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Manohar K, Mittal BR, Agrawal K, Kashyap R, Bhattacharya A, Mandal AK. Response assessment to Sunitinib by F-18 Fluorodeoxyglucose PET/CT in a case of venous tumor thrombosis from renal cell carcinoma. Indian J Cancer 2014; 51:390. [PMID: 25494158 DOI: 10.4103/0019-509x.146770] [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]
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Kamaleshwaran KK, Mittal BR, Santhosh S, Kashyap R, Bhattacharya A, Mete UK. Detection and response evaluation of penile metastasis from urinary bladder carcinoma demonstrated by F-18 FDG PET/CT. Indian J Cancer 2014; 51:391-392. [PMID: 25494159 DOI: 10.4103/0019-509x.146772] [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]
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Smischney NJ, Velagapudi VM, Onigkeit JA, Pickering BW, Herasevich V, Kashyap R. Retrospective derivation and validation of a search algorithm to identify emergent endotracheal intubations in the intensive care unit. Appl Clin Inform 2013; 4:419-27. [PMID: 24155793 DOI: 10.4338/aci-2013-05-ra-0033] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2013] [Accepted: 08/16/2013] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND The development and validation of automated electronic medical record (EMR) search strategies are important in identifying emergent endotracheal intubations in the intensive care unit (ICU). OBJECTIVE To develop and validate an automated search algorithm (strategy) for emergent endotracheal intubation in the critically ill patient. METHODS The EMR search algorithm was created through sequential steps with keywords applied to an institutional EMR database. The search strategy was derived retrospectively through a secondary analysis of a 450-patient subset from the 2,684 patients admitted to either a medical or surgical ICU from January 1, 2010, through December 31, 2011. This search algorithm was validated against an additional 450 randomly selected patients. Sensitivity, specificity, and negative and positive predictive values of the automated search algorithm were compared with a manual medical record review (the reference standard) for data extraction of emergent endotracheal intubations. RESULTS In the derivation subset, the automated electronic note search strategy achieved a sensitivity of 74% (95% CI, 69%-79%) and a specificity of 98% (95% CI, 92%-100%). With refinements in the search algorithm, sensitivity increased to 95% (95% CI, 91%-97%) and specificity decreased to 96% (95% CI, 92%-98%) in this subset. After validation of the algorithm through a separate patient subset, the final reported sensitivity and specificity were 95% (95% CI, 86%-99%) and 100% (95% CI, 98%-100%). CONCLUSIONS Use of electronic search algorithms allows for correct extraction of emergent endotracheal intubations in the ICU, with high degrees of sensitivity and specificity. Such search algorithms are a reliable alternative to manual chart review for identification of emergent endotracheal intubations.
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Chauhan V, Kumar RV, Mahesh DM, Kashyap R, Thakur S. Adult type 3 Gaucher disease as manifestation of R463C/Rec Nci I mutation: first reported case in the world literature. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2013; 61:346-348. [PMID: 24482953] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
Gaucher disease is the most common lysosomal storage disorder. It is autosomal recessive in nature and results from mutations in the GBA gene coding for acid beta glucosidase. It is classified into three types based on CNS involvement and its severity. Type 3, or chronic neuronopathic Gaucher disease, generally has an onset in childhood and by definition, includes all patients with any form of neurologic involvement who have survived the first few years of life. Here we present a 36 year old male patient presenting with hip pain showing bilateral avascular necrosis of femoral head with massive splenomegaly and on evaluation, showed mental retardation, seizures, bilateral vertical and horizontal gaze palsies and eventually turned out to be type 3b Gaucher disease. This is the first case of Type 3 Gaucher disease being reported from India with mutation analysis and only case of Type 3 Gaucher disease in world literature showing R463C/Rec Nci I mutation.
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Harisankar CNB, Mittal BR, Kashyap R, Bhattacharya A, Singhi S. (18)F-FDG Positron Emission Tomography in Multifocal Pyomyositis. World J Nucl Med 2012; 11:22-3. [PMID: 22942778 PMCID: PMC3425224 DOI: 10.4103/1450-1147.98741] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
18F-Fluoro-deoxyglucose–positron emission tomography/computed tomography findings in a case presenting with pyomyositis are presented in this report.
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Barry CT, D'Souza M, McCall M, Safadjou S, Ryan C, Kashyap R, Marroquin C, Orloff M, Almudevar A, Godfrey TE. Micro RNA expression profiles as adjunctive data to assess the risk of hepatocellular carcinoma recurrence after liver transplantation. Am J Transplant 2012; 12:428-37. [PMID: 22008552 DOI: 10.1111/j.1600-6143.2011.03788.x] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Donor livers are precious resources and it is, therefore, ethically imperative that we employ optimally sensitive and specific transplant selection criteria. Current selection criteria, the Milan criteria, for liver transplant candidates with hepatocellular carcinoma (HCC) are primarily based on radiographic characteristics of the tumor. Although the Milan criteria result in reasonably high survival and low-recurrence rates, they do not assess an individual patient's tumor biology and recurrence risk. Consequently, it is difficult to predict on an individual basis the risk for recurrent disease. To address this, we employed microarray profiling of microRNA (miRNA) expression from formalin fixed paraffin embedded tissues to define a biomarker that distinguishes between patients with and without HCC recurrence after liver transplant. In our cohort of 64 patients, this biomarker outperforms the Milan criteria in that it identifies patients outside of Milan who did not have recurrent disease and patients within Milan who had recurrence. We also describe a method to account for multifocal tumors in biomarker signature discovery.
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Negi RC, Kumar J, Kumar V, Singh K, Bharti V, Gupta D, Kashyap R, Raina S. Vitamin B12 deficiency presenting as pyrexia. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2011; 59:379-380. [PMID: 21751594] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Abstract
Vitamin B12 deficiency is an uncommon cause of pyrexia. We report the case of a patient who presented with pyrexia and anaemia, which after exclusion of infective, inflammatory or endocrine causes was attributed to megaloblastic anaemia secondary to vitamin B12 deficiency. The patient's fever responded to treatment of vitamin B12 deficiency.
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Gnanasekaran I, Kashyap R, Gunduz Y, Arampulikan J, Shergill S. 101 Proven Strategies to Improve Vascular Access Outcomes in an Inner City Hospital Based Hemodialysis Unit Serving Minority Population. Am J Kidney Dis 2011. [DOI: 10.1053/j.ajkd.2011.02.104] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Connolly GC, Safadjou S, Kashyap R, Chen R, Ndauguba A, Dunne R, Maliakal B, Khorana AA, Orloff M, Hezel AF. Impact of diabetes mellitus on risk of major vessel invasion and distant metastasis in hepatocellular carcinoma. J Clin Oncol 2011. [DOI: 10.1200/jco.2011.29.4_suppl.174] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
174 Background: Diabetes mellitus (DM) is identified as a negative prognostic indicator in hepatocellular carcinoma (HCC), though the basis for this is unknown. Methods: We conducted a retrospective review of 279 advanced and 191 transplanted HCC patients diagnosed between 1998 and 2008. Logistic regression analyses were conducted to assess the effect of clinical DM on clinical outcomes including distant metastasis and vascular invasion. Results: Eighty- four of 191 (44%) transplanted patients had DM at time of transplantation and 97 of 279 (34%) nontransplanted patients had DM at the time of diagnosis. The presence of DM was associated with an older age at time of diagnosis and a higher prevalence of hepatitis C virus (HCV) and nonalcoholic steatohepatitis (NASH). Also 30% (30/97) of diabetics compared to only 9.3% (17/182) of nondiabetics (p<0.0001) among the cohort with advanced disease had distant metastasis at the time of initial diagnosis, and this difference remained significant when adjusting for CLIP stage, age, and etiologic risk factors in a multivariate logistic regression analysis (OR=8.3, p<0.0001). The association of DM with invasive disease was echoed among early stage transplanted HCC patients in whom histologically confirmed macrovascular invasion was higher among patients with DM compared to those without (20.5% vs. 9.5%, p=0.032). The association of DM with increased risk of macrovascular invasion remained significant in a multivariate logistic regression analysis when adjusting for tumor size, number of nodules, age, obesity and etiologic risk factors (OR=3.2, p=0.025). Conclusions: DM was associated with significantly higher incidence of histological macrovascular invasion in a large cohort of HCC patients receiving liver transplantation and a significantly higher rate of distant metastatic disease at diagnosis in a large cohort of HCC patients with advanced disease. No significant financial relationships to disclose.
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Kashyap R, Mittal B, Kumari S, Bhattacharya A, Singh B. Retroperitoneal fibrosis masquerading as para-aortic lymphadenopathy on F-18 FDG PET/CT in a patient with carcinoma cervix. World J Nucl Med 2011; 10:23-4. [PMID: 22034580 PMCID: PMC3198043 DOI: 10.4103/1450-1147.82113] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
We present a case of carcinoma cervix found to have a soft tissue lesion in retroperitoneal region with intense FDG uptake. However, this FDG uptake was false positive as the final diagnosis was retroperitoneal fibrosis.
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Chawla S, Hezel A, Qu Z, Kashyap R, Philip A, Orloff M, Smudzin T, Katz A. Stereotactic Body Radiation Therapy as Definitive Therapy or Bridge to Transplant for Hepatocellular Carcinoma: Clinical Outcome and Pathologic Correlation. Int J Radiat Oncol Biol Phys 2010. [DOI: 10.1016/j.ijrobp.2010.07.206] [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]
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Kashyap R, Pradhan M. Maternal and fetal outcome in pregnancy-associated pure red cell aplasia. J OBSTET GYNAECOL 2010; 30:733-4. [DOI: 10.3109/01443615.2010.501919] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Lapointe J, Durette JF, Harhira A, Shaat A, Boulos PR, Kashyap R. A 'living' prosthetic iris. Eye (Lond) 2010; 24:1716-23. [PMID: 20847748 DOI: 10.1038/eye.2010.128] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
AIM To design and demonstrate dynamic pupils, which react to light for use with ocular prostheses. METHODS The realism of ocular prostheses is limited by the immobility of the pupil. Our solution is to use a liquid crystal display (LCD) in the prosthesis to vary the pupil size as a function of the ambient light. Several liquid crystal cells were fabricated and tested for survivability through the ocular prosthesis manufacturing process. The dynamic pupil is controlled by a novel and entirely autonomous, self-powered passive electronic circuit using a solar cell, matching the minimum diameter of the pupil. RESULTS The first LCD surviving the rugged conditions of the ocular prosthesis manufacturing steps and an entirely passive circuit controlling the pupil have been demonstrated for the first time to our knowledge. A design for a complete prosthesis with a dynamic pupil has been proposed. Finally, a standard device for the mass production of ocular prostheses is presented. CONCLUSION We have shown that a practical solution for an autonomous self-powered dynamic pupil is possible, given the constraints of size, fabrication process, weight, cost and manufacturability on a mass scale. We envision that the LCD could be mass produced, and only the final steps for the integration of the iris matched to a patient would be necessary before assembly using standard processing steps for the production of the prosthesis. Using a clinical trial, we hope to demonstrate that the dynamic pupil will have a positive impact on the quality of life of patients.
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Warnakulasuriya S, Kashyap R, Dasanayake AP. Is workplace screening for potentially malignant oral disorders feasible in India? J Oral Pathol Med 2010; 39:672-6. [DOI: 10.1111/j.1600-0714.2010.00915.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Kashyap R, Safadjou S, Hezel A, Khorana A, Cullen J, Agarwal S, Ramalingam S, Ramaraju G, Maliakkal B, Marroquin C, Barry C, Orloff M. STEREOTACTIC BODY RADIATION THERAPY TREATMENT FOR PATIENTS WITH HEPATOCELLULAR CARCINOMA AWAITING LIVER TRANSPLANT. Transplantation 2010. [DOI: 10.1097/00007890-201007272-01520] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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41
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Trillo-Alvarez C, Cartin-Ceba R, Kor DJ, Kojicic M, Kashyap R, Thakur S, Thakur L, Herasevich V, Malinchoc M, Gajic O. Acute lung injury prediction score: derivation and validation in a population-based sample. Eur Respir J 2010; 37:604-9. [PMID: 20562130 DOI: 10.1183/09031936.00036810] [Citation(s) in RCA: 109] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
Abstract
Early recognition of patients at high risk of acute lung injury (ALI) is critical for successful enrollment of patients in prevention strategies for this devastating syndrome. We aimed to develop and prospectively validate an ALI prediction score in a population-based sample of patients at risk. In a retrospective derivation cohort, predisposing conditions for ALI were identified at the time of hospital admission. The score was calculated based on the results of logistic regression analysis. Prospective validation was performed in an independent cohort of patients at risk identified at the time of hospital admission. In a derivation cohort of 409 patients with ALI risk factors, the lung injury prediction score discriminated patients who developed ALI from those who did not with an area under the curve (AUC) of 0.84 (95% CI 0.80-0.89; Hosmer-Lemeshow p = 0.60). The performance was similar in a prospective validation cohort of 463 patients at risk of ALI (AUC 0.84, 95% CI 0.77-0.91; Hosmer-Lemeshow p = 0.88). ALI prediction scores identify patients at high risk for ALI before intensive care unit admission. If externally validated, this model will serve to define the population of patients at high risk for ALI in whom future mechanistic studies and ALI prevention trials will be conducted.
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Connolly GC, Safadjou S, Kashyap R, Orloff M, Khorana AA, Hezel AF. The impact of diabetes mellitus on survival in hepatocellular carcinoma. J Clin Oncol 2010. [DOI: 10.1200/jco.2010.28.15_suppl.e14596] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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43
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Afessa B, Schramm G, Kashyap R, Gajic O. Mortality rate of vasopressor-dependent septic shock from 1997 through 2006. Crit Care 2009. [PMCID: PMC4084383 DOI: 10.1186/cc7661] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Stead LG, Vaidyanathan L, Bellolio MF, Kashyap R, Bhagra A, Gilmore RM, Decker WW, Enduri S, Suravaram S, Mishra S, Nash D, Wood HM, Yassa AS, Hoff AM, Brown RD. Knowledge of signs, treatment and need for urgent management in patients presenting with an acute ischaemic stroke or transient ischaemic attack: a prospective study. Emerg Med J 2008; 25:735-9. [DOI: 10.1136/emj.2008.058206] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Kashyap R, Herasevich V, Afessa B, Gajic O, Stead L, Decker W, Smith V. 45: Computerized Recruiting for Clinical Research in the Emergency Department. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.06.110] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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Kashyap R, Hess E, Campbell R, Bellolio M, Sztajnkrycer M, Smith V, Schears R, White R, Afessa B, Gajic O, Stead L. 37: Lower Thoracic Fluid Impedance Measured Non-invasively by Impedance Cardiography Predicts ICU Admission and In-hospital Mortality in Emergency Department Shock Patients. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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47
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Suravaram S, Bellolio M, Enduri S, Kashyap R, Brown R, Decker W, Stead L. 117: Presence of Pain in Patients With Stroke or Transient Ischemic Attack Coming to the Emergency Department. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Vaidyanathan L, Bellolio M, Nash D, Enduri S, Kashyap R, Suravaram S, Stead L. 173: Functional Outcome Following an Acute Ischemic Stroke: Sex Differences. Ann Emerg Med 2008. [DOI: 10.1016/j.annemergmed.2008.01.142] [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]
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Mahajan SK, Kashyap R, Sankhyan N, Sharma V, Rolain JM, Prasher BS, Raoult D. Spotted fever group rickettsioses in Himachal Pradesh. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2007; 55:868-870. [PMID: 18405137] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Abstract
Rickettsiae are in many places of the world emerging or reemerging pathogens. The spotted fevers group (SFG) composes a large group of tick- and mite-borne zoonotic infections that are caused by closely related rickettsiae. The SFG rickettsiae of Southeast Asia are yet to be identified. Earlier reports have documented the endemicity of rickettsioses among adults in the Himalayan belt but no confirmed case of spotted fever have been reported from this region of India. We present two cases of SFG rickettsioses; from the northern hilly region of India that were confirmed using specific microimmunofluorescence assay.
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Kaushik ML, Sharma M, Kashyap R. 'Himalayan' p wave. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2007; 55:856. [PMID: 18405133] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
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