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Book: Lipocrinology

Kalra, Sanjay / Priya, Gagan

the relationship between lipids and endocrine function

2019

Author's details	editors Sanjay Kalra, Gagan Priya
Language	English
Size	188 Seiten
Publisher	Jaypee Brothers Medical Publishers
Publishing place	New Delhi
Publishing country	India
Document type	Book
HBZ-ID	HT020040387
ISBN	978-93-5270-388-3 ; 93-5270-388-X
Database	Catalogue ZB MED Medicine, Health

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2019 A 1190	available for loan (reading room)	Lesesaal EG

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Article: Iatrogenic PVD Following Dilated Fundus Examination: A New Diagnosis or Fluke?

W Commiskey, Patrick / Kalra, Gagan / Chhablani, Jay

Journal of ophthalmic & vision research

2022 Volume 17, Issue 1, Page(s) 150–151

Language	English
Publishing date	2022-01-21
Publishing country	United Arab Emirates
Document type	Journal Article
ISSN	2008-2010
ISSN	2008-2010
DOI	10.18502/jovr.v17i1.10182
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Article ; Online: Vertebrobasilar dolichoectasia and other arterial abnormalities leading to abducens nerve palsy.

Aggarwal, Aishwarya / Kalra, Gagan / Caplan, Louis R

Journal of stroke and cerebrovascular diseases : the official journal of National Stroke Association

2023 Volume 32, Issue 5, Page(s) 107051

Abstract: Introduction: Dolichoectatic vessels can cause cranial nerve dysfunction by either direct compression or ischemia. Abducens nerve palsy due to neurovascular compression by elongated, enlarged, tortuous or dilated arteries is an uncommon but important ... ...

Abstract	Introduction: Dolichoectatic vessels can cause cranial nerve dysfunction by either direct compression or ischemia. Abducens nerve palsy due to neurovascular compression by elongated, enlarged, tortuous or dilated arteries is an uncommon but important cause. Aim: To highlight neurovascular compression as a cause of abducens nerve palsy and discuss various diagnostic techniques. Methods: Manuscripts were identified using the National Institutes of Health PubMed literature search system. Search terms included abducens nerve palsy, neurovascular compression, dolichoectasia and arterial compression. Inclusion criteria required that the articles were written in English. Results: The literature search identified 21 case reports where abducens nerve palsy was due to vascular compression. Out of these 18 patients were male and the mean age was 54 years. Eight patients had unilateral right abducens nerve involvement; eleven patients had unilateral left nerve involvement and two patients had bilateral involvement. The arteries causing the compression were basilar, vertebral and anterior inferior cerebellar arteries. A compressed abducens nerve is not usually clearly detected on CT (Computed Tomography) or MRI (Magnetic Resonance Imaging). MRA (Magnetic Resonance Angiography), Heavy T2- WI (weighted imaging), CISS (constructive interference in steady state) and FIESTA (Fast Imaging Employing Steady-state Acquisition) are essential to demonstrate vascular compression of the abducens nerve. The various treatment options included controlling hypertension, glasses with prisms, muscle resection and microvascular decompression.
MeSH term(s)	Humans ; Male ; Middle Aged ; Female ; Abducens Nerve Diseases/diagnosis ; Abducens Nerve Diseases/etiology ; Abducens Nerve Diseases/therapy ; Vertebrobasilar Insufficiency/complications ; Vertebrobasilar Insufficiency/diagnostic imaging ; Vertebrobasilar Insufficiency/therapy ; Abducens Nerve ; Basilar Artery/diagnostic imaging ; Basilar Artery/pathology ; Magnetic Resonance Imaging/methods
Language	English
Publishing date	2023-03-03
Publishing country	United States
Document type	Journal Article
ZDB-ID	1131675-5
ISSN	1532-8511 ; 1052-3057
ISSN (online)	1532-8511
ISSN	1052-3057
DOI	10.1016/j.jstrokecerebrovasdis.2023.107051
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Zs.A 3519: Show issues

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bis Jg. 1994: Bestellungen von Artikeln über das Online-Bestellformular
Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article: Barocrinology.

Kalra, Sanjay / Priya, Gagan / Kapoor, Nitin

JPMA. The Journal of the Pakistan Medical Association

2021 Volume 71, Issue 1(A), Page(s) 170–171

Abstract: The authors propose "Barocrinology", a novel terminology in medical literature, to comprehensively describe the rapidly expanding field of obesity medicine. This new term highlights the need to appreciate the role of endocrine physiology in the evolution ...

Abstract	The authors propose "Barocrinology", a novel terminology in medical literature, to comprehensively describe the rapidly expanding field of obesity medicine. This new term highlights the need to appreciate the role of endocrine physiology in the evolution of obesity, insights into its complications and changes in the hormonal milieu following weight loss therapies, including bariatric surgery. This term would not only reduce the stigma associated with obesity in affected individuals but also give them a better appreciation of its biological origin rather than self-criticism. This paper also undermines the importance of a multi-disciplinary approach needed in this field for achieving practical and sustainable goals, individualized to each person.
MeSH term(s)	Bariatric Surgery ; Humans ; Obesity/therapy ; Social Stigma ; Weight Loss
Language	English
Publishing date	2021-01-23
Publishing country	Pakistan
Document type	Journal Article
ZDB-ID	603873-6
ISSN	0030-9982
ISSN	0030-9982
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Article: Diabetes Insipidus: A Pragmatic Approach to Management.

Priya, Gagan / Kalra, Sanjay / Dasgupta, Arundhati / Grewal, Emmy

Cureus

2021 Volume 13, Issue 1, Page(s) e12498

Abstract: Diabetes insipidus (DI) is a disorder of water balance characterized by polyuria and polydipsia. It can occur due to genetic and acquired causes that affect the secretion or action of arginine vasopressin (AVP) or antidiuretic hormone (ADH).Markedly ... ...

Abstract	Diabetes insipidus (DI) is a disorder of water balance characterized by polyuria and polydipsia. It can occur due to genetic and acquired causes that affect the secretion or action of arginine vasopressin (AVP) or antidiuretic hormone (ADH).Markedly increased thirst and urination are not only quite distressing but also increases the risk of volume depletion and hypernatremia in severe situations. A careful diagnosis of the type of DI and its etiology is based on careful clinical evaluation, measurement of urine and serum osmolality, and water deprivation test. Management includes the correction of any water deficit and the use of specific pharmacological agents, including desmopressin, thiazides, and amiloride.
Language	English
Publishing date	2021-01-05
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2747273-5
ISSN	2168-8184
ISSN	2168-8184
DOI	10.7759/cureus.12498
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Article ; Online: Choroidal Mass in a Patient with Undiagnosed Pulmonary Langerhans' Cell Histiocytosis.

Kalra, Gagan / Fu, Roxana / Medina Mendez, Carlos A / Errera, Marie-Hélène / Waxman, Evan L

Ocular immunology and inflammation

2023 , Page(s) 1–6

Abstract: Background: Langerhan cell histiocytosis (LCH), although not a common cause, should be kept in the differential diagnosis for a patient that presents with a choroidal mass.: Case presentation: A 28-year-old female presented with a 4-day history of ... ...

Abstract	Background: Langerhan cell histiocytosis (LCH), although not a common cause, should be kept in the differential diagnosis for a patient that presents with a choroidal mass. Case presentation: A 28-year-old female presented with a 4-day history of vision loss and associated pain in her right eye. Examination and investigations: A dilated fundus examination revealed a deep subretinal, orange, mottled lesion with associated serous retinal detachment. Ultrasonography demonstrated a solid mass at the posterior pole. Fluorescein angiography revealed corresponding, small, punctate, hyperfluorescent areas with leakage and pooling in the late phase outlining the subretinal fluid. Optical coherence tomography confirmed the choroidal elevation and subretinal fluid. In addition to starting oral steroids for addressing the patient's acute symptoms, a metastatic workup was ordered due to the lesion's appearance. Diagnosis: Computed tomography (CT) of the chest showed nodular lesions and subsequent lung biopsy was S-100 and CD1a positive, diagnostic of Langerhan's cell histiocytosis (LCH). Treatment and outcome: The patient was treated with six cycles of vinblastine and prednisolone therapy followed with a subsequent taper of steroids. Complete resolution of signs and symptoms was noted. Discussion: A review of all reported cases of ophthalmic LCH with or without choroidal involvement was conducted. Diagnostic and therapeutic approaches described in these reportshave been summarized in the current manuscript. This case highlights the importance of pursuing a systemic workup in patients with uveal mass lesions. LCH should be considered in the differential of every choroidal mass.
Language	English
Publishing date	2023-04-12
Publishing country	England
Document type	Journal Article
ZDB-ID	1193873-0
ISSN	1744-5078 ; 0927-3948
ISSN (online)	1744-5078
ISSN	0927-3948
DOI	10.1080/09273948.2023.2192284
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Zs.A 4004: Show issues

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Jg. 1995 - 2021: Lesesall (2.OG)
ab Jg. 2022: Lesesaal (EG)

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Article ; Online: Surgical trends in glaucoma management: The current Indian scenario.

Ichhpujani, Parul / Singla, Ekta / Kalra, Gagan / Bhartiya, Shibal / Kumar, Suresh

International ophthalmology

2022 Volume 42, Issue 6, Page(s) 1661–1668

Abstract: Objectives: To assess the current trend in the surgical management of glaucoma in India.: Methods: An anonymous online survey evaluating the preferred choices in the surgical management of glaucoma was circulated among the members of Glaucoma Society ...

Abstract	Objectives: To assess the current trend in the surgical management of glaucoma in India. Methods: An anonymous online survey evaluating the preferred choices in the surgical management of glaucoma was circulated among the members of Glaucoma Society of India (GSI). Survey responses were compared to prior survey among GSI members in 2013 and members of American Glaucoma Society (AGS), 2016. Results: A total of 175 of 879(20%) GSI members participated in the survey of which 75.3% of the survey participants were practicing in the private sector. Trabeculectomy with or without augmentation with Mitomycin C(MMC) was the first-choice glaucoma incisional surgery for 96.6% of the survey participants. Of the participants doing tube surgery, use of valved GDD was the preferred choice (83.4%). Re-trabeculectomy was the preferred approach (60.7%) in case of trabeculectomy failure. For paediatric glaucomas, combined trabeculotomy with trabeculectomy was the preferred surgical approach for both hazy cornea (84.5%) as well as clear cornea (66%). For a POAG patient without prior incisional surgery and presenting with visually significant cataract, phacoemulsification with trabeculectomy was the preferred management approach by 58.7% of the participants. Conclusion: Trabeculectomy continues to be the clear winner for the Indian glaucoma surgeon because of its cost effectiveness, lack of expensive instrumentation, and a more robust surgical training for trabeculectomy during residency programs. A higher proportion of angle closure disease precludes the use of minimally invasive glaucoma surgery and very often tube shunts also. Economics, ease of access and follow-up made a combined cataract and glaucoma surgery a preferred choice among Indian surgeons.
MeSH term(s)	Cataract/complications ; Child ; Glaucoma/etiology ; Glaucoma/surgery ; Glaucoma Drainage Implants/adverse effects ; Humans ; Intraocular Pressure ; Mitomycin/therapeutic use ; Trabeculectomy/adverse effects ; Treatment Outcome
Chemical Substances	Mitomycin (50SG953SK6)
Language	English
Publishing date	2022-01-31
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	800087-6
ISSN	1573-2630 ; 0165-5701
ISSN (online)	1573-2630
ISSN	0165-5701
DOI	10.1007/s10792-021-02160-x
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Article ; Online: Breaking bad news about glaucoma: a SPIKES strategy primer.

Ichhpujani, Parul / Kalra, Gagan / Singla, Ekta / Kumar, Suresh

International ophthalmology

2021 Volume 41, Issue 12, Page(s) 3893–3901

Abstract: Purpose: Most ophthalmic physicians are not formally trained for breaking the news of having sight threatening diseases, requiring lifelong therapy. This study aims to ascertain physician practices and patients' experiences regarding delivery of bad ... ...

Abstract	Purpose: Most ophthalmic physicians are not formally trained for breaking the news of having sight threatening diseases, requiring lifelong therapy. This study aims to ascertain physician practices and patients' experiences regarding delivery of bad news. Methods: An online, anonymous questionnaire was sent to 400 ophthalmologists practising glaucoma to gather information as to how they deliver bad news to their patients. A parallel survey was also conducted amongst 100 established glaucoma patients to know whether how their doctor had delivered the diagnosis of glaucoma to them. After this, resident doctors were trained in SPIKES strategy and the patient survey was repeated in 100 new patients. Results: Two hundred and eighteen out of 400 ophthalmologists responded to our survey resulting in a survey yield of 54.5%. About 56.5% ophthalmologists dealt with disclosing the diagnosis >20 times a month; 70% of responders always discussed about the true severity of disease up-front. Only 8.70% respondents had formal training for breaking the bad news. Results of first phase of patient survey revealed that nearly one-third of patients (27%), felt that their doctor used incomprehensible medical terminology and 42% patients said that their doctor downplayed their diagnosis. Only 12% provided information to their patients about reliable sources to gather additional information. After the resident doctors were trained in SPIKES strategy, the second phase of patient survey had marked positive change in the way information was delivered. Conclusion: The current study shows that despite years of clinical experience, many ophthalmologists face difficulty in delivering bad news for a sight threatening disease such as glaucoma. Therefore, SPIKES strategy or a similar protocol must be taught to practising ophthalmologists at all levels, to alleviate worries of patients suffering from chronic, visually debilitating diseases.
MeSH term(s)	Glaucoma/diagnosis ; Humans ; Physician-Patient Relations ; Surveys and Questionnaires ; Truth Disclosure
Language	English
Publishing date	2021-07-28
Publishing country	Netherlands
Document type	Journal Article
ZDB-ID	800087-6
ISSN	1573-2630 ; 0165-5701
ISSN (online)	1573-2630
ISSN	0165-5701
DOI	10.1007/s10792-021-01956-1
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Article ; Online: Longitudinal Quantitative Ultrawidefield Angiographic Features in Diabetic Retinopathy Treated with Aflibercept from the Intravitreal Aflibercept as Indicated by Real-Time Objective Imaging to Achieve Diabetic Retinopathy Improvement Trial.

Kalra, Gagan / Wykoff, Charles / Martin, Alison / Srivastava, Sunil K / Reese, Jamie / Ehlers, Justis P

Ophthalmology. Retina

2023 Volume 8, Issue 2, Page(s) 116–125

Abstract: Objective: To report longitudinal trends of quantitative ultrawidefield fluorescein angiography (qUWFA) biomarkers in the Intravitreal Aflibercept as Indicated by Real-Time Objective Imaging to Achieve Diabetic Retinopathy Improvement (PRIME) diabetic ... ...

Abstract	Objective: To report longitudinal trends of quantitative ultrawidefield fluorescein angiography (qUWFA) biomarkers in the Intravitreal Aflibercept as Indicated by Real-Time Objective Imaging to Achieve Diabetic Retinopathy Improvement (PRIME) diabetic retinopathy (DR) clinical trial. Design: Post hoc analysis of the PRIME prospective randomized DR clinical trial comparing intravitreal aflibercept treatment based on the DR severity score (DRSS) or quantitative leakage index for DR improvement (ClinicalTrials.gov identifier: NCT03531294). Participants: Patients were enrolled with a DRSS level of 47A to 71A and best-corrected visual acuity of 20/800 or better. Key exclusion criteria were previous intravitreal injection, panretinal photocoagulation, vitrectomy, central-involving macular edema, or vitreous hemorrhage. Methods: A previously validated, machine learning-based qUWFA analysis platform was used for panretinal leakage index assessment and differentiation of generalized and perivascular leakage phenotypes. Additionally, microaneurysm count and ischemic index were quantified in panretinal and macular regions. The trends in these biomarkers and therapeutic response were studied over 1 year. Main outcome measures: Longitudinal trends of qUWFA biomarkers. The impact of these qUWFA metrics on treatment response was assessed by studying their associations with time to 2-step DRSS improvement and number of treatment-free days. Results: Forty eyes from 40 subjects with DR were enrolled. Lower baseline generalized leakage was noted in eyes that attained the 2-step DRSS improvement in < 16 weeks (1.9% vs. 2.8%; P = 0.026). Baseline macular perivascular-generalized leakage ratio had a significant correlation with the number of treatment-free days (r = 0.4; P = 0.012). At the end of 1 year, therapy significantly reduced the mean panretinal (3.9% vs. 5.8%; P = 0.002) and macular (6.2% vs. 12.2%; P = 0.008) generalized leakage indices compared with baseline, as well as the mean panretinal perivascular leakage index (1.5% vs. 2.3%; P = 0.002). The mean panretinal ischemic index demonstrated a small but likely clinically insignificant decrease from 12.5% at baseline to 11.6% at year 1 (P = 0.016). Conclusions: Down-trending leakage indices and microaneurysm counts were demonstrated over 1 year of anti-VEGF therapy. At baseline, DR eyes with lower generalized leakage responded to therapy more rapidly. Eyes with greater perivascular leakage relative to generalized leakage showed a longer-lasting anti-VEGF treatment response. Financial disclosure(s): Proprietary or commercial disclosure may be found in the Footnotes and Disclosures at the end of this article.
MeSH term(s)	Humans ; Diabetic Retinopathy/complications ; Diabetic Retinopathy/diagnosis ; Diabetic Retinopathy/drug therapy ; Angiogenesis Inhibitors/therapeutic use ; Microaneurysm ; Prospective Studies ; Treatment Outcome ; Tomography, Optical Coherence ; Biomarkers ; Diabetes Mellitus/drug therapy ; Recombinant Fusion Proteins ; Receptors, Vascular Endothelial Growth Factor
Chemical Substances	aflibercept (15C2VL427D) ; Angiogenesis Inhibitors ; Biomarkers ; Recombinant Fusion Proteins ; Receptors, Vascular Endothelial Growth Factor (EC 2.7.10.1)
Language	English
Publishing date	2023-09-09
Publishing country	United States
Document type	Journal Article
ISSN	2468-6530
ISSN (online)	2468-6530
DOI	10.1016/j.oret.2023.09.004
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Article: Ideal Illumination for Smartphone-based Trabeculectomy Bleb Photography.

Kalra, Gagan / Ichhpujani, Parul / Thakur, Sahil / Sharma, Urvashi

Journal of ophthalmic & vision research

2021 Volume 16, Issue 3, Page(s) 357–366

Abstract: Purpose: Ophthalmology has seen numerous novel uses for smartphones over the years including fundus photography, telemedicine, and operative videography. However, anterior segment photography for assessing and documenting trabeculectomy bleb morphology ... ...

Abstract	Purpose: Ophthalmology has seen numerous novel uses for smartphones over the years including fundus photography, telemedicine, and operative videography. However, anterior segment photography for assessing and documenting trabeculectomy bleb morphology using a smartphone has not been explored in detail. With the current study, we aim to characterize ideal illumination for the anterior segment smartphone photography in trabeculectomy patients. Methods: Thirty status post-trabeculectomy patients were enrolled in this study. Native camera application and FiLMiC pro camera application were used on iPhone X to compare bleb images using yellow and white pen-torches as illumination source. Measured bleb area was compared using ImageJ software from the two apps in different illumination settings by charting boxplots and using one-way ANOVA test using R software to establish consistency. Bland-Altman interoperability for repeatability of bleb-area measurements was analyzed by plotting Bland-Altman plots. Signal-to-noise ratio was calculated using ImageJ for native camera images using slit-lamp camera images as reference. Subjective rating of these images was then performed by two experienced ophthalmologists and kappa coefficient was calculated for inter-operator repeatability. Statistical analysis was performed. Results: The measured bleb area from images taken from both apps showed no significant difference, thereby establishing consistency, and Bland-Altman analysis indicated good repeatability and reproducibility. It was noted that SNR was lower for images shot in close illumination as compared to the ones shot in intermediate and distant illumination. Cohen's kappa coefficient was 0.7 for images with distant illumination using white light and 0.65 for images clicked with illumination at an intermediate distance using yellow light, suggesting substantial agreement between the observers. Conclusion: Smartphone photography is a reliable tool for morphological assessment trabeculectomy blebs. Optimal illumination helps achieve results free from digital noise and better delineation of specific morphological features. Intermediate illumination and distant illumination provides much better results in terms of high SNR while avoiding overexposure and clipping of highlight information in the images.
Language	English
Publishing date	2021-07-29
Publishing country	United Arab Emirates
Document type	Journal Article
ISSN	2008-2010
ISSN	2008-2010
DOI	10.18502/jovr.v16i3.9432
Database	MEDical Literature Analysis and Retrieval System OnLINE

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