Publications by authors named "Shah Alam Khan"

98 Publications

Cost-effectiveness of risk-based breast cancer screening: A systematic review.

Int J Cancer 2021 Apr 12. Epub 2021 Apr 12.

Division of Health Economics, German Cancer Research Center (DKFZ), Heidelberg, Germany.

To analyse published evidence on the economic evaluation of risk-based screening (RBS), a full systematic literature review was conducted. After a quality appraisal, we compared the cost-effectiveness of risk-based strategies (low-risk, medium-risk, and high-risk) with no screening and age-based screening. Studies were also analysed for modelling, risk stratification methods, input parameters, data sources, and harms and benefits. The ten modelling papers analysed were based on screening performance of film-based mammography (FBM) (three), digital mammography (DM) & FBM (two), DM alone (three), DM, ultrasound (US) and magnetic resonance imaging (one) and DM & US (one). Seven studies did not include cost of risk-stratification, and one did not consider the cost of diagnosis. Disutility was incorporated in only six studies (one for screening and five for diagnosis). None of the studies reported disutility of risk-stratification (being considered as high-risk). Risk-stratification methods varied from only breast density (BD) to the combination of familial risk, genetic susceptibility, lifestyle, previous biopsies, Jewish ancestry, and reproductive history. Less or no screening in low-risk women and more frequent mammography screening in high-risk women was more cost-effective compared to no screening and age-based screening. High-risk women screened annually yielded a higher mortality rate reduction and more quality-adjusted life years at the expense of higher cost and false positives. RBS can be cost effective compared to the alternatives. However, heterogeneity among risk-stratification methods, input parameters, and weaknesses in the methodologies hinder the derivation of robust conclusions. Therefore, further studies are warranted to assess newer technologies and innovative risk-stratification methods.
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http://dx.doi.org/10.1002/ijc.33593DOI Listing
April 2021

Outcomes of major musculoskeletal oncological reconstructions using prolene mesh-a retrospective analysis from a tertiary referral centre.

J Clin Orthop Trauma 2021 May 4;16:195-201. Epub 2021 Jan 4.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, 110029, India.

Background: Adequate reconstruction of the soft tissue defect following resection of bone tumors is challenging. Prolene mesh, despite being a useful tool, is not widely used due to the fear of deep infection. The aim of this study was to evaluate the functional outcome and complications of using a Prolene mesh in oncological reconstructions.

Methods: A retrospective study was conducted in bone tumor patients with soft tissue reconstruction using Prolene mesh between January 2017 and June 2019. Functional evaluation was done using MSTS 93 score. Complications were recorded and were classified as mechanical (dislocation and extension lag) or biological failure (wound problems and deep infection). Comparison was performed between groups with and without biological failure to identify predictive variables.

Results: Of 116 patients, 68 were males and 48 were females, with median age of 22.5 years. Thirty nine patients had tumors of proximal tibia, 23 of proximal femur, 25 of proximal humerus, 24 of pelvis, and five tumors at other sites. Approximately two-thirds (62.9%) of our patients underwent endoprosthetic reconstruction while the rest underwent either biological or cement spacer reconstructions. Excellent or good functional outcomes were reported in 98.3% patients as per MSTS 93 scoring. Complications were noted in 22 patients (18.9%), of which 16 had biological failure, with four patients requiring debridement and mesh removal. Dislocation of prosthesis occurred in 2 patients of proximal femur replacement. Overall re-surgery rate was 5.1% (6 patients). There was no statistically significant difference between the groups with or without biological failure with respect to demographics, site of tumor, type of procedure, blood loss, duration of surgery and history of chemotherapy.

Conclusion: Prolene mesh is a useful tool to reconstruct the soft tissue defects following bone tumor resections. It is readily available, reliable and provides reproducible results, with no added risk of wound complications.
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http://dx.doi.org/10.1016/j.jcot.2020.12.029DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7920099PMC
May 2021

Relationship between height and osteosarcoma at the time of diagnosis in the Indian population: A retrospective study.

J Clin Orthop Trauma 2021 Mar 18;14:162-166. Epub 2020 Apr 18.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, 110029, India.

Background: It has been indicated in several instances that tall stature is also an important risk factor in the development of osteosarcoma. This relationship between height and osteosarcoma is substantiated even more by the increasing evidences being put forth in the recent literature on dependence of certain tumors on the growth factors and their receptors, acting through autocrine or paracrine mechanisms. There has been no study on the Indian population that attempts to define such a relationship.

Purpose: The primary objective of this study was to define relationship between height of patients and osteosarcoma at the time of diagnosis in the Indian population.

Materials/methods: Retrospective data was collected from the old hospital records. Height of patients at the time of diagnosis was compared with expected height of patients of the same age with reference to the standardized growth charts provided by the Indian Academy of Paediatrics.

Results: Out of 98 patients, there were 65 male and 33 female patients with M: F ratio being 1.97:1. The mean age at diagnosis was 17 (SD = 8) years with range of 5-55 years (median = 17 years). Height of the patients at the time of diagnosis was 155.18 (SD = 15.47) cm with range of 115 cm-184 cm (median = 159 cm). Overall, patients with Osteosarcoma were found to be shorter than the expected height deduced from the national growth charts. When patients were divided into two groups of those who were of growing age and those who had completed growth, results were similar.

Conclusion: The observation that majority of patients with osteosarcoma in our study were stunted, is an important finding. It could be deduced from this observation that these patients are unable to mount the usual biological response to the overstimulated growth as part of tumorigenesis in osteosarcoma. This could point to a different scenario in the Indian population and more studies need to be carried out with larger number of patients to further elaborate on this observation.
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http://dx.doi.org/10.1016/j.jcot.2020.04.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7919943PMC
March 2021

What Is the Comparative Ability of 18F-FDG PET/CT, 99mTc-MDP Skeletal Scintigraphy, and Whole-body MRI as a Staging Investigation to Detect Skeletal Metastases in Patients with Osteosarcoma and Ewing Sarcoma?

Clin Orthop Relat Res 2021 Feb 26. Epub 2021 Feb 26.

A. Aryal, V. S. Kumar, S. A. Khan, Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background: Skeletal metastases of bone sarcomas are indicators of poor prognosis. Various imaging modalities are available for their identification, which include bone scan, positron emission tomography/CT scan, MRI, and bone marrow aspiration/biopsy. However, there is considerable ambiguity regarding the best imaging modality to detect skeletal metastases. To date, we are not sure which of these investigations is best for screening of skeletal metastasis.

Question/purpose: Which staging investigation-18F-fluorodeoxyglucose positron emission tomography/CT (18F-FDG PET/CT), whole-body MRI, or 99mTc-MDP skeletal scintigraphy-is best in terms of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) in detecting skeletal metastases in patients with osteosarcoma and those with Ewing sarcoma?

Methods: A prospective diagnostic study was performed among 54 of a total 66 consecutive osteosarcoma and Ewing sarcoma patients who presented between March 2018 and June 2019. The institutional review board approved the use of all three imaging modalities on each patient recruited for the study. Informed consent as obtained after thoroughly explaining the study to the patient or the patient's parent/guardian. The patients were aged between 4 and 37 years, and their diagnoses were proven by histopathology. All patients underwent 99mTc-MDP skeletal scintigraphy, 18F-FDG PET/CT, and whole-body MRI for the initial staging of skeletal metastases. The number and location of bone and bone marrow lesions diagnosed with each imaging modality were determined and compared with each other. Multidisciplinary team meetings were held to reach a consensus about the total number of metastases present in each patient, and this was considered the gold standard. The sensitivity, specificity, PPV, and NPV of each imaging modality, along with their 95% confidence intervals, were generated by the software Stata SE v 15.1. Six of 24 patients in the osteosarcoma group had skeletal metastases, as did 8 of 30 patients in the Ewing sarcoma group. The median (range) follow-up for the study was 17 months (12 to 27 months). Although seven patients died before completing the minimum follow-up, no patients who survived were lost to follow-up.

Results: With the number of patients available, we found no differences in terms of sensitivity, specificity, PPV, and NPV among the three staging investigations in patients with osteosarcoma and in patients with Ewing sarcoma. Sensitivities to detect bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 100% (6 of 6 [95% CI 54% to 100%]), 83% (5 of 6 [95% CI 36% to 100%]), and 67% (4 of 6 [95% CI 22% to 96%]) and specificities were 100% (18 of 18 [95% CI 82% to 100%]), 94% (17 of 18 [95% CI 73% to 100%]), and 78% (14 of 18 [95% CI 52% to 94%]), respectively, in patients with osteosarcoma. In patients with Ewing sarcoma, sensitivities to detect bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 88% (7 of 8 [95% CI 47% to 100%]), 88% (7 of 8 [95% CI 47% to 100%]), and 50% (4 of 8 [95% CI 16% to 84%]) and specificities were 100% (22 of 22 [95% CI 85% to 100%]), 95% (21 of 22 [95% CI 77% to 100%]), and 95% (21 of 22 [95% CI 77% to 100%]), respectively. Further, the PPVs for detecting bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 100% (6 of 6 [95% CI 54% to 100%]), 83% (5 of 6 [95% CI 36% to 100%]), and 50% (4 of 8 [95% CI 16% to 84%]) and the NPVs were 100% (18 of 18 [95% CI 82% to 100%]), 94% (17 of 18 [95% CI 73% to 100%]), and 88% (14 of 16 [95% CI 62% to 98%]), respectively, in patients with osteosarcoma. Similarly, the PPVs for detecting bone metastases for 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy were 100% (7 of 7 [95% CI 59% to 100%]), 88% (7 of 8 [95% CI 50% to 98%]), and 80% (4 of 5 [95% CI 28% to 100%]), and the NPVs were 96% (22 of 23 [95% CI 78% to 100%]), 95% (21 of 22 [95% CI 77% to 99%]), and 84% (21 of 25 [95% CI 64% to 96%]), respectively, in patients with Ewing sarcoma. The confidence intervals around these values overlapped with each other, thus indicating no difference between them.

Conclusion: Based on these results, we could not demonstrate a difference in the sensitivity, specificity, PPV, and NPV between 18F-FDG PET/CT, whole-body MRI, and 99mTc-MDP skeletal scintigraphy for detecting skeletal metastases in patients with osteosarcoma and Ewing sarcoma. For proper prognostication, a thorough metastatic workup is essential, which should include a highly sensitive investigation tool to detect skeletal metastases. However, our study findings suggest that there is no difference between these three imaging tools. Since this is a small group of patients in whom it is difficult to make broad recommendations, these findings may be confirmed by larger studies in the future.

Level Of Evidence: Level II, diagnostic study.
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http://dx.doi.org/10.1097/CORR.0000000000001681DOI Listing
February 2021

Unwinding Complexities of Diabetic Alzheimer by Potent Novel Molecules.

Am J Alzheimers Dis Other Demen 2020 Jan-Dec;35:1533317520937542

Department of Pharmacy, Oman Medical College, Muscat, Oman.

Diabetes mellitus is one of the aggressive disorders in global society. No pharmacotherapy is available for permanent diabetes cure, although management is possible with drugs and physical activities. One of the recent complications noticed in type 2 diabetes mellitus includes diabetes-induced Alzheimer. It has been proposed that the possible diabetes-induced Alzheimer could be of type 3 diabetes. A variety of cross-sectional studies have proved that type 2 diabetes mellitus is one of the factors responsible for the pathophysiology of Alzheimer. New drug molecules developed by pharmaceutical companies with adequate neuroprotective effect have demonstrated their efficacy in treatment of Alzheimer in various preclinical diabetic studies. Patients of type 2 diabetes mellitus may show the benefit with existing drugs but may not cause complete cure. Extensive studies are being carried out to find new drug molecules that show their potential as antidiabetic drug and could treat type 2 diabetes-induced Alzheimer as well. This review provides an overview about the recent advancement in pharmacotherapy of diabetes-induced Alzheimer. The pathomechanistic links between diabetes and Alzheimer as well as neurochemical changes in diabetes-induced Alzheimer are also briefed.
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http://dx.doi.org/10.1177/1533317520937542DOI Listing
February 2021

A management strategy for giant cell tumor of the metacarpal: A single-center series of 11 cases.

J Clin Orthop Trauma 2020 Jul-Aug;11(4):657-661. Epub 2020 Jun 9.

Department of Orthopaedics, All India Institute of Medical Sciences, Delhi, India.

Background: Primary giant cell tumor (GCT) arising from bones of hand are rare to occur. Metacarpals are often the most common site of involvement among hand bones. There are no uniform guidelines for treatment of GCT involving metacarpals due to lack of relevant literature.

Objective: To suggest a management strategy for GCT involving metacarpals.

Methods: Retrospective review of cases of GCT involving metacarpals over a period of 15 years from 2005 to 2019 managed at department of Orthopaedics, All India Institute of Medical Sciences, New Delhi.

Results: A total of 12 cases of GCT involving metacarpal were included, out of which one was lost to follow-up. Four cases were recurrent, and seven were primary at the time of surgery. All the patients were operated with wide excision of the tumor. In seven patients reconstruction of the metacarpal and MCPJ was done using fibular strut graft and silastic artificial joint, while in two patients, MCPJ arthrodesis was performed using fibula and/or iliac crest bone graft. In another two patients, the MCPJ was reconstructed using reversed vascularised toe transfer. Mean follow up of the patients was 3.22 ± 2.07 years. Mean Quick DASH score at latest follow-up of patients operated with silastic joint reconstruction, reversed vascularised toe transfer and arthrodesis of MCP joints were 30.5 ± 9.5, 25 ± 2.3 and 39.8 ± 3.4 respectively. Local recurrence occurred only in one patient at one year after surgery. All the patients were pain free at latest follow-up with quite functional and cosmetically acceptable hand.

Conclusion: Reversed vascularised metatarsal transfer has obtained better functional results compared to reconstruction with fibular grafting and silicone joint replacement but due to technical difficulties, vascularised joint transfer may not be performed in every setting and there is risk of donor site morbidities with this technique. Our strategy for the treatment of GCT involving metacarpal was to do vascularised joint transfer or arthrodesis for border digits and reconstruction with silicone joint for central digits.
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http://dx.doi.org/10.1016/j.jcot.2020.05.032DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7355077PMC
June 2020

Bone sarcoma surgery in times of COVID-19 pandemic lockdown-early experience from a tertiary centre in India.

J Surg Oncol 2020 Oct 13;122(5):825-830. Epub 2020 Jul 13.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background And Objectives: Coronavirus disease 2019 (COVID-19) lockdown has presented a unique challenge for sarcoma care. The purpose of this study is to evaluate the early results and feasibility of surgeries for bone sarcomas during the COVID-19 lockdown.

Methods: Our prospectively collected orthopaedic oncological database was reviewed to include two groups of patients- those who underwent surgery in the immediate 4 weeks before lockdown (non-lockdown group) and those operated in the first 4 weeks of lockdown (lockdown group). All patients were followed-up clinically and telephonically to collect the outcome data.

Results: Out of the 91 patients who qualified for inclusion, fifty were classified into the non-lockdown group while 41 patients formed the lockdown group. Both the groups were comparable with respect to baseline demographic parameters. However, during the lockdown period 37 patients (90%) had undergone a major surgical intervention as against 24 patients (48%) in the non-lockdown group (P < .001). There was no significant difference in type of anaesthesia, median estimated blood loss and procedure duration. None of the patients/health care workers had evidence of severe acute respiratory syndrome-coronavirus 2 infection at 15 days follow-up.

Conclusion: Our study results suggest that appendicular bone tumours can be safely operated with adequate precautions during the lockdown period.
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http://dx.doi.org/10.1002/jso.26112DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC7405233PMC
October 2020

Role of intravenous zoledronic acid in management of giant cell tumor of bone- A prospective, randomized, clinical, radiological and electron microscopic analysis.

J Clin Orthop Trauma 2019 Nov-Dec;10(6):1021-1026. Epub 2019 Sep 28.

Department of Orthopaedics, Hamdard Institute of Medical Sciences and Research, India.

Background: The primary treatment of Giant cell tumor of bone is surgical management. Bisphosphonates are antiresorptive drugs which inhibit osteoclast mediated bone resorption and shown to have inhibitory effect on various tumors. The present study aims to establish clinical, ultrastructural and radiological response of intravenous zoledronic acid on giant cell tumor of bone.

Methodology: Design - Prospective randomized controlled study. A group of 30 patients of GCT bone were randomized into two equal groups. Patients in control group did not receive any adjuvant therapy before surgery. Patients in bisphosphonate group received three doses of intravenous zoledronic acid at four weeks interval prior to definitive surgery. The evaluation was done based on size of swelling, VAS score, plain radiograph, MRI and histopathological and Transmission electron microscopic examination findings.

Results: Significant reduction in VAS score (from mean 5.33 to 1.8), increased mineralization particularly at periphery of lesion in plain radiograph, statistically significant increase in mean apoptotic index, P value < 0.0001 (mean 41.46 in bisphosphonate group and 6.06 in control group) was noted in bisphosphonate group. No significant change in tumor volume is noted in MRI. No significant side effects were noted.

Discussion: One distinctive feature of pathogenesis of GCT bone is osteoclastogenesis which causes extensive bone destruction. Use of intravenous Zoledronic acid counteracts this bone destruction. Further, possible antiangiogenic effect of intravenous bisphosphonates inhibits tumor growth and provides symptomatic improvement.

Conclusion: IV Zoledronic acid alleviates pain, produce sclerosis and induce apoptosis hence decrease the rate of tumor progression and decrease the rate of local bone destruction, hence they are useful adjuvant to surgery in GCT.
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http://dx.doi.org/10.1016/j.jcot.2019.09.011DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6844206PMC
September 2019

Melanotic neuroectodermal tumour of infancy presenting as a lytic lesion in femur: a rare tumour at a rare site with an unusual behaviour.

BMJ Case Rep 2019 Oct 5;12(10). Epub 2019 Oct 5.

Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Melanotic neuroectodermal tumour of infancy (MNTI) is an uncommon tumour, predominantly occurring in head and neck, mostly maxilla, but also in skull and mandible. Although a benign lesion, it is known to recur in 15%-27% of cases, and rarely, may undergo malignant transformation. We present a case of a 5-month-old female patient, who presented with a gradually progressive swelling in the right thigh. On imaging, an osteolytic lesion was seen, involving the metadiaphysis of shaft of right femur. A biopsy was performed, on which diagnosis of MNTI was made. MNTI is rarely seen in extremities. To the best of our knowledge, only six cases have been reported in femur, the present case being the seventh. The tumour showed spontaneous regression on follow-up in our patient, which has rarely been described. A knowledge of characteristic morphology and immunohistochemistry is the key to differentiate it from other tumours.
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http://dx.doi.org/10.1136/bcr-2019-231959DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6782039PMC
October 2019

Acetyl-11-keto-β-boswellic acid (AKBA) Attenuates Oxidative Stress, Inflammation, Complement Activation and Cell Death in Brain Endothelial Cells Following OGD/Reperfusion.

Neuromolecular Med 2019 12 12;21(4):505-516. Epub 2019 Sep 12.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center (SJHMC), Dignity Health, 350 W Thomas Rd, Phoenix, AZ, 85013, USA.

Brain endothelial cells play an important role in maintaining blood flow homeostasis in the brain. Cerebral ischemia is a major cause of endothelial dysfunction which can disrupt the blood-brain barrier (BBB). Oxygen-glucose deprivation (OGD)/reperfusion promote cell death and BBB breakdown in brain endothelial cells. Acetyl-11-keto-β-boswellic acid (AKBA), a biologically active phytoconstituent of the medicinal plant Boswellia serrata, has been shown to be protective against various inflammatory diseases as well as ischemic brain injury. The molecular mechanisms underlying these beneficial characteristics of AKBA are poorly understood. We subjected bEND.3 cells to OGD/reperfusion to investigate the protective role of AKBA in this model. We found that AKBA treatment attenuated endothelial cell death and oxidative stress assessed by means of TUNEL assay, cleaved-caspase-3, and dihydroethidium (DHE) staining. Furthermore, OGD downregulated tight junction proteins ZO-1 and Occludin levels, and increased the expressions of inflammatory cytokines TNF-α, ICAM-1, and complement C3a receptor (C3aR). We also noticed the increased phosphorylation of ERK 1/2 in bEND.3 cells in OGD group. AKBA treatment significantly attenuated expression levels of these inflammatory proteins and prevented the degradation of ZO-1 and Occludin following OGD. In conclusion, AKBA treatment provides protection against endothelial cell dysfunction following OGD by attenuating oxidative stress and inflammation.
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http://dx.doi.org/10.1007/s12017-019-08569-zDOI Listing
December 2019

C3a Receptor Inhibition Protects Brain Endothelial Cells Against Oxygen-glucose Deprivation/Reperfusion.

Exp Neurobiol 2019 Apr 30;28(2):216-228. Epub 2019 Apr 30.

Department of Neurosurgery, Barrow Neurological Institute, St. Joseph's Hospital and Medical Center, Dignity Health, Phoenix, Arizona 85013, USA.

The complement cascade is a central component of innate immunity which plays a critical role in brain inflammation. Complement C3a receptor (C3aR) is a key mediator of post-ischemic cerebral injury, and pharmacological antagonism of the C3a receptor is neuroprotective in stroke. Cerebral ischemia injures brain endothelial cells, causing blood brain barrier (BBB) disruption which further exacerbates ischemic neuronal injury. In this study, we used an model of ischemia (oxygen glucose deprivation; OGD) to investigate the protective effect of a C3aR antagonist (C3aRA, SB290157) on brain endothelial cells (bEnd.3). Following 24 hours of reperfusion, OGD-induced cell death was assessed by TUNEL and Caspase-3 staining. Western blot and immunocytochemistry were utilized to demonstrate that OGD upregulates inflammatory, oxidative stress and antioxidant markers (ICAM-1, Cox-2, Nox-2 and MnSOD) in endothelial cells and that C3aRA treatment significantly attenuate these markers. We also found that C3aRA administration restored the expression level of the tight junction protein occludin in endothelial cells following OGD. Interestingly, OGD/reperfusion injury increased the phosphorylation of ERK1/2 and C3aR inhibition significantly reduced the activation of ERK suggesting that endothelial C3aR may act via ERK signaling. Furthermore, exogenous C3a administration stimulates these same inflammatory mechanisms both with and without OGD, and C3aRA suppresses these C3a-mediated responses, supporting an antagonist role for C3aRA. Based on these results, we conclude that C3aRA administration attenuates inflammation, oxidative stress, ERK activation, and protects brain endothelial cells following experimental brain ischemia.
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http://dx.doi.org/10.5607/en.2019.28.2.216DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6526115PMC
April 2019

Ewing's Sarcoma of Scapula: a Rare Case Report.

Indian J Surg Oncol 2019 Mar 19;10(1):232-235. Epub 2018 Nov 19.

5Department of Orthopaedics, India Institute of Medical Sciences, New Delhi, India.

Neoplasms arising from scapula are rare. We herein, present a rare case of Ewing's sarcoma of scapula in a 9-year-old male child. Extensive literature search reveals that less than 20 similar cases have been reported so far. The index case had been treated with multimodal therapies-chemotherapy, surgery, and radiotherapy. This case is reported to highlight the rarity of the case and discuss the review of literature comprehensively.
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http://dx.doi.org/10.1007/s13193-018-0833-8DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6414565PMC
March 2019

Insights into the chemistry and therapeutic potential of furanones: A versatile pharmacophore.

Eur J Med Chem 2019 Jun 11;171:66-92. Epub 2019 Mar 11.

Department of Pharmacy, GRD (PG) Institute of Management and Technology, Dehradun, 248009, UK, India.

Furanone, a five-membered heteroaromatic ring containing oxygen atom, is of immense pharmaceutical importance. Presence of this nucleus in biologically active compounds of natural and synthetic origin has made it an indispensable motif for design and development of new therapeutic agents. In recent years synthesis of furanone derivatives and exploring their therapeutic actions has been the prime interest amongst researchers. Furanone containing compounds cover numerous therapeutic categories viz. Analgesic and anti-inflammatory, anticancer, anticonvulsant, antibacterial and antifungal, antioxidant, antiulcer and anti-TB, etc. There is a need to couple recent work done with previously available information on furanone, a well acknowledged scaffold, to help scientists to develop novel and new furanone based therapeutic agents at a faster pace. This updated review highlights the worth of numerous therapeutically active furanone based compounds developed by the medicinal chemists. SAR studies have also been derived which may be useful for rational designing of furanone derivatives with improved therapeutic index.
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http://dx.doi.org/10.1016/j.ejmech.2019.03.021DOI Listing
June 2019

Factors affecting compliance to hospital visit among clubfoot patients: A cross-sectional study from a tertiary referral clubfoot clinic in the developing country.

J Orthop Surg (Hong Kong) 2019 Jan-Apr;27(1):2309499019825598

2 Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Purpose: Ensuring compliance to treatment protocol, especially regular visit to treating facility, is an important aspect of clubfoot management. However, the factors affecting compliance to follow-up schedule are myriad.

Methods: A cross-sectional study was undertaken among caregivers of clubfoot patients from a tertiary referral clubfoot clinic in a developing country. Hospital records were reviewed to collect demographic data and subjects were classified as either "regular" or "irregular" if they missed ≤3 and >3 scheduled hospital visits, respectively. Various factors that could affect compliance such as family size, number of children, literacy of caregiver, occupation of breadwinner, and time taken to travel to hospital were studied. Caregivers were probed regarding the reason for their irregularity.

Results: A total of 238 patients were included, of which 138 formed the "regular" group and the rest 100 formed the "irregular" group. Patients in the regular group were significantly younger (mean age 43.8 months) compared to the irregular group (59.8 months; p = 0.001). The mean follow-up period in the regular group was 28.1 months and in the irregular group was 33.8 months. On univariate analysis, age, duration of follow-up, and transport duration were found to be significant between the two groups. However, multivariate analysis revealed that female children with clubfoot are more likely to be irregular as compared to males ( p = 0.038).

Conclusion: In a developing country setting, higher age and being a female child are associated with irregularity to hospital visit protocol. At clubfoot clinics, identifying these children and counseling their caregivers might improve compliance.
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http://dx.doi.org/10.1177/2309499019825598DOI Listing
March 2020

Role of Bisphosphonates as Adjuvants of Surgery in Giant Cell Tumor of Spine.

Int J Spine Surg 2018 Dec 21;12(6):695-702. Epub 2018 Dec 21.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background: The role of bisphosphonates is well established in giant cell tumor of bone (GCTB) of extremities, but its role in spine GCTB is still not established. Our main purpose was to evaluate the role of bisphosphonates in spinal GCTB with the help of radiologic assessment.

Methods: A retrospective analysis of all spine GCTB patients who underwent an operation from July 2005 to January 2014 was done. Patients of spine GCTB in whom bisphosphonates were given constituted the study group. This group was compared to patients in whom bisphosphonates were not given. Preoperative and postoperative radiographs and CT scans were studied. A thorough evaluation of the presence of sclerosis was done on them. Bisphosphonates were considered to be effective if either sclerosis or new bone formation was present.

Results: A total of 13 cases of spine GCT underwent operation from July 2005 to January 2014. All patients of GCTB spine who underwent an operation after 2008 at our institute were given bisphosphonates postoperatively. Of 13 cases, bisphosphonates were given postoperatively in 6 patients: 5 patients were female and 1 patient was male. Of these 6 patients, 3 patients had sacrum GCTB and 1 patient each had T9, T11, and L5 vertebrae GCTB. Average follow-up period was 39.33 months (minimum follow-up was 18 months and maximum follow-up was 72 months). Postoperative sclerosis was present in all 6 patients. No recurrence of the tumor was present in the bisphosphonate group, but 2 patients had a recurrence in the group that did not receive bisphosphonates.

Conclusions: Bisphosphonates are effective and safe adjuvant therapy along with appropriate surgical intervention in spinal GCTBs and may have a role in decreasing the recurrence of this tumor.
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http://dx.doi.org/10.14444/5087DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6314347PMC
December 2018

Development of a stress induced validated UPLC-PDA method for the analysis of Eslicarbazepine acetate.

Saudi Pharm J 2018 Feb 21;26(2):286-291. Epub 2017 Nov 21.

Department of Pharmaceutical Chemistry, School of Pharmaceutical Education and Research, Jamia Hamdard, New Delhi, India.

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http://dx.doi.org/10.1016/j.jsps.2017.11.009DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6111187PMC
February 2018

Nora's lesion of 2nd metacarpal treated by wide excision, autologous fibular grafting and metacarpophalangeal joint replacement: A rare case report.

J Clin Orthop Trauma 2018 Jun 24;9(Suppl 2):S58-S62. Epub 2017 Aug 24.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Bizarre paroxysmal osteochondromatous proliferation (BPOP) is a rare benign neoplastic lesion predominantly affecting small bones of the hand and known for its recurrence after local excision. We describe a rare case of BPOP involving second metacarpal of the dominant hand which was treated using a novel technique. Wide excision and reconstruction with non-vascularised fibular autograft was performed along with metacarpophalangeal joint replacement. At a follow up of two years, there was no evidence of recurrence and patient had good functional outcome. Hence this modality of treatment could be considered in dealing such cases of BPOP involving the small bones of hand.
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http://dx.doi.org/10.1016/j.jcot.2017.08.014DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6008605PMC
June 2018

Ameliorative Effect of Camel's Milk and Oil against Thioacetamide-induced Hepatorenal Damage in Rats.

Pharmacogn Mag 2018 Jan-Mar;14(53):27-35. Epub 2018 Feb 20.

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Hamdard University, New Delhi, India.

Background: Camel milk (CM) and (NS) have been traditionally claimed to cure wide range of diseases and used as medicine in different part of world, particularly in Saudi Arabia. Several research studies have been published that proved beneficial effects of CM and NS.

Objective: This study was undertaken to investigate the antihepatotxic potential of CM and NS oil (NSO) against thioacetamide (TAA)-induced hepato and nephrotoxicity in rats.

Materials And Methods: Thirty female Albino Wistar rats were randomly divided in to six groups having five rats in each group. A single subcutaneous injection of TAA (100 mg/kg b. w.) was administered to all the rats in Group-II to VI on 1 day to induce hepatorenal damage. Group I served as a normal control while Group II served as toxic control for comparison purpose. Experimental animals in Group III, IV, and V were supplemented with fresh CM, (250 mL/24 h/cage), NSO (2 mL/kg/day p. o.), and NSO + fresh CM, respectively. Group VI was treated with a polyherbal hepatoprotective Unani medicine Jigreen (2 mL/kg/day p. o.) for 21 days. TAA-induced hepatorenal damage and protective effects of CM and NSO were assessed by analyzing liver and kidney function tests in the serum. Histopathology of liver and kidney tissues was also carried out to corroborate the findings of biochemical investigation.

Results: The results indicated that the TAA intoxicated rats showed significant increase in the alanine transaminase, aspartate transaminase, gamma-glutamyl transpeptidase, alkaline phosphatase, lipid profile, urea, creatinine, uric acid, sodium, and potassium levels in serum. Treatment of rats with CM, NSO, and CM plus NSO combination and Jigreen significantly reversed the damage and brought down the serum biochemical parameters and lipid profile toward the normal levels. The histopathological studies also support the hepato and nephroprotective effects of CM and NSO.

Conclusion: This study demonstrated the ameliorative effects of CM, NSO, and CM plus NSO combination against TAA-induced hepatorenal toxicity in rats.

Summary: The antihepatotxic potential of Camel's Milk (CM) and oil (NSO) against thioacetamide (TAA) induced hepatorenal toxicity was evaluated in ratsThe oral administration of fresh CM (250 mL/24h/cage), NSO (2 mL/kg/day) and NSO+fresh CM and Jigreen (2 mL/kg/day) for 21 days significantly decreased the hepatorenal toxicity as evidenced from analyzed biochemical parameters in serum and histopathological studies of liver and kidney tissuesThis study demonstrated the ameliorative effects of CM and NSO against TAA induced hepatorenal toxicity. CM: Camel milk; NS: ; NSO: Oil; TAA: Thioacetamide; S.C.: Subcutaneous; Jig: Jigreen; b.w.: Body Weight; mL: Milli liter; mg: Milli gram; g: Gram; Kg: Kilo gram; ALT: Alanine transaminase; AST: Aspartate transaminase; GGT: Gamma-Glutamyl Transpeptidase; ALP: Alkaline Phosphatase; TC: Total Cholesterol; HDL-C: High Density Lipoprotein Cholesterol; LDL-C: Low Density Lipoprotein Cholesterol; TG: Triglyceride; TB: Total bilirubin; K: Potassium; Na: Sodium; CCl: Carbon Tetrachloride; °C: Degree Celsius; p.o.: Per Oral; RPM: Revolutions per minute; H&E: Hematoxylin and Eosin; SEM: Standard Error of Mean; ANOVA: The one-way analysis of variance.
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http://dx.doi.org/10.4103/pm.pm_132_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5858237PMC
February 2018

Primary Intraosseous Malignant Peripheral Nerve Sheath Tumor of Metacarpal Bones of the Hand in a Patient Without Neurofibromatosis 1: Report of a Rare Case.

Indian J Med Paediatr Oncol 2017 Apr-Jun;38(2):232-235

Department of Pathology, All Institute of Medical Sciences, New Delhi, India.

Malignant peripheral nerve sheath tumor (MPNST) usually arises in peripheral nerve sheath cells. The intraosseous location of MPNST is rare. Mandible is the most common site of bony involvement. Involvement of bones of the hand is quite unusual. We report a case of MPNST involving metacarpal bones of the left hand treated with surgery followed by adjuvant radiation and chemotherapy and review the pertinent literature.
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http://dx.doi.org/10.4103/ijmpo.ijmpo_5_17DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5582569PMC
September 2017

Solid Variant of Aneurysmal Bone Cyst Masquerading as Malignancy.

J Clin Diagn Res 2017 Jul 1;11(7):ED35-ED36. Epub 2017 Jul 1.

Assistant Professor, Department of Pathology, AIIMS, New Delhi, India.

Solid Variant of Aneurysmal Bone Cyst (SVABC) is an uncommon neoplasm seen in young patients. The lesion presents clinically as well as on radiology like a malignant bone tumour. The aggressive features in most of the cases lead to a wrong diagnosis. Radiologically, it is expansile osteolytic with cortical breach being seen in many of the cases. We report two cases of SVABC which were misdiagnosed as malignant bone tumours. Both cases were seen in long bones. Radiologically both lesions were expansile, osteolytic, solid cystic, with destruction of cortex and were diagnosed as osteosarcomas. Both the cases were referred to us for further management and were subsequently diagnosed as SVABC. Being extremely rare these tumours have a high chance of getting misdiagnosed and knowledge of this entity along with close correlation with clinical, radiological and histopathological findings plays a critical role in accurately diagnosing this condition. An accurate diagnosis is of utmost importance as this changes the treatment drastically avoiding mutilating surgeries and unnecessary chemo radiotherapy.
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http://dx.doi.org/10.7860/JCDR/2017/25950.10306DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5583895PMC
July 2017

Pes Anserinus Bursitis due to Tibial Spurs in Children.

Cureus 2017 Jul 5;9(7):e1427. Epub 2017 Jul 5.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Osteochondromas are the most common bone tumours. Although these tumors are relatively common in the long bones of children, the varied clinical and radiographic presentation of such neoplasms around the knee joint can cause diagnostic delays, especially when not associated with a palpable swelling. Proximal tibial osteochondromas can sometimes unusually present as spurs/ rose thorns leading to pes anserinus bursitis and vague knee pain. We describe the clinico-radiographic features of such proximal tibial metaphyseal osteochondromas giving rise to pes anserinus bursitis in three children, including bilaterally symmetrical osteochondroma in one of the cases, who were treated conservatively with good outcomes.
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http://dx.doi.org/10.7759/cureus.1427DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5585000PMC
July 2017

Factors associated with local recurrence in operated osteosarcomas: A retrospective evaluation of 95 cases from a tertiary care center in a resource challenged environment.

J Surg Oncol 2017 Apr 25;115(5):631-636. Epub 2017 Apr 25.

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background And Objectives: Local control of disease is one of the main goals of osteosarcoma management. We conducted a retrospective evaluation of 95 operated cases of osteosarcoma over 7 years to know about the factors associated with local recurrence in resource-challenged environment of the developing world.

Methods: The factors which were evaluated and compared between local recurrence and non-local recurrence groups included demographic profile, site of tumor, whether biopsy done outside, type of surgery (limb salvage or amputation), presence of pathological fracture, vicinity of neurovascular bundle, tumor volume, histological subtype, chemotherapy induced necrosis, surgical margins, and delay in surgery. The time to local recurrence after surgery was also noted in the local recurrence group.

Results: At a mean follow-up of 2.8 years, biopsy done from outside the treating center and delay in surgery after completion of neo-adjuvant chemotherapy emerged as significant risk factors for local recurrence. Most of the local recurrences (80%) occurred within 12 months of the primary surgery.

Conclusions: Lack of financial resources and availability of few tertiary care centers dealing with musculoskeletal oncology in the developing countries, lead to overburden with a long waiting list for tumor surgery making the scenario different from the Western world.
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http://dx.doi.org/10.1002/jso.24602DOI Listing
April 2017

Quinoline based furanones and their nitrogen analogues: Docking, synthesis and biological evaluation.

Saudi Pharm J 2016 Nov 11;24(6):705-717. Epub 2015 Jun 11.

Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Hamdard University, New Delhi, India.

A small library of twenty-four quinoline based butenolides also known as furanones and their nitrogen analogues was prepared by using two different aroylpropionic acids, viz. 3-(2-naphthoyl)propionic acid () and 3-(biphenyl-4-yl)propionic acid (), as starting materials. The 3-aroylpropionic acids were reacted with different 6-substituted-2-chloroquinolin-3-carbaldehydes () to obtain the corresponding furan-2(3)-ones (). The purified and characterized furanones were then converted into their corresponding 2(3)-pyrrolones () and -benzyl-pyrrol-2(3)-ones (). The antimicrobial activities of the title compounds were evaluated against two strains of each Gram +ve ( and ), Gram -ve bacteria ( and ) and against fungal strains of and . anti-inflammatory potential of the title compounds was investigated by standard method. Majority of the compounds showed significant antibacterial activity against both the Gram +ve strains. Eight most potent anti-inflammatory compounds ( which exhibited >53% inhibition in edema, were also screened for their analgesic activity. All the tested compounds were found to have significant reduction in ulcerogenic action but only three compounds ( and ) showed comparable analgesic activity to standard drug, diclofenac. The results were also validated using approach and maximum mol doc score was obtained for compounds . On comparing the and results of synthesized compounds, -benzyl pyrrolones () emerged as the potent anti-inflammatory agents. It was also observed that compounds that possess electron withdrawing group such as -Cl or NO are more biologically active.
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http://dx.doi.org/10.1016/j.jsps.2015.05.002DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5094435PMC
November 2016

An unusual case of Pigmented Villo-Nodular Synovitis of the second toe: A case report and review of literature.

Foot (Edinb) 2016 Aug 3;28:61-63. Epub 2016 Aug 3.

Department of Orthopaedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India. Electronic address:

Pigmented villo-nodular synovitis (PVNS) is a common disease entity particularly in the knee joint but its incidence in the foot is quite rare. A case of PVNS of the second toe that presented at the outpatient department with an insidious onset and slowly progressive painful swelling of the toe associated with stiffness is presented. The mass was subsequently excised and the diagnosis confirmed by histo-pathology samples. The patient's symptoms improved significantly after the operation. This case is one of the very few reported cases of PVNS involvement of flexor tendon sheath of the foot. It also signifies the importance of clinical suspicions based on the symptoms and examination in reaching to the presumptive diagnosis of the foot pathology and its confirmation by histo-pathological evaluation.
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http://dx.doi.org/10.1016/j.foot.2016.08.001DOI Listing
August 2016

Unusual presentation of Erdheim-Chester disease in a child with acute lymphoblastic leukemia.

World J Radiol 2016 Aug;8(8):757-63

Archana George Vallonthaiel, Asit Ranjan Mridha, Mehar Chand Sharma, Department of Pathology, All India Institute of Medical Sciences, New Delhi 110029, India.

Erdheim-Chester disease (ECD) is an uncommon, non-familial, non-Langerhans cell histiocytosis, which involves skeletal system and soft tissue usually in middle aged and elderly patients. The characteristic radiologic features include bilateral, symmetric cortical osteosclerosis of the diaphyseal and metaphyseal parts of the long bones, or bilateral symmetrically abnormal intense (99m)Technetium labelling of the metaphyseal-diaphyseal region of the long bones, and computed tomography scan findings of "coated aorta" or "hairy kidneys". ECD in childhood with osteolytic lesion is extremely rare. We describe an unusual case with an expansile lytic bone lesion at presentation in a case of acute lymphoblastic leukemia.
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http://dx.doi.org/10.4329/wjr.v8.i8.757DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5002507PMC
August 2016

Editorial: Pediatric Orthopedics at the Doorstep of the Pediatrician.

Indian J Pediatr 2016 Aug 9;83(8):814-6. Epub 2016 Jul 9.

Department of Orthopedics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, 110029, India.

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http://dx.doi.org/10.1007/s12098-016-2194-zDOI Listing
August 2016

Histopathological, immunohistochemical, and image analytic parameters characterizing the stromal component in primary and recurrent giant cell tumor of bone.

J Clin Orthop Trauma 2016 Apr-Jun;7(2):109-14. Epub 2015 Oct 26.

Department of Pathology, All India Institute of Medical Sciences, New Delhi, India.

Giant cell tumor (GCT) of bone is a benign locally aggressive tumor whose biological behavior is unpredictable. Currently, there are no definitive clinical, histological, biochemical, or immunological parameters that can predict its behavior. This study was undertaken to examine whether delineation of reactive and neoplastic stromal component of GCT can help in this regard. 55 cases of GCT (30 primary, 25 recurrent) were subjected to histopathological grading, immunohistochemistry, and image analysis. Spindling of stroma was more frequent in recurrent GCT with 64% cases having more than 50% spindled stroma (p < 0.001). Number of mitosis/10 HPF and higher grade were more in recurrent GCT. Mean percentage positivity for CD68 (38.36%) and α1-ACT (70.86%) was higher in primary than recurrent GCT. PCNA and MiB-1 labeling indices were higher in recurrent (42.62% and 9.18%, respectively) than in primary group (24.75% and 7.7%, respectively). A single numerical parameter encompassing stromal cell population and its proliferation was derived as ratio of PCNA/CD68 and PCNA/α1-ACT. Both ratios were higher in recurrent (0.81 ± 0.38; 1.58 ± 1.50) than in primary GCT (0.58 ± 0.62; 0.34 ± 0.29) (p = 0.002; 0.01). On image analysis, parameters significantly different between the two groups were nuclear area and nuclear integrated optical density. It was thus concluded that recurrent GCT shows higher grade, increased mitosis, more spindling, fewer reactive components, and higher proliferation than primary GCT. Delineation of reactive component (α1-ACT positive) and proliferating component (PCNA positive cells) using immunohistochemistry with calculation of the PCNA/ACT ratio delivers more information than image analysis.
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http://dx.doi.org/10.1016/j.jcot.2015.09.006DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4857144PMC
May 2016

Preoperative embolization of primary bone tumors: A case control study.

World J Radiol 2016 Apr;8(4):378-89

Roushan Jha, Raju Sharma, Shivanand Gamanagatti, Department of Radiodiagnosis, All India Institute of Medical sciences, New Delhi 110029, India.

Aim: To study the safety and effectiveness of preoperative embolization of primary bone tumors in relation to intraoperative blood loss, intraoperative blood transfusion volume and surgical time.

Methods: Thirty-three patients underwent preoperative embolization of primary tumors of extremities, hip or vertebrae before resection and stabilization. The primary osseous tumors included giant cell tumors, aneurysmal bone cyst, osteoblastoma, chondroblastoma and chondrosarcoma. Twenty-six patients were included for the statistical analysis (embolization group) as they were operated within 0-48 h within preoperative embolization. A control group (non-embolization group, n = 28) with bone tumor having similar histological diagnosis and operated without embolization was retrieved from hospital record for statistical comparison.

Results: The mean intraoperative blood loss was 1300 mL (250-2900 mL), the mean intraoperative blood transfusion was 700 mL (0-1400 mL) and the mean surgical time was 221 ± 76.7 min for embolization group (group I, n = 26). Non-embolization group (group II, n = 28), the mean intraoperative blood loss was 1800 mL (800-6000 mL), the mean intraoperative blood transfusion was 1400 mL (700-8400 mL) and the mean surgical time was 250 ± 69.7 min. On comparison, statistically significant (P < 0.001) difference was found between embolisation group and non-embolisation group for the amount of blood loss and requirement of blood transfusion. There was no statistical difference between the two groups for the surgical time. No patients developed any angiography or embolization related complications.

Conclusion: Preoperative embolization of bone tumors is a safe and effective adjunct to the surgical management of primary bone tumors that leads to reduction in intraoperative blood loss and blood transfusion volume.
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http://dx.doi.org/10.4329/wjr.v8.i4.378DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4840195PMC
April 2016

Synthesis, molecular properties, toxicity and biological evaluation of some new substituted imidazolidine derivatives in search of potent anti-inflammatory agents.

Saudi Pharm J 2016 Jan 9;24(1):104-14. Epub 2015 Mar 9.

Department of Biochemistry, Faculty of Science, King Abdulaziz University, Jeddah 21589, Saudi Arabia.

The aim of this study was to design and synthesize pharmaceutical agents containing imidazolidine heterocyclic ring in the hope of developing potent, safe and orally active anti-inflammatory agents. A number of substituted-imidazolidine derivatives (3a-k) were synthesized starting from ethylene diamine and aromatic aldehydes. The imidazolidine derivatives (3a-k) were investigated for their anticipated anti-inflammatory, and analgesic activity in Wistar albino rats and Swiss albino mice, respectively. Bioactivity score, molecular and pharmacokinetic properties of the imidazolidine derivatives were calculated by online computer software programs viz. Molinspiration and Osiris property explorer. The results of biological testing indicated that among the synthesized compounds only three imidazolidine derivatives namely 4-[1,3-Bis(2,6-dichlorobenzyl)-2-imidazolidinyl]phenyl-diethylamine (3g), 4-[1,3-Bis(3-hydroxy-4-methoxybenzyl)-2-imidazolidinyl]phenyl-diethylamine (3i) and 4-(1,3-Bis(4-methoxybenzyl)-4-methylimidazolidin-2-yl)-phenyl-diethylamine (3j) possess promising anti-inflammatory and analgesic actions. Additionally these derivatives displayed superior GI safety profile (low severity index) with respect to the positive control, Indomethacin. All synthesized compounds showed promising bioactivity score for drug targets by Molinspiration software. Almost all the compounds were predicted to have very low toxicity risk by Osiris online software. Compound number (3i) emerged as a potential candidate for further research as it obeyed Lipinski's rule of five for drug likeness, exhibited promising biological activity in-vivo and showed no risk of toxicity in computer aided screening.
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http://dx.doi.org/10.1016/j.jsps.2015.02.008DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4720031PMC
January 2016

Publication trend in the Indian Journal of Orthopaedics: What is published and why?

Indian J Orthop 2015 Nov-Dec;49(6):661-4

Department of Orthopaedics, All India Institute of Medical Sciences, New Delhi, India.

Background: Factors influencing publication of manuscripts in reputed journals have never been studied to the best of our knowledge. This study was conducted to evaluate the trend in publication within the Indian Journal of Orthopaedics (IJO).

Materials And Methods: A cross-sectional study was conducted by accessing the online database of the IJO. All the issues available online were included. Published articles were classified into one of the following thirteen categories: (i) Basic Sciences (ii) trauma (upper limb and lower limb) (iii) infections (iv) pediatric orthopedics (v) arthroplasty (vi) arthroscopy (vii) spine surgery (viii) musculoskeletal oncology (ix) hand and microvascular surgery (x) adult reconstruction (including the Ilizarov technique) (xi) general orthopedics and miscellaneous (xii) letter to editor (xiii) book review. A scatter diagram was plotted to study the individual trends.

Results: A total of 2213 articles from 110 issues published between 1967 and 2014 were studied. Total number of articles per issue have increased over the years. Publications in the fields of trauma, adult reconstruction, arthroscopy and hand and microvascular surgery have increased steadily. Arthroplasty and spine surgery have recorded dramatic increase in publication. On the other hand, publications in the rest of the fields have declined of which the greatest fall is noted in the field of musculoskeletal oncology.

Conclusions: Trend in publication with the IJO has changed over years with more articles being published in arthroplasty and Spine surgery. Despite advances, publication in the field of musculoskeletal oncology has fallen.
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http://dx.doi.org/10.4103/0019-5413.168766DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4705734PMC
January 2016