Browsing by Author "Duvuru, Ruthwik"

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An Incidental Finding of a Gastrointestinal Stromal Tumor in a 62-Year-Old Male: A Case Report
(2022-11) Duvuru, Ruthwik
Abstract: Gastrointestinal stromal tumors (GISTs) are uncommon GI tract cancers that develop from immature mesenchymal cells. It might be difficult to get an early diagnosis of people with small bowel GISTs, which can cause delays in therapy. We present here a case of a 62-year-old male with an incidental finding of a small intestine GIST during the workup for umbilical hernia. He presented with swelling above the umbilicus for the past six months that was progressive in nature and not associated with pain. Computer tomography (CT) of the abdomen with intravenous contrast revealed a heterogeneously enhancing mass lesion in the left paraumbilical intraperitoneal region, and immunohistochemistry results of the CT-guided biopsy showed a GIST. The patient underwent excision of the tumor with segmental resection and anastomosis, and supraumbilical hernia repair. Chemotherapy (imatinib for three years) after suture removal was planned for him.
A rare case of gastric duplication cyst in a male paediatric Caucasian patient: a case report
(2022) Duvuru, Ruthwik; AlAwadhi, Ahmad; Nawaz, Faisal
Abstract: Anywhere in the alimentary canal, you can find a gastric duplication cyst, a spherical muscle formation lined by mucosal membrane. It is an uncommon example of a group of congenital intestinal abnormalities. Gastric cysts typically develop on the stomach’s greater curvature. A Caucasian 4-year-old boy came in with his family after experiencing colicky central stomach pain for 2 days, along with vomiting for 4 days, decreased oral intake, a temperature of up to 38.5◦C and regular bowel movements. A region of the transverse colon with degraded and inf lammatory serosa covered in omentum with black necrotic sections was seen during the procedure.
A Rare Case of Miller Fisher Syndrome in a 45- Year-Old Female
(2023) Duvuru, Ruthwik
Abstract: Miller Fisher syndrome (MFS) is an uncommon form of Guillain-Barré syndrome (GBS), a neurological condition that is acquired, degenerative, demyelinating, and frequently characterized by gradual, symmetrical ascending paralysis. Ophthalmoplegia, ataxia, and areflexia are common symptoms that follow a bacterial or viral infection. Here, we want to draw attention to a rare case of MFS in a 45-year-old Indian female who had dysphagia, dysphasia, ataxia, and dyskinesia while moving around. Unusually, she had no past medical history of Campylobacter jejuni infection, recent vaccinations, upper respiratory tract infections, or any sexually transmitted diseases. Since this disorder has excellent prognosis, early diagnosis and effective treatment are crucial to minimizing unnecessary medical intervention and psychological suffering.
The scope of metaverse in enhancing telepsychiatry training and digital literacy among psychiatrists
(2023) Duvuru, Ruthwik
Introduction: The uptake of telemedicine in healthcare continues to gain popularity and widespread acceptance, particularly in the field of psychiatry. In the wake of robust evidence showing that telepsychiatry practices can improve health outcomes and increases patient satisfaction, policymakers, payers, and providers are increasingly considering ways to incorporate them. The effectiveness of telepsychiatry to provide reliable diagnosis and accurate assessment of cognitive, depressive, anxiety, and psychotic disorders1–5 has been proven. It has also been shown that treatment effectiveness and adherence as well as patients’ satisfaction were similar with video conferencing and in-person follow up.6 In the future, the metaverse may exist parallel to “conventional reality” as a confluence of virtual reality (VR), mixed reality (MR), and augmented reality (AR).7 The metaverse refers to a three-dimensional virtual environment where avatars can engage in social and collaborative activities.8 It is a vastly expandable, persistent network of linked virtual worlds which unifies the physical and digital worlds, allowing people to engage in a setting supported by artificial intelligence (AI), MR and extended reality, VR, and AR—all of which are enhanced by practically limitless data.
The scope of metaverse in enhancing telepsychiatry training and digital literacy among psychiatrists
(2023) Duvuru, Ruthwik
Introduction: The uptake of telemedicine in healthcare continues to gain popularity and widespread acceptance, particularly in the field of psychiatry. In the wake of robust evidence showing that telepsychiatry practices can improve health outcomes and increases patient satisfaction, policymakers, payers, and providers are increasingly considering ways to incorporate them. The effectiveness of telepsychiatry to provide reliable diagnosis and accurate assessment of cognitive, depressive, anxiety, and psychotic disorders1–5 has been proven. It has also been shown that treatment effectiveness and adherence as well as patients’ satisfaction were similar with video conferencing and in-person follow up.6 In the future, the metaverse may exist parallel to “conventional reality” as a confluence of virtual reality (VR), mixed reality (MR), and augmented reality (AR).7 The metaverse refers to a three-dimensional virtual environment where avatars can engage in social and collaborative activities.8 It is a vastly expandable, persistent network of linked virtual worlds which unifies the physical and digital worlds, allowing people to engage in a setting supported by artificial intelligence (AI), MR and extended reality, VR, and AR—all of which are enhanced by practically limitless data.
Statins and Male Fertility: Is There a Cause for Concern?
(2022) Omolaoye, Temidayo S.; Mubarak, Maitha; Cyril, Asha Caroline; Duvuru, Ruthwik; Radhakrishnan, Rajan; Du Plessis, Stefan
Abstract: The well-known 3-hydroxyl 3-methyl glutaryl-Coenzyme A reductase inhibitors, called statins, have been the main medication used in the treatment of hypercholesterolemia and some cases of cardiovascular diseases. The effectiveness of this drug in controlling cholesterol production is impeccable, however, patients often complain of a variety of side effects, such as myalgia, muscle atrophy, and in some cases, rhabdomyolysis. Not only has the use of statins caused the aforementioned side effects, but they are also shown to cause testicular discomfort, erectile dysfunction, altered semen parameters, and modified steroid hormone production. These reported adverse effects on male fertility are not generally agreed upon, as some have shown the use to be beneficial. Hence, this makes the aftermath effect of statin use on male fertility debatable and controversial. The negative effects have been associated with imbalanced or reduced steroid hormones, which are necessary for proper spermatogenesis and other sexual functions. Meanwhile, the beneficial effects are related to statin’s anti-inflammatory and cardioprotective properties. These contradictory findings are in part due to the different age of users, concentrations of statins, the type and duration of treatment, and the underlying disease and/or comorbidities. Therefore, the current study aims to analyze the literature and gather evidence as to the effects of statin on male sexual health and reproductive parameters, and subsequently give recommendations for the direction of future studies.
A successful management of left-sided posterior congenital diaphragmatic hernia of the jejunum, ileum, colon and left kidney: a case report
(2022-10) Al-Abdullah, Zainab; Duvuru, Ruthwik; Nawaz, Faisal A; Ennab, Farah
Abstract: Congenital diaphragmatic hernia (CDH) is a rare developmental anomaly in which abdominal contents herniate into the thoracic cavity due to underdevelopment of the diaphragm, possibly leading to pulmonary hypoplasia. Whereas surgery is not the first priority in treatment, it must be performed within a window of 2 weeks and after hemodynamic stability has been achieved. The patient described in this case report had a CDH of the jejunum, ileum, colon and left kidney diagnosed in a boy of South Asian origin who presented with tachypnea in the third hour of life. Imaging studies conducted included chest X-ray, chest ultrasound including echocardiogram, and abdominal and pelvic ultrasound. Treatment and management were successful despite complications. Future research on CDH is warranted in the populations in the Middle East, and local guidelines must be generated in order to improve diagnosis, treatment and prognosis.
Thanatogenomic Investigation of the Hydroxymethylome and Mitochondrial Genome of Cadaveric Cardiomyocytes: Proposal for a Proof-of-Concept Study
(2020) Naidoo, N; Duvuru, Ruthwik; Banerjee, Yajnavalka
Background: Cardiovascular disease (CVD) remains the leading cause of death in the United Arab Emirates (UAE). One of the common CVDs is hypertrophic cardiomyopathy (HCM). Recent studies conducted in heart cells of mice have shown that this condition involves a chemical modification called hydroxymethylation of the DNA of heart cells. Objective: Objectives of the proposed research are to profile the distribution of 5-hydroxymethylation in the cardiomyocyte (CMC) genome of cadaveric cardiac tissue and cardiac biopsy specimens; to compare the hydroxymethylome of cadaveric CMCs with that of cardiac biopsy specimens from HCM patients and/or cardiac transplant patients (control) undergoing cardiac catheterization; to histologically appraise sarcomere distribution and mitochondrial morphology of CMCs in the presence of HCM; to correlate the mitochondrial genome with the HCM phenotype; and to integrate anatomy with biochemistry and genetics into the instructional design of HCM in the core medical curriculum at Mohammed Bin Rashid University of Medicine and Health Sciences (MBRU). Methods: Normal and hypertrophic heart specimens will be obtained from 8 whole-body cadavers (2/8, 25% control and 6/8, 75% HCM). Myocardial biopsy specimens will be obtained from cardiothoracic and transplant units at the Cleveland Clinic in Abu Dhabi, UAE. As this is a proof-of-concept study, we plan to recruit 5 patients with HCM, where HCM has been diagnosed according to the guidelines of the 2014 European Society of Cardiology Guidelines. Patients with valvular heart disease, history of myocarditis, regular alcohol consumption, or cardiotoxic chemotherapy will be excluded. The control biopsy specimens will be obtained from patients who had received heart transplants. Three investigational approaches will then be employed: (1) gross anatomical evaluation, (2) histological analysis, and (3) profiling and analysis of the hydroxymethylome. These investigations will be pursued with minor modifications, if required, to the standard protocols and in accordance with institutional policy. The objective associated with the education of health professionals will be addressed through a strategy based on Graham’s knowledge translation model. Results: This study is at the protocol-development stage. The validated questionnaires have been identified in relation to the objectives. The MBRU and the Cleveland Clinic Abu Dhabi Institutional Review Board (IRB) are reviewing this study. Further clarification and information can be obtained from the MBRU IRB. There is funding in place for this study (MBRU-CM-RG2019-08). Currently, we are in the process of standardizing the protocols with respect to the various molecular techniques to be employed during the course of the study. The total duration of the proposed research is 24 months, with a provision for 6 months of a no-cost extension.