Publications by authors named "Rayamajhi S"

Extranodal natural killer/T-cell lymphoma (ENKTCL) is an aggressive EBV-associated non-Hodgkin lymphoma, most commonly arising from within the mucosa of the upper aerodigestive tract, typically with nasal presentation. Here, we present an interesting case of a 36-year-old man with ENKTCL with an atypical pattern of disease progression despite 3 cycles of SMILE chemotherapy. Restaging 18F-FDG PET/CT demonstrated widespread uptake within the skeletal musculature in a distribution concerning for a paraneoplastic polymyositis.

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Extranodal natural killer/T-cell lymphoma (ENKTCL) is an aggressive EBV-associated non-Hodgkin lymphoma, most commonly arising from within the mucosa of the upper aerodigestive tract, typically with nasal presentation. Here, we present an interesting case of a 36-year-old man with ENKTCL with an atypical pattern of disease progression despite 3 cycles of SMILE chemotherapy. Restaging 18F-FDG PET/CT demonstrated widespread uptake within the skeletal musculature in a distribution concerning for a paraneoplastic polymyositis.

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Article Synopsis
  • The study investigates how cancer cells influence the fitness of surrounding tumor microenvironment (TME) cells through a mechanism involving a long non-coding RNA called Tu-Stroma, which alters the expression of Flower isoforms, impacting their growth advantage.
  • The expression of Flower Win isoforms in cancer cells enhances their dominance over TME cells that express Flower Lose isoforms, leading to reduced fitness in the TME.
  • Targeting Flower proteins with a humanized monoclonal antibody in mice has shown promising results, significantly reducing cancer growth and metastasis while improving survival rates and protecting organs from potential lesions.
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Extracellular vesicles (EVs) are cell-secreted lipid bilayer delimited particles that mediate cellular communication. These tiny sacs of cellular information play an important role in cell communication and alter the physiological process under both normal and pathological conditions. As such, tracking EVs can provide valuable information regarding the basic understanding of cell communication, the onset of early malignancy, and biomarker discovery.

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Article Synopsis
  • Acute upper gastrointestinal bleeding (UGIB) often results from peptic ulcer disease or variceal bleeding, but rare causes like renal cell carcinoma (RCC) can also be involved.
  • A 55-year-old male experienced melena and right flank pain, leading to the discovery of active bleeding in the duodenum via esophagogastroduodenoscopy (EGD).
  • Imaging revealed a duodenorenal fistula caused by RCC, highlighting the need for thorough evaluations to uncover uncommon causes of UGIB.
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  • * After the pandemic, virtual care models continued to evolve, prompting a focus on understanding how telehealth can boost value, enhance access, and improve patient experiences while also addressing health inequalities.
  • * The article discusses telehealth within a value-based care framework, covering aspects like patient experience, quality of care, and provides recommendations to strengthen telehealth's role in delivering value-based care.
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  • * The study evaluated 236 wheat genotypes in Florida over two growing seasons, focusing on how resources are allocated within the plant, particularly between stems and grains.
  • * A genome-wide association study (GWAS) identified 114 significant marker-trait associations that could help breeders enhance HI, grain yield (GY), and grain number (GN) through marker-assisted selection.
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Dengue, caused by the dengue virus, presents with various clinical manifestations, including rare neurological complications. Guillain-Barre Syndrome (GBS), an immune-mediated polyradiculoneuropathy, is a rare complication, often triggered by antecedent infections. Herein, we report the case of a 30-year-old male presenting with GBS following dengue fever.

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Factor V Leiden (FVL) is the major genetic risk factor to predispose venous thromboembolism (VTE). We present a rare case of a 34-year-old Caucasian female heterozygous for this mutation and taking oral contraceptive pills (OCPs) for less than four months, who presented to the emergency department with acute onset of dyspnea and was diagnosed to have an isolated massive bilateral pulmonary embolism (PE). The patient was managed for six days in the hospital and was discharged on oral anticoagulants.

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Objective: This review aimed to assess the quality and nature of the literature related to digital simulation-based pharmacology education. Specifically, we sought to understand the influence of simulations on the knowledge, satisfaction, and confidence of pre-registration nurses and other healthcare students participating in such educational programs.

Design: Systematic review using the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) Statement.

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Homeobox 13 (HOXB13) is an oncogenic transcription factor that directly regulates expression of folate hydrolase 1, which encodes prostate-specific membrane antigen (PSMA). HOXB13 is expressed in primary and metastatic prostate cancers (PCs) and promotes androgen-independent PC growth. Since HOXB13 promotes resistance to androgen receptor (AR)-targeted therapies and regulates the expression of folate hydrolase 1, we investigated whether SUVs on PSMA PET would correlate with HOXB13 expression.

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Background This study addresses the participation gap in scholarly activities among internal medicine residents. While the Accreditation Council for Graduate Medical Education emphasizes the importance of these activities, the variability in their definition and support across residency programs presents a challenge. This study investigates these discrepancies and aims to identify the specific barriers and benefits residents perceive in scholarly writing, especially in case report writing, and to propose effective educational interventions.

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Quantifying the amount of proteinuria is mandatory in various disease conditions. The aim of this study was to study whether the spot urine protein-creatinine ratio (P-CR) correlates well with 24-h urinary total protein (UTP). The research hypothesis was that spot urine P-CR would correlate well with 24-h UTP.

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Hepatic encephalopathy is typically seen in advanced liver disease and in patients with a transjugular intrahepatic portosystemic shunt. Common triggers include infections, gastrointestinal bleeding, electrolyte disturbances, dehydration, and drug/toxin use such as benzodiazepines and alcohol. In rare instances, other metabolic abnormalities such as hypothyroidism may also exacerbate hyperammonemia in patients with underlying liver disease due to hypothyroidism-induced myopathy, which increases urea production and decreases clearance through reduced glutamine synthetase activity.

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Background: We previously performed a systematic review and meta-analysis which revealed a Phantom Limb Pain (PLP) prevalence estimate of 64% [95% CI: 60.01-68.1].

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Gamma Delta (γδ) T-cell lymphomas are uncommon and aggressive neoplasms originating from the γδ receptor-bearing lymphocytes. The most frequent entities include primary hepatosplenic γδ T-cell lymphomas, primary cutaneous γδ lymphoma, and monomorphic epitheliotropic T-cell lymphoma. F-18 fluorodeoxyglucose (FDG) PET/CT is an important modality in the staging of Hodgkin's and various non-Hodgkin's lymphoma.

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Cutaneous small vessel leukocytoclastic vasculitis (LCV) is isolated to the dependent areas of the skin. LCV can be induced by pharmaceutical drugs, and management requires abrupt discontinuation of the offending drug. Warfarin is a rare medication to cause LCV, with sparse literature to date.

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Pulmonary hypertension (PH) is a known chronic condition that can lead to increased morbidity and mortality. Patients who develop PH due to thromboembolic disease are catalogued as chronic thromboembolic pulmonary hypertension (CTEPH). Anticoagulation remains a topic of interest in these patients.

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Background: Cancer is a dynamic process and thus requires highly informative and reliable biomarkers to help guide patient care. Liquid-based biopsies have emerged as a clinical tool for tracking cancer dynamics. Extracellular vesicles (EVs), lipid bilayer delimited particles secreted by cells, are a new class of liquid-based biomarkers.

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Article Synopsis
  • - Nail-patella syndrome (NPS) is a rare genetic disorder characterized by skeletal deformities and various other health issues, such as renal failure and heart problems.
  • - A 17-year-old male patient exhibited multiple skeletal abnormalities, advanced renal failure, hypothyroidism, and dilated cardiomyopathy, leading to a clinical diagnosis of NPS supported by imaging and biopsy findings.
  • - The association of dilated cardiomyopathy with NPS is not well-documented, highlighting the importance of a thorough evaluation due to the disorder's diverse systemic effects.
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Background And Objectives: Esophageal and gastric fundic varices are common in liver cirrhosis patients. Ultrasound with the Doppler study assesses liver cirrhosis severity, measuring portal vein and splenic indices' association with gastroesophageal varices.

Methodology: This study was conducted on 64 subjects with sonographic features of chronic liver disease who were referred for routine follow-up scans.

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This study aimed to identify predictors of venous thromboembolism (VTE) in hospitalized cancer patients and develop a predictive model using demographic, clinical, and laboratory data. Our analysis showed that patient groups categorized under a very high risk, and high risk, patients with low hemoglobin levels and renal disease were at a significantly increased risk of developing VTE. We developed a VTE risk-assessment model (RAM) with moderate discriminatory performance, high specificity, and negative predictive value, indicating its potential utility in identifying patients without VTE risk.

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High grade serous ovarian carcinoma (HGSOC) accounts for ~ 70% of ovarian cancer cases. Non-invasive, highly specific blood-based tests for pre-symptomatic screening in women are crucial to reducing the mortality associated with this disease. Since most HGSOCs typically arise from the fallopian tubes (FT), our biomarker search focused on proteins found on the surface of extracellular vesicles (EVs) released by both FT and HGSOC tissue explants and representative cell lines.

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Tricuspid valve infective endocarditis (TVIE), often associated with vegetation in people who inject drugs, has introduced a less invasive option for vegetation removal: transcatheter vacuum-assisted mass extraction (TVME). This technique is emerging as an alternative to standard surgical debridement (SD) and valve repair. However, the comparative effectiveness of TVME versus SD in treating TVIE has yet to be investigated.

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In the sinonasal tract, diffuse large B-cell lymphomas are the predominant type non-Hodgkin's lymphoma while natural killer (NK) cell T-cell lymphoma, the nasal type, constitute only 3%-12% of NHLs in this region and is the more aggressive subtype. NK cell T-cell lymphoma mostly occurs in male at the median age of 50 years and has got a poor prognosis with a 3-years overall survival (OS) of 46.3% and a 5-years OS of 42%.

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