Rajesh Kumar

Bio: Rajesh Kumar is an academic researcher from Himachal Pradesh University. The author has contributed to research in topics: Medicine & Materials science. The author has an hindex of 149, co-authored 4439 publications receiving 140830 citations. Previous affiliations of Rajesh Kumar include Guru Nanak Dev University & Intuitive Surgical.

Carcinoma endometrium: role of 18-FDG PET/CT for detection of suspected recurrence.

Abstract: ObjectiveRecurrent carcinoma endometrium has a poor prognosis. However, successful salvage with long-term survival has been achieved after hormone therapy, radical surgery, and radiotherapy/chemotherapy in patients with recurrent disease. Conventional imaging (CI) and tumor marker have limited accur

Thyroid scintigraphy in detecting dual ectopic thyroid: a review.

Abstract: Dear Sir, The thyroid gland is the first endocrine gland to develop during embryogenesis on approximately 24th day of gestation. The developing thyroid is anatomically related to the developing heart, and it is pulled caudally to its definitive location in the anterior neck with the descent of heart. The thyroid completes its descent on reaching anterior to the trachea in the lower neck in the seventh gestational week. The development defects or aberrant migration of the thyroid descent will lead to ectopy of the thyroid. The Foxe 1 mutation is also shown to be associated with molecular pathology of ectopic thyroid in mouse models; however, till date, no known gene for human ectopic thyroid has been demonstrated [1]. An ectopic thyroid gland may occur anywhere along the path of initial descent of the thyroid. The most commonly found ectopic thyroid tissue is at the base of the tongue, i.e. lingual thyroid, which accounts for 90% of the reported cases. Other rare sites for ectopic thyroid are the sublingual, cervical, mediastinal, intracardiac and abdomen [2]. Most of the times, ectopic thyroid might be the only functioning thyroid tissue. Ectopic thyroid is a rare anomaly. It is further uncommon for two distinct ectopic thyroid tissues to be present simultaneously. The web search of Pubmed in English literature revealed only 26 cases of dual ectopic thyroid so far. In this letter, we describe a patient of dual ectopic thyroid where the Tc-pertechnetate thyroid scan clinched the diagnosis and led to correct management. The literature available on dual ectopic thyroid tissue is also being discussed. A 7-year-old girl presented with history of progressive midline swelling of the neck for 1 year. There was no history of pain, fever, pressure or obstructive symptoms and change in voice. Patient did not have any feature of hypo-thyroidism or hyper-thyroidism. Local examination revealed a midline neck swelling of 1.5×1 cm in size, soft in consistency, non-translucent in nature, which moved on tongue protrusion and swallowing. The oral examination showed another small irregular swelling of about 1 cm size near the base of the tongue, which was soft to firm on touch and non-tender (Fig. 1). Her thyroid function tests were suggestive of sub-clinical hypo-thyroidism with value of T3—75 ng/dL (normal=75–210), T4—4.30 μg/dL (normal=4–11) and thyroid-stimulating hormone (TSH)— 17.88 μIU/mL (normal=0.55–5.0). Based on clinical and biochemical examination, a diagnosis of ectopic thyroid was made, and the patient was referred for thyroid scan for confirmation. The thyroid Tc-pertechnetate scan demonstrated two distinct focal areas of radiotracer uptake in the sublingual and subhyoid region and no uptake in region of the thyroid bed (arrows; Fig. 2). A final diagnosis of dual ectopic thyroid was made based on thyroid scan findings. Eur J Nucl Med Mol Imaging (2008) 35:843–846 DOI 10.1007/s00259-007-0672-2

Cardiovascular disease risk management in a primary health care setting of north India.

Abstract: Objective This study was primarily carried out to assess the feasibility of an adapted WHO CVD risk management package in a primary care setting. Methods A community intervention trial was conducted in eight health posts located in rural, urban, and slum areas of northern India. After a 4 day training, eight health workers implemented the package among 1010 adults > or =30 years of age from a randomly chosen cluster of households. Locally adapted scenario 1 WHO protocol was used for the assessment of CVD risks. The health workers inquired about smoking, alcohol, diet, physical activity, symptoms of angina, and transient ischaemic attacks; and measured systolic blood pressure (SBP7), height, and weight. Those with a risk were counseled and referred to a physician. Hypertensives were followed at 1, 3, and 5-month interval to reinforce risk prevention and adherence to treatment. In a 20% random sub sample, in the study and control area before and after the intervention, WHO STEPS instrument was used to evaluate effectiveness of the package. Findings After training, the knowledge of health workers regarding risk factors and symptoms of CVDs increased from 47% to 92.5%, and their performance in detection of risks was comparable to the investigator. All health workers could pay scheduled home visits regularly. They referred 279 (27.6%) individuals having raised systolic blood pressure (SBP), and 74.5% contacted the doctor. Significant decrease in mean SBP (8.8 mm Hg) was observed during follow-up. Significantly higher reports of intention to quit tobacco (60.3% vs 25.5%) and regular intake of anti-hypertensive medication (58.3% vs 34.8%) were observed in the intervention area compared to the control area. Conclusion Adapted WHO CVD risk management package can be implemented through primary care system.

Identification of serum monocyte chemoattractant protein-1 and prolactin as potential tumor markers in hepatocellular carcinoma.

Abstract: Early diagnosis of hepatocellullar carcinoma (HCC) remains a challenge. The current practice of serum alpha-fetoprotein (AFP) measurement is inadequate. Here we utilized a proteomic approach to identify novel serum biomarkers for distinguishing HCC patients from non-cancer controls. We profiled the serum proteins in a group of 58 resectable HCC patients and 11 non-HCC chronic hepatitis B (HBV) carrier samples from the Singapore General Hospital (SGH) using the RayBio® L-Series 507 Antibody Array and found 113 serum markers that were significantly modulated between HCC and control groups. Selected potential biomarkers from this list were quantified using a multiplex sandwich enzyme-linked immunosorbent assay (ELISA) array in an expanded SGH cohort (126 resectable HCC patients and 115 non-HCC chronic HBV carriers (NC group)), confirming that serum prolactin and monocyte chemoattractant protein-1 (MCP-1) were significantly upregulated in HCC patients. This finding of serum MCP-1 elevation in HCC patients was validated in a separate cohort of serum samples from the Mochtar Riady Institute for Nanotechnology, Indonesia (98 resectable HCC, 101 chronic hepatitis B patients and 100 asymptomatic HBV/HCV carriers) by sandwich ELISA. MCP-1 and prolactin levels were found to correlate with AFP, while MCP-1 also correlated with disease stage. Subsequent receiver operating characteristic (ROC) analysis of AFP, prolactin and MCP-1 in the SGH cohort and comparing their area under the ROC curve (AUC) indicated that neither prolactin nor MCP-1 on their own performed better than AFP. However, the combination of AFP+MCP-1 (AUC, 0.974) had significantly superior discriminative ability than AFP alone (AUC, 0.942; p<0.001). In conclusion, prolactin and MCP-1 are overexpressed in HCC and are conveniently quantifiable in patients’ sera by ELISA. MCP-1 appears to be a promising complementary biomarker for HCC diagnosis and this MCP-1+AFP model should be further evaluated as potential biomarker on a larger scale in patients at-risk of HCC.

I and i

Abstract: There is, I think, something ethereal about i —the square root of minus one. I remember first hearing about it at school. It seemed an odd beast at that time—an intruder hovering on the edge of reality. Usually familiarity dulls this sense of the bizarre, but in the case of i it was the reverse: over the years the sense of its surreal nature intensified. It seemed that it was impossible to write mathematics that described the real world in …

Fast parallel algorithms for short-range molecular dynamics

Abstract: Three parallel algorithms for classical molecular dynamics are presented. The first assigns each processor a fixed subset of atoms; the second assigns each a fixed subset of inter-atomic forces to compute; the third assigns each a fixed spatial region. The algorithms are suitable for molecular dynamics models which can be difficult to parallelize efficiently—those with short-range forces where the neighbors of each atom change rapidly. They can be implemented on any distributed-memory parallel machine which allows for message-passing of data between independently executing processors. The algorithms are tested on a standard Lennard-Jones benchmark problem for system sizes ranging from 500 to 100,000,000 atoms on several parallel supercomputers--the nCUBE 2, Intel iPSC/860 and Paragon, and Cray T3D. Comparing the results to the fastest reported vectorized Cray Y-MP and C90 algorithm shows that the current generation of parallel machines is competitive with conventional vector supercomputers even for small problems. For large problems, the spatial algorithm achieves parallel efficiencies of 90% and a 1840-node Intel Paragon performs up to 165 faster than a single Cray C9O processor. Trade-offs between the three algorithms and guidelines for adapting them to more complex molecular dynamics simulations are also discussed.

Global strategy for the diagnosis, management, and prevention of chronic obstructive pulmonary disease: GOLD executive summary.

Abstract: Chronic obstructive pulmonary disease (COPD) remains a major public health problem. It is the fourth leading cause of chronic morbidity and mortality in the United States, and is projected to rank fifth in 2020 in burden of disease worldwide, according to a study published by the World Bank/World Health Organization. Yet, COPD remains relatively unknown or ignored by the public as well as public health and government officials. In 1998, in an effort to bring more attention to COPD, its management, and its prevention, a committed group of scientists encouraged the U.S. National Heart, Lung, and Blood Institute and the World Health Organization to form the Global Initiative for Chronic Obstructive Lung Disease (GOLD). Among the important objectives of GOLD are to increase awareness of COPD and to help the millions of people who suffer from this disease and die prematurely of it or its complications. The first step in the GOLD program was to prepare a consensus report, Global Strategy for the Diagnosis, Management, and Prevention of COPD, published in 2001. The present, newly revised document follows the same format as the original consensus report, but has been updated to reflect the many publications on COPD that have appeared. GOLD national leaders, a network of international experts, have initiated investigations of the causes and prevalence of COPD in their countries, and developed innovative approaches for the dissemination and implementation of COPD management guidelines. We appreciate the enormous amount of work the GOLD national leaders have done on behalf of their patients with COPD. Despite the achievements in the 5 years since the GOLD report was originally published, considerable additional work is ahead of us if we are to control this major public health problem. The GOLD initiative will continue to bring COPD to the attention of governments, public health officials, health care workers, and the general public, but a concerted effort by all involved in health care will be necessary.

Using Multivariate Statistics

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