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Kukielski C, Brion G, Elmore B, Mendelson A, Kohan L, Singla P. Unclear risk of intrapleural tissue plasminogen activator in the setting of thoracic epidural analgesia for rib fractures. Pain Med 2024:pnae017. [PMID: 38459618 DOI: 10.1093/pm/pnae017] [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] [Subscribe] [Scholar Register] [Received: 10/16/2023] [Revised: 02/02/2024] [Accepted: 02/29/2024] [Indexed: 03/10/2024]
Affiliation(s)
- Casey Kukielski
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Gavin Brion
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Brett Elmore
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Andrew Mendelson
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Lynn Kohan
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
| | - Priyanka Singla
- Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
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Abd-Elsayed A, Beal C, Brenner BR, Budwany R, D’Souza RS, Darji J, Ericson T, Falowski SM, Fishman MA, Gupta M, Gyorfi M, Habibi B, Hamamoto J, Kim C, Kohan L, Olsen A, Singla P, Viswanath O. Contributors. Spinal Fusion Techniques 2024:vi-vii. [DOI: 10.1016/b978-0-323-88223-1.00005-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] [Subscribe] [Scholar Register] [Indexed: 09/02/2023]
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3
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Karmakar S, Singla P. An Unreported Variation of Origin of Posterior Tibial Artery Encountered During Free Fibula Flap Harvest. Ann Plast Surg 2023; 91:101-103. [PMID: 37450867 DOI: 10.1097/sap.0000000000003577] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/18/2023]
Abstract
ABSTRACT Variations in the division of popliteal artery and origin of the 3 vascular systems are well documented. Here, we report a case in which the posterior tibial artery originated from the peroneal artery, in lower leg and then followed the normal course. The anomaly was detected intraoperatively precluding the harvest of free fibula flap. The procedure was abandoned and fibula was fixed using plates and screws and a free radial forearm flap was done over 2 mini-plates, which spanned the bone gap. A second bone flap procedure was to be planned in another sitting.The anomalous origin of posterior tibial artery from the peroneal artery in lower leg did not fall into any of the categories described previously by Kim et al (Ann Surg 1989;210:776-81.). In the event such atypical anatomy is encountered, it must be delineated, and the surgical plan adjusted accordingly. Flexibility in surgical approach can prevent vascular catastrophe.
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Affiliation(s)
- Shilpi Karmakar
- From the Department of Burns and Plastic Surgery, All India Institute of Medical Sciences, Jodhpur, India
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4
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Toppo P, Kagatay LL, Gurung A, Singla P, Chakraborty R, Roy S, Mathur P. Endophytic fungi mediates production of bioactive secondary metabolites via modulation of genes involved in key metabolic pathways and their contribution in different biotechnological sector. 3 Biotech 2023; 13:191. [PMID: 37197561 PMCID: PMC10183385 DOI: 10.1007/s13205-023-03605-z] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Accepted: 05/03/2023] [Indexed: 05/19/2023] Open
Abstract
Endophytic fungi stimulate the production of an enormous number of bioactive metabolites in medicinal plants and affect the different steps of biosynthetic pathways of these secondary metabolites. Endophytic fungi possess a number of biosynthetic gene clusters that possess genes for various enzymes, transcription factors, etc., in their genome responsible for the production of secondary metabolites. Additionally, endophytic fungi also modulate the expression of various genes responsible for the synthesis of key enzymes involved in metabolic pathways of such as HMGR, DXR, etc. involved in the production of a large number of phenolic compounds as well as regulate the expression of genes involved in the production of alkaloids and terpenoids in different plants. This review aims to provide a comprehensive overview of gene expression related to endophytes and their impact on metabolic pathways. Additionally, this review will emphasize the studies done to isolate these secondary metabolites from endophytic fungi in large quantities and assess their bioactivity. Due to ease in synthesis of secondary metabolites and their huge application in the medical industry, these bioactive metabolites are now being extracted from strains of these endophytic fungi commercially. Apart from their application in the pharmaceutical industry, most of these metabolites extracted from endophytic fungi also possess plant growth-promoting ability, bioremediation potential, novel bio control agents, sources of anti-oxidants, etc. The review will comprehensively shed a light on the biotechnological application of these fungal metabolites at the industrial level.
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Affiliation(s)
- Prabha Toppo
- Microbiology Laboratory, Department of Botany, University of North Bengal, Rajarammohunpur, Dist. Darjeeling, Siliguri, West Bengal India
| | - Lahasang Lamu Kagatay
- Microbiology Laboratory, Department of Botany, University of North Bengal, Rajarammohunpur, Dist. Darjeeling, Siliguri, West Bengal India
| | - Ankita Gurung
- Microbiology Laboratory, Department of Botany, University of North Bengal, Rajarammohunpur, Dist. Darjeeling, Siliguri, West Bengal India
| | - Priyanka Singla
- Department of Botany, Mount Carmel College, Bengaluru, Karnataka India
| | - Rakhi Chakraborty
- Department of Botany, Acharya Prafulla Chandra Roy Government College, Dist. Darjeeling, Siliguri, West Bengal India
| | - Swarnendu Roy
- Plant Biochemistry Laboratory, Department of Botany, University of North Bengal, Rajarammohunpur, Dist. Darjeeling, Siliguri, West Bengal India
| | - Piyush Mathur
- Microbiology Laboratory, Department of Botany, University of North Bengal, Rajarammohunpur, Dist. Darjeeling, Siliguri, West Bengal India
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Dash P, Mohanty P, Behura R, Behera S, Singla P, Sahoo SC, Sahoo SK, Jali BR. Detection of moisture in DMSO and raw food products by using an anthracene-based fluorescence OFF-ON chemosensor. J Photochem Photobiol A Chem 2023. [DOI: 10.1016/j.jphotochem.2023.114650] [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: 03/06/2023]
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Kankra M, Mehta A, Sawhney JPS, Solanki S, Bhargava S, Ahirwar A, Manocha A, Singla P, Sharma A, Sharma M. Improving the ACS Triage-Using High Sensitivity TroponinI and Copeptin for Early 'Rule-Out' of AMI. Indian J Clin Biochem 2022; 37:449-457. [PMID: 36262786 PMCID: PMC9573839 DOI: 10.1007/s12291-021-01015-7] [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: 07/01/2021] [Accepted: 10/26/2021] [Indexed: 10/19/2022]
Abstract
Rule-out of acute myocardial infarction (AMI) in patients presenting with acute chest pain at the emergency department (ED) is a major challenge across the globe. Patients presenting very early with chest pain may provide a diagnostic challenge even when using a cardiac necrosis specific biomarker, high sensitivity troponin (hs-Tn) as they are elevated at 3-6 h after the symptom onset. Copeptin is a marker of acute hemodynamic stress which is released within few minutes of the occurrence of MI and is elevated immediately at the presentation of patients with AMI. This indicates a complementary pathophysiology and kinetics of these two biomarkers. Hence, we evaluated whether or not a protocol with combined testing of copeptin and hs-TnI at admission in patients presenting with chest pain within 6 h in low to intermediate risk and suspected ACS leads to an earlier diagnosis of AMI and thereby, aids to prevent a higher proportion of major adverse cardiac events than the current standard protocol followed in ED. A total of 148 patients as per the inclusion criterion were recruited for the study. The dual biomarker copeptin and hs-TnI allows a rule-out of AMI at presentation with a sensitivity of 100% and NPV of 99.8%. Hence, the use of dual biomarker in conjunction with clinical assessment may obviate the need for a prolonged stay in the ED and retesting hs-TnI after 2 h (for delta check) in more than two-thirds of the patients. The inclusion of these tests could have an impact on the economic burden of the ED without jeopardizing the outcome for the patient.
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Affiliation(s)
- M. Kankra
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - A. Mehta
- Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
| | - J. P. S. Sawhney
- Department of Cardiology, Sir Ganga Ram Hospital, New Delhi, India
| | - S. Solanki
- Department of Emergency Medicine, Sir Ganga Ram Hospital, New Delhi, India
| | - S. Bhargava
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - A. Ahirwar
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - A. Manocha
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - P. Singla
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - A. Sharma
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
| | - M. Sharma
- Department of Biochemistry, Sir Ganga Ram Hospital, New Delhi, 110060 India
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Chahal M, Telsem M, Das B, Patel S, Gadiwala S, Stuart R, Mistry A, Satnarine T, Singla P, Bakarr A, Sharma P, Hsieh YC, Aedma K, Patel S, Pathrose R. Factors Affecting School Performance in the Adolescents of USA- Youth Risk Behavior Surveillance System. Eur Psychiatry 2022. [PMCID: PMC9567321 DOI: 10.1192/j.eurpsy.2022.587] [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] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Introduction Poor academic performance has been linked to factors such as sleep, health, illicit drug use, physical fighting, social media use, cyber bullying, physical activity, homelessness, times spent in video games and television. It is difficult to get a sense of the interplay between and relative importance of different behaviours/factors on academic performance as only limited research has been aimed at quantifying these factors. Objectives To evaluate association of school performance and variables in five categories of the YRBSS: physical fighting, diet/lifestyle, electronic device usage, concurrent substance use, and violence/self-harm. Methods The CDC Youth Risk Behavior Surveillance System (YRBSS) data from 1991-2019 was used in study. Respondents were grouped by good and poor school performance and variables related to nutrition/lifestyle, electronic device use, concurrent substance use, mood/violence/self-harm were analyzed using chi-square
test. Results A total of 41,235 student respondents.Nutrition/Lifestyle, electronic device use, concurrent substance use, mood/violence/self-harm are found to be significantly correlated with school performance. |
Poor Performance n(%) |
Good Performance n(%) |
Total n(%) | p-Value |
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Nutrition/Lifestyle | | Daily breakfast | 2,715(26) | 11,429(38.22) | 14,144(35.06) | <0.0001 | Sodas ≥2/day | 1,998(19.12) | 2,710(9.03) | 4,708(11.63) | <0.0001 | Concurrent Substance Use | | Alcohol use | 3,544(37.55) | 8,067(28.49) | 11,611(30.75) | <0.0001 | Cigarette smoking | 1,616(15.74) | 1,845(6.17) | 3,461(8.61) | <0.0001 | Mood/Violence/Self-Harm | | Difficulty concentrating | 4,188(46.34) | 7,327(28.27) | 11,516(32.94) | <0.0001 | Felt sad or hopeless | 4,373(41.06) | 9,038(29.67) | 13,410(32.62) | <0.0001 | Considered suicide | 2,567(24.14) | 4,810(15.8) | 7,377(17.96) | <0.0001 |
![]() Conclusions In national data, we found school performance is affected by nutrition, lifestyle, substance use, mood and exposure to surrounding violence, and self-harm. Further studies should be planned to evaluate benefits from the risk stratification to reduce this burden amongst US adolescents. Disclosure No significant relationships.
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Ericson T, Singla P, Kohan L. Intrathecal Pumps. Phys Med Rehabil Clin N Am 2022; 33:409-424. [DOI: 10.1016/j.pmr.2022.01.004] [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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9
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Singla P, Singh A, Sahoo SC, Soni PK, Kishore P. Synthesis, characterization and reaction kinetics of an energetic copper (II) complex based on 3,5 dinitrobenzoic acid and 2, 2' bipyridine. Chem Pap 2022. [DOI: 10.1007/s11696-021-02000-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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Abstract
Drug rash with eosinophilia and systemic symptoms (DRESS syndrome) is a severe, potentially life-threatening drug-induced hypersensitivity reaction characterized by cutaneous eruptions, fever, diffuse lymphadenopathy, along with eosinophilia and elevated liver enzymes. The severity and potential organ damage associated with DRESS mandates withdrawing the offending drug and provide a suitable replacement. We report a 55-year-old man who developed prolonged fever, generalized maculopapular rash and facial edema after 3 weeks of starting imatinib for chronic myeloid leukemia (CML). A diagnosis of DRESS was confirmed by eosinophilia and skin biopsy findings, along with a consistent RegiSCAR score. Imatinib was stopped and he was initiated on low-dose steroids, which led to complete resolution of rash and eosinophilia. A rechallenge with imatinib was positive, and he was switched to dasatinib for further therapy, following which he attained an optimal molecular response. DRESS following imatinib has only been reported in eight patients so far. In this report we summarize the current evidence for managing DRESS and its impact on the treatment of CML.
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Affiliation(s)
- S Kaur
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - S Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - R Singh
- Department of Medical Oncology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - P Singla
- Department of Dermatology, Dayanand Medical College and Hospital, Ludhiana, Punjab, India
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11
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Sharma H, Garg P, Marwah S, Jangra M, Kaushik D, Singla P. Clinical Evaluation of Desarda’s Repair for Inguinal Hernia. Indian J Surg 2021. [DOI: 10.1007/s12262-020-02382-w] [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] Open
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12
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Singla P, Abd-Elsayed A, Kohan LR. Radiofrequency Ablation. Trigeminal Nerve Pain 2021:103-110. [DOI: 10.1007/978-3-030-60687-9_10] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 09/01/2023]
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Abstract
Complex regional pain syndrome (CRPS) is a regional neuropathic pain syndrome. Excruciating pain often interferes with patients' ability to function normally. Spinal cord stimulators (SCS) have been effective in treating pain along with signs of sympathetic overactivity in patients with CRPS. Implantation of SCS is a high-risk interventional procedure with the potential for serious bleeding and neurological consequences in the spine. Meticulous evaluation and careful optimization are needed in patients with bleeding disorders.
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Affiliation(s)
- Priyanka Singla
- From the Division of Pain Medicine, Department of Anesthesiology, University of Virginia, Charlottesville, Virginia
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14
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Dunn LK, Taylor DG, Chen CJ, Singla P, Fernández L, Wiedle CH, Hanak MF, Tsang S, Smith JS, Shaffrey CI, Nemergut EC, Durieux ME, Blank RS, Naik BI. Ventilator Mode Does Not Influence Blood Loss or Transfusion Requirements During Major Spine Surgery. Anesth Analg 2020; 130:100-110. [DOI: 10.1213/ane.0000000000004322] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022]
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15
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Singla P, Dixon AJ, Sheeran JL, Scalzo D, Mauldin FW, Tiouririne M. Feasibility of Spinal Anesthesia Placement Using Automated Interpretation of Lumbar Ultrasound Images: A Prospective Randomized Controlled Trial. ACTA ACUST UNITED AC 2019; 10. [PMID: 31179158 PMCID: PMC6555430 DOI: 10.4172/2155-6148.1000878] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Background: This study evaluated the efficacy of spinal anesthesia administration by resident physicians when using an ultrasound system with automated neuraxial landmark detection capabilities. Methods: 150 patients were enrolled in this trial. Anesthesiology residents placed spinals in subjects undergoing scheduled cesarean delivery using one of three techniques to identify neuraxial landmarks: palpation, ultrasound, or combined palpation and ultrasound. Ultrasound was performed using a handheld system that automatically identified neuraxial landmarks (e.g. midline, intervertebral spaces). All residents watched a 10-minute video and received 20 minutes of hands-on training prior to participating in the study. First insertion success rate was the primary end point. Results: Among all patients, use of ultrasound resulted in a 11% greater first-insertion success rate (RR: 1.11 [0.85–1.47], p=0.431), a 15% reduction in needle insertions (RR: 0.85, p=0.052), and a 26% decrease in needle passes (RR: 0.74, p=0.070). In obese patients of BMI ≥ 30 kg/m2, use of ultrasound resulted in 26% greater first-insertion success rates (RR: 1.26, p=0.187), a 21% decrease in needle insertions (RR: 0.79, p=0.025), a 38% decrease in needle passes (RR: 0.62, p=0.030), and a 75% decrease in patients reporting neutral or low patient satisfaction with anesthesia administration (RR: 0.25, p=0.004). Discussion: Resident anesthesiologists competently utilized the ultrasound system after receiving minimal training. Technical endpoints and patient satisfaction trended towards improvement when ultrasound was used prior to spinal placement, with stronger trends observed in obese patients. Additional study is required to fully characterize the impact of the ultrasound system on clinical efficacy.
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Affiliation(s)
- Priyanka Singla
- Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, Virginia, USA
| | - Adam J Dixon
- Rivanna Medical, LLC, 107 E Water St, Charlottesville, VA 22902, Virginia, USA.,Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, Virginia, USA
| | - Jessica L Sheeran
- Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, Virginia, USA
| | - David Scalzo
- Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, Virginia, USA
| | - Frank W Mauldin
- Rivanna Medical, LLC, 107 E Water St, Charlottesville, VA 22902, Virginia, USA.,Department of Biomedical Engineering, University of Virginia, Charlottesville, VA 22908, Virginia, USA
| | - Mohamed Tiouririne
- Department of Anesthesiology, University of Virginia Health System, Charlottesville, VA 22908, Virginia, USA
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Raphael J, Collins SR, Wang XQ, Scalzo DC, Singla P, Lau CL, Kozower BD, Durieux ME, Blank RS. Perioperative statin use is associated with decreased incidence of primary graft dysfunction after lung transplantation. J Heart Lung Transplant 2017; 36:948-956. [DOI: 10.1016/j.healun.2017.05.007] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2016] [Revised: 03/21/2017] [Accepted: 05/03/2017] [Indexed: 12/28/2022] Open
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17
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Sharma H, Marwah S, Singla P, Garg A, Bhukkal B. Roux-en-Y duodenojejunostomy for surgical management of isolated duodenal obstruction due to chronic pancreatitis. Int J Surg Case Rep 2017; 31:209-213. [PMID: 28189119 PMCID: PMC5302187 DOI: 10.1016/j.ijscr.2017.01.008] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/04/2017] [Accepted: 01/04/2017] [Indexed: 12/27/2022] Open
Abstract
INTRODUCTION Duodenal obstruction in case of chronic pancreatitis is a very rare occurrence and usually presents with gastric outlet obstruction. These cases sometimes require surgical intervention when conservative treatment fails. Gastrojejunostomy and vagotomy has conventionally been performed for management of these cases. PRESENTATION OF CASE In this report, we present two cases of isolated duodenal obstruction due to chronic pancreatitis that were managed with Roux-en-Y duodenojejunostomy. All the patients had uneventful post-operative recovery and remained symptom free up to two years of follow up. DISCUSSION The isolated duodenal obstruction in chronic pancreatitis is very rare occurring due to fibrotic scarring following pancreatic inflammation an irreversible phenomenon requiring drainage procedure. The advantage of performing Roux-en-Y duodenojejunostomy in these cases is that it avoids complications of gastrojejunostomy such as bile reflux and stomal ulcerations. CONCLUSION Roux-en-Y duodenojejunostomy should be considered as an alternative procedure when duodenal obstruction occurs beyond second part of duodenum.
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Affiliation(s)
- Himanshu Sharma
- Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, Haryana, India.
| | - Sanjay Marwah
- Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, Haryana, India.
| | - Priyanka Singla
- Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, Haryana, India.
| | - Amit Garg
- Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, Haryana, India.
| | - Bittu Bhukkal
- Department of Surgery, Pt BDS Post-graduate Institute of Medical Sciences, Rohtak, Haryana, India.
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Bswas A, Sohal P, Baruah K, Singla P, Wig N, Aggarwal P, Dar L. Predictors of severity in dengue infection. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.397] [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] Open
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19
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Soin AS, Mohanka R, Saraf N, Rastogi A, Goja S, Menon B, Vohra V, Saigal S, Sud R, Kumar D, Bhangui P, Ramachandra S, Singla P, Shetty G, Raghvendra K, Elmagd KMA. India's first successful intestinal transplant: the road traveled and the lessons learnt. Indian J Gastroenterol 2014; 33:104-13. [PMID: 24500752 DOI: 10.1007/s12664-013-0437-8] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/11/2013] [Accepted: 12/14/2013] [Indexed: 02/04/2023]
Abstract
Intestinal transplant is a therapeutic challenge not just surgically but also logistically because of the multidisciplinary expertise and resources required. A large proportion of patients who undergo massive bowel resection and develop intestinal failure have poor outcome, because of inability to sustain long-term parenteral nutrition and limited availability of intestinal and multi-visceral transplantation facilities. We report the first successful isolated intestinal transplant from India.
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Affiliation(s)
- A S Soin
- Medanta Institute of Liver Diseases and Transplantation, Medanta-The Medicity, Sector 38, Gurgaon, Haryana, 122 001, India,
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20
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Soin AS, Raut V, Mohanka R, Rastogi A, Goja S, Balachandran M, Saigal S, Saraf N, Bhangui P, Sumana KR, Singla P, Srinivasan T, Choudhary N, Tiwari A, Raina V, Govil D, Mohan N, Vohra V. Use of ABO-incompatible grafts in living donor liver transplantation--first report from India. Indian J Gastroenterol 2014; 33:72-6. [PMID: 24369388 DOI: 10.1007/s12664-013-0424-0] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/22/2013] [Accepted: 10/13/2013] [Indexed: 02/04/2023]
Abstract
ABO incompatibility is the commonest reason for rejection of donors in living donor liver transplantation (LDLT). The donor pool could be expanded by 25 % to 35 % if the ABO barrier is overcome. In the absence of pre-conditioning, transplantation across the blood groups is fraught with the almost universal risk of antibody-mediated rejection (AMR) that rapidly leads to graft loss. However, AMR can be prevented by removal of preformed antibodies and reducing their production by B cells. We describe our initial experience of three cases of ABO-incompatible (ABO-i) LDLT: a 42-year-old male, an 8-month-old male and a 28-month-old female, all of blood group O+ who received blood group B + right lobe, B + left lateral segment, and A + left lateral segment liver grafts, respectively. Pre-LDLT conditioning included administration of anti-CD20 antibody (Rituximab(®)) to the adult 4 weeks prior, and four to seven sessions of double-filtration plasmapheresis to all, to remove preformed antibodies and achieve anti-donor blood group antibody (ADA) titers of ≤ 1:16 IgG and ≤ 1:8 IgM, respectively. In addition, cases 1 and 3 received mycophenolate mofetil for 7 days prior to LDLT. After LDLT, all three patients achieved normal graft function over 8-17 days with no evidence of AMR and without the need for further plasmapheresis. Postoperative complications included portal vein thrombosis (one successfully re-explored), CMV (one), Pseudomonas and Klebsiella sepsis (one each), and abdominal collection (one treated with percutaneous drainage). All are currently well with normal graft function and low ADA titers at 8, 16, and 19 months after ABO-i LDLT.
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Affiliation(s)
- A S Soin
- Medanta Institute of Liver Diseases and Transplantation, Medanta-The Medicity, Gurgaon, Haryana, 122 001, India,
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Arora S, Aggarwal A, Singla P, Jyoti S, Tandon S. Anti-proliferative effects of homeopathic medicines on human kidney, colon and breast cancer cells. HOMEOPATHY 2013; 102:274-82. [DOI: 10.1016/j.homp.2013.06.001] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Revised: 05/02/2013] [Accepted: 06/21/2013] [Indexed: 12/11/2022]
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Singla P, Long SS, Long CM, Genadry RR, Macura KJ. Imaging of the female urethral diverticulum. Clin Radiol 2013; 68:e418-25. [PMID: 23561897 DOI: 10.1016/j.crad.2013.02.006] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/06/2012] [Revised: 02/04/2013] [Accepted: 02/19/2013] [Indexed: 11/30/2022]
Abstract
Female urethral diverticulum is a localized out-pouching of the urethra that is becoming increasingly prevalent, but often poses a diagnostic challenge. Traditionally, conventional voiding cystourethrography has been used to make the preoperative diagnosis. With the development of higher-resolution images acquired through ultrasonography (US), computed tomography (CT), and magnetic resonance imaging (MRI), the anatomy and various abnormalities of the female urethra can be better elucidated. This article focuses on the imaging features of female urethral diverticulum, with emphasis on diagnostic pearls, particularly using MRI. Female urethral diverticulum can be best identified by their location in the posterolateral urethra and by their communication with the urethral lumen. Improved imaging techniques combined with increased physician awareness of urethral diverticulum will lead to more prompt and accurate diagnosis of this entity, leading to better treatment of affected patients.
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Affiliation(s)
- P Singla
- Brody School of Medicine, East Carolina University, Greenville, NC, USA
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Singla P, Kaur P, Mehta R, Berek D, Upadhyay S. Ring-Opening Polymerization of Lactide Using Microwave and Conventional Heating. ACTA ACUST UNITED AC 2012. [DOI: 10.1016/j.proche.2012.06.025] [Citation(s) in RCA: 11] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Sarin AR, Singla P, Kaur H. Maternal mortality -- aetiological factors: analytic study from a teaching hospital of Punjab. Indian J Matern Child Health 1992; 3:69-73. [PMID: 12288813] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Key Words] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 04/19/2023]
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Sharma GP, Sobti RC, Singla P. Cytogenetics of some species of the sub-family Eremninae (Curculionidae). CYTOLOGIA 1988. [DOI: 10.1508/cytologia.53.783] [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] [Indexed: 11/16/2022]
Affiliation(s)
| | | | - P. Singla
- Department of Zoology, Panjab University
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Sarin AR, Singla P, Gupta SK. A 5-year clinicopathological study of 2000 postmenopausal women from Northern India. Asia Oceania J Obstet Gynaecol 1985; 11:539-44. [PMID: 3833155] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
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Abstract
A large teratoma of the tongue, present at birth, was successfully removed at 32 h of age. It contained immature neural tissue consisting of a loose neurofibrillary matrix with primitive neurons, rossettes, and papillary tissue. Serum alpha fetoprotein was present at 8 days of age, as reported in some patients with malignant teratomas. Our case, however, had no histologic evidence of malignancy, no serum alpha fetoprotein at 7 months of age, and no recurrence at 1 years. The four glossal tumors reported in the literature, including one with immature neural elements, were all present at birth. In 1 case, another teratoma of the tongue was found 5 months after removal of the congenital one. It may not have been a recurrence, as the mass was located in a different area of the tongue. It appears that congenital teratomas of the tongue do not behave in a malignant fashion, at least in the 5 known cases.
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Abstract
Anomalous left coronary artery, arising from the pulmonary valve, may produce a clinical and radiologic picture mimicking parachute mitral valve (PMV). The pathogenesis is related to left myocardial hypoxia and consequent fibrosis. The authors report a patient with such involvement of the myocardium and contiguous anterior papillary muscle. The result was fibrous atrophy with consequent physiologic and radiologic abnormalities that occur in PMV because of the absence of this muscle, and superficial resemblance to its characteristic morphology.
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