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Articles by A. Agrawal
Total Records ( 3 ) for A. Agrawal
  J. D Waltonen , E Ozer , N. C Hall , D. E Schuller and A. Agrawal
 

Objective  To assess the efficacy of various diagnostic modalities in detecting occult primary tumor location.

Design  Retrospective medical record study.

Setting  Academic head and neck oncology practice.

Patients  A total of 183 consecutive patients with metastatic carcinoma of the neck from an unknown primary tumor during a 10-year period, after exclusion of those with previous history of head and neck cancer, a primary tumor site evident on physical examination, or primary tumors of the neck.

Main Outcome Measures  Identification of primary tumor location by various imaging modalities and panendoscopy with directed biopsies.

Results  Primary tumor location was identified in 84 patients (45.9%). Preoperative imaging (computed tomography [CT], magnetic resonance imaging, positron emission tomography [PET], and/or PET-CT fusion scan) identified sites suggestive of primary tumor location in 69 patients. Subsequent directed biopsy of these sites yielded positive results in 42 cases (60.9%). The rate of successful identification of a primary tumor for each of the imaging modalities was as follows: CT scan of the neck, 14 of 146 patients (9.6%); magnetic resonance imaging of the neck, 0 of 13 patients (0%); whole-body PET scan, 6 of 41 patients (14.6%); and PET-CT fusion study, 23 of 52 patients (44.2%) (P = .001). The highest yield in identifying primary tumor sites was obtained in patients who had undergone PET-CT plus panendoscopy with directed biopsies with or without tonsillectomy: 31 of 52 patients (59.6%).

Conclusion  Diagnostic workup including PET-CT, alongside panendoscopy with directed biopsies including bilateral tonsillectomy, offers the greatest likelihood of successfully identifying occult primary tumor location.

  I. Jyothi , Tanu Priya , T.M. Vijayakumar , S. Ramesh Kannan , K. Ilango , A. Agrawal and G.P. Dubey
  Use of Clonazepam was very common in Parkinson’s patient with sleep problems such as rapid eye movement behavior Disorder. A pilot study was performed to evaluate the effects of Clonazepam on sleep pattern in Parkinson’s patient using video polysomnography. Overnight polysomnography was performed prospectively in three healthy males (age 51.33±3.51 years) and with three male Parkinson’s patient (age 60.00±8.00 years) with sleep disorders. The study was conducted in two phases using standard techniques in accordance with guidelines published by the American Academy of Sleep Medicine (AASM). For sleep stages evaluation, an electroencephalogram (4 channels with 2 central and 2 occipital) chin electromyogram (with 1 channel) and electro-oculogram (with 2 channels) were achieved. Polysomnography characteristics of healthy volunteers and Parkinson’s patient with and with out Clonazepam effect was evaluated. Sleep latency was compared between healthy volunteers and Parkinson’s patients in both the phases. The difference was highly significant [Phase I (p = 0.004, R2 = 0.896), Phase II (p<0.001, R2=0.999)], but there was no considerable effect of Clonazepam in PD Patients [Phase I, (p = 0.606, R2=0.072) Phase II (p = 0.726, R2 = 0.081)]. Clonazepam significantly increases the sleep efficiency [Phase I (p<0.001, R2 = 0.991) Phase II (p = 0.002, R2=0.998)] in Parkinson’s patients but Clonazepam did not have any significant effect on wake after sleep onset, stage I sleep, sleep latency and wakefulness. Hence a larger population based longitudinal study should be performed to validate these findings.
  Z. B Moak and A. Agrawal
  Background

Low social support has been associated with several disorders. We test the relationship between perceived interpersonal social support (ISS) and aspects of mental and physical health.

Methods

We used data from National Epidemiological Survey on Alcohol and Related Conditions in which 34 653 individuals aged 20–99 years were interviewed twice (2001–02 and 2004–05), with the second interview including the interpersonal support evaluation list. The association of perceived ISS with lifetime DSM-IV psychopathology and physical health from the past 12 months was investigated. We also tested whether this association changes as a function of number of traumatic events in accordance with the buffering hypothesis.

Results

Low perceived ISS correlated with increased prevalence of major depressive disorder, generalized anxiety, social phobia and several physical health problems. There was a strong association between excellent self-perceived physical health and high social support.

Conclusions

There was evidence for both the main, beneficial effects of high perceived ISS and buffering, whereby increased perceived ISS ameliorated the pathogenic influence of exposure to traumatic life events on psychopathology. Current findings highlight the importance of perceived ISS in individuals' general mental and physical well-being, both in daily life and upon exposure to negative life events.

 
 
 
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