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Kirchheiner K, Zaharie AT, Smet S, Spampinato S, Chargari C, Mahantshetty UM, Segedin B, Bruheim K, Rai B, Cooper R, Van der Steen-Banasik E, Wiebe EM, Potter R, Kirisits C, Schmid M, Haie-Meder C, Tanderup K, De Leeuw A, Jurgenliemk-Schulz I, Nout RA. Association between Regular Vaginal Dilation and/or Sexual Activity and Long-Term Vaginal Morbidity in Cervical Cancer Survivors. Int J Radiat Oncol Biol Phys 2023; 117:S2-S3. [PMID: 37784450 DOI: 10.1016/j.ijrobp.2023.06.207] [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) To evaluate the association between regular vaginal dilation and/or sexual activity and vaginal morbidity in locally advanced cervical cancer patients after definitive radiochemotherapy and image-guided adaptive brachytherapy from the EMBRACE I study. MATERIALS/METHODS Physician-assessed vaginal morbidity (CTCAE v.3), vaginal dilation and patient-reported sexual activity (EORTC QLQ CX24) were assessed at baseline, every 3 months in the 1st year, every 6 months in the 2nd and 3rd year and yearly thereafter. For this longitudinal analysis, a subgroup of patients was selected with at least 3 follow-ups with information on vaginal dilation and/or sexual activity. Vaginal penetration summarized either the use of vaginal dilators or sexual activity or both. Regular vaginal penetration was defined if reported in ≥50%, infrequent if reported in <50% and absent if reported in 0% of follow-ups. Actuarial estimates of vaginal morbidity were calculated with Kaplan-Meier method and included the individual symptoms: vaginal dryness, stenosis, mucositis and bleeding. Group comparisons were evaluated with the log-rank test. RESULTS The EMBRACE I study included 1416 patients overall (2008-2015); the subgroup of patients for this longitudinal evaluation consists of 882 patients, with a median follow-up of 60 months (IQR 47-77). Of those, 565 (64%) reported regular, 205 (23%) infrequent and 112 (13%) no penetration. Reporting regular penetration was associated with a significantly lower risk of vaginal stenosis G≥2 of 23% at 5 years, compared to reporting of infrequent (37%) and no penetration (36%, p≤0.001). However, reporting regular penetration was associated with a significantly higher risk for vaginal dryness G≥1 (72% vs. 69% vs. 62%, respectively, p = 0.038) and bleeding G≥1 (61% vs. 40% vs. 25%, respectively, p≤0.001). No associations were seen for G≥1 vaginal stenosis, G≥2 dryness, G≥2 bleeding and G≥1/G≥2 mucositis. CONCLUSION Regular penetration (defined as vaginal dilation and/or sexual activity) was associated with lower risk for vaginal stenosis G≥2, but higher risk for vaginal dryness G≥1 and bleeding G≥1. Mild vaginal dryness seems to become apparent in particular for patients experiencing vaginal penetration. Minor vaginal blood loss during dilation and/or sexual activity is commonly reported by patients, resulting from atrophy of the vaginal mucosa and/or telangiectasia. While both of these G≥1 symptoms can be managed with lubricants, moisturizer and/or hormonal replacement therapy, G≥2 vaginal stenosis represents an irreversible fibrotic adverse event that can cause dyspareunia in many cancer patients. These long-term data support clinical recommendations for dilation and/or sexual activity after radiotherapy.
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Affiliation(s)
- K Kirchheiner
- Department Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Vienna, Austria
| | - A T Zaharie
- Department Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Vienna, Austria
| | - S Smet
- Department of Radiation Oncology, AZ Turnhout, Iridium Cancer Network, Antwerp, Turnhout, Belgium
| | - S Spampinato
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - C Chargari
- Department of Radiotherapy, Gustave-Roussy, Villejuif, Villejuif, France
| | - U M Mahantshetty
- Tata Memorial Hospital, Homi Bhabha National Institute, Mumbai & Homi Bhabha Cancer Hospital & Research Centre, Visakhapatnam, India
| | - B Segedin
- Department of Radiotherapy and Faculty of Medicine, Institute of Oncology Ljubljana and University of Ljubljana, Ljubljana, Slovenia
| | - K Bruheim
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Oslo, Norway
| | - B Rai
- Department of Radiotherapy and Oncology, Post Graduate Institute of Medical Education and Research, Chandigarh, India
| | - R Cooper
- Leeds Cancer Centre, St James's University Hospital, Leeds, United Kingdom
| | | | - E M Wiebe
- Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, AB, Canada
| | - R Potter
- Department for Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - C Kirisits
- Department for Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - M Schmid
- Department Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, Vienna, Austria
| | - C Haie-Meder
- Department of Radiotherapy, Gustave-Roussy, Villejuif, Villejuif, France
| | - K Tanderup
- Department of Oncology, Aarhus University Hospital, Aarhus, Denmark
| | - A De Leeuw
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - I Jurgenliemk-Schulz
- Department of Radiation Oncology, University Medical Center Utrecht, Utrecht, Netherlands
| | - R A Nout
- Department of Radiotherapy, Erasmus MC Cancer Institute, University Medical Center Rotterdam, Rotterdam, Netherlands
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Jones C, Gray S, Brown M, Brown J, Mc Closkey E, Rai B, Clarke N, Sachdeva A. Fracture and fall risk in men with advanced or metastatic prostate cancer treated with novel androgen receptor signalling inhibitors: A systematic review and meta-analysis of randomised controlled trials. Eur Urol 2023. [DOI: 10.1016/s0302-2838(23)01036-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/12/2023]
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Dey T, Rai B, Radhika S, Saha P, Rana S, Gowda S, Ghoshal S. Circulating Cell Free DNA as Predictive Biomarker in Cervical Cancer Patients Treated with Radical Chemo-Radiation. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.499] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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Dhiman S, Rai B, Vamsi K, Gowda S, Anand D, Miriyala R, Arora M, Jain V, Ghoshal S. Hypofractionated Two Week Short-Course Radiotherapy vs. Monthly Single Fraction Palliative Pelvic Radiation in Advanced Gynecologic Cancers. Int J Radiat Oncol Biol Phys 2022. [DOI: 10.1016/j.ijrobp.2022.07.360] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/31/2022]
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Spampinato S, Tanderup K, Nout R, Smet S, Lindegaard J, Fokdal L, Pötter R, Sturdza A, Segedin B, Jürgenliemk-Schulz I, Bruheim K, Mahantshetty U, Chargari C, Rai B, Cooper R, van der Steen-Banasik E, Sundset M, Wiebe E, Villafranca E, Van Limbergen E, Chopra S, Kirchheiner K. OC-0588 Impact of persistent symptoms on long-term quality of life of cervical cancer survivors in EMBRACE I. Radiother Oncol 2022. [DOI: 10.1016/s0167-8140(22)02610-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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Kasturiratne A, Khawaja KI, Ahmad S, Siddiqui S, Shahzad K, Athauda LK, Jayawardena R, Mahmood S, Muilwijk M, Batool T, Burney S, Glover M, Palaniswamy S, Bamunuarachchi V, Panda M, Madawanarachchi S, Rai B, Sattar I, Silva W, Waghdhare S, Jarvelin MR, Rannan-Eliya RP, Gage HM, van Valkengoed IGM, Valabhji J, Frost GS, Loh M, Wickremasinghe AR, Kooner JS, Katulanda P, Jha S, Chambers JC. The iHealth-T2D study, prevention of type 2 diabetes amongst South Asians with central obesity and prediabetes: study protocol for a randomised controlled trial. Trials 2021; 22:928. [PMID: 34922608 PMCID: PMC8684177 DOI: 10.1186/s13063-021-05803-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2021] [Accepted: 11/06/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND People from South Asia are at increased risk of type 2 diabetes (T2D). There is an urgent need to develop approaches for the prevention of T2D in South Asians that are cost-effective, generalisable and scalable across settings. HYPOTHESIS Compared to usual care, the risk of T2D can be reduced amongst South Asians with central obesity or raised HbA1c, through a 12-month lifestyle modification programme delivered by community health workers. DESIGN Cluster randomised clinical trial (1:1 allocation to intervention or usual care), carried out in India, Pakistan, Sri Lanka and the UK, with 30 sites per country (120 sites total). Target recruitment 3600 (30 participants per site) with annual follow-up for 3 years. ENTRY CRITERIA South Asian, men or women, age 40-70 years with (i) central obesity (waist circumference ≥ 100 cm in India and Pakistan; ≥90 cm in Sri Lanka) and/or (ii) prediabetes (HbA1c 6.0-6.4% inclusive). EXCLUSION CRITERIA known type 1 or 2 diabetes, normal or underweight (body mass index < 22 kg/m2); pregnant or planning pregnancy; unstable residence or planning to leave the area; and serious illness. ENDPOINTS The primary endpoint is new-onset T2D at 3 years, defined as (i) HbA1c ≥ 6.5% or (ii) physician diagnosis and on treatment for T2D. Secondary endpoints at 1 and 3 years are the following: (i) physical measures: waist circumference, weight and blood pressure; (ii) lifestyle measures: smoking status, alcohol intake, physical activity and dietary intake; (iii) biochemical measures: fasting glucose, insulin and lipids (total and HDL cholesterol, triglycerides); and (iv) treatment compliance. INTERVENTION Lifestyle intervention (60 sites) or usual care (60 sites). Lifestyle intervention was delivered by a trained community health worker over 12 months (5 one-one sessions, 4 group sessions, 13 telephone sessions) with the goal of the participants achieving a 7% reduction in body mass index and a 10-cm reduction in waist circumference through (i) improved diet and (ii) increased physical activity. Usual care comprised a single 30-min session of lifestyle modification advice from the community health worker. RESULTS We screened 33,212 people for inclusion into the study. We identified 10,930 people who met study entry criteria, amongst whom 3682 agreed to take part in the intervention. Study participants are 49.2% female and aged 52.8 (SD 8.2) years. Clinical characteristics are well balanced between intervention and usual care sites. More than 90% of follow-up visits are scheduled to be complete in December 2020. Based on the follow-up to end 2019, the observed incidence of T2D in the study population is in line with expectations (6.1% per annum). CONCLUSION The iHealth-T2D study will advance understanding of strategies for the prevention of diabetes amongst South Asians, use approaches for screening and intervention that are adapted for low-resource settings. Our study will thus inform the implementation of strategies for improving the health and well-being of this major global ethnic group. IRB APPROVAL 16/WM/0171 TRIAL REGISTRATION: EudraCT 2016-001350-18 . Registered on 14 April 2016. ClinicalTrials.gov NCT02949739 . Registered on 31 October 2016, First posted on 31/10/2016.
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Affiliation(s)
- Anuradhani Kasturiratne
- Department of Public Health, Faculty of Medicine, University of Kelaniya, PO Box 06, Thalagolla Road, Ragama, 11010, Sri Lanka
| | - Khadija I Khawaja
- Department of Endocrinology & Metabolism, Services Institute of Medical Sciences, Services Hospital, Ghaus ul Azam, Jail Road, Lahore, 54700, Pakistan
| | - Sajjad Ahmad
- Punjab Institute of Cardiology, Jail Road, Lahore, Pakistan
| | - Samreen Siddiqui
- Institute of Endocrinology, Diabetes & Metabolism, Max Super Speciality Hospital, 2, Press Enclave Road, Saket, New Delhi, 110017, India
| | | | - Lathika K Athauda
- Department of Public Health, Faculty of Medicine, University of Kelaniya, PO Box 06, Thalagolla Road, Ragama, 11010, Sri Lanka
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sara Mahmood
- Department of Endocrinology & Metabolism, Services Institute of Medical Sciences, Services Hospital, Ghaus ul Azam, Jail Road, Lahore, 54700, Pakistan
| | - Mirthe Muilwijk
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Tayyaba Batool
- Department of Endocrinology & Metabolism, Diabetes Management Centre, Services Hospital, Ghaus-ul-Azam, Jail Road, Lahore, 540000, Pakistan
| | - Saira Burney
- Department of Endocrinology & Metabolism, Diabetes Management Centre, Services Hospital, Ghaus-ul-Azam, Jail Road, Lahore, 540000, Pakistan
| | - Matthew Glover
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Daphne Jackson Road, Guildford, GU2 7WG, Surrey, England
| | - Saranya Palaniswamy
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | | | - Manju Panda
- Institute of Endocrinology, Diabetes & Metabolism, Max Super Speciality Hospital, 2, Press Enclave Road, Saket, New Delhi, 110017, India
| | - Suren Madawanarachchi
- Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Baldeesh Rai
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Iqra Sattar
- Punjab Institute of Cardiology, Jail Road, Lahore, Pakistan
| | - Wnurinham Silva
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
| | - Swati Waghdhare
- Institute of Endocrinology, Diabetes & Metabolism, Max Super Speciality Hospital, 2, Press Enclave Road, Saket, New Delhi, 110017, India
| | - Marjo-Riitta Jarvelin
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- Department of Life Sciences, College of Health and Life Sciences, Brunel University London, Kingston Lane, Uxbridge, Middlesex, UB8 3PH, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | | | - Heather M Gage
- Surrey Health Economics Centre, Department of Clinical and Experimental Medicine, University of Surrey, Leggett Building, Daphne Jackson Road, Guildford, GU2 7WG, Surrey, England
| | - Irene G M van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC, University of Amsterdam, Meibergdreef 9, 1105, AZ, Amsterdam, The Netherlands
| | - Jonathan Valabhji
- Department of Diabetes and Endocrinology, 1st Floor Mint Wing, St Mary's Hospital, Imperial College Healthcare NHS Trust, London, W2 1NY, UK
| | - Gary S Frost
- 6th Floor Commonwealth Building, Faculty of Medicine, Imperial College London, Hammersmith Campus, Ducane Road, London, W12 ONN, UK
| | - Marie Loh
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore
| | - Ananda R Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, PO Box 06, Thalagolla Road, Ragama, 11010, Sri Lanka
| | - Jaspal S Kooner
- National Heart and Lung Institute, Imperial College London, Hammersmith Hopsital Campus, Ducane Road, London, W12 ONN, UK
- , Uxbridge Road, Southall, Middlesex, UB1 3HW, UK
| | - Prasad Katulanda
- Department of Clinical Medicine, Faculty of Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sujeet Jha
- Institute of Endocrinology, Diabetes & Metabolism, Max Super Speciality Hospital, 2, Press Enclave Road, Saket, New Delhi, 110017, India
| | - John C Chambers
- School of Public Health, Epidemiology and Biostatistics, Imperial College London, St Mary's Campus, Norfolk Place, London, W2 1PG, UK.
- Lee Kong Chian School of Medicine, Nanyang Technological University, Singapore, 308232, Singapore.
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Baral R, Shrestha LB, Ortuño-Gutiérrez N, Pyakure P, Rai B, Rimal SP, Singh S, Sharma SK, Khanal B, Selvaraj K, Kumar AMV. Low yield but high levels of multidrug resistance in urinary tract infections in a tertiary hospital, Nepal. Public Health Action 2021; 11:70-76. [PMID: 34778019 DOI: 10.5588/pha.21.0044] [Citation(s) in RCA: 3] [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: 04/22/2021] [Accepted: 07/21/2021] [Indexed: 11/10/2022] Open
Abstract
SETTING There are concerns about the occurrence of multidrug resistance (MDR) in patients with urine tract infections (UTI) in Nepal. OBJECTIVE To determine culture positivity, trends in MDR among Escherichia coli and Klebsiella pneumoniae infections and seasonal changes in culture-positive UTI specimens isolated from 2014 to 2018 at the B P Koirala Institute of Health Sciences, Dharan, Eastern Nepal. DESIGN This was a cross-sectional study using secondary laboratory data. RESULTS Among 116,417 urine samples tested, 19,671 (16.9%) were culture-positive, with an increasing trend in the number of samples tested and culture positivity. E. coli was the most common bacteria (54.3%), followed by K. pneumoniae (8.8%). Among E. coli and K. pneumoniae isolates, MDR was found in respectively 42.5% and 36.0%. MDR was higher in males and people aged >55 years, but showed a decreasing trend over the years. The numbers of isolates increased over the years, with a peak always observed from July to August. CONCLUSION Low culture positivity is worrying and requires further work into improving diagnostic protocols. Decreasing trends in MDR are a welcome sign. Information on seasonal changes that peak in July-August can help laboratories better prepare for this time with adequate buffer stocks to ensure culture and antibiotic susceptibility testing.
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Affiliation(s)
- R Baral
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - L B Shrestha
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | | | - P Pyakure
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal.,School of Public Health and Community Medicine, BPKIHS, Dharan, Nepal
| | - B Rai
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S P Rimal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S Singh
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - S K Sharma
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - B Khanal
- BP Koirala Institute of Health Sciences (BPKIHS), Dharan, Nepal
| | - K Selvaraj
- All India Institute of Medical Sciences, Nagpur, India
| | - A M V Kumar
- International Union Against Tuberculosis and Lung Disease (The Union), Paris, France.,The Union South-East Asia Office, New Delhi, India.,Yenepoya Medical College, Yenepoya (deemed University), Mangaluru, India
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Muilwijk M, Loh M, Siddiqui S, Mahmood S, Palaniswamy S, Shahzad K, Athauda LK, Jayawardena R, Batool T, Burney S, Glover M, Bamunuarachchi V, Panda M, Madawanarachchi M, Rai B, Sattar I, Silva W, Waghdhare S, Jarvelin MR, Rannan-Eliya RP, Wijemunige N, Gage HM, Valabhji J, Frost GS, Wickremasinghe R, Kasturiratne A, Khawaja KI, Ahmad S, van Valkengoed IG, Katulanda P, Jha S, Kooner JS, Chambers JC. Effects of a lifestyle intervention programme after 1 year of follow-up among South Asians at high risk of type 2 diabetes: a cluster randomised controlled trial. BMJ Glob Health 2021; 6:e006479. [PMID: 34725039 PMCID: PMC8562508 DOI: 10.1136/bmjgh-2021-006479] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/01/2021] [Accepted: 09/30/2021] [Indexed: 12/17/2022] Open
Abstract
INTRODUCTION South Asians are at high risk of type 2 diabetes (T2D). We assessed whether intensive family-based lifestyle intervention leads to significant weight loss, improved glycaemia and blood pressure in adults at elevated risk for T2D. METHODS This cluster randomised controlled trial (iHealth-T2D) was conducted at 120 locations across India, Pakistan, Sri Lanka and the UK. We included 3684 South Asian men and women, aged 40-70 years, without T2D but with raised haemoglobin A1c (HbA1c) and/or waist circumference. Participants were randomly allocated either to the family-based lifestyle intervention or control group by location clusters. Participants in the intervention received 9 visits and 13 telephone contacts by community health workers over 1-year period, and the control group received usual care. Reductions in weight (aim >7% reduction), waist circumference (aim ≥5 cm reduction), blood pressure and HbA1C at 12 months of follow-up were assessed. Our linear mixed-effects regression analysis was based on intention-to-treat principle and adjusted for age, sex and baseline values. RESULTS There were 1846 participants in the control and 1838 in the intervention group. Between baseline and 12 months, mean weight of participants in the intervention group reduced by 1.8 kg compared with 0.4 kg in the control group (adjusted mean difference -1.10 kg (95% CI -1.70 to -1.06), p<0.001). The adjusted mean difference for waist circumference was -1.9 cm (95% CI -2.5; to 1.3), p<0.001). No overall difference was observed for blood pressure or HbA1c. People who attended multiple intervention sessions had a dose-dependent effect on waist circumference, blood pressure and HbA1c, but not on weight. CONCLUSION An intensive family-based lifestyle intervention adopting low-resource strategies led to effective reduction in weight and waist circumference at 12 months, which has potential long-term benefits for preventing T2D. A higher number of attended sessions increased the effect on waist circumference, blood pressure and HbA1c. TRIAL REGISTRATION NUMBER EudraCT: 2016-001350-18; ClinicalTrials.gov: NCT02949739.
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Affiliation(s)
- Mirthe Muilwijk
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Marie Loh
- Lee Kon Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
| | - Samreen Siddiqui
- Institute of Endocrinology Diabetes and Metabolism, Max Healthcare, New Delhi, Delhi, India
| | - Sara Mahmood
- Department of Endocrinology & Metabolism, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
| | - Saranya Palaniswamy
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
| | | | - Lathika K Athauda
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Ranil Jayawardena
- Department of Physiology, Faculty of Medicine, University of Colombo, Colombo, Western, Sri Lanka
| | - Tayyaba Batool
- Department of Endocrinology and Metabolism, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
| | - Saira Burney
- Department of Endocrinology & Metabolism, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
| | - Matthew Glover
- School of Biosciences and Medicine, Faculty of Health and Medical Sciences, University of Surrey, Guildford, Surrey, UK
| | - Vodathi Bamunuarachchi
- Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Western, Sri Lanka
| | - Manju Panda
- Institute of Endocrinology Diabetes and Metabolism, Max Healthcare, New Delhi, Delhi, India
| | - Madawa Madawanarachchi
- Diabetes Research Unit, Faculty of Medicine, University of Colombo, Colombo, Western, Sri Lanka
| | - Baldeesh Rai
- School of Public Health, Imperial College London, London, UK
| | - Iqra Sattar
- Punjab Institute of Cardiology, Lahore, Punjab, Pakistan
| | - Wnurinham Silva
- School of Public Health, Imperial College London, London, UK
| | - Swati Waghdhare
- Institute of Endocrinology Diabetes and Metabolism, Max Healthcare, New Delhi, Delhi, India
| | - Marjo-Riitta Jarvelin
- Center for Life Course Health Research, Faculty of Medicine, University of Oulu, Oulu, Finland
- School of Public Health, Imperial College London, London, UK
- Department of Life Sciences, College of Health and Life Sciences, Brunel University, London, UK
- Unit of Primary Care, Oulu University Hospital, Oulu, Finland
| | | | | | - Heather M Gage
- Surrey Health Economics Centre, Department of Clinical and Experimental Medicine, University of Surrey, Guildford, Surrey, UK
| | - Jonathan Valabhji
- Department of Diabetes and Endocrinology, Imperial College London, London, UK
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Gary S Frost
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Rajitha Wickremasinghe
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Anuradhani Kasturiratne
- Department of Public Health, Faculty of Medicine, University of Kelaniya, Kelaniya, Sri Lanka
| | - Khadija I Khawaja
- Department of Endocrinology & Metabolism, Services Institute of Medical Sciences, Lahore, Punjab, Pakistan
| | - Sajjad Ahmad
- Punjab Institute of Cardiology, Lahore, Punjab, Pakistan
| | - Irene Gm van Valkengoed
- Department of Public and Occupational Health, Amsterdam Public Health research institute, Amsterdam UMC Locatie AMC, Amsterdam, The Netherlands
| | - Prasad Katulanda
- Department of Clinical Medicine, University of Colombo, Colombo, Sri Lanka
| | - Sujeet Jha
- Institute of Endocrinology Diabetes and Metabolism, Max Healthcare, New Delhi, Delhi, India
| | - Jaspal S Kooner
- London North West University Healthcare NHS Trust, Harrow, London, UK
- National Heart & Lung Institute, Faculty of Medicine, Imperial College London, London, UK
| | - John C Chambers
- Lee Kon Chian School of Medicine, Nanyang Technological University, Singapore
- Department of Epidemiology and Biostatistics, Imperial College London, London, UK
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Ng Cheong Chung J, Isgro G, Page T, Thomas D, Haslam P, McNeil A, Soomro N, Rix D, Rai B, Veeratterapillay R. 562 Biopsy of Localised Renal Masses Offers High Diagnostic Yield and Low Complication Rate in Patients with Suspicious Renal Masses. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.1085] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
Abstract
Aim
Biopsy of localised renal masses is generally accurate at detecting benign or malignant histology but can cause complications. The aim of this study was to determine the detection rate and complication rate of renal mass biopsies.
Method
Patients undergoing a renal mass biopsy at a single tertiary centre between January 2015 and December 2019 were identified electronically using a prospective database. Details about their biopsies were recorded including tumour size, radiological guidance, number of cores, longest margin of biopsy, accuracy of biopsy, histology type, and complications.
Results
This study included 334 biopsies (Median age 68 years (IQR 60-72); 61.4% (n = 204) male). Median size of tumour was 30mm (IQR 25-50) and 79.9% (n = 267) were solid masses. The biopsies were done under ultrasound (78.4%) or computed tomography (21.6%) guidance. 91.9% had core biopsies (n = 307) with median biopsy margin of 14mm (IQR 9-21). Benign histology was observed in 18.9% (n = 63), malignant in 72.1% (n = 241) while biopsy was non-diagnostic in 9.0% (n = 30). 62.6% (n = 209) of the cases were renal cell carcinoma with clear cell subtype more commonly seen (72.2%, n = 151). Complications following biopsy included haematoma (n = 7, 2.1%), haemorrhage (n = 3, 0.9%), pneumothorax (n = 1, 0.3%) and vasovagal episode (n = 1, 0.3%), resulting in an overall complication rate of 3.6%.
Conclusions
Biopsy of localised renal masses in this study showed a detection rate of 91% and complication rate of 3.6%. This study suggests renal mass biopsies have high diagnostic yield and low complication rate.
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Affiliation(s)
| | - G Isgro
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - T Page
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - D Thomas
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - P Haslam
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - A McNeil
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - N Soomro
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - D Rix
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
| | - B Rai
- Freeman Hospital, Newcastle upon Tyne, United Kingdom
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10
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Connor M, Genie M, Gonzalez M, Hosking-Jervis F, Thippu Jayaprakash K, Sarwar N, Horan G, Klimowska-Nassar N, Sukumar J, Pokrovska T, Basak D, Rai B, Robinson A, Beresford M, Mangar S, Falconer A, Dudderidge T, Khoo V, Winkler M, Watson V, Ahmed H. Metastatic prostate cancer patients’ Attitudes towards Treatment of the local Tumour and metastasis Evaluative Research (IP5-MATTER): A multicentre, discrete choice experiment trial-in-progress. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01243-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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11
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Gravestock P, Veeratterapillay R, Nambiar A, Gupta A, Aboumarzouk O, Rai B, Heer R. Time to turn on the blue lights: A systematic review and meta-analysis of photodynamic diagnosis for bladder cancer. Eur Urol 2021. [DOI: 10.1016/s0302-2838(21)01093-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Lindegaard J, Petric P, Schmid M, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Huang F, Rai B, Cooper R, van der Steen-Banasik E, Van Limbergen E, Pieters B, Tan L, Nout R, de Leeuw A, Nesvacil N, Kirchheiner K, Jürgenliemk-Schultz I, Tanderup K, Kirisits C, Pötter R, Collaborative Group E. OC-0025 Tumor regression of cervical cancer during chemoradiation evaluated by the T-score in EMBRACE I. Radiother Oncol 2021. [DOI: 10.1016/s0167-8140(21)06277-0] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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13
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Patel K, Rai B, Scott M, O'Brien T. Veno-Venous Extracorporeal Membrane Oxygenation - Rapid Recovery for Post-Surgical Negative Pressure Pulmonary Edema. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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14
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Rai B, Rosse C, Gorder K, Rudick S, Chung E, Raymond T, O'Brien T, Egnaczyk G, Answini G, Griffin J, Smith J, Hasan S, Choo J, Smith T. Left Atrial Veno-Arterial Extracorporeal Membrane Oxygenation (LAVA-ECMO) is a Feasible Option for Patients in Cardiogenic Shock for Whom Impella Offloading is Contraindicated. J Heart Lung Transplant 2021. [DOI: 10.1016/j.healun.2021.01.2095] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
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15
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Ballari N, Rai B, Bahl A, Mittal BR, Ghoshal S. Prospective observational study evaluating acute and delayed treatment related toxicities of prophylactic extended field volumetric modulated arc therapy with concurrent cisplatin in cervical cancer patients with pelvic lymph node metastasis. Tech Innov Patient Support Radiat Oncol 2021; 17:48-56. [PMID: 33748442 PMCID: PMC7970137 DOI: 10.1016/j.tipsro.2021.02.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 02/10/2021] [Accepted: 02/15/2021] [Indexed: 11/30/2022] Open
Abstract
PURPOSE To evaluate the treatment related acute and delayed toxicities of extended field Volumetric modulated arc therapy (VMAT) with concurrent chemotherapy in patients of locally advanced cervical cancer with pelvic lymph nodes. MATERIAL AND METHODS From 2014 to 2016, 15 patients of locally advanced cervical cancer with Fluoro-deoxyglucose positron emission tomography (FDG-PET) positive pelvic lymph nodes were treated with extended field Simultaneous integrated boost (SIB)-VMAT 45 Gy/55 Gy/25#/5weeks and concurrent cisplatin. Acute toxicities were documented according to common terminology criteria for adverse events version 4 (CTCAE v.4). Dose volume parameters and patient characteristics were analyzed for association with toxicities. RESULTS Median age of patients at diagnosis was 48 years. 40% (6 patients) were stage IIB & 60% (9 patients) were stage IIIB. Median number of involved pelvic lymph nodes was 2 (range, 1-4), commonest location was external iliac lymph node region (86%). Median number of concurrent chemotherapy cycles received was five. Treatment was well tolerated and there were no grade ≥ 3 acute toxicities. Commonest acute toxicities observed were vomiting (≥grade2 -13.3%) followed by & nausea (grade ≥ 2 in 6%) and were associated with volume of bowel bag receiving 45 Gy. Constitutional symptoms (≥grade 2) were observed in 6% patients and had no dosimetric associations. At a median follow up of 43 months, delayed ≥ grade1, 2, 3 toxicity were observed in 80%, 0%, and 0% respectively with diarrhea being the commonest. CONCLUSION Prophylactic para aortic extended field VMAT with concurrent chemotherapy for locally advanced cervical cancer is well tolerated with acceptable acute toxicity profile. Significant grade 3 acute/delayed toxicities were not observed in this cohort of patients.
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Affiliation(s)
- N Ballari
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B Rai
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - A Bahl
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - B R Mittal
- Nuclear Medicine, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
| | - S Ghoshal
- Departments of Radiotherapy, Postgraduate Institute of Medical Education and Research (PGIMER), Chandigarh, India
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16
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Murthy P, Dosani A, Sikdar KC, Koleade A, Rai B, Scotland J, Lodha A. Parental perception of neonatal retro-transfers from level 3 to level 2 neonatal intensive care units. J Matern Fetal Neonatal Med 2021; 35:5546-5554. [PMID: 33586586 DOI: 10.1080/14767058.2021.1887125] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
Abstract
OBJECTIVE The primary objective of this study was to determine the overall parental satisfaction with retro-transfers from a level 3 to a level 2 Neonatal Intensive Care Unit (NICU). The secondary objectives were to explore factors that caused parental satisfaction associated with retro-transfer and investigate the factors that could be modified to improve the retro-transfer process. METHODS This is a retrospective cross-sectional study. Questionnaires were mailed to all parents of infants transferred from level 3 to level 2 NICUs from 2016 to 2017. Independent samples t-tests, Spearman's rank correlations, and multiple logistic regression analyses were conducted to identify factors associated with parental retro-transfer satisfaction. RESULTS Our response rate was 39.1% (n = 140). Of all parents, 64.29% parents were extremely satisfied with the overall retro-transfer process. In our bivariate analyses, multiple factors were found to be strongly associated with parental retro-transfer satisfaction, including parental level of education, the amount of notice and rationale given for the retro-transfer and the level of parental communication and engagement with their infant's healthcare team before and after transfer. Multiple logistic regression analyses revealed that when questions regarding the retro-transfer were answered and the level 2 NICU team demonstrated a concrete understanding of the infant's medical issues and history, parental satisfaction increased. CONCLUSION Majority of parents were satisfied with the retro-transfer process. However, close collaboration and ongoing and open lines of communication between parents and the level 3 NICU healthcare teams will increase parental retro-transfer satisfaction rates.
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Affiliation(s)
- P Murthy
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Health Services, Calgary, Canada.,Rockyview General Hospital, Calgary, Canada
| | - A Dosani
- School of Nursing and Midwifery, Mount Royal University, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,O'Brien Institute for Public Health, University of Calgary, Calgary, Canada
| | - K C Sikdar
- Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada
| | - A Koleade
- Alberta Health Services, Calgary, Canada
| | - B Rai
- Cumming School of Medicine, University of Calgary, Calgary, Canada
| | - J Scotland
- Alberta Health Services, Calgary, Canada.,Rockyview General Hospital, Calgary, Canada
| | - A Lodha
- Department of Pediatrics, University of Calgary, Calgary, Canada.,Alberta Health Services, Calgary, Canada.,Department of Community Health Sciences, University of Calgary, Calgary, Canada.,Alberta Children's Hospital Research Institute, University of Calgary Calgary, Canada
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17
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Kumar R, Rai B, Gahlyan S, Kumar G. A comprehensive review on production, surface modification and characterization of nanocellulose derived from biomass and its commercial applications. EXPRESS POLYM LETT 2021. [DOI: 10.3144/expresspolymlett.2021.11] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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18
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Schmid M, Kirisits C, Tanderup K, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Huang F, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Tan L, Nout R, De Leeuw A, Nesvacil N, Jürgenliemk-Schulz I, Lindegaard J, Pötter R. OC-1051: Local failure in cervical cancer patients after MR image-guided adaptive brachytherapy. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)01988-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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19
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Pötter R, Tanderup K, Schmid M, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Huang F, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Tan L, Nout R, De Leeuw A, Nesvacil N, Kirchheiner K, Jürgenliemk-Schulz I, Kirisits C, Lindegaard J, Embrace C. OC-0437: MRI guided adaptive brachytherapy in locally advanced cervical cancer: overall results of EMBRACE I. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00459-x] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
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20
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Smet S, Tanderup K, Nout R, Jürgenliemk-Schulz I, Spampinato S, Chargari C, Lindegaard J, Mahantshetty U, Strudza A, Schmid M, Hoskin P, Segedin B, Bruheim K, Rai B, Huang F, Van Der Steen-Basanik E, Cooper R, Van Limbergen E, Sundset M, Pötter R, Kirchheiner K. OC-0317: Risk factors for persistent late fatigue after radiochemotherapy in cervical cancer (EMBRACE study). Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00341-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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21
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Jensen N, Pötter R, Fokdal L, Chargari C, Lindegaard J, Schmid M, Sturdza A, Mahantshetty U, Jürgenliemk-Schulz I, Hoskin P, Segedin B, Rai B, Bruheim K, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters B, Nout R, Kirisits C, Kirchheiner K, Tanderup K. PH-0404: Risk factors for late diarrhoea after radio(chemo)therapy in cervical cancer: EMBRACE I results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00426-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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22
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Peters M, De Leeuw A, Pötter R, Nomden C, Tanderup K, Kirchheiner K, Schmid M, Fortin I, Haie-Meder C, Lindegaard J, Sturdza A, Mahantshetty U, Hoskin P, Segedin B, Bruheim K, Rai B, Huang F, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Nout R, Jürgenliemk-Schulz I. OC-0566: Risk factors for nodal failure in the EMBRACE study cohort. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00588-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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23
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Vittrup A, Kirchheiner K, Tanderup K, Jensen N, Spampinato S, Fokdal L, Kirisits C, Haie-Meder C, Lindegaard J, Schmid M, Sturdza A, Mahantshetty U, Jürgenliemk-Schulz I, Hoskin P, Segedin B, Bruheim K, Rai B, Wiebe E, Van der Steen-Banasik E, Cooper R, Van Limbergen E, Sundset M, Pieters B, Nout R, Pötter R. OC-0569: Incidence of severe gastrointestinal and urinary fistulas, bleeding and strictures: EMBRACE results. Radiother Oncol 2020. [DOI: 10.1016/s0167-8140(21)00591-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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24
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Knoth J, Pötter R, Jürgenliemk-Schulz IM, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Wiebe E, Rai B, Cooper R, van der Steen-Banasik E, van Limbergen E, Pieters BR, Sundset M, Tan LT, Nout RA, Tanderup K, Kirisits C, Nesvacil N, Lindegaard JC, Schmid MP. Clinical and imaging findings in cervical cancer and their impact on FIGO and TNM staging - An analysis from the EMBRACE study. Gynecol Oncol 2020; 159:136-141. [PMID: 32798000 DOI: 10.1016/j.ygyno.2020.07.007] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2020] [Accepted: 07/05/2020] [Indexed: 01/09/2023]
Abstract
OBJECTIVE To investigate differences in local tumour staging between clinical examination and MRI and differences between FIGO 2009, FIGO 2018 and TNM in patients with primary cervical cancer undergoing definitive radio-chemotherapy. METHODS Patients from the prospective observational multi-centre study "EMBRACE" were considered for analysis. All patients had gynaecological examination and pelvic MRI before treatment. Nodal status was assessed by MRI, CT, PET-CT or lymphadenectomy. For this analysis, patients were restaged according to the FIGO 2009, FIGO 2018 and TNM staging system. The local tumour stage was evaluated for MRI and clinical examination separately. Descriptive statistics were used to compare local tumour stages and different staging systems. RESULTS Data was available from 1338 patients. For local tumour staging, differences between MRI and clinical examination were found in 364 patients (27.2%). Affected lymph nodes were detected in 52%. The two most frequent stages with FIGO 2009 are IIB (54%) and IIIB (16%), with FIGO 2018 IIIC1 (43%) and IIB (27%) and with TNM T2b N0 M0 (27%) and T2b N1 M0 (23%) in this cohort. CONCLUSIONS MRI and clinical examination resulted in a different local tumour staging in approximately one quarter of patients. Comprehensive knowledge of the differential value of clinical examination and MRI is necessary to define one final local stage, especially when a decision about treatment options is to be taken. The use of FIGO 2009, FIGO 2018 and TNM staging system leads to differences in stage distributions complicating comparability of treatment results. TNM provides the most differentiated stage allocation.
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Affiliation(s)
- J Knoth
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - R Pötter
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | | | - C Haie-Meder
- Department of Radiotherapy, Gustave-Roussy, France
| | - L Fokdal
- Department of Oncology, Aarhus University Hospital, Denmark
| | - A Sturdza
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - P Hoskin
- Mount Vernon Cancer Centre, Northwood, United Kingdom
| | - U Mahantshetty
- Department of Radiation Oncology, Tata Memorial Hospital, India
| | - B Segedin
- Department of Oncology, Institute of Oncology Ljubljana, Slovenia
| | - K Bruheim
- Department of Oncology, The Norwegian Radium Hospital, Oslo University Hospital, Norway
| | - E Wiebe
- Department of Oncology, Cross Cancer Institute and University of Alberta, Edmonton, Canada
| | - B Rai
- Department of Radiotherapy and Oncology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - R Cooper
- Leeds Cancer Centre, St James's University Hospital, United Kingdom
| | | | - E van Limbergen
- Department of Radiation Oncology, University Hospitals Leuven, Belgium
| | - B R Pieters
- Department of Radiation Oncology, Amsterdam University Medical Centers, University of Amsterdam, The Netherlands
| | - M Sundset
- Clinic of Oncology and Women's Clinic, St. Olavs Hospital, Trondheim, Norway
| | - L T Tan
- Oncology Centre, Cambridge University Hospitals NHS Foundation Trust, Addenbrooke's Hospital, Cambridge, UK
| | - R A Nout
- Department of Radiation Oncology, Erasmus MC, Erasmus University Rotterdam, The Netherlands
| | - K Tanderup
- Department of Oncology, Aarhus University Hospital, Denmark
| | - C Kirisits
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - N Nesvacil
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria
| | - J C Lindegaard
- Department of Oncology, Aarhus University Hospital, Denmark
| | - M P Schmid
- Department of Radiation Oncology, Comprehensive Cancer Center, Medical University of Vienna, General Hospital of Vienna, Austria.
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25
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26
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Young M, Kailavasan M, Taylor J, Cornford P, Colquhoun A, Rochester M, Hanchanale V, Somani B, Nabi G, Garthwaite M, Gowda R, Reeves F, Rai B, Doherty R, Gkentzis A, Athanasiadis G, Patterson J, Wilkinson B, Myatt A, Biyani CS, Jain S. The Success and Evolution of a Urological "Boot Camp" for Newly Appointed UK Urology Registrars: Incorporating Simulation, Nontechnical Skills and Assessment. J Surg Educ 2019; 76:1425-1432. [PMID: 31036524 DOI: 10.1016/j.jsurg.2019.04.005] [Citation(s) in RCA: 26] [Impact Index Per Article: 5.2] [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: 12/08/2018] [Revised: 03/02/2019] [Accepted: 04/08/2019] [Indexed: 06/09/2023]
Abstract
BACKGROUND Urological training has dramatically changed in recent years. Training durations are shorter and a drive toward consultant led care has reduced trainees experience. Within the UK, approximately 50 registrars annually embark on a 5-year Urology training programme, with variable levels of basic urological experience. OBJECTIVE To describe a simulation programme aimed at delivering the knowledge and skills necessary to safely and effectively start working as a registrar in Urology by intensive training with a 1:1 faculty to delegate ratio. DESIGN, SETTING, AND PARTICIPANTS Our course content mirrors the UK training syllabus for junior Urology registrars. We delivered 8 modules over a 4-day programme with a fifth day of assessments. Delegates level of urological knowledge, operative competency and confidence pre-, immediately post-training and at 3-months postcourse were assessed. Objective delegate and faculty feedback was also collected. Technical skills modules include; inguinoscrotal surgery, ureteroscopy, transurethral resection, urodynamics, and Botox administration as well as basic reconstructive and laparoscopic operative skills. "Nontechnical" skills included simulated ward round, out-patient, and emergency scenarios. RESULTS Feedback from delegates and faculty members has been overwhelmingly positive. We have used this feedback to tailor the content of the course for following years. An increased knowledge level (based on mean examination scores [precourse 55.5%, postcourse 70.1%]) and operative competency was observed in all skills assessed (transurethral resection of the prostate, transurethral resection of bladder tumor, Ureteroscopy, laparoscopic skills, and instrument assembly). Operative confidence was increased immediately and at 3-months postcourse. CONCLUSIONS Our "boot camp" course provides a realistic introduction and foundation to begin Urological practice. Being delivered at the beginning of the training scheme, prior to intensive patient exposure, registrars are in an optimum position to develop their newly acquired knowledge and skills to enhance training and intends to improve patient safety and satisfaction.
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Affiliation(s)
- M Young
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom
| | - M Kailavasan
- Royal Birmingham Heartlands Hospital, Birmingham, United Kingdom
| | - J Taylor
- Forth Valley Royal Hospital, Scotland, United Kingdom
| | - P Cornford
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - A Colquhoun
- Cambridge University Hospitals NHS Foundation Trust, Cambridge, United Kingdom
| | - M Rochester
- Norfolk & Norwich University Hospitals NHS Foundation Trust, United Kingdom
| | - V Hanchanale
- Royal Liverpool and Broadgreen University Hospitals NHS Trust, Liverpool, United Kingdom
| | - B Somani
- University Hospital Southampton NHS Trust, Southampton, United Kingdom
| | - G Nabi
- Ninewells Hospital, Dundee, United Kingdom
| | - M Garthwaite
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - R Gowda
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - F Reeves
- University of East Anglia, Norwich, United Kingdom
| | - B Rai
- South Tees Hospitals NHS Foundation Trust, Middlesbrough, United Kingdom
| | - R Doherty
- Norfolk & Norwich University Hospitals NHS Foundation Trust, United Kingdom
| | - A Gkentzis
- Royal Bolton Hospital, Bolton, United Kingdom
| | | | - J Patterson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - B Wilkinson
- Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, United Kingdom
| | - A Myatt
- Hull and East Yorkshire NHS Trust, Hull, United Kingdom
| | - C S Biyani
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom.
| | - S Jain
- St James's University Hospital, Leeds Teaching Hospital Trust, Leeds, United Kingdom
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Yadav S, Rai B, Bhatta M, Thakur J. MON-313 PROFILE OF NEPHROTIC SYNDROME ATTENDING PEDIATRIC RENAL CLINIC: A SINGLE CENTER EXPERIENCE. Kidney Int Rep 2019. [DOI: 10.1016/j.ekir.2019.05.1124] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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28
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Chopra S, Mittal P, Viswanathan A, Tharavichitkul E, Zubizarreta E, Nout RA, Yap ML, Grover S, Rodin D, Rai B, Gondhowiardjo S, Shrivastava SK. Global Collaborations for Cervical Cancer: Can the East-West Alliance Facilitate Treatment for all? Clin Oncol (R Coll Radiol) 2019; 31:529-538. [PMID: 31229379 DOI: 10.1016/j.clon.2019.05.022] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/24/2019] [Revised: 05/11/2019] [Accepted: 05/28/2019] [Indexed: 12/20/2022]
Abstract
Despite the advances in the primary prevention of cervical cancer, there is an absolute increase in the incidence of cervical cancer as a result of an increase in world population. A vast majority of patients in low and low-middle income countries continue to present at a locally advanced stage, necessitating treatment with chemoradiation and brachytherapy. There is a dearth of equipment and trained professionals for the treatment of cervical cancer, especially in low and low-middle income countries. There is an urgent need to improve treatment availability and develop better treatments. Worldwide trends, however, reveal a low number of therapeutic and innovative research trials in cervical cancer. The present article elucidates the existing challenges and provides solutions to improve outcomes. The proposed strategies hinge on strengthening collaborations for global advocacy.
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Affiliation(s)
- S Chopra
- Department of Radiation Oncology, Advanced Centre for Treatment, Research and Education in Cancer (ACTREC), Tata Memorial Centre, Navi Mumbai, India; Homi Bhabha National Institute, Mumbai, India.
| | - P Mittal
- Homi Bhabha National Institute, Mumbai, India; Department of Radiation Oncology, Tata Memorial Hospital, Tata Memorial Centre, Mumbai, India
| | - A Viswanathan
- Department of Radiation Oncology, Johns Hopkins University Medical Center, Baltimore, Maryland, USA
| | - E Tharavichitkul
- Division of Radiation Oncology, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand
| | - E Zubizarreta
- Division of Human Health, International Atomic of Energy Agency - Vienna International Centre, Vienna, Austria
| | - R A Nout
- Department of Radiation Oncology, Leiden University Medical Center LUM, Leiden, the Netherlands
| | - M L Yap
- Collaboration for Cancer Outcomes, Research and Evaluation (CCORE), Ingham Institute, UNSW Sydney, Liverpool, New South Wales, Australia; Liverpool and Macarthur Cancer Therapy Centres, Western Sydney University, Campbelltown, New South Wales, Australia; School of Public Health, The University of Sydney, Camperdown, Australia
| | - S Grover
- Department of Radiation Oncology, University of Pennsylvania, Philadelphia, USA; Botswana-UPENN Partnership, University of Botswana, Gaborone, Botswana
| | - D Rodin
- Department of Radiation Oncology, University of Toronto, Toronto, Ontario, Canada
| | - B Rai
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Gondhowiardjo
- Department of Radiotherapy, Dr. Cipto Mangunkusumo National General Hospital, Jakarta, Indonesia
| | - S K Shrivastava
- Department of Radiation Oncology, Apollo Hospital, Belapur, Navi Mumbai, India
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Jayabal H, Dingari NN, Rai B. A linear viscoelastic model to understand skin mechanical behaviour and for cosmetic formulation design. Int J Cosmet Sci 2019; 41:292-299. [PMID: 31032974 DOI: 10.1111/ics.12535] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [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: 02/12/2019] [Accepted: 04/24/2019] [Indexed: 01/30/2023]
Abstract
OBJECTIVES Skin is arguably one of the most important organs that plays an active role in our everyday biological functions after brain. Owing to the wide range of applications in medicine, cosmetics industry and more recently robotics, skin research has gained tremendous attention with respect to its mechanical behaviour. Various macro modelling approaches are available for modelling skin's mechanical behaviour. The objective of this paper is to study skin's mechanical property change with age and demonstrate anti-ageing effects of cosmetic formulations from skin mechanical property change perspective. METHODS In this study, skin's mechanical behaviour was modelled using a 1D linear viscoelastic phenomenological model and the model was validated using two sets of experimentally observed skin data (strain, stress relaxation and cyclical loading). The model was further modified to study the effect of the presence of a thin layer of cosmetic polymer and to demonstrate anti-ageing effects of the cosmetic polymer from the perspective of change in the mechanical behaviour of skin with cosmetic layer. RESULTS The estimated values of skin mechanical properties from the model agree with those in literature. The extracted model features show good correlation with skin age (viscosity and time constant). The results from our model indicate that the cosmetic polymers enhance the mechanical properties of skin significantly. CONCLUSIONS This work will find its applications in designing and testing anti-ageing formulations. This model can be used to filter various combinations of cosmetic formulations by knowing the mechanical response of polymer on skin, thereby accelerating the product development.
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Affiliation(s)
- H Jayabal
- Physical Science Research Area, Tata Research Development and Design Centre, TCS Research, Tata Consultancy Services 54B, Hadapsar Industrial Estate, Pune, 411013, India
| | - N N Dingari
- Physical Science Research Area, Tata Research Development and Design Centre, TCS Research, Tata Consultancy Services 54B, Hadapsar Industrial Estate, Pune, 411013, India
| | - B Rai
- Physical Science Research Area, Tata Research Development and Design Centre, TCS Research, Tata Consultancy Services 54B, Hadapsar Industrial Estate, Pune, 411013, India
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Abstract
Objectives Long bone defects often require surgical intervention for functional restoration. The ‘gold standard’ treatment is autologous bone graft (ABG), usually from the patient’s iliac crest. However, autograft is plagued by complications including limited supply, donor site morbidity, and the need for an additional surgery. Thus, alternative therapies are being actively investigated. Autologous bone marrow (BM) is considered as a candidate due to the presence of both endogenous reparative cells and growth factors. We aimed to compare the therapeutic potentials of autologous bone marrow aspirate (BMA) and ABG, which has not previously been done. Methods We compared the efficacy of coagulated autologous BMA and ABG for the repair of ulnar defects in New Zealand White rabbits. Segmental defects (14 mm) were filled with autologous clotted BM or morcellized autograft, and healing was assessed four and 12 weeks postoperatively. Harvested ulnas were subjected to radiological, micro-CT, histological, and mechanical analyses. Results Comparable results were obtained with autologous BMA clot and ABG, except for the quantification of new bone by micro-CT. Significantly more bone was found in the ABG-treated ulnar defects than in those treated with autologous BMA clot. This is possibly due to the remnants of necrotic autograft fragments that persisted within the healing defects at week 12 post-surgery. Conclusion As similar treatment outcomes were achieved by the two strategies, the preferred treatment would be one that is associated with a lower risk of complications. Hence, these results demonstrate that coagulated BMA can be considered as an alternative autogenous therapy for long bone healing. Cite this article: Z. X. H. Lim, B. Rai, T. C. Tan, A. K. Ramruttun, J. H. Hui, V. Nurcombe, S. H. Teoh, S. M. Cool. Autologous bone marrow clot as an alternative to autograft for bone defect healing. Bone Joint Res 2019;8:107–117. DOI: 10.1302/2046-3758.83.BJR-2018-0096.R1.
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Affiliation(s)
- Z X H Lim
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - B Rai
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Science and Maths Cluster, Singapore University of Technology & Design (SUTD), Singapore
| | - T C Tan
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore
| | - A K Ramruttun
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - J H Hui
- Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
| | - V Nurcombe
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College, Singapore
| | - S H Teoh
- Lee Kong Chian School of Medicine, Nanyang Technological University-Imperial College, Singapore; School of Chemical and Biomedical Engineering, Nanyang Technological University, Singapore
| | - S M Cool
- Glycotherapeutics Group, Institute of Medical Biology, Agency for Science, Technology and Research, Singapore; Department of Orthopaedic Surgery, Yong Loo Lin School of Medicine, National University of Singapore, Singapore
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Knoth J, Pötter R, Jürgenliemk-Schulz I, Haie-Meder C, Fokdal L, Sturdza A, Hoskin P, Mahantshetty U, Segedin B, Bruheim K, Wiebe E, Rai B, Cooper R, Van der Steen-Banasik E, Van Limbergen E, Pieters B, Sundset M, Tan L, Nout R, Tanderup K, Kirisits C, Nesvacil N, Lindegaard J, Schmid M. PO-0827 Comparison of clinical examination and MRI for local cervical cancer staging (FIGO and T(NM)). Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)31247-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Erchick DJ, Rai B, Agrawal NK, Khatry SK, Katz J, LeClerq SC, Reynolds MA, Mullany LC. Oral hygiene, prevalence of gingivitis, and associated risk factors among pregnant women in Sarlahi District, Nepal. BMC Oral Health 2019; 19:2. [PMID: 30611255 PMCID: PMC6321675 DOI: 10.1186/s12903-018-0681-5] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2018] [Accepted: 11/27/2018] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The oral health status of pregnant women in low-resource communities such as Nepal has not been well characterized. This sub-population is also of specific interest given associations between poor oral health and adverse pregnancy outcomes previously documented in other settings. We explored relationships between gingivitis and risk factors among pregnant women in rural Nepal. METHODS The design was a community-based, cross-sectional study in a sub-area of Sarlahi District, Nepal. Pregnant women < 26 weeks gestation underwent clinical periodontal exams conducted by community-based oral health workers. Exams included a full mouth assessment measuring bleeding on probing (BOP), probing depth (PD) (six sites per tooth), and gingival recession, the distance from the cemento-enamel junction to the free gingival margin (two direct sites per tooth). Data on participant risk factors were collected through household surveys, including demographic characteristics, oral health behaviors, care seeking, and health attitudes. Multivariable logistic regression modeling was used to assess relationships between gingivitis and risk factors. RESULTS We enrolled 1452 participants, of which 40% (n = 582) had signs of clinical gingivitis and 60% (n = 870) clinical health. Average participant age was 23. Most participants (88%) had never received oral health care. Participants averaged 10% of sites with BOP with most (79%) having ≥1 site with BOP. Nine percent of participants had ≥1 site with PD ≥4 mm, although very few participants (0.7%) had sites with PD ≥5 mm. Few participants (13%) had any recession (≥1 mm). In the final adjusted model, odds of gingivitis increased by 3% for each year of age (aOR 1.03, 95% CI 1.00, 1.06) and were higher for women of short maternal stature (< 150 cm) (aOR 1.43, 95% CI: 1.14, 1.79) and among women reporting cost to be a barrier to seeking dental care (aOR 2.13, 95% CI: 1.09, 4.15). CONCLUSIONS Gingivitis was common and associated with age, maternal stature, self-reported high cost of dental care, and other risk factors among pregnant women in rural Nepal. TRIAL REGISTRATION ClinicalTrials.gov Identifier: NCT01177111 (Nepal Oil Massage Study) and NCT02788786 (Pilot Trial).
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Affiliation(s)
- D. J. Erchick
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - B. Rai
- Nepal Nutrition Intervention Project, Sarlahi (NNIPS), Krishna Galli, Lalitpur, Kathmandu Nepal
| | - N. K. Agrawal
- Department of Dentistry, Institute of Medicine, Tribhuhvan University, Kathmandu, Nepal
| | - S. K. Khatry
- Nepal Nutrition Intervention Project, Sarlahi (NNIPS), Krishna Galli, Lalitpur, Kathmandu Nepal
| | - J. Katz
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
| | - S. C. LeClerq
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
- Nepal Nutrition Intervention Project, Sarlahi (NNIPS), Krishna Galli, Lalitpur, Kathmandu Nepal
| | - M. A. Reynolds
- Department of Advanced Oral Sciences and Therapeutics, University of Maryland School of Dentistry, Baltimore, MD USA
| | - L. C. Mullany
- Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD USA
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Elangovan A, Bahl A, Patel F, Dracham C, Rai B, Trivedi G. Is bone marrow sparing intensity modulated radiotherapy better than 3-dimensional conformal radiotherapy in reducing haematological toxicities during pelvic irradiation in locally advanced carcinoma cervix?: A prospective study. Ann Oncol 2018. [DOI: 10.1093/annonc/mdy436.010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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Fokdal L, Tanderup K, Pötter R, Kirchheiner K, Sturdza A, Chargari C, Jürgenliemk-Schulz I, Segedin B, Tan L, Hoskin P, Mahantshetty U, Bruheim K, Rai B, Kirisits C, Lindegaard J. OC-0072: Risk factors for ureteral stricture after IGABT in cervical cancer: results from the EMBRACE studies. Radiother Oncol 2018. [DOI: 10.1016/s0167-8140(18)30382-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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Chowdhury MM, Ullah AA, Karim R, Ahmed A, Mohammed S, Sobhan SA, Farmidi AA, Zuwaida F, Pradan R, Mahmud R, Rai B, Pervin S, Habib R. Complete Annular Pancreas with Concurrent Entero-Pancreatico-Biliary Symptoms in Adult: A Case Report. Mymensingh Med J 2018; 27:196-200. [PMID: 29459613] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Complete Annular pancreas (AP) is a rare congenital anomaly, often presented and operated at the early age of life. Adult presentation group usually presents with either biliary or duodenal or pancreatic symptoms. We report a case of 43 years old female presenting with concurrent enteric, biliary and pancreatic symptoms admitted on April 2016 in Hepatobiliary and Pancreatic Surgery Department of BSMMU, Dhaka, Bangladesh. A complete type of annular pancreas with partial duodenal stenosis and dilated common bile duct was observed during laparotomy. We performed gastrojejunostomy as well as hepaticojejunostomy (Roux-en-Y anastomosis). Patient was discharged in a good symptom free condition. Complete Annular Pancreas can present at any age, with any one or all of the biliary, pancreatic or duodenal symptoms. Surgery is the treatment of choice and has a good outcome.
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Affiliation(s)
- M M Chowdhury
- Professor Md Mohsen Chowdhury, Professor & Head, Department of the Yellow Unit II, Hepatobiliary & Pancreatic Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh
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Kumar M, Pal A, Jain A, Ghoshal S, Rai B, Mohindra S, Das A. 35P Clinical significance of expression of cripto-1 in patients of squamous cell carcinoma of oropharynx. Ann Oncol 2016. [DOI: 10.1016/s0923-7534(21)00195-2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022] Open
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Kumar M, Pal A, Jain A, Ghoshal S, Rai B, Mohindra S, Das A. 35P Clinical significance of expression of cripto-1 in patients of squamous cell carcinoma of oropharynx. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw574.008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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Rai B, Miriyala R, Ghoshal S, Ballari N, Singla V. Margins Around the Involved Pelvic Lymph Nodes for Planning Simultaneous Integrated Boost in Patients With Cervical Cancer Undergoing Pelvic Intensity Modulated Radiation Therapy. Int J Radiat Oncol Biol Phys 2016. [DOI: 10.1016/j.ijrobp.2016.06.1421] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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Kumar N, Rai B, Bhat SA, Kharche SD, Gangwar C, Jindal SK, Chandra S. Effect of management system and season on semen freezability in Jakhrana bucks. Vet World 2016; 9:199-202. [PMID: 27051208 PMCID: PMC4819372 DOI: 10.14202/vetworld.2015.199-202] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/27/2015] [Revised: 12/30/2015] [Accepted: 01/12/2016] [Indexed: 11/16/2022] Open
Abstract
AIM The objective of the study was to determine the effect of the management system (intensive and semi-intensive) and season (autumn and winter) on semen freezability in Jakhrana bucks. MATERIALS AND METHODS A total of 24 Jakhrana bucks of same body weight and age (BW=30 kg, age=1 year) were randomly allotted into two groups, viz., Group I (intensive system, 12 bucks) and Group II (semi-intensive system, 12 bucks). These two groups were statistically tested for their homogeneity with respect to age and BW. Semen was collected twice weekly using an artificial vagina during two seasons: autumn (September-November) and winter (December-February). A total of 240 semen samples (120 from each group and season) were evaluated for post-thaw motility (PTM), viability, abnormality, functional membrane integrity (hypo-osmotic swelling [HOS]) response and acrosomal integrity. RESULTS The mean values of PTM and acrosomal integrity of spermatozoa were significantly (p<0.01) higher in Group II as compared to Group I. The mean values of viability and abnormality were also differed significant (p<0.05) between groups. However, the mean values of HOS response were found non-significant (p>0.05) between groups. The season showed a significant effect on all parameters except viability and HOS response. The PTM and acrosomal integrity of spermatozoa were significantly (p<0.01) higher in winter as compared to autumn season. Abnormality of spermatozoa was significantly (p<0.05) lower in winter season. CONCLUSIONS This study indicates that both management system and season influence semen freezability. The semen collected from bucks reared under the semi-intensive system and winter season showed better semen freezability characteristics.
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Affiliation(s)
- Narendra Kumar
- Department of Livestock Production and Management, ICAR - National Dairy Research Institute, Karnal - 132 001, Haryana, India
| | - B Rai
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - Showkat A Bhat
- Department of Livestock Production and Management, ICAR - National Dairy Research Institute, Karnal - 132 001, Haryana, India
| | - S D Kharche
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - Chetna Gangwar
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - S K Jindal
- Department of Physiology Reproduction and Shelter Management, ICAR- Central Institute for Research on Goats, Mathura - 281 001, Uttar Pradesh, India
| | - Subhash Chandra
- Department of Livestock Production and Management, ICAR - National Dairy Research Institute, Karnal - 132 001, Haryana, India
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Khosla D, Patel FD, Shukla AK, Rai B, Oinam AS, Sharma SC. Dosimetric evaluation and clinical outcome in post-operative patients of carcinoma vulva treated with intensity-modulated radiotherapy. Indian J Cancer 2016; 52:670-5. [PMID: 26960514 DOI: 10.4103/0019-509x.178448] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND To compare dosimetric parameters of intensity-modulated radiation therapy (IMRT) with 3D conformal radiotherapy (3DCRT) in post-operative patients of vulvar cancer and to assess clinical outcome and toxicity with IMRT. MATERIALS AND METHODS A total of 8 post-operative patients of vulvar cancer were treated with IMRT. All patients were also planned by 3DCRT for comparison with IMRT. The two plans were compared in terms of conformity index, homogeneity index, tumor control probability (TCP) and normal tissue complication probability (NTCP) for the planning target volume and organs at risk (OAR). RESULTS IMRT resulted in significantly lesser doses to rectum, bladder, bowel and femoral head as compared with 3DCRT plans. Mean conformity and homogeneity indices were better and within range with IMRT. The TCP was comparable between the two treatment plans and NTCP for rectum, bladder, bowel and femoral head was significantly less with IMRT as compared with 3DCRT. Treatment was well-tolerated and none of the patients developed Grade 3 or higher toxicity. CONCLUSION IMRT yielded superior plans with respect to target coverage, homogeneity and conformality while lowering dose to adjacent OAR as compared with 3DCRT. Thus, IMRT offers a reduction in NTCP while maintaining TCP.
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Affiliation(s)
- D Khosla
- Department of Radiotherapy and Oncology, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Kumar N, Rai B, Bhat SA, Kharche SD, Gangwar C, Jindal SK, Chandra S. Effect of management system and season on semen freezability in Jakhrana bucks. Vet World 2016. [DOI: 10.14202/vetworld.2016.199-202] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
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Rai B, Patel FD, Chakraborty S, Kapoor R, Sharma SC, Kumaravelu S, Raghukumar P, Aprem AS. Bladder-Rectum Spacer Balloon versus Vaginal Gauze Packing in High Dose Rate Brachytherapy in Cervical Cancer: A Randomised Study. Part II. Clin Oncol (R Coll Radiol) 2015; 27:713-9. [PMID: 26144319 DOI: 10.1016/j.clon.2015.06.014] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/10/2015] [Revised: 05/28/2015] [Accepted: 06/12/2015] [Indexed: 10/23/2022]
Abstract
AIMS To compare the inter-fraction dose variation for bladder and rectum using a bladder-rectum spacer balloon (BRSB) versus vaginal gauze packing (VGP) in patients treated with high dose rate intracavitary brachytherapy for carcinoma cervix. MATERIALS AND METHODS After the completion of external radiotherapy, 80 patients were randomised to receive intracavitary brachytherapy using either the BRSB or VGP. The procedure was carried out under general anaesthesia using tandem ovoid applicators. Computed tomography-based planning was carried out and the dose was prescribed to point A. Doses to 0.1, 1 and 2 cm(3) volumes were reported for bladder and rectum for each fraction. The absolute inter-fraction dose variation for each subvolume was compared using the independent sample t-test. RESULT The mean bladder and rectal volumes, as well as the inter-fraction volume variation, were comparable for the BRSB and VGP. The BRSB resulted in a significant reduction in absolute dose as well as the inter-fraction variation for dose to 2 cm(3) rectum volumes (BRSB 0.80 Gy, standard deviation 0.71 Gy versus VGP 1.16 Gy, standard deviation 0.83 Gy; P = 0.04). Cumulative bladder D2cm(3) doses of more than 90 Gy3 were observed in six patients in the BRSB arm versus four patients in the VGP arm (P = 0.73). In both the arms, the rectal D2cm(3) doses did not exceed 75 Gy3. CONCLUSIONS Use of a BRSB resulted in a significant reduction in inter-fraction variation in D2cm(3) rectal dose. However, no significant difference in the inter-fraction dose variation for the other subvolumes of bladder and rectum could be shown between the BRSB and VGP. The use of a BRSB may enable rectal dose reduction and inter-fraction variation where anaesthesia is not routinely used or where there is limited physician expertise. The modification suggested in the BRSB may facilitate its additional usage.
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Affiliation(s)
- B Rai
- Department of Radiotherapy, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
| | - F D Patel
- Department of Radiotherapy, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Chakraborty
- Department of Radiotherapy, Tata Memorial Hospital, Mumbai, India
| | - R Kapoor
- Department of Radiotherapy, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S C Sharma
- Department of Radiotherapy, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - S Kumaravelu
- Department of Radiotherapy, Regional Cancer Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - P Raghukumar
- Regional Cancer Centre, Thiruvananthapuram, Kerala, India
| | - A S Aprem
- HLL Life Care Limited, Thiruvananthapuram, Kerala, India
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Creswell J, Rai B, Wali R, Sudrungrot S, Adhikari LM, Pant R, Pyakurel S, Uranw D, Codlin AJ. Introducing new tuberculosis diagnostics: the impact of Xpert ® MTB/RIF testing on case notifications in Nepal. Int J Tuberc Lung Dis 2015; 19:545-51. [DOI: 10.5588/ijtld.14.0775] [Citation(s) in RCA: 38] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
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Rai B, Sinha P, Singh V, Vidhyarthi S, Amit A, Pandey A, Shahi S. Structural and Spectroscopic Aspects of Schiff Base Metal Complexes of Cobalt(II), Nickel(II) and Copper(II). ACTA ACUST UNITED AC 2014. [DOI: 10.13005/ojc/300366] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Rai B, Ali M, Kumar V, Krebit I. Transient acute adrenal insufficiency associated with adenovirus serotype 40 infection. Case Reports 2014; 2014:bcr-2014-204486. [DOI: 10.1136/bcr-2014-204486] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rai B, Moka S, Sharif F. Nocturnal lagophthalmos: never seen before in hypernatraemic dehydration. Case Reports 2014; 2014:bcr-2013-203427. [DOI: 10.1136/bcr-2013-203427] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/03/2022] Open
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Murali S, Rai B, Dombrowski C, Lee JLJ, Lim ZXH, Bramono DS, Ling L, Bell T, Hinkley S, Nathan SS, Hui JH, Wong HK, Nurcombe V, Cool SM. Affinity-selected heparan sulfate for bone repair. Biomaterials 2013; 34:5594-605. [PMID: 23632323 DOI: 10.1016/j.biomaterials.2013.04.017] [Citation(s) in RCA: 64] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2013] [Accepted: 04/07/2013] [Indexed: 12/01/2022]
Abstract
Bone morphogenetic protein (BMP)-2 is a potent bone healing compound produced at sites of bone trauma. Here we present a therapeutic strategy to harness the activity of endogenously produced BMP-2 by delivery of an affinity-matched heparan sulfate (HS) glycos aminoglycan biomaterial that increases the bioavailability, bioactivity and half-life of this growth factor. We have developed a robust, cost effective, peptide-based affinity platform to isolate a unique BMP-2 binding HS variant from commercially available preparations of HS, so removing the manufacturing bottleneck for their translation into the clinic. This affinity-matched HS enhanced BMP-2-induced osteogenesis through improved BMP-2 kinetics and receptor modulation, prolonged pSMAD signaling and reduced interactions with its antagonist noggin. When co-delivered with a collagen implant, the HS was as potent as exogenous BMP-2 for the healing of critical-sized bone defects in rabbits. This affinity platform can be readily tuned to isolate HS variants targeted ata range of clinically-relevant growth and adhesive factors.
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Affiliation(s)
- S Murali
- Glycotherapeutics Group, Institute of Medical Biology, A*STAR, 8A Biomedical Grove, #06-06 Immunos, Singapore 138648, Singapore
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Khosla D, Patel F, Rai B, Chakraborty S, Oinam A, Sharma S. Dose Escalation by Intensity-modulated Radiotherapy Boost after Whole Pelvic Radiotherapy in Postoperative Patients of Carcinoma Cervix with Residual Disease. Clin Oncol (R Coll Radiol) 2013; 25:e1-6. [DOI: 10.1016/j.clon.2012.07.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/01/2011] [Revised: 06/26/2012] [Accepted: 07/26/2012] [Indexed: 10/28/2022]
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Rai B, Patel F, Sharma S, Kapoor R, Aprem A. PD-0301 BLADDER-RECTUM SPACER BALLOON IN HDR BRACHYTHERAPY IN CARCINOMA CERVIX. Radiother Oncol 2012. [DOI: 10.1016/s0167-8140(12)70640-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mielczarski JA, Jeyachandran YL, Mielczarski E, Rai B. Modification of polystyrene surface in aqueous solutions. J Colloid Interface Sci 2011; 362:532-9. [PMID: 21802090 DOI: 10.1016/j.jcis.2011.05.068] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/18/2011] [Revised: 05/18/2011] [Accepted: 05/22/2011] [Indexed: 10/18/2022]
Abstract
Herein, we report our analysis of the surface modification of polystyrene (PS) when treated under ambient conditions with a common biological buffer such as phosphate buffered saline (PBS) or aqueous solutions of the ionic constituents of PBS. Attenuated total reflection Fourier transform infrared spectroscopy was used for the analysis because the resultant spectra are very sensitive to minor changes in the chemical and structural properties of PS films. In addition, ultraviolet-visible spectroscopy was applied to characterize the surface modifications of PS. Treatment with PBS resulted in the most significant chemical and structural surface modifications of the PS films, as compared with each of the solutions of the constituents of PBS, which were tested separately. A multistep mechanism for the wet modification of PS is discussed. We postulate that the observed surface modifications are the result of photo-oxidation/reduction, swelling, and conformational changes and re-arrangement of the polymer chain. The resultant surface modifications could be similar to those produced by commonly used dry processes such as plasma treatments and electron, ion or ultraviolet irradiation. We found that the modifications that occurred in PBS were more stable than those initiated by dry processes. The formation of active groups on the surface of PS can be controlled by adsorption of bovine serum albumin or thermal annealing of PS before PBS treatment. This approach provides a simple and efficient method for the surface modification of PS for biomedical applications.
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Affiliation(s)
- J A Mielczarski
- LEM, Nancy-Université, CNRS, 15 Avenue du Charmois, B.P. 40, F-54501 Vandœuvre lès Nancy, France.
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