Author: "John, Mathew" / Topic: medicine.medical_specialty - Searchworks@Jio Institute Digital Library Search Results

134 results on '"John, Mathew"'

1. Deficiency of adenosine deaminase 2 (DADA2): two cases of multisystem vasculitis managed in a South Indian tertiary care centre

Author: Arvind G Hegde, John Mathew, Daisy Doley, and Avanish Jha
Subjects: Adult, Vasculitis, medicine.medical_specialty, Necrosis, business.industry, Adenosine Deaminase, General Medicine, ADENOSINE DEAMINASE 2, medicine.disease, Dermatology, Tertiary care, Tertiary Care Centers, medicine, Humans, Intercellular Signaling Peptides and Proteins, medicine.symptom, business
Abstract: Deficiency of adenosine deaminase 2 (DADA2) is a newly described entity of monogenic vasculitis with multisystem involvement and prominent neurological features. With this report, we are adding to the growing spectrum of cases of DADA2 with two adult cases of early-onset recurrent cerebrovascular events with multisystem involvement. These cases highlight the need for high suspicion of this diagnosis in adults presenting late with symptoms compatible with DADA2. We further report the futility and probable harm of antiplatelet agents in DADA2. Tumour necrosis factor inhibitors have been shown to be beneficial for the treatment and prevention of severe manifestations of this condition.
Published: 2023

2. Prevalence of HLA-B*27 subtypes in the Tamil population of India with Ankylosing spondylitis and its correlation with clinical features

Author: Snehil Kumar, Grace Rebekah, John Mathew, Dolly Daniel, Nitty Skariah Mathews, Debashish Danda, and R. Sam Arul Doss
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Immunology, Population, India, Disease, Dactylitis, 03 medical and health sciences, Sex Factors, 0302 clinical medicine, Gene Frequency, Internal medicine, Ethnicity, Prevalence, Humans, Immunology and Allergy, Medicine, Genetic Predisposition to Disease, Spondylitis, Ankylosing, Typing, education, HLA-B27 Antigen, Ankylosing spondylitis, education.field_of_study, business.industry, Enthesitis, General Medicine, medicine.disease, HLA-B, language.human_language, Phenotype, 030104 developmental biology, Tamil, language, Female, Joints, medicine.symptom, business, 030215 immunology
Abstract: Introduction HLA-B*27 is strongly associated with Ankylosing spondylitis (AS). Its subtypes show considerable geographic and ethnic difference. The main aim of this study was to assess the frequency of subtypes of HLA-B*27 in the Indian Tamil AS patients. Methods and materials Adult AS patients positive for HLA-B*27 were considered for the study. The high-resolution typing to define HLA-B*27 subtypes were done using Invitrogen B kits from One Lambda (SeCore® Sequencing Kits, Thermo Fisher, United States). Results and conclusion Prevalence of subtypes identified were HLA-B*27:04 (52.2%), HLA-B*27:05 (41.6%), HLA-B*27:07 (3.5%) and HLA-B*27:02 (2.7%). All subtypes showed disease predisposition for males. The most common extra articular manifestation seen was enthesitis in HLA-B*27:04 and HLA-B*27:05. Uveitis was mainly associated with HLA-B*27:05 and dactylitis with HLA-B*27:04. A significant peripheral joints involvement for female and axial joint involvement for males was seen in HLA-B*27:04. Our study establishes the prevalence of HLA-B*27 subtypes and the associated clinical phenotypes among the Indian Tamil population. Considering the variability of presentation, organ involvement, and disease course in different subtypes and across ethnicities it is critical to define these associations in the ethnic populations we treat for their appropriate care considering the significant negative health and socioeconomic effects of AS.
Published: 2021

3. Can we safely accommodate larger volume implants in inframammary fold nipple sparing mastectomy compared to nipple sacrificing mastectomy in implant-based reconstruction with acellular dermal matrix?

Author: John Mathew
Subjects: Nipple-Sparing Mastectomy, medicine.medical_specialty, business.industry, medicine.medical_treatment, lcsh:Surgery, lcsh:RD1-811, 030230 surgery, Surgery, Radiation therapy, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Implant reconstruction, Inframammary fold, Original Article, Implant, business, Dermal matrix, Mastectomy, Volume (compression)
Abstract: Introduction: The aim of this study was to analyse if inframammary fold nipple sparing mastectomy (IMF NSM) could safely accommodate larger implants in relation to weight of the breast as opposed to nipple sacrificing mastectomy (NSacriM) in implant reconstruction with biological mesh. Methods: A review of prospectively collected data of implant-based reconstruction using biological mesh between Nov 2016 and December 2019 by a single surgeon. The volume of the implant was measured against the weight of the breast. The data was analysed using Chi-squared test and independent t-test, and a P value of < 0.05 was considered significant. Results: Sixty-five patients had 86 implant reconstructions during this period. Median follow-up was 18 months (1–38). There was no statistical difference between IMF NSM and NSacriM with regard to smoking, obesity (BMI>30) and radiotherapy (P>0.05). The volume of the implants was more than the weight of the breast in IMF NSM group compared to the NSacriM group (22/34 vs 21/52; P = 0.026). Significantly more patients in IMF NSM group had an implant volume within 100 g of the mastectomy weight compared to NSacriM group (31/34 vs 33/52; P = 0.003). None of the 34 IMF NSM had wound necrosis or threatened wound compared to 7/52 in NSacriM group (P = 0.025); 4 were managed in the clinic and 3 were managed in theatre. One patient in the NSacriM group lost her implant post radiotherapy at 5 months, and another patient lost her implant at 3 years. Comparisons were made between IMF-NSM and skin sparing mastectomy (SSM) having fixed volume silicone implants. The analysis showed that 22/33 (67%) IMF-NSM, had a volume of the implant more than the weight of the breast compared to 15/35 (43%) having SSM, this was statistically significant. There was a statistical difference between these two groups with regard to ischemic complications in favour of IMF-NSM. Conclusion: IMF NSM allows safer insertion of larger volume implants in relation to the weight of the breast as opposed to NSacriM.
Published: 2021

4. Mycophenolate in idiopathic inflammatory myositis: outcome data of a large South Asian cohort

Author: P. Chebbi, G. Arvind, Bijesh Yadav, John A. J. Prakash, Ashish J. Mathew, Grace Rebekah, John Mathew, Ruchika Goel, Aswin Nair, and Debashish Danda
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, business.industry, Interstitial lung disease, Retrospective cohort study, General Medicine, medicine.disease, Pericardial effusion, Rash, Gastroenterology, Rheumatology, Discontinuation, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, Cohort, Inclusion and exclusion criteria, medicine, 030212 general & internal medicine, medicine.symptom, business
Abstract: Consensus on treatment of idiopathic inflammatory myositis (IIM), particularly with regard to flares and interstitial lung disease (ILD), does not exist. We studied the long-term outcome and treatment response in our large, retrospective cohort of adult South-Asian patients exclusively with IIM. Electronic records of IIM patients satisfying inclusion and exclusion criteria were studied longitudinally at presentation, at 3, 6, 12, 18 and 24 months and thereafter yearly till their last follow up (F/u) visit. Depending on clinical, imaging, and muscle enzyme profile during the F/u period, patients were categorised as complete (CR) and partial responders (PRs). Parameters favouring CR were assessed using multivariate logistic regression analysis. Outcome parameters and flares on immunosuppressants (IS) were then assessed in patients with/without ILD. Two hundred thirty-two patients with median F/u duration of 44.5 months (25–80.25) were included. ILD was seen in 40.1%. Patients with non-Jo1 anti-synthetase antibodies (n=26) were numerically more than those with Jo-1 antibody (n=24). CR status was attained by 50.9% patients. Absence of pericardial effusion (p=0.042, OR 4.223, 95% CI: 1.05–16.9) and presence of Gottron’s rash (p=0.044, OR 1.78, 95% CI 1.017–3.121) at baseline predicted CR by multivariate regression. Majority received mycophenolate during the entire F/u period. Discontinuation of steroids was feasible in 51.7% after a median duration of 24 months (18–42). After excluding patients with ILD, flares were numerically lesser in patients only on mycophenolate compared with those only on methotrexate (p=0.06). Further flares were curtailed when switched from other agents to mycophenolate. Mycophenolate is an effective treatment option in IIM patients with and without co-existing ILD. Presence of Gottron’s rash and absence of pericardial effusion were found to be predictors of favourable clinical outcome in this largest single-centre study.
Published: 2021

5. A tale of two great mimickers: leprosy or sarcoidosis? A case-based review

Author: Reena Kharkele, John Mathew, RameshBabu Telugu, Shivraj Padiyar, and S Rima
Subjects: medicine.medical_specialty, business.industry, Diagnostic dilemma, Disease, Diseases of the musculoskeletal system, Radiological examination, medicine.disease, Dermatology, Rheumatology, RC925-935, medicine, uveitis, Leprosy, Sarcoidosis, sarcoidosis, business, granuloma, hansen's
Abstract: Leprosy and sarcoidosis are chronic multisystem disorders, with clinical features overlapping with each other. The diagnosis requires a thorough clinical, laboratory, histopathological, and radiological examination. Although it is possible to conclude on one particular diagnosis most of the time, in some cases, even after extensive evaluation, it is difficult to differentiate between the two diseases. In such scenarios, treating both the conditions is warranted. Here, we present a case with a diagnostic dilemma between Hansen's disease and sarcoidosis and systematically discuss the specific pointers which can help to differentiate between the two diseases.
Published: 2021

6. Speech Intelligibility and Communication-related Quality of Life in Tracheoesophageal Speakers

Author: Swapna Sebastian, John Mathew, Rajan Sundaresan, Mahasampath Gowri, and Rajiv Micheal
Subjects: Laryngectomy, medicine.medical_specialty, Quality of life (healthcare), business.industry, medicine.medical_treatment, Medicine, Audiology, business
Published: 2020

7. Wrestle while you learn: EMG as a teaching tool for undergraduate skeletal muscle physiology teaching

Author: Vinay Oommen, Mahatabb Nundy, Anandit John Mathew, and Niranjini Chandrashekaran
Subjects: Reflex, Stretch, medicine.medical_specialty, Universities, Electromyography, Physiology, business.industry, Teaching, MEDLINE, Skeletal muscle, General Medicine, Education, Physical medicine and rehabilitation, medicine.anatomical_structure, Teaching tool, Accelerometry, medicine, Reflex, Humans, Muscle, Skeletal, business, Muscle Contraction
Published: 2019

8. Comparison of Surgical and Oncological Outcomes between Chest Wall Perforator Flaps and Therapeutic Mammoplasty

Author: Samreen Khan and John Mathew
Subjects: medicine.medical_specialty, RD1-811, business.industry, medicine.medical_treatment, Significant difference, Patient characteristics, Mammoplasty, Single surgeon, Surgery, medicine, Fat grafting, In patient, Original Article, Breast, business, Mastectomy, Perforator flaps
Abstract: Background:. Chest wall perforator flaps (CPF) and therapeutic mammoplasty (TM) are often done in patients with anticipated poor cosmetic outcome with level 1 breast conservation surgery. The aim of this study was to assess the complications and oncological outcomes between CPF and TM. Methods:. Prospectively collected data of breast conservation surgery between September 2016 and January 2021 by a single surgeon were reviewed. Specific outcomes included complications needing intervention, re-excision and mastectomy rate, locoregional recurrence, and distant metastasis. Patients were followed up at 3 months and then every 12 months. Statistical analysis included chi-squared test and independent t test, and a P value of less than 0.05 was considered significant. Results:. There was no statistically significant difference between CPF and TM with regard to patient characteristics except for BMI and bra cup size, which was significantly higher in the TM group. One patient who had TM returned to the operating room for a hematoma evacuation, and one patient who had CPF had fat grafting, for unsatisfactory cosmetic outcome. Five of the 30 patients having CPF had further re-excision surgery for inadequate margins, but none needed mastectomy, and four of the 43 patients having TM had further surgery (one had re-excision of margins and three had mastectomy) and this was not statistically significant (P = 0.346). There was no locoregional recurrence in CPF and TM groups after a median follow-up of 22 months and 25 months, respectively. Conclusion:. There is no significant difference in early complications and oncological outcomes between CPF and TM.
Published: 2021

9. Short- to Medium-term Outcome of Prepectoral versus Subpectoral Direct-to-implant Reconstruction using Acellular Dermal Matrix

Author: John Mathew
Subjects: medicine.medical_specialty, RD1-811, business.industry, medicine.medical_treatment, medicine.disease, Surgery, Radiation therapy, Hematoma, Seroma, medicine, Implant reconstruction, Deformity, Original Article, Implant, Breast, medicine.symptom, Dermal matrix, business, Mastectomy
Abstract: Background:. Subpectoral implant reconstruction (SIR) is associated with animation deformity and increased postoperative pain. The aim of our study was to compare the short- to medium-term outcome of prepectoral implant reconstruction (PIR) and SIR with acellular dermal matrix. Methods:. A review of prospectively collected data of patients who underwent PIR and SIR using biological mesh by a single surgeon between Nov 2016 and Nov 2020 was done. Presentation, smoking history, BMI, bra size, radiology size, pathology data, mastectomy weight, implant volume, radiation treatment, and outcomes were analyzed. For intergroup comparisons, the data were analyzed using Pearson chi-square test and the Student t-test. P values of less than 0.05 were considered statistically significant. Results:. Eighty-two patients had 109 implant reconstructions (85 PIR and 24 SIR). Median follow-up was 27 months (4–53). Twenty-five of PIR and six of SIR were risk reduction surgeries. Two groups were comparable except for significantly higher percentage of node positive (13/18, 72% versus 20/60, 33%; P = 0.003), Her 2-positive disease (7/18, 39% versus 9/60, 15%; P = 0.027), and radiotherapy (15/24, 63% versus 21/85, 25%; P = 0.001) in SIR. There was no statistically significant difference between the two groups with regard to hematoma, wound infection, red reaction, seroma needing aspiration, wound necrosis, and implant loss. Significantly more patients in the prepectoral group had rippling needing fat grafting (n = 13, 15% versus 0; P = 0.041) and significantly more patients in the subpectoral group had fat grafting for contour deformity (n = 6, 25% versus n = 6, 7%; P = 0.025). Conclusion:. PIR is comparable to conventional SIR with regard to most of the complications.
Published: 2021

10. An Unusual Cause of Chylothorax after Esophagectomy

Author: Chokkappu S. Kumar, Abhishek Yadav, Rajesh Antony, John Mathew Manipadam, and H. Ramesh
Subjects: Thorax, Leak, medicine.medical_specialty, Chyle, medicine.medical_treatment, lcsh:Surgery, Case Report, 030204 cardiovascular system & hematology, Thoracic duct, Postoperative management, 03 medical and health sciences, 0302 clinical medicine, chylothorax, chyle, medicine, business.industry, Chylothorax, lcsh:RD1-811, medicine.disease, Surgery, medicine.anatomical_structure, Esophagectomy, 030220 oncology & carcinogenesis, esophagectomy, business, Complication
Abstract: Chylothorax due to inadvertent thoracic duct injury after esophagectomy is a well-known complication and requires careful postoperative management and timely intervention to prevent potential morbidity and mortality. We present a case of high-output chylothorax after esophagectomy where the source of chyle leak was not in the thorax.
Published: 2020

11. Thoracoscopic Esophagectomy for a Huge Leiomyosarcoma

Author: S. Mahesh, John Mathew Manipadam, H. Ramesh, Ami Maria Emmanuel, and Satinder Pal Singh Bains
Subjects: Leiomyosarcoma, medicine.medical_specialty, leiomyosarcoma of esophagus, business.industry, minimally invasive esophagectomy, lcsh:Surgery, thoracoscopic esophagectomy, Case Report, lcsh:RD1-811, medicine.disease, Esophageal Leiomyosarcoma, Surgery, body regions, 03 medical and health sciences, 0302 clinical medicine, medicine.anatomical_structure, 030220 oncology & carcinogenesis, Medicine, Thoracoscopic esophagectomy, 030211 gastroenterology & hepatology, Esophagus, business
Abstract: Esophageal leiomyosarcoma is the commonest of all esophageal sarcomas but yet has a very low incidence. These tumors have been resected by the open approach so far. We describe the steps and challenges involved in the thoracoscopic excision of a huge leiomyosarcoma of the esophagus.
Published: 2019

12. Multiple Mini-interview Consistency and Satisfactoriness for Residency Program Recruitment: Oman Evidence

Author: Lakshmanan Jeyaseelan, John Mathew, and Rashid Al Abri
Subjects: medicine.medical_specialty, 020205 medical informatics, Interview, Intraclass correlation, media_common.quotation_subject, Specialty, lcsh:Medicine, 02 engineering and technology, Education, 03 medical and health sciences, 0302 clinical medicine, Consistency (negotiation), 0202 electrical engineering, electronic engineering, information engineering, medicine, Personality, 030212 general & internal medicine, media_common, business.industry, lcsh:R, General Medicine, Residency program, Confidence interval, Otorhinolaryngology, Family medicine, Original Article, business
Abstract: Objectives: Standard interviews are used by most residency programs to assess non-cognitive skills, but variability in the interviewer’s skills, interviewer bias, and context specificity limit reliability. We sought to investigate the consistency and satisfactoriness of the multiple mini-interview (MMI) model for resident selection into an otorhinolaryngology head and neck surgery residency program. Methods: This pilot study was done in an independent academic residency training center for 15 applicants, in seven eight-minute MMI stations with eight raters for the 2015–2016 academic year. The raters included the chief resident and education committee chairman in one of the stations. Candidates were assessed on two items: medical knowledge (two standardized case scenarios) and behavioral knowledge (personality and attitude, professionalism, communication, enthusiasm to the specialty, and English proficiency). Results: Of 15 candidates, 10 (66.7%) were female and five (33.3%) were male; five were recommended for selection, and five were kept on the waiting list. The reliability, intraclass correlation coefficient (ICC), of the scores obtained from seven items of MMI was 0.36 (95% confidence interval (CI): -0.31–0.75; p = 0.110). However, the ICC of the medical interview was 0.54 (95% CI: 0.45–0.84; p = 0.090). The correlation between behavioral items score and MMI total score was r = 0.135 (p = 0.150). Conclusions: The interview evaluation/survey form given to candidates and interviewers has shown that MMI is a fair and effective tool to evaluate non-cognitive traits. Both candidates and interviewers prefer MMI to standard interviews. The MMI process for residency interviews can generate reliable interview results using only seven stations and is acceptable and preferred over standard interview modalities by residency program applicants and faculty members.
Published: 2019

13. Mycophenolate in scleroderma-associated interstitial lung disease: Real-world data from rheumatology and pulmonology clinics in South Asia

Author: John Mathew, Anoof Peediyakal, Leena Robinson Vimala, P. Chebbi, Debashish Danda, Devasahayam J. Christopher, Ramya Janardana, Aswin Nair, Shivraj Padiyar, Ruchika Goel, and Aparna Irodi
Subjects: 030203 arthritis & rheumatology, medicine.medical_specialty, South asia, Lung, business.industry, Immunology, Interstitial lung disease, Mycophenolate Sodium, Original Manuscript, medicine.disease, Mycophenolate, Dermatology, Scleroderma, Rheumatology, 03 medical and health sciences, 0302 clinical medicine, Pulmonology, medicine.anatomical_structure, 030228 respiratory system, Internal medicine, medicine, Immunology and Allergy, business
Abstract: Introduction: There is a paucity of real-world data on mycophenolate mofetil/mycophenolate sodium in systemic sclerosis-related interstitial lung disease. Aim: To study the efficacy of mycophenolate mofetil/ mycophenolate sodium in systemic sclerosis-related interstitial lung disease. Methods: In this single-centre study, clinical, laboratory and imaging details of consecutive patients with systemic sclerosis-related interstitial lung disease receiving mycophenolate mofetil/mycophenolate sodium from rheumatology and pulmonology clinics between January 2008 and March 2017 were retrospectively retrieved. The change in percentage of predicted normal forced vital capacity at last follow-up visit as compared with baseline was studied. In addition, high-resolution computed tomography scans at baseline and 2-year follow-up visit were scored as either stable/improved or worsened by experienced thoracic radiologists blinded to the clinical details of patients. Results: Altogether, 88 patients (85.2% females) with mean age (SD) of 33.8 years (± 11.3) and median (interquartile range) duration of disease since non-Raynaud’s symptoms of 36 months (13.5–60) were studied. Diffuse systemic sclerosis comprised 85.2% of them. The mean baseline forced vital capacity was 61.2 ± 17.9% and median scores for ground glass opacities and fibrosis in high-resolution computed tomography were 0.5 (0–1.3) and 1 (0–1.3), respectively. At a median follow-up duration of 30 months (interquartile range = 16.5–49), the percentage of forced vital capacity improved by 1.8% (–3.82 to 9.07) as compared with baseline visit ( p = 0.02). In the 2-year follow-up, the ground glass opacity and fibrosis scores in high-resolution computed tomography improved in 17.3% and 7.7% of patients and stabilized in 63.5% and 78.8% patients, respectively. Conclusion: Mycophenolate mofetil/mycophenolate sodium was efficacious in improving /stabilizing forced vital capacity irrespective of the baseline high-resolution computed tomography lung scores in our patients with systemic sclerosis-related interstitial lung disease during the ⩾ 2-year follow-up period.
Published: 2021

14. Unusual Morphological and Automated Hematology Analyzer Features in 3 Cases of B-cell Malignancy-associated Type I Cryoglobulinemic Vasculitis

Author: Sukesh Chandran Nair, John Mathew, Shivraj Padiyar, and Rutvi Gautam Dave
Subjects: medicine.medical_specialty, Pathology, Hematology, medicine.diagnostic_test, business.industry, Short Communication, medicine.disease, Cryoglobulinemia, Cryoglobulins, Flow cytometry, Basophilic, Cryoglobulin, Internal medicine, medicine, business, B cell malignancy, Cryoglobulinemic vasculitis
Abstract: Type I cryoglobulins are monoclonal immunoglobulins produced due to underlying hematological malignancy. Cryoglobulins spontaneously precipitate from serum and plasma at low temperatures and become soluble again on rewarming to 37 °C. Processing of blood at temperature lower than 37 °C in the laboratory may cause precipitation of cryoglobulins resulting in interferences in the automated cell counter analysis. We report three patients with cryoglobulinemic vasculitis wherein each case had different morphology of cryoglobulin precipitates on peripheral blood film, like needle shaped bluish-gray crystals, amorphous weakly basophilic extracellular deposits extraneously indenting red blood cells and basophilic neutrophilic inclusions respectively. The effect of cryoglobulins on two technologically different automated cell counters based on principles of impedance, Volume-Conductivity-Scatter (VCS) and fluorescence flow cytometry was assessed. This case series provides interesting insight into the varying morphological features of cryoglobulins on May-Grunwald-Giemsa stained blood films and interference caused by cryoglobulins in different automated cell counter analysis resulting in pseudo-leucocytosis, pseudo-thrombocytosis, abnormal histograms and scatterplots. Identification of these hematologic abnormalities and artifacts induced by cryoglobulins is necessary since it may be the first clue leading to the timely diagnosis of cryoglobulinemia and hence the underlying hematological malignancy, as in our cases.
Published: 2021

15. Timing of surgery following SARS-CoV-2 infection: an international prospective cohort study

Author: Dmitri, Nepogodiev, Joana Ff Simoes, Elizabeth, Li, Maria, Picciochi, James, C Glasbey, Glauco, Baiocchi, Ruth, Blanco-Colino, Daoud, Chaudhry, Ehab, Alameer, Kariem, El-Boghdadly, Funmilola, Wuraola, Dhruva, Ghosh, Rohan, R Gujjuri, Ewen, M Harrison, Herman, Lule, Haytham, Kaafarani, Mohammad, Khosravi, Irmgard, Kronberger, Sezai, Leventoğlu, Harvinder, Mann, Kenneth, A Mclean, Mengistu Gebreyohanes Mengesha, Maria Marta Modolo, Faustin, Ntirenganya, Lisa, Norman, Oumaima, Outani, Riinu, Pius, Peter, Pockney, Ahmad Uzair Qureshi, April Camilla Roslani, Sohei, Satoi, Catherine, Shaw, Aneel, Bhangu, Omar, M Omar, Waheed-Ul-Rahman, Ahmed, Leah, Argus, Alasdair, Ball, Edward, P Bywater, Amanpreet, Brar, Brett, E Dawson, Irani, Duran, Muhammed, Elhadi, Conor, S Jones, Sivesh, K Kamarajah, James, M Keatley, Samuel, Lawday, Ella, J Marson, Riinu, Ots, Irène, Santos, Elliott, H Taylor, Isobel, M Trout, Chris, Varghese, Mary, L Venn, William, Xu, Irida, Dajti, Arben, Gjata, Salah Eddine Oussama Kacimi, Luis, Boccalatte, Daniel, Cox, Philip, Townend, Felix, Aigner, Irmgard Elisabeth Kronberger, Elgun, Samadov, Amer, Alderazi, Kamral, Hossain, Greg, Padmore, Gabrielle van Ramshorst, Ismaïl, Lawani, Anis, Cerovac, Samir, Delibegovic, Gustavo Mendonça Ataíde Gomes, Igor Lima Buarque, Muhammad, Gohar, Mihail, Slavchev, Chukwuemeka, Nwegbu, Arnav, Agarwal, Janet, Martin, Joshua, Ng-Kamstra, Maricarmen, Olivos, Wenhui, Lou, Dong-Lin, Ren, Jose Andres Calvache, Carlos, J Perez Rivera, Ana Danic Hadzibegovic, Tomislav, Kopjar, Jakov, Mihanovic, Pablo Mijahil Avilés Jiménez, Nikolaos, Gouvas, Jaroslav, Klat, René, Novysedlák, Nicolas, Amisi, Peter, Christensen, Alaa, El-Hussuna, Sylvia, Batista, Eddy, Lincango-Naranjo, Sameh, Emile, Danilo Alfonso Arévalo Sandoval, Hailu, Dhufera, Samuel, Hailu, Mengistu, G Mengesha, Joonas, H Kauppila, Alexis, P Arnaud, Zaza, Demetrashvili, Markus, Albertsmeier, Hans, Lederhuber, Markus, W Löffler, Daniel Kwesi Acquah, Bernard, Ofori, Stephen, Tabiri, Symeon, Metallidis, Georgios, Tsoulfas, Maria-Lorena, Aguilera-Arevalo, Gustavo, Recinos, Tamás, Mersich, Dániel, Wettstein, Gabriele, Kembuan, Peiman Brouki Milan, Mohammad Hossein Khosravi, Masoud, Mozafari, Ahmed, Hilmi, Helen, Mohan, Oded, Zmora, Gaetano, Gallo, Francesco, Pata, Gianluca, Pellino, Yuki, Fujimoto, Naoto, Kuroda, Mohamad, K Abou Chaar, Faris, Ayasra, Ildar, Fakhradiyev, Intisar Hisham Said Hamdun, Jang, Jin-Young, Mohammad, Jamal, Lina, Karout, Aiste, Gulla, Fanjandrainy, Rasoaherinomenjanahary, Luc Hervé Samison, Iran Irani Durán Sánchez, Diana Samantha Gonzalez, Laura, Martinez, María José Martínez, Alejandra, Nayen, Antonio Ramos-De la Medina, Jade, Nunez, Pueya Rashid Nashidengo, Rakesh, Shah, Ashish Lal Shrestha, Pascal, Jonker, Schelto, Kruijff, Milou, Noltes, Pieter, Steinkamp, Deborah, Wright, Lukman, Abdur-Rahman, Adesoji, Ademuyiwa, Adewale, Adisa, Babatunde, Osinaike, Justina, Seyi-Olajide, Omolara, Williams, Emmanuel, Williams, Sofija, Pejkova, Zainab Al Balushi, Raza, Sayyed, Mustafa Abo Mohsen, Sadi, A Abukhalaf, Moises, Cukier, Hugo, Gomez-Fernandez, Sebastian Shu Yip, Ximena Paola Vasquez Ojeda, Marie Dione Sacdalan, Piotr, Major, José, Azevedo, Miguel, F Cunha, Ahmad, Zarour, Eduard-Alexandru, Bonci, Ionut, Negoi, Sergey, Efetov, Viktor, Kochetkov, Andrey, Litvin, Jc Allen Ingabire, Georges, Bucyibaruta, Ntirenganya, Faustin, Sosthene, Habumuremyi, Alphonsine, Imanishimwe, Haragirimana Jean de Dieu, Emmanuel, Munyaneza, Isaie, Ncogoza, Abdourahmane, Ndong, Dejan, Radenkovic, Min Hoe Chew, Frederick, Koh, James, Ngu, Arpád, Panyko, Uros, Bele, Jurij Aleš Košir, Hassan, Daoud, Ana Maria Minaya Bravo, Umesh, Jayarajah, Dakshitha, Wickramasinghe, Mohammed Elmujtba Adam Essa Adam, Martin, Rutegård, Malin, Sund, Michel, Adamina, Eleftherios, Gialamas, Karoline, Horisberger, Muhammad, Alshaar, Abel, Huang, Varut, Lohsiriwat, Shane, Charles, Haithem, Jlassi, Arda, Isik, Hervé Monka Lekuya, Slava, Kopetskyi, Hayder, Alsaadi, Sattar, Alshryda, Osaid, Alser, Brittany, Bankhead-Kendall, Kerry, Breen, Hassan, Mashbari, Fernando Bonilla Cal, Hamza, Al-Naggar, Mayaba, Maimbo, Dennis, Mazingi, Tom, Abbott, Melika, Akhbari, Ruth, Benson, Shivam, Bhanderi, Bruce, Biccard, Edward, Caruana, Sohini, Chakrabortee, Reema, Chapatwala, Ainhoa, Costas-Chavarri, Andreas, K Demetriades, Anant, Desai, Salomone Di Saverio, Thomas, Drake, John, Edwards, Jonathan, Evans, Marco, Fiore, Samuel, Ford, Christina, Fotopoulou, Alexander, Fowler, Kaori, Futaba, Ian, Ganly, Harelimana Grace James, Ewen, Griffiths, Alessandro, Gronchi, Peter, Hutchinson, Gabriella Yael Hyman, Joseph, Incorvia, Ritu, Jain, Michael, Jenkinson, Tabassum, Khan, Stephen Richard Knight, Angelos, Kolias, Søren, Kudsk-Iversen, Tsun Yu Kwan, Elaine, Leung, Julio, Mayol, Siobhan, Mckay, John, G Meara, Emily, Mills, Susan, Moug, Akshay, Patel, Roberto, Perinotti, Henry, E Rice, Keith, Roberts, Andrew, Schache, Richard, Shaw, Neil, Smart, Matthew, Stephens, 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Pu, Hanlin, Yin, Camilo, Caicedo, Diego Felipe Tellez Beltran, Alejandro, Escobar, Carolina Perez Granados, Lisbeth Alexandra Urueña Pinzon, Carlos, Bonilla, Diana, Santana, Oscar, Serrano, Andrea, Garcia, Fernando Giron Luque, Nasly, G Patino-Jaramillo, Laura Giselle Contreras Baquero, Nestor Augusto Muñoz Botero, Jhoana Andrea Murillo Castellanos, Andrea Juliana Vega Calvera, Lina, M Acosta Buitrago, Maria Paz Bohórquez-Tarazona, Paulo Andrés Cabrera Rivera, J Felipe Casas, Valeria Cormane Alfaro, Julian, Corso, Bayron, Guerra, Albert Franz Guerrero-Becerra, Akram Kadamani Abiyomaa, Felix Ramon Montes, Manuel Santiago Mosquera Paz, Camilo Andrés Polanía Sandoval, Natalia, Quintana, Carlos Fernando Roman Ortega, Carlos, Santacruz, Manuela, Téllez, Camilo Alejandro Velandia Sánchez, Fernando, Arias-Amézquita, Luis Felipe Cabrera Vargas, Natalia Cortes Murgueitio, Elkin, Escorcia, Kemel Ahmed Ghotme Ghotme, Jorge Luis Gomez-Mayorga, Alvaro Felipe Guerrero Vergel, Gabriel, 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Ioanna, Pozotou, Olga, Stavrinidou, Anneza, Yiallourou, Lukáš, Burda, Michal, Dosoudil, Lubomir, Martinek, Wladyslaw, B Gawel, Milan, Lerch, Matúš, Peteja, Jan, Žatecký, Toman, Daniel, Martin, Formánek, Veronika, Javurkova, Markéta, Kepičová, Nicole, Macečková, Petr, Matousek, Ondrej, Simetka, Petr, Vavra, Karol, Zelenik, Jan, Černý, Sami, Khan, Robert, Lischke, Martin, Přibyl, Temoore, Younus, Yenuksha, Amarasena, Karel, Klíma, Setareh, Pirmorad, Zuzana, Hotová, Aleš, Mladěnka, Nulvin, Bozo, Julie Lykke Harbjerg, Louise, Hviid, Helle, Ø Kristensen, Mira, Mekhael, Mette Fugleberg Nielsen, Laerke, Paulsen, Saija, Sinimäki, Louise Zinck Mogensen, Peter, Bonde, Anders Lyng Ebbehøj, Anne-Sophie, Fenger, Aleksander Fjeld Haugstvedt, Christine Hangaard Hansen, Maria Lovisa Jönsson, Lars, N Jorgensen, Peter-Martin, Krarup, Anne-Louise, Lihn, Christian, Meyhoff, Helena, Otte, Anas Ould Si Amar, Henrik, Palm, Nis, Schlesinger, Henry, Smith, Ida, Tryggedsson, Anne Reiss Axelsen, Jens Kristian 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Maher, Hosain, Ahmed, Hossam, Hamza Hussein Aly Salama Aly, Mohamed, Ibrahim, Abdelrahman, Ibrahim, Nourhan, Ibrahim, Noha Mohamed Salah Ibrahim Moussa Hamouda, Monica, Iskander, Islam, Khalifa, Mostafa, Kotb, Nada, Mahmoud, Alaa Mahmoud Abo Shabana, Nora, Mamdouh, Maram, Metwalli, Khaled, Metwally, Mahmoud, Moghazy, Moustafa, Mohamed, Mohamed, Mourad, Esraa, Moustafa, Kamilia, Mubarek, Nour Eldin Nader, Ahmed, Nasser, Samaa, Omar, Mostafa Shehata Qatora, Mohamed, Ragab, Marawan, Ragal, Dina, Ramadan, Rana, Ramadan, Sara, Ramadan, John, Romany, Ahmed, Sabry, Yasmeen, Said, Sara, Salamah, Ahmed Mostafa Saleh, Mona Saleh Mesbah Mohamed Elkaffas, Alaa, Salem, Hashem, Salim, Ahmed, Samih, Ahmed Samir Abdelaal, Ahmed, Shaheen, Yassmeen Sharafeldin Mohammed, Abdelrahman, Shehata, Mohamed, Shemeis, Karim, Shenit, Mennatallah, Sheta, Asmaa, Soffar, Yousef, Tanas, Ahmed, Tarek, Nermin, Yehia, Omar Khaled Mohamed Eid, Ammar Yasser Abdulfattah, Ahmed, Elsaghir, Mohamed Fouad Elganainy, Omar Ibrahim Elsayed, Omar, Elmandouh, Omar, Hamam, Mostafa Ahmed Shehata, Areej, A Abdelaziz, Ahmed, M Abbas, Wael Abd El-Ghani, Hossam Aldein, S Abd Elazeem, Mustafa Abd Elsayed, Ahmed Yassien Abd-Elkariem, Shimaa, Abdalla, Mahmoud, Abdel-Aleem, Khaled, Abdelazeem, Mahmoud, Abdelfattah, Mohammed, Abdelhafez, Mohamed, M Abdelkarem, Ali, Abdelraouf, Lamess, Abdullaha, Hossam, Abubeih, Moaiad Eldin Ahmed, Nagm Eldin Abu Elnga Ahmed, Ahmed, Ahmed, Sarah Ahmed Saad, Sherif, Alaa, Ali, Alhussaini, Abdelrahman Ahmed Abdelrahman Ali, Ibrahim, Ali, Wagdi, Ali, Mohamed Ali Mohamed, Mohamed, Ashraf, Muhammad, Bassiouni, Mohamed, G El-Adawy, Mohammad, El-Sharkawi, Hussein, Elkhayat, Khaled, Elmaghraby, Shady, Elsdfy, Mohamed, Elsharkawy, Almoutaz, Eltayeb, Mohamed Esmat Mohamed, Esraa, Essam, Mahmoud, Fahd, Osama, Farouk, Rabea, Gadelkareem, Ahmed, Ghoneim, Mohammed Hamada Takrouney, Ahmed, Hamdan, Abd El-Rahman Hamed, Ahmad, Hasan, Mohamed Abdelghafor Hassanin, Islam, Hawal, Kerollos, Henes, Mohamed Omar Herdan, Helal, F Hetta, Omar, Ibrahem, Mostafa, Ibrahim, Islam, H Ibrahim, Mahmoud, Kamel, Mohamed, Khallaf, Shrouk, M Elghazaly, Abobakr, Mahfouz, Osman, Mahmoud, Wesam, Mahran, Doha, Mahrous, Abadeer, Marsis, Ayman, Mohamed, Aliae Mohamed Hussein, Amr Mohamed Sayed, Mahmoud, M Mohammed, Ahmed, Mokhtar, Fatma, A Monib, Ahmed, Nageeb, Mariam Albatoul Nageh, Mohammed, Nageh, Nehal Gamal Omar, Abdelrahman, Ragab, Abdelrahman, Ramadan, Abdallah Rashad Temerik, Aya, Sabry, Hadeer, Safwat, Omar, Salah, Ahmed Elhussiny Salah Mahmoud, Ahmed, Saleh, Mahmoud, Sallam, Ahmed, Samir, Reem, Sayad, Esraa, Sayed, Ahmed, S Sedik, Mohammed, Shahine, Antonios, Soliman, Wael, Soliman, Mohamed Gamal Taher, Randa, Wanees, Ebrahim Ahmed Yousof, Ahmed, Youssef, Omar Zein Elabedeen, Ahmed Emad Sayed Hassan, Shrouk Abdel Fattah, Ahmed, Abostate, Samar, Ali, Saad Ali Saad Salama, Mohamed, Allam, Ahmed, Alsadek, Ebrahim, Arafa, Ahmed, Barakat, Mohammed El Sherpiny, Gehad, Elbehairy, Mahmoud, Eleisawy, Abdelrahman, Elgendy, Rewan, Elhawary, Sherif, Eltregy, Mahmoud, Hamdy, Gehad, Hassan, Aya, Khalifa, Ahmed, Mahmoud, Ahmed Mohamed Altukhy, Kareem, Noah, Yasser, Noureldin, Mostafa, Nowar, Moustafa, Saad, Ahmed Saad Elsaeidy, Khaled Saad Elsaeidy, Hesham, Sabry, Mostafa, Sameh, Ahmed Tarek Said-Elnaby, Mohamed, Zahed, Mohamed, Zahran, Abdelrahman, Zaid, Ahmed Zaki Zoghary, Mohamed, Atef, Ahmed, Mohamed, Mohamed, Youssef, Mahmoud Hossameldin Saad Abdelhamid, Emad, Alazab, Ahmed, K Awad, Amr, Darwesh, Lobna El Fiky, Ibrahim, Elgarhy, Mohamed Adel Nassef, Mahmoud, Shaban, Mahmoud Mohamed Mohamed Shalaby, Abdelrahman, Wahba, Omar Youssif Omar Fouad, Menan, Elsadek, Dalia, Gad, Ahmed, Abdelsamed, Abdulhakeem, Bayomy, Mohamed, Elsalhy, Ahmed, Fahim, Ahmed, Seleim, Eman, Afifi, Fatma Alzahraa Gamal, Mennatullah, Gamal, Omnia, Eldesouky, Mohamed Hatem Elmetwalli Eldwini Eldwini, Mostafa Medhat Fahmy Fahmy, Ahmed, Hussein, Abdallah, Ouf, Omar, Sami, Salem, Shaat, Abdullah Wael Mostafa Khalil 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Lisi, Tommaso Maria Manzia, Lorenzo, Petagna, Bruno, Sensi, Giuseppe, Sica, Leandro, Siragusa, Giuseppe, Tisone, Marco, Assenza, Barbara, Binda, Massimo, Biondi, Gioia, Brachini, Placido, Bruzzaniti, Mauro, Casagrande, Flavia, Ciccarone, Pierfranco Maria Cicerchia, Bruno, Cirillo, Daniele, Crocetti, Giancarlo, D'Ambrosio, Vito, D'Andrea, Francesca De Felice, Giorgio De Toma, Carlo Della Rocca, Giulia, Duranti, Pietro, Familiari, Enrico, Fiori, Giovanni Battista Fonsi, Alessandro, Frati, Stefania La Rocca, Filippo La Torre, Pierfrancesco, Lapolla, Giovanni, Marruzzo, Simona, Meneghini, Andrea, Mingoli, Andrea, Picchetto, Antonella, Polimeni, Diego, Ribuffo, Maurizio, Salvati, Antonio, Santoro, Paolo, Sapienza, Luigi, Simonelli, Valentino, Valentini, Martina, Zambon, Giuseppa, Zancana, Emma, Zuppi, Simone, D'Annunzio, Cosimo De Nunzio, Silvia, Fiorelli, Mohsen, Ibrahim, Chiara, Loffredo, Domenico, Massullo, Cecilia, Menna, Rocco, Monica, Massimiliano, Pelli, Erino Angelo Rendina, Leonardo, Teodonio, Andrea, Tubaro, Giulio, Argenio, Giulio, Accarino, Accarino, Giancarlo, Antonio Nicola Giordano, Luca, Cardinali, Elisa, Sebastiani, Grazia, Travaglini, Erika, Andreatta, Emanuele Luigi Giuseppe Asti, Daniele, Bernardi, Luigi, Bonavina, Caterina, Froiio, Andrea, Lovece, Chiara, Copelli, Alfonso, Manfuso, Pasquale Di Maio, Marco, Giudice, Oreste, Iocca, Rosario, Cennamo, Tommaso, Cornali, Francesco Di Marzo, Cristian, Altana, Francesco, Bussu, Giampiero, Capobianco, Anna Giacomina Carta, Sandro, Ciccarello, Maria Laura Cossu, Pietrina, Cottu, Giacomo De Riu, Salvatore, Dessole, Francesco, Dessole, Salvatora, Dettori, Carlo, Doria, Alessandro, Fancellu, Claudio, F Feo, Giorgio Carlo Ginesu, Giuliana, Giuliani, Marco Giuseppe Iannuccelli, Massimo, Madonia, Roberto, Mancino, Olindo, Massarelli, Gianfranco, Meloni, Fabio, Milia, Andrea, Mulliri, Teresa, Perra, Marco, Petrillo, Antonio, Piras, Franco, Piredda, Francesco, Pisanu, Alberto, Porcu, Davide, Rizzo, Angelino, Sanna, Antonio Mario Scanu, Fabrizio, Scognamillo, Damiano, Soma, Anna Rita Tanca, Alessandro, Tedde, Matteo, Tedde, Luigi Angelo Vaira, Andrea Bartalini Cinughi de Pazzi, Osvaldo Carpineto Samorani, Daniele, Fusario, Luigi, Marano, Gaia, Oldrà, Anna Lisa Pesce, Stefania Angela Piccioni, Luca, Resca, Vincenzo, Ricchiuti, Franco, Roviello, Vinno, Savelli, Alberto, Abrate, Pierpaolo, Bordoni, Lorenzo, Bosio, Guglielmo, Clarizia, Francesco, Fleres, Marco, Franzini, Antonio, Fratto, Pierluigi, Giumelli, Alessandro, Grechi, Alessandro, Longhini, Fabrizio, Lorusso, Elisa, Scarnecchia, Federica, Scolari, Alessandro, Spolini, Vincenzo, Maiuri, Matteo, Papandrea, Arturo, Roncone, Lorenzo, Conti, Andrea, Rizzi, Marco, Rovagnati, Alberto, Brolese, Tommaso, Cai, Francesco Antonio Ciarleglio, Francesca, Dalprà, Gianni, Malossini, Liliana, Mereu, Irene, Tamanini, Saverio, Tateo, Giovanni, Viel, Enrico, Battistella, Paolo Boscolo Rizzo, Cristoforo, Fabbris, Marco, Massani, Giacomo, Spinato, Roberta, Tutino, Ugo, Grossi, Alessandro, Iacomino, Simone, Novello, Maurizio, Romano, Serena, Rossi, Giulio, Santoro, Giacomo, Zanus, Sokol, Trungu, Giada, Aizza, Gabriele, Bellio, Selene, Bogoni, Marina, Bortul, Biagio, Casagranda, Sara, Cortinovis, Nicolò de Manzini, Davide, Drigo, Paola, Germani, Manuela, Mastronardi, Lucia, Paiano, Silvia, Palmisano, Pier Luigi Filosso, Francesco, Guerrera, Matteo, Marro, Mauro, Rinaldi, Enrico, Ruffini, Stefano, Salizzoni, Laura, Bardelli, Mattia, Berselli, Giacomo, Borroni, Eugenio, Cocozza, Matteo, Desio, Bottazzoli, Elisa, Giuseppe, Ietto, Valentina, Iori, Domenico, Iovino, Lorenzo, Livraghi, Valentina, Marchionini, Stefano, Megna, Emma Amal Nahal, Mara, Palumbo, Valeria, Quintodei, Alessandra, Zullo, Lucrezia, D'Alimonte, Giovanni, Pirozzolo, Chiara, Vignotto, Tommaso, Campagnaro, Andrea, Caravati, Simone, Conci, Carlotta De Cristofaro, Gabriele, Gecchele, Tommaso, Giuliani, Jacopo, Graziosi, Alfredo, Guglielmi, Salvatore, Paiella, Corrado, Pedrazzani, Tommaso, Pollini, Simone, Rattizzato, Andrea, Ruzzenente, Roberto, Salvia, Giulia, Turri, Matilde, Bacchion, Giovanni, Butturini, Andrea, Casaril, Alessandro, Giardino, Harmony, Impellizzeri, Marco, Inama, Frigerio, Isabella, Gianluigi, Moretto, Marco De Zuanni, Enrica, Deiana, Mario, Guglielmo, Alessandro, Broglia, Claudia, Casarini, Caterina Costanza Zingaretti, Marta, Bonaldi, Giovanni, Cesana, Francesco, Mastriale, Stefano, Olmi, Matteo Uccelli Yasuyuki Fukami, Takuya, Saito, Tsuyoshi, Sano, Naoki, Hirai, Kazuyoshi, Hirota, Tetsuya, Kushikata, Tasuku, Oyama, Junichi, Saito, Katsuhiko, Ishibashi, Mizue, Kamiyama, Kyongsuk, Son, Kentaroh, Tarao, Takayuki, Yamada, Toshiya, Shiga, Chisaki, Aze, Yoshihiko, Deguchi, Hirotoshi, Hasegawa, Tatsuki, Hoshino, Yasushi, Innami, Hiroyuki, Inoue, Shingo, Ito, Takeshi, Nomura, Tomomi, Ogihara, Reina, Okada, Takashi, Ouchi, Yuri, Sekiya, Keikoku, Tachibana, Emi, Takano, Masae, Yamamoto, Shuko, Matsuda, Yuka, Matsuki, Kenji, Shigemi, 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Mubaydeen, Husam, Sarayrah, Mohammad Abdel Elah, A Tarawneh, Mohammad Yousef Karasneh, Amany, Zurgan, Mohammad, Alassaf, Sayel, H Alzraikat, Justin, Z Amarin, Ahmed, Hijjawi, Haya, H Suradi, Louay, Y Zaghlol, Ahmad, Abdalah, Ghaida, Abdallah, Ammar Abu Tarieh, Tareq, Abu-Libdeh, Faisal, Abualteen, Murad Al Abdallah, Zakaria Al Bdour, Seif Al Dahabrh, Farah, Al-Kasaji, Zaid Al-Sheikh Ali, Mohammad, Al-Thaher, Tareq, Alnajjar, Mohannad, Alqedrh, Mohammad, Alsaleh, Mohammad, Alzaatreh, Ghandi, Amayreh, Yazeed, Ayasra, Ahmad, Eid, Ibrahim, Ghayada, Khaled Moh'd Ahmed Hasanein, Anas, Hassouneh, Raid, Hijazeen, Majedah, Hmeidan, Ahmed, Khaled, Barihan, Khasawneh, Omar, Kifayeh, Yasser, Lafi, Jasem, Seba, Qusai, Semrin, Fda, Sma, Mohammad, Theab, Haitham, Tumeh, Muna Aba Zaid, Alaa, Abazeed, Bader, Abbad, Osaid, Abbadi, Nizar, Abu-Ishkerih, Malk, Al-Osta, Reham, Al-Zyadat, Bashar Omar Falah Alawneh, Majd, Alhattab, Mohd Mujahed Alkurdieh, Ziad, Awwad, Mohammad, Hammouri, Hamzeh, Hussein, 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Rakotoarisoa, Maharo, Ramifehiarivo, Solonirina Harinarindra Ranaivoson, Hajamihamina Marina Parfaite Randriantsoa, Narindra Njarasoa Mihaja Razafimanjato, Jeannie Ba Razafindrahita, Solofoarimanana, Solofoarimanana, Guillaume Odilon Tsiambanizafy, Rakotonaivo Mamisoa Judicaël, Corinne Eulalie Solo, Tojomamy Herinjaka Ralaizafindraibe, Fanonjomahasoa Safiry Andofenohasina, Hanta, Rasataharifetra, Vanona Barijaona Razafindraibe, Angelin Sablon Herinirina, Andre, Das, Thanga, Ganapathy, Yohesuwary, Gunarasa, Kalyani, Mariapan, Maathichsudhaar, Muniandy, Mohd Firdauss Osman, Mohd Azem Fathi Mohammad Azmi, Jien Yen Soh, Wan Zainira Wan Zain, Andee Dzulkarnaen Zakaria, Zaidi, Zakaria, Kheng Hooi Chan, Firdaus, Hayati, Syamim, Johan, Jin Jiun Mah, Ratha Krishnan Sriram, Sentilnathan, Subramaniam, Nur Shahirah Binti Muhammad Shahimi, Khairul Hazim Hamdan, Mohd Razali Ibrahim, Guhan, Muthkumaran, Ju Ann Tan, Mohana Raj Thanapal, Dayang Anita Abdul Aziz, Mae-Lynn, Bastion, Mohd Hairul Nizam Harun, Farrah-Hani, Imran, Norshamsiah Md Din, Ayesha Mohd Zain, Mushawiahti, Mustapha, Syed, Nabil, Ainal Adlin Naffi, Abd Jabar Nazimi, Roszalina, Ramli, Bee Hong Soon, Pavin, Bal, Joo Qing Cheng, Mohd Rusdi Draman, Ahmad Nazran Fadzli, Sakina, Ghauth, Weipin, Hung, Suniza, Jamaris, Peng Soon Koh, Sivakumar, Krishnasamy, Yeong Sing Lee, Yew Toong Liew, Jeffery Zk Lim, Raymond Chung Siang Lim, Hiong Chin Lim, Siti Farhan Moh Pauzi, Shireen Anne Nah, Ashvin Krishna Nair, Doris Sin Wen Ng, Yuki Julius Ng We Yong, Kamarajan, Ramayah, Rahmah, Saaid, Anand, Sanmugam, Mee Hoong See, Kanesh Kumaran Seevalingam, Neha, Sethi, Srihari, Singaravel, Syeda Nureena Syed Jafer Hussain Zaidi, Chu Yik Tang, Li Ying Teoh, Kian Boon Wong, Ruben, Xavier, Ahmad Shuib Yahaya, Norhafiza, Ab, Rahman, Islah Munjih Ab, Rashid, Mohd Fahmi Abd Aziz, Mohd Norhisham Azmi Abdul Rahman, Nasser Muhammad Amjad, Shahidah Che Alhadi, Faisal, Elagili, Mohd Nazli Kamarulzaman, Azmi Md Nor, Ahmad Faidzal Othman, Mohd Yusof Sainal, Mat Salleh Sarif, Richelle, Chua, Aini Fahriza Ibrahim, Abdul Rauf Bin Ahmad, Yii Ling Lau, Ka Yee Liew, Kandasami, Palayan, Hui Yu Wong, Jasiah, Zakaria, Nor Azimah Abd Aziz, Norazila Abdul Rahim, Noorneza Abdul Rahman, Bahiyah, Abdullah, Mohamed Faizal Bin Sikkandar, Fatin, Firman, Nik Mohd Hazleigh, Intan Kartika Kamarudin, Shahril, Khalid, Mohd Fairudz Mohd Miswan, Akmal Zulayla Mohd Zahid, Norasyikin, Mustafa, Kadhim, Obaid, Mohd Yusoff Bin Yahaya Yahaya, Ahmad Ramzi Yusoff, Predrag, Andrejevic, Jeremy Borg Myatt, Svetlana, Brincat, Clifford, Caruana, Kurt Lee Chircop, Francesca, Chircop, Daniel Mario Chircop, Charles, Cini, Viktoria, Czok, Melanie, Farrugia, Gabriella, Grima, Fatimah Mj Hassan Almukhariq, Esther, Muscat, Darryl, Pisani, Mohsin Hassan Khan Roshan, Nicholas, Schembri, Mohamed, Shoukry, Neville, Spiteri, Gilbert, Tanti, Ziad Aboharp Hasan, Alberto Bazan Soto, Cedillo Rodrìguez Jonathan Rubén, Gustavo Esteban Lugo Zamudio, David Gerardo Miranda Gómez, José Alfredo Pérez Meave, Victor Pinto Angulo, Antonio Rojas Aguilar, Erik Efrain Sosa Duran, Alejandro Vàzquez Perez, Diego, Arroyo, Jose, Corona-Cruz, Hector, Martinez-Said, Heriberto, Medina-Franco, Manuel, Mendez, Teresa Moreno, Y Suárez Ma, Dolores Orta Díaz, Martha Patricia Pérez de León Vázquez, Angélica Azucena Soto Carvajal, Fidel Soto Hernández, Juan Ignacio Stenner, Adriana Valenzuela López, Mauricio Rene Hernandez, Rey Jesus Romero, Aldo Bernal Hernandez, Ana Olivia Cortes-Flores, Carlos Jose Zuloaga Fernandez Del Valle, Carlos Andres Colunga Tinajero, Jaime, Orozco-Perez, Laura Gabriela Peña Balboa, Guillermo, Yanowsky-Reyes, Víctor Hugo Alcalá Torres, Francisco José Barbosa Camacho, Irma Valeria Brancaccio Perez, Miguel Angel Calderon-Llamas, Aldo Camacho Gomez, Edgar-Joaquin, Cortes-Torres, Esteban, Cueva-Martinez, Oscar Durán Anguiano, Isaac Esparza Estrada, Roberto, Fierro-Rizo, Paola Flores Becerril, Clotilde Fuentes Orozco, Miguel García Castillo, Alejandro Gonzalez 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Antonio Galindo Nava, Blanca, Santos, Juan Roberto Torres Cisneros, Katya, Bozada-Gutiérrez, Jose Jesus Herrera, Mucio Moreno Portillo, Francisco Pérez López, Mario, Trejo-Avila, Carlos Valenzuela Salazar, Maria Regina Alvarez, Fernando, Cordera, Marco Antonio de la Rosa Abaroa, Antonio, Gómez-Pedraza, Roberto, Hernandez, Antonio, Maffuz-Aziz, José Antonio Posada, Carlos Robles Vidal, Jose-Luis, Beristain-Hernandez, Blas Eduardo Quintero Sada, Nicolás Uxmal Soruco Heredia, Ernesto, Anaya, Ricardo, Arceo-Olaiz, Bernardo Gutiérrez Sougarret, Sonia Lopez Flores, Francisco, J Ochoa Carrillo, Raymundo Alfredo Pérez Uribe, Ludwigvan Adriano Bustamante Silva, Arianne, I Lupián-Angulo, Christian Enrique Soulé Martínez, Francisco César Becerra García, Ernesto Javier Guerrero Casillas, Edgar, Uribe, Nereida Esparza Arias, J Mindy Hernández-Nava, David, Isla-Ortiz, Javier, Melchor-Ruan, Esmeralda Romero Bañuelos, Rosa, Salcedo-Hernández, Diana, Vilar-Compte, Paola Zinser Peniche, Jorge, L Aguilar 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Mendoza Pedraza, Monica Noguez Castillo, Jose Anatolio Resendiz, Oscar Alejandro Sánchez García, Laura Elena Fernandez Rios, Pamela, Frigerio, Iset, Garcia, Gloria Isela Mendoza Frías, Emmanuel, Moreno, Raquel, Quiroga, Alejandra Anzures Mendoza, Arantza Govela Hinojosa, Aldo, Izaguirre, Luis Hdez Miguelena, Jose Manuel Luna Vazquez, Indalecio Barcelata Rodriguez, Raul Ramos Mange, Carlos Reyes Utrera, David Zarate Saenz, Miguel Angel Zavala Gonzalez, Francisco Andrade González, Ludivina, Cortes, David, Roman, Aaron, Sanchez, Radu, Gurghiș, Gheorghe, Rojnoveanu, Marin, Vozian, Petru, Caraja, Gheorghe, Croitor, Roman, Mosneaga, Sarnai, Erdene, Lundeg, Ganbold, Sergelen, Orgoi, Soyombo, Orsoo, Altanchimeg, Sainbayar, Erdene, Sandag, Burmaa, Sanjaa, Rita Ait Benhamou, Abdessamad El Azhari, Bennis, Ghita, Sara, Lhassani, Sidi Mamoun Louraoui, Mounir, Rghioui, Sarra, Saaf, Taha, Gadouali, Iltimass, Gouazar, Moniba, Korch, Ahmed, Letrache, Amina, Louari, Anas, Zamame, Samia, Ousouss, Meryem, 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Alexander, Borgstein, Suzanne, Gisbertz, Sarah, Mikdad, Mark van Berge Henegouwen, Roel, Bakx, Marc, Besselink, Daniel Hl Lemmers, Anne-Jasmin, Roelofs, Paul van Amstel, Claire van Helsdingen, Ludi, Smeele, Niels, Harlaar, Frederik, Jonker, Sjirk van der Burg, Justin, Y van Oostendorp, Saranda, Ombashi, Tim van der Voort, Martijn van Geldorp, Lisanne, Posma-Bouman, Hans Donald de Boer, Annette, Olieman, Henriette, Smid-Nanninga, Jean-Paul P, M De Vries, Rianne, Hogenbirk, Tyche, Derksen, Josephine, Franken, Steven, Oosterling, Peter, Nolte, Jelle van der List, Ian, Alwayn, Okker, Bijlstra, Andries, Braat, Ruth, Bulder, Michèle de Kok, Robin, Faber, Ben, Goudsmit, Jaap, Hamming, Sven, Mieog, Alexander, Vahrmeijer, Fenna E, M van de Leemkolk, Joost van der Vorst, Jan van Schaik, Merel, Verhagen, Kim, Albers, Larsa, Gawria, Harry Van Goor, Michiel, Warle, Tessa, M van Ginhoven, Charlotte, Viëtor, Evert-Jan, Boerma, Lara, Lallitsch, Donald, Schweitzer, Wouter, Leclercq, Julie, Sijmons, 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Ceranic, Ivan, Dimitrijevic, Keramatollah, Ebrahimi, Daniel, Galun, Željko, Grubač, Nikola, Grubor, Nenad, Ivanović, Jelenko, Jelenkovic, Stefan, Kmezić, Djordje, Knezevic, Zoran, Krivokapic, Stojan, Latinčić, Velimir, Markovic, Slavko, Matić, Marko, Miladinov, Aleksandar, Ninic, Maja, Pavlov, Ivana, Pavlovic, Ilija, Pejovic, Zeljko, Radojkovic, Slobodan, Rašić, Milorad, Reljic, Predrag, Sabljak, Aleksandar, Sekulić, Vladimir, Šljukić, Boris, Tadic, Jovica, Vasljević, Dejan, Veličković, Marko, Zivanovic, Pavle, Gregoric, Zlatibor, Loncar, Dusan, Micic, Drago, Jelovac, Srbislav, Pajić, Milan, Petrovic, Sanela, Sumrak, Vladimir, Bascarevic, Ivan, Bogdanovic, Danica, Grujičić, Rosanda, Ilic, Miloš, Joković, Mihailo, Milićević, Filip, Milisavljević, Aleksandar, Miljković, Aleksandra, Paunovic, Vuk, Šćepanović, Aleksandar, Stanimirovic, Marko, Todorovic, Miljan, Folic, Ana, Jotic, Sanja Krejovic Trivic, Jovica, Milovanovic, Aleksandar, Trivic, Lazar, Davidovic, Stefan, Ducic, Igor, Koncar, Uros, Bumbasirevic, Zoran, Dzamic, Boris, Kajmaković, Bogomir, Milojevic, Nebojša, Prijović, Marko, Zivkovic, Aleksandar, Lazic, Nebojsa, Mitrovic, Dejan, Stevanovic, Marko, Buta, Ana, Cvetkovic, Igor, Djurisic, Merima, Goran, Zorka, Inic, Andjela, Ivezić, Nikola, Jeftic, Marko, Jevric, Vladimir, Jokic, Milan, Kocic, Zoran, Kozomara, Ivan, Markovic, Srdjan, Nikolic, Nada, Santrac, Nevena, Savković, Igor, Spurnic, Dobrica, Stevic, Dejan, Stojiljkovic, Jovana, Tripkovic, Nikola, Vucic, Milan, Zegarac, Tatjana, Dejanovic, Vladimir, Djukic, Srdjan, Marinković, Miljan, Milanovic, Nemanja, Pijanovic, Milena, Radosavljevic, Predrag, Savic, Dejan, Stojakov, Rastko, Živić, Sinisa, Ducic, Mikan, Lazovic, Jovana, Bojičić, Vladica, Cuk, Jovan, Juloski, Aleksandar, Karamarkovic, Marko, Kenic, Bojan, Kovacevic, Igor, Krdzic, Vladan, Milutinović, Vladimir, Djan, Velicko, Trajkovic, Dragana, Zivkovic, Aleksandar, Đermanović, Danica, Golijanin, Dejan, Lukic, Zoran, Radovanovic, Dragana, Radovanovic, Sanja, Zahorjanski, Adrian, Chiow, Jun Xian Hing, Lip Seng Lee, Sey Kiat Terence Lim, Chi Wei Mok, Su-Ming, Tan, Hiang Jin Tan, Hana, Arbab, Candy, Choo, Doris Mae Dimatatac, Yee, Low, Hui Wen Chua, Tousif, Kabir, Sabrina, Ngaserin, Lester, Ong, Kiat Tee Benita Tan, Alvin, Tan, Wei-Wen, Ang, Yew-Lam, Chong, Jeffrey, J Leow, Biquan, Liu, Ming Ngan Aloysius Tan, Ern Yu Tan, Kar Yong Wong, Sharon, Yeo, Ladislav, Czako, Branislav, Gális, Kristián, Šimko, Radoslav, Morochovič, Martin, Paulo, Marián, Sedlák, Jan, Grosek, Ales, Tomazic, Leyla Al Mahdawi, Nuhi, Arslani, Andrej, Avsenak, Andrej, Bergauer, Krešimir, Blažević, Dejan, Bratus, Dalibor, Cankoski, Andrej, Cokan, Bojana, Crnobrnja, Andraz, Dovnik, Vojko, Flis, Samo, Fokter, Urska, Gajsek, Minja, Gregorič, Marko, Hazabent, Tomaz, Jagric, Niko, Kavčič, Jure, Knez, Nina, Kobilica, Rok, Kovačič, Lara, Lukman, Urska, Marolt, Jan, Mlakar, Tamara, Mohorko, Andrej, Moličnik, Ivan, Perić, Stojan, Potrč, Milena Senica Verbic, Mateja, Sirše, Jerneja, Vidmar, Adnan Sayid Abdo, Abdifatah Dahir Ali, Abdilaahi Ahmed Hayir, Sadiq, Ibrahim, Afnan, Nuh, Kadra, Omar, Ridwan, Saeed, Nikita, Blake, Cassandra, Ferreira, Corne, Nel, Colin, Noel, Marcel de Kock, Nathan, Kaplan, Emile, Kayombo, Paballo Clinton Khaeane, Asha, Malan, Wikus Wessel Mulder, Daylen, Rutledge, Cornel, Steyn, Gert, Steyn, Naser, Almgla, Mohamed, Daoub, Hammaad, Gamieldien, Thomas, Hilton, Nazmie, Kariem, Maahir, Kariem, Christo, Kloppers, Maritz, Laubscher, Wanga, Mtimkulu, Walid, Mugla, Daniel, Nel, Ferhana, Gool, Timothy, Hardcastle, Wasim, Mahomed, Nivashen, Pillay, Kayla, Rossini, Stephanie Van Straten, Annamart, Laubscher, Adelaide, Lee, Mohammed Yusuf Parker, Sinead, Quirke, Therese Du Preez, Adeline, Jacobs, Reinier, Swart, Modise Zacharia Koto, Neha, Kumar, Imraan, Sardiwalla, Mapuor, Areu, Juan Campos Garcia, Paula, Ferrara, Christoph José Klein Zampaña, Raquel, Lopez, Hernan, Sandoval, Guillermo, Carreño, German Mínguez Ruiz, Conrado Andrés Ros, Raquel Angulo Artal, Luis, Barbier, Guillermo, García-Operé, Marta, Jiménez-Jiménez, Héctor, Marín, Mikel, Oñate, Luis Antonio Pascua-Gómez, María Alexandra Pesántez Peralta, Ibabe Villalabeitia Ateca, Ladislao Cayetano Paniagua, Joan, Camí, Pablo, Collera, Martínez, David, Carlos Javier Gómez Díaz, Jordi Querolt Coll, M Dolors Rosines Cubells, Cristina Soto Montesinos, Guillermo, Triana, Marina, Xicola, Alfonso, Alias, Albert, Baduell, Mariano, Balaguer-Castro, María Pilar Camacho Carrasco, Marina Cámara Vallejo, Borja Campuzano Bitterling, Guillem, Claret, Francisco, J Cuesta-González, Alberto Di Somma, Joaquim Enseñat Nora, Neus, Fabregas, Ada Ferrer Fuertes, Abel, Ferrés, Cesar, Ginesta, Jose Juan Gonzalez Sanchez, Isabel, Gracia, Jhon Alexander Hoyos Castro, Montsant, Jornet-Gibert, Xavier, Morales, Alejandra, Mosteiro-Cadaval, Leire, Pedrosa, José Poblete Carrizo, Marina, Renau-Cerrillo, Luis Alberto Reyes Figueroa, Pedro Roldan Ramos, Jordi Rumià Arboix, Marta, Sabater-Martos, Josep, M Segur, Thomaz, E Topczewski, Jorge, Torales, Ramon, Torné, Pere, Torner, Ricard, Valero, Marian, Vives-Barquiel, Eulalia, Ballester, Alberto Basterra Rincon, Vitiello, Giulia, Belén Martin Arnau, Marta, Gil, Silvia, Martin, Monica, Serrano-Navidad, Mauricio Agüero Mariño, Núria Casanova Torrequebrada, Berta Fabregó Capdevila, Adrián López Campillo, Gemma, Mancebo, Ester, Miralpeix, Blanca, Montcusí, Marina, Munarriz, Ariadna, Salvadó, Josep, M Sole-Sedeno, Clara Téllez Marquès, Ana Centeno Álvarez, Ruth Lopez Gonzalez, Luisana Riba Combatti, Andrea Sanz Llorente, Miguel Bejarano Serrano, Blanca Capdevila Vilaró, Maria Coronas Soucheiron, Mario Cuesta Argos, Irene de Haro Jorge, Yaiza Galvañ Félix, Luis, García-Aparicio, Rebeca, Leal, Albert Malet Contreras, Irene, Martínez-Padilla, Clara, Massaguer, Ines Moraleda Gudayol, María Elena Muñoz Fernández, Paco, Parri, Cristina Pérez Costoya, Javier, Rojas-Ticona, Leopoldo Tapia Moral, Francisco, Vicario, Francesc Angles Crespo, David Bosch Garcia, Berta, Escudero, Carlos Garcia Cardona, Sergi, Bellmunt-Montoya, Javier de la Torre, Úrsula, Acosta, Iago Alvarez Saez, Eva Andreu Riobello, Fernando Ascanio Gosling, Jose, Bagan, Irene, Brana, Bartomeu, Caimari, Marta Cicuendez López Ocaña, Anna, Conesa, Alba de Pablo García-Cuenca, Natalija, Dediulia, Francesc, Duran-Valles, Jordi Giralt López de Sagredo, Maria Jose Gomez-Jurado, Ernesto, Guerra-Farfan, Juan Sebastian Guillén, María Guisasola Rabés, Viviana Andrea Hernández Angel, Maria Jurado Ruiz, Yuri, Loaiza, Manuel, Lopez, Susana, Manrique, Maria Dolores Mateo Arzo, Joan, Minguell-Monyart, Enric Miret Alomar, Sonia Monreal Clua, Víctor Morales Ariza, Clara Morales Comas, Judith, Murillo, Jose Maria Nieto Rodriguez, Elena Vilardell Ortiz, Jorge, Pamias, Montserrat Pascual Pascual Arellano, Remei Perera Sarri, Aleix Pons Bartroli, Nil, Prat, Alfredo Pueyo Ferrer, Rosa Pujol Pina, Jordi, Raurich-Leandro, Maria José Reche Padilla, Joaquín Rivero Déniz, Natalia, 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Marqueta De Salas, Paula Martinez Pascual, Almudena Ortiz Simón, Laura, Osuna, Marta Perez Gonzalez, Antonio Ramos Bonilla, Lorena Rodríguez Gómez, Jose Luis Uquillas, Miguel Angel Alonso Prieto, Marta, Ballesteros-Pomar, Sara Busto Suarez, Mario, Castaño, Laura Castillo Pardo, Mario De Arriba Alonso, Fernando Diez Burón, Anna Farrés Rabanal, Diego Fernández-Samos Fernández, David, Garcia, Cristina García Pérez, Miguel García Sanz, Cesar, Gracia, Javier, Gualis, Gonzalo Gutiérrez Carrillo, Mateo, Hevia, Eva Higuera Miguélez, Gregorio, Laguna, Cristina Lombardia Gonzalez de Lera, Pablo López Martínez, Pasquale, Maiorano, Sergio Marcos Contreras, Elio Martín Gutiérrez, Marta, Molina, Irene, Perez, Teresa Renedo Villar, Luis Angel Suarez Gonzalez, Eva Alvarez Torres, Luz Bueno Rey, Zulay Adriana Calderon Barajas, Ana, M Castaño-Leon, Aida, Fernández, Pablo Garcia Pimentel, Luis, Jimenez-Roldan, Meta, Levstek, Rosalia Navarro Casado, Claudia Olea Vielba, Ana Maria Parada Rodriguez, Igor, Paredes, Patricia, Pascual-Cambero, Miguel Saiz Sánchez-Buitrago, Claudia Sarrais Polo, Victor Zarza Fernandez de Alegria, Mireya, Bonet, Alberto Encinas Vicente, Jose Miguel Villacampa Auba, Maria Dolores Burgueño, Patricia Serrano Méndez, Thomas, W Jorgensen, Mercedes, Martin, Mónica, Huecas, Felipe, Velasco, Verónica Alen Villamayor, Santiago Alonso Bartolomé, Miguel Alonso Juarranz, Luis Felipe Ávila-Ramírez, Javier Buendia Pérez, Barbara, Burgos-Blasco, Enrique Camarero Rodríguez, Paula Campelos Fernández, Claudia, Celotti, Marco Ciappara Paniagua, Ignacio, Cristobal, Alejandro Encinas Bascones, Elena, Fernandez-Martin, Inés Gil Prados, Jesus Gimeno Hernandez, Maria Alejandra Giraldo, Manuel Gomez Cervantes, Noemi Guemes Villahoz, Araceli Hernández Ramos, Maria Cruz Iglesias Moreno, Bibiana Lasses Martínez, Francisco Leyva Rodríguez, Leyre López Antoñanzas, Javier Martín Monterrubio, Jose Maria Martinez-de-la-Casa, Lourdes Montero Cruces, Jesús Moreno Sierra, Jose Maria Muguerza, Alexia Victoria Paluso Montero, Natalia Pérez Romero, Adriana, Poch, Jaime Rodríguez de Alarcón, Adriana Ruano Campos, Rebeca Ruiz Roman, Patricia Saez Carlin, Cristina Sánchez Del Pueblo, Lidia Sotillo Valenzuela, Armando, Galvan, Miguel Ángel García Ureña, Enrique, González, Manuel Medina Pedrique, Alvaro Robin Valle de Lersundi, Carlos San Miguel, Juan, Aragón-Chamizo, Monica, Ballon, Jose, M Barrio, Beatriz Castro Catalan, Laura Cebolla Rojas, Renan Carlo Colombari, Miguel Cuende Diez, Paula Dujovne Lindenbaum, Oscar, Gil-de-Sagredo, Silvia Kayser Mata, Pablo Lozano Lominchar, Yeniffer Tatiana Moreno Salazar, Angela, Moreno-Gutierrez, Melanie, Morote, Uxue, Murgoitio, Nikolas Palma Caucig, Lucía Polanco Pujol, Alejandro, Prosperi, María Belén Ramírez Senent, Diego Fernando Ruiz Chiriboga, Mercedes, Sanz, Maria, Tudela, María Adrien Lara, Raquel, Alarza, Isabel Alonso Sebastian, Mariano Artés Caselles, Laura, Calles-Sastre, Marcos Casas Sánchez, Aritz Equisoain Azcona, Lucía, Fuentes, Lucia Gil Cidoncha, Sofía Herrero Gámiz, Eva Iglesias Garcia, Jose Luis Lucena De La Poza, Mª Eugenia Marín Martínez, Pilar Martín Rodrigo, Joaquin Manuel Muñoz Rodríguez, Verónica, Polaino, Alberto Pueyo Rabanal, Xabier Remirez Arriaga, Xiana, Rial, Miguel Sánchez Suárez, Maria Eugenia Torguet Muñoz, Borja Bazán Inostroza, Lara Blanco Terés, Alba Correa Bonito, Angela de la Hoz, Gustavo, Eisenberg, Javier Garcia Septiem, Jose Maria Lopesino, Rocio, Maqueda, Elena, Martin-Perez, Jose Luis Muñoz de Nova, Julia Revuelta Ramírez, Ana Rodríguez Sánchez, Álvaro Valdés de Anca, Laura Colao García, David Díaz Pérez, Enrique Esteban Agustí, Pablo Galindo Jara, Ana Belén Gallardo, Cesar, Garcia, Maria Gutierrez Samaniego, Miguel Angel Hernandez Bartolome, Lorenzo, Rabadan, Barriga Sánchez Raquel, Beatriz, Diéguez, Miguel, Hernández-García, Carolina Alfonso Carrillo, María Belén Alonso Bartolomé, Estibaliz, Alvarez, Mario, Alvarez-Gallego, Paula, Aragón-Ramos, Pablo Cesar Arteaga Asensio, Luis Asensio Gomez, Diego, Carrion, Nuria, Chavarrias, Alvaro de Arriba, Jose Antonio Gazo Martínez Gazo, Alberto Gegúndez Simón, Juan Gómez Rivas, Natalia Gonzalez Alcolea, Carolina, Gonzalez-Gomez, Sara Gortázar de Las Casas, María Alexandra Heras Garceau, Alicia Hernández Gutierrez, Luis, Lassaletta, Fuad Samir Lopez Fernández, Marta, Mancheño, Blanca, Mateos-Serrano, Isabel Pascual Miguelañez, Maria Fernanda Pedrero Escalas, Julio, Peñarrocha, Yolanda, Perez, Maria Isabel Prieto-Nieto, Teresa Rivera Schmitz, Laura, Rodrigáñez, Ines, Rubio-Perez, Isabel Sanchez Cuadrado, José Ignacio Sánchez Méndez, Jorge Fernando Tone, Carlos Toribio Vazquez, Aitor, Urbieta, Diego Córdova García, Francisca Garcia-Moreno Nisa, Laura, Jiménez, Inmaculada, Lasa, Belen, Matías-García, Fernando, Mendoza-Moreno, Marina Pérez González, Ana Sánchez Gollarte, Alejandro Sanchez Pellejero, Cristina Vera Mansilla, Rafael, Barberá, Lourdes, Montes-Jovellar, Sara Fra Fernández, Nicolas Moreno Mata, Barbara, Algar-Yañez, Gutiérrez, Bérénice, Olga De La Varga-Martínez, Paula, Fernandez-Valdes-Bango, Sandra Maria Gadin-Lopez, José María Martínez-Gómiz, Elena, Nieto-Moreno, Ana, Nieto-Moreno, Montserrat Ocampos Hernandez, Maria Laura Pelegrina-Lopez, Alicia Ruiz Escobar, Elena, Sáez-Ruiz, Beatriz, Vazquez-Rivero, Antonio, Lara, Belén Vielva Del Campo, Fernando Alcaide Matas, Simbad, Costas-Ochoa, José María García Pérez, Elizabeth, Marmol, Paula Troncoso Pereira, Maria Del Pilar Concejo Cutoli, Juan Ramón Gómez López, Juan Carlos Martín Del Olmo, Paloma Guillamot Ruano, Javier Páramo Zunzunegui, Antonio Albarracín Marín Blázquez, Alfonso, Aliaga-Sanchez, Marta María Arroyo Domingo, Miriam Artés Artés, Ana Isabel Avellaneda Camarena, Aida, Blaya, Emny Rochell Bobadilla Romero, Pedro Vicente Fernández-Fernández, Lorena Galindo Iñiguez, Víctor Javier García Porcel, Clara Giménez Francés, Antonio Javier Gomez Poveda, Rebeca Gonzalez Celdran, Francisco Miguel González Valverde, Laura Guillamon Vivancos, Elena, Gurrea-Almela, Alejandra Jara Maquilón, Jose David Jimenez Parra, Abd Al Aziz Lanagrán Torres, Raquel Lax Perez, Carmen Maria Lopez Lopez, Francisco, Machado, Alfonso Marco Garrido, Florencio Manuel Marin Martinez, Victoria Martínez Muñoz, Esther, Medina, Olimpia, Molina, José Manuel Muñoz Camarena, Julian, Onate, Pedro Antonio Parra Baños, Emilio Peña Ros, Enrique, Rubio, Marina Sánchez Robles, Carlos Sanchez Rodriguez, María Valero Soriano, María Teresa Yepes García, Felipe, Alconchel, Andrés Balaguer Román, Valentín, Cayuela, Ana, Conesa, Ana Delegido García, Pedro José Gil Vázquez, Paula Gómez Valles, Francisco, Gómez-Bosch, Vicente, J León-Muñoz, Francisco, Martínez, Alvaro, Navarro-Barrios, Tatiana, Nicolás-López, Pablo Ramirez Romero, Emiliano, Cano-Trigueros, María Concepcion Alonso González, Leticia Gómez Viana, Ana Pastor Zapata, Elisa Contreras Saiz, Tamara Díaz Vico, Maria, Fernandez-Hevia, Luis Joaquín García Flórez, Raquel, Rodríguez-Uria, Sandra, Sanz, Lorena, Solar-Garcia, Aida Suárez Sánchez, Jaume, Gelonch, Dietmar, Reinaldo, Miriam Abdulkarim Polo, Asier, Aguirre, Marta Alomar Bofill, Santiago, Baena, Ashish, Bartakke, Carmen Cabeza Oliver, Marta Castro Suárez, José Andrés Cifuentes Rodenas, Olga Claramonte Bellmunt, Ant Onia Crespí Mir, Anabel De La Llave Serralvo, Mar, Escales, Isabel Rosa Fernández Burgos, Pablo Gandia Gonzalez, Juan Lliteras Jorge, María Cristina Martínez Canto, Javier, Mata, Andreu, Morell, Naila, Pagès, Sara Pérez Palao, Cristian Plaza Valiente, Catalina Ramon Barcelo, Carmen Reyero Fernández, Albert Reyes Claret, Leticia Rodriguez Vaquero, Maialen Saez de Vicuña Salinas, Pilar Santos Cidon, Concepcion, Segura, Aina, Serra, Maria Serra Guivernau, Maria Soler Pedrola, Marta, Tasende, Marta Torrent Lluch, María Inmaculada Valldeperas Hernández, Rosa-Maria, Yañez-Lpez, Andrea, Craus-Miguel, Laura Fernández Vega, Natalia Pujol Cano, Juan José Segura-Sampedro, Laura Colet Oliver, Ivan Dot Pascuet, Mireia, Duart, Isabel Tello Galindo, Eduardo Arrea Salto, Jaume Cámara Cabrera, Marta Camats Terré, Juan Gabriel Castro Ríos, Marta de la Rosa-Estadella, Anna, Fernandez-Colorado, Anna, Gasulla-Rodriguez, Antonio, Gimenez-Gaibar, Elena, Gonzalez, Yeray Maldonado Sotoca, Matilde, Molina-Corbacho, Montserrat Monfort Mira, Josep, Rodoreda, Marta Santos Espí, Arnau Verdaguer Figuerola, Elisa Angela Diego-Alonso, Jaime, López-Sánchez, Luis, Muñoz-Bellvis, Jacobo, Trebol, Borja, Aguinagalde, Cristina Gabriela Alzate Arsuaga, Ainhoa Andres Imaz, Iñigo, Arana, Coro Aranzabal Urrutia, Mikel, Armendariz, Lorena, Arrabal, Iñigo, Augusto, Adolfo, Beguiristain, Laura, Busto, Ainhoa, Cuevas, Itziar De Ariño, Alejandro, Elúa, Leticia, Fernandez, Arantza, Fernandez-Monge, Lander, Gallego, Alba, Garcia, Amaia Garcia Dominguez, Gregorio, Garmendia, Carmen, Grañén, Pelayo Hevia Rodríguez, Maria, Iraola, José Miguel Izquierdo, Aintzane, Lizarazu, Jon Ander Lizarbe, Claudia Cristina Lopes Moreira, Iker, López, Ruth Marquina González, Tania, Pastor, Adrián Recio Ayesa, Ana Paula Riverola Aso, Carballo, Rodríguez, Araceli, Rodrìguez, Maria Inmaculada Ruiz Montesinos, Patricia, Torres, Jose, Undabeitia, Ainara, Villafruela, Maria Barrionuevo Ramos, David, Blanco, Marta, Calderón, Eva Corral Rubio, Angel, Cuadrado-García, Daniela, Cubek, Ignacio, Fariña, Maria Fernandez LLorente, Natalia Flores Amador, Mariana García Virosta, Luis Garcia-Sancho Tellez, Adelina Gonzalez Martinez, María, Hernandez, Rubén Herreros Ruiz-Valdepeñas, Carmen Jimenez Sanchez, Eduardo Llamazares Cobo, María, López, Javier, López-Martin, Teresa Martínez Marivela, Luis Miguel Martinez Parra, Paloma Maté Mate, Paloma, Medrano, Manuel Moriche Carretero, Sara Núñez O'Sullivan, Manuel Ortega Oria de Rueda, María Begoña Pastor Nieto, Clara, Pérez, Antonio, L Picardo, Remedios Revilla Amores, Carmen Rodríguez Haro, Jose Alberto Rojo López, Fatima Sanchez Cabezudo Noguera, Cristina, Sanz, Daniel Serralta de Colsa, Cristina Valor Garcia, Marta Velasco Martinez, Iván Andújar Lara, Aranzazu, Calero-Lillo, Enrique, López-Ruiz, Alberto Díaz García, Alejandro Menéndez Moreno, Luis Eduardo Pérez-Sánchez, Ángela, Pascual, Miguel Adeba García, Marta Alonso Fernández, Javier Alvarez Gama, Roberto, Ballestero, Loreto Berjon De La Vega, Paola Calleja Hermosa, Mariana, Carrillo-Rivas, Alfonso, Casado, Andrea, Cerveró, Bonifacio Cimadevilla Calvo, Patricia Corriols Noval, Paloma de la Dehesa Cueto-Felgueroso, Miren Jasone Diez Zapirain, José Estevez Tesouro, José Antonio Fernández-Dívar Sánchez, Lucia Garcia Alcalde, Juan García Cardo, Tito García Moreno, Daniel, García-López, Belen Garcia-Montesinos Perea, Miren Gonzalez Benito, Rocio, Gonzalez-Aguado, Miguel Ángel Gordo Vega Gordo-Vega, Jose, Gutierrez-Banos, Jaime Jimeno Fraile, Yolanda Jubete Castañeda, Patricia Lopez Gomez, Antonia Jesús López López, David Mato Mañas, Carmelo, Morales-Angulo, Dieter, Morales-Garcia, Sara, Naranjo, Jose Luis Rabago, Jose Manuel Rabanal, Rocio Revuelta Zorrilla, Adriana Reyes Echeverría, Juan Carlos Rodríguez-Sanjuán, Juan Ramón Sanz, Isabel Simal Badiola, Guillermo, Tejón, Enrique Toledo Martínez, Raquel Varea Malo, Begoña, Fadrique, Tania, Funes, Elena González Revilla, Isaias, Alarcón, Daniel Aparicio Sánchez, Pablo Beltran Miranda, Carmen, Cepeda-Franco, María Josefa Cuevas López, Sandra, Dios-Barbeito, Virginia María Durán Muñoz-Cruzado, Carlos Gonzalez De Pedro, Rosa, M Jimenez-Rodriguez, Francisco, Manresa-Manresa, Gabriel, Marin, Cristobalina, Martin-Garcia, Sara, Martínez-Núñez, Juan Manuel Martos Martinez, Lucas, Mengíbar, Felipe Pareja Ciuro, Eduardo Perea Del Pozo, Veronica Pino Diaz, José, Pintor-Tortolero, Claudia, Quintero-Pérez, Maria Luisa Reyes Diaz, Mercedes Rubio Manzanares Dorado, Alejandro Sanchez Arteaga, Ana, Senent-Boza, Luis, Tallon-Aguilar, Jose, Tinoco-Gonzalez, Luis-Cristobal, Capitan-Morales, Juan Cintas Catena, Javier, Valdes-Hernandez, María Del Campo Lavilla, Alina López De Fernández, Miriam Abellan Lucas, Alba Diaz Padillo, Maria Gómez Romero, Linda Grace Puerto Tamayo, El Mostafa El Yaqine Er Raoudi, Melody García Domínguez, María Ángeles Gascón Domínguez, Marta González Pérez, Alba Hernáez Arzoz, Joana San Anton, Cristian, Ruminot, Hander Guillermo Acosta Diaz, Daniella, Laguado, Kristina, Aghababyan, Alba, Jr, Enrique, Artigues, Rocío, Belda, Miguel, Beltran, Jose Ignacio Blanes, Elena Campos Carot, Miriam, Cantos, Laura, Costa, Carolina Ferrer Gomez, José María Gallego Sánchez, Oscar, Gil-Albarova, Juan, Gilabert-Estellés, Emilio Lopez Alcina, Isabel López Sánchez, Severiano Marin Bertolin, Carolina, Martinez-Perez, Antonio Melero Abellán, Claudia Mulas Fernández, Beatriz, Novoa, Ruth, Nuñez, Pablo Renovell Ferrer, Guijarro-Jorge, Ricardo, Carolina Soledad Romero Garcia, Miguel Sanfeliu Giner, Silvia, M West, Enrique, Zapater, Ignacio, Miranda, Ana, Monís, Alejandro Roselló Añón, María José Sangüesa, Jorge Sanz Romera, Marcos, Adrianzén, Maria Barrios Carvajal, Mireia, Bauzá, Ana Benítez Riesco, Jose Antonio Carbonell Lopez, María-Carmen, Fernández-Moreno, Ricardo Gadea Mateo, Francisco, Garcia, Maris Luisa García-Pérez, Luisa Paola Garzon, Ana, Izquierdo, Maria Lapeña Rodríguez, Carlos, León-Espinoza, Fernando, Lopez, Rosa Martí Fernández, Sara Martínez Castro, Berta Monleón López, Isabel Mora Oliver, David, Moro-Valdezate, Ernesto Muñoz Sornosa, Sara Palomares Casasús, Leticia Pérez Santiago, Mara Albert Fort, Reyes, Balanzá, Lorena Bermell Marco, Carla Carratalá Pérez, Claudia Pilar Clemente Tomas, Marta, Córcoles, Jose Ángel Diez Ares, Carlos Domingo Del Pozo, Nuria Estellés Vidagany, Gonzalo, Garrigos, Mar Gimeno Gimeno Vicente, Blanca Alastrue Giner, Segundo, Gomez-Abril, Paloma, Gonzalez, Paula Gonzálvez Guardiola, Guillermo Sebastian Martínez Fernández, Charo Martínez García, Lucía, Martínez-Costa, Luz María Moratalla Charcos, Sergio Navarro Martínez, Carmen, Payá-Llorente, Álvaro Pérez Rubio, Nuria, Peris, Eduardo Picazo Pineda, Jordi Planelles Gómez, Francisco Ripoll Vidal, Andrea, Roca, Enrique, Salmerón-González, Raquel Segura Roselló, Ramon Trullenque Juan, Cristina Verdejo Gimeno, Jose Miguel Zaragozá García, Gema Zomeño Bravo, Marcos Bruna Esteban, Hanna, Cholewa, Milton de Jesus, Matteo, Frasson, Luis Oliver García, Héctor, J Aguado, Antonio Jose Alonso Villalba, Francisco, Ardura, Carmen Elena Badillo Bercebal, María Bedate Núnez, Alvarez-Ramos Begoña Aranzazu, Juan Beltrán de Heredia, Hugo, Bermejo, Juan Berrocal Cuadrado, Maria Bragado González, Juan, Bustamante-Munguira, Raul Calvo Gonzalez, Yolanda, Carrascal, Ana Belén Casas Marcos, María Carmen Cervera, Sergio Chávez Valladares, Ángel Cilleruelo Ramos, Susana, Cortes, Jesús, Crespo-Sanjuán, María, Cuaresma, Luis Antonio Cuellar Martin, Carlos Ferreras García, Alvaro, Fuentes-Martín, Abel, Ganso, Elena García García, Luis, Garcia-Florez, Virginia, Garcia-Virto, Juan, Gatón, Julio Alberto Gobernado Tejedor, Tania Gómez Sanz, Jose Ignacio González Martín, María Begoña Gregorio Crespo, Ana Herranz Arriero, Jose, Herreros, Marta Ibáñez Nieto, César, Infante, Carlos, Jezieniecki, Moises, Juarez, Gregorio de Jesus Labrador Hernandez, Ana Patricia Legido Morán, Ricardo León Fernández, Alejandro, Leon-Andrino, Almudena, Llorente, Maria Lopez Pais, Mauricio Loucel Bellino, Sergio, Martin, Miguel Angel Martin-Ferrero, Gonzalo Martinez Municio, Elvira Mateos Alvarez, José María Matilla, Luis María Merino Peñacoba, Mario, Montes-Manrique, Fernando Natal Álvarez, David, C Noriega, Henar Nuñez Del Barrio, Francisco Javier Ortiz de Solórzano Aurusa, Lucía, Pañeda, Victoria Pascual Escudero, Miguel Pascual Samaniego, Adela, Pereda, Marta Pérez Febles, Laura, Pesquera, Maria, Plata, Emma Puertas Ruiz, Mario, Rodriguez-Lopez, Alejandro Romero de Diego, Ana, Ruano, María Ruiz Soriano, Cristina Sánchez Torralvo, Silvia Santiago Maniega, Bárbara, Segura-Méndez, Clarisa Simon Perez, José, Soro-García, Paula Suárez Mansilla Suárez-Mansilla, Jeancarlos Trujillo Díaz, Mª Esther Valsero Herguedas, Andrea Vazquez Fernandez, Eduardo Velasco García, Ana, Zabalza, Álvaro Zamora Horcajada, Fernando Acebes García, Enrique Asensio Díaz, Martín, Bailón, Alejandro David Bueno Cañones, Alvaro Centeno Velasco, Ekta Choolani Bhojwani, Fernando Labarga Rodríguez, Sara, Mambrilla, Pablo, Marcos-Santos, Toledano, Miguel, David Pacheco Sánchez, Baltasar, Pérez-Saborido, Pilar, Pinto, Katherine, Plua, Javier Sanchez Gonzalez, Vicente, Simo, Rosalía Velasco López, Sandra Veleda Belanche, Fabiola Eugenia Michel Campos, Iciar Muñoz Lindez, Maria, Balluerca, Maite, Camuera, Pablo, Helguera, Imanol, Herrero, Patricia Paunero Vazquez, María, Sánchez-Rubio, Isami, Soeda, María Dolores Arribas Del Amo, Vicente Manuel Borrego Estella, Estefania, Casas, Néstor Castán Villanueva, Daniel Delfau Lafuente, Elena Delgado Blanco, María, Domingo, Ismael Gil Romea, Azucena, Gonzalo, Emilio Lagunas Lostao, Noelia Lete Aguirre, Yaiza Martinez Lahoz, Jesús Víctor Pérez-Tierra Ruiz, Maria Del Mar Soriano, Isabel Valero Lázaro, Esmeralda Carnicer Escusol, Guillermo Pola Bandres, Juan Luis Blas Laina, Beatriz, Cros, Patricio Andrés Freile Pazmiño, David, Garcia-Aguilera, Ana Mejía Casado, Ana, Nogués, Issa Talal El-Abur, Carlos, Yánez, Isabel Gascon Ferrer, Carlos, Gracia-Roche, Ursula María Jariod Ferrer, María Victoria Simón Sanz, Tomas, Uson, Waseem, Ahamed, Sumudu, Jayasinghe, Eranda, Karunadasa, Prathibha, Nelihela, Sujeewa Priyantha Bandara Thalgaspitiya, Dickson, Wickramarathna, Nagenthiram, Harivallavan, Pirashanthan, Nagarasa, Eranga, Perera, Kanapathipillai, Piratheep, Vithranage Srimantha Dewsiri Rodrigo, Meera, Thayalan, Rajendram, Thayaparren, Arulprashanth, Arulanantham, Kanishka De Silva, Gagana, Ganga, Anuja Nadeeshan Kumarasinghe, Mahanada, Udukala, Koculen, Vimaleswaran, Prashanthan, Yogarajah, Ravindri, Jayasinghe, Probhodana, Ranaweera, Mohamed, Rishard, Dharmabandhu, N Samarasekera, Sanjeewa, Seneviratne, Sivasuriya, Sivaganesh, Chamal, Fernando, Nishantha, Mendis, Balasingam, Balagobi, Balasupramaniam, Sathesan, Lanka, Dasanayake, Malitha, Patabendige, Wickramasooriya, Dj, Kugarajh, Ganeshapillai, Sathyamoorthy, Prasanna, Dileepa, Ediriweera, Sumudu, Kumarage, Asanka, Jayawardane, Athula, Kaluarachchi, Pituwala Liyanage Adithya Sirisena, Abubakr, Abubakr, Hozifa, Mohamed, Ismail, Mustafa, Mogahid, Sharfeldein, Samir, Ismail, Reem, Musa, Monira, Sarih, Mussab, Abaker, Eman Adam Abdalla, Mohamad, Abdelbagi, Alsafe, Adlan, Ahmed, Alnaeem, Safa, Atyah, Yasir, Awad, Rsheeda, Dawelbait, Mohamed El Hag, Ibrahim, Elbashir, Sami, Eldirdiri, Samwal, Eldirdiri, Mohammed Eltahier Abdalla Omer, Lana Abdalgadir Ahmed Mohamed, Hiba Hassan Rehmtallah Ahmed, Mohammed Balla Yousif Balla, Abdulmoiz, Aljafari, Abdulmalek, Aljafari, Elsagad, Mohamed, Abdulkader, Mohammad, Abdulkader, Shaar, Mohamed Nafea Shaar, Maab Hussein Yousif Elhafiz, Mohammed Husien Yosif Elhafiz, Abubakr Ali Mohammed Alhassan Humidan, Almigdad, Ali, Hisham, Eljack, Mohamedyasin, Elrashid, Manhal, Ahmed, Albrra, Alhag, Douaa, Ali, Mohammed Ahmed Babikir, Imad, Bakheit, Hytham K, S Hamid, Sami, Mohamed, Walid, Shaban, Nidhal, Siddig, Mohamed, Suliman, Rihab Yasir Abdelmagid, Abubaker, Yassin, Omer, Abbas, Eltahir, Abdelrahim, Muhammed, Ahmed, Mohamed, Elobaid, Adil, Hashim, Ali, Mohamed, Omer, Mohamed, Khalid, Osman, Abdallah, Yousif, Safaa, Abdulaal, Marwa, Elsadig, Mohammed, Hussain, Malaz Amir Ataalmanan, Doha Amir AtaAlmanan, Tebyan Amir AtaAlmanan, Alaa, Elgaili, Maria, Mohamed, Usra, Omara, Alkhansa, Osman, Amna, Osman, Safaa, Saad, Abdelkareem, Ahmed, Ali Adil Ali Karar, Aya, Alhassan, Mohanad, Alsidig, Mohamed, Eljack, Mohammed Ibrahim Mohammed Ali, Awad Kamal Awad Osman, Liena, Mohamed, Samah Ibrahim Omer Mohamed Osman Mohamed Osman, Altayeb, Mohammed, Ayman, Mohammed, Khadija, Muhmmed, Eltahir, Musa, Egbal Sahal Abdelmajed, Khalid Z M, Y Hamid, Omnia M, M Yousif, Mahmoud, Saleh, Osman, Bashir, Yassein, Elhussein, Omar, Madani, Eva, Angenete, Jennifer, Park, Lars, Gillberg, Monir, Jawad, Linas, Pieteris, Yousif, Saeed, Sergej, Safonov, Martin, Spångfors, Henrik, Andersson, Hans, Bahlmann, Karin Björnström Karlsson, Michelle, Chew, Lara, Daham, Lina De Geer, Helen, Didriksson, Gunilla, Gagnö, Carina, Jonsson, Anna, Oscarsson, Pamela, Buchwald, Mathilde, Delorme, Marie-Louise, Lydrup, Shahin, Mohseni, Arvid, Pourlotfi, Souheil, Reda, Kajsa, Anderin, Nina, Blomme, Josefin, Segelman, Malin, Simlund, Anders, Thorell, Fredrik, Wogensen, Daniel, Danielsson, Peter, Elbe, Rebecka, Hultgren, Boel, Hynning, Fredrik, Klevebro, Karin, Lind, Ebba, K Lindqvist, Carl, Montan, Ernesto, Sparrelid, Clara Svenberg Lind, Jeremy, Wales, Andreas, Älgå, Martin, Nordberg, Emil, Pieniowski, Ioannis, Gkekas, Niklas, Löfgren, Karolina, Niska, Robert, Zürner, Silvio, Däster, Otto, Kollmar, Savas, Soysal, Stephanie, Taha-Mehlitz, Athanasios, Tampakis, Dominik Valentin Flury, Marie, Heyne-Pietschmann, Gregor Jan Kocher, Ana, M Calinescu, Barbara, Wildhaber, Markus, Gass, Jürg, Metzger, Andreas, Scheiwiller, Lukas, Briner, Oliver, Dwidar, Steven, Grandjean, Pietro, Ricciardi, Alexandra, Calmels, Christodoulou, Michel, Morena, Antonilli, Dimitrios, Christoforidis, Alessandra, Cristaudi, Jacopo, Galafassi, Maria Luisa Gasparri, Francesco, Mongelli, Martino, Munini, Andrea, Papadia, Sotirios Georgios Popeskou, Alex, Alfieri, Thomas, Bächler, Matteo, Giardini, Christian, Gingert, Laura, Guglielmetti, Inna, Meyer, Tobias, Müller, Daniel, Schöni, Folco, Solimene, Frank, Weidner, Marco, Bueter, Daniel, Gero, Amelie, Müller, Carmen, Portenkirchner, Andreas, Thalheimer, Jeannette, Widmer, Ahmad, Hmaideh, Alaa, Kour, Saleem, Swaes, Omar, Alannaz, Ramez, Aljasem, Ezeddin, Dabbagh, M Wafa Hamoud Alhussein, Amr, Hamza, Mazen, Mohammad, Abd El-Fattah Mouhandes, Mohamad, Shareeda, Mohammad Nour Shashaa, Mousa, Sifat, Sheraa, Tahhan, Rahaf, Toutounji, Mohamed, Abdulrahman, Albaraa, Abdulsalam, Ziad Al Jarad, Hala, Alayyoubi, Dina, Alfarra, Ahmad, Alhamid, Mahmoud, Alnasser, Mulham, Gharib, Ruwaid, Gharib, Obaida, Kabel, Osama, Kherallah, Abdulqader, Klaho, Mohamed Shukri Najjar, Ahmad, Razouk, Joud, Shiekhoni, Wael, Alkhaleel, Amira, Almosa, Mohammad, Aloulou, Maen, Alzaeem, Khaled, Arnaout, Muhamad Zakaria Brimo Alsaman, Mohamad, Estanbouli, Hanadi, Hawa, Ahmad Nbrass Kabawi, Ghina, Maarawi, Yehia, Mashhadany, Sana Shaikh Torab, Waleed, Abd, Tayma Abd Alghafour, Hani, Abdalnour, Nazeeh Al Aktaa, Marwan Al Aliwy, M Maher Al Arje, Tasneem Al Najjar, Ahmad, Al-Mouakeh, Ahmad, Aldakhil, Aos, Alhamid, Hasan, Alhasan, Mohamad Shadi Alkarrash, Jumaa, Alkhamis, Sara, Alshekh, Ahmad Yamen Arnaout, Oula, Azizeh, Mohammed, Dalaleh, Aghyad, Danial, Zain, Douba, Raghad, Ghadri, Mohammad Maen Ghannam, Anas, Ghawi, Luma Haj Kassem, M Yasser Halwani, Shahed, Hamadieh, Mohammad, Hanino, Ala Aldeen Hasan, Haya, Jawish, Nasr Ullah Kabbani, Saadullah, Kabbany, Mohamad, Kadi, Lama, Kadoura, Ahmad Amir Kayali, Ammar, Kayyali, Aya, Kelzia, Amana, Kezze, Abdullah, Khalaf, Maymona, Khayata, Mohammad Nour Kitaz, Mohammad, Kour, Raghad, Makki, Ruqaya, Masri, Joseph, Masri, Noor, Masri, Muhammad, Mazketly, Shiar, Mustafa, Ezzeldin, Nashed, Yaman Qoudra Danial, Hasan, Raslan, Rima, Salem, Mohammed Asaad Salem, Thabet Sayed Bakir, Manaf, Sharabaji, Majd Sheikh Alganameh, Duaa Sheikh Kadro, Joudy, Shurbatji, Mohammad Noor Sultan, Dana, Sultan, Hala, Swied, Bakri Tarras Jarkas, Tayf, Toutounji, Fadi, Ward, Rama, Zazo, Aya, Zazo, Zainab, Zeino, Mohamed, Alaktaa, Wael, Alsado, Hala, Fares, Nouran, Hawa, Hamza, Ibrahim, Abdulmonem, Kawas, Mourad, Niazi, Bayan, Toutounji, Mohammad, Abdow, Mohamad, Ahmad, Tareq, Ahmad, Rawan Al Azhar, Hiba Al Hage Diab, Rahaf Al Mulke, Mohammad, Al-Jadaan, Ahmad, Alhussein, Zahra, Alnajem, Omar, Alneser, Bayan, Alsaid, Elias, Azar, Lubna, Bakr, Ammar, Hamza, Yara, Houdifa, Sami, Jomaa, Samer, Kefo, Hiba, Mardini, Alaa, Mohammad, Fadi, Rayya, Fatima, Razzouk, Mohannad, Saleh, Anwar, Shamandi, Ammar Youzkatli Alkhatib, Omar Abdul Salam, Dany, Ajami, Mohammad, Alhamid, Ahmad, Alkhaledi, Danny, Hadidi, Massa, Jabra, Mamdouh, Kallas, Antoine, Laktine, Joelle, Naem, Naya, Naoum, Ghena Mohammed Fawaz Ashour, Ahmad, Alhouri, Deema, Fallouh, Ahmad, N Mohammad, Ahmad, Rmman, Ali, Slitin, Christine, Tanos, Ibrahim, Wakim, Hanaa, Zahrawi, Majd, Abouassi, Layth, Abouassi, Ayham, Aboutrab, Basel, Ahmad, Ahmad Mustafa Ahmad, Aya, Ahmad, Afaf, Ahmad, Mohamad, Alabras, Mohammad, Albasheer, Ola, Alkasser, Mhd Khaled Alkasser, Ali, Alkhdor, Marah, Azkoul, Mohammad Karam Chaaban, Haya, Deeb, Basel, Jazieh, Basel, Kouz, Youssef, Kozah, Raied, Mohamad, Ammar, Mohammad, Mhd Zied Nasri, Mohammed Mouaz Shebani, Mohammed, Shwin, Alaa, Sommaq, Amal, Youssef, Tala Al Asadi, Suhad, Alkhateb, Rasha Khalil Alsayyad, Roula, Altom, Mhd Amin Alzabibi, Batoul, Bakkar, Hlma, Ismail, Salma Khadem Alsrouji, Sara, Melhem, Mohamad, Sankari, Mosa, Shibani, Noura, Shujaa, Ibrahim, 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Giorgini, Carlo Ingaldi, Elio Jovine, Kenji Kawamukai, Antonio Lanci Lanci, Raffaele Lombardi, Maria Elisa Lozano Miralles, Claudio Marchetti, Michele Masetti, Francesco Minni, Daniele Morezzi, Daniele Parlanti, Alice Pellegrini, Anna Myriam Perrone, Anna paola Pezzuto, Marco Pignatti, Gianluigi Pilu, Valentina Pinto, Gilberto Poggioli, Silvana Bernadetta Puglisi, Diego Raimondo, Matteo Ravaioli, Claudio Ricci, Sara Ricciardi, Francesco Ricotta, Roberta Rizzo, Angela Romano, Matteo Rottoli, Riccardo Schiavina, Renato Seracchioli, Matteo Serenari, Margherita Serra, Piergiorgio Solli, Gioia Sorbi, Mario Taffurelli, Marta Tanzanu, Achille Tarsitano, Marco Tesei, Gabriele Vago, Tommaso Violante, Simone Zanotti, Tommaso Frisoni, leonardo solaini, giorgio ercolani, Fruscio, R, Ornaghi, S, Collaborative, Covidsurg, Collaborative, Globalsurg, Palmisano, Silvia, de Manzini, Nicolo', Žundienė, Laura, Dulskas, Audrius, Kuliavas, Justas, Čekauskas, Albertas, Kielaitė-Gulla, Aistė, Poškus, Tomas, Strupas, Kęstutis, Želvys, Arūnas, COVIDSurg Collaborative, GlobalSurg Collaborative, Department of Surgery, HUS Abdominal Center, Simoes, Jff, Li, E, Picciochi, M, Glasbey, Jc, Baiocchi, G, Blanco-Colino, R, Chaudhry, D, Alameer, E, El-Boghdadly, K, Wuraola, F, Ghosh, D, Gujjuri, Rr, Harrison, Em, Lule, H, Kaafarani, H, Khosravi, M, Kronberger, I, Leventoglu, S, Mann, H, Mclean, Ka, Mengistu, Gm, Modolo, Mm, Ntirenganya, F, Norman, L, Outani, O, Pius, R, Pockney, P, Qureshi, Au, Roslani, Ac, Satoi, S, Shaw, C, Bhangu, A, Omar, Om, Ahmed, Wur, Argus, L, Ball, A, Bywater, Ep, Brar, A, Dawson, Be, Duran, I, Elhadi, M, Jones, C, Kamarajah, Sk, Keatley, Jm, Lawday, S, Marson, Ej, Ots, R, Santos, I, Taylor, Eh, Trout, Im, Varghese, C, Venn, Ml, Xu, W, Dajti, I, Gjata, A, Kacimi, Seo, Boccalatte, L, Cox, D, Townend, P, Aigner, F, Kronberger, Ie, Samadov, E, Alderazi, A, Hossain, K, Padmore, G, van Ramshorst, G, Lawani, I, Cerovac, A, Delibegovic, S, Gomes, Gma, Buarque, Il, Gohar, M, Slavchev, M, Nwegbu, C, Agarwal, A, Martin, J, Ng-Kamstra, J, Olivos, M, Lou, Wh, Ren, Dl, Calvache, Ja, Rivera, Cjp, Hadzibegovic, Ad, Kopjar, T, Mihanovic, J, Jimenez, Pma, Gouvas, N, Klat, J, Novysedlak, R, Amisi, N, Christensen, P, El-Hussuna, A, Batista, S, Lincango-Naranjo, E, Emile, S, Sandoval, Daa, Dhufera, H, Hailu, S, Mengesha, Mg, Kauppila, Jh, Arnaud, Ap, Demetrashvili, Z, Albertsmeier, M, Lederhuber, H, Loffler, Mw, Acquah, Dk, Ofori, B, Tabiri, S, Metallidis, S, Tsoulfas, G, Aguilera-Arevalo, Ml, Recinos, G, Mersich, T, Wettstein, D, Kembuan, G, Milan, Pb, Khosravi, Mh, Mozafari, M, Hilmi, A, Mohan, H, Zmora, O, Gallo, G, Pata, F, Pellino, G, Fujimoto, Y, Kuroda, N, Abou Chaar, Mk, Ayasra, F, Fakhradiyev, I, Hamdun, Ih, Jin-Young, J, Jamal, M, Karout, L, Gulla, A, Rasoaherinomenjanahary, F, Samison, Lh, Sanchez, Iid, Gonzalez, D, Martinez, L, Martinez, Mj, Nayen, A, and Ramos-De la Medina, A
Subjects: Male, Vascular damage Radboud Institute for Health Sciences [Radboudumc 16], MULTICENTER, infectious diseases, 0302 clinical medicine, 030202 anesthesiology, Anesthesiology, Cirugía, 80 and over, Prospective Studies, Young adult, Child, Lung, Aged, 80 and over, COVID-19, delay, SARS-CoV-2, surgery, timing, SARS‐CoV‐2 infection, Operative, Child, Preschool, Pneumonia & Influenza, Infection, Cohort study, Human, medicine.medical_specialty, Clinical Sciences, Sars-cov-2, GlobalSurg Collaborative, Settore MED/28 - MALATTIE ODONTOSTOMATOLOGICHE, 03 medical and health sciences, Clinical Research, Biodefense, Correspondence, Humans, PULMONARY COMPLICATIONS, CRIANÇAS EM IDADE PRÉ-ESCOLAR, Aged, Science & Technology, Cirurgia, Prevention, Infant, Odds ratio, Pneumonia, Prospective Studie, Clinical research, Surgery, Human medicine, 610 Medizin und Gesundheit, 1109 Neurosciences, Internationality, Settore MED/29 - CHIRURGIA MAXILLOFACCIALE, Settore MED/18 - CHIRURGIA GENERALE, Adolescent, Adult, Cohort Studies, Female, Middle Aged, Surgical Procedures, Operative, Time, Young Adult, Practice Guidelines as Topic, gastroenterology, Medicine and Health Sciences, 030212 general & internal medicine, Prospective cohort study, Mortality rate, Covid19, Infectious Diseases, Patient Safety, medicine.symptom, 6.4 Surgery, Life Sciences & Biomedicine, 610 Medicine & health, COVID-19, SARS-CoV-2, delay, surgery, timing, Asymptomatic, NO, COVIDSurg Collaborative, Vaccine Related, All institutes and research themes of the Radboud University Medical Center, medicine, Mortalitat, ddc:610, Mortality, Preschool, LS7_4, Surgical Procedures, business.industry, Neurosciences, Evaluation of treatments and therapeutic interventions, 1103 Clinical Sciences, 3126 Surgery, anesthesiology, intensive care, radiology, Reconstructive and regenerative medicine Radboud Institute for Health Sciences [Radboudumc 10], Anesthesiology and Pain Medicine, Emerging Infectious Diseases, Good Health and Well Being, Mortalidad, Cohort Studie, business
Abstract: Peri-operative SARS-CoV-2 infection increases postoperative mortality. The aim of this study was to determine the optimal duration of planned delay before surgery in patients who have had SARS-CoV-2 infection. This international, multicentre, prospective cohort study included patients undergoing elective or emergency surgery during October 2020. Surgical patients with pre-operative SARS-CoV-2 infection were compared with those without previous SARS-CoV-2 infection. The primary outcome measure was 30-day postoperative mortality. Logistic regression models were used to calculate adjusted 30-day mortality rates stratified by time from diagnosis of SARS-CoV-2 infection to surgery. Among 140,231 patients (116 countries), 3127 patients (2.2%) had a pre-operative SARS-CoV-2 diagnosis. Adjusted 30-day mortality in patients without SARS-CoV-2 infection was 1.5% (95%CI 1.4-1.5). In patients with a pre-operative SARS-CoV-2 diagnosis, mortality was increased in patients having surgery within 0-2 weeks, 3-4 weeks and 5-6 weeks of the diagnosis (odds ratio (95%CI) 4.1 (3.3-4.8), 3.9 (2.6-5.1) and 3.6 (2.0-5.2), respectively). Surgery performed ≥ 7 weeks after SARS-CoV-2 diagnosis was associated with a similar mortality risk to baseline (odds ratio (95%CI) 1.5 (0.9-2.1)). After a ≥ 7 week delay in undertaking surgery following SARS-CoV-2 infection, patients with ongoing symptoms had a higher mortality than patients whose symptoms had resolved or who had been asymptomatic (6.0% (95%CI 3.2-8.7) vs. 2.4% (95%CI 1.4-3.4) vs. 1.3% (95%CI 0.6-2.0), respectively). Where possible, surgery should be delayed for at least 7 weeks following SARS-CoV-2 infection. Patients with ongoing symptoms ≥ 7 weeks from diagnosis may benefit from further delay. ispartof: ANAESTHESIA vol:76 issue:6 pages:748-758 ispartof: location:England status: published
Published: 2021

16. Clinical profile of hereditary angioedema from a tertiary care centre in India

Author: A.J. Joseph, John Mathew, John Antony Jude Prakash, Dincy Peter, Susmitha Perumalla, Lydia Mathew, and P. Naina
Subjects: 0301 basic medicine, Microbiology (medical), Adult, Pediatrics, medicine.medical_specialty, Delayed Diagnosis, Adolescent, 030106 microbiology, India, Disease, Tertiary care, Tertiary Care Centers, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Medicine, Humans, Sex organ, 030212 general & internal medicine, Family history, Child, Retrospective Studies, business.industry, Angioedemas, Hereditary, Retrospective cohort study, Middle Aged, medicine.disease, Child, Preschool, Hereditary angioedema, Age of onset, business, Complement C1 Inhibitor Protein, Tranexamic acid, medicine.drug
Abstract: Introduction Hereditary angioedema (HAE) is a clinical condition which could be fatal if not identified and managed appropriately. Knowledge of this condition is mostly confined to individual case reports and literature reviews in India. In this retrospective study we describe HAE cases which presented to a tertiary care centre in India over a period of three and half years. Materials and methods Clinical case records of forty-two HAE patients diagnosed based on clinical and laboratory features were accessed after due approval from the Ethics committee. C1 esterase inhibitor (C1 INH) and C4 levels were measured using nephelometry. All relevant data was entered into Microsoft EXCEL worksheet and analysed using simple statistical tools. Results Among the 42 patients diagnosed as having HAE, 37 had low C1INH levels and were diagnosed to have type 1 HAE. The remaining 5 had normal C1 INH levels and were considered probable HAE based on family history and response to HAE specific treatment. The median age of onset of symptoms was 15 years (range 5–49) and median age at diagnosis, 27.5 years (range 5–55). The median delay in diagnosis was 10 years (range 1–27 years). Family history of HAE was observed in 52.6% and 29% reported deaths in the family with HAE like disease. Low dose androgens or tranexamic acid or both were prescribed in 64.2% of the patients. Orofacial edema was the commonest clinical presentation (76%) followed by edema of the extremities (38%), GI tract symptoms (19%) and genital involvement (11.9%). Conclusion Many cases of HAE may be going undetected in India. There is a need for clinical awareness and laboratory means to accurately identify and administer appropriate treatment.
Published: 2020

17. An unusual case of vomiting and arthritis: A diagnostic enigma

Author: Daisy Doley, Shivraj Padiyar, Ramesh Babu, and John Mathew
Subjects: medicine.medical_specialty, Unusual case, Rheumatology, business.industry, medicine, Vomiting, Arthritis, medicine.symptom, medicine.disease, business, Dermatology
Published: 2022

18. Single-stage versus two-stage revision anterior cruciate ligament reconstruction: a systematic review

Author: Jeremiah E Palmer, Cristin John Mathew, Joshua D. Harris, Patrick C. McCulloch, and Bradley S. Lambert
Subjects: 030222 orthopedics, medicine.medical_specialty, Anterior cruciate ligament reconstruction, business.industry, Single stage, medicine.medical_treatment, Anterior cruciate ligament, MEDLINE, 030229 sport sciences, Evidence-based medicine, Surgery, Two stage revision, 03 medical and health sciences, 0302 clinical medicine, Systematic review, medicine.anatomical_structure, medicine, Orthopedics and Sports Medicine, business, Fixation (histology)
Abstract: Importance Despite advances in surgical techniques and postoperative rehabilitation, long-term anterior cruciate ligament (ACL) graft rupture rate remains high. The increasing number of primary ACL reconstructions in an ageing population will lead to increasing revision reconstructions. Revision cases may have higher failure rates and worse patient-reported outcomes compared with primaries. While two-stage revisions may be indicated in certain complex cases, whether this is comparatively equivalent or even superior to revisions done in a single stage would assist preoperative planning. Objective The objective of this systematic review was to analyse and compare patient-reported outcomes and failure rate of single-stage versus two-stage revision ACL reconstruction. Evidence review Using PubMed, MEDLINE Complete and Ovid MEDLINE databases, a review was performed using Preferred Reporting Items for Systematic Reviews and Meta-analysis guidelines to identify level I–IV outcomes of revision ACL reconstruction with a minimum follow-up of 24 months. Findings Three studies reported outcomes of two-stage revisions with mean follow-up of 61.6 months, while 21 studies reported single-stage revisions with mean follow-up of 47.4 months. Pooled rate of two-stage revisions was 3.1% compared with 6.8% in single-stage (p=0.068). Clinical failure was reported in 5.1% of 79 two-stage patients compared with 13.8% of 533 single-stage patients (p 48 months follow-up had a higher rerupture rate (+5%, p Conclusions and relevance Although two-stage revisions may be performed in more complex cases, there are limited short-term data available regarding their outcomes. Two-stage revisions demonstrated comparable clinical outcomes and lower rate of revision surgery and clinical failure compared with single-stage revisions. Studies with shorter follow-up (24–48 months) showed higher clinical failure rates. Those with longer follow-up (>48 months) showed higher graft rerupture rates. The decision to perform staged reconstruction should made on whether adequate tunnel placement and fixation can be established in a single setting. Level of evidence Level IV.
Published: 2018

19. Superior Labral Anterior to Posterior Tear Management in Athletes

Author: David M. Lintner and Cristin John Mathew
Subjects: medicine.medical_specialty, medicine.medical_treatment, Population, Physical examination, Orthopaedics, 03 medical and health sciences, 0302 clinical medicine, medicine, education, Superior Labrum Anterior Posterior tear, 030222 orthopedics, education.field_of_study, Labrum, Rehabilitation, medicine.diagnostic_test, biology, Athletes, business.industry, Magnetic resonance imaging, SLAP, 030229 sport sciences, biology.organism_classification, Overhead Athletes, Baseball Players, Physical therapy, Tears, business, SLAP Repair, Throwing, MRI
Abstract: Background:The diagnosis and treatment of Superior Labrum Anterior to Posterior (SLAP) tears have been evolving and controversial. The lack of clear diagnostic criteria on physical examination, Magnetic Resonance Imaging (MRI), and arthroscopic evaluation clouds the issue. The high rate of MRI diagnosed SLAP lesions in the asymptomatic population of athletes and non-athletes warrants consideration when planning treatment for those with shoulder pain.Objective:To provide information on the evaluation, diagnosis and management of SLAP tears in athletes.Methods:The results of a structured non-operative rehabilitation program are discussed and compared to traditional surgical techniques. The evolution of the author’s treatment algorithm is presented. Results: The successful return to overhand throwing is more common with non-operative treatment than with surgical.Conclusion:A rehabilitation program focused on stretching the posterior capsule and correcting scapular posture is more successful than surgery for most throwers with SLAP lesions.
Published: 2018

20. Laparoscopic Repair of a Right Paraduodenal Hernia

Author: John Mathew Manipadam, Vamsi Syamprasad, V. Lekha, and H. Ramesh
Subjects: medicine.medical_specialty, Supine position, business.industry, Paraduodenal hernia, lcsh:Surgery, laparoscopic repair, Case Report, lcsh:RD1-811, digestive system diseases, Surgery, 03 medical and health sciences, 0302 clinical medicine, 030220 oncology & carcinogenesis, medicine, Ascending colon, 030211 gastroenterology & hepatology, Hernia sac, business, right paraduodenal hernia
Abstract: Laparoscopic repair of a right paraduodenal hernia has been described sparingly in literature. We present an account of how we laparoscopically repaired a right paraduodenal hernia along with a review of the current literature as regards the various techniques that have been attempted. With the patient in supine position, and with umbilical camera port and three 5 mm ports, we mobilized the cecum and ascending colon up to the third part of the duodenum, thereby widening the neck of the hernia sac in the Waldeyer fossa. This method is ideal for the less severe incomplete rotation presenting with right paraduodenal hernia where there are no Ladd's bands and there is no requirement for fetalization of the bowel.
Published: 2018

21. Antinuclear antibodies in scrub typhus: Transient occurrence during acute illness

Author: Sowmya Sathyendra, Reginald Alex, Thambu David Sudarsanam, Ravikar Ralph, John Mathew, John Victor Peter, John Jude, Maria Koshy, and J. Visalakshi
Subjects: Adult, Male, Vasculitis, medicine.medical_specialty, Anti-nuclear antibody, Fever, India, Immunology, rickettsial diseases, scrub typhus, tropical medicine, Scrub typhus, Severity of Illness Index, lcsh:Infectious and parasitic diseases, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Internal medicine, medicine, Humans, lcsh:RC109-216, Meningitis, Aseptic, Prospective Studies, skin and connective tissue diseases, Prospective cohort study, Pathological, APACHE, 030203 arthritis & rheumatology, Respiratory Distress Syndrome, integumentary system, business.industry, Organ dysfunction, Autoantibody, General Medicine, Middle Aged, medicine.disease, bacterial infections and mycoses, Orientia tsutsugamushi, stomatognathic diseases, Infectious Diseases, Scrub Typhus, Antibodies, Antinuclear, Case-Control Studies, Immunoglobulin G, Cohort, Acute Disease, Parasitology, Female, medicine.symptom, business, 030215 immunology
Abstract: Background & objectives: The pathological hallmark of scrub typhus infection is focal or disseminated vasculitis. As with other infections, antinuclear antibodies (ANA) have been previously described in scrub typhus. However, the underlying mechanisms and implications of this immunological phenomenon is not well understood. In the present work it was assessed whether ANA is associated with illness severity and outcomes. Methods: In this prospective study spanning one year, patients fulfilling the diagnostic criteria for scrub typhus were recruited. Patients with other acute infective febrile illnesses were taken as controls. ANA positivity was compared between the cases and controls. ANA in scrub typhus was assessed for correlation with disease severity, organ dysfunction and outcomes. Results: The cohort comprised of 149 patients (scrub 89; controls 60) with mean age 46.5 (SD=16.9) yr; 48.3% were female. ANA was detected in 48 (53.9%) patients with scrub typhus and 9(15%) controls (p < 0.001). The ANA pattern was predominantly speckled (93.8%) in both scrub typhus patients and controls. In patients with scrub typhus, ANA positivity was associated with increasing APACHE-III score [Odds ratio (OR) 1.01; 95% CI 0.99–1.03; p = 0.09]. On bivariate analysis, ANA tended to be correlated with acute respiratory distress syndrome (OR 2.32; 95% CI 0.98–5.46; p = 0.06), hepatic dysfunction (OR 2.25; 95% CI 0.94–5.39, p = 0.06) and aseptic meningitis (OR 6.83; 95% CI 0.80–58.05, p = 0.08). The presence of these antibodies did not correlate with duration of hospitalization or mortality. Convalescent sera on 31 ANA positive scrub typhus patients demonstrated persistence of ANA in only 5 (16.1%) patients. Interpretation & conclusion: The disappearance of ANA during the convalescent phase suggests that ANA is expressed during the acute phase of scrub typhus infection. Its association with organ dysfunction warrants further study of the mechanisms and impact of autoantibody formation in scrub typhus.
Published: 2018

22. Heterotrophic ossification post total knee arthroplasty in a patient with rheumatoid arthritis: a case report

Author: Aswin Thankachan Veliyil, Renjit John Mathew, Dileep S, and John Thayyil John
Subjects: musculoskeletal diseases, medicine.medical_specialty, business.industry, Ossification, Total knee arthroplasty, medicine.disease, Surgery, Knee pain, medicine.anatomical_structure, Under follow-up, Rheumatoid arthritis, medicine, Clinical significance, Quadriceps tendon, medicine.symptom, business
Abstract: Even though minor degrees of heterotrophic ossification are common in total knee arthroplasty, it is of little clinical significance. But severe degrees of heterotrophic ossification are very rare after total knee arthroplasty. Here we discuss about a 70 years old woman who initially had excellent post-operative range of movements after cemented total knee arthroplasty, but later presented with knee pain, swelling and loss of range of movements after 3 months. X ray showed severe heterotrophic ossification around knee near the quadriceps tendon. She was treated conservatively with non-steroidal anti inflammatory drugs and physiotherapy. After a period of 3 months of physiotherapy, patient regained the lost range of movements and is currently under follow up for the past 1 year. Hence this case instantiates that even in cases of severe Heterotrophic Ossification after total knee arthroplasty, non-operative treatments such as physiotherapy with anti-inflammatory drugs should be the primary option to treat the stiffness before considering surgery.
Published: 2021

23. Mycophenolate mofetil and deflazacort combination in neuropsychiatric lupus: a decade of experience from a tertiary care teaching hospital in southern India

Author: Nikhil Gupta, Prakash Ramasamy, Aswin Nair, Santosh Kumar Mandal, Debashish Danda, Arvind Ganpati, Ashish J. Mathew, Ruchika Goel, and John Mathew
Subjects: Adult, Male, 0301 basic medicine, medicine.medical_specialty, Adolescent, Side effect, Prednisolone, Lupus nephritis, India, Tertiary Care Centers, Young Adult, 03 medical and health sciences, 0302 clinical medicine, Rheumatology, Pregnenediones, Recurrence, Seizures, Internal medicine, medicine, Electronic Health Records, Humans, Retrospective Studies, 030203 arthritis & rheumatology, Systemic lupus erythematosus, business.industry, Medical record, Remission Induction, Age Factors, Brain, Retrospective cohort study, General Medicine, Mycophenolic Acid, Antiphospholipid Syndrome, medicine.disease, Lupus Nephritis, Surgery, Deflazacort, 030104 developmental biology, Cohort, Female, Steroids, business, Immunosuppressive Agents, Follow-Up Studies, medicine.drug
Abstract: Mycophenolate mofetil (MMF) is an effective therapeutic agent with high safety profile in the management of lupus nephritis. This retrospective study was conducted to assess the efficacy and side effect profile of MMF as induction as well as maintenance therapeutic agent along with tapering steroids in neuropsychiatric lupus (NPSLE). Hospital electronic medical records of patients with SLE diagnosed by ACR 1990 and/or SLICC 2012 criteria between January 2005 and May 2015 were retrieved. Among them, patients fulfilling ACR 1999 criteria for NPSLE were identified. Data of NPSLE patients treated with MMF as upfront second line immunosuppressive agent, both for induction and maintenance, were analyzed. Of the 140 patients with NPSLE, 88 fulfilled the inclusion criteria. Mean age of the cohort was 25.51 ± 7.82 years with female to male ratio of 84:4. Median duration of follow-up was 33 months (3-129 months). Seizure was the most common NPSLE manifestation (n = 37, 42.05%). Of the 88 patients, 18 had NPSLE solely due to secondary antiphospholipid syndrome. Of the remaining 70 patients, 61 (87.1%) had improved, 7 remained unchanged with no worsening and 3 patients had worsening or developed new symptoms during follow up after 3 months from baseline. At last follow-up, 55 out of 57 patients (97.1%) with detailed data had improved, while 2 patients had relapsed. Side effects were significantly more common in patients on prednisolone as compared to those on deflazacort. In patients with NPSLE, MMF along with tapering steroids is an efficacious combo in inducing remission and preventing relapse of disease.
Published: 2017

24. Serum Cytokine Profile in Asian Indian Patients with Takayasu Arteritis and its Association with Disease Activity

Author: Sudhir Babji, Aswin Nair, Visalakshi Jeyaseelan, Babu Ram, Ruchika Goel, George Joseph, John Mathew, Debashish Danda, Veeraraghavan Balaji, Lakshmanan Jeyaseelan, John Antony Jude Prakash, and Jayakanthan Kabeerdoss
Subjects: 0301 basic medicine, medicine.medical_specialty, Gastroenterology, Article, Proinflammatory cytokine, Pathogenesis, Interferon-gamma, 03 medical and health sciences, 0302 clinical medicine, Stable Disease, Rheumatology, Internal medicine, medicine, Interleukin 23, Interferon gamma, Asian Indians, Arteritis, Interleukin 6, 030203 arthritis & rheumatology, Large vessel vasculitis, biology, Interleukin-6, business.industry, medicine.disease, 3. Good health, 030104 developmental biology, Immunology, biology.protein, Cytokines, business, Biomarkers, Takayasu arteritis, medicine.drug, Transforming growth factor
Abstract: Background: Arterial inflammation Takayasu arteritis (TA) is an outcome of balance between pro- and anti-inflammatory cytokines. Comprehensive assessment of these cytokines is important for understanding pathogenesis and assessing disease activity. Objective: To study pro- and anti-inflammatory cytokines representing different T-helper cell pathway in serum samples of Asian Indian patients with TA and to assess their association with disease activity. Methods: Consecutive Indian patients with TA were assayed for serum interferon-γ, interleukin-6, interleukin-23, interleukin-17, interleukin-10 and transforming growth factor- β levels at baseline and follow up visit. Patients were grouped into active and stable disease based on Indian Takyasu Arteritis clinical Activity Score-2010. Serum levels of these cytokines between active and stable disease and between baseline and follow up visits were compared by non-parametric tests. Results: Among 32 patients enrolled, 15 were classified as active while 17 as stable disease at baseline. IFN-γ levels were significantly higher in active disease than stable disease (p=0.0129) while other cytokines did not differ significantly between 2 groups. Serum levels of none of the cytokines changed significantly over 2 visits in both responders and non-responders. IL23 levels positively correlate with disease duration ((r=0.999; p Conclusion: IFN-γ levels are raised in active disease in TA and correlates well with other biomarkers of disease activity and proinflammatory cytokines. There is also a direct correlation between Il-23 levels and disease duration.
Published: 2017

25. Endometrial Metastasis from an Occult Colonic Primary presenting with Massive Ascites

Author: Sindhu Gopalakrishnan, Shirly John, Ashok S Komaranchath, Pushpa Mahadevan, Lijesh Kumar, and John Mathew
Subjects: medicine.medical_specialty, business.industry, Internal medicine, Ascites, medicine, medicine.symptom, medicine.disease, business, Gastroenterology, Occult, Metastasis
Abstract: In most developed nations, endometrial cancer is the most common gynecological malignancy. However, the endometrium is an extremely rare site for metastasis from an extragenital site. Also, the most common presentation of such metastasis is with uterine bleeding, similar to primary endometrial cancers. We present an unusual case of a 38-year-old female who presented with abdominal pain and distension. Evaluation revealed an endometrial mass lesion with bilateral adnexal masses and massive ascites. An endometrial biopsy was done, which revealed a mucinous adenocarcinoma with signet ring cells. Immunohistochemistry showed cells positive for CK20 and CDX2 and negative for CK7, which was in favor of a colonic primary. A colonoscopy was attempted, but failed due to extrinsic compression at the rectosigmoid junction. There was no evidence of supradiaphragmatic disease. She was started on palliative chemotherapy. This case report highlights the indispensability of histological correlation and immunohistochemistry in the diagnosis of pelvic malignancies. How to cite this article Komaranchath AS, Gopalakrishnan S, John S, Mahadevan P, Mathew J, Kumar L. Endometrial Metastasis from an Occult Colonic Primary presenting with Massive Ascites. J South Asian Feder Menopause Soc 2017;5(2):138-141.
Published: 2017

26. AB0492 PREVALENCE OF IGA ANTICARDIOLIPIN ANTIBODY AND ITS ASSOCIATION WITH PREGNANCY MORBIDITY IN ASIAN INDIAN PATIENTS WITH PRIMARY ANTIPHOSPHOLIPID ANTIBODY SYNDROME AND SYSTEMIC LUPUS ERYTHEMATOSUS – A CROSS SECTIONAL STUDY

Author: Harshini Alur Shivakumar, John Mathew, K Jayakanthan, Debashish Danda, and Mahasampath Gowri
Subjects: Pregnancy, Lupus anticoagulant, medicine.medical_specialty, Eclampsia, business.industry, Cross-sectional study, Deep vein, medicine.disease, Thrombosis, Pulmonary embolism, medicine.anatomical_structure, Internal medicine, medicine, Clinical significance, skin and connective tissue diseases, business
Abstract: Background: There are many clinical and laboratory parameters which have been proven to be associated with increased risk of pregnancy morbidity in patients with SLE and APS. This study was undertaken as there is a lacuna in explaining all the pregnancy related morbidity in this group Objectives: Primary: Correlation of IgA anticardiolipin antibody with the risk for pregnancy morbidity in patients with APS/SLE Secondary: Association of IgA Anticardiolipin antibody with the risk of thromboembolic events Methods: Patients diagnosed as SLE and/or Primary APS who are married and conceived atleast once were recruited and 3ml blood sample was obtained from them. Patients with history of recurrent infections, which could suggest probable IgA deficiency, were excluded. Demographic data including duration of illness, number of pregnancies, thromboembolic events, disease activity were noted. They were categorized into two different groups depending on whether they had a pregnancy morbidity or not. The blood samples were subjected to IgA Anticardiolipin assay by ELISA. Results: A total number of 186 patients were recruited with mean age 34.54(+/-7.32)years, mean duration of illness of 5.52(+/-4.31)yrs with a diagnosis of 76.88% SLE, 7.53% primary APS and 15.59% SLE with secondary APS. On assessment of disease activity, mean SLEDAI score was found to be 4.46+/-6.32. Out of the total, 14.71% patients had conceived once, 14.56% twice, 16.72% patients thrice and 18.41% had conceived more than three times. 36.56% patients had pregnancy morbidity (majority being pregnancy induced hypertension 14.52%, prematurity 11.29%, IUGR 10.22%, pre-ecclampsia in 3.76%, eclampsia 1.08%,), 19.35% patients had history of thromboembolic events (6.45% pulmonary embolism, 5.38% deep vein thrombosis, 3.76% visceral vessel thrombosis, 0.54% cortical vein thrombosis, 6.99% other vessel thrombosis). 33.87% patients had positivity for antiphospholipid antibodies with 27.82% lupus anticoagulant positive, 20.97% IgG Anticardiolipin positive and 17.35% anti-beta2 glycoprotein positive. IgA Anticardiolipin was found to be positive in 4.84%(n=9) out of which, 10.29% were in the group with pregnancy morbidity as against 1.69% without pregnancy morbidity. Out of the total positives titre in 37.5% were indeterminate, 25% low positive and 37.5% high positive. All patients who had high titre positivity had pregnancy morbidity. The positivity of IgA anticardiolipin in the patient group with thromboembolic events was 5.56%. Conclusion: Among patients with SLE, APS or SLE and APS, the overall prevalence of IgA anticardiolipin antibody was found to be about 4.84%, which is much less as compared to the percentages reported by other groups[1] IgA Anticardiolipin antibody positivity was more in patients with pregnancy morbidity compared to patients without a pregnancy morbidity. In this study however, statistical significance was not reached. Similar studies with larger number of patients are required. We also need to prospectively follow up such patients with IgA ACLA and evaluate for morbidity during pregnancy References [1] Clinical significance of IgA anticardiolipin and anti-beta2-GP1 antibodies in patients with systemic lupus erythematosus and primary antiphospholipid syndrome, Clin Rheumatol. 2006 Mar;25(2):199-204 Disclosure of Interests: None declared
Published: 2019

27. Feasibility of Transoral Approach to Accessory Parotid Tumors

Author: Rajiv C Michael, Regi Thomas, John Mathew, and Suresh Mani
Subjects: pleomorphic adenoma, medicine.medical_specialty, transoral surgery, 030204 cardiovascular system & hematology, Resection, Pleomorphic adenoma, Otolaryngology, 03 medical and health sciences, 0302 clinical medicine, stomatognathic system, Surgical removal, medicine, business.industry, General Engineering, Transoral approach, medicine.disease, Facial nerve, Parotid gland, medicine.anatomical_structure, Oncology, Superficial Parotidectomy, General Surgery, Parotid tumors, facial nerve, Radiology, parotid gland, business, 030217 neurology & neurosurgery
Abstract: Tumors of the accessory parotid gland are very rare. Surgical removal of an accessory parotid tumor is usually accomplished by superficial parotidectomy through an external neck incision. However, this procedure inevitably results in a neck scar. In this case, we performed complete excision of a parotid tumor via an endoscopic-assisted transoral approach. Resection of such benign tumors can be achieved with less morbidity by endoscope-assisted surgery with a nerve monitoring system. The field of transoral surgery will continue to expand with technological advancements.
Published: 2019

28. Efficacy of two vertically integrated teaching–learning methods – The ocular basic science workshop versus lecture in enhancing knowledge and skills of ocular examination techniques and underlying principles in second clinical year medical students: A prospective interventional study

Author: Paul J, Rajalakshmi Subramanian, Anika Amritanand, Aby S. Charles, Timothy Prabhu, Aarwin Joshua, Supraja Srivatsava, Nimmy Thomas, Upasana Kachroo, Jeffrey Immanuel, Anandit John Mathew, Danica Lyngwa, Ann Eapen, and Jeyanth Suresh Rose
Subjects: medicine.medical_specialty, basic science principles, Objective structured clinical examination, Basic science, Teaching method, education, Physical examination, peer learning, Likert scale, ophthalmic clinical tests, Medicine, Medical physics, Peer learning, ocular examination skills, medicine.diagnostic_test, business.industry, practice-based learning and improvement, RE1-994, vertical integrated teaching, Confidence interval, Ophthalmology, Test score, ocular basic science workshop, acgme core competencies addressed medical knowledge, business, randomized comparative study
Abstract: Purpose: The purpose of the study was to compare the efficacy of two vertically integrated teaching–learning methods, a peer-led ocular basic science workshop (OBSW) versus lecture by ophthalmology faculty, in enhancing the underlying basic science knowledge and examination skills of ophthalmic clinical tests among second clinical year medical students. Design: This was a prospective, interventional comparative study. Students were randomly assigned to peer-led OBSW and interactive lecture-based method of teaching by a faculty. Change in knowledge was assessed using pre and post multiple-choice question test score. Quantitative assessment of clinical examination skills between the two groups was done using objective structured clinical examination (OSCE) at 2-week postintervention. All assessors were blinded. Student's attitude toward the teaching–learning methods was assessed using a 5-point Likert scale. Setting: This study was conducted in the departments of ophthalmology, anatomy, and physiology of a tertiary care medical college in southern India. Participants: Second clinical year students starting their ophthalmology rotation, 5 peer teachers, and 47 students were recruited. All completed the study. Results: Post intervention, there was a significant change in basic science knowledge from baseline among both the arms. Mean improvement in posttest score immediately following the OBSW was 9.25 (standard deviation [SD]: 3.34, 95% confidence interval (CI): 7.84–10.66, t = 13.57, P = 0.00) and 7.83 (SD: 3.66), 95% CI: 6.24–9.41, t = 10.24, P = 0.00) after the lecture. The improvement in scores continued in the 2-week posttest scores. There was no statistically significant difference in the OSCE scores between the two groups. Conclusions: The vertically integrated OBSW and lecture methods were equally effective in improving knowledge and clinical skills of basic ocular examination skills among the second clinical year medical students.
Published: 2021

29. Beyond sicca symptoms: Osteomalacia secondary to renal tubular acidosis in Sjogren syndrome

Author: John Mathew, H S Asha, Nitin Kapoor, Remya Rajan, Thomas V Paul, and Kripa Elizabeth Cherian
Subjects: Osteomalacia, medicine.medical_specialty, business.industry, Acidosis, Renal Tubular, Sjögren syndrome, medicine.disease, Gastroenterology, Renal tubular acidosis, Sjogren's Syndrome, Rheumatology, Sicca symptoms, Internal medicine, medicine, Humans, business, Cartilage Diseases
Published: 2021

30. Impact of COVID-19 Pandemic and Resultant Lockdown in India on Patients with Chronic Rheumatic Diseases: An Online Survey

Author: Sangeetha Priya, John Mathew, Upasana Kachroo, Aiswarya Nair, Aswin Nair, Arvind Ganapati, Shivraj Padiyar, and Mahasampath Gowri
Subjects: medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Physical health, Mental health, Rheumatology, Likert scale, Mental distress, Internal medicine, Family medicine, Pandemic, medicine, Social determinants of health, business
Abstract: Background: Impact of COVID-19 pandemic and consequential lockdown in India, on patients with chronic rheumatic diseases (CRD) pertaining these components of interest: (a) physical health, (b) mental health, (c) facets of social well-being, (d) health-care accessibility, and (e) COVID-19 related knowledge, attitude, and practices (KAP) was assessed. Methods: An online/onsite self-reported questionnaire-based cross-sectional survey was utilized to capture responses during May 20, 2020, to June 6, 2020, from CRD (both inflammatory and non-inflammatory) patients satisfying eligibility criteria, at a tertiary hospital in India. Adverse impact was defined as strong agreement/agreement on Likert scale to an impact on the individual components of interest. Results: From 1533 completed responses analyzed, adverse impact was noted on physical health (32.3%), mental health (42.9%), social health (54.8%), occupational life (55.9%), and financial condition (54.4%). Self-reported COVID-19 diagnosis (1.4%), flare/possible flare of CRD (41.3%), and symptoms of mental distress (64%) were also reported. Awareness and utilization of tele-video consultation (TVC) were 27.3% and 11.2%, respectively, with 89.9% expressing difficulty in procuring medication. COVID-19 KAP assessment revealed awareness of COVID-19 suspect symptoms and safety practices to be >60% and >70% respectively, with safety adherence being >75%. Conclusion: Majority of respondents reported adverse impact on social health, occupational life, financial condition, and interruption of CRD management, possibly complicated by the lack of awareness and low utilization of TVC. Although mental distress was greatly reported in the participants, a general preponderance toward self-education of current scenario and safety adherence was noted, indicating a favorable reception of future health-care directives.
Published: 2021

31. Minimally invasive oesophagectomy in prone versus lateral decubitus position: A comparative study

Author: John Mathew Manipadam, Amit Jain, Anil K. Agarwal, Raja Kalayarasan, Amit Javed, and Rajeev Uppal
Subjects: medicine.medical_specialty, medicine.medical_treatment, lcsh:Surgery, Anastomosis, 03 medical and health sciences, 0302 clinical medicine, medicine, esophageal cancer, lcsh:RC799-869, business.industry, Chylothorax, lcsh:RD1-811, Esophageal cancer, medicine.disease, Surgery, minimally invasive surgical procedures, Esophagectomy, Prone position, Dissection, 030220 oncology & carcinogenesis, T-stage, Population study, 030211 gastroenterology & hepatology, Original Article, lcsh:Diseases of the digestive system. Gastroenterology, business
Abstract: Background: Thoracoscopic oesophageal mobilisation during a minimally invasive oesophagectomy (MIE) is most commonly performed with the patient placed in the lateral decubitus position (LDP). The prone position (PP) for thoracoscopic oesophageal mobilisation has been proposed as an alternative. Materials and Methods: This was a retrospective, comparative study designed to compare early outcomes following a minimally invasive thoracolaparoscopic oesophagectomy for oesophageal cancer in LDP and in PP. Results: During the study period, between January 2011 and February 2014, 104 patients underwent an oesophagectomy for cancer. Of these, 42 were open procedures (transhiatal and transthoracic oesophagectomy) and 62 were minimally invasive. The study group included patients who underwent thoracolaparoscopic oesophagectomy in LDP (n = 23) and in PP (n = 25). The median age of the study population was 55 (24-71) years, and there were 25 males. Twenty-one (21) patients had tumours in the middle third of the oesophagus, 24 in the lower third, and 3 arising from the gastro-oesophageal junction. The most common histology was squamous cell cancer (85.4%). The median duration of surgery was similar in the two groups; however, the estimated median intraoperative blood loss was less in the PP group [200 (50-400) mL vs 300 (100-600) mL; P = 0.01)]. In the post-operative period, 26.1% patients in the LDP group and 8% in the PP group (8%) developed respiratory complications. The incidence of other post-operative complications, including cervical oesophagogastric anastomosis, hoarseness of voice and chylothorax, was not different in the two groups. The T stage of the tumour was similar in the two groups, with the majority (37) having T3 disease. A mean of 8 lymph nodes (range 2-33) were retrieved in the LDP group, and 17.5 (range 5-41) lymph nodes were retrieved in the PP group (P = 0.0004). The number of patients with node-positive disease was also higher in the PP group (19 vs 10, P = 0.037). Conclusion: MIE in the PP is an effective alternative to LDP. The exposure obtained is excellent even without the need for a complete lung collapse, thereby obviating the need for a double-lumen endotracheal tube. A more meticulous dissection can be performed resulting in a higher lymph nodal yield.
Published: 2016

32. Appendicular abscess: as a masquerader and pheochromocytoma as an incidentaloma in a 12 year old male child

Author: R Nidheesh Chandran, Jayasurya Suresh, and P John Mathew
Subjects: Pheochromocytoma, medicine.medical_specialty, nervous system, endocrine system diseases, business.industry, Incidentaloma, General surgery, Appendicular abscess, Medicine, business, medicine.disease
Abstract: A 12 year old boy presented initially with symptoms suggestive of urinary tract infection (UTI). Later, it turned out to be acute appendicitis with appendicular abscess. Pre-operative investigations revealed co-presentation of pheochromocytoma. Although this child was having no symptoms of pheochromocytoma, the presentation of phaechromocytoma with appendicular abscess needs to be dealt with extreme vigil as pheochromocytoma can result in severe sympathetic outburst storm. Laparoscopic appendicectomy was done and the child was discharged after complete recovery.
Published: 2020

33. P010: Does inframammary fold nipple sparing mastectomy safely accommodate larger volume implants in relation to weight of the breast compared to nipple sacrificing mastectomy in reconstruction with ADM?

Author: Abiodun Adigun and John Mathew
Subjects: Nipple-Sparing Mastectomy, medicine.medical_specialty, Oncology, business.industry, medicine.medical_treatment, medicine, Inframammary fold, Surgery, General Medicine, business, Mastectomy, Volume (compression)
Published: 2020

34. AB0596 PREDICTORS, LONG TERM CLINICAL AND TREATMENT OUTCOMES IN SOUTH ASIAN PATIENTS WITH IDIOPATHIC INFLAMMATORY MYOSITIS: A SINGLE CENTER STUDY

Author: Arvind Ganapati, Bijesh Yadav, Debashish Danda, P. Chebbi, Grace Rebekah, John Mathew, A. Nair, Ruchika Goel, Ashish J. Mathew, and John Antony Jude Prakash
Subjects: medicine.medical_specialty, Anti-nuclear antibody, business.industry, Immunology, Interstitial lung disease, medicine.disease, Connective tissue disease, Polymyositis, General Biochemistry, Genetics and Molecular Biology, Ground-glass opacity, Rheumatology, Usual interstitial pneumonia, Rheumatoid arthritis, Internal medicine, medicine, Immunology and Allergy, medicine.symptom, business
Abstract: Background:Idiopathic inflammatory myositis (IIM) are a heterogeneous group of immune-mediated disorders with varied presentations and multiple organ involvement. Data on long term outcome among South Asian patients with IIM is sparse.Objectives:To study the long term clinical outcome, treatment responses and factors predicting outcome among adult patients with IIMMethods:Patients diagnosed as ‘Idiopathic Inflammatory Myositis’ under the department of Clinical Immunology and Rheumatology at CMC, Vellore, India were screened retrospectively. Patients aged 18 years and above, satisfying Bohan and Peter criteria, having follow up of one year or more with atleast two outpatient or inpatient visits between January 2010 and April 2019 were included in this study. Those patients with connective tissue disease associated myositis were not included. Details on muscle weakness, extramuscular involvement, muscle enzymes and treatment administered were recorded at baseline, 3, 6, 12, 18, 24 months and yearly thereafter. After assessing their cumulative response, categorization of patients into complete and partial responders was done. Complete responders were defined as patients with persistent muscle power of more than 4/5 and/or MMT 8 more than 76/80, complete resolution of skin, articular and lung involvement (if any) as well as muscle enzymes less than twice the upper limit of normal without any documented flares during the entire follow up period. Patients not satisfying the said criterias were grouped as Partial responders. Disease free survival duration was also analyzed.Results:Out of 310 patients of IIM identified, 187 (60.3%) patients satisfied the inclusion criteria. Women were 2.2 times more than men and mean age at symptom onset was 35.7±12.6 years. Dermatomyositis was the predominant myositis subtype seen. All patients were put on steroids with the mean dose being 45.9 ± 18.6 mg/day. At baseline, the key immunosuppressants used were methotrexate in 44.9% and mycophenolate in 37.6% patients. The median follow up duration was 48 (25-80) months. An associated malignancy was diagnosed in 3.2% after a median duration of 24.5 months. Five patients expired after a median duration of 80 months from diagnosis. Normal muscle power was attained in 76.1% patients and 88.6% were vocational by the last follow up visit. Steroids were discontinued in 56.7% patients after a median duration of 24 months (p=0.0002). Discontinuation of the immunosuppressant was feasible in 10.2% patients after a median duration of 44 months. Assessment of the cumulative responses revealed a relapsing and remitting course in 45.9%. Outcome predictors in univariate analysis were Jo-1 status, presence of arthritis, interstitial lung disease and pericardial effusion at baseline. On multivariate analysis, absence of pericardial effusion (p=0.011) and interstitial lung disease (p=0.067) at baseline were found to be predictors of complete response. Disease free survival probability estimated at 5 years and 10 years was 91.6% and 72.4% respectively. Estimating the probability gender wise, males achieved disease free status earlier than females.Conclusion:A favorable clinical and functional outcome was seen in a significant proportion of these patients with IIM on long term follow up. Pericardial effusion and ILD were identified as predictors of poor clinical outcome.References:[1]Taborda AL, Azevedo P, Isenberg DA. Retrospective analysis of the outcome of patients with idiopathic inflammatory myopathy: a long-term follow-up study. Clin Exp Rheumatol. 2014 Apr; 32(2):188–93.Acknowledgments:NilDisclosure of Interests:None declared
Published: 2020

35. 22. SHORT TERM OUTCOMES OF CHEST WALL PERFORATOR FLAPS VERSUS THERAPEUTIC MAMMOPLASTY

Author: Abiodun Adigun, John Mathew, and Samreen Khan
Subjects: medicine.medical_specialty, Oncology, business.industry, medicine, Surgery, Mammoplasty, General Medicine, business, Perforator flaps, Term (time)
Published: 2020

36. Limitations and drawbacks of the hospital-based universal neonatal hearing screening program: First report from the Arabian Peninsula and insights

Author: Manal Al Jaradi, Hana Al Bahlani, John Mathew, Rashid Al Abri, Arif Ali Kolethekkat, Ahmed Al Omrani, Adil Ali Sulaiman, Zeyad Al Harasi, and Omar Hlaiwah
Subjects: Male, Parents, Medical institution, medicine.medical_specialty, Oman, Hearing loss, Hearing screening, Appointments and Schedules, 03 medical and health sciences, Neonatal Screening, 0302 clinical medicine, Surveys and Questionnaires, 030225 pediatrics, Intervention (counseling), Prevalence, Humans, Medicine, Prospective Studies, Hearing Loss, 030223 otorhinolaryngology, Retrospective Studies, business.industry, Communication, Infant, Newborn, Infant, General Medicine, Hospital based, Caregivers, Otorhinolaryngology, Family medicine, Pediatrics, Perinatology and Child Health, Patient Compliance, Female, Lost to Follow-Up, Performance indicator, medicine.symptom, business, Primary screening, Performance quality
Abstract: Objectives To assess the efficacy of the current universal neonatal hearing screening program in a tertiary medical institution in Oman, identify its limitations and drawbacks, and explore their causative factors. Methods A retrospective review was carried out to analyse the hearing screening of 12,743 live babies born between January 2016 and December 2018. Screen coverage, drop outs, follow up rate, and age at completion of screening, diagnosis, and intervention were analysed. The results were compared with the Joint Committee on Infant Hearing (JCIH) performance quality indices. Prospective questionnaire-based telephonic interviews were then conducted with the parents or caregivers of neonates with hearing loss. Finally, the causes of loss to follow up or delays in hearing screenings, diagnosis, and/or early intervention were studied. Results The true prevalence of hearing loss was 4.0 in 1000. The coverage of first-stage screening was 90% whereas the compliance with the second stage was 88.04%. 22.8% of the patients eventually obtained final diagnostic confirmation. The overall compliance with amplification was 30.2%. The completion ages of primary screening and final confirmation were 7.98 and 17.3 weeks respectively. The importance of hearing screening is well received by parents, but problems related to communication, delays in the appointment system, and inefficient follow up tracking were identified as the main limitations and drawbacks of the program. Conclusion The coverage of the neonatal hearing screening program had not yet reached the required goal of 95%. The performance indicators also fell below the international benchmark. There is a need to address the identified causative factors. Effective communication and well-maintained tracking systems need to be implemented.
Published: 2020

37. Hydroxychloroquine-induced auditory toxicity

Author: Yapi Jerang, John Mathew, and Abhishek Patil
Subjects: medicine.medical_specialty, hydroxychloroquine, lcsh:Diseases of the musculoskeletal system, Hearing loss, cinchonism, Cinchonism, sensorineural, Audiology, 03 medical and health sciences, 0302 clinical medicine, Mixed connective tissue disease, Rheumatology, deafness, otorhinolaryngologic diseases, medicine, 030212 general & internal medicine, 030203 arthritis & rheumatology, Hearing deficit, business.industry, Hydroxychloroquine, Audiogram, medicine.disease, Toxicity, audiogram, lcsh:RC925-935, medicine.symptom, Bilateral sensorineural hearing loss, business, medicine.drug
Abstract: A 51-year-old female with mixed connective tissue disease presented with bilateral sensorineural hearing loss. The hearing deficit was gradually progressive over a period of 6 months. On evaluation, no obvious cause for hearing was evident. Due to ototoxic potential of hydroxychloroquine, we decided to stop the drug and observe for improvement. Over time, her hearing loss stabilized, with improvement in audiometric findings. Hydroxychloroquine induced auditory toxicity is rare. Increased awareness and early recognition may minimize damage.
Published: 2020

38. Detection of micrometastasis in axillary lymph nodes of breast carcinoma patients and its association with clinical outcome

Author: Indu R. Nair, Vijaykumar Dehannaparambil Kottarathil, and Anand John Mathew
Subjects: Microbiology (medical), Adult, medicine.medical_specialty, Axillary lymph nodes, lcsh:QR1-502, Context (language use), Breast Neoplasms, 030204 cardiovascular system & hematology, lcsh:Microbiology, Pathology and Forensic Medicine, Metastasis, 03 medical and health sciences, Micrometastasis, 0302 clinical medicine, lcsh:Pathology, Medicine, Electronic Health Records, Humans, node-negative breast carcinoma, Aged, Retrospective Studies, business.industry, Axillary Lymph Node Dissection, General Medicine, Sentinel node, Middle Aged, medicine.disease, Prognosis, Immunohistochemistry, ultrastaging, Patient Outcome Assessment, Exact test, medicine.anatomical_structure, Neoplasm Micrometastasis, 030220 oncology & carcinogenesis, Axilla, Lymph Node Excision, Female, Radiology, Lymph Nodes, Neoplasm Recurrence, Local, Sentinel Lymph Node, Breast carcinoma, business, lcsh:RB1-214, Follow-Up Studies
Abstract: Context: There is heterogeneity in the clinical behavior of breast carcinoma patients with node negativity. Studies have analyzed different factors influencing the outcome in such patients. It is suggested that the presence of nodal micrometastasis can act as a tool in predicting the aggressiveness of these tumors. Aims: The aim of this study is to assess the yield of micrometastasis/isolated tumor cell (ITC) by ultrastaging the morphologically negative axillary nodes and staining them with immunohistochemistry for epithelial membrane antigen. The association of such metastasis with the clinical outcome is determined. Settings and Design: This was a retrospective analytical study. One hundred cases of node-negative breast carcinoma patients who underwent surgery along with axillary lymph node dissection were selected. Materials and Methods: The largest node from the axillary dissection was selected and subjected to ultrastaging and immunohistochemical staining (as sentinel node dissection was not a routine practice at that time), to look for occult metastasis in the form of micrometastasis or ITCs. Statistical Analysis: Occurrence of events in the form of recurrence or death was noted. Association of the parameters was analyzed using Fisher's exact test. Results: Among the 100 cases, 79 patients were followed up for a minimum period of 5 years. Two cases had micromets in one node each. These two patients were among the eight, who developed events subsequently (25%). Hence, a statistically significant association was found between the presence of micromets with events. Conclusions: There is a statistically significant association between the presence of micromets and disease recurrence. Hence, we suggest that ultrastaging of the negative axillary node (now sentinel node, as it is being routinely done) might prove effective in predicting the events/prognosis in clinically and morphologically node-negative breast carcinoma patients
Published: 2018

39. Study of clinical utility of antibodies to phosphatidylserine/prothrombin complex in Asian-Indian patients with suspected APS

Author: Debashish Danda, Jayakanthan Kabeerdoss, Mahasampath Gowri, Arvind Ganapati, Ruchika Goel, and John Mathew
Subjects: Adult, Male, medicine.medical_specialty, India, Enzyme-Linked Immunosorbent Assay, Phosphatidylserines, Sensitivity and Specificity, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Rheumatology, Antiphospholipid syndrome, Internal medicine, medicine, Humans, 030212 general & internal medicine, 030203 arthritis & rheumatology, biology, business.industry, General Medicine, Odds ratio, medicine.disease, Antiphospholipid Syndrome, Logistic Models, beta 2-Glycoprotein I, Case-Control Studies, biology.protein, Antibodies, Antiphospholipid, Female, Prothrombin, Antibody, business, PROTHROMBIN COMPLEX, Biomarkers, Phosphatidylserine-prothrombin complex
Abstract: Antiphospholipid syndrome (APS) is the most common acquired pro-thrombotic disorder, also associated with obstetric complications. Phosphatidylserine/Prothrombin complex antibody (aPSPT) though associated with various APS manifestations, is not included in the revised Sapporo Criteria. To study the prevalence of aPSPT in Asian-Indian patients with suspected APS and compare its performance with the criteria anti-phospholipid antibodies (APLs). Electronic charts of 372 individuals whose sera was tested for aPSPT in suspected APS between June 2014 and May 2016 were retrieved and analyzed. aPSPT was assayed by ELISA. aPSPT tested individuals were categorized into cases—seropositive and seronegative APS (SNAPS) and controls. aPSPT was positive in 24/58 (41.3%) cases and 17/314 (5.4%) controls (p
Published: 2018

40. Cartilage rim augmented fascia tympanoplasty: a more effective composite graft model than temporalis fascia tympanoplasty

Author: S Pillai, R. S. Al Abri, Sujin P. Jose, N Al Marhoobi, K Al Zaabi, John Mathew, and Arif Ali Kolethekkat
Subjects: Adult, Male, medicine.medical_specialty, Adolescent, medicine.medical_treatment, Hearing Loss, Conductive, Temporalis fascia, 03 medical and health sciences, Myringoplasty, Young Adult, 0302 clinical medicine, Tympanoplasty, Ear Cartilage, medicine, Humans, Fascia, 030223 otorhinolaryngology, Child, Ear Ossicles, Retrospective Studies, Tympanic Membrane Perforation, business.industry, Cartilage, Significant difference, General Medicine, Middle Aged, Surgery, medicine.anatomical_structure, Treatment Outcome, Otorhinolaryngology, 030220 oncology & carcinogenesis, Female, Composite graft, business, Bone Conduction
Abstract: ObjectiveTo validate a newly introduced cartilage rim augmented temporalis fascia tympanoplasty technique by statistically comparing it with the morphological and audiological outcomes of traditional temporalis fascia tympanoplasty.MethodsA retrospective comparative study was conducted on 115 patients who underwent tympanoplasty during 2013 and 2015. Fifty-eight patients underwent temporalis fascia tympanoplasty and 57 underwent cartilage rim augmented fascia tympanoplasty.ResultsIn the cartilage fascia group, graft healing was achieved in 94.7 per cent of cases; in the temporalis fascia group, the graft take-up rate was 70 per cent. In those with a normal ossicular chain, the post-operative air–bone gap was within 20 dB in 92.6 per cent of cartilage fascia group cases and in 69.7 per cent of the temporalis fascia group cases, which was a statistically significant difference. Among the defective ossicular chain cases, the post-operative air–bone gap was within 20 dB in 76.9 per cent in the cartilage fascia group, as against 57.1 per cent in the temporalis fascia group.ConclusionCartilage rim augmented temporalis fascia tympanoplasty has a definite advantage over the temporalis fascia technique in terms of superior graft take up and statistically significant hearing gain in those with normal ossicular mobility.
Published: 2018

41. Difficult Laryngeal Exposure in Microlaryngoscopy: Can it be Predicted Preoperatively?

Author: Sophia Amalanathan, Ramanathan Chandrasekharan, Ajoy Mathew Varghese, John Mathew, Syed Kamran Asif, Mary Kurien, and Roshna Rose Paul
Subjects: Neck circumference, medicine.medical_specialty, medicine.diagnostic_test, business.industry, Laryngoscopy, Odds ratio, Logistic regression, Confidence interval, Teaching hospital, Surgery, 03 medical and health sciences, 0302 clinical medicine, Otorhinolaryngology, 030220 oncology & carcinogenesis, Medicine, Original Article, 030223 otorhinolaryngology, business, Grading (education)
Abstract: The aim of the present study was to identify preoperative clinical predictors for difficult laryngeal exposure (DLE) and to define a simple grading system for laryngeal exposure. This is a prospective descriptive study carried out in a tertiary teaching hospital in South India. Patients above 18 years undergoing microlaryngoscopy had presurgical evaluation of 11 physical parameters. Grading of Modified Cormack-Lehane Score (MCLS) and rigid laryngoscopy were done during procedure. On logistic regression analysis, with a 95 % confidence interval (CI) MCLS was found to be a statistically significant predictor (odds ratio 12). With 90 % CI, neck circumference, atlanto-occipital extension and MCLS were significant (odds ratio of 4, 4, 12 respectively). Neck circumference of more than 34.25 cm and limited atlanto-occipital extension of less than 19.50, predicts difficult laryngeal exposure. A simple grading system for laryngeal exposure during microlaryngoscopy is being proposed. MCLS grade more than 2a done intra operatively correlates well with difficult intubation.
Published: 2015

42. Nasalance in Cochlear Implantees

Author: Anjali Lepcha, Swapna Sebastian, John Mathew, and N. Sreedevi
Subjects: Hearing aid, medicine.medical_specialty, Hearing loss, medicine.medical_treatment, lcsh:Medicine, Audiology, Speech therapy, medicine, otorhinolaryngologic diseases, Statistical analysis, Cochlear implantation, Hearing Loss, Nasality, Nasal Air Pressure, business.industry, lcsh:R, Speech Intelligibility, lcsh:Otorhinolaryngology, lcsh:RF1-547, Cochlear Implantation, Otorhinolaryngology, Hearing Aid Users, Surgery, Original Article, Nasalance, medicine.symptom, business
Abstract: OBJECTIVES: Speech intelligibility is severely affected in children with congenital profound hearing loss. Hypernasality is a problem commonly encountered in their speech. Auditory information received from cochlear implants is expected to be far superior to that from hearing aids. Our study aimed at comparing the percentages of nasality in the speech of the cochlear implantees with hearing aid users and also with children with normal hearing. METHODS: Three groups of subjects took part in the study. Groups I and II comprised 12 children each, in the age range of 4-10 years, with prelingual bilateral profound hearing loss, using multichannel cochlear implants and digital hearing aids respectively. Both groups had received at least one year of speech therapy intervention since cochlear implant surgery and hearing aid fitting respectively. The third group consisted of age-matched and sex-matched children with normal hearing. The subjects were asked to say a sentence which consisted of only oral sounds and no nasal sounds ("Buy baby a bib"). The nasalance score as a percentage was calculated. RESULTS: Statistical analysis revealed that the children using hearing aids showed a high percentage of nasalance in their speech. The cochlear implantees showed a lower percentage of nasalance compared to children using hearing aids, but did not match with their normal hearing peers. CONCLUSION: The quality of speech of the cochlear implantees was superior to that of the hearing aid users, but did not match with the normal controls. The study suggests that acoustic variables still exist after cochlear implantation in children, with hearing impairments at deviant levels, which needs attention. Further research needs to be carried out to explore the effect of the age at implantation as a variable in reducing nasality in the speech and attaining normative values in cochlear implantees, and also between unilateral versus bilateral implantees.
Published: 2015

43. What can be done when the cored specimen in a Frey procedure for chronic pancreatitis is reported as adenocarcinoma?

Author: Venugopal A, John Mathew Manipadam, H. Ramesh, S. Mahesh, and V. Lekha
Subjects: Adult, Male, medicine.medical_specialty, Adenocarcinoma, Gastroenterology, Diagnosis, Differential, 03 medical and health sciences, Pancreatectomy, 0302 clinical medicine, Pancreatitis, Chronic, Internal medicine, medicine, Frozen Sections, Humans, Retrospective Studies, business.industry, Middle Aged, Hepatology, medicine.disease, nervous system diseases, Pancreatic Neoplasms, 030220 oncology & carcinogenesis, Pancreatitis, Female, 030211 gastroenterology & hepatology, business, psychological phenomena and processes
Abstract: The aim of this study is to analyze the outcomes of patients with chronic pancreatitis who underwent the Frey procedure and who had a histologic evidence of adenocarcinoma in the cored out specimen.The type of analysis is retrospective. Out of 523 patients who underwent Frey procedure for chronic pancreatitis, seven (five males and two females; age range 42 to 54 years) had histologically proven adenocarcinoma. In the first four cases, intraoperative frozen section was not done. The diagnosis was made on routine histopathology and only one out of four could undergo attempted curative therapy. In the remaining three cases, intraoperative frozen section confirmation was available, and curative resection performed. Only four out of seven had a clear-cut mass lesion: (a) cancer can occur in chronic pancreatitis in the absence of a mass lesion and (b) intraoperative frozen section of the cored specimen is crucial to exercising curative therapeutic options and must be performed routinely. If frozen section is reported as adenocarcinoma, a head resection with repeat frozen of the margins of resection is appropriate. If the adenocarcinoma is reported on regular histopathology after several days, then a total pancreatectomy may be more appropriate.
Published: 2016

44. Bleeding Mass in the Ear: A Rare Etiology

Author: Anjali Lepcha, Vinu Moses, Ann Mary Augustine, John Mathew, and Bassin Thomas John
Subjects: Pseudoaneurysm, medicine.medical_specialty, Otorhinolaryngology, business.industry, Otology, medicine, Etiology, Skull base osteomyelitis, Malignant otitis externa, medicine.disease, business, Surgery
Abstract: We report a case of a 63 years old man who presented with a profusely bleeding mass in the left external auditory canal. He had been diagnosed to have left skull base osteomyelitis and had undergone surgery twice for the same. The mass was diagnosed radiologically to be a pseudoaneurysm arising from the left retroauricular artery. He subsequently underwent embolization of the retroauricular branch of the left external carotid artery following which the mass subsided and bleeding from the ear stopped. How to cite this article John BT, Augustine AM, Lepcha A, Mathew J, Moses V. Bleeding Mass in the Ear: A Rare Etiology. Int J Otorhinolaryngol Clin 2015;7(3):144-146.
Published: 2015

45. The Effect of Preoperative Biliary and Pancreatic Drainage on Postoperative Pancreatic Fistula: A Retrospective Cohort Study

Author: H. Ramesh, Jacob Mathew Kadamapuzha, John Mathew Manipadam, and S. Mahesh
Subjects: medicine.medical_specialty, medicine.medical_treatment, lcsh:Surgery, Biliary Stenting, Anastomosis, Single Center, 03 medical and health sciences, 0302 clinical medicine, Medicine, Common bile duct, business.industry, Retrospective cohort study, lcsh:RD1-811, Pancreaticoduodenectomy, medicine.disease, Surgery, medicine.anatomical_structure, preoperative biliary drainage, Pancreatic fistula, 030220 oncology & carcinogenesis, Pancreatitis, 030211 gastroenterology & hepatology, Original Article, pancreaticoduodenectomy, business, postoperative pancreatic fistula
Abstract: Background Surgeons and endoscopists welcome routine preoperative biliary drainage prior to pancreaticoduodenectomy despite evidence that it increases complications. Its effect on postoperative pancreatic fistula is variably reported in literature. Simultaneous biliary and pancreatic drainage is rarely performed for very selected indications and its effects on postoperative pancreatic fistula are largely unknown. Our aim was to analyze the same while eliminating confounding factors. Methods Retrospective single center cohort study of patients who underwent pancreaticoduodenectomy over the past 10 years for carcinoma obstructing the lower common bile duct. Patients who underwent biliary stenting alone, biliary and pancreatic stenting, and no stenting prior to pancreaticoduodenectomy were the three study cohort groups and their records were scrutinized for the incidence of postoperative pancreatic fistula. Results Sixty-two patients underwent biliary stenting alone, 5 patients underwent both biliary and pancreatic stenting, and 237 patients were not stented in the adenocarcinoma group without chronic pancreatitis. The pancreatic fistula rate was similar in the patients who underwent biliary stenting alone when compared with the group which was not stented. (24/62 versus 67/237, odds ratio [OR] =0.619, confidence interval (CI) =0.345–1.112, p = 0.121). However, the patients who underwent both biliary and pancreatic stenting had a significant increase in postoperative pancreatic fistula compared with the not stented (p = 0.003). By univariate and multivariate analysis using Firth logistic regression, pancreatic texture (OR = 1.205, CI = 0.103–2.476, p = 0.032) and the presence of a biliary and pancreatic stent (OR = 2.695, CI = 0.273–7.617, p = 0.027) were the significant factors affecting pancreatic fistula. Conclusion Preoperative biliary drainage alone has no significant influence on postoperative pancreatic fistula except when combined with pancreatic stenting. We need more such studies from other centers to confirm that the rare event of preoperative biliary and pancreatic stenting has indeed this harmful effect on healing of postoperative pancreatic anastomosis.
Published: 2017

46. Breast Cancer Screening

Author: Mark Sibbering and John Mathew
Subjects: medicine.medical_specialty, medicine.diagnostic_test, business.industry, 03 medical and health sciences, Breast cancer screening, 0302 clinical medicine, 030220 oncology & carcinogenesis, Epidemiology of cancer, medicine, Mammography, Breast MRI, Observational study, 030212 general & internal medicine, Overdiagnosis, business, Intensive care medicine, Breast ultrasound, Genetic testing
Abstract: Mammographic screening programmes aiming to reduce breast cancer mortality through early detection and treatment have been established in many European countries. Meta-analysis of screening trials and analysis of observational studies show a significant mortality reduction from mammographic screening. This needs to be balanced against the potential harms of mammographic screening, in particular over diagnosis. Although it remains a controversial subject, the current majority opinion is that the benefits in terms of mortality reduction outweigh any potential harms. Women should be given information regarding the potential risks and benefits to be able to make a fully informed choice to attend for breast screening.
Published: 2017

47. THU0322 Descriptive study of asian indian patients with rheumatoid vasculitis in retrospect: a single, tertiary care centre experience

Author: Debashish Danda, Ruchika Goel, Ashish J. Mathew, R Janardhana, Mahasampath Gowri, S Pulikool, John Mathew, and Arvind Ganapati
Subjects: medicine.medical_specialty, Thrombocytosis, business.industry, Rheumatoid nodule, Birmingham Vasculitis Activity Score, medicine.disease, Rheumatoid arthritis, Internal medicine, Ophthalmology, Cohort, medicine, Prednisolone, Rheumatoid vasculitis, medicine.symptom, business, Vasculitis, medicine.drug
Abstract: Background Rheumatoid vasculitis (RV) is a severe extra-articular manifestation of rheumatoid arthritis (RA), with high morbidity and mortality reported in literature Objectives To describe the Asian Indian perspective on RV patients, their clinico-laboratory features and their outcome along with the factors affecting them Methods A retrospective review of electronic medical records of 8984 RA patients from January 2007 to August 2016, was done for those satisfying Scott & Bacon criteria for RV 1 . Probable RV was defined as patients not satisfying Scott & Bacon Criteria, but were managed like RV after exclusion of alternate diagnosis. Birmingham Vasculitis activity score (BVAS) version 3 2 was used for monitoring activity of RV Results 63 patients of RV were identified, with a study period prevalence of 0.7%, in our RA cohort. 33 (52.4%) patients were female. Mean age of patients was 50.7±11.5 years with median duration of RA being 6 years. Involvement of Peripheral Nervous System (PNS) was the commonest manifestation of RV in 52/63 (82.5%) patients followed by skin in 34/63 (53.9%) patients. Rheumatoid Nodule was seen in 14/ 63 (22.2%) patients. Percentage of current and ex-smokers combined,was same as rheumatoid nodule prevalence. 52 (82.5%) patients had biopsy evidence of vasculitis.26/51 (50.9%)patients were started on mycophenolate mofetil, 13/51 (25.5%)patients on cyclophosphamide, 8/51 (15.7%) patients on azathioprine, 4/51 (7.8%) patients on Methotrexate as immunosuppressive (IS) agent along with mean dose of 46.6±13.7 (0.86±0.23mg/kg/day) prednisolone. Additionally, Rituximab & IVIg were used in 2 patients each respectively. 3 months after initiation of immunosuppression 26/50 (52%) patients on follow-up were in remission and 39/47 (82.9%) patients attained remission at 6 months. Mean time to achieve remission was 151.1±86.3 days. All IS agents were equally effective in inducing remission at 3 and 6 months and showed statistically similar BVAS reduction at 3 and 6 months from baseline (t test & chi-square test). 7 (11.2%) deaths noted in the cohort at their respective last visit during 195.3 patient years cumulative follow up. Multiple regression analysis showed that at baseline, presence of PNS involvement, eosinophilia, thrombocytosis, higher BVAS score and higher steroid requirement were predictors of persistently active vasculitis and absence of eye involvement and higher hemoglobin % at baseline were predictors for remission, at 3 months (p Conclusions Our cohort of Asian Indian RV was comparitively younger with lesser RA duration, less percentage of ever-smokers, lesser rheumatoid nodule prevalence, higher PNS involvement with better survival/mortality rates compared to published literature. All IS agents showed equal rates of BVAS remission & BVAS reduction at 3 and 6 months of treatment References Scott DG, Bacon PA. Intravenous cyclophosphamide plus methylprednisolone in treatment of systemic rheumatoid vasculitis. Am J Med. 1984 Mar;76(3):377–84. Mukhtyar C, Lee R, Brown D, Carruthers D, Dasgupta B, Dubey S, et al. Modification and validation of the Birmingham Vasculitis Activity Score (version 3). Ann Rheum Dis. 2009 Dec;68(12):1827–32. Disclosure of Interest None declared
Published: 2017

48. 303 Urinary vcam 1 as a disease activity indicator in lupus nephritis

Author: S Padiyar, John Mathew, and TS Vijayakumar
Subjects: medicine.medical_specialty, Creatinine, medicine.diagnostic_test, business.industry, Urinary system, Case-control study, Lupus nephritis, medicine.disease, Gastroenterology, chemistry.chemical_compound, chemistry, Internal medicine, Immunology, medicine, Biomarker (medicine), Outpatient clinic, Renal biopsy, business, Nephritis
Abstract: Background and aims Currently we do not have a biomarker that can closely reflect the renal disease activity. So the aim of this study is to study the utility of urinary VCAM 1(Vascular cell adhesion molecule 1) in lupus nephritis. Methods It was a diagnostic case control study. The patients presenting to Rheumatology outpatient department were recruited. Patients were divided into 2 groups, SLE without active nephritis and SLE with active nephritis based on the renal SLEDAI. Urinary VCAM1 was tested in all patients using an early morning spot urine sample using ELISA. Renal biopsy was done in patients with active nephritis. VCAM1 levels were compared with the renal SLEDAI, renal biopsy disease activity (ISNRPS) and standard of care markers. The results were analysd using SPSS software version 16.The validity and predictive value statistics was presented with 95 percent confidence interval. Results Urinary VCAM 1 levels had significant correlation (p=0.01) with disease activity based on renal SLEDAI. However, the correlation between the biopsy findings and VCAM levels was not statistically significant. Class 4 and 5 lupus nephritis had higher VCAM level than the lower classes. A positive correlation (r=0.38) was found between VCAM 1 and double stranded DNA. There was a negative correlation between C3 value and VCAM (r=−0.19). The sensitivity and specificity of urinary VCAM 1 is 65.22% and 75% respectively. The cut off value of VCAM is 23.8 pg/mg of creatinine. Conclusions Urinary VCAM 1 may not independently, but combined with other markers may be a promising biomarker for disease activity in lupus nephritis.
Published: 2017

49. 62 Study of clinical utility of antibodies to phosphatidylserine/prothrombin complex in indian patients

Author: Arvind Ganapati, Debashish Danda, Ruchika Goel, Mahasampath Gowri, John Mathew, and Jayakanthan Kabeerdoss
Subjects: Lupus anticoagulant, medicine.medical_specialty, biology, business.industry, medicine.disease, Gastroenterology, Concomitant, Internal medicine, Immunology, Anti-Phospholipid Syndrome, medicine, biology.protein, In patient, Anticardiolipin antibodies, Antibody, business, PROTHROMBIN COMPLEX, Phosphatidylserine-prothrombin complex
Abstract: Background and aims To explore utility of Antibodies to Phosphatidylserine/Prothrombin Complex (aPSPT), in Indian Anti phospholipid Syndrome (APS) patients. Methods Data of 372 subjects whose sera was tested for aPSPT by ELISA (AESUKU,GERMANY), was retrospectively analysed. Performance of various APLs was compared using non-parametric tests. To ascertain additional utility of aPSPT, patients with suspected APS were categorised into 2 groups i.e. i) those with any one of criteria antibodies positive ii) those with any one APL positivity including anti- PSPT positivity. Results In 46 patients of APS, 38 (82.60%) had thrombotic events (21 arterial , 26 venous) and 11 ( 23.91%) had obstetric events. Lupus anticoagulant was present in 37/46 (80.43%) ,anticardiolipin antibody in 19/46 (41.33%), aPSPT in 17/46 (36.95%), anti-β2glycoprotein1 (β2GP1) IgG and IgM in 13/46 (28.26%) and 7/46 (15.21%) patients of APS respectively. aPSPT tested positive in 9/60 (15%) patients with seronegative APS (SNAPS). aPSPT did not differ from other criteria APLs in any clinical parameter except compared to those with IgM B2GP-1 positivity. aPSPT was numerically more sensitive and specific than IgM B2GP1 for thrombotic, non-criteria events but less sensitive for detecting obstetric events (Table 2). Inclusion of aPSPT test in patients with suspected APS increased sensitivity marginally but with concomitant decrease in specificity. Conclusions In our study, aPSPT was third most common antibody in APS patients, displaying higher sensitivity and specificity in comparison to IgM anti-β2 GP1 for all APS manifestations except obstetric ones. SNAPS patients may test positive for aPSPT, thus endorsing its inclusion in classification criteria of APS.
Published: 2017

50. Controversies in Surgery for Pancreatic Cancer

Author: Saurabh Galodha, H. Ramesh, John Mathew Manipadam, and Jacob Mathew
Subjects: Oncology, medicine.medical_specialty, business.industry, General surgery, Mortality rate, Multivisceral resection, Disease, Uncinate Process, Key issues, medicine.disease, Surgery, Pancreatic cancer, Internal medicine, medicine, Long term outcomes, business, Pancreatic head cancer
Abstract: Pancreatic cancer continues to be a life-threatening disease with poor long term outcomes despite various treatments. Progress has been slow, although results of surgery have improved, and mortality rates have fallen. Surgery is still the modality with the highest potential to cure pancreatic cancer. We examine some of the key issues relating to the treatment of pancreatic cancer, largely to the description of issues related to pancreatic head cancer.
Published: 2017

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