Publications by authors named "Debashish Mishra"

17 Publications

  • Page 1 of 1

Complex Regional Pain Syndrome.

Mediterr J Rheumatol 2021 Jun 30;32(2):174-175. Epub 2021 Jun 30.

Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.31138/mjr.32.2.174DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8369268PMC
June 2021

A Rare Grotesque Skeletal Deformity: Munchmeyer's Disease.

Mediterr J Rheumatol 2021 Mar 31;32(1):91. Epub 2021 Mar 31.

Consultant Rheumatologist, Department of Rheumatology, Santokba Durlabhji Memorial Hospital, Jaipur, India.

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http://dx.doi.org/10.31138/mjr.32.1.91DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8314880PMC
March 2021

Disease activity assessment in non-radiographic axial spondyloarthritis- is it time to move beyond BASDAI or ASDAS ?

Arthritis Rheumatol 2021 Jun 27. Epub 2021 Jun 27.

Department of Clinical immunology and Rheumatology, Institute of medical sciences and Sum hospital, Bhubaneshwar, Odisha, India.

We read with great interest article on "Is treatment in patients with suspected non-radiographic axial spondyloarthritis effective? Six-months results of a placebo controlled trial" by Rusman T et al . It was an interestingly planned study where based on clinical disease activity as per BASDAI, patients with nr-ax SpA were randomized either to receive etanercept or placebo for 16 weeks. Results of this study bring forth many doubts on our currently prevalent assessment of disease activity in ax SpA, nr- ax SpA in particular.
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http://dx.doi.org/10.1002/art.41905DOI Listing
June 2021

A Giant Cell Tumor of the Distal Femur Managed by Excision and Knee Arthrodesis Using a Custom Made Long Intramedullary Interlocking Nail: A Case Report and Review of the Literature.

Cureus 2021 May 2;13(5):e14810. Epub 2021 May 2.

Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

Giant cell tumors (GCTs) are primary bone tumors that occur most commonly in long bones, with half such tumors occurring in the distal femur, proximal tibia, and fibula. Around 12% of patients present with a pathological fracture indicating more aggressive disease. Arthrodesis after tumor resection is a popular choice due to its affordability and early postoperative mobilization, as well as low risks of implant loosening, infections, malignant lesions, or mortality. A free fibular graft is a popular option in limb-sparing surgery for long bone tumors. A bone graft and nail can be used to reconstruct long bones and bridge defects up to 25 cm. In developing countries, the cost of the imported mega prosthesis, around 8,500 US$, means many patients cannot afford the treatment. We describe a case of a GCT of the distal femur treated by excision of the tumor and reconstruction using a fibular bone graft, with knee arthrodesis using a custom-made long intramedullary interlocking nail fixation across the femur to the knee and the tibia. The length was achieved with 1 cm shortening post-surgery. The result was satisfactory, and partial weight-bearing was allowed three months after the surgery. At the one-year follow-up, there was no recurrence, and the patient had the full weight-bearing ability.
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http://dx.doi.org/10.7759/cureus.14810DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8191858PMC
May 2021

Efficacy of a step-down regimen of oral prednisolone in axial spondyloarthritis: result of a double-blind randomized controlled trial (COBRA-AS Study).

Rheumatology (Oxford) 2021 04;60(4):1932-1941

Division of Rheumatology and Clinical Immunology, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Objectives: To evaluate the efficacy and safety of a step-down regimen of oral prednisolone over 24 weeks in patients of axial SpA (axSpA).

Methods: This proof-of-concept double-blind randomized controlled trial enrolled patients with active axSpA (BASDAI ≥4) having predominantly axial disease (≤1 active joint currently) and inadequate response to NSAIDs. They were randomized to receive either oral prednisolone (n = 32) or placebo (n = 33) at a dose of 60, 40, 30, 20, 15 and 10 mg daily for 1 week each, following which they received 5 mg prednisolone (or placebo) daily for 18 weeks. The primary endpoint was a 50% improvement in the BASDAI (BASDAI50) at week 24. Analysis was intention to treat.

Results: A BASDAI50 was achieved by 12 of 32 patients (37.5%) in the prednisolone arm and 3 of 33 patients (9.1%) in the placebo arm at 24 weeks [difference 28.4% (95% CI 7.9, 46.7)]. However, there was no difference in achieving a 20 or 40% improvement in the Assessment of SpondyloArthritis international Society response between the groups. Although there was a significant intergroup difference in adjusted ΔBASDAI and ΔAnkylosing Spondylitis Disease Activity Score with CRP at 24 weeks, there was no difference at 12 weeks. There was also no significant difference in ΔBASFI, ΔBAS-G or ΔBASMI at 12 or 24 weeks. No serious adverse events were noted. There was significant weight gain in the first 12 weeks in the prednisolone group vs placebo [0.9 (s.d. 0.4) kg], but not at 24 weeks.

Conclusions: In this small study, oral prednisolone was efficacious in axSpA in achieving the primary outcome, but many crucial secondary outcomes such as functional improvement were not met. Its impact on bone loss was not studied.Trial registration: CTRI/2018/01/011342.
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http://dx.doi.org/10.1093/rheumatology/keaa685DOI Listing
April 2021

Implementation of Anthropometric Measurements in Anterior Teeth Selection in Two Ethnic Groups: An Study.

J Pharm Bioallied Sci 2020 Aug 28;12(Suppl 1):S218-S221. Epub 2020 Aug 28.

Department of Prosthodontics, IDDM Dental Clinic & Hospital, Itanagar, Arunachal Pradesh, India.

Aim: The aim of this study was to evaluate whether there is any consistent relationship between interalar distance and six maxillary anterior teeth in two ethnic groups.

Materials And Methods: Two hundred subjects (Assamese 100 and Nyishi 100) of different age and sex ranging from 18 to 33 years were identified for this study. The distance between two widest points marked on the alae of nose was measured by means of sliding digital caliper. Statistical analysis of variance was the testing method to determine whether the nasal width and intercanine distance were different in various racial groups.

Results: The mean nasal width dimension in Assamese group was 36.38 mm (range 28.55-50.00 mm). The mean nasal width dimension in Nyishi group was 35.73 mm (range 31.34-41.90 mm). For the nasal width, no significant difference was observed between two races. For the canine cusp tip to cusp tip distance, the mean value of Assamese subjects was 43.63 mm (range 39.02-50.02 mm), whereas the Nyishi presented 41.77 mm (range 36.69-47.05 mm).

Conclusion: For the two racial groups studied, the measurements of the interalar width showed a weak correlation with the canine to canine distance, not sufficiently high to be used as a predictive factor. It suggests to select wider artificial teeth. Practitioners can use ethnic norms as guides, not absolute values.
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http://dx.doi.org/10.4103/jpbs.JPBS_65_20DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7595481PMC
August 2020

Comment on: EUREKA algorithm predicts obstetric risk and response to treatment in women with different subsets of anti-phospholipid antibodies.

Rheumatology (Oxford) 2021 03;60(3):e109

Department of Internal Medicine, Clinical Immunology and Rheumatology Unit, Post Graduate Institute of Medical Education and Research, Chandigarh, Punjab, India.

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http://dx.doi.org/10.1093/rheumatology/keaa533DOI Listing
March 2021

Rare cause of red eye in scleroderma.

BMJ Case Rep 2020 Aug 24;13(8). Epub 2020 Aug 24.

Clinical Immunology and Rheumatology, Department of Internal Medicine, Post Graduate Institute of Medical Education and Research, Chandigarh, India

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http://dx.doi.org/10.1136/bcr-2020-236042DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7449542PMC
August 2020

Short-Term Functional Outcome and Satisfaction Rate of Unicompartmental Knee Arthroplasty in Indian Population: A Retrospective Study.

Cureus 2020 Jul 6;12(7):e9033. Epub 2020 Jul 6.

Orthopaedics, Kalinga Institute of Medical Sciences, Bhubaneswar, IND.

Introduction: Unicompartmental knee arthroplasty (UKA) is a procedure used to treat isolated medial or lateral compartmental osteoarthritis of the knee joint. This procedure involves retention of cruciate ligaments which leads to better functional outcome due to preservation of normal kinematics of the knee joint. In the Indian population, due to requirement of squatting and cross leg sitting habits, knee with more range of movement and with good kinematics is a required feature. The study aims to observe the functional outcome, mortality, revision rate, length of hospital stay and satisfaction rate in two-year postoperative patients in a tertiary health care centre.

Methods: A total of 17 knees of 15 patients were recruited for the study after applying strict inclusion and exclusion criteria. These patients were operated during the period from March 2015 to March 2018. Ten female patients (67%) and five males (33%) were included. The average age was 61 years. All operations were performed by a single surgeon, with a similar implant from a single company. Similar protocol was used both for surgical technique (minimal invasive) and postoperative rehabilitation for all the patients.

Results: The functional outcome in the form of Oxford Knee Score (OKS) and Euro-Quol (EQ-5D) scores improved significantly in all the patients at one year postoperatively, and the improvement remained significant for two years. Satisfaction rate was 91.7% (SD-12.8) at two years. Except for one patient (5.8%), all patients were able to cross leg and squat easily. At the end of two years, the overall survival rate of the implant was found to be 94.1%.

Conclusion: The unicondylar arthroplasty provides excellent satisfaction to the appropriately selected patients with good survivorship of implant. It can be a surgery of choice for Indian population as it restores normal kinematics of knee joint and allows the patient to cross leg and squat with a more range of movement.
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http://dx.doi.org/10.7759/cureus.9033DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7410404PMC
July 2020

Determinants of Morning Stiffness in Rheumatoid Arthritis: Comment on the Article by Orange et al.

Arthritis Rheumatol 2021 01 7;73(1):174-175. Epub 2020 Dec 7.

Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.1002/art.41459DOI Listing
January 2021

Unprecedented 1,3-tert-butyl migration via the C-N single bond scission of isonitrile: an expedient metal-free route to N-sulfonyl amidines.

Chem Commun (Camb) 2020 Jul;56(60):8408-8411

Department of Chemistry, Gauhati University, Guwahati, Assam, India.

An unprecedented 1,3-migration of the tert-butyl group was observed while reacting tert-butyl isonitrile with N,N-dibromoaryl sulfonamides and nitrile. The reaction involves the simultaneous C-N single bond scission of isonitrile and the migration of the tert-alkyl group to the adjacent unsaturated nitrogen centre of the nitrile precursor, which eventually results in the formation of N-sulfonyl amidine. This method constitutes a new route for sulfonyl amidine, which does not rely on transition metals. The protocol exhibits a significant advantage in terms of substrate scope and additionally offers an easy synthesis route to guanidine molecules.
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http://dx.doi.org/10.1039/d0cc02430aDOI Listing
July 2020

Efficacy and safety of pirfenidone in systemic sclerosis-related interstitial lung disease-a randomised controlled trial.

Rheumatol Int 2020 May 1;40(5):703-710. Epub 2020 Apr 1.

Post Graduate Institute of Medical Education and Research, Chandigarh, India.

To assess the efficacy and safety of pirfenidone in systemic sclerosis-related interstitial lung disease (SSc-ILD). This was a double-blind, randomised, placebo-controlled, pilot study. Subjects with SSc-ILD and forced vital capacity (FVC) between 50 and 80% of the predicted (%pred) value were randomised in 1:1 ratio to receive either pirfenidone (2400 mg/day) or placebo for 6 months. Primary outcome was the proportion of subjects with either stabilisation or improvement in FVC at 6 months. Secondary outcomes were the absolute change in the %pred FVC, Mahler's dyspnoea index, 6-min walk distance (6MWD), modified Rodnan skin score (MRSS) and serum levels of tumour necrosis factor α (TNF-α) and transforming growth factor β (TGF-β). Thirty-four subjects with median (range) age of 41 (20-63) years (91.2% women) and median (range) %pred FVC of 65 (51-78) were enrolled. Stabilisation/improvement in FVC was seen in 16 (94.1%) and 13 (76.5%) subjects in the pirfenidone and placebo groups, respectively (p = 0.33). The median (range) absolute change in %pred FVC was - 0.55 (- 9 to 7%) and 1.0 (- 42 to 11.5%) in the treatment and control groups, respectively (p = 0.51). The changes in 6MWD, dyspnoea scores, MRSS, and levels of TNF-α and TGF-β were not significantly different between groups. Common adverse events were gastrointestinal disturbances and skin rash. We failed to find a significant beneficial effect of pirfenidone over placebo in improving/stabilising FVC, exercise capacity, symptoms, or skin disease. Study is underpowered to provide conclusive evidence. Larger studies with longer follow-up periods are required.
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http://dx.doi.org/10.1007/s00296-020-04565-wDOI Listing
May 2020

Calcinosis Cutis at an Unusual Location.

J Clin Rheumatol 2020 Sep;26(6):e200

From the Clinical Immunology and Rheumatology Services, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.1097/RHU.0000000000001069DOI Listing
September 2020

Keloidal Morphea: Clinical Picture.

J Clin Rheumatol 2020 Sep;26(6):e178-e179

From the Clinical Immunology and Rheumatology Services, Department of Internal Medicine, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

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http://dx.doi.org/10.1097/RHU.0000000000001053DOI Listing
September 2020

TARA study: a new perspective on tapering drugs in RA.

Ann Rheum Dis 2020 07 9;79(7):e79. Epub 2019 May 9.

Clinical Immunology and Rheumatology services, Department of Internal Medicine, PGIMER, Chandigarh, India

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http://dx.doi.org/10.1136/annrheumdis-2019-215594DOI Listing
July 2020

"Banana patella", fibrous dysplasia of patella: A rare case report.

J Clin Orthop Trauma 2019 Mar-Apr;10(2):418-421. Epub 2018 May 18.

Gujarat Cancer Research Institute, Ahmedabad, India.

Introduction: Patella is a very uncommon site for primary bone tumours and fibrous dysplasia lesion in patella has never been reported. Fibrous dysplasia is a benign fibrosseous lesion of the bone where the fibrous connective tissue replaces the normal bone.

Case Report: We report a case of 23 years female with 7 years history of progressive swelling and anterior knee pain. Radiographs showed enlarged, deformed patella like a shape of banana. The patient underwent patellectomy with extensor mechanism repair and biopsy proved to be fibrous dysplasia.

Conclusion: Fibrous dysplasia involving patella is very rare and never been reported earlier. Although primary patellar neoplasm are not common but should be kept in mind in chronic anterior knee pain with swelling for early diagnosis and intervention with intralesional therapy otherwise patellectomy has to be done in more advanced, deformed and enlarged lesions.
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http://dx.doi.org/10.1016/j.jcot.2018.05.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6382953PMC
May 2018

'MAINRITSAN2-the future', with some doubts!

Ann Rheum Dis 2019 12 12;78(12):e139. Epub 2018 Oct 12.

Department of Internal Medicine, Clinical Immunology and Rheumatology services, PGIMER, Chandigarh, India

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http://dx.doi.org/10.1136/annrheumdis-2018-214486DOI Listing
December 2019
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