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Awuah WA, Adebusoye FT, Wellington J, David L, Salam A, Weng Yee AL, Lansiaux E, Yarlagadda R, Garg T, Abdul-Rahman T, Kalmanovich J, Miteu GD, Kundu M, Mykolaivna NI. Recent Outcomes and Challenges of Artificial Intelligence, Machine Learning, and Deep Learning in Neurosurgery. World Neurosurg X 2024; 23:100301. [PMID: 38577317 PMCID: PMC10992893 DOI: 10.1016/j.wnsx.2024.100301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2023] [Revised: 07/23/2023] [Accepted: 02/21/2024] [Indexed: 04/06/2024] Open
Abstract
Neurosurgeons receive extensive technical training, which equips them with the knowledge and skills to specialise in various fields and manage the massive amounts of information and decision-making required throughout the various stages of neurosurgery, including preoperative, intraoperative, and postoperative care and recovery. Over the past few years, artificial intelligence (AI) has become more useful in neurosurgery. AI has the potential to improve patient outcomes by augmenting the capabilities of neurosurgeons and ultimately improving diagnostic and prognostic outcomes as well as decision-making during surgical procedures. By incorporating AI into both interventional and non-interventional therapies, neurosurgeons may provide the best care for their patients. AI, machine learning (ML), and deep learning (DL) have made significant progress in the field of neurosurgery. These cutting-edge methods have enhanced patient outcomes, reduced complications, and improved surgical planning.
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Affiliation(s)
| | | | - Jack Wellington
- Cardiff University School of Medicine, Cardiff University, Wales, United Kingdom
| | - Lian David
- Norwich Medical School, University of East Anglia, United Kingdom
| | - Abdus Salam
- Department of Surgery, Khyber Teaching Hospital, Peshawar, Pakistan
| | | | | | - Rohan Yarlagadda
- Rowan University School of Osteopathic Medicine, Stratford, NJ, USA
| | - Tulika Garg
- Government Medical College and Hospital Chandigarh, India
| | | | | | | | - Mrinmoy Kundu
- Institute of Medical Sciences and SUM Hospital, Bhubaneswar, India
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2
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Sah BK, Fatima Z, Sah RK, Syed B, Garg T, Chowdhury S, Ghosh B, Kunwar B, Shree A, Sah VK, Raut A. Guillain-Barre syndrome following COVID-19 vaccination: a study of 70 case reports. Ann Med Surg (Lond) 2024; 86:2067-2080. [PMID: 38576928 PMCID: PMC10990410 DOI: 10.1097/ms9.0000000000001915] [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: 05/11/2023] [Accepted: 02/25/2024] [Indexed: 04/06/2024] Open
Abstract
Background and objective Guillain-Barre syndrome (GBS) has been found to have some interesting association with vaccinations. This paper mainly focuses on exploring different associations between COVID-19 vaccination and GBS. Methods Electronic databases such as PubMed, Google Scholar, Cochrane, and Embase were searched using MESH terms for case reports published till 1 August 2023 from which 70 case reports were documented involving 103 individuals from 23 different countries. Result and discussion The case reports were from a wide range of individuals aged from 13 to 87 years with an average age of 53±20 interquartile range years along with male predominance. The average time between receiving the vaccine and the onset of symptoms was 13.08±2.14 days. Prominent clinical features included back pain, facial diplegia, weakness, and paraesthesia whereas the main diagnostic studies were cerebrospinal fluid (CSF) analysis and electromagnetic studies. The principal diagnostic clue was albumin-cytological dissociation in CSF while being negative for anti-ganglioside antibodies or SARS-CoV-2. Available treatment options consisted of intravenous immunoglobulin and Plasmapheresis. Patients with comorbidities such as diabetes mellitus, hypertension, dyslipidemia, permanent atrial fibrillation, hypothyroidism, Hashimoto's thyroiditis, Chronic Obstructive Pulmonary Disease, asthma, osteoporosis, migraine, rheumatoid arthritis, osteoarthritis, ulcerative colitis, coeliac disease, seizures, bipolar disorder, endometriosis, multiple sclerosis, bell's palsy, squamous cell carcinoma, prostate cancer were included in our study. Conclusion Overall, this review evaluated innovative and clinically relevant associations between COVID-19 vaccination and GBS. Understanding of this uncommon potential side effect of COVID-19 vaccination is crucial for prompt diagnosis and appropriate treatment. Importantly, GBS should not be considered a contraindication to vaccination. This underscores the importance of ongoing research to enhance the safety and efficacy of COVID-19 vaccination efforts.
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Affiliation(s)
| | - Zahra Fatima
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | | | - Bushra Syed
- Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Tulika Garg
- Government Medical College and Hospital, Chandigarh
| | | | - Bikona Ghosh
- Government Medical College and Hospital, Chandigarh
| | | | - Anagha Shree
- SGT Medical college and research institute, Gurgaon, India
| | - Vivek Kumar Sah
- Universal College of Medical Sciences and Teaching Hospital, Bhairahawa
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3
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Huang HYR, Wireko AA, Miteu GD, Khan A, Roy S, Ferreira T, Garg T, Aji N, Haroon F, Zakariya F, Alshareefy Y, Pujari AG, Madani D, Papadakis M. Advancements and progress in juvenile idiopathic arthritis: A Review of pathophysiology and treatment. Medicine (Baltimore) 2024; 103:e37567. [PMID: 38552102 PMCID: PMC10977530 DOI: 10.1097/md.0000000000037567] [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] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2023] [Accepted: 02/20/2024] [Indexed: 04/02/2024] Open
Abstract
Juvenile idiopathic arthritis (JIA) is a chronic clinical condition characterized by arthritic features in children under the age of 16, with at least 6 weeks of active symptoms. The etiology of JIA remains unknown, and it is associated with prolonged synovial inflammation and structural joint damage influenced by environmental and genetic factors. This review aims to enhance the understanding of JIA by comprehensively analyzing relevant literature. The focus lies on current diagnostic and therapeutic approaches and investigations into the pathoaetiologies using diverse research modalities, including in vivo animal models and large-scale genome-wide studies. We aim to elucidate the multifactorial nature of JIA with a strong focus towards genetic predilection, while proposing potential strategies to improve therapeutic outcomes and enhance diagnostic risk stratification in light of recent advancements. This review underscores the need for further research due to the idiopathic nature of JIA, its heterogeneous phenotype, and the challenges associated with biomarkers and diagnostic criteria. Ultimately, this contribution seeks to advance the knowledge and promote effective management strategies in JIA.
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Affiliation(s)
- Helen Ye Rim Huang
- Faculty of Medicine and Health Science, Royal College of Surgeons in Ireland, Dublin, Ireland
| | | | - Goshen David Miteu
- School of Biosciences, Biotechnology, University of Nottingham, Nottingham, UK
- Department of Biochemistry, Caleb University Lagos, Lagos, Nigeria
| | - Adan Khan
- Kent and Medway Medical School, Canterbury, Kent, UK
| | - Sakshi Roy
- School of Medicine, Queen’s University Belfast, Belfast, Northern Ireland, UK
| | - Tomas Ferreira
- School of Clinical Medicine, University of Cambridge, Cambridge, UK
| | - Tulika Garg
- Government Medical College and Hospital Chandigarh, Chandigarh, India
| | - Narjiss Aji
- Faculty of Medicine and Pharmacy of Rabat, Rabat, Morocco
| | - Faaraea Haroon
- Faculty of Public Health, Health Services Academy, Islamabad, Pakistan
| | - Farida Zakariya
- Faculty of Pharmaceutical Sciences, Ahmadu Bello University Zaria, Zaria, Nigeria
| | - Yasir Alshareefy
- School of Medicine, Trinity College Dublin, The University of Dublin, Dublin, Ireland
| | - Anushka Gurunath Pujari
- Faculty of Medicine and Health Science, Royal College of Surgeons in Ireland, Dublin, Ireland
- Department of Kinesiology, Faculty of Science, McMaster University, Hamilton, Ontario, Canada
| | - Djabir Madani
- UCD Lochlann Quinn School of Business and Sutherland School of Law, University College Dublin, Dublin, Ireland
| | - Marios Papadakis
- Department of Surgery II, University Hospital Witten-Herdecke, University of Witten-Herdecke, Wuppertal, Germany
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4
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Co EL, Hameed M, Sebastian SA, Garg T, Sudan S, Bheemisetty N, Mohan B. Narrative Review of Probiotic Use on the Recovery of Postoperative Patients with Esophageal Cancer. Curr Nutr Rep 2023; 12:635-642. [PMID: 37605086 DOI: 10.1007/s13668-023-00490-z] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/08/2023] [Indexed: 08/23/2023]
Abstract
PURPOSE OF REVIEW This narrative review discusses the significance of probiotic therapy in the postoperative care of patients with esophageal cancer and its role as an adjunct therapy to other treatment modalities for esophageal cancer. RECENT FINDINGS As such, there is an emerging need to address any malnutrition and gastrointestinal problems occurring in these patients which tend to have a strong negative impact on their prognosis. Probiotic effects on esophageal cancer biomarkers suggest that there is a positive correlation between these two factors. However, the beneficial effects remain controversial and warrant further investigation. Probiotics, now being widely utilized as postoperative therapy in some carcinomas of the gastrointestinal tract such as gastric cancer and colorectal cancer, have been shown in some clinical studies to positively impact the nutritional status of patients with esophageal cancer. Postoperative care among patients suffering from esophageal cancer is a very crucial aspect in the survival of these patients.
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Affiliation(s)
- Edzel Lorraine Co
- University of Santo Tomas Faculty of Medicine and Surgery, Manila, Philippines
| | - Maha Hameed
- Department of Internal Medicine, Florida State University/Sarasota Memorial Hospital, 1700 S Tamiami Trial, Sarasota, FL, 34239, USA.
| | | | - Tulika Garg
- Government Medical College and Hospital, Chandigarh, India
| | | | | | - Babu Mohan
- Department of Gastroenterology, University of Utah School of Medicine, Salt Lake City, UT, USA
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5
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Chenna VSH, Palle LRA, Emmanuel S, Gupta A, Francis DT, Hussain A, Dahal R, Carredo CKC, Francis SM, Garg T, Akuma O, Khan AM. A rare case of perforating chest wall including pericardial sac with penetrating trivial injury: A case report and literature review. Trauma Case Rep 2023; 48:100962. [PMID: 37964982 PMCID: PMC10641277 DOI: 10.1016/j.tcr.2023.100962] [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] [Accepted: 10/18/2023] [Indexed: 11/16/2023] Open
Abstract
Perforating chest wall injuries involving the pericardial sac in pediatric patients are exceedingly rare and pose a unique clinical challenge. Thoracic trauma in the pediatric population remains a significant cause of morbidity and mortality. We present a case of an 8-year-old boy with an acute history of a sharp injection needle embedded in his chest wall presented with severe chest pain and diaphoresis. Diagnostic evaluations included computed tomography revealed a hyperdense focus with a metallic artefact seen impacted in the interventricular septa and perforating the heart. He underwent a thoracotomy and cardioplegic arrest for needle retrieval and subsequent cardiac repair. Our case underscores the importance of a multidisciplinary approach, meticulous monitoring, and a profound understanding of the unique anatomical considerations in pediatric chest injuries. Summary This article presents a rare and challenging case of an 8-year-old male who arrived at the emergency department with a sharp injection needle embedded in his chest wall. Despite being relatively rare in children, thoracic injuries can be severe and potentially life-threatening. A fast and accurate diagnostic approach is crucial to prevent fatal complications. Thoracic trauma in the pediatric population remains a significant cause of morbidity and mortality. Timely diagnosis and appropriate interventions are critical in improving patient outcomes. The presented case highlights the need for caution and a well-planned approach in managing such rare and complex injuries in children.
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Affiliation(s)
| | | | | | | | - Deepa Treesa Francis
- Department of Internal Medicine, Windsor University School of Medicine, Cayon, Saint Kitts and Nevis
| | | | - Rojaj Dahal
- Department of Internal Medicine, Manipal College of Medical Sciences (MCOMS), Pokhara, Nepal
| | | | - Sandra Mary Francis
- Department of Internal Medicine, Windsor University School of Medicine, Cayon, Saint Kitts and Nevis
| | - Tulika Garg
- Government Medical College and Hospital, Chandigarh, India
| | | | - Aadil M. Khan
- Department of Trauma Surgery, OSF St Francis Medical Center, Peoria, USA
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Pultinevicius E, Rockenhäuser M, Kogel F, Groß P, Garg T, Prochnow OE, Langen T. A scalable scanning transfer cavity laser stabilization scheme based on the Red Pitaya STEMlab platform. Rev Sci Instrum 2023; 94:103004. [PMID: 37791857 DOI: 10.1063/5.0169021] [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] [Subscribe] [Scholar Register] [Received: 07/22/2023] [Accepted: 09/12/2023] [Indexed: 10/05/2023]
Abstract
Many experiments in atomic and molecular physics require simultaneous frequency stabilization of multiple lasers. We present a stabilization scheme based on a scanning transfer cavity lock that is simple, stable, and easily scalable to many lasers at minimal cost. The scheme is based on the Red Pitaya STEMlab platform, with custom software developed and implemented to achieve up to 100 Hz bandwidth. As an example demonstration, we realize simultaneous stabilization of up to four lasers and a reduction of long-term drifts to well below 1 MHz/h. This meets typical requirements, e.g., for experiments on laser cooling of molecules.
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Affiliation(s)
- E Pultinevicius
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - M Rockenhäuser
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - F Kogel
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - P Groß
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - T Garg
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - O E Prochnow
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
| | - T Langen
- Physikalisches Institut and Center for Integrated Quantum Science (IQST), Universität Stuttgart, Pfaffenwaldring 57, 70569 Stuttgart, Germany
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Huang H, Leung KSK, Garg T, Mazzoleni A, Miteu GD, Zakariya F, Awuah WA, Yin ETS, Haroon F, Hussain Z, Aji N, Jaiswal V, Tse G. Barriers and shortcomings in access to cardiovascular management and prevention for familial hypercholesterolemia during the COVID-19 pandemic. Clin Cardiol 2023; 46:831-844. [PMID: 37260143 PMCID: PMC10436799 DOI: 10.1002/clc.24059] [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: 02/10/2023] [Revised: 05/04/2023] [Accepted: 05/17/2023] [Indexed: 06/02/2023] Open
Abstract
Familial hypercholesterolemia (FH) is a hereditary condition caused by mutations in the lipid pathway. The goal in managing FH is to reduce circulating low-density lipoprotein cholesterol and, therefore, reduce the risk of developing atherosclerotic cardiovascular disease (ASCVD). Because FH patients were considered high risk groups due to an increased susceptible for contracting COVID-19 infection, we hypothesized whether the effects of the pandemic hindered access to cardiovascular care. In this review, we conducted a literature search in databases Pubmed/Medline and ScienceDirect. We included a comprehensive analysis of findings from articles in English related and summarized the effects of the pandemic on cardiovascular care through direct and indirect effects. During the COVID-19 pandemic, FH patients presented with worse outcomes and prognosis, especially those that have suffered from early ASCVD. This caused avoidance in seeking care due to fear of transmission. The pandemic severely impacted consultations with lipidologists and cardiologists, causing a decline in lipid profile evaluations. Low socioeconomic communities and ethnic minorities were hit the hardest with job displacements and lacked healthcare coverage respectively, leading to treatment nonadherence. Lock-down restrictions promoted sedentary lifestyles and intake of fatty meals, but it is unclear whether these factors attenuated cardiovascular risk in FH. To prevent early atherogenesis in FH patients, universal screening programs, telemedicine, and lifestyle interventions are important recommendations that could improve outcomes in FH patients. However, the need to research in depth on the disproportionate impact within different subgroups should be the forefront of FH research.
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Affiliation(s)
- Helen Huang
- Royal College of Surgeons in IrelandFaculty of Medicine and Health ScienceDublinIreland
| | - Keith S. K. Leung
- Aston University Medical School, Faculty of Health & Life SciencesAston UniversityBirminghamUK
- Epidemiology Research Unit, Cardiovascular Analytics GroupChina‐UK CollaborationHong KongChina
| | - Tulika Garg
- Government Medical College and Hospital ChandigarhChandigarhIndia
| | - Adele Mazzoleni
- Barts and The London School of Medicine and DentistryLondonUK
| | - Goshen D. Miteu
- School of Biosciences, BiotechnologyUniversity of NottinghamNottinghamUK
- Department of BiochemistryCaleb University LagosLagosNigeria
| | - Farida Zakariya
- Department of Pharmaceutical SciencesAhmadu Bello UniversityZariaNigeria
| | | | | | | | - Zarish Hussain
- Royal College of Surgeons in IrelandMedical University of BahrainBusaiteenBahrain
| | - Narjiss Aji
- Faculty of Medicine and Pharmacy of RabatMohammed V UniversityRabatMorocco
| | - Vikash Jaiswal
- Department of Cardiology ResearchLarkin Community HospitalSouth MiamiFloridaUSA
| | - Gary Tse
- Epidemiology Research Unit, Cardiovascular Analytics GroupChina‐UK CollaborationHong KongChina
- Tianjin Key Laboratory of Ionic‐Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of CardiologySecond Hospital of Tianjin Medical UniversityTianjinChina
- Kent and Medway Medical SchoolCanterburyUK
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Huang H, Awuah WA, Garg T, Ng JC, Mehta A, Ramamoorthy K, Kalmanovich J, Hasan MM. Prospects of evolution-based artificial intelligence models in genome-wide studies to stratify genetic risk variants in nonalcoholic fatty liver disease. Ann Med Surg (Lond) 2023; 85:2743-2748. [PMID: 37363524 PMCID: PMC10289529 DOI: 10.1097/ms9.0000000000000743] [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: 09/09/2022] [Accepted: 04/16/2023] [Indexed: 06/28/2023] Open
Abstract
The emergence of genome-wide association studies (GWAS) has identified genetic traits and polymorphisms that are associated with the progression of nonalcoholic fatty liver disease (NAFLD). Phospholipase domain-containing 3 and transmembrane 6 superfamily member 2 are genes commonly associated with NAFLD phenotypes. However, there are fewer studies and replicability in lesser-known genes such as LYPLAL1 and glucokinase regulator (GCKR). With the advent of artificial intelligence (AI) in clinical genetics, studies have utilized AI algorithms to identify phenotypes through electronic health records and utilize convolution neural networks to improve the accuracy of variant identification, predict the deleterious effects of variants, and conduct phenotype-to-genotype mapping. Natural language processing (NLP) and machine-learning (ML) algorithms are popular tools in GWAS studies and connect electronic health record phenotypes to genetic diagnoses using a combination of international classification disease (ICD)-based approaches. However, there are still limitations to machine-learning - and NLP-based models, such as the lack of replicability in larger cohorts and underpowered sample sizes, which prevent the accurate prediction of genetic variants that may increase the risk of NAFLD and its progression to advanced-stage liver fibrosis. This may be largely due to the lack of understanding of the clinical consequence in the majority of pathogenic variants. Though the concept of evolution-based AI models and evolutionary algorithms is relatively new, combining current international classification disease -based NLP models with phylogenetic and evolutionary data can improve prediction accuracy and create valuable connections between variants and their pathogenicity in NAFLD. Such developments can improve risk stratification within clinical genetics and research while overcoming limitations in GWAS studies that prevent community-wide interpretations.
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Affiliation(s)
- Helen Huang
- Royal College of Surgeons in Ireland, Faculty of Medicine and Health Science, Dublin, Ireland
| | | | - Tulika Garg
- Government Medical College and Hospital, Chandigarh, India
| | - Jyi Cheng Ng
- Faculty of Medicine and Health Sciences, University of Putra Malaysia, Serdang, Malaysia
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Krishna Ramamoorthy
- Department of Biochemistry and Microbiology, Rutgers University-New Brunswick, New Jersey
| | - Jacob Kalmanovich
- Drexel University College of Medicine, Philadelphia, Pennsylvania, USA
| | - Mohammad M. Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, Bangladesh
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Ahmad S, Khawaja UA, Haider SM, Mowlabaccus WB, Mohan A, Ansari A, Ahmad M, Garg T, Ahmed H, Ahmad S, Essar MY, Perez-Fernandez J, Yatzkan GD. Assessing the knowledge, attitude, and practice measures against tuberculosis in patients in ambulatory department facilities in Pakistan: a cross-sectional analysis. Monaldi Arch Chest Dis 2023; 94. [PMID: 37052048 DOI: 10.4081/monaldi.2023.2500] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2022] [Accepted: 03/22/2023] [Indexed: 04/14/2023] Open
Abstract
Tuberculosis (TB), at present, is the leading infectious etiology of death globally. In Pakistan, there are approximately 510,000 new cases annually, with more than 15,000 of them developing into drug-resistant TB, making the nation the fifth-leading country in TB prevalence in the world. Due to the ongoing COVID-19 pandemic, the focus has drifted away from TB screening, diagnostic and health awareness campaigns, and therapeutic measures endangering knowledge, attitude, and practices (KAP) towards TB in our population. We conducted a cross-sectional descriptive study in Pakistan to assess the KAP of Pakistani residents attending the adult outpatient departments of public hospitals for any health-related concerns. Our sample size was 856 participants, with a median age of 22 years. Occupation-wise, those who were employed had better knowledge of TB than those who were unemployed [odds ratio (OR): 1.011; 95% confidence interval (CI): 1.005-1.8005]. No differences were observed in TB knowledge between those adherents to common preventive practices versus those not adherent (OR: 0.875; 95% CI: 0.757-1.403). More than 90% of participants agreed that TB is dangerous for the community, and the majority opted against stigmatizing TB patients (79.1%). People who could read and write were 3.5 times more likely to have a good attitude towards TB compared to those who could not (OR: 3.596; 95% CI: 1.821-70.230; p=0.037). Similarly, employed subjects had better attitudes compared to unemployed ones (OR: 1.125; 95% CI: 0.498-1.852; p=0.024) and those with better knowledge of TB had a better attitude grade (OR: 1.749; 95% CI: 0.832-12.350; p=0.020). Age, occupation, and educational status were statistically significant among the two groups (p=0.038, p=0.023, p=0.000). Literate subjects had three times better practice towards TB than illiterate subjects (OR: 3.081; 95% CI: 1.869-4.164; p=0.000). Future education and awareness programs should target specific groups, such as the unemployed and illiterate, with practice-focused approaches. Our study outcomes can enable the concerned officials and authorities to take appropriate evidence-based steps to direct the efforts efficiently to curtail the burden of TB in Pakistan and to limit its progression, which could potentially lead our nation to become a multi drug-resistant TB endemic territory.
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Affiliation(s)
- Shoaib Ahmad
- Department of Medicine, Punjab Medical College, Faisalabad.
| | | | | | | | - Anmol Mohan
- Department of Surgery, Karachi Medical and Dental College.
| | | | | | - Tulika Garg
- Government Medical College and Hospital, Chandigarh.
| | - Hafsa Ahmed
- Department of Medicine, Dow University of Health Sciences, Karachi.
| | | | | | - Javier Perez-Fernandez
- Department of Pulmonary Medicine and Critical Care, Intensive Care Solutions LLC, South Miami, FL.
| | - George D Yatzkan
- Department of Pulmonary Medicine and Critical Care, Larkin Community Hospital, Hialeah, FL.
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Mehta A, Kumar H, Yazji K, Wireko AA, Sivanandan Nagarajan J, Ghosh B, Nahas A, Morales Ojeda L, Anand A, Sharath M, Huang H, Garg T, Isik A. Effectiveness of artificial intelligence-assisted colonoscopy in early diagnosis of colorectal cancer: a systematic review. Int J Surg 2023; 109:946-952. [PMID: 36917126 PMCID: PMC10389330 DOI: 10.1097/js9.0000000000000285] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/02/2022] [Accepted: 01/30/2023] [Indexed: 03/16/2023]
Abstract
INTRODUCTION As artificial intelligence (AI)-assisted diagnosis gained immense popularity, it is imperative to consider its utility and efficiency in the early diagnosis of colorectal cancer (CRC), responsible for over 1.8 million cases and 881 000 deaths globally, as reported in 2018. Improved adenoma detection rate, as well as better characterizations of polyps, are significant advantages of AI-assisted colonoscopy (AIC). This systematic review (SR) investigates the effectiveness of AIC in the early diagnosis of CRC as compared to conventional colonoscopy. MATERIALS AND METHODS Electronic databases such as PubMed/Medline, SCOPUS, and Web of Science were reviewed for original studies (randomized controlled trials, observational studies), SRs, and meta-analysis between 2017 and 2022 utilizing Medical Subject Headings terminology in a broad search strategy. All searches were performed and analyzed according to the Preferred Reporting Items for Systematic Reviews and Meta-Analysis methodology and were conducted from November 2022. A data extraction form based on the Cochrane Consumers and Communication Review group's extraction template for quality assessment and evidence synthesis was used for data extraction. All included studies considered for bias and ethical criteria and provided valuable evidence to answer the research question. RESULTS The database search identified 218 studies, including 87 from PubMed, 60 from SCOPUS, and 71 from Web of Science databases. The retrieved studies from the databases were imported to Rayyan software and a duplicate article check was performed, all duplicate articles were removed after careful evaluation of the data. The abstract and full-text screening was performed in accordance with the following eligibility criteria: Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) for observational studies; Preferred Reporting Items for Systematic Reviews and Meta-Analysis for review articles, ENTREQ for narrative studies; and modified JADAD for randomized controlled trials. This yielded 15 studies that met the requirements for this SR and were finally included in the review. CONCLUSION AIC is a safe, highly effective screening tool that can increase the detection rate of adenomas, and polyps resulting in an early diagnosis of CRC in adults when compared to conventional colonoscopy. The results of this SR prompt further large-scale research to investigate the effectiveness in accordance with sex, race, and socioeconomic status, as well as its influence on prognosis and survival rate.
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Affiliation(s)
- Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | | | - Katia Yazji
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | | | | | - Bikona Ghosh
- Dhaka Medical College and Hospital, Dhaka, Bangladesh
| | - Ahmad Nahas
- Faculty of Medicine, University of Debrecen, Debrecen, Hungary
| | - Luis Morales Ojeda
- Institute of Urology, University of Southern California, Los Angeles California, USA
| | - Ayush Anand
- BP Koirala Institute of Health Sciences, Dharan, Nepal
| | - Medha Sharath
- Bangalore Medical College and Research Institute, Bangalore, Karnataka
| | - Helen Huang
- RCSI University of Medicine and Health Sciences, Dublin, Ireland
| | - Tulika Garg
- Government Medical College and Hospital, Chandigarh, Punjab, India
| | - Arda Isik
- Department of General Surgery, Istanbul Medeniyet University, Istanbul, Turkey
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Chaudhari D, Vohra RR, Abdefatah Ali M, Nadeem H, Tarimci B, Garg T, Sharari RA, Joseph A, Khan A. A Rare Phenomenon of Lithium-Associated Acne Inversa: A Case Series and Literature Review. Cureus 2023; 15:e36051. [PMID: 37056525 PMCID: PMC10089641 DOI: 10.7759/cureus.36051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/12/2023] [Indexed: 03/14/2023] Open
Abstract
Lithium use has been associated with dermatological issues, including psoriasis, folliculitis, and acneiform outbreaks. The lithium dosage and the therapeutic range of serum lithium levels are closely correlated with the frequency of cutaneous adverse effects. Lithium-induced acne inversa is a less well-known adverse effect, causing significant morbidity. Acne inversa (hidradenitis suppurativa) is a chronic inflammatory illness of the skin seen in the folds of the skin and face and distinguished by the presence of painful nodules and fistulas, as well as a propensity for tissue fibrosis. We report two cases of bipolar affective disorder who received long-term lithium treatment and experienced acne inversa during treatment, which subsided once the lithium was withdrawn.
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12
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Joseph A, Sayeed T, Patel DK, Aiyadurai S, Shahbaz Z, Mettela SR, Garg T, Gadde R, Udoeyop D, Khan A. Central Pontine Myelinolysis With Carbamazepine-Induced Syndrome of Inappropriate Antidiuretic Hormone and Its Management: A Case Report and Literature Review. Cureus 2023; 15:e35816. [PMID: 37033593 PMCID: PMC10075004 DOI: 10.7759/cureus.35816] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/03/2023] [Indexed: 03/08/2023] Open
Abstract
Aggressive treatment of hyper or hypoosmolar conditions can trigger osmotic demyelination syndrome. We describe the case of a 53-year-old male who began using carbamazepine to treat bipolar affective disorder and was later diagnosed with carbamazepine-induced syndrome of inappropriate antidiuretic hormone secretion. The patient's mental state gradually improved once the hyponatremia was corrected using 3% normal saline and supportive therapy. The patient presented to the outpatient clinic with confusion and altered sensorium. Brain computed tomography showed diffuse cerebral atrophy and periventricular ischemia demyelination alterations, and magnetic resonance imaging showed an enhanced section in the brainstem that included the pons, suggesting osmotic demyelination alterations. Ventilatory support and supportive therapy were initiated, and hyponatremia was rectified. Although the patient did well with the treatment, his prognosis was still dismal, so he was sent home with instructions to follow up.
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13
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Garg T, Ring N, Weiss C. Abstract No. 200 Comparison Between Patients-Reported Outcome Measure for Vascular Malformations Questionnaire (PROVAM) and Outcome Measures for VAscular Malformations (OVAMA) Responses in Patients with Low-Flow Vascular Malformations. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.258] [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: 02/27/2023] Open
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14
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Lewis P, Charalel R, Andrew C, Aliaksei S, Kassin M, Dubel G, Garg T, Brooks O, Shah R, Halin N, Kleedehn M, Johnson M. Abstract No. 235 Challenges, Successes and Barriers of Structured Report Templates: A Brief Report on Survey Results. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.297] [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: 02/26/2023] Open
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15
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Garg T, Laguna A, Gong A, Khalil A, Weinstein R, Mitchell S, Weiss C. Abstract No. 195 Clinical and Imaging Outcomes of Sclerotherapy for Superficial Venous Malformations Involving the Trunk. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.253] [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: 02/27/2023] Open
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16
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Garg T, Park H, Solomon A, Lee C, Weiss C, Li X, Singh H. Abstract No. 171 Benchtop Testing with Procedural Feasibility and Safety Evaluation of an Ultrahigh-Resolution Optical Coherence Tomography Catheter for Assessment of the Biliary Tree. J Vasc Interv Radiol 2023. [DOI: 10.1016/j.jvir.2022.12.227] [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: 02/27/2023] Open
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17
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Nadia N, Moideen Sheriff S, Fewajesuyan A, Emmanuel S, Nguty Nkeng E, Inban P, Garg T, Lakhra S, Singh S, Khan A. An Infected Intrahepatic Pancreatic Pseudocyst and Calcified Pancreas: A Rare Complication of Chronic Pancreatitis. Cureus 2023; 15:e35384. [PMID: 36994245 PMCID: PMC10042498 DOI: 10.7759/cureus.35384] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/23/2023] [Indexed: 02/26/2023] Open
Abstract
Pancreatic pseudocyst is a common complication of pancreatitis and is usually located in the peripancreatic space, spleen, and retroperitoneum. An infected intrahepatic pseudocyst following acute on chronic pancreatitis is extremely rare. Here, we report a case of intrahepatic pancreatic pseudocyst with superimposed infection following chronic pancreatitis in a 42-year-old female who presented with severe abdominal pain, vomiting, and bloating sensation. Her labs showed elevated pancreatic enzymes (amylase and lipase), and a provisional diagnosis of acute pancreatitis was made. Imaging revealed a cystic lesion in the left lobe and a calcified pancreas. Endoscopic aspiration of the cystic lesion and pathologic examination confirmed infected intrahepatic pancreatic pseudocyst due to the high serum amylase level and positive Enterococci on culture in aspirated cystic fluid, complicated by chronic pancreatitis.
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18
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Gomes I, Garg T, Churchyard G, Gupta A, Hesseling AC, Swindells S, Gurupira W, Martel B, Mbata L, Patil S, Riviere C, Tonquin M, Dowdy D, Sohn H. The cascade of care for household contacts of people with drug-resistant TB. Int J Tuberc Lung Dis 2023; 27:154-156. [PMID: 36853100 PMCID: PMC10115168 DOI: 10.5588/ijtld.22.0473] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Affiliation(s)
- I Gomes
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - T Garg
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - G Churchyard
- Aurum Institute, Johannesburg, South Africa, School of Public Health, University of Witwatersrand, Johannesburg, South Africa, Department of Medicine, Vanderbilt University, Nashville, TN, USA
| | - A Gupta
- Division of Infectious Diseases, Johns Hopkins School of Medicine, Baltimore, MD, USA
| | - A C Hesseling
- Desmond Tutu TB Centre, the Department of Paediatrics and Child Health, Stellenbosch University, Stellenbosch, South Africa
| | - S Swindells
- Division of Infectious Diseases, University of Nebraska Medical Center, Omaha, NB, USA
| | - W Gurupira
- Clinical Trials Research Centre (UZ-CTRC), University of Zimbabwe, Harare, Zimbabwe
| | - B Martel
- Socios En Salud Sucursal Peru, Lima, Peru
| | - L Mbata
- Aurum Institute, Rustenburg, South Africa
| | - S Patil
- Byramjee Jeejeebhoy Government Medical College CRS, Johns Hopkins University Baltimore-Washington-India Clinical Trials Unit, Pune, India
| | - C Riviere
- Les Centres GHESKIO, Port-au-Prince, Haiti
| | - M Tonquin
- Research Division, De La Salle Medical and Health Sciences Institute, Dasmarinas City, Cavite, The Philippines
| | - D Dowdy
- Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - H Sohn
- Department of Preventive Medicine, Seoul National University College of Medicine, Seoul, Korea
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19
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Aiyadurai S, Garg T, Sayeed T, Shahbaz Z, Adewole IO, Nguty Nkeng E, Joseph A, Udoeyop D, Qamar Y, Khan A. A Case of Prostatic Metastasis from Intrahepatic Cholangiocarcinoma: An Extremely Rare Event. Cureus 2023; 15:e35100. [PMID: 36938164 PMCID: PMC10022909 DOI: 10.7759/cureus.35100] [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] [Accepted: 02/17/2023] [Indexed: 02/19/2023] Open
Abstract
The second most frequent primary carcinoma of the liver to emerge is intrahepatic cholangiocarcinoma (ICC), which is thought to be an incurable, rapidly proliferating tumor with a dismal prognosis. ICC is typically found at an advanced stage and is physiologically hostile. Regional lymph nodes and liver metastases are frequent tumor metastatic sites for ICC and serve as indicators of tumor recurrence. ICC metastasizing to the male urogenital tract has only seldom been documented. Typically, lymph vessels serve as the primary pathway for disseminating tumor cells. The high fatality rate associated with ICC and the rapid spread of the disease may be caused by this lymphatic route. The only curative therapeutic approach for treating these tumors is surgical removal. We report a case of prostatic metastasis from ICC.
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Affiliation(s)
| | - Tulika Garg
- Medicine, Government Medical College & Hospital, Chandigarh, IND
| | - Tass Sayeed
- College of Medicine, Windsor University School of Medicine, Chicago, USA
| | - Zainab Shahbaz
- Research and Development, Windsor University School of Medicine, Chicago, USA
| | - Idowu O Adewole
- College of Medicine, All Saints University School of Medicine Dominica, Roseau, DMA
| | | | - Abia Joseph
- Surgery, John F. Kennedy University School of Medicine, Willemstad, CUW
| | | | - Yusra Qamar
- Surgery, Lala Lajpat Rai Hospital, Kanpur, IND
| | - Aadil Khan
- Internal Medicine, Lala Lajpat Rai Hospital, Kanpur, IND
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20
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Rentiya ZS, Garg T, Ejiyooye T, Mahjabeen SS, Khan T, Apata EO, Chukwuedozie V, Rajpopat PB, Aiyadurai S, Ede G, Dave VA, Sajjad T, Chaudhry H, Khan AM. A massive malignant pleural effusion due to lung adenocarcinoma in an adult male: a case report. Radiol Case Rep 2023; 18:511-514. [DOI: 10.1016/j.radcr.2022.10.080] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/17/2022] [Revised: 10/15/2022] [Accepted: 10/23/2022] [Indexed: 11/25/2022] Open
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21
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Huang H, Mehta A, Kalmanovich J, Anand A, Bejarano MC, Garg T, Khan N, Tonpouwo GK, Shkodina AD, Bardhan M. Immunological and inflammatory effects of infectious diseases in circadian rhythm disruption and future therapeutic directions. Mol Biol Rep 2023; 50:3739-3753. [PMID: 36656437 PMCID: PMC9851103 DOI: 10.1007/s11033-023-08276-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] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 01/11/2023] [Indexed: 01/20/2023]
Abstract
BACKGROUND Circadian rhythm is characterised by daily variations in biological activity to align with the light and dark cycle. These diurnal variations, in turn, influence physiological functions such as blood pressure, temperature, and sleep-wake cycle. Though it is well established that the circadian pathway is linked to pro-inflammatory responses and circulating immune cells, its association with infectious diseases is widely unknown. OBJECTIVE This comprehensive review aims to describe the association between circadian rhythm and host immune response to various kinds of infection. METHODS We conducted a literature search in databases Pubmed/Medline and Science direct. Our paper includes a comprehensive analysis of findings from articles in English which was related to our hypothesis. FINDINGS Molecular clocks determine circadian rhythm disruption in response to infection, influencing the host's response toward infection. Moreover, there is a complex interplay with intrinsic oscillators of pathogens and the influence of specific infectious processes on the CLOCK: BMAL1 pathway. Such mechanisms vary for bacterial and viral infections, both well studied in the literature. However, less is known about the association of parasitic infections and fungal pathogens with circadian rhythm modulation. CONCLUSION It is shown that bidirectional relationships exist between circadian rhythm disruption and infectious process, which contains interplay between the host's and pathogens' circadian oscillator, immune response, and the influence of specific infectious. Further studies exploring the modulations of circadian rhythm and immunity can offer novel explanations of different susceptibilities to infection and can lead to therapeutic avenues in circadian immune modulation of infectious diseases.
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Affiliation(s)
- Helen Huang
- Royal College of Surgeons in Ireland, University of Medicine and Health Sciences, Dublin, Ireland
| | - Aashna Mehta
- Faculty of Medicine, University of Debrecen, Debrecen, 4032 Hungary
| | | | - Ayush Anand
- B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Maria Chilo Bejarano
- Facultad de Ciencias de la Salud Humana, Universidad Autónoma Gabriel René Moreno, Santa Cruz de la Sierra, Bolivia
| | - Tulika Garg
- Government Medical College and Hospital, Chandigarh, India
| | - Nida Khan
- Jinnah Sindh Medical University, Karachi, Pakistan
| | - Gauvain Kankeu Tonpouwo
- Faculté de Médecine, Université de Lubumbashi, Plaine Tshombé, Lubumbashi, Democratic Republic of the Congo
| | | | - Mainak Bardhan
- ICMR-National Institute of Cholera and Enteric Diseases (NICED), Kolkata, India
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22
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Asfaw YA, Huang H, Taimur M, Anand A, Poudel S, Garg T, Asfaw BA, Abebe BM, Akbariromani H, Lazovic G, Cueva W. Progressive Cerebral Venous Thrombosis with Cranial Nerve Palsies in an Adolescent African Girl & Associated Diagnostic Pitfalls: A Rare Case Report. Int Med Case Rep J 2023; 16:45-51. [PMID: 36660226 PMCID: PMC9842531 DOI: 10.2147/imcrj.s381748] [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: 07/09/2022] [Accepted: 12/31/2022] [Indexed: 01/13/2023] Open
Abstract
Cerebral venous thrombosis (CVT) is a cerebrovascular disorder caused by complete or partial occlusion of the cerebral venous and sinus system. The etiology has been attributed to hypercoagulability and pro-thrombotic states, leading to raised intracranial pressures that often manifest as headaches and focal neurological deficits. However, the multifactorial nature of CVT can create a diagnostic conundrum for clinicians. We describe a unique case of a 16-year-old female who presented with convulsions, postictal confusion, and drowsiness followed by residual weakness of her extremities. She initially presented to the primary care center with headache, high-grade fever, and altered mental status and was empirically treated for pyogenic meningitis. The patient failed to improve with a week of antibiotics and was referred to the tertiary care center for urgent attention. On presentation, the patient developed VI and VII cranial nerve palsy. Subsequently, MRI images showed filling defects in the superior sagittal, right transverse, and sigmoid sinuses with right parietal gyral T1 hyperintensity and T2 hypo-intensity. She was diagnosed with septic CVT based on sinus venous thrombosis and venous infarction, probably secondary to meningococcal pneumonia. It can be challenging to distinguish between both conditions as their presentations overlap. Moreover, cranial nerve palsy is an infrequent manifestation of CVT, with unclear pathogenesis. We highlight the role of neuro-imaging in the early detection of CVT and bring to light the unfamiliar symptoms and a more varied clinical spectrum that may hinder the diagnosis in a limited-resource setting. Future research should be explicitly modeled to improve the diagnostic efficiency of CVT and improve outcomes in younger patient populations.
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Affiliation(s)
- Yonathan Aliye Asfaw
- Internal Medicine Department, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia,Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA,Correspondence: Yonathan Aliye Asfaw, Internal Medicine Department, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia, Email
| | - Helen Huang
- Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA,Internal Medicine Department, University of Medicine and Health Sciences, Royal College of Surgeons in Ireland, Dublin, Ireland
| | - Muhammad Taimur
- Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA,Internal Medicine Department, Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan
| | - Ayush Anand
- Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA,Internal Medicine Department, B. P. Koirala Institute of Health Sciences, Dharan, Nepal
| | - Sujan Poudel
- Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA
| | - Tulika Garg
- Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA,Internal Medicine Department, Government Medical College and Hospital, Chandigarh, India
| | - Bethlehem Aliye Asfaw
- Internal Medicine Department, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia,Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA
| | - Befekadu Molalegn Abebe
- Internal Medicine Department, University of Gondar, College of Medicine and Health Sciences, Gondar, Ethiopia,Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA
| | - Hanieh Akbariromani
- Department of Research & Academic Affairs, Larkin Community Hospital, South Miami, FL, USA,Internal Medicine Department, Islamic Azad University, Tehran Medical Branch, Tehran, Iran
| | - Gavrilo Lazovic
- Department of Emergency Medicine, Larkin Community Hospital, South Miami, FL, USA
| | - Wilson Cueva
- Department of Neurology, Larkin Community Hospital, South Miami, FL, USA
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23
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Muacevic A, Adler JR, Hussaini H, Omar Z, Lakhra S, Mohamed KH, Abdefatah Ali M, Nguty Nkeng E, Garg T, Khan A. Cysticercal Encephalitis in a Young Female: A Rare Presentation of Neurocysticercosis. Cureus 2023; 15:e33931. [PMID: 36819416 PMCID: PMC9937515 DOI: 10.7759/cureus.33931] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/18/2023] [Indexed: 01/20/2023] Open
Abstract
One of the most frequent parasite infections of the central nervous system is neurocysticercosis. This neurologic condition is caused by Taenia solium (T. solium) larval infestation. Infected pork intake, poor hygiene practices, water tainted with T. solium, or asymptomatic carriers are the main ways of spread. We describe a case of neurocysticercosis in a young woman who presented with low-grade fever, headache, altered sensorium, and recurrent seizures. Computed tomography of the head revealed an inflammatory granuloma and a ring-increased attenuating lesion in the left temporal region. Additionally, a well-defined rounded discrete lesion was identified in the left parietal region on magnetic resonance imaging of the brain. Even if the symptoms do not initially suggest neurocysticercosis or if the patient lives in a region where the condition is uncommon, our case depicts adding neurocysticercosis to the differential diagnosis for encephalitis.
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24
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Kaur J, Garg T, Lamba A, Cheema Y. Purpura fulminans in chronic liver disease: A rare association. Apollo Med 2023. [DOI: 10.4103/am.am_99_22] [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: 02/09/2023] Open
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25
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Muacevic A, Adler JR, Owolabi OJ, Garg T, Ezenagu UE, Apata EO, Abdefatah Ali M, Omar Z, Chaudhry HA, Khan A. A Rare Presentation of Shared Phenomenon in Dissociative Disorders in Extreme of Ages: A Report of Two Cases. Cureus 2022; 14:e32911. [PMID: 36699802 PMCID: PMC9871685 DOI: 10.7759/cureus.32911] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/24/2022] [Indexed: 12/26/2022] Open
Abstract
Conversion disorders (CD) are changes in sensorimotor activity experienced by an individual due to an external event. Patients may experience "pseudoseizures" accompanied by the presence or absence of loss of consciousness. Disorders of movement and sensation is the term used to classify the various kinds of CDs in the International Classification of Diseases, Tenth Revision (ICD-10) diagnostic manual, and they are the rarest among all dissociative disorders. We will discuss two instances that are particularly rare. The first includes an older couple, starting with the wife, who had nervousness, heightened worry, intrusive thoughts, heavy perspiration, palpitations, headaches, and problems sleeping. She was prescribed 10 mg once-daily escitalopram. She stopped taking her medication and had facial and hand problems. The patient's 65-year-old husband started having strange hand and face movements and lost consciousness. The pair was hospitalized willingly and had radiographic (MRI and non-contrast computerized tomography {NCCT} head), nerve conduction, and neurological tests to rule out a movement issue. No inquiry or inspections uncovered anything unusual. The second case involves a mother and her 13-year-old son, who was taken to a psychiatric unit after urinating on a religious shrine. His mother had the same issue and couldn't urinate for days. Both patients were given 25 mg of paroxetine and benzodiazepines for anxiety and sleeplessness. After a week of medicine and psychotherapy after identifying stressors, both cases improved.
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26
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Rayamajhi S, Shahi K, Garg T, Dey S, Adhikari B, Mahaseth A. An exceptional survival in an unoperated tetralogy of Fallot in a 66-year-old man: A case report. Radiol Case Rep 2022; 17:4903-4906. [PMID: 36281282 PMCID: PMC9586846 DOI: 10.1016/j.radcr.2022.09.062] [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: 08/21/2022] [Revised: 09/15/2022] [Accepted: 09/18/2022] [Indexed: 10/30/2022] Open
Abstract
Tetralogy of Fallot is the most common cyanotic congenital heart disease in children which comprises an overriding aorta, right ventricular outflow obstruction, ventricular septal defect, and right ventricular hypertrophy. It has an elevated early mortality rate without surgical correction, with most patients dying in childhood. Only 2% of patients survive past the age of 40 years without surgical intervention. Very few cases of survival to middle age have been reported, particularly after the fourth decade. In this article, we present a case of a 66-year-old male with an unoperated tetralogy of Fallot, which is one of the longest time periods of diagnosis. Despite tetralogy and having right ventricular dysfunction, this patient presented with fatigue, exertional dyspnea, cyanosis, and systemic hypertension. Considering the patient's comorbid conditions and the risk associated with the surgery, the patient was managed conservatively. To our knowledge, this is the oldest unoperated tetralogy of Fallot case reported in Nepal.
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Affiliation(s)
- Sushil Rayamajhi
- Department of Internal Medicine, Swacon International Hospital, Battisputali, Kathmandu, Nepal,Corresponding author.
| | - Kopila Shahi
- Department of Internal Medicine, ZH Sikder Women's Medical College, Dhaka, Bangladesh
| | - Tulika Garg
- Department of Internal Medicine, Government Medical College and Hospital, Chandigarh, India
| | - Shraboni Dey
- Department of Internal Medicine, Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh
| | - Bibek Adhikari
- Department of Internal Medicine, Nepal Cancer Hospital and Research Center, Lalitpur, Nepal
| | - Aditya Mahaseth
- Department of Cardiology, Shahid Gangalal National Heart Center, Janakpur, Nepal
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27
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Rajpopat PB, Desai BN, Abro S, Garg T, Amedu OS, Ejiyooye TF, Fonseca A, Sajjad T, Hambolu E, Khan A. A Case of Allergic Bronchopulmonary Aspergillosis With Bronchial Asthma. Cureus 2022; 14:e29552. [PMID: 36312634 PMCID: PMC9595235 DOI: 10.7759/cureus.29552] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 09/25/2022] [Indexed: 11/11/2022] Open
Abstract
Allergic bronchopulmonary aspergillosis (ABPA) is a fungal hypersensitivity reaction in chronic lung diseases like bronchial asthma and cystic fibrosis. It is caused by an allergic reaction to aspergillus antigen in the lung mucus resulting in airway inflammation and damage. This condition usually presents in a patient with asthma as a poorly controlled disease with recurrent infection symptoms that do not respond to standard antibiotic therapy. Diagnosis is made by chest X-ray, computed tomography, eosinophilia, and raised serum IgE on serology and immunological tests for aspergillus antigen. Lack of diagnosis and treatment of the condition can lead to respiratory failure from bronchiectasis and pulmonary fibrosis.
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28
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Bhardwaj A, Garg T, Gupta M, Kaur N, Gupta S. Intracranial Calcifications in Systemic Lupus Erythematosus. Cureus 2022; 14:e27952. [PMID: 36120240 PMCID: PMC9465125 DOI: 10.7759/cureus.27952] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/12/2022] [Indexed: 11/22/2022] Open
Abstract
We present an unusual case of a 37-year-old woman diagnosed with systemic lupus erythematosus presenting with right-sided weakness and altered mentation. On computed tomography and magnetic resonance imaging, marked intracranial calcifications were seen. These localized calcifications are speculated to be secondary to the necrotic focus of repeated episodes of vessel inflammation. However, the pathogenesis of cerebral calcifications is largely unknown.
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29
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Chukwuedozie VC, Garg T, Chaudhry HA, Shawl SH, Mishra P, Adaralegbe NJ, Khan A. Late-Onset Hypokalemic Periodic Paralysis in an Adult Female With Type 2 Renal Tubular Acidosis: A Case Report. Cureus 2022; 14:e27695. [PMID: 36081958 PMCID: PMC9440985 DOI: 10.7759/cureus.27695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/04/2022] [Indexed: 11/05/2022] Open
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30
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Mehta A, Awuah WA, Kalmanovich J, Huang H, Tanna R, Iqbal DJ, Garg T, Bulut HI, Abdul-Rahman T, Hasan MM. Investigating discrepancies in demand and access for bariatric surgery across different demographics in the COVID-19 era. Ann Med Surg (Lond) 2022; 82:104368. [PMID: 36268323 PMCID: PMC9577451 DOI: 10.1016/j.amsu.2022.104368] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2022] [Accepted: 08/11/2022] [Indexed: 11/10/2022] Open
Abstract
Obesity affects over 650 million adults worldwide and increases the risk of cardiovascular events, diabetes, and hypertension. While lifestyle recommendations are popular management options, bariatric surgery has emerged as a standard of care in refractory cases, reported to cause at least a 30% reduction in mortality. In addition, it mitigates obesity-related complications leading to a significant improvement in the quality of life for morbidly obese patients (BMI >40). Despite the numerous benefits, demand and access to bariatric surgery vary across different demographics such as age, gender, and socioeconomic status. This demand and access were further reduced due to the COVID-19 pandemic. This has resulted in cancellations of elective surgeries such as weight loss procedures and promotes a sedentary lifestyle which has short-term and long-term detrimental consequences on the health of obese patients. In the context of the prevalent epidemiological trends, this reduction in bariatric services will disproportionately affect the elderly, males, low SES, and African Americans. This editorial highlights the prevalent discrepancies in demand and access to bariatric surgery amidst the COVID-19 pandemic, and possible recommendations to improve overall access and utilization of bariatric services in morbidly obese patients belonging to all demographics.
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Gowda P, Gong A, Garg T, Khalil A, Weinstein R, Raman A, Latif M, Mitchell S, Weiss C. Abstract No. 612 Evaluation of clinical outcomes of percutaneous sclerotherapy for the treatment of hand and wrist venous malformations. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.594] [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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Gong A, Gowda P, Garg T, Khalil A, Weinstein R, Raman A, Latif M, Mitchell S, Weiss C. Abstract No. 388 Percutaneous sclerotherapy of venous malformations involving the tongue: assessing clinical and imaging outcomes. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.469] [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] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gong A, Garg T, Gowda P, Khalil A, Weinstein R, Raman A, Latif M, Mitchell S, Weiss C. Abstract No. 387 Sclerotherapy improves clinical symptoms and reduces malformation size in patients with venous malformations of the foot and ankle. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.468] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Garg T, Huang J, Wadhwa V. Abstract No. 531 Bibliometric analysis of the 100 most cited articles in interventional radiology. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.513] [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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Weinstein R, Garg T, Gong A, Gowda P, Raman A, Latif M, Mitchell S, Weiss C. Abstract No. 611 The impact of sclerotherapy of venous malformations of the eye and orbit on clinical and imaging outcomes. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.593] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Gong A, Khalil A, Gowda P, Garg T, Weinstein R, Weiss C. Abstract No. 593 How is quality-of-life captured in the hereditary hemorrhagic telangiectasia population? A scoping review of quality-of-life instruments. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.575] [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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Gowda P, Khalil A, Garg T, Gong A, Raman A, Weinstein R, Morefield W, Latif M, Mitchell S, Weiss C. Abstract No. 39 Assessing safety and clinical outcomes of patients receiving serial doxycycline exchange sclerotherapy for lymphatic malformations. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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Garg T, Shrigiriwar A, Ahuja R. Abstract No. 178 Race representation in clinical studies evaluating embolization for hepatocellular carcinoma treatment compared with the United States Census data. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.259] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Garg T, Shaikh J, Payne M, Latich I, Elwood D, Nezami N. Abstract No. 568 Pump versus manual irrigation: comparing procedural and clinical outcomes in patients undergoing percutaneous biliary endoscopy. J Vasc Interv Radiol 2022. [DOI: 10.1016/j.jvir.2022.03.550] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022] Open
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Garg T, Gupta M, Gupta S, Kaur N, Rajesh R. Mumps Infection With Symptoms of Parotitis, Pancreatitis, and Orchitis Concurrently in an Adolescent Male. Cureus 2022; 14:e21963. [PMID: 35282503 PMCID: PMC8906564 DOI: 10.7759/cureus.21963] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/06/2022] [Indexed: 11/05/2022] Open
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Garg T, Shrigiriwar A. Abstract No. 181 Catheter-directed intra-arterial thrombolysis for the management of frostbite injuries: a systematic review. J Vasc Interv Radiol 2021. [DOI: 10.1016/j.jvir.2021.03.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Patel S, Garg T, Patel G, Roshani, Chaudhury B, Maiti TK. Motion Retargeting and Machine Learning for Humanoid Robotics. 2020 International Symposium on Devices, Circuits and Systems (ISDCS) 2020. [DOI: 10.1109/isdcs49393.2020.9263022] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 07/19/2023]
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Garg T. Increasing Social Media Involvement around the American Society of Neuroradiology Annual Meeting. AJNR Am J Neuroradiol 2019; 40:E56. [PMID: 31515210 DOI: 10.3174/ajnr.a6185] [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: 11/07/2022]
Affiliation(s)
- T Garg
- Seth GS Medical College and KEM Hospital Mumbai, Maharashtra, India
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Garg T, Baker L, Mell M. Postoperative Surveillance and Long-Term Outcomes After Endovascular Aneurysm Repair Among Medicare Beneficiaries. J Vasc Surg 2016. [DOI: 10.1016/j.jvs.2016.03.405] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Garg T, LaRosa C, Strawn E, Robb P, Sandlow J. Outcomes after testicular aspiration and testicular tissue cryopreservation. Fertil Steril 2007. [DOI: 10.1016/j.fertnstert.2007.07.514] [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]
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Sood A, Sharma VK, Garg T, Nair M, Dinda AK. Amyloidosis in Reiter's syndrome. J Assoc Physicians India 2001; 49:563-5. [PMID: 11361274] [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] [Subscribe] [Scholar Register] [Indexed: 04/16/2023]
Affiliation(s)
- A Sood
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi
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Garg T, Khaitan BK, Sood A. Limited role of calcipotriol in inflammatory linear verrucous epidermal naevus. Indian J Dermatol Venereol Leprol 2001; 67:48-9. [PMID: 17664706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/16/2023]
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Ramam M, Garg T, D'Souza P, Verma KK, Khaitan BK, Singh MK, Banerjee U. A two-step schedule for the treatment of actinomycotic mycetomas. Acta Derm Venereol 2000; 80:378-80. [PMID: 11200840 DOI: 10.1080/000155500459367] [Citation(s) in RCA: 20] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
Abstract
Actinomycotic mycetomas usually respond slowly to treatment with antibiotics. In an attempt to hasten clinical resolution, we used a 2-step regimen consisting of an intensive phase of therapy with penicillin, gentamycin and co-trimoxazole for 5-7 weeks, followed by maintenance therapy with amoxicillin and co-trimoxazole. Seven patients were treated, all of whom showed significant reduction in discharge and swelling after the intensive phase. Maintenance therapy was continued for 2-5 months after the lesions became completely inactive. Five patients completed maintenance therapy, which was given for 6-16 months (mean 10.7 months), and remained free of disease during a mean post-treatment follow-up period of 6.4 months. The other 2 patients also responded satisfactorily and continue to receive maintenance therapy. Side-effects necessitating a modification of the treatment schedule occurred in 2 patients but reversed on discontinuation of the drugs responsible. This treatment schedule produces a rapid clinical response during the initial, intensive phase and promotes compliance with the longer maintenance phase of treatment necessary to achieve a complete cure.
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Affiliation(s)
- M Ramam
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi.
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Chang SL, Griesgraber G, Abraham TW, Garg T, Song H, Zimmerman CL, Wagner CR. Synthesis and antiviral activity of amino acid carbamate derivatives of AZT. Nucleosides Nucleotides Nucleic Acids 2000; 19:87-100. [PMID: 10772704 DOI: 10.1080/15257770008032998] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Lipophilic amino acid methyl ester and methyl amide carbamates of 3'-azido-3'-deoxythymidine (AZT) were synthesized and their anti-HIV-1 activity in PBMCs was determined. The methyl amides were more potent (EC50s = 1.8-4.0 microM) than the methyl esters (EC50s = 2.0-20 microM). Carbamate hydrolysis by cell lysates and liberation of AZT was not observed for representative methyl ester or methyl amide AZT carbamates. No evidence of direct inhibition of HIV reverse transcriptase or integrase was observed.
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Affiliation(s)
- S L Chang
- Department of Medicinal Chemistry, College of Pharmacy, University of Minnesota, Minneapolis 55455, USA
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Bodey AR, Michell AR, Bovee KC, Buranakurl C, Garg T. Comparison of direct and indirect (oscillometric) measurements of arterial blood pressure in conscious dogs. Res Vet Sci 1996; 61:17-21. [PMID: 8819188 DOI: 10.1016/s0034-5288(96)90104-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
Oscillometric measurements of arterial blood pressure were compared with direct measurements made on seven dogs fitted with catheters. Tail and limb cuff sites were used while the dogs were gently restrained either standing or in lateral recumbency. The accuracy of the readings for the various cuff sites was compared with the direct (gold standard) readings. The accuracy of the indirect readings was improved by using mean values from a series of readings rather than individual values and when the dogs were in lateral recumbency rather than standing. The differences between the direct and indirect values were greatest with high pressures, and with systolic rather than diastolic values. In standing dogs, the proximal forelimb readings (when obtainable) correlated most closely with the direct readings. The tail cuff readings correlated significantly with the direct readings, though less closely. The tail cuff readings were the most easily recorded in the standing dogs. In the laterally recumbent dogs, the readings from all the cuff sites correlated closely with the direct values except for diastolic readings from the distal hindlimb.
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Affiliation(s)
- A R Bodey
- Royal Veterinary College, University of London, Hatfield, Hertfordshire
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