Publications by authors named "Goyal N"

Objective: The role of estrogen in developing thyroid malignancy is poorly understood. Epidemiological studies have shown exogenous estrogen is associated with increased risk in females. Still, no studies to date have investigated this association among biological males undergoing estrogen hormone therapy.

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Background: Sex inequality in randomized controlled trials (RCTs) related to cardiovascular disease has been observed. This study examined the proportion of women enrolled in atrial fibrillation (AF) ablation RCTs and the potential risks of underrepresentation of women.

Methods And Results: We systematically searched PubMed and Embase for AF ablation RCTs published from 2015 to 2022.

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Orthopedic surgery and traumatology necessitate cost-effective approaches that can be replicated across multiple venues. Finite Element (FE) simulation models have evolved as a solution, allowing for consistent investigations into biomechanical systems. Finite Element Analysis (FEA), which began in the 1950s aviation industry, has since expanded into orthopedics.

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Background: Studies have described a first pass effect (FPE) where patients with successful recanalization after one pass experience better outcomes. Few studies have evaluated this in patients with large core infarctions.

Objective: To determine whether patients with large core infarcts undergoing mechanical thrombectomy in which first pass reperfusion is achieved experience improved outcomes compared with those who undergo more than one pass.

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Case: A 47-year-old man presented with neck pain, restricted neck movements, along with involvement of facial and hypoglossal nerve. On the basis of clinico-radiological correlation, the patient was diagnosed with craniovertebral junction tuberculosis and was started on antitubercular therapy (ATT). Failing the conservative trial, the patient was operated and occipitocervical fusion was done with bone grafting.

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Limited metastatic squamous cell carcinoma of the oropharynx (OPC) lacks clear management guidelines, especially for HPV-associated disease. The objective of this study was to investigate if primary site radiotherapy (RT) benefits overall survival in limited metastatic OPC. Utilizing the National Cancer Database (NCDB), patients aged 18-90 with OPC presenting as cM1 with limited metastatic disease to one distant site were identified.

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Background: Proteinuria is associated with worse allograft outcomes in kidney transplant recipients (KTRs) and treatment strategies are limited. We examined the outcomes of calcineurin inhibitor (CNI) to belatacept conversion in proteinuric KTRs.

Methods: In a pilot phase II single-arm multicenter prospective trial, we recruited adult KTRs >6 months post-kidney transplantation with an estimated glomerular filtration rate (eGFR) ≥30 ml/min/1.

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Background: There are limited therapeutic options in cases of failed reperfusion (modified thrombolysis in cerebral infarction [mTICI] score < 2b) after stent-retriever and/or aspiration based endovascular treatment (EVT) for acute ischemic stroke. Despite the absence of data supporting its use, rescue therapy (balloon angioplasty and/or stent implantation) is often utilized in such cases. Studies are limited to large vessel occlusions, while the outcomes and complications after rescue therapy in medium/distal vessel occlusions (MDVOs) have not been reported.

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Contrails, formed by aircraft engines, are a major component of aviation's impact on anthropogenic climate change. Contrail avoidance is a potential option to mitigate this warming effect, however, uncertainties surrounding operational constraints and accurate formation prediction make it unclear whether it is feasible. Here we address this gap with a feasibility test through a randomized controlled trial of contrail avoidance in commercial aviation at the per-flight level.

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In , RecA plays a central role in the rescue of stalled replication forks, double-strand break (DSB) repair, homologous recombination (HR), and induction of the SOS response. While the RecA-dependent pathway is dominant, alternative HR pathways that function independently of RecA do exist, but relatively little is known about the underlying mechanism. Several studies have documented that a variety of proteins act as either positive or negative regulators of RecA to ensure high-fidelity HR and genomic stability.

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Objective: To compare patient outcomes across body mass index (BMI) subgroups in the setting of recent tracheotomy.

Methods: This retrospective chart review included patients over 18 years old who underwent tracheotomy placement between February 2017 and March 2020. Patients were divided into five groups based on BMI: underweight, normal weight, overweight, obese, and morbidly obese.

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Introduction Anemia during pregnancy can lead to poor pregnancy outcomes, increasing maternal, fetal, and neonatal morbidity and mortality. Timely detection and management can lead to improved pregnancy outcomes. Objective To study various fetomaternal outcomes in severe anemia during pregnancy.

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Background & Aims: Steatotic liver disease affects approximately 1 in 10 children in the U.S. and increases the risk of cirrhosis, diabetes, and cardiovascular disease.

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Introduction: Middle meningeal artery embolization (MMAe) is increasingly utilized as a primary or secondary treatment for chronic subdural hematoma (cSDH) and is usually performed with liquid embolics or particles. Outcomes after MMAe with coiling as a standalone treatment, or an adjunct to other agents, have not been reviewed.

Methods: A systematic review of the literature was performed to identify all original research that included patients who underwent standalone or adjunctive coiling for MMAe.

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Background: Orbital decompression is recommended for TED especially in the treatment of severe, refractory cases yet there are no clear guidelines regarding the optimal surgical approach. Previously conducted surveys assessed variations in the management of TED but only amongst ophthalmologists. Our study attempts to better characterize surgical and perioperative preferences amongst otolaryngologists in the management of TED.

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JNJ-75220795 or ARO-PNPLA3 is an investigational small interfering ribonucleic acid agent conjugated with N-acetyl-d-galactosamine that targets the PNPLA3 gene, currently being developed for metabolic dysfunction-associated steatohepatitis (MASH). This study evaluated the pharmacokinetics (PK) profile of single subcutaneous doses of JNJ-75220795 in preclinical species as well as in human subjects with homozygous or heterozygous PNPLA3 I148M mutation in two phase 1 studies-a first-in-human study in the United States and a first-in-Japanese study in Japan. Preclinical PK in rats and non-human primates (NHP) showed a rapid systemic absorption and elimination following single subcutaneous doses.

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Article Synopsis
  • A study assessed the impact of healthcare provider counseling on maternal knowledge regarding the risks of marijuana use during and after pregnancy, highlighting the commonality of perinatal marijuana use.
  • Conducted across 15 U.S. hospitals, the research involved a survey of 484 postpartum mothers, revealing that nearly 60% had used marijuana at some point and about 9% used it during their current pregnancy.
  • Results showed that only one-third of mothers received counseling from healthcare providers, but those who did had significantly better knowledge about the potential risks of marijuana to their children, emphasizing the need for improved counseling practices.
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Article Synopsis
  • The study investigates the effects of adding dexmedetomidine as premedication to ketofol for sedation in children undergoing MRI, aiming to improve sedation quality and reduce movement artifacts during scans.
  • A total of 132 children aged 6 months to 10 years were divided into two groups: one receiving dexmedetomidine and ketofol (DK group) and the other receiving only ketofol (K group). Results showed that the DK group had significantly better sedation quality and scan quality, along with lower propofol dosage.
  • The conclusion indicates that administering dexmedetomidine prior to induction enhances sedation quality, reduces the need for additional propofol, and maintains
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Background: Symptomatic intracranial hemorrhage (sICH) after mechanical thrombectomy (MT) is associated with worse outcomes. We sought to develop and internally validate a machine learning (ML) model to predict sICH prior to MT in patients with anterior circulation large vessel occlusion.

Methods: Consecutive adults who underwent MT for internal carotid artery/M1/M2 occlusions at a single institution were reviewed.

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Background: Underlying intracranial stenosis is the most common cause of failed mechanical thrombectomy in acute ischemic stroke patients with large vessel occlusion. Adjunct emergent stenting is sometimes performed to improve or maintain reperfusion, despite limited data regarding its safety or efficacy.

Methods: We conducted a prospective multicenter observational international cohort study.

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Background: High-frequency deep transcranial magnetic stimulation (dTMS) on the anterior cingulate cortex (ACC) and medial prefrontal cortex (mPFC) has been known to be effective in modulating emotional experience but not studied in children and adolescents with externalizing behavior disorders (EBDs). We present a novel protocol for a study that aims to assess the safety and efficacy of adjuvant dTMS in managing emotional dysregulation in EBDs in children and adolescents.

Methods: The trial is prospectively registered in the Clinical Trial Registry of India (CTRI) at www.

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Article Synopsis
  • Dissociative disorders disrupt normal psychological function, particularly affecting how individuals process threat-related information, with attachment styles significantly influencing their mental health.
  • The study involved 50 adolescents (25 with dissociative disorders and 25 healthy controls) testing their dissociative experiences and attachment styles using various assessment tools.
  • Results highlighted that attachment styles, particularly discomfort with closeness, are linked to information-processing biases, suggesting avenues for better understanding and management of dissociative disorders in adolescents.
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Study Design: Prospective Comparative Study.

Objectives: This study aims to study the outcome of thoracolumbar burst fractures by comparison of 3 different posterior constructs groups of patients treated by the posterior approach.

Setting: University level Tertiary care Centre of Northern India.

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Background: The duration of mechanical thrombectomy (MT) is a negative predictor of outcomes in acute ischemic stroke (AIS), yet the precise mechanisms are unclear. We investigated whether the placement of large-bore catheters intracranially reduces blood flow to the ischemic penumbra and diminishes the efficacy of MT.

Methods: We investigated the impact of different catheter sizes on flow through the intracranial circulation using an in vitro model.

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