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1. Predictors of atrial fibrillation post coronary artery bypass graft surgery: new scoring system

Author: Bobby John, Venkat Vangaveti, Kian Lotter, Sumit Yadav, and Pankaj Saxena
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background Atrial fibrillation (AF) following coronary artery bypass graft surgery (CABG) is common and results in significant increases in hospital stay and financial encumbrance.Objective Determine and use the predictors of postoperative AF (POAF) following CABG to develop a new predictive screening tool.Method A retrospective case–control study evaluated 388 patients (98 developed POAF and 290 remained in sinus rhythm) who undertook CABG surgery at Townsville University Hospital between 2016 and 2017. The demographic profile, risk factors for AF including hypertension, age≥75 years, transient ischaemic attack or stroke, chronic obstructive pulmonary disease (HATCH) score, electrocardiography features and perioperative factors were determined.Results Patients who developed POAF were significantly older. On univariate analysis HATCH score, aortic regurgitation, increased p-wave duration and amplitude in lead II and terminal p-wave amplitude in lead V1 were associated with POAF; as were increased cardiopulmonary bypass time (103.5±33.9 vs 90.6±26.4 min, p=0.001) and increased cross clamp time. On multivariate analysis age (p=0.038), p-wave duration ≥100 ms (p=0.005), HATCH score (p=0.049) and CBP Time ≥100 min (p=0.001) were associated with POAF. Receiver operating characteristic curve demonstrated that with a cut-off of ≥2 for HATCH score, POAF could be predicted with a sensitivity of 72.8% and a specificity of 34.7%. Adding p-wave duration in lead II >100 ms and cardiopulmonary bypass time >100 min to the HATCH score increased the sensitivity to 83.7% with a specificity of 33.1%. This was termed the HATCH-PC score.Conclusion Patients with HATCH scores ≥2, and those with p-wave duration >100 ms, or cardiopulmonary bypass time >100 min were at greater risk of developing POAF following CABG.
Published: 2023
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2. 2021 Asia Pacific Heart Rhythm Society (APHRS) practice guidance on atrial fibrillation screening

Author: Ngai‐Yin Chan, Jessica Orchard, Michael‐Joseph Agbayani, Dean Boddington, Tze‐Fan Chao, Sofian Johar, Bobby John, Boyoung Joung, Saravanan Krishinan, Rungroj Krittayaphong, Sayaka Kurokawa, Chu‐Pak Lau, Toon Wei Lim, Pham Tran Linh, Vien Hoang Long, Ajay Naik, Yasuo Okumura, Tetsuo Sasano, Bernard Yan, Sunu Budhi Raharjo, Dicky Armein Hanafy, Yoga Yuniadi, Nwe Nwe, Zahid Aslam Awan, He Huang, and Ben Freedman
Subjects: atrial fibrillation, prevention, screening, stroke, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published: 2022
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3. Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Author: Md Hasanuzzaman, Mohamed Ahmed, Ahmed Samir, Charlotte Smith, Lubna Samad, Vaishnavi Govind, Fakher Rahim, Ahmed Moussa, Adesoji O Ademuyiwa, Bobby John, Augusto Zani, Vivek Singh, Muhammad Arshad, Sadaf Altaf, Chan Hon Chui, Pooja Kumari, Thomas Smith, Ayesha Saleem, Matthew HV Byrne, Madhivanan Karthigeyan, Pravin Salunke, Darica Au, Kate Cross, Kokila Lakhoo, Vishal Kumar, Anna Maria Testi, Robyn Brown, Noel Peter, Georgios Tsoulfas, Francesco Pata, Adesoji Ademuyiwa, Tahmina Banu, Bruce Bvulani, Milind Chitnis, Maryam Ghavami Adel, Vrisha Madhuri, Pierfrancesco Lapolla, Andrea Mingoli, Hamidah Alias, Simone de Campos Vieira Abib, Ibukunolu Olufemi Ogundele, Felix M Alakaloko, Emmanuel A Ameh, Laila Hessissen, Kareem O Musa, Georgios Karagiannidis, Manoj Gupta, Maricarmen Olivos, Daniel Rhee, Maryam Khan, Christine Nitschke, Alexandra Valetopoulou, Ashrarur Rahman Mitul, Sabbir Karim, Mahmoud M Saad, Francis Abantanga, Gaetano Gallo, Mohamedraed Elshami, Mahmoud Elfiky, Soham Bandyopadhyay, Muath Alser, Elliott H Taylor, Duha Jasim, Somy Charuvila, Nazmul Islam, William B Lo, Uttam Kumar Nath, Robin Simpson, Zarina Abdul Latiff, Bruno Cirillo, Gioia Brachini, Megan Murphy, Zineb Bentounsi, Anette S Jacobsen, Anna Casey, Mohammed Alhendy, Taiwo Akeem Lawal, Samson Olori, Michael Boettcher, Muhammed Elhadi, Shaun Wilson, Dragana Janić, Amit Sehrawat, Patricia Shinondo, Shireen Anne Nah, Alhassan Abdul-Mumin, Karl-Heinz Frosch, Poorvaprabha Patil, Sarah Muma, Md Asaduzzaman, Athanasios Tragiannidis, Vijayendra Kumar, Mahan Salehi, Sara Ali, Renu Madan, Hafeez Abdelhafeez, Max Pachl, Benjamin Martin, Sonal Nagras, Mihir Sheth, Catherine Dominic, Suraj Gandhi, Divya Parwani, Rhea Raj, Diella Munezero, Rohini Dutta, Nsimire Mulanga Roseline, Kellie McClafferty, Armin Nazari, Smrithi Sriram, Sai Pillarisetti, King-David Nweze, Aishwarya Ashwinee, Gul Kalra, Priyansh Nathani, Khushman Kaur Bhullar, Nehal Rahim, Shweta Madhusudanan, Joshua Erhabor, Manasi Shirke, Aishah Mughal, Sravani Royyuru, Syeda Namayah Fatima Hussain, Daniel Robinson, Mehdi Khan, Alexandre Dukundane, Kwizera Festus, Rohan Pancharatnam, Lorraine Ochieng, Hritik Nautiyal, Leanne Gentle, Ehab Hanafy, Catherine Yang, Gideon Karplus, John Mathew, Olumide Abiodun Elebute, Oluwaseun Ladipo-Ajayi, Okechukwu Hyginus Ekwunife, Sherief Ghozy, Emily Hamilton, Dhruva Ghosh, Ahmed Sherif, Hajar Moujtahid, Ariana Axiaq, Amir Labib, Eman Abdulwahed, Kemal Tolga Saracoglu, Yasin Kara, Ahmed Y Azzam, Omar Elmandouh, Manjul Tripathi, Abdelrahman Azzam, Anfel Bouderbala, Aouabed Nesrine, Ammar Ayman, Mohamed Bonna, Safia Lorabi, Hira Zuberi, Iyad Sultan, Reto M Baertschiger, Kefas John Bwala, AM Umar, Abdurahaman Aremu, Dauda E Suleiman, Tybat Aliyu, Kashaf Turk, Oluseyi Oyebode Ogunsua, Tunde Talib Sholadoye, Musliu Adetola Tolani, Yakubu Alfa, Keffi Mubarak Musa, Ken Muma, Mitchelle Obat, Youssef Sameh Badran, Abdulrahman Ghassan Qasem, Faris Ayasra, Reema Alnajjar, Mohamed Abdel-Maboud, Abdelrahman Bahaa, Ayat M Saadeldin, Mohamed Adwi, Mahmoud Adly, Abdallah Elshenawy, Amer Harky, Kirstie Wright, Jessica Luyt, Olivia White, Nathan Thompson, Imogen Harrison, Sara Kader Alsaeiti, Fatma Saleh Benkhial, Hend Mohammed Masoud, Mabroukah Saeid Alshamikh, Fatma Mohammed Masoud, Nyararai Togarepi, Elaine Carrolan, Ahmed Saleh, Mahmoud Bassiony, Mostafa Qatora, Mohamed Bahaaeldin, Shady Fadel, Yasmine El Chazli, Kamel Hamizi, Mehdi Anouar Zekkour, Rima Rahmoun, Boutheyna Drid, Salma Naje Abu Teir, Mohamed Yazid Kadir, Yassine Zerizer, Nacer Khernane, Brahim Saada, Imane Ammouze, Yahya Elkaoune, Ghita Chaoui, Hajar Benaouda, Meryem Gounni, Narjiss Aji, Joana Mafalda Monteiro, Susana Nunes, Maria do Bom-Sucesso, Kerri Becktell, Md Afruzul Alam, Orindom Shing Pulock, Tasmiah Tahera Aziz, Rosanda Ilic, Danica Grujicic, Tijana Nastasovic, Igor Lazic, Mihailo Milicevic, Vladimir Bascarevic, Radovan Mijalcic, Vuk Scepanovic, Aleksandar Stanimirovic, Aleksandra Paunovic, Ivan Bogdanovic, Shahnoor Islam, AKM Amirul Morshed, Mehnaz Akter, Zannat Ara, Mohammed Tanvir Ahammed, Tania Akter, Kamrun Nahar, Fatema Sayed, Ashfaque Nabi, Elif Akova, Evren Aydogmus, Bekir Can Kendirlioglu, Tufan Hicdonmez, Asim Noor Rana, Mohammed A Azab, Alzhraa Salah Abbas, Olanrewaju Moses, Ibiyeye Taiye Taibat, Taiwo Jones, Kalu Ukoha, Olagundoye Goke, Okorie Ikechukwu, Abiodun Idowu Okunlola, Helga Nauhaus, Danelle Erwee, Agata Chylinska, Prasanna Gomes, Elvercio Pereira de Oliveira Junior, Fabiola Leonelli Diz, Mohamed El Kassas, Usama Eldaly, Ahmed Tawheed, Mohamed Abdelwahab, Oudrhiri Mohammed Yassaad, Bechri Hajar, El Ouahabi Abdessamad, Arkha Yasser, Hessissen Laila, Farah Sameer Yahya, Maria Teresa Peña Gallardo, Jacqueline Elizabeth Montoya Vásquez, Juan Luis García León, Sebastián Shu Yip, Mariam Lami, Harmit Ghattaura, Eric W Etchill, Stacy Cooper, Kevin Crow, Morgan Drucker, Benjamin Shou, Alan Siegel, Gül Nihal Özdemir, Ehab El Refaee, John George Massoud, Ayah Bassam Ibrahim, Ruaa Bassam Ibrahim, Faris Abu Za'nouneh, Toqa Fahmawee, Ghazwani Salman, Ehab Alameer, Al-Mudeer Ali, Ghazwani Yahia, Khozairi Waleed, Khalil Ghandour, Shaima' Al-Dabaibeh, Ammar Al-Basiti, Hazim Ababneh, Omaima El-Qurneh, Yousef Alalawi, Ahmad Al Ayed, Naif Al Bolowi, Heidi Barola, Aubrey L Pagaduan, Jingdan Fan, Olufemi Oni, Janita Zarrish, Ramsha Saleem, Soha Zahid, Atiqa Amirali, Ahsan Nadeem, Sameer Saleem Tebha, Zonaira Qayyum, Sana Tahir, Anneqa Tahir, Rabbey Raza Khan, Ayesha Mehmood, Taimur Iftikhar Qureshi, Victor Calvagna, Nathalie Galea, Matthew R Schuelke, Kirk David Wyatt, Agnes Vojcek, Seham M Ragab, Abdallah R Allam, Eman Ibrahim Hager, Kıvılcım Karadeniz Cerit, Adnan Dağçınar, Tümay Umuroğlu, Ayten Saraçoğlu, Mustafa Sakar, Can Kıvrak, Gül Çakmak, Ibrahim Sallam, Gamal Amira, Mohamed Sherief, Arissa Ikeda, Licia Portela, Marianne Monteiro Garrigo, Fernanda Lobo, Sima Ester Ferman, Andrew Nwankwo Osuigwe, Chisom Adaobi Nri-Ezedi, Eric Okechukwu Umeh, Abiodun Folashade Adekanmbi, Olubunmi Motunrayo Fatungase, Olubunmi Obafemi Obadaini, Sarah Al-Furais, Humaida Hemlae, Sreylis Nay, Fabianne Altruda de Moraes Costa Carlesse, Denis Cozzi, Paolo Musiu, Paolo Sapienza, Martina Zambon, Simona Meneghini, Pierfranco Cicerchia, Abdulrahman Omar Taha, Bouaoud Souad, Mebarki Malika, Bioud Belkacem, Fayza Haider, Halwani Yaninga Fuseini, Peter Gyamfi Kwarteng, Abubakari Bawa Abdulai, Sheba Mary Pognaa Kunfah, Stephanie Ajinkpang, Mary Joan Kpiniong, Kingsley Aseye Hattor, Kingsley Appiah Bimpong, Mohamed Elbahnasawy, Sherief Abdelsalam, Amanpreet Brar, Andreea C Matei, Hira Khalid Zuberi, Kishwer Nadeem, Naema Khayyam, Fatima Ambreen Imran, Nida Zia, Sadia Muhammad, Muhammad Rafie Raza, Muhammad Rahil Khan, Alaa Hamdan, Abdeljawad Mazloum, Ali Abodest, Nisreen Ali, Ammar Omran, Alaa Ahmed, Munawar Hraib, Victor Khoury, Abdulrahman Almjersah, Mohammad Ali Deeb, Akram Ahmed, Ahmad Bouhuwaish, Alqasim Abdulkarim, Marwa Biala, Reem Ghamgh, Amani Alamre, Marwa Shelft, Hoda Tawel, Emmanuel Hatzipantelis, Eleni Tsotridou, Assimina Galli-Tsinopoulou, C-Khai Loh, Doris Lau, Kelvin Ifeanyichukwu Egbuchulem, Olakayode Olaolu Ogundoyin, Isaac Dare Olulana, Oluwasegun Joshua Afolaranmi, AbdulBasit Fehintola, Annika Heuer, Matthias Priemel, Lennart Viezens, Martin Stangenberg, Marc Dreimann, Alonja Reiter, Jasmin Meyer, Leon Köpke, Uduak Offiong, Philip Mari Mshelbwala, Fashie Andrew Patrick, Aminu Muhammed Umar, N Otene ThankGod, Yuki Julius Ng, Syukri Ahmad Zubaidi, Murad Almasri, Rasaq Olaosebikan, Akila Muthukumar, Amon Ngongola, Azad Patel, Abdullahi Nuhu-Koko, Baba Jibrin, Gabriela Guillén, Sergio López, José Andrés Molino, Pablo Velasco, Omar Hamam, Rim Elmandouh, Nensi Melissa Ruzgar, Rachel Levinson, Shashwat Kala, Sarah Ullrich, Emily Christison-Lagay, Janice Hui Ling Wong, Reto Baertschiger, Essam Elhalaby, Guido Seitz, Judith Lindbert, Asimina Galli-Tsinopoulou, Calogero Virgone, Eric Mwangi Irungu, Outani Oumaima, Lily Saldana, Jan Godzinsky, Abdelbasit Ali, Mohamed Bella Jalloh, Nellie Bell, Annette Jacobsen, Israel Fernandez Pineda, Lucas Krauel, Waha Rahama, Hazim Elfatih, Arda Isik, Andrea Hayes-Jordan, Roshni Dasgupta, Krishna Kumar Govindarajan, Marta deAndres Crespo, Nitin James Peters, Santosh Kumar Mahalik, Rajat Piplani, Enono Yhoshu, K S Rajkumar, Sadi A Abukhalaf, Mohammed Miftah Faraj Almihashhish, Eman Salem Muftah Burzeiza, Raja Mari Mohammed Nasef, Benjamin J O'Sullivan, Mohamed Hassanin, Dave R Lal, Brian T Craig, Vishal Michael, M Joseph John, William Bhatti, Swati Daniel, Jyoti Dhiman, Hunar Mahal, Atul Suroy, Shruti Kakkar, Shaina Kamboj, Suraj Singh, AKM Khairul Basher, SM Rezanur Rahman, Md Asif Iqbal, Md Masud Rana, Monica Dobs, Mohamed Atef Mohamed Ghamry, Joana Monteiro, Marco Aurelio Ciriaco Padilha, Lucas Garschagen deCarvalho, Sandip Kumar Rahul, Digamber Chaubey, Rejin Kebudi, Sema Bay Buyukkapu, Kumaravel Sambandan, Smita Kayal, Gunaseelan Karunanithi, Bikash Kumar Naredi, Bibekanand Jindal, Ranya M Baddourah, Ayah Al Shraideh, Ahmad Ozair, Ankur Bajaj, Bal Krishna Ojha, Kaushal Kishor Singh, Atique Anwar, Vinay Suresh, Mohamad K Abou Chaar, Christopher O Bode, Justina O Seyi-Olajide, George C Ihediwa, Edamisan O Temiye, Adeseye M Akinsete, Iqra Effendi, Khaled Mamdouh, Mohamed Atef, Mohamed Faried, Jake A Kloeber, Robert L Owen, Alexander S Roth, J Hudson Barnett, Lucien P Jay, Paul J Galardy, Bernard Mbwele, Irene Nguma, Moshi Moshi Shabani, Amani Twaha, Bilal Matola, Mahmoud Maher Abdelnaby Alrahawy, Simone deOliveira Coelho, Ricardo Vianna deCarvalho, FernandaFerreira daSilva Lima, Moawia Mohammed AliElhassan, Nada Osman Yousif Elhaj, Hytham KS Hamid, Vincent E Nwatah, Adewumi B Oyesakin, RM Jeffri Ismail, Simone deCamposVieira Abib, Mayara Caroline Amorim Fanelli, Fernanda Kelly Marques de Souza, Sandeep Mohindra, Ninad R Patil, Richa Jain, Gopal Nambi, Norehan Johari, Anas Shikha, Win SabaiPhyu Han, Zahidah Ahmad, Yen Yan Lim, Roserahayu Idros, Noorainun Mohd Yusof, David Nelson Jaisingh, Fatema Naser AlFayez, Elana Kleinman, Taylor Ibelli, Rochelle Fayngor, Tzvi Najman, Etai Adam, Daniella Melamed, Cecilia Paasche, Farman Ali Laghari, Zainab Al Balushi, Abdulhakim Awadh SalimAl-Rawas, Ali Al Sharqi, Ammar Saif AlShabibi, Ismail Al Bulushi, Muna Alshahri, Abdulrahman AlMirza, Ola Al Hamadani, Jawaher Al Sharqi, Anisa Al Shamsi, Bashar Dawud, Sareya Al Sibai, Gilbert B Bonsaana, Edmund M Der, Francis A Abantanga, Bardisan Gawrieh, Hassan Salloum, Mohammad Ahmad Almahmod Alkhalil, Waseem Shater, Ali Farid Alelayan, Alaa Guzlan, Asmaa AM Albanna, Dayang AnitaAbdul Aziz, Azrina Syarizad Khutubul Zaman, Biobele J Brown, Ajiboye L Olalekan, Christopher S Lukong, Ezekiel I Ajayi, Luca Pio, Nitin James Peter, Ravi Kishore, Mohammad K Abou Chaar, Dayang Anita Abdul Aziz, Dhruva Nath Ghosh, and Raphael N Vuille-dit-Bille
Subjects: Medicine (General), R5-920, Infectious and parasitic diseases, RC109-216
Abstract: Introduction Childhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.Methods Prospective cohort study in 109 institutions in 41 countries. Inclusion criteria: children
Published: 2022
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4. Digital Health Approaches for Improved Population Health Outcomes: Time for a Disease Vulnerability Matrix for Individuals and Communities?

Author: Gaurav Laroia, Cole Zanetti, Vasant Kumar Ramaswamy, Benjamin D. Horne, David C. Klonoff, and Bobby John
Subjects: disease vulnerability, population health, precision health, health behavior, health impact bonds, Medicine, Public aspects of medicine, RA1-1270, Electronic computers. Computer science, QA75.5-76.95
Published: 2021
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5. Peroneal nerve palsy due to pseudoaneurysm following total knee arthroplasty: A case presentation

Author: Jennifer Sitther Solomon, Pranay Pawar, Bobby John, and Anil Luther
Subjects: bypass surgery, popliteal artery pseudoaneurysm, total knee arthroplasty, vascular injury, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Total knee arthroplasty (TKA) is among the commonly performed orthopedic procedures with a very good safety profile. Vascular injuries following TKA are very rare and usually identified intraoperatively or in the immediate postoperative period. Popliteal artery pseudoaneurysms post-TKA are very rare, and their management can be quite challenging. We describe a case that presented more than 3 months after the index surgery with a peroneal nerve palsy due to a pseudoaneurysm.
Published: 2021
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6. Delays in hospital admissions in patients with fractures across 18 low-income and middle-income countries (INORMUS): a prospective observational study

Author: Panthea Pouramin, MSc, Chuan Silvia Li, MSc, Jason W Busse, PhD, Sheila Sprague, PhD, P J Devereaux, MD, Jagnoor Jagnoor, PhD, Rebecca Ivers, PhD, Mohit Bhandari, MD, Mohit Bhandari, PJ Devereaux, Gordon Guyatt, Brad Petrisor, Lehana Thabane, Respicious L. Boniface, Bruce Browner, Fernando de la Huerta, Rebecca Q Ivers, Theodore Miclau, III, Paul Moroz, Andrew Pollak, Gerard Slobogean, Parag Sancheti, Emil Schemitsch, Junlin Zhou, Sheila Sprague, Paula McKay, Chuan Silvia Li, Raman Mundi, Nathan O'Hara, Diane Heels-Ansdell, Lisa Buckingham, Nicole Simunovic, Jagnoor Jagnoor, Robyn Norton, Jing Zhang, Maoyi Tian, Soumyadeep Bhaumik, Samina Parveen, Saam Morshed, Madeline C. MacKechnie, Yang Liu, Yanrui Zhao, Junfei Li, Haoran Zhang, Zhentao Zhang, Wei Zhang, Tao Guo, Guang Chen, Zichao Jia, Jianzhong Yang, Lixing Kang, Peng Zhang, Haoqing Ma, Donghai Liu, Yinghua Ma, Yanguo Qin, Jincheng Wang, He Liu, Xinlong Ma, Jianxiong Ma, Haobo Jia, Shuangshuang Cui, Zhihu Zhao, Lin Fu, Hongqiang Jiang, Jianwei Lv, Sanbao Hu, Yongwei Wang, Mingyao Sun, Shuqing Tao, Baochang Qi, Ming Gao, Bo Wu, Chunsheng Zhi, Ben Xing, Jun Yang, Wenjie Dai, Duo Lu, Shisheng He, Xinyu Cai, Gejun Liu, Gang Rui, Baoshan Hu, Pingfang Shi, Hua Chen, Te Wang, Qingqing Wang, Linzhen Xie, Huanguang Xie, Tony Mutanda, Juliet Ntuulo, Flavia Lubega, Gayita Teddy Tracy, Kayondo Zaitun, Sylvester Ndayisaba, Titus Amone, Samuel Remmy Odong, Mark Lutomia, Caesar Okatch, Thomas Bitok, Alexander Kiambuthi, Fred Mathew Toboso Otsyeno, Pankaj G Jani, Vincent Muoki Mutiso, John EO Ating'a, Peter Kavoo Kilonzo, James Muoki, Makena Mbogori, Joan Wambui Wambugu, Dorothy Torutt, Christopher Odok, Elisha Ngetich, Dean Otsyeno, Juma Wakhayanga, Desmond Nzioka, Deogracia Owende, Ruth Lucinde, Brian Ngure Kariuki, Dennis Kinyua, Maureen Kamau, Maureen Mwancha, Mellany Murgor, Marilyn Nyabuti, Rita Njoki, Patricia Wanza, Abraham Odongo, Paul Marealle, Athman Wanini, Marwa Elisha, Damas Zumbulu, Pariyo Bonane Godfrey, Benjamin Mukulu Ndeleva, Murila Johnson, Moses Kimani, Kinuthia Gichui, Rogers Joachin Temu, Angela Neofitus Mselle, Ancelimu Rafael Kimario, Mmampapatla Thomas Ramokgopa, Gregory Firth, Anna Grisillo Biscardi, Machuene Ananias Poopedi, Johan Moolman, Brenda Milner, Matimba Maluleke, Maxwell Jingo, Susan van Deventer, Timothy Pikor, Ravi Bhaga, Michael Mara, Geoffrey Chege Mwangi, Anthony Muchiri Maina, David Wamae Gicheru, Carol Mwangi, Isaac Kingori Wangai, Peter Watson Maina, Ezra Mitei Kiptoo, Olufemi Olukemi Temiloluwa, Adeyeye Adeolu Ikechukwu, Ige Oluwole Olugbenga, Ojodu Ishaq Bamidele, Oladimeji Oladipupo Akanbi, Panchu Subramanian, Olivia L Mosweu, Samuel Hailu, Geletaw Tessema, Bahiru Bezabih, Birhanu Ayana, Hiwot Hailu, Betelhem Zewdneh, Hana Tesfaye, Sosena Tadesse, Dominic Konadu-Yeboah, Vincent Ativor, Peter Konadu, Dominic Awariyah, Raphael Quartey, Raphael Kumah-Ametepey, Osman Saani, Robert Ekow Quansah, Paa Kwesi Baidoo, Peter Trafton, David Anyitey-Korkor, Michael Leat, Johnny Sobotie, Godwin Opuni, Kwasi Kusi, Twimasi Baah, Paul Okyere, Bernice Mensah, Doris Akuoko Sarpong, Felicia Agbenorwu, Phyllis Osei-Donkor, Priscilla Opoku, Michael Segbefia, Gerald Chukwuemeka Oguzie, Emmanuel Chino Iyidobi, Cajetan Uwatoronye Nwadinigwe, Sharon Amarachi Uloma Oguzie, Emina Bami Kesiena, Henry Tanyi Ndasi, Nietiayurk Aminake Ghislain, Mala Irine Shey, Ikose John Nanje, Ashok Shyam, Madhav Borate, Sampat Dumbre Patil, Sachin Karkamakar, Shailesh Patil, Abhijeet Ranaware, Shadab Tamboli, Manish Gandhalikar, Rohini Tupe, Vishal Chaudhari, Avanti Joshi, Sanjay Patil, Mohit Madhukar Dalwekar, Tejas Gandhi, Chintamani Latkar, Gopal Pundkare, Sandeep Shrivastava, Pradeep K Singh, Sanjay Deshpande, Sumit Baheti, Ravi Mittal, Vijay Sharma, Vinoo Mathew Cherian, Thilak Samuel Jepegnanam, Vijay T K Titus, Manasseh Nithyananth, Palapattu R J V C Boopalan, Viju Daniel Varghese, Justin Arockiaraj, Anupam Mahajan, Bobby John, Ritesh Pandey, Jeewan S Prakash, Valsamma Abraham, Arti Rajkumar, Harvinder Singh Chhabra, Rajesh Sharawat, Ritabh Kumar, Pushkar Chawla, Rashmi Yadav, Rajagopalan N Iyer, Naveen Nair, Rajkumar S Amaravathi, Srinivasalu Santhanagopa, Anoop Pilar, Keith Behram Tamboowala, Mandeep S Dhillon, Sarvdeep S Dhatt, Asolie Chase, Neel M Bhavsar, Rameez Musa, Darshan Shah, Sunil Chodavadiyah, Pankaj G Patel, Raja Irfan Qadir, Syed Imran Bukhari, Khushnood Ali Baz, Subin Byanjankar, Ruban Raj Joshi, Rajeev Dwivedi, Jay Raj Sharma, La Ngoc Quang, Nguyen Duc Chinh, Vu Bao Hong, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Wanjak Pongsamakthai, Irewin Alagar Tabu, Paula Veronica Reyes, Iardinne Caiquep, Joni Mitchell Robles Bituin, Jenna González, Mohammadreza Golbakhsh, Mashyaneh Haddadi, Soheil Saadat, Mohammadreza Zafarghandi, Clotilde Fuentes Orozco, José de Jesús Martínez Ruíz, Gustavo Armando Tafoya Arreguin, César Eduardo Pinedo Flores, Irydia Guadalupe Pellegrini Verduzco, Miguel Oscar Hernandez Camacho, Diego Abraham Estrada Téllez, Rodrigo Salcedo López, Ileana Guadalupe Canales Navarro, Mizael Dennis Pérez, Daniel de Jesús Enciso Carrillo, Paola Alejandra Álvarez López, Adán Cervantes Gómez, Fátima Nohemí Franco Bravo, Eugenia de los Ángeles Reyes Arias, Igor A. Escalante Elguezabal, Ennio Antonio Rizzo, Jean Michel Hovsepian, Victor Rodriguez, Manuel Malaret Baldo, Andres Serrano, Carlos G. Sanchez Valenciano, Edgar Efren Mercado Salcedo, Fryda Medina, Fernando Bidolegui, Sebastian Pereira, Gerardo Aguilar, Jorge Rubio-Avila, William Dias Belangero, José Ricardo Lenzi Mariolani, Bruno Livani, André Lugnani, Felipe Rossi, Angela Katayama, Fernando Baldy, Vinícius Ynoe de Moraes, Fabricio Fogagnolo, Kodi Edson Kojima, Jorge dos Santos Silva, Marco Kawamura Demange, Fernando Brandão de Andrade-Silva, Adriana Carvalho Gomes da Silva, Nelson Elias, Dino Aguilar Martinez, Fernando Contreras, Mario Garuz, Jose Eduardo Quintero, Gavino Merchan, Christian M. Lozano Lurita, Aturo D. Torres Manrique, Jorge Hurtado Fernandez, Sergio Iriarte Vincenti, Alfredo Pozzo Bobarin, Dalton Salinas Sanchez, Julio Segovia Altieri, Diego Almada, Derlis Bogado, Carlos Coronel, Cristian Boveda, Victor del Valle, Carlos Montiel, Nelson Marin, Antonio Barquet, Daniel Rienzi, Carlos Amanquez, Georges Beauvoir, Iván J Salce Cutipa, José Eduardo Grandi Ribeiro, José María Jiménez Avila, Luis Padilla, Hernando Cuevas Ochoa, Hernando Cuevas Cano, Adriana Vaca González, Nubia Itzel Gonzalez Gutierrez, and Victor Espinola
Subjects: Public aspects of medicine, RA1-1270
Abstract: Summary: Background: The Lancet Commission on Global Surgery established the Three Delays framework, categorising delays in accessing timely surgical care into delays in seeking care (First Delay), reaching care (Second Delay), and receiving care (Third Delay). Globally, knowledge gaps regarding delays for fracture care, and the lack of large prospective studies informed the rationale for our international observational study. We investigated delays in hospital admission as a surrogate for accessing timely fracture care and explored factors associated with delayed hospital admission. Methods: In this prospective observational substudy of the ongoing International Orthopaedic Multicenter Study in Fracture Care (INORMUS), we enrolled patients with fracture across 49 hospitals in 18 low-income and middle-income countries, categorised into the regions of China, Africa, India, south and east Asia, and Latin America. Eligible patients were aged 18 years or older and had been admitted to a hospital within 3 months of sustaining an orthopaedic trauma. We collected demographic injury data and time to hospital admission. Our primary outcome was the number of patients with open and closed fractures who were delayed in their admission to a treating hospital. Delays for patients with open fractures were defined as being more than 2 h from the time of injury (in accordance with the Lancet Commission on Global Surgery) and for those with closed fractures as being a delay of more than 24 h. Secondary outcomes were reasons for delay for all patients with either open or closed fractures who were delayed for more than 24 h. We did logistic regression analyses to identify risk factors of delays of more than 2 h in patients with open fractures and delays of more than 24 h in patients with closed fractures. Logistic regressions were adjusted for region, age, employment, urban living, health insurance, interfacility referral, method of transportation, number of fractures, mechanism of injury, and fracture location. We further calculated adjusted relative risk (RR) from adjusted odds ratios, adjusted for the same variables. This study was registered with ClinicalTrials.gov, NCT02150980, and is ongoing. Findings: Between April 3, 2014, and May 10, 2019, we enrolled 31 255 patients with fractures, with a median age of 45 years (IQR 31–62), of whom 19 937 (63·8%) were men, and 14 524 (46·5%) had lower limb fractures, making them the most common fractures. Of 5256 patients with open fractures, 3778 (71·9%) were not admitted to hospital within 2 h. Of 25 999 patients with closed fractures, 7141 (27·5%) were delayed by more than 24 h. Of all regions, Latin America had the greatest proportions of patients with delays (173 [88·7%] of 195 patients with open fractures; 426 [44·7%] of 952 with closed fractures). Among patients delayed by more than 24 h, the most common reason for delays were interfacility referrals (3755 [47·7%] of 7875) and Third Delays (cumulatively interfacility referral and delay in emergency department: 3974 [50·5%]), while Second Delays (delays in reaching care) were the least common (423 [5·4%]). Compared with other methods of transportation (eg, walking, rickshaw), ambulances led to delay in transporting patients with open fractures to a treating hospital (adjusted RR 0·66, 99% CI 0·46–0·93). Compared with patients with closed lower limb fractures, patients with closed spine (adjusted RR 2·47, 99% CI 2·17–2·81) and pelvic (1·35, 1·10–1·66) fractures were most likely to have delays of more than 24 h before admission to hospital. Interpretation: In low-income and middle-income countries, timely hospital admission remains largely inaccessible, especially among patients with open fractures. Reducing hospital-based delays in receiving care, and, in particular, improving interfacility referral systems are the most substantial tools for reducing delays in admissions to hospital. Funding: National Health and Medical Research Council of Australia, Canadian Institutes of Health Research, McMaster Surgical Associates, and Hamilton Health Sciences.
Published: 2020
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7. Three-dimensional echocardiography with left ventricular strain analyses helps earlier prediction of right ventricular pacing-induced cardiomyopathy

Author: N.M. Sharath Babu, Sirish C. Srinath, Anandaroop Lahiri, David Chase, Bobby John, and John Roshan
Subjects: Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background and objectives: Right ventricular (RV) pacing can lead to progressive ventricular dysfunction over a certain period. This pacemaker-induced cardiomyopathy (PiCMP) may be more common than previously reported. Speckle tracking imaging is a recent development in echocardiography that can identify left ventricular (LV) dysfunction even before the LV ejection fraction (LVEF) value decreases. Three-dimensional (3D) echocardiography has made more accurate assessment of LVEF possible. The objectives of this study are to study the incidence of RV PiCMP using 3D echocardiography and LV strain analysis over a follow-up of 6 months, and to identify its predictors. Methods: This is an observational study of consecutive patients without structural heart disease and with a baseline EF of more than 45% who received a permanent pacemaker. They were observed over a 6-month period. PiCMP was defined as a decrease in LVEF by 10 percentage points or a decrease in LV strain by 15% from baseline in the absence of other known causes of cardiomyopathy. PiCMP incidence and its associations were analyzed over a 6-month period. Results: The incidence of PiCMP was not only significant over a period of 6 months but also at 24 hours. Significant drops in 3D EF were noted in one (2.8%) patient at 24 hours and in another four (11.1%) patients at 6 months. A significant decrease in LV global longitudinal strain was noted in 23 (63.9%) patients by 6 months. In seven of these patients, there was significant decrease in global longitudinal strain 24 hours after implantation. In analyzing longitudinal strain, the parameter significantly influencing a decrease was a pacing percentage of ≥20% (p = 0.023). Conclusions: PiCMP is not uncommon in patients undergoing pacemaker implantation and is associated with RV pacing. PiCMP was associated with a ventricular pacing percentage of ≥20%. 3D echocardiography with LV strain analysis plays a vital role in identifying LV dysfunction at an earlier stage compared to EF. PiCMP, if picked up and intervened upon early, can help impede its progression. Keywords: Ejection fraction, Incidence, Pacing induced cardiomyopathy, Predictors, Three-dimensional echocardiography
Published: 2018
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8. Influence of ethnic background on left atrial markers of inflammation, endothelial function and tissue remodelling

Author: Carlee D. Ruediger, Bobby John, Sathesh Kumar, Han S. Lim, Geetanjali Rangnekar, Kurt C. Roberts-Thomson, Glenn D. Young, David Chase, Prashanthan Sanders, and Scott R. Willoughby
Subjects: Supraventricular tachycardia, Thrombogenesis, Ethnicity, Endothelial function, Inflammation, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Background: It has been suggested that ethnicity can make a significant difference to the likelihood of thromboembolic stroke related to atrial fibrillation. Ethnic differences have been shown to alter inflammatory and haemostatic factors; however, this may all be confounded by differences in cardiovascular risk factors between different ethnicity. The impact of different ethnicities on the thrombogenic profile is not known. The aim of this study was to investigate differences in markers of inflammation, endothelial function and tissue remodelling between Caucasian and Indian populations with supraventricular tachycardia (SVT). Methods: Patients with structurally normal hearts undergoing catheter ablation for SVT were studied. This study included 23 Australian (Caucasian) patients from the Royal Adelaide Hospital, Adelaide, Australia and 24 Indian (Indian) patients from the Christian Medical College, Vellore, India. Blood samples were collected from the femoral vein, and right and left atria. Blood samples were analysed for the markers of endothelial function (ADMA, ET-1), inflammation (CD40L, VCAM-1, ICAM-1), and tissue remodelling (MMP-9, TIMP-1) using ELISA. Results: The study populations were well matched for cardiovascular risk factors and the absence of structural heart disease. No difference in the echocardiographic measurements between the two ethnicities was found. In this context, there was no difference in markers of inflammation, endothelial function or tissue remodelling between the two SVT populations. Conclusion: Caucasian and Indian populations demonstrate similar inflammatory, endothelial function or tissue remodelling profiles. This study suggests a lack of an impact of different ethnicity in these populations in terms of thrombogenic risk.
Published: 2018
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9. Brucellar spondylodiscitis mimicking tuberculosis

Author: Eshani Dewan, Aroma Oberoi, Bobby John, Anuniti Mathias, and Dilip Abraham
Subjects: Automated blood culture system, BD BACTEC Blood Culture System, Brucella suis, brucellosis, spondylodiscitis, zoonosis, Medicine, Nursing, RT1-120
Abstract: Brucellosis is primarily a disease of domestic and wild animals that can be transmitted to humans (zoonosis). Infection with Brucella spp. continues to pose human health risk globally. Brucellosis in endemic and nonendemic regions remains a diagnostic puzzle due to misleading nonspecific manifestations and increasing unusual presentations. It may affect any organ of the body with clinical manifestations that include fever, joint pains, loss of weight, sweating, cough, sciatica, splenic enlargement, liver enlargement, orchitis, etc. Fewer than 10% of human cases of brucellosis may be clinically recognized and treated or reported. Routine serological surveillance is not practiced even in Brucella endemic countries. Whereas, this should be a part of laboratory testing coupled with a high index of clinical suspicion to improve the level of case detection. Rapid and reliable, sensitive and specific, easy to perform and semi-automated detection systems for Brucella spp. are urgently needed to allow early diagnosis and adequate antibiotic therapy in time to decrease morbidity and mortality.
Published: 2015
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10. Percutaneous Achilles Tenotomy with a Large Gauge Needle in Ponseti Management of CTEV: A Modified Technique

Author: RITESH ARVIND PANDEY and BOBBY JOHN
Subjects: clubfoot, equinus, tendo achilles, Medicine
Abstract: Introduction: Tenotomy of tendo achilles for clubfoot deformity is routinely done percutaneously with a surgical blade. This method though safe and effective, carries risk of complications such as excessive bleeding and injury to nearby neurovascular structures. Alternatively, sectioning of achilles tendon can be done safely by a large gauge needle percutaneously. Aim: To study the safety and effectiveness of the modified technique. Materials and Methods: A total of 37 children with 51 congenital clubfoot were included in this observational study. After successful correction of forefoot adduction and heel varus using the Ponseti technique, tendo achilles was sectioned percutaneously with a 16/18 gauge needle. Any complication occurring during the procedure was noted. Completeness of the tenotomy was checked by Thompson’s test and gain in passive dorsiflexion at ankle. Results: Complete division of tendon was achieved in all 51 feet. No incidence of excessive bleeding, neurovascular injury or formation of pseudoaneurysm was found. However, minor bleeding from the surgical site was noticed in three cases and was managed by applying mild pressure over the involved area. Conclusion: Percutaneous tenotomy of tendo achilles with a wide gauge needle is simple, safe and effective technique. It causes less morbidity and carries lesser risk of complications when compared to a surgical blade.
Published: 2017
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11. A Comparison of the Clinico-Radiological Outcomes with Proximal Femoral Nail (PFN) and Proximal Femoral Nail Antirotation (PFNA) in Fixation of Unstable Intertrochanteric Fractures

Author: Anirudh Sharma, Anupam Mahajan, and Bobby John
Subjects: cephalomedullary nails, osteoporosis, singh’s index, Medicine
Abstract: Introduction: Management of unstable intertrochanteric fractures poses challenges in terms of obtaining stable fixation and good postoperative outcomes. There is a paucity of clinical data comparing the commonly used Proximal Femoral Nail (PFN) and Proximal Femoral Nail Antirotation (PFNA) implants, especially in relation to osteoporosis. Aim: To assess comparative performance of PFN and PFNA in the setting of osteoporosis. Materials and Methods: Patients presenting with unstable intertrochanteric fractures (AO 31.A2 and 31.A3) were included and treated with either PFN or PFNA. Preoperative radiographs of normal side were used to grade osteoporosis by Singh’s index. Grade 3 or less was considered significant. Postoperative radiographs were assessed for tip-apex distance, Cleveland index and quality of reduction. Patients were followed up for a minimum of nine months and any complications noted. Comparison of functional outcomes was done using the Harris Hip Score and Parker-Palmer mobility score at final follow up. Statistical analysis was done using the unpaired t-test/MannWhitney U test and Chi-square test/Fisher’s-exact test. A p-value of < 0.05 was considered significant. Results: The study included 48 patients with unstable intertrochanteric fractures, of which 23 were treated with PFN and 25 with PFNA. Average age of PFN group was 60.78 years and of PFNA group was 74.12 years. In PFN group 8 patients (38.09%) and in PFNA group 13 patients (54.1%) had Singh’s osteoporotic index of ≤ 3. The average Harris Hip Score was 75.37 and 78.85 in PFN and PFNA groups (p=0.54) respectively. From PFN and PFNA groups, 35% and 32% patients respectively were able to return to pre-injury mobility status as assessed by the Parker-Palmer mobility score (p=0.83). Out of eight implant related complications; seven were in patients treated with PFN (p=0.02). Among patients with Singh’s grade ≤ 3, 3 (37.5%) in PFN group suffered from implant failure whereas all 13 patients in PFNA group had successful outcome (p=0.04). Conclusion: Although functional outcomes achieved with both implants are similar (p=0.83), number of implant related complications were fewer with PFNA (p=0.02), even in osteoporotic group (p=0.04). We recommend use of the PFNA in unstable fractures, especially in the elderly osteoporotic population.
Published: 2017
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12. Fatal delayed hemodynamic depression after carotid artery stenting

Author: George Joseph, Varsha Kiron, and Bobby John
Subjects: Carotid stenosis, Stents, Left ventricular dysfunction, Cardiac conduction defect, Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Abstract: Refractory and fatal hemodynamic depression remarkably occurred eight hours after left carotid artery stenting in a 62-year-old male who had no hemodynamic instability till then; possible contributory factors were pre-existing moderate left ventricular systolic dysfunction and new-onset complete heart block caused by vasopressor-induced sympathetic stimulation in the presence of covert distal conduction system disease.
Published: 2014
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13. T peak – T end interval: Marker for arrhythmic events at 30 days following ST elevation myocardial infarction

Author: Subrangshu Dey, John Roshan Jacob, and Bobby John
Subjects: Surgery, RD1-811, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published: 2014
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14. Response to 'Anatomic Twist to a Straightforward Ablation'

Author: David Chase, A. Devi, and Bobby John
Subjects: Ablation, Anatomic Twist, Diseases of the circulatory (Cardiovascular) system, RC666-701
Published: 2013
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15. Embedded Foreign Bodies in the Maxillofacial Region: Our Experience

Author: Joshna, E. K., Poorna, T. Anish, Bobby, John, and Mohan, S.
Published: 2022
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16. Infralingular Versus Supralingular Medial Osteotomy in Sagittal Split Osteotomy of the Mandible: A Randomized Control Study

Author: Bobby John, Anish Poorna T, Joshna E K, George Philip, and Arivarasan Bharathi
Subjects: Otorhinolaryngology, Surgery, Oral Surgery
Abstract: A recently proposed modification of the sagittal split osteotomy (SSO) of the mandible places the horizontal medial cut 'low and short' of the lingula. The purpose of the study was to answer the following clinical question: "Among patients undergoing mandibular setback procedures (≤ 8 mm) via SSO, does the placement of the medial horizontal osteotomy below the lingula (infralingular), when compared to placement above the lingula (supralingular), results in different neurosensory, bite force, and range of motion outcomes?"This was a single-center, double-blind, parallel-group study among patients undergoing mandibular setback by SSO (≤ 8 mm), between January 2021 and September 2022. Patients were randomly allocated in a ratio of 1:1 to the supralingular (control) and the infralingular (study) group. Primary outcome variables included neurosensory disturbance of the inferior alveolar nerve based on clinical neurosensory testing and severity graded using Zuniga and Essick's protocol, bite force, and maximum mouth opening evaluated postoperatively during the first week (T1), first month (T2), and third month (T3) of follow-up. Secondary outcome measures included the incidence of a bad split and distal segment interferences intraoperatively. Association between the variables was assessed using Pearson chi-squared test or Fisher's exact test based on the expected observations. A P value of ≤.05 was considered statistically significant.A total of 29 patients (58 osteotomies) were included in the study. Group 1 consisted of 15 patients (9 females and 6 males) with a mean age of 26.4 years. Group 2 consisted of 14 patients (8 females and 6 males) with a mean age of 25.9 years. Patients with severe neurosensory disturbance of the inferior alveolar nerve were more common in group 2 (n = 15, 53.6%) than group 1 (n = 4, 13.3%) at T1 (P value = .0001) and insignificant between the two groups at T2 (P value = .63) and T3 (P value = .99). Comparison of maximum mouth opening between the two groups at T1 (P value = .535), T2 (P value = .934), and T3 (P value = .703) and bite force at T1 (P = .324), T2 (P = .113), and T3 (P = .811) was not significant.Both SSO techniques have similar clinical outcomes among patients having mandibular setbacks (≤ 8 mm) for the variables studied.
Published: 2023
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17. Extracranial schwannoma of the maxillary nerve misdiagnosed as trigeminal neuralgia in an elderly patient with schizophrenia – A diagnostic dilemma

Author: Anish Poorna T, Lokesh JR, Joshna EK, Bobby John, Neethu S, and Shankar S
Subjects: General Dentistry
Published: 2022
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18. Role of Iodoform in jaw lesions - A systematic review

Author: Ramya Arangaraju, Ragavi Alagarsamy, Ajoy Roychoudhury, Babu Lal, Ongkila Bhutia, and Bobby John
Subjects: Otorhinolaryngology, Surgery, Oral Surgery
Published: 2023
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19. Comparison of the effectiveness of soft and hard splints in the symptomatic management of temporomandibular joint disorders: A randomized control study

Author: Anish Poorna T, Bobby John, Joshna E K, and Arun Rao
Subjects: Male, Treatment Outcome, Splints, Rheumatology, Humans, Female, Occlusal Splints, Temporomandibular Joint Disorders
Abstract: Splint therapy is a well-established modality in the management of temporomandibular joint disorders (TMDs). We aimed to evaluate and compare the effectiveness of hard and soft splints in the symptomatic management of TMDs using the modified Helkimo index.This study included 91 patients diagnosed with TMDs. Participants were randomly allocated into two treatment groups. All these patients were treated by hard or soft stabilization splint therapy. Group 1: hard splint group, n = 42 (mean age - 31.62 ± 8.5 years), 10 males and 32 females; group 2: soft splint group, n = 49 (mean age - 32.86 ± 9.06 years), 13 males and 36 females. The anamnestic and clinical dysfunction component of the modified Helkimo index was used to evaluate the outcomes at baseline (TSymptoms such as clicking of the joints, temporomandibular joint (TMJ) pain and muscle pain showed improvement in both groups (P .05). Restriction and deviation of mouth opening did not show significant improvement in either group. The patients who underwent hard splint therapy showed an early improvement of symptoms at TBoth hard and soft stabilization splints were effective in the symptomatic management of TMDs. However, hard splints provide an earlier reduction of symptoms.
Published: 2022
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20. Clinico-Radiological and Functional Outcome of Difficult Talipes Equinovarus Deformity Corrected With an Ilizarov Fixator

Author: Himani Khatter, Ritesh Arvind Pandey, Amit Sharma, Rajesh Paul, Bobby John, and Rajit John Cherian
Subjects: medicine.medical_specialty, Adolescent, business.industry, Deformity correction, Soft tissue, Ilizarov Technique, Recovery of Function, Surgery, Radiography, Conservative treatment, Clubfoot, Treatment Outcome, Child, Preschool, Radiological weapon, medicine, Deformity, Humans, Orthopedics and Sports Medicine, Serial casting, Congenital talipes equinovarus, medicine.symptom, Child, business, Talipes equinovarus
Abstract: Relapsed, resistant and untreated congenital talipes equinovarus poses significant challenges in view of functional outcome following conventional serial casting and soft tissue release procedures. The Ilizarov ring fixator here offers significant possibilities as an extended conservative treatment modality. The aim of the present study was to critically evaluate effectiveness of the Ilizarov ring fixator with regard to radiological, clinical and functional outcome, in the difficult clubfeet. The study was carried out on patients presenting with relapsed, resistant or untreated congenital talipes equinovarus deformity, who underwent deformity correction using the Ilizarov ring fixator application. All patients were reviewed at 6 monthly intervals for over 3 years following fixator removal with an objective clinical, radiological and functional assessment. Twenty-three patients with 30 clubfeet were enrolled in our study. The mean age was 8.3 +/- 3.6 (range 4 to 17) years. The postoperative clinical, radiological and functional scores showed statistically significant improvement among all patients when compared with the pre-operative data. All 30 feet developed varying complications during treatment with pin track infections being the most common. However, they were managed while continuing the distraction correction process. The Ilizarov ring fixator is an effective and reliable solution for difficult and challenging clubfeet. However, one must be aware of a strict adherence to a bracing protocol to avoid recurrence of deformities. A regular periodical functional and clinical follow up must be ensured among these children for a favourable outcome. Level of clinical evidence: 3
Published: 2022
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21. Gorlin Cyst of Maxilla: A Rare Case Report

Author: Joshna E. K., Anish Poorna T., Ramya A., and Bobby John
Subjects: stomatognathic diseases, parasitic diseases
Abstract: Calcifying odontogenic cyst was first described by Gorlin, so the name, Gorlin cyst. Calcifying Odontogenic Cyst (COC) is rare in occurrence and usually asymptomatic in nature. It is an uncommon benign odontogenic neoplasm which may show characteristics of both a cyst and solid neoplasm. Its clinical and radiographic features may mimic other odontogenic cysts or tumors, and a definitive diagnosis can only be arrived on histological examination. We report a classic case of calcifying odontogenic cyst in a 50 year old patient.
Published: 2022
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22. Post-traumatic Actinomycotic Oro-antral Fistula Closure with Three-dimensional Stereolithographic Modeling and Patient-Specific Titanium Implant

Author: P. G. Antony, Bobby John, Joshna Ek, T. Anish Poorna, and J. R. Lokesh
Subjects: Titanium implant, business.industry, Fistula, technology, industry, and agriculture, Dentistry, Oro antral fistula, Left posterior, Patient specific, medicine.disease, Otorhinolaryngology, Maxilla, medicine, Head and neck surgery, Surgery, business
Abstract: We report an interesting case of a post-traumatic actinomycotic oro-antral fistula of the left posterior maxilla, that was not salvageable via local flaps due to the size of the defect and was managed with the patient-specific titanium implant, fabricated by three-dimensional stereolithographic model planning followed by primary closure.
Published: 2021
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23. Optimal Depth of Penetration to Access the Superior Joint Space in Temporomandibular Joint Arthroscopy: A Single Institutional Retrospective Study

Author: Bobby John, T. Anish Poorna, and E. K. Joshna
Subjects: Otorhinolaryngology, Surgery, Oral Surgery
Published: 2022
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24. Caseous calcification of the mitral annulus presenting with symptomatic complete heart block

Author: Bobby John, Nita Danda, and Benjamin Thomas
Subjects: medicine.medical_specialty, Mitral annular calcification, medicine.diagnostic_test, business.industry, Heart block, Infrahisian block, Case Report, Caseous calcification of the mitral annulus, medicine.disease, Cardiac magnetic resonance imaging, Internal medicine, His bundle pacing, medicine, Cardiology, Complete heart block, Mitral annulus, Cardiology and Cardiovascular Medicine, business, Calcification
Published: 2021

25. Retrieval of Migrated Embedded Sewing Machine Needle from the Tongue

Author: T. Anish Poorna, Kavya Chandra, E. K. Joshna, and Bobby John
Subjects: Otorhinolaryngology, Surgery
Published: 2022
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26. Editorial

Author: Bobby John and Ullah Khan Amir
Published: 2021
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27. Current controversies in management of fracture neck femur in children: A review

Author: Bobby John and Ritesh Arvind Pandey
Subjects: 030222 orthopedics, medicine.medical_specialty, Premature Closure, business.industry, Nonunion, Coxa vara, Guideline, Fracture neck femur, medicine.disease, 03 medical and health sciences, Femoral head, 0302 clinical medicine, medicine.anatomical_structure, Inclusion and exclusion criteria, medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, medicine.symptom, Intensive care medicine, business, Physis, PAEDIATRIC ORTHOPAEDICS
Abstract: Paediatric femur neck fracture is an uncommon injury and is known for high rate of complications. This in turn, can have significant impact on development of hip and overall function of the child. Controversy prevails in many areas of management and it still remains a difficult injury to manage. Through this paper, an attempt has been made to summarize the current concepts in management and suggest current recommendations regarding the controversies so that these injuries can be managed judiciously. A systematic review was done as per PRISMA guidelines using pre-defined inclusion and exclusion criteria. 18 studies with better scientific evidence after quality assessment were included in the systematic review. Current trends and Controversial issues in management were then identified and discussed. It was observed that existing literature is inconclusive regarding several aspects of management of this injury with no clear guideline available. However, certain recommendations useful for decision making could be made. These injuries should be managed aggressively with operative fixation at the earliest and one should not hesitate to open reduce if acceptable alignment is not obtained after one or two gentle closed manipulations. Choice of implant and their configuration in neck can vary depending on age and weight of patient, type of injury and surgeon’s preference. Initial fracture displacement could be considered to be most predictive for development of osteonecrosis of the femoral head, whereas, role of surgical decompression, type of fixation and timing of surgery is still debatable. Functional outcome is primarily affected by osteonecrosis of the femoral head, nonunion and severe coxa vara, whereas mild coxa vara, shortening, and premature closure of physis when considered alone, don’t have significant influence on functional outcome in short term. Treatment of fracture neck femur in children is still controversial in many aspects and needs further research. It should be understood that complications can occur regardless of the method of treatment and might reveal their full impact many years after injury. Hence, a guarded prognosis should be explained to the parents and care-givers at the time of injury.
Published: 2020
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28. Complications of arthroscopic lysis and lavage in internal derangement of the temporomandibular joint - A single institutional experience with review of literature

Author: Anish Poorna T, Joshna EK, Bobby John, Antony PG, Mohan S, and Abin Ann Abraham
Subjects: Male, Arthroscopy, Otorhinolaryngology, Temporomandibular Joint, Joint Dislocations, Humans, Surgery, Female, Oral Surgery, Temporomandibular Joint Disorders, Therapeutic Irrigation, Retrospective Studies
Abstract: To evaluate the complications of arthroscopic lysis and lavage with joint sweep (ALL) procedure in the management of disc derangement of the temporomandibular joint.Patients with internal derangement of the TMJ who were treated by ALL in a tertiary institution from July 2018 to December 2021 were studied retrospectively.The study included 39 patients (males, n = 14; females, n = 25) and 50 joints. The complications observed in the study were classified into intra and post operative complications. Post operative complications such as pain (16%), swelling (6%), reduced mouth opening (22%) and neurological complications were the most commonly observed ones. Rare complications such as ipsilateral palatal swelling (6%), parapharyngeal swelling (4%), and post operative malocclusion (2%) were also observed.Although the complications of ALL are entirely unavoidable, their incidence can be reduced by strict adherence to standard techniques. Three-dimensional awareness and orientation of the dangerous angles and depth around the TMJ region is mandatory to reduce the complications.
Published: 2022

29. Twelve-month observational study of children with cancer in 41 countries during the COVID-19 pandemic

Author: Soham, Bandyopadhyay, Noel, Peter, Kokila, Lakhoo, Simone de Campos Vieira Abib, Hafeez, Abdelhafeez, Shaun, Wilson, Max, Pachl, Benjamin, Martin, Sonal, Nagras, Mihir, Sheth, Catherine, Dominic, Suraj, Gandhi, Divya, Parwani, Rhea, Raj, Diella, Munezero, Rohini, Dutta, Nsimire Mulanga Roseline, Kellie, Mcclafferty, Armin, Nazari, Smrithi, Sriram, Sai, Pillarisetti, King-David, Nweze, Aishwarya, Ashwinee, Gul, Kalra, Poorvaprabha, Patil, Priyansh, Nathani, Khushman Kaur Bhullar, Muhammed, Elhadi, Maryam, Khan, Nehal, Rahim, Shweta, Madhusudanan, Joshua, Erhabor, Manasi, Shirke, Aishah, Mughal, Darica, Au, Mahan, Salehi, Sravani, Royyuru, Mohamed, Ahmed, Syeda Namayah Fatima Hussain, Daniel, Robinson, Anna, Casey, Mehdi, Khan, Alexandre, Dukundane, Kwizera, Festus, Vaishnavi, Govind, Rohan, Pancharatnam, Lorraine, Ochieng, Elliott, H Taylor, Hritik, Nautiyal, Marta deAndres Crespo, Somy, Charuvila, Alexandra, Valetopoulou, Amanpreet, Brar, Hira, Zuberi, Imane, Ammouze, Dhruva, Ghosh, Nitin James Peters, Kefas John Bwala, M Umar, A, Abdurahaman, Aremu, Dauda, E Suleiman, Tybat, Aliyu, Ayesha, Saleem, Muhammad, Arshad, Kashaf, Turk, Sadaf, Altaf, Oluseyi Oyebode Ogunsua, Tunde Talib Sholadoye, Musliu Adetola Tolani, Yakubu, Alfa, Keffi Mubarak Musa, Eric Mwangi Irungu, Ken, Muma, Sarah, Muma, Mitchelle, Obat, Youssef Sameh Badran, Abdulrahman Ghassan Qasem, Faris, Ayasra, Reema, Alnajjar, Mohamed, Abdel-Maboud, Abdelrahman, Bahaa, Ayat, M Saadeldin, Mohamed, Adwi, Mahmoud, Adly, Abdallah, Elshenawy, Amer, Harky, Leanne, Gentle, Kirstie, Wright, Jessica, Luyt, Olivia, White, Charlotte, Smith, Nathan, Thompson, Thomas, Smith, Imogen, Harrison, Santosh Kumar Mahalik, Rajat, Piplani, Enono, Yhoshu, Manoj, Gupta, Uttam Kumar Nath, Amit, Sehrawat, S Rajkumar, K, Vivek, Singh, Sadi, A Abukhalaf, Ashrarur Rahman Mitul, Sabbir, Karim, Nazmul, Islam, Sara Kader Alsaeiti, Fatma Saleh Benkhial, Mohammed Miftah Faraj Almihashhish, Eman Salem Muftah Burzeiza, Hend Mohammed Masoud, Mabroukah Saeid Alshamikh, Raja Mari Mohammed Nasef, Fatma Mohammed Masoud, William, B Lo, Nyararai, Togarepi, Elaine, Carrolan, Benjamin, J O'Sullivan, Mohamed, Hassanin, Ahmed, Saleh, Mahmoud, Bassiony, Mostafa, Qatora, Mohamed, Bahaaeldin, Shady, Fadel, Yasmine El Chazli, Anfel, Bouderbala, Kamel, Hamizi, Safia, Lorabi, Mehdi Anouar Zekkour, Rima, Rahmoun, Boutheyna, Drid, Salma Naje Abu Teir, Mohamed Yazid Kadir, Yassine, Zerizer, Nacer, Khernane, Brahim, Saada, Yahya, Elkaoune, Hajar, Moujtahid, Ghita, Chaoui, Hajar, Benaouda, Meryem, Gounni, Narjiss, Aji, Laila, Hessissen, Joana Mafalda Monteiro, Susana, Nunes, Maria do Bom-Sucesso, Dave, R Lal, Brian, T Craig, Kerri, Becktell, Tahmina, Banu, Md Afruzul Alam, Orindom Shing Pulock, Tasmiah Tahera Aziz, Vishal, Michael, M Joseph John, William, Bhatti, Bobby, John, Swati, Daniel, Jyoti, Dhiman, Hunar, Mahal, Atul, Suroy, Rosanda, Ilic, Danica, Grujicic, Tijana, Nastasovic, Igor, Lazic, Mihailo, Milicevic, Vladimir, Bascarevic, Radovan, Mijalcic, Vuk, Scepanovic, Aleksandar, Stanimirovic, Aleksandra, Paunovic, Ivan, Bogdanovic, Shruti, Kakkar, Shaina, Kamboj, Suraj, Singh, Shahnoor, Islam, Akm Amirul Morshed, Akm Khairul Basher, Mehnaz, Akter, M Rezanur Rahman, S, Zannat, Ara, Mohammed Tanvir Ahammed, Tania, Akter, Kamrun, Nahar, Fatema, Sayed, Ashfaque, Nabi, Md Asif Iqbal, Md Masud Rana, Asaduzzaman, Md, Hasanuzzaman, Md, Kemal Tolga Saracoglu, Elif, Akova, Evren, Aydogmus, Bekir Can Kendirlioglu, Tufan, Hicdonmez, Ahmed, Y Azzam, Mohammed, A Azab, Sherief, Ghozy, Alzhraa Salah Abbas, Monica, Dobs, Mohamed Atef Mohamed Ghamry, Mohammed, Alhendy, Joana, Monteiro, Olanrewaju, Moses, Ibiyeye Taiye Taibat, Taiwo, Jones, Kalu, Ukoha, Olagundoye, Goke, Okorie, Ikechukwu, Abiodun Idowu Okunlola, Milind, Chitnis, Helga, Nauhaus, Danelle, Erwee, Robyn, Brown, Agata, Chylinska, Robin, Simpson, Prasanna, Gomes, Marco Aurelio Ciriaco Padilha, Elvercio Pereira de Oliveira Junior, Lucas Garschagen deCarvalho, Fabiola Leonelli Diz, Mohamed El Kassas, Usama, Eldaly, Ahmed, Tawheed, Mohamed, Abdelwahab, Oudrhiri Mohammed Yassaad, Bechri, Hajar, El Ouahabi Abdessamad, Arkha, Yasser, Hessissen, Laila, Farah Sameer Yahya, Sandip Kumar Rahul, Vijayendra, Kumar, Digamber, Chaubey, Maria Teresa Peña Gallardo, Jacqueline Elizabeth Montoya Vásquez, Juan Luis García León, Sebastián Shu Yip, Georgios, Karagiannidis, Rejin, Kebudi, Sema Bay Buyukkapu, Krishna Kumar Govindarajan, Kumaravel, Sambandan, Smita, Kayal, Gunaseelan, Karunanithi, Bikash Kumar Naredi, Bibekanand, Jindal, Mariam, Lami, Matthew Hv Byrne, Duha, Jasim, Harmit, Ghattaura, Eric, W Etchill, Daniel, Rhee, Stacy, Cooper, Kevin, Crow, Morgan, Drucker, Megan, Murphy, Benjamin, Shou, Alan, Siegel, Yasin, Kara, Gül Nihal Özdemir, Mahmoud, Elfiky, Ehab El Refaee, John George Massoud, Ayah Bassam Ibrahim, Ruaa Bassam Ibrahim, Faris Abu Za'nouneh, Ranya, M Baddourah, Toqa, Fahmawee, Ayah Al Shraideh, Ghazwani, Salman, Ehab, Alameer, Al-Mudeer, Ali, Ghazwani, Yahia, Khozairi, Waleed, Ahmad, Ozair, Ankur, Bajaj, Bal Krishna Ojha, Kaushal Kishor Singh, Atique, Anwar, Vinay, Suresh, Mohamad, K Abou Chaar, Iyad, Sultan, Khalil, Ghandour, Shaima', Al-Dabaibeh, Ammar, Al-Basiti, Hazim, Ababneh, Omaima, El-Qurneh, Yousef, Alalawi, Ahmad Al Ayed, Ehab, Hanafy, Naif Al Bolowi, Anette, S Jacobsen, Heidi, Barola, Aubrey, L Pagaduan, Jingdan, Fan, Olumide Abiodun Elebute, Adesoji, O Ademuyiwa, Christopher, O Bode, Justina, O Seyi-Olajide, Oluwaseun, Ladipo-Ajayi, Felix, M Alakaloko, George, C Ihediwa, Kareem, O Musa, Edamisan, O Temiye, Olufemi, Oni, Adeseye, M Akinsete, Janita, Zarrish, Ramsha, Saleem, Soha, Zahid, Atiqa, Amirali, Ahsan, Nadeem, Sameer Saleem Tebha, Zonaira, Qayyum, Sana, Tahir, Anneqa, Tahir, Rabbey Raza Khan, Ayesha, Mehmood, Iqra, Effendi, Taimur Iftikhar Qureshi, Pooja, Kumari, Mohamed, Bonna, Khaled, Mamdouh, Mohamed, Atef, Mohamed, Faried, Victor, Calvagna, Nathalie, Galea, Ariana, Axiaq, Matthew, R Schuelke, Jake, A Kloeber, Robert, L Owen, Alexander, S Roth, Catherine, Yang, J Hudson Barnett, Lucien, P Jay, Kirk David Wyatt, Paul, J Galardy, Bernard, Mbwele, Irene, Nguma, Moshi Moshi Shabani, Amani, Twaha, Bilal, Matola, Agnes, Vojcek, Mahmoud Maher Abdelnaby Alrahawy, Seham, M Ragab, Abdallah, R Allam, Eman Ibrahim Hager, Abdelrahman, Azzam, Ammar, Ayman, Kıvılcım Karadeniz Cerit, Adnan, Dağçınar, Tümay, Umuroğlu, Ayten, Saraçoğlu, Mustafa, Sakar, Can, Kıvrak, Gül, Çakmak, Ibrahim, Sallam, Gamal, Amira, Mohamed, Sherief, Ahmed, Sherif, Simone deOliveira Coelho, Arissa, Ikeda, Licia, Portela, Marianne Monteiro Garrigo, Ricardo Vianna deCarvalho, Fernanda, Lobo, Sima Ester Ferman, FernandaFerreira daSilva Lima, Moawia Mohammed AliElhassan, Nada Osman Yousif Elhaj, Hytham Ks Hamid, Emmanuel, A Ameh, Vincent, E Nwatah, Adewumi, B Oyesakin, Andrew Nwankwo Osuigwe, Okechukwu Hyginus Ekwunife, Chisom Adaobi Nri-Ezedi, Eric Okechukwu Umeh, Nellie, Bell, Ibukunolu Olufemi Ogundele, Abiodun Folashade Adekanmbi, Olubunmi Motunrayo Fatungase, Olubunmi Obafemi Obadaini, Sarah, Al-Furais, Humaida, Hemlae, Sreylis, Nay, John, Mathew, M Jeffri Ismail, R, Simone deCamposVieira Abib, Fabianne Altruda de Moraes Costa Carlesse, Mayara Caroline Amorim Fanelli, Fernanda Kelly Marques de Souza, Pierfrancesco, Lapolla, Andrea, Mingoli, Denis, Cozzi, Anna Maria Testi, Paolo, Musiu, Paolo, Sapienza, Gioia, Brachini, Martina, Zambon, Simona, Meneghini, Pierfranco, Cicerchia, Bruno, Cirillo, Manjul, Tripathi, Sandeep, Mohindra, Vishal, Kumar, Ninad, R Patil, Richa, Jain, Renu, Madan, Madhivanan, Karthigeyan, Pravin, Salunke, Gopal, Nambi, Abdulrahman Omar Taha, Janice Hui Ling Wong, Norehan, Johari, Anas, Shikha, Win SabaiPhyu Han, Zahidah, Ahmad, Yen Yan Lim, Roserahayu, Idros, Noorainun Mohd Yusof, David Nelson Jaisingh, Aouabed, Nesrine, Bouaoud, Souad, Mebarki, Malika, Bioud, Belkacem, Fayza, Haider, Fatema Naser AlFayez, Fakher, Rahim, Elana, Kleinman, Taylor, Ibelli, Emily, Hamilton, Rochelle, Fayngor, Tzvi, Najman, Gideon, Karplus, Etai, Adam, Daniella, Melamed, Cecilia, Paasche, Amir, Labib, Farman Ali Laghari, Zainab Al Balushi, Abdulhakim Awadh SalimAl-Rawas, Ali Al Sharqi, Ammar Saif AlShabibi, Ismail Al Bulushi, Muna, Alshahri, Abdulrahman, Almirza, Ola Al Hamadani, Jawaher Al Sharqi, Anisa Al Shamsi, Bashar, Dawud, Sareya Al Sibai, Alhassan, Abdul-Mumin, Halwani Yaninga Fuseini, Peter Gyamfi Kwarteng, Abubakari Bawa Abdulai, Sheba Mary Pognaa Kunfah, Gilbert, B Bonsaana, Stephanie, Ajinkpang, Edmund, M Der, Francis, A Abantanga, Mary Joan Kpiniong, Kingsley Aseye Hattor, Kingsley Appiah Bimpong, Mohamed, Elbahnasawy, Sherief, Abdelsalam, Ahmed, Samir, Reto, M Baertschiger, Andreea, C Matei, Augusto, Zani, Lubna, Samad, Hira Khalid Zuberi, Kishwer, Nadeem, Naema, Khayyam, Fatima Ambreen Imran, Nida, Zia, Sadia, Muhammad, Muhammad Rafie Raza, Muhammad Rahil Khan, Alaa, Hamdan, Ammar, Omran, Ahmed, Moussa, Bardisan, Gawrieh, Hassan, Salloum, Alaa, Ahmed, Abdeljawad, Mazloum, Ali, Abodest, Nisreen, Ali, Munawar, Hraib, Victor, Khoury, Abdulrahman, Almjersah, Mohammad Ali Deeb, Mohammad Ahmad Almahmod Alkhalil, Akram, Ahmed, Waseem, Shater, Ali Farid Alelayan, Alaa, Guzlan, Ahmad, Bouhuwaish, Alqasim, Abdulkarim, Eman, Abdulwahed, Marwa, Biala, Reem, Ghamgh, Amani, Alamre, Marwa, Shelft, Asmaa Am Albanna, Hoda, Tawel, Emmanuel, Hatzipantelis, Athanasios, Tragiannidis, Eleni, Tsotridou, Assimina, Galli-Tsinopoulou, Dayang AnitaAbdul Aziz, Zarina Abdul Latiff, Hamidah, Alias, C-Khai, Loh, Doris, Lau, Azrina Syarizad Khutubul Zaman, Taiwo Akeem Lawal, Kelvin Ifeanyichukwu Egbuchulem, Olakayode Olaolu Ogundoyin, Isaac Dare Olulana, Biobele, J Brown, Oluwasegun Joshua Afolaranmi, Abdulbasit, Fehintola, Annika, Heuer, Christine, Nitschke, Michael, Boettcher, Matthias, Priemel, Lennart, Viezens, Martin, Stangenberg, Marc, Dreimann, Alonja, Reiter, Jasmin, Meyer, Leon, Köpke, Karl-Heinz, Frosch, Samson, Olori, Uduak, Offiong, Philip Mari 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Lily, Saldana, Jan, Godzinsky, Abdelbasit, Ali, Dragana, Janic, Mohamed Bella Jalloh, Annette, Jacobsen, Chan Hon Chui, Israel Fernandez Pineda, Lucas, Krauel, Maricarmen, Olivos, Waha, Rahama, Hazim, Elfatih, Raphael, N Vuille-Dit-Bille, Arda, Isik, Asim Noor Rana, Kate, Cross, Andrea, Hayes-Jordan, Roshni, Dasgupta, Mohamedraed, Elshami, Collaborative, Global Health Research Group on Children’s Non-Communicable Diseases, and Bandyopadhyay S., Peter N., Lakhoo K., Abib S. d. C. V. , Abdelhafeez H., Wilson S., Pachl M., Martin B., Nagras S., Sheth M., et al.
Subjects: Social Sciences and Humanities, Health (social science), Social Sciences (SOC), Sosyal Bilimler ve Beşeri Bilimler, Epidemiology, IMPACT, SOCIAL SCIENCES, GENERAL, LOW-INCOME, Sağlık Bilimleri, paediatrics, REGISTRIES, Sociology, Occupational Therapy, Neoplasms, Epidemiyoloji, Health Sciences, ADOLESCENTS, Genel Sosyal Bilimler, Humans, cancer, Sosyal ve Beşeri Bilimler, Social Sciences & Humanities, Prospective Studies, Child, Sosyoloji, Pandemics, Halk, Çevre ve İş Sağlığı, Güvenlik Araştırması, RISK, PUBLIC, ENVIRONMENTAL & OCCUPATIONAL HEALTH, PEDIATRIC CANCER, COVID-19, health systems, CHILDHOOD-CANCER, SARS-CoV-2, MORTALITY, Health Policy, Public Health, Environmental and Occupational Health, General Social Sciences, Sosyal Bilimler Genel, CARE, KAMU, ÇEVRE VE İŞ SAĞLIĞI, İş Sağlığı ve Terapisi, SURVIVAL, Sosyal Bilimler (SOC), Safety Research, Sağlık (sosyal bilimler)
Abstract: IntroductionChildhood cancer is a leading cause of death. It is unclear whether the COVID-19 pandemic has impacted childhood cancer mortality. In this study, we aimed to establish all-cause mortality rates for childhood cancers during the COVID-19 pandemic and determine the factors associated with mortality.MethodsProspective cohort study in 109 institutions in 41 countries. Inclusion criteria: children ResultsAll-cause mortality was 3.4% (n=71/2084) at 30-day follow-up, 5.7% (n=113/1969) at 90-day follow-up and 13.0% (n=206/1581) at 12-month follow-up. The median time from diagnosis to multidisciplinary team (MDT) plan was longest in low-income countries (7 days, IQR 3–11). Multivariable analysis revealed several factors associated with 12-month mortality, including low-income (OR 6.99 (95% CI 2.49 to 19.68); pConclusionsChildren with cancer are more likely to die within 30 days if infected with SARS-CoV-2. However, timely treatment reduced odds of death. This report provides crucial information to balance the benefits of providing anticancer therapy against the risks of SARS-CoV-2 infection in children with cancer.
Published: 2022

30. Accelerated surgery versus standard care in hip fracture (HIP ATTACK-1) : a kidney substudy of a randomized clinical trial

Author: Flavia K. Borges, P.J. Devereaux, Meaghan Cuerden, Jessica M. Sontrop, Mohit Bhandari, Ernesto Guerra-Farfán, Ameen Patel, Alben Sigamani, Masood Umer, John Neary, Maria Tiboni, Vikas Tandon, Mmampapatla Thomas Ramokgopa, Parag Sancheti, Abdel-Rahman Lawendy, Mariano Balaguer-Castro, Richard Jenkinson, Paweł Ślęczka, Aamer Nabi Nur, Gavin C.A. Wood, Robert J. Feibel, John Stephen McMahon, Bruce M. Biccard, Alessandro Ortalda, Wojciech Szczeklik, Chew Yin Wang, Jordi Tomás-Hernández, Jessica Vincent, Valerie Harvey, Shirley Pettit, Kumar Balasubramanian, Gerard Slobogean, Amit X. Garg, Laurent Veevaete, Bernard le Polain de Waroux, Patricia Lavand'homme, Olivier Cornu, Karim Tribak, Jean C. Yombi, Nassim Touil, Jigme T. Bhutia, Carol Clinckaert, Dirk De Clippeleir, Maike Reu, Leslie P. Gauthier, Victoria RA. Avram, Mitchell Winemaker, Daniel M. Tushinski, Justin de Beer, Andrew Worster, Diane L. Simpson, Kim A. Alvarado, Krysten K. Gregus, Kelly H. Lawrence, Darryl P. Leong, Philip G. Joseph, Patrick Magloire, Benjamin Deheshi, Stuart Bisland, Thomas J. Wood, David AJ. Wilson, Sandra N. Ofori, Jessica Spence, Emmanuelle Duceppe, Maria E. Tiboni, John D. Neary, Anthony Adili, David D. Cowan, Vickas Khanna, Amna Zaki, Janet C. Farrell, Anne Marie MacDonald, David Conen, Steven CW. Wong, Arsha Karbassi, Douglas S. Wright, Harsha Shanthanna, Javier Ganame, Andrew Cheung, Ryan Coughlin, Moin Khan, Spencer Wikkerink, Faraaz A. Quraishi, Waleed Kishta, Emil Schemitsch, Timothy Carey, Mark D. Macleod, David W. Sanders, Edward Vasarhelyi, Debra Bartley, George K. Dresser, Christina Tieszer, Richard J. Jenkinson, Steven Shadowitz, Jacques S. Lee, Stephen Choi, Hans J. Kreder, Markku Nousiainen, Monica R. Kunz, Ravianne Tuazon, Mopina Shrikumar, Bheeshma Ravi, David Wasserstein, David J.G. Stephen, Diane Nam, Patrick D.G. Henry, Gavin CA. Wood, Stephen M. Mann, Melanie T. Jaeger, Marco LA. Sivilotti, Christopher A. Smith, Christopher C. Frank, Heather Grant, Leone Ploeg, Jeff D. Yach, Mark M. Harrison, Aaron R. Campbell, Ryan T. Bicknell, Davide D. Bardana, Katie McIlquham, Catherine Gallant, Samantha Halman, Venkatesh Thiruganasambandamoorth, Sara Ruggiero, William J. Hadden, Brian PJ. Chen, Stephanie A. Coupal, Stephen J. McMahon, Lisa M. McLean, Hemant R. Shirali, Syed Y. Haider, Crystal A. Smith, Evan Watts, David J. Santone, Kevin Koo, Allan J. Yee, Ademilola N. Oyenubi, Aaron Nauth, Emil H. Schemitsch, Timothy R. Daniels, Sarah E. Ward, Jeremy A. Hall, Henry Ahn, Daniel B. Whelan, Amit Atrey, Amir Khoshbin, David Puskas, Kurt Droll, Claude Cullinan, Jubin Payendeh, Tina Lefrancois, Lise Mozzon, Travis Marion, Michael J. Jacka, James Greene, Matthew Menon, Robert Stiegelmahr, Derek Dillane, Marleen Irwin, Lauren Beaupre, Chad P. Coles, Kelly Trask, Shelley MacDonald, J.A.I. Trenholm, William Oxner, C.G. Richardson, Niloofar Dehghan, Mehdi Sadoughi, Achal Sharma, Neil J. White, Loretta Olivieri, Stephen B. 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Gnanadurai, Carolin E. George, Tatarao Maddipati, K.P. Mary, Vijay Sharma, Kamran Farooque, Rajesh Malhotra, Samarth Mittal, Chavi Sawhney, Babita Gupta, Purva Mathur, Shivanand Gamangati, Vijaylaxmi Tripathy, Prem H. Menon, Mandeep S. Dhillon, Devendra K. Chouhan, Sharanu Patil, Ravi Narayan, Purushotham Lal, Prashanth N. Bilchod, Surya U. Singh, Uttam V. Gattu, Ravi P. Dashputra, Prashant V. Rahate, Maurizio Turiel, Riccardo Accetta, Paolo Perazzo, Daniele Stella, Marika Bonadies, Chiara Colombo, Giuseppe De Blasio, Stefania Fozzato, Fabio Pino, Ilaria Morelli, Francesco De Donato, Eleonora Colnaghi, Vincenzo Salini, Giacomo Placella, Giuseppe Giardina, Gaetano Lombardi, Anna Marcato, Luca Guzzetti, Ilaria Rivetti, Massimiliano Greco, H.M. Khor, Hou Yee Lai, C.S. Kumar, K.H. Chee, P.S. Loh, Kit Mun Tan, Simmrat Singh, Li Lian Foo, Komella Prakasam, Sook Hui Chaw, Meng-Li Lee, Joanne HL. Ngim, Huck Wee Boon, Im Im Chin, Ydo V. Kleinlugtenbelt, Ellie BM. Landman, Elvira R. Flikweert, Herbert W. Roerdink, Roy BG. Brokelman, Hannie F. Elskamp-Meijerman, Bas Staffhorst, Jan-Hein MG. Cobben, Dilshad Begum, Anila Anjum, Pervaiz M. Hashmi, Tashfeen Ahmed, Haroon U. Rashid, Mujahid J. Khattak, Rizwan H. Rashid, Riaz H. Lakdawala, Shahryar Noordin, Naveed M. Juman, Robyna I. Khan, Muhammad M. Riaz, Syedah S. Bokhari, Ayesha Almas, Hussain Wahab, Arif Ali, Hammad N. Khan, Eraj K. Khan, Kholood A. Janjua, Sajjad H. Orakzai, Abdus S. Khan, Khawaja J. Mustafa, Mian A. Sohail, Muhammad Umar, Siddra A. Khan, Muhammad Ashraf, Muhammad K. Khan, Muhammad Shiraz, Ahmad Furgan, Piotr Dąbek, Adam Kumoń, Wojciech Satora, Wojciech Ambroży, Mariusz Święch, Jacek Rycombel, Adrian Grzelak, Ilona Nowak-Kózka, Jaroslaw Gucwa, Waldemar Machala, Mmampapatla T. Ramokgopa, Gregory B. Firth, Mwalimu Karera, Maria Fourtounas, Virsen Singh, Anna Biscardi, Muhammad N. Iqbal, Ryan J. Campbell, Matimba L. Maluleke, Carien Moller, Lerato Nhlapo, Sithombo Maqungo, Margot Flint, Marcin B. Nejthardt, Sean Chetty, Stephen Venter, Ernesto Guerra-Farfan, Jordi Tomas-Hernandez, Yaiza Garcia-Sanchez, Miriam Garrido Clua, Vicente Molero-Garcia, Jordi Teixidor-Serra, Maria del Mar Villar-Casares, Jordi Selga Marsa, Juan A. Porcel-Vazquez, Jose-Vicente Andres- Peiro, Jaume Mestre-Torres, Patricia Guilabert, M Luisa Paños Gozalo, Luis Abarca, Nuria Martin, Gemma Usua, Pilar Lalueza-Broto, Judith Sanchez-Raya, Jorge Nuñez Camarena, Antoni Fraguas-Castany, Carlos Piedra Calle, Diego Soza Leiva, Maria Garcia Carrasco, Montsant Jornet-Gibert, Montserrat Monfort-Mira, Alfons Gasset-Teixidor, Francesc Antoni Marcano-Fernández, Isabel Simó- Sánchez, Begoña Mari-Alfonso, Christian Yela-Verdú, Raúl Pellejero-García, Júlia Casas-Codina, Ruben Iglesias- Sanjuan, Pau Balcells-Nolla, Oriol Vila-Sánchez, Mercè Bertrana de Bustos, Pablo Castillón, Martí Bernaus, Saioa Quintas, Olga Gómez, Jordi Salvador, Javier Abarca, Cristina Estrada, Marga Novellas, Francesc Anglès, Alfred Dealbert, Oscar Macho, Alexia Ivanov, Esther Valldosera, Marta Arroyo, Borja Pey, Antoni Yuste, Llorenç Mateo, Julio De Caso, Rafael Anaya, J.L. Higa-Sansone, Angelica Millan, Victoria Baños, Sergio Herrera-Mateo, Hector J. Aguado, Virginia García-Virto, Clarisa Simón-Pérez, Sergio Chavez, María Bragado, María Plata, Enrique Guerado, Encarnacion Cruz, Juan R. Cano, Jose M. Bogallo, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Nachapan Pengrung, Theerawat Chalacheewa, Vanlapa Arnuntasupakul, Teerapat Yingchoncharoen, Bundit Naratreekoon, Miriam A. Kadry, Surendini Thayaparan, Victor Babu, Arash Aframian, Souad Bentoumi, Amrinder Sayan, Ihab Abdlaziz, Marcela P. Vizcaychipi, Patricia Correia, Shashank Patil, Kevin Haire, Amy SE. Mayor, Sally Dillingham, Laura Nicholson, Ben T. Brooke, Joby John, Shashi K. Nanjayan, Martyn J. Parker, Susan O'Sullivan, Meir T. Marmor, Amir Matityahu, Robert T. McClellan, Curt Comstock, Anthony Ding, Paul Toogood, Robert O’Toole, Marcus Sciadini, Jason Nascone, Nathan O’Hara, Scott P. Ryan, Molly E. Clark, Charles Cassidy, Konstantin Balonov, Tristan Weaver, Laura S. Phieffer, Sergio D. Bergese, Andrew J. Marcantonio, Shrikant I. Bangdiwala, Michael H. McGillion, Sanela Dragic-Taylor, Chelsea Maxwell, Sarah Molnar, Jennifer R. Wells, Patrice Forget, Paul Landais, Giovanni Landoni, Ekaterine Popova, Iain K. Moppett, Robin Roberts, null Chairperson, Finlay McAlister, David Sackett, James Wright, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and UCL - (SLuc) Service de médecine interne générale
Subjects: Hip Fractures, Nephrology, Humans, Pelvic Bones, Kidney
Abstract: To the Editor: Acute kidney injury (AKI) is a lesser-known complication of hip fracture that may come about owing to decreased kidney perfusion and heightened inflammation from trauma, pain, bleeding, and fasting. Approximately 15%-20% of patients undergoing surgery for a hip fracture develop AKI, with 0.5%-1.8% receiving dialysis. [...]
Published: 2022

31. ASSESSMENT OF PULMONARY STATUS FOLLOWING INTERMAXILLARY FIXATION- A CLINICAL STUDY

Author: Joshna Ek, Anish Poorna T, Bobby John, and Sandhya K
Subjects: Clinical study, Orthodontics, 03 medical and health sciences, 0302 clinical medicine, business.industry, Medicine, 030208 emergency & critical care medicine, 030212 general & internal medicine, business, Intermaxillary fixation
Abstract: Aim: The aim of the study was to determine the effect of intermaxillary xation on pulmonary function. Methods:133 patients comprising 107 males and 26 females with age ranging from 18 to 50 were taken up for study. The patients' Pulmonary Function Tests were done using spirometer to measure the necessary parameters before and after the application of intermaxillary xation. The values obtained were also compared with 50 healthy volunteers. Results: The results showed that there is a signicant decrease in values of Pulmonary Function Test after the application of intermaxillary xation. Conclusion: Pulmonary status evaluation becomes necessary on account of the obstructive nature of intermaxillary xation. This simple and routinely used procedure should be avoided in respiratory compromised patients with Pulmonary Function Test values lower than the predicted value.
Published: 2021
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32. Editorial

Author: Bobby John and Amir Ullah Khan
Published: 2022
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33. 2021 Asia Pacific Heart Rhythm Society (APHRS) practice guidance on atrial fibrillation screening

Author: Ngai‐Yin Chan, Jessica Orchard, Michael‐Joseph Agbayani, Dean Boddington, Tze‐Fan Chao, Sofian Johar, Bobby John, Boyoung Joung, Saravanan Krishinan, Rungroj Krittayaphong, Sayaka Kurokawa, Chu‐Pak Lau, Toon Wei Lim, Pham Tran Linh, Vien Hoang Long, Ajay Naik, Yasuo Okumura, Tetsuo Sasano, Bernard Yan, Sunu Budhi Raharjo, Dicky Armein Hanafy, Yoga Yuniadi, Nwe Nwe, Zahid Aslam Awan, He Huang, and Ben Freedman
Subjects: prevention, screening, RC666-701, Diseases of the circulatory (Cardiovascular) system, atrial fibrillation, Cardiology and Cardiovascular Medicine, stroke
Abstract: In this paper, the Asia Pacific Heart Rhythm Society (APHRS) sought to provide practice guidance on AF screening based on recent evidence, with specific considerations relevant to the Asia-Pacific region. A key recommendation is opportunistic screening for people aged ≥65 years (all countries), with systematic screening to be considered for people aged ≥75 years or who have additional risk factors (all countries).
Published: 2021

34. Ludwig's angina in a COVID positive patient—An atypical case report

Author: Joshna Ek, Lokesh J R, Anish Poorna T, and Bobby John
Subjects: Odontogenic infection, medicine.medical_specialty, Coronavirus disease 2019 (COVID-19), business.industry, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Case Report, Case Reports, medicine.disease, Positive patient, Odontogenic, Angina, COVID‐19, extraction, Medicine, Effective treatment, Ludwig's angina, business, Intensive care medicine, odontogenic infection, General Dentistry
Abstract: The management of odontogenic infections is established and several guidelines have been proposed for its effective treatment. Outbreak of COVID‐19 has posed serious challenge in the management of odontogenic infections, further complicated by immunocompromised status of the patient, where adequate evaluation and prompt attention is mandatory to avoid untoward consequences. Ludwig's angina being a life threatening infection by itself, association or simultaneous presentation with COVID‐19 infection can add further complexity in the management for a maxillofacial surgeon. Here we present a case report of Ludwig's angina in a patient who tested positive for Coronavirus infection and how we treated her successfully.
Published: 2021

35. Peroneal nerve palsy due to pseudoaneurysm following total knee arthroplasty: A case presentation

Author: Pranay Pawar, JenniferSitther Solomon, Bobby John, and Anil Luther
Subjects: musculoskeletal diseases, total knee arthroplasty, surgical procedures, operative, popliteal artery pseudoaneurysm, Polymers and Plastics, bypass surgery, RC666-701, Diseases of the circulatory (Cardiovascular) system, musculoskeletal system, vascular injury, General Environmental Science
Abstract: Total knee arthroplasty (TKA) is among the commonly performed orthopedic procedures with a very good safety profile. Vascular injuries following TKA are very rare and usually identified intraoperatively or in the immediate postoperative period. Popliteal artery pseudoaneurysms post-TKA are very rare, and their management can be quite challenging. We describe a case that presented more than 3 months after the index surgery with a peroneal nerve palsy due to a pseudoaneurysm.
Published: 2021

36. Tip-apex distance and other predictors of outcome in cephalomedullary nailing of unstable trochanteric fractures

Author: Ritesh Arvind Pandey, Anupam Mahajan, Bobby John, and Anirudh Sharma
Subjects: Trochanteric fractures, 030222 orthopedics, medicine.medical_specialty, Multivariate analysis, business.industry, Radiography, Osteoporosis, Implant failure, medicine.disease, Surgery, 03 medical and health sciences, Femoral head, 0302 clinical medicine, medicine.anatomical_structure, Statistical significance, medicine, Orthopedics and Sports Medicine, 030212 general & internal medicine, Implant, business, TRAUMA
Abstract: Background Cephalomedullary nails are presently the gold standard in management of unstable trochanteric fractures. The tip-apex distance (TAD) is one of the most important factors that determines success or failure of fixation, but was described originally in context of an extramedullary hip screw. Cephalomedullary nails use a different biomechanical approach to fixation; and it is hypothesized that the TAD rule may not apply similarly with these. The aim of this study is to assess whether a high TAD correlates with poor outcomes with cephalomedullary nails, and to elucidate other factors that may predict such outcome. Methods We retrospectively reviewed the clinical and radiographic records of patients with intertrochanteric fractures, treated at our institution over a 2-year period. Those with unstable fractures (31.A2 and 31.A3), and who were treated with cephalomedullary nails were included in the study. The TAD and the position of the device in the femoral head (Cleveland index) were assessed. Other factors that could influence outcome like age, gender, AO fracture type, restoration of neck-shaft angle and degree of osteoporosis were analysed. Radiographic records of up-to at-least 3 months post-operatively were assessed for complications. Results After applying the exclusion criteria, 75 patients were included in the analysis. The overall rate of complications was 12%. They occurred in two major patterns - varus collapse and cut-out occurred in 5 patients (6.67%), and device migration in 4 patients (5.33%). The average TAD of patients with cut-out was 28.78 mm, compared to 19.44 mm in those without cut-out (p = 0.002). Our data predicted a cut-off TAD >23.56 mm as most significant for cut-out with cephalomedullary nails. On univariate logistic regression, high TAD (p = 0.009), sub-optimal device positioning (p = 0.02) and poor restoration of neck-shaft angle (p = 0.04) were found to be significant for varus collapse and cut-out, but not for complications relating to device migration. On multivariate analysis, none of the above factors reached statistical significance in isolation. Conclusion As with extramedullary devices, TAD, along with sub-optimal device positioning and poor restoration of neck-shaft angle is a useful predictor of cut-out even with cephalomedullary nails, negating the initial hypothesis. The above factors in combination have a more significant effect than any one factor in isolation to cause varus collapse and implant cut-out. However these do not affect Z effect, reverse Z effect or other types of device migration seen especially with dual-screw nails.
Published: 2019
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37. Autologous bone grafts vs bone graft substitutes in fracture healing in a tertiary care hospital of North India: A comparative study

Author: Noel Sukhjit Singh and Bobby John
Subjects: medicine.medical_specialty, business.industry, medicine.medical_treatment, Medicine, Bone healing, Bone transport, Bone grafting, Tertiary care hospital, business, North india, Autologous bone, Stable fixation, Surgery
Abstract: Today as a result of rapid urbanization and mechanization there has been a rapid increase in the rate of trauma. As a result of this the treatment of post-traumatic conditions such as delayed unions, non- unions, malunions and other problems has become very challenging. In most cases it is possible to treat a fracture by restoring the alignment and stable fixation of the bone. However, in many cases additional measures such as bone grafting or bone transport are required to bring about bone healing or fill defects. This study will be comparing the efficacy and complications of bone grafts and bone graft substitutes and determining if bone graft substitutes are a worthy alternative to the conventional autologous bone graft.
Published: 2019
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38. Co-Optimization of Piston Bowl and Cooling Gallery Designs Using Coupled Cfd and Conjugate Heat Transfer for Heavy-Duty Diesel Engines

Author: Jonathan Anders, Bobby John, Hyderuddin Mohammad, Chaitanya Kavuri, Sibendu Som, Prithwish Kundu, and Chao Xu
Published: 2021
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39. Atrial Fibrillation in Valvular Heart Disease

Author: Chu-Pak Lau and Bobby John
Subjects: Adult, medicine.medical_specialty, Heart disease, Adolescent, medicine.medical_treatment, Population, Heart Valve Diseases, 030204 cardiovascular system & hematology, 03 medical and health sciences, Young Adult, 0302 clinical medicine, Physiology (medical), Internal medicine, Mitral valve, Atrial Fibrillation, medicine, Humans, cardiovascular diseases, 030212 general & internal medicine, education, Aged, education.field_of_study, business.industry, valvular heart disease, Rheumatic Heart Disease, Atrial fibrillation, Middle Aged, medicine.disease, Ablation, medicine.anatomical_structure, Embolism, Parasternal line, Echocardiography, cardiovascular system, Cardiology, Cardiology and Cardiovascular Medicine, business
Abstract: Rheumatic heart disease results in significant remodeling of the atria that provides the milieu for maintaining atrial fibrillation. Some electrical remodeling is reversible and hence early intervention may prove useful. Active screening for atrial fibrillation in high-risk subset and instituting anticoagulation may reduce the devastating complications that follow. Age older than 50 years, NYHA functional class II symptoms, left atrial dimension >4.0 cm on echocardiogram in parasternal long-axis view, and gradients across the mitral valve >10 mm Hg are clinical indicators that identify the high-risk subset. Ablation strategy in this population may differ compared with the nonvalvular group.
Published: 2021

40. Preprosthetic Surgery

Author: Bobby John
Subjects: 03 medical and health sciences, 0302 clinical medicine, 030212 general & internal medicine, 030206 dentistry
Abstract: Preprosthetic surgery encompasses the surgical procedures with aim of redefining the soft or hard tissues or both by the accomplishment of relieving the biological interferences so that the individual can accept a comfortable prosthesis. In the early times it was regularly carried out in the specialty of oral and maxillofacial surgery. But the advent of implantology has relegated this area to a less performed corner but still some procedures remains valid and indispensable. The prosthetic management in certain cases pose great challenge in finding stability and retention, which in turn can successively catapulted by the manuvers of preprosthetic category.
Published: 2021
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41. Comparison of clinical outcomes of treatment of dysfunction of the temporomandibular joint between conventional and ultrasound-guided arthrocentesis

Author: K. George Varghese, D Annapoorani, P.G. Antony, N. Jayakumar, Aneesh Sebastian, Shiney Dominic, S. Mohan, and Bobby John
Subjects: medicine.medical_specialty, medicine.medical_treatment, Treatment outcome, 03 medical and health sciences, 0302 clinical medicine, stomatognathic system, medicine, Humans, Range of Motion, Articular, 030203 arthritis & rheumatology, Temporomandibular Joint, medicine.diagnostic_test, business.industry, Arthroscopy, Arthrocentesis, 030206 dentistry, Temporomandibular Joint Disorders, Ultrasound guided, Surgery, Temporomandibular joint, stomatognathic diseases, Treatment Outcome, medicine.anatomical_structure, Otorhinolaryngology, Oral Surgery, business
Abstract: Patients with disorders of the temporomandibular joint (TMJ) who do not respond to non-operative treatment may require invasive procedures such as arthrocentesis and arthroscopy. We divided 80 patients with dysfunction of the TMJ into two groups: a control group who were treated by conventional arthrocentesis, and an experimental group who were treated by ultrasound-guided arthrocentesis. Both groups were monitored three days, one week, and one month postoperatively and the clinical outcomes compared. The experimental group had a significant reduction in the degree of pain in the immediate postoperative period (p=0.015). However, ultrasound-guided arthrocentesis showed no significant improvement in symptoms overall compared with conventional arthrocentesis. Both techniques seem to be effective in the management of dysfunction of the TMJ.
Published: 2019
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42. Delays in hospital admissions in patients with fractures across 18 low-income and middle-income countries (INORMUS): a prospective observational study

Author: Panthea Pouramin, Chuan Silvia Li, Jason W Busse, Sheila Sprague, P J Devereaux, Jagnoor Jagnoor, Rebecca Ivers, Mohit Bhandari, PJ Devereaux, Gordon Guyatt, Brad Petrisor, Lehana Thabane, Respicious L. Boniface, Bruce Browner, Fernando de la Huerta, Rebecca Q Ivers, Theodore Miclau, Paul Moroz, Andrew Pollak, Gerard Slobogean, Parag Sancheti, Emil Schemitsch, Junlin Zhou, Paula McKay, Raman Mundi, Nathan O'Hara, Diane Heels-Ansdell, Lisa Buckingham, Nicole Simunovic, Robyn Norton, Jing Zhang, Maoyi Tian, Soumyadeep Bhaumik, Samina Parveen, Saam Morshed, Madeline C. MacKechnie, Yang Liu, Yanrui Zhao, Junfei Li, Haoran Zhang, Zhentao Zhang, Wei Zhang, Tao Guo, Guang Chen, Zichao Jia, Jianzhong Yang, Lixing Kang, Peng Zhang, Haoqing Ma, Donghai Liu, Yinghua Ma, Yanguo Qin, Jincheng Wang, He Liu, Xinlong Ma, Jianxiong Ma, Haobo Jia, Shuangshuang Cui, Zhihu Zhao, Lin Fu, Hongqiang Jiang, Jianwei Lv, Sanbao Hu, Yongwei Wang, Mingyao Sun, Shuqing Tao, Baochang Qi, Ming Gao, Bo Wu, Chunsheng Zhi, Ben Xing, Jun Yang, Wenjie Dai, Duo Lu, Shisheng He, Xinyu Cai, Gejun Liu, Gang Rui, Baoshan Hu, Pingfang Shi, Hua Chen, Te Wang, Qingqing Wang, Linzhen Xie, Huanguang Xie, Tony Mutanda, Juliet Ntuulo, Flavia Lubega, Gayita Teddy Tracy, Kayondo Zaitun, Sylvester Ndayisaba, Titus Amone, Samuel Remmy Odong, Mark Lutomia, Caesar Okatch, Thomas Bitok, Alexander Kiambuthi, Fred Mathew Toboso Otsyeno, Pankaj G Jani, Vincent Muoki Mutiso, John EO Ating'a, Peter Kavoo Kilonzo, James Muoki, Makena Mbogori, Joan Wambui Wambugu, Dorothy Torutt, Christopher Odok, Elisha Ngetich, Dean Otsyeno, Juma Wakhayanga, Desmond Nzioka, Deogracia Owende, Ruth Lucinde, Brian Ngure Kariuki, Dennis Kinyua, Maureen Kamau, Maureen Mwancha, Mellany Murgor, Marilyn Nyabuti, Rita Njoki, Patricia Wanza, Abraham Odongo, Paul Marealle, Athman Wanini, Marwa Elisha, Damas Zumbulu, Pariyo Bonane Godfrey, Benjamin Mukulu Ndeleva, Murila Johnson, Moses Kimani, Kinuthia Gichui, Rogers Joachin Temu, Angela Neofitus Mselle, Ancelimu Rafael Kimario, Mmampapatla Thomas Ramokgopa, Gregory Firth, Anna Grisillo Biscardi, Machuene Ananias Poopedi, Johan Moolman, Brenda Milner, Matimba Maluleke, Maxwell Jingo, Susan van Deventer, Timothy Pikor, Ravi Bhaga, Michael Mara, Geoffrey Chege Mwangi, Anthony Muchiri Maina, David Wamae Gicheru, Carol Mwangi, Isaac Kingori Wangai, Peter Watson Maina, Ezra Mitei Kiptoo, Olufemi Olukemi Temiloluwa, Adeyeye Adeolu Ikechukwu, Ige Oluwole Olugbenga, Ojodu Ishaq Bamidele, Oladimeji Oladipupo Akanbi, Panchu Subramanian, Olivia L Mosweu, Samuel Hailu, Geletaw Tessema, Bahiru Bezabih, Birhanu Ayana, Hiwot Hailu, Betelhem Zewdneh, Hana Tesfaye, Sosena Tadesse, Dominic Konadu-Yeboah, Vincent Ativor, Peter Konadu, Dominic Awariyah, Raphael Quartey, Raphael Kumah-Ametepey, Osman Saani, Robert Ekow Quansah, Paa Kwesi Baidoo, Peter Trafton, David Anyitey-Korkor, Michael Leat, Johnny Sobotie, Godwin Opuni, Kwasi Kusi, Twimasi Baah, Paul Okyere, Bernice Mensah, Doris Akuoko Sarpong, Felicia Agbenorwu, Phyllis Osei-Donkor, Priscilla Opoku, Michael Segbefia, Gerald Chukwuemeka Oguzie, Emmanuel Chino Iyidobi, Cajetan Uwatoronye Nwadinigwe, Sharon Amarachi Uloma Oguzie, Emina Bami Kesiena, Henry Tanyi Ndasi, Nietiayurk Aminake Ghislain, Mala Irine Shey, Ikose John Nanje, Ashok Shyam, Madhav Borate, Sampat Dumbre Patil, Sachin Karkamakar, Shailesh Patil, Abhijeet Ranaware, Shadab Tamboli, Manish Gandhalikar, Rohini Tupe, Vishal Chaudhari, Avanti Joshi, Sanjay Patil, Mohit Madhukar Dalwekar, Tejas Gandhi, Chintamani Latkar, Gopal Pundkare, Sandeep Shrivastava, Pradeep K Singh, Sanjay Deshpande, Sumit Baheti, Ravi Mittal, Vijay Sharma, Vinoo Mathew Cherian, Thilak Samuel Jepegnanam, Vijay T K Titus, Manasseh Nithyananth, Palapattu R J V C Boopalan, Viju Daniel Varghese, Justin Arockiaraj, Anupam Mahajan, Bobby John, Ritesh Pandey, Jeewan S Prakash, Valsamma Abraham, Arti Rajkumar, Harvinder Singh Chhabra, Rajesh Sharawat, Ritabh Kumar, Pushkar Chawla, Rashmi Yadav, Rajagopalan N Iyer, Naveen Nair, Rajkumar S Amaravathi, Srinivasalu Santhanagopa, Anoop Pilar, Keith Behram Tamboowala, Mandeep S Dhillon, Sarvdeep S Dhatt, Asolie Chase, Neel M Bhavsar, Rameez Musa, Darshan Shah, Sunil Chodavadiyah, Pankaj G Patel, Raja Irfan Qadir, Syed Imran Bukhari, Khushnood Ali Baz, Subin Byanjankar, Ruban Raj Joshi, Rajeev Dwivedi, Jay Raj Sharma, La Ngoc Quang, Nguyen Duc Chinh, Vu Bao Hong, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Wanjak Pongsamakthai, Irewin Alagar Tabu, Paula Veronica Reyes, Iardinne Caiquep, Joni Mitchell Robles Bituin, Jenna González, Mohammadreza Golbakhsh, Mashyaneh Haddadi, Soheil Saadat, Mohammadreza Zafarghandi, Clotilde Fuentes Orozco, José de Jesús Martínez Ruíz, Gustavo Armando Tafoya Arreguin, César Eduardo Pinedo Flores, Irydia Guadalupe Pellegrini Verduzco, Miguel Oscar Hernandez Camacho, Diego Abraham Estrada Téllez, Rodrigo Salcedo López, Ileana Guadalupe Canales Navarro, Mizael Dennis Pérez, Daniel de Jesús Enciso Carrillo, Paola Alejandra Álvarez López, Adán Cervantes Gómez, Fátima Nohemí Franco Bravo, Eugenia de los Ángeles Reyes Arias, Igor A. Escalante Elguezabal, Ennio Antonio Rizzo, Jean Michel Hovsepian, Victor Rodriguez, Manuel Malaret Baldo, Andres Serrano, Carlos G. Sanchez Valenciano, Edgar Efren Mercado Salcedo, Fryda Medina, Fernando Bidolegui, Sebastian Pereira, Gerardo Aguilar, Jorge Rubio-Avila, William Dias Belangero, José Ricardo Lenzi Mariolani, Bruno Livani, André Lugnani, Felipe Rossi, Angela Katayama, Fernando Baldy, Vinícius Ynoe de Moraes, Fabricio Fogagnolo, Kodi Edson Kojima, Jorge dos Santos Silva, Marco Kawamura Demange, Fernando Brandão de Andrade-Silva, Adriana Carvalho Gomes da Silva, Nelson Elias, Dino Aguilar Martinez, Fernando Contreras, Mario Garuz, Jose Eduardo Quintero, Gavino Merchan, Christian M. Lozano Lurita, Aturo D. Torres Manrique, Jorge Hurtado Fernandez, Sergio Iriarte Vincenti, Alfredo Pozzo Bobarin, Dalton Salinas Sanchez, Julio Segovia Altieri, Diego Almada, Derlis Bogado, Carlos Coronel, Cristian Boveda, Victor del Valle, Carlos Montiel, Nelson Marin, Antonio Barquet, Daniel Rienzi, Carlos Amanquez, Georges Beauvoir, Iván J Salce Cutipa, José Eduardo Grandi Ribeiro, José María Jiménez Avila, Luis Padilla, Hernando Cuevas Ochoa, Hernando Cuevas Cano, Adriana Vaca González, Nubia Itzel Gonzalez Gutierrez, and Victor Espinola
Subjects: Adult, Male, medicine.medical_specialty, Referral, INORMUS investigators, 030231 tropical medicine, MEDLINE, Logistic regression, Time-to-Treatment, 1117 Public Health and Health Services, 03 medical and health sciences, Fractures, Bone, 0302 clinical medicine, Patient Admission, Medicine and Health Sciences, medicine, Humans, 030212 general & internal medicine, Prospective Studies, Prospective cohort study, Developing Countries, business.industry, lcsh:Public aspects of medicine, lcsh:RA1-1270, General Medicine, Emergency department, Odds ratio, Middle Aged, 3. Good health, Socioeconomic Factors, Relative risk, Emergency medicine, Observational study, Female, business, 0605 Microbiology
Abstract: © 2020 The Author(s). Published by Elsevier Ltd. This is an Open Access article under the CC BY 4.0 license Background: The Lancet Commission on Global Surgery established the Three Delays framework, categorising delays in accessing timely surgical care into delays in seeking care (First Delay), reaching care (Second Delay), and receiving care (Third Delay). Globally, knowledge gaps regarding delays for fracture care, and the lack of large prospective studies informed the rationale for our international observational study. We investigated delays in hospital admission as a surrogate for accessing timely fracture care and explored factors associated with delayed hospital admission. Methods: In this prospective observational substudy of the ongoing International Orthopaedic Multicenter Study in Fracture Care (INORMUS), we enrolled patients with fracture across 49 hospitals in 18 low-income and middle-income countries, categorised into the regions of China, Africa, India, south and east Asia, and Latin America. Eligible patients were aged 18 years or older and had been admitted to a hospital within 3 months of sustaining an orthopaedic trauma. We collected demographic injury data and time to hospital admission. Our primary outcome was the number of patients with open and closed fractures who were delayed in their admission to a treating hospital. Delays for patients with open fractures were defined as being more than 2 h from the time of injury (in accordance with the Lancet Commission on Global Surgery) and for those with closed fractures as being a delay of more than 24 h. Secondary outcomes were reasons for delay for all patients with either open or closed fractures who were delayed for more than 24 h. We did logistic regression analyses to identify risk factors of delays of more than 2 h in patients with open fractures and delays of more than 24 h in patients with closed fractures. Logistic regressions were adjusted for region, age, employment, urban living, health insurance, interfacility referral, method of transportation, number of fractures, mechanism of injury, and fracture location. We further calculated adjusted relative risk (RR) from adjusted odds ratios, adjusted for the same variables. This study was registered with ClinicalTrials.gov, NCT02150980, and is ongoing. Findings: Between April 3, 2014, and May 10, 2019, we enrolled 31 255 patients with fractures, with a median age of 45 years (IQR 31–62), of whom 19 937 (63·8%) were men, and 14 524 (46·5%) had lower limb fractures, making them the most common fractures. Of 5256 patients with open fractures, 3778 (71·9%) were not admitted to hospital within 2 h. Of 25 999 patients with closed fractures, 7141 (27·5%) were delayed by more than 24 h. Of all regions, Latin America had the greatest proportions of patients with delays (173 [88·7%] of 195 patients with open fractures; 426 [44·7%] of 952 with closed fractures). Among patients delayed by more than 24 h, the most common reason for delays were interfacility referrals (3755 [47·7%] of 7875) and Third Delays (cumulatively interfacility referral and delay in emergency department: 3974 [50·5%]), while Second Delays (delays in reaching care) were the least common (423 [5·4%]). Compared with other methods of transportation (eg, walking, rickshaw), ambulances led to delay in transporting patients with open fractures to a treating hospital (adjusted RR 0·66, 99% CI 0·46–0·93). Compared with patients with closed lower limb fractures, patients with closed spine (adjusted RR 2·47, 99% CI 2·17–2·81) and pelvic (1·35, 1·10–1·66) fractures were most likely to have delays of more than 24 h before admission to hospital. Interpretation: In low-income and middle-income countries, timely hospital admission remains largely inaccessible, especially among patients with open fractures. Reducing hospital-based delays in receiving care, and, in particular, improving interfacility referral systems are the most substantial tools for reducing delays in admissions to hospital. Funding: National Health and Medical Research Council of Australia, Canadian Institutes of Health Research, McMaster Surgical Associates, and Hamilton Health Sciences.
Published: 2020

43. Bovine deciduous dentine is more susceptible to osteoclastic resorption than permanent dentine: results of quantitative analyses

Author: Varghese, Bobby John, Aoki, Kazuhiro, Shimokawa, Hitoyata, Ohya, Keiichi, and Takagi, Yuzo
Published: 2006
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44. Efficacy of Ponseti Technique in Virgin and Relapsed Clubfeet: A Comparative Study

Author: Prince Shanavas Khan, Bobby John, and Shiraz M Bhatty
Subjects: Male, Reoperation, medicine.medical_specialty, Congenital Clubfeet, Group ii, Cohort Studies, 03 medical and health sciences, 0302 clinical medicine, Recurrence, medicine, Deformity, Humans, Orthopedics and Sports Medicine, 030212 general & internal medicine, 030222 orthopedics, business.industry, Infant, Newborn, Infant, Ponseti method, Surgery, Casts, Surgical, Clubfoot, Treatment Outcome, Child, Preschool, Manipulation, Orthopedic, Female, medicine.symptom, business, After treatment
Abstract: Doubts still loom over the effectiveness of Ponseti casting in treating children with recurrent clubfeet. We have undertaken this study to confirm whether excellent results obtained in treating virgin clubfeet by Ponseti casting can be reproduced with equal success in relapsed clubfeet. The patients were divided into 2 groups; Group I was untreated children with congenital clubfeet younger than 1 year of age (21 feet) and Group II was children with relapsed congenital clubfeet younger than 2 years of age (21 feet). The Ponseti method was applied with equal success in both groups. Groups I (virgin) and II (recurrent) were similar in terms of number of casts, period of immobilization, and successful initial correction. We did not find statistically significant differences (p value = .75) when comparing the number of casts required for correcting deformity in virgin (mean 6.3) and relapsed group (mean 5.5). The Pirani score improved significantly after treatment from 4.3 to a post-treatment value of 0.4 (p < .001) in recurrent clubfeet and from 5.4 to 0.31 (p < .001) in virgin clubfeet. The results of our study suggest that excellent initial correction of deformity can be achieved without the need for an extensive soft tissue release in more than 95% of children with recurrent clubfeet.
Published: 2018
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45. A simple questionnaire for virtual follow‐up of orthognathic surgery patients during the COVID‐19 pandemic

Author: Anish Poorna T, Joshna EK, and Bobby John
Subjects: Government, Telemedicine, Coronavirus disease 2019 (COVID-19), business.industry, medicine.medical_treatment, Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), Orthognathic surgery, medicine.disease, Phone, Pandemic, Health care, Medicine, Surgery, Medical emergency, Oral Surgery, business
Abstract: The outbreak of COVID -19 pandemic has affected the health care infrastructure and wellness of health care workers in several ways1. Ever since its emergence, various guidelines and protocols have been proposed to curb its spread and increase the awareness among people. As the bulk of hospital and health care resources have been diverted to manage this pandemic outbreak, elective procedures like Orthognathic surgeries have been halted. In South India, as the cases were on gradual raise post the first wave of COVID-19, immediate lock downs were announced by the Government to prevent full blown second wave of COVID-192. As the strict lock downs were prevalent and number of COVID-19 cases increased, the hospital management of our Tertiary Reference Centre decided to reduce the number of reviews and Out-Patient cases. With the majority of the areas given red alert and marked as containment zones, the number of patients reporting for follow up reduced drastically. Telemedicine has gained popularity and practice among the various aspects of Medicine especially during this pandemic due to its efficiency and cost-effectiveness3. Hence, we decided to follow up the patients who underwent orthognathic surgery and could not report for review physically, via telemedicine (Phone/video calls) with the aid of contact numbers from the hospital registry.
Published: 2021
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46. A CASE REPORT OF MULTIPLE GRANULAR CELL TUMORS OF TONGUE WITH REVIEW OF LITERATURE

Author: Ramya A, Bobby John, Anish Poorna T, and Joshna Ek
Subjects: 03 medical and health sciences, Pathology, medicine.medical_specialty, 0302 clinical medicine, Granular cell, medicine.anatomical_structure, Tongue, business.industry, 030220 oncology & carcinogenesis, medicine, 030212 general & internal medicine, business
Abstract: Also called as Abrikossoff's tumor, the granular cell tumor (GCT) can occur in any part of the body, most of them occur in the head and neck especially in the tongue, cheek and palate. Almost three fourth of the lesions seen in head and neck are present over the tongue, oral mucosa or hard palate. Both benign and malignant lesions have been reported; although occurrence of malignancy is rare, comprising of 2% of all granular cell tumors. Here we present a case report of granular cell tumor of tongue at two different sites in a 17-year-old girl with a brief review of literature on granular cell tumors. Although oral GCTs exhibit a benign behavior they may demonstrate a wide variety of features and architectural patterns. Rather than a true neoplasm, GCTs could be regarded as lesions that reect a local metabolic or reactive change.
Published: 2021
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47. Influence of ethnic background on left atrial markers of inflammation, endothelial function and tissue remodelling

Author: Geetanjali Rangnekar, S. Kumar, Scott R. Willoughby, David Chase, Glenn D. Young, Carlee D. Ruediger, Prashanthan Sanders, Han S. Lim, Bobby John, and Kurt C. Roberts-Thomson
Subjects: medicine.medical_specialty, lcsh:Diseases of the circulatory (Cardiovascular) system, Heart disease, medicine.medical_treatment, Femoral vein, Inflammation, Context (language use), Catheter ablation, Thromboembolic stroke, 030204 cardiovascular system & hematology, 03 medical and health sciences, 0302 clinical medicine, Physiology (medical), Internal medicine, medicine, Ethnicity, Thrombogenesis, business.industry, Atrial fibrillation, Endothelial function, medicine.disease, Supraventricular tachycardia, lcsh:RC666-701, Cardiology, Original Article, medicine.symptom, Cardiology and Cardiovascular Medicine, business, 030217 neurology & neurosurgery
Abstract: Background It has been suggested that ethnicity can make a significant difference to the likelihood of thromboembolic stroke related to atrial fibrillation. Ethnic differences have been shown to alter inflammatory and haemostatic factors; however, this may all be confounded by differences in cardiovascular risk factors between different ethnicity. The impact of different ethnicities on the thrombogenic profile is not known. The aim of this study was to investigate differences in markers of inflammation, endothelial function and tissue remodelling between Caucasian and Indian populations with supraventricular tachycardia (SVT). Methods Patients with structurally normal hearts undergoing catheter ablation for SVT were studied. This study included 23 Australian (Caucasian) patients from the Royal Adelaide Hospital, Adelaide, Australia and 24 Indian (Indian) patients from the Christian Medical College, Vellore, India. Blood samples were collected from the femoral vein, and right and left atria. Blood samples were analysed for the markers of endothelial function (ADMA, ET-1), inflammation (CD40L, VCAM-1, ICAM-1), and tissue remodelling (MMP-9, TIMP-1) using ELISA. Results The study populations were well matched for cardiovascular risk factors and the absence of structural heart disease. No difference in the echocardiographic measurements between the two ethnicities was found. In this context, there was no difference in markers of inflammation, endothelial function or tissue remodelling between the two SVT populations. Conclusion Caucasian and Indian populations demonstrate similar inflammatory, endothelial function or tissue remodelling profiles. This study suggests a lack of an impact of different ethnicity in these populations in terms of thrombogenic risk.
Published: 2018

48. The World After COVID: Bootstrapping Development Policy

Author: Amir Ullah Khan and Bobby John
Subjects: Computer science, Econometrics, Bootstrapping (linguistics), Development policy
Published: 2021
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49. Editorial

Author: Bobby John and Amir Ullah Khan
Published: 2020
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50. Accelerated surgery versus standard care in hip fracture (HIP ATTACK): an international, randomised, controlled trial

Author: Flavia K Borges, Mohit Bhandari, Ernesto Guerra-Farfan, Ameen Patel, Alben Sigamani, Masood Umer, Maria E Tiboni, Maria del Mar Villar-Casares, Vikas Tandon, Jordi Tomas-Hernandez, Jordi Teixidor-Serra, Victoria RA Avram, Mitchell Winemaker, Mmampapatla T Ramokgopa, Wojciech Szczeklik, Giovanni Landoni, Chew Yin Wang, Dilshad Begum, John D Neary, Anthony Adili, Parag K Sancheti, Abdel-Rahman Lawendy, Mariano Balaguer-Castro, Paweł Ślęczka, Richard J Jenkinson, Aamer Nabi Nur, Gavin CA Wood, Robert J Feibel, Stephen J McMahon, Alen Sigamani, Ekaterine Popova, Bruce M Biccard, Iain K Moppett, Patrice Forget, Paul Landais, Michael H McGillion, Jessica Vincent, Kumar Balasubramanian, Valerie Harvey, Yaiza Garcia-Sanchez, Shirley M Pettit, Leslie P Gauthier, Gordon H Guyatt, David Conen, Amit X Garg, Shrikant I Bangdiwala, Emilie P Belley-Cote, Maura Marcucci, Andre Lamy, Richard Whitlock, Yannick Le Manach, Dean A Fergusson, Salim Yusuf, PJ Devereaux, Laurent Veevaete, Bernard le Polain de Waroux, Patricia Lavand'homme, Olivier Cornu, Karim Tribak, Jean Cyr Yombi, Nassim Touil, Maike Reul, Jigme Tshering Bhutia, Carol Clinckaert, Dirk De Clippeleir, Justin de Beer, Diane L Simpson, Andrew Worster, Kim A Alvarado, Krysten K Gregus, Kelly H Lawrence, Darryl P Leong, Philip G Joseph, Patrick Magloire, Benjamin Deheshi, Stuart Bisland, Thomas J Wood, Daniel M Tushinski, David AJ Wilson, Clive Kearon, David D Cowan, Vickas Khanna, Amna Zaki, Janet C Farrell, Anne Marie MacDonald, Steven CW Wong, Arsha Karbassi, Douglas Steven Wright, Harsha Shanthanna, Ryan Coughlin, Moin Khan, Spencer Wikkerink, Faraaz A Quraishi, Waleed Kishta, Emil Schemitsch, Timothy Carey, Mark D Macleod, David W Sanders, Edward Vasarhelyi, Debra Bartley, George K Dresser, Christina Tieszer, Steven Shadowitz, Jacques S Lee, Stephen Choi, Hans J Kreder, Markku Nousiainen, Monica R Kunz, Ravianne Tuazon, Mopina Shrikumar, Bheeshma Ravi, David Wasserstein, David JG Stephen, Diane Nam, Patrick DG Henry, Stephen M Mann, Melanie T Jaeger, Marco LA Sivilotti, Christopher A Smith, Christopher C Frank, Heather Grant, Leone Ploeg, Jeff D Yach, Mark M Harrison, Aaron R Campbell, Ryan T Bicknell, Davide D Bardana, Katie McIlquham, Catherine Gallant, Samantha Halman, Venkatesh Thiruganasambandamoorth, Sara Ruggiero, William J Hadden, Brian P-J Chen, Stephanie A Coupal, Lisa M McLean, Hemant R Shirali, Syed Y Haider, Crystal A Smith, Evan Watts, David J Santone, Kevin Koo, Allan J Yee, Ademilola N Oyenubi, Aaron Nauth, Emil H Schemitsch, Timothy R Daniels, Sarah E Ward, Jeremy A Hall, Henry Ahn, Daniel B Whelan, Amit Atrey, Amir Khoshbin, David Puskas, Kurt Droll, Claude Cullinan, Jubin Payendeh, Tina Lefrancois, Lise Mozzon, Travis Marion, Michael J Jacka, James Greene, Matthew Menon, Robert Stiegelmahr, Derek Dillane, Marleen Irwin, Lauren Beaupre, Chad P Coles, Kelly Trask, Shelley MacDonald, J Andrew I Trenholm, William Oxner, C Glen Richardson, Niloofar Dehghan, Mehdi Sadoughi, Achal Sharma, Neil J White, Loretta Olivieri, Stephen B Hunt, Thomas R Turgeon, Eric R Bohm, Sarah Tran, Stephen M Giilck, Tom Hupel, Pierre Guy, Peter J O'Brien, Andrew W Duncan, Gordon A Crawford, Junlin Zhou, Yanrui Zhao, Yang Liu, Lei Shan, Anshi Wu, Juan Manuel Muñoz, Philippe Chaudier, Marion Douplat, Michel Henri Fessy, Vincent Piriou, Lucie Louboutin, Jean Stephane David, Arnaud Friggeri, Sebastien Beroud, Jean Marie Fayet, Frankie Ka Li Leung, Christian Xinshuo Fang, Dennis King Hang Yee, Parag Kantilal Sancheti, Chetan Vijay Pradhan, Atul Ashok Patil, Chetan Prabhakar Puram, Madhav Pandurang Borate, Kiran Bhalchandra Kudrimoti, Bharati Anil Adhye, Himanshu Vijaykumar Dongre, Bobby John, Valsamma Abraham, Ritesh Arvind Pandey, Arti Rajkumar, Preetha Elizabeth George, Manesh Stephen, Nitheesh Chandran, Mohammed Ashraf, AM Georgekutty, Ahamad Shaheel Sulthan, S Adinarayanan, Deep Sharma, Satish Prasad Barnawal, Srinivasan Swaminathan, Prasanna Udupi Bidkar, Sandeep Kumar Mishra, Jagdish Menon, Niranjan M, Varghese Zachariah K, Santosh Angad Hiremath, Madhusudhan NC, Abhijit Jawali, Kingsly Robert Gnanadurai, Carolin Elizabeth George, Tatarao Maddipati, Mary KP KP, Vijay Sharma, Kamran Farooque, Rajesh Malhotra, Samarth Mittal, Chavi Sawhney, Babita Gupta, Purva Mathur, Shivanand Gamangati, Vijaylaxmi Tripathy, Prem Haridas Menon, Mandeep S Dhillon, Devendra K Chouhan, Sharanu Patil, Ravi Narayan, Purushotham Lal, Prashanth Nabhirajappa Bilchod, Surya Udai Singh, Uttam Vaidya Gattu, Ravi Prabhakar Dashputra, Prashant Vitthal Rahate, Maurizio Turiel, Giuseppe De Blasio, Riccardo Accetta, Paolo Perazzo, Daniele Stella, Marika Bonadies, Chiara Colombo, Stefania Fozzato, Fabio Pino, Ilaria Morelli, Eleonora Colnaghi, Vincenzo Salini, Giuseppe Denaro, Luigi Beretta, Giacomo Placella, Giuseppe Giardina, Mirko Binda, Anna Marcato, Luca Guzzetti, Fabio Piccirillo, Maurizio Cecconi, HM Khor, Hou Yee Lai, CS Kumar, KH Chee, PS Loh, Kit Mun Tan, Simmrat Singh, Li Lian Foo, Komella Prakasam, Sook Hui Chaw, Meng-Li Lee, Joanne HL Ngim, Huck Wee Boon, Im Im Chin, Ydo V Kleinlugtenbelt, Ellie BM Landman, Elvira R Flikweert, Herbert W Roerdink, Roy B.G. Brokelman, Hannie F Elskamp-Meijerman, Maarten R Horst, Jan-Hein MG Cobben, Anila Anjum, Pervaiz Mehmood Hashmi, Tashfeen Ahmed, Haroon Ur Rashid, Mujahid Jamil Khattak, Rizwan Haroon Rashid, Riaz Hussain Lakdawala, Shahryar Noordin, Naveed Muhammed Juman, Robyna Irshad Khan, Muhammad Mehmood Riaz, Syedah Saira Bokhari, Ayesha Almas, Hussain Wahab, Arif Ali, Hammad Naqi Khan, Eraj Khurshid Khan, Kholood Abid Janjua, Sajjad Hassan Orakzai, Abdus Salam Khan, Khawaja Junaid Mustafa, Mian Amjad Sohail, Muhammad Umar, Siddra Ahmed Khan, Muhammad Ashraf, Muhammad Kashif Khan, Muhammad Shiraz, Ahmad Furgan, Piotr Dąbek, Adam Kumoń, Wojciech Satora, Wojciech Ambroży, Mariusz Święch, Jacek Rycombel, Adrian Grzelak, Jaroslaw Gucwa, Waldemar Machala, Mmampapatla Thomas Ramokgopa, Gregory Bodley Firth, Mwalimu Karera, Maria Fourtounas, Virsen Singh, Anna Biscardi, Muhammad Nasir Iqbal, Ryan Jonathan Campbell, Matimba Lenny Maluleke, Carien Moller, Lerato Nhlapo, Sithombo Maqungo, Margot Flint, Marcin B Nejthardt, Sean Chetty, Rubendren Naidoo, Miriam Garrido Clua, Vicente Molero-Garcia, Joan Minguell-Monyart, Jordi Selga Marsa, Juan A Porcel-Vazquez, Jose-Vicente Andres-Peiro, Marc Aguilar, Jaume Mestre-Torres, Maria J Colomina, Patricia Guilabert, M Luisa Paños Gozalo, Luis Abarca, Nuria Martin, Gemma Usua, Pedro Martinez-Ripol, MA Gonzalez Posada, Pilar Lalueza-Broto, Judith Sanchez-Raya, Jorge Nuñez Camarena, Antoni Fraguas-Castany, Pere Torner, Monsant Jornet-Gibert, Jorge Serrano-Sanz, Jaume Cámara-Cabrera, Mònica Salomó-Domènech, Christian Yela-Verdú, Anna Peig-Font, Laura Ricol, Anna Carreras-Castañer, Luis Martínez-Sañudo, Susana Herranz, Carlos Feijoo-Massó, Mònica Sianes-Gallén, Pablo Castillón, Martí Bernaus, Saioa Quintas, Olga Gómez, Jordi Salvador, Javiera Abarca, Cristina Estrada, Marga Novellas, Mercè Torra, Alfred Dealbert, Oscar Macho, Alexia Ivanov, Esther Valldosera, Marta Arroyo, Borja Pey, Antoni Yuste, Llorenç Mateo, Julio De Caso, Rafael Anaya, JL Higa-Sansone, Angelica Millan, Victoria Baños, Sergio Herrera-Mateo, Hector J Aguado, Gonzalo Martinez-Municio, Ricardo León, Silvia Santiago-Maniega, Ana Zabalza, Gregorio Labrador, Enrique Guerado, Encarnacion Cruz, Juan Ramon Cano, Jose Manuel Bogallo, Paphon Sa-ngasoongsong, Noratep Kulachote, Norachart Sirisreetreerux, Nachapan Pengrung, Theerawat Chalacheewa, Vanlapa Arnuntasupakul, Teerapat Yingchoncharoen, Bundit Naratreekoon, Miriam Adel Kadry, Surendini Thayaparan, Ihab Abdlaziz, Arash Aframian, Arjuna Imbuldeniya, Souad Bentoumi, Sherif Omran, Marcela Paola Vizcaychipi, Patricia Correia, Shashank Patil, Kevin Haire, Amy SE Mayor, Sally Dillingham, Laura Nicholson, Mohamed Elnaggar, Joby John, Shashi Kumar Nanjayan, Martyn J Parker, Susan O'Sullivan, Meir T Marmor, Amir Matityahu, Robert Trigg McClellan, Curt Comstock, Anthony Ding, Paul Toogood, Gerard Slobogean, Katherine Joseph, Robert O'Toole, Marcus Sciadini, Scott P Ryan, Molly E Clark, Charles Cassidy, Konstantin Balonov, Sergio D Bergese, Laura S Phieffer, Alicia A Gonzalez Zacarias, Andrew J Marcantonio, Sanela Dragic-Taylor, Chelsea Maxwell, Sarah Molnar, Jennifer R Wells, Sandra N Ofori, Stephen S Yang, Michael K Wang, Emmanuelle Duceppe, Jessica Spence, Javiera P Vasquez, Francesc Marcano-Fernández, Hyungjoo Ham, Carlos Prada, Terence CH Yung, Isidro Sanz Pérez, Michael J Bosch, Michael R Prystajecky, Chinmoy Chowdhury, James S Khan, Steffan F Stella, Behrouz Heidary, Allen Tran, Katarzyna Wawrzycka-Adamczyk, Yu Chiao Peter Chen, Aránzazu González-Osuna, Grzegorz Biedroń, Anna Wludarczyk, Marco Lefebvre, Jaclyn A Ernst, Bas Staffhorst, Jason D Woodfine, Emad M Alwafi, Marko Mrkobrada, Simon Parlow, Robin Roberts, Finlay McAlister, David Sackett, James Wright, (HIP ATTACK, Investigators), Landoni, G., Faculty of Medicine and Pharmacy, Orthopaedics - Traumatology, Supporting clinical sciences, Emergency Medicine, UCL - SSS/IONS - Institute of NeuroScience, UCL - SSS/IONS/CEMO - Pôle Cellulaire et moléculaire, UCL - SSS/IREC/NMSK - Neuro-musculo-skeletal Lab, UCL - SSS/IREC/SLUC - Pôle St.-Luc, UCL - (SLuc) Service d'anesthésiologie, UCL - (SLuc) Service d'orthopédie et de traumatologie de l'appareil locomoteur, and UCL - (SLuc) Service de médecine interne générale
Subjects: Postoperative Complications/epidemiology, Male, Internationality, Femoral Neck Fractures/epidemiology, Arthroplasty, Replacement, Hip, Myocardial Ischemia, Comorbidity, Time-to-Treatment/statistics & numerical data, 030204 cardiovascular system & hematology, law.invention, Fracture Fixation, Internal, Postoperative Complications, 0302 clinical medicine, Randomized controlled trial, Residence Characteristics, law, Activities of Daily Living, Fracture fixation, Risk of mortality, Medicine and Health Sciences, Fracture Fixation, Internal/methods, Sepsis/epidemiology, 030212 general & internal medicine, Cardiovascular Diseases/mortality, Stroke, Aged, 80 and over, Hip fracture, Residence Characteristics/statistics & numerical data, Infections/epidemiology, General Medicine, Middle Aged, Open Fracture Reduction, Treatment Outcome, Cardiovascular Diseases, Diabetes Mellitus/epidemiology, Female, medicine.medical_specialty, Hip Fractures/epidemiology, Postoperative Hemorrhage, Infections, Early Medical Intervention/methods, Time-to-Treatment, 03 medical and health sciences, Arthroplasty, Replacement, Hip/methods, Early Medical Intervention, Sepsis, Diabetes Mellitus, medicine, Humans, Mortality, Myocardial Ischemia/epidemiology, Aged, Proportional Hazards Models, Postoperative Hemorrhage/epidemiology, Hip Fractures, Proportional hazards model, business.industry, Hemiarthroplasty/methods, Dementia/epidemiology, Delirium, Delirium/epidemiology, medicine.disease, Femoral Neck Fractures, Nursing Homes, Surgery, Open Fracture Reduction/methods, Dementia, Observational study, Hemiarthroplasty, business
Abstract: © 2020 Elsevier Ltd Background: Observational studies have suggested that accelerated surgery is associated with improved outcomes in patients with a hip fracture. The HIP ATTACK trial assessed whether accelerated surgery could reduce mortality and major complications. Methods: HIP ATTACK was an international, randomised, controlled trial done at 69 hospitals in 17 countries. Patients with a hip fracture that required surgery and were aged 45 years or older were eligible. Research personnel randomly assigned patients (1:1) through a central computerised randomisation system using randomly varying block sizes to either accelerated surgery (goal of surgery within 6 h of diagnosis) or standard care. The coprimary outcomes were mortality and a composite of major complications (ie, mortality and non-fatal myocardial infarction, stroke, venous thromboembolism, sepsis, pneumonia, life-threatening bleeding, and major bleeding) at 90 days after randomisation. Patients, health-care providers, and study staff were aware of treatment assignment, but outcome adjudicators were masked to treatment allocation. Patients were analysed according to the intention-to-treat principle. This study is registered at ClinicalTrials.gov (NCT02027896). Findings: Between March 14, 2014, and May 24, 2019, 27 701 patients were screened, of whom 7780 were eligible. 2970 of these were enrolled and randomly assigned to receive accelerated surgery (n=1487) or standard care (n=1483). The median time from hip fracture diagnosis to surgery was 6 h (IQR 4–9) in the accelerated-surgery group and 24 h (10–42) in the standard-care group (p
Published: 2020

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