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Sharma R, Pandey P, Srivastava A, Pasbola K, Saraya A, Dash N. 65P MicroRNA profiles associated with response to neoadjuvant chemotherapy in esophageal cancer patients. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.09.066] [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] Open
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2
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Pramanik R, Das P, Sharma A, Kumar S, Bhoriwal S, Pathy S, Saraya A. NOTCH3 expression predicts poor survival in advanced esophageal squamous cell cancers. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz422.021] [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: 11/14/2022] Open
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3
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Singh S, Saraya A, Das P, Sharma R. PO-037 Role of MARCH8 in esophageal squamous cell carcinoma. ESMO Open 2018. [DOI: 10.1136/esmoopen-2018-eacr25.82] [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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4
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Togasaki E, Takeda J, Yoshida K, Shiozawa Y, Takeuchi M, Oshima M, Saraya A, Iwama A, Yokote K, Sakaida E, Hirase C, Takeshita A, Imai K, Okumura H, Morishita Y, Usui N, Takahashi N, Fujisawa S, Shiraishi Y, Chiba K, Tanaka H, Kiyoi H, Ohnishi K, Ohtake S, Asou N, Kobayashi Y, Miyazaki Y, Miyano S, Ogawa S, Matsumura I, Nakaseko C, Naoe T. Frequent somatic mutations in epigenetic regulators in newly diagnosed chronic myeloid leukemia. Blood Cancer J 2017; 7:e559. [PMID: 28452984 PMCID: PMC5436079 DOI: 10.1038/bcj.2017.36] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2017] [Accepted: 03/06/2017] [Indexed: 01/30/2023] Open
Abstract
Although tyrosine kinase inhibitors (TKIs) have significantly improved the prognosis of chronic myeloid leukemia (CML), the ability of TKIs to eradicate CML remains uncertain and patients must continue TKI therapy for indefinite periods. In this study, we performed whole-exome sequencing to identify somatic mutations in 24 patients with newly diagnosed chronic phase CML who were registered in the JALSG CML212 study. We identified 191 somatic mutations other than the BCR-ABL1 fusion gene (median 8, range 1–17). Age, hemoglobin concentration and white blood cell counts were correlated with the number of mutations. Patients with mutations ⩾6 showed higher rate of achieving major molecular response than those<6 (P=0.0381). Mutations in epigenetic regulator, ASXL1, TET2, TET3, KDM1A and MSH6 were found in 25% of patients. TET2 or TET3, AKT1 and RUNX1 were mutated in one patient each. ASXL1 was mutated within exon 12 in three cases. Mutated genes were significantly enriched with cell signaling and cell division pathways. Furthermore, DNA copy number analysis showed that 2 of 24 patients had uniparental disomy of chromosome 1p or 3q, which disappeared major molecular response was achieved. These mutations may play significant roles in CML pathogenesis in addition to the strong driver mutation BCR-ABL1.
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Affiliation(s)
- E Togasaki
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - J Takeda
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - K Yoshida
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - Y Shiozawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - M Takeuchi
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - M Oshima
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - A Saraya
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - A Iwama
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - K Yokote
- Department of Clinical Cell Biology and Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - E Sakaida
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - C Hirase
- Department of Hematology and Rheumatology, Faculty of Medicine, Kinki University, Osaka, Japan
| | - A Takeshita
- Department of Internal Medicine, Hamamatsu University School of Medicine, Hamamatsu, Japan
| | - K Imai
- Department of Hematology, Sapporo Hokuyu Hospital, Sapporo, Japan
| | - H Okumura
- Department of Internal Medicine, Toyama Prefectural Central Hospital, Toyama, Japan
| | - Y Morishita
- Department of Hematology and Oncology, JA Aichi Konan Kosei Hospital, Konan, Japan
| | - N Usui
- Division of Clinical Oncology and Hematology, Department of Internal Medicine, The Jikei University Daisan Hospital, Tokyo, Japan
| | - N Takahashi
- Department of Hematology, Nephrology and Rheumatology, Akita University Graduate School of Medicine, Akita, Japan
| | - S Fujisawa
- Department of Hematology, Yokohama City University Medical Center, Yokohama, Japan
| | - Y Shiraishi
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - K Chiba
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - H Tanaka
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - H Kiyoi
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan
| | - K Ohnishi
- Japanese Red Cross Aichi Blood Center, Seto, Japan
| | - S Ohtake
- Department of Clinical Laboratory Science, Kanazawa University Graduate School of Medical Science, Kanazawa, Japan
| | - N Asou
- Department of Hemato-Oncology, Comprehensive Cancer Center, International Medical Center, Saitama Medical University, Saitama, Japan
| | - Y Kobayashi
- Division of Hematology, National Cancer Center Hospital, Tokyo, Japan
| | - Y Miyazaki
- Department of Hematology and Molecular Medicine Unit, Atomic Bomb Disease Institute, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - S Miyano
- Laboratory of DNA Information Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan.,Laboratory of Sequence Analysis, Human Genome Center, The Institute of Medical Science, The University of Tokyo, Tokyo, Japan
| | - S Ogawa
- Department of Pathology and Tumor Biology, Graduate School of Medicine, Kyoto University, Kyoto, Japan
| | - I Matsumura
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba, Japan
| | - C Nakaseko
- Department of Hematology, Chiba University Hospital, Chiba, Japan
| | - T Naoe
- Department of Hematology and Oncology, Nagoya University Graduate School of Medicine, Nagoya, Japan.,National Hospital Organization Nagoya Medical Center, Nagoya, Japan
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Abstract
Abstract
Background: Ciguatera intoxication is a form of food poisoning. It is caused by the consumption of certain warm-water fish that have accumulated ciguatera toxin (CTX) through the marine food chain. Ciguatera fish poisoning (CFP) is a global disease, which although common, has been largely ignored in Thailand. This may be attributed to lack of confirmatory tests and seemingly nonspecific clinical presentations.
Objective: We studied CTX contamination in marine fish sold at Bangkok markets.
Methods: A surveillance of CTX in fish using the Cigua-Check assay has been conducted in Bangkok, the center of seafood marketing in Thailand. Here, there are several types of fish. Some come from domestic fishing and others are imported from Indonesia, Myanmar, or India.
Results: A random survey at three fish markets in Bangkok revealed two samples possibly contaminated with ciguatera toxin from a total 227 fish samples (of 21 fish species). This is the first report of finding CTX contamination in fish meat sold in Bangkok.
Conclusion: It is possible that these CTX-positive fish were caught from other countries. Even though the positivity (0.88%) is lower when compared with studies of other endemic areas (5.0% in Hawaii and Pacific Islands), this finding should raise awareness of the possibility of facing rare CFP intoxication from fish obtained at local Thai markets.
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Affiliation(s)
- Chirapol Sintunawa
- Faculty of Environment and Resource Studies, Mahidol University, Nakorn Pathom 73170, Thailand
| | - Supaporn Wacharapluesadee
- Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, and WHO Collaborating Centre for Research and Training on Viral Zoonoses, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Abhinbhen Saraya
- Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, and WHO Collaborating Centre for Research and Training on Viral Zoonoses, Thai Red Cross Society, Bangkok 10330, Thailand
| | - Thiravat Hemachudha
- Faculty of Medicine, Chulalongkorn University and King Chulalongkorn Memorial Hospital, and WHO Collaborating Centre for Research and Training on Viral Zoonoses, Thai Red Cross Society, Bangkok 10330, Thailand
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Singh S, Saraya A, Sharma R. 52P Expression of CT antigens in periampullary carcinomas patients: Potential minimally-invasive biomarkers for diagnosis. Ann Oncol 2016. [DOI: 10.1093/annonc/mdw574.025] [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: 11/13/2022] Open
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7
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Mungaomklang A, Chomcheoy J, Wacharapluesadee S, Joyjinda Y, Jittmittraphap A, Rodpan A, Ghai S, Saraya A, Hemachudha T. Influenza Virus-Associated Fatal Acute Necrotizing Encephalopathy: Role of Nonpermissive Viral Infection? Clin Med Insights Case Rep 2016; 9:99-102. [PMID: 27812294 PMCID: PMC5091092 DOI: 10.4137/ccrep.s40610] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2016] [Revised: 09/19/2016] [Accepted: 09/26/2016] [Indexed: 12/02/2022]
Abstract
In 2014, two unusual peaks of H1N1 influenza outbreak occurred in Nakhon Ratchasima Province, in Thailand. Among 2,406 cases, one of the 22 deaths in the province included a 6-year-old boy, who initially presented with acute necrotizing encephalopathy. On the other hand, his sibling was mildly affected by the same influenza virus strain, confirmed by whole-genome sequencing, with one silent mutation. Absence of acute necrotizing encephalopathy and other neurological illnesses in the family and the whole province, with near identical whole viral genomic sequences from the two siblings, and an absence of concomitant severe lung infection (cytokine storm) at onset suggest nonpermissive infection as an alternative pathogenetic mechanism of influenza virus.
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Affiliation(s)
- Anek Mungaomklang
- Maharat Nakhon Ratchasima Hospital, Ministry of Public Health, Nakhon Ratchasima, Thailand
| | - Jiraruj Chomcheoy
- Maharat Nakhon Ratchasima Hospital, Ministry of Public Health, Nakhon Ratchasima, Thailand
| | - Supaporn Wacharapluesadee
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Yutthana Joyjinda
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Akanitt Jittmittraphap
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
- Department of Microbiology and Immunology, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand
| | - Apaporn Rodpan
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Siriporn Ghai
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Abhinbhen Saraya
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - Thiravat Hemachudha
- Neuroscience Centre for Research and Development, Faculty of Medicine, Chulalongkorn University, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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Abstract
The nutritional status of patients with chronic pancreatitis was assessed in 76 consecutive patients (63 males, mean age 35 ± 10 years; 13 females, mean age 40 ± 16 years) attending the pancreas clinic of a tertiary care hospital in India. A food frequency questionnaire was used to elicit information regarding dietary intake of food items. Nutrient intake was calculated using the 24 h recall method on a subsample of 20 patients. Anthropometric measurements were taken and haemoglobin and serum albumin were estimated. Thirty patients (45%) had made dietary modifications after they were diagnosed as having chronic pancreatitis. These changes in diet included a decrease in fat, spices and/or quantity of food consumed. Analysis of the qualitative data revealed that the majority of patients were taking wheat, lentils, vegetables, fruits, milk, curd, sugar and oils on a daily basis. The mean energy intake was 1750 ± 375 kcal in males and 1180 ± 246 kcal in females, which turned out to be 37% lower than the Recommended Dietary Allowances (RDA), both in males and females. Alhough most patients (86%) were in the normal range of Body Mass Index (BMI), 67% of the patients reported weight loss after onset of the disease. Biochemical parameters studied were in the normal range: haemoglobin 12.26 ± 1.99 gm% and albumin 4.05 ± 0.89 g/100 mL. We concluded that in patients with chronic pancreatitis, malnutrition occurs mainly due to a low intake of calories and protein as a result of dietary modification for symptomatic relief and pancreatic insufficiency. However, nutritional parameters such as haemoglobin and serum albumin are fairly well maintained.
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Affiliation(s)
- N Singh
- Department of Gastroenterology and Human Nutrition, All India Institute of Medical Sciences, New Delhi, India
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9
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Saraya A, Sintunawa C, Wacharapluesadee S, Swangpun K, Dumrongchua S, Wilde H, Hemachudha T. Marine Fish Toxins in Thailand: Report of 6 Suspected Ciguatera Cases. ACTA ACUST UNITED AC 2014. [DOI: 10.4236/crcm.2014.35065] [Citation(s) in RCA: 8] [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: 11/20/2022]
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10
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Saraya A, Mahavihakanont A, Shuangshoti S, Sittidetboripat N, Deesudchit T, Callahan M, Wacharapluesadee S, Wilde H, Hemachudha T. Autoimmune causes of encephalitis syndrome in Thailand: prospective study of 103 patients. BMC Neurol 2013; 13:150. [PMID: 24139084 PMCID: PMC3853593 DOI: 10.1186/1471-2377-13-150] [Citation(s) in RCA: 25] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/15/2013] [Accepted: 09/30/2013] [Indexed: 01/17/2023] Open
Abstract
Background Data on encephalitis in Thailand have not been completely described. Etiologies remain largely unknown. We prospectively analyzed 103 Thai patients from 27 provinces for the causes of encephalitis using clinical, microbiological and neuroimaging indices; caseswithout a diagnosis were evaluated for autoimmune causes of encephalitis. Methods Patients with encephalitis and/or myelitis were prospectively studied between October 2010 and August 2012. Cases associated with bacterial, rickettsial and mycobacterial diseases were excluded. Herpes viruses 1-6 and enteroviruses infection was diagnosed using PCR evaluation of CSF; dengue and JE viruses infection, by serology. The serum of test-negative patients was evaluated for the presence of autoantibodies. Results 103 patients were recruited. Fifty-three patients (52%) had no etiologies identified. Twenty-five patients (24%) were associated with infections. Immune encephalitis was found in 25 (24%); neuropsychiatric lupus erythematosus (4), demyelinating diseases (3), Behcet’s disease (1) and the remaining had antibodies to NMDAR (5), ANNA-2 (6), Yo (2), AMPA (1), GABA (1), VGKC (1) and NMDA coexisting with ANNA-2 (1). Presenting symptoms in the autoimmune group included behavioral changes in 6/25 (versus 12/25 in infectious and 13/53 in unknown group) and as psychosis in 6/25 (versus 0/25 infectious and 2/53 unknown). Seizures were found in 6/25 autoimmune, 4/25 infectious and 19/53 unknown group. Two patients with anti-ANNA-2 and one anti-Yo had temporal lobe involvement by magnetic resonance imaging. Two immune encephalitis patients with antibodies to NMDAR and ANNA-2 had ovarian tumors. Conclusions Autoantibody-associated encephalitis should be considered in the differential diagnosis and management algorithm regardless of clinical and neuroimaging features.
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Affiliation(s)
- Abhinbhen Saraya
- Neuroscience Centre for Research and Development, Division of Neurology, Department of Medicine, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
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Wilde H, Wacharapluesadee S, Saraya A, Lumlertdacha B, Hemachudha T. Human rabies prevention (comment from a canine-rabies-endemic region). J Travel Med 2013; 20:139-42. [PMID: 23577857 DOI: 10.1111/jtm.12022] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2013] [Accepted: 01/14/2013] [Indexed: 11/28/2022]
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12
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Mahavihakanont A, Saraya A, Shuangshoti S, Sittidetboripat N, Wacharapluesadee S, Wilde H, Hemachudha T. Encephalitis syndrome: Look for autoimmune causes. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.095] [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: 10/28/2022] Open
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13
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Laothamatas J, Sungkarat W, Saraya A, Wacharapluesadee S, Hemachudha T. Diffusion tensor imaging in encephalitis: a preliminary report of 28 patients. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.532] [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] Open
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14
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Saraya A, Wilde H, Hemachudha T. CSF pleocytosis is not always present in herpes simplex virus infection of the nervous system. Int J Infect Dis 2012. [DOI: 10.1016/j.ijid.2012.05.250] [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: 10/28/2022] Open
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15
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Sazawal S, Rathi S, Chikkara S, Chaubey R, Seth T, Saraya A, Das J, Mahapatra M, Saxena R. JAK2 mutation in patients with splanchnic venous thrombosis: a pilot study from India. Indian J Med Res 2012; 135:429-31. [PMID: 22561633 PMCID: PMC3361883] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022] Open
Affiliation(s)
- S. Sazawal
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - S. Rathi
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - S. Chikkara
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - R. Chaubey
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - T. Seth
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - A. Saraya
- Department of Gastroenterology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - J. Das
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - M. Mahapatra
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
| | - R. Saxena
- Department of Hematology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India,For correspondence: Dr Renu Saxena, Department of Hematology, IRCH Building (1st Floor), All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110 029, India
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Bajpai V, Saraya A. Socioeconomic inequalities and health outcomes in India. Natl Med J India 2012; 25:38-42. [PMID: 22693716] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- V Bajpai
- Jawaharlal Nehru University, New Delhi, India.
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Khaira A, Mahajan S, Kumar A, Prakash S, Saraya A, Singh B, Bora M, Tiwari SC, Agarwal SK, Bhowmik D. Oxidative stress, endothelial function, carotid artery intimal thickness and their correlates among chronic peritoneal dialysis patients. Indian J Nephrol 2011; 21:264-9. [PMID: 22022087 PMCID: PMC3193670 DOI: 10.4103/0971-4065.83736] [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] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023] Open
Abstract
We evaluated important nontraditional cardiovascular risk factors, endothelial function and oxidative stress (OS) among stable peritoneal dialysis (PD) patients. Their association with carotid intimal medial thickness (CIMT) was also assessed. Thirty-eight adult patients (13 diabetics, 20 males) on PD for >6 months and 15 age and sex-matched controls were studied. Duration of dialysis (DOD), residual urine output (UO), weekly Kt/V urea, detailed biochemical and lipid profile were noted. OS was measured by serum concentration of antioxidants; vitamin C and ferric reducing ability of plasma (FRAP) and pro-oxidant; thiobarbituric acid-reactive substances (TBARS). High-resolution ultrasonography was used to determine CIMT and flow-mediated dilatation of brachial artery [endothelium-dependent dilatation (EDD)] and dilatation subsequent to nitrate spray [endothelium-independent dilatation (EID)]. Mean age, DOD, UO and Kt/V of study population were 49.3 ± 11.6 years, 19.4 ± 11.8 months, 508.2 ± 422.9 ml/day and 1.73 ± 0.24, respectively. As compared to controls PD patients had higher CIMT (0.46 ± 0.05 vs 0.50 ± 0.07 mm, P = 0.003) and TBARS (1.5 ± 0.4 vs 5.1 ± 2.3 nM/ml, P < 0.001) but lower Vitamin C (1.7 ± 0.3 vs 0.6 ± 0.2 mg%, P < 0.001), FRAP (990.8 ± 78.1 vs 328.7 ± 183.5 μM/L, P < 0.001) and EDD (26.2 ± 5.4 vs 9.8 ± 4.6 %, P < 0.001). TBARS correlated positively with DOD and negatively with hemoglobin. Vitamin C and FRAP correlated positively with serum albumin. EDD correlated positively with UO, Kt/V and hemoglobin. CIMT correlated negatively with Kt/V and hemoglobin. Among themselves CIMT correlated negatively with EDD and vitamin C. EDD correlated positively with vitamin C, while FRAP correlated positively with vitamin C and negatively with TBARS. PD patients have higher OS, poorer endothelial function and higher structural atherosclerosis. These parameters are closely linked to each other, hemoglobin, DOD, residual UO, serum albumin and small solute clearances.
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Affiliation(s)
- A Khaira
- Department of Nephrology, All India Institute of Medical Sciences, New Delhi, India
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Mukund A, Gamanagatti S, Saraya A. Chronic pancreatitis causing thrombotic occlusion of IVC and renal veins. Trop Gastroenterol 2011; 32:337-338. [PMID: 22696924] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
- A Mukund
- Department of Radiology, All India Institute of Medical Sciences, New Delhi, India
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Chaudhary R, Kumar U, Saraya A, Sharma S, Seith A, Sreenivas. P29 Gastrointestinal involvement in systemic sclerosis—a cross sectional study in Indian population. Indian Journal of Rheumatology 2010. [DOI: 10.1016/s0973-3698(10)60644-9] [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: 10/18/2022] Open
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20
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Saraya A, Wacharapluesadee S, Khawplod P, Tepsumethanon S, Briggs D, Asawavichienjinda T, Hemachudha T. A preliminary study of chemo- and cytokine responses in rabies vaccine recipients of intradermal and intramuscular regimens. Vaccine 2010; 28:4553-7. [DOI: 10.1016/j.vaccine.2010.04.090] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2010] [Revised: 04/22/2010] [Accepted: 04/27/2010] [Indexed: 12/20/2022]
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Mahey R, Agarwal N, Kriplani A, Saraya A, Garg P. P116 Role of serum bile acids in diagnosis of intrahepatic cholestasis of pregnancy and effect of ursodeoxycholic acid therapy on bile acids and perinatal outcome. Int J Gynaecol Obstet 2009. [DOI: 10.1016/s0020-7292(09)61607-6] [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: 11/17/2022]
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Bajpai V, Saraya A. User charges in public health care: clouded wisdom. Trop Gastroenterol 2008; 29:55-57. [PMID: 18564673] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 05/26/2023]
Affiliation(s)
- V Bajpai
- Department of Biophysics, All India Institute of Medical Sciences, New Delhi, India
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Parshad R, Kumar MV, Bal S, Saraya A, Sharma MP. Laparoscopic Nissen fundoplication; results of a prospective pilot study. Trop Gastroenterol 2003; 24:152-6. [PMID: 14978994] [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: 04/29/2023]
Abstract
Laparoscopic fundoplication is rapidly becoming the surgical procedure of choice in western countries for the management of gastro-oesophageal reflux disease (GERD). Experience with this technique is limited in India. Most operations continue to be performed through the traditional open technique, thus denying the advantage of a minimal invasive approach to patients. This study was done to evaluate the feasibility and short term results of laparoscopic Nissen fundoplication. Between June 2000 and March 2002, a total of 10 patients with GERD refractory to medical therapy or requiring daily treatment underwent laparoscopic Nissen fundoplication. Preoperative evaluation included scoring of symptoms, oesophagogastroduodenoscopy, barium swallow and nuclear scan. The intraoperative and post-operative course of the patients was recorded. At 3 months post-surgery, patients were re-evaluated using pre-operative symptom scores and investigations to assess the benefit of and complications associated with surgery. Laparoscopic nissen fundoplication was successfully completed in all the patients. Follow up ranged from 3 to 18 months with a mean of 5.9 months. The mean symptom score decreased from 10.1 pre-operatively to 1.7 (p value < 0.001). Eight out of 9 patients (88%) had endoscopic resolution of oesophagitis. Seven patients (70%) were off medication following surgery while the remaining 3 (30%) were taking medication intermittently. Overall, 80% of the patients were satisfied with the surgery. One patient required re-exploration due to bleeding from a short gastric vessel. The most frequent post-operative complication was temporary dysphagia in 60% of patients, which improved with conservative management over 2 to 3 weeks. We concluded that laparoscopic Nissen fundoplication is a safe and effective procedure to treat patients with GERD.
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Affiliation(s)
- Rajinder Parshad
- Department of Surgery, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029.
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Saraya A, Acharya SK, Vashisht S, Tandon RK. A pancreaticographic study of malnutrition-related diabetes mellitus. Trop Gastroenterol 2003; 24:120-3. [PMID: 14978983] [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: 04/29/2023]
Abstract
Pancreatic involvement is considered to be the hallmark of malnutrition-related diabetes mellitus (MRDM). Of the 2 subgroups of the disease, fibrocalculous pancreatic diabetes (FCPD) is characterized by pancreatic calcification. The nature of pancreatic abnormalities in MRDM have not been studied extensively in Indian patients. The present study was designed to compare pancreatic abnormalities (exocrine and endocrine) including endoscopic retrograde pancreaticography in patients with FCPD and protein deficient pancreatic diabetes (PDPD), in relation to controls. Ten patients each of FCPD and PDPD were studied with regard to clinical features, biochemical exocrine and endocrine pancreatic responses, C-peptide response, islet cell antibody, and pancreatographic changes. Five normal pancreatograms were taken as control. Clinical and biochemical features in patient with FCPD and PDPD were as follows: pain in 8 and 2 patients, respectively; the mean duration of diabetes was similar in both groups (62.28 +/- 71.92 months V. 72 +/- 50.9 months); and faecal fat excretion and insulin requirements were comparable in both groups. The main pancreatic duct was dilated in 6 of 10 patient with FCPD and only 1 of 10 with PDPD on ultrasonography. On pancreatography the duct was dilated in 9 of 10 patients with FCPD and only 1 of 10 patients with PDPD. The number of side branches was reduced in all cases with MRDM; in those with FCPD, these were stunted and dilated while in PDPD side branches are thin and spastic. We conclude that pancreatic ductal changes involving the main duct and side branches are more frequent in patients with FCPD as compared to those with PDPD.
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Affiliation(s)
- A Saraya
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi 110029
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Saraya A, Acharya SK, Vashist S, Tandon RK. A pancreatography study of chronic calcific pancreatitis of the tropics. Trop Gastroenterol 2002; 23:167-9. [PMID: 12833701] [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: 03/03/2023]
Abstract
Chronic Calcific Pancreatitis of Tropics is a disease of unknown aetiology and is characterised by chronic pancreatitis with calcification in young persons who present with pain, diabetes, and/or steatorrhoea. ERCP performed on 42 patients with this condition revealed changes compatible with chronic pancreatitis. These changes were however, more marked and somewhat different from those seen in the alcoholic chronic pancreatitis. Cystic dilatation, tortuosity, and obstruction of the main pancreatic duct were similar to that in alcoholic pancreatitis. The features of CCPT that were different from those of latter, were large pancreatic calculi, absence of strictures/stenosis and absence of irregularity of the ductal wall. The calculi were predominantly in the head region of the pancreas causing maximal dilatation of the main pancreatic duct in the head of pancreas. The secondary branches were stunted, short and scanty but revealed a lower grade of changes, than the changes documented in the main pancreatic duct. The pancreatic ductal changes in CCPT seems to be different from that seen in chronic alcoholic pancreatitis and may be due to the difference in the pathophysiology of the underlying disease.
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Affiliation(s)
- A Saraya
- All India Institute of Medical Sciences, Ansari Nagar, New Delhi-110 029, India
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Miki T, Liss B, Minami K, Shiuchi T, Saraya A, Kashima Y, Horiuchi M, Ashcroft F, Minokoshi Y, Roeper J, Seino S. ATP-sensitive K+ channels in the hypothalamus are essential for the maintenance of glucose homeostasis. Nat Neurosci 2001; 4:507-12. [PMID: 11319559 DOI: 10.1038/87455] [Citation(s) in RCA: 417] [Impact Index Per Article: 18.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/20/2023]
Abstract
Glucose-responsive (GR) neurons in the hypothalamus are thought to be critical in glucose homeostasis, but it is not known how they function in this context. Kir6.2 is the pore-forming subunit of K(ATP) channels in many cell types, including pancreatic beta-cells and heart. Here we show the complete absence of both functional ATP-sensitive K+ (K(ATP)) channels and glucose responsiveness in the neurons of the ventromedial hypothalamus (VMH) in Kir6.2-/- mice. Although pancreatic alpha-cells were functional in Kir6.2-/-, the mice exhibited a severe defect in glucagon secretion in response to systemic hypoglycemia. In addition, they showed a complete loss of glucagon secretion, together with reduced food intake in response to neuroglycopenia. Thus, our results demonstrate that KATP channels are important in glucose sensing in VMH GR neurons, and are essential for the maintenance of glucose homeostasis.
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Affiliation(s)
- T Miki
- Department of Cellular and Molecular Medicine, Graduate School of Medicine, Chiba University, Chiba 260-8670, Japan
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Abstract
BACKGROUND Malnutrition-related diabetes mellitus is a distinct clinical entity subdivided into protein-deficient diabetes mellitus (PDDM) and fibrocalculus pancreatic diabetes (FCPD). Whereas FCPD has obvious pancreatitis manifested by pancreatic duct calculi, the evidence for involvement of the pancreas in PDDM is limited to the presence of ketosis-resistant hyperglycaemia. METHODS We studied 10 patients with PDDM biochemically and radiologically. Endoscopic retrograde cholangiopancreatography was performed to determine if they had any evidence of chronic pancreatitis. RESULTS Their mean faecal chymotrypsin level was low (13.2+/-5.72 microg/g), as was their basal c-peptide value (0.35+/-0.15 mmol/L). Islet cell antibodies were not detected in any of these patients. Ultrasound examination revealed pancreatic atrophy. In two patients, however, the pancreas was bulky. The ERCP showed generalized thinning of the pancreatic duct, measuring 2.4+/-0.06mm in the head, 2.01+/-0.08 mm in the body and 1.02 +/- 0.03 mm in tail region; side branches were seen but they were too sparse and thin. CONCLUSIONS The significance of these changes is not clear, but they may represent an ongoing pancreatic disease and may, indeed, be the earliest changes of chronic pancreatitis.
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Affiliation(s)
- A Saraya
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi
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Khurana AK, Saraya A, Jain N, Chandra M, Kulshreshta R. Profile of lower gastrointestinal bleeding in children from a tropical country. Trop Gastroenterol 1998; 19:70-1. [PMID: 9752757] [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: 02/08/2023]
Abstract
Eighty five children were evaluated endoscopically for recurrent lower gastrointestinal (GI) bleeding. The male: female ratio was 2.4:1 with a mean age of 6 years (range 8 months to 2 years). After adequate bowel preparation endoscopic evaluation was done using olympus CF 101 colonoscope. Sedation was given only in two patients. Full length colonoscopy had been done in 16 cases only, to look for extent of disease in 8 cases and to ascertain site of bleeding when no lesion could be seen on sigmoidoscopy. Juvenile polyps were seen in 40 cases, amoebic ulcer in 20, solitary rectal ulcer in 4 and polyposis syndrome in 5 cases. Sigmoidoscopy alone could establish the diagnose in 76 cases. We conclude that flexible sigmoidoscopy alone is safe and adequate in ascertaining the cause of prolonged recurrent lower GI bleeding.
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Affiliation(s)
- A K Khurana
- Dept. of Medicine, Safdarjung Hospital, New Delhi, India
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Khurana AK, Saraya A, Jain N, Aman V, Sen S. Management of foreign bodies of the upper gastrointestinal tract. Trop Gastroenterol 1998; 19:32-33. [PMID: 9641033] [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: 05/22/2023]
Abstract
The use of flexible endoscopes had made removal of foreign bodies in the upper gastrointestinal tract easier and safer. We describe our experience of 49 cases of foreign bodies of the upper gastrointestinal tract. Majority (67%) of the patients were children and only 4 patients (8%) were above 45 years of age. The most common foreign bodies encountered were coins (25), fruit stones (4) and dentures (3). In 29 patients foreign bodies were lodged in the oesophagus and in 15 cases in the stomach. Forty one patients were considered for endoscopic removal of the foreign bodies and 40 could be managed successfully. There were no procedure related complications. We conclude that endoscopic removal of the foreign bodies of the upper gastrointestinal tract is a safe and effective technique.
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Affiliation(s)
- A K Khurana
- Department of Medicine, Safdarjung Hospital, New Delhi, India
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Abstract
Dietary intake and plasma lipids were estimated in 200 patients with gallstones and 98 control subjects from a hospital in Northern India and were matched for age, sex, and social class. The intake of total calories and carbohydrates and the plasma triglyceride values were higher in all gallstone patients as compared with controls (p < 0.05 and p < 0.01, respectively). The dietary intake of refined carbohydrates was higher than in controls, but only in the female patients with gallstones (35.6 +/- 32.9 g/day compared with 24.5 +/- 11.8 g/day; p < 0.001). By contrast, the male patients with gallstones had an increased intake of fat (patients 79.0 +/- 38.1 g/day vs. controls 60.2 +/- 24.3 g/day; p < 0.05) and had increased plasma cholesterol values (patients 166.4 +/- 54.2 mg/dl vs. controls 140.3 +/- 32.8 mg/dl; p < 0.01). Such sex differences in the dietary intake and plasma lipid values may form a special feature of gallstone disease in Northern India and should be studied further.
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Affiliation(s)
- R K Tandon
- Department of Gastroenterology and Surgery, All India Institute of Medical Sciences, New Delhi
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Saraya A, Irshad M, Gandhi BM, Tandon RK. Plasma lipid profile in gallstone patients from North India. Trop Gastroenterol 1995; 16:16-21. [PMID: 8854950] [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: 02/02/2023]
Abstract
One hundred and thirty five patients with gallstones along with eighty nine matched controls were studied ultrasonographically to look for any association with hyperlipidemias. Plasma cholesterol and triglycerides were estimated by colorimetric methods and lipoproteins were classified according to Beaumont's classification. Male to female ratio in gallstone patients was 1:3. Mean plasma cholesterol and triglyceride values were higher in male gallstones patients as compared to controls (166.40 +/- 54.21 vs 40.26 +/- 32.80 mg/dl, p <0.01 and 182.65 +/- 84.49 vs 133.18 +/- 52.37 mg/dl, p <0.01 respectively). In female gallstone patients, on the other hand, only plasma triglyceride levels were raised as compared to control (182.65 +/- 84.49 vs 133.18 +/- 52.32 mg/dl, p <0.01). Prevalence of type IIb and type IV was 24.32% and 29.72% in male gallstone patients and 13.2 and 39.70% respectively in female gallstone patients. Thus, more than half of our gallstone patients had hyperlipidemia, the commonest types amongst them being type IIb and type IV.
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Affiliation(s)
- A Saraya
- Department of Gastroenterology & Human Nutrition, All India Institute of Medical Sciences, New Delhi
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Sharma MP, Saraya A, Anand AC, Karmarkar MG. Gall bladder dysmotility in diabetes mellitus--an ultrasound study. Trop Gastroenterol 1995; 16:13-18. [PMID: 8838037] [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: 05/22/2023]
Abstract
Fifty two diabetic patients and 15 healthy control subjects were prospectively studied for their gall bladder function by ultrasound examination. The fasting gall bladder volume (FGBV) was calculated by using ellipse formula from the dimension of gall bladder shadow seen on ultrasound screen in two different cuts. The contractility of gall bladder was measured by calculating post prandial ejection fraction (EF) of the gall bladder. The mean FGBV and EF in 52 diabetic patients was found to be 20.7 +/- 10.7 cc and 47.5 +/- 20.1%, which was not significantly different from that in normal controls. Age, sex, obesity, diabetic control and presence of dyspeptic symptoms had no impact in FGBV and EF. Diabetic symptoms had no impact in FGBV and EF. However, diabetics with longer duration of disease had poorer gall bladder contractility (p < 0.05). Patients with autonomic neuropathy (AN) had significantly larger FGBV but normal contractility. Our results suggest that (a) long standing diabetics may have poor gall bladder emptying predisposing to gall stone formation (b) patients with autonomic neuropathy have reduced tone of fasting gall bladder but normal contractility.
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Affiliation(s)
- M P Sharma
- Dept. of Gastroenterology, All India Institute of Medical Sciences, New Delhi
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Sarin SK, Negi VS, Dewan R, Sasan S, Saraya A. High familial prevalence of gallstones in the first-degree relatives of gallstone patients. Hepatology 1995; 22:138-41. [PMID: 7601405] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/06/2022]
Abstract
Limited information is available on the prevalence of gallstones in the first-degree relatives of gallstone patients. Three groups of subjects were studied by real-time ultrasound examination: group A, 105 index gallstone patients (male/female; 20:85); group B, 330 first-degree relatives of index patients; group C, matched controls for group A (n = 105) and group B (n = 330) subjects. Dietary, anthropometric, and biochemical investigations were carried out. In 39 of 105 (37%) index cases, one or more additional family members had gallstones (positive-index case). The positive-index cases were younger than the remaining index cases (mean age, 33.1 +/- 14 vs. 44.5 +/- 13.1 years; P < .05). Fifty-one of 330 (15.5%) first-degree relatives had gallstones, nearly four and a half times (95% confidence interval [CI], 2.4 to 8.5) more often than in the matched control population (12 of 330 [3.6%]). Thirty-three of 51 (65%) positive relatives were women; mother (37.3%), sister (17.6%) or daughters (10%) to the index patients. There was no difference in the diet, physical activity, and serum lipid profile between the positive index patients and the remaining gallstone patients and positive relatives and their controls. Our results show that there is a strong familial predisposition for gallstone formation. Female relatives of young gallstone patients should be routinely screened for gallstones.
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Affiliation(s)
- S K Sarin
- Department of Gastroenterology, G. B. Pant Hospital, Delhi, India
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Sarin SK, Saraya A. Effects of intravenous nitroglycerin and nitroglycerin and metoclopramide on intravariceal pressure: a double blind, randomized study. Am J Gastroenterol 1995; 90:48-53. [PMID: 7801949] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
OBJECTIVE Effective and safe reduction of variceal pressure by pharmacological means. METHODS Twenty patients with portal hypertension and large esophageal varices. Ten patients received i.v. nitroglycerin (300 micrograms-bolus) and an equal number received a combination of i.v. nitroglycerin (150 micrograms) and metoclopramide (20-mg bolus). Continuous measurement of variceal pressure and systemic hemodynamics was carried out. RESULTS Compared with the baseline, the variceal pressure was reduced at 10 min after injection of 300 micrograms nitroglycerin (22.3 +/- 7.9 vs. 17.3 +/- 7 mm Hg, p, not significant); the percentage reduction was 23.5 +/- 15.8%. With the combination of low dose (150 micrograms) nitroglycerin and metoclopramide, variceal pressure significantly decreased from 23.1 +/- 4.7 to 15.9 +/- 5.9 mm Hg (p < 0.01) (a reduction of 29.5 +/- 24.1%). There was no significant alteration in the heart rate or mean arterial pressure with either regimen. CONCLUSIONS Our results suggest that a combination of i.v. metoclopramide and low-dose nitroglycerin reduces variceal pressure more effectively than high-dose nitroglycerin used alone. This combination should be further evaluated in the control of acute variceal bleeding.
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Affiliation(s)
- S K Sarin
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
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Saraya A, Tandon RK. Pseudocyst of the pancreas: management options. Trop Gastroenterol 1995; 16:1-3. [PMID: 7645048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
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Saraya A, Sarin SK. Effects of intravenous nitroglycerin and metoclopramide on intravariceal pressure: a double-blind, randomized study. Am J Gastroenterol 1993; 88:1850-3. [PMID: 8237931] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
In search of an effective agent for decreasing intravariceal pressure, 27 patients with portal hypertension and large esophageal varices were studied. Thirteen patients received iv nitroglycerin (150-micrograms bolus), and 14 received iv metoclopramide (20-mg bolus). Continuous measurement of variceal pressure and systemic hemodynamics was carried out. Compared with the baseline, the variceal pressure was significantly reduced 10 min after nitroglycerin injection (20.23 +/- 3.1 vs. 14.6 +/- 4.8 mm Hg, p < 0.05): the percentage reduction was 27 +/- 25.4%. With metoclopramide, variceal pressure decreased by 12.7 +/- 22%; from 21.9 +/- 5.6 to 19.1 +/- 7.7 mmHg (p = NS). There was no significant alteration in the heart rate and mean arterial pressure with either drug. Our results thus suggest that in the dosages used, intravenous nitroglycerin effectively and safely reduces the variceal pressure. Further studies using a combination of nitroglycerin and metoclopramide need to be considered.
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Affiliation(s)
- A Saraya
- Department of Gastroenterology, G. B. Pant Hospital, New Delhi, India
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Dasarathy S, Buch P, Saraya A, Acharya SK, Tandon RK. Pancreatic abscess: is there a role for conservative therapy? Trop Gastroenterol 1993; 14:28-32. [PMID: 8342246] [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: 01/30/2023]
Abstract
Pancreatic abscess is a serious complication of acute pancreatitis and non-operative management has been reported to carry a mortality of nearly 100%. We present five patients with pancreatic abscess, who were successfully treated with antibiotics alone. All 5 patients had acute pancreatitis followed by prolonged fever and development of an abdominal mass. The diagnosis was confirmed in each of them by a contrast enhanced CT scan and an ultrasound guided aspiration of pus from the pancreatic mass. The choice of antibiotics was decided by the culture reports in two cases and by Gram's staining in the remaining three patients. We attribute the success of antibiotic therapy in our patients to early diagnosis by CT scan and guided aspiration as well as the absence of any unfavourable risk factors. This study suggests that a select group of patients with pancreatic abscess may be managed conservatively with antibiotics.
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Affiliation(s)
- S Dasarathy
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi
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Abstract
Portal hypertensive gastropathy (PGP) is an important cause of bleeding in portal hypertension patients. Although hyperdynamic congestion seems to be the underlying mechanism, the factors that influence the development of PGP are not understood. To investigate these, 107 patients [cirrhosis, 35; noncirrhotic portal fibrosis (NCPF), 24; extrahepatic portal vein obstruction (EHPVO), 46; Budd-Chiari syndrome, 2] were prospectively studied. Eighty-three patients had Child's A, 17 had Child's B, and 7 had Child's C liver disease. Before sclerotherapy, although intravariceal pressure was similar, 4 cirrhosis patients (3.7%) but no NCPF or EHPVO patients had PGP. After sclerotherapy, 21 additional patients (20.3%) developed PGP during a follow-up of 23.2 +/- 3.4 months (range, 1-52). The incidence of PGP was higher in cirrhotic patients (37.1%) than in NCPF (16.7%; P less than 0.05) or EHPVO (8.7%; P less than 0.01) patients. The probability of developing PGP among all patients at the end of 52 months of follow-up was 30%, more in cirrhosis than in EHPVO (55% vs. 15%; P less than 0.005). Only 2 patients bled from PGP during follow-up. Development of PGP correlated with severity of liver disease, being more common in Child's C than Child's A patients (87% vs. 13%; P less than 0.001). PGP was seen more often in patients with gastroesophageal varices than in patients with esophageal varices alone (42% vs. 11%; P less than 0.01). In conclusion, the results show that development of PGP is significantly influenced by sclerotherapy, severity of liver disease, etiology of portal hypertension, coexisting gastric varices and is not directly correlated with intravariceal pressure.
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Affiliation(s)
- S K Sarin
- Department of Gastroenterology, G.B. Pant Hospital, New Delhi, India
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Abstract
The postcholecystectomy patients who have a T-tube in situ offer a convenient route through the T-tube to perfuse solvents into the common bile duct (CBD) for dissolving any retained common duct stones. If successful, this approach is much simpler and cheaper than the usual therapeutic modality used for CBD stones, namely, endoscopic papillotomy. Thus a most potent cholesterol solvent, methyl t-butyl ether (MTBE) was perfused through the T-tube into the CBD of five patients with retained common duct stones. The dose of the solvent varied, 1.5-5 mL 0.5-1 h, given 7-13 times amounting to a total of 20-66 mL. Instillation of MTBE in the T-tube was alternated with aspiration of the bile through T-tube. Only one patient showed complete disappearance of the bile duct stone following MTBE perfusion. Others did not show any appreciable response and had to be treated by endoscopic papillotomy (three patients) or mono-octanoin perfusion (one patient). Side-effects of MTBE perfusion included pain in the abdomen in all patients, somnolence and nausea/vertigo in two patients and the smell of ether on the breath in two patients. It is concluded that MTBE is not an effective agent for dissolution of retained CBD stones in patients with T-tube in situ.
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Affiliation(s)
- A Saraya
- Department of Gastroenterology, All India Institute of Medical Sciences, New Delhi
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Saraya A, Sharma MP, Tandon RK. Gallstones are not common in cirrhosis of the liver in India. Am J Gastroenterol 1989; 84:683-4. [PMID: 2729243] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
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