured segment, 1 joint showed slightly imperfect but adequate fixation and 4 joints showed adequate fixation in open group. In the closed group, displaced fragment was fused with mandible at displaced position in all the joints. All the joints showed resorption of medial condylar head at 3 months follow-up in open group. There was minimal resorption of condyle in closed group. Occlusion was deranged in 3 patients in open group and 1 patient in closed group. MIO, pain scores and lateral excursions were equal in both the groups. Conclusion The results of the present study rejected the hypothesis that fixation of CH with UARPs was superior than closed treatment. There was resorption of medial CH fragment in open group as compared to closed group.
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Affiliation(s)
- Poonam Yadav
- Department of Oral and Maxillofacial Surgery, All India Institute of Medical Sciences, New Delhi, India
| | - Vidya Rattan
- Department of Oral and Maxillofacial Surgery, Oral Health Science Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sachin Rai
- Department of Oral and Maxillofacial Surgery, Oral Health Science Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Satnam Singh Jolly
- Department of Oral and Maxillofacial Surgery, Oral Health Science Center, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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8
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Lalhriatpuii M, Chatterjee A, Satapathy D, Mohammad A, Rai S, Bhakat C, Mandal D, Dutta T, Patra A. Effect of dietary inorganic and organic chromium on nutrient utilization and growth performance in Black Bengal goats (Capra hircus). Small Rumin Res 2022. [DOI: 10.1016/j.smallrumres.2022.106797] [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: 10/31/2022]
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9
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Maccaro A, Piaggio D, Leesurakarn S, Husen N, Sekalala S, Rai S, Pecchia L. On the universality of medical device regulations: the case of Benin. BMC Health Serv Res 2022; 22:1031. [PMID: 35962389 PMCID: PMC9375389 DOI: 10.1186/s12913-022-08396-2] [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: 11/09/2021] [Accepted: 07/31/2022] [Indexed: 11/25/2022] Open
Abstract
Background Regulatory frameworks surrounding medical devices (MDs) and medical locations are of utter importance for safeguarding patients and users, and for granting a universal access to healthcare. Currently, as the main existing regulatory frameworks are drafted by high-income countries, they pretend to be general and applicable globally, but fail to understand particular contexts, specifically those in low-resource settings (LRSs), resulting, therefore, inapplicable. In particular, LRSs present a varied situation, with legal transplants of guidelines from their previous colonial regimes. This apparently theoretical issue, is, effectively, a tangible and rising matter of concern, given the ever-increasing number of MD patent applications per year, as well as the appearance of low- and middle-income countries (LMICs) on the MD market itself. This article will focus on the European Regulation on MDs 745/2017 and its applicability in LRSs, specifically presenting the case of Benin, a Sub-Saharan African country. Methods This work is based on a field study conducted in 2019 in Benin, which is particularly exemplar to show the complexity of the “legal transplantation” concept. A multidisciplinary approach, comprising the standard tools and methods of ethics, law, and biomedical engineering, was used to draft a heuristic hermeneutic framework, and to analyse related bioethical issues concerning Medical Device Regulations (MDRs) in LRSs, the role of Maintenance, and other sociological questions; as well as the rural population’s perception on MDs and health technologies, and the role of ethics in the hospitals of LRSs. Results The definition of these themes helped approach the local perspective and define the research questions. Downstream of the analysis of the Medical Devices Regulations, the Maintenance and other bioethical issues in Benin, the heuristic hermeneutic framework was created to guide a shift in the paradigm of law and regulation making, so as to make them more contextualised and inclusive, globally. Conclusion This article proposes a framework that will help policymakers take into account the particularism of each context, especially those of the most vulnerable countries, when drafting and issuing regulatory frameworks, promoting an ever-evolving model of universalism. Supplementary Information The online version contains supplementary material available at 10.1186/s12913-022-08396-2.
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Affiliation(s)
- A Maccaro
- Applied Biomedical Signal Processing Intelligent eHealth Lab, School of Engineering, University of Warwick, Coventry, CV47AL, UK. .,Institute of Advanced Study, University of Warwick, Coventry, CV47AL, UK.
| | - D Piaggio
- Applied Biomedical Signal Processing Intelligent eHealth Lab, School of Engineering, University of Warwick, Coventry, CV47AL, UK
| | - S Leesurakarn
- The Warwick Interdisciplinary Research Centre for International Development (WICID), University of Warwick, Coventry, CV47AL, UK
| | - N Husen
- Nekemte Zonal Health Organization, Oromia, Ethiopia
| | - S Sekalala
- The Warwick Interdisciplinary Research Centre for International Development (WICID), University of Warwick, Coventry, CV47AL, UK
| | - S Rai
- The Warwick Interdisciplinary Research Centre for International Development (WICID), University of Warwick, Coventry, CV47AL, UK
| | - L Pecchia
- Applied Biomedical Signal Processing Intelligent eHealth Lab, School of Engineering, University of Warwick, Coventry, CV47AL, UK.,Università Campus Bio-Medico Di Roma, Via Álvaro del Portillo, 21, 00128, Rome, Italy
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10
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Vasudeva Rao U, Wasim MD, Rajeev P, Rai S, Pradeep Kumar K. Acute limb ischaemia: not an uncommon complication of COVID-19 infection. Ann R Coll Surg Engl 2022; 104:e211-e215. [PMID: 35446698 PMCID: PMC9246543 DOI: 10.1308/rcsann.2021.0342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
A new variant of coronavirus (2019-nCoV) causing acute respiratory distress in humans was identified for the first time in 2019, in Wuhan, China. One of the many complications of infection with this coronavirus is hypercoagulopathy, resulting in acute thrombosis; often leading to acute limb ischaemia. Herein, we report 20 cases of COVID-19 with peripheral arterial thrombosis involving either upper or lower limbs. Some patients underwent vascular procedures and most had to undergo amputation at some level. All the cases (n=20) were referred to us during the 8-month period June 2020 to March 2021. The most common age group was between 51 and 60 years, of whom 80% were males; all the patients had diabetes. The right lower limb was most affected (50%); 15 patients underwent embolectomy. Twenty-five per cent of patients presented with wet gangrene. One patient with upper limb thrombosis recovered after embolectomy and did not require any amputation. Eighty-five per cent of patients underwent some form of amputation and the mortality rate was 10%. Arterial thrombosis is one complication patients may develop during COVID-19 illness, which may affect the outcome. Patients with comorbid conditions like diabetes are at higher risk of developing arterial thrombosis during COVID-19 infection. Susceptibility to coagulopathy may continue even after patient discharge and it is important that both patients and treating physicians are aware of this limb-threatening complication and seek early medical attention.
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Affiliation(s)
| | - MD Wasim
- Sri Krishnasevasharama Hospital, Bangalore, India
| | - P Rajeev
- Sri Krishnasevasharama Hospital, Bangalore, India
| | - S Rai
- Sri Krishnasevasharama Hospital, Bangalore, India
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11
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Jaffer A, Lee M, Khalil O, Raslan M, Rai S, Kozan A, Hannah M, Al-Mitwalli A, Bryan M, Simms M, Dooldeniya M, Wilson J, JainChahal SR. The natural history of low-risk non-muscle-invasive bladder cancer: a collaborative multi-centre study. Int Urol Nephrol 2022; 54:2175-2180. [PMID: 35754065 DOI: 10.1007/s11255-022-03264-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2022] [Accepted: 05/30/2022] [Indexed: 08/30/2023]
Abstract
BACKGROUND International guidelines vary in terms of their definition and recommendation for management of low-risk non-muscle-invasive bladder cancer (LRNMIBC). The ideal management for this large subset of bladder cancer patient remains unclear. OBJECTIVE To evaluate long-term outcomes of patients with LRNMIBC. As a secondary objective, to assess for intergroup heterogeneity in disease-specific outcomes between G1 and G2LG diseases. METHODS A multi-centre, retrospective study of patients who met the 2015 NICE definition of LRNMIBC. Timeline of diagnosis ranged from 01/01/2012 to 30/06/2016. RESULTS A total 390 patients had available follow-up data (G1: 142, G2LG: 249). Over a median follow-up time of 36 months (IQR 25-50), 29.2% of the patients developed a recurrence. G2LG patients were statistically more likely to develop a recurrence (G1: 26.8%, G2LG: 33.7%, p < 0.05). 51.8% of recurrences occurred after 1 year of surveillance. Progression to high-grade disease occurred in 1.8% (n = 7, G1: 3, G2LG: 4) and a further 1.0% (n = 4, G1:3, G2LG: 1) of patients developed muscle-invasive bladder cancer (MIBC). CONCLUSION The majority of recurrences occurred after 1 year of surveillance. The risk of disease progression was low; however, this was observed in a cohort of patients with regular cystoscopic follow-up. The risk may be higher if patients were pre-maturely discharged. If a 5-year surveillance programme were to be followed, 96.5% of recurrences would be captured. Lastly, there appears to be intergroup heterogeneity within LRNMIBC with G2LG patients having a statistically higher risk of recurrence compared to G1.
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Affiliation(s)
- A Jaffer
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.
| | - M Lee
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - O Khalil
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - M Raslan
- Hull University Teaching Hospital NHS Trust, Hull, UK
| | - S Rai
- Leeds Teaching Hospitals NHS Trust, Leeds, UK
| | - A Kozan
- Calderdale and Huddersfield NHS Trust, Huddersfield, UK
| | - M Hannah
- Hull University Teaching Hospital NHS Trust, Hull, UK
| | - A Al-Mitwalli
- Hull University Teaching Hospital NHS Trust, Hull, UK
| | - M Bryan
- Calderdale and Huddersfield NHS Trust, Huddersfield, UK
| | - M Simms
- Hull University Teaching Hospital NHS Trust, Hull, UK
| | - M Dooldeniya
- Mid Yorkshire Hospitals NHS Trust, Wakefield, UK
| | - J Wilson
- York Teaching Hospital NHS Trust, York, UK
| | - S R JainChahal
- Leeds Teaching Hospitals NHS Trust, Leeds, UK.,Bradford Teaching Hospitals NHS Trust, Bradford, UK
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12
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Rai S, Srivastava S, Krishnan S, Murlimanju B, Hegde A, Jolly A. Work-Related Musculoskeletal Disorders among Sonologists during the Pre-COVID-19 and Present COVID-19 Era: a Survey and Review of Best Practices. Muscles Ligaments Tendons J 2022. [DOI: 10.32098/mltj.02.2022.17] [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: 11/05/2022]
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13
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Sahu GR, Kaur A, Rattan V, Singh SP, Rai S. Effect of Orthognathic Surgery on Temporomandibular Disorders: A Prospective Study. J Maxillofac Oral Surg 2022; 21:277-282. [PMID: 35400935 PMCID: PMC8934891 DOI: 10.1007/s12663-021-01644-8] [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: 06/28/2021] [Accepted: 09/01/2021] [Indexed: 11/25/2022] Open
Abstract
Purpose The relationship of orthognathic surgery and temporomandibular disorders (TMD) has always been a topic of debate. The results have varied from mild/moderate improvement to actual worsening in some cases. The purpose of this study was to evaluate the effects of orthognathic surgery on TMD in patients with dentofacial deformities. Method An observational study was conducted on 56 patients (112 condyles) of patients with dentofacial deformities with age range of 19-35 years who underwent orthognathic surgery. TMD was evaluated using seven types of disorders in diagnostic criteria for TMD (DC/TMD, 2010) pre-operatively and after 6-month follow-up. Results There was minimal decrease in unassisted mouth opening without pain, maximum unassisted mouth opening and maximum assisted mouth opening after surgery. There was significant improvement in joint sounds and headache in 18 patients. Overall, there was improvement in 29 cases (33.93%), worsening in 8 cases (14.29%) and no change in 19 cases (33.93%). Conclusion There was high prevalence of TMDs in dentofacial deformity patients. Most of the patients with pre-operative TMD improved with orthognathic surgery, whereas a small percentage of patients who were asymptomatic pre-operatively developed TMD after surgery and in some patients TMD worsened. The risk of developing TMD and worsening of severity conditions is low.
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Affiliation(s)
- Gyana Ranjan Sahu
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Amanjot Kaur
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Satinder Pal Singh
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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14
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Kumar A, Rattan V, Rai S, Jolly SS, Popat SP, Bhadada SK. Fungal Necrotizing Fasciitis of Craniofacial Region: A Diagnostic Challenge. J Maxillofac Oral Surg 2021; 20:589-593. [PMID: 34776690 DOI: 10.1007/s12663-020-01342-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2019] [Accepted: 02/24/2020] [Indexed: 10/24/2022] Open
Abstract
Necrotizing fasciitis is a rare rapidly progressive, devastating surgical emergency that results in necrosis of superficial fascia, and subcutaneous tissue. It most commonly affects the abdominal wall, extremities and perineum, while the involvement in the head and neck region is relatively rare. Here, we report a successfully treated case of necrotizing fasciitis of the craniofacial region caused by Mucor in an uncontrolled diabetic patient. Early diagnosis, early surgical intervention with radical excision of infected tissue, management of underlying predisposing medical condition and supportive therapy (antimicrobials, rehydration, proper rest and nutrition) can reduce the morbidity and mortality associated with this condition.
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Affiliation(s)
- Arun Kumar
- Department of Oral Health Science, Satellite Centre, Postgraduate Institute of Medical Education and Research, Una, Himachal Pradesh 174303 India
| | - Vidya Rattan
- Department of Oral Health Sciences, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sachin Rai
- Department of Oral Health Sciences, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Satnam Singh Jolly
- Department of Oral Health Sciences, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Shyam P Popat
- Department of Oral Health Sciences, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Sanjay Kumar Bhadada
- Department of Endocrinology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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15
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Shetty G, Datta U, Rea I, Rai S, Hwang MJ, Hoar F, Sintler M, Mirza M, Husain A, Tan M. Rapid implementation of triaging system for assessment of breast referrals from primary care centres during the COVID-19 pandemic. Ann R Coll Surg Engl 2021; 103:576-582. [PMID: 34464568 DOI: 10.1308/rcsann.2021.0155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022] Open
Abstract
OBJECTIVE The aim of this study was to establish a triaging system for assessment of breast referrals from primary care to ensure safe and effective breast services without compromising breast cancer management. BACKGROUND COVID-19 was officially declared a global pandemic on 11 March 2020, and with no effective treatment available, preventing spread has been paramount. Previously, all referrals from primary care were seen in the rapid-access breast clinic (RABC). Clinic appointments exposed patients and healthcare professionals to risk. METHOD Initial triage during the lockdown was in line with national governing body guidance, rejected low risk referrals and streamed remaining patients through a telephone consultation to RABC or discharge. A modified triage pathway streamed all patients through virtual triage to RABC, telephone clinic or discharge with advice and guidance categories. Demographics, reasons for referral and outcomes data were collected and presented as median with range and frequency with percentages. RESULTS Initial triage (23 March-23 April 2020) found fewer referrals with a higher percentage of breast cancer diagnoses. Modified triage (22 June-17 July 2020) resulted in a 35.1% (99/282) reduction in RABC attendance. Overall cancer detection rate remained similar at 4.2% of all referrals pre-COVID (18/429) and 4.3% (12/282) during modified triage. After six months follow-up of patients not seen in RABC during the modified triage pathway, 18 patients were re-referred to RABC and none were diagnosed with cancer. CONCLUSION A modified triage pathway has the potential to improve triage efficiency and prevent unnecessary visits during the COVID-19 pandemic. Further refinement of pathway is feasible in collaboration with primary care.
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Affiliation(s)
- G Shetty
- Sandwell and West Birmingham NHS Trust, UK.,Kasturba Medical College Mangalore & Manipal Academy of Health Education, Manipal, India
| | - U Datta
- Sandwell and West Birmingham NHS Trust, UK
| | - I Rea
- Sandwell and West Birmingham NHS Trust, UK
| | - S Rai
- Sandwell and West Birmingham NHS Trust, UK
| | - M-J Hwang
- Sandwell and West Birmingham NHS Trust, UK.,North West Wales NHS Trust, UK
| | - F Hoar
- Sandwell and West Birmingham NHS Trust, UK
| | - M Sintler
- Sandwell and West Birmingham NHS Trust, UK
| | - M Mirza
- Sandwell and West Birmingham NHS Trust, UK
| | - A Husain
- Sandwell and West Birmingham NHS Trust, UK
| | - M Tan
- Sandwell and West Birmingham NHS Trust, UK
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Kumar A, Kaur A, Singh M, Rattan V, Rai S. "Signs and Symptoms Tell All"-Pseudoaneurysm as a Cause of Postoperative Bleeding after Orthognathic Surgery-Report of a Case and a Systematic Review of Literature. J Maxillofac Oral Surg 2021; 20:345-355. [PMID: 34408361 PMCID: PMC8313620 DOI: 10.1007/s12663-020-01476-y] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2020] [Accepted: 10/27/2020] [Indexed: 11/24/2022] Open
Abstract
PURPOSE Pseudoaneurysms are one of the rare complications that can be encountered after the orthognathic surgery. We are presenting a new case of pseudoaneurysm of bilateral sphenopalatine artery after Bijaw Surgery in a young male and a systematic review of all the cases in the literature emphasizing on signs and symptoms, epistaxis or bleeding episodes and treatment outcomes. METHODS A systematic research strategy was planned according to the PRISMA guidelines, and articles were taken from 1986 to September, 2019. A total of 899 articles were selected for screening, out of which only 26 articles met our inclusion and exclusion criteria. These were included in the study for qualitative analysis. RESULTS Most PAs were associated with Lefort I osteotomy (69.7%), followed by sagittal split osteotomy (24.24%). Average intraoperative blood was 635 ml. Maximum number of episodes of epistaxis/swelling or bleeding occurred in second week. Mean bleeding episodes were 2.58 ± 0.996. The arteries commonly affected were internal maxillary artery (42%), sphenopalatine artery (27.27%), facial artery (15.15%), descending palatine artery (12.12%), internal carotid artery (9.09%) and infraorbital artery (3.03%). Embolization was treatment of choice in 81.81% cases. CONCLUSION If a patient has recurrent epistaxis or swelling after orthognathic surgery, it is advisable to go for diagnostic imaging like angiography without any delay. In recent times, advanced techniques and expertise are readily available for early diagnosis and management of pseudoaneurysm.
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Affiliation(s)
- Arun Kumar
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Amanjot Kaur
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Manpreet Singh
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Vidya Rattan
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
| | - Sachin Rai
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Sector 12, Chandigarh, India
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Joshi S, Rao V, Shetty UC, Rai S, Arora S, Kumar SR. Functional Outcome of Open Latarjet Procedure in Non-Athletic Middle-Aged Patients. Malays Orthop J 2021; 15:151-158. [PMID: 34429836 PMCID: PMC8381674 DOI: 10.5704/moj.2107.022] [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: 12/31/2020] [Accepted: 05/19/2021] [Indexed: 11/17/2022] Open
Abstract
Introduction: The movement and steadiness of the shoulder joint is due to both the dynamic and static stabilisers. Recurrent anterior shoulder instability is common due to the Bankart lesion or the Hill Sachs lesion. The bone loss and soft tissue failure due to these lesions causing instability is well compensated by Latarjet procedure which acts by triple blocking effect of the bone graft, the sling effect of the conjoint tendon of subscapularis and the ligament of the coracoacromial ligament stump. Materials and methods: Middle-aged patients with recurrent anterior shoulder dislocation and a mid-range instability on clinical assessment with an isolated glenoid bone loss of 20% or Bankart lesion with engaging Hill Sachs lesion were selected for the study. The surgical procedure included a subscapularis split to expose the glenoid. The coracoid graft harvested was prefixed with Kirschner wires and placed flush over the glenoid ensuring no medial or lateral overhang and fixed with 4.0mm cancellous screws with the washer. The functional outcome was measured with the ROWE score and ASES score and the movements were evaluated. Results: A total of 24 patients fulfilled the inclusion criteria. Post-operatively at final follow-up, the mean ROWE score was 97.08 ±8.45 and the mean ASES score was 94.4±9.10. One patient had screw breakage as a complication and another had restriction of movement which was managed with physiotherapy. Conclusion: Open Latarjet is an effective procedure for recurrent anterior shoulder instability in non-athletic middle-aged patients as a excellent functional outcome was achieved with this technique. We therefore recommend open Latarjet as an alternative to arthroscopic treatment in developing countries where patient affordability and the availability of the resources are the issues.
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Affiliation(s)
- S Joshi
- Department of Orthopaedics, Government Medical College Kota, Kota, India
| | - Vkv Rao
- Department of Orthopaedics, Government Medical College Kota, Kota, India
| | - U C Shetty
- Department of Orthopaedics, Kundapur Hospital, Kundapur, India
| | - S Rai
- Department of Orthopaedics, Orthocity Hospital, Varanasi, India
| | - S Arora
- Department of Orthopaedics, Government Medical College Kota, Kota, India
| | - S R Kumar
- Department of Orthopaedics, Government Medical College Kota, Kota, India
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Bali RK, Rai S, Verma DK. Tertiary Healthcare Institutions and Maxillofacial surgery: A case for Reform. J Maxillofac Oral Surg 2021; 20:337-339. [PMID: 34408359 DOI: 10.1007/s12663-021-01616-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
Affiliation(s)
- Rishi Kumar Bali
- Oral and Maxillofacial Surgery, DAV Dental College & Hospital, Yamunanagar, Haryana India
| | - Sachin Rai
- Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Dinesh Kumar Verma
- Oral and Maxillofacial Surgery, Department of Dentistry, All India Institute of Medical Sciences, Bilaspur, H.P India
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Krautmann M, Walters R, Cole P, Tena J, Bergeron LM, Messamore J, Mwangi D, Rai S, Dominowski P, Saad K, Zhu Y, Guillot M, Chouinard L. Laboratory safety evaluation of bedinvetmab, a canine anti-nerve growth factor monoclonal antibody, in dogs. Vet J 2021; 276:105733. [PMID: 34391918 DOI: 10.1016/j.tvjl.2021.105733] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2021] [Revised: 06/30/2021] [Accepted: 08/09/2021] [Indexed: 11/19/2022]
Abstract
Nerve growth factor (NGF), a critical mediator of nociception, is a novel analgesic therapeutic target. Bedinvetmab, a canine monoclonal antibody (mAb), binds NGF and inhibits its interaction with tropomyosin receptor kinase A (trkA) and p75 neurotrophin receptor (p75NTR) receptors. The objective of three integrated laboratory studies was to demonstrate the safety of bedinvetmab in adult laboratory Beagle dogs. Daily health, veterinary, clinical pathology, systemic exposure, and anti-drug antibody evaluations were performed. Study 1 additionally included electrocardiography, neurologic, and ophthalmic assessments, and radiographic monitoring of joints of the appendicular skeleton. Study 2 evaluated T-lymphocyte-dependent immune function. Study 3 evaluated the safety of short-term concurrent administration of carprofen, a nonsteroidal anti-inflammatory drug (NSAID), with bedinvetmab. Studies 1 and 3 included terminal pathology and histopathology evaluations. Study designs and procedures included directed complementary morphologic and functional evaluations of a literature- and in vitro-based list of potential safety issues related to the NGF signaling pathway and characteristics engineered into this mAb. Screening-level general procedures evaluated effects associated with mAbs that target and inhibit soluble agonist cytokines. There were no treatment-related adverse changes in clinical evaluations, clinical neurological and ophthalmic examinations, joints, immune morphology or function, and no effects of short-term concurrent NSAID usage. Treatment-emergent immunogenicity was not observed. Bedinvetmab (1 mg/kg SC monthly; 3× and 10× dose multiples) was well tolerated in normal laboratory Beagle dogs for 6 months and with 2 weeks' concurrent NSAID administration.
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Affiliation(s)
- M Krautmann
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA.
| | - R Walters
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - P Cole
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - J Tena
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - L M Bergeron
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - J Messamore
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - D Mwangi
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - S Rai
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - P Dominowski
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - K Saad
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - Y Zhu
- Zoetis Inc, 333 Portage Street, Kalamazoo, MI 49007, USA
| | - M Guillot
- Charles River Laboratories Montreal, ULC, Senneville, Quebec, Canada
| | - L Chouinard
- Charles River Laboratories Montreal, ULC, Senneville, Quebec, Canada
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Mokhtar EA, Rattan V, Rai S, Jolly SS, Lal V. Analysis of maximum bite force and chewing efficiency in unilateral temporomandibular joint ankylosis cases treated with buccal fat pad interpositional arthroplasty. Br J Oral Maxillofac Surg 2021; 60:313-319. [PMID: 34690017 DOI: 10.1016/j.bjoms.2021.07.007] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2021] [Accepted: 07/04/2021] [Indexed: 11/15/2022]
Abstract
There is limited knowledge about masticatory function after the release of temporomandibular joint (TMJ) ankylosis. In this study, masticatory function was evaluated by measuring maximum voluntary bite force (MVBF) and chewing efficiency in 30 unilateral TMJ ankylosis patients who were treated with buccal fat pad (BFP) interpositional arthroplasty. Eighteen subjects over 12 years of age were included in study Group A and 12 subjects below 12 years of age in study Group B. Patients in the study groups had completed a minimum follow up of one year after surgery. Control groups C (over 12 years of age, n = 18) and D (under 12 years of age, n = 12) consisted of age, sex, and weight-matched normal subjects. The mean MVBF was measured between occluding molar teeth with a strain gauge transducer. Chewing efficiency was measured with two different coloured chewing gum strips. These were chewed for 5, 10, 20, 30, and 50 strokes. Compared with normal subjects, the study groups (A and B) could generate 64.7% (p = 0.004*) and 89.8% (p = 0.121) of MVBF, respectively. Overall chewing efficiency was 88.7% in Group A and 92.9% in Group B (p = 0.014* and p = 0.138, respectively) when compared with normal subjects. The study has shown that BFP interpositional arthroplasty effectively restores masticatory function.
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Affiliation(s)
- Ejaz Ahmad Mokhtar
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Satnam Singh Jolly
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India
| | - Vivek Lal
- Department of Neurology, Postgraduate Institute of Medical Education and Research, Chandigarh 160012, India.
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Kumar V, Rattan V, Rai S, Singh SP, Mahajan JK. Comparative Assessment of Autogenous Cancellous Bone Graft and Bovine-Derived Demineralized Bone Matrix for Secondary Alveolar Bone Grafting in Patients With Unilateral Cleft Lip and Palate. Cleft Palate Craniofac J 2021; 59:833-840. [PMID: 34137277 DOI: 10.1177/10556656211025197] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVE Comparison between bovine-derived demineralized bone matrix (DMBM) and iliac crest graft over long term for secondary alveolar bone grafting (SABG) in patients with unilateral cleft lip and palate (UCLP) in terms of radiological and clinical outcomes. DESIGN Prospective, randomized, parallel groups, double-blind, controlled trial. SETTING Unit of Oral and Maxillofacial Surgery, Oral Health Science Centre, Postgraduate Institute of Medical Education & Research, Chandigarh. PARTICIPANTS Twenty patients with UCLP. INTERVENTIONS Patients were allocated into group I (Iliac crest bone graft) and group II (DMBM) for SABG. Outcomes were assessed at 2 weeks, 6 months, and then after mean follow-up period of 63 months. OUTCOMES MEASURES Volumetric analysis of the grafted bone in the alveolar cleft site was done through cone beam computed tomography using Cavalieri principle and modified assessment tool. Clinical assessment was performed in terms of pain, swelling, duration of hospital stay, cost of surgery, alar base symmetry, and donor site morbidity associated with iliac crest harvesting. RESULTS Volumetric analysis through Cavalieri principle revealed comparable bone uptake at follow-up of 6 months between group I (70%) and group II (69%). Modified assessment tool showed no significant difference between horizontal and vertical bone scores over short- and long-term follow-up. In group II, there was higher cost of surgery, but no donor site morbidity unlike group I. CONCLUSIONS Demineralized bone matrix proved analogous to iliac crest bone graft as per volumetric analysis over shorter period. However, although statistically insignificant, net bone volume achieved was lower than the iliac crest graft at longer follow-up.
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Affiliation(s)
- Vijay Kumar
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Satinder Pal Singh
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, India
| | - Jai Kumar Mahajan
- Department of Paediatric Surgery, Postgraduate Institute of Medical Education & Research, Chandigarh, India
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Kim WS, Rai S, Ando K, Choi I, Izutsu K, Tsukamoto N, Yokoyama M, Tsukasaki K, Kuroda J, Ando J, Hidaka M, Koh Y, Shibayama H, Uchida T, Yang DH, Ishitsuka K, Ishizawa K, Kim JS, Lee HG, Minami H, Eom HS, Nagai H, Kurosawa M, Lee JH, Lee WS, Shindo T, Yoon DH, Yoshida S, Gillings M, Onogi H, Tobinai K. A PHASE 2B OPEN‐LABEL SINGLE ARM STUDY TO EVALUATE THE EFFICACY AND SAFETY OF HBI‐8000 (TUCIDINOSTAT) IN PATIENTS WITH RELAPSED OR REFRACTORY PERIPHERAL T‐CELL LYMPHOMA (PTCL). Hematol Oncol 2021. [DOI: 10.1002/hon.121_2880] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Affiliation(s)
- W. S. Kim
- Samsung Medical Center Division of Hematology‐Oncology Seoul Korea
| | - S. Rai
- Kindai University Hospital Department of Hematology and Rheumatology Faculty of Medicine Osakasayama Japan
| | - K. Ando
- Tokai University Hospital Department of Hematology and Oncology Isehara Japan
| | - I. Choi
- National Hospital Organization Kyushu Cancer Center Department of Hematology Fukuoka Japan
| | - K. Izutsu
- National Cancer Center Hospital Department of Hematology Tokyo Japan
| | - N. Tsukamoto
- Gunma University Hospital Oncology Center Maebashi Japan
| | - M. Yokoyama
- The Cancer Institute Hospital of Japanese Foundation for Cancer Research Department of Hematology and Oncology Tokyo Japan
| | - K. Tsukasaki
- International Medical Center Saitama Medical University Department of Hematology Saitama Japan
| | - J. Kuroda
- Kyoto Prefectural University of Medicine Division of Hematology and Oncology Kyoto Japan
| | - J. Ando
- Juntendo University Hospital Department of Hematology Tokyo Japan
| | - M. Hidaka
- National Hospital Organization Kumamoto Medical Center Department of Hematology Kumamoto Japan
| | - Y. Koh
- Seoul National University Hospital Department of Internal Medicine Seoul Korea
| | - H. Shibayama
- Osaka University Hospital Department of Hematology and Oncology Suita Japan
| | - T. Uchida
- Japanese Red Cross Nagoya Daini Hospital Department of Hematology and Oncology Nagoya Japan
| | - D. H. Yang
- Chonnam National University Hwasun Hospital Department of Hematology Hwasun Korea
| | - K. Ishitsuka
- Kagoshima University Hospital Department of Hematology and Rheumatology Kagoshima Japan
| | - K. Ishizawa
- Yamagata University Hospital Department of Third Internal Medicine Yamagata Japan
| | - J. S. Kim
- Yonsei University College of Medicine Severance Hospital Division of Hematology Department of Internal Medicine Seoul Korea
| | - H. G. Lee
- Konkuk University Medical Center Department of Hematology & Oncology Seoul Korea
| | - H. Minami
- Kobe University Graduate School of Medicine and Hospital Department of Medical Oncology/Hematology Kobe Japan
| | - H. S. Eom
- National Cancer Center Center for Hematologic Malignancy Goyang‐si Korea
| | - H. Nagai
- National Hospital Organization Nagoya Medical Center Clinical Research Center Nagoya Japan
| | - M. Kurosawa
- National Hospital Organization Hokkaido Cancer Center Department of Hematology Sapporo Japan
| | - J. H. Lee
- Gachon University Gil Medical Center Division of Hematology Incheon Korea
| | - W. S. Lee
- Inje University Busan Paik Hospital Department of Internal Medicine Busan Korea
| | - T. Shindo
- Kyoto University Hospital Department of Hematology and Oncology Kyoto Japan
| | - D. H. Yoon
- Asan Medical Center University of Ulsan College of Medicine Department of Oncology Seoul Korea
| | - S. Yoshida
- National Hospital Organization Nagasaki Medical Center Department of Hematology Omura Japan
| | - M. Gillings
- HUYA Bioscience International LLC, CEO & Executive Chair CA USA
| | - H. Onogi
- HUYA Bioscience International Executive Vice President, Head of Clinical Development‐Japan Tokyo Japan
| | - K. Tobinai
- National Cancer Center Hospital Department of Hematology Tokyo Japan
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23
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Khadhouri S, Gallagher K, MacKenzie K, Shah T, Gao C, Moore S, Zimmermann E, Edison E, Jefferies M, Nambiar A, Mannas M, Lee T, Marra G, Gomez Rivas J, Marcq G, Assmus M, Ucar T, Claps F, Boltri M, Montagna GL, Burnhope T, Nkwam N, Austin T, Boxall N, Downey A, Sukhu T, Anton-Juanilla M, Rai S, Chin YF, Moore M, Drake T, Green J, Nielsen M, Takwoingi Y, McGrath J, Kasivisvanathan V. 92 Reshaping the Diagnostic Pathways for Investigation of Haematuria During and After The COVID-19 Pandemic: Diagnostic Accuracy of Strategies for Detection of Bladder Cancer from The IDENTIFY Cohort Study. Br J Surg 2021. [PMCID: PMC8135806 DOI: 10.1093/bjs/znab135.029] [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] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Introduction
Diagnostic haematuria services have been reduced due to the COVID-19 pandemic, compromising patient care, and necessitating a more pragmatic pathway.
Method
The IDENTIFY study was an international, prospective, multicentre cohort study of over 11,000 patients referred to secondary care for investigation of haematuria. Using this data, we developed strategies using combinations of imaging and cytology as triage tests to maximise cancer detection within a pragmatic pathway.
Results
8112 patients (74·4%) received an ultrasound or a CT urogram, with or without cytology. 5737 (70·7%) patients had visible haematuria (VH) and 2375 (29·3%) had non-visible haematuria (NVH). Diagnostic test performance was used to determine optimal age cut-offs for four proposed strategies. We recommended proceeding directly to transurethral resection of bladder tumour for patients of any age with positive triage tests for cancer. Patients with negative triage tests under 35-years-old with VH, or under 50-years-old with NVH can safely be discharged without undergoing flexible cystoscopy. The remaining patients may undergo flexible cystoscopy, with a greater priority for older patients to capture high risk bladder cancer.
Conclusions
We suggest diagnostic strategies in patients with haematuria, which focus on detection of bladder cancer, whilst reducing the burden to healthcare services in a resource-limited setting.
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Affiliation(s)
- S Khadhouri
- University of Aberdeen, Aberdeen, United Kingdom
- BURST, London, United Kingdom
| | - K Gallagher
- Western General Hospital, Edinburgh, United Kingdom
- BURST, London, United Kingdom
| | - K MacKenzie
- Freeman Hospital, Newcastle, United Kingdom
- BURST, London, United Kingdom
| | - T Shah
- Charing Cross Hospital, London, United Kingdom
- BURST, London, United Kingdom
| | - C Gao
- Addenbrookes Hospital, Cambridge, United Kingdom
- BURST, London, United Kingdom
| | - S Moore
- Wrexham Maelor Hospital, Wrexham, United Kingdom
- BURST, London, United Kingdom
| | - E Zimmermann
- Torbay and South Devon NHS Foundation Trust, Torbay, United Kingdom
- BURST, London, United Kingdom
| | - E Edison
- Whipps Cross Hospital, London, United Kingdom
- BURST, London, United Kingdom
| | - M Jefferies
- Morriston Hospital, Swansea, United Kingdom
- BURST, London, United Kingdom
| | - A Nambiar
- Freeman Hospital, Newcastle, United Kingdom
- BURST, London, United Kingdom
| | - M Mannas
- University of British Columbia, Vancouver, Canada
| | - T Lee
- University of British Columbia, Vancouver, Canada
| | - G Marra
- University of Turin, Turin, Italy
| | | | - G Marcq
- University of Lille, Lille, France
| | - M Assmus
- University of Alberta, Edmonton, Canada
| | - T Ucar
- Istanbul Medeniyet University, Istanbul, Turkey
| | - F Claps
- University of Trieste, Trieste, Italy
| | - M Boltri
- University of Trieste, Trieste, Italy
| | | | - T Burnhope
- University of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - N Nkwam
- University of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - T Austin
- Queen Alexandra Hospital, Portsmouth, United Kingdom
| | - N Boxall
- Salford Royal NHS Foundation Trust, Salford, United Kingdom
| | - A Downey
- Doncaster Royal Infirmary, Doncaster, United Kingdom
| | - T Sukhu
- University of North Carolina Hospitals, Chapel Hill, USA
| | | | - S Rai
- St James University Hospital, Leeds, United Kingdom
| | - Y F Chin
- Aberdeen Royal Infirmary, Aberdeen, United Kingdom
| | - M Moore
- University of Derby and Burton NHS Foundation Trust, Derby, United Kingdom
| | - T Drake
- The Royal Bournemouth Hospital, Bournemouth, United Kingdom
| | - J Green
- Whipps Cross Hospital, London, United Kingdom
| | - M Nielsen
- University of North Carolina Hospitals, Chapel Hill, USA
| | - Y Takwoingi
- University of Birmingham, Birmingham, United Kingdom
| | - J McGrath
- University of Exeter Medical School, Exeter, United Kingdom
| | - V Kasivisvanathan
- University College London, London, United Kingdom
- BURST, London, United Kingdom
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Mukherjee A, Praharaj S, Rai S. Effect of add-on cathodal transcranial direct current stimulation (c-TDCS) over pre-supplementary motor area (pre-SMA) in patients with obsessive compulsive disorder: A randomized sham controlled study. Eur Psychiatry 2021. [PMCID: PMC9471924 DOI: 10.1192/j.eurpsy.2021.414] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Introduction Patients with OCD often show unsatisfactory response to first-line treatment, giving rise to a need for novel therapeutic approaches. Recent studies using tDCS for OCD treatment have shown promise. Objectives To assess efficacy and safety of add-on c-tDCS over pre-SMA compared to sham stimulation in patients with OCD. Methods In this double-blinded study, fourteen patients with OCD were randomized to receive 10 sessions of either active (Cathode over pre-SMA, anode over right deltoid, 2mA, 20 minutes per session, 2 sessions per day, 2 hours apart) or sham tDCS. YBOCS, HAM-D, HAM-A, CGI, Wisconsin Card Sorting Test (WCST), and Stroop Test were administered at baseline, post-tDCS, and 1 month post-tDCS. Results Group×time interaction effect for YBOCS scores with Repeated Measures ANOVA was not statistically significant, however, reduction in scores in active group was higher, with large effect size (YBOCS scores: Obsessions-ηp2=.344, Compulsions-ηp2= .384, Total-ηp2=.392) (Fig.1 & 2). At 1 month, 42.9% patients in active group and none in sham group showed response. CGI-S score (p=0.016, ηp2=.531) (Fig. 3) and four parameters of WCST (Perseverative responses:p=0.038, ηp2=.448;Percent perseverative responses:p=0.026, ηp2=.485;Percent perseverative errors:p=0.038, ηp2=.447;Trials to complete first category:p=0.011, ηp2=.563) significantly reduced in active group. No significant difference in change in depressive and anxiety symptoms between groups, or change in Stroop Test performance was noted. Adverse effects included transient headache and tingling sensation.![]() ![]() ![]() Conclusions Cathodal tDCS over pre-SMA may be effective in reduction of obsessions, compulsions, illness severity, and enhancing cognitive flexibility in patients with OCD, with no major adverse effects. Larger studies are required to confirm these findings. Disclosure No significant relationships.
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Sindhoora KM, Spandana KU, Ivanov D, Borisova E, Raghavendra U, Rai S, Kabekkodu SP, Mahato KK, Mazumder N. Machine-learning-based classification of Stokes-Mueller polarization images for tissue characterization. J Phys : Conf Ser 2021; 1859:012045. [DOI: 10.1088/1742-6596/1859/1/012045] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 04/02/2024]
Abstract
Abstract
The microstructural analysis of tissues plays a crucial role in the early detection of abnormal tissue morphology. Polarization microscopy, an optical tool for studying the anisotropic properties of biomolecules, can distinguish normal and malignant tissue features even in the absence of exogenous labelling. To facilitate the quantitative analysis, we developed a polarization-sensitive label-free imaging system based on the Stokes-Mueller calculus. Polarization images of ductal carcinoma tissue samples were obtained using various input polarization states and Stokes-Mueller images were reconstructed using Matlab software. Further, polarization properties, such as degree of linear and circular polarization and anisotropy, were reconstructed from the Stokes images. The Mueller matrix obtained was decomposed using the Lu-Chipman decomposition method to acquire the individual polarization properties of the sample, such as depolarization, diattenuation and retardance. By using the statistical parameters obtained from the polarization images, a support vector machine (SVM) algorithm was trained to facilitate the tissue classification associated with its pathological condition.
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Kumar V, Rattan V, Rai S. Congenital Maxillomandibular Syngnathia: Review of Literature and Proposed New Classification System. J Maxillofac Oral Surg 2021; 20:19-36. [PMID: 33584038 PMCID: PMC7855147 DOI: 10.1007/s12663-019-01308-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2019] [Accepted: 11/12/2019] [Indexed: 10/25/2022] Open
Abstract
PURPOSE Maxillomandibular fusion (syngnathia) is a rare craniofacial anomaly. It occurs as either fibrous (synechiae) or bony (synostosis) fusion of jaw or fusion of mandible to zygoma, tuberosity, hard palate and temporal bone. There are several documentations delineating this condition but owing to its varying presentation, association with both intraoral and extraoral anomalies and syndromes, reviewing it has been as uphill task. The non-unanimous description of cases in the literature and the use of different nomenclatures make it difficult to classify this condition. METHODS Extensive search of the literature was done from the year 1936 to 2018 which included a total of 118 cases with 62 cases of bony fusion, 48 cases of fibrous fusion and 8 cases of combined fusion, i.e., fibrous on one site and bony on another side. RESULTS This paper proposes a novel, simple and explicit classification system on the basis of nature of fusing tissues, location and extent, association with syndrome after reviewing the existing literature. Furthermore, this review reports 4 new cases of syngnathia along with their clinical, radiographic features and their management protocol. CONCLUSIONS This classification can be generalized to all the cases of syngnathia and can further facilitate in its appropriate diagnosis and treatment plan.
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Affiliation(s)
- Vijay Kumar
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Sarkar P, Biswas A, Abharana N, Rai S, Modi MH, Bhattacharyya D. Interface modification of Cr/Ti multilayers with C barrier layer for enhanced reflectivity in the water window regime. J Synchrotron Radiat 2021; 28:224-230. [PMID: 33399572 DOI: 10.1107/s1600577520013429] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Accepted: 10/07/2020] [Indexed: 06/12/2023]
Abstract
The influence of a carbon barrier layer to improve the reflectivity of Cr/Ti multilayers, intended to be used in the water window wavelength regime, is investigated. Specular grazing-incidence X-ray reflectivity results of Cr/Ti multilayers with 10 bilayers show that interface widths are reduced to ∼0.24 nm upon introduction of a ∼0.3 nm C barrier layer at each Cr-on-Ti interface. As the number of bilayers increases to 75, a multilayer with C barrier layers maintains almost the same interface widths with no cumulative increase in interface imperfections. Using such interface-engineered Cr/C/Ti multilayers, a remarkably high soft X-ray reflectivity of ∼31.6% is achieved at a wavelength of 2.77 nm and at a grazing angle of incidence of 16.2°, which is the highest reflectivity reported so far in the literature in this wavelength regime. Further investigation of the multilayers by diffused grazing-incidence X-ray reflectivity and grazing-incidence extended X-ray absorption fine-structure measurements using synchrotron radiation suggests that the improvement in interface microstructure can be attributed to significant suppression of inter-diffusion at Cr/Ti interfaces by the introduction of C barrier layers and also due to the smoothing effect of the C layer promoting two-dimensional growth of the multilayer.
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Affiliation(s)
- P Sarkar
- Atomic and Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - A Biswas
- Atomic and Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - N Abharana
- Atomic and Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
| | - S Rai
- Synchrotron Utilisation Section, Raja Ramnna Centre for Advanced Technology, Indore 752013, India
| | - M H Modi
- Synchrotron Utilisation Section, Raja Ramnna Centre for Advanced Technology, Indore 752013, India
| | - D Bhattacharyya
- Atomic and Molecular Physics Division, Bhabha Atomic Research Centre, Mumbai 400085, India
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Bhakat C, Mohammad A, Mandal DK, Mandal A, Rai S, Chatterjee A, Ghosh MK, Dutta TK. Readily usable strategies to control mastitis for production augmentation in dairy cattle: A review. Vet World 2020; 13:2364-2370. [PMID: 33363328 PMCID: PMC7750217 DOI: 10.14202/vetworld.2020.2364-2370] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2020] [Accepted: 09/29/2020] [Indexed: 11/16/2022] Open
Abstract
Mastitis in dairy cattle is the most common management disorder that causes higher economic losses by lowering production and quality of milk leads to substantial economical loss. The aim of this article was to review worldwide important advances in strategies to control mastitis for production augmentation in dairy cattle. Many scientists worked to identify effective strategies to control mastitis caused by Streptococcus agalactiae, Staphylococcus aureus, and others. It is necessary to identify mechanisms of infection, define clinical and subclinical states of disease, determine exposure time, and identify pathogen-specific characteristics. Evolvement of management strategies that incorporated hygienic procedures (animal, floor, and milkman), post milking standing period of animal and strategic use of antibiotic or herbal therapy at dry-off, nutritional supplementation, fly control, body condition score optimization, etc., resulted in widespread control of mastitis. The udder, teat of animal, scientific management of milking, automatic milking procedure, genetic selection are considered as important factors to control mastitis. As farm management changed, scientists were directed to redefine control of mastitis caused by opportunistic pathogens of environmental sources and have sought to explore management strategies which will maintain animal well-being in a judicial way. Although significant advances in mastitis management have been made changing herd structure, changing climatic scenario and more rigorous milk processing standards ensure that mastitis will remain important issue for future research.
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Affiliation(s)
- Champak Bhakat
- Department of Livestock Production and Management, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - A Mohammad
- Department of Dairy Extension, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - D K Mandal
- Department of Livestock Production and Management, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - A Mandal
- Department of Animal Breeding, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - S Rai
- Department of Livestock Production and Management, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - A Chatterjee
- Department of Animal Nutrition, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - M K Ghosh
- Department of Animal Nutrition, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
| | - T K Dutta
- Department of Animal Nutrition, ICAR-National Dairy Research Institute, ERS, Kalyani Nadia, West Bengal, India
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Popat SP, Rattan V, Rai S, Jolly SS, Malhotra S. Nutritional intervention during maxillomandibular fixation of jaw fractures prevents weight loss and improves quality of life. Br J Oral Maxillofac Surg 2020; 59:478-484. [PMID: 33589311 DOI: 10.1016/j.bjoms.2020.10.009] [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: 07/20/2020] [Accepted: 10/15/2020] [Indexed: 11/17/2022]
Abstract
Maxillomandibular fixation (MMF) for the management of jaw fractures leads to compromised nutritional intake and consequent weight loss and poor quality of life (QoL). The present study aimed to evaluate the effectiveness of a home-based dietary plan to prevent weight loss, and its effect on the QoL of patients who underwent four weeks of MMF for the treatment of maxillofacial fractures. A total of 50 patients were randomised into nutritional intervention (Group1) and non-intervention groups (Group 2). Patients in Group1 were counselled by a dietitian and given a diet plan. Patients in Group 2 were advised to take a liquid diet of their own choice in the form of shakes, juices, and milk, along with protein supplements. Patients in Group1 lost significantly less weight than those in Group 2 (p=0.001) at week four of follow up. Group1 patients had significantly better oral health-related QoL in the 'physical pain' domain during the two weeks of MMF, and in the 'physical discomfort' and 'psychological disability' domains two weeks after the release of MMF. They had significantly better nutrition-related QoL in all the domains during the two weeks of MMF and, except for the 'physical' domain, also during the two weeks after its release. Individual home-based diet plans effectively helped the patients maintain their weight and improved QoL.
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Affiliation(s)
- S P Popat
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - V Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - S Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - S S Jolly
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
| | - S Malhotra
- Department of Dietetics, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012, India.
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Jolly SS, Rattan V, Rai S, Verma U. Traumatic Posterior Dislocation of Bilateral Mandible Condyles into External Auditory Canal Treated with Midline Mandibulotomy: A Rare Case Report and Review of Literature. J Maxillofac Oral Surg 2020; 19:642-646. [PMID: 33071515 DOI: 10.1007/s12663-020-01442-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 08/25/2020] [Indexed: 11/25/2022] Open
Abstract
Background Posterior dislocation of the condyle from the glenoid fossa fracturing the anterior wall of the canal and ultimately restricting lower jaw movements is a rare condition. It may occur due to lax intra-articular ligaments or periarticular tissue or as a result of injury to the chin region. Very few cases of this condition are reported in the literature. Purpose The purpose of this article is to present a rare case report and review of literature related to posterior dislocation of bilateral mandible condyles to the external auditory canal, its diagnosis, and treatment with midline mandibulotomy. Method We used conservation methods to reduce it initially but not succeeded. Then we used midline mandibulectomy to reduce the individual condyle to its original position without opening the condyle region. Results We achieved a successful reduction of the dislocation and achieved with good occlusion and postoperative mouth opening. No complications like recurrence and TMJ ankylosis occurred. Conclusion Bilateral posterior dislocation is a rare condition; proper clinical, radiographic diagnosis, and early treatment with manual or surgical intervention are required to avoid complications.
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Affiliation(s)
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, OHSC PGIMER, Chandigarh, India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, OHSC PGIMER, Chandigarh, India
| | - Upma Verma
- Unit of Oral and Maxillofacial Surgery, OHSC PGIMER, Chandigarh, India
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Pruthi G, Parkash H, Bharathi P V, Jain R, Gupta A, Rai S. Comprehensive review of guidelines to practice prosthodontic and implant procedures during COVID-19 pandemic. J Oral Biol Craniofac Res 2020; 10:768-775. [PMID: 33101891 PMCID: PMC7568128 DOI: 10.1016/j.jobcr.2020.10.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/28/2020] [Revised: 08/27/2020] [Accepted: 10/14/2020] [Indexed: 12/23/2022] Open
Abstract
Objectives To present a comprehensive review of current literature available on Corona virus disease and dentistry, modifications required in dental and laboratory settings; and recommended disinfection protocols in current scenario. Special emphasis has been given to discuss guidelines for handling different prosthodontic procedures and implications of this pandemic on prosthodontic practice, education and research. Materials and methods Relevant literature pertaining to COVID-19 and dentistry was scrutinized on electronic search engines including PubMed, EMBASE and Cochrane. Guidelines given by various organizations, institutions, national and international regulatory bodies and Indian Prosthodontic Society were also consulted to gather information pertaining to the objectives of our review. Results and observations: A total of 160 articles including cross-sectional studies, in vitro study, narrative reviews, letters to the editor and opinions were found to be relevant in accordance with our search strategy. Documented literature revealed that Covid-19 pandemic has culminated in serious clinical, financial and psychological implications in the field of dentistry. Certain steps such as adoption of teledentistry, judicious use of protective equipment, use of rubber dams, pre-procedural rinses have been suggested unanimously. However, there is a dearth of evidence-based recommendations in literature. Data regarding consequences of delaying prosthodontic procedures and patients' perspectives is also sparse. Conclusion The COVID-19 necessitates the need to adopt a balanced approach while treating patients and safeguarding the dental professionals at the same time. Risk-benefit ratio has to be assessed along with stringent following of guidelines and disinfection protocols to combat this unprecedented situation.
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Affiliation(s)
- Gunjan Pruthi
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Hari Parkash
- Centre for Dental Education and Research, AIIMS, New Delhi, India
| | | | - Radhika Jain
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Arpit Gupta
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
| | - Sachin Rai
- Oral Health Sciences Centre, PGIMER, Chandigarh, India
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Kumar A, Rattan V, Rai S, Nambiyar K. Localized Oral Histoplasmosis in an Immunocompetent Patient: A Rare Occurrence with Review of the Literature. J Maxillofac Oral Surg 2020; 19:355-358. [PMID: 32801527 DOI: 10.1007/s12663-019-01273-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2019] [Accepted: 08/08/2019] [Indexed: 11/27/2022] Open
Affiliation(s)
- Arun Kumar
- Department of Oral Health Science Centre, Postgraduate Institute of Medical Education and Research, Satellite Centre, Una, Himachal Pradesh India
| | - Vidya Rattan
- Department of Oral Health Science Centre, Postgraduate Institute of Medical Education and Research, Satellite Centre, Chandigarh, India
| | - Sachin Rai
- Department of Oral Health Science Centre, Postgraduate Institute of Medical Education and Research, Satellite Centre, Chandigarh, India
| | - Kaniyappan Nambiyar
- Department of Histopathology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sharma VK, Rattan V, Rai S, Sharma P. Development and validation of temporomandibular joint ankylosis quality of life questionnaire. J Craniomaxillofac Surg 2020; 48:779-785. [DOI: 10.1016/j.jcms.2020.06.005] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2020] [Revised: 05/23/2020] [Accepted: 06/20/2020] [Indexed: 11/17/2022] Open
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Sharma P, Rattan V, Rai S, Chhabbra R. Does Intraoperative Computed Tomography Improve the Outcome in Zygomatico-Orbital Complex Fracture Reduction? J Maxillofac Oral Surg 2020; 20:189-200. [PMID: 33927486 DOI: 10.1007/s12663-020-01420-0] [Citation(s) in RCA: 2] [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: 05/04/2020] [Accepted: 07/10/2020] [Indexed: 12/01/2022] Open
Abstract
Purpose Zygomatico-orbital (ZMO) fractures pose considerable difficulty in intraoperative assessment during open reduction and internal fixation (ORIF), and this can be attributed to its three-dimensional complex anatomy and articulations. Recent advancements in the form of intraoperative imaging and navigation have led to an adequate assessment and correct reduction of these fractures minimizing chances of any revision surgery. The purpose of this study was to evaluate the advantage of intraoperative computerized tomography (CT) scan in the management of ZMO/isolated orbital complex fracture and further to develop a protocol for managing such fractures. Methods Twenty-three cases of ZMO/isolated orbital fractures were managed with ORIF, followed by an intraoperative CT scan. The evaluation was focused on the articulations of the zygoma and orbital wall reconstruction. The score of 0 and 1 was given for inadequate and adequate reduction, respectively. Necessary corrections were performed in case of improper reduction followed by a repeat CT scan if required. The reduction score was statistically correlated with number of incisions. Results In 8 (35%) out of 23 patients, clinical judgment was inaccurate when radiologically assessed with an intraoperative CT scan. In 6 out of 8 cases, a repeat CT scan was done after revision of reduction. The reduction score improved with additional incision and revision in the second CT scan. Conclusion Intraoperative CT has an important role in assessing the accuracy of reduction and confirming implant position in ZMO/isolated orbital fractures. This can avoid the need for secondary corrective surgery and postoperative imaging. Intraoperative CT is an important tool to improve surgical outcomes in the management of ZMO orbital fractures.
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Affiliation(s)
- Preeti Sharma
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Rajesh Chhabbra
- Department of Neurosurgery, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Sahu J, Rai S, Behera R, Mandal S, Jas R, Ghosh MK, Mandal DK, Chatterjee A. Faecal score and dry matter content after feeding synbiotics to neonatal Jersey crossbred calves. IJDS 2020. [DOI: 10.33785/ijds.2020.v73i03.015] [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: 11/23/2022]
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Singh AK, Bhakat C, Mandal DK, Mandal A, Rai S, Chatterjee A, Ghosh MK. Effect of reducing energy intake during the dry period on milk production, udder health, and body condition score of Jersey crossbred cows in the tropical lower Gangetic region. Trop Anim Health Prod 2020; 52:1759-1767. [PMID: 31898029 DOI: 10.1007/s11250-019-02191-8] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/02/2019] [Accepted: 12/22/2019] [Indexed: 10/25/2022]
Abstract
To find out the effect of reducing energy intake during dry period on milk production, udder health, and body condition, the experiment was conducted on 14 Jersey crossbred cows during whole dry period and continued up to 120 days of lactation. Reduction in energy intake was done during far-off period for each dry cow of treatment group as compared to control group. Statistically analyzed data revealed that overall significantly (P < 0.01) lower DMI and WI were recorded in control than treatment group. Overall significantly (P < 0.01) higher total milk production was found in treatment than control group. Overall significantly (P < 0.01) lower milk SCC, MCMT, pH, and EC were found in treatment than control group. Nonsignificant difference in milk fat, SNF, total solid, total protein, and fat:protein ratio was found. Overall significantly (P < 0.01) better quality milk (MBRT) was found in treatment than control groups. BCS during dry period and at calving was significantly (P < 0.01) different between groups. Significantly (P < 0.01) higher plasma NEFA concentration was estimated in control than treatment groups in all stages. No significant difference was found for plasma concentrations of glucose, urea, and total protein. The coefficients of correlation indicated significant (P < 0.01) correlation among BCS, milk production, milk SCC, MCMT, pH, and EC. It can be concluded that reducing energy intake during far-off dry period can lead to achieve optimum BCS at calving. Suitable BCS at calving was beneficial to get higher milk production with improved quality, better maintenance of udder health and body condition of Jersey crossbred cows at tropical lower Gangetic region.
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Affiliation(s)
- Amit Kumar Singh
- LPM Section, ICAR, National Dairy Research Institute (NDRI), Eastern Regional Station (ERS), Kalyani, Nadia, WB, Kalyani-741235, India
| | - Champak Bhakat
- LPM Section, ICAR, National Dairy Research Institute (NDRI), Eastern Regional Station (ERS), Kalyani, Nadia, WB, Kalyani-741235, India.
| | - D K Mandal
- LPM Section, ICAR, National Dairy Research Institute (NDRI), Eastern Regional Station (ERS), Kalyani, Nadia, WB, Kalyani-741235, India
| | - A Mandal
- Animal Breeding section, ICAR, National Dairy Research Institute (NDRI), Eastern Regional Station(ERS), Kalyani, Nadia, WB, Kalyani-741235, India
| | - S Rai
- LPM Section, ICAR, National Dairy Research Institute (NDRI), Eastern Regional Station (ERS), Kalyani, Nadia, WB, Kalyani-741235, India
| | - A Chatterjee
- Animal Nutrition Section, ICAR- National Dairy Research Institute (NDRI), Eastern Regional Station (ERS), Kalyani, Nadia, WB, Kalyani-741235, India
| | - M K Ghosh
- Animal Nutrition Section, ICAR- National Dairy Research Institute (NDRI), Eastern Regional Station (ERS), Kalyani, Nadia, WB, Kalyani-741235, India
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Watson J, Rai S, Ujam A. TMJ dislocation: late presentation. Br Dent J 2019; 227:435. [DOI: 10.1038/s41415-019-0789-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022]
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Sharma VK, Rattan V, Rai S, Malhi P. Quality of life assessment in temporomandibular joint ankylosis patients after interpositional arthroplasty: a prospective study. Int J Oral Maxillofac Surg 2019; 48:1448-1455. [PMID: 31109747 DOI: 10.1016/j.ijom.2019.04.017] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2018] [Revised: 03/11/2019] [Accepted: 04/30/2019] [Indexed: 10/26/2022]
Abstract
Temporomandibular joint (TMJ) ankylosis significantly impacts both physical and psychosocial patient wellbeing. A complete evaluation of treatment outcomes necessitates knowing the extent to which a patient's quality of life (QoL) is impacted. This study was performed to evaluate the impact of TMJ ankylosis on QoL in 25 TMJ ankylosis patients treated by interpositional arthroplasty. The patients completed OHIP-14 and UWQoL questionnaires once before and then at 3 months after the surgery. There was a significant improvement in mean cumulative scores for both questionnaires. With the exception of functional limitation, all OHIP domains showed significant improvement. Preoperatively, the worst scores were found in the psychological distress domain, followed by the social handicap, physical pain and physical disability domains. More than half of the subjects (56%) reported having suicidal thoughts. Amongst the individual UWQoL domains, appearance, chewing, anxiety (P < 0.01), recreation and mood (P < 0.05) showed improved scores. Appearance and chewing were the top ranked priority domains before and after surgery. No significant change was found in speech, taste, sleep, or breathing. Psychosocial factors were found to play a much bigger role than previously thought. The physical, psychological, and social factors were intricately related and dynamically interacted with each other. Surgical treatment produced a definitive QoL improvement in the patients.
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Affiliation(s)
- V K Sharma
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - V Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Malhi
- Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh
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Karunakaran M, Gajare VC, Mandal A, Mondal M, Das SK, Ghosh MK, Rai S, Behera R. Electrophoretic profile of seminal proteins and their correlation with in vitro sperm characters in Black Bengal buck semen. Vet World 2019; 12:621-628. [PMID: 31327896 PMCID: PMC6584853 DOI: 10.14202/vetworld.2019.621-628] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/03/2018] [Accepted: 03/08/2019] [Indexed: 11/24/2022] Open
Abstract
Aim: This study aimed to study the electrophoretic properties of seminal plasma and sperm proteins of Black Bengal buck semen and their correlation with in vitro sperm characters and freezability. Materials and Methods: Semen ejaculates from nine Black Bengal bucks were collected by artificial vagina (n=20/buck). Ejaculates were evaluated for in vitro sperm characters and electrophoretic profile of seminal protein. In vitro sperm characters were evaluated immediately after collection, after completion of equilibration period, and after freeze-thawing. For seminal protein studies, seminal plasma proteins were precipitated by ice-cold ethanol method, and sperm proteins were extracted by Triton X detergent extraction method. Discontinuous sodium dodecyl sulfate-polyacrylamide gel electrophoresis (SDS-PAGE) was performed to assess the molecular weight of seminal proteins. Correlation between in vitro sperm characters and protein bands was determined by Pearson’s correlation coefficient, and two-way ANOVA was applied to find the individual buck differences. Results: Significant difference (p<0.01) among the bucks was noticed in the in vitro sperm characters evaluated at all the three stages of semen evaluation such as immediately after collection, after completion of equilibration period, and post-freeze thawing. Progressive loss of sperm motility, membrane integrity, and other in vitro sperm characters were noticed during cryopreservation. A total of ten protein bands in the molecular weight ranging from 17 to 180 kDa were found in the SDS-PAGE of seminal plasma proteins, while nine bands of 17-134 kDa were observed in sperm proteins. Seminal plasma proteins of molecular weight 75, 62-49, 20, and 17 kDa and sperm proteins of 75, 20, and 17 kDa were present in all the nine bucks (100%) screened, and variation among the bucks was noticed for the presence of other proteins. Seminal plasma protein of 180-134 kDa showed a negative correlation with individual motility (−0.716) and functional membrane integrity of sperm cells (−0.724) in post-freeze–thaw analysis and 48 kDa protein had a positive correlation with individual motility (0.649) and functional membrane integrity of sperm cells (0.664) in post-thaw analysis. Sperm proteins of 63 kDa had a negative correlation (−0.616) with sperm concentration in neat semen. Conclusion: Variation among the bucks was noticed in the in vitro sperm characters and semen freezability. Correlation between seminal proteins and in vitro sperm characters and semen freezability had been found which might be useful as a tool to select breeding bucks.
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Affiliation(s)
- M Karunakaran
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - Vivek C Gajare
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - Ajoy Mandal
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - Mohan Mondal
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - S K Das
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - M K Ghosh
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - S Rai
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
| | - R Behera
- ICAR-National Dairy Research Institute, Eastern Regional Station, Kalyani, West Bengal, India
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Bhandari S, Ngo PT, Mandadi M, Wu X, Brown C, Rai S, Riley EC. Abstract P1-12-12: Bubble packaging of adjuvant endocrine therapy:updated analysis of compliance and survival. Cancer Res 2019. [DOI: 10.1158/1538-7445.sabcs18-p1-12-12] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Introduction: Adherence to endocrine therapy is a long recognized problem despite efficacy of these drugs with reported compliance rates of 89% in first year and 50% in fourth year. Most of our knowledge of noncompliance is observational and retrospective. This final analysis of the Bubble Study reports the compliance rate of adjuvant endocrine therapy among women with early stage breast cancer using “bubble” packaging. We previously reported adherence rates of 97% with bubble packaging. This updated analysis includes disease free survival (DFS) and overall survival (OS) at 5 years.
Methods: The Bubble study is a non-blinded, prospective observational cohort study, which enrolled 86 patients between August 2012 and April 2014. Demographic and clinical data were collected prospectively including age, race, insurance, duration of therapy, stage, treatment, comorbidities, recurrence and survival. Duration of therapy was divided into 3 cohorts: <12 months, 12-36 months, and 37-60 months. All patients received routine prescriptions in a “bubble” pack or daily blister pack. Patients returned all used bubble packs at follow up appointments for review and kept a diary of missed doses for analysis. DFS and OS data were obtained at 78 months. Compliance was defined as >90% adherence. We calculated institutional DFS and OS for breast cancer patients treated within a similar time frame from the tumor registry.
Results: 53 patients were included in the analysis. The remaining patients withdrew from the study prior to data collection or were deemed ineligible. The overall compliance rate was 97%; however, only 72% of enrolled patients were continued in the analysis. None of the variables examined (race, age, insurance status and stage) had an impact on compliance. Only duration of endocrine therapy had a marginal effect on compliance (p value = 0.06). The latest cohort (duration of therapy 37-60 months) was least likely to be compliant at 89.53%. Our 5-year DFS is 92% and 5-year OS is 96%. There is no statistically significant difference in DFS and OS between patients with compliance>90% and <90%. For ER+ breast cancer patients treated during similar timeframe at our institution outside the trial, 5-year DFS is 94% and 5-year OS is 90%.
Conclusion: There was no difference in OS or DFS based on compliance to oral anti-estrogens. Given the high overall compliance rate in this small patient population, the lack of OS and DFS difference is not surprising. However, the compliance rate of bubble packaging (>90%) is higher than expected based on current literature. Although this may suggest improved compliance with bubble packaging, more studies are necessary to confirm this given small sample size and high trial dropout rate. Trial withdrawal likely altered analysis of adherence rates as it selects for a largely compliant group of patients.This bias may also explain the lack of difference in compliance rate among race, insurance status and/ or age, which contradicts our current knowledge of high-risk groups.There was a trend towards lower DFS in the bubble cohort, but overall better survival when comparing to institutional rate. Studies are ongoing to confirm bubble packaging adherence rates and compare this to established strategies to improve adherence.
Citation Format: Bhandari S, Ngo PT, Mandadi M, Wu X, Brown C, Rai S, Riley EC. Bubble packaging of adjuvant endocrine therapy:updated analysis of compliance and survival [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-12-12.
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Affiliation(s)
- S Bhandari
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
| | - PT Ngo
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
| | - M Mandadi
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
| | - X Wu
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
| | - C Brown
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
| | - S Rai
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
| | - EC Riley
- James Graham Brown Cancer Center, University of Louisville, Louisville, KY; Cancer Registry, University of Louisville Medical Center, Louisville, KY
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Gupta A, Rattan V, Rai S. Efficacy of Chitosan in promoting wound healing in extraction socket: A prospective study. J Oral Biol Craniofac Res 2018; 9:91-95. [PMID: 30456164 DOI: 10.1016/j.jobcr.2018.11.001] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/26/2018] [Accepted: 11/06/2018] [Indexed: 11/29/2022] Open
Abstract
Purpose Chitosan has been shown to promote wound healing and induce bone formation. The aim of this split-mouth study was to evaluate the effectiveness of chitosan based dressing in wound healing after lower third molar extraction. Method Asymptomatic symmetrical mandibular third molars were extracted simultaneously in 27 patients and Chitosan dressing was placed into the extraction socket in the test side. Pain scores were recorded on VAS using a 0 to 10 pain score. Wound healing was compared between right and left side. Radiographic findings were evaluated by observing lamina dura and density of extraction socket. Results Test group had more pain than control at all time intervals and unerupted tooth sites showed mean pain score significantly more than erupted tooth sites. Test group was superior to control in event of wound healing. Healing was significantly better in erupted tooth than unerupted tooth. At second week 12 sites showed better radiographic findings in chitosan treated group compared to 3 sites in the control group. At third month, 14 sites showed improved bone formation in chitosan treated group compared to 4 in control group. None of the unerupted teeth group showed better radiographic finding in test side at 2 week and 3 month compared to erupted teeth group. Conclusion Chitosan is effective in promoting wound healing and early osteogenesis in erupted tooth socket after extraction. We recommend that chitosan dressing should be used in the sockets of erupted tooth after extraction but should be avoided in unerupted or impacted teeth cases.
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Affiliation(s)
- Akshat Gupta
- Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Vidya Rattan
- Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
| | - Sachin Rai
- Unit of Oral & Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education & Research, Chandigarh, 160012, India
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Affiliation(s)
- Divya Jain
- Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Tanvir Samra
- Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Pranshuta Sabarwal
- Department of Anesthesia and Intensive Care, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - Sachin Rai
- Department of Maxillofacial Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Rai S, Rattan V. Efficacy of Feracrylum as Topical Hemostatic Agent in Therapeutically Anticoagulated Patients Undergoing Dental Extraction: A Comparative Study. J Maxillofac Oral Surg 2018; 18:579-583. [PMID: 31624440 DOI: 10.1007/s12663-018-1156-6] [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: 09/20/2018] [Accepted: 09/25/2018] [Indexed: 11/25/2022] Open
Abstract
Aims and Objective To compare the efficacy of feracrylum with tranexamic acid (TXA), following dental extraction in patients who are therapeutically anticoagulated with warfarin. Study Design Sixty patients on warfarin were randomly divided into three groups. Groups 1 and 2 patients were given feracrylum (1%), and TXA (5%) solution pressure pack and a control group (Group 3) was given normal saline (NS) pressure pack after extraction. Postoperative bleeding was assessed and graded numerically and periodically (0, 1, 2, 5 and 7 days). The values were statistically analyzed. Results Sixty patients (M:F::37:23) with a mean age of 56 years who were therapeutically anticoagulated for different medical conditions were included. The mean warfarin dosage was 3.5 mg, and the mean INR was 2.83. Out of 27 patients who showed bleeding on day of extraction, eight, ten and nine patients belonged to groups I, II and III, respectively, and the difference was nonsignificant. Out of 15 patients who showed bleeding on post-extraction day 1, one, five and nine patients belonged to groups I, II and III, respectively. The difference was statistically significant on day 1 and nonsignificant in the next follow-ups. Conclusion Local hemostatic agents like TXA and feracrylum arrest bleeding without having any systemic action and without the necessity of altering the anticoagulant regimen. Feracrylum has an added advantage of a single application, formation of a mechanical barrier and an additional antimicrobial effect. These agents should be incorporated in the protocol for managing patients on oral anticoagulants.
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Affiliation(s)
- Sachin Rai
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
| | - Vidya Rattan
- Unit of Oral and Maxillofacial Surgery, Oral Health Sciences Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, 160012 India
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Price A, Rai S, Mcleod RWJ, Birchall JC, Elhassan HA. Topical propranolol for infantile haemangiomas: a systematic review. J Eur Acad Dermatol Venereol 2018; 32:2083-2089. [PMID: 29569772 DOI: 10.1111/jdv.14963] [Citation(s) in RCA: 25] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2017] [Accepted: 03/05/2018] [Indexed: 12/28/2022]
Abstract
Infantile haemangiomas are the most common tumour of infancy. Whilst the majority are left untreated to involute spontaneously, residual skin changes commonly occur, particularly in superficial haemangiomas. The current first-line treatment for problematic lesions is oral propranolol; however due to the risk of systemic adverse effects, the use of off-label topical preparations has recently been investigated. Our systematic review was conducted in accordance with PRISMA guidelines. Four databases were searched to identify original articles evaluating the use of topical propranolol as the primary therapy for infantile haemangiomas. Twelve articles with a total of 597 patients and 632 haemangiomas were included. Three topical propranolol preparations were used, creams, ointments and gels and were all prepared by local pharmaceutical laboratories. The concentration of propranolol ranged from 0.5% to 5%. Treatment duration ranged from two weeks to 16.5 months. Overall, 90% of lesions improved following the initiation of topical propranolol. A good or excellent response, defined as a reduction in the size of at least 50%, was seen in 59% of lesions. Earlier initiation of treatment (less than 3 months of age) was associated with improved outcomes. No systemic adverse effects were reported. Minor local reactions were seen in 1.3% of patients. Topical propranolol is safer than oral propranolol, though may be less effective. Topical propranolol may be more suitable for patients with small, superficial haemangiomas at risk of cosmetic sequelae, where the cosmetic or symptomatic impact does not warrant oral propranolol treatment.
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Affiliation(s)
- A Price
- Wound Healing Research Unit, Cardiff University, Cardiff, UK
| | - S Rai
- School of Medicine, Cardiff University, Cardiff, UK
| | - R W J Mcleod
- ENT Department, University Hospital of Wales, Cardiff, UK
| | - J C Birchall
- School of Pharmacy and Pharmaceutical Sciences, Cardiff University, Cardiff, UK
| | - H A Elhassan
- ENT Department, University Hospital of Wales, Cardiff, UK
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Rai S, Bhardwaj U, Misra A, Singh S, Gupta R. Comparison between photostability of Alexa Fluor 448 and Alexa Fluor 647 with conventional dyes FITC and APC by flow cytometry. Int J Lab Hematol 2018; 40:e52-e54. [PMID: 29575796 DOI: 10.1111/ijlh.12809] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
Affiliation(s)
- S Rai
- Department of Laboratory Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - U Bhardwaj
- Maharaj Vinayak Global University, Jaipur, Rajasthan
| | - A Misra
- Department of Laboratory Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - S Singh
- Department of Laboratory Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
| | - R Gupta
- Department of Laboratory Oncology, All India Institute of Medical Sciences (AIIMS), New Delhi, India
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Weber SF, Bélard S, Rai S, Reddy R, Belurkar S, Saravu K. Immune thrombocytopenia secondary to tuberculosis: a case and review of literature. Int J Tuberc Lung Dis 2018; 21:466-470. [PMID: 28284263 DOI: 10.5588/ijtld.16.0515] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Immune thrombocytopenia (ITP) is an auto-immune condition that results in isolated thrombocytopenia associated with possibly lethal haemorrhage. In its secondary form, ITP can be triggered by many infectious and non-infectious conditions. Secondary ITP associated with tuberculosis (TB) has rarely been described in the literature. We report on a 22-year-old patient presenting with hypermenorrhoea and petechiae due to ITP secondary to tuberculous lymphadenitis. Normalisation of thrombocytopenia was only achieved after initiation of anti-tuberculosis treatment following failure of thrombocyte substitution and immune-modulatory treatment. A search of the literature available on TB-associated ITP identified 50 cases published between 1964 and 2016. We reviewed all cases using suggested case definitions on the likelihood of association between ITP and TB. A broad spectrum of TB sites was reported to be associated with ITP, and anti-tuberculosis treatment was the most effective therapy for platelet count normalisation. Time from initiation of anti-tuberculosis treatment to platelet count recovery ranged from 2 days to 3 months. In endemic regions, TB should be considered as an underlying cause of ITP. Early diagnosis of TB and initiation of anti-tuberculosis treatment appears crucial for rapid platelet count recovery, and can reduce the risks associated with long-term immunosuppression, transfusions and the time at risk for haemorrhage.
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Affiliation(s)
- S F Weber
- Department of Medicine, Kasturba Medical College, Manipal University, Manipal, India
| | - S Bélard
- Department of Paediatric Pneumology and Immunology, Charité-Universitätsmedizin Berlin, Berlin, Berlin Institute of Health, Berlin, Germany
| | - S Rai
- Department of Medicine, Kasturba Medical College, Manipal University, Manipal, India
| | - R Reddy
- Department of Medicine, Kasturba Medical College, Manipal University, Manipal, India
| | - S Belurkar
- Department of Pathology, Kasturba Medical College, Manipal University, Manipal
| | - K Saravu
- Department of Medicine, Kasturba Medical College, Manipal University, Manipal, India, Manipal McGill Center for Infectious Diseases, Manipal, India
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Alex R, Ramesha KP, Singh U, Kumar S, Alyethodi RR, Deb R, Rai S, Sharma S, Sengar GS, Kumar A, Prakash B. Association analysis of novel polymorphisms in 2', 5'-oligoadenylate synthetase gene with reproductive traits in indigenous and cross-bred cattle of Indian Origin. Reprod Domest Anim 2017; 53:442-449. [PMID: 29277982 DOI: 10.1111/rda.13129] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2017] [Accepted: 11/28/2017] [Indexed: 12/17/2022]
Abstract
2', 5'-Oligoadenylate synthetases (OAS) are important components of an interferon-mediated antiviral pathway. No polymorphisms in exonic regions of bovine OAS1 gene have been identified and associated with reproduction traits. The objective of the study was to detect and evaluate the effects of mutations in exonic region of bovine OAS1 gene with reproduction traits in cattle. DNA samples collected from 250 individual cows of two Indian dairy breeds (Sahiwal and Frieswal) of cattle were used in the study. The genetic variants of the OAS1 gene were identified with polymerase chain reaction-single-strand conformation polymorphism (PCR-SSCP) and sequence analysis using seven set of primer pairs. The PCR-SSCP analysis revealed polymorphism in the fragments comprising of exon 2, exon 5 and first fragment of exon 6 while the fragments of exons 1, 3, 4 and second fragment of exon 6 were monomorphic in Sahiwal and Frieswal cattle. The mutations in the amplified region comprising of exon 2 were found to have significant association with age at first breeding and calving, service period, dry period and pregnancy rate. Significant associations were found between SNPs in the exon 5 and service and dry periods of the animal, whereas the genetic variants in the first fragment of the exon 6 showed significant association with age at first breeding and calving. To our knowledge, this study demonstrated for the first time that the polymorphisms in OAS1 gene were associated with reproductive traits and it can be chosen as a candidate gene for improvement of reproductive performance of cattle.
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Affiliation(s)
- R Alex
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - K P Ramesha
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India.,Dairy Production, SRS, ICAR-National Dairy Research Institute, Banglore, India
| | - U Singh
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - S Kumar
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - R R Alyethodi
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - R Deb
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - S Rai
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India.,ERS, ICAR-National Dairy Research Institute, Kalyani, West Bengal, India
| | - S Sharma
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - G S Sengar
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - A Kumar
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
| | - B Prakash
- Animal Genetics and Breeding Section, ICAR-Central Institute for Research on Cattle, Meerut, UP, India
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Abstract
Abdominal tuberculosis (TB) tends to present with non-specific features and can be hard to diagnose. In the University Hospitals of Leicester, which serve a large immigrant population, 36 patients had this diagnosis between 1995 and 2001. We examined their records to identify features, including history, clinical presentation, investigations and diagnostic procedures, that might help with diagnosis of future cases. 32 of the patients were of Asian origin, predominantly from the Indian subcontinent. The most common presenting complaints were abdominal pain and weight loss. On clinical examination the findings were non-specific. Only 2 patients were found to have concurrent pulmonary TB. The most consistent laboratory finding (>90%) was a low haemoglobin with a raised C-reactive protein. The tuberculin test (Mantoux) was positive in only 7 patients (22%), and Ziehl-Neelsen staining of ascitic fluid was negative in all 11 patients in whom it was examined. An ultrasound scan of the abdomen revealed findings consistent with TB in 9/28 patients and a CT scan was helpful in 6/11. Laparoscopy, although usually performed as a last resort, proved the most effective investigation, yielding the diagnosis in 23 (92%) of the 25 patients in whom it was performed. In patients with the relevant background and clinical history, laparoscopy is the investigation of choice.
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Affiliation(s)
- S Rai
- Department of General Surgery, Leicester General Hospital, Gwendolen Road, Leicester LE5 4PW, UK.
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Young M, Rai S, Sproson C, Chang C, Browning T. 10 Months and Counting...Are You Ready to Safely Manage Your Ward? A Pilot Study Evaluating the Impact of a Simulated Surgical Ward Round for Final Year Medical Students. Int J Surg 2017. [DOI: 10.1016/j.ijsu.2017.08.034] [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: 10/18/2022]
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Johansen A, Boulton C, Burgon V, Rai S, Wakeman R. 21COGNITIVE IMPAIRMENT - PROFILING ITS IMPLICATIONS FOR PATIENTS WITH HIP FRACTURE. Age Ageing 2017. [DOI: 10.1093/ageing/afx115.21] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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