Clinical behaviour and outcome in pediatric glioblastoma: current scenario

Aditya Kumar Singla,Renu Madan,Kirti Gupta,Shikha Goyal,Narendra Kumar,Sushant Kumar Sahoo,Deepak K. Uppal,Chirag K. Ahuja 대한방사선종양학회 2021 Radiation Oncology Journal Vol.39 No.1

Pediatric glioblastoma (pGBM) is a rare entity accounting for only approximately 3% of all childhood brain tumors. Treatment guidelines for pGBM have been extrapolated from those in adult glioblastoma. Rarity of pGBM and underrepresentation of pediatric population in major studies precludes from defining the ideal treatment protocol for these patients. Maximum safe resection is performed in most of the cases followed by postoperative radiotherapy in children over 3 years of age. Benefit of temozolomide is unclear in these patients. Here, we present the clinicopathological details and outcome of six pGBM patients treated at our institute in 2018–2019.

Episodes of prolonged “trance-like state” in an infant with hypothalamic hamartoma

Rakesh Kumar,Jaivinder Yadav,Jitendra Kumar Sahu,Manjul Tripathi,Chirag Ahuja,Devi Dayal 대한소아내분비학회 2019 Annals of Pediatirc Endocrinology & Metabolism Vol.24 No.1

Hypothalamic hamartoma (HH) is one of the most common causes of central precocious puberty (CPP) in first few years of life. It can present with either seizures or CPP, although both manifestations coexist in the majority of the children. Gelastic seizures (GS), or laughing spells, are usually the first type of seizures seen in patients with HH. Although a wide variety of seizure types are known to occur in children with HH, GS are most common and consistent seizure type. The clinical presentation of HH may vary with the size and position of the mass, although large tumours typically present with both CPP and seizures. Although CPP can be managed with medical therapy, seizures can be very difficult to treat, even with multiple antiepileptic drugs. Noninvasive gamma knife surgery has been used with some success for the treatment of refractory epilepsy. We present a case of HH with very early onset seizures and CPP. The patient had an atypical form of seizures described by the parents as a "trance-like state" in which the patient had prolonged episodes of unresponsiveness lasting for hours with normal feedings during the episodes. GS occurred late in the course and were refractory to various combinations of antiepileptic drugs. A brain magnetic resonance imaging showed a large sessile HH (>20 mm). Later in the course of the disease, the patient experienced cognitive and behavioural problems. The patient underwent gamma knife surgery at nearly 5 years of age and experienced a modest response in seizure frequency. This case highlights the presentation of HH as a previously unreported seizure morphology described as a prolonged "trance-like state."

Optical Properties and Phase Transition in VO2 and Ti:ZnO/VO2 Thin Films

Chirag Saharan,Pawan S Rana,Manish Kumar 한국진공학회 2023 Applied Science and Convergence Technology Vol.32 No.4

Energy saving methods/materials are becoming increasingly important for meeting society’s energy demands. Smart windows made of thermochromic materials show great promise in reducing the energy consumption of buildings. Thermochromic vanadium dioxide (VO2) is a potential candidate for smart window applications; however, its commercial usage is limited by its low visible light transmittance. To address this issue, we integrated a VO2 layer with an antireflecting Ti-doped ZnO (TZO) layer. Single-layer VO2 and bilayer TZO/ VO2 thin films were fabricated on c-Al2O3 substrates using radio frequency sputtering, and their structural, morphological, and optical properties were investigated. The single-phase growth of the VO2 and TZO layers in single and bilayer samples was confirmed through room-temperature X-ray diffraction (XRD) measurements. Temperature-dependent grazing incidence XRD measurements during the heating and cooling cycle were performed in a synchrotron to explore the structural changes in the VO2 and TZO/VO2 thin-film samples. The structural phase transition curves were modified in the TZO/VO2 thin-film sample. The increase in visible light transmittance was examined using ultraviolet-visible spectroscopy in the transmittance mode at room temperature. The enhanced visible light transmittance of the TZO/VO2 bilayer shows promise for realizing more effective smart windows.

Epitrochlear lymphadenopathy

( Ashok Kumar Pannu ),( Gaurav Prakash ),( Aditya Jandial ),( Chirag Rajkumar Kopp ),( Savita Kumari ) 대한내과학회 2019 The Korean Journal of Internal Medicine Vol.34 No.6

Routine double-J stenting for live related donor kidney transplant recipients: It doesn't serve the purpose, but does it serve a better purpose?

Vikash Kumar,Chirag B Punatar,Kunal K Jadhav,Jatin Kothari,Vinod S Joshi,Sharad N Sagade,Madhav H Kamat 대한비뇨의학회 2018 Investigative and Clinical Urology Vol.59 No.6

Purpose: Despite meticulous techniques, surgical complications continue to be problematic in kidney transplant recipients. Role of routine stenting to reduce complications is controversial. In this study, we compare incidence of early urological complications, lymphoceles, urinary tract infections (UTI) and graft function; with or without double-J stenting. Materials and Methods: All patients who underwent live related donor renal transplantation from February 2014 to February 2016 were included. Transplants prior to February 2015 were without routine stenting; subsequent transplants were with routine stenting. Patients with neurogenic bladder, previously operated bladder and delayed or low urinary output were excluded. Follow-up was for at least three months. Descriptive statistics was performed for all parameters. Chi square test and Fisher's Exact test were used for qualitative variables. For quantitative variables, Mann-Whitney test was used to test median difference and independent samples t-test for mean difference. The p-value ≤0.05 was considered significant. Results: We analysed 74 patients (34 stented and 40 non-stented). There was no difference in the incidence of urinary leak, anastomotic obstruction, lymphoceles or UTI (p>0.4 for all comparisons). However, mean estimated glomerular filtration rate at sixth day, 14th day, one month and two months were 76.1 vs. 61.5 (p=0.025), 72.1 vs. 56.6 (p=0.005), 79.4 vs. 63.1 (p=0.002) and 82.0 vs. 63.3 (p=0.001) in the stented versus non-stented groups. Conclusions: Placement of ureteral stent in renal transplant does not significantly affect the incidence of early urinary complications or UTI. However, graft function is significantly better in stented recipients, at least in the short term.

Cement Augmentation of Dynamic Hip Screw to Prevent Screw Cut Out in Osteoporotic Patients with Intertrochanteric Fractures: A Case Series

Avinash Kumar Rai,Rajesh Goel,Chirag Bhatia,Sumer Singh,Srikiran Thalanki,Ashwin Gondane 대한고관절학회 2018 Hip and Pelvis Vol.30 No.4

Purpose: The purpose of this study is to describe a method of inserting cement in the femoral head before fixation with dynamic hip screw to prevent screw cut out due to osteoporosis and to evaluate its clinical outcome in these patients. Materials and Methods: In this prospective study, 30 patients aged 60 years and older with intertrochanteric fracture were included. Bone mineral density was measured. After reaming of the femoral head and neck with a triple reamer and polymethyl methacrylate, bone cement was introduced into the femoral head using a customized nozzle and a barrel fitted on a cement gun. A Richard screw was inserted and the plate was fixed over the femoral shaft. Patients were mobilized and clinical outcomes were rated using the Salvati and Wilson’s scoring system. Results: More patients included in this study were between 66 and 70 years old than any other age group. The most common fracture according to the Orthopaedic Trauma Association classification was type 31A2.2 (46.7%). The T-score was found to be –2.506±0.22 (mean±standard deviation); all patients were within the range of –2.0 to –2.8. The duration of radiological union was 13.67±1.77 weeks. Salvati and Wilson’s scoring at 12 months of follow up was 30.96±4.97. The majority of patients were able to perform their normal routine activities; none experienced implant failure or screw cut out. Conclusion: Bone cement augmentation may effectively prevent osteoporosis-related hardware complications like screw cut out in elderly patients experiencing intertrochanteric fractures.

Climatic Analysis of a Haveli in Shekhawati Region, Rajasthan

Madhvi Chulet,Chirag Kumar ASCONS 2018 INTERNATIONAL JOURNAL OF EMERGING MULTIDISCIPLINAR Vol.2 No.2

The havelis of Shekhawati region, Rajasthan stand evidence of the glorious history of the land and rich cultural heritage of the state. These havelis are majorly known for their fresco paintings and building envelope in a semi-arid region. However, the havelis of Fatehpur town in Shekhawati region are threatened. They are either demolished or handed over to the ignorant new owners or they are abandoned or left at the mercy of poor care take cares. The negligence of these will lead to the extinction of this rich cultural heritage of Shekhawati region, Rajasthan. This paper will be primarily focusing upon a climatic analysis of a haveli of Shekhawati region. This shall also analyse proportion of spaces and the spatial organization with respect to controlled light, heat ad dust, exterior walls, small openings, courtyards, materials and construction techniques catering to a typical desert climate.

Role of aliasing and interacting factors in the enhanced production of dehalogenase from Yarrowia lipolytica for degradation of brominated compounds

Aakanksha Vatsal,Chirag Potdar,Smita S. Zinjarde,V. Ravi Kumar,Bhasker D. Kulkarni,Ameeta RaviKumar 한국공업화학회 2016 Journal of Industrial and Engineering Chemistry Vol.41 No.-

Use of persistent organobromines for industrial applications has led to their accumulation inenvironment. Yarrowia lipolytica NCIM 3589, a tropical marine yeast, degrades and detoxifiesbromocompounds by an initial hydrolytic step. By optimizing culture conditions with 1-bromodecaneas reference compound, the dehalogenase involved was remarkably enhanced 13-fold (384.13 U/ml) by ahybrid statistical Plackett–Burman and Box–Behnken design of experiments. Studies bring out in a novelway the role of aliasing and other masked interactions in growth media factors. Importantly, the enzymeacted on C3–C16 bromoalkanes and bromoaromatics, thereby generalizing the ‘green chemistry’applicability of optimized media formulation for biotechnological applications.

The Diagnostic Dilemma of Neurolymphomatosis

Ritu Shree,Manoj Kumar Goyal,Manish Modi,Balan Louis Gaspar,Bishan Dass Radotra,Chirag Kamal Ahuja,Bhagwant Rai Mittal,Gaurav Prakash 대한신경과학회 2016 Journal of Clinical Neurology Vol.12 No.3

Neurolymphomatosis (NL) defned as infltration of the central nervous system or the peripheral nervous system (PNS) by malignant lymphoma cells is a rare clinical entity. However, the increasing use of fuorodeoxyglucose positron-emission tomography (FDG-PET) and magnetic resonance imaging in evaluating PNS disorders is resulting in; this condition being recognized more frequently. Here; we report fve NL patients and review the current literature. We report five patients with non-Hodgkin’s lymphoma (NHL) and NL, all of whom were men aged 47–69 years. Te clinical presentation varied from symmetrical peripheral neuropathy to mononeuropathy. Peripheral neuropathy was the presenting manifestation of a systemic lymphoma in two patients (40%). Neuroimaging as well as whole-body FDG-PET helped in determining the correct diagnosis in all of the patients. NL is an unusual presentation of NHL resulting from infltration of the PNS by malignant lymphomatous cells. While evaluating peripheral neuropathy, a high degree of suspicion of NL is required since the presenting symptoms vary, conventional radiology has only modest sensitivity, and a pathological diagnosis is ofen difcult. FDG-PET helps in the early diagnosis and treatment of this condition.

Retroperitoneal fibrosis-clinical presentation and outcome analysis from urological perspective

Kunal Kishor Jadhav,Vikash Kumar,Chirag B. Punatar,Vinod S. Joshi,Sharad N. Sagade 대한비뇨의학회 2017 Investigative and Clinical Urology Vol.58 No.5

Purpose: To study clinical presentation, laboratory results, imaging findings and treatment options and outcomes of retroperitoneal fibrosis (RPF). To determine whether it follows the same natural course and response to treatment in the Asian population as in the Western world. Materials and Methods: Medical records of patients diagnosed with RPF on imaging and histopathology between February 2010 and April 2016 were reviewed. Results: Of the 21 patients analyzed, mean age at presentation was 50.81 years. The male to female ratio was 0.9:1. Pain was most common presenting complaint (95.23% cases), almost 85% cases were idiopathic and rests were postradiation induced. The median creatinine level was 1.8 mg/dL. The mean erythrocyte sedimentation rate (ESR) was 53.2 mm/h. Hydronephrosis was present in all patients and 47.6% had atrophic kidneys. Diffuse retroperitoneal mass was present in 61.1%. Ureterolysis with lateralization, omental wrapping or gonadal pedicle wrap was done in 17 cases. Two patients underwent uretero-ureterostomy. One patient underwent ileal replacement of ureter, and one ileal conduit. Eighteen patients received concurrent medical treatment, 11 were given tamoxifen, 2 steroids (Prednisolone), and five were given both. Of the 20 patients with follow-up, 70% had complete symptomatic relief; ESR improvement was seen in 77.8%. Follow-up ultrasound showed resolved and decreased hydronephrosis in 20% and 55% respectively. One patient had treatment failure and 17.65% had disease recurrence. Conclusions: RPF is a rare disease with varied presentation and outcomes. The male to female ratio may be equal in Asians and smoking could be lesser contributing factor. More Asian cohort studies are required to support same.