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Mohan A, Krisanapan P, Tangpanithandee S, Thongprayoon C, Kanduri SR, Cheungpasitporn W, Herrmann SM. Association of Proton Pump Inhibitor Use and Immune Checkpoint Inhibitor Mediated Acute Kidney Injury: A Meta-Analysis and a Review of Related Outcomes. Am J Nephrol 2024:000538274. [PMID: 38471492 DOI: 10.1159/000538274] [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] [Received: 12/28/2023] [Accepted: 02/29/2024] [Indexed: 03/14/2024]
Abstract
INTRODUCTION Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment. However, they pose the risk of immune-related adverse events, including ICI-mediated acute kidney injury (ICI-AKI). Recent studies have implicated proton pump inhibitors (PPIs) as potential contributors to ICI-AKI development. This meta-analysis examines the association between PPI use and ICI-AKI, exploring a potential modifiable risk factor in ICI therapy, while also reviewing the possible outcomes of ICI-AKI. METHODS We conducted a comprehensive systematic review and meta-analysis of observational studies, assessing the risk of ICI-AKI in cancer patients concurrently using PPIs and potential outcomes. Odds ratios (ORs) were pooled using random-effects models. Subgroup analyses and sensitivity analyses were performed to evaluate heterogeneity and potential biases. RESULTS A total of 14 studies involving 12,694 patients were included. In total, we analyzed 639 patients with all-cause AKI and 779 patients with ICI-AKI. The pooled OR for the overall incidence of AKI from all-cause was 1.57 (95% Confidence Interval (CI), 1.02 to 2.40) among patients on PPIs. Specifically, the risk of ICI-AKI associated with PPI use was significantly higher, with a pooled OR of 1.84 (95% CI 1.16 to 2.90). This indicates approximately 84% higher likelihood of developing ICI-AKI with concurrent use of PPIs. Additionally, among patients with ICI-AKI, 67% had complete or partial recovery of renal function, 32% progressed to chronic kidney disease (CKD) and about 36% died during a follow-up period of at least 3 months. CONCLUSION This meta-analysis highlights the importance of cautious PPI prescription in cancer patients undergoing ICI therapy. Clinicians are advised to evaluate the risks and benefits of PPI use and consider alternative therapies when feasible.
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Rao YL, Pai MM, Krishnaprasad PR, Pai MV, Murlimanju BV, Mohan A, Prabhu LV, Vadgaonkar R. Virgin coconut oil - its methods of extraction, properties and clinical usage: a review. Clin Ter 2024; 175:83-91. [PMID: 38571463 DOI: 10.7417/ct.2024.5037] [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] [Subscribe] [Scholar Register] [Indexed: 04/05/2024]
Abstract
Abstract Virgin coconut oil (VCO) is a processed edible oil, which is removed from the mature coconuts. It is a colourless water insoluble liquid and obtained by the hot and cold extraction processes. The nutritional components of VCO are mainly contributed to by lauric acid, its primary content. VCO has shown its anticancer, antimicrobial, analgesic, antipyretic and antiinflammatory properties. Because of these medicinal properties, VCO has gained the wider attention among the medical field. Most evidently VCO has shown its potential antioxidant property, because of its phenolic compounds and medium chain fatty acids. It is one of the beneficial compounds used to prevent and treat the oxidative stress induced neurological disorders like stress, depression and Alzheimer's disease. Dietary supplementation of VCO is easy and economical and safer in daily life among all age groups. It is also beneficial for the cardiovascular, respiratory, dermatological, reproductive and bone health. It can also be applied to the skin as a moisturizer in the paediatric age group. Hence, exploration of antioxidant property as well as other beneficial effects of VCO in various health conditions will be valuable.
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Affiliation(s)
- Y L Rao
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - M M Pai
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - P R Krishnaprasad
- Department of Orthopaedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - M V Pai
- Department of General Surgery, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - B V Murlimanju
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - A Mohan
- Fourth Semester Medical Student, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - L V Prabhu
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - R Vadgaonkar
- Department of Anatomy, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Benington P, Anwar M, Mohan A, Gillgrass T, Ayoub A. Outcome measures of the surgery first approach for orthognathic correction of dentofacial deformities. Br J Oral Maxillofac Surg 2024; 62:71-75. [PMID: 38057176 DOI: 10.1016/j.bjoms.2023.10.023] [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: 08/11/2023] [Revised: 10/03/2023] [Accepted: 10/05/2023] [Indexed: 12/08/2023]
Abstract
In the surgery-first approach (SFA), orthognathic surgery is performed without the need for presurgical orthodontic treatment. This study was aimed at assessing the treatment durations and occlusal outcomes for a consecutive cohort of patients, with a range of dentofacial deformities, who had completed orthognathic treatment using SFA. The duration of orthognathic treatment was measured. The overall change in occlusion, and the quality of the final occlusion, were evaluated using the patients' study casts. A single, independent, calibrated operator carried out the occlusal scores, using the validated Peer Assessment Rating (PAR) index. This was repeated to test intraoperator reliability. A total of 51 patients completed surgery-first treatment during the study period. The mean (range) age at surgery was 23.3 (15-47) years. The pre-treatment skeletal jaw relationship was Class III in 39 cases, and Class II in 12 cases. The mean (SD) overall treatment duration was 11.7 (5.7) months. The intraexaminer reliability of assessing the occlusion was high. The PAR scores confirmed a significant improvement in the quality of occlusion at the completion of treatment, which compares favourably with previous studies on the conventional orthodontics-first approach. The surgery first approach can be effective at correcting both Class II and Class III malocclusion types with reduced treatment times.
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Affiliation(s)
- Philip Benington
- Dpartment of Orthodontics, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom
| | - M Anwar
- Dpartment of Orthodontics, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom
| | - A Mohan
- Dpartment of Orthodontics, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom
| | - T Gillgrass
- Dpartment of Orthodontics, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom
| | - A Ayoub
- Department of Oral & Maxillofacial Surgery, Glasgow University Dental Hospital & School/ University of Glasgow, 378 Sauchiehall Street, Glasgow G23JZ, United Kingdom.
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Majd Z, Mohan A, Johnson M, Essien E, Barner J, Serna O, Gallardo E, Fleming M, Ordonez N, Holstad M, Abughosh S. Effect of a motivational interviewing intervention on medication discontinuation among nonadherent patients with diabetes and hypertension. Res Social Adm Pharm 2023. [DOI: 10.1016/j.sapharm.2022.07.035] [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: 01/23/2023]
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Farooqui N, Mohan A, Isik B, Goksu BB, Thaler R, Zhu XY, Krier JD, Saadiq IM, Ferguson CM, Jordan KL, Tang H, Textor SC, Hickson LTJ, van Wijnen AJ, Eirin A, Lerman LO, Herrmann SM. Effect of Hypoxia Preconditioning on the Regenerative Capacity of Adipose Tissue Derived Mesenchymal Stem Cells in a Model of Renal Artery Stenosis. Stem Cells 2023; 41:50-63. [PMID: 36250949 PMCID: PMC9887092 DOI: 10.1093/stmcls/sxac073] [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] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2022] [Accepted: 08/26/2022] [Indexed: 02/02/2023]
Abstract
Atherosclerotic renal artery stenosis (ARAS) is associated with irreversible parenchymal renal disease and regenerative stem cell therapies may improve renal outcomes. Hypoxia preconditioning (HPC) may improve the regenerative functions of adipose tissue-derived mesenchymal stem cells (AMSC) by affecting DNA 5-hydroxymethylcytosine (5hmC) marks in angiogenic genes. Here, we investigated using a porcine ARAS model, whether growth of ARAS AMSCs in hypoxia (Hx) versus normoxia (Nx) would enhance renal tissue repair, and comprehensively analyze how HPC modifies DNA hydroxymethylation compared to untreated ARAS and healthy/normal pigs (n=5 each). ARAS pigs exhibited elevated serum cholesterol, serum creatinine and renal artery stenosis, with a concomitant decrease in renal blood flow (RBF) and increased blood pressure (BP) compared to healthy pigs. Renal artery injection of either autologous Nx or Hx AMSCs improved diastolic BP, reduced kidney tissue fibrosis, and inflammation (CD3+ T-cells) in ARAS pigs. In addition, renal medullary hypoxia significantly lowered with Nx but not Hx AMSC treatment. Mechanistically, levels of epigenetic 5hmC marks (which reflect gene activation) estimated using DNA immunoprecipitation technique were elevated in profibrotic and inflammatory genes in ARAS compared with normal AMSCs. HPC significantly reduced 5hmC levels in cholesterol biosynthesis and oxidative stress response pathways in ARAS AMSCs. Thus, autologous AMSCs improve key renovascular parameters and inflammation in ARAS pigs, with HPC mitigating pathological molecular effects on inflammatory and profibrotic genes which may play a role in augmenting regenerative capacity of AMSCs.
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Affiliation(s)
- Naba Farooqui
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Arjunmohan Mohan
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Busra Isik
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Busra B Goksu
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Roman Thaler
- Department of Orthopedic Surgery, Mayo Clinic, Rochester, MN, USA
| | - Xiang Yang Zhu
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - James D Krier
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Ishran M Saadiq
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | | | - Kyra L Jordan
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Hui Tang
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Stephen C Textor
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - La Tonya J Hickson
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | | | - Alfonso Eirin
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
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Sryma PB, Mittal S, Madan NK, Tiwari P, Hadda V, Mohan A, Guleria R, Madan K. Efficacy of Radial Endobronchial Ultrasound (R-EBUS) guided transbronchial cryobiopsy for peripheral pulmonary lesions (PPL...s): A systematic review and meta-analysis. Pulmonology 2023; 29:50-64. [PMID: 33441246 DOI: 10.1016/j.pulmoe.2020.12.006] [Citation(s) in RCA: 24] [Impact Index Per Article: 24.0] [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: 10/27/2020] [Revised: 12/16/2020] [Accepted: 12/16/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Transbronchial lung cryobiopsy (TBLC) is frequently described for the diagnosis of diffuse parenchymal lung diseases (DPLD). A few studies have reported transbronchial cryobiopsy for the diagnosis of peripheral pulmonary lesions (PPL...s). We aimed to study the utility and safety of transbronchial cryobiopsy for the diagnosis of PPL...s. METHODS We performed a systematic search of the PubMed and Embase databases to extract the relevant studies. We then performed a meta-analysis to calculate the diagnostic yields of transbronchial cryobiopsy and bronchoscopic forceps biopsy. RESULTS Following a systematic search, we identified nine relevant studies (300 patients undergoing cryobiopsy). All used Radial Endobronchial Ultrasound (R-EBUS) for PPL localization. The pooled diagnostic yield of transbronchial cryobiopsy was 77% (95% CI, 71%...84%) (I^2=38.72%, p=0.11). The diagnostic yield of forceps biopsy was 72% (95% CI, 60%...83%) (I^2=78.56%, p<0.01). The diagnostic yield of cryobiopsy and forceps biopsy was similar (RR 1.05, 95% CI 0.96...1.15), with a 5% risk difference for diagnostic yield (95% CI, ...6% to 15%). There was significant heterogeneity (I^2=57.2%, p=0.017), and no significant publication bias. One severe bleeding and three pneumothoraxes requiring intercostal drain (ICD) placement (major complication rate 4/122, 1.8%) were reported with transbronchial cryobiopsy. CONCLUSIONS R-EBUS guided transbronchial cryobiopsy is a safe and efficacious modality. The diagnostic yields of TBLC and forceps biopsy are similar. More extensive multicentre randomized trials are required for the further evaluation and standardization of transbronchial cryobiopsy for PPL...s.
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Affiliation(s)
- P B Sryma
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - S Mittal
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - N K Madan
- Department of Pathology, VMMC and Safdarjung Hospital, New Delhi, India
| | - P Tiwari
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - V Hadda
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - A Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - R Guleria
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India
| | - K Madan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences (AIIMS), New Delhi 110029, India.
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Carstens D, Mohan A, Ledford D, Lugogo N, Panettieri R, Moore W, Spahn J, Ambrose C. BIOMARKER LEVELS VARY BY SEX, RACE, AND ETHNICITY AMONG SPECIALIST-TREATED PATIENTS WITH SEVERE ASTHMA. Ann Allergy Asthma Immunol 2022. [DOI: 10.1016/j.anai.2022.08.631] [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: 11/11/2022]
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Nambirajan A, Jangra K, Khurana S, Malik P, Mohan A, Jain D. EP03.01-005 Clinicopathological Features of ROS1-rearranged Adenocarcinomas: A Single Institutional Experience Spanning Four Years From India. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.400] [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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Rathor A, Malik P, Tanwar P, Khurana S, Kumar S, Mohan A, Nambirajan A, Jain D. EP11.01-011 Clinical Application of Liquid Biopsy for Assessing Early EGFR Mutation Detection in Non-Small Cell Lung Carcinoma. J Thorac Oncol 2022. [DOI: 10.1016/j.jtho.2022.07.908] [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: 10/14/2022]
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Mohan A, Manikandan V, Devanesan S, AlSalhi MS, Rajeevgandhi C, Guo S, Guganathan L. Nanostructured nickel doped zinc oxide material suitable for magnetic, supercapacitor applications and theoretical investigation. Chemosphere 2022; 299:134366. [PMID: 35318014 DOI: 10.1016/j.chemosphere.2022.134366] [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] [Subscribe] [Scholar Register] [Received: 01/27/2022] [Revised: 02/23/2022] [Accepted: 03/16/2022] [Indexed: 06/14/2023]
Abstract
This Paper describes the synthesis of nickel doped ZnO is planned by chemical co-precipitation techniques. The prepared nanostructured nickel doped zinc oxide samples were analyzed by thermogravimetric differential thermal analysis (TG/DTA), X-ray diffraction (XRD), Fourier transform infra red (FTIR), field emission scanning electron microscopy (FESEM), high resolution transmission electron microscopy (HRTEM), electron paramagnetic resonance (EPR), and cyclic voltametry (CV). Nanostructure nickel doped ZnO materials have developed as promising for the basis of its broad range of employing in diverse areas. The attractive properties of nickel doped ZnO materials are highly demanded in high-energy potential applications. The nickel doped zinc oxide materials are hexagonal wurtzite arrangement is confirmed by XRD. The morphological -features of FE-SEM show nickel doped zinc oxide NPs are the structure of spherical type with agglomeration. The calculated particle size 11 nm is confirmed by HR-TEM. EPR spectra of nickel doped zinc oxide nanoparticles are ferromagnetic nature. Further, CV studies of Ni doped ZnO materials of the specific capacitance value is 133 Fg-1 at the scan rate 10 mVs-1 it is suitable for super capacitor application. The quantum chemical calculations were done by using DFT techniques through B3LYP/LANL2DZ level of basis set.
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Affiliation(s)
- A Mohan
- Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming, 650 093, China.
| | - Velu Manikandan
- Department of Bio Nanotechnology, Gachon University, 1342 Seongnam-daero, Sujeong-gu, Seongnam 8 Si, Gyeonggi-do, 13120, South Korea
| | - Sandhanasamy Devanesan
- Department of Physics and Astronomy, College of Science, King Saud University, P.O. Box-2455, Riyadh, 11451, Saudi Arabia
| | - Mohamad S AlSalhi
- Department of Physics and Astronomy, College of Science, King Saud University, P.O. Box-2455, Riyadh, 11451, Saudi Arabia
| | - C Rajeevgandhi
- Department of Physics, Sri Indu College of Engineering & Technology, Ibrahimpatan, Telangana, 501 510, India.
| | - Shenghui Guo
- Faculty of Metallurgical and Energy Engineering, Kunming University of Science and Technology, Kunming, 650 093, China
| | - L Guganathan
- Department of Physics, Annamalai University, Annamalainagar, Chidambaram, Tamil Nadu, 608 002, India
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Chandankhede U, Arora A, Prakash G, Pal M, Tummala M, Mohan A, Bakshi G. Outcomes of penile cancer stratified by nodal staging: Importance of pelvic nodal involvement. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00772-2] [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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Arora A, Prakash G, Pal M, Chandankhede U, Tummala M, Mohan A, Bakshi G, Chandankhede U, Chandankhede U. Patterns of recurrence in penile cancer: Implications for surveillance strategies. Eur Urol 2022. [DOI: 10.1016/s0302-2838(22)00774-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Gowda S, Mohan A. 424 Improving Interprofessional Teamwork in Plastic Surgery: A Novel Approach to Microsurgical Skills Training for Theatre Nurses. Br J Surg 2021. [DOI: 10.1093/bjs/znab259.697] [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: 11/13/2022]
Abstract
Abstract
Aim
Shared mental models between surgeons and scrub nurses allow them to effectively communicate with each other and react efficiently to intraoperative complications. Microsurgery poses unique challenges including the use of an operating microscope, fine instruments, and restricted views of the operative field. Our aim was to design and deliver a microsurgical skills session for theatre nurses and evaluate whether attendance influenced perceived understanding of microsurgery and ability in day-to-day role.
Method
A microsurgical training day for theatre nurses was delivered. This consisted of an introduction to and positioning of the operating microscope and three practical stations involving increasingly complex motor tasks, designed to highlight the importance of instrument handling and improve awareness of microsurgical challenges. Consultant plastic surgeons acted as scrub nurses to add an element of role-reversal. Qualitative and quantitative feedback was collected.
Results
Eight theatre nurses participated, all responded ‘strongly agree’ or ‘agree’ that the training was enjoyable, improved their understanding of microsurgery and was relevant and helpful to their day-to-day role. All attendees strongly agreed that they would partake in similar sessions in the future.
Conclusions
Role-reversal and skills-based training is a valuable tool in improving multidisciplinary collaboration in microsurgery. Increasing shared knowledge of complex procedures prospers effective teamwork and communication, which leads to improved efficiency and better patient care. Our study is a first step towards development of a standardized microsurgical skills course for theatre nurses and has broader implications for interprofessional education across all surgical specialties.
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Affiliation(s)
- S Gowda
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
| | - A Mohan
- St Mary's Hospital, Imperial College Healthcare NHS Trust, London, United Kingdom
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Nambirajan A, Singh V, Rana D, Malik P, Mohan A, Jain D. P59.27 Complementary Utility of Combined ALK/ROS1 FISH with Immunohistochemistry for ALK/ROS1 Rearrangement Testing in Lung Cancer. J Thorac Oncol 2021. [DOI: 10.1016/j.jtho.2021.08.616] [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: 10/20/2022]
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Mittal A, Malik PS, Kumar S, Saikia J, Chitikela S, Khurana S, Bharti S, Jain D, Pathy S, Thulkar S, Kumar R, Madan K, Mohan A. Dose-dense Paclitaxel and Carboplatin as Neoadjuvant Chemotherapy for Stage IIB/IIIA Non-small Cell Lung Cancer - A Phase II trial. Clin Oncol (R Coll Radiol) 2021; 33:e553-e560. [PMID: 34340919 DOI: 10.1016/j.clon.2021.07.008] [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] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/26/2021] [Revised: 06/02/2021] [Accepted: 07/14/2021] [Indexed: 12/25/2022]
Abstract
AIMS The approach to potentially resectable non-small cell lung cancer (NSCLC) remains controversial. There is a benefit of neoadjuvant chemotherapy (NACT), but the ideal regimen is unknown. We evaluated the efficacy and safety of dose-dense NACT in potentially resectable NSCLC in this phase II trial. MATERIALS AND METHODS Paclitaxel at 80 mg/m2 on days 1, 8 and 15 with AUC-6 carboplatin on day 1, 3 weekly for four cycles was evaluated as NACT. Patients with Eastern Cooperative Oncology Group performance status 0-2, stage IIB and IIIA (with only non-bulky N2 nodes) were included. The primary end point was the objective response rate. Secondary end points included toxicity, progression-free survival, recurrence-free survival, complete resection rate and overall survival. The relative dose intensity (RDI) was calculated to define tolerability (CTRI/2016/05/006916). RESULTS In total, 37 patients were enrolled (median age 55 years). Most (78.8%) were smokers. Most patients had adenocarcinoma (57.6%) and stage IIIA disease (81.0%) according to the seventh American Joint Committee on Cancer staging system. Seventy-eight per cent of patients completed four cycles. The objective response rate was 75.6% with a complete response in 10.8%. The mean RDI of paclitaxel was 88.61%, with 68.0% of patients able to maintain an RDI ≥85.0%. In total, 187 toxicity events were recorded (120 grade 1, 64 grade 2 and three grade 3 events). Common toxicities were peripheral neuropathy (20.3%), myalgia (19.8%), nausea (15.7%) and neutropenia (10.2%). There were no treatment-related deaths. Seventeen patients underwent surgery (lobectomy 82.4%). After a median follow-up of 47 months (95% confidence interval 27-50.7 months), the median progression-free survival was 9.6 months (7.4-17.4) and overall survival was 29.2 months (16.0-37.2). CONCLUSION Dose-dense paclitaxel-carboplatin is feasible, safe and efficacious and should be evaluated further in potentially resectable NSCLC.
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Affiliation(s)
- A Mittal
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - P S Malik
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India.
| | - S Kumar
- Department of Surgical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - J Saikia
- Department of Surgical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Chitikela
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Khurana
- Department of Medical Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Bharti
- Department of Oncoanaesthesia and Palliative Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - D Jain
- Department of Pathology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Pathy
- Department of Radiation Oncology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - S Thulkar
- Department of Radiodiagnosis, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - R Kumar
- Department of Nuclear Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
| | - A Mohan
- Department of Pulmonary Medicine, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India
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Musa J, Zielinski M, Hernandez M, Mohan A, Traynor M, Mahony C, Ferrara M, Immerman J, Aho J. Tension pneumothorax decompression with colorimetric capnography: pilot case series. Gen Thorac Cardiovasc Surg 2021; 70:59-63. [PMID: 34296395 DOI: 10.1007/s11748-021-01686-2] [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] [Received: 04/02/2021] [Accepted: 07/19/2021] [Indexed: 10/20/2022]
Abstract
Tension pneumothorax is a life-threatening condition that can develop when either the visceral pleura is disrupted, or with injury to the tracheobronchial tree. Rapid, accurate diagnosis and appropriate management are required to prevent significant atelectasis, hypoxia, circulatory arrest, and ultimate patient demise. Needle decompression is the current standard of care for the management of tension pneumothorax. Healthcare providers struggle to assess the success of decompression due to a lack of any immediate objective feedback. The gaseous composition of tension pneumothorax is similar to that of end respiratory gas. This includes an increased partial pressure of carbon dioxide in comparison to atmospheric air, which makes colorimetric capnography an ideal confirmatory test. This colorimetric capnography device may help the healthcare providers to make an objective and accurate assessment of the success of the needle decompression, in particular in prehospital environments.
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Affiliation(s)
- Juna Musa
- Department of Surgery, Mayo Clinic, Rochester, MN, USA
| | - Martin Zielinski
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Matthew Hernandez
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Arjunmohan Mohan
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, MN, USA
| | - Michael Traynor
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Cillian Mahony
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Michael Ferrara
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Joseph Immerman
- Department of Trauma, Critical Care and General Surgery, Mayo Clinic, Rochester, MN, USA
| | - Johnathon Aho
- Division of Trauma, Critical Care and General Surgery, Department of Physiology and Biomedical Engineering, Mayo Clinic, 200 1st Street SW, Rochester, MN, 55902, USA.
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Essar MY, Wara UU, Mohan A, Tsagkaris C, Silva DVN, Hasan MM, Hashim HT, Ahmad S, Mousavi SH. Challenges of COVID-19 vaccination in Afghanistan: A rising concern. ACTA ACUST UNITED AC 2021; 19:100703. [PMID: 34230889 PMCID: PMC8249683 DOI: 10.1016/j.jemep.2021.100703] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2021] [Accepted: 06/30/2021] [Indexed: 11/18/2022]
Affiliation(s)
- M Y Essar
- Kabul University of Medical Sciences, Kabul, Afghanistan
| | - U-U Wara
- Karachi Medical & Dental College, Karachi, Pakistan
| | - A Mohan
- Karachi Medical & Dental College, Karachi, Pakistan
| | - C Tsagkaris
- University of Crete, Faculty of Medicine, Heraklion, Greece
| | - D V N Silva
- State University of Minas Gerais, Passos, Brazil
| | - M M Hasan
- Department of Biochemistry and Molecular Biology, Faculty of Life Science, Mawlana Bhashani Science and Technology University, Tangail, 1902, Bangladesh
| | - H T Hashim
- University of Baghdad, College of Medicine, Baghdad, Iraq
| | - S Ahmad
- Punjab Medical College, Faisalabad, Pakistan
- Faisalabad Medical University, Faisalabad, Pakistan
| | - S H Mousavi
- Medical Research Center, Kateb University, Kabul, Afghanistan
- Afghanistan National Charity Organization for Special Diseases, Kabul, Afghanistan
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Abstract
We present a case of pseudo-acute kidney injury (AKI) following capmatinib therapy in an 84-year-old man with combined non-small cell (adenocarcinoma) and small cell lung cancer with MET exon 14-skipping mutation. His past medical history was significant for chronic kidney disease stage 3 with a baseline serum creatinine (Scr) of 1.6mg/dL rising to 2.44mg/dL (estimated glomerular filtration rate [GFR] 24mL/min/1.73m2) while on capmatinib. Scr improved to 1.84mg/dL with the cessation of capmatinib but rose again to 2.22mg/dL upon resumption of therapy. Further investigation with cystatin C and renal iothalamate clearance showed that despite fluctuation in Scr levels, there was not much variation in GFR calculated using these methods. Urinalysis and urinary protein-creatinine ratio were unremarkable. Treatment with capmatinib was continued at reduced dose and a third instance of rise in Scr was observed, followed by a spontaneous return to baseline. Thus, MET inhibitor therapy can result in an asymptomatic rise in Scr, and it must be distinguished from AKI with more accurate non-creatinine-based methods to evaluate GFR. This could spare such patients from invasive diagnostic tests, such as a kidney biopsy, and premature cessation of prognostically important cancer therapies.
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Affiliation(s)
- Arjunmohan Mohan
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, Rochester, Minnesota.
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Mohan A, Chengappa M, Herrmann S, Poonacha T. MO1037WOMEN REPRESENTATION IN CLINICAL PRACTICE GUIDELINES AMONG MAJOR NEPHROLOGY GUIDELINES. Nephrol Dial Transplant 2021. [DOI: 10.1093/ndt/gfab109.004] [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
Background and Aims
While the percentage of women entering nephrology has increased over the years, women representation and sex disparities in the authorship of major nephrology Clinical practice guidelines (CPG) has not been examined. Our study evaluates current sex disparities and women representation, and the nationalities of women authors in nephrology CPGs developed by the Kidney Disease: Improving Global Outcomes (KDIGO), Kidney Disease Outcomes Quality Initiative (KDOQI), and the European Renal Best Practice (ERBP), the official guideline body of the ERA-EDTA.
Method
We examined the number of female versus male guideline workgroup members (panelists) for all available CPGs in each of the three organizations as of Dec. 2020, which are available on their respective websites. We discerned the sex of the panelists based on google search and their affiliated institutional websites. We obtained the nationalities of the workgroup members from the authorship information of the respective CPG.
Results
Of the total 488 panelists in all three organizations, 115 (23.6%) were females and 373 (76.4%) males. KDIGO had 184 panelists, of which 46 (25%) were females. The CPGs with the highest and the least women representation are ‘Diabetes in Chronic Kidney Disease (CKD)’ (41.2%) and ‘Anemia in CKD’ (11.8%), respectively. The countries with the highest number of women representations are the USA (20), followed by Canada (6), and China (4). In KDOQI, 39 (31%) of 127 panelists were female. While CPGs related to ‘Evaluation and management of CKD’ and ‘Nutrition in children with CKD’ each had 50% female panelists, ‘Blood pressure management in CKD’ CPG had 10% female panelists. 28 (72%) of the total 39 women were from the USA. The ERBP had 30 (17%) females of the total 177 panelists. ‘CKD in older patients’ CPG comprised 42.1% female panelists. CPGs for ‘Glycemic control in diabetes’ and ‘Glucose lowering drugs in diabetes’ had no female panelists. Belgium and UK each had six women representatives, while France and The Netherlands 4 women representatives each.
Conclusion
The guidelines developed by the most prominent organizations – KDIGO, KDOQI, and ERA-EDTA have less than 25% women representation. While it is encouraging to note that there is more women representation in some of the CPGs developed by KDIGO in 2020, evaluating the barriers contributing to the under-representation of women in major nephrology organizations is warranted. Also notable is a lack of women representation from developing countries.
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Affiliation(s)
- Arjunmohan Mohan
- Mayo Clinic, Nephrology and Hypertension, Rochester, United States of America
| | - Madhuri Chengappa
- Nazareth Hospital, Medical Education, Philadelphia, United States of America
| | - Sandra Herrmann
- Mayo Clinic, Nephrology and Hypertension, Rochester, United States of America
| | - Thejaswi Poonacha
- M Health Fairview University of Minnesota Medical Center - West Bank, Internal Medicine, Minneapolis, United States of America
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Isik B, Thaler R, Goksu BB, Conley SM, Al-Khafaji H, Mohan A, Afarideh M, Abumoawad AM, Zhu XY, Krier JD, Saadiq IM, Tang H, Eirin A, Hickson LJ, van Wijnen AJ, Textor SC, Lerman LO, Herrmann SM. Hypoxic preconditioning induces epigenetic changes and modifies swine mesenchymal stem cell angiogenesis and senescence in experimental atherosclerotic renal artery stenosis. Stem Cell Res Ther 2021; 12:240. [PMID: 33853680 PMCID: PMC8048283 DOI: 10.1186/s13287-021-02310-z] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/14/2021] [Accepted: 03/25/2021] [Indexed: 12/13/2022] Open
Abstract
Background Atherosclerotic renal artery stenosis (ARAS) is a risk factor for ischemic and hypertensive kidney disease (HKD) for which autologous mesenchymal stem cell (MSC) appears to be a promising therapy. However, MSCs from ARAS patients exhibit impaired function, senescence, and DNA damage, possibly due to epigenetic mechanisms. Hypoxia preconditioning (HPC) exerts beneficial effects on cellular proliferation, differentiation, and gene and protein expression. We hypothesized that HPC could influence MSC function and senescence in ARAS by epigenetic mechanisms and modulating gene expression of chromatin-modifying enzymes. Methods Adipose-derived MSC harvested from healthy control (N = 8) and ARAS (N = 8) pigs were cultured under normoxia (20%O2) or hypoxia (1%O2) conditions. MSC function was assessed by migration, proliferation, and cytokine release in conditioned media. MSC senescence was evaluated by SA-β-gal activity. Specific pro-angiogenic and senescence genes were assessed by reverse transcription polymerase chain reaction (RT-PCR). Dot blotting was used to measure global genome 5-hydroxymethylcytosine (5hmC) levels on DNA and Western blotting of modified histone 3 (H3) proteins to quantify tri-methylated lysine-4 (H3K4me3), lysine-9 (H3K9me3), and lysine-27 (H3K27me3) residues. Results Specific pro-angiogenic genes in ARAS assessed by RT-PCR were lower at baseline but increased under HPC, while pro-senescence genes were higher in ARAS at baseline as compared healthy MSCs. ARAS MSCs under basal conditions, displayed higher H3K4me3, H3K27me3, and 5hmC levels compared to healthy MSCs. During HPC, global 5hmC levels were decreased while no appreciable changes occurred in histone H3 tri-methylation. ARAS MSCs cultured under HPC had higher migratory and proliferative capacity as well as increased vascular endothelial growth factor and epidermal growth factor expression compared to normoxia, and SA-β-gal activity decreased in both animal groups. Conclusions These data demonstrate that swine ARAS MSCs have decreased angiogenesis and increased senescence compared to healthy MSCs and that HPC mitigates MSC dysfunction, senescence, and DNA hydroxymethylation in ARAS MSC. Thus, HPC for MSCs may be considered for their optimization to improve autologous cell therapy in patients with nephropathies. Supplementary Information The online version contains supplementary material available at 10.1186/s13287-021-02310-z.
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Affiliation(s)
- Busra Isik
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Roman Thaler
- Department of Biochemistry and Molecular Biology, Rochester, USA.,Department of Orthopedics, Rochester, USA
| | - Busra B Goksu
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Sabena M Conley
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL, USA
| | - Hayder Al-Khafaji
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Arjunmohan Mohan
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Mohsen Afarideh
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Abdelrhman M Abumoawad
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Xiang Y Zhu
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - James D Krier
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Ishran M Saadiq
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Hui Tang
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Alfonso Eirin
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - LaTonya J Hickson
- Division of Nephrology and Hypertension, Mayo Clinic, Jacksonville, FL, USA
| | - Andre J van Wijnen
- Department of Biochemistry and Molecular Biology, Rochester, USA.,Department of Orthopedics, Rochester, USA
| | - Stephen C Textor
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Lilach O Lerman
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA
| | - Sandra M Herrmann
- Division of Nephrology and Hypertension, Mayo Clinic, 200, First Street SW, Rochester, MN, 55902, USA.
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Mohan A, Gupta P, Nair AP, Prabhakar A, Saiyed T. A microfluidic flow analyzer with integrated lensed optical fibers. Biomicrofluidics 2020; 14:054104. [PMID: 33062113 PMCID: PMC7532020 DOI: 10.1063/5.0013250] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/12/2020] [Accepted: 09/14/2020] [Indexed: 06/11/2023]
Abstract
Rapid optical interrogation of flowing cells or particles is a powerful tool in the field of biomedical diagnostics. Determination of size and composition of fast-flowing cells, with diameters in the range of 2- 15 μ m , often require complex open-space optics and expensive high-speed cameras. In this work, a method to overcome these challenges by using a hydrodynamic flow-based microfluidic platform coupled with on-chip integrated fiber optics is reported. The lab-scale portable device developed uses a combination of on-chip lensed and non-lensed optical fibers for precision illumination. The narrow light beam produced by the lensed fiber ( f = 150 μ m ) enables precise optical analysis with high sensitivity. A planar arrangement of optical fibers at various angles facilitates multi-parametric analysis from a single point of interrogation. As proof of concept, the laboratory-scale portable bench-top prototype is used to measure fluorescence signals from CD4 immunostained cells and human blood samples. The performance of microfluidic flow analyzer is also compared to the conventional Guava® easyCyte 8HT flow cytometer.
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Affiliation(s)
- A Mohan
- Department of Electrical Engineering, Indian Institute of Technology Madras (IITM), Chennai 600036, India
| | - P Gupta
- Discovery Innovation Accelerator, Centre for Cellular and Molecular Platforms (C-CAMP), Bengaluru 560065, India
| | - A P Nair
- Discovery Innovation Accelerator, Centre for Cellular and Molecular Platforms (C-CAMP), Bengaluru 560065, India
| | - A Prabhakar
- Department of Electrical Engineering, Indian Institute of Technology Madras (IITM), Chennai 600036, India
| | - T Saiyed
- Discovery Innovation Accelerator, Centre for Cellular and Molecular Platforms (C-CAMP), Bengaluru 560065, India
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22
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Thakkar M, King I, Mohan A. The extended external fixator kickstand for free and local flap reconstruction of the heel. Ann R Coll Surg Engl 2020; 102:751-752. [PMID: 32808798 DOI: 10.1308/rcsann.2020.0168] [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] [Indexed: 11/22/2022] Open
Affiliation(s)
| | - I King
- St Mary's Hospital, London, UK
| | - A Mohan
- St Mary's Hospital, London, UK
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Ciurea AV, Saceleanu V, Mohan A, Moreanu MS, Toader C. Craniopharyngiomas in children - experience of consecutive 152 operated cases. Acta Endocrinol (Buchar) 2020; 16:103-109. [PMID: 32685048 DOI: 10.4183/aeb.2020.103] [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] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/28/2022]
Abstract
Context Craniopharyngiomas (CPH) are benign tumors, rarely encountered in children, representing 5-6% of all intracranial tumors. Objective This study aimed to analyze the surgical management and quality of life in a series of CPH pediatric cases. Design This was a multicenter study performed over a 25-year period (1994 - 2019) in Bucharest. Subjects and Methods 152 children (0-17 years old) were treated for CPH. Preoperative manifestations were intracranial hypertension, endocrine dysfunction, visual impairment, ataxia, intellectual performance decrease. Results Considering all surgical approaches used, we advocate for pterional approach to best fit in CPH. We achieved gross-total removal (GTR) in 83 cases (54.4%), near-total resection (NTR) in 13 cases (9%), partial resection (PTR) in 51 cases (33.3%). 5 cases were biopsies (3.2%). Gamma Knife Surgery was performed in 10 cases (6.5%), all recurrences. At 6 months GOS revealed: Good Recovery 70 cases (46.2%), Moderate Disability 62 cases (40.7%), Severe Disability 13 (8.5%), Vegetative State 2 cases (1.3%), Deceased 5 cases (3.2%). Complications were: diabetes insipidus (89.3%); hypopituitarism (66.4%); hypothalamic damage (17.7%); visual deterioration (18.4%). Conclusions Surgery remains the main option, but GTR complications prove the necessity for a multidisciplinary approach. Outcome predicting factors are: age, tumor size, hydrocephalus degree, hypothalamic dysfunction.
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Affiliation(s)
- A V Ciurea
- "Carol Davila" University School of Medicine - Department of Neurosurgery
| | - V Saceleanu
- "Lucian Blaga" University of Sibiu, Faculty of Medicine - Department of Neurosurgery.,Sibiu County Emergency Hospital - Department of Neurosurgery, Sibiu
| | - A Mohan
- University of Oradea, Faculty of Medicine and Pharmacy - Department of Surgical Disciplines.,Bihor County Emergency Hospital - Department of Neurosurgery, Oradea, Romania
| | - M S Moreanu
- "Carol Davila" University School of Medicine - Department of Neurosurgery
| | - C Toader
- "Carol Davila" University School of Medicine - Department of Neurosurgery.,National Institute of Neurology and Neurovascular Diseases - Department of Neurosurgery, Bucharest
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Chawla A, Gudetti R, Kapadia A, Hegde P, Bin Mohammed Z, Mohan A. Super-mini PCNL (SMP) vs. standard PCNL for the management of renal calculi <2 cm: A randomized controlled study. EUR UROL SUPPL 2020. [DOI: 10.1016/s2666-1683(20)33271-7] [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] Open
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Gupta A, Singla R, Caminero JA, Singla N, Mrigpuri P, Mohan A. Impact of COVID-19 on tuberculosis services in India. Int J Tuberc Lung Dis 2020; 24:637-639. [PMID: 32553014 DOI: 10.5588/ijtld.20.0212] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Affiliation(s)
- A Gupta
- Department of Tuberculosis and Chest Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi
| | - R Singla
- Department of Tuberculosis and Chest Diseases, National Institute of Tuberculosis and Respiratory Diseases, New Delhi
| | - J A Caminero
- Department of Pneumology, Dr Negrín University Hospital of Gran Canaria, Barranco de la Ballena, Las Palmas de Gran Canaria, Spain, MDR-TB Unit, Tuberculosis Division, International Union against Tuberculosis and Lung Disease, Paris, France
| | - N Singla
- Department of Epidemiology, National Institute of Tuberculosis and Respiratory Diseases, New Delhi
| | - P Mrigpuri
- Department of Pulmonary Medicine, Vallabhbhai Patel Chest Institute, University of Delhi, New Delhi
| | - A Mohan
- Department of Pulmonary, Critical Care and Sleep Medicine, All India Institute of Medical Sciences, New Delhi, India, ,
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Purohit A, Harrison M, Berrang M, Singh R, Mohan A. Effects of Pyruvic Acid, Succinic Acid, and Oregano Essential Oil on Salmonella, Natural Microflora, and Quality of Raw Ground Chicken. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10730] [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: 11/03/2022] Open
Abstract
ObjectivesThe growing stringency of regulations related to pathogens in raw poultry and increasing consumer demand for more natural food ingredients makes it imperative to explore alternative antimicrobial agents. The aim of this study was to assess the anti-Salmonella effect of combinations of succinate or pyruvic acid with oregano essential oil in raw ground chicken. Additionally, their effect on natural microflora and quality of ground chicken over simulated retail display was evaluated.Materials and MethodsNalidixic acid (NA) adapted Salmonella Typhimurium was inoculated on skin-on broiler breast meat pieces. The antimicrobial treatments given to meat were 2 and 3% pyruvic acid (PA) or monosodium succinate (SA) in combination with 0.5% essential oil (EO). Agar at the concentration of 0.05% was added to water used to prepare antimicrobial solutions to disperse the essential oil. Mode of antimicrobial treatment was 30 s dip. The meat was then ground and evaluated for pathogen reduction. Data were analyzed using 1-way ANOVA. Surviving Salmonella were recovered on XLT-4 with 50 ppm NA. Non-inoculated meat was similarly treated with antimicrobial dip and ground. Ground chicken was packaged in foam trays with PVC overwrap, and evaluated for mesophilic aerobic plate count (APC), psychrotrophic count (PC), pH, instrumental color (CIE L*, a*, and b*), and expressible moisture over 8 d of simulated retail display.A factorial design was assigned to the experiment with antimicrobial treatments and display days as the fixed effect factors. Data were analyzed using a mixed general linear model that considered replicates as a random effect in addition to the mentioned fixed effects. All trials were conducted in three replicates.ResultsMaximum reduction obtained in Salmonella counts from ground chicken was 1.52 log CFU/g and 0.98 log CFU/g, resulting from 3% SA + 0.5% EO, and 3% PA + 0.5% EO, respectively. Three percent SA + 0.5% EO treatment resulted in ground chicken with approximately 1.2 log CFU/g lower APC on Day 8 that was significantly lower (P < 0.05) than all other treatments. This treatment also resulted in less pH variation over the entire shelf life duration and lighter color of ground meat on Day 8.ConclusionThese results indicate that combination of monosodium succinate and oregano essential oil provides effective reduction of Salmonella and improved raw quality of ground chicken. This antimicrobial combination can be employed as a clean label ingredient for raw chicken applications.
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Affiliation(s)
- A. Purohit
- University of Georgia Food Science and Technology
| | - M. Harrison
- University of Georgia Food Science and Technology
| | - M. Berrang
- University of Georgia Food Science and Technology
| | - R. Singh
- University of Georgia Food Science and Technology
| | - A. Mohan
- University of Georgia Food Science and Technology
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LeClair H, Purohit A, Mishra A, Mohan A. Effects of Drying, Lactic Acid, and an Antimicrobial Marinade on the Survival of Generic Escherichia coli on Biltong. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10766] [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: 11/03/2022] Open
Abstract
ObjectivesThe objective of the experiment was to evaluate the effects of drying, lactic acid spray, and a certain marinade application on the survival of generic Escherichia coli on biltong.Materials and MethodsFrozen eyes of round (IMPS #171C) were obtained from a local beef purveyor. The eyes of round were thawed (at 4°C), trimmed of extra fat and connective tissues, and cut into strips (L × W × T; 6 in × 2 in × 0.75 in). The experiment was divided into 2 groups and replicated once. Experiment 1 was further sub-grouped into 3 treatments: (1) negative control (NC), (2) negative control for dip treatment (NCD), and (3) inoculated group (I). Experiment 2 was sub-grouped into 6 treatments: (1) negative control (NC), (2) negative control for dip treatment (NCD), (3) positive inoculated control (PIC), and inoculated treatments (4) marinated (M), (5) 2% lactic acid spray (LA), and (6) marinated and lactic acid spray (MLA). For both experiments 1 and 2, 12 strips of biltong were randomly selected for each treatment (n = 36 for experiment 1; n = 72 for experiment 2). The inoculated samples were dipped for 30 s in a cocktail (5-log) of 4 different strains of nalidixic adapted Escherichia coli (beef isolates) and allowed 2 h for attachment at 4°C. The lactic acid was sprayed to each side of the respective biltong and allowed a 10-min resting period. Marinade was applied to respective treatment groups by dipping, rubbing, and incubating overnight (at 4°C). All samples were kept in a smokehouse in a controlled environment with drying cycle at 78°F and 60% relative humidity. Experiment 1 was incubated in the smokehouse for a total of 12 d and experiment 2 was incubated for 9 d total. Samples from each treatment group were removed on Days 0, 2, 5, 7, 9, and 12 (experiment 1 only) for microbiological sampling and analysis. Samples were homogenized, serially diluted, enumerated on TSA plus 200 ppm nalidixic acid, and incubated at 35°C for 18–24 h. Colonies were counted after 24 h and colony counts were transformed into log10 CFU for reporting.ResultsThe data for experiment 2 showed that the treatments LA, M, MLA, and PIC were able to achieve a 2.5–3 log10 CFU reduction after 9 d of drying. The M and MLA treatments exhibited a 2–3 log10 CFU reduction after 2 d of drying as compared with LA and PIC that showed a similar reduction in microbial counts after 9 d of incubation. The NC and NCD treatment groups resulted in no microbial growth from Day 0 till Day 9 of incubation. The data for experiment 1 showed that there was a 1 log10 CFU reduction of E. coli in treatment group I. The NC and NCD groups did not show microbial growth from Day 0 till Day 9 of incubation. The water activity decreased overtime to 0.722 for experiment 1 and 0.711 for experiment 2. Overall, the M and the MLA samples appeared to have the greatest and quickest killing effect on generic E. coli.ConclusionResults from these experiments suggest that the combination of drying with a lactic acid spray and marinade application causes a decrease in the E. coli population on Biltong during incubation for 9 or 12 d. While the results show that there may be a small decrease from drying alone, the greatest decreasing effect appears to be the combination of the drying, lactic acid, and marinade. Future work will include additional replicates and experiments with pathogens such as E. coli O157:H7.
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Affiliation(s)
- H. LeClair
- University of Georgia Food Science and Technology
| | - A. Purohit
- University of Georgia Food Science and Technology
| | - A. Mishra
- University of Georgia Food Science and Technology
| | - A. Mohan
- University of Georgia Food Science and Technology
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Mittal S, Suri T, Hadda V, Madan K, Mohan A, PB S, Tiwari P, Guleria R. A comparison of a wrist worn portable device (watchpat)™ with in-lab polysomnography for the diagnosis of obstructive sleep apnea. Sleep Med 2019. [DOI: 10.1016/j.sleep.2019.11.726] [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: 11/16/2022]
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Purohit A, Harrison M, Berrang M, Singh R, Mohan A. Anti-Salmonella Effects of Pyruvic and Succinic Acid in Combination with Oregano Essential Oil. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb.10815] [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: 11/03/2022] Open
Abstract
ObjectivesEffective decontamination approaches will aid in improving safety of poultry products and help processors comply with pathogen performance standards. Increasing consumer demand for clean label and more natural ingredients presents a scope to explore alternative decontamination approaches for meat and food contact surfaces. This study aimed to evaluate the antimicrobial efficacy of combinations of pyruvic acid (PA), succinic acid (SA), and oregano essential oil (EO) against Salmonella Typhimurium in suspensions, cells inoculated on raw chicken, and cells attached to steel.Materials and MethodsMinimum bactericidal concentration (MBC) assays were conducted in Mueller-Hinton broth (5 mL). Bacterial cells were added to broth suspensions of antimicrobial agents or their combinations. A contact time not exceeding 10 s was provided. Surviving bacteria were recovered on tryptic soy agar (TSA). Bacterial inactivation was confirmed by enrichment in D/E broth. Experiment involved completely randomized design with each concentration of organic acid and essential oil being considered as one level. Data were analyzed using 1-way ANOVA. Aqueous solutions of PA, SA, EO, and the mixtures of PA+EO and SA+EO were prepared using 0.05% agar to suspend the essential oil. Skin-on raw chicken breast meat pieces (2.5 cu cm) were used as a substrate to inoculate nalidixic acid (NA) adapted Salmonella cells. Pieces were treated with antimicrobial agents for 30 s by dipping, and surviving Salmonella were recovered using D/E broth on XLT-4 agar with 50 ppm NA. Four different experiments with variable acid and essential oil concentrations were performed and data were analyzed using 1-way ANOVA. Each experiment included an inoculated untreated control. Stainless steel coupons (2 × 5 cm) were used as a substrate for Salmonella attachment. Cells were allowed to grow and attach on coupons submerged in tryptic soy broth for 24 h. Coupons were rinsed to remove planktonic cells. Attached cells remaining on the coupon were dip treated with antimicrobial agents for 5 min. Surviving cells were recovered on TSA. For antimicrobial treatments leading to no cell recovery, additional experiments were performed. The recovery broth was enriched in tryptic soy broth and streaked on TSA to confirm inactivation. Three different experiments were conducted while including their respective inoculated and untreated controls and analyzed using 1-way ANOVA. All experiments were conducted in three replicates.ResultsMBC for was found to be PA (0.5%), SA(3%), EO (0.04%), PA+EO (0.25 + 0.02%), SA+EO (0.25 + 0.02%), respectively. 1% PA + 0.08% EO combination produced the maximum reduction (1.42 ± 0.11 log CFU/cm2) followed by 6% SA + 0.08% EO (1.02 ± 0.08 log CFU/cm2) in Salmonella populations on raw chicken. More than 6 log CFU/coupon of attached Salmonella were inactivated by mixtures of 0.25% PA + 0.02% EO and 1.5% SA + 0.02% EO.ConclusionThe combinations of PA+EO and SA+EO both exhibited strong anti-Salmonella activity in cell suspensions, on cells attached to stainless steel, and were effective in reducing Salmonella populations on raw chicken. Therefore, these antimicrobial combinations merit further research for raw poultry, meat, and other sanitation applications.
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Affiliation(s)
- A. Purohit
- University of Georgia Food Science and Technology
| | - M. Harrison
- University of Georgia Food Science and Technology
| | - M. Berrang
- University of Georgia Food Science and Technology
| | - R. Singh
- University of Georgia Food Science and Technology
| | - A. Mohan
- University of Georgia Food Science and Technology
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Malik P, Yadav A, Jain D, Pathy S, Mohan A, Khurana S, Kumar S. P1.01-02 Pemetrexed-Carboplatin Versus Paclitaxel (Weekly)-Carboplatin as First Line Chemotherapy in Advanced Non-Squamous NSCLC. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.717] [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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Kumar S, Sharawat S, Ali A, Malik P, Mohan A, Guleria R. EP1.03-20 Diagnostic and Prognostic Utility of Differentially Expressed Circulating MicroRNAs in Indian NSCLC Patients. J Thorac Oncol 2019. [DOI: 10.1016/j.jtho.2019.08.2100] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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Bläckberg L, Sajedi S, Mandl S, Mohan A, Vittum B, El Fakhri G, Sabet H. Exploring light confinement in laser-processed LYSO:Ce for photon counting CT application. Phys Med Biol 2019; 64:095020. [PMID: 30897557 PMCID: PMC7191943 DOI: 10.1088/1361-6560/ab1213] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
With the goal of developing a low-cost scintillator-based photon counting detector (PCD) with high dose efficiency suitable for CT, the light transport characteristics in LYSO:Ce detectors containing laser induced optical barriers (LIOB) are simulated. Light confinement and light collection efficiencies (LCE) are studied for a variety of optical barrier patterns and properties (refractive index (RI) and barrier/crystal interface roughness). Up to 80% confinement is achievable with a simple pixel pattern with one barrier wall separating each pixel coupled one-to-one to a photodetector (PD) pixel. Confinement is heavily dependent on barrier properties, and rough interfaces and higher RI results in increased cross-talk. Three approaches to enhance performance beyond the basic pattern are explored: (1) Multiple barrier walls separating each crystal pixel. (2) Introduction of long and short range confinement by having multiple crystal pixels per PD pixel. (3) Combination of LIOB and laser ablation (LA). (1) Is effective for rough interfaces where confinement can be increased by up to 24% for double compared to single walls. (2) Results in high confinement in the pixel centered on the PD pixel, but lower confinement closer to the PD edge. This feature may be explored to achieve spatial resolution beyond the PD pixel size using light sharing based positioning algorithms. (3) Can increase confinement for smooth interfaces using a smooth ablation in the bottom part of the crystal. A general trend across all configurations is a trade-off between light confinement and LCE. The LCE attainable is found comparable to that for mechanically pixelated arrays. While the confinement achievable with LIOB is always lower compared to a mechanically pixelated array, the former may offer a high level of flexibility in terms of detector design. This, in combination with the possibility to fabricate sub-mm pixels in a cost-effective manner, makes LIOB a promising technology for scintillator-based PCDs.
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Affiliation(s)
- L Bläckberg
- Department of Radiology, Gordon Center for Medical Imaging, Massachusetts General Hospital and Harvard Medical School, Boston, MA, United States of America
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Hassan S, Shafafy R, Mohan A, Magnussen P. Solitary ulnar shortening osteotomy for malunion of distal radius fractures: experience of a centre in the UK and review of the literature. Ann R Coll Surg Engl 2019; 101:203-207. [PMID: 30698462 DOI: 10.1308/rcsann.2018.0211] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [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 Isolated ulnar shortening osteotomies can be used to treat ulnocarpal abutment secondary to radial shortening following distal radius fractures. Given the increase of fragility distal radius fractures awareness of treating the sequelae of distal radius fractures is important. We present the largest reported case series in the UK of ulnar shortening osteotomies for this indication. MATERIALS AND METHODS Twenty patients with previous distal radial fractures were included, who presented with wrist pain and radiologically evident positive ulnar variance secondary to malunion of the distal radius with no significant intercalated instability. Patients were treated with a short oblique ulnar shortening osteotomy, using a Stanley jig and small AO compression plate system. Pre- and postoperative radiographical measurements of inclination, dorsal/volar angulation and ulnar variance were made. Patients were scored pre- and postoperatively using the Quick Disabilities of the Arm, Shoulder and Hand (QuickDASH) and Patient-Rated Wrist Evaluation scores by two orthopaedic surgeons. Mean follow-up was 24 months after surgery. RESULTS Radiographical analysis revealed a change in the ulnar variance with an average reduction of 5.74 mm. Mean preoperative scores were 61.1 (range 25-95.5) for QuickDASH and 70.4 (range 33-92) for Patient-Rated Wrist Evaluation. At the latest follow-up, mean postoperative QuickDASH scores were 10.6 (range 0-43.2) and 17.2 (range 0-44) for Patient-Rated Wrist Evaluation. Differences in scores after surgery for both QuickDASH and Patient-Rated Wrist Evaluation were statistically significant (P < 0.01). CONCLUSIONS The ulnar shortening osteotomy is a relatively simple procedure compared with corrective radial osteotomy, with a lower complication profile. In our series, patients showed significant improvement in pain and function by correcting the ulnar variance thus preventing ulna-carpal impaction.
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Affiliation(s)
- S Hassan
- Epsom and Saint Helier University Hospitals NHS Trust, Carshalton , Surry , UK
| | - R Shafafy
- Royal Surrey County Hospital NHS Foundation Trust, Guildford , Surrey , UK
| | - A Mohan
- Croydon University Hospital, Thornton Heath , Surrey , UK
| | - P Magnussen
- Royal Surrey County Hospital NHS Foundation Trust, Guildford , Surrey , UK
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LeClair H, Purohit A, Mishra A, Mohan A. Effects of Drying, Lactic Acid, and an Antimicrobial Marinade on the Survival of Generic Escherichia coli on Biltong. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0146] [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: 11/03/2022] Open
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Purohit A, Harrison M, Berrang M, Singh R, Mohan A. Effects of Pyruvic Acid, Succinic Acid, and Oregano Essential Oil on Salmonella, Natural Microflora, and Quality of Raw Ground Chicken. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0084] [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: 11/03/2022] Open
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Garg R, Nandi R, Hadda V, Mohan A. Conventional laryngoscopy as a rescue for fiber-optic-assisted tracheal intubation in a patient with perilaryngeal edema after rigid bronchoscopy : A case report. Lung India 2019. [DOI: 10.4103/0970-2113.257706] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Madan K, Mittal S, Hadda V, Mohan A. Cryoprobe transbronchial lung biopsy with flexible bronchoscope using Arndt endobronchial blocker. Lung India 2019. [DOI: 10.4103/0970-2113.257708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
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Purohit A, Harrison M, Berrang M, Singh R, Mohan A. Anti-Salmonella Effects of Pyruvic and Succinic Acid in Combination with Oregano Essential Oil. Meat and Muscle Biology 2019. [DOI: 10.22175/mmb2019.0148] [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: 11/03/2022] Open
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Pattnaik B, Chakraborty S, Bajpai P, Agrawal A, Guleria R, Mohan A. P2.11-17 MicroRNAs in Exhaled Breath Condensate and Bronchial Brushings as Biomarkers for Early Diagnosis of Lung Cancer. J Thorac Oncol 2018. [DOI: 10.1016/j.jtho.2018.08.1364] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Mohan A, Tharion G, Kumar RK, Devasahayam SR. An instrumented glove for monitoring hand function. Rev Sci Instrum 2018; 89:105001. [PMID: 30399736 DOI: 10.1063/1.5038601] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/04/2018] [Accepted: 09/14/2018] [Indexed: 06/08/2023]
Abstract
The measurement of hand kinematics is important for the assessment and rehabilitation of the paralysed hand. The traditional method of hand function assessment uses a mechanical or electronic goniometer placed across the joint of interest to measure the range of joint movement. Mechanical goniometers are imprecise and lack the ability to provide a dynamic measurement; electronic goniometers are expensive and cumbersome to use during therapy. An alternative to the goniometric based assessment is to use inertial motion sensors to monitor the hand movement-these can be incorporated in a glove. In this paper, we present the design of an instrumented glove equipped with Magnetic, Angular Rate and Gravity (MARG) sensors for the objective evaluation of hand function. The instrumented glove presented in this paper is designed to assess the range of movement of the hand and also monitor the hand function during the course of hand rehabilitation. Static and dynamic calibrations were performed for the Euler angles calculated from the MARG sensors. The results are also presented for physiological flexion/extension of the wrist (relative roll), flexion/extension of elbow (relative pitch), and internal rotation/external rotation (relative yaw). The static calibration results gave mean absolute errors of 4.1° for roll, 4.0° for pitch, and 4.6° for yaw. From the dynamic calibration, the speed of response to a step change gave a convergence time of 0.4 s; sinusoidally oscillating movement gave good tracking at 0.2 Hz but exhibits overshoot errors at higher frequencies which were tested to be 1 Hz. We present the results of the calibration of the instrumented glove (one sensor pair measuring one joint angle) measuring anatomical joint angles-mean absolute errors during static calibration: 6.3° for a relative roll (wrist flexion/extension), 5.0° for relative pitch (elbow flexion/extension), and 4.5° for relative yaw (shoulder internal rotation/external rotation). The experimental results from the instrumented glove are promising, and it can be used as an alternative to the traditional goniometer based hand function assessments.
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Affiliation(s)
- A Mohan
- Department of Bioengineering, Christian Medical College Vellore, Vellore, India
| | - G Tharion
- Department of Physical Medicine and Rehabilitation, Christian Medical College Vellore, Vellore, India
| | - R K Kumar
- Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India
| | - S R Devasahayam
- Department of Bioengineering, Christian Medical College Vellore, Vellore, India
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Hegde AV, Choubey S, Kanagali RS, Pipara G, Rao AN, Mohan A. Listening to his inner voice? An unusual urethral foreign body: A review of literature and few learning points. Asian J Urol 2018; 5:131-132. [PMID: 29736377 PMCID: PMC5934512 DOI: 10.1016/j.ajur.2017.06.007] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/07/2016] [Revised: 01/18/2017] [Accepted: 03/14/2017] [Indexed: 11/26/2022] Open
Affiliation(s)
| | - Suryakanth Choubey
- Department of Urology, St. Johns Medical College Hospital, Bangalore, India
| | | | - Gotam Pipara
- Department of Urology, St. Johns Medical College Hospital, Bangalore, India
| | - A Nagaraja Rao
- Department of Urology, St. Johns Medical College Hospital, Bangalore, India
| | - A Mohan
- Department of Urology, St. Johns Medical College Hospital, Bangalore, India
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Mohan A, Tharion G, Kumar RK, Devasahayam SR. An instrumented object for hand exercise and assessment using a pneumatic pressure sensor. Rev Sci Instrum 2018; 89:055004. [PMID: 29864878 DOI: 10.1063/1.5020348] [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] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/08/2023]
Abstract
Measurement of grip force is important for both exercise training and assessment of the hand during physical rehabilitation. The standard method uses a grip dynamometer which measures the force between the fingers and opposing thumb. The primary limitation of the grip dynamometer is the restriction of measurement to cylindrical grasps. Any deformation of the hand due to muscular or skeletal disease makes the grip dynamometer difficult or impossible to use. An alternative to the grip dynamometer is a sealed pneumatic object that can be gripped by the hand. Measurement of the internal pressure in the object can be related to the grip force. In this paper, we analyze such a pneumatic pressure sensing object for hand grip assessment and also describe an easy fabrication of the grip sensor. The instrumented object presented in this paper is designed to assess both the maximal voluntary grip forces and continuous grip force to monitor control of hand function during exercise under instruction from a therapist. Potential uses of such a pneumatic pressure sensing object for hand grip are in physical rehabilitation of patients following paralysing illnesses like stroke and spinal cord injury.
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Affiliation(s)
- A Mohan
- Department of Bioengineering, Christian Medical College Vellore, Vellore, India
| | - G Tharion
- Department of Physical Medicine and Rehabilitation, Christian Medical College Vellore, Vellore, India
| | - R K Kumar
- Department of Engineering Design, Indian Institute of Technology Madras, Madras, India
| | - S R Devasahayam
- Department of Bioengineering, Christian Medical College Vellore, Vellore, India
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Mohan A, Malathi M. Dielectric Relaxation and Thermodynamic Studies of Binary Mixtures of 2-Nitrotoluene with Primary and Secondary Alcohols at Different Temperatures. J SOLUTION CHEM 2018. [DOI: 10.1007/s10953-018-0744-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Vashistha V, Choudhari C, Garg A, Gupta A, Parthasarathy G, Mohan C, Madan K, Hadda V, Khilnani G, Mohan A. 41P Gender based variations in presentation and management of lung cancer at a south Asian tertiary referral centre. J Thorac Oncol 2018. [DOI: 10.1016/s1556-0864(18)30321-6] [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: 10/17/2022]
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Mohan A, Poulose R, Ansari A, Madan K, Hadda V, Khilnani GC, Guleria R. Novel use of bioelectric impedence technique to detect alterations in body composition in advanced small cell lung cancer. Indian J Cancer 2018; 54:478-480. [PMID: 29469082 DOI: 10.4103/ijc.ijc_497_17] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 11/04/2022]
Abstract
BACKGROUND Malnutrition is frequent in lung cancer and is measured using various tools, including the novel bioelectric impedance technique for measuring body composition. However, the validation of this technique for assessing body composition in advanced small cell lung cancer (SCLC) is untested. METHODS Forty-one treatment naïve patients (all males) and an equal number of age- and sex-matched controls were evaluated by anthropometric measurements of skinfold thicknesses and body composition parameters such as body fat%, fat mass, fat-free mass (FFM), and total body water (TBW). RESULTS The mean (SD) age of the patient group was 55.7 (7.5) years, median pack-years was 20 (range, 0-80), and mean (SD) duration of symptoms was 152.6 (153.7) days. Median Karnofsky Performance Scale was 70 (range, 50-90). Majority of our patients (68.3%) were Stage IV followed by Stage III (31.7%). The percentage of patients with low, normal, and high body mass index (BMI) was 31.7%, 61%, and 7.3%, respectively. All components of body composition, i.e., body fat%, FFM, and TBW were significantly lower in patients compared to controls. However, the body composition in patients and controls with normal BMI was similar. The phenomenon of sarcopenia as a cause of cancer cachexia may explain these findings, whereas the combination of loss of body fat and lean body mass may lead to weight loss and reduced BMI. CONCLUSION Our results indicate that body composition is markedly altered in Indian patients with advanced SCLC. The impact of these parameters on clinically relevant outcomes needs further evaluation.
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Affiliation(s)
- A Mohan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - R Poulose
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - A Ansari
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - K Madan
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - V Hadda
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - G C Khilnani
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
| | - R Guleria
- Department of Pulmonary Medicine and Sleep Disorders, All India Institute of Medical Sciences, New Delhi, India
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Kushwaha N, Mohan A, Bhikane AU. Accidental acetamiprid poisoning in a buffalo. Iran J Vet Res 2018; 19:318-320. [PMID: 30774674 PMCID: PMC6361594] [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] [Subscribe] [Scholar Register] [Received: 03/17/2018] [Revised: 09/18/2018] [Accepted: 09/24/2018] [Indexed: 06/09/2023]
Abstract
Acetamiprid is a first generation systemic neonicotinoid insecticide, routinely used for crop protection against sucking type insects. It is likely to be of low toxicity in mammals but severe poisoning may occur if ingested in large amount. A case of buffalo with accidental ingestion of acetamiprid was presented with severe gastrointestinal symptoms and respiratory distress. The patient was managed successfully with symptomatic and supportive treatment. As far as the present report is concerned, it is the first report of acute acetamiprid poisoning in buffalo from India. From this report it is concluded that awareness programs about safe use of pesticides should be implemented.
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Affiliation(s)
- N. Kushwaha
- Department of Teaching Veterinary Clinical Complex, College of Veterinary and Animal Sciences, Udgir-413 517, Maharashtra Animal and Fishery Sciences University, Maharashtra, India
| | - A. Mohan
- Department of Veterinary Epidemiology and Preventive Medicine, College of Veterinary and Animal Sciences, Udgir-413 517, Maharashtra Animal and Fishery Sciences University, Maharashtra, India
| | - A. U. Bhikane
- Department of Clinical Medicine, Ethics and Jurisprudence, College of Veterinary and Animal Sciences, Udgir-413 517, Maharashtra Animal and Fishery Sciences University, Maharashtra, India
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Jasti DB, Mallipeddi S, Apparao A, Vengamma B, Kolli S, Mohan A. Quality of Sleep and Sleep Disorders in Patients with Parkinsonism: A Polysomnography Based Study from Rural South India. J Neurosci Rural Pract 2018; 9:92-99. [PMID: 29456351 PMCID: PMC5812167 DOI: 10.4103/jnrp.jnrp_189_17] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE The objective of this study is to study the quality of sleep, sleep disorders, and polysomnographic profile in Parkinsonism patients from rural areas and to correlate polysomnographic profile with the staging of disease and with sleep questionnaire. MATERIALS AND METHODS Between May 2014 and December 2015, 168 Parkinsonism patients were prospectively screened using sleep questionnaire; Epworth Sleepiness Scale (ESS), Pittsburgh Sleep Quality Index (PSQI), Parkinson Disease Sleep Score-2 (PDSS-2). Sixty patients underwent overnight polysomnography subsequently. RESULTS The mean age of 168 patients in the study was 65.3 ± 12.8 years. The mean duration of Parkinsonism was 4.6 ± 3.1 years. The mean ESS, PSQI and PDSS-2 were 12.4 ± 3.2, 7.9 ± 2.1 and 44.7 ± 5.8, respectively. A total of 148 patients (88.1%) had poor quality sleep, which was reported only in 37 patients (22%). Excessive daytime sleepiness (80%) and insomnia (76.7%) were most common symptoms. Polysomnographic profile showed poor sleep efficiency (median interquartile range [IQR] 74.8% [17.8%-99.5%]), reduced slow wave sleep (median [IQR] 0% [0%-9.5%]), and reduced rapid eye movement [REM] sleep (median (IQR) 4.9% [0.1%-24.2%]). Sleep disorders in the study were sleep fragmentation (n = 60, 100%), obstructive sleep apnea syndrome (n = 40, 66.7%), central sleep apnea syndrome (n = 6, 10%), and periodic limb movement disorder (n = 52, 86.7%). Two patients had REM sleep behavioral disorder clinically. There was statistically significant positive correlation between staging of disease, sleep latencies, and sleep questionnaire. CONCLUSION Sleep is impaired in majority of Parkinsonism patients which needs to be diagnosed early and managed effectively. Patient education and awareness programs in rural areas regarding sleep disorders in Parkinsonism are required for early diagnosis.
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Affiliation(s)
| | | | - A. Apparao
- Department of Neurology, SVIMS, Tirupati, Andhra Pradesh, India
| | - B. Vengamma
- Department of Neurology, SVIMS, Tirupati, Andhra Pradesh, India
| | - Satyarao Kolli
- Department of Neurology, SVIMS, Tirupati, Andhra Pradesh, India
| | - A. Mohan
- Department of Medicine, SVIMS, Tirupati, Andhra Pradesh, India
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Rayudu AL, Kalawat T, Krishna Mohan VS, Mohan A, Lakshmi AY, Mantri RG. 18F-Fluorodeoxyglucose Positron Emission Tomography-computed Tomography in Evaluation of Large Vessel Vasculitis. Indian J Nucl Med 2018; 33:48-51. [PMID: 29430115 PMCID: PMC5798098 DOI: 10.4103/ijnm.ijnm_114_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
18F-fluorodeoxyglucose positron emission tomography-computed tomography (18F-FDG PET-CT) is a rapidly evolving hybrid imaging technique in evaluation of infection and inflammation. Usually, functional changes often precede anatomical changes. 18F-FDG PET-CT, a noninvasive diagnostic test and it is useful for the early detection of inflammation. Most of the large vessel vasculitis patients present with nonspecific signs and symptoms, which are difficult to diagnose clinically. Here, we discuss three cases of large vessel vasculitis with different clinical presentations, identified by 18F-FDG PET-CT scan.
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Affiliation(s)
| | - Tekchand Kalawat
- Department of Nuclear Medicine, SVIMS, Tirupati, Andhra Pradesh, India
| | - VS Krishna Mohan
- Department of Nuclear Medicine, SVIMS, Tirupati, Andhra Pradesh, India
| | - A Mohan
- Department of Medicine, SVIMS, Tirupati, Andhra Pradesh, India
| | | | - Ranadheer Gupta Mantri
- Department of Nuclear Medicine, SVIMS, Tirupati, Andhra Pradesh, India,Address for correspondence: Dr. Ranadheer Gupta, Department of Nuclear Medicine, SVIMS, Tirupati - 517 507, Andhra Pradesh, India. E-mail:
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Affiliation(s)
- T J Holme
- Croydon University Hospital , Croydon , UK
| | - A Mohan
- Croydon University Hospital , Croydon , UK
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