26
|
Ekmejian A, Cohen R, Vijayarajan V, Zaky F, Moragues J, David T, Yeung A, Owensby D, Shetty P, Nguyen-Dang T, Shetty P, Lee A, Danson E. Correlation Between Radial Artery Anomalies and Procedural Outcomes of Trans-radial Coronary Catheterisation. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.604] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
27
|
Zaky F, Rooney M, Ghodsian M, Shetty P. The CRE8 Polymer-free Amphilimus-eluting Coronary Stent. Real World Data from a Tertiary Hospital. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.696] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
28
|
Zaky F, Kan W, Norman S, Vijayarajan V, Cohen R, Bonin C, Clingan E, Elison B, Shetty P. GRACE Risk Assessment Provides Additional Value to MPS in Prediction of MACE and PCI. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.389] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
|
29
|
Zaky F, Vijayarajan V, Cohen R, Ekmejian A, Shetty P. Coronary Outcomes in Patients with Negative Fractional Flow Reserve (FFR) Studies. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.06.602] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
|
30
|
Searle A, Shetty P, Melov SJ, Alahakoon TI. Prenatal diagnosis and implications of microphthalmia and anophthalmia with a review of current ultrasound guidelines: two case reports. J Med Case Rep 2018; 12:250. [PMID: 30153864 PMCID: PMC6114735 DOI: 10.1186/s13256-018-1746-4] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2018] [Accepted: 06/12/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND Microphthalmia and anophthalmia are rare congenital fetal abnormalities. The combined incidence is estimated at 1 in 10,000 births. These two conditions arise from complex and incompletely understood genetic and/or environmental causes. Prenatal diagnosis is neither frequent nor easy and relies on precise, high-quality ultrasonography. Current antenatal ultrasound protocols for imaging of the fetal eye are inconsistent and inadequate to screen for the spectrum of ocular malformations, and there are no clear guidelines on detection of these rare abnormalities. Our study of two cases highlights the importance of early detection, and we review current practice and suggest a definitive fetal imaging protocol. CASE PRESENTATION We present two antenatal cases, one each of microphthalmia and anophthalmia, both diagnosed at the morphology scan at our tertiary fetal medicine unit. In both cases, the parents (a 36-year-old woman of Mauritanian ethnicity and a non-consanguineous partner of Nepalese descent, and a 31-year-old Caucasian woman and non-consanguineous Caucasian partner) elected to terminate their pregnancies and made unremarkable recoveries. Subsequent fetal autopsy confirmed the ultrasound scan findings. CONCLUSIONS We recommend that antenatal ultrasound guidelines are updated to specify use of a curvilinear transducer (2-9 MHz) to image both orbits in the axial and coronal planes, aided by use of a transvaginal probe when the transabdominal approach is inadequate to generate these images. When applicable, three-dimensional reverse-face imaging should be obtained to aid the diagnosis. The presence, absence, or non-visualization of lenses and hyaloid arteries should be documented in reports and these cases referred for a tertiary-level ultrasound scan and fetal medicine review. Imaging of the orbits should occur from 12 weeks' gestation. Magnetic resonance imaging and amniocentesis with chromosome microarray testing may provide additional genetic and structural information that may affect the overall morbidity associated with a diagnosis of microphthalmia or anophthalmia.
Collapse
|
31
|
Fernandes S, Singh A, Bhat R, Shetty P. A cadaveric study of fibular (peroneal) artery continuing as dorsalis pedis artery associated with hypoplastic anterior tibial artery and its developmental basis. J ANAT SOC INDIA 2018. [DOI: 10.1016/j.jasi.2018.06.019] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
32
|
Vijayarajan V, Ekmejian A, Zaky F, Shetty P. The Use of CHA2DS2VASc Score in Predicting the Outcome of Electrical Cardioversion in Patients with Persistent atrial Fibrillation Immediately Post–Cardioversion and at 4 Weeks. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.350] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
33
|
Eather S, Ekmejian A, Lim R, Zaky F, Owensby D, Yeung A, Shetty P, Sepahpour A, Hsieh C, Lee A. Atrial Fibrillation: A Descriptive Study of Management in a Large Cardiology Practice. Heart Lung Circ 2018. [DOI: 10.1016/j.hlc.2018.06.241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
|
34
|
Nayak SB, Shetty P, Reghunathan D, Aithal AP, Kumar N. Descendens vagohypoglossi: rare variant of the superior root of ansa cervicalis. Br J Oral Maxillofac Surg 2017; 55:834-835. [PMID: 28662922 DOI: 10.1016/j.bjoms.2017.06.007] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2017] [Accepted: 06/13/2017] [Indexed: 11/25/2022]
Abstract
Knowledge of variants in the formation and position of the ansa cervicalis is important in head and neck surgery, specifically in reconstructions of the tongue that use the infrahyoid muscles, and in the anastomosis of the ansa cervicalis to the recurrent laryngeal nerve when the laryngeal muscles have been paralysed. We describe a rare variant of the superior root of the ansa cervicalis, which had a contribution from the vagus and hypoglossal nerves. The inferior root was formed by the C2 and C3 ventral rami, but it passed medial to the internal jugular vein before it joined the superior root to form the loop.
Collapse
|
35
|
Shaila M, Shetty P, Pai P. A new approach to exfoliative cytology: A comparative cytomorphometric study. Indian J Cancer 2017; 53:193-8. [PMID: 27146777 DOI: 10.4103/0019-509x.180830] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
CONTEXT Early detection of oral premalignancy and malignancy using simple screening aids play a promising role in curbing the disease. AIM The primary aim of this study is to evaluate and the secondary aim of this study is to compare the cytomorphometry and cellular atypia in keratinocytes obtained from oral rinse and conventional exfoliative cytology in normal oral mucosa and clinically diagnosed oral leukoplakia. MATERIALS AND METHODS The study comprised of 55 clinically diagnosed cases of leukoplakia and 55 age and sex matched normal controls. Smears were prepared using oral rinse technique followed by the conventional exfoliative cytology. Papanicoloau stained smears were evaluated for atypia and subjected to image analysis. Based on the presence of atypia they were further divided into three groups (Group 1-cases with atypia, Group 2-without atypia and Group 3-normal controls) and analyzed. Statistical analysis used one-way analysis of variance followed by Tukey Honestly Significant Difference test for intergroup analysis and unpaired students t-test to compare the two methods. RESULTS Smears prepared with both methods demonstrated atypia in 18 cases. The cellular diameter and cellular area (CA) were progressively increased from Group 1 through Groups 2 and 3 in both the smears. Nuclear diameter and nuclear area and nuclear cytoplasmic ratio progressively decreased from Group 1 through Groups 2 and 3. Both the methods showed no significant differences among the cellular parameters except in normal controls. CONCLUSION Cytomorphometric analysis of keratinocytes obtained with oral rinse method and wooden spatula can serve as a useful screening aid to detect oral leukoplakia. Oral rinse method being more convenient results in smears of better quality.
Collapse
|
36
|
Tonse R, Sood S, Gupta T, Moiyadi A, Upreti R, Shastri J, Shetty P, Mahajan A, Bano N, Jalali R. P09.61 Detailed analysis and correlation of survival with subventricular zone dosimetry in patients diagnosed with glioblastoma treated with focal conformal radiotherapy: Results of a prospective trial. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.316] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
37
|
Gupta T, Gupta M, Rangarajan V, Purandare N, Sastri G, Menon H, Moiyadi A, Shetty P, Epari S, Jalali R. P15.01 Clinical utility of FDG-PET/CT for diagnosis and staging in patients with primary central nervous system lymphoma: prospective single arm study. Neuro Oncol 2017. [DOI: 10.1093/neuonc/nox036.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
|
38
|
Shukla T, Jabeen Taj R, Kulkarni K, Shetty P, Viswanath B, Purushottam M, Reddy Y, Jain S. Pharmacogenetic Association Between Glutamatergic Genes and Sri Treatment Response in Obsessive Compulsive Disorder. Eur Psychiatry 2017. [DOI: 10.1016/j.eurpsy.2017.01.1886] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
IntroductionPharmacogenetic studies in obsessive-compulsive disorder (OCD) primarily focussing on serotonergic and dopaminergic polymorphisms, provided inconsistent findings. There is recent evidence for glutamatergic abnormalities in OCD.AimsExamine the association glutamatergic genes with serotonin reuptake inhibitor (SRI) response in OCD.ObjectivesTo study pharmacogenetic association between SLC1A1 and GRIN2B polymorphisms with SRI response in OCD.MethodsDSM-IV OCD patients were recruited from a specialty OCD clinic and evaluated using the Yale-Brown obsessive compulsive scale (YBOCS), Mini International Neuropsychiatric Interview (MINI) plus, Clinical Global Impression scale (CGI). They were subsequently reassessed with YBOCS and CGI. To study extreme phenotypes, we included only full responders (> 35% YBOCS improvement and CGI-I score of 1 or 2) to any SRI (n = 191) and non-responders (< 25% YBOCS improvement and CGI-I score ≥ 4) to adequate trial of at least two SRIs (n = 84). Partial responders were excluded. Genotyping was performed using an ABI9700 PCR machine.ResultsGenotype frequencies did not deviate significantly from the values predicted by the Hardy-Weinberg equation. Case-control association analyses revealed no significant association between genotype/allele frequencies with SRI response.ConclusionOur data does not show any association between polymorphisms in glutamatergic genes and SRI response in OCD though such associations have been found in other studies. More SNP's in the same gene could be responsible for the pharmacogenetic associations. More homogenous sample considering symptom dimensions and other phenotypic variables may be needed. It may be critical to go beyond “usual suspect” candidate gene research. In this regard, a novel approach to identify SRI response biomarkers is the use of cellular models.Disclosure of interestThe authors have not supplied their declaration of competing interest.
Collapse
|
39
|
Shetty P, Mulay S, Chawala M, Shaikh M, Sawant S. Comparative evaluation of alkaline phosphatase levels in dental pulp of diabetic and nondiabetic individuals. JOURNAL OF DENTAL RESEARCH AND REVIEW 2017. [DOI: 10.4103/jdrr.jdrr_2_18] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
|
40
|
Agarwal PK, Singh P, Chowdhury S, Sharma SK, Majumdar A, Shah P, Sahay R, Ayyar SV, Phatale H, Batra CM, Syed R, Shetty P. A study to evaluate the prevalence of hypogonadism in Indian males with Type-2 diabetes mellitus. Indian J Endocrinol Metab 2017; 21:64-70. [PMID: 28217500 PMCID: PMC5240083 DOI: 10.4103/2230-8210.196008] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
BACKGROUND A high prevalence of hypogonadism in men with Type-2 diabetes mellitus (T2DM) has been reported worldwide. OBJECTIVES To evaluate the prevalence of hypogonadism in Indian males with T2DM and assess the primary and secondary hypogonadism along with androgen deficiency. MATERIALS AND METHODS In this cross-sectional study, 900 men with T2DM were evaluated using androgen deficiency in aging male questionnaire. They were screened for demographic characteristics, gonadal hormone levels, lipid profile, and glycosylated hemoglobin. RESULTS The prevalence of hypogonadism in T2DM patients was found to be 20.7% (186 out of 900). Hypogonadism was of testicular origin (primary) in 48/186 (25.8%) patients, of pituitary or hypothalamic origin (secondary) in 14/186 (7.53%), and remaining 124/186 (66.67%) patients were found to have low testosterone with the inappropriate normal level of luteinizing hormone and Follicle-stimulating hormone. 451/900 (50.1%) patients were only symptomatic but had normal testosterone levels. Further 263 patients out 900 were asymptomatic, of which 51/900 (5.7%) patients had low levels of testosterone and 212/900 (23.5%) patients had normal testosterone level without symptoms. There were no deaths or other serious adverse events except mild pyrexia which was not related to the study. CONCLUSION Hypogonadism diagnosis, at times, might not be validated with the help of androgen deficiency questionnaire or symptoms only. Given the large number of patients of T2DM in India, the incidence of hypogonadism is more in diabetic patients as compared to the general population. Hence, implementation of screening programs in diabetic patients is necessary to understand and detect individuals with low serum total testosterone at any early stage and to supplement testosterone accordingly.
Collapse
|
41
|
Zaky F, Ekmejian A, Evans O, Lynch C, Dejanipont S, Shetty P. Recurrent 12-Month Myocardial Infarction Rates in Patients Discharged with Acute Coronary Syndrome: A Retrospective Analysis from a Regional Referral Centre. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
42
|
Shetty S, Shetty P. Bleeding and In-hospital Outcomes in STEMI Patients Treated with Combination of Potent Thienopyridine and Fibrinolytic Therapy, Primary Percutaneous Intervention, Rescue Percutaneous Intervention or Routine Percutaneous Intervention Post Fibrinolytic Therapy in a Regional Setting. Heart Lung Circ 2017. [DOI: 10.1016/j.hlc.2017.06.361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
|
43
|
Ghoshal AG, Ravindran GD, Gangwal P, Rajadhyaksha G, Cho SH, Muttalif ARBA, Lin HC, Thanaviratananich S, Bagga S, Faruqi R, Sajjan S, Shetty P, Syed R, Hamrosi KK, Wang DY. The burden of segregated respiratory diseases in India and the quality of care in these patients: Results from the Asia-Pacific Burden of Respiratory Diseases study. Lung India 2016; 33:611-619. [PMID: 27890989 PMCID: PMC5112817 DOI: 10.4103/0970-2113.192878] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Chronic respiratory diseases such as asthma, allergic rhinitis (AR), chronic obstructive pulmonary disease (COPD), and rhinosinusitis are becoming increasingly prevalent in the Asia-Pacific region. The Asia-Pacific Burden of Respiratory Diseases study examined the disease and economic burden of AR, asthma, COPD, and rhinosinusitis across the Asia-Pacific and more specifically India. OBJECTIVES To estimate the proportion of adults receiving care for asthma, AR, COPD, and rhinosinusitis and assess the economic burden, both direct and indirect of these chronic respiratory disease. SUBJECTS AND METHODS Consecutive participants aged ≥18 years with a primary diagnosis of asthma, AR, COPD, or rhinosinusitis were enrolled. Surveys comprising questions about respiratory disease symptoms, healthcare resource utilization, work productivity, and activity impairment were completed by treating physicians and participants during one study visit. Costs, indirect and direct, that contributed to treatment for each of the four respiratory diseases were calculated. RESULTS A total of 1000 patients were enrolled. Asthma was the most frequent primary diagnosis followed by AR, COPD, and rhinosinusitis. A total of 335 (33.5%) patients were diagnosed with combinations of the four respiratory diseases; the most frequently diagnosed combinations were asthma/AR and rhinosinusitis/AR. Cough or coughing up sputum was the primary reason for the current visit by patients diagnosed with asthma and COPD while AR patients reported a watery, runny nose, and sneezing; patients with rhinosinusitis primarily reported a colored nasal discharge. The mean annual cost per patient was US$637 (SD 806). The most significant driver of direct costs was medications. The biggest cost component was productivity loss. CONCLUSIONS Given the ongoing rapid urbanization of India, the frequency of respiratory diseases and their economic burden will continue to rise. Efforts are required to better understand the impact and devise strategies to appropriately allocate resources.
Collapse
|
44
|
|
45
|
|
46
|
Femia G, Fetahovic T, Nguyen-Dang T, Yeung A, Shetty P, Lee A. Novel Oral Anticoagulants for Direct Current Cardioversion Procedures. Heart Lung Circ 2016. [DOI: 10.1016/j.hlc.2016.06.041] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
|
47
|
Anam J, Uday K, Shetty P, Moiyadi A, Epari S, Jalali R. Aggressive spinal glioblastoma in a child with adrenocortical adenoma--Case report and review of literature. Indian J Cancer 2016; 52:660-2. [PMID: 26960510 DOI: 10.4103/0019-509x.178392] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
48
|
Ghose J, Prabhash K, Shetty P, Moiyadi AV. Metachronous intradural and liver metastasis from adrenocortical carcinoma. Indian J Cancer 2016; 52:666-8. [PMID: 26960512 DOI: 10.4103/0019-509x.178397] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
49
|
Shetty P. Glucoamylase from the Predacious Fungus Arthrobotrys conoides: a Cationic Enzyme with High Debranching Activity and Raw Starch Digestibility. APPL BIOCHEM MICRO+ 2016. [DOI: 10.1134/s0003683816020150] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
|
50
|
Bonanthaya K, Rao DD, Shetty P, Uguru C. Correlation of vermilion symmetry to alveolar cleft defect in unilateral cleft lip repair. Int J Oral Maxillofac Surg 2016; 45:688-91. [PMID: 26754270 DOI: 10.1016/j.ijom.2015.11.019] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2015] [Revised: 10/09/2015] [Accepted: 11/26/2015] [Indexed: 10/22/2022]
Abstract
Asymmetry is a major problem in repaired unilateral cleft lip (UCL). One of the important manifestations of this is the asymmetry of the vermilion. The aim of this study was to correlate the severity of the asymmetry in the vermilion to the size of the alveolar defect. Twenty patients aged between 6 and 18 months with complete unilateral cleft lip, alveolus, and palate were included. An impression of each patient's alveolus at the time of cheiloplasty was taken using silicon rubber base material, and a study cast was prepared. The width of the cleft alveolus was measured on these casts using a transparent grid. Frontal photographs were taken at 6 months postoperative and vermilion symmetry was measured as the ratio between the cleft and non-cleft sides. The results obtained in this study showed a direct correlation between the size of the alveolar defect and the vermilion symmetry in repaired UCL. The wider the cleft alveolus and greater the antero-posterior discrepancy, the greater is the vermilion asymmetry. The asymmetry of the vermilion in UCL after repair is directly dependent on the size of the alveolar defect. The alveolar discrepancy causes 'in-rolling' of the vermilion on the cleft side and affects the vermilion symmetry.
Collapse
|