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Santra S, Kethepalli J, Agarwal S, Dhar A, Kulkarni M, Kundu A. Gap Statistics for Confined Particles with Power-Law Interactions. PHYSICAL REVIEW LETTERS 2022; 128:170603. [PMID: 35570430 DOI: 10.1103/physrevlett.128.170603] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/07/2021] [Accepted: 03/25/2022] [Indexed: 06/15/2023]
Abstract
We consider the N particle classical Riesz gas confined in a one-dimensional external harmonic potential with power-law interaction of the form 1/r^{k}, where r is the separation between particles. As special limits it contains several systems such as Dyson's log-gas (k→0^{+}), the Calogero-Moser model (k=2), the 1D one-component plasma (k=-1), and the hard-rod gas (k→∞). Despite its growing importance, only large-N field theory and average density profile are known for general k. In this Letter, we study the fluctuations in the system by looking at the statistics of the gap between successive particles. This quantity is analogous to the well-known level-spacing statistics which is ubiquitous in several branches of physics. We show that the variance goes as N^{-b_{k}} and we find the k dependence of b_{k} via direct Monte Carlo simulations. We provide supporting arguments based on microscopic Hessian calculation and a quadratic field theory approach. We compute the gap distribution and study its system size scaling. Except in the range -1<k<0, we find scaling for all k>-2 with both Gaussian and non-Gaussian scaling forms.
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Chennamsetty EP, Jain A, Kaur D, Meinia SK, Negi G, Agarwal S, Deb J. Life-saving transfusion in autoimmune hemolytic anemia: a case report and procedure review of the dilution method. Immunohematology 2022; 38:13-16. [PMID: 35852059 DOI: 10.21307/immunohematology-2022-035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
A woman with autoimmune hemolytic anemia (AIHA) presented in the emergency department with life-threatening anemia (hemoglobin 3 g/dL). Exaggeration of preexisting chronic anemia to severe anemia after a recent red blood cell (RBC) transfusion led to suspicion of delayed hemolytic transfusion reaction. Given the urgency for transfusion along with a stronger suspicion for coexistence of an alloantibody, the dilution method proposed by Lawrence Petz and George Garratty was used to find an RBC unit for transfusion. An alloantibody with Fyb specificity was identified, which was masked by the coexistent autoantibody. This method is based on the assumption that the titers of an alloantibody are higher than that of autoantibody. Diluting the autoantibody would reveal the alloantibody and, for this purpose, a serial doubling dilution of serum is performed. This method has an important limitation of missing any alloantibodies with titers less than that of the autoantibody. In spite of this, this method may be of use at a resource-poor setting, where trained personnel and other reagents intended for advanced immunohematology methods are unavailable.
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Agarwal S. Clinicopathologic spectrum of newly diagnosed multiple myeloma presenting with renal impairment: A tertiary care center experience from north India. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2022; 70:11-12. [PMID: 35443439] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Abstract
UNLABELLED Multiple myeloma (MM) is a hematologic malignancy, characterized by the neoplastic proliferation of plasma cells producing a monoclonal immunoglobulin. Patients presents with signs and symptoms related to the infiltration of plasma cells into the bone or other organs or to kidney damage from excess light chains. Renal involvement with various presentations may be the first manifestation of the disease. MATERIAL All patients of MM presenting with renal dysfunction between July 2019 to June 2021 were included. Diagnosis of MM was made according to the 2014 guidelines of international myeloma working group. OBSERVATION Out of total 144 cases of multiple myeloma renal involvement was present in 43 (29.8%). Mean age of study population was 55.49 years with 72% males. Most common clinical features were fatigue (59%), anorexia (47%) & edema (42%). Anemia was present in 79%, hypercalcemia in 16.2% and hyperuricemia in 20.9% patients. Renal failure was present in 72.1% with a mean eGFR 35.8 ml/min/1.73m2. Serum protein electrophoresis revealed M band in 81.4% and all except one patient had increased light chains in serum. Most common histological lesion were myeloma cast nephropathy (39.5%), primary amyloidosis (30.2%) & monoclonal immunoglobulin deposition disease (14%). Primary amyloidosis group had maximum 24-hour proteinuria and highest eGFR. CONCLUSION The spectrum of renal involvement in multiple myeloma is heterogenous. It mainly affects middle and elderly age group. Typical clinical features might not be seen in all the cases and therefore a high index of suspicion in unexplained renal failure cases might help in early diagnosis and timely management.
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Kota PB, Kota AA, Agarwal S, Keshava SN. De novo arteriovenous malformations in post-thrombotic limbs. BMJ Case Rep 2022; 15:e244576. [PMID: 35331999 PMCID: PMC8948383 DOI: 10.1136/bcr-2021-244576] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/09/2021] [Indexed: 06/14/2023] Open
Abstract
A 50-year-old woman presented with progressive, painful and disabling swelling of the left lower limb following a left ovarian cyst excision 2 years ago. She had gross oedema of the left lower limb with multiple pubic varices. Contrast-enhanced CT and digital subtraction imaging revealed diffuse arteriovenous malformation (AVM) with feeders from the left internal iliac artery and a short segment significant stenosis of the proximal left common iliac vein. She underwent angioplasty and stenting of the left iliac vein. Her symptoms dramatically improved following the procedure and her limb swelling regressed within 6 months. The occurrence of post-thrombotic AVMs has been long established in the dural and portal systems. This report deals with an analogous phenomenon following iatrogenic deep venous thrombosis of the left lower limb, its pathogenesis, natural history and a review of treatment options.
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YADAV R, Kumar D, Sangha S, Kumar A, Bhowmik D, Mahajan S, Bagchi S, Agarwal S. POS-821 TO STUDY THE ASSOCIATION OF SERUM VITAMIN D WITH POST -TRANSPLANT DIABETES MELLITUS (PTDM) IN KIDNEY TRANSPLANT RECIPIENTS IN INDIAN SETTINGS. Kidney Int Rep 2022. [DOI: 10.1016/j.ekir.2022.01.857] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Connor M, Rai A, Khoo C, Bass E, Eldred-Evans D, Agarwal S, Winkler M, Abboudi H, Dasgupta R, El-Husseiny T, Ahmed H. Patient-reported outcome measures and surgical retreatment rates from 181 patients treated with water vapor thermal therapy (Rezūm™). Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00802-8] [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]
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Agarwal A, Agarwal S, Chandak S. Response to the letter to the editor. ULTRASOUND (LEEDS, ENGLAND) 2022; 30:96. [PMID: 35173785 PMCID: PMC8841946 DOI: 10.1177/1742271x211055801] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
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Agarwal S, Kardam S, Chatterjee P, Kumar C, Boruah M, Sharma MC, Tabin M, Ramakrishnan L. CaSR expression in normal parathyroid and PHPT: new insights into pathogenesis from an autopsy-based study. J Endocrinol Invest 2022; 45:337-346. [PMID: 34302683 DOI: 10.1007/s40618-021-01646-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2021] [Accepted: 07/18/2021] [Indexed: 10/20/2022]
Abstract
PURPOSE Calcium sensing receptor (CaSR), on the surface of normal parathyroid cells, is essential for maintaining serum calcium levels. The normal pattern of CaSR immunostaining remains undefined and is presumptively circumferential. Given the physiological variation in serum calcium, we postulated that CaSR expression could not be uniformly circumferential. Also, cytoplasmic expression has not been evaluated either in normal or pathological tissues. We studied normal parathyroid tissues derived from forensic autopsies and those rimming parathyroid adenomas for membranous and cytoplasmic CaSR immunoexpression. Results were compared with primary hyperparathyroidism (PHPT) to look for any pathogenetic implications. MATERIALS AND METHODS We evaluated 34 normal parathyroid tissues from 11 autopsies, 30 normal rims, 45 parathyroid adenoma, 10 hyperplasia, and 7 carcinoma cases. Membranous expression was categorized complete/incomplete and weak/moderate/strong; scored using Her2/Neu and Histo-scores; predominant pattern noted. Cytoplasmic expression was categorized negative/weak/moderate/strong; predominant intensity noted. RESULTS Normal autopsy-derived parathyroid tissues were Her2/Neu 3 + , but incomplete membranous staining predominated in 85%. Their immune-scores were significantly more than the cases (p < < 0.05). The mean histo-score of normal rims was intermediate between the two (p < < 0.05). Cytoplasmic expression was strong in all autopsy-derived tissues, weak/negative in hyperplasia (100%), moderate in 16% adenomas, and 43% carcinomas. CONCLUSIONS Normal autopsy-derived parathyroid tissues showed strong but predominantly incomplete membranous expression. Surface CaSR expression decreased in PHPT and is probably an early event in parathyroid adenoma, seen even in normal rims. Whether there is a defect in CaSR trafficking from the cytoplasm to the cell surface in adenoma and carcinoma needs further evaluation.
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Freund MR, Kent I, Agarwal S, Wexner SD. Use of indocyanine green fluorescence angiography during ileal J-pouch surgery requiring lengthening maneuvers. Tech Coloproctol 2022; 26:181-186. [PMID: 35091791 DOI: 10.1007/s10151-021-02557-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Accepted: 11/28/2021] [Indexed: 11/25/2022]
Abstract
BACKGROUND The purpose of this study was to review whether routine usage of indocyanine green (ICG) perfusion assessment during complex ileal J-pouch surgery requiring lengthening maneuvers reduces ischemic complications. METHODS Retrospective chart review of patients with ulcerative colitis (UC) or familial adenomatous polyposis (FAP) who underwent ileal pouch-anal anastomosis (IPAA) surgery with lengthening maneuvers and intraoperative ICG assessment between January 2015 and January 2021. All patients underwent a double stapled anastomosis and were temporarily diverted. All patients underwent laparoscopic and trans-anal ICG assessment of their J-pouch and anastomosis. All J-pouches were evaluated 6 weeks after surgery via contrast enema and pouchoscopy. RESULTS One hundred fifty eight patients underwent ileal J-pouch surgery during the study period. Sixteen patients (10%) underwent lengthening maneuvers and intra-operative ICG assessment. Twelve patients underwent surgery for UC and 4 for FAP. Median age was 40.3 years and average body mass index was 24.9 kg/m2. Twelve patients underwent a two-stage procedure and the remaining underwent a three-stage procedure. 93.7% of cases were completed laparoscopically (15/16). All patients underwent scoring of the peritoneum and 43% (7/16) underwent division of the ileocolic or intermediate mesenteric vessels. There was no mortality or pouch ischemia and the leak rate was 12.5%. All patients underwent reversal after an average of 18 ± 7 weeks. CONCLUSION ICG perfusion assessment appears to be of utility in complex IPAA surgery requiring lengthening maneuvers. Its application may be associated with reduced J-pouch ischemia and leak rate in this unique setting.
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Thakur A, Agarwal S, Gupta B, Snehi S, Limbu S, Jain AK. Rosette cataract with intraocular foreign body. QJM 2022; 115:39-40. [PMID: 34694404 DOI: 10.1093/qjmed/hcab270] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Kota P, Kota A, Samuel V, Premkumar P, Selvaraj D, Stephen E, Agarwal S. Contemporary portrait of aortic bifurcated bypass procedures for occlusive disease in indian population: A transition in trends. INDIAN JOURNAL OF VASCULAR AND ENDOVASCULAR SURGERY 2022. [DOI: 10.4103/ijves.ijves_120_21] [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] Open
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Kota PB, Kota AA, Selvaraj D, Premkumar P, Samuel V, Stephen E, Agarwal S. Contemporary Portrait of Aortic Bifurcated Bypass Procedures for Occlusive Disease in the Indian Population: A Transition in Trends. Eur J Vasc Endovasc Surg 2022. [DOI: 10.1016/j.ejvs.2021.11.006] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Hazra D, Kota AA, Raj SP, Premkumar P, Selvaraj AD, Agarwal S, Thomas BP. Does endovascular repair of post-traumatic thoracic vascular injury of the subclavian/axillary arteries followed by brachial plexus injury improve outcome? Indian J Thorac Cardiovasc Surg 2021; 38:294-299. [PMID: 35528997 PMCID: PMC9023618 DOI: 10.1007/s12055-021-01278-y] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2021] [Revised: 09/15/2021] [Accepted: 09/16/2021] [Indexed: 11/25/2022] Open
Abstract
Traumatic injuries to the axillary artery or subclavian artery along with a brachial plexus injury are infrequent. Although the traditional management has been conservative because of robust collaterals, the functional improvement of the limb depends on the degree of brachial plexus injury and on the revascularization status. We report three cases of endovascular repair post-traumatic axillo-subclavian artery injuries followed by brachial plexus injury with good functional outcomes. Endovascular repair of post-traumatic subclavian and axillary artery injuries followed by brachial plexus injury is safe and feasible, and improves limb outcomes.
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Agarwal S, Kothiwal K, Verma S, Sharma M, Sharma CB, Verma N. Effects of COVID-19 on maternal, child healthcare (MCH) services in slums: lessons from India. Eur J Public Health 2021. [PMCID: PMC8574895 DOI: 10.1093/eurpub/ckab164.540] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Background The study aims to understand the effect of COVID lockdown on MCH for slum dwellers and coping mechanisms adopted in Indore and Agra, India. Slum women's perspectives on seeking, delaying, avoiding healthcare in COVID-19, barriers and facilitators were explored. Methods In-person qualitative interviews were conducted in slums in Sept-Oct 2020 with mothers who had deliveries; pregnant women needing ante-natal care; mothers with children <2 yrs needing immunization during COVID lockdown. 30 mothers requiring these MCH services during April -June 2020 (lockdown phase) were interviewed. We chose qualitative study over quantitative as a shorter and useful precedent to replicate in similar situations. Results Govt. and most private hospitals refused non-COVID services during lockdown.; Police restricted movement on roads. Being on COVID duty, frontline health functionaries were not doing outreach health sessions. Women missed ante-natal check-up, Iron Folate, Tetanus toxoid; Demand side challenges included fear of COVID infection, lack of money due to livelihood loss; Home deliveries by self, neighbors were resorted to; Maternal, neonatal deaths ensued; Children missed immunization e.g., Measles, DPT. Few peri-urban slum families visited nearby rural health facility for delivery. Some families borrowed money from community saving's groups for delivery in private hospitals. Few families visited low-cost private doctor/nurse for immunization of pregnant mother, children. Conclusions Demand and supply side factors led to pregnant women and children not receiving care during lockdown. Peri-urban slum families should be encouraged to link with nearby rural health facility for MCH services during COVID-19 or similar situations. Govt. partnering with private providers near slums will help access during challenging times. Promoting community savings groups as mandated under National Urban Health Mission can enable slum families borrow with ease when in need. Key messages Government health system should set up emergency (e.g., mobile clinic) MCH services for future epidemic, disaster, should partner with private doctors/nurses near slums. Rural health infrastructure serving nearby peri-urban slums formally recognized by Govt. despite separate jurisdictions is an approach adaptable in LMIC cities.
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Agarwal S, Verma N, Verma S, Vishvakarma K, Kothiwal K. Vegetable gardening in slum homes for food security especially in COVID-19 and well-being in India. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.277] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
Abstract
Issue
With livelihood loss, uncertain earning, slum families are often food insecure, at risk of undernutrition particularly during COVID-19 in Indian and other LMIC cities. While wheat flour was provided free during lockdown, later at subsidized costs and during non-COVID times, vegetables need to be bought at market price.
Methods
UHRC provided seeds, encouraged families to grow vegetables in slums of Indore, India for five years. In 2019-20 and 20-21, data was gathered through interviews, observations in 20 slums (where >15 families grew vegetables).
Results
Uptake of seeds increased from 900 families in 2019-20 to 1200 in 20-21. With sharing of surplus harvest, 70,000 persons benefited in 2020-21. Families overcame food insecurity by arranging just wheat flour and cooked a vegetable for a meal. Used paint tubs, broken buckets and small spaces were used. Creepers were made to climb on roofs, walls, trees. Green cover increased to > 8 acres in 2021. The practice saves valuable family resources particularly in COVID-19 distress through provision of vegetables for family consumption.
Lessons
Perseverant efforts are key and help build a ‘fairer, healthier world'. Yield per family increased as they grow with incremental confidence. Despite small spaces slum families creatively grew vegetables. Children and youth help overcome constraints and are key actors. Early adopters serve as motivators and champions for subsequent adopters who begin growing vegetables on observing neighbours, friends grow vegetables and share with them. Nurturing plants, seeing vegetables grow fostered positivity, hope, motivation to grow every year, enhanced self-worth, and a positive feeling about their abode. People particularly children and youth learn how eating home-grown vegetables reduces carbon footprint of purchased vegetables transported to urban markets, save cost and overcome food insecurity. They reduce ambient air temperature to cool urban spaces.
Key messages
Despite small spaces, slum families grow, share vegetables, feel accomplished, enable food security, social cooperation, all crucial to well-being of slum populations. Methods used and lessons learnt of perseveringly motivating slum families have the potential of replication/adaptation in cities of India and other LMICs.
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Agarwal S, Verma N, Verma S, Kothiwal K, Mandloi N. Birth Preparedness and Complication Readiness (BPACR) among brick kiln workers in Indore, India. Eur J Public Health 2021. [DOI: 10.1093/eurpub/ckab165.551] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Birth preparedness and complication readiness (BPACR), promotes utilization of skilled maternal and neonatal care. Preparing for childbirth reduces delays in seeking care. Brick-kiln workers constitute a vulnerable social group who contribute to city infrastructure by laboring at low wages. 37% of the sample were Scheduled Castes, 49% Scheduled Tribes.
Methods
139 mothers of children < 2 years, residing temporarily in brick kilns of Indore were asked about preparedness for birth of youngest child. Birth preparedness was assessed by enquiring about saving money, arranging transport, identifying health facility for delivery, identified family member to accompany for labor/emergency.
Findings
10% did >3 BPACR practices implying good level of preparedness; 50% did 1-2 BPACR practices; 40% did no birth preparedness. Access to maternity benefit scheme was twice as likely to result in reasonable birth preparedness as compared to no access. Those with primary to class XII were twice as likely to practice birth preparedness as compared to those with no formal education. >3 ANC was associated with 8 percentage points greater practice of reasonable BPACR as compared to < 2 or no ANC. Mothers with knowledge of one danger sign each of pregnancy and delivery were 3 times more likely to practice BPACR than those without this knowledge. FGDs revealed challenges in access to bank account, obtaining required documents to apply for and access state maternity benefit. Lack of family support led to low BPCAR and low institutional delivery.
Conclusions
Brick-kiln women face risk of low utilization of government healthcare services. The health systems should conduct outreach antenatal care sessions in brick-kilns on knowledge of key danger signs and BPACR during health education and ANC counselling can help promote BPACR and hospital delivery. Information on requisite steps to apply for maternity benefit schemes should be shared among brick-kiln workers.
Key messages
It is crucial to promote BPACR among urban vulnerable sections, through NUHM’s outreach sessions by ANMs/ASHAs in brick-kiln, construction workers and similar groups. Access to maternity benefit cash transfer scheme should be enhanced particularly among excluded temporary urban groups such as brick-kiln workers as it is a motivation to avail hospital care.
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Wang C, Xue Y, Huang J, Ren K, Greiner A, Agarwal S, Ji J. A facile method for high-throughput screening of drug-eluting coatings in droplet microarrays based on ultrasonic spray deposition. Biomater Sci 2021; 9:6787-6794. [PMID: 34528030 DOI: 10.1039/d1bm01213d] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
Coating modification such as drug-eluting coating is one of the most important approaches for the functionalization of biomedical devices. However, the throughputs are limited in conventional coating methods and the concept of miniaturization is rarely fulfilled. A droplet microarray (DMA), as a unique high-throughput platform, can avoid cross-contamination and reduce the consumption of materials which is inherently suitable for coating research yet is difficult to apply with coating materials via traditional methods. Here, we bring up a facile method based on ultrasonic spray deposition to integrate coating materials into a DMA. Several common polymer materials were selected to fabricate a DMA, and the obtained DMA showed the ability to anchor water droplets and form specific patterns. Coating arrays with a typical sandwich structure were also prepared for the high-throughput screening of drug-eluting coatings to demonstrate the potential of the platform in coating research. This developed method is efficient and compatible and enriches the choices of materials that can be applied in DMAs.
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Ang KL, Cheah W, Jesani H, Ooi R, Agarwal S. 224 A 5-Year Observational Study on Distal Femoral Periprosthetic Fractures in Elderly Patients in a Single Institution: Distal Femoral Replacement vs. Internal Fixation. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
To evaluate the outcome of distal femoral replacements versus internal fixation for elderly patients with distal femoral periprosthetic fracture in a single institution.
Method
A five-year retrospective observational study was conducted of a consecutive series of patients with distal femoral periprosthetic fracture who underwent either distal femoral replacement (DFR) or internal fixation (IF) in a tertiary referral centre. Clinical information analysed included patient demographics, co-morbidities, interval between primary total knee arthroplasty (TKA) to distal femoral periprosthetic fracture, type of fracture, operative technique, preoperative ASA grade, post-operative complications, intensive therapy unit (ITU) stay, length of hospital stay (LOS), re-fixation and mortality.
Results
Study included 27 patients of which fourteen patients underwent a DFR while 13 underwent an IF. 89% of the patients were females. Mean age of the patients at the time of fracture was 85 versus 80 (DFR vs IF). The mean interval from the primary TKA to the fracture were 80 months (range 0-181). There were no intraoperative complications in either group. Three patients required ITU stay from the DFR group while one patient from the IF group required re-fixation. Median LOS was 56 days (range 9-144) after DFR and 55 days (range 4-83) after IF. There was one 30-day mortality in the DFR group. One-year mortality for the DFR group was 7% vs 15% for the IF group.
Conclusions
In our study, DFR and IF were observed to have similar LOS with a higher mortality in the IF group at one year. There was one re-fixation in the IF group.
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Choi SM, Kumar R, Morgan-Jones R, Agarwal S. 1064 Extra-Articular Tibial Deformity Management in Total Knee Replacement. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
In knee replacements, restoration of mechanical alignment is essential. Patients with extra-articular deformities (EAD) pose challenges in planning knee replacements. We present a method, based on our experience and review of literature on planning knee replacement surgery, in the presence of extra-articular coronal plane deformity of the tibia.
Method
Retrospective analysis was made of six patients with EAD of the tibia who underwent knee replacement at our centre. Mechanical axis of the tibia is considered and positioning of the tibia component is planned perpendicular to the mechanical axis of the tibia. The integrity of the collaterals determines the need for correction. Tibial resection >15mm from medial or lateral aspect of the tibia is an indication for corrective osteotomy prior to replacement surgery. The hip knee ankle angle (HKA) was noted. Pre-operative, post-operative clinical score, degree of constraints and post-operative complications were recorded. A post-operative long leg alignment radiograph was obtained.
Result
All patients had total knee replacement without correction of deformity. Adequate alignment of the limb and restoration of mechanical axis was achieved in all six patients without the need for correction of tibial deformity. All patients had improvement in their HKA angle and Oxford knee score. No re-operations were required, and no complications recorded.
Conclusions
Our study will help provide guidance on operative planning and decisions making for patients with extra-articular coronal plane tibial deformities.
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Bisht A, Singh P, Kaur C, Agarwal S, Ajmani M. Progress and Challenges in Physiological Artifacts' Detection in Electroencephalographic Readings. Curr Med Imaging 2021; 18:509-531. [PMID: 34503420 DOI: 10.2174/1573405617666210908124704] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/23/2020] [Revised: 05/04/2021] [Accepted: 06/08/2021] [Indexed: 11/22/2022]
Abstract
BACKGROUND Electroencephalographic (EEG) recordings are used to trace neural activity within the cortex to study brain functioning over time. INTRODUCTION During data acquisition, the unequivocal way to reduce artifact is to avoid artifact stimulating events. Though there are certain artifacts that make this task challenging due to their association with the internal human mechanism, in the human-computer interface, these physiological artifacts are of great assistance and act as a command signal for controlling a device or an application (communication). That is why pre-processing of electroencephalographic readings has been a progressive area of exploration, as none of the published work can be viewed as a benchmark for constructive artifact handling. METHOD This review offers a comprehensive insight into state of the art physiological artifact removal techniques listed so far. The study commences from the single-stage traditional techniques to the multistage techniques, examining the pros and cons of each discussed technique. Also, this review paper gives a general idea of various datasets available and briefs the topical trend in EEG signal processing. RESULT Comparing the state of the art techniques with hybrid ones on the basis of performance and computational complexity, it has been observed that the single-channel techniques save computational time but lack in effective artifact removal especially physiological artifacts. On the other hand, hybrid techniques merge the essential characteristics resulting in increased performance, but time consumption and complexity remain an issue. CONCLUSION Considering the high probability of the presence of multiple artifacts in EEG channels, a trade-off between performance, time and computational complexity is the only key for effective processing of artifacts in the time ahead. This paper is anticipated to facilitate upcoming researchers in enriching the contemporary artifact handling techniques to mitigate the expert's burden.
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Thaduri A, Sehrawat A, Poonia D, Das A, Kumar R, Varghese A, Kottayasamy Seenivasagam R, Garg P, Gupta M, Agarwal S. 1492P A longitudinal cohort study on assessing the impact COVID-19 pandemic on the mental health of cancer care providers: Developing world scenario. Ann Oncol 2021. [DOI: https://doi.org/10.1016/j.annonc.2021.08.820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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Thaduri A, Sehrawat A, Poonia D, Das A, Kumar R, Varghese A, Kottayasamy Seenivasagam R, Garg P, Gupta M, Agarwal S. 1492P A longitudinal cohort study on assessing the impact COVID-19 pandemic on the mental health of cancer care providers: Developing world scenario. Ann Oncol 2021. [PMCID: PMC8454365 DOI: 10.1016/j.annonc.2021.08.820] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
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Bishnoi S, Huda N, Islam S, Pant A, Agarwal S, Dholariya R. Association between Psychological Status and Functional Outcome in Surgically Managed Fractures around Hip in Geriatric Patients - A Prospective Study. Malays Orthop J 2021; 15:18-25. [PMID: 34429818 PMCID: PMC8381662 DOI: 10.5704/moj.2107.004] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Accepted: 02/23/2021] [Indexed: 11/06/2022] Open
Abstract
Introduction: Fractures around the hip in the geriatric population not only lead to functional but also psychological impairment. Psychiatric disturbances can be associated with poor participation in rehabilitation, increased risk of falling again, and higher rates of mortality. The present study was undertaken to assess the association between the psychological status and functional outcome of surgically managed elderly Indian patients who had sustained fractures around the hip. Material and Methods: The present study was a hospital based prospective, single centre study. One hundred and two geriatric patients who had sustained hip fracture and had been managed surgically, having no cognitive dysfunction, living independently, having unhindered walking capability before the fracture, were included in the study. They were called for follow-up at 3rd, 6th, and 12th month after the hip surgery. Psychological assessment was done by the Hospital Anxiety and Depression Scale (HADS) and functional outcome by using the Harris hip score (HHS). Results: Our study did not show association between psychological status and functional outcome except in one sub-group. Significant correlation was observed between the psychological status and functional outcome in most of the patients in the extra-capsular group. We have identified improvement in the depression, anxiety and functional scores during the follow-up. Conclusion: We conclude that psychiatric disturbances in a geriatric patient after undergoing a surgery for hip fracture may lead to poor recovery. We recommend that all such geriatric patients should undergo a psychological assessment and proper therapy should be instituted to achieve good functional recovery.
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Kota AA, Joseph G, Thomson VS, Agarwal S. Endovascular repair of post-traumatic innominate artery pseudoaneurysm. J Vasc Surg 2021; 74:1015-1016. [PMID: 34425944 DOI: 10.1016/j.jvs.2020.10.070] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2020] [Accepted: 10/15/2020] [Indexed: 11/16/2022]
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Mukherjee P, Agarwal S, Kalyani N, Roy M, Doshi A, Kommineni S, Patel R. PO-0987 Evaluation of swallowing function using PSS-HN scale for head-neck cancer patients undergoing IMRT. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)07438-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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