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Singh PP, Jaiswal AK, Singh R, Kumar A, Gupta V, Raghuvanshi TS, Sharma A, Prakash B. Assessment of Trachyspermum ammi essential oil against Aspergillus flavus, aflatoxin B 1 contamination, and post-harvest quality of Sorghum bicolor. Food Chem 2024; 443:138502. [PMID: 38306909 DOI: 10.1016/j.foodchem.2024.138502] [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] [Subscribe] [Scholar Register] [Received: 09/30/2023] [Revised: 12/19/2023] [Accepted: 01/16/2024] [Indexed: 02/04/2024]
Abstract
The present investigation explored the antifungal effectiveness of Trachyspermum ammi essential oil (TAEO) against Aspergillus flavus, aflatoxin B1 (AFB1) contamination, and its mechanism of action using biochemical and computational approaches. The GC-MS result revealed the chemical diversity of TAEO with the highest percentage of γ-terpinene (39 %). The TAEO exhibited minimum inhibitory concentration against A. flavus growth (0.5 µL/mL) and AFB1 (0.4 µL/mL) with radical scavenging activity (IC50 = 2.13 µL/mL). The mechanism of action of TAEO was associated with the alteration in plasma membrane functioning, antioxidative defense, and carbon source catabolism. The molecular dynamic result shows the multi-regime binding of γ-terpinene with the target proteins (Nor1, Omt1, and Vbs) of AFB1 biosynthesis. Furthermore, TAEO exhibited remarkable in-situ protection of Sorghum bicolor seed samples against A. flavus and AFB1 contamination and protected the nutritional deterioration. Hence, the study recommends TAEO as a natural antifungal agent for food protection against A. flavus mediated biodeterioration.
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Affiliation(s)
- Prem Pratap Singh
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Atul Kumar Jaiswal
- Department of Computer Science and Engineering, School of Engineering Sciences and Technology, Jamia Hamdard University, New Delhi, India
| | - Ritu Singh
- Department of Plant Sciences, University of California, Davis, USA
| | - Akshay Kumar
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Vishal Gupta
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Tanya Singh Raghuvanshi
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, India
| | - Angad Sharma
- School of Computational and Integrative Sciences, Jawaharlal Nehru University, New Delhi, India
| | - Bhanu Prakash
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi, India.
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2
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Gupta V, Taneja N, Sati HC, Sreenivas V, Ramam M. 'Substantial clinical benefit' and 'substantial clinical worsening' cut-off of Vitiligo Impact Scale (VIS)-22 change scores. Br J Dermatol 2024:ljae178. [PMID: 38644793 DOI: 10.1093/bjd/ljae178] [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: 02/01/2024] [Revised: 04/16/2024] [Accepted: 04/20/2024] [Indexed: 04/23/2024]
Abstract
Patient-centric outcome measures focus on clinically meaningful change in various aspects of disease, including severity, quality-of-life, and psychological distress. The minimal important change (MIC) is a commonly used threshold of patient-reported outcome measures, representing the smallest difference that is considered significant by the patient and/or physician. However, it has been suggested that MIC is too low a bar for determining treatment success, and alternative thresholds such as substantial clinical benefit (SCB) and patient acceptable symptom state (PASS) may be preferred.
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Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, Institute of Medical Sciences, New Delhi, India
| | - Neha Taneja
- Department of Dermatology and Venereology, Institute of Medical Sciences, New Delhi, India
| | - Hem Chandra Sati
- Department of Biostatistics, All India, Institute of Medical Sciences, New Delhi, India
| | | | - M Ramam
- Department of Dermatology and Venereology, Institute of Medical Sciences, New Delhi, India
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3
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Chadha M, Shao T, Lit M, Gupta V, Zakashansky K, Zeligs K, Kolev V. Upfront boost to gross disease followed by elective pelvic radiation improves compliance to radiation therapy delivery metrics in locally advanced vulvar cancer. Gynecol Oncol Rep 2024; 52:101362. [PMID: 38495799 PMCID: PMC10940132 DOI: 10.1016/j.gore.2024.101362] [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] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Revised: 03/04/2024] [Accepted: 03/05/2024] [Indexed: 03/19/2024] Open
Abstract
Locally advanced cancer of the vulva (LACV) is commonly diagnosed in older women (>65 years), and is treated using combined multimodality therapy (CMT) that includes radiation therapy (RT). Compliance to optimal RT metrics, including completion of > 20 fractions, overall treatment duration of < 8 weeks (56 days), and < 1 week intra-treatment break is associated with better disease outcomes. However, published results note that a significant number of patients with LACV do not adhere to these metrics. The aim of our study is to evaluate whether a modified sequence of RT delivery, treating the localized boost volume upfront followed by the larger elective nodal volume is associated with improved compliance to optimal RT delivery metrics.
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Affiliation(s)
- M. Chadha
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - T. Shao
- Department of Medicine, Division of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States
| | - M. Lit
- Division of Gynecology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - V. Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - K. Zakashansky
- Division of Gynecology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - K. Zeligs
- Division of Gynecology, Icahn School of Medicine at Mount Sinai, New York, United States
| | - V. Kolev
- Division of Gynecology, Icahn School of Medicine at Mount Sinai, New York, United States
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Sharma S, Gupta V, Mudgal D. Experimental investigation of ultrasonic assisted coating on three-point bending behavior of 3D printed polymeric bone plates for biomedical applications. Med Eng Phys 2024; 126:104129. [PMID: 38621834 DOI: 10.1016/j.medengphy.2024.104129] [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] [Subscribe] [Scholar Register] [Received: 05/02/2023] [Revised: 01/22/2024] [Accepted: 02/25/2024] [Indexed: 04/17/2024]
Abstract
3D printed Poly Lactic Acid (PLA) bone plates exhibit limited three-point bending strength, restricting their viability in biomedical applications. The application of polydopamine (PDM) enhances the three-point bending strength by undergoing covalent interactions with PLA molecular structure. However, the heavy nature of PDM particles leads to settling at the container base at higher coating solution concentrations. This study investigates the impact of ultrasonic-assisted coating parameters on the three-point bending strength. Utilizing Response Surface Methodology (RSM) for statistical modeling, the study examines the influence of ultrasonic vibration power (UP), coating solution concentration (CC), and submersion time (TIME). RSM optimization recommended 100 % UP, 6 mg/ml CC, and 150 min TIME, resulting in maximum three-point bending strength of 83.295 MPa. Microscopic images from the comparative analysis revealed non-uniform coating deposition with mean thickness of 6.153 µm under normal coating. In contrast, ultrasonic-assisted coating promoted uniform deposition with mean thickness of 18.05 µm. The results demonstrate that ultrasonic-assisted coating induces PDM particle collision, preventing settling at the container base, and enhances three-point bending strength by 7.27 % to 23.24 % compared to the normal coating condition. This study emphasizes on the potential of ultrasonic-assisted coating to overcome the limitations of direct immersion coating technique.
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Affiliation(s)
- Shrutika Sharma
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology Patiala, 147004, Punjab, India
| | - Vishal Gupta
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology Patiala, 147004, Punjab, India.
| | - Deepa Mudgal
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology Patiala, 147004, Punjab, India
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Hsieh K, Bloom JR, Dickstein DR, Shah A, Yu C, Nehlsen AD, Resende Salgado L, Gupta V, Chadha M, Sindhu KK. Risk-Tailoring Radiotherapy for Endometrial Cancer: A Narrative Review. Cancers (Basel) 2024; 16:1346. [PMID: 38611024 PMCID: PMC11011021 DOI: 10.3390/cancers16071346] [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: 02/01/2024] [Revised: 03/21/2024] [Accepted: 03/28/2024] [Indexed: 04/14/2024] Open
Abstract
Endometrial cancer is the most common gynecologic cancer in the United States and it contributes to the second most gynecologic cancer-related deaths. With upfront surgery, the specific characteristics of both the patient and tumor allow for risk-tailored treatment algorithms including adjuvant radiotherapy and systemic therapy. In this narrative review, we discuss the current radiation treatment paradigm for endometrial cancer with an emphasis on various radiotherapy modalities, techniques, and dosing regimens. We then elaborate on how to tailor radiotherapy treatment courses in combination with other cancer-directed treatments, including chemotherapy and immunotherapy. In conclusion, this review summarizes ongoing research that aims to further individualize radiotherapy regimens for individuals in an attempt to improve patient outcomes.
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Affiliation(s)
| | | | | | | | | | | | | | | | | | - Kunal K. Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
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Basu A, Biswas J, Singh S, Gupta V, Dhawan B. Chronic sexually acquired reactive arthritis secondary to Chlamydiatrachomatis. Indian J Med Microbiol 2024; 48:100561. [PMID: 38458336 DOI: 10.1016/j.ijmmb.2024.100561] [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: 10/25/2023] [Revised: 01/13/2024] [Accepted: 03/05/2024] [Indexed: 03/10/2024]
Abstract
Reactive arthritis is included in the spectrum of seronegative spondyloarthritides, occurring secondary to triggers of genitourinary and gastrointestinal tract infections. We describe two cases of sexually acquired reactive arthritis secondary to genital infection by Chlamydia trachomatis, diagnosed by in-house polymerase chain reaction performed on the first void urine. Both patients were managed with a combined approach of short course antibiotics, immunosuppressive agents, biologicals and surgical intervention.
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Affiliation(s)
- Arkendu Basu
- Department of Microbiology and Medicine, All India Institute of Medical Sciences, New Delhi, India.
| | - Jaya Biswas
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Saurabh Singh
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India.
| | - Benu Dhawan
- Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
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Gupta V, Ahuja R, Sindhuja T, Imran S, Kumar Viswanathan G, Kumar Tembhre M, Pandey S, Khandpur S. Clinical and immunological predictors of post-rituximab paradoxical pemphigus flare: A prospective cohort study. Indian J Dermatol Venereol Leprol 2024; 0:1-6. [PMID: 38595008 DOI: 10.25259/ijdvl_894_2023] [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: 08/28/2023] [Accepted: 10/08/2023] [Indexed: 04/11/2024]
Abstract
Background Paradoxical flare of pemphigus following rituximab infusion has been reported previously, however, its incidence or risk factors have not been studied in detail. Objectives To evaluate the clinical and immunological predictors associated with post-rituximab paradoxical pemphigus flare. Materials and Methods This was a prospective cohort study including adult patients with pemphigus vulgaris or foliaceus who were treated with rituximab. Patients were administered 1000 mg of intravenous rituximab on days 0 and 14 (Rheumatoid arthritis (RA) protocol), with or without oral prednisolone and/or conventional immunosuppressive agents. Baseline clinical and immunological predictors of post-rituximab pemphigus flares were assessed. Results Fifty patients (mean age 40.44 ± 12.36 years) with a mean pemphigus disease area index (PDAI) score of 27.8 ± 15.48 were administered rituximab. Post-rituximab flare occurred in 10 (20%) patients after a mean of 14.1 ± 4.33 days after the first rituximab infusion. The mean baseline PDAI score (36.4 ± 11.7 vs. 25.6 ± 15.7, P = 0.02) and serum anti-Dsg1 levels (1216.8 ± 850.1 vs. 592 ± 562.12 RU/mL, P = 0.03) were statistically significantly higher in patients experiencing a flare. Using ROC-curve analysis, a PDAI score of 328 (OR 8.3, 95% CI 1.5-44.7) was 80% sensitive and 67.5% specific in predicting post-rituximab flare, while serum anti-Dsg1 level of 31137.78 RU/ml had a sensitivity of 60% and specificity of 85%. There was no significant difference in terms of affected body surface area, type of pemphigus, starting prednisolone dose, oral immunosuppressive adjuvant, serum anti-Dsg3, serum anti-AchRM3, and peripheral CD19+ B cell population. Limitations Our study is limited by a relatively small sample size. Immunological factors were not evaluated at the time of pemphigus flare. Though these unexpected pemphigus flares are likely to be associated with rituximab infusion, the possibility of spontaneous disease exacerbation cannot be entirely excluded. Conclusions Patients with more severe pemphigus or high serum anti-Dsg1 are at risk of post-rituximab paradoxical flare, and may benefit from rituximab administration under close monitoring.
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Affiliation(s)
- Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Rhea Ahuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Tekumalla Sindhuja
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Shafaque Imran
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | | | - Manoj Kumar Tembhre
- Department of Cardiac Biochemistry, All India Institute of Medical Sciences, New Delhi, India
| | - Shivam Pandey
- Department of Biostatistics, All India Institute of Medical Sciences, New Delhi, India
| | - Sujay Khandpur
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Singh P, Sharma A, Jasrotia A, Salgotra RK, Sharma M, Gupta V. Diversity in morpho-pomological attributes and biochemical profiling of bael ( Aegle marmelos (L.) Correa) genotypes of North-Western India. Heliyon 2024; 10:e26525. [PMID: 38404771 PMCID: PMC10884474 DOI: 10.1016/j.heliyon.2024.e26525] [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: 10/09/2023] [Revised: 01/23/2024] [Accepted: 02/14/2024] [Indexed: 02/27/2024] Open
Abstract
Bael is a medicinal cum fruit tree with multipurpose utility and propagated mostly through seeds. The present study aimed to assess and analyse the morpho-pomological and biochemical traits of eighty seedlings grown bael genotypes comparison with two commercial cultivars (NB-5 and NB-9) of bael. The significant differences were detected among the genotypes based on the measured morpho-pomological and biochemical traits. The morpho-pomological and biochemical traits of bael exhibited variation ranging from 6.17% to 133.65%. Trunk girth ranged from 29.50 to 63.40 cm and tree spread (N-S) varied 1.00-6.30 m. Fruit length ranged from 4.60 to 12.05 cm and fruit width ranged from 4.64 to 11.72 cm. Moreover, fruit weight ranged from 56.33 to 917.65 g and pulp percentage varied from 58.64 to 81.38%. Soluble Solid Content ranged from 25.90 to 36.77 0brix and ascorbic acid varied from 14.38 to 25.45 mg/100 g. Fruit length was positively correlated with fruit width, fruit weight, pulp percentage, seed length, seed diameter and number of seeds per fruit, while it was negatively correlated with fruit surface and total number of fruit per plant. Principal component analysis showed that 76.66% of the variability observed was explained by the 13 components. Ward cluster analysis using Euclidean distance classified the genotypes into two main clusters. These findings contribute to a better understanding of the diversity and relationships among the studied genotypes, aiding future breeding and selection programs for improved bael cultivation.
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Affiliation(s)
- Prabhdeep Singh
- Division of Fruit Science, Sher-e- Kashmir University of Agricultural Sciences and Technology of Jammu, Main Campus, Chatha, Jammu 180009, India
| | - Akash Sharma
- Advanced Centre for Horticulture Research, Udheywalla, Sher-e- Kashmir University of Agricultural Sciences and Technology of Jammu, Chatha, Jammu 180018, India
| | - Amit Jasrotia
- Division of Fruit Science, Sher-e- Kashmir University of Agricultural Sciences and Technology of Jammu, Main Campus, Chatha, Jammu 180009, India
| | - Romesh Kumar Salgotra
- School of Biotechnology, Sher-e- Kashmir University of Agricultural Sciences and Technology of Jammu, Main Campus, Chatha, Jammu 180009, India
| | - Manish Sharma
- Division of Statistics and Computer Sciences, Sher-e- Kashmir University of Agricultural Sciences and Technology of Jammu, Main Campus, Chatha, Jammu 180009, India
| | - Vishal Gupta
- Division of Plant Pathology, Sher-e- Kashmir University of Agricultural Sciences and Technology of Jammu, Main Campus, Chatha, Jammu 180009, India
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Angrup A, Sharma B, Joshi H, Vig S, Handa S, Singh SR, Gupta V, Biswal M, Ray P. Role of MALDI-TOF mass spectrometry and molecular typing methods in an outbreak investigation of Pseudomonas stutzeri acute endophthalmitis post-phacoemulsification. J Hosp Infect 2024; 144:146-149. [PMID: 37918527 DOI: 10.1016/j.jhin.2023.08.027] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2023] [Accepted: 08/22/2023] [Indexed: 11/04/2023]
Affiliation(s)
- A Angrup
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - B Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - H Joshi
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Vig
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Handa
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S R Singh
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - V Gupta
- Department of Ophthalmology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - M Biswal
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - P Ray
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Sharma S, Gupta V, Mudgal D. Response surface methodology and machine learning based tensile strength prediction in ultrasonic assisted coating of poly lactic acid bone plates manufactured using fused deposition modeling. Ultrasonics 2024; 137:107204. [PMID: 37979518 DOI: 10.1016/j.ultras.2023.107204] [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] [Subscribe] [Scholar Register] [Received: 01/09/2023] [Revised: 11/10/2023] [Accepted: 11/11/2023] [Indexed: 11/20/2023]
Abstract
Poly Lactic Acid (PLA) based bone plates fabricated using Fused Deposition Modeling have poor mechanical strength which can be improved by biocompatible polydopamine (PDM) coating. However, PDM particles, being heavy in nature, settle at the container bottom with increase in coating solution concentration at the time of bone plate coating using dip coating technique. Thus, the present work aims to witness the effect of ultrasonic assisted coating parameters on tensile strength of coated bone plates. The coating parameters involving power of ultrasonic vibrations, coating solution concentration and immersion time were varied. The standard Response Surface Methodology (RSM) was applied and experimental trials were performed for obtaining tensile strength of bone plates under varied coating parameters. The objective of the present study was to compare the values of tensile strength predicted using RSM and machine learning (ML) models. Based on the obtained experimental values, gradient boosting regression (GBReg), linear regression (LReg) and random forest regression (RFReg) were trained and tested for predicting tensile strength of bone plates. The accuracy and prediction errors corresponding to RSM and ML based models were compared with respect to R2, Mean Squared Error (MSE), Mean Absolute Error (MAE) and Root Mean Squared Error (RMSE). The findings revealed that GBReg exhibited R2, MSE, RMSE and MAE values as 0.9312, 1.7142, 1.2877 and 1.0861 respectively, while RSM showed R2, MSE, RMSE and MAE values as 0.882, 2.13, 1.4595 and 1.258 respectively. RSM model has shown minimum accuracy with high prediction errors amongst the four models. GBReg has outperformed other ML models in terms of their accuracy and error metrics. The present study therefore suggests the application of GBReg based ML model for predicting tensile strength of PDM coated bone plates in response to its accurate and robust prediction performance.
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Affiliation(s)
- Shrutika Sharma
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology, Patiala 147004, Punjab, India
| | - Vishal Gupta
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology, Patiala 147004, Punjab, India.
| | - Deepa Mudgal
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology, Patiala 147004, Punjab, India
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Bloom JR, Rodriguez-Russo C, Hsieh K, Dickstein DR, Sheu RD, Jain M, Moshier E, Liu J, Gupta V, Kirke DN, Roof S, Misiukiewicz K, Posner M, Bakst R, Sindhu KK, Sharma S. Head and Neck Cancer Patient Population, Management, and Oncologic Outcomes from the COVID-19 Pandemic. Curr Oncol 2024; 31:436-446. [PMID: 38248114 PMCID: PMC10814981 DOI: 10.3390/curroncol31010029] [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] [Subscribe] [Scholar Register] [Received: 11/27/2023] [Revised: 01/02/2024] [Accepted: 01/05/2024] [Indexed: 01/23/2024] Open
Abstract
The COVID-19 pandemic precipitated drastic changes in cancer care. Its impact on the U.S. head and neck cancer population has yet to be fully understood. This study aims to understand the impact of pandemic-related changes on the head and neck cancer population. An observational study of head and neck cancer patients at a single institution during the spring of 2020 and 2019 was performed. Clinical characteristics and survival outcomes were analyzed. In 2020, 54 head and neck cancer patients were evaluated in the department of radiation oncology vs. 74 patients seen in 2019; 42% of the patients were female in 2019 versus 24% in 2020 (p = 0.036). The median follow-up time was 19.4 and 31 months for 2020 and 2019, respectively. After adjusting for stage, the relapse-free survival probability at 6 and 12 months was 79% and 69% in 2020 vs. 96% and 89% in 2019, respectively (p = 0.036). There was no significant difference in the overall survival, with 94% and 89% in 2020 and 2019, respectively (p = 0.61). Twenty-one percent of patients received induction chemotherapy in 2020 versus 5% in 2019 (p = 0.011); significantly more treatment incompletions occurred in 2020, 9% vs. 0% in 2019 (p = 0.012). Moreover, the stage-adjusted RFS differed between cohorts, suggesting head and neck cancer patients seen during the initial wave of COVID-19 may experience worse oncologic outcomes.
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Affiliation(s)
- Julie R. Bloom
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Carlos Rodriguez-Russo
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Kristin Hsieh
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Daniel R. Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Ren-Dih Sheu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Mayuri Jain
- Department of Population Health Science and Policy, Tisch Cancer Institute Biostatistics Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Erin Moshier
- Department of Population Health Science and Policy, Tisch Cancer Institute Biostatistics Shared Resource Facility, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Jerry Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Vishal Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Diana N. Kirke
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Scott Roof
- Department of Otolaryngology-Head and Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Krzysztof Misiukiewicz
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
| | - Marshall Posner
- Department of Hematology/Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA
- Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, NY 10029, USA
| | - Richard Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Kunal K. Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY 10029, USA (K.K.S.)
| | - Sonam Sharma
- Department of Radiation Oncology, Summit Health, Berkeley Heights, NJ 07922, USA
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Singh A, Gupta S, Gupta V. Pigment migration into the glaucomatous optic cup after blunt trauma. J Fr Ophtalmol 2024; 47:103939. [PMID: 37730498 DOI: 10.1016/j.jfo.2023.05.021] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/25/2023] [Accepted: 05/18/2023] [Indexed: 09/22/2023]
Affiliation(s)
- A Singh
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
| | - S Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - V Gupta
- Dr. Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
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Singh M, Gupta V, Gupta R, Kumar B, Agrawal D. A Novel Method for Prediction of Raised Intracranial Pressure Through Automated ONSD and ETD Ratio Measurement From Ocular Ultrasound. Ultrason Imaging 2024; 46:29-40. [PMID: 37698256 DOI: 10.1177/01617346231197593] [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] [Subscribe] [Scholar Register] [Indexed: 09/13/2023]
Abstract
The paper presents a novel framework for the prediction of the raised Intracranial Pressure (ICP) from ocular ultrasound images of traumatic patients through automated measurement of Optic Nerve Sheath Diameter (ONSD) and Eyeball Transverse Diameter (ETD). The measurement of ONSD using an ocular ultrasound scan is non-invasive and correlates with the raised ICP. However, the existing studies suggested that the ONSD value alone is insufficient to indicate the ICP condition. Since the ONSD and ETD values may vary among patients belonging to different ethnicity/origins, there is a need for developing an independent global biomarker for predicting raised ICP condition. The proposed work develops an automated framework for the prediction of raised ICP by developing algorithms for the automated measurement of ONSD and ETD values. It is established that the ONSD and ETD ratio (OER) is a potential biomarker for ICP prediction independent of ethnicity and origin. The OER threshold value is determined by performing statistical analysis on the data of 57 trauma patients obtained from the AIIMS, New Delhi. The automated OER is computed and compared with the conventionally measured ICP by determining suitable correlation coefficients. It is found that there is a significant correlation of OER with ICP (r = .81, p ≤ .01), whereas the correlation of ONSD alone with ICP is relatively less (r = .69, p = .004). These correlation values indicate that OER is a better parameter for the prediction of ICP. Further, the threshold value of OER is found to be 0.21 for predicting raised ICP conditions in this study. Scatter plot and Heat map analysis of OER and corresponding ICP reveal that patients with OER ≥ 0.21, have ICP in the range of 17 to 35 mm Hg. In the data available for this research work, OER ranges from 0.17 to 0.35.
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Affiliation(s)
- Maninder Singh
- Electronics and Communication Engineering Department, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, India
| | | | - Rajeev Gupta
- Electronics and Communication Engineering Department, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, India
| | - Basant Kumar
- Electronics and Communication Engineering Department, Motilal Nehru National Institute of Technology Allahabad, Prayagraj, India
| | - Deepak Agrawal
- JPNATC, All India Institute of Medical Sciences, New Delhi, India
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Singh A, Panigrahi A, Gupta V, Gupta S. Vitiligo iridis in primary congenital glaucoma. J Fr Ophtalmol 2024; 47:103960. [PMID: 37777421 DOI: 10.1016/j.jfo.2023.07.011] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2023] [Accepted: 07/28/2023] [Indexed: 10/02/2023]
Affiliation(s)
- A Singh
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), Sri Aurobindo Marg, Ansari Nagar East, New Delhi 110029, India.
| | - A Panigrahi
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), Sri Aurobindo Marg, Ansari Nagar East, New Delhi 110029, India
| | - V Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), Sri Aurobindo Marg, Ansari Nagar East, New Delhi 110029, India
| | - S Gupta
- Dr Rajendra Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences (AIIMS), Sri Aurobindo Marg, Ansari Nagar East, New Delhi 110029, India
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Prakash B, Singh PP, Gupta V, Raghuvanshi TS. Essential oils as green promising alternatives to chemical preservatives for agri-food products: New insight into molecular mechanism, toxicity assessment, and safety profile. Food Chem Toxicol 2024; 183:114241. [PMID: 38013001 DOI: 10.1016/j.fct.2023.114241] [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] [Subscribe] [Scholar Register] [Received: 07/27/2023] [Revised: 10/27/2023] [Accepted: 11/20/2023] [Indexed: 11/29/2023]
Abstract
Microbial food spoilage caused by food-borne bacteria, molds, and associated toxic chemicals significantly alters the nutritional quality of food products and makes them unpalatable to the consumer. In view of potential adverse effects (resistance development, residual toxicity, and negative effects on consumer health) of some of the currently used preservative agents and consumer preferences towards safe, minimally processed, and chemical-free products, food industries are looking for natural alternatives to the chemical preservatives. In this context, essential oils (EOs) showed broad-range antimicrobial effectiveness, low toxicity, and diverse mechanisms of action, and could be considered promising natural plant-based antimicrobials. The existing technical barriers related to the screening of plants, extraction methods, characterization, dose optimization, and unpredicted mechanism of toxicity in the food system, could be overcome using recent scientific and technological advancements, especially bioinformatics, nanotechnology, and mathematical approaches. The review focused on the potential antimicrobial efficacy of EOs against food-borne microbes and the role of recent scientific technology and social networking platform in addressing the major obstacles with EOs-based antimicrobial agents. In addition, a detailed mechanistic understanding of the antimicrobial efficacy of EOs, safety profile, and risk assessment using bioinformatics approaches are summarized to explore their potential application as food preservatives.
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Affiliation(s)
- Bhanu Prakash
- Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India.
| | - Prem Pratap Singh
- Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Vishal Gupta
- Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
| | - Tanya Singh Raghuvanshi
- Department of Botany, Institute of Science, Banaras Hindu University, Varanasi, 221005, India
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16
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Hsieh K, Bloom JR, Dickstein DR, Hsieh C, Marshall D, Ghiassi-Nejad Z, Raince J, Lymberis S, Chadha M, Gupta V. Dose and fractionation regimen for brachytherapy boost in cervical cancer in the US. Gynecol Oncol 2024; 180:55-62. [PMID: 38052109 DOI: 10.1016/j.ygyno.2023.11.014] [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] [Subscribe] [Scholar Register] [Received: 08/28/2023] [Revised: 11/06/2023] [Accepted: 11/12/2023] [Indexed: 12/07/2023]
Abstract
PURPOSE Curative-intent radiotherapy for locally advanced and select early stage cervical cancer in the US includes external beam radiotherapy (EBRT) with brachytherapy. Although there are guidelines for brachytherapy dose and fractionation regimens, there are limited data on practice patterns. This study aims to evaluate the contemporary utilization of cervical cancer brachytherapy in the US and its association with patient demographics and facility characteristics. METHODS We retrospectively analyzed clinical covariates of cervical cancer patients diagnosed and treated in 2018-2020 with curative-intent radiotherapy from the 2020 National Cancer Database. Associations between patient and institutional factors with the number of brachytherapy fractions were identified with logistic regression. Factors with association (p < 0.10) were then included in a multivariable logistic regression model. All tests were two-sided with significance <0.05 unless specified otherwise. RESULTS Among the eligible 2517 patients, 97.3% received HDR or LDR and is further analyzed. More patients received HDR than LDR brachytherapy (98.9% vs 1.1%) and intracavitary than interstitial brachytherapy (86.4% vs 13.6%). The most common number of HDR fractions prescribed were 5 (51.0%), 4 (32.9%), and 3 (8.6%). After adjusting for the other variables in the model, ethnicity, private insurance status, overall insurance status, and facility type were the only factors that were significantly associated with the number of brachytherapy factions (p < 0.0001, p = 0.028, p = 0.001, and p < 0.0001, respectively, n = 2184). CONCLUSIONS In the US, various HDR brachytherapy regimens are utilized depending on patient and institutional factors. Future research may optimize cervical cancer brachytherapy by correlating specific dose and fractionation regimens with patient outcomes.
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Affiliation(s)
- Kristin Hsieh
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Julie R Bloom
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Daniel R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Celina Hsieh
- Department of Diagnostic Imaging, Warren Alpert Medical School of Brown University, Providence, RI, United States of America
| | - Deborah Marshall
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Zahra Ghiassi-Nejad
- Department of Radiation Oncology, Columbia University Medical Center, New York, NY, United States of America
| | - Jagdeep Raince
- Department of Radiation Oncology, New York University Langone Health, New York, NY, United States of America
| | - Stella Lymberis
- Department of Radiation Oncology, New York University Langone Health, New York, NY, United States of America
| | - Manjeet Chadha
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America
| | - Vishal Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY, United States of America.
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Jayaswal P, Ilyas M, Singh K, Kumar S, Sisodiya L, Jain S, Mahlawat R, Sharma N, Gupta V, Atmakuri K. Enrichment of Native and Recombinant Extracellular Vesicles of Mycobacteria. J Vis Exp 2023. [PMID: 38145372 DOI: 10.3791/65138] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/26/2023] Open
Abstract
Most bacteria, including mycobacteria, generate extracellular vesicles (EVs). Since bacterial EVs (bEVs) contain a subset of cellular components, including metabolites, lipids, proteins, and nucleic acids, several groups have evaluated either the native or recombinant versions of bEVs for their protective potency as subunit vaccine candidates. Unlike native EVs, recombinant EVs are molecularly engineered to contain one or more immunogens of interest. Over the last decade, different groups have explored diverse approaches for generating recombinant bEVs. However, here, we report the design, construction, and enrichment of recombinant mycobacterial EVs (mEVs) in mycobacteria. Towards that, we use Mycobacterium smegmatis (Msm), an avirulent soil mycobacterium as the model system. We first describe the generation and enrichment of native EVs of Msm. Then, we describe the design and construction of recombinant mEVs that contain either mCherry, a red fluorescent reporter protein, or EsxA (Esat-6), a prominent immunogen of Mycobacterium tuberculosis. We achieve this by separately fusing mCherry and EsxA N-termini with the C-terminus of a small Msm protein Cfp-29. Cfp-29 is one of the few abundantly present proteins of MsmEVs. The protocol to generate and enrich recombinant mEVs from Msm remains identical to the generation and enrichment of native EVs of Msm.
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Affiliation(s)
- Praapti Jayaswal
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Mohd Ilyas
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Kuljit Singh
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster; Clinical Microbiology Division, CSIR-Indian Institute of Integrative Medicine
| | - Saurabh Kumar
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster; ICAR-Research Complex for Eastern Region
| | - Lovely Sisodiya
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Sapna Jain
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Rahul Mahlawat
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Nishant Sharma
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Vishal Gupta
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster
| | - Krishnamohan Atmakuri
- Bacterial Pathogenesis Laboratory, Infectious Diseases and Immunology Group, Translational Health Science and Technology Institute, NCR Biotech Science Cluster;
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18
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Sood A, Kalavakunta JK, Gourineni V, Gupta V. WATCHMEN: a case report highlighting the closure of a bilobed left atrial appendage using two WATCHMAN-FLX devices. Eur Heart J Case Rep 2023; 7:ytad607. [PMID: 38093820 PMCID: PMC10716089 DOI: 10.1093/ehjcr/ytad607] [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: 06/28/2023] [Revised: 11/20/2023] [Accepted: 11/24/2023] [Indexed: 03/07/2024]
Abstract
Background Left atrial appendage occlusion (LAAO) performed percutaneously has emerged as a widely accepted method for stroke prevention, offering a viable alternative to anticoagulation. Numerous studies have demonstrated the effectiveness and safety of this procedure. However, in certain cases, the use of a single LAAO device may not adequately achieve optimal closure due to variations in the anatomy of the left atrial appendage (LAA). Case summary In this manuscript, we highlight the successful closure of a bilobed LAA with a large ostium utilizing two WATCHMAN™ FLX devices and using the double sheath technique. The aim was to achieve optimal closure and address the unique anatomical characteristics of the patient's LAA. Discussion The utilization of two LAAO devices in bilobed appendage anatomy, where a single device may not be sufficient, is possible, although it poses a challenge because of the lack of technical expertise and limited published evidence. Transoesophageal imaging can serve as a valuable tool for assessing the precise anatomy of the LAA and guide the selection and placement of the occlusion devices.
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Affiliation(s)
- Abhinav Sood
- Department of Interventional Cardiology, Ascension Borgess Hospital, GOC 331, 1521 Gull Road, Kalamazoo, MI 49048, USA
| | - Jagadeesh K Kalavakunta
- Department of Interventional Cardiology, Ascension Borgess Hospital, GOC 331, 1521 Gull Road, Kalamazoo, MI 49048, USA
| | - Venu Gourineni
- Department of Cardiology, Ascension Borgess Hospital, Kalamazoo, MI, USA
| | - Vishal Gupta
- Department of Interventional Cardiology, Ascension Borgess Hospital, GOC 331, 1521 Gull Road, Kalamazoo, MI 49048, USA
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Ahuja R, Patel V, Mallick S, Damle N, Sharma A, Gupta V. Anaplastic Lymphoma Kinase (ALK)-negative systemic anaplastic large cell lymphoma presenting as zosteriform skin nodules. Indian J Dermatol Venereol Leprol 2023; 0:1-5. [PMID: 38031677 DOI: 10.25259/ijdvl_1166_2022] [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: 12/29/2022] [Accepted: 09/17/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Rhea Ahuja
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | - Varniraj Patel
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
| | | | | | - Atul Sharma
- Department of Medical Oncology, AIIMS, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, AIIMS, New Delhi, India
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20
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Sharma S, Pahuja S, Gupta V, Singh G, Singh J. 3D printing for spine pathologies: a state-of-the-art review. Biomed Eng Lett 2023; 13:579-589. [PMID: 37872993 PMCID: PMC10590361 DOI: 10.1007/s13534-023-00302-x] [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: 01/27/2023] [Revised: 06/29/2023] [Accepted: 06/29/2023] [Indexed: 10/25/2023] Open
Abstract
Three-Dimensional Printing has advanced throughout the years in the field of biomedical science with applications, especially in spine surgeries. 3D printing has the ability of fabricating highly complex structures with ease and high dimensional accuracy. The complexity of the spine's architecture and the inherent dangers of spinal surgery bring the evaluation of 3D printed models into consideration. This article summarizes the benefits of 3D printing based models for application in spine pathology. 3D printing technique is extensively used for fabrication of anatomical models, surgical guides and patient specific implants (PSI). The 3D printing based anatomical models assist in preoperative planning and training of students. Furthermore, 3D printed models can be used for improved communication and understanding of patients about the spinal disorders. The use of 3D printed surgical guides help in the stabilization of the spine during surgery, improving post procedural outcomes. Improved surgical results can be achieved by using PSIs that are tailored for patient specific needs. Finally, this review discusses the limitations and potential future scope of 3D printing in spine pathologies. 3D printing is still in its infancy, and further research would provide better understanding of the technology's true potential in spinal procedures.
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Affiliation(s)
- Shrutika Sharma
- Department of Mechanical Engineering, Thapar Institute of Engineering and Technology, Patiala, Punjab 147004 India
| | - Sanchita Pahuja
- Biomedical Engineering, Thapar Institute of Engineering and Technology, Patiala, Punjab 147004 India
| | - Vishal Gupta
- Department of Mechanical Engineering, Thapar Institute of Engineering and Technology, Patiala, Punjab 147004 India
| | - Gyanendra Singh
- Physical Sciences, Inter University Centre for Teacher Education, Varanasi, 221005 India
| | - Jaskaran Singh
- Department of Mechanical Engineering, Thapar Institute of Engineering and Technology, Patiala, Punjab 147004 India
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Bhatia R, Gupta V. Exploring filaggrin gene polymorphisms in Indian children with atopic dermatitis: Hitherto an unchartered territory. Indian J Dermatol Venereol Leprol 2023; 89:795-796. [PMID: 37933961 DOI: 10.25259/ijdvl_1055_2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2023] [Accepted: 10/07/2023] [Indexed: 11/08/2023]
Affiliation(s)
- Riti Bhatia
- Department of Dermatology, AIIMS, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology, AIIMS, New Delhi, India
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22
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Swarnkar B, Sharma A, Gupta V, Ramam M, Khanna N. Traditional versus e-learning during COVID-19 pandemic: An online survey on dermatology postgraduate teaching. Indian J Dermatol Venereol Leprol 2023; 0:1-3. [PMID: 38031676 DOI: 10.25259/ijdvl_1172_2022] [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: 12/31/2022] [Accepted: 07/10/2023] [Indexed: 12/01/2023]
Affiliation(s)
| | | | - Vishal Gupta
- Department of Dermatology, AIIMS, New Delhi, India
| | - M Ramam
- Department of Dermatology, AIIMS, New Delhi, India
| | - Neena Khanna
- Department of Dermatology, Amrita Hospital, Faridabad, Haryana, India
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23
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Mehta N, Danish Khan M, Gupta V. Spontaneous ecchymoses and conjunctival deposits in primary systemic amyloidosis. Indian J Dermatol Venereol Leprol 2023; 0:1-2. [PMID: 38031688 DOI: 10.25259/ijdvl_427_2023] [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: 04/22/2023] [Accepted: 09/12/2023] [Indexed: 12/01/2023]
Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Mohammad Danish Khan
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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24
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Rayn K, Gupta V, Mulinti S, Clark R, Magliari A, Chaudhari S, Gokhroo G, Beriwal S. Evaluation of a Deep Image to Image Network (DI2IN) Auto-Segmentation Algorithm across a Network of Cancer Centers. Int J Radiat Oncol Biol Phys 2023; 117:e711. [PMID: 37786081 DOI: 10.1016/j.ijrobp.2023.06.2209] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Due to manual OAR contouring challenges, various automatic contouring solutions have been introduced. Historically, common clinical auto-segmentation algorithms used were atlas based, which required maintaining a library of self-made contours. Searching the collection was computationally intensive and could take several minutes to complete. Deep learning approaches have shown significant benefits compared to atlas-based methods in improving segmentation accuracy and efficiency in auto-segmentation algorithms. This work represents the first multi-institutional study to describe and evaluate an AI algorithm for auto-segmentation of organs at risk (OARs) based on a deep image-to-image network (DI2IN). MATERIALS/METHODS The AI-Rad Companion Organs RT (AIRC) algorithm (Siemens Healthineers, Erlangen, Germany) uses a two-step approach for segmentation. In the first step, the target organ region in the optimal input image is extracted using a trained Deep Reinforcement Learning network (DRL), which is then used as input to create the contours in the second step based on DI2IN. The study was initially designed as a prospective single-center evaluation. The automated contours generated by AIRC were evaluated by three experienced board-certified radiation oncologists using a 4-point scale where 4 is clinically usable and 1 requires re-contouring. After seeing favorable results in a single-center pilot study, we decided to expand the study to 6 additional institutions, encompassing 8 additional evaluators for a total of 11 physician evaluators across 7 institutions. RESULTS One hundred fifty-six patients and 1366 contours were prospectively evaluated. The 5 most commonly contoured organs were the lung (136 contours, average rating = 4.0), spinal cord (106 contours, average rating = 3.1), eye globe (80 contours, average rating = 3.9), lens (77 contours, average rating = 3.9), and optic nerve (75 contours, average rating = 4.0). The average rating per evaluator per contour was 3.6. On average 124 contours were evaluated by each evaluator. 65% of the contours were rated as 4 and 31% were rated as 3. Only 4% of contours were rated as 1 or 2. 33 organs were evaluated in the study, with 19 structures having a 3.5 or above average rating (ribs, abdominopelvic cavity, skeleton, larynx, lung, aorta, brachial plexus, lens, eye globe, glottis, heart, parotid glands, bladder, kidneys, supraglottic larynx, submandibular glands, esophagus, optic nerve, oral cavity) and the remaining organs having a rating of 3.0 or greater (female breast, proximal femur, seminal vesicles, rectum, sternum, brainstem, prostate, brain, lips, mandible, liver, optic chiasm, spinal cord, spleen). No organ had an average rating below 3. CONCLUSION AIRC performed well with greater than 95% of contours accepted by treating physicians with no or minor edits. It supported a fully automated workflow with the potential for time savings and increased standardization with the use of AI-powered algorithms for high quality OAR contouring.
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Affiliation(s)
- K Rayn
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY; Varian Medical Systems Inc, Palo Alto, CA
| | - V Gupta
- American Oncology Institute, Hyderabad, India
| | - S Mulinti
- American Oncology Institute, Hyderabad, India
| | - R Clark
- Varian Medical Systems Inc, Palo Alto, CA
| | - A Magliari
- Varian Medical Systems Inc, Palo Alto, CA
| | - S Chaudhari
- American Oncology Institute, Hyderabad, India
| | - G Gokhroo
- American Oncology Institute, Hyderabad, CA, India
| | - S Beriwal
- Varian Medical Systems Inc, Palo Alto, CA; Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
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Rayn K, Gokhroo G, Gupta V, Chaudhari S, Clark R, Magliari A, Beriwal S. Pelvic Nodal Auto-Segmentation Using a Deep Image to Image Network (DI2IN) Auto-Segmentation Algorithm: Comparing Male vs. Female Pelvis. Int J Radiat Oncol Biol Phys 2023; 117:e710-e711. [PMID: 37786079 DOI: 10.1016/j.ijrobp.2023.06.2208] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Deep Learning approaches have shown significant benefits compared to atlas-based methods in improving segmentation accuracy and efficiency in auto-segmentation algorithms. The AI-Rad Companion Organs RT pelvic nodal auto-segmentation feature was trained and developed for use in the male pelvis. There is no real-world data on its usability in male pelvis and whether it can be used for female pelvic nodal anatomy. This work represents the first multi-institutional study to describe and evaluate an AI algorithm for auto-segmentation of the pelvic nodal region in female patients based on a deep image-to-image network (DI2IN). MATERIALS/METHODS The AIRC algorithm uses a two-step approach for segmentation. In the first step, the target organ region in the optimal input image is extracted using a trained Deep Reinforcement Learning network (DRL), which is then used as input to create the contours in the second step based on DI2IN. We retrospectively evaluated AIRC pelvic nodal auto-segmentation in both male and female patients treated at our network of institutions. The automated pelvic nodal contours generated by AIRC were evaluated by one board-certified radiation oncologist, specializing in prostate and gynecologic malignancies. A 4-point scale was used, where 4 is clinically usable and 1 requires re-contouring. Pelvic nodal regions included the right and left side of the common iliac, external iliac, internal iliac, obturator and midline presacral nodes. A chi-squared test was then used to compare the scores of male and female pelvic nodal cases. RESULTS Fifty-two female and 51 male patients were included in the study, representing a total of 468 and 447 pelvic nodal regions, respectively. 96% (450 pelvic nodal contours) and 99% (443 pelvic nodal contours) required no or minor edits for female and male patients, respectively (p = 0.004). The right internal iliac was the only nodal group with a statistically significant difference between female (92% requiring no or minor edits) and male (100% requiring no or minimal edits) patients, p = 0.04. The percentage of patients requiring no, or minor edits was 87% (45 patients) and 92% (47 patients) for female and male patients, respectively (p = 0.36). CONCLUSION AIRC pelvic nodal auto-segmentation performed very well in both male and female pelvic nodal regions, with the male pelvic nodal regions performing better especially in the right internal iliac nodal group. It is usable in female pelvic nodal regions, with 96% of contours requiring no or minor edits. As auto-segmentation becomes more widespread, it may be important to have equal representation from all genders in training and validation of auto-segmentation algorithms.
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Affiliation(s)
- K Rayn
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY; Varian Medical Systems Inc, Palo Alto, CA
| | - G Gokhroo
- American Oncology Institute, Hyderabad, CA, India
| | - V Gupta
- American Oncology Institute, Hyderabad, India
| | - S Chaudhari
- American Oncology Institute, Hyderabad, India
| | - R Clark
- Varian Medical Systems Inc, Palo Alto, CA
| | - A Magliari
- Varian Medical Systems Inc, Palo Alto, CA
| | - S Beriwal
- Varian Medical Systems Inc, Palo Alto, CA; Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
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Dickstein DR, Lehrer EJ, Bloom JR, Hsieh K, Jones B, Runnels J, Powers A, Barlow J, Chen S, Monrose E, Sindhu K, Factor O, Liu JT, Gupta V, Roof S, Kirke D, Misiukiewicz K, Posner M, Genden E, Bakst RL. Is 80 the New 70? Octogenarians with Oropharyngeal Squamous Cell Carcinoma. Int J Radiat Oncol Biol Phys 2023; 117:e577-e578. [PMID: 37785756 DOI: 10.1016/j.ijrobp.2023.06.1915] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As the human papilloma virus (HPV) pandemic evolves and life expectancy increases, the number of older adults with oropharyngeal squamous cell carcinoma (OPSCC) continues to increase. However, there is a paucity of data regarding the fastest growing subset of this population: octogenarians (OGs). We sought to understand differences in treatment tolerability and clinical outcomes between septuagenarians (SGs) and OGs with OPSCC. MATERIALS/METHODS We identified SGs (age 70-79) and OGs (age 80-89) with OPSCC from a cohort of older adults with nonrecurrent, nonmetastatic head and neck squamous cell carcinoma (HNSCC) treated curatively from 2007-2020. We compared demographics, treatment characteristics and toxicities using Fischer's exact test. Time-to-event outcomes, overall survival (OS), locoregional control (LRC), and disease-specific survival (DSS), were evaluated using the Kaplan-Meier method. RESULTS Of 293 patients (age 70-89) with HNSCC, 39% (n = 114) had OPSCC: 93 SGs (median age: 73; interquartile range [IQR]: 71-76), and 21 OGs (median age: 81, IQR: 80-84). The median follow-up for included patients was 2.4 years; 82% were male, 64% white, 48% > 20 pack year smoking history, 37% ECOG 1. Patients had AJCC 8th edition Stage: I (27%); II (33%); III (18%); IV (22%) OPSCC. Treatment consisted of adjuvant radiation (RT) (19%), adjuvant chemoradiation (CRT) (8%), surgery alone (6%), induction/concurrent CRT (27%), concurrent CRT (28%), or RT (12%), with no significant differences in stage or treatment modalities noted between SGs and OGs. Of note, 69% of SGs and 76% of OGs were HPV+. Among 107 patients who received any RT, 24% experienced a treatment interruption (19% of SGs vs. 48% of OGs, p = 0.001) and 2 patients (both HPV- SGs) died on treatment due to unrelated health conditions. Percutaneous endoscopic gastrostomy (PEG) tubes were placed prior to or during treatment in 43% of SGs and 62% of OGs, with OGs more likely to have a PEG placed during treatment (p = 0.025). There was no difference in the prevalence of late (> 6 months) CTCAE grade 2+ dysphagia (36%) or xerostomia (31%) between SGs and OGs. Estimated 3-year LRC, DSS, and OS were not significantly different between SGs (LRC:85%; DSS:87%; OS:76%) and OGs (LRC: 81%; DSS:94%; OS: 55%, p-values: 0.98, 0.42, 0.052, respectively). However, HPV+ disease significantly increased estimated 3-year OS for both SGs (HPV+: 84%; HPV-: 56%, p = 0.0006) and OGs (HPV+: 68%; HPV-: 20%, p = 0.008). CONCLUSION In our cohort, OGs had a higher proportion of HPV+ OPSCC, which was associated with improved OS. This finding may provide insight into the latency of the virus. While there were similar amounts of toxicities among SGs and OGs, OGs more frequently underwent PEG tube placement and experienced more treatment interruptions. Given high rates of HPV+ OPSCC in OGs, our findings suggest that de-escalation strategies should be further investigated to improve tolerability and maximize outcomes for this neglected population.
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Affiliation(s)
- D R Dickstein
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E J Lehrer
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J R Bloom
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Hsieh
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - B Jones
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Runnels
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - A Powers
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J Barlow
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Chen
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E Monrose
- Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Sindhu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - O Factor
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - J T Liu
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - V Gupta
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - S Roof
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - D Kirke
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - K Misiukiewicz
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - M Posner
- Department of Hematology and Medical Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
| | - E Genden
- Department of Otolaryngology, Head & Neck Surgery, Icahn School of Medicine at Mount Sinai, New York, NY
| | - R L Bakst
- Department of Radiation Oncology, Icahn School of Medicine at Mount Sinai, New York, NY
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Sidhu M, Gokhroo G, Mulinti S, Patil MB, Murali M, Gupta V, Chaudhari S, Rayn K, Beriwal S. Pilot Study of Peer Review in Low Middle-Income Country (LMIC) through Cloud-Based Platform. Int J Radiat Oncol Biol Phys 2023; 117:e437. [PMID: 37785421 DOI: 10.1016/j.ijrobp.2023.06.1610] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Peer review is an essential step in clinical quality assurance and can impact patient safety and treatment outcomes. Most published data on peer review is from developed nations, with little data on peer review from low middle income countries (LMIC). Major challenges to peer review can include a lack of time, expertise and commitment from team members. With increasing access to advanced technology in LMIC, peer review is becoming more important to maintain quality and standard of care. We evaluated cloud-based e- peer review (Varian) in our network of hospitals in India with an aim to see feasibility and impact on care. MATERIALS/METHODS Four of 15 centers across India were selected for this pilot study. All team members were trained on the platform prior to implementation. New cases for the week treated with definitive intent were selected by the dosimetrist. The link to the cases were sent through email to reviewing physicians. Various aspects which were reviewed for each case were.1) Work up & staging (Documents were scanned and loaded).2) Treatment intent & prescription.3) Target contours.4) Normal Organ at risk contours.5) Dose- Volume -Histogram (DVH) with clinical goals attached. Cases were marked as "Not Appropriate", "Appropriate", "Appropriate with minor finding", "Represent with major revisions" as per volume and plan review. RESULTS Over a period of 2 months, a total of 80 cases underwent e-Peer Review at our network of hospitals prior to the start of treatment. Median turnover time (like from link sent to time to completion of review) was 48 (6-360) hours. Mean time taken by physician for review was 9 minutes (range 3 to15). 31.2% of cases were accepted without any changes, 51.9 % had a minor change and 16.9 % cases had major changes. Most frequent reason of major changes was contouring corrections 16.9%. 31% of major changes underwent recontouring and replanning before initiation of treatment. CONCLUSION Peer review was feasible in our network through this e-peer review system, with average turnover time and mean time taken for review of 48 hours & 9 min respectively. Peer review led to significant changes which could impact patient care delivery and outcome. The ability to review cases asynchronously via this cloud-based e-peer review system, helped to ease the burden of scheduling between treating and reviewing physician. We plan to implement this across the remaining centers in our network.
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Affiliation(s)
- M Sidhu
- American Oncology Institute- DMC Care Center, Ludhiana, India
| | - G Gokhroo
- American Oncology Institute, Hyderabad, CA, India
| | - S Mulinti
- American Oncology Institute, Hyderabad, India
| | - M B Patil
- American Oncology Institute, Nagpur, India
| | - M Murali
- American Oncology Institute, Calicut, India
| | - V Gupta
- American Oncology Institute, Hyderabad, India
| | - S Chaudhari
- American Oncology Institute, Hyderabad, India
| | - K Rayn
- Department of Radiation Oncology, Columbia University Irving Medical Center, New York, NY
| | - S Beriwal
- Allegheny Health Network Cancer Institute, Department of Radiation Oncology, Pittsburgh, PA
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Panigrahi A, Singh A, Gupta V. Acquired anterior pyramidal cataract: A surgical misadventure. J Fr Ophtalmol 2023; 46:983-984. [PMID: 37100715 DOI: 10.1016/j.jfo.2023.01.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2022] [Accepted: 01/05/2023] [Indexed: 04/28/2023]
Affiliation(s)
- A Panigrahi
- Doctor Rajendra-Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - A Singh
- Doctor Rajendra-Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
| | - V Gupta
- Doctor Rajendra-Prasad Centre for Ophthalmic Sciences, All India Institute of Medical Sciences, New Delhi, India.
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Gupta N, Singh R, Gupta V, Jain DP, Das M. Identification of plastic rice in adulterated raw and cooked rice. Toxicol Mech Methods 2023; 33:584-589. [PMID: 37032459 DOI: 10.1080/15376516.2023.2197490] [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] [Subscribe] [Scholar Register] [Received: 01/29/2023] [Revised: 03/24/2023] [Accepted: 03/25/2023] [Indexed: 04/11/2023]
Abstract
In the present study, attempts have been made to identify the presence of plastic rice in adulterated raw and cooked rice by comparing the compositional and morphological properties of fake rice and real rice using Fourier transform infrared spectroscopy (FTIR), scanning electron microscopy (SEM) and thermogravimetric analysis (TGA) techniques. Various rice samples from the national capital region of India were studied for their compositional and morphological properties. The surface morphology of real rice and plastic rice was analyzed using scanning electron microscopy. Results suggest that plastic rice used as an adulterant in raw or cooked rice is made up of polystyrene, which is a well-known toxic chemical entity. The studies suggest that these techniques can be used as a scientific tool to detect and identify the presence of plastic rice in adulterated raw and cooked rice.
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Affiliation(s)
- Nidhi Gupta
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Ruchi Singh
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Vishal Gupta
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Dharam Pal Jain
- Shriram Institute for Industrial Research Delhi, Delhi, India
| | - Mukul Das
- Shriram Institute for Industrial Research Delhi, Delhi, India
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Ahuja R, Garg S, Barwad A, Subbiah A, Gupta V. Recurrent erythema nodosum leprosum leading to secondary renal amyloidosis and nephrotic syndrome in an Indian patient with lepromatous leprosy. Int J Dermatol 2023; 62:e514-e517. [PMID: 37066445 DOI: 10.1111/ijd.16693] [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: 12/15/2022] [Revised: 03/14/2023] [Accepted: 04/03/2023] [Indexed: 04/18/2023]
Affiliation(s)
- Rhea Ahuja
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Shivangi Garg
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Adarsh Barwad
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Arunkumar Subbiah
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Departments of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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31
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Banga S, Abela GS, Saltiel F, Fischell T, Kalavakunta JK, Sood A, Jolly G, Najib K, Al-Ali H, Qintar M, Bazil J, Singh Y, Gupta V. Management of Atrial Fibrillation Post Transcatheter Aortic Valve Implantation. Am J Cardiol 2023; 200:171-177. [PMID: 37329837 DOI: 10.1016/j.amjcard.2023.05.024] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/01/2023] [Revised: 05/01/2023] [Accepted: 05/16/2023] [Indexed: 06/19/2023]
Abstract
Atrial fibrillation (AF) is a common complication in patients who underwent transcatheter aortic valve implantation. Some of these patients have preexisting AF as well. The management of these patients is complex, especially after the procedure, when there is a sudden change in hemodynamics. There are no established guidelines about the management of the patients who underwent transcatheter aortic valve replacement with preexisting or new-onset AF. This review article discusses the management of these patients with rate and rhythm control strategies with medications. This article also highlights the role of newer oral anticoagulation medications and left atrial occlusion devices to prevent stroke after the procedure. We will also discuss new advances in the care of this patient population to prevent the occurrence of AF after transcatheter aortic valve implantation. In conclusion, this article is a synopsis of both pharmacologic and device interventions for the management of AF in patients who underwent transcatheter aortic valve replacement.
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Affiliation(s)
- Sandeep Banga
- Department of Cardiology, Sparrow Hospital, Michigan State University, Lansing, Michigan.
| | - George S Abela
- Department of Cardiology, Sparrow Hospital, Michigan State University, Lansing, Michigan
| | - Frank Saltiel
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
| | - Tim Fischell
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
| | - Jagadeesh K Kalavakunta
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
| | - Abhinav Sood
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
| | - George Jolly
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
| | - Khalid Najib
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
| | - Haya Al-Ali
- Department of Physiology, Michigan State University, Lansing, Michigan
| | - Mohammed Qintar
- Department of Cardiology, Sparrow Hospital, Michigan State University, Lansing, Michigan
| | - Jason Bazil
- Department of Physiology, Michigan State University, Lansing, Michigan
| | - Yashbir Singh
- Department of Radiology, Mayo Clinic, Rochester, Minnesota
| | - Vishal Gupta
- Department of Cardiology, Ascension Borgess Hospital, Western Michigan University, Homer Stryker M.D. School of Medicine, Michigan State University, Kalamazoo, Michigan
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Mehta N, Manandhar K, Arava S, Gupta V. Symmetric plaques on the inguinoscrotal folds: An unusual pattern of lichen sclerosus post-penile amputation and perineal urethrostomy. Indian J Dermatol Venereol Leprol 2023; 0:1-2. [PMID: 37609742 DOI: 10.25259/ijdvl_443_2023] [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: 04/26/2023] [Accepted: 06/12/2023] [Indexed: 08/24/2023]
Affiliation(s)
- Nikhil Mehta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Delhi, India
| | - Keepa Manandhar
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Delhi, India
| | - Sudheer Arava
- Department of Pathology, All India Institute of Medical Sciences, Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, Delhi, India
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Kassier A, Soni R, Kassab K, Kumar D, Agrawal Y, Kotaru VP, Saltiel F, Gupta V, Kalavakunta J, Fischell TA. Real world single center experience with saphenous vein grafts interventions: should filters be filtered out? J Invasive Cardiol 2023; 35:398-414. [PMID: 37769613] [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] [Subscribe] [Scholar Register] [Indexed: 09/30/2023]
Abstract
BACKGROUND Percutaneous coronary intervention (PCI) of saphenous vein grafts (SVG) can be challenging due to no reflow phenomenon from distal embolization of debris and microvascular vasoconstriction, resulting in myocardial injury post-procedure. Guidelines promote the use of distal embolic protection devices (EPD) to protect the distal arterial bed during SVG PCI. However, this approach has shown less-than-optimal results in many studies. We report our data using the Borgess protocol [prophylactic intracoronary (IC) nicardipine injection and direct stenting], as an alternative to EPDs in a large series of SVG interventions. METHODS This is a retrospective, cohort study of our single center experience with SVG interventions between 2017 and 2021. The primary outcome of the study was major adverse cardiovascular events (MACE) [a composite of death, emergent coronary artery bypass graft surgery (CABG), myocardial infarction (MI), and target vessel revascularization (TVR)] at 30 days post-procedure. RESULTS There were 424 consecutive SVG interventions performed during the study period, and 76% of cases presented with acute coronary syndrome. Full adherence to the Borgess protocol was observed in 36% of cases; IC nicardipine was utilized in 72% of cases. MACE rate was 3.5% at 30 days driven primarily by MI (2.6%). CONCLUSION The Borgess protocol approach to vein graft interventions proved good outcomes when compared to SVG PCI in randomized trials utilizing EPDs. Our study is limited by the retrospective nature and single center experience.
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Affiliation(s)
- Adman Kassier
- Ascension Borgess Hospital, Michigan State University and Western Michigan University, 1521 Gull Rd, GOC 327, Kalamazoo, MI 49048.
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Sharma S, Mudgal D, Gupta V. Advancement in biological and mechanical behavior of 3D printed poly lactic acid bone plates using polydopamine coating: Innovation for healthcare. J Mech Behav Biomed Mater 2023; 143:105929. [PMID: 37263171 DOI: 10.1016/j.jmbbm.2023.105929] [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] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Revised: 05/20/2023] [Accepted: 05/21/2023] [Indexed: 06/03/2023]
Abstract
The metallic biomaterials have been proclaimed to exhibit stress shielding with discharge of toxic ions, leading to polymeric implants attracting interest in 3D Printing domain. In this study, Poly Lactic Acid based 336 bone plates are fabricated using Fused Filament Fabrication with printing parameters being varied. Polydopamine, being biocompatible, is deposited on fabricated bone plates at varying submersion time, shaker speed and coating solutions concentration. The study involves witnessing the effect of printing and coating parameters on biological behavior of bone plates upon preservation in Simulated Body Fluid and Hank's Balanced Salt Solution. The findings propose the close relation of degradation with apatite growth. The highest degradation rate with significant reduction in mechanical characteristics are shown by uncoated bone plates. These bone plates have porous structure at 20% infill density, 0.5 mm layer height, 0.4 mm wall thickness and 100 mm/s print speed which could result in complete degradation with partial healing of bone fracture. The study suggests the preservation of bone plates coated at 120 h' submersion time and 120 RPM shaker speed in 3 mg/ml concentrated solution which showed lower apatite formation. Thus, the coating would slow down degradation of PLA bone plates, resulting in complete healing of bone fracture.
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Affiliation(s)
- Shrutika Sharma
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology, Patiala, 147004, Punjab, India
| | - Deepa Mudgal
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology, Patiala, 147004, Punjab, India
| | - Vishal Gupta
- Mechanical Engineering Department, Thapar Institute of Engineering and Technology, Patiala, 147004, Punjab, India.
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Wintermark M, Gupta V, Hess C, Lee R, Maldjian J, Mukherjee S, Mukherji S, Seidenwurm D, Kennedy T. Realistic Productivity in Academic Neuroradiology: A National Survey of Neuroradiology Division Chiefs. AJNR Am J Neuroradiol 2023:ajnr.A7912. [PMID: 37348969 PMCID: PMC10337619 DOI: 10.3174/ajnr.a7912] [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: 04/27/2023] [Accepted: 05/08/2023] [Indexed: 06/24/2023]
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Yu B, Ma SJ, Khan M, Gill J, Iovoli A, Fekrmandi F, Farrugia MK, Wooten K, Gupta V, McSpadden R, Kuriakose MA, Markiewicz MR, Al-Afif A, Hicks WL, Seshadri M, Ray AD, Repasky EA, Singh AK. Association of pre-treatment lymphocyte-monocyte ratio with survival outcome in patients with head and neck cancer treated with chemoradiation. BMC Cancer 2023; 23:572. [PMID: 37344761 DOI: 10.1186/s12885-023-11062-3] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2023] [Accepted: 06/13/2023] [Indexed: 06/23/2023] Open
Abstract
BACKGROUND Given the role of systematic inflammation in cancer progression, lymphocyte-monocyte ratio (LMR) from peripheral blood has been suggested as a biomarker to assess the extent of inflammation in several solid malignancies. However, the role of LMR as a prognostic factor in head and neck cancer was unclear in several meta-analyses, and there is a paucity of literature including patients in North America. We performed an observational cohort study to evaluate the association of LMR with survival outcomes in North American patients with head and neck cancer. METHODS A single-institution, retrospective database was queried for patients with non-metastatic head and neck cancer who underwent definitive chemoradiation from June 2007 to April 2021 at the Roswell Park Comprehensive Cancer Center. Primary endpoints were overall survival (OS) and cancer-specific survival (CSS). The association of LMR with OS and CSS was examined using nonlinear Cox proportional hazard model using restricted cubic splines (RCS). Cox multivariable analysis (MVA) and Kaplan-Meier method were used to analyze OS and CSS. Pre-radiation LMR was then stratified into high and low based on its median value. Propensity scored matching was used to reduce the selection bias. RESULTS A total of 476 patients met our criteria. Median follow up was 45.3 months (interquartile range 22.8-74.0). The nonlinear Cox regression model showed that low LMR was associated with worse OS and CSS in a continuous fashion without plateau for both OS and CSS. On Cox MVA, higher LMR as a continuous variable was associated with improved OS (adjusted hazard ratio [aHR] 0,90, 95% confidence interval [CI] 0.82-0.99, p = 0.03) and CSS (aHR 0.83, 95% CI 0.72-0.95, p = 0.009). The median value of LMR was 3.8. After propensity score matching, a total of 186 pairs were matched. Lower LMR than 3.8 remained to be associated with worse OS (HR 1.59, 95% CI 1.12-2.26, p = 0.009) and CSS (HR 1.68, 95% CI 1.08-2.63, p = 0.02). CONCLUSION Low LMR, both as a continuous variable and dichotomized variable, was associated with worse OS and CSS. Further studies would be warranted to evaluate the role of such prognostic marker to tailor interventions.
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Affiliation(s)
- Brian Yu
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Sung Jun Ma
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Michael Khan
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Jasmin Gill
- University at Buffalo, The State University of New York, 12 Capen Hall, Buffalo, NY, 14260, USA
| | - Austin Iovoli
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Fatemeh Fekrmandi
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Mark K Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Kimberly Wooten
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Vishal Gupta
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Ryan McSpadden
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Moni A Kuriakose
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, 3435 Main Street, Buffalo, NY, 14214, USA
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, 955 Main Street, Buffalo, NY, 14203, USA
| | - Ayham Al-Afif
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Wesley L Hicks
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Mukund Seshadri
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Andrew D Ray
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Elizabeth A Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA
| | - Anurag K Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, 665 Elm Street, Buffalo, NY, 14203, USA.
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Datta A, Suthar P, Sarmah D, Jadhav P, Shah J, Katamneni M, Bhosale N, Gupta V, Bohra M, Baidya F, Rana N, Ghosh B, Kaur H, Borah A, Rathod R, Sengupta P, Bhattacharya P. Inosine attenuates post-stroke neuroinflammation by modulating inflammasome mediated microglial activation and polarization. Biochim Biophys Acta Mol Basis Dis 2023:166771. [PMID: 37286144 DOI: 10.1016/j.bbadis.2023.166771] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/03/2023] [Revised: 05/22/2023] [Accepted: 05/29/2023] [Indexed: 06/09/2023]
Abstract
To date, various agents and molecules have been developed to treat post-stroke neuroinflammation; however, none of them are clinically successful. Post-stroke neuroinflammation is primarily attributed to microglial polarization as the generation of inflammasome complexes shifts microglia to their M1 phenotype and regulate the downstream cascade. Inosine, an adenosine derivative reported to maintain cellular energy homeostasis in stressed condition. Although, the exact mechanism is still unexplored, various studies have reported that it can stimulate axonal sprouting in different neurodegenerative diseases. Hence, our present study aims to decipher the molecular mechanism of inosine mediated neuroprotection by modulating inflammasome signaling towards altered microglial polarization in ischemic stroke. Inosine was administered intraperitoneally to male Sprague Dawley rats at 1 h post ischemic stroke and were further evaluated for neurodeficit score, motor coordination and long-term neuroprotection. Brains were harvested for infarct size estimation, biochemical assays and molecular studies. Inosine administration at 1 h post ischemic stroke decreased infarct size, neurodeficit score, and improved motor co-ordination. Normalization of biochemical parameters were achieved in the treatment groups. Microglial polarization towards its anti-inflammatory phenotype and modulation of inflammation were evident by relevant gene and protein expression studies. The outcome provides preliminary evidence of inosine mediated alleviation of post-stroke neuroinflammation via modulation of microglial polarization towards its anti-inflammatory form through regulating the inflammasome activation.
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Affiliation(s)
- Aishika Datta
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Pramod Suthar
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Deepaneeta Sarmah
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Poonam Jadhav
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Jinagna Shah
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Mounika Katamneni
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Nikhil Bhosale
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Vishal Gupta
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Mariya Bohra
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Falguni Baidya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Nikita Rana
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Bijoyani Ghosh
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Harpreet Kaur
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Anupom Borah
- Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar 788011, Assam, India
| | - Rajeshwari Rathod
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Pinaki Sengupta
- Department of Pharmaceutical Analysis, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India
| | - Pallab Bhattacharya
- Department of Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat, India.
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Ma SJ, Khan M, Chatterjee U, Santhosh S, Hashmi M, Gill J, Yu B, Iovoli A, Farrugia M, Wooten K, Gupta V, McSpadden R, Yu H, Kuriakose MA, Markiewicz MR, Al-Afif A, Hicks WL, Seshadri M, Ray AD, Repasky E, Singh AK. Association of Body Mass Index With Outcomes Among Patients With Head and Neck Cancer Treated With Chemoradiotherapy. JAMA Netw Open 2023; 6:e2320513. [PMID: 37368400 DOI: 10.1001/jamanetworkopen.2023.20513] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 06/28/2023] Open
Abstract
Importance Combined modality therapy, such as chemoradiotherapy, often results in significant morbidity among patients with head and neck cancer. Although the role of body mass index (BMI) varies based on cancer subtypes, its association with treatment response, tumor recurrence, and survival outcomes among patients with head and neck cancer remains unclear. Objective To evaluate the role of BMI in treatment response, tumor recurrence, and survival outcomes among patients with head and neck cancer undergoing chemoradiotherapy. Design, Setting, and Participants This retrospective, observational, single-institution cohort study conducted at a comprehensive cancer center included 445 patients with nonmetastatic head and neck cancer who underwent chemoradiotherapy from January 1, 2005, to January 31, 2021. Exposure Normal vs overweight or obese BMI. Main Outcomes and Measures Metabolic response after chemoradiotherapy, locoregional failure (LRF), distant failure (DF), overall survival (OS), and progression-free survival (PFS), with Bonferroni correction used to adjust for multiple comparisons and P < .025 being considered statistically significant. Results A total of 445 patients (373 men [83.8%]; median age, 61 years [IQR, 55-66 years]; 107 [24.0%] with normal BMI, 179 [40.2%] with overweight BMI, and 159 [35.7%] with obese BMI) were included for analysis. Median follow-up was 48.1 months (IQR, 24.7-74.9 months). On Cox proportional hazards regression multivariable analysis, only overweight BMI was associated with improved OS (5-year OS, 71.5% vs 58.4%; adjusted hazard ratio [AHR], 0.59 [95% CI, 0.39-0.91]; P = .02) and PFS (5-year PFS, 68.3% vs 50.8%; AHR, 0.51 [95% CI, 0.34-0.75]; P < .001). On logistic multivariable analysis, overweight BMI (91.6% vs 73.8%; adjusted odds ratio [AOR], 0.86 [95% CI, 0.80-0.93]; P < .001) and obese BMI (90.6% vs 73.8%; AOR, 0.89 [95% CI, 0.81-0.96]; P = .005) were associated with complete metabolic response on follow-up positron emission tomography-computed tomography after treatments. On Fine-Gray multivariable analysis, overweight BMI was associated with reduction in LRF (5-year LRF, 7.0% vs 25.9%; AHR, 0.30 [95% CI, 0.12-0.71]; P = .01), but not DF (5-year DF, 17.4% vs 21.5%; AHR, 0.92 [95% CI, 0.47-1.77]; P = .79). Obese BMI was not associated with LRF (5-year LRF, 10.4% vs 25.9%; AHR, 0.63 [95% CI, 0.29-1.37]; P = .24) or DF (5-year DF, 15.0% vs 21.5%; AHR, 0.70 [95% CI, 0.35-1.38]; P = .30). Conclusion In this cohort study of patients with head and neck cancer, when compared with normal BMI, overweight BMI was an independent factor favorably associated with complete response after treatments, OS, PFS, and LRF. Further investigations are warranted to improve understanding on the role of BMI among patients with head and neck cancer.
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Affiliation(s)
- Sung Jun Ma
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Michael Khan
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo
| | - Udit Chatterjee
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Sharon Santhosh
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo
| | | | - Jasmin Gill
- University at Buffalo, The State University of New York, Buffalo
| | - Brian Yu
- Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo
| | - Austin Iovoli
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Mark Farrugia
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Kimberly Wooten
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Vishal Gupta
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Ryan McSpadden
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Han Yu
- Department of Biostatistics and Bioinformatics, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Moni A Kuriakose
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Michael R Markiewicz
- Department of Oral and Maxillofacial Surgery, School of Dental Medicine, University at Buffalo, The State University of New York, Buffalo
- Department of Neurosurgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo
- Department of Surgery, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo, The State University of New York, Buffalo
| | - Ayham Al-Afif
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Wesley L Hicks
- Department of Head and Neck Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Mukund Seshadri
- Department of Oral Oncology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Andrew D Ray
- Department of Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Elizabeth Repasky
- Department of Immunology, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Anurag K Singh
- Department of Radiation Medicine, Roswell Park Comprehensive Cancer Center, Buffalo, New York
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Swarnkar B, Gulati M, Agarwal S, Gupta V. Diffuse Neurofibroma Presenting as Unilateral Facial Plaques with Overlying Hair Loss. Indian Dermatol Online J 2023; 14:437-439. [PMID: 37266099 PMCID: PMC10231719 DOI: 10.4103/idoj.idoj_363_22] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Revised: 11/25/2022] [Accepted: 11/26/2022] [Indexed: 06/03/2023] Open
Affiliation(s)
- Bhavya Swarnkar
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
| | - Malvika Gulati
- Department of Radiodiagnosis, All India Institute of Medical Sciences, New Delhi, India
| | - Shipra Agarwal
- Department of Pathology, All India Institute of Medical Sciences, New Delhi, India
| | - Vishal Gupta
- Department of Dermatology and Venereology, All India Institute of Medical Sciences, New Delhi, India
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Gupta V, Singh PP, Prakash B. Synthesis, characterization, and assessment of chitosan-nanomatrix enriched with antifungal formulation against biodeterioration of active ingredients of selected herbal raw materials. Int J Biol Macromol 2023; 234:123684. [PMID: 36791939 DOI: 10.1016/j.ijbiomac.2023.123684] [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: 10/07/2022] [Revised: 02/08/2023] [Accepted: 02/10/2023] [Indexed: 02/16/2023]
Abstract
Aflatoxin B1 (AFB1), a potent natural group 1 carcinogen produced by Aspergillus flavus is considered an unavoidable toxic contaminant of herbal raw materials, which often deteriorates their active ingredients making them less effective and hazardous during their formulation in herbal drugs. The present investigation reports the antifungal (0.5 μl/ml) and AFB1 inhibitory (0.4 μl/ml) effects of the developed formulation CIM based on a mixture of essential oils (Carum carvi, and Illicium verum), and methyl anthranilate using mathematical modeling. The insight into the mechanism of action has also been explored using biochemical, molecular docking, and RT-PCR. Further, the nanoencapsulation of CIM (Ne-CIM) was prepared using a green facile synthesis of chitosan-based nanomatrix and characterized by Dynamic light scattering (DLS), Fourier transform-infrared, (FTIR), and X-ray diffraction analysis (XRD). The in-situ results showed that at MIC doses Ne-CIM effectively controls the A. flavus (81.25-89.57 %), AFB1 contamination (100 %), and protects the active ingredients deterioration of Piper nigrum, P. longum, Andrographis paniculata, Silybum marianum, and Withania somnifera caused by toxigenic species of A. flavus without affecting their sensory properties. Hence, Ne-CIM could be used as a green chemical agent to protect the biodeterioration of active ingredients of herbal raw materials caused by toxigenic species of A. flavus.
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Affiliation(s)
- Vishal Gupta
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, India
| | - Prem Pratap Singh
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, India
| | - Bhanu Prakash
- Centre of Advanced Study in Botany, Institute of Science, Banaras Hindu University, Varanasi 221005, India..
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Khaladkar SM, Goyal S, Vinay Kumar Parripati SS, Gupta V, Goyal S. Tracheo-oesophageal fistula in a case of organophosphate poisoning. Afr J Thorac Crit Care Med 2023; 29:10.7196/AJTCCM.2023.v29i1.267. [PMID: 37476659 PMCID: PMC10354871 DOI: 10.7196/ajtccm.2023.v29i1.267] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Indexed: 07/22/2023] Open
Affiliation(s)
- S M Khaladkar
- Department of Radiodiagnosis, Dr D Y Patil Medical College, Hospital
and Research Centre, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - S Goyal
- Department of Radiodiagnosis, Dr D Y Patil Medical College, Hospital
and Research Centre, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - S S Vinay Kumar Parripati
- Department of Radiodiagnosis, Dr D Y Patil Medical College, Hospital
and Research Centre, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - V Gupta
- Department of Radiodiagnosis, Dr D Y Patil Medical College, Hospital
and Research Centre, Dr DY Patil Vidyapeeth, Pune, Maharashtra, India
| | - S Goyal
- Government Medical College, Amritsar, Punjab, India
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42
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Gupta V, Singh NS, Kumar L, Annapoorni S. Temperature dependent characteristics of flexible p-PANI/n-ZnO based hybrid heterojunction diode. Nanotechnology 2023; 34:255202. [PMID: 36917850 DOI: 10.1088/1361-6528/acc40a] [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] [Subscribe] [Scholar Register] [Received: 09/26/2022] [Accepted: 03/14/2023] [Indexed: 06/18/2023]
Abstract
This study aims to develop and characterize a flexible p-PANI/n-ZnO heterojunction diode developed from a combination of electrochemical and sputtering technique. Investigation of structural properties and morphology of the thin films has been done from XRD and SEM analysis. To study the temperature effect on the electrical properties of the diode, current-voltage-temperature (I-V-T) measurements were done for the temperature range 25-300 K. Applying the ideal thermionic emission theory, various diode parameters like reverse saturation current, quality factor, series resistance and barrier height were computed utilizing the semilogarithmic plot ofI-Vcurve and Cheungs' method. Barrier height, reverse saturation current and quality factor calculated from ln(I)versusVcurve were observed to vary from 0.0627-0.725 eV, 0.236-98.8 nA and 54.43-3.29 respectively over the temperature range 25-300 K. It has been found that the series resistance falls with a rise in temperature. The barrier height, series resistance and ideality factor were observed to vary from 0.0628-0.692 eV, 15 900-46.8 Kohm and 41.88-2.27 respectively for the temperature range 25-300 K. The activation energy estimated from Arrhenius plot was observed to be 14.51 meV. Additionally, the fabricated PANI/ZnO diode was mechanically robust that can be bent without affecting its performance.
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Affiliation(s)
- Vishal Gupta
- Department of Physics and Astrophysics, University of Delhi, Delhi 110007, India
- Department of Physics, Hindu College, University of Delhi, Delhi 110007, India
| | | | - Lalit Kumar
- Department of Physics, Hindu College, University of Delhi, Delhi 110007, India
| | - S Annapoorni
- Department of Physics and Astrophysics, University of Delhi, Delhi 110007, India
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Rigsby RK, Brahmbhatt P, Desai AB, Bathla G, Ebner BA, Gupta V, Vibhute P, Agarwal AK. Newly Recognized CNS Tumors in the 2021 World Health Organization Classification: Imaging Overview with Histopathologic and Genetic Correlation. AJNR Am J Neuroradiol 2023; 44:367-380. [PMID: 36997287 PMCID: PMC10084895 DOI: 10.3174/ajnr.a7827] [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: 11/02/2022] [Accepted: 12/14/2022] [Indexed: 04/01/2023]
Abstract
In 2021, the World Health Organization released an updated classification of CNS tumors. This update reflects the growing understanding of the importance of genetic alterations related to tumor pathogenesis, prognosis, and potential targeted treatments and introduces 22 newly recognized tumor types. Herein, we review these 22 newly recognized entities and emphasize their imaging appearance with correlation to histologic and genetic features.
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Affiliation(s)
- R K Rigsby
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - P Brahmbhatt
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - A B Desai
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - G Bathla
- Department of Radiology (G.B.), Mayo Clinic, Rochester, Minnesota
| | - B A Ebner
- Department of Laboratory Medicine and Pathology (B.A.E.), Mayo Clinic, Rochester, Minnesota
| | - V Gupta
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - P Vibhute
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
| | - A K Agarwal
- From the Department of Radiology (R.K.R., P.B., A.B.D., V.G., P.V., A.K.A.), Mayo Clinic, Jacksonville, Florida
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Bhagat S, Gupta V, Jain SK, Aaggarwal S, Khanduri S, Batra S. The Diagnostic Accuracy of a Novel Scoring System Using Multi-Detector Computed Tomography to Diagnose Lung Cancer. Cureus 2023; 15:e35848. [PMID: 37033527 PMCID: PMC10076812 DOI: 10.7759/cureus.35848] [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] [Received: 02/14/2023] [Accepted: 02/26/2023] [Indexed: 03/09/2023] Open
Abstract
INTRODUCTION Lung cancer is the leading cause amongst the cancer deaths in the world. Detection of malignancy at an early stage and with precision is the utmost objective of radiological evaluation. The final diagnosis of lung cancer is histopathological evaluation of the mass. The authors hereby have tried to convert the multi-detector CT (MDCT) characteristics and patient demographics into quantitative data to formulate a scoring system that can predict lung malignancy as close to histopathology as possible. MATERIALS AND METHODS After obtaining ethical clearance, 104 cases of suspected lung cancer by history, clinical and radiographic evaluation were enrolled in the study. These patients were undergoing CT thorax (contrast) on 384 slice siemens somatom force. After undergoing the radiological evaluation biopsy of the mass was done either by CT guided or bronchoscopy guided. Radiological and histopathological findings were correlated. Patients aged >50, lymphadenopathy, tumor volume >50 cc, enhancement >15 HU (Hounsfield unit) after contrast injection were given a score of 15 each. History of smoking, bronchus cut off, spiculated/lobulated margins, mediastinal/pleural involvement, and angiogram sign positive were given a score of 20 each. So, a maximum score of 160 can be achieved by history and MDCT evaluation. RESULTS Sensitivity, specificity, positive predictive values (PPV), negative predictive values (NPV), and diagnostic accuracy of MDCT by using conventional parameters against histopathology was 97.5%, 85%, 96.29%, 89.47%, and 95.0%. The sensitivity and specificity calculated through Receiver-Operating-Characteristic (ROC) for predicting malignancy were found to be 98.8% and 90.0% for a cut-off score of >97.5 out of maximum of 160. Conclusion: MDCT serves as a tool for early diagnosis of lung cancer, and it is the utmost important tool for cases where biopsy or fine needle aspiration cytology (FNAC) is not possible. By creating a quantitative criterion to diagnose lung malignancy, the subjective nature of MDCT diagnosis can be converted into an objective based evaluation.
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Tao S, Zhou X, Greco E, Gupta V, Freund BE, Westerhold EM, Feyissa AM, Tatum WO, Grewal S, Patel V, Middlebrooks EH. Edge-Enhancing Gradient-Echo MP2RAGE for Clinical Epilepsy Imaging at 7T. AJNR Am J Neuroradiol 2023; 44:268-270. [PMID: 36732031 PMCID: PMC10187818 DOI: 10.3174/ajnr.a7782] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/15/2022] [Accepted: 01/03/2023] [Indexed: 02/04/2023]
Abstract
The 3D edge-enhancing gradient-echo (EDGE) MR imaging sequence offers superior contrast-to-noise ratio in the detection of focal cortical dysplasia. EDGE could benefit from 7T MR imaging but also faces challenges such as image inhomogeneity and low acquisition efficiency. We propose an EDGE-MP2RAGE sequence that can provide both EDGE and T1-weighted contrast, simultaneously, improving data-acquisition efficiency. We demonstrate that with sequence optimization, EDGE images with sufficient uniformity and T1-weighted images with high gray-to-white matter contrast can be achieved.
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Affiliation(s)
- S Tao
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
| | - X Zhou
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
| | - E Greco
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
| | - V Gupta
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
| | | | - E M Westerhold
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
| | | | | | - S Grewal
- Neurosurgery (S.G., E.H.M.), Mayo Clinic, Jacksonville, Florida
| | - V Patel
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
| | - E H Middlebrooks
- From the Departments of Radiology (S.T., X.Z., E.G., V.G., E.M.W., V.P., E.H.M.)
- Neurosurgery (S.G., E.H.M.), Mayo Clinic, Jacksonville, Florida
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Khosla D, Kapoor R, Kataria V, Sekar A, Das C, Kumar D, Gupta R, Gupta V, Singh H, Dey T, Madan R, Nada R. 75P Primary sarcomas of gastrointestinal tract: A single-institution experience of a rare entity. ESMO Open 2023. [DOI: 10.1016/j.esmoop.2023.101112] [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: 04/05/2023] Open
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Gupta V. How to achieve the critical view of safety for safe laparoscopic cholecystectomy: Technical aspects. Ann Hepatobiliary Pancreat Surg 2023; 27:201-210. [PMID: 36793183 DOI: 10.14701/ahbps.22-064] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 11/20/2022] [Accepted: 11/28/2022] [Indexed: 02/17/2023] Open
Abstract
Laparoscopic cholecystectomy is associated with a higher incidence of biliary/vasculobiliary injuries than open cholecystectomy. Anatomical misperception is the most common underlying mechanism of such injuries. Although a number of strategies have been described to prevent these injuries, critical view of safety method of structural identification seems to be the most effective preventive measure. The critical view of safety can be achieved in the majority of cases during laparoscopic cholecystectomy. It is highly recommended by various guidelines. However, its poor understanding and low adoption rates among practicing surgeons have been global problems. Educational intervention and increasing awareness about the critical view of safety can increase its penetration in routine surgical practice. In this article, a technique of achieving critical view of safety during laparoscopic cholecystectomy is described with the aim to enhance its understanding among general surgery trainees and practicing general surgeons.
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Affiliation(s)
- Vishal Gupta
- Department of Surgical Gastroenterology, All India Institute of Medical Sciences (AIIMS), Bhopal, Madhya Pradesh, India
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Sarmah D, Sarkar A, Datta A, Ghosh B, Rana N, Sahu S, Gupta V, Thongire V, Chaudhary A, Vadak N, Kaur H, Raut S, Singh U, Borah A, Bhattacharya P. Cardiolipin-Mediated Alleviation of Mitochondrial Dysfunction Is a Neuroprotective Effect of Statin in Animal Model of Ischemic Stroke. ACS Chem Neurosci 2023; 14:709-724. [PMID: 36706354 DOI: 10.1021/acschemneuro.2c00645] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/28/2023] Open
Abstract
In clinical settings, the benefit of statin for stroke is debatable as regular statin users may suffer from myalgia, statin-associated myopathy (SAM), and rarely rhabdomyolysis. Studies suggest that patients on statin therapy show lesser vulnerability toward ischemic stroke and post-stroke frailty. Both pre- and post-treatment benefits of statin have been reported as evident by its neuroprotective effects in both cases. As mitochondrial dysfunction following stroke is the fulcrum for neuronal death, we hereby explore the role of statin in alleviating mitochondrial dysfunction by regulating the mitochondrial dynamics. In the present study, we intend to evaluate the role of statin in modulating cardiolipin-mediated mitochondrial functionality and further providing a therapeutic rationale for repurposing statins either as preventive or an adjunctive therapy for stroke.
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Affiliation(s)
- Deepaneeta Sarmah
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Abhishek Sarkar
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Aishika Datta
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Bijoyani Ghosh
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Nikita Rana
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Shubhrakanta Sahu
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Vishal Gupta
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Vrushali Thongire
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Antra Chaudhary
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Namrata Vadak
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Harpreet Kaur
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Swapnil Raut
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Upasna Singh
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
| | - Anupom Borah
- Cellular and Molecular Neurobiology Laboratory, Department of Life Science and Bioinformatics, Assam University, Silchar, Assam 788011, India
| | - Pallab Bhattacharya
- Pharmacology and Toxicology, National Institute of Pharmaceutical Education and Research (NIPER), Ahmedabad, Gandhinagar, Gujarat 382355, India
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Kumar T, Virador GM, Brahmbhatt P, Bhatt AA, Middlebrooks EH, Desai A, Agarwal A, Vibhute P, Gupta V. High-Resolution 7T MR Imaging of the Trochlear Nerve. AJNR Am J Neuroradiol 2023; 44:186-191. [PMID: 36657953 PMCID: PMC9891327 DOI: 10.3174/ajnr.a7774] [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: 11/08/2022] [Accepted: 12/31/2022] [Indexed: 01/21/2023]
Abstract
BACKGROUND AND PURPOSE The trochlear nerve has traditionally been difficult to identify on MR imaging. The advent of 7T MR imaging promises to greatly benefit visualization of small structures due to gains in the signal-to-noise ratio allowing improved spatial resolution. We investigated the utility of a clinically feasible ultra-high-resolution 7T MR imaging protocol for identification of the trochlear nerve, as well as assessment of normal trochlear nerve anatomy. MATERIALS AND METHODS Coronal high-resolution 2D T2-weighted TSE images used in a 7T epilepsy protocol of 50 subjects at our institution were reviewed by 2 independent radiologists for visualization of the trochlear nerve at the nerve origin and cisternal, tentorial, and cavernous segments. The frequency of nerve visibility within these segments and their anatomy were documented, and disagreements were resolved by joint review. RESULTS Of the 100 nerves reviewed in 50 subjects, at least 2 segments of the trochlear nerve from the brainstem to the cavernous sinus were identified in 100% of cases. The origins from the brainstem and cisternal segment were visible in 65% and 93% of nerves, respectively. The trochlear nerve was identified at the trochlear groove in 100% of cases and in the posterior wall of the cavernous sinus in 74% of cases. CONCLUSIONS Coronal high-resolution 2D TSE at 7T reliably identified the trochlear nerve throughout its course and is a promising tool for imaging patients with suspected trochlear nerve pathology.
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Affiliation(s)
- T Kumar
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - G M Virador
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - P Brahmbhatt
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - A A Bhatt
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - E H Middlebrooks
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - A Desai
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - A Agarwal
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - P Vibhute
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
| | - V Gupta
- From the Department of Radiology, Mayo Clinic, Jacksonville, Florida
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Kassab K, Gupta V. Simultaneous ST-elevation myocardial infarction in monozygotic twins: a case report of entangled twins. Eur Heart J Case Rep 2023; 7:ytad050. [PMID: 36793936 PMCID: PMC9924499 DOI: 10.1093/ehjcr/ytad050] [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: 07/08/2022] [Revised: 08/23/2022] [Accepted: 01/25/2023] [Indexed: 02/01/2023]
Abstract
Background The development of coronary artery disease (CAD) is strongly influenced by genetic and environmental factors. Monozygotic twins represent a unique population that provides insights into the interaction of genetic, environmental, and social factors and their effects on the development of CAD. Case summary Two 54-year-old identical twins presented to an outside hospital with acute chest pain. Twin B developed chest pain after witnessing Twin A in distress from an acute chest pain episode. Electrocardiogram performed on each of them was diagnostic of ST-elevation myocardial infarction. Upon arrival at the angioplasty centre, Twin A was taken for emergency coronary angiography yet his pain subsided on the way to the catheterization lab hence, Twin B was taken for angiography instead. Twin B angiography demonstrated acute occlusion of the proximal left anterior descending coronary artery and was treated with percutaneous coronary intervention. Twin A coronary angiogram demonstrated 60% ostial first diagonal branch stenosis with a normal distal flow. He was diagnosed with possible coronary vasospasm. Conclusion This is the first report of a simultaneous presentation of monozygotic twins with ST-elevation acute coronary syndrome. While genetic and environmental contributions to the development of CAD have been described, this case highlights the strong social bond that exists between monozygotic twins. Once CAD is diagnosed in one twin, aggressive risk factor modification and screening should be implemented in the other.
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