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Mehta N, Khan E, Choudhary R, Dholakia D, Goel S, Gupta S. The performance of an artificial intelligence-based computer vision mobile application for the image diagnosis of genital dermatoses: a prospective cross-sectional study. Int J Dermatol 2024. [PMID: 38314623 DOI: 10.1111/ijd.17060] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/21/2023] [Revised: 01/11/2024] [Accepted: 01/16/2024] [Indexed: 02/06/2024]
Abstract
BACKGROUND There is a huge demand-supply gap between the incidence of genital dermatoses (including sexually transmitted infections and non-venereal genital dermatoses) and physicians trained to manage them. OBJECTIVES To find out the performance of an artificial intelligence (AI)-based mobile application in the image diagnosis of genital dermatoses, and to compare it with primary care physicians (PCPs) and dermatologists. METHODS Photos of the genital diseases of consecutive patients presenting to the STD and genital diseases clinic were included. The gold standard diagnosis was established by the consensus of two certified dermatologists after examination and one positive investigation. Image diagnoses by the DermaAId application, two PCPs, and two dermatologists were recorded and compared to the gold standard diagnosis and to each other. RESULTS A total of 257 genital disease images, including 95 (37.0%) anogenital warts, 60 (22.2%) lichen sclerosus, 20 (7.8%) anogenital herpes, 15 (5.8%) tinea cruris, 14 (5.4%) molluscum contagiosum, 9 (3.5%) candidiasis, 8 (3.1%) scabies, 6 (2.3%) squamous cell carcinomas, were included. The top-1 correct diagnosis rate of the application was 68.9%, compared to the 50.4% of the PCPs and 73.2% of the dermatologists. The application significantly outperformed PCPs with regard to the correlation with the gold standard diagnosis (P < 0.0001), and matched that of the dermatologists. CONCLUSIONS AI-based image diagnosis platforms can potentially be a low-cost rapid decision support tool for PCPs, integrated with syndromic management programs and direct-to-consumer services, and address healthcare inequities in managing genital dermatoses.
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Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Ejaz Khan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rajat Choudhary
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Dhwani Dholakia
- Data Analyst (Bioinformatician), Rajiv Gandhi Cancer Institute and Research Centre, New Delhi, India
| | - Sachin Goel
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Somesh Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Suneja A, Wamborikar HS, Deshpande SV, Jadawala VH, Ahmed S, Goel S. Management of Vancouver B3 Periprosthetic Femur Fracture Using a Modular Uncemented Long Femoral Stem Prosthesis With Cerclage Wiring Technique. Cureus 2024; 16:e53895. [PMID: 38465082 PMCID: PMC10925070 DOI: 10.7759/cureus.53895] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2023] [Accepted: 02/08/2024] [Indexed: 03/12/2024] Open
Abstract
Periprosthetic fractures (PPF) of the femur in connection with total hip arthroplasty are becoming common and also frequently challenging to repair. Such patients typically are frail, elderly, and have osteoporosis. Owing to a scarcity of research there are no clear strategies for its effective management. However, the Vancouver classification may help in facilitating treatment decisions. For fractures around a loose femoral prosthesis (types B2 and B3), revision using a modular uncemented long stem, with or without additional fracture fixation, has been known to provide a reliable outcome. It is prudent to treat osteoporosis for fracture healing and to prevent further fractures. In this case report, we share our experience with the use of an uncemented modular long femoral stem prosthesis with a cerclage wiring technique for the management of Vancouver type B3 PPF of the left femur in a 63-year-old male patient. Revision arthroplasty using a long stem prosthesis with a cerclage wiring technique can provide better fixation, stability, and functional outcomes for the patient.
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Affiliation(s)
- Anmol Suneja
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hitendra S Wamborikar
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanjay V Deshpande
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vivek H Jadawala
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Salahuddin Ahmed
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sachin Goel
- Department of Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Goel S, Deshpande S, Dhaniwala N, Singh R, Suneja A, Jadawala VH. A Comprehensive Review of Genetic Variations in Collagen-Encoding Genes and Their Implications in Intervertebral Disc Degeneration. Cureus 2024; 16:e52708. [PMID: 38384607 PMCID: PMC10880043 DOI: 10.7759/cureus.52708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/02/2024] [Accepted: 01/22/2024] [Indexed: 02/23/2024] Open
Abstract
This comprehensive review examines the intricate relationship between genetic variations in collagen-encoding genes and their implications in intervertebral disc degeneration (IVDD). Intervertebral disc degeneration is a prevalent spinal condition characterized by structural and functional changes in intervertebral discs (IVDs), and understanding its genetic underpinnings is crucial for advancing diagnostic and therapeutic strategies. The review begins by exploring the background and importance of collagen in IVDs, emphasizing its role in providing structural integrity. It then delves into the significance of genetic variations within collagen-encoding genes, categorizing and discussing their potential impact on disc health. The methods employed in studying these variations, such as genome-wide association studies (GWASs) and next-generation sequencing (NGS), are also reviewed. The subsequent sections analyze existing literature to establish associations between genetic variations and IVDD, unraveling molecular mechanisms linking genetic factors to disc degeneration. The review concludes with a summary of key findings, implications for future research and clinical practice, and a reflection on the importance of understanding genetic variations in collagen-encoding genes to diagnose and treat IVDD. The insights gleaned from this review contribute to our understanding of IVDD and hold promise for the development of personalized interventions based on individual genetic profiles.
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Affiliation(s)
- Sachin Goel
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanjay Deshpande
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nareshkumar Dhaniwala
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul Singh
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anmol Suneja
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vivek H Jadawala
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Jadawala VH, Deshpande S, Ahmed S, Goel S, Suneja A. Synovial Chondromatosis in a Young Athlete: A Report of a Rare Case. Cureus 2024; 16:e53173. [PMID: 38420086 PMCID: PMC10901533 DOI: 10.7759/cureus.53173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2023] [Accepted: 01/29/2024] [Indexed: 03/02/2024] Open
Abstract
Synovial chondromatosis is a rare and benign disorder that involves the synovial lining of joints, synovial sheaths and bursae. The synovial layer of the joint is affected by a metaplastic process which in turn converts it into cartilagenous tissue. Eventually, it gets dislodged and transformed into a loose body in the large joints. We report the case of a 24-year-old young athlete who presented with complaints of painful movements and restriction of joint movements associated with a growing deformity in the right knee joint. This case report aims to describe a rare synovial pathology that necessitated arthroscopic synovectomy and diagnostic arthroscopy to treat, particularly in younger individuals. The atypical feature, in this case, was metaplastic development from the peripheral joint capsule attached to the surrounding cartilage, which, to the extent that the authors are aware, has only been documented in one instance in the record. Magnetic resonance imaging (MRI) was performed which demonstrated evidence of the joint effusion, synovial hypertrophy and a loose calcific body just anterior of the distal femoral condyle causing pressure over the patellar tendon anteriorly as well as a hyper-dense cyst in the popliteal region. Treatment often requires partial or complete synovectomy with either an arthroscopic or open approach.
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Affiliation(s)
- Vivek H Jadawala
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanjay Deshpande
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Salahuddin Ahmed
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sachin Goel
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anmol Suneja
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Deshpande SV, Jadawala VH, Ahmed S, Goel S. Subcutaneous Angiofibroma of the Ankle: A Rare, Undescribed Clinical Entity. Cureus 2024; 16:e53033. [PMID: 38410349 PMCID: PMC10895384 DOI: 10.7759/cureus.53033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2023] [Accepted: 01/27/2024] [Indexed: 02/28/2024] Open
Abstract
Soft tissue angiofibroma is a pathology consisting of a benign fibrous vascularized tumor that mimics low-grade sarcoma. Such tumors frequently arise in the extremities, more commonly in the lower extremities, presenting as a slow-growing, painless swelling. Females are more commonly affected than males. We present the case of a 42-year-old male with a slow-growing, painless mass on the extensor aspect of his left foot. Differential diagnoses considered were soft tissue fibrosarcoma, liposarcoma, and sebaceous cysts. Surgical excision of the tumor was done, and upon histopathology, there were multiple lobules with well-circumscribed, alternating areas of collagenous and myxoid tissues. There was a prominent small vascular network with uniformly arranged spindle cells consisting of pale eosinophil-rich cytoplasm and small ovoid nuclei, fine chromatin, and an indistinct nucleolus. There are not many reported cases of this clinical entity, and every new case reported brings light to the pathology and progression of this tumor. Understanding this pathology is necessary since it mimics many other skin and soft tissue tumors.
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Affiliation(s)
- Sanjay V Deshpande
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Vivek H Jadawala
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Salahuddin Ahmed
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
| | - Sachin Goel
- Department of Orthopaedic Surgery, Jawaharlal Nehru Medical College, Datta Meghe Institute of Medical Sciences, Wardha, IND
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Kragholm K, Abdelkarim O, Sinha A, Zook S, Chao MF, Faza N, Goel S, Reardon M, Kleiman N, Little S, Chang SM. Aortic Valve Calcium Score in Addition to Dobutamine Stress Echocardiography for Low-Flow, Low-Gradient Aortic Stenosis Assessment. J Am Soc Echocardiogr 2023; 36:1324-1326. [PMID: 37586665 DOI: 10.1016/j.echo.2023.08.009] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/10/2023] [Revised: 08/08/2023] [Accepted: 08/09/2023] [Indexed: 08/18/2023]
Affiliation(s)
| | | | - Abhiraj Sinha
- Houston Methodist DeBakey Heart Center, Houston, Texas
| | - Salma Zook
- Houston Methodist DeBakey Heart Center, Houston, Texas
| | - Min-Fang Chao
- Houston Methodist DeBakey Heart Center, Houston, Texas
| | - Nadeen Faza
- Houston Methodist DeBakey Heart Center, Houston, Texas
| | - Sachin Goel
- Houston Methodist DeBakey Heart Center, Houston, Texas
| | | | - Neal Kleiman
- Houston Methodist DeBakey Heart Center, Houston, Texas
| | | | - Su Min Chang
- Houston Methodist DeBakey Heart Center, Houston, Texas
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Goel S, Dhaniwala N, Singh R, Suneja A, Jadawala VH. Exostosis of Ulna With Developmental Deformity of the Left Forearm: A Rare Case. Cureus 2023; 15:e50528. [PMID: 38226087 PMCID: PMC10788317 DOI: 10.7759/cureus.50528] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2023] [Accepted: 12/14/2023] [Indexed: 01/17/2024] Open
Abstract
This case report presents a rare occurrence of exostosis of the ulna associated with a developmental deformity of the left forearm in a 15-year-old female. The patient reported a history of trauma resulting in a supracondylar humerus fracture managed conservatively eight years prior. The patient presented with a two-year history of pain and swelling over the left forearm. Clinical examination revealed a firm, non-tender, immobile swelling closely associated with the ulna, accompanied by a 20-degree cubitus varus deformity and forearm shortening. Radiographs and computed tomography scans confirmed the presence of a solitary external bony protuberance over the ulna shaft, communicating with the medullary cavity. A preliminary diagnosis of osteochondroma was established based on clinical and imaging findings. The patient underwent extraperiosteal en bloc resection of the lesion under supraclavicular nerve block anesthesia. A histopathological examination confirmed the diagnosis. Postoperative physiotherapy was initiated, and at the one-month follow-up, the patient reported being pain-free. This case highlights the rarity of exostosis of the ulna with associated developmental deformity, emphasizing the importance of a comprehensive diagnostic approach. Early surgical intervention resulted in a successful outcome, underscoring the significance of timely management in improving patient outcomes and quality of life.
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Affiliation(s)
- Sachin Goel
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Nareshkumar Dhaniwala
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Rahul Singh
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Anmol Suneja
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Vivek H Jadawala
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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8
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Arora S, Jaswaney R, Khawaja T, Jain A, Khan SU, Gidwani UK, Osman MN, Goel S, Shah AR, Kleiman NS. Outcomes With Intravascular Ultrasound and Optical Coherence Tomography Guidance in Percutaneous Coronary Intervention. Am J Cardiol 2023; 207:470-478. [PMID: 37844404 DOI: 10.1016/j.amjcard.2023.08.065] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/03/2023] [Accepted: 08/11/2023] [Indexed: 10/18/2023]
Abstract
Intracoronary imaging has become an important tool in the treatment of complex lesions with percutaneous coronary intervention (PCI). This retrospective cohort study identified 1,118,475 patients with PCI from the Nationwide Readmissions Database from 2017 to 2019. Intravascular ultrasound (IVUS) and optical coherence tomography (OCT) were identified with appropriate International Classification of Diseases, Tenth Revision codes. The primary outcome was major adverse cardiac events. The secondary outcomes include net adverse clinical events (NACEs), all-cause mortality, myocardial infarction (MI) readmission, admission for stroke, and emergency revascularization. The multivariate Cox proportional hazard regression was used to adjust for demographic and co-morbid confounders. Of 1,118,475 PCIs, 86,140 (7.7%) used IVUS guidance and 5,617 (0.5%) used OCT guidance. The median follow-up time was 184 days. The primary outcome of major adverse cardiac events was significantly lower for the IVUS (6.5% vs 7.6%; hazard ratio [HR] 0.89, 95% confidence interval [CI] 0.86 to 0.91, p <0.001) and OCT (4.4% vs 7.6%; HR 0.69, 95% CI 0.61 to 0.79, p <0.001) groups. IVUS was associated with significantly lower rates of NACEs (8.4% vs 9.4%; HR 0.92, 95% CI 0.89 to 0.94, p <0.001), all-cause mortality (3.5% vs 4.3%; HR 0.85, 95% CI 0.82 to 0.88, p <0.001), readmission for MI (2.7% vs 3.0%; HR 0.95, 95% CI 0.91 to 0.99, p = 0.012), and admission for stroke (0.5% vs 0.6%; HR 0.86, 95% CI 0.78 to 0.95, p = 0.002). OCT was associated with significantly lower rates of NACEs (6.6% vs 9.4%; HR 0.81, 95% CI 0.73 to 0.89, p <0.001) and all-cause mortality (1.8% vs 4.3%; HR 0.51, 95% CI 0.42 to 0.63, p <0.001). Emergency revascularization was not significantly different with IVUS guidance. Readmission for MI, stroke, and emergency revascularization were not significantly different with OCT guidance. A subgroup analysis of patients with ST-elevation MI and non-ST-elevation MI showed similar results. In conclusion, the use of IVUS and OCT guidance with PCI were associated with significantly lower rates of morbidity and mortality in real-world practice.
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Affiliation(s)
- Shilpkumar Arora
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas; Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
| | - Rahul Jaswaney
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio; Temple University Hospital Heart and Vascular Center, Philadelphia, Pennsylvania
| | - Tasveer Khawaja
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
| | - Akhil Jain
- Mercy Catholic Medical Center, Darby, Pennsylvania
| | - Safi U Khan
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas
| | | | - Mohammed Najeeb Osman
- Harrington Heart and Vascular Institute, Case Western Reserve University, Cleveland, Ohio
| | - Sachin Goel
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas
| | - Alpesh R Shah
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas
| | - Neal S Kleiman
- Houston Methodist DeBakey Heart & Vascular Center, Houston, Texas.
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Suneja A, Deshpande SV, Wamborikar H, Date SV, Goel S, Sekhon G. Outcome Analysis of Posterior Cruciate Ligament Injuries: A Narrative Review. Cureus 2023; 15:e47410. [PMID: 38022148 PMCID: PMC10658065 DOI: 10.7759/cureus.47410] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 10/20/2023] [Indexed: 12/01/2023] Open
Abstract
The primary posterior stabilizer of the knee is the posterior cruciate ligament (PCL), the largest intra-articular ligament in the human knee. One of the four primary ligaments of the knee joint, the PCL, serves to support the tibia on the femur. An extreme force applied anteriorly to the proximal tibia of the flexed knee results in trauma to the PCL. Dashboard injuries, which occur when the knee is driven into the dashboard after a collision with a motor vehicle, are frequent causes. Grade 1 and 2 acute injuries are often addressed conservatively due to the PCL's natural capacity for mending. If a grade 3 injury occurs, a cautious trial can be conducted on elderly or low-demand patients. When standard treatment for isolated grade 3 injuries has failed, surgery is advised. Single-bundle or double-bundle techniques using either transtibial tunnel or tibial inlay techniques are among the reconstruction approaches. Restoring the natural kinematics of the knee and forestalling persistent posterior and mixed rotatory knee laxity are the ultimate goals of treating PCL injuries through a personalized strategy. These injuries may become more common in the future as more people participate in sports. As a result of ongoing instability, discomfort, diminished function, and the emergence of inflammatory and degenerative disorders of joints, PCL rips are becoming more well-acknowledged as a cause of morbidity and decreased function.
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Affiliation(s)
- Anmol Suneja
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sanjay V Deshpande
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Hitendra Wamborikar
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Swapnil V Date
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Sachin Goel
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
| | - Gursimran Sekhon
- Orthopaedics, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND
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Elbadawi A, Dang AT, Hamed M, Ali A, Saad M, Jneid H, Chhatriwalla AK, Goel S, Bhatt A, Mani P, Bavry A, Kumbhani DJ. Transcatheter edge-to-edge repair for mitral regurgitation using PASCAL or MitraClip. Catheter Cardiovasc Interv 2023; 102:521-527. [PMID: 37493443 DOI: 10.1002/ccd.30772] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2023] [Revised: 05/25/2023] [Accepted: 07/09/2023] [Indexed: 07/27/2023]
Abstract
BACKGROUND There is a paucity of data regarding the comparative efficacy and safety of Mitral valve transcatheter edge-to-edge repair (MTEER) using the PASCAL or MitraClip systems for patients with mitral regurgitation (MR). METHODS An electronic search was conducted for MEDLINE, COCHRANE, and EMBASE, through February 2023, for studies comparing the clinical outcomes of MTEER using PASCAL versus MitraClip systems among patients with severe MR. The primary study outcome was residual MR ≤ 2 at discharge. Data were pooled using a random-effects model. RESULTS The final analysis included six studies with a total of 1581 patients, with a weighted follow-up period of 3.5 months. Two studies only included patients with degenerative MR, while the remaining studies included both degenerative and functional MR. There was no significant difference in procedure duration between MTEER with the PASCAL or MitraClip systems. There was no difference in residual MR ≤ 2 at discharge (94.7% vs. 91.9%; odds ratio [OR]: 1.44; 95% confidence interval [CI]: 0.92-2.27) or residual MR ≤ 2 at the mid-term follow-up (94.6% vs. 91.0%, p = 0.05) among the PASCAL versus MitraClip systems. There was no difference between both groups in residual MR ≤ 1 at discharge (73.1% vs. 63.8%, p = 0.12), while there was greater incidence of residual MR ≤ 1 at midterm follow-up with the PASCAL system (71.3% vs. 56.2%, p < 0.001). There was no difference between the PASCAL and MitraClip MTEER systems in technical success (97.0% vs. 97.9%, p = 0.15), procedural success (89.1% vs. 87.1%, p = 0.78), single leaflet detachment (1.8% vs. 1.4%, p = 0.55), or all-cause mortality (3.6% vs. 4.6%, p = 0.71). CONCLUSION In this meta-analysis, we demonstrated comparable efficacy and safety between the PASCAL and MitraClip MTEER systems at short- and mid-term assessments. Randomized trials are warranted to evaluate the comparative long-term outcomes between both MTEER systems.
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Affiliation(s)
- Ayman Elbadawi
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Alexander T Dang
- Department of Internal Medicine, University of Texas Medical Branch, Galveston, Texas, USA
| | - Mohamed Hamed
- Department of Internal Medicine, Florida Atlantic University, Boca Raton, Florida, USA
| | - Abdelrahman Ali
- Division of Internal Medicine, Department of Cardiology, The University of Texas MD Anderson Cancer Center, Houston, Texas, USA
| | - Marwan Saad
- Department of Medicine' Division of Cardiology, Alpert Medical School of Brown University, Lifespan Cardiovascular Institute, Providence, Rhode Island, USA
| | - Hani Jneid
- Division of Cardiology, University of Texas Medical Branch, Galveston, Texas, USA
| | - Adnan K Chhatriwalla
- Division of Cardiology, Saint Luke's Mid America Heart Institute and University of Missouri-Kansas City, Kansas City, Missouri, USA
| | - Sachin Goel
- Division of Cardiology, Houston Methodist, Houston, Texas, USA
| | - Anish Bhatt
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Preethi Mani
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Anthony Bavry
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
| | - Dharam J Kumbhani
- Division of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA
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Garcia S, Ye J, Webb J, Reardon M, Kleiman N, Goel S, Hatab T, Fam N, Peterson M, Liauw S, Frisoli TM, Bashir H, Paige D, Rock D, Schmidt C, Jollis JG, Kereiakes DJ. Transcatheter Treatment of Native Aortic Valve Regurgitation: The North American Experience With a Novel Device. JACC Cardiovasc Interv 2023; 16:1953-1960. [PMID: 37212431 DOI: 10.1016/j.jcin.2023.05.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2023] [Revised: 05/04/2023] [Accepted: 05/09/2023] [Indexed: 05/23/2023]
Abstract
BACKGROUND Transcatheter treatment of patients with native aortic valve regurgitation (AR) has been limited by anatomical factors. No transcatheter device has received U.S. regulatory approval for the treatment of patients with AR. OBJECTIVES The aim of this study was to describe the compassionate-use experience in North America with a dedicated transcatheter device (J-Valve). METHODS A multicenter, observational registry was assembled of compassionate-use cases of J-Valve implantation for the treatment of patients with severe symptomatic AR and elevated surgical risk in North America. The J-Valve consists of a self-expanding Nitinol frame, bovine pericardial leaflets, and a valve-locating feature. The available size matrix (5 sizes) can treat a wide range of anatomies (minimum and maximum annular perimeters 57-104 mm). RESULTS A total of 27 patients (median age 81 years [IQR: 72-85 years], 81% at high surgical risk, 96% in NYHA functional class III or IV) with native valve AR were treated with the J-Valve during the study period (2018-2022). Procedural success (J-Valve delivered to the intended location without the need for surgical conversion or a second transcatheter heart valve) was 81% (22 of 27 cases) in the overall experience and 100% in the last 15 cases. Two cases required conversion to surgery in the early experience, leading to changes in valve design. At 30 days, there was 1 death, 1 stroke, and 3 new pacemakers (13%), and 88% of patients were in NYHA functional class I or II. No patient had residual AR of moderate or greater degree at 30 days. CONCLUSIONS The J-Valve appears to provide a safe and effective alternative to surgery in patients with pure AR and elevated or prohibitive surgical risk.
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Affiliation(s)
- Santiago Garcia
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA.
| | - Jian Ye
- Center for Heart Valve Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | - John Webb
- Center for Heart Valve Innovation, St. Paul's Hospital, Vancouver, British Columbia, Canada
| | | | | | - Sachin Goel
- Houston Methodist Hospital, Houston, Texas, USA
| | - Taha Hatab
- Houston Methodist Hospital, Houston, Texas, USA
| | - Neil Fam
- St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Mark Peterson
- St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | - Samantha Liauw
- St. Michael's Hospital and University of Toronto, Toronto, Ontario, Canada
| | | | - Hanad Bashir
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA
| | - Debra Paige
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA
| | - Darlene Rock
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA
| | - Christian Schmidt
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA
| | - James G Jollis
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA
| | - Dean J Kereiakes
- The Christ Hospital Heart and Vascular Institute and Lindner Center for Research and Education, Cincinnati, Ohio, USA
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12
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Goel S, Batra A, Singhal G, Goel S. To Study the Role of PTEN, EGFR and HER2 in Early Glottic Squamous Cell Carcinoma. Indian J Otolaryngol Head Neck Surg 2023; 75:707-712. [PMID: 37275058 PMCID: PMC10234964 DOI: 10.1007/s12070-022-03455-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/20/2022] [Accepted: 12/25/2022] [Indexed: 01/09/2023] Open
Abstract
Laryngeal carcinoma is the most common site of malignancy in head and neck region worldwide. Surgical options are limited in cases of laryngeal malignancy and moajority of cases are treated with chemoradiotherapy. Targeted therapy is an evolving novel approach to treat laryngeal carcinoma. The study was conducted to evaluate the role of PTEN, EGF and HER2 in early glottic squamous cell carcinoma cases. 52 samples of early glottis carcoinoma were collected in UCMS and GTB hospital, New Delhi after patients had undergone CO2 laser excision at the centre. Histopathologic and IHC examination was conducted on the specimen for PTEN, EGFR and HER2 molecules. PTEN was negative in 82.69% cases compared to the stroma with three year local control rate of 72.09%. EGFR was positive in 67.31% samples with three year local control rate of 68.57%. HER2 was negative in all the samples. PTEN and EGFR can be used as prognostic markers as well as novel agents for targeted therapy in the future.
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Affiliation(s)
- Sachin Goel
- Department of ENT, ABVIMS & Dr RML Hospital, New Delhi, India
| | - Ankur Batra
- Department of ENT, Royal Hmapshire County Hospital, Winchester, UK
| | - Gaurang Singhal
- Department of pathology, Action Care hospital, New Delhi, India
| | - Snigdha Goel
- Department of ENT, ABVIMS and Dr. Ram Manohar Lohia hospital, New Delhi, India
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13
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Zahid S, Hashem A, Rai D, Khan MZ, Ullah W, Gowda S, Munir MB, Tan BEX, Velagapudi P, Naidu S, Goel S, Bhatt DL, Depta JP. Same-Day Discharge after Percutaneous Left Atrial Appendage Closure: Insights from the Nationwide Readmission Database 2015-2019. Curr Probl Cardiol 2023; 48:101588. [PMID: 36638903 DOI: 10.1016/j.cpcardiol.2023.101588] [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] [Received: 12/28/2022] [Accepted: 01/03/2023] [Indexed: 01/13/2023]
Abstract
Data on the feasibility of same-day discharge (SDD) following percutaneous left atrial appendage closure (LAAC) remain limited. We analyzed the US Nationwide Readmission Database from quarter four of 2015 to 2019 to study the safety and feasibility of SDD after LAAC. After excluding non-elective cases and in-hospital deaths, a total of 54,880 cases of LAAC were performed during the study period. Following LAAC, 2% (n=1077) of patients underwent SDD, 88% (n=48,428) underwent next-day discharge (NDD), 5.2% (n=2881) were discharged on the second day (ScD), and 4.5% of patients (n = 2494) were discharged 3 or more days after LAAC. There was no difference in 30-day readmission rates between SDD and NDD (7.3% [n=79] vs 7.4% [n=3585], P=0.94). The hospitalization costs were significantly lower for SDD compared with NDD ($22,963 vs $27,079, P≤0.01). SDD discharge following percutaneous LAAC appears to be safe and is associated with lower hospitalization costs. Further prospective studies are needed to determine the safety and feasibility of SDD with percutaneous LAAC.
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Affiliation(s)
- Salman Zahid
- Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY
| | - Anas Hashem
- Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY
| | - Devesh Rai
- Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY
| | - Muhammad Zia Khan
- Division of Cardiovascular Medicine, West Virginia University Heart & Vascular Institute, Morgantown, WV
| | - Waqas Ullah
- Department of Cardiovascular Medicine, Jefferson University Hospitals, Philadelphia, PA
| | - Smitha Gowda
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
| | - Muhammad Bilal Munir
- Division of Cardiovascular Medicine, University of California (San Diego) Medical Center, La Jolla, CA
| | - Bryan E-Xin Tan
- Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY
| | - Poonam Velagapudi
- Division of Cardiovascular Medicine, University of Nebraska Medical Center, Omaha, NE
| | - Srihari Naidu
- Department of Cardiovascular Medicine, Westchester Medical Center, Westchester, NY
| | - Sachin Goel
- Houston Methodist DeBakey Heart & Vascular Center, Houston, TX
| | - Deepak L Bhatt
- Mount Sinai Heart, Icahn School of Medicine at Mount Sinai Health System, New York, NY.
| | - Jeremiah P Depta
- Sands-Constellation Heart Institute, Rochester General Hospital, Rochester, NY
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14
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Goel S, Agrawal R, Bharti R. Epileptic seizure prediction and classification based on statistical features using LSTM fully connected neural network. IFS 2023. [DOI: 10.3233/jifs-222745] [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: 01/15/2023]
Abstract
Epilepsy, the most common neurological disorder by which over 65 million people are affected across the world. Recent research has shown a very large interest to predict and diagnose epilepsy well before time. The continuous monitoring of EEG signals for seizure detection in electroencephalogram (EEG) is a very tedious and time taking process and therefore requires a qualified and trained clinical specialist. This paper presents a novel approach to detect and predict the epileptic signal in the recorded electroencephalogram (EEG). There is always a requirement for a nonlinear technique to examine the EEG signals due to the random nature of EEG signals. Therefore, we are providing an alternate method that extracts various entropy measures such Sample Entropy, Spectral Entropy, Permutation Entropy, and Shannon Entropy as statistical features from EEG signal. Based on these extracted features LSTM Fully connected Neural Network is used to classify the EEG signal as Focal and Non-focal. The proposed method gives a new insight into EEG signals by providing sensitivity as an added measure using deep learning along with accuracy and precision.
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Affiliation(s)
- Sachin Goel
- Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun, India
| | - Rajeev Agrawal
- Lloyd Institute of Engineering & Technology, Greater Noida, India
| | - R.K. Bharti
- Bipin Tripathi Kumaon Institute of Technology, Dwarahat, Uttarakhand, India
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15
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Tilmon S, Aronsohn A, Boodram B, Canary L, Goel S, Hamlish T, Kemble S, Lauderdale DS, Layden J, Lee K, Millman AJ, Nelson N, Ritger K, Rodriguez I, Shurupova N, Wolf J, Johnson D. HepCCATT: a multilevel intervention for hepatitis C among vulnerable populations in Chicago. J Public Health (Oxf) 2022; 44:891-899. [PMID: 34156077 PMCID: PMC8692481 DOI: 10.1093/pubmed/fdab190] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2020] [Revised: 05/07/2021] [Accepted: 05/20/2021] [Indexed: 01/19/2023] Open
Abstract
BACKGROUND Hepatitis C infection could be eliminated. Underdiagnosis and lack of treatment are the barriers to cure, especially for vulnerable populations (i.e. unable to pay for health care). METHODS A multilevel intervention from September 2014 to September 2019 focused on the providers and organizations in 'the safety net' (providing health care to populations unable to pay), including: (i) public education, (ii) training for primary care providers (PCPs) and case managers, (iii) case management for high-risk populations, (iv) policy advice and (v) a registry (Registry) for 13 health centers contributing data. The project tracked the number of PCPs trained and, among Registry sites, the number of people screened, engaged in care (i.e. clinical follow-up after diagnosis), treated and/or cured. RESULTS In Chicago, 215 prescribing PCPs and 56 other health professionals, 86% of whom work in the safety net, were trained to manage hepatitis C. Among Registry sites, there was a 137% increase in antibody screening and a 32% increase in current hepatitis C diagnoses. Engagement in care rose by 18%. CONCLUSIONS Hepatitis C Community Alliance to Test and Treat (HepCCATT) successfully targeted safety net providers and organizations with a comprehensive care approach. While there were challenges, HepCCATT observed increased hepatitis C screening, diagnosis and engagement in care in the Chicago community.
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Affiliation(s)
- Sandra Tilmon
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
| | - A Aronsohn
- Gastroenterology, University of Chicago Medicine, Chicago, IL 60637, USA
| | - B Boodram
- Department of Public Health, University of Illinois at Chicago, Chicago, IL 60607, USA
| | - L Canary
- CDC: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA 30329, USA
| | - S Goel
- Division of General Internal Medicine and Geriatrics, Northwestern University (Medicine), Chicago, IL 60611 USA
| | - T Hamlish
- Cancer Center, University of Illinois at Chicago, Chicago, IL 60612 USA
| | - S Kemble
- Hawaii Department of Health, Honolulu, HI 96813, USA
| | - D S Lauderdale
- Public Health Sciences, University of Chicago Medicine, Chicago, IL 60637
| | - J Layden
- Illinois Department of Public Health, West Chicago, IL 60185, USA
| | - K Lee
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
| | - A J Millman
- CDC: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA 30329, USA
| | - N Nelson
- CDC: Division of Viral Hepatitis, National Center for HIV/AIDS, Viral Hepatitis, STD, and TB Prevention, CDC, Atlanta, GA 30329, USA
| | - K Ritger
- Chicago Department of Public Health, Chicago, IL 60604, USA
| | - I Rodriguez
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
| | - N Shurupova
- Medical Research Analytics and Informatics Alliance (MRAIA), Chicago, IL 60606, USA
| | - J Wolf
- Caring Ambassadors Program, Oregon City, OR 97045, USA
| | - D Johnson
- Academic Pediatrics, University of Chicago Medicine, Chicago, IL 60637, USA
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16
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Goel S, Slomovich S, Edris S, Park WJ, Agarwal C, Hooda A, Krishnamoorthy PM, Gidwani U, Sharma S, Kini A. Fractional flow reserve versus angiography guided revascularization for patients with multivessel coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. Eur Heart J 2022. [DOI: 10.1093/eurheartj/ehac544.1368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Recently published randomized controlled trials (RCT) have questioned the utility of Fraction Flow Reserve (FFR) to guide revascularization in patients with multivessel coronary artery disease (CAD) as compared to Angiography
Purpose
This current analysis aimed to compare the clinical outcomes associated with FFR guided versus standard angiography-guided revascularization for patients with multivessel CAD using a large number of randomized patients with stable CAD and acute coronary syndrome (ACS)
Methods
We conducted an electronic database search of all published data for RCT that compared FFR versus Angiography for patients with multivessel CAD and reported on subsequent mortality, cardiac death, myocardial infarction, revascularization, and other outcomes of interest. Event rates were compared using a forest plot of odds ratios using a fixed-effects model assuming interstudy heterogeneity.
Results
Eleven RCT (n=6052; FFR = 3043, Angiography = 3027) were included in the final analysis. Mean follow-up period was 1.7 years. In our analysis, FFR guided revascularization as compared to angiography guided revascularization alone was not associated with any significant reduction in overall mortality (OR = 1.10, 95% CI = 0.83–1.47, P=0.47, I2=0), cardiac mortality (OR = 0.95, 95% CI = 0.63–1.45, P=0.42, I2=0), all revascularization (OR = 0.96, 95% CI = 0.80–1.14, P=0.17, I2=31%) or myocardial infarction (OR = 0.99, 95% CI = 0.79–1.23, P=0.33, I2=12%). There was also no difference between two groups in terms of major adverse cardiac or cerebrovascular event [MACCE] (OR = 1.13, 95% CI = 0.90–1.42, P=0.39, I2=5%), major adverse cardiac event [MACE] (OR = 0.86, 95% CI = 0.70–1.07, P=0.55, I2=0), stroke/TIA (OR = 1.61, 95% CI = 0.92–2.82, P=0.36, I2=8%) or target lesion revascularization [TLR] (OR = 0.86, 95% CI = 0.44–1.67, P=0.71, I2=0). Furthermore, sensitivity analysis was conducted to include only studies with ACS patients and studies which used CABG only for revascularization. However, there was no difference between the two groups for any of the above outcomes
Conclusion
There is no difference in clinical outcomes in patients undergoing FFR-guided versus angiography guided revascularization for multivessel CAD
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- S Goel
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - S Slomovich
- South Nassau Communities Hospital, Internal Medicine , Oceanside , United States of America
| | - S Edris
- South Nassau Communities Hospital, Internal Medicine , Oceanside , United States of America
| | - W J Park
- South Nassau Communities Hospital, Cardiology , Oceanside , United States of America
| | - C Agarwal
- Maimonides Medical Center, Cardiology , Brooklyn , United States of America
| | - A Hooda
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - P M Krishnamoorthy
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - U Gidwani
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - S Sharma
- Icahn School of Medicine at Mount Sinai , New York , United States of America
| | - A Kini
- Icahn School of Medicine at Mount Sinai , New York , United States of America
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17
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André F, Nadal J, Denys H, Goel S, Litchfield L, Appiah A, Chen Y, Tolaney S. LBA18 Final overall survival (OS) for abemaciclib plus trastuzumab +/- fulvestrant versus trastuzumab plus chemotherapy in patients with HR+, HER2+ advanced breast cancer (monarcHER): A randomized, open-label, phase II trial. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.08.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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18
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Supehia S, Bahurupi Y, Singh M, Goel S, Kishore S, Aggarwal P, Sharma N. Compliance of vendors with legislation restricting the sale of tobacco near educational institutions in India. Int J Tuberc Lung Dis 2022; 26:883-885. [PMID: 35996286 DOI: 10.5588/ijtld.22.0174] [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: 11/10/2022] Open
Affiliation(s)
- S Supehia
- Department of Community and Family Medicine, Dr Rajendra Prasad Government Medical College, Kangra, India
| | - Y Bahurupi
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - M Singh
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - S Goel
- Department of Community Medicine, School of Public Health, Post Graduate Institute of Medical Education & Research, Chandigarh, India
| | | | - P Aggarwal
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
| | - N Sharma
- Department of Community and Family Medicine, All India Institute of Medical Sciences (AIIMS), Rishikesh, India
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19
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Zaid S, Fukuhara S, Marin-Cuartas M, De Backer O, Bhadra O, Grubb K, Shih E, Meier D, Goel S, Tang G. TCT-399 Impact of Mechanism of TAVR Failure on Outcomes after Reintervention for Failed TAVR: Insights From the EXPLANTORREDO-TAVR International Registry. J Am Coll Cardiol 2022. [DOI: 10.1016/j.jacc.2022.08.469] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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20
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Goel S, Bharti RK, Rao ALN. Advancement in Healthcare Systems by Automated Disease Diagnostic Process Using Machine Learning. International Journal of E-Adoption 2022. [DOI: 10.4018/ijea.310002] [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: 11/09/2022]
Abstract
E-adoption of emerging technology plays an important role during the pandemic. The COVID-19 pandemic taught us that everyone must make himself healthy and immune to viral disease. Diabetes is the most common disease in the Indian population found in people of every age. The objective of this research work is to use the emerging technologies such as machine learning to implement e-adoption in the healthcare system. The proposed methodology can predict the diabetes disease by using vital parameters like age, glucose level, blood pressure, etc. This proposed model is implemented into Python programming language and various machine learning classifiers such as random forest, decision tree, logistic regression, and XGBoost are used on PIMA database. Thereafter, comparative analysis is performed to test which technique is better for predicting and diagnosing diabetes disease. The method founds XGBoost classifier gives the highest accuracy (i.e., 84%) among all classifiers with single database and single classifier.
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Affiliation(s)
- Sachin Goel
- Veer Madho Singh Bhandari Uttarakhand Technical University, Dehradun, India
| | - R. K. Bharti
- Bipin Tripathi Kumaon Institute of Technology, Dwarahat, India
| | - A. L. N. Rao
- Lloyd institute of Engineering and Technology, Greater Noida, India
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21
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Pournazari P, Chang SM, Little SH, Goel S, Faza NN. Prosthetic Aortic Valve Thrombosis. US Cardiology Review 2022. [DOI: 10.15420/usc.2021.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Prosthetic valve thrombosis is the second leading cause of prosthetic valve deterioration and is being more readily diagnosed with the use of echocardiography and multidetector cardiac CT. Presentation of valve thrombosis can be acute or subacute and any change in clinical status of a patient with a prosthetic valve should raise a suspicion of prosthetic valve thrombosis. Diagnosis entails detailed clinical examination and comprehensive imaging. The choice of therapeutic options includes anticoagulation, fibrinolytic therapy, or valve replacement. Antiplatelet and anticoagulation therapy remain the mainstay of thrombosis prevention in patients with a prosthetic valve and a personalized approach is required to optimize prosthetic valve function and minimize the risk of bleeding.
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Affiliation(s)
- Payam Pournazari
- Department of Cardiology, Houston Methodist Debakey Heart & Vascular Center, Houston, TX
| | - Su Min Chang
- Department of Cardiology, Houston Methodist Debakey Heart & Vascular Center, Houston, TX
| | - Stephen H Little
- Department of Cardiology, Houston Methodist Debakey Heart & Vascular Center, Houston, TX
| | - Sachin Goel
- Department of Cardiology, Houston Methodist Debakey Heart & Vascular Center, Houston, TX
| | - Nadeen N Faza
- Department of Cardiology, Houston Methodist Debakey Heart & Vascular Center, Houston, TX
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22
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Mdkhana B, Goel S, Saleh MA, Siddiqui R, Khan NA, Elmoselhi AB. Role of oxidative stress in angiogenesis and the therapeutic potential of antioxidants in breast cancer. Eur Rev Med Pharmacol Sci 2022; 26:4677-4692. [PMID: 35856359 DOI: 10.26355/eurrev_202207_29192] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/15/2023]
Abstract
The escalation of cancer cases globally, especially breast cancer, is of concern. Angiogenesis is hallmark of cancer pathogenesis and plays an important role in cancer progression and metastasis. Pro-angiogenic agents, secreted by tumor cells, form new blood vessels, and produce reactive oxygen species (ROS). ROS promote angiogenesis via two major pathways: namely Vascular Endothelial Growth Factor (VEGF) dependent and non-VEGF dependent pathways. As a consequence of unbalanced ROS overproduction and low antioxidants levels, oxidative stress occurs and promotes angiogenesis in breast cancer tissues. Thus, the potential use of antioxidants as a preventive therapy in breast cancer. Preclinical studies depict that vitamins A and E may counter oxidative stress resulting in reduction of metastasis and viability of breast cancer. Furthermore, clinical studies demonstrate a decline in breast cancer risk in postmenopausal women upon the consumption of antioxidants. Herein, we discuss various pro-angiogenic agents that may play an important role in breast cancer angiogenesis. Moreover, the contribution of oxidative stress in inducing the angiogenic process is extensively reviewed here. Furthermore, the findings of pre-clinical and clinical studies on the use of antioxidants, namely vitamins A and E, in breast cancer are deliberated upon, along with the role of angiogenesis in cancer therapy.
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Affiliation(s)
- B Mdkhana
- Sharjah Institute of Medical Research, Clinical Sciences Department, College of Medicine, University of Sharjah, Sharjah, UAE.
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23
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Swain L, Qiao X, Everett K, Bhave S, Reyelt L, Aryaputra T, Surks W, Goel S, Zweck E, Diakos N, Kapur N. Trans-Valvular Unloading Reduces Anaerobic Glycolysis Before Reperfusion and Preserves Energy Substrate Utilization After Reperfusion in Models of Acute Myocardial Infarction. J Heart Lung Transplant 2022. [DOI: 10.1016/j.healun.2022.01.1710] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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24
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Joseph D, Adeuti A, Ali A, Edward GA, Nguyen D, Little SH, Faza NN, von Ballmoos MCW, Atkins M, Kleiman NS, Reardon MJ, Goel S. LONG-TERM OUTCOMES OF TRANSCATHETER AORTIC VALVE REPLACEMENT IN PATIENTS WITH END-STAGE RENAL DISEASE ON DIALYSIS. J Am Coll Cardiol 2022. [DOI: 10.1016/s0735-1097(22)01669-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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25
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Ravindra K, Malik V, Padhi B, Goel S, Gupta M. Asymptomatic infection and transmission of COVID-19 among clusters: systematic review and meta-analysis. Public Health 2022; 203:100-109. [PMID: 35038628 PMCID: PMC8654597 DOI: 10.1016/j.puhe.2021.12.003] [Citation(s) in RCA: 24] [Impact Index Per Article: 12.0] [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: 04/20/2021] [Revised: 09/08/2021] [Accepted: 12/06/2021] [Indexed: 12/18/2022]
Abstract
OBJECTIVES Countries throughout the world are experiencing COVID-19 viral load in their populations, leading to potential transmission and infectivity of asymptomatic COVID-19 cases. The current systematic review and meta-analysis aims to investigate the role of asymptomatic infection and transmission reported in family clusters, adults, children and health care workers, globally. STUDY DESIGN Systematic review and meta-analysis. METHODS An online literature search of PubMed, Google Scholar, medRixv and BioRixv was performed using standard Boolean operators and included studies published up to 17 August 2021. For the systematic review, case reports, short communications and retrospective studies were included to ensure sufficient asymptomatic COVID-19 transmission data were reported. For the quantitative synthesis (meta-analysis), participant data from a collection of cohort studies focusing on groups of familial clusters, adults, children and health care workers were included. Inconsistency among studies was assessed using I2 statistics. The data synthesis was computed using the STATA 16.0 software. RESULTS This study showed asymptomatic transmission among familial clusters, adults, children and health care workers of 15.72%, 29.48%, 24.09% and 0%, respectively. Overall, asymptomatic transmission was 24.51% (95% confidence interval [CI]: 14.38, 36.02) among all studied population groups, with a heterogeneity of I2 = 95.30% (P < 0.001). No heterogeneity was seen in the population subgroups of children and health care workers. The risk of bias in all included studies was assessed using the Newcastle Ottawa Scale. CONCLUSIONS For minimising the spread of COVID-19 within the community, this study found that following the screening of asymptomatic cases and their close contacts for chest CT scan (for symptomatic patients), even after negative nucleic acid testing, it is essential to perform a rigorous epidemiological history, early isolation, social distancing and an increased quarantine period (a minimum of 14-28 days). This systematic review and meta-analysis supports the notion of asymptomatic COVID-19 infection and person-to-person transmission and suggests that this is dependent on the varying viral incubation period among individuals. Children, especially those of school age (i.e. <18 years), need to be monitored carefully and follow mitigation strategies (e.g. social distancing, hand hygiene, wearing face masks) to prevent asymptomatic community transmission of COVID-19.
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Affiliation(s)
- K. Ravindra
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Corresponding author. Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, 160012, India. Tel.: +911722755262; fax: +911722744401
| | - V.S. Malik
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India,Department of Pediatrics, Advanced Pediatric Centre, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - B.K. Padhi
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - S. Goel
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - M. Gupta
- Department of Community Medicine and School of Public Health, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Choudhury PR, Saha T, Goel S, Shah JM, Ganjewala D. Cross-species virus transmission and its pandemic potential. Bull Natl Res Cent 2022; 46:18. [PMID: 35095263 PMCID: PMC8787036 DOI: 10.1186/s42269-022-00701-7] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 11/11/2021] [Accepted: 01/11/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The majority of pandemics are known to be a result of either bacteria or viruses out of which viruses seem to be an entity of growing concern due to the sheer number of yet unidentified and potentially threatening viruses, their ability to quickly evolve and transform, their ability to transfer and change from one host organism to another and the difficulty in creating safe vaccines on time. MAIN BODY The present review attempts to bring forth the potential risks, prevention and its impact on the global society in terms of sociological and economic parameters. Taking hindsight from previously as well as ongoing current viral epidemics, this article aims to draw a concrete correlation between these viruses in terms of their origin, spread and attempts to compare how much they can affect the population. The study also assesses the worst-case scenarios and the amount of preparedness, required to fight against such pandemics and compares the required amount of preparedness to the current precautions and measures by different governments all across the world. SHORT CONCLUSION Learning from the current pandemic, we can implement certain measures to prevent the adverse effects of pandemics in the future and through severe preparedness can combat the challenges brought about by the pandemic.
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Affiliation(s)
- Priyanka Ray Choudhury
- Amity Institute of Biotechnology, Amity University Noida, Sector 125, Noida, 201303 India
| | - Tapoja Saha
- Amity Institute of Biotechnology, Amity University Noida, Sector 125, Noida, 201303 India
| | - Sachin Goel
- Department of Biotechnology, Noida Institute of Engineering and Technology, 19, Knowledge Park-II, Institutional Area, Greater Noida, 201306 India
| | - Janvi Manish Shah
- Department of Biotechnology, Thadomal Shahani Engineering College, Mumbai, 400050 India
| | - Deepak Ganjewala
- Amity Institute of Biotechnology, Amity University Noida, Sector 125, Noida, 201303 India
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Goel S, Choudhary R, Magoon R, Sharma R, Usha G, Kapoor PM, Bagga D. A randomized comparative evaluation of C-MAC video-laryngoscope with Miller laryngoscope for neonatal endotracheal intubation. J Anaesthesiol Clin Pharmacol 2022; 38:464-468. [PMID: 36505196 PMCID: PMC9728438 DOI: 10.4103/joacp.joacp_422_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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/08/2020] [Revised: 02/14/2021] [Accepted: 04/14/2021] [Indexed: 11/06/2022] Open
Abstract
Background and Aims An efficient neonatal airway management is peculiarly challenging even in the most experienced hands. Considering the recent interest in assessing the performance of various video-laryngoscopes (VL) in pediatric cohort, the prospective randomized study was contemplated to stage a comparative evaluation of C-MAC with Miller laryngoscope for neonatal endotracheal intubation. Material and Methods 150 neonates were randomized to undergo intubation with either the C-MAC VL (n = 75) or the Miller laryngoscope (n = 75) performed by an experienced anesthesiologist in a tertiary care perioperative setting. The percentage of glottic opening (POGO), time to best glottic view (TTBGV), time to intubation (TTI), number of attempts, optimal external laryngeal manipulation (OELM) employed, and the complications were assessed and compared between the two groups. Results C-MAC group demonstrated a significantly higher POGO, compared to the Miller group (88 ± 26.7%;76.8 ± 32.1%, respectively, P = 0.022). TTBGV was significantly lower in the C-MAC (7.7 ± 0.1s) group as opposed to the Miller group (11.3 ± 1.1s). The C-MAC group displayed higher TTI values compared to the Miller group (25.4 ± 1.6s; 19.7 ± 1.2s, respectively, P < 0.01). The first-attempt intubation success rate and the number of attempts were comparable in both the groups. OELM was required in 24% of the patients in the Miller group as opposed to 10.7% in the C-MAC group (P = 0.031). Higher patient percentage in the C-MAC group required the need of stylet for assisting a successful intubation, although the difference between the two groups was not statistically significant. Conclusion Despite an improved view of the glottis, the TTI was higher for C-MAC compared to direct laryngoscopy with a comparable first-attempt success rate in the two techniques.
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Affiliation(s)
- Sachin Goel
- Department of Anaesthesia and Intensive Care, Vardhman Mahavir Medical College and Safdarjung Hospital, Baba Kharak Singh Marg, New Delhi, India
| | - Ripon Choudhary
- Department of Anaesthesia and Intensive Care, Govind Ballabh Pant Hospital, Baba Kharak Singh Marg, New Delhi, India
| | - Rohan Magoon
- Department of Cardiac Anaesthesia, Atal Bihari Vajpayee Institute of Medical Sciences (ABVIMS) and Dr. Ram Manohar Lohia Hospital, Baba Kharak Singh Marg, New Delhi, India
| | - Ridhima Sharma
- Department of Paediatric Anaesthesia, Postgraduate Institute of Child Health, Noida, Uttar Pradesh, India,Address for correspondence: Dr. Ridhima Sharma, Department of Paediatric Anaesthesia, Assistant Professor, Post Graduate Institute of Child Health, Noida - 201 310, Uttar Pradesh, India. E-mail:
| | - G. Usha
- Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, Baba Kharak Singh Marg, New Delhi, India
| | - Poonam M. Kapoor
- Department of Cardiac Anaesthesia, Cardiothoracic Centre, CNC, All India Institute of Medical Sciences, NewDelhi, Ansari Nagar, New Delhi, India
| | - Deepak Bagga
- Department of Paediatric Surgery, Vardhman Mahavir Medical College and Safdarjung Hospital, Baba Kharak Singh Marg, New Delhi, India
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Brodin P, Velten C, Zhu S, Hauze M, Tome W, Rajdev L, Goel S, Chuy J, Guha C, Kalnicki S, Garg M, Kabarriti R. Outcomes of Patients Living With HIV and Anal Cancer Treated With Definitive Intensity-Modulated Radiation Therapy and 5-Fluorouracil- or Capecitabine-Based Chemotherapy. Int J Radiat Oncol Biol Phys 2021. [DOI: 10.1016/j.ijrobp.2021.07.342] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Chitturi K, Bhardwaj B, Murtaza G, Karuparthi P, Faza N, Goel S, Reardon M, Kleiman N, Aggarwal K. TCT-416 Clinical Impact of Tricuspid Regurgitation on Transcatheter Edge-to-Edge Mitral Valve Repair for Secondary Mitral Regurgitation: A Systematic Review and Meta-Analysis. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.1269] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Saleh Y, Al-abcha A, Abdelkarim O, Abdelfattah O, Abela G, Hashim H, Goel S, Kleiman N. TCT-87 Clinical Outcomes of Optical Coherence Tomography-Guided Compared With Intravascular Ultrasound-Guided Percutaneous Coronary Intervention: A Meta-Analysis. J Am Coll Cardiol 2021. [DOI: 10.1016/j.jacc.2021.09.937] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Sardana K, Arora P, Goel S, Gupta A, Agarwal A, Malhotra P, Majumder A. Repurposing super saturated potassium iodide as an adjunctive treatment in mucormycosis: An exposition in a diabetic patient with rhino-orbital disease with cutaneous extension. Dermatol Ther 2021; 35:e15181. [PMID: 34708500 DOI: 10.1111/dth.15181] [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: 06/04/2021] [Revised: 09/25/2021] [Accepted: 10/25/2021] [Indexed: 11/30/2022]
Affiliation(s)
- Kabir Sardana
- Department of Dermatology, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Pooja Arora
- Department of Dermatology, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Sachin Goel
- Department of ENT, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Ankur Gupta
- Department of ENT, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Aastha Agarwal
- Department of Dermatology, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Purnima Malhotra
- Department of Pathology, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
| | - Ankur Majumder
- Department of Pathology, Dr Ram Manohar Lohia Hospital & ABVIMS, New Delhi, India
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Kyaw H, Vengrenyuk A, Johal G, Goel S, Sharma S, Kini A. New era of education: mobile learning of coronary guidewires in cardiovascular medicine. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.3116] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Online education has transformed the way we teach and learn, especially in the midst of a global pandemic. Multiple devices, including coronary guidewires, are required to perform a successful coronary intervention, and understanding the engineering aspect of coronary guidewire technology is paramount.
Purpose
We aim to develop and evaluate a novel teaching tool/mobile learning app to understand a complex guidewire architecture and appropriate wire selection based on a lesion characteristics.
Methods
A guidewire is incredibly complex, consisting of a multitude of technologies allowing a range of tip softness, trackability around curves, and precise torque control. Despite operator preference, the process of choosing an appropriate coronary guidewire has gone mostly unchanged. We envisioned developing the GuidewireAID app with three main parts: 1) wire basics, 2) lesion-based guidewire selection, and 3) cased-based approach. Appropriate teaching cases were selected from a large-volume catheterization laboratory and divided into non-chronic total occlusion (non-CTO) and CTO. Non-CTO cases include simple, calcified, angulated, and bifurcation lesions, as well as thrombotic occlusion and tortuous vessels (Figure 1). Each case is described and analysis is offered on how to select an appropriate wire, followed by teaching points pertinent to the topic.
Results
Twenty-three detailed clinical cases and more than a hundred wires are illustrated in the GuidewireAID app. Case presentation, angiographic analysis, and a thorough understanding of wire characteristics allows the operator to know which wire to use and when it is time to switch, especially when dealing with complex coronary cases.
Conclusion
The GuidewireAID app will help fellows in training (FIT), early career interventionists, and practicing interventional cardiologists understand the complex aspects of a coronary guidewire and appreciate how their nuances could overcome real-world clinical challenging scenarios.
Funding Acknowledgement
Type of funding sources: None. Figure 1
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Affiliation(s)
- H Kyaw
- Mount Sinai Medical Center, New York, United States of America
| | - A Vengrenyuk
- Mount Sinai Medical Center, New York, United States of America
| | - G Johal
- Mount Sinai Medical Center, New York, United States of America
| | - S Goel
- Mount Sinai Medical Center, New York, United States of America
| | - S Sharma
- Mount Sinai Medical Center, New York, United States of America
| | - A Kini
- Mount Sinai Medical Center, New York, United States of America
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Hamilton E, Goel S, Arend R, Chu C, Richardson D, Corr B, John V, Janku F, Hays J, Michenzie M, Reichmann W, Achour H, Sherman M, Ruiz-Soto R, Mathews C. 728P A phase Ib/II study of rebastinib and paclitaxel in advanced/metastatic platinum-resistant ovarian cancer. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.1171] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Agarwal N, McGregor B, Maughan B, Dorff T, Kelly W, Fang B, McKay R, Singh P, Pagliaro L, Dreicer R, Srinivas S, Loriot Y, Vaishampayan U, Goel S, Curran D, Panneerselvam A, Liu LF, Choueiri T, Pal S. LBA24 Cabozantinib (C) in combination with atezolizumab (A) in patients (pts) with metastatic castration-resistant prostate cancer (mCRPC): Results of expanded cohort 6 of the COSMIC-021 study. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.08.2100] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Satyam R, Bhardwaj T, Goel S, Jha NK, Jha SK, Nand P, Ruokolainen J, Kamal MA, Kesari KK. miRNAs in SARS-CoV 2: A Spoke in the Wheel of Pathogenesis. Curr Pharm Des 2021; 27:1628-1641. [PMID: 33023438 DOI: 10.2174/1381612826999201001200529] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2020] [Revised: 07/28/2020] [Accepted: 08/04/2020] [Indexed: 02/08/2023]
Abstract
INTRODUCTION The rapid emergence of Severe Acute Respiratory Syndrome coronavirus 2 (SARS-- CoV-2) has resulted in an increased mortality rate across the globe. However, the underlying mechanism of SARS-CoV-2 altering human immune response is still elusive. The existing literature on miRNA mediated pathogenesis of RNA virus viz. Dengue virus, West Nile virus, etc. raises a suspicion that miRNA encoded by SARS-CoV-2 might facilitate virus replication and regulate the host's gene expression at the post-transcriptional level. METHODS We investigated this possibility via computational prediction of putative miRNAs encoded by the SARS-CoV-2 genome using a novel systematic pipeline that predicts putative mature-miRNA and their targeted genes transcripts. To trace down if viral-miRNAs targeted the genes critical to the immune pathway, we assessed whether mature miRNA transcripts exhibit effective hybridization with the 3'UTR region of human gene transcripts. Conversely, we also tried to study human miRNA-mediated viral gene regulation to get insight into the miRNA mediated offense and defense mechanism of virus and its host organisms in toto. RESULTS Our analysis led us to shortlist six putative miRNAs that target, majorly, genes related to cell proliferation/ differentiation/signaling, and senescence. Nonetheless, they also target immune-related genes that directly/ indirectly orchestrate immune pathways like TNF (Tumor Necrosis Factor) signaling and Chemokine signaling pathways putatively serving as the nucleus to cytokine storms. CONCLUSION Besides, these six miRNAs were found to be conserved so far across 80 complete genomes of SARS-CoV-2 (NCBI Virus, last assessed 12 April 2020) including Indian strains that are also targeted by 7 human miRNAs and can, therefore, be exploited to develop MicroRNA-Attenuated Vaccines.
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Affiliation(s)
- Rohit Satyam
- Department of Biotechnology, Noida Institute of Engineering and Technology (NIET), Greater Noida, India
| | - Tulika Bhardwaj
- Institute of Clinical Medicine, University of Eastern Finland, Kuopio, Finland
| | - Sachin Goel
- Department of Biotechnology, Noida Institute of Engineering and Technology (NIET), Greater Noida, India
| | - Niraj Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, India
| | - Saurabh Kumar Jha
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, India
| | - Parma Nand
- Department of Biotechnology, School of Engineering & Technology (SET), Sharda University, Greater Noida, India
| | | | - Mohammad Amjad Kamal
- West China School of Nursing / Institutes for Systems Genetics, Frontiers Science Center for Disease-related Molecular Network, West China Hospital, Sichuan University, Chengdu, 610041, Sichuan, China
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Chen S, Redfors B, Nazif T, Kirtane A, Crowley A, Ben-Yehuda O, Kapadia S, Finn MT, Goel S, Lindman BR, Alu MC, Chau KH, Thourani VH, Vahl TP, Douglas PS, Kodali SK, Leon MB. Impact of renin-angiotensin system inhibitors on clinical outcomes in patients with severe aortic stenosis undergoing transcatheter aortic valve replacement: an analysis of from the PARTNER 2 trial and registries. Eur Heart J 2021; 41:943-954. [PMID: 31711153 DOI: 10.1093/eurheartj/ehz769] [Citation(s) in RCA: 24] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/10/2019] [Revised: 07/08/2019] [Accepted: 10/15/2019] [Indexed: 01/09/2023] Open
Abstract
AIMS Left ventricular pressure overload is associated with activation of the cardiac renin-angiotensin system, which may contribute to myocardial fibrosis and worse clinical outcomes. We sought to assess the association between treatment with angiotensin-converting enzyme inhibitors (ACEIs) or angiotensin II receptor blockers (ARBs) at baseline and clinical outcomes in patients with symptomatic, severe aortic stenosis (AS) undergoing transcatheter aortic valve replacement (TAVR) in the PARTNER 2 trial and registries. METHODS AND RESULTS A total of 3979 intermediate, high, or prohibitive risk patients who underwent TAVR in the PARTNER 2 trial and registries (excluding the valve in valve registry) were included in the study. Clinical outcomes at 2 years were compared according to baseline ACEI/ARB treatment status using Kaplan-Meier event rates and study-stratified multivariable Cox proportional hazards regression models. Sensitivity analysis was conducted using propensity score matching. Of 3979 patients who were included in the current analysis, 1736 (43.6%) were treated and 2243 (56.4%) were not treated with ACEI/ARB at baseline. Treatment with ACEI/ARB was associated with lower 2-year all-cause mortality (18.6% vs. 27.5%, P < 0.0001), cardiovascular mortality (12.3% vs. 17.9%, P < 0.0001), and non-cardiovascular mortality (7.2% vs. 11.7%, P < 0.0001). Angiotensin-converting enzyme inhibitor/ARB treatment at baseline remained independently associated with a lower hazard of 2-year all-cause and cardiovascular mortality after multivariable adjustment, and propensity score matching. CONCLUSION In a large cohort of patients with severe symptomatic AS from the PARTNER 2 trial and registries, ACEI/ARB treatment at baseline was independently associated with a lower risk of 2-year all-cause and cardiovascular mortality.
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Affiliation(s)
- Shmuel Chen
- Cardiovascular Research Foundation, 1700 Broadway, Floor 9, New York, NY 10019, USA.,Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Bjorn Redfors
- Cardiovascular Research Foundation, 1700 Broadway, Floor 9, New York, NY 10019, USA.,Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA.,Department of Cardiology, Sahlgrenska University Hospital, Bruna Straket 16, 413 45 Gothenburg, Sweden
| | - Tamim Nazif
- Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Ajay Kirtane
- Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Aaron Crowley
- Cardiovascular Research Foundation, 1700 Broadway, Floor 9, New York, NY 10019, USA
| | - Ori Ben-Yehuda
- Cardiovascular Research Foundation, 1700 Broadway, Floor 9, New York, NY 10019, USA
| | - Samir Kapadia
- Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Matthew T Finn
- Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Sachin Goel
- Department of Cardiovascular Medicine, Cleveland Clinic, 9500 Euclid Ave, Cleveland, OH 44195, USA
| | - Brian R Lindman
- Structural Heart and Valve Center, Cardiovascular Medicine Division, Vanderbilt University Medical Center, 1161 21st Ave S., Nashville, TN 37232, USA
| | - Maria C Alu
- Cardiovascular Research Foundation, 1700 Broadway, Floor 9, New York, NY 10019, USA.,Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Katherine H Chau
- Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Vinod H Thourani
- Department of Cardiac Surgery, Piedmont Heart Institute, 95 Collier Road NW, Atlanta, GA 30309, USA
| | - Torsten P Vahl
- Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Pamela S Douglas
- Duke Clinical Research Institute, Duke University School of Medicine, 300 W Morgan St, Durham NC 27701, USA
| | - Susheel K Kodali
- Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
| | - Martin B Leon
- Cardiovascular Research Foundation, 1700 Broadway, Floor 9, New York, NY 10019, USA.,Center for Interventional Vascular Therapy, Columbia University Irving Medical Center/ NewYork-Presbyterian Hospital, 161 Ft. Washington Ave. HIP-6, New York, NY 10032, USA
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Singh S, Goel S, Iqbal A. Anatomical segment 4b/5 resection for gall bladder cancer using intraoperative ultrasound. J Visc Surg 2021; 158:253-257. [PMID: 33896696 DOI: 10.1016/j.jviscsurg.2021.04.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Affiliation(s)
- S Singh
- Department of GI and HPB Oncosurgery, Rajiv-Gandhi cancer Institute and research centre, Delhi, India.
| | - S Goel
- Department of GI and HPB Oncosurgery, Rajiv-Gandhi cancer Institute and research centre, Delhi, India
| | - A Iqbal
- Department of GI and HPB Oncosurgery, Rajiv-Gandhi cancer Institute and research centre, Delhi, India
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Tiwari R, Pandey SK, Goel S, Bhatia V, Shukla S, Jing X, Dhanasekaran SM, Ateeq B. Correction: SPINK1 promotes colorectal cancer progression by downregulating Metallothioneins expression. Oncogenesis 2021; 10:16. [PMID: 33619267 PMCID: PMC7900126 DOI: 10.1038/s41389-021-00305-2] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
Affiliation(s)
- R Tiwari
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - S K Pandey
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - S Goel
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - V Bhatia
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India
| | - S Shukla
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - X Jing
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA
| | - S M Dhanasekaran
- Michigan Center for Translational Pathology, University of Michigan, Ann Arbor, MI, USA.,Department of Pathology, University of Michigan, Ann Arbor, MI, USA
| | - B Ateeq
- Department of Biological Sciences and Bioengineering, Indian Institute of Technology, Kanpur, India.
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Aoun J, Avenatti E, Kleiman N, Little S, Barker C, Khan M, Tea I, Lawrie G, Goel S. TCT CONNECT-351 Percutaneous Interventions for Recurrent Mitral Regurgitation After Surgical Repair: Decision-Making Algorithm and Long-Term Outcomes for MitraClip. J Am Coll Cardiol 2020. [DOI: 10.1016/j.jacc.2020.09.372] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau T, Cervantes A, Fariñas-Madrid L, Mileshkin L, Fu S, Plummer R, Evans J, Horvath L, Prawira A, Qu K, Pelham R, Barve M. 530MO Clinical benefit in biomarker-positive patients (pts) with locally advanced or metastatic solid tumours treated with the PARP1/2 inhibitor pamiparib in combination with low-dose (LD) temozolomide (TMZ). Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.644] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
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Hamilton E, Goel S, Arend R, Chu C, Richardson D, Diamond J, John V, Janku F, Matthews C, JeBailey L, Kuida K, Achour H, Ruiz-Soto R, Hays J. 839P A phase Ib/II study of rebastinib and paclitaxel in advanced or metastatic platinum-resistant ovarian cancer. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.978] [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] Open
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Guigay J, Lee KW, Patel M, Daste A, Wong D, Goel S, Gordon M, Gutierrez M, Balmanoukian A, Le Tourneau C, Mita A, Vansteene D, Keilholz U, Schöffski P, Grote H, Zhou D, Bajars M, Penel N. 920P Avelumab (anti-PD-L1) in patients with platinum-refractory/ineligible recurrent or metastatic squamous cell carcinoma of the head and neck (R/M SCCHN): Results from a phase Ib cohort. Ann Oncol 2020. [DOI: 10.1016/j.annonc.2020.08.1035] [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: 11/27/2022] Open
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Abstract
<b><i>Introduction:</i></b> Kikuchi-Fujimoto disease (KFD) is a rare benign disease with a self-limiting course. Patients usually present with clinical features of tender cervical lymphadenopathy (LAP), fever, malaise, weight loss, and night sweats. The disease may mimic infective LAP or lymphoma on clinical and histopathological examination (HPE). <b><i>Case Report:</i></b> We report a case of 3-year-old male child who presented to us with bilateral cervical LAP not responding to conservative management. Excision biopsy was done and HPE revealed KFD. <b><i>Conclusion:</i></b> Clinicians should have high index of suspicion for diagnosis of KFD in patients with cervical LAP not responding to conservative management. Excision biopsy is important for accurate diagnosis and to avoid aggressive interventions like chemotherapy.
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Al-Akchar M, Ibrahim AM, Tandan N, Sawalha K, Prakash V, Salih M, Goel S, Goswami N, Fanari Z. COMPARISON OF OUTCOMES OF PATIENTS WITH CARDIOMYOPATHY UNDERGOING TRANSCATHETER AORTIC VALVE REPLACEMENT: ISCHEMIC VS. NON-ISCHEMIC. J Am Coll Cardiol 2020. [DOI: 10.1016/s0735-1097(20)32047-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Goel S, Joshi N, Uddin MS, Ng S, Acosta E, Ramachandran A. Interfacial Tension of the Water-Diluted Bitumen Interface at High Bitumen Concentrations Measured Using a Microfluidic Technique. Langmuir 2019; 35:15710-15722. [PMID: 31631660 DOI: 10.1021/acs.langmuir.9b02253] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/10/2023]
Abstract
The interfacial tension (IFT) is a critical parameter to inform our understanding of the phenomena of drop breakup and droplet-droplet coalescence in sheared water-in-diluted bitumen (dilbit) emulsions. A microfluidic extensional flow device (MEFD) was used to determine the IFT of the dilbit-water emulsion system for bitumen concentrations of 33%, 50%, and 67% by weight (solvent to bitumen ratio (S/B) = 2, 1, and 0.5, respectively) and two different pH values of water: 8.3 and 9.9. The IFT was observed to increase with the bitumen concentration and decrease significantly upon lowering the water pH. The time scale for achieving the steady state IFT increased with bitumen concentration and was less sensitive to the water pH. But the most important feature of our measurements is that the IFTs recorded were significantly smaller than the values reported in the literature. We recognized two important differences between our studies and prior investigations: measurement of the IFT of water drops in dilbit as opposed to dilbit drops in water in earlier studies, and time scales of measurement of IFT that ranged from hundreds of milliseconds to a few seconds, as compared to a minute or longer in past investigations. These differences were examined carefully, but neither was found to explain the low IFTs measured in our studies. Our work leads to the following hypothesis: the mechanical properties of the interface of a sheared water drop in bitumen are significantly different from a stagnant one.
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Affiliation(s)
- Sachin Goel
- University of Toronto , Department of Chemical Engineering and Applied Chemistry , 200 College Street , Toronto , ON M5S 3E5 , Canada
| | - Niyati Joshi
- University of Toronto , Department of Chemical Engineering and Applied Chemistry , 200 College Street , Toronto , ON M5S 3E5 , Canada
| | - Muhammad Siraj Uddin
- University of Toronto , Department of Chemical Engineering and Applied Chemistry , 200 College Street , Toronto , ON M5S 3E5 , Canada
| | - Samson Ng
- Syncrude Canada Limited, Edmonton Research Centre , Edmonton , Alberta Canada
| | - Edgar Acosta
- University of Toronto , Department of Chemical Engineering and Applied Chemistry , 200 College Street , Toronto , ON M5S 3E5 , Canada
| | - Arun Ramachandran
- University of Toronto , Department of Chemical Engineering and Applied Chemistry , 200 College Street , Toronto , ON M5S 3E5 , Canada
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Meric-Bernstam F, Somaiah N, DuBois S, Dumbrava EEI, Shapiro G, Patel M, Goel S, Bauer T, Pinchasik D, Annis A, Aivado M, Vukovic V, Saleh M. A phase IIa clinical trial combining ALRN-6924 and palbociclib for the treatment of patients with tumours harboring wild-type p53 and MDM2 amplification or MDM2/CDK4 co-amplification. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.037] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [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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Percy E, Luc J, Hirji S, Vervoort D, Zhu K, Goel S, Pelletier M. CHARACTERISTICS OF HIGH-IMPACT ARTICLES IN THE CANADIAN JOURNAL OF CARDIOLOGY. Can J Cardiol 2019. [DOI: 10.1016/j.cjca.2019.07.412] [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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Tolaney S, Wardley A, Zambelli S, Hilton J, Troso-Sandoval T, Ricci F, Im SA, Kim SB, Johnston S, Chan A, Goel S, Catron K, Yang Z, Gainford C, André F. MonarcHER: A randomized phase II study of abemaciclib plus trastuzumab with or without fulvestrant versus trastuzumab plus standard-of-care chemotherapy in women with HR+, HER2+ advanced breast cancer (ABC). Ann Oncol 2019. [DOI: 10.1093/annonc/mdz394.012] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Stradella A, Johnson M, Goel S, Chandana S, Galsky M, Calvo E, Moreno V, Park H, Arkenau HT, Cervantes A, Madrid LF, Mileshkin L, Plummer R, Evans J, Horvath L, Prawira A, Pelham R, Mu S, Andreu-Vieyra C, Barve M. Updated results of the PARP1/2 inhibitor pamiparib in combination with low-dose (ld) temozolomide (TMZ) in patients (pts) with locally advanced or metastatic solid tumours. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz244.013] [Citation(s) in RCA: 1] [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] [Indexed: 11/13/2022] Open
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Pernas S, Goel S, Johnson N, Harrison B, Guerriero J, Hu J, Winship G, Sokolov A, Regan M, Mittendorf E, Overmoyer B. Early on-treatment vs pre-treatment tumour transcriptomes as predictors of response to neoadjuvant therapy for HER2-positive inflammatory breast cancer. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz239.031] [Citation(s) in RCA: 1] [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] [Indexed: 11/13/2022] Open
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