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Mohakud S, Ranjan A, Naik S, Deep N. COVID-19 preparedness for portable x-rays in an Indian hospital - Safety of the radiographers, the frontline warriors. Radiography (Lond) 2020; 26:270-271. [PMID: 32327384 PMCID: PMC7167544 DOI: 10.1016/j.radi.2020.04.008] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/11/2020] [Accepted: 04/13/2020] [Indexed: 12/23/2022]
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Ranjan A, Choubey M, Yada T, Krishna A. Nesfatin-1 ameliorates type-2 diabetes-associated reproductive dysfunction in male mice. J Endocrinol Invest 2020; 43:515-528. [PMID: 31691259 DOI: 10.1007/s40618-019-01136-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/24/2019] [Accepted: 10/25/2019] [Indexed: 12/19/2022]
Abstract
PURPOSE The present study was aimed to demonstrate the recuperative effect of nesfatin-1 on testicular dysfunction in the high-fat diet (HFD)/streptozotocin (STZ)-induced type-2 diabetes mellitus (T2DM) mice. METHOD AND RESULTS Three experimental groups were formed: (1) vehicle control (VC), (2) T2DM mice, (3) T2DM + nesf-1. The mice with blood glucose level higher than 300 mg/dL following HFD and a single dose of STZ were used for the experiment. The T2DM mice showed increases in body mass, blood glucose and insulin levels, reductions in spermatogenesis and steroidogenesis, production of antioxidative enzymes, and disturbed lipid profile. These alterations were all ameliorated by administration of nesfatin-1 at 20 μg/Kg BW for 15 days. Nesfatin-1 treatment also increased the production of testosterone (T), improved insulin sensitivity, and effectively ameliorated the testicular aberrations, and increased spermatogenesis and steroidogenesis. In addition, nesfatin-1 treatment upregulated the PCNA and Bcl2 expression and inhibited the caspase-3 and prohibitin expression in T2DM mice. Nesfatin-1 increased insulin receptor (IR) and GLUT8 expressions, and lactate production, the changes that further substantiate the increase of energy influx to the testis. CONCLUSION Altogether, the results suggest the ameliorative effect of nesfatin-1 against T2DM-associated testicular dysfunctions and improved insulin sensitivity along with promoting T production and fertility in T2DM mice.
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Balusamy SR, Veerappan K, Ranjan A, Kim YJ, Chellappan DK, Dua K, Lee J, Perumalsamy H. Phyllanthus emblica fruit extract attenuates lipid metabolism in 3T3-L1 adipocytes via activating apoptosis mediated cell death. PHYTOMEDICINE : INTERNATIONAL JOURNAL OF PHYTOTHERAPY AND PHYTOPHARMACOLOGY 2020; 66:153129. [PMID: 31794911 DOI: 10.1016/j.phymed.2019.153129] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/20/2019] [Revised: 10/23/2019] [Accepted: 10/29/2019] [Indexed: 06/10/2023]
Abstract
BACKGROUND Phyllanthus emblica L. (Indian gooseberry) is widely used in the Ayurveda for thousands of years to treat health complications including disorders of the immune system, diabetes, and obesity. PURPOSE For the first time, our study aims to demonstrate the molecular mechanisms of the fruit extract of Phyllanthus emblica (PEFE) involved in the promotion of fat cell apoptosis and alleviation of adipogenesis. METHODS The active constituents from PEFE were identified using high performance liquid chromatography-mass spectrometry (HPLC-MS). We carried out the 3-(4, 5-dimethylthiazol-2-yl)-2, 5-diphenyl tetrazolium bromide (MTT) assay to evaluate the cytotoxic effects of PEFE using 3T3-L1 pre-adipocytes. The colonogenic assay was carried out to determine the inhibitory effect of 3T3-L1 adipocytes after PEFE treatment. In addition, inhibition of pancreatic lipase activity was performed and the lipolytic activity of PEFE and digallic acid was compared with the well-known standard drug orlistat. Besides, the molecular interaction and ligand optimization between digallic and adipogenesis/apoptosis markers were also carried out. Furthermore, to confirm fat cell apoptosis we have used several detection methods that includes Hoechst staining, PI staining, Oil staining and qPCR respectively. RESULTS Digallic acid was identified as a major component in the PEFE. The IC50 values of digallic acid and PEFE were found to be 3.82 µg/ml and 21.85 µg/ml respectively. PEFE and digallic acid showed significant anti-lipolytic activity compared to the standard drug orlistat. In the mature adipocytes, PEFE significantly decreased triglyceride accumulation by downregulating adiponectin, PPARγ, cEBPα, and FABP4 respectively. We further analyzed the expression of apoptosis related genes upon PEFE treatment. Apoptotic process initiated through upregulation of BAX and downregulation of BCL2 resulting in an increased caspase-3 activity. In addition, we have also confirmed the apoptosis and DNA fragmentation in 3T3-L1 cells using Hoechst, PI and TUNEL assays. CONCLUSION PEFE negatively regulates adipogenesis by initiating fat cell apoptosis and therefore it can be considered as a potential herbal medicinal product for treating obesity.
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Balusamy SR, Perumalsamy H, Ranjan A, Park S, Ramani S. A dietary vegetable, Moringa oleifera leaves (drumstick tree) induced fat cell apoptosis by inhibiting adipogenesis in 3T3-L1 adipocytes. J Funct Foods 2019. [DOI: 10.1016/j.jff.2019.05.029] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
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Bhardwaj L, Sharma S, Ranjan A, Jindal T. Persistent organic pollutants in lakes of Broknes peninsula at Larsemann Hills area, East Antarctica. ECOTOXICOLOGY (LONDON, ENGLAND) 2019; 28:589-596. [PMID: 31044329 DOI: 10.1007/s10646-019-02045-x] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 04/11/2019] [Indexed: 06/09/2023]
Abstract
Anthropogenic activity in East Antarctica has increased since the last 2-3 decades because of various scientific expeditions. Additionally, global pollution due to various newly introduced pollutants like pesticides is on use since the past century and many factors contribute to contamination even in Antarctica. During thirty fourth Indian Scientific Expedition to Antarctica (ISEA) in austral summer of 2014-2015, fifteen lake water samples were collected from five different lakes at Broknes peninsula, Larsemann Hills, East Antarctica. Persistent Organic Pollutants (POPs) residue levels found in lake water samples varied from 10.33-70.00 pg/mL in five different lakes. Presence of p,p'-DDT was detected in all different lakes but high concentration found in P4 lake water. After study confirms that Broknes peninsula in the Larsemann Hills area, East Antarctica has a trace amount of POPs which is an alarming situation and needs to be investigated further to maintain the pristine environment in Antarctica. The presence of POPs may be attributed to orographic effects, migratory birds, biomagnification and anthropogenic sources. In the future, new emerging pollutants must be analyzed like microplastics, phthalate, Paraxanthene etc.
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Ranjan A, Pey KL, O'Shea SJ. The interplay between drift and electrical measurement in conduction atomic force microscopy. THE REVIEW OF SCIENTIFIC INSTRUMENTS 2019; 90:073701. [PMID: 31370442 DOI: 10.1063/1.5095647] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/11/2019] [Accepted: 06/05/2019] [Indexed: 06/10/2023]
Abstract
In Conduction Atomic Force Microscopy (CAFM), it is sometimes required to monitor electrical data at a single location over an extended period of time. However, thermal drift of the microscope will cause the tip to move with respect to the sample and thus limit the collection of data. We investigate a method to prolong the time a tip dwells at a location by choosing the AFM cantilever to have small spring constants in the lateral directions. The basis of the approach is that the tip can only move (or slip) once the lateral forces caused by drift overcome the friction force pinning the tip to the surface. We demonstrate the effect experimentally using platinum wire tips and diamond coated tips on SiO2 and HfO2 dielectric films. Simultaneous measurement of the current flow and lateral force signals show that the onset of tip slipping correlates with the beginning of a decrease in the measured current flow, and the onset of slip is prolonged for blunt tips or cantilevers having soft lateral spring constants. The approach not only provides a way to improve the CAFM method for time dependent measurements but also assists in interpreting CAFM data in the presence of drift.
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Doddamani P, Ojha V, Prashant A, Manjrekar P, Ranjan A. Sample rejection rate as a major quality indicator: Comparative findings from clinical biochemistry laboratory of two tertiary care hospitals from Southern India. Clin Chim Acta 2019. [DOI: 10.1016/j.cca.2019.03.1541] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Kumar M, Patel A, Jaiswal A, Ranjan A, Mohanta D, Sahu S, Saraswat A, Rao P, Rao T, Mehta V, Ranjith kumar S, Bhattacharyay R, Rajendrakumar E, Malhotra S, Satyamurthy P. Engineering design and development of lead lithium loop for thermo-fluid MHD studies. FUSION ENGINEERING AND DESIGN 2019. [DOI: 10.1016/j.fusengdes.2018.09.016] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Tetzschner R, Nørgaard K, Ranjan A. Effects of alcohol on plasma glucose and prevention of alcohol-induced hypoglycemia in type 1 diabetes-A systematic review with GRADE. Diabetes Metab Res Rev 2018; 34. [PMID: 29135074 DOI: 10.1002/dmrr.2965] [Citation(s) in RCA: 32] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Revised: 10/26/2017] [Accepted: 11/01/2017] [Indexed: 11/10/2022]
Abstract
Because ethanol is thought to be a risk factor for severe hypoglycemia, patients with type 1 diabetes (T1D) are recommended to limit ethanol intake. However, little is known on how ethanol affects plasma glucose and how ethanol-induced hypoglycemia can be prevented. In this study, we systematically reviewed the literature for ethanol effects on plasma glucose and for prevention strategies on ethanol-induced hypoglycemia. Electronic searches on PubMed and Google were conducted in February 2017. Randomized clinical trials and observational studies were included. Studies involved patients with T1D with no history of ethanol abuse. The primary aims were changes in plasma glucose after ethanol intake and prevention strategies for ethanol-induced hypoglycemia. Quality of the studies was assessed by GRADE. Additionally, we searched for guidelines from diabetes associations on their suggested prevention strategies. We included 13 studies. Eight studies reported that ethanol, regardless of administration intravenously or orally, were associated with an increased risk of hypoglycemia due to decrease in plasma glucose, impaired counter-regulatory response, awareness of hypoglycemia, and cognitive function. Five studies did not report an increased risk of hypoglycemia. None of the studies investigated prevention strategies for ethanol-induced hypoglycemia. Recommendations from 13 diabetes associations were included. All associations recommend that ethanol should only be consumed with food intake. The majority of included studies showed that ethanol intake increased the risk of hypoglycemia in patients with T1D. However, the evidence for how to prevent ethanol-induced hypoglycemia is sparse, and further investigations are needed to establish evidence-based recommendations.
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Ranjan A, Raghavan N, O'Shea SJ, Mei S, Bosman M, Shubhakar K, Pey KL. Conductive Atomic Force Microscope Study of Bipolar and Threshold Resistive Switching in 2D Hexagonal Boron Nitride Films. Sci Rep 2018; 8:2854. [PMID: 29434292 PMCID: PMC5809508 DOI: 10.1038/s41598-018-21138-x] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/09/2017] [Accepted: 01/29/2018] [Indexed: 11/09/2022] Open
Abstract
This study investigates the resistive switching characteristics and underlying mechanism in 2D layered hexagonal boron nitride (h-BN) dielectric films using conductive atomic force microscopy. A combination of bipolar and threshold resistive switching is observed consistently on multi-layer h-BN/Cu stacks in the low power regime with current compliance (Icomp) of less than 100 nA. Standard random telegraph noise signatures were observed in the low resistance state (LRS), similar to the trends in oxygen vacancy-based RRAM devices. While h-BN appears to be a good candidate in terms of switching performance and endurance, it performs poorly in terms of retention lifetime due to the self-recovery of LRS state (similar to recovery of soft breakdown in oxide-based dielectrics) that is consistently observed at all locations without requiring any change in the voltage polarity for Icomp ~1–100 nA.
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Ranjan A, Chauhan A, Jindal T. In-silico and in-vitro evaluation of human acetylcholinesterase inhibition by organophosphates. ENVIRONMENTAL TOXICOLOGY AND PHARMACOLOGY 2018; 57:131-140. [PMID: 29272792 DOI: 10.1016/j.etap.2017.12.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/11/2017] [Revised: 08/25/2017] [Accepted: 12/16/2017] [Indexed: 06/07/2023]
Abstract
Organophosphates (OP) inhibit the acetylcholinesterase (AChE) activity and devastate the nervous system of pest however its mode of action is ubiquitous and acts similarly on human AChE (hAChE). Screening of OP was carried out by molecular docking with hAChE using Glide docking module of Schrodinger suite as the structural information of hAChE and OP together as co-crystal structure is rarely available. The docking was done at three different precision levels, high throughput virtual screening (HTVS), standard precision and extra precision. The ranking was done using over all binding energy i.e. dock score and molecular modelling generalized born surface area (MM-GBSA). Investigation reported Tryptophan (Trp86) residue involved in most interactions by forming a π-cation interaction apart from Ser203 on anionic subsite of hAChE. The top rank ligand was Phoxim ethyl phosphonate (PEP) interacting with Trp86, Gly121 and Ser203. However contact with Gly121 was lost during simulation and Asp74 appeared and sustained. Molecular dynamic simulation (GROMACS 4.5.5) of hAChE-PEP complex for 4 × 104 pico-second with SPC16 water system at 310 K temperature explained the evident role of Trp86 in stabilizing the ligand at P-site of the enzyme. Asp74 and Tyr124 were noticed in conveying H-bonds. Trp86 has shown consistent and better stability of bond based on distance between residues and ligand. The top ranked OP i.e. PEP was used to establish a dose response relationship between OP and hAChE. PEP inhibits half of the enzyme activity at concertation of 29.99 μM (calculated by sigmoid plot) at R2 = 0.996 and P < 0.0001.
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Ahmad S, Jin H, Sahoo K, Griffin R, Herman T, Ranjan A. Proton Therapy in Combination With Mild Hyperthermia Enhances Killing of Radio-Resistant Hypoxic Tumor Cells. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.1982] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Kalita J, Naik S, Bhoi SK, Misra UK, Ranjan A, Kumar S. Pontomesencephalic Atrophy and Postural Instability in Wilson Disease. AJNR Am J Neuroradiol 2017; 38:1343-1347. [PMID: 28495941 DOI: 10.3174/ajnr.a5207] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 02/21/2017] [Indexed: 12/28/2022]
Abstract
BACKGROUND AND PURPOSE The MR Parkinsonism index helps in differentiating progressive supranuclear palsy from Parkinson disease and multisystem atrophy. Pontomesencephalic involvement is common in neurologic Wilson disease, but there is no prior study evaluating the MR Parkinsonism index and its indices in Wilson disease. We report the MR Parkinsonism index and its indices in Wilson disease and correlate these changes with clinical severity and postural reflex. MATERIALS AND METHODS Thirteen individuals with neurologic Wilson disease were included, and their clinical details, including neurologic severity, postural reflex abnormality, and location of signal changes on MR imaging, were noted. The 3D BRAVO T1 sequence was used for measurement of the MR Parkinsonism index and its indices. The MR Parkinsonism index and its indices were also obtained in 6 age- and sex-matched controls. The morphometric parameters in Wilson disease were compared with those in with healthy controls and among the patients with and without abnormal postural reflex. RESULTS The midbrain area was reduced in patients with Wilson disease compared with controls (112.08 ± 27.94 versus 171.95 ± 23.66 mm2, P = .002). The patients with an abnormal postural reflex had an increased MR Parkinsonism index and pons-to-midbrain ratio compared with controls, whereas these parameters were equivalent in patients with normal postural reflex and controls. The patients with abnormal postural reflex had more severe illness, evidenced by higher Burke-Fahn-Marsden scores (51.0 ± 32.27 versus 13.75 ± 12.37, P = .04) and neurologic severity grades (2.57 ± 0.53 versus 1.67 ± 0.82, P = .04). CONCLUSIONS An increase in the MR Parkinsonism index in Wilson disease is mainly due to midbrain atrophy and it correlates with neurologic severity and abnormal postural reflex.
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Ranjan A, De Almeida JSFD, Franca TCC, Chauhan A, Ghosh S, Jindal T. Toxicodynamics of Organophosphates with Human Acetylcholinesterase Interaction at Novel Site Trp-86 for Antidote Action. ACTA ACUST UNITED AC 2017. [DOI: 10.22506/ti/2017/v24/i1/149042] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Dinesh DS, Ranjan A, Palit A, Kishore K, Kar SK. Seasonal and nocturnal landing/biting behaviour ofPhlebotomus argentipes(Diptera: Psychodidae). ANNALS OF TROPICAL MEDICINE AND PARASITOLOGY 2016. [DOI: 10.1080/00034983.2001.11813629] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
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Wang F, Ranjan A, Wei D, Wu C. Comment on "A histone acetylation switch regulates H2A.Z deposition by the SWR-C remodeling enzyme". Science 2016; 353:358. [DOI: 10.1126/science.aad5921] [Citation(s) in RCA: 29] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2015] [Accepted: 06/10/2016] [Indexed: 11/02/2022]
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Kalita J, Ranjan A, Misra UK. Outcome of Guillain-Barre syndrome patients with respiratory paralysis. QJM 2016; 109:319-23. [PMID: 26475599 PMCID: PMC4888327 DOI: 10.1093/qjmed/hcv190] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/12/2015] [Accepted: 09/29/2015] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND AND AIMS To evaluate the outcome of patients with Guillain -: Barre syndrome (GBS) having respiratory failure treated with modified intubation policy. DESIGN AND METHODS Consecutive patients with GBS having single breath count below 12 and respiratory rate >30/min were included and their clinical details noted. The patients were intubated and mechanically ventilated (MV) if their PaO2 was <60 mmHg on venturi mask, PaCo2 > 50 mmHg or pH < 7.3. Their electrophysiological subtypes and complications were noted. The hospital mortality and 3 months outcome were compared in MV and those could be managed without MV even with respiratory compromise. RESULTS Out of 369 patients, 102 (27.6%) patients had respiratory compromise who were included in this study. Of the patients with respiratory compromise, 44 (43.1%) were intubated and mechanically ventilated after a median of 4 days of hospitalization. The median duration of MV was 21 (range 1-88) days. The patients with autonomic dysfunction (56.8% vs. 19%), facial weakness (78% vs. 36.2%), bulbar weakness (81.8% vs. 31%), severe weakness (63.8% vs. 31%) and high transaminase level (47.7% vs. 25.9%) needed MV more frequently. In our study, 6.8% patients died and 26.6% had poor outcome which was similar between MV and non-MV patients. The MV patients had longer hospitalization and more complications compared with non-MV group. CONCLUSION In GBS patients with respiratory compromise, conservative intubation does not increase mortality and disability.
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Ranjan A, Schmidt S, Madsbad S, Holst JJ, Nørgaard K. Effects of subcutaneous, low-dose glucagon on insulin-induced mild hypoglycaemia in patients with insulin pump treated type 1 diabetes. Diabetes Obes Metab 2016; 18:410-8. [PMID: 26743775 DOI: 10.1111/dom.12627] [Citation(s) in RCA: 31] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/30/2015] [Revised: 11/22/2015] [Accepted: 12/20/2015] [Indexed: 02/06/2023]
Abstract
AIM To investigate the dose-response relationship of subcutaneous (s.c.) glucagon administration on plasma glucose and on counter-regulatory hormone responses during s.c. insulin-induced mild hypoglycaemia in patients with type 1 diabetes treated with insulin pumps. METHODS Eight insulin pump-treated patients completed a blinded, randomized, placebo-controlled study. Hypoglycaemia was induced in the fasting state by an s.c. insulin bolus and, when plasma glucose reached 3.4 mmol/l [95% confidence interval (CI) 3.2-3.5], an s.c. bolus of either 100, 200, 300 µg glucagon or saline was administered. Plasma glucose, counter-regulatory hormones, haemodynamic variables and side effects were measured throughout each study day. Peak plasma glucose level was the primary endpoint. RESULTS Plasma glucose level increased significantly by a mean (95% CI) of 2.3 (1.7-3.0), 4.2 (3.5-4.8) and 5.0 (4.3-5.6) mmol/l to 6.1 (4.9-7.4), 7.9 (6.4-9.3) and 8.7 (7.8-9.5) vs 3.6 (3.4-3.9) mmol/l (p < 0.001) after the three different glucagon doses as compared with saline, and the increase was neither correlated with weight nor insulin levels. Area under the plasma glucose curve, peak plasma glucose, time to peak plasma glucose and duration of plasma glucose level above baseline were significantly enhanced with increasing glucagon doses; however, these were not significantly different between 200 and 300 µg glucagon. Free fatty acids and heart rates were significantly lower initially after glucagon than after saline injection. Other haemodynamic variables, counter-regulatory hormones and side effects did not differ between interventions. CONCLUSIONS An s.c. low-dose glucagon bolus effectively restores plasma glucose after insulin overdosing. Further research is needed to investigate whether low-dose glucagon may be an alternative treatment to oral carbohydrate intake for mild hypoglycaemia in patients with type 1 diabetes.
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Nandanwar N, Hussain A, Ranjan A, Jadhav S, Ahmed N. Population structure and molecular epidemiology of human clinical multi-drug resistant (MDR) Escherichia coli strains from Pune, India. Int J Infect Dis 2016. [DOI: 10.1016/j.ijid.2016.02.741] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Rai R, Lalchandani A, Singh V, Senthilraj, Godara M, Ranjan A, Kumar A, Singh P, Kumar A. Serum vitamin D level and carotid artery intima-media thickness in CVA infarct patients as a marker of atherosclerosis. Indian Heart J 2015. [DOI: 10.1016/j.ihj.2015.10.305] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022] Open
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Zheng Y, Fernando R, Maples D, Ranjan A. Improving the Effectiveness of Proton Therapy With Nanomedicine. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.1945] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
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Reiband HK, Schmidt S, Ranjan A, Holst JJ, Madsbad S, Nørgaard K. Dual-hormone treatment with insulin and glucagon in patients with type 1 diabetes. Diabetes Metab Res Rev 2015; 31:672-9. [PMID: 25533565 DOI: 10.1002/dmrr.2632] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/10/2014] [Accepted: 12/08/2014] [Indexed: 11/09/2022]
Abstract
Intensive insulin treatment in type 1 diabetes reduces the incidence and slows the progression of microvascular and macrovascular complications; however, it is associated with an increased risk of hypoglycaemia and weight gain. In this review, we propose dual-hormone treatment with insulin and glucagon as a method for achieving near normalization of blood glucose levels without increasing hypoglycaemia frequency and weight gain. We briefly summarize glucagon pathophysiology in type 1 diabetes as well as the current applications of glucagon for the treatment of hypoglycaemia. Until now, the use of glucagon has been limited by the need for reconstitution immediately before use, because of instability of the available compounds; however, stabile compounds are soon to be launched and will render long-term intensive dual-hormone treatment in type 1 diabetes possible.
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Ranjan A, Kalita J, Kumar V, Misra UK. MRI and oxidative stress markers in neurological worsening of Wilson disease following penicillamine. Neurotoxicology 2015; 49:45-9. [PMID: 26004675 DOI: 10.1016/j.neuro.2015.05.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/18/2015] [Revised: 04/27/2015] [Accepted: 05/11/2015] [Indexed: 01/08/2023]
Abstract
BACKGROUND AND AIM There is no report of MRI correlation with neurological worsening following chelating treatment in Wilson disease with neurological manifestation (WDN). We report radiological changes in four patients with WDN who worsen after penicillamine. METHODS WDN was diagnosed on the basis of clinical, KF ring, serum ceruloplasmin and 24h urinary copper. Hematological, biochemical and cranial MRI were repeated at the time of clinical deterioration following chelating treatment. RESULTS Four WDN patients had neurological deterioration within 4-8 weeks of penicillamine therapy. This was associated with new lesions in white matter, thalamus, pons and mid brain and these lesions showed diffusion restriction. The neurologic deterioration was associated with increased free serum copper and malanodialdehyde and reduced glutathione. Clinical conditions stabilized after few weeks of penicillamine discontinuation. CONCLUSION Neurological worsening was associated with new lesions on MRI which revealed diffusion restriction. Increased free copper induced oxidative stress may be responsible for these changes.
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Tripathi UC, Nagaraja SB, Tripathy JP, Sahu SK, Parmar M, Rade K, Bhatnagar S, Ranjan A, Sachdeva KS. Follow-up examinations: are multidrug-resistant tuberculosis patients in Uttar Pradesh, India, on track? Public Health Action 2015; 5:59-64. [PMID: 26400602 DOI: 10.5588/pha.14.0095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2014] [Accepted: 11/25/2014] [Indexed: 11/10/2022] Open
Abstract
SETTING All multidrug-resistant tuberculosis (MDR-TB) patients who had completed 6 months of treatment under the Revised National Tuberculosis Control Programme (RNTCP) in Uttar Pradesh, the largest state in northern India. OBJECTIVE To determine the proportion of MDR-TB patients with regular follow-up examinations, and underlying provider and patient perspectives of follow-up services. METHODS A retrospective cohort study was undertaken involving record reviews of 64 eligible MDR-TB patients registered during April-June 2013 in 11 districts of the state. Patients and programme personnel from the selected districts were interviewed using a semi-structured questionnaire. RESULTS A total of 34 (53.1%) patients underwent follow-up sputum culture at month 3, 43 (67.2%) at month 4, 36 (56.3%) at month 5 and 37 (57.8%) at month 6. Themes associated with irregular follow-up that emerged from the interviews were multiple visits, long travel distances, shortages of equipment at the facility and lack of knowledge among patients regarding the follow-up schedule. CONCLUSION The majority of the MDR-TB patients had irregular follow-up visits. Provider-related factors outweigh patient-related factors on the poor follow-up examinations. The programme should focus on the decentralisation of follow-up services and ensure logistics and patient-centred counselling to improve the regularisation of follow up.
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Ranjan A, Bhudia N, McGovern I, Walker C, Kuppurao L. Levosimendan: use, cost-effectiveness and outcome in a tertiary cardiothoracic centre. Crit Care 2015. [PMCID: PMC4473041 DOI: 10.1186/cc14232] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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