Browsing by Author "Goel, Gaurav"
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Item Central motor conduction in brachial monomelic amyotrophy.(2008-10-08) Pal, Pramod K; Atchayaram, Nalini; Goel, Gaurav; Beulah, EbenezerBACKGROUND: Prevalence of subclinical involvement of motor pathways in clinically diagnosed Brachial Monomelic Amyotrophy (BMMA) is unknown. AIMS: To determine the prevalence of subclinical involvement of central motor pathways in BMMA using transcranial magnetic stimulation. SETTING AND DESIGN: Prospective case-control study. MATERIALS AND METHODS: Central motor conduction time (CMCT) was determined by 'F' wave method using figure-of-eight coil attached to Magstim 200 stimulator, in 17 patients with BMMA. Motor evoked potentials were recorded from first dorsal interosseous of the affected (AFF) and unaffected upper limbs (UNAFF) at rest and during partial contraction. Comparison was made with data from 10 healthy controls (CTRL). STATISTICAL ANALYSIS: Descriptive analysis and Analysis of Variance (ANOVA). RESULTS: Compared to controls, the mean CMCT of AFF was significantly prolonged, both at rest and contraction: (a) Rest: AFF-6.68+/-1.78 ms, UNAFF-6.36+/-1.16 ms, CTRL-5.71+/-1.02 ms; Fisher's PLSD for AFF vs. CTRL: P =0.037, (b) Contraction: AFF-5.78+/-1.62 ms, UAFF - 4.86+/-1.38 ms, CTRL-4.06+/-0.80 ms; Fisher's PLSD for AFF vs. CTRL; P =0.0002, AFF vs. UNAFF- P =0.044). Prolonged CMCT (>mean+2SD of controls) was observed in 29.4% of AFF and 6.25% of UNAFF at rest, and in 47.1% and 23.5% respectively during contraction. CONCLUSIONS: Dysfunction of central motor pathways was observed in both affected and unaffected upper limbs of some patients with BMMA of upper limbs. The dysfunction was more pronounced during voluntary contraction. A larger study is needed to validate the significance of these findings.Item Do blood groups influence our pain perception.(2011-10) Shankar, Nilima; Gautam, Shikha; Rajkumari Rolinda, Shikha; Goel, GauravItem Microbiology, infection control and infection related outcome in pediatric patients in an oncology center in Eastern India: Experience from Tata Medical Center, Kolkata.(2014-10) Bhattacharyya, Arpita; Krishnan, Shekhar; Saha, Vaskar; Goel, Gaurav; Bhattacharya, Sanjay; Hmar, LalawmpuiaCONTEXT: Infection is a major determinant in the outcome of patients with cancer. AIMS: The aim was to know the epidemiology and outcome of patients with cancer in a cancer care center in Eastern India. SETTINGS AND DESIGN: Retrospective study of pediatric patients in Tata Medical Center, Kolkata, India. Methods: Patients (n = 262) between the age group of 0 and 18 years were reviewed for infections and infection‑related outcome (January to December 2013). STATISTICAL ANALYSIS: Modified Wald method was used to determine confidence interval of proportions. RESULTS: Gram‑negative bacteria were found to be the most common cause of bloodstream infections (BSIs) (56.4%), followed by Gram‑positive cocci (34.5%), and Candida species (9.1%). Carbapenem‑resistance was noted among 24% of Gram‑negative bacilli (GNB), and extended‑spectrum beta‑lactamase among 64% of GNBs. A single case of Vibrio cholerae septicemia was also noted. No case of vancomycin‑resistant Enterococcus was observed, whereas only two cases of methicillin‑resistant Staphylococcus aureus bacteremia (1/3 of all Staphylococcus aureus bacteremia) were detected. Escherichia coli, followed by Klebsiella, Pseudomonas, and Acinetobacter were the predominant organisms detected in BSIs. Among Candida spp. BSIs no resistance to caspofungin, amphotericin B, Voriconazole was noted. Candida tropicalis was the most common isolate, and 1 isolate of Candida glabrata showed dose‑dependent sensitivity to fluconazole. Three out of 25 patients died of multi‑drug resistant Gram‑negative bacteria (12%) in 2013. Seventeen patients had radiological evidence of invasive fungal infections (no mortality was noted). CONCLUSIONS: Periodic review of infection‑related data, as well as infection control practices, is essential to optimize clinical outcome in patients with pediatric malignancies.Item Prognostic significance of residual nodal burden using lymph node ratio in locally advanced breast cancer after neoadjuvant chemotherapy(Indian Cancer Society, 2019-07) Agarwal, Reshu; Philip, Arun; Pavithran, Keechilat; Rajanbabu, Anupama; Goel, Gaurav; Vijaykumar, DKOBJECTIVE: To investigate the prognostic value of lymph node ratio (LNR) after neoadjuvant chemotherapy (NAC) according to breast cancer molecular subtypes. METHODS: From 2004 to 2014, patients with definitive surgery after NAC were identified. LNR was calculated for node positive patients who underwent axillary dissection and at least 10 nodes (LNT) were removed. Disease free and overall survivals were analysed using Kaplan-Meier test and compared using log rank test for ypN0-3, LNR categories (LNRC) ≤0.2 (low), 0.21-0.65 (intermediate), >0.65 (high), and single LNR cut-off value. RESULTS: Of 224 analysed patients: ypN0 72 (32.1%), ypN+ 152 (67.9%). Of 118 LNT ≥10 ypN+ patients LNRC: Low risk 48 (40.7%), intermediate risk 36 (30.5%), high risk 34 (28.8%). Factors significantly different in LNR categories were ypN (P < 0.001); extranodal extension (P < 0.001); present status of patients (P < 0.001); and disease status (P = 0.029). LNRC was inversely associated with 5-year DFS: Low 52.3%, intermediate 40%, and high 12.2% (log rank P < 0.001); and OS: Low 64.4%, intermediate 58.3%, and high 13.6% (log rank P < 0.001). Significant association of LNRC and DFS and OS were demonstrated in TNBC (P < 0.001) and HER2 subtypes (P = 0.045 and 0.005 respectively). A single value of LNR = 0.25 in node positive was found significant for DFS and OS in TNBC (P < 0.001) and Her2+ (P = 0.013 and P = 0.001 respectively) but not for HR+ (DFS: P = 0.132; OS: P = 0.144). CONCLUSION: Residual nodal disease after NAC analysed by LNRC or LNR = 0.25 cut-off value, is prognostic and can discriminate between favourable and unfavourable outcomes for TNBC and Her2+ breast cancers.Item To Do Or Not To Do In An Interesting Case Of Stroke(Atharva Scientific Publications, 2019-09) Chatterjee, Apratim; Mahajan, Anshu; Banga, Vinit; Goel, Gaurav