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Patel D, Jha A, Shah J. Technological Aspects of Nanoemulsions for Post-harvest Preservation of Fruits and Vegetables. Comb Chem High Throughput Screen 2024; 27:CCHTS-EPUB-139577. [PMID: 38584565 DOI: 10.2174/0113862073297299240325084138] [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: 01/20/2024] [Revised: 03/01/2024] [Accepted: 03/11/2024] [Indexed: 04/09/2024]
Abstract
Recent times have witnessed a growing demand for sustainable technology for food preservation that can retain its freshness, promises lower contents of additives and preservatives, safe consumption, eco-friendly milder processing technologies and eco-friendlier packaging solutions. Application of Biopolymers has served as the most sustainable and viable option to its synthetic counterparts. These biopolymers have been incorporated to develop biodegradable packaging like edible films and coatings owing to their biological origin. Nanoemulsion technology offers a leap forward to upgrade the features of conventional biodegradable packaging items. The present review discusses various trends and perspectives of nanoemulsion technology in post-harvest preservation for enhancing the shelf life of fresh fruits and vegetables. It investigates the interconnectedness between food preservation techniques, biodegradable packaging materials made from biopolymers, and nanoemulsions. It further addresses the preservation challenges post-harvest and underscores the limitations of conventional preservation methods, advocating for eco-friendly alternatives with a specific focus on the potential of nanoemulsions in enhancing food safety and quality. This review elaborates on the composition, formulation techniques, nanoemulsion products and role of nanoemulsions in the management of foodborne pathogens. Furthermore, it examines the potential health hazards linked to the use of nanoemulsions and stresses the significance of a regulatory framework for food safety. In conclusion, this review offers insights into the promising prospects of using nanoemulsions in food preservation.
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Affiliation(s)
- D Patel
- Department of Biological Sciences, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology, Changa, Anand-388421, Gujarat, India
| | - A Jha
- Department of Biological Sciences, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology, Changa, Anand-388421, Gujarat, India
| | - J Shah
- Department of Biological Sciences, P D Patel Institute of Applied Sciences, Charotar University of Science and Technology, Changa, Anand-388421, Gujarat, India
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2
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Dosis A, Husnoo N, Roney S, Hendry C, Bonner C, Kronberga M, Moran E, Ninh V, Jha A, Grey T, Saha AK. A census of general surgery consultants in England and Wales: implications for the current and future surgical workforce. Ann R Coll Surg Engl 2024; 106:150-159. [PMID: 37489525 PMCID: PMC10830335 DOI: 10.1308/rcsann.2023.0018] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/01/2023] [Indexed: 07/26/2023] Open
Abstract
INTRODUCTION This study aimed to describe the composition of the current general surgical consultant body in England and Wales and quantify levels of inequality within it as well as describe future workforce challenges. METHODS This is an observational study of all general surgical departments in England and Wales. Consultant general surgeons were identified and data regarding their gender, country of undergraduate medical education, subspecialty and private practice were recorded. RESULTS Of the 2,682 consultant general surgeons in England and Wales identified for this study, just 17% are women, with gender inequality most marked in university teaching hospitals and among certain subspecialties. Almost 40% of consultants did not obtain their primary undergraduate degree in the United Kingdom and there are considerably fewer surgeons who studied abroad in university teaching hospitals. Over 40% of current general surgical consultants have been qualified for more than three decades and there is no equivalent sized group of younger consultants. CONCLUSIONS There remains considerable gender and racial inequality in the consultant general surgical workforce, with pockets of a lack of diversity within university or teaching hospital surgical departments and some subspecialties. The proportion of surgeons in their fourth decade of clinical practice represents the largest group of current practising consultants, which points towards an impending workforce crisis should senior clinicians seek to reduce activity or consider taking early retirement.
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Affiliation(s)
- A Dosis
- Yorkshire and the Humber Deanery, UK
| | - N Husnoo
- University of Sheffield & Sheffield Teaching Hospitals NHS Foundation Trust, UK
| | - S Roney
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | | | - C Bonner
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - M Kronberga
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - E Moran
- Yorkshire and the Humber Deanery, UK
| | - V Ninh
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - A Jha
- South Tees Hospitals NHS Foundation Trust, UK
| | - T Grey
- Calderdale and Huddersfield NHS Foundation Trust, UK
| | - AK Saha
- Calderdale and Huddersfield NHS Foundation Trust, UK
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Ballal S, Ahmad N, Jha A, Sharma V, Mishra R, Patel M G. AN EVALUATION OF ANTIBIOTIC PRESCRIPTION PRACTICES: PERSPECTIVES OF VETERINARY TRAINEES AND PRACTICING VETERINARIANS. Georgian Med News 2023:71-77. [PMID: 38096520] [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: 12/18/2023]
Abstract
Antibiotic resistance is a major worldwide problem that has an impact on the well-being of humans as well as animals. Antibiotic resistance is caused by the misuse and excessive use of antibiotics. The key to reducing this issue lies in educating veterinary medical learners on the proper and accountable utilization of antibiotics for the care of animals. Objective - using awareness-raising and instruction as the foundation, this research of Indian veterinary learners can help resolve the issue of antibiotic resistance throughout the care of animals. The questionnaire survey was taken between June and July 2022 and it was aimed at learners registered in veterinary medical studies at academic and research institutions in India. The study included 500 pupils overall. The purpose of the survey was to gather information about students' knowledge of antibiotics, including antibiotic resistance, as well as their feelings on the consequences of antibiotic resistance on the globe at large and their acquaintance with the one health ideology. According to this study's findings, 83.3 percent of respondents thought antibiotic resistance was a serious problem. 57.92 percent of respondents understood the issue's worldwide consequences and its one health ideology. The study emphasizes the significance of expanding the veterinary educational program to include thorough instruction on prudent antibiotic usage and the concepts of one health.
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Affiliation(s)
- S Ballal
- 1Department of Biochemistry, School of Sciences, JAIN (Deemed-to-be University), Karnataka, India
| | - N Ahmad
- 2School of Allied Sciences, Dev Bhoomi Uttarakhand University, Dehradun, India
| | - A Jha
- 3Department of Allied Healthcare and Sciences, Vivekananda Global University, Jaipur, India
| | - V Sharma
- 4Department of Microbiology, TMMC&RC, Teerthanker Mahaveer University, Moradabad, Uttar Pradesh, India
| | - R Mishra
- 5Department of Pharmacy, Noida Institute of Engineering and Technology (Pharmacy Institute), Uttar Pradesh, India
| | - G Patel M
- 6Department of Community Medicine, Parul University, PO Limda, Tal. Waghodia, District Vadodara, Gujarat, India
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Inkman M, Eaton A, Zhang H, Waters MR, Swamidass J, Mazur TR, Jha A, Schwarz JK, Zhang J. Development of a Radiomic Signature from Pre-Treatment FDG-PET for Recurrence Prediction in Cervical Cancer. Int J Radiat Oncol Biol Phys 2023; 117:e469. [PMID: 37785492 DOI: 10.1016/j.ijrobp.2023.06.1674] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) As many as 30-50% of patients with locally advanced cervical cancer (LACC) experience recurrence after standard-of-care chemoradiation therapy (CRT), creating a critical need to identify pre-treatment biomarkers of treatment failure. The purpose of this study is to identify whether radiomic features derived from pre-treatment FDG-PET imaging can be used to construct a predictive signature useful for assessing risk of recurrence during treatment planning. MATERIALS/METHODS Standardized uptake values (SUV) were obtained from within the physician-defined metabolic tumor volumes (MTV) delineated on FDG-PET scans acquired for 90 LACC patients at our institution prior to standard of care curative-intent CRT. Clinical outcome data of these patients has a median follow-up time of 85 months. The clinical endpoint was local recurrence within 3 years of treatment. 851 quantitative radiomic features describing intensity, shape, texture and high and low frequency spatial filters of the MTV were extracted for each patient. Low information features, defined by pairwise correlation > 0.85 with another feature or a maximum deviation within 20% of the mean, were discarded, leaving 146 features. Predictive signatures were constructed from features using multiple techniques, including multivariate Cox modelling, a set of machine learning models (random forest (RF), support vector classifier (SVC), ridge regression, LASSO regression, and elastic net regression), and a deep neural network (DNN) classifier. RESULTS The DNN classifier had the best overall performance, predicting a patient's recurrence group with an F1 score of 0.917 ± 0.028 under 5-fold cross-validation. By contrast, the Cox model classifier yielded an F1 score of 0.604 ± 0.085 and the best performing of the alternative machine learning models, elastic net, yielded F1 score of 0.868 ± 0.018. A set of textural features contributed the most to the output of the DNN classifier, including Large Area Low Gray Level Emphasis of the gray level size zone matrix (GLSZM) and coarseness and busyness of the neighboring gray tone difference matrix (NGTDM), reflecting the important role patterns of tumor heterogeneity play in post-treatment recurrence. CONCLUSION In this pilot study, we investigated multiple techniques to construct predictive radiomic signatures for local recurrence in LACC, determining that a DNN classifier is most capable of stratifying patients by risk of early recurrence. Future work will seek to validate this result on additional PET imaging data sets and to integrate radiomic features with gene expression data from matched tumor samples to establish radiogenomic biomarkers for recurrence.
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Affiliation(s)
- M Inkman
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - A Eaton
- Washington University in St. Louis, St. Louis, MO
| | - H Zhang
- Washington University in St. Louis, St. Louis, MO
| | - M R Waters
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - J Swamidass
- Washington University in St. Louis, St. Louis, MO
| | - T R Mazur
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
| | - A Jha
- Washington University in St. Louis, St. Louis, MO
| | - J K Schwarz
- Washington University School of Medicine in St. Louis, St. Louis, MO
| | - J Zhang
- Washington University School of Medicine in St. Louis, Department of Radiation Oncology, St. Louis, MO
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Goda JS, Punwatkar D, Jha A, Guha A, Sakhadeo U, Nayak L, Bagal B, Jain H. CT Based Tumor Radiomics with Machine Learning Classifiers for Molecular Subtyping of Diffuse Large B Cell Lymphoma. Int J Radiat Oncol Biol Phys 2023; 117:e467. [PMID: 37785489 DOI: 10.1016/j.ijrobp.2023.06.1670] [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: 10/04/2023]
Abstract
PURPOSE/OBJECTIVE(S) Diffuse large B-cell lymphoma (DLBL) has been classified into two distinct molecular subtypes based on their cell of origin- namely germinal center B-cell-like (GCB) and activated B-cell-subtype (ABC) based on Han's algorithm. These two entities are also prognostically distinct. We assessed CT based tumor radiomic features using machine learning classifiers to distinguish the two molecular subtypes. MATERIALS/METHODS One hundred one patients were accrued in the study after institutional ethics committee approval. GCB subtype was diagnosed in 59 while 42 patients were ABC subtype. Lesion with maximum SUV was delineated using a semi-automated segmentation tool (3D slicer) and radiomic features were extracted using Pyradiomics. A total of 1030 features were extracted including Shape features, first, second, third, higher order and wavelet-based features. Recursive feature elimination was used for feature selection and optimal 10 features were selected. Five machine learning (ML) tools were used to build a model to sub- classify the two molecular subtypes. (Table -1) Model performance was assessed using Accuracy, Precision, Recall, F1 score and Area under curve of receiver operating characteristic curve. The models were constructed by two methods.1) A 5-fold internal cross validation strategy & 2) splitting the data into training (70%) and validation set (30%). RESULTS Recursive feature elimination using a random forest algorithm method was used to select 7 radiomic features. These 7 features were then used to build the model using the 5 ML classifiers. Of the five classifiers, Random Forest Classifier (RFC) using a 70:30 training: test strategy was the best performer among all the ML models, with the highest accuracy of 80%, AUC of 0.87, recall(sensitivity), f1score(specificity) & precision (Positive Predictive value; PPV) or precision of 82% respectively. When an internal 5-fold cross validation strategy was used, RFC again performed better than other ML classifiers with an accuracy of 75%, AUC of 0.80, recall of 79%, PPV of 77% and specificity of 79%. CONCLUSION The machine-learning based Radiomics features extracted from pre-treatment CT images can provide a simple and non-invasive method for the prediction of DLBL molecular subtypes with favorable predictive accuracy. The Random Forest Classifier was the most accurate in distinguishing GCB subtype from the ABC subtype.
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Affiliation(s)
- J S Goda
- Department of Radiation Oncology, Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - D Punwatkar
- Tata Memorial Center, Homi Bhaba National Institute, Mumbai, India
| | - A Jha
- Tata Memorial Center, Homi Bhaba National Institute, Mumbai, India
| | - A Guha
- Tata Memorial Center, Homi Bhaba National Institute, Mumbai (Suburban), India
| | - U Sakhadeo
- Tata Memorial Center, Homi Bhaba National Institute, Mumbai (Suburban), India
| | - L Nayak
- Tata Memorial Center, Homi Bhaba National Institute, Mumbai (Suburban), India
| | - B Bagal
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
| | - H Jain
- Tata Memorial Centre, Homi Bhabha National Institute, Mumbai, India
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Jha A, Khatiwada S, Pokharel K, Ghimire A, Singh SN, Prasad JN. Analgesic Efficacy of Fascia Iliaca Compartment Block for Positioning During Spinal Anesthesia in Patients with Femur Fractures. Kathmandu Univ Med J (KUMJ) 2023; 21:133-137. [PMID: 38628004] [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] [Indexed: 04/19/2024]
Abstract
Background Positioning patients with femur fractures for spinal anesthesia is associated with excruciating pain. Fascia iliaca compartment block has the potential to block all nerves supplying the femur and therefore may provide effective analgesia during positioning these patients for spinal anesthesia. Objective To assess the analgesic efficacy of Fascia iliaca compartment block, during positioning patients with femur fracture for spinal anesthesia. We also assessed the duration of analgesia and the requirement for rescue analgesics in the postoperative period. Method Seventy adult patients with fracture femurs were randomly divided into two equal groups (A and B). Patients in both groups received fentanyl one mcg/kg intravenously, 20 minutes before positioning them for spinal anesthesia. Patients of group B additionally, received ultrasound-guided Fascia iliaca compartment block with 40 ml of 0.25% Ropivacaine, immediately after intravenous fentanyl. Numerical rating score (0-10) was used for the assessment of pain at five, 10, and 20 minutes after the block and immediately after positioning patients for spinal anesthesia. Result Immediately after positioning patients for spinal anesthesia, the numerical rating score of pain was 5.06±1.5 in group A and 2.49±1.2 in group B (p<0.001). The duration of analgesia was 799.7±62.1 minutes in group B and 314.65±118.9 minutes in group A (p<0.001). One (2.8%) patient of group B and 18(51.4%) patients of group A required rescue analgesics within four to twelve hours in the postoperative period (p=0.001). In group A, seven patients were satisfied with the analgesia technique while in group B, 17 were satisfied and eight patients were strongly satisfied (p<0.001). Conclusion Ultrasound-guided Fascia iliaca compartment block is effective in reducing pain during positioning patients with femur fractures for spinal anesthesia. Patients receiving this block had a prolonged duration of analgesia, required lesser analgesics, and were more satisfied in the postoperative period as compared to patients not receiving the block.
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Affiliation(s)
- A Jha
- Department of Anesthesiology and Critical Care, Rapti Academy of Health Sciences (RAHS), Ghorahi, Dang, Nepal
| | - S Khatiwada
- Department of Anesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - K Pokharel
- Department of Anesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - A Ghimire
- Department of Anesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - S N Singh
- Department of Anesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
| | - J N Prasad
- Department of Anesthesiology and Critical Care, B.P. Koirala Institute of Health Sciences, Ghopa, Dharan, Nepal
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Nazari MA, Abd-Elmoniem KZ, Jha A, Matta J, Talvacchio S, Charles K, Feeley J, Patel M, Feelders R, Pacak K, Gharib AM. Reduced coronary artery luminal area in pheochromocytoma and paraganglioma patients. J Endocrinol Invest 2022:10.1007/s40618-022-01982-5. [PMID: 36538160 DOI: 10.1007/s40618-022-01982-5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 12/04/2022] [Indexed: 12/24/2022]
Affiliation(s)
- M A Nazari
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), National Institutes of Health, Bethesda, MD, USA
| | - K Z Abd-Elmoniem
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, USA.
| | - A Jha
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), National Institutes of Health, Bethesda, MD, USA
| | - J Matta
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, USA
| | - S Talvacchio
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), National Institutes of Health, Bethesda, MD, USA
| | - K Charles
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), National Institutes of Health, Bethesda, MD, USA
| | - J Feeley
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, USA
| | - M Patel
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), National Institutes of Health, Bethesda, MD, USA
| | - R Feelders
- Division of Endocrinology, Department of Internal Medicine, Erasmus Medical Center, Rotterdam, The Netherlands
| | - K Pacak
- Section on Medical Neuroendocrinology, Eunice Kennedy Shriver National Institute of Child Health and Development (NICHD), National Institutes of Health, Bethesda, MD, USA
| | - A M Gharib
- Biomedical and Metabolic Imaging Branch, National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK), National Institutes of Health, Bethesda, MD, USA
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Solomonsz A, Cheong J, Ali N, Jha A, Murray C, Williams M, Blundell A. 956 AN AUDIT CONDUCTED LOOKING INTO THE USE OF IV IRON TO TREAT IRON DEFICIENCY ANAEMIA ON THE ELDERLY CARE WARDS. Age Ageing 2022. [DOI: 10.1093/ageing/afac126.017] [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: 11/12/2022] Open
Abstract
Abstract
Aims
To assess whether patients on the elderly care wards at NUH (Nottingham University Hospitals) were appropriately given IV (intravenous) iron for Iron deficiency anaemia (IDA). To improve our practice in the investigation and follow up of patients with IDA.
Method
Data was obtained of patients who had IV iron dispensed from June—September 2019. This totalled 146 patients. Digital medical records and Notis results. Server were reviewed and a spread sheet database compiled with patient demographics, presentation, blood results. Co-morbidities, medication, investigations and follow up.
Results
The average age of the patients receiving IV iron on the elderly care wards was 86 (range 74–106). 89 were female and 57 male. The top presenting complaints were; fall (38%), abdominal symptoms of pain, diarrhoea or vomiting (15%), SOB (12%). 30% of patient were on anti-coagulation and 27% were on an anti-platelet with 2% of patient on both. Mean female Hb was 89 (41–129) and male Hb was 91 (49–117). The data showed that 8 out of 81 female patients were given IV iron despite not being anaemic. In 7.5% of cases ferritin, TSAT, iron and transferrin had not been checked. Ferritin was not checked 16%. 82% of patients had no documentation with regards to the rationale for choosing not to proceed with invasive investigation.
Conclusion
Improvement is needed in the way we manage patients with IDA. This audit highlighted the need for continued review of medications—particularly anti-platelets and anti-coagulants. If there is a weak indication consider the risks and benefits. It is important we discuss and document the consideration or unsuitability of invasive investigations and follow up. A proforma is being written to guide clinicians with regards to the appropriate prescribing of IV iron and to guide investigation and follow up.
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Affiliation(s)
- A Solomonsz
- Department of Elderly Medicine, Nottingham University Hospitals
| | - J Cheong
- Department of Elderly Medicine, Nottingham University Hospitals
| | - N Ali
- Department of Elderly Medicine, Nottingham University Hospitals
| | - A Jha
- Department of Elderly Medicine, Nottingham University Hospitals
| | - C Murray
- Department of Elderly Medicine, Nottingham University Hospitals
| | - M Williams
- Department of Elderly Medicine, Nottingham University Hospitals
| | - A Blundell
- Department of Elderly Medicine, Nottingham University Hospitals
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Kc S, Aryal A, Jha A, Karn D. Nevus Lipomatosus Cutaneous Superficialis of Hoffmann and Zurhelle: a rare cutaneous hamartoma. Kathmandu Univ Med J (KUMJ) 2022; 20:238-239. [PMID: 37017173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/06/2023]
Abstract
Nevus lipomatosus cutaneous superficialis (NLCS) is a rare idiopathic cutaneous hamartoma characterized by ectopic clusters of mature adipose tissues in dermis. It is classified into two types. Classical type presenting as multiple lesions with onset at birth or within third decade of life and solitary type with onset between third to sixth decade of life. Here we present a case of 45 years female with adult onset, asymptomatic, grouped, skin colored, soft sessile growth in zosteriform pattern on left buttock. We here intend to report rare case of classical Nevus Lipomatosus Cutaneous Superficialis.
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Affiliation(s)
- S Kc
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - A Aryal
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
| | - A Jha
- Madhyabindu District Hospital, Nawalparasi, Nepal
| | - D Karn
- Department of Dermatology, Dhulikhel Hospital, Kathmandu University Hospital, Dhulikhel, Kavre, Nepal
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Verma P, Suvirya S, Jha A, Shukla P, Singhai A. Atypical presentations of cutaneous tuberculosis: Series of 10 cases. Indian J Tuberc 2022; 69:113-119. [PMID: 35074143 DOI: 10.1016/j.ijtb.2021.02.007] [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] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/18/2020] [Accepted: 02/03/2021] [Indexed: 06/14/2023]
Abstract
Cutaneous tuberculosis classically presents as Lupus vulgaris, scrofuloderma, tuberculosis verrucose cutis and tubercular abscess. Hypersensitivity reaction to the bacilli leads to Lichen scrofulosorum and papulonecrotic tuberculids. At the same time, it can have myriad of clinical presentations, many of which are still undescribed. It is important to regularly update ourselves with these unusual manifestations so as to ensure early treatment and reduction of overall morbidity. In this case series tuberculosis manifesting as rapidly progressing diffuse facial granulomas, sporotrichoid tuberculosis, tuberculosis mimicking squamous cell carcinoma, scrofuloderma as tubercular ulcer, lupus vulgaris with nasal septal perforation, lupus vulgaris resembling furuncle, psoriasis, dermatitis and BT Hansen are described in immunocompetent individuals. These cases highlight the importance of recognition of atypical forms of cutaneous tuberculosis to minimize scarring and dissemination of bacilli.
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Affiliation(s)
- P Verma
- Department of Dermatology Venereology and Leprosy, King George's Medical University, Lucknow, UP, 226003, India.
| | - S Suvirya
- Department of Dermatology Venereology and Leprosy, King George's Medical University, Lucknow, UP, 226003, India
| | - A Jha
- Department of Dermatology, Adesh Medical College and Hospital, Ambala, India
| | - P Shukla
- Department of Dermatology Venereology and Leprosy, King George's Medical University, Lucknow, UP, 226003, India
| | - A Singhai
- Department of Pathology, King George's Medical University, Lucknow, UP, 226003, India
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Gupta R, Kesavadev J, Krishnan G, Agarwal S, Saboo B, Shah M, Mittal A, Durani S, Luthra A, Singhal A, Rasheed M, Rao GVS, Tripathi V, Jha A, Ghosh A, Mohan V, Singh AK, Phatak S, Panicker J, Bhadada SK, Joshi S, Pal R, Mithal A, Vikram N, Misra A. COVID-19 associated mucormycosis: A Descriptive Multisite Study from India. Diabetes Metab Syndr 2021; 15:102322. [PMID: 34717135 PMCID: PMC8635309 DOI: 10.1016/j.dsx.2021.102322] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 10/21/2021] [Accepted: 10/22/2021] [Indexed: 02/07/2023]
Abstract
BACKGROUND AND AIMS Mucormycosis is an invasive fungal infection and carries a significant morbidity and mortality. A number of cases of mucormycosis have been reported in association with COVID-19. In this study, a consortium of clinicians from various parts of India studied clinical profile of COVID-19 associated mucormycosis (CAM) and this analysis is presented here. METHODS Investigators from multiple sites in India were involved in this study. Clinical details included the treatment and severity of COVID-19, associated morbidities, as well as the diagnosis, treatment and prognosis of mucormycosis. These data were collected using google spreadsheet at one centre. Descriptive analysis was done. RESULTS There were 115 patients with CAM. Importantly, all patients had received corticosteroids. Diabetes was present in 85.2% of patients and 13.9% of patients had newly detected diabetes. The most common site of involvement was rhino-orbital. Mortality occurred in 25 (21.7%) patients. On logistic regression analysis, CT scan-based score for severity of lung involvement was associated with mortality. CONCLUSION Universal administration of corticosteroids in our patients is notable. A large majority of patients had diabetes, while mortality was seen in ∼1/5th of patients, lower as compared to recently published data.
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Affiliation(s)
| | | | - Gopika Krishnan
- Jothydev's Diabetes Research Centre, Trivandrum, Kerala, India
| | | | | | | | - Atul Mittal
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Suhail Durani
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Atul Luthra
- Fortis Memorial Research Institute, Gurugram, Haryana, India
| | - Anuj Singhal
- Fortis Escorts Heart Institute, New Delhi, India
| | | | - G V S Rao
- Dr Rao's ENT Centre, Hyderabad, Telangana, India
| | | | - Alka Jha
- Fortis Rajan Dhall Hospital, New Delhi, India
| | | | - V Mohan
- Dr Mohan's Diabetes Specialities Centre and Madras Diabetes Research Foundation, Chennai, Tamilnadu, India
| | | | | | | | | | | | - Rimesh Pal
- Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | | | - Naval Vikram
- All India Institute of Medical Sciences, New Delhi, India
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Affiliation(s)
- A Jha
- Royal Papworth Hospital NHS Foundation Trust, Cambridge, UK
| | - G Zilahi
- St George's University Hospitals NHS Foundation Trust, London, UK
| | - A Rhodes
- St George's University Hospitals NHS Foundation Trust, London, UK
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Mittal A, Pramanik R, Gogia A, Batra A, Jha A, Kumar L, Deo S, Bhoriwal S, Deb K, Dhamija E, Ramprasad V, Olopade O. 155P Profile of pathogenic mutations and evaluation of germline genetic testing criteria in consecutive breast cancer patients treated at a North Indian tertiary care center. Ann Oncol 2021. [DOI: 10.1016/j.annonc.2021.03.169] [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: 11/27/2022] Open
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Ali F, Ghareeb AE, Jha A, Van der Voet H, Garg D, Jha M. Anal cancer survival: a socioeconomic analysis. Ann R Coll Surg Engl 2021; 103:191-196. [PMID: 33645271 DOI: 10.1308/rcsann.2020.7019] [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] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Squamous cell carcinoma is the most common variant of anal malignancy. Certain disease-related factors have been established in determining survival. These include tumour size, differentiation and nodal involvement. Other factors such as HIV status, human papillomavirus infection, smoking and socioeconomic disparity may have important roles, however few data are available on the UK population. We aim to correlate social deprivation and survival of anal cancer patients at a tertiary centre. MATERIALS AND METHODS All consecutive cases diagnosed with anal squamous cell carcinoma and treated as per local protocol between July 2010 and April 2017 were included. The pathological and demographical details were collected from a prospectively maintained database. Socioeconomic deprivation was defined for each postcode using the Index of Multiple Deprivation decile compiled by local governments in England. Survival was estimated using Kaplan-Meier analysis and Cox regression was used to investigate the effect of different factors on overall survival. RESULTS A total of 129 patients with anal squamous cell carcinoma over a median follow-up of 43 months were included. Overall survival for the entire patient cohort was 87.7% (95% confidence interval, CI, 82.0-93.7%), 75.5% (95% CI 67.5-84.5%) and 68.9% (95% CI 59.7-79.6%) at one year, three years and five years, respectively. On multivariate analysis, Index of Multiple Deprivation and income do not significantly influence overall survival (p = 0.79, hazard ratio, HR, 1.07; 95% CI 0.61-1.63), (p = 0.99, HR=1.00; 95% CI 0.61-1.63), respectively. Increased risk of death was observed for male sex (p = 0.02, HR=2.80; 95% CI 1.02-5.50) and larger tumour size (p = 0.01, HR=1.64; 95% CI 1.12-2.41). CONCLUSION In contrast to US studies, there is little difference in survival between the least deprived and most deprived groups. We attribute this to equal access to intensity-modulated radiation therapy-based chemoradiotherapy. Thus, a highly effective treatment made available to all mitigates any survival difference between socioeconomic groups.
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Affiliation(s)
- F Ali
- James Cook University Hospital, Middlesbrough, UK
| | - A E Ghareeb
- Biosciences Institute, Newcastle University, Newcastle Upon Tyne, UK
| | - A Jha
- James Cook University Hospital, Middlesbrough, UK
| | | | - D Garg
- James Cook University Hospital, Middlesbrough, UK
| | - M Jha
- James Cook University Hospital, Middlesbrough, UK
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Ansari SN, Baral J, Gurung G, Jha A. Comparison of Outcome of Borderline and Normal Amniotic Fluid Index in Term Pregnancy. Kathmandu Univ Med J (KUMJ) 2021; 19:17-21. [PMID: 34812152] [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] [Indexed: 06/13/2023]
Abstract
Background Determination of Amniotic Fluid Index (AFI) is an important component of antepartum assessment of all normal pregnancies. Objective To compare the obstetric interventions and neonatal outcomes in term pregnancies with borderline Amniotic Fluid Index versus normal Amniotic Fluid Index. Method This hospital based prospective study was conducted at Tribhuwan University Teaching Hospital over 1 year between 2017 and 2018 in 128 women having uncomplicated term pregnancy admitted in labor ward. Of the 128 women, 64 women had borderline Amniotic Fluid Index (5.1-8 cm) and 64 normal AFI (8.1 - 24 cm). Parameters studied were induction of labor, cesarean section, instrumental delivery, intrapartum abnormal fetal heart rate, meconium staining of liquor, APGAR score at 5 and 7 minutes, birth weight, neonatal intensive care unit (NICU) admission and neonatal death. Data was analyzed using software OpenEpi. Result Statistically significant difference in result was obtained in the two groups in terms of rate of induction of labor (73.4% vs 35.9%, p = 0.0001, OR = 4.9), rate of cesarean section (42.1% vs 28 .1%, p = 0.04, OR = 1.8), tachypnea (50% vs 11.1%, p = 0.01) and low birth weight (9.1% vs 4.5%, p = 0.04). No statistical significance was found in meconium staining of liquor (33% vs 38.3%, p = 0.3) and APGAR score of <7 at 5 minutes (3.1% vs 1.5%, p = 0.06). There were no neonatal intensive care unit admissions and neonatal mortality in any of the babies. Conclusion Detection of amniotic fluid volume at term is important for timely maternal interventions to improve the overall fetal outcome.
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Affiliation(s)
- S N Ansari
- Paropakar Maternity and Women's Hospital(PMWH), Thapathali, Kathmandu, Nepal
| | - J Baral
- Department of Obstetrics and Gynecology, Institute of Medicine, Tribhuwan University Teaching Hospital, Maharajgunj, Kathmandu Nepal
| | - G Gurung
- Department of Obstetrics and Gynecology, Institute of Medicine, Tribhuwan University Teaching Hospital, Maharajgunj, Kathmandu Nepal
| | - A Jha
- Department of Radiology, Institute of Medicine, Tribhuwan University Teaching Hospital, Maharajgunj, Kathmandu Nepal
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Ghosh A, Anjana RM, Shanthi Rani CS, Jeba Rani S, Gupta R, Jha A, Gupta V, Kuchay MS, Luthra A, Durrani S, Dutta K, Tyagi K, Unnikrishnan R, Srivastava BK, Ramu M, Sastry NG, Gupta PK, Umasankari G, Jayashri R, Mohan V, Misra A. Glycemic parameters in patients with new-onset diabetes during COVID-19 pandemic are more severe than in patients with new-onset diabetes before the pandemic: NOD COVID India Study. Diabetes Metab Syndr 2021; 15:215-220. [PMID: 33450530 PMCID: PMC7771314 DOI: 10.1016/j.dsx.2020.12.033] [Citation(s) in RCA: 30] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2020] [Revised: 12/18/2020] [Accepted: 12/18/2020] [Indexed: 12/12/2022]
Abstract
BACKGROUND AND AIMS It is not known if new onset diabetes during Coronavirus-19 disease (COVID-19; NOD COVID) is phenotypically or biochemically different than new onset diabetes before COVID-19 (NOD). METHODS All adults diagnosed with new onset diabetes from during the time of COVID-19 were compared with new onset diabetes prior to COVID-19 from two tertiary care hospitals in Chennai and Delhi. RTPCR test for SARS-CoV-2 virus was done as appropriate, and COVID-19 antibody test was done in all other NOD COVID patients. RESULT A total of 555 patients with new onset diabetes were included in the study (282 NOD and 273 NOD COVID patients). Patients with NOD COVID had higher fasting and post prandial blood glucose and glycated hemoglobin levels vs. NOD patients. Both the groups had high average body mass index; ∼28 kg/m2. Interestingly, fasting C-peptide levels were significantly higher in the NOD COVID group vs. NOD group. There was no difference in C-peptide levels or glycemic parameters between the COVID-19 antibody positive and negative NOD COVID cases. CONCLUSION Individuals who were diagnosed with diabetes during COVID-19 epidemic (NOD COVID) do not significantly differ from those diagnosed before COVID-19 in symptomatology, phenotype, and C-peptide levels but they had more severe glycemia.
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Affiliation(s)
- Amerta Ghosh
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Ranjit Mohan Anjana
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | - Saravanan Jeba Rani
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ritesh Gupta
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Alka Jha
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Vimal Gupta
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | | | - Atul Luthra
- Fortis CDOC Center for Diabetes, Fortis Memorial Institute, Gurgaon, India
| | - Suhail Durrani
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Koel Dutta
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Kanika Tyagi
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India
| | - Ranjit Unnikrishnan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | - Muthu Ramu
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | | | - Prasanna Kumar Gupta
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ganesan Umasankari
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Ramamoorthy Jayashri
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation & Dr. Mohan's Diabetes Specialities Centre, Chennai, India.
| | - Anoop Misra
- Fortis CDOC Centre for Diabetes and Allied Sciences, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation, New Delhi, India; Diabetes Foundation (India), New Delhi, India.
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Jha A, Glatfelter K, Goel A, Krishnan A, Patel H, Buda K, Wu F, Shah D. Outcomes, resource utilization and predictors of thirty day readmission in patients with heart failure with preserved ejection fraction (HFpEF): insights from the Nationwide Readmissions Database 2017. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.0896] [Citation(s) in RCA: 1] [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: 11/13/2022] Open
Abstract
Abstract
Background and aims
Nearly half of all heart failure patients have heart failure with preserved ejection fraction (HFpEF). Due to differences in pathophysiology of heart failure with preserved and reduced ejection fraction, as well as a paucity of studies, the treatment of hHFpEF remains a challenge.
We aimed to determine the rate of hospital readmission within 30 days of acute or acute on chronic HFpEF and its impact on mortality and health care utilization in the United States. We also focused on patient demographics as well as independent variables affecting readmission.
Methods
We performed a retrospective study using the Agency for Health-care Research and Quality's Health-care Cost and Utilization Project (HCUP), Nationwide Readmission Database (NRD) for the year of 2017 (data on approximately 18 million hospital stays at 2,454 hospitals in the United States). We collected data on hospital readmissions of 60,514 adults who were hospitalized for acute or acute on chronic diastolic heart failure and discharged. The primary outcome was the rate of all-cause readmission within 30 days of discharge. Secondary outcomes were reasons for readmission, readmission mortality rate, and resource use (length of stay, total hospitalization costs and charges). Independent risk factors for readmission were identified using Cox regression analysis.
Results
The 30-day rate of readmission was 21%. Only 1,175 (9.17%) of readmissions were associated with an admitting diagnosis of acute on chronic diastolic heart failure. The most common readmission diagnosis was hypertensive chronic kidney disease with heart failure (1,245; 9.7%). Readmission cases were associated with increased in-hospital mortality compared to index admission (7.9% vs 2.9%, p=0.000). Readmission was associated with a total of 81,997 hospital days. Total health care in-hospital economic burden was $206 million (in costs) and $779 million (in charges). Significant predictors of increased thirty-day readmission were Medicaid insurance (1.15, 1.05–1.27, p=0.004), higher Charlson co-morbidity score (1.08, 1.06–1.09, p=0.000), patient admitted to teaching hospital (1.09, 1.04–1.15, p=0.001) and longer stays in the hospital (1.01, 1.01–1.02, p=0.000). Residence in a small metropolitan (0.91, 0.86–0.97, p=0.003) or micropolitan area (0.83, 0.77–0.90, p=0.000), older age (0.99, 0.993–0.997, p=0.000), female sex (0.91, 0.86–0.95, p=0.000), private (0.85, 0.77–0.93, p=0.000) or no insurance (0.70, 0.53–0.93, p=0.015) were associated with lower odds of readmission. Interestingly discharges to rehabilitation had no effect on re-admission (0.67, 0.28–1.6, p=0.381).
Conclusions
In conclusion patients hospitalized for acute or acute on chronic HFpEF, we found that 21% of patients were readmitted to the hospital within 30 days of discharge. Readmissions were associated with higher mortality and resource utilization. Most readmissions were due to cardiorenal syndrome.
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- A Jha
- Lawrence General Hospital, Boston, United States of America
| | - K Glatfelter
- Lawrence General Hospital, Boston, United States of America
| | - A Goel
- University of Arkansas for Medical Sciences, Little Rock, Arkansas, United States of America
| | - A.M Krishnan
- University of Connecticut Health Center, Framington, United States of America
| | - H.K Patel
- Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - K Buda
- Hennepin County Medical Center, Minneapolis, United States of America
| | - F Wu
- Memorial Hospital West, Pembroke Pines, United States of America
| | - D Shah
- Cedars Heart Clinic, Cardiology, Phoenix, United States of America
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Vyas VK, Qureshi G, Dayani H, Jha A, Ghate M. Pharmacophore-based identification and in vitro validation of apoptosis inducers as anticancer agents. SAR QSAR Environ Res 2020; 31:869-881. [PMID: 33100034 DOI: 10.1080/1062936x.2020.1827030] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/23/2020] [Accepted: 09/18/2020] [Indexed: 06/11/2023]
Abstract
Ligand-based pharmacophore modelling and virtual screening along with in vitro screening were performed as a rational strategy for the identification of novel compounds as apoptosis inducers and anticancer agents from the chemical database. Known apoptosis inducers were selected from the literature for generation of pharmacophore models, which were subjected to validation using Receiver operating characteristic (ROC) and Günere-Henry (GH) scoring methods. Based on highest fitness score of 4680.61, ROC value of 0.872 and GH score of 0.758, pharmacophore model-2 was selected as the best model. Model-2 as 3D search query was searched against the IBS database to find novel compounds as hits. Three hits were selected with a QFIT value more than 82 for in vitro screening as apoptosis inducers and anticancer agents. In vitro anticancer activity was performed using resazurin cell variability assay, and apoptosis inducing activity was determined using caspase-3 activation and annexin-FITC assays. One of the retrieved hit, STOCK5S-44056 demonstrated IC50 value of 23.56 µM in cell variability assay, and had EC50 value of 26.95 µM in caspase-3 activation assay. STOCK5S-44056 also indicated late stage induction of apoptosis in annexin assay. The results of in vitro activity revealed that STOCK5S-44056 has a potential to become anticancer agents.
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Affiliation(s)
- V K Vyas
- Institute of Pharmacy, Nirma University , Ahmedabad, India
| | - G Qureshi
- Institute of Pharmacy, Nirma University , Ahmedabad, India
| | - H Dayani
- Institute of Pharmacy, Nirma University , Ahmedabad, India
| | - A Jha
- Department of Pharmacology, Institute of Pharmacy, Nirma University , Ahmedabad, India
| | - M Ghate
- Institute of Pharmacy, Nirma University , Ahmedabad, India
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Jha A, Vasudevan K. Demographic history of the fragmented yellowthroated bulbul (Pycnonotus xantholaemus) population in the Deccan Peninsula, India. ENDANGER SPECIES RES 2020. [DOI: 10.3354/esr01062] [Citation(s) in RCA: 1] [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] [Subscribe] [Scholar Register] [Indexed: 11/23/2022] Open
Abstract
The yellow-throated bulbul (YTB) is an endemic passerine restricted to scrub forests along hill slopes with exposed rocky outcrops in the Deccan Peninsula, India. It is found in small, discontinuous populations and is vulnerable to extinction due to ongoing habitat loss and subsequent population decline. To assess the genetic connectivity and past demography, we sequenced 1050 nucleotide base pairs of the mitochondrial control region of 60 individuals that represent distinct populations in the geographic range of the species. We recovered 39 haplotypes defined by 81 variable sites. Haplotype diversity was high with low nucleotide diversity, suggesting rapid population growth from a founder population with a small effective population size. The negative values of Tajima’sDand Fu’sFsand small positive value of Ramos-Onsins and Rozas’R2suggest deviation from neutrality and population expansion. The haplotype network and demographic expansion parameters further suggest historical population expansion. Mismatch analysis statistics and Bayesian skyline plots estimate population expansion during the late Pleistocene. Although the species presently occurs in small, disconnected we found no structuring of the population. Dispersal events are the most likely explanation for the absence of genetic structuring in the YTB population. These results represent important data for the design of a conservation plan for this endemic and globally threatened species.
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Affiliation(s)
- A Jha
- Laboratory for the Conservation of Endangered Species, CSIR-Centre for Cellular and Molecular Biology, Hyderabad, Telangana 500048, India
| | - K Vasudevan
- Laboratory for the Conservation of Endangered Species, CSIR-Centre for Cellular and Molecular Biology, Hyderabad, Telangana 500048, India
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Rosenblum JS, Tunacao JM, Chandrashekhar V, Jha A, Neto M, Weiss C, Smirniotopoulos J, Rosenblum BR, Heiss JD. Tentorial Venous Anatomy: Variation in the Healthy Population. AJNR Am J Neuroradiol 2020; 41:1825-1832. [PMID: 33023913 DOI: 10.3174/ajnr.a6775] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2020] [Accepted: 07/02/2020] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE A new transtentorial venous system consisting of medial, intermediate, and lateral tentorial veins, connecting infra- and supratentorial compartments, was recently shown in 2 cadaver dissections and 2 patient scans. We sought to characterize the venous patterns within the tentorium and their relation to measures of skull development in a cohort of healthy adults. MATERIALS AND METHODS We retrospectively reviewed tentorial venous anatomy of the head using CTA/CTV performed for routine care or research purposes in 238 patients. Included studies had adequate contrast opacification of venous structures and a section thickness of ≤2 mm; we excluded cases with space-occupying lesions and vascular pathologies. Tentorial angle, dural sinus configurations, and measures of skull base development were assessed as predictors of tentorial venous anatomy variation via Cramér V association, the binary encoded Pearson correlation, and nearest-point algorithm with the Euclidean distance metric for clustering. RESULTS Tentorial vein development was related to the ringed configuration of the tentorial sinuses (P < .005). There were 3 configurations. Groups 1A and 1B (n = 50/238) had ringed configuration, while group 2 did not (n = 188/238). Group 1A (n = 38/50) had a medialized ringed configuration, and group 1B had a lateralized ringed configuration (n = 12/50). Measurements of skull base development were predictive of these groups. The ringed configuration of group 1 was related to the presence of a split confluens, which correlated with a decreased internal auditory canal-petroclival fissure angle. Configuration 1A was related to the degree of petrous apex pneumatization (P value = .010). CONCLUSIONS Variations in the transtentorial venous system directly correlate with cranial development.
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Affiliation(s)
- J S Rosenblum
- Surgical Neurology Branch (J.S.R., J.D.H.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland .,Neuro-Oncology Branch (J.S.R.), National Cancer Institute, National Institutes of Health, Bethesda, Maryland
| | - J M Tunacao
- Department of Radiology and Radiological Science (J.M.T., C.W.), The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - A Jha
- Section on Medical Neuroendocrinology (A.J.), Eunice Kennedy Shriver National Institute of Child Health and Human Development, National Institutes of Health, Bethesda, Maryland
| | - M Neto
- Department of Neurosurgery (M.N.), Hospital Beneficência Portuguesa de São Paulo, Institute of Neurological Science of São Paulo Bela Vista, São Paulo, Brazil
| | - C Weiss
- Department of Radiology and Radiological Science (J.M.T., C.W.), The Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - J Smirniotopoulos
- Department of Radiology (J.S.), George Washington University, Washington, DC.,MedPix® (J.S.), National Library of Medicine, Bethesda, Maryland
| | - B R Rosenblum
- Department of Neurosurgery (B.R.R.), Riverview Medical Center, Red Bank, New Jersey
| | - J D Heiss
- Surgical Neurology Branch (J.S.R., J.D.H.), National Institute of Neurological Disorders and Stroke, National Institutes of Health, Bethesda, Maryland
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Jha A, Pathak J, Sonthalia S, Keshavmurthy V. Use of polarized dermoscopy in the evaluation of congenital erythropoietic porphyria. Clin Exp Dermatol 2020; 46:556-557. [PMID: 32909623 DOI: 10.1111/ced.14445] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2020] [Revised: 09/01/2020] [Accepted: 09/04/2020] [Indexed: 11/28/2022]
Affiliation(s)
- A Jha
- Department of Skin and Venereal Disease, Patna Medical College, Patna, 800004, India
| | - J Pathak
- PGT, Department of Conservative Dentistry and Endodontics, Buddha Institute of Dental Sciences and Hospital
| | - S Sonthalia
- Skinnoncence, The Skin Center and Reaearch Centre, Gurugram, India
| | - V Keshavmurthy
- Department of Dermatology, Venereology and Leprology, Postgraduate Institute of Medical Education & Research (PGIMER), Chandigarh, India
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Agrawal S, Shreeram S, Jha A, Prajapati B. Recurrent Pneumonias and Bronchiectasis - Is it an Immunodeficiency Disorder? - A Case Report. J Nepal Paedtr Soc 2020. [DOI: 10.3126/jnps.v40i2.29625] [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] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Common Variable Immunodeficiency (CVID) is a form of primary immunodeficiency disorder characterised by hypogammaglobulinemia and recurrent sino-pulmonary infections. Its diagnosis is based on the presence of low serum IgG (< 2 SD below normal for age) with or without low IgA/ IgM levels and presentation beyond two years of age. These children also have disorders of autoimmunity with majority of them presenting as autoimmune cytopenias, predominantly thrombocytopenia and some having anaemia and neutropenias. Here we report a nine years old boy with past history of recurrent pneumonia, presenting this episode with fungal pneumonia, thrombocytopenia and anaemia eventually diagnosed as CVID.
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Upadhyaya RP, Ansari MA, Jha A, Kayastha P, Paudel S. Sonographic Quantification of Ovarian Volume in Adults Attending General Health Checkup and General Out Patient Department in Tribhuvan University Teaching Hospital. Kathmandu Univ Med J (KUMJ) 2020; 18:275-278. [PMID: 34158436] [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] [Indexed: 06/13/2023]
Abstract
Background Ultrasonography is the easily available, cheap and reliable method for evaluation of ovaries. Ovarian volume is the major factor in the diagnosis of various ovarian pathologies and confusing discrepancies are found in the literature. Objective To determine the ovarian volume among individuals attending outpatient department in tertiary level hospital. Method Descriptive cross sectional study design was used; 305 patients of 16-60 years attending general outpatient department in the Tribhuvan University Teaching Hospital, Kathmandu, Nepal were included. Ovarian volume was calculated by using transabdominal ultrasonography. Data was collected in the predesigned proforma and analyzed using statistical package for the social sciences software. Result The study showed mean total ovarian volume 5.95 ± 2.44 cc (centimeter cube) with mean right ovarian volume 5.94 ± 2.70 cc and mean left ovarian volume 6.05 ± 2.79 cc. Significant decrease in ovarian volume with age was observed. Height and weight did not show significant correlation with ovarian volumes and no significant variation seen in the volumes of right and left ovaries. Periovulatory ovaries show significantly higher volumes on right side than luteal phase. Similarly, significantly higher volume of left ovary seen in mixed ethnic group than mongoloid group. Conclusion Measurement of ovarian volume is important for evaluation and management of ovarian disorders. Ultrasonography which is readily available, simple and cost effective is better suited for our environment than other imaging modality. Values of ovarian volume from this study may provide a baseline of normal ovarian volume in our community.
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Affiliation(s)
- R P Upadhyaya
- Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - M A Ansari
- Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - A Jha
- Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - P Kayastha
- Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
| | - S Paudel
- Department of Radiodiagnosis and Imaging, Tribhuvan University Teaching Hospital, Maharajgunj, Kathmandu, Nepal
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Jha A, Misra A, Gupta R, Ghosh A, Tyagi K, Dutta K, Arora B, Durani S. Dipeptidyl peptidase 4 inhibitors linked bullous pemphigoid in patients with type 2 diabetes mellitus: A series of 13 cases. Diabetes Metab Syndr 2020; 14:213-216. [PMID: 32172176 DOI: 10.1016/j.dsx.2020.03.001] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
BACKGROUND Dipeptidyl peptidase 4 (DPP4) inhibitors have increasingly been linked to bullous pemphigoid, but there is paucity of data from India where about 1.85 million patients have been estimated to use these drugs. METHODS In 30,000 patients with T2DM seen by us in two tertiary care centres since 2015, we detected 13 cases of bullous pemphigoid linked to DPP4 inhibitors. We used WHO-UMC (World Health Organisation-Uppsala Monitoring Centre) causality assessment system for assessment. RESULTS Lesions of bullous pemphigoid appeared at varied intervals (within 1 weeks-2 years) after start of DPP4 inhibitors. Implicated drugs were Linagliptin (n, 8), Vildagliptin (n, 4) and Sitagliptin (n, 1). Mostly, lesions were seen after 60 years age, and over trunk and extremities. Skin biopsy was compatible with bullous pemphigoid in two patients. Lesions regressed within a month of stopping DPP4 inhibitors in 9 patients while delayed regression up to 6 months in 4 patients. Overall, skin lesions remitted in all patients and did not recur. CONCLUSION Any new bullous lesion appearing while patient is on DPP4 inhibitors should be considered as bullous pemphigoid and should necessitate prompt withdrawal of the drug.
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Affiliation(s)
- Alka Jha
- Fortis Flt.Lt. Rajan Dhall Hospital, Vasant Kunj, New Delhi, India
| | - Anoop Misra
- Fortis-C-DOC Hospital, Diabetes, Endocrinology and Allied Specialties, New Delhi, India; National Diabetes, Obesity and Cholesterol Foundation(N-DOC), New Delhi, India; Diabetes Foundation India (DFI), New Delhi, India.
| | - Ritesh Gupta
- Fortis-C-DOC Hospital, Diabetes, Endocrinology and Allied Specialties, New Delhi, India
| | - Amerta Ghosh
- Fortis-C-DOC Hospital, Diabetes, Endocrinology and Allied Specialties, New Delhi, India
| | - Kanika Tyagi
- Fortis-C-DOC Hospital, Diabetes, Endocrinology and Allied Specialties, New Delhi, India
| | - Koel Dutta
- Fortis-C-DOC Hospital, Diabetes, Endocrinology and Allied Specialties, New Delhi, India
| | - Bhavya Arora
- Fortis-C-DOC Hospital, Diabetes, Endocrinology and Allied Specialties, New Delhi, India
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Anastasiou AD, Nerantzaki M, Gounari E, Duggal MS, Giannoudis PV, Jha A, Bikiaris D. Antibacterial properties and regenerative potential of Sr 2+ and Ce 3+ doped fluorapatites; a potential solution for peri-implantitis. Sci Rep 2019; 9:14469. [PMID: 31597949 PMCID: PMC6785562 DOI: 10.1038/s41598-019-50916-4] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 09/09/2019] [Indexed: 01/07/2023] Open
Abstract
Scaffolds and implants in orthopaedics and regenerative dentistry usually fail because of bacterial infections. A promising solution would be the development of biomaterials with both significant regenerative potential and enhanced antibacterial activity. Working towards this direction, fluorapatite was synthesised and doped with Sr2+ and Ce3+ ions in order to tailor its properties. After experiments with four common bacteria (i.e. E. Coli, S. Aureus, B. Subtilis, B. Cereus), it was found that the undoped and the Ce3+ doped fluorapatites present better antibacterial response than the Sr2+ doped material. The synthesised minerals were incorporated into chitosan scaffolds and tested with Dental Pulp Stem Cells (DPSCs) to check their regenerative potential. As was expected, the scaffolds containing Sr2+-doped fluorapatite, presented high osteoconductivity leading to the differentiation of the DPSCs into osteoblasts. Similar results were obtained for the Ce3+-doped material, since both the concentration of osteocalcin and the RUNX2 gene expression were considerably higher than that for the un-doped mineral. Overall, it was shown that doping with Ce3+ retains the good antibacterial profile of fluorapatite and enhances its regenerative potential, which makes it a promising option for dealing with conditions where healing of hard tissues is compromised by bacterial contamination.
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Affiliation(s)
- A D Anastasiou
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK.
- Department of Chemical Engineering and Analytical Science, University of Manchester, Manchester, UK.
| | - M Nerantzaki
- Sorbonne University, UPMC Univ Paris 06, CNRS, UMR 8234, PHENIX Laboratory, case 51, 4 place Jussieu, 75252, Paris cedex 05, France
- Laboratory of Polymer Chemistry and Technology, Chemistry Department, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - E Gounari
- Laboratory of Biochemistry, Faculty of Medicine, Aristotle University of Thessaloniki, Thessaloniki, 541 24, Macedonia, Greece
| | - M S Duggal
- Faculty of Dentistry, National University Centre for Oral Health, Singapore, Singapore
| | - P V Giannoudis
- Academic Department of Trauma and Orthopaedic Surgery, School of Medicine, University of Leeds, Leeds, LS2 9JT, UK
| | - A Jha
- School of Chemical and Process Engineering, University of Leeds, Leeds, LS2 9JT, UK
| | - D Bikiaris
- Laboratory of Polymer Chemistry and Technology, Chemistry Department, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
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Kumar V, Jha A. Phrenic nerve palsy: A rare cause of respiratory distress in newborn: A literature review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1641] [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: 10/25/2022]
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Ragunathan B, Jha A. Adult hirschsprung disease due to defect in the myenteric plexus. A systematic review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1677] [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: 11/27/2022]
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Coates J, Jha A. A comparison between phantom breast syndrome and phantom limb: A systematic review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.635] [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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Neymour D, Jha A. A comprehensive analysis of research advances in terms of the pathophysiology of primary spinal syringomyelia. A systematic review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1647] [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: 11/28/2022]
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Kashyap P, Jha A. Impact of acute myocardial infarction and cardiac failure on brain dysfunction: A literature review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1646] [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: 11/28/2022]
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Idris-Agbabiaka A, Jha A, Sarkar S, Millaneise M, Agbabiaka I. The role of autonomic nervous system in intractable hiccup: A review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1335] [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: 10/25/2022]
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32
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Campbell G, Jha A. Dementia risk and hypertension: A literature review. J Neurol Sci 2019. [DOI: 10.1016/j.jns.2019.10.1050] [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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Lam M, Figueroa J, Orav E, Jha A. Are Oncologists Leaving Smaller Practices over Time? Int J Radiat Oncol Biol Phys 2019. [DOI: 10.1016/j.ijrobp.2019.06.1508] [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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34
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Trefz KF, Muntau AC, Kohlscheen KM, Altevers J, Jacob C, Braun S, Greiner W, Jha A, Jain M, Alvarez I, Lane P, Schröder C, Rutsch F. Clinical burden of illness in patients with phenylketonuria (PKU) and associated comorbidities - a retrospective study of German health insurance claims data. Orphanet J Rare Dis 2019; 14:181. [PMID: 31331350 PMCID: PMC6647060 DOI: 10.1186/s13023-019-1153-y] [Citation(s) in RCA: 38] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Accepted: 07/03/2019] [Indexed: 01/05/2023] Open
Abstract
BACKGROUND Phenylketonuria (PKU) is an inherited deficiency in the enzyme phenylalanine hydroxylase (PAH), which, when poorly-managed, is associated with clinical features including deficient growth, microcephaly, seizures, and intellectual impairment. The management of PKU should start as soon as possible after diagnosis to prevent irreversible damage and be maintained throughout life. The aim of this study was to assess the burden of illness in PKU patients in general and in PKU patients born before and after the introduction of newborn screening in Germany. METHODS This retrospective matched cohort analysis used the Institut für angewandte Gesundheitsforschung Berlin (InGef) research database containing anonymized healthcare claims of approximately 4 million covered lives. PKU patients were compared with matched controls from the general population within the same database (1:10 ratio via direct, exact matching on age and gender without replacement). PKU patients were included if they were aged ≥18 years on 01/01/15 and were continuously enrolled from 01/01/10 to 31/12/15. The 50 most commonly reported comorbidities and 50 most commonly prescribed medications in the PKU population were analyzed. Differences between groups were tested using 95% confidence interval (CI) of prevalence ratio (PR) values. RESULTS The analysis included 377 adult PKU patients (< 5 of which were receiving sapropterin dihydrochloride) and 3,770 matched controls. Of the 50 most common comorbidities in the PKU population, those with a statistically significant PR > 1.5 vs controls included major depressive disorders (PR = 2.3), chronic ischemic heart disease (PR = 1.7), asthma (PR = 1.7), dizziness and giddiness (PR = 1.8), unspecified diabetes mellitus (PR = 1.7), infectious gastroenteritis and colitis (PR = 1.7), and reaction to severe stress and adjustment disorders (PR = 1.6). The most commonly prescribed Anatomical Therapeutic Chemical (ATC) subcodes among PKU patients (vs the control population) are for systemic antibacterials (34.7% vs 32.8%), anti-inflammatory and antirheumatic (29.4% vs 27.5%), renin-angiotensin agents (30.0% vs 27.0%), acid-related disorders (29.4% vs 20.2%), and beta-blockers (24.9% vs 19.9%). CONCLUSION The overall clinical burden on patients with PKU is exacerbated by a significantly higher risk of numerous comorbidities and hence, prescribing of the requisite medication, both for recognized (e.g. major depressive disorders) and more unexpected comorbidities (e.g. ischemic heart disease).
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Affiliation(s)
- K F Trefz
- Zentrum für Kinder- und Jugendmedizin, Universitätsklinikum Heidelberg, Heidelberg, Germany
| | - A C Muntau
- University Children's Hospital, University Medical Center Hamburg-Eppendorf, Hamburg, Germany
| | | | | | - C Jacob
- Xcenda GmbH, Hannover, Germany
| | - S Braun
- Xcenda GmbH, Hannover, Germany
| | - W Greiner
- Fakultät für Gesundheitswissenschaften, Universität Bielefeld, Bielefeld, Germany
| | - A Jha
- BioMarin Europe Ltd., London, UK
| | - M Jain
- BioMarin Europe Ltd., London, UK
| | | | - P Lane
- BioMarin Europe Ltd., London, UK
| | - C Schröder
- BioMarin Deutschland GmbH, Kronberg/Ts, Germany
| | - F Rutsch
- Kinder- und Jugendmedizin - Allgemeine Pädiatrie, Universitätsklinikum Münster, Münster, Germany.
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Lam M, Figueroa J, Reimold K, Orav E, Jha A. End of Life Spending among Cancer Patients in an ACO vs. non-ACO. Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.07.1222] [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]
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36
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Lam M, Burke L, Reimold K, Orav E, Jha A. Healthy Days at Home: A Population-Based Quality Measure for Cancer Patients at the End of Life? Int J Radiat Oncol Biol Phys 2018. [DOI: 10.1016/j.ijrobp.2018.06.380] [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]
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Schwarze J, Openshaw P, Jha A, Giacco SR, Firinu D, Tsilochristou O, Roberts G, Selby A, Akdis C, Agache I, Custovic A, Heffler E, Pinna G, Khaitov M, Nikonova A, Papadopoulos N, Akhlaq A, Nurmatov U, Renz H, Sheikh A, Skevaki C. Influenza burden, prevention, and treatment in asthma-A scoping review by the EAACI Influenza in asthma task force. Allergy 2018; 73:1151-1181. [PMID: 29105786 DOI: 10.1111/all.13333] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/15/2017] [Indexed: 12/19/2022]
Abstract
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.
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Affiliation(s)
- J. Schwarze
- Centre for Inflammation Research The Queens Medical Research Institute University of Edinburgh Edinburgh UK
| | - P. Openshaw
- Respiratory Sciences National Heart and Lung Institute Imperial College London London UK
| | - A. Jha
- Respiratory Sciences National Heart and Lung Institute Imperial College London London UK
| | - S. R. Giacco
- Department of Medical Sciences and Public Health “M. Aresu” University of Cagliari Cagliari Italy
| | - D. Firinu
- Department of Medical Sciences and Public Health “M. Aresu” University of Cagliari Cagliari Italy
| | | | - G. Roberts
- Faculty of Medicine Southampton and David Hide Asthma and Allergy Centre St Mary's Hospital University of Southampton Newport Isle of Wight UK
| | - A. Selby
- Faculty of Medicine Southampton and David Hide Asthma and Allergy Centre St Mary's Hospital University of Southampton Newport Isle of Wight UK
| | - C. Akdis
- Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland
| | - I. Agache
- Department of Allergy and Clinical Immunology Faculty of Medicine Transylvania University Brasov Brasov Romania
| | - A. Custovic
- Department of Paediatrics Imperial College London London UK
| | - E. Heffler
- Personalized Medicine Asthma and Allergy Clinic Department of Biomedical Sciences Humanitas University Milan Italy
| | - G. Pinna
- Department of Medical Microbiology National Kapodistrian University of Athens Athens Greece
| | - M. Khaitov
- National Research Center Institute of Immunology of Federal Medicobiological Agency Moscow Russia
| | - A. Nikonova
- National Research Center Institute of Immunology of Federal Medicobiological Agency Moscow Russia
| | - N. Papadopoulos
- Division of Infection, Inflammation & Respiratory Medicine The University of Manchester Manchester UK
- Allergy Department 2nd Paediatric Clinic National Kapodistrian University of Athens Athens Greece
| | - A. Akhlaq
- Department of Health and Hospital Management Institute of Business Management Korangi Creek Karachi 75190 Pakistan
| | - U. Nurmatov
- Division of Population Medicine School of Medicine Cardiff University the National Centre for Population Health and Wellbeing Research Wales UK
| | - H. Renz
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics Philipps University Marburg University Hospital Giessen & Marburg Marburg Germany
| | - A. Sheikh
- Asthma UK Centre for Applied Research Usher Institute of Population Health Sciences and Informatics The University of Edinburgh Edinburgh UK
| | - C. Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry Molecular Diagnostics Philipps University Marburg University Hospital Giessen & Marburg Marburg Germany
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Abstract
Mycetoma caused by either filamentous fungi (eumycotic) or bacteria (actinomycotic) has recently been recognized by the World Health Organization as a neglected tropical disease. Although mycetoma is preventable and treatable, especially in the early stages, it carries high morbidity and a huge socioeconomic burden. Skin and subcutaneous tissue is affected, with a classic presentation of hard woody swellings, discharging sinuses and presence of grains (containing the causative organism). Variants with swelling without sinuses have also been described. Left untreated it may involve underlying bone and muscle, leading to permanent disability. Common actinomycotic species include Streptomyces somaliensis, Actinomadura madurae, Actinomadura pelletieri, Nocardia brasiliensis and Nocardia asteroides, while Madurella mycetomatis, Madurella grisea, Pseudoallescheria boydii and Leptosphaeria senegalensis are common eumycotic agents. Men are more commonly affected than women, and the leg is the most frequently affected site. Diagnosis in suspected lesions is made with the help of grain examination, microscopy, imaging (radiography, ultrasonography, magnetic resonance imaging) and culture, and more recently by molecular methods such as PCR and molecular sequencing. Molecular sequencing for both fungi and bacteria is important for rapid and correct diagnosis, especially in culture-negative cases. Treatment is long, more successful in actinomycetoma than eumycetoma, and may require a holistic approach comprising antimicrobials, surgery and rehabilitation. Mycetoma can be prevented by simple measures such as wearing protective garments and shoes, especially in rural areas and during outdoor activities.
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Affiliation(s)
- P Verma
- Department of Dermatology and Venereology, King George's Medical University, Lucknow, India
| | - A Jha
- Department of Dermatology, Kaya Skin Clinic, Chandigarh, India
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39
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Anastasiou A, Strafford S, Thomson C, Gardy J, Edwards T, Malinowski M, Hussain S, Metzger N, Hassanpour A, Brown C, Brown A, Duggal M, Jha A. Exogenous mineralization of hard tissues using photo-absorptive minerals and femto-second lasers; the case of dental enamel. Acta Biomater 2018; 71:86-95. [PMID: 29462711 DOI: 10.1016/j.actbio.2018.02.012] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2017] [Revised: 02/05/2018] [Accepted: 02/09/2018] [Indexed: 11/29/2022]
Abstract
A radical new methodology for the exogenous mineralization of hard tissues is demonstrated in the context of laser-biomaterials interaction. The proposed approach is based on the use of femtosecond pulsed lasers (fs) and Fe3+-doped calcium phosphate minerals (specifically in this work fluorapatite powder containing Fe2O3 nanoparticles (NP)). A layer of the synthetic powder is applied to the surface of eroded bovine enamel and is irradiated with a fs laser (1040 nm wavelength, 1 GHz repetition rate, 150 fs pulse duration and 0.4 W average power). The Fe2O3 NPs absorb the light and may act as thermal antennae, dissipating energy to the vicinal mineral phase. Such a photothermal process triggers the sintering and densification of the surrounding calcium phosphate crystals thereby forming a new, dense layer of typically ∼20 μm in thickness, which is bonded to the underlying surface of the natural enamel. The dispersed iron oxide NPs, ensure the localization of temperature excursion, minimizing collateral thermal damage to the surrounding natural tissue during laser irradiation. Simulated brushing trials (pH cycle and mechanical force) on the synthetic layer show that the sintered material is more acid resistant than the natural mineral of enamel. Furthermore, nano-indentation confirms that the hardness and Young's modulus of the new layers are significantly more closely matched to enamel than current restorative materials used in clinical dentistry. Although the results presented herein are exemplified in the context of bovine enamel restoration, the methodology may be more widely applicable to human enamel and other hard-tissue regenerative engineering. STATEMENT OF SIGNIFICANCE In this work we provide a new methodology for the mineralisation of dental hard tissues using femtosecond lasers and iron doped biomaterials. In particular, we demonstrate selective laser sintering of an iron doped fluorapatite on the surface of eroded enamel under low average power and mid-IR wavelength and the formation of a new layer to substitute the removed material. The new layer is evaluated through simulated brushing trials and nano-indentation. From the results we can conclude that is more acid resistant than natural enamel while, its mechanical properties are superior to that of current restorative materials. To the best of our knowledge this is the first time that someone demonstrated, laser sintering and bonding of calcium phosphate biomaterials on hard tissues. Although we here we discuss the case of dental enamel, similar approach can be adopted for other hard tissues, leading to new strategies for the fixation of bone/tooth defects.
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40
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Schwarze J, Openshaw P, Jha A, Del Giacco SR, Firinu D, Tsilochristou O, Roberts G, Selby A, Akdis C, Agache I, Custovic A, Heffler E, Pinna G, Khaitov M, Nikonova A, Papadopoulos N, Akhlaq A, Nurmatov U, Renz H, Sheikh A, Skevaki C. Influenza burden, prevention, and treatment in asthma-A scoping review by the EAACI Influenza in asthma task force. Allergy 2017. [PMID: 29105786 DOI: 10.1111/all.13333.] [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] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
To address uncertainties in the prevention and management of influenza in people with asthma, we performed a scoping review of the published literature on influenza burden; current vaccine recommendations; vaccination coverage; immunogenicity, efficacy, effectiveness, and safety of influenza vaccines; and the benefits of antiviral drugs in people with asthma. We found significant variation in the reported rates of influenza detection in individuals with acute asthma exacerbations making it unclear to what degree influenza causes exacerbations of underlying asthma. The strongest evidence of an association was seen in studies of children. Countries in the European Union currently recommend influenza vaccination of adults with asthma; however, coverage varied between regions. Coverage was lower among children with asthma. Limited data suggest that good seroprotection and seroconversion can be achieved in both children and adults with asthma and that vaccination confers a degree of protection against influenza illness and asthma-related morbidity to children with asthma. There were insufficient data to determine efficacy in adults. Overall, influenza vaccines appeared to be safe for people with asthma. We identify knowledge gaps and make recommendations on future research needs in relation to influenza in patients with asthma.
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Affiliation(s)
- J Schwarze
- Centre for Inflammation Research, The Queens Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - P Openshaw
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London, London, UK
| | - A Jha
- Respiratory Sciences, National Heart and Lung Institute, Imperial College London, London, UK
| | - S R Del Giacco
- Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy
| | - D Firinu
- Department of Medical Sciences and Public Health "M. Aresu", University of Cagliari, Cagliari, Italy
| | - O Tsilochristou
- Department of Pediatric Allergology, King's College, London, UK
| | - G Roberts
- Faculty of Medicine, Southampton and David Hide Asthma and Allergy Centre, St Mary's Hospital, University of Southampton, Newport, Isle of Wight, UK
| | - A Selby
- Faculty of Medicine, Southampton and David Hide Asthma and Allergy Centre, St Mary's Hospital, University of Southampton, Newport, Isle of Wight, UK
| | - C Akdis
- Swiss Institute of Allergy and Asthma Research, University of Zurich, Davos, Switzerland
| | - I Agache
- Department of Allergy and Clinical Immunology, Faculty of Medicine, Transylvania University Brasov, Brasov, Romania
| | - A Custovic
- Department of Paediatrics, Imperial College London, London, UK
| | - E Heffler
- Personalized Medicine, Asthma and Allergy Clinic, Department of Biomedical Sciences, Humanitas University, Milan, Italy
| | - G Pinna
- Department of Medical Microbiology, National Kapodistrian University of Athens, Athens, Greece
| | - M Khaitov
- National Research Center Institute of Immunology of Federal Medicobiological Agency, Moscow, Russia
| | - A Nikonova
- National Research Center Institute of Immunology of Federal Medicobiological Agency, Moscow, Russia
| | - N Papadopoulos
- Division of Infection, Inflammation & Respiratory Medicine, The University of Manchester, Manchester, UK.,Allergy Department, 2nd Paediatric Clinic, National Kapodistrian University of Athens, Athens, Greece
| | - A Akhlaq
- Department of Health and Hospital Management, Institute of Business Management, Korangi Creek, Karachi, 75190, Pakistan
| | - U Nurmatov
- Division of Population Medicine, School of Medicine, Cardiff University, the National Centre for Population Health and Wellbeing Research, Wales, UK
| | - H Renz
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen & Marburg, Marburg, Germany
| | - A Sheikh
- Asthma UK Centre for Applied Research, Usher Institute of Population Health Sciences and Informatics, The University of Edinburgh, Edinburgh, UK
| | - C Skevaki
- Institute of Laboratory Medicine and Pathobiochemistry, Molecular Diagnostics, Philipps University Marburg, University Hospital Giessen & Marburg, Marburg, Germany
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Kamali D, Reddy A, Imam S, Omar K, Jha A, Jha M. Short-term surgical outcomes and patient quality of life between robotic and laparoscopic extralevator abdominoperineal excision for adenocarcinoma of the rectum. Ann R Coll Surg Engl 2017; 99:607-613. [PMID: 29022779 PMCID: PMC5696922 DOI: 10.1308/rcsann.2017.0093] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 04/23/2017] [Indexed: 12/28/2022] Open
Abstract
Introduction Some studies advocate a laparoscopic extralevator abdominoperineal excision (l-ELAPE) approach for low rectal cancer. The da Vinci™ robot (r-ELAPE) technique has potential to overcome some limitations of l-ELAPE, such as reduction of the learning curve and more precise tissue handling. It is unknown whether this approach results in improved surgical or quality of life outcomes compared with l-ELAPE. This study aimed to address this issue. Methods Consecutive patients having undergone either robotic or laparoscopic ELAPE for adenocarcinoma were studied. All operations were performed by two surgeons experienced in laparoscopic and recently introduced robotic surgery. Surgical outcomes were determined by postoperative histology and short-term complications. Quality of life was prospectively assessed using the European Organisation for Research and Treatment of Cancer QLC-CR30 and QLC-CR29 questionnaires. Results A total of 22 patients (11 r-ELAPE) with a median follow-up of 13 months (8 months robotic; 22 months laparoscopic) were studied. The groups were similarly matched for age, gender, American Society of Anesthesiologists status, preoperative chemoradiotherapy and tumour height. All had R0 resection. There was no significant difference in short-term surgical outcomes between groups. There was no significant difference in mean global health scores between the two groups (74 ± 14 r-ELAPE vs. 73 ± 10 l-ELAPE). The r-ELAPE group had a lower mean impotence score compared with the I-ELAPE group (55.5 ± 40 vs. 72.2 ± 44), although this was not statistically significant. Conclusions The newly introduced r-ELAPE was non-inferior to l-ELAPE in either patient quality of life or surgical outcomes. Robotic surgery could be particularly beneficial in the technically challenging area of low rectal cancer surgery with a shorter learning curve than laparoscopy.
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Affiliation(s)
- D Kamali
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, UK
| | - A Reddy
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, UK
| | - S Imam
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, UK
| | - K Omar
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, UK
| | - A Jha
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, UK
| | - M Jha
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, UK
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Lam M, Burke L, Zheng J, Jha A. Spending Among Cancer Patients between ACO and Non-ACO Participants. Int J Radiat Oncol Biol Phys 2017. [DOI: 10.1016/j.ijrobp.2017.06.102] [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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Kamali D, Omar K, Imam SZ, Jha A, Reddy A, Jha M. Patient quality of life and short-term surgical outcomes between robotic and laparoscopic anterior resection for adenocarcinoma of the rectum. Tech Coloproctol 2017; 21:355-361. [PMID: 28560480 DOI: 10.1007/s10151-017-1631-y] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/28/2016] [Accepted: 04/16/2017] [Indexed: 12/18/2022]
Abstract
PURPOSE To compare patient quality of life (QoL) and short-term surgical outcomes between robotic anterior resection (r-AR) and laparoscopic (l-AR) approach. METHODS Consecutive patients having undergone either robotic or laparoscopic AR for adenocarcinoma were studied. All operations were performed by two surgeons experienced in laparoscopic and recently introduced robotic surgery. Surgical outcomes were determined by post-operative histology and short-term complications. QoL was prospectively assessed using the EORTC QLC-CR30 and QLC-CR29 questionnaires. RESULTS In total, 36 patients (18 r-AR) with a median follow-up of 12 months following surgery (9-month robotic and 20-month laparoscopic) were studied. The two groups were similarly matched for age and gender. Laparoscopic patients had a lower ASA grade (p = 0.02). There was no significant difference in surgical outcomes between groups. r-AR patients reported lower pain scales (2 ± 6 vs. 11 ± 13) (p = 0.04), lower levels of insomnia 0 vs. 8 ± 15 (p = 0.04) and a lower abdominal pain scale (2 ± 9 vs. 17 ± 27) (p = 0.04). Male impotence scores were higher in l-AR 33 ± 35 compared to r-AR 7 ± 21 (p = 0.03). CONCLUSION Despite its recent introduction to our centre, the quality of oncological resection using the robotic surgery is comparable to laparoscopy. Lower impotence and QoL scores in patients after robotic procedure may be explained on the basis of better visualisation and precise tissue handling.
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Affiliation(s)
- D Kamali
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, TS4 3BW, UK.
| | - K Omar
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, TS4 3BW, UK
| | - S Z Imam
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, TS4 3BW, UK
| | - A Jha
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, TS4 3BW, UK
| | - A Reddy
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, TS4 3BW, UK
| | - M Jha
- South Tees NHS Trust, James Cook University Hospital, Middlesbrough, TS4 3BW, UK
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Lewis C, Al-Mousawi A, Jha A, Allison K. Is it time for a change in the approach to chemical burns? The role of Diphoterine ® in the management of cutaneous and ocular chemical injuries. J Plast Reconstr Aesthet Surg 2017; 70:563-567. [DOI: 10.1016/j.bjps.2017.02.013] [Citation(s) in RCA: 15] [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] [Received: 12/22/2016] [Revised: 02/09/2017] [Accepted: 02/17/2017] [Indexed: 11/29/2022]
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Ladha S, Makhija N, Das S, Jha A, Gupta S, Kiran U. Clinical and echocardiographic predictors for postoperative recovery in children undergoing tetralogy of fallot surgery. J Cardiothorac Vasc Anesth 2017. [DOI: 10.1053/j.jvca.2017.02.123] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jena A, Taneja S, Jha A, Damesha NK, Negi P, Jadhav GK, Verma SM, Sogani SK. Multiparametric Evaluation in Differentiating Glioma Recurrence from Treatment-Induced Necrosis Using Simultaneous 18F-FDG-PET/MRI: A Single-Institution Retrospective Study. AJNR Am J Neuroradiol 2017; 38:899-907. [PMID: 28341716 DOI: 10.3174/ajnr.a5124] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/27/2016] [Accepted: 12/21/2016] [Indexed: 11/07/2022]
Abstract
BACKGROUND AND PURPOSE Differentiating glioma recurrence from treatment-induced necrosis can be a challenge on conventional imaging. This study aimed to assess the diagnostic performance of each functional MR imaging and PET parameter derived by using simultaneous FDG-PET/MR imaging individually and in combination in the evaluation of suspected glioma recurrence. MATERIALS AND METHODS Thirty-five treated glioma patients with 41 enhancing lesions (World Health Organization grade II = 9, III = 13, IV = 19) on MR imaging after an operation followed by radiation therapy and/or chemotherapy formed part of this study. Using PET/MR imaging, we calculated the normalized mean relative CBV, mean ADC, Cho/Cr, and maximum and mean target-to-background ratios. Statistical analysis was performed to determine the diagnostic performance of each parameter by receiver operating characteristic analysis individually and in combination with multivariate receiver operating characteristic analysis for the detection of glioma recurrence. Histopathology or clinicoradiologic follow-up was considered the criterion standard. RESULTS Of 35 patients, 25 (30 lesions) were classified as having a recurrence and 10 (11 lesions) patients as having treatment-induced necrosis. Parameters like rCBVmean (mean relative CBV), ADCmean, Cho/Cr, and maximum and mean target-to-background ratios were statistically significant in the detection of recurrent lesions with an accuracy of 77.5%, 78.0%, 90.9%, 87.8%, and 87.8%, respectively. On multivariate receiver operating characteristic analysis, the combination of all 3 MR imaging parameters resulted in an area under the curve of 0.913 ± 0.053. Furthermore, an area under the curve of 0.935 ± 0.046 was obtained when MR imaging parameters (ADCmean and Cho/Cr) were combined with the PET parameter (mean target-to-background ratio), demonstrating an increase in diagnostic accuracy. CONCLUSIONS Simultaneous PET/MR imaging with FDG offers correlative and synergistic multiparametric assessment of glioma recurrence with increased accuracy and clinical utility.
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Affiliation(s)
- A Jena
- From the PET SUITE (A. Jena, S.T., A. Jha, P.N.)
| | - S Taneja
- From the PET SUITE (A. Jena, S.T., A. Jha, P.N.)
| | - A Jha
- From the PET SUITE (A. Jena, S.T., A. Jha, P.N.)
| | - N K Damesha
- Neurosurgery (N.K.D., S.K.S.), Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India
| | - P Negi
- From the PET SUITE (A. Jena, S.T., A. Jha, P.N.)
| | - G K Jadhav
- Departments of Molecular Imaging and Nuclear Medicine, Radiation Oncology (G.K.J., S.M.V.)
| | - S M Verma
- Departments of Molecular Imaging and Nuclear Medicine, Radiation Oncology (G.K.J., S.M.V.)
| | - S K Sogani
- Neurosurgery (N.K.D., S.K.S.), Indraprastha Apollo Hospitals, Sarita Vihar, New Delhi, India
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Anastasiou AD, Strafford S, Posada-Estefan O, Thomson CL, Hussain SA, Edwards TJ, Malinowski M, Hondow N, Metzger NK, Brown CTA, Routledge MN, Brown AP, Duggal MS, Jha A. β-pyrophosphate: A potential biomaterial for dental applications. Mater Sci Eng C Mater Biol Appl 2017; 75:885-894. [PMID: 28415544 DOI: 10.1016/j.msec.2017.02.116] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/25/2016] [Revised: 12/09/2016] [Accepted: 02/21/2017] [Indexed: 10/20/2022]
Abstract
Tooth hypersensitivity is a growing problem affecting both the young and ageing population worldwide. Since an effective and permanent solution is not yet available, we propose a new methodology for the restoration of dental enamel using femtosecond lasers and novel calcium phosphate biomaterials. During this procedure the irradiated mineral transforms into a densified layer of acid resistant iron doped β-pyrophosphate, bonded with the surface of eroded enamel. Our aim therefore is to evaluate this densified mineral as a potential replacement material for dental hard tissue. To this end, we have tested the hardness of β-pyrophosphate pellets (sintered at 1000°C) and its mineral precursor (brushite), the wear rate during simulated tooth-brushing trials and the cytocompatibility of these minerals in powder form. It was found that the hardness of the β-pyrophosphate pellets is comparable with that of dental enamel and significantly higher than dentine while, the brushing trials prove that the wear rate of β-pyrophosphate is much slower than that of natural enamel. Finally, cytotoxicity and genotoxicity tests suggest that iron doped β-pyrophosphate is cytocompatible and therefore could be used in dental applications. Taken together and with the previously reported results on laser irradiation of these materials we conclude that iron doped β-pyrophosphate may be a promising material for restoring acid eroded and worn enamel.
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Affiliation(s)
- A D Anastasiou
- School of Chemical and Process Engineering, University of Leeds, Leeds LS2 9JT, UK.
| | - S Strafford
- Leeds Dental School, Worsley Building, University of Leeds, Leeds LS2 9JT, UK
| | - O Posada-Estefan
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, LS2 9JT, UK
| | - C L Thomson
- SUPA, School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews, Fife KY16 9SS, UK
| | - S A Hussain
- SUPA, School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews, Fife KY16 9SS, UK; Cambridge Graphene Centre, Engineering Department, University of Cambridge, 9, JJ Thomson Avenue, Cambridge CB3 0FA, UK
| | - T J Edwards
- SUPA, School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews, Fife KY16 9SS, UK
| | - M Malinowski
- Leeds Dental School, Worsley Building, University of Leeds, Leeds LS2 9JT, UK
| | - N Hondow
- School of Chemical and Process Engineering, University of Leeds, Leeds LS2 9JT, UK
| | - N K Metzger
- SUPA, School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews, Fife KY16 9SS, UK
| | - C T A Brown
- SUPA, School of Physics and Astronomy, University of St Andrews, North Haugh, St Andrews, Fife KY16 9SS, UK
| | - M N Routledge
- Leeds Institute of Cardiovascular and Metabolic Medicine, Faculty of Medicine and Health, University of Leeds, LS2 9JT, UK
| | - A P Brown
- School of Chemical and Process Engineering, University of Leeds, Leeds LS2 9JT, UK
| | - M S Duggal
- Leeds Dental School, Worsley Building, University of Leeds, Leeds LS2 9JT, UK
| | - A Jha
- School of Chemical and Process Engineering, University of Leeds, Leeds LS2 9JT, UK
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Pathak R, Prasad KBR, Rauniyar SK, Pudasaini S, Pande K, Koirala S, Kafle S, Jha A, Chalise S, Basnyat AS. Fine needle aspiration cytology of head and neck lesions and its correlation with histopathology. J Pathol Nep 2016. [DOI: 10.3126/jpn.v6i12.16276] [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: 11/18/2022] Open
Abstract
Background: Fine needle aspiration cytology is a minimally invasive technique used in the initial diagnosis of different types of lesions located in head and neck region commonly originating from cervical lymph node, thyroid gland, salivary glands and soft tissues. The objective of this study was to evaluate the diagnostic accuracy, sensitivity and speci city of FNAC in various head and neck lesions in correlation with their histopathological examination. Materials and methods: A hospital based prospective study was conducted among 209 patients with palpable head and neck region swellings in the Department of Pathology, Bhaktapur Cancer Hospital and the Department of Pathology, Nepal Medical College from August 2014 to July 2015. FNAC were done from palpable masses of head and neck regions. Data entry and analysis were done using SPSS 17. Result: There were 209 FNAC cases enrolled, out of which lymph node lesions (n=128) were the most common lesions followed by thyroid (n=40), other soft tissues (n=27) and salivary gland (n=14). Reactive lymph nodes, colloid goiter, epidermoid cyst and sialadenosis were the predominant diagnosis of lymph nodes, thyroid gland, soft tissues and salivary gland respectively. Highest accuracy, sensitivity and speci city were observed in thyroid gland, salivary gland and soft tissues. However, four false negative results for malignancy were reported in lymph node lesions. Conclusion: Head and neck region swellings are the commonly encountered conditions. FNAC being highly accurate, sensitive and speci c makes it useful and reliable procedure for screening and diagnosis of palpable masses in head and neck region.
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Soni K, Patel N, Singh K, Jha A, Patel H, Gupta R, Srinivas NR. A Sensitive Triple Quadrupole Liquid Chromatography Mass Spectrometric Method for the Estimation of Valproic Acid in K2EDTA Human Plasma using Furosemide as the Internal Standard. Drug Res (Stuttg) 2016; 66:666-672. [PMID: 27652903 DOI: 10.1055/s-0042-114777] [Citation(s) in RCA: 2] [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] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Abstract
A valproic acid is primarily being used in the treatment of epilepsy is a histone deacetylase inhibitor and it is under investigation for treatment of HIV and various cancer indications. A specific, sensitive and fast bioanalytical LC-MS/MS method was developed with furosemide as an internal standard (IS) and thoroughly validated for the quantitation of valproic acid using turbo ion spray in negative ion mode. The analyte and IS was extracted using protein precipitation. The chromatographic separation of analytes from extracted matrix was achieved using a Chromolith RP 18e (2.0×50 mm) column with a gradient mobile phase comprising of acetonitrile and purified water with acetic acid. The elution of both peaks was achieved within 5.2 min, with retention times of 2.55 min and 1.67 min for valproic acid and IS, respectively. Quantitation of valproic acid was achieved by the pseudo SRM transition pairs (m/z 142.8→m/z 142.8), and SRM transition pair (m/z 328.8 →m/z 204.6) for internal standard.The calibration standards of valproic acid showed linear over a range from 50 to 40 000 ng/mL, with a lower limit of quantitation of 50 ng/mL with accuracy of 3.74% and precision of 5.06%. The bias for inter- and intra-batch assays was 1.24-6.14% and 3.85-11.84%, respectively; while the corresponding precision was 2.56-16.37% and 1.29-11.34%, respectively. The developed method was used to monitor valproic acid levels in clinical samples. Because of higher sensitivity, this method can be used for therapeutic drug monitoring in pediatric subjects.
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Affiliation(s)
- K Soni
- Zydus Research Centre, Bioanalytical Laboratory, Ahmedabad, Gujarat, India
| | - N Patel
- Zydus Research Centre, Bioanalytical Laboratory, Ahmedabad, Gujarat, India
| | - K Singh
- Zydus Research Centre, Bioanalytical Laboratory, Ahmedabad, Gujarat, India
| | - A Jha
- Zydus Research Centre, Bioanalytical Laboratory, Ahmedabad, Gujarat, India
| | - H Patel
- Zydus Research Centre, Bioanalytical Laboratory, Ahmedabad, Gujarat, India
| | - R Gupta
- Zydus Research Centre, Clinical Research, Ahmedabad, Gujarat, India
| | - N R Srinivas
- Zydus Research Centre, Bioanalytical Laboratory, Ahmedabad, Gujarat, India
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Beudel M, Oswal A, Jha A, Foltynie T, Zrinzo L, Hariz M, Limousin P, Derrey S, Akram H, Litvak V, Brown P. SP 4. Distribution of oscillatory activities in MRI confirmed subthalamic nucleus subregions. Clin Neurophysiol 2016. [DOI: 10.1016/j.clinph.2016.05.190] [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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