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Khurana A, Sachdeva S, Paliwal P, Gogate S. Subcorneal Pustular Dermatosis Occuring in Association with Pyoderma Gangrenosum and Rheumatoid Arthritis: A Triple Whammy! Indian Dermatol Online J 2023; 14:861-863. [PMID: 38099012 PMCID: PMC10718099 DOI: 10.4103/idoj.idoj_706_22] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/31/2022] [Revised: 03/20/2023] [Accepted: 03/21/2023] [Indexed: 12/17/2023] Open
Abstract
Neutrophilic dermatoses are a wide group of disorders encompassing indolent to severely disabling conditions. A co-existence of two such conditions, pyoderma gangrenosum (PG) and subcorneal pustular dermatosis, necessitates a thorough investigation for IgA dysglobulinemia. We report a middle-aged woman who developed PG following 18 years of (undiagnosed) subcorneal pustular dermatosis, along with rheumatoid arthritis, a known association of PG.
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Affiliation(s)
- Ananta Khurana
- Department of Dermatology, Dr RML Hospital and ABVIMS, New Delhi, Delhi, India
| | - Soumya Sachdeva
- Department of Dermatology, Saraswathi Institute of Medical Sciences, Hapur, Uttar Pradesh, India
| | - Purnima Paliwal
- Department of Pathology, Dr RML Hospital and ABVIMS, New Delhi, Delhi, India
| | - Siddharth Gogate
- Department of Dermatology, Dr RML Hospital and ABVIMS, New Delhi, Delhi, India
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Khurana A, Mathachan SR, Paliwal P. Treatment of Acquired Digital Arteriovenous Malformation With Intralesional Bleomycin: An Effective Modality for a Lesser Known Condition. Dermatol Surg 2023; 49:809-811. [PMID: 37184505 DOI: 10.1097/dss.0000000000003830] [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] [Indexed: 05/16/2023]
Affiliation(s)
- Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sinu Rose Mathachan
- Department of Dermatology, Venereology and Leprosy, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, ABVIMS & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Thakur S, Paliwal P, Saxena KK. Regions of homozygosity and a novel variant in Steel syndrome: An added dilemma to diagnosis. J Postgrad Med 2023; 69:99-101. [PMID: 36695248 DOI: 10.4103/jpgm.jpgm_1153_21] [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: 01/14/2023] Open
Abstract
Steel syndrome is an autosomal recessive disorder that is caused by mutations in COL27A1 gene. The majority of reported cases have been of Puerto Rican origin, with few reports from India. The present case adds to the repertoire of homozygous recessive disorders from non-consanguineous Indian families. With the present case, a 4-year-old girl, we wish to signify that although mutations in several genes are known to cause skeletal abnormalities, identification of underlying mutations is important as it not only helps with the ascertainment of diagnosis but also aids in determining the role of surgical interventions which is particularly true for Steel syndrome, where the outcome of surgical intervention is usually dismal.
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Affiliation(s)
- S Thakur
- Department of Genetics and Fetal Diagnosis, Fortis Hospital, New Delhi, India
| | - P Paliwal
- Cytogenetics Lab, Institute of Medical Genetics and Genomics, Sir Ganga Ram Hospital, New Delhi, India
| | - K K Saxena
- Radiology, Sir Ganga Ram Hospital, New Delhi, India
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Arora D, Arora P, Goyal P, Paliwal P, Sardana K. A prospective real-world study evaluating serum levels of arginine and cysteine in women with chronic telogen effluvium: do we really need blanket prescription of amino acid supplementation? Clin Exp Dermatol 2022; 47:2006-2011. [PMID: 35844071 DOI: 10.1111/ced.15333] [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] [Accepted: 07/11/2022] [Indexed: 01/26/2023]
Abstract
Amino acids form a major component of hair fibres and are prescribed routinely in the form of nutritional supplements in patients with chronic telogen effluvium (CTE). Such a practice is based on assumption of a nutritional deficiency state in such patients. In this prospective study, we evaluated the serum levels of cysteine and arginine in 30 women with CTE and in healthy controls. We found no significant difference between the two groups in terms of serum arginine levels. Cysteine levels were higher in patients with CTE (P < 0.001). No correlation was found between levels of serum amino acids (cysteine and arginine) and either diet type (vegetarian or not) or body mass index, and no significant correlation between levels of the two amino acids and severity of disease. Our work suggests that arginine and cysteine deficiency is not present in women with CTE. Supplementation is unlikely to be of any benefit in nutrient-replete populations and only adds to the cost of therapy.
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Affiliation(s)
- Damini Arora
- Departments of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Pooja Arora
- Departments of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Parul Goyal
- Departments of Biochemistry, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Purnima Paliwal
- Departments of Pathology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
| | - Kabir Sardana
- Departments of Dermatology, Dr Ram Manohar Lohia Hospital and Atal Bihari Vajpayee Institute of Medical Sciences, New Delhi, India
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Bathula S, Sardana K, Mathachan SR, Khurana A, Ahuja A, Paliwal P. A real-world study of low-dose thalidomide in severe erythema nodosum leprosum highlighting its mechanistic rationale in a resource-constrained target population. Int J Dermatol 2022; 62:48-55. [PMID: 35924464 DOI: 10.1111/ijd.16315] [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] [Received: 01/20/2022] [Revised: 05/03/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
BACKGROUND Corticosteroids remain the main therapy in erythema nodosum leprosum (ENL), and long-term usage in chronic or recurrent ENL is a cause of significant morbidity and mortality. Thalidomide exerts dramatic effect in controlling ENL and helps reduce the dose of steroids, but the cost is a hindrance to its usage. METHODS Patients of ENL (steroid naïve and steroid-dependent) were recruited over a 1-year period. An escalating dose of low-dose thalidomide with a reducing dose of prednisolone was titrated depending on the control of disease activity. The primary aim was to reduce the dose of steroids to the lowest effective dose, and the secondary aim was to stop. RESULTS Sixteen patients of ENL were studied (mean duration of ENL 22.1 months, 15 severe ENL), and a majority (11/16, 68%) were on steroids with a mean duration of 11.27 months. All patients had steroid-related side effects (cushingoid habitus 81.8%, weight gain 54.5%, diabetes mellitus 9%, hyperlipidemia 18.18%, cataract 18.1%, osteoporosis 36.3%, striae 36.3%, acneiform eruptions 18.1%, and myopathy 9%). Steroids could be tapered in a majority of patients (n = 9) within 3 months (mean 2.44 months) with a low dose of thalidomide (25-150 mg/day, mean 78.3 mg) achieving a significant reduction in prednisolone dose (33.16 mg at baseline; 4.28 mg at 3 months, P < 0.05). Steroids could be stopped in 92% of patients by 3.03 months, and both drugs could be stopped in 80% of cases by 5.83 months. CONCLUSION The rapid and effective control of ENL with low-dose thalidomide in our series is comparable to the historical efficacy of high-dose thalidomide regimens, making it an affordable therapy in resource-constrained settings and an excellent steroid-sparing agent. The rapid onset of disease control is likely attributable to its action via neutrophils.
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Affiliation(s)
- Savitha Bathula
- Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Sinu Rose Mathachan
- Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, Venereology and Leprosy, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Paliwal P, Rahar S, Sharma A, Gupta D, Ahuja A, Chauhan DS. Intestinal mucormycosis in a patient with COVID-19: A case report. INDIAN J PATHOL MICR 2022; 65:475-477. [PMID: 35435400 DOI: 10.4103/ijpm.ijpm_1436_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/14/2023] Open
Abstract
The novel coronavirus disease (COVID-19) has spread to all the continents posing a serious threat to global health. It can present with myriad symptoms and complications including susceptibility to fungal co-infections. We hereby describe a case of mucormycosis in a 17 year old COVID-19 positive female with no known comorbidities presenting with abdominal pain and distention and ultimately developing intestinal perforation. Early identication of the symptoms is essential to make a correct and early diagnosis to prevent complications.
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Affiliation(s)
- Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Seema Rahar
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Anjnee Sharma
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Deepika Gupta
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Devender Singh Chauhan
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences, Dr Ram Manohar Lohia Hospital, New Delhi, India
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7
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Suteri P, Ahuja A, Sen AK, Goel H, Bhardwaj M, Chauhan DS, Paliwal P. Granulomatous prostatitis: A clinico-pathological series of 27 cases. Journal of Clinical Urology 2022. [DOI: 10.1177/2051415820970429] [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: 11/15/2022]
Abstract
Objectives: This study aimed to assess the incidence and discern the histomorphological spectrum of granulomatous prostatitis. Methods: A retrospective analysis of histopathological records of 1773 prostatic specimens received in the pathology department was done over a period of seven years. All histologically proven cases of granulomatous prostatitis were retrieved, the relevant clinical data were collected from patient records and the lesions were categorized accordingly. Results: Out of 1773 cases, 27 cases of granulomatous prostatitis were identified. The age range of these patients was between 50 and 89 years. Among the patients, non-specific granulomatous prostatitis (NSGP) was the most common followed by tubercular prostatitis, post-surgical prostatitis and xanthogranulomatous prostatitis. Three cases of post-surgical prostatitis were associated with malignancy. Serum prostate-specific antigen (PSA) levels ranged between 0.8 and 20.94 ng/mL (median 10.78 ng/mL). The diagnosis was made by histopathological examination of transrectal ultrasound (TRUS)-guided core biopsies, Trucut biopsies, transuretheral resection of prostate chips, prostatectomy and cystoprostatectomy specimens. Conclusion: In the present study, the incidence of granulomatous prostatitis was 1.5%. The patients usually present as hard nodules on digital rectal examination along with raised serum PSA levels. Carcinoma or benign prostatic hyperplasia was kept as a clinical diagnosis in these cases. Since the diagnosis of granulomatous prostatitis is made on histopathological examination only, meticulous histomorphological assessment is therefore required to reach a definitive diagnosis of granulomatous prostatitis.
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Affiliation(s)
- Pooja Suteri
- Department of Pathology, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
| | - Achin K Sen
- Department of Pathology, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
| | - Hemant Goel
- Department of Urology and Renal Transplantation, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
| | - Minakshi Bhardwaj
- Department of Pathology, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
| | - Devendra Singh Chauhan
- Department of Pathology, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Institute of Medical Sciences (formerly PGIMER) and Dr Ram Manohar Lohia Hospital, India
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8
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Mathachan SR, Arora P, Sardana K, Paliwal P. Pemphigus Foliaceous With Prominent Neutrophilic Pustules: A Rare Variant Responsive to Colchicine. Indian J Dermatol 2022; 67:481. [PMID: 36578702 PMCID: PMC9792025 DOI: 10.4103/ijd.ijd_672_21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/30/2022] Open
Affiliation(s)
- Sinu Rose Mathachan
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Pooja Arora
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Kabir Sardana
- From the Department of Dermatology, Venereology and Leprosy, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, ABVIMS and Dr. Ram Manohar Lohia Hospital, New Delhi, India E-mail:
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Jilowa S, Paliwal P, Kapur A, Verma GC. Exostosis of Rib: Case Report of an Extremely Rare Giant Osteochondroma at an Unusual Site, Radiopathological Correlation with Brief Review of Literature. Indian J Radiol Imaging 2021; 31:740-744. [PMID: 34790327 PMCID: PMC8590580 DOI: 10.1055/s-0041-1736406] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Osteochondromas are common benign tumors developing as an abnormal bony growth in the metaphyseal region. Being more of a developmental anomaly rather than a true neoplasm, they are usually found around the growth plates of long bones such as the knee, hip, and shoulder. These are typically managed conservatively if they are asymptomatic; however, they require excision in symptomatic patients. A 38-year-old woman presented with a huge swelling causing disfigurement measuring 16 × 16 cm on the left side of chest wall. Radiographs and computed tomography scan showed a bony outgrowth at costochondral junction of second rib which was in continuity with the periosteum. Excision via mediastinal sternotomy and left thoracotomy was done. Histopathological features corroborated with the radiological diagnosis of osteochondroma. Osteochondroma should be considered in the differential diagnosis of chest wall tumors. Rib is an extremely rare site of presentation. The cartilaginous cap becomes fully ossified and is lost in longstanding lesions. Huge tumors at such a location can cause irritation of adjacent viscera which can lead to pleural effusion or hemothorax; therefore, a cautious and logical approach to diagnosis is warranted for appropriate therapeutic management.
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Affiliation(s)
- Sarita Jilowa
- Department of Radio-diagnosis, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr. RML Hospital, New Delhi, India
| | - Arun Kapur
- Department of Surgery, Lady Hardinge Medical College and Dr. RML Hospital, New Delhi, India
| | - G C Verma
- Department of Orthopedics, Sanjay Gandhi Memorial Hospital, New Delhi, India
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Paliwal P, Jain S, Ahuja A, Mittal S, Chauhan DS. Coronary arteritis as a cause of sudden cardiac death in a young girl. Autops Case Rep 2021; 11:e2021310. [PMID: 34458178 PMCID: PMC8387068 DOI: 10.4322/acr.2021.310] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2021] [Accepted: 06/21/2021] [Indexed: 11/23/2022] Open
Abstract
A case of probable coronary arteritis in a young girl who died suddenly and unexpectedly is presented. The histologic presentation of the disorder is discussed, especially the differential diagnosis of arteritis of the coronary arteries with an emphasis on tuberculosis (TB). TB myocarditis with or without concomitant lung involvement is rare, and tubercular coronary arteritis without underlying pulmonary Koch’s disease is all the rarer. We herein describe a case where the cause of death was ascertained on post-mortem examination.
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Affiliation(s)
- Purnima Paliwal
- Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, Department of Pathology, New Delhi, India
| | - Swasti Jain
- Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, Department of Pathology, New Delhi, India
| | - Arvind Ahuja
- Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, Department of Pathology, New Delhi, India
| | - Sachin Mittal
- Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, Department of Forensic Medicine, New Delhi, India
| | - Devender Singh Chauhan
- Atal Bihari Vajpayee Institute of Medical Sciences, Dr. Ram Manohar Lohia Hospital, Department of Pathology, New Delhi, India
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Majumder A, Ahuja A, Chauhan DS, Paliwal P, Bhardwaj M. A clinicopathological study of peripheral schwannomas. Med Pharm Rep 2021; 94:191-196. [PMID: 34013190 PMCID: PMC8118219 DOI: 10.15386/mpr-1708] [Citation(s) in RCA: 1] [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: 05/11/2020] [Revised: 11/27/2020] [Accepted: 12/17/2020] [Indexed: 12/14/2022] Open
Abstract
Aim and objective Schwannomas are benign neoplasms of neural origin with sporadic or syndromic occurence. They are commonly seen in cranial nerves. Peripheral schwannomas occur rarely and may have unique presentations. The aim of this study is to evaluate the clinico-pathological characteristics of peripheral schwannomas. Methods A retrospective cross sectional study of peripheral schwannomas excluding head neck region was conducted. The study group consisted of 18 cases which were recorded over a period of seven years. The corresponding data were collected from the archives of the Department of Pathology. Results Male to female ratio was 1:1. The average age of the cases was 47 years. The most common site was the upper limbs (55.55%) followed by lower limbs, chest and penis. The lesions mostly presented as painless swellings (62%). Histopathological examination revealed classic features of schwannoma. Secondary changes included cystic degeneration, foam cells, epitheloid cells, hyalinization, microcystic change and collection of plasma cells. All cases were confirmed by positive S100 staining. Conclusion Peripheral schwannomas may be missed due to its rarity and atypical presentations. Both clinicians and pathologists should be aware of this common entity at unusual sites for the proper management of the patients. Surgery is usually the treatment of choice.
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Affiliation(s)
- Ankur Majumder
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Arvind Ahuja
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - D S Chauhan
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
| | - Minakshi Bhardwaj
- Department of Pathology, Atal Bihari Vajpayee Instititute of Medical Sciences (ABVIMS) & Dr. Ram Manohar Lohia Hospital, New Delhi, India
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Dixit N, Sardana K, Paliwal P. The rationale of ideal pulse duration and pulse interval in the treatment of steatocystoma multiplex using the carbon dioxide laser in a super-pulse mode as opposed to the ultra-pulse mode. Indian J Dermatol Venereol Leprol 2021; 86:454-456. [PMID: 32362600 DOI: 10.4103/ijdvl.ijdvl_154_19] [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: 11/04/2022]
Affiliation(s)
- Niharika Dixit
- Department of Dermatology, PGIMER and Dr. RML Hospital, Delhi, India
| | - Kabir Sardana
- Department of Dermatology, PGIMER and Dr. RML Hospital, Delhi, India
| | - Purnima Paliwal
- Department of Pathology, PGIMER and Dr. RML Hospital, Delhi, India
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13
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Ramu R, Sharma B, Karunakara D, Paliwal P, Bansal N, Taneja RS. Liposomal amphotericin B-induced reversible ototoxicity in a patient with disseminated histoplasmosis. Indian J Pharmacol 2021; 53:157-159. [PMID: 34100400 PMCID: PMC8265420 DOI: 10.4103/0253-7613.316948] [Citation(s) in RCA: 1] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Amphotericin B (AmB) is a polyene antifungal agent used widely for systemic fungal infections. Infusion-related side effects, nephrotoxicity, and dyselectrolytemia are well-known adverse effects with the use of this drug. Liposomal preparation of AmB has less adverse events. However, ototoxicity due to AmB is scarcely mentioned in the literature. We report a case of disseminated histoplasmosis who was treated with liposomal amphotericin B (LAmB) and developed hearing loss during the treatment, which recovered after discontinuing the drug. This is a rare adverse effect of LAmB and reported only once from India, to the best of our knowledge.
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Affiliation(s)
- Ramadoss Ramu
- Department of Medicine PGIMER and Dr. RML Hospital, New Delhi, India
| | - Brijesh Sharma
- Department of Medicine PGIMER and Dr. RML Hospital, New Delhi, India
| | | | - Purnima Paliwal
- Department of Pathology, PGIMER and Dr. RML Hospital, New Delhi, India
| | - Naman Bansal
- Department of Medicine PGIMER and Dr. RML Hospital, New Delhi, India
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Varshney R, Bharadwaj P, Choudhary A, Paliwal P, Kaushik K. A rare case of intramedullary schwannoma at conus medullaris: A case report with review of literature. Surg Neurol Int 2020; 11:454. [PMID: 33408939 PMCID: PMC7771414 DOI: 10.25259/sni_718_2020] [Citation(s) in RCA: 1] [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: 10/12/2020] [Accepted: 12/05/2020] [Indexed: 01/24/2023] Open
Abstract
Background: Intramedullary spinal schwannomas constitute only 0.3% of primary spine tumors. We could identify only 13 such cases involving the conus that were not associated with neurofibromatosis (NF). Here, we report a 70-year-old male without NF who was found to have a paraparesis due to a schwannoma of the thoracolumbar junction/conus (D11-L2). Case Description: A 70-year-old male presented with an L1-level paraparesis with urinary incontinence. The magnetic resonance showed an intramedullary mass of 85 × 10 mm extending from D11 to L2; it demonstrated significant patchy enhancement. The patient underwent a D12 and L1 laminectomy with gross total excision of the mass that proved to be a schwannoma. Three months postoperatively, he was able to ambulate with support, and regained sphincter function. Conclusion: Intramedullary schwannomas involving the conus/thoracolumbar junction are rare, and can be successfully excised resulting in good outcomes.
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Affiliation(s)
- Rahul Varshney
- Department of Neurosurgery, Dr. RML Hospital, New Delhi, India
| | | | - Ajay Choudhary
- Department of Neurosurgery, Atal Bihari Vajpayee Institute of Medical Sciences and RML Hospital, New Delhi, India
| | | | - Kaviraj Kaushik
- Department of Neurosurgery, Dr. RML Hospital, New Delhi, India
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Saxena S, Khurana A, B S, Sardana K, Agarwal A, Muddebihal A, Raina A, Paliwal P. Severe type 2 leprosy reaction with COVID-19 with a favourable outcome despite continued use of corticosteroids and methotrexate and a hypothesis on the possible immunological consequences. Int J Infect Dis 2020; 103:549-551. [PMID: 33326870 PMCID: PMC7831392 DOI: 10.1016/j.ijid.2020.12.024] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2020] [Revised: 12/04/2020] [Accepted: 12/10/2020] [Indexed: 01/04/2023] Open
Abstract
Type 2 leprosy reaction (T2LR), or Erythema Nodosum Leprosum (ENL), often poses a therapeutic challenge to clinicians and commonly requires long courses of steroids for control. While immunosuppressants are known to achieve control and lower steroid dependence in T2LR, the prospect of managing a severe T2LR in conjunction with COVID-19, with the concern of worsening COVID-19 with long-term immunosuppression has not previously been encountered. We report a case of severe T2LR treated with oral steroids and methotrexate, with COVID-19 infection acquired during hospital stay, and a favourable outcome achieved despite the continued use of immunosuppressants. We discuss the possible reasons for this both in terms of the drug pharmacodynamics and the immunological profile of T2LR.
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Affiliation(s)
- Snigdha Saxena
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Ananta Khurana
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India.
| | - Savitha B
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Kabir Sardana
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Aastha Agarwal
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Aishwarya Muddebihal
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Alok Raina
- Department of Dermatology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Atal Bihari Vajpayee Institute of Medical Sciences and Dr Ram Manohar Lohia Hospital, New Delhi, India
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Aranha A, Kumar P, Choudhary A, Paliwal P. Long segment cervicothoracic intramedullary dermoid with concomitant conal lesion - A case report. Surg Neurol Int 2020; 11:268. [PMID: 33024606 PMCID: PMC7533096 DOI: 10.25259/sni_474_2020] [Citation(s) in RCA: 1] [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: 07/27/2020] [Accepted: 08/05/2020] [Indexed: 11/28/2022] Open
Abstract
Background: Spinal dermoid cysts are benign tumors that result from congenital or acquired ectodermal inclusions. Long segment intramedullary involvement of the spinal cord is exceedingly rare, and there are only a handful of case reports found in the literature. Case Description: A 30-year-old female presented with a 3-month history of myelopathy characterized by progressive quadriparesis and urinary incontinence. Magnetic resonance imaging revealed multifocal heterogeneous intramedullary masses extending from C2 to T4 and at T12–L1 with similar intensity lesions seen within the central cord from T5 to T11 level. Following tumor decompression, she showed significant improvement in neurological function 1 month later. The histopathological examination confirmed the diagnosis of a multifocal intramedullary dermoid cyst. Conclusion: Partial surgical extirpation is a reasonable treatment for long segment intramedullary dermoid cysts, particularly when the tumor capsule is adherent to critical adjacent neural tissues.
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Affiliation(s)
- Andrew Aranha
- Department of Neurosurgery , Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, Delhi, India
| | - Pankaj Kumar
- Department of Neurosurgery , Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, Delhi, India
| | - Ajay Choudhary
- Department of Neurosurgery , Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, Delhi, India
| | - Purnima Paliwal
- Department of Pathology, Post Graduate Institute of Medical Education and Research, Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, Delhi, India
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Paliwal P, Sinha AK, Sharma VK. Reversal of the 'reversed Robin Hood syndrome' in severe intracranial stenosis after enhanced external counterpulsation therapy. Eur J Neurol 2020; 27:2371-2372. [PMID: 32748471 DOI: 10.1111/ene.14459] [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: 06/11/2020] [Revised: 07/24/2020] [Accepted: 07/25/2020] [Indexed: 11/25/2022]
Affiliation(s)
- P Paliwal
- Division of Neurology, National University Hospital, Singapore, Singapore
| | - A K Sinha
- Department of Diagnostic Imaging, National University Hospital, Singapore, Singapore
| | - V K Sharma
- Division of Neurology, National University Hospital, Singapore, Singapore.,YLL School of Medicine, National University of Singapore, Singapore, Singapore
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Dixit N, Sarswat S, Paliwal P. Lichenoid reaction to red-inked tattoo – A known but forgotten problem. Indian J Paediatr Dermatol 2020. [DOI: 10.4103/ijpd.ijpd_136_18] [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
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19
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Murthy SS, Rajappa SJ, Gundimeda SD, Mallavarapu KM, Ayyagari S, Yalavarthi P, Fonseca D, Paliwal P, Nair H, Koppula V, Raju K, Rao ST. Anaplastic lymphoma kinase status in lung cancers: An immunohistochemistry and fluorescence in situ hybridization study from a tertiary cancer center in India. Indian J Cancer 2017; 54:231-235. [PMID: 29199697 DOI: 10.4103/0019-509x.219533] [Citation(s) in RCA: 6] [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] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND AND OBJECTIVES Fluorescence in situ hybridization (FISH) and immunohistochemistry (IHC) have shown good concordance for the detection of echinoderm microtubule-associated protein-like 4 and anaplastic lymphoma kinase (ALK) rearrangement. Since studies reporting FISH/IHC concordance, clinicopathological features, and clinical outcomes of ALK-positive patients from India are lacking, this study was undertaken. MATERIALS AND METHODS This is a retrospective, observational study of patients with adenocarcinoma of the lung on whom ALK test was performed between March 2013 and December 2015. ALK status was assessed in 341 patients by FISH using Vysis ALK Dual Color Break Apart Rearrangement Probe and IHC using ALK D5F3 clone. Clinicopathological features were noted. Patients were managed as per the standard guidelines. Clinical outcomes - response rate (RR) and progression-free survival (PFS) - were measured. RESULTS ALK rearrangement was positive in 37 patients (10.9%). ALK positivity was observed more commonly in younger patients with no predilection for any gender or any specific histological subtype. ALK by IHC was highly sensitive (100%), compared to FISH with concordance rate of 94.4%. Thirty one of thirty seven (31 of 37) patients received therapy of which 3 patients received palliative chemotherapy and 28 patients received tyrosine kinase inhibitors (crizotinib/ceritinib). Overall RR observed was 77.4%, and median PFS had not been reached at a median follow-up of 12.5 months. INTERPRETATION AND CONCLUSIONS We report higher frequency of ALK positivity (10.9%) in patients with adenocarcinoma of the lung. ALK by IHC is more sensitive than FISH for ALK detection with high concordance. These patients had good clinical outcome with TKIs targeting ALK fusion protein.
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Affiliation(s)
- S S Murthy
- Department of Pathology and Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - S J Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - S D Gundimeda
- Department of Pathology and Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - K M Mallavarapu
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - S Ayyagari
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - P Yalavarthi
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - D Fonseca
- Department of Pathology and Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - P Paliwal
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Hgr Nair
- Department of Pathology and Laboratory Medicine, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - V Koppula
- Department of Radiology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - Kvvn Raju
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
| | - S T Rao
- Department of Surgical Oncology, Basavatarakam Indo American Cancer Hospital and Research Institute, Hyderabad, Telangana, India
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Paliwal P, Rajappa S, Santa A, Mohan M, Murthy S, Lavanya N. Clinical profile and outcomes of patients with Stage IV adenocarcinoma of lung: A tertiary cancer center experience. Indian J Cancer 2017; 54:197-202. [PMID: 29199690 DOI: 10.4103/0019-509x.219595] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND There is limited Indian data on clinical profile and treatment outcomes for patients with Stage IV adenocarcinoma of lung. AIM We aimed to prospectively study the clinical profile and treatment outcomes for patients with Stage IV adenocarcinoma of lung at a tertiary cancer center. MATERIALS AND METHODS One hundred and ninetyfour patients with Stage IV adenocarcinoma of lung were prospectively analyzed for demographic and molecular profile (epidermal growth factor receptor [EGFR] and echinodermal microtubuleassociated proteinlike 4anaplastic lymphoma kinase [EML4ALK] mutations). Patients with EGFR and EML4ALK mutations were treated with tyrosine kinase inhibitors. Patients without these mutations were treated with standard chemotherapy regimens. Maintenance chemotherapy was offered to patients as per standard guidelines. Clinical outcomes measured were response rate (RR), progressionfree survival (PFS), and overall survival (OS). RESULTS Median age of patients was 56 years (range, 26-82) with a male:female ratio of 2.3:1. EGFR and ALK mutation testing was feasible in 169 (87.1%) and 164 (84.5%), respectively, and detected in 37.9% and 5.5% patients, respectively. Overall RR, PFS and OS of whole cohort were 44.3%, 6.9, and 15.5 months, respectively. PFS and OS of mutated group (EGFR, EML4ALK) were longer than nonmutated group (10.5 vs. 5.4 months, P < 0.0001 and 21.5 vs. 11 months, P = 0.0001, respectively). PFS and OS of patients who received pemetrexed maintenance were longer than those who did not receive maintenance (8.5 vs. 6.5 months, P = 0.1613 and 18.5 vs. 12.5 months, P = 0.0219, respectively). CONCLUSIONS Mutation testing at diagnosis is feasible in the vast majority of patients with Stage IV adenocarcinoma of the lung. Patients with EGFR or EML4ALK mutation and those who received pemetrexed maintenance had better clinical outcomes.
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Affiliation(s)
- P Paliwal
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - S Rajappa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - A Santa
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - Mvtk Mohan
- Department of Medical Oncology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - S Murthy
- Department of Pathology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
| | - N Lavanya
- Department of Pathology, Basavatarakam Indo American Cancer Hospital, Hyderabad, Telangana, India
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21
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Tan B, Kong W, Yuan C, Tan D, Teoh H, Sharma V, Chan B, Yeo L, Paliwal P. The tale of 2 clots: Synchronous acute ischemic stroke and pulmonary embolism. J Neurol Sci 2017. [DOI: 10.1016/j.jns.2017.08.3121] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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22
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Lim M, Omuro A, Vlahovic G, Reardon D, Sahebjam S, Cloughesy T, Baehring J, Butowski N, Potter V, Zwirtes R, Paliwal P, Carleton M, Sampson J, Brandes A. Nivolumab (nivo) in combination with radiotherapy (RT) ± temozolomide (TMZ): Updated safety results from CheckMate 143 in pts with methylated or unmethylated newly diagnosed glioblastoma (GBM). Ann Oncol 2017. [DOI: 10.1093/annonc/mdx366] [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] [Indexed: 11/14/2022] Open
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23
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Lalchandani A, Singh AK, Paliwal P, Godara M, Naveen M, Midha T, Garg A, Singh A, Singh P. To study Troponin T levels and its significance in relation to mortality and morbidity in acute ischemic stroke. Indian Heart J 2014. [DOI: 10.1016/j.ihj.2014.10.339] [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: 10/24/2022] Open
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24
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Yeo LLL, Paliwal P, Teoh HL, Seet RC, Chan BP, Ting E, Venketasubramanian N, Leow WK, Wakerley B, Kusama Y, Rathakrishnan R, Sharma VK. Assessment of intracranial collaterals on CT angiography in anterior circulation acute ischemic stroke. AJNR Am J Neuroradiol 2014; 36:289-94. [PMID: 25324493 DOI: 10.3174/ajnr.a4117] [Citation(s) in RCA: 83] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Abstract
BACKGROUND AND PURPOSE Intracranial collaterals influence the prognosis of patients treated with intravenous tissue plasminogen activator in acute anterior circulation ischemic stroke. We compared the methods of scoring collaterals on pre-tPA brain CT angiography for predicting functional outcomes in acute anterior circulation ischemic stroke. MATERIALS AND METHODS Two hundred consecutive patients with acute anterior circulation ischemic stroke treated with IV-tPA during 2010-2012 were included. Two independent neuroradiologists evaluated intracranial collaterals by using the Miteff system, Maas system, the modified Tan scale, and the Alberta Stroke Program Early CT Score 20-point methodology. Good and extremely poor outcomes at 3 months were defined by modified Rankin Scale scores of 0-1 and 5-6 points, respectively. RESULTS Factors associated with good outcome on univariable analysis were younger age, female sex, hypertension, diabetes mellitus, atrial fibrillation, small infarct core (ASPECTS ≥8), vessel recanalization, lower pre-tPA NIHSS scores, and good collaterals according to Tan methodology, ASPECTS methodology, and Miteff methodology. On multivariable logistic regression, only lower NIHSS scores (OR, 1.186 per point; 95% CI, 1.079-1.302; P = .001), recanalization (OR, 5.599; 95% CI, 1.560-20.010; P = .008), and good collaterals by the Miteff method (OR, 3.341; 95% CI, 1.203-5.099; P = .014) were independent predictors of good outcome. Poor collaterals by the Miteff system (OR, 2.592; 95% CI, 1.113-6.038; P = .027), Maas system (OR, 2.580; 95% CI, 1.075-6.187; P = .034), and ASPECTS method ≤5 points (OR, 2.685; 95% CI, 1.156-6.237; P = .022) were independent predictors of extremely poor outcomes. CONCLUSIONS Only the Miteff scoring system for intracranial collaterals is reliable for predicting favorable outcome in thrombolyzed acute anterior circulation ischemic stroke. However, poor outcomes can be predicted by most of the existing methods of scoring intracranial collaterals.
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Affiliation(s)
- L L L Yeo
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - P Paliwal
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - H L Teoh
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - R C Seet
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.) Yong Loo Lin School of Medicine (R.C.S., V.K.S.), National University of Singapore, Singapore
| | - B P Chan
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - E Ting
- Department of Diagnostic Imaging (E.T.), National University Health System, Singapore
| | - N Venketasubramanian
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - W K Leow
- Department of Computer Science (W.K.L.)
| | - B Wakerley
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - Y Kusama
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - R Rathakrishnan
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.)
| | - V K Sharma
- From the Division of Neurology, Department of Medicine (L.L.L.Y., P.P., H.L.T., R.C.S., B.P.C., N.V., B.W., Y.K., R.R., V.K.S.) Yong Loo Lin School of Medicine (R.C.S., V.K.S.), National University of Singapore, Singapore
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Abstract
CONTEXT Epithelial to mesenchymal transition (EMT) is a process involving conversion of cells from an epithelial to mesenchymal phenotype. The role of candidate genes promoting EMT and favoring a promigratory phenotype has been demonstrated in epithelial cancer. Existing scientific research has not yielded a clinically relevant biomarker with predictive capacity beyond grade and stage in bladder cancer. AIM The purpose of this study is to evaluate the immunohistochemical expression pattern of a panel of epithelial and mesenchymal markers in paraffin-embedded archival material of primary urothelial carcinoma as evidence of EMT. MATERIALS AND METHODS Immunohistochemical expression of transcription factor twist, epithelial (E-cadherin, cytokeratin) and mesenchymal (vimentin, N-cadherin) markers was analyzed on archival paraffin-embedded tissue samples from 48 patients with diagnosis of primary urothelial carcinoma of bladder. STATISTICAL ANALYSIS Karl Pearson's χ2 test was used to evaluate the association between the expression of immunohistochemical markers and various clinico-pathologic variables. Non-parametric Kendall's tau-b statistics was used to determine the correlation between categorical variables. RESULTS AND CONCLUSION The study demonstrated statistically significant association of cytokeratin, E-cadherin, vimentin, and twist with stage and grade of bladder cancer. Since these markers form part of the spectrum of changes associated with EMT, the study establishes proof of concept of the existence of this process in vivo. A significant negative correlation was noted between the expression of twist and E-cadherin. Exploiting its role as a transcriptional repressor of E-cadherin, twist may prove to be a useful candidate for targeted therapy in urologic oncology.
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Affiliation(s)
- Purnima Paliwal
- Department of Histopathology, National Institute of Pathology, Safdarjang Hospital Campus, New Delhi, India
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26
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Affiliation(s)
- Jyoti Gupta
- Department of Dermatology and STD,-Vardhaman Mahavir Medical College and Safdarjung Hospital, New Delhi, India
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Paliwal P, Rathakrishnan R. Early Electroencephalography (EEG) in Patients with New-Onset Seizures: Diagnostic Yield and Impact on Clinical Decision-Making (P07.120). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p07.120] [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] Open
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28
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Yeo L, Paliwal P, Wakerley B, Ahmad A, Ng K, Pei Kee L, Hock Luen T, Chan B, Ting E, Sharma V. Presence of Good Collateral Circulation Is a Good Predictor of Favorable Outcome after Intravenous Thrombolysis in Acute Anterior Circulation Ischemic Stroke (S03.006). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s03.006] [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] Open
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29
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Yeo L, Paliwal P, Wakerley B, Ahmad A, Ng K, Pei Kee L, Hock Luen T, Chan B, Sharma V. Extending Therapeutic Window for Intravenous Thrombolysis to 4.5 Hours Remains Safe and Effective in Asian Acute Ischemic Stroke Patients (P02.196). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.p02.196] [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] Open
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30
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Shivaprasad C, Paliwal P, Khadgawat R, Sharma A. Identification of a novel mutation in an Indian patient with CAII deficiency syndrome. J Postgrad Med 2010; 56:290-2. [PMID: 20935402 DOI: 10.4103/0022-3859.70944] [Citation(s) in RCA: 3] [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
Carbonic anhydrase II (CAII) deficiency syndrome characterized by osteopetrosis (OP), renal tubular acidosis (RTA), and cerebral calcifications is caused by mutations in the carbonic anhydrase 2 (CA2) gene. Severity of this disorder varies depending on the nature of the mutation and its effect on the protein. We present here, the clinical and radiographic details along with, results of mutational analysis of the CA2 gene in an individual clinically diagnosed with renal tubular acidosis, osteopetrosis and mental retardation and his family members to establish genotype-phenotype correlation. A novel homozygous deletion mutation c.251delT was seen in the patient resulting in a frameshift and a premature stop codon at amino acid position 90 generating a truncated protein leading to a complete loss of function and a consequential deficiency of the enzyme making this a pathogenic mutation. Confirmation of clinical diagnosis by molecular methods is essential as the clinical features of the CAII deficiency syndrome are similar to other forms of OP but the treatment modalities are different. Genetic confirmation of the diagnosis at an early age leads to the timely institution of therapy improving the growth potential, reduces other complications like fractures, and aids in providing prenatal testing and genetic counseling to the parents planning a pregnancy.
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Affiliation(s)
- C Shivaprasad
- Department of Anatomy, All India Institute of Medical Sciences, New Delhi, India
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31
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Yu E, Massard C, Gross M, Wilding G, Posadas E, Culine S, Carducci MA, Trudel G, Paliwal P, Sternberg C. A phase II study of once-daily dasatinib for patients with castration-resistant prostate cancer (CRPC) (CA180085). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5147] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5147 Background: Dasatinib is a potent oral SRC family kinase inhibitor that also inhibits c-KIT and PDGFR in vitro. The anti-proliferative/anti-metastatic activity as well as osteoclast inhibitory function of dasatinib in pre-clinical models supports its potential as a targeted therapy for prostate cancer. Previously we presented results on BID dosing of dasatinib in the treatment of CRPC (ASCO. 2008 Abstract 5156). A second group of patients (pts) was enrolled to investigate the activity, safety and bone effects of 100 mg once daily dosing. Methods: Male pts with progressive metastatic CRPC, rising PSA, castrate levels of testosterone (< 50 ng/dL) and no prior chemotherapy were enrolled. Dasatinib dose was 100 mg QD. Continuation of bisphosphonates was permitted. Primary endpoint was a composite of: PSA responses, bone scans and disease control by RECIST. Urinary N-telopeptide (uNTX) and bone alkaline phosphatase (BAP) were determined Q 4-weeks as indicators of bone metabolism. Results: 47 pts were treated (median treatment duration was 2.3 months). 11 patients were evaluable by RECIST; of these 64% achieved SD. The composite response rate was (8/47) 17%. Of 22 pts with bone scans, 50% were stable at 12 weeks and 3/9 (33%) were stable at 24 weeks. A prolonged PSA doubling time was observed in 32 of 39 pts (82%), including one pt with a PSA response. Of the pts with evaluable bone markers, including those who continued on bisphosphonate therapy, 20/41 (49%) had a ≥ 35% decrease in uNTX and 21/42 (50%) had a decrease from baseline in BAP. Grade 3/4 adverse events (AEs) were experienced by 13% of pts (diarrhea, asthenia, and pleural effusion [n=1]). Grade 1/2 AEs (≥ 15% of pts) were diarrhea, nausea, headache, fatigue, asthenia, anorexia and dyspnea. Conclusions: Fewer and less severe AEs were observed in all categories for the QD dosing group compared to the previously reported BID dosing cohort. In addition, preliminary clinical activity (tumor and PSA response; decreasing bone turnover [uNTX, BAP]), is now confirmed to be similar in pts treated with 100mg QD and BID dosing. These data support the relevance of further studies of dasatinib in metastatic CRPC. [Table: see text]
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Affiliation(s)
- E. Yu
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - C. Massard
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - M. Gross
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - G. Wilding
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - E. Posadas
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - S. Culine
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - M. A. Carducci
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - G. Trudel
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - P. Paliwal
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
| | - C. Sternberg
- University of Washington, Seattle, WA; Institut Gustave Roussy, Villejuif, France; Louis Warschaw Prostate Cancer Center, Los Angeles, CA; UWCCC, Madison, WI; University of Chicago Medical Center, Chicago, IL; CHU Henri Mondor, Créteil, France; The Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD; Bristol-Myers Squibb, Wallingford, CT; San Camillo Forlanini Hospital, Rome, Italy
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Araujo J, Armstrong AJ, Braud EL, Posadas E, Lonberg M, Gallick GE, Trudel GC, Paliwal P, Agrawal S, Logothetis CJ. Dasatinib and docetaxel combination treatment for patients with castration-resistant progressive prostate cancer: A phase I/II study (CA180086). J Clin Oncol 2009. [DOI: 10.1200/jco.2009.27.15_suppl.5061] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
5061 Background: Dasatinib, a potent inhibitor of SRC family kinases, inhibits in vitro prostate cancer cell proliferation and migration. Consistent with those findings are the clinical observations that osteoclast activity and bone turnover are downregulated in patients treated with dasatinib. We report promising preliminary results of dasatinib in combination with docetaxel (D) for treatment of metastatic castration-resistant prostate cancer (CRPC). Methods: Male pts with progressive CRPC and castrate levels of testosterone (≤50 ng/dL) requiring chemotherapy were enrolled. Escalating doses of dasatinib (50–120 mg QD) and D (60–75 mg/m2 Q 21 days) were evaluated (n = 16) followed by enrollment of 30 pts at the phase 2-selected dose (100 mg dasatinib QD + D at 75 mg/m2 Q 21 days). Continuation of bisphosphonates was permitted; anti-androgens were discontinued. Primary endpoint (Ph. 2) was to determine drug-drug interactions. Secondary endpoints were: changes in PSA, bone scans and tumor size, bone metabolism [urinary N-telopeptide (uNTX) and bone alkaline phosphatase (BAP)] and PK. Results: 46 pts were treated with 28 pts still on therapy. Median treatment duration (n = 18, pts off study) was 4.2 months (0.13–9.63). Preliminary analysis showed no interaction between dasatinib and D. PSA response was seen in 13/32 (41%) pts, clinical benefit (PR + SD) for RECIST-evaluable pts was 21/21, [7 PR, 5 uPR and 4 SD (at ≥21 wks) and 5 SD at ≥6 wk)]. Of 31 pts with bone scans, 30 patients had a best response of either improved (32%) or stable (65%) at ≥6 weeks. For pts with measurable bone markers levels, 12/26 (46%) had a ≥35% decrease in uNTX and 17/24 (71%) had a decrease in BAP from baseline. 6 of 42 pts experienced ≥ grade 3 adverse events (AEs), including fatigue, myelosuppression and pleural effusion (n = 1). Most common grade 1/2 AEs were fatigue, dysgeusia, GI, and skin disorders. Conclusions: Dasatinib and D at doses up to 120 mg QD and 75 mg/m2 are safe with manageable toxicities and no drug-drug interactions. These data confirm the antitumor and antiosteoclast activity of dasatinib in combination with D and serve as the basis for the ongoing phase III study of this combination. [Table: see text]
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Affiliation(s)
- J. Araujo
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - A. J. Armstrong
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - E. L. Braud
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - E. Posadas
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - M. Lonberg
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - G. E. Gallick
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - G. C. Trudel
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - P. Paliwal
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - S. Agrawal
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
| | - C. J. Logothetis
- M. D. Anderson Cancer Center, Houston, TX; Duke University Medical Center, Durham, NC; Springfield Clinic, Springfield, IL; University of Chicago Medical Center, Chicago, IL; Hematology-Oncology Associates of Rockland, New York, NY; Bristol-Myers Squibb, Wallingford, CT; Bristol-Myers Squibb, Lawrenceville, NJ
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Sharma A, Paliwal P, Dadhwal V, Sharma Y, Deka D. Rare finding of 2n/4n mixoploidy in mother and fetus with severe immune hydrops. Cytogenet Genome Res 2009; 124:90-3. [DOI: 10.1159/000200092] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/18/2008] [Indexed: 11/19/2022] Open
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Yu EY, Wilding G, Posadas E, Gross M, Culine S, Massard C, Hudes GR, Cheng S, Paliwal P, Sternberg CN. Dasatinib in patients with hormone-refractory progressive prostate cancer: A phase II study. J Clin Oncol 2008. [DOI: 10.1200/jco.2008.26.15_suppl.5156] [Citation(s) in RCA: 14] [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: 11/20/2022] Open
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Fox HC, Axelrod SR, Paliwal P, Sleeper J, Sinha R. Difficulties in emotion regulation and impulse control during cocaine abstinence. Drug Alcohol Depend 2007; 89:298-301. [PMID: 17276626 DOI: 10.1016/j.drugalcdep.2006.12.026] [Citation(s) in RCA: 226] [Impact Index Per Article: 13.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2006] [Revised: 11/13/2006] [Accepted: 12/11/2006] [Indexed: 10/23/2022]
Abstract
RATIONALE Prior research has shown that cocaine dependence is associated with dysfunction of brain systems involved in emotions and motivational states. OBJECTIVES To examine whether difficulties in emotion regulation are associated with early cocaine abstinence using the recently validated Difficulties in Emotion Regulation Scale (DERS). METHOD Recently abstinent treatment-seeking cocaine patients (n=60) completed the DERS during their first week of inpatient treatment and at discharge (3-4 weeks later), and scores were compared with community controls (n=50). RESULTS Compared with controls, cocaine-dependent individuals reported difficulties relating to understanding emotions, managing emotions and impulse control in the first week of abstinence. With continued abstinence, cocaine-dependent individuals showed continued difficulties only in impulse control. CONCLUSION Cocaine-dependent individuals report emotion regulation difficulties, particularly during early abstinence. Additionally, protracted distress-related impulse control problems suggest potential relapse vulnerability.
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Affiliation(s)
- H C Fox
- Department of Psychiatry, Yale University School of Medicine, Substance Abuse Center, Connecticut Mental Health Center, 34 Park Street, New Haven, CT 06519, USA.
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Tayyab S, Paliwal P, Khan MM. Modulation in the photosensitivity of albumin-bound bilirubin. Int J Biol Macromol 2001; 29:267-71. [PMID: 11718823 DOI: 10.1016/s0141-8130(01)00170-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
Abstract
Exposure of BR-albumin complexes to visible light at pH 8.0 led to a change in the fluorescence intensity at 525 nm, which was found to be different for different serum albumins. Whereas a complex of BR with human serum albumin (HSA) showed a marked increase in fluorescence upon photoirradiation, BR-sheep serum albumin (SSA) complex failed to produce a marked increase. On the other hand, a complex of pig serum albumin (PSA) with BR produced a remarkable decrease in fluorescence upon photoirradiation. Equilibration of these complexes with approximately 20 mM chloroform for 1 h resulted in alteration in the photoinduced fluorescence. These photoinduced fluorescence modulations were found to be concentration dependent. Photoirradiation of BR-HSA complex led to a significant decrease in the positive CDCEs of the bisignate CD spectra in a time dependent manner that can be reconciled, to a significant extent, in the presence of chloroform. Taken together, all these results suggest that chiroptical properties/stability of albumin-bound BR varies with albumin species, protein concentration and the presence of chloroform.
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Affiliation(s)
- S Tayyab
- Interdisciplinary Biotechnology Unit, Aligarh Muslim University, 202002, UP, Aligarh, India.
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