Publications by authors named "Pranav Mahajan"

10 Publications

  • Page 1 of 1

Acute reversible mitral regurgitation: a rare complication of TAVR.

BMJ Case Rep 2021 Jul 20;14(7). Epub 2021 Jul 20.

Interventional Cardiology, Cardiology, Carle Foundation Hospital, Urbana, Illinois, USA.

Transcatheter aortic valve replacement (TAVR) is becoming the standard of care in the management of severe aortic stenosis for patients in all risk stratifications. Many causes have been identified for acute drop in blood pressure during TAVR. Mitral regurgitation (MR) is a rare, but important acute intraprocedural complication that requires rapid assessment and treatment. Two important reasons for acute MR during TAVR include entanglement of the guide wire in papillary muscles and extension of the guidewire into the left atrium. Here, we report a case of acute reversible MR which was assessed using an echocardiogram and rapidly reversed by removing the stiff preshaped Safari wire from the left ventricle post valve deployment.
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http://dx.doi.org/10.1136/bcr-2021-242899DOI Listing
July 2021

Eptifibatide-induced profound thrombocytopaenia: a rare complication.

BMJ Case Rep 2021 Jun 14;14(6). Epub 2021 Jun 14.

Interventional Cardiology, Cardiology, Carle Foundation Hospital, Urbana, Illinois, USA.

Drug-induced immune thrombocytopaenia (DITP) is a type of thrombocytopaenia caused by medications. It is one of the common causes of unexplained thrombocytopaenia. It is caused by the formation of autoantibodies against a particular drug and is commonly observed with medications like heparin and beta-lactam antibiotics. One of the rare causes of DITP is eptifibatide, a widely used antiplatelet agent for pretreatment in cardiac catheterisation. These patients can be asymptomatic or develop complications like skin bruising, epistaxis and even intracranial haemorrhage. We present a case of a 64-year-old man who developed eptifibatide-induced profound thrombocytopaenia leading to extensive skin bruising. He was treated with platelet transfusions followed by prompt improvement in platelet count.
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http://dx.doi.org/10.1136/bcr-2021-241594DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC8204166PMC
June 2021

Reverse Transcription Loop-Mediated Isothermal Amplification Assay for Ultrasensitive Detection of SARS-CoV-2 in Saliva and Viral Transport Medium Clinical Samples.

Anal Chem 2021 06 25;93(22):7797-7807. Epub 2021 May 25.

Department of Bioengineering, University of Illinois at Urbana-Champaign, Urbana, Illinois 61801-3028, United States.

The COVID-19 pandemic has underscored the shortcomings in the deployment of state-of-the-art diagnostics platforms. Although several polymerase chain reaction (PCR)-based techniques have been rapidly developed to meet the growing testing needs, such techniques often need samples collected through a swab, the use of RNA extraction kits, and expensive thermocyclers in order to successfully perform the test. Isothermal amplification-based approaches have also been recently demonstrated for rapid severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) detection by minimizing sample preparation while also reducing the instrumentation and reaction complexity. In addition, there are limited reports of saliva as the sample source, and some of these indicate inferior sensitivity when comparing reverse transcription loop-mediated isothermal amplification (RT-LAMP) with PCR-based techniques. In this paper, we demonstrate an improved sensitivity assay from saliva using a two-step RT-LAMP assay, where a short 10 min RT step is performed with only B3 and backward inner primers before the final reaction. We show that while the one-step RT-LAMP demonstrates satisfactory results, the optimized two-step approach allows detection of only few molecules per reaction and performs significantly better than the one-step RT-LAMP and conventional two-step RT-LAMP approaches with all primers included in the RT step. We show control measurements with RT-PCR, and importantly, we demonstrate RNA extraction-free RT-LAMP-based assays for detection of SARS-CoV-2 from viral transport media and saliva clinical samples.
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http://dx.doi.org/10.1021/acs.analchem.0c05170DOI Listing
June 2021

Predictors of permanent pacemaker insertion after TAVR: A systematic review and updated meta-analysis.

J Cardiovasc Electrophysiol 2021 May 17;32(5):1411-1420. Epub 2021 Mar 17.

Department of Cardiology, Kansas City Heart Rhythm Institute and Research Foundation, Overland Park, Kansas, USA.

Objectives: The aim of this analysis was to evaluate the predictors associated with increased risk of permanent pacemaker implantation (PPMI) following transcatheter aortic valve replacement (TAVR).

Background: While TAVR has evolved as the standard of care for patients with severe aortic stenosis, conduction abnormalities leading to the need for PPMI is one of the most common postprocedural complications.

Methods: A systematic literature search was performed to identify relevant trials from inception to May 2020. Summary effects were calculated using a DerSimonian and Laird random-effects model as odds ratio with 95% confidence intervals for all the clinical endpoints.

Results: Thirty-seven observational studies with 71 455 patients were identified. The incidence of PPMI following TAVR was 22%. Risk was greater in men and increased with age. Patients with diabetes mellitus, presence of right bundle branch block, baseline atrioventricular conduction block, and left anterior fascicular block were noted to be at higher risk. Other significant predictors include the presence of high calcium volume in the area below the left coronary cusp and noncoronary cusp, use of self-expandable valve over balloon-expandable valve, depth of implant, valve size/annulus size, predilatation balloon valvuloplasty, and postimplant balloon dilation.

Conclusion: Fourteen factors were found to be associated with increased risk of PPMI after TAVR, suggesting early identification of high-risk populations and targeting modifiable risk factors may aid in reducing the need for this post TAVR PPMI.
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http://dx.doi.org/10.1111/jce.14986DOI Listing
May 2021

Acoustic and Language Based Deep Learning Approaches for Alzheimer's Dementia Detection From Spontaneous Speech.

Front Aging Neurosci 2021 5;13:623607. Epub 2021 Feb 5.

Cognitive Neuroscience Lab, Department of Biological Sciences, BITS Pilani University K. K. Birla Goa Campus, Pilani, India.

Current methods for early diagnosis of Alzheimer's Dementia include structured questionnaires, structured interviews, and various cognitive tests. Language difficulties are a major problem in dementia as linguistic skills break down. Current methods do not provide robust tools to capture the true nature of language deficits in spontaneous speech. Early detection of Alzheimer's Dementia (AD) from spontaneous speech overcomes the limitations of earlier approaches as it is less time consuming, can be done at home, and is relatively inexpensive. In this work, we re-implement the existing NLP methods, which used CNN-LSTM architectures and targeted features from conversational transcripts. Our work sheds light on why the accuracy of these models drops to 72.92% on the ADReSS dataset, whereas, they gave state of the art results on the DementiaBank dataset. Further, we build upon these language input-based recurrent neural networks by devising an end-to-end deep learning-based solution that performs a binary classification of Alzheimer's Dementia from the spontaneous speech of the patients. We utilize the ADReSS dataset for all our implementations and explore the deep learning-based methods of combining acoustic features into a common vector using recurrent units. Our approach of combining acoustic features using the Speech-GRU improves the accuracy by 2% in comparison to acoustic baselines. When further enriched by targeted features, the Speech-GRU performs better than acoustic baselines by 6.25%. We propose a bi-modal approach for AD classification and discuss the merits and opportunities of our approach.
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http://dx.doi.org/10.3389/fnagi.2021.623607DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7893079PMC
February 2021

Q fever: a rare but potentially life-threatening zoonotic disease.

BMJ Case Rep 2021 Feb 18;14(2). Epub 2021 Feb 18.

Internal Medicine, Carle Foundation Hospital, Urbana, Illinois, USA.

Q fever can present as a fever of unknown aetiology and can be challenging to diagnose because of the rare incidence. It can present as an acute illness with manifestations, including influenza-like symptoms, hepatitis, pneumonia or chronic disease involving the cardiovascular system. We present a case of a 39-year-old woman in the USA, who developed acute Q fever with associated sepsis and severe hepatitis. She received treatment with recovery from acute infection but currently has symptoms of post Q fever syndrome.
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http://dx.doi.org/10.1136/bcr-2020-237155DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7896566PMC
February 2021

COVID-19-Associated Systemic Thromboembolism: A Case Report and Review of the Literature.

Cardiorenal Med 2020 22;10(6):462-469. Epub 2020 Oct 22.

Baylor University Medical Center, Baylor Scott and White Heart and Vascular Institute, Texas A&M College of Medicine, Dallas, Texas, USA.

Introduction: Coronavirus disease 2019 (COVID-19) is a pandemic that has affected >188 countries, involved >24 million people, and caused >840,000 deaths. COVID-19, in its severe form, presents as acute respiratory distress syndrome (ARDS), shock, and multiorgan failure. Thrombotic microangiopathy of the lungs and kidneys has been observed in these patients. Elevated D-dimer levels have been observed in people with serious COVID-19 illness, and this could be helpful in guiding treatment with anticoagulation in these patients.

Objective: To analyze the role of anticoagulation as a treatment modality for COVID-19.

Methods: We present the unique case of a COVID-19 patient who developed sepsis, ARDS, acute kidney injury, and deep-vein thrombosis (DVT), who was deteriorating clinically. She was treated with anticoagulation.

Results: There was rapid recovery after treatment with systemic anticoagulation.

Conclusions: Systemic anticoagulation could prove to be essential in the treatment of CO-VID-19. Further studies are required to assess its role in improving long-term morbidity and mortality in these patients.
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http://dx.doi.org/10.1159/000511800DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7649692PMC
December 2020

Etiological and Endoscopic Profile of Middle Aged and Elderly Patients with Upper Gastrointestinal Bleeding in a Tertiary Care Hospital in North India: A Retrospective Analysis.

J Midlife Health 2017 Jul-Sep;8(3):137-141

Department of Medicine, Government Medical College, Jammu, Jammu and Kashmir, India.

Background: Upper gastrointestinal (GI) bleeding is a common medical emergency associated with significant morbidity and mortality. The clinical presentation depends on the amount and location of hemorrhage and the endoscopic profile varies according to different etiology. At present, there are limited epidemiological data on upper GI bleed and associated mortality from India, especially in the middle and elderly age group, which has a higher incidence and mortality from this disease.

Aim: This study aims to study the clinical and endoscopic profile of middle aged and elderly patients suffering from upper GI bleed to know the etiology of the disease and outcome of the intervention.

Materials And Methods: Out of a total of 1790 patients who presented to the hospital from May 2015 to August 2017 with upper GI bleed, and underwent upper GI endoscopy, data of 1270 patients, aged 40 years and above, was compiled and analyzed retrospectively.

Results: All the patients included in the study were above 40 years of age. Majority of the patients were males, with a male to female ratio of 1.6:1. The most common causes of upper GI bleed in these patients were portal hypertension-related (esophageal, gastric and duodenal varices, portal hypertensive gastropathy, and gastric antral vascular ectasia GAVE), seen in 53.62% of patients, followed by peptic ulcer disease (gastric and duodenal ulcers) seen in 17.56% of patients. Gastric erosions/gastritis accounted for 15.20%, and duodenal erosions were seen in 5.8% of upper GI bleeds. The in-hospital mortality rate in our study population was 5.83%.

Conclusion: The present study reported portal hypertension as the most common cause of upper GI bleeding, while the most common endoscopic lesions reported were esophageal varices, followed by gastric erosion/gastritis, and duodenal ulcer.
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http://dx.doi.org/10.4103/jmh.JMH_86_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5625578PMC
October 2017

Cross-Sectional Study to Assess the Functional Outcome of Neglected Bimalleolar Fracture.

Foot Ankle Spec 2017 Dec 27;10(6):509-512. Epub 2016 Dec 27.

Department of Orthopedics, Sri Aurobindo Medical College and Post Graduate Institute, Indore, Madhya Pradesh, India.

Introduction: Ankle fracture is the most common intra-articular fracture of a weight-bearing joint and accounts for 9% of all fractures. Ankle fractures are classified into 3 subgroups: unimalleolar, bimalleolar, and trimalleolar fractures. Accurate reduction and stable internal fixation is necessary in bimalleolar fractures; otherwise, it may lead to posttraumatic painful restriction of movements or osteoarthritis. The purpose of this study is to assess the functional outcome and results of treatment of neglected bimalleolar fracture.

Materials And Methods: Seventeen neglected bimalleolar fracture patients were treated with open reduction and internal fixation. Patients were followed-up at 1, 2, and 5 years and functional ability was assessed by using the modified Weber Rating Scale.

Results: The mean age of patients was 41.4 ± 13.28 years. After 2 year of surgery, 13 out of 17 patients showed excellent results and 4 patients had fair results.

Conclusion: Good to excellent functional results were observed after long-term follow-up in neglected bimalleolar fracture treated with open reduction and internal fixation, and we advise surgical intervention in all such patients.

Levels Of Evidence: Therapeutic, Level III: Retrospective Cohort study.
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http://dx.doi.org/10.1177/1938640016685149DOI Listing
December 2017

Outcome of Total Knee Replacement via Two Approaches in Indian Scenario.

J Knee Surg 2017 Feb 23;30(2):174-178. Epub 2016 May 23.

Sri Aurobindo Medical College and PG Institute, Central Research Laboratory, Indore, India.

This study was designed to assess the early and late clinical and functional outcome based on Knee Society Score in patients undergoing total knee replacement (TKR) by medial parapatellar approach/midvastus approach. A total of 52 patients were included in the study of whom 28 patients were operated by medial parapatellar approach and 24 by midvastus approach. Patients were assessed on the basis of Knee Society Score, along with other parameters such as duration of hospital stay, blood loss during, and after surgery. The patients were followed up at 2 weeks, 6 weeks, 3 months, 6 months, and 1 year. The knee objective score showed significant better scores in midvastus group at 2 weeks, 6 weeks, and 3 months, but the score in both the groups was not significant at 6 months and 1 year. The knee functional score showed significant better score in midvastus group at the end of 2 and 6 weeks. However, score in both the groups was not significant by the end of 3 months, 6 months, and 1 year. Patients' satisfaction and expectation scores were similar in both groups at all time intervals. The functional outcome of TKR surgery by midvastus approach was better in the first 3 months in comparison to medial parapatellar approach.
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http://dx.doi.org/10.1055/s-0036-1584192DOI Listing
February 2017
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