Cmc Scientific Research Publication for the Year 2017 (January to June)
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CMC SCIENTIFIC RESEARCH PUBLICATION FOR THE YEAR 2017 (JANUARY TO JUNE) S.No AUTHOR, TITLE, SOURCE, AUTHOR AFFILIATION, ABSTRACT NAT / INT MONTH PMID 1. Aaron, S., Mani, S., Prabhakar, A. T., Babu, P. S., Kumar, S., Benjamin, R. N., Sivadasan, A., Muthusamy, NAT JAN TO JUN PMID:28084238 K., Patil, A. K., Mathew, V. and Alexander, M. Sonothrombolysis for acute ischemic stroke - Break on through to the other side Neurol India; 2017, 65 (1): 52-57 Address: Department of Neurological Sciences, Neurology Unit, Christian Medical College, Vellore, Tamil Nadu, India. Department of Radiology, Christian Medical College and Hospital, Vellore, Tamil Nadu, India. BACKGROUND: Intravenous (IV) tissue plasminogen activator (tPA) infusion combined with transcranial low-frequency ultrasound waves targeted on the occluded arterial segment (sonothrombolysis) can increase recanalization in large artery-acute ischemic stroke (LA-AIS). AIMS: To evaluate the benefits of sonothrombolysis in LA-AIS. SETTINGS AND DESIGNS: An open-labeled observational study done in a quaternary care teaching hospital. METHODOLOGY: Patients with LA-AIS within the window period (<4.5 h) with no contraindications for IV-recombinant tPA were sonothrombolysed. Recanalization was monitored and graded using the transcranial Doppler thrombolysis in brain ischemia (TIBI) flow criteria and also by time of flight magnetic resonance angiography using a modified thrombolysis in myocardial infarction score. Parenchymal changes were assessed using computed tomography (CT) or diffusion- weighted imaging-Alberta Stroke Programme Early CT Score. National Institutes of Health Stroke Scale (NIHSS) and modified Rankin Scale (mRS) were used to assess the outcome. RESULTS: Eighteen patients underwent sonothrombolysis and the mean onset to needle time was 138 min (range 65-256). TIBI residual flow grade of >/=2 was seen in 15 of 18 patients (83%). Immediate dramatic improvement (NIHSS score </=3 points or improvement by >/=10 points) was seen in 6 of 18 patients (30%) and in 9 of 18 patients (50%) within the next 24 h. Two patients (one with TIBI 0, another with re-occlusion) underwent mechanical thrombectomy post-sonothrombolysis. Symptomatic hemorrhage occurred in 5.5% of the patients. At 6 months, 2 of 18 patients (11%) died and 10 of 16 patients (63%) achieved mRS </=2. CONCLUSIONS: Sonothrombolysis appears to be a safe way to augment the effect of tPA without increasing the door to needle time with the added advantage of observing flow through theoccluded artery in real time. 2. Abraham, A. P., Franklyn, J., Chandramohan, J., Gaikwad, P. and Muthusami, J. C. NAT JAN TO JUN PMID:28546722 Malignant Peripheral Nerve Sheath Tumour of the Small Bowel Presenting with Intussusception and Perforation: a Double Jeopardy? Indian J Surg Oncol; 2017, 8 (2): 206-209 Address: Department of General Surgery, Christian Medical College, Vellore, Tamil Nadu India. Department of Pathology, Christian Medical College, Vellore, Tamil Nadu India. Malignant peripheral nerve sheath tumours (MPNST) are rare soft tissue sarcomas which largely occur in the extremities and the head and neck region. The tumours are aggressive with a high rate of recurrence. INT – INTERNATIONAL; NAT – NATIONAL; PMID: PUBMED ID; PMCID: PUBMED CENTRAL ID CMC SCIENTIFIC RESEARCH PUBLICATION FOR THE YEAR 2017 (JANUARY TO JUNE) Radical surgical resection remains the treatment of choice with adjuvant radiation therapy and chemotherapy still failing to demonstrate a clear benefit. The gastrointestinal tract is an exceedingly rare site for these tumours. We report an unusual case of a young male with an MPNST of the small bowel who presented with an ileocolic intussusception and sigmoid perforation. 3. Agarwal, I. and Al-Ghitany, A. INT JAN TO JUN PMID:28352023 Anti-glomerular basement membrane: A rare cause of renal failure in children Saudi J Kidney Dis Transpl; 2017, 28 (2): 379-383 Address: Department of Pediatric Nephrology, Christian Medical College, Vellore, Tamil Nadu, India. Department of Internal Medicine, Nephrology Unit, Ain Shams University, Cairo, Egypt. Anti-glomerular basement membrane (GBM) disease is a rare cause of acute renal failure and known to have bad prognosis regarding renal functions recovery and patient survival specially when diagnosed late and presents with severe renal failure that requires dialysis. We report a case of 11-year-old child with acute renal failure secondary to anti-GBM disease and associated with antineutrophil cytoplasmic antibody-positive vasculitis. He was treated with plasmapheresis, steroids, and cyclophosphamide with recovery of his kidney functions. 4. Aithala, R., Alex, A. G. and Danda, D. INT JAN TO JUN PMID:28205373 Pulmonary hypertension in connective tissue diseases: an update Int J Rheum Dis; 2017, 20 (1): 5-24 Address: Department ofClinical Immunology & Rheumatology, Christian Medical College, Vellore, Tamil Nadu, India. Department ofCardiology, Christian Medical College, Vellore, Tamil Nadu, India. Pulmonary hypertension (PH) is a relatively commoner complication of systemic sclerosis (SSc) with estimated prevalence ranging between 8% and 12% as compared to much lower figures in other connective tissue diseases (CTD). It is a major cause of morbidity and mortality in CTDs. PH is classified into five major groups. CTD-associated PH belongs to group 1 PH, also known as pulmonary arterial hypertension (PAH). Around 30% of scleroderma-related deaths are due to PAH. Underlying pathogenesis is related to pulmonary vasculopathy involving small vessels. The Evidence-based Detection of Pulmonary Arterial Hypertension in Systemic sclerosis (DETECT) algorithm outperforms the current European Society of Cardiology/European Respiratory Society guidelines as a screening tool in SSc-PAH; it can, therefore, suggest when to refer a patient for right heart catheterization. CTD-PAH patients constitute at least 20% of patients included in all major trials of PH-specific therapy and the results are comparable to those of idiopathic PAH. The role of anticoagulation in CTD-PAH is associated with a high risk-benefit ratio with the caveat of its potential role in those with severe disease. There appears to be no role of immunosuppression in scleroderma-PAH; however, immunosuppressive agents, namely the combination of glucocorticoids and pulse cyclophosphamide / possibly mycophenolate, may result in clinical improvement in a subset of patients with systemic lupus erythematosus and mixed connective tissue INT – INTERNATIONAL; NAT – NATIONAL; PMID: PUBMED ID; PMCID: PUBMED CENTRAL ID CMC SCIENTIFIC RESEARCH PUBLICATION FOR THE YEAR 2017 (JANUARY TO JUNE) disease-related PAH. 5. Alarcon Falconi, T. M., Kulinkina, A. V., Mohan, V. R., Francis, M. R., Kattula, D., Sarkar, R., Ward, H., INT JAN TO JUN PMID:27773615 Kang, G., Balraj, V. and Naumova, E. N. Quantifying tap-to-household water quality deterioration in urban communities in Vellore, India: The impact of spatial assumptions Int J Hyg Environ Health; 2017, 220 (1): 29-36 Address: Department of Civil & Environmental Engineering, Tufts University, Medford, MA, USA. Department of Community Health, Christian Medical College, Vellore, Tamil Nadu, India. Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India. Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India; Department of Geographic Medicine, Tufts Medical Center, Boston, MA, USA. Department of Civil & Environmental Engineering, Tufts University, Medford, MA, USA; Division of Gastrointestinal Sciences, Christian Medical College, Vellore, Tamil Nadu, India; Friedman School of Nutrition Science & Policy, Tufts University, Boston, MA, USA. Electronic Address: [email protected]. Municipal water sources in India have been found to be highly contaminated, with further water quality deterioration occurring during household storage. Quantifying water quality deterioration requires knowledge about the exact source tap and length of water storage at the household, which is not usually known. This study presents a methodology to link source and household stored water, and explores the effects of spatial assumptions on the association between tap-to-household water quality deterioration and enteric infections in two semi-urban slums of Vellore, India. To determine a possible water source for each household sample, we paired household and tap samples collected on the same day using three spatial approaches implemented in GIS: minimum Euclidean distance; minimum network distance; and inverse network-distance weighted average. Logistic and Poisson regression models were used to determine associations between water quality deterioration and household-level characteristics, and between diarrheal cases and water quality deterioration. On average, 60% of households had higher fecal coliform concentrations in household samples than at source taps. Only the weighted average approach detected a higher risk of water quality deterioration for households that do not purify water and that have animals in the home (RR=1.50 [1.03, 2.18], p=0.033); and showed that households with water quality deterioration were more likely to report diarrheal cases (OR=3.08 [1.21, 8.18], p=0.02). Studies to assess contamination between source and household are rare due to methodological challenges and high costs associated with collecting paired samples. Our study demonstrated it is possible to derive useful spatial links between samples post hoc; and that the pairing