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George K, Talapatra K, Mhatre V, Chadha P, Deshpande M, Mistry R. PO-0852: Can we ignore Submandibular gland constraints for Xerostomia prevention in Parotid sparing IMRT? Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00869-0] [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: 10/22/2022]
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2
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Talapatra K, Chadha P, Deshpande M, Mistry R, Vadgaonkar R, Mhatre V, Pilakkal S, Goyle S, Limaye S, Shaikh I, Badhwar S. PO-0827: Hypofractionated image guided re-irradiation in head - neck cancers; an Indian experience. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00844-6] [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: 10/22/2022]
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Kaur R, Kaur J, Kaur M, Kalotra V, Chadha P, Kaur A, Kaur A. An endophytic Penicillium oxalicum isolated from Citrus limon possesses antioxidant and genoprotective potential. J Appl Microbiol 2020; 128:1400-1413. [PMID: 31841255 DOI: 10.1111/jam.14553] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [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: 01/03/2019] [Revised: 08/20/2019] [Accepted: 12/12/2019] [Indexed: 01/29/2023]
Abstract
AIMS This study aimed at isolating endophytic fungi from Citrus limon (L.) possessing antioxidative and genoprotective potential. METHODS AND RESULTS Endophytic fungi were screened for antioxidant activity using 2,2-diphenyl,1-picryl hydrazyl radical scavenging assay and maximum activity (79·70%) was exhibited by culture MP1 identified to be Penicillium oxalicum on the basis of morphological and molecular characteristics. The ethyl acetate extract of MP1 was subjected to silica column chromatography followed by LH 20 column chromatography for purification of active metabolites. The partially purified active fraction of P. oxalicum MP1 possessed good antioxidant activity as detected using various assays. It also exhibited a strong DNA damage protection potential on pUC19 plasmid DNA treated with Fenton reagent. On exposure to active fraction of MP1 significant reduction (P < 0·05) in nuclear deformities (like nuclear buds, micronuclei, nuclear ridges and binucleated cells) was observed in human lymphocytes pretreated with a toxic concentration of H2 O2 . In vivo genoprotectivity studies were conducted in fresh water fish Channa punctatus pretreated with a damaging compound 4-nonyl phenol. The active fraction of P. oxalicum MP1 caused a reduction of 94·7 and 66·60% in micronuclei and aberrant cell formation, respectively. A significant reduction (P < 0·05) in tail length and tail DNA parameters was also observed in comet assay. CONCLUSION The endophytic P. oxalicum isolated in this study has the potential to produce metabolites possessing antioxidant and genoprotective activities. SIGNIFICANCE AND IMPACT OF THE STUDY The isolated culture can be exploited in the field of therapeutics by virtue of its in vitro and in vivo genoprotective potential.
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Affiliation(s)
- R Kaur
- Department of Microbiology, Guru Nanak Dev University, Amritsar, Punjab, India
| | - J Kaur
- Department of Microbiology, Guru Nanak Dev University, Amritsar, Punjab, India
| | - M Kaur
- Department of Zoology, Guru Nanak Dev University, Amritsar, Punjab, India
| | - V Kalotra
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India
| | - P Chadha
- Department of Zoology, Guru Nanak Dev University, Amritsar, Punjab, India
| | - A Kaur
- Department of Human Genetics, Guru Nanak Dev University, Amritsar, Punjab, India
| | - A Kaur
- Department of Microbiology, Guru Nanak Dev University, Amritsar, Punjab, India
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Chauhan R, Mhatre V, Talapatra K, Chadha P, Shree P, Balasubramanium A, Kumar A. EP-1830 Dosimetric comparison of planning techniques in Radiosurgery for Arteriovenous Malformation. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32250-9] [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: 10/26/2022]
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Talapatra K, Raturi V, Vadgaonkar R, Jadhav S, Chadha P, Mhatre V, Pilakkal S. EP-1341 Evaluation of tumor motion variability with and without abdominal compression plate in lung SBRT. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31761-x] [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: 10/26/2022]
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6
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Talapatra K, Medichelme C, Chauhan R, Chadha P, Mhatre V, Muthu V. EP-2001 Efficacy of CBCT guided IMRT for Head and Neck cancers and its dosimetric impact on other structures. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)32421-1] [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: 10/26/2022]
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Kaur M, Chadha P, Kaur S, Kaur A, Kaur R, Yadav AK, Kaur R. Evaluation of genotoxic and cytotoxic effects of ethyl acetate extract of Aspergillus flavus on Spodoptera litura. J Appl Microbiol 2019; 126:881-893. [PMID: 30216609 DOI: 10.1111/jam.14105] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [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: 06/27/2018] [Revised: 08/28/2018] [Accepted: 09/03/2018] [Indexed: 01/31/2023]
Abstract
AIM Recent concerns about the possible adverse effects of agricultural chemicals on health and environment have generated a considerable interest in biological alternatives. This study aimed to test the insecticidal potential of fungus Aspergillus flavus and revealed its genotoxic and cytotoxic effects using Spodoptera litura (Fabricius) as a model. METHODS AND RESULTS The fungus was isolated from the surface of the dead insect and investigated for its insecticidal potential against S. litura by bioassay studies. Significant increase in mortality, prolonged development period and reduced adult emergence in S. litura were observed in larva fed on diet supplemented with fungal extract. In addition, fungus was also found to cause oxidative stress, DNA damage and cell death. Significantly higher percentages of necrotic cells and DNA damage were observed in larvae treated with fungal extract. Furthermore, DNA repair studies predicted the longevity of toxic effects induced by fungus. Phytochemical and ultra-high performance liquid chromatography studies revealed the presence of phenolic compounds in the extract and liquid chromatography-mass spectrometry indicated it to be a non-aflatoxin strain of A. flavus. Fungal extract was less toxic to mammalian cell lines as compared to cytotoxic drug doxorubicin (DOX) in the MTT assay. CONCLUSION The study highlights the insecticidal potential of A. flavus by revealing its genotoxicity and cytotoxicity causing potential. This is the first report showing the genotoxic and cytotoxic effects of the fungus A. flavus on S. litura. SIGNIFICANCE AND IMPACT OF THE STUDY The study provides a useful insight to explore microbial agents as biopesticides in order to reduce various environmental as well as human health problems due to synthetic pesticides.
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Affiliation(s)
- M Kaur
- Department of Zoology, Guru Nanak Dev University, Amritsar, India
| | - P Chadha
- Department of Zoology, Guru Nanak Dev University, Amritsar, India
| | - S Kaur
- Department of Zoology, Guru Nanak Dev University, Amritsar, India
| | - A Kaur
- Departments of Microbiology, Guru Nanak Dev University, Amritsar, India
| | - R Kaur
- Departments of Microbiology, Guru Nanak Dev University, Amritsar, India
| | - A K Yadav
- Department of Biotechnology, Guru Nanak Dev University, Amritsar, India
| | - R Kaur
- Department cum National Centre for Human Genome Studies and Research, Panjab University, Chandigarh, India
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Arshad Z, Pettitt D, Chadha P, Davies B, Carr A, Walmsley P. Artificial Intelligence to Predict Periprosthetic Joint Infection after Total Hip Replacement. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.708] [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: 10/28/2022]
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Arshad Z, Pettitt D, Chadha P, Davies B, Carr A, Walmsley P. An artificial neuronal network to predict revision surgery after total hip replacement. Int J Surg 2018. [DOI: 10.1016/j.ijsu.2018.05.363] [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: 11/30/2022]
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10
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Pywell MJ, Wordsworth M, Kwasnicki RM, Chadha P, Hettiaratchy S, Halsey T. The Effect of Electronic Cigarettes on Hand Microcirculation. J Hand Surg Am 2018; 43:432-438. [PMID: 29398329 DOI: 10.1016/j.jhsa.2017.12.003] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2017] [Revised: 11/04/2017] [Accepted: 12/04/2017] [Indexed: 02/02/2023]
Abstract
PURPOSE Smoking conventional cigarettes reduces peripheral microcirculation leading to worse outcomes after hand surgery. Patients are increasingly using electronic cigarettes (eCigarettes); however, there is no published research investigating the effects of eCigarettes on hand microcirculation. METHODS Fifteen healthy subjects with a median age of 26 years were recruited: 7 smokers and 8 nonsmokers. A noninvasive O2C laser Doppler probe measured a baseline control reading at deep (7-mm) and superficial (3-mm) levels. Participants commenced a 5-minute smoking protocol of nonnicotine (0-mg) eCigarettes with continuous microcirculation measurements during smoking and for 20 minutes afterward. This was repeated with nicotine (24-mg) eCigarettes. Readings were averaged over 5-minute periods and standardized as a percentage of baseline. A linear mixed-effects model with an unstructured covariance structure was used to analyze the data. RESULTS Smokers had a statistically significant reduction in hand microcirculation during and up to 20 minutes after smoking a 24-mg eCigarette. There was a maximum reduction of 77% in superficial flow and 29% in deep flow. After smoking a 0-mg eCigarette, smokers demonstrated an increase in superficial flow of up to 70% with no change in deep flow. Nonsmokers had no statistically significant change in superficial or deep flow after smoking either eCigarette. CONCLUSIONS A 24-mg eCigarette significantly reduced smokers' hand microcirculation during and after smoking. Microcirculation increased in smokers after inhalation of a 0-mg eCigarette. CLINICAL RELEVANCE We advise smokers undergoing hand surgery to avoid high-dose eCigarettes and, if necessary, to use 0-mg eCigarettes as an alternative.
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Affiliation(s)
| | | | | | - Priyanka Chadha
- Imperial College Healthcare NHS Trust, London, United Kingdom
| | | | - Tim Halsey
- Chelsea and Westminster NHS Foundation Trust, Chelsea, London, United Kingdom
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Chadha P, Jakharia-Shah N, Geh J. Review of follow-up requirements of low-risk squamous cell carcinomas after surgical excision. J Plast Reconstr Aesthet Surg 2017; 71:441-443. [PMID: 29269112 DOI: 10.1016/j.bjps.2017.11.017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/12/2017] [Revised: 10/16/2017] [Accepted: 11/09/2017] [Indexed: 11/19/2022]
Affiliation(s)
- Priyanka Chadha
- Department of Plastic Surgery, Guys and St Thomas' Hospital, London, UK
| | | | - Jenny Geh
- Department of Plastic Surgery, Guys and St Thomas' Hospital, London, UK
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12
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Jakharia-Shah N, Chadha P, Kulkarni M. Spontaneous painful subungual thumb haematoma. BMJ Case Rep 2017; 2017:bcr-2017-222412. [PMID: 29066663 DOI: 10.1136/bcr-2017-222412] [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] [Indexed: 11/04/2022] Open
Abstract
We present the case of a 56-year-old man who presented to our accident and emergency department 15 years after a work-based injury to his left thumb.In January 2017, the patient was woken up acutely with excruciating pain in his left thumb with no preceding trauma. On clinical examination, only a subungual haematoma was noted. Radiographs of the effected thumb demonstrated a round, lytic lesion with an accompanying hairline fracture on the distal phalanx of the left thumb. The radiologist suggested a differential diagnosis of enchondroma should be considered.The patient was referred for a routine plastic surgery outpatient appointment. Curettage sampling of the lesion was performed and a cement filler was used to prevent further pathological fractures.The biopsy report stated that the sample contained normal bone tissue with no evidence of enchondroma or other malignancy and the patient was discharged without any further complications.
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Affiliation(s)
| | - Priyanka Chadha
- Department of Plastic Surgery, Chelsea and Westminster Hospital, London, UK
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Affiliation(s)
- J.S. Yadav
- Human Genetics Unit, Department of Zoology, Kurukshetra University, Kurukshetra 136 119, Haryana, India
| | - S. Thakur
- Human Genetics Unit, Department of Zoology, Kurukshetra University, Kurukshetra 136 119, Haryana, India
| | - P. Chadha
- Human Genetics Unit, Department of Zoology, Kurukshetra University, Kurukshetra 136 119, Haryana, India
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Affiliation(s)
- J.S. Yadav
- Human Genetics Unit, Department of Zoology, Kurukshetra University, Kurukshetra, 136119, Haryana, India
| | - P. Chadha
- Human Genetics Unit, Department of Zoology, Kurukshetra University, Kurukshetra, 136119, Haryana, India
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15
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Jakharia-Shah N, Chadha P, Geh J. Reply to: 'Patients with low-risk cutaneous squamous cell carcinoma do not require extended out-patient follow-up'. J Plast Reconstr Aesthet Surg 2017; 70:1304-1306. [PMID: 28655512 DOI: 10.1016/j.bjps.2017.05.059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2017] [Accepted: 05/31/2017] [Indexed: 10/19/2022]
Affiliation(s)
| | - Priyanka Chadha
- Department of Plastic Surgery, Guys and St Thomas' Hospital, London, UK
| | - Jenny Geh
- Department of Plastic Surgery, Guys and St Thomas' Hospital, London, UK
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Pahuja D, Chadha P, Sharma U, Bhatia H, Nagpal P, Jordan J, Lannom C, de Los Santos E. PHYSICIAN ADVISERS ADD UP FOR SOME HOSPITALS. Physician Leadersh J 2017; 4:44-48. [PMID: 30571884] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/09/2023]
Abstract
A team of health care experts crunches the numbers sand reaches the conclusion that creating - or expanding - a physician adviser program is a good return on investment for any organization that's considering it.
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Chadha P, Bast F. Patient-performed pinnaplasty using industrial nail glue. Int J Pediatr Otorhinolaryngol 2017; 93:75-77. [PMID: 28109503 DOI: 10.1016/j.ijporl.2016.12.020] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/03/2016] [Revised: 12/14/2016] [Accepted: 12/15/2016] [Indexed: 10/20/2022]
Abstract
Malformations of the pinna occur in around 2-5% of all newborns. Prominent ears in childhood can be a source of psychological distress and lead to bullying and social exclusion. We present the case of a 14-year-old girl who inflicted chronic, non-healing wounds in the post auricular area bilaterally after attempting to glue back her ears with industrial strength glue. To our knowledge, this is the first case of its kind to be published.
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Affiliation(s)
- Priyanka Chadha
- St Thomas' NHS Trust, Westminster Bridge Road, London, SE1 7EH, United Kingdom.
| | - Florian Bast
- AMEOS Klinikum Haldensleben, Department for Otorhinolaryngology, Haldensleben, Germany
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Abstract
BACKGROUND It is a known fact that bacterial or viral acute otitis media occurs more frequently in the winter months. Only a few older studies on seasonal differences in middle ear findings are available. These studies are based solely on tympanography, without correlation to intraoperative middle ear findings. This study addresses the question of whether seasonal differences can be found in the preoperative tympanogram and in the corresponding intraoperative findings in children with chronic middle ear problems. PATIENTS AND METHODS This retrospective study included patients who had undergone myringotomy with or without tympanostomy tube insertion at the Charité-Universitätsmedizin Berlin between January and December 2011. Corresponding to the catarrhal phases, winter months were defined as those from November to April; summer months from May to October. The preoperative tympanogram and the documented intraoperative middle ear finding were statistically analyzed for seasonal differences. RESULTS A total of 654 ears from 206 male and 127 female patients with mean age 3.7 ± 2.5 years were analyzed. In the majority of cases, a type B tympanogram was found (n = 376; 57.5%), whereas the middle ear was filled with air in 19.1% of cases. No significant seasonal differences were found for either the intraoperative middle ear findings or the preoperative tympanograms (p > 0.05). CONCLUSION For children with a typical history of chronic otitis media without effusion and chronic tube ventilation dysfunction, myringotomy with or without tympanostomy tube insertion is indicated independently of the season. The results indicate that a wait-and-see approach with hope of improvement during the summer months is not rational.
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Affiliation(s)
- S Knopke
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany.
| | - A Böttcher
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - P Chadha
- Craniofacial Unit, Chelsea and Westminster Hospital, London, UK
| | - H Olze
- Department of Otorhinolaryngology, Head and Neck Surgery, Charité - Universitätsmedizin Berlin Campus Virchow-Klinikum, Augustenburger Platz 1, 13353, Berlin, Germany
| | - F Bast
- Department of Otorhinolaryngology, AMEOS Klinikum Haldensleben, Haldensleben, Germany
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Talapatra K, Doss G, Sharma D, Churi A, Patil A, P S, Chadha P, Kumar A. Comparison of Invasive and Noninvasive Frame for Set-up Error Accuracy in Intracranial Radiation Therapy—An Indian Institute Experience. Int J Radiat Oncol Biol Phys 2016; 96:E132-E133. [DOI: 10.1016/j.ijrobp.2016.06.924] [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: 11/25/2022]
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Hobday D, Chadha P, Din AH, Geh J. Denaturing the Lionfish. Eplasty 2016; 16:ic20. [PMID: 27298709 PMCID: PMC4892334] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Affiliation(s)
- Dorian Hobday
- aDepartment of Medicine, Kings College London,Correspondence:
| | - Priyanka Chadha
- bDepartment of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, UK
| | - Asmat H. Din
- bDepartment of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, UK
| | - Jenny Geh
- bDepartment of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, UK
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Chadha P, Hobday D, O'Connor EF, D'Cruz D. Burning vasculitis. BMJ Case Rep 2016; 2016:bcr-2016-214654. [PMID: 27118745 DOI: 10.1136/bcr-2016-214654] [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: 11/04/2022] Open
Abstract
We present the case of a 69-year-old man who was found collapsed close to a heat source and admitted to hospital for severe sepsis. He was also found to have widespread blistering and ulceration of his right leg; however, a history was unobtainable due to reduced consciousness levels. The leg lesions had the initial appearance of mixed depth burns and a management plan was made to transfer the patient to a burns unit for debridement. It was subsequently noted that the patient had a previous diagnosis of seropositive erosive rheumatoid arthritis. A biopsy of the leg lesion was performed and a diagnosis of rheumatoid vasculitis confirmed. Treatment with systemic steroids, intravenous antibiotics and intravenous immunoglobulin therapy for severe hypogammaglobulinaemia was started, and the patient was not transferred for surgical debridement. Rheumatoid vasculitis is a rare and extremely serious complication of rheumatoid arthritis that can manifest in a number of ways, occasionally mimicking other conditions. This case is essential to raise awareness of rare, severe rheumatoid vasculitis and of the potential for its misdiagnosis as a mixed depth burn.
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Affiliation(s)
| | - Dorian Hobday
- Department of Medicine, King's College London School of Medical Education, London, UK
| | | | - David D'Cruz
- Department of Rheumatology, Guys and St Thomas' NHS Trust, London, UK
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Chadha P, Hachach-Haram N, Shurey S, Mohanna PN. A Randomized Control Trial Exploring the Effect of Mental Rehearsal and Cognitive Visualization on Microsurgery Skills. J Reconstr Microsurg 2016; 32:499-505. [PMID: 26934963 DOI: 10.1055/s-0036-1577566] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
Background Many factors are known to influence the performance of surgeons within the operating theater, including tiredness, previous experience, and stress levels. The effects of mental rehearsal and cognitive visualization on microsurgical skills have not been assessed. Methods Thirty-six subjects recruited from the Northwick Park Microsurgery Skills Course were randomized into three groups; (1) a control group (C) with no mental rehearsal script, (2) a visual anastomosis group (VA), with a detailed rat anastomosis script, and (3) a visual relaxation (VR) group with a relaxation script, unrelated to the anastomosis. Participants ran through relevant scripts from day 2 to 5 and were assessed through recorded arterial rat anastomosis, scored using the structured assessment of microsurgery skills. Results Results were analyzed by double-blinded assessors. No statistical significance was found on Monday and Tuesday (first day post intervention), p = 0.326 (VA vs. C) and p = 0.283 (VR vs. C). A statistically significant difference was noted at the end of day 4; p < 0.001 (VA vs. VR) and p = 0.001 (VA vs. C). Further analysis demonstrated that domains within the global rating scoring system showed statistical significance for (1) dexterity: VA versus VR, p = 0.001, (2) visuospatial skills: VA versus VR, p = 0.001, and VA versus C, p = 0.002, and (3) operative flow: VA versus VR, p = 0.044, and VA versus C, p = 0.026. Conclusion The benefits of cognitive visualization and mental rehearsal in microsurgery may result in fewer complications from errors and thus lead to enhanced patient safety and better operative outcomes.
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Affiliation(s)
- Priyanka Chadha
- Department of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, United Kingdom
| | | | - Sandra Shurey
- Department of Surgical Research, NPIMR, Northwick Park and St Marks' Hospital, London, United Kingdom
| | - Pari-Naz Mohanna
- Department of Plastic Surgery, SHO, Guys and St Thomas' Hospital, London, United Kingdom
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Bast F, Chadha P, Shelly J, Collier JM. Prevention of postoperative ear canal stenosis using stents made of dental impression material: a rapid, cost-effective solution. Clin Otolaryngol 2015; 42:954-956. [PMID: 26586501 DOI: 10.1111/coa.12487] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/15/2015] [Indexed: 11/28/2022]
Affiliation(s)
- F Bast
- Department of ENT and facial plastic surgery, AMEOS Hospital Haldensleben, Haldensleben, Germany
| | - P Chadha
- Craniofacial Unit, Chelsea and Westminster Hospital, London, UK
| | - J Shelly
- Dematology Department, Chelsea and Westminster Hospital, London, UK
| | - J M Collier
- Craniofacial Unit, Chelsea and Westminster Hospital, London, UK
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Bast F, Collier S, Chadha P, Collier J. Septic arthritis of the temporomandibular joint as a complication of acute otitis media in a child: A rare case and the importance of real-time PCR for diagnosis. Int J Pediatr Otorhinolaryngol 2015; 79:1942-5. [PMID: 26340928 DOI: 10.1016/j.ijporl.2015.08.014] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/07/2015] [Revised: 08/05/2015] [Accepted: 08/06/2015] [Indexed: 12/21/2022]
Abstract
We document the case of a 7-year-old boy who presented with pain in his left ear and trismus after a diagnosis of acute otitis media one week previously. His blood inflammatory markers were raised and magnetic resonance imaging (MRI) showed significant left temporomandibular joint effusion and partial attenuation of the left mastoid. A clinical diagnosis of septic arthritis of the TMJ was made and the patient was commenced on broad-spectrum antibiotics. Analysis using real time PCR enabled identification of the offending organism, confirmation of the diagnosis and antibiotic treatment to be specifically tailored for treatment.
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Affiliation(s)
- F Bast
- AMEOS Klinikum Haldensleben, Department for Otorhinolaryngology, Haldensleben, Germany
| | - S Collier
- Department of Microbiology, Great Ormond Street Hospital, London, United Kingdom
| | - P Chadha
- Chelsea and Westminster Hospital, Craniofacial Unit, London, United Kingdom.
| | - J Collier
- Chelsea and Westminster Hospital, Craniofacial Unit, London, United Kingdom
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Muktar S, Chadha P, Khan O. Improving informed consent in orthopaedic surgery. Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.358] [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: 10/22/2022]
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Chadha P, Bast F, Collier J. Dental sinus infections: why are we still missing the well-documented diagnosis? Int J Surg 2015. [DOI: 10.1016/j.ijsu.2015.07.256] [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: 10/22/2022]
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Azhar B, Patel S, Chadha P, Hakim N. Indications for renal autotransplant: an overview. EXP CLIN TRANSPLANT 2015; 13:109-114. [PMID: 25871361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/04/2023]
Abstract
Advances in transplantation led to the first renal autotransplant in 1963 performed due to high ureteral injury sustained during aortic surgery. The procedure involves excision of the kidney and autologous re-implantation. Subsequently, multiple cases of renal autotransplantation have been reported in the literature for a range of indications. This reviews aims to assess the literature and experiences reported to assess the varying indications for renal autotransplant. The evidence and literature generated from experiences in this procedure are largely limited to case reports and relatively small or moderately sized case series. The main indications reported for performing autotransplant broadly includes renovascular disease, ureteral pathology and neoplastic disease. The advent of laparoscopic techniques and their implications on renal autotransplant also are discussed. Varying degrees of success are reported with this procedure with controversial issues surrounding this procedure remain, particularly in the area of neoplastic surgery. Renal autotransplant may be a useful last resort in preventing kidney loss in highly selected circumstances and when conventional methods have failed.
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Affiliation(s)
- Bilal Azhar
- From the London Postgraduate School of Surgery, London, UK
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Chadha P, Wordsworth M, Eckersley R. Spontaneous hematoma into the carpal tunnel and palmar aponeurosis. Eplasty 2015; 15:ic8. [PMID: 25671059 PMCID: PMC4313669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
Affiliation(s)
- Priyanka Chadha
- Chelsea and Westminster NHS Trust, London, UK,Correspondence:
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Chadha P, Lloyd-Hughes H, Halsey T. Compartment syndrome resulting from undetected ulnar artery injury in the absence of a forearm fracture. BMJ Case Rep 2014; 2014:bcr-2014-206763. [PMID: 25538213 DOI: 10.1136/bcr-2014-206763] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
A 6-year-old boy presented following a transient crush injury to his forearm. He displayed mild abrasions but no laceration or associated fractures. The injury resulted in traumatic rupture of the ulnar artery, which caused a large forearm haematoma and an acute forearm compartment syndrome. Prompt clinical diagnosis and operative intervention were required to prevent disastrous consequences.
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Riga C, Bicknell C, Sidhu R, Cochennec F, Normahani P, Chadha P, Kashef E, Hamady M, Cheshire N. Advanced Catheter Technology: Is This the Answer to Overcoming the Long Learning Curve in Complex Endovascular Procedures. J Vasc Surg 2011. [DOI: 10.1016/j.jvs.2011.08.026] [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: 11/25/2022]
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Patel SR, Chadha P, Papalois V. Expanding the live kidney donor pool: ethical considerations regarding altruistic donors, paired and pooled programs. EXP CLIN TRANSPLANT 2011; 9:181-186. [PMID: 21649566] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
In renal transplant, there is a well-known deficiency in organ supply relative to demand. Live donation provides superior results when compared with deceased donation including a better rate of graft success and fewer immunologic complications. This deficiency in organs leads to significant morbidity and mortality rates. Alternative avenues have been extensively explored that may expand the live donor pool. They include altruistic donation as well as paired and pooled exchange programs. Altruistic donation is a truly selfless act from a donor unknown to the recipient. Kidney paired donation involves 2 incompatible donor-recipient pairs swapping donors to produce compatibility. Pooled donation involves at least 2 pairs, and can take the form of domino chains in which altruistic input sets up a chain of transplants, in which each recipient's incompatible donor makes a donation for the next recipient. Despite application of these various methods, there lie extensive ethical issues surrounding them. Misconceptions frequently occur; for instance, the perceived benefit that donating an organ to a loved one is greater for a related donor than for an altruistic one. Additionally, it is frequently believed that immunologic incompatibility offers coerced donors liberation from surgery, and that overcoming these barriers by introducing exchange programs provides vulnerable donors less protection. This article explores these and other complex ethical issues surrounding the various methods of expanding the donor pool. The authors offer opinions that challenge the ethical issues and attempt to overcome those views that hinder progress in the field.
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Affiliation(s)
- Shaneel Rajendra Patel
- The West London Renal and Transplant Centre, Imperial College Kidney and Transplant Institute, Imperial College Healthcare NHS Trust, Hammersmith Hospital, London, United Kingdom.
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Chadha A, Chadha P, Monasterio O. Evaluation of emerging cleft lip and palate therapies—lessons from the foetal cleft surgery experience. Br J Oral Maxillofac Surg 2011. [DOI: 10.1016/j.bjoms.2011.03.045] [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: 10/18/2022]
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Riga CV, Bicknell CD, Sidhu R, Cochennec F, Normahani P, Chadha P, Kashef E, Hamady M, Cheshire NJW. Advanced catheter technology: is this the answer to overcoming the long learning curve in complex endovascular procedures. Eur J Vasc Endovasc Surg 2011; 42:531-8. [PMID: 21388839 DOI: 10.1016/j.ejvs.2011.02.004] [Citation(s) in RCA: 30] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2010] [Accepted: 02/02/2011] [Indexed: 12/28/2022]
Abstract
INTRODUCTION Advanced endovascular procedures require a high degree of skill with a long learning curve. We aimed to identify differential increases in endovascular skill acquisition in novices using conventional (CC), manually steerable (MSC) and robotic endovascular catheters (RC). MATERIALS/METHODS 10 novices cannulated all vessels within a CT-reconstructed pulsatile-flow arch phantom in the Simulated Endovascular Suite. Subjects were randomly assigned to conventional/manually-steerable/robotic techniques as the first procedure undertaken. The operators repeated the task weekly for 5 weeks. Quantitative (cannulation times, wire/catheter-tip movements, vessel wall hits) and qualitative metrics (validated rating scale (IC3ST)) were compared. RESULTS Subjects exhibited statistically significant differences when comparing initial to final performance for total procedure times and catheter-tip movements with all catheter types. Sequential non-parametric comparisons identified learning curve plateau levels at weeks 2 or 3(RCs, MSCs), and at week 4(CCs) for the majority of metrics. There were significantly fewer catheter-tip movements using advanced catheter technology after training (Week 5: CC 74 IQR(59-89) versus MSC 62(44-81); p = 0.028, and RC 33 (28-44); p = 0.012). RCs virtually eliminated wall hits at the arch (CC 29(28-76) versus RC 8(6-9); p = 0.005) and produced significantly higher overall performance scores (p < 0.02). CONCLUSION Advanced endovascular catheters, although more intricate, do not seem to take longer to master and in some areas offer clear advantages with regards to positional control, at a faster rate. RCs seem to be the most intuitive and advanced skill acquisition occurs with minimal training. Robotic endovascular technology may have a significantly shorter path to proficiency allowing an increased number of trainees to attempt more complex endovascular procedures earlier and with a greater degree of safety.
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Affiliation(s)
- C V Riga
- Regional Vascular & Endovascular Unit, Imperial College London, United Kingdom.
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Pahuja D, Chadha P. Cocaine and cardiomopathy. Heart Lung Circ 2008. [DOI: 10.1016/j.hlc.2007.11.092] [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: 10/22/2022]
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Nair MP, Mahajan S, Chadha KC, Nair NM, Hewitt RG, Pillai SK, Chadha P, Sukumaran PC, Schwartz SA. Effect of cocaine on chemokine and CCR-5 gene expression by mononuclear cells from normal donors and HIV-1 infected patients. Adv Exp Med Biol 2002; 493:235-40. [PMID: 11727771 DOI: 10.1007/0-306-47611-8_28] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/24/2022]
Affiliation(s)
- M P Nair
- Buffalo General Hospital, NY 14203, USA
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Chadha P, Puri M, Gupta R. A comparative evaluation of clinical examination, pelvic ultrasound and laparoscopy in the diagnosis of pelvic masses. Indian J Med Sci 1994; 48:158-60. [PMID: 7959976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/28/2023]
Abstract
This is a prospective study conducted on one hundred female patients with pelvic masses. The diagnostic accuracy of clinical examination alone and in conjunction with ultrasonic examination was comparable (p > 0.05). However diagnostic accuracy of 92% with laparoscopy was statistically significant as compared to 68% of clinical examination (p < 0.001) and 76% of ultrasonic examination (p < 0.05).
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Rewari N, Chadha P, Kriplani A. Microbiological study of vaginal discharge associated with the use of CuT 200. J Indian Med Assoc 1991; 89:289-91. [PMID: 1815012] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
A microbiological study of the vaginal discharge was conducted on 75 women attending family planning outdoors. In 24 out of 25 symptomatic CuT 200 users suffering from non-specific vaginitis, Gardnerella vaginalis was isolated from 19 cases (79%). The difference in the recovery rate of Gardnerella vaginalis was highly significant between symptomatic CuT 200 users and non-users (p less than 0.001) and that between symptomatic and asymptomatic CuT 200 users (p less than 0.05). But the difference between asymptomatic CuT 200 users and non-users was not statistically significant. The presence of clue cells on direct Gram's staining of vaginal discharge is significantly (p less than 0.05) related to the recovery of Gardnerella vaginalis on culture.
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Affiliation(s)
- N Rewari
- Department of Obstetrics and Gynaecology, MAMC Hospital, New Delhi
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Bhalla P, Rewari N, Chadha P. Gardnerella vaginalis vaginitis in Cu T 200 users. Indian J Med Res 1989; 89:80-6. [PMID: 2786846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/02/2023] Open
Abstract
Vaginal samples obtained from intrauterine contraceptive device (IUD) users with and without vaginitis and from healthy non-users were studied for presence of G. vaginalis and cytological changes. Vaginitis was present in 29.5 per cent IUD users and most of them (76%) yielded G. vaginalis. G. vaginalis was also recovered from asymptomatic IUD users and from non-users, but heavy colonisation was infrequent. The presence of clue cells and many small Gram negative bacilli and scanty lactobacilli were associated with G. vaginalis recovery. Inflammation was more frequent in IUD users than in non-users (P less than 0.001). A significant correlation was also found between inflammatory changes and G. vaginalis colonisation among all groups of patients.
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