2.Unusual presentation of keratocystic odontogenic tumor in the mandible with imaging features – a case report.
Mathew AK ; Shenai P ; Chatra L ; Veena KM ; Rao PK ; Prabhu R.
Pacific Journal of Medical Sciences 2013;11(1):39-44
Keratocysytic Odontogenic tumor is a lesion occurring in the oral cavity that has a high recurrence rate. This lesion has an ability to mimic other lesions affecting the jaw. The tumor has a varied clinical and radiographic presentation. This article presents a case report of a 45 year old male patient presenting with an asymptomatic swelling on the right lower jaw associated with an impacted tooth and depicts an unusual radiographic picture.
3.Unusual occurrence of Epidermolysis bullosa with Amelogenesis Imperfecta – a rare case.
Javed AP ; Shenai P ; Chatra L ; Veena KM ; Rao PK ; Prabhu R.
Pacific Journal of Medical Sciences 2012;10(2):45-50
Epidermolysis bullosa is an inherited disorder which is characteristically presented as skin blisters developing in response to minor injury. Junctional variety of Epidermolysis bullosa is associated with enamel hypoplasia. Amelogenesis imperfecta presents with abnormal formation of the enamel both in deciduous and permanent dentition. This is a case report of amelogenesis imperfecta with complete loss of enamel in a young female patient with epidermolysis bullosa.
4.Lamotrigine in pregnancy: safety profile and the risk of malformations.
Prakash ; L V PRABHU ; M A NASAR ; R RAI ; S MADHYASTHA ; G SINGH
Singapore medical journal 2007;48(10):880-883
The use of antiepileptic drugs in pregnancy always presents challenges to doctors and their patients as it may have deleterious effects on the developing embryo. Lamotrigine is most commonly-prescribed drug among the newer antiepileptic drugs; hence, it has been selected for the present review. A number of studies pertaining to the safety of lamotrigine use during pregnancy have been reported, with differing results. Contradictory results have been reported in animals regarding lamotrigine teratogenicity, and human studies have also proven inconclusive. In many countries, human pregnancy registries are maintained to establish the safety of antiepileptic drugs during pregnancy, as all the different suggestions favour some over others, with specific antiepileptic combinations still being questioned. It is our hope that the present work may integrate the available disparate relevant facts into a directed effort towards minimising the risk of foetal compromise.
Abnormalities, Drug-Induced
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Animals
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Anticonvulsants
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adverse effects
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therapeutic use
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Epilepsy
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drug therapy
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Female
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Folic Acid Deficiency
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chemically induced
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Humans
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Pregnancy
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Teratogens
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pharmacokinetics
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pharmacology
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Triazines
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adverse effects
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therapeutic use
5.Cadavers as teachers in medical education: knowledge is the ultimate gift of body donors.
Prakash ; L V PRABHU ; R RAI ; S D'COSTA ; P J JIJI ; G SINGH
Singapore medical journal 2007;48(3):186-quiz 190
In most of the medical colleges in India, unclaimed bodies from various mortuaries reach the dissection hall; and here, the body donors club has yet to gain the desired dimensions. In spite of all the adverse circumstances, the cadaver and the dissection both have survived the most rigorous test of pedagological fitness--the test of time. Today, many of the Western countries have long donor waiting lists where cadavers are acquired as anatomical gifts or through body donor programmes. Thailand's approach to body donors offers a role model for resolving the present situation. The spirit of volunteerism reflects the drastic shift in public perception and a global change in approach is needed in the present time.
Anatomy
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education
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Cadaver
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Dissection
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Education, Medical, Undergraduate
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Humans
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India
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Tissue Donors
6.Teratogenic effects of the anticonvulsant gabapentin in mice.
Prakash ; L V PRABHU ; R RAI ; M M PAI ; S K YADAV ; S MADHYASTHA ; R K GOEL ; G SINGH ; M A NASAR
Singapore medical journal 2008;49(1):47-53
INTRODUCTIONWe aim to study and elucidate the safety profile of the antiepileptic doses of gabapentin during pregnancy, and to evaluate gabapentin-induced murine fetotoxicity at different dose levels.
METHODSA total of 60 pregnant mice, divided into 12 groups of five mice each, were exposed to gabapentin in four different doses of 0 (control), 113, 226, or 452 mg/kg body weight per day, at three different gestational stages including early gestation (1-6 days), mid-gestation (7-12 days), and late gestation (13-17 days). The pregnant mice were euthanized on day 18 of gestation, and foetuses were examined for teratogenic manifestations. Their brains were dissected and examined for gross changes, malformations, histological changes, and quantitative protein estimation.
RESULTSFoetal resorptions were observed in all treated groups with gabapentin administration at early gestation (1-6 days), and mid-gestation (7-12 days). On the other hand, growth retardation along with stunting in size of live foetuses were observed in all the mid-gestation (7-12 days), and late gestation (13-17 days) treated groups. Various gross malformations were observed with all the three doses (113, 226, and 452 mg/kg body weight per day) when gabapentin was administered at mid-gestation (7-12 days). The same trends were confirmed by gross and microscopic examination of brains along with quantitative protein estimation.
CONCLUSIONGabapentin should not be prescribed during pregnancy, as no therapeutic dose of gabapentin is safe during this period as far as the foetal well-being is concerned.
Abnormalities, Drug-Induced ; Amines ; adverse effects ; Animals ; Anticonvulsants ; adverse effects ; Body Weight ; Congenital Abnormalities ; prevention & control ; Cyclohexanecarboxylic Acids ; adverse effects ; Dose-Response Relationship, Drug ; Female ; Mice ; Mice, Inbred ICR ; Models, Chemical ; Pregnancy ; Pregnancy, Animal ; drug effects ; Teratogens ; gamma-Aminobutyric Acid ; adverse effects
7.Does Baseline Severity of Arm Pain Influence Outcomes Following Single-Level Anterior Cervical Discectomy and Fusion?
Madhav R. PATEL ; Kevin C. JACOB ; Frank A. CHAVEZ ; Alexander W. PARSONS ; Nisheka N. VANJANI ; Hanna PAWLOWSKI ; Michael C. PRABHU ; Kern SINGH
Asian Spine Journal 2023;17(3):500-510
Methods:
Individuals undergoing single-level ACDF were identified. Patients were grouped by preoperative Visual Analog Scale (VAS) arm ≤8 vs. >8. PROMs collected preoperatively and postoperatively included VAS-arm/VAS-neck/Neck Disability Index (NDI)/12-item Short Form (SF-12) Physical Composite Score (PCS)/SF-12 mental composite score (MCS)/Patient-Reported Outcomes Measurement Information System physical function (PROMIS-PF). Demographics, PROMs, and MCID rates were compared between cohorts.
Results:
A total of 128 patients were included. The VAS arm ≤8 cohort significantly improved for all PROMs excepting VAS arm at 1-year/2-years, SF-12 MCS at 12-weeks/1-year/2-years, and SF-12 PCS/PROMIS-PF at 6-weeks, only (p ≤0.021, all). The VAS arm >8 cohort significantly improved for VAS neck at all timepoints, VAS arm from 6-weeks to 1-year, NDI from 6-weeks to 6-months, and SF-12 MCS/PROMIS-PF at 6-months (p ≤0.038, all). Postoperatively, the VAS arm >8 cohort had higher VAS-neck (6 weeks/6 months), VAS-arm (12 weeks/6 months), NDI (6 weeks/6 months), lower SF-12 MCS (6 weeks/6 months), SF-12 PCS (6 months), and PROMISPF (12 weeks/6 months) (p ≤0.038, all). MCID achievement rates were higher among the VAS arm >8 cohort for the VAS-arm at 6-weeks/12-weeks/1-year/overall and NDI at 2 years (p ≤0.038, all).
Conclusions
Significance in PROM score differences between VAS arm ≤8 vs. >8 generally dissipated at the 1-year and 2-year timepoint, although higher preoperative arm pain patients suffered from worse pain, disability, and mental/physical function scores. Furthermore, clinically meaningful rates of improvement were similar throughout the vast majority of timepoints for all PROMs studied.
8.Validation of Neck Disability Index Severity among Patients Receiving One or Two-Level Anterior Cervical Surgery
Cara E. GEOGHEGAN ; Shruthi MOHAN ; Conor P. LYNCH ; Elliot D. K. CHA ; Kevin C. JACOB ; Madhav R. PATEL ; Michael C. PRABHU ; Nisheka N. VANJANI ; Hanna PAWLOWSKI ; Kern SINGH
Asian Spine Journal 2023;17(1):86-95
Methods:
A surgical database was reviewed to identify patients undergoing cervical spine procedures. Demographics, operative characteristics, comorbidities, NDI, Visual Analog Scale (VAS), and 12-item Short Form (SF-12) physical and mental composite scores (PCS and MCS) were recorded. NDI severity was categorized using previously established threshold values. Improvement from preoperative scores at each postoperative timepoint and convergent validity of NDI was evaluated. Discriminant validity of NDI was evaluated against VAS neck and arm and SF-12 PCS and MCS.
Results:
All 290 patients included in the study demonstrated significant improvements from baseline values for all patient-reported outcome measures (PROMs) at all postoperative timepoints (p<0.001) except SF-12 MCS at 2 years (p =0.393). NDI showed a moderate- to-strong correlation (r≥0.419) at most timepoints for VAS neck, VAS arm, SF-12 PCS, and SF-12 MCS (p<0.001, all). NDI severity categories demonstrated significant differences in mean VAS neck, VAS arm, SF-12 PCS, and SF-12 MCS at all timepoints (p<0.001, all). Differences between NDI severity groups were not uniform for all PROMs. VAS neck values demonstrated significant intergroup differences at most timepoints, whereas SF-12 MCS showed significantly different values between most severity groups.
Conclusions
Neck disability is strongly correlated with neck and arm pain, physical function, and mental health and demonstrates worse outcomes with increasing severity. Previously established severity categories may be more applicable to pain than physical function or mental health and may be more uniformly applied preoperatively for cervical spine patients.