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Malik A, Siraj F, Shruti S, Gupta P, Khullar G, Ramesh V. Clinicopathological Concordance in 2216 Cases of Skin Biopsy over One Year: An Indian Experience. Cureus 2020; 12:e7752. [PMID: 32455069 PMCID: PMC7243079 DOI: 10.7759/cureus.7752] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
Introduction To determine the spectrum of diseases and the level of clinicopathological concordance in skin biopsies received over a period of one year. Methods A total of 2216 skin biopsy cases received over a period of one year at a tertiary care center were retrospectively analyzed. The cases were further divided into further categories in levels of concordance based on the agreement between the clinical and histopathological diagnosis rendered. Results Of the cases, 61.01% showed clinicopathological concordance. Cases with a descriptive pathological diagnosis, not matching the clinical diagnosis, constituted 31.54%, whereas 4.02% of cases had a definitive pathological diagnosis, which was discordant with the clinical differentials; 3.29% biopsies were inadequate. Conclusion This study highlights the clinicopathological concordance in all the biopsies received from dermatology. It emphasizes the importance of skin biopsies in arriving at the diagnosis. However, it is a tool that must be used judiciously. Skin biopsies are also pivotal in flagging malignancies that may mimic benign lesions.
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Gupta J, Khunger N, Ramesh V. Comparative study of three different modalities of topical anesthesia in various dermatological procedures. INDIAN JOURNAL OF DRUGS IN DERMATOLOGY 2020. [DOI: 10.4103/ijdd.ijdd_43_18] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Khullar G, Bhandari M, Sharma S, Ramesh V. Curious case of coexistence of erythema induratum and penile papulonecrotic tuberculid. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2020. [DOI: 10.4103/ijdpdd.ijdpdd_36_20] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Rao G, Ramesh V, Ramachandran D, Chakravarthy AK. WATER MEDIATED ONE-POT, FOUR COMPONENT SYNTHESIS OF 3,3-DIMETHYL-13-ARYL-3,4-DIHYDRO-1H-INDAZOLO[1,2-b]PHTHALAZINE-1,6,11(2H,13H)-TRIONES. EUROPEAN CHEMICAL BULLETIN 2019. [DOI: 10.17628/ecb.2019.8.339-342] [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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Singh S, Capoor MR, Varshney S, Gupta DK, Verma PK, Ramesh V. Epidemiology and Antifungal Susceptibility of Infections Caused by Trichosporon Species: An Emerging Non- Candida and Non- Cryptococcus Yeast Worldwide. Indian J Med Microbiol 2019; 37:536-541. [PMID: 32436877 DOI: 10.4103/ijmm.ijmm_19_146] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Introduction Over the past four decades, there has been an increase in the number of fatal opportunistic invasive trichosporonosis cases especially in immunocompromised hosts. Objective The objective of the study is to evaluate the epidemiological, clinical details and antifungal susceptibility pattern of the patients with Trichosporon infections. Materials and Methods Twenty-four clinical isolates of Trichosporon species isolated from blood, samples, pleural fluid and nail were included in this study, over a period of 12 years (2005-2016) in a tertiary hospital in North India. The isolates were characterised phenotypically and few representative isolates were sequenced also. The minimum inhibitory concentration (MIC) was determined as per Clinical and Laboratory Standards Institute, 2012. Results Trichosporon spp. from blood culture (57.78%), nail (37.5%) and pleural fluid (4.17%). On phenotypic tests, 79.16% of the isolates were Trichosporon asahii, followed by Trichosporon dermatis (8.33%), Trichosporon japonicum (4.17%), Trichosporon ovoides (4.17%) and Trichosporon mucoides (4.17%). The MIC range of Trichosporon species from invasive infections were fluconazole (0.06-256 μg/ml), amphotericin B (0.125-16 μg/ml), voriconazole (0.0616-8 μg/ml), posaconazole (0.0616-32 μg/ml) and caspofungin (8-32 μg/ml). The isolates from superficial infection were resistant to fluconazole (0.06-256 μg/ml) and itraconazole (0.125-32 μg/ml), all were susceptible to ketoconazole and while only two were resistant to voriconazole (0.25-4 μg/ml). Conclusion T. asahii was the most common isolate. Disseminated trichosporonosis is being increasingly reported worldwide including India and represents a challenge for both diagnosis and species identification. Prognosis is limited, and antifungal regimens containing triazoles appear to be the best therapeutic approach. In addition, accurate identification, removal of central venous lines and voriconazole-based treatment along with control of underlying conditions were associated with favourable outcomes.
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Ramesh V, Rao GPC, Ramachandran D, Chakravarthy AK. ONE-POT SYNTHESES OF 2-(1H-BENZO[d]OXAZOLE-2-YL)-N-ARYLBENZAMIDES BY SELF-CATALYSIS. EUROPEAN CHEMICAL BULLETIN 2019. [DOI: 10.17628/ecb.2019.8.318-321] [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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Boczonadi V, King MS, Smith AC, Olahova M, Bansagi B, Roos A, Eyassu F, Borchers C, Ramesh V, Lochmüller H, Polvikoski T, Whittaker RG, Pyle A, Griffin H, Taylor RW, Chinnery PF, Robinson AJ, Kunji ERS, Horvath R. Correction: Mitochondrial oxodicarboxylate carrier deficiency is associated with mitochondrial DNA depletion and spinal muscular atrophy-like disease. Genet Med 2019; 21:2163-2164. [PMID: 31028354 PMCID: PMC8075975 DOI: 10.1038/s41436-019-0506-1] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
This Article was originally published under Nature Research's License to Publish, but has now been made available under a [CC BY 4.0] license. The PDF and HTML versions of the Article have been modified accordingly.
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Ramesh V, Rao GPC, Ramachandran D, Chakravarthy AK. Synthesis and Biological Evaluation of Amide Derivatives of Imidazopyridine as Anticancer Agents. RUSS J GEN CHEM+ 2019. [DOI: 10.1134/s1070363219070193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/21/2023]
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Ramesh V, Rajarajan K, Gunasekaran B. Bis(15-crown-5-κ5
O)barium tetrakis(isothiocynato-κN)zinc(II). IUCRDATA 2019. [DOI: 10.1107/s2414314619008885] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
In the title compound, [Ba(C10H20O5)2][Zn(NCS)4], the 15-crown-5 molecules are disordered over two positions with site occupancies of 0.706 (4) and 0.294 (4). The Ba2+ ions are sandwiched between the 15-crown-5 rings and Zn2+ ions are surrounded by four N atoms from the thiocyanate ligands in a distorted tetrahedral geometry. The crystal studied was refined as an inversion twin.
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Purna Chander Rao G, Ramesh V, Ramachandran D, Kalyan Chakravarthy A. Design, Synthesis and Anticancer Evaluation of Novel Furan Sulphonamide Derivatives. RUSS J GEN CHEM+ 2019. [DOI: 10.1134/s1070363219030204] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Ng CH, Kato T, Han C, Wang G, Trivedi M, Ramesh V, Shao D, Gala S, Narayanan S, Tan W, Feng Y, Kasper S. Definition of treatment-resistant depression - Asia Pacific perspectives. J Affect Disord 2019; 245:626-636. [PMID: 30445388 DOI: 10.1016/j.jad.2018.11.038] [Citation(s) in RCA: 33] [Impact Index Per Article: 6.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/29/2018] [Revised: 09/07/2018] [Accepted: 11/03/2018] [Indexed: 01/25/2023]
Abstract
BACKGROUND The lack of uniformity in the definition of treatment resistant depression (TRD) within the Asia-Pacific (APAC) region may have implications for patient management. We aimed to characterize the most commonly used TRD definition in selected APAC countries. METHODS A systematic literature review of TRD definitions in APAC countries was conducted in Medline and Embase (2010-2016) and conference proceedings (2014 and 2016). TRD guidelines (APAC, Europe regional, US, or international) were also searched. An expert-panel explored APAC nuances in TRD definitions to achieve consensus for a regional-level definition. RESULTS Ten guidelines and 89 studies qualified for study inclusion. Among the studies, variations were observed in definitions regarding: number of antidepressants failed (range: ≥1 to ≥3), classes of antidepressants (same or different; 59% did not specify class), duration of previous treatments (range: 4-12 weeks), dosage adequacy, and consideration of adherence (yes/no; 88% of studies did not consider adherence). No TRD-specific guidelines were identified. The emerging consensus from the literature review and panel discussion was that TRD is most commonly defined as failure to ≥2 antidepressant therapies given at adequate doses, for 6-8 weeks during a major depressive episode. LIMITATIONS Few studies provided definitions of TRD used in daily clinical practice, and a limited number of countries were represented in the included studies and expert panel. CONCLUSION Attaining consensus on TRD definition may promote accurate, and possibly early detection of patients with TRD to enable appropriate intervention that may impact patient outcomes and quality of life.
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Bhargava A, Ramesh V, Verma S, Salotra P, Bala M. Revisiting the role of the slit-skin smear in the diagnosis of Indian post-kala-azar dermal leishmaniasis. Indian J Dermatol Venereol Leprol 2019; 84:690-695. [PMID: 30058565 DOI: 10.4103/ijdvl.ijdvl_970_16] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Background Post kala azar dermal leishmaniasis (PKDL) is a neglected dermatosis that develops as a sequel to kala azar after apparent complete treatment. Being a non life threatening condition, patients often delay treatment thereby maintaining a reservoir of infection. The diagnosis of PKDL rests on the demonstration of the parasite in tissue smears, immune diagnosis by detection of parasite antigen or antibody in blood, or detection and quantitation of parasite DNA in tissue specimens. Sophisticated molecular tests are not only expensive but also need skilled hands and expensive equipment. To be useful, diagnostic methods must be accurate, simple and affordable for the population for which they are intended. Aims This study was designed to assess functionality and operational feasibility of slit-skin smear examination. Methods Sensitivity and specificity was evaluated by performing slit-skin smear and histo-pathological examination in 46 PKDL patients and the results were compared with the parasite load in both the slit aspirate and tissue biopsy specimens by performing quantitative Real-time PCR (Q-PCR). Results The slit-skin smear examination was more sensitive than tissue biopsy microscopy. The parasite loads significantly differed among various types of clinical lesions (P < 0.05). The threshold of parasite load for detection by SSS microscopy was 4 parasites/μl in slit aspirate and 60 parasites/μg tissue DNA in tissue biopsy while that for tissue microscopy was 63 parasites/μl and 502 parasites/μg tissue DNA respectively. As detection of Leishmania donovani bodies may be challenging in inexperienced hands, the microscopic structure of these has been detailed along with a comprehensive discussion of pre analytical, analytical and post analytical variables affecting its identification. To facilitate the diagnosis of PKDL, some scenarios have been suggested taking into consideration the clinical, epidemiological, immunological and microscopic aspects. Conclusion Such evidence based medicine helps minimize intuition, systematize clinical experience and provides a diagnostic rationale as sufficient grounds for a clinical decision.
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Ramesh V. To be or not to be an oral pathologist. J Oral Maxillofac Pathol 2019; 23:316-317. [PMID: 31942105 PMCID: PMC6948044 DOI: 10.4103/jomfp.jomfp_323_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Ramesh V, Khullar G. Chronic cutaneous miliary tuberculosis - a forgotten entity. Int J Dermatol 2018; 58:e29-e30. [PMID: 30387135 DOI: 10.1111/ijd.14279] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Revised: 09/08/2018] [Accepted: 10/01/2018] [Indexed: 11/29/2022]
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Verma P, Kaur M, Narula V, Ramesh V, Singh A, Saxena AK. Verrucous eccrine angiomatous hamartoma. Indian J Dermatol Venereol Leprol 2018; 83:367-369. [PMID: 28071609 DOI: 10.4103/0378-6323.197391] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Khullar G, Sharma S, Ramesh V, Mann KK. Blaschkoid distribution of composite syringocystadenoma papilliferum and tubular apocrine adenoma without naevus sebaceous. Clin Exp Dermatol 2018; 44:438-440. [PMID: 30251370 DOI: 10.1111/ced.13753] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/21/2018] [Indexed: 11/30/2022]
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Khullar G, Saxena AK, Ramesh V, Sharma S. Asymptomatic indurated plaque on the tongue in an immunocompetent man. Int J Dermatol 2018; 58:423-424. [PMID: 30229879 DOI: 10.1111/ijd.14225] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/28/2018] [Accepted: 08/22/2018] [Indexed: 11/30/2022]
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Turankar R, Lavania M, Singh I, Singh V, Ahuja M, Pathak V, Jakhmola P, Das L, Darlong J, Hembrom U, Ramesh V, Khanna N, John A, Sengupta U. Paucibacillary Leprosy: Reappraisal using Ziehl-Neelsen staining of slit skin smears and 16S rRNA Real Time Polymerase Chain Reaction of nasal swabs. LEPROSY REV 2018. [DOI: 10.47276/lr.89.3.272] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Saini C, Tarique M, Ramesh V, Khanna N, Sharma A. γδ T cells are associated with inflammation and immunopathogenesis of leprosy reactions. Immunol Lett 2018; 200:55-65. [PMID: 30006101 DOI: 10.1016/j.imlet.2018.07.005] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2018] [Revised: 06/12/2018] [Accepted: 07/10/2018] [Indexed: 01/23/2023]
Abstract
BACKGROUND Leprosy reactions appear episodically in leprosy patients, which lead to high inflammation, morbidity and peripheral nerve damage. The role of Th17 cell has been well studied in leprosy reactions but the role of γδ or unconventional T cells which is an other major source of IL-17 in many diseases, not studied in leprosy reactional episodes. OBJECTIVE The aim of the present study to elucidate the role of γδ T cells in leprosy reactions. METHODOLOGY A total of 40 untreated non-reaction and reactions patients were recruited. PBMCs were isolated and stimulated with M. leprae sonicated antigen (MLSA) for 48 h and immuno-phenotyping was done using flow cytometry. Moreover, γδ T cells were isolated by Magnetic beads technology and mRNA expression of IL-17, IFN-γ, TGF-β and FOXP3 were analyzed by real-time PCR (qPCR) and cytokine was estimated in the culture supernatant by ELISA. RESULTS γδ T cells were significantly increased in both Reversal reaction (RR) and Erythema nodosum leprosum (ENL) reaction patients. These cells produced significant amount of IL-17 and IFN-γ. Furthermore, CD3+TCRγδ+ T cells expressed transient FOXP3 with a low amount of TGF-β in both reactions as compared to stable patients. Moreover, low TGF-β producing TCR-γδ cells were associated with low phosphorylation of STAT5A. CONCLUSION This study will add to our understanding of the immunological features that mediate and regulate the pathogenesis of leprosy and may helpful to reduce the immuno-pathogenesis of leprosy reaction by targeting these cells.
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Batra J, Ramesh V, Molpariya A, Maan KK. Palisaded Encapsulated Neuroma: An Unusual Presentation. Indian Dermatol Online J 2018; 9:262-264. [PMID: 30050817 PMCID: PMC6042183 DOI: 10.4103/idoj.idoj_354_17] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022] Open
Abstract
Palisaded encapsulated neuroma (PEN) is a distinctive benign neural tumor, which usually presents as a solitary skin-colored papule or a nodule. It is a benign lesion and may clinically mimic a cutaneous neurofibroma, melanocytic nevi, or cutaneous schwannoma. Here we report a rare case of multifocal cutaneous PENs and its differentiation from cutaneous schwannomas, which is possible by histopathology.
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Chakrapani B, Ramesh V, Pourna Chander Rao G, Ramachandran D, Madhukar Reddy T, Kalyan Chakravarthy A, Sridhar G. Synthesis and Anticancer Evaluation of 1,2,4-Oxadiazole Linked Imidazothiadiazole Derivatives. RUSS J GEN CHEM+ 2018. [DOI: 10.1134/s1070363218050304] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022]
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Gill J, Faubert B, Tasdogan A, Ramesh V, Morrison S. 202 Utilization of in vivo [U-13C]glucose tracing to identify metabolic alterations in metastatic melanoma cells. J Invest Dermatol 2018. [DOI: 10.1016/j.jid.2018.03.207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Puri P, Nandar SK, Kathuria S, Ramesh V. Effects of air pollution on the skin: A review. Indian J Dermatol Venereol Leprol 2018; 83:415-423. [PMID: 28195077 DOI: 10.4103/0378-6323.199579] [Citation(s) in RCA: 123] [Impact Index Per Article: 20.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
The increase in air pollution over the years has had major effects on the human skin. Various air pollutants such as ultraviolet radiation, polycyclic aromatic hydrocarbons, volatile organic compounds, oxides, particulate matter, ozone and cigarette smoke affect the skin as it is the outermost barrier. Air pollutants damage the skin by inducing oxidative stress. Although human skin acts as a biological shield against pro-oxidative chemicals and physical air pollutants, prolonged or repetitive exposure to high levels of these pollutants may have profound negative effects on the skin. Exposure to ultraviolet radiation has been associated with extrinsic skin aging and skin cancers. Cigarette smoke contributes to premature aging and an increase in the incidence of psoriasis, acne and skin cancers. It is also implicated in allergic skin conditions such as atopic dermatitis and eczema. Polyaromatic hydrocarbons are associated with extrinsic skin aging, pigmentation, cancers and acneiform eruptions. Volatile organic compounds have been associated with atopic dermatitis. Given the increasing levels of air pollution and its detrimental effects on the skin, it is advisable to use strategies to decrease air pollution.
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Shruti S, Siraj F, Ramesh V, Ramesh V. Recurrent pyogenic granuloma over nevus flammeus. Indian J Dermatol Venereol Leprol 2018; 85:236. [PMID: 29547139 DOI: 10.4103/ijdvl.ijdvl_80_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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den Boer M, Das AK, Akhter F, Burza S, Ramesh V, Ahmed BN, Zijlstra EE, Ritmeijer K. Safety and Effectiveness of Short-Course AmBisome in the Treatment of Post–Kala-Azar Dermal Leishmaniasis: A Prospective Cohort Study in Bangladesh. Clin Infect Dis 2018; 67:667-675. [DOI: 10.1093/cid/ciy172] [Citation(s) in RCA: 19] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2017] [Accepted: 03/14/2018] [Indexed: 12/31/2022] Open
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Sethuraman G, Dev T, Kudligi C, Ramesh V. Extensive post-kala-azar dermal leishmaniasis. Indian Dermatol Online J 2018; 9:77. [PMID: 29441312 PMCID: PMC5803956 DOI: 10.4103/idoj.idoj_149_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
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Megalaa N, Thirumurugan K, Kayalvizhi G, Sajeev R, Kayalvizhi EB, Ramesh V, Vargeese A. A comparative evaluation of the anticaries efficacy of herbal extracts (Tulsi and Black myrobalans) and sodium fluoride as mouthrinses in children: A randomized controlled trial. Indian J Dent Res 2018; 29:760-767. [DOI: 10.4103/ijdr.ijdr_790_16] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Shruti S, Siraj F, Singh A, Ramesh V. Epidermodysplasia verruciformis: three case reports and a brief review. ACTA DERMATOVENEROLOGICA ALPINA PANNONICA ET ADRIATICA 2017; 26:59-61. [PMID: 28941263 DOI: 10.15570/actaapa.2017.19] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
Epidermodyplasia verruciformis (EV) is a rare heritable disease that is characterized by an increased susceptibility to infection with specific human papillomavirus (HPV) types due to a defect in cell-mediated immune response to HPV infection. Widespread infection with HPV is responsible for the development of wart-like lesions and pityriasis versicolor-like spots. These individuals have a lifelong risk of developing cutaneous malignancies, especially Bowen's disease and squamous cell carcinoma, mainly in sun-exposed parts. Being the first disease to correlate cancer and viral infection, EV serves as the cornerstone of the understanding of viral oncogenesis. We report three cases of EV, of which one patient subsequently developed Bowen's disease. The patients had multiple hypopigmented papules and plaques of varying sizes that started erupting in childhood and were mainly distributed over sun-exposed parts of the body. Histopathology of the skin biopsies was consistent with EV. One of these patients had started developing an ulcerated plaque over the left clavicle 2 years earlier. A biopsy from the clavicular region also showed histopathological features of Bowen's disease arising in EV. Hence, this clinical review discusses three cases of EV presenting in different age groups with detailed histopathological findings typical for EV.
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Singh VP, Sinha N, Ramesh V, Tewari S, Khan F, Agrawal S. Mutation in the Gene Encoding Sterol Regulatory Element Binding Protein (SREBP-2) in Hyper-Cholesterolaemic Subjects. INT J HUM GENET 2017. [DOI: 10.1080/09723757.2007.11886012] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Bharani V, Ramesh V, Rao RN, Tewari S. Evaluation of gamma glutamyl transferase as a marker of cardiovascular risk, in 200 angiographically proven coronary artery disease patients. Indian Heart J 2017. [PMID: 28648423 PMCID: PMC5485402 DOI: 10.1016/j.ihj.2017.03.010] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
Abstract
Gamma glutamyl transferase (GGT) is emerging as a promising marker for assessing cardiovascular risk. GGT predicts cardiovascular mortality in the population and is positively associated with traditional risk factors for coronary artery disease (CAD). This study was undertaken on 200 north Indian CAD patients diagnosed with coronary angiography to study relation of GGT with risk factors for CAD and severity of CAD. GGT values ranged from 5 to 69U/L and were divided in 4 quartiles. GGT was positively associated with triglyceride (p=0.008) and VLDL cholesterol (p=0.002) in our subjects. Also an increase in total cholesterol from GGT quartile I to quartile IV (p=0.28) was noted.
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Verma S, Singh R, Sharma V, Bumb RA, Negi NS, Ramesh V, Salotra P. Development of a rapid loop-mediated isothermal amplification assay for diagnosis and assessment of cure of Leishmania infection. BMC Infect Dis 2017; 17:223. [PMID: 28335752 PMCID: PMC5363003 DOI: 10.1186/s12879-017-2318-8] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/06/2016] [Accepted: 03/10/2017] [Indexed: 11/10/2022] Open
Abstract
Background Leishmaniasis is a spectrum of diseases with great relevance to public health. Conventional diagnostic methods are time consuming, needing trained personnel. A robust, rapid and cost effective diagnostic test is warranted for on-time diagnosis and field application. Methods We have developed a loop mediated isothermal amplification (LAMP) assay with primers (n = 6) based on Leishmania donovani kDNA for detection of Leishmania infection, using a closed tube to prevent cross-contamination. The assay was used to detect Leishmania infection in biological samples obtained from patients of visceral leishmaniasis (VL), post kala-azar dermal leishmaniasis (PKDL) and cutaneous leishmaniasis (CL). Results The assay was positive for L. donovani, L. tropica and L. major parasites, with the highest sensitivity towards L. donovani (1 fg DNA). The high sensitivity of the assay for detection of L. donovani was reflected in its ability to detect parasite DNA within 30 min of amplification time with a threshold detection limit of ≥25 copies per reaction. The assay detected parasite in 64 of 66 VL blood samples (sensitivity, 96.9%; 95% CI: 89.6-99.2%), 15 of 15 VL bone marrow aspirate samples (sensitivity, 100%; 95% CI:79.6-100%), 65 of 67 PKDL tissue biopsy samples (sensitivity, 97%; 95% CI:89.7-99.2%). The assay was evaluated in a few cases of CL wherein it was found positive in 8 of 10 tissue biopsies (sensitivity, 80%; 95% CI: 49-94.3%). The assay was negative in all control blood (n = 76) and tissue biopsy (n = 24) samples (specificity, 100%; 95% CI: 96.3-100%). Further, the assay was evaluated for its utility in assessment of cure in treated VL and PKDL patients. The assay detected parasite DNA in 2 of 20VL blood samples and 2 of 21 PKDL tissue samples. Out of 4 cases that were positive for parasite DNA at post treatment stage, 2 patients (1VL and 1 PKDL) returned with relapse. Conclusions The study demonstrated a Leishmania genus specific closed tube LAMP assay for reliable and rapid molecular diagnosis of VL and PKDL with potential for application in assessment of cure.
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83
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Molpariya A, Ramesh V. Lichen scrofulosorum: importance of early recognition. Clin Exp Dermatol 2017; 42:369-373. [DOI: 10.1111/ced.13050] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 06/14/2016] [Indexed: 11/28/2022]
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84
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Raj J, Bahuleyan H, Ramesh V, Vanajakshi LD. Soft Computing-Based Traffic Density Estimation Using Automated Traffic Sensor Data under Indian Conditions. CURR SCI INDIA 2017. [DOI: 10.18520/cs/v112/i05/954-964] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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85
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Jha A, Khunger N, Malarvizhi K, Ramesh V, Singh A. Familial Disseminated Cutaneous Glomuvenous Malformation: Treatment with Polidocanol Sclerotherapy. J Cutan Aesthet Surg 2017; 9:266-269. [PMID: 28163461 PMCID: PMC5227083 DOI: 10.4103/0974-2077.197083] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Glomuvenous malformations (GVMs) present as asymptomatic multiple pink-to-blue nodules or plaques. Disseminated lesions are rare, representing 10% of all the cases. Familial cases are caused by mutations in the glomulin gene. A young male presented with multiple bluish-to-dusky red-coloured nodules 10-15 in numbers over the trunk, limbs and buttocks since 12 years of age. They ranged in size from 1 to 3 cm, partially to non-compressible and tender on palpation. There was no history of any systemic complaint. His sister and mother had similar lesions but in a limited distribution. Biopsy showed multiple ectatic dilated vascular channels lined by multiple layers of glomus cells consistent with the diagnosis of GVM. The biopsy of the lesions from the mother and sister also showed similar features. Mutation analysis for glomulin gene could not be done because of the unavailability of the facility at our setting. He underwent sclerotherapy with 3% polidocanol every 2 weeks, and there was significant improvement in the lesions after six sessions of sclerotherapy. The patient is under follow-up and there is no recurrence of the lesions over treated sites after 6 months.
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86
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Nitin M, Ramesh V, Radhakrishnan M. Hemodynamic changes in cervical myelopathy with prone position using non invasive cardiac output monitor. JOURNAL OF NEUROANAESTHESIOLOGY AND CRITICAL CARE 2017. [DOI: 10.1055/s-0038-1646241] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022] Open
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87
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Sharma B, Singh PK, Pandey K, Mittal G, Ramesh V, Deb M. Subcutaneous Cyst due to Medicopsis romeroi in a Diabetic Lepromatous Leprosy Patient: An Interesting Case Report and Review from India. J Clin Diagn Res 2017. [DOI: 10.7860/jcdr/2017/30102.10718] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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88
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Shruti S, Singh A, Ramesh V, Siraj F. Phaeohyphomycosis of the Face Masquerading as Basal Cell Carcinoma in an Immunocompetent Patient. Indian Dermatol Online J 2017; 8:271-273. [PMID: 28761846 PMCID: PMC5518581 DOI: 10.4103/idoj.idoj_294_16] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/10/2023] Open
Abstract
Pheohyphomycosis is a rare heterogeneous group of mycotic infections caused by dermatiaceous (phaeoid) fungi affecting the skin, subcutaneous tissue, and the central nervous system.Involvement of the face is extremely rare, and very few cases have been reported in India so far. We reporta case of phaeohyphomycosisin a 45-year-old female with 1-year history of a well- defined hypertrophic plaque over the right cheek advancing towards the forehead. The lesion was ulcerated with rolled-up margins; a provisional clinical diagnosis of basal cell carcinoma was given. Histopathology of the skin biopsy revealed numerous multinucleated giant cells and fungal hyphae with in and in between the giant cells. Various histochemical stains were used toconfirm the presence of fungal hyphae. Melanin pigment in the fungus was demonstrated with Masson's Fontana stain. Based on the histopathological and histochemical findings, a diagnosis of phaeohyphomycosis was given and it was concluded that the disease was more of a histopathological than clinical diagnosis. This case is being reported due to its unusual presentation and it also highlights the importance of histopathology in the diagnosis of this rare disease.
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89
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Ramesh V. The molecular phylogeny and taxonomy of endophytic fungal species from the leaves of Vitex negundo L. STUDIES IN FUNGI 2017. [DOI: 10.5943/sif/2/1/4] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022] Open
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90
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Dalal V, Kaur M, Rai C, Singh A, Ramesh V. Histopathological spectrum of lichen sclerosus Et atrophicus. INDIAN JOURNAL OF DERMATOPATHOLOGY AND DIAGNOSTIC DERMATOLOGY 2017. [DOI: 10.4103/ijdpdd.ijdpdd_66_16] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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91
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Sheetal, Ramesh V, Balamurali PD, Premalatha B, Chaudhary M. Cystadenoma in Retromolar Region: A Case Report. J Clin Diagn Res 2016; 10:ZD17-ZD18. [PMID: 27891483 DOI: 10.7860/jcdr/2016/20149.8679] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/16/2016] [Accepted: 05/25/2016] [Indexed: 11/24/2022]
Abstract
Cystadenoma is a rare benign salivary gland epithelial tumor that is characterized by intraluminal papillary projection. Majority of the tumors are located in minor salivary glands and usually occur in palatal and buccal mucosa, but rarely found in retromolar area. Clinically it is difficult to differentiate it from other minor salivary gland tumors, and diagnosis is chiefly based on characteristic clinical features and immunohistochemistry. We present a case of Cystadenoma arising from the minor salivary gland in retromolar area of a 44 year old female patient with a special emphasis on the immunohistochemistry to rule out the metastatic follicular carcinoma of thyroid.
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92
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Gupta V, Ramesh V. Understanding cutaneous tuberculosis in children. Int J Dermatol 2016; 56:242-244. [DOI: 10.1111/ijd.13441] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/17/2015] [Accepted: 07/11/2016] [Indexed: 11/27/2022]
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93
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Ramesh V. Alopecias: Practical evaluation and management. Indian J Med Res 2016. [PMCID: PMC5345317 DOI: 10.4103/0971-5916.200879] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022] Open
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94
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Reka SS, Ramesh V. Demand side management scheme in smart grid with cloud computing approach using stochastic dynamic programming. ACTA ACUST UNITED AC 2016. [DOI: 10.1016/j.pisc.2016.04.024] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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95
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Sarojini S, Ramesh V, Senthilkumaar P. Cytotoxicity effect of ethanolic extract of Mikania glomerata against A549 human lung cancer cell line. ACTA ACUST UNITED AC 2016. [DOI: 10.7439/ijasr.v2i7.3512] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The genus Mikania is the largest of its kind in the family Eupatorieae (Asteraceae), with more than 430 species concentrated mainly in the tropical regions, among which, Mikania glomerata is a most common herb generally employed in the treatment of respiratory disorders. The Milania glomerata plant leaf extracts were used for anticancer study against A549 human lung cancer cell line. The solid liquid extraction method has been employed to prepare the ethanol extract of Mikania glomerata through soxhelt apparatus method. To check the anti-proliferative effect of this extract, the extract chosen was tested for cell viability on the lung cancer cells A549 in different concentrations. Cell viability was evaluated by MTT assay for 24 hour and 48 hours. The LD50 value was calculated for the level of cell death and its effectiveness. The dose-dependent manner plays an important role in the treatment of lung cancer cell lines. The present study suggests that Mikania glomerata may be used as an alternative anticancer agent and further research is needed to improve the effectiveness.
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Kaushal H, Bras‐Gonçalves R, Avishek K, Kumar Deep D, Petitdidier E, Lemesre J, Papierok G, Kumar S, Ramesh V, Salotra P. Evaluation of cellular immunological responses in mono- and polymorphic clinical forms of post-kala-azar dermal leishmaniasis in India. Clin Exp Immunol 2016; 185:50-60. [PMID: 26948150 PMCID: PMC4908291 DOI: 10.1111/cei.12787] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/02/2016] [Indexed: 11/28/2022] Open
Abstract
Post-kala-azar dermal leishmaniasis (PKDL) is a chronic dermal complication that occurs usually after recovery from visceral leishmaniasis (VL). The disease manifests into macular, papular and/or nodular clinical types with mono- or polymorphic presentations. Here, we investigated differences in immunological response between these two distinct clinical forms in Indian PKDL patients. Peripheral blood mononuclear cells of PKDL and naive individuals were exposed in vitro to total soluble Leishmania antigen (TSLA). The proliferation index was evaluated using an enzyme-linked immunosorbent assay (ELISA)-based lymphoproliferative assay. Cytokines and granzyme B levels were determined by cytometric bead array. Parasite load in tissue biopsy samples of PKDL was quantified by quantitative polymerase chain reaction (qPCR). The proportion of different lymphoid subsets in peripheral blood and the activated T cell population were estimated using flow cytometry. The study demonstrated heightened cellular immune responses in the polymorphic PKDL group compared to the naive group. The polymorphic group showed significantly higher lymphoproliferation, increased cytokines and granzyme B levels upon TSLA stimulation, and a raised proportion of circulating natural killer (NK) T cells against naive controls. Furthermore, the polymorphic group showed a significantly elevated proportion of activated CD4(+) and CD8(+) T cells upon in-vitro TSLA stimulation. Thus, the polymorphic variants showed pronounced cellular immunity while the monomorphic form demonstrated a comparatively lower cellular response. Additionally, the elevated level of both activated CD4(+) and CD8(+) T cells, coupled with high granzyme B secretion upon in-vitro TSLA stimulation, indicated the role of cytotoxic cells in resistance to L. donovani infection in polymorphic PKDL.
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MESH Headings
- Adolescent
- Adult
- Antigens, Protozoan/pharmacology
- CD4-Positive T-Lymphocytes/immunology
- CD4-Positive T-Lymphocytes/parasitology
- CD4-Positive T-Lymphocytes/pathology
- CD8-Positive T-Lymphocytes/immunology
- CD8-Positive T-Lymphocytes/parasitology
- CD8-Positive T-Lymphocytes/pathology
- Cell Proliferation
- Cytokines/genetics
- Cytokines/immunology
- Cytotoxicity, Immunologic
- Female
- Flow Cytometry
- Gene Expression
- Granzymes/genetics
- Granzymes/immunology
- Humans
- Immunophenotyping
- India
- Killer Cells, Natural/immunology
- Killer Cells, Natural/parasitology
- Killer Cells, Natural/pathology
- Leishmania donovani/immunology
- Leishmania donovani/pathogenicity
- Leishmaniasis, Cutaneous/diagnosis
- Leishmaniasis, Cutaneous/immunology
- Leishmaniasis, Cutaneous/parasitology
- Leishmaniasis, Cutaneous/pathology
- Leishmaniasis, Visceral/diagnosis
- Leishmaniasis, Visceral/immunology
- Leishmaniasis, Visceral/parasitology
- Leishmaniasis, Visceral/pathology
- Leukocytes, Mononuclear/immunology
- Leukocytes, Mononuclear/parasitology
- Leukocytes, Mononuclear/pathology
- Lymphocyte Activation
- Male
- Parasite Load
- Primary Cell Culture
- Skin/immunology
- Skin/parasitology
- Skin/pathology
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Jain S, Ramesh V, Singh A, Yadav A, Ramam M, Khandpur S. Clinical and histopathological features of paucibacillary leprosy before and after multidrug therapy: a prospective study. Trans R Soc Trop Med Hyg 2016; 110:350-8. [PMID: 27317754 DOI: 10.1093/trstmh/trw039] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2016] [Accepted: 05/16/2016] [Indexed: 11/13/2022] Open
Abstract
BACKGROUND Leprosy often heals with residual skin lesions after completion of treatment. WHO recommends fixed duration multidrug therapy (MDT) irrespective of whether lesions clear or persist after treatment. Patients with residual lesions are often unsatisfied and may undergo repeat biopsy and re-treatment. This study was conducted to compare the clinicohistopathological features in paucibacillary leprosy before and after MDT from September 2012 to February 2014. METHODS Sixty-one untreated cases of paucibacillary leprosy were investigated and given standard WHO paucibacillary-MDT for 6 months. Scoring of clinical activity was done; histopathological activity was graded according to granuloma fraction. Forty-four patients who completed the treatment were subjected to post-treatment biopsy. Clinical response to therapy was graded as active, resolving and inactive and histopathological changes were compared in all patients. RESULTS Among the 44 patients, the lesions were inactive, resolving and active in 39% (17/44), 39% (17/44) and 23% (10/44) of patients respectively. Histologically, disease was inactive, resolving and active in 30% (13/44), 9% (4/44) and 61% (27/44). But histomorphological features suggesting regression: loose granulomas (59%, 26/44); lymphocyte predominance (66%, 29/44); vacuolar change in epithelioid cell cytoplasm (59%, 26/44), were statistically significant in post-treatment compared to pre-treatment. CONCLUSIONS Although histological resolution is slower than clinical resolution, qualitative histomorphological changes in correlation with clinical inactivity can offer a fair suggestion to the clinician to terminate therapy.
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Kaur M, Dalal V, Ramesh V, Singh A. Multinucleated giant cells in angiolymphoid hyperplasia with eosinophilia. Indian J Dermatol Venereol Leprol 2016; 82:567-9. [PMID: 27241504 DOI: 10.4103/0378-6323.182977] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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99
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Kasivisvanathan R, Ramesh V, Rao Baikady R, Nadaraja S. Preoperative anaemia is associated with increased allogeneic pack red cell transfusion in revision hip and knee joint arthroplasty: a retrospective analysis of 5387 patients over a 10-year period at a single high volume centre. Transfus Med 2016; 26:271-7. [DOI: 10.1111/tme.12322] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2015] [Revised: 05/01/2016] [Accepted: 05/03/2016] [Indexed: 11/30/2022]
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100
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Kandhari R, Sharma V, Ramesh V, Singh A. Familial reactive perforating collagenosis in three siblings. Indian J Dermatol Venereol Leprol 2016; 80:86-7. [PMID: 24448140 DOI: 10.4103/0378-6323.125488] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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