Publications by authors named "Gandhi C"

Since its outbreak, the novel coronavirus (COVID-19) has significantly impacted the pediatric population. Pulmonary surfactant dysfunction has been linked to other respiratory diseases in children and COVID-19 in adults, but its role in COVID-19 severity remains unclear. We hypothesized that elevated surfactant protein (SP) levels and single nucleotide polymorphisms (SNPs) of SP genes are associated with severe COVID-19 in children.

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Background/objectives: Recent studies reveal an "obesity paradox", suggesting better clinical outcomes after intracranial hemorrhage for obese patients compared to patients with a healthy BMI. While this paradox indicates improved survival rates for obese individuals in stroke cases, it is unknown whether this trend remains true across all forms of intracranial hemorrhage. Therefore, the objective of our study was to investigate the incidence, characteristics, and outcomes of hospitalized obese patients with intracranial hemorrhage.

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Background: Data about the safety and the efficacy of flow diversion for distal anterior cerebral artery (DACA) aneurysms are limited. We present the largest multicenter analysis evaluating the outcomes of flow diversion in unruptured DACA aneurysm treatment.

Methods: Databases from 39 centers were retrospectively reviewed for unruptured DACA aneurysms treated with flow-diverting stents.

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  • This study analyzed decisions regarding decompressive hemicraniectomy (DHC) and early withdrawal of life-sustaining therapy (WLST) in patients with large vessel occlusion (LVO) and large ischemic strokes from the SELECT2 trial.* -
  • Among 352 patients, DHC was utilized in 55 patients, and WLST was chosen for 81, showing no significant differences in usage between those receiving endovascular thrombectomy (EVT) and those treated medically.* -
  • About 21% of DHC patients were able to walk independently after one year, indicating that DHC did not negatively impact the benefits of thrombectomy, while WLST generally resulted in poor outcomes.*
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  • Endovascular thrombectomy (EVT) has proven safe and effective for patients suffering from large core strokes, but the effects of reperfusion quality and procedure details on outcomes are still unclear.
  • In the SELECT2 trial, findings indicated that 80% of patients experienced successful reperfusion, which correlates with better clinical outcomes, particularly in those who achieved near-complete reperfusion.
  • Longer procedure times negatively impacted patient outcomes, while the method of thrombectomy (aspiration vs stent-retriever) showed no significant differences in reperfusion success or functional recovery.
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Glioblastoma (GBM) is categorized by the World Health Organization (WHO) as a grade 4 glioma and is a uniformly fatal tumor of the central nervous system. With the discovery of specific gene anomalies, GBM classification has been modified several times to provide better diagnostic and prognostic accuracy. Survival outcomes remain dismal despite the current therapeutic modalities, which include a combination of surgical resection, adjuvant chemotherapy, and radiotherapies, providing brief control of tumor progression.

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The conducting polymer polyaniline (PANI) has shown significant interest for the development of electrified membranes (EMs) with superior antifouling characteristics. However, the blending and doping of PANI with other polymers and nanomaterials highly influence the properties of the membrane surface. PANI exists in two forms: oxidized, known as emeraldine salt (ES), and unoxidized, referred to as emeraldine base (EB).

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  • Migraine prevalence during reproductive years can be as high as 25%, yet the connection between migraines and stroke is not well understood, particularly in pregnant women.
  • This study analyzed data from over 19 million pregnant patients, finding that those with migraines were more likely to experience ischemic and hemorrhagic strokes compared to those without migraines.
  • Pregnant women with migraines, especially those experiencing aura, have a significantly higher risk of stroke and should consult their healthcare providers to monitor for potential neurological issues.
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Background: Glioblastoma multiforme (GBM), a high-grade primary brain tumor, presents a formidable challenge in neuro-oncology because of its aggressive nature, infiltrative growth, and limited response to treatment. The septum pellucidum represents an uncommon and unexpected location for GBM, adding complexity to the diagnosis and management of this rare intracranial malignancy.

Observations: A 69-year-old male with a previous history of prostate carcinoma presented to an outside hospital with a 2-week history of a "trance-like state" and cognitive decline.

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The proportion of women surgeons is increasing, but studies show that women in surgical residency are granted less autonomy than men. We utilized the Surgical Autonomy Program (SAP), an educational framework, to evaluate gender differences in self-reported autonomy, attending-reported autonomy, and operative feedback among US neurosurgical residents. The SAP tracks resident progression and guides teaching in neurosurgery.

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Background And Purpose: Cerebral venous thrombosis (CVT) is associated with a high degree of morbidity and mortality. Our objective is to elucidate characteristics, treatments, and outcomes of patients with cancer and CVT (CA-CVT).

Methods: The 2016-2019 National Inpatient Sample (NIS) database was queried for patients with a primary diagnosis of CVT.

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Background And Objectives: Although ventriculoperitoneal (VP) shunts are a common treatment for hydrocephalus, there are complication risks including infections. Late complications such as ventriculitis from ascending abdominal infections can have severe consequences. However, the incidence of central nervous system (CNS) infections in VP shunt patients with abdominal infections is not well understood.

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The severity of respiratory syncytial virus (RSV) may be linked to host genetic susceptibility. Surfactant protein (SP) genetic variants have been associated with RSV severity, but the impact of single-nucleotide polymorphism (SNP)-SNP interactions remains unexplored. Therefore, we used a novel statistical model to investigate the association of SNP-SNP interactions of genes with RSV severity in two- and three-interaction models.

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  • The Tigertriever is an innovative stentriever designed to improve mechanical thrombectomy by allowing better user control for tackling different clot types and vessel sizes.
  • This paper combines insights from experienced professionals to evaluate the Tigertriever's capabilities and shares updated techniques for its use in clinical settings.
  • It highlights the "FLEX" approach, which promotes efficient clot integration while minimizing disruption, especially important for working in challenging distal locations.
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As the incidence of subdural hematoma is increasing, it is important to understand symptomatology and clinical variables associated with treatment outcomes and mortality in this population; patients with subdural hematoma were selected from the National Inpatient Sample (NIS) Database between 2016 and 2020 using International Classification of Disease 10th Edition (ICD10) codes. Moderate-to-severe subdural hematoma patients were identified using the Glasgow Coma Scale (GCS). Multivariate regression was first used to identify predictors of in-hospital mortality and then beta coefficients were used to create a weighted mortality score.

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  • Dural venous sinus stenting is a growing procedure in otolaryngology that works in tandem with neurosurgeons and neuroradiologists, having been introduced around 20 years ago.
  • * It is now a standard treatment for patients experiencing increased intracranial pressure due to transverse sinus stenosis, with ENT doctors often being the first to diagnose these issues.
  • * Traditional treatments like high-dose diuretics were largely ineffective, and other methods have posed serious risks, making endovascular sinus stenting a promising option for patients with specific clinical and imaging characteristics.
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Endovascular thrombectomy (EVT) safety and efficacy in patients with large core infarcts receiving oral anticoagulants (OAC) are unknown. In the SELECT2 trial (NCT03876457), 29 of 180 (16%; vitamin K antagonists 15, direct OACs 14) EVT, and 18 of 172 (10%; vitamin K antagonists 3, direct OACs 15) medical management (MM) patients reported OAC use at baseline. EVT was not associated with better clinical outcomes in the OAC group (EVT 6 [4-6] vs MM 5 [4-6], adjusted generalized odds ratio 0.

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Aggressive pituitary neuroendocrine tumors (PitNETs) present significant morbidity, and multimodal therapies including surgery, radiotherapy, and medications are frequently required. Chemotherapy, particularly temozolomide, is often pursued for tumors that progress despite these treatments. Although peptide receptor radionuclide therapy (PRRT) using radiolabeled somatostatin analogs is approved for the treatment of well-differentiated gastrointestinal neuroendocrine tumors, its use in aggressive PitNETs is limited.

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  • The study investigates the link between acute kidney injury (AKI) and outcomes in patients with spontaneous subarachnoid hemorrhage (SAH), a serious condition with a high risk of complications.
  • An analysis of over 76,000 SAH patients from 2010 to 2019 shows that about 14% developed AKI, with these patients being older and more likely to be obese compared to those without AKI.
  • Findings indicate that AKI is significantly associated with poorer functional outcomes, longer hospital stays, and higher in-hospital mortality, highlighting the need for early detection to improve recovery chances.
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Background: Atlantoaxial subluxation (AAS) is a diagnosis describing misalignment of the C1 vertebra relative to C2. Excessive translation of this joint, located adjacent to the medullary brain stem, can lead to devastating neurological consequences. A higher prevalence of AAS within the Down syndrome (DS) population has been well-established.

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Background: Endoscopic ultrasound-guided gallbladder drainage (EUS-GBD) offers a safe and minimally invasive alternative for percutaneous cholecystostomy (PCC) in acute cholecystitis patients with high-surgical risk. Additionally, EUS-GBD serves as a rescue biliary drainage in malignant distal biliary obstruction. Despite its widespread application, data within the Indian context remains sparse.

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  • The study analyzed trends and risk factors related to antenatal pyelonephritis hospitalizations in the US from 2010 to 2020.
  • A total of 49,140 out of 10.2 million delivery hospitalizations involved antenatal pyelonephritis, showing a 29% decrease in associated admissions over the decade.
  • Despite this decline, there has been an increase in the risk of sepsis and severe maternal morbidity during these hospitalizations, indicating potential concerns for maternal health.
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