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Dahiya R, Walia A, Kaur J, Kumar P, Verma I, Rani N. Diabetic Retinopathy - Pathophysiology to Treatment: A Review. Curr Diabetes Rev 2024; 20:CDR-EPUB-137631. [PMID: 38315658 DOI: 10.2174/0115733998259940231105200251] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/10/2023] [Revised: 08/14/2023] [Accepted: 09/28/2023] [Indexed: 02/07/2024]
Abstract
Diabetic retinopathy (DR) is a microvascular disease affecting the eyes of diabetic patients, and is the most prevalent complication of diabetes mellitus. Vision improvement is not possible in the majority of DR patients. Several studies have indicated that microvascular changes, inflammation, oxidative stress, and retinal neurodegeneration are involved in the pathogenesis of DR. Therefore, there is an urgent need for the development of new and effective treatment for DR. Understanding the molecular mechanisms involved in the pathogenesis of disease will pave a way for better treatment and management of DR. This article has emphasized the molecular pathogenesis and treatment of DR.
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Affiliation(s)
- Randhir Dahiya
- Department of Pharmacology, Central University of Punjab, Bathinda, Punjab, India
- Department of Pharmacy, Graphic Era Hill University, Dehradun, India
| | - Aditya Walia
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Jasleen Kaur
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
| | - Praveen Kumar
- SunPharma, Hill Top Area, Vill. Bhatolikalan, P.O. Barotiwala, Distt.Solan, Himachal Pradesh, 174103, India
| | - Inderjeet Verma
- MM College of Pharmacy, Maharishi Markandeshwar (deemed to be) University, Mullana, Ambala, Haryana, India
| | - Nidhi Rani
- Chitkara College of Pharmacy, Chitkara University, Punjab, India
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Hakimi K, Carbonara U, Djaladat H, Mehrazin R, Eun D, Reese A, Gonzalgo M, Margulis V, Uzzo R, Porter J, Sundaram C, Abdollah F, Mottrie A, Tellini R, Ferro M, Meagher M, Saidian A, Walia A, Veccia A, Ghoriefi A, Cacciamani G, Bhattu A, Minervini A, Autorino R, Derweesh I. Impact of node count on survival outcomes of lymph node dissection in non-metastatic upper tract urothelial carcinoma: Analysis of the robuust registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00393-1] [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: 11/30/2022]
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Tanaka H, Fukuda S, Yasuda Y, Patil D, Saidian A, Walia A, Meagher M, Perry J, Nguyen M, Narasimhan R, Yoshida S, Yokoyama M, Matsuoka Y, Master V, Derweesh I, Saito K, Fujii Y. Disparities in cancer-specific mortality between Asian and Caucasian patients with non-metastatic renal cell carcinoma: Analysis of the INMARC registry. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00223-8] [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: 11/25/2022]
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Garland SM, Pitisuttithum P, Ngan HYS, Cho CH, Lee CY, Chen CA, Yang YC, Chu TY, Twu NF, Samakoses R, Takeuchi Y, Cheung TH, Kim SC, Huang LM, Kim BG, Kim YT, Kim KH, Song YS, Lalwani S, Kang JH, Sakamoto M, Ryu HS, Bhatla N, Yoshikawa H, Ellison MC, Han SR, Moeller E, Murata S, Ritter M, Sawata M, Shields C, Walia A, Perez G, Luxembourg A. Efficacy, Immunogenicity, and Safety of a 9-Valent Human Papillomavirus Vaccine: Subgroup Analysis of Participants From Asian Countries. J Infect Dis 2019; 218:95-108. [PMID: 29767739 PMCID: PMC5989602 DOI: 10.1093/infdis/jiy133] [Citation(s) in RCA: 21] [Impact Index Per Article: 4.2] [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: 11/15/2017] [Accepted: 03/16/2018] [Indexed: 01/17/2023] Open
Abstract
Background A 9-valent human papillomavirus-6/11/16/18/31/33/45/52/58 (9vHPV) vaccine extends coverage to 5 next most common oncogenic types (31/33/45/52/58) in cervical cancer versus quadrivalent HPV (qHPV) vaccine. We describe efficacy, immunogenicity, and safety in Asian participants (India, Hong Kong, South Korea, Japan, Taiwan, and Thailand) from 2 international studies: a randomized, double-blinded, qHPV vaccine-controlled efficacy study (young women aged 16–26 years; NCT00543543; Study 001); and an immunogenicity study (girls and boys aged 9–15 years; NCT00943722; Study 002). Methods Participants (N = 2519) were vaccinated at day 1 and months 2 and 6. Gynecological samples (Study 001 only) and serum were collected for HPV DNA and antibody assessments, respectively. Injection-site and systemic adverse events (AEs) were monitored. Data were analyzed by country and vaccination group. Results 9vHPV vaccine prevented HPV-31/33/45/52/58–related persistent infection with 90.4%–100% efficacy across included countries. At month 7, ≥97.9% of participants seroconverted for each HPV type. Injection-site AEs occurred in 77.7%–83.1% and 81.9%–87.5% of qHPV and 9vHPV vaccine recipients in Study 001, respectively, and 62.4%–85.7% of girls/boys in Study 002; most were mild to moderate. Conclusions The 9vHPV vaccine is efficacious, immunogenic, and well tolerated in Asian participants. Data support 9vHPV vaccination programs in Asia. Clinical Trials Registration NCT00543543; NCT00943722.
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Affiliation(s)
- S M Garland
- Western Pacific Regional HPV Labnet Reference Laboratory, Department of Infectious Disease and Microbiology, Royal Women's Hospital, Murdoch Children's Research Institute, Royal Children's Hospital and Department of Obstetrics and Gynaecology, University of Melbourne, Parkville, Victoria, Australia
| | | | - H Y S Ngan
- Department of Obstetrics and Gynaecology, the University of Hong Kong, China
| | - C-H Cho
- Department of Obstetrics and Gynecology, Keimyung University School of Medicine, Daegu, South Korea
| | - C-Y Lee
- Department of Gynecology, Chang Gung Memorial Hospital, Chiayi Branch, Taipei
| | - C-A Chen
- Department of Obstetrics and Gynecology, National Taiwan University Hospital, Taipei
| | - Y C Yang
- MacKay Memorial Hospital, Taipei
| | - T-Y Chu
- Tzu Chi Medical Center, Hualien
| | - N-F Twu
- Department of Obstetrics and Gynecology, Taipei Veterans General Hospital, Taipei, Taiwan
| | - R Samakoses
- Department of Pediatrics, Phramongkutklao Hospital, Bangkok, Thailand
| | | | - T H Cheung
- Department of Obstetric and Gynaecology, Chinese University of Hong Kong, China
| | - S C Kim
- Division of Gynecologic Oncology, Ewha Womans University Mokdong Hospital, School of Medicine Ewha Womans University, Seoul, South Korea
| | - L-M Huang
- Department of Pediatrics, National Taiwan University Hospital, Taipei, Taiwan
| | - B-G Kim
- Department of Obstetrics and Gynecology, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, South Korea
| | - Y-T Kim
- Department of Obstetrics and Gynecology, University of Ulsan College of Medicine, Asian Medical Center, Seoul, South Korea
| | - K-H Kim
- Department of Pediatrics and Center for Vaccine Evaluation and Study, Ewha Womans University College of Medicine, Seoul, South Korea
| | - Y-S Song
- Obstetrics and Gynecology, College of Medicine, Seoul National University, Seoul, South Korea
| | - S Lalwani
- Bharati Vidyapeeth Deemed University Medical College and Hospital, Pune, India
| | - J-H Kang
- Department of Pediatrics, Seoul St. Mary's Hospital, College of Medicine, the Catholic University of Korea, South Korea
| | - M Sakamoto
- Department of Gynaecology, Sasaki Foundation Kyoundo Hospital and Department of Obstetrics and Gynaecology, School of Medicine, the Jikei University, Tokyo, Japan
| | - H-S Ryu
- Department of Obstetrics and Gynecology, School of Medicine, Ajou University, Suwon, South Korea
| | - N Bhatla
- Department of Obstetrics and Gynaecology, All India Institute of Medical Sciences, New Delhi, India
| | - H Yoshikawa
- Ibaraki Prefectural Central Hospital, Kasama, Ibaraki, Japan
| | | | | | - E Moeller
- Merck & Co., Inc., Kenilworth, New Jersey
| | | | - M Ritter
- Merck & Co., Inc., Kenilworth, New Jersey
| | | | - C Shields
- Merck & Co., Inc., Kenilworth, New Jersey
| | - A Walia
- Merck & Co., Inc., Kenilworth, New Jersey
| | - G Perez
- Merck & Co., Inc., Kenilworth, New Jersey
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Morais E, Wang X, Luttropp K, Nicholson M, Varga S, Eriksson J, Wong J, Drury R, Kothari S, Walia A. PO-152 Epidemiological trends of HPV-related head and neck cancer in males: a systematic literature review. Radiother Oncol 2019. [DOI: 10.1016/s0167-8140(19)30318-4] [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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Tay SK, Hsu TY, Pavelyev A, Walia A, Kulkarni AS. Clinical and economic impact of school-based nonavalent human papillomavirus vaccine on women in Singapore: a transmission dynamic mathematical model analysis. BJOG 2019; 125:478-486. [PMID: 29266694 DOI: 10.1111/1471-0528.15106] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/29/2017] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the epidemiological and economic impact of a nine-valent (nonavalent) human papillomavirus (HPV) 6/11/16/18/31/33/45/52/58 vaccine programme for young teenagers in Singapore. DESIGN Mathematical modelling. SETTING Pharmaco-economic simulation projection. POPULATION Singapore demography. METHODS Clinical, epidemiological and financial data from Singapore were used in a validated HPV transmission dynamic mathematical model to analyse the impact of nonavalent HPV vaccination over quadrivalent and bivalent vaccines in a school-based 2-dose vaccination for 11- to 12-year-old girls in the country. The model assumed routine cytology screening in the current rate (50%) and vaccine coverage rate of 80%. MAIN OUTCOME MEASURES Changes over a 100-year time period in the incidence and mortality rates of cervical cancer, case load of genital warts, and incremental cost-effectiveness ratio (ICER). RESULTS Compared with bivalent and quadrivalent HPV vaccination programmes, nonavalent HPV universal vaccination resulted in an additional reduction of HPV31/33/45/52/58 related CIN1 of 40.5%, CIN 2/3 of 35.4%, cervical cancer of 23.5%, and cervical cancer mortality of 20.2%. Compared with bivalent HPV vaccination, there was an additional reduction in HPV-6/11 related CIN1 of 75.7%, and genital warts of 78.9% in women and 73.4% in men. Over the 100 years, after applying a discount of 3%, disease management cost will be reduced by 32.5% (versus bivalent) and 7.5% (versus quadrivalent). The incremental cost-effectiveness ratio (ICER) per quality-adjusted life-year gained was SGD 929 compared with bivalent vaccination and SGD 9864 compared with quadrivalent vaccination. CONCLUSION Universal two-dose nonavalent HPV vaccination for 11- to 12-year-old adolescent women is very cost-effective in Singapore. TWEETABLE ABSTRACT Nonavalent HPV vaccination of 11- to 12-year-old girls is cost-effective in Singapore.
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Affiliation(s)
- S K Tay
- Department of Obstetrics & Gynaecology, Singapore General Hospital, Singapore
| | - T-Y Hsu
- Medical Affairs, MSD Pharma (Singapore) Pte. Ltd., Singapore
| | | | - A Walia
- Department of Medical Affairs, MSD International GmbH (Singapore Branch), Singapore
| | - A S Kulkarni
- Center for Observational and Real World Evidence, Merck & Co., Inc., Kenilworth, NJ, USA
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Walia A, Martinez Lomeli L, Jiang P, Benca R, Yafi F. 034 Prospective Evaluation of Depression and Sleep Disorders in Patients Presenting to a Men's Health Clinic. J Sex Med 2018. [DOI: 10.1016/j.jsxm.2017.11.053] [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]
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Amirouche F, Solitro G, Walia A. No effect of femoral offset on bone implant micromotion in an experimental model. Orthop Traumatol Surg Res 2016; 102:379-85. [PMID: 26970866 DOI: 10.1016/j.otsr.2016.01.010] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/17/2015] [Revised: 01/15/2016] [Accepted: 01/19/2016] [Indexed: 02/02/2023]
Abstract
BACKGROUND In total hip replacement (THR), the femoral offset (FO) is assessed preoperatively, and the surgeon must determine whether to restore, increase, or decrease the FO based on experience and the patient's clinical history. The FO is known to influence the abductor muscle strength, range of motion (ROM), gait, and hip pain after THR; however, the true effect of FO on bone implant micromotion is unclear. Therefore, we investigated to assess: (1) the muscle loading response during gait, (2) whether FO affects bone implant micromotion during gait. HYPOTHESIS A variation of ±10mm from the anatomical FO affects the muscle loading forces. MATERIALS AND METHODS We modified a personalized musculoskeletal model of the lower extremity to determine the 3-dimensional contact forces at the hip joint in the presence of a stem with varying offsets during a gait cycle. A detailed finite element (FE) model was then constructed for increased, restored, and decreased FOs. The maximum load obtained during normal walking gait from the musculoskeletal model was applied to the respective FE models, and the resultant stem-bone micromotion and stress distribution were computed. RESULTS Increasing the FO to +10mm decreased the peak force generated by the abductor muscles during the cycle by 15.0% and decreasing the FO to -10mm increased the von Mises stress distribution at the distal bone by 77.5% (P<0.05). A variation of the offset within 10mm of the anatomical offset showed no significant differences in micromotion (P>0.05) and peak stresses (P>0.05). DISCUSSION Coupling the musculoskeletal model of the gait cycle with FE analysis provides a realistic model to understand how FO affects bone implant micromotion. We found that there was no effect of FO on bone implant micromotion; thus, a surgeon does not need to evaluate the implications of FO on micromotion and can determine a FO that best decreases the work load of abductor muscles, increases ROM, and reduces hip pain. LEVEL OF EVIDENCE IV, biomechanical study.
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Affiliation(s)
- F Amirouche
- University of Illinois at Chicago, Department of Orthopaedics, 835, S. Wolcott avenue, Room E270, Chicago, IL 60612, USA.
| | - G Solitro
- University of Illinois at Chicago, Department of Orthopaedics, 835, S. Wolcott avenue, Room E270, Chicago, IL 60612, USA
| | - A Walia
- University of Illinois at Chicago, Department of Orthopaedics, 835, S. Wolcott avenue, Room E270, Chicago, IL 60612, USA
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Saxena A, Sharma V, Walia A, Sharma P. Over, but not out-recognition and preventing aircraft-assisted murder-suicide by Aircrew. Eur Psychiatry 2016. [DOI: 10.1016/j.eurpsy.2016.01.2261] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/21/2022] Open
Abstract
Context and introductionThe recent crash of Germanwings Flight 4U9525 appears to be the latest act of aircraft-assisted murder-suicide. The psychiatric preventive aspects of the murder-suicide need to be discussed, and effective measures for recognition and prevention of this murder-suicide are needed. Aircrew health is biased towards the physical ailments, and evaluation manuals have not discussed the mental health aspects, especially preventive strategies. These strategies involve multifactorial interventions, their applicability and usefulness are not globally validated.Objectives and methodsThanatology has since long, focused on early detection of mental distress and elucidating behavioural and psychological factors that predispose towards attempts at self-harm. Aircrew forms a different group from the general population. The recognition and preventive strategies in this special group, must, therefore, be tailored to this group with its special characteristics.Data sources, study selection and data synthesis publications were identified via electronic searches using multiple search terms related to suicide prevention. The available effective preventive measures were juxtaposed on the current concepts in aerospace psychiatry.ConclusionsMurder-suicide by aircrew is an event that is the culmination of undetected, ignored or even condoned discrete events that gradually progress and insidiously escalate. The importance of psychological factors in this catastrophic event needs to be disseminated amongst psychiatrists, and aircrew medical examiners. Ascertaining which components of suicide prevention programmes are effective in early recognition of aircrew who may attempt or complete the murder-suicide and putting into practice these to optimize the use of limited resources, is therefore essential and necessary.Disclosure of interestThe authors have not supplied their declaration of competing interest.
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Schumann R, Mandell S, Michaels MD, Klinck J, Walia A. Intraoperative fluid and pharmacologic management and the anesthesiologist's supervisory role for nontraditional technologies during liver transplantation: a survey of US academic centers. Transplant Proc 2014; 45:2258-62. [PMID: 23953537 DOI: 10.1016/j.transproceed.2013.03.026] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2012] [Revised: 03/04/2013] [Accepted: 03/12/2013] [Indexed: 11/20/2022]
Abstract
BACKGROUND Volume resuscitation and use of vasoactive medications during liver transplantation has not been systematically assessed. Furthermore, the anesthesiologist's role for intraoperative oversight of technologies such as renal replacement therapy and procedures such as venovenous bypass is poorly defined, and it is unclear if the center's annual transplant frequency affects these practices. METHODS We conducted a database analysis of the Liver Transplant Anesthesia Consortium survey 202 that addresses these questions. Data from US academic liver transplant anesthesia programs meeting inclusion criteria were included. Results were categorized by their annual transplant volume. RESULTS A representative sample of 66% of all eligible centers contributed to the results. Normal saline among crystalloids and albumin among colloids were the most frequently chosen maintenance and non-blood product volume expansion fluids, with little variation by center size. A large variety of vasoactive agents is routinely utilized across programs, with vasopressors as a cornerstone of hemodynamic support. Large programs seem to use less of these agents compared with lower volume centers. CONCLUSION Anesthesiologists are increasingly involved in oversight and management of intraoperative renal replacement therapies, venovenous bypass and cell saver devices with rising transplant frequency. This new insight may be indicative of skill sets needed by members of liver transplantation anesthesia teams and should be considered in curriculum design for hepatobiliary transplant anesthesia fellowships.
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Affiliation(s)
- R Schumann
- Tufts Medical Center, Department of Anesthesiology, Tufts University School of Medicine, Boston, Massachusetts 02111, USA.
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Wray C, Scovotti JC, Tobis J, Niemann CU, Planinsic R, Walia A, Findlay J, Wagener G, Cywinski JB, Markovic D, Hughes C, Humar A, Olmos A, Sierra R, Busuttil R, Steadman RH. Liver transplantation outcome in patients with angiographically proven coronary artery disease: a multi-institutional study. Am J Transplant 2013; 13:184-91. [PMID: 23126562 DOI: 10.1111/j.1600-6143.2012.04293.x] [Citation(s) in RCA: 61] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2012] [Revised: 08/01/2012] [Accepted: 08/22/2012] [Indexed: 01/25/2023]
Abstract
Over the last decade the age of liver transplant (LT) recipients and the likelihood of coronary artery disease (CAD) in this population have increased. There are no multicenter studies that have examined the impact of CAD on LT outcomes. In this historical cohort study, we identified adult LT recipients who underwent angiography prior to transplantation at seven institutions over a 12-year period. For each patient we recorded demographic data, recipient and donor risk factors, duration of follow-up, the presence of angiographically proven obstructive CAD (≥50% stenosis) and post-LT survival. Obstructive CAD was present in 151 of 630 patients, the CAD(+) group. Nonobstructive CAD was found in 479 patients, the CAD(-) group. Patient survival was similar for the CAD(+) group (adjusted HR 1.13, CI = [0.79, 1.62], p = 0.493) compared to the CAD(-) group. The CAD(+) patients were further stratified into severe (CADsev, >70% stenosis, n = 96), and moderate CAD (CADmod, 50-70% stenosis, n = 55) groups. Survival for the CADsev (adjusted HR = 1.26, CI = [0.83, 1.91], p = 0.277) and CADmod (adjusted HR = 0.93, CI = [0.52, 1.66], p = 0.797) groups were similar to the CAD(-) group. We conclude that when current CAD treatment strategies are employed prior to transplant, post-LT survival is not significantly different between patients with and without obstructive CAD.
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Affiliation(s)
- C Wray
- Department of Anesthesiology, David Geffen School of Medicine at UCLA, Los Angeles, CA, USA.
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Vig AP, Walia A. Beneficial effects of Rhizopus oligosporus fermentation on reduction of glucosinolates, fibre and phytic acid in rapeseed (Brassica napus) meal. Bioresour Technol 2001; 78:309-312. [PMID: 11341693 DOI: 10.1016/s0960-8524(01)00030-x] [Citation(s) in RCA: 54] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
Abstract
Solid state fermentation was employed using Rhizopus oligosporus to develop a fermented product from rapeseed meal (RSM). The contents of glucosinolates, thiooxazolidones, phytic acid and crude fibre declined by 43.1%, 34%, 42.4% and 25.5%, respectively, following inoculation with R. oligosporus. Fermentation also increased nitrogen and protein contents of the meal. This study may open a new prospective for a simple and cost effective technique for reduction of toxicants in RSM.
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Affiliation(s)
- A P Vig
- Department of Botanical Sciences, Guru Nanak Dev University, Amritsar, India.
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Dawood MM, Gutpa DK, Southern J, Walia A, Atkinson JB, Eagle KA. Pathology of fatal perioperative myocardial infarction: implications regarding pathophysiology and prevention. Int J Cardiol 1996; 57:37-44. [PMID: 8960941 DOI: 10.1016/s0167-5273(96)02769-6] [Citation(s) in RCA: 216] [Impact Index Per Article: 7.7] [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] [Indexed: 02/03/2023]
Abstract
The aim of this study was to determine the pathology of fatal postoperative myocardial infarction (MI) and compare it with that of non-operative myocardial infarction. Histopathological analyses of coronary arteries and myocardium were performed on autopsy heart specimens (n = 67), and clinical attributes were studied. Findings of perioperative MI (n = 42) were compared to those of non-perioperative MI (n = 25). Significant atherosclerotic obstruction (> 50% cross-sectional narrowing) was observed in the majority of patients (93%). Left main (> 50% cross-sectional narrowing) and/or three-vessel coronary artery disease were especially common (44%) in this group. Evidence of unstable plaques with disruption was noted in 55% of perioperative MI patients (n = 23); plaque hemorrhage was found in 45% (n = 19). Predicting the site of infarction based on severity of underlying stenosis would have been unsuccessful in more than half the patients in both perioperative and nonoperative MI groups. Clinical profiles of the patients in the two groups were similar in terms of prior cardiac history, gender and age. Fatal perioperative MI occurs predominantly in patients with multivessel coronary disease, especially left main and three-vessel disease. The severity of preexisting underlying stenosis did not predict the resulting infarct territory. Evidence of acute plaque disruption in the infarct-related artery is common. Perioperative MIs have similar coronary artery pathology to non-operative MIs with regard to coronary plaque hemorrhage, rupture, and thrombus formation and probably occur by a similar mechanism.
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Affiliation(s)
- M M Dawood
- Department of Medicine, Vanderbilt University Medical Center, Nashville, Tennessee, USA
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Walia A, Lall JC, Saini AS, Singh H, Singhal SC, Aggarwal VP. Relationship of renal function tests in newborn infants to gestational age. Indian J Med Res 1981; 74:407-11. [PMID: 7319579] [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: 01/24/2023] Open
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Abstract
The 1 : 1 complexes of
chelating diphosphine, [2-{di(m-tolyl)phosphino}ethyl]diphenylphosphine (pmtpf), with
nickel(II), palladium(II) and platinum(II) halides and thiocyanates
and 2 : 1 complexes with nickel(II) perchlorates have
been prepared. Ligand (pmtpf) forms low-spin
square-planar and diamagnetic [M(pmtpf)X2](where
X = Cl, Br, I or NCS; M = Ni, Pd or Pt) and [Ni(pmtpf)2]- (ClO4)2
complexes. Complexes of metal carbonyls having the general formula [(pmtpf)M(CO)4] (where M = Cr, Mo or W) have also
been synthesized. These complexes have been characterized on the basis of
element analysis, electronic, infrared and 1H N.M.R. spectral
measurements, magnetic susceptibilities and electrical conductance data. In all
cases studied this ligand acts as a chelating ditertiary
phosphine.
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