Browse Health
Internist, Critical Care Specialist, Pulmonologist (lungs), Sleep Medicine Specialist
15 years of experience
Video profile
Accepting new patients

Education ?

Medical School
Christian Medical College, Vellore (1995)
Foreign school

Awards & Distinctions ?

Associations
American Board of Internal Medicine

Affiliations ?

Dr. Raj is affiliated with 8 hospitals.

Hospital Affilations

Score

Rankings

  • Northwestern Memorial Hospital
    Pulmonary Disease
    251 E Huron St, Chicago, IL 60611
    • Currently 4 of 4 crosses
    Top 25%
  • University Medical Center - Lubbock
  • The Methodist Hospital
  • Lincoln County Medical Center
  • Veterans Affairs Medical Center
  • Ben Taur General Hospital
  • University Medical Center
  • TX Tech Physicians Associates
  • Publications & Research

    Dr. Raj has contributed to 55 publications.
    Title Obstructive Sleep Apnea and Respiratory Complications Associated with Vagus Nerve Stimulators.
    Date January 2012
    Journal Journal of Clinical Sleep Medicine : Jcsm : Official Publication of the American Academy of Sleep Medicine
    Excerpt

    Intermittent vagus nerve stimulation can reduce the frequency of seizures in patients with refractory epilepsy. Stimulation of vagus nerve afferent fibers can also cause vocal cord dysfunction, laryngeal spasm, cough, dyspnea, nausea, and vomiting. Vagus nerve stimulation causes an increase in respiratory rate, decrease in respiratory amplitude, decrease in tidal volume, and decrease in oxygen saturation during periods of device activation. It usually does not cause an arousal, or a change in heart rate or blood pressure. Most patients have an increase in their apnea-hypopnea index (AHI). Patients with VNS can have central apneas, obstructive hypopneas, and obstructive apneas. These respiratory events can be reduced with changes in the vagus nerve stimulator operational parameters or with the use of CPAP. In summary, there are complex relationships between epilepsy and obstructive sleep apneas. In particular, patients with refractory epilepsy need assessment for undiagnosed and untreated obstructive sleep apnea before implantation of vagus nerve stimulator devices. Patients with vagus nerve stimulators often have an increase in apneic events after implantation, and these patients need screening for sleep apnea both before and after implantation.

    Title Hybrid Iii-v Semiconductor/silicon Nanolaser.
    Date December 2011
    Journal Optics Express
    Excerpt

    Heterogeneous integration of III-V compound semiconductors on Silicon on Insulator is one the key technology for next-generation on-chip optical interconnects. In this context, the use of photonic crystals lasers represents a disruptive solution in terms of footprint, activation energy and ultrafast response. In this work, we propose and fabricate very compact laser sources integrated with a passive silicon waveguide circuitry. Using a subjacent Silicon-On-Insulator waveguide, the emitted light from a photonic crystal based cavity laser is efficiently captured. We study experimentally the evanescent wave coupling responsible for the funneling of the emitted light into the silicon waveguide mode as a function of the hybrid structure parameters, showing that 90% of coupling efficiency is possible.

    Title Anesthetic Management of a Patient with Kimura's Disease for Superficial Parotidectomy.
    Date November 2011
    Journal Journal of Anaesthesiology, Clinical Pharmacology
    Excerpt

    Kimura's disease is a rare form of chronic eosinophilic inflammatory disease with vascular proliferation involving salivary gland, skin, lymph node, and kidney. Important anesthetic concerns include increased surgical bleeding due to its vascular nature, airway involvement by the mass leading to a possible difficult airway, allergic symptoms associated with high eosinophil count and elevated IgE level and nephrotic syndrome due to involvement of kidney by the inflammatory process. There is paucity of information in the literature on the anesthetic management of Kimura's disease. We describe the anesthesia technique and review the literature of such a case posted for superficial parotidectomy.

    Title Enhanced Efficiency of the Second Harmonic Inhomogeneous Component in an Opaque Cavity.
    Date September 2011
    Journal Optics Letters
    Excerpt

    In this Letter, we experimentally demonstrate the enhancement of the inhomogeneous second harmonic conversion in the opaque region of a GaAs cavity with efficiencies of the order of 0.1% at 612 nm, using 3 ps pump pulses having peak intensities of the order of 10 MW/cm(2). We show that the conversion efficiency of the inhomogeneous, phase-locked second harmonic component is a quadratic function of the cavity factor Q.

    Title Health-related Quality of Life in Indian Patients with Three Viral Sexually Transmitted Infections: Herpes Simplex Virus-2, Genital Human Papilloma Virus and Hiv.
    Date August 2011
    Journal Sexually Transmitted Infections
    Excerpt

    Health-related quality of life (HRQOL) has not been studied in Indian patients with viral sexually transmitted infections (STIs): herpes simplex virus-2 (HSV-2) and genital human papilloma virus (HPV) infections. Furthermore, there is no reported study that compares HRQOL among these two viral STIs and HIV.

    Title Preserve and Strengthen Family to Promote Mental Health.
    Date July 2011
    Journal Indian Journal of Psychiatry
    Title Tourette's Disease with Impulse Control Disorder.
    Date July 2011
    Journal Indian Journal of Psychiatry
    Excerpt

    We report a case of Tourette's disease (TD) with impulse control disorder which is rare;these type of patients are prone to rage attack and explosive outbursts in the childhood and adolescence which can be detrimental. Hence, a case is reported to understand the phenomenology of its co-morbidity in TD.

    Title Revisiting Human Il-12rβ1 Deficiency: a Survey of 141 Patients from 30 Countries.
    Date December 2010
    Journal Medicine
    Excerpt

    Interleukin-12 receptor β1 (IL-12Rβ1) deficiency is the most common form of Mendelian susceptibility to mycobacterial disease (MSMD). We undertook an international survey of 141 patients from 102 kindreds in 30 countries. Among 102 probands, the first infection occurred at a mean age of 2.4 years. In 78 patients, this infection was caused by Bacille Calmette-Guérin (BCG; n = 65), environmental mycobacteria (EM; also known as atypical or nontuberculous mycobacteria) (n = 9) or Mycobacterium tuberculosis (n = 4). Twenty-two of the remaining 24 probands initially presented with nontyphoidal, extraintestinal salmonellosis. Twenty of the 29 genetically affected sibs displayed clinical signs (69%); however 8 remained asymptomatic (27%). Nine nongenotyped sibs with symptoms died. Recurrent BCG infection was diagnosed in 15 cases, recurrent EM in 3 cases, recurrent salmonellosis in 22 patients. Ninety of the 132 symptomatic patients had infections with a single microorganism. Multiple infections were diagnosed in 40 cases, with combined mycobacteriosis and salmonellosis in 36 individuals. BCG disease strongly protected against subsequent EM disease (p = 0.00008). Various other infectious diseases occurred, albeit each rarely, yet candidiasis was reported in 33 of the patients (23%). Ninety-nine patients (70%) survived, with a mean age at last follow-up visit of 12.7 years ± 9.8 years (range, 0.5-46.4 yr). IL-12Rβ1 deficiency is characterized by childhood-onset mycobacteriosis and salmonellosis, rare recurrences of mycobacterial disease, and more frequent recurrence of salmonellosis. The condition has higher clinical penetrance, broader susceptibility to infections, and less favorable outcome than previously thought.

    Title Lenalidomide-induced Interstitial Lung Disease.
    Date May 2010
    Journal Pharmacotherapy
    Excerpt

    Lenalidomide is a more potent and less toxic oral analog of thalidomide. The drug is indicated for treatment of multiple myeloma and other hematologic disorders and has rarely been associated with pulmonary toxicity. We describe a 73-year-old woman who received lenalidomide therapy for multiple myeloma. Nine weeks after starting the drug, she developed progressive dyspnea, cough, and constitutional symptoms, and was found to be hypoxic. A computed tomography scan of the chest showed bilateral interstitial infiltrates. Bronchoalveolar lavage was negative for infection, but transbronchial biopsy showed an organizing pneumonia. The patient was diagnosed with lenalidomide-induced interstitial lung disease after other causes were excluded. Clinical and radiologic resolution occurred after lenalidomide was discontinued and a tapering course of corticosteroids was begun. Use of the Naranjo adverse drug reaction probability indicated a high probability (score of 7) that this adverse drug reaction was caused by lenalidomide. Lenalidomide inhibits prostaglandin E(2) (PGE(2)) secretion by cells. If fibroblast PGE(2) synthesis is impaired in the lung, the mitogenic action of cysteinyl leukotrienes may be unmasked, promoting fibroblast proliferation and collagen synthesis, eventually leading to interstitial lung disease. Another potential mechanism may be an immunologic one similar to that seen in the interstitial pulmonary process in patients with hypersensitivity pneumonitis. To our knowledge, only one other case of lenalidomide-induced pulmonary toxicity has been reported in the literature. Although lenalidomide-induced pulmonary toxicity is uncommon, clinicians should consider this potential adverse drug reaction in the differential diagnosis in patients receiving lenalidomide who present with symptoms of interstitial lung disease for which alternative causes have been excluded.

    Title Amiodarone-induced Loculated Pleural Effusion: Case Report and Review of the Literature.
    Date April 2010
    Journal Pharmacotherapy
    Excerpt

    Pleural effusion is an uncommon manifestation of amiodarone toxicity and is usually associated with amiodarone-induced interstitial pneumonitis. We describe a 70-year-old woman who came to the emergency department with bilateral pleuritic chest pain and malaise 4 weeks after her amiodarone dose was increased from 200 mg/day to 600 mg/day. She had bilateral exudative pleural effusions without associated pneumonitis. She was diagnosed with amiodarone-induced pleural effusions after a thorough workup during her hospitalization excluded other causes for the effusions. Due to intractable arrhythmias, the patient's amiodarone was not discontinued, and she was discharged home. Four days later at a follow-up visit at the pulmonary clinic, the patient complained of worsening chest pain as well as dyspnea and cough. A computed tomography scan showed left-sided pleural effusion with multiple loculations. She underwent a pulmonary vein isolation procedure, and amiodarone was discontinued. She was treated with prednisone 40 mg/day, tapered over the next 2 weeks. Three weeks after the amiodarone was stopped, the patient was asymptomatic, and a chest radiograph showed complete resolution of the effusions. Review of the patient's medical records revealed that she had experienced similar symptoms and exudative pleural effusions 2 years earlier after a similar dose escalation of amiodarone; the symptoms and pleural effusions resolved after the amiodarone dosage was reduced. Use of the Naranjo adverse drug reaction probability scale indicated that the association between the pleural effusions and amiodarone was highly probable (score of 9). This case report emphasizes that amiodarone should be considered in the differential diagnosis of patients with exudative effusions after a thorough workup has excluded other causes. Amiodarone should be replaced with alternative antiarrhythmic therapy if clinically feasible, and corticosteroids may be beneficial.

    Title Novel Swine-origin (s-oiv) H1n1 Influenza A Pneumonia in a Lung Transplant Patient: a Case Report and Review of the Literature on Performance Characteristics of Rapid Screening Tests for the S-oiv.
    Date January 2010
    Journal The American Journal of the Medical Sciences
    Excerpt

    Rapid screening tests are insensitive for detecting the novel swine-origin influenza A (H1N1) virus (S-OIV), and false negatives can delay the diagnosis and initiation of appropriate antiviral therapy. The case of a 26-year-old double lung transplant recipient presenting with fever, bilateral pulmonary infiltrates, and a negative influenza direct immunofluorescent antibody on bronchoalveolar lavage is presented. A diagnosis was made, and antiviral therapy was started 10 days after the initial bronchoalveolar lavage on receipt of a positive culture for S-OIV. The published literature on the performance characteristics of rapid screening tests for S-OIV is reviewed in this clinical context.

    Title One Hundred-foot Walk Test for Functional Assessment of Clinic Patients.
    Date December 2009
    Journal The American Journal of the Medical Sciences
    Excerpt

    Gait velocity measurements provide functional assessment of patients with diverse diseases and allow predictions about future adverse events. The optimal distance for patient classification is uncertain.

    Title Feature Selection and Classification Employing Hybrid Ant Colony Optimization/random Forest Methodology.
    Date September 2009
    Journal Combinatorial Chemistry & High Throughput Screening
    Excerpt

    Accurate classification of instances depends on identification and removal of redundant features. Classification of data having high dimensionality is usually performed in conjunction with an appropriate feature selection method. Feature selection enables identification of the most informative feature subset from the enormously vast search space that can accurately classify the given data. We propose an ant colony optimization (ACO)/random forest based hybrid filter-wrapper search technique, which traverses the search space and selects a feature subset with high classifying ability. We evaluate the performance of our algorithm on four widely studied CoEPrA (Comparative Evaluation of Prediction Algorithms, http://coepra.org) datasets. The performance of the software ants mediated hybrid filter/wrapper approach compares well with the available competition results. Thus, the proposed Ant Colony Optimization based technique can effectively find small feature subsets capable of classifying with a very good accuracy and can be employed for feature subset selection with a high level of confidence.

    Title Exercise for Prevention of Obesity and Diabetes in Children and Adolescents.
    Date September 2009
    Journal Clinics in Sports Medicine
    Excerpt

    As rates of obesity and type 2 diabetes continue to escalate, effective means of prevention become paramount in curbing the largest epidemic of our times. With adult obesity rates in the United States already at 34%, according to the most recent National Health and Nutrition Examination Survey (NHANES) data, preventing obesity in childhood is of increasing urgency. Exercise and lifestyle modification have been shown to be effective in adult trials for diabetes prevention, such as the Diabetes Prevention Program (DPP), Finnish Diabetes Study, and Da Qing Study. This article reviews randomized, controlled trials in children, using exercise and lifestyle modification in the prevention of insulin resistance and obesity. This review encompasses studies within the past decade from Planet Health in 1999 to the Beijing Obesity Intervention trial published in 2007 and covers both school-based and family-based approaches. A challenging task by any means, these trials have contributed valuable insight into the efficacy of various approaches toward preventing childhood obesity and insulin resistance, a pressing public health concern.

    Title Granulocyte Transfusion in Children.
    Date September 2009
    Journal Indian Pediatrics
    Excerpt

    We describe a single institution experience with the use of granulocyte transfusion in children. This is a retrospective analysis of 45 collections of granulocyte units obtained by apheresis after priming with dexamethasone, infused into 17 children with severe neutropenic infections. Ten children survived the acute infection. Granulocyte transfusion is a useful adjunct to antimicrobials and growth factors in post chemotherapy neutropenic sepsis and is highly effective in children with chronic granulomatous disease and life threatening infections.

    Title Advanced Locally Invasive Squamous Cell Carcinoma.
    Date August 2009
    Journal The American Journal of the Medical Sciences
    Title Quantitative Heel Ultrasonography, 25-hydroxyvitamin D, and Urine Amino-terminal Cross-linking Telopeptide of Type I Collagen in Patients with a Recent Hip Fracture.
    Date June 2009
    Journal Journal of Ultrasound in Medicine : Official Journal of the American Institute of Ultrasound in Medicine
    Excerpt

    This study examined quantitative heel ultrasonography (QUS), 25-hydroxyvitamin D (25-OHD) levels, and urine amino-terminal cross-linking telopeptide of type I collagen (NTX-I) levels in patients with a recent osteoporotic hip fracture to see whether they were clinically useful.

    Title Thermocapillary Convection During Subcooled Boiling in Reduced Gravity Environments.
    Date May 2009
    Journal Annals of the New York Academy of Sciences
    Excerpt

    Complete understanding of the origin of thermocapillary convection during subcooled boiling remains elusive. Some recent studies have suggested that the presence of dissolved gas inside the vapor bubble leads to the formation of a localized concentration and temperature gradient along the liquid-vapor interface and thus to the onset of thermocapillary convection. These studies reported that the dissolved gas content determines the onset of thermocapillary convection and that no thermocapillary motion was observed for subcooled boiling with pure liquid. However, other experiments performed in reduced gravity suggest that the strength of the thermocapillary convection around the primary bubble in a gas-saturated fluid is much weaker than that in a degassed fluid. This paper presents a qualitative study of the effects of dissolved gas content, bubble shape and size, and heat transfer coefficient on the strength of thermocapillary convection and offers possible explanations for the existing confusion. Owing to the presence of different complex and interrelated mechanisms, we decoupled the individual mechanisms to study their overall effect on thermocapillary convection. The results indicate that variations in the heat transfer coefficient and in the shape and the size of the bubble play a major role in the development of thermocapillary motion.

    Title Plasma Carboxy-terminal Peptide of Procollagen Type I is an Independent Predictor of Diastolic Function in Patients with Advanced Systolic Heart Failure.
    Date April 2009
    Journal Congestive Heart Failure (greenwich, Conn.)
    Excerpt

    Severe diastolic dysfunction has important clinical implications in advanced systolic heart failure. The authors investigated whether a marker of fibrosis, serum carboxy-terminal peptide of procollagen type I (PICP) is a major determinant of diastolic function in 40 patients with heart failure and ejection fraction <35%. Patients with unstable heart failure or ischemic symptoms were excluded. The authors found PICP to be an independent predictor of diastolic function in addition to age and pulmonary artery systolic pressure. The authors' findings suggest that studies evaluating whether therapy that improves myocardial fibrosis could have a favorable impact on diastolic function in this population are warranted.

    Title Dynamics of Band-edge Photonic Crystal Lasers.
    Date April 2009
    Journal Optics Express
    Excerpt

    Band-edge photonic crystal lasers were fabricated and their temporal characteristics were minutely analyzed using a high resolution up-conversion system. The InGaAs/InP photonic crystal laser operates at room temperature at 1.55 microm with turn on time ranging from 17ps to 30ps.

    Title Eyelid Nystagmus in Miller Fisher Syndrome.
    Date January 2009
    Journal The British Journal of Ophthalmology
    Title An Ontology-driven Method for Hierarchical Mining of Temporal Patterns: Application to Hiv Drug Resistance Research.
    Date November 2008
    Journal Amia ... Annual Symposium Proceedings / Amia Symposium. Amia Symposium
    Excerpt

    Many biomedical research databases contain time-oriented data resulting from longitudinal, time-series and time-dependent study designs, knowledge of which is not handled explicitly by most data-analytic methods. To make use of such knowledge about research data, we have developed an ontology-driven temporal mining method, called ChronoMiner. Most mining algorithms require data be inputted in a single table. ChronoMiner, in contrast, can search for interesting temporal patterns among multiple input tables and at different levels of hierarchical representation. In this paper, we present the application of our method to the discovery of temporal associations between newly arising mutations in the HIV genome and past drug regimens. We discuss the various components of ChronoMiner, including its user interface, and provide results of a study indicating the efficiency and potential value of ChronoMiner on an existing HIV drug resistance data repository.

    Title Challenges in the Use of Carbon Nanotubes for Biomedical Applications.
    Date August 2008
    Journal Critical Reviews in Therapeutic Drug Carrier Systems
    Excerpt

    Carbon nanotubes (CNTs) are considered for use in numerous technological applications, including as biocompatible modules for the delivery of bioactives. However, there are unique properties of CNTs that limit their use as vehicles for various purposes. This review highlights the various challenges to a pharmaceutical scientist while exploring CNTs as bioactive delivery vehicles. The lack of solubility, nonbiodegradability, circulation half-life of 3-3.5 hours, biocompatibility, and immunogenicity limitations of CNTs are discussed in this review. These limitations indicate the need for modifications in order to explore the feasibility of CNTs as delivery vehicles.

    Title Gottron's Syndrome.
    Date August 2007
    Journal Indian Journal of Dermatology, Venereology and Leprology
    Excerpt

    An 18-year-old man presented with erythematous hyperkcratotic plaques symmetrically distributed on the extremities of 12 years duration. Histopathology confirmed the clinical diagnosis of symmetrical progressive erythrokeratoderma.

    Title Fast Thermo-optical Excitability in a Two-dimensional Photonic Crystal.
    Date June 2007
    Journal Physical Review Letters
    Excerpt

    We experimentally demonstrate excitability in a semiconductor two-dimensional photonic crystal. Excitability is a nonlinear dynamical mechanism underlying pulselike responses to small perturbations in systems possessing one stable state. We show that a band-edge photonic crystal resonator exhibits class II excitability, resulting from the nonlinear coupling between the high-Q optical mode, the charge-carrier density, and the fast (sub-micros) thermal dynamics. In this context, the critical slowing down of the electro-optical dynamics close to the excitable threshold can delay the optical response by an amount comparable to the duration of the output pulse (5 ns). The latter results from a short thermal dynamical excursion along a high local intensity manifold of the phase space.

    Title Nonadiabatic Dynamics of the Electromagnetic Field and Charge Carriers in High-q Photonic Crystal Resonators.
    Date May 2006
    Journal Physical Review Letters
    Excerpt

    We address, both experimentally and theoretically, phase and amplitude dynamics of the electromagnetic field in a two-dimensional photonic crystal when femtosecond pulses are injected. We demonstrate that the usual adiabatic approximation underlying the dynamics of field and carriers in a semiconductor resonator is no longer valid, since in general the photon lifetime cannot be neglected with respect to the carrier recombination lifetime. Parameter regions where adiabaticity is broken are shown, and the ubiquity of the observed dynamical scenario in the new generation of active photonic microresonators is predicted.

    Title A Simple Method of Measuring Total Daily Energy Expenditure and Physical Activity Level from the Heart Rate in Adult Men.
    Date April 2006
    Journal European Journal of Clinical Nutrition
    Excerpt

    To evaluate a simple method that uses only a heart rate monitor to predict total energy expenditure (TEE) and physical activity level (PAL) from 24 h heart rate (HR) measurements.

    Title Contrast Statistics for Foveated Visual Systems: Fixation Selection by Minimizing Contrast Entropy.
    Date January 2006
    Journal Journal of the Optical Society of America. A, Optics, Image Science, and Vision
    Excerpt

    The human visual system combines a wide field of view with a high-resolution fovea and uses eye, head, and body movements to direct the fovea to potentially relevant locations in the visual scene. This strategy is sensible for a visual system with limited neural resources. However, for this strategy to be effective, the visual system needs sophisticated central mechanisms that efficiently exploit the varying spatial resolution of the retina. To gain insight into some of the design requirements of these central mechanisms, we have analyzed the effects of variable spatial resolution on local contrast in 300 calibrated natural images. Specifically, for each retinal eccentricity (which produces a certain effective level of blur), and for each value of local contrast observed at that eccentricity, we measured the probability distribution of the local contrast in the unblurred image. These conditional probability distributions can be regarded as posterior probability distributions for the "true" unblurred contrast, given an observed contrast at a given eccentricity. We find that these conditional probability distributions are adequately described by a few simple formulas. To explore how these statistics might be exploited by central perceptual mechanisms, we consider the task of selecting successive fixation points, where the goal on each fixation is to maximize total contrast information gained about the image (i.e., minimize total contrast uncertainty). We derive an entropy minimization algorithm and find that it performs optimally at reducing total contrast uncertainty and that it also works well at reducing the mean squared error between the original image and the image reconstructed from the multiple fixations. Our results show that measurements of local contrast alone could efficiently drive the scan paths of the eye when the goal is to gain as much information about the spatial structure of a scene as possible.

    Title Lung Retransplantation After Posttransplantation Lymphoproliferative Disorder (ptld): a Single-center Experience and Review of Literature of Ptld in Lung Transplant Recipients.
    Date October 2005
    Journal The Journal of Heart and Lung Transplantation : the Official Publication of the International Society for Heart Transplantation
    Excerpt

    BACKGROUND: Retransplantation in adult lung transplant recipients developing progressive bronchiolitis obliterans syndrome as a consequence of posttransplantation lymphoproliferative disorder (PTLD) therapy has not been reported in the literature. Literature on PTLD after lung transplantation is limited mostly to case reports or small case series, limiting the validity of conclusions. METHODS: Retrospective chart review of patients at our center. Analysis of pooled data published on lung transplant patients developing PTLD. RESULTS: Two patients who underwent pulmonary retransplants for PTLD have functioning grafts 23 and 36 months postoperatively, with no evidence of PTLD recurrence. Review and analysis of published data and from our center revealed that incidence of PTLD, proportion of patients with thoracic involvement, and proportion of patients who were Epstein-Barr virus seronegative before transplantation decreased continuously as a function of time from transplant. Patients developing PTLD within the first 6 months after transplantation had a clinically distinct pattern of PTLD and a significantly better survival than patients developing PTLD more than 6 months after lung transplant. CONCLUSIONS: Lung retransplantation can be considered after careful selection for lung transplant recipients developing bronchiolitis obliterans syndrome as a consequence of reduced immunosuppression for PTLD. Acquisition of PTLD and pattern of organ involvement is a continuous process as a function of time. Defining "early PTLD" as occurring in the first 6 months more accurately predicts progress and prognosis of this disease than the traditional 1 year definition of early vs late onset PTLD.

    Title Tuning a Two-dimensional Photonic Crystal Resonance Via Optical Carrier Injection.
    Date March 2005
    Journal Optics Letters
    Excerpt

    We report on wide wavelength tuning through optical injection of carriers of a photonic resonance observed in reflectivity at 1543 nm in an InP-based two-dimensional photonic crystal slab. An 8-nm blueshift, which represents 20 times the resonance linewidth, is observed when a 4-kW/cm2 intense optical pump is incident on the sample. An analytical model that we developed, based on a coupled-mode nonlinear approach, allows us to describe this phenomenon in detail.

    Title Genetic Variation Among Temporally and Geographically Distinct West Nile Virus Isolates, United States, 2001, 2002.
    Date February 2004
    Journal Emerging Infectious Diseases
    Excerpt

    Analysis of partial nucleotide sequences of 22 West Nile virus (WNV) isolates collected during the summer and fall of 2001 and 2002 indicated genetic variation among strains circulating in geographically distinct regions of the United States and continued divergence from isolates collected in the northeastern United States during 1999 and 2000. Sequence analysis of a 2,004-nucleotide region showed that 14 isolates shared two nucleotide mutations and one amino acid substitution when they were compared with the prototype WN-NY99 strain, with 10 of these isolates sharing an additional nucleotide mutation. In comparison, isolates collected from coastal regions of southeast Texas shared the following differences from WN-NY99: five nucleotide mutations and one amino acid substitution. The maximum nucleotide divergence of the 22 isolates from WN-NY99 was 0.35% (mean = 0.18%). These results show the geographic clustering of genetically similar WNV isolates and the possible emergence of a dominant variant circulating across much of the United States during 2002.

    Title Effect of the New Medicare Guideline on Patient Qualification for Positive Airway Pressure Therapy.
    Date January 2004
    Journal Sleep Medicine
    Excerpt

    New Medicare criteria for prescribing continuous positive airway pressure (CPAP) recognize hypopnea as a sleep disordered breathing event. In so doing, hypopnea was redefined as requiring a 4% oxygen desaturation. The criteria omit electroencephalogram (EEG) arousals from the definition. This study was designed to assess how the new Medicare guideline changes CPAP eligibility.

    Title Kimura's Disease: Upper Limb Involvement in a Pacific Island Man.
    Date November 2003
    Journal Anz Journal of Surgery
    Title Partially Matched Related Donor Peripheral Blood Progenitor Cell Transplantation in Paediatric Patients Adding Fludarabine and Anti-lymphocyte Gamma-globulin.
    Date July 2003
    Journal Bone Marrow Transplantation
    Excerpt

    Twenty-one paediatric patients (11 males and 10 females) received a CD34-selected partially matched related donor transplant for malignant (16 cases) and non-malignant conditions (five cases). The average cell dose was 11.13 x 10(6)/kg. Fifteen of 16 patients with malignant conditions and one with non-malignant disease received total body irradiation plus cyclophosphamide. Three of 5 patients with non-malignant conditions and one with leukaemia, received busulphan plus cyclophosphamide. One patient with Fanconi anaemia received 100 mg/kg of cyclophosphamide. Fludarabine (25 mg/m(2)/day for 5 days) was administered prior to all these regimens. Additionally, anti-lymphocyte gamma-globulin (12.5 mg/kg/day) was administered from day -2 to day +2. Three (15%) patients failed to achieve complete chimaerism (CC). These patients received a second cell infusion. Two of them achieved CC. In the third patient, the percentage of donor cells was increased. The likelihood for engraftment was not related to the cell dose received. Acute graft-versus-host disease (GVHD) occurred in nine patients but only one developed GVHD >grade II. Eight patients developed active viral infections, which resolved after treatment. Patients receiving cell doses higher than our average had a significantly faster CD3 and CD4 cell recovery and experienced a lower incidence of viral infections. After 480 +/- 255 days of median follow-up, 16/21 patients are alive and well and have CC. Three patients died of leukaemic relapse and a fourth from progression of his disease (adreno-leuko-dystrophy). We conclude that partially matched related donors are a feasible source of haemopoietic progenitor cells for transplantation for patients without matched familial or unrelated donors.

    Title Systemic Lupus Erythematosus in the Intensive Care Unit.
    Date January 2003
    Journal Critical Care Clinics
    Excerpt

    SLE causes significant morbidity and mortality by multisystem organ involvement. Infections are the leading cause of morbidity and mortality in patients with SLE. Meticulous exclusion of infection is mandatory in patients with SLE, because infections may masquerade as exacerbation of underlying disease; and the immunosuppression used to treat severe forms of exacerbation of lupus can have catastrophic consequences in patients with infections. Corticosteroids are the first-line therapy for most noninfectious complications of SLE, with various adjuvant immunosuppressive agents such as cyclophosphamide being increasingly used in combination with plasmapheresis. Some recent series have shown an improved survival rate, but this improvement needs to be confirmed by further studies. Controlled trials comparing various therapeutic options are lacking, and optimal therapy has not been defined.

    Title Scedosporium Apiospermum Fungemia in a Lung Transplant Recipient.
    Date June 2002
    Journal Chest
    Excerpt

    Scedosporium apiospermum, the asexual anamorph of the cosmopolitan fungus Pseudallescheria boydii, is emerging as an important cause of disseminated infection in immunocompromised patients. We present our experience with the first reported case of S apiospermum fungemia in a lung transplant patient. Disseminated infection resulted in sepsis, multiorgan failure, and death. Review of the literature highlights the diagnostic difficulties related to the similarities between S. apiospermum and Aspergillus sp. This superficial resemblance has a significant impact on clinical outcomes considering the inherent resistance of Scedosporium to amphotericin B, the traditional antifungal of choice for disseminated hyalohyphomycoses.

    Title The Influence of Climate Variation and Change on Diarrheal Disease in the Pacific Islands.
    Date May 2001
    Journal Environmental Health Perspectives
    Excerpt

    Freshwater resources are a high-priority issue in the Pacific region. Water shortage is a serious problem in many small island states, and many depend heavily on rainwater as the source of their water. Lack of safe water supplies is an important factor in diarrheal illness. There have been no previous studies looking specifically at the relationship between climate variability and diarrhea in the Pacific region. We carried out two related studies to explore the potential relationship between climate variability and the incidence of diarrhea in the Pacific Islands. In the first study, we examined the average annual rates of diarrhea in adults, as well as temperature and water availability from 1986 to 1994 for 18 Pacific Island countries. There was a positive association between annual average temperature and the rate of diarrhea reports, and a negative association between water availability and diarrhea rates. In the second study, we examined diarrhea notifications in Fiji in relation to estimates of temperature and rainfall, using Poisson regression analysis of monthly data for 1978-1998. There were positive associations between diarrhea reports and temperature and between diarrhea reports and extremes of rainfall. These results are consistent with previous research and suggest that global climate change is likely to exacerbate diarrheal illness in many Pacific Island countries.

    Title Human Immunodeficiency Virus Infections in Adolescents.
    Date August 2000
    Journal Adolescent Medicine (philadelphia, Pa.)
    Excerpt

    Human immunodeficiency virus (HIV) infection, once largely confined to adolescents with hemophilia, has come to involve the general adolescent population. Individuals younger than 22 years comprise up to 25% of the people newly infected with HIV. Unsafe sexual practices, intravenous drug abuse, homelessness, psychiatric disorders, and inadequate psychosocial support are only some of the factors that have contributed to the epidemic. Present data indicate that interventions have had a positive impact on adolescent behavior in preventing the continuing spread of the disease, but more needs to be accomplished before we consider the problem controlled. Although proper medical treatment and providing adequate psychological and social support to adolescents who are already infected constitute an important aspect of care, the true solution of the problem lies in altering the behavior and practices that lead to the acquisition of this infection.

    Title Finger Dominance.
    Date October 1999
    Journal Journal of Hand Surgery (edinburgh, Scotland)
    Excerpt

    Two hundred and ninety-eight normal participants were reviewed to assess finger dominance. Participants were recruited from several large hospitals across the north-west of England and the study was done under blind conditions. From the 298 people originally in the trial, six had to be excluded as the dominant finger could not be confirmed with certainty. The index finger was the most dominant in 82.5% of the test group. However, in 10.6% of the test group, the middle finger was found to be the most dominant.

    Title A Piece of My Mind. Crossing Over.
    Date December 1997
    Journal Jama : the Journal of the American Medical Association
    Title Polycythemia Associated with Leiomyoma of the Uterus.
    Date January 1993
    Journal British Journal of Obstetrics and Gynaecology
    Title Pineal-thyroid Relationship in Breast Cancer.
    Date December 1986
    Journal Indian Journal of Cancer
    Title A Case of Acute Sodium Fluoride Intoxication.
    Date June 1970
    Journal The Journal of the Association of Physicians of India
    Title Optical Nonlinearities in Multiple Quantum Wells: New Insight on Band-gap Renormalization.
    Date
    Journal Physical Review. B, Condensed Matter
    Title Optical Reflectivity Studies of Polycrystalline La4bacu
    Date
    Journal Physical Review. B, Condensed Matter
    Title Spurious States in Quasiparticle Theory.
    Date
    Journal Physical Review C: Nuclear Physics
    Title High Contrast Reflection Modulation Near 1.55mum in Inp 2d Photonic Crystals on Silicon Wafer.
    Date
    Journal Optics Express
    Excerpt

    We report on reflection modulation results near 1.55 mum in InP-based two-dimensional photonic crystals. The fabrication technology uses a polymeric bonding technique to integrate the InP thin-slab onto a Silicon wafer. Reflectivity modulation greater than 90% is obtained by pumping at 810 nm with optical excitation densities of 15 muJ/cm(2). The resulting optical broadband modulation is based on the saturation of absorption of InGaAs quantum wells at a photonic mode frequency tunable by lithography.

    Title Continuous-wave Operation of Photonic Band-edge Laser Near 1.55 Microm on Silicon Wafer.
    Date
    Journal Optics Express
    Excerpt

    We report on the continuous-wave operation of a band edge laser at room temperature near 1.55 mum in an InGaAs/InP photonic crystal. A flat dispersion band-edge photonic mode is used for surface normal operation. The photonic crystal slab is integrated onto a Silicon chip by means of Au/In bonding technology, which combines two advantages, efficient heat sinking and broad band reflectivity.

    Title Investigation of the Infrared Properties of Zns:diamond Composites.
    Date
    Journal Optics Letters
    Excerpt

    A tough, IR, transparent dielectric has been fabricated from a sintered ZnS:diamond composite. Far-IR reflectivity measurements of the reststrahlen band with volume fill fractions as large as 33% diamond give results consistent with the predictions of the effective medium approximation.

    Title Hyperprolactinaemia with Amisulpride.
    Date
    Journal Indian Journal of Psychiatry
    Excerpt

    Amisulpride, a substituted benzamide derivative, is a second-generation antipsychotic that preferentially binds to D2/D3 receptors in limbic rather than striatal structures. High dosage preferentially antagonizes postsynaptic receptors, resulting in reduced dopamine transmission; and low dosage blocks presynaptic receptors, resulting in enhanced transmission. Hyperprolactinaemia may occur in patients receiving amisulpride at low dose of 50 mg/day and results in galactorrhoea, amenorrhea and sexual dysfunction. The symptom ameliorates on withdrawing the drug, switching to non-prolactin-elevating drugs, and timely management with dopamine agonist.

    Title Benign Familial Neonatal Convulsions: A Family with a Rare Disorder.
    Date
    Journal Annals of Indian Academy of Neurology
    Excerpt

    The authors report a family from Punjab (India) with 10 members having benign familial neonatal convulsions (also known as benign familial neonatal seizures) in two generations. This disorder is quite rare. The clinical presentation of index case along with the findings of computed tomography of the brain and electroencephalograph is described. Important features of all the family members along with a brief review of the literature are also given.

    Title Rejoinder in Reply to Critical Appraisal on "factitious Schizophrenia".
    Date
    Journal Indian Journal of Psychiatry
    Title Angioneurotic Oedema with Tadalafil: A Rare Case Report.
    Date
    Journal Indian Journal of Psychiatry
    Excerpt

    A case is reported where the patient developed angioneurotic oedema of the lip after the use of tadalafil.1 On withdrawal of tadalafil, complete remission was obtained through required symptomatic treatment. Clinicians should be aware of the possibility of development of angioneurotic oedema in patients undergoing treatment with tadalafil.

    Title Critical Appraisal of an Article on Factitious Schizophrenia.
    Date
    Journal Indian Journal of Psychiatry
    Title Low-dose Oral Interferon {alpha} Possibly Retards the Progression of Idiopathic Pulmonary Fibrosis and Alleviates Associated Cough in Some Patients.
    Date
    Journal Thorax

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