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Giri S, Singh A, Kolhe K, Kale A, Shukla A. Reply: Portal vein thrombosis in cirrhosis: exploring the uncharted waters. J Gastroenterol Hepatol 2023; 38:2254. [PMID: 37804045 DOI: 10.1111/jgh.16378] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2023] [Accepted: 09/25/2023] [Indexed: 10/08/2023]
Affiliation(s)
- S Giri
- Department of Gastroenterology, Nizam's Institute of Medical Sciences, Hyderabad, India
| | - A Singh
- Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - K Kolhe
- Department of Gastroenterology, Narayana Hospital, Nanded, India
| | - A Kale
- Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, India
| | - A Shukla
- Department of Gastroenterology, Seth GS Medical College and KEM Hospital, Mumbai, India
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Lee T, Roth E, Shukla A, Gupta N, Lee R, Kryger J, Groth T, Canning D, Mitchell M, Weiss D, Borer J. Pelvic Ectopic Kidney Prevalence and Pressure Changes During Cloacal Exstrophy (Omphalocele-Exstrophy-Imperforate Anus-Spinal Defects Syndrome) Closure. Urology 2023; 181:124-127. [PMID: 37634851 DOI: 10.1016/j.urology.2023.07.037] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/28/2023] [Accepted: 07/03/2023] [Indexed: 08/29/2023]
Abstract
OBJECTIVES To assess the prevalence of pelvic ectopic kidneys (PEK) and compare renal parameters of the PEK to the orthotopic kidney following pubic bone approximation. METHODS In four Omphalocele-Exstrophy-Imperforate Anus-Spinal Defects Syndrome (OEIS) patients undergoing second-stage repair with known pelvic and orthotopic kidneys, changes in the renal pelvis pressure (RPP), peak systolic velocity (PSV), and resistive index (RI) were measured in the pelvic and orthotopic kidneys following pubic bone approximation. A paired t-test was performed for analysis. Prevalence was tabulated using a multi-institutional retrospective review. RESULTS Mean rise in RPP was +26.0 mmHg in the PEK and +10.3 mmHg in the orthotopic kidney (P = .55). One patient had immediate increase in RPP of 66 mmHg in the PEK (7 mmHg in the orthotopic kidney) which decreased to +17 mmHg in the PEK upon release of the pubic approximation stitch. Mean change in PSV was +67.7 cm/s in the PEK compared to - 25.7 cm/s in the orthotopic kidney (P = .09). Mean change in renal RI was + 0.06 in PEK compared to - 0.01 in the orthotopic kidney (P = .29). Among 80 OEIS patients, 24 (30%) had a PEK. 3 (4%) had a solitary PEK. CONCLUSION During second-stage OEIS closure, we witnessed patterns of higher change in RPP, PSV, and RI of the PEK compared to the orthotopic kidney. Furthermore, PEKs were found in nearly a third of our OEIS patients. Real-time RPP monitoring, especially those with solitary PEK, may aid in the management of OEIS patients during the perioperative period.
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Affiliation(s)
- Ted Lee
- Boston Children's Hospital, Department of Urology, Boston, MA.
| | - Elizabeth Roth
- Children's Wisconsin, Department of Urology, Milwaukee, WI
| | - Aseem Shukla
- Children's Hospital of Pennsylvania, Department of Urology, Philadelphia, PA
| | - Naveen Gupta
- Boston Children's Hospital, Department of Urology, Boston, MA
| | - Richard Lee
- Boston Children's Hospital, Department of Urology, Boston, MA
| | - John Kryger
- Children's Wisconsin, Department of Urology, Milwaukee, WI
| | - Travis Groth
- Children's Wisconsin, Department of Urology, Milwaukee, WI
| | - Douglas Canning
- Children's Hospital of Pennsylvania, Department of Urology, Philadelphia, PA
| | | | - Dana Weiss
- Children's Hospital of Pennsylvania, Department of Urology, Philadelphia, PA
| | - Joseph Borer
- Boston Children's Hospital, Department of Urology, Boston, MA
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Godlewski KF, Mittal S, Hyacinthe N, Fischer K, Weaver J, Van Batavia J, Weiss D, Srinivasan A, Shukla A, Zderic S, Kolon T, Zaontz M, Long C. Does Preoperative Testosterone Administration Decrease Complications in Distal Hypospadias Repair With Urethroplasty? J Urol 2023; 210:352-359. [PMID: 37195856 DOI: 10.1097/ju.0000000000003548] [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: 03/06/2023] [Accepted: 05/04/2023] [Indexed: 05/19/2023]
Abstract
PURPOSE Testosterone administration prior to hypospadias repair is common practice among pediatric urologists; however, its impact on surgical outcomes remains controversial. We hypothesize that testosterone administration prior to distal hypospadias repair with urethroplasty significantly decreases postoperative complications. MATERIALS AND METHODS We queried our hypospadias database for primary distal hypospadias repairs with urethroplasty from 2015 to 2021. Patients undergoing repair without urethroplasty were excluded. We collected information on patient age, procedure type, testosterone administration status, initial visit and intraoperative glans width, urethroplasty length, and postoperative complications. To determine the role of testosterone administration on incidence of complications, a logistic regression adjusting for initial visit glans width, urethroplasty length, and age was performed. RESULTS A total of 368 patients underwent distal hypospadias repair with urethroplasty. One hundred thirty-three patients received testosterone and 235 did not. Initial visit glans width was significantly larger in the no-testosterone vs testosterone group (14.5 mm vs 13.1 mm, P = .001). Testosterone patients had significantly larger glans width at the time of surgery (17.1 mm vs 14.6 mm [no-testosterone group], P = .001). On multivariable logistic regression analysis after controlling for age at surgery, preoperative glans width, testosterone status, and urethroplasty length, testosterone administration did show significant association with reduced odds of postoperative complications (OR 0.4, P = .039). CONCLUSIONS This retrospective review of patients shows that on multivariable analysis there is significant association between testosterone administration and decreased incidence of complications in patients undergoing distal hypospadias repair with urethroplasty. Future studies on testosterone administration should focus on specific cohorts of patients with hypospadias as benefits of testosterone may be more evident in some subgroups than others.
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Affiliation(s)
| | - Sameer Mittal
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - John Weaver
- Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | | | - Dana Weiss
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Arun Srinivasan
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Aseem Shukla
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephen Zderic
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Thomas Kolon
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Mark Zaontz
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Godlewski KF, Mittal S, Hyacinthe N, Fischer K, Weaver J, Van Batavia J, Weiss D, Srinivasan A, Shukla A, Zderic S, Kolon T, Zaontz M, Long C. Reply by Authors. J Urol 2023:101097JU000000000000354803. [PMID: 37254672 DOI: 10.1097/ju.0000000000003548.03] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 06/01/2023]
Affiliation(s)
| | - Sameer Mittal
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | | | | | - John Weaver
- Rainbow Babies and Children's Hospital, Cleveland, Ohio
| | | | - Dana Weiss
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Arun Srinivasan
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Aseem Shukla
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Stephen Zderic
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Thomas Kolon
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
| | - Mark Zaontz
- Children's Hospital of Philadelphia, Philadelphia, Pennsylvania
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Lee T, Weiss D, Roth E, Bortnick E, Jarosz S, Eftekharzadeh S, Groth T, Shukla A, Kryger JV, Lee RS, Canning DA, Mitchell ME, Borer JG. Prenatal Diagnosis of Bladder Exstrophy and OEIS over 20 Years. Urology 2023; 172:174-177. [PMID: 36460061 DOI: 10.1016/j.urology.2022.11.020] [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] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2022] [Accepted: 11/17/2022] [Indexed: 12/03/2022]
Abstract
OBJECTIVE To examine the prenatal diagnosis rates of bladder exstrophy (BE) and Omphalocele-Exstrophy-Imperforate anus-Spinal Defect Syndrome (OEIS) in a large cohort of patients over a 20-year period. We hypothesized that prenatal diagnosis rates improved over time due to evolving techniques in fetal imaging. METHODS A multi-institutional database was queried to identify BE or OEIS patients who underwent primary closure between 2000 and 2020. We retrospectively determined prenatal or postnatal diagnosis. Those with unknown prenatal history were excluded. Multivariable logistic regression was used to investigate temporal pattern in rate of prenatal diagnosis while adjusting for sex and treating institution. RESULTS Among 197 BE and 52 OEIS patients, 155 BE and 45 OEIS patients had known prenatal history. Overall prenatal diagnosis rates of BE and OEIS were 47.1% (73/155) and 82.2% (37/45), respectively. Prenatal diagnosis rate was significantly lower in BE compared to OEIS (P <.0001). The prenatal diagnosis rate for BE significantly increased over time (OR 1.10; [95%CI: 1.03-1.17]; P = .003). Between 2000 and 2005, the prenatal diagnosis rate of BE was 30.3% (10/33). Between 2015 and 2020, prenatal diagnosis rate of BE was 61.1% (33/54). Prenatal diagnosis rate for OEIS did not change over time. Rates of prenatal diagnosis did not differ by sex or treating institution. CONCLUSION Rates of prenatal diagnosis of BE and OEIS are higher than previously reported. Prenatal diagnosis rate of BE doubled in the last 5 years compared to the first 5 years of the study period. Nonetheless, a significant proportion of both BE and OEIS patients remain undiagnosed prior to delivery.
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Affiliation(s)
- Ted Lee
- Department of Urology, Boston Children's Hospital, Boston, MA.
| | - Dana Weiss
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - Elizabeth Roth
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | - Eric Bortnick
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Susan Jarosz
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | | | - Travis Groth
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | - Aseem Shukla
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | - John V Kryger
- Division of Urology, Children's Wisconsin, Milwaukee, WI
| | - Richard S Lee
- Department of Urology, Boston Children's Hospital, Boston, MA
| | - Douglas A Canning
- Division of Urology, Children's Hospital of Philadelphia, Philadelphia, PA
| | | | - Joseph G Borer
- Department of Urology, Boston Children's Hospital, Boston, MA
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Chaudhary G, Pradhan AK, Shah S, Roy S, Singh V, Dwivedi SK, Sethi R, Chandra S, Vishwakarma P, Sharma AK, Bhandari M, Shukla A, Singh A. Unraveling the invisible demon: a study of the oxidative stress markers, antioxidant activities and inflammatory markers in patients admitted with complete heart block. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.011] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Introduction
Despite the recent advancements in the management of Complete Heart Block (CHB), the aetiology of CHB is still idiopathic in most of the cases. Our study explores this hitherto untouched aspect of complete heart block.
Purpose
We aimed to assess the aetiological profile of Complete Heart Block patients in our study.
Methods
The study population consisted of 60 patients with complete heart block aged between 30 to 80 years, attending as an inpatient in ER. Oxidative stress was measured by serum MDA, serum GSH, serum Catalase activity and serum SOD activity. Antioxidant activity was obtained by measuring the levels of serum total antioxidant capacity. Inflammatory stress was measured by IL-5 and TNF-alpha levels. These values were compared to 30 healthy controls with no prior history of smoking and diabetes mellitus.
Results
The mean age of the patient was 62.48 ± 7.98 years and the gender distribution was 37 males and 23 females out of 60 patients. The mean value of serum MDA (ng/mL) in cases is 1451.26 ± 206.32, and in controls, the mean value is 1197.98 ± 234.71 (p=<0.001). The mean value of serum GSH (mcg/mL) in cases is 46.982 ± 18.613, and in controls, the mean value is 54.155 ± 10.762 (p=0.027). The mean value of serum Catalase Activity (U/min/mg protein) in cases is 10.763 ± 4.038 and in controls, the mean value is 19.878 ± 7.787 (p=0.003). The mean value of serum SOD Activity (U/g) in cases is 24.950 ± 5.4565, and in controls, the mean value is 46.214 ± 14.6309 (p=0.891). The mean value of serum Total Antioxidant Capacity (U/mL) in cases is 5.546 ± 0.620 and in controls, the mean value is 8.346 ± 2.781 (p=0.025). The mean value of serum IL-5 (pg/mL) in cases is 481.442 ± 28.8995, and in controls, the mean value is 67.347 ± 20.445 (p<0.001). The mean value of serum TNF-ALFA (pg/mL) in cases is 196.741 ± 73.771, and in controls, the mean value is 144.530 ± 42.599 (p= 0.081).
Conclusions
During a complete heart block, SOD (p=0.891), CAT (p=0.003), GSH (p=0.027) and total antioxidant (TAOC) (p=0.025) were significantly decreased in cases, compared to healthy controls, thus suggesting that the elevated levels of oxidative free radicals causes endothelial dysfunctioning. The increase in ROS was observed by a highly significant increase of malondialdehyde (MDA) (p=<0.001) showing high ROS-mediated tissue damage. Besides damage by oxidative stress, our study suggests that there are certain inflammatory markers like TNF-α and IL-5 that actively participate in causing heart block. There was a significant increase in the concentration of IL-5 (p<0.001) in the cases as compared to the controls.
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Affiliation(s)
- G Chaudhary
- King George's Medical University , Lucknow , India
| | - A K Pradhan
- King George's Medical University , Lucknow , India
| | - S Shah
- King George's Medical University , Lucknow , India
| | - S Roy
- King George's Medical University , Lucknow , India
| | - V Singh
- King George's Medical University , Lucknow , India
| | - S K Dwivedi
- King George's Medical University , Lucknow , India
| | - R Sethi
- King George's Medical University , Lucknow , India
| | - S Chandra
- King George's Medical University , Lucknow , India
| | | | - A K Sharma
- King George's Medical University , Lucknow , India
| | - M Bhandari
- King George's Medical University , Lucknow , India
| | - A Shukla
- King George's Medical University , Lucknow , India
| | - A Singh
- King George's Medical University , Lucknow , India
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Roy S, Singh V, Ahmed J, Dwivedi SK, Sethi R, Chandra S, Pradhan AK, Vishwakarma P, Sharma AK, Bhandari M, Shukla A, Singh A, Chaudhary G. The surprises in optical coherence tomography (OCT) findings in patients presenting with in-stent restenosis: the road less travelled. Eur Heart J 2023. [DOI: 10.1093/eurheartj/ehac779.056] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/26/2023] Open
Abstract
Abstract
Funding Acknowledgements
Type of funding sources: None.
Background
Morphological features of neointimal tissue play a pivotal role in the pathophysiology of In-Stent Restenosis (ISR) after percutaneous coronary intervention, hence understanding these features and patterns is crucial.
Purpose
The present study was designed to qualitatively and quantitatively assess neointimal characteristics of lesions using OCT in patients presenting with ISR.
Methods
This was a single-center, prospective, observational study performed between 1st August 2020 and 30th December 2021 at a tertiary-care center in India. Patients diagnosed with stable angina and acute coronary syndrome with post-procedural angiographically documented restenosis (>50%) were included. Qualitative and quantitative assessment of neointimal hyperplasia patterns was performed using OCT.
Results
A total of 34 patients with ISR were studied. Neointimal hyperplasia was classified as (i) homogenous group (n=18) and (ii) non-homogenous group (n=16). As many as 14 (77.8%) diabetics belonged to the homogenous group. Predominant plaque characteristics such as neoatherosclerosis, cholesterol crystals, and calcium were documented in 14 (77.8%), 12 (66.7%), and 11 (61.1%) patients in the homogenous group and in 10 (62.5%), 10 (62.5%), and 9 (56.2%) patients in the non-homogenous group, respectively. Unexpanded stent struts were identified in 11 (61.1%) and 11 (68.8%) patients in the homogenous and non-homogenous groups, respectively. Mean strut thickness was 93.73 ± 31.03 µm and 83.54 ± 18.0 µm, ISR was 72.50 ± 15.93% and 65.37 ± 21.69%, the neointimal thickness was 588.06 ± 167.82 mm and 666.25 ± 218.05 mm, and neointimal hyperplasia was 54.54 ± 11.23% and 59.26 ± 8.86% in the homogenous and non-homogenous groups, respectively.
Conclusion
Neoatherosclerosis and stent underexpansion was predominantly observed in our study, which was in contrast to most of the existing literature [1,2,3], and only diabetes was found to be significantly associated with homogenous neointimal hyperplasia, irrespective of the generation of the stent.
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Affiliation(s)
- S Roy
- King George's Medical University , Lucknow , India
| | - V Singh
- King George's Medical University , Lucknow , India
| | - J Ahmed
- King George's Medical University , Lucknow , India
| | - S K Dwivedi
- King George's Medical University , Lucknow , India
| | - R Sethi
- King George's Medical University , Lucknow , India
| | - S Chandra
- King George's Medical University , Lucknow , India
| | - A K Pradhan
- King George's Medical University , Lucknow , India
| | | | - A K Sharma
- King George's Medical University , Lucknow , India
| | - M Bhandari
- King George's Medical University , Lucknow , India
| | - A Shukla
- King George's Medical University , Lucknow , India
| | - A Singh
- King George's Medical University , Lucknow , India
| | - G Chaudhary
- King George's Medical University , Lucknow , India
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Shukla A, Kumar A, Mozumdar A, Acharya R, Aruldas K, Saggurti N. Restrictions on contraceptive services for unmarried youth: a qualitative study of providers’ beliefs and attitudes in India. Sex Reprod Health Matters 2022; 30:2141965. [DOI: 10.1080/26410397.2022.2141965] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- A Shukla
- Researcher, Research Institute for Medical and Health Sciences, University of Sharjah, Sharjah, United Arab Emirates
| | - A Kumar
- Senior Program Officer, Population Council, Delhi, India
| | - A Mozumdar
- Senior Program Officer, Population Council, Delhi, India
| | - R Acharya
- Senior Associate, Population Council, Delhi, India
| | - K Aruldas
- Implementation Science Coordinator, DeWorm3 Study, Christian Medical College, Vellore, India
| | - N Saggurti
- Director, Population Council, Delhi, India
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Choudhary A, Kumar P, Sahu SK, Pradhan C, Singh SK, Gašparović M, Shukla A, Singh AK. Time Series Simulation and Forecasting of Air Quality Using In-situ and Satellite-Based Observations Over an Urban Region. Nat Env Poll Tech 2022. [DOI: 10.46488/nept.2022.v21i03.018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Air quality is directly associated with the health of society. So, it becomes essential to forecast air pollution, which assumes an imperative part in air pollution warnings and control. A time-series simulation approach was adapted for the forecasting of monthly mean ambient air pollutants (PM2.5, O3, NO2) concentration and Aerosol Optical Depth (AOD) at an urban traffic site (Mathura Road, CSIR-CRRI) in New Delhi, India. Satellite-based aerosol loading (AOD550) retrieved from the Terra MODIS (Collection 6) enhanced Deep Blue (DB) algorithm was used for further analysis. The analysis considered the average monthly mean concentration of air pollutants and AOD between 2012-2017 and, simulates the concentrations of PM2.5, O3, NO2, and AOD for the same period and then forecasts air quality for the years 2020-2023. The forecasted results were validated with 24 months of in-situ and satellite data from 2018-to and 2019. In the year 2020, observed and simulated results are in lower agreement due to the shutdown of anthropogenic activities to combat pandemic situations. Otherwise, modeled and forecasted results are in good harmony with the in-situ and satellite observations. The results also signify that the time series Autoregressive Integrated Moving Average (ARIMA) modeling approach can be an effective and simple tool for air pollution simulation and future forecast. The results are evocative concerning the forecast of near future aerosol loading information and will also be profound to address the problems.
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Shukla A, Bromage S, Dholakia Y, Hemler EC, Dev P, Govekar L, Tipre P, Shah D, Keshavjee SA, Wang M, Mistry N, Fawzi WW. Case-control study of vitamin D status and adult multidrug-resistant pulmonary TB. Int J Tuberc Lung Dis 2022; 26:826-834. [PMID: 35996288 PMCID: PMC11097200 DOI: 10.5588/ijtld.21.0639] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [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] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND: India has the highest prevalence of multidrug-resistant TB (MDR-TB) globally. Vitamin D deficiency is potentially an important risk factor for MDR-TB.METHODS: We conducted a case-control study of 90 newly diagnosed adult MDR-TB cases, 180 household controls and 82 non-household controls in Mumbai, India. Serum 25-hydroxyvitamin D (25(OH)D), anthropometry, clinical status and history, dietary data and sociodemographic data were collected from each participant. Interferon-gamma release assay (IGRA) was also performed in controls to assess latent TB. Multivariable regression was performed to estimate associations between 25(OH)D vs. case status and IGRA positivity.RESULTS: Mean participant age was 33.8 ± 12.0 years; 72.8% had 25(OH)D <20 ng/ml. Mean 25(OH)D was significantly (P < 0.05) lower in cases (12.5 ± 7.9) than both household (17.5 ± 11.2) and non-household controls (16.4 ± 9.1). In multivariable models, 25(OH)D concentration was inversely associated with MDR-TB case status among cases and household controls (OR 0.95 per 1 ng/ml, 95% CI 0.92-0.99; P = 0.015), and among cases and non-household controls (OR 0.94 per 1 ng/ml, 95% CI 0.89-1.00; P = 0.033); 53.6% of controls were IGRA-positive. 25(OH)D status was not associated with IGRA positivity.CONCLUSION: Vitamin D status was independently associated with MDR-TB case status. Research should evaluate the effectiveness of vitamin D supplementation in prevention and adjunctive treatment of MDR-TB.
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Affiliation(s)
- A Shukla
- Department of Tuberculosis Research, Foundation for Medical Research, Mumbai, India
| | - S Bromage
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - Y Dholakia
- Department of Tuberculosis Research, Foundation for Medical Research, Mumbai, India
| | - E C Hemler
- Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - P Dev
- Department of Tuberculosis Research, Foundation for Medical Research, Mumbai, India
| | - L Govekar
- Department of Tuberculosis Research, Foundation for Medical Research, Mumbai, India
| | - P Tipre
- Municipal Corporation of Greater Mumbai, Mumbai, India
| | - D Shah
- Municipal Corporation of Greater Mumbai, Mumbai, India
| | - S A Keshavjee
- Department of Global Health and Social Medicine, Harvard Medical School, Boston, MA, USA
| | - M Wang
- Department of Biostatistics, Harvard T H Chan School of Public Health, Boston, MA, USA
| | - N Mistry
- Department of Tuberculosis Research, Foundation for Medical Research, Mumbai, India
| | - W W Fawzi
- Department of Nutrition, Harvard T H Chan School of Public Health, Boston, MA, USA, Department of Global Health and Population, Harvard T H Chan School of Public Health, Boston, MA, USA, Department of Epidemiology, Harvard T H Chan School of Public Health, Boston, MA, USA
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11
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Mittal S, Eftekharzadeh S, Aghababian A, Shah J, Fischer K, Weaver J, Tan C, Plachter N, Long C, Weiss D, Zaontz M, Kolon T, Zderic S, Canning D, Van Batavia J, Shukla A, Srinivasan A. Trends in opioid and nonsteroidal anti-inflammatory (NSAID) usage in children undergoing common urinary tract reconstruction: A large, single-institutional analysis. J Pediatr Urol 2022; 18:501.e1-501.e7. [PMID: 35803865 DOI: 10.1016/j.jpurol.2022.05.025] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/11/2022] [Revised: 04/20/2022] [Accepted: 05/31/2022] [Indexed: 11/29/2022]
Abstract
INTRODUCTION AND OBJECTIVE Opioid stewardship is recognized as a critical clinical priority. We previously reported marked reductions in narcotic administration after implementation of an opioid reduction protocol for pediatric ambulatory urologic surgery. We hypothesize that a decrease in post-operative and discharge opioid administration will not increase short-term adverse events. STUDY DESIGN All pediatric patients undergoing open or robot-assisted laparoscopic pyeloplasty or ureteral reimplantation between 2015 and 2019 were included. Patients' demographics, opioid and NSAID administration, urology or pain-related emergency department (ED) visits, readmissions, and reoperations within 30 days of surgery, were aggregated. RESULTS 438 patients, with a median age of 3.5 years (IQR 1.5-8.3) at the time of surgery, met the inclusion criteria. Annual rates of inpatient opioid administration and prescriptions decreased significantly over the study period, while rates of intra-operative, inpatient, and prescribed NSAIDs significantly increased. There was no significant difference in the occurrence of ED visits, readmissions, or reoperations within 30 days of surgery between patients who received an opioid prescription and those who did not. Multivariate regression showed that patients who did not receive an opioid prescription at discharge were found to be at a lower risk for unplanned encounters including ED visits, readmissions, or reoperations (OR:0.5, 95%CI: 0.2-0.9, p = 0.04). DISCUSSION The present study shows the decreasing trend in inpatient opioid administration and opioid prescription after discharge, when accompanied by an increase NSAID administration, does not result in a significant change in rates of unplanned encounters and complications, similar to results from previous studies on non-urological and ambulatory urological surgeries. CONCLUSIONS Non-opioid pain control after major pediatric urologic reconstruction is safe and effective. We found that a reduction in opioid administration can be associated with a reduced risk of unplanned ED visits, readmissions, or reoperations. Further investigations are required to corroborate this finding.
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Affiliation(s)
- Sameer Mittal
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Sahar Eftekharzadeh
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Aznive Aghababian
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Jay Shah
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Katherine Fischer
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - John Weaver
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Connie Tan
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Natalie Plachter
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA
| | - Christopher Long
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Dana Weiss
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Mark Zaontz
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Thomas Kolon
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Stephen Zderic
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Douglas Canning
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Jason Van Batavia
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Aseem Shukla
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA
| | - Arun Srinivasan
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA 19104, USA.
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Aggrwal A, Lunt R, Lesley H, Hockenhull S, Nithin L, Shukla A, Gregoire R, Lewis S, Drakeley A. P-033 A third of men with normospermia attending for initial fertility assessment could have DNA damage. Hum Reprod 2022. [DOI: 10.1093/humrep/deac107.031] [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: 11/14/2022] Open
Abstract
Abstract
Study question
What is the incidence of sperm DNA damage in men with normal semen analyses attending for initial fertility investigation?
Summary answer
Half of men (54%) attending for infertilty investigation had a normal semen analysis of which a third (32%) of these had abnormal sperm DNA.
What is known already
Conventional semen analysis assesses sperm concentration, motility, and morphology but with a high degree of biological variability. Around 25% of men are given a diagnosis of unexplained infertility by normal semen analysis. The World Health Organisation (WHO) stated in 2021 that ‘clinically there is a growing awareness that chromosomal anomalies and gene mutations underlie a diverse spectrum of male infertility,’ so now recommends that sperm DNA is determined as an extended analysis. Sperm DNA damage occurs more often in infertile men and DNA damage is associated with recurrent pregnancy loss and decreased live birth rates following fertility treatment.
Study design, size, duration
A prospective cohort study of men attending a secondary fertility clinic were offered a standard semen analysis plus sperm DNA fragmentation using SpermComet technology. UK IRAS ethical approval was obtained. Men attending were given a patient information leaflet at their first appointment. The study duration was 6 months. In total, 142 men were recruited out of a possible maximum of 409 attendees.
Participants/materials, setting, methods
Participants included men who had been referred as a couple to a secondary level infertility clinic for an initial assessment. Information leaflets were either posted to them prior to their first appointment or given to them at the initial nurse-led consultation. Those who subsequently contacted our research team re-attended for a sperm analysis and an aliquot was cryopreserved and sent in weekly batches to Examen (Northern Ireland) for SpermComet DNA fragmentation assessment.
Main results and the role of chance
Between May and November 2021, there were 409 attendees of whom 142 consented to the study.
Sperm DNA quality for the participants was assessed and reported as average, low and high DNA damage as a percentage compared with clinical thresholds used by Examen from their sperm bank of 63 fertile sperm donors who had recently achieved clinical pregnancies.
Of the 142 recruited, 77 men (54%) attending for initial investigations had normospermia assessed against the WHO criteria, so were initially classified as unexplained. Of these, 25 (32%) had abnormal sperm DNA values. The average comet score was 39.7% +/-1.3, low comet score was 37.8% +/- 4.4 and high comet score was 17.0% +/-2.0. These values were all significantly outside ( p < 0.001) of the fertile parameters from 63 fertile donors used by Examen (fertile range: average <26%%, low >74% and high <4%).
Our results suggest that up to a third of men reported to have normospermia will have DNA damaged sperm. This is important to consider before labelling a couple as 'unexplained'. Knowing the male's sperm DNA fragmentation assessment would allow for further discussion and exploration of lifestyle and dietary advice.
Limitations, reasons for caution
During the study period, not all attendees agreed to participate as it required an additional hospital visit. In this single site study, men have not yet been followed up for future fertility outcome such as natural conception and need or success of assisted conception.
Wider implications of the findings
Sperm DNA damage was found in a third of men who would previously have been classified as fertile and offered no further investigations or treatment to improve their sperm quality. Thus, this tool could be a useful adjunct to semen analysis to guide these couples’ future treatment pathways.
Trial registration number
not applicable
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Affiliation(s)
- A Aggrwal
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
| | - R Lunt
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
| | - H Lesley
- Examen, andrology , Belfast, United Kingdom
| | - S Hockenhull
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
| | - L Nithin
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
| | - A Shukla
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
| | - R Gregoire
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
| | - S Lewis
- Examen, andrology , Belfast, United Kingdom
| | - A Drakeley
- Hewitt Fertility Centre- Liverpool Women's Hospital, Reproductive Medicine , Liverpool, United Kingdom
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13
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Kaushal M, Shukla A, Mahajan S. P-209 Management of insulinoma, changing trends in developing world. Ann Oncol 2022. [DOI: 10.1016/j.annonc.2022.04.299] [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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14
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Aghababian A, Mittal S, Eftekharzadeh S, Hamdan D, Weaver J, Godlewski K, Fischer K, Long C, Weiss D, Van Batavia J, Zaontz M, Zderic S, Kolon T, Canning D, Shukla A, Srinivasan A. Office Based Pediatric Urologic Procedures: A safe and effective alternative to interventions under anesthesia. Urology 2022; 166:223-226. [DOI: 10.1016/j.urology.2022.04.008] [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] [Received: 01/25/2022] [Revised: 04/04/2022] [Accepted: 04/10/2022] [Indexed: 11/16/2022]
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Kumar D, Dwivedi S, Chaudhary G, Sharma A, Chandra S, Vishwakarma P, Pradhan A, Sethi R, Bhandari M, Shukla A, Singh A. Role of oral flecainide in assessement of atrio-ventricular conduction in symptomatic bifascicular block. Eur Heart J 2021. [DOI: 10.1093/eurheartj/ehab724.0607] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
Abstract
Background
Intravenous flecainide is used to stress Atrio-ventricular (AV) conduction in patients (pts) with a history of syncope & bifascicular (Bi-Fasc) block. Role of oral flecainide is unclear.
Objective
To assess effect of oral Flecainide on infra-Hisian AV conduction in patients with symptomatic Bi-Fasc block.
Methods
Pts presenting with syncope & Bi-Fasc block without advanced AVCD on ECG, 24 hr holter or treadmill exercise test were taken. Those with history suggestive of reflex syncope & positive tilt test were excluded. Remaining underwent electro-physiological (EP) study. Pts with HV interval >100ms or intra/infra-Hisian block at rest or incremental pacing were subjected to PPI. Remaining received oral Flacanide 5 mg/kg (max 300 mg) & EP study was repeated after ½ hr, 1 hr, 2 hrs and 3 hrs. Primary end-point was HV ≥100ms or infra/intra-Hisian type IIB or III block.
Results
Of 41 pts enrolled for study, 28 patients (mean age 60.0 yrs, mean LVEF 60.7%) were eligible for EP Study. Basal PR interval was 185.8±47.4 ms & mean QRS width was 130.6±18.65 ms. On EP study, 4 (14.3%) with resting HV >100 ms & 6 (21.4%) with HV >100 ms on incremental pacing underwent PPI.
Out of remaining 18 pts who were given flecainide, 11 (66.1%) achieved primary endpoint (HV >100 ms in 6, infra-hisian IIB in 2 and 2:1 block in 3 patients). At mean follow up of 6.5 months, 13 (59.1%) out of 22 with PPI had mean 59.1% VP & none of 6 remaining patients had any symptom.
Conclusion
Oral Flecainide significantly increases the diagnostic yield of EP study in patients with symptomatic bi-fasc block.
Funding Acknowledgement
Type of funding sources: None.
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Affiliation(s)
- D Kumar
- King George's Medical University, Lucknow, India
| | - S.K Dwivedi
- King George's Medical University, Lucknow, India
| | - G Chaudhary
- King George's Medical University, Lucknow, India
| | - A Sharma
- King George's Medical University, Lucknow, India
| | - S Chandra
- King George's Medical University, Lucknow, India
| | | | - A Pradhan
- King George's Medical University, Lucknow, India
| | - R Sethi
- King George's Medical University, Lucknow, India
| | - M Bhandari
- King George's Medical University, Lucknow, India
| | - A Shukla
- King George's Medical University, Lucknow, India
| | - A Singh
- King George's Medical University, Lucknow, India
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Dixit S, Thakur N, Shukla A, Upadhyay SK, C Verma P. Molecular characterization of N-methyl-d-aspartate receptor from Bemisia tabaci. Insect Mol Biol 2021; 30:231-240. [PMID: 33368750 DOI: 10.1111/imb.12690] [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] [Subscribe] [Scholar Register] [Received: 10/30/2020] [Revised: 12/13/2020] [Accepted: 12/23/2020] [Indexed: 06/12/2023]
Abstract
The N-methyl-d-aspartate receptors (NMDARs) are ionotropic ligand gated channels that are highly permeable to calcium ions. In insects, NMDARs are associated with glutamatergic neurotransmission governing diverse physiological and biological processes like vitellogenesis and ovarian development. Therefore, NMDAR may act as attractive target for insect pest control. In present study, we performed structural and functional characterization of NMDARs in Bemisia tabaci, a highly invasive crop pest and potent virus vector. We identified that NMDAR consists of three subunits each encoded by single gene in whiteflies which are highly conserved among different insect orders. Expression analysis suggests that subunit 1 (BtNR1) and subunit 2 (BtNR2) are the main functional units. External supplementation of NMDAR ligand or BtNRs silencing was lethal to insects, which suggested that NMDAR function is highly balanced in whiteflies.
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Affiliation(s)
- S Dixit
- Molecular Biology and Biotechnology, CSIR-National Botanical Research Institute, (Council of Scientific and Industrial Research), Rana Pratap Marg, Lucknow, India
- Department of Biology, University of Western Ontario, London, Ontario, Canada
| | - N Thakur
- Molecular Biology and Biotechnology, CSIR-National Botanical Research Institute, (Council of Scientific and Industrial Research), Rana Pratap Marg, Lucknow, India
- DST-Centre for Policy Research, IIT-Delhi, New Delhi, India
| | - A Shukla
- Department of Biology, University of Western Ontario, London, Ontario, Canada
| | - S K Upadhyay
- Department of Botany, Panjab University, Chandigarh, India
| | - P C Verma
- Molecular Biology and Biotechnology, CSIR-National Botanical Research Institute, (Council of Scientific and Industrial Research), Rana Pratap Marg, Lucknow, India
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, Uttar Pradesh, India
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17
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Bowen DK, Mittal S, Aghababian A, Eftekharzadeh S, Dinardo L, Weaver J, Long C, Shukla A, Srinivasan AK. Pyeloplasty is a safe and effective surgical approach for low functioning kidneys with ureteropelvic junction obstruction. J Pediatr Urol 2021; 17:233.e1-233.e7. [PMID: 33526368 DOI: 10.1016/j.jpurol.2020.12.018] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/23/2020] [Revised: 12/10/2020] [Accepted: 12/17/2020] [Indexed: 02/05/2023]
Abstract
INTRODUCTION Indications for treatment of ureteropelvic junction obstruction (UPJO) include symptomatic obstruction, urinary tract infections, presence of an obstructive pattern on functional renal scan and/or worsening differential renal function (DRF). This paper aims to determine the relationship between preoperative DRF and surgical outcomes after pyeloplasty. We hypothesized that low preoperative DRF is not an independent predictor of pyeloplasty failure. METHODS A retrospective chart review was performed to identify all patients undergoing pyeloplasty for UPJO between 2008 and 2019. Patients were included only if they had at least one preoperative functional scan and a minimum of one renal ultrasound post-operatively. Patients were divided into three groups based on DRF for analysis: Group 1- 0-10%, Group 2 - >10-≤20%, Group 3 - >20%. Baseline, intraoperative and postoperative characteristics, including success and complications were compared. Additional sensitivity analyses were performed comparing patients with ≤20%, and >20% function, ≤30%, and >30% function as well as an analysis of patients undergoing only minimally invasive reconstruction. RESULTS Three hundred and sixty-four patients met inclusion criteria. We identified 8 patients in Group 1, 24 patients in Group 2 and 332 patients in Group 3. Mean procedure time was longest for the ≤10% function group (237.9 vs 206.4 vs 189.1; p = 0.01). We found no difference in 30-day post-operative complications, overall success rate or the need for additional procedures among the three groups. For patients in Group 1, we noted variation in the post-procedure DRF with a range of -2.8 to +47% change. In this group, none of patients with low DRF underwent nephrectomy. Multivariate logistic regression did not identify renal function as a predictor of operative success OR 1.00 (95% CI: 0.97-1.03) (p-value: 0.88). DISCUSSION The results of the present study suggest that low DRF alone is not associated with worse outcomes and shows no difference in the failure rate. The incidence and type of complications were not increased for the lower functioning groups. The main limitation of this study would be its retrospective nature and single-institution experience. Furthermore, post-operative functional studies were not available for all patients, limiting the ability to draw conclusions on the change in DRF after surgery. CONCLUSIONS In a large cohort, preoperative DRF was not predictive of pyeloplasty success rate. DRF ≤10% was not associated with higher incidence of complications or failure rate. The DRF alone should not dictate the management options available for patients with UPJO.
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Affiliation(s)
- Diana K Bowen
- Department of Urology, Ann & Robert H. Lurie Children's Hospital of Chicago, 225 E. Chicago Ave, Chicago, IL 60611, USA
| | - Sameer Mittal
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA, 19104, USA
| | - Aznive Aghababian
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Sahar Eftekharzadeh
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Lauren Dinardo
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - John Weaver
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA
| | - Christopher Long
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA, 19104, USA
| | - Aseem Shukla
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA, 19104, USA
| | - Arun K Srinivasan
- Division of Urology, Children's Hospital of Philadelphia, 3401 Civic Center Blvd, Philadelphia, PA, 19104, USA; Division of Urology, Hospital of the University of Pennsylvania, Perelman Center for Advanced Care, 3400 Civic Center Blvd, 3rd Floor West Pavilion, Philadelphia, PA, 19104, USA.
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18
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Dimri AP, Allen S, Huggel C, Mal S, Ballesteros-Cánovas JA, Rohrer M, Shukla A, Tiwari P, Maharana P, Bolch T, Thayyen RJ, Stoffel M, Pandey A. Climate Change, Cryosphere and Impacts in the Indian Himalayan Region. CURR SCI INDIA 2021. [DOI: 10.18520/cs/v120/i5/774-790] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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19
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Lee T, Vasquez E, Logvinenko T, Venna A, Frazier J, Lingongo M, Roth E, Weiss D, Groth T, Shukla A, Kryger JV, Canning DA, Mitchell ME, Borer JG. Timing of inguinal hernia following complete primary repair of bladder exstrophy. J Pediatr Urol 2021; 17:87.e1-87.e6. [PMID: 33317945 PMCID: PMC8329731 DOI: 10.1016/j.jpurol.2020.11.025] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/25/2020] [Revised: 10/27/2020] [Accepted: 11/16/2020] [Indexed: 10/22/2022]
Abstract
INTRODUCTION/BACKGROUND Bladder exstrophy patients have a high prevalence of inguinal hernia that often become clinically evident following bladder closure. Understanding when the bladder exstrophy patient is under greatest risk of developing an inguinal hernia following bladder closure is important, since incarceration resulting in strangulation of intra-abdominal contents can lead to significant morbidity if not addressed in a timely fashion. Although the incidence and risk factors of inguinal hernia have been reported, the timing of occurrence is not well understood. OBJECTIVE The primary objective of this study was to assess the timing of inguinal hernia following complete primary repair of bladder exstrophy (CPRE). In addition, we aimed to evaluate possible risk factors associated with inguinal hernia, including sex, age at bladder closure and iliac osteotomy status. STUDY DESIGN A multi-institutional retrospective review identified patients with bladder exstrophy repaired by CPRE under 6 months of age while excluding those who underwent inguinal hernia repair before or during bladder closure. Timing of inguinal hernia following bladder closure was evaluated using Kaplan-Meier methods. Cox proportional hazards model was used to investigate association of sex, age at bladder closure, and osteotomy on the risk of developing of inguinal hernia while clustering for institution. RESULTS 91 subjects were included in our analysis with median follow-up time of 6.5 years. 34 of 53 males (64.2%) and 2 of 38 females (5.3%) underwent inguinal hernia repair. The median time to inguinal hernia was 4.7 months following closure. The greatest hazard of inguinal hernia was within the first six months following closure. In multivariate analysis, male sex was strongly associated with inguinal hernia (HR = 19.00, p = 0.0038). Osteotomy and delay in closure were not significantly associated with inguinal hernia. 7 of 36 patients (19.4%) who underwent inguinal hernia repair presented with recurrence on the ipsilateral side. DISCUSSION Our results suggest that the greatest risk of inguinal hernia is within the first six months following bladder closure. The decreased risk of inguinal hernia after one year of follow-up may reflect anatomic stability that is reached following major reconstruction of the pelvis. While male bladder exstrophy patients are significantly more susceptible to inguinal hernias following CPRE, osteotomy and delayed bladder closure do not appear to be protective factors for inguinal hernia development following initial bladder closure. CONCLUSIONS There is a heightened risk of inguinal hernia in the first six months following closure. The rate of recurrence following inguinal hernia repair is significantly elevated compared to the general pediatric population.
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Affiliation(s)
- Ted Lee
- Boston Children's Hospital, Department of Urology, 300 Longwood Avenue Boston, MA 02115, USA.
| | - Evalynn Vasquez
- Boston Children's Hospital, Department of Urology, 300 Longwood Avenue Boston, MA 02115, USA
| | - Tanya Logvinenko
- Children's Hospital of Wisconsin, Division of Urology, 8915 West Connell Court, Milwaukee, WI 53226, USA
| | - Alyssia Venna
- Boston Children's Hospital, Department of Urology, 300 Longwood Avenue Boston, MA 02115, USA
| | - Jennifer Frazier
- Children's Hospital of Philadelphia, Division of Urology, 3401 Civic Center Boulevard Philadelphia, PA 19104, USA
| | - Melissa Lingongo
- Children's Hospital of Wisconsin, Division of Urology, 8915 West Connell Court, Milwaukee, WI 53226, USA
| | - Elizabeth Roth
- Children's Hospital of Wisconsin, Division of Urology, 8915 West Connell Court, Milwaukee, WI 53226, USA
| | - Dana Weiss
- Children's Hospital of Philadelphia, Division of Urology, 3401 Civic Center Boulevard Philadelphia, PA 19104, USA
| | - Travis Groth
- Children's Hospital of Wisconsin, Division of Urology, 8915 West Connell Court, Milwaukee, WI 53226, USA
| | - Aseem Shukla
- Children's Hospital of Philadelphia, Division of Urology, 3401 Civic Center Boulevard Philadelphia, PA 19104, USA
| | - John V Kryger
- Children's Hospital of Wisconsin, Division of Urology, 8915 West Connell Court, Milwaukee, WI 53226, USA
| | - Douglas A Canning
- Children's Hospital of Philadelphia, Division of Urology, 3401 Civic Center Boulevard Philadelphia, PA 19104, USA
| | - Michael E Mitchell
- Children's Hospital of Wisconsin, Division of Urology, 8915 West Connell Court, Milwaukee, WI 53226, USA
| | - Joseph G Borer
- Boston Children's Hospital, Department of Urology, 300 Longwood Avenue Boston, MA 02115, USA
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Shukla A, Mannheim K. Gamma-ray flares from relativistic magnetic reconnection in the jet of the quasar 3C 279. Nat Commun 2020; 11:4176. [PMID: 32826906 PMCID: PMC7442797 DOI: 10.1038/s41467-020-17912-z] [Citation(s) in RCA: 22] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/16/2019] [Accepted: 07/17/2020] [Indexed: 11/10/2022] Open
Abstract
Spinning black holes in the centres of galaxies can release powerful magnetised jets. When the jets are observed at angles of less than a few degrees to the line-of-sight, they are called blazars, showing variable non-thermal emission across the electromagnetic spectrum from radio waves to gamma rays. It is commonly believed that shock waves are responsible for this dissipation of jet energy. Here we show that gamma-ray observations of the blazar 3C 279 with the space-borne telescope Fermi-LAT reveal a characteristic peak-in-peak variability pattern on time scales of minutes expected if the particle acceleration is instead due to relativistic magnetic reconnection. The absence of gamma-ray pair attenuation shows that particle acceleration takes place at a distance of ten thousand gravitational radii from the black hole where the fluid dynamical kink instability drives plasma turbulence. Blazars show variable non-thermal emission across the electromagnetic spectrum from radio waves to gamma rays. Here, the authors show blazar 3C 279 reveals a characteristic peak-in-peak variability pattern on time scales of minutes if particle acceleration is due to relativistic magnetic reconnection.
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Affiliation(s)
- A Shukla
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, Emil-Fischer-Str. 31, 97074, Würzburg, Germany. .,Discipline of Astronomy, Astrophysics and Space Engineering, Indian Institute of Technology Indore, Khandwa Road, Simrol, Indore, 453552, India.
| | - K Mannheim
- Institut für Theoretische Physik und Astrophysik, Universität Würzburg, Emil-Fischer-Str. 31, 97074, Würzburg, Germany
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von Doetinchem P, Perez K, Aramaki T, Baker S, Barwick S, Bird R, Boezio M, Boggs S, Cui M, Datta A, Donato F, Evoli C, Fabris L, Fabbietti L, Ferronato Bueno E, Fornengo N, Fuke H, Gerrity C, Gomez Coral D, Hailey C, Hooper D, Kachelriess M, Korsmeier M, Kozai M, Lea R, Li N, Lowell A, Manghisoni M, Moskalenko I, Munini R, Naskret M, Nelson T, Ng K, Nozzoli F, Oliva A, Ong R, Osteria G, Pierog T, Poulin V, Profumo S, Pöschl T, Quinn S, Re V, Rogers F, Ryan J, Saffold N, Sakai K, Salati P, Schael S, Serksnyte L, Shukla A, Stoessl A, Tjemsland J, Vannuccini E, Vecchi M, Winkler M, Wright D, Xiao M, Xu W, Yoshida T, Zampa G, Zuccon P. Cosmic-ray antinuclei as messengers of new physics: status and outlook for the new decade. J Cosmol Astropart Phys 2020; 2020:035. [PMID: 34712102 PMCID: PMC8549764 DOI: 10.1088/1475-7516/2020/08/035] [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] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The precise measurement of cosmic-ray antinuclei serves as an important means for identifying the nature of dark matter and other new astrophysical phenomena, and could be used with other cosmic-ray species to understand cosmic-ray production and propagation in the Galaxy. For instance, low-energy antideuterons would provide a "smoking gun" signature of dark matter annihilation or decay, essentially free of astrophysical background. Studies in recent years have emphasized that models for cosmic-ray antideuterons must be considered together with the abundant cosmic antiprotons and any potential observation of antihelium. Therefore, a second dedicated Antideuteron Workshop was organized at UCLA in March 2019, bringing together a community of theorists and experimentalists to review the status of current observations of cosmic-ray antinuclei, the theoretical work towards understanding these signatures, and the potential of upcoming measurements to illuminate ongoing controversies. This review aims to synthesize this recent work and present implications for the upcoming decade of antinuclei observations and searches. This includes discussion of a possible dark matter signature in the AMS-02 antiproton spectrum, the most recent limits from BESS Polar-II on the cosmic antideuteron flux, and reports of candidate antihelium events by AMS-02; recent collider and cosmic-ray measurements relevant for antinuclei production models; the state of cosmic-ray transport models in light of AMS-02 and Voyager data; and the prospects for upcoming experiments, such as GAPS. This provides a roadmap for progress on cosmic antinuclei signatures of dark matter in the coming years.
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Affiliation(s)
- P. von Doetinchem
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K. Perez
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - T. Aramaki
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - S. Baker
- Imperial College London, London, SW7 2AZ, U.K
| | - S. Barwick
- Department of Physics & Astronomy, University of California at Irvine, 4129 Frederick Reines Hall, Irvine, CA 92697, U.S.A
| | - R. Bird
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - M. Boezio
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - S.E. Boggs
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Cui
- Purple Mountain Observatory, Yuanhua Road, Qixia District, Nanjing 210033, China
| | - A. Datta
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - F. Donato
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - C. Evoli
- Gran Sasso Science Institute, Viale Francesco Crispi 7, 67100 L’Aquila, Italy
- INFN, Laboratori Nazionali del Gran Sasso, Via G. Acitelli, 22, 67100 Assergi, L’Aquila, Italy
| | - L. Fabris
- Isotope and Fuel Cycle and Technology Division, Oak Ridge National Laboratory, PO BOX 2008, Oak Ridge, TN 37831, U.S.A
| | - L. Fabbietti
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - E. Ferronato Bueno
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - N. Fornengo
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
| | - H. Fuke
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - C. Gerrity
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - D. Gomez Coral
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Physics, National Autonomous University of Mexico, Circuito de la investigación científica, C.U. 04510, Ciudad de México, Mexico
| | - C. Hailey
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - D. Hooper
- Theoretical Astrophysics, Fermi National Accelerator Laboratory, Wilson and Kirk Rds, Batavia, IL 60510, U.S.A
- Department of Astronomy and Astrophysics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
- Kavli Institute for Cosmological Physics, University of Chicago, 5640 S. Ellis Ave, Chicago, IL 60637, U.S.A
| | - M. Kachelriess
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - M. Korsmeier
- Department of Physics, University of Turin, Via Pietro Giuria, 1, 10125 Torino, Italy
- INFN, Sezione di Torino, Via Pietro Giuria, 1, 10125 Torino, Italy
- Institute for Theoretical Particle Physics and Cosmology, RWTH Aachen University, 52056 Aachen, Germany
| | - M. Kozai
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - R. Lea
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
- Dipartimento di Fisica dell’Universitá Trieste, Via Valerio 2, 34127 Trieste, Italy
| | - N. Li
- CAS Key Laboratory of Theoretical Physics, Institute of Theoretical Physics, Chinese Academy of Sciences, Beijing 100190, China
- University of Chinese Academy of Sciences, No.19A Yuquan Road, Shijingshan District, Beijing 100049, China
| | - A. Lowell
- Department of Physics, University of California at San Diego, 9500 Gilman Dr., La Jolla, CA 90037, U.S.A
| | - M. Manghisoni
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - I.V. Moskalenko
- Hansen Experimental Physics Laboratory, Stanford University, 452 Lomita Mall, Stanford, CA 94305, U.S.A
- Kavli Institute for Particle Astrophysics and Cosmology, Stanford University, CA 94305, U.S.A
| | - R. Munini
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - M. Naskret
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
- Institute of Theoretical Physics, University of Wroclaw, pl. M. Borna 9, 50-204 Wroclaw, Poland
| | - T. Nelson
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - K.C.Y. Ng
- Department of Particle Physics and Astrophysics, Weizmann Institute of Science, Rehovot 76100, Israel
| | - F. Nozzoli
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
| | - A. Oliva
- INFN, Sezione di Bologna, Via Irnerio 46, Bologna 40126, Italy
| | - R.A. Ong
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - G. Osteria
- INFN, Sezione di Napoli, Strada Comunale Cinthia, 80126 Naples, Italy
| | - T. Pierog
- Institute for Nuclear Physics, Karlsruhe Institute of Technology, Hermann-von-Helmholtz-Platz 1, 76344 Eggenstein-Leopoldshafen, Germany
| | - V. Poulin
- Laboratoire Univers & Particules de Montpellier, CNRS, Université de Montpellier, Place Eugène Bataillon, 34095 Montpellier Cedex 05, France
| | - S. Profumo
- Department of Physics and Santa Cruz Institute for Particle Physics, University of California, Santa Cruz, CA 95064, U.S.A
| | - T. Pöschl
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - S. Quinn
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - V. Re
- INFN, Sezione di Pavia, Via Agostino Bassi 6, 27100 Pavia, Italy
- Dipartimento di Ingegneria Industriale, Università di Bergamo, Viale Marconi 5, 24044 Dalmine, Italy
| | - F. Rogers
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - J. Ryan
- Department of Physics and Astronomy, University of California at Los Angeles, 475 Portola Plaza, Los Angeles, CA 90095, U.S.A
| | - N. Saffold
- Department of Physics, Columbia University, 500 W 120th St, New York, NY 10027, U.S.A
| | - K. Sakai
- NASA-Goddard Space Flight Center), 8800 Greenbelt Rd, Greenbelt, MD 20771, U.S.A
- CRESST, University of Maryland, Baltimore County, MD 21250, U.S.A
| | - P. Salati
- Laboratoire d’Annecy-le-Vieux de Physique Théorique, 9 Chemin de Bellevue, 74940 Annecy, France
| | - S. Schael
- I. Physikalisches Institut, RWTH Aachen University, Sommerfeldstr. 14, 52074 Aachen, Germany
| | - L. Serksnyte
- Department of Physics, Technical University of Munich, James-Franck Str. 1, 85748 Garching, Germany
| | - A. Shukla
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - A. Stoessl
- Department of Physics and Astronomy, University of Hawaii at Manoa, 2505 Correa Rd, Honolulu, HI 96822 U.S.A
| | - J. Tjemsland
- Department of Physics, Norwegian University of Science and Technology, 7491 Trondheim, Norway
| | - E. Vannuccini
- INFN, Sezione di Firenze, 50019 Sesto Fiorentino, Florence, Italy
| | - M. Vecchi
- Kapteyn Astronomical Institute, Rijksuniversiteit Groningen, Landleven 12, 9717 AD Groningen, The Netherlands
| | - M.W. Winkler
- The Oskar Klein Centre for Cosmoparticle Physics, Department of Physics, Stockholm University, Alba Nova, 10691 Stockholm, Sweden
| | - D. Wright
- Stanford Linear Accelerator Center, 2575 Sand Hill Rd, Menlo Park, CA 94025 U.S.A
| | - M. Xiao
- Department of Physics, Massachusetts Institute of Technology, 77 Massachusetts Ave, Cambridge, MA 02139 U.S.A
| | - W. Xu
- Department of Physics, Harvard University, 17 Oxford St, Cambridge, MA, 95129, U.S.A
| | - T. Yoshida
- Institute of Space and Astronautical Science, Japan Aerospace Exploration Agency (ISAS/JAXA), Sagamihara, Kanagawa 252-5210, Japan
| | - G. Zampa
- INFN, Sezione di Trieste, Padriciano 99, 34149 Trieste, Italy
| | - P. Zuccon
- INFN, Trento Institute for Fundamental Physics and Applications, Via Sommarive, 14, 38123 Povo, Italy
- Department of Physics, University of Trento, Via Sommarive 14, 38123 Povo, Italy
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Shukla A, Sharda B, Sharma S, Bhardwaj S, Kailash U, Kalani R, Satyanarayana L, Shrivastava A. Association Between Serum Testosterone and Serum PSA Among Men With and Without Partial Androgen Deficiency. Indian J Clin Biochem 2020; 35:127-131. [PMID: 32071506 DOI: 10.1007/s12291-018-0785-3] [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: 06/21/2018] [Accepted: 07/25/2018] [Indexed: 01/28/2023]
Abstract
Serum prostatic specific antigen (PSA) and serum testosterone levels share an undefined relationship with each other, with many conflicting studies showing both positive and negative correlation between them. Our aim was to assess association between serum PSA and serum testosterone in healthy men with normal testosterone levels and men with partial androgen deficiency (PADAM). A cross sectional study was conducted at a teaching hospital setting where serum testosterone and aging male symptom scale (AMS) scores along with PSA were studied in 255 men (> 50 years) with and without PADAM. Mean total testosterone and serum PSA was 9.35 ± 1.33 nmol/L, 1.96 ± 0.76 ng/mL in males with PADAM and 15.30 ± 1.95 nmol/L, 1.85 ± 0.73 ng/mL respectively in males without PADAM. No significant relationship was observed between serum PSA and serum testosterone levels among healthy males irrespective of PADAM in the study population. We suggest, there is no need to adjust PSA values for biopsy decisions according to testosterone levels.
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Affiliation(s)
- A Shukla
- Department of Biochemistry, Rajiv Gandhi Super Specialty Hospital, Dilshad Garden, New Delhi, 110093 India
| | - B Sharda
- 2Department of Urology, RG Stone Urology and Laparoscopy Hospital, F-12, East of Kailash, New Delhi, 110065 India
| | - S Sharma
- 3Department of Biochemistry, All India Institute of Medical Sciences, Jodhpur, Basni Industrial Area, Phase-2, Jodhpur, Rajasthan 342005 India
| | - S Bhardwaj
- Department of Biochemistry, Rajiv Gandhi Super Specialty Hospital, Dilshad Garden, New Delhi, 110093 India
| | - U Kailash
- 4ICMR-National Institute of Cancer Prevention and Research, Sector-39, Noida, Uttar Pradesh 201301 India
| | - R Kalani
- Department of Biochemistry, Rajiv Gandhi Super Specialty Hospital, Dilshad Garden, New Delhi, 110093 India
| | - L Satyanarayana
- 4ICMR-National Institute of Cancer Prevention and Research, Sector-39, Noida, Uttar Pradesh 201301 India
| | - A Shrivastava
- 4ICMR-National Institute of Cancer Prevention and Research, Sector-39, Noida, Uttar Pradesh 201301 India
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23
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Lai B, Singh SC, Bindra J, Saraj C, Shukla A, Yadav T, Wu W, McGill S, Dalal N, Srivastava A, Guo C. Hydrogen evolution reaction from bare and surface-functionalized few-layered MoS 2 nanosheets in acidic and alkaline electrolytes. Mater Today Chem 2019; 14:100207. [PMID: 31903442 PMCID: PMC6936932 DOI: 10.1016/j.mtchem.2019.100207] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/17/2019] [Revised: 10/04/2019] [Accepted: 10/06/2019] [Indexed: 06/01/2023]
Abstract
Hydrogen is considered as an ideal and sustainable energy carrier because of its high energy density and carbon-free combustion. Electrochemical water splitting is the only solution for uninterrupted, scalable, and sustainable production of hydrogen without carbon emission. However, a large-scale hydrogen production through electrochemical water splitting depends on the availability of earth-abundant electrocatalysts and a suitable electrolyte medium. In this article, we demonstrate that hydrogen evolution reaction (HER) performance of electrocatalytic materials can be controlled by their surface functionalization and selection of a suitable electrolyte solution. Here, we report syntheses of few-layered MoS2 nanosheets, NiO nanoparticles (NPs), and multiwalled carbon nanotubes (MWCNTs) using scalable production methods from earth-abundant materials. Magnetic measurements of as-produced electrocatalyst materials demonstrate that MoS2 nanoflakes are diamagnetic, whereas surface-functionalized MoS2 and its composite with carbon nanotubes have strong ferromagnetism. The HER performance of the few-layered pristine MoS2 nanoflakes, MoS2/NiO NPs, and MoS2/NiO NPs/MWCNT nanocomposite electrocatalysts are studied in acidic and alkaline media. For bare MoS2, the values of overpotential (η10) in alkaline and acidic media are 0.45 and 0.54 V, respectively. Similarly, the values of current density at 0.5 V overpotential are 27 and 6.2 mA/cm2 in alkaline and acidic media, respectively. The surface functionalization acts adversely in the both alkaline and acidic media. MoS2 nanosheets functionalized with NiO NPs also demonstrated excellent performance for oxygen evolution reaction with anodic current of ~60 mA/cm2 and Tafel slope of 78 mVdec-1 in alkaline medium.
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Affiliation(s)
- B. Lai
- The Institute of Optics, University of Rochester, Rochester, NY, 14627, USA
- Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences, Changchun, 130033, China
| | - Subhash C. Singh
- The Institute of Optics, University of Rochester, Rochester, NY, 14627, USA
- Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences, Changchun, 130033, China
| | - J.K. Bindra
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, FL, 32306, USA
| | - C.S. Saraj
- Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences, Changchun, 130033, China
| | - A. Shukla
- Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences, Changchun, 130033, China
| | - T.P. Yadav
- Department of Physics, Institute of Science, Banaras Hindu University, Varanasi, 222005, India
| | - W. Wu
- Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences, Changchun, 130033, China
| | - S.A. McGill
- National High Magnetic Field Laboratory, Florida State University, Tallahassee, FL, 30201, USA
| | - N.S. Dalal
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, FL, 32306, USA
| | - Amit Srivastava
- Department of Chemistry and Biochemistry, Florida State University, Tallahassee, FL, 32306, USA
- Department of Physics, TDPG College, VBS Purvanchal University, Jaunpur, 222001, India
| | - Chunlei Guo
- The Institute of Optics, University of Rochester, Rochester, NY, 14627, USA
- Changchun Institute of Optics, Fine Mechanics and Physics, Chinese Academy of Sciences, Changchun, 130033, China
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Talokar P, Shukla A, Bansal T, Vyas P. Higher Baseline Fibrinogen is an Independent Predictor of Major Adverse Cardiac Events after Elective Percutaneous Coronary Intervention. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.114] [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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25
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Mishra K, Yanamandra U, Shukla A, Pramanik S, Kapoor R, Das S. Risk stratification of CML-CP in a real-world scenario, comparison of S.H.E. with rate of fall of BCR/ABL. Ann Oncol 2019. [DOI: 10.1093/annonc/mdz427.013] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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26
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Pandey V, Korde K, Shukla A, Vyas P. Incidence and profile of cardiac arrhythmias in patients presenting with acute ST elevation myocardial infarction. Indian Heart J 2019. [DOI: 10.1016/j.ihj.2019.11.242] [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] Open
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27
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Uttarilli A, Shah H, Shukla A, Girisha KM. A review of skeletal dysplasia research in India. J Postgrad Med 2019; 64:98-103. [PMID: 29692401 PMCID: PMC5954821 DOI: 10.4103/jpgm.jpgm_527_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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
We aimed to review the contributions by Indian researchers to the subspecialty of skeletal dysplasias (SDs). Literature search using specific keywords in PubMed was performed to retrieve all the published literature on SDs as on July 6, 2017. All published literature on SDs wherein at least one author was from an Indian institute was included. Publications were grouped into different categories based on the major emphasis of the research paper. Five hundred and forty publications in English language were retrieved and categorized into five different groups. The publications were categorized as reports based on: (i) phenotypes (n = 437), (ii) mutations (n = 51), (iii) novel genes (n = 9), (iv) therapeutic interventions (n = 31), and (v) reviews (n = 12). Most of the publications were single-patient case reports describing the clinical and radiological features of the patients affected with SDs (n = 352). We enlisted all the significant Indian contributions. We have also highlighted the reports in which Indians have contributed to discovery of new genes and phenotypes. This review highlights the substantial Indian contributions to SD research, which is poised to reach even greater heights given the size and structure of our population, technological advances, and expanding national and international collaborations.
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Affiliation(s)
- A Uttarilli
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - H Shah
- Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - A Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, Karnataka, India
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Desai S, Shukla A, Nambiar D, Ved R. Patterns of hysterectomy in India: a national and state-level analysis of the Fourth National Family Health Survey (2015-2016). BJOG 2019; 126 Suppl 4:72-80. [PMID: 31309706 PMCID: PMC6772015 DOI: 10.1111/1471-0528.15858] [Citation(s) in RCA: 15] [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] [Accepted: 07/03/2019] [Indexed: 11/29/2022]
Abstract
Objective The National Family Health Survey‐4 in India provided the first nationally representative estimates of hysterectomy among women aged 15–49. This paper aims to examine the national and state‐level age‐specific prevalence of hysterectomy, individual and household level factors associated with the procedure, and state‐level indicators that may explain variation across states. Design Cross‐sectional, nationally representative household survey. Setting National Family Health Survey was conducted across all Indian states and union territories between 2015 and 2016. Population The survey covered 699 686 women between the ages of 15 and 49 years. Methods Descriptive analyses and multivariate logistic regression. Main outcome measures Women who reported ever having a hysterectomy and age at hysterectomy. Results Age‐specific prevalence of hysterectomy was 0.36% (0.33,0.39) among women aged 15‐29; 3.59% (3.45,3.74) among women aged 30‐39; and 9.20% (8.94,9.46) among women 40‐49 years. There was considerable variation in prevalence by state. Four states reported age‐specific prevalence similar to high‐income settings. Approximately two‐thirds of hysterectomies were conducted in private facilities, with similar patterns across age groups. At the national level, higher age and parity (at least two children); not having had formal schooling; rural residence (adjusted odds ratio [AOR] 1.36; 95% CI 1.27,1.45; P < 0.01) and higher wealth status were associated with higher odds of hysterectomy. Previously sterilised women had lower odds (AOR 0.64; 95% CI 0.61,0,68; P < 0.01) of reporting hysterectomy. Exploratory analyses suggest state‐level factors associated with prevalence of hysterectomy include caesarean section, female illiteracy, and women's employment. Conclusions Hysterectomy patterns among women aged 15–49 in India indicate the critical need to ensure treatment options for gynaecological morbidity and to address hysterectomy among young women in particular. Funding This study was part of the RASTA initiative of the Population Council's India country office under the Evidence Project supported by USAID. Tweetable abstract Hysterectomy patterns in India highlight the need for alternatives to treat gynaecological morbidity among younger women. Hysterectomy patterns in India highlight the need for alternatives to treat gynaecological morbidity among younger women.
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Affiliation(s)
- S Desai
- Population Council, New Delhi, India
| | - A Shukla
- Population Council, New Delhi, India
| | - D Nambiar
- The George Institute India, New Delhi, India
| | - R Ved
- National Health Systems Resource Centre, New Delhi, India
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Abstract
Acute limb ischemia and peripheral vascular disease (PVD) are unusual presentations of polyarteritis nodosa (PAN). Here, we present a case with PVD of both lower limbs leading to foot claudication. Digital subtraction angiography showed narrowing, irregularity, and occlusion of both lower limb arteries with no involvement of the abdomen visceral arteries. Based on significant weight loss, diastolic blood pressure >90 mmHg, myalgia, testicular pain, and angiographic abnormalities in medium-sized arteries, he was diagnosed as having PAN. He was treated with corticosteroid and bolus intravenous cyclophosphamide following which he had prompt and near-complete recovery of the symptoms without any tissue loss.
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Affiliation(s)
- A Shukla
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - A Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Dalal K, Dalal B, Bhatia S, Shukla A, Shankarkumar A. Analysis of serum Haptoglobin using glycoproteomics and lectin immunoassay in liver diseases in Hepatitis B virus infection. Clin Chim Acta 2019; 495:309-317. [PMID: 31014754 DOI: 10.1016/j.cca.2019.04.072] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/08/2018] [Revised: 04/18/2019] [Accepted: 04/18/2019] [Indexed: 12/29/2022]
Abstract
BACKGROUND Hepatocellular carcinoma (HCC) due to Hepatitis B viral (HBV) infection is a major cause in Asia-Pacific countries. Its early detection is of paramount importance using a marker having both sensitivity and specificity. The present study promises diagnostic and prognostic markers by the identification of site-specific glycoforms on Haptoglobin (Hp) using LC-MS/MS and lectin ELISA in liver diseased conditions in HBV infection. METHODS Three groups of patients: chronic, liver cirrhosis and HCC with HBV infection along with controls were enrolled. Hp was purified using affinity column chromatography and, peptide sequence, N-glycosylation site, glycan composition and glycoforms were identified using mass spectrometry. Quantitative lectin ELISA was used to measure levels of fucosylation on Hp in liver diseases due to HBV. RESULTS Hp levels were significantly lower in HCC when compared with Non-HCC cases (p < .05). Fucosylated glycoforms were significantly increased at site Asn184, Asn207 and Asn211 in liver diseased stages versus controls. A significant association was observed between the Fuc-Hp/Hp Elisa index and, advanced liver disease stages and controls using lectin Elisa (p < .001). CONCLUSION Quantitation of fucosylation levels on Hp protein using Lectin ELISA may be useful glycobiomarker either alone or in combination (AFP + DCP + FucHp; AUC = 0.94) in HBV HCC diagnosis in clinical practice.
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Affiliation(s)
- K Dalal
- Transfusion Transmitted Diseases Department, National Institute of Immunohaematology (ICMR), 13th Floor, New Multi-storeyed Bldg, KEM Hospital Campus, Parel, Mumbai 400 012, Maharashtra, India
| | - B Dalal
- Transfusion Transmitted Diseases Department, National Institute of Immunohaematology (ICMR), 13th Floor, New Multi-storeyed Bldg, KEM Hospital Campus, Parel, Mumbai 400 012, Maharashtra, India
| | - S Bhatia
- Department of Gastroenterology, Seth G S Medical College and K E M Hospital, Acharya Donde Marg, Parel, Mumbai 400 012, Maharashtra, India
| | - A Shukla
- Department of Gastroenterology, Seth G S Medical College and K E M Hospital, Acharya Donde Marg, Parel, Mumbai 400 012, Maharashtra, India
| | - A Shankarkumar
- Transfusion Transmitted Diseases Department, National Institute of Immunohaematology (ICMR), 13th Floor, New Multi-storeyed Bldg, KEM Hospital Campus, Parel, Mumbai 400 012, Maharashtra, India.
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McLean K, Glasbey J, Borakati A, Brooks T, Chang H, Choi S, Goodson R, Nielsen M, Pronin S, Salloum N, Sewart E, Vanniasegaram D, Drake T, Gillies M, Harrison E, Chapman S, Khatri C, Kong C, Claireaux H, Bath M, Mohan M, McNamee L, Kelly M, Mitchell H, Fitzgerald J, Bhangu A, Nepogodiev D, Antoniou I, Dean R, Davies N, Trecarten S, Henderson I, Holmes C, Wylie J, Shuttleworth R, Jindal A, Hughes F, Gouda P, Fleck R, Hanrahan M, Karunakaran P, Chen J, Sykes M, Sethi R, Suresh S, Patel P, Patel M, Varma R, Mushtaq J, Gundogan B, Bolton W, Khan T, Burke J, Morley R, Favero N, Adams R, Thirumal V, Kennedy E, Ong K, Tan Y, Gabriel J, Bakhsh A, Low J, Yener A, Paraoan V, Preece R, Tilston T, Cumber E, Dean S, Ross T, McCance E, Amin H, Satterthwaite L, Clement K, Gratton R, Mills E, Chiu S, Hung G, Rafiq N, Hayes J, Robertson K, Dynes K, Huang H, Assadullah S, Duncumb J, Moon R, Poo S, Mehta J, Joshi K, Callan R, Norris J, Chilvers N, Keevil H, Jull P, Mallick S, Elf D, Carr L, Player C, Barton E, Martin A, Ratu S, Roberts E, Phan P, Dyal A, Rogers J, Henson A, Reid N, Burke D, Culleton G, Lynne S, Mansoor S, Brennan C, Blessed R, Holloway C, Hill A, Goldsmith T, Mackin S, Kim S, Woin E, Brent G, Coffin J, Ziff O, Momoh Z, Debenham R, Ahmed M, Yong C, Wan J, Copley H, Raut P, Chaudhry F, Nixon G, Dorman C, Tan R, Kanabar S, Canning N, Dolaghan M, Bell N, McMenamin M, Chhabra A, Duke K, Turner L, Patel T, Chew L, Mirza M, Lunawat S, Oremule B, Ward N, Khan M, Tan E, Maclennan D, McGregor R, Chisholm E, Griffin E, Bell L, Hughes B, Davies J, Haq H, Ahmed H, Ungcharoen N, Whacha C, Thethi R, Markham R, Lee A, Batt E, Bullock N, Francescon C, Davies J, Shafiq N, Zhao J, Vivekanantham S, Barai I, Allen J, Marshall D, McIntyre C, Wilson H, Ashton A, Lek C, Behar N, Davis-Hall M, Seneviratne N, Esteve L, Sirakaya M, Ali S, Pope S, Ahn J, Craig-McQuaide A, Gatfield W, Leong S, Demetri A, Kerr A, Rees C, Loveday J, Liu S, Wijesekera M, Maru D, Attalla M, Smith N, Brown D, Sritharan P, Shah A, Charavanamuttu V, Heppenstall-Harris G, Ng K, Raghvani T, Rajan N, Hulley K, Moody N, Williams M, Cotton A, Sharifpour M, Lwin K, Bright M, Chitnis A, Abdelhadi M, Semana A, Morgan F, Reid R, Dickson J, Anderson L, McMullan R, Ahern N, Asmadi A, Anderson L, Boon Xuan JL, Crozier L, McAleer S, Lees D, Adebayo A, Das M, Amphlett A, Al-Robeye A, Valli A, Khangura J, Winarski A, Ali A, Woodward H, Gouldthrope C, Turner M, Sasapu K, Tonkins M, Wild J, Robinson M, Hardie J, Heminway R, Narramore R, Ramjeeawon N, Hibberd A, Winslow F, Ho W, Chong B, Lim K, Ho S, Crewdson J, Singagireson S, Kalra N, Koumpa F, Jhala H, Soon W, Karia M, Rasiah M, Xylas D, Gilbert H, Sundar-Singh M, Wills J, Akhtar S, Patel S, Hu L, Brathwaite-Shirley C, Nayee H, Amin O, Rangan T, Turner E, McCrann C, Shepherd R, Patel N, Prest-Smith J, Auyoung E, Murtaza A, Coates A, Prys-Jones O, King M, Gaffney S, Dewdney C, Nehikhare I, Lavery J, Bassett J, Davies K, Ahmad K, Collins A, Acres M, Egerton C, Cheng K, Chen X, Chan N, Sheldon A, Khan S, Empey J, Ingram E, Malik A, Johnstone M, Goodier R, Shah J, Giles J, Sanders J, McLure S, Pal S, Rangedara A, Baker A, Asbjoernsen C, Girling C, Gray L, Gauntlett L, Joyner C, Qureshi S, Mogan Y, Ng J, Kumar A, Park J, Tan D, Choo K, Raman K, Buakuma P, Xiao C, Govinden S, Thompson O, Charalambos M, Brown E, Karsan R, Dogra T, Bullman L, Dawson P, Frank A, Abid H, Tung L, Qureshi U, Tahmina A, Matthews B, Harris R, O'Connor A, Mazan K, Iqbal S, Stanger S, Thompson J, Sullivan J, Uppal E, MacAskill A, Bamgbose F, Neophytou C, Carroll A, Rookes C, Datta U, Dhutia A, Rashid S, Ahmed N, Lo T, Bhanderi S, Blore C, Ahmed S, Shaheen H, Abburu S, Majid S, Abbas Z, Talukdar S, Burney L, Patel J, Al-Obaedi O, Roberts A, Mahboob S, Singh B, Sheth S, Karia P, Prabhudesai A, Kow K, Koysombat K, Wang S, Morrison P, Maheswaran Y, Keane P, Copley P, Brewster O, Xu G, Harries P, Wall C, Al-Mousawi A, Bonsu S, Cunha P, Ward T, Paul J, Nadanakumaran K, Tayeh S, Holyoak H, Remedios J, Theodoropoulou K, Luhishi A, Jacob L, Long F, Atayi A, Sarwar S, Parker O, Harvey J, Ross H, Rampal R, Thomas G, Vanmali P, McGowan C, Stein J, Robertson V, Carthew L, Teng V, Fong J, Street A, Thakker C, O'Reilly D, Bravo M, Pizzolato A, Khokhar H, Ryan M, Cheskes L, Carr R, Salih A, Bassiony S, Yuen R, Chrastek D, Rosen O'Sullivan H, Amajuoyi A, Wang A, Sitta O, Wye J, Qamar M, Major C, Kaushal A, Morgan C, Petrarca M, Allot R, Verma K, Dutt S, Chilima C, Peroos S, Kosasih S, Chin H, Ashken L, Pearse R, O'Loughlin R, Menon A, Singh K, Norton J, Sagar R, Jathanna N, Rothwell L, Watson N, Harding F, Dube P, Khalid H, Punjabi N, Sagmeister M, Gill P, Shahid S, Hudson-Phillips S, George D, Ashwood J, Lewis T, Dhar M, Sangal P, Rhema I, Kotecha D, Afzal Z, Syeed J, Prakash E, Jalota P, Herron J, Kimani L, Delport A, Shukla A, Agarwal V, Parthiban S, Thakur H, Cymes W, Rinkoff S, Turnbull J, Hayat M, Darr S, Khan U, Lim J, Higgins A, Lakshmipathy G, Forte B, Canning E, Jaitley A, Lamont J, Toner E, Ghaffar A, McDowell M, Salmon D, O'Carroll O, Khan A, Kelly M, Clesham K, Palmer C, Lyons R, Bell A, Chin R, Waldron R, Trimble A, Cox S, Ashfaq U, Campbell J, Holliday R, McCabe G, Morris F, Priestland R, Vernon O, Ledsam A, Vaughan R, Lim D, Bakewell Z, Hughes R, Koshy R, Jackson H, Narayan P, Cardwell A, Jubainville C, Arif T, Elliott L, Gupta V, Bhaskaran G, Odeleye A, Ahmed F, Shah R, Pickard J, Suleman Y, North A, McClymont L, Hussain N, Ibrahim I, Ng G, Wong V, Lim A, Harris L, Tharmachandirar T, Mittapalli D, Patel V, Lakhani M, Bazeer H, Narwani V, Sandhu K, Wingfield L, Gentry S, Adjei H, Bhatti M, Braganza L, Barnes J, Mistry S, Chillarge G, Stokes S, Cleere J, Wadanamby S, Bucko A, Meek J, Boxall N, Heywood E, Wiltshire J, Toh C, Ward A, Shurovi B, Horth D, Patel B, Ali B, Spencer T, Axelson T, Kretzmer L, Chhina C, Anandarajah C, Fautz T, Horst C, Thevathasan A, Ng J, Hirst F, Brewer C, Logan A, Lockey J, Forrest P, Keelty N, Wood A, Springford L, Avery P, Schulz T, Bemand T, Howells L, Collier H, Khajuria A, Tharakan R, Parsons S, Buchan A, McGalliard R, Mason J, Cundy O, Li N, Redgrave N, Watson R, Pezas T, Dennis Y, Segall E, Hameed M, Lynch A, Chamberlain M, Peck F, Neo Y, Russell G, Elseedawy M, Lee S, Foster N, Soo Y, Puan L, Dennis R, Goradia H, Qureshi A, Osman S, Reeves T, Dinsmore L, Marsden M, Lu Q, Pitts-Tucker T, Dunn C, Walford R, Heathcote E, Martin R, Pericleous A, Brzyska K, Reid K, Williams M, Wetherall N, McAleer E, Thomas D, Kiff R, Milne S, Holmes M, Bartlett J, Lucas de Carvalho J, Bloomfield T, Tongo F, Bremner R, Yong N, Atraszkiewicz B, Mehdi A, Tahir M, Sherliker G, Tear A, Pandey A, Broyd A, Omer H, Raphael M, Chaudhry W, Shahidi S, Jawad A, Gill C, Fisher IH, Adeleja I, Clark I, Aidoo-Micah G, Stather P, Salam G, Glover T, Deas G, Sim N, Obute R, Wynell-Mayow W, Sait M, Mitha N, de Bernier G, Siddiqui M, Shaunak R, Wali A, Cuthbert G, Bhudia R, Webb E, Shah S, Ansari N, Perera M, Kelly N, McAllister R, Stanley G, Keane C, Shatkar V, Maxwell-Armstrong C, Henderson L, Maple N, Manson R, Adams R, Semple E, Mills M, Daoub A, Marsh A, Ramnarine A, Hartley J, Malaj M, Jewell P, Whatling E, Hitchen N, Chen M, Goh B, Fern J, Rogers S, Derbyshire L, Robertson D, Abuhussein N, Deekonda P, Abid A, Harrison P, Aildasani L, Turley H, Sherif M, Pandey G, Filby J, Johnston A, Burke E, Mohamud M, Gohil K, Tsui A, Singh R, Lim S, O'Sullivan K, McKelvey L, O'Neill S, Roberts H, Brown F, Cao Y, Buckle R, Liew Y, Sii S, Ventre C, Graham C, Filipescu T, Yousif A, Dawar R, Wright A, Peters M, Varley R, Owczarek S, Hartley S, Khattak M, Iqbal A, Ali M, Durrani B, Narang Y, Bethell G, Horne L, Pinto R, Nicholls K, Kisyov I, Torrance H, English W, Lakhani S, Ashraf S, Venn M, Elangovan V, Kazmi Z, Brecher J, Sukumar S, Mastan A, Mortimer A, Parker J, Boyle J, Elkawafi M, Beckett J, Mohite A, Narain A, Mazumdar E, Sreh A, Hague A, Weinberg D, Fletcher L, Steel M, Shufflebotham H, Masood M, Sinha Y, Jenvey C, Kitt H, Slade R, Craig A, Deall C, Reakes T, Chervenkoff J, Strange E, O'Bryan M, Murkin C, Joshi D, Bergara T, Naqib S, Wylam D, Scotcher S, Hewitt C, Stoddart M, Kerai A, Trist A, Cole S, Knight C, Stevens S, Cooper G, Ingham R, Dobson J, O'Kane A, Moradzadeh J, Duffy A, Henderson C, Ashraf S, McLaughin C, Hoskins T, Reehal R, Bookless L, McLean R, Stone E, Wright E, Abdikadir H, Roberts C, Spence O, Srikantharajah M, Ruiz E, Matthews J, Gardner E, Hester E, Naran P, Simpson R, Minhas M, Cornish E, Semnani S, Rojoa D, Radotra A, Eraifej J, Eparh K, Smith D, Mistry B, Hickling S, Din W, Liu C, Mithrakumar P, Mirdavoudi V, Rashid M, Mcgenity C, Hussain O, Kadicheeni M, Gardner H, Anim-Addo N, Pearce J, Aslanyan A, Ntala C, Sorah T, Parkin J, Alizadeh M, White A, Edozie F, Johnston J, Kahar A, Navayogaarajah V, Patel B, Carter D, Khonsari P, Burgess A, Kong C, Ponweera A, Cody A, Tan Y, Ng A, Croall A, Allan C, Ng S, Raghuvir V, Telfer R, Greenhalgh A, McKerr C, Edison M, Patel B, Dear K, Hardy M, Williams P, Hassan S, Sajjad U, O'Neill E, Lopes S, Healy L, Jamal N, Tan S, Lazenby D, Husnoo S, Beecroft S, Sarvanandan T, Weston C, Bassam N, Rabinthiran S, Hayat U, Ng L, Varma D, Sukkari M, Mian A, Omar A, Kim J, Sellathurai J, Mahmood J, O'Connell C, Bose R, Heneghan H, Lalor P, Matheson J, Doherty C, Cullen C, Cooper D, Angelov S, Drislane C, Smith A, Kreibich A, Palkhi E, Durr A, Lotfallah A, Gold D, Mckean E, Dhanji A, Anilkumar A, Thacoor A, Siddiqui Z, Lim S, Piquet A, Anderson S, McCormack D, Gulati J, Ibrahim A, Murray S, Walsh S, McGrath A, Ziprin P, Chua E, Lou C, Bloomer J, Paine H, Osei-Kuffour D, White C, Szczap A, Gokani S, Patel K, Malys M, Reed A, Torlot G, Cumber E, Charania A, Ahmad S, Varma N, Cheema H, Austreng L, Petra H, Chaudhary M, Zegeye M, Cheung F, Coffey D, Heer R, Singh S, Seager E, Cumming S, Suresh R, Verma S, Ptacek I, Gwozdz A, Yang T, Khetarpal A, Shumon S, Fung T, Leung W, Kwang P, Chew L, Loke W, Curran A, Chan C, McGarrigle C, Mohan K, Cullen S, Wong E, Toale C, Collins D, Keane N, Traynor B, Shanahan D, Yan A, Jafree D, Topham C, Mitrasinovic S, Omara S, Bingham G, Lykoudis P, Miranda B, Whitehurst K, Kumaran G, Devabalan Y, Aziz H, Shoa M, Dindyal S, Yates J, Bernstein I, Rattan G, Coulson R, Stezaker S, Isaac A, Salem M, McBride A, McFarlane H, Yow L, MacDonald J, Bartlett R, Turaga S, White U, Liew W, Yim N, Ang A, Simpson A, McAuley D, Craig E, Murphy L, Shepherd P, Kee J, Abdulmajid A, Chung A, Warwick H, Livesey A, Holton P, Theodoreson M, Jenkin S, Turner J, Entwisle J, Marchal S, O'Connor S, Blege H, Aithie J, Sabine L, Stewart G, Jackson S, Kishore A, Lankage C, Acquaah F, Joyce H, McKevitt K, Coffey C, Fawaz A, Dolbec K, O'Sullivan D, Geraghty J, Lim E, Bolton L, FitzPatrick D, Robinson C, Ramtoola T, Collinson S, Grundy L, McEnhill P, Harbhajan Singh G, Loughran D, Golding D, Keeling R, Williams R, Whitham R, Yoganathan S, Nachiappan R, Egan R, Owasil R, Kwan M, He A, Goh R, Bhome R, Wilson H, Teoh P, Raji K, Jayakody N, Matthams J, Chong J, Luk C, Greig R, Trail M, Charalambous G, Rocke A, Gardiner N, Bulley F, Warren N, Brennan E, Fergurson P, Wilson R, Whittingham H, Brown E, Khanijau R, Gandhi K, Morris S, Boulton A, Chandan N, Barthorpe A, Maamari R, Sandhu S, McCann M, Higgs L, Balian V, Reeder C, Diaper C, Sale T, Ali H, Archer C, Clarke A, Heskin J, Hurst P, Farmer J, O'Flynn L, Doan L, Shuker B, Stott G, Vithanage N, Hoban K, Nesargikar P, Kennedy H, Grossart C, Tan E, Roy C, Sim P, Leslie K, Sim D, Abul M, Cody N, Tay A, Woon E, Sng S, Mah J, Robson J, Shakweh E, Wing V, Mills H, Li M, Barrow T, Balaji S, Jordan H, Phillips C, Naveed H, Hirani S, Tai A, Ratnakumaran R, Sahathevan A, Shafi A, Seedat M, Weaver R, Batho A, Punj R, Selvachandran H, Bhatt N, Botchey S, Khonat Z, Brennan K, Morrison C, Devlin E, Linton A, Galloway E, McGarvie S, Ramsay N, McRobbie H, Whewell H, Dean W, Nelaj S, Eragat M, Mishra A, Kane T, Zuhair M, Wells M, Wilkinson D, Woodcock N, Sun E, Aziz N, Ghaffar MKA. Critical care usage after major gastrointestinal and liver surgery: a prospective, multicentre observational study. Br J Anaesth 2019; 122:42-50. [PMID: 30579405 DOI: 10.1016/j.bja.2018.07.029] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 07/19/2018] [Accepted: 07/23/2018] [Indexed: 11/23/2022] Open
Abstract
BACKGROUND Patient selection for critical care admission must balance patient safety with optimal resource allocation. This study aimed to determine the relationship between critical care admission, and postoperative mortality after abdominal surgery. METHODS This prespecified secondary analysis of a multicentre, prospective, observational study included consecutive patients enrolled in the DISCOVER study from UK and Republic of Ireland undergoing major gastrointestinal and liver surgery between October and December 2014. The primary outcome was 30-day mortality. Multivariate logistic regression was used to explore associations between critical care admission (planned and unplanned) and mortality, and inter-centre variation in critical care admission after emergency laparotomy. RESULTS Of 4529 patients included, 37.8% (n=1713) underwent planned critical care admissions from theatre. Some 3.1% (n=86/2816) admitted to ward-level care subsequently underwent unplanned critical care admission. Overall 30-day mortality was 2.9% (n=133/4519), and the risk-adjusted association between 30-day mortality and critical care admission was higher in unplanned [odds ratio (OR): 8.65, 95% confidence interval (CI): 3.51-19.97) than planned admissions (OR: 2.32, 95% CI: 1.43-3.85). Some 26.7% of patients (n=1210/4529) underwent emergency laparotomies. After adjustment, 49.3% (95% CI: 46.8-51.9%, P<0.001) were predicted to have planned critical care admissions, with 7% (n=10/145) of centres outside the 95% CI. CONCLUSIONS After risk adjustment, no 30-day survival benefit was identified for either planned or unplanned postoperative admissions to critical care within this cohort. This likely represents appropriate admission of the highest-risk patients. Planned admissions in selected, intermediate-risk patients may present a strategy to mitigate the risk of unplanned admission. Substantial inter-centre variation exists in planned critical care admissions after emergency laparotomies.
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Ablett JM, Prieur D, Céolin D, Lassalle-Kaiser B, Lebert B, Sauvage M, Moreno T, Bac S, Balédent V, Ovono A, Morand M, Gélebart F, Shukla A, Rueff JP. The GALAXIES inelastic hard X-ray scattering end-station at Synchrotron SOLEIL. J Synchrotron Radiat 2019; 26:263-271. [PMID: 30655494 DOI: 10.1107/s160057751801559x] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Accepted: 11/03/2018] [Indexed: 06/09/2023]
Abstract
GALAXIES is an in-vacuum undulator hard X-ray micro-focused beamline dedicated to the study of the electronic structure of materials with high energy resolution using both photoelectron spectroscopy and inelastic X-ray scattering and under both non-resonant (NR-IXS) and resonant (RIXS) conditions. Due to the penetrating power of hard X-rays and the `photon-in/photon-out' technique, the sample environment is not a limitation. Materials under extreme conditions, for example in diamond anvil cells or catalysis chambers, thus constitute a major research direction. Here, the design and performance of the inelastic X-ray scattering end-station that operates in the energy range from ∼4 keV up to 12 keV is reported, and its capabilities are highlighted using a selection of data taken from recently performed experiments. The ability to scan `on the fly' the incident and scattered/emitted X-ray energies, and the sample position enables fast data collection and high experimental throughput. A diamond X-ray transmission phase retarder, which can be used to generate circularly polarized light, will also be discussed in the light of the recent RIXS-MCD approach.
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Affiliation(s)
- J M Ablett
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - D Prieur
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - D Céolin
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - B Lassalle-Kaiser
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - B Lebert
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - M Sauvage
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - Th Moreno
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - S Bac
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
| | - V Balédent
- Laboratoire de Physique des Solides, 91400 Orsay, France
| | - A Ovono
- École Nationale Supérieure d'Ingénieurs de Limoges, France
| | - M Morand
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Sorbonne Université, UMR CNRS 7590, MNHN, IRD UMR 206, 4 Place Jussieu, F-75005 Paris, France
| | - F Gélebart
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Sorbonne Université, UMR CNRS 7590, MNHN, IRD UMR 206, 4 Place Jussieu, F-75005 Paris, France
| | - A Shukla
- Institut de Minéralogie, de Physique des Matériaux et de Cosmochimie, Sorbonne Université, UMR CNRS 7590, MNHN, IRD UMR 206, 4 Place Jussieu, F-75005 Paris, France
| | - J P Rueff
- Synchrotron SOLEIL, L'Orme des Merisiers, BP 48, Saint Aubin, 91192 Gif-sur-Yvette, France
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Shukla A, Wright G, Denehy L, Granger C. Prehabilitation for Individuals Having Lung Cancer Surgery. Heart Lung Circ 2019. [DOI: 10.1016/j.hlc.2019.02.028] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Tang L, Kamat M, Shukla A, Vora M, Kalal C, Kottilil S, Shah S. Comparative Antiviral Efficacy of Generic Sofosbuvir versus Brand Name Sofosbuvir with Ribavirin for the Treatment of Hepatitis C. Interdiscip Perspect Infect Dis 2018; 2018:9124604. [PMID: 30364048 PMCID: PMC6188723 DOI: 10.1155/2018/9124604] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2018] [Revised: 08/20/2018] [Accepted: 09/05/2018] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Chronic hepatitis C infection is a major cause for liver failure and liver cancer and can be treated with highly effective all oral directly acting antiviral (DAA) drugs. Generic versions of these DAAs are available in India. METHOD This was an open-label, single-center, prospective, nonrandomized observational study for the comparative safety and efficacy of generic versus brand name sofosbuvir with ribavirin therapy for chronic hepatitis C infection (all genotypes). Between December 2014 and December 2015, 66 patients received either generic sofosbuvir (400mg) or brand name SOLVALDI (400mg) with weight based ribavirin for 24 weeks in a single multispecialty hospital in Mumbai. Monitoring viral loads and safety labs was performed as per national guidelines. RESULTS Sustained virologic response was 72.4% versus 75.7% (p=0.78) among patients treated with generics and SOVALDI, respectively. At 4 weeks on-treatment, approximately 90% of patients from both groups had undetectable or below the lower limit of quantification. Change in hemoglobin was comparable in both groups (p=0.26). CONCLUSION Generic versions of sofosbuvir reported in this study are safe and efficacious to treat hepatitis C. However, bioequivalency studies of all generic DAAs need to be performed before wider use of such drugs for the treatment of hepatitis C.
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Affiliation(s)
- L. Tang
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - M. Kamat
- Department of Hepatology, Institute of Liver Diseases, Hepato Pancreato Biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - A. Shukla
- Department of Hepatology, Institute of Liver Diseases, Hepato Pancreato Biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - M. Vora
- Department of Hepatology, Institute of Liver Diseases, Hepato Pancreato Biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - C. Kalal
- Department of Hepatology, Institute of Liver Diseases, Hepato Pancreato Biliary Surgery and Transplant, Global Hospitals, Mumbai, India
| | - S. Kottilil
- Division of Clinical Care and Research, Institute of Human Virology, University of Maryland, Baltimore, MD, USA
| | - S. Shah
- Department of Hepatology, Institute of Liver Diseases, Hepato Pancreato Biliary Surgery and Transplant, Global Hospitals, Mumbai, India
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Salian S, Shukla A, Shah H, Bhat SN, Bhat VR, Nampoothiri S, Shenoy R, Phadke SR, Hariharan SV, Girisha KM. Seven additional families with spondylocarpotarsal synostosis syndrome with novel biallelic deleterious variants in FLNB. Clin Genet 2018; 94:159-164. [PMID: 29566257 DOI: 10.1111/cge.13252] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [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: 01/18/2018] [Revised: 03/15/2018] [Accepted: 03/17/2018] [Indexed: 02/01/2023]
Abstract
The location and/or type of variants in FLNB result in a spectrum of osteochondrodysplasias ranging from mild forms, like spondylocarpotarsal synostosis syndrome and Larsen syndrome, to severe perinatal lethal forms, such as atelosteogenesis I and III and Boomerang dysplasia. Spondylocarpotarsal synostosis syndrome is characterized by disproportionate short stature, vertebral anomalies and fusion of carpal and tarsal bones. Biallelic loss-of-function variants in FLNB are known to cause spondylocarpotarsal synostosis syndrome and 9 families and 9 pathogenic variants have been reported so far. We report clinical features of 10 additional patients from 7 families with spondylocarpotarsal synostosis syndrome due to 7 novel deleterious variants in FLNB, thus expanding the clinical and molecular repertoire of spondylocarpotarsal synostosis syndrome. Our report validates key clinical (fused thoracic vertebrae and carpal and tarsal coalition) and molecular (truncating variants in FLNB) characteristics of this condition.
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Affiliation(s)
- S Salian
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - A Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - H Shah
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - S N Bhat
- Department of Orthopedics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - V R Bhat
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
| | - S Nampoothiri
- Department of Pediatric Genetics, Amrita Institute of Medical Sciences and Research Centre, Cochin, Kerala, India
| | - R Shenoy
- Department of Pediatrics, KS Hegde Medical Academy, Mangalore, Karnataka, India
| | - S R Phadke
- Department of Medical Genetics, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - S V Hariharan
- Department of Pediatrics, Sree Avittom Thirunal Hospital, Government Medical College, Trivandrum, Kerala, India
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal Academy of Higher Education, Manipal, Karnataka, India
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Borer JG, Sack BS, Weiss DA, Canning DA, Kryger JV, Groth T, Shukla A, Cullen LM, Mitchell ME. V09-03 SAFE AND SOUND: PRINCIPLES FOR SUCCESSFUL COMPLETE PRIMARY REPAIR OF BLADDER EXSTROPHY (CPRE) IN THE BOY. J Urol 2018. [DOI: 10.1016/j.juro.2018.02.2175] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
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37
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Slavik J, Wang S, Tao L, Shukla A, Clancy R, Ellsworth R, Smith RD, Rodland KD, Cutler ML, Shriver CD, Iida J. Abstract P1-03-05: Not presented. Cancer Res 2018. [DOI: 10.1158/1538-7445.sabcs17-p1-03-05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
This abstract was not presented at the symposium.
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Affiliation(s)
- J Slavik
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - S Wang
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - L Tao
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - A Shukla
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - R Clancy
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - R Ellsworth
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - RD Smith
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - KD Rodland
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - ML Cutler
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - CD Shriver
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
| | - J Iida
- Chan Soon-Shiong Institute of Molecular Medicine at Windber, Windber, PA; Pacific Northwest National Laboratory, Richland, WA; Henry-Jackson Foundation, Windber, PA; USUHS, Bethesda, MD; Walter Reed National Military Medical Center, Bethsda, MD
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Sack BS, Vasquez E, Roth E, Canning DA, Kryger JV, Weiss DA, Groth T, Shukla A, Mitchell ME, Borer JG. Manual of Operations for the Multi-Institutional Bladder Exstrophy Consortium: A Recipe for Successful Continuing Surgical Education. J Am Coll Surg 2017. [DOI: 10.1016/j.jamcollsurg.2017.07.473] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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39
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Shukla A, Dokala R, Philomen J. Factors Negatively Affecting Voluntary Cervical Cancer Screening Among Educated Indians Above Poverty Line. Ann Oncol 2017. [DOI: 10.1093/annonc/mdx372.051] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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40
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Boysen WR, Ellison JS, Kim C, Koh CJ, Noh P, Whittam B, Palmer B, Shukla A, Kirsch A, Gundeti MS. Multi-Institutional Review of Outcomes and Complications of Robot-Assisted Laparoscopic Extravesical Ureteral Reimplantation for Treatment of Primary Vesicoureteral Reflux in Children. J Urol 2017; 197:1555-1561. [DOI: 10.1016/j.juro.2017.01.062] [Citation(s) in RCA: 44] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 01/17/2017] [Indexed: 12/28/2022]
Affiliation(s)
| | | | - Christina Kim
- Connecticut Children’s Medical Center, Hartford, Connecticut
| | | | - Paul Noh
- Cincinnati Children’s Hospital, Cincinnati, Ohio
| | | | | | - Aseem Shukla
- Children’s Hospital of Philadelphia, Philadelphia, Pennsylvania
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41
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Shah SR, Chowdhury A, Mehta R, Kapoor D, Duseja A, Koshy A, Shukla A, Sood A, Madan K, Sud R, Nijhawan S, Pawan R, Prasad M, Kersey K, Jiang D, Svarovskaia E, Doehle B, Kanwar B, Subramanian M, Acharya SK, Sarin S. Sofosbuvir plus ribavirin in treatment-naïve patients with chronic hepatitis C virus genotype 1 or 3 infection in India. J Viral Hepat 2017; 24:371-379. [PMID: 27933698 DOI: 10.1111/jvh.12654] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 09/14/2016] [Accepted: 11/01/2016] [Indexed: 12/14/2022]
Abstract
Until 2014, pegylated interferon plus ribavirin was the recommended standard of care for the treatment of chronic hepatitis C virus (HCV) infection in India. This open-label phase 3b study, conducted across 14 sites in India between 31 March 2014 and 30 November 2015, evaluated the efficacy and safety of sofosbuvir plus ribavirin therapy among treatment-naïve patients with chronic genotype 1 or 3 HCV infection. A total of 117 patients with genotype 1 or 3 HCV infection were randomized 1:1 to receive sofosbuvir 400 mg and weight-based ribavirin (1000 or 1200 mg) daily for 16 or 24 weeks. Among those with genotype 1 infection, the primary efficacy endpoint of sustained virologic response at 12 weeks post-treatment (SVR12) was reported in 90% (95% confidence intervals [CI], 73-98) and 96% (95% CI, 82-100) of patients following 16 and 24 weeks of treatment, respectively. For patients with genotype 3 infection, SVR12 rates were 100% (95% CI, 88-100) and 93% (95% CI, 78-99) after 16 and 24 weeks of therapy, respectively. Adverse events, most of which were mild or moderate in severity, occurred in 69% and 57% of patients receiving 16 and 24 weeks of treatment, respectively. The most common treatment-emergent adverse events were asthenia, headache and cough. Only one patient in the 24-week group discontinued treatment with sofosbuvir during this study. Overall, sofosbuvir plus ribavirin therapy achieved SVR12 rates ≥90% and was well tolerated among treatment-naïve patients with chronic genotype 1 or 3 HCV infection in India.
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Affiliation(s)
- S R Shah
- Global Hospitals, Mumbai, Maharashtra, India
| | - A Chowdhury
- Institute of Postgraduate Medical Education and Research, Kolkata, West Bengal, India
| | - R Mehta
- Nirmal Hospital Pvt Ltd, Surat, Gujarat, India
| | - D Kapoor
- Global Hospitals, Hyderabad, Andhra Pradesh, India
| | - A Duseja
- Postgraduate Institute of Medical Education and Research, Chandigarh, Chandigarh, India
| | - A Koshy
- Lakeshore Hospital, Kochi, Kerala, India
| | - A Shukla
- Seth G.S. Medical College and King Edward Memorial Hospital, Mumbai, Maharashtra, India
| | - A Sood
- Dayanand Medical College and Hospital, Ludhiana, Punjab, India
| | - K Madan
- Artemis Hospitals, Gurgaon, Haryana, India
| | - R Sud
- Medanta - The Medicity, Gurgaon, Haryana, India
| | - S Nijhawan
- Sawai Man Singh Medical College and Hospital, Jaipur, Rajasthan, India
| | - R Pawan
- Fortis Memorial Research Institute, Gurgaon, Haryana, India
| | - M Prasad
- VGM Hospital, Coimbatore, Tamil Nadu, India
| | - K Kersey
- Gilead Sciences, Inc., Foster City, CA, USA
| | - D Jiang
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - B Doehle
- Gilead Sciences, Inc., Foster City, CA, USA
| | - B Kanwar
- Gilead Sciences, Inc., Foster City, CA, USA
| | | | - S K Acharya
- All India Institute of Medical Science, New Delhi, Delhi, India
| | - S Sarin
- Institute of Liver and Biliary Sciences, New Delhi, Delhi, India
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42
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Shukla A, Gaur P, Aggarwal A. Effect of probiotics on clinical and immune parameters in enthesitis-related arthritis category of juvenile idiopathic arthritis. Clin Exp Immunol 2017; 185:301-8. [PMID: 27238895 DOI: 10.1111/cei.12818] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [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: 04/13/2016] [Revised: 05/21/2016] [Accepted: 05/24/2016] [Indexed: 01/01/2023] Open
Abstract
Gut microflora and dysbiosis as an environmental factor has been linked to the pathogenesis of enthesitis-related arthritis (JIA-ERA); thus, we performed a proof-of-concept study of probiotics to modulate the gut-flora and study the effects on immune and clinical parameters of children having JIA-ERA. Forty-six children with active JIA-ERA were randomized to placebo or probiotic therapy along with non-steroidal anti-inflammatory drugs (NSAIDs) for 12 weeks. Patients were assessed using a six-point composite disease activity index (mJSpADA) based on morning stiffness, joint count, enthesitis count, sacroiliitis/inflammatory back pain, uveitis and erythrocyte sedimentation rate/C-reactive protein (ESR/CRP). Frequencies of T helper type 1 (Th1), Th2, Th17 and regulatory T cells in blood were measured using flow cytometry. Serum cytokines interferon (IFN)-γ, interleukin (IL)-4, IL-17, IL-10, tumour necrosis factor (TNF)-α and IL-6 were measured by cytokine bead array using flow cytometer. The average age of 46 children (44 boys) was 15 ± 2.5 years and duration of disease was 3.5 ± 3 years. There was no significant difference in improvement in mJSpADA between the two groups (P = 0·16). Serum IL-6 levels showed a decrease (P < 0·05) in the probiotic-group. Th2 cell frequency (P < 0·05) and serum IL-10 levels (P < 0·01) showed an increase in the placebo group, but again the probiotic use did not show a significant change in immune parameters when compared to the placebo. Adverse effects among the probiotic and placebo groups were diarrhea (36 versus 45%), abdominal pain (9 versus 20%), minor infections (4·5 versus 20%) and flatulence (23 versus 15%), respectively. Thus, we can conclude that probiotic therapy in JIA-ERA children is well tolerated, but failed to show any significant immune or clinical effects over NSAID therapy.
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Affiliation(s)
- A Shukla
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - P Gaur
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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43
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Kotabagi S, Shah H, Shukla A, Girisha KM. Second family provides further evidence for causation of Steel syndrome by biallelic mutations in COL27A1. Clin Genet 2017; 92:323-326. [PMID: 28276056 DOI: 10.1111/cge.13006] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2016] [Revised: 02/20/2017] [Accepted: 03/01/2017] [Indexed: 11/27/2022]
Abstract
Steel syndrome is a rare disorder of the skeleton characterized by facial dysmorphism, short stature, carpal coalition, dislocated radial heads, bilateral hip dislocation and vertical talus. Homozygous variants in COL27A1 were reported in an extending family from Puerto Rico. Here, we report a 5-year-old girl from a non-consanguineous family with facial dysmorphism, short stature, carpal coalition, dislocation of radial heads, bilateral hip dislocation, scoliosis and vertical talus. Exome sequencing identified 2 novel compound heterozygous variants c.521_528del (p.(Cys174Serfs*34)) and c.2119C>T (p.(Arg707*)) in COL27A1 in this child and the parents were heterozygous carriers. We hence report the second molecularly proven case of Steel syndrome and the first case to be reported among non-Puerto Rican population. Our report further validates the role of COL27A1 mutations in causation of Steel syndrome.
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Affiliation(s)
- S Kotabagi
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - H Shah
- Department of Orthopedics, Kasturba Medical College, Manipal University, Manipal, India
| | - A Shukla
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
| | - K M Girisha
- Department of Medical Genetics, Kasturba Medical College, Manipal University, Manipal, India
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Shukla A, Aggarwal A. Reply to Letter to Editor regarding the article, "Polyarteritis nodosa presenting as peripheral vascular disease and acute limb ischemia". J Postgrad Med 2017; 63:141-142. [PMID: 28397743 PMCID: PMC5414429 DOI: 10.4103/jpgm.jpgm_111_17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Affiliation(s)
- A Shukla
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
| | - A Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Srinivasan A, Kawal T, Canning D, Kolon T, Zderic S, Shukla A. MP61-04 THE IPSILATERAL URETERO-URETEROSTOMY: DOES FUNCTION OF THE OBSTRUCTED MOIETY MATTER? J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1862] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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46
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Johnson E, Kurtz M, Rosoklija I, Gong E, Tu D, Ryan S, Kawal T, Shukla A, Srinivasan A, Yu R, Lindgren B, Koh C. MP61-15 TECHNICAL VARIABILITY IN ROBOT-ASSISTED LAPAROSCOPIC URETERAL REIMPLANTATION: FEASIBILITY OF A MULTI-INSTITUTIONAL COLLABORATIVE. J Urol 2017. [DOI: 10.1016/j.juro.2017.02.1873] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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47
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Singha RK, Shukla A, Yadav A, Sasaki T, Sandupatla A, Deo G, Bal R. Pt–CeO2 nanoporous spheres – an excellent catalyst for partial oxidation of methane: effect of the bimodal pore structure. Catal Sci Technol 2017. [DOI: 10.1039/c7cy01493g] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
Bimodal pore size distribution played the most important role for the catalyst's superior activity during POM.
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Affiliation(s)
- R. K. Singha
- Nanocatalysis Area, Conversions & Catalysis Division
- CSIR-Indian Institute of Petroleum
- Dehradun 248005
- India
| | - A. Shukla
- Nanocatalysis Area, Conversions & Catalysis Division
- CSIR-Indian Institute of Petroleum
- Dehradun 248005
- India
| | - A. Yadav
- Nanocatalysis Area, Conversions & Catalysis Division
- CSIR-Indian Institute of Petroleum
- Dehradun 248005
- India
| | - T. Sasaki
- Department of Complexity Science and Engineering
- Graduate School of Frontier Sciences
- The University of Tokyo
- Kashiwa-shi
- Japan
| | - A. Sandupatla
- Department of Chemical Engineering
- Indian Institute of Technology Kanpur
- Kanpur
- India
| | - G. Deo
- Department of Chemical Engineering
- Indian Institute of Technology Kanpur
- Kanpur
- India
| | - R. Bal
- Nanocatalysis Area, Conversions & Catalysis Division
- CSIR-Indian Institute of Petroleum
- Dehradun 248005
- India
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Khan E, Shukla A, Jadav N, Telford R, Ayala AP, Tandon P, Vangala VR. Study of molecular structure, chemical reactivity and H-bonding interactions in the cocrystal of nitrofurantoin with urea. NEW J CHEM 2017. [DOI: 10.1039/c7nj01345k] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
Abstract
The cocrystal of nitrofurantoin with urea (C8H6N4O5)·(CH4N2O), a non-ionic supramolecular complex, has been studied.
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Affiliation(s)
- E. Khan
- Department of Physics
- University of Lucknow
- Lucknow 226 007
- India
| | - A. Shukla
- Department of Physics
- University of Lucknow
- Lucknow 226 007
- India
| | - N. Jadav
- Centre for Pharmaceutical Engineering Science and School of Pharmacy and Medical Sciences
- University of Bradford
- Bradford
- UK
| | - R. Telford
- School of Chemistry and Biosciences
- University of Bradford
- Bradford
- UK
| | - A. P. Ayala
- Departamento de Física
- Universidade Federal do Ceará
- Fortaleza
- Brazil
| | - P. Tandon
- Department of Physics
- University of Lucknow
- Lucknow 226 007
- India
| | - V. R. Vangala
- Centre for Pharmaceutical Engineering Science and School of Pharmacy and Medical Sciences
- University of Bradford
- Bradford
- UK
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Aggarwal A, Sarangi AN, Gaur P, Shukla A, Aggarwal R. Gut microbiome in children with enthesitis-related arthritis in a developing country and the effect of probiotic administration. Clin Exp Immunol 2016; 187:480-489. [PMID: 27861762 DOI: 10.1111/cei.12900] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 11/03/2016] [Indexed: 12/18/2022] Open
Abstract
In Asia, enthesitis-related arthritis (ERA) is the most frequent category of juvenile idiopathic arthritis. ERA has a strong association with human leucocyte antigen (HLA)-B27 and subclinical gut inflammation. In an HLA-B27 transgenic rat model, the presence of Bacteroides bacteria in the gut appears to cause spondyloarthropathy (SpA). Thus, we studied gut microbiota in children with ERA. Stool specimens from 33 patients with ERA and 14 age-matched healthy controls were studied; none had any gastrointestinal symptom, or had received a drug known to affect gut motility or microbiota in the preceding 6 weeks. From each specimen, a cDNA library for the V3 region of bacterial 16S rRNA was subjected to high-throughput, massively parallel sequencing. Relationship of the specimens was studied using principal co-ordinate analysis (PCoA), and abundances of various bacterial taxa and alpha diversity were compared between groups. In eight patients, a repeat faecal specimen was studied after 12 weeks of probiotic therapy. The 55 specimens yielded a median (range) of 397 315 (102 093-1 502 380) high-quality reads each. In PCoA, gut microbiota from ERA showed a wider dispersion than those from controls. In patients, families Bacteroidaceae and Enterobacteriaceae were more abundant and Prevotellaceae were less abundant than in controls. Also, genera Bacteroides, Entercoccus and Klebsiella were over-represented and genus Prevotella was under-represented in ERA patients. Probiotic therapy led to a non-significant increase in Prevotellaceae. Patients with ERA have a dysbiosis in the gut, with increased abundance of Bacteroides and reduction of Prevotella. Probiotic supplementation in a subset of patients did not reverse these changes significantly.
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Affiliation(s)
- A Aggarwal
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A N Sarangi
- Biomedical Informatics Center, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - P Gaur
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - A Shukla
- Department of Clinical Immunology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
| | - R Aggarwal
- Department of Gastroenterology, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India
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Abstract
Pancreatic trauma is relatively uncommon and although the surgical management is in many cases comparatively simple, occasionally complex technical surgery is required. Early diagnosis is paramount, although this remains difficult. The challenge of pancreatic trauma is compounded by a high incidence of associated injuries to adjoining organs and major vascular structures that may require damage control surgery and delayed definitive repair and add to the high frequency of postoperative complications, morbidity and mortality.
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Affiliation(s)
- A Brooks
- Department of General Surgery, Queens Medical Centre, Nottingham, UK
| | - A Shukla
- Department of Surgery, Edinburgh Royal Infirmary, Edinburgh, UK
| | - I Beckingham
- Department of General Surgery, Queens Medical Centre, Nottingham, UK
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