1,425 results on '"Gupta, P."'
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2. Outcomes and Complications of Donor and Recipient of Renal Transplantation: An Experience from Tertiary Care Center – A Retrospective Observational Study
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Sahil Punia, Nripesh Sadasukhi, Trilok Chand Sadasukhi, Hoti Lal Gupta, Manish Gupta, and Ashish Sharma
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acute graft rejection ,delayed graft function ,live donor ,renal transplant ,Surgery ,RD1-811 - Abstract
Introduction: Kidney transplantation has emerged as a preferred method for improving survival and quality of life for patients with end-stage renal disease in comparison with dialysis. Living donation provides a better patient and allograft survival when compared with deceased-donor transplantation, specifically when the live donor transplant is accomplished before the onset of dialysis. The present study aimed to create and add data for the long-term survival, complications occurred in donor as well as in recipient both in single study in India. Materials and Methods: We performed a retrospective cohort study of all adult patients undergoing renal transplantation. Data on kidney transplantation and operative variables, as well as follow-up data, were obtained retrospectively from the Internal Medical Record Department. The primary outcomes examined were both donor and recipient and graft survival after 2 years and 5 years. Secondary outcomes included the presence of acute rejection and delayed graft function, as well as the rate of postoperative complications. Results: A total of 500 donors and 500 recipients participated in the research overall. The mean warm ischemia time was 3.1 ± 1.4 min and cold ischemia time was 44.3 ± 23.4 min. Surgical complications were encountered in 32.8% (164/500) of patients. The 2-year and 5-year graft survival rates were 90.2% and 84.8%, respectively. Conclusion: Our patients’ rate of complications was not greater than that noted in the previous publications. A thorough and meticulous medical assessment of the donor and recipient is required, as well as a rigorous and responsible evaluation of the indications.
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- 2024
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3. Multiple Renal Arteries in Live Donor Renal Transplantation and Impact on Graft Function and Outcome: A Retrospective Study
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Ankit Modi, Nripesh Sadasushi, Manish Gupta, Hoti Lal Gupta, Ashish Sharma, Trilok Chand Sadasukhi, Anant Giri, and Jaun Zeb Rizvi
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delayed graft function ,multiple renal arteries ,single renal arteries ,slow graft function ,Surgery ,RD1-811 - Abstract
Objective: The objective of the study is to evaluate the outcomes of live-donor renal allografts with multiple and single renal arteries taking into consideration ischemia times, graft function, and other complications including vascular and urological. Materials and Methods: We conducted a retrospective study by analyzing a prospectively maintained database from January 2021 to December 2021 of all patients undergoing live-related renal allograft transplants at a tertiary care center in North India. A total of 239 live donor kidney transplants were performed during this period. Patients were divided into two groups – Group 1: Single artery single anastomosis and Group 2: Multiple arteries with two or more anastomoses. Duplex imaging of the graft was done at 6 months. Recipients were followed up for possible graft dysfunction, arterial insufficiency, and major urological complications. Results: Mean ischemia times in the two groups were 20.62 ± 1.05 and 30.45 ± 1.77 min, respectively. Failure to normalize creatinine ( 0.05). Slow graft function was encountered in 6 cases in Group 1 and 3 cases in Group 2. Delayed graft function occurred in two patients in both groups. One-year graft survival among the groups was 5/183 and 2/56, respectively (P > 0.05). One patient from Group 1 developed transplant renal artery stenosis. Six patients from Group 1 developed ureteric complications. Conclusion: Donor grafts with multiple renal arteries may be accepted safely with careful surgical reconstruction and close surveillance posttransplant.
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- 2024
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4. Organizational Climate as Perceived by Veterinary Assistant Surgeons of Andhra Pradesh in India
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Ratnayake, Talata Chandrakanthi and Gupta, Jancy
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Purpose: To identify various organizational climatic factors responsible for role performances of veterinary officers in Andhra Pradesh, India. Design/methodology/approach: Study was conducted in 11 selected districts. Data were collected from 220 respondents through a pretested interview schedule and subjected to correlation and multiple regression to draw valid inferences. Organizational climate was measured by using the index specially prepared for the study. Findings: Around 76% of the respondents perceived that the organizational climate prevailing in the department of animal husbandry was favorable. Leadership, teamwork and trust had significant contribution towards perception of organizational climate. The respondents were least satisfied with motivation, decision-making and goal setting components of the organizational climate. The model with seven variables out of 16 independent variables was a good fit with R square of 85.59%. Work motivation, persistence disposition, participativeness, job satisfaction, physical facilities availability and timeliness of availability of facilities were found to have significant positive influence while job stress had significant negative influence on perceived organizational climate. Practical implications: This investigation has an organizational and social significance for development of livestock organizations not only in India, but also to other SAARC countries as well. Originality/value: No empirical evidence on inter-relation between organizational climate and job performance of veterinarians is available at present in Andhra Pradesh.
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- 2014
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5. Clinical and magnetic resonance imaging spectrum of complex perianal fistulizing Crohn’s disease: A cohort study from northern India
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Singh, Arshdeep, Kakkar, Chandan, Garg, Shreya, Arora, Kirti, Midha, Vandana, Mahajan, Ramit, Virk, Satpal Singh, Jain, Narender Pal, Singh, Dharmatma, Sood, Kriti, Tripathi, Ashish, Gupta, Dhruv, Kaushal, Ishita Gupta, Galhotra, Ritu Dhawan, Saggar, Kavita, and Sood, Ajit
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- 2023
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6. Kite String or Manja Cut Injury: A New Culprit
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Surendrakumar B. Patil, Neha Gupta, Anshoo Gandhi, Mayank Bhasin, Prabhakar Rakhonde, and Sushil Machhale
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kite string ,Chinese manja ,hand injuries ,Surgery ,RD1-811 - Abstract
Background Kite string injuries (manja cut injuries), particularly those caused by Chinese manja, are new culprit of emergencies especially in the month of January in Maharashtra region. These injuries commonly affect the neck, face, hands, and legs, especially among individuals traveling on two wheelers. The visibility challenge, where the kite's thread is difficult to see, further exacerbates the risk.
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- 2024
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7. Foreign Body Ingestion in Children: An Experience of 99 Cases in a Tertiary Care Center in Delhi
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Meghna Kinjalk, Mehak Sehgal, Simmi K. Ratan, Nitin Jain, Chiranjiv Kumar Gupta, Sujoy Neogi, Prafull Kumar, Dhruv Bhoria, Vanshika Arora, and Gautam Chellani
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foreign body ingestion ,foreign body management ,pediatric ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Background: Accidental ingestion of foreign bodies in children is critical, as the inability to effectively communicate can potentially lead to devastating consequences. We aimed to determine the epidemiology of foreign body ingestion and variability according to age, gender, type, and location of foreign body, and describe its management. Aim and Objective: The aim was to study the various types of foreign body ingestions in children admitted to pediatric surgery and their management. Materials and Methods: A retrospective study was conducted from January 2020 to June 2022 on children under the age of 12 years with a confirmed diagnosis of foreign body ingestion. Patients were clinically and radiologically assessed, after which standard protocols were followed wherein patients were followed by either observation or emergent management. Emergent management included removal of the foreign body by either endoscopy or surgery. Comparisons among multiple age groups, gender, type of foreign body, location of foreign body, and their management were analyzed. Results: Out of 99 subjects in our study, there were 76 boys and 23 girls. The median age of presentation was 5 years. Most children were asymptomatic at presentation. The most frequently ingested foreign body was a coin in all age groups. The majority of the foreign bodies were suspected to be in the small bowel. The foreign bodies that had crossed the duodenojejunal flexure (n = 74, 74.7%) were managed conservatively with the observation of a variable period of a minimum of 24 h and a maximum of 48 h. 21 cases were managed by endoscopic removal, while three cases required surgical intervention. Conclusions: Overall, the most common gastrointestinal foreign body was a coin in all age groups. Button battery is the most worrisome foreign body; however, depending on its position, it can be managed conservatively. Upper GI foreign bodies can be safely removed endoscopically. Parental counseling is very important for the prevention of ingestion of foreign bodies.
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- 2024
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8. A Unique Case of Eight Fetuses in a Single Fetu.
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Mohammad Imran, Rajesh Kumar, Khalid M. Saifullah, Vikash Chandra Gupta, Abhishek A. Verma, and Uday Kumar
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eight ,fetus in fetu ,fetuses ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Fetus in fetu is a rare congenital anomaly in which a malformed parasitic twin is found within the body of a living child or adult. In this case report, a 1-day-old child presented with a large firm abdominal mass on the left side of the upper abdomen. Imaging studies misdiagnosed the mass as an intraperitoneal benign dermoid cyst displacing the bowel loops and internal viscera. A surgical resection was performed on 21 days of life, and pathology confirmed eight fetuses inside the cyst.
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- 2024
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9. Establishing Apolipoprotein-B and non-high-density-lipoprotein-C goals in Indian population: A Cross-sectional study
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Parul Berry, Ritvik Amarchand, Lakshmy Ramakrishnan, Ruby Gupta, Dimple Kondal, Vishwesh Bharadiya, Anand Krishnan, Nikhil Tandon, Dorairaj Prabhakaran, and Ambuj Roy
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Apolipoproteins B ,Low-density lipoprotein-cholesterol (LDL-C) ,High-density lipoprotein-cholesterol (HDL-C) ,Indian population ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Defining lipid goals solely on low-density lipoprotein-cholesterol (LDL-C) levels in Indian population may cause misclassification due to high prevalence of hypertriglyceridemia and small dense LDL-C particles. International guidelines now recommend Apoliporotein-B (Apo-B) and non-high-density lipoprotein-cholesterol (non-HDL-C) levels as alternative targets. In this study, we used a cross-sectional representative population database to determine Apo-B and non-HDL-C cut-offs corresponding to identified LDL-C targets and compared them to international guidelines. Methods: A community-based survey carried out in urban Delhi and adjacent rural Ballabhgarh provided lipid values for 3047 individuals. The Spearman correlation coefficient was used to evaluate the degree of relationship between Apo-B and LDL-C and non-HDL-C. Cut-off values for Apo-B and non-HDL-C were established using receiver operator curve analysis correlating with guideline-recommended LDL-C targets. Results: Spearman's rank correlations between Apo-B and LDL-C (0.82) and non-HDL-C and LDL-C (0.93) were significant (p 150 mg/dl the corresponding Apo-B and non-HDL-C values were 85.1, 92.7, 103.5, 117.5 and 135 mg/dL and 124.5, 126.5, 147.5, 167.5 and 190.5 mg/L respectively. Conclusion: Based on this study we provide Apo-B and non-HDL cut-offs corresponding to target LDL-C values in Indian patients with and without high triglycerides. It is noted that in individuals with triglycerides ≥ 150 mg/dl, the Apo-B levels are much higher than the values recommended by guidelines.
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- 2024
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10. Impact of early surgical complications on kidney transplant outcomes
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Michelle Minkovich, Nikita Gupta, Michelle Liu, Olusegun Famure, Yanhong Li, Markus Selzner, Jason Y. Lee, S. Joseph Kim, and Anand Ghanekar
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Surgical complications ,Kidney ,Transplantation ,Clinical outcomes ,Surgery ,RD1-811 - Abstract
Abstract Background Kidney transplantation (KT) improves clinical outcomes of patients with end stage renal disease. Little has been reported on the impact of early post-operative surgical complications (SC) on long-term clinical outcomes following KT. We sought to determine the impact of vascular complications, urological complications, surgical site complications, and peri-graft collections within 30 days of transplantation on patient survival, graft function, and hospital readmissions. Methods We conducted a single-centre, observational cohort study examining adult patients (≥ 18 years) who received a kidney transplant from living and deceased donors between January 1st, 2005 and December 31st, 2015 with follow-up until December 31st, 2016 (n = 1,334). Univariable and multivariable analyses were performed with Cox proportional hazards models to analyze the outcomes of SC in the early post-operative period after KT. Results The cumulative probability of SC within 30 days of transplant was 25%, the most common SC being peri-graft collections (66.8%). Multivariable analyses showed significant relationships between Clavien Grade 1 SC and death with graft function (HR 1.78 [95% CI: 1.11, 2.86]), and between Clavien Grades 3 to 4 and hospital readmissions (HR 1.95 [95% CI: 1.37, 2.77]). Conclusions Early SC following KT are common and have a significant influence on long-term patient outcomes.
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- 2024
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11. Goodbye Hartmann trial: a prospective, international, multicenter, observational study on the current use of a surgical procedure developed a century ago
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Gennaro Perrone, Mario Giuffrida, Fikri Abu-Zidan, Vitor F. Kruger, Marco Livrini, Gabriele Luciano Petracca, Giorgio Rossi, Antonio Tarasconi, Brian W. C. A. Tian, Elena Bonati, Ricardo Mentz, Federico N. Mazzini, Juan P. Campana, Elisabeth Gasser, Reinhold Kafka-Ritsch, Daniel M. Felsenreich, Christopher Dawoud, Stefan Riss, Carlos Augusto Gomes, Felipe Couto Gomes, Ricardo Alessandro Teixeira Gonzaga, Cassio Alfred Brattig Canton, Bruno Monteiro Pereira, Gustavo P. Fraga, Leticia Gonçalves Zem, Vinicius Cordeiro-Fonseca, Renato de Mesquita Tauil, Boyko Atanasov, Nikolay Belev, Nikola Kovachev, L. Juan José Meléndez, Ana Dimova, Stefan Dimov, Zdravko Zelić, Goran Augustin, Branko Bogdanić, Trpimir Morić, Elie Chouillard, Melinda Bajul, Belinda De Simone, Yves Panis, Francesco Esposito, Margherita Notarnicola, Lelde Lauka, Anna Fabbri, Hassen Hentati, Iskander Fnaiech, Venara Aurélien, Marie Bougard, Maxime Roulet, Zaza Demetrashvili, Irakli Pipia, Giorgi Merabishvili, Konstantinos Bouliaris, Georgios Koukoulis, Christos Doudakmanis, Sofia Xenaki, Emmanuel Chrysos, Stamatios Kokkinakis, Panteleimon Vassiliu, Nikolaos Michalopoulos, Ioannis Margaris, Aristotelis Kechagias, Konstantinos Avgerinos, Jevgeni Katunin, Eftychios Lostoridis, Eleni-Aikaterini Nagorni, Antonio Pujante, Francesk Mulita, Ioannis Maroulis, Michail Vailas, Athanasios Marinis, Ioannis Siannis, Eirini Bourbouteli, Dimitrios K. Manatakis, Nikolaos Tasis, Vasileios Acheimastos, Sotiropoulou Maria, Kapiris Stylianos, Harilaos Kuzeridis, Dimitrios Korkolis, Evangelos Fradelos, George Kavalieratos, Thalia Petropoulou, Andreas Polydorou, Ioannis Papacostantinou, Tania Triantafyllou, Despina Kimpizi, Dimitrios Theodorou, Konstantinos Toutouzas, Alexandros Chamzin, Maximos Frountzas, Dimitrios Schizas, Ioannis Karavokyros, Athanasios Syllaios, Alexandros Charalabopoulos, Maria Boura, Efstratia Baili, Orestis Ioannidis, Lydia Loutzidou, Elissavet Anestiadou, Ioannis Tsouknidas, Georgios Petrakis, Eleni Polenta, Lovenish Bains, Rahul Gupta, Sudhir K. Singh, Archana Khanduri, Miklosh Bala, Asaf Kedar, Marcello Pisano, Mauro Podda, Adolfo Pisanu, Gennaro Martines, Giuseppe Trigiante, Giuliano Lantone, Antonino Agrusa, Giuseppe Di Buono, Salvatore Buscemi, Massimiliano Veroux, Rossella Gioco, Gastone Veroux, Luigi Oragano, Sandro Zonta, Federico Lovisetto, Carlo V. Feo, Antonio Pesce, Nicolò Fabbri, Giulio Lantone, Fabio Marino, Fabrizio Perrone, Leonardo Vincenti, Vincenzo Papagni, Arcangelo Picciariello, Stefano Rossi, Biagio Picardi, Simone Rossi Del Monte, Diego Visconti, Giulia Osella, Luca Petruzzelli, Giusto Pignata, Jacopo Andreuccetti, Rossella D’Alessio, Massimo Buonfantino, Eleonora Guaitoli, Stefano Spinelli, Gianluca Matteo Sampietro, Carlo Corbellini, Leonardo Lorusso, Alice Frontali, Isabella Pezzoli, Alessandro Bonomi, Andrea Chierici, Christian Cotsoglou, Giuseppe Manca, Antonella Delvecchio, Nicola Musa, Massimiliano Casati, Laface Letizia, Emmanuele Abate, Giorgio Ercolani, Fabrizio D’Acapito, Leonardo Solaini, Gianluca Guercioni, Simone Cicconi, Diego Sasia, Felice Borghi, Giorgio Giraudo, Giuseppe Sena, Pasquale Castaldo, Eugenia Cardamone, Giuseppe Portale, Matteo Zuin, Ylenia Spolverato, Marialusia Esposito, Roberta Maria Isernia, Maria Di Salvo, Romina Manunza, Giuseppe Esposito, Marcello Agus, Emanuele Luigi Giuseppe Asti, Daniele Tiziano Bernardi, Tommaso Panici Tonucci, Davide Luppi, Massimiliano Casadei, Stefano Bonilauri, Angela Pezzolla, Annunziata Panebianco, Rita Laforgia, Maurizio De Luca, Monica Zese, Dario Parini, Elio Jovine, Giuseppina De Sario, Raffaele Lombardi, Giovanni Aprea, Giuseppe Palomba, Marianna Capuano, Giulio Argenio, Gianluca Orio, Mariano Fortunato Armellino, Marina Troian, Martina Guerra, Carlo Nagliati, Alan Biloslavo, Paola Germani, Giada Aizza, Igor Monsellato, Ali Chaouki Chahrour, Gabriele Anania, Cristina Bombardini, Francesco Bagolini, Gabriele Sganga, Pietro Fransvea, Valentina Bianchi, Paolo Boati, Francesco Ferrara, Francesco Palmieri, Pasquale Cianci, Domenico Gattulli, Enrico Restini, Nicola Cillara, Alessandro Cannavera, Gabriela Elisa Nita, Jlenia Sarnari, Francesco Roscio, Federico Clerici, Ildo Scandroglio, Stefano Berti, Alessandro Cadeo, Alice Filippelli, Luigi Conti, Carmine Grassi, Gaetano Maria Cattaneo, Marina Pighin, Davide Papis, Giovanni Gambino, Vanessa Bertino, Domenico Schifano, Daniela Prando, Luisella Fogato, Fabio Cavallo, Luca Ansaloni, Roberto Picheo, Nicholas Pontarolo, Norma Depalma, Marcello Spampinato, Stefano D’Ugo, Luca Lepre, Michela Giulii Capponi, Rossella Domenica Campa, Giuliano Sarro, Vincenza Paola Dinuzzi, Stefano Olmi, Matteo Uccelli, Davide Ferrari, Marco Inama, Gianluigi Moretto, Michele Fontana, Francesco Favi, Erika Picariello, Alessia Rampini, Andrea Barberis, Antonio Azzinnaro, Alba Oliva, Luigi Totaro, Ilaria Benzoni, Valerio Ranieri, Gabriella Teresa Capolupo, Filippo Carannante, Marco Caricato, Maurizio Ronconi, Silvia Casiraghi, Giovanni Casole, Desire Pantalone, Giovanni Alemanno, Maximilian Scheiterle, Marco Ceresoli, Marco Cereda, Chiara Fumagalli, Federico Zanzi, Stefano Bolzon, Enrico Guerra, Francesca Lecchi, Paola Cellerino, Antonella Ardito, Rosa Scaramuzzo, Andrea Balla, Pasquale Lepiane, Nicola Tartaglia, Antonio Ambrosi, Giovanna Pavone, Gian Marco Palini, Simone Veneroni, Gianluca Garulli, Claudio Ricci, Beatrice Torre, Iris Shari Russo, Matteo Rottoli, Marta Tanzanu, Angela Belvedere, Marco Milone, Michele Manigrasso, Giovanni Domenico De Palma, Micaela Piccoli, Gianmaria Casoni Pattacini, Stefano Magnone, Paolo Bertoli, Michele Pisano, Paolo Massucco, Marco Palisi, Andrea-Pierre Luzzi, Francesco Fleres, Guglielmo Clarizia, Alessandro Spolini, Yoshiro Kobe, Takayuki Toma, Fumihiko Shimamura, Robert Parker, Sinkeet Ranketi, Mercy Mitei, Saulius Svagzdys, Henrikas Pauzas, Justas Zilinskas, Tomas Poskus, Marius Kryzauskas, Matas Jakubauskas, Andee Dzulkarnaen Zakaria, Zaidi Zakaria, Michael Pak-Kai Wong, Asri Che Jusoh, Muhammad Nazreen Zakaria, Daniel Rios Cruz, Aurea Barbara Rodriguez Elizalde, Alejandro Bañon Reynaud, Edgard Efren Lozada Hernandez, Jose maria Victor Palomo Monroy, Diego Hinojosa-Ugarte, Martha Quiodettis, María Esther Du Bois, José Latorraca, Piotr Major, Michał Pędziwiatr, Magdalena Pisarska-Adamczyk, Maciej Walędziak, Andrzej Kwiatkowski, Łukasz Czyżykowski, Silvia Dantas da Costa, Bela Pereira, Ana Rita Oliveira Ferreira, Filipe Almeida, Ricardo Rocha, Carla Carneiro, Diego Pita Perez, João Carvas, Catarina Rocha, Cátia Ferreira, Rita Marques, Urânia Fernandes, Pedro Leao, André Goulart, Rita Gonçalves Pereira, Sara Daniela Direito Patrocínio, Nuno Gonçalo Gonçalves de Mendonça, Maria Isabel Cerqueira Manso, Henrique Manuel Cardoso Morais, Paulo Sebastião Cardoso, Valentin Calu, Adrian Miron, Elena Adelina Toma, Mahir Gachabayov, Abakar Abdullaev, Andrey Litvin, Taras Nechay, Alexander Tyagunov, Anvar Yuldashev, Alison Bradley, Michael Wilson, Arpád Panyko, Zuzana Látečková, Vladimír Lacko, Dusan Lesko, Marek Soltes, Jozef Radonak, Victor Turrado-Rodriguez, Roser Termes-Serra, Xavier Morales-Sevillano, Pierfrancesco Lapolla, Andrea Mingoli, Gioia Brachini, Maurizio Degiuli, Silvia Sofia, Rossella Reddavid, Andrea de Manzoni Garberini, Angelica Buffone, Eduardo Perea del Pozo, Daniel Aparicio-Sánchez, Sandra Dos Barbeito, Mercedes Estaire-Gómez, Rebeca Vitón-Herrero, Mª de los Ángeles Gil Olarte-Marquez, José Gil-Martínez, Felipe Alconchel, Tatiana Nicolás-López, Aida Cristina Rahy-Martin, María Pelloni, Raquel Bañolas-Suarez, Fernando Mendoza-Moreno, Francisca García-Moreno Nisa, Manuel Díez-Alonso, María Elisa Valle Rodas, María Carmona Agundez, María Inmaculada Pérez Andrés, Claudia Cristina Lopes Moreira, Aintzane Lizarazu Perez, Iñigo Augusto Ponce, Ana María González-Castillo, Estela Membrilla-Fernández, Silvia Salvans, Mario Serradilla-Martín, Pablo Sancho Pardo, Daniel Rivera-Alonso, Jana Dziakova, Jose Mugüerza Huguet, Naila Pagès Valle, Enrique Colás Ruiz, Cristina Rey Valcárcel, Cristina Ruiz Moreno, Yeniffer Tatiana Moreno Salazar, Juan Jesús Rubio García, Silvia Sevila Micó, Joaquín Ruiz López, Silvia Pérez Farré, Maite Santamaria Gomez, Nuria Mestres Petit, Alberto Titos-García, Jose Manuel Aranda-Narváez, Laura Romacho-López, Luis Sánchez-Guillén, Veronica Aranaz-Ostariz, Marina Bosch-Ramírez, Aleix Martínez-Pérez, Elías Martínez-López, Juan Carlos Sebastián-Tomás, Granada Jimenez-Riera, Javier Jimenez-Vega, Jose Aurelio Navas Cuellar, Andrea Campos-Serra, Anna Muñoz-Campaña, Raquel Gràcia-Roman, Javier Martínez Alegre, Francisca Lima Pinto, Sara Nuñez O’Sullivan, Francisco Blanco Antona, Beatriz Muñoz Jiménez, Jaime López-Sánchez, Zahira Gómez Carmona, Rocio Torres Fernández, Isabel Blesa Sierra, Laura Román García de León, Verónica Polaino Moreno, Eva Iglesias, Paola Lora Cumplido, Altea Arango Bravo, Ignacio Rey Simó, Carlota López Domínguez, Aloia Guerreiro Caamaño, Rafael Calleja Lozano, Manuel Durán Martínez, Álvaro Naranjo Torres, Javier Tomas Morales Bernaldo de Quiros, Gianluca Pellino, Miriam Moratal Cloquell, Elsa García Moller, Sami Jalal-Eldin, Ahmed K. Abdoun, Hytham K. S. Hamid, Varut Lohsiriwat, Aitsariya Mongkhonsupphawan, Oussama Baraket, Karim Ayed, Imed Abbassi, Ali Ben Ali, Houssem Ammar, Ali Kchaou, Ahmed Tlili, Imen Zribi, Elif Colak, Suleyman Polat, Zehra Alan Koylu, Ali Guner, Mehmet Arif Usta, Murat Emre Reis, Baris Mantoglu, Emre Gonullu, Emrah Akin, Fatih Altintoprak, Zulfu Bayhan, Necattin Firat, Arda Isik, Ufuk Memis, Mehmet Bayrak, Yasemin Altıntaş, Yasin Kara, Mehmet Abdussamet Bozkurt, Ali Kocataş, Koray Das, Ahmet Seker, Nazmi Ozer, Semra Demirli Atici, Korhan Tuncer, Tayfun Kaya, Zeynep Ozkan, Onur Ilhan, Ibrahim Agackiran, Mustafa Yener Uzunoglu, Eren Demirbas, Yuksel Altinel, Serhat Meric, Nadir Adnan Hacım, Derya Salim Uymaz, Nail Omarov, Emre Balık, Giovanni D. Tebala, Hany Khalil, Mridul Rana, Mansoor Khan, Charlotte Florence, Christie Swaminathan, Cosimo Alex Leo, Lampros Liasis, Josef Watfah, Ivan Trostchansky, Edward Delgado, Marcelo Pontillo, Rifat Latifi, Raul Coimbra, Sara Edwards, Ana Lopez, George Velmahos, Ander Dorken, Anthony Gebran, Amanda Palmer, Jeffrey Oury, James M. Bardes, Sirivan Suon Seng, Lauren S. Coffua, Asanthi Ratnasekera, Tanya Egodage, Karla Echeverria-Rosario, Isabella Armento, Lena M. Napolitano, Naveen F. Sangji, Mark Hemmila, Jacob A. Quick, Tyler R. Austin, Theodore S. Hyman, William Curtiss, Amanda McClure, Nicholas Cairl, Walter L. Biffl, Hung P. Truong, Kathryn Schaffer, Summer Reames, Filippo Banchini, Patrizio Capelli, Federico Coccolini, Massimo Sartelli, Francesca Bravi, Carlo Vallicelli, Vanni Agnoletti, Gian Luca Baiocchi, and Fausto Catena
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Hartmann’s procedure ,Ostomy ,Emergency surgery ,Resection ,Primary anastomosis ,Left side ,Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background Literature suggests colonic resection and primary anastomosis (RPA) instead of Hartmann’s procedure (HP) for the treatment of left-sided colonic emergencies. We aim to evaluate the surgical options globally used to treat patients with acute left-sided colonic emergencies and the factors that leading to the choice of treatment, comparing HP and RPA. Methods This is a prospective, international, multicenter, observational study registered on ClinicalTrials.gov. A total 1215 patients with left-sided colonic emergencies who required surgery were included from 204 centers during the period of March 1, 2020, to May 31, 2020. with a 1-year follow-up. Results 564 patients (43.1%) were females. The mean age was 65.9 ± 15.6 years. HP was performed in 697 (57.3%) patients and RPA in 384 (31.6%) cases. Complicated acute diverticulitis was the most common cause of left-sided colonic emergencies (40.2%), followed by colorectal malignancy (36.6%). Severe complications (Clavien-Dindo ≥ 3b) were higher in the HP group (P
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- 2024
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12. The diagnostic conundrum in necrotizing otitis externa
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Abiya A. Ahmed, Shaan Rashid, Vinay K. Gupta, Neil C. Molony, and Keshav K. Gupta
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diagnostic ,malignant otitis externa ,necrotizing ,osteomyelitis ,skull base osteomyelitis ,temporal bone osteomyelitis ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Abstract Necrotizing otitis externa (NOE) is an aggressive and fast‐evolving infection of the external auditory canal. Late diagnoses and untreated cases can lead to severe, even fatal consequences and so early diagnosis and treatment are paramount. NOE is a notoriously challenging diagnosis to make. It is therefore important to understand what diagnostic modalities are available and how otolaryngologists can use them to accurately treat such an aggressive disease. This review aims to evaluate the different diagnostic options available in NOE and discuss their advantages and limitations, thus, providing an up‐to‐date picture of the multimodal approach required in the diagnosis of this disease.
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- 2024
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13. Practice Patterns for Managing Recurrent Glioblastoma Multiforme
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Jitin Bajaj, Shweta Kedia, Arvind Sharma, Pankaj Gupta, Mohammad Ansari, Harsh Deora, Kanwaljeet Garg, Chinmaya Dash, Venkatesh S. Madhugiri, Kuntal Kanti Das, Manjul Tripathi, Deepak K. Singh, Subodh Raju, Anita Jagetia, Vikas Vazhayil, Manmohan Singh, R.S. Mittal, Subhash Gupta, Y.R. Yadav, Altaf Ramzan, Alok Umredkar, Deepak Kumar Jha, and A.K. Mahapatra
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brain tumor ,glioblastoma ,glioma ,recurrent glioblastoma ,Surgery ,RD1-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Introduction Glioblastoma multiforme (GBM) is a devastating form of cancer with a poor prognosis despite available treatments. Managing recurrent GBM remains challenging and lacks guidelines. This study aims to provide practice patterns for managing recurrent GBMs in India.
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- 2024
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14. Reverse lymphatic mapping during robotic inguinal lymphadenectomy for the prevention of lymphedema
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Belén Mora-Garijo, J. Bradley Mason, Laura Tom, Neil Mendhiratta, Lambros Stamatakis, Mohit Gupta, Keith Kowalczyk, and Ross Krasnow
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Penile cancer ,Inguinal lymph node dissection ,Lymphedema ,Indocyanine green ,ICG ,Reverse lymphatic mapping ,Surgery ,RD1-811 ,Diseases of the genitourinary system. Urology ,RC870-923 - Abstract
Background: Penile squamous cell carcinoma (SCC) is a rare malignancy with a high propensity for regional dissemination. While current guidelines recommend inguinal lymph node dissection (ILND) for patients with high-risk features, the surgery carries a high risk of lymphedema [1]. Indocyanine Green (ICG)-guided lymphangiography has been used to increase nodal yield and detection rates in lymph node dissections [2]. Objectives: To demonstrate that “reverse” ICG-guided ILND is a safe and novel technique that may reduce rates of postoperative lymphedema in penile cancer patients and may intraoperatively help identify candidates for lymphovascular anastomosis (LVA). Methods: To evaluate the efficacy of “reverse” ICG-guided ILND, 2.5 mg mixed ICG solution was injected superficially into the intradermal layer at the first and fourth interdigital spaces of the foot prior to beginning robotic-assisted bilateral ILND. The lower extremity lymphatic channels are prospectively identified and preserved during dissection with the aid of near infrared fluorescence imaging. Results: A total of 9 groin dissections have been completed using this technique. Reverse lymphatic mapping was successful in 7 out of 9 (77.7 %) groin dissections. With a follow-up range of 0.9–24 months, there have been no instances of post-operative lymphedema in patients who underwent successful mapping. Conclusion: Reverse lymphatic mapping during robot-assisted inguinal lymphadenectomy is a safe and feasible technique. Enhanced intraoperative visualization of lymphatic structures not only may help minimize the risk of postoperative lymphedema, but it may also help identify those patients at high risk of developing lymphedema and allow for prophylactic interventions. Further investigation is necessary to establish the oncologic safety of reverse lymphatic mapping during ILND.
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- 2024
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15. Cardiac magnetic resonance evaluation in recipients of hepatitis c virus-infected donor hearts
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J. Lukas Laws, MD, Benjamin Palmer, MD, Jonathan H. Soslow, MD, MSCI, Cassandra Hennessy, MS, Richa Gupta, MD, MPH, JoAnn Lindenfeld, MD, Jeffrey M. Dendy, MD, Dandan Liu, PhD, Kelly H. Schlendorf, MD, MHS, Daniel E. Clark, MD, MPH, and Sean G. Hughes, MD
- Subjects
cardiac transplantation ,cardiac MRI ,hepatitis C virus ,graft surveillance ,transplant rejection ,cardiac imaging ,Surgery ,RD1-811 ,Specialties of internal medicine ,RC581-951 - Abstract
Hepatitis C virus positive (HCV+) organ donors offer a viable strategy for expansion of the heart donor pool without an increased risk of recipient mortality. Cardiac magnetic resonance imaging (CMR) is an effective tool for graft surveillance in heart transplant (HT) recipients. However, there are no data comparing CMR findings in HT recipients based on donor HCV status. The aim of this propensity score matched case-control study was to evaluate baseline CMR characteristics of HCV+ HT recipients and HCV- HT recipients, as well as compare cardiac allograft structure, function, performance, and tissue characterization between groups. CMR normative values did not differ between groups in matched analysis. There were no significant differences in CMR-derived biventricular function, strain, late gadolinium enhancement, or myocardial tissue characteristics by parametric mapping. This study suggests CMR can be a valuable tool for surveillance in HCV+ HT patients, and abnormalities on imaging should not be attributed to HCV infection.
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- 2024
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16. Soft frontal swelling in a young girl: Diagnostic nuances and surgical management of a rare case of sinus pericranii
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Mobin Ibne Mokbul, Farjana Yesmin, Pukar Gupta, Aminur Rahman, Md. Sumon Rana, and Md. Shafiqul Islam
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endovascular embolization ,extracalvarial arteriovenous malformation ,sinus pericranii ,surgery ,venous anomalies ,Medicine ,Medicine (General) ,R5-920 - Abstract
Key Clinical Message A 17‐year‐old girl with a congenital, painless right forehead swelling obstructing her visual field was diagnosed with sinus pericranii. Radiological imaging confirmed extracalvarial arteriovenous malformation with serpentine vessels and bony erosion. Endovascular surgery was chosen for management, highlighting the necessity of considering SP in differential diagnosis for scalp swellings. Despite its rarity, awareness of it is essential to prevent complications from injury, misdiagnosis, or invasive procedures.
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- 2024
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17. Calvarial hemangiomas: Series of 6 cases and review of literature
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Prasad Krishnan, Rajesh Bhosle, Shamshuddin Patel, Dimble Raju, Rafael Cincu, Luis Rafael Moscote-Salazar, Amit Gupta, and Amit Agrawal
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Calvarial haemangioma ,Intra diploic ,En bloc resection ,Cranioplasty ,Skull tumours ,Surgery ,RD1-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Abstract
Calvarial haemangiomas are benign, vascular tumours of the skull involving parietal and frontal bones. Mostly these lesions remain asymptomatic, and present with cosmetic deformity, headache, uncommon neurological symptoms and reported as case reports and case series. The radiological appearance can range from sessile growing intradiploically to globular and the lesions may extend outwards or inwards after eroding the outer and inner tables of the skull. “Sunburst appearance” and “Wagon-wheel sign” are classical radiological findings but the lesions may present simply as a lytic expansile or even sclerotic calvarial mass. Because of varied clinical presentation and atypical radiological characteristics, the final diagnosis can be clinched by histology only. In selected cases where these lesions are not cosmetically acceptable, en bloc resection with tumour free margins followed by cranioplasty is the treatment of choice. Most reports of calvarial haemangiomas in literature are in the form of case reports.
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- 2024
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18. The Perspectives of General Nephrologists Toward Transitions of Care and Management of Failing Kidney Transplants
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Alhamad, Tarek, Murad, Haris, Dadhania, Darshana M, Pavlakis, Martha, Parajuli, Sandesh, Concepcion, Beatrice P, Singh, Neeraj, Murakami, Naoka, Casey, Michael J, Ji, Mengmeng, Lubetzky, Michelle, Tantisattamo, Ekamol, Alomar, Omar, Faravardeh, Arman, Blosser, Christopher D, Basu, Arpita, Gupta, Gaurav, Adler, Joel T, Adey, Deborah, Woodside, Kenneth J, Ong, Song C, Parsons, Ronald F, and Lentine, Krista L
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Biomedical and Clinical Sciences ,Clinical Sciences ,Clinical Research ,Kidney Disease ,Transplantation ,Organ Transplantation ,Renal and urogenital ,Adult ,Humans ,Nephrologists ,Kidney Transplantation ,Nephrology ,Immunosuppression Therapy ,Surveys and Questionnaires ,re-transplantation ,failing kidney allograft ,transition of care ,immunosuppression management ,multidisciplinary team ,Surgery ,Clinical sciences - Abstract
The management of failing kidney allograft and transition of care to general nephrologists (GN) remain a complex process. The Kidney Pancreas Community of Practice (KPCOP) Failing Allograft Workgroup designed and distributed a survey to GN between May and September 2021. Participants were invited via mail and email invitations. There were 103 respondents with primarily adult nephrology practices, of whom 41% had an academic affiliation. More than 60% reported listing for a second kidney as the most important concern in caring for patients with a failing allograft, followed by immunosuppression management (46%) and risk of mortality (38%), while resistant anemia was considered less of a concern. For the initial approach to immunosuppression reduction, 60% stop antimetabolites first, and 26% defer to the transplant nephrologist. Communicating with transplant centers about immunosuppression cessation was reported to occur always by 60%, and sometimes by 29%, while 12% reported making the decision independently. Nephrologists with academic appointments communicate with transplant providers more than private nephrologists (74% vs. 49%, p = 0.015). There are heterogeneous approaches to the care of patients with a failing allograft. Efforts to strengthen transitions of care and to develop practical practice guidelines are needed to improve the outcomes of this vulnerable population.
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- 2023
19. Teaching Consultation-Liaison Psychotherapy: Assessment of Adaptation to Medical and Surgical Illness
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Hunter, Jonathan J., Maunder, Robert G., and Gupta, Mona
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Objective: Little has been written about teaching consultation-liaison inpatient psychotherapy to residents or other trainees. Method: Resident interviews at completion of consultation-liaison training identified learning needs. In response, the authors created a seminar series and modified it reiteratively eight times. Results: In this approach, the primary task of consultation-liaison psychotherapy assessment is to determine the success of a patient's adaptation to hospitalization, and to identify obstacles to adaptation. Selected determinants of adaptation are reviewed and organized as individual factors and intrahospital and extrahospital environmental factors. This provides a viable means of organizing and integrating disparate bodies of knowledge for the student. Conclusions: The teaching model awaits empirical validation as a tool that enhances teaching and patient care outcomes.
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- 2007
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20. Morphometric Analysis of Distal End of Dry Human Radius in Northern India and its Clinical Implications in Relation to Wrist Joint and Inferior Radioulnar Joint Arthroplasty: A Cross-sectional Study
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Archana Singh, Parul Saxena, Rakesh Gupta, and Arun Singh
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distal end radius ,dorsal tubercle ,lunate facet ,palmar tilt ,radial inclination ,scaphoid facet ,ulnar notch ,Medical physics. Medical radiology. Nuclear medicine ,R895-920 ,Surgery ,RD1-811 - Abstract
Introduction: The lower end of the radius is involved in the formation of the wrist joint and inferior radioulnar joint. Its morphometry is crucial for surgical procedures related to wrist arthroplasty. Aim: To measure the various morphometric parameters of the distal end of the radius and the distal articular surface of the radius. Materials and Methods: The present cross-sectional study was conducted in the Department of Anatomy, Rohilkhand Medical College and Hospital, Bareilly, Uttar Pradesh, India, from April 2023 to July 2023. The following parameters were measured: Length (LR) and Weight of Radius (WR), Length of Styloid Process (L-SP), Anteroposterior Length (APL-UN), Height (H-UN) and Depth (D-UN) of Ulnar Notch, Transverse Width (TW-DR), Oblique Width (OW-DR) and Anteroposterior Diameter (APD-DR) of the Distal Radius, Dorsal Tubercle Distance from the styloid process (DTD-SP) and from the Ulnar Notch (DTD-UN), Anteroposterior Length (APL-SF) and Transverse Length (TL-SF) of Scaphoid Facet, Anteroposterior Length (APL-LF) and Transverse Length (TL-LF) of Lunate Facet, Radial Inclination (RI) and Palmar Tilt (PT). Statistical analysis was performed using International Business Machines (IBM) Statistical Package for the Social Sciences (SPSS) software version 22.0. The values of the right and left sides were compared with a Student’s t-test. Results: Various morphometric parameters were measured on 80 dry adult radii (44 right and 36 left). The mean LR was 23.27±2 cm, WR was 39.24±9.84 gm, and L-SP was 10.9±2.40 mm. APL-UN, H-UN and D-UN were 14.29±1.80 mm, 7.75±2.07 mm and 1.68±0.63 mm, respectively. TW-DR, OW-DR and APD-DR of the distal end of the radius were 27.22±3.55 mm, 29.17±3.09 mm and 18.29±2.36 mm, respectively. The mean DTD-SP and DTD-UN were 20.66±2.40 mm and 16.29±2.53 mm, respectively. Mean values of the scaphoid facet and lunate facet were 11.75±1.44 mm (APL-SF), 15.16±2.165 mm (TL-SF), and 15.96±1.92 mm (APL-LF), 10.20±1.52 mm (TL-LF), respectively. The mean angles of RI and PT were 24.48±5.06° and 10.91±3.179°, respectively. No significant difference was found between the right and left side values (p-value >0.05). Among the 80 radii, 43.8% had four grooves, 42.5% had three grooves, and 13.8% had only two grooves present on the dorsal surface of the lower end of the radius. Out of 262 observed grooves in 80 radii, 50 (19.09%) were vertical and 212 (80.91%) were oblique. The groove medial to the dorsal tubercle was oblique in 70 (87.5%) radii and vertical in 10 (12.5%) radii. A highly positive correlation was found between the oblique and transverse width of the distal radius (r-value=0.74 and p-value=0.01). Conclusion: The present study found no significant difference between the values of the right and left sides. The parameters identified may assist surgeons in selecting the appropriate size of the prosthesis or in corrective surgeries related to the lower end of the radius.
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- 2024
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21. Epidemiological profile and clinical outcomes of very young
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Mohit D. Gupta, Vishal Batra, Subrat Muduli, Girish MP, Shekhar Kunal, Ankit Bansal, Ankur Gautam, Rajeev Kumar Malhotra, Dixit Goyal, Arman Qamar, and Jamal Yusuf
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STEMI ,Young ,Acute coronary syndrome ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Despite significant progress in primary prevention, rates of myocardial infarction (MI) in South Asian population is alarmingly high. Objectives: We sought to compare risk factor profiles and outcomes between individuals with ST-Segment Elevation Myocardial Infarction (STEMI) in young (
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- 2024
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22. Non-syndromic oropharyngeal hamartoma: A case report
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Kanwar Vikrant Singh, Gurpreet Singh, Surabhi Gupta, and Paromita Patra
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non-syndromic ,oropharyngeal ,hamartoma ,tissue lesions ,tongue ,excision ,pediatric ,Medicine (General) ,R5-920 ,Surgery ,RD1-811 - Abstract
This case report details the presentation, investigation, management, and histopathological examination of a rare occurrence – non-syndromic oropharyngeal hamartomas in a 2-year-old child. The child presented with a substantial orofacial mass on the dorsum of the tongue, causing significant functional impairments. Notably, the mass measured 8×4 cm and protruded outside the oral cavity. Additional findings included a nodular mass at the tongue tip, a lobulated mass on the right buccal mucosa (3×4 cm), cleft palate, microphthalmos of the right eye, and an accessory pinna on the right cheek. Diagnostic investigations, including ultrasound, revealed irregular soft tissue lesions with hypoechoic areas and vascular channels, indicative of hemangioma. Blood parameters were within normal limits. Due to the size and symptomatic nature of the mass, surgical intervention was planned and executed under general anesthesia with nasal intubation. The procedure involved complete dissection and excision of the masses from the tongue and buccal mucosa. The surgical site was meticulously closed in layers using 4-O vicryl. Postoperatively, the child resumed oral feeds on the third day, and the recovery period was uneventful. Histopathological examination of the excised specimen depicted a hamartomatous lesion of the tongue characterized by stratified squamous epithelial lining, admixture of blood vessels, adipose tissue, fibrocollagenous tissue, cartilaginous tissue, nerve bundles, adnexal structures, and minor salivary glands. The report concludes by highlighting the rarity of lingual hamartomas, emphasizing the exceptional size and vascularity of the presented case. It stresses the necessity of considering hamartomas in the differential diagnosis of tongue lesions in pediatric patients. The definitive management approach discussed is complete surgical excision, with the importance of confirming the diagnosis through histopathological examination of the excised specimen. This case contributes with valuable insights into the clinical presentation and management of non-syndromic oropharyngeal hamartomas in pediatric patients.
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- 2024
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23. An Outcome Analysis of Fibrin Sealant versus Staples for Fixation of Split-Thickness Skin Grafts
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Akshara Shuchi, Deepti Gupta, and Sujata Sarabahi
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fibrin sealant ,split-thickness skin grafting ,granulating raw area ,staples ,Surgery ,RD1-811 - Abstract
Background Skin grafting plays a vital role in post-burn and post-traumatic wound management. Split-thickness skin grafts (STSG) are traditionally fixed using staples or sutures, which have tedious application and their removal necessitates painkillers, medical equipment, and human intervention. As an alternative, fibrin sealant is a biological tissue adhesive, composed of thrombin, calcium, and fibrinogen. Fibrin sealant promotes hemostasis and acts as a biological adherent.
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- 2024
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24. Frozen shoulder after COVID-19 vaccination versus idiopathic frozen shoulder: similar clinical features and functional improvement at 1-year follow-up
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Dipit Sahu, MS Orthopaedics, Sonam Gupta, BSc, PGD, Gautam Shetty, MS Orthopaedics, and Himanshu S. Choudhury, MD Radiodiagnosis
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Frozen shoulder ,Adhesive capsulitis ,SIRVA ,COVID-19 vaccine ,Vaccination ,Shoulder pain ,Surgery ,RD1-811 - Abstract
Background: Frozen shoulder after COVID-19 vaccination is sparsely discussed in the medical literature. We aimed to evaluate: (1) the differences in the baseline clinical features and functional outcomes of conservatively treated frozen shoulder following COVID-19 vaccination compared to idiopathic frozen shoulder (2) the improvements in pain scores, functional outcomes, and range of motion (ROM) at 6-10 months and at 1 year of follow-up in patients with frozen shoulder after COVID-19 vaccination treated by conservative therapy. Methods: Between June 2021 and December 2021, 12 patients (13 shoulders) that were diagnosed with frozen shoulder after COVID-19 vaccination (vaccine related frozen shoulder [VRF] group) (final follow-up of 12.4 months ± 0.8 months) were compared with 20 patients that were diagnosed as idiopathic frozen shoulder unrelated to vaccination (unvaccinated frozen shoulder [UFS] group) (average follow-up of 13.4 ± 3.1 months). All patients were treated with home-based stretching exercises. Four (33%) patients in the VRF group and 15 (75%) patients in the UFS group underwent steroid injection in the suprascapular notch by an experienced radiologist. Results: The left side was affected more frequently in the VRF group [n = 10 (83.3%)] than in the UFS group [n = 8 (40%), P = .03]. The VRF and the UFS groups were similar in the rest of the baseline clinical features, such as the age distribution, men/women ratio, baseline Oxford Shoulder Scores (OSS), ROM deficit, and pain visual analogue scale (VAS) scores. The OSS, VAS pain scores, and the ROM deficit significantly improved in the VRF group at the 6-10-month follow-up and then at the final (12.4 ± 0.8 months) follow-up compared to the baseline values. At the final follow-up, there were no significant differences in the average external rotation, external rotation deficit, elevation, elevation deficit, internal rotation, pain VAS scores, and OSS between the VRF and the UFS group. Conclusion: To conclude, frozen shoulder following COVID-19 vaccination may present with clinical features similar to those of the idiopathic frozen shoulder. Furthermore, the patients with frozen shoulder following COVID-19 vaccination may continue to improve over one year with conservative treatment; the final improvements in function and ROM are similar to those with idiopathic frozen shoulder.
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- 2024
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25. Intra-peritoneal migration of abdominal drain after cholecystectomy - Laparoscopic retrieval: A case report
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Vivek Bindal, Shailesh Gupta, Dhananjay Pandey, and Tushar Goel
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abdominal drain ,cut and bag ,intra-peritoneal migration ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Intra-peritoneal migration of abdominal drain is a rare complication. Cutting of abdominal drain and putting a colostomy bag over it is done to reduce the pain and infection and to increase the mobility of a patient, but it is also a risk factor for drain intra-peritoneal migration. This case report depicts a case of intra-peritoneal migration of abdominal drain after laparoscopic cholecystectomy and its retrieval.
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- 2024
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26. Nagpur technique (triple wedge technique) for cleft lip repair in the first plastic surgery department of India: Principle and its evolution
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Surendrakumar B Patil and Neha Gupta
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cleft lip chelioplasty ,dr. c. balakrishnan ,nagpur technique ,Dentistry ,RK1-715 ,Surgery ,RD1-811 - Abstract
Background: Cleft lip chelioplasty can be approached with a wide array of different techniques.The ultimate goal of all techniques is to restore sphincter competence and aesthetically favorable outcome. Dr.C. Balakrishnan of Government medical college,Nagpur devised an original triple wedge technique,a form of three triangular flap,that was evolved independently of the triangular flap technique.Unfortunately he did not publish his technique,even today many of his 4th and 5th generation trainees perform triple wedge technique for cleft lip repair.[1],[2,],[3] The history of cleft lip repair in Nagpur and it's growth can not be dissociated from modern plastic surgery in India by the father of modern plastic surgery in India Dr. C.Balakrishnan himself,who established the first department of plastic surgery in India at GMC Nagpur,credited it with a new classification of cleft lip and palate, a new technique of cleft lip repair and propagated the principles of comprehensive cleft care. In our institute triple wedge repair for cleft lip is the repair of choice since 1950, although many modifications have been done in original technique since then. I was trained in KEM hospital,Mumbai and learned Millard's repair there. After coming to Nagpur,I joined the department as lecturer under respected Dr S.M. Kale sir and I got the opportunity to learn triple wedge technique from him. Over the last 20 years I have added few modifications like changing the orientation of triangles,using the mucosal element for anterior palate repair which used to be discarded in original triple wedge technique and primary rhinoplasty. Aims and Objectives: In this original article we are describing the original triple wedge technique invented by father of modern plastic surgery in India Dr.C. Balakrishnan 2 and its evolution since then in the first department of plastic surgery in India. Materials and Methods: Patients operated in last 50 years at Government Medical college,Nagpur and data available in department. Results: Early and late postoperative pictures showing result of the technique. Conclusion: The purpose of this article is illuminating unpublished work of legend of plastic surgery in India Dr. C. Balakrishnan.
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- 2024
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27. Hypothyroidism in acute coronary syndrome – A prospective Indian study
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Priyadarshini Arambam, Shikhar Gupta, Upendra Kaul, Priya Ranjan, Sudhir Sekhawat, and Rajiv Janardhanan
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Cardiovascular diseases ,Acute coronary syndrome ,Prevalence ,Hypothyroidism ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Evidence suggests that hypothyroidism may be associated with an increased risk of acute coronary syndrome (ACS).The data regarding the influence of hypothyroidism on cardiovascular disease in the Asian population is conflicting. Therefore, we undertook this study to assess the overall prevalence of hypothyroidism in Acute Coronary Syndrome (ACS) patients and determine if there is a relationship between hypothyroidism, both sub-clinical and overt and other significant risk factors of ACS in an Indian population. Methods: We studied 487 hospitalized patients between March 2018 and February 2021 with a diagnosis of ACS to determine the prevalence of hypothyroidism, both clinical and sub-clinical and their relationship with other known coronary risk factors. Thyroid function Tests - free T3, free T4 and TSH were collected from all the patients within 24 h of their admission to the coronary care unit (CCU) of 2 major hospitals in New Delhi and Imphal (Manipur). Results: Subclinical hypothyroidism was prevalent in 44 (9 %), followed by overt hypothyroidism in 25 (5.2 %).Subclinical hypothyroidism was more common in females, whereas overt hypothyroidism was more common in males. ST Elevation Myocardial Infarction (STEMI) (52 %), followed by Non-ST-Elevation Myocardial Infarction (NSTEMI) (25 %), was the commonest diagnosis at presentation. Patients with overt hypothyroidism showed a higher proportion of increased triglyceride levels.Patients with hypothyroidism had no differences in the prevalence of concomitant diabetes hypertension and other coronary risk factors. Conclusions: Patients with ACS without known thyroid disorders should be screened for hypothyroidism since it is found frequently. There might be a case to treat their thyroid dysfunction appropriately.
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- 2024
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28. Endothelial nitric oxide synthase (eNOS) gene polymorphism (Glu298asp) and nitric oxide (NO) levels in patients with ST-segment elevation myocardial infarction (STEMI)
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Mohit Dayal Gupta, Cherian Akkarappatty, Shekhar Kunal, Girish MP, Ankit Bansal, Vishal Batra, and Sanjay Tyagi
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Acute coronary syndrome ,Allele ,Gene polymorphism ,STEMI ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Background: Genetic polymorphism in endothelial Nitric Oxide Synthase (eNOS) are associated with occurrence of multiple cardiovascular diseases (CVDs). Methods: This study included 300 young ST-segment elevation myocardial infarction (STEMI) patients and 300 healthy controls. STEMI patients were divided into two groups: premature coronary artery disease [CAD] (STEMI40 years of age). Genetic polymorphisms in the eNOS gene (894G/T) was evaluated in both subjects and controls. Plasma levels of nitric oxide (NO) were estimated for both patients as well as controls. Results: Mean age of the study population was 49.7 ± 9.2 years with premature CAD being present in 58 (19.3 %) patients. No significant difference at genotypic (P = 0.589, odds ratio (OR) = 0.9, 95 % CI = 0.6–1.6) and allelic level (P = 0.173, OR = 1.2, 95 % CI = 0.9–1.4) was observed between STEMI patients and healthy controls. Genotype 894 TT had significantly higher frequency in STEMI patients >40 years (P = 0.047, OR: 2.5; 95 % CI = 1.0–6.0). No significant difference at genotypic (P = 0.279) and allelic level (P = 0.493) was observed between premature CAD (STEMI age 40 years of age (P= 0.001). Conclusion: There was significant association of eNOS gene polymorphism Glu298Asp with STEMI patients > 40 years. However, this association was not observed in premature CAD patients. Lower levels of NO in STEMI patients >40 years suggests its potential role as a marker of CVD.
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- 2024
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29. Outcome of biliary-enteric reconstruction with hepaticoduodenostomy following choledochal cyst resection: A prospective study
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Ashok Kumar Goyal, Rahul Gupta, and Neelam Meena
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biliary-enteric reconstruction ,choledochal cyst ,complications ,good outcome ,hepaticoduodenostomy ,meta-analysis ,Pediatrics ,RJ1-570 ,Surgery ,RD1-811 - Abstract
Background: The two most commonly performed methods of biliary-enteric reconstruction following choledochal cyst resection are Roux-en-Y hepaticojejunostomy (HJ) and hepaticoduodenostomy (HD). There is a lack of consensus regarding the better technique between them. This study aimed to evaluate the outcomes, efficacy and early complications of HD as a mode of biliary reconstruction after surgical resection of a choledochal cyst. Materials and Methods: This was a multi-institutional prospective study carried out in high-volume tertiary care teaching institutes from January 2010 to December 2022. All children managed with HD following choledochal cyst resection were analysed for their early complications and outcomes. Results: A total of 74 patients were included in this study. There were 59 (79.73%) females and 15 (20.27%) males. Thirty-nine (52.70%) patients had jaundice at the time of presentation. Magnetic resonance cholangiopancreatography was performed in 57 (77.03%) patients following ultrasonography. Intraoperatively, malrotation was present in 2 (2.70%) patients. In our study, operating time ranged from 60 to 195 min (mean: 118 min). Hospital stays ranged from 8 to 17 days (mean: 11.5 days). The post-operative biliary leak was seen in 7 (9.50%) patients, out of which 6 (8.11%) minor leaks were managed conservatively. Roux-en-Y HJ was performed on 1 (1.35%) patient with a major leak. In our series, 4 (5.40%) patients developed cholangitis; post-operative haemorrhagic nasogastric aspirate 5 (6.76%), post-operative pancreatitis 3 (4.05%) and wound infection 4 (5.40%) were observed and managed conservatively. None of the patients in our study developed an anastomotic stricture, bile gastritis and adhesive small bowel obstruction. Conclusion: Resection of choledochal cyst with HD reconstruction is safe and feasible with short operative time. HD is a viable option for operative management of choledochal cyst with low complication rates and faster recovery.
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- 2024
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30. Efficacy and outcome of indocyanine green-based intraoperative cholangiography using near-infrared fluorescence imaging: A prospective study
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Anubhavv Gupta, Jaspal Singh, Atul Mishra, Sanjeev K Singla, Ravinder Pal Singh, Amandeep Singh Nar, and Ashvind Bawa
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biliary anatomy ,indocyanine green ,laparoscopic cholecystectomy ,near-infrared imaging ,Surgery ,RD1-811 ,Diseases of the digestive system. Gastroenterology ,RC799-869 - Abstract
Introduction: The most dreaded complication during laparoscopic cholecystectomy still remains to be injury to the common bile duct. The primary cause for bile duct injury during LC is misinterpretation of the biliary anatomy. Intra-operative cholangiography was introduced as a means of reducing the chances of biliary injury, done using Fluoroscopic imaging or Near-infrared fluorescence imaging method. NIRF is one of the most popular imaging methods in biomedical sciences. Indocyanine Green is sterile and water soluble which completely binds to albumin and is excreted in bile. Patients and Methods: This prospective study was conducted among 70 patients between July 2020 and December 2021. Subjects were administered 5mg of ICG dye pre-operatively and procedure performed using Karl Storz HD image S1 system with a D-light P light source for NIRF imaging. Results: The average duration of surgery was 58.10 minutes. After calot's dissection, the CBD was visualized in 88.71 % patients, with a mean time to visualization at 26.33 minutes. The cystic duct was visualized in 87.3% cases with a mean time of visualization of 32.10 minutes. The hepatic duct was visualized in 28.57% and the hepatic duct-CBD confluence was visualized in 34.28% patients. Conclusion: Near infrared imaging based intra-operative cholangiography, using Indocyanine Green dye, during Lap. Cholecystectomy is an easy, useful and inexpensive method of visualizing the biliary ductal anatomy.
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- 2024
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31. Early management of adult traumatic spinal cord injury in patients with polytrauma: a consensus and clinical recommendations jointly developed by the World Society of Emergency Surgery (WSES) & the European Association of Neurosurgical Societies (EANS)
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Edoardo Picetti, Andreas K. Demetriades, Fausto Catena, Bizhan Aarabi, Fikri M. Abu-Zidan, Oscar L. Alves, Luca Ansaloni, Rocco A. Armonda, Rafael Badenes, Miklosh Bala, Zsolt J. Balogh, Andrea Barbanera, Alessandro Bertuccio, Walter L. Biffl, Pierre Bouzat, Andras Buki, Ana Maria Castano-Leon, Davide Cerasti, Giuseppe Citerio, Federico Coccolini, Raul Coimbra, Carlo Coniglio, Francesco Costa, Federico De Iure, Bart Depreitere, Enrico Fainardi, Michael J. Fehlings, Nikolay Gabrovsky, Daniel Agustin Godoy, Peter Gruen, Deepak Gupta, Gregory W. J. Hawryluk, Raimund Helbok, Iftakher Hossain, Peter J. Hutchinson, Corrado Iaccarino, Kenji Inaba, Marcel Ivanov, Stanislav Kaprovoy, Andrew W. Kirkpatrick, Sam Klein, Angelos Kolias, Nikolay A. Konovalov, Alfonso Lagares, Laura Lippa, Angelica Loza-Gomez, Teemu M. Luoto, Andrew I. R. Maas, Andrzej Maciejczak, Ronald V. Maier, Niklas Marklund, Matthew J. Martin, Ilaria Melloni, Sergio Mendoza-Lattes, Geert Meyfroidt, Marina Munari, Lena M. Napolitano, David O. Okonkwo, Yasuhiro Otomo, Marios C. Papadopoulos, Ondra Petr, Wilco C. Peul, Aichholz K. Pudkrong, Zaffer Qasim, Frank Rasulo, Carla Reizinho, Florian Ringel, Sandro Rizoli, Elham Rostami, Andres M. Rubiano, Emanuele Russo, Aarti Sarwal, Jan M. Schwab, Franco Servadei, Deepak Sharma, Salman Sharif, Ehab Shiban, Lori Shutter, Philip F. Stahel, Fabio S. Taccone, Nicole A. Terpolilli, Claudius Thomé, Peter Toth, Parmenion P. Tsitsopoulos, Andrew Udy, Alexander R. Vaccaro, Albert J. Varon, Monica S. Vavilala, Alexander Younsi, Monika Zackova, Tommaso Zoerle, and Chiara Robba
- Subjects
Traumatic spinal cord injury ,Polytrauma ,Management ,Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Abstract Background The early management of polytrauma patients with traumatic spinal cord injury (tSCI) is a major challenge. Sparse data is available to provide optimal care in this scenario and worldwide variability in clinical practice has been documented in recent studies. Methods A multidisciplinary consensus panel of physicians selected for their established clinical and scientific expertise in the acute management of tSCI polytrauma patients with different specializations was established. The World Society of Emergency Surgery (WSES) and the European Association of Neurosurgical Societies (EANS) endorsed the consensus, and a modified Delphi approach was adopted. Results A total of 17 statements were proposed and discussed. A consensus was reached generating 17 recommendations (16 strong and 1 weak). Conclusions This consensus provides practical recommendations to support a clinician’s decision making in the management of tSCI polytrauma patients.
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- 2024
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32. Probable recurrence of cardiac sarcoidosis in a transplanted heart
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Matthew Seplowe, DO, Shazli Khan, MD, Lakshmisree Vemulakonda, MD, Fouzia Shakil, MD, Liana Michaud, DO, Chhaya Aggarwal-Gupta, MD, Gregg Lanier, MD, Avi Levine, MD, Suguru Ohira, MD, PhD, David Spielvogel, MD, Alan Gass, MD, and Stephen Pan, MD, MS
- Subjects
cardiac sarcoidosis ,orthotopic heart transplant ,immunosuppression ,recurrent sarcoidosis ,graft dysfunction ,Surgery ,RD1-811 ,Specialties of internal medicine ,RC581-951 - Abstract
Recurrence of cardiac sarcoidosis (CS) in post-transplant patients presents a rare but potentially life-threatening form of graft dysfunction and poses challenges due to varying clinical presentations, limited diagnostic modalities, and treatments based on anecdotal evidence. We discuss the case of a 46-year-old woman with CS, who developed cardiogenic shock necessitating orthotopic heart transplant. She subsequently developed likely recurrent CS in the transplanted heart. We discuss the rarity of this scenario as well as diagnostic modalities and management principles to consider.
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- 2024
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33. Management and Outcomes of Kidney Transplant Candidates With Severe Pulmonary Hypertension: A Single-center Strategy and Experience
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Dhiren Kumar, MD, Nihar Raju, MD, Bhupinder Prajapati, MD, Irfan Moinuddin, MD, Shreyank Tripathi, MD, Daniel Grinnan, MD, Deepak Thomas, MD, and Gaurav Gupta, MD
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Surgery ,RD1-811 - Abstract
Background. Severe pulmonary hypertension (PH) is associated with high mortality posttransplant and thus is considered a contraindication to kidney transplantation. In this study, we describe the pretransplant management and posttransplant outcomes in patients with severe PH using a multidisciplinary approach. Methods. Between 11 of 2013 and 8 of 2022, we identified all patients with severe PH on initial pretransplant workup who underwent ultrafiltration (UF) or medical therapy for PH before transplant. Posttransplant we evaluated the perioperative course, renal function, graft, and patient survival. We compared survival to those who remained waitlisted or were delisted. Results. Three-two patients (mean age = 55.03 ± 10.22 y) diagnosed with severe PH on pretransplant screening echocardiogram. Thirty patients (94%) were subjected to a median of 4 (range, 3–8) UF sessions with an average weight loss of 4.33 ± 2.6 kg. Repeat assessment of PH revealed a decline in mean pulmonary artery systolic pressure from 67 ± 12 mm Hg to 43 ± 13 mm Hg (P < 0.0001). Seventeen patients (53%) received a kidney transplant. The mean estimated Glomerular Filtration Rate at 3, 6, 9, and 12 mo was 72 ± 27, 72 ± 28, 75 ± 29, and 75 ± 29 mL/min/1.73 m2. Among, those who underwent transplantation both graft and patient survival was 100% at 1-y posttransplant. Overall, since the UF intervention, at a median follow-up of 88 ± 12 mo those transplanted had a patient survival of 88% while those who remained on dialysis had a survival of 53% (P = 0.0003). Conclusion. In this single-center study, we report postcapillary PH can be a significant contributor to elevations in pulmonary artery systolic pressure. Using a multidisciplinary approach, PH can improve with volume removal and phosphodiesterase 5 inhibitors therapy leading to a successful posttransplant outcome.
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- 2024
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34. Failure after operative repair is higher for ballistic femoral neck fractures than for closed, blunt-injury fractures: a multicenter retrospective cohort study
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Ranjan Gupta, Henry Tout Shu, Diane Ghanem, Davis L. Rogers, Oscar Covarrubias, Paul Izard, Jacques Hacquebord, Philip Lim, Greg M. Osgood, and Babar Shafiq
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Surgery ,RD1-811 ,Medical emergencies. Critical care. Intensive care. First aid ,RC86-88.9 - Abstract
Introduction The purpose of this study was to describe the outcomes after operative repair of ballistic femoral neck fractures. To better highlight the devastating nature of these injuries, we compared a cohort of ballistic femoral neck fractures to a cohort of young, closed, blunt-injury femoral neck fractures treated with open reduction and internal fixation (ORIF).Methods Retrospective chart review identified all patients presenting with ballistic femoral neck fractures treated at three academic trauma centers between January 2016 and December 2021, as well as patients aged ≤50 with closed, blunt-injury femoral neck fractures who received ORIF. The primary outcome was failure of ORIF, which includes the diagnosis of non-union, avascular necrosis, conversion to total hip arthroplasty, and conversion to Girdlestone procedure. Additional outcomes included deep infection, postoperative osteoarthritis, and ambulatory status at last follow-up.Results Fourteen ballistic femoral neck fractures and 29 closed blunt injury fractures were identified. Of the ballistic fractures, 7 (50%) patients had a minimum of 1-year follow-up or met the failure criteria. Of the closed fractures, 16 (55%) patients had a minimum of 1-year follow-up or met the failure criteria. Median follow-up was 21 months. 58% of patients with ballistic fractures were active tobacco users. Five of 7 (71%) ballistic fractures failed, all of which involved non-union, whereas 8 of 16 (50%) closed fractures failed (p=0.340). No outcomes were significantly different between cohorts.Conclusion Our results demonstrate that ballistic femoral neck fractures are associated with high rates of non-union. Large-scale multicenter studies are necessary to better determine optimal treatment techniques for these fractures.Level of evidence Level III. Retrospective cohort study.
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- 2024
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35. Gender Affirmation Surgery–related Hashtag Utilization on Instagram: Implications for Education and Patient Care
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Nisha Gupta, MS, Tahera Alnaseri, MPH, Ginger Slack, MD, and Michael DeLong, MD
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Surgery ,RD1-811 - Abstract
Background:. Gender-affirmation surgery (GAS) allows for transgender and nonconforming patients to achieve a more congruent physical appearance and alleviate dysphoria. Social media, such as Instagram, has adopted an increasingly important role in plastic and reconstructive surgery, and understanding trends and usage related to GAS can have significant implications for patient education and outreach. As such, this cross-sectional study aims to address the following questions related to GAS-related content available on Instagram: (1) Who is posting this content? (2) What specific hashtags are they using? and (3) What are the implications behind these posts? Methods:. This study analyzed 22 GAS-related hashtags on Instagram. Content analysis was then used to evaluate the “top” 15 posts (n = 330) associated with each hashtag. Results:. A total of 425,607 posts were associated with the 22 hashtags queried. #topsurgery had the highest number of associated posts (n = 279,480), followed by #ftmtopsurgery (n = 41,769) and #vaginoplasty (n = 39,737). Of the “top” 330 posts, 299 were not duplicates. Plastic surgeons eligible for membership in the American Society of Plastic Surgeons accounted for only 1.7% of “top” posts (n = 5); noneligible physicians accounted for 6.0% of posts (n = 18). Patients accounted for the majority of the “top” posts sampled (n = 236; 79.9%). Conclusions:. When used appropriately, social media can be a powerful tool for spreading awareness on procedures and educating patients. Although there is a paucity of plastic surgeons posting GAS-related content on Instagram, patients are playing an important role in disseminating information.
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- 2024
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36. Should post-operative stereotactic radiosurgery be the standard of care in Craniopharyngioma patients?
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Saurabh Gupta, Deepak Agrawal, Shweta Kedia, and Shashank Sharad Kale
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Craniopharyngioma ,Gamma knife ,Radiosurgery ,Survival ,Stereotactic ,Surgery ,RD1-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2024
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37. Objective triaging of traumatic brain injury patients with a novel machine learning powered near-infrared spectroscopy-based biomarker at different time-intervals post injury
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Sumit Raj, Radha Sarawagi Gupta, Rajesh Malik, Md Yunus, Pradeep Chouksey, Adesh Shrivastav, Manoj Nagar, and Amit Agrawal
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Intracranial hemorrhage ,Machine learning ,Near infrared ,Non-invasive detection ,Objective assessment ,Rapid detection ,Surgery ,RD1-811 ,Neurology. Diseases of the nervous system ,RC346-429 - Published
- 2024
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38. High Altitude Head and Neck Paragangliomas: A First Sub‐Himalayan Experience
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Sudesh Kumar, Niraj Gupta, Priyanka Thakur, Nitin Gupta, and Anita Bodh
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head and neck ,high altitude ,low altitude ,paraganglioma ,sub‐Himalayan ,Otorhinolaryngology ,RF1-547 ,Surgery ,RD1-811 - Abstract
Abstract Objectives High‐altitude natives have a high incidence of parangangliomas (PGL) of the head and neck, especially the carotid body tumor. The aim of this study is to describe the clinical presentation, pattern, altitude of residence, distribution, management, and follow‐up of head and neck paragangliomas (HNPGL) in our sub‐Himalayan population. Study Design Retrospective cohort study. Setting Academic tertiary care hospital. Methods Hospital records of 20 patients of HNPGL diagnosed from December 2017 to December 2021 were retrieved for analysis. Results Twenty patients with 23 HNPGL, with a mean age of 41.74 years were managed in our institute. The female‐to‐male ratio was 2.3: 1 and the mean follow‐up was 29.95 months. Nine had carotid body (CBPGL), 7 had tympanic (TPGL), 2 had jugular (JPGL), and 2 had vagal paragangliomas (VPGL). Multiple PGL were seen in 4 patients (20%). Majority of cases (all CBPGL and 57.14% of TPGL) were residents of the high altitude, and the rest were from the low altitude. Fifteen patients (8 CBPGL, 7 TPGL) were operated. There were no major complications except in a patient with large carotid body tumor required anastomosis of carotid artery. Five patients received stereotactic radiotherapy, and 1 malignant PGL received chemoradiotherapy. Conclusion In this study, JPGL and VPGL are common at low altitudes, whereas carotid body and tympanic PGL were the most common tumor at high altitudes. Being a retrospective and study small sample size, a definite conclusion is not established, however, a genetic analysis and inclusion of a wider population in a future prospective study may establish the hypothesis.
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- 2024
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39. The Alteration of Serum Galactomannan Levels in Surgically Treated Patients with Aspergilloma: a Prospective Observational Study
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Kumar, Suresh, Jaidev, S., Pal, Ajay Kumar, Kumar, Sanjeev, Singh, Pankaj, and Gupta, Prashant
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- 2023
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40. The transplant dilemma: Uniting rare entities – Diabetic nephropathy, type 3 diabetes mellitus, and acromegaly secondary to pituitary macroadenoma
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Arjun Agarwal, Dhananjai Agrawal, and Rakesh Gupta
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acromegaly ,diabetic nephropathy ,dual renal transplantation ,pituitary macroadenoma ,type 3 diabetes mellitus ,Surgery ,RD1-811 - Abstract
Diabetic nephropathy is a well-recognized complication of both Type 1 and Type 2 diabetes mellitus. This case report presents a unique and rare scenario of diabetes mellitus secondary to acromegaly, arising from a concealed, and long-standing pituitary macroadenoma. The report explores the challenges and dilemmas encountered in considering renal transplantation as a viable treatment option for this complex interplay of medical conditions.
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- 2024
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41. COVID-19 infected ST-Elevation myocardial infarction in India (COSTA INDIA)
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Abdullakutty Jabir, Geevar Zachariah, Padinhare Purayil Mohanan, Mohit Dayal Gupta, Sivasubramanian Ramakrishnan, Chandra Bhan Meena, L. Sridhar, Meennahalli Palleda Girish, Dipak Ranjan Das, Anshul Gupta, Praveen Nagula, Tom Devasia, Bhavesh Vajifdar, Kamlesh Thakkar, Urmil Shah, Tanuj Bhatia, Smit Srivastava, Sanjeev Sharma, Priya Kubendiran, Pathiyil Balagopalan Jayagopal, Sudeep Kumar, Deepthy Sadanandan, Lincy Mathew, Nitish Naik, Anup Banerji, S.M. Ashraf, P.K. Asokan, Bishwa Bhushan Bharti, Biswajit Majumder, Dhiman Kahali, Dhurjati Prasad Sinha, Dipak Sharma, Dipankar Ghosh Dastidar, Dipankar Mukhapdhyay, Gurpreet Sing Wander, Harinder Kumar Bali, B. Kesavamoorthy, Manoj Kumar Agarwala, Narendra Nath Khanna, B.H. Natesh, Pravin K. Goel, Rabindra Nath Chakraborty, Rajendra Kumar Jain, Rakesh Yadav, L. Sameer Dani, Satyavan Sharma, Satyendra Tewari, K.K. Sethi, Sharad Chandra, Subrato Mandal, Suman Bhandari, Sundandan Sikdar, Vivek Gupta, Pratap Chandra Rath, Vijay Harikisan Bang, Debabrata Roy, Mrinal Kanti Das, and Partho Sarathi Banerjee
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COVID positive STEMI ,MI during COVID ,STEMI and COVID ,STEMI during COVID ,STEMI management ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: To find out differences in the presentation, management and outcomes of COVID-19 infected STEMI patients compared to age and sex-matched non-infected STEMI patients treated during the same period. Methods: This was a retrospective multicentre observational registry in which we collected data of COVID-19 positive STEMI patients from selected tertiary care hospitals across India. For every COVID-19 positive STEMI patient, two age and sex-matched COVID-19 negative STEMI patients were enrolled as control. The primary endpoint was a composite of in-hospital mortality, re-infarction, heart failure, and stroke. Results: 410 COVID-19 positive STEMI cases were compared with 799 COVID-19 negative STEMI cases. The composite of death/reinfarction/stroke/heart failure was significantly higher among the COVID-19 positive STEMI patients compared with COVID-19 negative STEMI cases (27.1% vs 20.7% p value = 0.01); though mortality rate did not differ significantly (8.0% vs 5.8% p value = 0.13). Significantly lower proportion of COVID-19 positive STEMI patients received reperfusion treatment and primary PCI (60.7% vs 71.1% p value=< 0.001 and 15.4% vs 23.4% p value = 0.001 respectively). Rate of systematic early PCI (pharmaco-invasive treatment) was significantly lower in the COVID-19 positive group compared with COVID-19 negative group. There was no difference in the prevalence of high thrombus burden (14.5% and 12.0% p value = 0.55 among COVID-19 positive and negative patients respectively) Conclusions: In this large registry of STEMI patients, we did not find significant excess in in-hospital mortality among COVID-19 co-infected patients compared with non-infected patients despite lower rate of primary PCI and reperfusion treatment, though composite of in-hospital mortality, re-infarction, stroke and heart failure was higher.
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- 2023
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42. Periorbital reconstructive techniques following Mohs micrographic surgery or excisions: a systematic review
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Archibald, Laura K., Gupta, Rachit, Shahwan, Kathryn T., Swick, Marki, Bakker, Caitlin, Mattox, Adam R., Alam, Murad, and Maher, Ian A.
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- 2023
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43. Hypo-fractionated accelerated radiotherapy with concurrent and maintenance temozolomide in newly diagnosed glioblastoma: updated results from phase II HART-GBM trial
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Mallick, Supriya, Gupta, Subhash, Amariyil, Adila, Kunhiparambath, Haresh, Laviraj, M. A., Sharma, Seema, Sagiraju, Hari Krishna Raju, Julka, Pramod Kumar, Sharma, Dayanand, and Rath, Goura Kishor
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- 2023
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44. A Century of Laffer-Ascher Syndrome
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Parveen Rewri, Swapnil Garg, Rajender Kumar, and Gulab Gupta
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Laffer-Ascher syndrome ,double lip ,blepharochalasis ,Surgery ,RD1-811 - Abstract
Laffer-Ascher syndrome is characterized by double lips, blepharochalasis, and nongoiter thyroid enlargement. The syndrome was first described in 1923 and several case reports have been published thereafter. We illustrate the syndrome through a case of a 46-year-old woman who presented with both upper and lower double lips and blepharochalasis, and review the literature published.
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- 2023
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45. A New Method of Matrix-Based Triage for Nuclear Disasters
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Pramod Kumar and Apoorva Gupta
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rapid triage ,clinical radiation dosimetry ,nuclear disasters ,Surgery ,RD1-811 - Abstract
During nuclear disaster, infrastructure is severely damaged and injuries are often combined with trauma/burns and whole-body radiation. This makes triage difficult, especially when resources are severely deficient. To solve this problem, in this article, the authors have suggested a new less technology-dependent radiation dosimetry and quick triage using a specially designed triage matrix during nuclear disasters.
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- 2023
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46. Impact of early initiation of proprotein convertase subtilisin/kexin type 9 inhibitors in patients with acute coronary syndrome: A systematic review meta-analysis
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Lakshmi Nagendra, Kunal Mahajan, Gunjan Gupta, and Deep Dutta
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PCSK9 antibodies ,PCSK9 inhibitors ,meta-Analysis ,Acute coronary syndrome ,Low-density lipoprotein cholesterol ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Objective: Scant data is available on the efficacy and safety of proprotein convertase subtilisin/kexin type-9 inhibitors (PCSK9i) for early and rapid reduction of low-density lipoprotein cholesterol (LDL-C) within 4–8 weeks of an acute event in patients with acute coronary syndrome (ACS). We undertook this meta-analysis to address this knowledge-gap. Methods: Electronic databases were searched for RCTs involving patients with ACS receiving PCSK9i in intervention arm, and placebo/active comparator in control arm. Primary outcome was to evaluate changes in 1-month LDL-C post ACS. Secondary outcomes were to evaluate alterations in other lipid parameters and adverse events. Results: From initially screened 194 articles, data from 3 studies was analyzed. After 4-weeks therapy, patients receiving PCSK9i had lower LDL-C [MD -0.95 mmol/L (95%CI:-1.51 to −0.40); P = 0.0007; I2 = 96%, total cholesterol (TC) [MD-1.05 mmol/L (95%CI:-1.83 to −0.27); P = 0.009; I2 = 94%] and triglycerides (TG) [MD-0.27 mmol/L (95%CI:-0.44 to −0.10); P = 0.002; I2 = 0%] compared to controls. After 4–8 weeks therapy, patients receiving PCSK9i has lower apolipoprotein B [MD-27.74% (95%CI:-42.59 to −12.89); P = 0.0003; I2 = 89%] as compared to controls. High density lipoprotein cholesterol (HDL-C) [MD 0.05 mmol/L (95%CI:-0.00–0.11); P = 0.05; I2 = 0%], lipoprotein(a) [MD-20.63 mmol/L (95%CI:-41.86– 0.59); P = 0.06; I2 = 54%] and apolipoprotein A1 [MD 0.02 g/L (95%CI:-0.02–0.07); P = 0.32; I2 = 0%] were comparable between groups. Hospital readmission for ACS was significantly lower in group receiving PCSK9i compared to controls [OR0.25 (95%CI:0.07–0.85); P = 0.03; I2 = 0%]. Occurrence of cardiac death [OR3.75 (95%CI:0.41–34.22); P = 0.24; I2 = 0%], serious adverse events [OR0.71 (95% CI:0.13–3.83); P = 0.69; I2 = 70%] and total adverse events [OR1.01 (95%CI: 0.19–5.30); P = 0.99; I2 = 92%] was comparable between groups. Conclusion: PCSK9i are highly effective in early reduction of LDL-C along with reduction of early hospital readmissions post-ACS.
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- 2023
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47. Independent prognostic value of high-risk ventricular premature complexes during exercise or recovery in asymptomatic patients: A meta-analysis of observational studies
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Kartik Gupta, Sulmaz Zahedi, Tanya Singh Kakar, Akhilesh Khuttan, Rajat Kalra, and Bryan M. Zweig
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Ventricular premature complexes ,Premature ventricular contractions ,Ventricular ectopy ,Exercise stress test ,Cardiovascular mortality ,All-cause mortality ,Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Abstract
Introduction: Ventricular premature contractions (VPCs) are a common finding during cardiac stress tests. The independent prognostic value of these findings in patients in asymptomatic patients is unclear. Methods: We conducted a systematic review and meta-analysis of observational studies exploring the independent prognostic value of VPCs to predict all-cause mortality. The secondary outcome was cardiovascular (CV) mortality. We excluded studies that did not report outcomes after adjusting for ≥1 confounder. Random effect meta-analyses were used to predict cumulative hazard ratios. We stratified results based on VPC during exercise or recovery. Results: We found 7 studies with 24,518 patients that met our inclusion criteria. Two studies reported all-cause mortality only, 1 study reported CV mortality only, rest 4 reported both. There was significant heterogeneity in the baseline population, definition of high-risk VPCs, and variables used in adjusted models. Using multivariable summary estimates from individual studies, only VPCs during exercise were associated with a higher risk of all-cause mortality (HR 1.27, 95 % CI 1.07, 1.48). Both VPCs during exercise and recovery were associated with a higher risk CV mortality (HR 1.69, 95 % CI 1.19, 2.20, I2 = 17.6 % and 1.62, 95 % CI 1.25, 2.00, p
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- 2023
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48. Anti-inflammatory therapy in atherosclerotic cardiovascular disease: Current reappraisal
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Subrat Muduli, Mohit D. Gupta, Girish MP, and Rakesh Yadav
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Surgery ,RD1-811 ,Diseases of the circulatory (Cardiovascular) system ,RC666-701 - Published
- 2023
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49. Perioperative myocardial injury is associated with increased postoperative non-cardiac complications in patients undergoing vascular surgery: a post hoc analysis of a randomised clinical pilot trial
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A. Valadkhani, A. Gupta, and M. Bell
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Myocardial injury ,Vascular surgery ,Postoperative complications ,Surgery ,RD1-811 - Abstract
Abstract Background Elevated cardiac biomarkers, such as high-sensitivity cardiac Troponin T and N-terminal pro-B-type natriuretic peptide improve the prediction of major adverse cardiac events. However, very few trials have investigated the association between perioperative cardiac injury and non-cardiac complications. The primary aim of this study was to determine the association between peri-operative myocardial injury and non-cardiac complications in patients undergoing vascular surgery. Additionally, the association between elevated pre-operative high-sensitivity cardiac Troponin T or N-terminal pro-B-type natriuretic peptide and non-cardiac complications was explored. Methods This study is a post hoc analysis of a multicentre randomised controlled trial. Patients were recruited from three centres in Sweden between 2016 and 2019. Cardiac troponin level was measured pre-operatively and at 4, 24, and 48 h after the start of surgery in patients undergoing vascular surgery. N-terminal pro-B-type natriuretic peptide was measured pre-operatively. The primary outcome was a composite of major postoperative non-cardiac complications assessed at 30 days. Results A total of 184 patients undergoing peripheral or aortic vascular surgery were included in this study. The primary endpoint occurred in 67 (36%) patients. Perioperative myocardial injury was significantly associated with non-cardiac complications, with an adjusted odds ratio (OR) of 2.71 (95% confidence interval 1.33–5.55, P = 0.01). Sensitivity and specificity were 0.40 and 0.81, respectively. No association was found between pre-operative hs-cTnT or NT-proBNP and non-cardiac complications. Conclusion In this pilot study, we found that new peri-operative myocardial injury is associated with an increased risk of non-cardiac complications within 30 days after index surgery in patients undergoing vascular surgery. Pre-operative high-sensitivity cardiac Troponin T or N-terminal pro-B-type natriuretic peptide did not appear to predict non-cardiac complications. Larger studies are needed to confirm our findings. Trial registration EudraCT database: 2016-001584-36
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- 2023
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50. Venous thromboembolism following surgical management of proximal humerus fractures: a systematic review
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Erick M. Marigi, MD, John W. Sperling, Jr., MD, Rodrigo De Marinis, MD, Puneet Gupta, BS, Leslie C. Hassett, MLS, Francisco Soza, MD, and Joaquin Sanchez-Sotelo, MD, PhD
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Proximal humerus fracture ,Open reduction internal fixation ,Hemiarthroplasty ,Reverse total shoulder arthroplasty ,Venous thromboembolism ,Deep vein thrombosis ,Surgery ,RD1-811 - Abstract
Background: Currently, there is limited information on the incidence of venous thromboembolism (VTE), including deep vein thrombosis (DVT) and pulmonary embolism (PE) after surgical treatment of proximal humerus fractures (PHFs). Therefore, the purpose of this systematic review is to evaluate the incidence of VTE, DVT, and PE following surgery for PHFs. Methods: A comprehensive search of several databases was performed from inception to May 27, 2022. Studies were screened and evaluated by 2 reviewers independently utilizing the Preferred Reporting Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Only original, English studies that evaluated the incidences of VTE following surgical management of PHFs were included. Surgical procedures consisted of shoulder arthroplasty (SA) including both hemiarthroplasty (Hemi) and reverse shoulder arthroplasty (RSA) in addition to open reduction and internal fixation (ORIF). A pooled incidence for postoperative DVT, PE, and overall VTE was reported. Results: Twelve studies met the inclusion and exclusion criteria, encompassing a total of 18,238 patients. The overall DVT, PE, and VTE rates were 0.14%, 0.59%, and 0.7%, respectively. VTE was more frequently reported after SA than ORIF, (1.27% vs. 0.53%, respectively). Among SA patients, a higher rate of DVT was seen with RSA (1.2%) with the lowest DVT rate was observed for ORIF with 0.03%. Conclusions: Symptomatic VTEs following surgical treatment of PHFs, are rare, yet still relevant as a worrisome postoperative complication. Among the various procedures, VTE was the most frequently reported after SA when compared to ORIF, with RSA having the highest VTE rate.
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- 2023
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