Publications by authors named "Rajiv Shah"

A 27-year-old woman presented with bilateral blurry vision for 2 weeks. She had a presumed diagnosis of idiopathic intracranial hypertension given her bilateral disc edema; however, bilateral disc and retinal infiltration was noted on ophthalmoscopy. This report presents a rare case of chronic myelogenous leukemia (CML) in the non-blast phase presenting as bilateral optic disc infiltration, indicating central nervous system involvement at the time of diagnosis.

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Immunotherapy has significantly improved overall survival in patients with pleural mesothelioma, yet this benefit does not extend to those with the epithelioid subtype. Tumor growth is believed to be influenced by the immune response. This study aimed to analyze the tumor microenvironment to gain a better understanding of its influence on tumor growth.

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Background And Aim: Continuous glucose monitoring systems (CGMs) have been commercially available since 1999. However, automated insulin delivery systems may benefit from real-time inputs in addition to glucose. Continuous multi-analyte sensing platforms will meet this area of potential growth without increasing the burden of additional devices.

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Article Synopsis
  • - Noninfectious uveitis is a major cause of vision loss and there is a need for better treatment options, prompting the investigation of filgotinib, a JAK1 inhibitor, for this condition.
  • - The HUMBOLDT trial was a phase 2 study involving 74 participants, aged 18 and older, with active noninfectious uveitis, comparing filgotinib to a placebo over 52 weeks.
  • - Results showed that 37.5% of those on filgotinib experienced treatment failure by week 24, significantly lower than the 67.6% for placebo, indicating that filgotinib may be an effective option for treating this illness.
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Background: 10 million people are chronically infected with the hepatitis C virus (HCV) in sub-Saharan Africa. The assessment of viral genotypes and treatment response in this region is necessary to achieve the WHO target of worldwide elimination of viral hepatitis by 2030. We aimed to investigate the prevalence of HCV genotypes and outcomes of treatment with direct-acting antiviral agents in Benin, a country with a national HCV seroprevalence of 4%.

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Background: Predictive biomarkers in use for immunotherapy in advanced non-small cell lung cancer are of limited sensitivity and specificity. We analysed the potential of activating KRAS and pathogenic TP53 mutations to provide additional predictive information.

Methods: The study cohort included 713 consecutive immunotherapy patients with advanced lung adenocarcinomas, negative for actionable genetic alterations.

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Purpose: To examine postoperative outcomes of internal limiting membrane peeling (ILMP) versus flap (ILMF) in the closure of full-thickness macular holes.

Methods: Retrospective chart review of patients who underwent pars plana vitrectomy and gas tamponade with ILMP or ILMF to close full-thickness macular hole at the Atrium Health Wake Forest Baptist from January 2012 to October 2022 with at least 3 months follow-up. Main outcome measures were type 1 primary full-thickness macular hole closure and postoperative best-corrected visual acuity in mean logMAR.

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Adult intussusception is much rarer than pediatric intussusception and usually occurs secondary to a pathological lead point, most frequently neoplasm. Terminal ileum lipomas are an infrequent cause of adult ileocolic intussusception but can be seen together with the intussusception on initial imaging evaluation, which can guide appropriate diagnosis and management. We describe a case of a 42-year-old man presenting with 12 hours of severe right lower quadrant pain.

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Background: Currently, two classification systems, namely Stephens and Sanders, based on axial CT images, and Zwipp and Rammelt, which consider deformities, are used for calcaneus malunions. Existing classifications have limitations due to their pure anatomical basis, and the complexity of the problem, involving both bone and soft tissues. As a solution, the senior author proposed a novel ADIENS classification system for calcaneal malunion, based on pain generators.

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Purpose: To describe a case of retinal and optic nerve metastases masquerading as acute retinal necrosis secondary to primary squamous cell carcinoma of the lung.

Observations: A 66-year-old male with a history of Stage IV lung cancer, actively on chemotherapy, presented with right eye vision loss, an afferent pupillary defect, and partial visual field deficiencies. Exam revealed vitritis, macula-involving infiltrative retinitis, optic neuritis, and vasculitis of the right eye.

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Objective: First-line pembrolizumab alone, as approved for PD-L1 ≥50%, or with chemotherapy was analyzed in older non-small-cell lung cancer (NSCLC) patients, for whom evidence is scarce.

Materials And Methods: A total of 156 consecutive ≥70 year-old patients treated between January 2016 and May 2021 were retrospectively analyzed. Tumor progression was verified through radiologic review, while toxicity was captured from records.

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Article Synopsis
  • The objective of the study was to evaluate how well the consent documentation for assisted vaginal births (AVBs) at two Canadian hospitals aligns with national practice guidelines.
  • The study involved reviewing records of 551 assisted births to analyze the types of documentation used and the presence of risk information reported by healthcare providers.
  • The findings revealed significant gaps in documentation, particularly concerning the risks associated with both maternal and neonatal health during AVB, highlighting a need for improvement in consent processes.
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Introduction: Dislocations of lesser metatarsophalangeal joints (MTPJs) following trauma, inflammatory arthritis, and synovitis are not uncommon. Closed reduction is sufficient in most instances. However, if it is not addressed scientifically in the first instance; rarely, a habitual dislocation may result.

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Leveraging real-world data (RWD) for drug access is necessary to overcome a key challenge of modern precision oncology: tackling numerous low-prevalence oncogenic mutations across cancers. Withholding a potentially active medication in patients with rare mutations for the sake of control chemotherapy or "best" supportive care is neither practicable nor ethically justifiable anymore, particularly as RWD could meanwhile be used instead, according to scientific principles outlined by the US Food and Drug Administration, European Medicines Agency and other stakeholders. However, practical implementation varies, with occasionally opposite recommendations based on the same evidence in different countries.

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Background: The exact role and type of surgery for malignant pleural mesothelioma (MPM) remains controversial. This study aimed at analyzing a 20-year single center perioperative experience in MPM surgery at our high-volume thoracic surgery center and comparing the overall survival after trimodal extrapleural pneumonectomy (EPP) and extended pleurectomy and decortication combined with hyperthermic intrathoracic chemoperfusion (EPD/HITOC) and adjuvant chemotherapy with that after chemotherapy (CTx) alone.

Methods: Patients with epithelioid MPM treated with neoadjuvant chemotherapy, EPP and adjuvant radiotherapy within a trimodal concept or EPD/HITOC in combination with adjuvant chemotherapy between 2001 and 2018 were included in this retrospective analysis.

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Unlabelled: Direct-acting antivirals (DAAs) have revolutionised the treatment of Hepatitis C virus (HCV), allowing the World Health Organisation (WHO) to set a target of eliminating HCV by 2030. In this study we aimed to investigate glecaprevir and pibrentasvir (GP) treatment outcomes in a cohort of patients with genotype 2a infection.

Methods: Clinical data and plasma samples were collected in NHS Greater Glasgow & Clyde.

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Background: EGFR exon20 insertions (ex20ins) are targeted by novel compounds in non-small-cell lung cancer (NSCLC). However, data about outcome under conventional therapies and the influence of molecular features are scarce.

Patients And Methods: We retrospectively analysed 118 patients with evaluation of radiologic response based on RECIST v1.

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Artificial intelligence and machine learning (AI/ML) is becoming increasingly more accessible to biomedical researchers with significant potential to transform biomedicine through optimization of highly-accurate predictive models and enabling better understanding of disease biology. Automated machine learning (AutoML) in particular is positioned to democratize artificial intelligence (AI) by reducing the amount of human input and ML expertise needed. However, successful translation of AI/ML in biomedicine requires moving beyond optimizing only for prediction accuracy and towards establishing reproducible clinical and biological inferences.

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Pleural mesothelioma is an aggressive malignancy arising from pleural mesothelial cell lining, predominantly associated with prior exposure to asbestos. The ban on asbestos use has led to its lower incidence in many countries, but globally the disease burden is expected to rise. Therefore, well-planned research is needed to develop more effective, tolerable and affordable drugs.

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Article Synopsis
  • Hepatitis C virus (HCV) is a major cause of liver disease, and this study is the first to provide prevalence data from Southern Africa, specifically Blantyre, Malawi.
  • A random sample of 1,661 individuals revealed an HCV RNA prevalence of 0.2% in the general population, while higher rates were found among patients with cirrhosis (1.9%) and hepatocellular carcinoma (5.0%).
  • The study identified specific endemic HCV genotypes, predominantly genotype 4, and noted that infections predominantly occur in older individuals from peri-urban areas, indicating a historical transmission pattern.
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We describe a case of hemorrhagic fever with renal syndrome caused by Seoul virus in a woman in Scotland, UK. Whole-genome sequencing showed the virus belonged to a lineage characterized by recent international expansion, probably driven by trade in pet rats.

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