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  1. Article: Cultural Adaptation of Patient Health Questionnaire-9 in Hindi for Use with Patients with Cancer in Community Palliative Care Settings.

    Bhardwaj, Tushti / Arora, Neha / Paul, Anu / Chowdhary, Pallika

    Indian journal of palliative care

    2023  Volume 29, Issue 3, Page(s) 292–311

    Abstract: Objectives: Patient Health Questionnaire-9 (PHQ-9) in Indian settings is yet not very often used in palliative care with the Hindi-speaking population. The Hindi version of PHQ-9 is available but its cultural adaptation to the Hindi-speaking population ... ...

    Abstract Objectives: Patient Health Questionnaire-9 (PHQ-9) in Indian settings is yet not very often used in palliative care with the Hindi-speaking population. The Hindi version of PHQ-9 is available but its cultural adaptation to the Hindi-speaking population in North India receiving palliative care services is required to be tested. PHQ-9 as a depression screening questionnaire may help to identify depression symptoms among patients with cancer. This study aimed to examine the cultural equivalence of PHQ-9 Hindi for use with patients with cancer receiving palliative care services in North India.
    Material and methods: Based on the standard methodology of translation and adaptation of the scale, the following process was used: (i) Two focused group discussions with 17 experts working in a cancer palliative care setting, (ii) qualitative interviewing with 11 patients, and (iii) research team review. All interviews were audio recorded, transcribed, and item-wise content analysis was conducted.
    Results: A few difficult phrases in the original PHQ-9 were 'dilchaspi', 'avasadgrast', 'kam urja', 'nakaam', parivar ko neecha dhikhana and 'ashthir' which were changed to Kam Mann Lagna, Mann Dukhi hona, kamjori, saksham nahi hain' 'asafal', Parivar ko nirash karna' and 'bechain,' respectively. Two items, namely no. 6 and 8 were changed to shorten the length for appropriately conveying the meaning.
    Conclusion: Hindi language involves various dialects which change from region to region bringing variations in understanding the meaning of the words. It is recommended that culturally equivalent scales are used in practice and research. PHQ-9 is now culturally adapted for the Hindi-speaking population in North India. PHQ-9 will help identidy depressive symptoms at an early stage. Psychometric testing of PHQ-9 is underway.
    Language English
    Publishing date 2023-09-02
    Publishing country United States
    Document type Journal Article
    ISSN 0973-1075
    ISSN 0973-1075
    DOI 10.25259/IJPC_96_2023
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  2. Article ; Online: Response to letter to the editor: are there anatomical limiting factors to foreskin reconstruction at the time of single-stage hypospadias repair?

    Mosa, Hazem / Olczak, Bartlomiej / Paul, Anu / Mishra, Pankaj / Taghizadeh, Arash / Garriboli, Massimo

    Journal of pediatric urology

    2024  

    Language English
    Publishing date 2024-03-10
    Publishing country England
    Document type Letter
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2024.02.025
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  3. Article ; Online: Response to commentary on How accurate is eyeball measurement of curvature? A tool for hypospadias surgery.

    Mosa, Hazem / Paul, Anu / Solomon, Eskinder / Garriboli, Massimo

    Journal of pediatric urology

    2022  Volume 18, Issue 4, Page(s) 478–479

    MeSH term(s) Male ; Humans ; Hypospadias/diagnosis ; Hypospadias/surgery ; Urologic Surgical Procedures, Male ; Penis/surgery
    Language English
    Publishing date 2022-05-21
    Publishing country England
    Document type Letter ; Comment
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2022.05.002
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  4. Article ; Online: How accurate is eyeball measurement of curvature? A tool for hypospadias surgery.

    Mosa, Hazem / Paul, Anu / Solomon, Eskinder / Garriboli, Massimo

    Journal of pediatric urology

    2022  Volume 18, Issue 4, Page(s) 470–476

    Abstract: Introduction: Correction of penile curvature or "chordee" is a major component in the management of hypospadias. Accurate assessment and management of penile curvature influence both short- and long-term outcomes of surgery.: Aim of the study: The ... ...

    Abstract Introduction: Correction of penile curvature or "chordee" is a major component in the management of hypospadias. Accurate assessment and management of penile curvature influence both short- and long-term outcomes of surgery.
    Aim of the study: The objective of this study is to investigate the accuracy of eyeball measurement and how does it compare to objective measurement by standard goniometry (SG) and smartphone app goniometry (AG).
    Materials and methods: A Dropbox file request link was shared with paediatric urologists on various social media platforms requesting participants to upload a picture of their index finger showing what they thought 30 degrees of curvature look like using their proximal inter phalangeal joint as the point of maximal curvature., The images were assessed using SG to measure the angle of curvature. The images were also assessed using AG by the principal investigator, a physician, a scrub nurse and a paediatric urology consultant., Statistical analysis was performed using SPSS statistics software version 26 (Armonk, NY: IBM Corp). A one sample t-test and a one-way chi squared test were used to evaluate significant frequency differences. Pearson correlation was used to compare AG measurements to test intra- and inter-observer reliability and to compare AG measurements vs SG measurements. Assuming 5-degree variability in goniometer measurements and 2-degree difference between the sample and population, the number of participants needed was calculated to be 49.
    Results: Fifty-two responses were received.32.7% of respondents simulated 30° accurately (17/52). A significant proportion (23/52, 44.2%) overrepresented the degree of curvature and 23.1% (12/52) underrepresented it (p = 0.01). Compared with objective measures, eyeball estimates differed by an average of 10° ± 1.5 SE. Measurements obtained by AG were comparable to measures obtained by SG and showed excellent intra-observer and inter-observer correlation (R = 0.983, P < 0.001).
    Discussion: We demonstrated a significant discrepancy between eyeball assessment of curvature and objective measurements in a cohort of hypospadiologists. This can be very relevant to intraoperative decision making. The limitation of the study is the use of a simulated model rather than assessment of curvature in patients with hypospadias. Another limitation is the lack of standardization of the way the pictures were taken.
    Conclusion: We demonstrated a tendency among hypospadiologists to overestimate or underestimate curvature by an average of 10° on eyeball assessment. The use of App Goniometry shows excellent interobserver reliability and is comparable to standard goniometry in curvature assessment.
    MeSH term(s) Male ; Humans ; Child ; Hypospadias/diagnosis ; Hypospadias/surgery ; Reproducibility of Results ; Penis ; Penile Diseases ; Cohort Studies
    Language English
    Publishing date 2022-04-20
    Publishing country England
    Document type Journal Article
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2022.04.009
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  5. Article ; Online: Are there anatomical limiting factors to foreskin reconstruction at the time of single-stage hypospadias repair?

    Mosa, Hazem / Olczak, Bartlomiej / Paul, Anu / Mishra, Pankaj / Taghizadeh, Arash / Garriboli, Massimo

    Journal of pediatric urology

    2023  Volume 19, Issue 6, Page(s) 700.e1–700.e10

    Abstract: Introduction: Foreskin reconstruction (FR) at the time of primary hypospadias repair is a truly anatomically complete reconstruction of the hypospadic penis. We prospectively collected penile and preputial measurement of children undergoing single-stage ...

    Abstract Introduction: Foreskin reconstruction (FR) at the time of primary hypospadias repair is a truly anatomically complete reconstruction of the hypospadic penis. We prospectively collected penile and preputial measurement of children undergoing single-stage hypospadias repair and FR with the aim to identify possible relations between penile and preputial anatomy and the likelihood to develop complications.
    Materials and methods: We prospectively studied children who underwent single stage hypospadias repair associated with FR from 2016 to 2019. We recorded intra-operative foreskin and penile measurements and post-operative outcomes. Logistic Regression analysis was performed to explore independent factors affecting urethroplasty and skin complications. Chi square test was used to compare outcomes in different groups based on ventral foreskin defect (VFD) width, Glans size, age at surgery and meatal location.
    Results: From a total of 181 consecutive patients, 86 boys who underwent a single stage hypospadias repair combined with FR were included in the study. Patients were excluded because they were either lost at follow up (n = 10), required a 2-stage repair (n = 2), were circumcised at birth (n = 3) or parents requested a circumcision (n = 78); in 2 patients, a decision to perform circumcision was made intraoperatively due to aesthetic reasons (monk-hood deformity of the prepuce). Median age at surgery was 17 months. Mean glans width was 14.4 mm. Mean unstretched and stretched foreskin circumference were 29.5 mm and 40.9 mm, respectively. Mean VFD (the distance between the proximal insertion of the foreskin hood on either side of the midline at the level of the coronal sulcus) was 7.2 mm (Fig. 1). At median follow-up of 8 months (6-23), 9 complications were recorded (10.4%): foreskin dehiscence occurred in 1% (1/86), a foreskin fistula was noted in 4.6% (4/86), tight, non-retractile, foreskin in 1% (1/86); urethrocutaneous fistula in 2.3% (2/86) and complete dehiscence of the glans and foreskin in 1 (1.2%). Multiple logistic regression analysis demonstrated that none of the measurements obtained was an independent risk factor for developing urethroplasty or skin complications. There was no significant difference in complications between wide VFD (>7 mm) vs. narrow VFD (≤7 mm), large glans (>14 mm) vs. small glans (≤14 mm), age at surgery ≤24 months vs. > 24 month and meatal location distal (glanular, coronal, subcoronal and distal penile) vs. proximal (midpenile, proximal penile and penoscrotal).
    Conclusion: To the best of our knowledge, this is the first study reporting a prospective and objective assessment of the foreskin in the context of single stage hypospadias repair. Individual anatomical differences in preputial and penile anatomy do not seem to affect the likelihood of skin and urethroplasty complications. FR can, therefore, be offered to all boys undergoing primary single stage hypospadias repair . Further studies on larger numbers and external validation of these measurements is necessary.
    MeSH term(s) Male ; Child ; Infant, Newborn ; Humans ; Infant ; Child, Preschool ; Hypospadias/surgery ; Hypospadias/etiology ; Foreskin/surgery ; Prospective Studies ; Treatment Outcome ; Urologic Surgical Procedures, Male/adverse effects ; Urethra/surgery ; Retrospective Studies
    Language English
    Publishing date 2023-08-16
    Publishing country England
    Document type Journal Article
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2023.08.004
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  6. Article ; Online: Evolution of sialic acids: Implications in xenotransplant biology.

    Paul, Anu / Padler-Karavani, Vered

    Xenotransplantation

    2018  Volume 25, Issue 6, Page(s) e12424

    Abstract: All living cells are covered with a dense "sugar-coat" of carbohydrate chains (glycans) conjugated to proteins and lipids. The cell surface glycome is determined by a non-template driven process related to the collection of enzymes that assemble glycans ... ...

    Abstract All living cells are covered with a dense "sugar-coat" of carbohydrate chains (glycans) conjugated to proteins and lipids. The cell surface glycome is determined by a non-template driven process related to the collection of enzymes that assemble glycans in a sequential manner. In mammals, many of these glycans are topped with sialic acids (Sia), a large family of acidic sugars. The "Sialome" is highly diverse owing to various Sia types, linkage to underlying glycans, range of carriers, and complex spatial organization. Presented at the front of cells, Sia play a major role in immunity and recognition of "self" versus "non-self," largely mediated by the siglecs family of Sia-binding host receptors. Albeit many mammalian pathogens have evolved to hijack this recognition system to avoid host immune attack, presenting a fascinating host-pathogen evolutionary arms race. Similarly, cancer cells exploit Sia for their own survival and propagation. As part of this ongoing fitness, humans lost the ability to synthesize the Sia type N-glycolylneuraminic acid (Neu5Gc), in contrast to other mammals. While this loss had provided an advantage against certain pathogens, humans are continuously exposed to Neu5Gc through mammalian-derived diet (eg, red meat), consequently generating a complex immune response against it. Circulating anti-Neu5Gc antibodies together with Neu5Gc on some human tissues mediate chronic inflammation "xenosialitis" that exacerbate various human diseases (eg, cancer and atherosclerosis). Similarly, Neu5Gc-containing xenografts are exposed to human anti-Neu5Gc antibodies with implications to sustainability. This review aimed to provide a glimpse into the evolution of Sia and their implications to xenotransplantation.
    MeSH term(s) Animals ; Heterografts/drug effects ; Heterografts/immunology ; Humans ; Immunoglobulins/immunology ; Polysaccharides/immunology ; Sialic Acids/chemistry ; Sialic Acids/immunology ; Sialic Acids/pharmacology ; Transplantation, Heterologous/methods
    Chemical Substances Immunoglobulins ; Polysaccharides ; Sialic Acids
    Language English
    Publishing date 2018-06-22
    Publishing country Denmark
    Document type Journal Article ; Research Support, Non-U.S. Gov't ; Review
    ZDB-ID 1236298-0
    ISSN 1399-3089 ; 0908-665X
    ISSN (online) 1399-3089
    ISSN 0908-665X
    DOI 10.1111/xen.12424
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  7. Article ; Online: Specific Detection of Neu5Gc in Animal Tissues by Immunohistochemistry.

    Paul, Anu / Bachar Abramovitch, Shirley / Padler-Karavani, Vered

    Methods in molecular biology (Clifton, N.J.)

    2020  Volume 2110, Page(s) 59–72

    Abstract: One of the major obstacles in xenotransplantation is tissue expression of the non-human mammalian carbohydrate N-glycolylneuraminic acid (Neu5Gc). This 9-carbon backbone acidic sugar is the hydroxylated form of N-acetylneuraminic acid (Neu5Ac), and both ... ...

    Abstract One of the major obstacles in xenotransplantation is tissue expression of the non-human mammalian carbohydrate N-glycolylneuraminic acid (Neu5Gc). This 9-carbon backbone acidic sugar is the hydroxylated form of N-acetylneuraminic acid (Neu5Ac), and both constitute the two most common sialic acid types in mammals. Loss of CMP-Neu5Ac hydroxylase encoding gene in humans dictates the immunogenic nature of Neu5Gc-containing xenografts. Here we describe an immunohistochemistry method for the detection of Neu5Gc in mammalian-derived tissues using affinity-purified chicken anti-Neu5Gc IgY. Specificity is further demonstrated by competitive inhibition with free Neu5Gc or Neu5Gc-glycoproteins, but not with Neu5Ac or Neu5Ac-glycoproteins. This method can be used to evaluate potential Neu5Gc-immunogenicity of xenografts.
    MeSH term(s) Animals ; Biomarkers ; Humans ; Immunohistochemistry/methods ; Liver/cytology ; Liver/metabolism ; Mammals ; Mice ; Neuraminic Acids/metabolism ; Organ Specificity ; Sialic Acids/metabolism ; Transplantation, Heterologous
    Chemical Substances Biomarkers ; Neuraminic Acids ; Sialic Acids ; N-glycolylneuraminic acid (1113-83-3)
    Language English
    Publishing date 2020-01-30
    Publishing country United States
    Document type Journal Article ; Research Support, Non-U.S. Gov't
    ISSN 1940-6029
    ISSN (online) 1940-6029
    DOI 10.1007/978-1-0716-0255-3_4
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  8. Article ; Online: The Response of a Tertiary Paediatric Urology Unit to the COVID-19 Pandemic in central London: what have we learned?

    Garriboli, Massimo / Mishra, Pankaj / Taghizadeh, Arash / Paul, Anu

    The British journal of surgery

    2020  Volume 107, Issue 12, Page(s) e578–e580

    MeSH term(s) COVID-19/epidemiology ; Child ; Comorbidity ; Disease Management ; Humans ; London/epidemiology ; Pandemics ; SARS-CoV-2 ; Tertiary Care Centers/statistics & numerical data ; Urologic Diseases/epidemiology ; Urologic Diseases/therapy ; Urology/statistics & numerical data
    Keywords covid19
    Language English
    Publishing date 2020-09-14
    Publishing country England
    Document type Letter
    ZDB-ID 2985-3
    ISSN 1365-2168 ; 0263-1202 ; 0007-1323 ; 1355-7688
    ISSN (online) 1365-2168
    ISSN 0263-1202 ; 0007-1323 ; 1355-7688
    DOI 10.1002/bjs.11978
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  9. Article ; Online: Retroperitoneoscopic single-instrument horseshoe nephrectomy for dilated non-functioning right moiety.

    Chong, Clara / Mishra, Pankaj / Paul, Anu / Taghizadeh, Arash / Garriboli, Massimo

    Journal of pediatric urology

    2021  Volume 17, Issue 4, Page(s) 577–578

    Abstract: Retroperitoneoscopic horseshoe nephrectomy is an uncommon procedure, in particular in the paediatric practice. We present a procedure carried out via a posterior approach with a single working port in a 20 months old boy. The video goes through the ... ...

    Abstract Retroperitoneoscopic horseshoe nephrectomy is an uncommon procedure, in particular in the paediatric practice. We present a procedure carried out via a posterior approach with a single working port in a 20 months old boy. The video goes through the technical aspect, from the positioning of the patient and the port insertion, to the end of procedure. Highlighted are the critical steps of directing the initial fascial dissection more caudal and medial compared to a standard approach for nephrectomy, as well as tips to safely ligate and divide the very short right renal vein. The operative time was 90 min. The postoperative course was uneventful. The retroperitoneal access provides a good visualisation of the hylum (including the IVC in case of right side approach), the ureter and the isthmus and has the advantage to preserve the abdominal cavity. The retroperitoneal approach is safe also in horseshoe kidney.
    MeSH term(s) Child ; Fused Kidney/diagnostic imaging ; Fused Kidney/surgery ; Humans ; Infant ; Laparoscopy ; Male ; Nephrectomy ; Retroperitoneal Space/surgery ; Ureter
    Language English
    Publishing date 2021-04-30
    Publishing country England
    Document type Journal Article
    ZDB-ID 2237683-5
    ISSN 1873-4898 ; 1477-5131
    ISSN (online) 1873-4898
    ISSN 1477-5131
    DOI 10.1016/j.jpurol.2021.04.018
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  10. Article ; Online: Biomarkers in Multiple Sclerosis.

    Paul, Anu / Comabella, Manuel / Gandhi, Roopali

    Cold Spring Harbor perspectives in medicine

    2019  Volume 9, Issue 3

    Abstract: Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease with a complex clinical course characterized by inflammation, demyelination, and axonal degeneration. Diagnosis of MS most commonly includes finding lesions in at least two ... ...

    Abstract Multiple sclerosis (MS) is a chronic neurodegenerative autoimmune disease with a complex clinical course characterized by inflammation, demyelination, and axonal degeneration. Diagnosis of MS most commonly includes finding lesions in at least two separate areas of the central nervous system (CNS), including the brain, spinal cord, and optic nerves. In recent years, there has been a remarkable increase in the number of available treatments for MS. An optimal treatment is usually based on a personalized approach determined by an individual patient's prognosis and treatment risks. Biomarkers that can predict disability progression, monitor ongoing disease activity, and assess treatment response are integral in making important decisions regarding MS treatment. This review describes MS biomarkers that are currently being used in clinical practice; it also reviews and consolidates published findings from clinically relevant potential MS biomarkers in recent years. The work also discusses the challenges of validating and application of biomarkers in MS clinical practice.
    MeSH term(s) Antibodies, Neutralizing/metabolism ; Biological Specimen Banks ; Biomarkers/metabolism ; Brain Diseases/diagnosis ; Early Diagnosis ; Genetic Markers/genetics ; Humans ; Magnetic Resonance Imaging ; Multiple Sclerosis/diagnosis ; Polyomavirus Infections/diagnosis ; Prognosis ; Research Design ; Risk Assessment
    Chemical Substances Antibodies, Neutralizing ; Biomarkers ; Genetic Markers
    Language English
    Publishing date 2019-03-01
    Publishing country United States
    Document type Journal Article ; Review
    ISSN 2157-1422
    ISSN (online) 2157-1422
    DOI 10.1101/cshperspect.a029058
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