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Tandon R, Singal G, Chand Arya R, Sachdeva S, Goyal A, Takkar Chhabra S, Aslam N, Singh Wander G, Mohan B, Batta A. Role of two-dimensional strain echocardiographic parameters in suspected acute coronary syndrome patients with initial non-diagnostic electrocardiogram and troponins: An observational study. Echocardiography 2023; 40:802-809. [PMID: 37417914 DOI: 10.1111/echo.15647] [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: 03/25/2023] [Revised: 06/11/2023] [Accepted: 06/29/2023] [Indexed: 07/08/2023] Open
Abstract
INTRODUCTION Diagnosis of acute coronary syndrome (ACS) is often challenging especially in presence of initial normal troponins and non-specific electrocardiogram. The index study aimed at determining the diagnostic value of strain echocardiography in patients with suspected ACS but with non-diagnostic electrocardiogram and echocardiography findings. METHODS The study was conducted on 42 patients with suspected ACS and non-diagnostic electrocardiograms, normal quantitative troponin-T levels, and left ventricular function. All patients underwent conventional and 2D-strain echocardiography followed by coronary angiography, within 24 h of admission. Patients with regional wall motion abnormalities (RWMA), valvular heart disease, suspected myocarditis, and past coronary artery disease (CAD) were excluded. RESULTS Amongst the global strains, the global circumferential strain (GCS) was significantly reduced (p = .014) amongst those with significant CAD on angiography as opposed to global longitudinal strain (GLS) which was similar in the two groups (p = .33). The GCS/GLS ratio was also significantly reduced in patients with significant CAD compared to those with normal/mild disease on coronary angiography (p = .025). Both the parameters had good accuracy in predicting significant CAD. GCS displayed a sensitivity of 80% and a specificity of 86% at an optimal cut-off 31.5% (AUROC: .93, 95% CI: .601-1.000; p = .03), and likewise GCS/GLS ratio had a sensitivity of 80% and a specificity and 86% at a cut-off of 1.89% (AUROC: .86, 95% CI: .592-1.000; p = .049). GLS and peak atrial longitudinal strain (PALS) did not differ significantly in patients with/without significant CAD (p = .32 and .58, respectively). CONCLUSION GCS and GCS/GLS ratio provides incremental value in comparison to GLS, PALS, and tissue Doppler indices (E/e') in patients with suspected ACS and non-diagnostic electrocardiogram and troponins. GCS at cut-off of >31.5% and GCS/GLS ratio >1.89 can reliably exclude patients with significant CAD in this setting.
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Affiliation(s)
- Rohit Tandon
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Gautam Singal
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Rajesh Chand Arya
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Sidhant Sachdeva
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Abhishek Goyal
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Shibba Takkar Chhabra
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Naved Aslam
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Gurpreet Singh Wander
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Bishav Mohan
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
| | - Akash Batta
- Department of Cardiology, Dayanand Medical College and Hospital (DMCH), Ludhiana, India
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Mohan B, Singal G, Singh AK, Singh B, Singla A, Hatwal J, Uppal A, Tandon R, Singh G, Goyal A, Chhabra ST, Aslam N, Roy A, Wander GS, Batta A. Prevalence and predictors of lower extremity atherosclerotic disease amongst high-risk patients using ankle brachial index. Indian Heart J 2023:S0019-4832(23)00048-2. [PMID: 37003536 DOI: 10.1016/j.ihj.2023.03.008] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2022] [Revised: 02/15/2023] [Accepted: 03/28/2023] [Indexed: 04/03/2023] Open
Abstract
INTRODUCTION The prevalence of lower extremity artery disease (LEAD) continues to increase worldwide. This is expected to translate into logarithmic rise in lower-limb amputations especially in the developing world. Majority of patients suffering from LEAD remain asymptomatic until late and are vulnerable to limb-threatening complications unless actively screened and treated. METHODS This was a prospective, single-center, observational study to determine the prevalence and predictors of LEAD. Patients with known atherosclerotic vascular disease (but not known LEAD) or those at risk were enrolled. All underwent ABI measurement as per the standard protocol. A threshold of ABI ≤ 0.90 was taken to diagnose LEAD. RESULTS A total of 1000 patients were enrolled. The mean age of the group was 61.4±10.0 years and the prevalence of LEAD was 10.2%. Amongst those who had LEAD, the majority of patients (69.6%) had no symptoms. The prevalence of LEAD in diabetic population in our study was 13.2% and in coronary artery disease patients it was 30.9%. Factors independently linked to LEAD on regression analysis included advanced age, presence of diabetes, smoking history, lower serum HDL and a lower ejection fraction. CONCLUSIONS The vast majority of patients suffering from LEAD are asymptomatic. Early diagnoses and institution of appropriate medical and physical therapy can prevent excess morbidity and mortality due to LEAD. Factors independently linked to LEAD are advanced age, presence of diabetes, smoking history, lower serum HDL and a lower ejection fraction. The presence of either of these should signal undertaking of appropriate steps to unmask underlying LEAD.
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Affiliation(s)
- Bishav Mohan
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Gautam Singal
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Adesh Kumar Singh
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Bhupinder Singh
- Department of Cardiology, All India Institute of Medical Sciences, Bathinda, Punjab-151001, INDIA
| | - Ankur Singla
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Juniali Hatwal
- Department of Internal Medicine, Advanced Cardiac Centre, Post Graduate Institute of Medical Education & Research, Chandigarh-160012, INDIA
| | - Aditya Uppal
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Rohit Tandon
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Gurbhej Singh
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Abhishek Goyal
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Shibba Takkar Chhabra
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Naved Aslam
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Ambuj Roy
- Department of Cardiology, All India Institute of Medical Sciences, Ansari Nagar- New Delhi, 110029, INDIA
| | - Gurpreet Singh Wander
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA
| | - Akash Batta
- Department of Cardiology, Dayanand Medical College and Hospital, Ludhiana, 141001, INDIA.
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Chhabra ST, Kaur G, Aggarwal R, Bansal N, Kishore H, Goyal M, Gupta A, Batta A, Singal G, Gupta V, Goyal A, Tandon R, Aslam N, Mohan B, Wander G. Outpatient Attendance in COVID Pandemic Lockdown: An Observational Study. IJCDW 2023. [DOI: 10.25259/ijcdw_17_2023] [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] [Subscribe] [Scholar Register] [Indexed: 03/06/2023]
Abstract
Objectives:
The objectives of this study were to analyze the profile of outpatient department (OPD) attendance of a tertiary care hospital during pre- and post-pandemic lockdown period.
Materials and Methods:
All consecutive patients presenting to OPD from August 1, 2019 to November 23, 2020 were included in the study. The sample was divided into Zone R (Regular domain) and Zone L (Lockdown domain). Zone L was divided into three groups A, B, and C; representing attendance to be <30%, 30–60%, and >60% of previous (i.e., Zone R), respectively. The patient gender, intradepartmental, and inter departmental OPD attendance data were collected and analyzed.
Results:
n = 428,322 patients attended the OPD in the study period. 301,586 patients presented in Zone R and 126,736 presented in Zone L (P = 0.000). Zone L recorded an OPD attendance drop to 42% of Zone R. The least attended an OPD (Group A) was ophthalmology, ENT, dermatology, surgery, and orthopedics versus highest attendance (Group C) was noticed in emergency OPD and oncology with a moderate decline in the rest (P = −0.00, 0.00, and 0.00, respectively). Both male and female attendance in the OPD showed a decline; however, the gender divide was apparent with significantly low women attendance in all the departments (P = 0.00).
Conclusion:
OPD attendance showed a significant reduction in COVID lockdown era hitting the non-emergent medical branches the most. The gender divide significantly widened with less female attendance recorded in most OPDs in pandemic lockdown. Apt administrative measures could prove fruitful by an improved OPD attendance and its psychosocial implications to a society with less disease burden.
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Affiliation(s)
- Shibba Takkar Chhabra
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Gurleen Kaur
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Riya Aggarwal
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Namita Bansal
- Research and Developement Centre, Dayanand Medical College and Hospital, Punjab, India
| | - Harsh Kishore
- Research and Developement Centre, Dayanand Medical College and Hospital, Punjab, India
| | - Mamta Goyal
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Anshuman Gupta
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Akash Batta
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Gautam Singal
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Vivek Gupta
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Abhishek Goyal
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Rohit Tandon
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Naved Aslam
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Bishav Mohan
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
| | - Gurpreet Wander
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India,
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Singal G, Batta A, Bhargava S, Kumar S, Tandon R, Gupta A, Goyal A, Chhabra ST, Aslam N, Wander GS, Mohan B. Clinical profile and outcome of cardiac manifestations in patients presenting with multisystem inflammatory syndrome in children associated with SARS-CoV-2 infection. Ann Pediatr Cardiol 2023; 16:114-117. [PMID: 37767171 PMCID: PMC10522157 DOI: 10.4103/apc.apc_18_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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 02/10/2023] [Accepted: 02/16/2023] [Indexed: 09/29/2023] Open
Abstract
Multisystem inflammatory syndrome in children (MIS-C) can cause significant morbidity and mortality in children. This study was conducted to assess the pattern and outcome of cardiac abnormalities in MIS-C. This retrospective study was conducted in children with MIS-C between 1 month and 18 years. We enrolled 53 children with a mean age of 7.78 ± 4.62 years. Overall, 35.8% of children with MIS-C had cardiac manifestations in the form of coronary artery abnormalities (CAAs) or left ventricular (LV) dysfunction. Younger age (P 0.009) and high C-reactive protein at admission (P = 0.001) were significant predictors of cardiac involvement. CAAs were seen in 11.3% of children. On follow-up, 67% and 83% of children showed regression of CAA at 1 and 6 months, respectively. 24.5% of patients had presented with LV dysfunction. LV ejection fraction improved significantly at 1 month (P = 0.002) and 6 months (P = 0.001). Cardiac outcomes in MIS-C were favorable with timely identification and treatment.
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Affiliation(s)
- Gautam Singal
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Akash Batta
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Siddharth Bhargava
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Sushil Kumar
- Department of Pediatrics, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - Rohit Tandon
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Anshuman Gupta
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Abhishek Goyal
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Shibba Takkar Chhabra
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Naved Aslam
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Gurpreet Singh Wander
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
| | - Bishav Mohan
- Department of Cardiology, Dayanand Medical College and Hospital, Unit Hero DMC Heart Institute, Ludhiana, Punjab, India
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Batta A, Gupta AK, Singal G, Mohan B, Kumar S, Jaiswal B, Hatwal J, Tandon R, Singh G, Goyal A, Singh B, Mittal N, Chhabra ST, Aslam N, Wander GS. Autoimmune polyendocrine syndrome II presenting paradoxically as Takotsubo cardiomyopathy: A case report and reappraisal of pathophysiology.. [DOI: 10.21203/rs.3.rs-1900621/v1] [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] [Subscribe] [Scholar Register] [Indexed: 06/27/2023]
Abstract
Abstract
BackgroundTakotsubo cardiomyopathy (TCM) is a rare disease entity characterized by acute, non-ischemic, reversible myocardial dysfunction that mimics acute myocardial infarction. Activation and excessive outflow of sympathetic nervous system is believed to be central to the figure in the disease pathogenesis. Adrenocortical hormones potentiate the systemic actions of sympathetic nervous system and accordingly are essential for regulation of myocardial function. We present an unusual case of a middle-aged woman with primary adrenal insufficiency who presented paradoxically with TCM. Case presentation A 50-year-old woman with past history of hypothyroidism presented to emergency department with history of acute chest pain and syncope. There was no significant drug history or history of an emotional or physical stimulus prior to admission. Prominent pigmentation over the tongue and skin creases of hands were noted. On presentation she was in shock and had ventricular tachycardia which required electrical cardioversion. The subsequent electrocardiogram demonstrated diffuse T-wave inversions with prolonged QTC. There was apical hypokinesia on echocardiogram and cardiac biomarkers were elevated. There was persistent inotropic requirement. She had marked postural symptoms and a postural blood pressure drop of 50mm Hg was present. Initial laboratory parameters were significant for hyperkalemia (7.8mEq/L) and hyponatremia (128mEq/L). These findings prompted evaluation for adrenal insufficiency which was confirmed with appropriate tests. Autoimmune polyendocrine syndrome II was thus diagnosed based on the above findings. Coronary angiography revealed normal coronaries. The diagnoses of TCM was established in accordance with the International takotsubo diagnostic criteria. She was started on stress dose steroid replacement therapy and improved dramatically. At one month of follow-up, the patient is asymptomatic and there was normalization of her left ventricular function. ConclusionsIntricate relationship and interplay exist between the steroid hormones and catecholamines in the pathogenesis of TCM. Steroid hormones not only potentiate the actions of catecholamines, they also regulate and channelize catecholaminergic actions preventing their deleterious effects on the cardiac tissue. Hence, both steroid deficiency and exogenous steroid replacement may precipitate TCM. Evidence from more such cases and larger perspective studies in the future will further improve our understanding of this complex disease process and its myriad associations.
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Affiliation(s)
| | | | | | | | | | | | - Juniali Hatwal
- PGIMER: Post Graduate Institute of Medical Education and Research
| | | | | | | | - Bhupinder Singh
- AIIMS Bathinda: All India Institute of Medical Sciences Bathinda
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Kataria V, Yaduvanshi I, Singal G, Nair M. Establishing a diagnostic reference level of radiation dose in coronary angiography and intervention: A prospective evaluation. Indian Heart J 2021; 73:725-728. [PMID: 34861982 PMCID: PMC8642644 DOI: 10.1016/j.ihj.2021.09.012] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2021] [Revised: 07/12/2021] [Accepted: 09/13/2021] [Indexed: 12/01/2022] Open
Abstract
INTRODUCTION Invasive Coronary Angiography (CAG) leads to significant radiation exposure to the patients. Guidelines suggest that a local landmark or Diagnostic Reference Level (DRL) for these procedures should be established for every region and country. This study attempts to create a DRL for a tertiary care hospital, acting as an interim DRL for the country/region. METHODS Radiation exposure data for all coronary procedures done at a tertiary care hospital between October 2016 to September 2018 were collected. Data was segregated into diagnostic Coronary Angiography (CAG) and single-vessel Percutaneous Intervention (PCI). The parameters collected include dose surface product (PKA), skin surface entry dose (KAR), and fluoroscopy time (FT). The 75th percentile of the PKA was used to define the DRL. RESULTS 500 Patients were included in the CAG group, in which the Median KAR was 412.05 mGy, Median PKA was 2635.7 μGysqm, and median FT was 2.25 min. The DRL for coronary angiography was calculated as 3695.1 μGysqm. Two hundred fifty patients were in the PCI group, the Median KAR was 1649 mGy, Median PKA was 8822.1 μGysqm, the median FT being 8.2 min. The DRL for single-vessel coronary intervention was calculated as 11038 μGysqm. CONCLUSION This study establishes a benchmark for radiation dose for diagnostic coronary angiography and single-vessel coronary intervention at a tertiary care hospital in NCR. It establishes an interim DRL that can be used for future studies in other institutions in the region and country and to compare with other countries.
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Affiliation(s)
- Vikas Kataria
- Department of Cardiology, Holy Family Hospital, New Delhi, 110025, India
| | - Ishita Yaduvanshi
- Department of Cardiology, Holy Family Hospital, New Delhi, 110025, India
| | - Gautam Singal
- Department of Cardiology, Holy Family Hospital, New Delhi, 110025, India
| | - Mohan Nair
- Department of Cardiology, Holy Family Hospital, New Delhi, 110025, India.
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Menon S, Ellis C, Poudel S, Johnson J, Szabo A, George B, Kevin Kelly W, Grant S, McPherson J, Cristofanilli M, Hoimes C, Gutierrez M, Doudement J, Chan L, Singal G, Alexander B, Miller V, Sohal D. B08 Impact of Concurrent STK11 Loss and c-MYC Amplification in Metastatic Non-Small Cell Lung Cancer (NSCLC). J Thorac Oncol 2020. [DOI: 10.1016/j.jtho.2019.12.077] [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: 11/28/2022]
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Madison R, Schrock A, Gregg J, Carson K, Castellanos E, Singal G, Miller V, Ali S, Alexander B, Chung J. P1.01-23 Retrospective Analysis of Real-World Clinico-Genomic Data for Clinical Impact of Genomic Profiling of ctDNA in NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.738] [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: 10/25/2022]
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Murugesan K, Li G, Kaushik G, Singal G, Miller V, Frampton G, Albacker L. Identification of genomic markers of sensitivity and resistance to checkpoint inhibitors in non-small cell lung cancer in a real world clinico-genomic database. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy292.033] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Ross J, Goldberg M, Albacker L, Gay L, Agarwala V, Elvin J, Vergilio JA, Suh J, Ramkissoon S, Severson E, Daniel S, Ali S, Schrock A, Frampton G, Fabrizio D, Miller V, Singal G, Abernethy A, Stephens P. Immune checkpoint inhibitor (ICPI) efficacy and resistance detected by comprehensive genomic profiling (CGP) in non-small cell lung cancer (NSCLC). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.004] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Singal G, Miller P, Agarwala V, Li G, Gossai A, Albacker L, Goldberg M, He J, Frank S, Bourque D, Ivanov I, Fabrizio D, Caron T, Parker A, Guria A, Miller V, Elvin J, Ross J, Abernethy A, Stephens P. Analyzing biomarkers of cancer immunotherapy (CIT) response using a real-world clinico-genomic database. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx376.005] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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Chandna P, Adlakha VK, Singal G, Sharma R. Pediatric oral lichen planus: review and case report. Curr Pediatr Rev 2014; 10:292-6. [PMID: 25594529 DOI: 10.2174/1573396311666150113212652] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/20/2014] [Revised: 12/10/2014] [Accepted: 12/25/2014] [Indexed: 11/22/2022]
Abstract
Oral Lichen Planus (OLP) is one of the most common dermatologic diseases occurring in the mouth with an overall prevalence of 0.5 - 2.2%. Childhood OLP is rare and follows an atypical course. OLP typically presents clinically as bilateral, symmetrical, flat- topped polygonal papules and plaques that may be symptomatic or asymptomatic. The aim of this article is to present a brief review of OLP with a case report of a 7 year old girl with OLP.
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Affiliation(s)
| | | | | | - Rohit Sharma
- Department of Paedodontics and Preventive Dentistry, Subharti Dental College, Meerut, India.
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Meng M, Cherian T, Singal G, Sinha P. Functional lateralization of face processing. J Vis 2010. [DOI: 10.1167/10.7.562] [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: 11/24/2022] Open
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