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Gupta A, Loftus EV, De Felice KM, Khanna S. Letter: cytomegalovirus colitis in a patient treated with ipilimumab for metastatic melanoma - authors' reply. Aliment Pharmacol Ther 2016; 43:176. [PMID: 26638940 DOI: 10.1111/apt.13467] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/08/2022]
Affiliation(s)
- A Gupta
- Department of Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - E V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - K M De Felice
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S Khanna
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
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Bima C, Zimmitti G, Ongaro R, Szichta N, Iuliani R, Rolfo G, Warren J, Carbonell A, Tran H, Tran M, Zajkowska M, Hawthorne W, Tantia O, Chaudhuri T, Khanna S, Cavalini WP, Loureiro M, Loi K, Darecchio A, Violi V, Bocchi P, Kukleta JF, Augenstein V, Huntington C, Cox T, Lopez R, Heniford BT, Akiyama G, Uematsu D, Yamamoto K, Sugihara T, Magishi A. Topic: Recent Innovations in Hernia Surgery. Hernia 2015; 19 Suppl 1:S375-8. [PMID: 26518858 DOI: 10.1007/bf03355403] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Affiliation(s)
- C Bima
- Ospedale Cottolengo, Torino, Italy
| | | | - R Ongaro
- Ospedale Cottolengo, Torino, Italy
| | | | | | - G Rolfo
- Ospedale Cottolengo, Torino, Italy
| | - J Warren
- Greenville Health System, Greenville, USA
| | | | - H Tran
- University of Sydney, Sydney, Australia
| | - M Tran
- Sydney Hernia Specialists Clinic, Sydney, Australia
| | - M Zajkowska
- Sydney Hernia Specialists Clinic, Sydney, Australia
| | | | | | | | | | | | - M Loureiro
- Instituto Jacques Perissat, Curitiba, Brazil.,Mestrado em Biotecnologia, Universidade Positivo, Curitiba, Brazil
| | - K Loi
- St George Private Hospital, Sydney, Australia
| | - A Darecchio
- Parma University School of General Surgery, Fidenza, Italy
| | - V Violi
- Parma University School of General Surgery, Fidenza, Italy
| | - P Bocchi
- Valparma Hospital, Langhirano, Italy
| | - J F Kukleta
- Faculty of Medicine, University of Zurich, Zurich, Switzerland
| | - V Augenstein
- Department of GI and MInimally Invasive Surgery, Carolinas Medical Center, Charlotte, USA
| | - C Huntington
- Department of GI and MInimally Invasive Surgery, Carolinas Medical Center, Charlotte, USA
| | - T Cox
- Department of GI and MInimally Invasive Surgery, Carolinas Medical Center, Charlotte, USA
| | - R Lopez
- Department of Radiology, Carolinas Medical Center, Charlotte, USA
| | - B T Heniford
- Department of GI and MInimally Invasive Surgery, Carolinas Medical Center, Charlotte, USA
| | - G Akiyama
- Saku Advanced Care Center, Saku city, Japan
| | - D Uematsu
- Saku Advanced Care Center, Saku city, Japan
| | - K Yamamoto
- Saku Advanced Care Center, Saku city, Japan
| | - T Sugihara
- Saku Advanced Care Center, Saku city, Japan
| | - A Magishi
- Saku Advanced Care Center, Saku city, Japan
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Khanna S, Qureshi M, Agarwal A, Ahuja D, Hirsch A. Disparities in Time from Diagnosis to Treatment in Breast Cancer Patients at a Diverse Academic Medical Center. Int J Radiat Oncol Biol Phys 2015. [DOI: 10.1016/j.ijrobp.2015.07.636] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/22/2022]
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Gupta A, De Felice KM, Loftus EV, Khanna S. Letter: anti-CTLA-4-associated colitis and inflammatory bowel disease pathogenesis--authors' reply. Aliment Pharmacol Ther 2015; 42:1032-3. [PMID: 26374261 DOI: 10.1111/apt.13373] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/15/2022]
Affiliation(s)
- A Gupta
- Department of Internal Medicine, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - K M De Felice
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - E V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S Khanna
- Department of Internal Medicine, University of Texas, Southwestern Medical Center, Dallas, TX, USA. .,Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
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Gupta A, De Felice KM, Loftus EV, Khanna S. Systematic review: colitis associated with anti-CTLA-4 therapy. Aliment Pharmacol Ther 2015; 42:406-17. [PMID: 26079306 DOI: 10.1111/apt.13281] [Citation(s) in RCA: 186] [Impact Index Per Article: 20.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/10/2015] [Revised: 03/11/2015] [Accepted: 05/27/2015] [Indexed: 02/06/2023]
Abstract
BACKGROUND Cytotoxic T-lymphocyte-associated protein-4 (CTLA-4) has an important role in T-cell regulation, proliferation and tolerance. Anti-CTLA-4 agents, such as ipilimumab and tremelimumab, have been shown to prolong overall survival in patients with metastatic melanoma, and their use is being investigated in the treatment of other malignancies. Their novel immunostimulatory mechanism, however, predisposes patients to immune-related adverse effects, of which gastrointestinal effects such as diarrhoea and colitis are the most common. AIMS To discuss the existing literature and summarise the epidemiology, pathogenesis and clinical features of anti-CTLA-4-associated colitis, and to present a management algorithm for it. METHODS We searched PubMed for studies published through October 2014 using the terms 'anti-CTLA,' 'ipilimumab,' 'tremelimumab,' 'colitis,' 'gastrointestinal,' 'immune-related adverse effect,' 'immunotherapy,' 'melanoma,' and 'diarrhoea.' RESULTS Watery diarrhoea is commonly associated with anti-CTLA-4 therapy (27-54%), and symptoms occur within a few days to weeks of therapy. Diffuse acute and chronic colitis are the most common findings on endoscopy (8-22%). Concomitant infectious causes of diarrhoea must be evaluated. Most cases may be successfully managed with discontinuation of anti-CTLA-4 and conservative therapy. Those with persistent grade 2 and grade 3/4 diarrhoea should undergo endoscopic evaluation and require corticosteroid therapy. Corticosteroid-resistant cases may respond to anti-tumour necrosis factor-alpha therapy such as infliximab. Surgery is reserved for patients with bowel perforation or failure of medical therapy. CONCLUSION Given the increasing use of anti-CTLA-4 therapy, clinicians must be aware of related adverse events and their management.
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Affiliation(s)
- A Gupta
- Department of Internal Medicine, University of Texas, Southwestern Medical Center, Dallas, TX, USA
| | - K M De Felice
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - E V Loftus
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - S Khanna
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
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Sasmal PK, Das PC, Tantia O, Patle N, Khanna S, Sen B. Acute small intestinal obstruction-an unusual complication of capsule endoscopy. Indian J Surg 2015; 77:21-3. [PMID: 25972632 DOI: 10.1007/s12262-014-1051-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2010] [Accepted: 03/29/2010] [Indexed: 10/25/2022] Open
Abstract
We report a case of endoscopic capsule impaction causing acute small intestinal obstruction in a patient with Crohn's disease (CD), having obscure gastrointestinal bleeding. A 57-year old female presented with features of acute small bowel obstruction 2 days after capsule endoscopy elsewhere for the evaluation of intermittent bleeding per rectum and iron deficiency anemia. Patient underwent an exploratory laparotomy with right hemicolectomy for the diseased ileocecal region which mimicked malignancy. The capsule was found to be impacted in the strictured lumen of the terminal ileum. Post operative histopathological examination revealed it to be Crohn's disease.
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Affiliation(s)
- Prakash K Sasmal
- Department of Minimal Access Surgery, ILS Hospital, DD-6, Sector 1, Salt Lake City, Kolkata, West Bengal 700064 India
| | - Prakhar C Das
- Department of Minimal Access Surgery, ILS Hospital, DD-6, Sector 1, Salt Lake City, Kolkata, West Bengal 700064 India
| | - Om Tantia
- Department of Minimal Access Surgery, ILS Hospital, DD-6, Sector 1, Salt Lake City, Kolkata, West Bengal 700064 India
| | - Nirmal Patle
- Department of Minimal Access Surgery, ILS Hospital, DD-6, Sector 1, Salt Lake City, Kolkata, West Bengal 700064 India
| | - S Khanna
- Department of Minimal Access Surgery, ILS Hospital, DD-6, Sector 1, Salt Lake City, Kolkata, West Bengal 700064 India
| | - B Sen
- Department of Minimal Access Surgery, ILS Hospital, DD-6, Sector 1, Salt Lake City, Kolkata, West Bengal 700064 India
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Wattal C, Goel N, Khanna S, Byotra SP, Laxminarayan R, Easton A. Impact of informational feedback to clinicians on antibiotic-prescribing rates in a tertiary care hospital in Delhi. Indian J Med Microbiol 2015; 33:255-9. [DOI: 10.4103/0255-0857.153582] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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108
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Pardi DS, Shivashankar R, Khanna S, Baddour LM. Letter: clinical predictors of Clostridium difficile infection - advanced age and residential status are important factors for prediction and prevention - authors' reply. Aliment Pharmacol Ther 2015; 41:233. [PMID: 25511771 DOI: 10.1111/apt.13033] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/29/2014] [Accepted: 10/30/2014] [Indexed: 12/08/2022]
Affiliation(s)
- D S Pardi
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
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110
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Khanna S, Priya R, Bhartiya SK, Basu S, Shukla VK. Adrenal tumors: An experience of 10 years in a single surgical unit. Indian J Cancer 2015; 52:475-8. [DOI: 10.4103/0019-509x.176749] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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111
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Johnson DH, Khanna S, Smyrk TC, Loftus EV, Anderson KS, Mahoney DW, Ahlquist DA, Kisiel JB. Detection rate and outcome of colonic serrated epithelial changes in patients with ulcerative colitis or Crohn's colitis. Aliment Pharmacol Ther 2014; 39:1408-17. [PMID: 24779703 PMCID: PMC4894660 DOI: 10.1111/apt.12774] [Citation(s) in RCA: 60] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/18/2013] [Revised: 12/21/2013] [Accepted: 04/08/2014] [Indexed: 12/11/2022]
Abstract
BACKGROUND Chronic ulcerative colitis (CUC) and colonic Crohn's disease (CD) increase colorectal neoplasia (CRN) risk. While sessile serrated polyp (SSP) is a known cancer precursor, serrated epithelial changes (SEC) are of uncertain prevalence and neoplastic risk. AIM To assess the serrated lesion detection rates in CUC and CD and documented incidence of subsequent CRN in a retrospective, single-centre cohort study. METHODS Patients were identified by a central diagnostic index and pathology review confirmed SEC, SSP, CUC and CD diagnoses from 2006-12. Matched controls were identified from among all CUC and CD patients having colonoscopy during the second half of the time period. All were followed for incident CRN, estimated by the Kaplan-Meier method. RESULTS Between 2006 and 2012, 79 SEC and 10 SSP cases were identified. Detection rates were estimated to be 10/1000 and 2/1000 patients, for SEC and SSP respectively, among 4208 unique CUC or CD patients having colonoscopy from 2010-12. With only 10 cases, SSP patients were not further analysed. Cumulative incidence of subsequent CRN at 1 and 3 years was 12% (95% CI, 0-30%) and 30% (3-57%), respectively, in SEC patients compared to 4% (0-12%) and 9% (0-23%), respectively, in CUC or CD controls (P = 0.047, log-rank). However, this statistical difference was not significant after patients were stratified for history of prior or synchronous dysplasia (P = 0.09). CONCLUSIONS Serrated epithelial changes and sessile serrated polyps are uncommonly detected by colonoscopy in chronic ulcerative colitis and Crohn's disease patients. Histology with changes of serrated epithelium may be associated with risk of subsequent colorectal neoplasia, however further studies are needed to explore this relationship.
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Affiliation(s)
- D. H. Johnson
- Divsion of Internal Medicine, Mayo Clinic, Rochester, MN, USA
| | - S. Khanna
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - T. C. Smyrk
- Division of Anatomic Pathology, Mayo Clinic, Rochester, MN, USA
| | - E. V. Loftus
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - K. S. Anderson
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - D. W. Mahoney
- Division of Biomedical Statistics and Informatics, Mayo Clinic, Rochester, MN, USA
| | - D. A. Ahlquist
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
| | - J. B. Kisiel
- Division of Gastroenterology & Hepatology, Mayo Clinic, Rochester, MN, USA
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Affiliation(s)
- H Gupta
- Department of Nephrology, PSRI Hospital, New Delhi, India
| | - R Bansal
- Department of Nephrology, PSRI Hospital, New Delhi, India
| | - S Khanna
- Department of Gastroenterology, PSRI Hospital, New Delhi, India
| | - S Saxena
- Department of Nephrology, PSRI Hospital, New Delhi, India
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Chaudhari M, Kumar R, Khanna A, Dalal D, Khanna S, Goyal J. Estimation of genetic trends for economic traits in crossbred cattle by using regression methods. INDIAN J ANIM RES 2014. [DOI: 10.5958/0976-0555.2014.00025.9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lopresti ML, Edmiston KL, Oconnor A, Gates E, Vijayaraghavan G, Sood R, Khanna S. Abstract P2-04-04: Breast cancer risk reduction in high risk women identified at the time of screening mammography. Integrating data from an established high risk clinic. Cancer Res 2013. [DOI: 10.1158/0008-5472.sabcs13-p2-04-04] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Background: At the time of screening mammography, patient data can be collected and entered into a Modified Gail Model Risk Assessment Tool to identify patients at increased risk of invasive breast cancer. In turn, these patients can be referred to high risk centers where risk reduction strategies and chemoprophylaxis can be considered. The objective of this study is to establish how many women are at high risk of invasive breast cancer in a screening population who should be referred to a high risk center for counseling.
Methods: This is an observational prospective study evaluating 1,000 women at a single institution presenting for mammographic screening or diagnostic evaluation. At the time of mammography, these women routinely complete a standard intake questionnaire addressing breast cancer risk factors put forward by the institutional clinic. Modified Gail model risk scores were calculated from these data sheets. Women with a 5 year risk of invasive breast cancer of 1.7% or greater were identified as well as women at particularly high risk (≥3.4% or double the 5-year risk). At the time of analysis patients with a history of breast cancer or who underwent diagnostic mammography were excluded. Retrospective data from our institutional high risk clinic from January 2007 to December 2009 was analyzed in respect to patient age at referral, Gail Model Score, personal history of breast cancer, history of benign breast biopsies, and recommendation for and acceptance of chemoprophylaxis.
Results: Of 1,000 women screened in the prospective analysis, 366 had ≥1.7% 5-year risk of invasive breast cancer. 26% (96) of these women were under 60 years old while 74% (270) were ≥60 years old. Among the latter group, 19.6% (53) were found to have ≥ 3.4% of developing invasive cancer. In these women with double the 5-year risk, 96.2% had a family history of breast cancer and 69.8% had a prior biopsy. Similarly, in women under 60, greater than half were high risk secondary to a prior biopsy or family history. In the retrospective analysis of 600 patients evaluated in the high risk clinic, 38.8% were eligible for chemoprevention based on age >35, Gail model risk score, and no contraindications to treatment. 45.7% accepted recommendation for chemoprophylaxis as opposed 54.3% who had declined. Age was not found to be a predictor of acceptance of treatment.
Conclusions: 1/3 of patients who receive annual screening are at high risk for breast cancer. These patients can be identified from data routinely obtained at the time of screening mammography. These women should be referred for high-risk counseling and consideration of chemoprevention at the time of screening mammography. Further prospective studies may be warranted to determine if this is an effective way to provide risk reduction strategies for high risk women.
Citation Information: Cancer Res 2013;73(24 Suppl): Abstract nr P2-04-04.
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Affiliation(s)
- ML Lopresti
- Umass Memorial Medical Center, Worcester, MA
| | - KL Edmiston
- Umass Memorial Medical Center, Worcester, MA
| | - A Oconnor
- Umass Memorial Medical Center, Worcester, MA
| | - E Gates
- Umass Memorial Medical Center, Worcester, MA
| | | | - R Sood
- Umass Memorial Medical Center, Worcester, MA
| | - S Khanna
- Umass Memorial Medical Center, Worcester, MA
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Khanna S, Oberoi JK, Datta S, Aggarwal S, Wattal C. Variables affecting the performance of galactomannan assay in high-risk patients at a tertiary care centre in India. Indian J Med Microbiol 2013; 31:34-9. [PMID: 23508427 DOI: 10.4103/0255-0857.108717] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
BACKGROUND Diagnosis of invasive aspergillosis (IA) in immunocompromised patients using galactomannan ELISA (GM-ELISA) has shown variable sensitivity and specificity. OBJECTIVES To assess the diagnostic performance of GM-ELISA and analyze the effect of decreasing the cut off value, neutropenia, antifungals and piperacillin-tazobactam (PTZ). Prognostic value using 30 day all-cause mortality was also determined. MATERIALS AND METHODS Serum samples from 81 patients categorized into "proven," "probable," and "possible," categories based on revised EORTC/MSG definitions were tested by GM-ELISA. RESULTS Sensitivity of GM-ELISA in proven, probable and possible cases was 91.7%, 84.6% and 83.3% respectively. At an index cut-off value of 0.5 an increased sensitivity with minimal loss of specificity was observed. Use of antifungals demonstrated a decrease in sensitivity in proven and possible cases whereas it remained unaffected in probable category. Specificity increased from 75% to 100% with a positivity criterion of >2 consecutive samples. Although an increase in specificity was observed in patients not receiving PTZ, it was not statistically significant. Serial GM index values increased significantly in neutropenic patients and were associated with a poor prognosis. CONCLUSIONS GM-ELISA may be a useful diagnostic and prognostic modality for the detection of IA in high risk patients.
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Affiliation(s)
- S Khanna
- Department of Clinical Microbiology, Sir Ganga Ram Hospital, Rajinder Nagar, New Delhi, India
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Khanna S, Vij JC, Kumar A, Singal D, Tandon R. Dengue fever is a differential diagnosis in patients with fever and abdominal pain in an endemic area. Annals of Tropical Medicine & Parasitology 2013; 98:757-60. [PMID: 15509430 DOI: 10.1179/000349804x3153] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Affiliation(s)
- S Khanna
- Pushpawati Singhania Research Institute for Liver, Renal and Digestive Disease, Press Enclave Marg, Sheikh Sarai, Phase-II, New Delhi - 110017, India.
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Elmantaser M, McMillan M, Smith K, Khanna S, Chantler D, Panarelli M, Ahmed SF. A comparison of the effect of two types of vibration exercise on the endocrine and musculoskeletal system. J Musculoskelet Neuronal Interact 2012; 12:144-154. [PMID: 22947546] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Abstract
BACKGROUND Whole body vibration (WBV) is a novel training intervention but a comparison of different methods of WBV has rarely been performed. AIM To compare the short and medium term effects of two regimens of WBV on endocrine status, muscle function and markers of bone turnover. PATIENTS AND METHODS Over a period of 16 weeks, 10 men with a median age of 33 yrs (range, 29,49), were randomised to stand on the Galileo platform (GP) or Juvent1000 platform (JP) 3 times/wk. The total study duration was 16 weeks with measurements performed in a 4 week period of run-in, 8 weeks of WBV and a 4 week period of washout. These measurements included an assessment of anthropometry, body composition, muscle function and biochemical markers of endocrine status and bone turnover. To assess immediate effects of WBV, measurements were also performed at 60 mins before and 5, 30 and 60 mins after WBV. To assess immediate effects of WBV, measurements were also performed at 60 mins before and 5, 30 and 60 mins after WBV. RESULTS GP at 22 Hz was associated with an immediate increase in serum GH, rising from 0.07 μg/l (0.04,0.69) to 0.52 μg/l (0.06,2.4) (p=0.06), 0.63 μg/l (0.1,1.18) (p=0.03), 0.21 μg/l (0.07,0.65) (p=0.2) at 5 mins, 20 mins and 60 mins after WBV, respectively. An immediate effect was also observed in median serum cortisol which reduced from 316 nmol/l (247,442) before WBV to 173 nmol/l (123,245) (p=0.01),165 nmol/l (139,276) (p=0.02) and 198 nmol/l (106,294) (p=0.04) at 5 mins, 20 mins and 60 mins after WBV, respectively. Median serum CTX reduced significantly after 8 weeks of WBV training in the GP group from 0.42 ng/ml (0.29,0.90) pre-WBV to 0.29 ng/ml (0.18,0.44) at the end of WBV training (p=0.03). Over the 8 weeks, there was a reduction in median serum cortisol in the GP group from 333 nmol/l (242,445) (pre-WBV) to 270 nmol/l (115,323) (WBV) (p=0.04). None of the changes observed in the JP group reached statistical significance. Neither group showed any significant effect on muscle function, IGF-1, testosterone, leptin, CRP, creatine kinase, insulin or other markers of bone turnover. CONCLUSION WBV can stimulate GH secretion, reduce circulating cortisol and reduce bone resorption. These effects are independent of clear changes in muscle function and depend on the type of WBV that is administered.
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Affiliation(s)
- M Elmantaser
- Bone and Endocrine Research Group, Department of Child Health, Royal Hospital for Sick Children, Glasgow, UK
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Oberoi JK, Wattal C, Aggarwal PK, Khanna S, Basu AK, Verma K. Pulmonary coccidiomycosis in New Delhi, India. Infection 2012; 40:699-702. [DOI: 10.1007/s15010-012-0315-9] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 08/03/2012] [Indexed: 10/28/2022]
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Abstract
Robotic surgery is gaining widespread popularity due to advantages such as reduced blood loss, reduced postoperative pain, shorter hospital stay and better visualisation of fine structures. Robots are being used in urological, cardiac, thoracic, orthopaedic, gynaecological and general surgery. Robotic surgery received US Food and Drug Administration approval for use in gynaecological surgery in 2005. The various gynaecological robotic operations being performed are myomectomy, total and supracervical hysterectomy, ovarian cystectomy, sacral colpopexy, tubal reanastomosis, lymph node dissection, surgery of retroperitoneal ectopic pregnancy, Moskowitz procedure and endometriosis surgery. The anaesthetic considerations include difficult access to the patient intraoperatively, steep Trendelenburg position, long surgical duration and the impact of pneumoperitoneum. We highlight the complications encountered in these surgeries and methods to prevent these complications. Robotic gynaecological surgery can be safely performed after considering the physiological effects of the steep Trendelenburg position and of pneumoperitoneum. The benefits of the surgical procedure should be weighed against the risks in patients with underlying cardiorespiratory problems.
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Affiliation(s)
- K. Gupta
- Department of Anaesthesia, Medanta Medicity Hospital, Gurgaon, Delhi, India
- Department of Anaesthesia and Critical Care, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi
| | - Y. Mehta
- Department of Anaesthesia, Medanta Medicity Hospital, Gurgaon, Delhi, India
| | - A. Sarin Jolly
- Department of Anaesthesia, Medanta Medicity Hospital, Gurgaon, Delhi, India
| | - S. Khanna
- Department of Anaesthesia, Medanta Medicity Hospital, Gurgaon, Delhi, India
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Rathod K, Khanna S, Kanojia RP, Rao KLN. A novel variant of esophageal atresia with tracheo-esophageal fistula with a crossed-over proximal esophageal pouch: a diagnostic dilemma. Dis Esophagus 2012; 25:393-4. [PMID: 22759370 DOI: 10.1111/j.1442-2050.2010.01175.x] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Diagnosis of esophageal atresia (EA) with tracheo-esophageal fistula (TEF) can be easily done in newborns with symptoms of excessive salivation and failure to pass infant-feeding tube (IFT) into the stomach. There are many reports in the literature which describe the diagnostic pitfall of this IFT test. We describe a case of a neonate with EA with TEF in which the upper atretic esophageal pouch had grown long enough to reach up to the level of diaphragm, thus allowing the IFT to go up to significant distance from the alveolus giving the radiograph as if the tube is in the upper part of stomach, thus creating a diagnostic dilemma.
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Affiliation(s)
- K Rathod
- Pediatric Surgery, Post Graduate Institute of Medical Education and Research, Chandigarh, India
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Stocchi F, Dillmann U, Ellenbogen A, Hsu A, Khanna S, Rubens R, Liang G, Gupta S. Comparison of IPX066, a Novel Carbidopa-Levodopa (CD-LD) Extended-Release Formulation, and CD-LD-Entacapone (CLE) in Advanced Parkinson's Disease (ASCEND-PD Trial) (S02.005). Neurology 2012. [DOI: 10.1212/wnl.78.1_meetingabstracts.s02.005] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
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Affiliation(s)
- S Khanna
- Division of Gastroenterology and Hepatology, Mayo Clinic College of Medicine, Rochester, Minnesota 55905, USA
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Singh I, Sharma RK, Phulia SK, Kumar D, Saxena O, Verma R, Khanna S. 228 DOMINANT FOLLICLE ABLATION IMPROVES SUPEROVULATORY RESPONSE AND EMBRYO YIELD IN BUFFALOES SUBJECTED TO INTEGRATED SINGLE-OVULATION EMBRYO TRANSFER - MULTIPLE-OVULATION EMBRYO TRANSFER PROGRAM. Reprod Fertil Dev 2012. [DOI: 10.1071/rdv24n1ab228] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
Effect of the removal of inhibitory consequences of a dominant follicle (DF) on the recruitment, growth and ovulation of follicles in cyclic buffaloes induced to superovulate, was evaluated. Eight elite, multiparous, donor Murrah buffaloes, 80 to 120 days postpartum, were included in an integrated single-ovulation embryo transfer–multiple-ovulation embryo transfer (SOET-MOET) schedule. Superovulation with FSH (Folltropin® NIH-FSH-P1, Bioniche Animal Health, Belleville, ON, Canada) was preceded by nonsurgical single embryo (SOET) recovery on Day 5 or 6 after prostaglandin F2α (Lutalyse®, Pfizer, Madison, NJ, USA)-induced oestrus and AI (Day 0). For MOET, Folltropin was administered from Day 9 p.m. through to Day 13 p.m. in a twice-daily descending dose schedule (0–5, 5–4, 4–3, 3–2, 2–1 mL; total dose of 580 mg of NIH-FSH-P1). A dose of 25 mg of Lutalyse was administered on Day 12 a.m. and p.m. Donors were inseminated with proven semen on Day 14 a.m. and p.m. and Day 15 a.m. Nonsurgical embryo collection was carried out on Day 19 or 20 followed by administration of Lutalyse on Day 25. Following sexual rest for one complete oestrous cycle, Day 5 or 6 SOET was repeated. On Day 9, ultrasound-guided follicle aspiration was used to ablate the DF and the second MOET treatment was initiated at the same time. Mean diameter of DF at the start of superovulation treatment on Day 9 was similar between the first (12.5 ± 0.66 mm) and second (12.2 ± 0.33 mm) MOET cycles. At AI, mean number (9.6 ± 1.43 vs 13.4 ± 1.87) of follicles >9 mm were higher (P < 0.05) in the second (ablation) MOET cycle, though their mean diameters were similar (11.7 ± 0.21 vs 12.3 ± 0.21 mm; P = 0.17). On the day of ova/embryo collection, almost similar numbers of large follicles (4.1 ± 0.93 and 4.4 ± 0.84), with mean diameters of 12.9 ± 0.74 and 13.4 ± 0.83 mm, were observed for the first and second MOET, respectively. Mean (± SEM) numbers of corpora lutea (3.9 ± 0.81 and 4.9 ± 0.61; P = 0.19) and transferable quality embryos (0.6 ± 0.37 and 1.6 ± 0.37; P = 0.077) were counted in the first and second (ablation) MOET cycles, respectively. These preliminary findings suggest that ablation of DF before start of superovulatory treatment may be beneficial in improving the yield of transferable embryos in a buffalo MOET program.
Director, CIRB, is acknowledged for the experimental facilities.
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Khanna S, Mittal S, Sharma N. MP-08.10 Role of DNA PCR in Early Diagnosis of Genitourinary Tuberculosis. Urology 2011. [DOI: 10.1016/j.urology.2011.07.187] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
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125
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Saifee Y, Gupta M, Khanna S. POD-04.08 Management Algorithm for Bladder Outlet Obstruction in Women. Urology 2011. [DOI: 10.1016/j.urology.2011.07.429] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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126
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Khanna S, Mittal S. UP-03.012 Optical Internal Urethrotomy Revisited: The Modified Way We Do It. Urology 2011. [DOI: 10.1016/j.urology.2011.07.1102] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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127
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Khanna S, Mittal S. MP-08.09 Minimally-Invasive Management of Prostatic Abscess: Transrectal Ultrasound Guided Aspiration of Prostatic Abscess Under Local Anesthesia: Ganga Ram Needle. Urology 2011. [DOI: 10.1016/j.urology.2011.07.186] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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128
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Bhatnagar S, Khanna S, Roshni S, Goyal GN, Mishra S, Rana SPS, Thulkar S. Early ultrasound-guided neurolysis for pain management in gastrointestinal and pelvic malignancies: an observational study in a tertiary care center of urban India. Pain Pract 2011; 12:23-32. [PMID: 21615855 DOI: 10.1111/j.1533-2500.2011.00467.x] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/05/2023]
Abstract
Patients with advanced gastrointestinal and pelvic malignancies commonly present with pain of varying severity. In a majority of these patients, pain can be effectively managed using an integrated systemic pharmacological approach with oral morphine being the cornerstone of treatment. However, with escalating doses, intolerable side effects of oral morphine may lead to patient dissatisfaction. When oral pharmacotherapy fails to adequately address the issue of pain or leads to insufferable side effects, neurolytic blocks of the sympathetic axis are usually used for pain alleviation. As these blocks may reduce oral analgesic requirement, a reevaluation of their timing is merited. This article presents our hospital-based in-patient palliative care unit experience with early ultrasonography-guided neurolysis of celiac plexus, superior hypogastric plexus and ganglion impar. Of the 44 patients we studied, 20 underwent celiac plexus neurolysis, 18 superior hypogastric plexus neurolysis, and 6 ganglion impar neurolysis. Their pain was being managed with oral morphine before neurolysis, but only 11.4% patients required oral morphine for satisfactory pain control, 2 months after neurolysis. The mean Visual Analog Scale score before block placement was 5.64 ± 0.69 and fell to 2.25 ± 1.33 at 2 months post neurolysis (P < 0.001). We suggest that bedside ultrasonography-guided sympathetic axis neurolysis may be employed early in patients with incurable abdominal or pelvic cancer. Its use as a first-line intervention for achieving pain control with minimal complications warrants further consideration and investigation.
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Affiliation(s)
- Sushma Bhatnagar
- Department of Anesthesiology, IRCH, All India Institute of Medical Sciences, New Delhi, India.
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Abstract
Neonatal paraesophageal hernia with intrathoracic gastric volvulus is very rare in the newborn period. We report a case of a 2-day-old term neonate who presented with an antenatal diagnosis of paraesophageal hernia. We discuss the diagnosis and management with classical radiological features including an antenatal diagnosis of this extremely rare surgical cause of neonatal nonbilious emesis.
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Affiliation(s)
- M Bawa
- Department of Pediatric Surgery, Advanced Pediatric Center, Post Graduate Institute of Medical Education and Research (PGIMER), Sector 12, Chandigarh, 160012, India
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Lappalainen Z, Lappalainen J, Oksala NKJ, Laaksonen DE, Khanna S, Sen CK, Atalay M. Exercise training and experimental diabetes modulate heat shock protein response in brain. Scand J Med Sci Sports 2010; 20:83-9. [PMID: 19017295 DOI: 10.1111/j.1600-0838.2008.00872.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
Abstract
In diabetes, defense systems against cellular stress are impaired. Heat shock proteins (HSPs) function primarily as molecular chaperones. Factors that raise tissue HSP levels may slow progression of diabetes and improve diabetic complications that also affect brain tissue. This study tested the effect of an 8-week exercise training on brain HSP response in rats with or without streptozotocin-induced diabetes (SID). In untrained animals, the HSP levels were not different between SID and non-diabetic groups. Endurance training, however, increased HSP72 and HSP90 protein in non-diabetic rats, whereas SID significantly decreased the effect of training on these HSPs. At the mRNA level, HSP60, HSP90 and GRP75 were increased due to training, whereas HSP72 mRNA was only increased in exercise-trained diabetic animals. Training or diabetes had no effect on protein carbonyl content, a marker of oxidative damage. Altogether, our findings suggest that endurance training increases HSP expression in the brain, and that experimental diabetes is associated with an incomplete HSP response at the protein level.
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Affiliation(s)
- Z Lappalainen
- Institute of Biomedicine, Physiology, University of Kuopio, and Institute of Clinical Medicine, Surgery, Kuopio University Hospital, Kuopio, Finland
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Bhatnagar S, Mishra S, Roshni S, Gogia V, Khanna S. Neuropathic Pain in Cancer Patients—Prevalence and Management in a Tertiary Care Anesthesia-Run Referral Clinic Based in Urban India. J Palliat Med 2010; 13:819-24. [DOI: 10.1089/jpm.2009.0405] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Sushma Bhatnagar
- Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Seema Mishra
- Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - S. Roshni
- Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Vikas Gogia
- Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
| | - Sandeep Khanna
- Department of Anaesthesia, Institute Rotary Cancer Hospital, All India Institute of Medical Sciences, New Delhi, India
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Wong JHD, Carolan M, Lerch MLF, Petasecca M, Khanna S, Perevertaylo VL, Metcalfe P, Rosenfeld AB. A silicon strip detector dose magnifying glass for IMRT dosimetry. Med Phys 2010; 37:427-39. [PMID: 20229851 DOI: 10.1118/1.3264176] [Citation(s) in RCA: 27] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE Intensity modulated radiation therapy (IMRT) allows the delivery of escalated radiation dose to tumor while sparing adjacent critical organs. In doing so, IMRT plans tend to incorporate steep dose gradients at interfaces between the target and the organs at risk. Current quality assurance (QA) verification tools such as 2D diode arrays, are limited by their spatial resolution and conventional films are nonreal time. In this article, the authors describe a novel silicon strip detector (CMRP DMG) of high spatial resolution (200 microm) suitable for measuring the high dose gradients in an IMRT delivery. METHODS A full characterization of the detector was performed, including dose per pulse effect, percent depth dose comparison with Farmer ion chamber measurements, stem effect, dose linearity, uniformity, energy response, angular response, and penumbra measurements. They also present the application of the CMRP DMG in the dosimetric verification of a clinical IMRT plan. RESULTS The detector response changed by 23% for a 390-fold change in the dose per pulse. A correction function is derived to correct for this effect. The strip detector depth dose curve agrees with the Farmer ion chamber within 0.8%. The stem effect was negligible (0.2%). The dose linearity was excellent for the dose range of 3-300 cGy. A uniformity correction method is described to correct for variations in the individual detector pixel responses. The detector showed an over-response relative to tissue dose at lower photon energies with the maximum dose response at 75 kVp nominal photon energy. Penumbra studies using a Varian Clinac 21EX at 1.5 and 10.0 cm depths were measured to be 2.77 and 3.94 mm for the secondary collimators, 3.52 and 5.60 mm for the multileaf collimator rounded leaf ends, respectively. Point doses measured with the strip detector were compared to doses measured with EBT film and doses predicted by the Philips Pinnacle treatment planning system. The differences were 1.1% +/- 1.8% and 1.0% +/- 1.6%, respectively. They demonstrated the high temporal resolution capability of the detector readout system, which will allow one to investigate the temporal dose pattern of IMRT and volumetric modulated are therapy (VMAT) deliveries. CONCLUSIONS The CMRP silicon strip detector dose magnifying glass interfaced to a TERA ASIC DAQ system has high spatial and temporal resolution. It is a novel and valuable tool for QA in IMRT dose delivery and for VMAT dose delivery.
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Affiliation(s)
- J H D Wong
- Centre for Medical Radiation Physics, University of Wollongong, New South Wales 2522, Australia
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Kumar M, Khanna S. Diversity of 16S rRNA and dioxygenase genes detected in coal-tar-contaminated site undergoing active bioremediation. J Appl Microbiol 2010; 108:1252-62. [DOI: 10.1111/j.1365-2672.2009.04523.x] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/01/2022]
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134
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Jhamb U, Chawla V, Khanna S. Clinical profile of group A meningococcal outbreak in Delhi. Indian Pediatr 2009; 46:794-796. [PMID: 19179744] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/05/2008] [Accepted: 08/11/2008] [Indexed: 05/27/2023]
Abstract
We present a retrospective analysis of clinical profile of 100 children admitted to a Government hospital at Delhi between April 2005 and December 2006 with group A meningococcal infection. Maximum children presented in late winter and spring. Younger children were less affected (5% children < 1 year). Fever (86%), vomiting (64%) and rash (63%) were the most common presenting symptoms. All children presented within 5 days of onset of symptoms and 52% within 24 hours. 67 % children had meningococcal meningitis; 20% had meningococcemia; and 13% had both. Overall mortality was 17%. Altered sensorium and shock at presentation significantly increased the mortality. All culture positive cases had group A Neisseria meningitides. All meningococcal isolates were sensitive to penicillin/ampicillin, ciprofloxacin, ceftriaxone, chloramphenicol and erythromycin except, one each resistant to ampicillin and erythromycin.
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Affiliation(s)
- Urmila Jhamb
- Department of Pediatrics, Maulana Azad Medical College and LN Hospital, New Delhi, India.
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135
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Abstract
BACKGROUND Desmoids are infiltrative, locally destructive, soft tissue tumors. Although they do not metastasize, the incidence of local recurrence is quite high. AIM Present study aimed at reporting the 10-year experience of 32 desmoid cases and reviewing some facts with symptoms, investigation, and treatment of the disease. MATERIALS AND METHODS Thirty two cases of desmoid tumors were reviewed over a 10-year span. Surgical resection and adjuvant radiotherapy were the treatments of choice whenever histological margins were positive. RESULTS Multiparous women in reproductive age were the most commonly afflicted. The commonest site of presentation was the abdominal wall. Ninety one percent (20/22) were infraumbilical. The tumors were found in the rectus sheath in 14 patients (64%) and were laterally situated in 8 patients (36%). Local infiltration was found in six patients and the urinary bladder was most commonly involved (3/6). Locally recurrent desmoids were seen in eight patients (25%). CONCLUSIONS In our experience, 25% of the desmoid tumors (8/32) were recurrent and postoperative radiotherapy did not seem to influence the local recurrence rate. The most important predictor for recurrence was tumors of > 5 cm.
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Affiliation(s)
- V Kumar
- Department of Surgical Oncology, Institute of Medical Sciences, Banaras Hindu University, Varanasi-221 005, UP, India.
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136
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Abstract
Oxidized glutathione (GSSG) is commonly viewed as a byproduct of GSH metabolism. The pathophysiological significance of GSSG per se remains poorly understood. Adopting a microinjection approach to isolate GSSG elevation within the cell, this work identifies that GSSG can trigger neural HT4 cell death via a 12-lipoxygenase (12-Lox)-dependent mechanism. In vivo, stereotaxic injection of GSSG into the brain caused lesion in wild-type mice but less so in 12-Lox knockout mice. Microinjection of graded amounts identified 0.5 mM as the lethal [GSSG]i in resting cells. Interestingly, this threshold was shifted to the left by 20-fold (0.025 mM) in GSH-deficient cells. This is important because tissue GSH lowering is commonly noted in the context of several diseases as well as in aging. Inhibition of GSSG reductase by BCNU is known to result in GSSG accumulation and caused cell death in a 12-Lox-sensitive manner. GSSG S-glutathionylated purified 12-Lox as well as in a model of glutamate-induced HT4 cell death in vitro where V5-tagged 12-Lox was expressed in cells. Countering glutamate-induced 12-Lox S-glutathionylation by glutaredoxin-1 overexpression protected against cell death. Strategies directed at improving or arresting cellular GSSG clearance may be effective in minimizing oxidative stress-related tissue injury or potentiating the killing of tumor cells, respectively.
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Affiliation(s)
- H-A Park
- Department of Surgery, Davis Heart and Lung Research Institute, The Ohio State University Medical Center, Columbus, OH 43210, USA
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Khanna S, Sekhon K, Prakash N. Cloning and Expression of a Biosurfactant Gene from Endosulfan Degrading Bacillus sp.: Correlation Between Esterase Activity and Biosurfactant Production. ACTA ACUST UNITED AC 2009. [DOI: 10.3923/biotech.2009.235.241] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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138
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Floyd BN, Camilleri M, Busciglio I, Sweetser S, Burton D, Wong GY, Kell S, Khanna S, Hwang S, Zinsmeister AR. Effect of a kappa-opioid agonist, i.v. JNJ-38488502, on sensation of colonic distensions in healthy male volunteers. Neurogastroenterol Motil 2009; 21:281-90. [PMID: 18823290 DOI: 10.1111/j.1365-2982.2008.01202.x] [Citation(s) in RCA: 14] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/08/2023]
Abstract
Kappa-opioid receptors are located on visceral pain fibres. JNJ-38488502 is a highly selective tetrapeptide kappa-opioid agonist with little access to the central nervous system and low risk of central nervous system side effects. The aim of the study was to evaluate the effects of i.v. JNJ-38488502 on sensations, including pain, during colonic distension. In a single-centre study, 23 healthy adult males underwent a single-dose, randomized, double-blind crossover study of JNJ-38488502 (0.42 mg kg(-1) i.v. infusion) vs placebo on left colon compliance, sensory thresholds and ratings during standard distensions. One participant could not undergo sensation studies. In the other 22, JNJ-38488502 increased colonic compliance (pressure at half-maximum volume 17.9 +/- 0.8 mmHg) compared to placebo (21.6 +/- 0.9 mmHg, P = 0.007). There was no significant effect on sensory thresholds which, however, were not reached by 44 mmHg in >50% of participants in both treatment phases. There were no significant treatment effects on sensory ratings to distensions at 8, 16, 24, 32 and 36 mmHg above baseline operating pressure. JNJ-38488502 was associated with increased urine output and plasma prolactin, consistent with kappa-opioid receptor activation. This study concluded that i.v. JNJ-38488502 induced kappa-opioid effects, but did not attenuate colonic sensations following random order colonic distension. Further studies of effects on pain sensations in health and disease are required.
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Affiliation(s)
- B N Floyd
- Clinical Enteric Neuroscience Translational and Epidemiological Research, Mayo Clinic, Rochester, MN 55905, USA
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139
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Talukdar R, Chaudhuri D, Vora P, Khanna S, Saikia N, Mazumder S, Kumar A. A child with upper abdominal pain and pancreatitis. Case Reports 2009; 2009:bcr2006110601. [DOI: 10.1136/bcr.2006.110601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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140
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Khanna S, Choudhury M, Kiran U. Total anomalous pulmonary venous connection: post operative problems and management. Indian J Anaesth 2009; 53:71-4. [PMID: 20640082 PMCID: PMC2900038] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/08/2008] [Indexed: 11/19/2022] Open
Abstract
SUMMARY The uncommon congenital cardiac anomaly, total anomalous pulmonary venous connection is incompatible with life unless early surgical intervention is done. Most of the post operative problems and mortality in these children are also due to the changes in pulmonary vasculature. We hereby report two such cases that experienced a stormy postoperative course.
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Affiliation(s)
- Sandeep Khanna
- Senior Resident, Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences
| | - Minati Choudhury
- Associate Professor, Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences
| | - Usha Kiran
- Professor and HOD, Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences,Correspondence to: Usha Kiran, Department of Cardiac Anaesthesia, Cardiothoracic Centre, All India Institute of Medical Sciences,
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141
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Avasthi R, Chaudhary SC, Khanna S. Visceral Leishmaniasis Simulating Chronic Liver Disease: Successful Treatment with Miltefosine. Indian J Med Microbiol 2009. [DOI: 10.1016/s0255-0857(21)01771-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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142
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Avasthi R, Chaudhary SC, Khanna S. Visceral leishmaniasis simulating chronic liver disease: successful treatment with miltefosine. Indian J Med Microbiol 2009; 27:85-86. [PMID: 19172077] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
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143
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Shah Y, Joshi S, Jindal KC, Khanna S. High Performance Liquid Chromatographic Determination of Diclofenac Diethylammonium in Gels. Drug Dev Ind Pharm 2008. [DOI: 10.3109/03639049409038370] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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144
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Chaudhary RS, Gangwal SS, Gupta VK, Shah YN, Jindal KC, Khanna S. Dissolution system for Nifedipine Sustained Release Formulations. Drug Dev Ind Pharm 2008. [DOI: 10.3109/03639049309073900] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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145
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146
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147
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Chaudhary RS, Gangwal SS, Gupta VK, Shah YN, Jindal KC, Khanna S. Dissolution System for Nifedipine Sustained Release Formulations. Drug Dev Ind Pharm 2008. [DOI: 10.3109/03639049409038366] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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148
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Zheng F, Khanna S. Intra-hippocampal tonic inhibition influences formalin pain-induced pyramidal cell suppression, but not excitation in dorsal field CA1 of rat. Brain Res Bull 2008; 77:374-81. [PMID: 18852032 DOI: 10.1016/j.brainresbull.2008.09.004] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2008] [Revised: 08/12/2008] [Accepted: 09/12/2008] [Indexed: 10/21/2022]
Abstract
It has been hypothesized that intra-hippocampal GABAergic inhibitory interneurons mediate formalin pain-induced suppression of dorsal hippocampal CA1 pyramidal cell discharge. The present study performed on anaesthetized rats tested the hypothesis by disrupting GABAergic mechanisms with intra-hippocampal administration of the GABA(A) receptor antagonist bicuculline methiodide, applied either dorsally into the pyramidal cell layer and stratum oriens (dorsal-bicuculline) or ventrally into the region of apical dendrites (ventral-bicuculline). It was found that ventral-, but not dorsal-bicuculline attenuated formalin-induced suppression of pyramidal cell extracellular discharge. The antagonism was selective in such a way that the excitation of pyramidal cell was unaffected. Interestingly, ventral-bicuculline strongly disinhibited CA1 pyramidal cells and shifted the distribution of their spontaneous discharge to values higher than the control group. However, dorsal-bicuculline disinhibited the local CA1 interneurons that were strongly excited on injection of formalin. Overall, the findings favour the notion that tonic GABA(A) receptor mechanisms located in the region of apical dendrites facilitate formalin-induced pyramidal cell suppression by masking the background excitatory drive impinging on the pyramidal cells. Interestingly, both the attenuation of formalin-induced inhibition and facilitation of basal discharge of CA1 pyramidal cells by ventral-bicuculline are similar to the effects seen previously with the destruction of medial septal cholinergic neurons. This convergence of effects strengthens the proposal that the network of medial septal cholinergic neurons and hippocampal GABAergic interneurons influence formalin pain-induced CA1 pyramidal cell suppression. In addition, the data point to a non-overlapping excitatory drive whose strength is unaffected by the inhibitory drive that underpins formalin suppression.
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Affiliation(s)
- F Zheng
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, Blk MD9, 2 Medical Drive, Singapore 117597, Singapore.
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149
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Lee ATH, Shah JJ, Li L, Cheng Y, Moore PK, Khanna S. A nociceptive-intensity-dependent role for hydrogen sulphide in the formalin model of persistent inflammatory pain. Neuroscience 2008; 152:89-96. [PMID: 18248901 DOI: 10.1016/j.neuroscience.2007.11.052] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/09/2007] [Revised: 11/30/2007] [Accepted: 11/30/2007] [Indexed: 10/22/2022]
Abstract
The present study investigated the hypothesis that hydrogen sulfide (H2S) is pro-nociceptive in the formalin model of persistent inflammatory pain in the adult rat. Hind paw injection of formalin evoked a concentration-dependent increase in the hind paw concentration of H2S. Increased concentration of H2S was found in homogenates prepared from hind paws injected with 5% (but not 1.25%) formalin. Correspondingly, animal nociceptive flinching and hind paw edema were maximal with 5% formalin. Both nociceptive flinching and hind paw edema induced by injection of 5% formalin were attenuated by pretreatment with DL-propargylglycine (PPG; 50 mg/kg, i.p.) which is an inhibitor of the H2S synthesizing enzyme cystathionine-gamma-lyase (CSE). The effect of pretreatment with PPG was selective and the drug did not influence animal behavior or hind-paw edema with injection of 1.25% formalin. Furthermore, PPG pretreatment attenuated the induction of c-Fos in spinal laminae I-II following injection of 5% formalin. In contrast, co-injection of 1.25% formalin with sodium hydrogen sulfide (NaHS; 1 nmol/0.1 ml), a H2S donor, into the hind paw increased animal nociceptive behavior. Collectively, these findings show that the effect of peripheral H2S in the pathogenesis of inflammatory pain depends, at least in part, on the nociceptive intensity level.
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Affiliation(s)
- A T H Lee
- Department of Physiology, Yong Loo Lin School of Medicine, National University of Singapore, 2 Medical Drive, Singapore 117597
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150
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Abstract
In a retrospective analysis of bone densitometry scans performed in an audit of 576 children with chronic disease, lean-mass-adjusted bone mineral content (BMC) for the total body and the lumbar spine was marginally lower in children with fractures. However, the predictive ability of different bone mineral densities (BM) and BMC cut-offs to identify fracture risk in children with chronic disease needs to be tested for specific disease conditions in larger prospective studies.
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Affiliation(s)
- S C Wong
- Dept of Child Health, Bone and Endocrine Research Group, Royal Hospital for Sick Children, Yorkhill, Glasgow, UK
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