Publications by authors named "Chirag Desai"

The impact of surgical resection for chronic pancreatitis on subsequent endocrine outcomes remains unclear. A single-center analysis of patients with chronic pancreatitis who underwent either a parenchymal-preserving surgery (PPS) or a total pancreatectomy (TP) with/without islet autotransplantation (IAT) between 2018 and 2024 was performed. Preoperative and postoperative changes in hemoglobin A1C (HbA1C) and long-acting insulin dose were compared.

View Article and Find Full Text PDF

MicroRNAs or miRNAs are characterized as non-coding RNAs, and these are the critical regulators of gene expression post-transcription. Emerging evidence highlights their important role in both the progression and repression of cancer. miRNAs, found in both primary tumor cells and circulation, not only regulate primary tumor development but also regulate metastatic progression by affecting the behavior of primary tumor cells and resident cells at distant organs.

View Article and Find Full Text PDF

Objectives: Pain control following surgery for chronic pancreatitis presents a significant challenge. Options like epidurals used in parenchymal preserving pancreatic surgery (PPS) are contraindicated in certain settings such as total pancreatectomy (TP) with islet cell auto-transplantation (IAT). Our aim is to assess the efficacy and safety of ketamine in these patients and compare it to that of epidural analgesia.

View Article and Find Full Text PDF

Background: Intraductal papillary mucinous neoplasms (IPMNs) are premalignant lesions with established surveillance and surgical resection guidelines. This systematic review aims to provide evidence-based guidance for managing IPMNs in transplant patients.

Methods: A search of MEDLINE, Embase, and Scopus identified studies published between January 1, 2004, and July 31, 2024, describing transplant candidates or recipients with IPMNs.

View Article and Find Full Text PDF

Living donor transplantation constitutes a small portion of total transplants in the United States as compared Southeast Asia and Middle East. Recent consensus meeting has identified reluctance on the part of transplant providers and donor financial concerns as the major hindrance in increasing the Living donor liver transplants in US. There is a need to carefully analyze the recent outcome data from across the globe and from large volume North American centers that clearly establishes the benefit of Living donor transplants for both adults and children and reducing wait list mortality.

View Article and Find Full Text PDF

Background: Worldwide, lung cancer stands as a leading cause of mortality, with EGFR-mutated metastatic non-small cell lung cancer (NSCLC) accounting for a large percentage of cases in the Indian population. Different generations of EGFR-tyrosine kinase inhibitors (TKIs) are available to treat EGFR-mutated NSCLC. The purpose of our research was to evaluate and compare the superiority of osimertinib over gefitinib/erlotinib in terms of clinical effectiveness and safety.

View Article and Find Full Text PDF

This research aims to optimize adjuvant ovarian function suppression (OFS) for premenopausal Indian women with hormone receptor-positive (HR+) /human epidermal growth factor receptor 2-negative (HER2-) early breast cancer (eBC). To address specific challenges identified in clinical practice, a comprehensive questionnaire consisting of 21 statements was developed. These statements were reviewed and validated by a scientific committee, ensuring their accuracy and relevance to the study's objectives.

View Article and Find Full Text PDF
Article Synopsis
  • * A study reviewed 261 liver transplant patients, finding that 9 had prior bariatric surgery, and 33% of those experienced biliary complications, primarily in patients with Roux-en-Y or biliopancreatic diversion surgeries.
  • * Effective management of these complications included advanced endoscopic techniques and surgical revisions, with no recurrent strictures observed by the study's end, highlighting the importance of a multidisciplinary approach.
View Article and Find Full Text PDF

Background: Despite genetic testing being recommended by international guidelines for the selection of targeted therapy for prostate cancer (PCa), limited data are available on genetic testing for PCa in India.

Objectives: The objective is to understand the current genetic testing practice pattern for PCa in India.

Materials And Methods: A panel of 9 experts developed and validated a premeeting online questionnaire comprising 12 objective questions.

View Article and Find Full Text PDF

Context.—: Recently, a new type of antibody-drug conjugate, trastuzumab-deruxtecan (T-DXd), has been approved for the treatment of metastatic breast cancer with low level of human epidermal growth factor receptor 2 (HER2) gene expression. Thereby, eligibility relies on an accurate diagnosis of HER2-low status defined by immunohistochemistry IHC 1+/2+ with no gene amplification.

View Article and Find Full Text PDF

The global demographic and epidemiological transition have led to a rapidly increasing burden of cancer, particularly among older adults. There are scant data on the prevalence and demographic pattern of cancer in older Indian persons. This was a multicentric observational study conducted between January 2019 and December 2020.

View Article and Find Full Text PDF

Introduction: Surgeries for chronic pancreatitis are tailored based on disease process and either include parenchymal-preserving surgeries or total pancreatectomy with or without islet cell autotransplantation. It is critical to account for vascular variants as injuries to these are associated with short- and long-term morbidity and mortality. There is a lack of contemporary data on the true incidence of aberrant arterial anatomy, and it is likely to be underreported by nonhepatobiliary radiologists.

View Article and Find Full Text PDF

Biliary strictures afterlivertransplant are amenable to endoscopic dilatation or percutaneous dilatation and stenting in most cases. In rare cases, for recurrence or tight stricture, surgery is required, and hepaticojejunostomy is the favored procedure. We report a case of posttransplant stricture in a duct-to-duct anastomosis that could not be accessed due to prior gastric bypass.

View Article and Find Full Text PDF
Article Synopsis
  • The study aimed to assess the effects of ligating the gastroduodenal artery during liver transplants on preventing hepatic artery thrombosis and overall patient outcomes.
  • Researchers reviewed data from 210 liver transplant procedures performed between 2016 and 2021, comparing patients who had the artery ligated versus those who did not.
  • Results indicated that while there was no hepatic artery thrombosis in either group, patients with ligation experienced higher rates of postoperative hyperamylasemia and delayed feeding symptoms compared to the non-ligated group.
View Article and Find Full Text PDF

The COVID-19 pandemic has had a remarkable impact on the field of liver transplantation. Increasing evidence demonstrates a minimal risk of transmission of SARS-CoV-2 from non-lung donors who test positive for SARS-CoV-2; however, the risks of donor-derived SARS-CoV-2 from liver donors are unknown. We present our experience with two cases in which a liver was transplanted successfully from a brain-dead donor with incidental SARS-CoV-2 infection.

View Article and Find Full Text PDF

Introduction: Chronic pancreatitis and recurrent acute pancreatitis comprise a spectrum of disease that results in complications related to exocrine and endocrine insufficiency and chronic pain with narcotic dependence and poor quality of life. The mainstay of therapy has been medical and endoscopic therapy; surgery, especially total pancreatectomy, was historically reserved for few select patients as the obligate exocrine insufficiency and pancreatogenic diabetes (type 3C) are challenging to manage. The addition of islet cell autotransplantation after total pancreatectomy helps to mitigate brittle type 3c diabetes and prevents mortality related to severe hypoglycemic episodes and hypoglycemic unawareness.

View Article and Find Full Text PDF

In advanced Renal Cell Carcinoma (aRCC), systemic therapy is the mainstay of treatment, with no or little role for surgery in these patients. Tyrosine kinase inhibitors (TKIs) and immune-oncological (IOs) therapies, either alone or in combination, are recommended in these patients depending on patient and tumour factors. The sequencing of therapies is critical in RCC because the choice of subsequent line therapy is heavily dependent on the response and duration of the previous treatment.

View Article and Find Full Text PDF

Total pancreatectomy (TP) and islet cell autotransplantation (IAT) are complex operations that require intensive postoperative monitoring with standardized protocols. There are few studies detailing immediate perioperative management. The purpose of this study was to describe the perioperative management of post-pancreatectomy patients in the first week following surgery to guide clinicians in addressing salient points from different organ systems.

View Article and Find Full Text PDF

Background: The phase 3 JAVELIN Bladder 100 trial showed significantly prolonged overall survival (OS) with avelumab first-line maintenance + best supportive care (BSC) vs. BSC alone in patients with advanced urothelial carcinoma (UC) that had not progressed with first-line platinum-containing chemotherapy. Here, efficacy and safety were assessed from the initial analysis of the JAVELIN Bladder 100 trial (data cutoff October 21, 2019) in patients enrolled in Asian countries.

View Article and Find Full Text PDF