1
|
Kulkarni S, Dwivedi G, Singh A, Tiwari V. Hemangioma - A Rare Cause of Laryngeal Growth in an Adult and its Management with Sclerotherapy and Laser Surgery: A Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:2485-2487. [PMID: 37636733 PMCID: PMC10447348 DOI: 10.1007/s12070-023-03765-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [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: 01/25/2022] [Accepted: 03/31/2023] [Indexed: 08/29/2023] Open
Abstract
Hemangiomas are benign tumors of vascular origin commonly affecting head and neck region. Laryngeal Hemangiomas are however rare and have no well-defined management protocols. We present an interesting case of a 42-year-old adult who was diagnosed as a case of Laryngeal Hemangioma based on clinical and radiological findings and was managed with local injection of sclerosing agent followed by CO2 Laser fulguration. The patient had a satisfactory outcome and remains asymptomatic.
Collapse
Affiliation(s)
| | | | | | - Vibhu Tiwari
- Swargiya Drigchandra Memorial Clinic, Bendo, 210429 Mahoba, Uttar Pradesh India
| |
Collapse
|
2
|
Shukla S, Dwivedi G, Goyal S, Sengupta P. 'Lateral Aberrant Thyroid Carcinoma' or 'Thyroglossal Duct Cyst Carcinoma Metastasizing to Neck Node': Can we Decide in this Interesting Case Report?. Indian J Otolaryngol Head Neck Surg 2023; 75:2626-2629. [PMID: 37636601 PMCID: PMC10447327 DOI: 10.1007/s12070-023-03874-3] [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: 04/27/2023] [Accepted: 05/06/2023] [Indexed: 08/29/2023] Open
Abstract
Lateral aberrant thyroid(LAT) belongs to subset of ectopic thyroid, mostly presenting as asymptomatic lateral neck swelling and are challenging to diagnose without histopathological examination. Malignant transformation in LAT is even rare and is best managed by surgical excision. Here, we report a case of papillary carcinoma of LAT, but with an unusual post-operative finding, revealing papillary carcinoma of thyroglossal duct cyst.
Collapse
Affiliation(s)
- Shambhavi Shukla
- Department of ENT, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| | - Gunjan Dwivedi
- Department of ENT, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| | - Sunil Goyal
- Department of ENT, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| | - P Sengupta
- Department of Pathology, Command Hospital (Eastern Command), Alipore-700027, Kolkata, India
| |
Collapse
|
3
|
Dwivedi G, Ranganathan Y, Bandopadhyay A, Mukherjee T. Solitary Fibrous Tumor of Parapharyngeal Space: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2023; 75:1152-1156. [PMID: 37275014 PMCID: PMC10235249 DOI: 10.1007/s12070-022-03439-w] [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: 11/07/2022] [Accepted: 12/22/2022] [Indexed: 01/01/2023] Open
Abstract
Solitary fibrous tumors are rare vascular tumours, earlier referred to as hemangiopericytoma. Their occurrence in parapharyngeal space is very rare. Hence, they should also be considered in the differential diagnosis of parapharyngeal soft tissue tumours. This case is being reported to bring out an extremely rare vascular tumour at rare site and represents a surgical challenge because of difficult access in parapharyngeal space with difficult planes between tumour and rest of parapharyngeal space, approach to it is also difficult.
Collapse
Affiliation(s)
- Gunjan Dwivedi
- Department of ENT, Command Hospital Eastern Command, 17/1E, Alipore Main Road, Alipore, Kolkata, 700027 India
| | - Yamuna Ranganathan
- Department of ENT, Command Hospital Eastern Command, 17/1E, Alipore Main Road, Alipore, Kolkata, 700027 India
| | - Arnab Bandopadhyay
- Department of Surgical Oncology, Command Hospital Eastern Command, Kolkata, India
| | - Tanushri Mukherjee
- Department of Pathology, Command Hospital Eastern Command, Kolkata, India
| |
Collapse
|
4
|
Negi M, Patnaik U, Sood A, Thakur S, Kumari A, Dwivedi G, Gupta V. Complications of Acute Bacterial Rhinosinusitis in Contemporary Practice: Lessons Learnt and the Way Ahead. Indian J Otolaryngol Head Neck Surg 2023; 75:1024-1032. [PMID: 37206759 PMCID: PMC10188724 DOI: 10.1007/s12070-023-03571-1] [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: 03/21/2022] [Accepted: 02/06/2023] [Indexed: 02/27/2023] Open
Abstract
There are variable presentations of complications of rhinosinusitis, which may be subtle especially due to use of antibiotics. Thus the classical picture as described by Chandler is rarely seen and threshold for diagnosing and treating a complication should be low. To identify possible risk factors for development of complications in acute bacterial rhinosinusitis (ABRS) and suggest a new method of reporting/classifying the complications. We conducted a retrospective study and observed the clinical presentation and risk factors of 9 patients who presented with complications of ABRS in our OPD during a period of 6 years, and then tried to formulate a reporting method based on the risk factors. We identified certain risk factors which include age, gender, sinus involved, extension beyond sinus, history of trauma, anatomical variations, and duration of symptoms. There are possible risk factors for development of complications. These factors can be studied in further details to ascertain their causal relationship in causing these complications. We also suggest a new method of reporting the complications. Such a reporting system would help in accurately identifying the exact severity of the disease, prognosticating the disease and guide treatment.
Collapse
Affiliation(s)
- Mayank Negi
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| | - Uma Patnaik
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| | - Amit Sood
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| | - Somesh Thakur
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| | - Abha Kumari
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| | - Gunjan Dwivedi
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| | - Vikas Gupta
- Department of Otorhinolaryngology, Command Hospital (Southern Command), Pune, India
| |
Collapse
|
5
|
Sethi D, Dwivedi G, Raina S. Endoscopy Assisted Removal of Post Traumatic Impacted Foreign Body in the Nose Extending into Opposite Parapharyngeal Space. Indian J Otolaryngol Head Neck Surg 2023; 75:1108-1112. [PMID: 37206836 PMCID: PMC10188839 DOI: 10.1007/s12070-023-03677-6] [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: 01/09/2023] [Accepted: 02/27/2023] [Indexed: 03/17/2023] Open
Abstract
The head and neck region is a complex anatomical area with vulnerable nervous and vascular structures, auditory and visual organs and upper aero-digestive tract. Penetrating foreign bodies of head and neck region are not uncommon and pertain mostly to wood, metal and glass (Levine et al. in Am J Emerg Med 26:918-922, 2008). This case report describes an airborne high velocity foreign body blown off from a lawn mower penetrating the left side of the face, penetrating deep into nasopharynx and opposite parapharyngeal space through paranasal sinuses. A multidisciplinary team managed this case successfully, avoiding injuries to adjacent vital skull base structures.
Collapse
Affiliation(s)
| | - Gunjan Dwivedi
- Department of ENT & HNS, Command Hospital (EC), Kolkata, India
| | - Sheetal Raina
- Department of ENT & HNS, Command Hospital (EC), Kolkata, India
| |
Collapse
|
6
|
Thakur S, Patnaik U, Saxena P, Tevatia MS, Dwivedi G, Kumari A, Rao NP, Sood A. Varied presentations of complicated rhinosinusitis in COVID era: a rational approach to management. Egypt J Otolaryngol 2023. [PMCID: PMC9829229 DOI: 10.1186/s43163-022-00374-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/11/2023]
Abstract
Abstract
Aim
To study the various presentations and manifestations of complicated rhinosinusitis in COVID era- ranging from bacterial rhino sinusitis to invasive fungal rhino sinusitis.
Methods
Design-A retrospective observational study was carried out from March 2020 to May 2021. Setting-Tertiary care hospital subjects—all COVID-positive patients who had paranasal sinus involvement. Methods-Patients were evaluated based on their symptomatology profile. Fungal stains and culture were carried out for all. They underwent Magnetic resonance Imaging and Computed Tomography scan on case-to-case basis, apart from routine nasal endoscopy. All were managed both medically and surgically depending upon their diagnosis. The natural course including outcomes, was studied, documented and analyzed.
Results
Out of 496 patients presenting with sinonasal disease, 126 were COVID-positive, 16 patients had complicated rhino sinusitis, of which 4 patients had complicated rhinosinusitis with intraorbital, intracranial or combined complications. All patients were managed successfully with combined medical and surgical approach. Twelve patients had invasive mucormycosis with overall mortality rate of 37%.
Conclusion
Complicated sinusitis was encountered in COVID-positive patients either when they were being actively treated for COVID-19 or as part of post-COVID sequalae. Though rhino-orbito-cerebral mucormycosis constituted the major disease burden in such patients but the possibility of bacterial rhino sinusitis with or without complications must also be kept in mind while evaluating such patients. We must remember every complicated rhinosinusitis in COVID-positive patient may not be mucor and manage appropriately.
Collapse
|
7
|
Gupta V, Dwivedi G, Chugh R, Sahu PK, Gupta DK, Basu A, Upadhyay K, Patnaik U, Bhatia R. Role of Octreotide in Conservative Management of Chyle Leak Post Neck Dissection in Cases of Head Neck Cancer: A Retrospective Analysis. Indian J Otolaryngol Head Neck Surg 2022; 74:6078-6086. [PMID: 36742480 PMCID: PMC9895617 DOI: 10.1007/s12070-021-02746-y] [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: 02/24/2021] [Accepted: 06/27/2021] [Indexed: 02/07/2023] Open
Abstract
Chyle leak is a dreadful complication in patients undergoing neck dissections. Octreotide has been used in the management of chyle leak post neck dissections in head and neck cancer patients. Currently there is no consensus and practice guidelines on the same. (1) To study the role of octreotide in early cessation of post neck dissection chyle leak. (2) To study incidence of intra-operative and post-operative CL, its relation to the extent of nodal disease and neck dissection, prior radiotherapy. Retrospective analysis of 16 patients out of 529 neck dissection over a period of 03 years between Jan 2016 and Dec 2019 who developed post-operative chyle leak. All patients who had post-operative chyle leak were administered octreotide. Time taken for chyle leak to stop was primary outcome. Secondary outcomes were duration of hospitalization post-operatively, incidence of intra-operative and post-operative chyle leak, its relation to the extent of nodal disease, prior radiotherapy and type of neck dissection. 59 of 529 neck dissections (11.15%) were noted to have intra-operative chyle leak. 16 of 529 neck dissections (3.02%) developed post-operative chyle leak. On applying chi square test, prior multimodality and N plus neck were found to be significant risk factors in developing postoperative chyle leak. Considering only RT versus no RT in prior multimodality treated group, the difference was insignificant. Onset of chyle leak varied from 1 to 5 post-op day (mean 2.68 days). 15 (93.75%) patients responded to octreotide. Chyle leak resolved between 3 and 10 days (mean 5.18 days) and octreotide was given for 5-12 days (mean-7.18 days). Overall duration of hospitalization ranged from 09 to 18 days (mean 12.18 days). 01 patient (6.25%) had to be re-explored due to high volume leak despite using octreotide. Adverse effects of octreotide were minimal and tolerable. Octreotide is effective in reducing the duration of chyle leak, hospital stay and need for surgical intervention. It may be considered as suitable adjunct to conservative measures in the management for post-operative chyle leak.
Collapse
Affiliation(s)
- Vikas Gupta
- Department of ORL-HNS, Command Hospital, Lucknow, Uttar Pradesh India
| | - Gunjan Dwivedi
- Department of ORL-HNS, Command Hospital, Pune, Maharashtra India
| | - Rajeev Chugh
- Department of ORL-HNS, Army Hospital (Research and Referral), New Delhi, India
| | | | | | - Abhijit Basu
- Department of ORL-HNS, Command Hospital, Lucknow, Uttar Pradesh India
| | - Kiran Upadhyay
- Department of ORL-HNS, Command Hospital, Lucknow, Uttar Pradesh India
| | - Uma Patnaik
- Department of ORL-HNS, Command Hospital, Pune, Maharashtra India
| | - Ritika Bhatia
- Department of ORL-HNS, Command Hospital, Lucknow, Uttar Pradesh India
| |
Collapse
|
8
|
Dwivedi G, Sood A, Patnaik U, Kumari A. Assessment of Level of Patient Satisfaction with Day-Care Surgery: An Observational Study. Indian J Otolaryngol Head Neck Surg 2022; 74:5252-5257. [PMID: 36742571 PMCID: PMC9895141 DOI: 10.1007/s12070-020-01972-0] [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: 03/17/2020] [Accepted: 07/13/2020] [Indexed: 02/07/2023] Open
Abstract
To assess the level of patient satisfaction with day-care surgery at a tertiary care centre and to find out the different determinants that influence the patient satisfaction. Observational study; Tertiary care hospital in Western India; Patients undergoing Day-care surgery at Dept of ENT from Feb 2018 to Aug 2018; All patients who underwent day-care surgery were given a questionnaire to determine level of satisfaction. On analysis of data according to questions the average score was in the range of 3.5 to 4.22 out of a maximum score of 5. On analysis of data according to domains of patient care the scores ranged from 3.61 to 4.19. Although patients were generally satisfied with the level of care being provided to them there is still scope of improvement.
Collapse
Affiliation(s)
- Gunjan Dwivedi
- Department of ENT Command Hospital Southern Command, Pune, India
| | - Amit Sood
- Department of ENT Command Hospital Southern Command, Pune, India
| | - Uma Patnaik
- Department of ENT Command Hospital Southern Command, Pune, India
| | - Abha Kumari
- Department of ENT Command Hospital Southern Command, Pune, India
| |
Collapse
|
9
|
Etheve L, Courcelles E, Lefaudeux D, Kurbatova P, Gomez G, Kahoul R, Boissel JP, Kulesza A, Dwivedi G, Schmidely N, Bertocchio JP, Gittoes N, Siebert U, Bechet E. 4Essais cliniques in silico, une approche innovante visant à compléter les essais cliniques dans le domaine des maladies rares : validation d'un modèle computationnel chez les patients atteints d'hypoparathyroïdie. Rev Epidemiol Sante Publique 2022. [DOI: 10.1016/j.respe.2022.09.063] [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: 11/06/2022] Open
|
10
|
Sehly A, He A, Jaltotage B, Lan NSR, Joyner J, Flack J, Sokolov J, Chronos N, Ko B, Chow B, Dwivedi G, Ihdayhid AR. Coronary artery stenosis and vulnerable plaque quantification on CCTA by deep learning methods. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.196] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Introduction
Coronary computed tomography angiography (CCTA) has emerged as a reliable non-invasive modality to assess coronary artery stenosis (CAS) severity and vulnerable plaque (VP). However, comprehensive CCTA assessment, especially VP, is time-consuming and dependent on reader expertise, limiting CCTA's true potential.
Purpose
In this study, we aim to develop and validate a deep learning (DL) based system capable of evaluating CAS severity and characterising VP on CCTA.
Methods
A DL system was trained to assess CAS severity on 3909 expert annotated vessels. A subset of 824 vessels was used to train the model to assess for the presence of VP. The model was based on a 2D U-Net and 3D convolutional neural network architecture. The system automatically performed vessel tracking and segmentation to quantify stenosis severity and characterise the presence of VP. CAS severity was categorised as 0%, 1–49% and ≥50%. VP was defined as: low attenuation plaque (LAP; ≤30 Hounsfield units), positive remodelling (PR; ≥10% diameter) and spotty calcification (SC; <3mm). The model was then tested on 1435 vessels for CAS (mean calcium score 197±502) and a subset of 365 vessels for VP (mean calcium score 419±551), and its diagnostic performance compared with expert readers.
Results
The CAS testing data had a prevalence of 75% (1080/1435), 18% (257/1435) and 6.8% (98/1435) for 0%, 1–49% and ≥50% stenosis, respectively. VP was present in 20% (72/365) in the respective dataset with 44% (32/72) LAP, 19% (14/72) PR and 36% (26/72) SC. Average analysis time for CAS severity and VP was 3.7±2.0s and 3.5±1.8s, respectively. Diagnostic performance of our system is summarised in Tables 1 (CAS severity) and 2 (VP characteristics).
Conclusions
We developed an DL based system capable of rapidly evaluating CAS severity and characterising VP on CCTA. Our system demonstrated high specificity and accuracy for both CAS severity and VP quantification when compared with expert readers.
Funding Acknowledgement
Type of funding sources: None.
Collapse
Affiliation(s)
- A Sehly
- Fiona Stanley Hospital , Perth , Australia
| | - A He
- Fiona Stanley Hospital , Perth , Australia
| | | | - N S R Lan
- Fiona Stanley Hospital , Perth , Australia
| | | | | | - J Sokolov
- University of Southern California, School of Medicine , Los Angeles , United States of America
| | - N Chronos
- School of Medicine , Stanford , United States of America
| | - B Ko
- Monash Heart , Melbourne , Australia
| | - B Chow
- Ottawa Heart Institute , Ottawa , Canada
| | - G Dwivedi
- Harry Perkins Institute of Medical Research , Perth , Australia
| | - A R Ihdayhid
- Harry Perkins Institute of Medical Research , Perth , Australia
| |
Collapse
|
11
|
Dwivedi G, Gupta V, Tiwari V, Patnaik U, Sood A, Kumari A, Bharadwaja S. Different Approaches to the Overlapping Infratemporal Fossa and Parapharyngeal Spaces: a Case Series and Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:2337-2343. [PMID: 36452571 PMCID: PMC9702234 DOI: 10.1007/s12070-020-02168-2] [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: 08/09/2020] [Accepted: 09/21/2020] [Indexed: 11/29/2022] Open
Abstract
Parapharyngeal space and infratemporal fossa are 2 overlapping spaces in head and neck which have complex anatomy with vital neurovascular structures passing through them. Tumors of this region are extremely rare but majority of them (80%) are benign. Benign tumors of this region can lead to swellings in facial region, neck and oropharynx. Dysphagia may be a complaint of the patient. Many of these tumors have malignant potential. Removal of these tumors requires a good understanding of the anatomy of this space so that correct surgical approach can be selected. The surgeon needs to be adept in using the most suitable surgical approach for excision of these tumors. There are various approaches which can be used to access these deeply seated tumors but the issue of prime importance is selecting the appropriate approach for the various tumors here based on their size and their exact location in this complex anatomical space. Inappropriate approach can lead to inadequate tumor excision and can lead to injuries to the neurovascular structures in this region which can cause significant disability. The case series reported here describes the various approaches to this region and highlights the importance of correct selection of the surgical approach.
Collapse
Affiliation(s)
| | | | | | | | - Amit Sood
- Department of ENT, CHSC, AFMC, Pune, India
| | | | | |
Collapse
|
12
|
Dwivedi G, Bharadwaja S, Kovilapu UB, Swain P, Kumari A. Carotid Body Tumor: A Case Report and Review of Literature. Indian J Otolaryngol Head Neck Surg 2022; 74:2409-2416. [PMID: 36452787 PMCID: PMC9702211 DOI: 10.1007/s12070-020-02189-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [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: 08/31/2020] [Accepted: 09/28/2020] [Indexed: 10/23/2022] Open
Abstract
Carotid body tumour (CBT) is a rare hypervascular tumor in the head and neck region. It develops from neural crest origin paraganglionic tissue which is an arterial chemoreceptor. It presents as a slow growing mass at the carotid bifurcation. Its optimal evaluation and treatment requires involvement of multiple specialities. Because of the high rate of neurovascular complications, resection of this tumor is challenging for surgeons. Early tumor detection, meticulous evaluation and multidisciplinary approach are vital for successful management of these tumors. A case of CBT in a 50 year-old lady managed at our centre is being reported here along with a review of literature.
Collapse
|
13
|
Mishra PS, Sidhu A, Dwivedi G, Mulajker DS, Awasthi S. Determining PD-L1 expression in head and neck squamous cell carcinoma using immunohistochemistry. Indian J Cancer 2022; 59:474-479. [PMID: 33753620 DOI: 10.4103/ijc.ijc_920_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Advanced head and neck squamous cell carcinoma (HNSCC) has limited treatment options. Programmed death-ligand1 (PD-L1) expressed by tumor cells interacts with PD-1 receptor on T lymphocytes leading to immune evasive response and survival advantage. Therapy with immune check-point inhibitors target PD-1/PD-L1 blockade inducing tumor regression. Immunohistochemistry (IHC) for PD-L1 expression enables patient selection for immunotherapy and may be considered a potential predictor of clinical response. Methods A retrospective analysis of IHC for PD-L1 expression using manual laboratory developed technique (LDT) with antibody clone 22C3 (Dako) in 93 cases of HNSCC. PD-L1 expression was correlated with age, gender, tumor site, grade and stage. Results PD-L1 IHC was performed in 93 cases and immunopositivity was noted in 59 (63.4%) cases. High expression with combined proportion score (CPS) ≥50 was seen in 15 (16.1%) cases and low expression with CPS ≥1 expression was seen in 44 (47.3%) cases. An almost-perfect interobserver agreement was noted by two pathologists for PD-L1 IHC expression (Cohen's kappa coefficient = 0.910). No statistically significant correlation was noted between PD-L1 score and patient demographics, tumor site, grade or stage. Conclusion Detection of PD-L1 status by IHC enables identification of HNSCC patients eligible for future targeted immunotherapy.
Collapse
Affiliation(s)
- Prabha S Mishra
- Department of Pathology, Command Hospital, Pune, Maharashtra, India
| | - Avnit Sidhu
- Department of Pathology, Command Hospital, Pune, Maharashtra, India
| | - Gunjan Dwivedi
- Department of Otorhinolaryngology, Command Hospital, Pune, Maharashtra, India
| | - Deepak S Mulajker
- Department of Internal Medicine and Oncology, Command Hospital, Pune, Maharashtra, India
| | - Shivali Awasthi
- Department of Pathology, Armed Forces Medical College, Pune, Maharashtra, India
| |
Collapse
|
14
|
Dwivedi G, Saxena P, Patnaik U, Kumari A, Sood A. Dermoid Cyst Floor of Mouth: A Diagnostic Conundrum. Indian J Otolaryngol Head Neck Surg 2022; 74:1961-1963. [PMID: 36452799 PMCID: PMC9702317 DOI: 10.1007/s12070-020-01939-1] [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: 05/31/2020] [Accepted: 06/25/2020] [Indexed: 10/23/2022] Open
Abstract
Dermoid cysts are benign tumours of ectodermal origin, commonly seen in young. The clinico-radiological presentation of dermoids can be equivocal, like in our case of a teenager who had painless swelling of floor of mouth. Radiological findings were consistent with cystic lesion but histopathological examination proved it as dermoid cyst.
Collapse
Affiliation(s)
| | | | | | | | - Amit Sood
- Department of ENT, CHSC, AFMC, Pune, India
| |
Collapse
|
15
|
Dwivedi G, Singh D, Surya N, Patnaik U, Sood A, Kumari A. Laryngeal Trauma Managed with Titanium Mesh Fixation: A Rare Case Report. Indian J Otolaryngol Head Neck Surg 2022; 74:2061-2064. [PMID: 36452665 PMCID: PMC9702437 DOI: 10.1007/s12070-020-02016-3] [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: 06/26/2020] [Accepted: 07/27/2020] [Indexed: 10/23/2022] Open
Abstract
Laryngeal fractures are though uncommon they can be potentially life threatening. Comminuted laryngeal cartilage fractures are difficult to manage and various fixation techniques have been described in literature. Outcome results of fixation with different materials can be varied. We report a case of 27 years old male who sustained laryngeal cartilage fracture following accidental fall. Patient underwent emergency tracheostomy and early surgical repair of fractured laryngeal thyroid cartilage with one of the newest techniques "titanium mesh fixation". After a month of surgery tracheostomy tube was removed and patient recovered with good laryngeal function. Titanium mesh fixation gave immediate effective fixation and stability to laryngeal fracture leading to good surgical outcome.
Collapse
Affiliation(s)
| | | | | | | | - Amit Sood
- Department of ENT CHSC, AFMC, Pune, India
| | | |
Collapse
|
16
|
Sahoo L, Dwivedi G, Behera A, Nayak NK, Sahoo KS, Patnaik U, Sood A. The Effect of Environmental Noise on Consonant Perception in Individual With Normal Hearing: A Prospective Observational Study. Indian J Otolaryngol Head Neck Surg 2022; 74:114-119. [PMID: 36032824 PMCID: PMC9411432 DOI: 10.1007/s12070-020-01899-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2020] [Accepted: 06/05/2020] [Indexed: 11/29/2022] Open
Abstract
This study was done to identify the effect that environmental noises have on consonant perception of individuals with normal hearing sensitivity. The objectives were to find out the effect of white noise and environmental noises on consonant identification and to find the effect of noises on consonant features. Adult with normal hearing in both ears whose mother tongue was Odia were included. Initially the participants underwent pure tone audiometry, speech audiometry, immittance audiometry to confirm their normal hearing, good speech identification scores and normal middle ear function. For consonant identification test, the presentation level was 40 dB sensation level with reference to speech recognition threshold for all subjects. Consonant identification test was carried out in white noise and real environmental noises (traffic noise, classroom noise, park noise, restaurant noise) at 0 dB signal to noise ratio (SNR) and at + 5 dB (SNR). The results showed that at + 5 dB SNR condition all subjects were able to get 80% and above consonant identification (CI) scores irrespective of type of noise used for stimulus while at 0 dB SNR, the mean scores ranged from 75.5% (restaurant noise) to 84% (traffic noise). At + 5 dB SNR only in restaurant noise the CI scores were low as compared to those in white noise. At 0 dB SNR, the scores were low for both the test conditions of park noise and that of restaurant noise. Different types of noisy environments can affect consonant perception which can affect speech intelligibility.
Collapse
|
17
|
Dwivedi G, Gupta V, Singh Y, Basu A, Upadhyay K, Bhatia R. Evaluation of Eustachian Tube Function in Cases of Chronic Otitis Media by Dynamic Slow Motion Videoendoscopy and Impedance Audiometry. Indian J Otolaryngol Head Neck Surg 2022; 74:339-344. [PMID: 36032911 PMCID: PMC9411281 DOI: 10.1007/s12070-020-02131-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/13/2020] [Accepted: 09/01/2020] [Indexed: 11/30/2022] Open
Abstract
Eustachian tube (ET) dysfunction is known to be a cause for various middle ear diseases. Dynamic slow motion videoendoscopy (DSVE) and impedance audiometry (IA) can both be employed to evaluate ET dysfunction. To assess the role of DSVE and IA for diagnosing ET dysfunction in cases of middle ear disorders. It is a prospective case control study. 102 ears with chronic otitis media were taken as cases and 102 healthy ears as controls. IA and DSVE were performed to assess ET function in both the groups. Sensitivity/ specificity of both the diagnostic tests were evaluated in case and control groups. Out of 102 ET of case group exposed to both tests, 87 were found to have ET dysfunction by DSVE and 80 by IA. Among 102 ET of control group 78 were identified as normal by DSVE while 87 by IA. On applying chi square test in both these groups, the associations were significant. (p value < 0.0001). Patients with grade 2B or higher on DSVE endoscopy had abnormal IA findings, indicating that higher the grade on DSVE, higher the chance of abnormal IA. DSVE and IA are potentially useful tools in evaluation of cases of COM and which provide information regarding functional and pathological factors responsible for ET dysfunction.
Collapse
|
18
|
He A, Sehly A, Jaltotage B, Lan N, Joyner J, Flack J, Sokolov J, Chronos N, Ko B, Chow B, Dwivedi G, Ihdayhid A. 448 Comprehensive Assessment Of Coronary Artery Disease On CCTA Using Deep Learning Methods. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.053] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
|
19
|
Sehly A, He A, Lan N, Jaltotage B, Joyner J, Flack J, Kwok S, Chow B, Ko B, Ridner M, Ihdayhid A, Dwivedi G. 402 Artificial Intelligence Based CT Quantification Of Left Ventricular Mass. J Cardiovasc Comput Tomogr 2022. [DOI: 10.1016/j.jcct.2022.06.007] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
|
20
|
Dorfman MR, Dwivedi G, Dambra C, Wilson S. Perspective: Challenges in the Aerospace Marketplace and Growth Opportunities for Thermal Spray. J Therm Spray Technol 2022; 31:672-684. [PMID: 37520273 PMCID: PMC9014972 DOI: 10.1007/s11666-022-01351-x] [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] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 11/08/2021] [Accepted: 11/08/2021] [Indexed: 08/01/2023]
Abstract
The market needs for increased engine efficiency and environmentally friendly solutions remain the key drivers for the aerospace industry. These efficiency gains will be achieved by meeting the challenges of higher engine operating temperatures, weight reduction, and novel surface solutions for increased component longevity. A critical question to address is if the thermal spray (TS) industry can continue to meet the challenges and demands seen by the airlines and the engine manufacturers. In addition to non-aerospace influences, the COVID-19 pandemic has dramatically affected the landscape of industry growth, not only directly on airlines but also on the associated supply chain. This article reviews this market, its suppliers, and identifies the challenges and opportunities for future growth. Primary focus is on technology and what will be required to bring about reliable, robust, and cost-effective TS solutions into the marketplace. Several issues affecting the global landscape of the aerospace industry are discussed including (1) sustainability, (2) technology, (3) cost of ownership, (4) evolving marketplace, (5) workforce and behavior, and (6) supply chain vitality. An important question to address is if the TS industry can accelerate development with its supply chain and have the ability to commercialize technology more efficiently. Despite the market setbacks from the pandemic and previous issues with the Boeing 737 MAX fleet, the aerospace industry is poised to make significant advancements. These will create new opportunities for thermal spray technology in materials, equipment, and processes. To deliver on them, the implementation of Industry 4.0 along with the investment in human resources is more critical than ever. Based on the findings, the authors project a bright long-term future for both the aerospace and thermal spray industries.
Collapse
Affiliation(s)
| | | | - C. Dambra
- Oerlikon Metco US Inc, Westbury, USA
| | - S. Wilson
- Oerlikon Metco US Inc, Westbury, USA
| |
Collapse
|
21
|
Kelly C, Lan N, Phan J, Hng C, Matthews A, Rankin J, Dwivedi G, Hillis G, Ihdayhid A. An Evaluation of Standard Modifiable Risk Factor (SMuRF) Prevalence and Preventive Treatment Among Patients ≤45 Years of Age Presenting With ST-Elevation Myocardial Infarction. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.484] [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: 10/16/2022]
|
22
|
Thomas D, Lan N, Jones C, Raju V, Soon J, Otto J, Wood C, Spencer R, Rankin J, Dwivedi G, Ihdayhid A. Evaluation of a Chest Pain Evaluation Pathway in the Emergency Department Utilising Computed Tomography Coronary Angiography as a First-Line Outpatient Test. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.337] [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: 10/16/2022]
|
23
|
Huangfu G, Jaltotage B, Pang J, Lan N, Abraham A, Otto J, Ihdayhid A, Rankin J, Watts G, Ayonrinde O, Dwivedi G. CT Evaluation of Hepatic Fat: A Novel Marker for High-Risk Coronary Atherosclerosis in Familial Hypercholesterolaemia. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.240] [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: 11/26/2022]
|
24
|
Sehly A, He A, Lan N, Jaltotage B, Kwok S, Flack J, Joyner J, Sokolov J, Chow B, Ko B, Figtree G, Ihdayhid A, Dwivedi G. Fully Automated Characterisation of Vulnerable Plaque Features on Cardiac CT Using Deep Learning Techniques. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.014] [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: 10/16/2022]
|
25
|
Bartlett B, Ludewick H, Verma S, Corrales-Medina V, Waterer G, Lee S, Dwivedi G. Cardiovascular Changes After Pneumonia in a Dual Disease Mouse Model. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.041] [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: 10/16/2022]
|
26
|
Lan N, Tan H, Chong T, Raju V, Dwivedi G, Ihdayhid A. Prevalence, Characteristics and Management of Individuals With Anomalous Coronary Arteries Detected on Cardiac Computed Tomography: an Australian Tertiary Hospital Experience. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.276] [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: 10/16/2022]
|
27
|
Lu J, Stewart J, Bennamoun M, Goudie A, Eshraghian J, Ihdayhid A, Sanfilippo F, Small G, Chow B, Dwivedi G. Machine Learning Models to Predict Exercise Stress Test Results: Optimising the Diagnostic Test Selection Strategy and Reducing Wastage in Suspected CAD Patients. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.522] [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: 10/16/2022]
|
28
|
Ghodsian M, Lee T, Nguyen H, Walters C, He A, McCarthy M, Ihdayhid A, Dwivedi G. Prevalence and Clinical Significance of Incidental Cardiac Uptake of Technetium99m Hydroxydiphosphate (Tc99m-HDP) on Bone Scintigraphy. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.274] [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: 10/16/2022]
|
29
|
Sehly A, He A, Ihdayhid A, Grey C, O'Connor S, Rankin J, Fegan P, Yeap B, Dwivedi G, Lan N. SGLT2 Inhibitor use Pre-Discharge Improves Left Atrial Reservoir and Contractile Function Following Acute Coronary Syndrome in Patients With Siabetes. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.287] [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]
|
30
|
He A, Sehly A, Lan N, Jaltotage B, Kwok S, Flack J, Joyner J, Chronos N, Chow B, Ko B, Figtree G, Dwivedi G, Ihdayhid A. Automated Assessment of CT Coronary Artery Stenosis Using a Deep Learning Approach. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.225] [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: 10/16/2022]
|
31
|
Jaltotage B, Pang J, Abraham A, Krishnan A, Chow B, Ihdayhid A, Mohd S, Watts G, Dwivedi G. Value Of Atherosclerotic Plaque Characteristics And Pericoronary Adipose Tissue In Predicting Outcomes In Familial Hypercholesterolemia: Should CCTA Be Carried Out In All Adult Patients With FH? J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.275] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
32
|
Jaltotage B, Abraham A, Pang J, Krishnan A, Chow B, Ihdayhid A, Lu J, Watts G, Dwivedi G. Can We Predict High-risk Plaques In Familial Hypercholesterolemia Using Clinical Variables And Coronary Artery Calcium. J Cardiovasc Comput Tomogr 2021. [DOI: 10.1016/j.jcct.2021.06.274] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
|
33
|
Jaltotage B, Pang J, Abraham A, Krishnan A, Chow B, Ihdayhid A, Mohd S, Watts G, Dwivedi G. Value of Atherosclerotic Plaque Characteristics and Pericoronary Adipose Tissue in Predicting Outcomes in Familial Hypercholesterolaemia: Should CCTA be Carried out in all Adult Patients With FH? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.014] [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: 10/20/2022]
|
34
|
Bhat S, deKemp R, Seto J, Green M, Birnie D, Beanlands R, Chow B, Dwivedi G. Does Left Ventricular Dyssynchrony by Positron Emission Tomography Predict Ventricular Tachyarrhythmia? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.028] [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: 11/29/2022]
|
35
|
Hegde A, Dorle S, Dwivedi G, Kovilapu U, Mishra PS, Jain A, Ahmed F. IgG4 Licks base of skull, wastes tongue: An unusual presentation. Indian J Rheumatol 2021. [DOI: 10.4103/injr.injr_195_20] [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: 11/04/2022] Open
|
36
|
Bartlett B, Ludewick H, Lee S, Corrales-Medina V, Waterer G, Dwivedi G. A Twin Disease Mouse Model to Assess Atherosclerosis Progression Following Lung Infection in ApoE Deficient Mice. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.050] [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: 10/20/2022]
|
37
|
Jaltotage B, Abraham A, Pang J, Krishnan A, Chow B, Ihdayhid A, Lu J, Watts G, Dwivedi G. Can we Predict High-Risk Plaques in Familial Hypercholesterolaemia Using Clinical Variables and Coronary Artery Calcium? Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.190] [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: 10/20/2022]
|
38
|
Sahoo L, Kumari A, Patnaik U, Dwivedi G. Cochlear implant habilitation during Covid-19 pandemic: A parents' perspective. Indian J Otol 2021. [DOI: 10.4103/indianjotol.indianjotol_232_20] [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: 11/04/2022]
|
39
|
Ihdayhid A, Lickfold C, Flack J, Adler B, Dembo L, Chow B, Dwivedi G. Feasibility And Performance Of Fully Automated Coronary Artery Calcium Scoring Using Deep Machine Learning. J Cardiovasc Comput Tomogr 2020. [DOI: 10.1016/j.jcct.2020.06.124] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
|
40
|
Dwivedi D, Dwivedi G, Gupta V, Kate S. Pediatric airway management in undiagnosed congenital subglottic stenosis patients. Indian Anaesth Forum 2020. [DOI: 10.4103/theiaforum.theiaforum_63_19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
|
41
|
Ali U, Lan N, Gilfillan M, Ho K, Pavey W, Dwivedi G, Edelman J, Larbalestier R. 843 Do Preoperative Balloon Pumps Really Make a Difference? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.850] [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: 11/16/2022]
|
42
|
Balaji Srinivasan S, Dwivedi G, Qin S, Marangou J, Rankin J, Sanfilippo F. 518 Optimal Duration of Dual Antiplatelet Therapy After Coronary Stent Implantation: A Population-Based Retrospective Cohort Study. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.525] [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: 10/23/2022]
|
43
|
Ali U, Lan N, Ho K, Dwivedi G, Merry C, Larbalestier R. 618 Additional Benefits of Lipid Lowering Drugs After Cardiac Surgery. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.625] [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]
|
44
|
Dwivedi D, Sud S, Dwivedi G, Singh S. Face-mask ventilation leading to neurapraxia of buccal branch of the facial nerve. J Med Sci 2020. [DOI: 10.4103/jmedsci.jmedsci_67_19] [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: 11/04/2022] Open
|
45
|
Ali U, Lan N, Dwivedi G, Merry C, Larbalestier R. 748 Predicting the Requirement for Inpatient Rehabilitation after Cardiac Surgery: Can Cardiologists Make a Difference? Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.755] [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: 10/23/2022]
|
46
|
Lu J, Dwivedi G, Sanfilippo F, Bennamoun M, Hung J, Briffa T, Sohel F, Hutchens R, Stewart J, Chow B, McQuillan B. 230 Machine Learning Models for Predicting Ischemic Stroke and Major Bleeding Risk in Patients with Atrial Fibrillation. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.237] [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: 11/15/2022]
|
47
|
Lee S, van den Berg N, Divitini M, Sanfilippo F, Knuiman M, Dwivedi G. 459 CMV Antibody Level is an Independent Risk Factor for MACCE and Death in the General Population. Heart Lung Circ 2020. [DOI: 10.1016/j.hlc.2020.09.466] [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: 10/23/2022]
|
48
|
Gupta V, Dwivedi G, Sahoo L, Singh S, Patnaik U, Kumar M, Sood A. Incidence of Otitis Media with Effusion in Cases of Head and Neck Malignancies Undergoing Radiotherapy: A Prospective Observational Study. Indian J Otolaryngol Head Neck Surg 2019; 71:1621-1625. [DOI: 10.1007/s12070-019-01698-8] [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] [Received: 05/11/2019] [Accepted: 06/24/2019] [Indexed: 11/28/2022] Open
|
49
|
Bami K, Tewari S, MacPherson P, Corrales-Medina V, Verma S, Yanagawa B, Ruel M, Dwivedi G. KNOWLEDGE, ATTITUDES AND PRACTICE PATTERNS OF CANADIAN CARDIAC SURGEONS REGARDING PATIENTS WITH HUMAN IMMUNODEFICIENCY VIRUS. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.526] [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] Open
|
50
|
Juneau D, Grammatopoulos G, Alzahrani A, Thornhill R, Inacio JR, Dick A, Vogel KI, Dobransky J, Beaulé PE, Dwivedi G. Is end-organ surveillance necessary in patients with well-functioning metal-on-metal hip resurfacings? Bone Joint J 2019; 101-B:540-546. [DOI: 10.1302/0301-620x.101b5.bjj-2018-1478.r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [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] [Indexed: 02/06/2023]
Abstract
Aims Cardiac magnetic resonance (CMR) was used to assess whether cardiac function or tissue composition was affected in patients with well-functioning metal-on-metal hip resurfacing arthroplasties (MoMHRA) when compared with a group of controls, and to assess if metal ion levels correlated with any of the functional or structural parameters studied. Patients and Methods In all, 30 participants with no significant cardiac history were enrolled: 20 patients with well-functioning MoMHRA at mean follow-up of 8.3 years post-procedure (ten unilateral, ten bilateral; 17 men, three women) and a case-matched control group of ten non-MoM total hip arthroplasty patients (six men, four women). The mean age of the whole cohort (study group and controls) at the time of surgery was 50.6 years (41.0 to 64.0). Serum levels of cobalt and chromium were measured, and all patients underwent CMR imaging, including cine, T2* measurements, T1 and T2 mapping, late gadolinium enhancement, and strain measurements. Results None of the MoMHRA patients showed clinically significant cardiac functional abnormality. The MoMHRA patients had larger indexed right and left end diastolic volumes (left ventricular (LV): 74 ml/m2 vs 67 ml/m2, p = 0.045; right ventricular: 80 ml/m2 vs 71 ml/m2, p = 0.02). There was a small decrease in T2 time in the MoMHRA patients (median 49 ms vs 54 ms; p = 0.0003). Higher metal ion levels were associated with larger LV volumes and with shorter T2 time. Conclusion Although cardiac function is not clinically adversely affected in patients with well-functioning MoMHRA, modern imaging is able to demonstrate subtle changes in structure and function of the heart. As these changes correlate with systemic ion measurements, they may be consequences of wear debris deposition. Longer, longitudinal studies are necessary to determine whether cardiac function will become affected. Cite this article: Bone Joint J 2019;101-B:540–546.
Collapse
Affiliation(s)
- D. Juneau
- Department of Radiology and Nuclear Medicine, Centre Hospitalier de l’Université de Montréal (CHUM), Montréal, Canada
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, Ottawa, Canada
| | - G. Grammatopoulos
- Division of Orthopaedic Surgery, University of Ottawa Faculty of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - A. Alzahrani
- King Saud bin Abdulaziz University for Health Sciences, King Faisal Cardiac Center, Jeddah, Saudi Arabia
| | - R. Thornhill
- The Ottawa Hospital, Department of Medical Imaging, Ottawa, Canada
| | - J. R. Inacio
- The Ottawa Hospital, Department of Medical Imaging, Ottawa, Canada
| | - A. Dick
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, Ottawa, Canada
| | - K. I. Vogel
- Division of Orthopaedic Surgery, University of Ottawa Faculty of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - J. Dobransky
- Division of Orthopaedic Surgery, University of Ottawa Faculty of Medicine, The Ottawa Hospital, Ottawa, Canada
| | - P. E. Beaulé
- Division of Orthopaedic Surgery, University of Ottawa Faculty of Medicine, The Ottawa Hospital, Ottawa, Canada
- University of Ottawa, Ottawa, Canada
| | - G. Dwivedi
- University of Ottawa Heart Institute, Division of Cardiology, Department of Medicine, Ottawa, Canada
- Consultant in Cardiology and Professor of Cardiology, The University of Western Australia, Harry Perkins Institute of Medical Research and Fiona Stanley Hospital, Perth, Australia
| |
Collapse
|