Nikita Mehta

KLE University

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Mark Nelson Awori

University of Nairobi

Suraj Venna

Virginia Cancer Institute

Frederick O. Mitema

University of Nairobi

Naomi Kebba

Uganda Management Institute

Guilherme Rabinowits

Baptist Health South Florida

Emily S. Ruiz

Harvard University

Michael R. Migden

The University of Texas MD Anderson Cancer Center

David M. Ellison

Charleston Hematology Oncology Associates

John Strasswimmer

Florida Atlantic University

Davide Carino

Vita-Salute San Raffaele University

Cooperative Institutions

University of Nairobi

Kenyatta National Hospital

Hospital Clínic de Barcelona

Universitat de Barcelona

Consorci Institut D'Investigacions Biomediques August Pi I Sunyer

Regeneron (United States)

Harvard University

Govind Ballabh Pant Hospital

KLE University

The University of Texas MD Anderson Cancer Center

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Percussion Gun and Scapular Stabilization Exercises versus Scapular Stabilization Exercises in Participants with Upper Cross Syndrome: A Randomized Controlled Trial

Indian Journal of Physical Therapy and Research (2024)

Basavaraj Motimath Shivani Narvekar Rakshanda Narulkar Nikita Mehta

Background: Upper cross syndrome (UCS) is a muscle imbalance caused by a postural problem. This needs correction to improve the posture and help to regain muscle strength. Scapular stabilization exercises are the exercises that positively help to prevent UCS. Aim: The purpose of the study was to investigate if there was a difference in the effect of percussion gun and scapular stabilization exercises versus only scapular stabilization exercises in participants with UCS within the age group of 19–25 years. Settings and Study Design: A randomized controlled trial was conducted on collegiate students between the age group of 19–25 years. Methodology: Individuals with UCS ( n = 40) were randomly allocated to experimental (Group A) and control groups (Group B). Participants in the experimental group were treated with percussion gun and scapular stabilization exercises, while participants in the control group were given only scapular stabilization exercises. Outcome measures used were craniovertebral angle (CVA), shoulder angle (SHA), cervical range of motion (ROM), and the strength of cervical flexors, which were assessed. Results: Participants in both the groups showed a significant improvement in CVA, SHA, cervical ROM, and strength of cervical flexors. However, the experimental group revealed a more significant increase in CVA, SHA, cervical ROM, and strength of cervical flexors than the control group. Conclusion: Both the experimental and control groups have shown improvements in ROM, CVA, SHA, and muscle strength. However, the study concluded that the percussion gun, along with scapular stabilization exercises, revealed better results than only scapular stabilization exercises.

10.4103/ijptr.ijptr_32_22

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Early degeneration of two different tricuspid bioprostheses in restrictive cardiomyopathy

Journal of Cardiac Surgery (2019)

Davide Carino Nikita Mehta María Ascaso Jorge Alcocer Eduard Quintana

Early degeneration of tricuspid bioprostheses is a rare, but extremely serious, complication. Several mechanisms have been described, both for surgically implanted and transcatheter bioprosthesis. We report a case of early degeneration of tricuspid porcine bioprosthesis and a subsequent transcatheter valve-in-valve bovine prosthesis due to severe fibrosis with leaflet retraction in a patient with restrictive cardiomyopathy who finally underwent orthotopic heart transplantation.

Degeneration (medical)

Restrictive cardiomyopathy

Endomyocardial fibrosis

10.1111/jocs.14372

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Citations (1)

Monocusp Valves Do Not Improve Early Operative Mortality in Tetralogy of Fallot: A Meta-Analysis

World Journal for Pediatric and Congenital Heart Surgery (2020)

Mark Nelson Awori Jonathan Awori Nikita Mehta O Makori

Monocusp valves are thought to reduce early operative mortality and morbidity associated with pediatric tetralogy of Fallot repair. As there are no published randomized clinical trials comparing outcomes with and without a monocusp valve, we performed a meta-analysis of observational studies in accordance with established protocols. After systematically searching PubMed, the Cochrane Library, and Google Scholar, 12 studies were included. The operative mortality was compared in 695 patients, and we found no difference between patients with and patients without a monocusp valve. Monocusp valves may not improve operative mortality of tetralogy of Fallot repair in pediatric patients.

10.1177/2150135120934763

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Citations (1)

Optimal Z-Score Use in Surgical Decision-Making in Pulmonary Atresia With Intact Ventricular Septum

World Journal for Pediatric and Congenital Heart Surgery (2017)

Mark Nelson Awori Nikita Mehta Frederick O. Mitema Naomi Kebba

Objectives: In the surgical treatment of pulmonary atresia with intact ventricular septum, the size of the tricuspid valve annulus (as measured by z-scores) has emerged as a significant factor in deciding which repair to perform. Various tricuspid valve annulus z-scores are reported as “cutoffs” for successful biventricular repair. We aimed to determine whether the use of different z-score data sets contributed to the gross variation in “cutoffs” for successful biventricular repair reported in the literature. Methods: A single search was made of PubMed using the “advanced” setting with the following search terms: pulmonary, atresia, intact, septum, z, and score. The filters “title” and “title/abstract” were used for the first four and last two terms, respectively; the instruction “AND” combined all terms. Articles that identified which z-score data set was used in patients with biventricular repairs were included. Results: From 13 articles, 1,392 patients were studied, 410 (29.5%) of which achieved biventricular repair. Three z-score data sets were quoted; mean tricuspid valve annulus z-scores in biventricular repair patients ranged between −0.53 and −5.1. After correcting for discrepancies between z-score data sets, no study reported a mean tricuspid valve annulus z-score <−2.8 in biventricular repair patients and 83.3% reported mean tricuspid valve annuli z-scores >−1.7. Conclusion: The use of varied tricuspid valve annuli z-score data sets may have contributed to gross variations in reported “cutoffs” for successful biventricular repair. This could lead to inappropriate surgical pathway allocation.

Pulmonary atresia

Tricuspid atresia

Pulmonary valve

Annulus (botany)

Cardiac skeleton

Standard score

10.1177/2150135117701407

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Citations (24)

Post-cardiotomy intra-aortic balloon counter pulsation: application and prognostic evaluation.

PubMed (1998)

Devendra K. Agrawal Shamsher Singh Lohchab Nikita Mehta Mandeep Bhargava Swati Panwar

Arteriotomy

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Huge left ventricular pseudoaneurysm rupture in an African young adult patient

Interactive Cardiovascular and Thoracic Surgery (2014)

Michele di Summa Federica Iezzi Gilbert Oburu Nikita Mehta

A pseudoaneurysm of the ventricle is formed when there is rupture of the myocardial wall with the discontinuity being roofed over by the pericardium and mural thrombus or fibrous tissue without myocardial elements. Cardiac pseudoaneurysm is a rare and a potentially life-threatening event. Early prophylactic surgical aneurysmectomy has been the treatment of choice. In this context, we report an unusual case of giant left ventricular pseudoaneurysm, as a result of unknown aetiology, appearing like a pulsatile mass, which was easily seen from the chest wall, in a young female, successfully treated with surgery.

Pseudoaneurysm

Pulsatile flow

Heart Aneurysm

10.1093/icvts/ivu086

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Citations (5)

A Comparative Study to Evaluate the Effects of Dexamethasone & Tube Drain on Post-Operative Sequelae After Surgical Extraction of Impacted Mandibular Third Molars – An In Vivo Study

European Journal of Molecular & Clinical Medicine (2021)

Prerna Agrawal Khemraj Agrawal Gangaraju Shakapuram B Baji Sri Mouna Govardhani Kottapalli

Mandibular third molar

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Citations (1)

Checkpoint inhibition in immunosuppressed or immunocompromised patients with advanced cutaneous squamous cell carcinoma (CSCC): Data from prospective CemiplimAb-rwlc Survivorship and Epidemiology (C.A.S.E.) study.

Journal of Clinical Oncology (2021)

Guilherme Rabinowits Soo Jung Park David M. Ellison Francis P. Worden Rhonda Gentry

9547 Background: Immunosuppressed and/or immunocompromised patients are at increased risk for solid tumors and cutaneous malignancies. Limited data exist on the safety and effectiveness of immune checkpoint inhibitors (ICIs) in these patients because they are frequently excluded from clinical trials. Here, we describe the safety and effectiveness results from the initial cohort of immunosuppressed and/or immunocompromised patients with advanced CSCC enrolled in the C.A.S.E. study (NCT03836105). Methods: C.A.S.E. is a prospective, real-world, multi-center, longitudinal study evaluating the effectiveness, safety, quality of life, and survivorship in patients with advanced CSCC treated with cemiplimab. Patients received cemiplimab 350 mg intravenously every 3 weeks per routine standard of care. Patient demographics, disease characteristics, immunosuppression, and relevant medical history were collected. Immunosuppressive regimens varied amongst patients. Investigator assessment of objective response rate (ORR), safety, and tolerability was conducted. Data from 26 immunosuppressed and/or immunocompromised patients with advanced CSCC treated with cemiplimab are presented. Recruitment is ongoing. Results: As of November 17, 2020, 121 patients were enrolled in the C.A.S.E. study, of which 26 patients (median age: 74 years [IQR: 71-84]; 85% male; 89% Caucasian) were designated as immunocompromised or immunosuppressed due to a history of solid organ transplant (n = 6), autoimmune disorder (n = 11), or hematologic malignancy (n = 9). Median duration of cemiplimab exposure was 14 months (IQR: 9.1–42, range: 0, 67). Among 19 immunocompromised or immunosuppressed patients who enrolled in C.A.S.E. prior to their third dose of cemiplimab, ORR per investigator assessment was 47% (95% CI: 24–71); 1 (5%) patient had complete response; 8 (42%) had partial response. One patient had a treatment-related serious adverse reaction of organ transplant rejection. One (3.8%) patient discontinued treatment due to increased alanine aminotransferase (not treatment-related). Immune-related AEs (irAEs) occurred in 23% of patients. No treatment-related AEs led to death. Conclusions: The safety, tolerability, and effectiveness of cemiplimab in this initial cohort of immunosuppressed and/or immunocompromised patients with advanced CSCC appear to be consistent with those observed in clinical trials that excluded these patients. Further follow-up and additional data would add to our general understanding of safety and effectiveness of anti-PD1 therapy in immunocompromised and/or immunosuppressed patient populations overall. Clinical trial information: NCT03836105.

Immunosuppression

Tolerability

10.1200/jco.2021.39.15_suppl.9547

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Citations (9)

Surgical correction of a pulmonary artery aneurysm with severe pulmonary regurgitation with a valve-sparing technique

Interactive Cardiovascular and Thoracic Surgery (2019)

Davide Carino Nikita Mehta Alejandro Fernández‐Cisneros Daniel Pereda

Pulmonary artery aneurysms are rare but are associated with a significant risk of rupture and dissection. Moreover, pulmonary valve regurgitation and/or stenosis often coexist. In this study, we present a case of a pulmonary artery aneurysm with severe pulmonary regurgitation in a patient with pulmonary hypertension treated with aneurysm resection and pulmonary valve repair.

Pulmonary valve

10.1093/icvts/ivz224

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Citations (1)

Optimal Use of Z-Scores to Preserve the Pulmonary Valve Annulus During Repair of Tetralogy of Fallot

World Journal for Pediatric and Congenital Heart Surgery (2018)

Mark Nelson Awori Nikita Mehta Frederick O. Mitema Naomi Kebba

Objective: The size of the pulmonary annulus measured as a z-score is often used to determine when to insert a transannular patch (TAP). Multiple “cutoffs” are quoted in the literature; this could lead to inappropriate insertion. We aimed to determine whether the use of z-scores derived from different populations may have contributed to the varied “cutoffs” quoted. Methods: PubMed was searched using the terms: “tetralogy,” “Fallot,” “transannular,” “patch,” “mortality,” and “death.” Studies published between January 1, 2005, and October 5, 2017, were included; studies without participants under the age of 18 years and studies that did not describe the operative procedure were excluded. Results: Of 52 papers retrieved, 19 were included representing 2,500 repaired patients; 1,371 (54.8%) had a TAP. Five (26.3%) papers representing 638 patients (25.5%) quoted a z-score “cutoff” and what data set was used; “cutoffs” ranged from −2 to −4 and were derived from 2 different data sets. Three studies quoted a data set that has been shown in previous work to be problematic; the only quoted “cutoffs” of −4 were from two of these studies. Conclusions: Surprisingly few (26.3%) studies mention what pulmonary annulus size “cutoff” was used to decide when to insert a TAP. Z-scores derived from different populations were used by different studies and it is possible that this may have contributed to the varied “cutoffs’ quoted. Recommendations to perform valve-sparing surgery in pulmonary annuli as small as −4 may not be warranted. Future papers should record “cutoffs” employing recommended z-score data set.

Cut-off

Pulmonary valve

10.1177/2150135118757991

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Citations (15)