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Garg A, Papagermanos V, Midura M, Strunk A. Incidence of hidradenitis suppurativa among tobacco smokers: a population-based retrospective analysis in the U.S.A. Br J Dermatol 2018; 178:709-714. [PMID: 28960235 DOI: 10.1111/bjd.15939] [Citation(s) in RCA: 68] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/30/2017] [Indexed: 12/24/2022]
Abstract
BACKGROUND The relationship between tobacco use and hidradenitis suppurativa (HS) is controversial. OBJECTIVES To determine the incidence of HS among tobacco smokers. METHODS Retrospective cohort analysis identifying incident HS cases among adult tobacco smokers and nonsmokers sampled from a demographically heterogeneous population-based sample of over 50 million unique patients across all census regions in the U.S.A. RESULTS We identified 3 924 310 tobacco smokers, which included 7860 patients newly diagnosed with HS. Tobacco smokers diagnosed with HS were most commonly aged 18-39 years (3795 of 7860; 48·3%), women (5640 of 7860; 71·8%), white (5200 of 7860; 66·2%) and those with body mass index (BMI) ≥ 30 (5690 of 7860; 72·4%). Overall incidence of HS was 0·20% (7860 of 3 924 310) among tobacco smokers and 0·11% (8430 of 8 027 790) among nonsmokers (P < 0·001). Incidence was greatest among tobacco smokers who were aged 30-39 years (0·35%), women (0·28%), African Americans (0·46%) and those with BMI ≥ 30 (0·33%). The overall adjusted odds of developing HS was 1·90 (95% confidence interval 1·84-1·96) among tobacco smokers, compared with nonsmokers (P < 0·001). HS incidence among tobacco smokers remained increased within each demographic subgroup. CONCLUSIONS Incidence of HS appears to be doubled among tobacco smokers. These findings may support evidence-based counselling efforts for the cessation of smoking in populations at risk for HS.
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Garg A, Strunk A, Midura M, Papagermanos V, Pomerantz H. Prevalence of hidradenitis suppurativa among patients with Down syndrome: a population-based cross-sectional analysis. Br J Dermatol 2018; 178:697-703. [DOI: 10.1111/bjd.15770] [Citation(s) in RCA: 27] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/21/2017] [Indexed: 02/03/2023]
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78
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Garg A, Panda BN, Tai K. True stress measurement of nuclear fuel rod cladding material subjected to DSA regime. Neural Comput Appl 2017. [DOI: 10.1007/s00521-016-2298-4] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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79
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Duffin K, Merola J, Latella J, Christensen R, Garg A, Gottlieb A, Armstrong A. LB956 Identifying a core domain set to assess psoriasis in clinical trials: Delphi survey of patients and healthcare professionals from the International Dermatology Outcome Measures Psoriasis Initiative. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.031] [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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80
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Garg A, Kirby J, Lavian J, Lin G, Strunk A. LB938 US prevalence estimates for hidradenitis suppurativa with a focus on race. J Invest Dermatol 2017. [DOI: 10.1016/j.jid.2017.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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81
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82
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Garg A, Chan D, Turner S. P17: MANAGING ALLERGIES AND ADVERSE DRUG REACTIONS IN A TERTIARY HOSPITAL AT A MULTI-DISCIPLINARY FORUM. Intern Med J 2017. [DOI: 10.1111/imj.17_13578] [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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83
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Modi M, Sharma K, Prabhakar S, Goyal MK, Takkar A, Sharma N, Garg A, Faisal S, Khandelwal N, Singh P, Sachdeva J, Shree R, Rishi V, Lal V. Clinical and radiological predictors of outcome in tubercular meningitis: A prospective study of 209 patients. Clin Neurol Neurosurg 2017; 161:29-34. [PMID: 28843114 DOI: 10.1016/j.clineuro.2017.08.006] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2017] [Revised: 08/11/2017] [Accepted: 08/12/2017] [Indexed: 10/19/2022]
Abstract
OBJECTIVES The predictors of poor outcome in tuberculous meningitis (TBM) remain to be delineated. We determined role of various clinical, radiological and cerebrospinal fluid (CSF) parameters in prediction of outcome in TBM. PATIENTS AND METHODS Current study was a prospective observational study including 209 patients of TBM. All patients underwent detailed evaluation including Gadolinium enhanced Magnetic resonance imaging (GdMRI) of brain as well as tests to detect evidence of tuberculosis elsewhere in body. They also underwent GdMRI at three and nine month follow up. All patients received treatment as per standard guidelines. RESULTS Mean age was 30.4±13.8years. 139 (66.5%) patients had definite TBM while 70 (34.5%) had highly probable TBM. 53 (25.4%) patients died. On univariate analysis, longer duration of illness, altered sensorium, stage III TBM, hydrocephalus and exudates correlated with poor outcome. On multivariate analysis presence of hydrocephalus (p=0.003; OR=3.2; 95% CI=1.5-6.7) and stage III TBM (p<0.0001; OR=8.7; 95% CI=3.7-20.2) correlated with higher risk of mortality. In addition, there was significant positive association between presence of hydrocephalus (p=0.05; OR=2.2; 95% CI=0.97-5.1), stage III TBM (p<0.0001; OR=28; 95% CI=4.9-158) and presence of altered sensorium (p=0.05; OR=22; 95% CI=0.99-4.8) with either death or survival with severe disability. CONCLUSIONS It is possible to prognosticate TBM using a combination of clinical and radiological. The duration of illness (65.9±92days) before diagnosis of TBM continues to be unacceptably long and this stresses on need to educate primary care physicians about TBM. Future studies where intensity and duration of treatment is guided by these cues may help in sorting out some of the most difficult questions in TBM, namely duration of antitubercular therapy as well as dose and duration of steroid therapy etc.
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84
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Mishra A, Datta S, Malik A, Garg A, Nair D, Nair S, Mair M, Bal M, Agarwal J, Chaturvedi P. Role of microscopic spread beyond gross disease as an adverse prognostic factor in oral squamous cell carcinoma. Eur J Surg Oncol 2017; 43:1503-1508. [DOI: 10.1016/j.ejso.2017.04.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2016] [Revised: 04/10/2017] [Accepted: 04/26/2017] [Indexed: 10/19/2022] Open
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85
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Arora R, Singh M, Garg A, Gupta M, Gupta N. Successful Treatment of BK Virus Hemorrhagic Cystitis (HC) Post Allogenic Hematopoietic Stem Cell Transplantation with Low Dose Cidofovir. THE JOURNAL OF THE ASSOCIATION OF PHYSICIANS OF INDIA 2017; 65:93-94. [PMID: 28598058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
BK virus (BKV) hemorrhagic cystitis (HC) is a serious cause of morbidity and mortality after allogeneic hematopoietic SCT (allo-HSCT) in patients with hematological malignancies. Around half of allogenic HSCT patients present with BKV viruria at some point after HSCT; about 5-40% of these patients subsequently develop active HC. Supportive care including bladder irrigation, blood transfusions and symptomatic pain management remains the mainstay of therapy; the acyclic nucleoside analogue cidofovir is currently the front-line drug for BKV-HC treatment. Here we report the first case of severe hemorrhagic cystitis from India who was successfully treated with low dose cidofovir therapy.
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86
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87
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Bang KO, Pandilwar PK, Shenoi SR, Budhraja NJ, Ingole P, Kolte VS, Garg A. Evaluation of Teeth in Line of Mandibular Fractures Treated with Stable Internal Fixation. J Maxillofac Oral Surg 2016; 17:164-168. [PMID: 29618880 DOI: 10.1007/s12663-016-0993-4] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2015] [Accepted: 12/04/2016] [Indexed: 11/25/2022] Open
Abstract
Purpose To determine whether retention or removal of teeth in line of mandibular fractures affects the incidence of postoperative complications. To evaluate the fate of teeth retained in mandibular fractures based on location of fracture line in relation to apical foramen and lateral periodontium of retained tooth. Method 51 mandibular fracture sites in 39 patients were treated by open reduction and internal fixation using miniplates. Teeth in line of fracture were removed if showed extensive caries, excessive mobility of tooth, or root fracture. Accordingly patients were divided into two groups, group I tooth removed (15 sites) and group II tooth retained (36 sites). Teeth retained in fracture line were classified based on position of the fracture in relation to apical foramen and the lateral periodontium of involved tooth estimated from preoperative panoramic radiograph into four types. Postoperative periodic follow up done for 1 year and seen for incidence of postoperative complications and fate of tooth in line of fracture. Results Out of 36 fracture sites in which teeth were retained 5 (13.89%) showed postoperative complications, and out of 15 fracture sites in which teeth were removed 3 (20%) showed postoperative complications. Out of 36 fracture sites in which tooth was retained we found in 3 cases fracture line passed through 2 adjacent teeth. Thus we had in total 39 teeth in fracture line out of them 26 required no treatment 9 required endodontic treatment and 4 teeth required extraction. Need for extraction and endodontic treatment was found more in type I and type III relation. Conclusion There is an increased risk for postoperative complications when a tooth is removed, although it is not statistically significant. Evaluation of fate of retained teeth showed better prognosis of teeth in type II cases than type III and type I cases. Results of this study leads to conclusions that teeth associated with mandibular fractures need not be removed on prophylactic basis.
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88
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Das C, Garg A, Gogia A. 533P Docetaxel induced cutaneous toxicity in breast cancer patients. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw599.012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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89
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Vaswani R, Garg A, Pathai L, Youn Y, Vaswani S. P286 Systemic allergic reaction to jackfruit (artocarpus heterophyllus). Ann Allergy Asthma Immunol 2016. [DOI: 10.1016/j.anai.2016.09.299] [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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90
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Ruane D, Do Y, Brane L, Garg A, Bozzacco L, Kraus T, Caskey M, Salazar A, Trumpheller C, Mehandru S. A dendritic cell targeted vaccine induces long-term HIV-specific immunity within the gastrointestinal tract. Mucosal Immunol 2016; 9:1340-52. [PMID: 26732678 PMCID: PMC5819881 DOI: 10.1038/mi.2015.133] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2015] [Accepted: 11/20/2015] [Indexed: 02/04/2023]
Abstract
Despite significant therapeutic advances for HIV-1 infected individuals, a preventative HIV-1 vaccine remains elusive. Studies focusing on early transmission events, including the observation that there is a profound loss of gastrointestinal (GI) CD4(+) T cells during acute HIV-1 infection, highlight the importance of inducing HIV-specific immunity within the gut. Here we report on the generation of cellular and humoral immune responses in the intestines by a mucosally administered, dendritic cell (DC) targeted vaccine. Our results show that nasally delivered α-CD205-p24 vaccine in combination with polyICLC, induced polyfunctional immune responses within naso-pulmonary lymphoid sites that disseminated widely to systemic and mucosal (GI tract and the vaginal epithelium) sites. Qualitatively, while α-CD205-p24 prime-boost immunization generated CD4(+) T-cell responses, heterologous prime-boost immunization with α-CD205-p24 and NYVAC gag-p24 generated high levels of HIV-specific CD4(+) and CD8(+) T cells within the GI tract. Finally, DC-targeting enhanced the amplitude and longevity of vaccine-induced immune responses in the GI tract. This is the first report of a nasally delivered, DC-targeted vaccine to generate HIV-specific immune responses in the GI tract and will potentially inform the design of preventative approaches against HIV-1 and other mucosal infections.
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MESH Headings
- AIDS Vaccines/administration & dosage
- AIDS Vaccines/biosynthesis
- AIDS Vaccines/immunology
- Administration, Intranasal
- Animals
- Antigens, CD/genetics
- Antigens, CD/immunology
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- CD4-Positive T-Lymphocytes/cytology
- CD4-Positive T-Lymphocytes/drug effects
- CD4-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/cytology
- CD8-Positive T-Lymphocytes/drug effects
- CD8-Positive T-Lymphocytes/immunology
- Carboxymethylcellulose Sodium/analogs & derivatives
- Carboxymethylcellulose Sodium/pharmacology
- Dendritic Cells/cytology
- Dendritic Cells/drug effects
- Dendritic Cells/immunology
- Female
- Gastrointestinal Tract/cytology
- Gastrointestinal Tract/drug effects
- Gastrointestinal Tract/immunology
- HIV Core Protein p24/genetics
- HIV Core Protein p24/immunology
- HIV Infections/immunology
- HIV Infections/prevention & control
- HIV Infections/virology
- HIV-1/genetics
- HIV-1/immunology
- Humans
- Immunity, Cellular/drug effects
- Immunity, Humoral/drug effects
- Immunization, Secondary
- Interferon Inducers/pharmacology
- Lectins, C-Type/genetics
- Lectins, C-Type/immunology
- Mice
- Mice, Inbred BALB C
- Mice, Inbred C57BL
- Minor Histocompatibility Antigens/genetics
- Minor Histocompatibility Antigens/immunology
- Poly I-C/pharmacology
- Polylysine/analogs & derivatives
- Polylysine/pharmacology
- Receptors, Cell Surface/genetics
- Receptors, Cell Surface/immunology
- Vaccination/methods
- Viral Vaccines/administration & dosage
- Viral Vaccines/immunology
- gag Gene Products, Human Immunodeficiency Virus/genetics
- gag Gene Products, Human Immunodeficiency Virus/immunology
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91
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Gupta V, Garg A, Chandra S, Sharma M, Gaikwad S, Gulati S, Mishra N. Cerebellar Epilepsy. ACTA ACUST UNITED AC 2016. [DOI: 10.1177/197140090301600520] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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92
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Puri A, Garg A, Mishra N, Gaikwad S, Mehta V. Bilateral Cerebellar Dysplastic Gangliocytomas (Lhermitte Duclos Disease) with Cerebellar Ectopia and Presyrinx Cord Changes. Neuroradiol J 2016; 19:717-21. [DOI: 10.1177/197140090601900605] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/29/2006] [Accepted: 12/18/2006] [Indexed: 11/16/2022] Open
Abstract
Lhermitte-Duclos disease (LDD) is a rare cerebellar lesion with features of both malformation and benign neoplasm. However, the fundamental nature of the entity, its pathogenesis, and the exact genetic alterations remain unknown. We describe a rare case of bilateral LDD with cerebellar ectopia and presyrinx spinal cord changes. Bilaterality of lesions should argue against a neoplastic origin and support a hamartomatous origin.
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93
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Mannava S, Garg A. E-014 Management of Blood Pressure for Acute Ischemic Stroke in the Modern Era of Mechanical Thrombectomy. J Neurointerv Surg 2016. [DOI: 10.1136/neurintsurg-2016-012589.86] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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94
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Garg A, Zhao A, Erickson SL, Mukherjee S, Lau AJ, Alston L, Chang TKH, Mani S, Hirota SA. Pregnane X Receptor Activation Attenuates Inflammation-Associated Intestinal Epithelial Barrier Dysfunction by Inhibiting Cytokine-Induced Myosin Light-Chain Kinase Expression and c-Jun N-Terminal Kinase 1/2 Activation. J Pharmacol Exp Ther 2016; 359:91-101. [PMID: 27440420 DOI: 10.1124/jpet.116.234096] [Citation(s) in RCA: 43] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2016] [Accepted: 07/19/2016] [Indexed: 02/06/2023] Open
Abstract
The inflammatory bowel diseases (IBDs) are chronic inflammatory disorders with a complex etiology. IBD is thought to arise in genetically susceptible individuals in the context of aberrant interactions with the intestinal microbiota and other environmental risk factors. Recently, the pregnane X receptor (PXR) was identified as a sensor for microbial metabolites, whose activation can regulate the intestinal epithelial barrier. Mutations in NR1I2, the gene that encodes the PXR, have been linked to IBD, and in animal models, PXR deletion leads to barrier dysfunction. In the current study, we sought to assess the mechanism(s) through which the PXR regulates barrier function during inflammation. In Caco-2 intestinal epithelial cell monolayers, tumor necrosis factor-α/interferon-γ exposure disrupted the barrier and triggered zonula occludens-1 relocalization, increased expression of myosin light-chain kinase (MLCK), and activation of c-Jun N-terminal kinase 1/2 (JNK1/2). Activation of the PXR [rifaximin and [[3,5-Bis(1,1-dimethylethyl)-4-hydroxyphenyl]ethenylidene]bis-phosphonic acid tetraethyl ester (SR12813); 10 μM] protected the barrier, an effect that was associated with attenuated MLCK expression and JNK1/2 activation. In vivo, activation of the PXR [pregnenolone 16α-carbonitrile (PCN)] attenuated barrier disruption induced by toll-like receptor 4 activation in wild-type, but not Pxr-/-, mice. Furthermore, PCN treatment protected the barrier in the dextran-sulfate sodium model of experimental colitis, an effect that was associated with reduced expression of mucosal MLCK and phosphorylated JNK1/2. Together, our data suggest that the PXR regulates the intestinal epithelial barrier during inflammation by modulating cytokine-induced MLCK expression and JNK1/2 activation. Thus, targeting the PXR may prove beneficial for the treatment of inflammation-associated barrier disruption in the context of IBD.
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95
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Garg A, Mishra N, Gaikwad S, Gupta V. Bilateral Internal Carotid Artery Segmental Agenesis Associated with Persistent Trigeminal Artery, Vascular Ectasia, Abnormal Configuration of Brain Stem and Cerebellum. Neuroradiol J 2016; 20:25-9. [DOI: 10.1177/197140090702000103] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2006] [Accepted: 01/20/2007] [Indexed: 11/15/2022] Open
Abstract
Bilateral segmental agenesis of the internal carotid artery is a rare developmental anomaly. We report a case of congenital bilateral internal carotid arteries segmental agenesis associated with persistent trigeminal artery, vascular ectasia and abnormal configuration brain stem and cerebellum. We postulate that these findings could result from interference in development during the early stages.
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96
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Bisht R, Kale S, Natanasabapathi G, Singh M, Agarwal D, Rath G, Julka P, Kumar P, Thulkar S, Garg A, Sharma B. SU-F-T-593: Technical Treatment Accuracy in a Clinic of Fractionated Stereotactic Radiosurgery. Med Phys 2016. [DOI: 10.1118/1.4956778] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
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97
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Genovese M, Fay J, Parrino J, Garg A, van Hoogstraten H, Boddy A, Martincova R, Graham N, Simon J, Burmester G. FRI0228 Sarilumab Dose Reduction To Manage Laboratory Abnormalities in An Open-Label Extension Study in RA Patients. Ann Rheum Dis 2016. [DOI: 10.1136/annrheumdis-2016-eular.3709] [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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98
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Vise E, Das S, Garg A, Karam A, Ghatak S, Sen A, Shakuntala I, Puro K, Sanjukta R, Ahuja A, Bhattacharjee U, Kakoty K, Sharma N. Isolation and identification of a novel Non-tuberculous Mycobacterium species of canine origin by multiple gene sequencing approach. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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99
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Garg A, Merrison A. ID 516 – Simultaneous occurence of myasthenia gravis and polymyositis in a patient – Clinical and electrophysiological features. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2015.11.218] [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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100
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Baidya A, Ghosh A, Chopra S, Garg A, Sood S, Kapil A, Das BK. Congenital syphilis in the era of decreasing seroprevalence. Indian J Med Microbiol 2016; 34:111-2. [PMID: 26776135 DOI: 10.4103/0255-0857.167674] [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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