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Book ; Online ; E-Book: Imaging in Critical Care Medicine

Choudhuri, Anirban Hom / Verma, Ashish / Kumar, Ishan

2024

Abstract: Imaging in critically ill patients is a ubiquitous but challenging line of investigation for the physician as accurate interpretation is often difficult as patient cooperation during the procedure is grossly compromised, and the resultant image is often ...

Author's details	edited by Anirban Hom Choudhuri and Ashish Verma ; associate editor, Ishan Kumar
Abstract	"Imaging in critically ill patients is a ubiquitous but challenging line of investigation for the physician as accurate interpretation is often difficult as patient cooperation during the procedure is grossly compromised, and the resultant image is often suboptimal. This book provides details on principles of imaging and the diagnostic hallmarks of common diseases helping in correct interpretation. It contains guidance to overcome the deficiencies observed during the performance of bedside imaging and equipment handling and addresses the rationale for various procedural/management and imaging approaches. This is a useful companion for most doctors and trainees working in critical care settings"--
Keywords	Diagnostic imaging ; Catastrophic illness
Subject code	616.0754
Language	English
Size	1 online resource (219 pages)
Publisher	CRC Press
Publishing place	Boca Raton, FL
Document type	Book ; Online ; E-Book
Note	Includes index.
Remark	Zugriff für angemeldete ZB MED-Nutzerinnen und -Nutzer
ISBN	1-00-321873-3 ; 1-003-21873-3 ; 1-000-88510-0 ; 9781032111780 ; 978-1-00-321873-9 ; 978-1-003-21873-9 ; 978-1-000-88510-1 ; 103211178X
Database	ZB MED Catalogue: Medicine, Health, Nutrition, Environment, Agriculture

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Article ; Online: Pulmonary Artery Hypertension in Transfusion-Dependent Thalassemia.

Gupta, Vineeta / Vijayakumar, Vishnu / Aggarwal, Priyanka / Kumar, Ishan / Agrawal, Vikas

Indian pediatrics

2024 Volume 61, Issue 1, Page(s) 49–52

Abstract: Objective: Patients with transfusion-dependent thalassemia (TDT) are at risk of developing pulmonary artery hypertension (PAH) due to chronic hemolysis, iron overload, hypercoagulability and splenectomy. The objective of the study was to assess the ... ...

Abstract	Objective: Patients with transfusion-dependent thalassemia (TDT) are at risk of developing pulmonary artery hypertension (PAH) due to chronic hemolysis, iron overload, hypercoagulability and splenectomy. The objective of the study was to assess the prevalence and predictors of PAH in patients with TDT. Methods: Patients aged 6-18 years with TDT were included. 2D-echocardiography was done to measure the pulmonary artery systolic pressure (PASP) and left ventricular ejection fraction (LVEF). T2* MRI was done to evaluate cardiac iron overload. N-terminal-pro brain natriuretic peptide (NT-pro BNP) level was also assessed. Results: Out of 61 participants, PAH was noted in 19 (31.6%). Mean (SD) age of the patients with PAH and without PAH was 12.2 (3.8) and 9.6 (3.5) years, respectively (P = 0.016). Five of 19 patients with PAH (26.3%) had undergone splenectomy as against 5 of 41 patients without PAH (12.2%) (P = 0.17). Years since splenectomy was higher in the PAH group. Mean (SD) NT-Pro BNP levels were also higher in patients with PAH [63.80 (25.89) vs 41.97 (23.95), P = 0.01]. Significantly higher number of patients with PAH had cardiac T2* value of < 10 ms (P = 0.04). Age (OR 4.11; 95% CI 1.46-8.77), years since splenectomy (OR 3.24; 95% CI 1.30-7.86), NT-Pro BNP levels (OR 4.43; 95% CI 2.14-9.61) and cardiac T2* MRI (OR 2.46; 95% CI 2.18-6.90) values were predictors of PAH in patients with TDT. Conclusion: PAH was observed in 31.6% of patients, with older age and years since splenectomy being important risk factors. NT-Pro BNP can be used as screening test for detecting PAH.
MeSH term(s)	Humans ; Pulmonary Artery ; Stroke Volume ; Ventricular Function, Left ; Thalassemia/complications ; Thalassemia/epidemiology ; Thalassemia/therapy ; Iron Overload ; Hypertension
Language	English
Publishing date	2024-01-03
Publishing country	India
Document type	Journal Article
ZDB-ID	402594-5
ISSN	0974-7559 ; 0019-6061
ISSN (online)	0974-7559
ISSN	0019-6061
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Zs.A 859: Show issues

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Article: High-Resolution Ultrasound in Evaluation of Peripheral Neuropathy in Patients of Hansen's Disease.

Rai, Tulika / Singh, Atul M / Indal, Manish / Kumar, Ishan

Indian dermatology online journal

2024 Volume 15, Issue 2, Page(s) 213–217

Abstract: Introduction: Hansen's disease (HD) is a major public health problem in developing countries. It causes peripheral neuropathy, and if left untreated, it leads to deformities. It is important to diagnose such cases early, and prompt treatment should be ... ...

Abstract	Introduction: Hansen's disease (HD) is a major public health problem in developing countries. It causes peripheral neuropathy, and if left untreated, it leads to deformities. It is important to diagnose such cases early, and prompt treatment should be given to patients to preserve nerve function. Materials and methods: A total of 40 patients with HD who were already on multi-drug therapy (MDT) or treatment-naive were included in this study. These were clinically diagnosed cases of HD as per the Ridley-Jopling classification, and these patients were subjected to high-resolution ultrasonography (HRUS). A total of 19 controls were also included. The patients were clinically evaluated, and HRUS of bilateral ulnar nerves (UNs) was performed in all cases and controls. The other peripheral nerves, if clinically thickened, were evaluated using HRUS. Results: The cross-sectional area (CSA) of the UN in cases was significantly thickened as compared to controls. There was no difference in the CSA of patients on MDT as compared to treatment naïve patients. In two patients with pure neuritic HD, the clinical examination missed the bilateral nerve enlargement, and only unilateral nerve thickening was clinically appreciated. However, bilateral thickening was detected on HRUS. Conclusion: HRUS is a non-invasive and sensitive diagnostic tool that gives significant information on nerve structure and morphology. HRUS adds a new dimension to diagnosing HD, particularly the pure neuritic type, with the assessment of early nerve damage, which can prevent disabilities. HRUS is an objective diagnostic tool that can complement the clinical examination.
Language	English
Publishing date	2024-02-13
Publishing country	India
Document type	Journal Article
ZDB-ID	2585814-2
ISSN	2249-5673 ; 2229-5178
ISSN (online)	2249-5673
ISSN	2229-5178
DOI	10.4103/idoj.idoj_271_23
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Article: Illegal interlocks among life science company boards of directors.

Manjunath, Anoop / Kahrobai, Nathan / Lemley, Mark A / Kumar, Ishan

Journal of law and the biosciences

2024 Volume 11, Issue 1, Page(s) lsae005

Abstract: Competition between life science companies is critical to ensure innovative therapies are efficiently developed. Anticompetitive behavior may harm scientific progress and, ultimately, patients. One well-established category of anticompetitive behavior is ...

Abstract	Competition between life science companies is critical to ensure innovative therapies are efficiently developed. Anticompetitive behavior may harm scientific progress and, ultimately, patients. One well-established category of anticompetitive behavior is the 'interlocking directorate'. It is illegal for companies' directors to 'interlock' by also serving on the boards of competitors. We evaluated overlaps in the board membership of 2,241 public life science companies since 2000. We show that a robust network of interlocking companies is present among these firms. At any given time, 10-20 percent of board members are interlocked; the number of interlocks has more than doubled in the last two decades. Over half of these interlocked firms report over $5 million in historical revenue, exceeding a legal threshold that makes an interlocking directorate a violation of antitrust law. Those interlocks are only illegal if the companies compete, even in part. Using the disease categories for which companies have sponsored clinical trials, we discover that a few markets are responsible for a large fraction of interlocks. We show that in dozens of cases, companies share directors with the very firms they identify as their biggest competitive threats. We provide a data-driven roadmap for policymakers, regulators, and companies to further investigate the contribution of anticompetitive behavior to increased healthcare costs and to enforce the law against illegal interlocks between firms.
Language	English
Publishing date	2024-04-13
Publishing country	England
Document type	Journal Article
ZDB-ID	2756090-9
ISSN	2053-9711
ISSN	2053-9711
DOI	10.1093/jlb/lsae005
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Book ; Online: Coarse-Grained Configurational Polymer Fingerprints for Property Prediction using Machine Learning

Kumar, Ishan / Jha, Prateek K

2023

Abstract: In this work, we present a method to generate a configurational level fingerprint for polymers using the Bead-Spring-Model. Unlike some of the previous fingerprinting approaches that employ monomer-level information where atomistic descriptors are ... ...

Abstract	In this work, we present a method to generate a configurational level fingerprint for polymers using the Bead-Spring-Model. Unlike some of the previous fingerprinting approaches that employ monomer-level information where atomistic descriptors are computed using quantum chemistry calculations, this approach incorporates configurational information from a coarse-grained model of a long polymer chain. The proposed approach may be advantageous for the study of behavior resulting from large molecular weights. To create this fingerprint, we make use of two kinds of descriptors. First, we calculate certain geometric descriptors like Re2, Rg2 etc. and label them as Calculated Descriptors. Second, we generate a set of data-driven descriptors using an unsupervised autoencoder model and call them Learnt Descriptors. Using a combination of both of them, we are able to learn mappings from the structure to various properties of the polymer chain by training ML models. We test our fingerprint to predict the probability of occurrence of a configuration at equilibrium, which is approximated by a simple linear relationship between the instantaneous internal energy and equilibrium average internal energy.
Keywords	Physics - Chemical Physics ; Computer Science - Artificial Intelligence ; Computer Science - Machine Learning
Subject code	006
Publishing date	2023-11-20
Publishing country	us
Document type	Book ; Online
Database	BASE - Bielefeld Academic Search Engine (life sciences selection)

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Article ; Online: Disorders of sexual development: structured radiological reporting and practical approach.

Kumar, Ishan / Prakash, Adity / Aggarwal, Priyanka / Chowdhary, Sarita / Verma, Ashish

Abdominal radiology (New York)

2023 Volume 49, Issue 2, Page(s) 523–534

Abstract: Disorders of sexual development (DSD) comprise a complex group of conditions with varied clinical presentations, such as atypical genitalia, non-palpable testes, primary amenorrhea, or infertility. Besides being associated with other congenital anomalies, ...

Abstract	Disorders of sexual development (DSD) comprise a complex group of conditions with varied clinical presentations, such as atypical genitalia, non-palpable testes, primary amenorrhea, or infertility. Besides being associated with other congenital anomalies, DSDs bear substantial ethical issues regarding assigning the sex of rearing to the child and future fertility options. Establishing the correct diagnosis is essential for the appropriate management of such cases. Various imaging modalities, such as ultrasonography, genitography, and MRI, when complemented with detailed clinical evaluation and karyotyping, are the key to diagnosing the condition. This article attempts to present a concise approach to various patterns of DSD, which will aid radiologists to solve these diagnostic dilemmas.
MeSH term(s)	Child ; Female ; Humans ; Disorders of Sex Development/diagnostic imaging ; Radiography ; Magnetic Resonance Imaging ; Ultrasonography ; Infertility
Language	English
Publishing date	2023-10-13
Publishing country	United States
Document type	Journal Article ; Review
ZDB-ID	2839786-1
ISSN	2366-0058 ; 2366-004X
ISSN (online)	2366-0058
ISSN	2366-004X
DOI	10.1007/s00261-023-04066-x
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Article ; Online: Comparison of T2-weighted and diffusion-weighted imaging for the diagnosis of placenta accreta spectrum abnormality.

Prakash, Adity / Kumar, Ishan / Verma, Ashish / Shukla, Ram C

Acta radiologica (Stockholm, Sweden : 1987)

2022 Volume 64, Issue 4, Page(s) 1694–1701

Abstract: Background: Diffusion-weighted imaging (DWI) is feasible in prenatal imaging, and it exhibits better contrast between the placenta and the myometrium compared to T2-weighted (T2W) images.: Purpose: To compare magnetic resonance imaging (MRI) features ...

Abstract	Background: Diffusion-weighted imaging (DWI) is feasible in prenatal imaging, and it exhibits better contrast between the placenta and the myometrium compared to T2-weighted (T2W) images. Purpose: To compare magnetic resonance imaging (MRI) features of placenta accreta on T2W and DW imaging. Material and methods: In this retrospective study, 42 pregnant patients who underwent prenatal MRI were included. MRI was performed on a Siemens 1.5-T scanner. T2W and DWI sequences in the axial, sagittal, and/or coronal planes were compiled for review. Two radiologists independently interpreted T2W and DW images for placenta accreta. T2W and DWI scores were calculated based on the presence of features and graded as low, intermediate, and high risk. The association between imaging features and placental invasion on pathology was calculated using chi-square tests. Sensitivity, specificity, and positive and negative predictive values (NPV) were compared between T2W and DWI interpretations. Inter-reader agreement between the two radiologists for T2W and DWI scores was calculated using Cohen's kappa coefficient. Results: Out of 42 pregnant patients, 10 were pathologically/surgically proven to have placenta accreta. There were no significant differences between T2W and DWI interpretations. Considering a cutoff >6 as positive, the T2W score had higher sensitivity (90% vs. 80%) and NPV (96.9% vs. 94.1%) than the DWI score. The specificity and positive predictive value were 100% for both scores. The inter-reader agreement of T2W score was higher (k = 0.943 vs. 0.882). Conclusion: T2W and DWI are comparable in diagnosing placenta accreta spectrum. T2W sequences have higher sensitivity, NPV, and inter-reader agreement than DWI.
MeSH term(s)	Humans ; Female ; Pregnancy ; Placenta Accreta/diagnostic imaging ; Retrospective Studies ; Placenta ; Diffusion Magnetic Resonance Imaging/methods ; Magnetic Resonance Imaging/methods ; Sensitivity and Specificity
Language	English
Publishing date	2022-11-13
Publishing country	England
Document type	Journal Article
ZDB-ID	105-3
ISSN	1600-0455 ; 0284-1851 ; 0349-652X
ISSN (online)	1600-0455
ISSN	0284-1851 ; 0349-652X
DOI	10.1177/02841851221137274
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Article ; Online: Child with Intellectual Disability and Seizures.

Kumar, Ishan / Ranjan, Manoj / Singh, Ankur / Aggarwal, Priyanka / Verma, Ashish

Indian journal of pediatrics

2022 Volume 89, Issue 10, Page(s) 1048–1049

MeSH term(s)	Child ; Family ; Humans ; Intellectual Disability/diagnosis ; Seizures/diagnosis ; Seizures/etiology
Language	English
Publishing date	2022-06-27
Publishing country	India
Document type	Journal Article
ZDB-ID	218231-2
ISSN	0973-7693 ; 0019-5456
ISSN (online)	0973-7693
ISSN	0019-5456
DOI	10.1007/s12098-022-04261-6
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Article ; Online: Comparison of the effects of calcium channel blockers plus iron chelation therapy versus chelation therapy only on iron overload in children and young adults with transfusion-dependent thalassemia: A randomized double-blind placebo-controlled trial.

Gupta, Vineeta / Kumar, Ishan / Raj, Vibhesh / Aggarwal, Priyanka / Agrawal, Vikas

Pediatric blood & cancer

2022 Volume 69, Issue 6, Page(s) e29564

Abstract: Background: Myocardial iron deposition is a significant cause of morbidity and mortality in patients with transfusion-dependent thalassemia (TDT). Amlodipine, L-type calcium channel blocker with regular chelation therapy may reduce myocardial iron ... ...

Abstract	Background: Myocardial iron deposition is a significant cause of morbidity and mortality in patients with transfusion-dependent thalassemia (TDT). Amlodipine, L-type calcium channel blocker with regular chelation therapy may reduce myocardial iron overload. Lack of randomized trials prompted this study to assess the effect of calcium channel blocker (amlodipine) in combination with iron chelation therapy on iron overload in patients with TDT. Methods: Sixty-four eligible patients were randomized to receive either amlodipine and chelation (group A) or chelation alone (group B) in double-blind placebo-controlled trial. Myocardial iron concentration (MIC) using T2* magnetic resonance imaging (MRI), liver iron concentration (LIC), left ventricular ejection fraction (LVEF), and serum ferritin were measured at baseline and 12 months. Results: In the amlodipine group, mean cardiac T2* value significantly increased from 18.11 ± 8.47 to 22.15 ± 7.61 (p = .002) at 12 months, whereas in control group, there was a nonsignificant increase (p = .62) in cardiac T2* value from 19.50 ± 8.84 to 20.03 ± 9.07. There was a significant decrease in MRI-derived MIC in the amlodipine group compared to control group (1.93 ± 1.61 to 1.29 ± 0.90, p = .01). Changes in the LVEF (p = .45), MRI-derived LIC (p = .09), and serum ferritin (p = .81) were not significant between the two groups. Conclusion: Amlodipine is safe and when combined with chelation therapy appears to be more effective in reducing cardiac iron overload than chelation only in children and young adults with TDT.
MeSH term(s)	Amlodipine/therapeutic use ; Calcium Channel Blockers/therapeutic use ; Chelation Therapy ; Child ; Ferritins ; Humans ; Iron/metabolism ; Iron Chelating Agents/therapeutic use ; Iron Overload/drug therapy ; Iron Overload/etiology ; Liver ; Magnetic Resonance Imaging ; Stroke Volume ; Thalassemia/complications ; Thalassemia/drug therapy ; Ventricular Function, Left ; Young Adult ; beta-Thalassemia/therapy
Chemical Substances	Calcium Channel Blockers ; Iron Chelating Agents ; Amlodipine (1J444QC288) ; Ferritins (9007-73-2) ; Iron (E1UOL152H7)
Language	English
Publishing date	2022-01-29
Publishing country	United States
Document type	Journal Article ; Randomized Controlled Trial
ZDB-ID	2131448-2
ISSN	1545-5017 ; 1545-5009
ISSN (online)	1545-5017
ISSN	1545-5009
DOI	10.1002/pbc.29564
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Article ; Online: Enhancement of Sensorimotor Cortical Adaptation after Dental Implantation in Comparison to the Conventional Denture - Demonstration by Functional MRI at 1-5T.

Verma, Aprajita / Bhatnagar, Atul / Kumar, Ishan / Verma, Ashish

Neurology India

2021 Volume 69, Issue 3, Page(s) 665–669

Abstract: Background and purpose: Dental implantation is thought to be associated with enhancement of neuro-cortical sensorimotor activity which has been lost due to an edentulous state. Such changes are either feeble or absent after the placement of a ... ...

Abstract	Background and purpose: Dental implantation is thought to be associated with enhancement of neuro-cortical sensorimotor activity which has been lost due to an edentulous state. Such changes are either feeble or absent after the placement of a conventional denture. In the present study, we test this hypothesis using blood oxygen level-dependent (BOLD) activity on functional MRI (fMRI) as a bio-surrogate. Materials and methods: fMRI was performed in 12 consecutive edentulous subjects (mean age = 59.2 years) after the placement of a conventional complete denture (CD) and subsequently after intraoral dental implantation (IOD). The semi-quantitative data of the BOLD activity was compiled to depict the activation seen in both scenarios in six anatomical regions. Statistical analysis was done to evaluate the significance of enhancement in BOLD activity in these regions in patients having an IOD as compared to those having a CD. Results: The enhancement of BOLD activity on fMRI after placement of an IOD was much more significant as compared to that noted with CD. Using Wilcoxon's signed-rank test the nonparametric data showed a significant positive elevation in global and regional assigned mean ranks of BOLD activity. Conclusion: Intraoral implantation leads to a significant elevation in the BOLD activity of the sensorimotor cortex as compared to the placement of a conventional CD.
MeSH term(s)	Dental Implantation ; Denture, Overlay ; Humans ; Magnetic Resonance Imaging ; Middle Aged ; Oxygen ; Sensorimotor Cortex
Chemical Substances	Oxygen (S88TT14065)
Language	English
Publishing date	2021-06-25
Publishing country	India
Document type	Journal Article
ZDB-ID	415522-1
ISSN	1998-4022 ; 0028-3886
ISSN (online)	1998-4022
ISSN	0028-3886
DOI	10.4103/0028-3886.317239
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