Publications by authors named "Harman Chopra"

Background: Crohn's disease (CD) is a chronic relapsing-remitting, immunological, inflammatory bowel disease involving any part of the gastrointestinal tract, most commonly, the terminal ileum. Abdominal pain is a prominent debilitating symptom of CD due to continuous intestinal inflammation, associated with disease severity and complications. However, abdominal pain has shown to occur even with disease remission.

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Psilocybin shows promise as a treatment for CRPS, offering significant pain relief and functional improvement in a patient with refractory symptoms. This case highlights the need for further research into psilocybin's efficacy and optimal dosing for chronic pain management.

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Objectives: Spinal cord stimulation (SCS) has been challenged by the lack of neurophysiologic data to guide therapy optimization. Current SCS programming by trial-and-error results in suboptimal and variable therapeutic effects. A novel system with a physiologic closed-loop feedback mechanism using evoked-compound action potentials enables the optimization of physiologic neural dose by consistently and accurately activating spinal cord fibers.

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Article Synopsis
  • Crohn's disease is a chronic inflammatory bowel condition that leads to significant abdominal pain and complications like abscesses and strictures; approximately 60% of patients experience this pain, regardless of the severity of their disease.
  • A 20-year-old female college student with Crohn's disease and juvenile idiopathic arthritis struggled with persistent pain despite various pain management medications, negatively impacting her quality of life.
  • After considering dorsal root ganglion (DRG) stimulation, the patient experienced a notable 25% decrease in pain and improved daily functioning, leading to satisfaction with the treatment and a decision for permanent implantation.
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  • Cancer pain significantly affects the quality of life, with up to 70% prevalence in advanced stages, and is managed using the WHO pain ladder that incorporates NSAIDs, opioids, and adjuvant medications.
  • A case study of a patient with metastatic colon cancer experiencing severe pain and immobility due to epidural metastasis illustrates the limitations of traditional pain management strategies.
  • The patient benefited from spinal cord stimulation, achieving over 80% pain relief and functional recovery, highlighting the need for alternative pain management solutions as the medical community shifts away from opioid reliance.
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  • Prostate cancer is a major health issue for males, being the second most diagnosed cancer globally, while radiation therapy, a common treatment, has several adverse effects, leading to interest in proton beam therapy for its precision and reduced toxicity.
  • A case study of a 68-year-old man who developed delayed-onset lumbosacral polyradiculitis five months after undergoing proton beam therapy illustrates potential complications, with MRI and EMG confirming nerve root issues likely due to radiation.
  • The conclusion stresses the rarity of radiation-induced lumbosacral plexopathy and underscores the importance of ongoing patient follow-up and thorough review of cancer histories post-treatment.
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Background/importance: Chronic pain affects many people globally, requiring alternative management strategies. Psilocybin is gaining attention for its potential in chronic pain management despite being classified as Schedule I.

Objective: This systematic review critically evaluates the evidence for psilocybin, a Schedule I substance, in the treatment of chronic pain.

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Background: Intractable hiccups, defined as those persisting for over 1 month, represent a rare but significant clinical challenge often associated with substantial morbidity and refractory to standard treatments.

Case Presentation: This case report describes the innovative use of phrenic nerve peripheral neuromodulation for managing chronic intractable hiccups in a 73-year-old male patient with a 6-year history of daily hiccups. Conventional treatments and interventional procedures had failed to provide lasting relief.

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Key Clinical Message: Long-COVID syndrome lacks effective holistic treatment options. We present a case of a 41-year-old fully vaccinated female with Long-COVID syndrome who obtained significant symptomatic relief after self-medicating with psilocybin and MDMA.

Abstract: Long-COVID, a syndrome persisting after the acute phase of coronavirus disease 2019 (COVID-19), lacks effective holistic treatment options.

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Spasticity is a potentially debilitating symptom of various acquired and congenital neurologic pathologies that, without adequate treatment, may lead to long-term disability, compromise functional independence, and negatively impact mental health. Several conservative as well as non-nerve targeted surgical strategies have been developed for the treatment of spasticity, but these may be associated with significant drawbacks, such as adverse side effects to medication, device dependence on intrathecal baclofen pumps, and inadequate relief with tendon-based procedures. In these circumstances, patients may benefit from nerve-targeted surgical interventions such as (i) selective dorsal rhizotomy, (ii) hyperselective neurectomy, and (iii) nerve transfer.

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Background: Iatrogenic cervical deformity is a devastating complication that can result from a well-intended operation but a poor understanding of the individual biomechanics of a patient's spine. Patient factors, such as bone fragility, high T1 slope, and undiagnosed myopathies often play a role in perpetuating a deformity despite an otherwise successful surgery. This imbalance can lead to significant morbidity and a decreased quality of life.

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Zinc deficiency has been linked to human diseases, including cancer. MDMX, a crucial zinc-containing negative regulator of p53, has been found to be amplified or overexpressed in various cancers and implicated in the cancer initiation and progression. We report here that zinc depletion by the ion chelator TPEN or Chelex resin results in MDMX protein degradation in a ubiquitination-independent and 20S proteasome-dependent manner.

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Background: Vertebral hemangiomas (VHs) are common benign tumors that only rarely become symptomatic. There is a paucity of data regarding their surgical management and outcomes. Here, we reported a case involving an aggressive cervical VH, discussed its surgical management and outcomes, and reviewed the literature.

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Castration-resistant prostate cancer (CRPC) frequently develops after initial standard radiation and androgen deprivation therapy, leaving patients with limited further treatment options. Androgen receptor (AR) is a transcription factor that plays a key role in the initiation and progression of prostate cancer. p53, a major tumor suppressor that is rarely mutated in early-stages of prostate cancer, is often deregulated during prostate cancer progression.

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