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Annadanam A, Hicks PM, Lu MC, Pawar M, Kochar P, Selvaraj S, Kuppuraj D, Rathod C, Muppala RS, Gaur S, Krishnan A, Sumithra SR, Woodward MA, Prajna NV. The effect of social determinants of health on severity of microbial keratitis presentation at a tertiary eye care hospital in Southern India. Indian J Ophthalmol 2023; 71:2448-2454. [PMID: 37322658 PMCID: PMC10417972 DOI: 10.4103/ijo.ijo_331_23] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2023] [Revised: 03/10/2023] [Accepted: 03/20/2023] [Indexed: 06/17/2023] Open
Abstract
Purpose Understanding the association between social determinants of health (SDoHs) and microbial keratitis (MK) can inform underlying risk for patients and identify risk factors associated with worse disease, such as presenting visual acuity (VA) and time to initial presentation. Methods This was a cross-sectional study was conducted with patients presenting with MK to the cornea clinic at a tertiary care hospital in Madurai, India. Patient demographics, SDoH survey responses, geographic pollution, and clinical features at presentation were collected. Descriptive statistics, univariate analysis, multi-variable linear regression models, and Poisson regression models were utilized. Results There were 51 patients evaluated. The mean age was 51.2 years (SD = 13.3); 33.3% were female and 55% did not visit a vision center (VC) prior to presenting to the clinic. The median presenting logarithm of the minimum angle of resolution (logMAR) VA was 1.1 [Snellen 20/240, inter-quartile range (IQR) = 20/80 to 20/4000]. The median time to presentation was 7 days (IQR = 4.5 to 10). The average particulate matter 2.5 (PM2.5) concentration, a measure of air pollution, for the districts from which the patients traveled was 24.3 μg/m3 (SD = 1.6). Age- and sex-adjusted linear regression and Poisson regression results showed that higher levels of PM2.5 were associated with 0.28 worse presenting logMAR VA (Snellen 2.8 lines, P = 0.002). Patients who did not visit a VC had a 100% longer time to presentation compared to those who did (incidence rate ratio = 2.0, 95% confidence interval = 1.3-3.0, P = 0.001). Conclusion Patient SDoH and environmental exposures can impact MK presentation. Understanding SDoH is important for public health and policy implications to mitigate eye health disparities in India.
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Affiliation(s)
- Anvesh Annadanam
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Patrice M Hicks
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Ming-Chen Lu
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Mercy Pawar
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | - Prabhleen Kochar
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Suvitha Selvaraj
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Dhanya Kuppuraj
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Chetan Rathod
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Rekha Sravya Muppala
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Smriti Gaur
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Abinaya Krishnan
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - SR Sumithra
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
| | - Maria A Woodward
- Department of Ophthalmology and Visual Sciences, University of Michigan, Ann Arbor, Michigan, USA
- Institute for Healthcare Policy and Innovation, University of Michigan, Ann Arbor, USA
| | - N Venkatesh Prajna
- Department of Cornea & Refractive Surgery, Aravind Eye Hospital, Madurai, Tamil Nadu, India
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Dhakre VW, Galande ST, Patil VG, Shah NC, Rathod C, Sethna KS, Amrapurkar AD. Mixed Neuroendocrine and Non-Neuroendocrine Neoplasm of Pancreas: What Do We Know, What Have We Learnt? Gastrointest Tumors 2023; 10:14-18. [PMID: 37102120 PMCID: PMC10123363 DOI: 10.1159/000528759] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/30/2021] [Accepted: 12/05/2022] [Indexed: 04/28/2023] Open
Abstract
Pancreatic adeno-mixed neuroendocrine non-endocrine (pMINEN) tumors are extremely rare [Pancreatology. 2021;21(1):224-235]. They are known to have distal metastasis at presentation and have a comparatively lower survival rate than similar staged neuroendocrine (NEN) carcinoma, adenocarcinoma, and small-cell lung tumor from which its treatment patterns are extrapolated. Also, very less is known about its molecular structure and natural courses. There is a dearth of data about pMINEN in the literature, and also there is a lack of large multicentral trials due to which the MINEN tumors do not have a standard universal management protocol. We discuss here the clinical dilemmas that arise during diagnosis and reporting and urge to form a multicentric trial to formulate a focused protocolized approach. We describe here our encounter with a pancreatic head lesion which on immunohistochemical analysis turned out to be a pMINEN with moderately differentiating ductal adenocarcinoma and low-grade NEN tumor. Radical R0 surgery with multimodal treatment (chemotherapy + radiotherapy) gains improved survival in long term.
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Affiliation(s)
- Vijay W. Dhakre
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Sneha Tukaram Galande
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Varsha Gunvant Patil
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Nikita C. Shah
- Department of Pathology, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Chetan Rathod
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Kaiumarz S. Sethna
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Anjali D. Amrapurkar
- Department of Pathology, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
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Dhakre VW, Suryawanshi SS, Shewale VP, Rathod C, Galande ST, Sethna KS. Successful Use of Direct Splenic Vein Anastomosis to the Interposition Internal Jugular Vein Graft after Extended Pancreatoduodenectomy to Avoid Sinistral Portal Hypertension. Gastrointest Tumors 2022; 9:69-73. [PMID: 36590853 PMCID: PMC9801392 DOI: 10.1159/000522590] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/24/2021] [Accepted: 02/06/2022] [Indexed: 01/04/2023] Open
Abstract
Splenic vein (SV) ligation may be needed during portomesenteric junction resection, in pancreatoduodenectomy. Sinistral portal hypertension is a concern if the SV is not drained. Various techniques are described to reconstruct SV to avoid the variceal formation and sinistral portal hypertension which may lead to GI bleed. We describe a case of a 19-year-old female who underwent pancreatoduodenectomy for solid pseudopapillary neoplasm with portal-superior mesenteric vein junction resection and splenic venous was anastomosed into the interposition graft. We here share our unique experience of using an interposition internal jugular vein graft for a long venous defect and diverging morbidity of sinistral portal hypertension.
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Affiliation(s)
- Vijay W. Dhakre
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India,*Vijay W. Dhakre,
| | - Shrikant S. Suryawanshi
- Department of Cardiovascular and Thoracic Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Vijay P. Shewale
- Department of Cardiovascular and Thoracic Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Chetan Rathod
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Sneha Tukaram Galande
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
| | - Kaiumarz S. Sethna
- Department of Surgery, Lokmanya Tilak Municipal General Hospital and Lokmanya Tilak Municipal Medical College, Mumbai, India
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Shah SM, Shah MA, Singh R, Rathod C, Khanna R. A prospective cohort study on the epidemiology of ocular trauma associated with closed-globe injuries in pediatric age group. Indian J Ophthalmol 2021; 68:500-503. [PMID: 32057012 PMCID: PMC7043148 DOI: 10.4103/ijo.ijo_463_19] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Purpose: To study the epidemiology of mechanical ocular trauma and closed globe injury using the Birmingham Eye Trauma Terminology System in patients belonging to the pediatric age group. Methods: This work involved a prospective cohort study of all ocular trauma patients (pediatric age group) registered between 2002 and 2017 at the ocular trauma care center. The data were collected using the international ocular trauma society form through our online MIS data and exported to the Excel sheet. The statistical analyses including the univariate analysis and cross tabulation were carried out using SPSS 22 software. Results: Our cohort consisted of 12687 patients with mechanical ocular trauma. There were 7546 (59.4%) eyes with open globe ocular injuries and 5328 (41.9%) with closed globe injuries. Of all closed globe injury patients, 1010 (19.0%) belonged to the pediatric age group (0-18 years), including 690 males (68.3%) and 320 females (31.7%). The mean age of the patients was 10.2 ± 5.1 years. Of all closed globe injuries, 692 (68.5%) were closed globe contusion and 318 (31.5%) were lamellar laceration. Conclusion: Closed globe injury is an important in cause of vision loss in children (24% <1/60). The condition is more prevalent in males and >51.7% in children under 10 years of age. The treatment has significant impact on the visual outcome in patients belonging to the pediatric age group.
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Affiliation(s)
- Shreya M Shah
- Department of Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India
| | - Mehul A Shah
- Department of Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India
| | - Romi Singh
- Department of Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India
| | - Chetan Rathod
- Department of Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India
| | - Ranuq Khanna
- Department of Pediatric Ophthalmology, Drashti Netralaya, Dahod, Gujarat, India
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Patil AS, Iratwar S, Rathod C, Korde P. Target Sign of Third Ventricle in Basilar Dolichoectasia with Multiple Clinical Presentations: A Case Report. Indian Journal of Neurosurgery 2020. [DOI: 10.1055/s-0039-3402536] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Abstract
AbstractBasilar dolichoectasia (BDE) is an uncommon anatomical variant usually detected incidentally or during stroke evaluation. BDE can occasionally become symptomatic and may present with stroke (infarct or hemorrhage), raised intracranial pressure due to obstructive hydrocephalus, or with cranial nerve palsies. We present a unique case of BDE presenting with obstructive hydrocephalus, stroke, and cranial nerve palsy in single patient and propose a radiological sign (target sign of third ventricle), which could aid in imaging diagnosis and further management.
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Affiliation(s)
- Akshay S. Patil
- Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
| | - Sandeep Iratwar
- Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
| | - Chetan Rathod
- Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
| | - Paresh Korde
- Department of Neurosurgery, Jawaharlal Nehru Medical College and Acharya Vinoba Bhave Rural Hospital, Sawangi, Wardha, Maharashtra, India
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Chakraborty A, Patel J, Mukherjee P, Sethna K, Ghag G, Goswami J, Rathod C. 701. Comparison of oral hydration versus conventional intravenous hydration in patients receiving cisplatin in preventing nephrotoxicity. Eur J Surg Oncol 2016. [DOI: 10.1016/j.ejso.2016.06.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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Bross ID, Gregory AR, Rathod C, Bross DS. Unobstrusive biomedical data-input systems. Int J Biomed Comput 1973; 4:219-28. [PMID: 4747169 DOI: 10.1016/0020-7101(73)90020-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/12/2023]
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